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Excluding chicken pox the total number of notifications received during the year
was 430 in comparison with 543 in the year 1922.
Attention has had again especially to be called to the non-notification of whooping
cough, primary pneumonia and ophthalmia neonatorum. A list of the notifiable diseases
is from time to time supplied to all doctors practising in the Borough.
Smallpox.
No notification was received.
Fifteen cases of smallpox were notified in London.
During the year information was received respecting a resident in this Borough
who had been in contact with a case of smallpox at a hotel in one of the Metropolitan
areas.
The contact, a waitress at the hotel in question, was at once visited, and was
found to have been revaccinated, The contact resided with her four children, three of
whom had been recently vaccinated and the fourth revaccinated. The contact was kept
under observation until the danger of infection was past.
Information of 30 other contacts of cases occurring outside London or of passengers
arriving on vessels on which smallpox had occurred during the voyage, was received,
and the necessary visits for keeping such contacts under observation were made.
Chicken pox was made compulsorily notifiable in the Borough for six months
including and following on December 4th, 1922.
During 1923 the number of cases notified was 57. My services were frequently
called upon to examine patients whom it was feared might be suffering from smallpox ;
the experience brought home to me the severity of the eruption which might occur in
chicken pox and in such cases it was only by the careful application of several diagnostic
rules that the diagnosis of chicken pox could be made.
The subject of vaccination has been prominently before the public during the year.
There has been no alteration in general medical opinion as to the advisability of the
practice; although the arrangements to prevent spread in London have proved efficient,
when tested in 1922, those carrying out the arrangements are insistent on the need of
general vaccination; the human element involved in the prevention of spread of smallpox
by the prompt detection and isolation of actual cases and the supervision of
contacts is fallible; the possibility of confusion of smallpox with chicken pox has
been increased recently owing to the occurrence of a milder form of smallpox.