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Close surveillance was made of all the remaining residents and
staff in the Home; all were bacteriologically tested but no further
cases were found.
As the diagnosis of typhoid fever in respect of the woman
domestic was made whilst she was an in-patient of a hospital outside
the Borough, the case was not included in the statistics for Wandsworth.
Smallpox
Smallpox is a very serious disease which fortunately does not
occur very often in this country. Over the recent years almost all
cases have arisen directly or indirectly from persons entering this
country from abroad, and with the increasing frequency and speed
of air travel, this is a risk which is always present and could well
be the cause of an outbreak at any time in the future.
In October, the first case in Wandsworth since 1928 was reported.
The patient, a Pakistani female child aged three years arrived in
this country by air with her parents on 1st October, developed
symptoms of fever on 9th October, and a rash had fully developed
on 13th October and became vesicular on the following day.
The girl was admitted to the receiving ward of a local hospital
late on 16th October, and the consultant physician made a clinical
diagnosis of smallpox; the consultant immediately informed my
Deputy, Dr. Gordon, by telephone. At the hospital a little later
I had no difficulty in agreeing the consultant's diagnosis. Arrangements
were made to transfer the child to an isolation hospital at
once. The mother accompanied the child to the hospital and remained
there with her. At a meeting held on the following morning
attended by all staff of the department likely to be concerned with
the problem, the general lines of action were decided and immediately
put into operation. Visits to the home were arranged to
ascertain the family and other household contacts of the infected
child, to the two doctors' surgeries where the patient had originally
attended, and to the Teachers' Training College which the father
of the child attended as a student.
In order to carry out medical surveillance of all known contacts
of the case seven teams were formed comprising a medical officer,
a public health inspector and in some cases a health visitor or a
clinic nurse. Medical surveillance, entailing physical examination
and temperature recording began on the eighth day after the first
contact, and was continued daily until the sixteenth day after the
last contact. In certain instances surveillance was continued after
the sixteenth day. Visits were made every day of the week, including
Saturdays and Sundays and, of necessity, many visits were made
in the evening. A comprehensive chart setting out the day-to-day
commitments was prepared and essential records of the investigation
maintained. The clinic in Fairfield Street was staffed and
available every day for the surveillance of certain contacts, and