Mr. Spear's report to the Local Government Board on the fatal prevalence of scarlatina in the first (central) division of the Neath rural sanitary district / [John Spear].

  • Spear, John.
Date:
[1890]
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Licence: Public Domain Mark

Credit: Mr. Spear's report to the Local Government Board on the fatal prevalence of scarlatina in the first (central) division of the Neath rural sanitary district / [John Spear]. Source: Wellcome Collection.

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    . .V*. V*.' ,_s JJr. Spear’s Report to the Local Government Board on the WELLCOME 1 Fatal Prevalence of Scarlatina in the First (Central) Division of the Neath Rural Sanitary District. LIBRARY General Collections +P ✓7* 7? George Buchanan, Medical Department, November 3rd, 1890. The compulsory notification of the principal infectious diseases has been in operation in the Rural District of Neath since January 1st of the present year, so that an approximately complete list of the cases of scarlatina that have occurred since that date is available. The numbers recorded in the various months are as follows:—In January, 5 ; in February, 2 ; in March, 1 ; in April, 9 ; in May, 35 ; in June, 25 ; in July, 59 ; in August, 24 ; and in the first three weeks of September, 21. The total number reported during this period was 181, and of these 31 were fatal. The first division of the Neath Rural District has a population now estimated at 13,300, and contains six separate hamlets. Coedfranc, with a population estimated at 4,400, is the most important of these, and the one that suffered most severely from the scarlatina prevalence. Of the total number of 181 cases reported, 81 were from Coedfranc, and of the deaths, 21 of the 31 recorded occurred in that locality. In other words, the fatality of the disease at Coedfranc exceeded 25 per cent, of the reported attacks; while in the remainder of the district the corresponding proportion was the more cus¬ tomary 10 per cent. The causes of the large prevalence of the disease and of its excessive fatality at Coedfranc, were two special points in the inquiry. At Coedfranc the outbreak in the spring and summer of the present year appears to have been the climax of a long continued prevalence. In July 1889 the Medical Officer of Health reported “ scarlatina is still hovering “ aboutin August, “ there have been a few cases of scarlatina, but the “ disease has not broken out into any activity in October, “ scarlatina is “ a little more prevalentin December, seven cases were reported. In all, during 1889, five deaths from the disease were registered at Coedfranc. The compulsory notification of infectious disease has not been accom¬ panied by any efficient action for preventing the spread of infection in the district. In effect, the notification certificates received were simply filed. The Medical Officer of Health has visited houses from which fatal attacks were reported, but not upon receiving information of infectious sickness. On occasions chloride of lime has been given by the Sanitary Authority to infected households, but the use of disinfectants has not been systematically, or as a rule, enforced. For example, in October 1889, two children suffered from scarlatina in a house at Springfield, Coedfranc, and one died. The Medical Officer of Health visited the house, but no disinfectants were used, nor was any lime-washing or re-papering, or other special cleansing of the rooms, carried out. The disease again made its appearance in the same family in January of the present year, and another child died, and again no measures of disinfection were taken. The Medical Officer of Health has frequently advised the Authority to provide an isolation hospital, but his advice has not been followed. He has frequently reported that isolation was impossible in the cottages of the poor. One of the schools at Coedfranc was closed during the scarlatina prevalence in the summer of 1889, but nothing of the sort was attempted at Coedfranc during the far more serious prevalence of 1890. There is little doubt that school attendance played a considerable part in the dissemination of infection. The mistress of the Abbey Infant School gave me to understand, for example, that on four different occasions she found children attending school whose skin was in a state of active desquamation after scarlatina. As a matter of fact, the school suffered from the disease to a greater degree than other schools. Amongst the 150 children, or thereabouts, who habitually attend E 64440. 150.—11/90, Wt. 12791. E. & S.