ENG-1965 — Page 140

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HEALTH

Diphtheria continued to occur mainly among children under 10 years of age. An immunization campaign has been in progress since 1959, interrupted only by the need for anti-poliomyelitis and cholera inoculation drives. House-to-house visits are conducted in resettlement estates and other crowded areas, and teams of inoculators visit squatters both on hillsides and on rooftops. Every effort is made to inform parents of the dangers of the disease and of facilities available for the protection of their children. As a result there has been a steady decrease in the incidence of the dis- ease from the high total of 2,087 cases in 1959. During the first three months of the year the incidence of diphtheria was somewhat higher than anticipated. However with the onset of cooler weather in October the usual sharp rise in the number of cases did not occur so that taking the year as a whole the annual incidence of the disease showed a further decrease. The case fatality rate rose from 5.4 per cent in 1964 to 6.4 per cent in 1965. Most deaths occur in non- immunized children who have advanced largyngeal or pulmonary complications due to delay in seeking proper medical attention.

Typhoid fever showed a very considerable decrease compared with 1964 and preceding years. This disease is frequently associated with dirt and generally insanitary conditions, and its decrease is probably connected with the continuous water supply available throughout the year. Free inoculation is offered and the usual control measures are enforced with special attention to the detection of carriers among food handlers.

Poliomyelitis, which had shown a low incidence since a widespread immunization campaign using oral vaccine was carried out early in 1963, increased during the year. This increase was largely due to an outbreak of Type I infection which occurred mainly in the northern part of Kowloon and in Tsuen Wan during March, April and May. Approximately half of all children born receive anti-poliomyelitis vaccine at maternal and child health centres and general campaigns are held yearly in an attempt to immunize the remainder.

Measles is most prevalent during the cooler months and outbreaks normally occur in alternate years. Such an outbreak occurred during the winter months of 1964–5. There were 217 deaths recorded during the year and the high case fatality among notified cases reflects the incompleteness of notification. Mortality is mainly due to