Communicable Disease Control

Introduction Public health in Britain effectually began with the publication of the famous report of the Poor Law Commissioners, 'on an inquiry into the sanitary condition of the Labouring Population of Great Britain' in 1842, the principal author of which was Edwin Chadwick. He suggested 'that for the promotion of the means necessary to prevent disease it would be good economy to appoint a district medical officer,...' (Poor Law Commissioners 1842), a suggestion which was taken up first by the City of Liverpool with the appointment of Dr Andrew Duncan as Officer ofHealth in 1847; in 1848 Dr John Simon was appointed the Medical Officer of Health of the City of London. These and all the subsequent appointments ofmedical officers of health were district or local appointments, a most appropriate base because the diseases they were appointed to prevent were local diseases. The cholera outbreak in Soho, London, investigated by Dr John Snow in 1854, was caused by contaminated water from the local Broad Street pump (Snow 1855), and even at the end of the nineteenth century communicable disease still remained predominantly local; for example, the Maidstone typhoid outbreak in 1897 (Borough of Maidstone 1898) was caused by contamination of the local reservoir at Barming by sewage-polluted water from the nearby catchment area at East Farleigh. However, the spread of communicable -disease began to change from local to national and then international by the turn of the century, and particularly after World War I, as a result of the widespread national and international distribution of foodstuffs and other materials and the greatly increased movement ofpopulation. The foodborne outbreak of typhoid fever in Aberdeen in 1964 (Aberdeen Typhoid Outbreak 1964) was caused by the contamination of canned corned beef in South America, where sewage-polluted river water had been used in the cooling process of the cans; it was one ofa series ofsuch episodes which had been taking place since at least as early as 1929 (Anderson & Hobbs 1973).