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22
Cerebro-Spinal Meningitis.
Case 1.—On the 5th April, 1932, the ss. "Clan MacBean" arrived at Tilbury
from Chittagong and other Indian ports via the Suez Canal for Tilbury Dock.
The Master reported that a Lascar fireman had been off duty in bed for the last
24 hours with a bad cold. He was examined by the Boarding Medical Officer and
found to have a normal temperature, but no other symptoms except those of a cold.
The Master was advised to obtain the services of a doctor, and, if necessary, to send
the patient to Tilbury Hospital. There were then no symptoms of Cerebro-spinal
Meningitis.
On the 14th April your Deputy Medical Officer of Health, on receipt of a notification
from London, proceeded to Tilbury Hospital with Dr. Kean and examined the
patient there. It was ascertained that he had been admitted to this Hospital on
the 6th April, complaining of pains in the head and spasms of the neck. He subsequently
had lumbar puncture on three occasions, and serum was given three times.
A culture was made of the fluid from a lumbar puncture and the characteristic germ,
the meningococcus, was discovered in pure growth. On the date on which the patient
was seen he was found to be recovering. He was isolated in Hospital, and all precautions
were being, and had been, taken. He was considered to be unfit to be
removed, and it was arranged that he should stay in Tilbury Hospital until he
recovered.
Case 2.—The ss. "Manaar" arrived at Gravesend early on 20th April. This
vessel left Calcutta on 12th January and proceeded to Boston, New York and
Philadelphia during February, and Baltimore, Norfolk, Philadelphia and Santa Cruz
during March, arriving at Criselda on 4th April.
On 5th March a native fireman was sent to hospital at Baltimore with suspected
Meningitis, but the diagnosis was not confirmed before the vessel left. He was
reported as having suffered from delirium, and no other particulars could be obtained.
Case 3.—On 21st March a native coal trimmer complained of headache and
pains in the back, he became comatose and died on 10th April and was buried at sea.
He was seen by a Spanish doctor at Criselda and treated for "intoxicated stomach,"
which might have been one of the symptoms of the disease. It is considered that
both these were cases of Cerebro-spinal Meningitis, and that Case 3 was infected
from Case 2.
Observations.—The ss. "Clan MacBean" arrived subsequently at Liverpool via
Rotterdam, and the Liverpool Port Sanitary Authority was notified and the vessel
disinfected there. The crew of the ss. "Clan MacBean" had been transferred to the
ss. "Halizones" which had also left for Middlesbrough and the Medical Officer of
that Port was similarly informed. The patients' effects were recovered from Tilbury
Hospital and taken to Denton Hospital for disinfection. No further cases were
reported.
The ss. "Manaar" was kept under daily observation while in this Port, and no
fresh cases were discovered. The infected forecastle was disinfected and subsequently
repainted.
V.—MEASURES AGAINST RODENTS.
The measures taken for the prompt detection of rat Plague in ships or on shore
in the Port, for the examination of ships in accordance with the Public Health
(Deratisation of Ships) Regulations, for the destruction of rats and for the extension
of rat-proofing which I described in my last Report, have been continued throughout
the year.
The total number of rats destroyed in ships was 3,944, of which 1,803 were killed
by fumigation and 2,141 were trapped. On shore 5,698 rats were destroyed, all by
trapping or poisoning.