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48
Typhus Fever.
In the list of cases of infectious disease notified, reference is made to one of
typhus fever, and as this condition is rare nowadays and commonly regarded with great
seriousness, the following report with regard to it, submitted to the Public Health
Committee at the time, may be of interest.
"The patient, a woman named Mrs. Annie Marks (otherwise Pisetsky), aged
40 years, and residing at No. 6, Charlton Street, was first taken ill on the evening of
Saturday, 19th November, 1922, with shivering and general malaise. On the Sunday
she attempted to get up, but had to go back to bed again, the symptoms being more
or less the same. The first time I saw her was on the night of Thursday,
23rd November, when I was asked to give an opinion as to whether or not she was
suffering from smallpox. I decided that the case was not one of smallpox, and
accepted the statement of the medical man in attendance that possibly the condition
was pneumonia and influenza. On Friday, 24th November, I was informed that the
woman was still ill, and on the Saturday, Dr. Young, one of the physicians at the
Middlesex Hospital, was called in consultation, but did not suggest removal. He
saw her again on Sunday morning, and apparently then began to have suspicions that
the patient might have typhus fever. He arranged with the Resident Medical Officer
of the Middlesex Hospital to admit her to the isolation ward at the hospital, and this
was done. I was not informed that she had been admitted until Monday evening,
27th November, when I went down and had a look at her. Being unable to convince
myself that the condition was, in fact, typhus fever, I asked Dr. Brincker, of the
London County Council, to see her with me, and eventually, after a consultation with
Dr. Goodall, of the North-Western Fever Hospital, I arranged that she should be
notified as suffering from typhoid fever and admitted to the North-Western Hospital.
Here she was kept under observation, and eventually, on Friday, 1st December,
Dr. Goodall informed me that from the course of the illness he must conclude that
the case was one of typhus fever. I visited the hospital on Sunday, 3rd December,
and found the patient to be well on the way to recovery, and on the 20th December,
being well enough to return home, she was discharged. Judging from the
temperature chart the patient must be regarded as having suffered from some form
of poisoning, and having regard to the symptons and course, though by no means
typical, I cannot see that Dr. Goodall could arrive at any other conclusion than that
the poisoning was due to the organism of typhus fever. Little or no assistance was
obtained from tests applied to the patient's blood.
The house, No. 6, Charlton Street, is an ordinary tenement house. All the
rooms, and particularly those occupied by the patient, were extraordinarily clean for
that type of property. The family contacts were all admitted to the Shelter in
order to permit of disinfection being thoroughly carried out, and, this having been
done, I induced the landlord to have the rooms stripped and re-papered.
Particulars of all contacts engaged outside St. Marylebone were notified to the
medical officers of health of the respective districts, and details of the case forwarded
to the Medical Officer of Health of the London Counry Council, and the Ministry of
Health.
In conclusion, I have only to add that the case has been a rather obscure one,
and, despite exhaustive investigations, I have been quite unable to discover anything
as to the possible source of infection. Up to the present no other case suggestive of
typhus fever, either in the patient's family or in the neighbourhood, has been noted,
which may be due to the fact that as soon as it was suggested that the case might be
one of typhus fever, all the preventive measures commonly applied in this disease
were immediately put in operation."
Infectious Diseases in Schools.
The accompanying table shows the number of cases of measles, whooping
cough, chicken-pox and the notifiable infectious diseases reported from Schools
during 1922. During the year in certain of the schools, one or more classrooms
were closed on account of measles.