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Probably, had it not been for bacterial examination, they
would have been regarded as Scarlatinal sore throat. The
mildness of the disease is shown by the fact that there was no
death from notified Diphtheria, and only one from Membranous
Croup.
Typhoid or Enteric Fever.
Nine cases of this disease were notified during the year as
compared with four for 1905. Of this number four subsequently
proved not to be Enteric Fever, but diseases which closely
simulated it, so that there were only five undoubted cases during
the year. The first case was notified June 30th, in a cottage at
Top Locks, which was without drainage, and supplied by very
polluted well water. The remaining cases all occurred at North
Hyde, two cases in one house notified July 31st and September 1st,
respectively. This cottage was in a dirty and insanitary state,
and drained into a cesspool but supplied with Company's water.
The next case was September 30th, a house on the opposite
side of the canal at North Hyde, drained into the council's
sewer, supplied with Company's water; house in good sanitary
condition. These three patients frequently bathed in the
canal.
The next case occurred October 17th, in a cottage close to
the first two cases. This cottage was not sewered, but supplied
with Company's water; the premises were in an insanitary
condition.
A case was brought to my notice by the County Medical
Officer of a patient with Enteric Fever in Harlington, who
worked in Southall, and went home for week ends. Full
enquiries were made into the circumstances of this case, some
minor defects of sanitation in the premises where he worked
were found, but there was nothing to show how these could have
given rise to Enteric Fever. We ascertained, however, that two
weeks before the patient was taken in he had been away for
a four days' holiday, but his employer did not know where he
went.
It is difficult to say how these cases of Enteric Fever
arose. I think the well water of the case at Top Docks was
undoubtedly responsible; and the grouping of the cases at North
Hyde was suspicious of some common factor in operation there.
Milk was easily excluded; the water supply was common to
all, but had this been responsible we should certainly have had
cases in other parts of the District, so I think that may be put
aside ; the most probable explanation is that it arose from the
insanitary condition of the premises in which the cases occurred.
It is generally held that an incidence of Enteric Fever
not exceeding 0.5 per 1,000, indicates satisfactory sanitary
circumstances; a rate of 1 per 1,000 is considered excessive.