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(b) Daily visitation of all known contacts by Sanitary
Inspectors who report any deviation from normal health.
(c) Visitation by a medical officer to cases referred by a
Sanitary Inspector.
(d) Notification of Employers.
(e) Notification of M.O.H.'s of surrounding districts.
(f) Removal of cases and disinfection of premises, bedding,
etc.
(g) Distribution of leaflets.
(h) Circular letter to all medical practitioners.
History of Outbreak.
On the 23rd February, 1931, 1 was asked to see a patient in
a doctor's surgery in South Croydon, and on the same evening a
similar request was made by a doctor in Addiscombe. Both
patients were inmates of the Municipal Lodging House and were
found to be suffering from Small Pox. The same evening my
deputy and myself visited the Municipal Lodging House and
inspected all the men then resident. As a result two were discovered
suffering from Small Pox in a rather later stage than the
two seen at the doctors' surgeries. The cases were removed to
Clandon Isolation Hospital and vaccination advised to the contacts.
Very few, however, took this advice. No further cases arose until
March 5th when I was requested to see a case in the Mayday Road
Hospital, sent there, suffering from Chronic Bronchitis by his
private doctor. This case had mild Small Pox and was removed.
His ordinary place of residence was the Municipal Lodging House
and his connection with the four previous cases undoubted. The
diurnal inspection of lodgers at the Municipal Lodging House
enabled us to detect another case on the 9th March ; on the 11th a
case was seen in Mayday Road Hospital, having been sent there
by his private doctor for another complaint. This man also lived
in the Municipal Lodging House. On the next day's Municipal
Lodging House inspection a further case was discovered and two
more cases removed from Mayday Road, in the persons of men
sent for other complaints but who resided at the Municipal Lodging
House. On the 13th two more cases were found at the Municipal
Lodging House. The outbreak in the Municipal Lodging House
and the Mayday Road Hospital was now controlled, only two more
cases occurred among inmates of the Lodging House, viz., on the
15th and 16th and two cases at Mayday Road, viz. on the 26th and
It is a commentary on the relatively low infectivity that so