SMALLPOX EPIDEMICS

Otago Daily Times, Issue 15825, 25 July 1913, Page 5

SMALLPOX EPIDEMICS

UNEASINESS IN SYDNEY. TWO DEATHS AFTER VACCINATION. DOCTORS' REASSURING STATEMENTS. Prtu Association—By Telegraph—Copyright. SYDNEY, July 24. (Received July 24, at 6.10 p.in.) The fact that two deaths have occurred after vaccination has caused public uneasiness in view of the severe effects in many cases following the injection. Death in the first case, a doctor stated, was not due to vaccination. In the second case the coroner refused to accept a certificate until a pest-mortem examination had been held. The doctor attending the patient reported that death was due to heart and kidney diseases, and was in no way associated with vaccination. THE GOVERNMENT'S PROPOSALS. CRITICISM BY MR WADE. SYDNEY, July 24. In the Assembly Mr Wade condemned the proposal to vacoinate infants only, who could not hit back. In view of the hold smallpox had gained in the city and suburbs, the obvious course was to make vaccination universal, and 60 protect the willing against the unwilling. The Government proposal was an exhibition of want of courage in dealing with an urgent matter. ORIGIN OF THE OUTBREAK. A NEW THEORY. BROUGHT FROM CUBA. SYDNEY, July 24. (Received July 24, at 6.10 p.m.) Dr Paton now claims that the smallpox came from Cuba, whence it spread right across the United States and Teached Australia and New Zealand by one of the Vancouver mail boats. He adds:" At any rate New Zealand did not get the disease from us."

ANOTHER CASE IN QUEENSLAND. 5 BRISBANE, July 24. A case of smallpox has been diagnosed at Ispwich. There was a previous case in the same family, but it wa6 so mild that it ■*as not reported. PRECAUTIONARY MEASURES. MELBOURNE, July 24. The Federal Executive has proclaimed the North Island of New Zealand an area from or through which a quarantinable disease is liable to be brought. INEFFECTIVE LYMPH statement by a doctor. SYDNEY, July 24. (Received July >24, at 9.20 p.m.) Dr Harris, of Newcastle, .states that he found that the first fifty tubes of lymph 6ent from Auckland were ineffective he cabled inquiring the cause, and got a reply stating that it was supplied by the Health Department. Dr Harris says the first 50 tubes were weak. Another 50 have arrived, but they 6eem to he slightly different. SCARE ENDED IN MELBOURNE. RELEASE OF KAROOLA'S

PASSENGERS,

MELBOURNE, July 24. (Received.July 24, at 9.20 p.m.) The scaTe has subsided, and the vaccination bureaus are empty.

Dr Cumpston is of opinion that Melbourne can be declared a clean city. If the passenger by the Karoola v;ho developed smallpox here had infected anybody the disease would now be noticeable. Nearly all the Karoola's passengers have been released from quarantine. CASE IN ADELAIDE. A WOMAN ATTACKED. ADELAIDE, July 24. (Received July 24, at 9.20 p.m.) A woman living in Hawthorn, one of the suburbs, has developed smallpox. She visited Sydney recently. SIX NEW CASES. SYDNEY, July 24. (Received July 25, at 1.10 a.m.) Five cases of smallpox were reported today! All the patients aTe young men, and one of them is from the Domain and has no permanent abode. A case at Grenfcll has been diagnosed as smallpox. DISCUSSION IN PARLIAMENT. MERITS OF VACCINATION. REASSURING STATEMENTS. INTER-ISLAND COMMUNICATION. THE CABINET ALERT. fFaou Our Own Correspondent.) WELLINGTON, July 24. Parliament spent upwards of an hour this afternoon in discussing the epidemic raging in the north and the measures being taken to cope with the situation. Mr G. W. Russell inquired, in view of the serious news coming from the north, if the -Minister of Public Health was quite satisfied and able to assure the House that everything possible was being done to deal with this unfortunate outbreak. He directed attention particularly to the very 6erious news sent in by Dr Te Rangihiroa, who was a member of the House and who was devoting himself to work amongst thp Natives. He.urged that no question of economy should weigh with the Minister, as he felt that the whole House would agree-that everything should lie done to fight the disease, even if it meant tho concentration of a very large ' staff of medical men and nurses in the infected districts. VACCINATION OF NATIVES. Mr I'earce stated that it was reported from Wanganui that the lymph at one pa was not affecting the Natives. He had understood that. Natives received certificates of vaccination whether successful or not, and in th:s case it would mean that, they could travel over tho country when not immune. Mr Campbell drew attention to the fact that Natives from infected areas could travel into unaffected areas. He had heard that day that a Native had ridden recently front the Bay of Islands right down to Hawke's Bay. In travelling down this route and stopping at various pas lie could spread the inseasc right through the whole of the North Island, Mr I'earce: Was lie vaccinated! Mr Campbell: No, he was never vaccinated. " EVERYTHING POSSIBLE." The Hon. R. H. Rhodes stated that the Health Department was doing everything possible to prevent the-spread of smallpox. He wquld not say that people were not getting away from the affected areas. That mignfc bo possible, as it was verv difficult in scattered districts to keep everyone in their settlements, but they were doing everything in their power to prevent,them from travelling to other districts. It was not necessary that Natives should receive certificates of successful vaccination if they were not going from pn infected area. If they did seek to

travel from the infected area they must first receive certificates of successful

vaccination, and even then, if there "was a fear of conveying the germs, they would not he permitted to travel. Dr Te Rangihiroa was doing excellent work amongst the Natives, and .had telegraphed that he considered the steps taken by the department justified and absolutely necessary. the doctor could point out any other steps the department would be very pleased to comply with his suggestions. The' doctor stated that all those who had been vaccinated were immune, and he held that all unaffected Maoris should be vaccinated. Dr Makgill had said that no fatal cases bad occurred in Sydney, and it was now a well-established fact that vaccination protected against the disease. This proved conclusively the value of vaccination in an outbreak of this sort.

Mr Ngata asked the Minister whether it would be possible for nuTses to bo public vaccinators in the out districts, where it was impossible for medical men to cover all the ground.

GUARD THE SOUTH ISLAND,

Mr Nosworthy asked the Minister whether he did not think it advisable that the principle of compulsory vaccination should be applied to all persons travelling from the North to the South Island.

Chorus of voices: "No! No! You have been done."

Mr Nosworthy said that so far as was known at present, the South Island was still clean , and it should be kept clean. In about three weeks' time several thousand people would be going down to the Grand National race meeting, and every precaution should be taken to keep the island free from infection. Mr Payne said that the question of sanitation was of great importance ;n connection with the disease, and he asked whether the department had taken any stecs in this direction. VACCINATION QUESTIONED. Mr Buick, who agreed with Mt Payne as to the importance of sanitation, deprecated any panic in regard to vaccination. It should be borne in mind that although a'person might ho vaccinated, it was 6till possible for him to spread the infection through the medium of hia clothes, He was sorry that members of the House were giving way to a silly craze in regard to vaccination. He had seen it stated that Maoris who had been vaccinated were infected with smallpos.

Several voices: "No! No!" Mr Buick said that Mr Nosirorthy W already been vaccinated, and he was like the fox with the burnt tail, who went about trying to persuade all other foxes to have'their_ tails burnt—(Laughter.) "I am not going to bo vaccinated," Mr Buick added. "If vaccination is made compulsory I shall develop a conscience, although I have not been troubled with one so far."—(Laughter.) Mr Nosworthy: It is trne that I have been vaccinated, but I am not making any noise about it.

THE FAITH DEFENDED. Dr Newman said that he was amazed at the speech made by Mr 'Buick. All medical men agreed as to the efficiency of vaccination. Mr Wilford: No, absolutely, no. Dr Newman: The whole of the evidence of the last 100 years proved that vaccination is a preventative against the disease. There is one remedy only, and that is vaccination, and the sooner the House and the oountrv recognise that fact the better. No one who had been vaccinated in recent years had contracted the disease in the present case. As to the nature of_ tho diseass, the photographs of two patients that liad been exhibited round the House must convince the most sceptical person that the disease was smallpox, although of a mild type. PANIC DEPRECATED. Mr Buddo deprecated the mad panic amongst the members of the House. The disease was a "contact", disease, and could not be communicated through the air. Mr Young said that whatever the disease was it was something more serious than chickenpox. Several men who had had experience of the disease said that, it was smallpox. The only man in one of the Native settlements who had not contracted the disease was a man who was vaccinated six years ago.

Mr Buick explained that he recognised the efficacy of vaccination, but he objected to "panic vaccination."

AN OFFICIAL STATEMENT.

Mr R. H. Rhodes, in reply, said that the Health Department was not tied down in any way in the appointment of public vaccinators, A number of chemists had been appointed, and if members would point out any districts where it was necessary that othej* public vaccinators should be appointed he would be very happy to make provision. The member for Ash'burton Jiail asked whether the department was gong to take steps to isolate the North Island and to enforce vaccination on all persons leaving it for the South Island. This was a matter that had been considered day by day by the Cabinet, and they had not yet decided that it was necessary to do so.—(Hear, hear.) He assured the House that lie would recommend Cabinet to take this step if more cases occurred in Wellington. He knew that the member for Christchurch North did not agree with this step, but lie did not propose to enter into a discussion as to the merits or demerit.? of vaccination. The efficacy of vaccination had been sufficiently proved. If lion, members did not believe' in vaccination after hearing the medical reports they must bo very- hard to convince. The Health Department was assisting local bodies to cleanse their districts. Certain boroughs were alive to the necessity of cleaning out their slums, and all' the Maori Councils were taking steps to clean out their settlements. It would be for the local authorities rather than for the • Government to find the necessary disinfectants. He was glad that the member for Avon had assured him that the House would back up the department in any necessary action. Already considerable expense had been incurred which no" doubt the House would recognise as necessary. From the first he had assured hon. members that there was no need for panic in this matter. The department had been aware_in good time of the outbreak of the disease, and had from the first taken what steps were necessary, although it had been accused in some quarters of not taking sufficient precautions to prevent the spread of the disease. VACCINATION. HOW IT SHOULD "TAKE." (Fboit Our Own Correspondent.) WELLINGTON, July 21 There is much uncertainty among people who have been vaccinated recently a 6 to the signs by which they may' know whether the vaccine has "taken" or not. A medical man stated yesterday in response to a reporter's inquiries, that the effects oi vaccination vary, depending upon the natural immunity to smallpox and to vaccination acquired by the subject ancestrally or by previous vaccination in infancy. Taking a normal case, a red spot should anncar at the point 'or points of scarification at the end of the third day, counting the. day of the operation as the _ first day. This spot should increase in size, and by the fifth or sixth day should form a vesicle containing watery-looking material. The vehicle should increase in size up to about the eighth day, and about that period a red band should appear surrounding the vesicle and increasing in size for the next day or two. At the same time the clear fluid which was in the vesicle should have become opaque and thick, and bv the tenth or eleventh day the inflammatory symptoms should begin to subside and the vesicles begin to dry up and turn u brownish colour. At the end of a fortnight a reddish-brown incrustation should be formed, which should gradually shrink and fall off somewhere about the twenty-, first day. A star should remain, pink at first but afterwards turning to white, which should be sliirhtly hollow or depressed, circular in shape, and dotted with small indentations. HEALTH OFFICER'S POWERS. (From Oun Own Comiesponpext.) WELLINGTON, July 24. There is no fixed rule with respect, to quarantine ami isolation as affecting residences, buildings, and "contacts." The

widest powers possible are given to the Chief Health Officer under the provisions of the Public Health Act, and if in his judgment the circumstances warranted it lie can close up a house for a fortnight. On the other hand, he may deem a week's quarantine sufficient, witti one or several, fumigations. It all depends on circumstances—the disease, its particular character, -what association has existed between the "case" and the "contacts," and a dozen other things.

POSITION IN AUCKLAND PROVINCE. RESTRICTIONS ON THE MAORIS. POWERS OF HOSPITAL BOARDS. PROGRESS OF VACCINATION. (Per United Pbsss Association.) AUCKLAND, July 24. Only one additional case of smallpox was sent to the isolation hospital at Point Chevalier to-day. The patient is a European, and a driver by occupation. He was removed from Morningside, and is known to have been in contact with .Maoris like the other European patients. He is suffering from a very mild form of the disease.

All the sufferers in isolation are reported to be making favourable progress. The total number now under Dr Spedding's care at Point Chevalier is 52.

Sufficient lymph reached the District Health Office from the vaccine depot at Wellington to enable 700 doses to be distributed throughout the Auckland health district.

A vaccination depot is to be opened at the premises of the St. John Amublance Association.

When questioned as to what steps the Health Department is taking to restrict the movements of the Maoris in the infected areas, Dr Frenelev stated that'the proclamations prohibiting Natives from travelling from such districts were proving effectual. As illustrating this, he said complaints were reaching the Health Office that in some of the infected districts the Maoris were being 'so efficiently restricted to their own settlements that they were having some difficulty in obtaining food supplies. In such cases the department had taken immediate steps to sec that the needs of the Maoris in question were provided for.

In 'reply to a questi6n as to when the department anticipated completing tlio vaccination of the Maori population of the Auckland district,. Dr Frenglev said that with the copious supplies of lymph now ooming to hand it was hoped to have the whole of the Natives in the district vaccinated by the end of next week. The Maoris wcjre, he added, most anxious for vaccination, which they had noticed had had the cffect of protecting their friends. Dr Eleanor Baker, at Kaihou, has advised the Health Office that convalescent Maoris in that district do not "take" after vaccination. She has only found the epidemic in one patient who had been vaccinated previously. This was an olu Maori who must have been vaccinated 40 years ago, and whose wife had been very ill with the disease. Dr Baker has noticed that many of the old marks left on -hejr patients are whitening, shrivelling, and pitting.

The Chief Health Officer has written to the Hospital Board asking it to bring under the notice of all public vaccinators the neeesity for scrupulous cleanliness in performing the operation, and also for the careful sterilisation of all the instruments after vaccinating each patient.. This action is in consequence of complaint that sufficient care was not being exercised by some of the vaccinators. Dr Yalintinc has telegraphed pointing out that the board has full power to act in restricting the movements of Natives from areas where the disease is known to be prevalent,and calling upon the board to exercise its powers. The board will hold a special meeting to consider the matter.

The precautions beinc taken to prevent the spread of the disease among the Natives of Tarawera were criticised to-day by Dr J. S. Reekie, of 'J'e Awamutu. About 100 Natives comprise the settlement, which is situated about 10 miles from Te Awamutu. During last week the people were all assembled in the Native schoolhouse for vaccination, and were given instructions to remain in the'ir homes and clean up the settlement; but Dr Reekie states that no further attention was given to them, nor were steps taken to enforce the directions given to them until the beginning of this week.

TWO CASES AT TE RAPA. 1 NECKssrrfFoß action. "OUTRACEOUS. CALLOUS INDIFFERENCE. (Pee United Press Association.) HAMILTON, July 24, Two cases of smallpox were reported today at To Rapa, a few miles from Hamilton. The Waikato Hospital Board has decided to write to the .Minister of Railways requesting daily fumigation of all carriages and that more drastic steps bo taken to stamp out the, disease. One member declared that there was an outrageous callous indifference on the part of the Government. The local health inspector waited on the board and asked for the appointment of several subinspectors, as it was impossible for him to cope with the rapid spread alone. He said that unless additional precautions wore immediately taken the disease would spread all over the country. It must exist in numerous Native districts not yet visited. Complaints were also made to the board of Natives being allowed to wander atJarge in the Waikato, especially in the infected districts. At Whatawhata they had blocked the post office all day using the telephone.

The Hamilton vaccinators report a shortage of lymph. DR VALJNTINE'S BULLETIN. (Peb United Press Association.) WELLINGTON, July 24. The following official bulletin "dealing with the smallpox outbreak was issued by the Health Department at 9.30 this evening, . There are 52 cases isolated at the infectious diseases hospital at Auckland, 10 being Europeans. Dr Te Rangihiroa, M.l'., reports some 72 cases in the Bay of Islands district, four being acute and, 18 convalescent. l)r Cawkwell reports from Tantoro that the disease is more evident among young people. A case is reported at Whangarua. Dr Ross reports that he has vaccinated 400 persons in the Raglan district. Dr Couzens is at Te Kohi. He has seen no suspicious cases. There is an ample supply of lymph available,— T. 11. R. Valintixk, Chief Health Officer.

NATURE OF THE DISEASI'

THE PROPOSED COMMISSION,

UNFAVOURABLE REPLY. NO UNCERTAINTY. IFBOK OUB OWN Correspondent.) WELLINGTON, July 24. The Minister of Public Health (the Hon. R. H. Rhodes) is forwarding an unfavourable reply to the suggestion made by the Deputy Mayor of Auckland (AllJohn Court) that a medical commission should be appointed to investigate the character of the prevailing epidemic. In reply to an inquiry this evening Mr Rhodes stated that he had written to Mr Court pointing out that the department has already consulted several medical men of standing in Auckland and elsewhere, who have with one exception confirmed the diagnosis of smallpox. All the doctors, including the exception, were agreed that the precautions adopted by the department are essential.

Dr Vnlintine, in nil interview this evening, stated that on the occasion of his recent visit to Auckland he had a consultation in Tegard to some of the patients who were attacked by the epidemic with I)r Robertson, who had had experience of smallpox in Zululand: Dr Dudley, who was formerly superintendent of "a smallpox hospital an London; and Dr M'Guire, modioli superintendent, of (lie Auckland Hospital, who has also had experience of smallpox. Subsequently Dr Douglas, of Hamilton, Dr Frazer Hurst, of Whangarei, and Dr Harke, of Oneliunga, all of whom bad bad experience of smallpox, wore consulted.

Dr Valintine pointed out that the officers of the Public Health. Department, in order to obtain the diploma of public health, had to pass a special examination. 111 epidemiology; including the diagnosis and treatment of infectious diseases.

DISCUSSION AT HOSPITAL BOARD

PROVISION FOR PATIENTS.

SUGGESTED BUILDING AT PELICHET BAY.

At the meeting of the Hospital and Charitable Aid Board last evening a communication was received from Dr Valintine, Chief Health Officer, notifying the existence of a pustular disease among the Natives in the Auckland province, which was causing the department much concern. He considered it his duty to acquaint the board of the circumstances, so that it 6 oflicere might be on the lookout for suspicious cases. 'Chickenpox had been made a notifiable disease, and the board could greatly assist the department by lending weight to the necessity for general vaccination as the only really efficient means of protection against smallpox. He also stated that he had instructed the bacteriologist to forward to every hospital board' tubes of vaccine. The Secretary read a letter received from Dr Champtaloup regarding accommodation for dangerous and infectious diseases. Already, he 6aid, there had been a suspected case of smallpox which they had had to isolate alongside the Fever Hospital, and this might give rise to complaint. He asked that a shelter containing three rooms be immediately erected at the back of tho Fever Hospital—the central room to be for the nurse and tho room on either side for male or female patients. Dr Champtaloup, who waited on the board in support of his letter, pointed out that Otago had always had far too little accommodation for infectious diseases. A very considerable responsibility rested on the health authorities down hero just now, and though they intended to do everything possible to prevent the disease spreading to Otago there were many loopholes by which it might elude them. He instanced correspondence and the clothing of travellers. They ought to make provision for at least three or four cases on the ground at the back of the Fever Hospital at a distance sufficiently removed to obviate any danger. Two beds for males and two for females who were suspected to bo suffering from the disease would meet the immediate difficulty. The Chairman (Mr J. H. Walker) stated that the architect had estimated that the building required cevdd bo erected for £150.

Dr Champtaloup answered several questions, and the Chairman expressed the entire sympathy of the 'board with Dr Champtaloup and its desire to assist him in cverv wav.

The matter was left to the chairman and Drs Falconer and Champtaloup to arrange. Some good-natmed banter oil the Gubject of vaccination was indulged in before Dr Champtaloup retired, the Chairman remarking that <1 lady member of the board had already set an example to the others by undergoing the treatment,