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7
This is the first meeting of your Board since the receipt of that letter, and I
beg therefore to submit for your inspection a complete list of all cases notified as
Small-pox, since, and including, the 9th July last.
The total number of cases amounted to 75. Of these it was discovered upon
examination at the Wharf belonging to the Metropolitan Asylum's Board that 3
cases were erroneously diagnosed. These patients were accordingly re-vaccinated
and returned to their homes. I have also been informed by returns from Somerset
House that 2 deaths from Small-pox have taken place from amongst our cases
in the hospital ships—one aged 25, unvaccinated, and the other 39 years old,
said to have been vaccinated in infancy. In none of the cases had re-vaccination
been performed previously to exposure, but in 1 case the disease was contracted
where vaccination was performed 2J days after the patient had been exposed to
the risk of contagion. In the only young child who contracted Small-pox it was
with its two elder brothers at the time the exposure occurred; they were
vaccinated and escaped, the other was unvaccinated and suffered from Small-pox
in its confluent form. Only 2 of the cases remained at home for treatment.
They were both very modified cases of the disease, and were allowed to remain
at home because means of isolation were present to satisfy the doctor in
attendance. In each case the Medical practitioner gave a certificate to that
effect.
This Report takes into consideration 6 weeks particulars. It will be seen
that the cases per week which were notified took place as follows:—
During the week ending July 13th there were 3 cases.
,, ,, 20th ,, 3 ,,
27th „ 43 „
„ August 3rd ,, 8 „
„ „ 10th „ 13 „
„ „ 17th „ 5 ,,
The period has of course expired during which the 43 cases in the above Table
could exert any influence upon the District. I am of opinion that the rapid
isolation and thorough disinfection carried out in every case, together with revaccination,
which lias gone hand in hand with the other measures, must claim
much of the credit for the want of power which the disease has exhibited to
spread itself more throughout the District. Whitechapel has been for very many
years admittedly one of the best vaccinated Districts in London, and the value
of such claim must be apparent when one considers the fact that although such
a splendid opportunity has been afforded to Small-pox to become alarmingly
epidemic in Whitechapel, yet out of a total of 72 cases of the disease only
18 have taken place in private houses; in 1 case the child had not been
vaccinated and in all the other cases sufficient time had elapsed for the primary
vaccination to have lost a great deal of its prophylactic power. No re-vaccinated
person properly so called contracted the disease.
A second letter as to persons who had Small-pox, and who were not removed
to hospital, was received from the Local Government Board. The matters
mentioned therein have been included in the above Report. I have only to add
that I have supplied the Infirmary Medical Superintendent with Vaccine
Lymph sufficient to re-vaccinate the staff and many of the patients.
So far as I can learn, only one woman—a scrubber at the Infirmarycontracted
Small-pox. She had not been re-vaccinated.
I believe that I have re-vaccinated nearly all the persons who are employed at
the Salvation Army Shelter in the Whitechapel Road, and also the men
employed at the Victoria Home, No. 1 in Commercial Street, where 8 of the
cases occurred.
As a matter of fact, therefore, 50 per cent, of the cases were reported as
coming from Salvation Army Shelters, 25 per cent, from private houses, and 25
per cent, from Registered Common Lodging-houses, the Whitechapel Infirmary,
and from all outside Philanthropic Shelters.
At present about 16 of the cases may be centres from which fresh cases may
arise, and to these our attention must remain for the present directed.
JOSEPH LOANE,
Medical Officer of Health.