II.
COMMUNICABLE DISEASES
The total mumber of notifications of communicable diseases during 1974 was 12,866 including 639 cases of viral hepatitis and 454 cases of food poisoning both of which were made statutorily notifiable since March 1974. Tuberculosis comprised 64.7 per cent of the total.
Cholera
The incidence of major infectious diseases is shown in Figure 3.
Routine
Cholera has not been reported since October 1969. sampling of nightsoil for cholera vibrio was continued on a year-round basis as part of the surveillance programme, with no positive isolations reported. Emphasis was placed on the importance of personal, environmental and food hygiene as safeguards rather than on mass immunization.
Poliomyelitis
For the first time since 1948 when the disease became notifiable no case had been reported. Yet the maximam trumber of cases ever recorded in one year was 363 with 52 deaths in the year 1962. This represents another triumph of meticulous planning and twelve years' hard work by the staff of the Department- It is indeed a comforting thought that hundreds of healthy young people living to-day have been saved from the sorrow of having to struggle through life with a permanent disability.
Approximately 94 per cent of infants received one dose of type I polio-vaccine after birth and 78 per cent received two doses of trivalent vaccine at government maternal and child health centres. Virological investigation failed to detect any excretor of wild poliovirus among 491 stool samples studied.
Bacillary Dysentery
The mumber of cases dropped from 407 in 1973 to 316 in 1974. 24.4 per cent of cases occurred in children under five. A total of 118 carriers were detected during investigation.
Diphtheria
Malaria
Only two cases were notified, compared with 2087 cases in 1959.
There was no indigenous infection reported. Of the 21 cases recorded 18 were imported while the remaining 3 were induced cases.
Measles
A total of 1,575 notifications and 53 deaths was reported. A
The measles vaccination survey was undertaken by the Department in 1974. results showed 41 per cent of children under five had been vaccinated and that only 22 per cent were still susceptible. The findings from this study paved the way for the planning of future immunization campaigns with a view to reach the target groups, to rectify misconceptions and to convince mothers to accept vaccination. The notifications reported in the
past years are shown in Figure 4.
Influenza
A moderate outbreak occurred in February-March and there were sporadic cases throughout the year. The prevalent strain was virus A/Port Chalmers/1/73, a variant of the A/Hong Kong/1/68 (H3N2).
Viral Hepatitis
A total of 639 cases with 47 deaths was notified. Most cases were among adolescents and young adults and a higher proportion was found among men.
III. HEALITI SERVICES
Tuberculosis and Chest Service
There was a gratifying fall in the tuberculosis death rate from 27.7 of 1973 to 22.9 per 100,000 population. The notification rate remained stationary at 196. Figures 5 and 6 show the mortality and notification rates by age and sex. Tuberculosis is now rare under the age of 15.
Attendances at government chest clinics remained at the high level of 1,417,017. Intermittent streptomycin and high dosage of INAR have in the majority of cases replaced the monthly issues of PAS/INAH tablets as the follow-up treatment of choice. At the end of 1974, there were 5,372 cases on intermittent streptomycin and INAH compared with 1,220 on FAS/INAH .
During the year 98 per cent of the new-born were given BCG probably the highest in the world. The decline in infant mortality from tuberculosis which resulted is shown in Figure 7.
Early in 1975 two experts arrived from the United Kingdom by invitation to review the present service and advise on the future.