HH62/1/AYR/35

Transcription

[Page] 34

maps" of the District may be given in which the various infectious
diseases will be localised in different colours.

DISEASES NOTIFIED UNDER NOTIFICATION ACT DURING THE LAST
QUARTER OF YEAR.

[Table inserted]

In reference to the infectious diseases notified since the Act came
into operation on the first of October, it will be noticed that scarlet fever
was the most prevalent, the only parishes escaping being West Kil-
bride, Dunlop, Stewarton, and Ardrossan. It had broken out at Skel-
morlie, Beith, and other places before the Act came into operation,
so that the above table gives us only a partial view of the extent of
the epidemic. At Skelmorlie the outbreak became so general that
the School Board closed the school there for several weeks, the
attendance having become very attenuated. I visited Skelmorlie
several times in connection with this outbreak, and, in making a
house-to-house inspection of the place known as Innes Park Buildings,
discovered five or six cases in various stages of the disease, and no
medical man had been called in. In the end of August one of the
skilful neighbouring old women there having diagnosed the early
cases of the disease as "chicken pox", it was not likely that they
would either incur doctors' bills or take precautions against its
spread, hence the cause of the epidemic. On visiting the school
there I found two of the children present in the desquamating stage
of the disease. Some of the cases were sent to hospital, but the
greater number were treated at home. As there was no means of
getting a history of the outbreaks, at Beith and other places, in their

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initial stages, the sources of the infection could not be traced. It is
satisfactory to note that the cases were nearly all of a very mild type,
the mortality being comparatively low. Taking the diseases notified
in their numerical order, the next is erysipelas, which we notice was
somewhat prevalent in Beith and Kilbirnie. This disease is
frequently found connected with the effluvia from defective drains,
filthy ash-pits, &c., but it does not very often prove fatal. Enteric
fever comes next with 4 cases in Beith parish, 3 at Dreghorn (to
which may be added 4 cases of doubtful continued fever, making in
all 7 cases), 2 in the parish of Dalry, 1 at Kilbirnie, and 1 in Kil-
winning parish. With three exceptions, the water supply was found
suspicious. In the remaining three cases, the milk supply from a
neighbouring house with enteric fever (which had a different water
supply) was clearly the source of the infection in one of them,
while another case was due probably to infection left in the house
by a pre-existing case, which occurred in the former occupier's time.
This refers to the case in Kilbirnie, where the present party on
entering the house had it disinfected; and in scraping the old paper
off the walls, a child five years of age, it was alleged, was found to
put a piece of it in his mouth. He was attacked with enteric fever
some days later. This theory would have still more force had the
drainage been good, which is not the case, but the water supply is
above suspicion. In the remaining case, the cause was probably
connected with defective drainage. Diphtheria and membranous
croup may be considered one and the same disease. This disease
does not seem to have been abating in the same ratio as other
infectious diseases, and it would appear that its presence is not always
a sign of bad drainage, filthy surroundings, and such like. That
these conditions intensify its infectiousness and severity no one can
deny, but cases do occur where the hygienic surroundings are, as far
as we are able to judge, in a perfect state. In these cases some
occult cause, perhaps connected with the site and exposure of dwelling,
soil, season, diseases of domestic animals, contagion from contact
with a case of the disease, or infected article, &c., may account for
an outbreak. There is no evidence that polluted water is a cause,
although it is frequently credited with this. In cases where I
investigated outbreaks of diphtheria, I found dampness of houses a
very frequent condition. But the number of cases were too small to
draw any reliable inference from them. The two cases of puerperal
fever do not require any special notice. As to the causes and origin
of the diseases with which we are dealing, it is impossible to enter
fully in this report.
Birth-rate. - The birth-rate (34.0 per 1000) of this district
during the year is somewhat high The five parishes of Stevenston,
Dreghorn, Kilwinning, Beith, and Kilbirnie, being above the
average, while the remaining seven are under it.
Death-rate from all Causes. - The total death-rate (18.91) of the
district is high for a rural population. For a healthy country district
with an average age distribution of the population, 16 per 1000 may
be considered a fair standard; but in a district such as this, where