'IRAQ AND THE PERSIAN GULF' [‎274v] (551/862)

PUBLIC HEALTH AND DISEASE
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walking unshod on ground polluted with human faeces. The larvae
make their way through blood-vessels, heart, lungs, trachea, throat,
and stomach to the small intestine, where they reach maturity and
attach themselves to the gut wall. The worms are small, the males
being 6 to 8 mm. in length and the females 10 to 12 mm.; they are
readily killed by drugs, but with the present lack of even elementary
sanitation early reinfection is probable.
After A. duodenale the round worm [Ascaris lumbricoides) is second
in prevalence. Of no great pathological importance, it may give rise
to fever and other symptoms in children. Evidence of Ascaris has
been found in 13-6 per cent, of apparently healthy Iraqis.
The tape worm (Taenia saginata) is less common in Iraq than in
Syria and Lebanon, possibly because Iraqis eat well-cooked meat; it
was found in o-6 per cent, of 1,000 persons examined.
Hydatid Disease
Man may act as the intermediate host of the small cestode worm,
Echinococcus granulosus, the adult form of which is found in the dog’s
intestine. Infection results from the ingestion of the eggs of this
worm. The larvae that escape from the eggs penetrate the gut wall
and not infrequently reach the liver, lung, or brain. The larva in
process of development forms multiple cysts which may attain a very
large size. The position and size of these hydatid cysts determine the
nature and severity of the disease, and surgical operation is often
necessary.
Iraq is prominent among countries in which this disease occurs.
Between 1935 amd 1938, of all admissions to the Royal Hospital at
Baghdad, 107 or 1 in 319 were suffering from it. It may be possible to
eliminate the disease in large towns, but hardly in rural areas where
the association of man with dog is close.
Undulant Fever
Brucellosis or undulant fever is a febrile disease of long duration,
caused by a minute organism Brucella, communicated to man from
cattle, sheep, or goats. There are two closely related species, B.
abortus, the cause of contagious abortion of cows, and B. melitensis,
the infection common in goats and sheep. In man B. melitensis is the
cause of that form of undulant fever that was once called Malta fever,
which is endemic in Iraq and not infrequent.
Only 17 cases of undulant fever were notified in 1939, and only 10
were treated in medical institutions, but these figures bear no relation