37
ENTERIC FEVER.
It will be seen that the total number of cases of Enteric Fever reported dur- ing the year was 129 as compared with 44 in 1903 and 55 in 1902. The European cases numbered 54, and 24 of these were imported, leaving 30 of local origin, 12 of which occurred on board various men-of-war in the Harbour. The Chinese cases numbered 55, while 20 cases occurred among other Asiatics.
The most fruitful source of infection of Enteric Fever in this Colony is un- doubtedly the eating of raw vegetables in salads, owing to the time-honoured Chinese custom of manuring market gardens with an emulsion of human excre- ta. This method of cultivation is strictly prohibited in the Colony, and the Inspectors are always on the watch to see that it does not occur, but the great bulk of the food supply of the Colony is grown in Chinese territory in the Delta of the Canton River, and it is distinctly dangerous therefore to partake of raw salads in this Colony, unless they have been grown in a private garden and under the imme- diate eye of a European. Oysters are also a source of infection here and these again come from Chinese territory, so that we have no control over the fattening processes which usually precede their consumption.
The public water supply of the Colony is unquestionably above suspicion, but there are a certain number of small streams in the New Territory which may oc- casionally be used to furnish water to the shipping-though there is no necessity for this as water can always be obtained from the public mains, on payment-and those streams are liable to occasional contamination from market gardens.
In my Annual Report for 1897 I discussed at length the question of the appa- rent immunity of the Chinese from Enteric Fever, and attributed this apparent immunity of the adult native population to the protective influence of an attack dur ing childhood. At that time it was not customary to make an exhaustive exami- nation of the bodies of Chinese infants brought to the Mortuary, with a view to the elucidation of this particular point, but this has been done since my Report was published and it is noteworthy that out of a total of 35 Chinese cases, no less than 32 were in children under five years of age and a further 5 between the ages of five and fifteen. These figures show moreover that adult Chinese do occasionally con- tract the disease, but in comparing the figures it must be borne in mind that the Chinese population is more than eighteen times as numerous as the non-Chinese population, and that they live under less sanitary conditions, so that they ob- viously enjoy some degree of immunity, as compared with the Non-Chinese popu- lation. The actual age distribution of all the cases is given in the following Table
Nationality.
Under Age 1 year.
Age Age Age Age 1-5 5-15 | 15–25 | 25-45 | 45-60 Total. years. years. years. years. years.
European,
1
1
22
29
1
54
Chinese,.
15
17
10
7
1
55
Other Asiatics,
1
9
10
20
Total,
16
18
6
41
46
2
129
Cases of Enteric Fever in infants and young children are of rare occurrence in Europe and America, where it is regarded as essentially a disease of early adult life.