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and sixty-seven recovered. In a group of twenty-six patients who stated that they had been inoculated in 1938 only three died. The respective mortality rates in these two groups were, therefore, 36.7 per centum and 11.5 per centum. The series are too small for importance to be attached to them, but nevertheless the figures are both significant and suggestive.
(c) Smallpox.
69. The disastrous epidemic of smallpox which raged throughout the Colony at the beginning of 1938 has already been described in outline.
70. The preventive measures taken against the disease included vaccination throughout the Colony. During the year, 1,035,448 vaccinations were performed. The Legislative Council gave its approval to an amendment of the Vaccination Ordinance making vaccination compulsory for all classes on the 22nd of April, 1938. Free vaccination centres were opened in hospitals, dispensaries, and at other convenient points. With Government approval, twenty-four temporary officers were added to the quota of twelve public vaccinators. The St. John Ambulance Association lived nobly up to its past record and gave great help in carrying out this large number of vaccinations.
71. A certain amount of vaccine lymph was imported by Government as a precautionary measure, but most of the lymph used was prepared at the Government Bacteriological Institute which, as usual, rose to the occasion. The resources of the Institute as regards animal accommodation were taxed to the uttermost, but over fifty litres of lymph were prepared during the year.
72. Cases of the disease were isolated at the Infectious Diseases Hospital at Kennedy Town. Reference has already been made to the increase in accommodation effected at this institution. The total number of cases recorded in 1938 was 2,327 of whom 1,833 died, a mortality rate of 79 per centum.
73. The epidemic was waning by the end of May and finally out in July, in which month only five cases were reported. Thirty-seven cases were reported during November and December, mostly in refugee children.
74. The outbreak was the most virulent the Colony has ever known, and the high number of toxic cases—almost 10 per centum of the number admitted to hospital—gives an index of the virulence of the virus.
75. The deplorable Chinese custom of waiting till the second year of a child's life to have it vaccinated means that whenever smallpox breaks out in the Colony there is a holocaust of infants. In 1938, of those who perished 1,388 were babies and children of five years and under.
76. It is gratifying to be able to record that during the year under review steps were taken which will in time bring the sanitary inspectorate directly under the control of the medical officers of health—an absolutely essential measure if effective use is ever to be made of this body of potentially very valuable public servants.
(iii) Other Diseases. (a) Leprosy.
77. Two important steps were taken regarding leprosy during the year. Firstly, arrangements were made with the approval of Government to give financial aid to the Catholic Mission at Sheklung, in Chinese territory, which in its turn undertook to build accommodation for 200 lepers, the number to be increased later to 400. The lepers will be maintained at Sheklung at the expense of the Hong Kong Government. Secondly, Government acquired the former Tung Wah Smallpox Hospital and the plot of land on which it stands. It is hoped that this step will enable some form of discipline to be imposed on the lepers. It was also arranged late in the year that convicted lepers should serve their term of imprisonment in a special building to be erected at some future date in the precincts of Hong Kong Prison.
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and sixty-seven recovered. In a group of twenty-six patients who stated that they had been inoculated in 1938 only three died. The respective mortality rates in these two groups were, therefore, 36.7 per centum and 11.5 per centum. The series are too small for importance to be attached to them, but nevertheless the figures are both significant and suggestive.
(c) Smallpox.
69. The disastrous epidemic of smallpox which raged throughout the Colony at the beginning of 1938 has already been described in outline.
70. The preventive measures taken against the disease included vaccination throughout the Colony. During the year, 1,035,448 vaccinations were performed. The Legislative Council gave its approval to an amendment of the Vaccination Ordinance making vaccination compulsory for all classes on the 22nd of April, 1938. Free vaccination centres were opened in hospitals, dispensaries, and at other convenient points. With Government approval, twenty-four temporary officers were added to the quota of twelve public vaccinators. The St. John Ambulance Association lived nobly up to its past record and gave great help in carrying out this large number of vaccinations.
71. A certain amount of vaccine lymph was imported by Government as a precautionary measure, but most of the lymph used was prepared at the Govern- ment Bacteriological Institute which, as usual, rose to the occasion.
The re- sources of the Institute as regards animal accommodation were taxed to the uttermost, but over fifty litres of lymph were prepared during the year.
72. Cases of the disease were isolated at the Infectious Diseases Hospital at Kennedy Town. Reference has already been made to the increase in accom- modation effected at this institution. The total number of cases recorded in 1938 was 2,327 of whom 1,833 died, a mortality rate of 79 per centum.
73. The epidemic was waning by the end of May and finally out in July, in which month only five cases were reported. Thirty-seven cases were re- ported during November and December, mostly in refugee children.
74. The outbreak was the most virulent the Colony has ever known, and the high number of toxic cases-almost 10 per centum of the number admitted to hospital-gives an index of the virulence of the virus.
75. The deplorable Chinese custom of waiting till the second year of a child's life to have it vaccinated means that whenever smallpox breaks out in the Colony there is a holocaust of infants. In 1938, of those who perished 1,388 were babies and children of five years and under.
76. It is gratifying to be able to record that during the year under review steps were taken which will in time bring the sanitary inspectorate directly under the control of the medical officers of health-an absolutely essential measure if effective use is ever to be made of this body of potentially very valuable public servants.
(iii) Other Diseases. (a) Leprosy.
77. Two important steps were taken regarding leprosy during the year. Firstly, arrangements were made with the approval of Government to give financial aid to the Catholic Mission at Sheklung, in Chinese territory, which in its turn undertook to build accommodation for 200 lepers, the number to be increased later to 400. The lepers will be maintained at Sheklung at the expense of the Hong Kong Government. Secondly, Government acquired the former Tung Wah Small- pox Hospital and the plot of land on which it stands. It is hoped that this step will enable some form of discipline to be imposed on the lepers. It was also arranged late in the year that convicted lepers should serve their term of im- prisonment in a special building to be erected at some future date in the precincts of Hong Kong Prison.
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