Dr. Netten Radcliffe's report to the local government board on the prevalence of diphtheria and scarlet fever at Sidmouth, and on the sanitary state of the town and district.

  • Radcliffe, Netten.
Date:
1877
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Licence: Public Domain Mark

Credit: Dr. Netten Radcliffe's report to the local government board on the prevalence of diphtheria and scarlet fever at Sidmouth, and on the sanitary state of the town and district. 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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    Mr. Netten Radcliffe’s Report to the Local Government Board on the prevalence of Diphtheria and Scarlet Fever at Sid- mouth, and on the Sanitary State of the Town and District. George Buchanan, ■ - ■ - ■■ Assistant Medical Officer, September 5, 1877. In accordance with instructions I visited Sidmouth (3rd—7th August), and made inquiry as to the prevalence of diphtheria and of scarlet fever there, and generally as to the sanitary condition of the town and district. I now submit briefly the results of the inquiry, as also of a conference with the Local Board of Health on the several subjects to which it related. Six deaths from diphtheria or diphtheritic affection have been registered, and probably seven have occurred, in the Urban Sanitary District of Sidmouth (population. Census 1871, 3,360) since the beginning of the year.* Two of these deaths happened in January, in separate families, one in March (in one of the families in which fatal cases had occurred in January), one in June, and two (three?) in one family, in July. The last of these deaths occurred on the 25th July. With regard to scarlet fever, the district appears to have been free from the disease at the beginning of the year. On the 17th July the Medical Officer of Health reported its epidemic prevalence in the district, and at the time of my visit 60 cases or thereabout had come to his knowledge, and one fatal case had to that time been reported.f Excepting diphtheria and scarlet fever no other form of fatal infectious disease appears to have been recently prevalent in the district. But on the 17th July the death of a girl, aged 17 years, from “ fever,” probably enteric, was registered; and it is not unimportant to mention here that small-pox has recently shown itself in a neigh- bouring district. It would appear then that an epidemic of diphtheria is imminent in the district, that scarlet fever is rapidly extending there, that there is present danger from enteric fever, and that a near approach of small-pox has to be guarded against. The Local Authority is unprepared to meet either the present or any threatened epidemic. It has no hospital for the isolation of cases of infectious disease, no public means for disinfection, and no mortuary. In other words, it has made no provision whatever of the sort the law empowers it to make for the direct arrest or limitation of infection, though such provision is here peculiarly necessary under the crowded condition in which much of the cottage population lives, if any control is to be exercised over the prevalence of infectious disease in the district. With respect to small-pox, the population of Sidmouth appears to be in a particularly unfortunate position, not only from the want of any provision for dealing with the disease on the part of the Local Authority, but also from the imperfect state of infant vacci- nation among it. I would refer to the Medical Officer of Health’s statements on this subject, in his annual report for 1876. This imperfection is said to arise from the public vaccination being seriously interfered with by a practice of gratuitous vaccina- tion carried on at the Public Dispensary of the toAvn. This practice, although of im- portance when the Dispensary was first established, and until the present regulations as to public vaccination came into force, is now detrimental to the population of the town and district, as well, it would appear, from the difficulty of making it efficient as from its impairing the efficiency of the arrangements for public vaccination. The recommendations of the Medical Officer of Health (17th July) in view of the present epidemic of scarlet fever were such as Avere practicable in the absence of hospital accommodation and public means of disinfection, and consisted in the closure for a time of the parish day schools and the Sunday schools, the gratuitous supply of disinfectants, the distribution of printed instructions for the guidance of the people during the epidemic, early burial of the dead from the disease, and a house-to-house visitation for the discovery and removal of nuisances. All of these recommendations were judicious and of the last importance in the •unprepared state of the Local Authority + if the epidemic were to be arrested ; but * There is reason to believe that a death registered as “hydrocephalus” should have been registered as “diphtheria.” The patient was a child two years of age, who died on the 17th July. On the 21st and 25th July two other children of the same family, aged respectively 5 years and 6 years, died. The cause of death in the one case was registered as “ diphtheria,” and in the other as “ sore-throat, diphtheritic.” f Under date the 31st August, the Medical Officer of Health informs me that about 100 additional cases of scat let fc\er have come to his knowledge since my visit, and that t hree other deaths from the disease have bet n tegistered. X The Medical Officer of Health, the Local Board not acting in this respect, himself communicated with the vicar and other school managers, and induced them to close the schools. 42918. 100.—9/77. A\rt. 6641.