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All four cases were removed to hospital ashore and the bedding and other fomites removed
with them for steam disinfection. The ship's hospital and forecastle were 'spray disinfected'
with a fluid smelling strongly of 'carbolic'.
The entire crew of 23 Europeans and 66 Asians, plus 3 British Passengers, were vaccinated.
Action in London
The description given of the rashes, distribution of lesions, etc., were too vague to offer
much conclusive evidence but it is noteworthy that none of the four cases exhibited 'cropping',
a point which was pressed in Dr. Willoughby's enquiries and was productive of a positive
answer.
The fact that two of the cases occurred in deck ratings and two amongst the engineroom staff
is accounted for by the fact that six spare crew were being carried for other vessels in the
Shipping Company's fleet and owing to shortage of space some engineroom ratings were accommodated
in the seamen's forecastle.
Close inspection of all personnel on board failed to produce any fresh case on arrival.
A conference with the Master and Heads of the Ship's Departments was held and the following
measures were agreed and carried out by the Port Health Authority staff:—
(1) Quarantine
The vessel to remain in the Quarantine Anchorage in Higham Bight until the a.m. tide on
Monday, 21st March. This would allow the full sixteen days to elapse since the removal of the
cases at Suez. In this connection it was gratifying that the full co-operation of the Ellerman
Lines was extended to us.
(2) Vaccination
The previous vaccinal state of the entire crew was ascertained and valid certificates were
held by all. Without being too critical of the vaccinations carried out at Calcutta and Suez, it is
of interest to note that on inspection at Gravesend only one person could produce a positive
'take'. This was one of the passengers, so all the remainder were promptly re-vaccinated by
Dr. C.D. MacCarthy, 91 in all. The efficacy of this re-vaccination was subsequently shown by
the high percentage of 'takes'.
(3) Medical Inspection
A daily muster of all hands tobe carried out by the Duty Boarding Medical Officers on Friday,
Saturday and Sunday.
(4) Disinfection of Quarters, Bedding, etc. and Bathing of Native Crew
On the morning of Friday, 18th March, the Asian Crew were landed in three batches of 22
each to Denton Hospital for bathing in the Cleansing Block, an evolution which went off without
a hitch under the supervision of the recently appointed Port Health Inspector, Mr. Gwyer. During
this operation the Port Health team were carrying out fumigation of the ship's hospital and forecastle.
Bedding was handled into the launch by the third batch of Asians before they were
taken ashore for bathing. The bedding was then disinfected. Advantage was taken of the bathing
at Denton Hospital to inspect all the Asians when in a state of nudity and no rashes were
found.
(5) Channel Pilot
The Channel Pilot, who was vaccinated at Guildhall previous to joining the ship at Brixham,
was allowed to land under surveillance. His vaccination was inspected by Dr. Willoughby and
showed signs of an early positive 'take'.
(6) Treatment of Medical Case
The 7th Engineer (European) had some sepsis of the arm due to a burn. He was seen by
Dr. J.A. Jones and removed to Denton Hospital for treatment there.
Clearance of the Vessel
By the morning of Sunday, 20th March, no further cases of sickness had occurred on board
and, as the shipping Company were anxious to dock the vessel on the p.m. tide so as to begin
discharge of cargo on Monday morning, the vessel was released from all control by the Port
Health Authority.
Summary
At the time of the Great Plague, King Charles II instructed the Lord Mayor of London, who
was in administrative charge of the arrangements for plague control, to stop all ships coming up
the River Thames beyond Gravesend for a period of forty days and he placed two warships at the
disposal of the Lord Mayor for that purpose. The idea was to let any disease on board 'burn
itself out' before releasing the ship from quarantine control.
This report shows how we were able recently to apply the same principle in relation to
smallpox. Here was a ship with a history of smallpox cases on board up to March 5th (but no
known cases of sickness since), which we were able to seal up and keep under observation till
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