Dr. Parsons's report to the Local Government Board on a recent outbreak of diphtheria at Queen Camel, in the Wincanton rural sanitary district, Somerset / [H. Franklin Parsons].

  • Parsons, H. Franklin (Henry Franklin), 1846-1913.
Date:
1888
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Licence: Public Domain Mark

Credit: Dr. Parsons's report to the Local Government Board on a recent outbreak of diphtheria at Queen Camel, in the Wincanton rural sanitary district, Somerset / [H. Franklin Parsons]. Source: Wellcome Collection.

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    causation of the disease, but the numbers are too small to exclude casual coincidence; moreover, the other sewer is of equally bad construction and the two sewers join below. It is stated by old residents that a foul open ditch formerly ran through the village street at Queen Camel, and that at that time fever was very prevalent in the village. After a severe epidemic of fever in the year 1836 the ditch was filled in and a stone sewer made. Since this was done fever has become rare, but sore throats have become frequent and there have been several outbreaks of diphtheria. Diarrhoea is not particularly prevalent. There were, however, ample opportunities for the disease to spread by personal communication. In all but one of the six households attacked up to the time of my visit the first case was a child attending the National school; the exception was the elderly woman before mentioned who was living in close relationship with a family previously attacked. Of the five school children three were taken ill within a few days of each other, viz., between November 17th and 23rd. On the latter date the school was closed, and remained so until December 6th. It seems that the brothers and sisters of children who were ill of diphtheria were in some cases allowed to continue to attend school. Some of the families attacked were related and the children used to meet at each others’ houses. The milk supply of the several families came from different sources, and in two no milk was used before the illness. At one farm at Queen Camel the cows were affected with sore udders in the summer, but are said to have been well a month before the diphtheria broke out; the milk from these cows was not drunk by any of the people who had diphtheria. At several of the houses where diphtheria or sore throat occurred the household cat was said to have been recently ill, but the symptoms differed in different cases; languor, vomiting, and cough were spoken of, but there was nothing to show that the cats’ illness was of a diphtheritic nature. Together with the cases of diphtheria there existed some cases of sore throat, not presenting the appearances of that disease, but Dr. Hurley thinks that sore throats were not more prevalent than usual (they are always fre¬ quent, he says, in that neighbourhood), and they were not followed by symptoms of paralysis. It is noteworthy that the present outbreak differs from the pre¬ vious one in that most of the patients who have recovered have subsequently suffered from paralytic symptoms, whereas in 1885 none did. Dr. Hurley says that in the later cases of the present outbreak false membrane has been more abundantly developed than in the earlier ones. So far as I could learn, the other places in the Wincanton district were free from diphtheria. The sanitary condition of Queen Camel, as of other places in the district, requires much more attention than it receives from the Rural Sanitary Autho¬ rity, with the view of abating nuisances and providing the requisites of healthy existence; nothing whatever appears to have been done in this direction at Queen Camel since my previous visit. A proper system of sewers should be provided, and the houses should be drained into this by impervious pipe-drains, kept when possible outside the houses, and with properly trapped inlets. The polluted wells should be closed, and a pure supply of water provided, as by bringing water from one of the springs in the neighbourhood. Pail privies or other suitable closets should be substituted for the old offensive vaults. In reconstructing privies or drains the old vault or drain should be emptied, taken up, and filled in with clean material. The abatement of nuisances, among which damp and dilapidated houses may be reckoned, should be enforced. In reference to these and other matters, I beg to refer to the recommendations appended to my previous report. February 10th, 1888. H. FRANKLIN PARSONS. P.S.—Since writing this report I learn from Dr. Hurley that three fresh cases of diphtheria have occurred in as many houses, two in the northern part of the village (one of these being in connexion with the village sewer below the junction of the two branches ; the other drained independently of the sewer) and one in an outlying hamlet. The patients were adults ; they are not known to have been in communication with previous cases, but unsanitary conditions existed at their residences. o 53317. 200.—3/88. Wt. 22187.