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28
Robert W-, aged 23, of No. 30, Ware Street, was taken ill with what
was believed to be an attack of influenza and bronchitis about September
7th; he was ill for nearly 8 weeks and confined to his bed for five; he had
diarrhoea and lost a good deal of flesh. He was getting about again at the
end of October. He was nursed by his wife Julia W-, aged 23. She began
to ail about October Gth, and was certified to have enteric fever on October
29th and removed to hospital. About October 1st, John W-, aged 1 year
and 4 months, was taken ill. He had attacks of diarrhoea and feverishness
and lost flesh. He seems to have been ailing for about a month. On the
removal of his mother to hospital he was taken care of during the day time
at No. 29, Ware Street, by a family named C—, and at night he was looked
after at No. 31, by a family named L—, these two families being relatives
of the W—'s. As shown in the list one case subsequently developed in
the C— family at No. 29, and five cases in the L— family at No. 31, Ware
Street.
I think an infant or young child with unrecognised enteric fever, owing
to contamination of clothing, bedding, etc., with excreta, must be regarded
as a very potential source of infection.
Although there was nothing to indicate that infected food or drink was
a common cause in connection with the prevalence of the disease I have not
much doubt that contamination of the food in a household may have been
frequently the means by which infection was conveyed. Take for
instance cases 33 to 37 on the list: here we have a mother ill with enteric
fever for nearly a month and looking after her domestic affairs, preparing
food and handling the loaf from which she cuts the bread for her children.
It is impossible to gainsay the risk run by a family under such circumstances.
Another instance where a person suffering from the disease handled food,
was case 18 on the list. This person was selling fruit from a barrow in the
street for aBout 10 days whilst she was suffering from enteric fever which
she contracted through nursing her child. Here was undoubtedly risk to the
public, but I was not able to trace any cases to this source.
The main characteristics of the cases during the year were infectivity above
and severity somewhat below the average. Early during the prevalence it
became apparent that unrecognised cases would have to be traced, and the enquiries
made resulted in a number being brought to light, some of which might
have escaped recognition altogether, whilst others would certainly have dragged
on for several days longer before medical advice was sought. Notwithstanding
the efforts made, however, cases did escape recognition and without doubt
played their part in the chain of infection. As a matter of fact it came to my
knowledge towards the end of the year that there had been three cases of
illness in a house in Ware Street during the months of June and July. The
history obtained leaves no doubt in my mind as to the illness having been