Towards the end of 1905, Lt Col A M Davies, Maj W H Horrocks and Staff Surgeon E A Shaw had completed their investigations into Malta Fever and were no longer available. On 6 Mar 1906, the Royal Society requested the DGAMS to detail two new officers to continue the highly important epidemiological work carried out the previous year by Lt Col A M Daviess among the military barracks and hospitals of Malta.
A third medical officer was to be selected from the navy. These were to investigate each case of fever among troops as soon as it was notified. In addition they were to superintend the evacuation and disinfection of infected barrack rooms and ensure the complete isolation of patients suffering from Mediterranean Fever.
The selected officers were Maj Thomas McCulloch, Maj James Christopher Weir and Maj James Gibson McNaught RAMC. They formed part of the Mediterranean Fever Commission and reported directly to the Royal Society's Committee. Capt J C Kennedy RAMC was retained on the committee until the following winter.
The Royal Society also recommended the services of an experienced bacteriologist to carry out bacteriological work in the investigation of Malta Fever. It proposed that Dr J W H Eyre of Guy's Hospital be granted 6 months leave and depart for Malta by 24 Mar 1906.
Maj Weir and Maj McCulloch reviewed the incidence of Malta Fever from 1902 onwards. This year was chosen as the starting point of their enquiry, as the serum reaction for the diagnoses was not widely used until the close of 1901. They gathered information on the prevalence of the fever in units, its occurrence in the different barracks, and its relation to simple continued fever and enteric fever.
In July 1906, there were only 12 fresh cases of Malta fever, in Aug 8 admissions, and in Sept only 5. This compared favourably with 1905 when 77 cases appeared in July, 94 in Aug, and 87 in September. McCulloch and Weir confirmed the role played by the goat in the spread of disease and the importance of milk as a causative agent. They found no evidence of spread by mosquitoes.
By 24 Feb 1906, the Royal Society Malta Fever Commission had established that there were 20,000 goats in Malta which supplied practically all the milk drunk on the island. Half of these animals were infected with Malta Fever and a tenth were constantly passing the micrococcus in their milk. It found that Mediterranean Fever was acquired by absorption of infected goat's milk. This mode of infection played a notable part in the spread of the disease among those who drank unboiled milk.
The PMO stated that up to the middle of 1906, which marks the new era, the garrison of Malta lost annually the services of some 650 soldiers and sailors for a period of 120 days each, making a total of some 80,000 days of illness. Hence Malta was looked upon as one of the most unhealthy and dangerous foreign station. Since July 1906, when the new preventive measures were brought into use, this has all changed, and in fact Malta Fever may be said to have practically disappeared from the garrison.
On 21 May 1906, the supply of goats' milk to military hospitals was discontinued; in June the military banished goats' milk from all barracks, substituting it with tinned milk. No cases of Mediterranean Fever were contracted in military hospitals after June 1906.
During 1906, there were 161 admissions to hospital from Malta fever, of which 19 were distinct relapses. The total average strength of the garrison was 6,666, giving a percentage of admissions to strength for Malta Fever of 2.13%, and relapses of 0.29%.
In 1907, the number of admissions for Malta fever was 11. Of these, two were relapses of cases admitted the previous year. The percentage of admissions to strength among the troops in 1907 was only 0.19%. Other cases occurring among the officers (2), their wives (2) and the women (3) and children (1) were traced to the use of goats' milk.
Malta Fever - Bighi Hospital
The average number of sailors affected by Malta Fever from 1898 to 1906 was 348 per year. Of these, 180 were invalided out of the service annually and six died per year. In the second half of 1905 there were in the garrison 363 cases of Mediterranean Fever, whereas in the corresponding part of 1906 there were only 35 cases. Among the sailors there was also as marked a fall in the number of cases.
The Naval Hospital had a bad reputation, as one-third of the cases of fever occurring in the fleet at Malta could be traced to residence in this hospital, either as patients suffering from other diseases or among the nursing staff. The goats supplying the hospital were found to be infected, and since their milk had been absolutely forbidden, not a single case of Malta fever had occurred in or been traced to residence in this hospital.
Lecture on Mediterranean Fever
Extract from General Orders, dated Valletta, 29 May 1906: A lecture on Mediterranean Fever, Means of Prevention, will be given at the Office of the Colonel, General Staff, 2, Piazza Regina, Valletta, at 11 am, on Friday, June 1, by Major T. McCulloch MB RAMC, member of the Mediterranean Fever Commission. All Quartermasters, Quartermaster-Sergeants and Regimental Sergeant Majors should attend. Other Officers, Warrant Officers and Sergeants are invited to attend. Accommodation can be provided for about eighty.
St George's and St Andrew's Barracks
St George's Bay was the common bathing place for troops from St Andrew's and St George's Barracks. St George's Barracks overlooked the western side of St George's Bay and was practically on the sea shore. The company blocks were in two levels with the exception of blocks "G" and "H". From 1904 to 1906, they were occupied continuously by one battalion.
From 1906, St George's Barracks became a depot for troops attending the annual musketry camp, and the blocks were occupied for short periods at a time by detachments of different corps. The barrack rooms were infested with sand flies and mosquitoes. The rocky coast around the barracks was honeycombed by the sea and the holes were filled with salt water in which the Acartomyia zammitii mosquitoes bred in myriads.
The average strength of the command was 10,019 men. The number of women and children at Mtarfa remained practically the same even though the strength of the garrison had been reduced in 1906. In 1906, the families of the Sussex Regiment stationed in Crete were kept at Mtarfa. The married quarters at Mtarfa were occupied by families sent there on the recommendation of the PMO for a change of air. The distribution of the garrison was:
Malta and Gozo: 8294 men
Crete Detachment: 860 men
RMA: Officers: 35, men 593, women 135, children 360
Officers 217, females 217, children 548
Total in Command: 10,019 men
Army Medical Department Sanitary Report for the year 1906, Vol XLVIII, London 1907.
TNA:CO 158/351, Sanitary Department dated 23 March 1906.
TNA:CO 158/354, McCulloch to Bruce dated Malta 14 September 1906.
No 12. Stations of units of the Regular, Militia, Yeomanry and Volunteer Forces - 1 Jan 1906. HM Stationery Office.