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95
the district and to the Finsbury Park reservoir. With respect to
these mains, they are so arranged that there are no dead ends, but
are connected in such a way by by-passes as to secure a complete
circulation of water throughout the district.
3. The deep well water, which is a very small proportion of the
whole, is pumped into the open channels and reservoirs, which
convey it to the filter beds at Lea Bridge, where after Alteration it is
pumped into the district mixed with the Lea water.
The question may now be asked: Has the water supply to the
Borough had any influence in causing the outbreak of enteric fever ?
The evidence in favour of a negative reply to this question is the
following:—
1. Most of the cases of enteric fever have occurred in that part
of Hackney supplied by the mixed water from the Thames and the
River Lea; but while the bulk of the cases have occurred in this
area, they are grouped close together within a circle of f mile
diameter, thus affecting only about 1/3 of the area in Hackney
supplied by the mixed water, the other 2/3 being almost free from
cases of enteric fever. Moreover, if we look at the other Boroughs
supplied by mixed water, we find that they have not been notably
affected by enteric fever cases. The other parts of the district
supplied by Lea water or deep well water have not been visited with
cases of enteric fever to raise a suspicion that a water-borne epidemic
of enteric fever was in progress.
2. The progress of the outbreak is altogether unlike the progress
of a water-borne epidemic. This latter has a characteristic course.
Its onset is more abrupt, and there is a quick and steady rise in the
notifications. The notifications increase until the source of infection
is removed. At no time during the outbreak in question did the
notifications in any week rise above 15, the numbers varying from
day to day. The outbreak had more the appearance of infection by
means of some article of food other than water.