London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1908
[Report of the Medical Officer of Health for London County Council]
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thus somewhat in excess of that which might have been expected as a matter of pure chance. No
causal significance can be held to be implied by such a degree of excess, having in view the smallness
of the numbers dealt with.
It will be seen that only four persons can be classed as not having eaten fried-fish,
and hence a hypothesis of infection by fried-fish cannot be at once dismissed from further consideration,
for the four negative cases may, of course, have been instances of mere chance infection
independent of the special cause operating in the district during September and October. It will
be borne in mind that the area is entitled to show four, or indeed rather more than four, sporadic
cases of enteric fever during these two months. If the four negative cases could be regarded as sporadic
cases, all the remaining persons attacked in the area of special prevalence would have been fried-fish
eaters. In other words, a fried-fish hypothesis is (so far as these figures go) adequate for explanation
of the outbreak. It was not possible to demonstrate that cooked fish had been obtained from
any single retail shop. Detailed information was obtained as regards the shops from which fried
fish was purchased in the case of 18 of the patients. At least eight different shops were referred to,
in one or another instance. The shop named by the largest number of sufferers was one from which
six certainly, and possibly ten of the 18 had obtained fish. This shop is situated centrally within
the area affected. As regards the remaining eight sufferers, one or two of them may quite exceptionally
have obtained fish from this shop, but the fact must be accepted that this particular shop was
not, at any rate, a recognised source of supply of these eight persons. Difficulties inseparable from
investigations of this sort render it impracticable to make any more precise statement than this.
The possibility was considered as to whether fish purchased in the uncooked condition had
played a part in producing the special prevalence of enteric fever. This question will be further
referred to in connection with the remarks to be made on the Shoreditch prevalence.
Tabular statement giving certain particulars with regard to 28 cases referred to in the preceding report:—
| Date of notification. | Date of onset. | Sex. | Age. • | Milk supply. | Whether mussels consumed at or about time when disease was presumably contracted. If so, whence derived. | Whether fried fish was consumed at or about time when disease was presumably contracted. If so, whence derived. | |
|---|---|---|---|---|---|---|---|
| Kept. 16 | Sept. 2 | 17 | Yes from D. or elsewhere. | ||||
| „ 22 | „ 6 | F. | 16 | R. | No. | Yes. N. or elsewhere. | |
| „ 23 | ,, 17 | F. | 15 | Cond. | No. | Yes. N. or elsewhere. | |
| „ 25 | „ 18 | F. | 37 | W. | Yes. Stall in main road | Yes. D. twice a week. | |
| „ 27 | „ 16 | 38 | W. | Yes. Not known. | |||
| „ 28 | F. | 30 | M. | Yes. 3 or 4 weeks before illness. | Yes. D. frequently. | ||
| „ 28 | „ 5 | 32 | S. | Yes. | Yes. P. or elsewhere. | ||
| „ 28 | „ 23 | 45 | No. | Yes. Often. | |||
| „ 29 | „ 16 | 16 | |||||
| Oct. 6 | „ 29 | 8 | Cond. | No. | Yes. D. twice a week. | ||
| „ 24 | 11 | Cond. | No. | Yes. B., or elsewhere. | |||
| „ 13 | „ 17 | F. | 24 | Cond. | |||
| Oct. 6 | M. | 11 | E. | No. | Yes. D. frequently. | ||
| Sept. 27 | M. | 45 | Cond. | Yes. P. or elsewhere. | |||
| „ 17 | Oct. 3 | 7 | Cond. | No. | Yes. Various places. | ||
| „ 20 | „ 6 | 6 | Cond. | Yes. | Yes. Landlord of house keeps a fried-fish shop. | ||
| „ 26 | ,, 19 | M. | 35 | G. | Yes. | Yes. Various places. | |
| „ 17 | F. | 32 | J. | No. | Yes. | Very frequently usually from P., or R., possibly from D. | |
| „ 26 | „ 18 | M. | 13 | J. | No. | Yes. | |
| „ 27 | ,, 18 | F. | 8 | J. | No. | Yes. | |
| „ 27 | „ 19 | F. | 6 | J. | No. | Yes. | |
| „ 27 | „ 6 | F. | 30 | S. | Yes. | ||
| „ 29 | ,, 9 | M. | 9 | D. | No. | Yes. S., and elsewhere. | |
| Nov. 1 | „ 19 | F. | 26 | P. | Yes. | Yes. H. | |
| „ 3 | ,, 23 | 9 | Cond. | Yes. | Yes. P., and elsewhere. | ||
| ,, 25 | 32 | F. | |||||
| „15 | — | 9 | Yes (not known). | ||||
| „ 17 | F. | 7 | H. & G. | No. | Yes. D., P. or B. | ||
The Shoreditch Outbreak.
The particulars supplied in Dr. Bryett's report for 1908, show that while 101 cases occurred
during the year in Shoreditch, nearly three-fourths of these were notified from one of the eight wards
into which the borough is divided. A closer examination shows that by far the majority of the cases
in this ward occurred in a limited area near its eastern border. In fact, more than half the total
number of cases in Shoreditch were notified from six streets, or from a population of about one-fiftieth
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