View report page

8
to the difficulty of dealing with insane patients it was decided to isolate the cases of
smallpox at Springfield Mental Hospital instead of sending them to the smallpox
hospital.
In April and May, 9 cases occurred in connection with Lambeth Hospital, but
the original source of infection was never discovered.
In April, the outbreak amongst the general population commenced with cases
in Wandsworth and Poplar. The source of infection in Poplar was not traced but
in Wandsworth there is no doubt that the infection spread from the Springfield
Mental Hospital. The outbreak in Wandsworth lasted until July, and produced
88 known cases, including those at the Mental Hospital. During the outbreak the
Council's schools, and also business firms became involved. At one factory, in
Balham, a "missed" case gave rise to 8 other cases and eventually the firm made
vaccination a condition of employment with the result that they had no more cases
of smallpox. The local sanitary authority decided to draw the attention of the public
to the menace of the disease and the need for more stringent preventive measures.
Over 90,000 letters urging vaccination were sent by the medical officer of health to
householders in the borough with the result that over 13,000 vaccinations were
performed within a few weeks. Notices urging people to be vaccinated were exhibited
at cinemas and were also read out in places of worship in the borough.
Smallpox appeared in another institution, the St. Marylebone Workhouse, in
June, where 29 cases occurred, including two cases which were transferred to the
St. Marylebone Hospital, which is in the borough of Kensington.
During June and July, a few cases occurred in South Lambeth and were undoubtedly
associated with the Wandsworth epidemic. The main outbreak in Lambeth was
traced to a girl who lived in Wandsworth and whose mother was an in-patient at
St. Thomas's Hospital in North Lambeth. The girl visited her mother at the hospital
on 1st, 4th and 8th July. She was absent from school from 18th June—9th July and
on her return was examined by the school doctor and found to be suffering from smallpox,
the rash of which had appeared on 22nd June. As a result of her visits to her
mother in St. Thomas's Hospital, a series of "missed" cases occurred in the neighbourhood
of the hospital and the infection was taken to the hopfields in September
by one of these "missed" cases. Hop pickers who had been infected returned to
London and spread the infection in Poplar and North Lambeth. Cases of smallpox
had occurred in Poplar earlier in the year but the infection appeared to have died
down during the summer months until it was re-introduced by the returning hop
pickers. In both Poplar, where 68 cases were notified during the year, and Lambeth,
52 cases, the unvaccinated school population was heavily attacked. The disease
was aided in its spread by its mildness and by the frequency with which it was
mistaken for chickenpox. In Lambeth also, there were several cases of deliberate
concealment of contacts and a general unwillingness to submit to vaccination. In
both boroughs the outbreaks were brought under control when chickenpox
was madea notifiable disease under Section 55 of the Public Health (London)
Act, 1891.
In October, cases of smallpox occurred in a dressmaker's establishment in West
Ham, where the proprietress had suffered from an unrecognised attack. The disease
spread rapidly amongst the unvaccinated population and by the end of the year
an outbreak had become established. Up to May, 1929, some 500 cases had been
reported. This serious outbreak on the eastern border of London has been a serious
menace to London as many of the patients and their contacts are employed in,
or visit, London daily. This applies particularly to the borough of Poplar which
adjoins West Ham and where the intercourse with the heavily infected area is free
and continuous.
On a review of the year's cases, it is seen that the present type of smallpox
conforms very closely to previous experience in selecting the unvaccinated. It is