Prognosis
The mortality is usually reported as 2% but there have been epidemics where the mortality, owing to the frequency of the very fatal malignant type, has exceeded 10%. It must be remembered however that the invaliding connected with the long course of the disease and protracted convalescence makes Malta fever a serious affection. Neurasthenia, susceptibility to neuralgias, cardiac weakness and formation of morphine habit may result from the disease.
Prophylaxis and Treatment
Prophylaxis.—The danger from carriers seems slight but should be considered.
Disinfection of excreta, in particular urine, is important.
Boiling of goat’s milk or killing of infected goats is a prime consideration.
A rapid method of detecting infected goats is by carrying out a macroscopic agglutination of M. melitensis with the milk obtained from goats. The lacto-reaction should be confirmed by a serum one.
Treatment.—There is no specific treatment generally recognized as efficient. Recently, an anti-melitensis serum, from animals injected with the nucleo-proteid material from the organisms, has been used with some success.
A serum prepared by injecting horses intravenously with the specific organism has been recommended by Sergent in doses of 50 cc.