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from the Far East arrived reporting 26 crew and 5 passengers, all recovered, and again on the
18th June a vessel arrived having had 10 passengers down with the disease during the voyage.
It was not until the 22nd July that a vessel arrived with actual cases on board. Ninety-two
passengers and crew had been affected and whereas 87 had recovered, 3 passengers and 2 crew
were ill on arrival and were admitted to Denton Hospital.
During August and early September vessels continued to arrive with patients on board but in
no case did the number exceed 8 on any one individual ship and they were accommodated without
difficulty at this time at Denton Hospital.
On the 17th September, however, a vessel arrived with 131 cases (98 crew and 33 passengers)
and of these all the passengers had recovered and only 4 of the crew required removal to Denton
Hospital.
At this stage a certain amount of concern was felt by the fact that if a vessel arrived having
on board a large number of cases requiring hospital treatment, the accommodation at Denton
Hospital would be inadequate to meet the situation. The maximum number of cases that could be
taken into Denton Hospital at any one time would only be 24 and this only if the Hospital was
completely empty.
I brought this matter to the notice of the Ministry of Health who referred me to the South-East
Metropolitan Regional Hospital Board. They in turn requested the Dartford Hospital Management
Committee to take all necessary steps in order to be prepared to meet all eventualities and I
then decided to discuss detailed arrangements with Mr. Durrant, the Secretary of the Dartford
Hospital Management Committee who control the Joyce Green and Southern Hospitals, Dartford,
of the South-East Metropolitan Regional Hospital Board.
As a result of our consultation the following memorandum was circulated to the Medical and
Inspectorial Staff of the Port Health Authority:—
Hospitalisation of Cases of Asian Influenza
"In view of the increasing number of cases of Asian Influenza arriving and occurring in
the Port, I think that for the time being all cases of influenza should be concentrated on
Denton Hospital.
"All other cases of sickness, depending on the nature of the illness, should be sent to
Joyce Green Hospital or, in certain cases requiring clinical investigation, to Thurrock
Isolation Hospital.
"I have arranged with Mr. Durrant, the Secretary of the Dartford Hospital Management
Committee that Joyce Green Hospital will accept infectious cases (other than influenza) at
any time, including cases arriving during the night.
"Further, in the event of Denton Hospital not being able to accept further cases of
influenza, then Mr.. Durrant will arrange to accommodate them elsewhere, but this will apply
only if Denton is full and provided that as long notice as possible is given, preferably
24 hours.
"In the case of ambulatory patients from the Royal Docks who are being conveyed by the
West Ham or East Ham Ambulance Services, the patients will be taken to the Tilbury Landing
Stage and, on request by the Ambulance Service, the Boarding Medical Officer should
arrange for the launch to transfer the cases from the Tilbury Landing Stage to Denton
Hospital, this arrangement being necessary to avoid high charges for the conveyance of
the ambulance via the Tilbury — Gravesend Ferry.
While it is, of course, always desirable to formulate a policy which it is hoped will cover all
foreseeable contingencies, it nearly always happens that some particular circumstances arise
which are not covered by that policy.
For instance, towards the end of August a small Danish vessel with a crew of 25 arrived from
Aalborg and on being boarded off Gravesend by your Boarding Medical Officer it was found that
6 members of the crew were suffering from influenza and they were promptly admitted to Denton
Hospital.
The vessel proceeded to her berth at Hay's Wharf, Tooley Street, to discharge her cargo and
on being visited by the Health Inspector for the Upper River District, it was found that 3 further
members of the crew had developed the infection during the voyage up the River.
The removal of these cases to hospital raised certain difficulties:—
(a) The Seamen's Hospital, Greenwich did not wish to receive them since they would have
to be isolated and they did not have the necessary space for so doing.. The same applied
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