AC.4369 PLON 51 99. 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, 1943. PORT OF LONDON HEALTH AUTHORITY 5, CHURCH PASSAGE, GUILDHALL, B.C.2 Telegraphic Address "PORTELTH LONDON". Telephone No. CLERKENWELL 2011. LIMITS OP THE PORT OF LONDON. THE LIMITS OP THE PORT OP LONDON AS AT PRESENT DEFINED COMMENCE AT HIGH-WATER MARK IN THE RIVER THAMES AT TEDDINGTON LOCK, IN THE COUNTY OP SURREY, AND EXTEND DOWN BOTH SIDES OP THE RIVER THAMES TO AIT IMAGINARY STRAIGHT LINE DRAWN PROM THE PILOT MARK AT THE ENTRANCE OP HAVENGORE CREEK, IN THE COUNTY OP ESSEX, TO THE LAND'S END AT WARDEN POINT, IN THE ISLE OP SHEPPEY, IN THE COUNTY OP KENT, SUCH POINT BEING THE NORTH-WES TERN LIMIT OP THE PORT OP FAVERSHAM, AND EXTEND UP AND INCLUDE BOTH SIDES OP THE RIVER MEDWAY TO AN IMAGINARY STRAIGHT LINE DRAWN PROM THE SOUTH-EAST POINT OP LAND WESTWARD OP COALMOUTH CREEK, THENCE ACROSS THE SAID RIVER MEDWAY TO THE WESTERNMOST POINT OP THE PIECE OP LAND WHICH FORMS THE EASTERN SIDE OP THE STANGATE CREEK, OR, IN OTHER WORDS THE NORTH-WEST POINT OP FLEET MARSH, AND PROM THENCE IN A SOUTHERLY DIRECTION TO IWADE CHURCH, IN THE SAID COUNTY OP KENT, AND THENCE IN A NORTH-EASTERLY DIRECTION TO ELMLEY CHAPEL IN THE SAID ISLE OF SHEPPEY, A SUPPOSED DIRECT LINE PROM ELMLEY CHAPEL TO IWADE CHURCH, BEING THE WESTERN LIMIT OP THE PORT OP FAVERSHAM, AND THE SAID PORT OP LONDON INCLUDES THE ISLAHDS OF HAVENGORE CREEK AFORESAID, CALLED POTTON AND RUSHLEY ISLANDS, AND SO MUCH OF THE SAID CREEK AND WATERCOURSE AS EXTENDS PROM IT TO THE TOWN OP ROCHFORD, AND ALSO INCLUDES ALL OTHER ISLANDS, RIVERS, STREAMS, CREEKS, WATERS, WATERCOURSES, CHANNELS, HARBOURS, DOCKS AND PLACES WITHIN THE BEFORE-MENTIONED LIMITS CONTAINED. STAFF List of Officers forming the Staff of the Port of London Health Authority, 31st December,1943. 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. 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 » ► 2. STAFF - Continued Office Name of Officer Date of entering the Services BOARDING MEDICAL OFFICERS. Gravesend ø J.A.Jones, M.B. Ch.B., D.P.H. April 1 do. do. J.R.Davies, M.R.C.S., L.R.C.P. , D.T.M. & H. January 1 do. do. ø G.N.M. Wishart, M.R.C.S., L.R.C.P., D.P.H. August 1 do. do. ≠ J.M.Horan, L.R.C.P. & S.I., L.M March 1 Sheerness ≠ H.A. Madwar, L.R.C.P., L.R.F.P.S. December 1 OFFICE STAFF. Principal Clerk W.C. Barham March 19 Principal Assistant J.A. Gillis March 19 1st Class „ A.W. Moore January 19 2nd „ „ ø W.L. McLorg February 19 3rd „ „ ø R.C. Ratliff March 19 3rd „ „ ø E.V. Smith October 19 Junior Clerk ^ ø D.W. Steib February 19 Tempy.Clerical Asst. ≠ Miss P.E.Nierses March 19 „ „ „ ≠ P.G. Newman September 19 Charwoman Mrs. E.S.Veale September 19 SANITARY INSPECTORS. (Senior) + F.J. Massie March 19 + W.J. Berry February 19 + W. Gray September 19 + R. Clifford July 19 ø + P.W. Coombe December 19 + E.H. Johnson August 19 + T.G. Edwards June 19 ø + D.E. Madeley September 19 + C.E. Wright July 19 ø + J.S. Beattie May 19 ø + L.A.R. Hundy January 19 ø + T.L. Mackie, O.B.E. A.M. I.N.A. November 19 ø + L.F.J. McDermott June 19 SANITARY INSPECTORS. (Junior) + G.Dring February 19 RODENT OFFICERS. C.F.Woodrow November 19 C.W. Moody February 19 E.C. Watkins June 19 S.A. Croft June 19 C. Stockton June 19 H.S. Adams July 19 RODENT CONTROL. D.J.Davis August 19 S. Bouttell July 19 L.L. Goodsall August 19 F.D. Cartman April 19 A.G. Blagdon April 19 3. STAFF - Continued Office Name of Officer Date of entering the Service DENTON HOSPITAL (temporarily closed). Medical Officer in charge 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 ≠ - do. ≠ - Handyman, etc. ≠ - Laundress ≠ — Gardener W.H.James January 1931 Housekeeper ≠ — 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. do. S.J. Crutchley June 1939 Deckhand (Vacant) - do. ø C.R. Simons August 1938 do. W.G. King September 1939 Deckboy ≠ L. Firmin August 1942 do. ≠ E. Bland November 1943 "Alfred Robertson" Master A.F. Rough October 1914 Engineer ø A. Cook July 1938 Deckhand (Vacant) - "Frederick Whittingham" Driver ø W.J. Reader November 1934 Deckboy ø J. Attwater May 1939 do. ≠ J.G. Edards November 1943 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. 4. 5, Church Passage, Guildhall, E.C. January, 1944, To THE WORSHIPFUL, THE PORT OP LONDON HEALTH COMMITTEE. Gentlemen, I have the honour to submit ray Annual Report as Medical Officer of Health of the Port of London: In the absence of any further instruction the report has been prepared in accordance with Circular 2768 of the Ministry of Health, dated 15th February, 1943, which states: "I am directed by the Minister of Health to refer to Circular 1937 of the 11th January, 1940, and to request that the Authority will instruct their Medical Officer of Health to prepare his report for 1942, on the lines indicated in that Circular, and that two copies of the report may be forwarded to this Department not later than the 31st March, 1943." Two hundred and ninety-five cases of Communicable Diseases (including malaria) were reported as having occurred on vessels during the voyage of which 62 were landed in the Port. Twenty-five cases, particulars of which are given in Appendix II (b),were admitted to Infectious Diseases Hospitals. The Port Isolation Hospital at Denton was closed on the 26.10.40 and arrangements were made for the reception of cases of communicable disease in Hospitals in the vicinity of the River. These arrangements have worked satisfactorily during the year. Disinfection of cases, their clothing, bedding and effects continued to be carried out at Denton Hospital. No case of human plague occurred during the year on any vessel bound for London. Of the 1,618 rats examined bacteriologically, 731 were from ships and 887 were from shore premises. No rats were reported to be infected with Plague. Ninety-nine vessels were fumigated for rodent destruction and the issue of an International Certificate, under the supervision of your Inspectors, 8 by sulphur dioxide resulting in the destruction of 232 rats and 154 mice and 90 by hydrogen cyanide accounting for 2,575 rats and 236 mice. Cne vessel was fumigated with a combined fumigant of sulphur dioxide and hydrogen cyanide which accounted for 61 rats. A total of 4,199 rats were destroyed in ships and 1,797 on shore premises in the Port. The work of rodent repression as described in my two previous reports has been energetically pursued and improved upon during the year and will be the subject of a further special report. The Parrots (Prohibition of Import) Regulations, 1930, continued in operation and the work thereunder is reported on page 8. The number of Water Barges in operation has considerably declined during the year but their registration is still made conditional upon the report of your Officers as to their fitness for the carriage of drinking water. 5. During the year 1,820 tons of foodstuffs were seized and condemned for human consumption and were either reconditioned or disposed of for animal consumption or for industrial purposes under guarantee, or destroyed. The same policy, namely, 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, has continued throughout the year and details of the uses to which the foodstuffs have been put are given on page 7. Your Medical Officer wishes to take this opportunity of thanking the Officers of the Ministry of Pood, the Port of London Authority and private firms for their valuable collaboration in the building up of what is no?/ a highly efficient service of food salvage resulting in the saving to the nation of large quantities of valuable foodstuffs. He also wishes to thank the Officers of His Majesty's Customs, Port of London Authority, the Pilots and the Members of the staffs of the Shipping Companies and Merchants for their collaboration and help 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 CASES OF COMMUNICABLE DISEASES PROM VESSELS. DISEASE NUMBER OF CASES DURING THE YEAR Smallpox - Scarlet Fever 5 Diphtheria 2 Enteric Fever - Measles - German Measles 1 Scabies 24 Pulmonary Tuberculosis 11 Tuberculosis (Other Kinds) - Pneumonia 1 Influenza - Dysentery - Malaria 14 Chickenpox 2 Mumps 2 62 6. CASES OP COMMUNICABLE DISEASES OCCURRING ON VESSELS DURING THE VOYAGE BUT DISPOSED OP PRIOR TO ARRIVAL. DISEASE NUMBER OF CASE DURING THE YEAR Smallpox — Scarlet Fever - Diphtheria 1 Enteric Fever — Measles 1 German Measles - Scabies - Pulmonary Tuberculosis 1 Tuberculosis (Other Kinds) - Pneumonia 1 Influenza - Dysentery - Malaria 227 Chickenpox 2 Mumps — 233 RATS DESTROYS!) DURING 1943. (1) ON VESSELS. (a) (b) (c) No. of Rats Destroyed. No. of Rats Examined. No. of Rats found to be infected with Plague. 4,199 731 NIL ( 2 ) IN DOCKS. QUAYS. WHARVES AND WAREHOUSES (a) (b) (c) No. of Rats Destroyed. No, of Rats Examined. No. of Rats found to toe infected with Plague. 1,797 887 NIL HYGIENE OF CREWS' SPACES. Classification of Nuisances. BRITISH: Defects of original construction 44 Structural defects through wear and tear 134 Dirt, Vermin and other conditions prejudicial to health 39 OTHER NATIONS: Defects of original construction 3 Structural defects through wear and tear 10 Dirt, Vermin and other conditions prejudicial to health 4 7. COASTING VESSELS. Your Medical Officer thinks it necessary to draw attention to a certain deterioration in the cleanliness and the living conditions generally in coasting vessels. An appreciable number are found on inspection to be infested with rats and mice and also with cockroaches. No doubt these conditions are due in large measure to the very high pressure under which the coastal trade is working at present. The stay of these ships in port has been reduced to the minimum necessary to discharge and re-load cargo and it is seldom that the ships are empty for more than a few hours. Furthermore, the crews are working under difficult conditions and have little time to spare for cleaning up their quarters. On the other hand, everything possible is being done by the owners to secure an improvement of sanitation and living conditions in these vessels and your Medical Officer wishes to express his appreciation of their endeavour to collaborate and to carry out his recommendations whenever time and circumstances permit. One measure would go some way to secure improvement. Coasting vessels are exempt from the obligation laid down in the International Sanitary Convention, 1926, (Article 28), to undergo a periodic inspection for the presence of rodents and to carry a Certificate declaring that the ship, after inspection, has been found to be free from rodents or is free from rodents following fumigation. This obligation imposed on foreign-going vessels could usefully be extended to all vessels, whether British or foreign, engaged in the coastal trade in these Islands. FOOD INSPECTION. The inspection of foodstuffs under the Public Health (Imported Pood) Regulations. 1937, and the Public Health (Preservatives, &c. in Pood) Regulations, 1925-1927, resulted in the seizure and destruction of 1,820 tons of foodstuffs. The policy that has been adopted during the war years, namely, the conservation of food supplies, has resulted in the saving of large quantities of foodstuffs which, by careful sorting and by reconditioning, have been rendered, without appreciable deterioration of quality, perfectly fit for human consumption. Large quantities of foodstuffs which in peace time would have been for the most part destroyed have been diverted to useful purposes such as animal and poultry feeding. The following is a summary showing the method of disposal of the foodstuffs seized: DISPOSAL WEIGHT APPROX.PER CENTAGE OP TOTAL Tons cwts. qrs. lbs. Cattle and Poultry Feeding 583. 16. 1. 13. 32.00 Refining 157. 2. 0. 6. 8.60 Boiling Down(Recovery of Fats, etc.) 390. 4. 1. 26. 21.40 Reconditioning 674. 8. 3. 3. 36.70 Industrial Purposes 4. 10. 0. 12. 0.24 Soap - 11. 1. 15. 0.01 Salvage of Tins 2. 10. 0. 0. 0.10 Buried 5. 4. 3. 4. 0.29 Burnt 1. 2. 2. 25. 0.06 Total 1,819. 10. 2. 20. 99.40 8. PARROTS (PROHIBITION ON IMPORT) REGULATIONS, 1930. Twelve parrots etc., came under the notice of your Officers during the year. Ten notices were issued in respect of 12 parrots etc. Number exported in respect of Notices served Number destroyed (Notice served to export) Number admitted under ministry of Health permits Bodies of birds sent for investigation to the Ministry of Health Number transhipped on through Bills DANGEROUS DRUGS. During the year 38 certificates authorising the purchase of scheduled Dangerous Drugs were issued by your Medical Officer under the Dangerous Drugs (No.3) Regulations, 1983, amending the Dangerous Drujs Regulations, 1921. PUBLIC HEALTH ACT, 1936. PART X - CANAL BOATS. No Canal Boats were inspected during the year due to the fact that this type of croft has practically disappeared from the River. APPENDIX I. BACTERIOLOGICAL EXAMINATION OF RATS DURING 1943. Total EXAMINED BLACK RATS. BROWN RATS. SPECIES UNKNWN. MICE. Rats Infected with Plague Found Dead Trapped Poisoned etc. Found Dead Trapped Poisoned etc. Found Dead Trapped Poisoned etc. Found Dead Traped Poisoned I 1,618 457 923 30 208 - - - - NIL 9. APPENDIX, II INFECTIOUS DISEASE. DISEASE 1934 1935 1936 1937 1938 1939 1940 1941 1942 MEAN ANNUAL NO. FOR 10 YEARS ENDING 3IST DECEMBER 1943. 1943 (a) CASES REPORTED: CHOLERA (INCLUD1NG SUSPECTED CASES) - - - - 1 - - - - 0.1 YELLOW FEVER „ - - - - - - - - - - - PLAGUE „ - - - - - - - - - - - SMALLPOX 11 4 9 - 4 5 1 1 1 3.6 - SCARLET FEVER 7 9 10 6 16 13 3 1 2 7.2 5 DIPHTHERIA 13 5 16 3 9 13 4 11 5 8.2 3 ENTERIC FEVER 23 16 29 38 36 16 7 1 1 15.7 - MEASLES 38 41 16 57 49 40 9 1 1 25.3 1 GERMAN MEASLES 5 8 4 6 25 34 17 5 2 10.7 1 ERYSIPELAS 2 2 2 2 4 2 1 2 - 1.7 - TYPHUS FEVER - 1 - 1 - - - - - 0.2 - TUBERCULOSIS PULMONARY 114 133 120 94 75 83 19 4 5 65.9 12 OTHER KINDS 9 1 - 2 3 1 - - - 1.6 - OTHER DISEASES (INCLUDING CHIGKENPOX) 516 647 543 508 540 388 178 88 179 386.0 273 TOTALS 736 867 749 707 762 395 239 114 196 526.2 295 (b) ADMITTED TO HOSPITAL: CHOLERA (INCLUDING SUSPECTED CASES) - - - - - - - - - - - YELLOW FEVER „ - - - - - - - - - - - PLAGUE „ - - - - - - - - - - - SMALLPOX - - - 2 - - - - 0.2 - TYPHUS FEVER - 2x - - - - - - - 0.2 - SCARLET FEVER 5 2 I 2 14 - - - 2 2.9 5 DIPHTHERIA 2 1 I6x 1 5 4 - 9 5 4.5 2 ENTERIC FEVER 1 6 9 7 12 8 1 - I 5.7 - MEASLES 13 10 5 37 28/- 7/- 3 - 1 10.4 - ERYSIPELAS - - - 1 1 - - 2 - 0.4 - PAROTITIS 4 5x 1 2 4 9 - - - 2.7 2 DYSENTERY - - - - - - 2 - - 0.2 - OTHER DISEASES (INCLUDING CHICKENPOX) 21 26 36 63 I33xx 79 52 26 15 16.9 16 TOTALS 56 52 68 115 199 107 58 37 24 74.1 25 x Includes one Contact, xx Includes three contacts. /- Includes six contacts.