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54
From the outset close liaison was maintained with the Area Medical
School Officer, and the wholehearted co-operation of both the headmaster
of the Junior School and headmistress of the Infants School was
freely available.
The canteen and general sanitary arrangements in the school were
discussed very frequently between the school staff and my District
Sanitary Inspector. I myself repeatedly visited the school with my
Inspector and discussed the position with the school staff. There was
no evidence found to incriminate school meals.
It was arranged from the outset that cases of slight illness should
be excluded from school until the cause of the illness became apparent.
The necessity for the highest standard of individual hygiene even in
infants was emphasized. Numerous home enquiries were made into the
circumstances of cases and suspected cases. Where necessary local
practitioners were approached.
In a disease of this kind it is not thought practicable to insist upon
the exclusion of contacts. In outbreaks of infectious disease generally
(and this includes Infective Hepatitis) it is necessary to draw a mean
by adopting those measures of restriction which can prove of value
without at the same time being of a nature so completely to paralyze
the life of the school or community concerned as to prove on that very
account impossible of fulfilment.
Discussion.
The best method of attacking an outbreak of this nature is by
devoting attention to restricting spread along the channels thought to
be capable of causing spread and hence emphasis should be laid on
personal hygiene, undiagnosed illness and the like.
The age incidence of those affected is evident from the details I
have given of the outbreak. It will be known that the school mainly
involved is of very modern construction with equivalent high standards
of canteen and general sanitation, and to these advantages must be
added the real interest of the headmaster and headmistress in securing
that personal hygiene was always maintained at the highest possible
level. There is not, I think, any method of radically stopping an outbreak
of this kind, although one can hope with reason that stringent
measures can prevent the extent of spread.
In this instance the school holidays came at a time when the
epidemic showed a substantial lessening in extent, and it was in fact
found that the school holidays saw a cessation of the outbreak.
Visit of Mass Radiography Unit.
A visit by Unit 6 B. was paid to this district from 14th June to
22nd July 1954. An improved coverage of the district as compared
with the previous Unit visit was obtained and I note below details of
the centres at which the Unit operated and the attendances at each
centre.
Although the total attendances was reduced as compared with the
visit in 1951 the figures are not wholly comparable since on the previous
occasion the operating Unit coincidently carried out certain large factory
visits, the attendances at which were included—justifiably—in our
totals.