ENG-1974 — Page 116

HEALTH

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organisations. The estimated capital expenditure on hospitals and other buildings including furniture and equipment is $55,047,000.

Communicable Diseases

The total number of communicable diseases reported during 1974 was 12,866, but cholera has not been reported in Hong Kong since 1969. Routine nightsoil sampling for cholera vibrios was continued on a year-round basis as part of the surveillance programme. No cholera vibrio was isolated from the samples collected. However, there was no room for complacency and the public was advised to observe strictly the rules of personal and food hygiene. Following a decision of the World Health Assembly cholera vaccination certificates were not required for international travellers entering Hong Kong after January 1, 1974.

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Tuberculosis remains a community health problem in Hong Kong. It has been estimated that about 0.7 per cent of the population is suffering from active pulmonary tuberculosis requiring treatment. Males are affected as frequently as females, the disease being common in elderly man, while drug addicts are also prone.

The government, either by subvention or directly through the Government Chest Service, spends more than 35 million annually on control measures. The tuberculosis control programme is a combined effort between the Government Chest Service, the Hong Kong Anti-Tuberculosis and Thoracic Diseases Association, and the Junk Bay Medical Relief Council; while certain other organisations, including the Tung Wah Group and the Caritas Medical Centre also provide treatment facilities with the aid of substantial government subventions. The Government Chest Service operates seven full-time clinics. There are 11 subsidiary centres throughout Hong Kong. Co- ordination is ensured by the Co-ordinating Committee for Treatment of Tuberculosis which meets every three months.

The Chest Service maintains an extensive Bacille Calmette-Guerin (BCG) vac- cination programme and during the year 97 per cent of babies born in Hong Kong received BCG vaccination within 72 hours of birth. The widespread use of this prophylactic measure has led to the rapid fall in tuberculosis in young people in Hong Kong. The investigations of the different techniques of BCG to newborn infants showed that the simple triangular needle technique gave more satisfactory results than the bifurcated needle technique. An intensive survey of children born after July 1966 notified as suffering or dying from tuberculosis is proceeding smoothly.

The cornerstone of treatment is ambulatory chemotherapy on an outpatient basis. Treatment of tuberculosis in the last 15 years has changed completely, and the disease can now usually be cured, provided the patient is co-operative and takes treatment regularly. The patient is given initially an intensive three-month daily treatment of streptomycin, PAS and Isoniazid, followed by a regimen of twice weekly streptomycin injections and high dosage Isoniazid tablets. This has the advantage of being a completely supervised regimen.

Large scale co-operation with the Medical Research Council of the United Kingdom continued. The majority of new patients are treated on an outpatient basis and it is now possible to treat a proportion of drug resistant cases--which previously