A bacteriological study of subclinical and atypical enteric infections was undertaken in 1958. Three thousand-one hundred seventy four persons were examined, from February 1958 to February 1959 in Yonsei University, Severance Hospital, Seoul, Korea. Each person was given a physical examination. Enquiries were made regarding of fever, nausea, vomiting, gastrointestinal disturbances, anemia, lymphadenopathy, rash and hepatomegaly.
Specimens of stool and blood were obtained and examined for enteric bacteria according to Edwards and Ewing´s Procedures for the isolation of Salmonellae and Shigellae and by Widal Test for the detection of enteric fever antibodies.
Reference to the table reveals that 53 of the 3,174, or 1.58 per-cent, were infected with pathogenic bacteria. Of these 29, or 0.91 per-cent, with Salmonellae and 21, or 0.6 per-cent, with Shigellae. There was a marked uniformity in the incidence of infection in the group of healthy person(6 of 358, or 1.68 per-cent) and in patients (34 of 1,726, or
1.73 per-cent). In the patient group there were 9 out of 239, or 3.76 per--cent, who had fever of unknown origin and -8 out of 256; or 3.14 per-cent, whose disease was not diagnosed.
Most of the patients had atypical symptoms of enteric disease, but this disease was not suspected.
Those, however, who were given appropriate treatment for enteric infection recovered completely
Approximately 70 per-cent of the isolated strains had acquired resistance -against antibiotics, such as penicillin, streptomycin, tetracycline, erythrozaycin and neomycin, etc,
The group distribution of-the strains which were isolated during the study were-:almost identical with these from patients with enteric, infections previously reported.
It might be commented upon that the high percentage and wide range of distribution of subclinical enteric bacterial infections is due to: 1. Seoul City is equipped with a poor water and a poor sewage disposal system.
2. The living conditions of the citizens in Seoul are unsanitary.
3. The clinical diagnosis of enteric bacterial infection is not easily made because enteric bacteria are of numerous types and clinical symptoms for each type are not identical.
4. In Seoul, many mutant strains have acquired resistance against antibiotics due to inappropriate treatment. Those strains may cause atypical symptoms of enteric-infections.
5. As a rule general practitioners do not request a laboratory examination before treating enteric infections.
6. The eating of unwashed vegetables and fruits exposed on the street must be a .frequent cause.
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