View report page

20
Course.
Once the diarrhœa had stopped in most cases there was rapid
recovery, but a few cases continued ill for some time—in one or
two cases for about three weeks. In these cases there was usually
a recurrence of the symptoms, the second attack giving noticeably
more severe results in the way of prostration than the first. Kecurrences
were observed in about 10 per cent. of cases, though
figures are not very reliable for the reasons stated later.
Treatment.
All cases reporting sick were given an immediate dose of
Bismuth Carb. with Chlorof. and Morph. co. and sent home with
the instructions to have no solid food and to call in their own
doctor at once.
Steps Taken.
The symptoms and sudden onset suggested some form of food
poisoning, and the canteen was at once suspected. Detailed statements
were taken from cases seen at once as to the food and drink
they had had at the factory, and it was found at once that the food
was rarely a common factor, but that drinks—coffee, tea, and water
—had been taken in practically every case. The Canteen was inspected
and all found in order; samples of water were taken from
the Canteen hot water supply and from all the drinking taps and
sent for analysis, but nothing was discovered. The Metropolitan
Water Board Authorities were communicated with, but they could
discover nothing abnormal. The Medical Officer of Health was
informed of the outbreak and proceeded to make investigations.
At about this time the Engineer discovered a possible way of entry
of small quantities of canal water into the general supply.
I tried to find out the probable time that elapsed before symptoms
commenced after infection, but this was obviously difficult in
view of the doubt as to the infection. In a large number of cases
during the first day, however, the men left work about 5 p.m., and
were taken suddenly ill late at night—an average of 4-6 hours after
leaving work.