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suffering from. "chicken-pox." This statement was at once reported to the medical officers of
Chelsea and Fulham, who found the women to be suffering from small-pox. All four women
(and they only) had been employed in the dirty-linen sorting room; and all, it may be added,
fell sick on or about the same day.
At this point the matter rested until Monday, June 25th, when a notification was received
of small-pox in the person of a married woman, Elizabeth M., aged 32, who lived
at Wornington-road, North Kensington. The surname was that of Jessie M. also (our first
case), whose residence was first visited for enquiry, when it was ascertained that Elizabeth M.
was sister-in-law to Jessie M., whose mother, Jane M., aged 55 years, was now
ill, and had a typical rash of small-pox at an early stage. She was removed
to hospital the same day. Elizabeth M. had been removed on the previous day.
The date of attack in both cases indicated that the sufferers had been infected by Jessie M.
about three days before the notification of that person's illness was received. On the same day,
June 25th, the laundry was visited to ascertain if, perchance, the company washed for the
employer of (and) the late Mr. D., the Westminster valet. They did! Three of the employees,
supposed to have had chicken-pox, had, at this time, returned to their work, but were sent away
forthwith. One of them admitted that her brother and sister were unwell, and had a rash.
The medical officer of health of Fulham was immediately apprised, with the result that, on that
day and the next, four of the inmates of the house were removed to the small-pox hospital.
It cannot be doubted that the four laundry employees contracted small-pox by contact
with the infected clothing of Mr. D., the deceased valet, whose employer, as before stated, lived
in a flat. In the flat immediately overhead lived Emma E., aged 39 years, housekeeper to
another gentleman, and who was on intimate terms with Mr. and Mrs. D. Being ill, with
pneumonia following influenza, Emma E. was admitted on May 11th (the date of Mr. D.'s
funeral) to St. Mary's hospital, where, on or about May 25th, she developed a fresh illness,
followed on the 27th by a rash. She was placed in the isolation ward on May 28th, and died on
June 4th, the cause of death, as certified, being Erythema-multiforme. The disease no doubt was
small-pox; for subsequently, five persons—a nurse, a wardmaid, a patient, and two medical
students—who had been in contact with Emma E., fell ill, and were removed to the small-pox
hospital.
It may be mentioned, as an illustration of human folly, that despite the warning given to
the inmates of the Barker-street tenement house to avoid contact with Mr. A.'s family, within
half-an-hour afterwards a female resident was found in the room where Amy A. was awaiting
the arrival of the ambulance. Mr. A. was suspiciously ill at the time, and was told to keep his
room, and yet within an hour he was seen at the front door in conversation with another man.
The vaccination officer was made acquainted with the successive cases as they occurred,
and revaccination was offered to the inhabitants of the infected houses. In one family three
unvaccinated children were found. Proceedings were instituted against the father by the
vaccination officer, and an order for the vaccination of the children was obtained.
MEASLES.
Measles was the cause of 98 deaths (all but four under five years of age, and 26 of them
under one year), as compared with 33, 120, and 24 in the three preceding years; 93 in the town
sub-district, and 5 in Brompton; the corrected decennial average being 81. All but seven of
the deaths occurred in the first half-period of this year. The deaths from this cause in the
metropolis, as a whole, were 1,936, and 886 below the corrected decennial average.
Should Measles be made a Notifiable Disease?—This question has received consideration
more than once in these reports, and the reasons which led me to an adverse decision have
been fully set out. Another question was raised last year by the Public Health Committee of
the County Council in a communication to the borough councils designed to elicit their views
as to whether it was advisable that the Council should include "measles" in the term
"dangerous infectious disease," for the purposes set out in certain sections of the Public Health
(London) Act, 1891 ? The sections referred (inter alia) to the exposure of infected persons
and things (68), the conveyance of infected persons in public conveyances (70), the casting of
infectious rubbish into ash-pits (62), the disinfection of infected premises, articles, and public
conveyances (60, 61, 65, and 74), the letting of infected houses (63 and 64), and the removal to
hospital of infected persons without proper lodging (66).*
In 1898 a somewhat similar communication was received from the Public Health Committee
of the Council, consequent on a letter having been addressed by the School Board for
London to the Council, in which it was urged that measles should be declared a "dangerous
infectious disease," for the purposes of section 68 of the Act, which prohibits the exposure of
infected persons, it having been alleged that children had been sent to school whilst suffering
* Other sections were cited in the County Council's letter, viz., 69, 72, 73.