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signing off, were alerted. No further cases were discovered.
(2) Another case of typhoid fever which presented a difficult epidemiological problem first
came to notice of the Port Health Authority when a telephone message was received from another
London borough saying that a patient who had been diagnosed at the Hospital for Tropical Diseases
as suffering from typhoid fever had arrived in the Port of London from Bombay some five
weeks previously. Furthermore the hospital indicated a strong possibility that the onset of the
illness antedated the patient's embarkation on the ship by some four days. It was, therefore,
possible that she had been infectious during the whole of her time on the ship.
This was particularly disquieting, especially as the lapse of time between the ship arriving
in the Thames (when no declaration had been made that the patient was ill) and notification of the
final diagnosis reaching this Authority made normal surveillance procedures useless. The following
measures were therefore adopted, in consultation with the Ministry of Health:—
(a) With regard to passengers it was apparent that after such a lapse of time the address
lists submitted by the master of the ship on arrival would, in many cases, be no longer accurate
and consideration was given to the possibility of informing all health authorities of
the circumstances so that Medical Officers of Health would be alerted.
It was decided, however, that too long a time had elapsed for even this measure to be worthwhile
because any cases due to contact on the ship would already have developed and, as no
such cases had been reported, it was considered highly unlikely that any of the other passengers
had been infected.
(b) The members of the crew were also a difficult problem, as, by the time the case came to
the notice of the Port Health Authority the vessel was cruising and was not due back in
Southampton for another week. In consultation with the Shipping Company it was determined
that some four fifths of the crew (and this included all the Goanese saloon crew members)
who had been on board at the same time as the patient, had signed on again and a cable was
sent to the ship's surgeon to inform him of what had happened. The Medical Officer of Health
of Southampton was also notified.
This left approximately one fifth of the crew still unaccounted for and they presented a most
difficult problem as they could be scattered all over the world. A comparison of crew lists
showed that 130 members of the crew had not re-signed articles and with the most willing
co-operation of the Shipping Federation Medical Service it was established that the majority
of these men had remained with the same shipping company and were, therefore, comparatively
easy to follow up. The small number still outstanding were found living at home and a few
had left the ship before the patient had embarked at Bombay. All crew members (except
these last few) were followed up but no further cases were reported.
SECTION X
OBSERVATIONS ON THE OCCURRENCE OF MALARIA ON SHIPS
No cases of Malaria were reported on ships during the year under review. This compares
with four cases in 1965.
SECTION XI
MEASURES TAKEN AGAINST SHIPS INFECTED OR SUSPECTED OF PLAGUE
No ships infected with or suspected of plague arrived during the year.
SECTION XII
MEASURES AGAINST RODENTS IN SHIPS FROM FOREIGN PORTS
A five day rodent and parasite seminar was held in Geneva by the World Health Organisation
during the year. The rat was described as "the travelling salesman of the scourge". It was
appropriate, in view of the war in South Vietnam and the subsequent outbreak of plague in that
country, that the subject should be discussed and the world alerted to possible dangers. This
grim reminder helps to prevent complacency and stresses the perpetual need of care and attention
to rodent control measures within the Port.
As mentioned earlier in this report the Public Health (Ships) Regulations 1966 introduced a
new provision giving powers to require repetitive deratting measures where there is definite
evidence that earlier measures seem to have been ineffective, or the number of rodents on board
is substantially more than negligible. Not-withstanding the validity of the Deratting Certificate
or Deratting Exemption Certificate the medical officer may exercise his powers to require the
ship to be deratted in a manner to be determined by him.
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