4
TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1917-18 TO 1919-20.
affairs existed in Magwe. In Yamèthin the supervisor inspected 971 cases
only—but this was due to his employment in other directions. In Kyauksè
the supervisor was absent on sick leave for five months out of the twelve, but for
the seven months he was at work, he verified only 1,399 cases. The Northern
Shan States, Tavoy, Mergui, Sandoway, Ruby Mines and Myitkyina have all
shown less than 3,000 cases verified by supervisors and other inspecting officers.
The present class of supervisors are capable of doing quite useful work but
they themselves require supervision. Rarely can Civil Surgeons devote the
necessary time to this work, though generally speaking I think they might do a
great deal more than they have done in the past. A District Sanitary Officer,
one of whose duties would be the supervision of vaccination, is essential to place
the Department on a satisfactory footing.
8. Quality of the Vaccination.—The percentage of success in primary
vaccination was 97.53 in1919-20 as compared with 97.83 in 1918-19 and
95.88 in 1917-18.
Taking into consideration the length of time which lymph takes to reach
many of the stations—this is a very fair result, and I hope it represents the true
state of affairs, but in pessimistic moments I cannot help wondering how some
vaccinators in far away lonely places, with lymph sometimes 3 or 4 weeks old,
can get just as good results as are got in Rangoon or Meiktila, the two places
where lymph is always obtainable, fresh, vigorous and newly made. The Arakan
Division, until the end of the war and for some time afterwards, could only be
reached via Calcutta, and lymph supplies were always a fortnight and frequently
three weeks before they reached the vaccinators and perhaps another week
before they reached the patient. It is not therefore surprising that this Division
shows the lowest percentage of success, i.e., 93.07. On the other hand there
seems no reason whatever why Sandoway district with a percentage of success of
only 78.34 should be so much worse than any of the other districts in the Division.
As it is a matter of considerable importance to know how long lymph can
be depended on to retain in its vitality, a number of experiments were carried out
to test its longevity under the ordinary conditions to which it is subjected.
Unused returned lymphs which had been twice through the post and carried
about for a week or two by a vaccinator were tested. It was found that the lymph
retained its vitality for three weeks except during the months of March, April
and May, when a fortnight or even less was the usual limit. If kept longer there
was a slight but definite falling off in the fourth week and after that a rapid deteri-
oration. A few lymphs however showed remarkable and unexplained vitality—
giving good results when from one to four months old. But while such good
results are obtainable, that is not to say that the ordinary vaccinator will obtain
them, and practically speaking the earlier a vaccinator uses the lymph the more
likely is he to get good results. No vaccination should be done during the hot
weather months in stations where the lymph cannot be used within 10 or 12
days of its issue. A large number of failures dishearten both people and vacci-
nator, and unless in the presence of a small-pox epidemic, the risk should not be run.
9. Lymph Supplies.—All vaccine lymph used in the Province, outside
Rangoon, is made at Meiktila.
Four hundred and eighty-four calves were inoculated during the past year as
compared with 523 in 1918-19 and 435 in 1917-18.
The total number of doses issued was 1,068,553. The output per calf
being 24.06 grammes, or over 2,000 doses. The total output for the triennium
was 2,491,269 doses as compared with 2,179,724 in the preceding three years.
As usual there was a great deal of wastage ; some of this is unavoidable but
with better organization and greater care on the part of Civil Surgeons, the
wastage might be greatly reduced. The following stations have been the worst
offenders:—
Lashio
Pyu „ „
Myaungmya „
Tavoy „
Maymyo „
Kyaiklat „
wasted 81.2 per cent. of the lymph supplied.
64.8 „ „ „
55.6
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53.4
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48
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45
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