5
of plague in 1916-17 is said to have retarded vaccination, but I am of opinion
that want of proper supervision and the consequent neglect of the vaccinator are
also responsible. During my recent tours of inspection, I found vaccination work
very unsatisfactory in several of the important towns. The vaccinators' registers,
especially the birth registers, were incomplete ; no careful note was made of the
unvaccinated children, who therefore escaped notice. In fact no organised
attempt was made to enforce the Vaccination Act. I hope Civil Surgeons
will use their best endeavours and get as many of the unprotected children as
possible vaccinated before the commencement of the next vaccination
season. It is no use expecting much help from the Municipal authorities.
It the vaccinators' registers are carefully kept and up to date, a notice through
the Municipal authorities will bring the person responsible to the vaccination
station, and if the notice fails, prosecution should be instituted without delay, so
as to punish the offender, but the punishment to be effective should be heavy in
a few selected cases.
20. The provisions of the Vaccination Act were, during the triennium,
extended to the towns of Etawa in the Saugor district, Sohagpur and Itarsi in
Hoshangabad, Betul and Multai in Betul, Sindi in Wardha, Khapa and Katol
in Nagpur, Gondia in Bhandara,Bhatapara in Raipr and Drug in the Drug District.
Deaths from small-pox and
the proportion of persons
protected by vaccination.
APPENDIX B.
21. It is satisfactory to note that small-pox has declined considerably during
the past few years. There were 6,174 deaths from this
disease in 1913-14, which fell to 3,133 in the following
year, while in the next two years they numbered 865
and 292 only, and some districts, such as Saugor,
Jubbulpore and Chhindwara, remained free. The disease still persists in the
Chhattisgarh and Berar districts, and unless systematic efforts are made on the
lines indicated in previous reports, and a larger proportion of the population is
protected by vaccination and revaccination, it is difficult to eradicate the
scourge. The protection afforded now-a-days—38.93, 38.71 and 36.05 per
1,000 of population in the past three years—is too low to control it.
22. Lieutenant-Colonel Kenrick writes: " I consider revaccination, as
practised by the District vaccinators, to be of very little use. For troops,
institutions as Jails, schools, etc., and during small-pox epidemics, it is of
undoubted value, but the amount of protection afforded to the district as a
whole by the revaccinations performed by the vaccinators during their ordinary
tours, is insignificant.
Some circles show year after year extremely few
revaccinations, nevertheless they remain practically free from small-pox."
Small-pox is a disease with decided peculiarities. It remains quiescent for
many years, then suddenly flares up in widespread outbreaks, which carry off
many adults and adolescents. It is to prevent this that revaccination is
necessary. It is a fallacious idea that infant vaccination confers life-long
immunity from the disease: it affords protection for 7 to 10 years only. If
re-vaccination is to make headway, it must be enforced at all Government,
Municipal and Local Board schools.
General remarks.
23. Several improvements were effected during the
triennial period :—
(1) The rotatory lancet used in the Bombay Presidency, was introduced into this
province. It is highly spoken of by almost all Civil Surgeons who used it.
It is easier to work and produces a very satisfactory vesiculated area.
(2) The village records were ordered to be kept in the form of a register and not in
loose sheets, which used to get lost.
(3) The pay of the staff has been raised and their usefulness considerably improved.
The men have now to undergo a special training in vaccination, hygiene,
epidemiology and vital statistics.
During the triennium, as many as 70 vaccinators were trained at the Central
Vaccine Depôt by the Assistant Superintendent of the institution, who
receives Rs. 10 from District Funds per vaccinator trained. The men in the
Central Provinces are now content and happy, but in Berar the pay does not
seem to attract suitable men.