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addresses of all known primary contacts, which subsequently
totalled approximately 475.
On Friday afternoon confirmation of the diagnosis was received
from the smallpox hospital at Dartford that the patient was in fact
considered to be suffering from smallpox and had died of it.
Following from enquiries of the secretaries of the various meetings
which the patient had attended, a list of names and addresses
of contacts was prepared and all of these were visited by public
health inspectors and health visitors during Saturday and Sunday.
An explanatory letter outlining the position and advising vaccination
or re-vaccination of all contacts was delivered, together with a
leaflet of general advice. All persons living in the same house as
primary contacts, or otherwise exposed to special risk were similiarly
advised.
Special vaccination sessions were arranged at the Town Hall on
Saturday afternoon and evening, Sunday all day, and on Monday,
Tuesday and Wednesday mornings and afternoons and by the end
of the emergency 1,466 vaccinations or re-vaccinations had been
done at the Town Hall vaccination clinics and 154 at welfare
centres. In addition 4,142 had been done by family doctors at their
surgeries.
On the Friday afternoon a circular letter was addressed to all
doctors practising in Walthamstow and to neighbouring Medical
Officers of Health, giving the history and facts and stating that the
medical staff would be on continuous call to see any suspect case,
especially adult and unvaccinated cases of chicken-pox which may
closely resemble smallpox. This advice had also been stated in the
circular letter addressed to family doctors on the 29th June notifying
them of the Tottenham case.
In view of the need to offer immediate vaccination to all direct
contacts, authority was obtained to issue a statement to the Press
and the B.B.C. stating the facts and the arrangements which had
been made for vaccination over the weekend. The help of the
Press and the B.B.C. was readily forthcoming.
A further circular was addressed to family doctors and others
concerned on the Saturday morning stating that in the opinion of
the specialists who had seen the patient, the clinical diagnosis and
cause of death was smallpox. A notification of smallpox and a
certified copy of the entry of death stating the cause of death to be
smallpox were later received but laboratory confirmation was lacking.
The modern method of control in such outbreaks is to vaccinate
and re-vaccinate as soon as possible all primary or direct contacts
and in addition all those residing in or using the same house, so that
if the primary contact develops smallpox, an immune ring of
secondary contacts in the same dwelling will have been built up.