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Koch. Hafenarzt Hamburg
Reference Baltic Trader. Case landed Dover died
Poliomyelitis. Owners very anxious about case
landed Hamburg. Urgently request opinion, please
Jones. Portelth London
Reply received 08.30 hours 5.12.57:—
Portelth London
Hamburg Patient polio. End stage of very light case.
No danger for life. Presumably infected Dover case.
Portelth Hamburg.
"I telephoned this message to the Marine Superintendent and at 10.00 hours on the 6th December,
the following day, I telephoned him again to enquire if there were any new developments.
He informed me that the ship was in "semi-quarantine" and the crew not allowed ashore. However,
a telephone had been placed on board and he had spoken to the Master of the ship.
"It appeared that the man in hospital in Hamburg was suspected of being a carrier.
number of the crew had become alarmed and the United Baltic Corporation's Hamburg Agent
had been told that any member of the crew who so wished should be given a medical "check up"
"A request for advice on quarantine matters is not unusual. However, this is the first time
that I have been asked to take any action in respect of a ship in another port. I consider that it
is reasonable for the Port Health Authority to obtain information on quarantine matters, especially
as affecting individual cases, from other ports on behalf of a London Shipping Company. Certainly
it was much appreciated in this instance."
TUBERCULOSIS CONTROL IN THE PORT HEALTH SERVICE
The following paper was read by your Medical Officer at the Joint Conference of the British
Tuberculosis Association and the Tuberculosis Society of Scotland, Glasgow, June,1957, and,
as it is based largely on experience in the Port of London, it is felt that the inclusion of the
paper in this Report is not out of place and will serve to illustrate an important aspect of port
health work
"Our legislators seem slow to recognise tuberculosis as an infectious disease.
"Thus although by the Public Health (Tuberculosis) Regulations, 1952 it is notifiable, it is not
included with the infectious diseases notifiable under the Public Health Act, 1936, e.g. smallpox,
cholera, diphtheria and scarlet fever.
"By the Public Health (Ships) Regulations, 1952, "infectious disease" means a quarantinable
disease or any other infectious or contagious disease, other than venereal disease or tuberculosis.
This deliberate exclusion could mean that tuberculosis need not be notified in advance to
the medical officer of health of the port who, further, has no power to compel hospitalisation of
any case from a ship, both of which desiderata would apply in the case of any disease that is
labelled "infectious" in terms of the regulations. All that the Port Medical Officer has legal
power to do under these regulations is, if the patient disembarks, to notify the medical officer of
health of the area of the patient's destination. This is better than nothing but taken at their
face value these regulations are obviously not much help in tuberculosis control through the port
health service.
"Fortunately the enthusiastic case finder in the port health service can do much better than
the regulations imply. There is, for example, the Declaration of Health which by the Public
Health (Ships) Regulations must be completed and signed by the Master of any vessel coming
from a foreign port and handed to the Customs Officer or port Medical officer, whoever first visits
the ship. The Declaration includes on the front page a number of questions which must be
answered "Yes" or "No", including Question 5 — "Is there any sick person on board now"
Give particulars in Schedule". The schedule requires particulars as to name, class or rating, age
sex, nationality, port of embarkation, date of embarkation, nature of illness, date of onset, result
of illness, disposal of case. With the end of the schedule on page 2, the Declaration of Health
comes, "officially", to an end, but most ports add to it a 3rd and 4th page, the 3rd asking, for
the convenience of port health administration, further details of the voyage, ships complement,
etc., the 4th giving instructions and advice to ships' captains as to advance signals, crew musters,
port health mooring stations and the like.
"On the 3rd page immediately following the "official" schedule for particulars of illness, most
port health authorities give, for the guidance of the ship's captain, a list of typical infectious
diseases which would obviously call for reference and particulars in the schedule, but we in
London include tuberculosis in that list. Of course the main purpose of the Public Health (Ships)
Regulations is to prevent the import, I nearly said "of the seven deadly sins", but I mean of the
six quarantinable diseases", (reminiscent of the bad old days when pestilence was still a
frequent visitor to these shores) viz. plague, cholera, yellow fever, smallpox, typhus and relapsing
fever. But it is arguable that a differential diagnosis involves consideration of most of
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