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32
Smallpox.—Smallpox of the mild type known as "variola minor,"
hitherto prevalent in the North and Midlands, began to appear in London
in 1928, when 285 cases were notified. In 1929, however, the number has
increased to 1,116 in the London area. It would appear that the bulk
of the cases came from outlying districts, such as the County Borough
of West Ham, and boroughs on the eastern side of London, Hackney,
Bethnal Green, Poplar and Stepney. There were 6 deaths. The disease
appears to have been rife where large masses of the population have
neglected to take advantage of the protection afforded by vaccination.
Although only two cases occurred among residents in Westminster
and 10 in those who worked in Westminster but resided in other districts,
the work entailed in keeping non-resident contacts under supervision
has become very onerous. Authorities of districts where patients reside
rely on those in charge of districts where the contacts of such patients
work to keep the said contacts under observation. This has required
frequent visits by the Sanitary Inspectors to workplaces. Some 478
contacts were visited 1,400 times. Lists of contacts provided by employers
totalling some 1,500 names and addresses have been received
in the department, and have been circulated to the districts of residence
of contacts of cases of smallpox found at work or known to have been at
work in Westminster.
The 2 eases of this disease notified during the year in the City were
both females, aged 30 and 27 respectively. The latter case, a school
teacher, contracted the mild variety of smallpox which is still
prevalent throughout the country. The former case was a first-class
passenger on board the S.S. Tuscania, from which vessel cases of smallpox
had been landed on the way home from India. She took up her
residence at a large hotel in Westminster, was subsequently seen by the
Medical Officer of Health and removed to hospital as a case of smallpox
of the Eastern variety, although greatly modified owing to vaccination.
Other cases among passengers and crew of this vessel were notified in
various parts of the Country and in London. The disease was mostly
of the severe type, "Variola major," and a number died. Fortunately,
both Westminster cases were but slightly affected and made speedy
recoveries.
Information was received from Port Sanitary Authorities of 102 contacts
from various ships in which cases of smallpox had occurred. The
names of all contacts are circulated by the Port Sanitary Authorities to
the various districts to which they intend to proceed. This only applied,
until recently, to persons remaining on the vessel until it reached a port