Dr. S.W. Wheaton's report to the Local Government Board on diphtheria in the Enfield Urban District and on sanitary administration by the Urban District Council.

  • Wheaton, S. W.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Dr. S.W. Wheaton's report to the Local Government Board on diphtheria in the Enfield Urban District and on sanitary administration by the Urban District Council. Source: Wellcome Collection.

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    ending on August 29th being 3, 3, 2, 5, 1, respectively, and in the Aveek ending September 5th two only. When, hoAvever, the tem- ])erature rose together with the rising ground water diphtheria broke out. That is to say, there was at the time of the commence- ment of the epidemic a combination of excessive dampness, unusual fouling of the subsoil by organic matter, and high temperature, the first two factors being exceptionally present in the invaded areas as compared with the rest of the district. These three factors appear to have been specially associated with the epidemic in these two areas. Sore throat, called by the local medical practitioners “ septic,” has been especially prevalent in Enfield in the Chase Side and Enfield Lock areas during the autumn of 1908. It began at the beginning of September, and still continues, especially in Chase Side. It is characterised by inflammation of the tonsils, soft palate, and pillars of the fauces, which are swollen, and the mucous membrane of which is red and congested. There is some enlargement of the glands of the neck and general depression. The school medical officer informs me that it is easy to pick out children who are suffering from this affection, owing to their pallor, languid appearance, and the enlargement of the glands of the neck. Bacteriological examination of the throat secretions from a number of cases of this form of sore throat in a very few instances has led to the detection of the bacillus of diphtheria. The passage of sore throat of this form into typical diphtheria has not been observed. The treatment Avhich has been most successful consists in the use of local antiseptic gargles or sprays combined with the administration of tonics, especially of perchloride of iron. It is noteworthy that the epidemic of diphtheria in 1887-8, investigated by Dr. Bruce Low, began in this same Chase Side area, in the same streets, and at the same time of the year’, as the one now under consideration, and extended to other parts of the district later. In that year there were 41 deaths from diphtheria, which is in excess of the number which have occurred in 1908. (c) Measures taken eor the Prevention of the Spread OP Diphtheria and other Infectious Diseases. The medical officer of health has no assistant or clerk, nor has he any office provided for his accommodation. The inspector of nuisances has a staff consisting of two assistant inspectors, each of whom holds the certificate of the Royal Sanitary Institute, two office clerks, and an ambulance attendant, who also acts as disinfector. The certificates of notification of infectious disease are addressed to the medical officer of health at the council’s offices at Enfield. They are mostly brought by hand by the medical practitioners certifying, but some come by post and others are made by telephone in the first instance. I found that some Avhich had been made to the late medical officer of health by telephone to his residence had not been recorded in the register, because apparently no certificate had been forwarded at the time. During office hours, which are 9 to 5 on Aveekdays, Avith the exception of Saturdays 9 to 1 p.m., a member of the sanitary staff is always present and receives the notification. One of the assistant inspectors also attends