View report page

37
August and September in the neighbourhood of Ferdinand-place, St. Pancras, of which fourteen
appeared to be due to infection from an antecedent case, but explanation, after careful inquiry, was
wanting for the others. Dr. Reginald Dudfield states the number of instances in which multiple
recognised cases occurred in houses. Thus, there were two houses with two cases in each, one
house with three cases, one house with four cases, and one house with five cases.
The statements made in the annual reports as to the number of persons attacked who shortly
before their illness had eaten articles of food which come under suspicion as a possible cause may be
thus summarised:—
In Paddington, watercress and winkles in one case, and oysters in two cases. In Kensington,
shellfish in a few cases, oysters in seven. In Fulham there was strong ground for suspecting shellfish
in two cases. In Chelsea in one case the consumption of oysters at Yarmouth was regarded as the cause
of the illness. In Westminster in four cases there was direct evidence of probable infection from shellfish,
and Dr. Allan heard of persons in other boroughs attacked after eating shellfish in Westminster. In
Stoke Newington in one case the evidence pointed to watercress. In Holborn one case was attributed
to the eating of raw cockles at Whitstable, another to raw mussels, one was probably due to eating
oysters, two had eaten fried fish, and one watercress. In Finsbury nine persons attributed their illness'
to shellfish. In Shoreditch a woman developed enteric fever after eating cockles with a friend at Southend.
This woman's husband was employed by the friend's husband in London, and the friend's husband
and probably her son also subsequently developed enteric fever. In Bethnal Green eight persons who
were attacked were in the habit of eating shellfish, seven fried fish, three ate watercress, three ice
cream, one mussels and fried fish, and one watercress and fried fish. In Poplar, in twelve cases
eating of shellfish was suspected, and in two of these cockles had been eaten at Southend. In
Bermondsey shellfish had recently been eaten in three cases. In Lambeth in twenty-three cases
there was a history of shellfish having been eaten from one to three weeks before attack. In
Battersea there was reason for suspecting shellfish in six cases, viz., oysters in four cases, cockles in
one, and mussels in one case. Of the above, two patients had eaten Emsworth oysters, and one mussels
from Leigh-on-Sea. In Wandsworth shellfish had been eaten in eleven cases, watercress in five, and
ice cream in two cases. In Camberwell it was possible in some instances to ascribe infection to cockles
or other shellfish, and in others ice cream had been eaten. In Deptford, infection was thought to be due
to the eating of oysters in two cases, and mussels in two cases. In Greenwich, suspected articles of
food had been eaten at about the critical period in thirteen cases, viz., shellfish five (one oysters, and
another cockles at Southend), one fried fish and winkles, one fried fish and stewed eels, two fried fish,
three mackerel, and one eels and haddocks. In Woolwich one had eaten oysters at Dinard, one oysters
and mussels, two mussels, three had eaten watercress, and two were in the habit of eating fried fish.

The seasonal prevalence of the disease in 1904 may be compared with that of the period 18901904
by reference to diagram XV. The sharp rise in the 34th-39th weeks in 1904 is largely due to
increase in the number of cases of the disease in Hackney.
Enteric fever—Age mid sex distribution.
The following table shows the cases, deaths, case-rates, death-rates, and fatality of enteric fever
at the several ages and for each sex in London during the year 1904. The case-rate at "all ages" was
greater among males than among females, as were also the death-rate and fatality. In the age-groups
adopted for the purposes of this table the greatest incidence of attack was upon both males and females
aged 10-15. The greatest incidence of death was upon males aged 25-35 and upon females
aged 20-25. The fatality was greatest among males aged 35-45 and among females aged 55 and
upwards.
6108] f