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Puerperal Pyrexia
As a result of the introduction of the amended Puerperal Pyrexia
Regulations, 1951, the number of pyrexia cases coming within the scope
of the Regulations has been greatly increased. As a result, the number of
notified cases of rise of temperature in lying-in women rose to 197, of
which 58 were Carshalton women.
It should be noted that the St. Helier Hospital, which provides the
majority of these notifications, has a large maternity unit which caters
for a large part of Metropolitan Surrey. Moreover, abnormal maternity
has first priority on this accommodation and it is this type of case in
which fever is most liable to occur. The incident rate of 245.94 per
thousand births as shown in the summary of vital statistics in the first
section of this report is, of necessity, calculated on total births to
Carshalton mothers only, and is therefore without any significance as an
indication of the extent to which confinements are attended by a
notifiable rise of temperature.
All but one were hospital deliveries and 121 were in respect of
first confinements.
Food Poisoning
Thirty-seven notifications of food poisoning were received. Four of
these were single isolated cases, unassociated, as far as could be
ascertained, with any others. Of these four, 3 were due to infection by
Salmonella Typhimurium, but no causal organism was identified in the
fourth. As is usual in the single cases, it is very difficult to identify the
source of the infection unless remnants of the infected food are available,
which they seldom are. This was so in respect of these four patients, but
there was a strong suspicion that almond paste on a cake was the vehicle
in one instance.
The remaining 33 notifications fell into two groups of 17 and 16
relating to two outbreaks in local hospitals.
Between 30th April and 8th May a number of persons were taken
ill at a hospital with diarrhoea and abdominal pain, accompanied by
a varying degree of temperature, most of them on the 2nd, 3rd and 4th
of May. Most of the cases, too, were patients in the hospital, a few only
being members of the staff. Bacteriological investigation revealed 21
cases to be suffering from infection from Salmonella enteritidis var Jena.
Some 30 other individuals in the hospital were found to have suffered
from diarrhoea, but the S. enteritidis was not isolated in their case.
In view of the fact that diarrhoea from one cause or another is not
infrequent among hospital patients it is difficult to estimate how far
these 30 unidentified cases might have been due to the same cause. The
cases were distributed over many wards, but not all, in the hospital
and the number of people at risk was estimated at 860. A detailed
investigation was undertaken of the dietary at the material time and
many foodstuffs in use were submitted for bacteriological examination
with completely negative results.
The hospital patients were fed from a separate kitchen and a close
scrutiny was made of the culinary arrangements. Some weaknesses in
equipment and practices employed were revealed and these received
the prompt attention of the Management Committee. All the kitchen
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