[Report 1944] / Medical Officer of Health and School Medical Officer of Health, Southend-on-Sea Borough.

  • Southend-on-Sea (England). Borough Council.
Date:
1944
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1944] / Medical Officer of Health and School Medical Officer of Health, Southend-on-Sea Borough. Source: Wellcome Collection.

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    must remain open in order to fulfil its purpose often necessitate the adoption of some sort of shift system whereby the staff change froraj one set of duties to another in accordance with the time they are orl duty. This makes it difficult to ensure that persons engaged in th(| preparation or serving of food do not also undertake toilet duties. I A medical officer visited the Nursery daily, accompanied by s nurse, admissions to the Nursery were suspended and the affecteci children and their home contacts excluded from all departments of the school save the Senior. Tlie staff engaged in the handling oil food were swabbed and measures taken to tighten up the hygienic, precautions both in the preparation of meals and in the managemenfi of toilet duties. I With the exclusion of the affected children and their home contacts the numbers in attendance were much reduced but it wa? decided that to keep the Nursery open offered a better prospect of bringing the outbreak rapidly under control than would its temporarj closure. The symptoms were in many cases so mild and transieni that had the children not been kept under observation in the Nurserj their infection might have been overlooked or not reported and the} would have returned to the class as potential reservoirs of re-infection Although sporadic cases occurred for some weeks the majoi incidence of the outbreak was limited to about ten days, but a periocj of over two months elapsed before all the affected ehildren were finally clear of infecticn. The duration of infectivity in Sonne Dysentery differs widel} in individual cases and the degree of reliance to be placed on negative rectal swabs has engaged much attention in recent outbreaks. Il seems clear that when dealing with cases not confined to hospita' no scheme of swabbing which is likely to be accepted by the public can be guaranteed to eliminate the possibility of missing a persisteni carrier. The scheme adopted in this case was to begin taking “ clearance ” swabs one week after the clinical recovery of the patieni and to accept six corsecutive negative swabs, taken on alternate days, as presumptive evidence of freedom from infection. Thh procedure is less drastie than some which have been suggested, bul nevertheless opposition was encountered in a few cases, particular!} where a child remained intermittently positive and thus required repeated swabbing. Despite the maintenance of rigid hygienic pre¬ cautions after the outbreak had ceased, it was decided to adhere strictly to the standarl of clearance laid down, though there is nc, doubt that the length} period elapsing before some of the childrer were fit for re-admissi)n was a source of inconvenience to mother?^ whose opportunity for employment was dependent on their childrer'i attending the Nursery. ■ Some of the persistently positive children were admitted to th( Borough Sanatorium for treatment with Sulphaguanidine. In few cases home treatment with Sulphonamides was tried but ii proved less satisfactory owing to the difficulty of controlling tht dosage.