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APPENDIX B
SICKNESS IN RESIDENTIAL NURSERIES
It was decided in 1954 to make a pilot survey of sickness in residential nurseries with
the object of trying to ascertain :
(a) the amount of sickness in a nursery population ;
(b) the causes of such sickness ;
(c) how (a) and (b) varied according to
(i) the number of children exposed to risk
(ii) the turnover of children ;
(d) how often, where physical separation between blocks or floors existed, there
was evidence of spread of sickness from one part of the nursery to another ;
(e) the proportion of introductions of infectious disease attributable to known
outside sources, and
(f) the extent of the spread of infectious disease.
Methods
For the purpose of this pilot survey St. Margaret's residential nursery in London and
the Downs residential nursery at Sutton, Surrey (since closed) were used. Both establishments
were in former hospital premises, the first being a single building near the centre of
London in which the children were accommodated on two separate floors, and the
second two separate blocks in an open situation. The age distribution of the children in
the two nurseries was roughly comparable but there were proportionately more
children aged under 1 year at St. Margaret's than the Downs (some 18 per cent. and
11 per cent. respectively at the end of 1956). Interchange of children between floors or
blocks was not usual.
It is the practice for all nurseries to notify to the department cases of infectious
disease and for this survey this practice was extended to cover all sickness.
This information was supplemented by a discharge report to indicate the date of
recovery of the children from a spell of sickness (including discharge from hospital in
cases of sickness requiring hospital treatment) and by a weekly strength return including
details of admissions or discharges, so that the turnover and numbers exposed to risk
could be calculated. It will be apparent that the two nurseries were not entirely closed
communities partly because of the constant turnover of children and partly because
there was contact with relatives through visits to the nursery and also through children,
at times, going home ' on leave',
Results
Table (i) shows the basic data relating to the two nurseries and Table (ii) the sickness
experienced therein during the two years 1955 and 1956 by days of sickness, number
of children sick, and the number of spells of sickness.
In Table (iii) the sickness experience shown in Table (ii) is related to the basic data
in Table (i), and expressed as sickness rates having regard to the number of children at
risk and the duration of exposure to risk of illness. For the purpose of these tabulations
infective and non-infective illnesses were kept separate. The infective group included
any disease of bacterial, virus or fungal origin and was not limited to the specific
infectious diseases. All cases of tonsillitis, bronchitis and pneumonia were included in
this group. It is at once apparent from the tables that this group includes most of the
sickness occurring in the nurseries.
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