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52
The patient had died the previous night, and the body was removed, in
due course, to the mortuary, where it was kept prior to burial. Thorough
disinfection was immediately carried out, and the house and family were
kept under daily supervision for 14 days. I visited the hospital and
made full enquiries into the case. It appears that the infant was
brought to hospital on Tuesday, February 5th, and again on the 6th,
when it was admitted. What is now regarded as the specific germ of
the disease was detected, and both on the facts of the clinical diagnosis
and the autopsy there can be no doubt that the case was one of
epidemic cerebro-spinal meningitis, of which there have recently been
outbreaks in Belfast and in Glasgow. The disease is not of very rare
occurrence in the United Kingdom, though this was the first case to
occur in the Metropolis at the present time. Every step was taken to
prevent the spread of infection, and no further cases occurred, nor was
there any kind of illness in the house in which the case occurred. I
took the precaution of sending a letter to each medical man practising
in the Borough, with a copy of the memorandum respecting the disease,
issued by the Local Government Board, asking for an early intimation
of any cases of illness simulating this disease which might occur.
Unfortunately, the disease has various anomalous forms in addition to
its typical form, which increases the difficulty of diagnosis. Whether
the disease is spread by direct infection from person to person is a
matter of uncertainty; indeed, there is no definite knowledge as to the
way or ways in which its transmission may take place. Throughout
the investigation we were not able to trace the source of infection in
any of the four cases we have had.
The second case was notified on March 25th, from St. Bartholomew's
Hospital, a child, A. C., aged 2¼ years, of 76, Bastwick Street. The
specific organism was isolated.
On 29th June, I received the third notification from St.
Bartholomew's Hospital, in the person of J.H , aged 30, of 13, Gastigny
Place, Old Street, E.C. This case presents somewhat exceptional
characteristics. It appears that on the night of Saturday, 15th June,
this man was assaulted in the street in the vicinity of his home, or at
all events was involved in some street quarrel in which he seems to
have received various blows on his head. Two or three days later he