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53
Progress of Outbreak.
Apart from an isolated case at Hacton Primary School in midJanuary
no trouble arose until the last week of that month when a
batch of cases was suddenly reported at Oglethorpe Junior Mixed
School. Early in February a single case was reported from Oglethorpe
Infants, but until late March Oglethorpe Junior School provided the
main focus of trouble. Then, however, a batch of some 7 cases arose
at Oglethorpe Infants, followed almost immediately by another 5 cases
in the same school. April and May saw the same source of trouble with
the Junior School providing a few sporadic cases also. June and early
July figures were contributed to from both Junior and Infants Schools
at Oglethorpe, but the epidemic appeared to lose impetus after the end
of May as evidenced by the monthly totals, viz. :
General
(including
Oglethorpe)
Oglethorpe
January 11 10
February 17 13
March 17 15
April 20 16
May 27 22
June 9 5
July 9 7
110 88
Distribution.
The picture is that arising from a school outbreak. The majority
of cases had the common factor that they attended Oglethorpe School
although living in different parts of this district and outside the district.
Naturally most of them resided close to the school, but this is clearly to
be expected. The figures I have already noted show, however, that
Aveley Estate itself provided a relatively substantial number of cases.
Multiple Cases.
Two cases arose in one family in four instances. Three cases arose
in one family in two instances. Where the two cases arose in one
family the interval between the first and second cases appeared to be
in the region of 23 days, 25 days, and 32 days. The fourth example
provided a gap of 63 days between the first and second case. It is to
be noted that in two of the above examples the second case had a minor
upset shortly after the first case developed Jaundice although the
second case did not itself develop Jaundice until some time after the
minor upset.
In the two instances where three cases occurred in one house the
gap between the first case and the third was never longer than 17 days.
Control Measures.
I have already noted that control was difficult because of the subclinical
case and possibly because of " carriers." It should be realised
also that there is no ready bacteriological or other test (as there is for
example in certain infectious diseases and food poisoning) which enables
us to substantiate the presence of the disease in certain cases or the
freedom from infection in any individual.