View report page

33
branches, but at, or in connection with, the centra! bakery. This point was
established three days after the inquiry was begun, and just at the time when
the next batch of pies baked at the central bakery was about to be despatched
to the various branches. The Borough Hospital Sub-Committee of
the Public Health Committee, which met on that date, decided to ask the
firm to withhold this batch of pies from sale owing to the risk of this supply
also being infective; and to facilitate rapid control of this stock, purchased
the whole stock of pies, irrespective of whether these were
to be sold within the borough or elsewhere. The pies were promptly handed
over by the firm to the Public Health Department for destruction. A few were
selected for bacterial examination at the Ministry's laboratories and at the
Borough Hospital. The results of these examinations, as of that of samples
of gelatine and of flour from the bakehouse, were in all cases negative in
regard to the organisms of paratyphoid fever.
Infection by confectionery other than meat pies.
(1) The next stage in the enquiry arose from the notification of a case
of suspicious illness in Croydon by a medical practitioner. The patient,
a child, had an illness clinically suggestive of paratyphoid (B) fever, and
this was confirmed by a blood test. The child had not had any meat pies,
but had eaten on August 29th (three days before the onset of her illness) a
fancy cake crowned with a gelatinous material. This cake had been bought
from a branch of the same firm of confectioners distinct from any branch
so far involved.
Enquiry at the bakery showed that this type of fancy cake was made
there; that the gelatinous material covering its apex did, in fact, contain
gelatine with some whipped cream (sugar and cream, whisked), and that
this type of cake and the meat pies were the only articles in the manufacture
of which powdered gelatine was used in the bakery. The other ingredients
common to these two were flour, lard and water, and certain of the employees
were engaged in making both. Thus, attention was again rivetted on the
chance of the gelatine being infected through human or animal sources.
At this stage, after a full discussion of the position with the firm and
an explanation of the fact that only a provisional hypothesis of the source
and means of infection could be made, the latter voluntarily adopted the
following precautions suggested by me:—(a) The emptying, scraping, and
cleansing of the storage flour bins, prior to their being refilled with fresh
flour; (b) the provision of a bone-stock receptacle without a tap, to be emptied
by pivot action, and the adoption of special precautions in cleaning the utensil ;
(c) special care in cleansing and storage of funnel used for filling pies with
gelatine; (d) lining cupboards containing jam, pastry, etc., with zinc to
protect against mice; (e) to replace bacterial rat virus by other less objectionable
methods of rat and mice extermination; (f) to keep all lard, margarine,
sugar, and similar foodstuffs inaccessible to mice; (g) to use automatically
closing lids for flour bins, sugar and gelatine casks, and other
receptacles containing food materials; (h) to destroy existing stock of powdered
gelatine (already nearing its end), and certain other minor points. The firm
had already dealt with the insufficient washing accommodation for male staff
previously mentioned.
(2) The view that the stock of gelatine, contaminated in some way not
ascertained, was the agency carrying infection, now received a severe blow.
Cases of paratyphoid (B) fever were reported which on investigation showed
that they had had neither meat pies nor the special type of cake covered with
gelatine; but that they had obtained from various branches of the same firm
other fancy cakes which had one feature in common, viz., the presence on or
within the cake of a layer of " butter-cream " flavoured in various ways.
Enquiry at the bakery showed that these cakes did not contain gelatine, that
the only ingredients which they had in common with the meat pies and the