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Metropolitan Borough of Bermondsey.
To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bermondsey.
Gentlemen,
I beg to present herewith a special report on the recent small-pox epidemic and the
measures which have been adopted to prevent its spread. For convenience, I have treated it
under the following heads:—
Origin and course of the Epidemic,
Statistical,
Aerial Diffusion of Small-pox;
and under the head of Prevention will be found: —
Vaccination,
Isolation,
Disinfection,
Notification of Chicken-pox,
Issuing of Handbills and Posters,
Examination of Contacts and House to-House Inspection,
Closure of Schools,
Quarantine.
The information concerning the number of vaccinations has been kindly supplied by the
Public Vaccinators, and that concerning the workmen employed in building the new shelters,
as well as the number of small-pox patients who passed through the Wharf, by the Metropolitan
Asylums Board.
I desire here to express my appreciation of the very able way my efforts to check the disease
have been seconded by the whole Sanitary staff, from the Chief Inspector to the disinfectors.
Your obedient servant,
R. K. BROWN.
Origin and course of Epidemic.
As stated in my annual report, the epidemic which started in London during August made its
appearance in Bermondsey on October the 12th, 1901, when two cases were notified from
Farthing Alley. This was followed in the second week by one case; in the third and fourth
weeks by 20 and 30 cases respectively. As will be seen by the accompanying chart, from the
fourth week of November till the third week in June we had an average of five to ten cases per
week, the latter number being only exceeded three times, viz.: on the first week of April, when
there were thirteen cases, and on the second and fourth weeks of May, when the cases numbered
11 and 12 respectively. The notifications declined steadily after the first week in June, till the
first week in July. From this date onwards the cases averaged about one per week. This report
deals with 297 complete cases which occurred up to the week ending September 6th. There is
no accounting for the origin of the first case. It was supposed to have been imported in the
form of an unrecognised case from the hopping gardens, but the evidence in support of this is
very flimsy. As regards locality the cases continued to crop up in this region till the middle of
November. By this time some forty cases had occurred in and about where the first cases
occurred, viz.: Wolseley Buildings, London Street, Farthing Alley, Eckett Street, Jacob Street,
the rest of the Borough being comparatively free. From the middle of November, 1901,
onwards, no part of the Borough could be said to be specially attacked, and the cases continued
to occur sporadically according as the infection was imported from one place to another. The
incidence in the region of the South Wharf will be discussed later.
Statistical.
There were 333 notifications of small-pox. Mostly on removal to the wharf, but in a few cases
after being seen by myself, 36 were found not to be suffering from small-pox, thus making a
total of 297 actual cases.
The distribution in the three registration sub-districts of the Borough will be seen in the
following Table.
Table I.
Bermondsey.
Rotherhithe.
St. Olave's.
Whole Borough.
Deaths.
Rate %
No.
Deaths.
Rate %
No.
Deaths.
No.
Deaths.
Rate %
No.
Rate %
77
13
16.9
25
27
4
297
44
14.8
16.0
195
13.81
Bermondsey had the largest actual number. The highest attack rate per thousand living was
in St. Olave's, viz., 2.66, as compared with 2.38 for Bermondsey, and 2.03 for Rotherhithe.
In Table II. will be found particulars of the cases as regards age distribution, vaccination and
mortality. The statistics concerning vaccination have all been carefully revised; where in doubt
letters have been written to friends concerning the vaccination of the children, parents
interviewed, and in many cases the patients have been revisited after recovery and the statements
carefully verified. This has all entailed a considerable amount of work, but I present the result
in the present table with every confidence in the correctness of the figures. The table has been
made on the model of the Metropolitan Asylums Board one, which for the sake of comparison is
appended herewith, Those cases have been placed among the vaccinated where there was the
slightest evidence of vaccination or where the parents made a positive statement that the
operation had been done, though it had only "taken" very slightly or not at all.