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No history of illness prior to the outbreak was obtained from any of the food handlers, although
subsequently the cook and her assistant both suffered from symptoms. The cook first felt ill on
Friday, 19th September but remained at work that day. She called her doctor in on Monday, 22nd
September and salmonella Newport was isolated from her faeces. The assistant cook submitted a
specimen on 22nd September which proved negative, but on 24th September she became unwell and
was reported to be absent from work on the following day. She also was later diagnosed as suffering
from salmonella Newport infection. As a result of this, a second faecal specimen from all the
remaining food handlers was examined with negative results in each case.
The origin of the infection in this outbreak could not be definitely established. As all the patients
had taken school meals on Wednesday 17th or Thursday 18th, it seemed probable that one or both
of these meals gave rise to infection and on balance likely that some cases were infected at each of the
meals.
The assistant cook's illness appeared to have started on 24th September. With this exception
the onset of all cases positive for salmonella was reported to have occurred within the normal
incubation period of up to 48 hours of either the Wednesday or Thursday meals. The later onset of
the assistant cook's illness is difficult to explain unless she became infected from some other source.
The points that emerged were:—
(1) Specimens of meals should be kept for at least 24 hours beyond the recognised maximum
incubation period to allow for late reporting by G.P.s.
(2) Menus should be complete and specimens of every item of food should be kept.
(3) One patient reported that his G.P. had said "We had better call this Gastro Enteritis or we
shall have to keep you away from school, notify the Medical Officer of Health and have all
the trouble of taking specimens." This appears to have been a typical reaction as, apart
from the verbal notification of the original case, only 3 of the remaining 61 cases were notified.
(4) When notice of the outbreak was first reported to this department on Saturday morning
20th September, the Public Health Inspector who immediately visited the school kitchen
was unable to collect the meal specimens for examination as the key to the refrigerator was
not available. It is suggested that a spare key held by the school caretaker for emergency
use would be an advantage.
Impetigo.
No cases of impetigo were referred to the Cleansing Station for treatment during the year.
Scabies.
The Council's Cleansing Station in Lisson Grove dealt with 128 cases of scabies: adults 59 (men 37,
women 22); children 69 (boys 41, girls 28).
Venereal Diseases.
Continued assistance was given to the propaganda campaign for drawing public attention to the
dangers of these conditions and to the adequate facilities which exist for those in need of treatment.
Disinfection.
During the year 38 rooms and 413 articles of bedding (mattresses, blankets, sheets, bolsters,
pillows, etc.), and 363 books, were disinfected.
The Department continued to be asked by residents in the Borough to certify that worn clothing
intended for despatch to foreign countries was free from infection. Disinfection was carried out only
when clothing had actually been in contact with infectious disease but, during the year, 197 certificates,
relating to a total of 2,725 articles, were issued to indicate that no infectious disease had been reported
for at least one month at the premises from which the clothing was purported to have come.
Exclusion from Work of Contacts of Infectious Disease.
Both by Regulations made under the National Insurance Act, 1946, and the Public Health
Disease Regulations, 1953, persons may be excluded from work and qualify for National Health
sickness benefit if, in the opinion of the Medical Officer of Health, they are contacts or carriers of
disease and it is necessary to exclude them from work in order to prevent the spread of infection.
These regulations apply particularly to food handlers in shops and to cooks, kitchen hands and others
employed in cafes, canteens and restaurants. During the year one certificate was issued.