Dr. Ballard's report to the local government board on an epidemic of enteric fever at Newlyn, in the rural sanitary district of St. Columb, Cornwall.

  • Ballard, Edward.
Date:
1880
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Licence: Public Domain Mark

Credit: Dr. Ballard's report to the local government board on an epidemic of enteric fever at Newlyn, in the rural sanitary district of St. Columb, Cornwall. 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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    privies by several families in common, and exposure to the emanations from these and from their overflows running sometimes under houses in their course to the town drain; and generally, exposure to accidental infection by infected excrement lying about the surface of the village and about the Butt’s spring. A third probable cause has been the scarcity of water in infected families, which forbad the observance of that personal cleanliness essential to the prevention of the spread of the disease in infected families. These three additional facilities for the spread of the fever have been operative all through the epidemic period. Judging from the date of the earliest attacks, and allowing from 10 to 14 days for incubation of the disease, the town well probably became infected specifically with the contagium of enteric fever through the medium of the town drain, somewhere about the 5th or 6th of September. At this time the water in the well must have been low, and the well must have been deriving part of its supply by infiltration through the ground from the town drain. According to the rain register kept by Mr. Tredidgo, of Newquay, a few miles from Newlyn, the rainfall of June was 2-23 inches, and that of July 3‘23 inches. Throughout the month of August rain only fell on two days, and then only to the total amount of * 14 inch, and from August 10 to September 9 no rain whatever had fallen. The most careful inquiries, however, that I have been able to institute have failed to discover by what means the specific contagium of enteric fever obtained access to the town drain. But various more or less probable agencies are conceivable; such, for instance, as the disturbance of some filthy and anciently infected material in the course of the drains; or the introduction of the disease by some person from elsewhere, the specific character of whose ailment failed to be recognised, or who passing through the village in an early, perhaps incubative, stage of his illness, had deposited excrement where it would reach the town drain, or whose soiled linen had been washed in the village. Enteric fever had been prevalent in various parts of Cornwall and Devon. Newlyn is not many miles from Truro, where fever, I understand, had also been prevalent, and there is frequent communication between the two places. Such facts, while they add to the probability that Newlyn itself may have received its specific contagium from a distance, teach also how mischievously a neglected village may affect other communities. On October 21 I had an interview with the Bural Authority, and after explaining the main points mentioned in this report, I gave them in . substance the following advice:—1. That a parochial committee should be appointed as early as possible to superintend and carry out, under the advice of the Medical Officer of Health, the necessary measures for arresting the epidemic. 2. That drinking-water from a demonstrably wholesome source outside the village should be daily supplied by a water- cart to the inhabitants until a permanent wholesome village supply can be provided. 3. That printed placards, to be drawn up by the Medical Officer of Health, should be affixed in various parts of the village, calling attention to the temporary water-supply, and warning against the use of the local wells. 4. That immediate steps should be taken by the Authority itself to disinfect thoroughly all accumulations of filth of every kind and all the privies in the village, under the direction of the Medical Officer of Health; and that proper disinfectants should be provided for domestic use, with printed directions how to use them. 5. That in the absence of any public means of disinfection of soiled bed clothes, linen, &c., the Authority should temporarily establish a public laundry where such soiled articles could be disinfected and washed free of cost. 6. That a temporary hospital should be at once established for the reception of cases from newly-invaded families, and, so far as practicable, from other families not having proper lodgment. I left with the Authority a written memorandum embodying this advice. EDWARD BALLARD. November 5, 1880.