Dr. Airy's report to the Local Government Board on an outbreak of diphtheria in 1889 in the Samford rural sanitary district (Suffolk) / [Hubert Airy].

  • Airy, Hubert, 1838-1903.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Airy's report to the Local Government Board on an outbreak of diphtheria in 1889 in the Samford rural sanitary district (Suffolk) / [Hubert Airy]. Source: Wellcome Collection.

    4/6 (page 4)
    f 4 Bv the end of the year this severe epidemic had subsided, and the first quarter of the present year (1890) has passed without a recrudescence of the infection. It remains to be seen whether a fresh crop will appear next °°S there were about 75 cases, of which 15 were fatal, or 16 including Mrs Palmer. In five families one or both of the parents caught the disease from the children. There was one fatal case (Samuel Palmer) at the age of 75 and another (Sarah Palmer) at 73 ; and three non-fatal cases m young ueople of 20,18, and 15. All the rest were children from 1 to 12 years. The most susceptible age appeared to be from 5 to 6 years. There was evidence of remarkable difference in degree of susceptibility m different families. In many families only one child was attacked out of four or five while m others the infection spread rapidly from one child to another. In Barney Bullaul s family at Tattingstone, all five children and both parents were attacked, and four of the children died; while of five children in Aldridge s family none caught the disease from the boy who was first attacked, though one o± them slept in the same bed with him. . As to the probable cause of the outbreak, it is difficult to deny a certain weight to the considerations on which the earlier cases were ascribed by local belief to the malodorous traffic in London manure.* I tried to learn from what part of London the particular cargo in question had come, but did not succeed. The manure barges take their freight at many points on both sides of the Thames. Some significance attaches to the circumstance that this traffic has (it is stated) increased considerably in recent years; while at the same time diphtheria has become increasingly prevalent in London. For example, in the fourth quarter of 1882 the deaths from that cause in London were 229 ; but in the fourth quarter of 1888 they were 460. This necessarily implies increase of such danger as diphtheria-infected refuse conveyed from London may cause to the agricultural districts where the manure is used on the land. The Medical Officer of Health, Mr. G. S. Elliston, informed me that some years ago he had reason to think that an epidemic of scarlet fever which broke out at Shotley was connected with a deposit of London manure in that parish; and only last year (1889) there was an outbreak of scarlet fever, fortunately of a mild type and unattended by any fatal consequences, in the village of Stutton, and this appeared to arise from two children playing about a heap of London manure that had recently been carted into a field. Similar occurrences have also been reported from other districts receiving London refuse, j* The subject is one that might well repay comprehensive inquiry. Seeing that Chelmondiston is only five miles distant from Ipswich, and that there is frequent communication between them, it might be thought not unlikely that the infection had been derived from that town, especially as there had been three deaths from diphtheria in Ipswich in the fourth quarter of 1888, and six in the first quarter of 1889. I give, below, a table showing the regis¬ tered diphtheria mortality in the two sub-districts of the Samford Union, and in Ipswich respectively. It cannot be said that there has been any evident correspondence between them in former years, but it is certainly noteworthy that the recent mortality in the Holbrook sub-district is found occurring side by side with a heavy mortality in Ipswich, suggestive of some re-action between the two districts, or else of common exposure to the same cause, or to the same set of conditions favourable to the development of the disease. Beyond this parallelism, however, there was no evidence of connexion between the cases of diphtheria in Ipswich and those in the Samford district. * In view of the case I shall presently have to record, of an occurrence of diphtheria in Chelmondiston antecedent to the June outbreak, and in view of our habitual difficulty of recognizing diphtheria in its minor phases, the suggestion has been made to me that the foul effluvia of this London manure may have operated to hasten forward the development of some home growth ot the disease, rather than to introduce the disease, in its already full grown form, from the metropolis. For practical purposes, I may include this suggestion in the accusation against London manure propounded in the text. t E.g., the Strood Rural Sanitary District in Kent,