the general level of public health are demonstrated by the decline in mortality from infectious, respiratory and intestinal diseases, while the ageing of a relatively young population is reflected by the increasing mortality from neoplastic, neurological and circolatory diseases.
11. 15 years ago bronchopneumonia, tuberculosis and gastro- enteritis were the leading causes of death; by 1966 these had declined considerably and their places have been taken by cancer, diseases of the heart and cerebro-vascular accidents. Of particular note has been the rise in deaths from carcinoma of the lung: these have increased from a mortality rate of 2.76 deaths per 100,000 population in 1952 to 14.76 deaths per 100,000 in 1966, a rate of increase which is more than twice that observed in respect of other neoplastic diseases.
COMMUNICABLE DISEASES
(Sce tables 13-16)
12. In the field of communicable disease. tuberculosis remains the predominant problem but the prevalence of certain others still gives rise to concern (Figure 3). The total number of notifications of such
CASES REMIATED
611
ככדן
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*
16
FIGURE
THE BUENCE OF MADE INFECTIOUS Krísiquiksi teda ke
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*
BATHTHERIA
GERATIONARY
OTSENTERT
JT
J
YLAN
H
ENTERIC TEVEL
POLIWY ELLA
דיי
diseases during 1966 was approximately 2,800 less than in the previous year. There was some increase in the number of deaths from com- municable diseases which comprised 10.6% of deaths from all causes, the increase being mainly due to an epidemic of measles during the winter months of 1966 and 1967. There was no notable variation in the incidences of amoebiasis and typhoid, and the incidences of diphtheria, poliomyelitis and malaria continued to remain low. During the first quarter of 1967 there was some indication of increased prevalence of cerebro-spinal meningitis in neighbouring countries. The situation was closely watched and a slight increase in the incidence of the disease in the Colony was recorded during the quarter. Apart from the occurrence of a single case of cholera in November, the Colony remained free from all quarantinable diseases during the year.
Cholera
13. The single case of cholera was notified on 24th November. The case was a man aged 56 living in a hul at Tai Hang Tung in North- West Kowloon and employed as a labourer in the wholesale marketing of fish. He presented at hospital with severe gastro-enteritis, but gave a history of several mild attacks of the discase within the previous three months for which he had not sought treatment; subsequent laboratory examination revealed the presence of cholera vibrios.
14. The usual investigations for the detection of cholera vibrios at The patient's home and in the family contacts were carried out but no positive findings were obtained.
15. Routine sampling of nightsoil, which has been carried out since 1962 as part of Hong Kong's anti-cholera surveillance programme, revealed that some samples taken from the western and central districts of Hong Kong Island were infected with cholera vibrios between 23rd and 27th November. Five premises were traced from which cholera vibrios were recovered. Further investigations carried out among residents in these premises did not reveal any positive findings, but precautionary measures, including prophylactic administration of drugs. were carried out. All further samples proved negative.
16. Apart from nightsoil sampling, all the other necessary public health preventive measures which had been undertaken as a matter of routine before the outbreak were reinforced. Bacteriological investiga- tions were continued of all specimens sent to Government laboratories from cases of gastro-enteritis attending Government hospitals and clinics
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