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NOTIFIABLE INFECTIOUS DISEASES
Although some diseases are notifiable by statute and others by
regulation it is freely admitted that the notification rate is usually
a considerable understatement of the actual incidence of the respective
diseases.
In some cases the diseases themselves have changed so much,
e.g. scarlet fever, that some authorities have doubts as to whether
notification is worth while. In other instances, such as Acute
Poliomyelitis, there are so many latent cases that many indeed must
be missed. Despite these drawbacks, however, notification is still
considered a useful and essential method of obtaining information
in the Public Health Department provided, of course, it is received
early enough and with sufficient detail. The need for immediate
and full details, particularly in regard to cases of food poisoning,
cannot be overstressed. That only 7 cases of food poisoning occurred
in 1957 is open to considerable doubt, but any attempt at investigation
tion of these cases is doomed to failure if notifications do not come
in for several days after the incident, by which time any food remnants
or tins will have been disposed of and the vital evidence lost.
In the case of tuberculosis the dangers are no less now that the
disease is less common. It is a common finding that the origin
of infection in nearly every case of tuberculous meningitis treated
in hospital can be traced to an elderly relative living at home who
was thought "just to have a smoker's cough" or to be "bronchitic"
but, on investigation, was proved to have tuberculosis.
One serious problem arose during the year in regard to tuberculosis
A report was received from the Mass X-Ray Unit in the
area to the effect that six cases of tuberculosis had been discovered
in a food factory. The authorities in charge of the Unit relieved
themselves of the responsibility to notify or give any other information
about these cases by saying that possibly it could be harmful
to the interests of the patients. It is doubted that the other employees
ployees would be comforted by this thought in the event of their
becoming infected contacts.
A further incidence of the same character has also occurred.
A year after the actual survey took place at a food factory, information
tion was received that five members of the staff were considered to
require supervision as cases considered tuberculous. Further investigation
elicited the fact that one of these men worked in a section
of the factory where not only was he liable to cough over food but
considerable handling was also entailed.
The Food Hygiene Regulations specify a number of diseases
that are an indication for excluding a workman from the preparation
of food but mention of tuberculosis is carefully avoided; it is
suggested, however, that employees should "refrain from spitting".
No doubt the fact that the consumptive patient might well cough
into the food he is preparing has not been thought worthy of
consideration.