The birth-rate per mille in 1946 is estimatad to be 26.6 as compared with 41.9 for 1940, the last year for which accurate figures are available. There is, of course, no proof that the age-sex make-up of the population was identical for the two years in question.
It is noteworthy that by a Proclamation No. 16 dated the 11th of February, 1946, the general public ware invited to register without charge births and deaths occurring in the period 24th November, 1941, and 15th of December, 1946. Under the Proclamation in question some 5,450 births and 1,223 deaths were post-registered.
This stimulus to birth registration was further accentuated by the passing of the Chinese Collaborators (Surrender) Ordinance, No. 7 of 1946, which drew attention to the value of Hong Kong birth. An additional incentive was provided by the requirement relating to Hong Kong birth or residence in connexion with the issue of rice ration cards,
B. Deaths,
While death registration was equally unsatisfactory throughout the occupation and many thousands of bodies never received burial in recognised cemeteries, such records as are available: are given in the following table with those for 1940, 1941 to 1946:
Year
Denthar
1940
61,010
1941
61.324
1942
82.435
1948
40.117
Year:
1944
Deathe: 24,936
1945
19467
23,098 (lo 81st August) 16,653
Death-rates per mille for 1940 and 1946 were 66.9 and 14.24 respectively.
This very marked fall in the post-war death-rate after forty-four months on a very low dietary for most of the community and in the face of high prices of neces- sities of life and strict rationing, provides food for conjecture.
One theory that has bean advanced suggests that the weaker went to the wall under rigorous siege conditions. It is, however, an undoubted fact that a third of the bodies examined at autopay soon after the liberation showed evidence of death from food deficiency of one sort or another. Another theory suggests that the rationing of rice and its partial replacement by flour has resulted in a better balanced diet and a greatly lessened incidence of beri beri and other nutritional diseases. This hypothesis is unproven.
C. Infant mortality.
Although the deaths of infants under one year of age formed a fifth of deaths for all ages, the number of infant deaths per thousand live births was only 109.* This #gure compares with one of 327 for 1940 and 617 in 1931. This figure is the lowest to be found in any of the records saved from destruction going back to the carliest days of the existence of the department.
(i) Acute infectious diseases.
(a) Smallpox.
D. Causes of death.
The first case of smallpox occurred at the end of January, The outbreak did not appear to be serious and smouldered on until August when it became apparent that many foci of infection existed. The peak was reached in November and the epidemic showed definite signs of declining by the end of 1946.
1,3085 of the total of 1,9985 cases were fatal, giving a mortality rate of 65.2 per hundred cases.
Low vaccinal state, concealment of cases, importation of florid cases from Canton, Shanghai and other cutports, and the dumping of dead, thus preventing dis- infection of premises and vaccination of contacts, all tended to the dissemination of the disease.
†1946–47 deaths 18,807, death-rate 15.9.
*104847 infantile mortality rate 110. $1946-47 smallpox 2.183 cases, 1,408 deaths.
5
Counter measures included the vaccination of 1,525,106 persons with the assistance of volunteers from St. John Ambulance Brigade; intensive house-to-house searches by the health inspectorate for cases: the isolation of cases at Sai Ying Pun Hospital (468 patients with 130 deaths) and Lai Chi Kok Hospital (470 patients with 124 deaths); vaccination of contacts; examination and vaccination, where neces- sary, of all arrivals and departures by sea, air and land; disinfection of premises and effects; cremation of bodies illegally dumped in streets to avoid disinfection of premises, etc.; and, lastly, public health propagande through mobile loud speaker, cinema and the Chinese and English press.
The mortality in treated cases was 27.8 in the Sai Ying Pun Hospital and 26.4 in Lai Chi Kok Hospital. Penicillin and sulfadiazine lowered the mortality In cases treated to 10% in the Sai Ying Pun Hospital,
rbi Cholera.
Cholera first put in an appearance carly in January, but the outbreak did not attain to serious dimensions until the hot weather set in ia June.
A total of 246* deaths were recorded out of a total of 514* cases, a mortality rate of 47.9 per centum.
The mortality rates in Sai Ying Pun and Lai Chi Kok Hospitals were 37.7 and 21 per centom respectively.
Treatment with solutions of brilliant green (1-2,500) appeared to have a beneficial effect and reduced the carrier rate. Half an ounce every hour for eight doses was found to be the optimum dose,
There are grounds for the belief that the outbreak was in no amall way due to a combination of low standard of communal hygiene from lack of transport to remove vast accumulations of bousehold refuse and the existence of many thousand unlicensed food hawkers selling their wares under extremely inhygienic surroundings.
As in the case of smallpox, so with cholera, numerous inoculation stations were set up on both sides of the harbour and every encouragement was given to the general public to accept what protection cholers inoculation may afford. All passen- gers arriving from cholera-infected ports and all intending passengers from Hong Kong were also inoculated. 371,608 inoculations were given în 1946.
The last case of cholera was isolated on the 26th of September, and the Colony remained free from the disease for the remainder of the year.
/ej Typhus.
Typhus of the socalled "scrub" variety in which the vector is believed to be a mite carried by a rodent was reported on several occasione. There was no obvious connexion with these cases which affected men în all classes of society. The mode of infection remained a mystery, although contact with rat-infested places was a factor in some of the patients. During the year, 42† cases were reported with two deaths. The vector was not discovered, although certain of the cases had worked in rat- infested places.
(d) Enteria fever.
The enteric group of diseases was more commonly diagnosed, amounting to 221 cases with 118 deaths, a case mortality of $2 per centum.
(e) Cerebro-spinal meningitia,
Cerebro-spinal meningitis was most prevalent in April and 2938 cases were reported of which 85 or 29 per centum proved fatal.
(1) Diphtheria.
Diphtheria accounted for sixty-two deaths in 161 cases (88.5 per centum) and stimulated an active immunization campaign in schools. 3,452 children were protected with alum precipitated toxoid.
(p) Dysentery,
Dysentery, mostly of the bacillary type, was notified in 172 cases of whom
60 or 34.0 per centum proved fatal
*1946-47, cholera cases 507, deaths 241-
†1946-47, typhus cases 46, deaths 2.
$1046-47 cerebro-spinal meningiti casos 517, deaths 140.