View report page

36
In the County of London the case-rate was 0 04 and the deathrate
0.04 per 1,000 population.
Of the 29 typhoid-infected houses, 11 (i.e., 34 per cent.) showed
on inspection defective traps, fittings or appliances. In 4 of the
houses the drains themselves were found to be defective.
The source of infection in 15 cases was probably due to personal
infection or to a so-called "carrier" case. In 2 cases the
eating of mussels was suspected to have been the cause of the disease,
and in 1 case it was ascertained that fried fish had been partaken
of during the critical period, and may have been the cause of the
disease. In the remainder of the cases it was impossible, notwithstanding
a rigid investigation in each instance, to trace the
probable source of infection.
In my Annual Report for the year 1909, a somewhat remarkable
local outbreak of enteric fever, which occurred in a street in
East Battersea (Nine Elms Ward) was recorded. A similar outbreak,
though not so serious as regards the number of cases or
fatality, occurred in the same street during 1910, an interval of
some four months separating the last case notified in 1909 from the
first case occurring in 1910. Between the 11th February and 17th
May I received the following notifications :—
Date of
Notification.
Name.
Age.
Address.
Date of Onset.
11th Feb.
9th March
3rd April
16th April
9th May
11th „
17th „
George G. *
Leslie C.
Leonard C.
Frank C.
George G.
Emily L.
Cyril C.
68
11
13
8
14
14½
11
18, L-Street
35, „ ,,
„ „ v
„ „ „
76, „ „
35, ,, ,,
„ „ „
Dec., 09
3rd March
31st „
8th April
24th „
10th May
No symptoms
* This case was notified as continued fever.
The history of the outbreak was as follows: George G. was
notified as suffering from continued fever on the 11th February, his
illness dated from early in December, but he was not seen by a doctor
until the 2nd January. The nature of his illness was suspected to
be enteric fever and a specimen of his blood was bacteriologically
examined, with a negative result. When first seen by the doctor
he was feverish temperature 101 deg. F. General malaise, no chest
symptoms, no eruption was noticed, his skin was dry, harsh, tongue