View report page

44
INFECTIOUS DISEASE AND THE MILK SUPPLY.
In the sixth report (June 19th, page 69) reference was made to the then recent prevalence
of scarlet fever in some of the Metropolitan Boroughs, mainly in the east of
London, the cause of the endemic having been traced to its source in specifically infected
mik obtained from the country, and supplied by a dealer to numerous retailers in
the Metropolis. The outbreak, which affected some 300 persons, and ceased on the stoppage
of the milk from a particular farm where cases of scarlet fever had occurred, formed the
subject of an enquiry by the County Council's medical officer, and of two reports by the
Public Health Committee of that body which were forwarded to the several Borough Councils.
In these reports the necessity of legislation, to prevent or limit the spread of infectious diseases
through the agency of milk, was urged, and the Council expressed the hope that the Borough
Councils would support the proposals of the Committee in respect to the amended legislation
thought to be desirable. The state of the law was set out in the first report of the Committee
(9th May), wherein it is stated that medical officers of health in London possess powers for this
purpose (under section 71 of the Public Health (London) Act, 1891), as follows—
"On finding evidence that any person in his district is suffering from dangerous infectious disease
attributable to milk supplied from any dairy, situated either within or without his district; or
that the consumption of milk from such dairy is likely to cause such infectious disease, the
Medical Officer of Health, if authorised by an order of a justice having jurisdiction in the
place where the dairy is situated, may inspect the dairy; and, if accompanied by a veterinary
surgeon, may inspect the animals therein. If, on such inspection, he is of opinion that any
such infectious disease is caused by the consumption of the milk supplied from such dairy, he
is required to report thereon to his authority, and his report must be accompanied by any
report furnished to him by the veterinary surgeon. The sanitary authority is then
empowered to serve on the dairyman notice to appear before them within not less than 24
hours; and, if he fails to show cause why an order should not be made, they may make an
order requiring him not to supply any milk from the dairy within their district."
This procedure, if strictly followed, involves considerable delay, and in the outbreak referred
to, when a considerable number of persons were infected daily during the period in which
the infected milk was being supplied, had the supply of the milk been continued pending the
carrying out of the procedure, numerous cases which ought to and might have been prevented,
would have occurred. Moreover, in the event of disease being produced by milk from one source,
in more than one district, the medical officer of each of the infected districts would have separately
to inspect the offending dairy, and comply with all legal requirements before the implicated
milk could be excluded from his district.
In regard to this the Committee observed that—
"When disease has been traced to a particular milk supply the sale of such milk should be
altogether stopped, and not merely that it should be excluded from the district in which the
outbreak had occurred."
They added that—
"The County Council has no power to exclude from London even a particular milk known to be
the cause of disease. Moreover, when a sanitary authority in London excludes from its
district the milk from a particular farm, notice is required to be given to the council of the
county in which the farm is situated ; but we know of no power of the County Council to stop
the sale of the milk."
The Committee pointed out that sanitary authorities in Scotland have much wider powers
and duties in connection with the distribution and sale of milk than similar authorities in London,
and which are as follows—
"Under section 60 (2) of the Public Health (Scotland) Act, 1897, if the medical officer of any
district has evidence that any person in the district is suffering from an infectious disease
attributable to milk from any dairy without the district, or that the milk from any such
dairy is likely to cause any such disease to any person residing in the district, such medical
officer shall forthwith intimate the same to the local authority of the district in which such
dairy is situate, and such other local authority shall be bound, forthwith, by its medical
officer, to examine the dairy and the persons aforesaid ; and by a veterinary surgeon to
examine the animals therein, previous notice of the time of such examination having been
given to the local authority of the first-mentioned district, in order that its medical officer or
veterinary surgeon may, if they so desire, be present at the examinations referred to, and the
medical officer of the second-mentioned local authority shall forthwith report the results of
his examination, accompanied by the report of the veterinary surgeon, if any, to that local
authority.
"Sub-section 3 of the same section requires the local authority of the district in which the dairy
is situate, to meet forthwith and consider the reports and any other evidence by parties concerned,
and either to make an order requiring the dairyman not to supply any milk from the
dairy until the order has been withdrawn by the local authority, or to resolve that no such
order is necessary.