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Section II.
INFECTIOUS DISEASES.
Small-pox.—Two cases of small-pox were notified in Chelsea in
1900. The circumstances attending both these cases are of interest, as
showing how both very severe and very mild types of the disease are
mistaken for other illnesses, with the result that the initial case forms
the starting point for a more or less extended outbreak.
The first case, that of Mrs. D., aged 39 years, was seen by me in
consultation on the 21st May, and was removed to hospital on the same
day. Mrs. D. was the widow of a valet, who had died of what was
supposed to be malignant measles on the 9th May, in a neighbouring
parish. After her husband's death, Mrs. D. was removed to St.
George's Infirmary in the Fulham Road, but was discharged on the
16th May. She slept for two nights at a house in the Kensington
district, and came to reside in Chelsea on the 18th May, being then ill.
No further cases occurred in the house in Chelsea in which Mrs. D. was
living, although all the inmates (adults) declined re vaccination. They
were, however, quarantined for 14 days, and compensated for loss of
work, three of them being employes of large omnibus companies.
From the first case, that of the valet, Mr. D., who died on the 9th
May, of what must have been hoemorrhagic small-pox, arose the
following cases:—(1) Mrs. D., his wife, already alluded to ; (2) his son,
who attended his father's funeral, and resided in a midland town. His
illness was not diagnosed, and resulted in the infection of his child, a
servant, and the child's nurse, the latter dying of confluent hoemorrhagic
small-pox. All these cases occurred in an inn; and it is
marvellous that a wide-spread epidemic did not result. (3) A housekeeper
in the house where the valet died, was removed to a West End
Hospital for pneumonia, and subsequently developed small-pox,
infecting a nurse, a ward-maid, a patient, and two medical students of
the Institution. (4) Four laundry maids at a Chiswick laundry, which
received the "washing" from the house where the valet died, and who
sorted the dirty linen, were attacked with small-pox. For some time
they were thought to be suffering from chicken-pox, the disease being
of the modified tpye. Two of these maids resided in Kensal Town.
There was no spread of the disease from either of them; but the other
two were the means of infecting some 9 or 10 others, mostly relatives
or friends who had visited them when ill, before the disease was
diagnosed. (5) A nurse in the St. George's Infirmary was infected by
clothing brought by Mrs. D. from the house, where her husband died;
and two children were infected from a similar source at the house in
Kensington where Mrs. D. slept two nights, before coming to Chelsea.