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37
On September 7th, on making my routine inspection, 1
found a lad R., age 20, suffering from enteric fever, be bad
only taken to bis bed that day although he had been feeling
unwell for a week, and had continued at his work. He was
at once removed to the Hornsey Hospital, where he suffered
from a most severe attack. This lad lived next door to 1.
A fortnight previously he bad visited a seaside resort for a
day, but I am of opinion that he contracted the disease from
the same source as the others.
On September 9th another case was notified, viz.: E.P,
age 4, and on September 11th W.P., age 7, was removed to
the Hornsey Hospital suffering from enteric fever. He is
brother to M.P., and grandchild to L., and lived in the same
house with them.
No further cases were notified till October 15th, just 5
weeks after the last case. On making a visit to the district
on this date I enquired why a child I saw wandering
about was not at school, and was informed that the parents
did not think she was well. Careful examination revealed
the fact that she was suffering from enteric fever. This case
is particularly remarkable in that this patient passed through
an attack of typhoid fever without having a rise of
temperature with the exception of a slight rise to 99 degrees
Fahrenheit one evening; in other respects her attack although
a mild one was quite typical. Apyrexial typhoid is well recognised,
but it is generally considered to be of great rarity ,
although probably during an outbreak of typhoid it is more
common than supposed, but seldom recognised. This case also
shews the great difficulty in dealing with outbreaks of enteric
fever, as, had she been an adult the probability is that she
would never have come under observation, but would have
been a fertile source of infection.
On October 17th a further case occurred, and was
immediately removed to Hospital, viz.: R.F. Over four