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16
ENTERIC FEVER.
ENTERIC FEVER.*
Since 1901 this disease has decreased in prevalence in the Borough, the cases recorded
during the last six years having been in 1901, 92; in 1902, 84; in 1903, 46; in 1904, 48;
in 1905, 46; and in 1906, 35, the lowest on record. I he average number of cases occurring
in each quarter during the last ten years has been:—
1st Or., 14 ; 2nd Qr., 10; 3rd Qr., 19; and 4th Qr., 28,
which figures compare with 5, 7, 6, and 17 respectively for last year. A comparison with the
averages for the past five years is given in Table 12. In Harrow Road Ward only were the
cases reported last year (11) in excess of the quinquennial average (8). From Table 6 it
appears that the disease was slightly more prevalent last year in Harrow Road and Church
Wards than in 1905. A small outbreak in connection with one of the local institutions was
responsible for 3 cases, out of the 35 notified.
Last year's morbidity rate for the Borough (0*22) is practically half the mean rate for
the five years 1901-05 (Table 4) and, with the exception of that of Kensington (0*21), the
lowest of the rates included in Table 7.
Multiple cases occurred at two (2) houses last year, one house having two (2) cases and
the other three (3) in two (2) families. In 9 instances the fact of the infection having been
acquired outside the Borough was more or less (generally the former) clearly proved, in
addition to which there were several cases of patients who were in the habit of having
meals in other parts of the Metropolis, but in connection with whose cases no history of any
infection could be obtained. One of the 9 cases was connected with a small milk outbreak
at a Hydro in Scotland. One patient contracted the disease while nursing. In one instance
only was any history obtained of consumption of shell-fish (mussels).
Twenty-six of the patients, including 3 cases erroneously diagnosed as enteric fever,
were removed to hospital for isolation (Table 13), equal to 74*2 per cent, of all cases notified,
as compared with a mean of 67*7 per cent, for the preceding five years (Table 14). The
fatality of the disease, both at home and in hospital, was above the mean (Table 14), but the
former was strikinglv above the latter.
There were 8 deaths during the year from this disease, but one death was that of a
patient whose case was reported during 1905. The mortality was equal to 0*05 per 1,000
persons. The Registrar-General gives the total number as 7 equal to a rate of 0*04, which is
higher than anv of the rates mentioned in Table 10. Correction for sex-age composition
of the populations makes no difference in the order of magnitude of the rates (Table 15).
Personal Infection.—The following notes of a small outbreak of enteric fever in
connection with one of the institutions in the Borough will be of interest in continuation
of the remarks made in the last Report (pp. 25, 26) on the spread of the disease by personal
contact :—
On October 1st, C.G., f., cetat. 24, probationer nurse, was reported ill with enteric
fever.
History.—C. G. returned to duty after her holiday on August 21. She worked in the Surgical Ward,
the only one then open. She was taken ill on September 22nd, and removed to King's College Hospital
on the 29th.
*In accordance with the practice of former years, cases certified as "Simple Continued Fever" are included
under "Enteric Fever." No case of either typhus or relapsing fever has been reported in the Borough for several
years.