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the Press and the somewhat alarmist accounts that were published and further,
having regard to the unfortunate incidence of smallpox on the previous voyage , that
the shore men working the ship were nervous of infection.
In view, however , of the severe measures that were taken to control the most
obvious sources of infection as soon as the ship arrived, for example the
chlorination of the residual 'water in the tanks, followed by its discharge overside
and the taking on of London water and its chlorination, the locking up of the
ice and ice cream and the separation of the lavatory accommodation of the crew and
furthermore the injunction applying to all shore workers that they were not to eat
any ship's food nor, in the first days to drink ship's water, the Port Medical
Officer considered it safe to issue a notice that, subject to the precautions to be
taken by shore men working on board, i.e. no food or water to be consumed on board
and a thorough washing of the hands in soap and water before consuming food, there
was no risk in working on board the ship
.
Nevertheless there still remained some nervousness and the men's Representatives
insisted that the Company should declare that any man or member of his family, who
was found to have contracted Typhoid fever as the result of working on board,
should be indemnified and this the Company accepted on the advice of the Port
Medical Officer.
Following a conference with the men's Representatives when all aspects of the
matter were discussed with the Port Medical Officer and with Medical Officers of
the Ministry of Health, further trouble ceased and so far as is known up to the
time of writing this report, no case of Typhoid fever has occurred in any shore
worker nor in any member of his family.
MINISTRY OF HEALTH.
23. The Port Medical Officer had been in close contact with the Medical Officers
of the Ministry of Health right from the beginning.
The rapid succession of cases among the crew discovered during the last week
of December and the early days of January overwhelined the available accommodation
in the Dreadnought Hospital, Greenwich, and rendered it necessary to transfer a
certain number of cases from that Hospital to isolation hospitals in the
Metropolitan area and to distribute succeeding cases among these hospitals, notably
the Brook Hospital, the Park Hospital, and Rush Green. The result was that the
distribution of cases to these hospitals became unknown and their diagnosis
uncertain to an extent that the Port Medical Officer rapidly became completely
out of touch with this important aspect of the outbreak.
Furthermore , the fact that the ship had been in port for some time and that
despite the measures that had been taken cases "were still occurring, led the Port
Medical Officer to feel that the assistance of the Ministry of Health in providing
Medical Officers to pursue enquiries into the possible cause of the infection was
urgently required. Consequently, the Port Medical Officer, after consultation
with the Medical Superintendent of the P.& 0. Steam Navigation Co., invoked
the assistance of the Ministry of Health and on January 4th a conference was held
between the Medical Officers of the Ministry, the Port Medical Officer, and
representatives of the Company, on board the "Mooltan" and a programme of further
investigation was drawn up. At the same time Medical Officers of the Ministry
rent round all the hospitals in which patients were known to be or to which they
night have been sent to find all cases that had been evacuated from the ship and
to ascertain the diagnosis, if any, that had been made in each case.
The action taken by the Port Medical Officer in the matter of the chlorination
of the water supply and of investigating the plumbing arrangements, food distribution,
and other possible factors, was reviewed and further more detailed investigations
were planned.
Subsequently several conferences were held on board and while the investigations
failed to reveal any cause to which the outbreak might definitely be
attributed, the Port Medical Officer was very grateful for the assistance and
advice of the Ministry, and particularly for the additional personnel it enabled
him to bring in on the investigations.
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