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tion is mainly by direct contact. It had been shown that 50% of
children concerned in an outbreak of Sonne Dysentery carry the
germs on their hands. This is readily understood if they are to
young to avoid soiling their hands, or effectively washing the
without adult supervision. It is thus obvious why the youngest
age groups in primary schools are mainly involved in outbreak
of Sonne Dysentery. These outbreaks occasion considerable work
and interfere with school routine. It is necessary, however,
to observe a reasonable balance between doing too much for what
is a relatively mild illness or taking no action to prevent it
spread. School closure was not considered justifiable, but the
following measures were applied:-
Advising teachers, parents and medical practitioners of the
prevalence of Sonne Dysentery.
Immediate check on water supplies, school milk and school
meals service.
Exclusion from school of all pupils with a recent history of
suspicious illness, domiciliary visiting of all children
reported absent and continued exclusion of any case or suspected
case until proof of freedom from infection had been
obtained.
Exclusion of all family contacts until shown free from infection.
Continuous disinfection of school premises and all articles
in common use.
Emphasis on the importance of toilet drill for young children
and careful supervision of hand hygiene.
(In one school (Rowdown) bacteriological tests were carried
out on all the children in the Infant Department to detect
symptomless carriers. I do not think it can be shown that the
outbreak was curtailed to a degree, which justified the work
involved and I would not recommend this procedure as a routine
for the control of Sonne Dysentery in schools). The prevention
of the illness rests mainly on the maintenance at all times of
a satisfactory standard of hand hygiene and a high state of
cleanliness of school sanitary annexes. Outbreaks in schools
arise when unrecognised cases continue in attendance.
Vigilance to detect and exclude children suffering from suspicious
illnesses pending their investigation is an obvious
safeguard. It is unreasonable, however, to expect this safeguard
to be applied when Sonne Dysentery is not known to be prevalent
in the area. In such circumstances, the exclusion of every small
child suffering from some minor digestive upset, pending laboratory
examinations, is virtually impossible. One can only hope
for speedy recognition that a number of children have such an
illness and the effectiveness of the normal hygienic arrangements
in the school in preventing the condition becoming widespread
amongst other scholars before special measures are applied.