Mr. R.D.R. Sweeting's report to the Local Government Board on diphtheria in the Farnham registration district / [R.D.R. Sweeting].

  • Sweeting, R. Deane.
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: Mr. R.D.R. Sweeting's report to the Local Government Board on diphtheria in the Farnham registration district / [R.D.R. Sweeting]. Source: Wellcome Collection.

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    school age and attendants at school.* Similar sudden development of fatal Diphtheria was witnessed shortly after the re-opening from November 24th to December Oth, though not to the same extent. Escapes were related to age,—infants under 2 years and children over 14 years, for the most part escaping, though two babies, set. 6 and 9 months respectively, were attacked, of whom the latter died, and some adults and old people suffered. Parents who took the precaution of keeping their children from school at the time of successive re-openings, and forbade them to play with other children in the street, were often rewarded by the immunity from attack of their families. It was noticed, too, that better-class people, who possessed means of isolating, suffered no second, invasion in their families ;f whilst the removal of the two early cases to Earnliam Workhouse Infirmary was followed by a cessation of the epidemic in the row of cottages from which they were removed. Milk distribution, and the condition of the farms whence the milk came, were inquired into, but set aside as having no influence in spreading the disease. Neither was any relation between animal illness and human Diphtheria found. The conclusion seems, then, warranted that personal communication of various sorts, school attendance, and absence of any isolation, either at home or in hospital, were the three main factors influencing the spread of Diphtheria in Ash during 1884.J Eatality was also apparently related to age, 26 of the 32 fatal cases being between 2 and 10 years of age, whilst no death above 14 years was recorded. Minor sore throat existed in families coincidently with true Diphtheria, and in some cases a trivial throat affection appeared to give rise by direct infection to severe and fatal Diphtheria. Again, cases deriving infection from a common source showed some, membrane, others none at all; the latter cases suggest the existence of an abortive form of Diphtheria analogous to that of “ Small-pox without eruption/’ Suspicion of early infectiousness of the disease, in its pre-exudative stage, was also afforded. The questions of physical circumstances and grouping of houses in determining attack were inquired into ; and although in Ash Yale and Ash Common low-lying and clustered houses escaped, whilst those situate on elevations and ridges, and isolated one from another, were attacked, yet in the larger part of Ash, viz., Ash Street, this contrast was not observed. And indeed these factors, though duly considered, were judged to be subsidiary to that of personal communication in the determination of attack. The immunity of Wyke, Normandy, and the portion of Wrorplesdon in Ash may be explained by reference to their straggling, disconnected characters, which lessen the chances of mutual intercourse of their inhabitants, as well as their distance from Aldershot, and comparative freedom of communication with this place ; they also contributed no children to the Ash Schools. No means but school closure were taken in Ash by the Rural Authority to limit the extension of Diphtheria. Disinfection was practised, but no sustained attempt at isolation was made. On the first death occurring in Ash, the Ash Street Schools were closed from May 8th to June 7th; they were then re-opened until June 24th, and closed on that day until July 7th. They were then in operation for five days; following which, prolonged closure (until November 24th) was carried out. They were again open from November 24th to December 6th, but closed on that day until December 29th, since which date they have remained open. Ash Common School was closed, from (1) May 8th to June 7th ; (2) July 12th to November 24th; (3) December 6tli to December 29th. Since the latter date, they, too, have remained open. The operations of the schools may be thus shown : — Schools open. Schools closed. June 7tli—June 24tli. June 24tli—July 7th (Ash Common only). July 7th—July 12tli. November 24th—December 6th. May 8th—June 7th. June 24th—July 7tli (Ash Street only). July 12th—November 24th. December 6th—December 29tli. * There are two schools at Ash, viz., Ash Common School and Ash Street School ; the majority of Ash children attend the latter. I found them both well built, adequately lighted, and on the whole well ventilated (though the Infant room at Ash Street might be improved iu this particular). There was no overcrowding Garden mould and ashes are thrown down the cesspit privies daily ; the urinals are also drained to the cesspits, which have been recently cemented and ventilated, and are emptied when full. ' t Thus, a child at the Rectory was attacked on December 26th with “ Croup,” but no further invasion of the family occurred, though, at least, one other was of susceptible age. | Ihe influence of season upon the faculty of spread of Diphtheria was displayed in the fact that the disease did not extend so rapidly in June as later, particularly during August and September.
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