View report page

55
SMALLPOX
To the risks of importation of persons in the incubationary and
therefore undetectable stage of smallpox, must now be added the possibility
of the admission to the country of persons by air. Particulars
of those who come from countries where the disease is present, and who
might, therefore, later become infectious are received by the medical
officers of health of the areas to which these people proceed. Such
persons are warned of their risks and are visited until the expiration of
the incubation period. Although notifications of a number of such
persons were received during the year 1949, there were no cases of smallpox
in this district.
Patients suffering from smallpox are admitted not to the ordinary
isolation hospitals which accept patients suffering from the commoner
infectious diseases, but to special hospitals which deal only with those
suffering from that disease. Any patient from this area will be admitted
probably to one of the hospitals previously maintained by the London
County Council, being removed to hospital in an ambulance provided
by the hospital.
Before patients are removed to hospital the diagnosis must be confirmed
by a consultant. The Ministry of Health has issued an approved
list of those who might be summoned to patients in this district.
Smallpox of all diseases is the one against which protective measures
can effectively be carried out. Vaccination can be performed free of charge
by any of the medical practitioners who have entered into the arrangements
of the County Council to do this work for them, irrespective of
whether or not they are taking part in the general medical service under
the National Health Service Act. Since the removal of the compulsory
element of the Vaccination Acts and since, too, it is no longer the responsibility
of one single person to try to see that any particular child has
been vaccinated as it was under the former arrangements, it is likely
that even fewer than were done before will in future be vaccinated against
smallpox. It might need the stimulation of an outbreak to induce
mothers to obtain this protection for their babies. Those who are
opposed to the practice point to the fact that vaccination is sometimes
followed by an illness which in itself is sometimes fatal. That is admitted
and in any one year it might well be that the number of these deaths
exceeds the number of deaths in the country from smallpox. The
risks of these occurrence though are very much less when vaccination is
carried out in infancy than when it is left until later. While presentday
practice can control the wide spread of true smallpox, it is too much
to hope that unless the entire population is adequately vaccinated, the
disease can indefinitely be kept out of the country. When the disease is
introduced into the country there is the rush for vaccination. Many
will be treated then who had not been protected in infancy and the
complications will be much more common than if the same person had
been treated in infancy. That is the case for the practice of routine
vaccination of infants.