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among the lascar elements of the crew, points fairly strongly towards a -water borne
infection. The fact that a water supply is originally sound and free from
contamination at the source, does not mean that it is not subject to contamination
during its transit from shore to ship., It has to be transferred from the shore
through pipes which are liable to pollution and also at times in water barges which
are also liable to pollution. Ships tanks are notoriously uncertain elements for
the storage of water and there may conceivably have been pollution in the tanks and
in the water lines throughout the ship.
Pollution of this kind is generally harmless and may continue so for years until
certain factors meet i.e. a water supply open to pollution and a polluter ashore
or in the ship in the shape of a carrier or a case of Typhoid fever whose germs
gain access to the water. This is probably what has happened at some stage in the
events of the voyage.
27. But vra.ter itself, unless very heavily polluted with Typhoid organisms, will
not cause Typhoid because the germs will not develop even in a moderately clean
water but requires, like all other living things, some nutriment for life and
propagation. It may be that the nutriment supplied on this occasion was the
milk powder mixed with the polluted water. In this connection it is interesting
to remember that the lascar crew, which remained practically free from infection,
had not consumed milk powder, their milk being supplied in the form of condensed
milk in tins. On the other hand, lascars drink plenty of water and if the water
were polluted with typhoid a few might receive a threshold dose sufficient to
cause the disease to develop.
23. The fact that the water taken on in Bombay was not chlorinated renders one
very suspicious that the source of infection was through this water. and the
chronological distribution of cases in relation to the days on which the Bombay
water was consumed, strengthens this hypothesis.
29. Any defects there may have been in the plumbing system are only of importance,
qua source of infection, in relation to the water supplies. It is not very
likely that the plumbing alone would cause contamination of foods consumed.
30. Of other potential sources of infection the ice cannot be completely absolved
from defect and it is true that lascars are seldom provided with ice. The fact
that it has not been possible to recover Typhoid organisms from the ice
(technically very difficult) does not mean that the ice was not infected, and
the ice and the methods of handling it must remain a possible, though unlikely,
source of the infection. The ice cream can very probably be ruled out
altogether.
31. There remains the possibility of infection by a carrier and the only means
whereby this could come about and produce widespread infection of the ship would
be through food prepared in the galley and distributed equally among passengers
and crew. It is known that excretors were working in the main galley whence food
for all persons on board is derived but this possibility must remain an unknown
quantity.
32. A frequent source of an outbreak of Typhoid fever in this country for example,
is the presence of a Typhoid carrier in a food preparing establishment. It may be
that the infection gained access to the powdered milk and water mixture from the
hands of a carrier and this must remain one of the more likely hypotheses.
33. In conclusion, every conceivable measure was taken to render the ship free
from infection at the time of her sailing. None of the crew who had Typhoid
fever or were found to be excretors returned to the ship, nor were they allowed
to sail in any other ship until they were proved to be free from the disease. All
the drinking water and every other water supply that was in any way associated
with the drinking water lines was thoroughly chlorinated and continued to be
chlorinated daily during the voyage. All plumbing defects, however slight, were
put right.
V. MEASURES AGAINST RODENTS.
1. Steps taken for the detection of Rodent Plague.
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