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27
ENTERIC OR TYPHOID FEVER.
The increase in the cases of Enteric Fever began about the second
week in September, and reached the highest point by the fourth
week in October. The cases notified week by week up to the end
of the year, were far in excess of what we are accustomed to have
in this Parish.
All the cases from the middle of September to the middle of
November I carefully investigated. In quite one half of the cases
notified within those two periods, the friends of the patients
attributed the disease to the eating of Shell-fish—principally
Mussels. Certainly, the eating of the Mussels had taken place
about eight or ten days before the illness commenced, or within
the usual incubation period. The Mussels were the Dutch variety.
In one of my reports I mentioned "that Newington is not a Parish
particularly affected with Enteric Fever, as anyone can see by
looking at the annual reports. The Parish is generally in its
Enteric rate a little below that of London as a whole. The
outbreak of Enteric Fever in London commencing in the second
week of September has appeared in nearly all the London parishes,
but has reached its highest prevalence in the eastern and southern
parishes.
Enteric Fever is usually a water borne disease, and generally is
introduced into the body either in drinking water, or in milk with
which contaminated water had been mixed. There is another way
in which the disease may be propagated by the emanations arising
from a water-logged subsoil contaminated with sewage. Shell-fish
living at the mouth of a river polluted with sewage may also spread
the disease. Milk, as a cause in the cases reported, may, I think, be
excluded, especially as no two persons affected appear to have taken
their supply from the same source. It has been considered that a
polluted subsoil to cause Enteric Fever must be more than polluted
by the occasional storms which we complain of as flooding the
basements. It must be a condition similar to what exists in parts
of Dublin where the sewage polluted subsoil water is constantly on
the ebb and flow.
The disease, as the cases shew, has not been introduced into this