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There is, however, a possibility that the infection may have been spread
by contaminated milk drinking straws. It is the practice for the older
children to take the caps off the bottles and to distribute the straws. As
it is likely that the original ones may have done this, a probable mode of
spread is by this means.
It is noteworthy that this epidemic was practically confined to the
infants' department of the school, and that such cases as did occur elsewhere
did not give rise to secondary cases. This was also a feature of the
epidemic reported in my last annual report.
It is perhaps to be expected that an infants' school would be the type
of community in which intestinal infections would spread most rapidly. The
children are ignorant of the principles of hygiene and it is extremely
difficult for the staff to see that all children wash their hands after using
the toilet and more so to see that some 350 children wash their hands before
their school dinner, especially as the facilities provided for washing are
usually woefully inadequate.
Typhoid Fever
There was one case of typhoid during the year in a married man aged 41.
Investigations showed that his wife, although quite well, was a carrier of
the disease. She gave a history of inoculation against typhoid fever some
five years ago. Since her carrier state was discovered she has had several
courses of treatment in an effort to clear up the infection, but at the time
of writing she was still excreting the organism.
She is being kept under regular supervision, and investigations are
being made at intervals to ascertain whether she is still a carrier. She is
a qualified nurse and, as such, is fully aware of the implications of her
condition from a public health point of view.
It is inpossible at this stage to say whether the wife infected her
husband, or whether they both acquired their infection from a common source.
In the absence of other cases, either in the borough or in the districts in
which the husband worked, the most likely explanation would be that the wife
has been a carrier for some time and the husband contracted the disease from
her.
Paratyphoid Fever
One case of paratyphoid B in a child of 2 years was notified during the
year.