Dr. Blaxall's report to the Local Government Board on an epidemic of diphtheria in the rural sanitary district of Sculcoates in the county of York, and upon the sanitary condition of the infected localities / [F.H. Blaxall].

  • Blaxall, F. H.
Date:
1878
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Licence: Public Domain Mark

Credit: Dr. Blaxall's report to the Local Government Board on an epidemic of diphtheria in the rural sanitary district of Sculcoates in the county of York, and upon the sanitary condition of the infected localities / [F.H. Blaxall]. Source: Wellcome Collection.

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    VILLAGE. Population under 15 Years of Age. No. of Children in attendance at School. No. of Children attacked with Diphtheria. No. of Children who did not go to School. No. of Attacks amongst the Children who did not go to School. Anlaby - 175 42 3 133 Nil. Willerby - 92 49 1. 43 >5 Kirkella, and other Villages - - Not known 51 Nil Not known Total - 267 142 4 176 — It will be seen (1) that the attacks were confined to the children in attendance from Anlaby and Willerby, to the exclusion of the children from Kirkella and other villages; (2) of the 42 children who attended school from Anlaby, 3 were attacked, and of the 49 children from Willerby, 1 was attacked; (3) of the 133 remaining children at Anlaby, and the 49 at Willerby, who did not go to school, not one was attacked. The incidence of the attacks thus falling upon the schoolgoers from Anlaby, to the almost total exclusion of the other children (one case only occurring amongst them), may find some explanation in the circumstance that the Anlaby children living at a distance usually took their dinners to school, and thus would be likely to drink of the school water; wdiereas the other children going home to dinner would have less inducement to partake of it. Moreover, it is in evidence that the 3 Anlaby children attacked were in the habit of drinking the water direct from the tank, and had complained to their mothers of its being very bad. Two of the said children admitted to me having drunk of it about the time they were taken ill. In the case of the third child (deceased) the sister told me that the sufferer had been in the habit of drinking the water, and had done so shortly before she was taken ill. It is presumable, also, that the fourth child, viz., the boy who resided at Willerby, drank of it prior to his attack, for he told me that he drank of the water on his return to school, after his illness ; though not before. But inasmuch as he admitted having drunk of it at one time, the probability is that he did so on other and previous occasions. On the other hand, it should be mentioned that the schoolmaster’s family, consisting of himself, his wife, four young children, and a servant, who habitually drank of the water, all escaped. It is, however, noteworthy, as possibly affecting the question, that the water in their case was passed through a silica filter before it was allowed to be drunk. The question may arise as to whether the first case (24th April) may not have been the source of infection to the three other cases that folloAved. (These cases, for convenience, we will designate A., B., C., D.) In answer to this it is in evidence that (1.) A. attended school for the last time on the 24th of April (the date of attack) from which date I am credibly informed that neither B., C., nor D. had any communication with A., nor did they go to the infected house. (2.) B. was not at school on the 23rd or 24th of April (the last days of A.’s atten¬ dance), so probably, their houses being a distance apart, A. and B. did not come in contact with each other on those days. Allowing this, if B. did contract the disease from A. it was presumably prior to the 23rd of April. Noav as B. first showed symptoms on the 3rd of May, this Avould give the exceptionally long period of at least II days incubation. (3.) C. and D. Avere both at school on the 23rd and 24th of April, and were attacked respectively on the 4th and 8th of May, consequently if they contracted the disease from A. there Avouldjbe a period of II days incubation in the case of C. and 14 days in the case of D. Thus the exceptionally long periods of incubation in the three cases Avould seem to negative the proposition that A. was the source of infection to B., C., D. Having shown that the attacks were confined to children who presumably drank of the Avater at the Kirkella school, it seems necessary at this stage of the Report to consider the quality of the water with reference to its probable exposure to contamina¬ tion. The supply consists of rain water collected from the roof of the school-house and stored in an underground tank. The tank at the time of the outbreak was described by the Medical Officer of Health as being situated at a distance of a feAv feet from the schoolmaster’s house and about nine feet from a catcli-pit, and 20 or 30 feet