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source of infection was established.
(b) The second outbreak affected fifteen persons staying at
a residential club. At the time of the outbreak, there were eighty-four
guests and a staff of nine staying at the premises. The sufferers
exhibited symptoms of stomach pain, diarrhoea and vomiting which, although
fairly severe, quickly moderated. Bacteriological examination of specimens
showed the presence of Clostridium welchii.
Although no food remained for examination, enquiries suggested
that the practice of reheating meat was responsible for the outbreak.
In other respects, the food handling techniques and the kitchen at the
establishment were found to be of a good order.
The patients were cared for from the onset of symptoms by a
local medical practitioner and they soon recovered.
Outbreaks of undiscovered cause (4 outbreaks)
(a) The first outbreak affected seven persons (only one of
whom lived in Kensington) who had eaten meals at a Kensington restaurant.
All the sufferers had symptoms of vomiting or nausea, whilst others
experienced, in addition, diarrhoea, thirst, prostration, drowsiness and
headache. One patient was admitted to hospital for forty-eight hours.
Although the outbreak seemed to be one of staphylococcal food
poisoning (average interval between ingestion and onset = 3½ hours), the
picture was confused in that the sufferers had different meals with perhaps
only the condiments as a common item. Furthermore, laboratory
investigation of food handlers revealed no supporting evidence.
The meals at this restaurant were obtained from a food factory
in another borough, whose Medical Officer of Health reported satisfaction
as to methods and absence of complaints. In the restaurant itself, the
food handling routine was good.
The possibility of chemical poisoning was investigated and
although no evidence was found, accidental poisoning by chemical means could
not be ruled out. The origin of this outbreak was not established.
(b) The second outbreak affected four persons (three adults and
a child aged 4 years) who suffered fever, pain, headache, diarrhoea and
thirst. Faeces specimens submitted by the patients were found to be
negative.
Investigations indicated that egg sandwiches eaten in a
restaurant outside Kensington were the likeliest vehicle of infection.
The Medical Officer of Health of the borough concerned reported that his
enquiries revealed nothing of significance at the premises. Neither the
source nor the agent of infection was definitely found.
(c) Two adults, who suffered symptoms of giddiness, nausea,
and vomiting, were concerned in this outbreak. Specimens of their faeces
were reported negative.
Enquiries elicited no definite evidence as to the food causing
symptoms or any source of infection.
(d) The last outbreak involved two adults and a child aged
4 years, who suffered symptoms of pain, diarrhoea and vomiting. Two
other members of the same family remained well.
Faeces specimens submitted by patients and contacts were
reported negative. With treatment, the patients soon recovered, but
investigations as to the source of infection prove unrewarding.