HH62/1/DUMFRI/21

Transcription

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District Committee. The opposition to its inclusion has been very
slight, and the arguments against rather contradictory. In one
Committee it was urged that the disease was one which all children
were expected to take, and therefore not worthy of being brought
under the notice of a Sanitary Authority. In another, that it was
much too serious in most cases to admit of them being removed to
isolation hospitals. The latter argument is probably nearer the
truth than the former, but the inference that all cases notified must
at once be removed to isolation hospitals when these are provided
is erroneous. Notification will be beneficial not so much by enab-
ling us to remove cases of measles as by assisting us to give
prompt information to schoolmasters, and to have the schools
closed against children from infected houses. It will also give
the Sanitary Staff the opportunity of seeing whether disinfection is
properly carried out.
The Districts from which cases of the disease were reported
were Dumfries, Annan, and Lockerbie.
The two Dumfries cases occurred in the parish of Kirkmahoe,
one in October and the other in November.
In Annan District the majority of the cases occurred in Ruth-
well, 11 having been notified. The affection was introduced by a
child who had been brought from Carlisle to the Brow Cottages
when convalescent. There was one death. Four children in one
house in Middlebie suffered. They had caught the infection in
Tundergarth, where they attended school, and where measles were
prevalent during the months of June and July. Two notifications
were received from Dalton and one from Annan.
In the Lockerbie District the disease was epidemic in the
parish of Tundergarth during the greater part of June, July, and
August. There is little doubt that it spread from the Burgh of
Lockerbie, where it was prevalent a short time before. Certain of
the cases occurred before the Act came into force, but 28 were
afterwards reported. In addition, five were reported from St.
Mungo and two from Dryfesdale.
Though the mortality from measles in the rural districts
of Dumfriesshire is considerably less than it is in the mainland
rural districts generally, there is little doubt that the disease is
tending to become more fatal and widespread. It is one
of those maladies that are not directly amenable to im-
proved sanitary conditions, but spread by direct infection, and
particularly through the agency of day and Sunday schools. It

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must be dealt with by prompt isolation of early cases, and at
present the most efficient means of preventing it assuming an
epidemic form is the closing of schools.

Diphtheria occurred in two Districts only, Dumfries and
Annan.
In Dumfries two of the cases were reported from the parish
of Dumfries, one from Kirkmahoe, and one from Caerlaverock. One
of the Dumfries cases was imported. The other, as well as the
Caerlaverock case, was certainly connected with insanitary sur-
roundings. In one of them there was a tendency to attacks of
sore throat and probably a hereditary predisposition. In Kirk-
mahoe, where I did not see the case, it having occurred during
my absence in August, the surroundings were not quite satisfac-
tory.
In the Annan District diphtheria broke out at Bonshawside and
Breconbeds in November. There were eight cases, of which two
proved fatal. The house at Bonshawside was found in an unsatis-
factory state. It is built on a wet soil, and lies low. The walls
were damp, and we were informed that fungus growths sometimes
appeared on them. The drainage was most defective, there being
only some field tiles, which were frequently blocked up, while the
liquid filth from the piggeries was allowed to make its way over
the surface of the ground. These defects have begun to receive
some attention from those responsible for them. At Breconbeds
the water supply was exposed to some risk of contamination, but
I do not think there was evidence to show that it bore any relation
to the outbreak. It has, however, been put right. The school
was closed for some weeks in consequence of the outbreak. In
addition to these, two cases occurred early in the year in the
parish of Gretna and one in Kirkpatrick-Fleming.
Diphtheria caused six deaths - three in Thornhill, two in Annan,
and one in Lockerbie. Two of them occurred before the adoption of
the Notification Act. The rates are considerably less than the average.
While this is so, it has to be remarked that throughout Great
Britain it is the one zymotic whose death-rate has undergone an
increase. Though it is found chiefly in districts where the sur-
roundings are distinctly unhealthy, it has increased, particularly in
urban populations, in spite of improved sanitation. It is particu-
larly liable to spread through milk, and there is strong presumption
that in some of the epidemics which have been investigated in