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The Maidstone typhoid epidemic (11 September 1897 - 29 January 1898), was the largest typhoid epidemic the United Kingdom had experienced. It is considered to have led to critical changes in public health, including the first trials of water chorination and typhoid vaccinations.


Context

Typhoid is
bacteria Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of Prokaryote, prokaryotic microorganisms. Typically a few micr ...
l illness, caused by eating contaminated food or water, or by cross contamination with infected
faeces Feces (also known as faeces American and British English spelling differences#ae and oe, or fæces; : faex) are the solid or semi-solid remains of food that was not digested in the small intestine, and has been broken down by bacteria in the ...
and
urine Urine is a liquid by-product of metabolism in humans and many other animals. In placental mammals, urine flows from the Kidney (vertebrates), kidneys through the ureters to the urinary bladder and exits the urethra through the penile meatus (mal ...
. In 1897,
Maidstone Maidstone is the largest Town status in the United Kingdom, town in Kent, England, of which it is the county town. Maidstone is historically important and lies east-south-east of London. The River Medway runs through the centre of the town, l ...
had an estimated population of 34,000 people, and at least 1,908 of them caught typhoid. At least 132 people are known to have died, the majority of them dying outside the hospitals.Borough of Maidstone, ''Report to the Local Government Board on the Epidemic of Typhoid fever 1897,'' London 1898, p.11 They either died at home or in make- shift temporary hospitals. The epidemic was a ‘...turning point in public health...’; leading to water sterilisation methods by using chlorination. The first immunisations with
typhoid vaccine Typhoid vaccines are vaccines that prevent typhoid fever. Several types are widely available: typhoid conjugate vaccine (TCV), Ty21a (a live oral vaccine) and Vi capsular polysaccharide vaccine (ViPS) (an injectable subunit vaccine). Dep ...
were carried out in Maidstone. The Board of Inquiry determined that the cause of the outbreak was contaminated water from the Farleigh Springs. The springs were used for the
water supply Water supply is the provision of water by public utilities, commercial organisations, community endeavors or by individuals, usually via a system of pumps and pipes. Public water supply systems are crucial to properly functioning societies. Th ...
of the town, but typhoid-carrying hop-pickers had deposited their faeces within or near the water. Because the
Maidstone Borough Council Maidstone is the largest town in Kent, England, of which it is the county town. Maidstone is historically important and lies east-south-east of London. The River Medway runs through the centre of the town, linking it with Rochester and the T ...
did not have a sufficient number of nurses to care for the victims, 100 nurses were supplied to the town by the
City of London Corporation The City of London Corporation, officially and legally the Mayor and Commonalty and Citizens of the City of London, is the local authority of the City of London, the historic centre of London and the location of much of the United Kingdom's f ...
. Additional nurses arrived as volunteer workers from various areas of the United Kingdom.
Queen Victoria Victoria (Alexandrina Victoria; 24 May 1819 – 22 January 1901) was Queen of the United Kingdom of Great Britain and Ireland from 20 June 1837 until Death and state funeral of Queen Victoria, her death in January 1901. Her reign of 63 year ...
donated £50 to the M.T.E. relief fund. She had a personal interest in efforts to combat typhoid, since her husband had died from typhoid in 1861.


Outbreak

At least 132 people are known to have died, the majority dying outside the hospitals- either at home or in make shift temporary hospitals. The medical officer stopped keeping a record of the deaths after early October 1897 so more people may have died. The epidemic was a ‘...turning point in public health...’; during the epidemic trials of water sterilisation using chlorination and the first immunisations with
typhoid vaccine Typhoid vaccines are vaccines that prevent typhoid fever. Several types are widely available: typhoid conjugate vaccine (TCV), Ty21a (a live oral vaccine) and Vi capsular polysaccharide vaccine (ViPS) (an injectable subunit vaccine). Dep ...
were carried out in
Maidstone Maidstone is the largest Town status in the United Kingdom, town in Kent, England, of which it is the county town. Maidstone is historically important and lies east-south-east of London. The River Medway runs through the centre of the town, l ...
. The Board of Inquiry which was set up to establish the cause of the epidemic, found that it was due to contaminated water from the Farleigh Springs, one of three springs which supplied Maidstone. This had been contaminated by faeces, deposited by typhoid-carrying hop-pickers camping nearby. It was exacerbated by an increased level of rainfall before the epidemic, which created a high level of subsoil water which in turn contaminated the water supply.Borough of Maidstone, ''Report to the Local Government Board on the Epidemic of Typhoid fever 1897,'' London 1898 The enquiry closed on 19 February 1898.
Maidstone Borough Council Maidstone is the largest town in Kent, England, of which it is the county town. Maidstone is historically important and lies east-south-east of London. The River Medway runs through the centre of the town, linking it with Rochester and the T ...
was overwhelmed by people with typhoid requiring nursing care and had insufficient nurses to care for the typhoid
epidemic An epidemic (from Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infection ...
victims. The
Corporation of London The City of London Corporation, officially and legally the Mayor and Commonalty and Citizens of the City of London, is the local authority of the City of London, the historic centre of London and the location of much of the United Kingdom's fi ...
supplied 100 nurses, including
Edith Cavell Edith Louisa Cavell ( ; 4 December 1865 – 12 October 1915) was a British nurse. She is celebrated for treating wounded soldiers from both sides without discrimination during the First World War and for helping some 200 Allied soldiers escape ...
, a probationer from The London Hospital to help in the epidemic.Sarah Rogers, ‘The Nurses of the 1897 Maidstone Typhoid Epidemic: Social Class and Training. How representative were they of mid-nineteenth century nursing reforms?’ (Unpublished Master of Letters dissertation, Dundee, March 2016) Nurses volunteered from around the United Kingdom, and
Eva Luckes Eva Charlotte Ellis Luckes (8 July 1854 – 16 February 1919) was matron of the London Hospital from 1880 to 1919. Early life Eva Charlotte Ellis Luckes (she spelled her name Lückes with the umlaut until World War I)Rogers, Sarah (2022). ...
, Matron of
The London Hospital The Royal London Hospital is a large teaching hospital in Whitechapel in the London Borough of Tower Hamlets. It is part of Barts Health NHS Trust. It provides district general hospital services for the City of London and Tower Hamlets and spe ...
sent nine probationers including Edith Cavell to work in the epidemic, as well as others from the hospital's Private Nursing Institute. Prominent nurse reformer,
Ethel Gordon Fenwick Ethel Gordon Fenwick (née Manson; 26 January 1857 – 13 March 1947) was a British nurse who played a major role in the History of Nursing in the United Kingdom. She campaigned to procure a nationally recognised certificate for nursing, to sa ...
visited the hospitals and wrote about her visits. The nurses and others who served in the epidemic were either given, or able to purchase a Maidstone typhoid epidemic Medal. Queen Victoria's husband
Prince Albert Prince Albert most commonly refers to: *Prince Albert of Saxe-Coburg and Gotha (1819–1861), consort of Queen Victoria *Albert II, Prince of Monaco (born 1958), present head of state of Monaco Prince Albert may also refer to: Royalty * Alb ...
had died from typhoid in 1861, which may explain her donation of £50 to the M.T.E. relief fund, the equivalent of £5,459.42 as of September 2024.


Borough of Maidstone Typhoid Emergency Hospitals, 1897-1898

Hospitals were opened in a number of sites. Eleven local buildings were used to accommodate up to 339 people:                                    Fig 2: Table Produced for the Local Government Board of Inquiry in to the Maidstone Typhoid Epidemic.


Staff who worked in the epidemic

As well as over 270 nurses members of the Army also worked in the epidemic, as well as volunteer cooks, laundry workers and many others.{{Cite web , last=Rogers , first=Sarah , title=Maidstone Typhoid Epidemic , url=http://maidstonetyphoidepidemic.weebly.com/nurse-recipients-of-the-medal.html , access-date=25 April 2023 , website=Maidstone Typhoid Epidemic


References

1897 in England 1898 in England September 1897 October 1897 November 1897 December 1897 January 1898 in Europe 1890s epidemics 19th-century disease outbreaks 19th century in Kent Disease outbreaks in England Maidstone Typhoid fever