[Report 1925] / Medical Officer of Health, Dorset County Council.

  • Dorset (England). County Council.
Date:
1925
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1925] / Medical Officer of Health, Dorset County Council. Source: Wellcome Collection.

    11/28 (page 11)
    Deaths among vaccinated doctors and nurses during small-pox epidemics are unknown. They can face the most malignant and fatal outbreaks with absolute safety. This is in marked contrast to epidemics of typhus fever, a disease of nearly equal mortality and infectivity to small -pox, but for which no protective vaccine has yet been found. This disease takes a large toll of the lives of doctors and nurses in attendance on typhus patients. During the past few years two doctors known in this county have succumbed to this disease ;—Dr. Reginald Farrar, a late Medical Officer of the Ministry of Health, and Dr. Lilian Dingle, who was an Assistant Medical Officer here in 1919 and 1920 ; the one died at Moscow attending typhus patients, the other died at a Mission Hospital in China. It has been asked—why, if vaccination against small-pox is to be compulsory, is vaccination not made compulsory against other infectious diseases, such as measles, whooping-cough, influenza, diptheria, which occasion a far greater mortality than small-pox. The answer is that small-pox stands alone as regards the four following combined characteristics :— 1. Its great infectivity : very few unprotected persons exposed to it escape. 2. Its high case-mortality. In outbreaks of the severe form the death-rate among the unvaccinated is 30 per cent. 3. The repulsive disfigurement which frequently results. 4. The existence of a vaccine which is an absolute protection against a severe attack, and a great protec- tion against any attack, and which can be effected by a single simple harmless operation. The dangers of vaccination are absurdly exaggerated. In 1922, 340,000 infants were vaccinated, and 8 deaths occurred, 4 from vaccination and 4 from deaths due to want of cleanliness, etc. (septic infection and eczema). Thus only 1 in 40,000 of those vaccinated infants died. Now, in England and Wales 75 infants out of every 1000 died of various complaints, or 1 in 14. It is obvious that the effect of vaccination on infantile mortalit}^ is negligible. The average number of persons killed yearly when travelling on the railway is 150 (average for years 1912- 1923). It is therefore far more dangerous to travel regularly by train than to be vaccinated, yet people face the risk daily, and increasing numbers face the far greater risks involved in motoring, hunting, etc. INFECTIOUS DISEASES. During the past five years, apart from influenza, there have been no serious outbreaks of epidemic disease. The two largest towns in the county—Poole and Weymouth—have suffered very little from epidemic illness. The prevalence of epidemic jaundice in some districts in 1924 is the only disease for which new measures were necessary. Small-pox. No case of small-pox was notified during the year. Diphtheria. The only important outbreak was at Motcombe, in the Shaftesbury Rural District. Fourteen cases were notified. The patients were mainly the children of dairy workers. I visited the district and consulted with the acting Medical Officer of Health, Dr. Harris of Shaftesbury. I made a series of recommendations to him and to the District Council, which were promptly and ca.refully carried out. The Isolation Hospital was opened and 12 of the cases treated there. Drastic measures were taken to prevent any infection of the milk supply. No dairy workers were permitted to resume their duties until after quarantining, swabbing, and disinfection. The measures taken effectually prevented the spread of the outbreak. The first case was notified on 21st September, and the last case on 2nd October. Scarlet Fever. There was an outbreak of Scarlet Fever in Dorchester Borough in July, which was promptly and effectively dealt with by Dr. Cyril Day, the Medical Officer of Health of the Borough, who is also, fortunately. Medical Officer of Health of the Rural District. The exceedingly prompt measures taken by Dr. Day without doubt prevented a serious epidemdc ; as it was, the outbreak was limited to only 12 cases in the town. In 1909, when a milk-borne outbreak occurred, 60 persons were affected. Dr. Day gives the following account in his Annual Report ;— “ On the 4th July, 1925, a milk-borne scarlet fever epidemic broke out in Dorchester and was quickly traced to a dairy seven miles away, from which milk was brought in daily to a town retailer. I examined the four milkers (Father, two sons and daughter), but all were in good health, nor did they admit that any illness had ociTiirred in their family, but on careful examination of an infant in the dairyman's house, I found evidence of peeling on the feet, and in the village school I found two out of four more children of this family were also peeling with Scarlet Fever. There is no doubt that the daughter in attending to the younger children between the milking times, conveyed the infection to the milk supply. The supply was immediately stopped and all infected milk destroyed, the utensils boiled and a fresh batch of milkers put on to milk, and other suitable precautions taken. The children were immediately removed to hospital, and the epidemic ended on the 10th—all the twelve cases had taken milk from this dairy. In Sherborne Urban District 51 cases of Scarlet Fever were notified in 1925, 47 of the cases being admitted to Hospital. The outbreak was difficult to deal with owing to the mild character of the disease. Several of the cases were diagnosed only after peeling had begun. In the Rural Districts, 10 cases were notified in the Beaminster District, 14 cases in the Dorchester District, 9 in the Wareham, and 10 in the Weymouth Districts respectively. In the Dorchester district, some of the cases were the origin of the small milk-borne outbreak in Dorchester Borough already referred to.