DR. CAMERONasked the President of the Local Government Board, Whether his attention has been called to the alarming increase of small-pox in London; whether revaccination of persons exposed to infection is regarded by his medical advisers as constituting a most effective mode of preventing the spread of the disease; whether, in London, it is the duty of local medical officers of health to report cases of smallpox to vaccinating officers, whose duty it is to inform public vaccinators, whose duty it is to send the persons concerned handbills informing them that on certain days, at certain hours, and in certain stations, they may, if they choose, be revaccinated without charge; whether he is aware that in Glasgow, and other large towns, all this circumlocution is avoided, and the medical officer of health personally looks after the isolation of small-pox cases, and sees that revaccination is promptly offered to all 1173 who have been exposed to the infection; and, whether he will recommend the appropriation of a few hundred pounds to encourage medical officers of health in London to undertake the same work, and test whether outbreaks of small-pox in the Metropolis may not be controlled as cheaply, speedily, and effectually as they have repeatedly been in Glasgow?
§ SIR CHARLES W. DILKEWe are aware of the large increase in the number of small-pox cases in the Metropolis during the last eight weeks. The re-vaccination of persons exposed to infection is regarded by the medical adviser of the Board as constituting a most effective mode of preventing the spread of the disease. The Question does not accurately set forth the duties of the medical officers of health and the public vaccinators. What is or should be done on the occurrence of small-pox is that the vaccination officer, with such assistance as the Guardians may give him for the occasion, should make detailed visits to the houses in infected streets, for the purpose of detecting any children who may not have been vaccinated, and of urging re-vaccination on adults and adolescents who have not already been re-vaccinated, and who are exposed to danger of small-pox infection. The object of this special visiting is to urge people to apply, without loss of time, for vaccination and re-vaccination, and to apply at the place where it is provided in the best form, and will be practised with the best success. Special places for re-vaccination in this form are frequently provided by Guardians to meet the convenience of special classes of people. These measures have repeatedly been carried into effect through a Union with excellent results, and the Board loses no opportunity of commending them to Guardians. It may further be mentioned, with regard to the Metropolis, that in the case of persons who are removed to asylums of the managers —and these constitute a very large proportion of the cases of small-pox occurring in London—the patients are, as a rule, in the first instance, attended by the district medical officer, and the Vaccination Acts contemplate that where a medical officer attends a person suffering from small-pox, he may at once vaccinate or re-vaccinate any of the inmates 1174 of the house, where such operation is required, and be paid for the vaccination or re-vaccination the same fee as the public vaccinator would have been entitled to receive. Under similar circumstances, the public vaccinator might re-vaccinate other than at the usual station; and the vaccination officer would, doubtless, where necessary, give notice for the purpose. As the Board understand, re-vaccination at Glasgow under circumstances of hazard is then and there performed by the medical officer of health. As already stated, in exceptional cases, the vaccination may be performed at once in England also, although it is not part of the general system on which English vaccination proceeds. The last part of the Question raises the point whether—as, indeed, was advised by the Royal Commission on Hospitals—the vaccination arrangements should not be transferred from Boards of Guardians in the Metropolis to the sanitary authorities. This is a question which, at the present moment, when material changes are proposed in the constitution of the Metropolitan sanitary authorities, cannot well be determined; but it is a matter which must receive full consideration as soon as such changes have been made.
DR. CAMERONIn order that it may receive consideration, I beg to give Notice that on the first available opportunity in Supply I will call attention to the different results of the Glasgow and London systems.