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The cases were treated at various hospitals, and St. John's Hospital for Diseases of
the Skin carried out the mycological investigations. The infecting agent was found to
be M. Audouini.
Visits were made by the school nursing sister/health visitor to the homes of cases,
and contacts were investigated and treatment arranged when necessary.
This example affords a good illustration of the great value of the regular hygiene
inspections carried out in schools by school nursing sisters.
Outbreak of
illness at
Brackenbury
Road Infants
School
An outbreak or illness at Brackenbury Road Inrant School started on loth March,
1953, when one pupil was sent home ill. The sequence then ran 23, 20, 9 and 2 cases
on successive days. No new cases were reported on 25th March, or subsequently. The
pattern suggested a single short exposure to infection, but no diagnosis was made, and
all of the affected pupils recovered without after effects.
An extract from the school doctor's report on this outbreak is as follows: 'Children
became ill in school. All complained of headache and sudden and severe lassitude.
Many said they had sore throats, but pain was found to be located about the neck and
shoulders. Many had watering and puffy eyes. Some had slight cough. All were feverish
with raised temperatures. All complained of nausea. No rash has been reported. There
are 8 classes in the infant school—4 of which were affected. 90 per cent. of the cases
were in one class, of which 80 per cent. were affected. The pupils work in table groups,
and complete tablegroups accounted for the absentees, i.e., no one pupil was left
unaffected at any table '.
Juvenile
Spring
Eruption at
Sayer's Croft
Camp
In April, 1953, the children at Sayer's Croft Holiday Camp presented an unusual
set of symptoms, the numbers affected, over 90 per cent., giving the appearance of an
epidemic. The signs were those of a local dermatitis on the ears, and some glandular
enlargement in the associated lymph drainage area. Many more boys were affected
than girls, probably as a result of the girls' longer hair giving protection to the ears.
The condition was investigated by St. John's Hospital for Diseases of the Skin, as
it was thought that it might be a virus infection, but no evidence in support of this
theory was discovered. It is likely that a combination of meteorological conditions was
responsible, namely, cold strong wind and bright sunshine for many hours. The condition
is not uncommon but the unusual feature of this outbreak was the number of cases
occurring in a short space of time. There were no after effects and all the children
recovered completely within a few days.
A fuller account of the investigations carried out has been given by Anderson,
Wallace and Howes (Lancet, 10th April, 1954, page 755).
Medical treatment
Under Section 3 of the National Health Service Act, 1946, it became a duty of the
Minister of Health to provide through Regional Hospital Boards and Boards of
Governors of Teaching Hospitals, the services of specialists at hospitals, health centres,
clinics, etc. The Council, as local education authority, also has a duty under Section 48(3)
of the Education Act, 1944 'to make such arrangements as are necessary for
securing that comprehensive facilities for free medical treatment are available to its
pupils either under this Act or otherwise'. As the provision of specialist services for
the school health services in London was, therefore, the concern of both the Council
and of the Metropolitan Regional Hospital Boards, it became necessary to determine
the extent of the responsibilities of each authority in regard to this matter.
Guiding principles on the specialist work carried out at local education authority
clinics were laid down in Circular 179 issued by the Minister of Education, and discussions
took place in 1950 and 1951 with officers of the Metropolitan Regional Hospital
Boards at which it was agreed that responsibility for the provision of specialists at
rheumatism, ear, nose and throat, vision and orthoptic clinics lay with the Metropolitan
Regional Hospital Boards, while the Council remained wholly responsible for the
minor ailment, audiology, special investigation, nutrition and dental clinics.