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Smallpox, therefore, although less prevalent in London during 1894 than in the preceding
year, was widely distributed over the county, the small district of St. Olave alone being able to claim
that not a single case was known to have occurred within its area. The disease was, moreover,
distributed over the whole year, but an especially large number of cases (143) was notified in the week
ending the 28th July. This exceptional number was due mainly to a serious prevalence of the disease
in the district of Marylebone. The very complete measures taken by the sanitary and vaccination
authorities of Marylebone, and the opportunities afforded by the Metropolitan Asylums Board for the
isolation of the sick proved adequate for the limitation of the extension of the disease. Some of the
eastern districts, notably Bethnal-green and Poplar, suffered somewhat heavily in May and June, and
the occurrence of smallpox in West Ham was probably associated with this circumstance. In many
instances, mild, and at the time unrecognised, cases of smallpox served as centres for the infection of
numerous persons.
The reports of the medical officers of health of the several districts supply the following
information—
Paddington—The source of infection of the cases occurring in the first and second
quarter was not apparent; of the cases occurring in the third quarter one came from an
invaded house in the East-end; of the cases in the fourth quarter there was evidence of the
infection of two in other parts of London, and three others appeared to be secondary to cases
previously notified.
Kensington—A group of cases of smallpox occurred in Kensington due to exposure of the
first patient to infection in Shoreditch. The Shoreditch case was not recognised as smallpox