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Smallpox: From the Medical Officer of Ware I learned that a man had been found on
a barge there, suffering from Smallpox, and that he had been at a wharf adjoining Millbank
for a few days about the 5th October. On enquiry I found that he had kept to his cabin
most of the time, but on one occasion at least had visited a public house in the neighbourhood,
and a man who visited him on the 5th observed that he had an eruption on his face. A
number of persons were kept under observation in consequence ; most of the men employed
on the wharf had been re-vaccinated during the last year or two and none of them contracted
the disease. Three persons residing in the neighbourhood were seized with illness about the
17th October, which would give the usual incubation period of twelve days. One of these
is (a) the manager of a public house (said to have been vaccinated in infancy but with no
marks), another (b) an unvaccinated child of five years of age, and the third (c) a married
woman aged 38 (since dead) who had had a previous attack of smallpox at the age of 7 years.
This woman did some washing, which possibly came from the barge above mentioned.
Another case (d) of smallpox came from Wiltshire, the eruption appearing on arrival
in London, and a child (e), who had been sleeping in the same bed, has subsequently had a
slight feverish attack, probably varioloid in its nature, and treated as such ; a person in an
adjoining Borough who had been with (d) in the country also developed smallpox on coming
to London. A number of business premises and private houses had been visited by (d), but
no further cases have occurred in connection therewith ; the persons therein were either
promptly re-vaccinated or had been re-vaccinated during the last two years.
Typhoid Fever: Of the three cases notified, there is a history connecting the disease
with the consumption of shell-fish in two; in the third there is no history of any kind
obtainable.
The Fishmongers' Company, finding that the Leigh Cocklers were not carrying out their
undertaking as to the deposit and cooking of cockles, on the 14th October wrote to each
of them that from that date the sale of cockles from Leigh is absolutely prohibited. There
is no doubt, from the reports obtained by the City of London and by the Fishmongers'
Company, that shell-fish from other points on the Thames Estuary besides Leigh are polluted,
as, for example, at West Shoebury (one of the above cases ate cockles at Gravesend), and the
Fishmongers' Company have now prohibited the sale in London of any shell-fish from the
Thames estuary.

Thirty-three Certificates of Infectious Disease have been sent to School Teachers, and
Certificates of each case notified have been sent to each of the Public Libraries in the City.
Intimations have been received from School Teachers and others relating to 78 cases
of Measles,! of Chickenpox, 1 of Mumps and 2 cases of German Measles.