M 37
Smallpox.
106. Every year during the winter months this disease manifests in outbreaks which are sometimes epidemic and sometimes sporadic to disappear with the advent of summer.
107. Evidence collected by the League of Nations, Singapore Health Bureau, from countries in Asia extending from Baghdad on the west to Japan on the east shows that the season of greatest prevalence commences about November and declines about March to disappear during the next two months. What causes this disappearance is not clear. It cannot be temperature alone, for in Southern India and Ceylon and Malaya it is always hot. Humidity is probably the potent factor for the commencement of the hot weather often coincides with the commencement of the rainy season.
108. During the year 248 cases were reported of which 129 were notified through the Medical Officers in charge of Mortuaries, that is after death had occurred. The total number of deaths was 175. Allowing for a case death rate of 25 per cent for all ages in this well-vaccinated Colony the real number of cases was 175 x 4 or 700. If this be the true figure then 64.5 per cent of the cases evaded discovery by the sanitary authorities and went through the various stages of this very infectious disease in one or other of the overcrowded tenement houses.
109. Of the 129 mortuary cases many were corpses dumped in the street at night and conveyed to the Mortuary next morning by the Police. The total number of dumped bodies was 1,427 so that the claim that the chief cause of dumping is concealment of infectious cases for fear of the attention of the Sanitary Authorities cannot be substantiated. It is, however, true that fear of punishment for concealment is one cause of dumping.
110. That a child should not be vaccinated until it has passed its second Chinese New Year is a belief prevalent among the local people, and immediately after the New Year the dispensaries are crowded with mothers bringing their infants to be done. A child born just after New Year is thus two years of age before it is vaccinated. In spite of the law requiring children to be vaccinated within six weeks of birth many remain undone until the so-called propitious period, and thus there is always in the Colony sufficient suitable soil for the growth and development of the smallpox virus.
111. The concealment of cases, the dissemination of the virus by fomites and contacts and the existence of a sufficiency of suitable soil explains the continuance of smallpox despite the number of vaccinations which are done yearly.
112. The total number vaccinated during the year under review was 279,420 as compared with 154,451 in 1931 and 244,789 in 1930.
M 37
Smallpox.
106. Every year during the winter months this disease mani- fests in outbreaks which are sometimes epidemic and sometimes sporadic to disappear with the advent of summer.
107. Evidence collected by the League of Nations. Singapore Health Bureau, from countries in Asia extending from Baghdad on the west to Japan on the east shows that the season of greatest prevalence commences about November and declines about March to disappear during the next two months. What causes this disappearance is not clear. It cannot be temperature alone, for in Southern India and Ceylon and Malaya it is always hot. Humidity is probably the potent factor for the commence- ment of the hot weather often coincides with the commencement of the rainy season.
108. During the year 248 cases were reported of which 129 were notified through the Medical Officers in charge of Mortuaries, that is after death had occurred. The total number of deaths was 175. Allowing for a case death rate of 25 per cent for all ages in this well vaccinated Colony the real number of cases was 175 x 4 or 700. If this be the true figure then 64.5 per cent of the cases evaded discovery by the sanitary authorities and went through the various stages of this very infectious disease in one o other of the overcrowded tenement houses.
109. Of the 129 mortuary cases many were corpses dumped m the street at night and conveyed to the Mortuary next morn- ing by the Police. The total number of dumped bodies was 1,427 so that the claim that the chief cause of dumping is concealment of infectious cases for fear of the attention of the Sanitary Au- thorities cannot be substantiated. It is, however. true that fear of punishment for concealment is one cause of dumping.
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110. That a child should not be vaccinated until it has passed its second Chinese New Year is a belief prevalent among the local people, and immediately after the New Year the dispensaries are crowded with mothers bringing their infants to le done. A child born just after New Year is thus two years of age before it is vaccinated. In spite of the law requiring children to be vaccinated within six weeks of birth many remain undone until the so-called propitious period, and thus there is always in the Colony sufficient suitable soil for the growth and develop- ment of the smallpox virus.
111. The concealment of cases, the dissemination of the virus by formites and contacts and the existence of a sufficiency of suitable soil explains the continuance of smallpox despite the number of vaccinations which are done yearly.
112. The total number vaccinated during the year under review was 279,420 as compared with 154,451 in 1931 and 244,789 in 1930.
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