London's Pulse: Medical Officer of Health reports 1848-1972

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Woolwich 1901

[Report of the Medical Officer of Health for Woolwich]

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9
certain mild cases of Small-pox from Varicella (Chickenpox)
seems almost insuperable. In certain cases of Small-pox,
the vesicles are monolocular and not unbilicated, and if in
addition there is no clear history, it is impossible to arrive at a
diagnosis. Two cases of this kind came under my observation.
Both of them were notified as Chicken-pox, and the diagnosis
was only made by the occurrence of secondary cases of Smallpox
among the friends. Neither the history nor distribution
were of assistance in clearing up the doubt. Unfortunately,
the notification of Chicken-pox was not made immediately on
the occurrence of the rash. If this had been done earlier steps
would have been taken to obtain vaccination of contacts, and
the secondary cases prevented.
8 Delay in Notification. Medical practitioners are under
obligation to notify patients on becoming aware that they
are suffering from an infectious disease. For the most part
there is little reason to complain of the celerity with which
this duty is carried out, but some medical men have an excess of
caution, with the result that several days are allowed to elapse
before a case is notified, and often too before any steps are
taken to prevent the spread of infection, and thus valuable
time is lost in taking preventative measures. I consider that
it should be compulsory to notify immediately there is reasonable
cause to suspect infectious disease. If a medical man
may wait till he is certain of the diagnosis, some would never
notify at all.

Age Distribution.—The following table gives the age distribution of the cases:—

Age0-55-1010-2020-4040-60over 60
Cases5952140345