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for the examination of suspected cases at the Port of London
and immediate isolation in various localities in different parts of
London, coupled with efficient disinfection. In cases of difficulty
in diagnosis occurring in London the London County Council
retained the services of a Plague expert, formerly medical officer in
one of the Plague hospitals in Hong Kong, and of Dr. Klein, the
bacteriologist. The London County Council also issued a
memorandum on the signs and symptoms of Plague, and asked for
immediate notification of any mortality among rats observed in
this and other Metropolitan Districts. This last precaution was
taken on the ground that it is supposed that rats are infected with
Plague previously to an epidemic affecting humanity.
There is yet one more prophylactic measure, namely, Protective
Inoculation, introduced by Professor Haffkine in invaded districts
in India. The Local Government Board made arrangements to
supply, if necessary, this protective material to the Sanitary
Authority for persons subjected to sustained exposure to Plague
infection.
From these facts it will be gathered that London was as
thoroughly prepared for, and as thoroughly protected against, an
epidemic of Plague as it is possible for a community to be forearmed.
It may be convenient that the chief signs and symptoms of
Plague should be briefly stated here, as suspicious conditions may
occur at any moment on account of "imported" cases from places
where Plague is at present epidemic:—
Plague fastens most readily on that section of the community which is badly
housed, poor, uncleanly, and generally insanitary. Dirt, squalor, and overcrowding
and the conditions generally which favoured typhus fever in the past
are the favourable conditions for Plague.
Plague, in all its forms, should be regarded as personally infective. It is
spread chiefly by human agency. But rats, body parasites, household insects
and vermin, wounds, bedding, excreta, clothing, food and drink, and even
infection by the air are all possible agents in the spread of the disease.
Rats are very prone to the disease. The first warning of Plague may be
deaths among rats. It is by the vermin in the rat's coat that infection is probably
conveyed to man. The vermin leave the rat after the animal dies, and as
it is found that the vermin contain the bacilli the poison may gain entrance to the
human body by vermin bites or by the abrasion of the skin consequent on the
scratching they induce.