Mr. Spear's report to the Local Government Board on the continued prevalence of diphtheria in the Aylesbury urban sanitary district.

  • Spear, John.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Mr. Spear's report to the Local Government Board on the continued prevalence of diphtheria in the Aylesbury urban sanitary district. Source: Wellcome Collection.

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    The text table shows the incidence of the disease, at different periods of the School epidemic, upon children attending different schools and upon non-attendants, children. Table IV. Schools. No. of Children Initial Attacks in Families, 1887-88. on Books. Total. April. May. June. July. Aug. Sept. Oct. Nov. Dec. Jan.—. April 1888. British - 467 20 1 3 1 3 — — 2 6 2 2 St. John’s 271 12 — — — 1 — 1 — 7 1 2 St. Mary’s 302 5 — 1 1 — — — — 3 — — Walton - 224 • “ Latin ” 40 1 — r — — 1 — — — — — Free - 100 2 — 2 — — — — — — — — Private Day Schools (six represented). 143 12 1 — 2 1 3 — — 3 — 2 Total school attend¬ ants. ? 52 2 6 4 5 4 1 2 19 3 6^ SI Non-attendants ? 39 1 2 4 1 4 5 1 5 10 6 Note._The three schools first mentioned above were closed on November 29th, at the request of the Sanitary Authority, and remained closed until January 1st. The three cases entered against them in December occurred within 4 days of their closure. These three schools were closed also for the summer holidays from July 29th to August 29th. The facts given in the above table cannot be studied without a strong suspicion that at one period, in the month of November, certain schools became centres of infection. From April to November the evidence would not, I think, justify such suspicion, for although during that time certain schools are seen to have suffered more than others, this was not, on the whole, inconsistent with the explanation that their pupils chanced to be drawn from the more infected localities * I have shown that in already infected households, where all may be said to be exposed to infection, children of school age, 4 to 14, supplied 56 per cent, of secondary attacks, and this may probably be taken as indicating approximately the normal disposition to infection at such age. From the commencement of the outbreak until November the proportion of school children (attendants) amongst primary sufferers was equal to 55 per cent, of the total number, f During November, of 24 primary attacks, 19 were amongst children attending school. On the 29th of that month certain schools, as mentioned above, were closed, and remained closed throughout December, so that further comparison for that time is, of course, invalidated. When the circumstances come to be more closely examined a doubt, however, The.“’ - n arises whether this excessive activity of the infection in November resulted November.11 simply from opportunity offered by school attendance. If it were only this, it is singular that three of the public schools should be simultaneously involved in the greater activity ; and then, as to different classes and divisions of the schools, except at St. John’s, where the infants suffered in excess, there was no particular incidence of the disease in this more intimate sense. Coincident activity of the infection, although less marked, was noticeable also amongst the pupils of private day schools, and amongst “non-attendants,” a little more notice¬ able than appears from the above table, for just at this time one of those “ recrudescences ” of the disease, in a family infected some months before, occurred, as well as one other case which, although I have not classed it as a “ recrudescence,” the interval since the previous attack being short, was probably of that nature; it was now, too, that one of the families in the rural district was infected from the town. The disease, again, exhibited at this period, as I have said elsewhere, extraordinary increase of fatality. It is * Walton, and the immediate neighbourhood of the Walton Schools, remained throughout almost entirely free from the disease. The western side of the town, whence the British Schools derive a large number of pupils, was, on the contrary, early and seriously infected. The Free School is supplied from a wider source, but the two children belonging to that school infected in May both lived in New Street, in the more involved quarter of the town. . f It will be remembered, however, that the elementary schools were closed during August. the comparison, for this and other reasons, is not exact, and possesses only approximate value.