The Incidence of Cerebro-Spinal Fever in the Borstal Institution and Central Jail, Lahore, during 1934, with a Note on the Use of Anti-Meningococcus Prophylactic Vaccine

The general scheme of prophylaxis consisted in keeping in quarantine all fresh admissions to the jails until their post-nasal swabs had been examined and found negative for the meningococcus, isolation of the sick and of carriers, segregation of contacts, adoption of general measures for the avoidance of overcrowding and the use of 1 in 5,000 solution oi potassium permanganate in normal saline for gargling and for sniffing up the nose. In addition, the prophylactic inoculation of prisoners with anti-meningococcus vaccine was also carried out. A quantity of vaccine, pre." pared at the Central Research Institute, Kasauli, was obtained through the courtesy of Lieutenant-Colonel J. Taylor, d.s.o., i.m.s., the Director of the Institute, for the purpose of conducting a controlled experiment amongst the prisoners of Lahore jails to ascertain the immunizing value of the vaccine. With this object the population of both the jails?the Borstal Institution and the Central Jail?was divided into approximately two equal portions. One portion was inoculated with the vaccine, [whilst the other was left as a control. Both portions were otherwise kept under identical conditions as regards work, sleep and general environment, etc. The vaccine was administered at weekly intervals in three divided doses of 0.5 c.cm., 1 c.cm. and 2 c.cm. to each prisoner. Altogether 1,769 individuals were inoculated, 1,002 in the Central Jail and 766 in the Borstal Institution; of the latter group 46 received only two and 55 only one injection. Up to date (April 1935J 6 cases of cerebrospinal fever have been reported in the Borstal Institution amongst the non-inoculated group and none from the inoculated group. In the case of the Central Jail, however, one fulminant case of cerebro-spinal fever which proved rapidly fatal was reported from the inoculated group in addition to an imported case from Lahore district. Reactions following inoculations.?There was some constitutional disturbance consisting of headache and a rise of temperature varying between 99.5?F. and 100.5?F. in about 60 per cent of the prisoners after the first inoculation. A few prisoners also complained of pains in the joints. The reaction progressively decreased in severity with the second and third inoculations. The reactions, both general and local, were in no case so severe as to incapacitate a person from doing his work for more than a day. Immunizing value of the vaccine.?The number of cases of cerebro-spinal fever that have so far been reported from both the jails are all amongst the non-inoculated with the exception of the one fatal case reported from the inoculated group in the Central Jail, Lahore. The number of cases, however, is so small that no significance can be attached to the result and it is not possible to express an opinion as to the (Continued at foot of opposite page) MONTHLY O/57/?MTJ0rt OF C*HS MO DM 70S