HH62/1/DUNBAR/49

Transcription

[Page] 48

inmates, constituting two families. One of the inmates was a
woman with a baby two or three days old. In this house there were
four cases. Tracing backwards from these, other four were met with,
all of which had been sent to Dunbarton hopital, as suffering
from some kind of fever. No evidence whatever could be got as
to where the first case had contracted the infection. The illness
had begun in the second week of August. Contemporary with
the first four cases (in the families of Henderson and Fraser,
134 Back Street), seen by me, other four were discovered, one at
McCrae's, 18 Burn Street, another at Murray's, 18 Burn Street,
one at Bell's, 6 Lennox Street, and one at Haddow's, 68 Back
Street. These were at once sent to hospital. Subsequently, other
five cases occurred in the above-mentioned houses, there being thus
17 cases in all, constituting the outbreak.
The steps taken were briefly as follow:- All cases were re-
moved to hospital, and the bedding and clothing burned or dis-
infected. The houses were fumigated, lime-washed, and left with
windows open for a sufficient time before being used again. In the
same tenement to which I was first called it happened that there
was an empty house of two apartments. A little furniture was got
for it, and the people from the infected house were removed into it.
until the danger had passed. As the newly-confined mother was
one of the persons taken to the hospital, a nurse was got from
Glasgow to attend to the baby, which escaped the fever altogether.
In regard to each case of the disease, a list of all persons known to
have been exposed to infection was made out, and these were
visited to ascertain if any had developed symptoms of typhus.
An attempt was made to get, outside of the town, a reception house
large enough to accommodate in quarantine all these persons. A
suitable house was obtained in a sparsely populated locality, but so
much local feeling was aroused when the arrangement became
known that it had to be abandoned. The fear of harm from the
reception house was entirely groundless; but it is not rare to find
in purely rural districts a greater dread of infection than prevails
in a crowded locality. The next best plan had therefore to be
adopted. Dr. Mitchell agreed to take the list of persons who
ought to have been quarantined, and to visit each of them
daily for between two and three weeks. With one exception all
those on the list who were employed in workshops gave up work

[Page] 49

and stayed at home while under observation. It was in this way
that the last five cases were got hold of as soon as the first symp-
toms appeared, and were removed to hospital. I caused the
following notice to be posted through the town:-
"Typhus Fever. - An epidemic of typhus fever is at present
threatened in Renton, and may readily extend throughout the
Vale of Leven. Typhus is a most dangerous and infectious
disease, and the Public Health Department earnestly requests the
aid of the inhabitants to prevent its spread.
"The disease usually begins with headache, pains in the back
and limbs, great muscular debility, and a feeling of chilliness on
the part of the patient, though the skin is really hot to the touch.
Wherever any such symptoms are present, though in a slight
degree, the doctor should at once be sent for, in the interests alike
of the patient, the household, and the public. Concealment even
of the mildest case may be disastrous.
"The circumstances which above all others favour the develop-
ment of typhus are overcrowding, bad air, and dirt. People who
keep lodgers should see that their rooms have not too many in-
mates. Doors and windows should be kept as freely open during
the day as the weather will permit, and at night a chink should
be left open at the top of the windows of all sleeping apartments.
A bright fire makes an excellent ventilator.
"Floors, walls, and furniture should be kept thoroughly clean,
and all unnecessary curtains, hangings, and other means of inter-
fering with the circulation of air, especially around and underneath
beds, should be removed.
"Immediate intimation of slight or suspicious cases of illness
should be left at Dr. Mitchell's consulting rooms."
At the same time a house to house visitation was made in the
neighbourhood of all the known cases, partly to search for others,
and partly to impress on the inmates the need for ventilation and
cleanliness. I have already given some notes of this visitation. A
deal of extra scavenging was carried out, and extended not only to
the cleaning of streets, but to the emptying of ashpits.
The result of all these measures was that, excepting the
attacks which developed in those who had already the sickness
in their blood, no other person was affected. The disease was
for the time stamped out, and an epidemic which might have deci-

-- D