Hemolytic Streptococci in the Throats of Normal Men.—The percentage of normal individuals harboring hemolytic streptococci in their throats was investigated in three distinct classes of men, classified according to the degree of exposure to contact infection.
The first group includes men largely from country districts, cultured within an hour after being assembled by their local draft board. The laboratory car “Lister” was sent to Hot Springs, Ark. to meet the November draft of men to be sent to Camp Pike. These men were returned to their homes when the armistice was signed, so that there was no opportunity to study them after they had lived under camp conditions.
The second group includes men on duty in Camps Funston and Pike. These men, while largely from country districts, had been living crowded together in the camp for a period varying from a few weeks to several months.
The third group includes normal men resident in the base hospitals at Ft. Riley and Camp Pike. This group includes at Camp Pike the medical personnel of the measles and measles pneumonia wards and represents individuals most exposed to contact infection with hemolytic streptococci. On the other hand, the group includes doctors, nurses and seasoned medical detachment men who are perhaps less susceptible to respiratory infections than are raw recruits.
The results of studies of these groups are presented in Tables LXVI and LXVII.
| Table LXVI | ||||
|---|---|---|---|---|
| Hemolytic Streptococci in Throats of Normal Men Not Resident in the Base Hospital | ||||
| PLACE OF STUDY DATE | NO. OF CASES | NO. POSITIVE FOR HEM. STREP. | PER CENT POSITIVE FOR HEM. STREP. | REMARKS |
| Camp Funston, Kan., Aug., 1918. | 274 | 60 | 21.9 | Men on duty in camp including 201 white and 73 colored; in great part newly drafted men |
| Camp Pike, Ark., Nov. 5 to Dec. 10, 1918 | 337 | 25 | 7.4 | Largely white men on duty in camp |
| Hot Springs, Ark., Nov. 12, 1918 | [[100]]64 | 0 | 0.0 | Men from country districts, assembled by the local draft board |
| Table LXVII | ||||
| Hemolytic Streptococci in Throats of Normal Men Resident in the Base Hospital | ||||
| PLACE OF STUDY DATE | NO. OF CASES | NO. POSITIVE FOR HEM. STREP. | PER CENT POSITIVE FOR HEM. STREP. | REMARKS |
| Ft. Riley, Kan., Aug., 1918 | 24 | 7 | 29.2 | 14 convalescent patients in a surgical ward; 10 laboratory workers |
| Camp Pike, Ark., Sept. 10 to Nov. 30, 1918. | 153 | 22 | [[101]]7.5 | Personnel of measles wards |
The group of men studied at Hot Springs represents individuals among whom there was little chance for contact dissemination of hemolytic streptococci. It is a control series of men from outlying districts examined before their throat bacteriology has been complicated by the interchange of mouth organisms which occurs when a group of men are crowded into close quarters. The entire absence of hemolytic streptococci by the throat culture method is noteworthy. By multiplying the chances of identifying hemolytic streptococci by making parallel cultures from the saliva, and from the peritoneal exudates of mice inoculated with saliva, hemolytic streptococci were found, in small numbers, in 3 instances. The findings in this group were only three throats lightly infected with hemolytic streptococci. They are in direct contrast with the findings among individuals living in camps under crowded conditions and are in accord with the findings among recruits arriving in camp as recorded by Levy and Alexander.
In the second group, men living for a time in camp, the findings at Camp Funston and at Camp Pike show rather striking differences. The lower percentage incidence at Camp Pike is the more remarkable since the studies were made soon after the influenza epidemic had swept the camp and made necessary the hospitalization of about 20 to 25 per cent of the camp population.
In the third group, namely, individuals resident in the hospital, percentage rates at Camp Funston are slightly higher than for men resident in camp. This difference disappears for the entire group at Camp Pike if we consider a single throat culture, as we must for the sake of comparison. The majority of these individuals at Camp Pike served in measles wards from which patients carrying hemolytic streptococci were removed at weekly intervals. Seven and one-half per cent of the ward personnel were positives when first cultured. An additional 7.5 per cent acquired the streptococcus while under observation.
Duration of the “Carrier” State.—Unfortunately there are very few observations with regard to the duration of the “carrier” state which can be determined only by repeated cultures at short intervals. We have made no observations of the duration of the “carrier” state in healthy men. Two hundred and forty-two individuals carrying hemolytic streptococci were identified in the ward treatment of measles. All except 37 of these cases were “noncarriers” when first observed. The remaining 205 include 166 contact “carriers” and 39 patients with acute symptoms of infection by hemolytic streptococci.