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cases which were subsequently certified were cases secondary to them. There
were several children belonging to the family in the house, and although no
positive evidence was forthcoming it is not improbable that one or more mild
unrecognized cases occurred amongst them. The fact that infection was in the
house for such a long period before the nature of the disease was recognized
exercised an important influence in spreading infection in the neighbourhood
during the early part of the year.
The following cases are worth noting:—
On May 14th a Mr. and Mrs. R- with their three children, one of
whom was a baby about nine months old, removed from No. 31, Watson's Place,
which is within a few yards of No. 2, Nancy Street, to No. 62, Queensbury
Street, Islington. Two of the R- children appear to have been playmates
of some of the children from No. 2, Nancy Street. On May 28th one of the
R- children was noticed ill, and on June 3rd and 7th respectively another
child and the mother sickened. They were all removed to St. Bartholomew's
Hospital on June 10th, and were certified to have enteric fever on June 15th.
Elizabeth P-, aged 26, married, of No. 11, Louisa Street, visited the
R- family when they were ill, and also when they were removed to
hospital she washed clothing belonging to the family. Mrs. P-'s
husband was a brother of Mrs. R-. About July 1st Mrs. P- began
to ail and was certified to be suffering from enteric fever on July 10th. When
Mrs. R-was removed to hospital her baby was brought to No. 32, Watsons
Place to be taken care of by a Mrs. C- (not the same name as that of
the family at No. 2, Nancy Street) whilst its mother was in hospital. The
following cases then occurred at No. 32, Watson's Place:—Henry J. L-,
aged 13£ began to ail about June 25th, was admitted to the Metropolitan
Hospital on July 25th and certified to have enteric fever on July 21st; Alfred
E. C-, aged 14, cousin to above-mentioned patient, and shared the same
bed, was ailing from about July 6th, admitted to the Metropolitan Hospital
on July 15th and certified to have enteric fever on July 21st; Ann C-,
aged 36, mother of the above patient, was ailing from about July 20th, and
certified to be suffering from enteric fever on July 27th.
That these cases were infected through Mrs. R-'s baby appears highly
probable. When seen on July 28th, although the infant was stated to be well
and to be putting on flesh, it looked pallid and thin, and there was a history
of wasting with feverishness and diarrhoea lasting over a month. I have
little doubt that this infant had enteric fever, and was the source of infection
in the house. Ann C- may have been directly infected from her son or
nephew.
The following cases may be mentioned as also affording evidence of a
young child being a source of infection:—