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17
Secondary Infection.
More than one case occurred in 19 households. In one there were
4 cases, in two 3, while in the remainder only the two patients, the
secondary and the presumed infecting case, though in one household, the
two children apparently succumbed simultaneously. In 9 of these households
the primary patient was treated at home. On 7 occasions the onset
of illness of the secondary case preceded the removal of the first patient
to hospital, while in another case the onset was on the date of removal.
The interval between the onset of the primary to the onset of the secondary
case was two days in 4 instances, three days in 2, and four days in 5,
i.e. in more than one-half it was four days or less. The longest such
interval was 16 days.
Return Cases.
Return cases occurred in only 6 households, one patient being
affected in each case. In only two instances was the interval between
the return home of the primary and the onset of illness of the return case
under one week; in both of these instances the primary patient was
apparently normal. In one of the remaining four the onset of illness was
in the third week after return home of the primary case who developed
a nasal discharge, while, in the other three it was the fourth week. The
primary case was apparently perfectly well in three instances, but the
other had developed an otorrhœa 7 days after his return home.
Schools and Infection.
There was very little suggestion this year that school attendance
was responsible for the spread of this infection. In the spring term there
were suggestive groupings such as 8 cases over seven weeks in the Stag
Lane School, 7 over five weeks at Kenmore, 2 in each of two successive
weeks at Priestmead and 3 cases over a fortnight at Stanburn. In the
summer term the only occasions were 3 cases in a fortnight at Belmont,
and 4 in a fortnight at Headstone. In the Christmas term, Stag Lane
again had 3 cases in one week, while Vaughan Road had 2 in a week
followed by a fortnight's interval and then 4 cases in a fortnight. The
instance where it was felt that school attendance was really operative
in the spread was at Cannon Lane School. Over a period of 13 weeks
there were 7 cases amongst children attending this school and living in
this district, 3 occurring in one week, while children attending the school
but living in an adjoining district also succumbed. A child thought
possibly to be a missed case was excluded. This step was followed by a
temporary freedom, with a later recurrence.
SMALLPOX.
A service patient while in a hospital in an adjoining district in
February was recognised as suffering from smallpox. Other cases
occurred amongst the staff and visitors. There were over 80 persons
resident here who were contacts either of the original case or of one of
those secondarily infected. These were visited for the usual period;
none developed the infection.
B