Annual report of the Department of Public Health / Union of South Africa.

  • South Africa. Department of Health.
Date:
[1926]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report of the Department of Public Health / Union of South Africa. Source: Wellcome Collection.

    44/74 (page 42)
    wound healed up without any local trouble, but on 5th June the boy became drowsy and the site of the bite painful. On the following day the arm was painful and itchy, and the patient scratched it until he drew blood. Spasms of the throat muscles occurred when he attempted to drink ; towards evening the spasms became worse; he was unable to swallow anything and could not sleep. In the morning he was unable to swallow anything, and any attempt to swallow brought on a violent spasm, as did the sight or even the mention of water ; after each spasm he biought up a little blood-stained watery fluid, containing dark material like coffee-grounds. The subcutaneous tissue of the neck and front of the chest, and of the back to a slight extent, was emphysematous, apparently from escape of air from the trachea or larynx during spasms ; the pupils were equally dilated during spasms and normal between. The boy died on the afternoon of 7th June, and the body was buried without examination. Some vomited matter was sent to the South African Institute for Medical Research, but was, of course, useless for examination. No information of the case reached this Department until several weeks later, so that another opportunity of making a definite diagnosis was lost. The two cases mentioned, although the possibility of tetanus or some similar disease cannot be excluded, tend to strengthen the disquieting suspicion mentioned in the 1924 report that there may be sparse and smouldering rabies infection amongst the wild fauna of South Africa. Vigilance should be exercised by all concerned, and any suspected case in man or animals should be promptly reported for investigation ; animal suspects should, if possible, be preserved alive, as decomposition greatly increases the difficulties of pathological examination. In fatal suspected cases in man a careful post-mortem examination should be made, and the brain, upper portion of the spinal cord, and a quantity of the cerebro-spinal fluid sent, packed in ice and by special messenger, to the South African Institute for Medical Research, Johannesburg, or the Government Pathological Laboratories at Cape Town or Durban, which¬ ever of the three is the nearest, the institute or laboratory being first advised by telegraph or telephone and requested to have everything in readiness for examination of the materials immediately on receipt. 9. Smallpox and Vaccination.—The following tables show the occurrences of smallpox and the public vaccinations performed during the year. Although the Union has never been entirely free from smallpox during the period, no serious prevalence has occurred. Ten of the cases, with one death, occurred in Johannesburg. Owing to the non-prosecution of defaulters pending the further consideration by Parliament of the “ conscientious objector ” question, vaccinations amongst all classes of the population are tailing off, and concurrently the unvaccinated section of the population is increasing—a state of matters which, if not remedied before long, may lead to a severe epidemic. TABLE N.—(i) SMALLPOX : CASES AND DEATHS REPORTED DURING THE YEAR ENDED 30TH JUNE, 1926. Province. Number of Districts Affected. European. Non-European. Total. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cape. 12 5 31 1 36 1 Natal. — — — — — — — Transvaal. 10 1 — 28 1 29 1 Orange Free State 4 — — 7 — 7 — Union. 26 6 — 66 2 72 2 1