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quarantining, or watching of "contacts" or " suspects," is carried
out will depend largely the success of the preventive measures
taken in dealing with an outbreak of Smallpox. With one or two
cases of Smallpox nothing is easier, but as the cases of Smallpox
increase in numbers, the practical difficulties in the way of quaran-
tining increase proportionately.
These "contacts" have arisen in connection with cases of
Smallpox (1) in the Borough of Lambeth, or (2) elsewhere.
"Contacts" living in Lambeth have been watched for the incuba-
tion period of 16 days by the Lambeth Inspectors, and outside
"contacts" watched by the officers of the Sanitary Authorities,
in whose districts such "contacts" reside, for a similar period.
So, too, "contacts" from other districts have, in the same way,
been watched during the 16 days' incubation period, and the
number of these outside "contacts" watched in Lambeth was
large, especially when the epidemic was in full swing throughout
London and the adjoining Counties.
A daily inter-communication of information re Smallpox
patients and "contacts" was started at the commencement of the
epidemic amongst the different Metropolitan Medical Officers of
Health, at the instigation of their Society, and these daily
returns were sent out from the office of the County
Medical Officer of Health, and have proved of the greatest value.
The telephone service has also been requisitioned enormously
(hourly) during the epidemic, and many cases in this way have
been followed up at once, and prompt action taken. The Metropolitan
Asylums Board decided in the early days of the Epidemic
to send out daily returns to all Medical Officers in London re
discharges from, and deaths at the Smallpox Hospitals, together
with the names and addresses of all visitors to the Smallpox
Hospitals.
The amount of work involved in carrying out systematically and
carefully this quarantining will best be gauged by the numbers of
persons dealt with in the Borough of Lambeth by your officials,
careful details of all quarantined persons having been tabulated
for this purpose by the Medical Officer of Health.
In connection with the 333 infected houses and the 404 cases
of Smallpox notified in Lambeth, a total of 4182 persons have
been watched and quarantined—3236 adults 10 years of age and
over, and 946 children under 10 years of age; whilst in connection
with cases of Smallpox outside Lambeth, a total of 739 persons
have been watched and quarantined in Lambeth Borough, con-
sisting of 677 adults 10 years of age and over, and 62 children
under 10 years of age. In addition, 133 persons visited the
Smallpox Hospitals for the purpose of seeing their friends when
dangerously ill, and these 133 persons (all adults) were watched
and quarantined.