Not very long ago H.M. Government plastered walls and hoardings with a large scale portrait of a haggard woman in deep mourning surmounted by the words “ Keep Death Off the Roads ”. A solemn warning for the rising toll taken of human life through the carelessness of others. It seems strange that no similar publicity is vouchsafed to the number of deaths caused through food poisoning. Figures recently quoted give these as five thousand a year. The Central Council for Health Education set the ball rolling in 1947 when they held a one‐day conference on food and drink infections which was attended by representatives of all branches of the food industry and of local authorities in England, Wales, and Northern Ireland. Advocating the instruction of managements, food handlers, and housewives, Dr. Robert Sutherland, Medical Adviser and Secretary to the Central Council, explained that the purpose of the conference was to get local authorities to start a campaign in their own area to encourage the food handler to become conscious of his responsibilities. Posters, leaflets, film strips, lecture syllabuses were all to be made available, and this looked like a step in the right direction. Guildford, Surrey, perhaps as a result of this conference, staged a campaign for cleaner food last March. They issued pamphlets, demonstrated likely hiding places for germs, and bestowed certificates upon those shops and premises agreeing to a certain standard in the preparation of food. (An article by the M.O.H., Guildford, in last month's issue, on page 122, described this campaign.) More recently, the Mayor of Lambeth has been saying much on the subject of hygiene; he even attributes some cases of food poisoning to the nail varnish adorning the fingers of waitresses. This is perhaps carrying things a little too far, but the Mayor rightly pounces on the dangers of hidden bacteria in cracked china. Much controversy has been waged on whether or not cracked cups are a potential source of infection. A writer in a recent issue of The Municipal Journal discounts this theory and says that the risk of anyone acquiring infection from a cup or glass with a chip in it is so remote as to be not worth considering. Having dismissed the danger so lightly, he goes on to say that the cracked and chipped utensil is really only disliked because something that is clean and pleasant to look at is preferred. This, no doubt, is true, but the warnings, supported by test results, given and made by Dr. Sidney Linfoot and published in The Lancet in 1945 cannot be disregarded. That these dangers are very real was demonstrated by the results of a bacteriological examination of twenty cups obtained from different public restaurants in which the microorganisms obtained from cultures from the cracks in each of the cups were enumerated. In many cases there was a free growth of Staph. aureus and also haemolytic streptococcus. There was also a fairly frequent appearance of intestinal organisms (B. coli, B. proteus, etc.) and one cup gave a heavy growth of Friedlander's bacillus. Nearly all the organisms found were such as are commonly associated with stomatitis and mouth and gum complaints generally. Dr. Linfoot further suggested that the presence of Friedlander's bacillus was also an indication that respiratory organisms might be a source of infection and that it was reasonable to assume that the Klebs‐Loeffler bacillus might be found if the cups had been used by a carrier. The presence of haemolytic streptococci is also a reminder that a cracked cup may be an agent in the spread of scarlet fever. Syphilitic infection is unlikely but not impossible, and in the same category falls tuberculosis. These organisms, particularly the former, would be difficult to discover from cracks, but the fact that even relatively easily killed organisms can be found alive in such sites suggests that their transmission is not impossible. The most obvious danger, states Dr. Linfoot, is that of ulcerative stomatitis. Education of the public, always a little dubious about the existence of microbes, would mean expensive advertising campaigns; legislation would help, but there are doubts as to whether or not it could be enforced. According to the Ministry of Food, Dr. Edith Summerskill is already busy drawing up a list of by‐laws for submission to local authorities with a code of practice applicable to every trade. This is useful, but in no way sufficient to tackle the problem. It has been suggested that much could be done by the private medical practitioner who, during contacts with patients, could drop a word of warning. Talk will not solve the problem: strong measures are needed substantially to reduce this appalling loss of life each year which, by the exercise of strict hygiene in the kitchen, canteen or restaurant, and by the supervision of staff cleanliness, could to some extent be curtailed.
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