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This incident was an example of the "all or none law" which applies to quarantine work.
Once the possibility of cholera was raised, medical staff had no choice but to act as if cholera
were present, until proved otherwise. It is also an example of the way in which doctors and inspectors
can carry out a complex investigation, and yet allow rapid turn round of a ship, by good
communications and consultation.
Gastro enteritis/?Cholera
On the arrival of a ship on 24th October from Cadiz it was reported that an Assistant Steward
had suffered several attacks of "diarrhoea" with stomach pains during the preceding 12 days.
This despite some treatment with antibiotics during this time. In the circumstances it was decided
to admit the man to Joyce Green Hospital for investigation.
Unfortunately he was found to be drunk on admission and had rigors which were suspected to
be due to delirium tremens. Consequently the examination of stool samples had to be delayed. In
view of the history of the case and the previous ports of call of the ship it was decided to take
faecal samples from all the crew. Samples of ship's water were also taken.
The ship's Master had meant to sail within three days of arrival but fortunately had been delayed
one day. This gave more time for investigations of the samples. Members of the crew who
left the ship in London were "followed up" during this time.
The results of laboratory examination of samples submitted proved negative for Salmonella,
Shigella and Cholera and the water sample was satisfactory. These results came through on the
day that the ship was due to sail as did the information that the member of crew was now well
in hospital and examination of his samples showed no evidence of pathogenic organisms.
Accordingly, the ship was given a "clean bill of health" and no further action was considered
to be necessary.
Malaria
A ship arrived in London on 6th December and was held at Southend Anchorage. One member
of crew was reported as being sick, so the Boarding Medical Officer went downriver and boarded
the ship. He made a provisional diagnosis of malaria (malignant tertian). The man was landed to
Joyce Green Hospital and the Ship then received pratique.
On 10th December, whilst the ship was still anchored in Sea Reach a further case of sickness
was reported and this second man was also provisionally diagnosed as a case of malaria (benign
tertian). He, too, was landed to Joyce Green Hospital.
Disinsection of the vessel was carried out and a daily surveillance routine established until
the ship berthed at Shellhaven on 16th December.
The provisional diagnoses were subsequently confirmed by the hospital.
No further cases were reported but the ship was kept under supervision until she sailed. The
origin of the illness would appear to have been mosquito bites in Port Harcourt on-21st November.
This instance illustrates the problems inherent in such cases, where, despite advice and
guidance men are not meticulous in attention to preventive measures. While human nature remains
unchanged malaria will continue to be found on ships arriving in the U.K.
Gastro-Enteritis probably caused by contaminated ship's stores
Prior to the arrival of a ship in the Port of London on Saturday 4th December the Master
radioed that three out of seven crew members were suffering from fever and diarrhoea. The ship
had left Portugal on 30th November and the Portuguese authorities had declared the country free
of cholera only a few days previously.
Arrangements were made for the ship to be boarded by the duty Medical Officer and Port
Health Inspector in the Lower Hope Reach. After careful medical examination and consideration
of the epidemiological data available two of the three ill members of the crew were admitted to
Joyce Green Hospital while the third member (the Master) remained on board.
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