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STAPHYLOCOCCUS FOOD POISONING
1453 the excellent use which has been made, being made, of all subscriptions, gifts, and bequests to the College. The story of Epsom is one of progress, while the indications for lines of advance are such that they must call for substantial support in money. but
by
and is
STAPHYLOCOCCUS FOOD POISONING THAT certain staphylococci can produce food poisoning has been established not only by monkey tests with sterile filtrates but by a large number of experiments with human volunteers. Moreover, several outbreaks have now been recorded where the staphylococcus has been definitely incriminated. The isolated strains differ widely both in cultural and in agglutinative characters. Some are hsemolytic, some are not, some are of albus, some of aureus type. Prof. E. 0. JORDAN of Chicago has shown also that the strains producing toxic filtrates are not restricted to those isolated from implicated foods but may be derived from many sources, including normal and diseased human throats. The vehicle in which the organism is conveyed is mostly " cream cakes," filled with custard rather than pure cream, although in the first recorded
outbreak (M. A. BARBER, 1914) the agent was milk. Cream-filled pastries often contain a few staphylococci, but the sound articles do not appear to contain organisms in numbers comparable to those found in the implicated foods. With W. BURROWS, JORDAN has recently described2 five characteristic outbreaks which occurred in America in 1932 and 1933. The first of these, in Milwaukee in March, 1932, involved 54 persons, all of whom had eaten custard-filled pastries ; from an uncut cream-filled cake of the same batch numerous staphylococci were isolated. From one strain a toxic filtrate was obtained, and 20 c.cm. of this filtrate given by mouth to a rhesus monkey caused violent vomiting 4thours later. All the victims were violently ill after an incubation period of about three to four hours ; none died. The second outbreak was in Chicago in April, 1932 ; 31 persons were affected, the vehicle being again cream-filled cakes. The incubation period was and nausea and vomiting were the similar, again most characteristic
symptoms. Staphylococci
were
isolated and sterile filtrates caused violent vomiting in several rhesus monkeys. The third outbreak occurred in Milwaukee in May, 1932, and involved seven children, all of whom had eaten custardThe staphylococci isolated filled coffee cake. a toxic to a monkey, and the filtrate produced same applies to that obtained from dough-nuts filled with custard associated with the illness of two persons in Chicago in the same month. The outbreak in Winona in May, 1933, involved several cases, the vehicle being chocolate eclairs, and from these also a staphylococcus was isolated yielding a filtrate toxic to monkeys. Several features associated with staphylococcal food poisoning still remain obscure. Although the number of recorded outbreaks amount to a dozen 1See THE LANCET, 1930, i., 1354; 1932, i., 33; 1933, ii., 197. 2Amer. Jour. of Hyg., November, 1934, p. 604.
or more, they are rare indeed when we consider the probable frequency of infection of foodstuffs with the organism. Toxin-producing staphylococci are not uncommon, and there must be some unknown factors which cause them to produce enterotoxic substances in certain cases. In the laboratory various methods may have to be tried before toxic filtrates are obtained ; in these recorded outbreaks the best results were procured when the culture was incubated in an atmosphere of 20 per cent. C02. A suitable medium is essential, and it is noteworthy that custard-filling standing at room temperature is likely to be an excellent culture medium. Another curious feature is the geographical limitations of the proved cases. Almost all have occurred in America, and although since the establishment of staphylococci as a source of food poisoning English bacteriologists have been on the look-out for them, no outbreaks have been recorded in this country, though staphylococci are as common here as in America, and The cream-filled cakes are much consumed. favourable to the of toxin conditions production from the organism appear to be even less prevalent here than in America. This circumstance has led some workers to doubt the incidence of food poisoning due to these organisms, but the evidence supplied has convinced most toxicologists and the facts now seem to be well established.
VESTIGIAL SURVIVALS IN THE POOR-LAW FROM time to time, in our public health and other rate-aided services, there are signs of a too rigid regard for local boundaries. Summoned to the scene of a traffic accident, an ambulance stops shorts and goes home because the victim is lying a few yards beyond some invisible line of demarcation. A patient is refused admission at a council’s hospital because he is only a temporary visitor to that council’s area. Mutual arrangements can be made between local authorities, but a certain spirit of non-cooperative parochialism still survives in public assistance as a relic of the curious law of settlement’ and removal which various representative committees of the London County Council recommend should now be repealed. If an excursion into ancient history be permissible in the holiday season, the problem must be viewed against its mediaeval background. From time immemorial everyone in England has legally belonged to some particular parishthe parish of his " settlement." Thus from the beginning it arose that the local inhabitant who had to contribute to the relief of his indigent fellow-parishioners was naturally anxious to limit his liabilities. For this and other reasons it befell that the poor were penned within their own parishes. If the labourer was found outside, he and his family were liable to be removed in custody to what was believed to be their proper parish where possibly their " settlement " would be still Under statutes of further disputed on arrival. Edward VI. (partly aimed at the wandering monks dislodged from the suppressed monasteries) all aged, impotent, and lame persons who were
by
and is
STAPHYLOCOCCUS FOOD POISONING THAT certain staphylococci can produce food poisoning has been established not only by monkey tests with sterile filtrates but by a large number of experiments with human volunteers. Moreover, several outbreaks have now been recorded where the staphylococcus has been definitely incriminated. The isolated strains differ widely both in cultural and in agglutinative characters. Some are hsemolytic, some are not, some are of albus, some of aureus type. Prof. E. 0. JORDAN of Chicago has shown also that the strains producing toxic filtrates are not restricted to those isolated from implicated foods but may be derived from many sources, including normal and diseased human throats. The vehicle in which the organism is conveyed is mostly " cream cakes," filled with custard rather than pure cream, although in the first recorded
outbreak (M. A. BARBER, 1914) the agent was milk. Cream-filled pastries often contain a few staphylococci, but the sound articles do not appear to contain organisms in numbers comparable to those found in the implicated foods. With W. BURROWS, JORDAN has recently described2 five characteristic outbreaks which occurred in America in 1932 and 1933. The first of these, in Milwaukee in March, 1932, involved 54 persons, all of whom had eaten custard-filled pastries ; from an uncut cream-filled cake of the same batch numerous staphylococci were isolated. From one strain a toxic filtrate was obtained, and 20 c.cm. of this filtrate given by mouth to a rhesus monkey caused violent vomiting 4thours later. All the victims were violently ill after an incubation period of about three to four hours ; none died. The second outbreak was in Chicago in April, 1932 ; 31 persons were affected, the vehicle being again cream-filled cakes. The incubation period was and nausea and vomiting were the similar, again most characteristic
symptoms. Staphylococci
were
isolated and sterile filtrates caused violent vomiting in several rhesus monkeys. The third outbreak occurred in Milwaukee in May, 1932, and involved seven children, all of whom had eaten custardThe staphylococci isolated filled coffee cake. a toxic to a monkey, and the filtrate produced same applies to that obtained from dough-nuts filled with custard associated with the illness of two persons in Chicago in the same month. The outbreak in Winona in May, 1933, involved several cases, the vehicle being chocolate eclairs, and from these also a staphylococcus was isolated yielding a filtrate toxic to monkeys. Several features associated with staphylococcal food poisoning still remain obscure. Although the number of recorded outbreaks amount to a dozen 1See THE LANCET, 1930, i., 1354; 1932, i., 33; 1933, ii., 197. 2Amer. Jour. of Hyg., November, 1934, p. 604.
or more, they are rare indeed when we consider the probable frequency of infection of foodstuffs with the organism. Toxin-producing staphylococci are not uncommon, and there must be some unknown factors which cause them to produce enterotoxic substances in certain cases. In the laboratory various methods may have to be tried before toxic filtrates are obtained ; in these recorded outbreaks the best results were procured when the culture was incubated in an atmosphere of 20 per cent. C02. A suitable medium is essential, and it is noteworthy that custard-filling standing at room temperature is likely to be an excellent culture medium. Another curious feature is the geographical limitations of the proved cases. Almost all have occurred in America, and although since the establishment of staphylococci as a source of food poisoning English bacteriologists have been on the look-out for them, no outbreaks have been recorded in this country, though staphylococci are as common here as in America, and The cream-filled cakes are much consumed. favourable to the of toxin conditions production from the organism appear to be even less prevalent here than in America. This circumstance has led some workers to doubt the incidence of food poisoning due to these organisms, but the evidence supplied has convinced most toxicologists and the facts now seem to be well established.
VESTIGIAL SURVIVALS IN THE POOR-LAW FROM time to time, in our public health and other rate-aided services, there are signs of a too rigid regard for local boundaries. Summoned to the scene of a traffic accident, an ambulance stops shorts and goes home because the victim is lying a few yards beyond some invisible line of demarcation. A patient is refused admission at a council’s hospital because he is only a temporary visitor to that council’s area. Mutual arrangements can be made between local authorities, but a certain spirit of non-cooperative parochialism still survives in public assistance as a relic of the curious law of settlement’ and removal which various representative committees of the London County Council recommend should now be repealed. If an excursion into ancient history be permissible in the holiday season, the problem must be viewed against its mediaeval background. From time immemorial everyone in England has legally belonged to some particular parishthe parish of his " settlement." Thus from the beginning it arose that the local inhabitant who had to contribute to the relief of his indigent fellow-parishioners was naturally anxious to limit his liabilities. For this and other reasons it befell that the poor were penned within their own parishes. If the labourer was found outside, he and his family were liable to be removed in custody to what was believed to be their proper parish where possibly their " settlement " would be still Under statutes of further disputed on arrival. Edward VI. (partly aimed at the wandering monks dislodged from the suppressed monasteries) all aged, impotent, and lame persons who were