Typhoid and paratyphoid fevers / prepared by the Standing Medical Advisory Committee for the Central Health Services Council, the Secretary of State for Social Services and the Secretary of State for Wales.
- Great Britain. Standing Medical Advisory Committee
- Date:
- 1972
Licence: Open Government Licence
Credit: Typhoid and paratyphoid fevers / prepared by the Standing Medical Advisory Committee for the Central Health Services Council, the Secretary of State for Social Services and the Secretary of State for Wales. Source: Wellcome Collection.
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![infected in Croydon. There were 43 deaths. A more recent example of an outbreak, in which circumstantial evidence pointed to the contamination of supplies of drinking water, was that associated with Zermatt in March 1963. A total of 68 bacteriologically confirmed cases of typhoid fever in England and Wales occurred among persons who had recently returned from holiday in Zermatt. It is note- worthy that, in spite of this considerable importation of infection, only one secondary case is known to have occurred in Britain. This illustrates the relatively unimportant role of person-to-person contact in the spread of this disease. Food such as shellfish contaminated by infected water or sewage has also been the source of typhoid outbreaks; Baird gives an interesting account of such outbreaks and the measures used to control this source of infection (Baird 1961). Contaminated milk and ice-cream have been associated with large outbreaks of typhoid fever. Milk may be contamin- ated directly by an excreter or indirectly eg through contaminated water used for cleaning milking utensils: in the latter event the outbreak would in the strict sense be water-borne. A notable example of milk-borne typhoid infection is the Bournemouth outbreak of 1936. In August and September of that year more than 500 cases were notified in Bournemouth, Poole and Christchurch and approxi- mately 200 other patients who had been on holiday in these towns developed typhoid fever after returning home. It was established that all the patients with primary infections had consumed raw milk retailed by one firm which in turn was supplied by farms scattered throughout Dorset. Typhoid organisms were recovered from a stream which flowed through the grounds of 2 of these farms. Subsequent investigations brought to light a chronic typhoid carrier living in a large house from which sewage spilled into the stream. Aberystwyth provides a good example of an outbreak in which ice cream proved to be the vehicle of infection. During the summer of 1946 over 90 cases of typhoid fever occurred in the borough, 30 or more in the rural districts and about 75 in other parts of the country among holiday makers who had been infected in Aberystwyth. The source of infection was speedily traced to an ice cream vendor who had suffered from typhoid fever in 1938. Tests showed that he was a chronic carrier. Regulations introduced since that time make recurrence of outbreaks caused by ice cream very unlikely. [The Ice-Cream (Heat Treatment, etc) Regulations, 1959 and 1963.] More recently canned meats have been recognized as a potential vehicle of typhoid infection. Outbreaks in Harlow, South Shields and Bedford during 1963 and in Aberdeen during 1964 were all associated with corned beef in 6 lb cans, opened and sliced before sale. An earlier outbreak at Pickering in 1955 was attributed to canned tongue. Canned meats have previously been regarded as the safest of foods and spread of infection by this means has hitherto been thought to be due to B 3](https://iiif.wellcomecollection.org/image/b32230692_0005.jp2/full/800%2C/0/default.jpg)
