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In all other cases no specific organisms were isolated.
The reason for the large increase in the number of cases is
mainly due to the fact that early in the year outbreaks were reported
from two hospitals in the Borough.
The first two cases of the main outbreak occurred at the end of
March. They were both mothers in a Maternity Ward.
After consultation between the Medical Superintendent, the
Medical Staff and myself the following action was taken :
1. All the patients and staff submitted faecal specimens and if
Salmonella was identified they were excluded from contact with the
Hospital.
2. The Public Health Department staff supplied and collected
all containers and specimens and notified the Medical Superintendent
of the results. (The hospital laboratory service also collaborated
with this work.)
3. The Public Health Department disinfected Wards as
required by the Medical Superintendent.
4. Admission to the Hospital was restricted as little as possible
in order not to interfere with essential treatment. This was
suggested in view of the extremely mild symptomatology of the
clinical cases resulting from infection with this strain of Salmonella
Typhi-murium.
5. The Public Health Department investigated foods arriving
at the Hospital which might be responsible (the Hospital laboratory
also collaborated in this work).
The facts of the outbreak were reported to the Ministry of
Health with an undertaking to report any new information which
might be forthcoming, and subsequently two of the doctors from
the Ministry of Health met the Medical Superintendent and myself
at the hospital to study the situation. During this period a small
outbreak of food poisoning occurred at the other Hospital, but the
infection did not spread and it was not necessary to take any special
measures.
Examinations of all persons at risk in both hospitals were
carried out and a large number of positive results were obtained,
the majority being symptomless excreters (carriers).
The organism responsible for the great majority of the cases
was identified as Salmonella Typhi-murium Phage Type 27.
The food and drink supply of both hospitals was the same
until 1st April, 1959.