Small-pox in New Jersey.

From June 30th, 1897, to October 31st, 1902, 3,694 cases of small-pox were reported in New Jersey. During the week ending September 27th, 1902, no cases of the disease were reported, and, although scattering cases occurred during the past year, the general epidemic which had covered a period of over four years terminated. The constant recurrence of the disease caused increasing numbers of individuals in this State to avail themselves of the protection which vaccination affords, and the experience of local boards of health led to improved methods of dealing with the various problems which are presented whenever small-pox occurs in a locality. The total number of cases which were reported during the year ending October 31st, 1903, was 397. The localities in which the disease appeared, together with certain data as to the cause of the infection, and the action taken by local boards of health to prevent the spread of the disease, is herewith submitted:

Atlantic City.-Five cases of small-pox were reported in this city during the year ending October 31st, 1903, and in each instance the patient was removed to the isolation hospital.

Bayonne. From October 31st, 1902, to October 31st, 1903, six cases of small-pox occurred in this city. Four of these cases occurred in one family. One person is supposed to have contracted the disease from exposure to the infection in Jersey City, and another by direct exposure to the other cases. Under the rule of the Hudson county board of health all persons were removed to the isolation hospital, excepting those living in private houses. Whenever a patient remained at home the house was placed under quarantine and guarded by special police for fourteen days. These regulations were strictly carried out, and after the patient had recovered the following methods were used in disinfection: All the wall papers in the house were removed and the woodwork, walls and floors were thoroughly scrubbed with diluted crude creolin. All bedding was destroyed. Free vaccination was offered by the city board of health to those applying for it, and wherever a case of small-pox occurs the vaccination of all persons who have been exposed (241)

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is made compulsory. Of the six cases which were reported, not one of the persons attacked had ever been vaccinated.

Bedminster Township.-Two cases of small-pox were reported in this township during the year ending October 31st, 1903.

Bordentown.-During the year ending October 31st, 1903, twenty-five cases of small-pox occurred in this city. The first case was reported April 24th, and the patient was quarantined at his home. Three members of the same household contracted the disease. No other cases were reported until May 24th. Between May 24th and June 17th, twenty-one cases were reported. Of the twenty-five cases, twelve had never been vaccinated. Five deaths occurred, and in three of the fatal cases the patients had never been vaccinated, while the two remaining deaths were of persons who had not been vaccinated within forty years. There were 101 persons living in infected houses, and of this number only five contracted the disease. At the time when the disease was first reported no hospital provision for the care of such cases was available, but when the number of cases increased steps were taken to secure hospital accommodations and a building was erected for the purpose. Fourteen cases were removed to the hospital. A census of the inhabitants of the city was taken to ascertain how many were unvaccinated, and but few such persons refused to have this preventive measure applied. Out of a total population of 4,110, but 295 persons remained who had not been vaccinated within three years, and of this number 150 had been vaccinated in early life.

Bordentown Township.-Two cases of small-pox occurred in this township during the year ending October 31st, 1903. The origin of the first case was traced to direct exposure to the disease. The patient nursed her son, who had contracted the disease in Bristol, Pennsylvania. The son's case was never reported to the township until the mother had contracted the disease. The second case occurred in a person who had been exposed to the disease in Bordentown. There is no isolation hospital in the township, but an agreement has been made with the city authorities in Bordentown by which, in future, cases may be removed to the isolation hospital located in that city. The secretary of the local board of health states that every man, woman and child in the township, with one exception, have been vaccinated during the past year. The township committee offered free vaccination, and also demanded compulsory vaccination. Whenever the vaccination did not take, the individual was revaccinated.

Bridgeton. Three cases of small-pox occurred in this city during t year ending October 31st, 1903. In the first and third cases which we! reported the disease was traced to exposure of the patients to small-po. in the city of Millville. The second case was in the person of an individual who had been visiting in Philadelphia, and it is presumed that the disease was contracted in that city. The city is provided with an isolation hospital, which is of sufficient capacity to permit of the care of six patients at one time, and the cases above referred to were all removed to the hospital.

Buena Vista Township.-Three cases of small-pox were reported in this township during the year ending October 31st, 1903. The disease was contracted by the first patient in Philadelphia, and one of the other cases was traced to exposure in Vineland. As there is no isolation hospital in this district, domestic quarantine was resorted to.

Camden.—During the year ending October 31st, 1903, fifty-two cases of small-pox were reported in this city. The city is provided with an isolation hospital, and each case, as it occurred, was immediately removed to this institution.

Centre Township.-Thirty-two cases of small-pox occurred in this township during the year ending October 31st, 1903. The majority of these cases were reported from a small section known as Snow Hill, located one mile from Magnolia. In this settlement a large number of colored persons reside. The first cases of the disease were unrecognized and a diagnosis of chicken-pox was made. It finally became necessary for the board to send to Philadelphia for Dr. Welch, who made a thorough investigation and decided that the disease was small-pox in a mild form. As there is no hospital in the township, domestic quarantine was resorted to. The vaccination of all of the inhabitants of Snow Hill assisted very materially in limiting the spread of the disease.

Clayton. Seven cases of small-pox occurred in this borough during the year ending October 31st, 1903.

Elmer.-Five cases of small-pox occurred in this borough during the year ending October 31st, 1903. The first case was reported December 24th, 1903, and four cases followed as the result of direct exposure to the infection.

Fairfield Township.-Two cases of small-pox occurred in this township during the year ending October 31st, 1903. The first case which was reported was in the person of a young colored man who had been exposed to the disease in Vineland. This case was immediately quarantined and guards were employed to render the quarantine effective. The second case which was reported was also due to exposure to the disease in Vineland. As there is no isolation hospital in the township, domestic quarantine was enforced.

Florence Township.-Seven cases of small-pox occurred in this township during the year ending October 31st, 1903. The cause of the outbreak was traced to the exposure of individuals to the disease in neighboring towns. The local board of health established strict quarantine in each instance, and after the patient recovered the infected premises were fumigated. There is no isolation hospital in this township. Franklin Township, Gloucester County.-During the year ending October 31st, 1903, nine cases of small-pox occurred in this township. The cases were at first regarded as chicken-pox, but the development of several cases of confluent type determined the true nature of the disease. In all nine cases were reported, three of which were confluent in type. In every case a strict quarantine was maintained, and the premises were disinfected after the patient had recovered. There was no extension of

the disease from the families in which the disease originally developed. Every person exposed to the disease was immediately vaccinated.

Freehold. Four cases of small-pox occurred in Freehold during the year ending October 31st, 1903. The first case was reported on February 17th, 1903. The origin of this case was traced to the exposure of the individual to the disease in Bristol, Pennsylvania. Three other cases occurred in the same house, and were caused by direct exposure to the disease. The local board of health placed the cases in charge of Dr. Henry Neafie. Strict quarantine was instituted, and after the recovery of the patients the premises were thoroughly disinfected. A lot upon which to build an isolation hospital was obtained, but as no more cases developed the building was not constructed.

Glassboro Township.-Seven cases of small-pox were reported to the local board of health of Glassboro during the year ending October 31st. 1903. The first case was probably contracted in Camden, and five more cases occurred in one house as a result of direct exposure to the original case. The origin of the last case which occurred was untraced. The patients were removed to the isolation hospital, which is located on the county farm.

Hightstown. During the month of July, 1903, two cases of small-pox occurred in a boarding-house in this borough. The origin of the disease was traced to exposure in Newark, New Jersey. A lady came from Newark, and a short time after her arrival her child, nineteen months of age, contracted the disease, and another child in the same household developed small-pox at the end of two weeks. It is possible that the mother was recovering from the disease in a mild form. The cases were immediately removed to the isolation hospital, and all persons exposed to the infection were vaccinated.

Hoboken. Only one case of small-pox was reported in this city during the year ending October 31st, 1903.

Holmdel Township.-Three cases of small-pox, of a mild type, occurred in this township during the year ending October 31st, 1903. It is supposed that the disease was contracted by exposure of individuals to infected clothing. Domestic quarantine was instituted.

Hopatcong.-One case of small-pox occurred in the borough of Hopatcong during the year ending October 31st, 1903. The disease was contracted in Newark, New Jersey. The patient was isolated until his complete recovery. Infected clothing and bedding were destroyed, and the premises were disinfected. All persons exposed to the disease were vaccinated, and no other cases were reported.

Jersey City. During the year ending October 31st, 1903, twenty cases of small-pox occurred in this city. A number of the cases were found in lodging-houses and some were brought to the city by ships coming into port. The practice of the local board of health is to remove every case of smallpox to the isolation hospital, located at Snake Hill. All persons exposed to the disease are vaccinated and infected houses are thoroughly disinfected. School children are kept from school for

twenty-one days, and working men and women are not allowed to return to their employment until after the expiration of ten days.

Kearny. Five cases of small-pox occurred in this district during the year ending October 31st, 1903. The patients were removed to the isolation hospital, at Snake Hill, and infected houses were quarantined for a definite period.

Lawrence Township, Mercer County.-One case of small-pox occurred in this township during March, 1903.

Long Branch.-Seven cases of small-pox occurred. in Long Branch during the year ending October 31st, 1903. The first two cases occurred in the residential section of the town. No definite source of infection was traced, but it is supposed that the disease was contracted in New York City. The patients had been shopping in New York during the Christmas holidays, and the disease appeared fourteen days after visiting the city. The three cases that followed were undoubtedly due to exposure to the first two cases. The sixth case was in the person of a colored man employed at the crematory. The last case was reported in the latter part of October.

Middle Township, Cape May County.-A case of small-pox occurred in this township in the winter of 1903. The person having the disease had visited Vineland and it is presumed that he was exposed to the infection in that city. As there is no hospital in this sanitary district, domestic quarantine was resorted to.

Millville. During the year ending October 31st, 1903, forty-four cases of small-pox occurred in this city. The first case was brought from South Vineland, three miles north of Millville. It is probable that in the second and subsequent cases the infection was due to direct exposure to persons having the disease. The last case that occurred in the city was imported from Philadelphia. The majority of the cases were of a mild type. The local board of health took prompt action in establishing strict quarantine in every instance, and free vaccination was offered to the public. No deaths resulted from the outbreak of the disease. The total cost of dealing with the cases was $4,000. There is no isolation hospital for the care of cases of small-pox, and it was necessary to depend upon domestic quarantine.

Montclair. Two cases of small-pox occurred in Montclair during the year ending October 31st, 1903. The first case was reported April 18th, 1903. The patient was a young, unvaccinated person, who had come from New York City. The case was discovered and isolated within a few hours after the arrival of the patient, so that there had been very little exposure to the infection. All persons, however, who had been exposed to the case were vaccinated, and there were no secondary cases. The patient recovered and was released from quarantine within three weeks. The second case occurred in the person of a domestic that had been vaccinated in childhood, and had been a resident in the town for some time. She was taken ill August 22d, and a diagnosis of small-pox was made August 26th, upon which date she was removed to the isolation hospital. The patient was in quarantine for