1949/12/03 by Wilfred Shaw, W. Shaw · 1 citation
Medicine · #Intraocular Surgery and Lenses #Intraoperative Neuromonitoring and Anesthetic Effects #Vascular Malformations Diagnosis and Treatment
paper · pdf · doi:10.1136/bmj.2.4639.1261
EGGSMEBRiTISH 1261 low thermal death point, the survival of Salmonellae in even lightly cooked dishes is difficult to explain.Recent experiments (Report of M.R.C., 1947) with reconstituted dried egg known to be infected showed that the great majority of the organisms were killed by scrambling (producing a temperature of 830 C. for three-quarters of a minute) and in omelette-making (850 C. for one minute).Only when the reconstituted egg was first incubated overnight, so producing a bacterial content of between 10,000 and 1,000,000 per g., were positive cultures obtained after cooking, and then only from an inoculum of no less than 50 g.In view of these findings, and of failure to recover organisms from an experimental pudding of the kind concerned here, the survival of sufficient numbers of bacteria in the incriminated food to cause so high an attack rate in those consuming it remains a mystery.This outbreak is also of interest on account of the hazardous measures without which the work of the hospital could not have been continued.The only persons forbidden to return to work until after repeated negative stool examinations were food-handlers, a kitchen employee, and two dining-room maids.It was necessary that nurses should return to duty as soon as they were fit to do so, and proof of their freedom from infection was not obtained until some time later: for a few days at least after their return to duty many were probably carriers, and some were shown to be.They were of course fully instructed in the precautions they must take, and evidently observed them faithfully.A greater problem at the height of the epidemic was the nurse with a mild or unrecognized attack of the disease who remained on duty.It is possible that some transmission to previously uninfected patients took place during this brief and strenuous period.Summary An account is given of an outbreak of Salnti.typhi-muriumti enteritis involving nursing and other female staff and patients in a large general hospital.The vehicle of infection was a lightly cooked pudding containing 200 duck eggs.The clinical features of the disease are described, together with laboratory investigations and the steps taken to control the epidemic.We are indebted to Dr. Joan Taylor, of the Salmonella Reference Laboratory, for kindly examining five of the strains isolated from patients and confirming their identity.