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Paratyphoid Fever. There were 16 notifications of Paratyphoid
'B' during the year. Three of these eases occurred in
one family, there were three single cases, apparently unconnected,
and ten eases formed part of an outbreak at a school
just outside our area.
Cases 1, 2 and 3. These cases, which occurred in June,
form the family group. A little girl aged 4½ years was
admitted to hospital with a history of five days of general
malaise, pyrexia, sickness and diarrhoea. The hospital laboratory
isolated salmonella paratyphi from the stools. Upon
receiving this information faecal specimens were obtained from
the remainder of the family and other contacts. The mother
and a brother aged 5 years proved to be positive to salmonella
paratyphi although neither of them showed any symptoms.
All other contacts had negative specimens. It was not possible
to trace the source of infection and the original case turned
out to be quite mild. All three cases were free from the
organism in six weeks. Results of phage typing showed that
the cultures belonged to Vi-phage Type 3A1.
Cases 4, 5 and 6. The onset dates in these three cases
were 11th, 19th and 27th September. In each case the patient
had been removed to hospital with a history of general malaise
and temperature and diagnosed after salmonella paratyphi
had been isolated from the stools. Although exhaustive enquiries
were made, no connection between these cases could be
established. Two of them were typed as Vi-phage Type 1.
In the other case the hospital had omitted to send cultures
for phage typing.
Cases 7 -16. Early in October information was received from
the Medical Officer of Health of a neighbouring district that
there were three confirmed cases of Paratyphoid ' B ' amongst
children at a school situated in his area and that arrangements
were being made to take fecal specimens from all children
and staff at the school. Seventy-four children from our district
were attending this school and fæcal specimens were accordingly
obtained from all of them. In ten instances salmonella
paratyphi were isolated from the stools and the children
concerned were excluded from school. Five of these had had
symptoms of the disease whilst the other five were symptom
free. Three of the cases were removed to isolation hospital
as home circumstances did not permit of adequate precautions
being taken. By arrangement with the School Medical Officer
of the area concerned, none of the cases were allowed to return
to school until three negative stools had been obtained.
These ten cases all originated at the school, at which, it
is understood, there were 25 established cases in all—24
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