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milk, and again we were fortunate, because the retailer had at his
premises a pasteurising plant, which he used frequently during
periods of warm weather.
On making enquiries at the farm we found that one of the
farmer's sons had returned from a holiday at the early part of
August. Whilst on holiday, he had developed a sore throat, which
was diagnosed as tonsilitis. For a day or two he was confined to
bed, and apparently was quite well after that till the end of August
when he developed another sore throat. He was removed to
the Romford Isolation Hospital, but, in the interval between returning
from holiday till he developed his second attack, he had
been milking. Another son, and a friend of the family who was
residing at the farm for a few days, also developed sore throats,
and were removed to Hospital. Both these had been milking. The
farmer himself, and one of his employees also had sore throats
about this time, and were likewise removed. Both had been milking.
Altogether, we had 18 cases which could definitely be associated
with this outbreak. None of these had an onset of symptoms
after the milk had been pasteurised. Swabs taken from the patients
admitted to the Isolation Hospital were sent for typing purposes
to Dr. F. E. Camps at the Department of Pathology, Chelmsford
and Essex Hospital, Chelmsford, and the results of all were returned
as positive to Streptococcus Pyogenes, Type 2.
The Ministry of Health was informed immediately of the
possibility of a milk borne epidemic, and valuable advice was
received from Dr. J. R. Hutchinson, one of the Senior Medical
Officers. A Veterinary Officer of the Ministry of Agriculture and
Fisheries carried out an inspection of the herd at the farm, but
nothing having a material bearing on the epidemic was found.
Batch samples of milk were taken by the Chief Sanitary Inspector,
and these were forwarded to the Ministry of Health Pathological
Laboratory for examination. Dr. F. Griffith of this laboratory reported
that Haemolytic Streptococci of the human pathogenic group
had not been found in any of the samples. The medical practitioners
were circularised at an early stage, as also were the Medical Officers
of Health of the adjacent districts.
There is no doubt but that many cases of apparently simple
sore throat without manifestation of rash might have been present
at this time without being brought to our notice, but from the foregoing
it will be seen that in tackling epidemics of this nature we
can put into operation a closely co-ordinated, and highly technical
system for the prevention of spread.