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Amount of sickness
From column 2 of Table (iii) it is seen that over the two-year period about half the
children at one time or another had an illness of some kind. Column 3 gives the information
that in the nurseries there was an average of one spell of illness for each child in
the two years. In general, therefore, a quarter of the children were ill each year ; and
the numbers of spells of illness each year was two for each ill child or half for each child
in the nurseries.
In the Luton survey1 the incidence of illness in children under one year of age,
for the most part living at home, was 0.4 incidents a child per annum compared with
0.5 among the children aged 0-4 years in the present survey. In the Newcastle
' Thousand families'2 survey there was an average incidence of two illnesses a child
per annum in the first five years of life, over 80 per cent. of the Newcastle 'episodes'
being of an infective nature.
Comparisons between the Luton and Newcastle surveys and the present survey
are not strictly justified. The children differ in age constitution and it is well known
that sickness rates differ at different ages. Moreover the conditions of life of the children
differ ; the present survey being limited to these two large residential groups and the
Luton and Newcastle groups being almost entirely children living in their own homes.
Also in making these comparisons no notice has been taken of possible differences in
the defmition of reportable illness. Nevertheless it can be said that there is in the figures
from the Downs and St. Margaret's nurseries, no sign of a level of illness greatly in
excess of expectation.
From columns 2 and 3 of Table (iii) an impression of similarity between the nurseries
is obtained which is at once dispelled by reference to column 4 which discloses a considerable
difference between the two nurseries in the average days of sickness for each
sick person. Further details are provided by Table (iv) which gives the information
set out for different causes of infective illness. One cause of the difference in days of
sickness between the nurseries emerges from consideration of the figures for gastroenteritis.
At the Downs nursery the average duration of illness from this cause was
15.6 days, compared with 30.6 days in the St. Margaret's children. This is probably
due, in large measure, to the fact that the Downs children did not receive routine
bacteriological tests of freedom from E.coli serotypes during a large part of the survey.
(It should be mentioned that for the purposes of this analysis symptomless excreters of
E.coli have been regarded as cases of gastro-enteritis.) In contrast to the findings with
gastro-enteritis is the fact that the duration of illness of Sonne dysentery was almost
identical at each nursery. The three-week period of isolation, contrasted with the
extremely short period of a day or two in which symptoms are present, demonstrates
the price that must be paid for the attempt to control this disease by segregation of
infected children.
Further consideration of Table (iv) shows that in both nurseries infective illness of
one kind or another accounted for practically all the sickness encountered, a finding
which in view of the age of the children was not unexpected.
Both nurseries had outbreaks of Sonne dysentery and measles. In view of the
universality of these diseases during epidemics it would have been surprising if the
nurseries had escaped.
Whereas St. Margaret's nursery had an excess of gastro-enteritis and chicken-pox,
the Downs had a comparatively high incidence of tonsillitis and ringworm. The excess
of gastro-enteritis at St. Margaret s was largely explained by the routine search for
symptomless excreters of E.coli serotypes in that nursery and the somewhat higher
proportion of infants under one at that nursery. The ringworm epidemic at the Downs
appeared first of all as scaly patches on the hair margin with minimal involvement of
the scalp and had spread within the nursery before its true nature was appreciated.
1 Illness in Infancy—A comparative study of infant sickness and infant mortality in Luton—R. M. Dykes (1950),
p.p. 9—12.
s A Thousand Families in Newcastle-upon-Tyne, by J. Spence, W. S. Walton, F.J. W. Miller and S. D. M. Court—
p. 32.
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