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cination was carried out wherever necessary and the appropriate
surveillance exercised.
During 1951, 37 cases of paratyphoid fever occurred
in an area covering adjacent London boroughs and districts
in Kent and Sussex. The cause of the outbreak was judged
to be synthetic cream supplied from a food establishment in
a neighbouring district. Some of the cases occurred in the
Urban District, an extensive investigation developed and it
is likely that the control measures which were instituted prevented
a more widespread epidemic.
Generally speaking the infectious diseases which took
such a heavy toll of life and health in the past have diminished
in importance but continued vigilance is needed as some
change in the natural history of the organisms or some lowering
of individual resistance in peace or in war may precipitate
a return to former conditions.
Tuberculosis remains the most important of the
infectious diseases which are encountered. It is a tragedy
tha this disease which is preventable is not being prevented.
It resents a medico-social problem of great complexity, a
description of which is outside the scope of this foreward. I
would d emphasise one aspect, however, which demands immedlate
attention, namely, the discharge from sanatorium to their
own homes of open, i.e. infectious, cases when their continued
stay in hospital can no longer be of benefit to them. These,
freuently, chronic cases are responsible for a good deal of
mishief and our powers under the Public Health Act, 1936.
to ontrol this source of infection are inadequate in that such
patients may only be compulsorily removed to hospital provided
suitable accommodation is available for them.
In my view an anomalous position has arisen in regard
to he domiciliary tuberculous patient. The presence of a
tuberculous person in a household is, often, regarded by the
Housing Committee, and rightly so, as grounds for the rehousing
of the patient or of a second family, especially if it
includes young children, who are occupying the same premises.
It would, perhaps, be more efficacious and less costly to
remove the source of infection to suitable hospital or other
accommodation.
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