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

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Bermondsey 1914

Report on the sanitary condition of the Borough of Bermondsey for the year 1914

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"infective diarrhoea" have proved abortive. Various kind of
bacteria found in the intestines have been in turn accused of causing
the disease, but it may eventually turn out that there are several
implicated. In the meantime there are certain facts established in
connection with the causation and these are (1) The disease is
strictly seasonal, i.e., it begins every year about the middle of June
and continues till the middle or end of October after which period
the mortality is very slight; (2) It is connected with heat: this is
proved by its occurrence in summer and also by the fact that if
the summer is hot and dry the deaths may be trebled or quadrupled
as compared with a cold wet summer: in 1911 when we had 226
deaths in Bermondsey the summer was very hot and dry to be
followed by a cold wet summer in 1912 with only 84 deaths: 1913
with its 78 deaths was notoriously cool and wet; (3) Contamination
of food, especially of milk, has long been considered as a cause, the
main proof of this being the comparative immunity of breast fed
infants; and (4) It is infective, i.e., when one person in a house
gets an attack it is liable to spread to other members.
"All the above-mentioned are well established facts, but while
it is clear that the disease is infective and should be classed with
the infectious diseases the method of spread from one case to
another has remained obscure. Since the discovery in the latter
part of the last century that malaria is spread by mosquitoes,
insects of various sorts have been looked upon as possible bearers
of disease. We know this to be true of yellow fever which is
conveyed by a different species of mosquito than that causing
malaria and also of sleeping sickness which is spread by the tsetse
fly. The last insect which has come to be suspected is the common
house fly and allied species such as blue-bottles, manure flies, etc.
During the last two years investigations have been carried on by
many scientific workers, especially those of the Local Government
Board and they have pretty well established the fact that these
insects are capable of spreading many diseases. Such diseases
include epidemic diarrhoea, typhoid fever, cholera, ophthalmia,
tuberculosis, diphtheria and possibly many others. When one
considers the habits of flies this will not appear extraordinary;
they walk over and feed on all sort of filth, and no doubt transfer
injested bacteria to our food and drink by means of their excreta,
but also by means of their feet and legs which become covered with
infective material. As a matter of fact typhoid tubercle and other
bacilli have actually been found on and in flies as a result of the