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FEVER. 25
In 1903 multiple cases occurred in 5 houses (4 houses, 2 cases; 1 house, 3). In two
instances direct personal infection was apparently the cause of the secondary cases.
(Page 24.)
In 1904 multiple cases occurred in 5 houses (2 houses 2 cases, and three houses with
3, 4 and 5 cases each). In 3 out of the five groups, all channels of infection except the
direct personal appeared to he excluded bv the inquiries made. (Page 2(5.)
In 1905 multiple cases occurred in one house only. The particulars were as follow:—
K. Y., f., æt. 7, returned to her home from Teignmouth on September 1st. She was
reported to have had shellfish (periwinkles, and possibly other varieties) whilst at the seaside.
She was certified to be ill with enteric fever (after a positive result with the Widal test) on
September 9th. The history given of her attack was that she had been ailing since
August 26th, and had taken to her bed on September 3rd. The patient was kept at home.*
A communication to the Medical Officer of Health of Teignmouth elicited the following
information:—"With regard to shellfish. The estuary of the Teign is polluted with the
crude sewage of some 30,000 (persons) and every year I hear of visitors apparently
contracting enteric (fever) by this means. Local cases are comparatively rare, though some
thirty per cent. of our few typhoids (sic) can be traced to the like cause."
On September 25, S. F., m., æt. 9, residing in the same house as K. Y., was reported
ill, and removed to hospital the same day. His case was erroneously diagnosed, although a
Widal test made before notification gave a positive result.
On October 18th, H. H., f., aet. 29—a district nurse—was removed to University College
Hospital, ill with the disease. She had been attending K. Y., and sickened October 15th.
An aunt of K. Y., in service in the country, whilst in Town for her holiday, assisted to
nurse the patient. The aunt was taken to a nursing home, after her return to the country
ill with the disease. She sickened about October 10th.
Disinfection after K. Y.'s illness was carried out on October 24th.
On October 14th, M. Y., f., æt. 42, K. Y.'s mother, sickened and was removed to
hospital on the 28th. She died on November 7th.

* The Medical Officer of Health was away on leave at the time.