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required daily observation including hospital out-residents and
special cases referred by doctors in the district and health
visitors - many of the latter concerned reactions to vaccination.
This surveillance continued for a period of sixteen days.
Notification of chicken pox
Because of the close contact with local doctors who agreed to
report all cases of chicken pox it appeared unnecessary in the
early stages to seek action under Section 147, Public Health Act,
1936.
General liaison
Under the direction of the chief clerk (Mr. AW. Lawrence)
rapid compilation of records and distribution of information
became the first task of the public health offices Other work
was put aside except for matters of absolute urgency and the whole
staff concentrated on control of the outbreak This called for
sustained work until late at night throughout the first week-end
and following week. Bulletins to general practitioners and adjoining
medical officers of health were sent out daily Lists of
contacts which arrived from St Ann's Hospital and other sources
were classified according to the districts in which the persons
resided. The medical officers of health of the districts concerned
were first telephoned and the information confirmed the
same day by letter. For those living within the borough contact
sheets were made out and passed to the district public health
inspectors who undertook surveillance for sixteen days
In addition to the information which required to be telephoned
out there were continuous incoming telephone messages and enquiries.
As a result, despite six telephone extensions in the department
there was often an acute shortage of telephone facilities. It
was also necessary to arrange for the switchboard operators to
stay on duty to deal with calls which continued throughout the
evenings.
National Health Insurance Benefits
None of the smallpox patients was a contributor for National
Health Insurance benefits but a number of primary contacts were
able to claim upon the certificate of the medical officer of health
A special emergency procedure laid down in a Ministry of Pensions
and National Insurance memorandum for dealing with claims arising