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22
ENTERIC FEVER.
(38 deaths. Decennial average 22).
The total number of cases reported during the year was 199.
Seventy were reported from the North Sub-District, with 16 deaths;
66 from the South, with eight deaths; and 63 from the East, with
14 deaths. The case mortality on the number notified was 19.1
per cent.
Enteric Fever was prevalent throughout London, and the reported
cases exceeded those of any year since notification was made
compulsory. The disease was most deadly in the City of London,
0.43 deaths per thousand population; in Limehouse, 0.38; in
Clerkenwell, 0.35; and in Bethnal Green, 0.29. With the exception
of a limited outbreak in the Jews' quarter in the neighbourhood of
Weaver Street, the cases were distributed fairly equally throughout
the parish. I carefully investigated every case myself, and sought
in vain for some probable cause common to a number of sufferers.
As usual, it was in the late autumn that the fever cases were most
numerous, and an inspection of the chart herewith shews a very
sudden rise in the number of cases notified at the end of October,
and suggests some widely distributed cause such as contamination
of either milk or water; but I was unable to discover any facts in
support of this theory.
It is interesting to note that the arrangements for intercommunication
recently made by the companies, for the purpose of avoiding
a future water famine, will result in a mixed supply, so that in the
event of contamination through careless filtration or otherwise, it
will become increasingly difficult to discover the offender.
The Inspectors report that in 77 instances the residence of the
person notified to be suffering from Enteric Fever was found to be
in a satisfactory condition; but in 41 the w.c.'s were defective; in
13 the external drainage arrangements were faulty; in 11 the drains
inside the house were leaky; and other insanitary conditions were
found in 81 cases. Twenty-two cases occurred in families inhabiting