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Cases 1- 3 were associated with one confectioner and 4—5
with another. The mother of case 2 became a chronic carrier for
some months, but was at last cleared. The mother of case 4 became
infected from her baby.
In cases 1—3, the confectionery was supplied by a firm with
multiple branches in East London and South West Essex and the
total number of cases in Greater London was considerable.
The probability is that the infected foreign egg products contaminated
bakehouse machinery which was not properly cleansed
with boiling water after use. In turn the artificial cream (which is
normally sterile when received from the manufacturer) became
cross-infected. Further reference is made under "Imported Egg
Products."
The single case of typhoid fever was in a male, aged 44 years,
who appears to have contracted the infection abroad. This was due
to Vi-phage Type C.4 and this was apparently the first recorded
instance of this type in the country. In spite of the closest enquiries
into his itinerary, no source of infection could be suggested.
Imported Egg Products
Several cases of paratyphoid fever notified in May again
focussed attention on the risk of using these products. These cases
were part of a considerable outbreak (of over 40 cases) which
affected East London and Metropolitan Essex and which were
associated with cream filled confectionery from bakeries where
imported egg products were in use.
In the Report for 1955, reference was made to the finding of
Salmonella organisms in two out of twelve batches of Chinese dried
egg supplied to the school kitchens and to the action of the Committee
for Education in prohibiting the use of such products.
A circular letter was sent to all bakers and confectioners in
1955 advising them, if possible, not to use these products.
This was followed in November, 1955, by a letter setting out a
statement prepared by the bakery trade as to the precautions to be
taken in dealing with Chinese albumen. Amongst the advice given
was the need to cleanse all utensils in boiling water, to avoid
infecting other utensils and for operatives to wash hands and arms
before handling other foodstuffs.
In view of the 1956 series of paratyphoid cases, the Health
Committee instructed in June that bakers and confectioners were
again to be circularised on the danger of using imported egg
products and the precautions which were necessary if they were
used. This was all the more necessary because the enquiries at
Walthamstow in connection with the cases of paratyphoid clearly
showed that this advice was not being followed.