London's Pulse: Medical Officer of Health reports 1848-1972

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Lambeth 1966

[Report of the Medical Officer of Health for Lambeth Borough]

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31
TYPHOID FEVER
1. On 15th February, 1966 information was received from a local hospital that
a female patient, Miss M.T., resident in the Borough had been diagnosed las
suffering from typhoid fever, and removed to an infectious diseases hospital.
A visit was made to the patient's home address and it was ascertained that
she had moved there from another address in the borough about a fortnight ago,
and had been ill before leaving there.
The patient's sister stated that the landlady at the latter address had been ill
a few weeks previously.
It proved very difficult to get specimens from this latter household, and the
first specimens obtained from all the occupants were negative for S. Typhi, as
were sewer swabs. All subsequent specimens from the household were negative,
with exception of one obtained on 19th March, from the landlady, Mrs. M.B. who,
at that time was feeling ill. She was removed to an infectious diseases hospital,
and the history of her case is given below.
All other contacts both at the home and in hospital proved negative to S. Typhi.
She made a slow but good recovery, and was discharged home on 19th April,
but was taken ill again on 25th April, and was found to be excreting the typhoid
organism. Her condition again improved after treatment, but as it was felt that her
gall-bladder was the reservoir of infection this was removed, and she made an
uneventful recovery and has remained free from the disease ever since.
2. As stated above, Mrs. M.B. was a contact of the above case, but as she
gave a history of previous similar illnesses, it was felt that she in fact was the
source of the disease for the previous patient. The course of this case was
similar to that of the previous one, as the infection did not clear up until her gallbladder
was removed. Both of these cases were infected with the same strain of
S. Typhi (phage-type 45) which is prevalent in the West Indies, whence both of
these ladies came.
3. This case of typhoid, Miss E.G., was diagnosed, in the same hospital as
the first case reported, on 25th February, but must have been from another source
as the strain of organism - type E.l. - was different.
This lady lived with her sister, but had quite a number of meals out, but
generally patronised the same establishments. She had not been abroad in the
period prior to the onset of her illness. None of her contacts, or the staff of the
restaurants she frequented, were found to carry the organism, and swabs in the
sewers also proved negative, so that the source of her infection was not found.


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