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vendor P. already referred to. Enquiry showed that P. was also supplied with milk by
the contractor X., and was wholly supplied by him. It was also found that there were
other cases amongst P's customers in Bethnal Green, and taking all the circumstances
into consideration there was now very little room for doubting that X. was
supplying the milk implicated in the outbreak. Instructions were accordingly given
to both M. and P. to cease the sale of X's. milk in Shoreditch.
On May 2nd it was becoming evident that there were cases amongst the customers
of other milk vendors supplying X's milk. Steps were taken as far as possible to stop
the infected supply locally and hand bills warning people to boil all milk before use
were left at the houses in the neighbourhood of the outbreak. It was, however,
obvious that the only effective measure for cutting short the outbreak was the
stoppage of the infected supply at its source. This task under existing conditions one
of no inconsiderable difficulty, was as stated, being undertaken by the medical officer
of the London County Council, Mr. Shirley Murphy. The steps taken are briefly
referred to in a report of the Public Health Committee of the County Council,
dated May 9th. The circumstances of X's business were investigated
with results which pointed to the infected milk coming from one of
some half-a-dozen farms situate in Derbyshire, Bucks, and Staffordshire. The
medical officers of health of the districts in which the farms were situate having been
communicated with, a letter was received on the morning of May 4th by the Council's
medical officer stating that on one of the farms in question, situated in Staffordshire,
the milk from which had been chiefly suspected, some cases of throat illness
suggestive of scarlet fever had occurred. The enquiries of Dr. Hamer at the farm the
same day resulted in the provisional diagnosis of scarlet fever being made, which was
subsequently confirmed by the peeling of one of the patients. The milk from this
farm was stopped on May 4th and, with the exception of a small quantity which was
not distributed in Shoreditch, none of the infected milk was supplied after May 3rd.
Having thus dealt generally with the steps taken during the early days of the
outbreak, I will now give some details respecting the numbers of cases, their
distribution, the houses invaded, the various milk supplies, and other particulars
bearing upon the story of the outbreak.
Appended is a list of the cases of scarlet fever certified during the last week of
April and the month of May, giving the ages, sex, and addresses of the patients, the
dates of the certificates and the onset of symptoms in each case, together with the milk
supply and other particulars (see appendix, p. 14). This list shows what a
large proportion of the cases occurring during the early days of the outbreak was
amongst persons supplied with X's milk. Upon this list the tables hereinafter
given are to a large extent based.