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Bacillary Dysentery

74. A 50% increase was recorded in the notifications of this disease but mortality remained low. Just over half the cases reported were in children under 10 years of age. The preponderant organism found is Sh. flexneri, while both Sh. boydii and Sh. sonnei are reported from time to time.

Enteric Fever

75. The increase in the notifications of this disease was due to the recurrence, during 1959, of a summer peak after a lapse of four years. The incidence rate in the 5-9 and 10-14 age groups remained high, children in these groups accounting for 44% of the cases reported. This disease is particularly prevalent in the parts of the Kowloon Peninsula where squatters are concentrated with consequent lowered standards of sanitation and increased dependence on water sources other than the Government mains supply.

Chickenpox

76. There was no change in the number of notifications as compared with 1958 and mortality remained low. It is primarily a disease of the colder months, the great majority of the cases occurring during the first four months of the year.

Cerebro-Spinal Meningitis

77. The incidence remained at a low level and this disease is not a public health problem in the Colony at present,

Diphtheria

78. As previously mentioned, there was a disturbing rise in the incidence and the number of cases was the highest ever recorded: 80% of the cases occurred in children under the age of 10 years. However, the case fatality rate was the lowest ever recorded,

79. As usual, the rise occurred during the cooler months, reaching a peak during December, 1959, The main concentration of the disease was in the densely-populated tenement areas of Kowloon and in the Mainland portion of the New Territories. The incidence on Hong Kong Island remained comparatively low but there also the majority of cases were reported from the densely-populated areas.

RO. The clinical picture was predominantly that of laryngeal diph- theria due to C. diphtheriae mitis: only in rare instances was a gravis strain isolated. The occurrence of "bull-neck" in many patients who bad

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previously had herbal throat powders insufflated onto the fauces, a traditional practice referred to in last year's Report, was further investigated. In the samples of powder analysed there were varying concentrations of realgar (arsenic disulphide) and investigations are continuing with a view to determining whether or not the condition is due to a non specific irritant cffect of the powder itself rather than due to the arsenic content.

Measles

81. There was a slight drop in the number of notifications of this disease but the high case fatality rate, 23.7% during 1959, is a strong indication that reporting of this disease is by no means complete. As in other diseases spread by droplet infection, most of the cases occur during the first quarter of the year.

Poliomyeliries

There was a marked drop in the incidence of this virus infection, and cases occurred uniformly throughout the year, there being no peak during the summer months as in 1958/59. There was, however, an increase in the case fatality rate. Most of the cases and deaths amongst Chinese were in the 0-1 year age group: seven non-Chinese cases were reported, mainly in Europeans recently arrived in the Colony. Two- thirds of the cases occurred on the Kowloon Peninsula.

Whooping Cough

83. There was a considerable drop in the number of notifications, and only two deaths were recorded. As in the cases of chicken-pox and measles, the number of unreported cases is estimated to be considerable. Puerperal Fever

84. Only one instance of this disease was recorded in a patient who, having been attended by a qualified midwife, left the Maternity home against advice.

Ophthalmia Neonatorum

85. This disease, made notifiable in June 1958, showed a marked increase in the number of notifications, 98% of which came from: Government Ophthalmic Clinics; these cases were investigated by Health Visitors working in the Government Ophthalmic Service.

Maluria

86. There was a drop of 33% in the number of notifications of this disease during 1959 as compared to 1958, Of these, 89% were amongst

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