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Since the s.s. "Strathaird" was expected to return to London in due course, your Medical
Officer called the attention of the Boarding Medical Officers at Gravesend to the report, stressing
the importance of boarding the vessel on arrival to make sure that there was no danger of the
introduction of smallpox into this country, e.g., through "missed cases" on the vessel.
The vessel duly arrived off Gravesend at 0500 hours on the 30th September and was
boarded by your Deputy Medical Officer, Dr. H. Willoughby, who reported as follows: —
"The patient, a bedroom steward, had been in the ship since 10.9.52, on which date he
had been vaccinated but there was no information as to reaction.
"On 28.7.54 he went ashore in Bombay where he met some friends one of whom gave him
a second-hand suit of clothes. On 5.8.54 (8 days later) he developed headache, backache,
temperature 101°—103° and a rash, profuse on hands, feet, face, arms and chest. The lesions
did not crop but developed into ' blisters ' which were multilocular.
"On 7.8.54 the case was seen by the Medical Officer of Health of Fremantle who diagnosed
smallpox and removed the case to hospital ashore. His diagnosis was supported by a specialist
who also saw the case.
"The peak occupied by the patient was fumigated with formaldehyde gas and potassium
permanganate. His peak mates were taken ashore for bathing and disinfection as was all
bedding, etc.
"The entire crew and passengers were vaccinated at Fremantle.
"An Assistant Medical Officer of Health from Fremantle accompanied the ship to
Melbourne where he was relieved by another Medical Officer who continued in her to Adelaide
where yet another Medical Officer joined and accompanied the ship to Sydney—14 days after
removal of the patient. No further case occurred.
"In the absence of a confirmatory completent fixation and egg culture test the diagnosis
must be in some doubt and it is significant that the incubation period was only eight days if
the case was, in fact, infected in Bombay. On the other hand nine cases of chickenpox occurred
on the outward voyage soon after leaving London.
"It would appear possible, therefore, that in reality this case was one of chickenpox of
some severity and atypical in the distribution of the rash.
"The Ship's Surgeon was a Czech who stated that he had had considerable experience of
smallpox in the Balkans and that he thought this case was a true smallpox.
"Although the case occurred on the outward voyage it is reported as of interest and the
measures taken were carefully enquired into to ensure that there was no residual infection.
"In fact six cases of chickenpox (3 passengers and 3 crew) developed on the homeward
journey. All three passengers embarked at Sydney on 25.8.54. The first case occurred on
the 9.9.54, the second on 15.9.54 and the third on 16.9.54. The three cases amongst the crew—
all Goanese—occurred on the 7th, 9th and 10th September and it is significant that chickenpox
was epidemic in Sydney at the time of the vessel's call at that Port.
"One passenger and the three members of the crew were landed at Bombay on the 13.9.54.
The remaining two passengers recovered and were well on arrival.
"All infected bedding was removed on arrival to Denton Hospital for steam disinfection and
the ship's isolation hospital was fumigated."
s.s. " INDIAN MERCHANT " SUSPECT BUBONIC PLAGUE.
The above-mentioned vessel arrived off Gravesend at 0745 hours on the 24th November,
having called at Calcutta 22.10.54; Cochin 30.10.54; Alleppy 2.11.54; Aden 7.11.54; Suez 11.11.54;
Port Said 13.11.54 and Alexandria 15.11.54.
The vessel was boarded by your Boarding Medical Officer, Dr. J. A. Jones, who reported
as follows:-
"The patient, a native seaman, aged 21, embarked at Calcutta on 11.10.54. On 16.11.54
the patient reported to the Ship's Surgeon with a swelling in the right axilla with pains and
puffiness. This condition reached maximum in two days and the patient was treated with
penicillin and subsequently with sulphathiazole which gradually reduced the swelling. The
patient was never ill nor at any time did he show feverish symptoms. He was last ashore at
Cochin (30.10.54).
"On arrival at Gravesend the patient was up and about. He did not look ill and his
temperature was normal. On being examined he was found to have a fusiform swelling in the
right axilla. No other glands were enlarged."
Dr. Jones further reported his opinion that the appearance of the swelling was consistent
with that found in certain mild cases of plague, otherwise there was nothing in favour of such
a diagnosis. On the contrary there were many factors against—
1. The Chief Officer's statement that there were no rats on board.
2. The patient had not been ashore for 16 days before onset
3. The patient had had no fever.
4. The patient had two small healed scars on the right hand but had had no lymphangitis.
Dr. Jones, however, recalled having seen similar cases during an epidemic of bubonic plague
of low virulence in Algeria during his war service.
It was decided, therefore, with the concurrence of your Medical Officer who had journeyed
to Gravesend to see the patient, to remove him to Denton Isolation Hospital, pending pathological
investigation of a specimen of pus taken from the swelling in the axilla, but as there did
not seem to be sufficient evidence to justify putting into operation the full measures prescribed
m the Public Health (Ships) Regulations, 1952, in respect of a plague infected or suspected ship,
the vessel was allowed to proceed to her berth in the Tilbury Dock.
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