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27
noted that the patient has undergone an attack of enteric fever without the
disease having been recognised at the time at all. During the early stages
of the illness before its recognition, every case of enteric fever is a danger,
and remains so until it is isolated and properly dealt with. It is, in fact,
a carrier of infection. Instances have been recorded of outbreaks of enteric
fever attributable to what are termed "carrier" cases. Such cases are persons
who, having had an attack of enteric fever and recovered therefrom, nevertheless,
from time to time, pass the micro-organisms of enteric fever with their
dejecta. The evidence which has been put forward leaves little doubt as to
such cases resulting in outbreaks as described in the reports published about
them. In like manner every case of enteric fever so long as the patient is
able to go about is liable to infect those with whom he comes in contact.
They are, in fact, carriers of the disease. Even after isolation and with all the
precaution of modern nursing some risk still remains. Nurses take the disease
from the patients. Case 27 is an instance of this which occurred this year.
This nurse had been nursing cases of enteric fever in the infirmary for several
months. She, unfortunately, lost her life. Case 34 is another instance. This
nurse in all probability took the disease whilst assisting in the nursing of
case 27. She made a good recovery after a long illness. Altogether, it came to
my knowledge that seven persons whose duty brought them into contact with
enteric fever cases either in connection with nursing or disinfection took the
disease during the years 1908 and 1909, whilst following their avocations with
respect to the cases in Shoreditch.