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54
Local Practitioners were circularised on two occasions during the
year as to the facilities offered and requesting that telephonic notification
of cases be made. On confirmation of the diagnosis, circulars
are drawn up giving the following particulars:—Name, address,
occupation, place of employment, and date of last attendance,
vaccinal condition, suspected source of infection, date of onset and
of appearance of rash, together with a complete list of names and
addresses of home and other contacts, their employment and vaccinal
condition. Copies of these circulars are sent on the day of notification
to all local Practitioners, Medical Officers of Health of adjoining
areas and of areas affected by contacts, and totalled 70 for each
case, representing 12,930 during the year. The enormous amount
of clerical work alone involved can thus be realised.
Lists of Contacts of "outside" cases are also periodically circularised
to local Practitioners, so that they may be alive to the possibility
of Smallpox when consulted by any of these contacts.
Removal to Hospital is immediately effected and immediate
vaccination offered by the Public Vaccinator, Dr. Mackenzie, who
has co-operated, often late at night, in a most willing manner. No
effort is spared in persuading contacts to be vaccinated, and the
virtual cessation of the epidemic towards the end of the year was
mainly due to the fact that in the latter half of the year in only one
household was complete refusal met with. All four members of the
family involved were ultimately removed to Hospital with Smallpox.

From the above it will be seen that vaccination of home contacts,
when done not later than the first day after the appearance of rash
in the primary case, protected them in every instance. Even in