Printed in “As We See It”

Smallpox Epidemics

IN view of the fact that there have been recent outbreaks of smallpox in severe form in California, Texas, Oklahoma, Pennsylvania, and Maryland, it is well to give attention to an editorial article in the Cleveland Medical Journal of January, protesting against the fact that there are now 20,000 unvaccinated children in the public schools of that city. This journal says: —

“The memory of man is truly brief. It is only ten years since the close of an epidemic costing the city over $3oo,000, and incidentally resulting in some 250 deaths. It is only two years since the close of a smaller epidemic, which would have reached larger proportions but for the prompt and vigorous action of the board of health, and yet in spite of these examples, the presence of this large unprotected population is apparently looked on with equanimity, not to say cheerfulness. Let us refresh our memory as regards these two epidemics. In 1901 there was an extensive outbreak of a mild type, during which there was no serious attempt at general vaccination. As a result the people were not protected and in 1902 a far more serious epidemic occurred.”

Then follows a report of the health officer of the city for 1902, describing a recent epidemic of 1,248 cases, of whom 224 died, a death-rate of 17.95 per cent. Owing to the strenuous opposition to vaccination, the school council had to make vaccination a compulsory prerequisite to attendance at school, and a physician was placed in each school to attend to it. Employers urged vaccination upon their employees, and advised them to have their families vaccinated. The city paid for 195,000 vaccinations, paying only for those that were successful. The epidemic disappeared, and during the next two years there were less than 15o cases.

No epidemic followed until 1910, when an outbreak in the southeast threatened the entire city. By isolation and vaccination of 55,000 children, this epidemic was checked. Since then no serious outbreak, but with the presence of new accretions of unvaccinated persons, the Journal has some reason to fear the consequences in case of another outbreak.

Printed in “News Notes”

Unvaccinated Children Barred.— Because they failed to observe the order for vaccination, 2,40o pupils were recently barred from the schools in Berkeley, Cal., and 500 in Evansville, Ind. It seems hard, but not so hard as a smallpox epidemic.