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A large amount of extra work has been thrown upon the cleri-
cal staff in connection with the 5054 "contacts," or "suspects,"
under observation, e.g., letters to Medical Officers of Health,
employers of labour, teachers of schools, librarians, vaccinating
officers, etc.
Before leaving the subject of quarantining, reference may be
made to a letter sent round by the Local Government Board, and
dated February 22nd, 1902, officially drawing attention to the
necessity for medical observation of "contacts" for a fortnight
after their exposure to infection, and stating that, when under
special circumstances "ontacts" are kept at their homes or in
a special Refuge, a reasonable expenditure out of the
Rates will be sanctioned by the Board. The Lambeth
Borough Council had, long before the receipt of the Board's
letter, i.e., on December 12th, 1901, adopted the practice of medi-
cally observing all "contacts," or "suspects," for a period of 16
days with compensation for loss of work, etc., the Council laying
much stress on such medical observation as one of the preventive
measures in dealing with Smallpox outbreaks.
5. Vaccination and Re-vaccination.
The Vaccination Officers and Public Vaccinators (officials
under the control of the Board of Guardians) have worked well,
and in complete unison with the officials of the Borough Council.
Immediately on a patient being removed suffering from Smallpox,
the vaccination officials were informed by the Medical Officer of
the Borough, visited the house and offered vaccination and
re-vaccination to the inmates and others, not only to the members
of the infected family, but also to other persons living in the
same house, court, or street. The people did not respond as they
might have done to the offers of free vaccination thus given,
though statistics (when ready) will show that very large numbers
of persons have been vaccinated or re-vaccinated by the Public
Vaccinators, and it is reasonable to conclude that Private Practi-
tioners have also been performing an equally large amount of
private vaccinations and re-vaccinations. The full statistics are
not yet prepared for publication, but the following are significant
facts: —
1. The total number of successful primary vaccinations at all
ages performed by the Public Vaccinators amongst persons living
in Lambeth was 7992 during 1901, as compared with 6571 during
1900—the increase in 1901 being during the 3rd and 4th
quarters, and due to the Smallpox epidemic that began in London
in July, and in Lambeth in August. Further, the total number
of primary vaccinations performed in Lambeth Borough by the
Public Vaccinators during the 12 months of the epidemic (August,
1901, to August, 1902) is 10,183.