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35 [1930
It will be noted that even where the cases occurred in blocks of dwellings the
spread was adequately controlled. To show the difficulty in tracing the source of
infection in obscure cases, it is interesting to consider a man infected at a common
lodging.house. He attended at one of the hospitals, re.attended for a special
blood test, attended the skin department and the casualty department, is said to
have slept at a Salvation Army Shelter, and came to reside with a relative in
Islington three days prior to his discovery and removal to hospital. Such a case,
which is typical of some others, shows the risk a person unprotected by vaccination
runs of contracting smallpox from an unknown source, meeting such a case in the
street, in a public vehicle, in waiting.rooms of hospitals, etc.
The Medical Officer of Health was visiting some households in Holloway
where there had been smallpox, when he noticed passing in the street a school.girl
with a rash on her face. He stopped and questioned her and found the cookery
teacher considered she "should not cook with such a face." She was therefore
being sent by the teacher to attend the local school treatment centre. She was
forthwith directed to go home, found to have smallpox, and was removed to
hospital.
In addition to the number notified, 6 cases occurred at Archway Hospital,
Archway Road, the home addresses of the patients being.one in Holborn and five
in Finsbury, and another case, which, however, was eventually returned as not
smallpox, was a St. Marylebone case in the London Fever Hospital, Liverpool
Road.
The difficulty of tracing all contacts is instanced by a visitor at one of the
households, who was a ship's steward. This man had left the very day the case
was discovered, his address was not known, nor the ship to which he would be
sent, nor the Shipping Company. Later it was known that a ship had been held
up at Liverpool, the crew dismissed while the ship underwent disinfection, and a
new crew engaged, all through a case eventually diagnosed as smallpox in a
steward. The Medical Officer of Health communicated with the Medical Officer
of Health for Liverpool to get particulars, and it turned out to be our lost contact.
The Medical Officer of Health for Liverpool kindly supplied us with a memorandum
from the Port Sanitary Authority, from which the following is gleaned:.
"The vessel arrived at Liverpool on the 23rd February from Glasgow.
The steward apparently joined at Cardiff on the 3rd February. He went with
the ship to Glasgow, where he was treated for Influenza and sweat rash. He
was examined again at Liverpool on the 25th February and diagnosed as
smallpox."
Having regard to the number of cases of smallpox in the previous year, 71 in
number, and the grave possibility that the infection would continue and increase
in 1930 owing to the large proportion of the population now unprotected by vaccination,
the Medical Officer of Health drew attention to the fact that the Public Health
Acts Amendment Act of 1907, which is an adoptive Act, gives under section 61
very useful powers to the local authority in connection with smallpox and other
infectious diseases, and to the advantage that would be gained in having chicken.
pox notifiable. This Act, however, had not been adopted in Islington. The Public
Health Committee of the Council directed that the matter of the notification of
chicken.pox in a modified form as suggested by the Medical Officer of Health
should be taken up with the Ministry of Health. On enquiry it was stated that
there were difficulties, as all cases of chicken.pox were not to be notified, and this