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for the most part, appeared to have originated in this country; even a Salmonella brandenburg, a
Salmonella indiana and a Salmonella panama. A Salmonella enteritidis infection in a person working
in a zoo raised some interesting questions, but no answers were forthcoming.
A typhimurium infection was the start of an investigation which extended into other parts of
London. The day before taking ill the patient had attended an African wedding, where exotic dishes
were served at the reception, but not being an invited guest was rather vague about its location.
After several days' work of piecing together the facts and eliminating a number of false trails we were
able to locate the church and subsequently the participants.
When following up an attack of gastro-enteritis it is desirable to request specimens from food
handlers who may have a connection with the disease. They are usually very co-operative, but
occasionally we encounter one who feels that this is a sluron his occupational standards and personal
hygiene. It then has to be pointed out that this is the only way in which he can be excluded from
responsibility for causing the disease, and that if it is not supplied, some doubt must always remain.
In fact,duringtheyeara number of cooks and canteen staff were eliminated from suspicion in this way,
and a proportion of the outbreaks with which we dealt were identified as epidemic or winter vomiting,
a virus infection with airborne spread.
Dysentery
Where bacilliary dysentery was concerned, shigella sonnei remained by far the commonest offender,
occasionally even turning up in the symptomless contacts of people being investigated for other
infections. There were two incidents involving its more potent relative, shigella flexner, while there
was one case of amoebic dysentery.
Psittacosis
Psittacosis is an infection of birds which is transmissible to human beings. A single case
occurred in which it was found that two pet budgerigars sickened and died shortly before the patient
became ill with the pneumonia which is typical of the condition. Examination of one of the birds
revealed that psittacosis had indeed been present.
Tuberculosis
This year witnessed the closure after many years of Finchley Chest Clinic. We are sorry to have
come to the end of the happy partnership we had with Dr. B.A. Butterworth and the staff of this clinic,
but there was a remarkably smooth changeover of its responsibilities to Islington Chest Clinic, under
Dr. J. Wallace Craig, and a high level of service has been maintained.
Chest Clinics and Mass Radiography still have a vital role to play in the prevention of the spread
of tuberculosis, and everything possible is done to follow up the contacts of open cases of the disease.
Here as elsewhere, efficiency and economy go hand in hand, and in order to avoid the unnecessary
x-raying of large numbers of people an arrangement has been made with St. Ann's Chest Clinic whereby,
if a case occurs in an establishment, i.e. an office or workshop, a chest physician and a Council
medical officer visit together, consult with the senior staff, and make a joint estimate of what is
required. Unanimity has always been achieved, and whereas in one instance, fortunately a small
office, x-ray of all those working there was felt to be necessary, in another it was found to be required
for only a few, and in still another, none at all.
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