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for distribution to the various branches. This could be tested only by detailed
enquiry in the several districts, and the medical department of the Ministry
of Health were good enough to arrange for one of the medical officers of
the Ministry, Dr. E. Wilkinson, to collaborate with the medical officers of
health of the various districts outside Croydon likely to be concerned, in
order to see whether any link could be established between cases of paratyphoid
fever which had occurred within recent weeks in these districts, and
the consumption of any type of provisions from one or other branch of the
firm implicated. Pending the receipt of this information, or of fresh cases
arising in connection with other branches, visits of investigation were paid
to the central bakeries, for the purpose of enquiring into the possibility of
contamination of the ingredients of the veal and ham pies at some stage in
the process of manufacture or delivery. It is to be remembered that at this
stage there were no grounds for suspicion as to other types of confectionery
conveying the specific infection.
General circumstances at the Central Bakeries.
(A) Bread Bakery.
The bakery concerned in the baking of bread needs only the
briefest reference. No point of note arose out of the inspection, and nothing
was found to suggest that the bread was connected with the outbreak of
paratyphoid fever, or that the members of this bakery staff had any connection
with the outbreak. The most positive and complete assurance was
given as to this staff being entirely distinct and separate from that for the
bakery concerned in the manufacture of meat pies and fancy cakes.
(B) Bakery for Meat Pies and Fancy Cakes.
Premises.—The premises were, in general, modern in type, well lighted
and ventilated, and evidently maintained at a good level of cleanliness. Only
two points resulting from the first survey of the premises need here be noted.
(a) The sanitary arrangements were defective, in that no wash basin was
provided for the use of the male staff before returning to the bakery after a
visit to the lavatory, the only washing facilities—which they were stated
to use—being the sink in which various utensils, crockery and cutlery from
the bakery were left to soak in hot water during the process of cleaning.
(b) Bacteria! rat virus was laid down as a routine once a fortnight at
several points in the bakery, and certain baking ingredients, especially the
daily stock of flour stored in bins in the bakehouse, and the powdered gelatine
used in the preparation of meat pies and of certain other articles, as well as a
small proportion of the pies stored overnight on the premises, were insufficiently
protected against contamination by rats or mice suffering from the
effects of the virus. It may be added that samples of the flour and gelatine
were submitted for bacteriological examination at the laboratory of the
Ministry of Health and at that of the Borough Hospital, but with negative
results as regards the organism of paratyphoid (B) fever.
Staff.—Particulars, purporting to be complete, were obtained from the
firm as to the staff at work on the meat pies at the time when the two
batches of meat pies up to this point implicated had been baked, viz., on
August 25th and 27th; as to members of staff engaged in the preparation of
meat pies absent owing to illness or holiday; as to other members of the staff,
whether present or absent, and periods and causes of absence; as to members
discharged within recent months, and temporary staff during recent months.
These particulars were not all obtained at once, and it will be seen that
the inadvertent omission of one name from the list by the firm gave rise to a
good deal of unnecessary difficulty in the investigation.
The net result of the enquiry into the health of the staff at the present
stage was to cause suspicion as to one individual, all the rest presenting, so