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Smallpox
There were no cases in Haringey in 1967, though two were suspected of having the infection in
May. Fortunately investigations did not confirm our fears.
During the year 24 persons without international certificates entered or re-entered the country and
came into Haringey from areas where smallpox is deemed to be endemic. Each was kept under
surveillance for 14 days and remained in good health throughout this period.
Typhoid Fever
This disease has kept us quite busy during the year. Foreign travel has played a large part in its
origins. Much of our work involved investigating members of parties who have been abroad, one of whom
developed the infection. For example, we took specimens from a Haringey resident who had been on
an adventure tour in North Africa. A member of the same party from Scotland had been unfortunate
enough to develop both typhoid and malaria. Luckily we found no evidence of either disease. There
was also some perplexity over a patient born abroad who showed serological evidenceof typhoid, but
from whom no organism could be isolated. It was eventually concluded that there had been an infection
in the past from which she had recovered, leaving traces of antibodies in her blood, while the fever for
which she was admitted had had another cause.
Our most difficult investigation began with a report from another borough that customers at a cafe
hadbeen taken ill with typhoid, and that the source of the infection had been shown to be aresidentof
Haringey, was a cook in the establishment and had been shown to be a chronic carrier. This individual
was admitted to hospital, but it proved impossible to clear up the infection which had evidently been
present since an attack of typhoid abroad about twenty years before. A puzzling feature was that the
close relatives of this carrier appeared to have escaped the disease, probably owing to the patient's
high standards of personal hygiene; but this of course left the question why these standards should
suddenly have slipped. No answer to this was ever found, but the patient gave an undertaking never
to cook or handle food outside the immediate family circle in the future, and the immediate problem was
solved.
Not long afterwards the hospital informed us that five months previously they had admitted from
yet another borough a patient suffering from typhoid infection of a strain closely resembling that found
in our own case. Both had had degraded Vi-strain organisms, a classification meaning that they were
impossible to identify exactly; but while we could not be sure they were the same, the coincidence of
their appearance in two adjoining boroughs could not be ignored.
Enquiry at once revealed that the families were known to one another. An investigation was then
undertaken into their movements over the preceding months. Although this may seem a task, there was
no shortage of clues. What seemed to be the crucial meeting had taken place a fortnight before the
patient intheother borough had taken ill. This fitted in well with the incubation period of the disease;
but the curious thing was that there was no evidence that food had passed between them. Their only
contact had been a handshake. We reached the conclusion that this had probably been the means by
which the infection had been passed on.
Paratyphoid Fever
A case occurred during the year involving a tourist who had just returned from a car tour to the
Levant. The disease was also suspected though not confirmed beyond doubt in a patient in a local
hospital. A family, all of whom had been treated in hospital for the disease, moved to this Borough,
and the Department completed the investigations which showed they were clear of the infection.
Food Poisoning
There is a si ightly disenchantedair in the Health Department where summer holidays are concerned.
While others plan for days of unalloyed delight on far-off southern European beaches or still remoter
strands, we tend to think of the stomach troubles that might plague them there or come back with them;
and if we are going in the same directions ourselves we take careful precautions to know what foods to
avoid and also put ourselves on courses of tablets to prevent these illnesses. It must be conceded,
however, that the majority of the infections that came to our notice this year, Salmonella typhimurium
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