ENDEMIC TYPHUS AND LICE

We shouldn't debate on the necessity to include this book in our reference list. It's importance is multifaceted, not least it represents a classical example for study of a disease entity with good citation apparatus and contemporary data-based information. For the time being of it's publication and this book represented an excellent achievement for the burgeoning bulgarian medical /i.e., and epidemiologic-bacteriological/ science, which need such impetus to find a face of identity.

Petar Verbev /1891-1977/ is an interesting figure for bulgarian epidemiology, whatsoever his name is encroached with some unexplained details of professional and publication activity that we have entailed to clarify in this and some further reviews. We shall not aim to write a definitive biography for Dr. Petar Verbev here and now, while our effort in this presentation will concentrate on his activity as epidemiologist working for the Directorate of Public Health - viz., from 1935-1941 as editor of "Bulletin de la Direction Generale de la Sante Publique" plus some additional administrative work at Alexander's Hospital /1941-1946/. The second part of his biography, when he became a professor and head of the first tenure Department of Epidemiology, Medical University at Sofia will be narrated at some other time.

There are few things that we wish to mention here. The archives of the "Directorate of Public Health" for the above mentioned pre-war period were fully destroyed, while only fragments of the whole currency were recovered by the author of this lines and mainly by personal means. This makes the exposition at hand a first rate narrative, which could hardly be corroborated by anything found in the literature from the socialist period. I have checked some of the details from various issues of the "Bulletin de la Direction ...", however they rarely coincide with facts from "latest" and "newest" reports. Whatever, we have a story here and will continue undetached from turmoil of time and space, while leaving the glances and critique of some opponents behind.

Browsing the pages of the recovered pre-war archive has encountered us with a wealth of sophisticated data, which subsequently have been omitted in the purposes of this review. For instance, there are contained many original contributions on variety of epidemiological and administrative issues that should be commented at other suitable workloads of narrative. Our job has been to evaluate the role of the bulletin and its co-editor - viz., to establish for first time a comprehensive system for surveillance and notification of communicable disease in the country. It was our opportunity to check-out and verify a full tablet of unofficial reports on a whole list of epidemic diseases, dutifully appended at the end of each year's currency. It is credible to believe, that this was done in accord with the instructions from international authorities at that time - most notably, the Section of Epidemiologic Diseases at the League of Nations.

We conclude our observation on notifiable disease in Bulgaria for the period 1935-1941, subsequently with a note on its most significant part - viz., the "Regulations for Control of Infectious Diseases" published in year 1939 of the "Bulletin de la Direction ...", volumes 171-175, pp. 3964-4096. This publication has the character of a monograph itself, with i./ basic part, consisting of general rules for combating infectious diseases and early measures to detect, investigate and notify at the hearth of the infection; further, ii./ special part, which gives essential clinical information on some 37 /thirty-seven/ most important notifiable diseases of public health importance. We should preclude here and return on the topic later, when discussing the role and development of epidemiologic knowledge in this country, ditto.

A few final words for the book at hand. It is a nicely written monograph with clear cut vision on the problematic of "typhus fever", its causative agent, its means of transmission and the forms of control & therapy. As an early example, this book should serve as a classic in the bulgarian epidemiological literature.

(a). Here we have presented some graphics from the early monograph of P. Verbev on the rates of morbidity and mortality from typhus fever, per 100 000 population and in the period 1914-1934.

(b). Further, we present a complementary graphic from P. Georgiev /i.e., year 2000/ on rates of morbidity from typhus and para-typhus, per 100 000 population in the period 1921-1994. It is evident from the curves, that there have been two significant epidemics from the disease - in early 1920s and mid 1940s - subsequently, it has subsided and disappeared in the second half of the century.

Addendum: While it wouldn't make tribute to the original author to retell the contents of the whole book, further we should drive the attention of an interested reader to some supportive information available on-line. These are most notably,

1. The inaugurating lecture of the 1928 Nobel Prize for Medicine to Dr. Charles Nicolle, Director of the Pasteur Institute at Tunis.

2. The work of Hans Zinsser /1878-1940/, who is known for his work in isolating the typhus germ and developing a protective vaccine. He wrote several books about biology and bacteria, notably "Rats, Lice and History", a "biography" of typhus fever.