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120
HACKNEY BOROUGH COUNCIL.
PREVENTION OF TYPHOID OR ENTERIC FEVER.
Typhoid or enteric fever is a dangerous infectious disease, attacking
all classes and both sexes, but chiefly adults during the most
active portion of life (from 15 to 40 years). The disease may occur at
any time of the year, but it is most common during the late summer
and autumn months. The fatality varies in different epidemics, but
it is always high. In Hackney, during the year 1903, there were
247 cases of this disease, of which 35 died, thus giving a death rate
of over 14 per cent. A disease with such a high death rate must
always be regarded as extremely dangerous. Typhoid is one of
those diseases which is due to the presence and action of a microbe,
the bacillus typhosus, in the system. This microbe has been found
in nearly all the tissues of the body, but especially in the excretions
of those suffering from the disease; and it is the excretions which are
the sole cause of spreading the disease through the community.
The disease may spread—(1) By contagion from persons ill with
the disease to nurses or others attending upon or coming into close
relation with them; sometimes by direct transmission through the
air, but chiefly by infected or soiled bed or body linen or clothes.
(2) By infected water. Many serious epidemics of enteric fever
have occurred by drinking water polluted by the excretions from
persons suffering from this disease. A notable instance, within the
memory of most persons, is the Maidstone outbreak of 1897. (3)
By effluvia from drains or sewers which have been infected by
typhoid excretions. (4) By infected food. The foods which can
with reliance be regarded as active media in spreading the disease
are (a) milk. This may be brought about by washing the milk cans
with polluted water, or even adulterating milk with such water; (b)
oysters and other shell.fish fattened in waters to which sewage has