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(3). A married woman, F. W., aged 26, was taken ill with typhoid fever
about May 24th. There is reason for believing that a fortnight
previously she had had oysters from a stall in Hoxton, but not the one
referred to above.
(4). A young man, A. J., aged 17, by occupation a tailor, was first noticed
to be ill on August 18th, took to his bed on August 22nd, and was
certified to be suffering from typhoid fever on August 29th. There was
no history of any recent illness in the house where he resided, which
was in very fair sanitary condition. He was at Southend on August 3rd,
and whilst there had cockles to eat. He brought some cockles home
with him, and a few of them were eaten by two persons in the house,
but the rest were thrown away as they were not considered to be quite
fresh. The two persons who ate of these cockles remained well.
(5). A school-girl, H. B., aged 10, was at Leigh, near Southend, from
August 1st to August 29th. On her return home she was noticed to be
ill about August 31st, took to her bed on September 2nd, was certified on
September 9th and removed to hospital the following day. Whilst at
Leigh she ate cockles on numerous occasions.
With respect to the first three of the foregoing cases the evidence as to infected
shell-fish being the cause of the disease is not very convincing. There may have been
a direct connection between case (2) and case (1), for there must be a risk of spreading
infection when a person suffering from enteric fever is handling food which is to be
consumed by other people. In cases (4) and (5) the probability is greater that the
consumption of the cockles was the cause of the patients' suffering from the disease.
The evidence from various parts of the country as to the danger attending the
consumption of shell-fish which have been exposed to sewage contamination, has
satisfied the Eoyal Commission on Sewage Disposal that a considerable number of
cases of enteric fever result from eating shell-fish which have been grown under
conditions exposing them to such contamination. In their fourth report the
Commissioners recommend, therefore, that tidal waters should be placed under the
jurisdiction of some authority with power to prevent shell-fish being taken from any
dangerous position and to enforce regulations for preventing pollution of the shell-fish.
It is to be hoped that there will bo no unnecessary delay in giving effect to the
recommendation of the Commission and that prompt steps will be taken to secure that
the conditions under which shell-fish are grown for human consumption shall be
above suspicion.
The subjoined series of cases came under obserration during the year, and may be
recorded as further illustrating the manner in which typhoid fever not infrequently
spreads amongst the members of a family when the conditions are favourable:—
(1). On September 3rd, Mrs. H., aged , of No. 2, D-Crescent, went
hop-picking on a farm at Yalding in Kent. She returned about October