1929-07-24 — Page 5

M.O.H. ON TYPHOID

THE HONG KONG DAILY PRESS, WEDNESDAY, JULY 24, 1929.

DANGERS.

葛

DIFFICULTY OF DIAGNOSIS AND SYMPTOMS

TO BE WATCHED.

CHINESE "COOK-BOYS" AS POSSIBLE CARRIERS.

|

NORMAL RISKS OF INFECTION INCREASED.

Speaking at the Sanitary Board meeting yesterday, Dr. H. A. Fawcett, the Mediçal Officer of Health, stressed the point that, although, there la no cause för alarm or panic, the normal risks " of an outbreak of typhoid fever, in the Colony have certainly been lacreased by the widespread... use of doubtful water, open to pollution.

The Doctor also spoka briefly upon the early symptoms of typhoid fever and urged the need for medical advice should any of them be experienced at any time by members of the public.

"VAGUE DISEASE WITH A GRADUAL

Owing to the death of his father, were possibly used, without his Mr. Wong Kwong Tin was unable knowledge, as fertilisers, to attend the meeting. In his ab-Recent analyses of the regular sence, and at the requeat of the Chairman of the Board, Mr. N. L.

water supplies at Shek O suggest Smith, certain questions relating to

no seriods pollution but we know the typhoid warning issued by the there a far from ideal, and that at that the septic tank sewage disposa! 30.H, which, pursuant to notice,

least one of these tanks drains into were to be asked by the absent member, were

a stream from which the nearby but by Mr. T. N. Chau.

native villagers bave obtained

water.

ONSET."

Kowloon City."

The next question asked whether Kowloon City, where the supply of water was mainly from wells, was Y other

RESERVOIRS' BIG GAIN.

180 MILLION GALLONS ON ISLAND.

THE CRISIS OVER?

"The reservoirs are coming up well, and we will be in same posi tion as in 1999 at same date," op served Mr. A. B. Purves, the P.W.D. Water Engineer, who supi plied the day's water figures. "I!! the rain goes on as we expect the storage should increase to about 700 | million gallons during the next 24 hours. On July 24, 1992, when res- During the 24 hours ending at 7.30trictions were in fores, the storage a.. yesterday, the water storage was 753 million. I expect we will in Island reservoirs increased by 150 million gallons, bringing the total storage to 632 millions. This gain during a 24-hour period is the biggest recorded so far this year.

The average rainfall recorded at the various reservoirs during the 24 hours is one-fifth of an inch less than the previous day, but the gain in storage increased three times, which shows that the streams in the catchment areas are now flowing very strongly and a maximum effect is registered from the rainfall.

Rainfall For Monday and Tuesday,

Yesterday's, rainfall,' up to 4 p.m. was 18 inches, while 3.59 feli dur- ing the previous 24 hours.

not be worse off than in 1922. The population then was rather less, but. on the other hand, since then more catchwaters have been built."

Rider Main Supply Not Yet Possible.

to a

On the question of making further concessions in the atreet fountain apply which from yesterday went Purves stated that people must be twelve-hour period, Mr. content with that, as it will relieve any real hardship. With the in- there was now a good prospect of creased gain in storage, however, the twelve-bour supply being con- tinued for a longer period. If the wet weather continued it was pos- sible that such a service might be continued till next year's rainy sea

xon.

At present the twelve-hour foun- tain supply means an expenditure of 4.1 million gallons a day. It is estimated that if a two-hour daily supply were given through the rider mains, the consumption would be increased by two or three million gallons.

more infected than Locality in the Colony.

"According to the scanty figures from Kowloon City," replied Dr. Fawcett, the answer is "No,' but we must remember that this is a In reply to the question whether,

rural population, entirely native, For many reasons the condi. and mostly immune to the ill effects in view of the many cases of typhoid tions in this Colony are ideal for of a water supply which has been

The total fall for the year is 31.13 fever reported, was it his opinion the maintenance of typhoid. Daily in use there for many generations. inches against an average of 47.95. that an increase in the number of domestic contact with people who. It cannot be compared with a mix Ceases was imminent. Dr. Fawcett

An average of 3.30 inches was replied that he could only "repeat

are often of primitive and un- ed and fuctuating population in what he had already said in the hygienic habits establishes the modernised city, which requires recorded at the reservoirs during Prese: that it was his duty. S

cycle. The Chinese cook-boy, ever-increasing precautionary, mea- the 24 hours ending at 7.30 a.m. M.O.H.. anticipate all possible vier. The typhoid chain has many gers which it. itself, creates

sures to combat the evils and dan-yesterday, the individual readings very satisfactory, is always a possible car- events affecting public health and links.' to act on the assumption that even the most unlikely may happen. It" was his policy to be prepared, but neither to prophesy nor raise alarm.

An Effective Motto,

even

Case of Mr. Whyte, "

We are not taking routine sam ples of well-water in Kowloon City. ly general impression is that the people there are surprisingly · free from these infectious diseases. is unlikely that they will remain no when closer contact is established with larger Kowloon,"

Dr. Fawcett weat on to say that the M. Whyte mentioned was not notified as a case of typhoid but was certified as having died from appendicitis. The questioner prob

ly meant to refer to the case of the late Mr. Coesart. Mr. 'Whyte

Asked what was the I am prepared to say only was not living in the Peninsula

"A molto summarising preventive medicine," he went on. might be, *Suspect: Inspect Protect.

He continued:

Hotel"

.

41

Difficulty of Isolation.

It

percentage

being:-

Tytam

3.85 inches.

17

At Kowloon.

The position in Kowloon is also 113 the total storage figure yesterday morning was 309 million-an increase of 80 million gallons since Saturday morn day. The rainfall during the 24 hours was 1 to 1 inches..

Tytam Tuk

3.50 Pokfulam

1.80 M Wongnelchang

........ 4.25 Reservoir levels taken at the same

Fu Kwong To Be Paid On. time show that Pokfulam is now i

The Water Control Office an- nounce that the Fu Kwong will make only 10 feet 10 inches below over-only one more trip and will be paid Row, or two-thirds full capacity. off on Friday. Tytam is 15 feet below overflow, but

capacity, and the rise in the level Tytam Tuk is still 74 feet below full

of the latter will be gradual until

into the larger reservoir. chemical Tytam reaches overflow and drains

Tuk level has, however, risen 31 feet in a fortnight.

of bacili coll in water to be regard- it is impossible to lay down any ed as dangerous, the M.O.H," said

rule or scale on the Bacteriologica content only. It must be taken in conjunction with the

analysis; the sourse of water; the locality; the geologica! formation and above all the opportunities of contamination.

that this is the season when typhoid is most prevalent (May

In the case of Mr. Cossart, the to September) in Hong Kong authorities were unable to find any that the incidence of notified particular source of infection. The casts is, so far, no less or no food at the Hotel was well known greater than the same period last to be bepond reproach and Mr. year that the widespread use of Coseart might have taken food ani doubtful water. open to pollution, drink at a place outside the Hotel increases the risks which are In that event, observing that the normally present in the Colony disease took about twelve days to "This technical matter neede con. and that an epidemie of infec. become positive, it would be ex-siderable experience," he went on. tious disease would be far more ceedingly difficult to trace any and even an expert will hesitate difficult to control under the con particular source, even if the full to do more than give a genera ditions such 25 exist at the facts were available.

opinion. The Bacillus coli is mere. moment."

Asked whether he had traced the source of infection of the first ease, the 31.0.. said it was not clear whether the question referred to the first case this year or not. ! The disease was eademic here and

contamination, harmless in itself.

numbers.

Two water boats have been re-

Chi Kok and the Tsun Wan all that turned as the Commission has suf ficient lighterage to convey from Lai is needed for the tanks.

These are still being maintained Tytam full but less water is being drawn

(Continued on next Column.}

off.

The

water queues have dis- appeared in a day and at each street fountain there are small groups! drawing water at leisure.

THE WEEKLY REPORT.

Hong Kong.

am told." enid, the Doctor, y an indicator of sewage or animal "that Mr. Cessart was fond of but a warning if found in large oysters and shellfish, and these may have been infected. But I do not! know anything definite about this."aimed at is no B. coli in 10.

"The usual standard of purity The Opening of Wells. of shallow well water. Suspicion of sporadic cases occurred all the year With regard to the next question, amount of water, from which this would come from a source of supply of 108.15 million gallons during the pollution rises in proportion as the round. If the first case in January Prior to the recent general open. bacterium 1929 was meant, he must reply in ing of wells, were there any cases diminishes.

сад be cultured, the negative.

of typhoid fever, reported this "Knowing the average B. coli year the M.O.. said it was content of untreated sewage, difficult to say exactly when the can draw up a table to show the general opening of weils started presumed bar, if it was taken as the middle tion of any sample.

Thus B. coli

Dicult to Trace."

Asked what were the statistic of typhoid fever for various localities for the last five years. Dr. Fawcett asked for in table form. The table said he had prepared the figures appears at the end of this report.] The figures are taken from the Notification of

excremental

we

contamina.

"The bacillus of typhoid, ítrek, is difficult to isolate from ordinary water supplies.

SOME SYMPTOMS TO WATCH.

J

"In any case," he continued, with the many potential sources of infection in this Colony, it is of June, there had heen es notified present in 0.1 c... but not in 0.01 unlikely we could trace one case to cases prior to June 13 this year. e.c., might represent pollution with any particular origin, With a large Of these, 15 were non-Chinese and 0.01 per cent. of sewage, series of cases even, it is by no were Chinese. Twelve imported means easy to find the common cases were not included in these factor. We seldom get a clear or figures. accurate history-especially of the Chinese cases. It is a vague dis case with a gradual onset; a fairly long incubation period and difficult to diagnose in the earlier stage Several wecks may elapse between the catching and the notification: cause and effect get dissociated and many cases are missed altogether.

"It must also be remembered that there are many vectors of enteric fever besides water... One source may start an epidemie but it spreads by varied means which Bies and human carriers "may be ones of importance. There 38, in fact, only one cause-the typhoid bacillas-but many agente for propogation.

Diseases register

Some Fallacies.

W

THAT INFLUENZA

FEELING!"

Dangers of Water.

very common carrier of phoid, Water, he continued, was not a

the water supply would be a very day, July, amounted to 460.22 sidered. An epidemic arising from although it had always to be con

The total storage in the island reservoirs on the morning of Mon- serious thing indeed as the disease million gallons shoving an increase available to the whole of the past week; the amount collected population. On the other band, an from streams being 125.91 million epidemic originating in milk would

gallons. be more easy to curb as only the people who purchased milk from the particular source involved would be liable to infection and that area could be more easily controlled.

Open latrines were another link in the chain of infection on account of the flies.

A complete and proper water carriage system is the best way to keep clear of the typhoid menace,' declared the Doctor."

Varying Symptoms.

The early symptoms of typhoid fever varied considerably; he went on. It was useless to watch one's body for the appearance of spots.

beginning of the second week of the

disease.

The week's consumption totals 25.32 million gallons and is made up! as follows:-

ין

From City mains .........17.09

Taikoo

.28 Lai Chi Kok..... 8.73* Tauzi Wan ............. Steamers, etc.

26

*...To tanks.

Kowloon,

1.32*

.... 0.43*

25.32

reservoirs on the morning of Mon. The total storage in the mainland day, July 29, mounted to $77.00 million gallons showing an increase of 60.60 million gallons during the

newes

The week's consumption, exclud- ing supplies to Eong Kong is 23.28 million gallons plus 14 from the of 23.49 million gallons. Tsun Wan supply making a total

Nor was typhoid fever neces- sarily ushered in with diarrhea. The case might, on the other hand, suffer from acute and very

The yield from the Shing Mus distressing constipation. The most River and streams during the week noticeable symptoms were a con.is 96.78 million gallons.

shown as whole years. The period the questions asked on behalf of when they did appear, it would not and, for the sake of simplicity, Having concluded his replies to Often no spots appeared at all and, separately. Imported cases are not dealt with the subject rather fully of 1929, January to June, is shown Mr. Walls, Dr. Fawcett said he had be before the end of the first or the shown and ali nationalities are added together."

in case other members of the Board | were in the dark us to the symp- toms and causes of typhoid, He said he did not want the water. "There are some fallacies, how-shortage to be the starting-point of ever, of which I have mentioned a typhoid "scare" here." joat the difficulty of diagnosis and Uncooked Vegetables.

There were no signs of an epide missed Cazes," continued the "mie so far, although the" normal Another of Mr. Wong's questions M.O.H. In addition, it must be risks had been increased. At the asked whether infection in the pointed out that these district same, time, it had to be remember- casts of the late Mr. Buchanan of figures are of very little compara ed that, although there were many Shek O and Mr. Whyte of the tive value. They are based on ways by which typhoid could be Peninsula Hotel, was caused by the addresses giv a on the notification spread, there was only one cause. drinking of well water. The M.OH, forms and the very uncertain re. It could not be spread in the same observed that, for the reasons given ported "movements of the native

manner that plague could. in answer to the foregoing ques- population. Moreover, it does not tion, he was not in a position to follow that the locality where the gire a definite reply.

patient is taken ill is the same, as

The Fly Menace, Typhoid could be spread by flies, "In the case of the late Mr. that where the disease was contract- but the method was different. The Buchanan," said Dr. Fawcett, the ed, some 12 days previously. fies could alight on the excreta information was second hand and "The danger of typhoid from a of a typhoid case and could convey scanty, but it appears that he ate public health point of view, lies in germs to food. Ordinarily, the dia. "uncooked-vegetables from his gar-this very difficulty of tracing and ease could not be caught by bodily

den at Shek O. Human excreta controlling it."

but only through the

5-YEAR TABLE OF TYPHOID AND PARATYPHOID FEVERS.

יו

Districts.

1924.

Victoria

137

1925. 1926, 1927. 1328. Yearly Total

91 103 141

17

1570

Peak

16

3

D

+

20

Pokfulam

3

1

0

0

4

Villages of Hong

Kong, etc.

14

12

14

13

19

73

Tsimshatsui .....

3

21

53

Kowloon City

I

8

193; -151

Total Cases -194 ---- 101 - 121

Case of Typhoid and Paratyphoid Fevers from Jamary Hong Kong 6; Tsimshatsui 6; Kowloon City 3..

contact mouth.

stant feeling of malaise with prob. able loss of appetite and a full feeling in the stomach. Many of the symptoms were the same as those of influenza-head ache, dry nose, etc. The tem

perature rises.

"Of all the diseases in the tropics," concluded the Doctor, typhoid is the most difficult to diagnose."

"When you feel at all ill, see ni a doctor, is the best advice I can give. Don't get scared and don't worry."

Island Supply Quadrupled. The minimum storage on the Island was reached on July 8, when the supply was only 157 million gallons. Since then the storage has Geen quadrupled. Kowloon on June 17 was down to 80.5 million gallons.

WATER FROM PRAYA⚫

TANKS.

GOVERNMENT ANALYST IS SATISFIED. WITH QUALITY.

The

The quality of the water supplied from the tanks on the Praya was mentioned at the meeting of the Sanitary Board yesterday. Chairman announced that Mr. Wong Kwong Tio had asked a question concerning its purity.

Dr. Koth's Experience. It was a very difficult disease for even the most experienced medical Endorsing Dr. Fawcett's remarks, man to tackle. Its onset was very Dr. Koch said that, about 20 years gradual and the general symptoms ago, he assisted Dr. Hunter, the were very vague. The majority of Government Bacteriologist of that cases, in the beginning, simply felt time, in his research work in con- "vaguely ill" and did not consult nection with the incidence of typhoid a doctor until the disease got hold among the Chinese. They examined of them. Some that were inoculas every body taken to the Mortuary ed might get a mere mild attack and and were aurprised to and that the did not see & doctor at all. Such body of nearly every child from the cases may be missed by the health age of 6 or 8 months upwards show authorities but they were a positive. ed signs of typhoid. danger to their friends as they, "The inference to be drawn, might be carriers" of the disease. said Dr. Koch, "is that the attacks This City, I am thankful to of typhoid would have made these say," continued the Doctor, "is children immune in after life. We, practically free from flies. Flies are therefore, drew the conclusion that sources to the public is also tested a very serious menace in the summer typhoid does not occur as readily daily and the Government analyst time and in the villages, fies are among the Chinese generally us reports that it is perfectly good very much more amorous, mully foreigners is they acquire water and of the Yame quality a

(Continued on next Column.) immunity in their infancy."

that supplied from the mains."

"These tanks are cleaned and also examined daily by the Govern ment analyat," said Mr. N. L Smith," and he tests the water for free chlorine. If free chlorine is not. present in suficient quantity, it is added.

Water supplied from

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