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In view of the difficulty in tracing the precise movements of the
patient whilst in Kensington. I requested the Ministry of Health to
arrange for the patient to be interviewed in hospital. This was done by
one of their medical officers and an interpreter who, I understand, had
considerable difficulty as the patient only spoke a rather obscure
Bengali dialect. Further difficulties arose from the fact that his
passport, passenger ticket and baggage check, and international vaccination
certificate could not be found. Search for these continued at the
two lodging houses, at the hospital and at the airport, until the
passport and ticket were located on the evening of 2nd March, 1968, but
the international certificate was not found. From the information
obtained from this source, from my own officers and from my colleages in
Westminster, a reasonably clear picture was obtained of the problem which
we faced in the isolation and observation of contacts.
Thirty-seven people were found to be living in the house and, of
these, five were found to have been in close contact with the patient.
In view of their involvement in the catering trade, it was considered
advisable to suspend them from work from the ninth day after the earliest
possible date of effective contact. Arrangements were accordingly made
with each of their employers to exclude them from work until further
notice. Children in the house were similarly excluded from school.
All contacts in the house were vaccinated by a principal medical
officer, unless they were able to produce written and clinical evidence
of recent vaccination. Every contact was interviewed and questioned
concerning his state of health and the immediate contacts were given a
medical examination with special reference to incipient signs of
smallpox.
Subsequently, and up until the sixteenth day from the last known
contact with the patient, at least two visits per day, including weekends,
were made to the premises by officers from the department. Each
morning between 8.30 and 9.00, the five close contacts were medically
examined and their temperatures taken. Precise enquiries were also made
concerning the health of each of the other occupiers. A second visit
was made to the premises by a Public Health Inspector during the late
afternoon to ascertain that all contacts were still well.
The patient's room was disinfected with formalin in the manner
prescribed by the Ministry, and all the bedding, bedclothes and
personal effects of the patient and the other occupants of the room
were taken to the Disinfecting Station and disinfected by steam under
the required pressure. The room was sealed and was not re-opened
until the next day. All the recommended precautions were taken in
connection with the disinfection of the Council's vehicle which was used
and the clothing which was worn by the operators.
The five close contacts were in virtual isolation at Cromwell Road
and, with a view to assisting them in preventing spread of a possible
infection, arrangements were made for periodic collection of articles
for washing, which were then taken to the Disinfecting Station,
laundered and returned; this, of course, meant special precautions
being taken as a considerable amount of other laundry work is undertaken
at these premises.
Shopping became a problem for the contacts and, therefore,
arrangements were made for this to be done, where necessary, by an
officer from my department. Wages were collected and delivered to the
persons concerned. All documents in connection with sickness pay,
etc., which were handled by the contacts, were collected by my
officers, disinfected and then transmitted to the authorities
concerned. Milk bottles from the premises were collected by the
disinfecting staff and sterilized before returning them to the dairy
companies.