Prompt control measures were instituted and included intensified health education and publicity on the importance of measles vaccination, utilising the mass media, printed matter as well as interpersonal counselling of parents. The recommended age of measles vaccination was advanced to six months and five special vaccination centres were set up to provide vaccination or revaccination for children aged between 6 and 14. Inoculation teams visited kindergartens, child care centres and primary schools to provide vaccination to susceptible children.
The response to the efforts was satisfactory, and over 70 000 were vaccinated between the end of April and July. Notification of measles dropped from June onwards, and reached a normal level in early August, when the age of anti-measles vaccination was reverted to 12 months and the special vaccination centres were closed.
Immunisation programmes against common childhood infections are carried out in schools as well as Maternal and Child Health Centres. Primary 1 and 6 school children receive booster vaccination against diphtheria, tetanus and poliomyelitis. In addition, girls in Primary 6 are given rubella vaccination. The coverage was up to 98.7 per cent.
To increase the protection of the at-risk group, namely women of child-bearing age, rubella vaccination is made available to nurses, teachers and social workers and other female staff in the Government service. The vaccination is also provided for eligible women attending maternal and child health centres.
To reduce the long term effects of hepatitis B, such as cirrhosis and liver cancer, the Hepatitis B Vaccination Programme was introduced in 1983. The strategy is to give immunisation to the new borns of carrier mothers, and health care workers who are in frequent contact with blood and other tissue products, as they are at risk of contracting the disease, During the year, the vaccination programme was expanded to cover all new born babies. The wide acceptance of the programme can be reflected by the high coverage rates that of the first dose is over 98%.
The Medical & Health Department continued to administer a combined neonatal screening programme for glucose-6-phosphate dehydrogenase deficiency and congenital hypothyroidism to facilitate early diagnosis and treatment of infants who may otherwise develop disabilities or mental retardation. The programme now covers all babies born in Government, subvented and private hospitals. Based on the results of the screening programme so far, the prevalence of G-6-PD deficiency in local male babies is 4.5 per cent whereas the frequency of congenital hypothyroidism disorder is one in 3 200 live births. Prompt follow-up and remedial measures are instituted so that the development of permanent disabilities in these children is avoided.
In
Gastrointestinal diseases are endemic in the territory and small outbreaks occur from time to time. There were 534 outbreaks of food poisoning involving 1 239 persons. Organisms responsible for these outbreaks include salmonella, Staphylococcus and Vibrio parahemolyticus. addition, 521 persons were affected by an insecticide, identified as methamidophos, found to be present in incriminated vegetables imported across the border. There were also 182 cases of enteric fever, and 454 cases of bacterial dysentery. Active case finding, contact tracing, health education on food and personal hygiene by the regional health staff and the co-ordination of other control measures helped to limit the spread of these diseases in the community.
IV
Health-Services
Tuberculosis-and-Chest«Services
The Hong Kong Tuberculosis and Chest Services continue to provide care to the public who have respiratory problems requiring investigations, hospital management, clinic care and treatment. Special efforts have been spent in the prevention and control of tuberculosis, including case finding, diagnosis, treatment and BCG vaccination.
Tuberculosis remains an important disease in Hong Kong. With continuing diligence and dynamic programmes in the fight against the disease, both the number and rate of notifications started to fall since 1985. The total number of notifications was 7 021 in 1988, representing a notification rate of 123.6 per 100 000 population. The factors which accounted for the high level in notifications are an increased awareness of the disease by the public and an increased response to the case finding measures. Another important factor is the influx of population from other parts of the region where the incidence of the disease is higher.
Death from tuberculosis, however, continued to fall from 405 in 1987 to 388 in 1988 and the death rate from 7.2 to 6,8 per 100 000 population, representing about 1.4% of the total registered deaths in the year. Attendances at Government chest clinics were 725 468 compared with 720 282 in 1957. BCG vaccination remains a recommended programme and covers nearly all the newborns. Booster doses are also given to a primary school children and to new immigrant children after an initial Mantoux test.
During 1988, 90 510 patients attended the Government chest clinics of which 42 863 were new patients and diagnosed to be suffering from sone kinds of chest diseases, namely pulmonary tuberculosis (12.3%), bronchitis not specified as acute or chronic (10.3%), pneumonia (3.8%), acute bronchitis (3.2%), malignant neoplasm of trachea and bronchus (2.1%), bronchiectasis (1.4%), chronic bronchitis (0.4%), emphysema (0.4%) and asthma (0.4%).
5
Page