Mr. John Spear's report to the Local Government Board on the prevalence of "fever" in the urban sanitary district of Maryport.

  • Spear, John.
Date:
[1882]
Catalogue details

Licence: Public Domain Mark

Credit: Mr. John Spear's report to the Local Government Board on the prevalence of "fever" in the urban sanitary district of Maryport. Source: Wellcome Collection.

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    r. John Spear’s Report to the Local Government Board on the prevalence of “Fever” in the Urban Sanitary District of Maryport. George Buchanan, Medical Department, April 13th, 1882. On the 24th June 1881 the Local Government Board received information from the Registrar-General that “fever” was prevalent in Maryport. Amongst a population of 8,126, eight deaths, three of which were ascribed to enteric and two to typhus fever, had been registered within the preceding three weeks; and the Board accordingly requested information of the Sanitary Authority as to the nature of the fever, the number of ascertained attacks, and the condition of infected localities. In reply, a report by the Medical Officer of Health was forwarded. Fever was spoken of as epidemic, and, in regard to its nature, as having “from the mild typhoid form assumed the form of typhus.” Ho indication was given of any action by the Sanitary Authority under these circumstances. On the contrary, statutory deficiencies were spoken of as likely to render any such action, beyond provision “ for the cleanly condition of the streets,” even if attempted, futile. During the following (the third) quarter five deaths were again registered from fever— three from typhus, one from enteric, and one from “low” fever. On the 4th of January of the present year I received instructions to visit the district and inquire into the nature and circumstances of the outbreak. During my visit, lasting from the 12th to the 14th of January, I saw two cases of fever, the only two remaining at that time under treatment at a stage when a diagnosis could be made. Both were un¬ equivocal attacks of true typhus. One, especially, was associated in its causation with many preceding cases; it was one, indeed, of a long and unbroken series that had constituted the major part of the outbreak, and its diagnosis therefore was possessed of a wider application. Several persons recovering from the disease were likewise seen, and they presented all the appearance—in marked distinction from the aspect of typhoid cases—of typhus convalescents. The epidemic visitation which formed the immediate subject of this inquiry, was, it may be said with certainty, one of typhus fever. The origin of the infection cannot now be determined. There were rumours of earlier cases of “fever,” and two deaths, it is to be noted, were registered from “ typhoid” during the last months of 1880 ; but the first undoubted case, and the one from which apparently all subsequent mischief sprang, occurred in a wretched crowded tenement in Eaglesfield Street. The sufferer here was a man aged 39, living with a woman and eight children, and associating with the sailors of vessels trading between Maryport and places in Ireland. This man died on April 18th, 1881, after a few days’ illness, the cause of death being registered as “ bronchitis,” although the medical attendant, from subsequent events, now recognizes the case as having been one of fever. A brother-in-law, aged 29, who had assisted in nursing the deceased man, was the next to sicken ; he died on the 6th of May. His death, likewise now ascribed to “fever,” was registered as from “meningitis.” The house this man occupied, in Bank Lane, consisted of two small rooms and an attic; it was built on the back-to- back plan, and the ventilation of the rooms was most imperfect. Here lived five adults and five children, and they all, with the exception of one or two of the children, caught the fever. The mother-in-law, one of the inmates, died on May 25th from, as registered, “ heart disease, enteric fever,” duration 14 days. A sister-in-law, aged 29, another inmate, died the day before, her death being registered as from “ tubercular meningitis, convulsions.” A woman who came to nurse the sufferers was likewise infected, and, going then to her own home, infected her sister. These two people, together with three others from the house in Bank Lane, were eventually removed to the fever hospital of the Guardians. Meanwhile the fever was spreading in and from the house first invaded. The children of the deceased man, and the children of the woman with whom he lived, caught it; and the former, being removed on their father’s death, and whilst still ailing, to the house of an aunt, infected that family. The aunt died on the R 923. 100.—4/82. Wt. 20177. E. & S. A