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13
The second case of small-pox was seen by me in consultation on
the 19th November. The patient, aged 22, unvaccinated, was a servant
in a large house in the east end of the parish. She was suffering from
confluent small-pox, and was removed to hospital the same day. She
appears to have contracted the disease from the master of the house,
who returned to London from Paris, where small-pox was then somewhat
prevalent, on the 18th October. On the 20th October, he was
taken ill, and had a rash on the 25th October; but he was supposed to
be suffering from some form of influenza. He was ill for rather over a
fortnight. About the 11th or 12th November, the unvaccinated
servant was attacked with what proved to be confluent small-pox;
another servant (vaccinated) was also taken ill at the same time, and
sent to her home, as she was believed to be suffering from chicken-pox;
and the lady of the house was ill, but developed no rash. There was
no further spread, either in the house, after tho servant had been
removed to hospital, or in the home of the other servant who was sent
away with supposed chicken-pox. All tho other inmates of the house
were revaccinated with successful results, except in the cases of the
master and mistress of the house, whose arms did not "take." The
former undoubtedly had just recovered from an attack of small-pox,
and the latter most probably had an attack of what is known as
Variola sine Eruptions.
It is interesting to observe, that out of the 10 people living in this
house, who were exposed to infection from the original case, 9 were
vaccinated, and one unvaccinated. The one unvaccinated developed a
severe form of confluent small-pox; one of tho vaccinated developed
the disease in its mild, modified form, which was mistaken for chickenpox,
whilst another was ill with symptoms pointing to small-pox, but
without rash. Tho other seven, although undoubtedly exposed to
infection, escaped.
In London during 1900, 89 cases of small-pox were notified, as
against 29 in 1899, and 35 in 1898. In the eight parishes forming the
Western district of London (population 799,857), 25 cases of small-pox
were notified, as against only one case in 1899, and 3 in 1898.
Enteric Fever.—The number of cases of enteric fever notified in
Chelsea in 1900 was 79 (home district, 37; Kensal Town, 42). In
addition there were 3 cases of continued fever—two being in Kensal
Town, and one in the home district.
Of the 44 cases of enterio fever in Kensal Town (including the two
cases of continued fever, which were undoubtedly enteric), no fewer
than 41 were notified between the 1st September and the end of the
year. There was in fact a localised outbreak of enteric fever causing
17 cases (primary) in the part of Kensal Town south of the canal, in
the immediate neighbourhood of West, Middle, and South Rows. The
dates of onset of these primary cases varied between the 25th of August
and the 16th September; and it is probable that the source of infection