Mr. Spear's report to the Local Government Board upon the prevalence of diphtheria in the Fareham registration district, and upon the occurrence therein of enteric fever.

  • Spear, John.
Date:
1889
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Licence: Public Domain Mark

Credit: Mr. Spear's report to the Local Government Board upon the prevalence of diphtheria in the Fareham registration district, and upon the occurrence therein of enteric fever. Source: Wellcome Collection.

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    / Earlier history. Diphtheria at Salisbury, Swanwick, and the Common. Infected families 1—5. Sarisbury schools. 2 According to the census returns of 1881 the population of this limited area was some 2,600, 1,600 being in the little town of Titchfield. Since then a number of houses have been built at Sarisbury and Swanwick and on the Common, so that the population now exceeds 3,000. Good roads traverse the district; the common school for the outlying parts (Swanwick, Sarisbury, and the Common) is on Sarisbury Green, and Titchfield is the resort for shopping purposes. The locality in question appears to have been comparatively free from diphtheria for many years previous to 1886. In the death returns of the 20 years preceding, I find only two deaths, both in 1872, specifically recorded under this head, although during the same period seven were ascribed to “ croup.” Dr. Hoar, who practices in Titchfield and the neighbourhood, tells me that for 30 years previous there had been nothing approaching an epidemic of the disease.* The previous history of diphtheria in neighbouring localities appears likewise to have been, on the whole, uneventful. At Warsash, a little village on the coast, two miles from Sarisbury—a village ill-drained, badly supplied with water, and subjected to occasional nuisance from the unloading of manure barges—one death was registered from diphtheria and one from croup in 1882, and in 1884 one death from diphtheria and two from laryngitis. At Wickham, an inland village four miles up the Titchfield river, one death Avas registered from diphtheria in 1865, three in 1871, one in 1872, and one in 1873, besides a death from “ croup ” and another from “ cynanche trachealis ” in the latter year. Previous to 1886 these were all the noticeable occurrences of fatal diphtheria or croup, during recent years, in the Titchfield Registration Sub-District. In the Fareham Sub-District I have not examined the mortality registers for such a lengthened period. Since 1880 to this present date the deaths registered from diphtheria and croup have been as follows:—In the Fareham Urban District (about two-and-a-half miles from Titchfield), in 1882, two from croup ; in 1884, three from diphtheria and one from croup; in 1885, two from diphtheria; in 1886, three from diphtheria and one from croup ; in 1887, three from diphtheria, one from croup; in 1888, two from diphtheria. In the remaining part of the Sub-District, comprising parts of the Fareham Rural Sanitary District further removed from Titchfield: two deaths from diphtheria in 1880 ; one in 1883; four in 1884, and one from “angina trachealis”; three from diphtheria in 1886, and one in 1887. Between the more or less isolated appearances of diphtheria, previous to 1886, here noted, and the epidemic prevalence of the disease that commenced in that year in the western portion of the district, I could trace no connexion. So far as can be ascertained, the first case of the prolonged prevalence of diphtheria in the Titchfield parish occurred in July 1886, in a row of houses known as “ Long Shore,” remotely situated on the banks of the Hamble River. The row in question contains 11 dwellings and 46 inhabitants; and between the date named and the beginning of the following September five families were invaded by diphtheria. In all 26 per cent, of the inhabitants were attacked, and there were besides two or three cases of mild sore throat. Of the cases of diphtheria, three terminated fatally; and, in addition, one convalescent died of what was registered as typhoid fever and another of “ consumption.” The sufferers of the first family attacked (six in number) were not medically treated, but the history leaves little doubt as to the nature of their ailments. Two boys, aged respectively 15 and 17, first sickened, and this within a few days of each other while employed in fruit picking on grounds where a number of stran¬ gers worked. In three of the remaining four families, the first sufferer was a young child (not a school attendant) who apparently contracted the infection on the spot; and this is probable also as regards the first case in the fifth family, although this child had perhaps opportunities also of infection at the elementary (infant) school. The sanitary conditions under which this little community was living were exceedingly unfavourable. The houses are small and low, and ill-ventilated, and very damp ; sewage nuisances polluted the atmosphere of all the back premises, while that in front was contaminated by a particularly foul fold yard hard by; sewage, too, was percolating into the well. Nearly all the children of school age from the western part of the parish (comprising the hamlets of Swanwick and Sarisbury, but not including Titch- Amongst isolated occurrences, the repeated appearance of, “ diphtheritic sore-throat ” amongst the pupils and teachers of a private boarding-school at Titchfield was mentioned. The school was eventually (February 1888) broken up in consequence o'f the ill health suffered, and removed permanently from the town. One attack had terminated fatally, it was believed, after the sufferer’s removal to his own home in another district. 22502705855