Observations on one hundred cases of relapsing fever
The following observations were made on 'patients suffering from RELAPSING FEVER in Egypt from February, I916 to June, 1917 inclusive. All the cases were soldiers from the Egyptian Expeditionary Force, and every case was proved definitely to be one of Relapsing Fever by finding the spirochaetes in the peripheral blood.It would only be a matter of repetition if a set of conclusions was now drawn up, as they are plainly understood under each heading of these observations. However,there are two points which should be mentioned: -1. The clinical phenomena of the A type of fever and the microscopical characters of the organism causing the disease correspond to those mentioned by various authors in describing the Obermeieri Spirillum ( recurrentis ) or the organism which causes the European relapsing fever,while those causing the B type of fever correspond to those described under the heading of African Spirochaetosis or Spirillum Duttoni in books on Tropical Diseases.2. Why was it that the B type of' fever was suddenly introduced about the month of April 1917, before which time no cases of this type were observed.This is a question which is very difficult to answer properly but the following coincidence is worth noting:-Just, previous to the same time of the year as the B type of fever made its appearance,the British troops had advanced over the frontier line of the Sinai Peninsula and Palestine, and had entered a well-cultivated and fertile land compared to the barren and sandy ground of the Sinai Peninsula, to which they had been long accustomed. Owing to the different environment and the altered nature of the soil it is quite reasonable to presume that a different strain of spiro-chaste had been introduced among the troops by the transmitters of the disease.