Typhoid fever in Aberdeen. A critical analysis

In May 1964 I was a house-physician in the City Hospital, Aberdeen, when an outbreak of typhoid fever began. This hospital is the fever hospital for Aberdeen and consists of several separated wards with a total of 231 beds. Because of a shortage of senior staff I was involved in admitting and caring for the vast majority of the typhoid patients during part or all of their stay in hospital. My duties were partly clinical and partly administrative. A "Typhoid Co-ordination Centre" was established, of which I was in charge; the functions of this centre were initially to facilitate the admission of patients by general practitioners to the various hospitals involved and to advise the general practitioners and the Medical Officers of Health by telephone of all positive laboratory findings. Later the same centre controlled the clearance programme of all typhoid patients, co-ordinated the clinical trial of ampicillin which was conducted in 4 different hospitals, and maintained a record of all laboratory investigations performed after the patients were discharged from hospital. This outbreak of typhoid fever occurred in a country in which this disease is comparatively rare and is certainly not endemic. The chance that the course of the disease was influenced by previous exposure to typhoid infection was slight. When the wealth of data which accumulated during this time was finally examined it seemed to me that useful evidence could be obtained from this outbreak which might contribute, by way of certain limited conclusions, to the modern knowledge of typhoid fever and have some influence on present-day belief about the disease and its treatment. This thesis is therefore a series of short discussions on several aspects of typhoid fever, each illustrated by examples from the Aberdeen outbreak of 1964