[Report 1886] / Medical Officer of Health, Wolverhampton County Borough.

  • Wolverhampton (England). County Borough Council.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: [Report 1886] / Medical Officer of Health, Wolverhampton County Borough. Source: Wellcome Collection.

    8/36 page 6
    year; broadly stated, tlie facts then are these : there has this year been an alto¬ gether unprecedented remission of Scarlet Fever in the Borough, this remissoin is particularly in the sub-district which offers the greatest facility for the disease— the East—where it has steadily diminished for two years, until it has (for the time at least) disappeared. Of course Scarlet Fever, like other epidemic disease, has naturally periods of increase and decrease, and table 9 shows this, and shows that these periods occur at intervals of four or five years; from 26 in 1875 the deaths rose to 226 in 1877, fell again to 17 in 1879, rose again to 64 in 1881, fell to 24 in 1888, and rose in 1885 to a much lower than any previous maximum, viz., 46, falling this year to only 5. In last year’s report I pointed out very fully the strong grounds for concluding that the low maximum of 46 was due to the preventative measures taken, and especially to the use made of the Borough Hospital as a means of isolating the convalescents ; this year’s results forcibly confirm that conclusion, and I think it will appear morally certain that the extra means of isola¬ tion provided has brought about our satisfactory condition. In a district like ours, with such facilities for unnoticed, unreported, and uncared-for cases, no measures could stamp out Scarlet Fever, but in proportion to their thoroughness they should modify its severity, we must expect good and bad periods still, and can only hope that each will be respectively better than those of former years ; this is exactly what table 9 shows to be the case with us the last two years; now (as regards our position towards this fever), the only difference between these and former years has been the extra isolation attained by the use of the Borough Hospital, it is hardly possible not to associate the two as effect and cause. (There is a great improvement on 1875-79 in 1880-84; this was probably due to generally greater care and to an increasing use of the General Hospital isolation, but as already pointed out in the 1885 report, that isolation could not be rendered fully efficient, and the addition of the Borough Hospital for mild and convalescing cases was an immense advance.) This conclusion is confirmed by the East returns, here this isolation has been very thoroughly utilised, and here the good results are by far the most marked ; although much used (and more of late) in the West also, it has never been so much used as in the East, hence, although a good effect has been produced there, it does not nearly attain the perfect result of a Quarter without a case. The force of all this is greatly intensified if we bear in mind that in all other respects the East is much the most favourable for the extension of Scarlet Fever. It will add greatly to the appreciation of the foregoing if the introductory remarks on the use of the Borough Hospital and the article on Scarlet Fever in the 1885 report are read in connection with it. It was not found necessary to move any case of Scarlet Fever to the General Hospital during the year, but 5 cases were taken there by their friends and detained, most being cases of dropsy during a late period of the disease. The following shows briefly the proportion of cases and removals in the two sub¬ districts :—-
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