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TYPHOID AND PARATYPHOID FEVER
There were three cases of typhoid fever during the year but none of paratyphoid.
The first two cases occurred in a family comprising father, mother and three sons aged 9, 8 and 5
years respectively, who had returned to this country on 8th April, 1972, after a three months' stay in India.
It was reported that the 9-years-old boy felt unwell about 29th March with mild fever, cough, cold
and headache, and was treated in Bombay for these complaints. The symptoms persisted and on 6th April
he was noticed to be pyrexial with chills. After his return to this country he continued to remain feverish
with cough and developed diarrhoea; on 14th April he vomited and was admitted to an isolation hospital.
Subsequently, salmonella typhi was isolated from blood culture taken on 18th April. The patient improved
until 23rd May when he had a relapse and blood culture again grew salmonella typhi. However, by
23rd June after several further tests had been made which proved negative, he was thought fit and discharged
home.
The patient's brothers, although having no symptoms, were also admitted to the same isolation hospital
on the 14th April, as a precaution. In the ward, the 5-years-old boy ran an intermittent pyrexia, was
found to be weak and lethargic and had several loose stools. Subsequently, salmonella typhi was isolated
from a blood culture taken on 24th April and also from a repeat blood specimen on 27th April. Six faecal
and urine specimens were all negative for salmonella typhi and other pathogens. This child was discharged
from hospital on 30th May. All tests for the 8-years-old boy were negative and he was discharged home on
28th April.
Enquiries and routine bacteriological investigations of the family and other domiciliary contacts
were carried out and their medical practitioners informed, as were the medical officers of health of the
areas concerned in respect of non-residential contacts. All bacteriological results from these contacts
proved negative.
Periodical checks made on two positive cases after discharge from hospital were negative until
November 1972 when the family moved to another borough, and the medical officer of health of that
area was acquainted with the history of the cases.
The third case of typhoid fever concerned a 3½-years-old male who was admitted to a general
hospital on 27th October, 1972 with a history of cough and fever, with onset date reported as 20th/21st
October. From blood culture taken at the hospital salmonella typhi was isolated and the child transferred
to an isolation hospital on 30th October.
The patient had arrived in this country from India on 15th September with his mother and 5-yearsold
brother, the father having been in this country for some seven months. The mother, who was pregnant
and reported to have contracted typhoid in 1971, was also admitted to the isolation hospital on 1st
November to be with the child as he was rather fretful. Subsequently, her stools also grew salmonella
typhi which proved to be of untypable strain. She remained persistently positive.
As the child progressed satisfactorily, he was thought to be fit and finally discharged on 1st December.
However, the mother, who was delivered of a daughter on 15th December, was not discharged until 31st
December, still in a carrier state. Due to this carrier state, the father who worked in a supermarket, was
excluded from his employment and, in accordance with Section 41 of the Public Health Act, 1961, was
compensated in full for loss of earnings for the period from 31st October, 1972, until he was found
employment by this department which was not connected with food handling. In addition, as the family
occupied rooms in multiple occupied premises and there was a risk of the other tenants contracting typhoid
due to the mother's carrier state, the medical officer of health recommended priority rehousing on medical
grounds and the family was rehoused on 4th December.
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