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board and that all persons who were or had been working on board could be vaccinated
forthwith by attending at the Ship's Dispensary.In this my a large number of
vaccinations were performed on the afternoon of April 7th and also onApril 8th.
36. Meanwhile yellow "Business Reply" cards were issued to the 510 men involved a
their names and addresses forwarded to the 55 individual Medical Officers of Ilealt
of the districts in which they resided together with a covering note explaining th
circumstances and asking for daily medical supervision of the men until 25rd April
37. The compartment normally occupied by the case and the cabin in which he had
been isolated were closed and fumigated and his bed and bedding sent to Denton for
steam disinfection.
38. On Saturday, 9th April, I was informed by Dr. Coneybeare, that, in regard to
the first lascar, "the complement fixation test was negative and that no bodies had
been found in the scrapings of the papules or vesicles and I received a telephone
call from Dr. McPherson, the Medical Officer at Clandon to the effect that he agre
with the opinion of Dr. Boul and myself that the case was clinically one of
chickenpox.
39. On Monday, 11th April, Dro McCallum reported that the egg culture was negativ
to smallpox and Tt was agreed that the case could now be regarded definitely as on
of chickenpox.
40. Consequently on Tuesday morning, 12th April, I sent a notice to the Medical
Officers of all the districts in which the men working on the ship resided stating
that the case was now regarded clinically and bacteriologically as one of chickonp
and that therefore the daily supervision of the shore workers could be discontinued.
Further measures of precautionary disinfection.
41. On Monday and Tuesday, 11th and 12th April, I discussed with Dro Corbett such
further measures as might be thought necessary or desirable to remove all trace of
infection from the ship and, to that end, I asked Dr. Coneybeare if ho would
convene a meeting at the Ministry of Health to discuss the matter. This meeting
took place on Wednesday, 13th April, when certain principles were discussed and
agreement reached.
(a) It was agreed that the infectivity of a developing case of smallpox began
in all probability not earlier than 48 hours preceeding the development of
the rash and that for practical purposes it would bo safe to regard the
period of potential infectivity as definitely not excoeding three days. 0
that assumption secondary cases arising from contact with Mr. A* were
probably infected during the 24th and 25th March during which time Mr. A.
was either in his cabin or possibly moving about the ship complaining only
on the 24th at any rate, of indigestion.
(b) As to the persistence of the virus it was considered that the virus
contained in naso-pharyngeal droplets was unlikely to persist in the publi
rooms for any length of time. Virus in scabsiwas, of course, a different
matter altogether but the possibility of infection by this means could be
ruled out in this case.
(c) Consequently there might possibly be traces of virus in the public rooms and
in the dining saloon, visited by Mr. A. and it would be desirable to have
this accommodation fumigated. It was considered that fumigation carried out
in the cabins occupied by Mr. and Mrs. A. the stewards, nursing and medical
staff, that had been in close contact was already sufficient but the
meeting was glad to hear that it was proposed thoroughly to wash down these
spaces and then to re-paint or re-spray.
(d) As regards the public rooms it was agreed that it would be desirable to have
them fumigated (not sprayed) with formaldehyde to be followed by a thorough
washing down of the decks. Dr. Corbett subsequently informed me that the
Company had decided to engage Messrs* Associated Fumigators Ltd., to carry
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