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42
the whole family. She has been specially warned as to steps
she should take to avoid infecting other persons, and will be
kept under observation. She is what is called a "carrier
case," though fortunately discovered to be such at an early
stage. 2 other cases were infected by a "carrier case"
of long standing. She had been in India, where she had
"fever" some two or three years ago. She was acting as
child's nurse in Eltham, and the baby, age 10 months,
sickened with enteric. No other source being discovered,
the nurse's blood was examined, and was found to give a
Widal reaction—proof that she had had enteric at some time.
Her excretions were then examined, and typhoid bacilli
found, showing that she was still infectious. Written instructions
were given, which the Medical Officer of Health
personally enforced by word of mouth to the girl and her
father. She ceased to be a nurse, but went as a general
servant in a place where the mistress prepared all the food.
On close inquiry, it was found that on one occasion the
mistress had cleansed a w.c. which the servant had fouled,
and thus became infected. This girl has now left the district,
but the Medical Officer of Health of her present residence has
been notified.
Of the remaining cases, 1, a sailor on a ship from Buenos
Ayres, was presumably infected by foul water taken on in the
River Plate. I was probably infected by oysters, 2 by
periwinkles, and 1 possibly by fried fish.
58. Bacteriological Diagnosis. 11 samples of blood were
sent to the Lister Institute to be examined for Widal's reaction.
A positive result was obtained in 5.