Food and its effect on public health is a subject which takes an important place in Part II of the Ministry of Health's Report for 1951, and the Ministry of Food, in recognising the seriousness of food poisoning, has given prominence to the section devoted to food contamination by including, in one of its October Bulletins, a summary of this part of the Report. Food poisoning is described in the Report as a problem which grows more and more important, and which calls for a much higher standard of hygiene in food handling and its preparation. Figures compiled from the reports of the Public Health Laboratory Service, from bacteriologists in certain hospital laboratories, and from medical officers of health show that the total number of incidents notified in 1951 was 64 per cent higher than the number notified in 1949, but there is evidence that the actual number of persons affected by food poisoning was far in excess of the number of cases reported. Laboratory facilities for the investigation of food poisoning vary considerably in different districts, and medical officers are not always informed in time to carry out a full investigation; it is, therefore, difficult to obtain an accurate picture. In 255 outbreaks (47 per cent of the total) the source of contamination was traced. Of these outbreaks 101 occurred in canteens, 41 in hotels, cafés and restaurants, 9 in butchers' shops, 83 in hospitals, nurseries and institutions, and 18 in other places. The number of outbreaks traced to canteens is disturbingly high, but it should be remembered that canteen outbreaks are investigated and reported more frequently than outbreaks originating in shops and restaurants. When infected persons disperse from restaurants to their homes before the onset of symptoms, tracing the source is always difficult and often impossible. There is no reason to suppose that food poisoning arises less often in restaurants than in canteens. The figures reflect the difficulties of discovering and investigating outbreaks where the patients live in a number of different areas; they do not indicate the relative incidence of poisoning in canteens and restaurants. The Report states that 48 per cent of all outbreaks in which the food responsible was identified were traced to processed and made‐up meat such as re‐heated meat, stews, sausages, brawn, rissoles, gravy and stock. Out of 435 outbreaks in which the food thought most likely to have been responsible was traced, other foods—in addition to the meat dishes mentioned above—contributing to this type of infection were trifles, ice‐cream, custards and cream buns, also ducks' eggs. Milk was mentioned in 16 outbreaks. Inadequate standards of personal hygiene and faulty methods in preparing food for large numbers were the main reasons for contamination. Harmful bacteria usually get into food from insufficiently cleansed hands. Every effort must, therefore, be made by employers to provide kitchens and water‐closets with hand‐basins, abundant hot water, soap, nail brushes and clean towels. Though education in the hygiene of food preparation is now spreading, it still lags far behind what is necessary. Members of the public can speed the progress by actively insisting that their food is prepared and served with due regard to cleanliness at all stages. Reverting to the fact that nearly half of the outbreaks traced to specific foods were associated with processed, made‐up, and re‐heated meat dishes, the Report states that, if all meat dishes were cooked shortly before they were to be consumed, and if they were eaten while they were still hot, there is no doubt that the incidence of food poisoning would show an immediate and substantial decline. If food has to be prepared in stages, then precautions should be taken to prevent the growth of bacteria. After cooking and rapid cooling, it should be refrigerated until it is wanted, If it is to be re‐heated, this should be done rapidly and the food brought to boiling point. The Report refers to the setting‐up, by the Ministries of Health and Food, during the year under review, of two Working Parties and a Committee; these bodies have been making enquiries and have produced reports on the precautions to be observed in various branches of the food industry. These reports, have already been referred to in previous articles. Although there is no doubt that great improvements have been made in the handling of food—due to the enthusiasm of Medical Officers of Health and Sanitary Inspectors—it is generally realised that a persistent drive, requiring a long sustained effort and embracing complete health education of the food trade and the consuming public, is needed before safe food becomes a reality. Public opinion has been given the necessary impetus, and, on the business side, it is now obvious that good sanitary practices are also good trade practices, and that there is no conflict between the two interests. The way in which premises, the design and condition of equipment, and the human element affect the practices which are enforced or permitted in any particular food business, has a part to play in achieving and maintaining a high standard of food hygiene. Many food handlers have a confused idea of the difference between detergent and sterilizing action, and of the fundamental principle that sterilization must follow, and not precede nor be substituted for, cleaning with a detergent. On the other hand, it is very encouraging to visit so many small catering businesses, such as transport and other workmen's cafés, where the owner is intensely proud to show off the improvements and the efforts he has made to raise his food handling to a higher standard. At the other end of the scale, some multiple caterers have utilised their highly organised resources continuously to improve their premises, equipment and methods. There is, we all agree, endless scope for further health education.
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