Bacteriological and epidemiological studies of streptococcal infections: with particular reference to epidemiological analyses by serological typing of haemolytic streptococci
(1) PREPARATION OF TYPE -SPECIFIC SERA:
(a) Vaccine was prepared from Griffith's thirty
types of haemolytic streptococci.
(b) Rabbits were injected and test-bleedings made
at various times to estimate the titre of the serum.
(c) The method of preparing type- specific agglutinating sera was described, and particular mention of
cross -reactions was made.(2) THE TYPING OF HAEMOLYTIC STREPTOCOCCI:
(a) A series of investigations were carried out t
determine the most suitable media for growing homogeneous suspensions of haemolytic streptococci.
The method of incubation best suited was
described.
(b) A description of the slide -agglutination method
of typing used throughout this work was given.CLINICO- BACTERIOLOGICAL INVESTIGATIONS OF
SCARLET FEVER CASES.
(3) The procedure adopted in swabbing patients
was intimated.(4) There followed a description of the method
adopted for storing haemolytic streptococci "in vacuo".(5) Statistical records for the period September 1937 to January 1939 were drawn up and included
the total number of admissions of scarlet fever cases
to the City Fever Hospital, the total number swabbed,
the total number of complications, and the total
number of complications swabbed.(6) Monthly graphs and tables indicating the
result of typing the above cases was given.(7) The monthly percentage increase and decrease
of the various types of haemolytic streptococci were
recorded.(8) An investigation was carried out to show
whether any difference in the types of haemolytic
streptococci found in the throats and noses of scarlet
fever cases existed.(9) The next investigation was carried out to
determine whether there occurred more than one type of
haemolytic streptococcus in the throat swabs of
patients on admission to hospital.(10) This investigation was an attempt to ascertain whether any cases, which had been in the wards
for some time, had more than one type of haemolytic
streptococci in their throats.(11) The results of the last investigation were
compared with those found during the first day complications became manifest.(12) Daily swabs were taken in a single ward
over a period of 23 days and all the patients typed.
All cross- infections were noted.(13) The same investigation was carried out over
a period of 46 days.(14) 384 cases showing complications were investigated. The haemolytic streptococci present on
admission and those responsible for the complications
were noted. Correlations between types and lesions,
etc., were recorded.(1 5) An investigation was undertaken showing the
decrease of haemolytic streptococci in the throats of
patients during their stay in hospital.(16) During the month of May, 1938, twenty cases
of scarlet fever were typed and the same done to fifteen cases showing complications. The results were
investigated.(17) A statistical record of scarlet fever cases
occurring in the City of Edinburgh from the 1/9/37 to
31/12/38 was drawn up.(18) The number of patients per month from the
various schools and institutions in Edinburgh was calculated and recorded in tables.A graph comparing the number of school children
with all other cases is given.(19) The types of haemolytic streptococci found
in school cases and other patients were noted and
certain correlations observed.(20) An attempt was made to show that there
existed a relationship of types of haemolytic streptococci found in the patients from individual schools.(21) 54 cases of puerperal fever were investigated bacteriologically.(22) Similarly 40 cases of erysipelas were
investigated.(23) This was also done with 10 cases of otitis
media or mastoiditis, and(24) with 60 cases of tonsillitis.(25) A miscellaneous group of diseases sent into
the City Fever Hospital as scarlet fever cases was
examined for haemolytic streptococci (42 patients).(26) Eight positive haemolytic streptococci
;swabs from the Third Year Medical Students were examined. This was carried out during a time when "coughs,
and colds" were common.(27) 32 cases of respiratory diseases occurring
in a rural area were investigated for the presence of
haemolytic streptococci. These were typed and compared with the urban strains.(28) The next investigation was carried out to
ascertain the presence of haemolytic streptococci in
normal throats and to find what correlation there
existed between the types found and the various streptococcal infections. The normal throats were those of:
(a) 40 nurses from the City Fever Hospital.
(b) The positive swabs from a number of nurses
from the Western General Hospital,
(c) Six resident doctors in the City Fever Hospital.
(d) Ten strains from the Third Year Medical students were typed. The period was one when
only a few "coughs and colds" were about.
(e) 16 families, from whom cases of scarlet fever
had been sent to hospital, were visited and
all members swabbed, with a view to determining the presence of haemolytic streptococci and observing any correlations.
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(f) This investigation was carried out upon my own'
person to estimate the number of haemolytic
streptococci present in throat and nose
before and after contact with scarlet fever
patients.(29) The presence of haemolytic streptococci on
toys and food in the scarlet fever wards was investigated.(30) A similar investigation was carried out on
the handkerchiefs of patients.AIR -CONTAMINATION WITH HAEMOLYTIC STREPTOCOCCI
IN THE CITY FEVER HOSPITAL WARDS.(31) (a) A research was made to determine the
incidence of haemolytic streptococci in the air of
fever wards.
(b) A similar investigation was done in a
puerperal ward; and in
(c) an erysipelas ward; and in
(d) a diphtheria; and in
(e) a measles ward.
(f) The first investigation (a) was
repeated in a ward with a high complication rate, and
repeated in another with a low complication rate. The
results were correlated.(32) Air contamination with haemolytic streptococci in the Ear, Nose and Throat Department of the
Edinburgh Royal Infirmary was investigated.(33) The next investigation was to determine
the presence of haemolytic streptococci and their
types in picture houses, buses, trams, shops and
open places.(34) An attempt was made to correlate the
types found in scarlet fever with those of all other
streptococcal infections.(35) A research into the problem of air-borne
infection was carried out. The object of this investigation was to determine what effects variations of
ventilation, and wet and dry sweeping have on the
number of organisms in the air.B. prodigiosus was the organism used in this
investigation and was sprayed by means of an atomiser.(36) Cross-contamination in the cubicles of the
City Fever Hospital was investigated.(37) The final investigation was an attempt to
type those strains of haemolytic streptococci which
were either too granular or failed to type by ordinaryj
methods
