Bilious remittent fever shows earlier jaundice, a more rapid pulse rate and malarial parasites.
In yellow fever there is more marked rachialgia and earlier and more marked albuminuria. The marked leucocytosis of Weil’s disease should be of differentiating value.
The early jaundice and haemoglobinuria of blackwater fever should distinguish this disease.
Prophylaxis and Treatment
Prophylaxis.—As the infection appears to be transmitted through the medium of the urine and faeces, sterilization of these discharges from those sick with the disease should be practised. Extermination of the rat, the host of the parasite, is the important method of eradication of the disease.
Treatment.—This would appear to be solely symptomatic. Arsphenamine has no effect on the infection. Hexamethylenamine has been recommended. A serum against the organism has been prepared and seems to show protective value.
CHAPTER VII
RAT BITE FEVER
Definition
Rat bite fever is a relapsing type of fever following the bite of rats infected with Leptospira morsus-muris, which brings about the infection of man with this spirochaete. Following the healing of the wound we have developing in the cicatrix inflammatory signs with lymphangitis and swelling of the tributary lymphatic glands. The onset is sudden with rigors and fever, which latter continues for several days to then fall to normal and after an apyrexial period to be followed by relapse. Numerous relapses follow during the following weeks, months or even years of the disease. In Japan the disease is known by the name of Sodoku.