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"The main burden falls upon Port Health Authorities and their staffs to put up a good
show and one that will appeal to the public as an effort to keep the disease out of the
country even though we know within ourselves that scientifically speaking we have little
hope of success.
"It will be necessary, therefore, to make every endeavour to hospitalise sick persons as
they come into the Port and at the first opportunity, i.e., at Gravesend rather than from the
London Docks.
"Passengers and members of crews that are paid off from ships suspected to be incubating
influenza should be handed a yellow warning card, copy enclosed herewith. Further
supplies will be sent in a day or two.
"Routine measures of disinfection of cabins etc., should be undertaken in respect of
recent cases but there is no need to send bedding etc., to Denton or elsewhere for steam
disinfection.
"There remains the question of hospitalising any considerable numbers of cases and as
to this I am in touch with officials of the Ministry of Health in the hope that the necessary
emergency arrangements can be made.
"Finally there is the question of research into the nature of the virus and as to this I am
arranging for equipment to be supplied from the Central Virus Laboratory at Colindale so
that specimens may be sent from any cases of influenza that may be admitted to hospital
from ships entering the Port of London.
The reference above to 'yellow warning cards' was included as the result of a suggestion
made by an Honourable Member that I should compare notes with the Medical Officer at the
London Airport as to any special measures to be taken in connection with the threatened importation
of influenza into this country.
I therefore rang up the London Airport Medical Officer and found that in general the measures
being taken there are similar to those at a sea port. I was, however, reminded of the practice
which is normally confined to airports but which under the present circumstances might be
useful in sea ports.
With the approval of the Ministry of Health arrangements were made to adopt this practice in
the Port of London. It is to issue so called yellow warning cards to persons arriving from
abroad if it is thought that they may be about to fall ill of an epidemic disease.
The notice which is in English, French and German, reads as follows:-
"IMPORTANT NOTICE TO PERSONS ARRIVING FROM ABROAD
Whilst abroad you may, without knowing it, have been in contact with some dangerous
epidemic disease such as smallpox or typhus. If during the next 21 days — wherever you
may be — you or any person living in the same house falls ill, in your own interest call in
a doctor immediately and give him this card.
NOTICE TO DOCTOR CALLED TO A PERSON RECENTLY ARRIVED FROM ABROAD
The holder of this card arrived at the place and on the date stated on the front. It is possible
that he may be suffering from some acute infectious disease not normally present in
this country. Smallpox should be particularly borne in mind as the rash may be modified
by previous vaccination. If you suspect any such illness please notify the Medical Officer
of Health by telephone."
It is explained to the recipient of these cards that although the wording refers to the quarantinable
diseases (smallpox, etc.), they are intended to refer, for the time being, to influenza.
Meanwhile at the meeting of the Honourable Court of Common Council held on the 20th June,
the following question was put by Mr. Deputy Horner
"Has the Chairman's attention been drawn to a leading article in a London Medical
Journal that this country is unlikely to escape the new type of influenza now sweeping
Asia and what, if any, special precautions are being taken with regard to Passengers and
Crew on Liners coming into the Port of London from the Far East."
To this question the Chairman replied as follows:-
"Extensive outbreaks of influenza have occurred recently in several countries of the Far
East. Brief reports have been published in the Medical Press. Cases were first observed,
inmid April, at Hong Kong and Singapore where large numbers of persons have been affected.
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