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were re-vaccinated and were removed to 191, High Holborn, a vacant house the property of the
Council, some of the rooms of which were prepared and furnished for the occasion.
Only 20 of the 56 inhabitants of the house could be persuaded to be re-vaccinated.
A second case (an Italian woman) occurred in the same house (not the same family) about
a fortnight later, but was not notified until the sixth day of the rash. No other case was notified
from this house.
After the first case and prior to the second case at 21, Portpool Lane, the five successive
cases notified all occurred at a distance from this house, and in the western half of the Borough,
and were all scattered cases, and probably contracted from persons living outside the Borough.
A cause of much of the spread of the disease in the Borough was a woman of the
unfortunate class who slept at common lodging houses, and was visiting public houses in the
Borough for about a week with the eruption on her. I saw her in the street with another woman
of the same clays near the Relief Offices, Endell Street, and prevailed upon her to see a doctor
there. She was notified and detained, but unfortunately escaped before the ambulance arrived,
and was not again found and removed to hospital until after midnight more than two days after
her escape.
Delay in notification either on account of neglect in calling in a Doctor, or on account of
difficulty of diagnosis, has been another great cause of spread of the disease.
In one house, 43, Great Wild Street, a tenement house which contained 28 persons, 12
contracted Small-pox, and of these ten most probably contracted it from a youth who had not
been attended by a Doctor, and a younger brother who had the eruption out for six or seven
days before a Doctor was called in. The eleven persons had all refused re-vaccination after the
first case.
These two youths also infected at least 8 or 9 relatives and friends who lived in the neighbourhood
and had visited them at this house.
In another house, 15, Nottingham Court, a small tenement house of only 6 rooms, and
which contained 16 persons, 9 contracted small-pox. The first was a man aged 30 who had been
visiting at a common lodging-house in Queen Street where there had been many cases of
small-pox. The case was notified on the 30th December, 1901, as soon as the rash appeared, and
the patient was at once removed to hospital. The patient's wife was at once re-vaccinated and a
child aged 3¼ had already been vaccinated, and an unvaccinated daughter aged 2 years was then,
fortunately, living with her grandmother. Many others in the house promised to be re-vaccinated,
but afterwards refused. No further case was notified until the 15th February, 1902, an infant
10 months old, who had not been vaccinated. This child became ill on the 9th February, and
the rash appeared on the llth, but the child was not seen by a doctor until it was taken to
King's College Hospital on the 15th February, from which place it was removed to the hospital
ships, and soon afterwards died there. On the 25th February, 10 days afterwards, four other cases
were notified from this house, viz., the mother of the child, a brother aged 8 years, who was
unvaccinated at the time of infection, having been vaccinated for the first time on February 16th
and two friends of the family, a female aged 28 and a male aged 25. On the following day,
February 26th, three other patients were notified and removed; the father (aged 35) of the infant
removed on the 15th February, and two friends of the family, a female aged 24, and a female
aged 18. Three of these patients were removed from our shelter, No. 191, High Holborn, where
they had been kept under observation during the disinfection of the house. One patient (female,
24) was removed as soon as she became ill before the rash appeared, and was re-vaccinated the
same day just prior to her removal. Several other patients who lived in the neighbourhood were
known to have been infected from the infant mentioned above. One, a boy 7 years old, who lived
in the adjoining house, No. 14, who was unvaccinated, although a sister one year old who had
been vaccinated did not contract small-pox. Another case was an unvaccinated infant 7 months
old.