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59
Circumstances existed in this incident that would allow of
widespread infection, and I believe that had we not discovered
the carrier of the infection, a serious epidemic might have
arisen. The circumstances that gave rise to this danger were:
(1) The long period before diagnosis could be established—
September 23rd to November 11th. (2) The large number of
persons, both at home and at the school exposed to the infection
for a lengthy period and not limited to Bromley residents. (3)
The virulence of the infection which led to the boy's death.
(4) The fact that the carrier, a resident maid, was for a period
of three weeks employed in the preparation of food for family
and guests.
From the period September 23rd to October 23rd, the case
attended school, except for seven days spread over that period.
His brother, aged 17 years, had a minor illness for four days at
the end of September, and has been proved, following bacteriological
investigation, to have had an abortive attack.
The carrier was of Public Health interest. She gave no
history of illness since she had German Measles nine years ago.
For a year prior to coming as a resident maid on September 13th,
she had been a Naafi Superintendent and had a week's holiday
in Northumberland before coming to Bromley. In neither place
was there any Typhoid. Blood and stools which were taken
from this girl on November 17th showed her to have Typhoid
bacilli of the same type and character as the bacilli of the case
that died. She was therefore either an active case of typhoid
without symptoms, or a carrier. There was presumptive evidence
that she was a carrier and the cause of the infection. It is
significant that she went to the home on September 13th and
within three weeks one acute typhoid and one abortive case
arose in the family. Further tests taken from her confirmed her
as a carrier and not a patient. On discovering the typhoid
bacilli in her stools she was admitted to the Isolation Hospital
where she now is and remains an active carrier.
It is the responsiblity of the local authority to inform her
officially that she is a carrier and while she remains so, must
not be employed in the handling or preparation of food. Should
she take her discharge from hospital and become employed
in food handling, her employers must be so informed that she
is a carrier. So far as I understand the law, there is nothing
to stop her taking her discharge and seeking employment elsewhere
in the country and it may be difficult to control her
movements should she act in defiance of the advice rendered
to her. As she is an unmarried mother, I have advised Sister
Papps, who has an interest in the girl, that she should not be