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On being visited by your Health Inspector, Mr. P.A. Traynier, on the 5th November, it was
found that there had been several cases of'stomach trouble' on board during the last 14 days.
A local medical practitioner who had been called in found that 24 members of the crew of 45
were suffering from 'enteritis' to a varying degree, though none were confined to bed.
Faeces specimens were collected from 13 members of the crew and sent for bacteriological
examination and in addition, two samples of the drinking water on board were submitted for
examination.
In the meantime, an inspection of the vessel revealed fairly satisfactory hygienic conditions,
with the exception of the food storerooms and galley. The provision rooms were also badly
infested with weevils and one cabin was infested with bed bugs.
The attention of the master was called to these unsatisfactory conditions and he undertook to
have the matters dealt with at the vessel's next port of call.
The vessel left the Port of London on the 6th November for Rotterdam and a letter setting
out the circumstances was forwarded to the Medical Officer of that port with a promise to forward
the results of the faeces and water examinations referred to above, as soon as they were received.
These reports were duly received and showed that the water samples were 'highly satisfactory'
and that the bacteriological examination of the 13 faeces specimens revealed no evidence of
pathogenic organisms. These reports were immediately forwarded to the Medical Officer of
Health of Rotterdam.
Your Medical Officer received the following letter dated 15th November from the Medical
Officer of Health of Rotterdam
"Thank you for your letters of the 7th and 8th November. We inspected the m.v. "Tromaas"
on November 12th. There were no more cases of enteritis or stomach trouble. I understand
the Master has arranged for the insect infestation to be dealt with.
Yours faithfully."
The vessel arrived back at the Isle of Grain on the 16th November and was again boarded by
Mr. Traynier who reported that all the crew were fit and working, extensive insect control had
been undertaken by a specialist firm in Rotterdam with satisfactory results and that the storerooms
and galley had been thoroughly cleaned and were now in a good condition.
S.S. "CORNELIA B3" - FEVER OF UNKNOWN ORIGIN
This vessel arrived from the West Coast of Africa on the 4th November and your Boarding
Medical Officer, Dr. R.D. MacLean, admitted a member of the crew, a cabin boy who was suffering
from fever, to Denton Hospital, for observation.
This is a small vessel of 267 tons, carrying a crew of 15 and as such need not and does not
carry a surgeon.
As your Boarding Medical Officers were not satisfied about the diagnosis in this patient who
was very seriously ill and had symptoms suggesting the possibility of typhoid fever, they called
in your Worshipful Committee's Infectious Disease Consultant, Dr. W.T.G. Boul, who narrowed the
diagnosis down to a choice of fever of unknown origin giving meningeal signs and symptoms,
meningitis of unknown origin or 'cerebral' Malaria.
Dr. Boul advised removal of the patient to Thurrock Hospital for more elaborate investigations
than can be carried out at Denton, and this was done.
Meanwhile results had come in from the laboratory examination of blood films that had already
been taken by Dr. MacLean before the patient was transferred to Thurrock Hospital. These
results showed a blood infection with malarial parasites of a malignant type.
With infections of this kind the destruction of blood corpuscles can be so great that the smaller
blood vessels, the capillaries, become clogged with debris and when this happens in the cerebral
capillaries, cerebral or meningeal symptoms occur.
The patient made a complete recovery and it is probably true to say that he owed his life to
the diagnosis of his condition that was made at Gravesend while there was still time for rigorous
anti-malarial treatment to be effective.
The case seems to represent a regrettable failure of malaria prevention — the Ship Captain's
Medical Guide provided for use in our own Merchant Navy contains elaborate instructions for the
prevention and treatment of malaria.
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