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24. The Dairy Farm was visited by the Health Officer and the plant carefully inspected. The roster of employees was scrutinised to ascertain whether any of the staff was at that time or had recently been off duty from sickness. There was nothing to indicate that any of the employees had a previous history of intestinal infection. Four men were off duty owing to illness. These cases were seen by the Health Officer who ascertained that only one had any symptoms of bowel complaint and this was a watchman who was suffering from a mild diarrhoea with no dysenteric symptoms and whose duties were not such as involved the handling of milk.
25. On the 16th Surgeons Captains Fergusson and Flint of the Royal Navy conferred with the Director of Medical Services and the Health Officers and were given all information available regarding the investigations made and the action taken or contemplated.
26. On that day the D.M.S. saw the Attorney General and discussed with him. the question of amendment to the Quarantine and Prevention of Disease Ordinance, No. 7 of 1936, necessary to make dysentery notifiable.
27. On the 17th there was a conference attended by the Director of Medical Services, the Chairman Urban Council, the Deputy Director, Medical Services, the Health Officers, the Colonial Veterinary Surgeons, the Government Bacteriologist and the Government Analyst. The situation was reviewed and discussed.
28. The Government Bacteriologist reported that the results of pasteurisation as shown in the bacterial counts of samples submitted were satisfactory. Samples taken on the 13th instant showed a marked difference in the bacterial count brought about by the process. While the raw milk contained 192000 organisms per c.c. the pasteurised product contained only 700 per c.c. a result which easily brought it within the standard required in England for Grade A pasteurised milk.
29. With regard to the water supply of the Dairy Farm the Government Bacteriologist reported that routine examination of this water had for years been carried out by his department and that in the great majority of cases the results of examination indicated water of a high degree of purity. It was decided that the Government Bacteriologist and the Government Analyst should make special examinations.
30. As with most exacerbations of endemic groups of disease difficulties were experienced in ascertaining what were the real facts with regard to the incidence of particular types constituting the group. Practitioners differed in their methods of diagnosis, some relying on clinical signs only, others on laboratory findings. Their methods of reporting also differed some notifying all cases having dysenteric symptoms others only those that had been proved positive by the bacteriologist. methods of sending specimens for examination varied and in a number of cases any dysentery bacilli present were dead on arrival at the laboratory and consequently gave negative results on culturing.
31. From the 9th to the 19th of November specimens from 64 cases clinically diagnosed dysentery were examined by the Government Bacteriologist. Of these 16 were positive for Shiga, 6 for Flexner, 1 for Schmitz and 41 were negative. In some cases where the first specimen proved negative a second or a third was positive. Some practitioners were content with one negative examination others submitted further specimens.
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32. The list of the names of patients whose stools had been submitted for
· examination and which was kept by the Government Bacteriologist differed widely from the list of names of persons reported to the Health Officer as suffering from dysentery. In thirty cases only out of the sixty-four were the same names included in each list. This means that out of the forty-seven cases reported only thirty had had their stools examined and out of the sixty-four whose stools were examined and who presumably were suffering from symptoms which clinically were those of dysentery only thirty-four were reported.