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120
SMALLPOX
It is only exceptionally these days that there are any patients in this
country suffering from smallpox. The greatest risk of entry of the
disease is when a person on a boat or an aeroplane coming to this country
develops the infection; he might have passed on the disease to his
contacts. In such cases, the contacts are listed, the health authorities of
the areas to which they are proceeding are advised, and the contacts are
visited up to the limit of the incubation period of the disease. Air
transport has added to the risks of importation of this infection, and has
considerally swollen the number of persons who have to be kept under
observation. The Aircraft Regulations 1950 modified the arrangements
by which information about possible contacts of smallpox arriving by air
was passed on to local authorities in the same way as that about those
arriving by boat.
There were no occasions in 1954 on which persons in the district
were thought to have been contacts of those suffering from smallpox.
The National Health Service Act removed the compulsory element
of the Vaccination Acts. Instead of the practice being obligatory, except
to those exempted under the conscientious objection clauses, it is now
left to the parents to decide about having their children vaccinated
This they can have done by their own doctors. As in the case of
diphtheria the local health authority pays 5s. for a report submitted by
a doctor that he has vaccinated or revaccinated anyone. Encouragement
to mothers to have their children vaccinated against smallpox is given by
the doctors themselves and by the health visitors, clinic medical officers
and other members of the local health authority's staff. In spite of this
only about one child in three was being vaccinated. In 1952 the County
Council obtained the approval of the Ministry of Health for arrangements
being made for infants who were attending the infant welfare centres to
be vaccinated against smallpox just as they are immunised against
diphtheria.
In this district in 1954, 1,808 persons were vaccinated against smallpox
for the first time. Of these 1,387 were under one year of age and
144 over one but under two years of age. 654 persons were revaccinated.
2,747 babies were born in that year. The number of vaccinations of those
under one year of age was, therefore 50.5 per cent. of the births. This
figure compares with that of 34.5 for the country as a whole in 1954, a
figure which was an improvement on those of the preceding years. of
those under one year of age who were vaccinated, 462 were treated at
the local infant welfare centre sessions.
While most emphasis needs to be placed on the desirability of each
member of the population being vaccinated, because there is no assurance
that in the case of any particular person the degree of protection will
not wane and fall to a dangerously low level, it is advisable that all
should be revaccinated. This is especially desirable to reduce the risk
of the spread of infection, a risk which occurs because of the atypical
nature that an attack of smallpox might take in a person who has been
vaccinated but whose protection has waned, but has not complete)
disappeared; the atypical attack may not be recognised for what it is
In the meantime the illness from which the patient is suffering may be