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London County Council.
Public Health Department,
Spring Gardens, S.W.,
19th November, 1895.
Report by the Medical Officer, presenting a Report by Dr. Hamer
on a recent outbreak of Enteric Fever in Plumstead.
{Printed by order of the Public Health Committee, 11th November, 1895.)
In presenting Dr. Hamer's report on an outbreak of enteric fever in Plumstead, due to an
infected milk supply, I may point out that interest attaches to this outbreak especially because the
-dairy from which the milk was derived was supplied with water from a source which there is no reason
for thinking was contaminated. Inquiry into all the circumstances of the dairy failed to throw light
upon the cause of the milk acquiring its infective property. But although the result of the inquiry
was completely negative, there is advantage in putting the history of this occurrence on record,
inasmuch as an account of the actual facts observed may possibly prove useful to future investigators.
Appended to Dr. Hamer's report is the report of Dr. Klein on samples of water from certain ditches
which served for the supply of a cow antecedent to her removal to the dairy, and on the milk and the
condition generally of this cow.
Shirley F. Murphy,
Medical Officer of Health.
Dr. Hamer's Report.
On May 14th a letter was received from Dr. Sidney Davies, medical officer of health of
Plumstead, stating that an outbreak of enteric fever had occurred in his district, 18 cases of this
disease confined to a limited area having come to his knowledge since the 9th of May. Dr. Davies
wrote, "the information at hand points to the milk supply as the source," and he added that he was
taking steps to stop the supply implicated. I saw Dr. Davies on the afternoon of the same day,
May 14th, and in company with him visited the premises of the vendor whose milk was under suspicion.
At these premises, situated in Princes-road, Plumstead-common-road, 12 cows were kept, and the milk
of these cows was the only milk distributed by the vendor. Dr. Davies informed me that there was a
special incidence of the malady upon consumers of this milk, and that a meeting of the Public Health
Committee of the vestry was to be held the same evening to decide what action should be taken in the
matter. At this meeting it was decided, in accordance with the terms of section 71 of the Public
Health (London) Act, 1891, to serve 24 hours' notice on the dairyman, to show cause why an order
prohibiting the sale of milk from his dairy should not be made. Such an order, bearing date
May 15th, was ultimately served upon him.
On the 18th May, however, it was found that milk was being distributed by the Princes-road
vendor, and a summons against him was accordingly applied for by the vestry. Difficulty at first
arose in connection with proving that the defendant was "selling milk from the dairy," but ultimately,
on May 20t.h, at the Woolwich Police Court, the vendor was convicted and fined £5 and £2 2s. costs.
After this occurrence no more milk was supplied from the dairy as long as the cows remained
at Princes-road. On the 28th May, however, the 12 animals were sold by auction, and were removed
from the premises.
The results of inquiry into the circumstances of the outbreak may be set out under the following
heads—
The extent and duration of the outbreak.
During the early part of 1895, Plumstead was comparatively free from enteric fever, as although
five cases were notified in January, the number had fallen to one in February, and no cases at all were
reported in March or in April. It may be noted that the January cases and the February case were
notified from houses not situated within the limited area already referred to. Early in May it became
apparent that an outbreak of the disease was in course of development; the first case was notified on
May 7th, and was followed by two more cases on the 10th. The number of notifications per day speedily
reached its maximum, viz. 12, this number being recorded on May 16th. By the end of the month
the number of notifications per day was beginning to show a tendency to decline, but it was not until
after the middle of June that the outbreak was manifestly at an end. For some weeks after this time,
although there was no longer an epidemic prevalence of enteric fever, the number of cases notified was
greater than is usual at the time of year in Plumstead.
In a special report on this outbreak, dated 20th August, Dr. Davies estimates the number of
cases occurring between the commencement of the outbreak and the 30th June, at 177, of which 159,
or 90 per cent., were found to have had milk from the Princes-road dairy, or from other dairies which
supplied the same milk. With a view to testing the extent to which consumers of this milk had been
effected, Dr. Davies made a house to house inquiry in Barnfield-road and Princes-road, two roads
particularly affected by the epidemic, and found that "of 49 houses which had had milk from the
Princes-road dairy, only 20 escaped having a case of enteric fever," while on the other hand "only
two had the fever out of 150 houses which were stated not to have had this milk."
Sold by Edward Stanford, 26 and 27, Cockspurstreet, Charing-cross, S.W.
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