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Between the years 1882 and 1892 Vaccination was most actively carried out with
regard to the children born in Shoreditch. Since 1892 there has been a rapid falling
off in the numbers of children vaccinated, so that at the present time we have with
respect to the numbers of unvaccinated children in Shoreditch a condition of things
approximating to that mentioned by Dr. Barnes some forty years ago. So far as
Shoreditch is concerned I am unable to come to any conclusion as to what extent
vaccination has assisted in bringing about the reduction in the amount of small.pox
which has become apparent during the past fourteen or fifteen years. This period
coincides with that during which great improvement has taken place in the means for
the isolation of cases of small.pox. The practice of prompt isolation in proper hospitals
has I believe been very effective in preventing or cutting short outbreaks of small-pox
in London, and there is no doubt that it has been a very potent factor in reducing the
prevalence of the disease in Shoreditch. Formerly, there was no notification of
Infectious Diseases Act in operation; but few of the cases of small-pox occurring in
Shoreditch were treated in hospital, the vast majority being retained in their own
homes under conditions mostly precluding any possibility of isolation.; and the means for
efficient disinfection were inadequate. Now-a-days cases of small-pox have to be
certified to the medical officer of health; they are forthwith removed to hospital and
so far as I am aware no cases of small-pox have during the past 10 years been retained
at home for treatment in Shoreditch ; the necessary precautions are taken for the
disinfection of the infected houses, and persons who have been exposed to infection
are vaccinated or re-vaccinated, if they are willing to submit to the operation, and kept
under observation until it is deemed safe for them to resume their avocations.
The reduction in the prevalence of small-pox in Shoreditch may I think be regarded
as one of the beneficial results of Public Health legislation, but the fact ought not to be
overlooked that there are periods when infectious diseases tend to spread far and wide,
to possess greater powers of infection and to be more difficult to control. Small-pox
has in the past exhibited this tendency at intervals; it remains to be seen whether the
present methods of dealing with it will be as efficacious under such conditions as they
are now.
SCARLET FEVER (SCARLATINA).
The cases of scarlet fever certified during 1900, numbered 330, including six which
were found subsequently not to be cases of the disease. Eighteen of the cases
erminated fatally.
The numbers of deaths yearly recorded as due to scarlet fever
from 1859 to 1899 are as set out in the following table:—