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84
In the years 1940 to 1941 there was an increase in the number
of cases of Cerebro-Spinal Fever, 69 such cases being notified and
resulting in 19 deaths. This disease exhibits high incidence at
irregular intervals and a few cases were notified annually during
each of the 30 years I have been Medical Officer of Health. The
numbers notified in other years have varied between one and fifteen
cases with an annual average of five cases.
In 1935 a sewerman employed by the Council died from
Leptospiral Jaundice (or Weil's Disease), a form of jaundice which
is spread through the urine of sewer rats. This disease is not
notifiable but cases come to the knowledge of the Public Health
Department through either hospitals or the Borough Engineer and
Surveyor, who has been asked to inform the Department when
any sewer worker is absent from work because of jaundice or
suspected jaundice.
As a result of this death the following instructions were included
in the booklet issued to the Council's employees working in sewers:—
"Precautions against risk of Leptospiral Jaundice.
(а) After leaving a sewer, the hands and forearms should
always be thoroughly washed with soap and warm water.
This should also be done before taking any food or drink.
(b) Particular care should be taken to wash thoroughly any
cut, scratch or abrasion of the skin as soon as possible,
whether the injury was sustained on the work or not.
An antiseptic should be then applied to the affected part
with a clean piece of cloth or cotton wool and the wound
protected with a strip or gauze completely covered with
adhesive plaster. The wound should be kept covered
until it is quite healed.
(c) A suitable antiseptic, gauze and adhesive plaster are
supplied for use.
(d) Avoid rubbing nose or mouth with the hands during work.
(e) This book must be carried when on duty, and whenever you
go to your doctor or to a hospital on account of illness, show
it, and make sure that those attending you know your
occupation.''
A further case came to the knowledge of the Department
in 1936 but concerned a man employed by a firm of building contractors
and in 1937 another death occurred, this patient also
having been employed by a private building contractor.
In 1937, in order to ensure that any sewerman contracting
this disease could receive immediate treatment, I addressed a
letter to all medical practitioners in the borough asking them
to bear in mind the possibility of this disease when treating