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PREVENTIVE MEASURES.
The preventive measures used with success in stamping out the
epidemic may be tabulated as follows : —
(1) Notification,
(2) Isolation,
(3) Disinfection,
(4) Quarantining,
(5) Vaccination and re-vaccination.
1. Notification.
The importance of early and exact notification is the first step
in dealing with an epidemic of Smallpox, as it is clear that with-
out exact knowledge as to where the cases exist in the Borough,
preventive measures cannot be taken. Knowing the difficulties
that medical men (especially the younger medical men, who have
had no experience of the disease) have in diagnosing Smallpox
in some of its modified forms, I communicated by letter early in
the outbreak (October 15th, 1901), with every medical man resi-
ing or practising in Lambeth Borough, pointing out the danger of
the Smallpox spreading on account of modified cases being mistaken
for other diseases (e.g.. Chickenpox, Lichen, etc.). and the
consequent importance of correctly diagnosing the disease in all
its varied forms. To accomplish this I suggested that all doubtful
or suspicious cases should be voluntarily notified to me, as
Medical Officer, and I undertook to act as consultant in such cases
and take all responsibility. As a result, 277 doubtful or
suspicious cases were notified, and all these the Medical
Officer visited and removed to the Smallpox Hospital,
or left at home, according as they were Smallpox, or other diseases.
During 1901 (four months), 53 cases were notified, and during 1902
as follows: — January 51, February 38, March 30, April 40, May
30, June 24, July 10, and August 1; total 277. Of the 277 cases,
it is of medical interest to note that 94 were Smallpox, 84
Chickenpox, 17 Lichen, 15 Erythema, 19 Acne and Echthyma,
14 Porrigo and Eczema, 6 Vaccinia, 6 Measles, 4 Herpes, 4
Psoriasis, 3 Scarlet Fever, 2 Erysipelas, 9 other skin diseases.
Had the 94 doubtful cases, which proved to be Smallpox, been
left to be treated as doubtful cases at home, it is appalling to
think what proportions the epidemic might have assumed in Lambeth
Borough. Copy of the letter sent out is as follows : —
Public Health Department,
333, Kennington Road, S.E.
October 15th, 1901.
Dear Sir,
re Smallpox.
As Smallpox appears to be taking an epidemic form in London,
and as several imported cases have already been notified in Lambeth
Borough, it is of importance that the greatest care should be