NOTES AND STATISTICS ON VACCINATION IN BURMA FOR THE YEAR 1912-13.
3
personal supervision given by the Civil Surgeon, Pegu, to vaccination, has for years
past been only nominal. A special enquiry is being made into the condition of
vaccination in these localities.
The Civil Surgeon, Pyapôn, does not appear to have verified a single case
of vaccination during the year. It is not difficult to account for the alleged
hostile attitude of the people of the district to vaccination if this is the policy
of the Superintendent of the District Vaccination Staff.
10. Inoculation.—Inoculators of small-pox have been active in many districts.
In Thatôn, Pyapôn and Pegu Districts outbreaks of epidemic small-pox were
directly traced to their action. Inoculators were convicted and fined in Pegu,
Magwe and Myaungmya Districts and one was sentenced to 9 months' imprison-
ment in Bassein District.
As evidence of the rapid progress that can be attained as the result of active
support given by the Deputy Commissioner and his Assistant District Officers in
the promulgation of vaccination in a district where the people had for years been
described as antagonistic to the operation, and where a negligible number of
operations were being performed annually, I cannot do better than detail the
success gained in Ma-ubin District under the able direction of the present Deputy
Commissioner Captain A. B. Roberts, I.A., who has taken the greatest interest in
the work of this Department. For two years the District Vaccinators have been
working in direct touch with the Subdivisional and Township Officers, with the
result that the total number of successful operations performed annually has risen
from 5,371 in 1910-11 to 13,173. The successful primary operations have risen
from 5,219 to 12,955 in the same period. The number of primary cases verified
by the Civil Surgeon was in 1910-11, 833, and in 1912-13, 2,321 which however
falls short of the verification work performed by him in the year 1911-12 by 518.
The personal attention devoted by Mr. Hollingsworth to verification of results has
had the important result of proving that the returns submitted by the Native Staff
of successful operations have not been to any extent exaggerated, and that the
figures recorded indicate solid progress.
11. Protection afforded by Vaccination.—It is unfortunate that the materials
available for the study of this most important and interesting subject are extremely
meagre and of doubtful trustworthiness. As to the condition of protectedness
against Small-pox before the attack of most sufferers no record is available. The
greater number of Small-pox patients are never seen alive by a Medical Officer,
and many others are seen too late in the course of the disease for the marks of
vaccination to be detected if present. But even in those instances where care is
exercised to note at the time of registration of the seizure or death whether the
patient had previously been vaccinated or had been otherwise protected from
Small-pox, the entry does not always contain the whole truth. Thus in the early
months of 1912 when Small-pox was widespread in Prome Town practically every
apparently healthy infant found in a house-to-house search was compulsorily
vaccinated under the Vaccination Act. The return of deaths quoted in last year's
Vaccination Note (paragraph 9, page 4) shows that 41 children of ages between
six months and two years died, of whom 14 only had been vaccinated. It is
probable that several, possibly nearly all, of these 14 young children had but just
been vaccinated before they developed Small-pox, too late for the prophylatic
results of the operation to come into effect.
The Health Officer, Rangoon, reports that in the epidemic of Small-pox
which occurred in that town in 1912 some 352 of the cases (persons of all ages)
were said to have been vaccinated once, and of these III or nearly a third, died ;
118 had been vaccinated twice, and of these 8 died, and of 145 unvaccinated
persons 69 died. The percentage deaths amongst the once vaccinated were
31.53, amongst the twice vaccinated 6.78, and among the unvaccinated 47.59.
Among children under five years of age 9 out of 38 vaccinated, died, or
23.68 per cent. and there were 20 fatal cases among 21 unvaccinated infants, or
95.24 per cent. Thus in the first five years of age the advantage on the side of
the vaccinated person over the unvaccinated is just over 4 to 1, while in later life
the once vaccinated person has an advantage over the unvaccinated of only 1.5
to 1; the advantage possessed by the twice vaccinated over the unvaccinated
is as 7 to 1.
But these returns are very incomplete. It appears probable that none of the