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5
well-known " tuberculosis officers " by rather vaguer " chest physicians"
are all matters which may take away from tuberculosis its importance
in the eyes of the public as a specialised infectious disease.
Many countries have experimented with a vaccine to give protection
to babies and young children who are susceptible to tubercular infection ;
in fact this work may now be considered to have passed the experimental
stage and to be well established in Europe, particularly the Scandinavian
countries, and elsewhere. Little however has been done in England
to encourage the use of the vaccine, and in the meanwhile it will be
necessary to rely on other measures of a preventive nature. Housing
and early hospital treatment must remain in the forefront of these ;
both of them unfortunately beset with difficulties owing to shortages
either of materials or of staff.
It is mentioned in the body of the report that the dispensary staff
was increased during the year to deal with extra work being carried
out there. On July 5 the service was handed over to the regional
hospital board, but for some three months afterwards we acted as the
board's agents for this change-over period.
Food hygiene
A table (No. 26) is included for the first time to show the food
poisoning outbreaks which came to the notice of the department. This
table is no doubt very incomplete as many cases of what is in fact
food poisoning do not come to the notice of the department. The
symptoms may be transient, just a little abdominal pain, sickness or
diarrhoea lasting two or three hours, all symptoms and signs having
completely cleared up two or three hours later. Nevertheless with the
increase in communal feeding any infection in food, or which gets into
food through defective hygiene in kitchens, is likely to have a more
widespread effect than it would if the food were prepared in an individual
family. There is still much that can be done in protecting food
in shops and in seeing that it is properly wrapped. Some relaxation of
the regulations covering the use of paper in foodshops has recently
occurred and therefore more wrapping of food should be possible. It is
desirable, however, to get the position in correct perspective. There are
many foods which are wrapped nowadays and which need not be
wrapped at all insofar as avoidance of food infection is concerned.
It is aesthetically more pleasing for them to be wrapped, but it is not
essential. Much more danger is likely to occur from the person handling
the food, either in the shop or in the kitchen, than is probable from
chance contamination through the food being insufficiently wrapped.
This applies of course particularly to food which is eaten without
further cooking, such as cooked meats, cheese, butter, meat pies and so
on, and one shop assistant or communal cook with infected fingers
through deficient personal hygiene may well infect a large number of
customers. Again it is necessary to differentiate between the different
types of food, some of which will grow the causal germs much more
easily and much more rapidly than others. For example, fat in the