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17
epidemic. It will there be geen that it was not until the last week
in December that the disease began to assume serious dimensions.
The rise in the notifications at that time was caused by secondary
cases infected by a fatal case which had been medically attended at
home for a week, after the rash had appeared, owing to the nature of
the disease not having been recognised by the medical attendant.
This one error in diagnosis led to the infection of 24 persons,
several of whom died. From this point onwards the disease appears
Ito have spread extensively, until it reached its maximum in the last,
Kveek of March and the first week in April, during which fortnight
Ino less than 77 cases were notified. After this date the disease
[gradually declined, until the end of July, when the epidemic, so far
lis Hackney is concerned, practically came to an end. There were
lour subsequent cases notified during the months of November, since
Kvhich date the disease has been absent from the Borough. Thus,
Ithe total number of cases of small-pox notified in Hackney during
the whole of the epidemic was 467; but of these 30 were, on
Subsequent examination, decided not to be small-pox, and were
returned to their homes. This gives an attack-rate of 1.9 per 1,000
living persons. The mistakes in diagnois is equivalent to 6.4 per
cent. of cases notified. The rate of mistaken diagnosis determined
by the Metropolitan Asylums Board for the whole of the Metropolis
during the epidemic, amounted to 13.3 per cent. The comparison
shows Hackney in a very favourable light lompared with the rest of
London. The following table shows the distribution of the notified
cases in the different sub-districts of Hackney.
All Hackney 467
North 107
Central 127
S. East 124
S. West 109
From these figures it shows that the disease was very nearly
evenly distributed over district; no locality could be said to be more
affected than the other to any very great extent.