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Two common characteristics of Enteric Fever namely, that it
attacks young adults and that it appears more frequently in the
autumn, are well illustrated by the cases which occurred in
Clerkenwell in 1900. The average age of the 58 cases was
22 years, and more than half of all the cases occurred in the
fourth quarter of the year. In the first quarter their were 9 cases;
in the second, 10; in the third, 8, and in the fourth, 31. Between
October 16th and November 16th there were 18 cases.
Enteric Fever is generally looked upon as a preventable disease,
and in the light of these figures the question of cause and prevention
naturally arises. Whilst accepting provisionally the five channels
of infection above enumerated, it is difficult to say which channel
is most largely responsible for the 58 cases which have occurred
during the year. Inhalation of sewer gas and pollution of soil
may, for various reasons, be set on one side as regards Clerkenwell.
Infection through the water-supply may also be considered as
extremely unlikely, if not impossible. It is well known that the
London Water Supply is of a high degree of purity.* There is the
* Thames water which has not passed through the filter beds, contains about
1,500—2,000 microbes per cubic centimetre (i.e., about 20 drops) whilst the
New River water filtered, and as delivered, contains 8-10 microbes in 20 drops.
The usual standard of purity accepted by bacteriologists is anything under 100
microbes per 20 drops. So that the drinking water of the parish may be looked
upon as of very pure quality as regards bacteria. Unclean cisterns or delivery
pipes, may of course, bring about pollution of the purest water.