Reports and papers on suspected cases of human plague in East Suffolk and on an epizootic of plague in rodents.

Date:
1911
Catalogue details

Licence: In copyright

Credit: Reports and papers on suspected cases of human plague in East Suffolk and on an epizootic of plague in rodents. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    in the story, the balance of evidence certainly seems in favour of u view that the malady was bubonic and septicaemic plague. Two of the cases admitted into the Ipswich Hospital suffered from inguinal buboes, and several of the other cases arc stated by some of those intimately associated with them to have had large painful swellings or “ knots,” as they were termed, in the neck. The short incubation period, two to five days, the rapidly fatal resiilts, the suffused eyes, and the rashes, together with the buboes, suggest plague rather than any other disease. The only other diseases, which seem on account of their infectivity to call for consideration, are influenza or typhus fever, and these only because of their possible parallel in infectivity. Otherwise, there seems to be nothing in support of this view. The ‘‘ knots ” in the neck of some of the cases might perhaps have been glandular swellings caused by tonsillitis or diphtheria, but the evidence as regards the remaining cases seems sufficient to render this very improbable, and the other inguinal or femoral buboes increase this improbability. Assuming, therefore, that the Trimley cases were cases of bubonic and septicaunic plague, is it j)ossible to account for the case of H. F. at Nacton in the same fashion. It has already been said that no e.xplanation of the illness was forthcoming at the time, and that the surgeon who performed the oi)eration and found a quantity of enlarged glands in the mesentery and omentum, has, in the light of subse(|uent events, expressed the opinion that he was dealing with a ca.se of plague. If, therefore, the Nacton case is best explained on this view, was this ca.se of sei)arate origin, or was it connected with the Trimley .series r* I was informed at one stage of my inquiries that dead rats had been observed in the neighbourhood of the house at Nacton about the time of the child’s illness, but on visiting the locality I was unable to obtain confirmation of this .story, which must be left an o])cn question. The main jioint of iiniK)rtance as regards connecting this case with the Trimley series, is whether the interval which elapsed between the return of the girl H. 11. from the ho.spital to Nacton and the occurrence of the symptoms in the case of H. F. was sutticiently long to justify an association of the two events as cause and effect. The ])eriod was certainly below the average incuba- tion period of plague, but in Volume V. of the Eeport of the Indian Plague Commission, which was issued in 1901, several instances are furnished where the incubation period was 1 to 1^ days. In one instance the period was 8 hours, in another 24 to 36 hours. Dealing with these facts, the report states that plague may develop, possibly, within 24 hours, certainly within 48 hours after expo.sure to infection. “ Several instances of incubation periods, not exceeding 24 hours, are, we may note, recorded in connection with Mahamxirrie in Kumasie.” There is one other point which nuist be referred to, and that is the que.stion as to whether H. E. may have infected H. F.