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59
Distribution Throughout the Year.
The months of the year in which the 55 cases occurred were:—
Non-Residents. Residents.
January — —
February 5 3
March — —
April 1 16
May — 16
June 1 1
July 1 —
August — —
September 1 2
October — 2
November 2 1
December 1 2
12 43
Distribution in Groups.
We were able to trace a connection between many of the cases resident in
Holborn: —
Group 1 consisted of three cases discovered in February, brought to light as
a result of enquiries made after the receipt of information from the Medical Officer
of Health of Leigh-on-Sea that a patient in his district with smallpox had been
employed in Holborn. On enquiry at the place of employment, one of the largest
buildings in High Holborn accommodating many firms, and investigation into
recent illnesses and absentees in all these firms, an errand boy (living in Holborn)
was found to be recovering from an attack of smallpox. Examination of his
family resulted in the notification of two of his sisters.
Group 2.—The main set of cases, 20 in all, ranged from the beginning of
April up to and including the first week in May. It was a school outbreak, the
first case being a boy attending the Princeton Street L.C.C. Boys' School. It
very soon became evident that he had been infected by a missed case because on
the same day, or the following day, four other children attending the same school
became ill and also the mother of the original patient. Other cases amongst
children of the same school or members of the affected families were notified within
the normal incubation period following the first detected case until in all 20 cases
(three crops, including the original missed case as a crop) were infected from this
source. Of these, 15 were children in attendance at this school; the other five
included a mother, a father, two sisters and a brother of children attending the
school. All the children in the school were examined by the London County
Council medical staff in order to detect any other missed cases, but none was
found.
Group 3.—Four eases all in one house, three in the same family. The first
case brought to our notice was a girl, aged 16 years, whom the Medical Officer
of Health was asked to see on the 23rd April. She had been ill for some 10 days,
was found to be suffering from smallpox and removed to hospital. The Medical