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the other districts concerned, and we kept each other informed
of the day to day position in regard to the paratyphoid fever
in our respective districts. This enabled me to keep a central
register of cases and contacts occurring over the whole area,
a fact appreciated by the Ministry of Health who were, of
course, informed and who kept in close touch with us during
the outbreak.
The following measures were taken in Erith, Bexley and
Crayford.
1. All Doctors were warned of the prevalence of Paratyphoid
fever and an offer made for me to see suspected cases
with them.
2. All suspected cases and carriers were quickly admitted
to hospital.
3. A search for contacts was made and specimens of
stools, and in a few cases, of blood, were submitted to the
Public Health Laboratory at Maidstone for examination.
4. The Sanitary Inspectors visited all shops supplied by
the firm in question and withdrew any cream products which
were still exposed for sale.
The major part of the investigation was, of course, in
connection with the firm in question which I visited with the
Senior Sanitary Inspector and made a full investigation as
follows.
1. A list was obtained of all cream products supplied by
the firm.
2. The source and composition of the synthetic cream
used was ascertained.
3. The method of manufacture, handling and packing of
the cream products was fully gone into.
4. A full list of handlers, fillers and packers of these
cream products was obtained together with a detailed account
of their duties.
5. I interviewed personally every member of the staff in
this section of the firm with particular reference to past
illnesses of themselves and their families. A number was
away for various reasons and these persons were visited at
home, or if away on holiday, interviewed later.
6. The plant in general was inspected.