Dr. S. Monckton Copeman's report to the Local Government Board on an outbreak of enteric fever in the borough of Eccles, Lancashire, due to the consumption of ice-cream.

  • Copeman, S. Monckton (Sydney Monckton), 1862-
Date:
1911
Catalogue details

Licence: In copyright

Credit: Dr. S. Monckton Copeman's report to the Local Government Board on an outbreak of enteric fever in the borough of Eccles, Lancashire, due to the consumption of ice-cream. Source: Wellcome Collection.

    18/22 (page 16)
    u Although it did not appear likely that the ice-cream collected in the third week in November would exhibit any evidence of the infection to which the outbreak was attributable, two samples of ice-cream were forwarded to me on November 21st (LB-4245). These samples were found to contain a very large number of bacteria cultivable on gelatine at 20° C., 14,800,000 and 18,000,000 per cc. respectively, but no evidence of specific pollution was obtained. In order to ascertain how far it was possible to find bacterio- logical evidence throwing light upon the character of the November outbreak, I have analysed the records which I have kept of the examination of the blood of persons living in Eccles between the years 1897 and 1910 inclusive, and who had been affected with illnesses which on clinical grounds were suspected of being possibly typhoid fever. The value of these records is in great part due to the fact that the method of testing for the Widal’s reaction which I devised and elaborated in 1896 has been used during the whole period and has undergone no modification, so that the results obtained in 1897 are absolutely comparable with those obtained in 1910. (This method was described in the “Medical Chronicle” for October, 1896, and the “ Lancet,” December 5th, 1896.) (The following analysis which was prepared on December 1st, 1910, does not include some 14 cases which have been investigated between November 27th and December 7th, except when it has been possible to introduce these cases in the returns without incon- venience.) Between the years 1897 to 1909 inclusive 387 cases were notified to the Eccles medical officer of health as being certainly or possibly cases of typhoid fever. Of these cases 324 were tested bacteriologically in my laboratory, so that on an average over 84 per cent, of the suspected cases have been tested bacteriologically. During the November outbreak samples of the blood of patients residiug in 51 streets were examined. Between the 8th and the 28th of November 140 persons residing in these 51 streets were thus examined. During the 14 years (1897-1910) preceding the outbreak the blood of 62 persons residing in the same streets was examined with the view of finding whether they were affected with typhoid fever. Out of these 62 persons, 19 gave a positive reaction, or 30*4 per cent. Of the 140 cases investigated between November 8th and November 28th, 87 gave a positive reaction, or 61*77 per cent. There were, therefore, on an average, more cases of typhoid fever occurring daily during the outbreak than yearly during the preceding period of 14 years. There can be no doubt, therefore, that both as regards the number of cases and the specificity of the disease, the districts in question were affected in an unprecedented manner. A study of the spot maps supplied to me by Dr. Hamilton shows ^hat most of the cases may be arranged in three groups, according to the part of the town in which they occurred during the months of November and December.