Mr. Spear's report to the Local Government Board upon an outbreak of enteric fever in the Pemberton urban sanitary district, Lancashire / [John Spear].

  • Spear, John.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Mr. Spear's report to the Local Government Board upon an outbreak of enteric fever in the Pemberton urban sanitary district, Lancashire / [John Spear]. Source: Wellcome Collection.

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    two (one of them being tbe isolated case at Orrell Post) it was 10 days before first complaint of sickness, and in one 14. The disease appears to have been of a strictly normal type, the distinctive characters and course of enteric fever being observed in a large proportion of cases. The fatality during the third quarter was equal to 12^ per cent, of the ascertained cases. Of the 58 family invasions during the third quarter of the year, multiple attacks occurred in 27. In 12 families there were two sufferers; in eight, three ; in three, four ; and in four, five. The 58 infected households consisted of 362 inmates, and 111 of these suffered from fever. In eight of the 27 families in which multiple cases occurred, it appears that the second sufferer fell ill within a fortnight of the first, and in six of these cases the interval was no longer than a week. As to these practically simultaneous attacks in families, they all occurred in the village of Lamber- head Green during the period of smart epidemicity of the disease—the beginning of August; and, with one exception, the subjects were all under 16 years. The age and sex of the sufferers generally, distinguishing primary from secondary cases, are given below:— Sex. Total. 1-2. 2-4. 4-8. 8-12. 12-16. 16-20. 20-30. 30-40. 40-50. Initial sufferers - M. 25 — 1 2 6 7 3 4 i 1 F. 33 — 1 6 6 8 1 2 7 2 Secondary suf- J M. 28 1 2 6 8 1 4 4 2 — ferers - -1 F. 25 — 3 7 6 2 3 2 2 — Of the 32 initial sufferers at Lamberhead Green during the 16 days of smart epidemicity, 29, or 90 per cent., were children under 16 years. The corresponding proportion during the remainder of the third quarter at Lamberhead Green was 54 per cent., and in the districts beyond that village, of the 13 initial sufferers, only one (a boy who had visited Lamberhead Green a fortnight before his seizure) was below 16 years of age. No notable discrepancy in the infection of the two sexes was observed at Lamberhead Green during the 16 days, when 15 males and 17 females were attacked. Subsequently, females between 30 and 40 years of age suffered somewhat disproportionally ; probably, as it seemed, from the fact, already spoken of, of their greater exposure in busying themselves about infected houses. It would seem from the foregoing evidence that there are two principal sets of conditions needing consideration. In the third quarter of the year enteric fever showed a disposition to become prevalent amongst the general popu¬ lation of Lamberhead Green, New Town, and the intervening locality, and several scattered household invasions resulted. Over and above this, some time in July, possibly only for a single day, the youthful population of a certain part of Lamberhead Green were exposed to the infection in a special way; and as the first cases of a series of resulting attacks occurred on or about the 30th of July, the approximate date when this special infective influence exerted itself, (taking eight days as the shortest probable period of incubation) may be fixed as July 22nd. I will consider first the evidence as to the origin of the comparatively moderate prevalence amongst the general population. Except for the 163 houses at the Pemberton entrance of the village, and for 26 houses in the lower locality to the south, all Lamberhead Green is supplied from the high level reservoir of the Pemberton Local Board ; the remainder, with other parts of the Pemberton district (including New Town and the intervening locality), being supplied from the low level service. From the high level reservoir there are supplied, in addition to the above, the whole remaining portions of the Orrell district (about 500 houses), the portion of Kit Green in the Pemberton district (48 houses), and a small locality (30 houses) in the Upholland urban sanitary district. As these extra Lamberhead A 2 Type and fatality of the disease. Individual family invasions. Age and sex. Conclusions from pre¬ ceding evidence. Water supply.
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