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46
by a doctor as chicken-pox; and her daughter (aged 9½) fell ill on 26th
February, the rash being noticed on 2nd March, and was also diagnosed by
the doctor as chicken-pox. A woman (42) living next door attended the first
case in her illness, and sickened on 27th February, the rash appearing on
1st March). (She died in hospital on 9th March.) On 4th March the doctor
in her case called in the Medical Officer of Health, who found her to be
suffering from smallpox, as well as the three cases next door, of which he had
not previously been informed in any way. The four were at once removed to
hospital. A fifth case developed on 5th March (rash 7th March) in a girl
aged six, living in Leverton Street, who had visited on February 22nd or
23rd the Countess Road house where the three cases occurred. Two resulting
cases also occurred in neighbouring streets in Islington, and there was a sixth
St. Pancras case in the person of a doctor (Dartmouth Park Road) who
attended one of them (onset 4th March: rash 6th March: last attended
10th March), and was not re-vaccinated. He fell ill on 22nd March, developed
the rash on 24th March and was removed to hospital on 26th March. All the
contacts in this outbreak were re-vaccinated where possible and kept under
observation in their homes. The offer of vaccination was refused in very few
instances.
The results of prompt vaccination and observation of all contacts in these
outbreaks were most satisfactory.
The history as to vaccination of the 10 cases was as follows:—
Age Sex
1 21 M Vaccinated in infancy only.
2 21 F Unvaccinated until 2nd January, the date of
onset of the smallpox.
3 13 F Unvaccinated.
4 37 F "Vaccinated in infancy and when aged about 20.
5 40 F Vaccinated in infancy only.
6 6 mths. M Unvaccinated.
7 9½ F Unvaccinated.
8 42 F Vaccinated in infancy only.
9 6 F Unvaccinated.
10 56 M Vaccinated in infancy only.
26 cases of smallpox were notified in the County of London during 1919,
and two died.
SCARLET FEVER.
558 (civil) patients were notified in 1919 as suffering from scarlet fever.
Of these, 38 were afterwards found not to be suffering from the disease by
medical superintendents of the Metropolitan Asylums Board, and 4 by other
medical practitioners.
The corrected number of scarlet fever cases (civil) notified was, therefore,
516, equal to an incidence rate of 2'35 per 1,000 civil population.
The number of deaths from scarlet fever certified during the year was 5,
equal to a death-rate of 0'02 per 1,000 civil population, and a case mortality
of 0*97 per cent, of cases notified.