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I think the evidence is sufficiently strong to warrant the statement that this outbreak
of scarlet fever was the result of milk-borne infection. Milk has on numerous
occasions been found to have played an important part in the propagation of infectious
disease, and serious outbreaks of scarlet fever have been traceable to infected
milk. The infection of scarlet fever may be imparted to milk by persons
suffering from the disease milking cows or manipulating milk utensils. It may also be
stated that investigations carried out by Klein and Power, in connection with an outbreak
of scarlet fever in London during 1885, afford grounds for believing that the cow
itself may suffer from scarlet fever, and that the milk from cows so suffering is capable
of causing extensive outbreaks of the disease.
As to the precise manner in which the milk implicated in the recent outbreak
became infected I have no information to give, but I understand that eminent
authorities have been engaged in investigating this important point.
It is beyond the scope of this report to enter upon the very important subject of
the milk supply of the Metropolis in relation to infectious disease. I would, however,
direct attention to the need which exists, and which the recent outbreak has emphasised,
for legislation making it a statutory obligation upon all milk vendors in the Metropolis
whether wholesale or retail, to be in a position to give forthwith, when required to do
so by a medical officer of health, reliable information both as to the farm or farms from
which any particular day's supply of milk is received and the customers to whom it is
delivered. Had such information in connection with the outbreak dealt with in this
report been obtainable forthwith on application to the milk vendors, I believe that
valuable time would have been saved in stopping the infected milk at its source
and some scores of cases might have been prevented, for there is little doubt that
when the infected milk was stopped on May 4th it was still in a highly infectious
condition.
I have the honour to be, Gentlemen,
Your obedient Servant,
LEWIS T. FRASER BRYETT,
Medical Officer of Health.
Town Hall, Old St., E.C.
July 24th, 1901.