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11
and resided in a boarding house containing a considerable number of residents from
abroad. It was therefore considered that there was good ground for the doctor's
anxiety and desire for confirmation. Pathological material was sent to the Virus
Research Laboratory, Colindale, for confirmation regarding the diagnosis.
As another example of precautionary measures taken in connection with suspected
smallpox, information was received that a patient, not resident in Islington,
was admitted to a hospital outside the Borough and was diagnosed as a probable
case of smallpox. The ambulance which conveyed this patient was afterwards used
to convey other patients to various hospitals, including an Islington resident who was
transferred to a hospital in this Borough. This Islington resident, therefore, had to
be regarded as a presumptive smallpox contact and all ward patients and various
members of the hospital staff as possible secondary contacts. Full smallpox precautions
were, therefore, taken and the ambulance contact at the hospital, ward
patients and staff were vaccinated by the hospital medical staff. Fortunately, the
original patient proved in the end not to be a case of smallpox, but the measures
which had to be taken in this case are typical of the constant vigilance which has
to be exercised.

(Figures from 1948 onwards kindly furnished by Divisional Medical Officer,
London County Council.)
* Including Re-vaccinations.
The Vaccination Acts were rescinded under the National Health Service Act,
1946, as from 5th July, 1948.
Certificates of Vaccination and Inoculation—Authentication—Ministry of Health
Circular 60/48.
The number of applications for authentication continued to increase rapidly,
and during the year the Medical Officer of Health dealt with 394 requests for
authentication of International Certificates of Vaccination and Inoculation against
smallpox, cholera, typhoid, etc.
Measles and Whooping Cough.
Measles and Whooping Cough became generally notifiable in London at the
end of 1939. Prior to this there was only a limited notification.
Measles.
I reported in 1953 that this was a high incidence year for measles, with 2,541
notifications. 1954 followed the normal course with a relatively low incidence, the
number of measles cases notified being 1,191.