Report of the Board of Health on a second outbreak of plague at Sydney, 1902 / by J. Ashburton Thompson.
- Thompson, J. Ashburton (John Ashburton), 1848-1915.
- Date:
- 1903
Licence: Public Domain Mark
Credit: Report of the Board of Health on a second outbreak of plague at Sydney, 1902 / by J. Ashburton Thompson. Source: Wellcome Collection.
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![5. Here, in Sydney, we formed tlie o]nnion in 1900 that plague-rats constituted the sole source from which the infection was communicated to man. A good deal of evidence in support was furnished, hut it was, and under then circumstances almost necessarily was, incomplete. It has now been largely supplemented. How far it reaches towards demonstration of causative association between plague-rats and individual cases of plague is left to the reader’s judgment. It is shown below that the task of fully examining into, and of exhibiting, the relationship referred to is one of great difficulty in any city. 6. But supposing the invariable precedence of rat plague and a constant association of plague-rats with individual plague cases to he established : Another and important difficulty presents itself, which is that in all probability the rat unaided cannot cause epidemic bubonic plague. An intermediary is necessary to convey this septicaemia of the rat to man. Whether that intermediary may consist in inanimate objects on which plague-rats have deposited the infection in a way to facilitate its effective contact with man, is a question which is discussed at length below. Some ground for answering it in the negative is there shown. 7. It has been already noted (Beport, 1900, p. 38) that Simond had suggested in 1898* * that the requisite intermediary might be furnished by the flea and thebecl-bug. Personally, I had accepted this suggestion before the disease had appeared here, on the ground that it served to explain a greater number of reported, and apparently discordant, observations than any other which had been made; and when the first case of the epidemic of 1900 occurred which, as it happened, indirectly exemplified it, I took it for guide, although the proofs adduced had remained uncorroborated, and although direct experiments by Nuttallf (which were made, however, with Cimex only) had yielded negative results. By the end of that epidemic it had been generally accepted in this Department on the ground that it, and it alone, appeared capable of co-ordinating the observed facts; and, notwithstanding an adverse remark on “rat-fleas” made by NetterJ, and vivacious contributions on the same subject by Professor Galli-Valerio§, which intervened, we regarded it with similar favour at the end of the second epidemic. Attention lias now been given to determining the species of the fleas which infest rats in this part of the world, to variations in their frequency on rats at different times, and to examining into their ability to bite man. 8. The importance of the foregoing remarks, which, to those who are content with the simple theory which is expressed in the one word “rat,” will appear recondite and superfluous, lies in this : That while our experience regarding non¬ diffusion of the infection by direct or indirect communication with the sick and non-maintenance by place-infection, is not the same as has elsewhere been recorded, it has yet been acted upon by us with an apparent diminution of the number of persons attacked, together with large saving of direct expenditure, and avoidance of many of the indirect occasions of loss to individuals which, in spite of our advice, were caused to operate so largely during the first epidemic. 9. And now, unnecessary though it be to repeat all the advice on management of epidemic plague which was given in 1900, because it has but been corroborated by the further experience of 1902, it is yet well to recall the most important of the lessons which we then inculcated. This, repeated to-day with the emphasis which such corroboration warrants, runs as follows :—The promise of safety for the future lies neither with attempts to prevent the importation of plague-rats (which must fail from time to time), nor with attempts to exterminate the rats infesting the locality to be defended (which we have learned is practically impossible), though both of these measures have their valuable uses, but in habitually excluding rats from inhabited premises. This, manifestly, is a defence which can be set up successfully by Local Authorities; it requires persistent effort, but involves hardly any expenditure of municipal funds. Part I. v Annales de l’lnstitut Pasteur, 1S9S. + Johns Hopkins Hospital Reports, VIII, pp. 17-2R Microb Pans, 1900. § Cent, f, Bakter, XXVII, p. 1, and XXVIII, p. 842. ' ' * ' * jJ](https://iiif.wellcomecollection.org/image/b31353046_0008.jp2/full/800%2C/0/default.jpg)
