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they could be carriers, while many who have been infected and can infect
others might have had no symptoms at all. Most of the communicable
diseases with gastro-intestinal symptoms are contracted by the consumption
of infected food or drink. It is probable that most of the cases of
dysentery are contracted in this way,—But not all illnesses of a gastrointestinal
nature are spread by this means. At times the prominent
feature of influenza is gastro-enteritis, and in this case there is no reason
for assuming that the infection is spread in any other than the usual way.
The spread of some of these dysenteric complaints would seem to be
understandable only on the assumption that the infective element passes
by these means and not solely by means of food and drink.
There was a sharp rise this year in the number of cases of dysentery,
though again as is usually the case these figures cannot be accepted as
indicating the true incidence of the complaint. In all during the year 30
notifications were received.
The first three cases were two members on the staff of a day nursery,
not in this district, at which there were cases of Sonne dysentery; and
the younger brother of one of these, presumably infected by his older
sister as were other members of the family who were not notified.
On the 27th April a boy of five was notified to be suffering from Sonne
dysentery. Within the next fortnight four other members of his family
succumbed. On the 5th May another boy of five attending the same
school fell ill. Within two weeks two other members of his family
succumbed. This was the beginning of an invasion of the Cedars school
which lasted throughout May and well into June. Many pupils were
attacked and in many cases other members of their families succumbed.
That the illnesses were associated with school attendance was supported
by the fact that this school has a group of pupils from another part of
the district some four miles away and some of these children were affected,
but as far as is known no others in that area, except later some home
contacts of the pupils of the school. On the other hand the view that the
school meals probably were not responsible for the spread was supported
by the fact that although many sufferers had their meals at school, large
numbers did not do so and yet succumbed to the illness. Over these few
weeks 24 notifications of dysentery were received relating to pupils at
this school, or home contacts of these pupils where these pupils lived in
the district immediately round the school, or in the other part of the area
from which pupils at the school were drawn. During this same period
from the same population a number of notifications of food poisoning
were received.
The remaining four cases occured in September, scattered in different
parts of the district, in most of them salmonella organisms being recovered
from the stools.
On the spread of dysentery the Chief Medical Officer of the Ministry
says—"The experience is that the infection is rarely conveyed by food,
and that direct or indirect personal contact is mainly responsible. The
danger of spread of the infections is much enhanced by the large numbers
of symptomless excreters often associated with the clinical cases, not
only within day nurseries, schools and elsewhere in which outbreaks
occur but also in homes. This means that the home conditions as well
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