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Nearly 86 per cent. of the cases certified were removed to hospital for treatment.
The cases certified as enteric fever in London during 1902 numbered 3,405, as
compared with 3,193 in 1901, 4,309 in 1900, and 4,460 in 1899, the attack-rate being
0.74 per 1,000 inhabitants, as compared with 0.70 in 1901, 0.93 in 1900, and 0.97 in
1899. The deaths due to enteric fever in the metropolis numbered 537, and the deathrate
was 0.11 as compared with 0.12 in 1901, and 017 in 1900.
From time to time, during the last ten years or so, outbreaks of typhoid fever
have been observed in this country, in France, and in America, which have been
attributed to the consumption of infected shell fish. Several observers, amongst
others may be mentioned Sir Charles Cameron, the medical officer of health of Dublin, Sir
W. Broadbent and Dr. W. A. Newsholme, have directed attention to the risks attending
the consumption of shell-fish, more especially oysters obtained from layings exposed
to sewage contamination. Eecently, Dr. Klein has shewn that there are good
reasons for believing that the specific micro-organism of typhoid fever—the bacillus
typhosus—is capable of preserving its vitality in the interiors of oysters and cockles
for a considerable length of time, even after the outside of these molluscs have been
subjected to the influence of boiling water.
Beyond the occasional occurrence of a case in which the illness was attributed by
the patient or the friends of the patient to the consumption of oysters until the
summer of the year under consideration, there has been no evidence during recent
years that shell-fish has played any part as a vehicle of infection in connection with
typhoid fever in Shoreditch. This year, however, during the months of June, July,
August and September, the subjoined series of cases, concerning which brief particulars
are given, occurred in the Borough, the patients having partaken of cockles whilst
staying at Southend-on-Sea:—