TRIENNIAL REPORT ON VACCINATION IN BURMA FOR THE YEARS 1896-97-1898-99.
17
rapidly and steadily declined. Excepting 1898-99, the decrease has been equally
marked both under primary operations and re-vaccinations throughout the period
dealt with in the table. This extraordinary falling off in the outturn of work from
year to year has been explained by the Health Officer to be for the most part only
apparent and not real as the accuracy of the figures of 1896-97 and the previous
years is, in his opinion, open to grave doubt. In part, however, the deficiency is
attributable to the compulsory vaccination of adults being put a stop to. The de-
crease in 1898-99 is exclusively owing to the fact that the vaccination operations
on convicts in the Central Prison, Rangoon, which hitherto used to be added to
municipal returns, have during that year been credited to dispensary vaccinations
in the Rangoon Town district.
Notwithstanding the large and continuous decrease in the quantity, the qua-
lity of the work has steadily improved. In primary cases the ratio per cent.
of successful operations has risen from 85.95 per cent. in 1895-96 to 96.91 per
cent. in 1898-99, whilst in the case of re-vaccinations the increase during the same
period has been from 45.35 to 80.42 per cent. Considering the large number of
operations performed the rate of success in re-vaccinations would seem to be
exceptionally high. The Health Officer attributes it to the improved quality of
glycerinated lymph paste prepared by him, but, even making due allowance for the
alleged potency of the lymph, I am unable to accept the explanation as thoroughly
satisfactory and am rather inclined to think that the exaggeration in part at least
was due to wrong classification.
25. The average cost of each successful case shows a progressive rise from
As. 3-4 in 1895-96 to As. 8-6 in the last year of the triennium. The explana-
tion of the large increase in the average cost lies no doubt in the very marked de-
crease in the outturn of the work done. For the same reason the average number
of persons vaccinated by each vaccinator fell from 7,080 in 1895-96 to 2,366 in
1898-99.
26. The details regarding the vaccination of infants under one year of age
are set forth in the following table:—
Year.
1895-96 ... ...
1896-97 ... ...
1897-98 ... ...
1898-99 ... ...
Number of
births during
the year.
3,457
3,103
3,176
3,314
Number of
deaths during
the year.
1,293
1,234
1,425
1,424
Number living
after deduct-
ing deaths in
coumn3
from column
2.
2,164
1,869
1,751
1,890
Number suc-
cessfully
vaccinated
during the
year.
1,665
1,724
1,218
1,507
Percentage of
successful
vaccinations
to total num-
ber of survi-
vals.
76.94
92.24
69.56
79.74
It is noticeable from the figures given in the foregoing statement that protec-
tion by vaccination to infants under one year of age falls considerably short of the
actual accession to population in each of the four years referred to in the table
above. Comparing the annual results the protection was highest in 1896-97
when it amounted to 92.24 per cent. of the total number of subjects available, and
lowest in 1897-98 when the percentage of protection was only 69.56. As regards
the children that escaped vaccination, the Health Officer is unable to give any
explanation, but presumes that a large number of them have either been removed
from the town or vaccinated by private practitioners. But seeing that the Vacci-
nation Act has been in force in Rangoon since February 1884 and vaccination
establishment at the command of the Health Department is adequate for all re-
quirements, the plea of inability to trace over 20 per cent. of the available subjects
would hardly seem to be satisfactory. It is, however, gratifying to note that the
Health Officer is trying to take steps with a view to enable him to account for
every survival in future.
27. Lymph supply.—With the exception of Mandalay, Bassein, Moulmein,
and Akyab, where locally prepared calf lymph was in use, the requirements of the
province were obtained from the Rangoon and Taunggyi vaccine depôts.
5