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Typhoid Fever
On the 8th August, 1969 a Hornchurch man who had been working in an
Hotel in Tangier returned to Barking with his mother, father, sister and
younger brother who had been to the hotel on holiday. He had a temperature
and had been ill since the 10th July, 1969.
On the 9th August he reported to his Local General Practitioner who
found his condition satisfactory.
On the 10th August this man returned to his own flat in Hornchurch
which he shared with two friends.
On the 17th August his mother found him ill when she paid a visit to
the flat, and she persuaded him to return to the family's home.
On the l8th August his General Practitioner, finding no obvious
symptoms, decided to send him for tests at a local hospital.
On the 24th August the hospital tests proved positive - Salmonella
Typhi, and the General Practitioner ordered immediate hospital isolation.
The emergency system brought the assistant Medical Officer of Health and
the Deputy Chief Public Inspector to the hospital within an hour and all
persons at risk were investigated. Tracing of contacts was an enormous
job involving hundreds of holidaymakers who visited the hotel in Tangier,
the passengers on the homecoming journey, in addition to family, friends,
home contacts and neighbours, one of whom worked in an ice cream factory.
No secondary case was notified which may be due to luck and the
patient's high standard of personal hygiene.
While all aspects of a thorough investigation were quickly put in
hand, it is alarming to record that several frustrating delays were encountered
in the tracing of contacts.
The names and addresses of persons staying at the hotel in Tangier
during the risk period were not readily available although they comprised
organised tours run by a large British Company. This Company could only
supply the names of the holidaymakers and the Travel Agents who had booked
the holiday. As a result, the department had to contact more than one
hundred Travel Agents all over the country by letter and telephone to obtain
the home addresses of these clients.
To add to this difficulty it was found that some Travel Agents were very
reluctant to disclose the necessary information even when the urgency of
the situation was explained.
Delay was again experienced when the air-line whose aircraft ferried
the patient to Heathrow was asked for details of the other passengers on
the flight. No list was available in this country and a time-consuming
telex was made to Morocco to obtain the information.
This is most unsatisfactory and could have resulted in a very serious
and widespread outbreak.
Since more and more people are now taking holidays abroad the time has
come for a thorough re-appraisal of the situation. Information concerning
holidaymakers who have had contact with a confirmed case of infectious disease
abroad should be readily available to Health Authorities where speedy action
is vital.
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