4. Private horrors

‘Private horrors’ details the experiences of plague, looking at narrative sources illustrating how people coped. There were always two stories to tell about plague. One is about heroes undeterred by contagion, the other about victims of harsh officialdom and of quarantine measures. The fullest accounts tried to combine the two and show men and women, physicians, churchmen, magistrates, and citizens trying to cooperate in impossible circumstances. Most poignant of all are expressions of the pain and loss created by one of plague’s cruellest features: the heavy mortality it inflicted on single families and households, as relatives and servants died one after the other.

Soil-borne Septicaemic Colibacillosis in Neonatal Lambs: Salient Observations

Background: In sheep, Escherichia coli infection can occur as asymptomatic entity to septicaemic episode. Chiefly, it causes heavy mortality in lambs and devastates the farm economy. With an objective of documenting the salient epidemiological and clinico-pathological observations in this naturally occurred outbreak of septicaemic colibacillosis, this communication is made herewith. Methods: In February 2019, sudden death in lambs was observed in three flocks of sheep. Carcasses were subjected for necropsy and histopathological examination. Swab samples from heart, abomasum, intestines, liver and lung were examined for bacteriological and molecular confirmation. Result: The mean (±SE) age of lambs that were affected was 11.00 ±0.49 days (n=404). Lambs of native Malpura breed (87.5%) and other two crossbred sheep were affected. Overall mortality of lambs was 23.76%. Gross pathological observations were pulmonary edema, ecchymotic lesions in lungs, congestion in kidney and liver and presence soil-mixed ingesta in abomasum. From the morbid materials including stomach and intestinal swabs, 45 E. coli isolates were identified and they were also confirmed on polymerase chain reaction (PCR). Consequently, virulence genes for shiga toxin (stx2) and intimin (eae) were identified from the isolates. Although antibiotics were administered, only probiotics could control the new infection rate.

Climate change risks and mitigating measures of freshwater aquaculture in unmanaged ponds of Kaushambi district U.P.

The purpose of the study is to identify various climatic change risks encountered by fish farmers while doing freshwater aquaculture in the unmanaged ponds of district kaushambi Uttar Pradesh. The various climate change risks which were faced by rural farmers of Kaushambi are water quality, flooding of ponds, less rain, heavy mortality of fishes, planktonic collapse, long dry spells, disease outbreak, destruction of embankments etc. The study also includes the measures to encounter these risks. To maintain the quality of water the farmers have used lime, manure, alum, KMnO4, salt and exchange of water. To control the flooding of ponds the farmers raises embankments by bamboo fencing with net. They have filled their ponds with pumps from canals / rivers and tube well water to face the problem of less rain and long dry spells. To avoid the heavy mortality of the fishes they have used early harvest, liming, shading and water movement by beating of water for oxygenation. To overcome with the planktonic collapse the farmers have used cow dung, gobar gas slurry, use of khari, choker in the water and exchange of 50 percent water. To control the disease outbreak the farmers have adopted lime, KMnO4, medicines, neem leaves, banana stem etc.

Infectious Endocarditis in Sub-Saharan Africa: Epidemic-Clinical Aspects, Evolutionary and Prognostic: Multicentre Study on 81 Cases Followed Over 1 Year in Lomé (Togo)

Introduction: Infectious endocarditis remains a relatively common, serious pathology and suffering heavy mortality in sub-Saharan Africa. Purpose: The objective of this study was to describe the epidemic-clinical, evolutionary aspects patients hospitalized for infectious endocarditis and assess their prognosis. Methods: This is a prospective, 5-year, multicentre study of 81 hospitalized patients and treated for infectious endocarditis. These patients were followed for at least a year. Results: We observed that in our sub-Saharan context, patients who suffer from infectious endocarditis are often young, with an average age of 30 years. Rheumatic valve disease and congenital heart disease underlying the most frequent. Blood cultures are often negative, making it difficult the choice of appropriate antibiotic therapy. Surgical treatment (heart surgery) is difficult to access (2% in our study). As a result, the mortality is very high (63% at 1 year), with a survival rate of only 37% at 1 year. Conclusion: Our study shows that despite progress in diagnosis and therapeutic management, infectious endocarditis remains a pathology serious with heavy mortality in sub-Saharan Africa. It is important to highlight the importance of prevention, early diagnosis of infectious endocarditis, and especially the need for early medical-surgical management of these patients to improve their prognosis.

Complications of typhoid fever in digestive surgery: a descriptive study based on 295 cases in a sub Saharan environment

Background: Typhoid fever is endemic in sub-Saharan Africa. Inadequate management often leads to complications, which are mainly surgical. Surgical complications are fraught with heavy mortality. Objective: To describe the surgical and digestive complications of typhoid fever in the Surgical Department of Tenkodogo Regional Hospital in Central-Eastern Burkina Faso. Methods: This was a descriptive study performed in the digestive surgery department of Tenkodogo Regional Hospital. It covered the period from January 2014 to December 2018. The records of all patients who were admitted for a surgical complication of typhoid fever were included. Results: Two hundred and ninety-five patients were treated for a surgical complication of typhoid fever. There were 184 male patients (62.4%) and 111 female patients. Their average age was 15.7 years. The reported complications were peritonitis by ileal perforation with 212 cases (71.2%), acute cholecystitis with 45 cases (13.8%), primary biliary peritonitis with 23 cases (6.8%) and liver abscess with 15 cases (5.1%). Patients were operated on by laparotomy and laparoscopy under general anaesthesia. The ileal perforations were treated according to 3 surgical procedures: excision-suture of the perforation, resection-anastomosis at the same time and ileostomy with restoration of the digestive continuity after 3 weeks. In cases of acute cholecystitis or biliary peritonitis, a cholecystectomy was proposed. The liver abscesses were drained by laparotomy or by puncture. Antibiotic therapy was associated with surgical treatment. The average length of stay of patients was 9 days. Twenty-eight patients died, which represents 9.5% mortality. Conclusion: The surgical complications of typhoid fever are responsible for heavy mortality in digestive surgery.

‘It Is Necessary to Find a Way Out Soon, or the Russian People Shall Be Destroyed’: A ‘Plain-Speaking Petition’ to Authority of a Kozelsk Citizen in March 1919

The article studies the letter to authority that originated in the Kaluga gubernia, in which a man signed Roshchin expressed his extreme concern about the way the government policy of building a new life was implemented. The Kozelsk citizen resolved to write his ‘plain-speaking petition’ in March 1919, believing that the very life of the Russian people was under the threat. He considered it his duty to report to Moscow about ‘sinful and harmful’ doings in the uezd. He thought that uneducated, ignorant, and experienced leaders of socialism builders were unfit for authority. The peasant youths were bent on destruction of all things, that took centuries evolve, and yet had no clue about socialism. The new authority felt no need in seasoned professionals or skilled managers, its only interest was in making self-profit in troubled waters. Its activities in the sphere of trade and agriculture caused shortages or total unavailability of food and essential goods for local population. Under the new regime in education with its antireligious policy, schools resembled taverns where the songs, dances, and vulgar expressions could be heard all day long. Roshchin noted that health services were deplorable and starvation increased death rate daily. He had no faith in methods of economic management, he observed from the inside, and awaited a deadlock. Thinking over all facts stated in the letter leads to the conclusion that it was written by a passionate and active citizen, who involuntary witnessed and experienced the plight of the early days of the Bolshevik regime: hunger, cold, epidemics, heavy mortality, and total economic disorganization. Seeing ignorance, incompetence, and lack of ability in local leaders, party nominees from rural youth, who, he believed, were unfit to manage and had no good qualities, Roshchin feared to entrust them with his life and future and, seeing no other way, pleaded with the central government to take measures and save the nation. The letter sums up the most crucial drawbacks of the Bolshevik inner policy.

Periurban outbreaks of bovine calf scours in Northern India caused byCryptosporidiumin association with other enteropathogens

SUMMARYBovine calf scours reported to be caused by multiple aetiologies resulting in heavy mortality in unweaned calves and huge economic loss to the dairy farmers. Among these, cryptosporidiosis is an emerging waterborne zoonoses and one of the important causes of neonatal calf diarrhoea. Poor immune response coupled with primary cryptosporidial infections predispose neonatal calves to multiple secondary infections resulting in their deaths. In the present study, faecal samples from 100 diarrhoeic calves randomly picked up out of 17 outbreaks of bovine calf diarrhoea in periurban Ludhiana, Punjab in Northern India were subjected to conventional (microscopy, modified Zeihl–Neelsen (mZN) staining) and immunological and molecular techniques (faecal antigen capture ELISA and PCR) for detection of primaryCryptosporidium parvuminfection as well as other frequently reported concurrent pathogens,viz. rotavirus and coronavirus,Salmonellaspp.,Escherichia coli,Clostridium perfringensandEimeriaspp. The faecal antigen capture ELISA and PCR revealed 35% prevalence ofC. parvumin contrast to 25% by mZN staining with a relatively higher prevalence (66·7%) in younger (8–14-day-old) calves. The detection rate of the other enteropathogens associated withC. parvumwas 45·71% forC. perfringensfollowed bySalmonellaspp (40·0%), rotavirus (36·0%), coronavirus (16·0%),E. coli(12·0%) andEimeriaspp (4·0%) The sensitivity for detection ofC. parvumby ELISA and mZN staining in comparison to PCR was 97·14% and 72·72%, respectively. An important finding of the study was thatC. parvumalone was found in only 10% of the diarrhoeic faecal samples, whereas, majority of the samples (90%) showed mixed infections ranging from a combination of two to five agents. This is the first documentary proof ofC. parvumand associated pathogens responsible for severe periurban outbreaks of bovine calf diarrhoea culminating in heavy mortality from Northern India.

Population dynamics of Saissetia oleae. Ι. Assessments of ροpulation and mortality

The population dynamics of Saisselia oleae (Oliv.) (Homoptera: Coccidae) was studied in Corfu during five successive yearly generations (1981-1986). Successive estimates of the population of S. oleae were obtained within each of the five yearly generations and survivorship curves were constructed showing the progressive re­duction of the living population within each generation and population changes from generation to generation. The calculated mortality rates indicate that the population of S. oleae suffers heavy mortality. The major mortality factors were high temperatures during summer, the action of predators, particularly during spring, and mortality of crawlers during summer. Overall survival rate was very low and corresponded to total generation mortality that ranged from 99.693% to 99.987%. It is assumed that variation in the action of mortality factors cause considerable I’l Uctuations of the S. oleae population.

Survival and development of chicken ascarid eggs in temperate pastures

SUMMARYEggs of chicken ascarids (Ascaridia galliandHeterakisspp.) are believed to be hardy and survive for long periods. However, this has not been evaluated quantitatively and our study therefore aimed to determine development and recovery of chicken ascarid eggs after burying in pasture soil. Unembryonated eggs were mixed with soil, placed in sealed nylon bags and buried at 7 cm depth in pasture plots April (spring,n= 72) and December 2014 (winter,n= 72). Eight randomly selected bags per season were used to estimate pre-burial egg recovery [0 week post-burial (wpb)]. Eight random bags were removed at 5, 12, 23, 38, 52, 71 wpb per season and additionally at 104 wpb for spring burial. The content of each bag was analysed for numbers and development stages of eggs. Eggs buried in spring were fully embryonated within 12 wpb. In contrast, eggs buried in winter were developing between 23 and 38 wpb, so that all viable eggs seemed to be fully developed by 38 wpb. About 90% eggs disappeared within 23 wpb (spring) and 38 wpb (winter). Small proportions (2–3%) of seemingly viable and infective eggs were still recovered up to 2 years after deposition. In conclusion, most eggs buried in temperate pasture soil seem to experience a heavy mortality within a few months after the deposition, especially during warm periods. However, a small proportion of eggs may survive and remain infective for at least 2 years.

Neuromeningeal cryptococcosis in sub-Saharan Africa: Killer disease with sparse data

ABSTRACT Introduction: The extent of neuromeningeal cryptococcosis (NMC) has increased since the advent of HIV/AIDS. It has non-specific clinical signs but marked by high mortality. Objective: To analyze the characteristics of the NMC in sub-Saharan Africa. Materials and Methods: We have conducted a literature reviewed on the NMC in sub-Saharan Africa from the publications available on the basis of national and international data with keywords such as “Cryptococcus, Epidemiology, Symptoms, Outcomes and Mortality” and their equivalent in French in July 2011. All publications from 1990 to 2010 with 202 references were analyzed. The following results are the means of different studied variables. Results: We selected in final 43 publications dealing with the NMC which 24 involved 17 countries in Africa. The average age was 36 years old. The average prevalence was 3.41% and the average incidence was 10.48% (range 6.90% to 12%). The most common signs were fever (75%), headaches (62.50%) and impaired consciousness. Meningeal signs were present in 49% of cases. The mean CD4 count was 44.8cells/mm3. The India ink and latex agglutination tests were the most sensitive. The average time before the consultation and the hospital stay was almost identical to 27.71 days. The average death rate was 45.90%. Fluconazole has been the most commonly used molecule. Conclusion: The epidemiological indicators of NMC varied more depending on the region of sub-Saharan Africa. Early and effective taking care of patients to reduce diagnostic delay and heavy mortality remains the challenges.