Edward S. Murray

Rocky Mountain Spotted Fever in the Eastern United States

Abstract The majority of 13 cases of Rocky Mountain spotted fever from an endemic focus of the disease in the Cape Cod area of Massachusetts were diagnosed late, and two patients died. However, earlier diagnosis, earlier initiation of specific therapy, and prevention of fatalities should have been possible. Clinical, epidemiologic and laboratory data highly suggestive of the disease were almost all available early in the first week of illness to help in the diagnosis. There was high fever, severe headache, toxicity, mental confusion and myalgia. A generalized measles-like rash involved the palms and soles in almost all cases. Cases occurred seasonally between April and September, sharply restricted geographically to a known endemic focus, and predominantly in children. Complement-fixing and Weil-Felix antibodies rose late in the second week and were of no help in early diagnosis. Thrombocytopenia was surprisingly frequent, occurring in seven of 11 patients tested.

Immunization of Mice against Toxic Doses of Homologous Elementary Bodies of Trachoma

Death of mice occurs 2 to 8 hours after intravenous inoculation of concentrated viable elementary bodies of trachoma. Toxic death can be prevented by vaccinating the mice with concentrated suspensions of homologous strains inactivated by formalin or phenol. Judged by toxic challenges, at least two antigenically distinct types of elementary bodies of trachoma occur in Saudi Arabia and Egypt.

Differentiation of 19S and 7S Complement Fixing Antibodies in Primary versus Recrudescent Typhus by either Ethanethiol or Heat.

Summary The CF test can be modified so as to permit the differentiation of 19S and 7S antibodies in primary and secondary typhus infections. The 19S CF antibodies are markedly inhibited by the sulfhydryl compound ethanethiol and to a lesser degree by 60° C inactivation of the sera, The 7S CF antibodies are not inhibited by either of these procedures. The technic described may have application to the clinical and epidemiological investigation of other infectious diseases and may prove useful as a tool in studies of the immune globulins.

Further Report on Effect of Para-Aminobenzoic Acid in Experimental Tsutsugamushi Disease (Scrub Typhus)

Summary Additional evidence has been cited to indicate that the sodium salt of p-aminobenzoic acid definitely reduced the mortality of experimental tsutsugamushi disease in gerbilles. A description has been given of the routine of administration of Na PAB which was successful. Data from other, less successful, routines have been reported to emphasize the importance of the mode of therapy in the evaluation of PABA in experimental infection with R. orientalls. A clinical trial of PABA in human tsutsugamushi disease is strongly recommended.

Immunity Following Para-Aminobenzoic Acid Therapy in Experimental T sutsugamushi Disease (Scrub Typhus)

Summary Gerbilles which were infected with tsutsugamushi disease and survived through treatment with PABA were tested 6 to 9 months later and found to be immune to homologous strains of R. orientalis. This is interpreted as evidence that the mode of action of para-aminobenzoic acid in scrub typhus is rickettsiostatic. Cross-immunity tests revealed that these gerbilles were also immune to heterologous strains of R. orientalis.