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a visual examination of the nose and throat, and having regard to
the time of the year and compared with similar mass examinations
previously carried out in the winter at other schools, the findings were
not significant and the fauces seemed to be less injected than
expected.
Arrangements were made for all absentees to be visited by the
school and welfare staffs and all Family Doctors and parents were
advised as to the position. Doctors were advised as to the acute
onset and fatal progress and parents for their part were told that
although there was not necessarily any connection between the two
deaths, the Family Doctor should be called at once if any of their
children appeared to be unwell and the doctor's attention was to be
drawn to the fact that the child was in attendance at this particular
school.
An outline of the position was conveyed to the appropriate
Medical Officers of the Ministries of Health and Education, the
Principal School Medical Officer of Essex, and the Public Health
Laboratory Service. A consultation was arranged for the next day
(November 27th) with Medical Officers of the Ministry of Health
and of the Public Health Laboratory Service, whose help is gratefully
acknowledged together with the co-operation of H.M. Coroner
and his pathologist.
Following the nose and throat swabbings of the class concerned,
the whole class and the teacher were excluded until all had been
proved negative for haemolytic streptococci Group A, and arrangements
were made to swab the whole staff and scholars as soon as
possible and this was done on December 2nd. When the results
came to hand, all Group A carriers were excluded and referred
to their family doctors for treatment. No absentee child was readmitted
until negative swabs had been obtained. Several children
had complained of nausea and vomiting, but all gave negative swabs
and were regarded as cases of "winter vomiting." Daily medical
sepervision continued until the Christmas closure and the following
shows the positive findings out of a school with 170 children.
Class 1— A/4 (2): A/12 (1): A/28 (1): C (1): Total = 5
Class 2—A (untyped) (1): C (2): ,, = 3
Class 3— A/2 (1): A/12 (1): A/28 (1): C (1): „ = 4
Class 4— A/12 (1): A/28 (2): O (1) ,, = 4
Class 5—A (untypable) (1): A/12 (1): A/28 (1): C (2): „ = 5
Grand Total: 21
(The class concerned was class 4)
Children carrying Group A streptococci were not re-admitted
until cleared. Urine tests were arranged for those carrying nephritogenic
Types 4 and 12.