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37
1929
"carrier" enjoys does not extend to the susceptible person.
Alternatively, it is possible that a change of pressure such as
occurs in a person diving might conceivably determine the migration
of the germ in a "carrier" from the naso-pharynx into the
meninges. These are, of course, only surmises but have been put
forward by certain authorities who have investigated epidemics of
the disease. That various depressent experiences may determine
an attack of disease is known and cases of encephalitis following
vaccination have been reported from different parts of the
country.
What light does the life history of the meningo-coccus or
the epidemiology of cerebro-spinal fever throw upon the occurrence
of these cases in Acton ? It can be stated quite definitely that
the infection in every instance must be direct from person to person.
The meningo-coccus will not grow in bath water ; in fact it cannot
survive in such a medium or such a temperature which obtains
in Public Baths. The only possible conditions under which infecttion
could take place in the bath water would occur if a "carrier"
took in some water through her nose, spat it out of her mouth and
a susceptible person immediately inhaled that same water through
her nose. Such a theory is really too grotesque to be considered
seriously, but it is the only possible way in which ordinary bath
water could be the medium of spread. If infection had taken place
in the baths, the only two persons who could have been infected
together would be F.K. and J.M., and that date would be on July
20th. J.M. may have been infected on July 22nd, but it is extremely
doubtful if F.K. could have been infected as late as July
22nd.
C.W. was probably infected as early as July 22nd. The
incubation period is very rarely over a week, and she was not
taken ill until July 31st.
Other circumstances could be mentioned which would point
against the probability of the baths being the medium of infection.
The three sufferers were all girls, but on July 20th and July 22nd,
the baths were also used by boys and men. On Saturday, July
20th, the 2nd class baths were reserved for ladies from 9 a.m. to
12.30 p.m. and from 12.30 p.m. until closing time, men only were
allowed to use them. On July 22nd men only used the 2nd class
baths up to 2 p.m. and ladies only from 2.0 p.m. to closing time.
From the elementary schools on July 22nd, 157 girls and 139 boys
attended. On the two days it may be assumed that quite as
many men and boys attended as women and girls and yet infection
was limited to girls. Again the three cases all live south of the
main Uxbridge Road, but the baths are attended by persons from
all parts of the Borough.