The Pleasantville press. (Pleasantville, N.J.) 1912-1929, 1920-01-17

Found Simple Task, but to Prevent
Reinfection From Larvae in Soil Is
Dificult-Fight on Fifteen Years.
Failure to eradicate completely hook
worm disease from any one area during
10 years of scientific struggle against
that scourge by its own and other
health agencies Is acknowledged in
the Rockefeller foundations annual
report.
Intensive scientific study of certain
control factors, notably the viability
of the worms in various kinds of soil
and other mediums and the possibility
Of making certain the existence of 9TH
er forms of transmission than those al
ready well understood, are suggested
as offering hope of attaining more COM
plete results. 1t is probable that such
studies soon will be undertaken.
Nothing could be simpler in theory
than the few measures necessary for
the control of hookworm Infection"
the report says. THE cycle of the
worm from the moment the egg is de-
posted on the ground until it has
reached the small intestine of its hui
man host and developed to its adult
stage is well understood, as are also
the details of its life story and envi-
rOnment and there are at least two
drugs which are most potent in free
ing the human system of the parasites.
1t should therefore be relatively SIM
pie to locate and to cur those who
have the disease, to prevent others
from contracting it, and thus to bring
about, within limited areas at least,
its complete eradication.
Although the problem of complete
eradication is simple when stated on
paper, it is not so in practice. The
board has been engaged in work
against hoOkworm disease since 1910,
similar work was undertaken in Porto
Rico in 1904. and the attack on the
disease in the mines of Belgium, Hol-
land and Germany began as early as
1902, yet it is impossible to point to
any n mine or area from which the
infection has been completely eradi-
Gated. In the mines of Germany it
was reduced from 1853 per cent in
1903 to Is per cent in 1912; in those
of tn Netherlands. from Is per cent
In 1903 to ~ percent tn 1913, aud IN
those of the Liege district of Belgium,
from 22.8 per rent in 1902 to IL per
cent in 1913. These are the nearest
recorded approaches to complete con-
troll.
Many Obstacles in Way.
"Many obstacles stand in the way of
complete eradication, even in isolated
areas having no immigration and with
natural conditions that either limit or
preclude intercourse with the outside
world. 1t is seldom possible to examine
every individual in an area or to treat
until cured all who are found infected
when Iatrines of a proper type are in
stalled in sufficient Numbers to pre-
vent soil pollution, it is still necessary
TO accustOm the people to the use of
them-and this is a task that usually
requires a long period of education
and enlightenment and ever when
both the foregoing conditions are full
filled there still remains for a time the
danger of reinfection from hookworm
larvae already in the SOIL"
After an extended survey of its ex-
perience with reinfections, which were
found to show the highest rates on es-
tates in Ceylon. the foundation re-
ports:
These high rates of r%einfection
should not be accepted as Indicating
that no considerable progress has been
made toward bringing the disease un-
der control. 1t should be remembered
that the problem of hookworm control
is primarily one of reducing mass in
lection. The practical phase of the
task is concerned with the removal of
the largest possible number of worms
from the largest possible number of
infected persons. Upon this basis the
best criterion for judging the effective
ness of a curative campaign in any
Urea is not the percentage of infected
persons who are cured or who remain
cured. but the proportion, expelled and
destroyed, of the total worms har-
bored by the population.
Even though in certain of the areas
mentioned from 80 to 100 per cent of
the persons formerly cured of the dis
ease have since become reinfected
there a be little doubt that as a re-
suit of treatment the average number
of worms harbored by each infected
person has been very materially re-
duced. Conditions extremely favorable
for the prevalence and persistence of
the Infection exist practically through
out all countries in which the work
has been conducted there Is at pres
ent lack of definite knowledge as to
how long larvae remain infective in
the soil the latrine accommodations
provided in many areas have been de-
fective or inadequate, the habits of
the people grossly insanitary. and, in
addition, war conditions have inter
fered seriously with due and effective