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86
DYSENTERY
Although dysentery can be caused by a variety of organisms, most of
the cases of this now quite prevalent complaint in this country are caused
by Shigella Sonnei. At one time the means of infection was food or drink.
Some cases are still occasionally contracted by these means, but the
commoner pattern of spread today is by direct or indirect contact. Many
cases seem to have been contracted at school, infection often then being
handed on at home to other members of the family. Most cases occur in
the first half of the year. In general, it is a relatively mild complaint. The
result is, that a doctor is not called in, and even where he is, often enough
the case is not notified. The notification figures then do not indicate the
prevalence of this infection. The department gets to know from the schools
of quite heavy infections. Enquiries about the suffering pupils leads to
further information about attacks amongst home contacts; and yet
perhaps none of the cases have been notified. On the other hand, notifications
are received of persons suffering from this disease based on
clinical symptons and not on bacteriological findings. This overweighting
by numbers of cases which might not really be dysentery might lead to the
notification figures being above the true incidence of infection if there
have been no school outbreaks during the year. Where however, as is
often the case, there are one or more of these school outbreaks where
many of the sufferers are not notified, the numbers of cases notified fall
very short of representing the actual incidence. For these reasons no
conclusions can be drawn about trends, nor can the figures be usefully
compared with those of other years for the same district, or with those of
other areas.
Very few cases were notified, in all only five. Of these, one, an adult,
almost certainly contracted the infection while on holiiday abroad;
another a child, was suffering from the early symptons of the illness when
his family came to live here from another district. Two adults were
notified on clinical grounds. The organism was recovered in only one
patient, a school child. A number of other children thought to be suffering
from dysentery were found on bacteriological examination to be suffering
from food poisoning.
FOOD POISONING
The number of cases of food poisoning notified each year since the
war have been far greater than the numbers before the war. Part of the
rise is no doubt real; part though is due to the recognition as instances of
food poisoning of cases which before would have been missed. One reason
for this is the Laboratory Service which the war gave the country. This
provided greatly improved facilities for the bacteriological examination
of food stuffs and excreta. Another reason is the greater interest in the
subject. This too is largely the outcome of the activities of those in the
Laboratory Service. Part of the increase though is real, and to a very large