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27
Dysentery
At the beginning of November several nurses at Kings College
Hospital were notified to be suffering from Sonne Dysentery.
The outbreak was at first mainly confined to the nursing staff,
many of whom were living outside the hospital at various addresses
in Lambeth and Camberwell. The one common focus from which
the infection could have and most likely had been spread is the
nurses' dining room where every nurse had at least one meal a
day. The dining arrangements are on the self service cafeteria
principle and some colour was given to a suggestion that mousse
which had been decorated with butter cream was the vehicle conveying
the infection. The epidemic however rapidly became widespread
far beyond the original infection, so much so that the
admission of more patients to the hospital had to be suspended.
In all, there were 91 cases notified, of which no less than 61 were
nursing staff, the remainder being nine administrative staff and 21
patients in the wards. Most of the secondary cases in the wards
followed the primary cases among the nurses on duty in those
wards, but this did not by any means occur everywhere.
Some cases among the hospital patients, although notified later
than the nurses, gave dates of onset on or about the first three days
of November so that there is a great probability of the primary
focus having been the hospital kitchen which supplies both the
nurses' dining room as well as the wards. The fair inference to
draw in reviewing the features of the epidemic is that all were
infected from the kitchen and that infection from nurse to patient
was unlikely although, of course, not entirely out of the question.
There were no cases in the children's ward where ices are in greater
favour than other dishes and it would appear that mousse was not
eaten there. There was no case either in one of the surgical wards,
despite the fact that cases occurred among the nurses on duty in
both these wards.
Swabs were taken from all those who had any symptoms as well
as from the catering staff and in consequence a number of almost
symptomless carriers were discovered. The strictest precautions
to see that all food was safeguarded were adopted with notices
reminding the users of all conveniences to wash their hands afterwards,
but in spite of every care, cases continued to crop up daily,
the onsets being from the 29th October to the 11th November and
the date of notification from the 4th November to the 28th November,
depending upon the time taken after swabbing before the
dysentery bacillus could be isolated.