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that practically only in confluent and hæmorrhagic cases, which are always
in the minority, is there any difficulty in deciding as to the presence, or absence,
of vaccination.
With regard to age periods it is pointed out that under" the age of 10
"there were only 12 vaccinated cases, and no deaths; 6 'doubtful' cases, all
"of whom died; and 95 unvaccinated cases, of whom 52 died, a percentage
"of 54.74."
"Under 20 there were 161 vaccinated cases, of whom 3 died, a percentage
"of 1.87; 12 'doubtful' cases, of whom 7 died, a percentage of 58.33; and
"161 unvaccinated cases, of whom 79 died, a percentage of 49.07."
"There appears to be a distinct diminution in the protective power
"afforded by primary vaccination after the age of 20 years, the death rate
"rising from 9.85 in vaccinated cases between 20 and 25 years of age to
"28.95 in cases between 35 and 40."
Special attention is also called to the heavy incidence of the disease on
public officials and other persons brought, while in the performance of their
duties, into contact with Small-pox cases.
During the year no fewer than 21 persons employed in disinfecting were
admitted into hospital suffering from Small-pox, not one of whom had been
re-vaccinated. Two sanitary inspectors, two dustmen, one undertaker, one
medical officer, and three other persons who had been in contact with the
disease were also admitted.
All these persons ought to have been protected by re-vaccination.
As a contrast to this, the Managers call attention to the fact that "of 2,198
"persons employed at the Small-pox Hospitals between 1884 and 1900
"inclusive, in which period 17,900 Small-pox cases were received into the
"hospitals, only 17 persons contracted Small-pox, of whom 13 were not
"re-vaccinated until after they had joined the ship, and four were workmen
"who escaped medical observation."
"From the year 1881 to the end of 1901 there have been employed in the
"ambulance service of the Board 1,282 persons. Four of these persons
"contracted Small-pox, of whom one escaped vaccination when appointed—
"he died; one was unsuccessfully re-vaccinated on joining the service, and the
"operation was not repeated—she died; the two others had been re-vaccinated,
"and recovered."
The Borough Councils were from the first fully alive to the serious danger
which threatened them, and the arrangements to cope with it were on a more
complete and thorough scale than London has ever previously seen.