[Report 1949] / Medical Officer of Health, Cork County Borough.

Cork (Ireland). County Borough Council.

Date:: 1949

Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1949] / Medical Officer of Health, Cork County Borough. Source: Wellcome Collection.

11/180 (page 5)

There is scarcely any doubt that this disease is much more prevalent in this country than is generally believed (particularly in rural areas where it appears to be associated with the increased acreage under sugar beet and the consequential increase in the rat population. At least so it is argued). One knows of several instances in which personal acquaintances have become infected and died. It does not seem to be generally appreci- ated among the medical profession that this is a notifiable disease. The disease is primarily one of the rat in which the infecting organism does not appear to affect its host, or only in a mild degree. It is voided in the rat’s urine and consequently those most at risk are they who would have the handling of materials so contaminated. Sewer workers, in particular, are liable to contract it ; mine workers, agricultural workers and persons who swim in stagnant waters are also liable to suffer. The organism almost always enters the body by some scratch, abrasion or other injury to the skin and having done so gives rise to the characteristic symptoms which have given it its scientific name—haemorrhagic jaundice. In the case under review there was a history of having fallen into the river Lee some time before the illness developed. I am obliged to Dr. Andrew Whelton for permitting me to examine his records in this case, to Dr. John Fitz- gerald who drew my attention to it and who submitted a copjr of the patient’s case sheet and to Dr. J. C. Broom of the Wellcome Laboratories of Tropical Research, London, who carried out serological investigation and kindly placed his results at my disposal. Two cases of cerebro spinal meningitis were reported, both in the same day, from the North Fever Hospital. Both were females. One was a woman, aged, 53, years who had been transferred from the Victoria Hospital. She was taken ill on 20th January and was admitted to hospital three days later complaining of severe frontal headache and vomiting which was constant. A lumbar puncture was carried out and meningococci were found in the cerebro spinal fluid. She was treated with large closes of penicillin and with sulphamethazine and was admitted to the fever hospital in a semi-conscious condition. Under treatment she ran an irregular temperature until the 29th January after which she gradually improved and was eventually discharged on 15th February. The second case was a child aged 5 years who presented similar symptoms and, in addition, had some neck rigidity. In her case also the diagnosis was confirmed by the finding of meningococci in the spinal fluid. She improved steadily under treatment and was discharged on 8th February. Scarlet fever pursued its accustomed mild course during the year. ,. lere were cases an(l no death. The disease has been of mild character or many decades and has had a very low mortality rate. An interesting incident came to our notice during the year in connection with a small private day school in which two cases occurred. The children were taken hi and on investigation it was learned that another pupil had been operated on for what had been diagnosed as mastoid disease. This opera- 3rdMav ?„T,t °t 1“ Februa,y 1W»- This «»y ™tamod to sohod on ' , ,•) lhe,/ir8t case arose two days later, the second child was a ten ill on 20th May-. At the time of investigation the original child was not attending school and I went to his home to see him. I confirmed that he had been operated on and on examination found him to have a partly healed scar, covered with dried crust, behind the left ear. Some of this