REPORT ON THE WORKING OF THE KING INSTITUTE, GUINDY
excreting cholera vibrios on 5th and 6th July respectively. One died. One case of gastro
enteritis occurred on 18th July. He had severe vomitting and purging. Bacteriological
examination failed to reveal any sign of Cholera. From the history and clinical condition
Dr. Ramakrishnan is of opinion that it was due to irritation caused by eating cocoanuts.
He recovered.
Having thus established the diagnosis of the epidemic, we proceeded to inquire into
its history and to commence an investigation into its causation.
History of the Epidemic.
Seventy-six cases of cholera with 43 deaths have occurred in the Jail. The first case
occurred on 14th May, the second on 28th May from which date until the explosive outburst
commenced on 20th June, a case occurred every 3rd or 4th day. All these earlier cases seven
in number proved fatal. The details of the number of cases and the dates on which they
occurred are shown graphically on the chart. Prior to May 14th, there had been occasional
cases of gastro enteritis 15 in all since January 1st. Three of these cases died. Six had been
discharged by the time of our visit, the remaining six were examined by us.
Inquiry showed that the cases occurred all over the main jail. Only six cases occurred in
the annexe. The distribution of the cases is shown on the plan of the jail at the end of
the report. Eight of the cases were on mixed diet, the remainder being rice eaters. All but
14 were Mappillas. Inquiry into where the cases had been working, showed a slight but
not marked preponderance among factory workers.
Causation of the Epidemic.
In view of the facts detailed in the last paragraph my suspicions fell on the water-supply
especially as an examination of the last report showed that the water was bad. The sudden
cessation of the epidemic after chlorination of the water was commenced by the order of
the Inspector-General of Prisons on June 25th lent support to the view that the infection
was probably water-borne.
The drinking water-supply of the main jail is derived from the æromotor well at the
main gate from which it is pumped to a covered tank. Work had been going on at this
well during the preceding three weeks, removing the æromotors, etc. On examination certain
defects were found.
(1) The parapet wall around the well was broken for the pumping arrangements, thus
permitting surface drainage to enter the well.
(2) The manhole in the cement cover at the top of the well proper—some 40 feet
down—was open.
(3) There was a hole in the cement cover.
(4) There was a pit some four feet deep in one corner of the cement cover, this con
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tained dirty water which was said to be baled out every other day. In addition to these
defects there was a washing place for newly arrived prisoners near by, also there was no
latrine at the main gate where the guard is posted and where in addition there was always
a good deal of traffic.
There was 3 inches of rain on June 18th two days before the explosive outburst com
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menced. There also was rain between the 10th and 12th of May and again between the
15th and 18th. I immediately had the water thoroughly examined at the King Institute
with the result that it was found to be generally very unsatisfactory and that vibrios were
found in it. A copy of the report on the water, which has already been forwarded through
the usual channels, is attached. I would here draw attention to the markedly superior quality
of the water supplying the annexe. It is unfortunate that it is not sufficient in quantity
to supply the whole jail. At the time of the epidemic the aeromotor well was supplying the
whole jail, the supply from the annexe not then being in working order.
There is also considerable difficulty owing to the shortage of the water-supply necessita
-
ting much pumping; also the pipe in the jail have not been relaid or examined for nearly
20 years, and the aeromotor well has not been cleaned out for a long time.
I drew the attention of the Inspector-General of Prisons and the Superintendent to the
abovementioned defects which are being remedied as quickly as possible.
I also recommended that the chlorination of the water be put on a more satisfactory
basis and the Superintending Engineer has now put up a tank to regulate the flow of the
bleach solution and to ensure its being thoroughly mixed with the water. In addition I think
that each bottle of bleaching powder should be tested for available chlorine before use.
This night be done at the Agricultural College.
There were some flies in the jail, but not a very great number and in view of the facts
detailed above, I consider that their influence in the epidemic has been a very minor one if
indeed they have had any effect at all. We thought that the amount of greens in the dietery
and to a lesser extent the quality of the dhall might have had some influence on the epidemic
by causing a certain amount of gastro intestinal irritation. These matters were rectified
when brought to the notice of the Superintendent and the Medical Officer.
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