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Annual Report of the Medical Officer of Health—1898. 31
Turning next to the floor space, we find it a few inches over 25 square feet per
inmate, which is, in my opinion, inadequate.
The general condition of the house was fairly clean.
The w.c. was at back, in a small yard closely hemmed in by houses.
Walker Street is composed of small two and four-roomed houses, and lies in the
midst of a network of streets and courts of similiar small dwellings, closely packed
together. The inhahitant3 of this area are chiefly fish curers, hawkers, costermongers
and labourers.
The source of the infection in F.K., I have been unable to trace.
Since the above case, another patient has been notified to me as suffering from
typhus. The patient was removed to the South-Eastern Fever Hospital on the 30th
October. His symptoms were obscure and misleading, but subsequently a postmortem
examination revealed the fact that death was not due to typhus.
Previously to the case of F.K., the only typhus notified to me in this parish
occurred in April, 1898. Infection was traced to a patient at Kensington. Before
that, no case had been reported since my appointment as Medical Officer in 1892;
but a serious outbreak of the malady took place in 1864 and 1865.
GENERAL OBSERVATIONS.
Typhus, it is well known, is a most infectious disease, with a period of
" sickening " of seven to fourteen days, and has not yet been traced to a definite
micro-organism. It is quite certain that the chief cause of its spread are overcrowding
and depressing conditions, such as poverty, want of food, intemperance,
bad ventilation and insanitary environment. It is a disease of the poor, spread
mainly by personal contact, and attacks chiefly children and young adults. In
patients over middle age it is exceedingly fatal.
The importance of any one case as regards the rest of London may perhaps best
be shown by means of a particular example.
The case spoken of as occurring in this parish early in that year was traced to
North Kensington. Your parishioner who was attacked, went to nurse some sick
relatives in the suburb mentioned, where she contracted the disease. The Kensington
outbreak involved about fourteen cases, with three deaths (including that of the doctor
in attendance). To quote the words of the Medical Officer of Health—Dr. Dudfield
—our parishioner " probably would have escaped taking typhus, had it been possible
to place her in a shelter whilst the rooms of the two flats at W.D. . . . were
being disinfected." This incident shows how necessary it is for the welfare of the
Metropolis for all districts to be equally well provided with sanitary safeguards, and
also how the occurrence of an infectious disease in one quarter is a possible danger to
the inhabitants of any or all other quarters.
THE SPECIAL PRECAUTIONS TAKEN.
These consisted in disinfection of the surroundings of the patient. The bedding
and clothes were burnt, and the house disinfected and cleansed at the cost of the
authority. The other inmates of the house were taken to the Reception House, and
retained over the full incubation period of the disease, fourteen days. At the same
time they were personally cleansed and their clothes disinfected.
CONCLUSIONS.
From a careful consideration of the foregoing facts, I conclude that this case,
if not actually contracted from disease germs latent in the house, wa* certainly