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39
It will be understood that it is almost impossible to trace
sources of infection in isolated cases of typhoid fever. In an
outbreak various conditions and circumstances exist which
assist in the detection of the source of infection. One group
of five cases occurred in a single family due to personal contact
or continuous infection of food. On November 1st, a little
girl, R.C., was removed from Northampton Buildings to the
Hospital for Sick Children in Great Ormond Street as suffering
from " tuberculosis of the lungs." Her blood was examined
for the typhoid reaction without result, and she made an
apparently good recovery. But three weeks after, her brother,
G. H. C., aged 14, sickened with typhoid fever and was removed
to hospital on December 7th. The tenement was disinfected.
On December 12th, the father, G. C., aged 42, was removed
with typhoid fever and died in hospital. Disinfection was again
carried out. On December 18th, another son, T. A. C., aged 8,
was notified and removed, and on January 6th yet another son,
A. C., aged 4, was notified and removed. It is possible that the
girl suffered from unrecognised typhoid fever, and started the
infection in the family ; and although disinfection was carried
out each time, the infection was not destroyed. It is evident
that in this instance that, by careless pollution of food, clothing,
or some other medium, the infection spread through the family
in spite of our efforts at prevention. Cleanliness was lacking,
which is, of course, a fatal mistake in combating typhoid
infection. The only person in the family that escaped was the
mother. Another instance occurred during the year of infection
passing through a family.
Bacteriological Diagnosis has been arranged gratis for
all medical practitioners in Finsbury. A few drops of the blood
of the patient are taken and examined by means of the Widal
test as to whether or not the blood contains typhoid toxins. The
results are as follows:—