HH62/1/ABERD/33

Transcription

[Page] 32

of these investigations showed the necessity of adopting
careful precautionary measures in dealing with first cases
of typhoid fever.

OFFENSIVE TRADES.
The district is purely an agricultural one. There is only
one slaughter-house, and it is in fairly good condition.

BAKEHOUSES.
I have inspected a number of these, but found none in
such a condition as to require interference.

MEASURES ADOPTED FOR PREVENTION OF SPREAD
OF DISEASE.
In all cases of infectious disease that came to my know-
ledge, the case was visited by the Sanitary Inspector, and
in most of the cases by myself; and every precaution was
taken to secure the isolation of the patient and of the house.
Disinfection was carefully attended to in all cases by the
Inspector.

CAUSES, ORIGIN, AND DISTRIBUTION OF DISEASE.
Diseases of the respiratory system bulk very largely in
the death-rate, being 2.774; including phthisis, they amount
to 3.606, out of a total of 13.780. That these may be
diminished by improvement in the houses of the working
classes is extremely probable.
In this district typhoid fever is the most prevalent of
the zymotic diseases. Typhoid or gastric or enteric fever is
due generally to the drinking of water contaminated by
sewage, or to the emanations of foul drains. Milk is an
admirable carrier of the germs of this disease, and many
epidemics have been caused in this way. These germs are
always contained in the stools of a typhoid fever patient, and
these stools are most virulently infectious. The number of
cases in the district ought undoubtedly to be diminished
by:- (1) prompt isolation; and (2) improvement of the
water supplies.
(1) Prompt isolation. It has been my experience in
this and other districts of the County that cases of typhoid
fever, unless isolated, are apt to give rise to others in the
same house. The great authority of Murchison engendered
a false security in regard to typhoid fever, and the necessary
precautions in regard to it have been too much neglected.
(2) By removal of the sources of water pollution. The
removal of the dangers of water supply pollution will tend
to prevent outbreaks of typhoid fever, as well as diarrhœa.

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In my Report on the Ellon District, I have called attention
to the remarks of the Registrar-General regarding the
incidence of these diseases in towns and country districts,
and have pointed out that in Alford and the other upland
districts of the County, where the water supply is naturally
purer, the death-rate from this cause is less than in the
more low-lying parts of the County. Prompt attention to
the water supply, in the first case of enteric fever or diarr-
hœa in a house may often be the means of preventing
others.
One of the cases of enteric fever that I investigated
appeared to have originated from the patient - a mechanic -
sleeping above a byre in which some calves were kept,
and from which a most nauseous and sickening smell
emanated. Typhoid fever is undoubtedly common among
farm servants; but it is probable that most of these cases
are due to the drinking of polluted water from about the
farm steading.
Diphtheria is a common form of disease in this district.
Several cases occurred at the village of Alford. Improved
drainage of the village may prevent the recurrence of such
cases.
A number of cases of scarlet fever occurred during
1891. Most of these were traced to infection from Aber-
deen. The immediate notification and prompt isolation
of such cases is, therefore, all the more important to prevent
the disease from spreading through the district.
In future Reports I hope to enter upon a more full
discussion of this question.

TABLES.
The Tables in the Appendix are prepared from Returns
kindly furnished me by the various Registrars in the
County, to whom I must express my obligation for fur-
nishing me gratuitously with the information I required,
information involving very considerable labour, in many
cases, on their part.

I have the honour to be,
GENTLEMEN,
Your obedient Servant,
JAMES P. WATT.

COUNTY HEALTH DEPARTMENT,
MUNICIPAL BUILDINGS,
ABERDEEN, 1892.