The history of small-pox in Australia, 1788-1908 / compiled from various sources by J.H.L Clumpston.

Date:
1914
Catalogue details

Licence: In copyright

Credit: The history of small-pox in Australia, 1788-1908 / compiled from various sources by J.H.L Clumpston. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    45/210 (page 35)
    Then Dr. McCrae, not finding himself satisfied either with the direct infection or the air-borne infection hypothesis, turns to the fly-borne infection hypothesis for the explanation of the facts, not only in connexion with the cases in the first period, but also those in the metropolitan area throughout the epidemic. He asks, Could not the disease be conveyed by flies from the bodies of patients who were suffering from small-pox to others who were susceptible of it ? and proceeds to discuss this question, as follows :— The hypothesis of the contagion having been conveyed by means of flies would account for the erratic manner in which the disease appeared in different localities ; would meet the otherwise insuperable difficulty of the distance to which the infection was conveyed ; would explain why persons situated near the focus of contagion escaped while others furtliei olf in the sand direction were infected ; and would remove the difficulty raised ])y the period of incubation. 1 put it forward with some hesitation as the only one which, under the cu'cumstances, is tenable and wdiich will account for the course of the <lisease, but as one which must be left to future more extensive and minute observation to either adopt or reject. It is, at all events, remarkable, that after this idea struck me, and the flies in the Royal Park Hospital were in consequence destroyed, only four cases of the disease occurred, two of which—Nos. 40 and 43—were both traced to distinct jjrevious contagion. Mobile the other two cases-—Nos. 41 and 42—were such doubtful ones, that, had small-pox not been prevalent in the Colony at the time, no one would have pronounced them to be variola. This is, so far as can be ascertained, the first occasion on which fly con- vection has been officially put forward in Australia as the mode of spread of infectious diseases. The facts, however, would not seem, on critical examination, to lend any weight to the theory. Why flies should, starting their flight from the Royal Park, attack only one person in St. Kilda, one in South Yarra, one in Fitzroy, one in Richmond, two in Collingwood, and miss the rest of the population in these places, is difficult to understand. It would have been expected that the intensity of the incidence would have varied inversely with the distance from the hospital, and it is very doubtful whether a fly could travel nearly 4 miles from Royal Park to St. Kilda, even with a strong northerly wind. The review of the evidence leads to little satisfaction as to the method of spread of the contagion, and it must be left undetermined. Inasmuch, however, as all the other Australian epidemics show very markedly the importance of personal contact, and as this was the controlling factor in the Greensborough group of cases, it is not unreasonable, in the absence of full evidence, to look with suspicion upon, and even doubt the necessity for, any other hypothesis. This section should not be closed, however, without reference to Dr. McCrae's suggestion at one stage. The conclusion seems to me irresistible that the disease has arisen from some atmospheric or telluric influences which has been epidemic for some months. This can hardly be considered very seriously, although it is interesting to note that the epidemic subsided soon after the first heavy fall of rain. There was one instance w^here the recorded facts are in favour of spread by fomites— Case 41.—This woman moved into the house in which No. 31 had resided, after the latter's removal to hospital. After a fort- night's residence in the house, the eruption of small-pox appeared. '