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44
disease. The incident is complicated by the doubt as to whether
Christopher C. introduced the infection amongst the members of
the M. family at 217, W— Road or Mrs. M., by her own illness,
caused by the soiled linen of Mrs. C. which she brought home to
217, W-Road to be washed. However, whether introduced by
the boy Christopher, who, it may be noted, associated with the
children of Mrs. M. at 217, W-Road during a period when he
must have been capable of conveying infection, or by Mrs. M.;
the disease attacked all the children of the family in rotation with
the exception of one child.
My object in giving details of these groups of cases of enteric
fever is to emphasize the importance of recognising personal or
contact infection as a considerable factor in the spread of this
disease, especially in the homes of the poor. In the more exciting
chase after infection by food, especially fish of various kinds, and
"carriers," the more commonplace mode of transmission by personal
or contact infection is apt to be thrust into the background. I am
of opinion that a considerable decrease in this disease might be
anticipated, if this mode of infection is always borne in mind, both
by medical practitioners and by the public ; especially if the former
were to make freer and earlier use of the Agglutination test for
enteric fever, when called in to attend obscure cases of feverish
conditions.
The deaths from enteric fever in the Borough last year
numbered 8. This is equal to an annual mortality of 20'5 per cent,
attacked, and .036 per 1,000 living.
During 1911 specimens of blood from 21 persons suspected to
be suffering from enteric fever were submitted to Widal's test. Of
these 7 gave a positive and 14 a negative reaction.
The mortality for all London for the same period is .03 per
1,000 living.
Chicken-pox.—During the month of March of last year, whilst
small-pox was prevalent in the East End of London, the London
County Council thought it desirable to make chicken-pox a notifiable
disease for a limited period.