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necessary to disembark the passengers when all names and addresses had been taken
and vaccination completed and it will be appreciated that so large a number of
passengers carried in the "Mooltan" could only be rapidly and expeditiously disembarked
if the ship were tied to the Stage. To take them off by tender from the
ship lying in the River would have involved many complications and much loss of time,
58. A further criticism took the form of an expression of doubt as to whether the
ship should not have been put into quarantine and kept in quarantine with all
passengers and crew until all risk of the appearance of further cases had been
eliminated. Such criticism fails to appreciate the innumerable difficulties in
feeding 1,400 souls for a period of 16 days in isolation in the ship. It was even
suggested that as an alternative the passengers should have been disembarked and
kept in isolation ashore during the period of quarantine - an equally difficult
proposition.
59. Above all the criticism fails to appreciate the present day policy in this
country as regards its protection against smallpox. The procedure is that actual
cases should be disembarked and isolated and contacts, after offer of vaccination,
should be placed under 'surveillance' but not isolation. The only power given to
a Port Medical Officer to isolate a contact is one in which he considers, either by
a refusal of vaccination or as a result of such close contact with an infected
person in point of time, that the contact is immediately threatened with an attack
of smallpox, such a person oan be kept under observation until the immediate risk to
himself and to others is past. These powers were only recently given to Port
Health Author it ie s.
60. "Business Reply" Cards. The system of handing the contact a yellow card of the
"Business Reply" type, instructing him to notify any change of address during the 16
days after disembarkation has on the whole, worked well on this occasion. One
hundred and forty six cards have been returned to this office during the 16 days
following disembarkation notifying change of addresses. So far as one can judge,
notification of the Medical Officers of Health of the districts into which the
passengers were proceeding has also worked remarkably to 11 and it is believed that
with only one or two exceptions, all passengers and crew contacts liave effectively
been kept under daily medical supervision.
51. In an appreciable number of instances there has been some delay in the receipt
of the 'Business Reply' cards notifying a change of address to this office. I have
taken the matter up with the Post Office Authorities and I have been assured there
should be no delay what soever. These cards should be delivered by the same
delivery as normal correspondence and the individual instances of delay have been
taken up to ascertain how the delay lias occurred.
62. In any case they have been very few in number but it is obviously important
that there should be no delay at all if supervision of contacts is to be continuous.
In one instance, owing to delay, a contact embarked on the "Queen Elizabeth" two
days before the receipt of her card at this office notifying that she was about to
embark .
63. It is clear that there are defects in the system which call for investigation©
I have received today (l9th April) fifteen cards most of them with a London
postmark, notifying change of address, bearing the Post Office stamp of the 14th
April, a delay of five days due in part, but not wholly, to the Easter holidays.
54. Finally although there have been a very large number of enquiries from the
public as to the risk of harbouring or coming into contact with a contact passenger,
generally speaking my impression is that the public have played up very well indeed
and there has been very little nervousness, a fact which I think demonstrates
confidence arising from the daily supervision of contact cases by the Medical
Officers of Health.
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