Dr. R. Bruce Low's report to the local government board on an outbreak of enteric fever at Helmsley, in the Helmsley rural district, North Riding of Yorkshire.

Low, Robert Bruce, 1846-1922.

Date:: 1896

Credit: Dr. R. Bruce Low's report to the local government board on an outbreak of enteric fever at Helmsley, in the Helmsley rural district, North Riding of Yorkshire. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

5/22 (page 3)

$unprovided with fireplaces. Some houses are in had repair and dilapidated. Usually each house is provided with garden space, but in a few instances, as in Smith’s and Simpson’s yards, there is none. Sometimes cows and pigs are kept too close to human habitations. Some houses have no means of access at the back, and the midden contents have, in process of their removal, to be carried through the dwellings to the street. Enteric Fever. There has been no outbreak of this fever in Helmslev for some years; only sporadic cases generally traced to importation. The disease was not recognised in the town during 1893 or 1894, though it has to be mentioned that two cases notified as “ continued fever ” occurred in two children in a house in Pottergate, in November 1893. No definite information could be obtained as to the.origin of these two cases. The present outbreak appears to have first shown itself about the middle of August (1895) ; and from that time till the end of September, no fewer than 43 persons were attacked, and of these eight died. During September a number of cases of the same disease were notified as occurring at Newton and Stonegra^e in the Oswaldkirk Division of the Helmsley Dural District; several cases were also reported at Nunnington, in the Kirkbymoorside Dural District, and one case in September from Dutter- wick, another riverside village, 4 miles below Nunnington, in the Malton D-ural District. These places are situated along the valley of the Diver Dye below Helmsley. The cases in these riverside localities numbered 17, not including some six cases of unnotified illness of an enteric character occurring in members of invaded households, or among fellow workers in the harvest fields. Of the riverside cases, only one proved fatal. In Table II., I give the total number of cases of enteric fever which occurred in the two outbreaks ; together with information as to population, &c., of the places invaded. Table II., Giving the Number of Cases of Enteric Fever occurring in each of certain Localities during the Four Months, July, August, September, and October 1895. ( Sanitary District. Place invaded by Enteric Eever. Population (1891). July. Aug. Sept. Oct. Total. Helmslev Rural District Helmsley town - 1,350 — 34 9 — 43 Helmsley Rural District Stonegrave and New- ton. 175 — — 5* — o Kirkbymoorside Rural District. Nunnington - 354 — — 10 11 Malton Rural District - Butterwick 69 — — 1 1 — — 34 25 1 60 In what follows I propose to deal with the two outbreaks separately, giving the facts as to the Helmsley town cases first, and then briefly relating the circumstances connected with the outlying cases in Dyedale. I.—Enteric Fever at Helmsley. The first intimation that Dr. Porter, the Medical Officer of Health, had of the presence of enteric fever in the town was the occurrence of two cases in his own private practice. These cases were recognised as true enteric fever on August 15th. About the same time he received notice from Dr. Muil, of Kirkbymoorside, that a young servant girl had come home ill from Helmsley to Nawton, suffering from enteric fever. On August 19th Dr. Deid * There were six other cases of illness during September, characterised bj headache, feverishness, and diarrhoea, followed by debility and anmmia, in persons who were members of invaded households or otherwise associated with notified cases of enteric fever. f A secondary case in a house already invaded. e 89620. 675.—2/96. Wt. 16868. \ O$