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14
Summer Diarrhoea is now generally believed to be an infectious disease,
capable of spreading from the sick to the healthy. Direct infection may be
conveyed by the milk or other foods, as well as by other means such as the
use of comforters, placing the babies on dirty floors, etc.
The disease is believed to be due to many different species of microorganisms,
and that they reside in the superficial layers of the earth which
contain suitable food for them, that is, soil polluted with decomposing organic
matter. The development and multiplication of the micro-organisms depend
on a high temperature, not of the air itself, but of the superficial layers of the
soil.
It is well known that warm summers are generally associated with
excessive prevalence of diarrhoea. As long ago as 1887, Dr. Ballard in his
special report to the Local Government Board pointed out the connection of
diarrhoea with air temperature, and with earth temperatures at depths of 1 ft.
and 4 ft. He stated that the prevalence of summer Diarrhoea in epidemic
form, was in proportion to the temperature at the depth of 4 feet, and that the
ascent of the curve began when the earth thermometer recorded a temperature
of about 56° F. The amount of Diarrhoea attained its maximum when the
4 ft. thermometer attained its mean weekly maximum.
There is no doubt that temperature and weather conditions are associated
with epidemic diarrhoea. But more important than a general average
temperature is the correlation which has been shown to exist between the
morbidity rate of infants and the maximum daily temperature. When these
are both high,the cases of Infantile Diarrhoea are markedly increased,particularly
among artificially-fed children. The babies who are entirely breast-fed are
relatively free from infantile diarrhoea even during the hottest summers.
This goes to show that the increase in temperature acts indirectly as a
cause of Infantile Diarrhoea. In warm weather, artificial foods are a suitable
nidus of infection under bad home conditions.
Excessive rainfall during the summer causes a diminution in the number
of deaths from Diarrhoea. This may be due, however, to the fact that with
excessive rainfall the temperature of the air is reduced.
The prevalence of flies has been stated to be a cause of Diarrhoea. It is
very difficult to prove or disprove this statement, because if you have a hot
dry summer you have flies in increased numbers. It is true flies have
diminished in recent years in London due to the change from horse to mechanical
transport. This has naturally resulted in the reduction of the amount of
manure stored near houses, with the elimination of breeding ground for flies.
It is also partly due to the propaganda by handbills, posters and cinema films,