Mr. W. H. Power's report to the local government board on diphtheria at Hern Hill, in the Faversham rural sanitary district ; on the sanitary state of that district ; and on administration by the rural sanitary district.

Power, W. H.

Date:: 1880

Credit: Mr. W. H. Power's report to the local government board on diphtheria at Hern Hill, in the Faversham rural sanitary district ; on the sanitary state of that district ; and on administration by the rural sanitary district. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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$because they took tbe opposite direction, and did not inhale the (supposed) malaria ; but if it is only by j^ersonal communication, and especially by cone ourse of children at school, that this disease is spread, we are driven to suppose that by somo means, in virtue of their suburban habitat, these Builth children jwere practically in- susceptible of the diphtheritic infection, as compared with those who came from isolated hill-side homes. 7. A secondary outbreak of diphtheria occurred in January and February of the present year (1880) in the parish of Aberedw, on the opposite side of the valley of the W ye, apparently traceable to the previous outbreak in Llandewyrcwm. The father of one of the sufferers in that outbreak, who also himself had a Ijad sore throat, attended with difficulty of swallowing, and enlargement of glands, used to work at a farm called Tanycoed, on the southern slope of the hill above i\.beredAV village. He took his meals with the servants at the farm house. A servant girl there was taken ill with sore throat about Christmas Day. A daughter of the farmer was taken ill witli diphtheria on January 7th, and died on the 15th. She had attended Aberedw school up to the time of her illness. Another daughter had a slight attack. The mother also had a sore throat. Thence the infection spread to a neighbouring farm (Trevaughan). The two farms are held by two brothers, and there was frequent intercourse between the two families. At Trevaughan six children were attacked, and three died. Shortly after the seizure of the child first attacked at Tanycoed (who had been attending Aberedw school) some children of another family attending the same school were taken ill with severe sore throats, and also the father and mother, but all recovered. The school master’s infant also had a slight attack. 8. There was nothing in the local conditions to account for this outbreak, no com- munity of poisoned milk, or water, or air, no prevalence of disease among animals (though since the children were ill at Trevaughan, some of the horses have had “strangles”). The outbreak appears to have been simply due to personal communi- cation, and serves to illustrate the facile difFusibility of the diphtheritic infection by adults going to work, and children gathering together at school. 9. In this secondary outbreak there had been, at the time of my inquiry, 19 cases, four of them fatal. [Since then I have heard from Mr. J. B. Herring, Medical Officer of Health for the Builth rural sanitary district, that two more cases, both ending fatally, have occurred, one in the family at Trevaughan, and one at Tanycoed. Still more recently the disease has re-appeared fatally at the cottage in Aberedw, where previously the whole family had sore throats.] PEMBROKE. [Registrar-General’s Quarterly Return, 1879, Eourth quarter.—District, Pembroke ; Sub-district, Tenby. Nine deaths registered from diphtheria. (Registrar’s note. “ The nine deaths from diphtheria occurred in the parish of Manorbier.” Popu- lation, 691.)] 1. The occurrence, within a space of three months, of nine deaths from diphtheria in a parish having a population of only 691 persons, indicated a strongly localised outbreak which might be expected to repay study, especially as the district had been for some time past remarkably free from fatal diphtheria. Additional reason for inquiry was furnished by a letter from the Vicar of the parish complaining of its neglected sanitary condition. The Board therefore ordered an inquiry to be made as to the prevalence of diphtheria, and also as to the general sanitary condition of the parish of Manorbier. I beg to report that I visited the district on March 9 to 13th. Comparatively little time was spent in examination of the local conditions, but various ramifications of the inquiry, having for their object the tracing the different threads of the diphtheria epidemic, occupied much time, though they produced but little satisfactory result. 2. Manorbier parish (area 3,493 acres, population 694, proportion of persons to acres 1 to 5), occupies a part of the south coast of Pembrokeshire, and extends inland to the Ridgeway, a conspicuous ridge of old red sandstone wliich runs across the peninsula east and west from Penally to Pembroke Dock. Between the Ridgeway’ on the north and the limestone sea cliffs on the south there is a middle range of high ground, of the Cambrian formation, which, at the surface, crumbles iuto a clayey soil. It was at Jameston, a high bleak village on this soil, that the first recognised cases of diphtheria occurred. Subsequently the disease spread to families residing on the limestone tracts. Q 23ri0. I)$