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Communicable Diseases
HEALTH
Cholera has not been reported in Hong Kong since October 1969. Routine sampling of nightsoil for cholera vibrio was carried out on a year-round basis as part of the surveillance programme. In June, cholera vibrio were isolated from a sample of nightsoil taken routinely from a collection route at Shau Kei Wan on Hong Kong Island. In July, cholera organisms were again isolated from the same nightsoil route, but in each case subsequent samples from the same route were reported as negative. In September, specimens taken from nightsoil vehicles serving the Happy Valley and Wan Chai areas were found to be positive. However, subsequent investigations for cholera organisms from these two sources proved negative. No case of cholera was reported during the period when positive nightsoil samples were obtained. The public were informed of the findings and advised to observe strictly the rules of personal and food hygiene.
Tuberculosis remains Hong Kong's principal community health problem. It is believed from the figures available that approximately 0.8 per cent of the population is suffering from active pulmonary tuberculosis requiring treatment. Males are affected at least twice as commonly as females, the disease being especially common in elderly men, while drug addicts are also particularly prone. Tuberculosis in the young is now relatively uncommon and the once large numbers of acute and often fatal cases of tuberculosis in infants are no longer seen.
The government either by subvention or directly through the Government Chest Service spends more than $21 million annually on control measures. The tuberculosis control programme is a combined effort between the Government Chest Service, the Hong Kong Anti-Tuberculosis and Thoracic Diseases Association, and the Junk Bay Medical Relief Council; while certain other organisations, including the Tung Wah Group and the Caritas Medical Centre also provide treatment facilities with the aid of substantial government subventions. The Government Chest Service operates seven full-time clinics, the newest being the one at Kwai Chung which was officially opened by HRH Princess Alexandra in October. There are 15 subsidiary centres throughout Hong Kong.
The Chest Service maintains an extensive Bacille Calmette-Guerin (BCG) vac- cination programme and during the year 96 per cent of babies born in Hong Kong received BCG vaccination within 72 hours of birth. It is believed that the widespread use of this prophylactic measure had led to the precipitate fall in tuberculosis in the very young in Hong Kong. There are several lines of investigation proceeding with BCG. An investigation of the different techniques of giving BCG to newborn infants, a study on the advantages and disadvantages of direct BCG and an intensive survey of children born after July 1, 1966 notified as suffering or dying from tuberculosis, should produce helpful results.
The cornerstone of treatment in Hong Kong is ambulatory chemotherapy on an outpatient basis. The position with regard to the treatment of tuberculosis in the last 15 years has changed completely, and the disease can now nearly always be cured provided the patient is co-operative and takes his treatment regularly. The previous monthly issue of PAS/Isoniazid tablets has now, in a large proportion of cases, been