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St. George's Infirmary, where, on further development, it was found to
be malignant small-pox, and a number of the inmates of the ward in
which he had been placed became infected. One of these, who discharged
himself from the Infirmary before the diagnosis of this first case had
been made, was a means of introducing the complaint into Mayfair,
Chelsea, and to Tonbridge in Kent, through persons visiting him.
Infection was introduced on several other occasions from various
points, but only a few persons were infected therefrom, and no further
actual cases occurred in the City after the end of June, 1902 (two were
notified in July, but they were found not to be suffering from that
disease). There were thus 334 notifications of citizens, but 35 of these
proved not to be small-pox; two cases were discovered and not notified,
one not being diagnosed until after death, the other not until after
recovery. There were thus 301 actual cases,* and these were chiefly
connected with the Strand, Covent Garden, and St. John Wards.
Westminster being so centrally situated and the resort of so many
persons, for work and pleasure, it necessarily followed that it was specially
prone to attack, and while on the one hand persons brought infection
into it from outlying districts, on the other hand there was also the
great opportunity for such persons to communicate infection to those
with whom they associated, and who, in the majority of instances, did
not reside in the City. From this cause the work of the Health Department
was considerably increased, and constant communication (telephonic
and otherwise) had to be maintained with the medical officers of
metropolitan and suburban boroughs. During the course of the outbreak
it became necessary to correspond about cases or persons who had
been in contact therewith, with officials in Liverpool, Brighton, Southead,
Gravesend, Southampton, Merhyr Tydvil, Glasgow, Perthshire, Yorkshire,
Essex, Surrey, Suffolk, &c.
The list of "contacts" was a very large one, and included names of
persons employed in the City, and living either in the City or in other
boroughs, and of persons living in the City but employed elsewhere.
In almost every instance employers of labour readily submitted lists of
persons in their employ, and gave every assistance in preventing the
spread of the disease.
As it takes twelve to fourteen days after a person has received the
infection of small-pox before any signs of the disease appear, observation
* The Metropolitan Asylums Board Authorities at the Small-pox shelter were of
opinion that in three of these instances the patients were not suffering from small-pox, and
sent them home; but, having kept them isolated and under observation, I am satisfied that
they had been so suffering. The attack, however, in two of the cases aborted and was
checked by re-vaccination, which had been performed within a couple of days after
receiving infection. The third case was insusceptible to vaccination after the attack, and
had not been vaccinated previously.