[Report 1921] / Medical Officer of Health, Edinburgh City.

Edinburgh (Scotland). City Council

Date:: 1921

Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1921] / Medical Officer of Health, Edinburgh City. Source: Wellcome Collection.

12/130

Infectious Disease. Scarlet Fever. All fever cases, which were formerly treated in that Institution, are now trans- ferred to Colinton Mains Hospital, where additional bed accommodation has been rendered possible through the transference of advanced pulmonary cases which, prior to the re-arrangement, were treated in tw7o pavilions there. The Shelters at Colinton Mains Hospital which have been sanctioned for the accommodation of 63 patients are now utilised for the accommodation of cases of tuberculous disease other than pulmonary, while the Craiglockhart Poorhouse pavilions continue as formerly relegated to the treatment of Parish cases of Pulmonary Tuberculosis, there being for that purpose a total of 48 beds. If due account be also taken of 21 beds which are set apart for convalescent tuberculous cases in Polton Farm Colony, Lasswade, it will thus be apparent that the total bed accommodation existing for the use of the City at present for the treat- ment of cases of Tuberculosis, pulmonary and non-pulmonary. amounts to 362 beds. There were during the year 318 deaths from all forms of infectious disease, except those of tuberculous origin, being equal to a rate of '7 per 1,000 of the population. 2,163 cases of this disease have been notified during the year, showing an incidence rate of 5T4 per 1,000 of the population, as compared with 4'51 per 1,000 during the previous year within Edinburgh’s former boundaries. The increased incidence was largely, if not wholly, accounted for by an epidemic which occurred in Leith during last summer, and which fortunately ran an extremely short course, although at its inception there were elements present which might have occasioned results of a much more widespread nature, and a persistence during a much longer period than fortunately was the case. The epidemic broke out on 9th July and was practically at an end ten days later. 337 cases occurred throughout its course, and there being elements connected with it which are certainly of interest from a Public Health point of view, the following- details are here submitted :— “ Enquiry as to the origin of the epidemic was immediately set on foot. It was at once evident that owing to the sudden occurrence of so large a number of cases, from the fact] that adults and children of all ages were involved, and from the localised nature of the epidemic, that characteristics associated with a milk supply were so evidently present as to remove all source of doubt regarding it. Attention was therefore immediately directed to the milk supply. In the course of these enquiries a very remarkable sequence of events was disclosed. Indeed, instead of the ordinarily occurring infection being traceable to one milk supply, there was actually found in connection with this outbreak no fewer than four separate milk supplies. These were as follows :— (1) A. Cow-feeder.—While no case of Scarlet Fever was found present in A.’s house or that of any of her workers, her son, who assisted in the cow byre as a milker, was found suffering from illness accompanied by a sore throat as a prominent symptom. A.’s byre stood out prominently from the first as an evident source of the spread of the disease. Indeed the milk supply from that byre formed at least part of the supply in 282 cases of infection, and itself formed the sole supply in 10 cases. One or two of these were extremely instructive. In one case a child wholly fed on condensed milk and living with its parents in Newhaven visited a grandmother in Leith. A special supply of milk was obtained from A.’s dairy as a treat for the infant, who in a few days was found suffering from Scarlet Fever and was removed to hospital. Another very similar case occurred, and further there were 8 patients who received a supply directly from that cow byre. In view of the virulence of the outbreak, A.’s milk supply was wholly stopped on the evening of Tuesday, 12th July.