$120
LPOX AND QUARANTINE REGULATIONS.
IMPORTANT DISCUSSION.
In connection with the outbreak of smallpox smongst the Cirens company the following letter
AWBS TORd
Sanitary Board Officos, Hongkong, 3rd February, 1897. Sir, I have the honour to report for the information of the Board that four cases of smallpox have occurred among the employés of Willison's Circus, who arrived from Haiphong by the steamer Hongkong on the 1st inst. From the history of the cases I am of the opinion that the infection was contracted at Saigon. The cases were all removed to hospital yesterday and the hotel at which they were staying has been temporarily placed out of bounds by the naval and military authorities pending its thorough disinfection. I consulted the Acting President of the Board yesterday as to what action it was necessary to take in regard to the public performances at the circus and we agreed that the immediate vaccination of all the employés and a daily medical inspection of them would be a sufficient protection of the public health. This was agreed to by the mana- ger and will be at once carried out. I have the honour to be, &c.,
FRANCIS W. Clark, Medical Officer of Health. There was also a letter from Mr. Willison stating that he had made arrangements for the whole of the company to be vaccinated and for a report as to the health of the company to be made daily by Dr. Rennie. In connection with this letter Dr. Clark (Medical Officer of Health) suggested that Dr. Rennie's report be forwarded daily to the Board.
The following minutes were appended Mr. Ede-How comes it that four sick people were allowed to land and go to a hotel when suffering from smallpox ?
Who is responsible for this ?
The Captain Superintendent of Police-I arranged with Mr. Willison to send the report of Dr. Rennie to Dr. Clark. Perhaps Dr. Clark can ascertain whether any of the patients were suffering from smallpox when they arrived. Two certainly were not.
THE HONGKONG WEEKLY PRESS AND
The Medical Officer of Health-In reply to the President's minute the steamer Hongkong arrived from Hoihow (about 48 hours' journey) at 9 am. on Monday, February 1st. The passengers went ashore at once and were not medically examined; the vessel does not carry a surgeon. The two children were taken to Dr. Ronnie that same morning and had suspicious rashes which could not be pronounced definitely to be smallpox until Dr. Hartigan saw them in the evening. Dr. Hartigan also saw, at the same time, the two men and pronounced them to be suffering from smallpox. Both these men declared they had been ill for about four days and that the rash had come out on Sunday, January 31st, .., about 24 hours before their arrival in this port. I saw one of these men (Albert Home) early on the morning of the 2nd inst. and should certainly say that he must have had the rash out for 48 hours. The other man had been removed to hospital before my visit to the hotel. The captain of the vessel is evidently the person at fault for not complying with section 2 (b) of the quarantine regulations. Section 2 (a) does not apply to this case, as the ports of Hoihow and Haiphong have not been declared to be infected, nor is there any evi- dence that any infectious contagions disease "prevails there," as I understand the vessel brought a clean bill of health from those ports. Personally I consider that passengers should not be allowed to land from any vessel which does not carry a surgeon until they have been inspected by the port medical officer, but unfortunately there is no regulation to that cot and consequently occurrences of this atur are liable to be repeated at not infre- quent intervals.
or
The Captain Superintendent of Police upon wrote the following additional minute:-The of course pleads ignorance of the men in a state of suffering from smallpox. I the Medical Officer of Health's last and will move a resolution at next recommend Government to adopt
the suggestion
The CAPTAIN SUPERI
or POLICE |
—Dr. Clark and I discussed this question to day and Dr. Clark has a suggestion which will meet the object I am trying to get at by a resolution amending the quarantine regula tions.
4.
The MEDICAL OFFICER OF HEALTH-I
aware
think, sir, that some slight alterations in the quarantine regulations, page 72 of the book, will obviate the occurrence of passengers being disease. At the present time, although section landed whilst suffering from an infections B, sub-section 9, states that any vessel arriving here with an infectious case on board must be reported. yet, in fact, that only occurs when a
surgeon is carried. The captain of the ship invariably pleads, and he can plead I believe, that he was not that he had a case of infectious disease on board; therefore, even if the captain is prosecuted the probability is that he will be acquitted, because it is impossible to say that he knew that the case was infections and that therefore he did not proceed to the quarantine ground and he allowed his passengers to land. The suggestion I have to make is first of all that the regulations be slightly altered and that certain ports should at the present time be declared as infected with smallpox. There is no question that the ports in Japan are infected with smallpox and also A similar occur- certain of the coast ports. rence--the landing of infected passengers- took place in regard to cholers; those pas- sengers ought not to have been allowed to land, and so in the same way there were four cases of smallpox-two were suspicious cases-which were also allowed to land when the vessel arrived here, I would suggest that sub-section A, section 2, be altered so as to read that vessels not carry- ing a surgeon be inspected on arrival at I would exempt vessels carry- this port. ing a surgeon from medical inspection, as I think we may safely rely upon the fact that where a surgeon is carried and a case of infec- tious disease exists he will comply with sub-section B and report the case. to the Health Officer of the port. The only difficulty is in regard to the shipping interest, as all ships arriving from Japan without a surgeon will have to go to the quarantine. anchorage until the Health Officer has had time to see everything on board. There may be half a dozen arrivals in an hour and the last may not be seen by the Health Officer until five or six hours after arrival, and all vessels arriving late at-night will have to wait till the morning, and steamers so arriving may not be cleared until noon on the following day; so that there is the shipping interest to think of and also the question of whether the Government can provide a second Health Officer temporarily while we are surrounded, as we undoubtedly are surrounded at the present time, by ports in- fected with smallpox. The reason why I sug- gest the alteration from three days to Afteen is that the incubation period will be covered. I also suggest that plague be added to the list of infectious and conta gious diseases mentioned in the regulations. Those vessels coming from Bombay which have a surgeon on board would not be required to go into quarantine. I do not say that this alteration would have the effect of protect ing us from smallpox except so far as it would protect as from the importation of cases; it would not protect us of course from people coming here and developing the disease afterwards. This is the system that is carried out at home and it was found to work excellently in my own personal experience in regard to cholera during the Hamburg epidemic, and it is certainly the English, if not the European, system of quarantine.
The PRESIDENT-Vessels include junks. The MEDICAL OFFICER OF HEALTH-I
would not suggest that Canton be included among the infected ports, and there are not a large number of junks coming from Shanghai or Saigon.
The PRESIDENT-As yon read it, section 2 would read "where the disease prevails."
[February 17, 1897.
clare a port infected that mea tion will not кө control over the amount in that way...
The COLONIAL SURGEON WO applied for one outside.
reon: The MEDICAL OFFICER OF HEAL
is a matter for the Government Whether they can get a man I'do There is no question that the matt
hật
The CAPTAIN SUPERINTENDENT -If you make every vessel surgeon on board go into qua then there is nothing to compel has a sase on board and carrying to go into the quarantine anchorage at
The MEDICAL OFFICER OF HEALTH But Section 2 B applies then,
how
Mr. EDE The question, to my mind, long are these ships going to be detained here ? We have plenty of ships coming into bour and they may be more than an hour i quarantine unless you have enough 'officers to inspect them. This rule should not be put into force unless there is a sufficient medical staf to perform the work within a reasonable time. The COLONIAL SURGEON—Yes, it is a very serious thing.
The MEDICAL OFFICER OF HEALTH-Can you say how many steamers arrive.from Japan every day?
The COLONIAL Surgeon-Sometimes are as many as ten or twelve.
horo
Mr. EDE-At present we are practically sur- rounded by smallpox-Calcutta, the Straits -I- believe there are. some cases at Singapore... Hoihow, and Japan. These ports altogether mean a great many arrivals here.
The MEDICAL OFFICER OF HEALTH- there twenty steamers arriving each day?
Mr. EDE-On some days probably. The MEDICAL OFFICER OF HEALTH-Would twenty be the average number ?
Mr. EDE-I do not say it would be the average. I think on some days there would be quite that number. On Monday the morning paper contains an immense list. I should-say you will find that on some days twenty, stedmers come in.
The MEDICAL OFFICER OF HEALTH-Half of them have doctors.
Mr. EDI do not think any steamors carry doctors unless they are liners, such as the Empress boats and the mail steamners.
The MEDICAL OFFICER OF HEALTH—Is there not a law that if they carry over twenty- five passengers they must have a doctor P
The COLONIAL SURGEON-I do not think Chinese passengers are included.
Mr. EDE-I quite agree this would be a good. thing to do providing you have a sufficient staff to carry out the work within reasonable time after arrival. I do not think you ought to detain a ship which is in good health.
The MEDICAL OFFICER of HEALTH MY suggestion is that it shall be only a tem porary measure. First of all we must consent to make the alteration in th gulations. After that we will not put into force until we have a sufficient The thing is to have the alterations mad even if we are not able to put them into force directly they are made.
The PRESIDENT-From a theoretical point
all of view I think we Medical Officer of Health. It tion whether. in view of past and in view of the staff available and the staff usually available": to put into force the alteration the Medical Officer, we can fro point of view now
600mm
the Governor in Council tions referred to. The o
the and the question
received considerable nor in past years and somewhat as follows would
the Board as a whole. I ti
That following resolution- the Board it is desirable" The MEDICAL OFFICER OF HEALTH—The
Practicable with due regard: port must be declared by the Governor in unnecessarily detained, be Council to be infected. The meaning of that 25 of Ordinance 26 of 1891 term is that the port must be proclaimed by the coming from an infe Governor in Council, so we have control over | surgeon to proceed it in that way. If the Governor does not de- | and not to land any
this colony
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