View report page

INFECTIOUS DISEASES ON SHIPS
?Typhoid Fever
A ship arrived at night on 25th July but prior to arrival it had been reported that two cases of
typhoid fever had been landed en route to London. In view of this it was decided to take faecal and
urine samples from all the crew and also to sample likely suspect food and also the water supply.
Samples from the crew were taken on 26th July except for two members who had gone on leave
from whom samples were obtained subsequently. Repeat samples were taken from the catering
staff. Members of the crew who went on leave were kept under surveillance by their local medical
officers.
On 29th July it was reported that samples from two crew members were showing, respectively,
Shigella Flexner and an unidentified Salmonella. By this time the vessel had sailed for Sicily.
However, contact was made with the ship and the Medical Department of the Shipping Line, and
the necessary treatment and preventive measures were set in train immediately.
D iarrhoea/?Cholera
A ship arrived on 10th August and no illness was reported. Subsequently the Master reported
that illness had occurred but it had not been disclosed to him until after the ship berthed.
The Boarding Medical Officer made enquiries and it transpired that three members of crew
and the Master's wife, who was the Stewardess, had had diarrhoea during the voyage. The Stewardess's
illness had lasted only twenty-four hours. The illnesses commenced within five days of
leaving Spain.
Accordingly, the Boarding Medical Officer instructed the Master to take the three members of
the crew who still had diarrhoea to the Seamen's Hospital. Due to a misunderstanding, the Master
went to the Albert Dock Hospital, where a Senior Port Health Inspector found him and his crewmen,
shortly after the Casualty Officer had declared that on the basis of macroscopic examinations
of stools, cholera could not be excluded.
Consultations then took place as a result of which the following plan was put into operation:-
(1) The three seamen were admitted to the Seamen's Hospital, Greenwich for investigation.
(2) The rest of the crew were confined to the ship.
(3) The dockers working the ship's cargo of steel were informed that a possibly infectious
condition existed on board and were advised of the necessary precautions. They continued
to work.
(4) Faecal specimens were taken from all remaining crew members.
(5) Suspect food stuffs and water were sampled and sent to the Public Health Laboratory at
County Hall.
(6) Disinfection measures particularly aimed at the fly population aboard the ship were put
in hand. General cleaning was stepped up.
(7) All fresh water on board was hyperchlorinated and pumped to waste. New water supplies
were taken on from barges.
(8) Patients bedding was disinfected.
This thorough investigation made it possible to allow the ship to sail in the early hours of
the next day (12th) for Karlstad in Sweden. Cholera was definitely excluded by bacteriological
investigation of the patients, also on the 12th, and this information was passed to the Health
Authority at Karlstad. Final bacteriological results showed only that the Master's son was excreting
a Salmonella, but this could not be regarded as the cause of the outbreak. The samples of food
and water were all negative. This information was also passed to Karlstad.
17