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Special enquiries and investigations were made on various lines
to establish the cause of the outbreak, and all suspicious circumstances
as to possible infection of food have been followed up.
At one time it appeared that the infection might have arisen
from a trader's premises supplying pastries, cream fancy goods and
cakes. Special enquiries were made into the history of the health of
the workers and blood tests of the employees (six in number) most
likely, if they had been carriers, to have caused infection, were made
with negative results.
Other possible sources of food infection have been investigated,
but no evidence has been sufficient to give grounds for suspicions or
doubt as to any article of food.
In July and August, 262 cases were notified in London (76
typhoid, 183 paratyphoid, and 3 continued fever).
No supplies of cream which appeared to give rise to the cases
in London and elsewhere were traceable as causes of infection in
this district, but 10 cases from Ilford partaking of food in London, or
outside Ilford, might have been so infected, but it would appear
that Ilford had an earlier incidence.
Many of the cases had the symptoms of influenza infection, and
reliable diagnosis could only be ascertained by the serological test.
(e) Cerebrospinal Meningitis and Anthrax.—No cases of these
diseases were notified.
(f) Ophthalmia Neonatorum.—Four cases were notified during
1928, as compared with 2 in 1927: 3 in 1926; 3 in 1925; and 4
in 1924. One was admitted to the Ilford Isolation Hospital; 1
received treatment as an out-patient at St. Bartholomew's Hospital.

(g) Acute Influenzal and Acute Primary Pneumonia.—92
cases of Pneumonia were notified (of which 10 were in institutions)