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The origin of the first case was obscure, but, in my opinion, the cause of the
spread of the disease was personal infection, because neither the water nor the milk
supply appear to have been the cause of any other cases in the neighbourhood, and
although the drainage of the house was defective, no member of the other two
families in the house suffered.
The relative frequency of sick room infection in typhoid fever had recently
been the object of an inquiry by Dr. Herbert Peck, Medical Officer of Health,
Chesterfield Rural District, reported in the British Medical Journal of the 2nd
September, 1899. He found 13½ per cent. of 206 cases were undoubtedly brought
home to sick-room infection, and in other cases it was possible.
This danger of sick-room infection from person to person, as I have for years
constantly urged, points to the advisability not only of not nursing typhoid fever
cases at home amongst other persons not sick, but also of not nursing them in the
general wards of hospitals amongst other patients not suffering from typhoid.
Erysipelas.—Following the inquiries made as to the action taken in other
London Districts upon the notification of erysipelas, the summarised replies to
which were set out in the Annual Report for 1895, in this disease also inquiry is
now made, the best isolation obtainable is advised, the bedding and clothing are
disinfected, sanitary inspection of the premises is made, and the drains are tested.

The number of cases of Notifiable Infectious Diseases removed to hospital in
each week of the year, were as stated in the attached table.