68. Unfortunately too many cases still come under medical care only when the disease has gone so far that tracheotomy is necessary. Nevertheless the falling fatality rate is encouraging evidence that the value of medical services is appreciated.
69. In the first quarter of 1953 alter intensive propaganda a vigorous immunization campaign was launched. The response was remarkably good, in fact so good as to embarrass the supply organization. At one stage supplies of toxoid ran out and had to be replenished by air lift from the United States of America, and the United Kingdom. The greater part of the toxoid for this campaign was supplied by the United Nationa International Children's Emergency Fund. Children in the age range 6 months -10 years were offered protection. During the year 195,797 received the first injection of toxoid and the total number fully immunized was 154,377.
70. As the period of greatest incidence of this infection is during the colder months of the year, namely December, January and February, the immunization campaign was again intensified In the first quarter of 1954. During this period 82,146 first immunization doses were given and 30,159 second doses. The occurrence of cases in the first quarter of 1954 was very much less than in the corresponding quarter in 1953, there being 341 cases notified as compared with 507. This would suggest that the intensive immunization campaigns carried out in the first quarter of 1953 and the first quarter of 1954 were successful and it may well be that during 1954 incidence of this disease will fall.
Cerebro-spinal Meningitis.
71. This infection, so liable to become epidemic in conditions of overcrowding, showed only endemic incidence. Preventive measures cannot claim credit for this and there is the ever present possibility of the cases reaching epidemic proportions, particularly in the cold weather. In present circumstances there is no practicable way of countering this threat.
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72. There were 12 cases and 5 deaths, exactly the same figures as in 1962.
Measles.
78. There was no major epidemic outbreak of this infection but the incidence was fairly high and, among the infectious diseases, it was a not unimportant cause of mortality. 661 cases were notified and 50 deaths were attributed measles, giving a case fatality rate of 7.6% as compared with 11.4% in the previous year. The majority of notified cases were treated in hospital. No specific preventive measures were taken against this infection.
Poliomyelitis.
74. The number of notifications of this infection during 1953 was 22 and there were 3 deaths as compared with 19 cases and 4 deaths in 1952. Of these, 17 were Chinese and 5 nut- Chinese and they appeared to be unconnected.
75. During the first quarter of 1954 there was a sharp increase in incidence and 18 cases occurred with 3 deaths. Chinese cases numbered 4 and there were 14 non-Chinese. The majority of the latter were persons who had come to the Colony within the previous 12 months or so and, with few exceptions, were either children or young adults,
Rabies.
76. Two human cases were recorded and on three occasiona the infection was diagnosed in animals. This incidence is cun- sidered not unsatisfactory, but stringent measures against the importation of dogs from the mainland and restrictions on the movement of dogs within the Colony were maintained. The arrangements for the protective inoculation of persons possibly exposed to the infection were modified as a result of the occur- rence cases of neuroparalysis following on anti-rabic treatment. This treatment is now given only when it is considered that the risk of infection is great.
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