when conditions are favourable. In view of the unusually early appearance of numbers of cases in the last quarter of 1957, the anti- diphtheria campaign was extended to the middle of January 1958. At the same time, anti-diphtheria propaganda was intensified.
94. The inoculation figures for the whole year were 143,897 first doses, 100,941 second doses and 66,231 booster doses as compared with 74,082 first doses, 58.197 second doses and 46,303 booster doses in 1956.
95. The routine investigation of notified cases and their contacts was carried out by the Health staff and resulted in the discovery of seventeen carriers.
Measles
96. Cases reported during the year numbered 875 including ten imported from abroad. This figure, representing an increase of 166 or 23-4% over that of the preceding year (709), is the highest on record.
97. The number of deaths attributed to measles was ninety three, giving a case fatality rate of 10-6% as against eighty six deaths and 12-1% respectively in the preceding year. The death rate from measles as reported is unduly high because many of the non-fatal and milder cases of the disease are not notified.
98. The infection was most prevalent in the first quarter of the year with a total of 643 cases as against 178, 39 and 15 in the second, third and fourth quarters.
99. As in the case of chickenpox, outbreaks occurred in schools and institutions all over the Colony. Notification was more complete in the non-Chinese than in the Chinese Community and a total of 253 non-Chinese cases, mainly Europeans, was recorded during the year representing almost 29% of the total.
Poliomyelitis
100. Forty five cases, including eight Europeans, with seven deaths were recorded in 1957 as compared with thirty one (eight Europeans) with three deaths in 1956.
101. A definite seasonal activity was evident this year, thirty of the forty live cases (66%) occurring in the months of June, July and August.
102. The following table indicates in more detail the age and race distribution of the cases and deaths.
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TABLE 5
Chinese
Non-Chinese
Torel
Ager
Caser Deaths
30
Cases Deaths Cases
31
Deaths
5
1
3
37
Od years $$ years 10.-19 yearsS
20 years and over
Total
6
1
1
45
103. The overall incidence rate of poliomyelitis was 1-74 cases per 100,000 of the population and the mortality rate 0-27 per 100,000.
Scarlet Fever
104. Only five mild cases were reported in 1957 as against fourteen in 1956. No death was recorded.
Whooping Cough
105. Ninety six cases (ninety three Chinese and three non-Chinese) were notified during the year as compared with 119 in the preceding year; more cases were reported by private practitioners than by public Clinics or hospitals.
Puerperal Fever
106. There were only two cases with no deaths registered this year as against seven cases with two deaths in 1956. Deliveries in connexion with both these cases were done at home without the help of either a doctor or a qualified midwife. The sick mothers were later removed to a Government Hospital where a diagnosis of puerperal infection was made.
Vaccination and Inoculation Campaigns
107. Free prophylactic vaccinations against smallpox, typhoid and diphtheria were offered to members of the public throughout the year and were developed into large scale vaccination campaigns, preceded by propaganda, as circumstances warranted. Mobile vaccination teams continued to be sent to Resettlement areas, factories, institutions and offices. Employers of labour are now co-operating well, as shown by an increasing number of requests received by the Epidemiologist for the giving of prophylactic vaccinations to employees and their families.
108. The anti-smallpox campaign of December 1956 continued to operate until 15th March, 1957. This was followed by the T.A.B. inoculation campaign which lasted from May to July. Almost
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