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24
As far as one can judge from recent notifications shown in the above
table the outbreak appears to be on the decrease.
With reference to the water used for drinking I may say it is supplied
on the constant system to the infected houses in about equal proportions
by the Southwark and Vauxhall and by the Lambeth Water Companies.
In some instances the water is drawn direct from the main, and in others
it is supplied through the intervention of cisterns. Samples of water from
both companies drawn from the supplies to various of the infected houses
are being examined both chemically and bacteriologically. So far I have
not been able to find any evidence of pollution of the water by the specific
poison of enteric fever. The possibility of the milk being the medium of
the dissemination of the fever is still under investigation. The milk supply
is—I may add—taken from various sources, and samples both of cow's
milk and of condensed milk are being examined chemically and
bacteriologically.
As regards " the drainage and method of disposal of excrement in the
localities where the disease has been prevalent." The w c.'s are mostly
of modern type. Several of the house drains—which are both separate and
combined—are only imperfectly ventilated, and are apparently not disconnected
by any trap from the sewers. In 17 instances the house-drain
was found on examination with the chemical test ,'an imperfect one) in
use by your Sanitary Authority to be defective. Steps have been taken
to remedy the defects. The sewers into which the sewage drains are
mostly either imperfectly ventilated or not ventilated at all, and some of
them, e.g., those in Bittern Street, Toulmin Street, and Marcia Road,
have been condemned by your Surveyor (Mr. Harrison).
In conclusion I have personally visited every house in which a case
or cases of enteric fever has been notified to me, and have as fully as
possible enquired into the origin and circumstances of the outbreak. I
may add that the investigation of the possible cause or causes of the outbreak
is still engaging my attention.
The chief preventive measures which have already been adopted by
your Sanitary Authority are :—
1. Isolation of 89 of the cases in Hospital—13 patients only remaining
under treatment at home.
2. Disinfection of clothing and other articles that have been exposed
to risk of contamination, and of infected rooms and premises.