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* There were no cases of the following diseases, which are also notifiable in the Borough : Smallpox,
diphtheria, cholera, typhus fever, paratyphoid fever, relapsing fever, continued fever, plague, glanders,
farcy, anthrax, induced malaria, polio-encephalitis, encephalitis lethargica.
Smallpox.—The S.S. "Mooltan" from Australia arrived in the Port of London on the 2nd April, 1949,
with the body of a person who had died of smallpox at sea. All passengers, after being offered
vaccination, disembarked on the 3rd April, 1949. Twelve cases of confirmed or doubtful smallpox
were subsequently removed to hospital in the London area (none of them from St. Marylebone) of
whom three died. Four cases were also isolated in hospital in the provinces and two of these proved
fatal. Four of the fatal cases were persons who were unvaccinated at the time of infection, the fifth
being a man of 61 who was vaccinated in infancy. In other cases the Ministry of Health reported
that there was evidence that vaccination had produced considerable modification of the disease, and
this had sometimes given rise to difficulty in diagnosis. Twenty-five passengers proceeded to
addresses in the Borough, and all had been vaccinated either on board or within recent months. One
of these contacts developed spots and as a precautionary measure a member of the panel of smallpox
consultants, formed by the Metropolitan Regional Hospital Boards, was called in, but the case proved
to be not smallpox. All 25 contacts were kept under surveillance for the requisite period and this
involved many visits and close contact with the medical officers of health of other areas
where movements out of the Borough took place. A number of passengers on the " Mooltan " were
nurses, and several of them after disembarkation visited the premises of the Royal College of Nursing
and the General Nursing Council, both situated in the Borough. At the request of these bodies
arrangements were made for the vaccination of 160 nurses and staff. No case of smallpox occurred
in St. Marylebone.
International Certificates of Vaccination and Inoculation.—In accordance with the request of the
Ministry of Health, arrangements were made for the authentication by the Medical Officer of Health
of certificates of vaccination and inoculation issued by medical practitioners in St. Marylebone in
respect of persons proceeding abroad.
Food Poisoning Outbreaks.—Food poisoning was more prevalent during 1949 than for some years,
and details of the cases notified are given below :—
(a) Number of outbreaks.—One outbreak of 71 cases ; one of 10 cases ; two of 2 cases each ; and
10 single cases.
(b) Total number of cases.—Ninety-five.
(c) Deaths.—None.
(d) Organisms or other agents responsible, with number of outbreaks attributable to each.
Salmonella typhi-murium—-One outbreak (71 cases).
Salmonella aertrycke—One outbreak (10 cases) and one single case.
Salmonella group—One case.
Not ascertainable—Two outbreaks of two cases each and eight single cases,