Small-pox epidemic in New South Wales, 1913 / by D. G. Robertson.

  • Robertson, D. G.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Small-pox epidemic in New South Wales, 1913 / by D. G. Robertson. 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.

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    In some instances successful vaccination performed after exposure to small-pox seems to have aborted the disease before the appearance of the eruption, although the patient had acquired the disease. Several contacts admitted to the Station were isolated on account of developing the typical symptoms of onset of small-pox. They were acutely ill for a few days, with high temperature, and complaining of severe headache, vertigo, backache, shivering, vomiting, epigastric pains, and general aches and pains, and then these symptoms suddenly subsided without any eruption. These symptoms most frequently appeared from the fifth to the ninth day after inoculation, and were definitely those of variola onset and not symptoms of vaccinia. THE PERIOD OF INVASION. The symptoms of onset were not recorded in a number of cases, and could not be elicited in young children, but reliable histories were obtained in 722 cases. Of these, 37 had no symptoms whatever prior to the eruption. In the others the symptoms most frequently noted were headache, backache, shiver- ing, vertigo, vomiting and nausea, aches and pains in the limbs and joints, and abdominal pains. Fifty-six of these were not sufficiently prostrated to cause them to retire to bed, and many of them followed their usual occupation until discovery. The most constant feature was headache. This occurred in 627, or 86 per cent. The headache was usually frontal, but occasionally occipital. Back- ache was present in 452, or 62 per cent. It was usually referred to the sacrum or across the loins. Shivering occurred in 427, or 59 per cent. This was usually merely an uncomfortable feeling of chilliness. Actual rigors were uncommon. Vertigo was present in 317, or 43 per cent. This symptom was very severe in some cases, and sometimes was present without any headache. Vomiting and nausea occurred in 389, or 54 per cent. Actual vomiting occurred in 299, or 41 per cent. Pains and aching in the limbs and joints were present in 298, or 41 per cent. Many of these compared the feeling as similar to “ having been beaten all over with a stick.” Abdominal pains, usually referred to the epigastrium, occurred in 89, or 13 per cent. Anorexia and insomnia were usually noted. Drowsiness was frequently present, and in young children was the com- monest initial feature. Convulsions occurred in two children, one three and the other eleven years of age. Sore throat, pains in the chest, pains in the shoulders and back of neck, diarrhoea were all occasionally complained of. Delirium was not uncommon. In some cases the spleen was definitely enlarged, sufficiently so as to be easily palpated. This subsided rapidly after the appearance of the eruption. The symptoms of onset #,re most frequently mistaken for influenza. Eleven cases were admitted into the wards of the Sydney hospitals, five being diagnosed as enteric fever, one as appendicitis, four as abdominal cases for observation, and one, seven months pregnant, was admitted into the Royal Hospital for women under the impression that labour was setting in. As a rule, these symptoms subsided as soon as the eruntion appeared, but in 40 cases they continued after, in 21 for one day, in 12 for two, in 5 for three, and in 2 for four days. Backache is quite commonly complained of in severe cases for several days after the eruption.