Epizoötics and their control during war : a guide for army, government, and practicing veterinarians

Front matter

^rvWi.A^^^V

CORNELL UNIVERSITY.

THE

Appendix

Hints on Handling War Horses in America, by A. A. Leibold 197

INDEX 209

ILLUSTRATIONS

PAGE

Fig. 1. Formalin disinfection apparatus 25

Fig. 2. Nodules and ulcers on the skin of a glanderous

horse 31

Fig. 3. Ulcers and scars on the nasal mucosa of a horse. . 34 Fig. 4. Glanderous ulcers of the mucosa on the ventral

wall of the trachea 35

Fig. 5. Glanders sears on the tracheal mucosa 36

Fig. 6. Section through lung of a horse showing new and

old glanders nodules 37

Fig. 7. Calcareous fibrous nodules of embolic nature in

the lung 43

Fig. 8. Male guinea pig infected with glanderous material 45

Fig. 9. Agglutination 49

Fig. 10. Schematic representation of complement-fixation

reaction 54

Fig. 11. Complement-fixation experiment 55

Fig. 12. Schematic representation of conglutination reaction 59

Fig. 13. Mallein, antimallein and complement 61

Fig. 14. Ophthalmic reaction 65

Fig. 15. Ophthalmic reaction; degree of reaction 67

Fig. 16. Agglutination and fixation titre and ophthalmic

reaction during the course of a glanders case. . 74

Fig. 17. Bacillus anthracis 85

Fig. 18. Precipitation experiment in anthrax 94

Fig. 19. Negri bodies in a ganglion cell 99

Fig. 20. Female Sarcoptes communis 113

Fig. 21. Female Psoroptes communis 115

Fig. 22. Sarcoptic mange 119

12 ILLUSTRATIONS

PAGE

Fig. 23. Trypanosoma equiperdum 155

Fig. 24. Unpigmented spots on the vulvar lips in dourine. . 157

Fig. 25. Swelling of the udder in dourine 159

Fig. 26. Swelling of the testicle and penis in dourine 161

Fig. 27. Pustular skin eruption 163

Fig. 28. Scheme of contagious pleuropneumonia sectioned

lung 169

Fig. 29. Diphtheroid lesions on the mucosas of the upper

and lower jaws in rinderpest 177

Fig. 30. Reddening of the gums with loss of substance and

fibrinous layers in rinderpest 179

Fig. 31. Losses of substance wnth diphtheroid layers on the

hard palate of cattle in rinderpest 181

Fig. 32. Heifer sick with rinderpest 183

Fig. 33. Diphtheroid lesions on the mucosa of the tongue

and pharynx 185

Fig. 34. Hyperemia of the abomasum in rinderpest 187

Fig. 35. Striated hyperemia in rinderpest 189

Fig. 36. Portion of small intestine showing striated and

patchy hemorrhages of the mucosa in rinderpest 190 Fig. 37. Acute inflammation of the gall bladder in rinderpest 191

Part One

HORSE HOSPITALS AND HORSE DEPOTS PROBLEMS OF HORSE HOSPITALS AND DEPOTS

It is an obvious necessity that the army be supplied with horse hospitals and horse depots, maintained in the interests of the health of horses and the prevention and combating of infection diseases. Opportunity must be given to the righting and marching army divisions to ship behind the battle fronts for treatment their sick horses, as well as those horses that ai*e unable to travel. For this horse hospitals must be provided. In order to meet the demand at all times, army divisions must also be given opportunity to replace rapidly any horses that have either died or become sick. With this object in view, horse depots should be placed near the front, which will supply a great number of serviceable, healthy horses, destined for the front. It has been proved expedient to separate entirely the horse hospitals from the horse depots, in order to prevent any infection of horses at the depots through the medium of sick horses which have been returned from the troops, and in that way keep these horses at the depots serviceable and free from disease. Since the very sick horses or horses otherwise made unfit for war purposes are sent back home, suitable hospitals should be made available for these returning animals. In a like manner horse depots should be arranged at home and in the army corps in order to receive healthy horses destined for the front.

Besides caring for those animals showing external disease, it becomes the duty of the horse hospitals and depots to combat all possible infectious diseases with the best available methods, special attention being directed to glanders. Since many of the hospital horses that are useless for war purposes, are returned to the civil population, proper preventive measures are carried out at the hospitals to preclude the spread of a communicable disease to the horses of the civil population ; and, on the other hand, it becomes the problem of the depots to prevent the transmission of diseases from horses from home to the army horses of the fighting' troops.

ARRANGEMENTS OF HORSE HOSPITALS AND DEPOTS

In order to prevent the spread of diseases, it is necessary that all horse hospitals and depots have three-room stables, each of which is separate from the others. Stable No. 1 serves to receive the incoming horses ; stable No. 2 receives such horses as have been shown to be infected, and is comprised of three divisions in which are kept the—

(a) Glanders suspects.

(b) Strangles cases.

(c) Horses infected with other diseases — all being separated from one another.

Stable No. 3 is intended for those horses known to be absolutely free from infectious diseases and which are ready for distribution.

The stables must provide separate drinking troughs and mangers; in case this is not possible it becomes necessary to erect heavy partitions; and even individual nose-bags must be provided, for feeding and watering the horses in some instances.

All horses are to be examined for symptoms of glanders before they are given quarters. The glanderous horses should be killed immediately and not allowed to be placed in these stables. Every horse is to be given a serial number which is best done by cutting it into the hair, or burning it on the hoof or braiding a numbered card in the mane or tail. Before horses leave the hos-

HOUSE HOSPITALS AND DEPOTS 15

pitals or depots they are to be subjected to the ophthalmic mallein test and, as far as possible, to the serodiagnostic tests.

Division Horse Hospitals

In order to relieve the fighting and marching troops of the severely sick horses and others unfit to travel, a hospital must be arranged in the neighborhood to care for such animals; i.e., a division horse hospital. The division horse hospitals are to be made mobile since they must follow the troops, even though they follow at a slower rater of speed. It is therefore necessary that they send such animals, which require a long time to cure or those not fit to travel or to be used in war, to the corps or army horse hospitals in the rear.

Staff Veterinarian Ohm very kindly made some valuable suggestions to me by letter. According to him, all horses must be carefully marked so that those discharged from the division hospital as cured can be returned to the regiment and officers from which they came. In this way only, will the confidence in this arrangement be kept and strengthened and an early delivery of sick and other horses needing careful handling, be made possible. This is of special interest in order quickly to restore the horses and rapidly to make them serviceable again. It is necessary to inscribe the serial number of the hospital on the left side of the horse's neck by cutting the hair, and to renew the regimental brand on the left side of the cheek ; in such cases, where horses belong to officers, a leather tag with the officer's name on it is braided into the tail. All horses placed in the receiving stable No. 1 are immediately groomed and well cared for; in the evening the ophthalmic mallein test is applied and blood is withdrawn for serodiagnosis. Horses found, by means of the biological tests, to be infected with glanders are immediately killed and buried according to instructions. Horses that react doubtfully are subjected to further observation and examination by means of the usual methods in stable No. 2, division for glanderous suspects. In a similar manner the remaining horses are distributed to the different divisions of the stable, depending on the conditions from which the horses are suffering. Horses showing fever and suffering from an incurable external malady are killed and buried, whereas those that do not give evidence of having fever are sold to the slaughterer.

Horses which can not be used any longer by the troops, but which are still serviceable for farm work, must be immediately sent to the permanent horse hospitals and sold there.

Thoroughly experienced practicing veterinarians are selected for the horse hospitals; and, beside the commanding veterinarian, it is necessary to have one veterinarian to about every 100 horses.

Dietetic forage (bran, linseed oil cake, crushed oats, etc.) must be provided for the horses which are in poor physical condition or very sick.

Corps or Army Horse Hospitals

The corps or army horse hospitals afford a place to care for the sick horses and combat the infectious diseases according to the instructions given. Such animals, that are either difficult to cure or known to be incurable or unfit for war purposes, should be sent to the immobile hospitals at home.

The corps or army horse hospitals are to be equipped with a plentiful supply of modern veterinary operating apparatus such as the excellent portable collection arranged in a synoptical manner in a box offered by the Hauptner firm (Berlin).

These hospitals also have to supply suitable transport

HORSE HOSPITALS AND DEPOTS 17

ambulance wagons in order to get those horses which are unfit for travel from the division hospitals, or to take them to the nearest railroad station so they may be sent home.

It would also be useful to have a laboratory connected with the corps or army horse hospitals which would be equipped with microscopes, staining utensils and glassware in which ordinary bacteriological examinations could be carried on. Dissecting instruments are to be kept on hand and dissecting rooms arranged where, as occasion arises, the post-mortem examination of horses suffering with infectious diseases (glanders) ought to be performed in order to insure an orderly examination and disposition of the cadaver.

Immobile Horse Hospitals

We then finally come to immobile horse hospitals back home, which receive those horses that require prolonged treatment or that need to be especially cared for, and which transfer with the usual caution the unfit horses to the civil authorities. The horses that have been cured and shown to be free from infectious diseases and their usefulness determined, can be given over to the permanent horse depots at home.

Immobile Horse Depots

The duty of the immobile horse depots is to determine whether the horses that are well and serviceable for war purposes, from the immobile horse hospitals, as well as the newly purchased horses from home, are free from glanders ; this is done by means of the ophthalmic mallein test and blood examination. These horses are to be trained so that in the event of their being needed at the front, they may be sent as horses accustomed both to the saddle and wagon.

18 EPIZOOTICS: THEIR CONTROL DURING WAR Mobile Horse Depots

In case no direct transportation of horses to the troops is desired, they are then sent from the immobile horse depots to the mobile horse depots of the army or army corps, from where the required horses are given over to the individual bodies of troops.

GENERAL MEASURES FOR THE PREVENTION OF INFECTIOUS DISEASES

Inspections of the horses are to be carried out at least every 14 days. The horse depots, horse hospitals and military formations often come in contact with strange horses and when infectious diseases are actually present in the military formation or in their neighborhood, inspections should be repeated every seven days. Notice should be taken that at these times all horses should be examined.

Horses recently assigned to troops are held separate until the veterinary examination shows them to be free from infectious disease, after which they are allowed to enter the military formations. Captured horses are not to be placed with the regular army horses until, by the use of the ophthalmic test or serological tests, they have been shown to be free from infectious diseases, especially from glanders.

To prevent the nasal discharges and saliva of sick horses from soiling drinking and feeding utensils, such articles should not be allowed to be used in common. In that way the chief sources of spreading infectious diseases like glanders and strangles are overcome. Before occupying stables the mangers should be carefully cleaned whenever circumstances permit. The bedding is removed whenever possible; and where a permanent bedding is used the upper layer, at least, should be changed.

BLOOD EXAMINATION STATIONS 19

Periodic disinfections of the hospitals and depots should be carried out by using formalin and milk of lime, for which special apparatus must be provided (see chapter- on disinfection on page 21).

The changing and mixing up of horses during the movement of troops or while they are in their quarters are to be limited as far as possible.

The placing together of army horses or bringing them in contact with horses of the civil population is to be especially avoided. Cattle and sheep barns, and sheds and granaries are to be used whenever possible.

Stables in which infected horses are stalled or have been stalled are to be marked with distinct and substantial inscriptions, stating the name of the disease in question. Furthermore these inscriptions should designate the branch of the service and the time of departure of such troops. Infected places should not be allowed to be occupied by strange horses.

By regular and repeated instructions, the troops are to be taught how to recognize infectious diseases of horses and how to combat them. All horses that are to be given over to a horse hospital or depot or sent back home, must be branded with the insignia of the branch of the service from which they have come, or marked in some other manner, so that in case of inquiry regarding a glanderous case it can be determined from what body of troops the horse originates.

BLOOD EXAMINATION STATIONS

IMMOBILE BLOOD EXAMINATION STATIONS

Near the front at suitable and conveniently centralized points, blood examination stations are located. It is the function of those in charge of these stations to examine, for glanders-antibodies, with the agglutination and complement-fixation methods, the blood of all horses within their province. The blood examination stations are supplied with trained veterinarians and the necessary helping personnel in order to handle the large amount of work required of them. They provide laboratories which make it possible to examine 1,000 or more horses per day.

The equipment of the laboratory consists of waterbaths with racks that, at the same time, will receive 100 or more test tubes, winch can be regulated ; centrifuges, pipettes, test tubes, centrifuge tubes, bottles, small animal cages, etc., as well as the necessary washing apparatus for cleaning the glassware. From these laboratories suitable boxes are also forwarded containing centrifuge tubes necessary for the examinations and bleeding needles; also the examination lists are to be placed in these boxes (see chapter on glanders on page 29).

MOBILE BLOOD EXAMINATION STATIONS

It was found necessary, especially when difficulties in transportation were to be taken into consideration, to have, besides the immobile ones, mobile blood examination stations, which could move forward with the quickly advancing troops, in order not to delay the results of the examinations through the long transportation of the blood samples. These blood examination stations are equipped with wagons, automobiles, etc., with which means the blood can be collected direct from those bodies of troops that must be examined. The equipment of the mobile examination stations is similar to that of the immobile ones except that they are provided with smaller apparatus on account of their smaller range of activity. The arrangement has the advantage that the apparatus necessary for the blood examination can easily be packed and in emergency can be shipped to a more favorably located point, where a new mobile blood examination station is to be fitted out.

By disinfection we mean the freeing of objects from infectious materials, everything living or dead which can cause infectious diseases in man or animals being looked upon as infectious matter. The disinfection consists of (1) the mechanical removal of the infectious materials; (2) the killing or preventing the growth of living disease-producing agents. It is necessary that objects to be disinfected undergo a mechanical cleaning process first; without following such a procedure it is questionable whether effect of the disinfection reaches such objects and no proof can be given that all infectious matter is destroyed.

Disinfection is effected in several different ways. In some cases it may result in the infectious material disintegrating entirely as by the use of antif ormin ; in other cases it depends on the osmotic disturbances which may lead to the death of delicate bacteria. Likewise, oxidizing processes may assist in the rapid extinction of bacteria. However, the destruction is mostly done by coagulating the living protoplasm. The lesser effect of dry heat in contrast to that of moist heat can be easily accounted for by this method; also the greater resistance of spores, as a general rule, compared to the vegetative forms of life. The vegetative forms contain decidedly more water (80%) than the spores. As a result of this greater water content, they are more easily coagulated and are, therefore, destroyed at lower temperatures than the spores, which contain little water. Moist heat has a stronger effect than dry heat because in this way moisture is brought in contact with the spores so that the albumin is caused to coagulate more quickly.

Most of the disinfecting agents, including those which form gas, work best in watery solutions ; therefore, as an example, concentrated formaldehyd gas or absolute alcohol is not good for disinfecting purposes, but, the moment these substances are diluted with water, their disinfecting powers are very materially increased.

Oils are not suitable as vehicles for disinfectants for they prevent water from penetrating the bacteria. Albumins hinder the disinfecting power in the same way, since they form insoluble compounds with metals. To demonstrate : bichlorid of mercury will kill anthrax bacteria in a 1 to 500,000 watery solution, but in an albuminous solution, not in a weaker solution than 1 to 1,500. The following demands are to be made of disinfectants : They must —

1 — act quickly,

2 — be readily soluble in water, 3 — be cheap and easily kept, 4 — not too poisonous, 5 — have recognizable odor, 6 — be as little injurious as possible to the objects which are to be disinfected.

DISINFECTION OF EQUIPMENT

Disinfection of metal objects, cbains, etc., is best done with fire. Parts of harness should, as far as practicable, be left in a disinfectant for some time (bacillol, creolin, lysol). If this is not possible they should be carefully cleaned and then washed with a disinfectant.

DISINFECTION OF STABLES AND RAILROAD CARS

Disinfection of these places must necessarily be preceded by a mechanical cleansing. Litter that may be present, is to be removed and stowed away in some outlying spot, or eventually burned. We may proceed as follows : A layer of noninfected manure, straw or peat is placed on the floor of the stables or cars about 25 cm.

deep, 1.5 to 2 m. wide and of desirable length, and on this the manure to be disinfected is piled with slanting sides about 1.25 m. high. On top of this pile is placed a layer of noninfected manure, straw, leaves, peat or other loose material about 10 cm. thick ; if this is done in the open the pile is then covered with a layer of earth about the same thickness. Further disposition of this material may then be made as suggested above. This is to be followed by a thorough mechanical cleaning of the floor, walls and ceilings of the respective quarters. Steam is best for this purpose, although brushing with stiff brushes and hot soda water must suffice in most instances.

After the cleaning the disinfection follows. Any of the various disinfectants may be used for this purpose. The simplest and safest is to disinfect with formaldehyd, milk of lime or milk of chlorinated lime. Attention is called to the fact that in the field one has to deal chiefly with the killing of the nonspore-bearing bacteria. "When sporulating bacteria (anthrax) are in question, it is important that the disinfection be more thorough.

(a) FORMALDEHYD

Formaldehyd (CH,0) is derived by oxidizing methyl alcohol (Ch 3 OH).

CH 3 OH + = CH 2 + H 2 Methyl alcohol Formaldehyd

This is done by passing the methyl alcohol vapors mixed with air over glowing spirals of platinum or copper, and while these vapors are cooling a solution of formaldehyd is yielded. By passing this into water a solution of formaldehyd of about 40 per cent strength — formalin — is obtained; this is better known in the Pharmacopoeia as formaldehydrin solution.

Use of Formaldehyd

The best disinfecting action from formaldehyd can be gotten when formaldehyd and water are heated, and a sufficient quantity of the mixed vapors developed to saturate a given area (Fliigge). Five per cent solutions of formaldehyd (12.5 per cent formalin) have proved themselves to be most effective. Therefore the dry formaldehyd preparations which can be obtained on the market are not suited for disinfecting purposes; the formaldehyd must be diluted with water and applied in the form of vapor. In order to vaporize diluted watery formaldehyd solutions, an apparatus which has been recommended by Fliigge 's has proved to be very good. It consists of a kettle for the formaldehyd solution and above is a little spout (Diise) which leads the steam away. Below the kettle an alcohol lamp is placed. Both the kettle and alcohol lamp are encased in a metal covering in order to prevent any loss of heat. For an area of 10 cb. m. which has been tightly closed and where several hours' disinfection is desired, one liter of formaldehyd solution, i.e., 50 grams formaldehyd or 125 grams formalin, is necessaiy. When applying the formaldehyd process, it is always necessary to tightly close the building so as to prevent the entrance of air or exit of formaldehyd vapors.

Formaldehyd remains in the building for quite a while and irritates the mucous membranes. One can overcome this disadvantage in human medicine by the introduction of ammonia into the disinfected room by which means the formaldehyd is changed to neutral hexamethylentetramin. For this purpose about 150 e.em. commercial, 25 per cent ammonia should be vaporized for every 100 c.cm. formol or 40 gm. formaldehyd. The ammonia vaporizers are given to the formaldehyd disinfectors (in human medicine) but can be dispensed with in veterinary medicine. For the vaporization and distribution of the formalin one can use an apparatus as seen in the accompanying illustration ; the segmented sheet lead cans serve as containers for the formalin, alcohol and ammonia. The catalogue of Leitz-Bergmann,

VSC-jj^--

FlGURE 1

Formalin disinfection apparatus according to Fliigge, model 1914, of the main sanitary depot of Berlin.

Berlin, lists this apparatus with all the parts at 127.50 Mk. ; without the ammonia developer, 110 Mk.

Besides the formaldehyd vapors one can use one to one and one-half per cent formaldehyd solution, which is best applied by using a fire water-pump or a disinfecting apparatus as is used for the spraying of milk of lime. Schniirer recommends that disinfection with formaldehyd solution be repeated after an interval of one to one and one-half hours, since by this method a stronger and more lasting action is obtained. For the disinfection of a railroad car he uses each time 30 liters of a one per cent formaldehyd solution, 15 liters being sprayed through one door and 15 through the other. When repeating he uses a like amount, which makes a total of 60 liters of a one per cent formaldehyd or 2.25 per cent formaldehyd solution for such an area. In disinfecting a stable a similar procedure is to be followed. In order that the disinfector may not be too much annoyed himself by this preparation, he must station himself in the stable door or some other place which opens on the outside and from there spray all corners and angles of the stable.

(b) MILK OF LIME

If formaldehyd can not be had, milk of lime or milk of chlorinated lime will give good results.

Milk of lime is best applied by the use of a pressure apparatus. Such disinfection apparatuses are provided with a hand pump, pressure hose and long nozzle. They can be carried on the back and hold 25 liters, or are transportable and contain 60 liters. If such apparatuses are lacking one can use a brush or scouring rag fastened to a long stick.

The preparation of milk of lime is done as follows:

One slakes the lime (CaO) by sprinkling it evenly with one-half its quantity of water until it is entirely pulverized. ^ ^ ^ = ^ ^^

quick lime slaked lime.

By mixing the slaked lime (pulverized hydrate of lime) with different quantities of water, milk of lime can be made to any desired strength.

Thick milk of lime is made by adding three liters of water while gently stirring to one liter of freshly slaked lime.

Thin milk of lime (5 per cent milk of lime) is prepared by adding 20 liters of water to one liter of freshly slaked lime. In case freshly slaked lime is not to be had, one can also prepare the milk of lime by mixing to every liter of slaked lime 3 to 20 liters of water.

The unslaked lime in the lime quarry remains unchanged approximately four years, since on the surface a thin layer of carbonate of lime is formed which prevents the penetration of air into the depths of the lime. This upper layer in lime quarries is not suitable for disinfecting purposes and must first be removed. The milk of lime should be thoroughly stirred before using and in case one wishes to apply it with a spraying apparatus, it should also be passed through a sieve in order to prevent any clogging of the apparatus.

(c) MILK OF CHLORINATED LIME

Milk of chlorinated lime is produced from chlorid of lime. Thick milk of chlorinated lime is made by slowly adding one liter of chlorid of lime to three liters of water, stirring it all the while. Thin milk of chlorinated lime is made in the same manner except that 20 liters of water are used instead of but three. It is to be noted that the chlorid of lime must be kept in a closed vessel where it is protected from light and must have a strong chlorin odor. Milk of chlorinated lime should always be freshly prepared before using.

(d) CRESOLS

Cresol is obtained by first adding lye to coal tar from which a shake extract is then made. This is acidified and distilled at 200° C. (392° F.). The various cresols are soluble in water only to the extent of five per cent; the addition of soap increases the solubility. Such mixtures can be used as disinfectants with very little fear of poisoning and are on the market under the following names: liquor cresoli saponatus (earboxal I); carboxal II (substitute for ereolin) ; bacillol; diluted cresol-water, e.g., liq. eres. sap. 50, aq. 100.

(e) PHENOLS

Coal tar, distilled at 200° C. (392° F.) which contains 40 per cent phenol, is shaken with lye and then mixed with hydrochloric acid ; the phenols floating on the surface are removed and distilled. Pure carbolic acid becomes red when exposed to air and readily decomposes. When wishing to keep it for some length of time it is better to use carbolic acid liquefied with ten per cent water.

Three per cent phenol solution is made :

Acid carbol. liquef 3

Aq. font 100

(f) BICHLORID OF MERCURY

Tablets of bichlorid of mercury contain equal parts of bichlorid and sodium chlorid (NaCl). Bichlorid of mercury is obtained by dissolving mercury in nitrohydrochloric acid and then evaporating this to the point of crystallization. Its solubility is increased by the addition of sodium chlorid. A 1 to 1,000 solution destroys vegetative forms and a 1 to 100 solution destroys spores in a short time.