Please acknowledge Ac 4369 104. PORT OF LONDON HEALTH COMMITTEE PLON 56 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (MONTAGU TRAVERS MORGAN, C.M.G., M.C., M.D., Ch.B., D.P.H.) TO 31st DECEMBER, 1948. Port of London Health Authority., 5, Church Passage, Guildhall, E.C.2. Telegraphic Address "PORTELTH LONDON". Telephone Number CIERKENWELL 2011. LIMITS OF THE PORT OF LONDON. THE LIMITS OF THE PORT OF LONDON AS AT PRESENT DEFINED COMMENCE AT HIGHHATER MARK IN THE RIVER THAMES AT TEDDINGTON LOCK, IN THE COUNTY OF SURREY, AND EXTEND DOWN BOTH SIDES OF TIE 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 TIE SOUTH-EAST POINT OF LAND WESTWARD OF GOALMOUTH CHEEK, THENCE ACROSS TIE SAID RIVER MEDWAY TO TIE WESTERN-MOST POINT OF THE PIECE OF LAND WHICH FORMS TIE EASTERN SIDE OF TIE STANGATE CREEK , OR, IN OTHER WORDS THE NORTH-TEST POINT OF FLEET MARSH AND FROM THENCE IS A SOUTHERLY DIRECTION TO IWADE CHURCH IN THE SAID COUNTY OF KENT, AND THENCE IN A NORTH-EASTERLY DIRECTION TO ELMIEY CHAPEL IN TIE SAID ISLE OF SHEPPEY, A SUPPOSED DIRECT LINE FROM ELMIEY CHAPEL TO IWADE CHURCH, BEING THE WESTERN LIMIT OF TIE PORT OF FAVERSHAM, AND TIE SAID PORT OF LONDON INCLUDES TIE 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 PUCES WITHIN TIE BEFOREMENTIONED LIMITS CONTAINED. STAFF. List of Officers forming the Staff of the Port Health Authority, 31st December, 1948. Office Name of Officer Date of entering the service Medical Officer of Health M.T. Morgan, C.M.G., M.C., M.D., Ch.B., D.P.H. September 1938. Deputy Medical Officer of Health and Medical Officer in Charge, Denton Hospital. H.M. Willoughby, V.D., M.R.C.S., L.R.C.P., D.P.IH, D.T.M. & H., R.N.V.R. May 1929. Assistant Port Health Officer .J. A. Jones, M.B., Ch. B., D. P.H. April 1935 ditto. J.r. Davies, M.R.C.S., L.R.C.P., D.T.M. & H. January 193 9 ditto, (vacant) Sheerness Roarding Station (Tempy: Part Time). H.A. Madwar, L.R.C.P., L.R.F.P.S. December 1927 Office Name of Officer Date of entering the service. CLERICAL- Principal Clerk W.C. Barham March 1901 Principal Assistant J.A. Gillis March 1914 First Class Assistant A .W. Moore January 1920 General Grade Male Clerical Assistant W.L. McLorg February 1927 ditto. R.C. Ratliff March 1930 ditto. E.V. Smith October 1938 ditto. R.H. Lott May 1947 INSPECTORIAL- Sanitary Inspector and W. Gray September 1921 Inspector of meat and R. Clifford July 1925 other food P.W. Coombe December 1924 ditto. E.H. Johnson August 1929 ditto. T.G. Edwards June 1929 ditto. D.,E. Madley September 1932 ditto. C.E. Wright July 1931 ditto. J.S. Beattie May 1931 ditto. L.A.R. Hundy January 1934 ditto. T.L. Mackie , M.B.E., November 1934 A.M.I.N.A. ditto. G. Dring. February 193 7 ditto. J. Aiken July 1946 ditto. A. Trevethick August 1946 ditto. L.N. Tope August 1946 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 F.D. Cartnian January 1943 RODENT CONTROL SCHEME- Rodent Officers. D.J. Davis August 1941 G. Lamont March 1945 H.A. Baxter June 1945 J.E. Carrington January 1946 W.G. Stimson on February 1946 A. G. Blagdon September 1946 DENTON HOSPITAL (transferred to the State on 5th July 1948 under the National Health Service Act) Medical Officer in Charge H.M. Willoughby May 1929 LAUNCHES AND HULKS Launches Howard Deighton Alfred Robertson Frederick Whittingham Alfred Roach Hulks Hygeia at Grave send Uplees at Greenwich Navigator (senior) P.J. Wilkins November 1928 do. J.R. Steen March 1926 do. H.J. Debnam April 1931 (2) Office Name of Officer Date of entering the service. Navigator (senior) W.S. Stiwason March 1944 do. W.G.A. King September 1939 do. C.R. Simons August 1938 Engineer (senior) S.J. Crutchley June 1939 do. A. Cook July 1938 do. E.G. Smith January 1946 do. J.F. Trice M.B.E September 1947 Deckhand A.R.L. Potter July 1945 do. Simmons July 1945 do. (Three Vacancies) - - do. (Acting) R.A. Mantripp March 1945 do. (Acting) L.J. Nicholls September 1945 do. (Acting) C. Sams January 1946 Deckboy G.A. Simmonds February 1947 do. C.F. Bowen December 1945 do. B. Bowen June 1947 do. A.R. Watkins August 1948 do. J.J. Easterbrook October 1948 do. R.F. Day June 1948 Steward (Part Time) J.F. Smeed July 1927 Shipkeeper A.R. Burge August 1945 do. E. Alewood January 1947 Watchman E.W.S. Edmonds September 1933 do. H.J. Mason August 1946 January 1949. To THE WORSHIPFUL THE PORT OF LONDON HEALTH COMMITTEE. Gentlemen, I have the honour to submit my Annual Report as Medical Officer of Health of the Port of London. On the 11th October, 1943, the following letter was received from the Secretary of the Ministry of Health:- "I am directed by the Minister of Health to request that the Annual Report of the Medical Officer of Health for 1948 be prepared on the lines indicated in Memorandum 302/S.A, and that three copies of the Report may be forwarded to the Ministry". The directives of Memo. 302/S.A. have been followed in so far as the information asked for is available. Tonnage. The tonnage of vessels entering the Port of London during 1948 was 22,116,113 tons as compared with 19,923,674 tons during 1947. Eight thousand one hundred and eighty two vessels arrived from foreign ports and of these 1,525 were boarded by your Medical Officers. (Table A). Communicable Disease. Two hundred and fifty nine cases of notifiable communicable deceases (including malaria) were reported as having occurred on 133 vessels during the voyage, of which 144 were landed in the Port. (Tables C & D) . One hundred and twenty cases, particulars of which are given in Appendix II(b), were admitted to the Port Isolation Hospital at Denton. (3) No case of human plague occurred during the year on any vessel bound for London. Fumigations. One hundred and fifty three vessels were fumigated for rodent destruction and the issue of International Certificates under the supervision of your Inspectors, of which 152 were fumigated with hydrogen cyanide resulting in the recovery of 3,012 rats and 598 mice and one by sulphur dioxide accounting for 53 rats. (see Table 'II'). Rodents. A total of 7,310 rats were destroyed and their bodies recovered during the course of the year, 3,921 in ships and 3 ,3 89 on shore premises in the Port. In addition 2,174 mice were destroyed, 595 in ships and 1,579 on shore premises (see page 13 and Tables E & F). Of the 1,086 rats examined bacteriologically, 750 were from vessels and 336 from shore premises. No rat was reported to be infected with plague. (see Tables E & F) . Psittacidae. The work under the Parrots (Prohibition of Import) Regulations, 1930, still in operation, is reported on page 21. Water Barges. Fifteen water barges were in use during the year. The registration of these craft by the Port of London Authority is made conditional upon the report of your Officers as to the fitness of the barges for the carriage of drinking water. These arrangements worked smoothly. (see page 6) House Boats. The new House Boat Bye laws are still in draft form. Objections are still being received and during the year several conferences were held at which discussions took place between the interested parties, (see page 21) Imported Foods. The total amount of foodstuffs seized and condemned for human consumption and either reconditioned or disposed of for animal consumption or for industrial purposes under guarantee or destroyed was 93 7 tons as compared with 1,094 tons during the previous year. See page 16. Launches. The Authority's Launch m.v. "ALFRED ROACH" built by Messrs. John I. Thornycroft & Co. Ltd., at their works at Hampton, -was named on the 21st July, 1948, at an appropriate ceremony by Mrs. D.E. Eriebach, wife of the Deputy Chairman of the Port Health Committee. After satisfactory trials the launch was subsequently handed over to the Authority on the 1st October, 1948 and at once put into commission on the lower reaches of the River. She has, so far, given every satisfaction and it is no exaggeration to say that she has been the subject of many highly complimentary remarks by those, working on the River who are competent to judge of her good qualities. A report by Mr. T.L. Mackie, the Authority's Supervisory Engineer, on her construction, equipment and performance is to be found on pages 8,9 & 10 of this Report. Instruction of P.P.H. and D.I.H. classes in Port Health work. Arrangements have continued during tho year for giving practical instruction to Post-Graduate Students of the Royal Institute of Public Health and the London School of Hygiene and Tropical Medicine taking their course for the Diploma in Public Health and in Industrial Hygiene, The students have paid visits to one or other of the Dock groups and have been given practical demonstrations of the day to day work of the Port Health Services on the River and Docks. Your Medical Officer wishes to take this opportunity of thanking the Officers of His Majesty's Custowas, of the Port of London Authority, the Pilots and members of the staffs of the Shipping Companies and Merchants for their collaboration and assistance in every aspect of the work of the Port Health Authority throughout the year. Your Medical Officer also has pleasure in reporting that all members of your staff have carried out their duties both willingly and efficiently. I have the honour to be, Gentlemen , Your obedient servant, M.T. MORGAN. (4) 1. AMOUNT OF SHIPPING ENTERING THE PORT DURING THE YEAR, 1948. TABLE A. Number Tonnage Number Inspected Number Reported to Be Defective Number of Vessels on Which Defects were Found Number of Vessels on Which Defects were fond and Reported to Ministry of Transport;s Surveyors. Number of Vessels reported as having or Having had, During the Voyage,Inspectiious Disease on Board. By the medical officer of health By the Saintary inspector Reign Steamers 4,307 9,714,861 1,130 7,109 876 823 45 132 MOTOR 3,874 4,093,444 394 - Sailing 1 2,154 1 15 18 18 - - Fishing - - - - - - - - Total Foreign 8,182 13,810,459 1,525 7,124 894 841 45 132 Coast wise Steamers 7,541 7,074,343 1 2,194 189 160 41 1 MOTOR 3,871 1,201,635 - - Sailing 435 29,676 - 184 11 11 - - Finishing - - - - - - - - Total Coastwise 11,847 8,305,654 1 2,378 200 171 41 1 Foreign and Coastwise 20,029 22,116,113 1,526 9,502 1,094 1,012 86 133 11. CHARACTER AND TRADE OF THE PORT. TABLE B. (a) Passenger traffic during the year. (l) To and Prom Non-European Countries. 1st Class. 2nd Class* 3rd Class Tourist Class Total. INWARD 14,397. 5,029. 781. 14,565. 34,772. OUTWARD 17,570. 5,049. 719. 23,396. 46,734. *Includes Cabin Class. (ll) To and From the Continent of Europe. INWARD 38,355. OUTWARD 34,762. Countries from which passengers principally arrive: India, Australia, New Zealand, South America, South Africa, the Par East and the United States of America. (b) Cargo Traffic (Imports and Exports). Particulars for the year 1948 are not available. (c) Foreign Ports from which vessels arrive:- The Port of London trades with all parts of the world. MEDICAL INSPECTION OP ALIENS. Annual Return by the Medical Inspector of Aliens for the year ended 31st December,1948. Total Number Inspected By the Medical Inspector Number Subjected To Detailed Examination By the Medical Inspector Certificates Issued. migration Lunatic Ididot or M.D. Undesirable \for medical reasons. physically Incapicated Suffering from Acute Infectious Disease Landing Necessary for Adequate Medical Examination Total number of aliens landing at the port. 42,260 32,946 1,339 - - - 1 - - Alien & Refused Permission to Land by the Immigration Officer. 102 - - - - - - - - Transmigrants. - - - - - - - - - Total Aliens Arriving at the Port. 42,362 32,946 1,339 - - - 1 - - Total number of vessels arriving carrying Alien passengers- 2,111. (5) III. - WATER SUPPLY. 1. Source of Water Supply- (a) For the Port- All the Docks in the London area obtain their water supplies from the Metropolitan Water Board., Tilbury Dock obtains its water from the South Essex Water Company. The majority of the wharves are supplied by Public Water Authorities within whose area of distribution they are situated, while several have their own deep wells. A few have no water supplies, available for shipping, in which case any water required can be obtained from water barges. (b) For Shipping- Ships usually obtain water from the shore supplies as indicated above but when no water is available at the berth or if a ship is lying at buoys in the river, supplies are obtained from water barges. 2. Hydrants and Hosepipes- Hydrants within the dock area are of the standard type in use by the Metropolitan Water Board. These are situated at intervals along the quayside and consist of an upright stackpipe with a nozzle coupling to which are attached the hoses. The hoses, usually of rubber covered with a metal coil, when not in use are coiled up and hung in specially constructed boxes at convenient points within the docks. When in use particular care is taken that the hoses do not sag into the dock water and in transference from the ship to shore, that at no time do they come into contact with the dock water. If this should happen the hoses are thoroughly cleansed and flushed with fresh water before being again used. 3. Number of water boats and their sanitary conditions There were fifteen water boats working in the Port during the year. Water boats are all of steel construction and of the "single skin" type., i.e. the skin of the boat forwas the sides and bottom of the tanks and the deck forwas the top. The manholes are raised from 6 inches to 1 foot above the level of the deck and have steel covers, fitted with locks to prevent unauthorised persons dipping water from the tanks into buckets which may be dirty, while the craft is unattended. It is the usual practice to clean the tanks every three months and to cement wash them every six months. All water boats must be registered annually with the Port of London Authority and before a certificate is granted they must be inspected as to their fitness for navigation in the river and docks. Notification is received that a vessel is coming up for re-registration by the Port of London Authority and this opportunity is taken by the Port Health Authority to inspect the vessel as to its fitness for the carriage of drinking water. The Port of London Authority await a communication from the Port Health Authority stating that the vessel is in a fit condition for the carriage of drinking water before issuing the certificate. This arrangement has worked smoothly for a number of years and enables your Officers to get such repairs and improvements as are from time to time necessary, carried out without difficulty. IV. PORT HEALTH REGULATIONS, 1933 and 1945. (1) Arrangements for dealing with Declarations of Health. (2) Boarding of vessels on arrival. (3) Notifications to the Authority of inward vessels requiring medical attention. (6) (4) Mooring stations designated under Article 10. (5) Particulars of any Standing Exemptions from the provisions of Article 14. (6) Experience of working Article 16. All the above remained the same as reported in my Annual Report for 1947. (7) What, if any, arrangements have been made for (a) Premises and waiting roowas for medical examination.. Medical examinations are usually carried out on board ship but there are roowas available for the medical inspection of Aliens on the Tilbury Landing Stage. (b) Cleansing and disinfection of ships. persons and clothing and other articles. Disinfection of infected quarters is usually carried out by the Sanitary Inspector in whose area the vessel is berthed. Should, however, the space requiring disinfection be large, a private firm is employed who carries out the disinfection under the supervision of the Sanitary Inspector. Although Denton Hospital was taken over by the South-East Metropolitan Regional Hospital Board on the 5th July, 1948, the Disinfecting Station, containing a Washington Lyons Steam Disinfector has been continuously available for the disinfection of clothing, bedding etc. (c) Premises for the temporary accommodation of persons for whom such accommodation is required for the purposes of the Regulations- No special provision on a large scale has been necessary, but if suoh necessity did arise the ship would be detained until temporary accommodation ashore had been found. (d) Hospital accommodation available for Plague, Cholera, Yellow Fever, Smallpox and other infectious diseases- Until the handing over of Denton Hospital to the South-East Metropolitan Regional Board on the 5th July, 1948, arrangements were made with the medical officers of Health of the Essex County and Grays Thurruck Rural District Council for the reception of oases of infeotious disease. DENTON HOSPITAL. The Port Health Committee decided to reopen the Denton Isolation Hospital in August, 1947 and to carry on as best they could with a staff of male nurses recruited from ex-Navy Sick Bay Petty Officers and Attendants. A Sick Bay Chief Petty Officer was appointed as Nursing Superintendent together with two Sick Bay Petty Officers and two Sick Bay Attendants. This arrangement worked fairly satisfactorily but had the disadvantage that no female cases could be admitted to the Hospital but had to be 'farmed out' to other Isolation Hospitals. On the 5th July, 1948, with the passing of the National Health Service Act, the Hospital was transferred to the State and was allocated to the Seamen's Hospital Group under the South-East Metropolitan Regional Hospitals Board. Discussions took place between tho Management Committee of the Group and the Port Health Committee on details associated with the transfer of the property and on the continuance of admission and treatment of cases of infectious diseases found in the Port by the Port Medical Officer of Health and his Medical Staff. It is too early to judge whether the transfer can be regarded as an advantage to the sea-faring population of the Port but, generally speaking, the arrangements should work satisfactorily when adequately trained nursing staff (male & female) becomes available . (7) (e) Ambulance Transport- The launch "Howard Deighton" used by the Medical Officers as a boarding launch is fitted with an ambulance room on deck with accommodation for four stretcher cases or eight walking cases. The middle river launch the "Alfred Robertson" has a fairly spacious after cabin in which a stretcher case can be carried. The following is a report by Mr. Mackie on the new motor launch "Alfred Roach":- M.L. "ALFRED ROACH" The new twin screw motor launch was built by Messrs. John I. Thornycroft & Co. Ltd. at their Hampton-on-Thames yard in accordance with our design. I supervised the construction throughout and the subsequent trials, all of which gave complete satisfaction. The trials embraced such tests as speed, fuel consumption, endurance, manoeuvring, heeling, stability and vibration. She was accepted for service in the Lower River District, commencing 1st October, 1948. The duties required of the launch are arduous and comprehensive, which involve her being ready for duty, if not in service, by night and day. Normally, she will be engaged in daily routine with the Sanitary Inspector, but it is intended that the duties shall include:- (a) Sanitary Inspectors' duty launch. (b) Rapid conveyance for patients and bedding etc. from ship to shore. (c) To assist or relieve the "Howard Deighton" and "Alfred Robertson" in appropriate circuwastances. The vessel represents the latest developments in ambulance launch design, which allows for quick convertibility, also the comfortable handling and transport of three stretcher cases and eight sitting patients. In consequence of her limited draught and super structural arrangement, she is able to negotiate bridges and operate over the entire district of the Port Health Authority at any state of the tide. Measurements Reg. Ton 12.13/100 Length 53 ft. 0 ins. Beam l2 ft. 0 ins. Draught (mean) 3 ft 6 ins. Block Coeff 0.408 Construction The hull is of round-bilge form and is constructed of doubleskin mahogany on elm timbers. Oak is used on the heavier sections and mahogany employed throughout the superstructure. All timber is of good quality, while fastenings and workmanship conform with the best boat-building practices. The sunken type of accommodation is to reduce the height of superstructure and the raked wheelhouse front are features which reduce wind resistance. The bow is given considerable flare to deflect storm water and the quarters well rounded to facilitate a clear get away from larger vessels. The decks are clear and of sufficient width to afford free movement from forward to aft and the internal arrangement allows easy passage from bows to the cockpit for use in stormy weather. Lifting: Gear A collapsible type of mast and derrick are provided to lift and discharge stretcher cases from the launch. Internal Arrangement Seven bulkheads add to the transverse stiffening of the hull and divide the interior into eight compartments. viz. forepeak, crew's messroom, wheelhouse, engine-room, galley and lavatory, saloon, cockpit and afterpeak. By a series of doors at the bulkheads, it is possible to pass from the forepeak to the afterpeak without using the deck, a great advantage in stormy weather. (8) Forepeak Anchor cable stowage only. Messroom Furnished with settees, table, lockers and escape hatch. Wheelhouse Contains settees, screen-wipers and a full set of dashboard and nautical equipment for ship and engine control, with a clear view in all directions. Engine-room A spacious compartment with central gangway and sound-insulated bulkheads. Galley:- Contains a pressure-paraffin cooker, wash-up sink and lockers. Lavatory:- Comprises washbasin, W.C., toilet equipment and lockers. Saloon:- Provides table accommodation for six persons and settee seating for eight persons. Wardrobe and stores lockers are supplemented by settee lockers. The table top is portable and when the supports are conjoined to the hinged framing from the wing spaces behind the settee backs, a framework is assembled to carry three stretchers. The stretchers and table top can be properly stored in these wing spaces. In this manner it is possible in five minutes to convert the saloon into a sick-bay for three stretcher cases. Cockpit A sufficiently large open space to receive a stretcher and deep enough to protect the occupants from storm water. It is capable of accommodating eight sitting patients. Fuel tanks, launch store lockers and steering gear occupy the three adjacent spaces of this compartment, and it is fitted with a portable awning and spars to protect the seated patients. Afterpeak This is fitted with a large W/T door which affords easy access to the twin rudder mechanism. All compartments are adequately lighted, heated and ventilated, according to their requirements. Machinery The propelling machinery comprises two Thornycroft type RNR/6 six-cylinder diesel engines, each developing 95 b.h.p. at 1650 r.p.m., fitted with oil operated reverse gears and driving handed propellers through 2 : 1 reduction gears. An important feature of the installation is the remote control of engines from the wheelhouse. A bilge pump is fitted to one engine. but a hand pump is also provided. The engines are fitted with electric starting devices, which can be operated from the engine-room and the wheelhouse. Electrica1 Two 24-volt batteries with an aggregate capacity of 220 ampere hours are used for starting the engines and lighting. These are charged by generators mounted on the propelling machinery. In addition to a liberal supply of internal lighting. the batteries supply navigation lights, searchlight, horn, and an illuminated sign for night work. Observations Max. Trial speed 14,55 Knots 1650 r.p.m. Continuous Rating speed 13.85 „ — 1580 Operational speed 11.25 „ 1300 „ Cruising speed 12.15 „ 1400 „ Mean Propeller Slip 21% Fuel consumption for 522 hours running time amounts to 2,100 galls. which is to be considered highly satisfactory. For the greater part of this time the engines have run at 1,350 - l,400 r.p.m. and developed approximately 100 b.h.p. Neglecting allowances for temporary reduction in speeds due to manoeuvring:- Total consumption per hour 4 Galls. @ 12 Knots. Fuel consumption per b.h.p. hour 0.344 lbs „ „ Endurance for 200 galls. 600 miles „ „ (9) General Remarks The vessel is manned and maintained by a crew of three; viz. Navigator, deckhand and deckboy, and with this staff continues to give entirely satisfactory service, a result which is in part due to the care of the Navigator, who has control of ship and machinery. She is a very useful addition to the Service, and though not able to withstand the heavy punishment accepted by her steel-built sister ships, it is certain that she will acquit herself worthily in the tasks for which she is intended. (Sgd.) T.L. MACKIE. A Bronze commemoration plaque. inscribed as under, is placed in the saloon M.L. "ALFRED ROACH" THIS VESSEL WAS NAMED AND LAUNCHED BY MRS. D.E. ERLEBACH AT MESSRS. THORNYCROFT'S YARD, HAMPTON, ON 21st JULY 1948. IN THE PRESENCE OF THE FOLLOWING:- H.R. HILL Esq., Deputy Chairman D.E. ERLEBACH Esq. Immediate Past Chairman VICTOR ALL/CARD Esq. Deputy FREDERICK WHITTINGHAM Esq. J. P. ALDERMAN D.H. TRUSCOTT A.F.I. PICKFORD Esq. B.A. Town Clerk M.T. MORGAN Esq. M.C., M.D. Port Medical Office of Heal A MAHOGANY CLOCK FOR THE WHEELHOUSE, INSCRIBED AS UNDER, WAS KINDLY PRESENTED BY MRS. D.E. ERLEBACH:- "PRESENTED BY J. ISABEL ERLEBACH GOD BLESS THIS SHIP AND ALL WHO SAIL IN HER." (f) Supervision of contacts. The method of dealing with contacts who are leaving a ship has been described on page 7. Arrangements for the Bacteriological or Pathological Examination of RatsArrangements made for other Bacteriological and Pathological Examinations Arrangements for the diagnosis and treatment of Veneral Diseases among sailors. Arrangements made under the Brussels Agreement 1924. Arrangements for the interment of the dead. All these remain as reported in my Annual Report for 1947. TABLE C. CASES OF INFECTIOUS SICKNESS LANDED FROM VESSELS. Disease Number of Cases during the year Number of vessels concerned Average number of cases for previous 5 year Passengers Crew Measles 64 2 11 4.6 German Measles 1 - 1 1.0 Chickenpox 5 18 13 7.2 Pulmonary Tuberculosis 8 17 22 14.0 Enteric Fever - 3 3 1.0 Scarlet Fever 1 2 3 5.0 (10) Disease Number of Cases during the year Number of vessels concerned Average number of cases for previous 5 years Passengers Crew Diphtheria - 2 2 4.2 - 11 11 17.2 Pneumonia 1 1 2 4.0 Dysentery 1 2 3 3.6 Typhus - 1 1 - Mumps 2 2 4 2.6 TABLE D. CASES OF INFECTIOUS SICKNESS OCCURRING ON VESSELS DURING TIE VOYAGE BUT DISPOSED OF PRIOR TO ARRIVAL. Disease Number of Cases during the year Number of vessels concerned Average number of cases for previous 5 years. Passengers Crew Measles 33 - 9 5.0 German Measles 1 1 1 1.4 Chickenpox 7 4 10 9.6 Pulmonary Tuberculosis 6 1 7 6.0 Enteric Fever 1 6 5 3.0 Smallpox 1 2 3 1.4 Dysentery - 2 2 4.2 Malaria 2 40 12 57.2 Pneumonia 1 2 3 3.4 Cholera (suspected) - 1 1 - Mumps 3 1 4 2.2 TYPHUS (MURINE). The s.s. "CANTON" arrived at Gravesend on the 11th June, 1948 from Hong Kong via Singapore, Penang, Colombo, Bombay, Aden and Port Said. On arrival the 2nd Officer, aged 35, was removed to Denton Isolation Hospital as a suspected case of typhoid fever and after a period of a few days at Denton Hospital was transferred to the Seamen's Hospital, Greenwich, owing to the unsatisfactory results of the bacteriological examination for B. Typhosus and of the Widal reaction. The Bacteriologist at the Seamen's Hospital carried out a Weil Felix test which proved to be strongly positive. The patient had some paresis of the tongue and a slightly staggering gait (which may have been due purely to weakness from lying in bed for some three weeks). He had no rash save a few probably sudaminal rose spots which were thought might be typhoid spots. It was subsequently learned that the Weil Felix tost was positive for Murine Typhus. (11) SMALLPOX. Your Medical Officer regrets to state that the arrangements for dealing with smallpox and suspected smallpox and with contacts are far from satisfactory. This was brought out by an incident in a large passenger ship which arrived in the Port with an undiagnosed fatal case of smallpox on board in April, 1949, A full account of the incident will be given in your Medical Officer's report for that year. Owing to the unvaccinated state of the population this country is in a dangerous state of risk of the introduction of smallpox with potentially disastrous results. The discovery of a case of smallpox of which the diagnosis is in no doubt is not nearly so serious in its potentialities for spreading infection as is the case of mild smallpox which slips in undiagnosed or is the subject of an erroneous diagnosis. Smallpox is so subtle in its attack and is of such high infectivity that only the strictest measures of isolation, carried out by a thoroughly trained and experienced staff of doctors and nurses can be regarded as likely to meet the risks involved. Unfortunately nursing staffs trained in the handling of smallpox cases are by no means readily obtainable at short notice so that the early isolations, which is the critical period in the prevention of the spread of the disease, is not easy to arrange. The Isolation Hospital at Denton provides excellent accommodation and facilities for strict isolation of smallpox but only if other cases of infectious disease are forthwith evacuated from the hospital and the trained nursing staff is immediately available to take control. The actual treatment of the case is not of primary importance; it is the strict isolation that is the essential requirement. This involves not merely isolation of the case in a ward or cubicle but proper handling of infected bedding and personal effects, the sterilisation of all articles, crockery etc. that come into contact with the patient, disinfection of soiled linen and last, but not least, strict attention to the personal hygiene of the nurses so that infection is not conveyed through them to others while they are off duty. Adequate arrangements for the conveyance of the case under strict control from the ship or dock to the isolation hospital and for the removal of infected bedding, furniture and indeed all articles that nay have be con. contaminated, also under strict control, for disinfection or sterilisation, are also essential. It is to be hoped that a better organisation than at present obtains will be built up to meet the needs of the Port in the near future. One thing is certain that smallpox does not await the convenience of anyone. It is only by making precise arrangements which can be put into force at any moment of the day or night that the menace of this disease can be regarded with any complacency. V. MEASURES AGAINST RODENTS. 1. Steps taken for the detection of Rodent Plague. 2. Measures taken to prevent the passage of rats between ship and shore. 3. Methods of Deratisation. 4. Measures taken for the detection of rat prevalence in ships and on shore. 5. Rat-proofing The action taken under the above headings was fully described in my Report for 1947. (12) RODENTS. The Rodent Control Scheme which has now been in force in the dock groups since 1941 continues to work satisfactorily and it is believed that the Port of London Authority, their Tenants and the various shipping companies are satisfied with the results. Nevertheless your Medical Officer is not himself satisfied that even better results could be achieved by the use of methods of rodent destruction which have recently been discovered and are in extensive use in the United States of America. Present methods are based on prolonged and carefully controlled scientific experimental work carried out at the Bureau of Animal Population, Oxford and by members of the staff of the Bureau working in the London Docks in collaboration with your Medical Officers and his staff. Very briefly the principle consists of pre-baiting with a known rat attractive bait such as sausage rusk or flour and sugar or moist wheat and, after good takes are registered, introducing a poison such as zinc phosphide or arsenic or red squill. A count is made of the amount of pre-bait taken and then of the amount of poisoned bait taken and from this the number of rats destroyed is deduced. Post-baiting with a different bait than that first employed is carried out after an interval of one or two weeks to ascertain if there is any residual rat population and if necessary a different poison is laid to destroy this residue. In addition to poisoning, trapping is occasionally resorted to though it is a less satisfactory method than poisoning but is more applicable to small rat populations in ships and may occasionally be quite successful in destroying a mouse population. The disadvantage of trapping lies in the fact that it is seldom that the whole colony can be thus eliminated while the residue becomes trap shy and indeed shy of any method of destruction. In recent years a number of "super poisons" have been elaborated in the United States and one of them "1080" (sodium fluoro-acetate) is now extensively used in the Western Hemisphere not only for the destruction of rats on shore but also in ships. It will readily be appreciated that any method which eliminates the costly process of using poisonous gases, such as hydrogen cyanide, so long as it is equally efficient, would be welcomed not only by Port Health Authorities but also by shipping companies. Unfortunately "1080" cannot yet be obtained in this country but the small quantity that has been made available in the port has sufficed to reveal its remarkable properties. "1080" is intensely poisonous not only to rodents but to all animals including human beings and must, therefore, be used with great care to avoid any risk to human and to animal life other than the rodents that it is intended to destroy. Such precautions are fortunately quite simple and if carefully folio-wed render the operator free from risk. It is very attractive to rats and mice and can be used without any pre-baiting in the form of a solution of 0.25% in plain water. Rats however shy of other methods for their destruction take the liquid freely and many of them can be found dead within a few feet of the container. It is to be hoped that "1080" will be manufactured in this country in the near future thus overcoming the difficulty of finding dollars for its purchase in the United States of America and your Medical Officer is confident that remarkable results would emerge from its use in the Port. (13) RATS DESTROYED DURING 1948. TABLE E. (1) ON VESSELS. Number of Jan Feb Mch Apl May Jne Jly Aug Sep Oct Nov Dec Total in year. Black Rats 241 294 222 348 301 416 653 432 322 184 157 351 3,921. Brown Rats. — — - - - - - - - - - — — Species not recorded. - - - - - - - - - - - - - Rats examined 69 63 49 80 98 46 82 72 58 50 52 31 750. Rats infected with plague. - - - - - - - - - - - - - TABLE F. (2) IN DOCKS, QUAYS, WHARVES AND WAREHOUSES. Number of Jan Feb Mch Apl May Jne Jly Aug Sep Oct Nov Dec Total in year. Black Rats 167 123 186 143 82 125 145 117 221 223 218 198 1,948. Brown Rats. 127 127 193 81 92 116 88 130 135 125 110 117 1,441. Species not recorded. - - - - - - - - - - - - - Rats examined 28 18 30 28 21 6 12 28 27 40 44 54 336. Rats infected with plague. - - - - - - - - - - - - - TABLE G. MEASURES OF RAT DESTRUCTION ON PLAGUE "INFECTED" OR "SUSPECTED" VESSELS OR VESSELS FROM PLAGUE INFECTED PORTS ARRIVING IN THE PORT DURING THE YEAR. TOTAL NO. OF SUCH VESSELS ARRIVING NUMBER OF SUCH VESSELS FUMIGATED BY SO2 NO. OF RATS KILLED NUMBER OF SUCH VESSELS FUMIGATED BY HCN. NO. OF RATES KILLED NUMBER OF SUCH VESSELS ON WHICH TRAPPING, POISONING ETC, WAS EMPLOYED. NO. OF RATES KILLED. NUMBER OF SUCH VESSELS ON WHICH MEASURES OF RAT DESTRUCTION WERE NOT CARRIED OUT. 1,562 1 53 110 2,440 (527 Mice) 327 No Record. 1.255 Table H. Deratisation certificates and Deratisation exemption certificates issued during the year. Net Tonnage No.of Ships. Number of Deratisation Certificates Issued. Number of Deratisation Exampition certificates Issued Total Certificate issued. After Fumigation With Aftrer Trapping Poisoning Etc. Total HCN SO2. HCN AND SO2. Ships up to 300 tons. 118 2 — - — 2 116 118 „ From 301 to1,000 Tons. 118 5 - — — 5 113 118 „ „ 1,001 to 3,000 129 30 - — - 30 99 120 „ 3,OOl to 10,000 „ 415 109 1 — — 110 305 415 „ over 10,000 Tons. l6 6 — — — 6 10 16 Totals 796 152 1 — — 153 643 796 (14) VI. HYGIENE OF CHEWS' SPACES. TABLE J. CLASSIFICATION OF NUISANCES. Nationality of Vessel. Number inspected during the year. Defects of Original construction. Structural defects through wear and tear. Dirt, vermin and other conditions prejudicial to health. BRITISH 8,3 22 173 354 849 OTHER NATIONS 2,269 1 - 42 TOTALS 10,591 174 354 891 Despite the figures recorded in Table "J" , your Medical Officer has to report remarkable progress in the provision of suitable and hygienic accommodation for crews in British built vessels. While there is still a number of old vessels in commission the accommodation in which is far from satisfactory, such vessels are gradually disappearing and are being replaced by ships of modern construction.-. There is no comparison in the accommodation of these new vessels with those of pre-war construction: two berth cabins tastefully furnished and kept clean and sweet by crews who appreciate decent living quarters, ample provision for bathing and washing with a plentiful supply of hot and cold water, accommodation for drying clothes, spacious well lit and well ventilated messrooms in close proximity to the galley. provided either with chairs or upholstered benches and lockers for the storing of food and table utensils are now the rule. An example of this type of accommodation and how it can be kept is given, in the report of your Inspector, Mr. C.E. Wright, on a collier plying between the Tyne and Thames- S.S.(Crew 23). "Sir, I am pleased to report that on the many occasions I have inspected the s.s. " ", I have found this collier consistently so clean and shipshape that I consider her indeed a model amongst coastwise shipping. The crews' quarters situated aft are always spotless, every bunk is made, the bedding clean with blue and white counterpanes and the carpets so bright that they appear new at every inspection. The wash places and water closets are in excellent condition. The built in 1942 is not the newest of ship, a fact which in regard to this report is, if anything, much to her credit. I sincerely feel that this vessel's consistently good appearance is a credit to her Master, Officers and men and I am so impressed that I beg to suggest a word to the Owners would be opportune and I know would be much appreciated. Yours faithfully, (Sgd.) C.E. WRIGIHT. Inspector" . Complaints of untidiness and dirty conditions in new accommodation of this type are becoming rare and go to show that the British seaman is, generally speaking, quite ready to appreciate decent accommodation and to live decently in it. (15) VII. FOOD INSPECTION. The total amount of foodstuffs seized and condemned for human consumption and either re conditioned or disposed of for animal consumption or for industrial purposes under guarantee or destroyed was 937 Tons 14 cwts. 0 qrs. 3 lbs. as compared with 1,094 tons in 1947 and 630 tons in 1946. The following is a summary showing the method of disposal of the foodstuffs seized:- Method of Disposal WEIGHT Approximate Percentage of Total seized Tons. cwts. Qrs. lbs. Boiling Down 36 12 1 15 3.8 Cattle food 283 16 3 11 30.3 Refining 147 8 3 1 15.7 Re conditioning 41 13 1 2 4.3 Industrial 58 19 1 11 6.3 Re-exported 3 0 3 6 0.3 Buried 350 3 3 3 34.3 Burnt 15 18 3 10 1.7 TOTAL 937 14 0 3 99.7 Damaged or overripe (at the time of entry into the Port) bananas, oranges, tomatoes and similar soft fruits form the bulk of the foodstuffs diverted for cattle food or buried. There seems at present no method for the salvaging of overripe bananas for human consumption. Such methods as might be applicable, e.g. desiccation, are probably not regarded as a commercial or economic proposition® Bananas must, of course, arrive in the Port green in order to allow sufficient ripening time for distribution to the retail trade. Consequently any incident which tends to delay the arrival of a banana boat results in a comparatively heavy loss of the cargo., Loss of oranges is often due to flimsy packing and to damage to the cases while loading or unloading. Tomatoes which are a particularly frail cargo are generally stowed as deck cargo and are consequently liable to damage or deterioration owing to weather conditions. THE PUBLIC HEALTH (IMPORTED FOOD) AMENDMENT REGULATIONS, 1943. A Statutory Instrument, 1948 No. 886 given under the respective official seals of the Minister of Health and the Minister of Food, dated 27th April, 1948, roads as follows In exercise of the powers conferred upon them by Section 8 of the Food and Drugs Act, 1938 (a), and by the Transfer of Functions (Food and Drugs) Order, 1948 (b) , and of all other powers them enabling, the Minister of Health and the Minister of Food hereby jointly make the following Regulations:- 1. The Public Health (imported Food) Regulations, 1937 (e) shall be amended by inserting in paragraph (c) of the First Schedule thereto (which Schedule specifies the kinds of oversea meat which may not be imported into England or Wales for sale for human consumption) after the word "meat" where it first appears the words "other than mutton and lamb". 2® (l) These Regulations may be cited as the Public Health (imported Food) Amendment Regulations, 1948, and these Regulations and the Public Health (imported Food) Regulations, 1937, shall be construed together and may be cited as the Public Health (imported Food) Regulations 1937 and 1948. (16) (2) These Regulations shall come into operation on the 1st day of May, 1948". An Explanatory Note is added as follows "(This note is not part of the Regulations, but is intended to indicate their general purport). These Amending Regulations remove the prohibition of the import into England and Wales of any mutton or lamb from which a lymphatic gland has been taken out". Accompanying this Statutory Instrument was a Circular M.F. 1/48 from the Ministry of Food enclosing a supplementary memorandum (Memo. 62b/Foods) modifying the criteria of meat inspection recommended in Memorandum 62/Foods, issued by the Ministry of Health on the 16th March, 1922. Memo 62b/Foods reads as follows:- "The following new Section IVa is to be substituted for that contained in Memo 62a/Foods, dated September 1937. Memo 62a/Foods is cancelled together with item "17® Lymphadenitis, caseous" in Section Va of the Memorandum on Meat Inspection (Memo 62/Foods). A. METHOD OF INSPECTION. 1. All carcases and viscera shall be examined by visual examination and by palpation of the accessible lymphatic glands® 2® The prescapular, superficial-inguinal, supra-mammary and pre crural lymphatic glands of sheep shall be incised and examined as a routine. These glands in lamb carcases need only be incised if evidence of disease is found or disease is suspected in the course of visual examination and palpation. B. ACTION TO BE TAKEN: 1. An organ shall be condemned when caseous lymphadenitis exists on its surface, or in its substance, or in the associated lymphatic glands. 2. The entire carcase and all the organs and viscera shall be condemned when the following conditions are present:- (a) emaciation associated with caseous lymphadenitis, (b) generalised caseous lymphadenitis. The following shall be regarded as evidence of generalisation- (i) The presence of multiple lesions which are acute and actively progressive; or (ii) the presence of multiple lesions which are inactive, but widespread. 3. All infections not included in paragraphs 1 and 2 of B above shall be regarded as localised, and only the lesion and the surrounding part shall be condemned. The size of the part condemned should depend on the age and degree of activity of the lesion. Old lesions which are firmly encapsulated may be regarded as inactive". Copies of the above-mentioned Regulations and Memorandum have been forwarded to your Inspectors with instructions that they should act upon them forthwith. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937 and 1948. Circular MF 6/48, dated 19th November, 1948, issued by the Ministry of Food, reads as follows:- "I am directed by the Minister of Food to state, for the information (17) of the Authority, that he has caused to be published in the 'London Gazette' of the 29th October, 1948, a Notice containing in the Schedule thereto the description of a label issued by the Government of the Colony of Nigeria, which has been recognised as an Official Certificate for the purposes of the Public Health (Imported Food) Regulations, 1937 and 1948". The Notice reads as follows:- "The Minister of Food gives notice, in pursuance of the above-named Regulations, that he hereby recognises the Official Certificate, of which particulars are given in the Schedule hereto, as showing (a) that the meat to which it relates was derived from animals inspected ante and post-mortem and passed in accordance with criteria satisfactory to the Minister, and (b) that all necessary precautions for prevention of danger to public health were taken in the dressing or preparing and packing of the meat. The Certificate being in the form of a label, recognition will apply only if the label is securely affixed to the meat or to the package containing the meat and if the label has not in any other circumstances or on any other occasion been used as an Official Certificate". The Certificate relates only to meat, namely bacon, pork and beef carcases. FOOD AND DRUGS ACTS, 1958 and 1944. TRANSFER OF FUNCTIONS (FOOD AND DRUGS) ORDER, 1948. Circular 81/48 from the Ministry of Health dated 31st May, 1948, enclosed copies of four Statutory Instruments transferring from the Minister of Health to the Minister of Food certain administrative functions under the Regulations referred to below. This transfer is supplementary to the transfer from the Minister of Health to the Minister of Food of certain functions under the Food and Drugs Act, 1938, which has been made by the Transfer of Functions (Food and Drugs) Order, 1948. These amendments which come into operation on the 1st June are as follows STATUTORY INSTRUMENTS 1948 No. 1118. The Public Health (Preservatives etc. in Food) (Amendment) Regulations 1948. The Public Health (Preservatives etc. in Food) Regulations, 1925 as amended, shall be further amended by substituting in paragraph (l) of Article 2 thereof for the definition of "The Minister" the following definition:- "The Minister' means the Minister of Food". STATUTORY INSTRUMENTS 1948 No. 1120. The Public Health (Shellfish) (Amendment) Regulations 1948. The Public Health (Shellfish) Regulations, 1934, shall be amended as to the parts thereof referred to in Column 1 of the Schedule to these Regulations in the manner specified in relation thereto in Column 2 of the said Schedule. (18) SCHEDULE Column 1. Column 2. Part of the Regulations to be amended Amendment l. Article 7. Insert after the word 'Minister' where it first appears the words 'the Minister of Food'. 2. Paragraph (l) of Article 10. -ditto- STATUTORY INSTRUMENTS 1948 No. 1121. The Public Health (Imported Food) (Amendment No. 2) Regulations, 1948. The Public Health (imported Food) Regulations, 1937, as amended shall be further amended as to the parts thereof referred to in Column 1 of the Schedule to these Regulations in the manner specified in relation thereto in Column 2 of the said Schedule. SCHEDULE Column 1. Column 2. Part of the Regulations to be amended Amendment. l. Paragraph (l) of Article 2. Substitute for the definition of 'the Minister' the following definition:- "the Minister' means the Minister of Food". 2. Article 20. Substitute for the word 'Minister' wherever it appears the words 'Minister of Health'. STATUTORY INSTRUMENTS 1948 No. 1122 The Public Health (Condensed Milk) (Amendment) Regulations, 1948. The Public Health (Condensed Milk) Regulations, 1923, as amended, shall be further amended by substitution in paragraph (l) of Article 2 thereof for the definition of "The Minister" the following definition "The Minister' means the Minister of Food". FOOD INSPECTION. The substance of these Amending Regulations is that the central Authority responsible for the policy and practice underlying the Public Health (imported Food) Regulations and the Public Health (Preservatives etc., in Food) Regulations is henceforth the Ministry of Food and no longer the Ministry of Health. It is in fact a bookkeeping transfer and it remains to be seen whether it will be of advantage to Port Health Authorities whose duty it is to give effect to the Regulations. On the other hand the effect of the Public Health (Imported Food) Amendment Regulations which came into force on the 1st May, 1948 is to remove the prohibition of the import into England and wales of any mutton or lamb from which a lymphatic gland has been removed. To explain the intent and effect of this amendment one must refer to the (19) original Regulations and in particular to the First Schedule, "Prohibited Meat", para. (c) which reads as follows:- "Meat from which a lymphatic gland, except a gland necessarily removed in preparing the meat, has been taken out". By inserting the words "other than mutton and lamb" the effect is to remove these commodities from the classification of "prohibited meat". Before the war this country could afford to import only the best quality meat completely free from disease and had plentiful supplies from which to pick and choose. The world shortage of meat has changed all that and we have now to take more or less what is offered. Chilled beef is no longer imported as such and has given place to frozen beef, when it can be obtained, which is not very frequently. The bulk of frozen imported meat now takes the form of frozen mutton and lamb, or what passes for lamb. Before the war there wore two broad classes of mutton, a better quality free from disease and a so-called 'Continental1 quality in which the carcases, or a certain proportion, were infected with caseous lymphadenitis. If, in view of the world shortage, this country were to maintain its ration of meat, it was necessary that mutton infected with a certain degree of caseous lymphadenitis be accepted and to enable caseous mutton to be removed from the category of "prohibited meat" it was necessary to amend the Regulations so that an enlarged gland or glands infected with caseous lymphadenitis and removed from the carcase at the time of dressing, could be passed for human consumption. In this connection it must be stated, to be fair, that there is no evidence that caseous lymphadenitis is transmissible to man and unless the infection is extensive the health and general, nutrition of the animal suffers but little from the disease. Caseous lymphadenitis tends to produce abscess formation of the glands and in the parts of the carcase drained by the glands and there is, therefore, the somewhat unpleasant risk that the housewife in cutting into the Sunday joint may discover an abscess. On the other hand it is understood that most, if not all the 'Continental' class of imported meat is diverted to meat manufacturers who will, in all probability, discover abscess formation during the process of disjointing and cutting up the meat for making pies, canned meat soups and similar commodities. CANNED FOODS. Owing to the shortage of fresh meat and at times of fresh fish the importation of canned meat and meat products and of fish of various kinds has been permitted and as a result a number of 'mushroom' firms have sprung up abroad to satisfy the public demand for canned foodstuffs. These firms are permitted to import canned foods on private account but it would appear that many of them are not equipped with suitable apparatus for canning meat and fish. Consequently the number of occasions on which imported canned foodstuffs have had to be seized and either condemned or re-exported, is tending to increase. A very careful watch is being kept on this class of import and consignments which are not up to standard are severely dealt with. It is important that the housewife should be able to accept without question any canned foodstuff as sound and free from conditions which might lead to food poisoning, however mild® She has been educated as also has the retailer to reject any can which shows signs such as 'blowing or 'wobbling' of the can and anything which might lead her to depart from that standard is to be thoroughly deprecated. Importers of long standing and of rood repute arc perfectly aware of the strict requirements imposed on imports of canned goods (20) into this country and there is no excuse for any attempt to depart from these standards which can, without difficulty, bo complied with by factories properly equipped for canning meat and fish. DANGEROUS DRUGS. During the year eleven certificates authorising the purchase of scheduled Dangerous Drugs were issued 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 master 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) 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 or 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 9th January, 1949, 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 Health Authority, during the year ended 31st December, 1948. No Canal Boats were encountered within the district of the Port of London by your inspectors during the year. No new boats were registered during the year under review, the actual number of Canal Boats on the Register on the 31st December, 1948, being 216. PARROTS (PROHIBITION OF IMPORT) REGULATIONS, 1930. Sixty-eight parrots etc., came under notice of your officers during the year, and 40 notices were issued in respect of these birds. One parrot died on board and the body was sent to the Ministry of Health for examination. Number exported in respect of notices served 66 "destroyed (notice issued to export) 1 "died on board 1 TOTAL 68 HOUSEBOATS. As the result of the entry into force of the Southend-on-Sea Corporation Act, 1947, a number of houseboats lying in the Creeks now taken over by the Corporation have been broken up.. Unfortunately a certain number of houseboats capable of being removed from the area have taken up residence in some of the adjoining creeks and some of them continue to be a nuisance and a danger to the public health. The Authority's draft new Bye laws aiming at the registration of houseboats and a better control tending to improve their hygienic condition have not been well received by the Riparian Authorities concerned who do not wish to see any houseboats moored on their foreshores. The opposition of the Riparian Authorities threatens to render the Bye laws inoperable on account of the lack of facilities offered to the houseboats for the disposal of night soil and refuse and for the provision of a suitable water supply. These facilities cannot obviously be offered to houseboat dwellers by the Port Health Authority, consequently the new Houseboat Byelaws are still sub judice. (21) OFFENSIVE CARGO BYE LAWS. New Bye laws for the carriage of refuse by lighters from loading points in the River to refuse tips down River came into force on 1st November, 1948. The object of the bye laws is to improve the conditions under which refuse is transported down the River and it has been considered necessary to require that craft conveying such refuse shall be so constructed and maintained as to avoid all reasonable possibility of the refuse causing a nuisance either by overloading of the craft or by exposure to the elements and, incidentally, to depredations by seagulls and by fly development. Many of the loading tips on the River front are far from satisfactory and are the cause of many complaints of smell, dust and other undesirable features associated with what can only be regarded as a most inefficient method of loading refuse into the barges. The principal difficulty that has to be surmounted is due to the tidal rise and fall of the Thames so that lighters may at one moment be only a few feet below the loading tip and at another sixteen feet or more be low a It, seems clear that the only my of overcoming this difficulty is by constructing loading basins which maintain a constant level of water. The loading basin of the Metropolitan Borough of Westminster at Grosvenor Dock is a striking example of how satisfactorily this can be done. (22) APPENDIX 1. MEDICAL INSPECTION - From 1st January to 31st December, 1948. GRAVESEND. Jan. Feb. mch Apl. may Jne J1y Aug Sep Oct Nov Dec Total . Dically pected 103 97 128 151 134 127 14.3 I52 134 111 107 138 1,525 If Sengers 676 421 2,138 1,939 3,232 5,519 7,244 5,334 4,966 1,36s 802 1,170 34,809 F Ews 801 115 391 1,623 1,096 1,113 980 436 576 591 601 753 9,078 Foreign Rivals 535 526 564 636 672 572 700 732 666 666 563 713 7,548 (23) APPENDIX II. INFECTIOUS DISEASE. Disease. 1939 1940 1941 1942 1943 1944 1945 1946 1947 Mean Annual n9 For 10 years Ending 31st December 1948 1948 Cases Reported (Including Suspected Cases) - - - - - - - - - - - Alow Fever -Do- - - - — — — — — — — — Ague -Do- - - - - - - - - - - - Phus Fever - - - - - - 1 - - 0.2 1 All Pox 5 1 1 1 - 1 - 3 2 1.9 3 Arlet Fever 13 3 1 2 5 4 5 2 10 4.8 3 Phtheria 13 4 11 5 3 5 3 8 5 6.1 2 Ateric Fever 16 7 1 1 - - 4 9 5 5.3 10 Easles 40 9 1 1 1 1 8 11 26 19.7 99 Erman Measles 34 17 5 2 1 - 2 6 5 7.5 3 Rysipelas 2 1 2 - - — — — 1 o.6 - Pulmonary 83 19 4 5 12 6 14 21 27 22.3 32 Other Kinds 1 - — — — - - — - 0.1 - (Including Chicken Pox) Other Diseases 388 178 88 179 273 180 115 79 102 168.8 106 Totals. 505 239 114 196 295 197 154 141 183 237.3 259 Admitted to Hospital (Including Suspected Cases) Cholera - - — — — — - - - - - Ellow Fever-Do- — - — - - - - - - - - Plague-Do- - - - - - — - — — — - Typhus Fever - - - - - — — - — 0.1 1 Small Pox - - - - - — — — — - - Scarlet Fever - - - 2 5 4 4 2 - 2.0 3 Diphtheria 4 - 9 3 2 4 5 7 4 4.2 2 Enteric Fevcr 8 1 - 1 - - 3 - 2 1.8 3 Measles 7 3 - 1 - 1 4 6 10 5.6 24 Erysipelas - - 2 - - - — — - 0.2 — Dysentery - 2 - - - — 1 8 9 2.3 3 Parotitis 9 - - — 2 3 1 5 1 2.5 4 (Including Chicken Pox) 79 32 2.6 15 16 34 50 43 60 45.5 80 Totals 107 58 37 24 25 4.6 68 71 86 64.2 120 APPENDIX III. HOSPITAL. Number of cases admitted during 1948. (Hospital taken over by the South-East Metropolitan Regional Hospital Board on 5th July,1948). DISEASE Admitted Discharged Transferred To Other Hospital Dieo. Remaining in Hospital Chicken Pox 18 17 1 - - Measles# 27 27 — - — Scarlet Fever 1 1 — - - Diphtheria 1 - 1 - — Malaria 7 7 - - - Mumps 1 1 - — - Dysentery. 1 - 1 - - Enteric Fever 4 3 - 1 - Thphus Fever 1 — 1 - - Other Diseases 25 20 5 — — Totals 86 76 9 1 NIL.. Includes 2 Contacts. # Includes 13 contacts. Remaining in Hospital on 31st December,1947 7 Admitted during 1948 86 Discharged or Died (l Died) 93 Average daily number of patients 2.4 Average number of days in Hospital 9.0 Greatest number of patients at one time 13 Smallest number of patients at one time Nil. APPENDIX IV. BACTERIOLOGICAL EXAMINATION OP RATS DURING 1948. Source Total. Black Rats Brown Rats Species Unknown Mice Rats Infected With Plages. Found Dead Trapped Poisoned Etc. Found Dead Trapped Poisoned Etc. Found Dead Trapped Poisoned Etc. Found Dead. Trapped Poisoned Etc. Vessels. 750 423 327 - - - - - - - London Dk. 118 3 72 1 42 - - — — - St Katharine Dk. 1 - 1 - - - - - - - Royal Albert Dk. 74 1 23 4 46 - - - - - Victoria Dk . 42 - 24 1 17 - - - - - King GeorgeVdk. 60 - 25 11 18 - - - - - Surrey Come Dk. 6 - 4 - 2 - - - - - Regents Canal. Dk 5 - 5 - - - — - - - Millwall Dk . 11 11 - - - - — — - - West India Dk. 5 - 1 - 4 - - - - - 5th West India Dk. 6 2 4 - - - - - - - East India Dk. 2 - 1 — 1 - - — - - Tilbury Dk. 6 - 4 — 2 - - - - - Totals 1,086 446 491 17 132 — — — - Nil (24) APPENDIX V. RETURN OF RATS CAUGHT AMD DESTROYED DURING THE YEAR 1948. Jan Feb Mch Apl May Jne Jly Aug Sep Oct Nov Dec Total London Dock- Warehouses 41 45 37 28 22 52 36 15 43 76 73 72 540 VESSELS — 2 - — 1 — - - - 7 2 - 12 Katharine Dock- Warehouses 7 3 5 6 3 3 3 4 2 1 2 - 39 Vessels - - - - - - — — — - - - - Jurrey Commercial Dk. Warehouses. 26 36 33 27 9 22 48 19 46 44 18 56 383 Vessels 22 - 8 5 - — 20 - 9 - 9 12 85 West India Dock — Warehouses 1 - 4 4 2 1 18 4 18 6 1 3 62 Vessels - — — - - - - — 2 - - - 2 West India Dock— Warehouses 24 17 32 20 8 14 9 15 43 25 19 14 240 Vessels 6 9 72 54 16 15 23 163 135 38 32 130 692 Millwall DocK- Warehooses 45 13 50 11 9 26 33 35 35 16 8 13 294 Vessels 1 5 19 1 - - 85 46 3 10 4 - 174 Royal Victoria Dock- Warehouse 72 52 70 35 41 37 39 37 62 75 68 41 620 Vessels 29 88 32 39 16 125 91 85 75 19 - 56 655 Royal Albert Dock— Warehouses 32 36 69 37 18 37 19 35 36 26 32 36 412 Vessels 73 80 56 185 6 131 415 116 18 54 30 38 1,202 King George V.Dock- Warehouses 34 34 50 49 49 25 18 39 35 33 21 19 406 Vessels. 70 92 32 42 204 79 15 22 48 29 13 56 702 Warehouses 8 8 10 5 13 15 3 36 8 15 66 41 237 Vessels. 40 2 3 22 58 66 4 - 32 27 67 39 380 Regent's Canal Dock- Warehouses 5 6 10 2 — 9 7 8 29 31 20 20 147 Vessels. - 17 - - - - - - - - - - 17 River - Vessels - - - - - - - - - - - - - 535 544 601 572 475 657 886 679 678 532 485 666 7,310 (25) APPENDIX VI - General Summary and Analysis of the Sanitary Inspections of vessels etc., in the Port of London for the year ended 31st December,1948. foreign Coastwise Inland Navigation Shore Premises Sick Seaman Referred To Hospital. Water Barges Steam Sail Steam Sail. Steam Sail Lighters (Uninhab-Ited) canal Boats Inspected Defective To Be cleaned inspected Defected To Be Cleaned lnspected Defective To Be Cleaned Inspected Defective To Be Cleaned Inspected defective To Be Cleaned Inspected Defective To Be Cleaned Inspected Defective To Be Cleaned Inspected Defective To Be Cleaned Inspected Defective To Be Cleaned No In District In Good condition 31st December,1947. New Barges Condemned Use Discontinued Previously With Drawn and Since Resumed Work No In District On 31st December,1948 "7»7,109 226 153 15 2 2 2194 86 119 184 - 11 119 2 6 8 - - 862 5 4-7 - - - 10,298 222 437 250 15 - - — - 15 Inspections Docks And River N2 Nationalities N2 Total Inspections From 1st January to 31st December, 1948:- London And St Kats: 866 American 1 33 Belgian 78 Foreign 7,124 Recent's Canal. 376 Brazilian 2 Coastwise 2,376. Inland Navigation 989 Surrey Commercial 856 British 8,223 Shore Premises 10,298 Danish 205 Total 20,789 East India 255 Dutch 698 EGYPTIAN 4 Number or Vessels inspected in the Launches: West India 713 Finnish 109 French 39 Millwall 721 German 43 "Howard Deighton 610. Greek 35 Royal Victoria 663 "Frederick Whittingham 1,345 IcelanOic 5 "Alfred Robertson" 1,305 Royal Albert 914 Indian 3 Italian 13 King George.V. 720 Mexican 1 Tilbury 1,147 Panamanian 35 Polish 37 River - Upper 1,345 Portuguese 1 „ Middle l,305 Russian 68 „ Lower 610 Spanish 8 Swede Norwegian 702 Swiss 1 Total 3,260 River Medway Yugo Slavian 50 In The docks Etc. 7,231 Total Vessels 10,491 Total Vessels 10,491 Shore Premises 10,298 Shore Premises 10,296 Shore Premises 10,298 TotalS 20789 TOTALS 20,769 Totals 20,789 (20) APPENDIX VII. HYGIENE OF CREW SPACES. CLASSIFICATION OF NUISANCES 1948. British owned Vessels. Foreign owned Vessels. Smoke Nuisances:- No. of complaints received 11 - No. of recurrences reported - - Offensive Cargoes:- No. of infringements reported - - Structural and other Defects:- Inadequate ventilation 26 1 Defective Lighting - Natural 7 - do. do. - Artificial 11 - Defective Heating 37 - Condensation 25 - Leaking Docks 44 - Leaking Ports, Decklights etc. 36 - Leaking Sideplates 5 - Leaking Hawse and Chain Pipes 6 - Deficient or Obstructed Floor drainage 28 - Water lodging on top of Peak Tanks 4 - Defective Bulkheads 9 - do. Floors 10 - do. Doors 6 - do. Chain Pipes 1 - do. Bunks 9 - do. Clothes Lockers 24 - do. Food Lockers 8 - do. Food Storage 22 - do. Cooking Arrangements 6 - Defective or Uncleanly drinking water storage 6 — Water Closets Obsolete 6 - do. Defective 33 - do. Foul or Choked 24 - do. Inadequate Flush 23 - Wash Basins Defective 16 - do. Foul 7 - Neglected Paintwork or Distemper 22 - Absence of Washrooms 14 - Absence of Messrooms 17 - Misappropriation of Crew Spaces 4 - Verminous quarters 76 2 Dirty quarters 773 40 Miscellaneous 31 - TOTALS 1,387 43 Total number of vessels on which sanitary defects were reported 1,053 41 Total number of vessels on which sanitary defects were remedied 972 40 (27) APPENDIX VIII. DOCKS WITHIN THE JURISDICTION OF TIE PORT HEALTH AUTHORITY. Docks Water Area Lineal Quayage Acres Yards Miles Yards Regent's Canal 11 38 - 966 St. Katharine 10 488 - 1,654 London 34 4,460 3 119 Surrey Commercial 161 2,717 16 200 West India 97 3 ,957 4 1,134 East India 31 2,878 1 1,242 Millwall 35 3,217 2 155 Royal Victoria 95 1,772 5 1,479 Royal Albert 87 213 3 905 King George V 64 997 3 663 Tilbury 104 2,166 3 1,667 The River distance between the Western and Eastern limits of the Port is about 68½ miles. APPENDIX IX. POWERS. The work of the Port of London Health Authority is carried out under the following Acts of Parliament and Statutory Rules and Orders:- EXISTING ACTS AND ORDERS APPLICABLE TO THE PORT OF LONDON HEALTH AUTHORITY. CONSTITUTION OF TIE AUTHORITY. Public Health (London) Act, 1936. ASSIGNMENT OF POWERS. L.G.B. Order, Port Sanitary Authority Assignment of Powers, Port of London 25th March, 1892 L.G.B. Order, Port Sanitary Authority Assignment of Further Powers, Port of London 29th December, 189 L.G.B. Order, Port Sanitary Authority Assignment of Powers, Port of London. 30th June, 1898. S.R. & 0. 1922, No. 781. London Port Sanitary (Additional Powers) Order, 1922. 18th July, 1922 S.R. & 0. 1923, No. 812. London Port Sanitary (Additional Powers) Order 1923. 16th July, 1923. S.R. & 0. 1933, No. 803. The Port of London (Assignment of Powers) Order, 1933 11th August, 1933. ADMINISTRATION. Port Sanitary Administration and Medical Inspection of Aliens under the Aliens Order, 1920. (Grants in Aid) 14th July, 1920. City of London (Various Powers) Act, 1922. Part IV. Section 30. City of London (Various Powers) Act, 1933. Part III. Sections 6 and 7. S.R. & 0. 1926, No. 552. Sanitary Officers Order, 1926. 27th May, 1926. (28) INFECTIOUS DISEASE. Infectious Disease (Notification) Act,, 1839 to 1899. Public Health Act, 1896. Public Health (Ports) Act, 1896. S.R. & 0. 1910. No. 1165. Prevention of Epidemic Diseases Regulations as to Plague. Destruction of Rats, 1910. 10th November, 1910 S.R. & 0. 1912. No. 1226. Public Health (Cerebrospinal Fever and Acute Poliomyelitis) Regulations, 1912. 15th Augusts 1912 S.R. & 0. 1918. No. 67. Public Health (Notification of Infectious Diseases) Regulations, 1918. 19th January, 1918 S.R. & 0. 1926. No. 972. Public Health (Notification of Puerperal Fever and Puerperal Pyrexia) Regulations, 1926. 31st July, 1926. S.R. & 0. 1927. No, 1207. Infectious Diseases (London) Regulations, 1927. 22nd December, 1927 S.R. & 0. 1930. No. 299. Parrots (Prohibition of Import) Regulations, 1930. 24th April, 1930. S.R. & 0. 1933. No. 38. The Port Sanitary Regulations , 1933 . 4th February, 1933. S.R. & 0. 1945 No. 1282. The Port Health Amendment Regulations. 1945. 10th October, 1945. CANAL BOATS. Public Health Act, 1936. FOOD. Public Health (Regulations as to Food) Act, 1907 S.R. & 0. 1924. No. 1432. Public Health (Meat) Regulations, 1924 (Part IV). 20th December, 1924. S.R. & 0. 1925 No. 775 ) Public Health S.R. & 0. 1926 No. 1577 ) (Preservatives, etc. in Food) Regulations, S.R. & 0. 1927 No. 577 ) 1928. S.R. & 0. 1926 No. 820. Public Health (imported Milk) Regulations, 1926. 6th July, 1926. S.R. & 0. 1937 No. 329. Public Health (imported Food) Regulations, 1937 16th April, 1937. Statutory Instrument No. 886. Public Health (imported Food) Amendment Regulations, 1948. 27th April, 1948® SHELLFISH. S.R. & 0. 1934. No. 1342. Public Health (Shellfish) Regulations, 1934. 7th December, 1934 S.R. & 0. 1935. No. 1221. The Medrny (Shell- Fish) Regulations, 1935. 11th December, 1935® (29) RATS AND MICE Rats and Mice (Destruction) Act, 1919. SMOKE ABATEMENT Public Health (London) Act, 1936. ABATEMENT OF NUISANCES AND REMOVAL OF REFUSE. Public Health (London) Act, 1936. FERTILISERS AND FEEDING STUFFS. Fertilisers and Feeding Stuffs Act, 1926. S.R. & 0. 1932 No. 658. Fertilisers and Feeding Stuffs Regulations, 1932. S.R. & 0. 1928. No. 43 9. Order appointing 1st July, 1928 as the date for the coming into operation of the Fertilisers and Feeding Stuffs Act, 1926. DANGEROUS DRUGS. S.R. & 0. 1923. No. 1095. Dangerous Drugs (No. 3) Regulations, 1923 . ALIENS. S.R. & 0. 1920. No. 448. The Aliens Order, 1920. AIRCRAFT. S.R. & 0. 1938. No. 229. Public Health (Aircraft) Regulations, 1938. IMPORTATION OF CATTLE. 11th August, 193 2. 30th May, 1928. 10th September, 1923, 7th April, 193 8. Ministry of Agriculture and Fisheries Animals (importation) Order, 1930, dated 4th November, 1930. Part III, Article 22: Part IV, Articles 23, 24 and 25. Ministry of Agriculture and Fisheries Animals (Landing from Ireland, Channel Islands and Isle of Man) Order 1933, dated 17th January, 1933. Part II, Article 17. BYE-LAWS. Bye-laws have been made by the Port of London Health Authority 1. For preventing nuisances arising from barges or vessels carrying offensive cargoes. 2. For removing to hospital any person suffering from dangerous infectious disorders, and for the keeping therein of such persons as long as may be deemed necessary. 3. With respect to Houseboats used for human habitation within the limits of the Port of London (30)