Mr. Spear's report to the Local Government Board on an outbreak of diphtheria in the Dingestow registration sub-district of the Monmouth rural sanitary district.

  • Spear, John.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Mr. Spear's report to the Local Government Board on an outbreak of diphtheria in the Dingestow registration sub-district of the Monmouth rural sanitary district. Source: Wellcome Collection.

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    No extension beyond this household appears to have taken place at Ragland, although children from the infected family continued to attend the elemen¬ tary school. As to the origin of diphtheria at Dingestow, the evidence is very meagre; it is even impossible to identify with certainty the first case that occurred. About the middle of September a child, Elizabeth M., living in one of the 32 cottages above referred to, suffered from sore throat; a brother was similarly attacked early in October, and a sister and the mother suffered in January and February respectively of the following year. The history of the childrens’ ailments is very incomplete, and no medical assistance was obtained. So far as it goes, it favours the view that the disease from which they suffered was diphtheria; the mother’s case is said to have been one of quinsy. On or about September 13th a man named Alford was attacked by severe sore throat. He was one of a family of three adults, living near Dingestow, but in the Ragland parish, and was employed as carter, &c., to a builder, whose stables were situated amongst the collection of 32 cottages at Dingestow. He was confined to bed two or three days, and was away from work a week, afterwards suffering from weakness, &c., but with no distinct evidence of paralysis. His mother, living with him, had a slight attack of a similar character a few days later. About September 20th a young woman, Margaret P., living with a nephew in a small cottage standing just opposite the stables where Alford worked, sickened with what there is little doubt was diphtheria, although spoken of at the time as quinsy. Her nephew fell ill on October 14th, and another nephew, living at Llanvihangel (the fatal case already spoken of), on October 12th. The history of all the subsequent cases in the three parishes of1 Dingestow, T*regare, and Penrose, is not wholly inconsistent with a theory of continuous infection, starting with Margaret P., and extending through a widening circle of relatives and acquaintances, although there are certain difficulties in the acceptance of this simple explanation. Respecting the sanitary condition of the three cottages referred to above, there were defects of drainage associated with each, but in each case dampness was the most marked defect. In the cottages occupied by Alford and Margaret P. the dampness was extreme. The sequence of cases during the epidemic prevalence of the disease was as follows:— Table 1. ! MU Ml .M ( Total. 1887. 1888. .£U.BO’iv.j ‘ M Sept. Oct. Nov. Dec. Jan. Eeb. Mar. Family invasions - 15 1 9 o 3 2 4 2 — Cases - -. - 30 1 6 5 2 11 5 — Deaths - - 7 — 1 — 1 4 1 — f Families 7 2* 1 — 1 2 — 1 Severe sore throat< [ Cases “ 12 3* 2 1 4 1 1 * The cases of Elizabeth M. and of the Alfords (mother and son). ,7 jui' - . ' . 1 • ’ [With two exceptions, the family invasions noted above include only those that occurred in one or other of the three western parishes ; the exceptional cases being the two already referred to as originating in Dingestow. A few isolated cases occurred elsewhere, as I shall presently explain.]