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With the discovery of J.T. and R.N. the series ended, but further enquiries
were made with the object of deciding where and how J.T. herself acquired the
infection.
It has been noted above that at the time A.T. and C.T. were notified, J.T.
alleged that she had always enjoyed good health, and had not been at all out of sorts.
By the time the fuller investigation came to be made, however, she recollected that
between Christmas 1913 and April 1914 she had not really been always well.
About Christmas time she had suffered from weakness and fainting fits, and had
been treated as an out-patient at one of the neighbouring hospitals. At Easter she
was confined to bed for a few days with "influenza," one of the outstanding
symptoms being diarrhoea.
This history was regarded as very suspicious, and when a specimen of her blood
was submitted to examination, the suspicion that the attack was enteric fever and
not influenza was confirmed. In the case of R.N. the facts elicited were very
similar, and it is easy to understand how these two patients managed to infect the
remaining three patients, A.T., C.T. and T.W.M. The house in which they all
resided is a tenement one, and all the occupants are closely associated. There is,
further, only one closet, and all the time the patients were ill and suffering from
diarrhoea they used this' convenience. In the common washhouse all the clothing,
probably soiled and certainly undisinfected, used by the patients, was washed and
afterwards put to dry in the yard and passages, common to all the occupants of the
house. Very many opportunities to spread were, therefore, given to the germ. After
the unwillingness of J.T. to give information had been overcome, and here it may
be noted that distrust and a tendency to conceal information are nearly always met
with in these cases, it was easy to account for the majority of the cases.
The great difficulty came, however, when the source of infection in J.T.'s case
was sought.
In all there seemed to be three possibilities: (1) That it was the same as in
A.J.P.'s case, i.e., possibly contaminated food; (2) that it had been acquired outside
the Borough, and (3) that there had been another unrecognized case.
Each of these seemed not unlikely. The facts supporting (1) were that A.T.
and A.J. P. were ill more or less about the same time; the families lived fairly close
together, and led very much the same kind of life. As regards (2) it was found on
enquiry that prior to her attack of "influenza" J.T. had visited the home of a sister
in one of the suburbs to see a member of the family, who was ill at the time, and
who died soon afterwards. No definite information as to the cause of death was
obtainable from the Medical Officer of Health of the district or from J.T,