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82
hand cases occurred not infrequently where symptoms were present, even
severe symptoms, without the discovery of any organism responsible for
them sometimes this may have been accounted for by the masking
effect of treatment given.
The infection also often spread in the families concerned involv
ing adults as well as children Apart from cases directly or in
directly associated with institutions a considerable number of
scattered cases throughout the Borough have occurred and there must be
substantial reservoir of infection in the population
The cases have arisen on the whole fairly evenly throughout the
year with perhaps a slight preponderance in the winter months
Although the disease is generally mild a few severe cases have
occurred from time to time and even the mild and symptomless carriers
often cause economic hardship by their exclusion from nursery school
or even work in the case of food handlers
The routine control policy has been such exclusion of all cases
discovered whether or not they have exhibited symptoms until 3 nega
tive specimens taken at defined intervals have been obtained Investigation
has included the pathological examination of specimen sometimes
repeated of all home and institutional contacts of all cases as they
have been recognized.
A detailed analysis of the statistics available is not submitted
as it would be liable to be misleading The figures depend to a con
siderable extent on the criteria adopted for distinguishing between
actual cases and symptomless excretors of the organism and these vary
widely from area to area and have also varied in Finsbury to some extent
during the past few years They also depend in some degree on
the circumstances of each case or outbreak as to the completeness with
which investigations can be carried out.
The following information in regard to 1955, however, may be
taken as an approximate guide to the incidence of this disease and
does not differ materially from that available for recent years.
The total number of cases reported during the year was 116 (14 of
whom were adults) of which number 54 were clinical cases (36 of whom
had one or more positive stool examinations) and 62 were symptomless