CO129-562-12 Dysentry epidemic- recommendation to enforce compulsory pasteurization of milk 7-6-1937 - 17-8-1937 — Page 29

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infants is boiled before use, and (b) whether orange juice or other anti-scorbutic is administered.

101. For Cambridgeshire answers were supplied with regard to the practices in some seventy rural parishes, being about half those the in the county. To the first question, except in four cases, answers were all in the affirmative; those to the second made it clear that in the parishes concerned fruit juice (and usually orange juice) is almost universally given to the bottle-fed infant. In Gloucestershire answers were supplied from one hundred and five separate districts. In all but four of these the milk is said to be always boiled before use, and in all but two, the addition of orange juice or more rarely tomato or swede juice is practically universal. In Wiltshire replies, twenty-three in all, were obtained from the staff of health visitors They were from and from twelve representative district nurses. several smaller country towns as well as from numerous villages. Again the answers to both questions were almost all in the affirma- tive. From one district alone came the statement that as the local supply is reliable the milk was not boiled. In all it was stated that the use of orange juice was general. From the county of Durham the information is less detailed. The schedules were not submitted, It would but the evidence is summarised by the medical officer.

seem that very few infants are given free milk, the majority of those artificially fed received dried milk, another and next largest number, condensed milk; when, however, liquid milk is given it is invariably heated. With regard to an anti-scorbutic addendum, it would appear that while a fair proportion of infants do receive a daily ration of fruit juice, its administration is less common than in the other counties investigated.

III.-ADMINISTRATIVE MEASURES IN FORCE.

102. The methods used to eradicate sporadic outbreaks of rapidly developing diseases among cattle include immediate notification, the temporary isolation of the infected district, the prohibition of the movement of animals within it, and the slaughter of animals infected or known to have been in contact with the disease. These methods are not applicable to the diseases with which we are concerned, which are endemic, have long periods of incubation, and are difficult to diagnose.

103. More effective measures against such widespread latent infections are possible in the case of those diseases the presence of which may be established by a simple and reliable test, such as the tuberculin test for bovine tuberculosis, the blood-agglutination test for contagious abortion, and the recently developed method of testing the milk of cows suffering from mastitis. It is possible, by segre- gating those animals which react to the test and by gradually recruiting the uninfected section with uninfected young stock (for the young stock are generally comparatively free from diseases of

this class), to build up herds which are entirely free from disease. Such a policy, though it may be followed by an individual farmer, generally requires some form of official supervision.

104. Finally, the state may improve the general standard of hygienic care among farmers. There are, however, limitations to such a policy, for the state must, in the main, rely upon advice and persuasion. Considerable advances have already been secured by such means.

105. Various measures may be adopted to provide the consumer with a safer milk supply. Where the danger to public health arises from a disease of the cow the public may be protected by three means of varying efficiency. First, disease may be eliminated from the cows.

This is only possible if the presence of disease can be determined at an early stage by a test. Fortunately the presence of bovine tuberculosis, which is the disease most dangerous to public health, may be so determined. Secondly, the milk supply may be protected to some extent by the removal from milking herds of cows found to be giving infected milk. These may be discovered the milk, by bacteriological or microscopical examination of and by the examination of the cow itself for clinical symptoms, associated with the giving of infected milk. These are well known to experienced veterinary surgeons. Thirdly, it is possible to render infected milk safe for human consumption by certain forms of heat treatment which destroy the organisms responsible for causing disease in man. These forms of treatment affect the constitution of milk in varying degrees. A satisfactory form must not only be an effective safeguard against infection, but also must not affect adversely the nutritive properties of milk, nor must it, if possible, affect the commercial properties which influence the sale of milk, such as taste, colour and the power of forming a cream line." It is contended that the process of pasteurisation, as at present defined by the Ministry of Health, fulfils these requirements.

106. Protection against diseases which may be introduced into the milk from human sources is afforded by scrupulous cleanliness in the handling of milk, and by the prohibition of persons suffering from diseases communicable by milk, or who are carriers of such diseases, from being concerned in the handling of milk at any stage. It is, however, impossible to insist on precautions which will eliminate all danger from this direction. Additional protection may be obtained by a satisfactory form of heat treatment. The later the stage at which this is applied, the greater is the protection to the

consumer.

(a) Existing legislation in regard to diseases of animals. 107. Under the diseases of animals act, 1894, the Ministry of Agriculture and Fisheries has not only special powers of control of the rapidly developing diseases referred to in paragraph 102 above,

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