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60
Two deaths were attributed to this disease during the year, compared
with 2, 2, and 4 in the preceding three years.
Upon the recovery or removal of a patient the necessary disinfection
has been carried out, consisting of the stripping and limewashing
of the infected room after fumigation, and of disinfecting the bedding
and infected articles and clothing in the Council's steam disinfector.
Enteric fever, it is believed, is slowly but surely succumbing to the
measures which have been directed against it. The part played by
shellfish in spreading the infection is becoming more and more obvious,
and new regulations for controlling the gathering and sale of mussels
and other shellfish are being framed. The "carrier" problem is more
difficult of solution, as a " carrier " is only discoverable after a fairly
large number of cases have occurred, and the further difficulty of
dealing with a known " carrier " is almost beyond the powers of the
law. The situation is this : A person—usually in this country a woman
who earns her living by preparing food for other people—is a continual
source of danger to the community, and this danger can only be
removed by supplying the individual with other employment, which will
offer no opportunity for the contamination of food.
The mortality throughout the country fell during 1912. There were
1,577 deaths, which represent a mortality of 19.1 per cent. of all notified
cases. The eating of contaminated shellfish has been referred to as the
potent cause of several epidemics, and new regulations are at present
being framed. There have been two presumably waterborne epidemics.
An epidemic at Colne was traced to milk infection : a case of enteric
fever which occurred in a dairyman's household escaped recognition,
and one individual carried out the dual functions of sick nurse and
dairymaid. Epidemics in Harwich and the West Riding were definitely
traced to milk infection by "carriers." Dr. Ledingham's work has
shown that among cases discharged from the Metropolitan Asylums
Board hospitals, and ascertained not to be passing bacilli at the time of
discharge, there were no carrier cases, whilst among those who were
passing bacilli at the time of discharge 5.4 per cent. proved to be
" carriers."
The death rate for Deptford was equal to an annual rate of 0.02
per 1,000, whilst for the three preceding years it was 0*02, 0*02, and
0'03. The case mortality for 1913 was 11'8 per cent, compared with
22.2 for 1912.
The rate of mortality for England and Wales was 0'04, for the 96
great towns 0'04, for the 145 smaller towns 0'05, and for the County of
London 0.02.