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with the date of infection. In five cases mussels had been
eaten, in five cases cockles, and in two cases oysters.
In most of these cases the shellfish had been obtained
from street barrows, and it was not possible to obtain
exact knowledge as to the original source of the fish. In
two cases, however, where the patients had eaten cockles, it
was found that the fish originally came from a certain gathering
ground at Leigh-on-Sea, Essex, which is known to be a
polluted source. The Medical Officer of Health of the district
was advised as to the circumstances relating to these cases.
In nine cases there was evidence that the disease had been
contracted outside the district, one of the cases being infected
at Cairo. One patient was a sewer flusher. In ten cases
the patient was infected by a previous case.
The number of houses invaded by the disease was 81. In
14 houses the drainage was found to be defective, and in 25
houses defects other than drainage defects were found to
exist.
Puerperal Fever.
The number of cases notified was 15, that number being
nine above the decennial average. 8 cases were notified in 1901
and 6 cases in 1900. The case-rate was o8 or 02 above the
mean case-rate for the preceding ten years, which was -06.
Fourteen cases were fatal. The death-rate was '08 or *04
above the decennial average, 04. The death-rate for London
was *04. 8 cases occurred in East Battersea, 3 North-West
Battersea, and 4 in South-West Battersea.
Puerperal Fever is now considerably less prevalent than
was the case in the early part of the preceding decennium,
as is shown by Table XV. In each case the nurse attending
upon the patient was cautioned personally by the Medical
Officer of Health against attending parturient women until
after a period of three to four weeks. The clothing of the
nurse was disinfected after every case. The value of these
measures is shown by the fact that no secondary case attended
by the same person occurred.