9. Of particular note has been the rise in deaths from carcinoma of the lung. These have increased from a mortality rate of 2.0 deaths per 100,000 population in 1951 to 12.2 deaths per 100,000 in 1964, a rate of increase which is more than twice that observed in respect of other neoplastic diseases,
COMMUNICABLE DISEASES
10. In the field of communicable disease, tuberculosis remains the predominant problem but the prevalence of certain others still gives rise to concern (Fig. 3). The total number of notifications of such discases
CASES REPORTED PER ANNUM
2,000
1,600
1,200
5:00
400
FIGURE 1
INCIDENCE OF MAJOR INFECTIOUS IMSEASES 1951-64
DIPHTHERIA
ENTERIC
9. DYSENTERY
„POLIOMYELITIS
L
52 * 5d 55
50 39
AX
YEAR
fit
during 1964 was approximately 4,000 less than in the previous year, and only whooping cough showed a small rise in recorded incidence.
Cholera
11. Following the occurrence of a completely sporadic case of cholera El Tor in February, 1964, Hong Kong remained free from infection until 30th April. 1964, when a second case was notified. The
Colony was declared infected on 1st May and thereafter a further 32 cases were reported, the onset of the last notified case being 30th June. There were four deaths. The Colony was declared free from infection. on 11th July and remained so for the remainder of the period covered by this report.
12. Most of the patients came from tenements, resettlement estates and squatter areas, and no case occurred among the boat dwellers. One case, notified on 12th May, was traced to a food-handler in a restaurant in Hong Kong who was a symptomless excretor of vibrios. On 13th May there commenced a short but severe outbreak in Kowloon which was traced to a well in a restaurant; this well had been infected by an employee of the restaurant who had experienced a very mild attack of gastro-enteritis and who was subsequently found to be excreting vibrios. The infection of the restaurant premises by the use of this polluted water was definitely responsible for the occurrence of fourteen cases, and three others were suspected to be associated although no definite connection could be established; all four deaths from cholera occurred. in patients of this group. The epidemiological and preventive measures taken in this outbreak, which is now widely known as the episode of the 'Temple Street Well', aroused widespread interest and favourable comment from scientists in many parts of the world.
13. In line with the experience of past years, the majority of cases occurred amongst the older age groups, 24 (70%) of the patients being aged 45 years and over. In addition, the more severe clinical cases tended to occur in the same age groups and particularly amongst those who had not received cholera vaccine or whose inoculation had expired. 14. Chatham Road Camp was again used as a quarantine centre for the isolation of domestic contacts of cases and a total of 385 contacts were isolated here for a period of not less than seven days. Among these contacts. 23 symptomless carriers were found, including 18 employees of the restaurant in Kowloon; in addition, four other carriers were isolated at the Sai Ying Pun Hospital.
15. During the year, approximately 65% of the Colony's population received anti-cholera inoculations. Demand for such inoculation was heavy in the week commencing 18th May, and the highest number of inoculations in one day (131,000) was recorded on the 22nd May.
16. Testing of the night-soil in the urban areas has been continued as a routine year-round measure. Eleven out of fifteen routes on Hong
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