meals in the New Territories townships, resulting in lowered standards in cooked-food stalls and the smaller restaurants; the need for better methods of control of theatrical performances in temporary matsheds: the control of sanitation standards in workmen's settlements around new development; and the prevention of illegal slaughter of animals for food.
EPIDEMIOLOGY
70. During the year 1960 there was a decrease in the number of cases of the more common notifiable diseases, the decrease being most marked for tuberculosis and diphtheria. Although this is encouraging. it is not yet possible to say it is an indication of success attending, at last, the intensive campaigns which have been waged against these diseases. Acute anterior poliomyelitis and malaria were the principal diseases showing an increase in the number of cases reported. Appen- dix 5 details the numbers of cases and deaths from notifiable infectious diseases recorded during the period 1956-60.
71. Free prophylactic vaccinations against smallpox, cholera, enteric fever and diphtheria continued to be available to members of the public at all Government Hospitals and Clinics, Port Health Inoculation Centres and District Health Offices. During the year, the main emphasis was laid on inoculation against diphtheria and no general anti-typhoid campaign was held during the summer months as had been the practice in previous years. The numbers of prophylactic immunization carried out during 1959 and 1960 are detailed in Appendix 6.
Antoe biasis
72. Although there was a marked rise in the number of cases of amoebiasis notified, mortality remained low and only nine deaths were registered. The extent of the problem presented by amoebiasis is diffi- cult to assess as it occurs sporadically throughout the Colony in direct relation to extremely high population densities, further complicated by frequent changes of address.
Bacillary Dysentery
73. The incidence remained virtually unchanged with $h. flexneri as the preponderant organism. The emerging resistance of many bacillary strains to antibiotics, notably to those of the sulphonamide group, gave rise to concern in the management of patients suffering from the dysen- teries.
12
74. Much intensive health education in the prevention of these infections is carried out by Health Officers amongst those connected with the handling, preparation and sale of food.
Cerebro-spinal Meningitis
75. This disease continued to occur sporadically throughout the Colony but, with its very low incidence, did not present a public health problem.
Chickenpox
76. During 1960 the incidence remained virtually unchanged, but there was a widespread outbreak during the first three months of 1961; however, few deaths resulted.
Diphtheria
77. The intensive inoculation campaign which commenced in the autumn of 1959 was continued throughout the year and resulted in a drop of 30.5% in the numbers of cases of diphtheria recorded as com- pared with 1959. However, the incidence still remains high and as yet there can be no complacency with regard to control.
78. Diphtheria remained particularly prevalent in the densely- populated tenements and squatter areas of Kowloon and the clinical picture was mainly that of laryngeal involvement due to C. diphtheriae miris; only in rare instances was an intermedius or a gravis strain isolated. Eighty per cent of cases occurred in children under the age of 10 years.
79. As previously mentioned, the intensive inoculation campaign. was continued throughout the year, with particular emphasis on inocu- lation facilities being made available as close as possible to the home. To encourage the widest acceptance of this immunization, a plastic figurine symbolizing 'Health' was given initially to each child receiving two doses of PTA.P. at the prescribed intervals; the response to the figurine was unenthusiastic and in the middle of the year it was replaced as an incentive by sweets, which were naturally accorded a better reception by the children. House-to-house visits were conducted in Resettlement and other crowded areas, inoculators visited squatter areas both on hillsides and roof-tops, and the villages of the New Territories were served by mobile teams or by inoculators working on the floating clinics. In the urban areas, the systematic coverage by inoculators of individual district health units to rotation, bas resulted
19