Dr. G.S. Buchanan's report to the Local Government Board upon an outbreak of enteric fever at Wadebridge, in the rural district of St. Columb Major, upon the sanitary condition of the place and upon administration by the St. Columb Major Rural District Council / [G.S. Buchanan].

  • Buchanan, George Seaton, Sir, 1869-1936.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Dr. G.S. Buchanan's report to the Local Government Board upon an outbreak of enteric fever at Wadebridge, in the rural district of St. Columb Major, upon the sanitary condition of the place and upon administration by the St. Columb Major Rural District Council / [G.S. Buchanan]. Source: Wellcome Collection.

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    from the Molesworth Street rubble drain, which passes within 5 yards of each of them. Moreover, all four wells being close together and on the same level, they must needs draw upon the same limited body of water, so that a pollution of soil which occasions contamination of any one of them would also make for contamination of the other three. In view of the numerous ways in which this group of wells may have been contaminated, there was difficulty in determining in what manner infection first reached them. It is clear that the water of each of these wells might readily have obtained its harmful quality, whether infectious matter from the first case or cases of enteric fever had been deposited in any one of the privies referred to, or on the adjacent dung heap or refuse heap, or whether brought into proximity of the well by way of the Molesworth Street rubble u sewer.” I note, however, that the earliest of the 50 cases of fever of which I heard was the case of Mr. Y., whose attack preceded by nearly three weeks that of any other person ascertained to have suffered by the outbreak. The soil pipe of a water-closet in Mr. Y.’s dwelling, which was used by him during his illness, is one that has already been described as opening into the Molesworth Street rubble drain, close to the right-angled bend within four yards of “ Craig’s Well.” Mr. Y .’s work, prior to his attack, took him every week to villages outside M adebridge, but I could not ascertain that shortly before his illness he had come into relation with any antecedent case of enteric fever, either without or within the town. YV hether or not, however, Mr. Y . was really the first person in Wade- bridge to be attacked during the outbreak, there appears to be no doubt that the circumstances of his illness afforded a means of specific contamination of the water of the implicated wells, and that specific pollution from this source may have occurred almost day by day antecedent to the first weeks of the outbreak. In view of the facts I have recorded, it may be concluded that the infective agent principally operative in this outbreak was drinking water derived from the group of wells in the Trevanson Street area. The facts do not, however, warrant assumption that every person attacked within Trevanson Street area had received his or her infection by way of drinking water. There can be little doubt that the soil of the area, and certain privies and closets serving premises there, became, in the course of the epidemic, polluted with infectious matters from enteric fever patients, and in exceptional cases such polluted soil, privies, or closets may have been the infecting agents. Nor, in respect of a certain few individuals, is it possible to exclude the supposition that they in each instance contracted infection within their own dwellings from some person or persons there who had already been attacked by the prevalent fever. Action taken in repression of the Outbreak. Although a number of persons in Wade bridge were recognised to be suffering fiom enteric fever in the month of July, neither Dr. Edwards, then acting as deputy to the Medical Officer of Health, nor any other officer of the St. Columb District Council became acquainted with the prevalence of fever in the place until August 12th. On this date Dr. Edwards learnt of a total of 14 cases He at TCeoPfs^al .incluilT at- Wadebridge, and subsequently reported to tie St. Columb Distiict Council and to the Hoard on the circumstances of the outbreak. That District Council meanwhile appointed its Wadebridge members a Committee to deal with tlie outbreak in conjunction with the St. Breock I arish Council. This Committee held several meetings, and, advised first by Dr. Edwards and later by Dr. Mackay, carried out a variety of remedial measures with commendable dispatch. A scavenger was appointed to give ms whole time to removal of excrement and refuse from streets and premises • invaded houses were provided with pails for the reception of infected matters • these pails were collected twice a day by the scavenger and their contents buried m a field some distance out of the town ; disinfectants were provided at invaded dwellings. \ isits to invaded houses were made by the Medical Officer of Health and inspector of Nuisances. In the absence of a hospital for infectious cases, little effective isolation of the sick could be practised. T wo nurses were enmmed