London's Pulse: Medical Officer of Health reports 1848-1972

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Hackney 1897

Report on the sanitary condition of the Hackney District for the year 1897

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13
Enteric Fever.—The total cases of this disease notified in the
district during the year numbered 203, with 87 deaths. These give
an attack-rate of .94, and a death-rate of .17 per 1,000 living. Of the
203 cases, no less than 14 appear to have been contracted outside
the district, and only one case seemed to be associated with oystereating;
but this latter may have been a coincidence only. The
connection of enteric fever with defective house drainage is important,
and I have referred to this in a subsequent part of this report.
The secondary cases of this disease, I have every reason to believe,
have arisen from personal infection from primary cases; but the
source of most of the primary cases has defied our efforts to discover.
During the last two years very important investigations have
been made by Dr. Sidney Martin for the Local Government Board,
into the connection of enteric fever with different kinds of soil. The
investigations which are still proceeding, took the direction of ascertaining
whether the bacillus of enteric fever survived for any
appreciable time in the soil, and the character of the soil which
favoured most the growth of the organism. Dr. Martin arrived at the
following results: That in organically polluted soil, the bacillus of
enteric fever, "increased speedily and spread abroad, whereas in the
virgin soil under like conditions of temperature and moisture, it
languished and quickly died out."
The practical importance of these facts lies in the indications
they afford of the measures to be applied in order to prevent the
spread of enteric fever, due to the growth of this micro-organism in
the soil about dwellings. The indications are such as will prevent
the fouling of the soil about dwellings. These are: 1.—The speedy
removal of all filth of an organic nature, from all dwellings
and their neighbourhood. 2.—The paving of yards; and what I
consider of most importance, the concreting of the whole site of the
house to prevent the entrance of the ground air. 3.—The provision
of proper surface drainage. 4.—The construction of all sewers and
house drains in such a manner as to prevent fouling of the soil.
5.—The abolition of all dust shoots, and the substitution of cremation
of all the filth for the present means of disposal.