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63
Salm. Typhi H to a titre of 1 /40.
Salm. Paratyphi A H to a titre of 1/160.
Salm. Paratyphi B H to a titre of 1/160.
It did not agglutinate:
Salm. Typhi O.
Salm. Paratyphi A O.
Salm. Paratyphi B O.
Brucella Abortus (Bang).
Vi-agglutination test: Negative.
At this stage the fact was accepted that this dishwasher was
a carrier of infection, and that her attack of Dysentery was probably
an attack of Typhoid. Except for the fact that no other case of
Typhoid had occurred either in her present or previous employments.
it seemed reasonable to conclude that the source of Infection
in this instance was due to her. As was ultimately proved, these
conclusions were wrong and premature.
Cultures from this carrier and from the patient were sent to
Colindale for Phage Typing—both proved on 24th February to be
a Type "K." so that there was relationship between the two cases.
An interesting and important fact was reported by Colindale—it
was that their records showed no other recorded case of Type "K"
in this country, except for one at Wincanton in 1942. Enquiries
made in 1947 by Colindale. showed that this patient had been a
transient visitor at the premises in Bromley for two nights prior to
her attack of Typhoid in 1942. There were no cases of Typhoid in
Bromley at that time. It was obvious from this Colindale Report
that the conclusions arrived at with regard to the "dishwasher
carrier "were to be negatived, and that within the premises there
must be a long time resident carrier of Type "K" Typhoid. There
were four persons still resident who were there in 1942. The Proprietor
and his wife, the cook, and one other occupant. On this
information, further stools, urine and bloods were taken. Those
from the proprietress proved positive to Typhoid and her blood
showed:—
Widals Typhi H plus 1/160.
Typhi O plus 1/20.
Vi-agglutination positive 1/10.
On close enquiries, the proprietress admitted that she had had
Typhoid when resident in India in 1935. but that she had forgotten
the incident until recently reminded of it by her daughter. Typing
of her culture at Colindale showed that she was Type "K." Stool
samples were not enforced from her in the first instance owing to
Ihe early discovery of the "dishwasher carrier."
It is surprising that a chronic carrier of Type "K" Typhoid
since 1935 who had been a proprietress of residential premises since
1938 had not infected anyone except one person in 1942 who was
a transient visitor for two nights, and a patient in 1953, who had
been in actual residence since the beginning of 1938.