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The policy of examining specimens of the stools and urine of every member of
the ship's crew was continued, and it was decided that no member of the crow
should return to sail in the ship unless three specimens of stool and one specimen
of urine had been found to be negative to typhoid. Incidentally, over 2,000
stool and 500 urine specimens were collected on board and sent to Colindale for
examination during the period of the outbreak. Further samples of the ice, ice
cream, and water from the various parts of the pipe lines in the ship were sent for
investigation but none of them revealed Typhoid organisms.
DECISION AS TO DATE OF SAILING.
24. The number of cases rapidly dropped after January 3rd and though one or two
excretors were discovered it looked as if the end of the outbreak had been
reached by January 13th. It was consequently decided, after consultation with all
concerned, that providing things went well and there was no further recrudescence
of cases the ship might be considered fit to sail on Wednesday, January 25th.
It will be appreciated that a decision to be reached as to the date of Sailing
of a large passenger vessel of this kind is not a light responsibility. Quite apart
from the weighing up of the risk of fresh infections, passengers must be informed
at least ten days in advance of the date of sailing, particularly where a considerable
proportion of them are leaving this country for good and have many domestic
arrangements to conclude
. The Company in issuing the preliminary notice of the
proposed sailing date warned all intending passengers that there had been an outbroa.
of Typhoid fever on board the ship.
On Thursday, January 19th a further case in a European Quartermaster was discovered
on board. This man had been feeling unwell since January 16th but without
fever, and it was only on the 19th that he was found at the daily muster to have a
temperature of 102°. He was promptly transferred to hospital and was eventually
found to be suffering from Typhoid fever. This man had been a close contact with
another member of the crew who bad been occupying the same cabin and had been one
of the first cases to be found when the ship arrived. It is possible, therefore,
that he contracted the disease from this first case by direct contact though there
is, of cours, no proof of this.
The Company decided, therefore, to issue a further notice to passengers informing
them that a further case had been found but since this did not constitute a
recrudescence of the outbreak of the disease it was decided to adhere to the
sailing date. No further cases were discovered and in due course the ship sailed
on January 25th.
25. During the course of the close investigation of the complicated water supply
in the ship - drinking water, ballast water, and engine room water - certain
possibilities, however unlikely in practice, of an interchange between these pipe
lines were discovered and though no definite proof that such an interchange had
occurred during the voyage it was felt that this was a potential source of
contamination which ought to be pursued. The Port Medical Officer decided,
therefore, to ask the Company to allow one of the Port Health Inspectors, Mr. T.L.
Mackie, who is a fully qualified Marine Engineer with long experience of engineroom
practice, to accompany the ship on her outward voyage as far as Port Said and
during that time to make a thorough investigation of the whole of the water supply
lines in the ship, together with plumbing arrangements that might have any link
with the galleys, under operating conditions at sea. The Company at once accepted
this request and Mr. Mackie sailed with the ship. Dr. Morgan obtained the
permission of the Chairman of the Port Health Committee to this proposal.
CONCLUSIONS.
26. The outbreak of Typhoid fever in the "Mooltan" , in view of the numbers involved
and the wide distribution through the ship, must be regarded as a serious outbreak
and it was of the first importance to trace the cause. This has not been possible
and its origin is sufficiently perplexing.
Nevertheless, there are certain indications which point toward the probable
source or sources of the infection.
As has alreadv been stated, the wide distribution among; all on beard, save
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