Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Report for the year ended 31st December 1920 of the Medical Officer of Health for the Port of London
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(a) The definition of "Infectious Disease" given is an inclusive term which
covers all the ship infections in which interference may be desirable on the part of a
Port Sanitary Authority.
(b) The power set out in paragraph 3 was sought by your Worshipful Committee
in the peculiar circumstances of the Port of London, where the boarding station is at
some distance from the extensive docks. Such power had hitherto only been given in
case of Cholera, Yellow Fever and Plague; it is necessary in case of Small-pox, Typhoid
or other Infectious Disease or in the examination of a ship suspected of carrying
infection Through paragraph 4 (b) passengers from inland infected places are
brought under examination whatever the state of the port of embarkation or condition
of the ship as regards known infection, a valuable departure from precedent which will
be applied to short voyage passenger ships when occasion demands.
(c) Paragraph 6 (a) throws upon the Master the onus of declaring mortality or
sickness among rats or the presence of dead rats. (By definition "Master" includes
"officer or any other person for the time being in charge or command of a ship.")
The necessity for this was seen and urged by your Worshipful Committee in connection
with the Plague-infected ships which have entered and rat mortalities which from time
to time have occurred in the Port.
(d) Paragraph 4 (g) implies powers of disinfestation somewhat equivalent to those
of the Rats and Mice Destruction Act as regards rats—the burden of the work being
placed where the advantages accrue. It also covers the removal of other verminous
conditions on the same lines; the presence of infection is not necessary to action in
removing conditions likely to convey infection or which harbour vermin.
The regulations have assumed their present form in place of the draft of 1919.
They are, in my opinion, a complete charter to a Port Sanitary Authority for effective
work in infectious disease, regularising procedures which hitherto have been
practicable only by the co-operation of the steamship companies, and conveying duties
to the Masters and travelling public which shall ensure the recognition on their part of
their responsibilities to the community. The basis of the regulations would appear
to be " reasonable necessity."
TABLE II.—INFECTIOUS DISEASE.
Disease. | 1911. | 1912. | 1913. | 1914. | 1915. | 1916. | 1917. | 1918. | 1919. | Mean annual number for 10 years ending 31st December, 1920. | 1920. |
---|---|---|---|---|---|---|---|---|---|---|---|
(a) Cases reported: | |||||||||||
Cholera (including suspected cases) | 9 | 2 | 19 | ... | 2 | 5 | 2 | ... | 9 | 5.8 | 10 |
Yellow Fever (ditto) | ... | ... | 4 | ... | ... | ... | ... | ... | ... | 0.6 | 2 |
Plague (ditto) | ... | 9 | 4 | 4 | 4 | ... | 18 | 12 | 20 | 7.7 | 6 |
Small-pox | 13 | 34 | 19 | 9 | 47 | 15 | 2 | 16 | 43 | 22.5 | 27 |
Scarlet Fever | 11 | 10 | 40 | 30 | 18 | 5 | ... | 8 | 4 | 13.7 | 11 |
Diphtderia | 18 | 37 | 16 | 10 | 18 | 7 | 9 | 23 | 25 | 18.4 | 21 |
Enteric Fever | 70 | 61 | 65 | 67 | 64 | 61 | 43 | 26 | 77 | 58.5 | 51 |
Measles | 175 | 61 | 64 | 228 | 337 | 836 | 168 | 256 | 52 | 269.0 | 513 |
German Measles | ... | 3 | 4 | ... | 10 | 8 | 33 | 4 | 7 | 8.1 | 12 |
Erysipelas | 11 | 3 | 3 | 3 | 9 | 1 | ... | ... | 3 | 3.6 | 3 |
Typhus Fever | ... | 1 | ... | ... | ... | ... | 1 | ... | ... | 0.3 | 1 |
Continued Fever | 5 | 9 | 13 | 2 | 7 | 5 | 2 | 2 | ... | 4.6 | 1 |
Relapsing Fever | ... | ... | ... | ... | ... | ... | 19 | ... | 1.9 | ... | |
Tuberculosis:— | |||||||||||
Pulmonary | ... | 71 | 151 | 127 | 96 | 53 | 45 | 38 | 51 | 69.9 | 67 |
Otder kinds (including Miners' Phtdisis). | ... | ... | 7 | 45 | 6 | 19 | 26 | 20 | 35 | 16.0 | 2 |
Otder diseases (including Chicken-pox). | 38 | 42 | 38 | 50 | 48 | 44 | 166 | 2,2 1 | 1887 | 563.1 | 766 |
Total | 350 | 343 | 447 | 575 | 666 | 1,059 | 515 | 2,976 2 | 2,213 | 1,063.7 | 1,493 |
(b) Treated in Port Sanitary Hospital: | |||||||||||
Cholera (including suspected cases) | ... | ... | ... | ... | ... | ... | ... | ... | 1 | 0.1 | ... |
Yellow Fever (ditto) | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... |
Plague (ditto) | ... | 1 | 2 | 1 | ... | ... | 9 | 12 | 10 | 3.7 | 2 |
Small-pox | 6 | 2 | 9 | 2 | 10 | 2 | ... | 1 | 13 | 5.5 | 10 |
Scarlet Fever | 6 | ... | 3 | 8 | 10 | 2 | ... | 5 | 1 | 3.8 | 3 |
Diphtderia | 3 | ... | 7 | 1 | 3 | 1 | 1 | ... | 1 | 2.1 | 4 |
Enteric Fever | 22 | 35 | 29 | 30 | 17 | 34 | 15 | 7 | 42 | 24.2 | 11 |
Measles | 7 | 27 | 18 | 9 | 33 | 4 | 3 | 2 | ... | 13.8 | 35 |
Erysipelas | ... | 1 | ... | ... | 1 | ... | 1 | ... | ... | 0.4 | 1 |
Typhus Fever | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... |
Continued Fever | 4 | 7 | 9 | 1 | 5 | 4 | 8 | 6 | ... | 4.5 | 1 |
Otder diseases (including Chicken-pox). | 8 | 7 | 14 | 9 | 11 | 6 | 24 | 24 | 22 | 13.8 | 13 |
Total | 56 | 80 | 91 | 61 | 90 | 53 | 61 | 57 | 90 | 71.9 | 80 |
Cholera (including suspected cases) | 9 | 2 | 19 | ... | 2 | 5 | 2 | ... | 9 | 5.8 | 10 |
Yellow Fever (ditto) | ... | ... | 4 | ... | ... | ... | ... | ... | ... | 2 | |
Plague (ditto) | ... | 9 | 4 | 4 | 4 | ... | 18 | 12 | 20 | 6 | |
Small-pox | 13 | 34 | 19 | 9 | 47 | 15 | 2 | 16 | 43 | 27 | |
Scarlet Fever | 11 | 10 | 40 | 30 | 18 | 5 | ... | 8 | 4 | 11 | |
Diphtheria | 18 | 37 | 16 | 10 | 18 | 7 | 9 | 23 | 25 | 21 | |
Enteric Fever | 70 | 61 | 65 | 67 | 64 | 61 | 43 | 26 | 77 | 51 | |
Measles | 175 | 61 | 64 | 228 | 337 | 836 | 168 | 256 | 52 | 513 | |
German Measles | ... | 3 | 4 | ... | 10 | 8 | 33 | 4 | 7 | 12 | |
Erysipelas | 11 | 3 | 3 | 3 | 9 | 1 | ... | ... | 3 | 3 | |
Typhus Fever | ... | 1 | ... | ... | ... | ... | 1 | ... | ... | 1 | |
Continued Fever | 5 | 9 | 13 | 2 | 7 | 5 | 2 | 2 | ... | 1 | |
Relapsing Fever | ... | ... | ... | ... | ... | ... | 19 | ... | 1.9 | ... | |
Tuberculosis:— | |||||||||||
Pulmonary | ... | 71 | 151 | 127 | 96 | 53 | 45 | 38 | 51 | 67 | |
Other kinds (including Miners' Phthisis). | ... | ... | 7 | 45 | 6 | 19 | 26 | 20 | 35 | 2 | |
Other diseases (including Chicken-pox). | 38 | 42 | 38 | 50 | 48 | 44 | 166 | 2,2 1 | 1887 | 766 | |
Total | 350 | 343 | 447 | 575 | 666 | 1,059 | 515 | 2,976 2 | 2,213 | 1,493 | |
(b) Treated in Port Sanitary Hospital: | |||||||||||
Cholera (including suspected cases) | ... | ... | ... | ... | ... | ... | ... | ... | 1 | ... | |
Yellow Fever (ditto) | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... |
Plague (ditto) | ... | 1 | 2 | 1 | ... | ... | 9 | 12 | 10 | 2 | |
Small-pox | 6 | 2 | 9 | 2 | 10 | 2 | ... | 1 | 13 | 10 | |
Scarlet Fever | 6 | ... | 3 | 8 | 10 | 2 | ... | 5 | 1 | 3 | |
Diphtheria | 3 | ... | 7 | 1 | 3 | 1 | 1 | ... | 1 | 4 | |
Enteric Fever | 22 | 35 | 29 | 30 | 17 | 34 | 15 | 7 | 42 | 11 | |
Measles | 7 | 27 | 18 | 9 | 33 | 4 | 3 | 2 | ... | 13.8 | 35 |
Erysipelas | ... | 1 | ... | ... | 1 | ... | 1 | ... | ... | 1 | |
Typhus Fever | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... |
Continued Fever | 4 | 7 | 9 | 1 | 5 | 4 | 8 | 6 | ... | 1 | |
Other diseases (including Chicken-pox). | 8 | 7 | 14 | 9 | 11 | 6 | 24 | 24 | 22 | 13 | |
Total | 56 | 80 | 91 | 61 | 90 | 53 | 61 | 57 | 90 | 80 |