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to the Government Laboratory at Colindale for biological examination by Dr.MaoCullum,
the child should be transferred to Long Reach Smallpox Hospital, Dartford, under
the care of Dr.Marsden. It is 'worthy to note that arrangements were made to remove
the child at approximately 4 p.m., but the ambulance did not arrive until 8 p.m., the
reason given being that it had been difficult to find an ambulance driver and
attendant -who had been vaccinated.
9, Dr.Marsden confirmed the clinical diagnosis of smallpox on Thursday morning,
Ithe 15th, and the Laboratory confirmed the diagnosis biologically the same morning.
10. The child remained in Long Reach Hospital until full convalescence.
,11. It will be appreciated that on the diagnosis of chickenpox made by the Port
Boarding Medical Officer, all the passengers were permitted to disembark and to
!disperse to their various destinations. Consequently, the first duty on the
morning of Wednesday, the 14th, was to obtain a passenger list from the Company and
to endeavour to trace all the passengers and any member of the crew who had left the
ship on leave.
12. In cases of this kind the addresses given by the passengers and transcribed
on to the passenger list by the purser contain a considerable percentage, no less
than twenty per cent in this instance, of accommodation addresses, such as C/o a
Bank, or Australia House or Cook's, or some similar organisation. People giving
accommodation addresses of this kind are extremely difficult to trace; consequently,
in addition to an explanatory letter (Annexe I) addressed to Medical Officers of
!Health of the districts in which known addresses were situated, a letter (Annexe II)
ves addressed to the accommodation addresses urging Banks and other organisations to
disclose, if it were known, the address to which the passenger had proceeded. It
mill be appreciated that Banks are usually averse to disclosing the addresses of
clients, but on this occasion they responded well to the appeal and the majority of
such passengers were traced, thanks to the information supplied in this my.
13. 188 letters were addressed and dispatched to Medical Officers of Health
and to accommodation addresses on Wednesday, the 14th, 219 on the 15th, and 75 from
Ithe 16th to the 21st February. Further letters were sent as changes of address
irere notified or contacts traced. Where close contacts were involved, a
communication was made with the local Medical Officer of Health by telephone.
14. In view of the fact that it was not possible to trace a certain number of
persons, the Ministry of Health deemed it desirable to make a statement to the Press
and to issue a warning notice to passengers by means of broadcasts, urging them to
visit their local Medical Officer of Health as soon as possible. The notice to
the Press and the broadcast transmission was made on Wednesday, the 14th.
15. A certain number of passengers were missed owing to a defect in the passenger
list supplied by the Shipping Company, which was short of twenty-one passengers of
various nationalities but these were eventually picked up and contact made with
them. There was also a number of defects in the passenger list addresses and
this gave rise to a good deal of trouble. It will be appreciated how important
it is that a passenger list should be complete and accurate and that Pursers when
compiling passenger lists should as far as possible refuse to accept an accommodation
address and Warn passengers well in advance of the date of arrival in the United
Kingdom that should anything untomrd happen in the ship in the shape of infectious
disease of whatever nature, they may not be permitted to disembark until they can
produce an address to which they are proceeding on the day of their disembarkation
and at which they will sleep on the first night after disembarkation. Unfortunately,
quite a number of passengers are extremely lackadaisical in this and have no idea
where they will pass the first night after arrival. Others rely on their Bank,
or on Cook's or similar organisations, to find them a bed without realising that it
is by no means easy to do so in London in present circumstances.
16. All the linen and bedding which had been in close contact with the patient
while in the isolation hospital -was removed by the Port Health Authority's launch
on the arrival of the ship, and taken to Denton Hospital for steam disinfection.
Unfortunately, the linen and mattress in the cabin occupied by the child before
isolation was not so dealt with and became mixed up with the general passenger
linen of the ship, with the result that it was necessary to arrange for the steam
disinfection of some 20,000 pieces of lien before they could be sent to the laundry.
This caused much avoidable time and delay. The cabin occupied by the child, the
ship's isolation accommodation and the quarters occupied by immediate contacts, that
is the Ship's Surgeon, the two Ship's Nurses, the Sick Bay attendant, and the Steward
and Stemrdesses attending on the cabin occupied by the child, were fumigated, then
thoroughly washed down with soap and water and antiseptic, and then repainted.
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