Two cases occurred, neither of which was recognised at the time.
One was removed as scarlet fever, and the other was suspected to
be plague or typhus fever. The true nature of the former was
recognised on admission to hospital, in the latter only after death.
In view of the possibility of plague, an examination of the body was
made, and Dr.Klein, the bacteriologist of the Local Government Board,
found that the blood contained two organisms: (1) the capsulated
diplococcus pneumonias in large numbers, and (2) in smaller numbers
a pathogenic microbe of an undescribed kind, which he proposes
calling bacterium myxoides, which in some respects (morphological
and, in less degree, experimental) resembles bacillus pestis (the
organism of plague), but in cultural respects it is altogether different
from bacillus pestis. Such cases are invariably fatal, and are
extremely infectious from the beginning.
In the latter of these two cases all the inmates of the house
who had not already been re-vaccinated were promptly done,
and no further case occurred, but in the former case several
would not avail themselves of it, and the wife and several others
who had been in attendance on the patient took smallpox, the wife
In several instances vaccination or re-vaccination was performed
after the person had already contracted the infection of smallpox,
with the result that the attack was extremely mild, or aborted
I have been frequently asked to what extent re-vaccination
will protect a person. The best answer I can give is that only
one person who had been re-vaccinated (12 years previously) had
been notified as suffering from smallpox, and in this case the
Metropolitan Asylums Board sent him home as not so suffering.
The patient was one of the Council's disinfecting staff, who had been
exposed to infection, and I believe it was smallpox which he had,
but that it aborted at an early stage; the preliminary symptoms
and temperature were typical, but when the time came for the
eruption only a couple of spots appeared, and rapidly faded away
without becoming pustular.
Very great assistance in visiting suspected cases, and in keeping
•' contacts " under observation night and day, was given by your
Chief Inspector and the District Inspectors, and by Dr. P. J.
Wilkinson, one of the Deputy Public Vaccinators of the Strand
Vaccination.—The Vaccination Officers for the three Unions have
kindly supplied me with information showing the amount of
vaccination done during 1901:—