Dr. Parson's report to the local government board on the prevalence of typhoid fever in the borough of Haverfordwest, and on the general sanitary condition of the borough.

Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Parson's report to the local government board on the prevalence of typhoid fever in the borough of Haverfordwest, and on the general sanitary condition of the borough. 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.

    2/12 (page 2)
    stagnant water lying in pools around them, and there are heaps of refuse at hand on which excreta are thrown : water is obtained from a well at some little distance. The remaining case occurred in Bridge Street, in the lower part of the town. Two of the cases at Albert Town were fatal, and the last recovered about February or March 1880. From that time the town continued, so far as could be learned, free from fever for nearly 6 months. In the beginning of August several cases of typhoid fever commenced nearly simultaneously in different parts of the town, and it soon attained a widespread prevalence. Of the origin of the outbreak I can give no explanation; the earliest of the cases, so far as dates could he obtained, lived in widely separated localities, in some instances unconnected with the town sewers or water service, and no direct communication between them or common cause can now be discovered. Sanitary defects indeed existed at the houses in which they occurred, but similar defects are to be found at only too many of the houses in Haverfordwest. To account satisfactorily for the occurrence of the earlier cases it should be shown how these particular patients came about the same time to be exposed to the specific poison of the disease. I am unable to do this, or to point out the means by which the typhoid poison (supposing the town to have been free from it before, which is by no means certain) may have been introduced. The first case was the son of a sergeant of militia, and several cases later on occurred in the families of the militia staff: but the militia, who assemble in Haverfordwest for drill, were disbanded in May, 3 months before the outbreak occurred. There are other occasions on which the town would be visited by persons from various parts of the county, e.g. the yeomanry drill in June, and the Assizes in July ; but I have no evidence to show that fever was introduced by such persons. Inquiries were made as to whether manure from Albert Town, infected by the excreta of the cases which occurred there during the previous winter, could have been spread over fields of which the drainage might have entered water used for drinking, but nothing definite could be ascertained. At the time when the fever commenced the weather was very hot and dry, the rainfall for the 12 months, October 1879 to October 1880, having been, as I am informed by Mr. Phillips, Surgeon, of Haverfordwest, 2\ inches less than in any other period of 12 months during the past 32 years. The first case, so far as could be ascertained, was a boy who was taken ill on August 2nd; he lived in a cottage on the south-west outskirts of the town, but attended the Board Schools in Haverfordwest. The cottage is uncon- nected with the town sewers or water-service. Bainwater is usually used for drinking purposes, but during the dry weather it failed, and water was obtained from wells at neighbouring houses, or purchased at the door from a watercart. The watercart is supposed to have been generally filled from a stream at Merlin’s Bridge, at the margin of the district on the road to Milford. This stream receives sewage from houses and privies, but there are several houses at Merlin’s Bridge the inmates of which drink the stream water, and no cases of fever are known to have occurred there. In whatever way the boy contracted his disease, it is hardly possible that this case could have been the starting point of the epidemic, both from the isolated position of the house, and the rapid succession in which it was followed by others in divers parts of the town. It is more probable that the cases owed their origin to a common and widespread cause in operation at an earlier date, such as the contamination of the town sewers or water-service by infectious matters from some previous case, the nature of which escaped recognition, or which was not reported. The approximate dates of com- mencement of the cases occurring in August are as follows :— August. 2nd. 9th. 10th. 11th. 18th. 20th. 21st. 23rd. 26 th. 27th. 28th. 30th. Indef. Total. Cases 1 2 1 1 1 2 1 2 1 1 1 1 2 17 All these occurred iu different households. All the persons attacked but four drank water supplied from the Portfield reservoir, to be mentioned further on. Of the exceptions, one was the first case already mentioned; another (August 10th) drank water from a brook, obtained probably sometimes below the place at which the brook receives the contents of a