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Outbreaks of variola minor, the milder form of smallpox, occurred in the Midlands and in
Wales. No case occurred in Waltham Forest but 42 surveillance visits were made to local residents
who had been in contact with cases.
Certainly the greatest danger we faced in 1966 was from typhoid. A Pakistani boy aged
14 was admitted to Whipps Cross Hospital on August 1st; a week later he developed symptoms of
typhoid and was at once transferred to the Fever Hospital. It reflects great credit on the high
standards of the medical and nursing staff at Whipps Cross that whilst they had no idea that the
boy was incubating typhoid and was being nursed in an open ward, not one patient or member of
the hospital staff caught the disease. Since his arrival by air on July 19th the boy had stayed at
two addresses in Walthamstow and had been in close contact with thirteen of his compatriots.
These were all kept under surveillance and tested throughout the incubation period but none of
them developed the disease; probably, like many adult Pakistanis, they had already become
immune after having had the disease in their own country. With treatment the boy made a complete
recovery.
The second, and far more dangerous case, was that of a little Indian girl of 13 who
arrived by air from Delhi on August 7th and became ill on August 10th. All local doctors,
hospitals and neighbouring Medical Officers of Health had been informed by circular of the first
case and warned to suspect typhoid in any unexplained fever, especially in Indians or Pakistanis,
and the doctor called to the second case promptly took a blood sample which proved positive for
typhoid and the child was at once admitted to the Infectious Diseases Unit at St.Ann's Hospital.
Meanwhile, she had spent a fortnight in a house in Leyton with nine Indians, six of whom were
children and almost certainly susceptible. Enquiries elicited a history of her having had a fever
some three weeks before boarding the 'plane at Delhi and that the Indian doctor treating her had
died. The girl was almost certainly a relapsed case of typhoid, incompletely treated, and would
have been very highly infectious for several weeks. The entire household (which included one
man working at a local bakery) was therefore quarantined and examined daily. Queen Mary's
Hospital, Stratford, kindly retained in their maternity unit the wife and newborn baby of one of the
residents until the expiration of the incubation period, after which the whole house was thoroughly
disinfected.
We owe a debt of gratitude to the family doctors of Waltham Forest for their unstinted
co-operation, to the staffs of the local hospitals and the public health laboratories for all the
detailed and exacting tests they carry out for us and to Dr.McKendrick and his staff at St.Ann's
General Hospital, Tottenham, for their readiness to help with advice at all times as well as giving
immediate admission to any patient who we suspect to be suffering from a serious contagious
condition.
Geoffrey Poole
Deputy Medical Officer of Health
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