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37
70 cases were notified to the Council in the year; of these 53
were notified under the Public Health Tuberculosis Regulations
of 1908.
ENTERIC FEVER.
16 cases of Enteric Fever were notified, and two deaths occurred.
7 cases occurred in one house. Although these were notified at
different times, the history of the cases went to show that all the
cases were probably simultaneously infected. They first exhibited
symptoms about the middle of September. The mother and six
children were attacked, and the husband and the smallest child
were the only persons in the family to remain unattacked. None of
the accepted modes of origin of Typhoid Fever could be appealed to
for explanation, and the only article of food partaken of by these 7
and not by the husband and youngest child was plaice. The outbreak
was investigated by Dr. Hamer of the London County Council
in the course of his investigations into the prevalence of Typhoid
Fever in London and the surrounding districts during last autumn.
In the report issued by Sir Shirley Murphy submitting the
report of Dr. Hamer, it is stated that examination of the facts
concerning these localised prevalences (33 in all) failed to show in
each instance that any ordinarily accepted cause of Typhoid Fever
had been operative, but it was found that all sufferers contributing
to the excessive prevalences had partaken of fish (usually fried fish),
and that in all instances in which information on this head could be
obtained, small plaice belonging to the category described by fried
fish vendors as " late steamer fish," was in question. The chances
against such a combination of circumstances being the result of
mere coincidence were of course very great. Dr. Hamer draws
attention to the interesting fact, established by the enquiries
and reports of Officers of the Board of Trade, that much of
the small plaice sold at Billingsgate comes from an area in which
are situated certain " nursing grounds," not far from the mouth of
the Elbe, and he suggests as a possibility that estuary fish may be
in question.