- M 166 -
(9) Puerperal Fever.
There is always some confusion over the definition of the notifiable forms of Puerperal Sepsis. The usual one of: “any febrile condition, occurring within twenty-one days after childbirth or miscarriage, in which a temperature of 100.4°F. or over has been sustained for a period of 24 hours or has recurred during that period" is not very helpful in private practice. The figures are, therefore, unreliable and err on the small side.
Moreover, in the absence of any organised Infant Welfare and Antenatal Schemes, there is little that can be done outside the Maternity Hospitals.
Where a certified midwife has attended, she is interviewed; cautioned and her apparatus inspected. "Health Visitors" are badly needed.
The actual notified cases in 1928 were 20 in number; all Chinese (16 in 1927). There were rather more cases in Summer than Winter.
(10) Plague.
This disease is endemic and of peculiar interest in this part of China. It is always Bubonic in type.
Serious Epidemics have occurred from time to time in Hong Kong, of which that of 1894 was the first recorded and the most devastating. Of more recent years, the outbreaks in 1914 and 1922 were the most severe.
Four cases were notified in 1928; all Chinese, of which two died.
Previous to these, no cases had been reported for four years (the last being in September 1923) but, under the present conditions of infectious disease control in the Colony, this cannot be taken as a fact.
Similarly, the absence of records of any plague-infected rats for the same period must be viewed with equal scepticism.
Although sanitary conditions and anti-plague measures have been greatly improved of recent years, it would be the greatest mistake to be led by these figures (they are no more) into a sense of false security. The rat and the plague-carrying flea still abound; the climate is ideal for their propagation and there is still a great deal of uncontrolled immigration, linked up to the mainland by an endless stream of small shipping. Precautions should be increased rather than relaxed.