14
REPORT OF THE KING INSTITUTE, GUINDY
the first fatal one and sent them to the Institute. In one of the eighteen blood
slides sent organisms were seen free in the blood which resembled B. pestis in
appearance and staining. It is impossible to know the significance of this finding
in the absence of cultures. The particular case concerned had the usual history
of short fever plus enlargement of a groin gland followed by recovery in
a few days.
The Unit arrived in Kara on the 7th August too late to see any cases in the
acute stage. Blood and gland smears and blood for agglutination tests and for
cultures were taken from as many convalescents as possible—14 cases, but with-
out any positive finding. Some blood smears were also taken at night but
microfilariae were not found. As the Unit was returning an acute case was found
at the village of Maddipalli near Kara. A man aged 30 had fever for about 12
hours and a slightly enlarged gland in the left axilla which was not painful to
pressure. He was moving about freely despite slight fever—temperature
100.8° F. He was practically in his usual health the next clay. Gland and
blood smears and gland cultures aerobic and anaerobic were made in this acute
case but no organism was found. The epidemiological findings showed the
absence of case to case contact. Thus there was no second case in any house ;
no two attacked persons were related to each other ; the huts of the attacked. were
far apart and scattered in the different hamlets. Further, there was no observed
epizootic—there were no rat falls, and no relation to malaria or filariasis. As is
evident the nature of the disease remains mysterious, so we should be glad if all
similar cases were at once reported by Health Officers. In Europe epidemics of
glandular fever have been reported, but they have referred to cases of fever for
2 or 3 weeks with lymphocytosis. Here there was no lymphocytosis and the
fever lasted usually for only one day.
(2) Typhoid Epidemic at Coonoon.—A n
i n c r e a s i n g n u m b e r o f H o s p i t a l
admissions for enteric fever during the months of April to August 1929 led the
Municipal authorities to requisition the services of an Investigation Unit. The
opinion of the Health Officer and the Civil Surgeon was that the epidemic was of
human carrier origin, and it was suggested that the unit should concentrate on
tracing the carriers from among the people who handled the food supply parti-
cularly, milkmen.
The requisition for the services of a Unit was received here on 9th Septem-
ber 1929 and a Unit under Military Assistant Surgeon J. H. Theodore was
despatched the same night. The Unit was accommodated at the Pasteur Insti-
tute, Coonoor, by the kind consent of the Director, Major K. R. K. Iyengar,
I.M.S. A full report was made and submitted to Government. The final conclu-
sions were as follows :
—
( a ) F r o m t h e f a c t s o b t a i n e d , i t i s n o t p o s s i b l e t o p u t d o w n t h e
epidemic as one of carrier origin, nor was it possible, at the time the investigation
was made, to be able to incriminate directly or indirectly any particular food
supply or the water-supply of Coonoor Municipality.
( b ) T h e f a c t o r s t h a t c o n t r i b u t e d t o t h e s p r e a d a n d u p - k e e p o f t h e e p i d e m i c
were the poor sanitary conditions in the crowded bazaar areas, the abnormal
prevalence of flies during these months, and the lack of a system of compulsory
notification. The large number of non-fly-proofed public latrines near dwelling
houses constitutes a distinct danger.
(3) Studies in Filariasis.—Dr. C. G. Pandit and Assistant Surgeon K. P.
M e n o n .
(a) Further studies on the Adhesion Phenomenon were made during the
year. The nature of the antibody concerned, the effect of heat and storage on
the antibody, and the possibilities of its absorption by its homologous antigen
were investigated. A qualitative analysis of the adhesing cells was also made.
(b) Some workers have recently suggested the existence of different species
of Micro-filariae Bancrofti as accounting for the differences in clinical manifesta-
tions of filariasis in different localities. It was decided to investigate this with
the aid of the adhesion phenomenon which had been found here to be given only