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33
[1928
The inference, as stated, is that these cases had been caused by a sufferer from
unrecognised Smallpox either in the person of this suspect or some other person
about the same time.
On the 20th February the Medical Officer of Health again at the call of the
Medical Superintendent went to the Holborn and Finsbury Hospital. This date was
a critical time, as it was nearing the time when one would expect infection in those
not protected sufficiently by vaccination. As he had indications from the Ministry
of Health that it would be advisable, rather than isolate there for observation, to
send suspects to the Metropolitan Asylums Board Hospital (which is now permitted)
seven cases which showed new illness in the shape of temperature, eruption, etc.,
were transferred.
On the 21st February other cases were examined, and one being definitely
certified as Smallpox, was removed. This case appeared in another ward (Ward 12),
the patient had evidently been largely protected by his re-vaccination, and was
only retained in the Smallpox Hospital for a week. The Wards, 9, 10, 11 and 12,
are all in the same block, and communicate by lift and staircase. Ward 10 had
harboured the two cases which occurred elsewhere, and probably also the original
suspect. Ward 9 had the first case diagnosed. Ward 12 the second case diagnosed.
The seven observation cases had after varying periods of detention been returned,
their re-vaccination having been proved efficient. One of these observation cases
was an unvaccinated lad of 14 years, he was retained the longest for observation.
The first notified case had been vaccinated in infancy, one scar. The second case
had also been vaccinated in infancy, four good marks.
The following are the particulars regarding the steps taken in respect of the
Holborn and Finsbury Hospital:—All the nurses and cleaners engaged in the
hospital, and practically all the officials and employees were promptly vaccinated
or re-vaccinated by Dr. Thomas Evans, the Medical Superintendent. All the patients,
except those whose illness rendered it inexpedient, were also re-vaccinated. With
the assistance of the hospital staff, a list of recent visitors to the particular wards
was prepared, together with particulars respecting recently dicharged patients
from these affected wards. The addresses of these contacts were forwarded to the
health authorities concerned in order that the visitors, etc., might be kept under
observation. Measures were also taken to segregate the nursing staff of the particular
wards. A smaller ward, situated in the top floor of the north wing, which had a
connection by an external iron bridge, was cleared and transformed into temporary
quarters for the nurses and cleaners, and these three wards were as far as possible
isolated from the rest of the building during the period of quarantine. The hospital
was closed to the public, only near relatives of "slated," that is, dangerously ill,
patients, being admitted. These were obliged to don an overall before entering the
ward, and whenever possible they were prevailed upon to submit to vaccination, or
re-vaccination.
At the suggestion of the Ministry of Health, if they refused re-vaccination, they
were permitted to visit upon signing a statement to the effect that they had refused.
Fortunately the laundry work of the institution is done on the premises, and much
of the refuse is burned in the boiler house. Special precautions were taken regarding
the nursing staff. and their movements when off duty were curtailed.
It would be impossible in a brief report to detail precisely the work entailed
in a large institution like this, but the following may prove of interest.