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60
oranienberg. Investigations narrowed the possible source of
infection to a cream doughnut, although the daughter had not eaten
this confection nor did the examination of similar articles from
the same baker reveal any further evidence. The storage
accommodation and general standard of hygiene at the home were
good, and it is possible that the mother contracted a chance
infection which was passed on to her daughter.
(b) The second outbreak involved the father and two
children in a family of four; the mother was unaffected. The
symptoms were suggestive of staphylococcal food poisoning and
enquiries were quickly concentrated on caerphilly cheese as this
was the likeliest vehicle of such an infection. The fact that
the mother disliked cheese and had eaten none was an additional
pointer. Specimens of faeces from the sufferers were negative,
but a remnant of the suspected cheese was found to be infected
with a particular strain of staphylococcus. Enquiries were made
to trace the origin of the cheese sold by the family's grocer,
and it was found that three farms in Somerset supplied the
wholesaler concerned. The appropriate Medical Officers of Health
were informed of the outbreak and bacteriological examination of
the cheesemaking process on each farm was undertaken. The
identical strain of staphylococcus was found in the investigations
at one of the farms.
(c) In the third outbreak, only two members (father and small
son) were affected in a family of five persons. The sufferers
exhibited symptoms of diarrhoea and vomiting, but quickly
recovered. Faeces specimens were examined from all members of
the family and those for the two patients were positive for
salmonella typhi-murium. Enquiries in this outbreak were
inconclusive, although a suggestion was made by the father and
the medical practitioner concerned that the source was ice-cream
procured from an itinerant vendor. Unfortunately, the vendor was
not traced,
(d) The fourth outbreak concerned two children, aged seven
years and one year; the mother and father were unaffected. Faeces
specimens were examined from all members of the family, and
those from the two sufferers were positive for salmonella typhimurium.
Investigations were hampered in this outbreak by
language difficulties, and nothing conclusive emerged.
(e) The last outbreak also affected two children, aged
seven and four years, although the mother and another child suffered
no symptoms. Bacteriological examination of faeces specimens
revealed salmonella typhi-murium. It was difficult in this
outbreak to obtain accurate details of food eaten. The home
conditions were only fair, and there was some evidence of mice
infestation.
Outbreaks of undiscovered cause (4 outbreaks)
(a) In this outbreak, the mother, father and one child in
a family had symptoms of diarrhoea; a second child was
unaffected. The symptoms were not severe. Bacteriological
examination of faeces specimens were negative for the whole family.
Beyond a few items, the adults were unable to give a coherent
history of food eaten.
(b) In a family of six persons, three suffered symptoms of
vomiting, discomfort, and slight diarrhoea. Investigations
pointed to a salami brought from Germany a week prior to onset
as the source of infection, but unfortunately none of it remained
for bacteriological examination. Faeces specimens submitted by
all members of the family were reported negative. Whilst this
outbreak may have been due to a true food poisoning, it is
believed it could equally well have been an exhibition of allergy
in that the salami was eaten by all members of the family. A