Reports and papers on suspected cases of human plague in East Suffolk and on an epizootic of plague in rodents.

Date:
1911
Catalogue details

Licence: In copyright

Credit: Reports and papers on suspected cases of human plague in East Suffolk and on an epizootic of plague in rodents. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    K Although there was, l)r. Browu points out, definite evidence of lung congestion in every case, in only one instance, that of A. M. P., was there extensive pneumonic consolidation. Diarrhuja and vomiting was pronounced in three out of the four cases. In other words, there was probably lobular pneumonia, which is such a characteristic feature of pneumonic plague, in two, if not three, out of the four cases. There was. Dr. Sleigh observes, dark, blood-stained expectora- tions in every case, except that of A. M. P., but such expectora- tion was in no sense typical of lobar pneumonia. The nervous system was but little involved, and there was only delirium in one instance. As regards the other cases, conscious- ness was retained until a few minutes before death. The infectivity of the disease was obviously high, but, as regards this point, it has to be observed that more or less continuous and intimate association with the patient, and this by persons relatively ignorant of the importance of taking pre- cautions, seems to have been necessary for infection. The two lj).swich nurses who, to their great credit, volunteered for service after the risks had been fully explained to them by Dr. Brown, escaped infection, as also did the district nurse and Mrs. C., the dead woman’s sister. The several medical men who were called in to see the cases, and who were brought, at least for a short time, into intimate contact with the patients e.scuped, as also did the rector of Preston, the liev. C. Durraut, and his daughter, both of whom fearlessly ministered to the sick. Moreover, in both of the invaded houses there were several persons—mostly children—who, before the nature of the disease was suspected, must have had opportunities, although, perhaps, minor and transient, of becoming infected, but who, never- theless, remained well. Subsequently, however, these persons were isolated, iirst on the premises and later at the isolation hospital at Tattingstone. As will be .seen in Part III. of this re])ort, a similar high infectivity characterised the outbreaks of illness at Shotley and Trimley. As regards fatality-rate, that of the Preston outbreak was lUO per cent., i.e., 4 cases and 4 deaths; while that of the two out- breaks of suspicious illness, described in detail later on, was almost equally high. It may be added that a high fatality-rate is one of the charac- teristics of pneumonic plague, as is being exemplified in the out- break of that disease in Manchuria. The Bacteriological Findings. As will be seen by the foregoing accounts of the clinical features of the Preston cases, and by the forms which the death certificates took in the first instance, the attending physicians were puzzled as to the i)recise nature of the malady. Dr. Brown, therefore, determined to have recourse to bacterio- logical examination, and he submitted to Dr. Llewellyn Heath, honorary bacteriologist of the Ipswich and East Suffolk Hospital,