Medical and sanitary report / Government of the Gold Coast.

  • Gold Coast. Medical Department
Date:
[1918]
Catalogue details

Licence: Public Domain Mark

Credit: Medical and sanitary report / Government of the Gold Coast. Source: Wellcome Collection.

    12/68 page 12
    “ Unhappily the appearance of the pandemic in this neighbourhood synchronised with a “ spell of quite unusually cold weather with high 'winds, and to this unfortunate coincidence “ may he attributed the grave character of the outbreak and the high ratio of pulmonary “ complications. “ Incubation period.—From 2-4 days. The onset sudden, but greatly varying in “ character from what was little more than a severe nasal and pharyngeal catarrh to a “ high fever with urgent symptoms and great prostration. “ Types of disease.—Apart from the typical uncomplicated cases—09 out of a total “ of 82—the disease manifested itself in a variety of forms, of which that affecting the “ respiratory passages was by far the most common. In two patients only gastro-intestinal “ symptoms—vomiting and diarrhoea—predominated at the onset. Only one, who later “ developed double pneumonia, presented marked cerebral symptoms in the earlier stage. “ Certain symptoms were common to all cases, although they varied greatly in severity. “ 1. General malaise, insomnia and prostration, with aching in the hack and limbs. “ 2. Pyrexia of sudden onset, hut only in a very few cases ushered in by an initial “ chill. « “ 3. Congestion of palpebral and scleral conjunctive, occasionally accompanied by “ photophobia. “ 4. Frontal headache. “ 5. Congestion of palate and pharynx. The appearance of the throat was “ perfectly characteristic: a deep congestion of the soft palate and a peculiar rawness “ of the pharynx, as if the mucosa of the posterior wall had been scraped with a “ grater. It was an irregular, bright red, angry injection extending from the “ posterior nares above to the lower limit of the pharynx below. It looked, and to the “ patient felt, ‘ raw.’ “ Accompanying this acute pharyngitis there was usually a hard, dry, hacking “ cough. “ 6. A feeling of oppression and tightness behind the upper half of the sternum “ and attached costal cartilages. “ 1. In the uncomplicated cases (39) the above description might be taken as fairly “ typical. The duration of the fever did not exceed four days. The initial temperature “ averaged between 101° and 102°, in only two cases exceeding 103°. Convalescence was “ usually established by the 5th day, the patient feeling quite well with no other discomfort “ than a little dry cough, which continued for a few days. “ In two the pharyngeal congestion extended to the middle ear, resulting in one in a “ perforation of the drum. “Two others reported vomiting and diarrhoea on the first day. “ 2. Cases iclio developed a slight capillary bronchitis (15).—These were rather more severe, “ beginning with a temperature of 102J-103° and lasting one or two days longer. The lower “ edge of the right lower lobe was the part usually affected. “ 3. Broncho-pneumonia (14).—In many of these the lungs did not become appreciably “ affected until the 3rd day. The temperature was higher, 103°-104°, and the period of “ pyrexia was more prolonged. In the more severe cases—four were distinctly grave—• “ respiratory distress was considerable; the cough constant and troublesome; expectoration “ abundant, containing purulent matter, and in several instances brightly tinged with blood. “ Convalescence in many was greatly delayed and in two was complicated by malaria. “ 4. Diffuse bronchitis (4).—From the onset these cases were grave. In three signs of “ cardiac failure were evident from the beginning. Two developed a petechial eruption on the “ day before death. Both lungs were affected with a diffuse capillary bronchitis, no doubt “ aggravated by cardiac weakness and incompetence in the 3 fatal cases. The fourth was a “ young man who had been in residence in West Africa for only a short period. “ The duration of the disease averaged 6-7 days. The temperature throughout “ maintained a level between 104° and 105°, the pulse corresponding except in the one who “{recovered, in whom it never exceeded 90. Heavy albuminuria was noted in the fatal cases. “ Repeated nasal hemorrhage was recorded in one.
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