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31
By the kind co-operation of the medical department of the
Local Government Board 1 was enabled to have specimens of
the excreta of the discharged patient and three other members
of the household examined by Dr. Ledingham of the Lister
Institute. In no instance however was the bacillus of enteric
fever discovered. Possibly one of the inmates of the house
may be an intermittent " carrieri.e., a person who harbours
the germs of the disease but only voids them intermittently. It
should also be noted that the premises were in a neglected
condition and it is quite possible that some of the contents of
the room may hare been infected by the first patient and not
subsequently submitted for disinfection.
Group 3.—Ivy " B." failed with enteric fever on September
9th, and was removed to the Borough Hospital on September
21st. Ellen " B.," aged 12, failed on September 30th. Albert
" B.," aged 3, failed on October 2nd. The intervals between the
removal to hospital of the first case and the onset of the second
and third were respectively nine and eleven days. These
periods correspond with what is known as to the incubation of
enteric fever and this group may therefore be regarded as
an instance of personal infection.
Group 4.—Mrs. " Z." (case I.) aged 25 and her brother
"R. H." (case 2), aged 19 failed with enteric fever on August
29th. " R. H." was admitted to the Borough Hospital on the
15th September but Mrs. "Z." was too ill to bear removal.
" G. H." (case 3), aged 18 failed with enteric fever on September
10th and "V. Z." (case 4), aged 27 on September nth. Cases
three and four may easily have acquired their infection from
case one or case two. Special interest however attaches to
cases one and two for the following reasons :—Mrs. "Z." (case 1.)
only arrived in Croydon on August 21st and as she failed on the
same day as her brother who had not been out of Croydon,
there is very great probability that both case one and case two
were infected in Croydon on or about the date of her arrival as
the incubation period is rarely less than eight or nine days. In
spite of the most careful enquiry into the food supply of the
house, no history could be obtained of the consumption of any
article of diet likely to have caused infection. Moreover " R. H."
was almost bedridden and was therefore only occasionally brought
into contact with the outside world. Further careful investigation
was therefore made into the past history of the other
inmates of the house. These were six in number and none of
them were known to have previously suffered from enteric fever.
Excreta of all six were examined on two occasions by Dr.
Ledingham but in no instance could the enteric fever bacillus
be found. It is however interesting to note that one of the six
inmates formerly lived in India., where he had suffered in 1907