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on Thursday, 7th April, and was confined to his room under
observation. On Sunday, 10th April, a macule and a papule
were noted on his forehead. Two macules were present on
his back. A diagnosis of Smallpox was confirmed by Dr.
Marsden, Consultant to the Ministry of Health. The patient
was removed to Clandon Isolation Hospital. Subsequently
scrapings from a minute pustule were examined at the Central
Public Health Laboratory, Colindale, and showed a pure
growth of the virus of Smallpox. The patient had been
vaccinated in 1944 and again on 2nd April before disembarking,
but too late to prevent the virulent infection from
manifesting itself. The rash was highly modified and abortive,
and the patient recovered rapidly without further constitutional
disturbance. All known direct contacts were vaccinated.
Appropriate disinfection was carried out. No secondary cases
arose.
Prevention of Smallpox. Vaccination is a voluntary
measure. It is essential that people should have a basic
immunity established in infancy, reinforceable as circumstances
of travel or contact in later life may require. With
the rapidity of modern transport and the increasing number
of travellers, there can be no guarantee that Smallpox will
not intrude into any home at any time. The abortive case
with little or no rash can escape detection with dire consequences
to the unvaccinated. There has been a general
tendency for infant vaccination to decline. Parents should
ensure that babies are vaccinated between three and six
months of age, the safest period for vaccination.

Puerperal Pyrexia. Four cases were notified in 1949,
compared with two cases in 1948. The case rate was 3.63 per
1,000 total births, compared with 6.31 per 1,000 total births
for England and Wales.
The early notification of Puerperal Pyrexia is of primary
importance in the prevention of maternal mortality. Medical
Practitioners should make the fullest use of the consultant,
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