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Ambulance Service.—The patients were removed in every case in the ambulances of the
Asylums Board with a promptitude altogether commendable—many of them at night.
Hospital Service.—The accommodation from the first was ample. In August, 1901, there
were some 1,442 beds available, or that could have been made available; viz., 250 at the ships and
1,192 at the Gore Farm Hospitals, the accommodation at which was largely extended (raising the
aggregate to about 1,850 beds) before the close of the epidemic. A temporary hospital for 300
patients was erected at Long Reach. Another temporary structure, the Orchard Hospital, at
Joyce Green, with accommodation for 800 beds, was rapidly constructed and furnished, but never
used. The accommodation at the several hospitals aggregated about 3,200 beds. The patients
at any one time scarcely exceeded half that number.
Disinfection.—Upon the removal of a patient the Council's staff disinfected the sick room or
rooms without loss of time, and the contractors removed the bedding.* This was frequently done
at night. It was not thought necessary to " strip " the wall papers—a course adopted in some
boroughs. In no instance was there any spread of the disease suggesting that the disinfection,
whether of rooms or infected articles, had not been effective. Sulphurous acid fumigation was
practised in the disinfection of rooms : all washable articles were cleansed after disinfection.
Re-vaccination.—Without loss of time the Vaccination Officer, and generally the Public
Vaccinator also, was informed of the occurrence of an outbreak, and vaccination or re-vaccination
was offered to every " contact" and readily accepted by most of them. Many persons were
vaccinated by the District Poor-Law Medical Officers these being authorised to vaccinate or
re-vaccinate the inmates of houses wherein small-pox occurs I had every reason to be satisfied
with the services rendered by the officers of the guardians in this respect.
In a special report (No. 10, 1901), the question of vaccination and re-vaccination was dealt
with, especially in connection with the examination of the arms of children in elementary schools—
Board and Voluntary. A large number of children were found to be unprotected—the majority of
them had been born without the borough—and were vaccinated forthwith. There were many
re-vaccinations of elder children, and their parents, and other inmates, at the homes—vaccination
on the school premises was prohibited—and it is common knowledge that a large number of other
persons sought and obtained protection at the hands of the Public Vaccinators and other medical
practitioners. Primary vaccinations, moreover, were unusually numerous, but statistical information
on the subject, as respects 1902, is not at present available.† Little information respecting
the state of vaccination, or otherwise, was forthcoming, the large majority of the patients having
been removed before receipt of the notification of an outbreak. Such information, however, in respect
of so few cases, would have little value; it is to be anticipated, moreover, that the Asylums Board will
publish the statistics of the vaccination-state of the more than 10,000 persons admitted to their
hospitals. [In the second report for 1902 reference was made to a preliminary statement by the
Managers on this subject, and in the fourth report statistics, furnished by the Registrar-General,
were cited as to the state as to vaccination, or otherwise, of over 1,000 fatal cases. Vide page 74.]
Contacts.—The incubation period of small-pox is about 12-14 days, and in order to prevent
spread of disease it became necessary to exercise supervision of persons who had been exposed to
infection. The names and addresses of these " contacts " were obtained, and the several persons
visited daily, from the twelfth to the fifteenth day after the first and the last exposure to infection.
Several contacts who had been exposed to infection before the receipt of the notification certificate
fell ill, but scarcely any when the sick person had been promptly notified and removed, and the
usual preventive measures had been adopted. It was not thought necessary to prevent the contacts
from following their usual pursuits. They were invited to place themselves in communication with
the Department, should occasion arise. Only in one case was it thought desirable to stop a man
from work; he was an operative baker who for two or three nights had pursued his occupation (in
another borough) at an underground bakehouse with a fellow workman who was suffering from
small-pox. He subsequently fell ill and was removed to hospital. (Case 46, page 27.)
The Action of the Board of Guardians.—At the commencement of the epidemic, in 1901,
the Guardians issued posters giving public information of the arrangements made for vaccination
and revaccination, together with the names and addresses of the public vaccinators. The
Guardians also adopted the precaution of having the inmates of the casual wards examined daily by
one of their medical officers, who revaccinated all who were willing to submit to the operation. No
case was discovered amongst the casuals ; but several outbreaks occurred at common lodging-houses,
the primary case having been an imported one in every instance.
* One of the contractors' employes became infected, having delayed to follow advice to get revaccinated.
† For particulars relating to vaccination in 1901 see table page 75. No information is at present available as to the
number of re-vaccinations.