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30
The following are the common channels by means of which the
specific germ, the Bacillus Typhosus, may be disseminated:—
1. Inhalation of Infected Sewer Air. — As a matter of fact, although
sewer gas, by its weakening effect, may predispose to
Enteric Fever, it does not alone, in all probability,
commonly convey the disease.
2. Drinking Infected Water.—This is generally looked upon as
the common channel of infection. In this country wellknown
outbreaks at Worthing, Maidstone, Lynn and
other places were attributed to this cause. In the recent
South African campaign, infected water played a
prominent part in the outbreaks of Enteric Fever.
3. Food may also be the means of conveying the Enteric
bacillus to the human system. Milk, shell-fish (infected
oysters, in particular those fattened on contaminated
oyster-beds), ice-cream, watercress, etc., have proved to
be not uncommon channels of infection.
4. Pollution of the Soil. — There is now some evidence to
show that certain kinds and conditions of soil favour
the growth and multiplication of the micro-organism outside
the human body. This being so, it is possible that
the soil may be, under certain circumstances, a means of
infection directly or indirectly.
5. Direct infection from person to person, or from soiled linen,
bed-clothes, etc., of a typhoid patient to a healthy person.
In Clerkenwell during 1900 there were 58 cases (as compared
with 92 in 1899) of Enteric Fever notified, out of which there were
2 deaths in the district, and 4 deaths among the 50 cases removed
to hospital for treatment. The total number of deaths was therefore
only six, (as compared with 23 in 1899) giving a death-rate of
0.09 per 1,000. This is the lowest Enteric death-rate for ten years
past. For London as a whole the Enteric death-rate was 0.16 per
1,000.