DENGUE FEVER IN AUSTRALIA. ITS HISTORY AND CLINICAL COURSE, ITS EXPERIMENTAL TRANSMISSION BY STEGOMYIA FASCIATA, AND THE RESULTS OF INOCULATION AND OTHER EXPERIMENTS.
DENGUE FEVER IN AUSTRALIA. ITS HISTORY AND CLINICAL COURSE, ITS EXPERIMENTAL TRANSMISSION BY STEGOMYIA FASCIATA, AND THE RESULTS OF INOCULATION AND OTHER EXPERIMENTS.
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DOI：
10.1017/s0022172400006690
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发表时间：
1918-01-01
影响因子：
--
通讯作者：
Bradley, Burton
中科院分区：
文献类型：
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作者：
Cleland, J. Burton;Bradley, Burton
1. 登革热在澳大利亚无疑是一种外来疾病。自1885.2年以来，它不时以流行病的形式存在。这种疾病的临床描述与教科书中对登革热的描述一致，唯一的不同之处在于，与温度相比，脉搏率相对缓慢，有时绝对缓慢。目前在“登革热”一词下可能包括一种以上的疾病。澳大利亚的登革热流行与已知的筋膜隐蝇分布大致相同。它不会扩展到这种蚊子普遍存在的地区以外。在登革热病例周围的登革热感染区捕获的筋膜潜蝇蚊子，其中一些已知在登革热患者患病的第一天和第二天以其为食，被运送到非登革热区，在对其进行叮咬实验的七个人中有四个人复制了该疾病。从这四个病例中的三个人身上采集的血液注射到其他人身上后，又复制了这种疾病。一例患者的血液没有检测。4例个案的潜伏期，由咬伤至发病，可能在5至9天半，或6天半至9天半之间。上述四个病例均未发生已知传染病例。从两例病例（其中一例被疲劳库蚊多次严重叮咬）中没有证据表明疲劳库蚊能够作为登革热的传播媒介。患登革热的病人的血液经皮下接种到健康人体内后，可使这种疾病重现。这样接种的疾病在自然感染登革热的各种方式中都是典型的。接种的疾病可能会或可能不会出现明显的皮疹和双期温度图，并呈现相对缓慢，有时绝对缓慢的脉搏；这种变异发生在自然疾病中。接种的疾病的潜伏期与蚊子传播的疾病的潜伏期相同，从5天到9天不等。接种结果表明：(a)登革热病毒整体上存在于血液中。(b)感染血凝块的血清可能含有病毒。(c)用洗涤过的小体进行三次实验，得到一个明显的阳性结果。(d)柠檬酸感染血液的液体部分可能含有病毒。(e)用巴斯德-张伯伦滤液对受感染的血清和小体进行了5次实验，得到1次阳性结果。在考虑这些结果时，不能将未传播疾病的情况解释为所使用的月经从未含有病毒，因为在某些情况下，抽血时血液可能不再具有传染性。(f)在患病的第二天和第三天证明血液中存在病毒。所做的两个实验可能被解释为表明在患病的第八天仍可能存在传染性物质。(g)一项实验似乎表明，从患病开始的第14天起，血液中不再存在病毒。(h)从典型的登革热发作中康复后24天，对感染血液接种的免疫似乎完全完成。(i)受感染的血液在体外如放置阴凉处至少7天，可保持其传染性。(j)在两种情况下，在同一天用相同材料接种的两个人表现出潜伏期。
1. Dengue Fever in Australia is undoubtedly an introduced disease. It has been existent from time to time in epidemic form since 1885.2. The clinical description of the disease agrees with that of the Dengue described in text-books, the only departure noted being the distinct tendency to a relatively, and sometimes absolutely, slow pulse rate as compared with the temperature.3. It is possible that under the single term “Dengue” more than one disease is at present included.4. Epidemic Dengue in Australia is approximately co-extensive with the known distribution of Stegomyia fasciata. It does not extend beyond the area in which this mosquito is prevalent.5. Stegomyia fasciata mosquitoes caught in a dengue infected district in the surroundings of cases of the disease, and some of them known to have fed on a dengue patient on the first and second days of his illness, transported to a non-dengue district, reproduced the disease in four out of seven persons on whom biting experiments were conducted.6. Blood taken from three of these four cases reproduced the disease when injected into further persons. The blood of one case was not tested.7. The incubation period of the four cases was found to be possibly between five and nine and a half days, probably between six and a half and nine and a half days, counting from the bitings to the definite onsets.8. No known case of contagion occurred from any of the above four cases.9. No evidence was obtained from two cases, one of which was heavily and repeatedly bitten with Culex fatigans, that Culex fatigans is capable of acting as a transmitter of dengue fever.10. The blood of patients suffering from an attack of dengue can reproduce the disease when inoculated subcutaneously into healthy persons.11. The disease thus inoculated is typical in every way of dengue fever naturally contracted. The inoculated disease may or may not shew marked skin rashes and double phases in the temperature charts, and presents a relatively and sometimes absolutely slow pulse; such variations occur in the natural disease. The incubation period of the inoculated disease varies from five to nine days corresponding with the incubation period of the mosquito-transmitted disease.12. Results of the inoculations shew that:(a) The virus of dengue is present in the blood as a whole.(b) The serum of clotted infective blood may contain the virus.(c) With washed corpuscles one apparently positive result was obtained out of three experiments.(d) The fluid part of citrated infective blood may contain the virus.(e) With Pasteur-Chamberland filtrates of infected serum and corpuscles, one positive result was obtained out of five experiments.In considering these results failure to convey tne disease must not necessarily be interpreted as meaning that the menstruum employed never does contain the virus, as in some of the cases the blood may no longer have been infective at the time at which it was withdrawn.(f) The presence of the virus in the blood has been demonstrated on the second and third days of the disease. Two experiments made may possibly be interpreted as shewing that infective material may still be present on the eighth day of the disease.(g) One experiment appears to indicate that the virus is no longer present in the blood on the fourteenth day from' the beginning of the illness.(h) Immunity to the inoculation of infective blood appears to be complete twenty-four days after recovery from a typical attack of dengue.(i) Infected blood may maintain its infectivity outside the body if kept in a cool place for seven days at least.(j) In two instances two individuals inoculated with the same material on the same day exhibited incubation periods …