conditions of each child, has been increasingly developed and during 1954 22,750 such visits were made. The visiting nurse advises the mother on the spot in her own home on the most practicable steps to take in her particular situation to safeguard the health, not only of her baby but of the whole family, checks on such matters as vaccinations and anti-diphtheria immuniza- tion, and notes any special risk or hardship for special attention.
69. Two special investigations carried out by the staff of the Maternal and Child Health Service are worthy of mention. A careful check on the number of births attended and of children attending the health centres revealed the fact that some 3% of births had not been registered within the first 12 months of life. The second investigation was an exhaustive study of the weight and growth of 2,000 infants which revealed that the growth rate of properly supervised Chinese children prior to weaning closely parallels the average growth rate of all children, but that after weaning, when they receive normal Chinese diet, there is a marked tendency for growth to slow up. Taken into consideration with other investigations made, parti- cularly the prevalence of cirrhosis of the liver amongst adult Chinese, and various spot checks on the composition of average diets, this observation lends confirmation to the impression that the average poorer class Chinese diet is gravely deficient in proteina deficiency which is probably also reflected in the serious tuberculosis incidence.
Malaria Control.
70. Malaria is not a serious problem in Hong Kong, there being only 475 cases recorded during the year under review with 16 deaths, and the spleen index rate amongst children in the New Territories, the most highly malarial area of the Colony, is only 4% (rates of 5-10% being regarded as "ideal targets" by the World Health Organization in malarious areas brought under control by residual spraying). But it must not be overlooked that this has only been achieved by constant and careful larvicidal control. Hong Kong was and still is poten- tially a dangerously malarious area. Vector mosquitoes abound
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ou the borders of the controlled areas and, given a favourable opportunity, can increase rapidly at any time. This constant threat of malaria to the Colony is not generally realized.
71. During the year experiments were carried out with new insecticides which were submitted for testing by various Companies. Under local conditions water-miscible Gammexane has been found to be the most efficient larvicide.
Port Health.
12. The Port Health Administration is responsible for the prevention of the importation into the Colony by sea, land, and air of the six quarantinable diseases and of leprosy. The work is governed by local ordinances, the Quarantine and Prevention of Diseases Ordinance (at present under revision) the Merchant Shipping Ordinance, the Vaccination Ordinance, and the Asiatic Emigration Ordinance. Passengers and crews of incoming vessels are inspected at the two Quarantine Anchorages at Kowloon Bay and at Stonecutters Island: arrivals by air are inspected at the Kai Tak Airport and persons entering by the land frontier are checked at Lo Wu Station. The work is carried out expeditiously and with the minimum interference with traffic or inconvenience to passengers and crews. During the year 4,715 ships carrying 57,251 passengers and 230,083 crew were inspected on arrival as against 2,734 ships and 57,10€ passengers and 200,701 crew in 1953. The routine spraying of all aircraft with insecticide before arrival is insisted upon. Arrivals by air increased from 15,372 in 1953 to 18,423 in 1964. A total of 189,957 persons entered the Colony by the land frontier compared with 301,670 and 163,695 in the previous two years. Of these 46,871 were vaccinated against smallpox.
Fumigation of Ships.
73. An important feature of port health work is the destruction of rats on ships by fumigation as an international measure against the spread of bubonic plague. During the year
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