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The following article was written by Wilson G. Smillie '12, professor of Public Health Administration, at the Medical School.
Almost every year an outbreak of acute gastro-intestinal disturbance occurs among the student body.
The usual symptoms are sudden in onset, with abdominal cramps, vomiting, diarrhea and prostration. The illness usually lasts two or three days. This type of outbreak occurs in every university, college and preparatory school in the land.
They are no more frequent in colleges than in institutions, hotels, and restaurants that serve food to large numbers of people. They are more striking, however, because in the college, all cases come to the attention of the authorities, whereas restaurant and hotel guests scatter and seldom report their illness.
Causes Are Varied
The causes of these outbreaks are varied. Protein decomposition is probably the commonest cause. Meat and meat products of all kinds, fish, shellfish, milk, and milk products, such as cream, ice cream, cheese and all substances made with milk, such as pastry and pie fillings, may be the cause of the disturbance.
The food need not be spoiled, with disagreeable odor and taste, yet may produce intestinal irritation.
Vegetables and fruits formerly were not a common source of illness. Over-ripe fruit or uncooked fruit and raw vegetables that has been improperly cleansed occasionally cause trouble. Recently the extensive use of arsenic sprays of apples, peas, green beans, spinach, cabbage and lettuce has resulted in wide-spread outbreaks of acute gastro-intestinal irritation.
Cider Often Source
Cider has been a prominent source of acute upsets, due to arsenic residues. Arsenic produces almost exactly the same symptoms as decomposed protein.
A few years ago some of the best hotels in New York, Atlantic City, and Boston were beseiged with complaints from individuals who became ill after a meal in these hotels. Intensive search failed to reveal the cause.
Finally it was discovered that a silver polish used in these hotels contained potassium cyanide. A minute residue of this polish on a fork or from a tea-pot spout was quite sufficient to produce severe gastro-intestinal symptoms.
How can these outbreaks be avoided?
The solution is not a simple one. In past years, when the route of food from producer to consumer was direct and the food passed through few hands, little difficulty was encountered. Now our milk comes from Vermont, and passess through a dozen processes before we drink it. Meat comes from Chicago, fresh vegetables from South Carolina and Texas, fruit from Florida, Oregon, or the tropics.
How is it possible to keep all this food clean and fresh and pure? The Federal Government aids by an elaborate system of inspection of inter-state shipment of food. The State has an extensive organization of food inspection with expert laboratory service and comprehensive laws, with heavy penalties for violation. Each local municipality has its system of food inspection, with regulations concerning food handling, refrigeration, storage, transportation, and sale of food.
Kitchens Are Spick and Span
The last and most important link is the University kitchen. Every modern method that has been devised for cleanly handling of food has been installed. Only the highest quality of food is purchased. All the milk and cream is pasteurized.
Everything is spick and span. All the dishes are thoroughly cleansed. Every employee in the kitchen is under medical inspection. He must be cleanly in his habits, and he is taught the principles of food sanitation. If ill, he must not work, but is given leave of absence with pay. Refrigeration temperatures of all food are under constant check. No food is allowed to accumulate, to spell, or to be utilized as left-overs.
Occasional Outbreaks inevitable
Despite all these precautions--federal inspection, state supervision, local health department food inspection and every precaution taken by the University staff--an occasional outbreak of gastro-intestinal illness occurs.
These are practically inevitable because of the complexity of our mode of life and the great number of processes that are required in bringing our wide variety of food stuffs from the farm to the table.
No epidemic of serious food-borne infection such as typhoid fever, or septic sore throat, has occurred in the University for many years. Our experience with the mild forms of gastro-intestinal outbreaks is almost identical with that of other colleges and universities, as well as that of the best type of hotels and restaurants.
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