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occurred, but she continued to produce positive specimens and
when a further course of treatment (Streptomycin, 5 days) still
failed to eliminate the organisms she was sent home (to Ireland)
to recuperate, rather than subject her immediately to a further
barrage of antibiotics. The patient was told of the precautions
she must observe as a carrier, and the County Medical officer of
Health (in Ireland) was given details of her case. She was later
admitted to a fever hospital there for further treatment but
remained a chronic carrier for many months.
This young lady had some weeks of acute illness, and several
more of hospitalisation in the attempts to clear her of the
carrier state which made her a danger to all with whom ihe came
in contact.
paratyphoid can be a serious illness with a mortality rate
of up to 4 per cent but, from a Public Health point of view, its
worst feature is its tendency to induce a chronic carrier state
lasting for months or even years after the acute infection has
subsided. No effort was spared, therefore, in attempting to
trace the source of K.M's infection. Living in the Nurses' Home
she had had little contact and few meals outside the hospital.
These was all followed up without result but the hospital notified
three more cases.
The first of these, T.W, aged 53, was admitted soon after the
Nurse. K.M. had been taken ill. He too, proved to have Paratyphoid
'B' (phage type I) but all his contacts were negative, and the most
extensive enquiries failed to discover any common contact or source
of infection (e.g. food) which they might have shared.
The other two cases were girls, S.B, aged two and a half, and
S.S. aged four. S.B. was admitted to Connaught on December 28th
with a temperature of 104°, and S.S on the 29th. Again, no
contact or common infecting source could be found, either with
each other or with the two previous cases. All three were
transferred to St. Ann's Hospital where they recovered, but both
girls became persistent carriers. The fifth case was a lady of
thirty three, E.L, who was admitted to Connaught Hospital on
January 5th, having been ill at home with colicky abdominal pain,
diarrhoea and vomiting, with a severe cough for about a month
She too was transferred to St. Ann's on January 9th and made a
complete recovery.
The Ministry of Health, local health authorities, local
hospitals and general practitioners were advised of the presence
of an outbreak of Paratyphoid in the district, and four more
cases came to light. C.F. (36) was sent in from Chingford
Hospital where he had been admitted on January 6th after having