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In many cases the patients were absent from their employment for
some clays before the onset of the disease.
When visiting contacts we never advised them to remain away from
work, but most employers insisted on a certificate from me that they could
go to work. Every applicant for such certificate was seen by me or my
Deputy and in cases of hardship where employers would not permit their
employees to resume work we endeavoured to get them to alter their decision,
and very often were successful in so doing. Large business firms insisted
on the employees being vaccinated and by taking this precautionary measure
no secondary cases occurred.
In addition to the Stepney contacts of our own patients we received
information of 1,200 contacts from 48 other districts. One Borough sent
us 393, another 275, and another 144. These contacts either resided,
worked in, or visited the borough. They were all visited from time to time.
The number of contacts resident in Stepney, working at various firms
outside the Borough was considerable. They were all visited at their home
addresses. Vaccination was offered to all contacts and a good many availed
themselves of it. It is worthy of note that no contacts who had recently
been vaccinated contracted the disease and all the people who did contract
Small Pox had not been recently vaccinated before exposure to infection.
During the year the number of our contacts residing or working in the
borough ran into thousands and a great deal of the time of the Sanitary
Inspectors was taken up in visiting them. A vast amount of clerical work
was also involved.
On one or two occasions where a man informed us he had been vaccinated
in the Army during the War we found that he developed Small Pox. On
going into the history of the case very carefully we were able to prove that
the man had not been vaccinated in the Army but had been inoculated for
Typhoid fever.
I have also noticed that when we were called in to see a contact with
"spots" who had been successfully vaccinated 12 days previously, the patient
almost invariably proved to be suffering from Small Pox.
Another interesting point in my experience is that where persons had
been vaccinated twice—once in infancy and once in adult life—we have never
found Small Pox to develop in such cases. These persons had been exposed
to infection in the same degree as other members of the household and yet
they escaped the disease whilst the unvaccinated members in the majority
of cases contracted the disease.