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14
Metropolitan Asylums Board, dated January, 1902, the importance of which cannot
be overlooked. It deals with 1,017 cases completed—that is cases terminating
fatally or recovering—during the year 1901. In this Eeport it is stated as follows:—
"The cases have been divided into three classes, namely :—1. "Vaccinated," i.e. cases
having visible cicatrices; 2. "Doubtful" which includes (a) cases stated to have been
vaccinated but bearing no visible evidence thereof; and (b) cases in which no statement
was made but in which the eruption prevented any reliable observation as to the cicatrices;
and 3 "Unvaccinated" i.e. cases admittedly unvaccinated or bearing no marks of the
operation and as to which no statement was made."
"The gross mortality is given as 24.29 per cent. It must, however, be borne in mind
that in arriving at this figure many cases of recent admissions have been included because
they have been completed by death; whereas the contemporary cases which will nearly all
ultimately recover, cannot be included until completed by discharge. The result being that
the rate of mortality above given is undoubtedly higher than it will be when all the cases
have been completed and the final rate ascertained."
"The total mortality rate per cent. of vaccinated cases was 14.21; of doubtful cases
65.08, and of unvaccinated cases 50.52."
"It is useful to consider the statistics as grouped under age periods. Under ten there
were only 12 vaccinated cases and no deaths; 6 doubtful cases all of whom died, and 95
vaccinated cases of whom 52 died, a percentage of 64.74."
"Under 20 there were 161 vaccinated cases of whom 3 died—a percentage of 1.86,
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 to 28.95 in cases between 35 and 40."
As shewing the value of re-vaccination the report contrasts the incidence of
small-pox on public officers and other persons who, whilst in the performance of their
duties were brought in coutact with the disease, with the experience of the Managers
of the Metropolitan Asylums Board at their hospitals and in their ambulance service,
in both of which re-vaccination is performed on officers entering their service. No
fewer than 21 persons employed in disinfecting work by the various local authorities
contracted the disease during the year. Not one of these had been re-vaccinated. On
the other hand to quote from the report:—
"Of 2,198 persons employed at the small-pox hospitals, between 1881 and 19 0 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 4 were workmen who escaped medical observation."
"During the past year a very large number of new staff have joined the Ships and the
Gore Farm Hospital (the exact number cannot be given at present) but not one case of smallpox
has occurred. Not one of the Staff of the Hospital Ships has ever died of small-pox
and not one has even suffered from the disease for the past 8 years."