London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1896

[Report of the Medical Officer of Health for London County Council]

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19
rash, with the result that three other cases arose in the immediate neighbourhood, and, though they
could not be definitely traced, it is probable that the patients contracted their disease indirectly from the
child. The three cases were, Emily R., aged 27 years, vaccinated in infancy, of 30, Ethelm.street
(sickened January 9th. 1896); Samuel B., aged 24 years, vaccinated in infancy, of 33, Wootton.street
(sickened January 8th, 1896; Caroline R., aged 22 years, vaccinated in infancy, of 19, Wootton.street
(sickened January 6th, 1896).
One of the disinfecting men (William H., aged 34 years, and vaccinated in infancy), who went to
50, Ethelm.street on December 27, 1895, sickened at 2, Sail.street, with smallpox 14 days afterwards, i.e.,
on January 10th, 1896, ar.d was removed to hospital. In connection with this case it is satisfactory to
report that all the members of the disinfecting staff have now been re.vaccinated or have had small.pox.
At 50, Ethelm.street, at the time of the outbreak of smallpox, there were twelve inmates, six adults
(vaccinated) and six children under 12 years of age (four vaccinated, and two who were vaccinated at
once); no other case occurred.
A second outbreak of smallpox occurred in Ufford.street, and is interesting as showing how easily
the disease may spread, and how important it is to follow up and watch those persons who may have
come in contact with it. The connection of this outbreak with the previous one could not be definitely
traced, but was highly probable. The facts are as follows_A child, Lucy A., aged 7 years, and
unvaccinated, died at 30, Ufford.street, on January 24th, 1896, after three days' illness, and was certified
by the medical attendant as having died from " measles with congestion of the lungs and cardiac
syncope." Another child (William A.), aged 10 years, and vaccinated in infancy, developed spots on
January 26th, and was treated for chickenpox at home, being ill altogether about 10 day3, whilst the
mother, (Sarah A.), aged 30 years, and vaccinated in infancy, also developed a few spots (principally on
the face) on January 29th, and was confined of a female child on the following day. The maturation of
the spots in the case of Sarah A. left no doubt as to the disease being smallpox, but unfortunately
(owing to the confinement) this patient was not removed to hospital until February 19th, and the infant
developed spots on February 14th, i.e., exactly 14 days after it was born and came in contact with its
mother, who was suffering from smallpox at the time. The infant was unvaccinated (vaccination being
refused when it was first horn), and had a severe attack of confluent small.pox at the hospital, whither
it was removed on February 19th.
In the upstairs rooms at 30, Ufford.street were living at the time the N. family_a man, his wife,
and three children under 10 years of age. The husband and wife had been vaccinated in infancy, and
two of the children had also been vaccinated. None of these sickened; but the unvaccinated child
(Emily N.), who was born on February 11th, sickened on February 23rd, i.e., exactly 12 days after it
was born, into a smallpox infected house. The mother was re.vaccinated at once, and did not develop the
disease, and the infant was taken to the hospital and died. There was evidence to show that the two
vaccinated children, aged 2 and 5 years respective^', had been in the midst of smallpox contagion_
actually in the same house_for a period of four weeks without contracting the disease, whilst during the
same period two unvaccinated children caught the disease, and one died.
Henry A. (aged 15 years and vaccinated in infancy) and Phoebe B. (aged 25 years and vaccinated in
infancy) sickened at 31 Wake.street, with smallpox on 25th February and March 4th respectively, and on
inquiry it was found that they had visited their sister.in.law (Sarah A.) at 30, Ufford.street, whilst she
was suffering from smallpox". They were removed to hospital on March 3rd and 9th respectively, and
their brother (Sidney A., aged 17 years, and vaccinated in infancy) sickened March 17th, and was also
removed to hospital. In connection with these last cases the vestry allowed compensation to the mother
for four weeks' loss of work at a jam factory, at 9s. per week.
A third outbreak occurred in another part of the parish, and is equally interesting as showing how
smallpox can be spread, and how important it is to examine the immediate neighbourhood for cases which
may otherwise be missed, and if missed, may give rise to a large outbreak. At 51, Warrior.road (a
domestic workshop) a child (Christopher A.), aged seven months and unvaccinated, developed " spots,"
which were treated by the medical attendant as those of severe chickenpox, with the result that the
child was kept at home (being ill for about four weeks from May 20th to June 20th) in a house where
articles of clothing were being made, and where three young women from the neighbourhood were
working. Two of these three young women sickened with smallpox, viz._Constance J. (aged 15 years
and unvaccinated), of 46, Warrior.road, on June 11th, and Daisy G. (aged 21 years and vaccinated in
infancy), of 3, Warrior.road, on June 7th. A house.to.house inspection was made in the immediate
neighbourhood, but no other cases were found, though many persons had to be watched during the
incubation period of the disease.
Battersea._Of eight cases of smallpox notified during the year, "four were not genuine cases
of the disease, but of other diseases difficult to differentiate in the early stages." All the eight persons
were removed to hospital. The four actual cases of small.pox were adults who had been vaccinated in
infancy and all recovered.
Camheru'ell._The report of the medical officer of health supplies information as to an outbreak
of smallpox in Toulon.street. " The first to be attacked was an unvaccinated infant two years of age,
ten days later a second case was notified from the same house, the patient this time being a boy ten
years old. After this two more persons were notified, with a further notification of three fresh attacks
at an interval of two days all from the same house." In addition to the house being visited, vaccination
advised and the premises disinfected, inquiry was made at the schools attended by the children, with a
view to obtaining information as to children who were absent through illness. A purveyor of cats'.
meat who lived in the invaded house was dissuaded from going on his rounds.
Greenwich,_In Greenwich parish three cases of smallpox were notified, one of which proved
fatal. Of the cases notified in Deptford parish nine only were found to be actually cases of smallpox;
of these four occurred in one house, two each in two houses and one in a fourth house.
Woolwich._One case of smallpox was notified during the year. The sufferer was the steward
of a steamship who had attended a passenger supposed to be suffering from chickenpox. He was
removed to hospital.
Lee._One case of smallpox occurred in Charlton parish during the year. The sufferer had
visited a house in Sheerness in which resided a woman who had recently come from Gloucester " where
she had been more or less in contact with some of the afflicted people."
PlumsteacL._The medical officer of health called the attention of the Vestry of Plumstead to
the neglect of vaccination in West Ham. He writes_
I found that whereas in Plumstead of the children born in 1894 there were only two still
unvaccinated, and prosecutions had taken place in both cases, in West Ham there were 975 unvaccinated,
and no prosecutions had taken place. A letter was sent to the Local Government Board pointing out
this danger to Plumstead. I also advised, as on previous occasions, that handbills should be printed
recommending voluntary re.vaccination in view of the serious prevalence of smallpox in several parts of