View report page

155
Enteric Fever.
Nine persons were notified during the year as suffering from
Typhoid or Paratyphoid Fever, but in one case the diagnosis was not
confiimed and the patient was found to be suffering from Cerebrospinal
Fever.
There were no deaths, but a case notified on the 30th December,
1937, died in hospital on the 5th January, 1938.
In seven instances the disease was typhoid, whilst one case was
paratyphoid fever (B). This latter patient was a recent arrival in
Hampstead and was infected elsewhere. One patient was infected
whilst on holiday in Denmark, another in Spain and a third in Belgium.
Cases of typhoid contracted abroad occur with great regularity. They
illustrate the importance of preventive inoculation for all persons who
contemplate a visit to places abroad where the water supply and general
sanitary arrangements are not above reproach. In one case infection
presumably took place elsewhere in England, but in the remaining three
cases no obvious source of infection could be traced. One patient—a
domestic servant aged 22—was recovering when admitted to a General
Hospital.
The occurrence of sporadic cases of typhoid represents a very
complex problem. Often no source of infection can be traced and
there is no record of the consumption of any unusual food stuffs. It
may be extremely difficult to arrive at a correct early diagnosis on
purely clinical grounds. In all cases of obscure illness, specimens of
blood, faeces and urine should be examined. There is little doubt that
individual susceptibility and resistance to infection vary within very
wide limits and this, combined with the multiplicity of sources from
which typhoid can be transmitted, accounts for the regular appearance
of sporadic cases.
Prophylaxis.
In two of the cases the immediate contacts were given a preventive
inoculation of Felix' Serum. In no instance did further cases occur
in the families concerned. Doses of 10 and 20 c.c. of the Serum were
administered to nine contacts, but in many of these the injections were
followed by rather severe local and general reactions which necessitated
treatment in hospital in two cases,