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42
OUTBREAK OF EPIDEMIC NAUSEA AND VOMITING
On the afternoon of 26th January, 1960, information was received of an outbreak
of suspected food poisoning affecting mainly members of the nursing staff
at a hospital in the Borough. At that time 17 cases had occurred.
The following day a visit was paid to the hospital when the total had risen
to 26. The onset was sudden, characterised by nausea, diarrhoea and vomiting,
the course of the illness being about 48 hours. At that time the impression was
obtained that there were two peaks, one about 21st and 22nd January and the
second on the 25th and 26th January. Bacteriological investigations had yielded
negative results.
An inspection of the kitchens which served both patients and staff showed
nothing abnormal, except that one kitchen employee had an unhealed vaccination
on. her leg which she was dressing herself. This was swabbed, and the person
temporarily put off duty. This swab failed to grow pathogens.
The following day the total of cases was 37 and it was becoming obvious
that this was not an outbreak of food poisoning, and the alternative diagnosis of
epidemic nausea and vomiting was considered.
By 29th December, 45 cases had occurred mostly amongst the staff, and
detailed histories from a number of the victims was obtained. The onset was
usually abrupt with nausea and/or vomiting although at least one case started
with a bout of diarrhoea. There was some pyrexia and generalised aches and
pains and it was reported that the patients usually "slept for hours" after going
to bed. The illness usually lasted for about 48 hours, the victims being up and
about although feeling a little exhausted at the end of that period.
Apart from a few odd cases, the outbreak came to an end about 28th January,
the last case reported occurring on the 3rd February.
Retrospectively a few cases not originally reported were found and in all
58 persons were affected, 49 staff and 9 patients.
Naturally, at the height of the outbreak the question of closing the hospital
for admissions was raised, and after consideration it was agreed that admission
should only be denied in. those cases where vomiting or diarrhoea would constitute
a hazard e.g. those needing gastric surgery.
Diphtheria
In February a small outbreak of diphtheria occurred in the Borough involving
three cases (two of which were notified) and seventeen carriers.