21
The comparative effect of the Enteric fever group on British soldiers of
over and under one year's service in India is shown below in Table No. 23.
Last year comment was made that for the first time no cases had occurred in
soldiers of under one year's service in India and the enhanced effects of the new
T. A. B. vaccine now issued by the Royal Army Medical College, Millbank and
the Central Research Institute, Kasauli, was credited with this achievement.
This year this record has been broken and the case incidence has reverted to
that of the period 1934-35.
TABLE No. 23
Effects of Enteric Group fevers on, British soldiers with under one year's service in
India
Under one year
Over one year
Cases
Deaths
Case
morta-
lity%
Cases
Deaths
Case
morta-
Actu-
als
Ratio
per
1,000
Actu-
als
Ratio
per
1,000
Actu-
als
Raio
per
1,000
A c t u - a l s
Ratio
per
1,000
lity %
Average for
1929—1933.
30
2.84
7
0.68
23.84
32
0.71
3
0.08 11.24
Average for
1934—1935.
7
0.65
2
0.18
28.57
20
0.47 4
0.11 22.50
1936
. . .
6
0.62
. . .
. . .
. . .
8
0.19 2
0.05 25.00
1937
. . .
. . .
. . .
. . .
. . .
. . .
6
0.15 3
0.08 50.00
1938
. . .
8
1.10
2
0.27
25.00
7
0.19 1
0.03 14.30
Inoculation.—The decline to the present almost insignificant figure of the
incidence of Enteric Group infections is due definitely, apart from improvements
in water supplies, milk supplies, protection and care of food stuffs and possibly
the reasonable standard of sanitation in cantonments, to the yearly increasing
care which is given to the production of our efficient T. A. B. vaccine and to the
high degree of protection obtained and the high percentage of personnel who
accept this voluntary inoculation. The fact that it is voluntary necessitates
constant alertness and supervision on the part of all medical officers in charge
of troops and families to ensure that individuals are kept up to date in their
protection and not missed by reason of being away for a time. In addition,
one or two non-believers who influence others are quite capable of upsetting the
efforts of medical officers to produce 100% protected personnel and such ob
- j e c t o r s c a u s e t h e r e b y m u c h e x t r a w o r k a n d o p e n g a p s i n o u r d e f e n c e w h i c h m a y
well account for some of the cases. We have also those who fail to remain
protected from mere forgetfulness. The following instances illustrate the
need for constant vigilence.
At the Staff College, Quetta, there were two cases of officers admitted
with enteric fever. Both were overdue for inoculation. In addition two of
the senior staff were ill with an obscure fever thought to be enteric. Now all
officers and families have to produce a certificate of inoculation and vaccination.
At Simla there was a small outbreak of Para-typhoid A amongst officers
and their families concurrent with a local epidemic which took effect from the
middle of June to the end of August. Three officers of Army Headquarters,
two wives and one daughter of officers were the military personnel involved.
In this case all except one had been inoculated at some time.
At Murree in the Lawrence College, a civil school at Ghora. Gali, there was
an explosive outbreak with 20 severe cases and 2 deaths.