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It will be seen from the above figures that 50% of cases occurred in children under 10
years of age and 14% in women between 20 and 40. Children under 1 year were relatively
immune.
One explanation of these figures would be that the children of the 2 age groups 1—10
are either more susceptible to the disease or, because of their tender years and consequent inability
to appreciate the supreme need for strict cleanliness, more likely to spread the disease.
It would naturally follow, therefore, that their mothers who are the people coming most intimately
into contact with them would be the next group to be chiefly affected.
Another possible explanation of the figures is that the disease may be transmitted by some
article of food or drink common to both mothers and children.
Case incidence and distribution.
A chart showing the weekly case incidence is appended. The case distribution was wide
spread and all parts of the Borough were affected.
CASE INCIDENCE AND DISTRIBUTION.
Summary and Conclusions.
In the foregoing report an effort has been made to record the findings in an outbreak of
Sonne dysentery as it has affected this Borough. Mention has been made of the difficulties encountered
in attempting to produce a correct statistical record. In view of the numerous boroughs
similarly affected it is hoped that this investigation may be of value for purposes of comparison.
As appears to be usual in similar outbreaks of Sonne dysentery women between 20 and
40 years of age and children under 10 were chiefly affected.
The results from bacteriological and serological examinations were disappointing as negative
findings were obtained in many cases who presented the typical features, of the disease. The
diagnosis was confirmed in 38% of cases only but all persons presenting the salient features
of the condition were included in the report.
The infectivity of the stools was highest during the first few days and cultivation of the
organism was found to be difficult in some cases even after the 4th day.
While the identification of the organism was soon established it was found to be impossible
to trace the factor responsible for its early transmission. The main hope, therefore, of discovering
such a factor and, consequently, of being in a position to deal with outbreaks in their
primary stages appears to rest in the earliest possible diagnosis of the disease. This can only
be accomplished by a thorough investigation of every case of enteritis for which a definite
diagnosis has not been made, such investigation to include a bacteriological examination and also
a serological examination as represented by agglutination reactions.
R. H. G. HECTOR DENHAM.
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