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fever and dysentery, as formerly) to typhoid fever, paratyphoid fever or other salmonella infections
(which include the diseases previously known as enteric fever), dysentery and staphylococcal infection
likely to cause food poisoning ; (ii) by applying these measures to persons shown to be carriers of these
diseases as well as to persons suffering from them; (iii) by preventing such persons (in either class)
not only from continuing employment involving the handling of food, as formerly, but also from
entering such employment, and (iv) by enabling a local authority to authorise the Medical Officer
of Health to issue notices in emergency in order to check the spread of these diseases.
International Certificates of Vaccination and Inoculation.—At the request of the Ministry of Health,
arrangements were continued for the authentication by the Medical Officer of Health of certificates
of vaccination and inoculation issued by medical practitioners in St. Marylebone in respect of persons
going abroad. During 1953, 3,119 applications were dealt with.
Food Poisoning Outbreaks.—Details of cases of food poisoning notified during the year are given
below in the form required by the Ministry of Health :—
(a) Number of outbreaks.—One of thirteen cases and five single unrelated cases.
(ib) Deaths.—None.
(c) Organisms or other agents responsible, with number of outbreaks attributable to each—-
Salmonella typhi-murium.—One case.
Not ascertainable.—The outbreak of thirteen cases and four single unrelated cases.
(d) Foods involved, with number of outbreaks associated with each food.—It was not possible to
identify a particular foodstuff as being the source of infection in any instance.
Twenty-three visits were paid by one of the women sanitary inspectors in connection with these
cases.
The outbreak affecting thirteen persons occurred in June amongst the members of a motor coach
party who came to London from the North and were taken ill with what appeared to be acute food
poisoning after taking a meal in a restaurant just outside the Borough. They were admitted to a
hospital in St. Marylebone and all were discharged within twenty-four hours. The Medical Officer
of Health of the district in which the restaurant was situated made an investigation but was unable
to trace the source of infection. A full report of the outbreak was sent to the Ministry of Health.
It was learned that on the 24th September there had been an outbreak of diarrhoea amongst the
pupils and staff of a local school, though no formal notifications of food poisoning or suspected food
poisoning were received. The onset of the illness was about five hours after the school mid-day meal
and, as similar outbreaks had occurred at two schools in an adjoining borough which obtain meals
from the same kitchen, this seemed to be the probable source of infection. Investigation showed that
a joint of silverside of beef served cold for lunch on 23rd September to all the people taken ill, had been
boiled at mid-day on the previous day, cut up into six joints and left to cool overnight in its own
liquid, thus probably affording an excellent medium for bacterial growth and being the likely cause
of the outbreak. Unfortunately, none of the suspected food was available for bacteriological
examination and faecal specimens obtained from the children and staff proved negative. The attacks
were very mild and the patients soon recovered.
Tuberculosis—New Cases and Mortality.—Table 8 contains information with regard to age and sex
distribution of, and mortality from, all forms of tuberculosis.

‡ Including all primary notifications and also any other new cases of tuberculosis which
came to^the knowledge of the Medical Officer of Health during the year.