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which " are at present disregarded, and are therefore uncontrolled;cases of
small-pox not infrequently escaping detection owing to their being regarded merely as cases
of chicken-pox." This course was adopted in February of the present year, chicken-pox being
made a notifiable disease for a period of six months. Previously to this, however, all known
cases of chicken-pox, mostly reported by head teachers of elementary schools, had been visited,
but of the bulk of such cases, in the absence of notification, no information was forthcoming.
The Board, moreover, called attention to cases of small-pox among employes of the
Borough Councils, especially those engaged in the work of disinfection of infected dwellings,
clothing, bedding, etc., and pointed out, and advised, that any officer employed by the Council, who
was in any way to come into close relation, with persons or articles, with small-pox, should first be
protected by being effectively revaccinated. Sensible of the danger which sanitary inspectors
and disinfecting officers incur in the discharge of their duty, I had already called the attention
of the staff to the obligation they lay under to their families, and the Council, to submit theselves
to the trifling inconvenience incident to the operation, and all who had not been recently
revaccinated were done—save one man in the service of the disinfecting contractor, who had
been repeatedly urged to submit to the operation, and " intended " to do so but put it off from
day to day. He contracted the disease but recovered after a fairly severe illness.
Action of the School Hoard for London.—The Local Government Board having addressed
a communication to the School Board pointing out the desirability of permission being given
to public vaccinators to examine, at the schools, the arms of the children with a view to ascertain
their state as to vaccination, a special meeting of the Board was held, on 23rd September, when
it was resolved—
"That facilities be given to the Public Vaccination Officers of the Metropolis, on the application
of the proper local authority, to enter the schools of the Board, in infected areas, for the
purpose of examining the arms of the children, with a view to advising the parents to allow
their children to be vaccinated : provided that the School Board issue a circular to the
parents of the children asking if they have any objection to this examination, and in case
of such objection in any particular case, that such examination shall not take place; and
that the Local Government Board and the Public Vaccination Officers be informed
accordingly."
This resolution was communicated to the Council, as sanitary authority, and to the head
teachers of schools, and to the clerks of the boards of guardians, who were requested to forward
it to the public vaccinator—the person obviously intended by the expression " Public Vaccination
Officer" employed in the resolution. In a circular letter the head teacher of each school was
instructed that, if he should receive any application from the sanitary authority, he was to inform
the Board at once, but meantime to take no other action. Whereas if the said authority applied
to the Board, copies of a circular to parents would be sent to them. The circular read as follows—-
" The London School Board have decided, on the request of the Local Sanitary
Authority, to allow the Vaccination Officer to visit the school which your child is attending.
He will examine the arms of those children whose parents do not object, in order to see
whether they have been vaccinated, and, if necessary, to advise the parents. If you object
to your child being examined, please sign the accompanying statement and send it at once
to the Head Teacher."
The parent's objection form ran as follows:—"I object to my child (or children) being
examined by the Vaccination Officer ; " who, however, was not the person to make the examination,
this being the duty of the Public Vaccinator.
The Kensington Guardians, having taken the School Board's letter into consideration
(26th September), passed resolutions as follows—
"That the Clerk be instructed to prepare and issue a notice urging upon the inhabitants of the
parish the importance of vaccination and revaccination as a protection against the threatened
outbreak of an epidemic of small-pox, and stating, for their information and guidance, the
conditions under which the operation can be performed.
"That in the event of the Borough Council applying for and obtaining the permission of the
School Board for London to the inspection of the children in the Board schools in the parish,
the Clerk be authorised to instruct the several public vaccinators to inspect the schools in
their respective districts, and take all such steps as may be possible to secure the vaccination
or revaccination of those children whom they consider not properly protected.
"That in the event of an inspection being made of the children in the schools of the London
School Board, application be made to the managers of the several voluntary schools in the
parish to allow the public vaccinators to inspect the children in such schools, and to take
such steps as may be necessary to secure the vaccination or revaccination of those children
whom they consider not properly protected.
"That a letter be addressed to the several medical practitioners in the parish asking them to
be good enough to at once notify to the vaccination officer any case of small-pox in the
parish which comes to their knowledge."