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45
The third case was notified from a local hospital following the
failure of the patient's temperature to resolve after the removal
of her appendix.
There were no discoverable common factors between the three
cases in spite of renewed enquiries, when it was found that all
three patients were of the same phage type.
The last case (C.F.) was admitted to hospital for Appendicitis,
and since his post-operative condition did not clear up he was
further investigated and found to be a case of Typhoid. In spite
of the most detailed enquiries the source of infection could not
be traced.
Early in January, 1950, a case was notified in an adjoining
area and the Medical Officer of Health stated that his patient had
taken meals in a cafe in Walthamstow, at which C.F. had also
taken meals. This cafe had already been visited in connection
with the enquiries in regard to C.F., but nothing suspicious had
been found. Further enquiries were now made including tests on
all staff at the cafe and as a result, one was found to be excreting
typhoid organisms of the same type as the patient, i.e., phage
type E.l.
Since the cafe was used by many persons from surrounding
areas and by Transport drivers, the Medical Officers of Health
of surrounding areas were notified and as a result, 5 further cases
were brought to light, one from each of five other areas—4 in
Essex and 1 in Middlesex, and all of whom were of the same phage
type. Unfortunately, one of these patients died.
The patient at the cafe who was found to be excreting typhoid
organisms was suspended under the Public Health (Infectious
Diseases) Regulations, 1927.
Public Health (Infectious Diseases) Regs., 1927. Typhoid
Carriers.—Part compensation continues to be paid to a chronic
carrier in order to prevent her from following her normal occupation
as a cook and to make up her wages as a convenience attendant.
Another chronic carrier has remained under supervision since
1946. Compensation for prohibition in regard to the manufacture
and sale of Ice Cream later became agreed at a sum of £501 11s. 6d.
for the period April, 1946 to April, 1949 plus costs of £23 12s. 6d.
An undertaking was also given for the payment of annual compensation
at the rate of £168 until the position was finally resolved.