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101
had been partaken of during the "critical " period, and may have
been the cause of the disease.
An outbreak which occurred in a house in Harley Street
towards the end of the year is of interest as exhibiting one of the
many channels by which the disease may be spread. So far as
the Metropolis is concerned, probably the most frequent medium
by which the disease is contracted is from eating infected food,
and in this connection shell fish (oysters, mussels, cockles, etc.)
have from time to time been proved to have been the infecting
agent. In this outbreak, however, the source of infection was
traced to personal contact.
Between the 12th and 28th November, five members of a
family were successively attacked and removed to hospital.
Careful enquiries were made with a view to tracing the source of
infection. It was ascertained that another member of the family
had left London for a village near Newport, in Monmouthshire,
on the 12th September, and returned to London on the 9th October.
When he arrived at his home in Battersea, he was feeling
ill and suffering from diarrhoea. He did not see a doctor, and at
the time that enquiries were being made into the first cases he
had apparently recovered. He stated that while staying at the
village of Cwmfelinfach, where he had gone to work as a
labourer on a building, he fell ill, and was treated for influenza.
On this information coming to my knowledge, I communicated
with the medical attendant, suggesting the advisability of taking
a specimen of this man's blood for bacteriological examination.
The result of the examination showed a positive reaction, and he
was notified and removed to the Metropolitan Asylums Board
Hospital for isolation purposes, and discharged on the 9th January,
1909. Three other members of his family, as already stated,
developed the disease, making in all 5 cases infected by the man.
Through the courtesy of the County Medical Officer of Health
for Monmouthshire (Dr. Rocyn Jones), to whom I wrote asking
whether Enteric Fever had been prevalent in the village of
Cwmfelinfach or its vicinity during the autumn, I was informed
that 5 cases had occurred, 4 in Cwmfelinfach and 1 in the