138. To provide beds on a scale sufficient to isolate all cases of the disease would necessitate the construction of hospitals with sufficient accommodation for 2% of the population. This is obviously far beyond the resources of the community and the adequate isolation of open cases must therefore be considered impracticable. As an alternative, efforts are being made to sterilize sources of infection by ambulatory chemotherapy. On this basis the problem assumes more reasonable proportions as it is possible to treat one patient at a cost of approxi- mately HK$330 per year and to treat nearly twenty patients at a cost equivalent to the maintenance of one case in hospital. With the ambulatory scheme, however, it is still necessary to admit a proportion of patients to hospital, those who are recoverable but who do not yield satisfactorily to ambulatory treatment and those who must be isolated for public health reasons. This is the function of the hospital beds available.
139. It has been found that the younger the patient the better the response to treatment and the earlier the treatment the better the result. Therefore contact examination is pressed to its limit and survey work is done in older school children as available resources permit. Owing to the fact that the clinics are at present working to capacity, case finding by general population surveys has not been practised but it is being kept in mind for the future.
140. Recognizing that tuberculosis infection at an early age is almost inevitable, B.C.G. vaccination is practised on a considerable scale and as the rate of infection is so high in early infancy, vaccination is offered to all newborn children within a few days of birth. Vaccina- tion at this age involves no preliminary tuberculin test and requires a minimum of records.
141. With children who have already been infected in early infancy as judged by the tuberculin test, but who show no apparent disease, INAH is now being given as a prophylactic for one year to those under the age of three years. This form of prophylaxis, though it has been advocated in certain parts of the world as a general population measure, has evoked a storm of criticism. Given to infants as it is in Hong Kong, little can be said against it as, with care, it may do a lot of good and will certainly do no harm. The scheme was introduced during the year and is being used in conjunction with the B.C.G.
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The floating clinic 'Chee Hong', provided by the Hong Kong
Jockey Club.
Patients going abroad for treatment.
ま
** CHEE HONG