BOARD OF HEALTH.

Globe, Volume XXIII, Issue 2269, 12 July 1881, Page 3

BOARD OF HEALTH.

The local Board of Health met yesterday afternoon. Present —Mr Harman (chairman), Messrs Brown, White, and Tancrod. The Chairman informed the Board that three communications had been received by the Board bearing on a highly important subject, namely, that of an outbreak of typhoid fever referred to.

The communications were then read, the first being a letter from Dr. Frankish, acting for Dr. Nedwill, which was as follows: The Chairman Local Board of Health. Sir, —I have the honor to report that while discharging the duties of health officer during Dr. NedwilTs absence from Christchurch, my attention was directed to the existence of typhoid fever in Victoria street and Hereford street west, Christchurch. I first inspected a house in Hereford street west, in which a child was reported to bo suffering from typhoid fever. The house and surrounding premises were perfectly clean, and the closet supplied with a pan which I was informed was emptied regularly. I found that a covered drain conveyed the whole of the house slops to the side channel in Hereford street. The drain was in good condition, and kept flashed with water from an artesian well having an abundant overflow. I ascertained that the milk supplied to the family was obtained from a dairyman who lived several miles from Christchurch. I next inspected the house and premises in Victoria street where typhoid ftTsr was reported to exist. I found both tho dwelling and premises clean, and a total absence of refuse of any kind lying about the yard. The house slops and drainage from the yard wore conducted by an open drain to the side channel. The drain, which I was told was swept ont daily, was kept flushed by a running stream of water obtained from an artesian well having an artesian overflow. The closet was supplied with a pan which was emptied regularly. I learnt that the milk used by the household was procured from the same dairyman as supplied the family in Hereford street west, where typhoid fever existed. Finding ne insanitary conditions likely to generate typhoid fover surrounding either case, I at once suspected that the illness was in some way connected with the milk supply. From enquiries made I learnt that one of the children of the dairyman who supplied both families with milk, had either suffered, or was still suffering, from “ low fever.”

The following afternoon a large number _ of typhoid cases were reported from the Snnnyside Lunatic Asylum. On visiting the institution the same evening, I examined, at the request of the Resident Medical Superintendent, the whole of the typhoid fever patients, observed that the disease was of unusual severity, and found that Attendant Newman had died suddenly a few minutes before my arrival. Finding the cases so widely distributed, and that the fever not only existed in each of the buildings set apart for the insane, but had invaded the detached residences ot the attendants, and even of the Resident Medical Superintendent himself, my first inquiries wore directed to the milk supply. The name of the dairyman who furnished the whole of the milk used in the Asylum was given to me, when X found him to be the same person who supplied the families in Victoria street and Hereford street west, where typhoid fever prevailed. In view of Attendant Newman’s death, of the severity of the epidemic, of milk from the same dairy having been used by those suffering from typhoid at Snnnyside, as well as by those in Christchurch, of the disease being almost entirely confined to such persons as had been large consumers of milk, and of the fact that the afflicted at Sunnyside had exhibited symptoms of fever about the same time as the Victoria and Hereford street cases, I concluded that the milk supply, and that alone,was responsible for the outbreak of typhoid fever. I at once condemned the whole of the milk then in the institution, and requested the Resident Medical Superintendent to issue instructions forbidding the use of milk from the suspected source by either attendants or inmates of the Asylum until further inquiries were instituted. J. D. Fkankish, Acting Health Officer. July 9th. Letters from Dr. Townend and Dr. Ned will were read as follows : Colombo street, Christchurch, 11th July, 1881. To the Chairman Christchurch Local Board of Health. Sir, —In view of the efforts made by yonr Board to trace the causes from which many of the prevailing infections fevers arise, I venture to submit a few remarks. I am at the present attending a large number of cases of typhoid fever in the city and suburbs. I have carefully ascertained that a large proportion of those cases are in households where the milk used is supplied from the same dairy, from which is also obtained the milk consumed by the inmates of one of our most important institutions, where typhoid fever also exists. Should yonr Board wish for any particulars which I might be able to supply, I would gladly do so. J. H. Townend. July Xlth. The Chairman Board of Health. Sir, —I have the honor to report for yonr information on the outbreak of typhoid fever, which will form the subject of a special report from Dr. Frankish, who kindly discharged the duties of medical officer during my absence from Christchurch. In addition to 15 cases which have already occurred among Snnnyside Asylum patients. Asylum attendants, and their children, two other cases in Christchurch, in separate houses, hive been seen bv Dr. Frankish. I have to day found out the following fresh cases —Two in one house in Addington, one in an adjoining house, one case in St. Asaph street, west of Montreal street; another case in the same street, east of Montreal street, and one case in Tnam street west. In all, 23 cases have already been reported, and in every case the milk supply has been obtained from the same farm. Two deaths have already occurred from tho epidemic at Snnnyside. The diagnosis has been proved in one case by post mortem examination to have been correct, and nearly all the other cases are of a severe type. With two exceptions, all the cases of typhoid fever recently reported have been using the same milk. I might here remind tho Board that, as so many cases have occurred at a season of the year when typhoid fever is rare, the probability points strongly to a common origin for all. I have visited Snnnyside, and although the surrounding sanitary conditions are bad, I have no hesitation in advising the Board that tho cases at the Asylum, and the other oases in the district referred to, have been brought about by using infected milk. The milkman lives on the Lincoln road, outside the district nnder the control of tho Board ot Health, and probably for this reason two cases of typhoid fever in his family, one convalescent and the other improving, have not been reported. The milkman told me that no milk had been supplied for over a month from the house where he is now living, that the dairy farm, on which he keeps 28 cows, is situated half a mile away from bis homestead, and that the milk is collected and distributed by his sons and a servant who live separately at the dairy. He admitted, however, that his daughter was in the habit of going to tho dairy to wash out the milk pails. From this and other circumstances, it appeared to mo clear that constant communication was carried on between tho two places. One of his sous, moreover, had recently been unwell for a few days from what ho considered a cold. Tho homestead is surrounded by pools of filthy water. It has a pump on an artesian pipe, in which there is a hole admitting of leakage from the ground, which is saturated with filth, and tho out office is in a dilapidated condition, with excrement coming np into the seat and oozing through tho boards at the back. I was informed that no precautions whatever had been taken either to disinfect or bnry the excreta of the patients. Tho milkman, it is right to state, intended shortly to leave tho house, and thus explained tho state of affairs above described. Tho dairy itself it a good new building, with a convenient dwelling house, but the only water available is from Jackson’s creek. There is no closet accommodation, and tho bank of the river above tho place where tho water ia drawn is befouled with excrement, some of which must find its way into water already unfit for use. I shall have further to report on this outbreak, but in the meantime I would suggest for tho consideration of the Board the advisableness of not only making the milkman’s name known, but preventing the further supply to the public of the milk, until I can report satisfactorily on tho state of the premises. Within the last ten years in England over seventy epidemics of infections 1 disease have been caused by contaminated milk. Notwithstanding jiast failures, it is to he hoped 1 that this epidemic will be the means of arousing ' tho public to tho necessity of having dairies licensed and inspected. The present Health Act enables sanitary authorities to deal with in-

fected milk,but it gives no power to prevent the milk from becoming infected. Before the outbreak is over, many valuable lives may be sacrificed, and the dairyman probably ruined, whereas if compulsory enactments had boon in force nothing of the kind need have occurred. The sanitary condition of the Asylum is still very imperfect, although many improvements have recently been carried ont by the resident medical officer, Dr Hacon. The drains and the piggeries are in an unsatisfactory state, and their mode of disposing of slop and bath water is a very defective one; the Heathcote is polluted with sewage, and the large cesspit now boing put down in concrete is objectionable on account of having a discharge pipe which will on occasion empty its into the Lincoln road. lam strongly of opinion that until the Asylum can connect with the system of sewers in Christchurch earth closets should be used, and efforts made to dispose of fluid filth by utilising it on the land in the neighborhood, provided enough can be obtained for this purpose. Dr. Hacon has been using disinfectants in abundance, and has wisely decided on isolating all cases showing the slightest suspicious symptoms. Dr. Prankish, I might state, accompanied me on my visit to inspect the Asylum and dairy. (Signed) COURTNEY NEDWILL, Medical Officer.

July 11th. The Chairman also read a communication from the head department, in Wellington, to the following effect : Colonial Secretary’s Office, Wellington, June 22nd, 1831, Sir, —I have the honor to acknowledge the receipt of your letter of 6lh ultimo, addressed to the Premier, forwarding two resolutions passed by tho Christchurch District Local Board of Health, requesting provision to bo mads for control over dairies by local sanitary bodies, and for the reporting of infections diseases by medical attendants.

In reply, I am directed to inform you that the question has been referred to the Central Board of Health, by whom the Government are advised that sections 80 to 83 of the Public Health Act, 1876, on tho subject of unsound meat, also provide sufficient means for dealing with milk ; also that section 27 and following sections of tho same Act, if strictly carried ont, provide sufficient protection for the public in the matter of reporting infections diseases. Q. S. Cooper.

It was resolved—“ That the chairman be requested to instruct the inspector to direct the milk contractor in question to discontinue supplying milk to his customers for tho present ; also, to send to the Premier copies of the letters from Drs. Nedwill, Frankish, and Townend.” Other letters were dealt with and accounts passed. Tho Board then adjourned.