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I might, however, properly mention the difficulty of effectively
controlling an outbreak of this kind, involving as it does, influencing
the habits of a large number of persons who may have suffered only
the slightest inconvenience through illness, but may nevertheless,
remain for a variable and even lengthy period, a source of danger
to others.
The question may be asked as to whether, in an outbreak of
this type, in which the danger to life in general is practically nil
and even the feeling of personal illness is both transient and mild,
the vast amount of routine work necessary even to keep in touch
with the position accurately, is worth while. The answer is that
the same mechanisms responsible for the outbreak of Sonne
Dysentery might well be responsible for a similar outbreak caused
by a. more dangerous germ.
It is also imperative that whatever degree of public alarm has
been caused should be allayed as quickly as possible, and this can
well be assisted by a very obvious interest being manifested in the
position by those responsible for dealing with it, i.e. by the Health
Authorities. In addition, advantage can be taken of the occasion
to emphasize to the public the necessity of adopting high standards
of personal hygiene.
Apart altogether also from the many contacts of cases which
might of themselves have very little potential danger, it is inevitably
found that a certain number of contacts are in fact employed
in duties concerned with communal feeding—often in other widespread
districts—and must therefore be dealt with appropriately to
prevent the spread of infection far beyond the confines of the
original outbreak.
I feel that the negligible number of secondary cases which are
thought to have occurred in our outbreak is largely due to the
assiduous visiting and advice given to households affected and
acted upon by them.
On outbreak of Enteritis of an explosive and very transient
type also occurred at another school in the district during the year,
and was fully investigated and duly reported upon. In this instance
no causative organism was discovered, but it was clearly established
that no connection existed with the outbreak of Dysentery noted
above.
Infective Hepatitis.
This disease is notifiable in this region and the case incidences
in the three years ended 1948 show that 90 cases were notified in
1946, 47 in 1947, and 9 in 1948. This is, of course, a dramatic drop
in the attack rate and even though, as in other diseases, the actual
number of notifications may differ materially from the actual
number of cases, it would appear to have some significance.
Only two of the cases concerned involved adults and no two
cases occurred in the same house.
No spread occurred in one instance where a party was held
within the period when the disease was in all probability capable of
being transmitted from a person attending the party.