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14
I investigated the milk supply as being a probable cause, but was
unable to get any reliable data, some families using condensed milk,
and others obtaining their milk from various purveyors.
It is difficult to say what was the cause of the outbreak. During
that time there was more Diphtheria in both the rural and urban
districts of Essex than there was during the corresponding period of
last year. As regards this distict, it may have been due to the water
famine of the earlier months of the year, followed, as it was by hot
and dry weather, and to the emanations that would arise, when such
conditions exist, from manholes and gullies—for instance, where the
dual system of drainage is not carried out, the dearth of water would
cause untrapping of the gullies and so allow sewer gas to escape. To
remedy this, water carts were sent round the infected area, flushing
the gullies and manholes with disinfectants.
In my Report I laid great stress on the advisability of flushing the
sewers in section throughout the whole of the District, and of erecting
more ventilating shafts to the sewers.
It will be seen that out of the 48 cases mentioned above, only 80
houses were infected, showing how the disease was spread from one
inmate to another, and how advisable it would be to have some
hospital near at hand wherein cases could be isolated at the commencement
of such an outbreak.
The disease continued in epidemic form for some weeks, and the
mortality in June and July was very severe, 26 deaths occurring in
these two months. After the heavy rainfall at the end of July, the
disease seemed to abate.
In August an outbreak occurred in the Union Schools, and will
be dealt with under the heading of Public Institutions.
MEMBRANOUS CROUP.
There have been 30 cases notified as compared with 6 last year,
and the mortality has been very high—20.1 per cent.
Of the 6 deaths, 4 were under five years of age.
TYPHOID FEVER.
There has been a slight decrease in the number of cases notified,
although the mortality has been greater. The majority of cases
occurred in September and October. Three of the cases were notified
as being treated in the London Hospital.
Of the 11 deaths, one was under five years of age. In addition to
the 74 cases notified there were 15 cases of this disease in the West
Ham Union Workhouse.