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The mattresses and bedding used by the patient were removed to Denton Hospital for steam
disinfection and the necessary quarters, including the After Hospital Block, were fumigated with
formalin candles. Other crew spaces were washed with a light solution of disinfectant.
Suspected Smallpox—
A ship arrived in London on the 8th September, 1965, and the Master reported that an Indian
crew member aged 44 years had died and had been buried at sea. The history given was that the
man joined the ship at Aden on 24th August, having left Bombay by air on the 21st August. He
went sick next day with generalised pains but with normal temperature and no other signs or
symptoms and was put to bed as a query heat stroke case. He was found dead next morning and
was buried at sea the same day.
In the absence of any evidence to the contrary it had to be assumed that there was a possibility
that he died from acute fulminating smallpox. The Ministry of Health were informed and
agreed that there was this possibility and that surveillance procedures should be instituted.
Accordingly, the names and addresses of persons leaving the ship in London were sent to the
Medical Officers of Health of the areas to which they were proceeding, the members of the crew
remaining on board were kept under surveillance and the Medical Officers of Health of the further
ports of call of the ship were notified.
Examination of International Certificates of Vaccination
against Smallpox
By the provisions of the Public Health (Ships) (Amendment) Regulations 1963 the Medical
Officer may require the production of international certificates of vaccination against smallpox
by persons arriving from abroad but will require production of such certificates if so requested by
the Minister of Health. The Minister of Health indicated by letter that persons arriving by ship
from ports in the smallpox endemic area should be required to produce valid vaccination certificates.
It was realised that there would be difficulties in examining vaccination certificites of
persons arriving in the Port of London where ships discharge their passengers at widely divergent
points. The Minister of Health was informed that to examine all certificates in every case
might result in a ship being delayed. An answer was received that a ship should not be held
merely for the inspection of vaccination certificates. Accordingly shipping Companies using the
Port of London were asked to arrange for lists of smallpox vaccination certificates of passengers
and crews, countersigned by the Master and by the ship's surgeon, if carried, to be produced on
the arrival of the ship in the Port of London.
A proportion of the ships arriving are now producing such lists and at least a spot check is
made of a percentage of the certificates. Certain of the larger passenger ships are boarded by a
Medical team at a previous port to examine aliens and commonwealth immigrants and in such
cases vaccination certificates are examined during the voyage to London.
The Regulations do not provide for any legal sanctions to be taken against a person arriving
without a valid certificate of vaccination if he agrees to be vaccinated or to be placed under
surveillance. Only if he refuses and it can be shown that he intended to evade the regulations
can any legal action be taken.
If masters of ships arriving could be legally required to produce certified lists with dates of
international certificates against smallpox of all persons on board checking would be simplified
and the number of persons arriving without valid certificates would no doubt be reduced.
Paratyphoid Fever
On the 25th October 1965, information was received that there were sick persons on board a
ship, lying at McDougall's Wharf, Millwall Dock. This information had been passed by the Agents
for the ship to the Boarding Medical Officer on Duty at Gravesend, they also stated that two
members of the crew, who had been left at Bremen as suffering from "severe flu" had now been
diagnosed as suffering from paratyphoid B fever (the ship made no declaration of this fact when
she entered the Port and the Captain had not told the Port Health Inspector of these facts when
the Inspector made a routine visit to the ship on the morning of the 25th October). Your Deputy
Medical Officer personally investigated the situation and discovered that, in all, 7 men had
fallen ill since the 7th October, 1965. Of these, 2 had been taken off at Bremen, 3 had recovered
and 2 were still ill. On examination the two men who were still ill were considered to be suffering
from paratyphoid fever and were admitted to the Seamen's Hospital, Greenwich.
Next day, arrangements were made for bacteriological investigation of everyone on board and
samples of water and for the disinfection of the quarters of those men who had suffered from the
disease. Another man fell ill on this day and was admitted to the same hospital by a doctor from
the Norwegian Public Health Service. All 3 men were later confirmed as suffering from paratyphoid
B fever.
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