Mr. W. H. Power's report to the local government board on an outbreak of "fever" that proved to be trichinosis on board the reformatory school ship "Cornwall".

  • Power, W. H.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Mr. W. H. Power's report to the local government board on an outbreak of "fever" that proved to be trichinosis on board the reformatory school ship "Cornwall". 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.

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    The boys on board the “ Cornwall ” are divided primarily into two watches, port and starboard, of equal strength ; and are also classed in messes which are 20 in number in all. A third sort of grouping of the boys, in 18 “divisions,” has reference to seniority and to sleeping quarters. The watches, each on alternate days, are employed on the work of the ship, seamanship-instruction, &c.; the watch not on duty being at school. On one afternoon in each week, Wednesday, all hands go ashore for recreation—cricket, football, and the like. The messes, each numbering 12 or 13 boys, have reference only to meals, and all meals are taken on the middle deck. Except at meal times boys of the same mess do not necessarily associate together. The sleeping berths, which are allotted without reference either to watches or messes, are with few exceptions on the middle and lower decks. Inmates of the sick-bay and wet-a-beds alone sleep on the main deck. Data of the sort furnished by the table were studied with reference to the domestic life on board the ship here glanced at, but they did not for a length of time afford any clue to the outbreak. Of the many direc- tions in which inquiry was pushed without result, some of the chief are as follows :— Nothing could be discovered leading to suspicion that any groups, large or small, of boys could have been infected while on shore for amusement or exercise; and, beyond a somewhat heavy incidence of the early outbreak on a particular mess (an incidence that could not it was thought be usefully considered until other questions had been exhausted), no sort of grouping led to any suggestion about the origin of the disease on the ship. Importation of infection to the ship by any individual boy seemed to be excluded. None of the boys early or severely attacked had been from the ship for many weeks previous to the outbreak. As regards new comers, in July seven, in August four, and in September two boys were admitted to the ship. One only of these 13 came under the doctor within two weeks of admission. He had slight diarrhoea on July 7th, 8th, and 9th. Short “leave” to boys who have been six months on board is often accorded, but only on written assurance by the friends to whom the visit is to be paid that their households are free from sickness. In the 12 weeks ending 23rd September 78 boys had leave, in no case exceeding five days. One only of the 78 came on the sick list within two weeks of his return. He suffered from “ stomach derangement and debility” on July 24th, 2oth, and 26th, after which he returned to duty. Importation of infection by visitors was considered. Visitors to the ship, notably “ old boys,” are very numerous. In the month of August alone, 42 old boys (14 of them on one day, 21st August) visited the ship. Old boys and other male visitors use (if they require to do so) the closets in the “ heads ”; females use the private closets. It has been already noted that spread of infection by means of the closets on board appeared altogether unlikely. Inquiry is made of all visitors to the boys as to infection at their homes before they are received on board. In the laundry arrangements no suggestion as regards importation or dissemination of the disease was afforded. All clothing of the boys is washed on board, in water from the domestic supply, on Mondays and Thursdays, and each boy does his own washing. Clothing and bed linen of sick cases were during the outbreak disinfected at the boat- house and then taken to Purfleet to be washed. Particulars respecting the dates of reception on board of new clothing and bedding, and the distribution of such articles to boys individually or in groups, afforded no clue to the outbreak. II. It was not until the foregoing lines of inquiry had been exhausted, that inquiry as to possible influence of food in producing the outbreak could be usefully made : for we have no knowledge of dissemination of enteric fever by constituents of food other than water and milk. In connexion, however, with the question of food of the boys, certain circumstances that had throughout the inquiry been borne in mind began to attain prominence. These were, the fact that the food supplied to and cooked for the boys was distinct and separate in all respects from that of the officers, who escaped illness ; that the incidence of the first outburst of disease had been exceptionally on mess 15; and, that the more serious cases arranged themselves in groups which were attacked mainly on Tuesdays or Wednesdays at weekly or fortnightly intervals. Thus in seeking among articles of food for a heretofore-