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message; the County Medical officer was notified and the Senior
Administrative Medical Officer of the NE Metropolitan Regional
Hospital Board was informed of the position and a circular letter
(thereafter issued daily) stating the situation was sent to all
general medical practitioners in the Borough and to medical officers
of health in adjoining local authorities The Chief Medical
Officer of the Ministry of Health notified all medical officers of
health in the country and port medical officers of the progress of
the outbreak by circular letters issued on the 28th June, 1st July
and finally on the 5th July
Contacts of M B before admission to hospital
The patient MB had been attending school until Friday, 2lst
June, The school was visited before closure for the week end and
duplicate registers and names and addresses of staff obtained for
purposes of offering vaccination or revaccination A list of
recent visitors to the patient"s home was prepared, including
relatives, friends, neighbours and tradesmen A list of patients
since conveyed in the same ambulance was obtained from the local
depot Arrangements were made with the Central Public Health
Laboratory, Colindale, for the supply of 2,000 capillary tubes of
calf lymph fior immediate vaccination or revaccination of primary
contacts and the staff of the health department
Public relations
On Saturday, 29th June a joint statement was issued to the
Press by the hospital and public health authorities
"In view of the suspected case of smallpox transferred from
St Ann's General Hospital on the 28th June, the hospital has
ceased to admit or discharge cases Members of the staff who
were in direct contact with the patient have been confined within
the hospital or if non-resident asked to remain within their own
homes The remainder of the staff of the hospital will continue
to work in the usual way and are not confined to the hospital
All contacts of the suspected case will have been vaccinated
during the week-end The clinical diagnosis of smallpox has been
confirmed and a relative of the patient has been admitted to a
smallpox hospital as a suspected case There is no indication
for mass vaccination of the general public All those who might
receive immediate benefit from vaccination are being visited16
Vaccination within the Borough
A sustained effort followed on Saturday afternoon and Sunday
to secure the vaccination of all known contacts in their own