AC. 4369 2nd Copy Hck 26/10/56- pton 63 111 PORT HEALTH AUTHORITY OF THE PORT OF LONDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To 31st DECEMBER, 1955 111 PORT HEALTH AUTHORITY OF THE PORT OF LONDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH (JOHN GREENWOOD WILSON, MD., F.R.C.P., D.P.H., F.A.P.H.A.) To 31st DECEMBER, 1955 Port Health Authority of the Port of London, 5, Church Passage, London, E.C.2. Telegraphic Address: "PORTELTH LONDON" Telephone Number: MONarch 3030. The governing body of the City of London, the Corporation of I.ondon, was originally constituted the Sanitary Authority of the Port of I.ondon by Section 20 of the Public Health Act, 1872. The cost of administration was met from the Corporation's private funds for close on fifty years, when it became rate (and grant) aided. By the Public Health (London) Act, 1936, the term "Port Sanitary" was changed to "Port Health". The limits of the Port Health District of the Port of London are still as originally defined by a Treasury Minute dated 1st August, 1883. They commence at high-water mark in the River Thames at Teddington Lock, in the County of Surrey, and extend down both sides of the said 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 northwestern 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 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 Watercourses 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. The Port of London Authority with which the Port Health Authority works in close co-operation, was established as the administrative body of the Port of London including the docks and tideway of the River Thames, by \ct of Parliament in 1909. The limits of its jurisdiction are about the same as, but not quite so extensive as those of the Port Health Authority. SECTION I—STAFF TABLE A Name of Officer Nature of Appointment Date of Appointment Any other Appointment held J. Greenwood Wilson Medical Officer of Health July, 1954 Medical Inspector of Aliens. h. m. wllloughby . Deputy Medical Officer of Health and Medical Officer in charge at Denton Hospital. May, 1929 ditto. J. A. Jones . Assistant Port Health Officer April, 1935 ditto. R. D. Maclean ditto. October, 1953 ditto. w. d. l. Smith Do. Isle of Grain (part time) January, 1954 ditto. H. A. Madwar Do. Sheerness Boarding Station (part time). December, 1927 - CLERICAL J. A. Gil lis Senior Clerk March, 1914 - W. L. McLorg Assistant Senior Clerk February, 1927 — R. c. rat lif f First Class Assistant Clerk March, 1930 — E. V. Smith Clerical Officer October, 1938 - (Vacant) Clerical Officer R. H. LOTT Intermediate Grade Clerk May, 1947 F. B. OS30RN ditto May, 1952 — T. A. Woods Messenger November, 1955 — INSPECTORIAL T. L. mackie, M.B.E. Chief Sanitary Inspector and Supervisory Engine er of Launch Service November, 1934 P. W. coombe Senior Sanitary Inspector December, 1924 — E. H. JOHNSON Sanitary Inspector 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 May, 1936 — 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 — W. M. Walker ditto October, 1954 — H. Butlin ditto July, 1955 — A. W. buchan ditto July, 1955 — MEAT SORTERS g. Simmonds Meat Sorter May, 1955 - W. H. clatworthy 4itto June, 1955 - RODENT INSPECTORS c. W. Moody Rodent Inspector February, 1929 — E. C. Wat kins ditto June, 1929 — s. A. Croft ditto June, 1929 — 2 TABLE A—continued RODENT INSPECTORS—conitnued Name of Officer Nature of Appointment Date of Appointment ther Appointment held C. Stockton Rodent Inspector June, 1940 — d. J. davis ditto August, 1941 - F. D. Cartman ditto September, 1943 — g. Lamont ditto March, 1945 — (Vacant) ditto RODENT CONTROL SCHEME H. A. Baxter ditto June, 1945 - W. g. Stimson ditto February, 1946 — g. clark A. L. southwood ditto ditto January, 1949 January, 1949 — R. M. Collier Rodent Operative July, 1951 — A. T. Evans ditto January, 1953 — C. E. W. Eastman ditto April, 1954 — (Vacant) ditto - LAUNCHES AND HULKS P. J. wllkins Navigator (Senior) November, 1928 — W. S. Stimson Navigator (i/c Greenwich Station) March, 1944 — J. R. Steen Navigator March, 1926 — W. g. A. king ditto September, 1939 — C. R. Simons ditto August, 1938 — H. J. Mason ditto August, 1946 — S. J. Crutchley, D.S.M. Engineer (Senior) June, 1939 - J. F. Trice, M.B.E. Engineer September, 1947 — E. Alewood ditto January, 1947 - K. Gittens ditto January, 1955 - A. R. L. Potter Deckhand July, 1945 — r. A. Mantripp ditto March, 1945 - A.w. Sutherland ditto November, 1955 — (Vacant) ditto (Vacant) ditto A. T. Bridges Deckboy March, 1953 — B. Osenton ditto December, 1953 — M. East ditto September, 1954 - A. SuSTINS ditto November, 1954 — R. Watts ditto March, 1955 — A. A. A. Green ditto June, 1955 — W. Lawrence ditto October, 1955 - D. A. Coomber ditto December, 1955 — J. F. Smeed Steward (part time) July, 1927 - A. R. burge Shipkeeper August, 1945 — A. C. Croft ditto October, 1950 — W. Simmons ditto May, 1955 — w. j. mace Watchman May, 1951 - F. W. Woodrow ditto October, 1954 - LAUNCHES- Date acquired "Howard Deighton" 1931 "Frederick Whittingham" 1934 "Alfred Robertson" 1938 "Alfred Roach" 1948 HULKS- "Hygeia" at Gravesend 1935 "UPLEES" at Greenwich 1945 3 January, 1956. To The worshipful The port of London health Committee, gentlemen, I have the honour to submit my Annual Report for the year ending 31st December, 1955, as Medical Officer of Health of the Port of London. Circular No. 16/55, dated 18th October, 1955, from the Secretary, Ministry of Health, contained a reminder that the Medical Officer of Health should prepare his Annual Report for 1955 on the lines indicated in Form Port 20 enclosed with Circular 33/52 of the 6th November 1952, adapted as may be necessary to the special needs of the Administration of the London Port Health District. Paragraph 5 of F,orm 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 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". In accordance with this directive this Report has been prepared recapitulating all the information required by the sections referred to above. Tonnage. The tonnage of vessels entering the Port of London during 1955 was 35,114,943 tons as compared with 33,789,022 tons during 1954. Fifteen thousand four hundred and fifty-two vessels arrived from foreign ports and of these 1,874 were visited by your Medical Officers. (Table B). Communicable Diseases. Four hundred and eighty-four cases of notifiable and other infectious diseases (including malaria) were reported as having occurred on 217 vessels during the voyage, of which 130 were landed in the Port. (Table D). Fumigations. One hundred and fifty-six vessels were either fumigated, trapped or poison baited for rodent destruction and the issue of International Certificates under the supervision of your Inspectors. Twenty-eight vessels were fumigated using hydrogen cyanide and resulted in the recovery of 499 rats and 381 mice. One vessel was fumigated using sulphur dioxide from which 9 rats were recovered. The remaining 127 vessels were subjected to various methods of poisoning and trapping in 119 of which '1080' was used, resulting in the destruction of 1,769rats and 576 mice. Rodents. A total of 5,717 rats were destroyed and their bodies recovered during the course of the year, 3,205 in ships and 2,512 on shore premises in the Port. (Table E). In addition 4,639 mice were destroyed, 803 in ships and 3,836 on shore premises. Forty-three rats were examined for plague with negative results. Water Barges. Thirteen water barges were in use during the year. The annual registration of these craft by the Port of London Authority is made conditionally 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 separate report (see page 28). 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 5,048 tons 12 cwts. 0 qrs. 23 lbs., as compared with 3,849 tons in 1954 and 3,574 tons in 1953. Shellfish. The routine inspection of shellfish under the Public Health (Shellfish) Regulations was continued throughout the year. Instruction of D.P.H. and D.I.H. Classes and Visitors to the R)rt. A detailed account appears on page 32 of this Report. Your Medical Officer wishes to record his appreciation of the collaboration and assistance rendered by Her Majesty's Customs, the Port of London Authority, the Shipping Federation, by the Pilots, members of the staffs of Shipping Companies and Merchants and the staff of the Central Public Health Laboratory, in every aspect of the work of the Port Health Authority throughout the year. I have the honour to be, Gentlemen, Your obedient Servant, J. GREENWOOD WILSON. 4 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 naving had during the voyage infectious disease on board. By the Port Medical Officer By the Port Sanitary Inspector Foreign Ports 15,452 26,089,386 1,874 9,973 215 Coastwise 11,882 9,025,557 2 2,078 2 T otal 27,334 35,114,943 1,876 12,051 217 SECTION ID—CHARACTER OF SHIPPING AND TRADE DURING THE YEAR. TABLE C Passenger Traffic 1 Number of Passengers—Inwards 99,230 1 Number of Passengers—Outwards 117,408 Cargo Traffic 1 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 can 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 pattern as used by the Metropolitan Water Board. They are contained in brick-lined pits constructed at intervals along the berthing quays and consist of an upright standpipe with nozzle coupling to which the supply hose can be coupled. 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 in the transference from the ship to the shore at no time do they come into contact with the dock water. If this should happen the hoses are thoroughly cleansed and flushed with fresh water before being used again. 4. Number and sanitary condition of water boats and powers of control by the Authority. There were thirteen 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 Medical Officer of Health of the Port 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. 5 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. 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 ships they board and accordingly supplies of the Declaration of Health are sent, from 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 ship's 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. (The following instructions apply only to the Port of London). I. If the answers 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; INDONESLA, 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 his vessel and the time fihe is expected to arrive off Gravesend. This message must be sent off not more than 12 hours and not less than 4 hours before arrival of the ship. In the case of vessels bound for the Medway, the wireless message should be addressed to "PORTELTH LONDON", as follows:- "(Name of Vessel) (Time of Arrival) Sheerness"* *(The addition of the word "Sheerness" to the wireless message is an indication that the vessel is proceeding up the River Medway). NOTE.— If wireless is not carried the Port Health Authority must be notified of the arrival of the ship as soon as possible. (2) By day, when within the Port of London, hoist the flag signal LIM, meaning "Port Health Officer required"; By night when approaching Gravesend, flash letter 'Q' repeatedly from the morse lamp. (3) If a Ship's Surgeon is not carried, have the crew mustered ready for inspection by the Port Medical Officer as soon as he boards the vessel. Free pratique will not be granted by Her Majesty's Customs until the vessel has been visited by the Port Medical Officer. II. If the answers to all the questions of page 1 are "NO", and the vessel has not called during the previous four weeks at any of the Ports mentioned above, the Master need not communicate with the Port Health Authority in the manner described above, unless requested to do so by the Customs Officer. (2) Radio messages. (a) Arrangements for sending permission by radio for ships to enter the district (Regulation 13). No such arrangement exists in the Port of London. (b) Arrangements for receiving messages by radio from ships and for acting thereon. (Regulation 14(l)(a) and (2) ). Arrangements are in force by which the General Post Office telephone direct to the Medical Officer on duty on the "Hygeia", all messages received by the North Foreland Radio Station, from vessels in accordance with the instructions on the Declaration of Health. Occasionally a vessel voluntarily sends a full Quarantine message in code, which is deciphered by the Medical Officer from Volume II (Radio) of the International Code of Signals. 6 (3) Notifications otherwise than by Radio (Regulation 14 (l)(b) ). Ships requiring medical attention are required to fly the flag signal "LIM" during the day and to flash 'Q' on their morse lamp by night when approaching Gravesend, both signals meaning ''Medical Officer required". The light signals to be used by ships at night as amended in the Public Health (Ships) Regulations, give rise, in the Port of London, to some difficulty owing to the fact that the red light is already in use, either singly or combined with the white, by petroleum vessels and also by the cross-river ferries. The matter is further complicated by the fact that the white signal is used to call the Custom's launch on the approach of a vessel in the Gravesend Reach. Consequently the flashing of 'Q' by morse lamp at night still continues but a number of Masters are flying the red over white signal prescribed in the 1952 Regulations. (4) Mooring Stations (Regulations 22 to 30). The new Mooring stations agreed between the Port of London Authority and the Waterguard Superintendent of Her Majesty's Customs and Excise in 1947, to replace those that had been destroyed by enemy action during the war, are as follows:— MOORING STATIONS -\ppointed by the Medical Officer of Health, Port of London, under Regulations 22 to 30 of the Public Health (Ships) Regulations, 1952. Destination of Ships (A) Within the Docks (B) Outside the Docks London and St. Katharine Dock The nearest available river moor ings by arrangement with the Harbour Authority. Gravesend Reach East India Dock Regent's Canal Dock Riverside Wharves and Creeks Surrey Commercial Dock Quebec Dock Buoys West India Dock Mark Lane Buoys Millwall Dock Millwall Dock Royal Victoria Dock Mudfield Quay, South Side Royal Albert Dock No. 1 Berth, R.A.Dk. Basin King George V. Dock No. 1 Berth (lay-bye) Tilbury Docks The most suitable quay berth available. River Buoys, e.g., Charlton 3uoys The buoys at which the vessel is moored. Dry Dock The dry dock in which the vessel is lying. Thameshaven Oil Tankers Place of mooring, loading or discharge. As under (A) Holehaven & Canvey Do. other ships North side of river opposite Jetties do. Chapmans Anchorage Place of mooring, loading or discharge. do. Southend and Leigh Do. Gravesend Reach Sheerness Ridham " Oil Tankers Do. As under (A) Chatham Rochester, etc. Do. other ships Do. Garrison Point Particulars of any Standing Exemptions from the provisions of Article 14. No standing exemptions have been made in regard to ships proceeding above Gravesend, but the question of exemption for certain vessels, particularly "oil tankers" proceeding up the River Medway and to Thameshaven, was the subject of correspondence with the Waterguard Superintendent of Her Majesty's Customs and Excise, resulting in the following arrangements :— 7 HEALTH REGULATIONS (Customs Code Vol. 4, Part 4) PORT OF LONDON Procedure to be followed for SHIPS PROCEEDING UP RIVER TO GRAVESEND AREA OR ABOVE The list of infected areas (Customs Code, Vol. 4, Pt. 4, para. 3) referred to as the "listed areas" below, is given on page 4 of the London Declaration of Health Form. Classification of ship C.C., Vol. 4. Pt 4, paras. 5 & 6. Answers given to questions on the Declaration of Health Form If vessel has come from a "listed area" within six weeks of her arrival in London. Customs Procedure (1) All "foreign going" ships other than Tankers. All in the negative No. Issue Certificate of Pratique (2) All "foreigngoing" ships other than Tankers. If any are in the affirmative, or Yes (a) Inform the Master that he (i) must not allow any unauthorised person to leave the ship without the Medical Officer's permission. (ii) should not proceed beyond Gravesend Reach without the Medical Officer's consent. (iii) by day immediately hoist LIM flag signals or by night flash "Q" signal to Hygeia. (b) Leave full Certificate of Ffcatique under cover addressed to Medical Officer of Health who will issue it in due course (see footnote (ii)). (c) In the most expeditious manner possible take any necessary action to ensure that the Medical Officer is cognisant of the vessel's arrival. (3) "Foreign going" ships. Tankers. Al1 in the negative. Can be disregarded. Issue Certificate of Pratique. (4) Do. If any are in the affirmative. Can be disregarded. As in the case of ships at (2) above. (5) Home Trade If a written Declaration of Health is taken and any answered in the affirmative. As in the case of ships at (2) above. (i) From the heading of Col. 3 it will be seen that the fact that a ship has come from a "listed area" before six weeks of her arrival here can also be disregarded. (iii) If the Medical Officer of Health detains the vessel he will not issue the Pratique Certificate but return it at once to the Preventative Officer who will then issue to the Master a Modified Certificate of Pratique. (Signed) C. R. PURSER, CUSTOM HOUSE, LONDON, E.C.3. Waterguard Superintendent. 8 HEALTH REGULATIONS (Customs Code, Vol. 4, Part 4) PORT OF LONDON Procedure to be followed for ships at— THAMESHAVEN, IIOLEHAVEN, CANVEY, CHAPMAN'S ANCHORAGE, SOUTHEND and LEIGH The list of infected areas (Customs Code, Vol. 4, Part 4, para. 3) referred to as the "listed areas" below, is shown on page 4 of the London Declaration of Health Form. Classification of ship C.C., Vol. 4. Pt 4, paras. 5 & 6. Answers given to questions on the Declaration of Health Form If vessel has come from a "listed area" within six weeks of her arrival in London. Customs Procedure (1) All "foreigngoing" ships other than Tankers. All in the negative. No. Issue Certificate of Pratique. (2) Do. If any are in the affirmative. Yes. (a) Inform the Master that he is not to allow any unauthorised person to leave the ship without the Medical Officer's permission. {b) Issue modified pratique and allow vessel to proceed to her place of mooring, loading or discharge. (See footnote (i)). (c) In the most expeditious manner possible notify the Medical Officer of Health on the Hygeia. Telephone Gravesend 325. (See footnote (ii)). (3) "Foreign going" ships. Tankers. All in the negative. Can be disregarded Issue Certificate of Pratique. (4) Do. If any are in the affirmative. Can be disregarded As in the case of ships at (2) above. (5) Home Trade Ships . If a written Declar tion of Health is taken and any answered in the affirmative. As in the case of ships at (2) above. i (i) A full "Certificate of Pratique" is to be left under cover on board addressed to the Medical Officer of Health who will issue in due course. (ii) Should any difficulty arise in contacting the Hygeia the message is to be passed via Custom House, telephone Gravesend 1234. From the heading of Col. 3 it will be seen that the fact that a ship has come from a "listed" area before six weeks of her arrival here can also be disregarded. (Signed) C. R. PURSER, Water Superintendent. CUSTOM HOUSE, LONDON, E.C.3. 9 Assistant Superintendent, Gravesend. Chief Preventive Officer, Sheerness. Preventive Officers-Rochester, Chatham dockyard and ridham dock HEALTH REGULATIONS (Customs Code, Vol. 4, Pt. 4). PORT OF LONDON. SHEERNESS PROCEDURE. 1. The list of infected areas, referred to as the "listed areas" below (Customs Code, Vol. 4, Part 4. nara. 3) is sriven on naee 4 of the London Declaration of Health Form. 2. The Medical Officer of Health, Port of London Health Authority, requests the application of the following procedure as from the 1st March, 1947. Classification of ship C.C., Vol. 4. Pt4, paras, 5 & 6 Answers given to questions on the Declaration of Health Form If vessel has come from a "listed area" within six weeks of her irrival at Sheerness Customs Procedure (1) All foreign-going ships other than Tankers. All in the negative. No. Issue Certificate of Pratique. (2) Do. If any are in the affirmative, or Yes. Inform the Master that he is not to allow any unauthorised person to leave the ship without the Medical Officer's permission. Issue Modified Pratique and allow vesselto proceed to her berth. In the most expeditious manner possible notify Dr. Madwar in the case of ships berthing at Sheerness or Dr. Murray in the case of ships proceeding direct to Rochester.* (3) Foreign-going ships. Tankers. Are all in the negative. Can be disregarded. Issue Certificate of Pratique. (4) Do. If any are in the affirmative. Can be disregarded. As in the case of ships at (2) above. (5) Home Trade ships. If a written Declaration of Health is taken and any answer is in the affirmative. As in the case of ships at (2) above. From the heading of Column 3 it will be seen that the fact that a ship has come from a "listed area" before six weeks of her arrival here can also be disregarded. As regards ships shown at (2) (4) and (5) it will facilitate matters if a full Certificate of Pratique is left under cover on board addressed to the Doctor for him to hand to the Master in due course. (Signed) C. R. PURSER, Waterguard Superintendent. Custom House, London, e.c.3. *The telephone numbers of Dr. Madwar and Murray are as follows: — Dr. H. A. Madwar — Sheerness 2088. Dr. S. 0. Murray — Chatham 3258. (5) Arrangements for — (a) Hospital accommodation for infectious diseases (other than smallpox — see Section VII). Denton Hospital having been transferred to the South-East Metropolitan Regional Hospital Board, arrangements have been made for a patient or patients suffering from an infectious disease to be removed to Denton Hospital, pending arrangements for the transference of such cases to the appropriate hospital under the management of the South-East Metropolitan Regional Hospital Board. Should weather conditions make it undesirable to land cases over the pontoon at Denton Hospital, arrangements have been made to land such cases over the Tilbury Landing Stage on the Essex shore for admission to Thurrock Hospital. 10 I (b) Surveillance and follow up of contacts. In the event of a vessel arriving on which there is or has been a case or cases of a major infectious disease, all persons on board are cons dered to be possible contacts. Such persons are individually interrogated as to the address to which they are proceeding immediately on disembarkation and given a specially prepared three part card on one section of which they give full details of their names and addresses. These particulars, together with an appropriate note of the circumstances are then forwarded to the Medical Officers of Health of the districts in which the contacts' address is situated. A third section of the card they are asked to keep and use only if they change their address during a specified period — usually the incubation period of the disease in question. This section of the card is on the "Business Reply Card" system so that it does not have to be stamped. (c) Cleansing and disinfection of ships, persons, clothing and other articles. Disinfection of infected quarters is usually carried out by the Sanitary Inspector in whose area the vessel berths. If, however, the space requiring disinfection is large, a private firm is employed which carries out disinfection under the supervision of the Sanitary Inspector. Although Denton Hospital has been taken over by the South-East Metropolitan Regional Hospital Board, the Disinfection Station, containing a Washington Lyons Steam Disinfector, is available to the Port Health Authority for the disinfection of clothing, bedding, etc., and for the cleansing of cases of scabies. 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 pontoon, available at all states of the tide, and from which they can be wheeled straight into the hospital via a ramp which connects the pontoon with the shore. 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, usually Long Reach Smallpox Hospital, Dartford. (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 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 vm - VENEREAL DISEASES The Venereal Diseases are not compulsorily notifiable but efforts are made to bring to the the notice of all seamen using the Port, the facilities for free treatment under the Brussels Agreement. When the Medical Officers board ships on arrival they always enquire whether there are any cases of venereal disease on board. Should there be a known case, the infected person's attention is drawn to the importance of obtaining skilled treatment as soon as possible and he is given a list of the Clinics near the ship's berth in London and the times at which cases may attend. Similarly the Sanitary Inspectors have a supply of pamphlets listing the names and addresses of places where treatment is available. This notice is printed in 21 different languages and is posted up at vantage points throughout the whole dock area. 11 SECTION IX - CASES OE NOTIFIABLE AND OTHER INFECTIOUS DISEASES ON SHIPS TABLE D Cases landed from ships from Foreign Ports Disease Passengers Crew Number of ships concerned Mumps 7 3 8 Measles 15 2 13 Scarlet Fever — 1 1 Tonsillitis 1 3 4 Influenza 1 6 6 Typhoid Fever - 5* 3 Pulmonary Tuberculosis 11 12 22 Fever of Unknown Origin - 5 6 Infective Hepatitis 1 5 6 Chickenpox - 9 16 Dysentery 1 7 8 Quinzy 1 - 1 Whooping Cough 2 — 1 Malaria — 4 - Gastro Enteritis - 5 1 Appendicitis - 1 1 Pneumococcal Endocarditis 1 - 1 Pneumonia 1 2 - Inflammation of Glands — 1 1 Glandular Fever - 1 1 Meningitis 1 - 1 German Measles 1 — 1 Poliomyelitis 1 - 1 Food Poisoning - 1 1 Rabies (suspect) - 1 1 Includes 2 'Carriers'. Cases disposed of before arrival Disease Passengers Crew Number of ships concerned Chickenpox 30 1 18 Mumps 18 3 12 German Measles 2 2 4 Infective Hepatitis 2 1 3 Measles 47 - 20 Typhoid Fever - 3 3 Malaria 1 20 12 Tick Bite Fever 1 - 1 Dysentery - 1 1 Pneumonia 1 2 Smallpox 1 - 1 Poliomyelitis 1 - 1 Whooping Cough 1 - 1 Tonsillitis - 4 Glandular Fever — 1 1 Pulmonary Tuberculosis 7 5 11 Gastro Enteritis 116 72 Shingles 1 1 Diptheria - 1 1 Fever cf Unknown Origin 1 6 Scarlet Fever 1 - 1 Rabies (suspect) 1 - 1 12 SMALLPOX IN BRITTANY In January, 1955 a notification was received from the Ministry of Health that the French Government had informed our Ministry of the existance of smallpox at the Port of Vannes in the Morbihan Department of Brittany. This is an "excepted area" under the Public Health (Ships) Regulations, 1952 and ships coming from there would normally be free under the Regulations from the requirement of medical quarantine clearance, before granting pratique. Arrangements were therefore made immediately with the Waterguard Superintendent of H.M. Customs that pratique should be withheld on all vessels coming from the Port of Vannes until they had been inspected by the Boarding Medical Officers at Gravesend. The position was also notified to the Medical Officers of Health of the principal Riparian Authorities concerned within the Port of London, namely Bermondsey, Deptford, Greenwich, Poplar, Stepney, Southwark and the City of London, because most of these vessels tie up alongside the River wharves without entering the docks. Subsequently a note published in the Ministry of Health Weekly Bulletin for the 14th January, reported a Paris Press account of the spread of smallpox from the Department of Morbihan to four other Departments in Brittany, and stated that there were then forty cases, including four deaths. Although this was only a Press report and not an official notification from the French Government it was deemed wise to arrange with the Waterguard Superintendent that free pratique should be withheld from all vessels coming from any port in Brittany until they had been inspected and cleared by one of the Boarding Medical Officers at Gravesend. A further bulletin from the Ministry of Health dated 21st January, read as follows "In a message dated the 14th January, 1955, from the French Ministry of Public Health and Population, the number of cases of smallpox in the Vannes area is given as 44 of whom 5 have died. (Later Press reports gave the number as 6)." "Contacts have been placed under strict surveillance and a programme of mass vaccination has been carried out in the region. The additional cases appear to have occurred in direct contacts of previous cases reported." A detailed medical examination was carried out by the Boarding Medical Officers of all vessels arriving from Brittany until July when the Ministry reported that the epidemic was at an end. No case or suspected case of smallpox was discovered. s.s. "STRATIIMORE" - SUSPECTED SMALLPOX On the 17th February, Dr. I. J. Corbett, the Medical Superintendent of the Peninsular and Oriental Steam Navigation Company, reported the receipt of the following signal from the s.s. "Strathmore" — "Doubtful chickenpox — Joao Mascarhinas, Scullion, Specimens landed Gibraltar 6.0 a.m. 17th February for air mail." It subsequently transpired that the vessel would not be calling at Brixham but would proceed direct to Gravesend, the expected time of arrival being 10.0 — 10.30 a.m., on Sunday, 20th F ebruary. In view of this, arrangements were made for the Shipping Company to send a signal to the vessel instructing the Surgeon to carry out full vaccination or re-vaccination of the personnel, for the Purser to check the addresses of the passengers and prepare at least three copies of this list and also for arrangements to be made for the vessel to drop anchor in Higham Bight, which is the mooring station designated under the Public Health (Ships) Regulations, 1952, and a gangway rigged ready to take on board a smallpox consultant and the Port Health Staff. Dr. J. Pickford Marsden, a smallpox consultant, in addition to agreeing to board the vessel at Gravesend and examine the patient also arranged for him to be admitted, if necessary, to Long Reach Smallpox Hospital, Dartford. It was considered best to admit the patient via the Port Isolation Hospital at Denton, where there is a private pier, and thence by ambulance to Long Reach Hospital. To this end and in order to avoid risk to others, Denton Hospital reduced its 11 patients to 2 as quickly as possible and the 2 patients remaining were vaccinated as were also the entire hospital nursing and domestic staff. In addition the Immigration and Customs Officers who were to board the ship on arrival—some 30 in all — were also vaccinated as were the Port Health staff, launch crews and Medical Officers. Arrangements were also made through the London County Council for a smallpox ambulance to proceed to Denton Hospital arriving at 10.0 a.m., on Sunday morning there to await the arrival of the patient and convey him direct to Long Reach Hospital which had recently been re-opened as a smallpox hospital for the Region. On the 18th February information was received that the Complement Fixation Test of the specimens submitted from Gibraltar to the Virus Laboratory at Colindale were negative to smallpox but that the Egg Culture Test would not be available until between 9 — 10.0 a.m., on Sunday, 20th February — about the time of the ship's arrival. 13 Action taken on arrival. The vessel arrived at 10.00 hours on Sunday, 20th February homeward bound from Australia and was boarded by your Medical Officer of Health and his staff and Dr. Marsden. Vaccine sufficient to vaccinate 1,000 persons was taken on board with them. Ports of Call. , Brisbane 12.1.55; Sydney 15.1.55; Melbourne 18.1.55; Adelaide 20.1.55; Fremantle 24.1.55; Colombo 31.1.55; Bombay 3.2.55; Aden 7.2.55; Port Sudan 8.2.55; Suez 10.2.55; Port Said 11.2.55; Marseilles 15.2.55; Gibraltar 17.2.55; London 20.2.55. Number of Persons on Board. (a) Crew:- British Alien White 259 3 Coloured ... 118 153 377 156 533 (b) Passengers:- 1st Saloon 4 6 2nd Saloon 346 382 350 388 738 (c) Other Persons on Board Distressed British Seaman 1 - Passenger Pilots 4 - 5 - 5 T otal 1,276 History of Case. The patient, a Goanese scullion, aged 36, was first seen by the Ship's Surgeon on the 16.2.55 with a well marked profuse rash on his face, trunk and limbs. His temperature was 101 °F. On interrogation, he admitted having been ill for 2-3 days previously and had absented himself from duty although he had not apparently been missed by his messmates. The prodromal symptoms did not appear to have been excessively severe. He had been ashore in Bombay on 3.2.55 and Colombo on 31.1.55. He had two successful vaccination scars on his right shoulder, the result of vaccination said to have been carried out in 1952. Condition on Arrival. The patient exhibited a considerable number of scabbing lesions on his scalp, face, chest, back, abdomen, upper arms and thighs. The distribution was, therefore, central and the lesions were, on the whole, superficial and of varying size. His hands were not involved but there were two lesions, one on each foot, on the solar instep. The case was seen by your Medical Officer, Drs. Marsden, Willoughby, Jones, Maclean and Jekyll (Deputy to Dr. Corbett) who were unanimous in their diagnosis of chickenpox. The patient was removed to the Port Isolation Hospital at Denton together with all bedding and effects from the ship's isolation hospital, as well as from the peak occupied by the patient and three associates. The peak and isolation hospital were also put under fumigation. Conclusion The arrangements worked smoothly and, in view of the final diagnosis, the ambulance was not required nor the vaccine, nor the services of Port Health clerical staff who had attended in case it was necessary to check the addresses of the passengers and crew under the system of surveillance. s.s. "MANAAR" - SUSPECTED SMALLPOX Late on the 22nd February, your Medical Officer received at home from the Boarding Medical Officer on duty at Gravesend a message that Dr. D. Avery, Medical Officer to the Brocklebank Line, had reported a case of sickness which he feared might be smallpox, in a Goanese seaman on the s.s. "Manaar" berthed in the Royal Albert Dock. Your Medical Offi cer accordingly arranged to visit the ship at once and to meet there, at midnight, a smallpox consultant, Dr. W. T. G. Boul. Mr. T. L. Mackie, your Chief Sanitary Inspector was also in attendance. The patient, who had been successfully vaccinated in November, 1954, was, on examination, found to be running a low grade fever and exhibiting a rash consisting of papules with a few vesicles. The opinion of the Smallpox Consultant and also that of your Medical Officer was that the patient was suffering from chickenpox but that in view of the curious nature of the vesicles, the Medical Officer of the Shipping Company had had reasonable grounds for suspecting the case to have been one of smallpox. In order that the patient might be kept under observation, Dr. Boul kindly agreed to admit the man to Gooseberry Green Hospital, Billericay, a hospital under the care of Dr. Boul himself. 14 Nothing further transpired to alter the diagnosis of chickenpox. Disinfection of the crew's quarters was arranged on the spot by the Chief Sanitary Inspector. s.s. "MALTESE PRINCE" - PARATYPHOID FEVER When this vessel arrived off Gravesend on the 11th October, the Boarding Medical Officer, Dr. R. MacLean, reported that the 2nd Engineer, was suffering from a fever of unknown origin. The patient was admitted to the Thurrock Isolation Hospital, for observation. Subsequently Dr. W. T. G. Boul of the Thurrock Hospital reported that the patient was suffering from paratyphoid fever. As, by this time the vessel had left London, the Shipping Company were immediately informed of the circumstances and their attention drawn to the probable sources of infection, e.g., fruit, vegetables, water, milk, ice cream, etc. On the 22nd October the Shipping Company reported that a member of the crew — an Apprentice who had been 'paid off' had been taken ill while at his home in Leicester, where he had been attended by his own doctor who had diagnosed him to be suffering from influenza. In view of the circumstances this diagnosis aroused suspicion and as a precaution the Medical Officer of Health of Leicester and the medical practitioner attending the patient,were immediately informed by telephone of the case of paratyphoid on the vessel, the details of which were confirmed by letter. This action was amply justified, for the Medical Officer of Health of Leicester reported that an organism, which was most probably Salm. paratyphoid B, had been isolated from both blood and faeces of the patient. Meanwhile it was ascertained that the vessel would be arriving back in London on the 22nd October and was due to berth in the West India Dock at about 6.0 p.m. The Shipping Company were requested to contact the Boarding Medical Officer on arrival at Gravesend by blowing "Q" on the siren and to have all bedding, effects, etc., used by the patient locked up pending the vessel's arrival in dock where it would be dealt with by the Sanitary Inspector. The Company were also requested to furnish a complete list of the names and addresses of the crew. Both the Boarding Medical Officer and the Sanitary Inspector concerned were informed of the arrangements made. The vessel duly arrived from Grangemouth at 12.30 p.m., on the 22nd October and was boarded at Gravesend by Dr. Jones who reported that most of the Officers and a number of the original crew had proceeded on leave and had been replaced by a relieving crew for the voyage to London, all of whom reported "well". The Sanitary Inspector on the West India Dock, Mr. G. Dring, visited the vessel first thing on Monday morning, 24th October, and on enquiry ascertained that two further members of the original crew had reported ill with "influenza" while on leave, one residing in Glasgow and the other in Chiswick, W.4. In both instances the local Medical Officer of Health was immediately notified by telephone and a confirmatory letter was sent. Investigation of these two cases showed that the patient in Glasgow, when visited, was found to be quite well, that the illness from which he had recently recovered appeared to have been of a respiratory type and that a specimen of faeces submitted had been found to be negative, whereas the patient in Chiswick who was another Apprentice, was also suffering from an illness which was finally diagnosed by hospital and laboratory investigations to be paratyphoid B. Meanwhile the Sanitary Inspector carried out a thorough disinfection of the infected quarters, the bedding, effects, etc., being submitted to steam disinfection ashore. Samples of the vessel's drinking water were sent for bacteriological examination, the results being satisfactory. It was decided, as a further precaution, to send those members of the crew most likely to have been in close contact with the paratyphoid cases or who had been engaged in the preparation or handling of food on board, to the Seamen's Hospital, Greenwich, for a stool test. In all, 14 members of the crew attended the Seamen's Hospital and in all cases the results of the tests were negative. In addition two further members of the crew coming within the above category but who had been 'paid off' and had not returned to the ship, were notified to the Medical Officers of Health of the district in which they were residing and in both cases the results of tests carried out on them were negative. One interesting point emerges from the numerous enquiries made in an attempt to trace the origin of this minor epidemic. It would appear that the three members of the crew affected were all keen swimmers and took every possible opportunity of bathing when the vessel anchored in ports abroad, namely, Alexandria, Beirut, Tripoli, Latakia and Iskenderon, where it is known that the water in the harbours is regularly contaminated by sewage and that paratyphoid fever is endemic. Your Medical Officer visited the ship the night before she sailed for a final check and in the course of his enquiries was able to interrogate a third apprentice, the sole 'survivor' of the three apprentices carried by the vessel on her previous voyage, his two colleagues being both victims of the paratyphoid fever. He had been a constant companion of the other two and confirmed that 15 they, like the 2nd Engineer who had also contracted the disease, had been keen swimmers at every port of call. He was also able to confirm that on only one occasion had any food or drink been consumed ashore by those who subsequently fell ill and this had been only a bottle of beer in a reputable establishment. Your Medical Officer believes that on this occasion the most likely source of infection was sewage contaminated sea water in one of the Mediterranean ports visited. Acting upon the suggestion of your Worshipful Committee your Medical Officer drew the attention of the Shipping Federation to the above sequence of events suggesting that they might think it worth while to arrange for the Federation to send out a circular to Masters warning them against the danger of bathing in infected ports. They replied that, while agreeing with the suggestion they were of the opinion that the surest way of getting this warning to every ship by the issue of a "Notice to Masters" was through the Ministry of Transport and Civil Aviation. The matter was accordingly referred to the appropriate Department of the Ministry of Transport and Civil Aviation whose Medical Advisers were consulted as to the terms of the warning notice and this resulted in the issue of Notice No. M.396, reproduced below Ministry of Transport and Civil Aviation. Notice No. M.396 DANGER OF INFECTION FROM BATHING IN DOCK OR HARBOUR WATER NOTICE TO MASTERS Cases of paratyphoid fever have occurred among members of crews who were in the habit of swimming in harbours or ports and the attention of Masters is drawn to the risk of contracting serious disease from this practice. The water in and adjacent to ports and harbours both of this country and abroad is frequently polluted by wholly untreated or partially treated sewage or industrial effluents. Polluted water may appear to be clean and attractive, but the risk of contracting infection from bathing in it nevertheless exists. In order to minimise this risk Masters should advise crew members to bathe only at places specially reserved for this purpose. Ministry of Transport and Civil Aviation, London, W.l. April, 1956. SUSPECTED RABIES (1) s.s. "TUCUMAN" When the Argentine ship 'Tucuman" arrived in London on the 29th October from Buenos Aires and Roasaria via Las Palmas, the Master reported that a Mess Boy had been bitten by a catand requested that the boy should have anti-rabies inoculation. The circumstances as reported by the Master were that on the 21st October, a cat, which had been on board since the end of May, started acting strangely and after biting the mess boy had a number of fits and died. The body of the cat was sent ashore for examination at Las Palmas on the 24th October and on the 28th October a telegram was received by the ship from the authorities at Las Palmas as follows "We pray communicate Master Tucuman result analysis dead cat. Suspicious rabies. You pray proceed treatment medical seaman bitten". Dr. R. D. Maclean, the Boarding Medical Officer who visited the ship on arrival, found the mess boy quite well and in his report gave as his opinion, that it was unlikely that the cat actually had had rabies. All the same it was considered that no chances should be taken in view of the consequences if the diagnosis were correct. On enquiry from the Ministry of Health it was ascertained that a supply of anti-rabies vaccine was held by the Central Public Health Laboratory at Colindale who were prepared to supply the vaccine to hospitals with full instructions as to its use, the course of inoculation being spread over a period of at least a fortnight. The Agents of the ship and the Master were consulted and they agreed that, though the boy would miss his ship for the return voyage, he should receive immediate treatment in this country. Through the kind co-operation of Dr. Robinson of the Seamen's Hospital, Greenwich, the boy was admitted there on the 31st October for the full treatment and was discharged on the 14th November, three and a half weeks after the cat bite and therefore too soon to know for certain the final result of the inoculations because the incubation period of rabies may be as long as six weeks. Your Medical Officer visited the hospital to see the patient on the day of his discharge and found him apparently in good health. 16 (2) s.s. "HIGHLAND CHIEFTAIN" On arrival of the s.s. "Highland Chieftain" at Gravesend on the 13th November, it was ascertained that a passenger, Ricardo Valle, aged 25, had been bitten by a dog in the left leg on the 19th October, while in Chile. On examination it was found that the wound had healed but the passenger had had no anti-rabies treatment. He was not, however, detained since it was understood that the was proceeding by air to Germany via Holland. Enquiries were made from the Shipping Company as to the passenger's destination but no information was forthcoming because the man ceased to be the responsibility of the Company after landing. It was ascertained, however, that the passenger had been met by a Courier of Messrs. Thomas Cook & Sons, Ltd., the Travel Agents and on enquiry it was found that they were responsible for a party of Chilian sailors (among whom was Ricardo Valle) who were en route for Germany. The party had left London on the 15th November by Dutch Air Line — K.L. Flight 118, for Bremen via Amsterdam, it being understood that the sailors would be joining a ship in Bremen which would eventually sail from that port to Chile. The Medical Officer of Health of Bremen was informed of the circumstances by letter. SECTION X — Observations on the occurrence of Malaria in ships Twenty-five cases of malaria were reported on sixteen vessels during the year under review. Twenty-four of the cases occurred amongst members of the crew and one a passenger. Twentyone of the cases were disposed of prior to the arrival of the vessels in this Port. SECTION XI — Measures taken against ships infected with or suspected of plague Plague being primarily a disease of rats all vessel are inspected immediately on arrival at their berths in the docks 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 dead rats are immediately sent to the Central Public Health Laboratory at Colindale for examination for bacillus pestis,each rat being accompained 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 moved 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 cargo would be permitted under observation. The destination of the cargo would be forwarded to the Medical Officer of Health of the districtto which the cargo was proceeding. Should any of the cargo be discharged overside into lighters, they 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 Operatives working in conjunction with and under the supervision of the Sanitary Inspectors. The Rodent Operatives first duty is the examination of those ships in his area which 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 Operative's 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. New and scientific methods of poisoning have now taken the place of trapping, this now only being occasionally used to clear up residual rats, if any, which have escaped a major poison operation or for occasional laboratory check for the presence of plague infection. The Port of London Authority have made byelaws requiring the Master of every vessel 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 to the vessel, may be used as communication between the ship and the shore. 17 (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 YI above, all rats for examination for plague, either by post mortem and subsequently, if necessary, by bacteriological examination, are promptly sent to the Central I'ublic Health Laboratory at Colindale. The bodies are placed in polythene 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. The rat population of 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 enable the spread of infection. Nevertheless, forty-three rats were went to the Laboratory and were examined for plague with negative results. (3) Arrangements in the district for deratting ships, the methods used, and if done by a coramerical contractor, the name of the contractor. (a) 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 ships, 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. For 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. (c) "1080" and "Warfarin". The employment of "1080" has been used regularly throughout the docks for some time with highly satisfactory results and more recently its use in ships has been equally effective. 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 grain or other forms 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 escaped a major poisoning operation or 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. Scientex (Southern) Ltd. Messrs. Insecta Laboratories Ltd. PREVENTION OF DAMAGE BY PESTS (APPLICATION TO SHIPPING) ORDER, 1951 Owing to the nature of coastwise shipping trade which includes scheduled movements, part cargoes and relatively quick 'turn round', there are difficulties confronting Sanitary Inspectors who are responsible for exercising the provision of this Order, particularly with regard to the issue of Rodent Control Certificates, e.g., most of the coasting vessels tie up in the River anddo not go into the docks. To assess the degree of rodent infestation reasonably correctly, the spaces inspected should be empty and must be, at least, almost so. Accordingly it is evident that, in order to regulate this part of the Inspectors' duties, more than one visit is frequently necessary to be present at the opportune time. In spite of this handicap, 103 ships have been inspected and have been granted Exemption Certificates. There has been no occasion to enforce rodent extermination methods. In connection with the rodent control of harbour craft, lighters in particular, some substantial progress has been made in the working relations between the Industry and the Authority's Officers. There are signs that a 'rodent control consciousness' has spread to all concerned with the lighters and the increasing co-operation at the repair yards is reflected in the greater number of lighters being voluntarily deratted and recorded for the information of the Authority. While full scale extermination measures are carried out wherever rodents are discovered in lighters, simple rat-proofing of the compartments is not overlooked and advice on this modification is always available to the Owners. Such a correction denies rodents access to any obscure spaces that could be used as living accommodation, without which they can neither breed nor survive. Lighters inspected 3,142 with no evidence of rodents 2,689 " negligible evidence of rodents 329 " treated for rodents 112 Dead rats recovered after treatments 820 18 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 215 272 299 214 275 307 289 331 313 94 301 278 3188 Brown Rats — 6 6 — — 2 — 2 — 1 — — 17 Rats examined 8 2 4 1 - 4 6 6 - 4 — 4 39 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 103 55 78 85 64 82 110 134 138 82 66 48 1045 Brown Rats 111 130 118 134 209 123 91 129 90 165 99 68 1467 Rats examined — 1 1 1 — — — 1 - — — — 4 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 Derattirtg 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. 28 1 1 "1080" 119 "Warfarin" 5 Zinc Phosphide 2 "1080" and Warfarin nil Trapping and "1080" nil Trapping & Warfarin nil 156 1,044 1,200 SECTION XIII — Inspection of Ships for nuisances TABLE G Inspections and Notices No. of Vessels Number of vessels visited by Sanitary Inspectors 13,175 Number of vessels on which sanitary defects were found, and details reported to the Master, Owners and/or Ministry of Transport 779 Number of Statutory Notices served NIL Number of vessels on which sanitary defects were remedied 756 Summary of Structural and other Defects Inadequate venti lation 17 Defective Lighting — Natural 1 Do. do. — Artificial 4 Defective Heating 13 Condensation 25 Leaking Decks 19 Leaking Ports, Decklights, etc. 15 Leaking Sideplates 4 Leaking Hawse and Chain Pipes — Deficient or Obstructed Floor Drainage 22 Water lodging on top of Peak Tanks — Defective Bulkheads 8 Do. Floors 31 Do. Doors 5 Do. Chain Pipes — Do. Bunks 4 Do. Clothes Lockers 2 Do. Food Lockers 12 Do. Food Storage 31 Do. Cooking Arrangements 33 Defective or Uncleanly Drinking Water Storage 5 Water Closet Obsolete 3 Do. Defective 22 Do. Foul or Choked 5 Do. Inadequate Flush 8 Wash Basins Defective 30 Do. Foul 6 Neglected Paintwork or Distemper 35 Absence of Washrooms — Absence of Messrooms 1 Misappropriation of Crew Spaces 3 Verminous Quarters 102 Dirty Quarters 564 Miscellaneous 64 Total 1,094 19 SECTION XIV - PUBLIC HEALTH (SHELLFISH) REGULATIONS, 1934 and 1948 The recommendations and improvements set out in a previous annual report on the operation of these Regulations with particular reference to the cockle industry, have been maintained throughout the year and since no complaints of gastro-intestinal disturbance have been received either from individuals or from the Medical Officer of Health of Southend, it must be assumed that the recommendations made have had the desired effect. SECTION XV - MEDICAL INSPECTION OF ALIENS 1. List of Medical Inspectors of Aliens holding warrants of appointment. Dr. J. Greenwood Wilson; Dr. H. M. Willoughby; Dr. J. A. Jones; Dr. R. D. Maclean. 2. List of other staff engaged on the work. Clerical Staff at the Central Office. 3. Organisation of the work. All vessels carrying aliens are intercepted on arrival atGravesend and the aliens are examined by the Medical Inspector of Aliens who is, in fact, the Boarding Medical Officer on Duty. Complete liaison exists between the Port Medical Staff and the Immigration Staff at Gravesend and should any doubtful case arrive, the Medical Inspector 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 2,284 (b) Total number of aliens (excluding transmigrants, seamen and airmen) (i) Arriving at the port 31,567 (ii) Medically inspected 19,426 (iii) Medically examined 173 (c) Certificates issued 1 (d) Transmigrants landed and medically inspected Nil 5. Accommodation for medical inspection and examination is provided on Tilbury Landing Stage, though in practice, the majority of aliens are inspected in the ship on arrival and any necessary chaperonage is provided by nursing sisters or stewardesses borne in the ship. SECTION XVI - MISCELLANEOUS Arrangements for the burial on shore of persons who have died on board ship from infectious disease. When cases of infectious sickness die in the Port Isolation Hospital, arrangements for interment are made with an Undertaker in Gravesend. 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 5,048 tons 12 cwts. 0 qrs. 23 lbs The following is a summary showing the method of disposal of the foodstuffs seized Method of Disposal Weight Approximate percentage of total weight Weight Tons cwts. qrs. lbs. Tons cwts. qrs. lbs. Burnt 65 7 0 16 1.28 82 9 2 10 Buried 832 18 0 13 16.50 2,287 14 3 7 Boiling down 83 6 3 24 1.84 91 10 1 21 Released to other districts 144 0 1 19 2.85 159 4 2 4 Reconditioning 214 14 0 16 4.26 111 18 3 25 Industrial — 10 3 4 0.01 47 6 1 14 Manufacturing *1,869 16 0 0 37.01 20 0 0 0 Re-export 19 7 1 5 0.37 62 8 2 0 Cattle food 414 14 0 16 8.22 626 19 2 20 Refining 1,393 17 3 8 27.61 360 6 0 27 Totals 5,048 12 0 23 99.98 3,849 19 0 16 * Please see separate report on page 23 Of the 5,048 tons listed in the table above, the principal items condemned for human consumption consisted of Burnt 9 cases, 93 cartons, 4,242 tins fruit, fruit pulp and fruit juices (burst, blown and leaky);121 tins canned meat (burst, crushed and pierced); a quantity of loose collected and 58 packages fresh fruits (decomposed, bilge and dock water damaged); 138 baskets vegetables (wasty); 50 cartons fish (decomposed); 45 bags nuts (wet damaged and mouldy). 20 Buried 545 tons bananas (decomposed); 111 cases and 32,606 tins canned fruit, fruit juices, etc., (burst, blown and leaky); 20 cases and 212 tins canned meats (burst, blown and leaky); 2,190 packages fresh fruits (decomposed); 668 tins tomato juice (burst, blown and leaky); a quantity of loose collected, 305 cartons and 2,570 bags vegetables (wasty); 19 barrels and 13 casks fruit juice (fermented); 25 casks preserved ginger (out of condition); 27 cases dried fruits (dock water damaged); 22 casks gherkins (soft and sour). Boiling down 206 cases and 137 tins canned meats (burst, blown and leaky); 89 crates rabbits (soft and decomposed); 13 boxes, 17 cartons and 224 drums lard (dock water damaged, loose collected and contaminated with extraneous matter); a quantity of carcases sheep and lambs, pieces beef, pork etc., (dock water damaged, brine damaged, iced, decomposed, mutilated, diseased, dirty and moulds). Cattle food 369 tons bananas (wasty); 357 cartons and 29 bags milk powder; 42 bags sugar of milk, 32 bags buttermilk (dirty and vermin damaged); 265 bags flour (oil damaged); 12 bags maize (wet damaged); 243 tins apricot pulp (blown and leaky). Re-export 156 cases dried egg albumen (unsatisfactory analysis); 1 cask sheep casings and 13 cases minced pork roll (absence of 'official certificate'); 248 cases canned tomatoes and 74 tins cucumbers (blown). Other districts 4,286 cartons various canned goods, 24 cases canned pineapple (burst, damaged, rusty and leaking); 204 cases and 400 cartons sweetened fat (rancid); released under the supervision of the local Medical Officer of Health. A quantity of rejected ship's stores (out of condition) recondition or converted into animal food under the supervision of the local Medical Officer of Health. Reconditioning 42 packages lard (dock water damaged); 1,000 cases currants, 372 boxes sultanas (wet damaged and mouldy); 57 bags wheat sweepings, 67 crates cheese (contaminated with extraneous matter); 192 boxes shelled walnuts, 60 cases and 2 bags almonds, 17 bags rice (wet damaged). Refining 16,788 bags sugar sweepings (dirty). Industrial 18 boxes lard (dirty); 2 cases dried egg albumen (unsatisfactory analysis). Manufacturing 84,141 cases apples (affected with 'brown heart'). (See separate report on page 23.) PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1937 and 1948 OFFICIAL CERTIFICATES Circular MF 2/55 from the Ministry of Agriculture, Fisheries and Food, dated 13th April, 1955 states that the Minister has caused to be published in the London Gazette of the 12th April, 1955, a notice containing in the Schedule thereto a description of a label or stamp issued by the Government of Hungary which has been recognised as an official certificate for the purposes of the above-named Regulations. The certificate is in respect of meat and/or meat products and is completed by the insertion of the place and date of the inspection and the signature of the Veterinary Inspector. Circular MF 9/55 of the Ministry of Agriculture, Fisheries and Food, dated 9th September, 1955, directs that the Minister has caused to be published in the London Gazette of the 9th September, 1955, a notice containing in the Schedule thereto a description of a label issued by the Government of Yugoslavia which has been recognised as an official certificate for the purposes of the above-named Regulations. The label hereby recognised is in substitution for the label having on it the design reproduced in part XX of the Schedule to the notice published in the London Gazette of the 6th August, 1937, which is hereby revoked. The certificate will be completed by the insertion of the number of the establishment and by the impression of the Veterinary Officer's seal. MYXOMATOSIS IN RABBITS AND HARES Circular MF 1/55 issued by the Ministry of Food stated that in a recent prosection of a trader for selling rabbits infected with myxomatosis, it was argued on behalf of the defendant, that the virus of this diease is not communicable to man. 21 In the Ministry's view, despite the fact that no case of transmission to man has been recorded, all carcases of rabbits and hares infected with the disease should be regarded as unfit for humai consumption. A large number of rabbits dead or dying from myxomatosis have been seen on waste land in the Tilbury Dock area. ARGENTINE OFFAL AND CYSTICERCUS BOVIS During the routine inspection of imported frozen offal from the Argentine at No. 6 Cold Store, Royal Albert Dock, your Meat Inspector reported as follows Ox Tongues 198 tongues examined — 3 tongues affected with cysticercus bovis. 1 tongue affected with actinomycosis. The finding of cysticercus bovis in imported meat has been, up to now, a rarity, although the presence of this disease in beef slaughtered in the United Kingdom and on the Continent has been known for some time and was the subject of a Memorandum issued by the Ministry of Food in November, 1948. The disease is caused by a parasite (Taenia saginata) commonly known as the beef tapeworm which is 10 to 25 feet in length and lives exclusively in the intestine of man. It is not fatal but exhibits a variety of symptoms such as nervousness, loss of appetite, loss of weight, stomach pains and digestive disturbances. A person harbouring this tapeworm and defecating in the neighbourhood of farm buildings may be responsible for the infection of a large number of cattle, in which the worm assumes the larval stage — cysticercus bovis. It has been established that cysticercus bovis will survive 14 to 16 days after slaughter of the host. Cysts may, however, be destroyed with certainty if carcases are frozen at 20 F. for at least three weeks, a period which may be shorted to 4 days if the carcase is divided into retail joints prior to freezing: the chilling of meat at 29°F to 30°F for three weeks is, however, not now regarded as adequate. The application of these facts in Port Health work is as follows (a) Frozen Meat cargoes. These are always carried at a temperature less than 20°F. and for a period of three weeks so that if any of the meat or offal is affected at the time of shipment, the cysts will be destroyed before arrival in the United Kingdom. (b) Chilled Meat cargoes. Consignments of chilled meat are arriving in ever increasing quantities and, since these consignments are carried at 29°F to 30°F a temperature at which the infection is not destroyed, it is obvious that a careful examination of chilled meat must be carried out. In view of these circumstances a Conference was convened at the Central Office which was attended by the Economic Counsellor to the Argentine Embassy, representatives from two importing firms of Argentine meat and two members of the Veterinary Staff of the Ministry of Agriculture, Fisheries and Food. The affected tongues were displayed and the seriousness of the findings amply demonstrated — the diagnosis of cysticercus bovis was confirmed microscopically. The Argentine Economic Counsellor requested that a detailed report of the circumstances be forwarded to him in order that he might take up the matter with the appropriate authorities in the Argentine. It may here be mentioned that the packages containing the offal each had affixed to them the Argentine 'Official Certificate' which should mean that the animals from which the offal was derived had been examined ante and post mortem and found to be free from disease, as required by the Public Health (Imported Food) Regulations. The Certificates gave the numbers of the Establishments in the Argentine from which the offal had come and these were given tothe Economic Counsellor to aid him in his investigations. Since this was a matter likely to affect other ports in the United Kingdom your Medical Officer lost no time in informing the Medical Officers of Health of Liverpool, Glasgow, Bristol and Southampton, of our findings. The Medical Officer of Health of the City of London was also informed. It was, however, considered that since this was a matter affecting the United Kingdom as a whole representations to the Argentine could better be made through the Ministry of Agriculture, Fisheries and Food. A full report of the affair was therefore sent to the Ministry by whom, it is understood, prompt and appropriate action was taken. In the meantime arrangements were put in hand at the docks for a routine inspecti on to be made thenceforth of chilled meat from the Argentine for the presence of cysticercus bovis but up to the time of writing this report no further infection has been found. Your Medical Officer considers that the timely discovery of diseased meat as described above reflects great credit on the skill and vigilance of the meat inspector concerned and, incidentally, gives an interesting practical illustration of the kind of danger to health from imported meat which your Worshipful Committee's new scheme for meat inspection at the docks is designed to avoid. 22 A CARGO OF APPLES FROM TASMANIA In September a consignment of apples arrived from Tasmania in the West India Dock and on inspection was found to be affected with a condition known as "Brown Heart". This term is a colloquialism used to describe the appearance of necrotic or dead tissues inside apples resulting from the cumulative effect of excess of carbon di-oxide gas. As apples ripen they breathe offmore and more carbon di-oxide which should not be allowed to accumulate beyond certain minimal quantities varying from approximately 3 or 4 to 10 per cent, according to the type of apple. Apples affected with 'Brown Heart' are, to all outward appearances perfectly sound and it is not until the apple is cut open that the condition is discovered. In view of the magnitude of the occurrence (including a cargo valued at a quarter of a million sterling) and the complexity of the problem of disposal, it was deemed necessary to prepare an account of more than usual length and detail, as follows:— 18th July, 1955 The National Federation of Fruit and Potato Trades reported by telephone that a cargo vessel was due to arrive in the Port of London on Tuesday, 19th July, with a cargo of apples on board. Discharge of part of the cargo at Hull and Hamburg revealed the apples to be in an unsatisfactory condition and they requested that the Port Health Officers would make a careful examination. It was ascertained that the vessel was due to berth in the West India Dock and your Port Sanitary Inspector there, Mr. G. Dring, was informed accordingly. 19th July, 1955 The vessel having arrived and commenced discharging the cases of apples into No. 11 Warehouse, West India Dock, it soon became apparent that something was wrong and Mr. Dring served a Detention Notice covering the consignment of 110,430 cases of apples of various marks and varieties, giving the reason for his action that the apples were affected with 'Brown Heart*. Subsequently and after approximately 16,000 cases had been landed, the Port of London Authority stopped the discharge of the apples mainly because of the lack of space ashore but also because the different varieties of apples were inextricably mixed together as the result of the way in which they had been stowed. Mr. Dring reported the matter to your Medical Officer who at that stage thought it advisable to condemn the whole consignment but on protest from the Shipping Company agreed to reconsider his decision the following day in consultation with their representatives. 21st July, 1955 Your Medical Officer invited representatives of the National Federation of Fruit and Potato Trades to call at the Central Office for a conference. When the respreentatives arrived, samples of apples were submitted and a number of varieties of them were cut. There was general agreement that the apples showed a very high percentage affected with "Brown Heart" in practically all varieties, the exceptions being the "Granny Smith" and "Democrat" which, although being affected, seemed to be less so than other varieties. In addition Mr. Dring reported three varieties in which he had not been able to detect any marked affection, namely "Rome Beauty", "King Pippin" and "Stone Pippin". As a result of this discussion the following action was agreed upon :— (a) That "Rome Beauty", "King Pippin" and "Stone Pippin" varieties would be released unconditionally. (b) That "Granny Smith" and "Democrat" varieties would receive further investigation, and (c) That all other varieties would be destroyed. Following this your Medical Officer received, as agreed, representatives of the Shipping Company. A further discussion took place, samples again being exhibited. A number of counter suggestions were put forward to which your Medical Officer could not agree and he finally persuaded the Shipping Company to accept the procedure already approved by the representatives of the National Federation of Fruit and Potato Trades. A letter setting out the above decision was forwarded to the forty-two merchants concerned. 22nd July, 1955 Mr. Dring reported to your Medical Officer that a Kentish firm had made an offer to dispose of the whole of the apples for making into cider because the poor apple harvest in Kent this year had meant that they were in exceptionally short supply of apples for cider making. Your Medical Officer on hearing of this offer made enquiries as to whether cider from apples affected with 'Brown Heart' would have any ill effects on human beings who drank the cider. His enquiries eventually led him to consult T.G. Tomkins Esq., Superintendent of the Ditton Laboratory of the Department of Scientific and Industrial Research and Professor T. Wallace, Honorary Director of the Agriculture and Horticultural Research Station, Bristol, both of whom strongly approved your Medical Officer's proposal to release the apples for cider making. Your Medical Officer then enquired of the Medical Officer of Health of the district in which the premises of the cider firm were situated and was assured by him that he knew the firm to be reliable but that in the event of the apples being released to them he would keep their disposal under supervision. 23 Other methods of destruction (a) It had been suggested that the apples be taken out to sea and dumped. It was pointed out, however, that it was doubtful whether the cases of apples would sink and extreme care would have to be taken to ensure that the apples were not washed ashore along the coast, there to be retrieved and perhaps eaten by the many holiday makers and their children. (b) The question as to whether the apples could be destroyed by dumping them on a recognised refuse shoot was considered,but here again care would have to be taken to see that apples, which outwardly appear to be sound, were not at the disposal of any unauthorised person. This opinion appears to be justified for your Medical Officer undertsands that where apples were dumped in this manner at Hull, they were rifled by unauthorised persons resulting in Police Court proceedings for so doing. Over the week-end of the 23rd/24th (Saturday and Sunday), Mr. Dring and his staff spent the whole of their time examining and classifying the various marks and varieties of apples concerned and arriving at a decision as to the percentage of apples of the various varieties affected with 'Brown Heart'. As a result of this inspection your Medical Officer, after himself seeing the staff at work and after consulting Mr. Comptroller and City Solicitor, issued Seizure Notices to the Importers concerned, as follows:— (a) Those who were interested in the varieties "Granny Smith" and/or "Democrat" were served with a Seizure Notice seeking authority to SORT the parcel. (b) Those interested in other varieties (save "King Pippin", "Stone Pippin", and "Rome Beauty") were issued with a Seizure Notice seeking authority to DESTROY the parcel. As the result of issuing the above Notices one firm of Importers interested in a fairly large consignment of apples coming under category (b) above, expressed their intention of exercising their right under the Regulations and requested that the matter be dealt with by a Justice. Before proceeding further in the matter your Medical Officer informed the Importer of the terms of Part IV. Section 15(1) of the Regulations, which reads as follows :— "Where in pursuance of these Regulations an application is made to a justice in respect of an article of food and the justice is satisfied that the article of food is diseased or unsound or unwholesome or unfit for human consumption, he shall condemn the article of food and order it to be destroyed or disposed of under the supervision of the Medical Officer of Health by such means and in such manner as to prevent its being used for human consumption." It was pointed out that should the justice issue such an order it would preclude any possibility of the apples being used for the manufacture of cider and/or vinegar. In other words the apples would have to be totally destroyed in such a manner as to prevent their being used for human consumption. On consideration of this point the Importer immediately decided to withdraw his request and sent a representative to this office to collect the letter making the request. At this stage(26th July) the Federation informed your Medical Officer that they were calling a meeting of their Members on the 28th July to agree upon a policy. At this meeting it was decided to appoint a small sub-committee of four members, including the Secretary of the Federation, with power of attorney to act on behalf of the members, particularly in relation to the use of the apples for cider or vinegar manufacture. The Federation apparently opened negotiations with the cider firm on the question of payment for removal of the apples, your Medical Officer having pointed out to the Federation that this was a question which they must settle between themselves. Arising out of these negotiations the Federation requested that the cider firm be allowed to draw samples from thecondemned apples in order that they might testthem foracid content which would enable them to arrive at a fair price. Samples were released for this purpose on 29.7.55 but the cider firm stated that,owing to the intervention of the August Bank holiday, they would not be able to make an offer until Tuesday, 2nd August, and it was not until late in the afternoon of Wednesday, 3rd August, that an agreement was reached. On Thursday, 4th August, the cider firm signed the guarantee required by your Medical Officer and the removal of the apples from the dock to their premises commenced. The Medical Officer of Health of the district concerned was informed both by telephone and confirmatory letter. Meanwhile the National Federation of Fruit and Potato Trades, in confirmation of a telephone call, had forwarded a letter to your Medical Officer in which they stated that they had been instructed on behalf of the Importers, to request the release to the cider firm of apples which had been found to be unfit for consumption as fresh apples, on the understanding that these apples would be used only for manufacturing purposes. Discharge and collection of the apples continued daily and was completed on the 9th August, twenty-two days after the vessel had berthed. The following is a summary of the action taken — TOTAL CONSIGNMENT - 110,430 cases apples. Released — 26,289 cases — 23.8% Destroyed* — 84,141 cases = 76.2% *"Destroyed" in this report means sent for cider making. 24 Your Medical Officer wishes to place on record his appreciation and thanks for the assistance given by all parties concerned in this matter, particularly the staff of the Pert of London Authority in the West India Dock whose whole-hearted co-operation was greatly appreciated by your Worshipful Committee's staff in this dock group who themselves worked all hours and over the week-end in order to get the consignment sorted and cleared as quickly as possible. A letter of appriciation was sent to the Superintendent of the West India Dock who replied "Thank you for your letter of the 16th August, 1955. I will certainly convey your sincere thanks to the staff concerned but I cannot let this opportunity pass without also informing you that the assistance given by your Officers in this matter was much appreciated in this Control. Our job is, as you know, to turn ships round quickly and at one time it looked though No. 11 Shed would be sterilised for two months or so. Your Officers gave speedy and generous attention to the work in hand however, and their efforts certainly contributed to ours to get the shed cleared quickly. As you know, this was done in just under a month". No problem of this magnitude has arisen since 1938 when a vessel arrived from Australia with a consignment of apples similarly affected save that in this instance the condition was found to affect only one particular variety of apple, of which there were approximately 80,000 boxes on board, and seemed to be confined to the apples carried in the lower holds, those in the 'tween decks being unaffected, a fact which made it much easier to unload the vessel so that the good apples were sorted from the bad at the time of unloading. In the recent instance, the involvement of apples stowed throughout the vessel with a complete mixing up of all the varieties made the problem of unloading and sorting infinitely more complex. Under these circumstances it was probably the best solution to send the majority of the apples for cider making without any attempt to sort the whole cargo. RE-ORGANISATION OF MEAT INSPECTION IN THE ROYAL DOCKS With the advent of the handing back of all imported meat by the Ministry of Food to private importers it became apparent that the Port Health Authority must obviously take some part and indeed have some say in any re-organisation, bearing in mind the important responsibilities imposed on this Authority by the Public Health (Imported Food) Regulations, 1937/1948 and the Public Health (Meat) Regulations 1924 (now being revised), in order to maintaih an efficient service ensuring the adequate initial inspection and subsequent examination of all meats landed in the Port of London. To this end the arrangements for meat inspection in the Port of London* were reviewed under three heads, as follows (a) The organisation pre-war and up to 1940. (b) The period 1940 to 1955. (c) From 1955 on. (a) The organisation pre-war and up to 1940 During the pre-war period and up to 1940, the Port Health Authority had, in the Royal Docks, two whole-time Food Inspectors with the part-time assistance of one general duty Sanitary Inspector. These Inspectors visited each ship daily to observe the discharge of meat cargoes and to note any abnormal conditions while at the same time contacting Importers' representatives at the ship side, calling their attention to any unsatisfactory conditions and subsequently instructing the Dock Authority to send to the Cold Stores any part of a consignment requiring reconditioning or further detailed examination for disease by the Port Health Authority, the Inspector on the North Sides of the Victoria Dock and Royal Albert Docks being responsible for glanding and supervision of the reconditioning of unsound meat at the five Cold Stores (4 — Port of London Authority and 1 — Messrs. Swift & Co., Ltd.) A quantity of meat requiring treatment was allowed to go out of the dock to various London Cold Stores to be dealt with but none was allowdd to go to Provincial Stores. The reconditioning in the Port of London Authority's Cold Stores within the docks was carried out under the supervision of your Food Inspectors, the labour being provided by the Port of London Authority from amongst the Cold Stores personnel who had had experience of that kind of work. In addition the Port of London Authority provided a thawing-out shed with a labourer in attendance where the glanding of tongues was carried out. In addition to carrying out meat inspection the two officers concerned carried out general food inspection and consequently only a limited time could be devoted to meat ships, their districts covering several miles of quayage which had to be visited on foot. It may be open to question in the light of modern knowledge whether the staff at that time was adequate to cope with all the duties of meat inspection and whether they had, as a result, to place too much reliance on assistance given to them by the staffs of the Dock Authority and of the Meat Importers. (b) The period 1940 to 1955 About 1940 when the Ministry of Food took over the responsibility of importing meat and meat products, three important organisations were set up in the Docks * As most of the meat imported into the Port of London comes through the Royal Docks Group, the greater part of the survey which follows refers to the work there. 25 (1) M.I.N.D .A .L. (Meat Importers National Defence Association Ltd.,) who were responsible for the transport of meat from the docks to its destination. (2) M.T.O.L. (Motor Transport Organisation Ltd.) and (3) Messrs. Perfect Lambert & Co., Ltd.; the Ministry of Food Meat Agent. All the Cold Stores were taken over and placed under the control of the Chief Cold Store Officer of the Ministry of Food. These organisations worked most efficiently and co-operated to a marked degree with the Port Health Authority. Messrs. Perfect Lambert & Co., Ltd., stationed a Surveyor and an Inspector at each and every ship discharging meat to examine and report on the condition of the meat and to carry out surveys in the interest of the Ministry of Food when the occasion arose. The co-operation of these representatives with the Food Inspectors of this Authority was most effective in-preventing damaged or unsound meat from leaving the docks. Arrangements were made in 1940 that all meat requiring to be reconditioned was sent to Messrs. Swift's Cutting Store in the Victoria Dock, there to be dealt with by skilled butchers but under the supervision of the Port Health Authority's Inspectors. These arrangements prevailed until June 1954 when Messrs. Swift & Co., Ltd., found that they could not carry on reconditioning in the face of their own Company's increased commitments but agreed to take small quantities as the occasion allowed. The consequence of this was that meat requiring reconditioning had to be allowed to proceed to various outside stores controlled by the local authority, a situation that was considered to be most unsatisfactory but, under the circumstances, unavoidable. In this dilemma the Port of London Authority came generously to our help through the provision of a modern and well equipped Meat Inspection Shop with tiling, heating and all the necessary lay-out for the inspection, thawing-out, glanding and reconditioning of meat. It is understood that the cost to the Port of London Authority was in the neighbourhood of £5,000. In January 1952 your former Medical Officer of Health re-organised the duties of the inspectorate in the Royal Docks Group with the result that whereas two whole-time food inspectors had been working the Group up to this date, the re-arranged duties involved four inspectors carrying out food inspection duties in addition to their other duties of general sanitation, ship hygiene and rodent control. The Senior Inspector continued to devote as much as possible of his time to the duties of food inspection, including the control of the four Cold Stores in the Group and supervising the reconditioning of damaged and unsound meat, as well as continuing the general supervision of all the work of the Inspectors and Rodent Staff in the area. In June 1954 it was found necessary to increase the number of Inspectors by one, this officer taking over duties of inspecting meat for disease and supervising the reconditioning of damaged and unsound meat in the dock Cold Stores. Despite this addition to the staff it was found that after the decontrol of meat the district Inspectors could not devote as much of their time as they would like and as the situation appeared to demand, to the inspection of meat on its discharge from ships. Although the Ministry of Food still had representatives on the dock to inspect the discharge of meat from ships bearing cargoes consigned to them the bulk of the meat coming into the country was to the order of private merchants. (Up to the end of 1954 some 90% of the total meat imports was in the hands of private merchants and it was anticipated that outstanding Ministry of Food contracts would cease by February, 1955). It has been estimated that some 75% of all meat imported into this country comes through the Port of London. These altered circumstances, while calling for a complete re-organisation affecting the Shipping Companies, Stevedoring Companies and Transport organisations also affected the Port Health administration and it had become apparent that this Authority must review its arrangements and decide what re-organisation was necessary in order to meet the changing circumstances. (c) From 1955 on Although it was appreciated that the meat trade would take several months of re-organisation to meet altered conditions and establish a new policy, it seemed prudent that the Port Health Authority should benefit by this interval and review its own position with a view to establishing a more adequate and efficient control of imported meats. The following points were, therefore, suggested for consideration (1) Re-arrangements and additions to the existing staff. (2) Transport. On the assumption that the previous arrangements were inadequate to meet the demand, it was suggested that the three District Inspectors should be relieved of the duties of meat inspection at the ship's side and devote their time to carrying out general food inspection in addition to their other duties of ship hygiene, rodent control, etc., while the appointed Cold Store Meat Inspector should carry out full-time duties at No. 6 Cold Store and supervise the examination and reconditioning of all meat sent to the new Port of London Authority Cutting store referred to above, as the "Meat Inspection Shop". It was further suggested that the Senior Inspector should assume full responsibility for the inspection of all meat landed from ships, this to be his only duty apart from his continued responsibility to supervise all the work carried by the Sanitary Inspectors and the Rodent Staff 26 in the Royal Docks Group — a responsibility which is recognised by his title of "Senior Inspector". To assist the Senior Inspector in his fuller responsibilities for meat inspection, the following recommendations were made (i) An additional Sanitary Inspector duly qualified both generally and for the inspection of meat and other foods should be appointed to the staff of the Port Health Authority and either he, or one of the existing members of the Inspectorate should be appointed as a whole-time assistant to the Senior Inspector on the Royal Docks in his responsibility for meat inspection. (ii) A second additional Sanitary Inspector with qualifications to inspect meat and other foods should also be added to the staff of Sanitary Inspectors employed by the Port Health Authority. This Inspector to work at Tilbury Docks as an assistant to the existing Sanitary Inspector who works single-handed there and has to cover a very large area with responsibilities that are likely to be increased following the implementation of the Port of London Authority's proposals to make a new Landing Stage and Quay in the Tilbury Dock. The present Inspector has to devote much of his time, often amounting to several hours, to enquiries and the disinfection of ships in connection with the numerous cases of infectious diseases which arise in the type of ship berthing within his area. He has also, on occasion, to deal with the Shellfish Industry at Leigh-on-Sea. It has been estimated that some 15% of the meat imported into the Port of London is landed in Tilbury Docks. The proposed new assistant could carry on during the present Inspector's absence on duties which take him out of the dock, when he is sick and when he is on vacation, whereas at the present time a locum tenens has to be provided from the already hardpressed Inspectorate at the Royal Dock Group. (iii) The Royal Dock Group has a quayage of approximately twelve miles and the meat discharging berths, which may be serving as many as seven meat ships at any one time, are scattered throughout this distance. As it is considered necessary for the Senior Inspector to visit these ships personally at least twice a day and also to meet various urgent calls throughout the Dock Group, the question of transport arises. In this connection it was suggested that a Utility Class Vehicle should be provided which, apart from being used by the Senior Inspector for the purposes mentioned above, would also be available, as necessary, to the other Inspectors working in the Royal Docks and to the Rodent Staff not already provided with transport. (iv) As an interim measure and to tide over an experimental period of two to three years, it was recommended that the appointment be made of two "Meat Watchers" or "Meat Sorters", each of whom would be allocated a district and would maintain a constant watch over the discharge of meat from ships to detect any damaged or unsound meat being landed, reporting any such conditions to the Senior Inspector who would then visit the ship and take the appropriate action as to disposal. In other words these "Meat Watchers" would take the place of the Ministry of Food representatives mentioned above and would be recruited from men with a thorough knowledge of meat and a wide experience of dock procedure. It so happened that there were at the time two employees of the Port of London Authority who were highly skilled and experienced in these matters and who were due to retire shortly. They could be re-employed by the Port Health Authority for an interim period of two to three years when their experience, understanding of the dockers and knowledge of the complexities of the meat trade, would prove invaluable at a time when the Sanitary Inspectors were still learning to become accustomed to the new arrangements. At the end of the interim period the position could be reviewed with the object of either (a) continuing their services, (b) replacing them by similar types of men or (c) replacing them by qualified Sanitary Inspectors. As the result of the above recommendations your Worshipful Committee duly appointed two additional fully qualified Sanitary Inspectors, one of whom was posted to the Royal Docks Group and one to the Tilbury Dock. In addition the two men referred to above were appointed as "Meat Watchers" in the Royal Docks and a Utility Class Vehicle was purchased and based on .-the Royal Docks in the charge of the Senior Sanitary Inspector. At the time of writing this report these additions to the staff coupled with the amenities provided by the full operation of the "Meat Inspection Shop" at No. 6 Cold Store, Royal Albert Dock has proved most satisfactory and has fully justified the decisions of your Worshipful Committee. DANGEROUS DRUGS During the year fifty-five 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 27 required for the use of the ship until it reaches its home port. The certificate given by the Medical Officer of Health of the Port shall be marked by the supplier with the date of the supply and shall be retained by him and kept available for inspection." PUBLIC HEALTH ACT, 1936. PART X - CANAL BOATS Seventy-seven inspections of canal boats were made during 1955. Eighteen canal boats were found to have a total of twenty-one defects, as follows:— No of defects Cabin in need of painting 10 Dampness due to defective cabin top, sides, etc. 5 Defective ventilation 4 Defective bulkhead causing fumes to enter cabin 1 Flooding of bilges due to defective timber 1 21 The Owners and/or Masters of the defective craft were in each case notified and requested to carry out the necessary repairs. In six instances the Certificate of Registration was not on board and in one instance the details of the accommodation were not correctly recorded on the Certificate of Registration. The owners were informed of the requirements of the Act in this respect. In March, 1955, a letter was sent to The Docks and Inland Waterways Executive suggesting that consideration be given to the provision, where practicable, of Elsan closets on canal boats. The Executive at once accepted this proposal and stated they would extend this facility to any of their boating personnel who wished to take advantage of it. No new registrations were effected during the year. HOUSEBOATS AT BENFLEET The Essex County Council Act, 1952, provides that the mooring of any houseboat within the County shall not be lawful without the consent of the Council of the district in which the houseboat is situated and that the Council may require the owner or occupier to remove or demolish any houseboat not authorised by them. Your Worshipful Committee are, however, still responsible for the sanitary supervision under the Public Health (London) Act, 1936, of houseboats coming within the jurisdiction of the Port Health Authority, although under the Essex County Council Act, the local Councils are now responsible for the licensing and drawing up of conditions under which they are pre pared to grant licences to houseboats. The duties of your Committee in regard to the sanitary supervision of houseboats are safeguarded by Section 212 of the Essex County Council Act, 1952, which provides inter alia that no consent shall be given by the controlling authority to the mooring or placing of any houseboat within the Port of London without the previous written consent of the Corporation of London as the Port Health Authority of the said Port of London. In March, 1954, the Clerk of the Benfleet Urban District Council wrote to the Town Clerk to say that his Council had agreed that, subject to the approval of the Port Health Authority, consents shall be issued in respect of forty specified craft for a period of twelve months without any conditions; and that the owners be informed that the boats must be removed at the expiration of that period unless a previous application has been made by them to the Council andrenewal granted. Your Medical Officer raised no objection to this proposal to grant 'temporary' consents and your Worshipful Committee approved the proposal of the Benfleet Urban District Council. In July, 1955, the following letter was received by the Town Clerk from the Clerk to the Benfleet Urban District Council:— " Dear Sir, HOUSEBOATS - BENFLEET CREEKS - TEMPORARY CONSENTS The temporary consents issued in 1954 expired on the 31st May last, and the Council have agreed that, subject to the approval of your Authority, consents should be renewed in respect of the houseboats for the period ending 31st May, 1956, without any conditions: the owners to be informed that the boats must be removed at the expiration of that period unless a previous application has been made and renewal granted :— WEST CREEK: Bill Busty, Balranald, Smugglers, Patsy Ann, Sans Souci, Misene, Lydia, Amy, Jewel, Michael David, Hi-di-Hi, Lowestoft, Haven, Wanderlust, Sunrise, Iris, Blake, Havic, Emma Jane and Yacht Club Boat. EAST CREEK:Manana, Whykaway, Madeline, Buchra, Frogmore, Bligh, Intruder, Lets Pretend, MTB. 492, Dolphin, Invader,Betta Glen,Bendigo , Mendip, Jenny Le e and Margot. I shall be glad to receive your Authority's consent to issue the 36 temporary licences. Yours faithfully, (Sgd.) D. GRUDGINGS, Clerk to the Council." 28 Your Medical Officer raised no objection to the granting of temporary licences in respect of the above-named houseboats and with your Worshipful Committee's approval, the Town Clerk was requested to inform the Clerk to the Benfleet Urban District Council accordingly. POLLUTION OF THE THAMES The "Municipal Journal" of the 4th March, 1955, carried an editorial which your Chairman considered would be of interest to your Worshipful Committee and it was accordingly quoted in full in the Monthly Report that was presented to the Committee on the 1st April, 1955, and as a result your Medical Officer was asked to report to Thames Pollution at their next meeting, which he did in the following terms:— "The Editor of the 'Municipal Journal' concludes his editorial comment as follows 'Meanwhile, the situation will remain tolerable only so long as there is an adequate flow of water into the Thames below Teddington: upon this forward surge of water over the weir depends the river's ability to cleanse itself. Thanks to exceptionally wet weather in recent months, this flow is now strong enough to induce a certain dilution and down-river movement of effluent. But if there is any repetition of the drought of the 1930's — and a warm summer is long overdue — the flow from Teddington, additionally weakened by larger abstractions by the Metropolitan Water Board, will become sluggish. Emergency measures might then become necessary to safeguard public health.' "The conditions of drought to which the editor refers would simply aggravate the dangers to public health which are ever present from the pollution of the Thames, pollution which has increased considerably since the Royal Commission on Sewage Disposal in 1908 reported that both the surface and the bottom of the Thames at all stages of the tide were largely de-aerated from North Woolwich to beyond Grays as a result of sewage contamination. "A much earlier observer than the Royal Commission was Professor Faraday who wrote to the 'Times' in the summer of 1855, as follows 'Sir, I traversed this day by steam-boat the space between London and Hungerford Bridges between half-past one and two o'clock; it was low water, and I think the tide must have been near the turn. The appearance and smell of the water forced themselves at once on my attention. The whole of the river was an opaque pale brown fluid. In order to test the degree of opacity, I tore up some white cards into pieces, moistened them so as to make them sink easily below the surface, and then dropped some of the pieces into the water at every pier the boat came to; before they had sunk an inch below the surface they were indistinguishable, though the sun shone brightly at the time; and when the pieces fell edgeways the lower part was hidden from sight before the upper part was under water. This happened at St. Paul's Wharf, Blackfriars Bridge, Temple Wharf, Southwark Bridge and Hungerford; and I have no doubt would have occurred further up and down the river. Near the bridges the feculence rolled up in clouds so dense that they were visible at the surface, even in water of this kind. 'The smell was very bad, and common to the whole of the water; it was the same as that which now comes up from the gully-holes in the streets; the whole river was for the time a real sewer. Having just returned from out of the country air, I was, perhaps, more affected by it than others; but I do not think I could have gone on to I.ambeth or Chelsea, and I was glad to enter the streets for an atmosphere which, except near the sink-holes, I found much sweeter than that on the river. 'I have thought it a duty to record these facts, that they may be brought to the attention of those who exercise power or have responsibility in relation to the condition of our river; there is nothing figurative in the words I have employed, or any approach to exaggeration; they are the simple truth. If there be sufficient authority to remove a putrescent pond from the neighbourhood of a few simple dwellings, surely the river which flows for so many miles through London ought not to be allowed to become a fermenting sewer. The condition in which I saw the Thames may perhaps be considered as exceptional, but it ought to be an impossible state, instead of which I fear it is rapidly becoming the general condition. If we neglect this subject, we cannot expect to do so with impunity; nor ought we to be suprised if, ere many years are over, a hot season gives us sad proof of the folly of our carelessness. I am, Sir, Your obedient servant, M. FARADAY.' Royal Institution, July 7. "Three years after Faraday wrote this letter, it is recorded that Queen Victoria went down the Thames by Royal Barge in 1858 in order to launch "The Great Eastern". Her Majesty kept a scented handkerchief firmly to her nose throughout the journey. 29 "Under natural conditions the surface of any water expanse 'breathes in' oxygen from the atmosphere; fresh river water contains approximately 10 parts of oxygen per million and uncontaminated sea water contains somewhat less due to its salinity, but the corresponding amount is about 8/2 parts of oxygen per million. The absorbtion of atmospheric oxygen through the surface of the water is by far the most important source of oxygen, but the tidal reaches of the Thames receive two other sources of oxygen supply, sea water coming up and fresh river water coming down — this is the water coming over Teddington Weir after two-thirds of London's water supply has been abstracted from the River Thames by the Metropolitan Water Board. Yet so great is the pollution and contamination by sewage and industrial wastes that most and sometimes all the dissolved oxygen in that part of the Thames is used up in oxidising putrescible and chemical matter and consequently at such times more gases like the 'rotten egg' smelling hydrogen sulphide are given off from the River than oxygen absorbed into it, particularly at times of drought. It is in drought periods too, that the Minister of'Health may permit the Metropolitan Water Board (faced perhaps with a crisis in meeting the demands of their consumers) to reduce the flow over Teddington Weir from the 'statutory minimum' of 170 million gallons per day to 90 million or even 50 million. "At such times the odour nuisance to people who live and work on, or near the Thames may become a serious menace to health both psychologically and physically when it leads in sensitive persons to nausea, retching and vomiting — in practice it means for them at such times that they are living in an atmosphere of hydrogen sulphide which, incidentally, effects material damage also by tarnishing metal and blackening paint, factors which must be reckoned with in the maintenance of your Worshipful Committee's launches. "Apart from noxious odours, other dangers to healthare from paddling and bathing in the Thames which in parts contains high concentrations of the so-called Salmonella organisms, i.e., the germs principally concerned in outbreaks of food poisoning. Worst danger of all is the accidental drinking of tidal water or its use for domestic purposes such as washing salads. Tidal water may find its way by mistake into drinking water tanks or may contaminate drinking water through accidental cross connections and back siphonage. An example of this kind of occurrence was reported verbally by your Medical Officer at your last meeting. "It is not known what the Editor of the "Municipal Journal" had in mind when he wrote of "emergency measures" that might become necessary to safeguard public health, but your Medical Officer knows of only two that are used in practice. First the London County Council may arrange for their effluent to be chlorinated. Chlorination reduces the danger to health from the sewage effluent, but the chlorine in turn is rapidly destroyed by the high organic content of the river. The second emergency measure is for the Metropolitan Water Board, in an endeavour to achieve a compromise between the demands of their customers and the reduction of the flow over Teddington Weir, to limit the use of water for gardens, washing cars, etc. "More hope lies in long term measures. The London County Council have a £1'3 million scheme (1) for sewage purification which enforced limitation of capital expenditure has so far prevented their implementing. (At the present time more or less untreated sewage from the London County Council works passes into the Thames in its tidal reaches at Barking and Crossness at the rate of about 300 million gallons of sewage in 24 hours. The vplume of tidal Thames water between Barking Creek and Teddington Weir is 8,000 million gallons at low tide and 23,500 million gallons at high tide). "Limitation of capital expenditure has also prevented the Metropolitan Water Board (2) from going ahead with ambitious schemes for enlarging their provision of reservoirs which if established would help to avoid their having to reduce the flow of 'fresh water' over Teddington Weir. "A much more remote 'long term' hope lies in the possibility that science may discover a means for the London Electricity Board to effect their necessary cooling arrangements without taking from the Thames every 24 hours 4,000 million gallons of water which they de-oxygenate and heat, the heated water on return to the River having a further harmful effect in reducingthe River's oxygen content, which varies inversely with the temperature of the water. "The 'last word' on the subject may be expected when the reports are published from two Committees which are already at work on the problems of Thames Pollution — The Thames Survey Committee of the Department of Scientific and Industrial Research (appointed in 1949) and The Heated and Other Effluents Committee of the Ministry of Housing and Local Government (appointed in 1951 with wider terms of reference). (3) "From these perhaps not over constructive thoughts about the problems of Thames Pollution it may be refreshing to remember that unpolluted natural river waters are so 'super-saturated' with oxygen that they have enough and to spare for their own economy and release spare oxygen into the neighbouring atmosphere, so promoting a feeling of exhilaration in people nearby. In the peroration to his paper on 'The Thames Estuary and the Problems of Sewage Disposal of Greater London' (The 'Medical Officer', 15th January, 1938), Colonel Bitler formerly Medical Officer (General Purposes), London County Council, wrote, 'Let us in our time have the air, the clean river air with the something in it that betters our health, quickens if not lengthens our town-sombred lives and in the prospect of its coming touches, perchance, the procrastinating lethargy, in which so long we have been steeped'." 30 . Since this report was written it is learned that — (1) the London County Council have now two schemes in hand (one for the Northern Outfall and the other for the Southern Outfall at a total cost for the two of £18 million) which when completed, as hoped by 1965, should result in a sewage effluent up to "Royal Commission" standards. (2) the Ministry of Housing and Local Government have now given permission to the Metropolitan Water Board to proceed with the construction of two new reservoirs. (3) both these Committees have now completed their investigations and their reports are in draft form. TILBURY DOCK FRESH WATER SUPPLIES In November a report was received from your Sanitary Inspector on the Tilbury Dock, Mr. D. E. Madeley, that the fresh water main on the South Side of the dock had become contaminated with salt water due, as subsequent enquiries showed, to a vessel having pumped dock water back into the shore fresh water main for a number of hours. Your Medical Officer, in reporting the incident, said that he had under consideration the whole question of water supplies in the dock areas and would report further when the enquiries had been completed but that meanwhile it was worth noting those details of ship construction and routine which may make possible occurrences of this kind under certain circumstances. As Mr. Madeley pointed out in his report most of the bigger and more modern ships have two distinct and separate fire fighting systems (1) A Fire-main system which is salt water piped at considerable pressure to all parts of the ship. There are numerous connections to which fire hoses can be fitted. This is the system which supplies the flush for water closets and the wash-deck service. (2) Sprinkler system which is an automatic device for damping out fires in passenger and crew spaces, etc. It is usually connected with some form of fire alarm. The pipes are numerous and of small diameter. It is maintained with fresh water to minimise corrosion. If, for any reason, the Fire-main pump is out of action in port it is possible to connect up with a pump ashore to maintain a fire-fighting pressure in the system. For this purpose there is a fire-main-"Shore to Ship" connection (in most ships more than one) with an Instantaneous Connection such as is used by most English Fire Brigades. If the smaller pump for the Sprinkler System is out of action it has been the practice to connect the system with the shore fresh water supply to maintain the Sprinkler in action. This works satisfactorily from a fire-fighting point of view since it provides the necessary pressure and quantity required. The connection on deck for this purpose has a "Butterfly" union corresponding to the type of fitting on the Port of London Authority's fresh water hose. It is usual to have a non-return valve incorporated in the ship's connection as a precaution against returning ship's water to the shore line. In this particular incident, on Wednesday afternoon, the 16th November, instructions were given on a certain ship in Tilbury Dock to connect the Sprinkler System with the shore fresh water system. The connection was carried out by an inexperienced member of the crew who on proceeding to the position on deck by No. 2 Hatch, observed the "Fire-main Shore to Ship" connection plainly marked in red lettering. He apparently did not observe the "Sprinkler Shore to Ship" connection a few feet away which is also marked in red lettering, but which lam informed was obscured at the relevant time by an accumulation of dunnage on deck. The man did, however, find that the connection on the Shore Fresh water hose (Butterfly type) would not fit the ship's Fire-main Service connection (Instantaneous type). Instead, however, of returning to his senior for further instructions he obtained an 'adaptor' (a short length of pipe with a Butterfly connection at one end and an Instantaneous connection at the other end)and with this he made the connection between the ship's salt water system and the shore fresh water system. When the valves were opened, salt water (from Tilbury Dock via the ship's pumps) was forced into the fresh water mains. This continued the whole of Wednesday night and was not discovered until Thursday morning. It was not reported to any Officer of the ship until much later when it was found that the ship's own drinking water was brackish. Your Sanitary Inspector on the Tilbury Dock did not get the full story until Saturday, 19th November at about 5.0 p.m., after three days of most painstaking investigation into what had seemed at first to be a most mysterious affair. Two vessels were involved in the incident both taking water simultaneously along the same water supply line. One of the vessels involved was almost ready to put to sea, so the dirty water had to be pumped out, after the tanks had been super-chlorinated. She left her berth in the dock and her tanks were refilled with fresh water, (at considerable expense to the shipping company) supplied by water boats while she was lying in Gravesend Reach. Later Mr. Madeley confirmed that the cause of the pollution in the dock mains was due to the supply hose from the dock hydrant having been directly connected, inadvertently, to one of the vessel's fire lines instead of the "sprinkler system". The polluted water 31 in the fire system regurgitated with a reverse flow into the fresh water supply which was serving both ships. Your Medical Officer, Chief Sanitary Inspector and Mr. Madeley, together with officials of the shipping company concerned, visited the other vessel which was still in dock and it was decided to super-chlorinate all her tanks, then empty and open them for cleaning before refilling. This was possible since the vessel was discharged of all cargo and the tanks were, therefore, accessible. Meanwhile the dock mains were chlorinated and thoroughly flushed through before the vessel's tanks were replenished. The incident proved the point that there is always a grave risk attached to coupling a fresh water hose directly to a closed water circuit aboard a ship except under supervision by a responsible officer who fully understands the complications of the various watering systems and their couplings. It was decided at the meeting aboard the ship to recommend that no such connection should be made in future and that the "sprinkler" supply connection and method of emergency supply should be reconsidered. The whole question of dock water supplies was being actively investigated by your Inspectors and discussed at Conferences attended by representatives of all the interested parties at the time this Report closed and the results will be reported in the next Annual Report. VISITORS AND STUDENTS The activities of the Port Health Authority have always been of outstanding interest and value to visitors from overseas engaged in port health administration and during the year fifteen visitors, either doctors or sanitary inspectors, from British Guiana, Canada, Egypt, Israel, Indonesia, Korea, Persia, Philippines, South Africa, Tanganyika, Spain, Tunisia and the United States of America, were at the request of the Ministry of Health, Colonial Office, British Council and other Departments, shown various branches of port health work in London. Facilities were also provided for students of the London School of Hygiene and Tropical Medicine, the Royal Institute of Public Health, the Army School of Health and the National College of Food Technology, to see aspects of port health work relating to their studies. LAUNCHES AND STATION HULKS During the past year, performances have been very satisfactory. Except for the repair interval on the "ALFRED ROACH", regular services at both Stations have been maintained efficiently without any interruption due to mechanical or structural defect, and normal working arrangements have been carried out smoothly in the absence of any misadventure or appreciable sickness among the crews. Every decision concerning the efficiency of the Service has been associated with expediency and economy, sparing no effort to maintain high standards of performance and appearance. No vessel has been withdrawn from duty for refitting, though all have received care and maintenance such as painting, running repairs and adjustments by the crews; only the "HYGEIA ' has received a major overhaul, which is to be the subject of a separate Report. The time has come to prepe-e a 'defect list' for m.l. "HOWARD DEIGHTON" which was refitted previously in 1952, and should be docked for a refit early this year. Consideration should be given later to the other launches that were refitted in 1953, and where any outstanding defects may need correction before a major refit, especially those defects capable of repair possibly without disrupting the normal routine or beaching the launches for underwater maintenance. "Uplees" This converted 'sailing barge', now 58 years old, has not been a source of any expenditure other than coal for heating and cooking, paraffin for lighting and consumable stores for cleaning and painting. The general condition is satisfactory. Nothing more will be done to this hulk other than emergency demands. "Hygeia" The major refit by John Ratzer of Gravesend has now been completed. It is noteworthy that this hulk has not been dry-docked for underwater survey for more than 20 years and, furthermore, a slight leakage from the shell plating of the starboard quarter has been discovered duringthe refitting and is located at a point 3 feet below the waterline. This leakage has been temporarily stopped with a 'cement-box' patch. Needless to add, no further ivestigation of the plate thick ness was advisable at the defective area or any other underwater plates. This incident does indicate, however, that the time is approaching when an underwater survey will be necessary, although such action will cause a temporary dislocation of the organisation at the Gravesend Station. "Howard Deighton" The behaviour of this launch is satisfactory and the starboard engine has continued to run with improved efficiency since the new timing wheels were fitted. The same improvementis 32 expected of the port engine after similar correction has been made. The engines are not easy to adjust for maximum economy and performance because of the intermittent demands imposed upon them and the fluctuating ranges of temperature obtained in the cylinders. In spite of this and other handicaps, the economical results and flexibility are quite satisfactory. There is a certain amount of periodic vibration due to the coincidence of mechanical vibrations from the propelling machinery, but this effect is common to all twin screw vessels. Apart from the usual minor defects due to years of wear and tear, the outstanding item for attention is the afterpeak watertight bulkhead which is dangerously weak and thin along the lower half and should be renewed at the next refit. At the same time the engines will need a complete overhaul and renewal of the anti-galvanic action zinc plates at the stern-post, for which there is a greater need owing to the heavy pollution of the river water. "Alfred Robertson" This launch has given no trouble in any way, but it is known that the counter-plates are quite thin due to corrosion during the first ten years of her service. The plates were corroded internally due to leakages from the rudder post gland left unattended. After scaling the plates in recent years, only thin plating remained. This wasting condition has been arrested, but new plates may be necessary at the next major refit. A considerable reduction in the auxiliary engine running hours has been achieved by using a portable paraffin heating stove as an alternative to the electric radiators and this accounts for the use of paraffin in this launch. Although becoming slow by present launch speed standards, she is suitable for the District duties and both deck and engine departments are well attended in care and maintenance. "Frederick Whittingham" A surprising feature of this smaller launch is its reliability after having been so erratic in performance during its earlier years of service. Since the structural modifications and complete mechanical overhaul eight years ago then a gearbox adjustment six years ago, she has given continuous and efficient service. Her size and robust structure are an advantage in the midst of barge traffic. Although the maximum speed of 7/2 knots is relatively slow, it is not a real handicap while doing work on a congested and limited District. Her shortcomings in design are offset to a great extent by the aforementioned reliability and the high standard of care and maintenance overall. "Alfred Roach- Owing to slight damage sustained to the planking of the transom as a result of an impact from a small yacht which was out of control, this launch was out of commission and laid aside for repairs at Thornycroft's boatyard for several days. On another occasion she was given superstructural modifications to meet requirements for the reception of distinguished visitors. Apart from these short intervals, the launch has continued in regular service and has met all demands with its customary efficiency. 8oth engines are running to complete satisfaction and the installation, together with the equipment and structure are very carefully maintained. The hand-operated window fittings which are concealed behind the panels are regularly greased, but wasting of the metal components can only be retarded by grease and it is anticipated that renewals of these fittings will be required soon. The zinc plates on the underwater surface at the stern continue to arrest the effects of galvanic action on the propeller shafts and allied fittings. The demands for consumable stores have remained steady and the consumption of fuel oil and lubricants almost the same as last year. It is impossible to calculate a specific consumption figure for the fuel oil on a horse-power basis, since the engines arc running on fluctuating loads during the tours of duty, but it is sufficient to conclude that all the engines operate with a smokeless exhaust and at economical sppeds. Naturally, there are very slight variations in the qualities of the personnel, but allare sufficiently interested in the Service and well-being of the vessels in their custody. Generally the standard is high and in some cases exemplary. Vessel Engine Running Hours TOTAL CONSUMPTION Gallons Lbs. Tons. Main Auxiliary Fuel Oil Lub. Oil Paraffin Grease Coal Coke "UPLEES" 80(1) 3'/2(2) "HYGEIA" 13(3) 11(2) "HOWARD DEIGHTON" 1,158 932 3,729 154 — 42 6 — "ALFRED ROBERTSON" 759 264 1,049 17 209(2) 18 ½(2) — "FREDERICK WHITTINGHAM" 420 340 10 100(2) 5 — — "ALFRED ROACH" 496 — 1,190 30 90(2) 2 - - TOTALS 2,833 1,196 6,308 211 290 67 23 11 (1) For lighting (2) For cooking and heating (3) For Doctors' lounge and galley 33 APPENDIX I MEDICAL INSPECTION—From 1st January to 31st December, 1955 GRAVESEND Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total No. medically inspected 149 146 185 181 159 165 154 157 147 142 138 151 1,874 No. of Passengers 753 460 1,270 926 1,691 4,684 3,613 3,849 3,674 738 808 358 22,724 No. of Crew 138 409 1,183 417 383 904 518 123 389 258 468 595 6,825 No. of Foreign Arrivals 1,138 1,049 1,220 1,125 1,201 1,103 1,180 1,256 1,163 1,184 1,129 1,092 13,835 APPENDIX II INFECTIOUS DISEASES Disease 1946 1947 1948 1949 1950 1951 1952 1953 1954 Mean Annual No. for 10 years ending 31st December, 1955 1955 (a) Cases reportedCholera (including suspected cases) - - - - - - - - - - - Plague do. — - - - - - - - - — — Yellow fever do. — — — — — — — — — — — Typhus fever do. — — 1 5 — — — — — 0.6 — Smallpox do. 5 2 3 2 4 6 — 1 1 2.5 1 Scarlet fever 2 10 3 3 7 3 — 2 — 3.2 2 Enteric fever 9 5 10 82 9 7 8 8 6 15.2 8* Measles 11 26 99 80 58 74 56 97 31 59.6 64 German measles 6 5 3 3 17 67 13 6 7 13.2 5 Diphtheria 8 5 2 1 — — 2 — - 1.9 1 Erysipelas — — 1 — 1 — — 1 — 0.3 — Pulmonary tuberculosis 21 27 32 43 41 53 67 46 43 40.8 35 Other diseases (including Chickenpox) 79 102 106 124 114 130 128 184 347‡ 168.2 368 Totals 141 182 260 343 251 340 274 345 435 305.5 484 (b) Admitted to Hospital- Cholera (including suspected cases) - - - - - - - - - - Plague do. - - - - - - - - - — — Yellow fever do. — — — — — — - — — — — Typhus fever do. — — 1 3 — — — — — 0.4 — Smallpox do. - - - - - - - — 2 0.7 5 * Scarlet fever 2 — 3 — — 1 — — — 0.6 — Diphtheria 7 4 2 — — 1 — — — 1.4 — Enteric fever — 2 3 — 6 — 1 1 — 1.6 3 Measles 6 10 24 8 5 12 3 16 21 11.7 12 Parotitis 5 1 4 3 1 13 4 2 1 4.4 10 Dysentery 8 9 3 1 — 1 1 — 6 3.5 6 Other diseases (including Chickenpox) 43 60 80 34 56 35 35 48 32 47.1 48 Totals 71 86 120 49 68 63 44 67 62 71.4 84 * Includes 221 Cases of Gastro-Enteritis * Includes 2 "Carriers" Contacts 34 APPENDIX ID RETURN OF RATS CAUGHT AND DESTROYED DURING THE YEAR 1955 Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total London Dock- Warehouses 34 17 10 44 12 34 22 15 72 35 21 14 330 Vessels — - — 12 — — - - - - - - 12 St. Katharine Dock- Warehouses 1 2 — 7 2 — — 3 — 3 6 3 27 Vessels - - — — - 5 — - - - — - 5 SurreyCommercial dock- Warehouses — — 1 2 1 2 8 4 15 - 4 4 41 Vessels — — 5 — 18 — — 40 — 1 — — 64 East India Dock— Warehouses - 7 - - 1 - - - 1 - - 1 10 Vessels - - - - - - - - - - - - - West India Dock- Warehouses 15 21 48 25 26 15 38 50 38 43 23 13 355 Vessels 8 - 34 - 4 - 1 14 72 - 28 53 214 MillwallDock- Warehouses 39 28 15 49 26 43 34 47 30 22 15 22 370 Vessels — - 1 42 4 47 — - 37 — 1 - 132 Royal Albert Dock- Warehouses 15 1 10 3 15 4 5 21 21 14 19 5 133 Vessels 52 3 40 41 69 1 75 91 64 48 73 14 571 Royal Victoria Dock- Warehouses 86 77 52 60 177 66 37 75 38 68 60 26 822 Vessels 10 71 151 42 28 74 148 37 34 4 45 121 765 King George V. Dock- Warehouses _ 3 4 3 4 5 - 17 - 2 - 16 54 Vessels 2 - 3 - 8 - 17 - 1 11 2 44 Tilbury Dock- Warehouses 24 29 50 26 9 31 44 26 6 27 7 11 290 Vessels 55 54 2 22 56 20 39 103 16 3 64 18 452 1 Regent's Canal Dock- Warehouses — — 6 — — 5 13 5 7 33 10 1 80 Vessels - - - - - - - - - - - - River- Vessels 88 150 69 55 88 162 9 48 90 38 79 70 946 Totals 429 463 501 433 548 514 490 596 541 342 466 394 5,717 35 APPENDIX IV—General Summary and Analysis of the Sanitary Inspections, etc., in the Port of London for the year ended 31st December, 1955, Foreign Going Inland Navigation -Continued Steam— Sail- Inspected 9,973 Inspected 3 Defective 305 Defective — To be cleaned 462 To be cleaned — Sail— Lighters— Inspected — Inspected 983 Defective 19 Defective — To be cleaned — To be cleaned 1 1 Coastwise Canal Boats— Inspected 77 Defective 18 Steam— To be cleaned — Inspected 2,070 Shore Premises Defective 47 To be cleaned 84 Inspected 8,213 Sail— Defective 830 To be cleaned 703 Inspected 8 Sick Seamen referred to Hospital 94 Defective — To be cleaned - Inland Navigation Water Barges No. in district in good condition on 31st December, 1954 14 New Barges _ Steam— Condemned — Use discontinued 1 Inspected 138 Previously withdrawn and since resumed work Defective 6 To be cleaned 7 No. in district on 31st December, 1955 13 Inspections Dock and River No. Nationalities No. American (U.S.A.) 130 Total Inspections London and St. Kats. 948 Argentinian 30 1st January to Belgian 69 31st December, 1955 :— Regent's Canal 526 Brazilian 14 Foreign Going 9,973 Surrey Commercial 1,359 British 8,933 Coastwise 2,078 Burmese 2 Inland Navigation 1,124 Costa Rican 34 Shore Premises 8,213 Danish 145 East India 216 Dutch 1,031 Total 21,388 Eire 2 Finnish 167 French 94 West India 956 German 554 Millwall 506 Greek 91 Honduras 11 Number of Vessels inspected in the Launches :— Icelandic 3 Royal Albert.. 1,353 Indian 30 Israeli 18 Royal Victoria 885 Italian 62 "Alfred Roach" ( 1,786 Japanese 55 "Howard Deighton" King George V. 896 Liberian 99 "Frederick Whittingham" 947 Maltese 1 River—Upper 947 Moroccan 7 Pakistani 2 "Alfred Robertson" 587 River—Middle 587 Panamanian 103 Polish 25 Portuguese 3 Puerto Rican 2 River—Lower 1,786 Roumanian 4 Russian 63 River—Medway 804 Spanish 66 Swedish and Norwegian 1,238 Swiss 10 Tilbury 1,406 Turkish 16 Yuge Slavian 61 In Docks, etc. 9,855 Total Vessels 13,175 Total Vessels 13,175 Shore Premises 8,213 Shore Premises 8,213 Shore Premises 8,213 Total 21,388 Total 21,388 Total 21,388 36 APPENDIX V DOCKS WITHIN THE JURISDICTION OF THE PORT HEALTH AUTHORITY Dock Group Docks Water Area Lineal Quayage Acres Yards Miles Yards I London 34 4,460 3 119 St. Katharine 10 488 — 1,654 Regent's Canal 11 38 - 966 II Surrey Commercial 161 2,717 16 200 III West India 97 3,957 4 1,134 East India 31 2,878 1 1,242 Millwall 35 3,217 2 155 IV Royal Victoria 95 1,772 5 1,479 Royal Albert 87 213 3 905 King George V 64 997 3 663 V Tilbury 104 2,166 3 1,667 The River distance between the Western and Eastern limits of the Port is about 68/ miles. POWERS The principal Acts of Parliament and Statutory Instruments affecting the work of the Port Health Authority of the Port of London are: ABATEMENT OF NUISANCES AND REMOVAL OF REFUSE Public Health (London) Act, 1936. ADMINISTRATION Public Health (London) Act, 1936. Sanitary Officers Order, 1926. S.R. & 0. No. 552. Sanitary Officers (London) Regulations, 1951. S.I. No. 1021. AIRCRAFT Public Health (Aircraft) Regulations, 1952 and 1954. S.I. 1952, No. 1410; 1954, No. 674. ALIENS Aliens Order, 1953. S.I. No. 1671 Ministry of Health Instructions to Medical Inspectors, 1955. CANAL BOATS Public Health Act, 1926. CONSTITUTION OF THE AUTHORITY Public Health (London) Act, 1936. CREW ACCOMMODATION Public Health (London) Act, 1936. Merchant Shipping (Crew Accommodation) Regulations, 1953. S.I. No. 1036. DANGEROUS DRUGS Dangerous Drugs (No. 3) Regulations, 1923. S.R. & 0. No. 1095. FERTILISERS AND FEEDING STUFFS Fertilisers and Feeding Stuffs Act, 1926. Fertilisers and Feeding Stuffs Regulations, 1955. S.I. No. 1673. FOOD Public Health (Preservatives, etc. in Food) Regulations, 1925 to 1948. S.R. & 0. 1925, No. 775; 1926, 1557; 1927, No.577; 1940, No. 633; 1948, No. 1118. Public Health (Imported Milk) Regulations 1926. S.R. & 0. No. 820. Public Health (Imported Food) Regulations, 1937 and 1948. S.R. & 0. 1937, No. 329; S.I. 1948, No. 886. Food and Drugs (Whalemeat) Regulations, 1949 and 1950. S.I. 1949, No. 404; 1950, No. 189 Food and Drugs Act, 1955. Food Hygiene Regulations, 1955. 37 FUMIGATIONS Hydrogen Cyanide (Fumigation of Ships) Regulations, 1951. S.I. No. 1760. Hydrogen Cyanide (Fumigation of Buildings) Regulations, 1951. S.I. No. 1759. HOUSEBOATS Public Health (London) Act, 1936. City of London (Various Powers) Act, 1933, Part III, Sections 6 and 7. INFECTIOUS DISEASE Public Health (London) Act, 1936. Public Health (Ships) Regulations, 1952 and 1954. S.I. 1952, No. 1411; S.I. 1954, No. 675. Public Health (Infectious Disease) Regulations, 1953. S.I. No. 299. RATS AND MICE Public Health (Ships) Regulations, 1952 and 1954. S.I. 1952, No. 1411; S.I. 1954, No. 675. Prevention of Damage by Pests Act, 1949 Prevention of Damage by Pests (Application to Shipping) Order, 1951. S.I. No. 967. SHELLFISH Public Health (Shellfish) Regulations, 1934. S.R. & 0. No. 1342. Order dated 23rd April, 1936 made by the Port Health Authority under the Public Health (Shellfish) Regulations, 1934. Medway (Shellfish) Regulations, 1935. S.R. & 0. No. 1221. SMOKE ABATEMENT Public Health (London) Act, 1936. BYE-LAWS Bye-laws have been made by the Port 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 diseases, 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 ml 5338. 38