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SMALL-POX.
The ss. "Warwickshire" arrived at Gravesend from Rangoon on the 1st January,
1927, having landed two of the native crew at Colombo, on December 8th, 1926,
suffering from suspected mild Small-pox. The diagnosis was subsequently confirmed
by telegram. Full disinfection was carried out by the Port Authorities at Colombo.
No further case occurred.
The ss. "City of Venice" arrived at Gravesend from Calcutta on the 3rd January,
1927, having landed a case of Small-pox and two contacts (all natives) at Aden on
the 17th December, 1926. The whole of the passengers and crew were vaccinated and
disinfection carried out. No further case occurred.
The ss. "City of Benares" arrived at Gravesend from Calcutta on the
9 th January, 1927, with Small-pox on board :—
Case 1. A Lascar who joined at Calcutta on the 7th December, 1926, was taken
ill on the 14th December. Temperature normal, spots on face and wrist. No other
symptoms. 15th December: Temperature 101.4, spots more pronounced on face,
limbs and body. 19th December to 23rd December: General pustular rash. The
patient was found dead at 7 a.m. on the 24th December, and was buried at sea the
same day. There was no evidence as to vaccination. The case was infected at Calcutta.
On arrival of the vessel at Suez, on the 26th December, all the crew were re-vaccinated
with the exception of Case 2: A fireman, who was missed and appears to have evaded
the operation. This case, not an immediate contact of Case 1, was first taken ill on
the 8th January, 1927, and isolated at once. On arrival at Gravesend the case was
seen by the Boarding Medical Officer, who reported: "Patient looks ill, has profuse
papular shotty rash on face and ears, also present on arms and limbs, particularly
wrists. Eash just coming out on trunk and limbs. No vaccination marks to be seen."
The case was removed to the hospital of this Authority at Denton. Infected from
Case 1.
The following precautions were taken:—
The starboard cabin forward was disinfected by wash and sulphur fumigation
and all contents removed to Denton Hospital with the patient. Five beds adjoining
the bunk in the forecastle were also removed, and general fumigation of the forecastle
was carried out. The native crew (71) remained on board, and the European crew's
addresses were notified to the Medical Officers of Health concerned as they left the ship.
It is a striking fact, but no longer a matter of wonder, that the disease should
have sought out the one member amongst the native crew, who, whether by evasion
or oversight, escaped the preventive measure of re-vaccination. Every other member
of the crew was vaccinated on the leg as a precautionary measure, and presented the
scars either of success or failure of this vaccination. The successful proved the efficacy
of the lymph used. The unsuccessful vaccinations show the large degree of immunity
to Small-pox which the persons unaffected by re-vaccination already possessed. Since
the patient in Denton Hospital was not in particular association with the original
infecting case who died during the voyage, one again notes the powerful selective
infectiousness of Small-pox for the unvaccinated.
The ss. "Clan Macnair" arrived at Gravesend on the 10th January, 1927, having
landed a case of Small-pox at Colombo on the 10th December, 1926. Disinfection was
carried out by the Port Authorities there. No further case occurred.