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Articles of food such as milk and milk products
especially cream and ice cream, may be infected by
bacterial carriers who have the bacilli in their stools or
urine without being aware of the fact. Persons who
handle food either in their own homes or in the
course of their occupations should take special care to
wash their hands after every evacuation of the bowel
and after passing urine. It is worth noting that the
typhoid group of diseases are not the only conditions
spread by dirty food handlers.
Plies may spread these and other diseases of the
bowel by feeding on the discharges of patients and conveying
the bacilli to food which lias been left uncovered.
The importance of keeping food covered and out of
the reach of flies can hardly be overestimated.
Description of the Fulham Cases.
The total number of cases notified in Fulham was 37
but in four instances the diagnosis was not confirmed
and in tAvo instances although the diagnosis was verified
the cases were almost certainly unconnected with the
outbreak. The four cases in which the diagnosis was
not confirmed were suffering from influenza except one
which was due to parametritis. The two cases unconnected
with the outbreak were as follows : —
S.K., a woman of 55, who became ill nearly 3 weeks before
the other cases, viz., on 16th June. This case was notifie
on 30th June.
F.C., a woman aged 30, whose illness commenced on 24th
August. Her notification was dated the 9th September.
It can be stated definitely that 31 cases at least
Mere affected by the outbreak in Fulham.
Paratyphoid fever is characterised by symptoms
which are very general and indefinite and is very difficult
to diagnose without a special examination of the blood
serum. The blood test usually employed, however, is
seldom of any value until 10 days after the beginning of
the illness. It is not therefore surprising that the outbreak
only became known to the Public Health Authorities
at the end of July although it actually commenced
some weeks before that time.