Burnet, Et.:

(1922) Sur les rapports du B. abortus (Bang) et du Micrococcus melitensis. Compt. rend. Acad. d. Sci., Paris, 175, 790-793.

(1923)-Rapports du Micrococcus melitensis et du B. abortus de Bang. Arch. Inst. Pasteur de l'Afrique du Nord, 3, 48-66.

Evans, Alice C.:

(1918) Further studies on Bacterium abortus and related bacteria. II. A comparison of Bacterium abortus with Bacterium bronchisepticus and with the organism which causes Malta fever. J. Infect. Dis., 22, 580-593.

(1922)—A buffered physiologic salt solution. Ibid., v. 30: 95–98.

(1923)—The nomenclature of the melitensis-abortus group of organisms. Pub. Health Rep., 38, 1943-1948.

Feusier, M. L., and Meyer, K. F. (1920): Principles in serologic grouping of B. abortus and B. melitensis. Correlation between absorption and agglutination tests. Studies on the genus Brucella nov. gen. II. J. Infect. Dis., 27, 185-206.

Fleischner, E. C., and Meyer, K. F. (1920): Preliminary observations on the pathogenicity for monkeys of the Bacillus abortus bovinus. Trans. Pediatric Soc., 32,

141-146.

Fleischner, E. C., Meyer, K. F., and Shaw, E. B. (1919): A résumé of some experimental studies on cutaneous hypersensitiveness. Am. J. Dis. Children, 18, 577-590. Fleischner, .E. C., Vecki, M., Shaw, E. B., and Meyer, K. F. (1921): The pathogenicity of B. abortus and B. melitensis for monkeys. Studies on the genus Brucella nov. gen. III. J. Infect. Dis., 29, 663--698.

Huddleson, I. Forest (1922): The comparative pathogenicity of several strains of Bacterium abortus (Bang). Michigan Agric. Exper. Sta., Tech. Bull. 55, pp. 1-4. Jaffé, R. Hermann (1922): Über die experimentelle Infektion des Meerschweinchens mit dem Bac. melitensis (Bruce) und dem Bac. abortus (Bang). Virchow's Arch. í. path. Anat. u. Physiol., Berlin, 238, 119–134.

Khaled, Z. (1921): A comparative study of bovine abortion and undulant fever, from the bacteriological point of view. J. Hyg., Cambridge, Eng., 20, 319-329. Lake, G. C. (1922): Malta fever in southwestern United States. With special reference to a recent outbreak in Phoenix, Ariz. Pub. Health Rep., 37, 2895-2899. Meyer, K. F., Fleischner, E. C., and Shaw, E. B. (1919): The pathogenicity of Bacterium melitensis for guinea pigs. Proc. Soc. Exper. Biol. and Med., 16, 152-156. Meyer, K. F., and Shaw, E. B. (1920): A comparison of the morphologic, cultural, and biochemical characteristics of B. abortus and B. melitensis. Studies on the genus Brucella nov. gen. I. J. Infect. Dis., 27, 173–184.

Meyer, K. F., Shaw, E. B., and Fleischner, E. C. (1922): The pathogenicity of B. melitensis and B. abortus for guinea pigs. Studies on the genus Brucella nov. gen. IV. J. Infect. Dis., 31, 159-197.

Nègre, L., and Raynaud, M.:

(1912) Melitensis et paramelitensis. Compt. rend. Soc. de biol., Paris, 72, 791793.

(1912)-Identification des paramelitensis par l'épreuve de la saturation des agglutinines. Ibid., 1052-1054.

Skarić, J. (1922): Über die Beziehungen des Bac. melitensis (Bruce) zum Bac. abortus infect, bovum (Bang). Ztschr. f. Hyg. u. Infektionskr., 95, 358-364.

Zeller (1920): Beziehungen zwischen dem Erreger des infektiösen Abortus der Rinder und des Maltafiebers. Berlin. tierärztl. Wehnschr., 36, 345-347.

THE "DEVIL'S GRIP" IN VIRGINIA.

By C. ARMSTRONG, Passel Assistant Surgeon, United States Public Health Service.

On July 23, 1923, at the request of State Health Commissioner Dr. E. G. Williams, of Virginia, the writer accompanied State Epidemiologist Dr. George C. Payne to Bowling Green and vicinity for the purpose of investigating an outbreak of a disease of unknown etiology.

From various physicians in Caroline, Hanover, and King William Counties it was learned that there had been in their practices for the past month an epidemic of unknown etiology, the like of which they had not previously encountered. The symptoms, as described by physicians, patients, and parents were striking and practically identical. They suggested to the writer an outbreak described by Prof. W. C. Dabney, M. D., of the University of Virginia, which occurred in June, 1888, in and about Charlottesville and among the students of the university. (Dabney suggested a relationship with dengue fever, but he recognized wherein the two diseases differed, and it seems certain that they are distinct.) During that epidemic in Rappahannock County, Va., a sufferer, on account of the severe pains, nicknamed the ailment "devil's grip." From the description given by Dabney it seems that he was dealing with the same ailment observed in 1923, a brief preliminary description of which is given here.

The patients visited were found to be principally children, several usually being affected in the same home. The onset was sudden, and often startling to the parents, beginning with an acute, severe pain usually of the epigastrium, which later shifted to the right or left side of the chest. In some cases the pain began in the chest, and in a few it radiated to the right or left shoulder. The pains were described as intermittent in some cases. The respirations were shallow, increased in rate, were quite painful (especially on deep inspiration), and were usually accompanied by a grunt. The temperature rose rapidly to 101°-103°; the pulse was usually moderately increased in rate. Headache occurred in some cases; vomiting was rare. The bowels were somewhat constipated or normal. The appetite was impaired. Hiccough was present in a few cases, and sweating was common at some time during the attack. The symptoms were transitory; the fever and pain usually subsided in from 12 to 36 hours, and, as a rule, did not recur. One child was seen, however, who had suffered three attacks, occurring, approximately, on alternate nights. There were no chills.

An account of an epidemic resembling dengue, which occurred in and around Charlottesville and the University of Virginia in June, 1888. By William C. Dabney. American Journal of the Medical Sciences, vol. 96, pp. 488-491.

Upon physical examination the physicians of the neighborhood were unable to find any adequate cause for the symptoms. Examinations made by the writer in a few cases just recovering revealed no lung involvement or other apparent cause, except in one case. This child began, it is said, with typical symptoms, but failed to recover, and when seen after a week there was involvement at the base of one lung and the mouth was surrounded by herpes. The transitory nature of the ailment and the fact that the disease was occurring throughout one of the most sparsely settled rural sections of Virginia prevented the writer from seeing a case in the carly and more active stages. The disease is, however, being investigated by the State Department of Health, and a more detailed report will be made later. The writer heard of no deaths being attributed to the disease. Judgment as to whether or not the condition here described is a separate clinical entity should remain suspended until further evidence is available.

MOSQUITO CONTROL IN BRUNSWICK, GA.

Reports coming to the Public Health Service from the quarantine station at Brunswick, Ga., indicate the success of mosquito control measures in that locality. During the months of April, May, and June, the report states, there was an entire absence of mosquitoes in Brunswick. This freedom from mosquitoes was due in part to the war made on mosquito breeding during the winter and spring months and in part to the prevailing temperature. The temperature up to the end of June was not conducive to productive breeding. With the advent of July, warmer weather and frequent rains produced conditions more favorable to mosquito propagation. The temperature for July ranged from 70° to 90° in the shade, with a mean temperature of 80° F.

Up to the end of July no stegomyia were observed. If stegomyia were breeding, they were passive. During July there was practically an absence of mosquitoes in Brunswick and the neighboring vicinities. This situation was unquestionably due to the active measures taken by the civic and county authorities to suppress mosquito breeding. The only mosquitoes observed during the month of July were the Culex and Anopheles, which appeared during the week of July 28. This invasion was mild, and measures were immediately taken to suppress further invasion and to keep the city free from malaria.

This work of malaria suppression and control in Georgia is being carried on under the direction of the sanitary department of Brunswick and the local board of health. Experienced officers are in charge. Ample help and facilities have been provided for the abatement of

all mosquito-breeding places and the destruction of all larvæ. Sanitary inspectors are employed to see that all property owners and tenants keep their property free from standing water exposed in such way as to provide a breeding place for mosquitoes. Penalties are also provided for persons who are negligent in observing the sanitary ordinances.

At the end of July the status of the public health in Brunswick and, in fact, throughout Glynn County, was remarkably good. There were but few cases of malaria, still fewer cases of typhoid, no dengue, and no diseases of a quarantinable kind.

DEATHS DURING WEEK ENDED AUGUST 11, 1923.

Summary of information received by telegraph from industrial insurance companies for week ended August 11, 1923, and corresponding week of 1922. (From the Weekly Health Index, August 14, 1923, issued by the Burcau of the Census, Department of Commerce.) Week ended Corresponding Aug. 11, 1923.

Policies in force.......

Number of death claims....

Death claims per 1,000 policies in force, annual rate.....

week, 1922.

Deaths from all causes in certain large cities of the United States during the week ended August 11, 1923, infant mortality, annual death rate, and comparison with corresponding week of 1922. (From the Weekly Health Index, August 14, 1923, issued by the Bureau of the Census, Department of Commerce.)

1 Annual rate per 1,000 population.

15

7.4

17

7.91

7.6

1

1

28

12.1 i

11.7

5

2028

72

99

2 Deaths under 1 year per 1,000 births-an annual rate based on deaths under 1 year for the week and estimated births for 1922. Cities left blank are not in the registration area for births.

3 Deaths for week ended Friday, Aug. 10, 1923.

Deaths from all causes in certain large cities of the United States during the week ended August 11, 1923, infant mortality, annual death rate, and comparison with corresponding week of 1922. (From the Weekly Health Index, August 14, 1923, issued by the Bureau of the Census, Department of Commerce.)—Continued.