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14
The Medical Officers of Health of the Districts to which
the contacts had gone were communicated with, letters being
sent on the 21.1.26.
A telephone message was also sent on the day of notification
(20.1.26) to the Medical Officer of Health, Port Sanitary
Authority, London, detailing the facts stated above, and
confirmed by a letter the same day. A similar communication
was also sent to the Medical Officer, Port Sanitary
Authority, Southampton.
The Widal reaction in this case showed agglutinations
in all the dilutions employed.
The patient is under the care of a private practitioner,
and is being nursed at home.
Conclusions. The above enquiries point to the disease
having been contracted abroad, either directly, or by contact
with the Steward (J. W.) who waited at the Officers' Mess,
of which the patient was a member.
There is no connection between this case and the following
cases
No. 2. R. M., male 67 years. Notified 31.1.26.
Paratyphoid " B."
This patient was notified originally on 26.1.26 as suffering
from Pneumonia, but on 31.1.26 he had an attack of
Melaena, and showed rose-pink spots on the abdomen. He
was diagnosed as suffering from Enteric Fever, and removed,
on my instructions, to the Molesey Isolation Hospital on the
same day.
Enquiries. Enquiries were made on 1.2.26, and it was
found that this man had been employed on road work in
Richmond Park. I communicated with the Park authorities,
and was informed that there were no other cases of illness
amongst his fellow employees.
Exhaustive enquiries were made with regard to the food
supplies (including milk), water, shellfish, and other possible
sources of infection, with negative results.
The house occupied by the patient is of average cottage
type, and the occupants consist of the patient and his wife.
They have received no visitors recently, and in turn have not
visited elsewhere.
Conclusions. The origin of this case is still obscure.
No. 3. The following four cases may, I think, be
grouped together as they all originated in the same house,
and probably from the same source.