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21
MALARIA ENTERING THE PORT OF LONDON.
The well-known malarial centres of East and West African Coasts and of India
will afford instances of malaria which have occurred during the voyage on every
incoming ship from ports situated therein.
The questions have only to be pushed to arrive at the case, which is generally
reported as " now well."
On the other hand, many febricula are reported as " malaria " by way of
definite diagnosis where definition is clearly impossible. " Malaria " and " Influenza
" share the mis-diagnoses of febrile cases with " cold " and " chill."
The definitely malarial invasions of a ship are mostly detected, and temporary
cure of symptoms effected by means of quinine. The masters and stewards of ships
which trade in infected regions are usually quick in detecting malaria, from long
experience. This does not always apply where the protean forms of Subtertian
Malaria are concerned, though in this disease quinine is usually given a successful
trial on instinct.
My impression is that the sea-faring community which goes into the tropics is
far more infected than appears from any record. Many men now date their present
attacks from the time of changing the gun at Dakar during the War.
Illustrative Ships.—ss. " Hunstanworth " from Rufisque, West Africa,
arrived at the mouth of the Medway on November 16th, 1922. The master declared
eight cases of malaria, three of pneumonia and one of peritonitis.
The ship left Rufisque on November 5th. The malaria came on after the ship
had left Las Palmas. The crew of 24 was or had been ill to a man ; only about four
men were fit to work the ship at the time of arrival. The ship had taken in cargo
up river and among swamps. Four of the crew had been taken on in Las Palmas,
these had there been in hospital, from another ship, which had also been at Rufisque;
one of these four men subsequently came into Denton Hospital, had the subtertian
parasite in his blood, and on entry was severely ill.
The ship had proceeded to Rochester before details could be fully gleaned,
but four men who were sent into Denton Hospital from Rochester, one with
delirium, showed the subtertian parasite—ring forms only.
The case of " peritonitis " (severe vomiting) died ; as also another.
ss. " Hesione " from Bombay, arrived 4th December at Gravesend and
reported 42 cases of Malaria as occurring when the ship was at Bombay, and subsequently
up the Malabar Coast. The type does not seem to have been severe.
The cases as they occurred were treated at various ports. The last case had occurred
15 days before arrival.
The crew was free from fever, but several were anemic and below par on
examination.
The master reported a good deal of Malaria on Bombay ships.
ss. " Chama " arrived 14th December. This ship had visited every port of
importance in the Bight of Benin and was coasting from early in September.
There were two cases of malaria on board on arrival and 6 cases in all had
occurred.
5 grains of quinine was given daily to all hands from the 3rd September to
the 20th November as a preventive measure. The ship was at Accra Secondee
Axim and Sierra Leone after the latter date.
The state of health of the crew appears to show the utility of the 5 grains
administered.
ss. " Hortensius " arrived from Beira at Rochester on July 21st. The report
of " about 22 cases of Malaria, all well now," is suggestive of the light way in which
the disease is viewed.
A subsequent single notification of Malaria from the Seamen's Hospital, in
a case which came from this ship on July 22nd, is at once a commentary on the report
and a clear indication in one case of the condition of infection which possibly
exists in nearly all the cases.