Malta or Mediterranean fever was renamed undulant fever when its wider geographical distribution became appreciated; the latter title being derived from the character of the patients' temperature charts. The disease, probably first introduced into Malta during the Crimean war, quickly became a permanent scourge of the island with a high death rate - the result of large numbers of both the civilian and garrison populations suffering attacks of this lengthy and debilitating illness. Sir David Bruce's discovery in 1887 of the causative organism, and the part he played later in demonstrating the role of the goat in spreading the fever, eventually resulted in the eradication of the disease from Malta.
It was while serving in Malta as an army medical officer that Bruce became concerned with the problem of Malta fever. He was convinced that the disease was due to some form of bacterial infection and concentrated his efforts on a search for the causative organism. Within two years he was successful for, in the speens of patients who had died of the disease, he discovered a 'micrococcus', and by careful experiment proved conclusively the aetiological significance of the organism, which he called Micrococcus Melitensis.
In 1920 Tensier and Meyer placed the organism in a separate genus, with the name Brucelia in honour of its discoverer and it became known as Brucella Melitensis.
Bruce's discovery of this organism had little immediate effect on the control of the disease, but the introduction in 1897, by Sir Almroth Wright and Frederick Smith of an agglutination test for the diagnosis of undulant fever was the first step in bringing it under control.
In 1904, twenty years after his intial discovery, Bruce returned to Malta and played an important part in the final conquest of the disease. Investigations showed that the disease was scattered across many different districts of the three islands. The density of the population was one of the highest anywhere in the world, and most families were crowded together in tiny houses. Contaminated water and poor hygiene were at first blamed for the disease.
In 1905 Themistohles Zammit (1864 - 1935), a Maltese member of the Commision for the investigation of Mediterranean Fever, the twelve-man team of experts headed by Bruce, then back in Malta, implicated goat's milk as the disseminating vehicle. The disease was conquered when goat's milk was eliminated from the diet of the Malta garrison. The eponymous term brucellosis has now replaced such names as Malta, Mediterranean and Udulant fever. |
