View report page

The patient's immediate contacts, about 40 persons, included
his clients in the Abbey Wood area whom he saw during the morning
of the l3th January, his family (five persons), and his medical
attendant. These were all placed under surveillance and other
necessary precautions were taken.
The patient made rapid and uneventful progress and was
discharged home 15 days after admission to Hospital. Although
the rash remained sparse, its further development in Hospital was
in accord with Smallpox and a further series of tests proved positive
for Smallpox. The patient had been well vaccinated whilst in the
Armed Forces, lastly in 1945, and this was probably the main factor
in producing this highly modified case.
The source of infection was not discovered; all possible
clues, including several rumours, were followed up but to no purpose.
As vaccination was not likely to be effective in preventing the
disease at that late stage, the patient's family and his medical
attendant, who had all been in close contact with him during the
infectious period were given serum injections in addition to vaccination.
A number of cases were referred by General Practitioners for
further opinion, but fortunately none proved to be Smallpox. One of
these was a young child living in a communal establishment in the
Borough containing over 100 families. As the possibility of Smallpox
could not be immediately excluded, precautions were instituted in
respect of over 300 residents there. The child was removed to Long
Reach Hospital and was subsequently found to have Chickenpox.
In addition to the vaccination of all known contacts, it was
found necessary, owing to the public demand, to arrange for mass
vaccination. The County Council gave every assistance in arranging
emergency vaccination sessions at their clinics and certain schools
in the area, and together with the help of all General Practitioners
in the Borough, who carried out a large number of vaccinations of
their own patients, altogether some 100,000 people were vaccinated
during this period.
I should like to pay tribute to the excellent work carried out
and the co-operation of all concerned.
This experience gives further support to the generally held
view that Smallpox is not infectious in the incubation period (i.e.
before first feeling ill) and tends to support the view that it is
also non-infectious in the prodromal stage (i.e. before the rash
appears). Further, it seems reasonable to assume that the injection
-59-