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the cause. The illness was of very short duration and occurring as it
had, just before the week-end, it was not possible to obtain vomit and
stool specimens from patients during their illness.
(2) An outbreak occurred at a residential hostel and restaurant where
15 residents, two members of the hostel staff and one member of the
kitchen staff were affected. The organisms responsible for this outbreak
of food poisoning could not be isolated despite the fact that 28 stool
specimens were submitted to the bacteriologist. It was not therefore
possible to determine the immediate cause of this outbreak. Examination
of the kitchen staff revealed that two food handlers w'th lesions on
their hands were infected with proteus vulgaris and staphylococcus
pyogenes respectively. Both were employed as general kitchen hands
and, as a precautionary measure, were referred for treatment. Suggestions
were made for many improvements in kitchen management and
there has since been no recurrence.
(3) An outbreak occurred in a public restaurant where 16 members
of the staff and 9 customers were known to be affected. No food remained
from the suspected meal. Seventeen specimens of urine and 18 of faeces
from persons affected were examined but no causative organism
was isolated. Only in one case were the symptoms very severe, and
that case was notified as dysentery, and removed to hospital. The
diagnosis was subsequently amended to that of non-specific enteritis.
Attention was called to unsatisfactory conditions in the kitchen, and
no further outbreak has occurred.
(4) A series of small outbreaks affecting in all 21 people occurred
at an hotel. The information was collected as opportunity presented,
and it is summarised here under three headings relating to the patients,
the food, the kitchens and the staff of food handlers. The investigations
of each outbreak were inconclusive individually ; but in March, 1951,
another outbreak occurred when nine persons were affected. The
information derived from this outbreak, taken in conjunction with the
shreds of evidence from the previous outbreaks, enabled the cause
to be identified with reasonable certainty. Most of the patients had
severe vomiting and diarrhoea; but they recovered quickly, usually
within 12 hours. The recovery was so rapid that on only very few
occasions was a specimen of vomit obtained and from one of these a
staphylococcus of a recognised enterotoxogenic phage type was isolated.
Sauces, either hollandaise or mushroom, were suspected both because
they were consumed by all affected persons and because they were a
very suitable medium for staphylococcal growth. Such of the suspected
foods as remained were examined bacteriologically. A staphylococcus
was isolated on two occasions from sauces and identified as belonging
to the same phage type.
The kitchens are large and have recently been renovated and are
kept in a good state of general cleanliness. Fifteen chefs are employed
and these were swabbed for bacterial cultures. The investigations of
these food handlers, simultaneously conducted, yielded these results.