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59
The work of the infectious disease visitors as agents of the medical
officer of health includes the investigation of home conditions, the giving
of advice to patients and contacts, particularly where the patient is left
at home, and in general the taking of such measures as may be necessary
to combat the spread of infection.
The following is a summary of the work in visiting infectious diseases
carried out during the year which is in addition to the visits paid
by the public health inspectors referred to in table 23

Paratyphoid B. fever
An outbreak of paratyphoid B fever occurred in April from which
12 cases were eventually notified. The cases were brought to notice at
various intervals of time, and it was not until nearly two weeks after the
first case had been notified, and the third case had just come to notice
that a pattern began to emerge. These cases and subsequent cases all
pointed to a bakery in the district as being the link between them.
A detailed investigation of the bakery was made, and it was found at
the time, something like 180 cream buns and cream doughnuts were
made daily, together with other cakes also with cream inside them.
The bakery had used Chinese egg certainly at the end of March and
possibly during the first few days of April, since when it had been using
New Zealand egg.
Chinese egg has given rise to trouble of this nature for many years
past, but for various reasons it has been found difficult to ban its importation
or to insist in its adequate pasteurisation. Recent work has
indicated that frozen Chinese egg can be pasteurised satisfactorily, and
the situation up and down the country became so relatively serious that
one riparian authority at least where this Chinese egg is handled, has
now put a stop on its distribution until it has been adequately pasteurised.
Sampling does not often reveal a paratyphoid infection and in fact, in
the riparian authority referred to, of 250 samples taken only one was
positive. In these circumstances there is in fact no firm legal basis for
putting such a stop on the product but it has been done after discussion
between the medical officer of health and a dozen or so main importers
who, because of the circumstances, have readily agreed to arrange
pasteurisation.
A circular letter was sent to 26 bakery firms with addresses in the
borough advising them to avoid using Chinese egg and to ensure that if
in spite of the advice they continued to use it, they should well wash
and sterilise all vessels, containers or implements used with it; furthermore
that the fullest hygienic standard should be required from their
employees.