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With regard to the majority of the cases a source of origin could not be suggested, and
even in the above table one can only speak with any certainty in those marked (b), (h) and (i).
In (b) W. G. S., of St. James' Road, was taken ill June 21st, 1904. Three weeks previously
he had eaten some mussels and whelks from a stall at New Cross Gate. Within an hour
of eating these he was taken ill with what was evidently ptomaine poisoning, and had some
difficulty getting home. He, however, did not completely recover from this before symptoms of
enteric developed. There is no doubt in my mind that these shellfish were contaminated with
the bacteria which produced these symptoms as well as those of enteric later.
In the case of (h) the following is the Report to the Public Health Committee in
October :-
"In one house in St. Helena Road, 9 cases have occurred. The following are the
names, ages, and dates on which they fell ill :—
Date Notified, 1904.
Name.
Age.
Fell ill.
Sept. 6
John J. Bernell
51
Aug. 20
„ 12
Phoebe „
19
Sept. 9
„ 12
Lily „
6
„ 9
„ 12
Rose „
4 1/1 ½
„ 12
Oct. 4
George „
10
„ 30
„ 6
John Rabjohns
4
Oct. 4
„ 6
Alice Bernell
43
„ 3
„ 12
Lottie „
12
„ 8
„ 12
John J. „
12
„ 8
"This is evidently an outbreak in which there was no common source of infection
for all the cases, but in which one case became infected from another. The father,
John James Bernell, was a week in the Infirmary before the nature of his disease was
discovered, and the three cases on September 12th evidently acquired their infection
from him. On October 4th another case occurred, at which time I visited the house and
discovered that the mother and another child were ill with the disease. they were
removed to the hospital, and the three smallest children taken into the Council's
shelter, the other two members of the family and the lodgers refusing to come in. In
the shelter two further cases occurred, viz., Lottie and John Bernell. They evidently
received their infection from the mother, who had been ill some little time before
removal. The father is the only death which has occurred so far.
" The house has been thoroughly cleansed and disinfected, and the drains are in
good order. The origin of the first case is obscure. He was in the habit of getting fish
from a shop in Derrick Street, but there is no reason for suspecting that this was the
source of infection."
The next report refers to (i) : —
" There have been three cases of enteric fever recently in connection with a house
in Pages Walk. They are as follow January 19th, A. T., 7 years (F) ; January 23rd,
T. S., 6 years (m); January 29th, F. T., 2 years (m). There is a history in connection
with these cases which suggests a common origin for the first two, the third one having
arisen direct from the first. The first two cases belong to separate families, who were
in the habit of frequently visiting one another. In the family of the second case there
has been some indefinite form of illness, which affected three members of the family
besides the one removed with enteric. Edith, 4 years, took ill at the end of November
with what appeared to be a cold, and was attended by a medical man, who described
the illness as bronchitis and pneumonia. She is slowly convalescing at present.
Frederick, 14 years, took ill with symptoms resembling influenza a week before
Christmas ; he is now recovered, but does not look very well. George, 12 years, had a
similar illness before Christmas, and has now recovered. The father, mother and baby
seem to be the only ones that escaped.
" If these should have been anomalous cases of enteric it would account for the first
two cases. I purpose making further investigations and will report at the next meeting."
The further investigation consisted in an endeavour to get specimens of the blood from
the un-notified cases with what result appears in the next report to the Committee : —
" The following is the full investigation into the three cases of typhoid fever which
occurred at 21, Pages Walk. The notifications occurred as follows: —
January 19th, 1904 A. T. 17 years, female.
„ 23rd, „ T. E. S. 6 „ male.
29th, „ F. T. 12 „
"E. S., 3 years (f), took ill at the end of November, 1903, with cold and bad
cough, later with diarrhœa and vomiting, and was diagnosed to be suffering from
pneumonia and bronchitis. She was ill when I saw her on February 3rd, and did not
recover until at least a fortnight later.
"F. S., 14 years (M), brother of above, took ill a week before Christmas He was
described as " sleepy and lying about," with pains and headache, loss of appetite, but
no bowel symptoms. He was ill about four weeks.
" G. S., 12 years (M), another brother, took ill about the new year, and had not
quite recovered when I saw him on February 3rd. He had similar symptoms to F. S.,
but had abdominal pains.
"As the laboratory was not fixed up, I did not examine the blood until February
26th, and was then only able to examine two of these, viz : E. S. and G. S.; the third