2
NOTES ON THE STATISTICS OF VACCINATION IN BURMA FOR THE YEAR 1899-1900.
Commissioner remarked that " it is desired that vaccinators should as far as
" possible confine their energies to primary operations until they have overtaken
" the annual increase of population by births, and this goal is far ahead except in
" large towns." This remark is as applicable today as it was four years ago.
Vaccinators will be required to give more particular attention to primary vaccina-
tion for the present.
By efficient vaccination in infancy most people are completely insured for
their whole lifetime against an attack of small-pox, and, in the proportionately
few cases where the protection is less complete, small-pox, if it be caught, will,
in consequence of the vaccination, be so mild a disease as not to cause death nor
disfigurement. Such being the almost perfect security which well-performed in-
fantile vaccination confers against death from small-pox, it is therefore a matter
of the utmost importance that infantile vaccination should be first of all strictly
enforced and the most scrupulous care taken as to the complete and perfect per-
formance of the operation. In a certain proportion-of the cases, on account of
unskilful or bad vaccination, partial protection only results, but this remnant of
danger is not great, and, if the annual births are but steadily and efficiently
vaccinated, the still considerable small-pox mortality of this province will soon be
reduced to a small fraction.
(c) Percentage of success.—The percentage of successful cases in primary
vaccination is the same as that returned for the year 1898-1899, namely, 94.71 ;
in re-vaccinations the percentage has fallen from 59.55 to 58.72. The success re-
ported as obtained in primary cases ranges from 98.76 in the Minbu district and
98.64 in Rangoon to 74.90 in the Southern and 62.30 in the Northern Shan
States. The low rate of success in the Shan States is attributed to the unsatis-
factory quality of the glycerinated lymph manufactured at Taunggyi.
In re-vaccinations the rate of success ranges from cent. per cent. in Thatôn
and Salween, 92.49 in Shwebo, 84.96 in Magwe,.and 81.82 in Thôngwa districts
to 15.45 in the Upper Chindwin, 13.89 in Myitkyina, and 7.33 in Sandoway
districts. The majority of Civil Surgeons submitting these returns are of opinion
that no abnormal results have been obtained. The regulations issued by the Privy
Council in 1859 point out that when persons who have once been efficiently vac-
cinated are re-vaccinated some years afterwards, the results in some instances
cannot be distinguished from the perfect results of primary vaccination. But far
more usually the results are more or less modified by the influence of such previous
vaccination. Often no true vescicle forms, but merely papular elevations surround-
ed by areola, and these results having attained their maximum on or before the
fifth day, afterwards quickly decline. The various district results obtained point
to the conclusion that proper judgment is not exercised in discriminating between
the perfect and modified vescicle, which alone is indicative of success. When
primary vaccination has been efficiently performed, more than 25 per cent. of suc-
cess in re-vaccination may not be looked for.
(d) Protection to population.—The mean ratios of persons protected per
1,000 of population for
the province has risen from
53.03 in 1898-99 to 55.56
in the year under report.
The ratios ranged as shown
in the margin. These
variations are remarkable and, inasmuch as they throw doubt upon the accuracy
of the returns, no useful comparison can be made.
Maximum.
District.
Tavoy ... ... ...
Sandoway...
...
...
Ruby Mines ... ... ...
Kyaukpyu...
...
...
Ratio.
228.84
189.89
141.48
95.30
Minimum.
District.
Akyab... ... ...
Myitkyina... ... ...
Southern Shan States... ... ...
Northern Shan States... ... ...
Ratio.
19.42
15.17
8.66
6.49
Vaccination and small-pox mor-
tality.
(a) Quinquennial periods.
3. Table showing the ratio per 10,000 successfully vaccinated and the
mortality from small-pox by quinquennial periods for
Lower Burma only is given in compliance with
orders contained in Local Government's General De-
partment letter No. 411-4Z.—3, dated the 18th August 1893.