CANADA’S NATIONAL MAGAZINE

The Case Of The S.S. Typhoid

ALAN EDMONDS May 1 1970
CANADA’S NATIONAL MAGAZINE

The Case Of The S.S. Typhoid

ALAN EDMONDS May 1 1970

The story that many of those involved now regard as the greatest detective thriller in modern medical history began at 5.52 a.m. Wednesday, January 14 of this year, when the 28,117-ton Peninsular and Oriental liner Oronsay sailed under the arch of Vancouver’s Lions Gate Bridge flying the dreaded Double Q — two yellow quarantine pennants that signal: “My vessel is suspect. I require medical clearance.” The Oronsay, en route to Australia from Southampton, had been shedding sick crewmen and passengers at ports of call halfway around the world. But not until she was one day out from Vancouver did the Captain know for sure that his ship was nursing an outbreak of a disease whose name still creates panic among laymen — typhoid. The Oronsay was, in the words of Vancouver’s Deputy Medical Officer of Health, Dr. George Mott, “a floating typhoid time bomb.” Later, long after the last carefully staged dockside huzzahs and the ship had gone, Dr. Mott reflected that ‘I still think it’s rather a good description of the situation at that time.”

Typhoid can be an agonizing disease. It begins with two days of queasiness and constipation. Soon the victim is wretchedly sick. His temperature soars by day— 103, 104; perilously near fatal degrees — and he has a brief respite at night, when his temperature sinks to normal or even below. His body retains little nourishment; his stomach and intestines reject food in paroxysms of diarrhea. The system even rejects fluids — the sweating victim is in danger of death through dehydration. Often, fluid containing life-sustaining glucose is fed intravenously.

When typhoid struck the ancient Romans, it killed half its victims. Before antibiotics, the rate was down to 12 in 100; with antibiotics it is still a killer — but the death rate is now down to two per 100. The Oronsay epidemic stayed within the limits prescribed by today’s statistics: 75 suspects, 61 confirmed victims, and one death — a retired Australian died on his 63rd birthday, 10 days after the Oronsay left Vancouver.

But to professionals such as Dr. Mott, concerned with whole populations, the word typhoid has more ominous implications. The disease can spread like wildfire. Six years ago 437 people in Scotland were struck with typhoid — apparently because one can of contaminated meat was opened and sliced on a supermarketbutcher’s counter. A similarly insignificant incident started an epidemic in Austria last year.

Typhoid gallops through populations because of disease carriers, who usually don’t know they are spreading the Salmonella Typhii. Often they don’t even know they’ve had the disease. Because modern hygiene has reduced the incidence, many doctors don’t recognize typhoid for what it is — as the two ship’s surgeons aboard the Oronsay did not at first. Doctors commonly treat the victim with antibiotics used for general bacterial infections; the visible symptoms change and the patient may be declared healthy when, in fact, he is still capable of infecting others.

The most common form of infection is by ingestion — through the mouth. The typhoid carrier has the bacilli in his intestines. Intermittently they appear in his faeces. If he — or she, because there are more women carriers than men — is less than meticulous in washing his (or her) hands after using the lavatory, the bacilli can be on the fingers or under fingernails. If the carrier then prepares food for others, or handles dishes and cutlery they use, he is probably passing typhoid on. There are other ways of getting the bug. It’s even possible, though unlikely, for it to be passed on through sexual intercourse. But outbreaks of Oronsay proportions are usually caused by the presence of the bacilli in food, milk or water.

So when the 19-year-old Oronsay steamed into Vancouver harbor and tied up at the Canadian Pacific terminal without anyone having an explanation of how the disease was being spread, it was precisely what Dr. Mott called it — a “floating typhoid time bomb.” And Dr. Kenneth Cox, port quarantine officer for the federal Department of Health and Welfare, and his team of medical detectives faced a mind-boggling array of questions.

Who had brought the disease aboard? A European crewman? Or one of the stewards, galley hands and cleaners from the former Portuguese enclave of Goa, in India? Or a passenger? Or even a visitor who had long since left the ship?

Which type of about 40 known strains of typhoid was it? The one found in Scotland, in Austria, or the one aboard a Spanish liner that had been in Southampton harbor just before the Oronsay? Or was it a yet unknown variety?

How was it being spread? Person to person? Through food? Milk? Water? Plumbing? Or by the inevitable kitchen cockroaches?

Above all, how could it be kept aboard the Oronsay, and prevented from spreading into Canada with the 146 passengers scheduled to disembark at Vancouver? The search for the answers led around the world: to San Francisco, Los Angeles, to Atlanta, Georgia, and across the Atlantic to Scotland, London, Austria and finally to Cape Town.

But 21 days later, when the Oronsay sailed from Vancouver at two minutes past noon on Wednesday, February 4, the questions had been answered. The occupationally cautious medical detectives will never say with 100 percent certainty just how the epidemic spread. But — and this is important — they do say that if the liner had not stayed in Vancouver, the epidemic would have gained galloping impetus so that, in the words of epidemiologist Bill Simon, “by the time she reached Hawaii she’d have been damned lucky to have enough crew left capable of running the ship.”

When the Oronsay sailed, there had been no new cases for a week. No more were to be reported. As Dr. Cox said, “The fact remains that this ship came into Vancouver with a typhoid epidemic. She’s leaving without one.”

But she was by then one of the world’s best-known vessels. Newspapers, radio and TV stations, news agencies and magazines from around the world were on hand to report as much of the story as doctors and the P and O Line would reveal. Mostly, the scraps of information posed more questions than they answered.

Maclean’s stayed on to ferret out the full story, and — in contravention of restrictions imposed by Dr. Cox, and alone among the reporters and photographers there — did get aboard while the ship was an “untouchable,” in quarantine. What follows, then, is the first time anywhere that the full story of the medical manhunt has been told, the ordeal of the Oronsay, its passengers and crew faithfully reconstructed.

WHEN THE ORONSAY left Southampton on December 16 bound for Sydney, Australia, via Panama, the west coast of North America and Hawaii, the crew scuttlebutt centred on the Walshes in tourist class. On the previous trip, which had ended only three weeks earlier, Michael Walsh had boarded the Oronsay in Sydney, off to perform the ritual of all affluent Australians — go walkabout in Europe for a while. At Cape Town, Beryl Pierce had come aboard with her mother. Mrs. Pierce met Michael and introduced him to Beryl. The young couple became a familiar twosome. By Southampton, Michael had proposed; Beryl had accepted. During their three-week stay in Britain they had married. Now — the walkabout suddenly ended — Michael was back aboard with his new bride, taking her and his new mother-inlaw back to Australia to meet his family. As June Booth, one of the ship’s entertainment hostesses, said, “Usually, these shipboard romances don't come to much except maybe a bit of heartache, so it’s rather wonderful to watch a romance blossom on the way in and see it become a honeymoon on the way back out.”

At Cherbourg, the Oronsay picked up Americans and Australians homeward bound from Europe, relieved to be escaping the worst flu epidemic in a decade. In retrospect, none could have been as relieved as the stowaway, discovered two days out from Southampton, must now feel. He was put off at Madeira — before he had a chance to get typhoid.

The Atlantic crossing was rough, and scores of passengers were either seasick or down with the flu. Or was it all flu? Later, people began to wonder. High fever followed by diarrhea could — just might — have been the symptoms of an atypical case of typhoid. Surgeons Noel MacMurray and Bob Billings treated many of the flu cases with antibiotics.

At Port Everglades in Florida two crewmen were left behind in hospital. Through the Panama Canal, the sun baked the slowly moving ship. The honeymooning Walshes lay in deckchairs, soaking up a tan, comfortably silent.

By Acapulco, the worst seemed over — though flu was still a problem. At San Pedro, the port for Los Angeles, two engineers were hospitalized. Even so, port medical authorities cleared the ship for all North American ports. But as the Oronsay sailed out of Los Angeles a launch streaked up behind her carrying the local P and O agent, who told the Captain, “You have typhoid aboard.” At dinnertime that day, January 9, Captain John Wacher told passengers one of the two crewmen landed at San Pedro was a confirmed typhoid case. Everyone would be vaccinated at San Francisco.

The ship reached San Francisco next day, and Captain Wacher was told the diagnosis had been a mistake. Passengers and crew went ashore freely.

But four more of the crew were taken to hospital with symptoms similar to those of the men landed at Los Angeles. Surgeon MacMurray was worried. Soon after setting out for Vancouver, Captain Wacher radioed San Pedro and San Francisco: “Please confirm diagnosis on crewmen landed.” As he was to say later, “We had heard one thing and we suspected another. We decided to take no chances.” They recommended that all passengers and crew receive antityphoid vaccinations, and he says most of the crew and some passengers had already been inoculated by the time San Francisco radioed back: “Typhoid confirmed.” It was Tuesday, January 13.

Later, deckhand Robin Eastick, who was taken ashore in Vancouver as a typhoid suspect and then refused to return aboard, said that when the Captain announced that typhoid was confirmed “there was panic among the passengers, who crowded up to the surgery demanding injections right away.” Another who refused to return aboard, Steward Denis Waters, said, “After San Francisco, the passengers didn’t want to have anything to do with the crew because the cases were among the crew. A lot of them were too frightened to eat.” But, Captain Wacher insists, “There was no panic aboard my ship, ever.”

Anyway, giving vaccinations after the outbreak had begun seemed futile: injections are ineffective until a month after the first of a series of shots.

That night there was what veteran steward Waters and other crewmen have described as “a massive cleanup.” Waters said that an officer told crewmen, “The ship is not clean at the moment. I don’t care how many hours overtime you put in as long as she’s clean when we get to Vancouver.” Furniture, walls, even carpets were scrubbed with disinfectant. Captain Wacher concedes that, in the circumstances, rather more attention was paid to cleaning than was normal.

A day’s steaming away, in the 90year-old yellow building that houses the federal Department of Health and Welfare quarantine and immigration medical unit, Dr. Kenneth Cox was examining a Greek seaman who had what looked suspiciously like mumps, and at the same time wondering how the hell to reconcile a new union contract for his nurses with the fact he’d just been told to cut his staff. It was around 10 a.m. when Jack Birx, a U.S. health inspector in Seattle, telephoned. “Ken,” he said, “I’ve just heard on the interoffice grapevine from San Francisco that the Oronsay has typhoid aboard. She’s headed your way.” It was the nearest thing to an official notification from the U.S. that Canadian authorities were to receive for 48 hours.

Cox is a 48-year-old bachelor with a discriminating taste in girl friends and a talent for making a small fortune on the stock market and in sundry entrepreneurial enterprises, including the supply of fresh lobsters to local restaurants. He lives in a luxurious suite in an English Bay apartment tower. He is garrulous, gregarious, and laughs a great deal, but there is at least one thing he takes very seriously indeed: his job.

He was serious now. He called Los Angeles port health authorities, and was told they had no details about typhoid on the Oronsay. By mid-afternoon Birx called again. Again the U.S. health service grapevine had provided the information: the two men in Los Angeles were European; one of the crewmen in hospital in San Francisco was Goanese. (The P and O Line employs many Goanese: there were 224 among the Oronsay crew, 40 of whom had been flown up from Goa to join the ship in Southampton, just before she sailed.)

At 5.30 p.m. Dr. Cox called a conference in his office with Vancouver’s Deputy Medical Officer of Health, Dr. George Mott, Dr. David Thompson, Pacific-region director of the Department of Health and Welfare, and other doctors or health officials likely to be involved.

“I wasn’t alarmed exactly,” said Cox later. “But knowing the spread of typhoid is usually through water, food or milk, we felt there must be some major fault in sanitary conditions on the ship. That meant we would have many more cases before the ship hit Vancouver — and many more still before it left. Our job was to keep the typhoid on the ship, not let it reach the city.”

Cox went home, sautéed a filet mignon in wine, and spent the evening trying to reach the Oronsay by radio-telephone. At midnight he succeeded, and Noel MacMurray told him there were 10 to 15 cases aboard, plus one old man who had been vomiting blood. At 2.30 a.m. Cox asked the radio operator to put him through to the Captain. The radio operator did so, after carefully telling Cox that Captain Wacher was pronounced Waysher, “with a soft c.” The Captain, sleepy and by now a little impatient with the on-off-on-again diagnoses of health authorities, said he thought Cox was taking the whole thing too seriously, but that, yes, he would come in flying the Double Q and, no, he wouldn’t let any passengers disembark or embark until given medical clearance.

On Wednesday, January 14, as the Oronsay sailed beneath Lions Gate Bridge, Cox and his task force met in the dockside office. They were sombre, but there was an air of suppressed excitement. With the exception of nurse Claudia Hoff and Don Thompson, the publichealth inspector, all wore sober business suits. Thompson, a lean, fiftyish, ex-army officer with an erudite, dry wit, wore his brass-buttoned blue uniform.

One of the team was Dr. Ernest Bowmer, director of BC’s Health Department laboratories. As he explained it: “The problem was at once simple and terribly complex. Simple, because our first task was to determine the way in which the epidemic was being spread, and in this, water, the most common carrier, was the prime suspect. Then it was complex because, if it was the water, we would need to find how the bacilli got into the water and the identity of the carrier who must have had the bacilli in his system and been excreting it when he went to the lavatory. We had to be sure it wasn’t being spread by personal contact. We didn’t know whether the carrier was a food handler, and was distributing the bacteria that way, or an inefficient dishwasher. In fact, we didn’t know for sure to begin with that it was typhoid.”

It was one of the few occasions Dr. Bowmer boarded the ship. For the rest of the Oronsay’s three-week stay he and his laboratory staff, aided by the laboratories at Vancouver General Hospital, Shaughnessy Veterans' Hospital, the federal Food and Drug laboratory and the BC Agriculture laboratory, worked night and day on complex tests to prove, and disprove, one possibility after another.

Ernie Bowmer — five-foot-five, dignified, a former lieutenant-colonel in the British Army Medical Corps — was, said Cox much later, “one reason why we did the job as well and as quickly as we did.”

Cox led his boarding party up the single gangplank to B deck. None of the 300 people due to board in Vancouver was to be allowed aboard. Cox and Mott examined 18 patients in the ship’s hospital. Said Cox later, “From the records I realized that a number of people had been sick from the start of the voyage — engineers njostlv, and some crewmen from the pantries. The ship’s doctors had thought that what thçy had was another flu outbreak. It was a natural assumption.” They sent the 18 patients to shore hospitals.

By 9 a.m., three hours after boarding, public-health inspector Thompson took water samples from the ship’s hospital in the stern, the bar tap in the crew’s recreation room in the bow, and from the European Crew’s Mess amidships. Each sample started on a complex route through laboratory tests designed to determine its coliform content — coliform being the main organism in human or animal excrement. Its presence in water does not prove the presence of faecal matter in that body of water, but it makes any public-health man suspicious. And it does indicate that disease-bearing bacteria could also survive in the water.

By midmorning the 146 passengers who wanted to disembark at Vancouver had been permitted to leave. Each had been seen by a doctor and warned to contact public-health authorities if he fell ill. That left 900 passengers and 583 crew aboard. It had been a difficult decision for Cox: he could have been letting the carrier leave the ship. Perhaps some of those disembarking were even now incubating the disease. But it did mean there were fewer to worry about on board. Those who left were led ashore by blue-eyed brunette Betty Garrett, an immigrant from Northern Ireland.

By midday Cox and his team were hungry and thirsty. They had neither eaten nor drunk anything aboard. Instead, they left for lunch. When he returned, Cox found that, contrary to his orders, the ship had begun to embark the 300 passengers scheduled to board at Vancouver. Furious, Cox announced: “Captain Wacher, you have 30 minutes to remove these people from the ship.” The Captain protested that he had not ordered them to be permitted aboard. And Cox faced another dilemma: “I had to decide whether they had been exposed to infection. Since they hadn't eaten or drunk anything aboard, I decided it was safe to let them leave — and crossed my fingers.” None of them did get sick.

Belatedly, Cox’s office received notification from the top U.S. authority on communicable diseases that the sick crewmen landed at Los Angeles and San Francisco were typhoid victims.

Back in his laboratory Dr. Bowmer handed over to his staff the first of what was to become more than 2,000 fæcal stool samples, the first batch taken from 40 Goanese new to the crew.

Bowmer’s staff of 70 set about trying to find the typhoid bacilli in the samples. If a man was excreting typhoid and yet was not ill, and did not subsequently become ill, then with reasonable certainty he could be labeled a carrier. But the bacteria is carried in the gall bladder, and a carrier may excrete the bacteria only intermittently. One negative stool test is, therefore, valueless: at least three are required over a period of a week.

Aboard the Oronsay, while his doctor aides and the ship’s surgeons were still trying tq„obtain stool samples from all the crew, Ken Cox worried his way around the ship, walking incognito among groups of mystified and sometimes frightened passengers. He recorded that “the state of the galleys was pretty poor. The floors were filthy, dishes were piled up, seamen were eating right *in the room where the clean plates were."

Most of the balance of that first day was spent in what Cox called "endless" debates with P and O officials, trying to keep the ship in harbor. Without their agreement, Cox would have had to invoke Article 19, subsection one, of the Canadian Quarantine Regulations, under which any vessel with a quarantinable disease (which typhoid is not) or infectious disease (which typhoid is) aboard may be detained for as long as is necessary for “disinfection or disinfestation” of “personnel, luggage and cargo.” The Captain said, “Well, our first concern must be the passengers and the crew.” He agreed to delay sailing for two days.

Meanwhile, public-health engineer Tom Tevendale followed Cox’s formula of disinfecting the contents of the ship’s sewage tanks with massive quantities of chlorine so that it could safely be discharged into Vancouver harbor.

At Vancouver General Hospital, doctors examining the 70-year-old typhoid suspect who had been coughing up blood discovered he had stomach cancer. Said Cox later, “It turned out to be inoperable — but by catching it then and giving treatment, they gave him another six months, maybe more, of life.”

Captain Wacher, having annnounced the ship would be delayed “for a few days,” sent down a footnote for the daily program sheet. It was from Robert Louis Stevenson’s Travels With A Donkey: “For my part, I travel not to go anywhere, but to go. I travel for travel’s sake. The great affair is to move.”

Cox left the ship around 10.30 p.m., exhausted. At the gangplank he met George Turner, president of P and O’s North American subsidiary, who had just arrived from San Francisco. Cox recalls that Turner announced, rather belligerently, that “we were making a mountain out of a molehill.”

Michael and Beryl Walsh, six weeks married, leaned against the taffrail and looked at the spangled lights of North Vancouver on the far side of the harbor, up against the foot of Grouse Mountain and its cap of snow. Michael said it would be nice to learn how to ski. Beryl said he could try it first, then teach her.

The ship’s movie that night was a western called Sam Whiskey. Captain Wacher, worried, called a conference of his officers. Cox drove his Chrysler Imperial back to his apartment, put a Debussy LP on the stereo set, poured a stiff Dimple Haig and sat and thought well into the night. The evening the Oronsay left Vancouver, he sat in the same setting and recalled that first night:

“Here’s a ship with 1,500 people aboard and the incidence of the disease already suggests we’ll be getting 10 to 15 new cases a.^day unless we find the source. Now the usual form of spread is ingestion of water, food or milk. It could even be a single can of infected food.

“But Í also knew that just before the Oronsay had been laid over in Southampton there had been a Spanish liner in port, the Angelina Lauria, which later proved to have 30 cases of typhoid aboard. I decided the first thing to do was to find out what type of typhoid the Angelina Lauria had had, and to confirm the type we had on the Oronsay.

“Then there was the obvious possibility that it was a fresh outbreak altogether. That meant someone had brought it on the ship. But even if he were a food handler, you would be unlikely to get so many cases by the direct person-to-person spread. Another thing: you don’t see so many typical typhoid cases any more. People have TAB shots, and can still have a mild case of typhoid, and not produce the same evidence — from stool tests, for example.

“So the next thought was that if we had an entirely new outbreak it meant we had a carrier on the ship. The number of cases indicated it was not spreading by direct contact. So, it seemed there would have to be a cross-linkage somewhere between sewage and water systems. The carrier’s faeces contained the typhoid, and were infecting the water. But how? When? And was I right?”

At 9 a.m. on the second day of quarantine, Thursday, January 15, bacteriologist Jean Campbell unlocked her room in Dr. Bowmer’s laboratories, went to the incubator to inspect the Oronsay water samples, then hurriedly called Dr. Bowmer on the intercom. The water taken from the tap on the European Crew’s Mess amidships -— for ratings only — showed a presumptive positive coliform content. And yet the water sample had only been under test for 18 hours; not the 24-48 hours normally required.

Bowmer called Cox: “Ken, we’ve got an alarming situation here,” he said. “We’ve got a heavy coliform growth in only 18 hours’ incubation.” Both men knew that a positive result from a water coliform-content test so quickly was, even in the ever-cautious words of Dr. Bowmer, “a red light to us: a strong indication that the water from the tap was yielding a high fæcal coliform content — in other words, it seemed highly likely that the water contained human faeces. It meant we could warn Dr. Cox that the water should be super-chlorinated immediately with enough chlorine to kill all bacteria on contact.”

Cox agreed — and so the medical detectives faced the bitter fact that to protect passengers and crew they were obliged to destroy the evidence they would need to prove conclusively that the ship’s water had been the cause of the epidemic. Super-chlorinating the water to destroy bacteria meant there would never be a chance to make the lengthy tests on a large water sample needed to prove that human faecal contamination held the typhoid bacilli.

By now, Strath Wishart, the chief public-health engineer and an acerbic Scots man, had joined assistant Tom Tevendale aboard the Oronsay. He faced the ship’s chief chef, who was demanding that something be done about the mounting piles of garbage that, on Cox’s orders, had not yet been taken off the ship. At this point Dr. Cox arrived with the peremptory order: “Strath, arrange to have the ship’s water supply super-chlorinated.” Wishart set a crew to installing equipment to put a relatively massive dose of chlorine into the water supply via the ship’s pumps. From then on there would be five parts per million of chlorine in the water, compared to the 0.4 parts per million found in the normal city water-supply system. It would “taste bloody awful” — but it would be safe.

On doctors’ orders. Wishart also arranged for the ship’s garbage to be loaded aboard a barge at night, tugged out to sea and .dumped on an outgoing tide.

On Cox’s recommendation, the Captain announced the water should not be drunk until the chlorination system was working, and began loading huge containers filled with Vancouver city water aboard for cooking and drinking.

At Vancouver General Hospital young immigrant Betty Garrett went to the emergency department; said she’d come from the typhoid ship — and felt ill. She was admitted to the isolation ward. She became a confirmed case. That day another half dozen aboard reported suspicious sickness and were hospitalized.

Then, at Cox’s request, the Captain again broadcast to passengers and crew, this time asking that people search their memories and report any contact any of them had ever had with typhoid. The result was what Dr. Bowmer wryly called “a fabulous haul.” Within three hours, 32 passengers and crew reported previous contact of some kind. The mystery was compounding itself.

Even after 70 years a man who had once had typhoid could still be a carrier — even though he had never given the disease to anyone else. But perhaps noy*;, with age, there had been a breakdown in his personal hygiene. One in evpry 1,200 people is a typhoid carrier. Most municipalities maintain a typhoid register. People listed on it can live normally, provided they maintain rigid hygienic standards — and never, ever prepare food for others to eat. In Vancouver there are around 70 registered typhoid carriers; in Winnipeg, about 40; in Toronto, around 1,600, and as many in Montreal.

The 32 people who responded to the Captain’s announcement were added to the priority list for stool tests. But by now — Friday — almost all the crew had been asked to provide one sample.

By this second day, the laboratory had provisional results on some of the first day stool tests. They showed that several crewmen were excreting typhoid bacilli, and yet had not developed symptoms of the disease. “When we found a man who was not ill but was excreting the bacilli, we became quite hopeful,” said Dr. Bowmer. “If he continued to show no symptoms, he was almost certainly a carrier.”

Strath Wishart was trying to understand the mechanics of the ship: he established she had a water capacity of 2,300 tons held in 24 supply tanks, plus additional tanks below the bilges in the ship’s engine room. Four of these additional tanks — later known as “the infamous Number Sevens” — were from time to time used to supplement the ship’s 24 regular tanks.

Wishart and assistant Tevendale also took six water samples from the pipe that fed the tap in the European Crew’s Mess — the tap from which had come a sample of contaminated water. That pipe runs through three crew messes, the butchers’ and the bakers’, the tourist cold-storage room for food and a still room where tea and coffee are mass produced. They also took samples from the ice-water tap in the first-class galley — the tap from which the engineering crew customarily filled the jug they kept in the engine room. And most of the typhoid victims were engine-room hands.

Wishart was developing a theory that contradicted the doctors’ belief that faecal contamination of the water supply was the source of the outbreak. He reasoned that if so, typhoid would not be the only bacteria to end up in the water: the various bacilli contained in faecal matter that would probably produce gastroenteritis would have to be there, too. There were not many cases of gastroenteritis. (In fact, other organisms were found — “more evidence of massive contamination,” claimed Cox.)

Food, milk, or contact spread — these were at that time Wishart’s prime suspects. Another thing: he and Tevendale saw the ratings at lunch. Each crewman had his own cutlery and mug. After eating, they washed both cutlery and mug in the sink filled from the tap that had produced the suspect water sample. And then the crewmen wiped them dry on the same two - teatowels. Wishart ripped down the towels, saying, “If you want to live, it would be safer for you to wipe your cutlery on your shirttail — as long as it’s your own shirt. That way, you won’t collect someone else’s bugs.”

That evening eight more suspect cases were taken to hospital. Then, the Oronsay moved out to midstream to make way at the dock for another P and O liner, the Oriana, which was about to take on passengers for a cruise to Honolulu. Tom Tevendale, Wishart’s assistant, took his family aboard the Oriana. His long planned holiday cruise aboard one P and O liner was not to be delayed by the troubles he had seen aboard another.

On the third day — Friday, January 16 — the Vancouver Sun bannered Dr. Mott’s “floating typhoid time bomb” remark. Captain Wacher broadcast to the passengers: “Don’t be alarmed at anything you read in the newspapers.”

There was, in fact, a communications lag. With only a ship-to-shore radio-telephone, the ship was often receiving information after the news media. Disturbed by news from the radio and the six TV sets placed on board, a group of first-class passengers set up a committee, which discussed their worries inconclusively with the Captain.

Strath Wishart and Cox were independently prowling the ship, seeking that suspected water-sewage system crossconnection. Thompson, watching the dishwashers, formulated this theory:

There were two sinks, detergent in the first and, in the second, hot water kept at about 170 degrees, or about pasteurizing temperature. Once washed, the crockery was submerged in the hot rinsing water. “To sterilize crockery adequately so that it is safe to be used again, it would have to be kept fully immersed at that temperature for two minutes. I repeatedly watched kitchen helpers lift the racks and dip them for about five seconds. It was a misconception that the dishes were being sterilized by being ‘scalded,’ but a five-second dip in water that hot won’t sterilize anything.”

Another mystery: if the carrier was a food handler or a galley worker, and if the typhoid bacteria were on the crockery, then, decided Thompson, the dish washing methods were leaving bacteria alive to pass along the line. He reported to Cox, who ordered that the disinfectant Hibitane be used in the rinsing water, and that crockery be left immersed for the prescribed two minutes.

The passengers were showing the first signs of restlessness. The entertainment staff maintained a stiff-upper-lip schedule of table tennis, keep-fit classes and bingo. The ship's movie that night was Hell In The Pacific. Captain Wacher and his officers that evening staged an all class cocktail party.

Doctors Cox and Bowmer debated the latest laboratory reports. There were several positive stool tests, involving among them two crewmen who were not sick. One was a European who had never been to India. Another was a Goanese steward who, as Cox described it, “was disgustingly well.”

By now the doctors had been told that the men landed at San Francisco had typhoid of the Kl type. Since K1 is indigenous to the Indian subcontinent, the steward was suspect. On a hunch, Cox said to Bowmer, “Ernie, I’ll wager that’s our carrier.”

The Goanese steward’s medical record showed that he was originally a member of the crew of another P and O liner, the Orsova; that last October he had been taken ill aboard ship and placed in hospital in Cape Town. He had been discharged at the time the Oronsay arrived at Cape Town and had signed on as a steward.

Then Cox and Bowmer tried to devise a way of quickly and conclusively stool testing the entire crew. They needed to find out what variety of typhoid had been discovered aboard the Spanish liner Angelina Lauria, at Aberdeen and in Austria. Bowmer suggested consulting his old teacher, Dr. E. S. Anderson of the Central Enteric Laboratories in London, England. Cox cabled: “DR. ANDERSON, CALL COLLECT SOONEST.”

The first tentative report on the water sample from the European Crew’s Mess had been confirmed: there was (or had been) faecal matter in that sample of water, though other samples had only produced a positive coliform content — an indication of possible faecal contamination, but not proof.

Public-health inspector Thompson was to say later that the coliform content of water samples taken before super-chlorination — including those from the icewater tap in the first-class galley where the engine-room crew filled its water jug — was 5.1 per 100 millimetres, high enough to be rated as "doubtful” and requiring investigation. Cox and Bowmer were convinced that in super-chlorinating the water they had stopped the source of the epidemic.

At midnight, Cox and Bowmer ended their review. The water had been contaminated — and they could never prove it because of the super-chlorination. And now: where had the contamination come from? Was there a cross-connection between sewage and water systems? A leakage from a sewage tank? Suppose Wishart was right — his discovery about the crew’s method of washing their cutlery was marginal, because only a few victims came from that mess. But it raised the question: how much was due to personal-contact spread?

And who was the carrier? Who was the man or woman who had started it all?

Canadian and foreign newspapers and agencies called Cox throughout a restless night. “But I was afraid to take the phone off the hook in case it was something important,” he said later. At 6 a.m., on the fourth day — Saturday, January 17 — it was important. Dr. Anderson, perhaps the world’s leading authority on enteric diseases, called from London, England. Anderson said that the typhoid aboard the Angelina Lauria, in Aberdeen and in Austria was not the Asiatic K1. One of the many “ifs” was eliminated. Anderson recommended that each crewman should be given a purgative called cholagogue. This would force his gall bladder to contract and would guarantee that, if it did contain typhoid bacillus, the bug would show up in his faeces.

It was also decided to take blood tests from those who had positive stool tests, or who had at some time been in contact with typhoid. A complex series of tests on blood serum — the white cells — might just help isolate the carrier.

That Saturday, the laxative “purge tests” began. Doctors found all the Goanese gave blood samples reluctantly.

Public - health inspector Thompson took samples of the water in the sinks that had been used to wash dishes in the vicinity of the European Crew’s Mess tap. It was to produce another complication: laboratory tests proved both water samples had high faecal coliform contents; yet the water from the tap was by now super-chlorinated and could not contain bacteria. So why should the water in sinks contain faecal coliforms?

Thompson again produced a persuasive hypothesis. The faecal coliforms in the sink had to come from the hands of the crew. The crew’s washrooms are not equipped with towels. “But a man coming down with any gastroenteric disorder may have to run to the toilet quite often. Is he likely to detour to get his towel from his cabin while he is in a hurry to get to the washroom? He had little encouragement to wash his hands.

“But three times a day he will eat, then will wash his cutlery by dipping it and his hands into water others are going to use for washing their utensils. Any bacteria on his skin or under his fingernails, perhaps left there from his visit to the washroom, will enter this water used for washing cutlery. It’s poor hygiene.”

Cox then had buckets of the disinfectant Hibitane placed in the mess and in the washrooms. Cutlery was left standing in the solution. Men were ordered to dip their hands in the Hibitane after using the lavatories.

By now Dr. L. Newnham, medical supervisor for the P and O Line, had arrived to suggest, in what Cox calls “a very gracious, gentlemanly manner,” that the port medical authorities were being hard on the Oronsay. On the other hand, says Cox, Captain Wacher “realized by now that he was being slain by a bug, and this was beyond his job as captain.”

On the fourth day, Cox began prowling around the engine room. “I went down to the bilges above the No. 7 water tanks and 1 smelled chlorine.” he said later. “The fellows had scattered it around the bilges on their own initiative. I asked why, but they wouldn’t tell me. They hinted I should find out what happened in Southampton.

“I went to the Captain and said I wanted to know what had happened in Southampton. I said, ‘You weren’t on the ship until the day before it sailed.”

Maybe Captain Wacher was as mystified as Cox; maybe he had to question the engineer himself about the “Southampton incident.” Later that night he got Cox’s permission to go ashore and phone London. He returned at 2 a.m. Sunday morning and met Cox in the surgery. Cox says: “He told me very quietly that there had been an accident in the sewage tank and that there had been major flooding of sewage into the shaft tunnels. He said he didn’t know all the details, but that he felt I should know. I thought afterward he did a very brave thing in telling me this. He was obviously not thinking of anything but his passengers and crew. But we still lacked details.”

While the Captain was ashore phoning London, engineer Strath Wishart was down in the engine room, drawing water from each of the water tanks in turn — including the No. 7 tanks below the bilges in the engine room. The laboratory subsequently made a preliminary report that these samples were free of coliform; and this strengthened Wishart’s conviction that it was the food, not the water, that caused the spread of typhoid.

The fifth day, Sunday, dawned bleak, grey, rainy. The passengers were bored. Captain Wacher took the Oronsay out on a one-day cruise up Howe Sound. While the mountains were cloud-shrouded and the sea grey, at least the ship was moving. The Thought For The Day on the ship’s bulletin was: “The more things change, the more they stay the same -— Alphonse Karr, 1808-1890.” The Oronsay was back at her mooring by dusk.

On the sixth day, Monday, two additions to the team arrived: Dr. John Davies, chief of the federal Department of Epidemiology, and his assistant, Bill Simon. Both were to play a key role in supporting Cox and Bowmer in their belief that the water was at fault. But first they had to be shown over the ship.

Aboard the Oronsay, Wishart led Davies, Simon and Cox — who went along as a courtesy — through the engine room. At the end of the line, Cox could hear little of Wishart’s explanations. He stopped to chat with a junior engineering officer. He raised the subject of “this Southampton incident the Captain told me about.” And it was this devious question that, says Cox, produced “a major breakthrough.”

It seems that at Southampton, with the ship empty except for the Goanese who had nowhere to go, plus a skeleton crew and dockworkers doing maintenance work, the engineering staff had repaired the sewage storage tank housed in the tunnel through which the twin-screw shafts pass from engine room to stern. There had been an accident in which the sewage had flooded into the tunnel. To wash it out, seawater had been pumped in at a time when the watertight door separating the tunnel from the bilges over the No. 7 water tanks had been open. Some of the seawater and sewage had either flooded, or been piped, over to the bilge area above the No. 7 water tanks. At the time, the hatches were off several tanks. The result: some of the polluted seawater slopped over into the tanks, from which water is periodically drawn to supplement the supply in the 24 normal freshwater tanks.

Cox was jubilant. At last he had information that might finally prove the water had been contaminated.

A few hours after his confrontation with the engineering officer, Cox and other doctors examined a middle-aged Englishwoman taken ashore as a typhoid suspect. They were to find she had not only typhoid but also potentially fatal cancer of the nasal tissues.

As the doctors worked, a game of What’s My Line? was under way in the first-class saloon. No one guessed the occupation of a demure lady from northern England. She was “a maker of wigs and shrouds for the dead.”

Overnight, the now highly suspect No. 7 tanks were pumped nearly dry. Just before noon on the seventh day — Tuesday, January 20 — Dr. Cox and Don Thompson watched the hatches being removed. Cox, a burly man, squeezed through one hatch to take a sample of the sediment — “sludge” he called it — that had settled to the bottom of the tank while the ship was at anchor.

Strath Wishart was by now convinced: the doctors were right — the sedimentary water, though not lab-tested, did look and smell contaminated.

That Tuesday, Sandy Sterling, a lean, well-bred Englishman with an elegant turn of phrase and one of the London based directors of the P and O Line, flew to Vancouver. On the eighth day — Wednesday, January 21 — Cox was asked to attend an “informal” meeting at the company offices. A P and O official said there was absolutely no evidence that the water had been unsafe. As Cox later recalled it, Sterling said, “Around the world I’ve drunk an awful lot of safe so-called dirty water.”

At this point Cox produced from his jacket pocket a water sample taken from one of the No. 7 tanks. He placed it on the table near Sterling. “Well, try this,” he said. The water was a muddy brown. There was perhaps an inch of sediment at the bottom. Sterling declined.

On the ninth day Dr. Bowmer’s laboratory confirmed the water samples from the sediment in the No. 7 tanks contained “relatively heavy” faecal contamination. By now many passengers had to be back at work or itched to continue their holiday. The company, waiting to charter a Qantas jet and fly out passengers bound for Australia and New Zealand, asked Cox what public-health criteria they would have to meet. Cox’s team had spent days tracking down passengers who had left the ship en route from Southampton to Vancouver and warned authorities they were typhoid contacts

On Thursday, Cox again met with Sterling and other company officials at their office. Sterling read a report that sounded as though it had been written by a lawyer; it conceded that “minor spillage” had taken place in Southampton. Sterling refused to hand over the report, saying something like, “You can remember it. You’re obviously an intelligent man.” The company men again asked for the criteria they must meet so that passengers flying to Australia and New Zealand would be acceptable to the health authorities there. Cox rattled off the details. Someone said, “Wait a minute, wait a minute — we want to get this down.” Cox replied, “No, you can remember it.” Then he got up to leave.

At that point, Sterling handed him a copy of the report on the “Southampton incident.” Cox returned to his seat and slowly repeated the list of criteria.

Now the epidemic was beginning to wane. The peak was 19 people — 16 crew, three passengers — taken to hospital on Monday, January 19. On the Tuesday there had been only 10 cases.

By this Thursday — Day No. 9 — only two suspect cases were removed.

That morning the hospital reported that the “disgustingly healthy” steward who had been excreting typhoid bacilli was still doing so -— and was still “disgustingly healthy.” It tended to confirm Cox’s original, intuitive suspicions. But it was still not conclusive proof that he was the carrier. The average period of incubation of typhoid is between four and 14 days — but a 55-day incubation period is on record. Reports from the hospital in Cape Town, where the man had been a patient between leaving the Orsova and joining the Oronsay, were vital. The first report said he had been ill for only a few days; there was no reason to suspect typhoid. Cox and Newnham asked for more details.

There was an underlying fear that they might have two simultaneous outbreaks of different strains of typhoid. They felt a sense of relief that the outbreaks in Aberdeen and in Austria had not been of the K1 variety first found on the Oronsay. But what type of typhoid were later victims suffering from? Dr. Bowmer’s laboratories did not possess the equipment to identify the typhoid bacilli. And so samples from confirmed cases were flown to the U.S. communicable-disease centre in Atlanta, Georgia; to Department of Health and Welfare laboratories in Ottawa; and to the Central Enteric Laboratory in London.

Engineer Strath Wishart sat up until 2 a.m. Friday morning producing a 25page formula for cleaning and purifying the Oronsay’s water tanks. Every accessible tank should be drained dry, scrubbed out with a near-lethal mixture of water and chlorine to sterilize it, then refilled with massive chlorine-content water. After 24 hours, they should then again be emptied, rinsed, refilled with freshwater and this freshwater then be tested for coliform content. To have access to adequate water-pumping facilities, the Oronsay moved to Centennial Pier.

But still the ship was in quarantine: no one was permitted on or off without a pass signed by Dr. Cox. Keeping passengers occupied was becoming a problem. The Vancouver City Visitors’ Bureau weighed in by sending out a launch bearing a rock band and a go-go dancer who, perched precariously on the deck, serenaded passengers with her remarkably mobile derrière. Now an effusive blonde, Mrs. Rai Donati, who runs a local hostess service, offered to help and found herself co-ordinator of dockside entertainment. The Musqueam Golf Centre donated 10,000 used golf balls and an old lifeboat was moored about 1 00 yards off the stern so passengers could swipe golf balls in its general direction.

Aboard, Mrs. Andy Anderson, of Honolulu, gave lessons in Hawaiian dancing, and passengers delivered lectures about everything from “Living With Headhunters In Borneo” to “My Experience While Traveling Aboard 99 Ships.” One inspired lady gave lessons in how to make hats from old gingham.

By the 10th day, January 23, Bowmer and his laboratories faced a dilemma in their efforts to detect the carrier.

There are three typhoid antibodies — the organisms developed by the body as protection against the disease. They are the H, the O and the Vi (for virulence) antibodies. Bowmer’s laboratories could handle the Hand O-level tests — but results are significant only if blood tests are taken 10 to 14 days apart.

And most Goanese refused a second blood test. Why, remains unclear. One doctor believes they feit discriminated against. Dr. Cox thinks it was because of a religious taboo in some way linked to a statue of the Virgin Mary in Goa that allegedly bleeds from time to time.

What remained was a test for the presence of the Vi antibodies in the one set of samples they had taken. The Vi antibody is more commonly found only in a typhoid carrier, not in a sufferer, but conclusions are based on interpretations of all three antibody tests. In gross oversimplification of the elaborate Vi-antibody tests, the serum is separated from the blood. To it is added Vi antigen — which, in this case, stimulates the antibody. If the Vi antibody is present, the antigen forms small white clumps.

But where was the vital Vi antigen to come from? There was none in Canada.

In London, England, Dr. Patricia Bradstreet of the Central Public Health Laboratories was asked to supply the antigen. It was delivered to the P and O Line’s London office on Day 1 1 of the Oronsay’s quarantine, Saturday, January 24. Company director Alfred MacKenzie drove it to the London airport, put it aboard the next Vancouver-bound plane. It arrived late Sunday evening and was rushed to Dr. Bowmer. He spent the next few hours reviewing test procedures, and his staff spent Monday, the 13th day, learning how to make the tests.

By now, Monday, the work of emptying and cleaning the ship’s water tanks had been under way for 36 hours; it became obvious the job would take longer than seven days. And all the time epidemiologists Davies and Simon prowled the ship, “like walking question marks.”

From the dates on which people fell ill, they concluded that exposure to the source of the disease was intermittent and spread by a single source. Their reasoning: “The people who have got or are suspected of having typhoid did not have the kind of connection or contact with one another to indicate that it could have spread by contact."

The fact that more engine-room staff were victims than any other group tended to confirm that Dr. Cox was right in incriminating the water: engineers, working where it’s hot, drink more water than most. And there were more tourist class victims than first-class victims — and tourist passengers drink more water. They also drink powdered milk reconstituted with water; first-class passengers and all children get fresh milk.

Most victims came from the lower decks. The epidemiologists developed a hypothesis that to reach the upper decks the water supply must be consistently at 50 pounds per square inch. This was available when the tank from which the supply was being drawn was full. But when the pumps began sucking water from the lower part of the tank, where any contaminated water would settle, the pressure dropped and there was only sufficient to serve the lower decks. At that point the engineer switched to a fresh tank. Was there a cross-connection between the water and sewage system? Since the water pressure is higher than that of the sewage system, sewage would not get into the water unless the water pressure dropped from time to time.”

The ship's engineers said it was an impossibility, but Davies and Simon pointed out they had spent a week living in cabins on A deck, the top deck, and found that the water pressure often disappeared almost entirely.

So engineer Strath Wishart put a red dye into the sewage system to see if it turned up in the freshwater supply. It didn’t — but Wishart said that “it did turn all the toilets into a lovely pastel pink.” It also eliminated the possibility of a cross-connection.

As Dr. Davies said, “Everything led back to the water supply as the primary source of infection.”

Midway through the second week, a planeload of ship’s passengers flew to Australia and New Zealand aboard a chartered jet. Before they left the ship all had been medically examined, and cleared. Most said they had enjoyed their quarantine. “A holiday at P and O’s expense,” said one. One man said he never feared he would catch typhoid because he practised yoga, and stood on his head for an hour every day as a precaution.

On the 15th day — Wednesday, January 28 — Bowmer reported the Vi tests on the suspect steward, still “disgustingly healthy,” had '“a very high positive response.” He was also still excreting typhoid bacilli. Then Bowmer compounded Cox’s problems: he added that two other crewmen who were excreting bacilli and were not sick also had “moderate” responses. There were, then, three probable typhoid carriers aboard, all of whose fæcal matter would have been in the sewage that spilled in Southampton.

That afternoon, Cox went to a press conference — the medical detectives’ first — confident enough to say, “We have found one carrier, and there may be others.” He refused to name the known carrier. As Dr. Thompson told reporters, “To be publicly identified as a typhoid carrier can have a quite devastating effect on the life of the person.”

On the 17th day — Friday, January 30 — Drs. Newnham and Cox received a detailed report on the suspected Goanese carrier’s stay in a South African hospital. He had been treated as a typhoid suspect, but tests that should have demonstrated whether he had typhoid in his system proved negative. Suspicious, Cox discovered the hospital was an apartheid institution. All the patients and most of the staff were non-whites. “This man must have had typhoid in Cape Town, and been released without treatment to end his carrier state,” said Cox.

As Bowmer’s laboratories were conducting the blood tests, the P and O company — assuming the estimate of seven days to clean out the water tanks was accurate — announced that the Oronsay would depart on Monday, February 2. By Friday, January 30, it was obvious the work would not be completed in time. Cox told Sterling he would not clear the ship until February 4, at the earliest.

As Sterling remembers it: “When Dr. Cox informed me of the delay, he said he would have no objections if I confirmed his decision with the director-general of his department in Ottawa. As I expected, he upheld Dr. Cox’s decision. It was an appeal against a decision. There was no dispute.” Dr. Cox’s version suggests it was a much more acrimonious discussion.

That weekend, photographer Don Newlands and I -— Alan Edmonds — boarded the Oronsay. How we did so must remain our business. The crew probably assumed we were part of the medical-investigation team. There was an almost tangible air of lassitude aboard. Older people played bridge, read, or slept in the saloons. On deck, a couple of hundred people leaned over the railing while a rock group blasted away at full volume on the dockside.

In the galley, Newlands was appalled that trays of peeled and chipped, but uncooked, potatoes stood on a floor muddied by the comings and going of crewmen. In one corner stood a prodigious pile of garbage, almost overflowing the cardboard boxes used as containers. (Later, Strath Wishart pointed out that this method of garbage storage was common aboard ships.) The entrances to the galley were dirtied with trampled-on cigarette butts and discarded pieces of paper. Newlands photographed a cockroach running up the galley wall; some say they are inevitable aboard any ship that sails tropic waters. On deck the tee from which people had spent days swiping golf balls in the direction of the moored lifeboat, was derelict. Empty deckchairs flapped in a chill breeze, the crack of the wind-whipped canvas, a melancholy sound. A girl and a young officer went into a deckhouse where chairs are stored and began to neck. A sturdy Australian and his wife marched arm in arm around the boat deck. “Mate, I walked around this here deck so much this past three weeks that I damn near walked all the way home to Sydney,” he said.

After a couple of hours we were spotted by Dr. Cox. First, he threatened to have us thrown off. Then he relented, took Newlands to the bilges above the No. 7 tanks and, by holding his hand against a pipe, tried to demonstrate how deep the flood of seawater and sewage spill had been. Then he ordered us off.

We didn’t see Strath Wishart, but it seems he was at about that time involved in a minor drama involving the water tank in the ship’s forepeak. He and Chief Officer Mike Bradford had three times inspected the cleaning job, and had three times ordered it done again. This day, wearying of the process, they donned overalls and scrubbed the tank out themselves. Wishart ruined his shoes. Later, to check the 14 miles of freshwater plumbing, he cut out sections of pipe from sundry points in the ship — including the Captain’s bathroom, “just to prove there was no discrimination.” His concern was that the pipes were still so corroded or contained so much organic matter that the chlorine in the water would be consumed before reaching the taps. But the pipes were not that dirty.

By the 20th day, Monday, there were no new cases.

It seemed to be all over. It wasn’t. The last tank wasn’t cleaned to Wishart’s satisfaction until 10 a.m. Wednesday, two hours before sailing time. He needed another 24 hours to conduct tests to make sure this tank, too, was coliform-free. He urged Cox to delay the ship another day. Cox refused. There was a longshoremen’s strike planned for midnight Wednesday. If he delayed the ship, it would be trapped in port.

An anonymous Canadian who kept a Layover Log throughout the 21 days of quarantine wrote: “The English passengers are reasonably friendly, and while they do not make any advances they will respond to ours. But there are some who go around with their snoots in the air and notice no one.” He also reported a great schism between Americans on one side and British, New Zealanders and Australians on the other. The Americans had demanded the central heating be turned up. The British, New Zealanders and Australians said it was too damned hot. They were in the majority, so thermostats were turned down.

And then it was Wednesday, almost noon. The passengers hung an enormous banner over the ship's side saying, in four-foot-high red letters: “THANK YOU, VANCOUVER.” Blond Rai Donati, in a blue cape, rushed up and down the dock, receiving gifts from first-class, tourist class passengers and crew. Arthur Delamont, a 74-year-old musician well known in Vancouver, conducted a brass band hired for the occasion by P and O public-relations man John Usher. One by one, the medical detectives left the ship, carrying their equipment. Ernie Bowmer had left his test tubes and microscopes to come down to see the Oronsay leave.

Dr. Cox’s coolly beautiful blond nurse, Claudia Hoff, cleared out Cabin B53, which had been the shipboard headquarters of the investigation. She left only Dr. Cox’s leather briefcase on a bunk. Dr. Cox himself had gone to the bridge. A few minutes before noon he could be seen from the dockside, handing Captain Wacher a document certifying that his ship’s water was pure, and the ship could leave. He went down to Cabin B53, picked up his briefcase and left.

The band played Anchors Aweigh, with old Arthur Delamont leading them, blasting away on his trumpet. Honeymooners Michael and Beryl Walsh stood hand in hand, smiling, on the boat deck. The ship’s whistle blasted; the passengers cheered and the crew on the lower fore deck roared out Rule Britannia. And the Oronsay was off for Hawaii, leaving behind 54 crewmen and 11 passengers either recovering from typhoid; about to become victims of it through late incubation; or carriers being treated with a new and experimental drug flown from Washington, D.C., in a bid to eradicate the typhoid bacilli from their systems. Among them was the Goanese steward Cox had suspected from the third day of the investigation; the two other crewmen, who had been labeled “moderate” carriers, and several other victims who had recovered from typhoid but were still producing the bacilli in their fæces. “In the final analysis we proved we had two, not three actual carriers aboard and the epidemic may have left us with one or two more carriers,” said Cox. “There’s no guarantee we can eradicate the bacilli from the systems of all the victims.”

As the gap between the ship and the dock widened, Cox opened his briefcase, and swore. His notés — the scientific history of the Oronsay story — were missing. They had been in the briefcase when he left Cabin B53.

Next day, when Sandy Sterling and other P and O officials visited the director-general of the Department of Health and Welfare in Ottawa, Sterling reportedly expressed dismay that somehow the notes should have sailed with the Oronsay. They would, he said, be mailed to Dr. Cox as soon as possible. As I finish this reconstruction of the events in Vancouver it is mid-March. The Oronsay has long since reached Australia, and stopped off in Hawaii and a few other places on the way. Asked whether his notes have been returned, Dr. Cox says, “No comment.” But without them it will be difficult to produce the technical article for scientific journals about the Oronsay Typhoid Outbreak — an outbreak his boss, regional director Dr. Thompson, says “will become a classic textbook case.”

After Sterling's visit to Ottawa there was some doubt as to whether the Canadian government would permit its medical detectives to publish their findings. Now, however, the official word is: “Reports will be published in time.”

There’s one thing the scientific report won’t mention. The Oronsay left behind a parting gift to Vancouver. As the liner sailed out, someone on board pulled the wrong lever and a few score gallons of oil were pumped into the harbor water. The oil was tainted with the red dye used for the water system-sewage system cross-connection test. It cost $800 to clean up the oil. But the P and O line — with a corporate sigh — paid the bill.