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It will be noted that in all the above outbreaks the foods thought to be responsible
in each case were meat and fish dishes. The most effective preventive measure for
outbreaks of this nature is the consumption of all food soon after preparation. It
is inadvisable to prepare food, especially meat and fish dishes, a day prior to the food
being served—and this procedure is all the more risky in the absence of a refrigerator
for storage.
Dysentery.
The notifications of dysentery in 1951 numbered 995, the highest to be recorded
in any one year. In view of the great increase in the number of cases which began
to be apparent from December, 1950, onwards, a special enquiry was undertaken
in each case and the results carefully recorded and summarised. The great increase
in the number of notifications of dysentery continued almost throughout the year,
reaching a maximum of 177 in March. Well over 100 cases were also recorded for
each of the months of April, May and June, but notifications decreased to 53 in
July and gradually fell towards the end of the year to 25 in December. In addition
to those cases notified a number of others were discovered during the course of the
investigation so that the total number recorded was over 1,100. The notification of
dysentery was exceptionally high in Islington—approximately 23 per cent, of all
the London cases for the year being notified from this Borough. All cases notified
were visited by a Sanitary Inspector or Infectious Disease Visitor and wherever
possible, and this occurred in the great majority of cases, examination of stool
specimens was arranged with the Archway Group Laboratory for confirmation or
otherwise of diagnosis, unless the patient was already attending a Hospital. A
diagnosis of dysentery due to Bacillus Sonne was confirmed in 574 cases, and in the
early months of the outbreak approximately two-thirds of the cases were confirmed.
At the commencement of the outbreak young children at the various day
nurseries in the Borough were mainly affected, due no doubt to the accidental
introduction of a child carrying the organism, but later families and school children
began to be affected. There was close collaboration throughout the year between
the Public Health Department and general practitioners, the Archway Group
Laboratory, and the Divisional Health organisation of the London County Council.
Nearly 50 per cent, of those affected were under the age of five years, with slightly
more boys than girls. Over the age of fifteen 213 females were notified as against
89 males, and this is thought to be due to the fact that when a child is ill, it is the
elder sister or the mother, or even the grandmother, who undertakes most of the
nursing of the child and is, therefore, most likely to be infected through contact
with the infectious sick child,