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  • 991

    in north and mid-England, the following infoimationis of interest:-


    4038 Cases of Small-pox (Vaccinated)-28 under 15 years...... no deaths.

    392 " 15-30 years.... 1 death.3618 over 30 years...... 3 deaths. *

    * Two over 70 years.

    17,718 Cases of Small-pox (Uyi.MMCMtaM)10,709 under 15 yearc .... 17 deaths..5,296 " 15-30 years.... 1 death.1,713 over 30 years...... 2 deaths. *

    * One over 70 years.

    At the present time there are two distinct and.different types, one of a high degree of virulence andusually impoited from the East and Africa; the.other of extreme mildness which may have come tous from the United States where this type of diseasehas been present for many years. Even in theUnited States there have been from time to time.outbreaks of the more severe form, presumably dueto importation from outside of a more virulentstrain. In the Detroit outbreak of 1924, for instance,there was a total of 795 cases and 105 deaths.The Merseyside area has been free from small-

    pox in epidemic form for some considerable time,and it may be opportune to record the few cases of,apparently virulent type which have recently,developed in this area and have been treated at theNew Ferry isolation hospital.The first case was that of a cotton-sampler who

    fell ill about the beginning of July, 1930, but wasnot recognised to be suffering from small-pox;five is stated to have attended a doctor for influenza.This patient did not go to work after the first day ofhis illness, and for at least three weeks subsequently.The rash was scattered over body, hands, and face,and when seen, the remains of the staining wereevident. This patient infected his wife and two otherpersons, one of whom died from haemorrhagic andtoxic small-pox. After an interval of about twomonths another group of four cases developed in theneighbouring borough with one very severe confluent