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17
COMMUNICABLE DISEASES
Cases of Scarlet Fever and Whooping Cough were more numerous
than in previous years, but the illnesses remained generally
mild in character. The complete absence of Poliomyelitis
throughout 1960 was very encouraging.
Of the two cases of Typhoid Fever notified, one patient aged
71 was undoubtedly a "carrier" of Typhoid Fever. During an illness
which was thought to be a mild attack of Sonne Dysentery a
faeces specimen was sent for laboratory test and this resulted
in the carrier state being detected. There were no other members
of the family at risk, and in view of the age of the patient
surgical treatment was not thought appropriate when chemotherapy
proved ineffective. The other patient was a boy of 14,
who while playing (trespassing) in a field used for the drying
of sewage sludge, fell into one of the sludge lagoons. He was
apparently completely submerged and may have ingested or inhaled
some of the material. He seemed dazed by the immersion but on
arrival home was seen by the family doctor who could find no
injury. Some three weeks later the boy complained of headache
and four weeks after the incident he was unable to attend school.
He took to his bed some ten days later and shortly afterwards
was admitted to hospital and diagnosed as suffering from a
fairly severe attack of typhoid fever. The organism recovered
from his faeces was not of the type being excreted by any known
carrier in the Borough. It was, however, the type prevalent
during the outbreak of typhoid fever in Croydon in 1937. All
investigations of family contacts were negative, and efforts to
grow typhoid bacilli from the sewage sludge were unsuccessful.
The drainage area of these sewage works extends beyond the
County Borough boundaries, and the population served is about a
third of a million. All the sludge has some six weeks of treatment
before being pumped on to the drying areas.
In 1956 the Medical Officer of Health of Sutton and Cheamdrew
my attention to a 13 year old resident of his area, who
when trespassing on the same sewage farm, fell into a "sewagetank"
and swallowed some sewage. Twenty one days later he developed
typhoid fever. No other source of infection could be
found. The typhoid organism recovered differed from that of any
known carrier in the Borough, and from the case described above.