It is unheard of for typhoid to be a cause of death in Launceston today, but in the 19th century and the first decade of the 20th, 'the fever' was a frequent visitor. The press described it as an 'Insidious Foe.'
Caused by the bacterium Salmonella typhi, Typhoid has stalked the human race for thousands of years. It is spread by consuming food or drink contaminated with the faeces of an infected person. Symptoms include temperature, headache, cough, general debility, abdominal swelling, delirium, rose-coloured spots and constipation or diarrhoea. The later stages can involve extreme agitation, intestinal ulceration, bleeding and perforation of the bowel.
Typhoid was particularly prevalent in both Launceston and Hobart throughout the 1880s and into the early 1900s. Outbreaks usually peaked in late summer and autumn. In 1889 there were 40 deaths out of 291 cases. Those most vulnerable were males in their prime, aged between 20 and 35 years. Many families suffered tragic losses.
There was little doubt about the source of the contagion: foul drains and sewers, filthy gutters, dirty backyards and poor sanitary practices. The low lying areas of Invermay and lower Margaret Street were disease hotspots. A report into the Sanitation of Launceston in 1886 identified a cause.
The main sewer along Margaret Street ran to an open outlet below high tide level on the Tamar River.
Under normal circumstances tides flowed two to 300 yards back up the sewer; higher tides or floods inundated the lower parts of York, Elizabeth and Bathurst streets with raw sewage.
Excrement also accumulated on the mud banks of the North Esk where it festered in the sun.
Other sources of infection included cesspits, impure water wells, contaminated milk and the rotting corpses of typhoid victims in inner city cemeteries.
Special wards at the Launceston General Hospital were dedicated to Typhoid patients. Before antibiotics and intravenous drips those hospitalized with the disease required constant care.
Eva Oakes, then a nurse at the LGH, recalled the use of cold compresses, sponging and four hourly baths. A liquid diet of beef tea was administered, and ice dispensed for sucking.
Delirious cases required close monitoring and sometimes restraint.
A patient who escaped his bed was considered a disgrace to the nurse in charge, but there was worse to be feared. Four LGH nurses died from typhoid in the 1885 and 1886 outbreaks.
Launceston's sewerage and drainage were in urgent need of improvement. The epidemics impelled the aldermen and ratepayers to overcome concerns about cost. From 1888 the sewerage system was upgraded and extended. By 1895 the majority of residents had water closets connected to sewers, or a night cart service. Cesspits were almost non-existent.
By the end of 1914 public health measures and the availability of an effective vaccine meant that Launcestonians had almost ceased to fear the 'insidious foe'.