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

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Stepney 1911

[Report of the Medical Officer of Health for Stepney]

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59
and respiration are quickened; rigors occur, succeeded by high temperature. There
is progressive weakness, with cyanosis, death occuring in from 12 to 48 hours. In
the more prolonged cases, widespread oedema and extensive enlargement of lymphatic
glands are marked features. In the glands, especially about the neck, actual
necrosis with ulceration may occur, constituting the so-called Anthrax Carbuncles.
On post-mortem examination, the most noticeable feature is the enlargement
of the spleen, which may be two or three times its natural size. It is of a dark red
colour, and on section the pulp is very soft and friable.
Anthrax is due to a pathogenic organism called Bacillus Anthracis. The bacilli
form spores (or eggs) which are enclosed in a thick membrane and are more tenacious
of life than the bacilli. They are able to stand heat, cold, and comparatively strong
disinfectants. Not only so, but under circumstances which would rapidly prove fatal
to the bacilli, the spores remain viable for years. The bacilli are killed by two minutes
exposure to a 1 per cent. solution of carbolic acid in water, but the spores will remain
alive for more than a week in a similar solution.
Anthrax is almost invariably transmitted to the healthy animal through the
medium of food or water containing the spores of the disease.
The cow in question had been in the shed for two months. It is therefore evident
that the disease was contracted through the food supply. The most likely cause was
the oil cakes which were used to feed the cows. These cakes—Bombay cakes—are
about 18 inches long and 6 to 7 inches wide. They are imported from India in bales
without any covering, or being put in sacks. It is quite possible that skins or hides
were placed on top of them in the hold of the ship, and that spores from an infected
hide became attached to one or more of the cakes.
Plague.
The occurrence of Plague in human beings in East Anglia in 1910 together
with the existence of this disease among rats, hares, and other rodent animals in
that locality, has naturally drawn the attention of the public to the danger from
this disease, which has not been epidemic in this country for over 200 years, but
small outbreaks have occurred during the last 12 years in Glasgow, Liverpool,
Cardiff, and Leith. Plague bacilli have, however, been discovered in dead rats in
the docks by the Port Sanitary Authority during the summer months for the last
3 or 4 years.
It has been definitely proved that the disease particularly affects rodent
animals such as rats, and that it is communicated from the animal to man by means
of fleas. When the animal dies, or is dying, it becomes cold, and the blood does
no longer circulate and afford nutriment to the fleas. They consequently leave their
host, and attach themselves to another rodent or even to man. When a flea requires