View report page

place with Dr. Corbett as to further disinfection that might be required and the
action eventually taken will be referred to later in the report.
25. On Monday 4th April the Ship's Dispenser, aged 56, was reported by the Ship's
Surgeon to be ill with Photophobia, irritability, Dysarthia, inability to understand
what was said to him and unable to act on instructions (patient was very deaf). No
pyrexia, normal pulse and respirations. He was thought to be suffering from
Haemaplegia or cerebral thrombosis.
26. After some delay due to the inability to find suitable side -ward accommodation
for him in any hospital, he was admitted to Denton Hospital on the 5th April and was
seen by myself and on the next day by Dr. Boul. A diagnosis of meningismus was made
due possibly to (a) alcoholism (b) fracture of the skull or (c) concussion.
27. There was clearly no evidence whatsoever of smallpox and the patient was
eventually transferred, on the 6th April to the London Hospital.
28. Incidentally the patient was conveyed to Denton from the Royal Docks in an
ambulance obtained from East Ham, the driver of which had never been vaccinated and
the attendant had been vaccinated in infancy in 1898. Both were vaccinated by
Dr. Willoughby on arrival at Denton and the blankets from the ambulance were held
for steam disinfections
29. On Thursday, 7th April, the Ship's Surgeon was called to a cabin to see a
lascar who was said to be ill and developing a rash. It appears that the man had
felt seedy the night before and had therefore been moved by the Serang out of the
compartment in the afterpeak which he occupied with ten other men into an empty
cabin. The Ship's Surgeon discovered that the man was feverish and had a rash and
he promptly notified Dr. Corbett who in turn notified the Port Health Office.
30. I went down without delay to the ship and in company with Dr. Corbett made an
examination of the patient. I found him to be a well developed man of about 30
years of age, lying in bed with fever and malaise. His temperature vias 100.4°F.
On examination he was found to be developing a papular vesicular rash practically
confined to the trunk, thighs and upper arms. The rash was profuse and rapidly
developing. No spots could be found on the face and head, other than two small
papules on the forehead. There were two small papules on the thenar eminence
of the right hand. There were no papules to be found on the feet. There was a
history of repeated previous vaccinations though only one mark could be clearly
seen and an immune reaction to the vaccination of the 2nd April at Tilbury.
31. In view of the history of smallpox in the ship I got into touch with Dr. Boul,
the Ministry Smallpox Consultant who kindly agreed to come to the ship as soon as
possible .
32. Dr. Boul agreed with my provisional diagnosis of chickenpox in the light of the
appearance of the rash and its distribution but he also agreed that in view of the
circumstances no risk whatever should be taken and that the case should be
transferred to Clandon for observation and bacteriological investigation. This was
done later in the day.
33. Meanwhile another case of fever in a lascar, was reported to me and I asked
Dr. Boul to look at the man. This turned out to be the result of a positive vaccina
reaction to the vaccination performed on Saturday, 2nd April.
34. A discussion took place between Dr• Boul, Dr. Corbett, the Marine Superintendent,
the Chief Officer and myself as to the measures to be taken following the
discovery of the case of chickenpox and it was agreed that measures should
promptly be taken as if the case were one of smallpox and -until confirmation of the
provisional diagnosis of chickenpox was obtained.
35.This involved the taking of preventive measures in regard to a large number of
shore gangs working on the ship and by arrangement with representatives of Messrs.
Green & Silley Weir, the Dock Labour Board, H.M. Customs and several other organisations,
lists were prepared of all the men concerned. Notices were set up in the
ship to the effect that a further case of suspected smallpox had been discovered on
(13)