Dr. Page's report to the Local Government Board on the circumstances of recent prevalence of scarlatina and enteric fever at Spennymoor, County of Durham.

  • Page, David, M.D.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Page's report to the Local Government Board on the circumstances of recent prevalence of scarlatina and enteric fever at Spennymoor, County of Durham. Source: Wellcome Collection.

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    “ lattice, helping to convey the effluvia into the pantry.” Even in one of the better houses invaded by the fever, a common privy (the ashpit in this instance being roofed over) existed within a couple of yards of the pantry window which has since been blocked up with a layer of charcoal : a pro¬ ceeding which can only very partially remedy the danger. And in Tuclhoe Grange, the only fatal attack occurred in a house where a common midden privy occupied a corner of a small confined and high-walled yard under circumstances calculated to intensify the filth-contamination of the air.:;: It is true that the unwholesome conditions referred to, and of which examples might be multiplied, are common to houses which on the present occasion escaped attack as well as to invaded houses, but nevertheless these are the conditions under which enteric fever is wont to occur in Spennymoor, and are, I need hardly remind the reader, competent above all others, to maintain endemic prevalence of a disease the specific contagion of which is intimately associated with and spread by excremental filth. Milk supply. On inquiry into the sources of milk supply of the 19 invaded households in both districts, I found that 11 had been deriving their milk from the suspected dairy farm. This' excess of attacks, and the fact of enteric fever having occurred at the dairy farm from July to the end of October, justified investiga¬ tion as to the real significance of this greater incidence upon its customers. I made inquiry in the first place into the distribution of milk from the farm. I learned that milk, in daily quantity ranging from 25 to SO gallons, was brought, morning and evening, to Spennymoor, and, with the exception of supplies delivered in separate tins direct from the farm to half-a-dozen private families, was divided among eight retailers, by two of whom it was used to supplement the yield of their own cows. Lists of customers were furnished, as already stated, by the several milksellers in Spennymoor, but unfortunately three of those supplied from the farm in question were unable to help in this respect, as the whole of their supplies were sold in small quantities over the counter to casual customers. The number of families ascertained to have been more or less habitually supplied with milk from the farm was 144, while those supplied from other sources numbered 500, the incidence on the former group being thus 7 * 5 per cent., and upon the latter 1 * 6 per cent., or a difference in the proportion of 4^ to 1 between the two. The following table gives for each of the 11 families using the suspected, milk the dates of attack and other particulars of their milk circumstances. In three of these families (marked f) the patients were not medically attended, and the true nature of their illness must be regarded as doubtful. Date of Invasion of Locality of Household. X umber in Household. Cases and Dates of Attack. Daily Milk Supply. Notes as to Consumption of Milk in invaded Households. Household. Adult. Other. Aug. 25 High Street 2 5 Aged 15, Aug. 25. Aged 17, Nov. 12, died Nov. 26. 1 quart direct from dairy farm. Both patients and another member of the family milk drinkers. Sept. 2 Carlton Terrace - 2 3 Aged 6, Sept. 2 - 4-5 quarts All the members of family milk drinkers. f Sept. 25 Whitworth Terrace 9 5 Aged 9, Sept. 25 - Milk partaken of in tea, See., only. Oct. 9 - Jackson Street 2 6 Aged 16, Oct. 9 - 1-2 pints Milk partaken of in tea and coffee only. Oct. 10 Tuclhoe Grange - 4 3 Aged 21, Oct. 10 ; died Oct. 29. A quart Patient and other members of family drink milk. fOet. 15 (about) George Street 4 5 Aged 9, Oct. 15 (about). •> All the children said to have been milk drinkers. Oct. 17 Jackson Street 2 6 Aged 16, Oct. 17 ; aged 4, Oct. 31. Patient first attacked drank milk. Oct. 18 Whitworth Terrace i 5 Aged 12, Oct. 18 ; aged 10, Nov. 2. 3-4 pints Patients and members- of family occasional milk drinkers. fOet. 22 George Street 2 — Aged 27, Oct. 22 ; died Nov. 4. pint - Milk only partaken of in tea, &c. Oct. 24 Craddock Street - / 9 4 Aged 6, Oct. 24 - 1 pint - Patient partook of milk in tea only. Oct. 27 George Street 6 3 Aged 59, Oct. 27. Aged 21, Nov. 4, died Nov. 24. NIilk bought oc¬ casionally. Milk occasionally par¬ taken of in tea. * At the National School in Spennymoor common midden privies exist in close proximity to the school buildings. The contents of the uncovered midden were wet and most offensive at the time of my visit.