HH62/1/DUMFRI/17

Transcription

[Page] 16

As these figures do not cover the same periods, the Act having
been adopted at different dates in the different Districts, it must be
understood that no fair comparison can be instituted between them,
nor do I think it proper to give any infectious sick rates. There
is one point to which I must, however, draw attention. Of the 297
cases, 275 were notified by medical men, 21 by heads of houses,
while one case was discovered, no doctor having been in attendance,
and the parents professing ignorance of the nature of their child's
illness, which was one of scarlet fever. Only 60 cases were notified
by both medical men and heads of houses. It should be widely
known that this omission to notify by heads of houses renders them
liable to a penalty. In the majority of instances I believe it is due
to ignorance of the law and to the fact that Notification Acts are
somewhat confusing in their provisions. There were several special
Acts providing for notification before the passing of that which has
been adopted in Dumfriesshire and other counties. Some of these
throw the burden of notification on the householder only, others on
the doctor, and a few, like that of 1889, on both doctor and house-
holder. I am aware that all medical officers do not agree with
me, but as my experience of notification increases I become more
than ever convinced of the necessity of insisting upon notification
by the householder as well as by the doctor in attendance. In the
first place, the law requires it; and in the second, its omission
enables certain cases to which a doctor is not called to escape our
observation. If the provisions of the Act were more universally
insisted upon, I believe that obscure outbreaks could be more
readily traced to their origin, and probably householders would be
more ready to call the doctor to cases which, while doubtful to
the untrained eye, may be quite clear to the skilled observer.

Scarlet Fever, as will be seen from the above figures, was
very prevalent, particularly in the Thornhill, Lockerbie, and
Annan Districts. The majority of cases occurred during the
summer and autumn months.
In Thornhill the northern part of the District was most
affected. There were 19 cases in Sanquhar parish, 14 in Kirk-
connel, 9 in Durrisdeer, 7 in Closeburn, 2 each in Dunscore and
Keir, and 1 each in Morton and Penpont. Of these cases two died.
The chief centre of the malady was Crawick Bridge and the
vicinity, where large families and small houses rendered it impos-
sible to secure the necessary isolation. No doubt also certain of

[Page] 17

the cases were due to infection caught at school. One case
occurred at a dairy farm, in consequence of which the milk trade
had to be stopped for a time.
In Dumfries District the greater number of the cases reported
were from the parishes of Dumfries and Caerlaverock. In the
former there were 8, in the latter 5. In Tinwald and Kirk-
mahoe there were three each, in Torthorwald 2, and in Kirk-
michael 1. One of the Caerlaverock cases was removed to the
Dumfries and Galloway Infirmary. One of those in Torthorwald
occurred at a dairy farm, and would also have been removed to
the Infirmary were it not that the farmer had an empty cottage at
his disposal, to which he preferred to send his child with an
attendant. Though one case only was reported from Kirkmichael,
there had been an epidemic in the upper part of the parish, in
consequence of which the School had to be closed. I heard
accidentally of the outbreak before entering on my duties, and
finding that the period agreed upon by the Board for closing was
too short, I recommended an extension so as to cover at least six
weeks from the date of attack of the last victim of the outbreak,
who happened to be one of the schoolmaster's children. This was
done, and, so far as I am aware, the spread of the malady ceased.
No further cases were reported. Three deaths occurred in the
district, one before, the others after, notifications had begun to be
made to me.
The parishes of Annan, Kirkpatrick-Fleming, and Middlebie
suffered most in the Annan District. The first furnished 11 of the
cases; the second 18; and the third, 9. From Cummertrees I
received 3 notifications, and from Ruthwell and Gretna 2 each.
The majority of the Annan cases occurred in the northern part of
the parish. Some of them were introduced from Hoddom, and the
Annan hiring fair appeared to be responsible for certain of the
cases which occurred both in Annan and Kirkpatrick-Fleming. In
the latter the school at Newton had to be closed. In Middlebie
there were 9 cases - 6 at the lower end of the parish (5 of them
being in one family) and 3 in Waterbeck. Two of the Cummer-
trees cases occurred close to Hoddom during the epidemic which
prevailed there. The third case was imported. Those in Ruthwell
and Gretna were probably imported also, and fortunately did not
spread. The type of fever appeared to be unusually mild, and
there were no fatalities.