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29
Another case had been staying at Ramsgate in the last
week in September and had eaten cockles there. She was taken
ill in the second week in October, and notified on October 19th.
It is now generally held that the consumption of shell fish
derived from polluted sources plays an important part in the
causation of Enteric Fever. In the light of evidence already
available there is reason for believing that much Enteric Fever,
the source of which is still unrecognised, and in particular
Enteric Fever occurring apart from considerable outbreaks, will
eventually be traced to the consumption of contaminated shell
fish.
Three cases were notified from the same honse in Shaftesbury
Road in October. The children had been ill since the first
week in October. They had all eaten some shell fish which
had been given away by a fish hawker in the street. The
hawker was in the street on the first and second Sundays
in September, and on one of these Sundays he had some
winkles which he was unable to sell, and these he had given
away.
In last year's report details were given of cases in which
the possible source of infection was plaice, and Dr. Hamer's.
report to the London County Council on the subject was quoted.
Dr. Hamer analysed the facts as to certain localised prevalences
of Enteric Fever in London in 1910, and arrived at the
conclusion that they were best explained on the hypothesis that,
these groups of cases were due to the eating of contaminated
fried fish. It was suggested that the small plaice (commonly
imperfectly gutted) brought their infection with them, possibiy
from the estuaries in which they may have been caught. If
this be the explanation, the temperature attained in some portion,
of the interior of the fish during frying must be much lower
than is popularly supposed. The report is important as drawing
attention to an additional source of typhoid infection, and as
indicating the need for further supervision over the source and
the gutting and over the details of preparation of fried fish,
for food.