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the 14 definite cases recorded above the severity of the disease was
very much diminished with the consequent shorter duration of
Hospital treatment.
Following removal to Hospital, the actual houses involved are
visited daily, up to the twenty-first day, either by a Medical Officer
or Sanitary Inspector. Other contacts are visited as often as
possible by a Sanitary Inspector, with a minimum of visits, on
alternate days up to the twenty-first after removal of the last case.
The enormous amount of work entailed will be realised from the
fact that 1,566 visits were paid by the Medical Staff and 4,646 visits
by the Sanitary Staff.
Leaflets describing symptoms, precautions and penalties were left,
and similar advertisements were displayed in the local Press on
two occasions.
To assist in the control of Smallpox, Chicken-pox was made a
notifiable disease on the 12th March, 1930, and notification was
extended for a further twelve months from the 30th September, 1930.
In view of the fact that five cases notified during 1930 by Practitioners
as Chicken-pox were, on being visited, found to be suffering
from Smallpox, there is no question that notification of Chicken-pox
is fully justified. During the year all cases of Chicken-pox were
visited by a member of the Medical Staff for verification of diagnosis.
From the 16th March to 31st May 344 cases occurred, or an
average of over 31 per week.
From the clinical aspect the average incubation period was 12
days and the average period between onset and rash four days. In
many cases there was no prodromal illness, while some cases showed
premonitory symptoms but followed by no rash. Two cases from
infected houses showing typical premonitory symptoms were
admitted to Hospital for observation but developed no rash and
were looked upon as cases of "variola sine eruptione." In some
the premonitory symptoms included delirium, but the severity
of the symptoms could not generally be taken as a guide to the
severity of the subsequent rash.
The difficulty of control is increased by the very mildness of the
disease, especially in view of the fact that the prodromal illness is
so frequently absent or so mild that patients are often not diagnosed
until the rash is several days old. At least 18 patients were
diagnosed on attending Practitioners' surgeries with well-developed
rashes. In addition, many mild and undiagnosed cases undoubtedly
remained at large.