Memorandum on typhoid fever.

Date:
1939
Catalogue details

Licence: Public Domain Mark

Credit: Memorandum on typhoid fever. Source: Wellcome Collection.

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    oD diagnosis. In an appendix to this memorandum notes on the collection of specimens and on the principles of laboratory diag- nosis have been added. Prevention and Control. The chiei factors responsible for the large reduction in the incidence of enteric fever have been the improvement in the control and supervision of water, milk and tood supplies, the more general introduction of the water-carriage system of sewage disposal, greater care in the collection and disposal of refuse and greater attention paid to cleanliness and personal hygiene. Water.—The possibility of the pollution of a water supply which has been satisfactory for many years must not be over- looked. Special vigilance is required where a gathering ground is being built upon, or in the event of operations concerned with the maintenance, improvement, or extension of water works. The importance of the routine control of water supplies was emphasised in Circular 1684 of 1938, Memorandum 221 oi 1939 and the Report on Public Health and Medical Subjects No. 71: ‘‘ The Bacteriological Examination of Water Supplies ”’ (revised edition of 1939), and attention is again drawn to these documents. Food.—During the past fifteen years, in 40 outbreaks of typhoid and paratyphoid fever in which there were definite grounds for an opinion as to the vehicle of infection the numbers were—water 11, milk 12, other foods 17. These fevers are not diseases of the cow and, in outbreaks in which milk is proved to be the vehicle of infection, the infection must have been introduced from without, at or after the time of milking. In this event subsequent pasteurisation would render the milk safe, although it is of course possible for milk to be infected after pasteurisation if sufficient care is not taken. It is noteworthy that none of the milks in the outbreaks in question was pasteurised. These figures are given with reserve, but they indicate the need for greater care in the handling of food for human con- sumption. Individual cleanliness is essential; no person should prepare food without previously washing his hands, and hands should always be washed after the use of the toilet. In estab- lishments dealing with food, adequate washing facilities should be provided and the personal routine of use should be strictly observed by the staffs to avoid the possible contamination of the food. The use of tongs when purveying unwrapped food- stuffs, the protection of food from fhes and the destruction of flies are important measures.