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

  • Airy, Hubert.
Date:
1879
Catalogue details

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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    3 the suspected dairy (which I will call A) had the custom of five families; while 22 other families in the same road were served from other dairies. In Oak Drive six families were served from A, and five from other dairies. In Carill Drive, two families from A, and two from other dairies. In Lady Barn Hoad three from A, and six from others. But scarlatina attacked only families served from A. It is quite impossible that any local cause unconnected with the milk-supply could have operated with such unerring selection upon the customers of one dairy, when so many who were supplied from other dairies were in all other respects exposed to the same local conditions. The con- clusion is irresistible that the contagium of scarlet fever was spread with the milk from the dairy A;—we must not say in the milk until we have described the mode of milk distribution. The families supplied from A were between 60 and 70, scattered over the whole village. With few exceptions they were families of the better class. Many of them were away from home at the time of the outbreak ; others were on the point of leaving, and the date of departure in some cases will prove to be of critical value in determining the probable date of infection. On the annexed map the houses supplied from the dairy A are marked blue ; those in which scarlet fever appeared are distinguished by a red mark. Those which are left blank were served from other dairies. It may be noticed that the whole village admits of division into two nearly equal groups, one to the north and the other to the south of Ladybarn Road ; and it will be seen at once that the number of infected families in the southern group was only two, while in the northern group it was sixteen, including doubtful cases. I shall be able to show that the milk-supply to these two groups was not exactly the same. The position of the dairy farm A is shown on the annexed map. The sign A is placed against the shippen in which the cows were milked. I may say at once that there was not the slightest reason for suspecting any wilful dilution of the milk or want of cleanliness in the vessels. The business was perfectly honest, and there was general testimony to the richness of the milk. The cans were washed out with water laid on- to the dairy from the Manchester Waterworks. In this respect this dairy was superior to some others in the district. The cows were about 20 in number, and were, as far as was known, free from disease. The milkers were three in number; (1) the daughter of the farmer’s widow who kept the dairy; (2) a young man who lodged in the farmhouse; (3) an old man who lodged at the house of his married son in Oak Street, in the crowded block in the centre of the village. Most of the milking was done by Nos. 1 and 2. There was no definite order of milking; each milker took one cow or another as it might happen, till all were milked. The produce of each cow was poured from the milking-can through a straining cloth into the gathering-can, special care being taken as regards the cleanness of the cloth, and from it when full into one of two delivery- cans which were taken round by cart. Thus the first half of the milking was poured into one delivery can, and the second half into the other. From the morning milking, two carts, each taking one delivery-can, were despatched on two separate rounds, one going to the right (northward); the other to the left (southward) from the bottom of Ladybarn Road, one driven by milker No. 2, and the other by a nephew of milker No. 1, who himself was one of the persons attacked with scarlet fever on August 4th. From the afternoon milking, at 3 p.m., only one cart was despatched, taking two delivery-cans for the whole round. At the bottom of Ladybarn Road an additional quantity of milk was poured into one or other of the two A cans from a can (S) belonging to a small dairy at Cheadle Hulme, six miles away. It could not be said whether the northern or the southern can was most likely to receive this addition ; but it must not be overlooked that this addition would almost necessarily make some difference in quality according as the 8 milk might be more or less pure than that from A) between the northern and southern supplies. After the can 3 had been emptied, it was left standing on a flagstone by the roadside, and was picked up and taken back to Cheadle Hulme in time for the next milking there. While the bulk of the customers were served by cart, those who resided near to the dairy A, in Aucklands (Ladybarn Road) and Carill Drive, were