Kala-azar hits again.

Six hundred and ninety-two cases of kala-azar were studied, all confirmed cases. Vaishali, Muzaffarpur, Samsatipur and Sitamarhi were the most affected districts of Bihar. Fever, weight loss, hepatosplenomegaly, anaemia, leucopenia and monocytes were the most commonly found features, whereas pigmentation of skin was found in only 4.48% of cases. Lymphadenopathy and voracious appetite were conspicious by their absence. Study of the incubation period of the disease showed that it may be as short as 24 h. Bone marrow study revealed hypoplastic marrow with increase in the cells of the monocytic series. Serum electrophoresis revealed reduction in albumin and rise in globulin, leading to decrease in A : G ratio. Tuberculin test was negative in the majority of the patients.