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An outbreak of pharyngoconjunctival fever caused by adenovirus type 3 was studied in a boarding school for 800 boys aged 11-18 years. A total of 96 clinical cases were confirmed by laboratory tests. Clinical infection rates were higher in the younger boys but total infection rate did not vary with age. Previous infection provided 88% protection against reinfection. The techniques of virus isolation, complement fixation and neutralization were compared in the diagnosis of cases. Virus isolation diagnosed 86% of confirmed cases. Where acute sera (collected at onset) and convalescent sera (collected within one month) were available complement fixation and neutralization tests each diagnosed 96% of cases.

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SUMMARYIn the spring term of 1985 there was a protracted outbreak of upper respiratory tract febrile illness consistent with a clinical diagnosis of influenza in a boys' boarding school, which lasted from 23 January to 29 March. Although influenza virus infection was confirmed in 89 % of cases in the first half of the term, 53 % of the cases which occurred in the second half of the term had no evidence of infection with influenza virus. Between 5 February and 31 March 28 boys presented with skin rashes consistent with a clinical diagnosis of erythema infectiosum; 68 % of these were associated with parvovirus B19. Investigation of the cases of clinical influenza with no identified respiratory pathogen revealed a 58% infection rate with B19. B19 DNA was identified in either throat swabs or acute stage bloods of nine pupils with influenza-like symptoms.Cohort studies revealed that 44% of pupils aged 15-16 years were immune before the outbreak compared with only 17 % of pupils aged 11-12 years. Infection in the younger group was common and was associated with influenzalike illnesses as well as rashes. Forty-eight per cent of those who did not report any symptoms were also infected with B19.

SUMMARYIn this review of 66 outbreaks of infectious disease in schools in England and Wales between 1979–88, 27 were reported from independent and 39 from maintained schools. Altogether, over 8000 children and nearly 500 adults were affected. Most of the outbreaks investigated were due to gastrointestinal infections which affected about 5000 children; respiratory infections affected a further 2000 children. Fifty-two children and seven adults were admitted to hospital and one child with measles died. Vaccination policies and use of immunoglobulin for control and prevention of outbreaks in schools have been discussed.

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