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Another condition which is notifiable to the Medical Officer of Health
is food poisoning; this is under the provisions of the Food & Drugs Act,
1938.
In general, notification is required by the medical attendant and by
the head of the household. In practice it is most exceptional for the
parent to send in a notification. The medical practitioner is required
to notify forthwith on becoming aware that his patient is suffering from
the notifiable condition. This is necessary not so much in the interests
of his patient, because so often no action by the local authority as regards
the patient might be necessary, but so that other steps might be taken to
limit the spread.
Enquiries.
Following receipt of the notification a visit is made to the home.
Up to recent years, this was carried out by the sanitary inspector, because
so many of the infections were considered to have their origin in some
defect in the drainage or in the structure or ventilation of the house.
To-day, with an appreciation of the individual as the source of infection,
in most cases the visit is made by the health visitor. It is felt, too that
she might be the more suitable person to give advice about isolation and
concurrent disinfection, which is considered to-day to be in most cases
of more importance than terminal disinfection. Nevertheless, in certain
conditions, such as food poisoning or the enteric or the dysenteric infections,
or smallpox, the sanitary inspector visits. The enquiries are directed to
two ends. The first is to determine, if possible, the source of the infection,
with the object of taking whatever steps might be practicable to avoid
others being infected from that source. It is for this reason that enquiries
are made as to the source of the water or milk, or about the school or
other buildings, at which the child has been. The second line of enquiry
is to enable such steps to be taken as will minimise the spread of infection
by the infected person. It is for this reason questions are asked about
his place of occupation and lists obtained of the contacts and their places
of work.
Aid to Diagnosis.
The earlier the diagnosis, the greater the likelihood that preventive
measures will limit the spread of infection. In some diseases, the laboratory
is of help. (See Laboratory Service, page 27.)
Where a patient is suffering from some clinical condition which is
suspected as being infectious, and in which the help of the laboratory
is sought, it is usually advisable, pending the confirmatory diagnosis,
for the same precautionary steps to be taken as if the patient were known
to be suffering from the infectious condition.
The other assistance a practitioner can obtain in the making of a
diagnosis is having the second opinion. Because of his training and
because, too, he was so often associated with an isolation hospital, the
Medical Officer of Health usually had more experience in infectious
diseases than his colleagues in general practice. It was quite usual
then for him to see cases about which the general practitioner was in
doubt. In future, the Medical Officer of Health will not be any more