Dr. Blaxall's report to the Local Government Board upon a wide-spread epidemic of scarlatina in the urban sanitary district of Lower Brixham (Devonshire), and upon the general sanitary condition of the town / [F.H. Blaxall].

  • Blaxall, F. H.
Date:
[1889]
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Licence: Public Domain Mark

Credit: Dr. Blaxall's report to the Local Government Board upon a wide-spread epidemic of scarlatina in the urban sanitary district of Lower Brixham (Devonshire), and upon the general sanitary condition of the town / [F.H. Blaxall]. Source: Wellcome Collection.

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    children, convalescing from the disease returning to school when in the desquamating stage. In this way the disease spread from infected to healthy children in the schools, and was carried by them to their respective homes, each newly- infected child and family becoming in turn a fresh centre of infection to their immediate neighbours and others with whom they came in contact. Thus there is no difficulty in accounting for the wide-spread nature of the epidemic, as well as for the scattered groups of dwellings that were invaded, as already mentioned. I witnessed many examples of reckless exposure of infected persons. In one house three members of the family suffering from scarlatina were seated in the same room with a lad who, having just come in for his dinner, was about to return to his shop where he would serve customers. In a second house a neighbour’s child had come in to play with a little one convalescing from the disease ; while in several other dwellings I saw infected children occupying the general living room frequented by neighbours and others. Again, eye-witnesses spoke of children in the streets peeling the skin off their fingers to see who could get the largest flake. I heard also of the infected dead being frequently kept in the houses from three to seven days awaiting burial, the children and neighbours in some instances going in to view the body, and attending the funerals in large numbers. I met with repeated instances in which attacks followed within a few days of such exposure to infection, notably so one case in which a child was taken to see the dead body of its little friend, and three or four days afterwards was attacked with scarlatina, and died within the fortnight; subsequently the three remaining children suffered from scarlatina, and the mother from sorethroat, while the father suffered from erysipelas. With regard to the public ceremony to which the increase of cases during the week ending the 10th of November has been referred, this took place on November 5th, on the occasion of laying a memorial stone on the spot where the Prince of Orange landed, and a large concourse of persons was thus brought together. Many persons stated that the first time of their children going out after their illness was to witness this ceremony; others that their children were well when they went to see the stone laid; but four or five days afterwards they were “ down with the fever.” There can be little doubt that this assembling of infected and healthy persons was instrumental in spreading the disease. A certain predisposition to contract the disease seemed apparent in several families, it being no unusual thing to find near relatives attacked with the disease, while others equally exposed escaped the infection. Further, it transpired that some persons and families invaded during the present epidemic had suffered from the disease four years ago when scarlatina was prevailing in Brixham. One family, in which five cases and three deaths have occurred during the recent epidemic, had three cases and one death on the former occasion, the two survivors being now attacked for the second time. Many other instances of second attacks came under observation during this inquiry. Reference to the Tables A. and B. shows a total of 180 families invaded, with 351 cases and 43 deaths. Multiple cases of definite scarlatina, from two to six in number, were observed in 94 of the families, to say nothing of cases of suspicious sorethroat. But medical practitioners spoke of bad and trouble¬ some sorethroats as being of frequent occurrence in families that had been invaded by eruptive scarlatina ; so probably there was more disease of a scarlatinal nature in the district than is expressed by the above figures. Multiple deaths, too, took place in some invaded families ; one family losing three, and two others losing two of their members. As regards the fatality of the disease among persons attacked, it is to be recorded that in the closely packed and generally unwholesome dwellings of the lower parts of the town, an excessive mortality took place. No less than 11 out of 48 known cases were fatal in the houses of These localities, or nearly one death to three recoveries; whereas in the remainder of the district, the deaths were 32 out of 303 known attacks, or more than eight recoveries to each death. The data of the foregoing Table B. as to attacks in this district are so far complete as to yield evidence of some interest respecting the age-distribution