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44
families had purchased cakes from the same baker, and had
possibly purchased ' iced lollies' which although obtained from
different itinerant dealers, were found to come from a common
source. The investigation made into the " iced lolly " source,
however, proved negative and we were left with the Baker as
the only possible source of infection. It was known that this
Bakery covered a very wide area in North West Kent and there
was definite evidence in two of the three cases that cream buns
had been eaten from this supply. On communicating with the
Medical Officer of Health of the area in which this firm is
established, it was found that another case had arisen about the
same time in his own area—the baker being the same itinerant
supplier. Steps were immediately taken by this Medical Officer
to investigate and control the source of supply. In the meantime
a further case arose in the Orpington district and other cases in
Lewisham, Dartford and Dartford Rural Distict and Crayford.
Of the fourteen cases which thus came to notice, eleven had the
same baker and there was evidence that cream buns had been
eaten. There was, therefore, presumptive evidence that the
infection lay with the ' cream.' As a result of action taken,
there were no further cases.
The comparatively small number of cases notified bears little
relationship to the number of persons who may have been
infected, for it is noteworthy that, in epidemics of Paratyphoid
' B,' cases occur which are not severe enough to call in medical
aid and, therefore, escape supervision."
Food Poisoning.
It is now happily the custom in any doubtful cases for the
General Practitioner to notify the Medical Officer of Health
of Food Poisoning or suspected Food Poisoning. It is only by
the very closest co-operation between the practitioner and the
department that control and investigations can be exercised. It
is of vital importance that these notifications should be made
within twenty-four hours of onset, otherwise we are unable to
co-relate the symptoms, the food taken and the movements of the
patient. It follows, however, that although twenty-six cases
were notified, in only three cases were we able to identify the
organisms concerned. Fortunately, there were no real outbreaks,
the twenty-six cases being individual patients. The adage that
"prevention is better than cure "is truly demonstrated in the
question of food poisoning. Hygienic handling of food in all its
aspects is the real controlling factor.