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DYSENTERY
Sixty-one cases of dysentery were notified during the year and in all but
one case the causal organism was shigella sonne. Shigella flexner was isolated
from the other patient, a man of 29 years who had recently been abroad.
An outbreak occurred in a local Primary School and lasted for the whole
of February. Twenty-one children in the Infants' Department and nine in the
Junior Department were reported as suffering from diarrhoea and vomiting and
of these twenty-one were found to be positive to shigella sonne. One member
of the School staff serving the meals and pne of the infants' supervisors were
also found to be carrying the organism and were excluded from work until shown
to be free from infection.
Previously, children were excluded until three consecutive negative
specimens had been submitted, but owing to dislocation at home and at school,
general practitioners were advised that children should be kept home for at
least a week and allowed to return to school at the end of that period provided
they had been symptom free for three days. The school lavatories were disinfected
daily by the disinfection staff until the outbreak subsided.
A recurrence of diarrhoea and sickness at the same school in September
soon after the summer holidays when seventeen children and one teacher were
affected was much milder in character and no causal organism was found.
In November there was an outbreak of illness in the Lower School forms.
of a Grammar School. The number of absentees rose from 41 to 61 in twentyfour
hours. The homes of nine of the boys living in Hornsey were visited and
faeces specimens bacteriologically examined. Six of them proved to be positive
to shigella sonne. Nine boys living outside the Borough were affected and two
of these were found to be excreting shigella sonne. Exclusion of children was
carried out as before and the outbreak subsided without further incident.
Early in April a family of father, mother and infant son of l| years was
notified as suffering from dysentery. On bacteriological examination the father
and the mother were shown to be negative but the baby proved positive to shigella
sonne. As the father was a butcher, regular bacteriological examinations were
carried out weekly until 1st June when the babyproved to be clear. Fortunately
during this time the father was consistently negative.
A child of 4 years, in attendance at a nursery class, contracted dysentery
on 26th September and was excluded until 3 consecutive negative faeces specimens
could be obtained. Despite treatment and regular bacteriological examination,
he was not able to return to school until 14th January, 1960, although
on two previous occasions two consecutive negative specimens had been obtained
before he reverted to positive again.
These two cases are cited to illustrate the considerable interference
with school life which may be caused by sonne dysentery. Exclusion only while
symptoms exist has greatly reduced absence from school and there is no evidence
that the control of outbreaks has been in any way made more difficult.
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