NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
25
DEPARTMENT—cont.
Madras Presidency for the official year 1927-28—cont.
vaccination.
Successful.
1 and under 6 years.
11
2,256
953
793
1,578
1,457
1,108
2,042
1,761
1,684
1,715
15,347
2,580
1,341
1,989
1,844
1,270
1,136
1,161
2,145
1,071
1,592
16,129
1,269
1,018
1,386
2,254
2,321
1,598
2,341
2,298
2,232
1,338
1,749
774
1,639
1,449
23,696
468,263
Total of all ages.
12
4,906
5,102
3,080
4,130
5,822
4,823
7,538
3,763
5,780
4,867
49,811
5,146
4,959
5,421
5,135
4,932
4,709
3,793
5,477
2,250
4,127
45,949
3,201
3,819
3,280
6,406
5,872
4,839
4,687
6,539
5,031
2,780
4,137
2,999
5,116
5,023
63,729
1,226,242
Unknown.
13
541
394
442
415
761
491
535
550
628
491
5,248
586
316
858
491
732
339
228
604
352
449
4,955
250
485
205
321
343
339
351
767
438
101
588
266
503
243
5,200
108,184
Re-vaccination.
Total number of operations.
14
634
1,604
367
716
1,082
792
982
395
602
759
7,933
1,802
2,003
1,830
2,021
1,528
2,057
1,188
2,110
599
736
15,874
1,637
1,472
698
3,086
3,457
2,648
2,398
1,387
1,486
451
1,103
l,233
2,415
2,435
25,908
365,892
Successful.
15
152
780
72
135
316
314
302
98
117
257
2,543
448
761
449
721
333
823
454
608
127
317
5,041
453
289
236
681
620
341
751
116
179
192
252
435
446
878
5,869
89,031
Unknown.
16
66
174
87
30
216
86
239
58
78
118
1,152
170
570
215
235
302
189
98
358
115
143
2,395
165
231
23
174
314
188
392
106
16
25
55
185
160
265
2,299
44,752
Percentage
of successful
cases in which
the results
were known.
Primary vaccination.
17
97.3
98.2
91.4
95.2
94.5
95.3
98.7
91.1
97.0
93.6
95.6
97.9
98.8
97.2
98.2
96.1
97.0
98.2
94.6
94.6
97.6
97.1
91.3
88.8
90.5
95.2
90.3
91.1
93.7
87.9
93.1
95.0
89.1
97.3
95.3
95.7
92.7
95.7
Re-vaccination.
18
26.8
54.5
25.7
19.7
36.5
44.5
40.6
29.1
22.3
40.1
37.5
27.4
53.1
27.8
40.4
27.2
44.0
41.6
34.7
26.2
53.4
37.4
30.8
23.3
35.0
23.4
19.7
13.9
37.4
9.1
12.2
45.1
24.0
41.5
19.8
40.5
24.9
27.7
Persons successfully vaccinated per
1,000 of population.
19
...
29.8
...
29.3
...
31.2
33.2
Percentage
of cases
unknown to
total cases.
Primary vacci-
nation
20
9.6
7.1
11.6
8.7
11.0
8.8
6.5
11.7
9.5
8.6
9.2
10.0
5.9
13.3
8.6
12.5
6.5
5.6
9.4
12.9
9.6
9.4
6.7
10.1
5.9
4.6
5.0
6.0
6.6
9.3
7.5
3.3
11.2
7.9
8.6
4.4
7.0
8.2
Re-vaccination.
21
10.4
10.8
23.7
4.2
19.9
10.9
24.3
14.7
13.0
15.5
14.5
9.4
28.4
11.7
11.6
19.8
9.2
8.2
17.0
19.2
19.4
15.1
10.1
15.7
3.3
5.6
9.1
7.1
16.3
7.6
1.1
5.5
5.0
15.0
6.6
10.9
8.9
12.2
Average
annual
number
of persons
successfully
vaccinated
during previous
5 years.
Number.
22
...
56,226
...
53,627
...
64,712
1,259,136
Ratio per 1,000.
23
...
32.0
...
30.8
...
30.5
31.8
Average
number of
deaths from
smallpox
during
previous
5 years.
Number.
24
...
632
...
642
...
446
17,090
Ratio per 1,000.
25
...
0.4
...
0.4
...
0.2
0.4
44
A.—VACCINE
Statement No. II showing the Cost of the Department
Number.
1
61
62
68
64
65
66
67
68
69
70
71
72
78
74
75
76
77
78
79
80
81
District.
2
Municipalities—cont.
Military
Canton
ments.
Municipalities.
3
Expenditure.
Assistant Director of
Public Health (Vacci
nation).
4
Srivilliputtūr... ... ...
Tadpatri...
...
...
Tanjore...
...
...
Tellicherry... ... ...
Tenali...
...
...
Tinnevelly...
...
...
Trichinopoly... ... ...
Tirupati ...
...
...
Tiruppattūr... ... ...
Tirūppūr... ... ...
Tiruvālūr... ...
Tiruvannāmalai... ...
Tuticorin... ... ...
Udamalpet... ... ...
Vāniyambādi... ... ...
Vellore...
...
...
Villupuram...
...
...
Virudhunagar... ... ...
Vizagapatam... ... ...
Vizianagram... ... ...
Walajapet...
...
...
Total of Municipalities.
Bangalore...
...
...
Secunderabad... ... ...
Total of Cantonments ..
Assistant Directors of
Public Health.
Grand total ...
...
...
...
..
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
1
1
Pay.
5
RS. A. P.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
13,914
13,914
8
8
0
0
Health
Inspectors.
Number.
6
...
...
...
...
...
...
*1
...
...
...
...
...
...
...
...
...
...
...
...
...
...
10
...
†1
l
...
277
Pay.
7
RS. A. P.
...
...
...
...
...
...
480 0 0
...
...
...
...
...
...
...
...
...
...
...
...
...
...
12,900 0 0
...
909
909
13
13
0
0
...
1,09,901 9
1
Vaccinators.
First class
8
...
...
1
...
...
1
...
...
...
...
...
...
1
...
...
...
...
...
1
...
...
59
1
1
2
...
208
Second class.
9
1
1
2
1
1
1
4
1
1
1
1
1
1
1
1
2
1
1
1
2
1
107
1
4
5
...
459
Probationers.
10
...
...
...
1
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
3
...
1
1
...
100
Pay.
11
RS.
342
287
870
486
360
750
1,494
412
360
547
218
490
818
327
383
671
420
491
901
726
379
69,780
660
1,825
2,485
A.
0
2
3
15
0
0
7
8
0
7
14
0
1
8
0
12
0
15
14
3
5
14
0
6
6
Peons, etc.
Number.
12
P.
0
0
0
3
0
0
6
0
0
0
0
0
3
0
0
10
0
11
7
7
8
6
0
0
0
...
3,10,036
0 0
...
...
...
1
...
1
...
...
...
...
1
...
1
...
...
...
...
...
...
...
...
38
...
5
5
...
308
Pay.
13
RS.
A. P.
...
...
...
155 0 0
...
144 0 0
...
...
...
...
12 0 0
...
162 0 0
...
...
...
...
...
...
...
...
7,295 13 8
...
621
621
3
3
0
0
...
22,165 10 11
Total pay of
establish-
ment.
14
RS.
342
287
870
641
360
894
1,974
412
360
547
230
490
980
327
383
671
420
491
901
726
379
89,976
660
3,356
4,016
13,914
4,56,017
A.
0
2
3
15
0
0
7
8
0
7
14
0
1
8
0
12
0
15
14
3
5
12
0
6
6
8
12
P.
0
0
0 3
0
0
6
0
0
0
0
0
3
0
0
10
0
11
7
7
8
2
0
0
0
0
0
* Sanitary Inspector for Vaccination Inspection.
† Superintendent of Vaccination.
‡ The average cost of each successful case was calculated on the total number of successful vaccinations performed by the Special
amount of recoveries made for wastage of lymph.
N.B.—In calculating the average cost of each successful case the pay and allowances of the Assistant Director of Public Health have
45
DEPARTMENT—cont.
in the Madras Presidency for the official year 1927-28—cont.
Paid from
Travelling
allowanæ.
15
RS. A. P.
...
...
...
23 2 0
...
57 9 3
...
23 5 8
...
...
30 0 0
...
...
...
...
...
...
...
...
...
...
567
240
180
420
2,524
1,33,620
8
0
0
0
2
0
0
0
0
0
0
4
Contin-
gencies.
16
RS.
24
8
77
22
13
134
50
0
15
16
18
11
73
2
110
50
42
68
114
38
50
8,665
A.
10
11
2
6
9
10
9
6
5
6
9
6
11
14
5
0
13
11
11
9
8
14
P.
9
0
3
6
0
1
8
0
0
6
0
0
0
0
0
0
6
4
6
0
6
7
...
105
105
69
38,103
0
0
1
4
0
0
5
3
Total cost.
17
RS.
366
280
947
687
373
1,086
2,025
436
375
563
279
501
1,053
330
493
721
462
560
1,016
764
429
99,210
900
3,641
4,541
16,507
6,27,741
A.
10
13
5
7
9
3
1
3
5
13
7
6
12
6
5
12
13
11
10
12
14
8
0
6
6
11
0
P.
9
0
3
9
0
4
2
8
0
6
0
0
3
0
0
10
6
3
1
7
2
6
0
0
0
5
7
Imperial
funds.
18
RS. A. P.
...
...
...
...
...
..
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
900 0 0
...
900 0 0
...
900 0 0
Provincial
funds.
19
RS.
A. P.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
16,507
1,86,714
11
10
5
2
Local funds.
20
RS. A.
P.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
3,37,274 12 11
Municipal
funds.
21
RS.
366
290
947
687
373
1,086
2,025
436
375
563
279
501
1,053
330
493
721
462
560
1,016
764
429
99,210
A.
10
13
5
7
9
3
1
3
5
13
7
6
12
6
5
12
13
11
10
12
14
3
P.
9
0
3
9
0
4
2
8
0
6
0
0
3
0
0
10
6
3
1
7
2
6
...
3,641
3,641
6
6
0
0
...
1,02,851 9 6
Total.
22
RS.
366
290
947
687
373
1,086
2,025
436
375
563
279
501
1,053
330
493
721
462
560
1,016
764
429
99,210
900
3,641
4,541
16,507
6,27,741
A.
10
13
5
7
9
3
1
3
5
13
7
6
12
6
5
12
13
11
10
12
14
3
0
6
6
11
0
P.
9
0
3
9
0
4
2
8
0
6
0
0
3
0
0
10
6
3
1
7
2
6
0
0
0
5
7
Number of all successful
primary vaccination and
re-vaccination.
23
1,335
463
2,646
1,078
794
2,728
6,076
616
594
663
727
905
1,931
433
714
2,024
569
2,072
1,442
1,311
450
143,750
849
6,941
7,700
...
1,466,813
Average cost, of each
successful case.
24
RS.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
A.
4
10
5
10
7
6
5
11
10
13
6
8
8
12
11
5
13
4
11
9
15
8
1
8
9
P.
5
1
8
2
6
4
4
4
0
7
2
10
9
2
1
8
0
4
3
4
3
9
0
5
4
...
‡0 6 8
Number.
25
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
Staff only, viz., Local Fund and Municipal Staff (Vide G.O. No. 1158 L,., dated 4th September 1911) and exclusive of Rs. 2,039-4-9 being the total
been excluded.
47
Statement No. IV showing the number of persons primarily vaccinated and the number of those persons who were successfully vaccinated in the Madras Presidency
in each of the undermentioned years.
Government vaccinators ...
Local Fund
do. ...
Cantonment
do. ...
Municipal
do. ...
Dispensaries ... ...
Medical Subordinates ...
Total ...
Persons primarily vaccinated in the Madras Presidency.
Total number.
Number success-
fully vaccinated.
1918-1919.
18,540
1,161,772
3,185
116,193
157
550
1,300,397
14,158
787,222
2,667
105,156
155
312
909,670
Total number.
Number success-
fully vaccinated.
1919-1920.
16,082
1,157,793
4,757
103,653
131
610
1,283,026
14,675
833,655
4,012
96,188
129
345
949,004
Total number.
Number success-
fully vaccinated.
1920-1921.
14,625
1,107,117
4,105
105,504
115
680
1,232,146
10,616
651,154
3,024
88,536
113
492
753,985
Total number.
Number success-
fully vaccinated.
1921-1922.
15,749
1,057,517
5,218
99,480
124
1,764
1,179,852
11,860
796,007
4,354
90,518
115
1,402
904,256
Total number.
Number success-
fully vaccinated.
1922-1923.
11,997
1,149,068
5,439
105,203
152
1,769
1,273,628
14,981
8,964,474
5,245
96,948
140
1,232
1,015,020
Total number.
Number success-
--lly vaccinated.
1923-1924.
20,959
1,270,638
5,859
113,237
148
1,188
1,412,029
16,852
1,149,187
5,850
109,620
143
842
1,282,494
Total number.
Number success-
fully vaccinated.
1924-1925.
21,275
1,298,064
4,204
116,000
2
1,342
1,440,887
19,629
1,226,452
4,275
115,688
2
1,267
1,367,313
Total number.
Number success-
fully vaccinated.
1925-1926.
24,284
1,248,458
5,264
115,486
...
576
1,394,063
22,270
1,167,748
5,320
115,099
...
423
1,310,860
Total number.
Number success-
fully vaccinated.
1926-1927.
30,055
1,240,915
6,282
122,535
749
2,658
1,403,194
26,610
1,156,949
6,230
122,008
711
2,239
1,314,747
Total number.
Number success-
fully vaccinated.
1927-1928.
33,869
1,281,914
5,749
118,443
129
2,011
1,442,115
30,651
1,195,691
5,674
118,038
125
2,003
1,352,082
13
Government
of Madras
LOCAL SELF-GOVERNMENT (PUBLIC HEALTH) DEPARTMENT
G.O. No. 1703-P.H., 21st August 1928
Vaccination—Annual Report of the Director of Public Health for
1927-28—Reviewed.
READ—the following paper :—
Letter from Lieut.-Col. A. J. H. RUSSELL, C.B.E., M.D., D.P.H., I.M.S.,
Director of Public Health, Madras, to the Secretary to Government, Local
Self-Government (Public Health) Department, dated Madras, the 20th June
1928, No. D. 21-V.
Order—No. 1703-P.H., dated 21st August 1928.
Recorded.
2. Good work has been done by the health staff in connexion with vaccina-
tion during the year under review. The mortality from smallpox declined from
9,816 to 7,610. The health staff continued to discover very large numbers of
children who have not been vaccinated. As many as 37,461 unregistered and
unprotected cases were detected in the Coimbatore District and 16,104 in the
North Arcot District against 15,000 cases detected in the two districts in the
previous year. The health staff discovered 32,666 such cases in the Tanjore
District, 20,137 in Vizagapatam, 15,657 in Malabar and 11,882 in Kurnool
districts. The Director of Public Health, in paragraph 4 of his report, has
specified several instances in which the union boards have failed to maintain
proper vaccination registers and to co-operate with the vaccination staffs in
improving vaccination. The Government trust that the boards concerned will
realize their responsibility in the matter and show better results in the current
year.
3. The total number of vaccination operations performed by all agencies
during the year under review was 1,970,382 against 1,948,062 in the previous
year. The number of operations performed in municipalities fell from 202,607 to
190,478. This decrease is reported to be mostly due to a fall in the number of
revaccination cases. Other reasons advanced are—
(i) increased difficulty in finding unprotected cases consequent on the
disposal of accumulated arrears ;
(ii) difficulty in maintaining revaccination work owing to decreased
incidence of smallpox ; and
(iii) the granting of leave to vaccinators without substitutes being
appointed, e.g., in Hospet and Cannanore.
The Government trust that the instances complained of in the two munici-
palities will not recur in future. The percentage of success for primary and
secondary vaccinations showed an increase of 1.1 per cent as compared with the
previous year. The Government are glad to note that the success rate during
the year under report, viz., 96.0, is the highest ever recorded and that this is due
to the continued high potency of the glycerine lymph issued by the King Institute
and also to the satisfactory work done by the vaccination staffs throughout the
presidency.
No. 1703-P.H., 21ST AUGUST 1928
3
the disease. The Director of Public Health is requested to submit this proposal
separately for consideration by the Government.
8. The Government regret to note that, in spite of the orders issued from
time to time, the presidents of certain local boards have shown little disposition
to co-operate with the District Health Officers or to accept their advice in matters
connected with vaccination. Vaccinators are for the most part still appointed,
transferred and granted leave without consulting the District Health Officers
concerned and local bodies generally seem reluctant to delegate to these officers
any powers in such respects, although wherever local boards, as in the case of
Bellary and Ghumsūr taluk boards, have made such delegation, it is reported
that no difficulties have been experienced. The example of these local boards is
commended to other presidents of taluk boards for general adoption.
(By order of the Government, Ministry of Local Self-Government (Public
Health) Department)
C. W. E. Cotton,
Secretary to Government.
To the Director of Public Health.
„ the Surgeon-General.
„ the Director, King Institute, Guindy, through the Surgeon-General.
„ the Inspector of Municipal Councils and Local Boards.
„ the Law (General) Department.
„ the Revenue Department.
„ the Board of Revenue (Land Revenue and Settlement).
„ the Director of Public Instruction.
„ the Accountant General.
„ the President, Corporation of Madras.
„ all Collectors and District Magistrates.
„ all Presidents of District Boards.
„ all Chairmen of Municipal Councils.
„ the Examiner of Local Fund Accounts.
„ the Assistant Quartermaster-General (with C.L.).
„ the Consul-General for Netherlands.
„ the Consul-General for Siam at Calcutta.
„ the Librarian, Legislative Council Library.
„ the Chief Editor, " Health and Welfare," Lucknow.
„ the Honorary Secretary, Local Self-Government Institute, Poona.
Editors' Table.
AGENTS FOR THE SALE OF MADRAS GOVERNMENT
PUBLICATIONS.
IN INDIA.
THE BOOK COMPANY, Calcutta.
THE BURMA BOOK CLUB (LTD.), 240-A, Merchant Street, Rangoon, Burma.
BUTTERWORTH & Co. (LTD.), 6, Hastings Street, Calcutta.
R. CAMBRAY & Co., Calcutta.
The Superintendent, DIOCESAN PRESS, Vepery, Madras.
E. M. GOPALAKRISHNA KONE, Pudumantapam, Madura.
HIGGINBOTHAMS (LTD.), Mount Road, Madras.
V. KALYANARAMA IYER & Co., Vellala Street, Vepery, Madras.
M. C. KOTHARI, Bookseller, Publisher and Newspaper Agent, Raopur Road,
Baroda.
THE LAW BOOK DEPOT (LTD.), 15 and 16. Francis Joseph Street, Madras.
G. C. LOGANADHAM BROTHERS, Madras.
THE MODERN STORES, Salem.
S. MURTHY & Co., Madras.
G. A. NATESAN & Co., Madras.
The Superintendent, NAZAIR KANUN HIND PRESS, Allahabad.
NIVASARKAR, Manager, " Hitawada," Nagpur.
P. R. RAMA IYER & Co., Madras.
RAMAKRISHNA & SONS, Lahore.
THE SRIVILLIPUTTUR CO-OPERATIVE TRADING UNION (LTD.), Srivilliputtur.
R. SUNDER PANDURANG, Kalbadevi Road, Bombay.
D. B. TARAPOREVALA SONS & Co., Bombay.
THACKER & Co. (LTD.), Bombay.
THACKER, SPINK & Co., 3 Esplanade East, Calcutta.
THE THEOSOPHICAL PUBLISHING HOUSE, Adyar.
THE UNIVERSAL PUBLISHING COMPANY, Bezwada.
THE UPPER INDIA PUBLISHING HOUSE (LTD.), Lucknow.
S. VAS & Co., Madras.
IN STRAITS SETTLEMENTS.
THE FEDERAL RUBBER STAMP Co., Penang.
NOTICE.
Official publications may be obtained in the United Kingdom
either direct from the office of the High Commissioner for
India, 42, Grosvenor Gardens, London, S.W. 1, or through any
bookseller.
REPORT
ON
VACCINATION IN THE MADRAS
PRESIDENCY
FOR THE TRIENNIUM ENDING 1928-29
MADRAS
PRINTED BY THE SUPERINTENDENT GOVERNMENT PRESS
1929
PRICE, 12 annas]
REPORT
ON
VACCINATION IN THE MADRAS
PRESIDENCY
FOR THE TRIENNIUM ENDING 1928-29
MADRAS
PRINTED BY THE SUPERINTENDENT, GOVERNMENT PRESS
1929
INDEX.
ADMINISTRATION
...
...
...
...
...
...
...
...
...
INSPECTIONS
...
...
...
...
...
...
...
...
...
...
VACCINATION STAFF
...
...
...
...
...
...
...
...
VACCINATION STATISTICS FOR THE LAST THREE TRIENNIA ... ...
VACCINATION SUCCESS RATES
...
...
...
...
...
...
...
VACCINATION IN DISTRICTS
...
...
...
...
...
...
...
VACCINATION IN MUNICIPALITIES
...
...
...
...
...
...
LYMPH WASTAGE
...
...
...
...
...
...
...
...
...
EXPENDITURE
...
...
...
...
...
...
...
...
...
...
INSPECTION OF VACCINATION OPERATIONS
...
...
...
...
SMALLPOX MORTALITY
...
...
...
...
...
...
...
...
ALASTRIM
...
...
...
...
...
...
...
...
...
...
SMALLPOX HOSPITALS
...
...
...
...
...
...
...
...
...
VACCINATION COMPLICATIONS
...
...
...
...
...
...
...
CONCLUSION
...
...
...
...
...
...
...
...
...
...
PARAS.
1—11
12
13 & 14
15 & 16
17
18—20
21—24
25
26
27
28—31
32
33
34
35
5
15. The total number of vaccinations performed by all agencies during the
last three triennia is shown below :—
Triennium
ending
1922-23
...
...
1925-26
...
...
1928-29
...
...
Number of
vaccination
operations.
4,804,613
5,911,588
...
...
5,926,477
...
...
Increase compared
with triennium
ending 1922-23.
Nil.
+ 1,106,975
+ 1,121,864
The marked increase in the outturn of work of the vaccination staff in the
last two triennia is a sufficient testimony to the activities of the District Health
staffs since the reorganization of the service in 1923.
16. The vaccination statistics for the individual years in the triennium under
report are shown below:—
Year.
1926-27
...
...
...
...
...
1927-28
...
...
...
...
...
1928-29
...
...
...
...
...
Total for the triennium ...
Primary and
secondary
vaccinations.
1,493,021
1,518,490
1,480,998
4,492,509
Revaccina¬
tions.
455,041
454,122
524,805
1,433,968
Total.
1,948,062
1,972,612
2,005,803
5,926,477
The decrease of about 37,500 in the primary and secondary operations in
1928-29 as compared with the previous year is more than compensated by the
increase of nearly 70,700 in revaccinations.
17. The accompanying statement shows the number of successful vaccina-
tions among the operations performed by the different agencies during the
triennium:—
Agency.
(1)
Local fund vaccinators ...
Government vaccinators ...
Municipal vaccinators ...
Cantonment vaccinators...
Dispensaries
...
...
Medical subordinates ...
Railways
...
...
...
Total ...
Number of successful vaccinations.
1926-27.
Primary
vaccination.
(2)
1,156,949
26,610
122,008
6,230
711
2,239
...
1,314,747
Revaccination.
(3)
91,466
1,992
34,548
1,323
133
4,637
...
134,099
1927-28.
Primary
vaccination.
(4)
1,195,591
30,651
118,038
5,674
125
2,003
271
1,352,353
Revaccination.
(5)
86,505
2,526
25,701
2,116
113
5,196
889
123,046
1928-29.
Primary
vaccination.
(6)
1,164,580
23,313
116,817
5,877
1,027
441
4,561
1,316,616
Revaccination.
(7)
101,238
4,227
30,769
2,212
484
3,602
1,182
143,714
Total number of successful
vaccinations in the
triennium.
Primary and
secondary.
(8)
3,517,120
80,574
356,863
17,781
1,863
4,683
4,832
3,983,716
Revaccination.
(9)
279,209
8,745
91,018
5,651
730
13,435
2,071
400,859
Total.
(10)
3,796,329
89,319
447,881
23,432
2,593
18,118
6,903
4,384,575
11
30. Thirty-five municipal towns were entirely free from smallpox ; the rest
reported in all 1,537 deaths during the year. The mortality was high in Madras
(391), Calicut (345) and Mannārgudi (199), these three towns alone accounting
for more than 60 per cent of the total deaths. Other towns in which the
epidemic was severe were Tellicherry, Proddatur and Negapatam, 70 to 80 deaths
occurring in each of these places.
31. Information of vaccinal condition has been furnished by Health Officers
in the case of 4,315 attacks and 914 deaths (among these cases) from smallpox.
These are classified below :—
All ages.
Among the vaccinated ... ... ... ...
„
unvaccinated
...
...
...
Total ...
Cases.
2,504
1,811
4,315
Deaths.
180
734
914
Fatality rate
per cent.
7.2
40.5
21.2
In the group of cases under consideration, the smallpox fatality rate in the
unvaccinated is more than 5½ times the rate among the vaccinated.
It should however be remembered that the immunity conferred by vaccination
begins to wane 7—10 years after the performance of the operations and that the
susceptibility to smallpox of vaccinated persons increases after the lapse of the
above period although it does not absolutely vanish. In order to judge the
efficacy of vaccination in protection against smallpox, the following table has been
drawn up showing the incidence of smallpox among 1,904 cases for which
information regarding age distribution has been furnished :—
—
Vaccinated
...
...
Unvaccinated ... ...
Age period.
0—10.
Cases.
168
229
Deaths.
3
65
Fatality
per cent.
1.8
28.4
10 and above.
Cases.
1,057
450
Deaths.
68
97
Fatality
per cent.
6.4
21.5
All ages.
Cases.
1,225
679
Deaths.
71
162
Fatality
per cent.
5.8
23.8
It will be seen from these figures that, in the case of children under 10 years, the
fatality rate among the unvaccinated is about sixteen times the rate among the
vaccinated; this table also shows that the fatality rate among the vaccinated
tends to increase with the lapse of time, constituting ample evidence of the
necessity for revaccination. This subject has been referred to in a previous
paragraph.
32. The Civil Surgeon, Vizagapatam Agency, has reported 7 non-fatal cases
of alastrim as having occurred during 1928-29 in Jeypore and Nowrangpur
ranges; the Municipal Health Officer of Tellicherry has also reported its occur
rence in the municipality, but the number of cases has not been stated. The
disease was not reported from any other part of the Presidency.
33. With reference to letter No. 1250, Health, dated 4th September 1925, of
the Government of India, the subjoined statement has been compiled showing
certain particulars regarding smallpox cases treated in the isolation hospitals and
wards in the Presidency during 1928-29. Three cases were treated in institutions
exclusively reserved for isolation of smallpox cases and 1,324 cases were treated
2-A
12
in sheds provided for infectious diseases in general. Information regarding
vaccinal condition could be ascertained only in 1,302 patients.—
(a) Vaccinated as evidenced by one or more cicatrices ... ...
(b) Stated to have been successfully vaccinated but no vaccination
cicatrices present ... ... ... ... ... ...
(c) Stated to be unvaccinated or unsuccessfully vaccinated but no
vaccination cicatrices present ... ... ... ...
(d) Previously unvaccinated but vaccinated during the incubation
period of smallpox ... ... ... ... ... ...
(e) Stated to have successfully re-vaccinated ... ... ...
757
51
445
22
27
1,302
34. A Committee appointed by the Ministry of Health of England to enquire
into the various factors associated with vaccination, preparation of lymph and other
similar subjects has submitted a report containing certain important recommen-
dations regarding technique of vaccination and other matters. The Committee's
report having been received in this office only very recently, there has not been
sufficient time to discuss with the Director of the King Institute how far these
recommendations can be adapted to suit local conditions. Necessary action will
however be taken at an early date.
35. Notwithstanding the various defects in the administration of vaccination
referred to in the report, the work of the vaccination staff during the triennium
under review has been on the whole one of progress, and 1 have to record my
appreciation of the co-operation of the chairmen of municipal councils and of the
presidents of local boards with the members of the Public Health Department,
but for which, the progress achieved would not have been possible.
OOTACAMUND,
Dated 16th June 1929.
N. R. UBHAYA, Capt., D.P.H.,
Acting Director of Public Health,
Madras.
13
ANNEXURE A.