Handbook of Medical Entomology

by William A. Riley; O. A. Johannsen

In 1909, Nicolle, Comte and Conseil, succeeded in transmitting typhus fever from infected to healthy monkeys by means of the body louse (Pediculus corporis). Independently of this work, Anderson and Goldberger had undertaken work along this line in Mexico, and in 1910 reported two attempts to transmit the disease to monkeys by means of body lice. The first experiment resulted negatively, but the second resulted in a slight rise in temperature, and in view of later results it seems that this was due to infection with typhus.

Shortly after, Ricketts and Wilder (1910) succeeded in transmitting the disease to the monkey by the bite of body lice in two experiments, the lice in one instance deriving their infection from a man and in another from the monkey. Another monkey was infected by typhus through the introduction of the feces and abdominal contents of infested lice into small incisions. Experiments with fleas and bed-bugs resulted negatively.

Subsequently, Goldberger and Anderson (1912b) indicated that the head louse (Pediculus humanus) as well, may become infected with typhus. In an attempt to transmit typhus fever (Mexican virus) from man to monkey by subcutaneous injection of a saline suspension of crushed head lice, the monkeys developed a typical febrile reaction with subsequent resistance to an inoculation of virulent typhus (Mexican) blood. In one of the three experiments to transmit the disease from man to monkey by means of the bite of the head louse, the animal bitten by the presumably infected head lice proved resistant to two successive immunity tests with virulent typhus blood.

In 1910, Ricketts and Wilder reported an experiment undertaken with a view to determining whether the young of infected lice were themselves infected. Young lice were reared to maturity on the bodies of typhus patients, so that if the eggs were susceptible to infection at any stage of their development, they would have every opportunity of being infected within the ovary. The eggs of these infected lice were obtained, they were incubated, and the young lice of the second generation were placed on a normal rhesus monkey. The experimenters were unable to keep the monkey under very close observation during the following three or four weeks, but from the fact that he proved resistant to a subsequent immunity test they concluded that he probably owed this immunity to infection by these lice of the second generation.

Anderson and Goldberger (1912b) object that due consideration was not given to the possibility of a variable susceptibility of the monkey to typhus. Their similar experiment was "frankly negative."

Prophylaxis against typhus fever is, therefore, primarily a question of vermin extermination. A brief article by Dr. Goldberger (1914) so clearly shows the practical application of his work and that of the other investigators of the subject, that we abstract from it the following account:

"In general terms it may be stated that association with a case of typhus fever in the absence of the transmitting insect is no more dangerous than is association with a case of yellow fever in the absence of the yellow fever mosquito. Danger threatens only when the insect appears on the scene."

"We may say, therefore, that to prevent infection of the individual it is necessary for him only to avoid being bitten by the louse. In theory this may readily be done, for we know that the body louse infests and attaches itself almost entirely to the body linen, and that boiling kills this insect and its eggs. Individual prophylaxis is based essentially, therefore, on the avoidance of contact with individuals likely to harbor lice. Practically, however, this is not always as easy as it may seem, especially under the conditions of such intimate association as is imposed by urban life. Particularly is this the case in places such as some of the large Mexican cities, where a large proportion of the population harbors this vermin. Under such circumstances it is well to avoid crowds or crowded places, such as public markets, crowded streets, or public assemblies at which the 'peon' gathers."

"Community prophylaxis efficiently and intelligently carried out is, from a certain point of view, probably easier and more effective in protecting the individual than is the individual's own effort to guard himself. Typhus emphasizes, perhaps better than any other disease, the fact that fundamentally, sanitation and health are economic problems. In proportion as the economic condition of the masses has improved—that is, in proportion as they could afford to keep clean—the notorious filth disease has decreased or disappeared. In localities where it still prevails, its further reduction or complete eradication waits on a further improvement in, or extension of, the improved economic status of those afflicted. Economic evolution is very slow process, and, while doing what we can to hasten it, we must take such precautions as existing conditions permit, looking to a reduction in or complete eradication of the disease."

"When possible, public bath houses and public wash houses, where the poor may bathe and do their washings at a minimum or without cost, should be provided. Similar provision should be made in military and construction camps. Troops in the field should be given the opportunity as frequently as possible to wash and scald or boil their body linen."