View report page

15
Smallpox
Reference was made in the 1961 Annual Report to the eight Islington residents who
were contacts of a smallpox case who arrived at London Airport on the 25th December
1961 from Karachi. The case had not visited Islington, but the public were very
concerned with smallpox in the early part of 1962, and it was mentioned in the 1961
Report also that although there was substantial demand for mass vaccination the view
of the Ministry of Health continued to be that in the circumstances, the procedure of
intensive tracing of all possible contacts and suspects together with immediate
vaccination or re-vaccination of such persons should suffice to contain any possible
spread.
As might be expected, there was an increase in the number of references for
suspected smallpox and supervision if possible of smallpox contacts
The precautions taken where suspected rashes were reported also involved precautionary
measures which gave rise to substantial inconvenience at a local hospital
A man aged 32 years arrived unannounced at the Casualty Department on account of
feeling unwell and having a rash. The Medical Officer of Health was informed and all
admissions to the hospital were temporarily suspended. The Deputy Medical Officer of
Health visited the hospital and was of the opinion that this was not a case of smallpox,
which permitted the re-opening of the hospital.
Information was received in mid-May that a ship had arrived at Liverpool from
India and the Middle East. Two passengers who boarded the ship at Bombay, father and
child, developed rashes and mild smallpox was diagnosed at Suez. The two patients and
their family were disembarked at Suez. The surgeon vaccinated everybody on board the
following day. Three contacts in one family who travelled in this ship were visited by
staff of this Department and kept under surveillance for the incubation period
Another case of suspected modified smallpox was reported in an Asian boy aged 3
years. The ship on which he was travelling arrived at Gravesend from Bombay in mid
August and the child was admitted to the Port of London Isolation Hospital, A
passenger on the ship, resident in Islington, was re-vaccinated and kept under
surveillance for the routine period.
Information was received at the end of October that a male Malayan passenger,
aged 22 years, who boarded a steamship at Singapore was diagnosed at Suez as suffering
from modified smallpox and was removed to hospital ashore. All passengers and crew
were vaccinated or re-vaccinated. Six passengers were reported resident in Islington
and were kept under surveillance.
Twelve patients were referred by family practitioners to the Medical Officer of
Health or his Deputy as suffering from rashes of a type where it was desirable to
exclude smallpox as a possible cause. Eight of these were confirmed as cases of
chickenpox, one as shingles two cases were diagnosed as not smallpox and the remaining
case proved to be one of Eczema Vaccinatum The last mentioned case was a girl
aged 7 years suffering from a rash and severely ill. She was admitted to hospital and
following laboratory tests, the diagnosis made was that the rash was caused by Vaccinia
in a child who had been subject to eczema from infancy The only traceable source for
the transmission of Vaccinia was a child who had been recently vaccinated and sat next
to the patient at school. It has long been appreciated by doctors that eczematous
children should not be vaccinated under normal conditions but coincidences such as
occurred here could hardly be foreseen and fortunately, the child affected made a good
recovery.