Weilsche Krankheit im Küstenland

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Abstract
This paper comprises the substance of an address given to Medical Officers of the German Army of Occupation in Holland, and includes a discussion of certain infections to which the troops scattered along the Western sea-board of Europe might be exposed. There is a brief reference to the possibilities of a smallpox epidemic, since in Holland for many years vaccination has not been compulsory, and the position in the country is now most unsatisfactory from that point of view. Malaria is next discussed, since the disease is still present in certain parts of Holland, but there are now very few cases, and no deaths from it have been reported since 1920. Reference is made to the ill-fated English Walcheren Expedition, but the very high % of sickness and deaths from diseases among the troops is not generally considered to have been due to malaria, but to a combination of diseases, among which intestinal infections seem to have been the most important. The author devotes most of his paper to a general discussion of Weil''s Disease which is 4 to 5 times as common in Holland as in Germany. Attention is called to the fact that during the past 10 yrs. at least 50-75 cases of the disease have followed accidental falling into ditches and canals. These ditches are liable to be infested with rats which may contaminate the water with the infective agent. It is pointed out that owing to the "black out" people are more liable to fall into ditches and canals, especially if they have been drinking. The disease is easily recognized if icterus develops, but when sending specimens of blood and urine to the laboratory for diagnosis it is important that the day of the illness should be given. Mild cases are often not diagnosed but are not very serious, since out of 158 mild cases without icterus no deaths occurred. On the contrary, out of 272 typical cases with icterus there were 52 deaths, and without treatment the mortality would doubtless have been higher.

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