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7. Arrangements were made for specimens of stools to
be taken from the 21 employees concerned and submitted for
bacteriological investigation.
8. Samples of synthetic cream of three different kinds
and actual products on sale were taken away for investigation.
9. I assembled all the staff in the section and explained
the nature of our investigation and the need for particular
care in cleanliness of the hands, especially after visits to the
lavatory.
10. Arrangements were made with the Management for
the immediate discontinuance of the manufacture and issue of
cream products of any kind until further notice, the staff to be
found other work not concerned with food handling in the
meantime.
11. After a suitable interval second specimens of stools
of the staff were submitted for examination.
12. Specimens were also taken from certain members of
the staff concerned with the handling and distribution of
other manufactured products as, in a number of cases, these
seemed to be the article of diet at fault, but the possibility of
contamination in transit had to be considered.
13. A daily inspection of the personnel and machinery was
carried out. One of the girls working on the cream side of the
firm was away ill with a diagnosis of German Measles. I
visited her at home and, as there appeared to have been a
history of abdominal upset, the question of a mistaken diagnosis
had to be considered, and I had her admitted to hospital for
investigation. Subsequent examinations proved to be
negative.
The possibility that the outbreak may have been caused
either by ice lollies, ice cream or milk had also to be
investigated, but it was decided that these were not implicated
in the present outbreak. It was ascertained that cases of
Paratyphoid fever had also occurred in various other parts of
the country including St. Helen's, Lancs., and Barnsley,
Yorks., and liaison was established through the Ministry of
Health to ascertain if there was some common factor, especially
as it was known that the synthetic cream concerned was also
distributed to those areas.
In all, 12 different strains of the Paratyphoid 'B' germ
are known to the Central Enteric Reference Laboratory of the
Medical Research Council, and the Hospital authorities sent