ENG-1957 — Page 178

PUBLIC HEALTH

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Prophylactic vaccination against diphtheria is carried out throughout the year and is intensified before the onset of winter when the infection is most active. This measure has caused a decline in diphtheria cases and deaths since the disease reached a peak in 1953, but the number of infants and children immunized each year is not sufficient to bring the disease under satisfactory control. With over 90,000 babies being born each year and a variable proportion of the infant and child population not immunized, a build-up of sufficient non-immunes can take place to support a large scale outbreak of diphtheria when conditions are favourable. In view of the unusual activity of the infection during the last quarter of the year, the anti-diphtheria campaign which started in August and was scheduled to terminate in November has been extended to the middle of January 1958. At the same time anti-diphtheria propaganda has been in- tensified and is producing a satisfactory response from the public, as shown in the A.P.T. inoculation returns.

Seventeen carriers were discovered during the year as against twelve in 1956, including a girl with chronic cutane- ous diphtheria, who was traced as the source of infection for four cases of diphtheria in the same house.

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Measles. There was a considerable outbreak of this in- fection among school children early in the year. 643 cases were reported in the first quarter as against 875 for the whole year. The number of deaths was 93, with a case fatality rate of 10.6% as compared with 86 deaths and a case fatality rate of 12.1% in the previous year. This mortality rate appears unduly high, but is due to the fact that the certifica- tion and registration of causes of death are more complete than notifications of actual cases of the disease.

Poliomyelitis. 45 cases, including eight non-Chinese, with seven deaths were notified during the year as compared with 31 (eight non-Chinese) with three deaths in 1956. The highest monthly return was 16 for June followed by eight for July.