AC. 4369 PLON 49 97. PORT OF LONDON HEALTH COMMITTEE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (MONTAGU TRAVERS MORGAN, M.C. ,M.D. ,Ch.B. ,D.P.H. ) TO 31st DECEMBER, 1941. 1. PORT OF LONDON HEALTH AUTHORITY 5, CHURCH PASSAGE, GUILDHALL, E. C. 2. Telegraphic Address "PORTELTH LONDON". i Tele-phone No CLERKENWELL 2011. BOARDING STATIONS. River Thames Hulk "Hygeia", Gravesend River Medway Garrison Point, Sheerness Telegraphic Address "PORTELTH LONDON. " Telephone No. (Hulk "Hygeia") Gravesend 325. HOSPITAL FOR INFECTIOUS DISEASES AT DENTON, NEAR GRAVESEND. Telephone No. (Hospital) GRAVESEND 257. LIMITS OP THE PORT OF LONDON The limits of the Port of London as at present defined commence at High-Water Mark In the River Thames at Teddington Lock, In the County of Surrey, and extend down both sides of the River Thames to an Imaginary straight line drawn from the Pilot Mark at the entrance of Havengore Creek, In the County of Essex, to the land's end at Warden Point, in the Isle of Sheppey, In the County of Kent, such point being the North-Western limit of the Port of Faversham, and extend up and Include both sides of the River Medway to an Imaginary straight line drawn from the South-East point of land westward of Coalmouth Creek, thence across the said River Medway to the Westernmost point of the piece of land which forms the Eastern side of the Stargate Creek, or, in other words the North-West point of Fleet Marsh, and from thence in a Southerly direction tolwade Church, In the said County of Kent, and thence In a North-Easterly direction to Elmley Chapel In the said Isle of Sheppey, a supposed direct line from Elmley Chapel to jwade Church, being the Western limit of the Port of Faversham, and the said Port of London Includes the Islands of Havengore Creek aforesaid, called Potton and Rushley Islands, and so much of the said Creek and watercourse as extends from It to the town of Rochford, and also includes all other Islands, rivers, streams, creeks, waters, watercourses) channels, harbours, docks and places within the before-ment toned limits contained. 2. STAFF List of Officers forming the Staff of the Port of London Health Authority, 31st December, 1941. Office Name of Officer Date of entering the service. MEDICAL OFFICER OF HEALTH M. T.Morgan, M.C., M.D.,Ch.B.,D.P.H. September 1938 DEPUTY do. 1 ø H.M.Willoughby, M.R.C.S.,L.R.C.P. D.P.H.,D.T.M & H. R.N.V.R. May 1929 BOARDING MEDICAL OFFICERS Gravesend ø J.A.Jones, M.B., Ch.B., D.P.H. April 1935 do. do. J.R.Davies, M.R.C.S. L.R.C.P. ,D. T.M & H. January 1939 do. do. ø G.N.M.Wishart, M.R.C. S.,L.R.C.P., D.P.H. August 1939 do. do. ≠ J.H.Horan, L.R.C.P. & S.I., L.M. March 1940 Sheerness ≠ H.A.Madwar, L.R.C.P. L.R.F.P.S. December 1927 OFFICE STAFF - Principal Clerk W.C.Barham March 1901 Principal Assistant. J.A.Gillis March 1914 1st Class „ A.W.Moore January 1920 2nd „ „ ø W.L.McLorg February 1927 3rd „ „ ø R.C.Ratliff March 1930 „ „ „ ø E.V.Smith October 1938 Junior Clerk ø D.W.Steib February 1939 „ „ ≠ D.E.Bartlett March 1941 „ „ ≠ D.H.Richards September 1941 Charwoman ≠ Mrs.E.S.Veale September 1935 SANITARY INSPECTORS (Senior) + F.J.Massie March 1909 + W.J. Berry February 1914 + W. Gray September 1921 + R. Clifford July 1925 ø+ P.W.Ccombe December 1924 + E.H.Johnson August 1929 + T.G.Edwards June 1929 + D.E.Madeley September 1932. SANITARY INSPECTORS (Junior) + C.E.Wright July 1931 ø+ J.S.Beattie May 1931 ø+ L.A.R.Hundy January 1934 + T.L.Mackie A.M.I.N.A. November 1934 ø+ L.F.J. McDermott June 1934 + G.Dring February 1937 RODENT OFFICERS C.F.Woodrow November 1928 C.W.Moody February 1929 E.C.Watkins June 1929 S.A.Croft June 1929 ≠ C.Stockton June 1940 H.S.Adams July 1941 3. STAFF-Continued. Office Name of Officer Date of entering the service RODENT CONTROL ≠ D.J.Davis August 1941 ≠ S.Bouttell July 1941 ≠ L.L.Goodsall August 1941 DENTON HOSPITAL Medical Officer in Charge ø H.M.Willoughby May 1929 do. J.R.Davies (acting) April 1935 Sister in charge ≠ - Staff Nurse ≠ - Senior Assistant Nurse ≠ - Assistant Nurse ≠ - Cook-General ≠ - Wardmaid ≠ - do. ≠ - Housemaid ≠ A.R.Robinson April 1939. do. ≠ - Handyman etc.(acting) ≠ R.V.Colin April 1940 Laundress ≠ - Gardener W. H. J ames January 1931 Housekeeper ≠ Mrs. L.P.Colin May 1941 LAUNCHES "Howard Deighton" Master P.J.Wilkins November 1928 Mate ø J.R.Steen March 1926 do. ø J.H. Debnam April 1931 Chief Engineer R. J.Roberts April 1931 Assistant Engineer J.C.Row December 1926 do. S.J.Crutchley June 1939 Deckhand ø L.J.Youngs May 1939 do. ø C.R.Simons August 1938 . do. ø W.G.King September 1939 Deckboy ≠ W.Simmons August 1939 do. ≠ H. Gates November 1940 do. ≠ G. Watts January 1941 "Alfred Robertson" Master A.F.Rough October 1914 Engineer ø A.Cook July 1938 Deckhand ø S.H.Strange November 1934 "Frederick Whittingham" Driver ø W.J.Reader November 1954 Deckboy ≠ J.Attwater May 1939 do. ≠ V.Goodayle April 1941 Steward of Launches J.F.Smeed July 1927 GRAVESEND-Hulk "Hygeia" Shipkeeper H.A.Clarkson May 1912 do. E.W.S.Edmonds September 1933 GREENWICH MOORINGS Barge "Ella Vicars" Watchman E.Ditch January 1915 do. A.E.Howard February 1912 + These Inspectors possess the Special Certificate of the Royal Sanitary Institute for Inspectors of Food. ≠ Temporary Staff. ø O.H.M.S. Denton Hospital temporarily closed as from 26th October, 1940. 4. 5, Church Passage, Guildhall, E.C.2. January 1942. TO THE WORSHIPFUL, THE PORT OP LONDON HEALTH COMMITTEE, Gentlemen, I have the honour to submit my Annual Report as Medical Officer of Health of the Port of London. Circular No.2641 of the Ministry of Health dated 30th April 1942, requests that the Report for the year 1941 "be prepared on the lines indicated in Circular No.1937 dated 11th January 1940, namely that "having regard to the desirability of reducing the number of records to be kept and of avoiding as far as possible the disclosure of information relating to the movement of ships, the Minister desires that the requirements set out in Memo-204/S.A., shall be modified during the period of emergency: the letterpress of the report should consist of short notes on any points of special interest". One hundred and fourteen cases of Infectious Disease were reported as having occurred on vessels during the voyage of which 38 were landed in the Port. Thirty seven cases, particulars of which are given in Appendix IIb. were admitted to Infectious Diseases Hospitals. The Port Isolation Hospital at Denton was closed on the 26.10.40 and has since been on a care and maintenance basis. Arrangements were made for the reception of cases of infectious disease in Hospitals in the vicinity of the River. Denton Hospital can be re-opened at short notice should the occasion arise. These arrangements have worked satisfactorily during the year. Disinfection of cases, their clothing, bedding and effects continue to be carried out at Denton Hospital. No case of human plague occurred during the year on any vessel bound for London. Of the 2,650 rats examined bacteriologically, 955 were from ships and 1,695 were from shore premises. No rats were reported to be infected with Plague. Ninety-four vessels were fumigated for rat destruction under the supervision of your Inspectors, 73 by sulphor dioxide resulting in the destruction of 2,815 rats and 626 mice; 21 by hydrogen cyanide accounting for 479 rats and 182 mice. One vessel was deratised by Trapping only, the number of rats so destroyed being 18. In addition 5,474 rats were trapped in ships and 3,022 on shore premises in the Port. The work of rat repression in the Port area has been considerably intensified during the year and is the subject of a separate report. The Parrots (Prohibition of Import) Regulations, 1930, continued in operation and the work thereunder is reported on page 7. The arrangements whereby the registration of Water Barges was made conditional upon the report of your Officers as to their fitness for the carriage of drinking water, continued to work smoothly, During the year 4,256 tons of foodstuff were condemned as unfit/ 5. unfit for human consumption and were either destroyed or disposed of for animal feeding or for industrial purposes under suitable guarant Particular attention has been paid to the salvage of damaged foodstuffs and their reconditioning where possible, to render them fit, either for human consumption or for animal consumption or for industrial purposes. Your Medical Officer is pleased to report that many hundreds of tons of foodstuffs have been saved and he wishes to take this opportunity of thanking the Officers of the various Government Deparments, of the Port of London Authority and of private firms for the valuable collaboration that made this possible. He also wishes to thank the Officers of His Majesty's Custom Port of London Authority, the Pilots and the members of the Staffs o the Shipping Companies and Merchants for their collaboration and hel in every aspect of the work of the Port of London Health Authority throughout the year. I have the honour to be, Gentlemen, Your obedient Servant, M. T. MORGAN. SOURCE OF WATER SUPPLY (a) For the Port. (b) For Shipping. These remain the same as reported in detail in 1938. (c) Water Barges and their sanitary condition:- The Port of London Authority notify the Port Health Authorit, when water boats are due for annual re-registration and will not iss a certificate to any waterboat until your Medical Officer has certifi that it is fit for the carriage of drinking water. This arrangement has continued to work smoothly. PORT SANITARY REGULATIONS 1935. ( a) Arrangements for dealing with Declarations of Health. (b) Boarding of Vessels on Arrival. (c) Notifications to the Authority of Inward Vessels requiring special attention. (d) Mooring stations designated under Article 10. (e) Particulars of any standing Exemptions from the Provisions of Article 14. (f) Experience of working Article 16. (g) What arrangements have been made for:- (i) Premises and waiting rooms for medical examination? (ii) Cleansing and disinfection of ships, persons and clothing, and other Articles? (iii) Premises for the temporary accommodation of persons for whom such accommodation is required for the purposes of the Regulations? (iv) Hospital accommodation available for Plague, Cholera, Yellow Fever, Smallpox and other Infectious Diseases? (v) Ambulance Transport? (vi) Supervision of contacts? 6. (h) Arrangements for the Bacteriological or Pathological Examinations of Rats for Plague. (i) Arrangements made for other Bacteriological or Pathological Examinations. (j) Arrangements for the Diagnosis and Treatment of Venereal Diseases amongst Sailors. (k) Arrangements for the Internment of the Dead. All the above-mentioned items (a) to (k), with the exception of items (d) and (j), remain in principle the same as reported in detail in 1957. Items (d) and (3) remain the same as reported in my Annual Report for 1938. Cases of Infectious Sickness landed from Vessels. Disease. Number of cases during the year. Scarlet Fever - Diphtheria 9 Enteric Fever - Measles - German Measles 2 Erysipelas 2 Pulmonary Tuberculosis 2 Tuberculosis (Other kinds) - Pneumonia 2 Influenza 2 Dysentery - Malaria 18 Chickenpox 1 Mumps - Encephalitis Lethargica — Cerebro-Spinal Meningitis — 38 Cases of Infectious Sickness occurring on Vessels during the Voyage, but disposed of prior to arrival. Disease. Number of cases during the year. Smallpox 1 Scarlet Fever 1 Diphtheria 2 Enteric Fever 1 Measles 1 German Measles 3 Pulmonary Tuberculosis 2 Pneumonia - Influenza 1 Corebro-Spinal Meningitis - Dysentery — Malaria 61 Chickenpox 1 Mumps — Dengue Fever 1 Blackwater Fever 1 76 7. RATS DESTROYED DURING 1941. (1) On Vessels. (a) (b) (c) No. of Rats Destroyed. No. of Rats Examined. No. of Rats found to be infected with Plague. 5,474 955 Nil. (2) In Docks, Quays, Wharves and Warehouses. (a) (b) (c) No. of Rats Destroyed. No. of Rats Examined. No. of Rats found to be infected with Plague. 3,022 1,695 Nil. HYGIENE OF CREWS' SPACES. Classification of Nuisances British:- Defects of original construction 115 Structural defects through wear and tear 376 Dirt, Vermin and other conditions prejudicial to health 80 Other Nations:Defects of original construction 6 Structural defects through wear and tear 27 Dirt, Vervain and other conditions prejudicial to health 8 FOOD INSPECTION. ACTION TAKEN UNDER THE PUBLIC HEALTH (IMPORTED POOD) REGULATIONS, 1937.- resulted in four thousand two hundred and fifty six tons of unsound food being destroyed or disposed of for Purposes other than human consumption. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS. 1937. PUBLIC HEALTH (PRESERVATIVES ETC. IN FOOD) REGULATIONS. 1925-1927 During the year 2 samples were submitted for analysis the results of which did not call for any further action. PARROTS (PROHIBITION OF IMPORT) REGULATIONS, 1930. 55 parrots, etc., came under the notice of your Officers during the year. 31 Notices were issued in respect of 55 parrots etc. Number exported in respect of Notices served 49 Number destroyed (Notice served to export) 3 Number admitted under Ministry of Health permits - Bodies of birds sent for investigation to the Ministry of Health 3 Number transhipped on through Bills - 55 8. DANGEROUS DRUGS. During the year three Certificates authorising the purchase of scheduled Dangerous Drugs were issued by your Medical Officer under the Dangerous Drugs (No. 3.) Regulations, 1923, amending the Dangerous Drugs Regulations, 1921 Regulation 15 of which is as follows:- "If a foreign ship in any port in Great Britain requires to obtain a supply of any of the drugs in order to complete the necessary equipment of the ship, the liaster of the Ship is authorised to purchase and be in possession of such quantity of any of the drugs as may be certified by the Medical Officer of Health of the Port where the ship is (or in his absence by the Assistant Medical Officer of Health of the Port) to be necessary for the purpose, the quantity not to exceed what is required for the use of the ship until it next reaches its home port. The certificate given by the Medical Officer of Assistant Medical Officer of Health of the Port shall be marked by the supplier with the date of the supply, and shall be retained by him and kept available for inspection." PUBLIC HEALTH ACT, 1936. PART X. CANAL BOATS. On the 12th January, 1942, the Port Medical Officer made a report on the steps taken to carry into effect the provisions of Part X of the Public Health Act, 1936, relating to Canal Boats within the district of the Port of London Health Authority, during the year ended 31st December, 1941. During the year 36 inspections of Canal Boats were made of which 34 were found to conform to the Acts and Regulations. Written cautions were given in respect of the two vessels found not to conform. No new boats were registered during the year under review the actual number of Canal Boats on the Register on the 31st December, 1941, being 216. APPENDIX I. BACTERIOLOGICAL EXAMINATION OF RATS DURING 1941. SOURCE TOTAL EXAMINED. BLACK RATS BROWN RATS SPECIES UNKNOWN MICE RATS INFECTED WITH PLAGUE. FOUND DEAD TRAPPED POISONED ETC. FOUND DEAD TRAPPED POISONED ETC. FOUND DEAD TRAPPED POISONED ETC. FOUND DEAD TRAFPED POISONED ETC. TOTAL 2,650 9 1,978 1 662 - - - - NIL. 9. APPENDIX II. INFECTIOUS DISEASE. DISEASE 1932 1933 1934 1935 1936 1937 1938 1939 1940 Mean Annual No for for 10 years ending 31st December, 1941. 1941 (a) CASES REPORTED: Cholera (including suspected cases) 3 - - - - - 1 - - 0.4 - Yellow Fever (ditto) - - - - - - - - - - - Plague (ditto) - - - - - - - - - - - Smallpox 14 4 11 4 9 - 4 3 1 5.1 1 Scarlet Fever 12 21 7 9 10 6 16 13 3 9.8 1 Diphtheria 10 7 13 5 16 3 9 13 4 9.1 11 Enteric Fever 23 29 23 16 29 28 36 16 7 20.8 1 Measles 25 26 38 41 16 57 49 40 9 30.2 1 German Measles 22 4 5 8 4 6 25 34 17 13.0 5 Erysipelas 2 1 2 2 2 2 4 2 1 2.0 2 Typhus Fever - - - 1 - 1 - - - 0.2 - Continued Fever - — - - - - - - - - - Relapsing Fever - - - - - - - - - - - Tuberculosis:- Pulmonary 135 148 114 133 120 94 75 83 19 92.5 4 Other kinds 4 1 9 1 - 2 3 1 - 2.1 - Other diseases (Including Chicken pox) 791 460 516 647 543 508 540 388 178 465.9 88 TOTAL 1,041 701 738 867 749 707 762 593 239 651.1 114 (b) ADMITTED TO HOSPITAL. Cholera (including suspected cases) - - - - - - - - - - - Yellow Fever (ditto) - - - - - - - - - - - Plague (ditto) - - - - - - - - - - - Smallpox - - - - - - 2 - - 0.2 - Typhus Fever - - - 2x - - - - - 0.2 - Scarlet Fever 4 15 5 2 1 2 14 - - 4.3 - Dlphtherla 4 4 2 1 14x 1 5 4 - 4.4 9 Enteric Fever 9 6 11 6 9 7 12 8 1 6.9 - Measles 1 2 13 10 5 37 28≠ 7≠ 3 10.6 - Erysipelas - - - - - 1 1 - 0.4 2 Parotitis 2 4 4 5x 1 2 4 9 - 3.1 - Dysentery - - - - - - - - 2 0.2 - Other Diseases (Including ChlckenPox) 33 22 21 26 36 65 133xx 79 52 49.3 26 TOTAL 53 53 56 52 66 115 199 107 58 79.6 37 x Includes one contact xx Includes three contacts /- Includes two contacts ≠ Includes six contacts