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Information regarding the action taken by the school medical service in collabora
tion with the borough health services, in connection with the control of smallpox in
the Council's schools, appears in Vol. III, Part II, of this report.
During the year three ships on which smallpox had occurred during their voyages
arrived in the port of London from Bombay.
In the first case the patient boarded the ship at Bombay. At Aden a fellow
passenger who shared a cabin with the patient informed the ship's surgeon that the
patient had been so ill for three days before embarking that he was only just well
enough to board the ship, and that he had some spots on him. The ship's surgeon
diagnosed variola and isolated the patient and the contact who were both landed at
Suez. The whole of the European crew (221) were vaccinated, except those who could
show evidence of successful vaccination within the previous two years. The native
crew (243) had all been vaccinated within the year. The passengers were offered
vaccination and, of those who landed in London, 219 availed themselves of the offer
and 152 declined. The majority of the latter had been vaccinated within the previous
five years.
In the second instance a native passenger was found on disembarkation at
Aden to have a few spots on his face and body. The case, which was diagnosed
provisionally as chickenpox, was removed to hospital at Aden. On arrival of the
vessel off Suez, the port health officer informed the ship's surgeon that the case
landed at Aden had been diagnosed as smallpox. All the crew, European and
native, had been vaccinated within the year. Four passengers were vaccinated
by the ship's surgeon at their request.
The case on the third vessel also occurred amongst the passengers. The patient
was not feeling well at the time of embarkation and reported to the ship's surgeon
that he had a "chill on the liver." He later developed a hæmorrhagic rash on his
trunk, arms and legs, and was removed to hospital at Aden where the ship's surgeon
took on board sufficient vaccine to vaccinate all on board. The ship later received a
message from Aden that the case was smallpox and that the patient had died. The
surgeon then vaccinated all the crew and as many passengers as would submit (257).
On arrival of these vessels in the port of London all precautionary measures were
taken by the port medical officer, including disinfection of the ship, bedding, etc., and
the notification to the medical officers of health concerned of the names and addresses
of passengers and crew.
No secondary cases occurred.
Passengers from four other ships on which smallpox had occurred arrived in
London. The names and addresses of these contacts were forwarded to the medical
officers of health concerned in order that the contacts might be kept under surveillance
during the incubation periods.
In the City of London and the borough of Poplar, orders, made under the provisions
of Section 55 of the Public Health (London) Act, 1891, making chickenpox
notifiable, were extended for a period of one year. At the end of the year this disease
was notifiable in Paddington, Hammersmith, Chelsea, Islington, City of London,
Poplar, Deptford and the port of London.
During the year 216 notifications of cerebrospinal fever were received, but in 13
of these the diagnosis was not confirmed. Of the 203 cases confirmed, 90 proved
fatal. In addition 24 deaths were recorded by the Registrar-General of cases which
had not been notified and 2 of cases which were notified in 1932, thus making a
total of 116 deaths.
The notifications of acute encephalitis lethargica numbered 22. In 4 of these
the diagnosis was not confirmed; of the 18 actual cases, 8 proved fatal. In addition
31 deaths were recorded by the Registrar-General of cases which had not been
notified, and 8 which had been notified in previous years, making a total of 47 deaths
for the year.
Particulars of cases admitted to the post-encephalitis lethargica unit at the
Council's Northern hospital are given in Vol. IV. Part I, of this report.
Chickenpox.
Cerebrospinal
(spotted)
fever.
Encephalitis
lethargica.