Public Health Dept. Reports collection COPY Ac11369 Plon 59 107 PORT OF LONDON HEALTH AUTHORITY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To 31st DECEMBER, 1951 107. P0RT OF LONDON HEALTH CO MM ITT E E ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (MONTAGU TRAVERS MORGAN, C.M.G., M.C., M.D. , Ch.B., D.P.H.) TO 51st December, 1951. Port of London Health Authority, 5, Church Passage, Guildhall, E.C.2. Telegraphic Address PORTELTH LONDON . Telephone Number IffONarch 3030 o LIMITS OF THE PORT OF LONDON. THE LIMITS OF THE PORT OF LONDON AS AT PRESENT DEFINED COMMENCE AT HIGHWATER MARK IN THE RIVER THAMES AT TEDDINGTON LOCK, IN THE COUNTY OF SURREY, AND EXTEND DOW 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 KENT9 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 YfESTWARD OF COALMOUTH CREEK, THENCE ACROSS THE SAID RIVER MEDWAY TO THE WESTERN-MOST POINT OF THE PIECE OF LAND WHICH FORMS THE EASTERN SIDE OF THE STANGATE CREEK, OR, IN OTHER WORDS THE NORTH-WEST POINT OF FLEET MARSH AND FROM THENCE IN A SOUTHERLY DIRECTION TO IWADE 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 WADE 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 TOYffl OF ROCHFORD, AND ALSO INCLUDES ALL OTHER ISLANDS, RIVERS, STREAMS, CREEKS, WATERS, WATERCOURSES, CHANNELS, HARBOURS, DOCKS AND PLACES WITHIN THE BEFOREMENTIONED LIMITS CONTAINED. STAFF. List of Officers forming the Staff of the Port Health Authority, 31st December, 1951. 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 H.M.Willoughby, V.R.D., M.R.C.S., L.R.C.P., D.P.H., D.T.M.& H., R.N.V.R. May 1929 Assistant Port Heath 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.& II. January 1939 ditto. (Vacant) Sheerness Boarding Station (Tempys: 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 - Senior Clerk J.A. Gillis March 1914 Assistant Senior Clerk W.L.McLorg February 1927 First Class Assistant Clerk R.C. Ratliff March 1930 Secretary to Medical Officer of Health E.V. Smith October 1938 Clerical Officer (Vacant) General Grade Clerk R.H. Lott May 1947 ditto A.E. Wood January 1950 ditto E.C. Simmonds November 1951 INSPECTORIAL - Chief Sanitary Inspector T.L. Mackie, M.B.E., A .M . I .N .A . November 1934 Sanitary Inspector and W. Gray September 1921 Inspector of Meat and other P.W. Coombe December 1924 Foods E.H. Johnson August 1929 ditto T.G. Edwards June 1929 ditto D.E. Madeley September 1932 ditto C.E. Wright July 1931 ditto J.S. Beattie May 1931 ditto G. Dring February 1937 ditto A. Trevethick August 1946 ditto L.N. Tope August 1946 ditto P.A. Traynier October 1950 ditto A.C. Good September 1951 ditto H. Lawson September 1951 ditto T.C.H. Rogerson October 1951 RODENT INSPECTORS - C.W. Moody February 1929 E.C. Watkins June 1929 S.A. Croft June 1929 C. Stockton June 1940 F.D. Cartman January 1943 D.J. Davis August 1941 RODENT CONTROL SCHEME - Rodent Inspector G. Lamont March 1945 ditto H.A. Baxter June 1945 ditto W.Gs Stimson February 1945 Rodent Operative G. Clark January 1949 ditto A.S. Southwood January 1949 ditto R.M. Collier July 1951 ditto R.A. Hutchins July 1951 LAUNCHES AND HULKS - Navigator (Senior) P . J © Wilkins November 1928 ditto J.R. Steen March 1926 ditto W.S. Stimson March 1944 ditto W.G.A. King September 1939 ditto C.R. Simons August 1938 ditto H.J. Mason August 1946 Engineer (Senior) S.J. Crutchley June 1939 ditto A. Cook July 1938 ditto E.G. Smith January 1948 ditto J.F. Trice, M.B.E. September 1947 De ckhand A.R.L. Potter July 1945 ditto L.J. Nicholls September 1945 ditto E. Alewood January 1947 ditto R.A. Mantripp March 1945 ditto (Acting) R.S. Parkins April 1951 (2) Office Name of Officer Date of entering the service Deckboy P.M. Meekham June 1951 ditto K.R. Rees July 1951 ditto E.G. Andrews July 1951 ditto C.G. Edwards September 1951 ditto K.G. Seagull September 1951 ditto D. Pollitt November 1951 Steward (Part time) J.F. Smeed July 1927 Shipkeeper A.R. Burge August 1945 ditto A.C. Croft October 1950 Watchman A. Lovey May 1951 ditto W.J. Mace May 1951 LAUNCHES Date acquired "Howard Deighton" 1931 "Frederick Whittingham" 1934 "Alfred Robertson" 1938 "Alfred Roach" 1948 HULKS "Hygeia" at Gravesend 1935 "Uplees" at Greenwich 1945 Januarys 1952. 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. The report is prepared on the lines indicated in Memorandum 302/s.A., in so far as the information asked for is available. Tonnage. The tonnage of vessels entering the Port of London during 1951, was 28 , 3 15 , 7 29 tons as compared with 26 9724,215 tons during 1950. Eleven thousand seven hundred and forty nine vessels arrived from foreign ports and of these 1,880 were visited by your Medical Officers (Table A). Communicable Disease. Three hundred and forty cases of notifiable communicable diseases (including malaria) were reported as having occurred on 170 vessels during the voyage, of whioh 188 were landed in the Port. (Tables C and D). Sixty-three cases* particulars of which are given in Appendix Il(b) were admitted to the Denton Isolation Hospital* No case of human or rat plague occurred during the year on any vessel bound for London. Fumigations. One hundred and fourteen vessels were either fumigated, trapped or poison baited for rodent destruction and the issue of International Certificates under the supervision of your Inspectorso One hundred and thirteen vessels were fumigated using hydrogen cyanide and resulted in the recovery of, 2,110 rats and 438 mice. The one vessel on which poison baits were used accounted for 56 mice. Rodents. A total of 9,811 rats were destroyed and their bodies recovered during the course of the year, 2,729 in ships and 7,082 on shore premises in the Port. In addition 2,824 mice were destroyed, 603 in ships and 2,221 on shore premises. (Tables "E" and "F"). psittacidae. The work under the Parrots (Prohibition of Import) Regulations, in operation up to the end of the year, is reported on page 27. (3) Water Barges« Thirteen water barges -were in use during the year® The registration of these craft by the Port of London Authority is made conditional upon a report of your Officers as to the fitness of the barges for the carriage of drinking isater as also upon the purity of the -water thus carried® House Boats. The new House Boat Byelaws are still in draft form. Imported Foods. The total amount of foodstuffs seized and condemned as unfit for human consumption and either reconditioned or disposed of for animal consumption or for industrial purposes under guarantee or destroyed outright either by burning or burying -was 1,917 tons 18 cwts 2 qrs 14 lbs, as compared with 2,661 tons during 1950 and 1,711 tons during 1949. (See page 24). Shellfishs Action taken under the Public Health (Shellfish) Regulations, 1934, is reported on page 28. Instruction of DaP.H. and D.I.H. Glasses in Port Health work. 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 again paid visits to one or other of the Dock Groups and were given practical demonstrations of the day to day -work of the Port Health Service on the River and in the Docks. Visit of Foreign Medical Officers to the Port,, A number of foreign Medical Officers and other Port Health Administrators visited the Port during the oourse of Port Health and Sanitary Control arranged under the auspices of the British Councils A detailed report of the itinerary covered is given on page 32. Your Medical Officer wishes to record his appreciation of the collaboration and assistance rendered by the Officers of His Majesty's Customs, of the Port of London Authority, the Pilots and members of the staffs of the Shipping Companies and Merchants, 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) I I. AMOUNT OF SHIPPING ENTERING THE PORT DURING THE YEAR 1951. TABLE A. Number Tonnage Number Inspected Number reported to be defective Number of vessels on which defects were remedied Number of vessels on which defects were found & reported to Ministry of Transport Sur-veyors Number of vessels reported as having or having had, during the voyage, infectious disease on board. By the Medical Officer of Health By the Sanitary Inspector (Steamers 5,031 11,946,683 1,316 7,847 779 769 10 165 Foreign(Motor 6,718 6,748,569 564 (Sailing - - - 11 - - - - (Fi shing - - - - - - - - Total Foreign 11,749 18,695,252 1,880 7,858 779 769 10 165 (Steamers 7,620 7,450,253 2,070 178 168 17 5 . (Motor 4,805 2,154,201 Coastmse(Sailing 242 16,023 - 38 5 5 - - (Fishing - - - - 1 1 - - Total Coast-wise 12,667 9,620,477 - 2,108 184 174 17 5 Total Foreign & Coast-wise 24,416 28,315,729 1,880 9,966 963 943 27 170 II. CHARACTER AND TRADE OF THE PORT (a) Passenger Traffic during the year - (i) To and From Non-European Countries® 1st Class 2nd Class 3rd Class * Tourist Class Total INWARD 26,497 277 424 33,644 60,842 OUTWARDS 34,263 3,617 552 48,536 86,968 * Includes Cabin Class. (ii) To and From the Continent of Europe. INWARD 42,368 OUTWARD 39,537 Countries from -which passengers principally arrive India, Australia, New Zealand, South America, the Far East and the United States of America. (b) Cargo Traffic (imports and Exports). Particulars for the year 1951 are not available. (c) Foreign ports from -which vessels arrive: The Port of London trades with all parts of the world. (5) MEDICAL INSPECTION OF ALIENS Annual Return by the Medical Inspector of Aliens for the year ended 31st December, 1951. Total Number inspected By medical officer Number subjected to detailed examination by the medical officer Certificates issued Trans migrant Lunatic idiot or M.D. undesirable for medical reasons Physically incapacitation Suffering from acute infectious disorder Landing necessary for adequate medical examination (a)Total number of Aliens landing at the Port. 33,068 21,873 1,091 - - - - - - (b)Aliens refused permission to land by the Immigration Officer® 72 - - - - - - - - (c)Transmigrants. - - - - - - - - - Total Aliens arriving at the Port. 33,140 21,873 1,091 - - - - - - Total number of vessels arriving carrying Alien passengers - 1,974. III. - 7JATER 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 is supplied by the South Essex Water Company« The majority of the wharves are supplied by Public Water Authorities within -whose area of jurisdiction 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 the -water barges. (b) For Shipping - Ships not able to obtain -water from the shore supplies as indicated above, or ships lying at buoys in the river, can obtain supplies from -water barges. 2. Hydrants and Hosepipes - Hydrants within the dock area are of the standard type in use by the Metropolitan Water Board. They are situated at intervals along the quayside and consist of an upright stackpipe with nozzle couplings 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 the shore, that at no time do thev 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 condition = Water boats are registered annually by the Port of London Authority and such registration is made conditional upon the report of the Port Health Officers as to the fitness of the craft for the carriage of drinking -water as also upon the purity of the -water thus carried® To this end sampling is carried out from time to time ® There -were thirteen -water boats -working in the Port during the year. IV. - PORT HEALTH REGULATIONS 1933 and 1945. (l) Arrangements for dealing with Declarations of Health._ Ships bound for London coming up the English Channel take on a Pilot off Dungeness, those coming across the North Sea take on a Pilot at the Sunk Lightship, (6) near Harwich. The Elder Brethren of Trinity House have kindly agreed that Pilots should hand copies of the Declaration of Health to the Masters of the ships they board and accordingly supplies of the Declaration of Health are sent, from time to time j to Trinity House® The Elder Brethren have, however, stipulated that Pilots should not be held responsible for any failure on the part of Masters to comply with the instructions of the Port Health Authority. Pilots have, however, co-operated willingly and conscientiously and consequently the arrangements are working very satisfactorily. In this manner delay in providing the Master with a Declaration of Health form to be filled up before arrival at Gravesend, is avoided. This is very important since there are occasions when even a few minutes delay may result in a ship missing the slack -water at high tide or low tide, essential for docking. Free pratique is granted to ships arriving at port in the United Kingdom from foreign, not by the Port Medical Officer but by the Officers of His Majesty's Customs® Consequently -when a ship arrives the Customs Officer examines the Declaration of Health and if all the answers to the six questions put to the Master in the Declaration are in the negative and the ship has not called within the last six -weeks at ports in certain regions listed in the Declaration of Health, the Customs Officer automatically grants the ship free pratique and the Medical Officer on duty is not called upon to board the ship® If, however, these conditions are not fulfilled^ the Customs Officer withholds pratique and instructs the Master to send the signal calling for the Boarding Medical Officer and it then rests with the Boarding Medical Officer to advise the Customs whether pratique should or should not be granted. 2. Boarding of vessels on arrival - The Port Health Authority maintain at Gravesend a hulk, the "Hygeia" on which the Boarding Medical Officers live during their tour of duty. The Boarding Launch "Howard Deighton" which has an ambulance room on deck, lies alongside the "Hygeia". There are three Boarding Medical Officers and three crews for the launch, each having 24 hours afloat and 48 hours ashore® Ships are boarded at any time of the day or night as soon as they arrive off Gravesend. The "Hygeia" is connected by an underwater cable to the telephone ashore and in accordance with the requirements set out in the Declaration of Health, wireless messages sent from an incoming vessel are picked up by the North Foreland Radio Station and transmitted by land cable to the "Hygeia". The Customs also maintain a launch constantly on duty in this Reach of the River and it is here also that the deep sea pilot hands over to the River pilot. Thus all three services are in close touch with one another. When the boarding launch is undergoing overhaul or is, by any other reason temporarily out of commission, the Medical Officer boards from the Customs launch, by courtesy of His Majesty's Customs® The m.l. "Alfred Roach" which is based at Gravesend and is at the disposal of the Sanitary Inspector in the Lower River district is constructed so that the saloon can be rapidly converted into a sick-bay capable of carrying three stretcher cases and has a cockpit with a sufficiently large open space to receive a stretcher and deep enough to protect the occupants from inclement weather® The launch is capable of accommodating eight sitting cases and would be used for transferring cases to hospital should the "Howard Deighton" be out of commission® 3. Notifications to the Authority of inward vessels requiring medical attention = Arrangements are in force by which the General Post Office telephone direct to the Medical Officer on duty on the "Tlygeia" all messages received by the North Foreland Radio Station from vessels in accordance with the instructions on the Declaration of Health® There is always a Medical Officer on duty and a launch available for removing infectious cases to hospital® Occasionally a vessel voluntarily send a full Quarantine message in code. which is deciphered by the Medical Officer from Volume II (Radio) of the International Code of Signals, but usually the message received from the vessel is that required in the Declaration of Health, namely, the name of the vessel and the time she is expected to arrive off Gravesend, with information of any infectious disease on board, this message being sent off not more than 12 hours and not less than 4 hours before the arrival of the vessel. (7) Ships requiring medical attention are required to fly the flag signal LIM during the day and to flash "Q" on their morse lamp by night -when approaching Gravesend, both signals meaning "Port Medical Officer required". 4. Mooring Stations Designated under Article 10 - During 1947 and after correspondence with the Port of London Authority and the Waterguard Superintendent of His Majesty's Customs and Excise, new Mooring Stations were adopted to replace those that had been destroyed by enemy action during the war. Such Mooring Stations were set out in full in my Annual Report for 1947. 5. Experience of working Article 16 <= (1) As ships are cleared in the River immediately on arrival, no difficulty has been experienced in preventing the embarkation or disembarkation of unauthorised persons. (2) When a vessel arrives which has on board a case of one of the major infectious diseases or on which such a case has died or has been landed abroad withii the incubation period of the particular disease, it is the practice to regard every person on board as a contact and accordingly to arrange for his or her observation or surveillance. Those persons intending to leave the ship must give their names and addresses before leaving and this is done by issuing such persons with a specially prepared double post-card on one half of which he gives full details of his name and the address to -which he is proceeding immediately on disembarkation; the other half he is asked to keep and use only should he change his address during a specified period. This half of the card is on the "Business Reply Card" system so that the person concerned does not have to stamp it. 6. What, if any, arrangements have been made for - (a) Premises and -waiting rooms for medical examination - Medical examinations are usually carried out on board ship but there are rooms available for the medical inspection of Aliens on the Tilbury Landing Stage ® (b) Cleansing and disinfection of ships, persons, clothing and other articles - Disinfection of infected quarters is usually carried out by the Sanitary Inspector in whose area the vessel berths. 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 has been taken over by the South-East Metropolitan Regional Hospital Board, the Disinfecting Station, containing a Washington Lyons Steam Disinfector is available for the disinfection of clothing bedding etc., and for cleansing cases of scabies. (c) Premises for the temporary accommodation of persons for whom such accommodation is required for the purposes of the Regulations - So far it has not been necessary to make provision on a large scale, and if the necessity did arise the ship would be detained until temporary accommodati ashore had been found. (d) Hospital accommodation available for Plague, Cholera, Yellow Fever, Smallpox and other infectious diseases - Denton Hospital having been transferred to the Seamen's Group of Hospitals attached to the Southeast Metropolitan Regional Hospital Board, arrangemei have been made for a patient or patients suffering from a major infectious disease to be removed to Denton Hospital pending arrangements for the transference of such cases to the appropriate hospital under the management of the South-East Metropolis Regional Hospital Board. (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 stretohei cases or eight miking cases. The middle river launch the "Alfred Robertson" has a fairly spacious aft* cabin in -which a patient could be carried but it would only be used as such in an emergency. The m.l. "Alfred Roach" is constructed to carry three stretcher cases. (8) has a cockpit -with a sufficiently large open space to receive a stretcher and deep enough to protect the occupants from inclement -weather. It is capable of accommodating eight sitting cases. The m.l. "Frederick Whittingham" is a much smaller launch and is used by the Sanitary Inspector in the Upper River District for the inspection of river craft of all kinds® (f) Supervision of Contacts - In the event of a vessel arriving on -which there is or has been a case or oases of a major infectious disease, all persons on board are considered to be possible contacts. Such persons are individually interrogated as to the address to which they are proceeding immediately on disembarkation and given a specially prepared double post-card, on one half of which they give full details of their names and addresses. These particulars, together with an appropriate note of the circumstances are then forwarded to the Medical Officers of Health of the districts in which the contacts' address is situated. The other half of the card they are asked to keep and use only should they change their address during a specified period, usually the incubation period of the disease in question. (g) Arrangements for the Bacteriological or Pathological examination of Rats ~ (h) Arrangements for other Bacteriological or Pathological examinations - All such examinations are now carried out at the Central Public Health Laboratory at Colindale. For many years past, rats caught or found dead on board ships, particularly ships arriving from ports which are, or occasionally are, plague infected, were sent as a routine for examination for plague. The last plague infected rat found in the Port of London was in 1927. This is an expensive service and it was decided to abandon it as a routine, save in the case of rats found dead on board, since the results have been so persistently negative over many years. 7. Arrangements for the diagnosis and Treatment of Venereal Diseases among Sailors, under International arrangements - The Venereal Diseases are not compulsorily notifiable but efforts are made to bring to the notice of all seamen using the Port, the facilities for free treatment under the Brussels Agreement. When the Medical Officers board ships on arrival they alusays enquire whether there are any cases of venereal disease on board and should there be a known case the infected person's attention is drawn to the importance of obtaining skilled treatment as soon as possible and he is given a list of addresses of the Clinics near the ship's berth in London and the time at which cases may attend. Similarly the Sanitary Inspectors have a supply of pamphlets listing the names and addresses of places of treatment available. This notice is printed in 21 different languages and is posted up at vantage points throughout the -whole of the dock area. 8. Arrangements for the Interment of the Dead - When cases of infectious disease die on board ship or at Denton Hospital, arrangements for interment are made with an Undertaker in the Gravesend area. PORT HEALTH REGULATIONS 1933 to 1945. Royal Fleet Auxiliaries and Merchant Fleet Auxiliaries. 26th January, 1951. Sir, 1. I am directed by the Minister of Health to say that the Medical Director-General of the Navy has proposed that the health control of Royal Fleet Auxiliaries and Merchant Fleet Auxiliaries when arriving in a naval or other port should in future be applied by the Port Health Authority or other Sanitary Authority (i.e., under the Port Health Regulations, 1933 to 1945), instead of by the Naval Medical Officer of Health as at present. 2. The Minister sees no objection to this proposal, and he has been (9) informed 'by the Association of Sea and Air Port Health Authorities that they concur with this view. 3. I am therefore to request that the Authority may bring this change of practice into operation as soon as practicable. 4* Authorities will no doubt wish to co-ordinate their action (including agreement as to the identity of the vessels affected by the change of practice) with the Naval Medical Officers of Health, who are being notified by the Medical Director-General of the Navy accordingly and who will continue to supervise the vessels in question (for rodent control, etc.,) whilst they remain in H.M. Dockyards. I am, Sir, Your obedient servant, (The Secretary). Instructions were issued to the Boarding Medical Officers accordingly. 7th February, 1951 Sir, Port Health Regulations 1933 to 1945. Declaration of Health. 1. I am directed by the Minister of Health to refer to Article 13 of the Port Sanitary Regulations, 1933, as amended by the Port Health Amendment Regulations, 1945, -which requires that the master of a foreign-going ship arriving from a foreign port shall deliver a Declaration of Health in the form set out in the Regulations. 2. For the purposes of these Regulations "foreign port*1 means (in effect) a port or place outside the United Kingdom, the Channel Islands, the Isle of Man or the Irish Republic, and "foreign-going ships" mean (in effect) a ship trading or going between this country and a foreign port excepting one between Brest and the River Elbe. 3. It will thus be seen that a Declaration of Health must be delivered for any ship arriving in this country from a port on the Mediterranean or Atlantic coast of France. 4. There have recently been discussions between the Brussels Treaty Powers (Western Union) with a view to applying a uniform procedure in all the countries for arriving ships, and it has been agreed that, as from the 1st March, 1951, a Declaration of Health should not be required from any ship which trades only between those countries and does not, during the voyage, call at a port outside them. 5. Except for the ships mentioned in paragraph 3 above, the Port Health Regulations already give effect to that agreement, and it is proposed in due course to amend them to exclude also those ships from the requirement of the Declaration of Health. Since the Regulations were amended in 1945, however, other amendments have been shown to be desirable, but formal effect cannot be given to them before the 1st March, and the Minister wishes to avoid several piecemeal amendments. Moreover, a review of the Regulations will be necessary after the International Sanitary Regulations, now under consideration by the World Health Organisation, have been promulgated. 6. It is, therefore, intended to defer formal amendment of the Regulations until the general review. But, pending their formal amendment, the Minister considers that Port Health Authorities need not, after the 1st March next, continue to require a Declaration of Health for a ship arriving in this country from a port on the Mediterranean or Atlantic coast of France, which has not, on its voyage, called at a port outside France, Belgium or Holland. 7. A copy of this letter is being sent separately to the Port Medical Officer. I am, Sir, Your obedient servant, (The Secretary) Instructions were issued to the Boarding Medical Officers accordingly* (10) 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 years. Passengers Crew Chickenpox 6 3 9 15.8 Influenza - 1 1 0.4 Poliomyelitis 1 2 3 0.6 Mumps 9 15 11 9.4 Scarlet Fever 2 1 3 3.6 Enteric Fever 1 2 3 16.6 Smallpox 1 - 1 0.4 Pulmonary Tuberculosis. 13 32 38 27.2 Measles 22 2 9 23.6 Dysentery 1 8 4 5.8 Malaria 1 4 5 12.2 German Measles - 61* 1 1.6 * Training Ship "Worcester". TABLE D. CASES OF INFECTIOUS SICKNESS OCCURRING ON VESSELS DURING THE 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 German Measles 6 - 4 5.2 Pneumonia 1 2 3 3.2 Measles 49 1 17 31.2 Malaria - 48 18 22.6 Chickenpox 13 2 15 19.0 Smallpox 1 4 3 2.8 Mumps 5 4 6 4.8 Pulmonary Tuberculosis. 5 3 8 5.6 Enteric Fever - 4 4 6.4 Poliomyelitis 1 - 1 0.4 Dysentery 1 2 3 6.6 (11) R.M. S. "STRATHMORE" - SMALLPOX. 1® The R.M.S. "Strathmore" left Sydney on the 6th January, 1951, on the return voyage to this countrye The folio-wing is a list of the ports called at Fort. Date of arrival. Sydney 6th January Colombo 23rd " Bombay 26th " Aden 30th " Suez 2nd February Port Said 3rd " Marseilles 7th " Gravesend 12th " On arrival at Gravesend the vessel had 833 passengers, 266 European crew and 277 Native crew. In addition, the pilot and eight members of the baggage staff of the Peninsular & Oriental Steam Navigation Company boarded the vessel at Brixham. 2. The vessel embarked at Bombay on the 26th January a lady and her two children - a girl aged 12 and a boy aged 11. 3. The girl felt out of sorts on the 28th January and remained in her cabin. On the 30th, the Ship's Surgeon was called in to see her and he found on examination her temperature to be 103., with pulse 120, but no other signs or symptoms. On the morning of the 31st her temperature was 102°, but in the evening the Ship's Surgeon found that she was developing a vesicular rash, the first spots appearing on the left scapula and on the forehead, arms and legs. He promptly admitted her to the ship's isolation hospital. On the 1st February the vesicular rash was developing with a distribution the Surgeon thought to be indicative of chickenpox. More vesicles appeared on the 2nd, the 3rd and the 4th February® Her temperature was 99° on the 4th but it dropped to normal on the 5th® 4. The Surgeon states that he was not altogether certain that the case was typical chickenpox, but he was reassured somewhat by the confirmation of his diagnosis by the Port Medical Officer at Suez, who stated that he considered the case to be one of chickenpox and gave as one reason the fact that the child had a pock in the armpit and this did not occur in smallpox - incidentally, a totally erroneous conception. The child continued to be regarded, therefore, by the Ship's Surgeon as a case of chickenpox and the mother, who had been admitted to isolation at the same time as the child, was permitted to leave isolation and to take her meals in the saloon - a somewhat unfortunate decision it must be confessed, 5. On the arrival of the ship at Marseilles, the case was seen by the Port Medical Officer who, again, agreed with the diagnosis of chickenpox. 6. By the time the ship had arrived at Tilbury on the 12th, the child was convalescent and the Boarding Medical Officer who saw her at 6.50 a.m., agreed with the diagnosis of chickenpox and arranged for the child to be admitted to the St. Andrew Annexe Isolation Hospital, Gooseberry Green, Billericay. The child, being a female, could not be admitted to Denton Isolation Hospital, all the nurses at Denton being male nurses® 7. At 11 p.m. on the 13th, Dr. Boul rang me up at my residence to inform me that he was not at all happy with the diagnosis of chickenpox, and he considered the child to be suffering from modified smallpox. His view was confirmed by Dr. Jamesj Medical Superintendent of Hither Green, whom he had called in in consultation. His grounds for regarding the case as one of smallpox were first, the distribution of the rash, which, though sparse, was chiefly scattered on the head and face, and the arms and legs, with very few spots on the trunk; secondly, he had ascertained that the child had had -what the mother called "a classic attack of chickenpox" as recently as May 1950 and it was, therefore, highly unlikely that the child vas suffering from a second attack, which is an extremely rare occurrence. 8. On the following morning (the 14th), after consultation with Dr. Bradley, Ministry of Health, it was agreed that, after the removal of some scabs to be sent (12) to the Government Laboratory at Colindale for biological examination by Dr.MaoCullum, the child should be transferred to Long Reach Smallpox Hospital, Dartford, under the care of Dr.Marsden. It is 'worthy to note that arrangements were made to remove the child at approximately 4 p.m., but the ambulance did not arrive until 8 p.m., the reason given being that it had been difficult to find an ambulance driver and attendant -who had been vaccinated. 9, Dr.Marsden confirmed the clinical diagnosis of smallpox on Thursday morning, Ithe 15th, and the Laboratory confirmed the diagnosis biologically the same morning. 10. The child remained in Long Reach Hospital until full convalescence. ,11. It will be appreciated that on the diagnosis of chickenpox made by the Port Boarding Medical Officer, all the passengers were permitted to disembark and to !disperse to their various destinations. Consequently, the first duty on the morning of Wednesday, the 14th, was to obtain a passenger list from the Company and to endeavour to trace all the passengers and any member of the crew who had left the ship on leave. 12. In cases of this kind the addresses given by the passengers and transcribed on to the passenger list by the purser contain a considerable percentage, no less than twenty per cent in this instance, of accommodation addresses, such as C/o a Bank, or Australia House or Cook's, or some similar organisation. People giving accommodation addresses of this kind are extremely difficult to trace; consequently, in addition to an explanatory letter (Annexe I) addressed to Medical Officers of !Health of the districts in which known addresses were situated, a letter (Annexe II) ves addressed to the accommodation addresses urging Banks and other organisations to disclose, if it were known, the address to which the passenger had proceeded. It mill be appreciated that Banks are usually averse to disclosing the addresses of clients, but on this occasion they responded well to the appeal and the majority of such passengers were traced, thanks to the information supplied in this my. 13. 188 letters were addressed and dispatched to Medical Officers of Health and to accommodation addresses on Wednesday, the 14th, 219 on the 15th, and 75 from Ithe 16th to the 21st February. Further letters were sent as changes of address irere notified or contacts traced. Where close contacts were involved, a communication was made with the local Medical Officer of Health by telephone. 14. In view of the fact that it was not possible to trace a certain number of persons, the Ministry of Health deemed it desirable to make a statement to the Press and to issue a warning notice to passengers by means of broadcasts, urging them to visit their local Medical Officer of Health as soon as possible. The notice to the Press and the broadcast transmission was made on Wednesday, the 14th. 15. A certain number of passengers were missed owing to a defect in the passenger list supplied by the Shipping Company, which was short of twenty-one passengers of various nationalities but these were eventually picked up and contact made with them. There was also a number of defects in the passenger list addresses and this gave rise to a good deal of trouble. It will be appreciated how important it is that a passenger list should be complete and accurate and that Pursers when compiling passenger lists should as far as possible refuse to accept an accommodation address and Warn passengers well in advance of the date of arrival in the United Kingdom that should anything untomrd happen in the ship in the shape of infectious disease of whatever nature, they may not be permitted to disembark until they can produce an address to which they are proceeding on the day of their disembarkation and at which they will sleep on the first night after disembarkation. Unfortunately, quite a number of passengers are extremely lackadaisical in this and have no idea where they will pass the first night after arrival. Others rely on their Bank, or on Cook's or similar organisations, to find them a bed without realising that it is by no means easy to do so in London in present circumstances. 16. All the linen and bedding which had been in close contact with the patient while in the isolation hospital -was removed by the Port Health Authority's launch on the arrival of the ship, and taken to Denton Hospital for steam disinfection. Unfortunately, the linen and mattress in the cabin occupied by the child before isolation was not so dealt with and became mixed up with the general passenger linen of the ship, with the result that it was necessary to arrange for the steam disinfection of some 20,000 pieces of lien before they could be sent to the laundry. This caused much avoidable time and delay. The cabin occupied by the child, the ship's isolation accommodation and the quarters occupied by immediate contacts, that is the Ship's Surgeon, the two Ship's Nurses, the Sick Bay attendant, and the Steward and Stemrdesses attending on the cabin occupied by the child, were fumigated, then thoroughly washed down with soap and water and antiseptic, and then repainted. (13) 17. The -whole of the crew remaining on board -were vaccinated as an added precaution, even though not entirely necessary since the ships crews employed by the P & 0 Company are regularly vaccinated. 18. The Medical Officers of Health were asked to keep passengers residing in their area under daily surveillance for sixteen days following their disembarkation, that is up to February 28 th 19. No secondary cases were reported among any of the passengers -who disembarked from this ship owing, in all probability, to the fact that the child ms confined to her cabin for the prodromal period proceeding the development of the rash and ms immediately isolated on the appearance of the eruption. Any contact, therefore, with other passengers -was remote and under conditions unlikely to convey the infectio 20. This case is of interest on several counts. The child suffered from a highly modified form of smallpox, probably for the reason that she had still sufficie immunity against the disease to prevent a full development of the infection, but not sufficient to prevent infection altogether. At the same time she must have had a sufficient level of immunity, on the assumption that the vaccine used at the time of her revaccination only four months before she embarked -was of sufficient potency and the vaccination properly performed, to prevent the revaccination producing a postive results This is, therefore, one of those dangerous threshold cases "where a revaccination appears to indicate immunity but -where, in fact, the immunity is not sufficient altogether to prevent an attack of smallpox -when confronted with a virulent viruso But it must not be forgotten, that records of the result of revaccinations are notoriously unreliable. 21. On the diagnosis, it must be stated quite categorically that these modified cases of smallpox are far from easy to distinguish from chickenpox. The MedicalOfficers concerned appear to have had their opinions coloured by the fact that the child -was satisfactorily vaccinated in infancy and revaccinated recently and, consequently, to have overlooked the vital point that the child had had a previous attack of chickenpox only so recently as May last year and that it -was therefore highly improbable, to say the least, that she -was suffering from a second attack of chickenpox. 22. Each incident of this kind brings with it a number of lessons to be learned and generally affords an opportunity to improve methods of defence against the introduction of disease into this country. Perhaps the most important lesson in this instance is the need for a complete and as far as possible accurate passenger list with the address of first destination on arrival. Without this essential information it is impossible to keep control of potential contacts. ANNEXE I. Telephone: Port of London Health Authority, Monarch 3030. 5, Church Passage, Guildhall, London, E.C.2. Dear Sir, ReM.S. "Strathmore'1 - Suspected Smallpox. The s.s. "Strathmorew arrived at Tilbury at 6®50 a.m., on the 12th instant from Sydney via Bombay. A girl, aged 12 years, embarked at Bombay on the 26th January and took ill on the 28th with malaise. She reported sick to the Surgeon on the 30th with a rash just appearing. She had slight pyrexia and malaise and she -was isolated in the ship's hospital as a case of chickenpox® The child had two vaccination marks from vaccination in infancy and held a certificate of recent unsuccessful vaccination. On arrival at Tilbury the Port Boarding Medical Officer agreed with the ship's surgeon's diagnosis of chickenpox and the child ms disembarked and admitted to the Billericay Isolation Hospital. Further careful clinical examination of the child and a history giving evidence of a previous attack of chickenpox and some scars on the abdomen, tended to confirm this. This history and the distribution of the rash, chiefly on the face and lower limbs, with little or no rash on the abdomen, chest and back, have been sufficient to raise some doubt as to whether the case is in fact chickenpox but is a modified smallpox. The child is, of course, now convalescing with the scabs becoming detachedo The child, therefore, is being regarded as a case of suspected smallpox pending the result of biological investigation. The undermentioned persons giving (14) an address in your area were on board the ship and I should be glad if you would kindly visit then at the earliest moment to ascertain if they are healthy and to keep them under observation for sixteen days from the date of their disembarkation, i.e., up to the 28th February. Will you also make sure that if they change their address, the Medical Officer of Health of the area to -which they are proceeding is notified of their arrival so that he may continue to keep them under observation. Vaccination might afford protection should they have contracted the disease just prior to disembarkation and if they are not in possession of a certificate of recent vaccination, you may consider it wise to offer them vaccination. Yours faithfully, Dr .M.T.MORGAN Medical Officer of Health, Port of London. No. Name. Address. To The Medical Officer of Health. ANNEXE II. Port of London Health Authority, Telephone: 5, Church Passage, Monarch 3030. Guildhall, London, E.G.2. Dear Sir, A case of suspected smallpox has occurred on board the R.M.S. "Strathmore" vtiich arrived at Tilbury on February 12th. The undermentioned person(s), passenger(s) on the "Strathmore", gave on disembarkation an address, care of your Bank/Organisation and you will appreciate that I am very anxious to trace all the ship contacts. Without your help I shall be unable to do so. I should be grateful, therefore, if you -mould give the address to which your client has proceeded. I appreciate that normally you are averse to disclosing the addresses of your clients, but I feel sure you will agree that in the circumstances it is of paramount importance that I should be able to get into touch with a possible contact -without delay so as to ensure that he has not developed the infection and lias thereby incurred what might be a fatal risk to himself and to others. In order to secure his supervision I must report his address to the Medical Officer of Health of the district in which he is resident, who will visit him daily during the balance of the incubation period of the disease. I should be most grateful if you would do everything in your power to help me to trace the undermentioned person(s). Any information you supply will, of course, be treated in strict professional confidence. Yours faithfully, Dr.M.T.MORGAN,' Medical Officer of Health, Port of London. No. Name. SUSPECTED CASE OF SMALLPOX IN s.s. "RANCHl". Information «s received by telephone from the Medical Superintendent of the Peninsular & Oriental Steam Navigation Co., at 11.30 a.m., on Saturday, 28th April to the effect that a suspected case of smallpox had been found in a tourist class passenger just after the vessel had left Port Said, home-ward bound® After consultation it was decided to radio the ship requesting that all on board should be vaccinated or re-vaccinated and that all close contacts should be kept under strict surveillance. The cabin and contents occupied by the patient was to be sealed and on the vessels arrival at Marseilles pathological material was to be sent by air to Colindale Laboratory for tests to be carried out. (15) An urgent request was also made for accurate passenger lists with destinations, including all passengers landing at Marseilles, to be prepared in quadruplicate and the Marseilles list to be airmailed in advance. As -will be seen later, these requests were dealt with with some modifications to suit the circumstances prevailing. Voyage Itinerary. lie ft Sydney 31. 3.51 " Melbourne 1.4.51 " Fremantle 5.4.51 " Colombo 14.4.51 " Bombay 17.4.51 " Aden * 22.4.51 " Port Said 27.4.51 " Marseilles 2.5.51 Arr. London 8.5.51 The patient, a man aged 18 years, left Calcutta by rail on 15.4.51, and joined the "Ranchi" at Bombay on 17.4.51. On 24.4.51 he appeared as an out-patient at the Ship's Surgery with a "cold", had a temperature of 98.6° and was given a linctus. He ms not seen again until 27.4.51 - three days later - in the morning some nine hours after the vessel had left Port Said, when he presented the following symptoms:- T.101° P.102s R.24., a marked maculo papular rash on his face, trunk, wrists and soles of his feet, and very few lesions on arms and legs. By the evening his temperature had risen to 104° P. 120.R.25 and the rash ms more prominent and vesicles were appearing. On 28.4.51 he exhibited palpable papular eruptions on the soles of his feet and palms of his hands. In consultation with Dr.B...... a passenger, the ship's surgeon decided that the case ms one of Variola Minor or Variola modified by vaccination. This conclusion ms reached on 27.4.51, and the Peninsular & Oriental Steam Navigation Co, ms notified by wireless. Precautions taken by the Ship's Surgeon. Immediate isolation of patient in ship's hospital on 27.4.51. Vaccination or re-vaccination of all passengers and European crew, plus close contact Asian crew, on 27=28.4.51., except those who could show scars of vaccination within one month. The Asian crew were not vaccinated until arrival at Marseilles owing to shortage of calf lymph. As the Company's rules for vaccination of Asian crews are strict it ms deemed that the Asian crew were less at risk than the passengers and European crew. The Goanese bedroom stemrd ms vaccinated at once in view of his being a close contact. The cabin ms evacuated by the remaining seven inmates and fumigated with SO2 candles on 27.4.51, but owing to the crowded state of the ship they had to re-occupy the cabin by nightfall as the only alternative ms to spread these seven contacts in ones and twos throughout the ship. Nevertheless, the SO2 fumigation would appear to have been good as regards quantity used and length of exposure 1-lb. per 1,000 cubic feet for eight hours. The patient's mattress ms removed after S02 fumigation to the isolation hospital and his pillowss towels and bed linen were destroyed at once. By a curious mischance a routine change of bed linen on the deck concerned had been made on the 26th April and sent to the ship's laundry and mshed before the diagnosis had been made. On the instructions of the Captain this linen ms re-laundered to ensure sterilization as far as possible. On arrival at Marseilles the diagnosis ms concurred in by the Port Medical Officer and the patient removed to l'Hospital de la Conception on 1st May, 1951, after scrapings and other material had been taken and sent to England by Air-Mail. (16) By another curious mischance the dispatch of this material coincided with May Day, -which is observed more as a public holiday in France than in England, and its arrival in England coincided with a "go-slow" movement of our G.P.O. employees so that the material -was not received until 5.5.51 - five days later. The preliminary pathological report ms negative, but not received by telephone until the Port Health Staff had arrived in Brixham and the second report -was not received until all precautions had been taken and the ship berthed at Tilbury® After removal of the patient at Marseilles the ship's hospital ms disinfected with SC2 candles and thoroughly cleansedo It had to be used a few days later owing to the occurrence of a case of Scarlet Fever and a case of Measles in infant passengers. To expedite matters it was decided that the Deputy Medical Officer of Health of the Port of London, the Chief Sanitary Inspector and three members of the office staff, should proceed to Brixham and join the ship there when she called in to embark her Channel Pilot. This was effected at 10 a.m., on 7.5.51. Precautions taken on boarding. After an address over the ship's broadcasting system, yellow address cards were distributed to all passengers and European crew members before lunch.' During the afternoon every passenger and all the European crew were medically inspected as they came to the tables for interrogation and checking of destination addresses. By taking the passengers alphabetically - they were broadcast for in batches A to C, D to G etc - all the 822 passengers were dealt with in .just over 2 hours and the European crew were called for by departments and similarly dealt with between 5 and 7 p.m„ The Asian crew were inspected at 6 a0ra«, next day on arrival in the Thames when they could be examined in daylight on the boat deck. Total personnel on board were 790 British and 32 Alien passengers, 212 Europeans and 209 Asian crew. The Chief Sanitary Inspector took charge of the hygiene side and apprised the quantities of bedding etc., for removal for steam disinfection at Denton and assessed the cabins etc., for fumigation. His services were most valuable and a great help in expediting matters on arrival. Apart from the case landed at Marseilles there were also on board one case of Scarlet Fever and two cases of Measles which, together with their bedding etc., were admitted to Denton Hospital on arrival. In dealing with the close contacts it was found that the Nursing Sister who had nursed the suspected smallpox case from the beginning, blanket bathed him etc., was taken ill on 3rd May with intense backache, pains in the limbs and headache. Her temperature rose steeply to 101° by the evening of 3.5.51 and fell by lysis during the next four days. At no time did she exhibit a rash. She had some watery diarrhoea. She was confined to her cabin throughout. Had a suspected case of Smallpox not occurred this patient would, no doubt, have been considered one of 'influenza', but although the longest incubation period could have been not more than 7 - 9 days the possibility of Contact fever immediately came to mind. As a precaution she ms removed to Joyce Green Hospital under the care of Dr. Marsden, on arrival, where certain tests carried out were negative to smallpox. The "Ranchi" arrived off Gravesend at 5 a.m., and anchored while the patients were landed, plus bedding for disinfection in Denton. An ambulance ms waiting for Sister C..... and she ms transferred to Joyce Green Hospital. The vessel berthed alongside Tilbury Landing Stage at 8 a.m., and disembarked her passengers, proceeding into Tilbury Dock at 3 p.m., all times being strictly to schedule. (17) The Staff who joined at Brixham worked continuously throughout the night on the passage up-Channel and all notifications to Medical Officers of Health were prepared and got off by post by the afternoon mail# The Marseilles address list was similarly disposed of and the whole operation completed by 4 p.m. RATS DESTROYED DURING 1951, TABLE E. (l) ON VESSELS. Number of Jan Feb Mch Apl May Jne Jly Aug Sep Dot Nov Dec Total in year Black Rats 243 193 221 666 209 132 166 190 99 259 227 123 2,728 Brown Rats - - - - - - 1 - - - - - 1 Species not recorded - - - - - - - - - - - - - Rats examined - - - - - - - - - - - - - Rats infected with plague - - - - - - - - _ - - - - TABLE Fe (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 248 183 261 302 297 250 240 321 323 332 257 206 3,220 Brown Rats 291 176 216 303 517 548 230 393 242 339 270 337 3,862 Species not recorded - - - - - - - - - - - - Rats examined - - - - - - - - - - - - - Rats infected with plague - - - - - - - - - _ - - - TABLE G. MEASURES OF RAT DESTRUCTION IN PLAGUE "INFECTED" OR "SUSPECTED" VESSELS OR VESSELS FROM PLAGUE INFECTED PORTS ARRIVING IN THE PORT DURING THE YEAR. Total No. of such vessels arriving No.of such vessels fumigated by SO2. No. of rats killed No.of such vessels fumigated By HCN. No .of rats killed No. of such vessels on which trapping ,poisoning etc., was employed No.of rats killed No.of such vessels on which measures of rat destruction were not carried out. 2,025 - - 98 1,952 (423 Mice) 362 143 (73 Mice 1,663 TABLE II. EERATISATI0N CERTIFICATES AND DERATISATION EXEMPTION CERTIFICATES ISSUED DURING THE YEAR., No, of ships Number of Deratisation Certificates issued No. of Deratisation Exemption Certificates issued. Total Certificates issued. After Fumigation with After trapping Poisoning etc. Total HCN SO2 1080 Ships up to 300 tons 160 - - - - - 160 160 " from 301 to 1,000 tons 190 6 - 1 - 7 183 190 " " 1,001 to 5,000' " 176 25 - - - 25 151 176 " " 3,001 to 10,000 " 417 75 • - - 75 342 417 " over 10,000 tons 57 7 - - - 7 50 57 Totals 1,000 113 - 1 - 114 886 1,000 (18) V. HYGIENE OF CREWS' SPACES. TABLE J. CLASSIFICATION OF NUISANCES. Nationality of Vessels® Number inspected during the year. Defects of original construction. Structural defects through wear and tear. Dirt, vermin and other conditions prejudicial to health. BRITISH 6,326 46 98 843 OTHER NATIONS 3,640 - 6 88 Totals® 9,966 46 104 931 VI. MEASURES AGAINST RODENTS. 1, Steps taken for the detection of Rodent Plague - The Port Health Authority employs thirteen Rodent Operators working in conjunction with and under the supervision of the Sanitary Inspectors® The Rodent Operators' first duty is the examination of such ships in his area as are due for inspection -under Article 28 of the International Sanitary Convention relating to the granting of Deratisation and Deratisation Exemption Certificates.. His second duty is to visit all ships arriving in his district, to search for evidence of rats, paying particular attention to vessels -which have arrived from plague infected ports and to visit such vessels during the discharge of cargo. The Rodent Operators' third duty is the examination of shore premises for signs of rat infestation paying particular attention to premises adjoining the berths of vessels from plague infected ports. In 1941 the Port Health Authority instituted a Rodent Control Scheme in all docks and premises of the Port of London Authority, on behalf of that Authority and in the premises of the tenants of the Authority on behalf of the occupiers. This scheme, in its early days, relied principally on trapping but with experience and the application of a more up-to-date knowledge of the habits of rats, new and scientific methods of poisoning gradually took the place of trapping, the latter now only being occasionally used to clear up residual rats, if any, which have escaped a major poison operation. 2. Measures taken to prevent the passage of rats between ships and shore - The Port of London Authority have made bye-laws requiring the master of every ship to cause all ropes and mooring tackle to be fitted Mth guards to prevent rats passing from ship to shore. The bye-laws also prescribe that -when the discharge or loading of cargo is not actually proceeding, one gangway, whitened for a length of 10-feet at the end next the vessel , may be used as a communication between the ship and the shore® 3. Methods of Deratisation of - (a) SHIPS - (i) The burning of sulphur at the rate of 3-lbs. per 1,000 cubic feet of space for a period of not less than 6 hours. The destruction of rats, whether it be by the open pot method or by sulphur gas is efficient and the great advantage is that when applied in the holds of a ship, the crew need not be put ashore overnight. Unfortunately a number of countries have, for some time past, refused to accept as valid, International Certificates, where this method of rat destruction has been employed, consequently it has fallen out of use. (19) (ii) 'the generation of hydro cyanic acid gas by various methods. For the destruction of rats a concentration of 0.2 per cent of HCN is required with a minimum of 2 hours contacts If the fumugation is for the destruction of insect life, bed bugs, cockroaches etc., two or three times the concentration is employed and the exposure increased up to twelve or even twenty-four hours, according to the time available. (iii) "1080" and "Warfarin". The employment of the new rodenticides "1080" and "Warfarin" ware referred to in the Report for 1950. The employment of "1080" has ceased to be experimental and is now used regularly throughout the docks with highly satisfactory results. Its use in ships is still in the experimental stage but there is every indication that its use in ships is equally satisfactory to its use ashore. A certain number of ships have been deratised by this method in preference to the use of cyanide, resulting in a considerable saving in time and cost to the shipowner. Satisfactory results have been obtained from the use of "Warfarin" but a suitable bait, particularly in granaries, with which to mix the poison which rats will take continuously in preference to the grain or other form of cereal on which they are normally feeding, has yet to be found. (iv) Trapping. Trapping is seldom employed save for the destruction of isolated rats which have not yet established themselves. (b) PREMISES IN THE VICINITY OP THE DOCKS AND QUAYS. Rodent Control is now done under the Rodent Control Scheme of the Ministry of Agriculture and Fisheries referred to elsewhere in this Report. 4. Measures taken for the detection of rat prevalence in ships and on shore - Examination by Inspectors and Rodent Operators as already described. 5. Rat-proofing. (a) To what extent are Docks, Wharves, Warehouses etc., rat-proof? During the war years nothing vas done to render the dock premises rat-proof, indeed many of the wliarves and warehouses suffered severely from enemy action but when the rebuilding of these premises is possible, every effort will be made to see that the recommendations made before the war are carried into effect. (b) Action taken to extend rat-proofing (i) in ships and (ii) on shore - This action is being actively pursued as and when post-war conditions make this possible. THE PREVENTION OF DAMAGE BY PESTS (APPLICATION TO SHIPPING) ORDER, 1951. This Order which comes into operation on the 1st October 1951 applies to certain classes of ships and harbour craft the measures laid down in the Prevention of Damage by Pests Act, 1949, applicable to shore premises. The classes of vessels to -which the Order applies are as follows 1. Coastal vessels. 2. Harbour craft of all kinds, including lighters, tugs, grain elevators etc. Excluded from the Order are foreign-going ships which are required under the International Sanitary Convention 1926 as applied to the United Kingdom by the Port Sanitary Regulations, 1933 to ships entering ports in the United Kingdom to be in possession of an international deratting certificate or exemption from deratting certificate. In substance the Order requires that the owner or occupier of vessels and harbour craft shall give to the local authority forthwith notice in writing if it comes to his knowledge that rats or mice are living on or resorting to (20) the vessel or craft in substantial numbers. Any person -who fails to give such notice shall be liable on summary conviction to a fine not exceeding five pounds. The local authority may serve on the owner or occupier of a vessel, a notice requiring him to take, within such reasonable period as may be specified in the notice, such steps as will rid the craft of rodents. The problem arising from the application of this Order to the Port of London can be judged by the following craft population in the Port at any given momenti- 1. Coastal Vessels (weekly arrivals) 300 2® Lighters 7,000 3. TUgS 382 4. Grain Elevators 9 COASTAL VESSELS. All coastal vessels are inspected, as soon as possible after their entry into the Port by the Sanitary Inspectors and Rodent Operatives, with a view to ascertaining the population, if any, of rodents on board. This information is reported to the owner or agent and he is requested to take steps to rid the vessel of the rodents. The problem of taking effective action against rodents in coastal vessels is considerably complicated by the fact that they are seldom empty of cargo and consequently the opportunity to fumigate the vessel throughout with hydrogen cyanide rarely occurs. If any effective action, therefore, is to be taken in regard to these vessels arrangements must be made for a partial deratting of an empty hold by means of a rodenticide other than a poisonous gas such as hydrogen cyanide, and the only effective rodenticide for this purpose if "t1080". It is considered that the Port Health Authority would not be well advised to adopt a policy of carrying out this work by direct labour since in doing so they would be in direct competition with the Operating Companies who are quite competent to carry out the work. The Port Health Authority has never carried out cyanide fumigation; it haa neither the staff nor the equipment for the purpose and the companies competent to fumigate should also be permitted to effect partial deratting with a poison such as "1080". In the Order coastal vessels are required to carry a certificate, in • the form laid down in the Order, declaring that the vessel is either (a) free as far as is practicable from rodents or (b) has been treated satisfactorily for the destruction of the rodents on board. This certificate is issued after inspection by the Port Medical Officer and is valid for a period of four months from the date of issue® While, as is at present the practice, all coastal vessels will continue to be inspected whether or not they are in possession of a valid certificate} if they are not in possession of such certificate and are found to harbour rodents, the oirner or agent will be so informed and recommended to take the necessary steps to rid the vessel of rodents, but he is under no obligation to do so until the expiry of the validity of the certificate. The Port Medical Officer considers that the inspection of coastal vessels now carried out as a routine will suffice to meet the requirements of the Order but he will now be required to issue a large number of certificates, to keep a register of the vessels entering the Port and the state of validity of their certificates as well as the results of inspections of such vessels® It would appear, therefore, that there would be no need to increase the present staff of Inspectors and Rodent Operatives unless it is found that the supervision of the v/prk of the Operating Companies called in by the owners or agents to derat a vessel and the issue of the appropriate certificate following what is regarded by The Port Health Authority as a satisfactory deratting, necessitates, as it will in all probability, a considerable amount of evening and early morning work (the °aly time when the vessel is free to carry out a deratting operation) and additional staff may be necessary to enable the existing inspectorate to carry out their normal duties during day-time working hours. (21) At the present moment the River is covered, by three Sanitary Inspectors, each with a launch, whose duty is to visit all ships and other craft lying in the River, principally for the inspection of crew accommodation, general hygiene and sanitation, including rater tanks, latrines, galleys, food lockers etc., and for the presence of rodents on boards There are no Rodent Operatives specifically posted to the River and where a Rodent Operative is required by an Inspector to assist him in the inspection of a vessel he has to be temporarily detached from one or other of the Dock Groups where he is normally working. Coastal vessels lying at the wharves, of which there are a large number, could, of course, be visited from the shore but this would involve a great deal of time -wasted in travelling and it is generally found to be more convenient to visit these vessels from the River. If the Sanitary Inspectors are to do their work properly and to look sufficiently carefully into the hygiene and sanitation of crew accommodation of each vessel, they will not be able to find much time to go closely into the state of the vessels qua rodents. It may be, therefore, in the light of experience, found necessary to appoint either an additional Inspector or Inspectors or additional Rodent Operatives, or both, to carry out this -work, particularly having regard to the need to supervise the measures taken by the Operating Companies called in by the owner to rid a ship of rats. This may even involve the acquisition of one or more additional launches. The Port Medical Officer hopes that experience will point to a simple and economic solution of this new problem and he wishes to make ho specific recommendations at the moment. It must hot be forgotten that in addition to coastal vessels the Sanitary Inspectors stationed on the River have also to visit and inspect 'foreign going* ships laying in the River, house-boats, refuse barges, water boats etc., etc. LIGHTERS. BARGES ETCe The rodent inspection of this very large number of craft is going to be a difficult problem to solve. In the first place they are seldom idle (there is in fact a great shortage at present of lighters in this Port) and they are scattered throughout the greater length of the Port, i.e., between Brentford and the Lower Reaches of the Thames. They are, of course, occasionally to be found collected in numerous "tiers" throughout the Port area and also at the repair yards, some 60 in number, when they go for a refit. It is at such places and probably only at such places that they can be picked up and properly dealt with by the Port Health Inspectorate. Incidentally the lighters and all other craft that remain within the port are not required to carry a periodic certificate such as is required for coastal vessels but it is the duty of the owner or lessee to maintain the lighters free from rodents and of the Port Health Authority to see that this is done. Owing to the wide distribution of these craft it is doubtful whether the Operating Companies irould be able, or even wish, to undertake their deratting and it seems that the Port Health Authority will have to carry out this -work by direct labour on behalf of the owner if such work is to be done at all efficiently. The Port Medical Officer has had a number of consultations with the industries concerned and has come to the conclusion that at least three whole time Rodent Operatives will be required to carry out an inspection of all these craft, particularly at the "tiers" and at the repair yards and to destroy rodent colonies found on board. (22) In addition they will be required to supervise the rat-proofing of lighters which is a matter which badly needs attention. Eliminating rat harbourage under the ceilings by blocking off the swims in the bilges with perforated flashings is neither difficult nor costly and has been found to be most effective. The inspection of lighters at the repair yards can best be done from the shore but the inspection of lighters at the "tiers" can only be done from a launch and is going to present special problems, the solving of which can only take place in the light of experience. TUGS. Tugs are seldom infested with rodents and there should be little difficulty in carrying out periodic inspections of these craft. Such inspections can be done by the present River staff. FINANCE. The Circular accompanying the Order, signed by Mr®McAulay Gracie, the Director of Infestation Control, Ministry of Agriculture and Fisheries, responsible to that Department for the proper administration of the Order states that Port Health Authorities may claim grant equal to one-half of the expenditure incurred by them in the performance of their functions under the Order. Incidentally, the Circular further states that to simplify accounting procedure, claims for grant by Port Health Authorities in respect of all rodent control expenditure incurred in the current and subsequent financial years, whether incurred in connection with the issue of International Deratting or Deratting Exemption Certificates under the Port Sanitary Regulations or under the Prevention of Damage by Pests (Application to Shipping) Order, should be submitted to the Ministry of Agriculture and Fisheries® Grant in respect of services which are the responsibility of the Ministry of Health will be subject to conditions of grant laid down by that Department. Income from the issue of International Deratting or Deratting Exemption Certificates will in future be included in the claim on the Ministry of Agriculture, although responsibility for the Certificates remains with the Ministry of Health. Port Health Authorities will not be asked to apportion their administrative expenditure; all expenditure of this kind will continue to be grant-aided by the Ministry of Health and should be included in claims on that Department® VII® FOOD INSPECTION. 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 1,917 tons 18 cwts 2 qrs 14 lbs® 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 49 4 1 7 2.6 Re-export 133 8 3 1 6.9 Other Districts 130 1 2 18 6.8 Cattle Food 963 14 2 15 50.2 Burnt 106 0 3 26 5.5 Buried 306 15 1 1 15.9 Refining 167 11 2 24 8.7 Reconditioning 60 9 1 12 3.1 Industrial - 11 3 22 0.3 1,917 18 2 14 100.0 (23) Of the 1,917 tons mentioned, above, the principal items condemned for human consumption consisted of- Boiling Down- Quantity of carcases of sheep and lamb, pieces of beef, pork, veal etc., (dock water damaged, brine stained, soft and decomposed, mutilated, dirty and moulds). 90 cases and 27 tins ham (blown). Re-export - 166 cases Hams, 522 cartons stewed steak, 6 casks pig rinds, 10 barrels beef middles, 399 drums hog grease (uncertificated). 500 cases canned cherries (excess of preservative). 40 cases sauce (excess of lead). Other Districts- Rejected ship's stores (weevilly and out of condition) released under supervision of the local Medical Officers of Health. Cattle Food - 52 loads bananas (wasting), 150 bags coconuts (wasting), 540 bags potatoes (wasting), 679 sacks wheat and grain (wet damaged 676 bags beans (wet damaged), 22 tons and 1,472 cases dates (sea water damaged), 144 bags flour - ship's stores (out of condition), 401 cases canned fruits (burst, blown and leaky), 860 cases candied peel (dirty and perished), 260 barrels mincemeat (dirty and rancid) 278 cases marzipan bars (rancid). Burnt - 118 cases fondant (dock water damaged), 200 cartons crystallised fruit (soft and. wet damaged), 150 cartons crystallised fruit (fermented), 253 bags coconuts and nuts (maggoty, dirty and sweeping 890 cases and 993 tins meats (burst, blown and leaky), 6 tons 15 cwts fish (contaminated with lead acetate), 245 cases currants and sultanas (wet damaged), 55 crates rabbits (decomposed) 14 tons loose collected fruit (dock water damaged), 188 cartons fruit paste (contaminated with extraneous matter). Buried - 37 tons bananas, 85 tons onions, 160 crates carrots, 34 tons tomatoes, 4 tons oranges (decomposed), 138 cartons, 190 cases and 3,237 tins and a quantity of tins loose collected fruit and fruit pulp (burst, blown and leaky), 25 barrels fruit (dirty and fermente 125 cases and 151 tins meat (burst, blown and leaky), 31 cases salad cream (burst, blown and leaky), 256 cartons salad cream (sour and solidified), 57 bags wheat (oil damaged). Refining - 1,694 bags sugar sweepings (dirty). Reconditioning- 70 bags sweet almonds, 378 cases currants, 159 cases sultanas, 327 cases fondant (wet damaged), 124 bags haricot beans (oil damaged), 309 bags almonds (contaminated with extraneous matter). Industrial - 2 chests tea (wet damaged). imports of canned meat and meat products. The change in the Government's rationing policy that began in 1946 and has progressively increased since then, whereby the public has been permitted to supplement their fresh and frozen rationed meat by, in the first place meat and meat products "on points" and later by a large variety of meat and meat products either cooked or canned "off points", has resulted in a vast increase in the last two years in the sale and consumption of canned meat and meat products. These products in the earlier days of off-ration foodstuffs generally took the form of chopped meat of all kinds or of stews or soups but the scope and variety has greatly widened particularly by the inclusion of cooked pork flesh in various forms ranging from canned, hams (sold only over the counter) to canned, pork cuts. This situation created an enormous demand for this type of canned foods - a demand -which could not be met physically other than by large purchases from hard, currency areas such as the United States and the meat exporting countries of South America. Certain European Continental soft currency countries were quick to appreciate the great potentialities of this market with the result that a large number of small butchering concerns and packing houses converted their small local trade into an exporting business for the United Kingdom market. Many of these packing houses had suffered severely from war conditions their machinery was either out of date or worn out - and was, in any case, not suits for the canning and processing of meat and meat products which require conditions more severe than those for the packing of fruit, vegetables or simple meat soups. Furthermore the supervision of the slaughter houses and of the packing houses IBs not always sufficiently thorough nor of the standard which we would expect in this country or require from the great packing houses in the United States and South America (24) A number of Continental packing houses some of which it is true had for some years been engaged in canning meat for the home market, greatly increased their output for export, regardless of the fact that their curing methods resulted in a satisfactory product for the home market for early consumption but would not stand up to the severe test of damage in transit, of high temperature and a long delay before final retail distribution and consumption. Packing machines intended for the packing of fruit and vegetables were turned over to the much more severe requirements of meat packing and could not stand up to these requirements. Two other factors also had played their part - first, the packing houses could only obtain a tin plate from British sources that -was of too thin a gauge for meat packing and, secondly, the containers were intended for use for metric weights whereas the Board of Trade licence referred to avoirdupois weights. This resulted very frequently in the over filling of cans without any head space and these cans often gave all the appearances of blowing. It must be said that the quality of much of the Continental canned meat and canned meat products was considerably below that to which the British consumer was accustomed. A good proportion of these goods were handled by small agencies in the United Kingdom without much, if any, knowledge or experience in the trade, which literally sprang up overnight and were devoid of any sound financial backing. The rejection of an unsound consignment was often, therefore, a disaster and it would appear that in a number of instances the underwriters were badly bitten. It must be confessed that there was big money in this young and in many -ways undesirable industry and there is no doubt that huge profits have been made. It is a situation which will probably continue so long as and until the carcase meat ration can be increased. Meanwhile great quantities of good food has had to be destroyed owing to defective processing and canning. PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS 1957 and 1948. OFFICIAL CERTIFICATES. During the year a number of Circulars were issued by the Ministry of Food, each of which directed that the Minister of Food had caused to be published in the London Gazette a Notice containing in the Schedule thereto, the description of a label or stamp issued by various countries which had been recognised as Official Certificates 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 thereto as showing (a) that the meat to which it relates or the meat from which the meat product to which it relates was prepared, 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 or meat product. The Certificate being in the form of a label or stamp, recognition will apply if the label is securely affixed to, or the stamp is clearly impressed on, the package containing the meat or meat product and the label or stamp has not in any other circumstances or on any other occasion been used as an Official Certificate" The following is a list of the Circulars issued:- Circular MF 3/51 dated 13th February, 1951 - Federal Republic of Austria. MF 6/51 "17th March "- Government of Cyprus. MF 12/51 "21st June "- Republic of Portugal. "MF 15/51 "2nd August "- Grand Duchy of Luxemburg. "MF 16/51 "29th" "- Republic of Italy. "MF 23/51 "21st December "- Government of Tanganyika. Circular MF 22/51, dated 17th December, 1951 directs that the Minister of Food has caused to be published in the London Gazette a Notice revoking (25) the Official Certificates which were recognised for the purposes of the above-named Regulations, for the importation of meat and meat products into England and Wales as notified in Circular 1639 (6th August, 1937) and Circular 1675 (15th March, 1938), in respect of the following Kingdom of Bulgaria. Republic of Estonia. " " Latvia. " " Lithuania. Free City of Danzig. DANGEROUS DRUGS. During the year thirty-three 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 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 18th January, 1952, 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, 1951. Twenty-seven vessels were inspected during the year of which twenty were found to conform with the Regulations. The remaining seven infringed the Regulations in respect of absence of certificate, marking, cleanliness and dilapidation. In each case the owners attention was called to the infringement and all were subsequently attended to. No new boats were registered during the year under review, the actual number of Canal Boats on the Register on the 31st December, 1951, being 156. PARROTS (PROHIBITION OF IMPORT) REGULATIONS 1930. The number of notices issued in accordance with the above-mentioned Regulations during the year was 67 in respect of 76 birds of the parrot family. Sixty-six birds were re-exported and 9 were destroyed under the supervision of your Officers. In addition 6 birds were admitted under Ministry of Health permits and 10 birds, destined for the Dublin Zoo were placed in quarantine at the London Zoo until arrangements could be made for their shipment to Dublin. An attempt was made to import illegally 6 birds and the action taken is reported elsewhere under "Legal Proceedings". PARROTS (PROHIBITION OF IMPORT) (REVOCATION) REGULATIONS, 1951. A Statutory Instrument, 1951 No.2275, was made by the Minister of Health on the 20th December, 1951 and may be cited as above, and shall come into operation on the 8th January, 1952. These Regulations revoke the Parrots (Prohibition of Import) Regulations 1930 and a Circular from the Ministry of Health accompanying the Regulations, reads as follows:- (26) "l. 1 am directed by the Minister of Health to say that he has been considering the need for retaining these Regulations -which were made following a world-wide outbreak of psittacosis among birds of the parrot species. 2. It was believed at the time that the only birds in which the disease occurred -were of that specie , but research has since shown that it also occurs in other birds such as seagulls, pigeons, ducks, turkeys, etc., and is understood to exist in an enzootic form among birds in this country at the present time. 3. The Minister is advised that there is no reason on health grounds for maintaining the ban against the import of parrots and he has accordingly made the enclosed Statutory Instrument revoking the Regulations of 1930 with effect from the 8th January, 1952". LEGAL PROCEEDINGS. On the 4th July, 1951, a Police Officer saw two men about to climb the boundary fence at the Royal Albert Dock. On seeing the constable the men ran away but one of them who was carrying a suitcase, was apprehended. The suitcase was opened and found to contain six live green parrots. It was ascertained that the man apprehended was a merchant seaman and after extensive enquiries by the police, two other members of the crew of his ship admitted that they had attempted to import six live parrots for the purpose of sale. On the 6th July, 1951, a successful application was made to the Magistrates sitting at East Ham Magistrates Court for summonses against the three men concerned, alleging that they had imported the parrots into Great Britain in contravention of Regulation 4 of the Parrots (Prohibition of Import) Regulations 1930 and the summonses were made returnable on the 10th July, 1.951. On the 10th July, 1951, the Assistant Solicitor to the Corporation appeared to prosecute the three defendants, who were not represented, and pleaded guilty to the summonses. After the facts had been fully stated the Magistrate fined the defendants £10, £15 and £20 and in addition ordered them to pay £1.1.0, £1.11.6 and £1.11.6 respectively towards the costs of the prosecution. SHELLFISH IN THE THAMES ESTUARY. The Port Medical Officer is indebted to Mr. D.E. Made ley, the Port Sanitary Inspector in charge of the application of the Shellfish Regulations, for the following notes relating to the cockle industry at Leigh-on-Sea:- During the year the close supervision of the cockle industry has been maintained. Approval under the Public Health (Shellfish) Regulations, 1934 was withdrawn in the case of one firm® This firm has ceased to gather shellfish in the Estuary and has dismantled all the cooking apparatus. The industry is now in the hands of nine firms, eight of whom are at Leighon-Sea and one at Southend-on-Sea. The firms actively engaged in the industry have modified their apparatus in accordance with the Port Health Authority's requirements. despite considerable delay in obtaining delivery of new apparatus or replacements for old apparatus. To quote only one instance. One Establishment had the misfortune to develop a boiler defect in July. Temporary and as is transpired, ineffective repairs were carried out and eventually a new boiler was ordered in August. It had not been delivered up to December 1951. (in fact it arrived in April 1952). The remarkable standard of cleanliness and upkeep which has always been a feature of the cockle-boats has been fully maintained. In the Establishments ashore, considerable improvements have been made to the cooking and washing apparatus, and to the structure of some of the Establishments themselves. Each Establishment has now a reducing valve so that steam can be admitted to the cooking pots at a prearranged and controlled pressure, which makes for steady (27) and comparatively slow cookings This was advocated as the result of experiments conducted and reported upon during 1950. Cockles so cooked are of a good firm texture. They present a far better appearance than formerly and they stand up well to brining. Each establishment has a steam hose which is used regularly to sterilize all equipment. All wooden apparatus has been eliminated. The 'Cockle Sheds' at Leigh-on-Sea have been in their present site for many years. There is at present no alternative site but the area leaves much to be desired. The whole water-front at Leigh is the subject of a Foreshore Improvement Scheme by the Southend-on-Sea County Borough Council, but with the present financial situation it is impossible to forecast when the scheme may be put into operation. There is, however, a prospect that by the removal of certain Establishments which are no longer active, space may become available for the expansion of the remainder on the present site. One such expansion is already taking place. The proprietor of this Establishment has purchased the building adjacent to his own and has rearranged his apparatus so that in one building he conducts the cooking, "washing and marketing of his shellfish while in the adjacent building he has his store room, boiler and fuel. The Port Health Authority and the Public Health Department of Southend have co-operated to produce a plan for this so that the apparatus has been re-grouped to give the best possible arrangement from the hygienic as well as the commercial stand-point. The responsibility of the Port Health Authority is governed by the Public Health (Shellfish) Regulations, 1934. Thus the Port Health Authority is responsible for the delineation of the ''Prescribed Area" from which shellfish may only be taken for sale for human consumption and only if they are dealt with in the manner prescribed in the Port Health Authority's Order made under the Regulations, and they are also responsible that the shellfish are cleansed and sterilized in accordance with the Order. In the case of cockles they must be "subjected to a process of sterilization by steam under pressure for at least six minutes in an apparatus which is for the time being approved by the said Port Health Authority." It is the responsibility of the Borough of Southend as the Pood and Drugs Authority to ensure that the shellfish are marketed in a clean and hygienic manner. In practice the Inspectors of the two Authorities co-operate at the Cockle Establishments in the closest possible manner and constitute themselves 'advisers in hygiene' to the Industry. They have gained the confidence of the Industry to a marked degree and from this has arisen a notable improvement in the hygiene of all processes. Systematic sampling has been carried out throughout the year by the Borough of Southend and the bacteriological examinations have been carried out at the Public Health Laboratories at Southends, Results have been forwarded regularly to the Port Health Authority. Special acknowledgement is made of the co-operation in this matter which has been afforded by Dr.Logan, Medical Officer of Health for Southend and Dr.Pilsworth, the Director of the Public Health Laboratories at Southend. During the year the condition of the cockles has not given cause for any anxiety but it is notable that the bacterial condition deteriorated this year in the early summer with the advent of warmer weather in a manner very similar to that noted in the previous year. There appears to be a connection between the curve of bacterial content and the curve of tap water temperature. Tap water is used for washing the cockles and in mid-summer its temperature ms observed to be as high as 68°F. Investigation of this problem will be continued. On the question of food poisoning from cockles it is possible to give some reassurance. With a satisfactory cooking process the danger from cockles, including those derived from a "prescribed area", does not lie so much in the risk of the contraction of typhoid fever or any other specific organism harmful to humans so much as in the very rapid growth of organisms only mildly harmful in themselves, to a point where the consumer receives a massive dose of such organisms and their toxic products sufficient to cause gastro-intestinal disturbance. Most cases of food poisoning, especially with cockles, are of this kind and seldom produce symptoms more alarming than diarrhoea and perhaps vomiting, though these can be severe and most unpleasant. (28) Mussels are present in the Estuary but are not gathered to anything like the same extent as cockles. Mussels when cooked are so soft that their transport over long distances would be quite difficult. This, added to the operation of the Shellfish Regulations which does not permit the sale of local mussels unless cooked in an apparatus approved by the Port Health Authority, has the effect of limiting the mussel "business to a strictly local market. Samples are taken periodically for bacteriological examination. The Oyster trade in the River Roach and its contributary creeks is again making headway after a long period of stagnation The Ministry of Agriculture and Fisheries have established an Experimental Station at Burnham on Crouch to study the problems involved. There is no restriction upon the area in which the oyster beds are situated, sampling of the water having revealed nothing -which would constitute a danger to the public health. One firm operating in the area has specialised in the import of Portuguese oysters for re-laying and fattening. Portuguese oysters are a completely different variety from the Native oysters. They are especially suitable for the summer trade for which Southend provides a valuable market, as they do not "go sick", that is they do not start to breed until the water temperature is at least 69°F, It is because Native oysters "go sick" in simmer that it has become accepted that oysters are only in season -when there is an "R" in the month. SAMPLING 1950. SOURCE OF SAMPLE WHOLE PERIOD 9th Febs1950 - 3rd Jan:1951. SIMMER ONLY. June,July.August,September. Total Samples Good and Very Good Fair and Moderate Poor and Very Poor Total Samples Good and Very Good Fair and Moderate Poor and Very Poor. % % % % % % A. 40 19 48 11 27 10 25 17 1 6 8 42 8 42 B. 19 13 58 5 26 1 6 12 6 50 5 42 1 8 C. 34 17 50 10 30 7 20 16 3 19 7 44 6 37 D. 33 15 45 12 37 6 18 17 4 24 7 41 6 35 E. 40 11 28 12 30 17 42 17 1 6 5 29 11 65 F. 29 11 38 7 24 11 38 14 1 7 3 22 10 73 G. 40 2 5 9 22 29 73 17 1 6 3 18 13 76 H. 35 10 29 14 40 11 31 17 2 12 6 36 9 52 J. 35 11 31 20 57 4 12 17 1 6 13 76 3 18 K. 26 14 54 7 27 5 19 14 3 22 6 43 5 35 Totals 331 123 37 107 35 101 30 158 23 14 63 40 72 46 SAMPLING 1951. SOURCE OF SAMPLE WHOLE PERIOD SUMMER ONLY. June,July,August,September. Total Samples Provisional Grading No of Samples From Which Bacteria Were Isolated Total Samples Provisional Grading No of Samples From Which Bacteria Were Isolated Satis- Factory Unsatis- factory None Isolanted. Staph- Aureus. Clostri- Dium Welch 11 Bacterium Coli Salmon- Ella Saris- Factory. Unsatis- Factory. None Isolated Staph- Aureus Clostri- Dium Welch 11 Bacterium Coli. Salmon- Ella. % % % % A. 49 40 81.6 9 18.4 24 - 19 9 - 16 8 50.0 6 50.0 9 - 2 6 - B. 49 36 73.4 13 26.6 25 - 20 9 - 1 6 37.5 10 62.5 10 - 2 5 - C. 30 26 86.7 4 13.3 9 - 21 2 - 1 1 90 0 3 20.0 6 - 9 2 - D. 38 8.6 8 17.4 24 1 17 4 - 17 3 53.0 8 47.0 11 1 3 2 - E. 45 36 80.0 9 20.0 28 - 12 5 - 16 8 50.0 8 50.0 10 - 3 3 ' F. 47 32 68.0 15 32.0 26 - 17 6 - 16 7 44.0 9 56.0 12 - 2 3 - G. 43 27 62.8 16 372 14 - 23 15 - 16 6 37.5 10 62.5 4 - 8 7 - H 49 35 71.4 14 28.6 18 1 19 21 - 16 4 25.0 12 75.0 8 1 2 7 - J. 48 37 77.0 11 23.0 25 - 21 6 . 16 7 44.0 9 56.0 9 - 7 2 - K. 45 37 82.2 8 17.8 23 - 13 14 - 151 9 60.0 6 40.0 5 - 3 7 - Total 451 344 76.2 107 23.7 216 2 182 931 159 76 47.8 83 52.2 84 2 41 44 % % % % - % % % % % - 48 0.44 40.5 20.6 47.8 53.0 1.25 25.7 27.6 (29) LEGISLATION, THE HYDROGEN CYANIDE (FUMIGATION OF BUILDINGS) REGULATIONS 1951. These Regulations make detailed provision as to the precautions to be taken in carrying out the fumigation of buildings, and replace the Hydrogen Cyanide (Fumigation of Buildings) Regulations, 1938, which are revoked. The principal additions of substance are that the operator is required to sign and give to the occupier before beginning a fumigation, a statement relating to the requirements of the Regulations as to the exclusion of unauthorised persons and other precautionary measures and, after the fumigation is completed, a certificate that all the requirements as to ventilation and other safety measures have been complied with. In addition detailed provision is made with regard to the composition of, and containers for, the fumigant, the precautions to be taken in,transferring the fumigant from one container to another and the protective apparatus and first-aid equipment to be provided. These Regulations come into force on the 1st February, 1952. THE HYDROGEN CYANIDE (FUMIGATION OF SHIPS) REGULATIONS 1951. These Regulations make detailed provision as to the precautions to be taken in carrying out the fumigation of ships. Notice of a forthcoming fumigation must be given to certain persons, including the Medical Officer of Health, the members of a fumigation staff are required to be adequately trained and equipped with protective apparatus. No unauthorised person may enter the area of risk until It has been established by tests that no danger remains, but provision is made, with the necessary safeguards, for the entry of members of the crew for starting ventilating fans where necessary, and for the entry of persons authorised by the owner or charterer to remove certain articles which may have absorbed the fumigant. Special provision is made with regard to the fumigation of foodstuffs. A person undertaking fumigations is required to keep a register in which reports containing certain particulars of each fumigation must be entered. These Regulations come into force on the 1st February, 1952. In the application of both these Regulations the Officers of the Port Health Authority are not responsible for the proper application of the safety precautions; the responsibility lies with the operating company, the ship owner or agent or other persons. The Port Medical Officer's duty is restricted to ensuring that the fumigation is properly carried out and warrants the issue of a deratting certificate. Nevertheless, the Port Medical Officer has instructed all sanitary inspectors charged with the supervision of a fumigation that they must be satisfied that the safety precautions are fully observed and should this be found not to be the case they should draw the attention of the responsible persons to the matter and should refuse to attend the operation until the requirements laid down are properly observed. THE PUBLIC HEALTH (LEPROSY) REGULATIONS, 1951. These Regulations require a medical practitioner who is attending, or called in to visit a person suffering from leprosy, to notify the Chief Medical Officer of the Ministry of Health of the case by sending him a certificate in the form set out in the Schedule to the Regulations. THE PUERPERAL PYREXIA REGULATIONS, 1951. These Regulations replace regulations which have been in force in London and the remainder of the country respectively. They continue the effect of those regulations making puerperal pyrexia a notifiable disease, with slight modifications, including a revised definition of puerperal pyrexia which the administration of the replaced regulations has shown to be necessary. (30) THE FERTILISERS AND FEEDING- STUFFS (AMENDMENT) REGULATIONS, 1951. The Fertilisers and Feeding Stuffs Act, 1926, provides that a Vendor of any article sold for use as food for cattle or poultry shall, if the article is included in the Second Schedule to the Act, give to the Purchaser a -written statement containing prescribed particulars of the nature, substance or quality of the article. It also provides that, if the article is sold by a name specified in the Fourth Schedule, there shall be a Warranty that the article accords with the definition contained in the Schedule. Because of the recent development in the drying of grass, various forms of the dried grass are now an important animal feeding stuff® These Regulations apply the provisions of the Fertilisers and Feeding Stuffs Act, 1926, to dried grass so that a Purchaser may now obtain particulars of the quality of the article he purchases, and, if the dried grass is sold under certain specified descriptions, a Warranty that it accords with the defintion set out in the Regulations. VISIT OF FOREIGN MEDICAL OFFICERS TO THE PORT OF LONDON - APRIL 23rd to 28th INCLUSIVE, The folio-wing is a detailed report of the itinerary covered by Medical Officers and other Port Health Administrators during the course of Port Health and Sanitary Control arranged under the auspices of the British Council. LIST OF DELEGATES. Hollands Dr. A.L. Noordam Medical Officer, Health Department, Municipality of Amsterdam., Dr. J.W. Tesch Department of Communicable Diseases, Municipal Health Service, Rotterdam. Portugal. Dr. S. Raposo Medical Officer of Health, Port of Lisbon. Italy. Dr. V. Mile11a Public Health Officer, Rome. Dr. N. Iliceto do. Naples. Belgium. Dr.I.E.M.J.Amerlinck Medical Inspector of Health, Maritime Sanitary Services. Mr. J. H. Hoeck Port Health Inspector, Antwerp. France. Dr. J. R. Cevaer Department of Hygiene and Health, Ministry of Merchant Marine, Paris. British Mr. D. Singh Senior Government Sanitary Inspector. Guiana. Wormy. Commander T.Jacobsen Harbour Master and Port Manager, Kristiansand. Monday, 23rd April; 1951. In the absence abroad of the Port Medical Officer the Delegates were received by Dr. C.F. White in the Conference Room at the Port Health Office, Guildhall. Dr. White, after welcoming the Delegates, gave a preliminary talk on the formation and activities of Port Health Authorities dealing briefly with each of these activities, following which he answered questions put by the Delegates. The party then proceeded to Guildhall House where they were received by the Chairman and other Members of the Port Health Committee, and were entertained to Luncheon® Following the Luncheon a brief speech of welcome was delivered by Major Vine. The party then proceeded to Tower Pier where they embarked on board the Howard Deighton", proceeded down River and entered the Royal Docks, cruised round the Docks, every berth of which was occupied, and finally returned to Tower Pier. The party was accompanied by Mr. 2. T. Malone from the Chief Information Office, Port of London Authority, who gave a "running commentary'1 on places of interest and general information regarding the River and Docks throughout the journey. Tuesday, 24th April, 1951. The Delegates proceeded by coach to the West India Dock where they were received and welcomed by the Dock Superintendent, Mr. E. A. Lewis. (31) Mr. Dring, the Port Health Inspector for the area, first conducted the party to the Port of London Authority Industrial Canteen were the Manager, after shewing them round the Canteen, explained the experiment which was being carried out in this Dock area, whereby one member from a "gang" of ship workers collected, in special containers provided by the P.L.A., the food and drink requirements of his "gang" and conveyed them to the ship, as opposed to the former practice of the men leaving the ship to visit either cafes in the vicinity or the P.L.A. Mobile Canteens. This arrangement was becoming increasingly popular and saved a lot of "man hours". The party then proceeded to a shed where another experiment was being carried out, namely, the opportunity for dock workers to arrive at the Docks in their normal everyday clothing and then change into clothing suitable for their work on the Docks. Similarly at the end of the working day they could return to the shed, wash and, if so inclined, take a shower bath, before donning their everyday clothing and proceeding home. This too was gradually becoming more and more popular, particularly with dockers handling dirty cargoes. While in this shed, Mr. Dring went very fully into the reasons for and the methods adopted in the examination of vessels for the issue of Deratisation and Deratisation Exemption Certificates and the methods of trapping, poisoning etc., in vessels and shore premises in his area. The party then proceeded to the s.s. "Ashanti Palm". This vessel's certificate had just expired and the vessel was going to be examined by the Rodent Officers to determine the type of certificate to be issued. After a further talk on board the ship, each of the Delegates was given a Rodent Officer's Report Form, and accompanied by a Rodent Officer, half proceeded to Nos. 1 & 2 Holds and the other half to Nos. 3 & 4 Holds, which they themselves examined for rat evidence, harbourage, etc., recording on the report forms provided their findings in each hold. They then returned to the saloon where the two parties made known their findings and were unanimous in deciding that on the evidence seen in the holds, this vessel should be fumigated and a Deratisation Certificate issued. This decision was confirmed by Mr. Dring and the Rodent Officers. After lunch in a P.L.A. Industrial Canteen, the party proceeded to Eastern Granary, Millwall Dock. In this Warehouse a "1080" operation was being carried out. The day previous to the visit a number of poison points had been laid on each of the six floors of the warehouse. The party entered the top floor of the warehouse and worked downwards making a superficial search for rats, i.e., without removing any of the piles of bagged grain. Twenty-seven dead rats were picked up. The party then saw the arrangements that had been made for tunnelling and baiting with "1080" the stacks of grain stored in the open on the dock quays, after which they saw and discussed a pre-baiting operation, using Zinc Phosphide, in a warehouse on the Millwall Dock. Wednesday, 25th April, 1951. The Delegates proceeded to Gravesend where they were met by Dr. Willoughby and proceeded via the m.l. "ALFRED ROACH" to the Isolation Hospital at Denton. During the trip and while at the Hospital Dr. Willoughby explained in detail the boarding and medical inspection of vessels arriving from 'foreign' for the prevention of the importation of infectious diseases, with special reference to plague and smallpox, and the issuing of 'free pratique'. The party visited the Hospital, inspecting the Cubicle Block, Smallpox Block, Disinfecting Station and Washington Lyons apparatus and the Sewage Plant, On the way back to Gravesend the attention of the party was called to the Tilbury Landing Stage and Customs Baggage Warehouse and Dr. Willoughby explained the facilities available and the action taken in the medical inspection of Aliens. The party lunched at the Royal Clarendon Hotel and since the majority wished to visit their Banks to change Travellers cheques the remainder of the day was placed at their disposal. (32) Thursday, 26th Aprils 1951. The Delegates proceeded by Coach to the Royal Docks, first visiting Wo. 6 Gold Store in the Royal Albert Dock and then proceeding to Swift's Cutting Store in the Royal Victoria Dock where Mr. Coombe gave them a talk on the importation and inspection of meat and canned foods, demonstrating his talk with samples. The Delegates were extremely interested and at the request of a number of them a copy of Mr. Coombe's notes on his talk, together with a paper he had prepared on the inspection of canned foods, was circularised to each Delegate. The party had luncheon in the Industrial Canteen on the Dock and afterwards boarded the s.s. "PORT VICTOR" and the s.s. "SINGAPORE" (the latest P & 0. passenger-cum-cargo vessel) where Mr. Tope and Mr. Aiken conducted them round the ships on an inspection of crew and passenger accommodation. Friday, 27th April, 1951. The Delegates proceeded by Coach to the South Dock, Surrey Commercial Dock where Mr. Gray conducted them over one of the modern rat-proof warehouses, calling their attention to the various features of the warehouse which made it such. While there, and quite incidentally, they saw a consignment of canned South African fruit being made 'full and sound' (burst, blown and leaky tins). From the Surrey Docks the party went to the London Dock -where, simply as a "showpiece", Mr. Johnson arranged a visit to the Crescent Wine Vaults. Then followed a visit to the still incomplete Canteen which the P.L.A. are erecting at a cost of £70,000. Although not yet completed, this canteen shows a number of novel features and when completed will undoubtedly be the finest of its kind in London, if not in the whole of the United Kingdom. After lunch in the Restaurant of Ibex House, the party proceeded by Coach to No. 3 Berth, King George V.Dock where the Royal Mail Lines, through the good offices of Captain Spridell, the Chief Marine Superintendent, had placed at our disposal the s.s. "HIGHLAND CHIEFTAIN" for a demonstration of H.C.N, fumigation for the issue of an International Certificate. The operation was in the hands of Mr. Potter of Messrs. Associated Fumigators Ltd., and the party was shown the preparation of the ship, the liberation of the gas (using water) and the subsequent testing of the spaces for residual pockets of gas after clearance. In addition, Mr. Potter gave a practical demonstration in a storeroom on the after end of the ship of the various methods used by his firm in disinsectisation, e.g. Kerosene+ 5% D.D.T+ 0.5% Pyrethrum solution emitted through a pressure spray and D.D.T. and Gammexane generators. In addition each Delegate was given a copy of Mr. Mackie's notes on "H.C.N Fumigation of Ships". Saturday, 28th April, 1951. The Delegates assembled in the Conference Room at 5, Church Passage. All the Inspectorial Staff who had been engaged during the week were present and Dr. Willoughby took the Chair. Dr. Willoughby gave a brief resume of the week's activities and then invited the Delegates to ask questions. At the conclusion of the meeting, Dr. Willoughby expressed on behalf of the Port Health Committee the pleasure it had been in meeting such distinguished visitors and the hope that the visit had been both interesting and instructive. Mr. Powells replied on behalf of the British Council and Dr. Tesch of Holland on behalf of the Delegates. (33) APPENDIX I MEDICAL INSPECTION - From 1st January to 31st Decembers 1951. GRAVESEND. Jan Feb Mch Apl May Jne Jly Aug Sep Oct Nov Dec Total No .MedicallyInspected. 139 136 145 137 161 164 204 195 176 156 124 143 1,88 No.of Passengers. 1103 650 1221 2338 2844 4884 6318 6270 4670 1818 802 814 33,731 No. of Crew. 502 443 458 727 948 326 595 1065 826 750 511 336 7,488 No. of Foreign Arrivals. 825 811 893 927 961 910 1002 988 886 932 796 830 10,761 APPENDIX II INFECTIOUS DISEASES DISEASE 1942 1943 1944 1945 1946 1947 1948 1949 1950 Mean Annual He for 10 years ending 31st December,1951 (a) Cases Reported- CH0LERA (including suspected cases) - - - - - - - - - - PLAGUE do. - - - - - - - - - - YELLOW FEVER do. - - - - - - - - - - TYPHUS FEVER - - - 1 - - 1 5 - 0.7 SMALLPOX 1 - 1 - 5 2 3 2 4 2.4 SCARLET FEVER 2 5 4 5 2 10 3 3 7 4.4 ENTERIC FEVER 1 - - 4 9 5 10 82 9 12.7 MEASLES 1 1 1 8 11 26 99 80 58 35.9 GERMAN MEASLES 2 1 - 2 6 5 3 3 17 10.6 DIPHTHERIA 5 3 5 5 8 5 2 1 - 3.4 ERYSIPELAS - - - - - - 1 - 1 0.2 PULMONARY TUBERCULOSIS 5 12 6 14 21 27 32 43 41 25.4 OTHER DISEASES (including CHICKENP0X) 179 273 180 115 79 102 106 124 114 140.2 Totals 196 295 197 154 141 183 259 343 251 235.9 (b) Admitted to Hospital- CHOLERA (including suspected cases) - - - - - - - - - - YELLOW FEVER do. - - - - - - - - - - PLAGUE do. - - - - - - - - - - TYPHUS FEVER - - - - - - 1 3 - 0.4 SMALLPOX - - - - - - - - - - SCARLET FEVER 2 5 4 4 2 - 3 - - 2.1 DIPHTHERIA 5 2 4 5 7 4 2 - - 3.0 ENTERIC FEVER 1 - - 3 - 2 3 - 6 1.5 MEASLES 1 — 1 4 6 10 24 8 5 7.1 PROTITIS - 2 3 1 5 1 4 3 1 3.3 DYSENTERY - - - 1 8 9 3 1 - 2.3 OTHER DISEASES (including CHICKENPOX) 15 16 34 50 43 60 80 34 56 42.3 Totals 24 25 46 68 71 86 120 49 68 62.0 APPENDIX III DENTON HOSPITAL. Disease Admitted. Discharged. Transferred to other Hospitals Died Remaining Hospital. CHICKENPOX 7 7 - - - MUMPS 13 13 - - - MEASLES 12 12 - - - SCARLET FEVER 1 1 - - - GERMAN MEASLES 7 7 - - - DIPHTHERIA 1 1 - - - DYSENTERY 1 1 - - - OTHER DISEASES 21 21 - - - Totals 63 63 - - - Remaining in Hospital on 31st December,1950 Nil. Admitted during 1951 63. Discharged, Transferred or Died 63. (34) appendix iv. return of rats caught and destroyed during the year 1951. Jan Feb Mch Apl May Jne Jly Aug Sep Oct Nov Dec Total Jon dock - larehouses 86 46 75 61 99 60 54 159 136 96 95 40 1,007 lessels — - - - - 2 21 - - 10 - - 33 iatharine dock - larehouses 30 7 11 28 22 7 18 13 2 14 15 10 177 lessel — - - - - - - - - - - - - IeY COMMERCIAL Dk- ■arehouses 14 44 39 32 41 46 18 20 21 3 9 27 314 tassels 10 - - - - 2 79 62 - - 153 rindia dock - larehouses 22 41 39 37 63 70 5 29 6 33 50 135 530 lessels - - - 106 - ■= - - - - - - 106 f INDIA DOCK larehouses 147 65 107 171 336 53 144 203 128 116 87 62 1,619 Vessels 46 4 86 454 51 16 5 - 77 51 - 39 829 pall dock par ©houses Vessels 143 60 47 132 60 3 432 103 106 80 15 106 9 42 66 1,377 27 albert dock Warehouses 35 17 29 31 46 36 22 31 32 58 51 51 439 Vessels — 58 13 - 99 9 28 85 3 90 49 42 476 al victoria dock = Warehouses 26 38 80 46 63 31 42 53 69 98 60 55 661 Vessels — — 12 11 - 49 22 11 4 21 2 - 132 ggeorge V.DOCK - Warehouses 5 5 21 22 29 9 13 34 25 32 50 29 274 Vessels 126 4 50 14 3 - 8 25 - 13 - - 243 .BURY DOCK ~ Warehouses 21 25 16 25 34 34 26 41 48 58 48 66 442 Vessels 61 127 60 81 53 54 4 7 - 54 176 42 719 ent's canal dock - Warehouses 10 11 13 20 21 20 25 25 18 57 20 2 242 Vessels — — - - - - - - - 1 - 1 SR - Vessels — - - - - - - - - 10 - - 10 Totals 782 552 698 1271 1023 930 637 904 664 930 754 666 9,811 (35) APPENDIX V.. HYGIENE OF CREW SPACES. CLASSIFICATION OF NUISANCES 1951. British owned vessels. Foreign owned vessels, Smoke Nuisances:- No. of complaints received 27 - No. of recurrences reported 3 - Offensive Cargoes:- 3 - No. of infringements reported 6 - Structural and other Defects:- Inadequate ventilation 10 - Defective Lighting - Natural - - do. do. - Artificial 3 - Defective Heating 13 1 Condensation 16 - Leaking Decks 13 - Leaking-Ports, Decklights etc 17 1 Leaking Sideplates 2 - Leaking Hawse and Chain Pipes 2 - Deficient or Obstructed Floor drainage 6 - Water lodging on top of Peak Tanks 5 - Defective Bulkheads 3 do. Floors 1 - do. Doors 2 - do. Chain Pipes - - do. Bunks - - do. Clothes Lockers 4 - do. Food Lockers 6 - do. Food Storage 4 - do. Cooking Arrangements 2 - Defective or Uncleanly drinking water storage 1 - Water Closets Obsolete 4 - do. Defective 5 2 do. Foul or Choked 9 - do. Inadequate Flush 10 - Wash Basins Defective 6 - do. Foul 6 - Neglected Paintwork or Distemper 17 1 Absence of washrooms 2 - Absence of Messrooms 1 - Misappropriation of Crew Quarters 2 - Verminous quarters 35 2 Dirty quarters 756 87 Miscellaneous 24 - Totals 1,023 94 Total number of vessels on which sanitary defects were reported 871 92 Total number of vessels on which sanitary defects were remedied 851 92 (36) APPENDIX VI - General Summary and Analysis of the Sanitary Inspections etc., in the Port of London for the year ended 31st December, 1951. FOREIGN COASTWISE INLAND NAVIGATION Shore Premises Sick seamen referred to Hospital WATER BARGES Steam Sail Steam Sail Steam Sail Unin: Ltrs. Canal Boats Inspected. Defective To be cleaned Inspected Defective To be cleaned Inspected Defective To be cleaned Inspected Defective To be cleaned Inspected Defective To be cle ane d Inspected Defective To be cleaned Inspected Defective To be cleaned Inspected Defective To be cleaned Inspected De fe ctive To be cleaned No. in district 1n. good condition on 31s£ December,1950. New Barges Condemned Use discontinued Previously withdrawn and since resumed work. No.in district on 31st December 1951. 17,847 178 696 11 2,070 46 142 38 1 5 26 - 4 6 - - 457 2 26 27 4 | 3 8,159 51 166 101 13 - - - - 13 INSPECTIONS DOCKS AND RIVER No. NATIONALITIES No. American 115 TOTAL INSPECTIONS LONDON & ST.KATS. 855 Argentinian 33 1st January to 31st December, 1951:- Belgian 109 REGENT'S CANAL 337 Brazilian 5 British 6,798 Chilian 4 FOREIGN 7,858 SURREY COMMERCIAL 1,303 COASTWISE 2,108 Costa Rica 16 INLAND NAVIGATION 489 SHORE PREMISES 8,159 EAST INDIA 260 Danish 270 Dutch 994 Total 18,614 Finnish 156 WEST INDIA 677 French 102 German 346 Greek 69 MILLWALL 638 Honduras 9 NUMBER OF VESSELS Icelandic 12 ROYAL ALBERT 663 Indian 21 INSPECTED IN THE Israeli 15 LAUNCHES:- ROYAL VICTORIA 446 Italian 64 Liberian 11 "Alfred Roach" 1,705 Monrovian 1 "Howard Deighton") KING GEORGE V. 484 Pakistan 4 "Frederick Panamanian 90 Whittingham" 1,291 TILBURY 1,043 Polish 34 "Alfred Portuguese 7 Robertson" 753 RIVER- UPPER 1,291 Roumanian 3 3,749 Russian 47 Spanish 58 "MIDDLE 753 Swede and Norwegian 973 "LOWER) Swiss 1 Turkish 21 1,705 Uruguayan 1 RIVER MEDWAY Yugo Slavian 66 In Docks etc. 6,706 Total Vessels 10,455 Total Vessels 10,455 Shore Premises. 8,159 Shore Premises 8,1.59 Shore Premises 8,159 Total 18,614 Total 18,614 Total 18,614 (37) APPENDIX VII. DOCKS WITHIN THE JURISDICTION OF THE 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 Mill-wall 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 bet-ween the Western and Eastern limits of the Port is about 68½ miles. APPENDIX VIII. 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 THE 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, 1894 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 . (38) INFECTIOUS DISEASE. 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 Polimyelitis) Regulations, 1912. 18th August, 1912. S.R. & 0. 1918. No.67. Public Health (Notification of Infectious Diseases) Regulations, 1918. 19th January, 1918. 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.1232. The Port Health Amendment Regulations, 1945. 10th October, 1945. Statutory Instrument 1951, No.1036. The Public Health (Leprosy) Regulations, 1951. 22nd June, 1951. Statutory Instrument 1951, No.1081. The Puerperal Pyrexia Regulations, 1951. 1st August, 1951. CANAL BOATS. Public Health Act, 1936. FOOD. 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. 4 0. 1926 No.1577. ) (Preservatives,etc, in S.R. & 0. 1927 No.577. ) Food) Regulations, 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. Statutory Instrument No.404. The Food and Drugs (Whalemeat) Regulations, 1949. 20th March, 1949. Statutory Instrument No.189. The Food and Drugs (Whalemeat) (Amendment) Regulations, 1950. 6th February, 1950. SHELLFISH. S.R. & 0. 1934. No.1342. Public Health (Shellfish) Regulations, 1934. 7th December, 1934. S.R. & 0. 1935. No.1221. The Medway (Shellfish) Regulations, 1935. 11th December, 1935. RATS AND MICE. Prevention of Damage by Pests Act, 1949. Statutory Instrument 1951. No.967. Prevention of Damage by Pests (Application to Shipping) Order, 1951. 1st October, 1951. (59) RATS AND MICE (Contd.) Statutory Instrument 1951. No.1759. The Hydrogen Cyanide (Fumigation of Buildings) Regulations, 1951. 1st February, 1.952, Statutory Instrument 1951. No.1760. The Hydrogen Cyanide (Fumigation of Ships) Regulations, 1951. 1st February, 1952, 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. 1928. No.439. Order appointing 1st July 1928 as the date for the coming into operation of the Fertilisers and Feeding Stuffs Act, 1926. 30th May, 1928. S.R. & 0. 1932. No.658. Fertilisers and Feeding Stuffs Regulations, 1932. 11th August, 1932. Statutory Instrument 1951. No.1189. Fertilisers and Feeding Stuffs (Amendment) Regulations, 1951. 1st August, 1951. DANGEROUS DRUGS. S.R. & 0. 1923. No.1095. Dangerous Drugs (No.3) Regulations, 1923. 10th September, 1923, ALIENS. S.R. & 0. 1920. No.448. The Aliens Order, 1920. AIRCRAFT. S.R. & 0. 1950. No.6. Public Health (Aircraft) Regulations, 1950. 3rd January, 1950. IMPORTATION OF CATTLE. 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, 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 nuisance 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. (40)