MORE AUCKLAND CASES. MILD SMALLPOX. DEPARTMENT'S VIEW GRAVE/ CABINET TO MEET DAILY. RUSH TO BE VACCINATED. The opidomic of smallpox which hag made its appearaaco in tho Auckland Province, appears to be slowly but surely spreading south. New eases arc being reported daily in various districts of the Country and tho Waikato, especially in places where thcro is nf considerable population of Maoris. Tlie Health Dcpartmont is taking a serious view of tlie situation,- and rigorous measures aro being resorted to. Tho officers of thq Department arc working night' and day, and the medical officers especially ara liaving a strenuous timo. In tho laboratory at Wellington tho staff is busily engaged profaring largo supplies of lymph for immediate distribution. Work proceeded throughout yesterday, and tho officers havo promise of a very full week. Several new cases have been reported from various localities to tho head ofiico of the Department. Ono case has been admitted to the Auckland Infeotious Diseases Hospital, making a total of twenty now under treatment. There were also three cases from To Awamutu, four from Taupiri (Ifuntly), three from Otorolianga, and one from Thames. Ono of (lie patients at Taupiri lias died, but Dr. Douglas is of tho opinion that smallpox was not tho direct causo of death. All these cases havo been isolated, and tho contacts vaccinated. LYMPH SUPPLY. The demands for lymph havo become so great t'nat tho Department has decided to limit tho supply until Wednesday to tho Infected districts only. All other districts have a sufficient supply on hand fov immediate use, but further consignments will be sent after Wednesday. It is apparent' that considerable waste of lymph has been oocurring, and the Department urges on practitioners the greatest economy in its uso. Somo vaccinators aro able to operate on fivcj different subjects with the contents of one tube, whilst somo others uso a whole tuba per patient. Tho 6upnly of lymph in.-'stock in tlie laboratory totals 10,000 tubes. By Wednesday another 15,000 tubes will have boon prepared, and an. Saturday an additional 20,000 tubes will be ready. Dr. Frengley, who went to Auckland by the Main Trunk express on Saturday took with him 3000 tubes. Yesterday afternoon a special ongino left Wellington for Auckland with an additional 5000 tubes. A parcel of 250 tubes was sent bji the same train to To,Awamutu. Other (supplies already distributed. Sncludo 100 tubes to New Plymouth, 100 to Hawera, 50 to Stratford. 200 to Wanganui, 200 to Palmerston North, 200 to Napier, 200 to Waipawa, 'and 200 to the Wairarnpa, BUSY OFFICERS. The medical officers of tho Department havo mostly been sent to tho infected areas. Dr. Frcngley is in Auckland, whero ho is co-operating with Dr. Honk, tlie local health officer. Dr. Cawkwell is in the Whangarei district, and proceeds north to ICaikohe to-day. Dr. Elizabeth Gunn, who wont up with Dr. Frengley, is in tho King Country. She proceads'from To Kuiti to Otorolianga, and thenco to tho Wailcato. Dr. Elearnor Baker is at Kaihu (North Auckland), and will journey .through tho districts on the West Coast. Dr. Ross, of tho Mental Hospitals Department, who has had considerable experience in BUoh epidemics, and who Is at present in clmrgo of tho Waitati Mental • Hospital, near Dunedin, Teports for duty to tho Public Health Department to-morrow, and will probably bo sent to one of tho infected districts in tho Waikato. All the other officers of tho Department aro at their regular posts, lifting required for administrative work. Hospital Iwards. throughout the Dominion havo been warned, if necessary, to appoint special medical officers iB case of «n outbreak, as the officers of the Department cannot possibly give tin? immediate attention neoessary to every new case reported. It appears that the report of tho epidemic in certain districts of North Auckland has been greatly exaggerated. Dr. Cawkwell reports from Whangarei that notification has been received of 300 suspected eases in tho Mmuigakawhia district. After going thoroughly through the distriot, ho oould himselt only discover one caso. Dr. Baker reports "all clear" in the Kaipara district. Tho vaccination of passengers and sear men leaving Wellington for the South-Is-land is being thoroughly and systematically carried out by a staff of local practitioners, under the direction of Dr. Pollen. On Saturday 330 persons were vaccinated on various vessels. No action has so far been taken with Tegard to railway passengers from stations in the Wellington province, beyond tho notification to Maoris and half-oasies that they liiay not travel on the trains, unless they can produce a certificate of successful vaccination. This notification appears in tho prinoipal newspapers throughout the Dominion to-day. Tho police aro eo-oporat-ing to enforCo this regulation, and also the isolation of suspected cases, , Officers of tho public services, whoso duties necessarily expose thtem to somo danger, aro being generally vaccinated. FUMIGATING MAILS. In ordor to prevent tho spread' of tho diseaso through documents and papers, which seems to liavla. occurred in Auc-k----land, where officers of the Nativo Lands Department havo beoomo affected, fumigation of tho mails is now being resorted to. For som*> timo past overseas mails arriving' at Auckland lirvo boeii fumigated by order of tho Health Department, but it lias only been carried out in Wellington since Saturday. Instructions have been given to this Secretary of tho Post and Telegraph Department that m future all mails irom overseas and from infocted areas must bo fumigated. CITY VACCINATIONS. Vaccination is proceeding apaco in Wellington, and hundreds of citizens aro taking tho opportunity of rendering themselves Immune from tho threatened disease. It is safe to predict that a week hence, when tho vaccine will bo "doing its worst" to those who aro now being treated, signs of tho fashionablo operation will bo easily discernible in the city strcots. In order to facilitate tho carrying out of tho work, and to savo the timo of practitioners, tho Department has arranged that public vaccinators will bo in nttendanco at tho offices of the Hospital and Charitablo Aid Board in Marion Street, between tho hours of 9 a.m. and 1 p.m., and 2 p.m. and 0 p.m. daily, until further notice. Vaccination is free, but the praotitionera receivo a fee of 2s. Gd. from tho Government for ovory operation performed. There is accordingly soniewlirt of a harvest for the doctors m such a situation as tho present. Tho Department wishes it to lie particularly understood that only pure calf lymph supplied by tho Government is used. Tho old system of arm-to-arm vaccination is now illegal. .It is probable that tho general vaccinntion of school children may bo ordered. DR. VALINTINE'S REMARKS. Discussing tho situation with a Dominion representative yesterday afternoon, Dr. T. A. H. Valintine, Chief Health Officer for tho Dominion, who is directing tho campaign against tho outbreak, made some interesting remarks. Although by tho law of the land vaccination of cliildrc.il is compulsory (a summary tvf the Act appears below), Dr. Valintine admitted that for yoare tho law had been practically in abeyaneo. No Government would enforce tho Act. Very largo, numbers of. exemptions wore granted, and tlio proportion of children vaccinated was absurdly small. In his last annua] report 'to Parliament, ho had pointed out that only 2000 children, out of 20.000 born during the year, had hern operated on. Out of 8000 observed ra.-'cs, it had been foiLU/1 that 72 per cent, were unvaecinabed. The, statement in tho Ho'.-." «• if
per cent, o'f children bom nowadays arf treated was not far irrong. Tho value of vaccination in caso of a smallpox epidemic was undoubted, said Dr. Vulintiho. Tho history of tho dis caso proved that in modern epidemic only about 2J per cent of the cases wen of vaccinated people. In tlio present out break his officers had reported that not a single case of a vaccinated contact coie tracting the diseaso had so far occurred Tho protection afforded bv vaccinatioi lasted a long tirap, and: there was n« doubt that a person onco treated had somo measure of protection throughout life. Nevertheless, it was advisable, if tho full measure of protection wore de< sired, for revaccination to take'ploco a' periods of about soven. years. CABINET MEETS. Cabinet sat on Saturday morning Co' consider measures recommended by tho Health Department for tho suppression o] tho opidomic which has brokeiu ?ut ia tho north, and will hold daily sittings fon the same purpose as long as it is con-' sidered necessary to do so. At tho conclusion of Saturday'? meeting tho Prlmo Minister informed a Voporter that a> proclamation had bcon issued in European' and in Maori languages, prohibiting Notives travelling from the infected arcarf without vaccination certificates. The Prime Minister expressed liia do< cidod opinion that there was no occasion tor panic or even for sorious alarm, al) though ho fully recognised tlio wisdou' of taking all possiblo precautious. M.P.'S VACCINATED. : ' 'Animated discussion as to tho merit# and demerits of vaocinatioii reigned' 6U* preme in the Parliamentary lobbies on Saturday. Tho Hon. E. H. Rhodes (Minister for Public Health) stated in tlio Houto on l-nday night that ho was going south on Saturday evening, and added: "I will bo vaccinated before I go." He was an good as his word, and on Saturday morning afforded members and others connected with the Parliament Buildings an opportunity of undergoing tho ordoal oE mooulation, Dr, Elizabeth Platts-Mills' was m attendance and. n corner of tho tea-room was screened off to servo as 9 surgery, Sir Walter Buohanan, tho vet< cran member for Wairarapa. was tho first member of Parliament to bare his arm and set an examplo to his brother legis. Jators. Mr, Nosworthy (the South. ls« land Government Whip) was next in ?«*». I"' 1 Mr- Dickson (Parncll) enmo third. The Minister for Publio Health, and tho Minister for Finance (tho Hon. Jas. Allen) were amongst those who camo up to the "scratoh," and a little later tlio Speaker of the House (tho Hon. F, W. Lang) bared his arm to tho doctor's needle. Dr. Valintine (Chief Health Officer) vaccinated himself in tho presence of an interested knot of spectators. In all, nearly twenty members oi tho Houso wero ■ vaccinated, thi number including, in addition to those mentioned, Messrs. Guthrie, (Senior Government Whip), M'auder Okoy, Statham, Young, Sykes, G. M. Jhoinson, G. AV. Russell, MaCdonald, and M Galium. Tho Scrgennt-at-Arms (Major Shepherd), and 6everal officials, including some of tho Ministers' private secretaries, and a number of messcngors, wero also ■ inoculated; ;The total number of vaccinations performed in tho Buildings during tho morning was thirty-four. One or two members also had thoir wives and children vaccinated. It is interesting ■to notio< though possibly it is only a coincidence, that nearly all tho members of tho House who wero vaccinated aro Government supporters. Tho threo members of i the Op« position who attendod Dr. Platts-Mills's reception weres Mr. Russell (ox-Minister for Publio Health), Mr. Macdonald, and Mr. M'Callum (tho last-named ivasleav-* ing on a visit to his homo in tho South' Island yesterday). HOW TO TELL THE DISEASE. Few other diseases have been so de. structive to human life as smallpox, and it has evofr been regarded with horror, alike from its fatality, its loathsome accompaniments, and disfiguring effects, and' from tho fact that no ago and condition, of lifo aro exempt from liability. Except' in tho caso of those protected by vaccinaimmunity is rare. Nevertheless, even in civilised countries epidemic outbreaks aro not uncommon, ailecting especially: those who are unprotected, or whoso protection lias bocome woakened by lapse of, time. Ono attack of the diseaso docs not invariably protect for lifo. A competent' medical observer has recorded 92 oases of recurrent smallpox out of 12,000, ' The diseaso has beon known in Europ# sinco tho thirteenth century, and opU demies have been fre<iuont over einco, Tlio only, known factor in tho origin of tho diseaso is contagion,- tho malady beinff probably the most contagious of all diseases. Ita outbreak as an opldemio in. any particular form and in any particular locality may frequently bo traced to tho introduction of a singlo caso from a dis-! lance. This is, of course, tho chief danger of an outbreak at tho present moment. By far tho most common cause of con-l voyanco of tho disoaso, is contact with tha persons or tho immediate surroundings oi those already nffectcd, Tho atmosphera around a smallpox patient is charged with tho products of tho disease, which din? to furniture, clothing, oto. Dark-skinned races aro moio susceptiblo to tho disease than white people. Overcrowding, and all insanitary surroundings, favour tlio sproaA of tlio diseaso when it has broken out. ' The symptoms of smallpox aro essentially the samo im charactor in all cases, although they may; bo modified according to tho form which tho diseaso may assume, thero being certain well-marked variotios of this, as of most other infectious maladies. TJio period of incubation extends froin alxxiit ten to fourteen dnyn after the reception into the system of tha contagion. During this period tho patient may or may not complain. Tho invasion of tho symptoms js sudden and severe, in tho form of a rigour, followed by fever, in which tho temperature rises to 103 deg. Fa'lir. Amongst other symptoms aro intense headache, vomiting, and pain in tho back, and occasionally convulsions. On the .third day tho characteristic eruption begins to make Its a-ppearanco. It is almost always first seen on tho face, particularly about tho roots of tho hair, in the form of a general redness. Tho eruption, which is accompanied by heat and itching, spreads over tho body and extremities m tlio .course of a few hours. Gradually tho pocks bwomo vcseiles nlxmfe, tho size of a pea, filled with a clear fluid, which gradually becomes turbid. Tha eruption is present also on mucous mem' branes, that of tlio throat and mouth being affected at am early period. , Tlio febrile symptoms which ushered in tli« disease undergo marked abatement on th<] appearance of tho eruption on the third day,.but on tho eighth or ninfch> when tlio voscilos become converted into pustules, t.harc is a return of tlio fever, ofton to a severo oxtont. On the aloventlu or twelfth dav t.lio pustules show signs'of drying up,'and along with this tho febrilo symptoms gradually deoline. Great, itching of the skin attends.this stag«. Tlio; eruptanns produced by the dried pustules' fall off, and a reddish brown spot remains, which, according to the depth of 6l;in involved in the disease, leaves a, permanent white depressed. sear-this "pitting" sa characteristic of smallpox being Bpociallv marked on tho face.. Tho mortality attending smallpox opi, demies varies largely, according to circumstnncos. In somo outbreaks tho tyj>o of the disease is much more tovero than in others, and the mortality consequently, greater. In 1901 and 1003 tljcro werp epi-J demies in tho United States, in which itl was only 2 per cent. In ono Philadelphia' outbreak it was 27 per cent, in 7201 cases, while in tho Glasgow epidemic of IDOO-OL' it reached 52 per cent, in the ulivaccinatea' and 10 per cent, in tho vaccinated. Tho deaths from smallpox ill tte United King-, dom deolinod from MM in 1002 to 12. in 1008, the deaths duo to the disenno in portion to every million living being proximately 75 and 0.3. VACCINATION & THE ACTv Vaccination is compulsory in New Zes, liind. The provisions of the law with roi gard to His matter constitute Part IV off tlio Public Health Act, 1908, being Sec-i tions 150 to 165. The following summary-, of this part of tho Act should bo valuablo, ns a guido to tlioso who uro familiar withThe Act provides that tlio Governor may from timo to timo constitute,vac-, cinalion districts, and may appoint within' those districts convenient places to be vaccination stations, at which 1 vaccination shall bo performed by tlio public vaccinators. The officers to bo appointed include publio vaccinators, vaccination insiwctors, and certifying officers, all of whom aro assigned definito duties. .Only medical practitionm may act as certifying officers, and except in tlio case of medical praotitioners, no person shall be deemed to bo qualified for appointment as a public vaccinator until certified to by a certifying officer as n component and proper poison for apliointmeiit. It is only in exceptional cir< cumslances that any but mediofll practi<
tionors are to bo appointed. Public vaccinators must attend at the vaccination stations at specified times to vaccinate -persona who present themselves,, and to observe tho progress of tho vaccination. It is tho duty of tho registrar, when the >birtli of a child is registered, to givo to tho custodian or parent of tits child "written notice that the child must be - and where and when the operation can bo performed. Vaccination must then bo carried out within twelve .months. If tho public vaccinator or medical practitioner to whom the child is taken is of the opinion that tho child is in a fit state to bo successfully or safely vaccinated at the time, he must hand ■,to tho parent a certificate of postpone'ment. If ho is of opinion that a child .whom he has three times unsuccessfully .vaccinated is not susceptible of successful [vaccination, and that tho child has alxeady had smallpox, ha shall give a cer'tiiicato of exemption. Persons over tho 'ago of fourteen years may present themselves for vaccination or re-vaccination, and the public vaccinator shall perforin :the operation if ho is satisfied it can safeily bo done. A return for examination 'on tho seventh day- following the operation is compulsory. All persons received into prisons, reformatories, industrial 'schools, hospitals, lunatio asylums, chari■table- institutions, etc., must bo vaccin'ated, unless they can show that the operation has'been performed within the preceding five years. Children attending 'public schools must also bo vaccinated. Penalties aro provided for non-complianco with the provisions of tho Act. If, after ' tho receipt of notice from an officer, a ; parent-,or custodian neglects to have a child vaccinated, he renders himself liable to a fine not . exceeding £2. A penalty ' not exceeding .£lO is provided for the- offence of using any but pure lymph, taken from a healthy heifer, and supplied by tho Government. A certificate of exemption may be granted by a magistrate or < registrar to any parent who within four V months after the birth of a child deolares What ; ho is conscientiously, of tho opinion that vaccination would be prejudicial to the. child's health. There are further provisions for the supply ,of lymph at convenient places throughout the Dominion, for tho remuneration of officers, etc. , COINCIDENCE. SMALLPOX & COLD WEATHER, "It's a rather strange thing," said a visitor to Wellington, who has' lived in India, "but the outbreaks of smallpox there usually occur in the cold weather, ■ and t hero in a temperate zone it has brok'en out at what is absolutely tho coldest time of the year. I remember talking over ithis very aspect of the disease to a medical man -in India, but he was' of . opinion that tho scourge had-little respect for the seasons. His reason for the to-' eurrence 'of outbreaks in' the winter in ' India was a curiously ingenious one. Bight through the torrid summer—in. fact, ivith the exception of about three months ■ of the year, the average Hindu wore very little ..clothes at all—the peasant class in ,the fields only wear a loin-cloth. Consequently, when the weather became cool— or, rather, less lot—they drag out a lot of old clothes; which they havo probably stored' away year- after year with a. -thought of cleansing them,:and : wear them, 'until the weather warms up again.-My •friend's theory was that tho bacilli of the disease were probably harboured in 1 these dirty old togs, and given liberty during tho cool of, the year to make their annual onslaught on man." . SCHOOLS & COLLEGES. Any ..day-now the order may go forth from the Government, through its adviser and Chief Health Officer, Dr. Valintine, for those attending schools and colleges to be vaccinated. All medical inspectors ■ of schools have been asjced .to hold themselves in readiness for orders from the Chief Medical Officer.' The' warning is 'significant, ACTORS SUBMIT. As the members, of the Hamilton-Plim- .. tner Company go north, to-day, some of them submitted themselves to public vaccinators on Saturday. As the grim Messenger from Mars put it in tho comedy played, on Saturday evening—it .was a thought for •' others (as .well as .themselves). VACCINATION FASHIONABLE. Vaccination has become fashionable ' within the past few days. _ Most of the medical men who are public vaccinators were Kept hard at wort on Saturday, and Mr.-H. Brittain—the only chemist in Wellington left on the list of public vaccinators—simply had his hands very full. For some time, indeed, a queue had to be formed outside his shop. TRAIN TRAVELLERS. % IMPORTANT ANNOUNCEMENT. (By TeJegraph—Pr£63 Association.) Auckland, July 13. An important statement affecting travellers by the train from Auckland was made by tho health officer yesterday. He ' said' that, from now onward each person desiring to leave Auckland by train would • need to show evidence of successful vacIcication before securing his ticket. Asked lif this precaution would apply to suburban traffic as well, Dr. Monk said that he ,'believed it wcruld. However, official notification to thia effect was being drafted, fond copies, would bo posted in conspicuous places. Ho added that the Depart!ment realised tho necessity for keeping a careful check on train traffic, in order to prevent the introduction of the prevailing disease to places outside the ptoVince. ' . The strict ■precautions that now apply to vessels from Sydney are "being .extended ito shipping from the north of Auckland. ■ Instructions havo been issued -from the ; Public Health Department that all coastal ;;vessels from thoso parts must be inspected ion arrival at Auckland, and that no passengers or member of tho crew is to be ; allowed ashore until vaccinated, ijnarks of recent vacoination can be shown. AUCKLAND CASESi '' INOCULATING THE MAORIS. Auckland. July 13. Tho district Health Officor :(Dr. Monk) reports that in addition ,to ,the new case 'admitted to the isolation hospital,' one ;jias occurred at Huntly, .another at OneVhoro (seven miles from Tuakau',, and a ■third, reported as chicken-pox, at Waikino. :Dr. Monk stated that tho Native settlement at Mangere had been thoroughly in!6pected, whilo those at Orakei and Shoal ißay wore undergoing similar treatment', '■/with a viow to thorough' vaccination. All Native inmates of boardinghouses in tho ; city had also been vaccinated. Tho liealth officer said that largo numbers of .Natives wlo had been granted certificates of successful vaccination, had left the city. . Others were ooming forward ifreely for vaccination, and in this way. ithe populous parts of Auckland would ivery soon be cleared of unvaccinated Natives, which should aid greatly in checking 'the spread of tho disease. THAMES CASE, GENUINE SYMPTOMS SHOWN. Thames, July 13. On Saturday an elderly Native'staying at a local hotel displayed alarming symptoms. The police tho Health Officer .were informed, and tnc man was taken to tho hospital and isolated. Already eruptions had. appeared on his face, though otherwise ho appeared to be in good health. Tho disease is believed to be similar to that manifested elsewhere.. The man attacked came from Raglan. So far as can be ascertained, this is the ■ only case reported to date. Tho bathroom .and the room at tho hotel where ■the Native stayed have, been fumigated , under tho supervision of tho Health Department. WAIRARAPA MAORIS. (By Telegraph.—Special Correspondent.) Masterton, July 13. Inquiries made from the Chief Health Inspector for Wairarapa show tbat neither chicken-pox nor smallpox has been reported among either Natives or Europeans of this district. A skin disease known as "Maori itch" lias beon in evidence for many years among tho Natives, but it is not regarded, as serious. ■ Tho inspector has arranged with the railway officials and leading Natives to bo advised of any Maoris arriving from north.
I , OTAGO MEASURES, LYMPH SUPPLY RUNS OUT. (By Tcloirrapli.—Fross Association.! Dunedin, July 13. j Owing to the smallpox epidemic in the I north, tlie local office of the Health De- ! has been making preparations
in case trouble should appear in Otago. To-morrow afternoon a meeting of representatives of the Hospital Board, Health Department, Port Health officers, and doctors attending Maoris, will be held, and tho matter will, bo thoroughly discussed, and a plan of campaign drawn up, in caso of tho epidemic making its appearance here. When the Manuka arrived yesterday at Port Chalmers, Drs. Borrie and Hodges boarded the vessel, and examined the vac-cination-certificates of passengers. They also vaccinated members of the crew. The supply of lymph at tho local Health I Office has completely run out. AUSTRALIAN OUTBREAK. GENERAL VACCINATION. Sydrtey, July 12. The authorities think that one caso at Penrith awl another at Taree are smallpox. General vaccination of school children in the infected area commencas on Monday next. The police have all' been vaccinated, and the vaccination of the railways and other public staffs is proceeding. Inter-State railway traffio has decreased by fully one-third. The services aro late through the vaccination of passengers, A number of persons in Victoria havo bteen fined for refusing to allow their children to bo vaccinated. \ MORE CASES IN SYDNEY. (Rec. July 14, 0.30 a.m.) Sydney, July 13. There were ten fresh smallpox cases yesterday and fourteen to-day,
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THE EPIDEMIC., Dominion, Volume 6, Issue 1801, 14 July 1913
THE EPIDEMIC. Dominion, Volume 6, Issue 1801, 14 July 1913
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