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On the return to school swabbing of the 37 children present in
Class I produced 8 symptomless positives. All family contacts of these and
5 children who were absent were negative. Because of this finding, as a
matter of academic interest to determine the possible distribution of the
organism, it was decided to swab the rest of the school by classes. 30
children present in Class III produced 6 positives, and 4 mare were found
among 12 children missed in the previous two classes - 3 from Class III and
1 from Class I.
Twenty-two children in Class II and all the family contacts of the
previous positives were swabbed; with the exception of one child under
school age, all were negative.
A child previously absent from Class II returned to school and was
found to be positive, also a report received from a neighbouring borough
that a family contact, a child attending the Junior School, was positive.
The last report concerning the outbreak was received from a Children's
Hospital and noted that one of the positives had failed to respond to a
full course of penicillin but was eventually cleared on aureomycin. This
observation confirmed an impression that the carrier state did not tend to
clear spontaneously without treatment, and that success with penicillin was
variable. Erythromycin appeared to be the drug of choice.
Of the 35 cases recorded, 30 occurred within the school (approximately
150 pupils), giving a carrier rate of 20% The remaining 5 cases were 2
adults (the first case and her husband), 2 children, attending the Junior
School, and one child under school age. The six cases admitted to hospital
included the first two cases (mother and son - the only cases considered to
be notifiable), the father of the boy, and 3 children who were admitted
because of varying home circumstances.
COMMENT
The chance finding, the presumptive avirulence, the apparent very local
distribution and the high carrier rate of this germ, were matters of some
epidemiological interest.
The germ does not appear to have been isolated recently in London, nor
was there any evidence of its spread to the local population, in spite of the
alerting of local doctors.
It was noted that nearly one half of the positives occurred in children
who were absent from school, but enquiry into every case showed that such
symptoms as were present were indefinite and so trivial that in no case had
medical attention been sought, the majority being classed as "colds".
Terminal disinfection was carried out in one case only (the original notified
case).
All positives were excluded from school until two, or in most cases,
three negative swabs had been obtained.
Close liaison was maintained throughout with all medical personnel
involved - Dr. Ian Taylor, Epidemiological Officer, L.C.C., and Dr. Russell,
Divisional Medical Officer, L.C.C.; Dr. Tomlinson, Public Health Laboratory
Service (London); Dr. Kelleher, Western Hospital; Dr. Straker, St. Mary
Abbot's Group Laboratory; Dr. Bloss, Ministry of Health; and Dr. Henderson,
Ministry of Education.