View report page

27
prevent infection from person to person, and such contact may be
responsible for many cases Again, food in such a district as
Clerkenwell is supervised only with difficulty, and milk, ice-cream,
cockles, oysters and other shell-fish (which have been fattened on
sewage-contaminated beds, etc.) may act as the vehicle of typhoid
fever.
The Medical Officer of Health for Lambeth (Dr. Priestley) says
in his Annual Report for 1899:—
"Personal contact, as a factor in the spread of Typhoid, is
"not sufficiently admitted, and the three special outbreaks
"investigated in connection with Lambeth—fortunately,
"small outbreaks, on account of the severe and prompt
"measures taken—will rank as important evidence in
"shewing that the disease is apt to spread from person to
"person oftener than is generally supposed—the faeces
"and urine of patients being sources of infection, well"proved
by bacteriological methods. The natural
"corollary to the above statement is the importance of
"strict isolation of all cases (preferably in hospital),
"whilst the absolute necessity of diagnosing the disease
"as early as possible must come to be more and more
"realised. Bacteriological examination of the blood of
"suspected persons is a ready means at hand for assisting
"medical practitioners in their diagnosis of doubtful
" Typhoid cases."
Diphtheria,—Diphtheria caused during the year eight deaths in
the district and 19 among the cases removed for treatment making
a total of 27, which yields a death-rate of 0.40. The London
death-rate for Diphtheria during 1899 was equal to 0.43, the
average of the last ten years being 0.49. It will be remembered
that in 1897 the Clerkenwell Diphtheria death-rate was 0.73 which
was the second highest rate in all the metropolitan sanitary areas
(Woolwich being o.8o). In 1898 our rate fell to 0.55 which
brought us into a more respectable position. We were then ninth on
the list of 43 districts. The rate 0.40 in 1899 is the lowest