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82
Report of the Medical Officer of Health.
him to let me have particulars of where the cockles were obtained
and how they were cooked and stored before being sold at
Billingsgate.
Of the 22 cases due to eating shellfish one was presumably
due to eating mussels, one to winkles, six to cockles, and 14 to
oysters.
A copy of the report made with reference to infection from
eating cockles was sent to Dr. Collingridge, Medical Officer of
Health for the City of London, and he instituted inquiries, the
result of which are contained in a special report made to the
Corporation of London.
The result of the bacteriological examinations made by Dr.
Klein show that most of the shellfish obtained in the Thames
estuary contain bacilli similar to those existing in sewage, and
in some instances bacilli resembling the typhoid bacilli were
isolated.
With regard to the causation of Enteric Fever from eating
oysters, it has been a most difficult matter to trace the source of
the oysters, as before being sold in this neighbourhood they
frequently pass through the hands of two or three dealers.
In only one of the cases were the oysters definitely traced to
their source, viz.:—Emsworth.
It was about the same period as the outbreak in Southampton
due to eating oysters from the same source.
Of the 22 cases due to shellfish, five were fatal, two of those
infected by cockles, two by oysters, and one by mussels.
In a large proportion of the cases it was impossible to ascertain
whether the patient had eaten shellfish, but personally I am of
opinion that a considerable number of the untraced cases were due
to this cause, as it is extremely difficult in cases which are removed
to hospital to get definite information from the occupiers of the
house.
The chart shows that the maximum number of cases were
notified in October and the minimum in January.