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27
The close co-operation which exists between the Medical Officers of
the Metropolis, and surrounding districts, of the County Council and the
Ministry of Health leads to a rapid discovery and the keeping under
observation of persons who have been in contact with small-pox, and it
is due to the prompt measures which are undertaken by these various
Officers that such an outbreak was kept within such small limits.
Information was received of 174 persons coming to Westminster
who had been in contact with cases or coming from infected ports.
These were kept under observation.

These figures do not include private vaccinations. Unvaccinated
infants in 1920 and 1921 were 21 per cent. In 1922, primary vaccinations
exceeded the possible by 50, about 3 per cent. In 1923, about 17 per
cent, were unvaccinated.
One child died some weeks after being vaccinated from septic infection
of the wound.
Vaccination was not done by the Medical Officer of Health under
the Public Health (Small-pox Protection Regulations, 1917).
Scarlet fever.—This disease was less prevalent than in 1922. No
deaths resulted.
Diphtheria was much less prevalent than in the three preceding
years and caused 4 deaths. Antitoxin was supplied free to medical men
in 62 cases, at a cost of £35 5s. 0d., and 281 swabbings from the throats
of suspected cases were examined.
Notwithstanding the facilities afforded, there is still regrettable delay
from time to time in recognising cases of this serious disease.
Typhoid Fever.—Twenty-one cases of this disease were notified, but 2
cases eventually proved not to be typhoid, and 7 were cases of paratyphoid
fever. One person not notified in Westminster was an inmate of an
asylum and died there.
Eight patients (7 typhoid and 1 paratyphoid) contracted the disease
before coming to Westminster. There was a history of shellfish having
(5416)Q c