Memorandum on typhoid fever.

Date:
1939
Catalogue details

Licence: Public Domain Mark

Credit: Memorandum on typhoid fever. Source: Wellcome Collection.

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    i 7 considerations that there are relatively few houses invaded by typhoid fever in which it is practicable satisfactorily to nurse a patient. The Carner.—The problem of the “‘ carrier ’’ was dealt with at length in the Report of the Chief Medical Officer for the year 1932. It would hardly be practicable to secure the systematic identification, segregation and treatment of chronic carriers, and it is by no means certain that, even if it were practicable, such action would be effective. The principle adopted in this country has been, therefore, to require certain steps to be taken only if circumstantial evidence is obtained which results in the identification of a carrier who is employed in the preparation or handling of food or drink for human consumption. The Public Health (Infectious Diseases) Regula- of the First Schedule that if a Medical Officer of Health has grounds for suspecting that any person in his district who is so employed is a carrier of enteric fever or dysentery, he shall report to the Local Authority. The Local Authority may then require a medical examination of the suspected person. If, from the result of such examination or from other evidence, the suspected person is found to be a carrier, the Medical Officer of Health must report to the Local Authority, who may give notice to the responsible manager of the business in which the carrier is employed and to the carrier himself, with a view to preventing for a specified time the employment of that person in any trade or business concerned with the preparation or handling of food or drink for human consumption. These steps are taken to prevent the carrier becoming a source of infection and should be combined with the instruction of the carrier in personal hygiene. Immunisation.—Persons particularly exposed to the risks of infection, e.g., troops serving abroad and Europeans residing in countries where typhoid infections are common, generally receive subcutaneous injections of I.A.B. vaccine. This confers a high degree of protection, which lasts for at least a year. So far as exposure to infection is concerned, the most comparable circumstances in this country are those of nurses on duty in typhoid fever wards, and it is customary to immunise them before they are exposed to infection. In explosive outbreaks due to a single source of infection, prophylactic inoculation is of limited value because it is either too late to protect those who are incubating the disease or unnecessary for those who will escape through warning or through removal of the source. The protection of persons who live in the same district but have not been exposed to infection is a different matter and one for individual decision based on local circumstances. Administra- tion of typhoid-paratyphoid vaccine by the mouth, though 9