Dr. Airy's report to the local government board on an outbreak of scarlatina at Fallowfield, near Manchester.

  • Airy, Hubert.
Date:
1879
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Licence: Public Domain Mark

Credit: Dr. Airy's report to the local government board on an outbreak of scarlatina at Fallowfield, near Manchester. 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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    outbreak of Scarlatina at Fallowfield, near Manchester. George Buchanan, Assistant Medical Officer, December 13, 1879. The following report relates to a sudden outbreak of scarlatina* in the village of Fallowfield, three miles south of Manchester, of which the Board received information on August 12, 1879. The inquiry was taken in hand on August 16. The main outline of the facts of the epidemic is as follows:—In the last week of July there were, among adults resident in Fallowfield, two or three attacks of illness (premonitory, so to speak, of the outbreak which followed) marked especially by vomiting and diarrhoea, and in one case by sore throat, but not developing the characteristics of scarlatina. On July 31 there occurred, in a child in one of the same families, a decided case of scarlet fever, which, however, could not be suspected of giving rise to any of the subsequent cases. On Sunday, August 3, two children of one family, living in Carill Drive (see map), and four children of another family living in Wilbraham (or Prince’s) Boad, were taken ill with symptoms which soon declared themselves to be those of scarlet fever, accompanied with vomiting and diarrhoea. In the course of Sunday night, August 3, and Monday, August 4, 18 persons in 11 other families, belonging to or having relation with, though some of them absent from, Fallowfield, sickened in the same way. Several of them had felt their throats sore on the Sunday evening. On Tuesday, August 5, two other cases occurred in two families previously attacked. On Wednesday, August 6, another family had a slight case of sore throat, which might have been passed over had not two other members of the same family subsequently sickened with scarlet fever, apparently caught from the first by direct contagion, on August 9 and 14. There was also a doubtful case on August 7, and another on August 13. Thus, including nine cases of somewhat doubtful or undeveloped character, such as are not unfrequently met with in connexion with epidemics of scarlet fever, there were in all 35 persons in 18 families attacked within a period of one month; and of these 35 no fewer than 24 were attacked within a space of 36 hours, between Sunday morning August 3 and Monday evening August 4. A list of the cases is given at the end of this report, with a few notes of the attendant circumstances. The symptoms which accompanied the onset of the disease were in many cases so remarkable as to lead the medical men who attended them to believe that there must be something exceptional in the cause or mode of infection. Not only was there frequent vomiting, but also severe and con- tinued diarrhoea ; indeed, in some of the persons attacked diarrhoea was the most prominent and almost the only symptom ; and in one of the earliest cases (No. 4 in the list), which occurred in an adult and did not show full febrile development, it was remarked that the symptoms were more those of irritant poisoning than of scarlet fever. There was, however, no doubt at all as to the real nature of the disease in other cases which with similar symptoms of irritation of the alimentary canal presented also all the characteristics of scarlet fever. Among the medical men who were in attendance on these cases a decided opinion prevailed that in all probability the morbific matter had entered the system through the alimentary canal. The outburst of 24 cases of scarlet fever within 36 hours pointed to some one common source and act of infection. At once suspicion fell upon the milk; and on inquiry it was found that every family that was attacked had received its supply of milk from one and the same dairy, while neighbouring families, taking milk from other dairies, had entirely escaped. * Note.—It need hardly be said that the names “ scarlatina,” “ scarlet fever,” are used indifferently in this report. 0 290. 100.—12/79. Wt. 10210. E. & S.