ENG-1960 — Page 160

HEALTH

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A table showing the principal statistics and rates over the decade 1951 to 1960 is to be found in Appendix VII.

COMMUNICABLE DISEASES

Following a five-year period of continuous rise in the notifica- tion of communicable diseases, the drop during 1960 was mainly due to decreases in the reported cases of tuberculosis, diphtheria and measles. The actual death rate from these diseases continued to decline. A table showing cases of and deaths from communi- cable disease in the period 1955-60 is in Appendix VII.

Tuberculosis. Tuberculosis is still the major communicable disease in Hong Kong. An estimated 2% of the adult population have the disease in an active form, so that with the present degree of overcrowding the chances of contact with an open case are very high. The limited hospital beds available make it impossible to segregate the active adult cases, estimated to number more than 40,000, and the control programme has had to be organized along unorthodox lines. The approach has been to protect the most vulnerable section of the community, the infants, by vaccination with BCG; to treat as many known cases as possible by ambulatory chemotherapy; and to select for hospital treatment those recover- able cases who are not responding adequately to chemotherapy or whose recovery can be hastened by surgery.

Vaccination with BCG is offered free throughout the Colony to all new-born children, and during the year almost 72% of children born were given this 'protection within two or three days of birth. Young children attending MCH centres and school entrants are also examined for tuberculosis and may be given BCG vaccination if they have a negative reaction or a course of isoni- cotinic acid hydrazide if they show a positive one.

Government operates four large full-time chest clinics in the urban area and nine smaller part-time clinics in outlying areas. These clinics are the main source for finding cases, and all those discovered are given treatment as out-patients as soon as the diagnosis is complete. During the year more than 25,000 cases were receiving continuous therapy, and this meant 1,750,000 visits to the clinics. Facilities are available at a number of strategic points for those receiving daily streptomycin injections, to cut