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18
Movements of Vessel:—
Melbourne January 29
Adelaide ,, 31
Fremantle February 4
Colombo ,, 13
Bombay „ 16
Port Sudan February 22
Suez ,, 24
Port Said ,, 25
Marseilles March 2
London ,, 8
Number of Persons on Board :—
Passengers, 475. Crew : European, 127 ; Native, 179.
In addition 72 passengers left the ship at Marseilles.
History of Case.—The patient, Mrs. B., aged 71, embarked with her
husband at Bombay on 16th February. On 19th February the bedroom steward
reported that she was " wandering in her mind." The assistance of the Ship's Surgeon
was refused, but he insisted on seeing the patient. There were then, however, no
symptoms suggestive of Small-pox. On the morning of 24th February Mr. B . . .
asked the Ship's Surgeon for a " tonic " and, on being questioned, admitted that the
medicine was not for himself but for his wife. Again the Surgeon insisted on seeing
the patient. He found her to be very ill, with a temperature of 102-2° F., and the
eruption of Small-pox just coming out. The distribution was typical, and during the
day the Surgeon observed the development of the rash from the macular to the papular
stage. In the evening of the same day the ship arrived at Suez, and the patient and
her husband were removed to hospital ashore.
Action taken on Board.—After removal of the patient to hospital her cabin was
disinfected. All the passengers landing at Port Said were vaccinated before
disembarking. On 25th February every member of the crew was vaccinated, and free
vaccination was offered to all passengers. 166 passengers accepted vaccination,
128 held certificates of vaccination within the last three years, 15 were exempted after
inspection because they had had Small-pox or had marks of recent successful
vaccination, 3 were ill and unfit to be vaccinated, and 45 stated that they have been
recently vaccinated but held no certificates. Seven refused vaccination ; of these
only two had never been vaccinated. Of the 109 military passengers, eight were
vaccinated on board and 101 had certificates of recent vaccination.
Action taken in London.—The " Mongolia " arrived off Gravesend at 11 a.m., and
was immediately boarded by Drs. Warrack, Willoughby, Mellows and Parry, two clerks
and two Sanitary Inspectors. The crew and passengers were all medically inspected
their names and addresses were carefully checked, and each was given a card on which
to notify any change of address Avithin 14 days of disembarkation.
The notifications were posted to 204 Medical Officers of Health by the evening
post from London.
Various articles which had remained in the patient's cabin were removed to
Denton Hospital for disinfection by steam and the cabin was again fumigated.
The ship was finally cleared at 1.30 p.m.
Observations.—Undoubtedly the patient was infected with Small-pox before
embarking at Bombay.
It appears that the passenger was disinclined to seek the advice of the Ship's
Surgeon and, had the latter not been particularly careful and conscientious, diagnosis
might have been delayed and the infection widely spread on board.
The Surgeon is to be commended for his insistence on seeing the patient, and for
the promptness with which he undertook the vaccination of passengers and crew.
The double post-card system of recording names and addresses on disembarkation
and changes of addresses subsequently worked admirably.