London's Pulse: Medical Officer of Health reports 1848-1972
View report page
Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1902
[Report of the Medical Officer of Health for London County Council]
This page requires JavaScript
Asylums Board, that within one or two hours of the receipt at the Board's offices of the necessary intimation, the ambulance usually had arrived at the invaded house. The following statement of the period of disease at which the patient was removed must, therefore, show very nearly the period which had elapsed before the nature of the malady was recognised—
| Day of removal, the day of onset being numbered 1.1 | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 or more. | |
| Shoreditch | 2 | 27 | 82 | 84 | 76 | 42 | 23 | 9 | 2 | 1 | … | l | 3 |
| Chelsea | … | 1 | 8 | 9 | 11 | 7 | 3 | 1 | … | 1 | … | l | … |
| Southwark | … | 5 | 12 | 33 | 25 | 9 | 11 | 2 | 2 | … | … | … | 1 |
| Fulham | 1 | 9 | 22 | 39 | 8 | 6 | … | … | 1 | … | … | … | 2 |
| Stepney | 1 | 9 | 16 | 24 | 25 | 12 | 8 | 4 | … | … | … | … | 1 |
It will be seen, therefore, that a considerable proportion of the persons attacked must have
been a source of infection to others for several days before the risk to the exposed persons was
recognised and the protection of vaccination could be sought.
Having regard to all these facts, it is obvious, therefore, that to postpone vaccination or
re-vaccination until the fact of exposure to smallpox is known, is for the individual to incur considerable
risk at times of prevalence of the disease. As an administrative measure applied to a
large population, the resort to vaccination and re-vaccination only at such times is for the community
but an imperfect substitute for routine vaccination and re-vaccination irrespective of
exposure to infection.
(e) Measures adopted for the prevention of smallpox in children.—In previous reports I have
referred to the large proportion of children born in London appearing in recent years in the
vaccination returns as "not finally accounted for." The proportion in successive years has been
as follows. The figures for the years subsequent to 1900 are not yet available.
| Year. | Children not finally accounted for (including cases postponed, and for which "certificates of exemption" were granted) per cent. of total births. | Year. | Children not finally accounted for (including cases postponed, and for which "certificates of exemption" were granted) percent, of total births. |
|---|---|---|---|
| 1872 | 8.8 | 1887 | 9.0 |
| 1873 | 8.7 | 1888 | 10.3 |
| 1874 | 8.8 | 1889 | 11.6 |
| 1875 | 9.3 | 1890 | 13.9 |
| 1876 | 6.5 | 1891 | 16.4 |
| 1877 | 7.1 | 1892 | 18.4 |
| 1878 | 7.1 | 1893 | 18.2 |
| 1879 | 7.8 | 1894 | 20.6 |
| 1880 | 7.0 | 1895 | 24.9 |
| 1881 | 5.7 | 1896 | 26.4 |
| 1882 | 6.6 | 1897 | 29.1 |
| 1883 | 6.5 | 1898 | 33.0 |
| 1884 | 6.8 | 1899 | 27.7 |
| 1885 | 7.0 | 1900 | 25.8 |
| 1886 | 7.8 |
It will thus be seen that at the beginning of the epidemic a large proportion of the child
population of London was unprotected by vaccination, hence attention was early directed to the
risk from smallpox to which these children were exposed. With a view to securing as far as
practicable the early vaccination of children who had up to that time remained unvaccinated,
leave was sought for the examination of the arms of children in the elementary schools. After
receiving a letter from the Local Government Board in September, 1901, the London School
Board adopted the following resolution—
"That facilities be given to the public vaccination officers of the metropolis, on the
application of the proper authority, to enter the schools of the Board, in infected areas, for
the purpose of examining the arms of the children with a view to advising the parents to
allow their children to be vaccinated, provided that the School Board issue a circular to
* The figures for Shoreditch and Chelsea are extracted from the reports of the medical officers of health; those for Southwark and
Stepney are based upon information contained in the reports as to each case, the first 100 being taken as a sample. The Stepney and
Southwark cases do not include any which occurred in common lodging-houses.
[5]