HH62/1/DUMFRI/19

Transcription

[Page] 18

In the Lockerbie District the affection was epidemic in the
Parishes of Hoddom and St. Mungo, and a sudden outbreak
occurred in Hutton in September. From the first came 22 notifi-
cations, from the second 13, and from the third 19. One case was
reported from each of Dryfesdale and Lochmaben parishes. The
disease appears to have been in existence both in St. Mungo and Hod-
dom at the time the Notification Act came into force. In both we
watched it spread from place to place, and felt ourselves practi-
cally powerless to prevent it. Isolation could not be properly
carried out. In many of the houses it was impossible to separate
the first affected from other members of the family, and during
convalescence the grossest carelessness was shown by those who
ought to have known better. Children were admitted to school or
allowed to play with their schoolmates when desquamating, and
in one instance a teacher went to her duties straight from an
infected house, and continued at them until a discovery was made
by me and the matter brought under the notice of the School
Board. The exposure of a convalescent from the same house was
so flagrant that a prosecution had to be ordered, with the result
that the accused pleaded guilty and was admonished. In addition
to the schools, the churches to some extent may have helped to
spread the infection, as far as people from infected houses were, until
stopped, fairly regular in their attendance. The fact that the
disease was of a mild type may account for the carelessness shown.
Out of the 56 cases there were only three deaths, one each in
Hoddom, St. Mungo, and Hutton. In the latter parish the disease
broke out in consequence of two boys being sent to school while
desquamating. Fifteen cases were notified within a few days.
The origin of the first cases could not be traced, and just at that
time we had no knowledge of scarlet fever nearer then Eccle-
fechan. It appears, however, from information we have since
received that there may have been intercourse between the two
places of a kind that would not be made known to us. I cannot, of
course, assert that the fever was so introduced, but a careful investi-
gation leaves it up to the present as the only likely source. In
consequence of the outbreak the school had to be closed for a
period of nearly seven weeks.
No cases were reported from Moffat District.
From Langholm I had ten notifications, but two referred to
the same case. They were all traceable to the outbreak in Hutton. The

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first case was that of a girl attending school there. She unfor-
tunately died, the only fatality of that outbreak. Other cases were
reported afterwards and traced to the same source. Eventually
the affection spread into Westerkirk and attacked two young
adults there. One of these was removed to his home in Canonbie,
and his case reported a second time. The removal gave rise to a
complaint on the part of the Canonbie School Board. With that
complaint I have every sympathy, but, on the other hand, the
patient appears to have been laid up at a farmhouse, where, in the
judgment of his medical attendant, he could not be treated with
safety either to himself or others. The manner of his removal
was, however, objectionable, and, as I am advised, illegal, inas-
much as the Public Health Act gives permission only to Local
Authorities or their servants to effect such removals. In this
instance no member of the Sanitary Staff was consulted. The
case is, to my mind, an example of the necessity of making some
provision in the shape of an hospital for infectious diseases as well
as a suitable carriage for the removal of such cases. Disinfection
in the form of sulphur fumigation was applied to the carriage in
which the patient had been taken to Canonbie, but as fumigation
has been known to fail, it is hardly safe to trust to it alone, and in my
view there ought to be a carriage specially reserved, or at any
rate so constructed that it can be well washed with a disinfectant
in addition to being fumigated.
Scarlet Fever is one of the zymotics which spread by direct
infection, and through articles of food and clothing as well as
from person to person. We have observed it more than once
recur in the same house after an interval of some months, a
circumstance that may be best explained on the supposition
that some part of the house, or some articles contained therein,
have escaped disinfection. The food by which it is most
liable to spread is milk, hence the necessity for stringent dairy
regulations, as well as complete and thorough isolation of
sufferers.

Measles is now notifiable in all the Districts except Langholm.*
It was included among the scheduled diseases when the Act was
adopted in the Annan, Lockerbie, and Moffat Districts. In Thorn-
hill and Dumfries it has been added by special resolution, and it
will probably be added in Langholm at an early meeting of the

*It becomes notifiable in this District on and after 15th May, 1892.