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19
SMALL-POX.
There was no death from Small-pox in the Royal Borough, in 1903, the corrected decennial
average number of deaths being 2·2. Six cases of the disease were recorded, all at common lodginghouses,
and under somewhat remarkable circumstances; four of them, and yet another outside
London (case 6) to be hereafter referred to, being due, it was thought, to a case which was not
definitely recognized to be small-pox so as to be notified. This case was that of Florence B., aged
31, of no confessed occupation, a resident at No. 33, Crescent-street, Notting-dale, a common
lodging-house. Failing in health on February 5th, she applied for medical aid at the Relief Offices,
Mary-place. She had a fash and was removed to the Infirmary with a provisional diagnosis of
measles. The medical certificate was endorsed with a suggestion for further careful examination of
the patient before her admittance to the sick ward. The medical superintendent believing the
woman to have small-pox, sent her to the South Wharf, whence she was returned to the Infirmary
on the following day, the diagnosis of small-pox not having been confirmed. The patient remained
in isolation at the Infirmary until March 25th, when she returned to her former place of abode in
Crescent-street.
The further cases were as follows:—
Case 2. John F., aged 38, flower-seller, was admitted to the Infirmary April 11th from
a furnished room in Bangor Street, having shortly before lived at No. 30, Crescent Street, a
common lodging-house opposite to No. 33. He appears to have failed in health on the day
of admittance. On the 15th he was found to have small-pox, and was removed to the
hospital.
Case 3. Julia H., aged 42, "deputy" at No. 30, Crescent Street, was removed to
hospital on April 15th.
Case 4. James S., aged 38, labourer, was removed to hospital April 16th from No. 33,
Crescent Street.
Case 5. Thomas R., aged 26, dealer in old clothes, resident at No. 30, Crescent Street,
applied for medical aid at the Relief Offices April 20th. He was found to have premonitory
symptoms of small-pox, and was removed to hospital forthwith.
Case 6. On April 16th a communication was received from the Medical Officer of Health
for Croydon, intimating that Laurence W., aged 45, travelling cutler, had sickened with
small-pox on April 11th at Penge, having previously resided at No. 30, Crescent Street,
where, doubtless, he contracted the disease.
Case 7. Sidney W., aged 25, tinman, who had spent but one night at a common lodginghouse,
at Hesketh Place, in the Potteries district, Notting Dale, was removed, April 18th, from
the Relief Offices. This case appeared to have no connection with the others.
In the course of enquiry into cases 2, 3, and 4, the facts relative to the illness of Florence B.
(case 1) came to light. She was still living at 33, Crescent-street, and bore the marks of a rash
which two medical men who examined her believed to have been that of small-pox.
The facts and dates suggested an antecedent case at No. 30, Crescent-street as the source of
infection in cases 8 and 5 and the Penge case (6), but none such could be traced. Nor was evidence
forthcoming of any case at No. 33, antecedent to that mentioned above (case 4) other than that of
Florence B.
Having regard to the freedom with which residents at common lodging-houses mix together,
and to the close proximity of the two houses (33 and 30), there is no improbability in the supposition
that Florence B. was the source of infection of cases 2, 3, and 4 (possibly 5 also), and the Penge
case (6), other than as suggested by the fact that she did not return to Crescent-street until seven
weeks after her admittance to the Infirmary. At the beginning of her illness she had left wearing
apparel at the house, and this may have conveyed the infection, for it was not disinfected until 16th
April, after notification of the subsequent cases which led to disclosure of the facts of her illness as
above set out. The clothing she wore when admitted to the Infirmary was destroyed at that
institution.
There was no further spread of the disease, a rather remarkable fact in the circumstances,
and not another case in the Borough during the year.
Small-pox in London.—There were thirteen deaths from this cause in London during the
year, the corrected decennial average number being 201. The deaths in the three preceding years
had been 4, 242, and 1,300 respectively. The cases notified were 417, compared with 7,796 in
1902. The mortality case-rate was low, only 3·1 per cent. on notifications, compared with 16·9 per
cent. in 1902.