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The wife of the patient, who refused vaccination, developed Small-pox on
20th January, 1929. No information was received of the occurrence of any other
secondary case.
The ss. "Karmala" arrived at Gravesend on the 10th January, from Yokohama,
having landed a case of Small-pox to hospital at Colombo. The native and European
crew and all the passengers, with the exception of one woman and two children, were
vaccinated, and the infected quarters, &c., fumigated at Colombo. No further case
occurred.
The ss. "Hector" arrived at Gravesend on the 30th January, from Darien,
having landed a case of Small-pox at Colombo, on 6th January. All the crew and
passengers were vaccinated by the ship's surgeon and the infected quarters disinfected
by the Colombo Port Authority. No other case occurred.
On the 13th February a telephone message was received from the London Agents
of the MV. "Tantalus," reporting the outbreak of Small-pox on this vessel. At the
time of the report the vessel was at Amsterdam, and was expected to leave for London
on the 16th-17th February. Further information to the effect that the cases had been
removed to hospital in Amsterdam, the crew isolated in the quarantine station and
disinfection carried out was received on the loth February.
On the arrival of the vessel at Gravesend, on the 19th February, she was boarded
by the Boarding Medical Officer, who carefully examined the crew. No suspicious
case was discovered. The names and addresses of the crew were carefully checked
and forwarded by post the same evening to the Medical Officers of Health concerned.
The crew were all paid off in London.
History of Outbreak.—The vessel came from the Dutch East Indies, and had
carried pilgrims thence to Jeddah. No case of Small-pox was detected amongst the
pilgrims, but one pilgrim, a child of 10 months, was reported to have died of "Vaccinia"
on 7th January, 1929.

As the vessel had not been to any port known to be infected with Small-pox, the
illness was first diagnosed as Dengue Fever, and not until the eruption became pustular
was Small-pox diagnosed.
The cases were isolated in the ship's hospital and the infected living quarters
were disinfected. All the crew were vaccinated by the ship's surgeon on 5th February.
T. M. died on 9th February, and was buried at sea.
On arrival at Amsterdam, on 13th February, S. H. and G. H. were removed to
hospital; J. M. and J. R. were put in observation isolation, as they had a slight rise in
temperature. The remaining 52 members of the crew were taken to the quarantine
station and given disinfectant baths. Their bedding and clothing were disinfected by
steam. The living quarters and hospital were fumigated with formalin.
On 14th February J. M. was diagnosed as Small-pox, and on 15th February all
the crew were re-vaccinated by the Port Medical Officer of Health, Amsterdam.
J. R. was detained in Amsterdam, but had not been declared as a case of Small-pox
when the ship left on the 18th February.