Report on an outbreak of enteric fever in the county borough of Bournemouth and in the boroughs of Poole and Christchurch / by W. Vernon Shaw.

  • Shaw, W. Vernon (William Vernon), 1874-1937.
Date:
1937
Catalogue details

Licence: Public Domain Mark

Credit: Report on an outbreak of enteric fever in the county borough of Bournemouth and in the boroughs of Poole and Christchurch / by W. Vernon Shaw. Source: Wellcome Collection.

    28/36 (page 17)
    This individual, who was unaware that he was a carrier and was most distressed to learn that he could even remotely be asso¬ ciated with the outbreak, did all he possibly could to facilitate our investigation. He gave no definite history of having had enteric fever; the possibility of his having been infected during the outbreak was considered and, it is thought, can be rejected not only on clinical grounds but also from a survey of his move¬ ments at the time. But many years ago he had an acute febrile illness which nearly proved fatal and which, in view of the present bacteriological findings, was probably enteric fever. It is also suggestive that during the last three years he has been subject to periodical attacks of abdominal discomfort which are characteristic of the carrier condition. He was staying here in April, 1934, when I.B. was infected, and was here also throughout the summer of 1936 until the 10th August, when he went away and did not return until the 28th September. Owing to a reduction in the number of occupants of this house after 10th August, only a small amount of excreta was dis¬ charged into the tank from then until late September, and it is significant that in the effluent on the 16th, 18th, 21st and 24th September and 2nd October the B. typhosus was not found, but it was present in large numbers on the 16th and 24th October, 18 and 26 days respectively after the suspected carrier had returned. The organism proved to be of the same cultural type as that recovered from such Bournemouth patients as were examined and also from Mrs. A/s son. The evidence therefore shows that this person is a typhoid carrier and, as is usual in such carriers, has been excreting the B. typhosus intermittently over a con¬ siderable period. We have then the position that there was, probably in April, 1934, and almost certainly in June and July, 1936, a potential source of infection at this house and that the stream into which the sewage from it flowed was little more than an open sewer liable at any time when the particular individual was staying there to contain the B. typhosus. The stream rises at about O.D. + 240, in marshy ground some two miles south of the cottages. Its level at the cottages is approximately O.D.-b 100, or thereabouts, and, as I have pointed out, in some places it may on occasion be 3 ft. deep. It flows through coppices and pasture land which it drains, and no other obvious source of gross human pollution was found. The possibility of infection of A/s milk through the agency of the water of the stream must now be considered. There are three ways in which this may have occurred— (1) That water direct from the stream was used for dairy purposes. (2) That it found its way into the common well.