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150 refugees. The stewardess remained in her cabin from 23rd to 25th January, and the chance of
contact with passengers was very small. It appears that the stewardess had previously been working
on board the s.s. Orange Nassau, another refugee boat, between the 7th and 15th January, and it is
probable that there was an undetected case among the refugees on board that vessel. On the 3rd
February, E. H. was found to be suffering from a severe attack of hemorrhagic smallpox, and she died
in the ambulance on the way to North Wharf Hospital. She had fallen ill on the 28th January, and
the rash was first observed on 31st January. She was last at work at Earl's Court on the 29th January.
In due course five further cases occurred in E. H.'a family. All these were removed to hospital by the
Medical Officer of Health of Fulham, in a very early stage of the disease, and no further cases followed
them. Of the six patients three died. All necessary precautions were taken at Earl's Court, including
vaccination of the staff and voluntary workers.
(6) On 7th February, 1915, the s.s. City of Marseilles arrived at Gravesend with a case of smallpox
on board, the patient having developed the rash on 29th January. The patient was removed to
Denton Hospital on the day of arrival. A number of passengers proceeded to London, and amongst
them was a man namel C. M , aged 25 years, who, with five companions, had come to London from
Ceylon to enlist. C. M., with two of his companions, went to reside at a boarding house in Kensington.
Of the remaining three friends, two stayed at hotels in Holborn, and the other went to Bedford. On
the 15th February, C. M. was notified to be suffering from smallpox, and was removed to hospital. The
date of onset of the first symptoms was the 11th February, and the rash appeared on 14th February.
C. M. had been isolated from the rest of the boarders from the day he fell ill; his two companions were,
however, with him until the 14th February ; both were re-vaccinated and neither of them contracted
the disease. No further cases occurred among the passengers from the s.s. Marseilles who came to
London, but of the contacts detained at Denton Hospital six developed the disease; two belonged to
the crew and four to the same family as the original case.
(c) On 11th March, 1915, at the request of the Medical Officer of Health of Greenwich, Dr.
Brincker visited a patient (J. H.), and found him to be suffering from smallpox. The man was a Channel
pilot, and had been conducting vessels in and out of London, his last pilotage being on the 4th March.
He had been unwell for three weeks suffering from indefinite symptoms of dyspepsia ; the rash was
first observed on March 7th, and he was removed to hospital on 11th March, when the disease was first
suspected and the diagnosis made. The patient was unvaccinated. There were five contacts, the
pilot's wife (E. H.), and four children. All were vaccinated on the 11th instant, the wife for the first
time, the children having been vaccinated before. On the 24th March, E. H, who had been nursing
her husband from 7th to 11th March, developed a rash, and on 25th March was notified to be suffering
from smallpox. She was removed to hospital. No further cases occurred. Both patients had mild
attacks, and were discharged from hospital on the 10th April, 1915.
(d) On the 9th May, 1915, the s.s. Werdenfels arrived at Gravesend from Alexandria
with a case of smallpox on board. The patient, a fireman, fell ill on the 26th April, and developed the
rash on the 30th April. The case was removed to Denton Hospital on the 9th May. The whole of the
crew were vaccinated the same day, and proceeded to their destinations, their names and addresses
being reported to the medical officers of health concerned. Arrangements were made for the Council's
inspectors to keep the seamen's and common lodging houses in London under observation. One of the
sailors on board (J. S.) went to the Sailors' Home, Wells-street, E. On the 17th May, the Council's
inspector reported from the Sailors' Home that one of the lodgers (J. S.), referred to above, was ill and
had a rash. Dr. Ross at once visited and found the man suffering from smallpox. The onset of first
symptoms occurred on 16th May, and the rash appeared on May 17th. Vaccination had been performed
six days previously, and this accounts for the mild attack from which the man was found to be suffering.
The patient was at once removed to hospital. All precautionary measures were taken at the Sailors'
Home, and no further cases occurred in London. It was ascertained that the cook on board the s.s.
Werdenfels, who went to Bristol on the 11th May, developed haemorrhagic smallpox.
Cases of smallpox were reported during the year on board five vessels arriving at different times
in the Port of London. The circumstances relating to two of these, from which secondary cases resulted,
are referred to above under (6) and (d) respectively. In the remaining three, no secondary cases occurred
amongst the contacts. In every case the patient was removed to Denton Hospital; all precautionary
measures were taken on board the vessels, and the names and addresses of passengers and crew proceeding
to their various destinations reported, in accordance with the usual practice, to the medical
officers of health concerned, for observation.
At the suggestion of the Local Government Board, the Council made an order on 9th March,
1915, extending to chickenpox the application of section 55 of the Public Health (London) Act, 1891,
within the administrative county of London, up to and including the 30th June, as an urgency measure.
The order was not further extended.
Measles, scarlet fever, diphtheria and whooping-cough.
The civilian deaths from measles in the administrative county of London during 1915 numbered
2,286, as compared with 1,376 in 1914. The incidence in 1915 appears to have been heavy upon the
western and south-western boroughs, the total deaths in Paddington, Kensington, Fulham, Wandsworth,
and Battersea, which numbered 128 in 1914, rose to 662 in 1915. Measles was a notifiable dis ease
in Paddington throughout the year 1915.
The civilian cases of scarlet fever notified in the administrative county of London during 1915
(52 weeks) numbered 16,974, as compared with 25,015 in 1914. The civilian deaths from this cause
Smallpox on
board vessels
arriving in
the Port of
London.
Compulsory
Notification
of Chickenpox.
Measles.
Scarlet fever.