Smallpox, 1961-62.

Great Britain. Ministry of Health.

Date:: 1963

Catalogue details

Licence: Public Domain Mark

Credit: Smallpox, 1961-62. Source: Wellcome Collection.

18/80 (page 10)

EVOLUTION OF THE OUTBREAK The five Pakistanis who subsequently developed smallpox after arrival in this country dispersed in the way described in the previous section. Their established or assumed relationship with indigenous cases is indicated at Figure II. The position of cases $.74, $.119 and particularly $.283 and §.381 remained uncertain. In this section the evolution of the outbreak in this country will be considered in relation to each of the geographical areas to which the importations travelled. Greater London Area Importation No. 1 may well have been ill on arrival at the airport. Persons who were most likely to have been placed at risk were his fellow countrymen who travelled with him in the taxi from London Air Terminal to St. Pancras, the occupants of the house in which his cousin and his wife lived and of the tenement in which he spent the nights of Christmas Eve and Christmas Day, and those who were present in the Casualty Depart- ment at University College Hospital during his examination there. Of those thus observed only two gave rise to serious anxiety. The first of these was the taxi driver who drove the patient and his compatriots from the Air Terminal to St. Pancras. He was successfully re-vaccinated on 30th December. On 7th January he produced a crop of vesicles on both forearms but these were similar to lesions he had had many times before. A member of the Smallpox Panel felt he could not totally exclude smallpox in this case and the patient was therefore admitted to Long Reach Smallpox Hospital, Dartford, Kent. Subsequent laboratory tests proved negative. The other contact who caused anxiety was the wife of the patient’s cousin ; it will be remembered that she had nursed the imported case during the daytime from the time of his arrival in St. Pancras until she accom- panied him to University College Hospital. She had been vaccinated in infancy and had shown a strong accelerated response to re-vaccination, which had been performed on 28th December. On 11th January she developed two tiny macules on her hands and her ‘temperature, which had been sub-normal, rose to above normal. On the next day one lesion under her wedding ring became papular. Expert opinion was against smallpox but, as her temperature rose to 100°F. that night, it was thought wise to admit her to Long Reach Smallpox Hospital. Next day her temperature settled and all laboratory investigations were negative. She was not notified or recorded as a case of smallpox but the possibility of this being a case of variola sine eruptione cannot be absolutely excluded. Thus there were no notified cases of smallpox directly associated with this importation. However, two unexplained cases arose in the Greater London area during the first three weeks of January. The significance of these is discussed in Section III. The first (S.74) was in an insurance - agent living in Woolwich Metropolitan Borough but based, for business