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Trench Fever

III. INDUCTION OF CLINICAL DISEASE IN VOLUNTEERS INOCULATED WITH Rickettsia quintana PROPAGATED ON BLOOD AGAR^*,,

A Mexican strain of Rickettsia quintana isolated directly on blood agar from a volunteer trench-fever patient and passaged exclusively on this medium induced typical clinical trench fever in two of three volunteers. The etiology of their infection was established by xenodiagnosis as well as by recovery of the rickettsiae from their blood directly on blood agar. The recovered microorganisms produced typical extracellular infection in lice after intrarectal inoculation. The numbers of rickettsiae circulating in the peripheral blood of the two infected volunteers at various intervals after onset of disease were quantified. Both infected volunteers had antibodies in low titer, which reacted with a complement-fixing antigen prepared from a European strain of R. quintana cultivated on blood agar. The experiments established that the microorganisms propagated on cell-free media from the blood of trench-fever patients were R. quintana.

^* This study was conducted under the sponsorship of the Commission on Rickettsial Diseases of the Armed Forces Epidemiological Board and was supported in part by the U. S. Army Medical Research and Development Command, Department of the Army, Research Contract No. DA-49193-MD-2111, and in part by General Research Grant No. FR 5446 to the Harvard University School of Public Health.

The principles, policies, and rules of the Office of the Surgeon General, which govern the use of volunteers in medical research, were followed in this study.