5. The most important medical finding amongst these immigrants was the high incidence of active tuberculosis in the older age groups: some 68,000, who were permitted to stay in the Colony, were required to undergo a chest X-ray during the process of registration and the issue of identity cards. The findings are described in some detail later in this report, under the section dealing with tuberculosis,
6. There is reason to believe that among the motives prompting in- dividuals to come to Hong Kong from China is a need for medical treatment. Certainly many of those who do come legally or illegally are very soon to be found at Government clinics. The impact falls most beavily on the Government tuberculosis, leprosy and mental health services.
7. A very significant and important event during the year was the visit by Professor F. HEAF. C.M.G. and Dr. Wallace Fox who came at the invitation of Government to make an assessment of the current status of tuberculosis as a community health problem. Their report and recom- mendations concerned the provision of enhanced facilities and staff for the Government Tuberculosis Service, the development of additional case finding, bacteriological and B.C.G. vaccination services, the ratio to population of hospital beds for the inpatient treatment of tuberculosis and the urgent need for research to guide policy planning for the future. 8. The Report was accepted in principle during October by Execu- tive Council, subject to detailed examination of the implementation of the recommendations. The Report was then referred to the Medical Advisory Board which consulted the various voluntary agencies engaged in tuberculosis control and it was still under consideration by the Board at the end of the year.
9. On the 22nd August, cholera re-appeared in the Colony and over the next six weeks, a total of eleven clinical cases occurred. The only fatality was in a man who had been ill for three days before being sem to hospital and who died on admission, before treatment could be start- ed. The whole Colony was declared an infected local area on the 23rd of August and the last case in the urban districts occurred on 20th September. One further case, the last in 1962, appeared in a village community in the New Territories on the 12th October.
10. Again there was a very widespread distribution of cholera vibrios throughout the community with remarkably few clinical cases presenting as a result. Strict quarantine measures were applied to all contacts of clinical cases and the appropriate environmental preventive precautions
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strictly enforced. Nevertheless, using the communal night soil as an indicator, the only conclusion to be reached was that there were large numbers of undetected carriers, excreting cholera vibrios, at large in the Colony.
11. A mass immunization campaign using cholera vaccine prepared in the Government Institute of Pathology had been conducted in February, March and April 1962, when 53% of the total population received vaccine. During the outbreak itself a further million people were inoculated. In assessing the epidemiology, it appears probable that the immunity induced by wide scale vaccination greatly reduced the attack rate of the disease in the face of the widespread distribution of the cholera vibrios.
12. During the outbreak, the routine sampling of night soil was in- tensified and from the 29th October, 1962 to the end of March 1963, no further cholera vibrios were isolated.
13. Of the other communicable discases of importance, poliomyelitis and measles showed unusually high incidence. The notifications of paralytic poliomyelitis during the year were the highest on record and the vaccination campaign using a Sabin type oral vaccine, which was conducted in two phases in January and March 1963, is believed to have cut short an epidemic of some proportions in which Type II and Type III polioviruses were playing a predominant part. In previous years. Type I virus had been almost exclusively the agent responsible for paralytic disease.
14. An epidemic of measles of considerable size and virulence occur- red in the winter months of the year under review following a period of 18 months during which the incidence was unusually low. The common fatal complication was broncho-pneumonia and an investigation carried out by the Paediatric Unit in Kowloon Hospital showed that the age group most vulnerable to this complication was that of 6 months to 2 years of age.
15. The Working Parly set up to advise Government on the organi- zation and scope of a comprehensive School Medical Service began work in May 1962 under the Chairmanship of Dr. the Hon. A. M. RODRIGUES, O.B.E., E.D. The intention is to establish a voluntary contributory scheme whereby the school children participating will receive physical examinations at prescribed intervals by private medical practitioners who will also supply curative treatment for ailments normally dealt with in a practitioner's consulting room. The Report of the Working Party was
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