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A page boy (W.S.), aged 14 years, employed at the hotel, was also found by Dr.
Porter to be suffering from a sore throat, and was removed to hospital as a precaution
(1.10.26). Some days after his admission a meagre and not very characteristic
rash appeared, and it was eventually decided that the case was one of mild smallpox.
The boy was vaccinated for the first time on the 1st October, and the vaccination
did not properly take.
No further cases occurred, and it was due to the energetic administrative action
taken, including the supervision and vaccination of large numbers of contacts, that
the disease did not spread.
Group II (two cases).—As in the case of the Group I. outbreak, the infection
originated in Paris, but there was no association between the two groups, except as
regards the common source of infection.
The first patient (A.D.), who had not been vaccinated since infancy, was a
woman, aged 52 years, who spent most of September in Paris, where there was an
outbreak of smallpox of a severe type, and returned to London on the 25th September.
She felt unwell on the 6th October, and attended the Royal Northern Hospital the
following day, when she was so ill that she was admitted as an in-patient. On
the 8th October a rash appeared, and on Saturday, the 9th October, she was isolated
in the hospital on suspicion of smallpox. A consultation was held that day, and
Dr. Wanklyn was called in on Monday, the 11th October, when the patient was
declared to be suffering from a severe attack of confluent smallpox. She was at
once removed to North Wharf, and vaccination of all contacts at the Royal Northern
Hospital was commenced the same evening. All the visitors to the hospital during
the week-end, 9th to 10th October, were regarded as contacts, and their names and
addresses, together with those of all patients who were discharged from the hospital
after the 8th October, were communicated to the medical officers of health of the
districts concerned.
A secondary case occurred in the person of an in-patient at the hospital (S.S.),
a female, aged 64 years, occupying the next bed to the patient (A.D.). S.S., who
had not been vaccinated since infancy, was re-vaccinated with other contacts on
the 11th October. Her rash appeared on the 20th October, and she was removed
to the Metropolitan Asylums Board receiving station the following day. The
attack was modified as a result of her re-vaccination. No further cases occurred.
Miscellaneous Cases and Supervision of Contacts.—From time to time cases of
smallpox occur outside the county area, in which the patient has passed through
or visited London during the infectious period. Similarly it frequently happens
that smallpox contacts from other parts of the country, or from abroad, come to
visit, or to stay in, London. In every case the Council's public health department
keeps in close touch with their movements, and co-operates with the medical officers
of health of the metropolitan boroughs and extra-metropolitan authorities with the
object of preventing spread of the disease.
A fatal case of smallpox occurred in January, 1926, at the Hague among a
party of South African students (55 males and 78 females) who were touring the
Continent. The patient was infected in Paris. All members of the party were
vaccinated before they left Holland, and they arrived in this country on the 31st
January. They came to stay at an hotel in St. Pancras, where they were kept under
daily observation for 12 days prior to their departure. The situation was complicated
by an outbreak of German measles among them whilst they were at the hotel,
but no further case of smallpox occurred.
In June, 1926, a girl (E.B.), aged 20 years, journeyed from South Shields to
Limpsfield, Surrey, via London. She fell ill with headache, shivering and vomiting
on 6th June, the day before she left South Shields, where several cases of smallpox
had occurred in the street where she lived. She arrived at King's Cross Station
on the 7th June feeling somewhat better, and was there met by an employee of the