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31
On Saturday morning the 5 swabs from the "W." family and
7 of the 14 taken at the Nursery School were reported to have yielded
B. Dysenteriae Sonne.
A further circular letter was sent to all medical practitioners
informing them that the outbreak was definitely dysenteric, drawing
attention to the secondary cases, to the comparative mildness of
the illness in most cases, and requesting co-operation in advising
patients and contacts as to its extreme infectivity, and in particular
requesting the name and address of any person trading in connection
with food supplies.
The Director of Education was asked to instruct the caretakers
of all schools in the St. James Street area to disinfect all lavatory
seats daily until further notice.
A total of 49 cases (all ages) were notified in connection with
the outbreak, but the total number of persons affected in more or
less degree is estimated at approximately 90.
The very mildness of the illness in most cases has rendered it
insidious and difficult to deal with.
The Nursery School was re-opened on July 12th with certain
additional safeguards put into operation to limit the danger of
further cases. In view of the possibility of "carriers," further
cases were expected, especially when it is remembered how difficult
children between the ages of 2 and 5 years are to deal with when
there is any tendency to diarrhoea. In addition, there is at any
Nursery School every conceivable factor favourable to the spread
of such an outbreak. Fortunately, no further cases were reported.
Two cases were reported amongst children attending a neighbouring
school, but no direct connection could be traced. 15 of
the total of 49 cases were scholars at the Nursery School and 25
were direct home contacts of these cases. The remaining 9 were
sporadic cases in homes in this portion of the Borough.
(b) Second, Series.
Following the apparent termination of the Nursery School
outbreak, three cases were notified between 8th and 23rd November.
A circular letter was again sent to all medical practitioners in the
Borough stating the Wards in which the cases had occurred and
giving all available information. Twenty-five of the cases attended
some 19 different schools, all of which, with one exception, were
situated in that part of the Borough to the south of Forest Road.
As with the first series of cases, no common cause could be
discovered and the infection appeared to be spread from case to
case.