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We do not propose at this moment to give further details of this outbreak,
but we intend later to present to the Council a final report by the
medical officer on the subject. It will now suffice to state that scarlet
fever associated with milk from the same dealer was found by the
medical officers of health of Finsbury, Islington and St. Pancras to have
occurred in these districts, and that all the evidence has tended to confirm
the conclusion provisionally arrived at. Moreover, the stoppage of the milk
from this particular farm, after allowing for the period of incubation of
the disease, was followed by the subsidence of the outbreak in the
several districts concerned. The total number of persons attacked may,
however, exceed 300.
The medical officer has brought under our notice the position of the
law in London in relation to the subject of limiting the spread of
dangerous infectious disease by milk. Medical officers of health in
London possess powers for this purpose under section 71 of the Public
Health (London) Act. On finding evidence that any person in his
district is suffering from dangerous infectious disease attributable to
milk supplied from any dairy situated either within or without his district,
or that the consumption of milk from such dairy is likely to cause such
infectious disease, the medical officer of health, if authorised by an order
of a justice having jurisdiction in the place where the dairy is situated,
may inspect the dairy, and if accompanied by a veterinary surgeon,
may inspect the animals therein. If, on such inspection, he is of opinion
that any such infectious disease is caused by the consumption of the
milk supplied from such dairy, he is required to report thereon to his
authority, and his report must be accompanied by any report furnished
to him by the veterinary surgeon. The sanitary authority is then
empowered to serve on the dairyman notice to appear before them within
not less than 24 hours, and, if he fails to show cause why an order should
not be made, they may make an order requiring him not to supply any
milk from the dairy within their district.
This procedure, if strictly followed, involves considerable delay. In
the outbreak which has recently been investigated, a considerable
number of persons were daily infected during the period in which the
infective milk was being supplied, and had the supply of this milk been
continued pending the carrying out of the procedure above indicated,
numerous cases which ought to and might have been prevented would
have occurred.
Moreover, when milk from a particular source has been found to be
producing disease in one district, and even when it transpires that cases
traceable to the same supply of milk are occurring in other districts, it
would be necessary for the medical officer of each of these other districts
separately to inspect the particular dairy from which the milk was
supplied and comply with the other requirements of the section before the