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63. Powers to prevent the importation of smallpox by requiring persons arriving in the Colony to produce either a valid international certificate of vaccination or satisfactory evidence of a previous attack of the disease have been provided by the amendment of the Quarantine and Prevention of Disease Ordinance. There is now little difficulty in securing voluntary acceptance of vaccination against smallpox and as the proportion of the population who have been immunized is extremely high, it was considered that there was little point in retaining the powers provided under the Vaccination Ordinance, which has therefore been repealed,

UI, PUBLIC HEALTH

GENERAL COMMENTS

64. There were no major outbreaks of epidemic disease during the year but there was a rise in the incidence of notifiable communicable diseases which was 3.86% greater than that of the previous year. Increased incidences of poliomyelitis, diphtheria, whooping cough, amoebiasis, the enteric fevers and malaria occurred. Ophthalmia neonatorum was gazelted as a notifiable disease in June 1958 and this accounted for part of the increase.

65. Despite widespread outbreaks of cholera and epidemics of smallpox in countries in close and direct communication with Hong Kong, the Colony again remained free from the six formidable epidemic diseases which are the subject of International Quarantine agreements. The strictest possible quarantine precautions were taken to prevent the re-introduction of cholera and vaccine production was increased to ensure an adequate reserve for any emergency. Fortunately the vaccina- tion state of the general population against smallpox remains high and when the need arises there is no difficulty in eliciting a massive response to vaccination.

66.

For the third year in succession there was no case of rabies either in animals or humans.

67. Tuberculosis continues to be the major communicable disease problem but encouraging progress is being made in the vaccination of newborn infants with B.C.G., in the development of the facilities for ambulatory chemotherapy and in the provision of beds for the accommodation of cases that will respond best to hospital care. The

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segregation of chronic cases with infections resistant to therapy is not yel possible on any significant scale and this essential adjunct to control is being reviewed in the light of staff and construction resources. The re-settlement of squatters proceeds steadily but the enormous re-housing problem means that the proper care of chronic tuberculosis in the home will have little place in the control programme for many years to come.

VITAL STATISTICS

68. Under the Births and Deaths Registration Ordinance. registra- tion of births and deaths occurring in the Colony is compulsory.

69. The number of 106.624 registered births again exceeds all previous totals. It was 8,790 more than in 1957, which itself was a record year. Taking the estimated mid-year population of 2,748,000, the crude birth rate was 38.8 per thousand of population, which was slightly higher than the rate in 1957 of 37.9 per thousand.

70. On the other hand, the total number of deaths from all causes was only 20,554, only 1.189 more than in 1957. The crude death rate was 7.5 per thousand of population, the same figure as for 1957.

71. The net natural increase in the population of the Colony during 1958 was thus 86,070, as against 78,469 in 1957.

12. There were 1,297 still births recorded, which gives a pre-natal wastage of just over 12 for every 1,000 of all births. The number dying in the first month of life, always the most dangerous period of a child's life, was 2.492, giving a neo-natal mortality rate of 23.4 in every thousand live births. This shows a slight decrease compared with 1957, when the rate was 23.8 per thousand live births,

73. Deaths of infants under one year of age numbered $ 786, which is 28.15% of deaths from all causes as compared with 28.07% in 1957, giving an infant mortality rate of 54.3 per thousand live births, compared with 55.6 per thousand in 1957. Of an increasing number of babies born, an increasing number is surviving. On an average 292 babies are born in the Colony each day, of which at least 276 survive their first year of life; in the past it would not have been unusual for at least one hundred of them to die before reaching the age of twelve months. This dramatic success is a tribute to those engaged in the maternal and child health services, but, this improved situation is posing fresh problems in regard to medical services, education, employment and housing.

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