Nothing to be Alarmed About

Contents

List of Tables

Dedication

Acknowledgements

Chapter 1: Introduction

Poliomyelitis: the origin of the word, its definition, and its impact on the victim.

This project

The sources of information and evidence. Why it was undertaken.

Chapter 2: One day in July 1938

One vivid case

The British Newspaper Archive

What the BNA archives. How news is gathered and published.

Short lives

Examples from my own family.

The Ministry of Health

A question in Parliament. The release of news through the Press Association.

Chapter 3: Notification

The history of infectious diseases and notifications.

The NOIDs database

The compilation of routine national statistics. Changes in diagnostic practices.

Historic phases

Three distinct phases in the twentieth century.

Chapter 4: Epidemiology

My interest in statistics.

Bradford Hill

The first analysis of inter-war outbreaks in Britain.

Analyses

How Bradford Hill analysed the data. What he concluded.

Chapter 5: The British Medical Journal

A regular section in the journal headed ‘Epidemiological Notes’.

The course of the outbreak

Week by week reports.

The end-of-year review

Graphs and maps. The idea of outbreaks having a focus.

Causality

How infection was spread.

Chapter 6: Annual reports

Introduction to the annual reports of local Medical Officers of Health (MOHs).

The Wellcome Collection

Searching the Collection’s archive for MOH reports.

The contents

How reports were organized.

Population and cases

How statistics were extracted and prevalence rates calculated. The identification of seven key centres. How rates varied across the country.

Chapter 7: Essex

The MOHs in the key county.

The 1926 outbreak

An earlier significant outbreak.

The 1938 outbreak

The part of Essex most affected.

The origin of the outbreak

Where it started.

The subsequent course of events

How it spread.

Dr. Bullough’s report

How the MOH for Essex reported on the outbreak.

Dr. Hatton’s report

Likewise, the MOH for Braintree, faced with the highest prevalence rate.

Colchester and Harwich

How the outbreak spread eastwards.

Adjacent areas

Impact on the south of Essex and adjacent parts of Suffolk.

Looking back

How the outbreak in Essex was, and might have been, seen in retrospect.

Chapter 8: Breaking news

The grapevine.

The awful horror

One published account of hearing the news on the grapevine.

When newspapers break the news

How newspapers construct news stories. One first-hand account of the impact on one family. A search of the Mass-Observation Archive. The first published reports of the outbreaks in 1938.

The seven centres

How the seven key centres were identified and became the national story.

What the MOHs said

Views expressed by three of the seven MOHs in interviews with journalists.

Chapter 9: Outbreaks elsewhere

Other counties with high prevalence rates.

South Wales

The distinctive approach of Thomas Evans, the MOH for Swansea. Evidence of the spread to neighbouring areas.

Lincolnshire

The impact of outbreaks in a sparsely populated rural county.

Oxford

A well-documented outbreak centred on a city.

The end of the epidemic

Cases in January 1939. The launch of the Infantile Paralysis Fellowship.

Chapter 10: The iron lung

A vivid description of how one victim of the disease was treated in an iron lung. Its invention, and how it became a global news story.

Eric Marchant

The first victim to be treated with an iron lung in Britain, in October 1937.

Treloar’s Hospital

An innovative hospital for the treatment of children with polio. Iron lungs and fresh air.

Arrangements with local authorities

How local authorities were able to send victims to Treloar’s.

Lord Nuffield

The philanthropist who funded the mass production of iron lungs.

Chapter 11: School closures

The impact of the disease on schools.

Boarding schools

The dilemma over what to do when pupils fall ill.

Felsted School

One notable example in Essex in 1938. Relations between school and village.

Wellington College

Another notable example, in Berkshire, late in the year.

School Medical Officers

Their concerns as expressed in reports archived in the Wellcome Collection.

Chapter 12: Isolation

How victims of infectious disease were isolated to reduce the risk to others.

Hill House Hospital

Yellow fever in Swansea.  The opening of an isolation hospital.

Isolation hospitals

Guidelines on how hospitals can minimize the risk of infection.  A biographical account of being a child isolated in hospital.

Migration and evacuation

The significance of ‘home’. The movement of patients, carriers and those at risk. Preparations for war.  

Crossing boundaries

Victims who crossed local authority boundaries prior to falling ill or in seeking hospital treatment. The isolation of affected communities.

Chapter 13: The press

The importance of newspapers in reporting outbreaks.

 The Essex Chronicle

A weekly newspaper. News of individual victims. The involvement of MOHs.

The South Wales Evening Post

The collaboration between local newspaper and MOH. Precautions and preventive medicine.

The Worthing Herald

The impact of outbreaks on local businesses. Conflict between national and local newspapers. 

Privacy and publicity

How to report a spreading outbreak while not generating alarm.

Chapter 14: So what?

Some basic facts about the 1938 epidemic.

The collation of sources

The value of different accounts in understanding how infectious disease spreads.

Concluding thoughts

So how infectious was poliomyelitis? Was there an epidemic in Britain in 1938, albeit a small one? Why was it an exceptional year?

Postscript

Testimony from another affected family.

Index