19 



He had influenza prior to November 24tli. All his 

 family ate cooked mussels on December 17th, but 

 he was the only one who became ill. 



(3) C ate raw and cooked mussels at the beginning of 



December. Other members of his household ate 

 cooked, but not raw mussels. C was ill on Dec. 12th, 

 and on December 31st his blood gave a positive 

 reaction. He died on January 27th. 



(4) D ate steamed mussels and a plate of oysters at a shop 



on December 21st. She was ill on January 3rd, and 

 her blood gave a positive reaction on January 10th. 

 She died on January 16th. Her three companions 

 also had mussels at the same time, but they had 

 had enteric fever about two years previously and 

 they did not become ill. 



(5) E ate cooked mussels on December 21st and was ill 



on December 28th. His blood reacted positively, 



and he died on January 24th. A friend who was 



with him also ate mussels, but did not become ill. 



All the above are actual records and they may be regarded 



as quite typical of the kind of evidence that has been taken 



as establishing the connection between mussels and disease. 



" From a review of all these cases there appears to be little 



doubt but that the association between enteric fever and 



mussel consumption is something more than mere coincidence." 



That was the opinion of most Medical Officers of Health, and 



may be so still, but nevertheless there have been other ways 



of looking at the facts. 



In 1910 there was an outbreak of enteric fever in the 

 London districts of Bethnal Green, Stepney and Poplar. 

 There are various criteria by means of which outbreaks due to 

 personal infection, polluted water or milk can be recognised, 

 and these criteria were applied by the London Health Officers 

 in investigating the origin of these outbreaks. A process of 



