London's Pulse: Medical Officer of Health reports 1848-1972

View report page

City of London 1961

[Report of the Medical Officer of Health for Port of London]

This page requires JavaScript

available for laboratory experimental purposes, or was
destroyed.
In Ceylon, certain mills were selected for modernization
and operation under conditions designed to exclude as far
as possible the risk of contamination arising within the
mill itself during the various processes, the output being
separately packed. Regulations designed to control the
milling, transport, packing and export of desiccated
coconut have been issued by the Ceylon Government.
Provision is made for registration of mills conforming to
the standard required, and for the registration of shippers
who must agree to ship their coconut on an export
licence obtained from the Ceylon Coconut Board, their
supplies being derived only from registered mills.
A laboratory is being set up to work in close association
with the Medical Research Institute in Colombo for the
examination of samples drawn from the mills, adverse
reports upon which will render the miller liable to refusal
of an export licence for a definite period.
Although percentage sampling is not an ideal method
of assessment, it is interesting to record that in two
instances importers requested 100 per cent examination
at their own expense with the following results:
Five per cent and 10 per cent sampling of 380 bags
comprising shipment "A'' gave a contamination rate of
8-8 per cent, and 100 per cent sampling of the shipment
gave a rate of 8-9 per cent.
Five per cent and 10 per cent sampling of 482 bags
comprising shipment "B" gave a contamination rate of
8-3 per cent, and 100 per cent sampling of the shipment
gave a rate of 12-2 per cent.
It is understood that four or five mills have satisfied the
requirements of the Ceylon Regulations.
It has been repeatedly suggested that each mill should
mark its output with an identifying mark to enable the
source of contamination to be traced. At present a shipment
usually bears a number of marks, some being the
importers mark and some presumably the mill or exporters
mark. There is no information as to the significance
of these marks, and the whole shipment therefore
is sampled and dealt with as a unit.
It is hoped the marks used by the mills which have
reached registration standard will be notified in due
course.
(h) Cheese
In 1960 a survey of the bacteriological condition of
imported cheese was undertaken. Many samples showed
very high surface plate counts, and in a number of
samples coagulase-positive staphylococci of a foodpoisoning
type.
Little or no information could be obtained from any
source as to what would be an acceptable limit of
bacterial contamination in cheese, but it was considered
that such plate counts as 150 million, 40 million, 15
million with the presence of coagulase-positive staphylococci
were excessive, and the attention of the authorities
of the exporting country was drawn to the unsatisfactory
results obtained. A serious view was taken of the position
by the exporting country and government investigations
were put in hand immediately.
On the day Government officers of the exporting
country called to explain what steps were being taken to
eliminate contamination, reports of two food poisoning
outbreaks were received in the Port Health office. Both
were at hospitals, one involving 100 patients and the
other 35 patients. Bacteriological investigation on the
spot in both instances confirmed the cause as being cheese
from the country whose representatives had been interviewed
that day.
Enquiries elicited the fact that cheese rejected for direct
sale at time of manufacture and imported for processing
in this country had been supplied in error to the hospitals
for direct consumption. All stocks were immediately withdrawn
from distribution, and the question as to whether
the cheese was even suitable for processing was considered.
The active growth of the staphylococcus is accompanied
by the creation of enterotoxin, and although in
processing the cheese the heat treatment involved would
be sufficient to destroy the organism it would not destroy
the enterotoxin. No technique is at present available for
the determination of the presence of enterotoxins
although it is understood one has been evolved and will
be available in time, so that the problem was being
approached somewhat theoretically and academically.
It was further stated that the staphylococcus count was
reduced with time, so that at moment of time "A" there
could be an extremely high plate count with consequent
rapid production of enterotoxin, but at moment of time
"A" + "B" the plate count could be negligible but the
toxin level still dangerously high without possibility of
determination.
Bacteriological sampling of cheese before export will be
carried out in future by the exporting country, and only
that reaching a certain standard will be allowed for
export. All milk used for cheese manufacture will be
pasteurized at 162°F for 15 seconds before use.
Cheese similar to that which caused food poisoning at
the hospitals was later consumed by a number of officers
of the Ministry of Health with no untoward result.
2. CONCLUSIONS
How far the United Kingdom falls short of being
self-supporting in food production may be gauged by
those who remember how the available food, and much
of that imported, was rationed during time of war. Meat,
butter, cheese, eggs, sugar, tea—practically every article
of food constituting our basic meals was rationed in
minute portions.
The nation's food imports are dictated by a host of
individual tastes which the world's exporters are continuously
attempting to supply and appeal to, leading to
imports of quick-frozen frogs' legs from Cochin, chicken
and shark soup from China, egusi (crushed melon seed),
yam flour, bitter leaves and gari from Africa. These foods
were unheard of a few years ago, and when egusi and
bitter leaves are found to contain salmonella organisms a
further problem is added to the list, that of discovering
what they are and what they are used for. The pattern of
food examination is changing with the emphasis now on
bacterial condition.
It may fairly be asked that if foods such as cheese,
coconut, prawns etc. have had no record as the causative
agent in food poisoning for the many years they have
been coming into the country, why create trouble by
looking for bacterial contamination ? The cause of food
poisoning is often never established, and it is felt that if
the item of food is found to be potentially capable of
causing poisoning it cannot be accepted as fit for human
consumption.
It may be apparent from the instances quoted in this
paper that in some cases relatively simple action in the
exporting country can rectify the position, in others at
least the potential danger is recognized and a sterilizing
heat treatment applied.
I am not asking for all food to be sterile—far from it.
But I do think there is a limit, which is not always welldefined,
beyond which it is not safe to go.
When assessing the fitness of food it should be
borne in mind that what may be quite innocuous to
the healthy adult may not be so to the child or the
sick.