"العراق والخليج الفارسي" [و‎‎٢‎٧‎٣] (٨٦٢/٥٤٨)

PUBLIC HEALTH AND DISEASE
421
imported from Persia, as is indicated by this distribution. Iraqi
Kurds are in frequent communication with Persian Kurds and there is
seasonal migration across the frontier. Shia pilgrims from Persia have
also occasionally brought infection, Kirkuk province being naturally
the most exposed to these contacts.
Typhus is a louse-borne infection, which has been most prevalent
from April to June. Little is known of the lousiness of the Iraqi, but it
is said that the long hair of the tribesmen is invariably infested with
lice.
During 1917 and 1918 there were 385 cases of typhus among Indian
troops and 149 cases among the British, contracted from Turkish
prisoners of war, Arabs, and refugees. A further 59 cases were
reported in 1919. The case mortality rate of these military cases was
227 per cent.
Preventive measures are directed against lice on clothes and persons.
Inoculation has recently been practised in some countries on a large
scale, but, though many forms of vaccine have been used, it is im
possible yet to dogmatize on its practical value.
Intestinal Infections
Intestinal infections are extremely prevalent in Iraq and they con
tribute largely to the high infant mortality rates. Contaminated water-
supplies, flies, dust, the absence of sanitary methods of excreta dis
posal, and ignorance of elementary rules of hygiene sufficiently
explain this wide prevalence. Prominent among the intestinal infec
tions is dysentery.
Dysentery
In 1939 the cases of dysentery treated in the medical institutions of
Iraq numbered 32,039. Of these, 27,888 were diagnosed as amoebic
dysentery, 1,395 as bacillary dysentery, and 2,756 were undefined.
Only 15,725 cases were notified to the Health Department and of
these 15,541 were amoebic; 159 °f the amoebic cases and 2 of the
bacillary cases ended fatally. Cases were reported from all provinces
and in every month of the year. The greatest prevalence was from
April to August, but cases of amoebic dysentery were also numerous
in December and January.
Dysentery came next to malaria as the chief cause of sickness among
British and Indian troops from 1914 to 1918, when the average annual
admission rates were 70-3 (British) and 35*7 (Indian) per 1,000. In all
other theatres of war bacillary dysentery was much more in evidence