BJouR 1627 impression of the teachers was that the majority of affected pupils were sensible and emotionally stable. As to the system affected by the infection, the sudden onset of severe frontal headache associated with vertigo and faintness tended to point to an involvement of the central nervous system rather than of the gastro-intestinal tract, and it was certainly feasible to consider the nausea to be of " central " origin. Conversely, the relatively small amount of vomiting and diarrhoea and the absence of pyrexia tended to exclude the gastro-intestinal system, especially in the absence of any association with a particular food or drink.The duration of symptoms was rather longer than is usual in this type of condition; the slightly shorter period for boys was probably not really significant, and it may simply reflect differences between boys and girls in psychological response to illness. It was not possible to define a period of communicability, but it appeared to be greater than one week-again rather longer than is usual in outbreaks of this character. The relapse rate was very disturbing, and it was not possible to offer an explanation for this phenomenon, but certain features suggested an hysterical element.This outbreak serves to illustrate the practical difficulties experienced by a public health medical officer in dealing in a rapid and effective fashion with " group illness " in a localized community of this nature. The initial difficulty was that of making an on-the-spot diagnosis adequate for the purposes of disposal of cases and the taking of immediate action to prevent the occurrence of further cases (it may well be imagined that a school gymnasium giving the impression of a "casualtyclearing station " is hardly an ideal situation in which to practise careful diagnostic technique). In this instance it did not prove too difficult to exclude gaseous poisoning, but this might not have been so straightforward had the school been of an older type using coal-gas and possibly with defective drains. The second problem was that of the logistics of case disposal; it was found that a substantial number of ambulance vehicles (sitting-case cars) had to be used daily, and this involved considerable rearrangement of other non-emergency ambulance duties. The third and possibly most difficult problem was that of the public-relations aspect of the matter; the condition was soon being discussed by the public at large as the " Coventry mystery virus," but, with the help of the school staff initially and subsequently the co-operation of the press and regional television news broadcasting service, it was possible to utilize the publicity to good purpose.
SummaryAn explosive outbreak affecting 404 pupils and two members of staff at three Coventry secondary modern schools is described, in which the prominent symptoms were frontal headache, nausea, and vertigo, accompanied by actual collapse.Arguments are put forward for considering the outbreak to be of infectious (probably viral) origin, although it is admitted that ...