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stemming the outbreak. Cases and symptomless carriers have
been found among the catering staff, including the vegetable
cleaner who was the probable cause of the typhimurium outbreak
of food poisoning a month ago. She is a symptomless carrier.
To illustrate some of the difficulties encountered in searching
for the origin of such an outbreak, there are six girls employed
on the internal telephone exchange, one of whom was notified by
the family doctor to be suffering from dysentery. This girl had
one meal only in the hospital during the previous two or three
weeks before she was ill. This might well have provided a real
clue at least to one meal at fault if she hadn't forgotten the date
when she had it. She returned to work but was found to be a
symptomless carrier. A few days after her return, one of her five
colleagues was taken ill and confirmed, bacteriologically, to be a
case of dysentery. The girls used to make tea for themselves,
and all except the first girl to be ill, had regular meals in the
hospital. Was the second telephonist infected by the first through
the telephone instruments or even the tea, or was she infected by
food taken in the hospital ? The indeterminate finding in this
case was repeated over and over again so that it is impossible to
say whether an early case introduced the disease or whether the
early case was infected by a symptomless carrier. The search
ended with its main object to isolate all the carriers, whether ill
or not, rather than to find the defaulter.
All the bacteriological investigations were admirably carried out
under the direction of Dr. Cunliffe in the hospital laboratories.
Approximately 1,500 separate bacteriological tests were undertaken
which is some indication of the work entailed in carrying out an
investigation of this kind, and further tests are necessary for a
few carriers still under observation.