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44.
With regard to the 31 Fulham cases one was a
nurse in an infectious diseases hospital and was presumably
infected in the hospital.
Twenty four of the remaining 30 patients were
proved to have taken either cream or milk (or both)
bought from retail dairymen who obtained their supplies
from wholesaler X.
It will be seen that only in six of the thirty cases
was the evidence insufficient to show that the supplies of
these articles had been obtained from X. It is not,
however, to be expec'ted that absolute proof can 'be
obtained in each individual case as cream and milk are
often consumed in various forms without the consumer
knowing their source and it is impossible to remember
every article of food one has taken, especially when the
enquiries are made some weeks afterwards.
Of the '24 cases mentioned above, sixteen were
proved to have consumed cream obtained through retail
dairymen from wholesaler X at dates previous to their
illnesses which tallied with the incubation period of the
disease. The other eight of the twenty-four cases had
milk derived from X and although they were not proved
to have had any cream from this source, in at least five
of the cases there was reason for suspecting that this
was the case.
In the investigation of the source of infection the
case of Miss R. was of special significance. She had an
aunt from Tunstall (Suffolk) staying with her for a
week-end and on Saturday, 7th July, her aunt and she
had strawberries and cream. The cream was bought
from a Fulham dairyman who obtained his supply from
wholesaler X. Miss R. contracted paratyphoid fever,
the symptoms appearing on 16th July and I was informed
that the aunt became ill with the same disease
two days later. No alternative medium of infection
could be ascertained in either case.