In Malta the preventive measures arising from the recognition of the transmitting agent have been effectual in reducing the incidence of sand- fly fever. In 1909 there were 253 attacks registered among the British troops; they fell to 124 in the following year; in 1911 there were 125 cases, and last year, I believe, there was a further reduction.
The Ionian Islands — Corfu, Paxo,- Santa Maura, Cephalonia, Ithaca, Zante and Cerigo — were occupied by the British during the first half of last century. Every year summer epidemics of this fever are recorded. In 1828, at Santa Maura, the epidemic began in June and ended in November, but not before almost every individual had been attacked.
DoERR and Russ^^ have continued their researches on the fever in Bosnia and Herzogovina, of which Franz and Kolar^^ have made a clinical study. According to these authors the disease is prevalent in the Balkans. Professor Leon^^ announces that he has captured the phlebotomus in Roumania, and Gallio Valeric^* and de Jongh have found it north of the Alps in Canton Waadt, Switzerland.
Aravandinos^^ states that these flies are common in Greece. He has observed the occurrence of phlebotomus fever in Athens. In the Naval Reports it is seen that cases originate at Platea and throughout the Mediterranean generally, including the Riviera.
At Crete, Fleet- Surgeon Kilroy and Surgeon Adshead studied the infection experimentally. Miorcec and Laplanche^^ state that more than half the detachment of 200 French troops were attacked in July and August, 1910.
Sandfly fever was very prevalent among the British troops at Cyprus during the early years of the occupation. A few cases are still recorded annually.
MiJHLENS^' announces the presence of the phlebotomus and of the malady at Jaffa and Jerusalem. In 1864 Chaplin^*^ recognised this infection in Jerusalem, and distinguished it from malaria.
The fever is endemic in Asia Minor. The crews of our ships suffer when they are anchored off the coast.
From 100 to 300 attacks of sandfly fever occur among the British troops quartered in Egypt every year. Dr. Sandwith^^ has observed cases in Cairo. Phillips^ and Wakeling^^ also report instances in Cairo. Balfour'* has recognised the ailment at Khartoum. The phlebotomus is found throughout Egypt and the Soudan.
