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32
Two children of the same class fell ill one day, then followed
the teacher of that class, who was ill for a short time before
giving up her duties. Her husband being excluded, there was
shortage of staff and one of the older girls was put in charge of
the class. She also succumbed. The class was then distributed
throughout the school. Owing to the alarm of the neighbourhood
many children were kept away from school. This added to
the difficulty of tracing the cause, as up to that time the absentees
had been visited. Cases continued to be notified for the
succeeding weeks making a total number for that neighbourhood
of 37. Of this number 25 were primary cases and 12 secondary
(secondary in this case is taken to include not merely those
actually living in the same house but those living elsewhere
who had sufficient contact inside the house to be considered to
be infected from there).
The actual number of persons attending the school whe
suffered from Diphtheria during this period was 20, of whom
6 were in the originally infected class. Home contacts of Ford's
School pupils were 11, and in addition there were six cases in
the immediate neighbourhood who were probably infected by
these, though they had not apparently entered the homes of
any of the patients.
The outbreak was not one affecting the new Housing Estate
to any extent. Of the 37 cases, 31 occurred in the older houses
(19 primary and 12 secondary) and only 6 in the new houses.
Below is an extract from the Report presented to the Council
at the time of the Outbreak.
"... 6 of these children were in the same class, which
was taken by the teacher who was infected. Realising the
possibilities of droplet infection the class incidence can be
considered to be light. It is regrettable that owing to the
shortage of staff the infected class was distributed round
the school, as it enormously increased the risk of spread;
besides making the tracing of carriers so much more difficult.
It also rendered out of the question any system of class closure
as means of checking the spread.
The advisability of school closure naturally arose. This
is a step to be taken only reluctantly. By keeping open the
school, investigating the cases, and following up any children
absent for. suspicious reasons, one obtains a clearer view of
the extent of the outbreak and is more favourably placed in
the difficult task of finding carriers. The value of school
closure too, undoubted as it is in rural districts, where the
children meet only at school, is negatived in congested areas
where there is so much opportunity of infection out of school.
. . . shortage of hospital accommodation. Although this