Scarlet Fever

In August 1870 Rev. Peter Thomas Ouvry wrote to the papers regarding the impact of scarlet fever on Wing. It was recorded thusly:

The Rev P.T. Ouvry, vicar of Wing, Buckinghamshire, invites notice to the destruction of life in peace. He is the incumbent of a parish where scarlet fever is now prevalent and very fatal. Straw-plaiting, in so-called “plaiting schools”, forms the chief occupation of the children. The medical officer on Saturday morning found a child suffering from scarlet fever lying in the corner of a room full of children engaged in straw-plaiting. Already 20 children, out of a population of 1500, have died, and several others are not likely to recover. The rev. gentleman adds :- “The law punishes people having infectious diseases for exposing themselves in streets and public places; should it not also punish parents who send their children into infected houses, and houseowners who receive children when an infectious diseases is in the house?

John Bull newspaper, 27 Aug 1870

The outbreak had begun in May, and if the statistic of 20 children dying by mid-August is correct this suggests that the majority of child deaths in May, June and August (there were none in July) must have been attributable to scarlet fever. There is a newspaper report on the death of Alice Thorp (who died in childbirth on 21 June) which mentions that one of the doctors called to attend her had been in Wing to visit scarlet fever patients. A detailed report on the epidemic in Wing was published in the Leighton Buzzard Observer on the 6th and 13th of December 1870 and appears in full below as it is very informative, not only on the outbreak itself but also on the living conditions of the Wing villagers at this time:

The following is a portion of the report of Dr Buchanan, one of the officers of the Medical Department of the Privy Council, on the late scarlatina epidemic at Wing and in its neighbourhood.

“In the Leighton Buzzard union scarlatina has, this year, been seriously epidemic in the parish of Wing, and it has also prevailed, though hitherto less severely, in the parishes of Mentmore, Cheddington, and Pitstone.

“In Wing parish there were 306 inhabited houses at the census of 1861; of these, 159 inhabited by the pauper class in receipt of Poor Law medical relief have been recently examined by Mr Harris, the medical officer, and Mr Brown, the sanitary inspector of the Union; 89 of those houses are found to have had cases of scarlatina; in all 172 patients. A small number of cases in private medical practice have to be added to these, and among the whole (200 cases or thereabouts) there have been 25 or 26 deaths. The population of Wing parish was 1,504 in 1861, and is now probably about the same. Of the population, about 1,100 live in the village, and the rest in outlying hamlets. Scarlatina has affected the village and the hamlets with equal severity.

“The origin of the fever is not clear. It began as an epidemic in May last, but scattered cases had previously occurred. It is uncertain whether it was imported from London, or from Wingrave (in the Aylesbury union, adjacent) where it is known to have existed last winter. At all events, it found in Wing conditions favourable to its increase, and it has lately spread thence to other parishes.

“Mentmore, a parish of 399 inhabitants, consists of Mentmore village, and the hamlet of Ledburn. Since the middle of October, there have been in the village four undoubted cases of scarlatina, and about twice as many doubtful ones. Ledburn has had a large portion of its children attacked, with two, if not three, deaths. Also, in October, the disease appeared in the parishes of Cheddington (628 inhabitants) and Pitstone (in the Berkhamstead union, population 18661, 457), and has already attached 13 or 14 people in the former, and 10 or 12 in the latter village : two children in Cheddington having died of it.

“At present the fever appears to be ceasing at Wing, perhaps because there are few susceptible people remaining to be attacked. It does not seem on the increase in Mentmore. In Cheddington and Pitstone the disease is extending.

“Not only has the proportion of attacks to population been large, but the mortality among those attacked has been high – about 15 per cent. In about half the fatal cases death has occurred at an early period, generally with serious throat symptoms. In the other half, however, the usual stages of the disease have been passed through, and the patients have died at a late period from kidney mischief. But for the deaths from this sequela, the epidemic would not have been particularly fatal.

“As usual with scarlatina, the fever appears to have spread through these villages by contagion from person to person.

“In 1863, on the occasion of a serious outbreak of enteric fever in Wing, the village was visited for the Privy Council by Dr Ord, who reported the following conditions as favouring disease there –

“1. The small size of the cottages, whereby the sleeping-room of families is very limited, and the living-place is overcrowded.

“2. Defective ventilation, and dirty condition of the interior of cottages.

“3. Impurity of the wells from which drinking-water is obtained, evident in some cases, probable in others.

“4. Nuisances dependent on inattention to the proper cleansing of privies, of back yards, of slop-channels, and of drains ; and on the deliberate accumulation of heaps of refuse in the neighbourhood of houses for the purpose of procuring manure.”

“Since 1863 some new drains have been made, especially one near the churchyard, to intercept the soil-water, which used to stand in the graves and thence ooze into the wells. Sanitary inspection has also been provided, with the effect of lessening, although not by any means of removing, the last class of the above-mentioned nuisances. In other respects, Dr Ord’s description applies perfectly well to the present state of the village.

“The privies of Wing are bad specimens of the ordinary bad type of cesspool privy. The cesspools are emptied every two months, when manure is wanted or when the inspector finds them full. Many of them have openings inside the privy structure, and into such cesspools much liquid is received. The opening is frequently wholly uncovered, or covered only by moveable planks, so that facility is given, not only for stinks getting out, but for people tumbling in. The filth-heaps, on which the solid and liquid refuse of the cottages accumulate, are still nuisances, but probably less so than formerly. The water-supply from some private wells has apparently been improved in quality by soil drainage ; but most, if not all, of the wells are open to suspicion, for they are sunk into clay through a few feet of porous ground into which various impurities are soaking, and from which the water is derived. And, if the quality of the village water is doubtful, its quantity is, out of all doubt, quite inadequate for the wants of the people. The wells soon get dry ; and I heard of a recent instance where it was desired to wash six infected blankets and two gallons of water were with difficulty procured for the purpose. The only public well of the village was made in 1863, in commemoration of the marriage of the Prince of Wales. Its water is from the same surface gravel as that of other wells, and in quantity it is very deficient. It is to be hoped that occasion may soon be found for giving another and better supply. The hamlets are as badly off as the village in the item of water. At Littleworth I saw a roadside well into which a drain was believed to leak, and which gives water that has actually stunk.

“The interior arrangements of cottages have had a most important bearing on the diffusion of scarlatina. Many of the cottages are dirty, some being so much out of repair that is impossible for them to be kept clean. Some are built back-to-back, and can scarcely be properly ventilated. In others the bedroom has far too small a window, with an insufficient opening in it – less than two square feet in some cases – and no fireplace or means of ventilation besides the window. But the nuisance most influential in the spread of scarlatina has been the over-crowded state of the cottages ; over-crowding is seldom from sub-letting, but commonly comes of large families living in rooms too small for them. The following are examples :-

A family, named FOUNTAIN, lives in a cottage with two bed-rooms, each of some 720 cubic feet. Nine persons sleep in four beds in these two rooms, getting only 160 cubic feet each.

Thomas PEASE’s cottage has only one bed-room, with three beds, in which eight persons of three generations, and both sexes, slept ; each person getting about 160 cubic feet. Three cases of scarlet fever had occurred here.

In BOLTON’s cottage, a single bed-room serves for seven people, three of whom have had scarlatina. The dimensions of this room gives about 150 cubic feet to each inmate.

In GUESS’s cottage, the bedroom is a large space under the thatch, very dirty, but with two small windows in its ends, and therefore fairly ventilated ; the room is large, but only 5 feet 9 inches high, and gives 168 cubic feet to each of seven inmates. There have been two cases of scarlatina in this house.

The DENCHFIELD family lives in a house of a group specially noted by Dr Ord as “very small and cramped” and which suffered intensely from enteric fever at the time of his visit. The Denchfields are not paupers. Their bed-room measures 1,800 cubic fee, but has less than two square feet of window opening. In this room there are four large beds, and one small one, and in these the family of nine (including grown-up sons and daughters) sleep. One of the young women suffers from monstrous favus. There has been no recent scarlatina here; but in respect of this and other families I did not learn how far those who escaped were protected by having previously been attached.

In Littleworth hamlet, PRIOR’s family, of eleven persons, sleep in three beds in a room 12 feet square and 7 ½ feet high, giving about 100 feet to each person ;  here there have been two cases of the fever.

BAKER’s house, adjoining the preceding, is about to be the subject of proceedings by the Board of Guardians, as not being fit for habitation. The bed-room is a lean-to, averaging 5 feet high, and having some 420 feet for the three persons who lived there. One has lately died of a malignant form of scarlatina.”  [William Baker, aged 7, was buried 24 Aug 1870]

“Overcrowding in this village has been repeatedly reported to the guardians by their sanitary inspector, but they have taken hardly any action in the matter, being daunted by the difficulty that poor people would have in getting any other than the existing house accommodation. There are now no cottages to let in the parish, and an empty one becomes an object of competition among proposing tenants. The inspector’s instructions in dealing with overcrowding appear to have had reference only to houses occupied by more than one family. In one or two flagrant cases proceedings have lately been taken to close houses that were unfit for habitation, and, in one instance of this kind, it has been managed to get two back-to-back cottages thrown into one, with adequate accommodation for one family in the rooms that had before been crowded by two.

“Such overcrowding as is here described is of course extremely potent in spreading contagious disease. A person sick of scarlatina, lying in the same room and bed with other persons, is almost certain to communicate his disease to those others who are susceptible of its contagion, especially when the common breathing space is at a rate of 100 or 200 cubic feet per person, and when no ventilation worth the name exists. But, in addition to these circumstances, special facility is given in Wing for the distribution of contagion from family to family. This is by the so-called ‘Plaiting Schools’ where numbers of children employed in making straw plait assemble, under the management of a mistress, who keeps them to their work, and sees that they get through a certain quantity of it. Twenty-two of these children were assembled at the time of my visit in one of these schools – Mrs TAYLOR’s- and this was considerably below their usual number. The room measured sixteen by twelve by seven feet giving about sixty cubic feet to each child, a quantity reduced, when the school is full, to forty feet or less. The chimney draught was the only means of ventilation, and the panes of the carefully closed windows were covered with dew with the heated bodies of the little workers. One of these children sickening with, or convalescent from, a scarlatina attack, cannot fail, under such conditions as these, to distribute the poison right and left through the village.

“Evidently these ‘Plaiting Schools’ are to all intents workshops and ought to be under the Act regulating such establishments. It would then be the duty of the local authority to enter such ‘schools’ and to examine touching any matter within the provisions of the ‘Workshops’ Regulation Act’ or of the ‘Sanitary Act 1866’ and to deal systematically with overcrowding, bad ventilation, and exposure of affected children. But it is stated that these so-called ‘schools’ are not precisely comprehended in the statutory definition of ‘workshops’ and they are accordingly left without any sustained inspection or control.

“The foregoing account has reference only to the parish of Wing, which alone I visited. But I learn that, with little variation, the same story would have to be told of other villages in which scarlatina has recently been epidemic. In Mentmore village, however, where nearly every cottage is owned by Baron Meyer de Rothschild, the house accommodation is good, the cottages clean, and there is no notable overcrowding.

“The sanitary inspection ordered by the Board of Guardians as nuisance authority, and the action that has been taken thereon, have been several times mentioned. The Sanitary Inspector has not instructions to make from time to time (“Sanitary Act, 1866,” sec 20), inspection of all places where nuisances may be found, but he inspects according to his judgement, and chiefly when complaint of nuisance reaches him. The Vestries, as sewer authorities since 1865, have no officer, and have performed no sanitary function.

“The action of authorities, in view of the present epidemic, has been very inadequate to the situation. Hardly any attempt has been made to limit the spread of contagion. The parochial fever hospital, or “pest-house” as it is called, is at Leighton Buzzard, three miles off Wing. Fever is here treated in separate wards, one for males and one for females, and a good many patients have been received. Neither the situation of the hospital, nor the extent of its accommodation ; neither its name, nor the amount of its comforts, indicate it as a proper or sufficient place to meet the requirements of the epidemic. And there is no place in any of the villages to which an early case of fever could be removed, and where it could be treated in isolation. No care has been taken to prevent contagion, by abridging the liberty of infected persons, in the sense of sections 26 and 38 of the “Sanitary Act, 1866” nor by providing disinfection under sections 22 and 23, nor by hastening interments under section 27 of the same Act. I believe some chemical disinfectants have been supplied by the Guardians.

“A beginning of some such work has lately been made in the parish of Wing through the private action of Baroness de ROTHSCHILD, aided by the Vicar and the Union Surgeon. Disinfectants have been given, and, as an inducement to people to obey the doctor’s instructions about cleanliness, Baroness de Rothschild has distributed 288 blankets, besides sheets and other articles of bedding, to those who have taken pains to wash their rooms and their infected bedding and clothes. And in Mentmore the village-school has been closed, and Mr Wagstaff, acting as medical adviser of Baron de Rothschild, is taking efficient measures for disinfection.

“The guardians have no medical officer for sanitary purposes, but Mr Harris, the Poor Law Surgeon, has undertaken, for the time, some of the functions of a Health Officer ; especially he has made careful investigation of the conditions under which poor people are lodged at Wing, and he has given advice about cleansing and disinfection.

“The sanitary measures required in Wing and the neighbouring parishes are : firstly, such as will most promptly deal with the existing epidemic ; and secondly, such as will put the villages in the best state of defence against the recurrence of the various fevers which have been epidemic in them. Immediate action should consist in :-

“1. The compulsory removal of the fever patients from places where they are ‘without proper lodging or accommodation’; for instance, where the only accommodation is the same bed or the same crowded room with other persons susceptible of the contagion. This removal can, at this moment, only be to the Union infirmary, which is only available for the class of people which come on the rates for medical relief. But it would be a great gain that the Vestry of each parish – of those parishes especially where the fever is only now beginning to be epidemic – should provide some temporary hospital accommodation under the powers of Section 37 of the Sanitary Act, 1866.

“2. Very thorough cleaning and disinfection of all houses where fever has occurred, and of infected articles therein, should immediately be done. I have pointed out to the Clerk of the Board of Guardians the power given to the Board by the latter part of  Section 22 of the Sanitary Act to cleanse and disinfect such houses and articles at the Board’s own expense ; and, in view of the occasion for instant action, I have urged him to act at once on behalf of the Board without waiting for a meeting. Mr Harris, the medical officer of the Union, has kindly promised to direct the details of disinfection.

“3. Careful admonition to the villagers to keep their convalescents at home, both for the patient’s own sake, and for the public good, for a month after attack, and until after needful disinfection. Herewith should be conjoined a general suspension of the plaiting and other schools ; or, if this course cannot be followed, at least very exact and repeated enquiry about every child attending them, so as to exclude any who present themselves coming from infected houses (Sanitary Act, 1866, Section 38).

“4. The bodies of all persons dying of fever should be removed and buried within twenty-four hours ; and as the right to enforce such removal only arises when the nuisance authority has provided a place for the reception of dead bodies, some place should at once be set apart for that purpose.

“The other sanitary measures that are required in Wing, and villages similarly circumstanced, may be postponed until the foregoing have been carried into effect, but they are not less urgently necessary for the prevention of disease. These are :-

“5. A much better supply of water, and of good water, to the villages.

“6. Proper means of excrement removal in substitution for the very dangerous cesspool arrangements now existing. The earth system, which can be seen in perfect working order at the neighbouring village of Halton, would appear to offer the best means for dealing with excrement in these parishes.

“7. Arrangements for the due scavenging of the villages, so as to procure the removal, at least once a week, of all house-refuse. And means must be taken to insure the disposal of liquid slop in a way that wells may not be contaminated by it.

“8. Action in the matter of overcrowding. In 1863, Dr. Ord pointed out to the authorities the mischief to health that was resulting from this state. Since [then] they have repeatedly been informed of the same thing by their own Inspector. In 1866, the Sanitary Act gave new papers [sic] of dealing with the particular form of overcrowding that is prevalent ; and yet nothing has been done. The Guardians have no right to plead the difficulty of acting in tis matter, as they have hardly yet given any serious consideration to the matter ; and especially, as in one instance, in the course of other proceedings, a very practical solution of such difficulty was indicated by two cottages being thrown into one.

“9. The ventilation and cleanliness of cottages, and of every room in them, must be secured ; and where cottages can be properly ventilated, or are so out of repair that they cannot be kept clean, they should be shut up as unfit for human habitation.

“In taking efficient action in the several directions here advised, the nuisance and sewer authorities of the villages will doubtless find obstacles and difficulties. But the difficulties must be met and overcome if the villages – Wing especially – are to be rescued from frequent epidemics, that are not only ruinous to the places themselves, but also spread away to other parishes. There will be very great advantage in employing the Medical Officer of the Guardians to make periodical inquiry and report upon the sanitary state of the parishes, in the manner provided by 23 and 24 Vict., cap. 77, sec. 14.

“In some places the local authorities will have the advantage of the land being owned by those who have the means and inclination to make thorough improvement, if the direction of their action is indicated. To build new and larger cottages in replacement of old ones is one such improvement. Some have been built of late years, and others will probably soon be built by Baron de Rothschild. Every such cottage gives peculiar opportunity to the nuisance authority to enforce the laws that apply to uninhabitable and overcrowded houses. But even if all cottages were reconstructed, vigilance against overcrowding would not be less needed, in order to prevent subletting and ignorant huddling together of everybody into one room.

“It would be a great convenience to the inhabitants of Wing if a public wash-house were provided there ; this could be done upon the Public Baths and Washhouses Acts being adopted by the vestry. See the Act 9 and 10 Vict., cap. 74, sec. 5.

GEORGE BUCHANAN November 14, 1870.

Leighton Buzzard Observer, 6th and 13th December 1870

There were also outbreaks of scarlet fever from around May 1894 (when the school was closed) through to 1895, and again in 1928 when the library was reported as being closed to prevent the spread. Generally multiple family members would be affected, and those who fell sick were often ordered to be taken to the Sanitary Hospital at the Leighton Buzzard workhouse (the hospital’s location unfortunately meant that people were reluctant to go to the hospital, whether under formal order or not) as homes did not have sufficient space to satisfactorily quarantine the patients. In September 1894 there was at least two who died from subsequent kidney disease. Henry RANDALL was charged with failing to comply with an order under the Infectious Disease (Notification) Act to remove his sick son Charles to the hospital, and the family also suffered the death of another son four-year-old Henry to the disease. In October 1894 it was reported that around £25 in costs had been incurred in relation to the Wing outbreak, however the Rothschild and Cotes families made donations to cover these costs. While some community activities were curtailed to stem the contagion, others continued – one issue of the Leighton Buzzard Observer mentions both a smoking concert that was held, and an update on new infections! The Wing scarlet fever outbreak actually managed to fill the Sanitary Hospital to the extent that temporary hospitals had to be set up in other locations to handle certain other disease outbreaks in other villages in the catchment area.

There are other stray mentions of scarlet fever, such as 4-year-old George GARDENER of Littleworth who was visited by the Leighton Buzzard district medical officer several times in May 1878.