[Report 1894] / Medical Officer of Health, County Council of the Palatine of Chester / Cheshire County Council.

  • Cheshire (England). County Council.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: [Report 1894] / Medical Officer of Health, County Council of the Palatine of Chester / Cheshire County Council. Source: Wellcome Collection.

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    were damp and in a very insanitary condition. In Wallasey, where there were 4 fatal cases of diphtheria and 5 fatal cases of croup, all nine houses were found defective as to their sanitary arrangements. In Altrincham Rural District out of 40 cases of diphtheria and croup notified, 8 were found associated with insanitary conditions. From Macclesfield and Runcorn Rural Districts also cases occurred on premises where sanitary defects were discovered. However, something beyond merely insanitary conditions is doubtless needed to produce diphtheria. As the Medical Officer of Health for Macclesfield Borough states — “Diphtheria cannot arise de novo; it must be imported from some other man or animal, but if introduced into insanitary dwellings it tends to take a severe type, to crop up again from time to time, and when established in a locality (especially where the sewerage is defective) it is very difficult to eradicate it. It is extremely likely to spread from schools, especially if they be ill-ventilated and badly drained.” As it is only by means of a bacteriological examination of the secretion of the throat that true diphtheria can be distin- guished from membranous croup, and preventive measures should be taken at once, it is safe to deal with all cases as if they were dangerously infective, and isolate them with at least as much care as if they were severe cases of scarlatina. The record for these diseases in 1894 compares very favourably with that in 1893, when there were 430 cases notified (395 diphtheria and 35 croup) and 165 deaths (116 diphtheria and 49 croup). Thus though the number of the two diseases was nearly the same in both years, the number of deaths in 1894 was less by 23. Whooping-cough is not notified, and the extent of its prevalence has to be gauged by the death record. The number of deaths in 1894 in the Municipal Boroughs was 64, in the other Urban Districts 91, and in the Rural Districts 62—in all 217. The total number of deaths from this cause in 1893 was 120. Thus the death-rate, which was 0*39 in 1894, was only 0*21 in 1893. It was specially prevalent in Northwich Urban and Rural Districts, 50 deaths being registered in these two districts, and in Stalybridge, where there were 23 deaths registered. Whooping-cough is very difficult to deal with from a public health point of view. Its onset is insidious, and the catarrhal stage (during which the symptoms are not charac- teristic) commonly lasts nearly a week. As a matter of fact, little seems to be done throughout the County to check the spread of this disease. Still there is no doubt about the infec- tiousness of whooping-cough, or the need of keeping infected children from others and in particular from school. The mortality from whooping-cough would probably be much, reduced if those in charge of children regarded the disease more seriously, and had the patients properly nursed and kept warm. B