View report page

28
smaller than that of Southwark, and slightly larger than that of Bermondsey. It was not much
affected by attacks of smallpox.
The western group of districts, comprising Paddington, Kensington, Hammersmith,
Fulham, Chelsea and Westminster was, as a whole, less affected by smallpox than the other
groups, and had it not been for the special incidence in Westminster, owing largely to the considerable
number of persons of the common lodging-house class in that district and to an outbreak of
smallpox in a Rowton House in Hammersmith, this difference would have been much more
marked. In Westminster, which suffered most, few cases of smallpox were notified until the latter
part of October, when a number of cases occurred due to infection from a woman suffering from
smallpox, of whom account is given in the last annual report, who remained at large for four
days, infecting especially the inmates of common lodging-houses and the frequenters of publichouses.
In December the number of cases declined, but in January, 1902, there was an accession
of cases largely occurring among the inmates of common lodging-houses. In February there was
less prevalence, but the number of cases was still considerable; in subsequent months fewer cases
occurred, but a weekly succession of cases was maintained until the beginning of July. In
Hammersmith there was little smallpox until the latter half of November, 1901, when the outbreak
in Rowton House occurred to which reference has been made; cases continued to occur in the
district, but not in great numbers until August, 1902, workers in laundries being conspicuous
among the sufferers. In Paddington, Kensington, Chelsea and Fulham the prevalence of the
disease began late and never attained any great magnitude.
In summary it may be stated that during 1900 and 1901 smallpox had been Irequently
introduced into London from abroad, especially from Paris, where smallpox was prevalent.* In
the beginning of August, 1901, two women living in a house in Tottenham-street, St. Pancras, were
attacked. Their illness had been preceded a fortnight before by that of their sister, who was employed
at a laundry as a sorter of dirty linen received from hotels and boarding-houses in the W.C.
district. This girl's illness had been regarded as chicken-pox. Then followed another case in this
house and four cases in the house next door. The illness of these four persons had been preceded
by that of a child who died, and whose illness had been regarded as chicken-pox. The
laundry girl's attack was apparently the first of the series. The disease spread in this neighbourhood
and in that of Sandwich-street, Gray's Inn-road, into which it was introduced by a sister
of the child in Tottenham-street previously mentioned. Smallpox then appeared in Holborn,
especially in the common lodging-house population. In October a woman who frequented common
lodging-houses in Holborn and Westminster, remained at large for four days, having, while
suffering from smallpox, escaped from the Endell-street Infirmary, where her disease had been
recognised. As a direct result, a very large number of persons were infected in the two districts;
"she visited nearly every public-house in the district, and from each one into which she had been
one or more of the inmates or customers took smallpox."† The disease continued to extend in this
class of the population, the common lodging-houses of Holborn, St. Pancras, Westminster, Stepney
and Southwark being especially affected in the last quarter of the year 1901.
Another factor in the spread of the disease became operative in the early part of 1902, and
may be here referred to. A number of men employed in the erection of additional smallpox
hospital accommodation in Essex, for the use of the London population, contracted the disease.
Thus, from returns which are no doubt incomplete, it is found that in London 23 persons were
attacked in January, 1902, 26 in February, 30 in March, and 13 in April, all infected in that
locality, and the great majority of whom had been employed in hospital construction. Cases thus
occurred in 22 of the 29 sanitary areas of London, the majority occurring in the southern districts.
The occurrence of cases of the disease in common lodging-houses will be referred to in more
detail later. With respect to hospitals, workhouses and workhouse infirmaries, it may be said
that while no extension of the disease of any magnitude is recorded in hospitals during the
epidemic a considerable number of the inmates of poor-law institutions were attacked.
In December, 1901, one of the inmates of a common lodging-house in Westminster was
admitted with malignant smallpox into the St. George's Infirmary, and a number of the inmates
were thus infected. Eleven cases also occurred in the Shoreditch Workhouse and Infirmary
and 32 in the Holborn Union Workhouse. The Mile-end Infirmary suffered especially, 91
of the inmates being infected. In the Whitechapel Infirmary 24 cases, in St. George's
Infirmary 7, and in Ratcliff Infirmary 2 cases occurred. Dr. Priestley reports that in Lambeth "on
eight separate occasions a workhouse or infirmary was infected, but in no single instance did the
disease spread, on account of strict isolation by removal to hospital, disinfection, and medical
inspection (together with re-vaccination of 'contacts.') The staffs at the workhouse and infirmary
were all re-vaccinated as required." In Southwark 12 cases occurred in the workhouses.
The behaviour of the disease in each of the metropolitan boroughs during the whole of the
period in which smallpox was epidemic in London will be seen on reference to Diagram V. This
diagram is based upon the number of cases of smallpox notified in each week, each square of
the diagram representing two cases. The diagram does not show the relative incidence of the
disease on each district as only the actual cases notified are shown, and no allowance is made
for the varying size of the populations concerned; the progress of the epidemic with regard to
time, and the period of maximum and minimum prevalence in each district are, however, well4
illustrated. The incidence of the disease on the populations of the several boroughs in the period
1892-1901, in the year 1902, and also in the two years 1901-2 (the latter period covering the whole
time during which the disease was epidemic in London) will be seen on reference to the following
table—
* The deaths from smallpox in Paris numbered in 1899, 4; in 1900. 211; in 1901, 417 ; and in 1902, 90.
† Annual report of the medical officer of health of Westminster, 1902.