14
VACCINATION REPORT
The municipalities which showed a comparatively high, cost per successful
case are Peddapuram (As. 13-5), Kodaikānal (As. 12-6) and Tirupati (As. 9-1).
The lowest figure was reached by Calicut Municipality where it was As. 1-11.
The rate in Cannanore was As. 2-1, in Tuticorin As. 2-3 and in Vizianagram
and Madura As. 2-6.
(v) Vaccination was compulsory in all the municipalities. The total number
of operations performed during the year is 195,110 against 174,810 in 1916-17,
i.e., there is an increase of 20,300 operations. The municipalities which show a
marked increase in the number of operations over the previous year are Madura,
(+14,140) and Cochin (+2,168). The towns which show a large decrease in this
respect are Madras (— 3,090) and Cocanada (— 1,541). The fall in Madras City
is attributed to the very large number of re-vaccinations performed in 1916-17
during the prevalence of an epidemic of smallpox there, and in the Cocanada
Municipality it is reported to be due to the reduction of the minimum fixed for
vaccinators, an explanation which can hardly be accepted as satisfactory.
(vi) The following table exhibits the comparative success obtained by the.
use of different kinds of lymph in primary vaccination (including secondary):—
Number of cases
excluding
unknown.
1,196,909
...
1,02,252
22,693
Area.
Local Fund ...
Do. ...
Municipalities ...
Do. ...
Kind of lymph.
Lanoline lymph ...
Glycerine „
...
Lanoline
„ ...
Glycerine „ ...
Whence obtained.
Supplied by the King Institute,
Guindy.
Do.
Do.
Do.
Percentage of
success.
82.6
...
89.3
98.3
The percentage of success from lanoline lymph was 82.6 in 1917-18
against 86.2 in 1916-17 in Local Fund areas and 89.3 and 92.2, respectively
in municipalities. On the other hand glycerine lymph showed an increased rate
of success of 98.3, against 96.8 in the previous year. The supply of glycerine
lymph is practically confined to the Madras City and all glycerine lymph supplied
is freshly prepared.
(vii) 34,958 deaths from smallpox were reported during the year 1917
against 21,903 in 1916. This means that there has been a considerable increase in
the number of deaths from smallpox in 1917 over that of the previous year. The
districts of South Arcot, North Arcot, Malabar, Madura, Vizagapatam, Tanjbre,
Coimbatore, Kistna, Guntūr, Rāmnād and Nellore reported large number of deaths
from smallpox. I may observe that all these districts with the exception of;
Tanjore were inspected by me and the district authorities were acquainted with
the poor state of vaccination existing there. The agencies employed for reporting
outbreaks of infectious diseases in villages are still very mperfect. It is often
weeks and months before the report of the village official reaches the proper
quarter. A more strict enforcement by the district authorities of the provisions
in the Board's Standing Order No. 102 seems highly necessary.
(viii) The Deputy Inspectors of Vaccination, Kavali (32.0), Pattukkōttai
(49.0) and Calicut (49.5) failed to verify the minimum of 50 per cent of the cases
vaccinated within their ranges. Of these the shortage in Calicut and Pattukkōttai
is small and the Deputy Inspectors have accounted for it satisfactorily. The
Deputy Inspector of Vaccination, Kavali range, is being dealt with suitably for his
neglect.
(ix) During the year under report one Deputy Inspector of Vaccination
was dismissed from service for submission of false diaries and returns, one was
removed from service for continued neglect and incompetence, one was reduced,
one was suspended and several were fined for serious irregularities of one sort or
another. Of the 86 Deputy Inspectors borne on the Provincial list 80 are quali
fied or Certificated Sanitary Inspectors, the remaining are either exempted men
or those specially selected for these posts before the present rules came into force.
The service registers of all the Deputy Inspectors of Vaccination are being verified
in the office of the Sanitary Commissioner for Madras.