[Report 1895] / Medical Officer of Health, Brighton County Borough.

  • Brighton (England). County Borough Council.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: [Report 1895] / Medical Officer of Health, Brighton County Borough. Source: Wellcome Collection.

    11/50 (page 11)
    escaped disinfection I am unable to say. Such secondary attacks are unknown in small-pox, though common in typhoid fever and occasional in scarlet fever (see page 47 of this report). There is an alternative supposition that the disease for which the gentleman was admitted to the Metropolitan hospital was not small-pox though simulating it; and that the “ few spots, on the forehead ” which he had after arriving in Brighton represented a modified attack caught in the hospital. This view is not favoured by the Medical Officer of the hospital. The case of the second charwoman was unfortunately not notified until the fourth day, and in the meantime she had been visited by neighbours from the opposite side of the street. These refused to be re-vaccinated. They were there- for visited daily, and on the 12th March I was able to state that both were suffering from small-pox, and they were at once removed to the Sanatorium. No further cases followed. All the above cases, occurring in persons who had been vaccinated in infancy, were mild in character. No other cases of small-pox have occurred during the year, and the above record is extremely satisfactory, in view of the frequent possibilities of importation to which we are subject. Our continued immunity depends on two conditions ; {a) The prompt notification of all doubtful cases by medical practitioners, and {b) the condition of the population of Brighton as regards vaccination. On the first point, I wish to acknowledge the readiness and promptitude with which doctors have asked me to see a number of cases which subsequently were found not to be small-pox. In such a matter it is obviously very necessary to commence isolation before the diagnosis can be free from uncertainty. The information supplied by Mr. Clifford, the Vaccination Officer for the Parish of Brighton (Table X., page 29), furnishes the necessary data on the second point, q’p per cent, of the children born were not accounted for by death or medical certificate, and probably escaped vaccination, as compared with 5‘3 per cent, in the two preceding years. Although a much smaller proportion escape primary vaccination than in many other towns, the table is not satisfac- tory. The proportion of vaccination performed by public vaccinators has steadily declined in recent years. In so far as this indicates that imperfect vaccination, probably by only one puncture, has replaced the more efficient vaccination per- formed by the public vaccinators, it is very regrettable. The imperfect vaccination referred to is performed by two or three doctors who advertise facilities for this purpose, and thus compete with the public vaccinators among the poor, whom it is specially important to protect by efficient primary vaccina- tion. ENTERIC OR TYPHOID FEVER. During 1895, 87 cases were notified to me as typhoid fever. Of these 12 were subsequently ascertained not to be typhoid fever, and in 19 other cases it was discovered that the disease had been acquired before the patient arrived in Brighton. This leaves 56 cases to be accounted for, which apparently originated in Brighton. In my last annual report, I made the statement that “at least 40 per