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20
previous outbreaks I think the following facts from the Report of the
Metropolitan Asylums Board are of special interest at the present time, as
illustrating the danger which may arise from the uncontrolled landing of
persons from infected vessels, who are apparently in good health.
On the 29th March, 1900, the s.s. " Caledonia," from Bombay, arrived
at Gravesend ("all well" on board, but had landed two cases of Small-pox at
Marseilles). Subsequently, after the vessel was in Dock, a steward and a ship's
clerk returned to their homes in St. Pancras and St. Marylebone. There they
developed Small-pox within a few days of one another. Five persons with
whom they came into contact afterwards developed the disease. On 21st May,
a woman was removed from the Westminster district with Small-pox. She
was a widow, and her husband had recently died, it was supposed from Measles,
but there is now little doubt his death was due to hæmorrhagic Small-pox, and
it appears probable he caught the disease from one of the cases originally from
the " Caledonia."
Three persons with whom this man's widow came into contact developed
Small-pox, while about the same time a woman who lived in the same house,
and a contact with either the deceased man or his widow, died in St. Mary's
Hospital from severe confluent Small-pox. The nature of the patient's illness
was unfortunately not at first recognised, and five other persons were
infected.
From the house in Westminster, where the man previously referred to had
died, some linen had been sent to a laundry at Chiswick. The earlier cases
were again not recognised ; result, nine more cases of Small-pox were
removed.
This is not all. The man's brother visited him at Westminster, and took
the disease to the provincial town where he dwelt, and four or five cases
resulted.
Thus at least 30 cases in London could be traced back to the " Caledonia,"
and at least 20 to the man who had died in Westminster from " Measles," and
who, as previously stated, in all probability derived the disease from the same
source.
Stronger evidence than this it would be difficult to conceive for the
immediate necessity of adding Small-pox to the diseases to be dealt with under
the Order of the Local Government Board of 9th November, 1896, referring to
Cholera, Yellow Fever and Plague.
At present, although the Port Sanitary Authority can remove actual, or
even suspected cases of Small-pox, persons who, although apparently healthy
are infected, must go free, and no power exists to demand names or addresses
for the purpose of notification. Had this power been in the hands of your
Medical Staff, it is quite possible that instead of the outbreak which did occur,
the cases would have been limited to the earlier ones alone.