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upset. Dysenteric infection is probably very widespread. Attack by
one variety of organism is responsible for the very marked invasions of
the populations of mental institutions. A different organism, however,
is responsible for the infections which occur so frequently in children's
hospital wards. How common the infection is amongst the general
population is not known. If the dejecta of those suffering from alimentary
disturbances were submitted more frequently to bacteriological
examination, it is probable that it would be demonstrated that infection
is very widespread. In the absence of full use being made of the services
of the laboratory it is probable that the number of infections bears little
relation to the actual number of persons infected. Probably in most
years the numbers of those throughout the country who are notified are
mostly the result of infection of those in institutions. Even if all cases in
which a doctor were summoned were correctly diagnosed and notified,
it is probable that these figures would still reflect only a fraction of those
who have suffered infection, as in so very many the severity of illness
would be too slight for the doctor to be summoned. However mild,
though, the attack might be, it is important that all cases should be
recognised because of their infectiousness, the unsuspected patient
infecting in most cases only one member of the same household; if she
handles food, though, she might infect very many, all of whom might not
escape with a similar mild attack.
There is a marked variation in the numbers of cases notified from
year to year. Single case were notified in two of the years from 1934,
28 in another year. The largest number of notifications received in
any one year was 45, but these included 26 cases at a residential school
at which there was an outbreak.
In this last year although 23 notifications were received, the corrected
number was 16. Of these 5 were pupils at a local residential school.
In 8 of the 9 instances in which the organism was recovered this was
Sh. Sonnei. In the other case the infection was amoebic dysentery;
this case was of interest because neither the patient nor any member of
his family had ever been abroad. In two instances more than one case
occurred in the same family.
FOOD POISONING
In spite of the attention given these days to the subject of food
hygiene, food poisoning seems to be just as prevalent throughout the
country, in this last year 37 cases were notified in this district. In
some of these there were groupings of cases. It is only in such cases
that there can be any real hope of determining the cause of the trouble.
In September seven members of one household succumbed to an illness
ehich was thought to be the result of consuming a stew. The organism
CL. Welchii was recovered from the stew and from the stools of some of
the sufferers. Two children of one family fell ill shortly after the return
from a holiday abroad; staphylococci were recovered from the stools,
Three members of a household fell ill within a few hours of eating minced
beef; the meat was found to be contaminated and organisms were
recovered from the stools, this probably being a case of staphylococcal
infection. In November and early December a number of persons in