PREVENTION OF RELAPSING FEVER ON NEW SOVIET CONSTRUCTION PROJECTS

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00809A000700120381-4
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 4
• Document Creation Date: December 22, 2016
• Document Release Date: September 14, 2011
• Sequence Number: 381
• Publication Date: July 31, 1953
• Content Type: REPORT

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CLASSIFICATION CONFIDENTIAL
SECURITY INFORMATION
CENTRAL INTELLIGENCE AGENCY REPOR'
INFORMATION FROM
FOREIGN DOCUMENTS OR RADIO BROADCASTS CD NO.
DATE OF
INFORMATION
1952
SUBJECT
HOW
Scientific - Medicine, sanitation and
epidemic control
DATE DIST. 3
Jul 1953
PUBLISHED
WHERE
PUBLISHED
DATE
PUBLISHED
Book
Moscow
1952
LANGUAGE
SUPPLEMENT TO
Russian REPORT NO.
SOURCE Voprosy Epidemiologii 1 Parazitologii. Organizatsiya Sanitarnykh i
Protivoepidemicheskikh Mero ri ti , Academy of Medical Sciences USSR,
1952, pp 32-3 .
PREVENTION OF RELAPSING FEVER ON NEW SOVIET CONSTRUCTION PROJECTS
rmhe following information on the prevention of relapsing fever
on new Soviet construction projects, by F. G. Barinskiy, Candidate
of Medical Sciences, appeared in Voprosy Epidemiologii 1 Parazitologii
Or anizatsi Sanitarn kh i Protivoe idemicheskikh Mero ri ti
Problems of Epidemiology and Parasitology. Organization of
Sanitation and Epidemic Control), a publication of the Academy of
Medical Sciences USSR, Moscow, 1952, A. N. Sysin, editor]
One of the functions of the health services at new construction projects
is the protection of workers from infectious diseases. Prevention of
importation and spread of all types of parasite-transmitted typhus diseases,
particularly relapsing fever, must be given special attention during the
period of construction of the Main Turkmen Canal.
The epidemic form of the European, cosmopolitan, louse-borne relapsing
fever has been liquidated in all parts of the USSR. The possibility exists,
however, that this infection may be brought into the Turkmen SSR from
countries bordering it, taking into consideration that occurrence of this
disease is encountered there. Sporadic cases of the tick-borne relapsing
fever were registered in several localities of the Turkmen SSR: the source
of this '"fection was the nidi of spirochaetae found in the immediate area.
These natural nicli of the tick-borne relapsing fever induce the disease among
various wild animals, mostly rodents. The transmitters of the disease are
local species of ticks. Although few deaths have been observed as a result
of relapsing fever, and although the majority of patients recover after a few
febrile attacks and nonfebrile periods, the severity of the course, the duration
of the disease, and particularly the circumstance that it may reach epidemic
proportions makes this infection very dangerous. Provisions must be made for
rational preventive measures to forestall possible importation of relapsing
fever into the area of canal construction. Discovery and isolation of patients
having acute fever and diagnosis of their illness must be given special
attention.
STATE
ARMY
NAVY
AIR
SRB F I _ DISTRIBUTION I ! I
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A network of deputy sanitation inspectors aunt be established in all
populated sections of regions where construction work taker place; these
depu?ies must be invited to make regular door-to-door visits, together with
the medical workers. All febrile patients must be reported to health agencies.
During their house-to-house visits, medical workers must take the
temperature of each individual suspected of having the disease. Each febrile
individual must be isolated.
The next stage is early and precise diagnosis for relapsing fever of
those febrile patients who are suspected of being infected. According to
regulations of the epidemic control service, such patients must be isolated.
Microscopic examination of the blood of all febrile patients is
obligatory. Presence of spirochaetae in the blood confirms the diagnosis
for relapsing fever; absence of spirochaetae in the blood, during the febrile
stage of the disease, signifies in most cases that relapsing fever is absent.
It is desirable, however, to repeat such microscopic examinations of the
blood. It is important also, whe,i microscopic examinations of the blood are
made for malaria or some other disease, to recognize the possibility of the
presence of spirochaetae of relapsing fever. In cases of lice-borne European
relapsing fever, spirochaetae are not found in the blood of the patient
during apyrexia. If the patient's temperature was normal at the time the
blood sample was taken, but there is still reason to suspect that he may
have contracted relapsing fever, the blood must be examined again during
the period of rise in temperature.
While a new construction project is in progress, an extremely cautious
attitude must be adopted under the conditions existing there when even the
slightest clinical symptoms of any infectious disease are observed. Among
purely clinical symptoms of relapsing fever is the character of the temperature
curve and alternation in attacks and apyrexia, which is typical of this
disease; other symptoms are sudden onset of the disense; severe fever; great
enlargement of the spleen; pain in the gastrocnemial muscles, creating great
discomfort; and a rapid fall of tempera cure, ac.:ompanied by profuse perspiration.
The decisive factor in establishing a diagnosis for relapsing fever,
however, is presence of spirochaetae in the blood of the patient; microscopic
examination of the blood must be made to confirm the disease. The blood must
be taken for examination at the time the patient has fever and at the time
when clinical symptoms of the disease are evident. It is necessary also to
take into consideration the epidemiological data. It is advisable to bear
in mind that the disease may be brought in by the new arrivals at the site
of the construction project. It is self-evident that all those individuals
who have fever or show other symptoms of relapsing fever, e.'en though these
symptoms are established by clinical observations only, must be isolated
and immediately hospitalized.
It is important to remember that people who have relapsing fever can
transmit the disease not only during the attack but also during apyrexia or
during the period of convalescence, if there are blood-sucking lice on their
persons.
Patients with relapsing fever must remain in the hospital for not less
than 15 days (preferably 20 days) after the last attack is over, provided
there is no rise in temperature during that period. The days are counted
starting with the day on which a drop in temperature is noted after the last
rise.
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Every patient who has recovered from relapsing fever and all people who
have come in contact with him must be placed under medical observation for a
period of one month.
It goes without saying that good hospital care must be provided for all
patients with communicable diseases, including those with relapsing fever. All
new construction projects must have hospitals equipped with a sufficient
number of beds and qualitatively adequate other equipment, so that they may
be in a position to handle emergency situations, including outbreaks of re-
lapsing fever.
Treatment of relapsing-fever patients consists of administration of
salvarsan preparations, penicillin, etc. Specific therapy in cases of
relapsing fever is of great significance as far as prevention is concerned,
because the source of infection (in the case of European relapsing fever)
ceases to exist after successful treatment. In other words, the patient who
has recovered from the disease is not only freed from the protracted and
painful illness, but made incapable of infecting others. Strict sterile
technique must be observed during the period of hospitalization; clothing
of patients must undergo disinfection.
All persons who have come in contact with the patient must undergo a
thorough checkup: they must be placed under medical observation for one
month. While the patients are under observation, the temperature is
checked, and all those whose temperature is above normal must be hospitalized.
To prevent spread of infection, it is necessary to discover the disease
early and have the diagnosis confirmed with the aid of microscopic laboratory
examination. The patient must be hospitalized immediately and a thorough
disinfection made of the nidus of infection and of the personal effects of
all persons who have come in contact with the patient. Such persons must
also be placed under medical observation. As a rule, the incidence of the
disease can be restricted if the appearance of the first case of relapsing
fever is discovered at an early date. It is self-evident that all transpor-
tation facilities used in bringing patients to the hospital must be
disinfected, and sterile technique must be strictly observed by the hospitals
themselves.
It is of primary importance that all newly arrived workers go through
a disinfection process. Such disinfection must be conducted at a special
receiving point which has special baths with disinfection chambers.
All persons who already live in the locality must go through systematic
disinfection periodically under medical supervision; special public baths
must be provided for that purpose. Homes, personal effects, dormitories,
and particularly the bedding must be subjected to thorough cleaning and
disinfection.
To prevent the spread of relapsing fever from one locality to another,
public transportation systems must strictly observe general rules of
sanitation; this applies particularly to the railroads, piers, and other
places where large masses of people are temporarily concentrated.
Effective destruction of lice, maintenance of appropriate sanitary
conditions at homes and public places, and continuous operation of baths
in the area of new construction projects are important means for the
prevention of relapsing fever. Educational work in hygiene, conducted by
the active workers of the community among workers and their famili:ns, is
the most important and essential effort toward prevention of communicable
diseases, including relapsing fever. Among the new preparations for
exterminating disease carriers at the nidus of infection are DDT prepara-
tions, hexachlorane, and others.
M ME
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Although the number of seizures of tick-borne relapsing fever may reach
up to 15 and higher, its clinical course is milder than that of lice-borne
relapsing fever. Fatalities as a result of the tick-borne relapsing fever
are rare, the duration of apyrexia is irregular, the spleen becomes enlarged
only slightly and is not tender in the majority of cases, and the character
of the temperature curve is somewhat different from that encountered in
European relapsing fever.
Diagnosis of tick-borne relapsing fever is based on an examination
of the blood smears and of a thick drop for the presence of spirochaetae;
morphologically the spirochaetae do not differ from Obermeier's spirilla,
but their number is fewer in the preparation. It is important to detect
the spirochaetae not only durin,; the periods of attack but also during the
apyTexial periods. In making a differential diagnosis for tick-borne
relapsing fever, as well as for lice-borne relapsing fever, it is important
to exclude malaria. In diagnosing both lice-borne and tick-borne relapsing
fever, it is necessary to take into account the following epidemiological
data: presence of a bite, reactive symptoms at the spot of the bite, the
locality the patient came from, etc.
The transmitter of tick-borne relapsing fever is a tick infected with
spirochaetae from the blood of wild animals. The disease is transmitted to
humans by the bite of this tick. Infected ticks remain carriers of
spirochaetae for a period of 5-9 years. The epidemic character of the
natural nidus of tick-borne relapsing fever depends mainly on the presence
of an enzeootic nidus of spirochaetosis of wild animals in specific
localities. The disease in humans, therefore, is of a zoonotic character.
The ticks are most active during the summer months; they shun daylight
and take refuge in darkened places. They usually attack man at night.
To prevent incidence of tick-borne relapsing fever and to forestall its
importati"n into the area where new construction projects are in progress,
it is necessary, first of all, to destroy ticks in homes, barracks, and
overnight lodging places for construction workers and for workers in the
fields. Measures must also be taken to eliminate the possibility that the
ticks may attack humans at night when the latter are aslee-+.
Destruction of ticks in a building of closed construction is carried out
by means of gases which are toxic to insects and ticks, i.e., chloropicrin,
hydrocyanic acid, sulfur dioxide, etc. Ticks may be destroyed in the fields
by burning the grass.
Use of the thick-drop method of examining the blood of all patients
suspected of having relapsing fever is obligatory. If spirochaetae are
found in the blood of the patient, he must be hospitalized immediately,
and ticks in his home must be eliminated by means of one of the above-stated
methods. This must not be limited to the home of the patient alone, but
ticks must be destroyed wherever they may be found within the area embraced
by the construction project. It must be remembered that the existence of
crevices and cracks in houses, close prrximity of homes to barns where domestic
animals are housed and to other farm buildings, and infestation of such
buildings with rodents are factors conducive to infiltration by ticks.
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