OBSERVATIONS ON MASS CHEMO-PROPHYLAXIS WITH SULFADIAZINE

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Abstract
20,000 soldiers were given daily prophylactic medication of 1 gm. of sulfadiazine, for 5 wks. They were instructed to report any untoward reaction such as rash, sore throat, nausea, etc., and medical officers were advised to be on the alert for toxic manifestations. Weekly admission rate for common respiratory diseases was reduced by 33-59%. Duringthis period no cases of meningitis occurred , and there were only 4 rheumatic fever admissions; during a like period, prior to prophylaxis, there were 10 rheumatics admitted; again 10 during the same interval immediately following cessation of the program. Within 2 wks. following cessation of prophylaxis, there were 2 new cases of meningitis. Lobar pneumonia declined, approx. by 1/4, and there was no influence upon the incidence of scarlet fever, There were 63 individuals who reacted adversely to the drug, none seriously. Skin reactions were present in 52 of all reactors ; 30 had pyrexia and rash. Mild angioneurotic edema in-volving eyelid, cheeks and wrists, nausea and vomiting oc-curred in this group. Among the other reactors, several de-veloped areaction comparable to serum sickness, reacting either immediately or after an incubation period of 6-14 days. In military establishments where troop population is constantly augmented by men fresh from civilian life, routine admn. of sulfadiazine prophylaxis appears to be a potent means of re-ducing infection rates. Its similar and timely application in civilian life especially in institutions such as schools, camps, asylums, etc., is fully as promising in reducing the incidence of certain diseases and their sequelae. Admn; of sulfadiazine even in small doses in the presence of a history of previous reactions is contraindicated.