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A seven months old baby was admitted to Coppetts Wood Hospital at the end of September suffering
from typhoid fever, and responded to treatment. Investigations in the home, a multi-occupied house,
revealed that his father was a likely source of the infection. A "fever" in the West Indies nearly twenty
years previously is thought to have been the origin of his typhoid carrier state. He, too, was treated in
hospital, apparently with good result. The mother showed signs of having been infected in the past, but
she, the remaining children and all the other inhabitants of the house were free of the disease. The
family later moved to an address elsewhere in the Borough.
The staff of the Health Department were also employed in the investigation of the contacts of typhoid
cases in other local authority areas. As the result of an outbreak in a ward of a hospital in an adjoining
borough, 65 people-discharged patients, staff, voluntary workers, relatives and friends-living in Haringey
were followed up and found to be clear. 37 residents of this Borough who may have been contacts of a
case in a seaside resort, were also investigated and shown to be negative.
It is not without significance that the three cases that occurred in Haringey all originated abroad.
The greater popularity of foreign travel is likely to increase this danger in future, especially since this
disease is not regarded as seriously in some countries as here. The kind of difficulties that can arise
is illustrated by an incident that occurred in October. A woman telephoned the Health Department to say
that her husband, who had flown to France the previous day, was in a hospital with suspected typhoid.
Since typhoid is not an internationally notifiable disease, a letter, written in French, was sent to the
hospital concerned, asking if this was correct. Meanwhile, the family were followed up as typhoid contacts.
The hospital's reply stated only the date of the patient's admission and discharge, by which time he had
returned home. Fortunately, he was found to have in his possession a copy of a letter to the doctor who
sent him into hospital. This was translated and a copy sent to his general practitioner. It stated that
typhoid and Malta Fever were suspected but not confirmed, and that he recovered after treatment. Our
own investigations were subsequently negative. Evidence was obtained that he might have been infected
while on holiday in the South of France during the summer, and this was sent to the French authorities; but
there is no information as to whether this was followed up or not.
While the risk of catching typhoid abroad is small, it is not insignificant, and the temporary
inconvenience of T.A.B. injections is well worth while as a protection, especially if visiting Southern
Europe or more distant places.
Dysentery
Bacillary dysentery caused by Shigella sonnei is a common, but usually mild infection. Many cases
are not notified and there are numerous symptomless carriers.
A Haringey contact of a typhoid outbreak in a hospital in a neighbouring borough was discovered to
be a carrier of a dysentery organism, Shigella flexneri.
Smallpox
There were no cases this year, due no doubt to strict international control of the disease, although
the advice of the Medical Officer of Health and his deputy was requested by general practitioners in a few
instances where it was suspected. The vaccination rate is still too low, and anxiety must remain whenever
a case occurs. International air travel has been blamed a good deal for the increase in this menace, but
one wonders why this fact has never been used to advantage. A five hundred seater aircraft will be flying
inafew years, and holidays on other continents will be financially possible for most people. Is this not
then an opportunity to remind parents that many countries will not admit travellers who have not been
vaccinated, and that the most suitable age is between one and two years?
Malaria
A woman recently arrived from Ghana was admitted to hospital suffering from malignant tertian malaria.
We were asked to follow up in Haringey some members of a party who had been on holiday in Tunisia.
Another member of the group, living elsewhere in London, was suffering from Malignant tertian malaria.
Fortunately, there were no further cases.
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