Epidemic!

Nearly 80 years ago, in late July 1936, people in Bournemouth and Poole began to feel ill. Their symptoms, a high temperature, stomach pain, headaches and diarrhoea, at first seemed to indicate food poisoning. It wasn’t until 20th August, when over 300 people had visited a doctor that typhoid was diagnosed and the Ministry of Health notified. The ministry sent Dr. W. Vernon Shaw, an epidemiologist, to investigate and advise on the situation.

About 300 years before, in the summer of 1645, some of the inhabitants of Poole began to fall sick with painful swellings in the armpit or groin and a blackening under the skin, followed in many cases by rapid death. The symptoms were quickly recognised as the dreaded signs of the plague, then endemic in the population. Many neighbouring towns had suffered outbreaks in recent decades but Poole had previously been spared. In spite of many obvious differences between the two epidemics, there are also some parallels in what followed.

CowIn 1936, a meeting was held in Poole between Dr. Shaw from the Ministry, Dr. Maule Horne, Medical Officer of Health for Poole and Bournemouth’s Deputy Medical Officer of Health, Dr. Pedley to decide what should be done. Also present at the meeting was Mr. William B. Long, the owner of Frowd’s Dairy of Sandbanks Road, Parkstone, since the common factor between the sufferers appeared to be that they had been supplied with Frowd’s milk. The dairy received milk from 37 local farms, mixed it together and distributed it across the whole conurbation. Although Frowd’s had won awards for hygiene, it did not pasteurise its milk, the process not being a legal requirement at the time. Dr. Shaw arranged for the milk to be pasteurised with effect from the next delivery to prevent any new cases and then embarked on a hunt to find the source of the infection.

OLYMPUS DIGITAL CAMERAIt was the height of the holiday season and the area was full of visitors, some of whom fell sick locally or after returning home. Some locals who had gone away on holiday developed symptoms in another part of the country, all of which caused complications for diagnosis and treatment. Mindful of the area’s reputation as a healthy resort, the local press at first tended to down-play the outbreak but by 3rd September, the Poole and Parkstone Standard was reporting 123 patients on the danger list. Under the headline ‘Typhoid May Cost Poole £3,000’, the paper described a ‘momentous meeting’ of the Borough Council to discuss the situation.

At the meeting, the Medical Officer of Health reported the arrival of Dr. Shaw and the steps that had been taken to prevent further infection and to trace the source of the outbreak. In the heated debate that followed, Councillor E. Osman Brown called for more investigation and wondered whether sea water could be the source while Sir James Marchant described his remarks as ‘dangerous, mischievous and ignorant’, amid cries of ‘Withdraw!’ Finally, the meeting accepted the assurance of the Medical Officer of Health that there was no need to worry about sea bathing, sewerage, the water supply or the milk supply and the Council gave the go-ahead to provide funds for the additional staff and extra accommodation needed. However some members of the public felt angry and bitter at what they saw as the authorities ‘hush hush’ policy and how it might have hampered diagnosis and treatment at the start of the epidemic.

Alderney Hospital today

Alderney Hospital today

Because typhoid is highly contagious, isolation was vital and the Borough took steps to have every sufferer possible admitted to hospital. Here they were only allowed to see their friends and relations through the windows. The hospital at Alderney was an inadequate structure, added to in a hurry over the years as emergencies arose. Plans in 1932 to spend £7,000 improving the hospital had been shelved indefinitely. At the start of the 1936 outbreak it had only around 40 beds, not nearly enough to cope with the numbers of patients. A disused ward was hastily refurbished, equipped and brought into service and men from the Borough Engineer’s department were put to work installing electric light, building an operating theatre and putting up temporary wards. One of the patients later recalled being treated in ‘a building which had just been thrown up – you could see through the wooden slats. The wood was new and some of it was still green’. Similar arrangements to increase hospital accommodation were made in Bournemouth and Christchurch.

In the rather primitive surroundings, the desperately ill patients were nursed by Matron Doyle and her staff including 51 temporarily recruited nurses, some working 17 hours a day. In the worst cases of the disease, complications could lead to internal bleeding, perforation of the intestine or bowel and peritonitis which could be fatal. By 14th September, 188 cases had been notified in Poole and there had been 11 deaths, but most patients were making progress. A series of diets were devised by Miss Doyle, ranging from a totally liquid regime to light meat and vegetables. However it was a slow process and the most seriously affected sufferers would take months to recover their strength.

Three centuries before, in 1645, the country was in the grip of the Civil War. Poole was a garrison town for Parliamentary soldiers and the small town was unusually full of people living in crowded and unhygienic conditions. Movements of troops, prisoners of war and others across the country aided the spread of disease and it is also likely that the people’s resistance to infection was reduced by food shortages over the previous couple of years.

WindmillThe town authorities under mayors George Skutt and from September, Aron Durell, quickly decided that isolation of the sick was necessary. At first they used the town windmill at Baiter, which was then a long shingle spit extending into the harbour. When this proved inadequate, four pest houses were rapidly built at a cost of £22.13s 8d [£22.66p] probably also on the Baiter peninsular. These were followed by more houses, maybe another six, costing £30 6s 4d [£30.33p]. The records suggest that they were built of wood and laths, perhaps plastered. Straw was supplied for bedding and as the weather grew colder, loads of turfs (the usual fuel at the time) were sent out for heating.

To tend the sick, the Corporation employed Doctor John Spence at a salary of 30s [£1.50p] a week. One of his methods was fumigation by burning pitch and tar, and on one occasion frankincense, in the houses. He also used drugs and ‘potts and pilles’ which were sent specially from Salisbury, but what they contained we do not know. Vinegar in large quantities was supplied to the houses, probably for washing the patients, a recognised 17th century treatment. A special diet for the sick is suggested by some items in the accounts eg. ‘ 2 rosts of mutton, bread, fruit & spice to make broth for the pest-houses’. It is likely that these treatments were of little use and mortality was high. Those who died were rapidly buried, some in graves near the pest houses.

30Not surprisingly, the people of the town felt trapped and terrified. According to a letter from Sir Anthony Ashley-Cooper to the Speaker of the House of Commons, ‘plague and famine busily contend for pre-eminence, and the distressed inhabitants, impatient of either of their reign, threaten to break out to the inevitable danger of the garrison and ruin of the places adjacent’. Watches were set at the pest-houses and elsewhere to make sure the people did not ‘break out’. Meanwhile, the authorities were trying to keep the town going by begging neighbouring communities for help. Over the autumn, as the plague deaths mounted, gifts began to arrive, cheeses, butter and wheat from the Isle of Wight and Blandford, 3 bullocks and 5 bushels of peas from Wimborne, corn, meal and cheeses from Christchurch and money from Southampton, Bridport and Dorchester, all put to immediate use to keep the town from starvation.

In 1645, the people of Poole probably saw the plague as a visitation from God. It would be hard not to think in apocalyptic terms, as they struggled with war, famine, pestilence and death. Three centuries later, Dr. Shaw’s painstaking investigation into the source of the typhoid outbreak involved knowledge, science and logic. Early tests having ruled out the workers and plant at Frowd’s, he turned his attention to the farms that supplied the dairy. At one small-holding providing milk for Frowd’s, the farmer’s wife had fallen ill with typhoid on 10th August. She could have been responsible for much of the infected milk but not for the earliest cases of the disease. There had to be another source.

Merley House

Merley House

The death of a 19-year-old girl in a neighbouring house from enteric fever two years before might be significant. Dr. Shaw decided to carry out tests on water from a small stream which ran past the farms. The results were negative for the typhoid bacillus but the presence of bacteria from the human gut suggested some contamination. Up stream he found a pipe discharging effluent into the water and carried out more tests on the outflow. Four times the results were negative but in mid October, the bacillus was present. It turned out that the pipe was connected to a small tank taking sewage and storm water from Merley House. Whenever the tank was full, effluent was discharged into the stream. It seemed that one of the occupants of the house might be typhoid carrier without being aware of it.

Among the 16 current inhabitants of the house, Dr. Shaw discovered the carrier of the disease. It was the owner of Merley House, Captain Angus V. Hambro, formerly M.P. for South Dorset and High Sheriff of the county. As a young man he had travelled widely and had once suffered a serious bout of fever which was probably typhoid. The information on the source of the outbreak was not released to the public at the time. A sewage disposal plant was built for the house to prevent any contamination of the stream in the future.

Across the conurbation there were about 718 cases, with 51 deaths locally and about 20 in other parts of the country. In Poole, 192 patients were admitted to hospital of whom 12 died. Among the 12 cases nursed at home, there were 3 deaths. Many victims suffered a prolonged illness which left them with impaired health for months or years. The cost of handling the epidemic in Poole was about £11,000, which had to be covered by loans, not counting the £1,000 a week estimated to be lost by hoteliers in reduced bookings. Mr W. B. Long’s dairy went out of business without compensation although he was able to resume dairy farming elsewhere in due course. The conurbation of Bournemouth, Poole and Christchurch became the first area in the country to introduce pasteurisation of all milk.

OLYMPUS DIGITAL CAMERA

Back in the 17th century, the month of November proved to be the climax of the outbreak. After that, the number of cases mercifully declined. By concerted efforts, the town had just survived its terrible ordeal although there were still the sick to nurse and people were still suffering extreme hardship. A rare and welcome moment of rejoicing came with the fall of Corfe Castle to the Parliamentarians in February 1646, celebrated by the guard with the treat of 4lbs of precious prunes from the stores.

By May, the remaining sick had left the pest houses to convalesce elsewhere. It is impossible know exactly how many people died but the number has been estimated at 118, around 8% of the normal population. The cost of coping with the epidemic was over £540, more than 10 times the usual annual expenditure, which was covered by charitable donations and funds from Parliament. The following year, the pest houses were sold to Thomas Pelly for the sum of £14 but given their grim associations, it is hard to imagine that anyone would have wanted to live there.

Jenny

Main Sources: The Typhoid Epidemic in Bournemouth, Poole and Christchurch 1936 by Mary Graham / The Poole and Parkstone Standard Sept 3rd & Sept 24th 1936 / Town Accounts 1645/6

 

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