TYPHOID FEVER

or ENTERIC, a specific infectious fever, characterized by an eruption on the skin, swelling of the spleen and lymph glands of the abdomen, and particularly by lesions in the intestine.. It is now known that the enteric group of fevers may be caused by one or other of at least three distinct bacilli. These are the Bacillus typhosus, B. paratyphosus A, and B. paratyphosus B. These organisms are short, thick rods with rounded ends and numerous flagella. They are distinguished by comparatively slight differences in their cultural characteristics, but an important distinction is that a vaccine prepared from one member of the group does not afford immunity from the effects of the others. At the beginning of the World War Brit. troops received a vaccine of B. typhosus only, and it was found that this did not prevent the occurrence of paratyphoid. Subsequently mixed vaccines were employed, and protection against the efiects of all three organisms was afforded. Infection is usually conveyed by water which has been contaminated by sewage, as the bacillus is present in the feces of affected persons. Milk and shell-fish are other carriers of infection. The incubation period of the disease is about twelve to fourteen days, and the onset is gradual, the first symptoms being headache, shiverings, a feelling of tiredne and of abdominal discomfort, and later a gradual rise of temp. accompanied by diarrhea. By the end of a week the temp. is high, the pulse is weak and rapid, the abdomen is distended, there may be diarrhea or constipation, and the spleen and abdominal lymphatic glands are enlarged. The treatment consists of isolation, complete confinement to bed, liquid, nourishing food, with plenty of water to drink, and stimulants if nece ary. Opium is given with lead acetate for intestinal hemorrhage and for severe diarrhea; and severe constipation is treated with enema, purgatives being harmful. Cooling baths or, when baths are impo ible, ice-packs are employed to relieve high temperatures. The period of isolation is four weeks, In. regard to preventive measures, a vaccine prepared from killed typhoid bacilli should be administered to persons who are likely to meet with infection. The urine and feeces of a person suffering or convalescent from typhoid fever must be disinfected. Healthy persons who have had typhoid may continue to harbor the bacilli. Such persons, known as typhoid-carriers may spread the disease.