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17
One of the London Port Health Authority's Boarding Medical Officers who saw
the patient when the ship arrived, subsequently developed a very mild attack of
modified Smallpox, and one other case occurred in Gravesend.
The disease in the case of the Medical Officer was not quite typical of Smallpox.
The incubation period was very short, seven days instead of twelve ; and though some
of the spots had the characteristics of the eruption of Smallpox, others had not.
It was thought that the condition might have been due to vaccination, to inoculated
Smallpox, or to Smallpox greatly modified by vaccination. The decision was finally
in favour of the latter.
As regards the Gravesend case of Smallpox, the patient lived opposite to the
engineer on duty on the boarding launch at the time the case was landed from the ship.
The Engineer helped the patient on and off the stretcher, and also handled his bedding
and effects, but he was dressed in a white boiler suit, and before he went home he
stripped and bathed and his clothing was disinfected at Denton Hospital. The
Engineer knew the Gravesend case, but had not seen him since Christmas. Two
brothers of the patient did, however, visit the engineer shortly after he had handled
the case.
This was very slender evidence on which to base the source of infection, but
nothing more convincing could be ascertained.
(2) On the 8th August the Ministry of Health reported having received the
following telegram from Aden on the 4th August:—
"Steamship- bound Liverpool landed Aden 2nd August case proved
mild modified Smallpox Stop Unprotected crew revaccinated against
Smallpox. Porthealth."
It was ascertained that the vessel would be calling at London before proceeding
to Liverpool.
On 20th August at 7.30 p.m., the vessel arrived at Gravsend, and was boarded
by the Assistant Port Health Officer.
A native crew had been signed on in Calcutta on 12th July, all having been
vaccinated on the preceding day (11th July).
The vessel had left Calcutta homeward bound on 15th July, calling at the following
ports :—
Colombo, 23rd July ; Aden, 2nd August; Suez, 7th August; and Port
Said, 8th August.
On 25th July the patient, a native coal trimmer, reported sick with a profuse
eruption on face, arms, body and legs, and later on his hands and feet. No history of
prodromal symptoms was obtained, and in the absence of a doctor on board the precise
distribution of the rash and its detailed character could not be obtained. The patient
was isolated in the hospital cabin on 26th July. On 2nd August the vessel arrived at
Aden, and the patient was seen by the Port Medical Officer, who removed him for
observation with all his bedding and effects. On 4th August the vessel received a
radio " Case proved mild modified Smallpox."
The patient had occupied a room with five other members of the crew. This
room had been scrubbed out and thoroughly cleansed with lysol. The hospital had
been fumigated with sulphur dioxide, the cot frame cleaned with lysol, and the cabin
and fittings subsequently painted throughout.
On arrival of the vessel at Gravesend the European crew (12 in number) were
personally interrogated, inspected, vaccinal state noted and their home addresses
checked.
The native crew (58 in number) were all carefully examined, and no secondary
case was discovered.
The circumstances and action taken in London, together with a list of the names
and addresses of the crew, were forwarded for the information of the Medical Officer
of Health of Liverpool, to which port the vessel proceeded on the 24th August.