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contact had been landed at Suez on the 28th January; the vessel was bound for
London, calling at Plymouth on 9th February. The Medical Officer of Health of Plymouth was immediately notified.

Number of Persons on Board.—Passengers, 371. Crew: Europeans, 221;
Natives, 243. In addition, 161 passengers left the vessel at Marseilles and 45 passengers
at Plymouth.
History of the Case.—The patient, J. H., an American passenger, came on board
at Bombay on 21st January with a fellow traveller, who occupied the same cabin.
At Aden this fellow traveller informed the Ship's Surgeon that J. H. had been so ill
for three days before embarking that he was only just well enough to come on board
at Bombay, and that he now had some spots on him. The Ship's Surgeon saw the
patient and found a pustular rash all over the body, particularly marked on forehead,
face and backs of wrists. There were three spots in the palms of his hands and two
on the soles of his feet. J. H. was a Christian Scientist, and therefore had not asked
for medical advice.
Action taken on Board.—The Surgeon diagnosed Variola, and at once isolated
both the patient and the contact in the ship's hospital on the poop deck. The contact
was at once vaccinated, but as he was landed with the patient at Suez the result could
not be ascertained.
The whole of the European crew (221) were vaccinated except those members
who could show evidence of successful vaccination within the last two years. The
native crew (243) were all protected by vaccination within the last year.
The passengers were all offered vaccination. Of those who landed at London,
219 availed themselves of the offer and 152 declined to be vaccinated. The majority
of the latter had been vaccinated within the last five years.
Action taken in London.—The vessel arrived off Gravesend at 4.30 a.m. on
Friday, the 10th February, and was boarded by Dr. H. Willoughby. The entire crew
(European and Native) was examined at 6 a.m., and the home addresses of the
Europeans checked. No member of the crew was found to be sick.
At 8.30 a.m., Dr. Willoughby, accompanied by Dr. Warrack and two of the
clerical Staff, again boarded the vessel off Tilbury landing stage, when the whole of
the passengers were examined and their addresses carefully checked with the passenger
lists. The names and addresses of the passengers were forwarded to the Medical
Officers of Health of the district concerned by 7.50 p.m. the same day, and those of
the European crew were posted on the morning of 11th February.
The entire alleyway in which the patient's cabin was situated had been disinfected
immediately after the removal of the case to the ship's hospital and the hospital had
been disinfected immediately after the landing of the case at Suez. The patient's
personal effects had been landed with him. The hospital bedding had been exposed
to Sulphur Dioxide. On arrival at Gravesend, this bedding, &c., was taken to Denton
Hospital for steam disinfection, and after the vessel docked the infected cabins and
the isolation hospital were again disinfected.
The native crew and those members of the European crew who remained on board
were kept under daily observation.