Dr. S.W. Wheaton's report to the Local Government Board on enteric fever among hop pickers in Staffordshire and Worcestershire in 1909.

  • Wheaton, S.W. (Samuel Walton)
Date:
1910
Catalogue details

Licence: In copyright

Credit: Dr. S.W. Wheaton's report to the Local Government Board on enteric fever among hop pickers in Staffordshire and Worcestershire in 1909. 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.

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    2X0 one in March, two in April, one in May, June, and July respec- tively, and one on September 15tli. Six of these were children. The case in September was a servant returning to the town, having fallen ill whilst in her situation near Bir- mingham, and no connection can be traced between her and previous or subsequent cases. The sanitary officials of Dudley could not find any explanation of the origin of these attacks of enteric fever, which were single cases in households scattered up and down the borough. All except two were admitted to hospital. No fresh notifications were received until October 18th, so that there was an interval of at least a month without any notification. After this, fresh notifications followed rapidly. Thirteen were notified in October and six in November, making nineteen in all. Fourteen of these were children, from nine to sixteen years of age, four were adult women, and one an adult man. Of these nineteen cases all but one had returned home from hop-picking on October 2nd, 4th, or 6th. The excep- tion was a woman living at a public-house in Dudley, who was attacked on October 29th, and was not removed to hospital. Of the eighteen cases which had returned from hop-picking, eleven had been at Moor Farm, six at the Pigeon House Farm, and one at a farm in the vicinity of Moor Farm, known as Stonehouse. In 15 of these 18 cases the date of onset of the illness was ascer- tained with a fair amount of certainty, and proved to have occurred within fourteen days of their return home. In the other three cases the date of onset was more doubtful, but in two appeared to have been a little over three weeks after their return home, while in the case of the child coming from Stonehouse, it was probably still later. Of these three later cases one was the child of a woman who had been attacked three days after returning home, so that it is possible the child was secondarily infected from the mother. It was also possible that secondary infection explained the second of these cases, and the illness of the child which had been at Stonehouse might also be explained in the same way, since there was a clear history of diarrhoea and suspicious, but unnotified, illness in the mother and also in a sister at a much earlier date. There was, therefore, a very strong probability, amounting to certainty in the larger number of instances, that the infection had been contracted by these persons before their return home from the hop-yards. The source of the infection will be dealt with later. It is noteworthy that, with the three possible exceptions just noted, there was no clear indication of multiple attacks or of secondary cases in the infected households at Dudley, but there was suspicion that mild cases had occurred which had escaped notification. However this may be, the very slight extension of the disease in the invaded households is remarkable, inasmuch as the sufferers belonged almost entirely to the lowest class of the casual labour- ing population, and the conditions under which they were living as regards overcrowding and unwholesome surroundings were such as would facilitate the spread of the fever to a marked degree. This fortunate absence of spread is possibly to be attri- buted to the activity of the sanitary officials in promptly remov- ing the sufferers to hospital, in disinfecting the dwellings, and 15821 A 2