Report on epidemic cerebro-spinal meningitis in India / by C.J. Robertson-Milne.

  • Robertson-Milne, C.J.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Report on epidemic cerebro-spinal meningitis in India / by C.J. Robertson-Milne. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    out and the outbreak terminates in a similar manner to that in which it commenced. In some epidemics no maximal period is evident; in the fourth outbreak at Bhagalpur and in the one at Raipur the attacks succeeded each other at intervals of two to five days throughout. Considering the number of persons in a central jail who are exposed to infection, it is remarkable that so few of them should be attacked. An outbreak of this disease is constituted by about thirty or forty attacks among a population of upwards of two thousand men. Manner of infection of jails.--The manner of infection of. jails has not been satisfactorily worked out. In some instances the disease was imported from the surrounding free population or from a district in which it prevailed. This was undoubtedly the case in the outbreaks at the jails at Delhi and Hissar in 1902. In the epidemic at the Raipur Central Jail in 1899, although the disease was not reported to exist in the neighbourhood, the first case occurred in an under-trial prisoner who had been only six days within the jail precincts. The presumption is that this man brought the disease into the jail. It must be remembered that the absence of any records from a particular locality by no means negatives the presence of such a disease as this even in its epidemic form. It is always mildly epidemic and cases occurring without obvious association at irregular intervals may be easily overlooked and returned by the village authorities under the generic head of fevers/' But that the disease does exist and is spread over a very wide areas in India in a sporadic form, is evident, not only from the fact that cases have occa- sionally formed the subjects of medico-legal inquiry, but isolated attacks are constantly being heard of from different parts of Northern India. Whatever the manner of primary infection, it would appear from most of the Indian prison records that when the disease gains a foothold in a jail it remains there for a considerable time, periodically assuming such proportions as to warrant its being considered epidemic. The historical data of the jails at Shikarpur, Alipur, Bhagalpur, and Allaha- bad, all, by the way, very widely separated, abundantly prove this. But in all except Bhagalpur, we are compelled to admit the possibility of successive re-infection of the jails from without, for the disease has been definitely declared to exist among the free populations from which the bulk of the convicts are drawn. Prophylaxis with regard to jails, etc.—The measures necessary to prevent the entrance of ccrcbro-spinal fever into jails must be, in the present state of our knowledge of that disease, similar to those adopted with regard to other infectious disorders. Every prisoner admitted to an Indian jail has his own clothes taken from him, disinfected and placed