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It will be seen that there is still a high incidence of Scarlet
Fever and Diphtheria in the district, as has been experienced in
the London area generally. This may be attributed largely to
the present difficulties as regards housing and transport, and is
unlikely to be rectified until these two conditions have been
improved.
(a) Small-pox.—One case was notified on 20th February and
removed to the Orsett Small-pox Hospital. The patient was an
Army officer on sick leave in Ilford from a military hospital, and
he suffered from a semi-confluent type of the disease, having
never been vaccinated. Some delay occurred before I was called
in consultation over the patient, but fortunately no further
cases arose and the man made an excellent recovery. Nine direct
contacts and five secondary contacts were kept under observation,
five contacts were vaccinated by the Medical Officer of Health
and six by private practitioners. 1 am informed by the Clerk to
the Guardians that during 1920, 780 primary vaccinations in Ilford
were performed. The number of births registered being 1,666,
gives the proportion of infants vaccinated as 4(68 per 1,000. The
difficulty of control of Small-pox when it breaks out in epidemic
proportions has been well illustrated in parts of Scotland and to a
less extent in England during the past year, and most Medical
Officers of Health view with concern the disposition of persons at
the present day to dispense with the safeguard of vaccination.
Small-pox Hospital Accommodation. — An agreement was
made in July, 1911, by which the West Ham Council was to
admit at their Hospital at Dagenham, patients from Ilford suffering
from Small-pox. This agreement was terminated by the