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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 been ineffective. Sulphur
fumigation was universally practised in the disinfection of rooms.
All washable articles were cleansed after disinfection.
Revaccination. —Without loss of time the Vaccination Officer,
and in the large majority of cases the Public Vaccinator also, was
informed of the occurrence of the outbreak, and vaccination or revaccination
was offered to every "contact" and readily accepted by most
of them. A considerable number of operations were performed by
the District Poor-Law Medical Officers also, these being authorised
to vaccinate or re-vaccinate the inmates of a house where small-pox
had occurred. I have every reason to be satisfied with the services
rendered by all 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 aims 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 revaccinations
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 very 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 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 a
notification of the outbreak. Such information, 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 (p. 28) reference was made to a
preliminary statement by the Managers on this subject, and in
the fourth Report (p. 87) statistics, furnished by the Registrar-
General, were cited as to the state, as to vaccination, or otherwise,
of over 1,000 fatal cases.
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