View report page

12
[Appendix IV.
SMALL-POX.
Paddington. London.
Cases reported, 1900 5 ... 89
Average annual number, 1890-99 14 ... 629
Case-rate*, 1900 0.04 ... 0.02
After an interval of upwards of four years this disease re-appeared in the Parish last year,
but it is satisfactory to state that all the cases were clearly accounted for. So far as Paddington
was concerned, all the cases were correctly diagnosed. What the proportion of error was as regards
the Metropolis is at present unknown. The proportion has of late years been somewhere about
25 per cent.
The 5 cases occurred during the second quarter of the year, all in connection with St. Mary's
Hospital. The sex and ages of the patients were:—
E. O., f. set. 21, in-patient; notified June loth
S. G., f. set. 24, do. ; do. 15th
C. B., m. set. 21, medical student; do. 16th
A. S., f. set. 21, ward-maid; do. 16th
M. M.,f. set. 26, nurse ; do. 18th
All had been vaccinated in infancy, but nothing is known of any subsequent re-vaccinations.
The first 4 cases were removed to the Asylums Board Hospital on the day of notification, and
the fifth on the 16th (a Saturday). The medical student alone resided outside the hospital.
The inquiries made elicited the following history:—
A widow, E. D., was admitted to the Hospital (Victoria Ward) on May 11th, for pneumonia
following influenza. The bacillus influenza; was found present in the sputum. She had fever on
admission, but that had disappeared by May 16th, when she appeared to he convalescent. On May
25th (after being in hospital 14 days) persistent vomiting set in, and the fever returned (temperature
102° F.). On the 27th a rash, papular but not "shotty," appeared on the chest, abdomen,
face, and neck. Next day the rash was described as " macular," and the fever continued. She was
transferred to the Isolation Ward of the Hospital on this the 17th day after her admission to
hospital. On May 31st the rash was " shotty," and was present all over the body, including the
palms of the hands. On the night of June 1st and 2nd the rash was (apparently) " hemorrhagic."
The patient died on June 4th, the cause of death being certified as " erythema multiforme." S. G.
was a patient in the Isolation Block, but not in the same ward as E. D. S. G. sickened with smallpox
on June 12th, the rash developing on June 15th. On June 12th E. O., in the same ward as
S. G., developed a rash, which was pronounced to be that of small-pox when S. G.'s rash appeared.
A. S. and M. M., were members of the staff on duty in the Isolation Block.† With the occurrence
of the case of recognized small-pox, the diagnosis of the case of E. D. required to be reviewed, and
there could be no doubt that her case was one of hæmorrhagic small-pox. It is believed that she
had been vaccinated in infancy only.
E . D. came from Westminster (2, M -T-), where she was in service as a housekeeper.
No. 2, M--- T--- is a block of flats, and in the flat immediately under that where E. D. resided
there occurred a death, on May 9th, in the person of a valet, J. D.J The cause of death of J. D.
was certified as "measles,9 days; bronchitis,4 days; exhaustion." His case presented very unusual
features, and he was seen by six medical men.
* All rates, except when otherwise indicated, are calculated per 1,000 persons of all ages.
| The Isolation Block consists of a number of small wards (1 or 2 beds), with a staff common to the Block, but
kept apart from that of the rest of the Hospital.
t E. D. and J. D. were in no way related to each other.