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Subsequent examination of tiie faeces, however, showed that their
excretions were infectious as late as January, 1909, and December,
1908.
Facts like these, together with investigation's made by Dr.
Davies, of Bristol, and a special enquiry set on foot by the Local
Government Board. have directed renewed attention to the subject of
personal infection. In respect, therefore, to every notified case,
enquiry lias been made as to whether any other inmate of the house
had previously suffered from enteric fever. In only one instance
'•ould we hear of such an occurrence. The facts are briefly as
follows :—
" T. J. V." failed with enteric fever on October 6th, 1908. No
clue to the origin of the disease could be found beyond the fact that
his brother had suffered from this same disease in July, 1902. An
endeavour was made to get his brother examined, but he refused to
submit. This family was living in the same house for nine years,
and a careful inspection of the premises revealed no insanitary
condition.
Attention was similarly directed to multiple cases occurring in
the same house. Of these we had five examples during 1908 : —
Grvup 1.—Mrs. " B." failed with enttric fevei on September
13th. On enquiry it was found that her husband had been
taken ill on August 28th and was under treatment at the
Croydon General Hospital. The staff at the Croydon Hospital
were then communicated with and a specimen of the husband's
blood examined, with the result that he was found to be suffering
from a mild attack of the same disease. Though the source of
the husband's infection could not be traced, there is little doubt
that the wife derived her infection from the husband.
Group 2.—Ernest " F." aged 34 failed with enteric fever
on September 21st and was removed to the Infirmary for
" influenza " on October 5th. He was subsequently found to
be suffering from enteric fever and was notified on October 16th.
On October 26th Elsie " F." aged 5 failed with enteric fever and
was removed to the Borough Hospital on October 30th where
she remained until December 31st. On January 4th, 1909,
Clara " G " occupying the upper floor of the same house failed
with the same disease. The association between these three
cases is obscure, the interval between the removal of the first
patient to the infirmary and the onset of the second case was as
long as twenty-one days, a period that renders direct personal
infection unlikely. The third patient failed four days after the
return home of the second patient from hospital. This period
on the other hand is so short that infection can hardly have
taken place from the discharged patient.