Dr. Parsons's report to the Local Government Board on certain outbreaks of diphtheria in the Leek rural sanitary district, Staffordshire / [H. Franklin Parsons].

  • Parsons, H. Franklin (Henry Franklin), 1846-1913.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Parsons's report to the Local Government Board on certain outbreaks of diphtheria in the Leek rural sanitary district, Staffordshire / [H. Franklin Parsons]. Source: Wellcome Collection.

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    School attendance was not concerned. The Warslow School was re-opened after the summer holidays on August 19th, at which date the first two cases had already commenced. Of the four households, Lomas’s was the only one in which the first case was a child attending school; she was there from August 19th to 23rd inclusive. The school was closed, by the advice of the Medical Officer of Health and Mr. Bury, after the morning of August 29th, and remained closed for seven weeks, re-opening on October 21st. Up to the date of my visit on November 5th no fresh cases had occurred since September, and the village was then free from the disease. Action taken to prevent the spread of Infectious Diseases.—The Medical Officer of Health gets returns of deaths from the registrars, but these are not received until the end of the month, and do not give the names of the deceased, so that they are almost useless for other than statistical purposes.* Thus two of the deaths from diphtheria at Quarnford had never been inquired about until the time of my visit, and it was only by questioning people living in the parish as to recent deaths there that it was found out who the persons were who had died of diphtheria. The Medical Officer of Health receives information of cases of pauper sickness, and also to some extent voluntary in¬ formation from medical men of infectious cases occurring in private practice. The Inspector of Nuisances, who is also school attendance officer, often gets to hear of cases of infectious illness in his latter capacity. A voluntary arrange¬ ment for the notification of such cases by medical men for a fee of 2s. 6d. per certificate existed for some time, but was discontinued by the Rural Sanitary Authority on the ground of the expense. A proposal to adopt the Infectious Diseases Notification Act, 1889, came before the Authority at the time of my visit, but was rejected by a large majority, I was informed, on a similar ground. Houses where infectious sickness is known to occur are visited by the Inspector of Nuisances, but not in the first instance nor in all cases by the Medical Officer of Health, whose conclusions are often formed, and his advice given, upon information obtained through the former officer. “ Sanitas ” powder is freely given for sprinkling about. One woman fixed the date of her children’s illness by saying that “ they began at the time when the powder was lying about.” When the illness is over the infected houses are fumigated by the Inspecter of Nuisances with carbolic acid vapour, and afterwards thoroughly cleansed and limewashed. There is no disinfecting apparatus, but washable clothes are boiled in water, and those which cannot be so treated are hung up in the carbolic vapour. Such measures of isolation as are practicable under the circumstances are recommended, but as the cottages in the district have, as a rule, only one or two bedrooms, these are practically nil, so far as the household itself is concerned. As a matter of fact in almost every household in which diphtheria has occurred during the past year, the disease has not been arrested until every child in the house has been attacked. As regards the limitation of diphtheria to the households first attacked, better success has been attained, owing no doubt partly to the alarm which the disease excited among the neighbours having restricted their intercourse with the infected household. School closing has been somewhat freely resorted to, and in some instances, as that of the Longsdon School already mentioned, perhaps rather as a matter of routine, than after due consideration of the question whether equally good results might not be attained by the less drastic measure of excluding children from the affected households or localities. The Rural Sanitary Authority have no hospital for the isolation of infectious cases. In 1874 the Medical Officer of Health, reporting on the best means of providing hospital accommodation for infectious disease in the district, recommended that a hospital should be provided for the populous district about Norton, Milton, and Endon ; and another for Longnor, Warslow, and Sheen ; that a cottage should be taken to serve for Butterton, Grindon, and Onecote, and that in the smaller outlying villages arrangements should be made with cottagers without families for the reception of infectious cases. * It may perhaps be observed that in this district too much attention is paid to the mere tabulation of deaths and sickness, and too little to the accurate investigation of the causes of disease with a view to taking steps for its prevention.