Communicable Disease Control

Control of communicable disease is a function of the local authority. It is interesting to trace how this came about following the events of the Industrial Revolution. Towards the end of the eighteenth century and during the early part of the nineteenth, dramatic social changes occurred, resulting in the migration of large numbers of a predominantly country-dwelling population into the new towns and embryonic cities. With them they brought their rural modes of sanitation and environmental hygiene, which had been relatively adequate in the more sparsely populated countryside. There was no adequate administrative or legislative framework to contend with such a situation. Sir John Simon (1897) vividly describes the problems: land drains were doubling up ineffectively as foul sewers, domestic cesspools were often constructed in the basements of houses and there was no system of refuse disposal -'the householder stored his filth as he liked, or got rid of it as he could'. It was not surprising that, with overcrowding, malnutrition, and long hours of work superimposed on such circumstances, infections of all kinds became rampant (Brockington 1956). Cholera was introduced into the country in 1832, with disastrous results. The disease became widespread and mortality was immense. Although it cannot be adequately quantified because returns