Jul 09 2013

Mediterranean (Malta) Fever


Serving with the 2/Rifle Brigade when they landed in Crete on 22 September 1896 was Captain Reginald Stephens. Capt. Stephens and his battalion had served in the recent Nile campaign which had culminated with the Battle of Omdurman in which the forces of the Kahlifa, the successor to the Mahdi, were utterly destroyed and from which Stephens had emerged unscathed. However, within a few days of arriving in Crete, direct from Egypt, Stephens was writing to his mother:

 “Please excuse the scrawl but I am in bed with a return of my old enemy the Mediterranean fever. I am not very bad and I hope it won’t be too long a job though it is a most tedious disease. It is very [curious – tedious] getting it back like this the moment I got to the  sea again after being so well all through the camping.”[1]

By the middle of October, Stephens was in hospital in Malta and writing that: “ ….I am simply delighted to get out of Crete which was shocking awful when one was ill…”[2]

Unfortunately for Stephens, Malta was potentially the worse place he could have been sent to suffering from Mediterranean fever. Also known at the time as Malta fever, the affect of the disease on the British army in Malta was such that “…up to the middle of 1906, […], 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.”[3]  Soldiers suffering from the disease had an average stay in hospital of nearly 90 days within a range of 15 days to two years and although the mortality rate amongst the military was low at around 2%, the mortality rate for civilians on Malta was much higher. [4]

The cause of Mediterranean/Malta fever, now known more commonly as Brucellosis, had been identified as early as 1887 by British military Surgeon Captain David Bruce, working in collaboration with his wife, Mary Elizabeth Steele, and a Maltese physician, Doctor Joseph Caruna Scicluna, as a bacteria; named by Bruce in 1893 as Micrococcus melitensis. However, at that time of its identification, the means of transmission of the bacteria was not yet understood. In spite of work carried out in 1902 among the civilian population by Themistocles Zammit, a Maltese Doctor and archaeologist, which indicated a likely means of transmission, it took the setting up of the Mediterranean Fever Commission in 1904 to produce a report in late 1905, which conclusively proved that the source of the infection on the island was, as Zammit had already shown, goats and goats’ milk in particular.[5] With the major source of infection identified, and in some samples taken at the time over 30% of the goats tested positive for the presence of the bacteria, steps could be taken to eradicate the disease, at least within the British forces. The compulsory pasteurisation of all milk supplied to British forces on Malta, introduced in 1900 to deal with typhoid fever, was even more strictly enforced in April 1906 and by July 1906 goats’ milk had been replaced by preserved milk. An outbreak of Mediterranean/Malta fever amongst British nurses in 1904/1905 appeared initially to contradict the theory of transmission via goats since, as trained professionals, it was assumed that the nurses would be aware of the need to ensure all milk was boiled before consumption. However, it was discovered that the nurses’ quarters were next door to the milking area of the Valetta barracks goats and when milking here was prohibited, the incident of infection ceased.[6]

(In the interests of delicacy the fact that the disease was also shown to be transmitted venereally will not be mentioned;[7] the suggestion that the British army removed this particular route of infection by ensuring only ugly goats only were allowed in the barracks is simply untrue.)

As a result of the steps taken by the military authorities, there was a dramatic decline of cases amongst British personnel; from an average of 104 cases per annum in 1902 – 1905, with 50 cases in the first quarter of 1906, they fell to one case from the end of April 1906 to the end of December 1907[8]and Mediterranean/Malta Fever for the most part ceased to be a major source of reduction in troop numbers.

Stamps issued for the 1964 anti-Bruscellosis Congress, Malta

Unfortunately, for the civilian population of Malta the matter was not as easily resolved. The consumption of unpasteurised milk from infected goats continued and in spite of efforts of the authorities efforts and the slaughter and consumption of the majority of the islands goats during the siege of Malta from 1941 to 1944, during which period the number of cases dropped considerably to rise again after the war when goat breeding was resumed, it wasn’t until 1988 that Brucellosis was more or less eradicated on the island.[9]

As for Captain Stephens, invalided back to England from Malta, after several months convalescence he returned to duty with 2/Rifle Brigade. He served in the Second Boer War and the First World War, was Director General of the Territorial Army from 1927 to 1931 and retired as a General in 1931.



[1] Capt Reginald Stephens  NAM 8902-201-83

[2] Capt Reginald Stephens  NAM 8902-201-84

[4] Journal of Maltese History. Vol.1 No.2 2009http://maltesehistoryonline.com/wp-content/uploads/2009/11/wyatt-pages-4-19.pdf p.5

[7] F.N. 24.  Journal of Maltese History. Vol.1 No.2 2009http://maltesehistoryonline.com/wp-content/uploads/2009/11/wyatt-pages-4-19.pdf  p.8

[8]  Ibid  p.10

[9]  Ibid.pp.11-13

1 ping

  1. Killer goats | The British in Crete, 1896 to 1913.

    […] in Crete, the presence of goats in both Malta and Crete had serious implications for their health. Mediterranean Fever (Brucellosis) transmitted from infected goats, was to prove, along with dysentery and malaria, one […]

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