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were no deaths. This type of the disease, however, was of the
very mild variety sometimes called Alastrim to differentiate it
from the severe or Asiatic type.
1930 saw an increase in the number of cases of this type of
smallpox, the number notified being no fewer than 493, one of
which was fatal. Happily, the disease this year also was of the
mild type and not in any way comparable with the Asiatic type
of the disease which had been experienced in 1901, when of 396
persons notified as suffering from smallpox, 71 died. Nevertheless,
the work falling upon the Department was enormous, for in addition
to the 493 cases referred to, 8,361 contacts had to be kept under
supervision. It is a peculiar fact, but experience has shown that
the virulent type of smallpox is much more easily extinguished
in this country than the milder type, since because of the publicity
given to the deaths resulting from the former type the public
becomes alarmed and co-operates more readily with the local
authority in all measures of control. This was borne out during the
recent outbreak of smallpox in Brighton when the public queued
up to be vaccinated, whereas with the milder type it is often necessary
to use considerable persuasion before vaccination is accepted.
In this year, as a means of identifying smallpox in the early
stages of the disease, the Council made Chicken Pox notifiable and
648 cases of this latter disease were notified.
An epidemic of Measles which developed in London towards
the end of 1929 but did not reach Hackney until February, 1930
placed considerable strain upon the infectious hospital accommodation
which was already much in demand because of the smallpox
epidemic, and in January, 1930, the Metropolitan Asylums Board,
at that time the authority controlling infectious hospitals, found it
necessary to reintroduce a scheme formulated in 1926 under which
applications for the admission of cases of measles and scarlet fever
were referred to the local medical officer of health for investigation
of the facilities for isolation and treatment in the homes of the
patients.
This selection of cases for removal to hospital continued
until April, 1930, and proved so satisfactory an arrangement that
in my Annual Report for that year I was able to state " .... I am
pleased to report that the delay in securing the admission of cases of
measles and scarlet fever was in no case of longer duration than a
day or two. On the other hand the prompt removal of cases from
overcrowded homes and of cases in urgent need of hospital treatment
was ensured.''
Although measles was not notifiable in Hackney, no fewer
than 2,461 cases came to the notice of the Public Health