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Enteric Fever.
44. There were 68 cases of Enteric Fever notified, giving a
rate of 0 58 per 1000 population compared with 0.52 and 0.59
in the two preceding years. Twenty-one cases occurred in
Woolwich parish, 32 in Plumstead, and 15 in Eltham. The
cases in Woolwich were slightly below the average of recent
years, in Plumstead above, and in Eltham, more than had
been recorded in the ten preceding years. Excluding Eltham,
the River and St. Nicholas Wards had the highest number of
cases proportional to population.
45. Of the 68 cases, 45 were removed to the Fever Hospital.
Thirteen cases died (or 20 per cent. of the total), of which 7
belonged to Woolwich Parish, 4 to Plumstead, and 2 to Eltham.
The death rate was 0.11 per 1000 population, which is the
same as the Enteric death rate of the County.
46. Source of Infection. Eight of the 68 cases were found
not to be Enteric after removal to the Fever Hospital. Of the
remainder, 4 were secondary cases, i.e. immediately traceable
to a previous case in the Borough; 13 had partaken of shell
fish within four weeks of the commencement of the illness,
4 of celery or watercress, and 3 of ice creams; 1 was attributed
to working on a blocked drainage manhole. In one case a wife
contracted the disease several months after her husband had
had it.
It has been discovered that the Typhoid bacillus may exist
in the urine for several months after recovery of the patient,
and this fact may explain the case just mentioned as well as
many other cases otherwise unaccountable.
47. Cases at Eltham.—The occurrence of 15 cases at
Eltham (1.9 per 1000 population) demands special comment.
Enteric appears to have been specially prevalent in Eltham for
some years past, the average for the 7 preceding years being
6 6, or about 1.0 per 1000 population, which is nearly twice as