2nd why ACK'D 7754 PLON 61 109 PORT OF LONDON HEALTH AUTHORITY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To 31st DECEMBER, 1953 109 PORT OF LONDON HEALTH COMMITTEE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (MONTAGU TRAVERS MORGAN, C.M.G., M.C., M.D., Ch.B., D.P.H.) To 31st December, 1953 Port of London Health Authority 5, Church Passage, Guildhall, E.C.2. Telegraphic Address: "Portelth London." Telephone Number : MONarch 3030. LIMITS OF THE PORT OF LONDON. The limits of the Port of London as at present defined commence at high-water mark in the River Thames at Teddington Lock, in the County of Surrey, and extend down both sides of the River Thames to an imaginary straight line drawn from the pilot mark at the entrance of Havengore Creek, in the County of Essex, to the Land's End at Warden Point, in the Isle of Sheppey, in the County of Kent, such point being the north-western limit of the Port of Faversham, and extend up and include both sides of the River Medway to an imaginary straight line drawn from the south-east point of land westward of Coalmouth Creek, thence across the said River Medway to the 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 Iwade Church, being the western limit of the Port of Faversham, and the said Port of London includes the Islands of Havengore Creek aforesaid, called Potton and Rushley Islands, and so much of the said Creek and Watercourse as extends from it to the Town of Rochford, and also includes all other Islands, Rivers, Streams, Creeks, Waters, Watercourses, Channels, Harbours, Docks and places within the before-mentioned limits contained. SECTION I—STAFF. TABLE A. Name of Officer. Nature of Appointment. Date of Appointment. Qualifications. Any other Appointment held. M. T. Morgan, C.M.G., M.C. Medical Officer of Health September, 1938 M.D., Ch.B., D.P.H. Medical Inspector of Aliens. Medical Adviser, Ministry of Transport. H. M. wllloughby, V.R.D., R.N.V.R. Deputy Medical Officer of Health and Medical Officer in Charge at Denton Hospital. March, 1939 M.R.C.S., L.R.C.P., D.P.H., D.T.M. & H. Medical Inspector of Aliens. J. A. Jones Assistant Port Medical Officer. April, 1935 M.B., Ch.B., D.P.H. ditto. R. D. McLean ditto. October, 1953 M.R.C.S., L.R.C.P., D.T.M. & H. ditto. H. A. Mad war Assistant Port Medical Officer Sheerness (Temporary Part time). December, 1927 L.R.C.P., L.R.F.P.S. - CLERICAL. J. A. Gillis000 Senior Clerk July, 1951 — — W. L. McLorg Assistant Senior Clerk July, 1951 — — R. C. Ratliff First Class Assistant Clerk. July, 1951 — — E. V. Smith Secretary to Medical Officer of Health. July, 1951 — — (Vacant) Clerical Officer — — — R. H. Lott General Grade Clerk May, 1947 — — A. E. Wood ditto. January, 1950 — — F. B. Osborn ditto. May, 1952 — — INSPECTORIAL. T. L. Mackie, M.B.E. Chief Sanitary Inspector October, 1950 M.I.N.A. — P. W. Coombe Senior Sanitary Inspector April, 1953 — — W. Gray Sanitary Inspector September, 1921 — — E. H. Johnson ditto. August, 1929 — — T. G. Edwards ditto. June, 1929 — — D. E. Madeley ditto. September, 1932 — — C. E. Wright ditto. July, 1931 —- — J. S. Beattie ditto. May, 1931 — — G. Dring ditto. February, 1937 — — L. N. Tope ditto. August, 1946 — — P. A. Traynier ditto. October, 1950 — — A. C. Good ditto. September, 1951 — — T. C. H. Rogerson ditto. October, 1951 — — A. H Marshall ditto. March, 1953 — — E. W. Ward ditto. April, 1953 — — RODENT INSPECTORS. C. W. Moody Rodent Inspector February, 1929 — — E. C. Watkins ditto. June, 1929 — — S. A. Croft ditto. June, 1929 — — C. Stockton ditto. June, 1940 — — D. J. Davis . ditto. August, 1941 — — F. D. Cartman ditto. September, 1943 — — G. Lamont ditto. January 1953 — — — (Vacant) — — — RODENT CONTROL SCHEME. H. A. Baxter Rodent Inspector April, 1950 — — W. G. Stimson ditto. April, 1951 — — G. Clark Rodent Operative January, 1949 — — A. L. Southwood ditto. January, 1949 — — R. M. Collier ditto. July, 1951 — — R. A. Hutchins ditto. July, 1951 — — A. T. Evans ditto. January, 1953 — — LAUNCHES AND HULKS. P. J. wllkins Navigator (Senior) November, 1947 — — J. R. Steen Navigator December, 1939 — — W. S. Stimson ditto. March, 1944 — — W. G. A. King ditto. May, 1946 — — C. R. Simons ditto. October, 1948 — — J. H. Mason ditto. June, 1951 — — S. J. Crutchley Engineer (Senior) April, 1946 — — E. G. Smith Engineer January, 1946 — — J. F. Trice, M.B.E. ditto. September, 1947 — E. Alewood ditto. September, 1953 — — A. R. L. Potter Deckhand July, 1945 — — L. J. Nicholls ditto. April, 1949 — — R. A. Mantripp ditto. November, 1951 — — — (Vacant) — — — — (Vacant) — — — A. R. Watkins Deckboy August, 1948 — — R. Tye ditto. July, 1952 — — A. G. Shelton ditto. January, 1953 — — C. S. Morgan ditto. January, 1953 — — A. T. Bridges ditto. March, 1953 — — E. O'Grady ditto. October, 1953 — — K. R. Bowyer ditto. November, 1953 — — B. Osenton ditto. December, 1953 — — J. F. Smeed Steward (Part time) July, 1927 — — A. R. Burge Ship keeper August, 1945 — — A. C. Croft ditto. October, 1950 — — A. Lovey Watchman May, 1951 — — W. J. Mace ditto. May, 1951 — — LAUNCHES— Date acquired. "Howard Deighton" 1931 "Frederick Whittingham" 1934 "Alfred Robertson" 1938 "Alfred Roac " 1948 HULKS— "Hygeia" at Gravesend 1935 "Uplees" at Greenwich 1945 2 January, 1954. 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. A letter from the Secretary, Ministry of Health, dated 19th November, 1952, enclosed copies of Circular 33 /52 and Form Port 20, and requested that the Annual Report of the Port Medical Officer for London be prepared on the lines of that Form, adapted as may be necessary to the special needs of the administration of the London Port Health District. Para. 5 of Form Port 20 reads as follows:—The information required by Sections I, V, VI, VIII, XIV, XV and XVI, which has been given in an earlier Report and has not since changed, need not be repeated every year. A recapitulation of all information should be made in the Reports for the years 1952 and 1955 and thereafter quinquennially. For the intermediate years, only the changes which have occurred during the year covered by the Report need be mentioned in those Sections; if there is no change, 'No Change' should be entered," and this Report has been prepared accordingly. Tonnage.—The tonnage of vessels entering the Port of London during 1953 was 33,392,667 tons as compared with 28,964,629 tons during 1952. Twelve thousand nine hundred and eleven vessels arrived from foreign ports and of these 2,000 were visited by your Medical Officers (Table B). Communicable Diseases.—Three hundred and forty-five cases of notifiable and other infectious diseases (including malaria) were reported as having occurred on 181 vessels during the voyage, of which 111 were landed in the Port (Table D). Sixty-seven cases, particulars of which are given in Appendix II (b) were admitted to Denton Isolation Hospital. No case of human or rat plague occurred during the year on any vessel bound for London. Fumigations.—One hundred and fifty-two vessels were either fumigated, trapped or poison baited for rodent destruction and the issue of International Certificates under the supervision of your Inspectors. Fifty-two vessels were fumigated using hydrogen cyanide and resulted in the recovery of 910 rats and 120 mice. Two were fumigated with sulphur dioxide accounting for 32 rats. In addition 98 vessels were subjected to various methods of poisoning and trapping in 72 of which " 1080 " was used, resulting in the destruction of 587 rats and 249 mice. Rodents.—A total of 5,756 rats were destroyed and their bodies recovered during the course of the year, 1,873 in ships and 3,883 on shore premises in the Port (Table E). In addition 3,907 mice were destroyed, 343 in ships and 3,564 on shore premises. No plague infected rats were found. Water Barges.—Eleven 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 carrying drinking water as also upon the purity of the water thus carried. Houseboats.—The routine inspection of houseboats was continued throughout the year and is the subject of a special report. (See page 15). Imported Foods.—The total amount of foodstuffs seized and condemned as unfit for human consumption and either reconditioned or disposed of for animal feeding or for industrial purposes under guarantee or destroyed outright either by burning or burying was 3,574 tons 7 cwts. 2 qrs. 7 lbs., as compared with 2,203 tons during 1952 and 1,917 tons during 1951. Shellfish.—Action taken under the Public Health (Shellfish) Regulations is reported on page 15. Instruction of D.P.H. and D.I.H. Classes 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 Services on the River and in the Docks. Visitors to the Port.—A considerable number of foreign Medical Officers and other Port Health Administrators visited the Port to study various aspects of Port Health Administration. Instruction was given according to the particular requirements of the individual. Your Medical Officer wishes to record his appreciation of the collaboration and assistance rendered by the Officers of Her Majesty's Customs, of the Port of London Authority, by 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 willingly and efficiently. Your Medical Officer regrets to report that Dr. J. R. Davies, an Assistant Port Medical Officer was superannuated after 14 years' service with the Authority, on the grounds of ill-health. I have the honour to be, Gentlemen, Your obedient servant, M. T. MORGAN. 3 SECTION II—AMOUNT OF SHIPPING ENTERING THE DISTRICT DURING THE YEAR. TABLE B. Ships from Number. Tonnage. Number Inspected. Number of ships reported as having, or having had during the voyage infectious disease on board. By the Medical Officer of Health. By the Sanitary Inspector. Foreign Ports 12,911 22,898,795 2,000 9,527 179 Coastwise 13,606 10,493,872 2 1,557 2 Total 26,517 33,392,667 2,002 11,084 181 SECTION III—CHARACTER OF SHIPPING AND TRADE DURING THE YEAR. TABLE C. Passenger Traffic Number of Passengers— Inwards 102,516 Number of Passengers— Outwards 117,017 Cargo Traffic Principal Imports All types of produce and merchandise. Principal Exports Principal Ports from which ships arrive. The Port of London trades with all parts of the world. SECTION IV—INLAND BARGE TRAFFIC. Numbers and tonnage using the district and places served by the traffic. There are approximately 7,000 barges of all types,; dumb barges, mechanically-propelled barges, etc., registered annually with the Port of London Authority. The approximate tonnage is 500,000 tons. The traffic of these craft extends throughout the length of the Port, while a number of them are employed carrying goods and merchandise via the canals to all parts of the country. SECTION V—WATER SUPPLY. 1. Source of supply for— (a) The district— 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 must be obtained from water barges. (b) Shipping— Ships not able to obtain water from the shore supplies indicated above, or ships lying at buoys in the river, can obtain supplies from water barges. 2. Reports of tests for contamination. Periodic sampling of drinking water from the quayside hydrants and from water barges is carried out, the samples being submitted to the Central Public Health Laboratory, Colindale, for examination. 3. Precautions taken against contamination of 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, of rubber lined canvas, 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, during the transfer from the ship to the shore, they should not come into contact with the dock water. If this should happen the hoses are thoroughly cleansed and flushed with fresh water before being used again. 4. Number and sanitary condition of water boats and powers of control by the Authority. There were eleven water boats working in the Port during the year. Water boats are registered annually by the Port of London Authority and such registration is made conditional upon the report of the Port Health Officer 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. SECTION VI—PUBLIC HEALTH (SHIPS) REGULATIONS, 1952. (1) List of Infected Areas (Regulation 6). Arrangements for the preparation and amendment of the list, the form of the list, the persons to whom it is supplied and the procedure for supplying it to those persons. The list of scheduled ports on page 4 of the Declaration of Health covers, broadly speaking, the whole of Asia, Africa, South and Central America and the Eastern Mediterranean. To attempt to supply to Pilots and Customs Officers a weekly list of infected ports based on the Weekly Record of Quarantinable Diseases issued by the Ministry of Health would lead to chaos and to much more delay and inconvenience to shipping than the system of inspecting, as a routine, ships from any part of the world in which dangerous infectious diseases are endemic or, from time to time, epidemic. 4 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, 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, to Trinity House. In addition several of the larger shipping companies using the Port are supplied, on request, with Declarations of Health which are placed on board their vessels with other ships' papers. The instructions on page 4 of the Declaration of Health (applying only to the Port of London) are as follows:— The Master of a foreign-going ship approaching a Port in England or Wales from a Foreign Port must ascertain the state of health of all persons on board, and fill in and sign a Declaration of Health in the prescribed form, which he must hand to the Customs Officer or to the Port Medical Officer, whichever first boards the ship. 1. If the answer to any of the questions on page 1 is "YES" or if the ship, except in the case of tankers, has called during the previous four weeks at any of the following ports :— All Ports in Asia, including Turkey, India, Pakistan and Ceylon; Indonesia, the East Indies, the Philippines, Formosa and Japan; Africa and Madagascar; Central America including Mexico ; South America the Master must:— (1) Send a wireless message to "PORTELTH LONDON," stating the name of the vessel and the time she is expected to arrive off Gravesend. This message must be sent off not more than 12 hours, and not less than 4 hours before the arrival of the ship. In the case of vessels bound for the Medway, the wireless message should be addressed "PORTELTH LONDON," as follows:— "(Name of Vessel) (Time of arrival) Sheerness." Note.—If wireless is not carried, the Port Health Authority must be notified of the arrival of the ship as soon as possible. 2. Radio Messages. (a) Arrangements for sending permission by radio for ships to enter the district. (Regulation 13.) No change. (b) Arrangements for receiving messages from ships and for acting thereon. (Regulation 14 (1) (a) and (2) ). No change. 3. Notifications otherwise than by Radio (Regulation 14 (1) (b)). No change. 4. Mooring Stations (Regulations 22 to 30). No change. 5. Arrangements for— (a) Hospital accommodation for infectious diseases No change. (b) Surveillance and follow up of contacts No change. (c) Cleansing and disinfection of ships, persons, clothing and other articles No change. BOARDING SERVICES—LAUNCHES AND STATIONARY CRAFT. The most important responsibility of a port health authority is to be so organised as to prevent the importation of specific infectious diseases and to suppress any ship-borne conditions capable of spreading disease. The Public Health (Ships) Regulations 1952 imposes this responsibility in various forms of prescribed action. From the foregoing it is clearly indicated that the state of health and/or sanitary conditions on all types of vessels must be investigated and this can only be done by the appropriate officers boarding the vessels. The vessels can be classified as one of the following groups:— (а) Ships arriving which must signal for the attention of the Port Medical Officer (as laid down in the Public Health Ships Regulations 1952). (b) Oil tankers which are regulated by a special arrangement. (c) Ships arriving from coastwise trade or overseas ports and are not required to signal for the attention of the Port Medical Officer. (d) Harbour craft and inland water transports. The appropriate officers include the medical officers, sanitary inspectors and rodent control inspectors. Ships in category (a) and any others in need of medical aid are boarded by the medical officers. All vessels are boarded when stationary somewhere within the Port by the sanitary inspectors and generally by the rodent inspectors. The vessels which berth at one of the five major dock groups and Regents Canal Dock can be boarded from the quay, but a considerable proportion of all the vessels in the Port can only be reached by water transport. It is seventy miles from Teddington to the seaward limits of the Port of London by river, a watercourse which has been divided into three districts for purposes of port health administration and four launches have been provided to cover these districts in conjunction with the medical officers boarding duty at Gravesend. Two hulks are also provided, one as a boarding station for Gravesend and the other as a moorings for two launches at Greenwich. The allocation is as follows:— "Hygeia." A strongly built steel hulk which is moored off Gravesend in close proximity to H.M. Customs and Pilot headquarters. This serves as a boarding duty station for the medical officers and a base for two launches, one of which is in continuous attendance on the medical officers while the other serves the sanitary inspector of the Lower River district. Commissioned 1935 Draught 14 ft. Length 96 ft. Superstructure 70 ft. by 14 ft. by 8 ft. Beam 25 ft. Main hold 72 ft. by 25 ft. by 8 ft. Depth 21ft. Peaks 12 ft. 5 A continuous service is maintained here by medical officers on a 24-hour three-watch and shipkeepers on a two-watch system. Underwater cables are laid between ship and shore to carry electric power and telephone communications. Drinking water supplies are maintained by a visiting fresh water boat. The spacious main hold is sub-divided into storerooms, workshop and coal bunkers, besides containing fresh water storage tanks and a central heating unit. The superstructure, in one complete unit, contains all necessary domestic and administrative facilities for the medical officers and shipkeepers including lounge, three sleeping cabins, office, galley, bathing and toilet amenities. The shipkeepers are provided with a sleeping cabin and w.c. There is an abundance of natural lighting and an immediate view over the Estuary. Electric lighting and central heating is installed throughout the accommodation and an open grate fire is fitted in the lounge for supplementary heating. "Uplees," built 1897. This is a comparatively old converted wooden sailing barge which lies at an anchorage off Greenwich and is used as a mooring station for the two launches which operate the Upper River and Middle River districts. The superstructure is a furnished cabin, providing living and cooking accommodation for two shipkeepers who are employed on a 24-hour two-watch system. Commissioned 1945 Depth 6.5 ft. Length 76.25 ft. Draught 3.0 ft. Beam 17.5 ft. Main hold 16 by 17 ft. The main hold is used as a base stores for equipment and fuel. The aft compartment is fitted as a workshop. The present anchorage is not a desirable place because of its close proximity to the riverside refuse tipping jetty and because transportation difficulties arise at low tide. The hulk is not connected to any electric supply or telephone. Fresh water is transported in cans by an open boat and a chemical closet is provided for the shipkeepers. Consideration has been given to the securing of a better anchorage or preferably to a landing stage with all amenities conducive to this Service, in which case the hulk would be redundant. m.l. "Howard Deighton," Commissioned 1931. Reg. tonnage 12.24. Main engines, h.p 192. Length 75.0ft. Fuel consumption 30 lbs./hr. Breadth 14.5 ft. Aux. engine, h.p. 15. Draught 6.0 ft. Fuel consumption 2.15 lbs./hr. Max. speed 10.8 knots. Lub. oil consumption 80 galls./yr. This strongly built steel vessel has twin screws driven by diesel engines and the electric power, which is generated by a diesel engine unit, is stored in a 140 ampere-hour battery. She is stationed on "Hygeia" for use by the boarding medical officers. Her internal construction comprises the following compartments from forward to aft. Forepeak and chain locker, battery room, crews' accommodation, engine room, saloon cabin with two emergency sleeping berths and the afterpeak. Externally, in addition to the wheelhouse and immediately abaft of it, there is a superstructure into which are built a galley, paint store, crew's w.c. and the ambulance room. Until recently, boarding from the launch in rough weather has been an uncomfortably wet job and to overcome this, two elevated boarding platforms have been erected over the ambulance room at a freeboard level of 12ft. In these positions, the movements of the medical officer can be seen by the navigator of the launch, while he has much less climbing to do when boarding the ship and he is clear of storm water. A word about the ambulance room. It is spacious, heated and lighted electrically, exhaust ventilated and has a drained, non-skid impervious deck. It has accommodation for four stretcher cases or eight seated patients. The reception of stretcher cases is simplified by two large doors which can expose the full widtlx of the ambulance room to receive the stretchers lowered or man-handled to the open deck of the launch. Since the freeboard of the launch approximates to that of the pontoon at Denton Isolation Hospital, the same ease of movement is afforded when discharging a patient. These provisions are essential, for they permit the stretcher case to be carried at the correct angle to combine comfort and welfare. During overhaul this year, new bulwarks with tumble-home have been fitted, extensive modifications to the wheelhouse completed and new cylinders to main engines, in addition to the boarding platforms. The launch has three crews of four, including a navigator, engineer, deckhand and boy, who work on the same duty rota as the medical officers. Fuel consumption is relatively low, because she seldom continues with both engines at full rated speed for long periods, nor does the diesel-generator run continuously at full load when charging the batteries. m.l. "Alfred Roach," Commissioned 1948. Length 53.0 ft. Max. speed 14.9 knots. Breadth 12.0 ft. Engines, h.p 200.0. Draught 3.5 ft. Fuel consumption 7 galls./hr. This new launch built to the design of the Authority is of timber construction, a departure from the usual steel type which became necessary owing to the restricted supply of steel at the time of building. Based on the "Hygeia," she is normally at the disposal of the sanitary inspector of the Lower River district. This stretch of the river is less congested and barge traffic is negligible, therefore she is able to operate without undue risk of collision damage. Special consideration has been given to the design in order to equip her as an ambulance launch capable of transporting stretcher cases from any part of the Port to the isolation hospital with comparative ease, comfort and speed. The engine-room accommodating twin diesel engines has been suitably insulated to reduce noise and resonance to a minimum. 6 The crew's messroom and the engine-room are directly accessible from the wheel house, wherein the navigator is in complete control of launch and engine movements. Engine starting and control mechanism is fitted alongside the steering wheel and all relevant information concerning fuel stocks and machinery behaviour is shown by a group of instruments on a panel before the navigator. The superstructure is designed to offer a minimum of wind resistance and the bow flare is capable of diverting appreciable quantities of storm water. A main mast, hinged to a tabernacle, carries a derrick and lifting gear by which stretcher cases can be landed. The cockpit is large enough to receive a stretcher case and afford sufficient space for the two stretcher bearers awaiting its descent. Protected accommodation is provided for eight sitting patients beneath a portable arrangement of spars and awning. There are no steps between the cockpit and saloon, a factor which obviates stumbling when carrying a stretcher case. The saloon, normally arranged for the inspector's use, can be quickly converted into an ambulance room. It is fully exposed to the cockpit by opening two sliding doors, and by removing the table top, engaging hinge supports which are normally secreted behind the settee backs, accommodation is provided for three stretcher cases. The toilet and galley lie immediately forward of the saloon. /There is an internal gangway from forward to aft, which is an advantage in bad weather. Electric lighting, both fixed and portable, is installed and the circuit draws its supply from a battery which also serves to start the engines, feed the searchlight and electric horn. Radiators are heated by paraffin and pressure-paraffin stoves are used in the galley. The crew consists of a navigator, deckhand and boy, whose accommodation lies forward of the wheelhouse and takes the form of a furnished messroom. Generally, the equipment of the launch is considered to be very satisfactory and she carries an illuminated sign of recognition for night work. m.l. "Alfred Robertson," Commissioned 1938. Reg. tonnage 12.37. Main engine h.p. 140. Length 57.0 ft. Fuel consumption 16.2 lbs./hr. Breadth 11.0 ft. Aux. engine h.p. 10.0. Draught 5.0 ft. Fuel consumption 2.0 lbs. /hr. Max. speed 9.7 knots. Lub. oil per year 18.0 galls. This launch is based on "Uplees" at Greenwich moorings. She is allocated to the Middle River district sanitary inspector and, being of robust construction, is suitable for this stretch of the river about which lie numerous small craft and traffic at dock entrances. As the river becomes more narrow, these conditions are accentuated and the launch is subjected to intermittent rough treatment. This steel vessel with a single screw, driven by a diesel engine, adequate tumble-home, stiffened bulwarks and a stout rubbing strake is quite able to fend off small craft, including barges, without sustaining hull damage. She is fitted with a diesel engine generator set to supply electric power for heating, lighting and cooking. The same unit can supply starting air for the main engine and drive an emergency water service pump. From forward to aft she has the construction of forepeak, crew's messroom, engine-room, saloon and afterpeak. A coal burning stove is fitted in the messroom for emergency heating and cooking. The saloon can accommodate two stretcher or six seated patients. At one time, moving a stretcher case in and out of the saloon was like an acrobatic feat for the stretcher bearers, because the tilted stretcher could only be admitted to the saloon by way of a small scuttle hatch over a steep flight of steps. To obviate this hazard a suitable mast, derrick and hand-operated winch have been erected and an extended aperture cut into the saloon superstructure with two sliding scuttle hatch tops. This arrangement allows a stretcher case to be lowered into or lifted from the saloon by a harness at any angle and discharged overside with ease and causing no discomfort to the patient. Thus, in an emergency, the "Alfred Robertson" is able to relieve the "Howard Deighton" at Gravesend. The launch is employed by the sanitary inspector for boarding a variety of vessels moored at buoys and wharves. She is manned by a navigator, engineer, deckhand and a boy, and is normally moored each night on " Uplees " under the watchful eye of the shipkeeper. m.l. " Frederick Whittingham," Commissioned 1934. Reg. tonnage 4. Max. speed 8.2 knots. Length 29.5 ft. Engine h.p. 60.0. Breadth 8.75 ft. Fuel consumption 10 lbs./hr. Draught 3.0 ft. Lub. oil consumption 10 galls. /year. She is smaller than her sister vessels and is presently at the disposal of the sanitary inspector and rodent inspector to whom she renders regular daily service in the Upper River and Middle River districts. Being of shallow draught, of strong construction and very susceptible to the helm makes this relatively small launch suitable for work among congested craft and navigation in the creeks. The Upper River district is comparatively shallow at low water level, is spanned by several lowlying bridges and is considerably used for barge towing traffic and houseboat moorings. In order to negotiate the low bridges, the masts of all the launches have been made collapsible and due attention has been paid to the height of funnels and superstructures. From Greenwich to Westminster the launch is able to operate at all states of the tide, but beyond that to Teddington the district is navigable only at certain states of the tide. She has a single screw propelled by a diesel engine. All the operating gear is located in the wheelhouse. thus the performance of the launch is completely controlled by the navigator. No electric machinery is installed—the lighting, cooking and heating is dependent on paraffin equipment, while starting the engine and pumping is done by hand gear. This is a sturdy steel craft, capable of taking reasonable punishment from lighters, etc., though it is generally agreed that her lines, low freeboard and high superstructure combine to give a rather clumsy appearance. Modifications have been made externally and internally to overcome this latter 7 shortcoming as far as practicable and the success is more apparent from inside than outside. However, she is very reliable, self-contained in equipment and well suited to the duties imposed. No provision is made for the transport of stretcher cases, but there is accommodation for four sitting patients. The internal construction is as follows:—Forepeak, galley, engine-room, wheelhouse, saloon and afterpeak. No w.c. is provided, nor is this a serious omission, because the launch is generally in close proximity to one of the landing stages, where a w.c. is available by courtesy of the P.L.A. The crew consists of a navigator and a boy. Minor repairs and adjustments to the engine are carried out by the engineer of the "Alfred Robertson," while the launches are moored at the station. During the war years little maintenance was done to the launches and a formidable legacy of defects had to be tackled and eliminated after the war. In addition to this, improvements had to be made in order to fit the launches for a more efficient and reliable service. These commitments have been met during the past seven years without any major dislocation of the Service. Higher prices for materials and labour have demanded caution and wise planning and, during this year, the programme has been completed by giving a major refit to the four launches. Strict control of expenditure of fuel and materials has been imposed upon the launch crews and have been gladly accepted by them; they have helped considerably by improvisation and doing minor maintenance work while on duty between overhauling periods. A fair proportion of the money spent during this long-term policy has been allocated to major improvements and the result has given general satisfaction to those who operate and use the launches. There are no spare hands among the floating staff and it is gratifying to see how the members are ready, often at much inconvenience to themselves, to fill the gaps which arise in emergencies and to keep the launches at all times ready for duty. By goodwill and a real sense of pride and responsibility, those who conduct the affairs of the Authority afloat and the launches at their disposal, combine to play a very effective part in this branch of the port health service. SECTION VII—SMALLPOX. (1) Name of Isolation Hospital to which smallpox cases are sent from the district. Denton Hospital is situated on the south bank of the River about a mile below Gravesend. The hospital buildings comprise a small administrative block and nurses' home, three ward blocks (one a cubicle ward with eight cubicles), a laundry, a disinfection station, a porter's cottage and a mortuary. Cases can be landed from the ambulance launch at a jetty and be wheeled straight into the hospital. In the event of a case or cases of smallpox one of the ward blocks (the smallpox block) could be opened for the reception and nursing of patients. Alternatively, patients may be removed to other approved hospitals under the management of the South-East Metropolitan Regional Hospital Board. (2) Arrangements for transport of such cases to that hospital by ambulance giving the name of the Authority responsible for the ambulance and the vaccinal state of the ambulance crews. The removal of a case or cases from a vessel to Denton Hospital would be carried out by the Port Health Authority's Ambulance Launch and that Authority would be responsible for the vaccinal state of the ambulance crew. In the case of patients removed to other isolation hospitals the responsible body would be the South-East Metropolitan Regional Hospital Board. (3) Names of smallpox consultants available. Dr. W. T. Boul. Dr. J. P. Marsden. Dr. W. J. Coughlan. Dr. M. T. Mitman. Dr. H. S. Banks. Dr. J. W. Armstrong. (4) Facilities for laboratory diagnosis of smallpox. Facilities are available at the Virus Laboratory of the Central Public Health Laboratory at Colindale SECTION VIII—VENEREAL DISEASES. No Change. SECTION IX—Cases of notifiable and other infectious diseases on ships. TABLE D. Cases landed from ships from foreign ports. Passengers. Grew. Number of ships concerned. Erysipelas — 1 1 Measles 16 — 8 Mumps — 1 1 Herpes Zoster 1 — 1 Infective Hepatitis 1 2 3 Chickenpox 16 6 14 Pulmonary Tuberculosis 8 23 30 Malaria — 2 2 Influenza —- 2 2 Pneumonia — 2 2 Tonsilitis 3 1 3 Pyrexia of Unknown Origin 9 9 17 Filiariasis 1 — 1 Enteric Fever . —- 3 3 Jaundice (unspecified) — 1 1 Dysentry —- 1 1 Undulent Fever 1 — 1 Glandular Fever — 1 1 8 TABLE D.—continued Cases disposed of before arrival. Disease. Passengers. Crew. Number of ships concerned. Chicken pox 32 2 16 Meningococcal Meningitis 1 — 1 Influenza — 4 3 Mumps 6 1 3 Measles 77 4 20 German Measles 4 2 4 Pyrexia of Unknown Origin — 2 2 Pulmonary Tuberculosis 6 9 12 Infective Hepatitis 1 3 4 Scarlet Fever 2 — 2 Uraemia 1 — 1 Gastro Enteritis 2 54 4 Dysentry 2 2 4 Pneumonia 1 — 1 Whooping Cough 3 — 2 Smallpox — 1 1 Enteric Fever 3 2 2 Malaria — 1 1 Tubercular Meningitis 1 — 1 Cases landed from other ships. Chicken pox — 1 (Cadet) 1 Training ship "Wendorian." SMALLPOX. A vessel arrived off Grave send at 0315 hours on the 2nd October, 1953, from the West Coast of Africa and was boarded by the Boarding Medical Officer. The Master declared one death from smallpox on 14th August, 1953, in hospital in Port Harcourt. Voyage Itinerary. London dep. 29.6.53 Dakar arr. 11.7.53 dep. 12.7.53 Takoradi 17.7.53 „ 17.7.53 Lagos „ 19.7.53 „ 29.7.53 Port Harcourt „ 4.8.53 ,, 10.8.53 Calabar „ 11.8.53 „ 16.8.53 Santa Isabel „ 17.8.53 ,, 18.8.53 Bata „ 19.8.53 „ 20.8.53 Santa Isabel „ 21.8.53 „ 21.8.53 Duala „ 22.8.53 „ 24.8.53 Port Gentil 25.8.53 „ 2.9.53 Libreville „ 3.9.53 „ 4.9.53 Lagos ,, 6.9.53 ,, 14.9.53 Takoradi „ 15.9.53 „ 15.9.53 Dakar 21.9.53 „ 21.9.53 London „ 2.10.53 Case History. On 7.8.53, while the ship was lying in Port Harcourt, a Carpenter, age 26, reported sick with temperature 101°, malaise and severe headache. He was seen that day by the Company's local doctor who tentatively diagnosed measles. Next day, 8.8.53, his temperature had risen to 102° and all symptoms were exacerbated. He was again seen by the doctor who then changed the diagnosis to chicken pox as a vesicular rash had appeared. Distribution of this rash could not be obtained from the Master. On 9.8.53 the patient was worse and he was removed to hospital ashore. During these two days the entire crew was vaccinated "as a routine" and not on account of the sick man. The patient was not vaccinated and never had been, not even in infancy. After arrival in hospital the case was seen by the Medical Officer of Health of Port Harcourt, who diagnosed smallpox. The patient died on 14.8.53 and was buried ashore in Port Harcourt. Meanwhile the vessel had sailed early on 10.8.53 for Calabar and on arrival there a signal was received giving smallpox as the diagnosis. Disinfection of the patient's cabin was carried out by the Chief Steward with approximately 2 lbs. of roll sulphur burnt in a bucket, the cabin being sealed for 24 hours with the bedding in situ. This fumigation was not carried out by the local Port Health Authority. Action taken on arrival. An inspection of the infected cabin, which was situated on the starboard side amidships on the main deck next to the exit to the after deck, showed it to be approximately 12 ft. by 10 ft. by 8 ft. so that 2 lbs. of roll sulphur would hardly be adequate for efficient fumigation, though climatic humidity and temperature would add to its efficacy. Next day the cabin floor and paintwork was thoroughly scrubbed down. The cabin was later occupied by a Native Customs Officer for two nights but has otherwise been unoccupied since except as a dump for soiled linen which was stiff there in large kit bags on the vessels arrival in the Thames. The entire contents of the cabin, including the original bedding (mattress, pillows, sheets and blankets) together with the bags of soiled linen and the soft furnishings of the cabin were removed to Denton Hospital for steam disinfection and the cabin locked for re-fumigation on the vessels arrival in dock. 9 The health of the remainder of the crew had been consistently good for the voyage and all were well at the time of boarding on arrival. It would appear that the patient had been infected in Lagos during the vessels stay there between 19.7.53 and 29.7.53. On visiting the ship at her berth it was ascertained that members of the crew had had access to the patient's cabin after fumigation which, as stated above, had been used as a soiled linen dump for the remainder of the voyage; consequently arrangements were made to vaccinate all the members of the crew and a letter, setting out the circumstances was forwarded to the Medical Officers of Health of the districts to which the members of the crew were proceeding. The cabin was again fumigated, washed down and repainted. The members of your staff who had been in contact with the bedding removed at Denton and with the above-mentioned cabin were also vaccinated. No further case was reported. SECTION X—Observations on the occurrence of malaria in ships. Only three cases of malaria were reported on three vessels during the year under review. All the cases occurred among members of the crews, one case being disposed of prior to the arrival of the vessel in this Port. SECTION XI—Measures taken against ships infected with or suspected for plague. Plague being primarily a disease of rats all vessels are inspected immediately on arrival at their berths in the dock and river for the presence of any mortality among the rats on board which is not attributable to any known cause, such as trapping, poisoning, etc. Any such rats are immediately sent to the Central Public Health Laboratory at Colindale for examination for bacillus pestis, each rat being accompanied by a label on which is given precise information as to where the rat was found in order to arrive at a focus of infection should the examination prove positive. In the event of a positive result the discharge of the cargo would be promptly stopped and, if necessary, arrangements made for the vessel to be fumigated throughout with hydrogen cyanide, with the cargo in situ, the vessel being removed to an approved mooring. Following the initial fumigation and collection of dead rats, further samples of which would be submitted for examination, the discharge of the cargo would be permitted under observation. The destination of the cargo would be ascertained and a note of the circumstances would be forwarded to the Medical Officer of Health of the district to which the cargo was proceeding. Should any of the cargo be discharged overside into lighters, such lighters would be fumigated immediately they were empty. On completion of the discharge of cargo from the vessel a second fumigation would be carried out again using hydrogen cyanide to destroy the residual rat population, if any. SECTION XII—Measures against rodents in ships from foreign ports. (1) Procedure for inspection of ships for rats. The Port Health Authority employs fourteen 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 19 of the Public Health (Ships) Regulations, 1952, relating to the granting of Deratting and Deratting 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. The Port of London Authority have made byelaws requiring the Master of every ship to cause all ropes and mooring tackle to be fitted with guards to prevent rats passing from ship to shore. The byelaws 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 communication between the ship and the shore. (2) Arrangements for the bacteriological examination of rodents, with special reference to rodent plague, including the number of rodents sent for examination during the year. As described in Section XI above all rats for examination for plague, either by post mortem and subsequently, if necessary, by bacteriological examination, are promptly sent to the Central Public Health Laboratory at Colindale. The bodies are placed in canvas bags which in turn are placed inside metal boxes, sealed and labelled so that there is no risk of the escape of any rat fleas during their transit to the Laboratory The boxes are, of course, delivered by hand. Examination of rats for evidence of plague being a public health measure, is now carried out at the Government Laboratory at Colindale free of charge, representing a considerable saving in cost to the Port Health Authority. The routine Laboratory examination of rats found dead from an unknown cause has been a regular practice in this Port for many years and it would appear to be a necessary and desirable precaution. Even the practice of sending rats killed by trapping or poisoning or a proportion of the number so killed would appear to be desirable. 10 Nevertheless the matter must be viewed objectively and in the light of a number of factors such as the incidence of plague infected rats found in the Port over a number of years, the cost of the service, the probability that the routine practice will have a bearing on the protection of the Port against plague and finally in the event of a plague rat arriving in the Port the probability of the transmission of the disease to the rat population in Port installations. To take each of these features seriatim, a plague infected rat has not been discovered in this Port since 1927, consequently the Laboratory examination of rats has been continued year after year for some 25 years, without any positive result. The incidence of rats in ships which increased considerably under war conditions has now returned to a pre-war state and is indeed much less than the incidence in pre-war days. This is confirmed by the diminishing number of rats destroyed in ships and the proportionately small number of deratting certificates issued as compared to exemption from deratting certificates. The rat population in the Port is now so small and is under such strict control that it can be said to be almost certain that the arrival of a plague infected rat would be highly unlikely to have any serious significance. In other words, an epizootic could not be introduced into the Port for the simple reason that there are insufficient rats to support an epizootic of this kind. Consequently the routine examination of rats was abandoned early in 1952 and only rats found dead in circumstances which might possibly indicate the presence of plague are being sent to the Laboratory. During the year 9 rats were sent to the Central Government Laboratory, none being found to be infected with plague. (3) Arrangements in the district for deratting ships, the methods used, and, if done by a commercial contractor, the name of the contractor. (а) The burning of sulphur at the rate of 3 lbs. per 1,000 cubic feet of space for a period of not less than six 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. 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. (b) The generation of hydrocyanic acid gas by various methods. Por the destruction of rats a concentration of HCN at the rate of 2 ozs. per 1,000 cubic feet of space is required with a minimum of two hours contact. If the fumigation 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. (c) "1080" and "Warfarin." The employment of the new rodenticides "10800" and "Warfarin" are referred to elsewhere in this report. The employment of "1080" has been used regularly throughout the docks with highly satisfactory results. There is every indication that its use in ships is equally satisfactory to its use ashore. A certain number of ships have been deratted 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. (d) Trapping. Trapping is seldom employed save for the destruction of isolated rats which have not yet established themselves. The following are the names of the firms approved for carrying out the deratting of ships:— Messrs. Associated Fumigators, Ltd. Messrs. Fumigation Services, Ltd. Messrs. London Fumigation Co., Ltd. Messrs. Ridpests, Ltd. Messrs. Deodor-X Hygiene Services, Ltd. Messrs. Insecta Laboratories, Ltd. RODENT CONTROL. The use of Sodium Fluoroacetate ("1080") as a rodent poison has been continued during the year both in dock installations and in ships and is now well beyond the experimental stage. Thanks to its use in the warehouses, offices and other premises in the docks it can safely be said that it is now difficult to find, even in grain silos and other highly rat attractive premises, any rodent infestation of appreciable dimensions and the comparatively small number of rats that are reported following control measures are for the most part due to incursions from surrounding areas. As regards ships we have maintained the thesis that in a majority of ship infestations the use of " 1080 " is as good and effective as hydrogen cyanide and at a quarter of the cost to the shipowner. An interesting example may be quoted— A foreign going ship lying in the West India Dock was, on inspection, found to have a well marked infestation of rats in Nos. 3 and 4 holds and was, in any ease, due for cyanide treatment against a weevil infestation (she was engaged in the grain trade with Canada). On an experimental basis, therefore, agreement was reached with the Agents to permit a "1080" operation following which the two infested holds would be thoroughly searched for dead rats and the following evening a cyanide fumigation would be carried out and again a thorough search would be made for dead bodies. Following the "1080" operation 68 bodies were recovered. The holds were then fumigated with hydrogen cyanide and no bodies at all were recovered. It must be accepted that this is pretty conclusive evidence of the efficiency of " 1080." Despite evidence of this kind and not inconsiderable endeavour to persuade other ports to adopt the use of "1080" for the deratting of ships, coupled with the not unnatural interest of the industry in a method which not only costs them very much less than a cyanide fumigation but renders to putting of the crew ashore during the operation unnecessary (in itself a very considerable saving in cost) it must be regretted that this method has not caught on and is not used, at least to any appreciable extent, in other ports. 11 The reason for this lies not in any conservatism in matters of procedure among Port Medical Officers but to an unfortunate propaganda by the Infestation Branch of the Ministry of Agriculture and Fisheries against the use of this rodenticide. The limitations of the use of this rodenticide have been repeated almost ad nauseam. It cannot and must not be used in places and by people where there is not strict control to the exclusion of any possibility of approach by unauthorised persons and by animals and last, but not least, by persons who are not fully trained in its use and aware of its dangers. It is maintained that if these considerations are accepted and observed, "1080" is no more dangerous to use, indeed much less dangerous than hydrogen cyanide or many other poisons. Nevertheless the Infestation Branch of the Ministry of Agriculture and Fisheries will not accept it and seem to continue to regard it as something almost as dangerous as an atomic explosion. This attitude is to be regretted and has yet to be explained by the Infestation Branch. CONTROL OF COCKROACHES. Reference was made in my report for 1952 to the newly developed insecticidal resins and there has been increasing interest in the shipping industry in these resins with the result that quite a number of ships have now been treated with highly satisfactory results. Here again, just as in the case of the use of "1080" for the destruction of rats, difficulties have been met in persuading Port Medical Officers to recommend the lacquer and shipping companies to use it. The circumstances, however, differ. It is not here a question of the efficiency of these coatings if properly applied but the high cost and the fact that their application is not primarily a painters job. In order that these resins shah do their work properly they must be applied by a man who is trained in the habits and harbourages of cockroaches and who has at his disposal the equipment for the efficient application of the lacquer to these harbourages. It is not simply a question of a supply of lacquer, a brush and an ordinary painting job. On the contrary, the lacquer must first be properly prepared for use, be applied with a spraying machine capable of getting into all the nooks and corners where cockroaches are likely to be found and these include the interstices of cookers, the inside of drawers, lockers, cupboards and even wireless cabinets. In other words in almost every space where it is difficult to apply a coating by means of the ordinary painter's brush. Consequently under all these conditions the job is considerably more expensive than an ordinary painting job. On the other hand it should last for at least two years and this is now being proved time and again. We are in the stage, therefore, of overcoming teething troubles, not the least important being the high cost of the material and the fact that it must be applied by skilled operators. Both these troubles will be overcome in the near future but shipping companies who have had the foresight to disregard them are delighted with the results. PREVENTION OF DAMAGE BY PESTS (APPLICATION TO SHIPPING) ORDER, 1951. The provisions contained in the Order have been exercised fully without any undue interference with the normal trading practices of vessels concerned. Rodent Control Certificates in the form prescribed in the Order, have been issued to 101 coasting vessels and, of these, only one required deratting treatment for slight evidence of rodents. The certificates are not issued to ships on which a reliable inspection cannot be carried out, a condition which is often found in coastwise traders where only part cargo may be discharged and other cargo loaded at the same time. Although a certificate is issued free of charge to the shipowner and is somewhat insignificant in appearance, there is a general tendency among the ships' officers to respect its value more than they had hitherto. Daring the year close contact with The Association of Master Lightermen and Barge Owners as well as individual owners has created an atmosphere of friendly and constructive relations concerning policy for the deratting and rat-proofing of lighters. A Rodent Inspector has been allocated to the Middle River district to intensify the inspection of lighters and subsequent deratting measures. The industry has collaborated with the scheme in a very encouraging manner, while the Authority has taken all reasonable action to facilitate the free movement of lighter traffic under surveillance. The actual work of inspection commenced in June and the detailed results are as follows:— Number of lighters inspected 1,768 Number of lighters without evidence of rats 1,517 Number of lighters with very slight evidence 125 Number of lighters reported for treatment 126 Number of rats recovered after treatment 204 Simple rat-proofing measures are the antidote for rat infestation of lighters and this information is persistently offered to the owners. The figures afore-mentioned indicate that the lighters are not infested to the extent popularly imagined and by a process of team work between industry and the Authority, it may soon be a rare occasion when rats are to be found resident in a lighter. 12 TABLE E. Rodents destroyed (bodies recovered) during the year in ships and in shore premises. (1) On vessels. Number of Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Black Rats 143 78 23 252 117 245 234 187 172 125 82 211 1,869 Brown Rats — — — 1 — — 3 — — — — — 4 Species not recorded — — — — — — — — — — — — — Rats examined — 4 — — — — — — — — 1 3 8 Rats infected with plague — — — — — — — — — — — — — (2) In Docks, Quays, Wharves and Warehouses. Number of Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Black Rats 88 Ill 77 145 41 88 116 123 136 157 89 156 1,327 Brown Rats 188 372 247 174 214 107 176 220 187 194 319 158 2,556 Species not recorded — — — — — — — — — — — — — Rats examined — — — — — — 1 — — — — — 1 Rats infected with plague — — — — — — — — — — — — — TABLE F. Deratting Certificates and Deratting Exemption Certificates Issued during the Year for Ships from Foreign Ports. No. of Deratting Certificates Issued. Number of Deratting Exemption Certificates Issued. Total Certificates Issued. After Fumigation with After Trapping. After Poisoning. After Trapping and Poisoning. Total. HCN Other Fumigant (state Method) S.O2. 1. 2. 3. 4. 4(a) 5. 6. 7. 52. 2. 5. "1080" 72 "Warfarin" 10 Zinc Phosphide 8 90. Trapping and "Warfarin" 2 Trapping & Zinc Phosphide 1 3. 152. 843. 995. SECTION XIII—Inspection of Ships for nuisances. TABLE G. Inspections and Notices. British owned vessels. Foreign owned vessels. Number of vessels visited by Sanitary Inspectors 7,501 4,305 Number of vessels on which sanitary defects were found, and details reported to the Master, Owners and /or Ministry of Transport 791 91 Number of Statutory Notices served Nil Nil Number of vessels on which sanitary defects were remedied 775 91 Summary of Structural and other Defects. Inadequate ventilation 8 — Defective Lighting—Natural 1 — Do. do. —Artificial — 1 Defective Heating 15 — Condensation 5 — Leaking Decks 19 — Leaking Ports, Deck lights, etc. 10 — Leaking Sideplates 1 — Leaking Hawser and Chain Pipes 1 — Deficient or Obstructed Floor Drainage 10 — Water lodging on top of Peak Tanks 1 — Defective Bulkheads 5 — Do. Floors 23 — Do. Doors 3 — Do. Chain Pipes — — Do. Bunks 2 —- Do. Clothes Lockers 1 — Do. Food Lockers 2 — Do. Food Storage 13 — Do. Cooking Arrangements 8 1 Defective or Uncleanly Drinking Water Storage 1 — Water Closet Obsolete 5 — Do. Defective 25 — Do. Foul or Choked 13 1 Do. Inadequate Flush 14 1 Wash Basins Defective 24 — Do. Foul 3 — Neglected Paintwork or Distemper 35 — Absence of Washrooms —- — Absence of Messrooms 1 —- Misappropriation of Crew Spaces — — Verminous Quarters 114 6 Dirty Quarters 595 83 Miscellaneous 61 1 Totals 1,019 94 HYGIENE RELATED TO CREWS ACCOMMODATION. Living conditions for officers and seamen of the Merchant Navy have been considerably improved in the past decade. There is widespread evidence, particularly in the ships constructed since the end of the war, that this subject has been given high priority by shipowners, naval architects and responsible officials. The effect of these efforts is reflected in the reports submitted by the Port Sanitary Inspectors, which indicate a considerable and progressive reduction in the number of nuisances found on any ship; moreover, the number of ships reported for nuisances is similarly declining. This trend of better sanitary standards combining social amenities for seafarers gives cause for much satisfaction to the Port Health Authorities who have for long striven, with somewhat limited powers to justify the need for such improvements. 13 Of the accommodation for the crew much has already been published concerning the arrangement, structural features and sanitary requirements. Suffice it therefore to state that most new ships provide one or two berth cabins with occasionally four to six berth cabins on the larger vessels for the junior staffs or asiatics. Petty Officers such as bosun's, carpenters, quartermasters, cooks, etc., may even find themselves in possession of a suite comprising a separate living and sleeping cabin with bathroom and w.c. attached. Attention can now be extended to the value of such provisions as those which were hitherto considered somewhat superfluous, e.g., supply of bedding and clean linen, complete messing facilities, tapped supplies of hot and cold water, radiator or warm air heating, air conditioning systems, adequate and continuous lighting, recreation rooms, adequate medical aids and supplies of insecticide, etc. These "benefits" are no longer exceptional, but are becoming recognised as accepted standards. The better housing conditions and advance in health education ashore have undoubtedly contributed substantially towards this change afloat, while training centres and hostels have also made their contribution. Too much must not be expected all at once. The evolution will continue with the progress of time and the conduct of the crews will, to a large extent, determine the degree of success or failure of this welfare venture. At present the overall picture is encouraging and this may be an opportune time to review the situation and consider the reactions of the crews to these changes. It cannot yet be expected that every complete crew fully appreciates these new advantages but there is no reason for pessimism. In the minds of the great majority there is a firm conviction that consideration for the health and welfare of the seafarer is a reality and the men are becoming increasingly conscious of their responsibility to maintain the improved standards. Of those who have not reacted so favourably, some may never rise to the level of normal human appreciation and others need a form of education or supervision which is not always implemented by those in authority. There is a tendency for the better type of seaman to select his ship and, apart from the trade route, he chooses the ship which provides the best living conditions. It is, therefore, not surprising to find some ships with less favourable conditions, persistently manned by the corresponding type of crew, with often obviously unfortunate results. On the design side there is, and possibly always will be, scope for simple improvements to promote hygiene. The elimination of harbourages and the interception of runs for pests such as rats and insects, the extractor ventilation of toilets, anti-syphon fittings on certain w.c.'s., a urinal stall in toilet compartments, domestic refrigeration, cooled drinking water, etc. Mention of a refrigerator attracts attention to the culinary department. Good order and cleanliness in the food storage and preparation centres is vital and no less in the pantries and messrooms. Often there are outstanding deficiencies—storerooms sited in places which necessitate that fresh stores be dragged around the decks and man-handled by hazardous operations, insufficient hanging gear or stowage for fresh meat, inadequate separation of perishable foods in cold or cooling chambers. Dry storerooms are frequently furnished with too many wooden fixtures which harbour insects, whereas metal could be used to advantage and the same places would benefit from an independent source of ventilation and temperature control. Pantries, galleys and messrooms are centres of attraction for insects, paticularly cockroaches, and yet the amount of wooden fixtures fitted in such a manner as to provide spaces for their breeding and security, continues. These comparatively inaccessible spaces are seldom properly cleaned. A last word about food preparation centres may be directed towards ships catering for a large number of personnel. The equipment and food handlers will be proportionately increased as also may be the demand for water. There are three questions which come readily to mind, e.g., is the water used exclusively from the potable water supply; is sanitary accommodation adequate and reasonably available for the staff; are there sufficient hand-washing facilities in or near to the centre of work ? The foregoing points are inseparable from the subject of hygiene, and it is probably not in appropriate to suggest that a wider application of the principles of sanitary science into the construction of ships would enable all concerned to achieve even better results. SANITATION ON COASTWISE SHIPPING. In the true meaning of the word, "coastwise" does not include the ships which trade into near continental ports, but since many ships combine a "coastwise trade" with continental or "home trade" all ships making short sea voyages to and from the Port can be reasonably classified as coastwise shipping. These ships vary in size and design with gross tonnages ranging from 200-2,000 tons and driven by steam or internal combustion engines. The sailing barges are now so rare that they may be discounted. In pre-war years, the standard of sanitation in many coasters left much to be desired and hygiene suffered accordingly. The causes were complex. Part of the responsibility rested with the seamen and part with the ship or her managers. Any change for the better demanded action from all concerned and it was increasingly apparent that the first move was being made by some owners of newly constructed ships. The improvements were not spectacular but indicated a trend towards better living accommodation. As motorships became more popular the allocation of extra space to the crew and extra amenities followed. There still remained, however, a number of the older ships with sub-standard conditions when compared with new conceptions of accommodation design, although some efforts were made at intervals to adjust these lower standards. Meanwhile, the crews responded to these improvements with varying expressions of appreciation. The post-war years have accounted for remarkable improvements. The young seamen know the old conditions by stories or literature only and they accept conditions now provided as normal, whereas in some new coasters the changed living standards actually reflect much credit to those who have initiated and achieved such a transformation. It is not to be expected that all ships have attained the same standard of sanitation and comfort nor must it be assumed that all the seamen adjust themselves accordingly, but the progress is very encouraging. Reviewing the various features contributing to this improved sanitation, probably the outstanding change has been the location and distribution of the spaces assigned to the crew. Freed from the hazards and dreary conditions of the storm-swept foc's'le, the crew now live amidships or aft in single and 2-berth cabins, with separate messroom and recreation room near the galley and 14 with convenient sanitary arrangements. Detailed attention has been given to these provisions. The spaces are afforded adequate natural and electric lighting at all times and they are heated by radiators of hot water, steam or electric pattern. Ventilators too, are sufficient, with a better planned distribution. Heating and ventilation combined with insulation of external steel plating considerably reduces dampness and condensation. In some quarters where the cabins are situated directly over the afterpeak tank and the tank top is insulated with composite cement, greater care is now taken to arrest condensation which would eventually cause dampness, corrosion and subsequent disturbance of the insulation. The cabins are comfortably furnished and no "tongue and groove" timber is used on the structure and furnishings, a factor which reduces breeding sites for insect pests and has contributed to the drastic reduction of insect nuisances. Properly sprung bunks with electric head lights, wardrobe lockers, chests of drawers, settees, writing facilities, seats, mirrors and in some cases washbasins are fitted in each cabin. Among soft furnishings provided are mattresses, linen, blankets, towels and floor covering. Many ships are now supplied with bunk and port curtains. Hot and cold fresh water is now generally available for washing purposes at appropriate places in the accommodation. Lavatory basins and w.c. pedestals of the glazed stoneware type have replaced the washing bucket and trough closet and are amply supplied with water. Washing and drying of clothes has not been overlooked and provision has been made where reasonably possible. Turning to the catering department and its amenities, the messrooms pantry and storerooms have been fitted with food lockers, hot presses, hot water wash-up sinks, refrigerators and adequate messing accommodation. Some of the galleys are still unsatisfactory; too many have old-fashioned wooden fixtures, stoves and coal bunkers which spread coal dust about the deck. The days when crews provided their own foodstuffs have gone and provision storerooms and ancillary equipment together with full facilities for preparing hot meals is made even in the smaller vessels where the number of crew does not warrant a whole-time cook. Now that blankets, linen and towels have become a regular provision for the crew, there is need to find storage space for clean and soiled changes and such articles should never be stowed in the provision room or living accommodation. Summarising the foregoing, it is evident that much progress has already been made in providing a higher standard of sanitation aboard coastwise ships and, judging by the developments aboard new vessels, there is good reason to believe that conditions will continue to improve throughout the coastwise fleet as old tonnage is scrapped and new vessels are built to replace them. Obviously, there are difficulties when planning satisfactory accommodation in the smaller vessels, but there are signs of success, and in any case, the basic principles of sanitation should be applied to all sizes of ships. Finally, it is noteworthy that a considerable proportion of the coastwise trade is operated by a few fleets of ships which offer a good standard of living and other attractive concessions to the crews. These incentives have stimulated the recruitment of seamen who are prepared to remain in the service of the fleet. HOUSEBOATS. Essex County Council Act, 1952. Part VII of this Act is devoted to Houseboats. The Part is adoptive, and the Riparian Authorities in Essex mainly concerned with Houseboats in the lower reaches of the Estuary have already adopted it. They have fixed the "Appointed Day" from which date the provisions of this Part of the Act apply within their respective districts and one Riparian Authority is already operating the appropriate sections. Briefly the provisions are that a Riparian Authority (known as a "Controlling Authority") has the power to order the removal of a houseboat placed on the saltings in their district, even though the houseboat may have been there before the coming into force of the Act. There are stipulations as to the Notice to be served, costs, advertising, appeals and compensation to the owners of the foreshore. There is also a provision that a Controlling Authority may not give consent to the placing of a houseboat within the Port of London without the previous written assent of the Port of London Authority or the Port Health Authority. Thus a more complete control of houseboats on the Essex foreshore is now in sight, but the control will be by the "Controlling Authority" and not by the Port Health Authority. It may well be that houseboats will disappear from the area completely within the next few years. The disastrous floods of February, 1953, gave the Riparian Authorities much anxiety and much extra work coping with the emergency and with re-habilitation problems afterwards. Happily that is now over and the Authorities concerned have now more time to attend to their normal functions. As part of the Government's scheme to prevent a recurrence of the floods, Smallgains Creek and Tewkes Creek, both on Canvey Island, have been dammed across at a point about half way between the head of the Creek and the outlet to the sea in each case. Consequently the effective length of these two Creeks has been reduced from about a mile in each case to about half a mile. The portion of each Creek above the dam being no longer connected with the sea is not within the Port Health Authority's district. In Tewkes Creek there is only one houseboat but in Smallgains Creek there are 26 houseboats, above the dam. Consequently these houseboats are no longer within the Port Health Authority's area. In the near future it is probable that Benfleet Small Creek will be similarly dammed. This will result in the removal of a quarter of a mile of Creek and about 20 houseboats from the Port Health Authority's area. PUBLIC HEALTH (SHELLFISH) REGULATIONS, 1934. The following report has been prepared by Mr. D. E. Madeley, the Sanitary Inspector in charge of the area:— Under the Public Health (Shellfish) Regulations, 1934, the Port Health Authority, then the Port Sanitary Authority, made an Order dated 23rd April, 1936, listing as a " Prescribed Area " all the sands on the Essex shores of the Estuary from Holehaven in the West to the Northern Boundary of the parish of North Shoebury in the East. 15 Thus all the shellfish layings on the Essex shore of the Thames which are within the Port Health Authority's area are controlled except a strip at the seaward (Eastern) end about If miles wide. Shellfish from the "Prescribed Area" must not be sold for human consumption unless they have been treated by one of the following methods:— (1) Subjected to a satisfactory process of cleansing at an establishment which is for the time being approved by the Minister of Health for the purpose, or (2) Relaid in pure water for such period and in such places as may from time to time be approved by the said Council for the purpose. (3) Subjected to a process of sterilisation by steam under pressure for at least six minutes in an apparatus which is for the time being approved by the said Council. By far the most important shellfish in the area are Cockles. They are treated under Section (3) above at establishments approved by the Port Health Authority for the purpose. There are at present nine of these approved establishments at Leigh and one at Southend, and it has been the practice for many years past to treat all cockles landed in the district by the same method, including those cockles derived from areas which are not "Prescribed" During 1950 /1951 a careful investigation was carried out into the methods by which cockles were cooked and with the co-operation of the Industry, certain modifications were advised in the apparatus. The two main modifications advised were— (1) The introduction of a reducing valve between the boiler and the cooking pots so that steam could be introduced into the cooking pots at a steady and pre-arranged pressure. (2) The extension of the "Three Pot System" of cooking (already in use by the more advanced operators). This system of cooking makes it more certain that the operator will maintain the six minutes cooking period required by the Regulations. A report on the experiments in cooking cockles was included in the Annual Report for 1950. Samples of cockles taken direct from the cooking pots have been subjected to bacteriological examination over the past four years. The results have been most satisfactory, the vast majority of the samples being returned as sterile. The cooking apparatus in use does not comply with the strict letter of the Regulations since there is no possibility of building up a steam pressure within the cooking pots. It does, however, function most satisfactorily. It produces not only a safe cockle from the Public Health point of view, but also a firm and uniform one which takes the salt well and which is acceptable to the trade. A full account of the cockle industry and particularly of the processing of the cockles in the cockle sheds and their distribution to the trade was given in the Annual Reports on the work of the Port Health Authority for 1949, 1950 and 1951. Ever since the outbreak of gastro intestinal disturbance which took place in the hot summer of 1949 among visitors to Southend and district which was clearly attributable to the consumption of cockles, there has been a very close supervision of the cockle sheds at Leigh-on-Sea, which fall within the jurisdiction of the Port Health Authority, and the retail local cockle industry which comes under the jurisdiction of Dr. Logan, Medical Officer of Health of Southend and thirdly with the Director of the Public Health Laboratories at Southend who carries out the periodic bacteriological examination of samples of cockles taken at various stages from their treatment in the sheds to their exposure for sale to the public. The table facing this page presents in diagrammatic form the results of the bacteriological examination of samples taken throughout the year of fresh unbrined cockles intended for immediate consumption and reveals certain interesting and important features. The table shows a direct correlation between the growth of organisms in the cockles and the temperature of the water in the mains at Southend used for cleansing the cockles after the steam cooking. It will be seen that excessive growth of organisms and incidentally of the poisons they develop, begin to appear when the mains water approaches 58° P. and continues to be unsatisfactory until the water returns to approximately the same temperature, i.e., cockles became, in 1953, potentially dangerous on this account in mid- June and continued so right through the summer months to the end of September and, in certain cases, until the end of October. Can the growth of organisms be avoided ? First by the observance of scrupulous cleanliness throughout the whole process from the sterilisation of the cockles in the steam retorts (a large number of samples tested reveals that the cockle meat is in fact sterile on emerging from the retort) right through to the time when they leave the cockle shed for distribution to the retail trade. Secondly by keeping the temperature of the water in which cockles are washed (it will be remembered that the cockles pass through four washings before they are completely free from sand, shell particles and other extraneous matter) as low as possible, in order to check the growth of bacteria. This is by no means easy to achieve and would involve an expensive refrigerating apparatus through which the mains water would have to pass before being used in the washing tanks. A third method—a heavy brining of the cockles, would prohibit the growth of organisms but would completely disturb the trade in fresh cockles since the brine would have to be washed out before they could be eaten and in any case the flavour of the fresh as against the heavily brined cockle would to some extent be lost. Both these precautions—scrupulous cleanliness at the cockle shed and the use of water at a temperature less than, say, 55° F., will only be achieved as an economic proposition in the trade when the proposal of the Southend Corporation to erect Municipal cockle sheds becomes a reality. 16 Even then the many opportunities for the contamination of the cockles or for the growth of organisms already present in the cockles, during distribution to the retail shops and stalls and the conservation of unconsumed cockles under appropriate refrigerated conditions has still to be taken into account before a really safe and sound cockle can be offered to the public. In this connection there are many problems still to be solved. Vendors of cockles must be in anticipation of demand and if their cockles are to be sound and wholesome they must keep a sharp look-out on weather conditions. Inclement weather in the early morning at the week-end may cause thousands of visitors to change their minds and postpone their trip to the coast with the result that the cockier finds himself with a considerable stock of cockles unconsumed at the end of the day and it is too much to expect him to discard these in favour of fresh cockles ordered for the next day. Properly speaking, these cockles should be kept in a refrigerator at a temperature sufficiently low to prevent the growth of organisms, much less decomposition, and indeed cockles should remain in the cold up to a point as near as possible to the estimated time of their consumption. To take them out of the refrigerator for some hours on a hot day and then to return them to the refrigerator unconsumed, is not sound hygienic practice. It is not only an excessive number of organisms in cockles that may produce gastro intestinal disturbance but also the poisons that they excrete and the latter are in no way affected by refrigeration. Fortunately great improvements have been achieved in recent years and offer a much greater security against the consumption of unwholesome cockles. On the other hand it is not so easy to improve the habits of the consumer who arrives at, say, Southend on a hot day and proceeds to consume quantities of liquid refreshment with which he mixes his cockles. He then betakes himself to the beach, undresses and lies with his body exposed to the hot sun, returning from time to time to the "Promenade" for more liquid refreshment and more cockles. Later in the day he feels agrieved because his interior arrangements protest and, may be, in such a manner as seriously to disrupt the pleasure of his day at the seaside and of the drive home. SMOKE ABATEMENTS. Vigilance has been maintained during the year in order to suppress instances of atmospheric pollution in the Port. Each district has been kept under surveillance but particular attention has been concentrated on the Middle and Upper reaches where any stream of smoke is most likely to offend the riverside population directly. At present the Authority has no bye-laws governing the content, density, colour and time factor, therefore the provisions of the Public Health (London) Act, 1936, are applied, while reference is made to the time standard laid down by the London County Council bye-laws for purposes of observation. To some extent this adoption is necessary if the Authority and the London County Council are to function harmoniously. By this standard an offence is committed when black smoke is emitted for a period of two minutes in the aggregate during any continuous period of 30 minutes observation. The nature of offensive smoke is defined in the Act and for sea-going ships only black smoke is considered, whereas all other vessels fall into the category where smoke includes soot, ash, grit and gritty particles. Comparatively few offenders are found among the larger sea-going ships while lying at the cargo berths and this is due in part to the use of shore installations for lifting the cargoes, thereby considerably reducing the load on the boiler. There are times however, when ships are raising steam for departure when a certain amount of black smoke may be emitted and calls for attention. Sometimes the boiler tubes are cleared of ash and soot by means of steam jets or compressed air during the hours of darkness and the immediate surroundings of the ship's funnel are covered with the deposits. Fortunately, this is becoming an infrequent occurrence. Usually, the sea-going ships respond forthwith to the advice or intervention of the Inspectors. Some difficulty has occasionally arisen with coastwise steamers which ply in the Upper district. Unless the fires are bright and a full head of steam is available when the ship leaves her berth on the outward voyage, it may be necessary to stoke the furnaces before the ship has cleared the Thames bridges. When such an incident occurs, and more so when the stoking is inefficient, large volumes of smoke invariably cause a nuisance to residents of the riverside and pedestrians who are crossing the bridges. This nuisance has been a feature of the tugs, but has now been considerably reduced. Many of the offending craft have outlived any days of efficiency and some complaints of low-grade fuel supplies are offered as a defence. The fuel burned by many hand-fired furnaces is undoubtedly quite unsuitable if smoke nuisance is to be avoided. Only hard grade boiler fuel comparable to the anthracite group should be used. In spite of the various handicaps, satisfactory progress has accrued as a result of the representations made at official level and direct approach to the stokers. Not all relations with officials are founded on formal notifications. Understanding and co-operation have developed from personal interviews and discussions. The trend to replace old steam-driven vessels with motorships is helping to solve the smoke problem, but the vessel which continues to burn bituminous coal of a low grade in a hand-fired furnace will invariably cause a smoke nuisance, especially the vessel with a fluctuating demand for steam. The fault by no means lies invariably with the Tugmaster who often has great difficulty in getting an appropriate allocation of hard steam coal from the Ministry of Fuel and Power, and I have refused to prosecute when such is the case. SECTION XV—Medical Inspection of Aliens. 1. List of Medical Inspectors of Aliens holding warrants of appointment. Dr. M. T. Morgan ; Dr. H. M. Willoughby ; Dr. J. A. Jones ; Dr. R. D. McLean. 2. List of other staff engaged on this work. Clerical staff at the Central Office. 3. Organisation of work. The inspection of ahens is carried out in accordance with the terms of the Alien Order, 1920. 17 All vessels carrying aliens are intercepted on arrival at Gravesend and the aliens are examined by the Medical Inspector of Aliens who is, in fact, the Medical Officer on duty. Complete liaison exists between the Port Health staff and the Immigration staff at Gravesend and should any doubtful case arrive the Medical Officer is immediately communicated with by telephone and an opinion given. 4. Nature and amount of alien traffic. (a) Total number of arriving vessels carrying aliens 2,026 (b) Total number of aliens (excluding transmigrants, seamen and airmen). (i) Arriving at the port 32,750 (ii) Medically inspected 18,691 (iii) Medically examined 882 (c) Certificates issued 2 (d) Transmigrants landing and medically examined Nil. SECTION XVI—Miscellaneous. Arrangements for the burial on shore of persons who have died on board ship from infectious disease. No change. 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 3,574 tons 7 cwts. 2 qrs. 7 lbs. The following is a summary showing the method of disposal of the foodstuffs seized :—- Method of Disposal. Tons. Weiqht. lbs. Approximate percentage of total weight. cwts. qrs. Burnt 96 0 1 20 2.6 Buried 1,200 1 0 11 33.5 Cattle Food 758 15 2 9 21.2 Boiling down 52 19 2 11 1.4 Reconditioning 182 1 0 12 5.0 Released to other districts 207 8 2 1 5.8 Manufacturing ... 9 7 1 18 0.2 Refining ... 1,056 1 2 10 29.4 Industrial... 4 19 1 11 0.1 Re-export 6 12 3 16 0.1 Total 3,574 7 2 7 99.3 Of the 3,574 tons mentioned above, the principal items condemned for human consumption consisted of:— Burnt.—1,754 tons Canned Meats (burst, blown and leaky); 4 boxes and 15 cartons Fish (sour and out of condition); a quantity of Lamb, Beef, Pork, Sausages, etc. (dock water damaged); 57 cartons, 4 cases and 616 tins Canned Fruits (burst, blown and leaky); 212 bags Onions (wasting); 36 cases Cheese (unwholesome); 27 cartons and 10 cases Sweetened Fat (rat damaged, melted and fouled); 39 boxes Apples (wasting) ; 45 bags Cocoa Sweepings (old and dirty). Buried.—1,110 tons Bananas (over-ripe and rotten); 168 cases, 47 cartons and 25 tins Canned Meats (burst, blown and leaky); 179 cartons, 60 cases and 316 tins Canned Fruit and Fruit Juices (burst, blown and leaky); 45 tons 1 cwt. Fresh Fruit and Vegetables (wet, wasting, etc.); 7 cases and 23 jars Pears (mouldy); 52 cartons Confectionery (flood water damaged); 2 cartons Sweetened Fat (dock water damaged); 62 bags Figs (dock water damaged); 10 casks Olives (sour and decomposed). Cattle Food.—619 tons and 10 cwts. Bananas (over-ripe and rotten); 38 tons 14 cwts. Flour and various other cereals (rejected ships' stores, weevilly and out of condition); quantity of Wheat Germ (dirty, rat damaged and wet); quantity of Dried Milk Powder (dock water damaged); 134 cases and 13 tins Cherries (blown); 53 cartons and 2 cylinders Lacto Albumen Powder (flood water damaged); 151 cases Dates (moth infested); 83 bags Michigan Pea (Navy) Beans (bilge water damaged). Boiling Down.—43 tons 2 cwts. Lamb, Beef, Mutton, Pork, Offal, etc. (dock water damaged, dirty, moulds, brine stained, etc.); quantity of Meat Sawdust (dirty); 155 Hams (mouldy); 2 drums Tallow (uncertificated); 37 drums Lard (dirty and contaminated). Reconditioning.—363 bags Beef Tripe (oil taint); 49 Cut-Beef Hinds (oil taint); 11 bags Cake Mixture (oil stained); quantity of Canned Cherries (blown and leaking); 106 cases Butter (dock water damaged); 51 cartons Milk Powder (contaminated); 25 bags Wheat Germ (rain water damaged); 11 crates Cheese (dock water damaged); 200 cases Lard (dirty and contaminated); 230 cartons and 14 bags Dried Fruit (wet damaged); 8,564 bags Figs (wet and fire damaged); 45 bales Bacon (vermin eaten). Released to other Districts.—For conversion to animal feeding under the supervision of the local Medical Officer of Health—99 tons 18 cwts. rejected ship's stores (weevilly and out of condition); 295 cases Canned Orange Segments (burst, blown and leaky); 650 cases Canned Molasses (blown); 571 cartons Canned Stewed Beef Steak (blown); 238 cartons Dried Milk Powder (wet damaged); 1,000 cases Canned Tomato Concentrate (blown); 23 chests Tea (dock water damaged); 18 bags Hazelnut Kernels (extraneous matter). 18 Manufacturing Purposes.—40 cartons Canned Hams (washy); 270 cases Canned Cherries (blown). Refining.—81 drums Lard (dirty and contaminated); 861 bags Sugar Sweepings (dirty); 966 tons Sugar (wet, bilge and sea water damaged). Industrial Purposes.—94 bags Gelatine (flood water damaged); 1 cask Sheep Casings (uncertificated). Re-Export.—50 cartons Canned Luncheon Meat (springers); 1 case Canned Chinese Pork Sausages (uncertificated) ; 20 casks Beef Casings (uncertificated); 10 casks Sheep Casings (uncertificated and /or incorrect official certificate). PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937 and 1948. Official Certificates. During the year five Circulars were received from the Ministry of Pood directing that the Minister has caused to be published in the London Gazette, notices containing in the Schedule thereto descriptions of certificates issued by the Sudan Government, the Government of Eritrea, the Government of the Falkland Islands, the Government of Greece and the Protectorate of Bechuanaland, which have been recognised as Official Certificates for the purposes of the Public Health (Imported Food) Regulations, 1937 and 1948. THE FOOD AND DRUGS (WHALEMEAT) REGULATIONS, 1949 and 1950. Veterinary Certificates. Two Circulars were received from the Ministry of Food directing that the Minister has caused to be published in the London Gazette, notices containing in the Schedule thereto, descriptions of labels issued by the Government of Norway and the Government of Denmark (in respect of whalemeat from the Faroe Islands) which have been recognised as Veterinary Certificates for the purposes of the Food and Drugs (Whalemeat) Regulations, 1949 and 1950. DANGEROUS DRUGS. During the year twenty-nine 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 supply and shall be retained by him and kept available for inspection." PUBLIC HEALTH ACT, 1936. PART X—CANAL BOATS. On the 15th January, 1954, 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, 1953. Twelve vessels were inspected during the year all of which were found to be satisfactory. In one instance a verbal warning was given to the Master who failed at the time of inspection, to produce the Certificate of Registration. No new boats were registered during the year under review, the actual number of Canal Boats on the Register on the 31st December, 1953, being 156. LEGAL PROCEEDINGS. A consignment of 100 cases of Tomato Concentrate arrived in the London Docks on the 29th January, 1953, from Palermo. The consignment was detained and one of the tins was submitted to your Public Analyst as a routine for examination for metallic contamination. Subsequently a further six tins were submitted for examination, resulting in several of the tins showing the presence of tin in excess of the limit recommended by the Metallic Contamination Sub-Committee of the Ministry of Food. An application was made to the appropriate Magistrate by Mr. Comptroller and City Solicitor for an Order condemning as unsound the above-mentioned consignment. On the 3rd March, 1953, the Assistant Solicitor appeared before the Magistrate sitting at the Thames Magistrates' Court when the application was adjourned until the 9th idem at the request of Counsel for the importers of the food. On the 9th March, 1953, the Assistant Solicitor again appeared before the Magistrate and applied for an Order condemning the food on the ground that it was unwholesome as the food contained an excessive amount of tin and your Medical Officer, the Public Analyst and a Sanitary Inspector gave evidence in support of the application, after which a Director of the importers and four analysts gave evidence against the application. After hearing the whole of the evidence the Magistrate dismissed the application on the grounds that the excess percentage of tin in the food was very small, there was no evidence of injury to health and the standard recommended by the Ministry of Food was merely advisory and not statutory. The Magistrate refused to grant costs to the defendants. 19 APPENDIX I. MEDICAL INSPECTION—From 1st January to 31st December, 1953. GRAVESEND. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total. No. medically inspected 158 148 165 191 184 153 131 156 171 188 176 179 2,000 No. of Passengers 571 344 811 1,199 2,069 3,923 5,015 3,307 1,773 1,332 589 658 21,591 No. of Crew 231 407 653 587 386 145 280 526 802 424 373 693 5,507 No. of Foreign Arrivals 881 837 924 946 1,010 987 1,059 988 967 959 972 962 11,492 APPENDIX H. INFECTIOUS DISEASES. Disease. 1944 1945 1946 1947 1948 1949 1950 1951 1952 Mean Annual No. for 10 years ending 31st December, 1953 1953 (a) Cases reported— Cholera (including suspected cases) - - - - - - - - - - Plague do. - - - - - - - - - - - Yellow fever do. - - - - - - - - - - - Typhus fever — 1 — — 1 5 — — — 0.7 — Smallpox 1 — 5 2 3 2 4 6 — 2.4 1 Scarlet fever 4 5 2 10 3 3 7 3 — 3.9 2 Enteric fever - 4 9 5 10 82 9 7 8 14.2 8 Measles 1 8 11 26 99 80 58 74 56 51.0 97 German measles — 2 6 5 3 3 17 67 13 12.2 6 Diphtheria 5 5 8 5 2 1 — — 2 2.8 — Erysipelas — — — — 1 — 1 — — 0.3 1 Pulmonary losis 6 14 21 27 32 43 41 53 67 35.0 46 Other diseases (including Chickenpox) 180 115 79 102 106 124 114 130 128 126.2 184 Totals ... 197 154 141 182 260 343 251 340 274 248.7 345 (b)Admitted to Hospital. Cholera (including suspected cases) - - - - - - - - - - - Plague do. - - - - - - - - - - - Yellow fever do. - - - - - - - - - - - Typhus fever — — — — 1 3 — — — 0.4 — Smallpox - - - - - - - - - — — Scarlet fever 4 4 2 .— 3 — — 1 — 1.4 — Diphtheria 4 5 7 4 2 — •— 1 — 2.3 — Enteric fever — 3 — 2 3 — 6 .- 1 1.6 1 Measles 1 4 6 10 24 8 5 12 3 8.9 16 Parotitis 3 1 5 1 4 3 1 13 4 3.7 2 Dysentery — 1 8 9 3 1 — 1 1 2.4 — Other diseases (including Chickenpox) 34 50 43 60 80 34 56 35 35 47.5 48 Totals 46 68 71 86 120 49 68 63 44 68.2 67 20 APPENDIX IV. RETURN OF RATS CAUGHT AND DESTROYED DURING THE YEAR 1953. Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total. London Dock— Warehouses 53 29 12 50 40 47 40 26 47 28 28 30 430 Vessels — — — 4 1 20 16 — — — 4 1 46 St. Katharine Dock— Warehouses 3 2 2 5 1 2 — — 4 — — — 19 Vessels - - - - - - - - 5 3 — — 8 Surrey Commercial Dock— Warehouses 1 1 2 22 2 1 2 3 10 11 3 11 69 Vessels — — 2 3 — 44 4 - - - - - 53 East India Dock— Warehouses 7 4 — — — 1 2 12 — — 6 11 43 Vessels - - - - - - - - - - - - - West India Dock— Warehouses 99 49 31 21 94 2 87 129 39 124 177 42 894 Vessels 43 32 — 67 — 17 30 — 10 — — 23 222 Millwall Dock— Warehouses 17 21 23 117 55 17 35 39 67 64 74 82 611 Vessels -— - - 1 2 1 1 86 - - 5 - 96 Royal Albert Dock— Warehouses 4 10 4 14 5 8 16 27 12 25 8 16 149 Vessels 31 31 14 24 55 22 9 38 14 32 — 20 290 Royal Victoria Dock— Warehouses 58 68 56 50 35 85 76 64 111 59 93 101 856 Vessels 20 —- 2 25 6 42 35 53 77 17 — 66 343 King George V. Dock— Warehouses 10 18 2 8 6 — 19 —- 9 28 6 1 107 Vessels 39 — — 9 41 — 22 — 4 — 2 31 148 Tilbury Dock— Warehouses 14 275 176 30 17 31 15 43 23 10 13 20 667 Vessels 10 15 5 120 12 96 14 2 —- 46 68 59 447 Regent's Canal Dock— Warehouses 10 6 16 2 — 1 — — 1 2 — — 38 Vessels - - - - - - - - - - - - - River— Vessels - - - - - 3 106 8 62 27 3 11 220 Totals 419 561 347 572 372 440 529 530 495 476 490 525 5,756 21 APPENDIX V—General Summary and Analysis of the Sanitary Inspections, etc., in the Port of London for the year ended 31st December, 1953. Foreign Going. Steam—■ Inland Navigation.—Continued, Sail- Inspected 9,527 Inspected 3 Defective 351 Defective 1 To be cleaned 541 To be cleaned 1 Sail- Lighters— Inspected - Inspected 567 Defective - Defective 1 To be cleaned - To be cleaned 24 Canal Boats— Coastwise. Steam— Inspected 12 Defective To be cleaned — Inspected 1,531 Shore Premises. Defective 51 To be cleaned 108 Inspected 8,087 Sail- Defective 79 To be cleaned 227 Inspected 26 Defective - Sick Seamen referred to Hospital 105 To be cleaned - Water Barges. Inland Navigation. Steam— No. in district in good condition on 31st December, 1952 14 New Barges — Condemned — Inspected 70 Use discontinued 3 Defective 1 Previously withdrawn and since resumed work — To be cleaned 4 No. in district on 31st December, 1953 11 Inspections. Dock and River. No. Nationalities. No. Total Inspections London and St. Kats. American (U.S.A.) 88 804 Argentinian 26 1st January to Belgian 57 31st December, 1953:- Regent's Canal 256 Brazilian 12 Foreign Going 9,527 Surrey Commercial 1,543 British 7,415 Coastwise 1,557 Costa Rican 2 Inland Navigation 640 Danish 248 Shore Premises 8,087 East India 221 Dutch 1,271 Finnish 176 Total 19,811 West India French 111 930 German 624 Millwall 582 Greek 69 Number of Vessels inspected in the Launches Royal Albert Honduras 11 1,007 Indian 30 Royal Victoria Israeli 14 790 Italian 95 "Alfred Roach " Japanese 25 " Howard Deighton" 1 745 King George V. 734 Liberian 38 Monro vian 6 "Frederick Whittingham" 1,432 River—Upper Pakistani 4 ... 1,432 Panamanian 80 Polish 29 "Alfred Robertson"... River-—Middle 752 Portuguese 44 752 Roumanian 3 3,929 Russian ... 46 South African ... 3 River—Lower Spanish ... 33 | 1,745 Swedish and Norwegian ,038 River Medway ... J Swiss 15 Turkish ... 23 Tilbury 928 Uruguayan 4 Yugo Slavian 84 In Docks, etc. 7,795 Total Vessels ...11,724 Total Vessels... ... 1] ,724 Shore Premises 8,087 Shore Premises ... 8,087 Shore Premises ... ,087 Total 19,811 Total ... ... 19,811 Total IS ,811 22 APPENDIX VI. 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 Millwall 35 3,217 2 155 Royal Victoria 95 1,772 5 1,479 Royal Albert 87 213 3 905 King George V. 64 997 3 663 Tilbury 104 2,166 3 1,667 The River distance between the Western and Eastern limits of the Port is about 68½ miles. POWERS. The work of the Port of London Health Authority is carried out under the following Acts of Parliament and Statutory Instruments:— 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 Purther Powers, Port of London, 29th December, 1894. L.G.B. Order, Port Sanitary Authority Assignment of Powers, Port of London, 30th June, 1898. London Port Sanitary (Additional Powers) Order, 1922. S.R. & O. No. 781. London Port Sanitary (Additional Powers) Order, 1923. S.R. & O. No. 812. Port of London (Assignment of Powers) Order, 1933. S.R. & O. No. 803. Administration. Port Sanitary Administration and Medical Inspection of Aliens under the Aliens Order, 1920. (Grants in Aid). City of London (Various Powers) Act, 1922, Part IV, Section 30. City of London (Various Powers) Act, 1933, Part III, Sections 6 and 7. Sanitary Officers Order, 1926. S.R. & O. No. 552. Sanitary Officers (London) Regulations, 1951. S.I. No. 1021. Infectious Disease. Prevention of Epidemic Diseases Regulations as to Plague. Destruction of Rats, 1910. S.R. & O. No. 1165. Public Health (Notification of Infectious Diseases) Regulations, 1918. S.R. & O. No. 67. Infectious Diseases (London) Regulations, 1927. S.R. & 0. No. 1207. Public Health (Acute Poliomyelitis, Encephalitis and Meningococcal Infection) Regulations, 1949. S.I. No. 2259. Public Health (Leprosy) Regulations, 1951. S.I. No. 1036. Puerperal Pyrexia Regulations, 1951. S.I. No. 1081. Public Health (Ships) Regulations, 1952. S.I. No. 1411. Canal Boats. Public Health Act, 1936. Pood. Public Health (Meat) Regulations, 1924-1948 (Part IV) S.R. & O. 1924. No. 1432; 1935 No. 187; S.I. 1948, No. 1119. Public Health (Preservatives, etc., in Food) Regulations, 1928. S.R. & O. 1925, No. 775 ; 1926, No. 1577 ; 1927, No. 577. Public Health (Imported Milk) Regulations, 1926, S.R. & O., No. 820. Public Health (Imported Food) Regulations, 1937 and 1948, S.R. & O., 1937, No. 329 ; S.I. 1948, No. 886. Food and Drugs (Whalemeat) Regulations, 1949. S.I. No. 404. Food and Drugs (Whalemeat) (Amendment) Regulations, 1950. S.I. No. 189. 23 Shellfish. Public Health (Shellfish) Regulations, 1934. S.R. & 0. No. 1342. Medway (Shellfish) Regulations, 1935. S.R. & 0. No. 1221. Rats and Mice. Prevention of Damage by Pests Act, 1949. Prevention of Damage by Pests (Application to Shipping) Order, 1951. S.I. No. 967. 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. Order appointing 1st July, 1928, as the date for the coming into operation of the Fertilisers and Feeding Stuffs Act, 1926. S.R. & 0. 1928. No. 439. Fertilisers and Feeding Stuffs Regulations, 1932. S.R. & O. No. 658. Fertilisers and Feeding Stuffs (Amendment) Regulations, 1951. S.I. No. 1189. Dangerous Drugs. Dangerous Drugs (No. 3) Regulations, 1923. S.R. & O, No. 1095. Aliens. Aliens Order, 1920. S.R. & 0. No. 448. Aircraft. Public Health (Aircraft) Regulations, 1952. S.I. No. 1410. 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 nuisances arising from barges or vessels carrying offensive cargoes. 2. For removing to hospital any person suffering from dangerous infectious disorders, and for the keeping therein of such persons as long as may be deemed necessary. 3. With respect to Houseboats used for human habitation within the limits of the Port of London. 400 -4/54. 24