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cases were due to some visitors who stayed with friends in their
tenement. One case was looked after by a nurse who also was in
care of a creche. The nurse caught enteric and one of her young
charges in the creche became infected. One of the cases in this
group was for six weeks not notified. She had nose bleeding,
headache, pains in the limbs and later diarrhœa but is stated to
have gone about her work as usual for some weeks.
One other case was that of a woman who had probably been
infected by her husband who had typhoid fever in 1905—for it is
now well recognised that a patient who has had typhoid fever may
remain infectious tor many years after the attack. These " carrier "
cases, people who have had typhoid 10, 20 or 30 years previously,
and who are now apparently in excellent health, may still pass
countless millions of typhoid germs daily in their stools or urine,
as result of the attack years ago.
At the present day there is every reason to believe that many of
these cases of enteric fever for which no source is found are due to
undiscovered "carriers."
It has been suggested that the fried fish which many of the poor
people eat in large amount may be partly responsible for occasional
outbreaks of typhoid in London.
It is difficult to see how the typhoid germ, even if present in the
fish could withstand the temperature to which it is subjected
during frying, and no satisfactory experimental evidence on this
head is at present forthcoming.
In order to carry the matter still a stage further it would be
expedient to show that the impugned fish, plaice, were derived from
a sewage contaminated nursery ground, or that the fish, or some
of the fish from this area did actually contain typhoid germs. And
even if these suggestions were well founded it would still be wise
to demonstrate experimentally, with proper precautions, that the
typhoid germs found in the fish were able to resist successfully the
temperature of frying in the vats of the suspected shops, or in vats
similarly constructed and subjected to the same conditions of
firing and stoking.