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the throat secretions. There can be little doubt that this was a mild
case of diphtheria. It is interesting to note that although this girl was
kept at home, she did not infect her brother, who was attending the
Boys' Department of the same school, nor did he act as a "carrier," as
no cases occurred in the Boys' Department.
Enteric Fever.—The number of cases of enteric fever notified in
Chelsea in 1910 was 16, as against 12 in 1909, the case-rate being 2.1
per 10,000 of the population. Twelve cases were notified in the first
quarter of the year, one in the second, two in the third, and one in the
fourth quarter. In North Chelsea 6 cases were notified, and in South
Chelsea 10 cases. Two cases ended fatally. The average duration of
the stay in hospital of 6 cases, of which the records are to hand, was 70
days, the corresponding figure for 1909 being 85 days.
Of the 16 cases, in 4 the infection was in all probability contracted
outside the Borough of Chelsea. There would appear, therefore, to have
been 12 cases in 1910, which can be regarded as having contracted the
disease in Chelsea, as against 8 in 1909, 12 in 1908, and 16 in 1907. One
blood specimen was sent during the year to the Lister Institute for the
Widal reaction, the result being positive. In only one case was any
history obtained of oysters having been the probable source of infection.
Three members of one family living in Foundry-place successively
suffered from enteric fever. The first case was that of a boy of 11 years,
who was taken ill on the 23rd January; but the illness was not diagnosed
as enteric fever until the 8th February, when a Widal blood reaction had
been obtained. His mother, who attended on the lad until he was
removed to hospital, was taken ill on the 12th February, and removed to
hospital on the 23rd; whilst later in the month a sister of 9 years was
taken ill, and removed to hospital on the 3rd March. These occurrences
illustrate the great tendency there is for enteric fever to spread in the
homes of the working classes, if, as often happens, an early diagnosis of
the disease is not made.
Amongst the cases of enteric fever in the early part of the year were
three boys, two of 11 years and one of 10 years, all living at different
addresses, attending different schools, and unknown to each other. The
first case was notified on the 16th January, the second on the 8th
February, and the third on the 9th February, but the dates of onset
appear to have been, respectively, the 7th, 23rd, and 28th January.
There was some suspicion at the time of these boys having become
infected by eating food of some sort obtained from street barrows, but it
was not possible to obtain any definite clue.
During the year specimens of faeces and urine have been sent to Dr.
Ledingham, of the Lister Institute, in respect of 5 patients who had been
treated for enteric fever in the M.A.B. hospitals. The specimens were
sent at six monthly intervals, commencing one month after discharge
from hospital, and iu every case the result of bacteriological examination
showed the absence of the Bacillus Typhosus. The cases were as
follows:—