View report page

2
A severe outbreak of typhoid (enteric) fever has occurred in the
School belonging to the Holborn Union on the rise of Highgate Hill.
As I receive no sickness returns from that establishment, I knew nothing
of it until twenty-six cases had been received into the London Fever
Hospital. My attention was first called to the probability of there being
something amiss in the sanitary arrangements of the establishment by
the return of a death from "cancrum oris" in the schedule which came
to me on March 24th. This death took place on March 18th. The first
death from typhoid fever was recorded in the mortuary schedule which
reached me on 31st March, that is to say, five weeks after the first
recognised case of typhoid had occurred in the house. I mention this
because it is a striking illustration of the necessity of weekly returns of
public sickness being forwarded to sanitary authorities, as well as returns
of deaths. I am morally certain that the disease might have been
prevented from spreading as it did in the School had I been in a position
to interfere at its first onset. The first recognised case occurred in a
boy who was sent to the Fever Hospital on February 24th; afterwards
the fever attacked both boys and girls. On visiting the house on
March 31st, I found that the children were in the habit of drinking
from a closely covered cistern, the waste-pipe of which, untrapped,
entered directly into the drain which conducted the overflow of a cesspool
communicating with the boys' closet. Both the boys' and the
girls' closets, in separate parts of the premises, are defective in construction.
Up to the close of the month of March, 31 cases, including
a nurse and a washerwoman, had been sent to the Hospital. I directed
the waste-pipes of the cisterns to be at once disconnected from the
drains, and the cisterns themselves to be cleansed and disinfected, and
that carbolic acid should be thrown daily into each drain inlet on the
premises and used for flushing the closets, and that the night-stools in
the infirmary and dormitories should be charged with the same disinfectant.
Up to the date of this report only three fresh cases have been
sent to the Hospital, and one of these patients was ailing at the time of
my first visit. Five cases of typhoid fever with two deaths in a house
in the Barnsbury Road have been traced to a similar cause. Householders
are scarcely even now aware of the danger to which they are
exposed from the stupid but common practice of covering the water