View report page

54
Enteric Fever.
1915 Average of
previous 10 years.
Number of Cases 37 24
Number of Deaths 5 4
Death rate per 1,000, Deptford 0.05 0.04
This disease has been endemic in the borough for many years.
There has been no serious outbreak of the disease during the last
ten years, and only once in that time have we had 40 cases notified in
the one year.
During the past year 37 cases were notified, as compared with
9 cases in 1914, and 17 cases in 1913, and 9 cases in 1912. Four of
this year's number were however errors of diagnosis.
It may further be pointed out that 16 of the notified cases occurred
between January 1st and March 8th, which was an unusually large
number, and it was more noticable because many of the cases came
from the North Ward.
I made special enquiries in order to ascertain the origin of the
disease. In no case has the testing of the drainage system of the house
revealed any defect. No shell-fish, watercress or other solid food likely
to be contaminated had been eaten by any of the patients. No carrier
of enteric was found in the homes.
I paid special attention to the milk supply with the following results:
That in no less than 16 cases the milk supply was from one dairyman.
I traced the dairyman's supply of milk on March 5th, and found that
he obtained his milk from a dairy farm at West Sussex, and that a
girl had been ill at the farm for a fortnight, and that on this date she
was notified as suffering from Enteric Fever.
On further enquiry I learnt that the patient was the daughter of the
proprietor of the farm. She had no connection with the dairy,but was the
only member of the household who was in the habit of drinking raw milk.
All the milk produced on the farm was sent to Deptford with the exception
of that used in the house. It seemed fairly obvious therefore that
the milk had been contaminated. About twenty cows are kept which
required the services of two cowmen. One of these had been many
years employed on the farm and had a clear history, but the second was
taken on temporarily in November last to fill the place of a regular
worker who had enlisted. This temporary milker who curiously enough
was leaving to resume his normal occupation of gardener, had enteric
fever in June, 1914, at Emsworth, Hants, and it seems probable
that he was a carrier.