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58
Enteric fever
During the year, there were five cases of typhoid fever and none
of paratyphoid fever.
The first case of typhoid fever was in a young man of 18 years
in whom the disease was confirmed after admission to hospital. At the time,
the patient was unemployed and had not been outside this country. Many of
his meals were taken in restaurants outside Kensington, and as he had no
set habits, it was impossible to establish a source of infection. The only
contact in Kensington submitted specimens for bacteriological examination which
were reported negative.
The second case involved a Uruguayan lady aged 29 years who was
admitted to hospital a few days after arriving in Kensington, having spent some
months in France and Spain. She had, in fact, exhibited clear signs of her
illness before leaving the continent where she obviously contracted the disease.
The patient's mother and sister, who were staying in Kensihgton too, submitted
negative specimens.
The third case was a man aged- 29 years who had not been out of
the country for many years; the only departure from his normal routine had
been a swim in the River Thames close to a drainage outlet. Having spent
just over two months in hospital he was discharged home, but although he had
given a series of negative faecal and urine specimens, his blood picture was
such as to suggest that he might be developing a carrier status. At the end
of the year, therefore, this patient was still being kept under surveillance
and further examinations were being arranged to ensure that the possibility of
carrier development was not overlooked. The only contact of this case
submitted negative specimens.
The fourth case occurred in a man aged 57 years who had recently
returned from a holiday in Italy. However, bacteriological investigation
revealed that the strain of organism was an unusual one having no connection
with Italy but being associated with English oysters from a particular locality.
It transpired that there were other cases in the country at the time
associated with oysters from the same locality. It was confirmed later
that the patient had, in fact, at a London restaurant eaten oysters obtained
from the suspected beds. The patient was nursed at home.
Towards the end of the year, the fifth case occurred in a Cypriot
woman aged 28 years who had been admitted to hospital after having been
nursed at home for two weeks. Exhaustive enquiries were made, particularly
into a party attended by the patient in a neighbouring borough, but without
revealing a source of infection. Early in 1959, two further cases occurred
associated with this one; the first was a woman of 59 years who had nursed
the original patient before her admission to hospital and the second was a
woman relative living in the same house. These two cases will be shown for
statistical purposes in my next Annual Report. All other contacts remained
well and submitted negative specimens.
Puerperal Pyrexia
During 1958, the number of cases of this disease notified was
one hundred and sixteen, of whom seventy-two were persons normally resident
outside the borough. Three of the cases occurred after home confinements;
the remaining one hundred and thirteen cases occurred in hospital.
In order to show some perspective in reviewing this disease
(defined as any febrile condition occurring in a woman in whom a temperature
of 100o4°P or more has occurred within fourteen days after childbirth
or miscarriage), the following table sets out an analysis of the cause of
pyrexia of the cases notified in 1958:-