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In all these and other cases full enquiries and firm steps were taken.
1923, On October 20th, 1 received a notification of enteric fever
in a child, E.H., 6 years, living at P. Street. The child was removed
to the South-Eastern Hospital. The last date on which he attended
school was October 9th. He was taken ill on the 9th and the doctor
was called in on the 10th, in view of his feverish condition. The
nature of the illness became manifest on the 18th, the diagnosis being
confirmed by a Widal test. I visited the house and made an appointment
to meet all the members of the three families living there next
day (Sunday). The three families were closely related, comprising
thirteen people, living in seven rooms, of which four were bedrooms.
Three brothers were the heads of the three families.
Taking the patient's family first. This consisted of E.G.H., 35
years, who shares a bed with his son, the patient E.H. The father
E.G.H. is an engine driver on the L. B. Railway, and has lived for five
years at P. Street. His health history was good with no recollection
of any transient febrile disorder such as might have been a mild typhoid
attack. He said that the patient, his son, had had headaches, pains in
the abdomen, sickness and vomiting. The father had had diarrhoea for
one day himself. A sample of the father's faeces was taken for a
bacteriological examination, but proved negative.
The second family consisted of J.H.H. (brother of E.G.H. above),
his wife, F.H., his sister, T.H., and five children, namely C.H., 13
years, T.A.H., female, 9 years, L.H., male, 8 years, E.H., female, 5
years, and B.H., female, 4 years. The health history of the family
was as follows:—The father, J.H.H. had pleurisy and pneumonia in
December, 1921, and was in bed 6 weeks. His physical signs were
slow in clearing up and the family doctor sent him to the Tuberculosis
Dispensary for co-operative observation. His chest cleared up and
since then his health had been satisfactory. In the past, one has come
across cases in which an attack of pneumonia has been a complication
of a true typhoid infection, so it was felt advisable that samples of his
dejecta should be examined lest he should be a typhoid carrier.
Mrs. J.H.H. had a goitre for which she was receiving medical
treatment. The sister, T.H. had suffered from anaemia and constipation.
The child C.H., aged 13, though seemingly in perfect health,
had diarrhoea on the 14th and 15th. His blood serum gave a negative
Widal. The faeces were negative, no B. Typhosus being isolated.