HH62/1/DUMFRI/23

Transcription

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recent years the milk has derived its infection from some condition
affecting the cow herself. The observations collected by Dr Thorne
and published recently in his Milroy lectures also tend to support
the view that some epidemics may have been in no small measure
due to the aggregation in schools of children suffering from mild
forms of sore throat, which frequently appear before an outbreak
of the disease.

Typhoid invaded all six Districts.
One case was notified from Dunscore, in Thornhill District. It
was, I believe, imported, and did not spread.
Of the Dumfries District cases, ten were in the parish of
Dumfries and one in Kirkmichael. Three of the Dumfries cases
were removed to the Infirmary, where one died and the other two
made good recoveries. The Kirkmichael case was too ill for
removal, though it was felt desirable. Even if he could have
been removed, I should have had grave misgivings about bringing
him into Dumfries in the fever cab, which at present is the only
conveyance available. All the typhoid cases were visited by the
Sanitary Inspector or myself, and in every instance the surround-
ings were more or less unhealthy. At one the ashpit was an open
cesspool. In another the closet accommodation was in an abomin-
able state of neglect, while in yet another the well was so situated
that it received surface washings, including manure, whenever
there were heavy rains.
The Annan cases were two in the parish of Cummertrees and
one in Gretna. One of the Cummertrees cases occurred in April,
the other in August. The water supply in both instances was
decidedly faulty. The Gretna case was that of a servant girl who
was reported to have shown symptoms of the disease a few days
after entering upon her duties in a new place. She was removed
to her home in Annan before the notification reached us.
In Lockerbie Districts three of the cases occurred in one
household in Hutton and Corrie. There did not seem to be any-
thing in the house itself, which is well isolated, to account for the
fever, but I understand that cases have occurred before, and the
water supply does not seem to me to be sufficiently guarded against
pollution. There were two cases in St. Mungo, one of them in a
house in which the germs of fever seem to have lurked for years,
it having become one of the plague-spots of the County. The
second case occurred in a neighbouring house, and as milk was

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obtained from that in which the first lay, I am inclined to take
the view that the one was referable directly to the other. The
sixth case was notified from Tundergarth and was imported.
The Notification Act came into force in the Moffat district on
November 15th. Immediately after, I received three notifications
of Typhoid. These have been the only cases of infectious disease
in the District which have come to our knowledge during the year.
They occurred in children in a house just outside the Burgh of
Moffat, and some time before the Act really came into force. I
had an opportunity of inspecting the house on November 9th, and
found it very defective, and the water supply polluted. Several
of the defects have since been remedied, but it is doubtful if the
house will ever be got into a satisfactory condition. Though
there have been no further cases of infectious disease within the
District, we received on December 27th a complaint from the
Sanitary Inspector of the Burgh that an outbreak of Typhoid had
occurred, and that it appeared to have been caused by the milk
from a dairy-farm in the District. This farm had been some time
before inspected and found to be in a satisfactory condition with
the exception of the water supply, the well being placed where it
might be liable to pollution. On investigation, we found that there
had been nine cases of typhoid in seven houses in the Burgh prior
to our visit, and that milk from this farm had been supplied to all
of these, that the first of the nine cases had occurred about the
middle of October, and the others at intervals up to the end of the
year. We visited five of the houses, and found in four of them
well-marked sanitary defects. In one these had apparently been
so bad that during the illness the internal fittings had been entirely
replaced, and a drain which passed underneath the house had been
taken out. In the fifth the smoke-test applied sometime after our
visit showed that sewer-gas was finding its way back by leaking
drain pipes. We interviewed the dairyman and took a sample of
water from the well for analysis. At the time when it began to
be said that the outbreak was probably due to milk from the dairy
he had over 110 customers within the Burgh. Occasionally he
found his supply short, and made it up by purchasing from indi-
viduals who, though not engaged in the trade, kept cows, and
found themselves able to spare some milk from their own use.
From the 13th to the 27th December he purchased daily a small
quantity from a house where two cows were kept. One of these
belonged to the people whose children were notified to me as