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or no evidence could be obtained implicating them. A few of
the patients are said to have eaten periwinkles prior to their
illness; one patient, the second in that house, was stated to
have had both cockles and oysters; and another patient was
said to have eaten mussels in London.
Fried fish is a more or less regular article of diet among
persons living in this neighbourhood. Counting only first
attack in houses, there were 19 patients in all who had consumed
this form of food prior to their illness. Some of these
patients stated that they were in the habit of eating fried fish
regularly once or twice or more a week, others only
occasionally.
No evidence to cast suspicion upon the sources from
which the fried fish was obtained, or upon the premises on and
conditions under which it was cooked and purveyed, was
forthcoming.
Six patients had eaten ice-cream before their illness, all
from the same source, but no evidence implicating this source
could be obtained.
Measures adopted to deal with and check the
outbreak:—
(1). Disposal of Patients and Disinfection.—All cases that
would be were at once removed to the Southgate Isolation
Hospital.
Disinfection of the houses was thoroughly carried out
immediately on removal of the patients. The bedding was
disinfected in the steam disinfector situated on the premises
of the Hospital, and in some cases the bedding, when of little
or no value, was destroyed by burning.
The cases which remained at home were isolated as well
as the circumstances in each case would permit, disinfectants
supplied, and instructions given as to the best means to adopt
to prevent the spread of infection.
When the isolation wards usually devoted to the accommodation
of typhoid fever and diphtheria patients, as
circumstances require, were full, as many cases as could
be received were sent to the Enfield Isolation Hospital. But
as further notifications continued to come in, it became
necessary to make further accommodation for the patients at
the Isolation Hospital. To effect this the scarlet fever block
was emptied, and, after very thorough disinfection, converted
into typhoid fever wards.
Fortunately the district was practically free from all
other infectious disease, and there were only two convalescent
scarlet fever patients in hospital at the time. These were
transferred to the Enfield Isolation Hospital.