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57
INFECTIOUS DISEASES
Details of infectious and contagious diseases notified in 1970 were as
follows:-
Anthrax Nil
Cholera Nil
Diphtheria Nil
Dysentery 45
Encephalitis (Acute) Nil
Enteric (Typhoid or
Para-typhoid fever) 2
Pood Poisoning 98
Infective Jaundice 29
Leptospirosis Nil
Malaria Nil
Measles 1,214
Meningitis (Acute) 11
Ophthalmia neonatorum 2
Plague Nil
Poliomyelitis
(Acute) Nil
Scarlet fever 42
Smallpox Nil
Tetanus Nil
Tuberculosis 115
Typhus fever Nil
Whooping Cough 117
Yellow fever Nil
The two enteric cases were one case of typhoid fever and one of paratyphoid
fever. The case of typhoid fever was a 12 years old immigrant child. It was
not possible to find the source of infection but a guest who had returned home
by the time the child was in hospital, may have been the culprit. The appropriate
health authorities were informed so that the local medical service could take
appropriate preventive measures. The paratyphoid case was a young school boy
of 16 years who was infected with Salmonella paratyphi B during a visit to the
U.S.A. Both cases recovered without any after-effects.
Only about a third of the food poisoning cases were typed. Of these 16
were Salmonella typhimurium, 4 S. flexneri, 3 S. Panama and one case each of
S. Virchow, Agona and CI. Welchii. There were eight cases of S. Indiana in
children who returned from a holiday home in Sussex where there was an outbreak
of this type of Salmonella.
The remaining cases were either notified as suspect food poisoning and
never confirmed or the salmonella species was untyped. The latter includes an
outbreak of 36 cases in St. Matthew's Hospital.
It is thought that the following detailed account of a case of typhoid
involving a typhoid carrier would be of interest.
Successful treatment of typhoid carriers is generally rare. A carrier
living in the London Borough of Hackney was cured and can now live and work as
an ordinary person. How this was achieved is told below.
At the beginning of 1969, a child developed typhoid fever. It was not
difficult to establish that this family were relatives of one of the known
typhoid carriers living in the Borough, the carrier being a sister of the child's
father. This typhoid carrier was a married lady (aged about 40 years) who came
to this country thirteen years ago. At an outbreak of typhoid fever in 1966 at
the house where she and her family were living two typhoid carriers were found
and she was one of them. In spite of different courses of treatment given by
her G.P. each of the six-monthly tests from 1966 until Summer, 1969 showed her
to be producing Salmonella typhi positive stools.
In view of the fact that this carrier might have been the source of more
than one case of typhoid fever within the Borough it was decided, partly from an
epidemiological and partly from a human point of view, again to try to cure her
of her typhoid carrier state. To this end some successful team work was carried
out between the patient, the G.P., the Consultant at the fever hospital
and the staff of the Health Department dealing with epidemiological problems.