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21
SUMMARY OP REPORT.
1. There were, between September 23rd, 1901, and June
30th, 1902, 245 cases of Small-pox and 40 deaths; 70 occurred
in Woolwich Parish, 169 in Plumstead and 6 in Eltham.
2. In the majority of cases the source of infection could
not be found, but it is probable that the disease was spread to
a large extent by very mild cases, undetected and unsuspected,
who were going about their ordinary duties, several of whom
were doubtless Arsenal employees.
3. In no case did the infection appear to spread from one
house to neighbouring houses, except by means of personal
communication.
4. All cases notified without a request for me to visit were
removed straightway to the Ambulance Station; of these 7
were returned without being sent to the Small-pox ships, the
diagnosis not being confirmed. None of the 94 cases seen by
your Medical Officers at the request of the Medical Attendant
were returned, but the diagnosis was confirmed in every case.
Further, no case was found not to be Small-pox after arriving
at the Small-pox ships and other hospitals.
5. The difficulty of distinguishing certain mild cases of
Small-pox from Varicella (or Chicken-pox) seems almost
insuperable.
6. I consider that it should be compulsory to notify
immediately there is reasonable cause to suspect infectious
disease.
7. Of the 245 cases 205 recovered and 40 died, giving a
case death-rate of 16.3. Among the 194 cases known to be
vaccinated, the deaths were 24 and the death-rate 12.3 per 100