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Some Points in the Epidemiology of an Outbreak of Cerebro-spinal Fever in Hong Kong, 1918

Published online by Cambridge University Press:  15 May 2009

A. M. Gale
A. M. Gale
Affiliation:
Acting Medical Officer of Health, Hong Kong, 1918.
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1. That there is reason to believe that sporadic cases of cerebro-spinal fever occurred in Hong Kong previous to the outbreak of the epidemic in 1918.

2. That the epidemic followed a widespread infection of influenza colds.

3. That the mortality out of a total of 1040 cases was 85–48 per cent.

4. That the most susceptible age was found to be the age period under five years.

The younger the individual, the greater the susceptibility, with the added proviso that the extremes of life suffered most.

5. That once the epidemic was established, a drop in the temperature, steadily maintained, accompanied by an increase in the saturation of the air as regards moisture, associated with a lack of sunshine, was found to be followed after a lag of a few days, by a rise in the number of cases. This lag showed a tendency to increase as the epidemic progressed, from three to four days at the beginning to six to seven days at the end of the epidemic.

6. That the number of cases in any given area varied directly with the overcrowding in that area, and this bears out the contention that overcrowding is one of the most important features in the epidemiology of cerebro-spinal fever.

7. That the housing conditions in Hong Kong are such as to necessitate immediate action on the part of the Government, to safeguard the public health of the colony.

8. That new entries to Hong Kong formed a large proportion of the cases, and that this appears to be an important factor in the epidemiology of the disease.

9. That the poorest, most hard worked and badly housed portion of the community suffered most in the epidemic.

10. That the recognition and isolation of carriers is impracticable in an epidemic of any considerable dimensions.

11. That in the present condition of the knowledge of the means by which infection is spread, the wearing of a screen composed of some impervious material such as celluloid would seem to afford complete protection to the wearer against droplet infection.

12. That known carriers should be compelled to wear this screen until such time as they are proved free from the meningococcus. Thus protected, the carrier could pursue his usual avocation and the community be safeguarded from infection at a minimum of expense.

Type
Research Article
Information
Journal of Hygiene , Volume 20 , Issue 3 , November 1921 , pp. 289 - 318
Copyright
Copyright © Cambridge University Press 1921

References

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