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P..was positive to a titre of 1/2500 and 0 1/300.
By this time all three patients were convalescent and had had normal temperatures
for more than a week.
It is interesting to note that at Newport fumigation of the ship gave a kill o
800 rats I
G,the Greenwich case had a profuse papulomascular rash on 29th August
and produced a positive Widal 1/400 Para B (H) on 7th September and a positive resued
]/l50 Proteus X 19 on 9th September. He appeared to have been more typical of
Typhus than the cases in Denton.
Further specimens of blood, faeces and urine were forwarded to both Greenwich
Laboratory and the Hendon Laboratory on the 12th September, so that the Para B
complication could be further investigated.
The patients in Denton were seen repeatedly by Drs. Willoughby, Jones, Davies
and Malcolm and by Dr. Pinching and Mr. Leeson of Seamen's Hospital, Greenwich.
All agreed that clinically the cases were Paratyphoid.
Both patients were examined for lice on heads and bodies but none were found.
Typhus was considered as a possible differential diagnosis from the beginning.
SMALLPOX - s.s. "MOOLTAN"
Peninsular & Oriental Steam Navigation Co.
The s.s. "MOOLTAN11 began her voyage from Australia to London at Brisbane on
the 8th February, 1949 and the following list shows the ports of call and the
dates:-
Brisbane 8.2.49 Bombay 10.3.49
Sydney 18.2.49 Aden 15.3.49
Melbourne 19.2.49 Port Said 18.3.49
Adelaide 22.2.49 Marseilles 25.3.49
Fremantle 26.2.49 London 2.4.49
Colombo 7.3.49
HISTORY OF CASE.
1. A passenger Mr. R.A. and his wife occupying the same cabin on board went ashore
at Bombay for a few hours. It is not known exactly what they did ashore but presui
ably they visited various parts of the town. Neither Mr. A. nor his wife had ever
been vaccinated.
2. On the 24th March Mr. A. complained of stomach pains and obtained from the
senior of the two Ship Surgeons, a bismuth mixture.
3. On the 25th March the ship arrived at Marseilles and it appears that Mr. A.
kept to his cabin and was not seen by anyone. It is believed that he had the
beginnings of a rash on that day and kept quiet in his cabin for fear that if he
reported his condition to the Ship's Surgeon, the Marseilles Quarantine Authorities
might remove him from the ship.
4. The "Mooltan" sailed from Marseilles on the night of the 25th March at 10.30
p.m., and he then called in the Ship's Surgeon who discovered a prolific papular
rash accompanied by fever and prostration. The rash is said to have appeared
rapidly in the following order - chest, back, face, arms, thighs, legs and feet*
Both axillae and groins were eventually involved and he had two melaenotic stools
on the second and third days after the onset of the rash.
5. The Ship's Surgeon called two Indian medical men, passengers on board, into
consultation on the patient's condition and either they pronounced that the disease
\vas, or concurred with the Ship's Surgeon's diagnosis of, chickenpox.
6. The Ship's Surgeon based his diagnosis on what he regarded as a centri-petal
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