Ebola : the English connection

When one considers that many persons from the African continent arrive in Malta legally or otherwise, it is not inappropriate to surmise that some unfamiliar and possibly highly dangerous exotic disease, to which we are not accustomed, may someday be introduced into the island and may primarily and principally expose our medical, nursing and laboratory staff and their families to an alien infection with unpleasant and possibly fatal consequences. This essay illustrates such an incident including medical emergency.peer-reviewe

Rubella

Important events which marked the discovery of the rubella virus and the relative medical advancements are presented. Two hundred years ago various medical papers written by German authors described one such fever-with-rash entity which was most commonly referred to as Rötheln and subsequently became more generally and more popularly known as German measles, precisely because of these geographical and historical antecedents. Of remarkable importance are the findings of Sir Norman McAlister Gregg Sir Norman McAlister Gregg, the Australian ophthalmologist who first showed the teratogenic effects of Rubella in pregnancy. Furthermore, the most significant advances of Weller and Neva are described. It is not always easy even in this day and age to diagnose clinically patients suffering from Rubella. It is to be noted that as the situation stands today the pregnant-to-be multipara is the main target needing priority in protection, as she runs the greatest risk of getting infected from her own children with whom she is in daily close contact.peer-reviewe

The Weil-Felix test for the rickettsioses

The so-called Weil-Felix reaction as a method of diagnosis in typhus fever has been widely accepted by German workers, especially on the Eastern fronts, where in the Balkans especially, cases of typhus fever have been numerous. World War I was responsible for some of the worst epidemics of typhus that the world has known. In this day and age everyone accepts unquestioningly the fact that the causative agent of epidemic typhus is Rickettsia prowazeki but in those days the candidate etiological agents were as numerous as candidate viruses have been in our days for the virus of infective hepatitis. When the Great War of 1914-1919 was over Weil devoted himself whole-heartedly to all aspects of typhus research; etiology, diagnosis and prophylaxis, whereas after World War II, Felix stressed the necessity of standardising the W-F test and his recommendations were published in the Bulletin of the World Health Organisation (1950).peer-reviewe

Cholera : some historical reflections

The cholera vibrio was first discovered by Koch in Egypt in 1883; this he confirmed in Calcutta in 1884 by finding it in every case of the disease examined. This was an excellent piece of research, as was to be expected from that immortal master, with the French team, in the unavoidable absence due to ill-health, of the equally immortal Pasteur, made up of Pasteur's best pupils' acting as a pace maker in Egypt, but it would appear that some merited honour even at this late hour should be given to the Italian Pacini who during the 1854 cholera epidemic in Florence detected the motile vibrios in the faeces of cholera patients and not only described their general morphological appearances but also correctly attributed an ethological relationship to the “immense number of vibrious which I have found in the distended intestines”. Cholera has been one of the biggest if not the biggest, public health problem that the World Health Organisation had to tackle in 1971-72.peer-reviewe

Tab/Cho vaccine

This paper sets out to show that when we inoculate the familiar inactivated typhoid vaccine and cholera vaccine, or when we administer orally these attenuated (live) or inactivated (dead) vaccines, or chemical extracts or fractions thereof, we are attempting to reproduce as faithfully and as closely as we can the conditions which we have observed result as a consequence of a natural infection by the enteric bacilli and the cholera vibrios. Historical information regarding the Tab/Cho vaccines is outlined, pointing out also that within medical textbooks typhoid and cholera are usually grouped together in one because they are considered as being both intestinal diseases. For the convenience of travellers and holidaymakers, a combined Tab/Cho vaccine is available commercially.peer-reviewe