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Report on the Infectious Diseases Hospital.
HOSPITAL FOR INFECTIOUS DISEASES, KENNEDY TOWN,
HONGKONG, February 22nd, 1905.
SIB, I have the honour to forward my report for the Infectious Diseases Hospital together with comments on the cases treated during the year ending December 31st, 1904.
The Plague Epidemic. The outbreak of Plague, as was generally anticipated I think, was not of an extensive nature, but the intensity of the disease was com- paratively great and the mortality high. Thus of a total prevalence of 510 cases, or perhaps it would be more correct to say that this number of cases was notified, the deaths amounted to 497-a percentage of 97.4, this being only one decimal point lower than the death-rate in 1902 which was the heaviest since the appear- ance of Plague in 1894.
The Admissions.-I append tables giving details of the cases admitted.
The Variety. There were 59 cases of Bubonic Plague admitted and 18 cases of the Septicæmic variety. No cases of the Pneumonic or the Intestinal variety came under treatment. This is naturally too small a number to work with satis- factorily as regards statistics, still it is not uninteresting to consider percentages. The Bubonic variety constituted 76.6 per cent. and the Septicæmis variety 23.4 per cent. of the cases admitted. Comparing this with regard to the total cases notified, I find that the percentage of Bubonic cases is only 63.6 and of Septica nic cases 31.4, the cases of Pneumonic Plague only constituting about 5 per cent. The difference in the percentages of cases notified and cases admitted for treat- ment is I think due to the fact that to the native mind Plague is invariably associated with the presence of a bubo or glandular swelling, and hence probably there is a greater chance of such a case of Bubonic Plague being taken for treat- ment or taken away from the Colony, whereas the Septicemic variety conveys but a vague impression of the disease and of infectivity and is not brought for breat- ment but is only diagnosed at the Mortuary.
Pneumonic Plague.-There were no cases under treatment.
Intestinal Plague.-No cases of this variety were admitted, nor indeed did any occur during the year. I think it can be safely stated that of the numerous cases of Plague that have been under observation since 1894 in all parts of the world this particular variety has been conspicuous by its rarity. The evidence on its behalf is treak. It should be remembered that the Plague organism is not a very resistant one, that heat and sunlight rapidly destroy it, and desiccation caused by a high atmospheric temperature is also rapidly fatal to it. Apart from this, it is known that it is extremely sensitive to the action of mineral acids which have a powerful and rapidly destructive effect on it. Under these circumstances primary infection of the alimentary tract to constitute the Intestinal variety-by infected food seems highly improbable. And this apart from the fact that proof is still needed to demonstrate the presence of the Plague organism in the foodstuffs sold in the open market.
Sex Incidence. Of the 77 admissions, 54 were males and 23 females, giving percentages of about 70 and 30. This ratio is not, in my opinion, expressive of a greater susceptibility on the part of the male sex. The susceptibility of the sexes is alike of the same degree. The difference in the ratio is to be explained on other grounds, most probably concealment and removal of the female sick.
Its Incidence with reference to Nationality.-All the patients, with the excep tion of two Indians, were Chinese. Contrary to what obtained last year no Euro- peans were admitted suffering from the disease-in point of fact no European con- tracted the disease this year.
Age Incidence.-My numbers are not large enough to do anything more than to indicate that in the Bubonic variety males were affected between the ages of 16 and 40, and females fairly evenly during the quinquenniads of life up to 70 years. The Septic variety prevailed among males principally between the ages of 16 and 35.