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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    THE INITIAL FEVER. In most cases the temperature was elevated in the prodromal stage. The highest temperature recorded was 105°. Chart 1 shows the typical tempera- ture of onset. In most cases the fever subsided rapidly to normal on the appearance of the eruption. The duration of the invasion stage varied. The eruption most frequently appeared four days after the onset of symptoms, but it was delayed undoubtedly in some cases to as late as the tenth. In 755 cases, the erup- tion appeared in 9 on the same day, in 28 one day, 76 two, 135 three, 205 four, 154 five, 80 six, 51 seven, 10 eight, 4 nine, and 3 ten days after the first symptoms. QUIESCENT PERIOD. In many instances a quiescent period between the subsidence of the initial symptoms and the appearance of the eruption was noted. Patients after being in bed one or two days felt perfectly recovered and returned to their work, the eruption appearing at various intervals afterwards. Two hundred and twenty-nine patients gave that history, 76 having a remission of one day, 78 of two days, 43 three days, 20 four days, 7 five days, 2 six days, 2 seven days, and 1 eight days. A remission of two days was noted in a contact who developed the erup- tion in the Station, but the temperature did not reach normal until the rash appeared, although relief was obtained from symptoms. PRODROMAL RASHES. In two cases rashes were recorded in the prodromal period, but had disappeared before the patients’ arrival in quarantine. Their histories are given below :— Case T. J., female, aged five months.—On the 11th September, 1913, seemed feverish and restless. This lasted until the 15th. On the 16th September, 1913, the mother states a rash “ like measles only smaller ” appeared on the back and nowhere else. It felt slightly rough to the touch. The spots were minute and red in colour (no white or yellow heads), and were thickly set all over the back. The rash became fainter the next day, 18th, when the small-pox eruption appeared on the face, buttocks, and back. On admittance to the Station on the 23rd September, 1913, no trace of the first rash was visible. The child had a very slight eruption, the back only having a few lesions. Case E. C., female, aged 32.—On 26th September, 1913, patient complained of frontal headache, pains in back from the shoulders down, aching in the legs and arms, and shivering. The symptoms lasted five days. On day of onset a rash “ like prickly heat ” appeared on the back of the left hand, inner side of knees, and right round the back of the thighs (in this order). The rash was very itchy and rough to touch, and consisted of little red papules with no white or clear heads. This was probably vaccinal, as patient was vaccinated on 1st September, 1913, a “ mulberry ” reaction resulting. It