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16
ENTERIC FEVER
In 2 of the 21 houses with three cases, and 1 of the 7 with 4, the patients were all kept at home.
From houses with 3 or more cases, 2 of the cases were reported on the same day on 11 occasions, and 3 or
more on 9.
In 16 houses occupied by 2 or more families infection spread from the first to a second family
In connection with 36 infected houses the infection was believed to have been introduced from beyond the
Borough, and in 5 other cases, allocated to houses in the Borough, the disease developed in hospitals.
On 32 occasions further cases occurred in households after the return of patients from hospitals, and in one
instance a similar occurrence followed the liberation of a patient from home quarantine. The last case gave
rise to three (3) cases, the 32 hospital discharges to 44 fresh cases, viz.
To one fresh case 26 times.
„ two „ cases 5 „
„ three „ „ once each.
„ five „ „ once each.
The cases ultimately found to have been erroneously diagnosed numbered at least 24.
The cases removed to hospital (536) constituted 92.5 per cent. of the total reported
(Table 13), as compared with 96.7 in 1906 and an average of 87.9 in the five years 1902-06.
From Church Ward all the cases were removed to hospital.
The fatality of cases treated at home was 2.3 per cent. (Table 14), as compared with
4.5 in the preceding year, and a mean 1.2 for the quinquennium. The fatality at hospital was
2.3 also, as compared with 2.4 in 1906 and 2.3 in 1902-06.
The nett mortality was at the rate of 0.08 per 1,000, 0.04 below that of the preceding
year, but 0.02 above the quinquennial mean rate (Table 14), while the corrected rate
(Table 15) was 0.10, 0.03 below the standard rate, but 0.02 above the mean corrected. The
corrected rates for the Metropolis (0.13), Marylebone (0.19), and Willesden (0.11) were above
that for the Borough, those of the other districts below. (Table 15).
ENTERIC FEVER.
The same numbers of cases of enteric fever (34) and of continued fever (1) were reported
in 1907 and 1906.* (Table 4.) The only Wards in which the cases reported during the past
year were in excess of the number in 1906 were Westbourne and Hyde Park. (Table 5.)
The annual average number of cases in the whole Borough during the five years 1902-06 was
52 (Table 12), the totals for each quarter of last year, except the first, being below the
corresponding average. In the fourth quarter of last year the cases reported (7) were just
one-third of the average. There was a complete absence of the autumnal increase in
prevalence of this disease, the cases reported in the third quarter (12) being in excess of
those reported in the fourth. In all the Wards last year's returns compared very favourably
with the averages for the preceding quinquennium.
The records of last year's cases present very little of interest. There were no multiple
cases. With regard to origin, 9 cases appeared to have been contracted outside the Borough,
some of them out of England. Positive reactions with the Widal test were obtained in 13
instances, including two cases which were clinically regarded as not enteric fever. Histories
of the consumption of shellfish were obtained from 4 patients (one each of mussels, oysters
and cockles, and one uncertain) and in 1 of watercress. In 2 instances death preceded
notification of the disease.
* "Continued fever" is deemed to be the same disease as "enteric fever."