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SMALLPOX.
11
SMALLPOX, 1894.
In St. Marylebone; during 1890, there were only three
cases of smallpox notified; in 1891, but a single case; in
1892, seven cases.
In 1893, smallpox began to cause some anxiety, for in
January of that year there were ten cases, in February four,
in March nineteen, and in May thirty-five. During the
remaining months cases occurred, bringing the total for the
year up to 127.
Smallpox, as a rule, has a distinct seasonal course,
increasing up to a maximum in May, and then decreasing,
and this course was followed in all the previous outbreaks;
so that when, during the whole of the six months ending
June 30th, 1894, only five cases of smallpox had been
notified, one would, from past experience, have confidently
predicted that, so far as St. Marylebone was
concerned, the year would be fairly free from smallpox.
In July, however, a fatal case occurred in Portland
Town, under circumstances which in the first place absolutely
precluded removal to hospital, and in the second place,
gave unusual facilities for its dissemination. An outbreak
of almost unprecedented character occurred in the immediate
locality of the case mentioned, the remote effects of which
are even now experienced. This outbreak commenced on
July 3rd, when four cases were notified, and during the
seven days from the 23rd to the 31st, no less than 139 cases
from a limited area were removed to hospital. After that
date, scattered cases only were reported until August 10th,
when there was a smaller but still a serious burst in and
around Nightingale Street. The cause of this was satisfactorily
traced to infection derived from Portland Town,
which had smouldered in Nightingale Street. In other
words, cases in Nightingale Street that had not been
reported were found to have existed from duly 25th up to
August 11th. By the end of August, 71 cases had been
reported in connection with this second outbreak. After
August, smallpox declined. In September there were 2(5
cases; in October, 10; in November, 11; and in December, 10.