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of the illegalities and that, although the by-laws and require- ments were found reasonable and capable of being enforced, considerably more supervision and food hygiene education was necessary to raise standards to a desirable level.

24. In the control of infectious diseases, immunization campaigns against smallpox, diphtheria and the typhoid fevers, were conducted during the months preceding the expected seasonal occurrence of each disease. Routine diagnostic throat swabbing was done for all family contacts of diphtheria cases and routine stool examination for similar contacts of all notified typhoid and dysentery cases.

25. A complete review and follow up of all known chronic carriers of typhoid and dysentery was undertaken in order to revise the current list and check on the occupations of carriers who might endanger public health.

26. In Kowloon nearly half the notified cases of typhoid fever occurred in the "undeveloped" and squatter areas where neither maing water supply nor water-borne sewage disposal was adequate.

Rural Areas.

27. Industrial and housing expansion continued at an in- creasing pace particularly in the Tsuen Wan area. Such rapid and uncoordinated development places a very considerable strain on public services.

28. In October 1956 the scavenging services throughout the New Territories were transferred from the Medical Department and became the responsibility of the District Administration. A long needed increase in the staff for these duties was made at the same time.

29. Standards of food hygiene still leave much to be desired and lack of hygienic methods of transport is partly responsible for the many unsatisfactory reports of bacteriological examina- tions. There has also been a great increase in the hawking of fresh meat and fish to supply the expanding population in the absence of official markets.

30. The expansion of clinic services has been successfully continued, particularly as regards Maternal and Child Health. The number of B.C.G. vaccinations given continues to increase steadily.

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A feature of the year was the absence of any reported case of rabies-animal or human. Increased anti-rabic inocula. tion of dogs and the strict measures controlling stray dogs have doubtless contributed to this record,

Epidemiology.

32. Notifiable diseases reported reached a total of 16,071 during the year, representing a drop of 2,071 or 10.8% as compared with the 1965 figure of 18,142. The largest variations were decreases of 1,993 for tuberculosis from 14,148 to 12,155; 126 for diphtheria from 840 to 714; 107 for chickenpox from 380 to 273 and rises of 65 for malaria from 481 to 496 and 166 for measles from 543 to 709. Of these notifications, 12,155 or 75.67 were reported by Government institutions, 1,976 or 12.3% by the Tung Wah Group of Ilospitals and the remaining 1,940 or 12.1% by other hospitals and private practitioners. The incidence rate of notiflable diseases during 1956 was 658.6 and the mortality rate 117.6 per 100,000 population. Excluding tuberculosis, the incidence and mortality rates were 160.5 and 9.9 respectively.

88. During the year under review, a total of 83 reminders covering 279 cases was sent out to various hospitals and practitioners calling attention to their failure to report a notifi- able disease. Of these, 63 were sent out to private practitioners, 11 to Government institutions and 9 to the Tung Wah Group of Hospitals.

34. The number of deaths due to notifiable diseases was 225 less than that in the preceding year, i.e.. 2,870 as compared with 3,095. Excluding tuberculosis, measles was responsible for the greatest number of deaths with 86, followed closely by diphtheria, 75, and enteric fever. 48.

35. The table at Appendix 2 sets out in detail the returns of communicable diseases notified during the year as compared with 1955, including the mortality due to these diseases.

36. The Colony was free from the 6 quarantinable diseases. One case of non-epidemic typhus, a non-quarantinable disease, was reported during the year.

37.

Racillary dysentery totalled 560 notifications in 1956 as against 524 in the preceding year, showing a slight increase of

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