Dr. Parsons's report to the Local Government Board on an outbreak of diphtheria at Camberley and York Town, in the parish of Frimley, in the Farnham rural sanitary district / [H. Franklin Parsons].

  • Parsons, H. Franklin (Henry Franklin), 1846-1913.
Date:
[1889]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Parsons's report to the Local Government Board on an outbreak of diphtheria at Camberley and York Town, in the parish of Frimley, in the Farnham rural sanitary district / [H. Franklin Parsons]. Source: Wellcome Collection.

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    Incidence on working class. As regards age and sex. Cause unde¬ termined. attendance, milk supply, and water supply. In one of the households two sisters, one attending school and one not, were taken ill on the same day, there having- been no previous sickness in the family, so far as could be ascertained. Towards the end of November and the beginning of December the number of households newly attacked fell off, but it increased again in the middle of December. In this later part of the period the disease presented some differences of behaviour from its earlier course; its extension from household to household was more obviously due to personal intercommunication, but it tended less to spread within the family, and the proportion of deaths was less. A curious circumstance, which I have noticed in some other outbreaks, is the much greater mortality among those members of the family who were first attacked than among the subsequent cases. In the families invaded, 13 out of 2S initial cases* died, whereas among 32 subsequent cases there were only six deaths. Whether this difference be due to the persons most susceptible of the disease being the first to be attacked, or to medical attendance having been more promptly called in to the later cases, with the result of averting a fatal issue, or to the earlier cases when mild not having been recognised as diphtheria, I cannot say. In its incidence upon persons of different social classes the present outbreak of diphtheria presents a strong- contrast to that reported on by Mr. Power. In that case households of the well-to-do class, i.e., large consumers of milk, were especially attacked. On the present occasion all the households attacked, with the exception of two tradesmen’s, were those of persons of the cottager class— college servants, artisans, and labourers. The following table shows the incidence of the disease as regards age and sex : — Age. Initial Cases.* Subsequent Cases. Total. Grand Total. Males. Females. Males. Females. Males. Females. Under 1 - 1 1 1 1-5 - - - 4 6 6 2 10 8 18 5-15 10 5 7 6 17 11 28 15 and upwards 1 2 3 *T i 4 9 13 Totals - 15 13 17 15 32 28 GO The bulk of the sufferers were thus children, especially children of school-going age. There were rather more males than females, except among adults; women having contracted the disease more frequently than men, no doubt owing to their being brought oftener into contact with infection in nursing patients. The deaths occurred at the following ages : — O O Age. Males, Females. Total. 1-5 5 7 12 5-15 4 2 6 34 — 1 1 Total - 9 10 19 In looking for the cause of the outbreak of diphtheria in November 1888, we seem to require, in order to explain the first dissemination of the disease, some condition or combination of circumstances first coming into operation about the beginning of November, and acting in a scattered fashion over a somewhat wide area, though exhibiting a preference for certain localities, and confined in its operation to persons of the poorer or lower middle class. Such a condition I have not been able to find; possibly it may have escaped notice, or have been of a nature as yet unsuspected, or possibly different causes may have been concerned in different cases. It will be necessary for us to consider the various circumstances known of suspected to stand in a causal relation to diphtheria, in order to ascertain how far each may have had a share in the result. * In the two households in each of which two children were taken ill on the same day, both cases are x-eckoned as initial ones. The number of initial cases is thus greater by two than that of the households invaded. A. 2