Dr. Parsons's report to the Local Government Board on some outbreaks of fever and diphtheria in the Romford rural sanitary district, and on the sanitary condition of the district / [H. Franklin Parsons].

  • Parsons, H. Franklin (Henry Franklin), 1846-1913.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Parsons's report to the Local Government Board on some outbreaks of fever and diphtheria in the Romford rural sanitary district, and on the sanitary condition of the district / [H. Franklin Parsons]. Source: Wellcome Collection.

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    gullies in the yards close to the houses. Complaints of bad smell from drains were frequently met with during the inspection. Closet accommodation consists of water- closets, hopper closets without water, and cesspit privies; some of the latter very near to, or built against the houses. The water supply is mostly furnished by the South Essex Company ; but there is a public pump in the centre of the town, the water of which is not only drunk by persons in the neighbourhood, but is carted to some outlying places not otherwise supplied, and retailed by the bucketful. The origin of the outbreak cannot be stated with certainty; but if the disease were introduced from without it must have been by some case prior to the middle of November, for the five households attacked in that month were all attacked within a few days of each other. The earlier fever cases were distributed in various parts of Ilford, and some occurred in outlying places about half a mile distant from the town. Unsanitary conditions were found at most of the houses in which they occurred, but of these houses different groups had different sewerage, and one group had a separate water supply ; at the others water was obtained either from the South Essex Company, or the public pump, both sources being used in other places where no fever occurred. The medical officer of health came ultimately to the conclusion that the main out¬ break in November and December was due to an infected milk supply. The circum¬ stances cannot now be submitted to such an examination as would settle the question, but the following facts appear to point to such a connexion:— (a.) Of the 21 households invaded up to the end of December 1882, this milk was in use in 16 * ; of three the milk supply was not ascertained; and in two only, and those near the end of December, by which time the infection would have become widely diffused, was it known to have been from other sources. On the other hand, in the households attacked subsequent to the end of December the milk was obtained from a number of sources with no special incidence upon any one. The dairy in question has a large custom, supplying more than 200 families ; but it does not supply half the town, as there are four or five others. Thus, though the fever appears to have been confined at its first onset to the customers of the particular dairy, it really attacked only a small proportion of them, so that if infection of the milk occurred, it must have been only of an occasional and doubtless accidental nature. (b.) The dairy farm, which is about a mile from Ilford and in the country, was then supplied with water from a well about 25 yards from a cesspit privy ; the water on analysis was found to be polluted. On the use of this water being discontinued the fever declined. (A new well has since been sunk, and other alterations made.) (c.) In December 1882 two of the dairyman’s daughters suffered from typhoid fever. As, however, the first was not taken ill until nearly the middle of the month, it is evident that their illness was not the cause of, but only an item in, the general outbreak ; that is to say, the circumstances, whatever they may have been, which, on the hypothesis, gave the milk a fever-producing quality, caused also the fever at the farmhouse. I learn that a young man, a nephew of the dairyman’s, who had been on a visit at the farm in November 1882, had been ill while there; he had recovered sufficiently to leave oh December 2nd. Mr. Bass, of Ilford, informs me that he attended him from November 14th to December 2nd; he cannot remember the dates of the young man’s arrival nor of the commencement of his illness, but has an impression that they were not long before his first visit on November 14th. As regards the nature of the disease, Mr. Bass says that he was on the look-out for typhoid, but could not find anything to corroborate his suspicions, either in the temperature (so far as he remembers it), in the condition of the bowels and skin, nor eventually in the duration of the disease. There was looseness of the bowels for about two days in the middle of the attendance. The disease was attended with great muscular pain, and Mr. Bass considered it at the time to be cold and rheumatism; he says that if it were typhoid it certainly presented very unusual symptoms. The subsequent lingering of the fever has, doubtless, been due to unsanitary condi¬ tions of the kinds previously mentioned, its spread having taken place through the medium of infected sewage exhalations. In several instances it has affected groups of neighbouring houses, particularly where sewage nuisances existed. • By 26 out of 31 persons attacked.