29
REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
II. The results of the serological examinations were as follows. A series of 73
specimens of sera of patients who had recovered from gastro-enteritis was tested against
strain 1,340 (a true Flexner isolated from a convalescent case of gastro enteritis who never
had dysentery before).
34 gave 1/200 positive agglutination microscopic
16
"
1/100
do.
10
"
1/50
do.
6
"
1/25
7
"
1 /25 negative
do.
The accompanying chart shows a well marked similarity in the rise and fall of gastro
-enteritis, dysentery and diarrhœa cases.
III. Results of kitchen gang examination—The examination of the stools of the kitchen
staff for probable carriers of dysentery gave the following results :—thirty men out of
hundred were found to be suffering from latent dysentery as found by naked eye examination
of their stools within one month. One man who had suffered from gastro-enteritis in the
first epidemic was found to be working in the kitchen during the second epidemic.
As a result of these investigations all the gastro-enteritis cases were treated as fulminat
-ing forms of dysentery due to Flexner type of B. Dysenteriæ and polyvalent anti-dysenteric
serum was used extensively in the treatment of these cases with success. More efficient
bowel control of the men in the barracks with regard to latent dysentery, protection of water
supply by the establishment of a permanent water gang to supply water to the convicts and
strict isolation of the kitchen gang with elimination of latent dysenteries from them was
undertaken. By these means the epidemic was brought rapidly under control.
In connection with this epidemic of gastro-enteritis it will be of interest to note the
following reference to a similar epidemic which occurred at Aberdeen in March to May 1919
and reported in the Journal of Hygiene for August 1923, volume 21, No. 4, pages 451 to 457,
quoted in Tropical diseases bulletin for December 1923 :
" An epidemic of diarrhœa or gastro-enteritis occurring in Aberdeen in 1919, and
causing over 1,000 cases and 72 deaths, has been proved to be due to infection of milk with
dysentery bacilli of Flexner type.
The Aberdeen epidemic of milk borne bacillary dysentery had run its course and had
caused 72 deaths before serological proof of bacillary dysentery was available. Since the
time of the Aberdeen epidemic, notable advances have been made in the methods for
bacteriological diagnosis of dysenteries as a result of the fundamental work of F. W. Andrews,
A. D. Gardner, C. J. Martin and others. Nevertheless modern bacteriological diagnoses are
not infallible and the Aberdeen epidemic clearly indicates that deaths will be prevented if
polyvalent anti-dysenteric serum and saline treatment are used at once in a disease having
the clinical symptoms of bacillary dysentery or in an acute enteritis from which has been
isolated organisms with the cultural reactions of the dysentery group bacilli."
At the request of the Inspector-General of Prisons, the Director of the institute asked
the unit to undertake the work of detection of enteric carriers from among the kitchen and
water gangs and from the post enteric gang (Ref. R. C. 5005–1/B of 27th December 1923).
Ten consecutive examinations of the stools of these convicts were done. The following is a
tabulated statement of the results obtained :—
Number of
examina-
tions.
Typhoid
group
organisms.
Other organisms.
B . Morgan. B. Fecalis
alkaligenes.
Kitchen and water gangs
1,020
Nil.
N i l .
1
Post enteric gang
570
Nil.
2
Nil.
In eliminating dysentery carriers from the kitchen and water gangs it was found that
new recruits to them had to be taken in groups of 3 or 4 every now and then. An attempt
at examining these new recruits for enteric carriers had to be given up, as the number was
not constant.