TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1914-15 TO 1916-17.
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1917, 30 deaths having been registered up to the end of March. Revaccination
returns show a great increase of 3,409 on the previous triennium, 1,925 operations
having been performed in 1916-17 alone.
Thatôn District returns a decrease of 7,573 primary and 4,758 revaccinations.
The maximum output (14,709 primary operations) was reached in 1912-13 as a
result of serious outbreaks of small-pox in that and the two previous years—the
decline commenced in 1913 (9,901 primary operations) and continued in spite of
260 deaths from small-pox being recorded in that year, and 41 in 1914; only
9,954 operations being returned for 1916-17. The organization of vaccination
work in this district is manifestly unsatisfactory, and must be improved.
The work of Toungoo District has shown a most satisfactory improvement
during the triennium, an increase of 8,922 primary operations and 802 revacci-
nations being recorded. The output of primary operations in the last year, 1916-17,
was 13,224, the high-water mark of work in the six years, though practically
equalled by that of 1914-15. The last serious small-pox outbreak in the district
occurred in 1911. The improvement, starting from 1914, is to be attributed to
the supervising work of the Assistant Health Officer, transferred to military duty
early in the war, and to the increasing interest shown in vaccination by Civil
Surgeons recently appointed to the district.
Mandalay Division.—Primary vaccination shows a relatively small decrease
of 1,492 operations (1.84 per cent.) and revaccination, of 14,250 (59.52 per cent.)
during the last triennium. The newly-created district of Putao submits returns
of vaccination for the first time, 242 having been performed during 1916-17. Of
the other five districts, Mandalay shows an increase of 4,888 primary operations
and a decrease of 13,010 revaccinations. The last small-pox outbreak occurred
in this district in 1913. Bhamo and Katha Districts return a deficit of 2,842 and
4,599 primary operations respectively. Ruby Mines and Myitkyina Districts
show a small increase in primary operations of 78 and 741, and the last-named
district an increase of 379 revaccinations.
Sagaing Division.—The work of vaccination has been almost uniformly good
throughout the division, all four districts showing an increase in primary vacci-
nation aggregating 6,846 on the previous triennium. The decrease in revacci-
nation, 16,212, to which deficit Sagaing contributed 50 per cent., is accounted for
by the absence of small-pox in the three most populous districts. There was an
increase of 343 revaccinations in the Upper Chindwin District. Steady progress
was made in Shwebo District during the triennium, the last year 1916-17 showing
a total of 12,753 primary operations. Work in Sagaing District fluctuated slightly,
the maximum outturn being 13,422 primary operations in 1914-15, the year
following the last epidemic of small-pox in the district.
In Lower Chindwin District the work shows a slightly progressive upward
tendency. The two last-named districts appear to be relatively well protected
against small-pox, no extensive outbreaks having been reported during the last
thirteen years. In Upper Chindwin District the outturn of work has maintained a
fairly even level during the last four years, 1916-17 showing the best results for
the triennial period. Shwebo shows the lowest returns numerically in respect to
population, and some added stimulus is needed to the vaccination work of this
district.
Magwe Division.—The grave deficit of 35,452 primary operations is returned
for Magwe Division, which is by no means retrieved by the small advance of 1,605
revaccinations. The worst defaulting districts are Minbu and Magwe, which
shows respectively decreases of 10,247 and 17,498 primary operations, but
Pakôkku had 5,508 less primary operations and Thayetmyo 2,199 less than in the
earlier triennium. The last small-pox epidemic visited these districts in 1912, and
that year saw the zenith of vaccination activity in all the districts. Vaccination
has since consistently declined year by year in Magwe District, from 20,143 in
1912-13, to 12,401 in 1916-17 In Minbu District the returns fell steadily from
14,037 in the epidemic year to 7,368 in 1915-16, with a slight recovery in the
last year of the second period. In Pakôkku District the fall has been from 21,346
to 16,898 in 1916-17, about 1,000 less than the previous year. In Thayetmyo
District the decrease is less marked, the fall from the maximum of 11,539 to 9,343
in 1916-17 being marked by fluctuations in intermediate years.
Meiktila Division.—The deficit in primary operations for the last triennium
is 14,628 and in revaccinations 4,815. Of the four districts Kyauksè alone shows
an increase of 141 primary operations, while Yamèthin returns an excess of 2,837
revaccinations. Myingyan has a deficit of 7,884 and Meiktila of 5,771 primary
operations. The last outbreak of epidemic small-pox in this division was in 1913,
but in Myingyan the mortality from the disease was higher in 1912, and Yamè-
thin returned its highest mortality from small-pox (262 deaths) in 1911. During
the last thirteen years there has been little small-pox mortality recorded in
Kyauksè District, and since the district is easily supervised and vaccination work
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