Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Stepney]
Probable Sources of Infection in Group X.—"d," first case, source untraced,
was related to "f," "g" and "h" all of whom he frequently visited at their
house. "d" may have infected "h." If so, he infected "h" before going
to fever hospital early in September. "h" may have infected "e." There
was a history of "h" being "very ill" while away from home from October
to December, 1937. The case "e" was in fairly close contact with "h" for
three weeks in November. She began symptoms of Typhoid early in
"f," the father of "h," who was related to "d" may have been infected
by "h" after the latter's return home in December, or by "d" after the
latter's discharge from hospital in November. This is assuming that "h"
was a missed case of Typhoid or that "d" was a "carrier" after discharge
from hospital. "g" was most probably infected by her husband "i" whom
Action taken in Group Y Cases.—Some anxiety was caused after the
notification of "f" who was a roundsman distributing bottled milk. He was
at once removed to hospital and all his family and the family of his relative
and the family of his employer and all his fellow employees had blood, faeces
and urine examined in a search for missed cases or carriers. All were
found healthy except his wife and baby who were removed to hospital.
Immediate steps had been taken to stop the sale of loose milk from the
dairy of his employer and only bottled pasteurised milk obtained from another
source was allowed to be sold from this dairy. All local general practitioners
and Medical Officers of Health concerned were notified and an unobtrusive
watch was kept for any signs of infection developing amongst customers who
had been supplied with milk when " f " was on duty as roundsman. No
infection whatever occurred to any of these customers, and as " f " had had
very little to do with the actual handling of the milk, none was expected.
The Ministry of Health was kept informed of the situation in Group Y
after the notification of "i" and medical officers of the Ministry consulted
with me as to the measures to be taken.
It should be mentioned that this minor outbreak Y occurred at a time
when much publicity had been given in the Press to a much larger epidemic
occurring elsewhere. Minor groups of Typhoid, however, do occur, not
unusually, throughout the country, and in any other year would probably be
dealt with equally successfully, but with less anxiety.
Group Z.—The remaining five cases notified in 1938 were of little
epidemiological interest, and might be regarded as not more than the normal
number of isolated cases which occur in a crowded population. One, however,
remained a " carrier " after her return home from hospital and has had to be
kept under surveillance. One was a paratyphoid case. One case was found
not to be typhoid.
It will be seen therefore that out of the eleven cases of Typhoid (or paratyphoid)
which were notified as such during this year, there were no deaths.
Anthrax.—One case of Anthrax occurred during the year, and recovered.
The history of the case was as follows:—The patient was a dock labourer
aged 36. On Thursday, 10th November, the patient who was working on a
wharf in the Borough developed an anthrax pustule on the left shoulder