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54
infected two cases at home. No other eases occurred in 1931
connected with this school outbreak. A number of cases, however,
occurring in the early part of 1931 when traced back showed that
at least three cases of Smallpox, occurring amongst children in
November and December, were unrecognised and gave rise to
many cases in the early part of this year.
All cases were of the mild type, though some suffered from
extensive rashes, even though the infecting cases suffered only to a
very slight degree.
When beds were available, patients were removed to Orsett
Hospital; otherwise they were admitted to the London County
Council Hospital at Joyce Green.
Smallpox appeared on one death certificate as a contributing
cause. Actually, the disease had apparently nothing to do with
the fatal termination. The case was a boy aged 5 of family D. who
was unrecognised as suffering from smallpox until found in the
home when visiting school contacts. At the time of the visit, his
skin lesions were almost healed, but he was found to be suffering
from diphtheria to which he succumbed.
Out of 32 cases, the rash appeared on the third day of illness,
ill 8 instances ; 9 on the fourth, 4 on the fifth, 7 on the sixth and 6
on the seventh day. The commonest interval between the onset
of the primary and of the secondary cases was 17 days and between
the first day of the eruption of the primary and of the onset of the
secondary, 14 days. The shortest periods for these intervals were
6 days and 13 days respectively. The longest interval between the
secondary, and the primary cases were, from onset to onset 20 days,
rash to onset 24 days, and rash to rash 28 days. In these instances
the primary case was not removed for several days after the onset.
lc longest period between the removal of the primary and the
onset of the secondary was 17 days, and from removal to the rash
of the secondary 19 days.
A total of 4,175 visits were paid to the homes of Smallpox
contacts by the Sanitary Inspector's. Visiting is continued to the
19th day from last exposure to infection.