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several persons were 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 of the others, when the
sick person had been promptly notified and removed, and the usual
preventive measures had been 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, and some did so. 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, No. 3 Report,
page 59.)
The Action of the Board of Guardians. —At the commencement of
the epidemic 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 ease
was discovered amongst the casuals; but several outbreaks occurred
at common lodging-houses, the primary case having been an imported
one in every instance.
General Precautionary Measures. —Never before was London so
well prepared to deal with an epidemic, whether regard be had to
means of removal and isolation of the sick, or the diffusion of
information as to the occurrence of outbreaks, the names and
addresses of contacts, etc. Through the intermediary of the medical
officer of health of the London County Council there was daily
intercommunication between the borough medical officers of health,
which kept each fully informed of the occurrence of illness in other
districts of the metropolis The Asylums Board, moreover, forwarded
to each medical officer daily a list of deaths and discharges at the
several hospitals; and, weekly, a list of cases admitted, embracing a
short history of each, indicating, where possible, the source of
infection.
Diagnosis of Small-pox. —Comparatively few medical men of the
present generation have had opportunities for becoming practically
acquainted with small-pox. To this circumstance, leading to failure
to recognise the disease, spread of the malady is not infrequently due.
Mild and modified cases are mistaken for chicken-pox. Having