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.

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    divided into three groups, all in the southern portion of the town, of which the main group occupied an area in the neighbourhood of the Town Hall and St. Mary’s Church. And, as was pointed out by Dr. Hamilton, the houses invaded by the disease are not of quite the poorest class, the rents ranging from 4s. 6d. to 7s. a week, according to their location, and according to whether they are provided with a hot-water supply or not. It is of interest to note that not a single case of enteric fever has been reported from the better-class houses in the portion of the town north of the railway, with an approximate population of 10,800. The explanation of this peculiar distribution of the disease will be discussed later on, when considering the question of causation of the outbreak. During the year 1910, up to October 31st, fourteen notifications of enteric fever were received, of which none (with two exceptions, in which blood-examinations gave negative results, and a third in which, although no blood examination was available, the diagnosis was almost certainly incorrect) were notified subsequent to April 5th, so that a period of no less than seven months elapsed between notification of the last undoubted case of this fever and the commencement of the epidemic with which this report is mainly concerned. Causation of the Outbreak. Although the peculiar age incidence of the fever indicated that some unusual source of infection might be expected to be in operation, investigation of the more usual and frequent sources for the spread of the infection of enteric fever was not neglected. The water supply is obtained from the Manchester Corporation, and comes from the same source (Thirlmere) as that supplied to the City of Manchester itself. The quality of this water is excellent, and there being no record of any simultaneous outbreak of enteric fever in Manchester or Salford (which is also supplied from the same source) it became obvious that no general infection of the water supply was in question. There remained, however, the possibility of some local contamination of the mains, especially as not a single case of the disease was notified from the Ellesmere Park district of Eccles, north of the railway line. But, upon examination of a plan of the Eccles mains and service pipes, and con- sideration of all repairs to water-mains or service-pipes during the previous three months, it became evident that the question of water supply in connection with the outbreak could be eliminated. Without going into unnecessary details, it will serve simply to record the fact that no evidence could be obtained pointing to the sewerage and drainage system of the town being in any way concerned in the dissemination of infection From enquiries made as regards possible relationship between milk supplies and the fever, it appeared that no milk was used in the invaded houses, except for puddings, other than the small quantity taken in tea. Moreover, no particular source of supply could be shown to be common to any considerable proportion of the families, one or more members of which had suffered attack by the disease. 19192 a 2