Volume 1

Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission.

  • Great Britain. Royal Commission on Vaccination
Date:
1889-1897
Catalogue details

Licence: Public Domain Mark

Credit: Reports of the Royal Commission appointed to inquire into the subject of Vaccination; with minutes of evidence and appendices / Vaccination Commission. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    46/510 (page 16)
    Assistance sought from Local Government 'Board. November nth. numbers. Source of infection of Group V. iSecond hospital breakdown. 24 hours, ciiid asking that Board to make regulations under the Epideniii- ;ind Other Diseases Prevention Act, ]8'*3. to enable the Corporation to cope with the epidemic by means of house-to liouse visitation, and the compulsory isolation of patients and of persons who had been in contact with them.* The Local Government Board declined to accede to this request j buta few days lateran inspector of the Board (Dr. T. W. Thompson) was sent to Warrington, who recommended the Sanitary Authority Inspector to adopt measures—(1.) For increased accommodation of small- iiisits town, pox patients away from inhabited dwellings ; (2.) For additions to the staff of inspectors of nuisances ; (3.) For increasing the scaven- ging staft ; (4.) For promoting facilities for vaccination and re- vaccination. Theiie were carried out on Nov. 16, as mentioned below. Group V. (November 13th to December 10th.)—102 eases. After the climax week (November \-2) we find that the weekly number only dropped to about where it had been before. 26, 25, 30, 21 persons developed the rash in the four succeeding weeks respectively. The fact that 88 persons developed the rash during the week ended November 12th has been mentioned. This figure, added to the 131 cases already in hospital at the commencement of that week, makes a total of 21.9 cases to be dealt with on the date named. But, even with the additional accommodation provided, it was impos- sible to find room for all the cases which arose diir- ing this week, and thus a second deficiency in the hospital accommodation took place. Fifty-nine of the 88 persons attacked during the climax week lacked prompt removal, being at home three or more days with the rash out, chiefly forwant of room in the New Flospital. Hence the weekly numbers during the four weeks now under con- sideration' (November 13 to December 10) only dropped back to their former position, albeit the means of recognition (by experience), notification, Were gradually becoming more perfect. and removal On-November 2nd the public vaccinator asked the guardians to be enabled to vaccinate upon an additional day eacli week, but the guardians refused permission. On November 16th, in pursuance of recommendations from Dr. Thompson, one of the Inspectors of the Local Government Board, theruardians afforded increased facilities for re-vaccina- tion, (1) by opening the public vaccination station on an additional afternoon and an evening each week ; and (2) by appointing two assistants to the vaccination officer for house-to-house visitation. All to remain in force for six months. In pursuance of resolutions adopted at a meeting of the medical men in Warrington, the Town Council empowered the medical officer of healtli to establish five stations for gratuitous vaccina- tion in the borough, and to secure the services of five medical practitioners to perform vaccination. Placards urging the inhabitants to be re-vaccinated were posted over the town. During the later part of November and early part of December large numbers of people flocked to the vaccination stations, now seven in number, to be re-vaccinated. November 2nd, J 892. Novembef 16th, 1892. The guar- dians yield. December Uh, 1892. Five extra vaccination stations. Placards,' Group VI. (December 11th to May 10th.)—187 cases. December But why pursue the narrative further P Up to Decem- nth. ijer 10th '!60 cases had been notified. The houses, shops, inns, and other places of public resort in the town were by this time pervaded with the poison. On the other hand the inhabitants were now inore on the look-out for the disease, t were more fully ahve to its contagious and fatal nature, and were now doing their best, in their own simple wav, to co-operate with the authorities- to check its spread bv avoiding coritagion and getting re-vaccinated; the doctors by experience were more ready to recognise^ its earliest manifestations; and lastly, the authorities, now ar','Used, were able to cope with the more moderate number of fresh cases. We may perhaps also assume that the number of susceptible people was daily lessening ? It is estimated by the Medical Officer of Health that over one-third of the population had been re-vaccinated by the middle of December. Taking always the persons who developed the eruptions during the week, the weekly numbers dropped on December 17th to 7, and ensuing weeks to 10, 6, 7, &c. {vide Chart, p. 8). The average number of cases per week from December 11 to May 10th was eight. Once only was there any marked deviation above this, during the week ended April 1st, when 18 cases developed the rash. If we examine the nine cases which developed the rash on the 10 days ended March 19th, i.e., two weeks before, ice find that three of those nine cases remained at home with the eruption out for four, six, and five days respectively. Then the weekly numbers dropped again. Throughout the epidemic the daily and weekly number of cases preserved the usual wave-like character. Finally, the numbers became less and less, gradually but irregularly, like the waves of a receding tide. Weekly numbers. Summary. Ghronological Summary of action of Local Sani- tary Authority, and of Central Authority,as regards Hospital Provision. 1881. Borough Infectious Diseases Hospital (Aikin Street) provided with 28 beds. 1888.—Dcecker Tent (two beds) added. Total 30 beds, or one bed for every 1,800 inhabitants in 1892. August 1890.—Provision made for enlargement of existing hospital for infectious disease in the Warrington Extension and Water Act, 1890. May 1892.—Medical Ofiicer of Health urges, for a second time, the need for better provision for small- pox and fever. June 1892.—Town Council decide to negotiate for one acre of ground near the Old Borough Fever Hospital, as the time limit of two years provided in the Aet of 1890 will shortly expire. * The Act of 1883 only confers borrowing powers. Appliofition had not been made under Section 13i, Public Health Act, 1875, wjuch confers powers on the Local Government Board to mo.ke Megulattons ''n time of danger as reirards Enirland. ■ , a. + Many cases were detected and notitied to tiie medical officer of health by th,T relatives of the patients. July 1892.—Medical Offlcei of Health again presses, pointing out that accommodation is inadequate even for scarlet fever. Aug. 23, 1892.—Town Council ask Local Government Board to sanction loan of 800/. to provide tem- jjorary small-pox accommodation. Aug. 2G, 1892.—Doecker Hut accidentally burnt down. Sept. 19th, 1892.—Opening of the disused ironworks for reception of small-pox cases. (Temporary or Hope Hospital in Dallam Lane.) Nov. 8th, 1892.—Corporation ask the Local Government Board to make special regulations (under Act of 1883) to enable them to cope with epidemic. Nov. 11th, 1892.—Local Government Board inspector visits the town and recommends Corporation to provide further accoininodation for small-pox, removed as fa.v as possible from inhabited dwellings.