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15
5. It cannot be expected that the supervision of contacts on the
lines laid down by the Ministry of Health can continue if the number of
cases increase more rapidly than at present, unless my staff is considerably
augmented.
A table showing some of the details of cases that have occurred
in the Borough during the past year is set out. The number of cases
amounted to 72, and these occurred between the 27th May and the
31st December; the difference in the figures as compared with the list
later on in the Report being due to the fact that I have set out the
total number of cases occurring during the calendar year, while the
Metropolitan Asylums Board list closed on the 28th December.
The list is divided up primarily into household infections showing
how, in the majority of instances, the cases spread through a house
owing to the absence of vaccination after the first case was removed.
In some instances, more than one family living at the same address
were infected. The largest number of cases removed from one address
was 5.
These few cases occurring at the latter end of 1929 are only a
fraction of the total number that have occurred in the Borough up to
the present date, but they show some of the particulars and manner
of spread of the disease well enough to give the reader some idea of
the situation.
As already stated, vaccination, if the immunity had not been permitted
to wane through lapse of time, zvonld have prevented every one
of these cases, just as vaccination protected the staff who dealt with
them in the Borough, and the staffs of the institutions to which they
were sent. Vaccination is always offered to persons who are known
to have been in contact to smallpox cases. Since it has been found thai
a person exposed to infection but successfully vaccinated within three
days of the exposure to infection is usually sufficiently protected to
escape infection, as the action of the vaccine is more rapid
than the action of the smallpox virus, I have starred the cases,
32 in number, zvho zvould, in my opinion, have certainly escaped
infection if they had accepted vaccination which was offered
when the first case was removed. A considerable number of those
not starred zvould in all probability have escaped also, and a certain
number have benefited by having a less sharp attack. In spite ot
the fact that many of the cases were very mild, and all of them of the
mild type as compared with the deadly variety existing in Asiatic
countries, the majority of the attacks were severe enough to be alarming
to the patient and family of the patient, and caused considerable
temporary distress. In three of the cases the appearance of the
patient was sufficiently distressing to lead me to enquire from the
County Council Medical Officer whether the hospital authorities considered
those cases of the mild type, but I was informed that they did
so consider them.