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control. Medical and Health Officers are seconded to the Urban Services Department from the Medical and Health Department and work under the direction of an Assistant Director of Medical and Health Services who is posted to the Urban Services Department as Assistant Director, Hygiene. He is responsible for the guidance of the Health Inspectorate in particular and for advice to the Urban Services Department as a whole on the day to day management of environmental health problems. 74. Medical and Health Officers in the urban areas, in addition to their duties connected with the maintenance of satisfactory standards of environmental sanitation and food hygiene, are responsible for the co- ordination of all epidemiological measures to control the transmission of infectious diseases. Exceptions are tuberculosis, venereal disease, leprosy, and malaria, which are the concern of specialized branches of the Medical and Health Department, Through the media of routine house inspections and regular visits to licensed food promises carried out by the Health inspectorate, much health education is possible in connexion with immunization campaigns and with the control of intes- tinal infections. With the assistance of qualified Health Visitors, the Health Officers maintain investigations into the sources of known cases of diphtheria, tetanus neonatorum, poliomyelitis, typhoid and certain other diseases.

75. These activities are closely co-ordinated with the activities of teams of inoculators from the Epidemiological Section of the Medical and Health Department, working under the immediate direction of area Health Officers and offering prophylactic immunization against small- pox, diphtheria, cholera and enteric fever,

Rural Areas

76. The Director of Urban Services has statutory powers controlling sanitation, food hygiene, cleansing. amenity and allied services in the townships and the more developed villages in the New Territories, while the District Commissioner is the licensing authority for all hawkers and premises where food is handled. The Medical and Health Department provides the curative and personal health services and the Principal Medical Officer of Health, New Territories, advises the respective authorities on all health matters affecting the area. The Medical and Health Department is also responsible for environmental health in rural areas. The main emphasis is on health education stemming from the curative services and designed to stimulate self-help in the villages through the development of simple measures which will improve en- vironmental sanitation.

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Quarantinable Diseases

EPIDEMIOLOGY

77. The whole Colony was declared a cholera infected local area în terms of the International Sanitary Regulations on the 23rd August on the laboratory confirmation of a case of Cholera El Tor and was declar- ed free of infection on the 8th October, 18 days after the occurrence of the tenth and last case in the urban areas. Five days later another case of Cholera El Tor was bacteriologically confirmed in the New Territories in the District of Yuen Long which district was declared an infected local area on the 13th October. No further cases occurred in the District and it was declared free of infection on the 29th October. There was a total of 11 cases with one death. No other case of quarantinable disease occurred during the year.

Cholera

78. Following on the outbreak in 1961 and the continuing incidence of cholera in nearby countries, special preventive measures were taken throughout the year. These consisted of the routine bacteriological in- vestigation for cholera vibrios of all specimens sent to the laboratory from cases of gastro-enteritis and the routine sampling of night soil, sea water, well water and foodstuffs liable to be sources of persistence or transmission of cholera vibrios. In addition a mass cholera immuniza- tion campaign was carried out during February, March and April, during which 53% of the total population received the appropriate one dose of standard vaccine of 8,000 million organismos per ml. Particular attention was paid to the boat people who live afloat, the residents in the New Territories, the waterfront communities, food handlers and school children. In these population groups the percentage inoculated ranged between 85% and 95%. In all, over 1,600,000 inoculations were given. 79. Quarantine restrictions were maintained throughout the year in respect of the infected local areas in the Philippines and the whole of Kwangtung Province. They were applied to Taiwan when it was declared infected in July 1962.

80. The first isolation of cholera vibrios in Hong Kong during 1962 was from a case of suspected cholera admitted to the Lai Chi Kok Hos- pital on the afternoon of the 22nd August. This was not an imported case and no contact with individuals coming recently from infected areas could be traced. Laboratory confirmation showed that vibrio cholerae El Tor was again responsible, the strain being in all respects similar to the strains isolated in 1961. Thereafter, between the 22nd August and

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