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30
So far as I know this test is not in use by any practitioner in the
Borough. It is a matter of prime importance and should he used in
any case presenting difficulty in diagnosis.
During 1925 your Medical Officer of Health made a number of
personal enquiries in respect to scarlet fever. Nothing pointed to conveyance
through milk; infection through contact was the outstanding
factor.
Enteric (Typhoid) Fever.
The steady decline in this disease is one of the triumphs of public
health.
Very common only a matter of fifteen or twenty years ago, to-day
there is difficulty in teaching the subject clinically to medical students
owing to the paucity of cases. For the past five years the incidence
in the Borough has been:—
1221 9
1922 7
1923 10
1924 20
1925 4
Unfortunately there is little tangible to report respecting the cases
in 1925, as two of these occurred amongst nurses on the staff of the
South Eastern Hospital. In respect to the third case which was not
really Enteric but Paratyphoid B, there were indications that the patient,
a boy of seven, had perhaps contracted the disease from infected fish
consumed at a seaside resort. An exhaustive enquiry failed to disclose
any other possible cause. The fourth case, in a boy also of seven years,
was diagnosed by your Medical Officer, called into consultation. This
also was a Paratyphoid B infection, and no proven cause could be
ascertained.
It is the cases which occurred in 1923 that I wish to deal with
mainly as these gave satisfaction in that the cause was ascertained on
a scientific and not a speculative basis.
The 1924 cases therefore need not detain us in our scrutiny for long.
Five of the twenty notified in 1924 were reported by the Medical
Superintendents not to be Enteric Fever. Of the fifteen cases:—
1. Cause not discovered.
2. Suspected cause: shrimps purchased from hawker.
3. Possibly contracted from work in London.
4. Believed to be due to watercress from an itinerant vendor.
5. Infected, perhaps, while under treatment for diphtheria.
6. Possibly frcm fried fish from Billingsgate.
7. From ice cream consumed at the coast—uncertain.
8. Watercress suspected.