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37
Of the 88 cases notified, 53 were removed to hospital, the Walthamstow
General Hospital receiving 11, West Ham Infirmary 24, the others
going to the general hospitals in London.
Efforts were made to have all the sufferers removed to hospital, but
for want of accommodation, these were unsuccessful.
That a large number of Typhoids nursed at home are a source of
danger to any district is well known, and 21 persons contracted the
disease for want of removal of primary cases.
This shows the need existing for proper provision for such cases at
the Sanatorium.
All possible precautions were taken with these nursed at home, and I
had special instructions issued against the spreading of the disease, and
they were given by the Sanitary Inspectors on their visits to those in
charge of the sick.
The 88 cases occurred in 69 houses, and sanitary defects were found
in 11 instances.
Enquiry as to the origin of the attack in each case elicited that 21
were from previous cases, 6 were supposed to be due to eating oysters
or shell-fish, and the causes assigned for the remainder might or might
not be considered sufficient according to the bias or belief of the
enquirer.
Personally I find it very difficult to assign a definite and unmistakable
cause for cases of infectious disease, especially Typhoid, but
the patient or his friends find a ready and assignable cause in drinking
dirty water, eating eels, oysters, bad fruit, smells, &c. One case
notified as Typhoid died, and was certified as Appendicitis and not due
to Enteric. Seven of the cases occurred in men who worked at a
particular club, and subsequent to a fellow workman who no doubt was
infected by oysters.
That these persons had a common infection is to be presumed, but
the sanitary arrangements of the club could not be blamed. Nor
could any real common infection be traced.
The sudden decrease in the number attacked in November and
December compared with September and October has since been
maintained, although apparently the same conditions exist as in those
months, except that the reports of the analysis of water are more
favourable.
The 88 cases notified caused 19 deaths, 6 being between 5 aud 15
years of age, 3 between 15 and 25, and 10 between 25 and 65 years.