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arrived in this country from Egypt. The remaining case was an infant
of fourteen months who in March was diagnosed as suffering from
para B. infection.
The following is an account of infection in a Children's Home in
this district:
On the 10th September a child of four at a children's nursery fell
ill, being admitted on the 20th September to Redhill County Hospital
suffering from bronchitis. The eruption suggesting a typhoid infection,
laboratory investigations were carried out with the result that on the
24th September a typhoid organism was recovered from the stools, on
which the child was transferred to the isolation hospital. The same
evening two other children at the home who were ailing—one from
gastro-intestinal symptoms—were removed to the isolation hospital.
All further admissions to the home were prohibited and precautionary
steps taken at the home.
The home was a large house which had been opened in August,
1946, for the admission of up to 30 refugee children of ages of up to five
years, many of whom had only recently come to this country. Unfortunately
the necessary adaptation of the house such as the installation
of lavatory pans, sluices, etc., to make it suitable for the number of
children had not been carried out. The house was under the supervision
of a trained nurse as matron, assisted largely by a staff of aliens
possessing some nursing or teaching qualifications or experience.
From the 24th September numbers of children ailing in some way,
usually with a raised temperature, but sometimes with gastro-intestinal
trouble, were removed to the isolation hospital; also two members of
the staff. There was nothing specific about these ailments, and had
they occurred in those living in ordinary households probably little
enough notice would have been taken of them. Full laboratory investigations
were made of the blood and excreta of these patients with negative
results. It was not until the 4th October that a typhoid organism was
found in one of the adult patients. This gave a lead to the investigations
of the remainder of the children and of the staff at the nursery,
examinations being made of the blood and of the stools. By the 9th
October the laboratory reported positive results from two more of the
children in hospital, the date of admission of the last positive case being
the 2nd October. Further admissions to hospital had brought the total
to 19 by the 17th October, being 15 children and 4 adults. There
was then a lull until the last known case, a child admitted on the 27th
October.
All the typhoid organisms were found to be of the same phage
type. A number of children admitted to hospital and also some of those,
who because they showed no abnormal signs remained at the home,
were found to have a Giardia infection. This might have been responsible
for the symptoms in some of the cases. There remained, however,
a number suffering from gastro-intestinal symptoms in whom no pathogenic
organisms could be found. At the home then there were probably
three separate infections : the limited number of typhoid cases probably
all of whom were detected, the Giardia infection which was present,
whether or not it was the cause of disturbances in any, and an undetected