THE SMALLPOX EPIDEMIC - SHEFFIELD 1887
"one of the most devastating diseases known to
Until I read the following article I was totally unaware
that towards the end of the nineteenth century, Sheffield had been in the grip
of a smallpox epidemic. The article written on the 7th January 1888 in The Times
and charts the course of the epidemic over the previous nine months.
Epidemic of Smallpox. FROM OUR
EPIDEMIC OF SMALLPOX
and, indeed, a great portion of the North of England seem likely to be
involved in the epidemic of smallpox that is now running its course in
and the neighbourhood. Isolation,
unfortunately, has failed in
, or rather the disease spread so rapidly
that sufficient means of isolation could not be provided in time.
The result was that the outbreak spread into every quarter of the
town; and so far from the disease having abated, the number of fresh
cases has increased month by month until, during December, over 800
additional cases were reported to the authorities.
The disease has now existed in
nearly nine months. On the 24th of March three cases were reported from the
district of Nether Hallam, not far from the barracks.
Although occurring in different houses the patients were near
relatives and had each come in contact with another relative who was
said to have had "spots on the skin."
These cases gave rise to four other cases in the immediate
neighbourhood, all being removed to the borough hospital, which is
situated in a thickly inhabited portion of the town.
During April smallpox appeared among the clerks in a large works
at Brightside, and the medical officer of health, after a searching
inquiry, inclines to the belief that the outbreak was due to fresh
importation of the disease into the town.
Several of the clerks had the disease in a mild form and,
unfortunately, these cases were not recognized to be smallpox until late
in the disease, and not until after they had infected several other
persons. The disease began
to assume alarming proportions about the middle of July.
Towards the end of that month the cases became so numerous that
the hospital had to be cleared of scarlet fever patients, and it has
been since used exclusively for persons suffering from smallpox, while
the number of beds available for patients has been increased from 64 to
84. In August the hospital
committee of the corporation, who still had hopes of checking the spread
of the disease, secured temporary hospital accommodation at Totley, four
miles from the town, and just over the Derbyshire boundary.
The inhabitants were scared, and issued a writ against the
corporation for an injunction, which, after four weeks' delay, was
dismissed. Unhappily this
delay proved very serious, for the disease spread, and many patients
were obliged to be treated at their own homes.
Even when there was a constant circulation of convalescent
patients from the borough hospital to Totley the accommodation was by no
means sufficient to enable the authorities to cope with the serious
character of the epidemic. In
fact, at this time the epidemic had got beyond the power of the hospital
committee, and all hope of isolation had gone.
This will be shown by the following figures.
the 8th of October 668
cases were reported to the medical
officer, 291 of which occurred previous to August 27 and 377 since that
date. Of the 291 cases, 229
were admitted to hospital, while of the 377 there was only accommodation
for 110. Soon after the
establishment of the hospital at Totley the Corporation acquired an
estate at Redmires, four miles from the town, with the view of
constructing premises of a permanent character. Contracts have been let,
and accommodation for 60 patients will be ready by the 15th
inst. There will then be 204
beds available for smallpox patients, apart from the hospitals in
connexion with the two workhouses. The
spread of the disease is shown by the following figures:-
In March there were 3 cases, 4 in April, 21 in May, 43 in June,,
91 in July, 146 in August, 275 in September, 498 in October, 604 in
November, and 800 in December. Up
to November 21, out of a total of something like 1,550 cases, only 581
were treated in hospital. The
epidemic has increased the death-rate in
, but not to a very exceptional extent.
For the week ending November 19 smallpox caused 25 deaths;
November 26, 16 deaths; December 17, 17 deaths; December 24, 21 deaths.
For the last five weeks the death-rate from all causes in
corresponded to the following rate:- December
3, 29.2; December 10, 23.8; December 17, 29.2 December 24, 23.9;
December 31, 27. One notable
circumstance in connexion with the epidemic has been a system of
workmen's insurance that has been adopted in nearly every manufactory in
the town. Every workman
agrees to pay so much to a general fund, the proceeds going to pay any
one who is either smitten with the disease or prevented from working
through having smallpox in his house.
This system has worked well and saved a great amount of distress,
besides doing much to secure isolation.
is credited with having spread the disease into the towns and villages
surrounding it and no doubt many of the outbreaks that have occurred can
be traced to
, but not all.
there are not 39 cases of smallpox in
the hospital of which 12 are convalescent, and at
a case has occurred, and there is some
fear lest the disease may have obtained a foothold in the town.
there have been three cases, but the
city is now free from the complaint.
At Rotherham, which is only six miles from Sheffield, the disease
is practically stamped out, five out of the six cases being
there is power to enforce compulsory
notification - a provision which is lacking in
of the villages near
have suffered severely, such as Rawmarsh,
Wath and Swinton. In every
direction local authorities are establishing infectious hospitals with
the view of stamping out the dreaded disease.
During the course of the epidemic it has been pretty well proved
that vaccination in infancy is an almost complete preventive of smallpox
during the first 12 to 15 years of life, and that a second vaccination
is a perfect preventive during the remainder of life
The Manchester Times (Manchester, England), Saturday,
November 5, 1887; Issue 1582 and The Birmingham Daily Post (Birmingham,
England), Wednesday, November 2, 1887; Issue 9157 gave a more intimate portrayal
in a brief article entitled SMALLPOX IN SHEFFIELD
"For some time there has been a
serious outbreak of smallpox at Sheffield and in spite of the efforts of the
health authorities it continues almost as bad as ever. On Monday night, (31st
October 1887) a Roman Catholic Priest the Rev Patrick M'Namara died from a
malignant form of the disease which was contracted whilst he was in the
discharge of his spiritual duties. He was only 30years of age and had been in
Sheffield about two years"
Two months earlier, The Birmingham
Daily Post (Birmingham, England), Friday, September 2, 1887; Issue 9105 noted
"The epidemic of smallpox in
Sheffield appears to be increasing in spite of the vigorous efforts which have
been made to check it. The resources of the Borough Hospital, which is now
entirely devoted to smallpox cases are taxed to the upmost, the numbers being in
excess of those initially contemplated"
But the most interesting item I came
across was a letter sent to The Birmingham Daily Post and published on
Saturday, November 19, 1887; Issue 9172. It is from a Mr William Tebb, and is
addressed to the editor of the Daily Post
In July 2021 I received this information relating to the
outbreak in Sheffield and its aftermath
"The disease remained prevalent in Sheffield until the early years of the 20th century. Forty seven cases occurred in the city in 1892, and was prevalent during the first half of 1891, before it gradually died out in September. The largest number of cases occurred during March and April 1892, 31 in March and 19 in April, during the whole year 102 cases occurred, of which 4 were fatal. Out of the 102 cases there was no evidence of vaccination in 17. 79 cases were male and 23 female. 35 of the cases had no fixed abode in the city, and were either struck down with the disease while travelling through Yorkshire, or had caught the disease in one of the common lodging houses in town, or as inmates of the workhouse.
In 1901 there were thirty cases of smallpox reported, compared with only two in 1902. Four cases of the disease were reported during 1905, but none were fatal. There was only one case in 1906, which did not prove fatal.
The diseases which causes excessive death rates in Sheffield between 1895 and 1905, were diphtheria and enteric fever. The chief Medical Officers of Health during most of the period we are writing about were: Harvey Littlejohn, John Robertson, and Charles Scarfield. Robertson resigned on 1st October 1903, and Charles Scarfield took over his duties on 1st January, 1904."
I have also put together in pdf format a document Smallpox
- The Facts that gives all the details
about the disease. Most of the information was obtained from
Organisationís website. There are also many other sources of information
on the disease.
However what interests
me was that although the Corporation and the Hospital Committee were knowledgeable
about the transmission of disease and how to contain it, they totally failed to
do so. The correct procedure to adopt is given below
must be placed on preventing epidemic spread. In doing so, it should be kept
in mind that smallpox patients are not infectious during the early stage of
the disease but become so from the first appearance of fever and remain so,
though to a lesser degree, until all scabs have separated. Also, immunity
develops rapidly after vaccination against smallpox.
of smallpox infection is probably easier than for any other infectious
disease. A distinctive rash is produced which is wholly characteristic in
the great majority of cases. The rash is most dense over the face and hands
Ė unclothed and readily visible portions of the body.
from the eradication campaign indicate that, in the presence of a strong
surveillance system sensitive to smallpox cases and backed by an adequate
infrastructure, small but rapid and thorough containment actions can break
the transmission chain and halt a smallpox outbreak within a relatively
short time. Containment involves efficient detection of cases and
identification and vaccination of contacts.
diagnosed with smallpox should be physically isolated. All persons who have
or will come into close contact with them should be vaccinated. As hospitals
have proven to be sites of epidemic magnification during smallpox outbreaks,
patient isolation at home is advisable where hospitals do not have isolation
facilities. Whatever the policy, isolation is essential to break the chain
who developed rash before their isolation should be asked to recount all
recent contacts. Contacts should be vaccinated. If it is not feasible to
vaccinate contacts, they should be placed on daily fever watch, which should
continue up to 18 days from the last day of contact with the case. If these
contacts have two consecutive readings of 38 degrees centigrade or above,
they should be isolated.
In the case of a widespread outbreak, people should
be advised to avoid crowded places and follow public health advice on
precautions for personal protection.
specimen collectors, care givers and attendants coming into close contact
with patients should be vaccinated as soon as smallpox is diagnosed as the
cause of an outbreak.
on the information in the article, it seems that the
Corporation and the Hospital Committee were slow in detecting the disease and
when they did realize
the severity of the outbreak they did not have the facilities in place to
effectively manage the outbreak. This complacency in turn exacerbated the spread
of the disease. Furthermore their increasingly frantic attempts to resolve
the crisis we hindered by the fear that smallpox created in the community.
Indeed, the correspondent infers that the people of Totley were partly to blame
for the spread of the disease in the summer of 1887.
"Unhappily this delay proved very serious, for the disease spread, and
many patients were obliged to be treated at their own homes."
It appears that the disease had peaked by
the time the article was written. The only positive element to come out of the
whole affair was that it gave the local civic authorities an almighty jolt for
there is no doubt that they were guilty of both neglect and complacency - "In
every direction local authorities are establishing infectious hospitals with the
view of stamping out the dreaded disease."
Sheffield's response was the founding of Lodge Moor "Fever" Hospital
Jan 07, 1888
; page 5; Issue 32276
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page was last updated on 10/07/21 16:36