Report of the Board of Health on a second outbreak of plague at Sydney, 1902 / by J. Ashburton Thompson.

  • Thompson, J. Ashburton (John Ashburton), 1848-1915.
Date:
1903
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Licence: Public Domain Mark

Credit: Report of the Board of Health on a second outbreak of plague at Sydney, 1902 / by J. Ashburton Thompson. Source: Wellcome Collection.

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    Part I.—The Epidemic. 10. The last case of the epidemic of 1900 was notified on 9th August of that year. An interval of rather more than fifteen months ensued, during which careful watch was kept for commencement of the recurrence which was feared; but among the many cases which were reported for diagnosis during its continuance, there were but two which afforded good ground for prim a facie suspicion, and after investigation it was shown that both were due to streptococcic infection. The rats which infested the areas on which cases had arisen were also watched until it appeared probable that the epizootic of plague which had prevailed among them had died out. 11. That long interval was determined by attack of a man on 4tli November, 1901; his case was notified on 12th November. A free term of thirty-four days ensued, and then, on 8th December, a second man was attacked. After a further free term of about thirty-five days, a woman fell ill on 10th or lltli January, 1902. During these two intermissions several cases of illness were reported for diagnosis, but no case of plague, nor any in which there was real ground for doubt, was among them. The epidemic declared itself with the third case, and, as the last patient was attacked on 8th June, it maybe referred to conveniently as the epidemic of 1902. It consisted of 139 cases, of which 39 ended fatally, and is the subject of the present account. 12. On 6tli August, however, one further case occurred at Newcastle. It was “ indigenous ” to that city, but, thanks to the measures immediately taken it remained solitary, and the danger to which that important seaport had been exposed was averted. It is separately described below. Management of the Epidemic. 13. Management of the epidemic rested with the Board of Health. Mr. Edmund Eosbery, C.M.G., who had been appointed by the Board to act as President during my absence on leave, and the Principal Assistant Medical Officer of the Government and Micro-Biologist to the Board (Dr. Frank Tidswell, M.B., D.P.H.), who at the same time had taken up the duties of the chief executive post, occupied those positions at its beginning. I resumed control on 7tli March. 14. The method of management differed essentially from that actually followed in 1900 in three important respects. First, in 1900 we had pointed out, in the course of our report on the case of A.P. (Case 1), dated 7th February, that the Coast Hospital was the only suitable place to which plague cases could be sent for isolation and treatment, and had repeated this recommendation several times during the earlier part of the epidemic. Secondly, we had announced, on 2nd March (Case 5), that it was unnecessary to segregate contacts, and that for the future we should, as a rule, remove only the sick from dwellings. Thirdly, on 23rd March (Case 32), we had so far expressed our opinion as regards probable diffusion of infection by merchandise as to give instructions that the latter might be removed in the ordinary course of trade from the Adelaide Bond, which stood on that infected area which was the first to be quarantined for cleansing. But the head of the Government of the day declined these several advices; and, as a matter of fact, patients were strictly isolated in the buildings, utterly inadequate to this purpose, and accessible with difficulty, which alone the Maritime Quarantine Station at North Head afforded, all contacts were segregated at the same place, and cleansing areas were as strictly closed, or “ quarantined,” during cleansing as physical circumstances permitted. 15. In 1902 our advice was implicitly accepted ; and consequently, as regards the three points mentioned, we did as we had wished to do in 1900. First, the sick were sent to wards within the Infectious Diseases Division of the Coast Hospital, where they were dealt with almost exactly as though they had been suffering from measles or from some other of the commoner infectious fevers; the only difference was that visitors, though discouraged, were more freely admitted than would have been the case had the disease been measles in fact. No other special precaution was taken than that of rendering the wards rat-proof ; and the general economy of the hospital was disturbed only by the number of patients suffering from this one disease for whom