TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1917-18 TO 1919-20.
3
period of his life is " protected " and cannot be vaccinated. The definition is
founded on the old belief that one vaccination in infancy was sufficient to render
an individual immune for life. The fallacy of this belief is now well known, but
the definition founded on it has never been altered.
It cannot be too often or too strongly repeated that an adult who has been
vaccinated once in infancy is an " unprotected " person, whatever the law may
say to the contrary.
Tens of thousands of these unprotected coolies arrive annually in Rangoon,
not only bringing the disease with them, but forming a huge susceptible popula-
tion for the spread of small-pox. Practically the whole of the patients suffering
from small-pox in the Contagious Diseases Hospital are Indian coolies, and the
burden of looking after them falls on this Province.
Out of 236,139 passengers inspected only 6,455 or 2.73 per cent. were
" unprotected " in the eyes of the law, and only this handful could be vaccinated.
3. Vaccination in Towns.—Twenty-nine towns show an increase and 29 a
decrease in primary vaccination during 1919-20 as compared with 1918-19.
Amongst the former are Bassein, Myaungmya, Yamèthin, Kawkareik, Nattalin and
Letpadan. Rangoon, Kyaiklat, Mandalay, Bhamo and Pyinmana show a decrease.
The percentage of success obtained in Primary vaccination in towns was
98.31 per cent. This is not a good result, as shown by the fact that in 14 towns
the success was 100 per cent. Moulmein stands at the bottom of the list with
86.48, which can only be due to downright bad workmanship. All towns can
use their lymph within a week of its issue from the Vaccine Depôt, when its
potency is at its highest and there ought to be no such thing as a failure except in
those rare cases where the patient is insusceptible to vaccination.
Re-vaccination in towns shows an increase on the preceding year of
16,564 cases.
4. Infant Vaccination in Towns.—In 59 towns 21,619 infants were success-
fully vaccinated in 1919-20, of which 19,502 were registered as having been born
in the towns in which they are vaccinated. The difference of 2,117 infants
represent immigrants into the towns from the surrounding districts and also
probably a number of infants whose births were never registered. A low propor-
tion of available infants were vaccinated in Thôngwa, Zigôn, Letpadan,
Gyobingauk, Shwedaung, Kyaiklat, Moulmein, Mandalay and Maymyo.
5. Dispensary Vaccination.—There has been an increase of 6,757 cases as
compared with the previous triennium—about one half of this increase occurred in
Katha district, where the Sub-Assistant Surgeons at Tigyaing and Mohnyin
appear to have taken a good deal of interest in the work. A good deal more
could be done in the smaller Hospitals and Dispensaries by the exhibition of a
little energy.
6. Vaccination in Fails.—A total of 27,248 vaccinations were done in 1919-
20 of which 2,873 are described as primary with a percentage of success of
57.06. This low figure is accounted for by the difficulty which often arises in
finding out whether a prisoner has been vaccinated or not. If there are no
marks either of vaccination or small-pox—he is described as a primary case,
although he may have had mild small-pox or been vaccinated many years before
and should really be classed as a re-vaccination.
7. Verification of Primary Vaccinations.—Civil Surgeons inspected 11.09
per cent. of primary vaccinations as compared with 13.68 and 12.6 in the two
previous years. The Lower Chindwin District with a percentage of 55.5 heads
the list. Next in order come the Putao 36.5, Ruby Mines 35.7, Kyauksè 29.8,
Yamèthin 28.3, Myaungmya 27.2, Sandoway 26.64 and Tavoy 25.1.
The average percentage of success in the cases inspected by Civil Surgeons
was 95.17, by Supervisors 96.12, and reported by vaccinators 97.53.
Supervisors verified an averageof 4,987 cases each of primary vaccination or
41.5 per cent. of the total. The amount of work done by these men varies in a
most unaccountable way. In Amherst, not an easy district to tour in, 13,430
cases were verified. In Pegu and Insein over 10,000, in Thatôn, Tharrawaddy,
Bassein, Myaungmya, Hanthawaddy over 9,000. In Katha only 987 cases were
verified as the supervisor resigned and could not be replaced. A similar state of