Sessional_Paper_1937 — Page 5

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HONG KONG.

No. 1937

1

REPORT ON AN OUTBREAK OF SHIGA DYSENTERY IN HONG KONG.

و,

1. As defined by Manson-Bahr " dysentery is merely a designation embracing a symptom complex but not indicating some particular disease of distinct etiology It is in fact the name of a symptom common to a number of diseases of very different origins and not that of one specific disease as is so commonly believed.

2. The principal forms of dysentery caused by parasites are:---

I. Bacterial causing Bacillary Dysentery and due to the Flexner bacillus, the Schmitz bacillus or the Shiga bacillus. Among the Flexner group there are nearly one dozen varieties each one of which is a specific organism producing a specific disease.

II. Protozoal-causing amoebic dysentery and due to the Entamoeba hystolitica.

III. Helminthic-caused by several varieties of Bilharzia.

3. In the majority of cases a diagnosis of dysentery is made when the symptoms are those of a diarrhoea with mucus and blood in the stools. As a rule no attempt is made to substantiate this by laboratory findings.

Not

4. Both bacillary and amoebic dysenteries are endemic in Hong Kong. being notifiable the total number of cases diagnosed clinically is unknown but from the returns of the Government Hospitals and the Chinese hospitals some indication of the prevalence can be obtained. Owing to the fact that in the Chinese hospitals diagnoses are more often than not left unsupported by microscopical findings it is impossible to accept the figures for amoebic and bacillary types as being correct. According to the Government Hospital figures which are in many cases supported by hacteriological findings the number of bacillary cases exceeds that of ambic cases by about five to one.

5. The Government Bacteriologist who carries out the thorough investigation of a large number of dysenteric stools each year is of opinion that the number of bacillary cases exceeds the number of amoebic cases in the proportion of 8 to 1, and that clinical diagnosis is more often wrong, than right. This opinion should be accepted.

6. The proportionate distribution of positive cases of bacillary dysentery as ascertained by the Government Bacteriologist was for the years 1934 and 1935-

B. dysenteriæ, Flexner

Schmitz

B.

多多

B.

Shiga

77.61%

16.42%

5.97%

7. The symptoms produced by the Flexner group bacilli are as a rule com- paratively mild and cases which receive proper treatment early usually recover. Shiga cases on the contrary early develop severe symptoms of a fulminant nature. which cause grave concern and not unfrequently prove fatal.