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SMALLPOX.
Your Medical Officer regrets to state that the arrangements for dealing
with smallpox and suspected smallpox and with contacts are far from satisfactory.
This was brought out by an incident in a large passenger ship which
arrived in the Port with an undiagnosed fatal case of smallpox on board in
April, 1949, A full account of the incident will be given in your Medical
Officer's report for that year.
Owing to the unvaccinated state of the population this country is in a
dangerous state of risk of the introduction of smallpox with potentially
disastrous results.
The discovery of a case of smallpox of which the diagnosis is in no
doubt is not nearly so serious in its potentialities for spreading
infection as is the case of mild smallpox which slips in undiagnosed or is
the subject of an erroneous diagnosis.
Smallpox is so subtle in its attack and is of such high infectivity
that only the strictest measures of isolation, carried out by a thoroughly
trained and experienced staff of doctors and nurses can be regarded as likely
to meet the risks involved.
Unfortunately nursing staffs trained in the handling of smallpox cases
are by no means readily obtainable at short notice so that the early
isolations, which is the critical period in the prevention of the spread of
the disease, is not easy to arrange.
The Isolation Hospital at Denton provides excellent accommodation and
facilities for strict isolation of smallpox but only if other cases of
infectious disease are forthwith evacuated from the hospital and the trained
nursing staff is immediately available to take control.
The actual treatment of the case is not of primary importance; it is
the strict isolation that is the essential requirement. This involves not
merely isolation of the case in a ward or cubicle but proper handling of
infected bedding and personal effects, the sterilisation of all articles,
crockery etc. that come into contact with the patient, disinfection of
soiled linen and last, but not least, strict attention to the personal
hygiene of the nurses so that infection is not conveyed through them to
others while they are off duty.
Adequate arrangements for the conveyance of the case under strict control
from the ship or dock to the isolation hospital and for the removal of
infected bedding, furniture and indeed all articles that nay have be con.
contaminated, also under strict control, for disinfection or sterilisation,
are also essential.
It is to be hoped that a better organisation than at present obtains
will be built up to meet the needs of the Port in the near future. One
thing is certain that smallpox does not await the convenience of anyone. It
is only by making precise arrangements which can be put into force at any
moment of the day or night that the menace of this disease can be regarded
with any complacency.
V. MEASURES AGAINST RODENTS.
1. Steps taken for the detection of Rodent Plague.
2. Measures taken to prevent the passage of rats between ship and shore.
3. Methods of Deratisation.
4. Measures taken for the detection of rat prevalence in ships and on shore.
5. Rat-proofing
The action taken under the above headings was fully described in my
Report for 1947.
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