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34
and amongst other points shows clearly that the diphtheria mortality falls
during school vacations.
Cholera.—In July the following letter was received from the Local
Government Board, but as the diarrhoea mortality was less than in any
previous year it was decided not to require the notification of this disease:—
Cholera.—Notification of Diarrhoea.
Local Government Board,
Whitehall, S.W.
16th July, 1894.
Sir,
I am directed by the Local Government Board to state that cholera,
from which certain parts of Europe have never been entirely free since the
summer of 1892, again shows some signs of recrudescence on the Continent.
In the late summer and autumn months of 1892 and 1893 the disease reached
our shores. In 1892 it failed to extend to any persons beyond those arriving
in our midst from abroad. But last year it led to a number of localised
outbreaks which, happily, were of trivial extent compared with previous
cholera visitations to this country.
In those localities where cholera made some headway it was found that
there had been antecedent diarrhœa, generally quite excessive in amount, often
choleraic in type ; the existence of this unusual diarrhœa being only discovered
when diarrhoea was, under section 7 of the Infectious Disease (Notification)
Act, 1889, added to the diseases notifiable under that statute. But notification
of diarrhoea was rarely, if ever, adopted until after the advent of cholera, when
the information to be derived from it could not be utilised to prevent that
disease from gaining a footing whilst in its least recognisable form.
Under these circumstances the Local Government Board have thought it
desirable to remind sanitary authorities that the utmost vigilance should be
exercised within their respective districts, to control any diarrhoea which may
be suspicious either in character or in amount during the present and forthcoming
season And, with a view of facilitating action in this direction, the
Board would give favourable consideration to any applications that may be
addressed to them for their approval to add diarrhoea to the list of notifiable
diseases, until the termination of the current quarter. In making any such
application, each sanitary authority will doubtless consider how far it may be
desirable, in the first instance at least, to limit notification of diarrhoea to
attacks occurring over one year of age.
I am, Sir,
Your obedient servant,
(Signed) Hugh Owen,
The Clerk to the Secretary.
Sanitary Authority.