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Meningitis on the Isthmus of Panama¹

1. In 457,701 admissions to Gorgas Hospital from May 1904 to December 31, 1941, there were 524 cases of bacterial meningitis, the incidence being 1.14 per 1,000 admissions.

2. Of the 524 cases, 157 or 29.9 per cent were caused by the tubercle bacillus, 120 or 22.9 per cent by the pneumococcus, 119 or 22.7 per cent by the meningococcus, 38 or 7.2 per cent by the streptococcus, 15 or 2.9 per cent by the staphylococcus, 14 or 2.7 per cent by H. influenzae, and 61 or 11.7 per cent by other or mixed organisms.

3. The relative incidence of pneumococcus meningitis on the Isthmus of Panama is higher than that in series from New York and Chicago, but the same as in New Orleans. The relative incidence of meningococcus meningitis on the Isthmus of Panama is half of that in series reported from New York and New Orleans; the incidence is somewhat less than in Chicago if transients are excluded from the Panama series.

4. The impression is gathered that Panamanians are more susceptible to meningitis than West Indians. The incidence of meningitis in Panamanian children, especially H. influenzae meningitis, is remarkably high.

5. The death rate for all cases of meningitis was 86.8 per cent. All patients with tubercle bacillus, pneumococcus, and staphylococcus meningitis died. Two out of 38 patients (5 per cent) with streptococcus meningitis, and 2^- of 13 (15 per cent) with H. influenzae meningitis recovered. Half of the patients with meningococcus meningitis died. The death rate of patients with meningococcus meningitis was about twice as high in West Indians as in whites.

Received July 5, 1943.
¹ From the Board of Health Laboratory, Gorgas Hospital, Ancon, Canal Zone.

Read before the Medical Association of the Isthmian Canal Zone, September 15, 1942.

² Lieutenant, Medical Corps, Army of the United States (Pathologist).

³ Lieutenant, Medical Corps, United States Naval Reserve.