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The man had reported sick on the 9th March but stated he had then had the rash for five
days. He was working up to the time of reporting sick. Temperature and pulse were then,
and at all subsequent takings, normal. The rash was on the arms and legs only. There were
some 24-36 lesions on each leg and 18-24 on each arm. The 'spots' were 'dark reddish
purple' about 3/8" diameter. He was also described as having a "rough red rash" on the
hands which were swollen. There had been no human contact with any case of infectious
disease and the man had not been ashore since leaving London. The diagnosis of "probable
modified smallpox" was the result of medical advice obtained through Portishead
Radio. The man was last vaccinated in October 1959.
The above information was passed by telephone to your Medical Officer. Although it now
seemed most unlikely that this was a case of smallpox, it was decided not to vary the arrangements.
Action on Arrival of Ship
(a) The "Sugar Producer" arrived in Gravesend Reach shortly after 11.30 hours on Sunday,
13th March, and was boarded by your Medical Officer, Dr. Pickford Marsden, Dr. J.A. Jones, the
Chief Port Health Inspector, the Port Health River Inspector, and the General Administrative
Officer.
(b) The patient, aged 64, a Donkeyrman-Greaser was isolated in the ship's hospital. He was
examined by your Medical Officer and Dr. Pickford Marsden, and a decision that the case was
non-infectious was quickly reached. Dr. Marsden, in his report to the Ministry of Health, stated':
"On examination I was satisfied that the man was not suffering from smallpox As a provisional
positive diagnosis I suggested erythema multiforme of undetermined origin. I did
not see any necessity for continuing to hold the patient in isolation."
(c) The Master was informed that the patient would be released from isolation and proceed
home to receive out-patient treatment from his own Doctor or at a Cardiff Hospital.
(d) Pratique was issued, the "QQ" signal lowered and the boarding party left the ship at
12.15 hours. There was still time for the ship to catch the day tide and the Master hoped to do
this, but unfortunately for him and his crew there was no berth available.
(e) As the man was proceeding to Cardiff, the Medical Officer of Health for that town was
informed of the circumstances.
Comment
There was little to learn from this exercise, although again the difficulty of making a diagnosis
by means of radio telegrams was demonstrated. The obvious advantage of direct conversation
by radio-telephone hardly calls for comment but the Master of this ship stated his range
for this was only 150 miles.
SMALLPOX - s.s. "CITY OF CALCUTTA"
On the 7th March, 1960, the Medical Superintendent of the Ellerman Lines reported by telephone
that four cases of Modified Smallpox (3 Indians and 1 Pakistani) had been landed at Suez
on the 5th March from the s.s. "City of Calcutta" which was due to arrive in London on March
17th from Chittagong, Trincomalee, Colombo, Aden and Suez. The ship carried a crew of 89,
including 66 natives, and 3 passengers.
In view of the very limited information available at the time, the Shipping Company were
asked to signal the ship and obtain from the Master (the ship did not carry a Surgeon) full details
of all sickness which had occurred during the last month, together with clinical notes on the
cases which had been landed. The Ministry of Health were also requested to obtain confirmation,
through the Foreign Office and the British Embassy in Cairo, of the diagnosis. Later, the
Ministry of Health received news from the World Health Organisation in Geneva that the cases
were modified smallpox, and this was confirmed by the British Embassy in Cairo.
The Suez Authorities had detained the ship for 24 hours to carry out disinfection and to revaccinate
the crew. So far there had been no further cases of illness on board.
The Ellerman Lines were most helpful in sending signals to the ship and, although it was
not easy to obtain precise information on a number of points, it was possible to build up a fairly
clear picture of events and dates which tended to the view that the cases might well have been
smallpox. Consequently, when your Medical Officer visited Gravesend on Sunday 13th March, to
deal with the suspected case of smallpox on the m.v. "Sugar Producer", the opportunity was
taken for a conference with Dr. Pickford Marsden, the Smallpox Consultant of the Ministry of
Health and also Medical Superintendent of Joyce Green Hospital, to discuss the action to be
taken when the "City of Calcutta" arrived in London a few days later.
Dr. Marsden held the view that this was a situation where there was a small closed and
controlled community, all of whom should now be protected against smallpox. If there were no
more cases the risk of any further spread of infection would be over by p.m. on the 20th March.
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