Mr. Spear's report to the Local Government Board upon the prevalence of diphtheria in the Fareham registration district, and upon the occurrence therein of enteric fever.

  • Spear, John.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Mr. Spear's report to the Local Government Board upon the prevalence of diphtheria in the Fareham registration district, and upon the occurrence therein of enteric fever. Source: Wellcome Collection.

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    field town) attend either the “ mixed” or the infant school on Sarisbury Green. As soon as it was re-opened after the summer holidays, on August 2nd, children from two infected houses at “ Long Shore,” who were themselves afterwards attacked, attended the mixed school, and within about ten days of the re¬ opening one child from another infected house in this locality attended the infant school also. The “mixed ” school had at this time 131 children on its books, and the infant school 69, although the average attendance in each case was considerably smaller. Both schools were closed on October 15th on account of diphtheria prevalence. Between August 10th (eight days after re-opening) and October 11th (four days before closure) seven children of the “mixed ” school, being the initial cases in their respective families, and living for the most part in localities widely separated, sickened of diphtheria. At the infant school, on the other hand, no initial case occurred at this time amongst the pupils, save for the child already referred to who lived at Long Shore, and who had abundant opportu¬ nities of infection from the several sick children in the same row of dwellings. There were, however, between the beginning of September and the middle of November, six “ initial ” cases amongst persons not attending school. In four of these, the families of immediate neighbours and friends (in one case the masters family) had been previously infected; and in the two remaining ones infection may have been conveyed by individuals not themselves ailing. Thus, a woman, nursed by a person coming from an infected house, was attacked ten days after her confinement; and an infant in an isolated cottage, who was infected, had brothers attending the “mixed” school. During the five weeks of the schools’ closure, there appear to have been only two fresh family invasions (two of the six above referred to); and on November 22nd (the medical officer of health not, however, being consulted on the matter) the schools were re-opened. At the re-opening, 11 children who had passed through an attack of diphtheria still remained absent from the “ mixed ” school on account of their late ailment. As to others thoroughly convalescent and attending school, there is, perhaps, insufficient assurance that their clothing was free from infection ; for, although carbolic powder, sanitas oil, &c., had been supplied by the sanitary authority, no proper disinfection of clothing, &c., by heat had been performed. Further, the instructions of the medical officer of health as to the cleansing of the school premises had not been carried into effect. On the 26th of November (four days after re-opening) two children of different families left the mixed school on account of sickness that proved to be diphtheria; on the 29th, four other children, one of them belonging to one of the families infected on the 2dth, and three to two other families, left from the same cause ; and on the 30th another child of a fifth family. There were thus, within eight days of re-opening, seven children of five families, living in houses widely separated, newly infected. No other family, so far as I have been able to ascertain, suffered at that time ; and the disease showed comparatively little disposition to spread in the households invaded, so that, although these included nine other (healthy) children, only two attacks in these families, beyond those of the school children referred to, occurred. Never¬ theless, the disease was of a severe type, although not rapidly fatal. Of the nine sufferers, five died, after intervals of, respectively, 5,11,12,14, and 20 days. The schools were again closed on December 2nd, and remained closed until February 28th, 1887. During the interval no further case of diphtheria appears to have occurred, but on March 14th, a fortnight after the re-opening, another of the pupils of the “mixed ” school was attacked; on April 25th, a second, and on April 26th, a third, fell ill; these three being all of different families, and occupying houses widely separated. Although there were 10 other children in these three families, none of them were infected. Two of the three attacks terminated fatally, on the fifth day and on the eighth, respectively. In one case, however, the disease appears to have spread to a neighbouring family. At the first infected house a little shop was kept, and shortly after the child’s seizure there a woman living in the same row and a visitor at the I 57828. 200.—4/89. Wt. 23743. K. & S. A 2 Infected families 6—12. 13—18. School closure (Oct. 15th). Re-opening (Nov. 22nd). Infected families 19—23. Schools closed (Dec. 2nd). Reopened (Feb. 28th). Infected families 24—26. 27.