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6
Vaccination 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 the
Borough. Some of the cases occurred in the Borough of
Erith, an extensive investigation developed and it is likely that
the control measures which were instituted prevented a more
widespread epidemic. Reference is made to the full report
on this outbreak in the body of the report. In addition to
these cases, 3 cases of food poisoning were notified during
the year.
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 that this
disease which is preventable is not being prevented. It
presents a medico-social problem of great complexity, a
description of which is outside the scope of this foreword. I
would emphasise one aspect, however, which demands
immediate 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
frequently chronic cases are responsible for a good deal of
mischief and our powers under the Public Health Act, 1936, to
control this source of infection are inadequate in that such
patients may onlybe compulsorily removed to hospital provided
suitable accommodation is available for them.
The report of the Central Health Services Council for the
year ended December 31st, 1950, recognises that "this is a
potent source of infection" and recommends "that for
chronic infectious patients who are ambulant it is desirable
to provide hostels affording domiciliary care and medical
supervision."
In my view an anomalous position has arisen in regard
to the domiciliary tuberculous patient. The presence of a
tuberculous person in a household is often regarded by the