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14
Human Source of Infection.—Unfortunately the foreman
pastrycook was away on holiday at the time of the enquiry.
It was found that this man was known to have had a temporary
illness early in August. He had been on duty during the period
in which all the confectionery so far suspected had been at the
bakery, and was capable to have helped in some way in their
preparation.
Investigations proved that this man's history was very
suggestive of an enteric group infection, and his blood gave a
strongly positive reaction in regard to Paratyphoid B.
This man, apart from general supervision, was personally
responsible for making the paste of the veal and ham pies and during
a part of August he took the unusual course of filling the pies
with gelatine. He was also responsible for making the butter
cream and whipped cream for various kinds of fancy cakes which
had produced infection.
On the return of the pastrycook from holiday, the following
interesting information was yielded.
For convenience, I will designate the pastrycook as A.
A and Mrs. A lived in a cottage on the bakery premises and
had been pastrycook for some twelve years. From the 23rd
July to the 3rd August a family of relations were staying with him,
and to celebrate the occasion A arranged for a large veal and ham
pie to be made at the bakery on the 30th July, and together with a
cream gateau, also prepared at the bakery, were eaten by Mr. and
Mrs. A and five guests. Two of them developed abdominal
symptoms on the third day, and two on the fourth day. A
himself developed diarrhoea with headache on the fourth day.
The diarrhoea continued for two days, after which he felt fairly
well again. He kept at work throughout.
It was thus clear that A had suffered from a mild and unrecognised
attack of Paratyphoid Fever B, and had been capable
of infecting foodstuffs.
This outbreak of Paratyphoid Fever B, affecting probably
many persons spread over a number of Districts, was definitely
traced to veal and ham pies and fancy cakes, infected at a late
stage of their preparation by a pastrycook who had suffered from
an unrecognised attack of the complaint. Unfortunately, the
source of his own infection could not be traced, but that source
was within the bakery, through either infected materials or an
infective person.