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Of the above notified eases 45 occurred singly and the remaining 9 in three small
family outbreaks involving 4, 3 and 2 persons respectively. In no case could the causal
agent be identified with certainty although in many cases there was evidence that a madeup
meat dish had been consumed shortly before the onset of symptoms. The investigation of
food poisoning involving single cases and small family groups is complicated by a number of
factors. By the time notification is received the remains of any suspected dishes have
often been destroyed. The patient is usually under treatment, often with a sulphonamide
drug which rapidly eliminates the infecting organism from the stools or at least prevents
its growth in specimens submitted to the laboratory. In addition, many cases are caused,
not by the organism itself, but by poisons which it has produced in the food during storage
and which survive the cooking or re-heating process even though this may kill the organism.
These poisons cannot be detected by the ordinary laboratory methods.
An account of the work of the West Ham Clean Pood Advisory Association, which is
largely directed towards the prevention of food infections will be found on pages 44 and 45.
DYSENTERY. There were 214 cases of this disease notified during the year (96 males
and 118 females), giving a case rate of 1.26 per 1,000 of the population.
West Ham shared the experience of the remainder of the country in having a large
number of cases of dysentery during the year. No satisfactory explanation has yet been
found for this widespread epidemic. Fortunately the majority of cases were extremely mild
and no deaths occurred. Unfortunately cases occurring in Day Nurseries caused some dislocation
of this service since it became necessary to exclude the actual cases and also
those found to be carriers of the dysentery organism, and on one occasion it was necessary
to completely close a Day Nursery for a week.
GASTRITIS, ENTERITIS AND DIARRHOEA. During the year the number of deaths from this
disease was 9, of which only 1 occurred in children under one year of age.
TYPHOID AND PARA-TYPHOID FEVERS. There were no cases of typhoid fever or para-typhoid
fever during the year.
MEASLES. The number of eases of measles notified during the year was 4,011 - 2,116 in
males and 1,895 in females. This compares with 697 cases notified during the previous year.
The case rate per 1,000 of the total population was 23.58. There were no deaths.
The incidence of measles throughout the country in 1951 was the highest recorded since
this disease became generally notifiable in 1940. In West Ham measles became notifiable in
October, 1938, and the 1951 figures were also the highest ever recorded. Most of the cases
occurred during the first five months of the year. The fact that there were no deaths in
spite of the very high incidence reflects the very greatly reduced virulence which this
disease has exhibited in recent years: it is also in part due to the prompt and effective
use of sulphonamldes and penicillin in the treatment of complications when they occur.
DIPHTHERIA. There were only 5 cases of this disease during the year. The case rate
was 0.03 per 1,000 of the total population and there were no deaths.
WHOOPING COUGH. During 1951 there were 1,085 cases of this disease - males 536 and
females 549. The case rate was 6.38 per 1,000 of the population. There were 4 deaths.
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