View report page

- 18 -
The co-operation of the Borough Surveyor was obtained, refuse
collection at the premises was suspended, and paper sacks were provided and
used instead of dustbins. During the isolation period, all refuse
collection was undertaken by the disinfecting staff, the sealed sacks
being taken to a neighbouring borough for destruction by incineration.
Although the majority of the staff are vaccinated each year, those
who were concerned with the outbreak were immediately re-vaccinated in
order to give them the maximum protection possible.
Ten sets of protective clothing, consisting of cap, gown, mask,
gloves and overshoes, were stored at appropriate points for use by the
medical staff, public health inspectors, and disinfecting staff.
Although this smallpox case was actually diagnosed in the City of
Westminster, the patient nevertheless spent a considerable amount of time
in Kensington & Chelsea. In these circumstances, a circular letter
giving the relevant details of the infection was sent to some 600 medical
practitioners in the borough, with copies for information to the
Ministry of Health, the Medical Adviser of the Greater London Council,
Medical Officers of Health of adjoining boroughs, the North West and
South West Metropolitan Regional Hospital Boards, all local hospitals,
assistant Medical Officers, the Divisional Education Officer, the Mayor,
the Chairman and Vice-Chairman of the Health Committee, and the Town
Clerk.
Under the provisions of Section 41 of the Public Health Act, 1961,
the Medical Officer of Health of a local authority may, by notice in
writing, request a person who has been in contact with an infectious
disease to discontinue work. As already stated, five close contacts of
the case were excluded from work in this way. The local authority are,
however, required to compensate such a person for any loss he may suffer
in complying with such a request. Verbal authority was obtained from
the Chairman of the Health Committee and the Chairman of the Finance
Committee to meet the necessary expenditure.
The persons who were excluded from work were entitled to Sickness
Benefit and, at the request of the Ministry of Social Security, the
Borough Treasurer made application on behalf of the Council to act as
agent for payment of benefit to the contacts. All information required
by the Ministry was obtained by officers of my department and passed to
the Borough Treasurer for onward transmission. At the same time, the
Borough Treasurer was able to deal with the question of compensation in
each case.
Special arrangements were made to deal with any emergency arising
during the week-end of 8th/llth March, 1968, which was the danger period
for any new cases of smallpox to occur. Fortunately, no secondary cases
occurred.
The last case of smallpox occurring within the former Royal Borough
of Kensington was notified in 1929, and in the former Metropolitan
Borough of Chelsea in 1928.
The case mortality from this present type of smallpox is variable,
depending mainly on previous vaccinal immunity. On average, it is
about 30% but, in the 1949 outbreak in this country, twenty-six deaths
occurred among sixty-eight cases, and in the more recent 1961/62 outbreak
in the West Midlands, West Yorkshire and South Wales (also
introduced via Karachi), twenty-seven deaths occurred among sixty-seven
cases.