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removed and disinfected at the disinfecting station. In cases in which it was impossible
to carry out efficient measures whilst the dwellings were in occupation, the
inhabitants thereof were sent to the shelter provided for the purpose. Whilst at the
shelter all clothing was disinfected and the people had the use of the baths provided at
the shelter. People were permitted to remain at the shelter until their own dwellings
were ready for them again, fire, light, cooking utensils etc., being provided and in
necessitous cases food also. The average length of stay at the shelter was about
twenty-four hours. Altogether, on account of small-pox, the shelter, which affords
accommodation for three families at one time, was made use of by the members of
104 families comprising some 335 persons. The shelter proved of very great service
during the outbreak ; in fact, in many cases, it would have been impossible to carry out,
with anything like the necessary despatch, the proper measures as to disinfection
without it.
The authorities of the public baths and libraries in Shoreditch and certain other
bodies were furnished daily with lists of the houses in which small-pox had occurred.
The schools attended were notified in accordance with the law, and information was
sent to the medical officers of health of districts in which persons who had been
exposed to infection resided or were employed. All persons dwelling in houses in
which cases of small-pox had ocurred or who had been exposed to infection were
recommended to lose no time in getting vaccinated or re-vaccinated. A list of infected
houses was sent every day to the vaccination officer, and whenever possible, in order
to save time, the public vaccinators were communicated with directly from the health
department. In many instances recommendations as to vaccination were adopted at
once; in other cases valuable time was lost through people having to make lip their
minds; some refused to submit to the operation and others after refusing changed their
minds when secondary cases occurred. It is needless to point out that the public
vaccinators were frequently obliged to pay several visits to the same house for the
purpose of vaccinating the inmates, where in most cases one visit ought to have been
sufficient for the purpose.
Infected houses were kept under observation until it was considered that the
danger of the recurrence of the disease was past. During the outbreak special
attention was given to the removal of house refuse and the general cleanliness of the
streets in which the disease was prevalent. So far as can be judged there is no reason
for believing that the measures taken as to disinfection were ineffectual. In practically
the whole of the secondary cases infection occurred during the period which elapsed
between the time the primary cases became manifest and the time the necessary disinfection
was carried out.
It is now necessary to say a few words respecting the influence of vaccination in
connection with the outbreak. As is well known it is claimed that efficient vaccination
exerts a very powerful influence in preventing attacks of small-pox and in mitigating
the severity of the attacks. Persons who have recently been vaccinated very rarely
take small-pox. With the lapse of time from the date of vaccination the protection