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On arrival in London the Master received a letter from the patient reporting that
he was convalescing.
At Madras the patient's personal effects were landed with him, his bedding
destroyed and his cabin disinfected. The native crew's quarters and latrines were also
disinfected. The whole of the crew—European and native—were inoculated against
Cholera. The fresh water which had been taken in at Calcutta was pumped out, and
the tanks were cleansed and refilled with Madras water.
No further action in this port was deemed necessary, and no other case occurred.
Plague.
The ss. "City of Tokio" arrived off Gravesend on 11th November, 1929, and
the Boarding Medical Officer ascertained that the chief steward had developed
Bubonic Plague on board on 12th July, and died on 21st July. The vessel was
fumigated with carbon dioxide at Woosung Forts on 22nd July, and again at Nagasaki
on 6th August, with sulphur dioxide. No further cases occurred. On arrival in
London all the crew were well, and careful examination revealed no suspicion of
rodent Plague on board. Though the vessel was not, on arrival in London, either
a Plague-infected or Plague-suspected ship, the history of the occurrence is interesting
and instructive, and is therefore detailed below :—
The chief steward went ashore at Singapore on 9th July to purchase stores at
a ship's chandlers. He was only away from his ship for about an hour. On 12th July
he was taken ill with fever (temperature 103° F.), but no localising symptoms. On
16th July the vessel arrived at Hong Kong, and the patient was seen by a doctor on
that and the following day. Plague was not diagnosed. On 19th July the patient
complained of pain in his right groin, and a bubo was found with a small black ring in
the centre of the inflamed area. The next day both the area of inflammation and the
central black patch had considerably increased in size, but the man no longer
complained of pain. Early the next morning he was found dead in his bunk. The
same day the vessel proceeded to Woosung Quarantine Station, where the Port Medical
Officer ordered the bodv to be taken ashore for examination. The case was
subsequently pronounced to have been one of Bubonic Plague, the diagnosis being
confirmed bacteriologically by culture and inoculation.
One lascar was found at Woosung to have a bubo in the groin. He was taken
ashore at Shanghai, but the bubo was proved to be of venereal origin, and he was
returned to the ship. No evidence of rat Plague was discovered on board at anv time,
and there is very little doubt that the chief steward contracted the disease in Singapore
while ashore, probably in the ship's chandlers stores.
Apparently a week elapsed between the onset of illness and the appearance of
the bubo, so that the case was not diagnosed as Plague at Hong Kong on the fourth
and fifth days.
Small-pox.
On 9th January information was received from the Medical Officer of Health of
Poplar that a fireman who had landed in London from the ss. "Guildford Castle," on
6th January, had developed the symptoms of Small-pox at home on 7th January.
The "Guildford Castle" had left London for Continental ports on 22nd December,
1928, and it is probable that the patient was infected in Poplar before he left, though
it is possible that the disease may have been contracted at the first Continental port
visited or from a missed case on board. The disease was of a mild type.
The names and addresses of the remainder of the crew were obtained, and notified
to the Medical Officers of Health of the districts concerned. The quarters which had
been occupied by the patient were disinfected and his bedding burned.
As the "Guildford Castle" was sailing again on 10th January, the ship's surgeon
and the Board of Trade were informed. A careful inspection of all members of the
crew who had been on board with the patient was carried out, and all immediate
contacts were vaccinated, as were also as many others of the crew as would consent
to the operation.