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traced with the outbreak which followed at the other end of the
Borough during 1954.
The first case in "Old" Barking occurred in January, 1954, in a
girl attending the Westbury Infants' School. In February there were
4 further cases 2 of these being in the same class as the first case.
The elder sister of the first case also developed the disease in February,
and spread infection to the Junior School. From there on the disease
spread throughout the two departments, there being a total of 37 cases
in the Infants' Department and 46 in the Junior School during the
year. There was a short outbreak at the Church of England School
from February to June involving 13 children. In April the first of
28 cases developed in the Gascoigne Infants' School, and the following
month saw the spread of infection to the Junior Department in which
36 cases had been reported by the end of the year. Ripple Infants'
School first became involved in August and the Junior School in
October, 5 infants and 13 juniors developing jaundice before the end
of the year. There were also 58 cases amongst children attending
various other schools.
It had been hoped that the infection would die out during the
long summer school holidays, but early in the September Term it was
apparent that this had not happened. I personally v sited each of
the schools primarily affected together with the appropriate Health
Visitor, and we took the opportunity of explaining to the members
of the teaching staff the methods by which the spread of infection
was believed to take place and the hygienic measures necessary to
control it.
I also suggested to the Barking Committee for Education that
we should try the effect of excluding known contacts from school
during the two-week period when it was most likely that the contacts
would be in an infectious stage.
Analysis of the results of this policy was not encouraging: 51
children were excluded from school and of these only 7 subsequently
developed attacks of hepatitis; 2 of these 7 children became ill before
the beginning of the exclusion period and 4 developed the disease
following exclusion at intervals varying from 1—11 days after return
to school. Only 1 case developed the disease during the exclusion
period. Exclusion was, therefore, discontinued after the Christmas
holidays.
By November figures suggested that whilst the outbreak was
drying out or was stationary in other schools, infection at the Gascoigne
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