View report page

61
knowledge, but the medical men in attendance did not feel justified in
notifying it as a case of typhoid fever.*
" All those attacked were young persons, and on enquiry it was elicited
that all of them had been to Southend-on-Sea or Southwick (a small
seaside village between Brighton and Worthing) for a fortnight. Of these
eighteen cases, seven had been to the former place only, one to Southwick
only, and ten to both places. All those who went to Southend bought
and ate cockles from itinerant vendors, and, with one exception (a boy
who went to Southend also), those who went to Southwick picked up
mussels and ate them—in some cases taking them to their lodgings to
be cooked, but in a good many instances the mussels were eaten raw.
In the one exception, although the boy did not eat mussels at Southwick,
he had eaten cockles at Southend, and the interval between so doing
and falling ill was not too long to preclude the cockles as the source of
the disease, but he had been constantly in the water bathing or paddling
at Southwick, and had assisted other boys in collecting mussels. From
enquiries I have made, there is no doubt that infection through the
medium of infected shellfish might be contracted at both the places
mentioned. The cockles sold in Southend came from Leigh, and I
described in my Annual Beport for 1901 the condition under which this
industry is conducted, and the Jenner Institute was able to demonstrate
in cockles brought from Leigh the presence of the bacillus which causes
typhoid fever. Dr. Xash, the Medical Officer of Health of Southend,
attributes cases in that borough to the same cause, and in a paper read
at the recent Congress at Manchester stated that he had ascertained
that several cases of typhoid fever had occurred in the district supplying
the sewage which falls into the creek, on the banks of which the cockles
are laid. Dr.-Xash informs me that steps are being taken to move the
site of the cockle-layings to another part of the foreshore at Leigh where
there is less chance of pollution.
"Dr. Klein has made some investigations on behalf of the Local
Government Board, and he reports (30th Annual Beport of the Local
Government Board, Medical Officerper cent.s Supplement for 1900-1) that the
recovery of the typhoid fever bacillus was easily achieved from the
interior of cockles that had been subjected to water infected therewith,
even when this infected water had been replaced for three days by clean
sea water, and that, moreover, this was the case even with cockles, of
which the shell and outer surface of the animal itself had been subjected
to the influence of boiling water, as in the method of preparing them
*Two other notified eases also form part of this group, and a non-notified one in a
married sister of a patient, both of whom had eaten cookies purchased in Southend and
brought home by their mother. The sister was confined, and subsequent thereto had a
high temperature for some time without any puerperal cause for it.