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 PROVINCE OF BRITISH COLUMBIA
Division of
Venereal Disease Control
Department of Health and Welfare
ANNUAL REPORT
For the Year 1951
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1952  TABLE OF CONTENTS
Page
1. List of Tables     4
2. List of Charts     4
3. Organization Chart     5
4. Introduction     7
5. Treatment     8
6. Epidemiology     8
7. Social Service    9
8. Education  10
9. General  11
10. Statistical Section  12 STATISTICAL SECTION
Table
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.
XIII.
XIV.
XV.
XVI.
XVII.
XVIII.
LIST OF TABLES
New Notifications of Venereal Infection and Rate per 100,000 Population,
1942-51	
New Notifications of Venereal Infection Compared with Reported Cases of
Certain Other Notifiable Diseases in Canada, British Columbia, and
Greater Vancouver, 1951	
New Notifications of Venereal Infection Classified According to Diagnosis,
Sex, and Source of Reporting of Notifications, British Columbia, 195L.
New Notifications of Venereal Infection Classified According to Diagnosis,
Sex, and Age-groups, British Columbia, 1951	
New Notifications of Syphilis by Age and Sex, British Columbia, 1951	
New Notifications of Gonorrhoea by Age and Sex, British Columbia, 1951	
Rate per 100,000 Population for Total Venereal Disease by Age-groups,
British Columbia, 1942-51	
New Cases of Syphilis Reported in British Columbia by Age-groups and
Marital Status, 1951	
Page
13
14
15
16
18
19
20
21
Total Primary and Secondary Syphilis, British Columbia, 1951... _ 21
New Notifications of Venereal Infection Classified According to Diagnosis
and Place of Residence, British Columbia, 1947-51  23
Patient-visits at All Clinics of the Division of Venereal Disease Control
Classified According to Diagnosis, 1942-51  29
Report of Laboratory Work Done by the Division of Laboratories Relating
to the Diagnosis and Treatment of Venereal Disease for All Agencies
in British Columbia, 1947-51  30
Free Medications Distributed to Private Physicians by the Provincial Department of Health and Welfare for the Treatment of Venereal Disease,
British Columbia, 1937-51  31
Places of Meeting Reported as Facilitating the Spread of Venereal Disease,
1947-51___.  32
Places of Exposure Reported as Facilitating the Spread of Venereal Disease,
1947-51  32
Contacts to Venereal Infection Classified According to Investigating Agency
and Result of Investigation, British Columbia, 1951  33
Contacts to Venereal Infection Classified According to Investigating Agency
and Result of Examination, British Columbia, 1951   33
Incidence and Rate per 100,000 Population of Total Venereal Disease,
Gonorrhoea, and Syphilis, by Quarters, British Columbia, 1947-51  35
LIST OF CHARTS
Chart
I. New Notifications of Venereal Infection and Rate per 100,000 Population by
Diagnosis, Reported by All Agencies, British Columbia, 1942-51  12
II. New Notifications of Syphilis by Age and Sex, British Columbia, 1951  18
III. New Notifications of Gonorrhoea by Age and Sex, British Columbia, 1951  19
IV. New Notifications of Venereal Infection and Rate per 100,000 Population,
British Columbia, 1941-51  20
V.
VI.
Patient-visits at All Clinics of the Division of Venereal Disease Control Classified
According to Diagnosis, 1942-51  29
Free Medications Distributed to Private Physicians by the Provincial Department
of Health and Welfare for the Treatment of Venereal Disease, British
Columbia, 1937-51  30 o
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u  DIVISION OF VENEREAL DISEASE CONTROL
ANNUAL REPORT FOR THE YEAR 1951
C. L. Hunt, M.D., Director
INTRODUCTION
There has been a slight decrease in the total number of venereal-disease cases
reported during the year 1951. Early infectious (primary and secondary) syphilis has
now become a comparative rarity in British Columbia, only thirty-two cases having
been reported during the year. Indeed, the infection rate per 100,000 population in
this Province is now the lowest in Canada. The number of syphilis cases reported in
the later stages has also decreased markedly in spite of sustained efforts at case-finding.
The policy of overtreating all cases of gonorrhoea with massive doses of penicillin
to eliminate any possible concomitantly acquired syphilis has been maintained. This
appears to have been justified if the extremely low incidence of early infectious syphilis
can be used as a measure of its success. Private physicians throughout the Province
have given their whole-hearted support to this policy.
There has been a slight but definite increase in the number of cases of chancroid
among mariners and in service personnel returning from the Far East, but most, if not
all, cases have been detected on arrival, and there has been no evidence of increased
spread of this infection among the general population.
The incidence of reported cases of gonorrhoea has shown a small decrease in spite
of better co-operation on the part of private physicians in notifying their cases. Divisional clinics still continue to play a major part in notification and treatment of venereal
disease, though the proportion of cases notified by private physicians has markedly
increased during the past year. This increased reporting by private physicians is apparent
in all parts of the Province and is not limited to the metropolitan areas.
Highly qualified consultants in various fields of medicine continue to be employed
by the Division, and consultative service on problems relating to venereal disease is given
extensively to private physicians throughout the Province.
Free drugs are made available to physicians for the treatment of any notified case
of venereal disease. In order to make these drugs more readily available to those physicians practising in outlying areas, stocks are held by all directors of health units and
by some of the more remote hospitals for local distribution.
Besides the convenience afforded to physicians, this policy enables directors of
health units to maintain a closer association with the health problems in their own
spheres of activity.
It is becoming increasingly evident in this Division that non-specific urethritis of
venereal origin is presenting a problem of growing importance. The actual cases
notified are few, but this is due in some measure to the comparatively large number
of cases which are diagnosed as gonorrhoea on clinical grounds but in whom smears
and cultures are negative. Most of these patients show a notable lack of response to
normal methods of treatment for gonorrhoea. These cases represent approximately 11
per cent of those treated for gonorrhoea at the Vancouver clinic. G 8 DEPARTMENT OF HEALTH AND WELFARE
Investigations into the causes of non-specific urethritis have not tended to clarify
the problem, for the causes are many and varied, with no single type of treatment being
universally successful.
Further consideration is being given to this problem, which appears to be causing
concern in many other centres of venereal-disease control throughout North America.
TREATMENT
Treatment schedules for the various stages of syphilis and for gonorrhoea were
reviewed periodically through the year, with the object of maintaining the highest standards available in the light of current knowledge.
The use of arsenic in the treatment of syphilis has been entirely discontinued, and
bismuth is being used in only a few specially selected cases as a preparatory form of
treatment before commencing penicillin.
Penicillin is the treatment of choice in all stages of syphilis and in gonorrhoea.
Non-specific urethritis of venereal origin still presents many problems in treatment
by virtue of the multiplicity of underlying causes. Streptomycin, sulphadiazine, and
aureomycin have their uses in the treatment of this condition, though none of these
materials is universally successful.
Aureomycin is used infrequently, and only on certain specially selected cases or
when other methods of treatment have failed to produce the desired effect. The high
price of aureomycin still precludes its use on a wide scale.
Seamen and service personnel returning from overseas with venereal infections have
presented a special problem within recent months. Diagnosis has frequently been
obscured by previous unstated or inadequate treatment. Occasionally, seamen are due
to leave for foreign ports within a few hours. Such problems have called for bold and
urgent treatment, with detailed instructions regarding follow-up examinations at future
ports of call.
There has been a marked decrease in the total number of patient-visits to the Divisional clinics during 1951, the figure being approximately 25,000, as compared with
32,000 in 1950. This appears to be due partly to a decrease of approximately 350
reported cases of venereal disease attending the clinics, but also to the marked decrease
in follow-up examinations required with modern methods of treatment.
EPIDEMIOLOGY
The prevalence of venereal disease is steadily decreasing, but the seeds of epidemic
still exist in the community.
It is for this reason that there can be no relaxing of effort on the part of this
Division in endeavouring to trace contacts and in using every available means to bring
venereal disease to light wherever it may exist.
Information regarding contacts is frequently inadequate and reluctantly given.
In order to overcome this defect, tact and understanding are essential in the armamentarium of the epidemiologist. Moreover, since much of the epidemiological investigation
must be carried out in more remote regions of the Province, the policy and methods of
the Division must be made known to public health personnel in the field.
Bearing all these points in mind, this Division has maintained a staff of well-trained
public health nurses, whose duty is not only to interview patients reporting to the
clinic, but also to give guidance to those persons employed in tracking down venereal
disease in outlying areas. Close liaison is therefore maintained with public health
personnel in the field, on whom much of the contact-tracing and follow-up investigations
fall. In order to facilitate this co-ordination, a manual has been completed for the use
of the public health field staff, British Columbia Department of Health, and relates to
venereal-disease control procedures and policy in areas outside Vancouver and Victoria. VENEREAL DISEASE CONTROL REPORT,  1951 G 9
An epidemiological worker is available on request to give guidance and assistance to
the local health services.
A second male epidemiological worker has been employed by the Division for the
purpose of interviewing male patients. It was felt that certain male patients would
probably be more willing to divulge information to a male questioner than to a female one.
New methods and tools for obtaining contact information are continually being
sought and reviewed. The interview is now recognized by the worker as the established
centre from which to work. The results obtained by reinterviewing the patient, where
indicated, for a more complete contact history have been so successful that this procedure
has become the rule.    Many more patients are bringing their own contacts to treatment.
A closer working relationship between the private physician and the Epidemiology
Section has been attempted during the past year. In each instance where inadequate contact information is received, the physician is telephoned and is offered the service of an
epidemiological worker to reinterview his patient. Greatest emphasis is placed on contacts to primary and secondary syphilis.
Case-finding and case-holding facilities have been further extended by the opening
of a venereal-disease clinic, primarily for diagnostic purposes, at Health Unit I in downtown Vancouver. This clinic is being operated under the joint direction of the Vancouver
City Health Department and the Division of Venereal Disease Control, Provincial Department of Health and Welfare. The number of blood tests done at that clinic has already
reached almost 900 per month.
Arrangements have been made with the Victorian Order of Nurses to provide treatment in the home for certain non-infectious patients. These cases are previously carefully selected and there must be a definite reason for home treatment.
The Vancouver City Gaol examination centre, which has proved so successful in
the past, continues to show excellent results regarding case-finding and case-holding.
In February, 1950, it was decided to extend treatment on epidemiological grounds to all
women who are brought in to the Vancouver City Gaol on morals charges and to certain
others who are known or believed to be actively carrying on promiscuous sexual relationships. Such treatment is not compulsory but is strongly recommended. In this
way it is hoped to limit still further the spread of gonorrhoea in that community which
presents the greatest problem in venereal-disease control.
Several meetings have been held with the Regional Superintendent, Indian Health
Services, to determine better methods of case-finding and follow-up of the British Columbia Indians. A survey to be carried out in a different part of the Province each year
seemed perhaps the best answer to the problem. In August a blood-testing survey was
completed on persons employed at the fish-canneries in New Westminster and Steveston.
Reports on any activities of the Division of Venereal Disease Control that are of
particular interest to the personnel of health units have been submitted at regular intervals
to the staff bulletins of both the Provincial Department of Health and Vancouver City
Health Department.
SOCIAL SERVICE
During the year the Social Service Section continued to focus its attention on the
basic personality disorders at the root of the venereal-disease problem. All newly diagnosed patients treated at the Vancouver clinic were interviewed by the social service staff.
This personal counselling, geared to the specific needs of the individual patient, was an
integral part of the treatment for venereal disease.
To gain some knowledge about the kind of people who were being treated at the
Vancouver clinic, the Social Service Section devised a rating scale to measure the capacity
of the individual to utilize this kind of counselling service. G 10 DEPARTMENT OF HEALTH AND WELFARE
Of 515 patients who were interviewed in a period from July, 1951, to November
30th, 1951, over 50 per cent were in the groups in which it was considered that personal
counselling could probably be effective.
In 1950 there were forty-six cases of venereal disease reported in children of 14
years and under. As this was a marked increase in incidence in this young age-group,
the social worker reviewed the information available in the Division regarding each of
the forty-six cases. It was found that this did not represent a real increase in the
incidence of venereal disease among children, but that many of these children were being
treated on suspicion as a precautionary measure rather than on laboratory or clinical
evidence of venereal disease.
The study also revealed that seventeen of the forty-six children reported were
Indians. To determine whether or not this indicated a deficiency in the public health
services in any specific area, these particular cases were again reviewed. It was found
that except in one area where eight of the children were treated on epidemiological
grounds as part of an intensive public health survey, the other nine cases occurred in
widely scattered areas. It was felt that in the Indian-patient group the problem was one
of education to modify the Indian way of life rather than a lack of public health facilities.
The social service worker has maintained a close liaison with the psychiatric consultant, to whom those patients presenting unusual personality problems have been
referred.
Excellent work has also been done by the psychiatrist, not only in helping those
patients presenting acute behaviour problems, but also in endeavouring to evaluate some
of the underlying factors responsible for promiscuous sexual behaviour resulting in the
spread of venereal disease.
EDUCATION
The prime responsibility of all health education in this Province rests with the Division of Public Health Education. However, in view of the specialized nature of education relating to venereal disease, a close liaison is necessarily maintained between that
Division and the Division of Venereal Disease Control.
The responsibility for lay education is shared by both Divisions, but education
directed to professional groups and student nurses remains the prime responsibility of the
Division of Venereal Disease Control.
Lectures on the venereal diseases and methods of control have been given to student
nurses at all the main training-schools in the Province. In addition to this, practical
experience is provided at the Vancouver clinic for student nurses in training at the Vancouver General Hospital.
Lectures have also been given to students in various other fields, including the
medical students at the University of British Columbia.
Every possible opportunity has been taken to promote professional education in the
venereal diseases, including the occasional publication of material in the Journal of the
Canadian Medical Association. Published articles include " Homosexuality as a Source
of Venereal Disease," written by Dr. B. Kanee, consultant in syphilology at this Division,
and Dr. C. L. Hunt, Director of this Division; " Effectiveness of Modern Treatment for
Gonorrhoea in Women "; and " The Role of Epidemiology in Venereal Disease Control,"
by Dr. C. L. Hunt.
Fortnightly meetings are held in the Divisional headquarters for all attending physicians, when lectures are given by members of the consulting staff on various aspects of
venereal disease.
The manual, Venereal Disease Information for Nurses, has been revised and reprinted. This manual is distributed, free of charge, to all student nurses in the Province
during the course of their training. VENEREAL DISEASE CONTROL REPORT,  1951 Gil
Other manuals which have been revised and brought up to date include Procedures
and Services in Venereal Disease Control and the Treatment Manual for Clinic Physicians.
The Venereal Disease Manual for Public Health Nurses has been rewritten and
enlarged. It is proposed to supply copies to all public health units and to individual
public health nurses in outlying areas for their use as reference manuals.
GENERAL
Deterioration of the premises occupied by the Divisional headquarters proceeds
apace, and it is fervently hoped that new quarters will be made available before the
urgency becomes too acute.
Mrs. Anna Grant, who has been with the Division for approximately eight years as
senior clinic nurse and staff nursing instructor, has resigned to take up residence with her
husband at Campbell River.    Her loss will be felt keenly by the Division.
The Epidemiology Section of the Division has temporarily lost the services of Miss
Muriel Scott, who was selected by the World Health Organization to serve on a team of
public health advisers in venereal-disease control to the Burmese Government. This
Division takes considerable pride in Miss Scott's selection, which should prove a source
of considerable interest and experience to her.
An additional loss to the Division has been the promotion of Miss Enid Wyness,
senior social service worker, to a higher position, in which her services are available only
in an advisory capacity. Miss Dora Porter now carries the entire patient-load in the
Social Service Section.
Dr. C. L. Hunt has resigned from his full-time appointment as Director, but continues to be employed in that capacity on a part-time basis.
Federal health grants continue to prove extremely useful in assisting the Division in
maintaining its ever-expanding services, as well as in affording opportunities for postgraduate training of medical and nursing personnel.
Funds from this grant have been made available toward the operation of the British
Columbia Medical Centre Library, where up-to-date literature on the venereal diseases
is maintained. The Divisional Director is an active member of the management committee of this library.
Much appreciation is felt toward the various community groups, the Vancouver
City Police, the Royal Canadian Mounted Police, the British Columbia Hotels Association, the Liquor Control Board, the Department of Indian Affairs, and the various other
groups who, by their co-operation and help, have contributed so much to the success of
the venereal-disease control programme of the Province.
In addition, special appreciation is expressed to the Division of Laboratories, without
whose ever-willing services and co-operation this Division would find it difficult to function, and also to the Division of Vital Statistics for its helpful advice and assistance so
freely given at all times. G 12
DEPARTMENT OF HEALTH AND WELFARE VENEREAL DISEASE CONTROL REPORT,  1951
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DEPARTMENT OF HEALTH AND WELFARE
The total number of cases of venereal disease reported in the Province in 1951
has shown a slight but definite improvement. The rate per 100,000 population has
declined more markedly and now shows less than a half of the rate reported in 1946.
The figures show that gonorrhoea is responsible for 85 per cent of all venereal
disease reported. This disease, with its very short incubation period, still presents the
greatest problem in venereal-disease control.
The situation with regard to syphilis continues to show a very marked improvement,
only thirty-six cases of early (primary and secondary) syphilis having been reported.
This represents a further decrease of 41 per cent over the remarkably low figures reported
for 1950. There has also been a decrease of nearly 18 per cent in the number of later
stages of syphilis detected. This represents, in a considerable proportion, patients who
were free from any symptoms of the disease, and whose detection depended originaUy
upon a routine blood test.
TABLE II.—NEW NOTIFICATIONS OF VENEREAL INFECTION COMPARED
WITH REPORTED CASES OF CERTAIN OTHER NOTIFIABLE DISEASES
IN CANADA, BRITISH COLUMBIA, AND GREATER VANCOUVER, 1951.
Notifiable Disease
Canada
British
Columbia
Greater
Vancouver
Chicken-pox...	
Measles	
Mumps	
Scarlet fever	
Venereal disease..
Rubella	
Tuberculosis	
Whooping-cough..
Diphtheria	
46,637
61,300
35,189
14,417
18,940
12,624
11,152
8,889
253
6,671
6,269
5,835
4,146
3,916
2,288
1,662
1,134
5
2,272
1,948
1,232
1,454
2,311
868
652
162
1 VENEREAL DISEASE CONTROL REPORT,  1951
G 15
TABLE III.—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED
ACCORDING TO DIAGNOSIS, SEX, AND SOURCE OF REPORTING OF
NOTIFICATIONS, BRITISH COLUMBIA, 1951.
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Totals     T.
M.
F.
Clinics, total    T.
M.
F.
Vancouver              .. T.
M.
F.
Victoria .   T.
3,916
2,843
1,073
2,001
1,357
644
1,783
1,246
537
99
75
24
22
14
8
77
20
57
3
2
1
1
3,336
2,461
875
1,831
1,237
594
1,663
1,162
501
70
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18
13
8
5
66
13
53
2
2
1
1
16
1,312
1,056
256
4
3
1
189
165
24
2
2
2
2
377
258
119
219
143
76
189
126
63
14
7
7
6
4
2
9
6
3
1
1
132
95
37
26
20
6
2,957
2,203
754
1,612
1,094
518
1,474
1,036
438
56
45
11
7
4
3
57
7
50
2
2
481
284
197
139
90
49
104
69
35
15
9
6
8
5
3
11
7
4
1
27
20
7
4
4
4
4
......
9
4
5
4
2
2
1
1
2
1
1
1
98
38
60
35
17
18
26
12
14
2
1
1
1
1
6
3
3
187
110
77
41
25
16
32
21
11
4
1
3
4
2
2
1
1
31
28
3
9
8
1
7
6
1
1
1
1
1
18
16
2
2
2
~2
2
87
60
27
31
26
5
23
19
4
4
3
1
1
1
3
3
7
6
1
2
1
1
2
1
1
25
13
12
7
5
2
5
3
2
2
2
10
5
5
6
2
4
4
2
2
17
16
1
6
5
1
6
5
1
82
82
25
25
To
10
14
M.
F.
New Westminster                                        _.T.
M.
F.
Oakalla                                                       T.
M.
F.
Peace River1                                              T.
M.
~~1
1
1
1
	
14
1
1
F.
1
272
149
123
22
16
6
48
29
19
20
14
6
' 3
2
1
1
5
2
3
54
16
38
1
1
8
5
3
115
66
49
7
5
2
24
14
10
42
23
19
12
9
3
2
2
5
5
—-
	
	
Prince Rupert.. _ T.
M.
1
1
15
15
1,178
961
217
4
3
1
163
145
18
	
F.
Girls' Industrial School and Juvenile Detention Home                                              _T.
M.
F.
Private physicians                                          T.
M.
F.
Institutions and hospitals T.
M.
F.
1
16
~16
1,605
1,226
379
26
19
7
284
241
43
10
4
6
3
3
8
8
13
13
Other    T.
M.
F.
Not stated     T.
	
8
4
4
1
1
3
3
44
44
M.
F.
f
	
1
1
1 Clinic discontinued as at October 1st, 1951.
Source: Notifications of Venereal Infection, Form N. 1.
There has been a marked decrease in the number of cases of venereal disease
reported by Divisional clinics, though the number reported by private physicians remains
essentially unchanged.
The decrease in clinic cases is borne almost entirely by the Vancouver clinic and
may be due in part to a gradual change in policy regarding the diagnostic criteria for
venereal disease. Patients who have been exposed to known infection are still given
treatment, but if their tests prove to be negative, they are no longer reported as suffering
from venereal disease.
There has been a slight increase in the number of cases reported with non-specific
urethritis of venereal origin. G 16
DEPARTMENT OF HEALTH AND WELFARE
TABLE TV.—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED ACCORDING TO DIAGNOSIS, SEX, AND AGE-GROUPS, BRITISH
COLUMBIA, 1951.
Age-group
Gonorrhoea
Syphilis
Acquired
Totals.
Under 1 year..
1- 4 years _
5- 9 years ...
10-14 years-
15-19 years ._
20-24 years__
25-29 years.
30-34 years.
35-39 years..
40-44 years _
45-49 years_
50-54 years.
55-59 years .
60-64 years..
65-69 years-
70-74 years __
75-79 years..
80 years and over~
Not stated 	
...T.
M.
F.
M.
F.
_T.
M.
F.
_T.
M.
F.
__T.
M.
F.
-T.
M.
F.
_T.
M.
F.
_T.
M.
F.
T.
M.
F.
___T.
M.
F.
_ T.
M.
F.
T.
M.
F.
...T.
M.
F.
_T.
M.
F.
_T.
M.
F.
_.T.
M.
F.
_T.
M.
F.
__T.
M.
F.
_T.
M
F.
...T.
M.
F.
3,916
2,843
1,073
3,336
2,461
875
3
9
3
6
6
1
5
16
3
13
332
179
153
1,0401
723
317
832
621
211
527
403
124
299
229
70
216
172
44
152
128
24
97
77
20
82
67
15
57
48
9
54
42
12
23
22
1
9
5
4
6
2
4
156
118
38
2,957
2,203
754
2
12
1
11
289
156
133
955
669
286
774
583
191
478
374
104
265
208
57
183
148
35
108
98
10
65
54
11
37
33
4
20
19
1
11
11
125
101
24
2
4
1
41  7
471 242
26| 130
21
98
65
33
91
62
29
64
50
14
23
20
3
18
12
6
9
9
~5
2
3
4
3
1
112
857
604
253
683
521
162
414
324
90
242
188
54
165
136
29
99
89
10
60
52
8
33
30
3
20
19
1
9
9
113
94
19
481
284
197
1
1
4
2
2
4
1
3
4
2
2
24
5
19
531
221
31|
351
15
201
42
221
201
25
12
13
32
23
9
41
27
14
31
22
9
44
33
11
36
28
8
42
30
12
20
19
1
7
3
4
6
2
4
30
16
14
11 11
1
2  1
6
12
6
6
13T 1
6  1
2  1
4| „..._
82
82
27
27
20
20
Source: Notifications of Venereal Infection, Form N. 1. VENEREAL DISEASE CONTROL REPORT,  1951 G 17
There has been a decrease in the number of cases of venereal disease reported in
the 10-14 age-group, from twenty-five in 1950 to sixteen in 1951. The actual number
of acquired infections in this age-group has fallen from twenty-five to twelve, the remaining four cases in 1951 being recorded as prenatal syphilis.
The relative proportion of male and female cases recorded in the 15-19 age-group
has shown a remarkable change over figures reported for previous years. In the past
four years this proportion has shown a marked preponderance of females over males,
in the ratio of approximately 3:2. In 1951 males showed a preponderance over females,
in the ratio of 6:5. This is accounted fdr by a slight increase in the number of males
and a marked decrease in the number of females reported during the year. The significance of this change is not yet apparent.
Five cases of prenatal syphilis occurred in children under the age of 4 years. Four
of these were children of Indian mothers living in inaccessible regions. For this reason,
in three of these cases, treatment was given on suspicion, on account of a positive blood
in the mother, the diagnosis never having been actually confirmed in the infant.
The fifth case was a child of white parents. Prenatal blood tests had not been done
in this instance, largely owing to the reluctance of the mother. G 18
DEPARTMENT OF HEALTH AND WELFARE
CHART II.—NEW NOTIFICATIONS OF SYPHILIS BY AGE AND SEX,
BRITISH COLUMBIA, 1951
CASES
lOOi-
MALE I
FEMALE |
0-4 5-9 10-14       15-19        20-24       25-29       30-34       35-39       40-44       45-49       50-54       55-59       60-64      65-69       70 +
AGE GROUP
TABLE V.—NEW NOTIFICATIONS OF SYPHILIS BY AGE AND SEX,
BRITISH COLUMBIA, 1951
Age-group
Totals.
Under 1 year _
1- 4 years	
5- 9 years.	
10-14 years	
15-19 years	
20-24 years	
25-29 years	
30-34 years	
Male
Female
284
197
1
2
2
1
3
2
2
5
19
22
31
15
20
22
20
Age-group
35-39 years	
40-44 years	
45-49 years 	
50-54 years	
55-59 years	
60-64 years	
65-69 years	
70 years and over..
Not stated	
Male
Female
12
13
23
9
27
14
22
9
33
11
28
8
30
12
24
9
16
14
In the first four decades, syphilis appears to have been fairly evenly distributed
between males and females. After the age of 40, however, there appears to have been
a definite preponderance of male patients notified. VENEREAL DISEASE CONTROL REPORT,  1951
G 19
CHART III.—NEW NOTIFICATIONS OF GONORRHGEA BY AGE
AND SEX, BRITISH COLUMBIA, 1951
10-14       15-19
30-34       35-39       40-44
AGE GROUP
TABLE VI.—NEW NOTIFICATIONS OF GONORRHCEA BY AGE AND
SEX, BRITISH COLUMBIA, 1951
Age-group
Male
Female
Age-group
Male
Female
Totals.
Under 1 year..
1- 4 years..—
5- 9 years	
10-14 years	
15-19 years	
20-24 years__
25-29 years..
30-34 years..
2,461
1
156
669
583
374
875
2
4
2
11
133
286
191
104
35-39 years_
40-44 years..
45-49 years.
50-54 years -
55-59 years
60-64 years
65-69 years
70 years and over	
Not stated	
208
148
98
54
33
19
11
5
101
57
35
10
11
4
1
24
These figures demonstrate the preponderance of male over female gonorrhoea infections, the ratio in this table being approximately 3:1.   In 1950 the ratio was only 2:1
This preponderance of male infections is evident in all ages except the 10-14 age-
group. G 20
DEPARTMENT OF HEALTH AND WELFARE
CHART IV.—NEW NOTIFICATIONS OF VENEREAL INFECTION
AND RATE PER 100,000 POPULATION, 1941-51
TABLE  VII.—RATE  PER   100,000  POPULATION  FOR   TOTAL   VENEREAL
DISEASE BY AGE-GROUPS, BRITISH COLUMBIA, 1942-51
Age-group
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
0- 4 years-
5- 9 years-
10-14 years _
15-19 years-
20-24 years..
25-29 years._.
30-34 years-
35-39 years..
40-44 years..
45-49 years...
50-54 years...
55-59 years _
60-64 years..
65-69 years...
70 and over-
All ages	
24
19
23
326
1,046
770
619
518
375
249
265
133
188
113
83
21
26
24
385
1,133
843
598
543
474
272
218
193
141
80
74
23
17
43
616
1,383
953
619
534
573
337
309
196
183
106
61
29
23
19
637
1,525
1,039
751
699
586
446
307
211
188
169
53
35
24
33
709
2,069
1,547
986
737
565
457
292
232
215
157
83
25
20
9
697
1,921
1,306
689
607
474
438
325
234
208
172
81
16
10
12
523
1,413
1,036
555
495
361
308
238
141
119
100
62
10
459
1,451
1,012
542
454
379
307
230
148
162
111
64
10
10
34
489
1,342
957
535
446
315
279
219
163
118
113
62
392
415 |  508 |  553
677
575 j  419
406
378
10
6
21
442
1,168
878
559
357
292
233
160
137
99
110
52
336
There is again a striking decrease in the infection rate in all ages, with the exception
of the 30-34 age-group, which shows a slight increase.
The rate for early teen-agers, though decreasing, has still not returned to the
1947_49 level.
The total infection rate for all ages has shown a very steady decline annually since
the peak year of 1946. VENEREAL DISEASE CONTROL REPORT,  1951
G 21
TABLE VIII.—NEW CASES OF SYPHILIS REPORTED IN BRITISH
COLUMBIA BY AGE-GROUPS AND MARITAL STATUS, 1951
Single
Unmarried1
Married
Age-group
Male
Female
Male
Female
Male
Female
No.
Rate
No.
Rate
No.
Rate
1
No.   1 Rate
1
1
No.   1 Rate
1
No.
Rate
15-19 years __. 	
5
13.6
15
42.2
5
13.6
15
42.1
1
41.1
20-24 years    	
19
53.8
14
54.1
19
53.6
15
56.9
3
39.7
14
71.3
25-29 years 	
11
51.9
6
44.2
11
50.8
9
60.5
4
16.9
11
31.8
30-34 years 	
12
93.2
1
12.5
13
94.6
5
49.8
8
24.8
15
39.2
35-39 years  	
3
31.2
1
19.8
4
37.1
5
64.3
7
22.6
8
23.4
40-44 years	
10
132.2
2
60.8
10
110.0
2
30.9
10
34.3
7
23.9
45-49 years 	
8
138.8
1
41.8
9
117.1
5
80.3
16
59.4
8
32.7
50-54 years	
10
186.8
13
176.1
3
46.5
7
28.2
6
27.3
55-59 years 	
8
145.1
12
147.1
3
40.1
21
87.2
8
39.3
60-64 years 	
9
159.8
13
144.2
3
34.5
13
57.5
4
23.0
65-69 years 	
8
154.9
12
128.8
5    [    55.6
16
85.4
7
58.2
1 Includes single, widowed, divorced, and separated.
Note.—Rates shown per 100,000 population in each marital group.
It is a little unwise to read too much into figures where small numbers are involved.
It is interesting to note, however, that the greatest numbers of notified cases of syphilis
occur in young women—both married and unmarried—and in young unmarried men.
In married men the greatest number of infections is discovered in the latter half of life.
These cases probably represent the late tertiary stages of infections acquired in earlier
years, possibly even before marriage.
The extraordinary rise in the infection rate among single or unmarried males in the
older age-groups appears to suggest two probable conclusions: That there are markedly
fewer single than married men in the latter half of hfe, and that their necessarily promiscuous sexual life has been the cause of the greater proportion of infections.
Single females in later life have shown a striking absence of syphilis in any stage.
This may be accounted for by the fact that those women who have remained single up
to and beyond the age of 50 represent a comparatively small group, and possibly one
which has always indulged sparingly in sexual experience. The fact that syphilis tends
to remain latent in females and to give rise less frequently to tertiary changes than in
males may also account to some extent for its lack of detection in this group.
TABLE IX.—TOTAL PRIMARY AND SECONDARY SYPHILIS,
BRITISH COLUMBIA, 1951
(Age specific rates per 100,000 population.)   .
Age-group
0- 4 years	
5- 9 years	
10-14 years	
15-19 years ~	
20-24 years	
25-29 years 	
30-34 years	
35-39 years	
40-44 years	
45-49 years	
50-54 years	
55-59 years	
60-64 years	
65-69 years	
70 years and over._
Not stated	
Totals	
Male
Number
Rate
5.4
16.3
4.4
13.1
2.4
10.5
2.9
3.1
40.2
Female
Number
Rate
13.1
6.5
2.1
2.4
2.8 G 22 DEPARTMENT OF HEALTH AND WELFARE
In view of the small numbers, little of statistical significance can be gleaned from
this table, beyond the obvious fact that early infectious syphilis (primary and secondary)
is essentially a disease acquired during the age of greatest sexual activity.
Males in this series outnumber females by 2:1, but since primary syphilis more
frequently remains undetected in females than in males, these figures—particularly in
view of their small numbers—should not be regarded as too significant. VENEREAL DISEASE CONTROL REPORT, 1951
G 23
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fe G 28 DEPARTMENT OF HEALTH AND WELFARE
Over 60 per cent of all venereal disease notified in the Province is reported in the
Greater Vancouver area. This is in accordance with previous experience, and stems
from a combination of many factors in addition to the high population concentration.
Among these may again be mentioned the importance of Vancouver as a centre for
shipping, fishing, logging, and other industries, and also its use as a holiday centre for
persons engaged in these occupations throughout the Province.
The high activity and concentration of the epidemiology programme in venereal-
disease control in this area may also be responsible in some degree for the large number
of discovered infections. VENEREAL DISEASE CONTROL REPORT,  1951
G 29
CHART V.—PATIENT-VISITS AT ALL CLINICS OF THE DIVISION OF VENEREAL DISEASE CONTROL CLASSIFIED ACCORDING TO DIAGNOSIS,
1942-51.
Patient Visits
100,000
TABLE XL—PATIENT-VISITS AT ALL CLINICS OF THE DIVISION OF
VENEREAL DISEASE CONTROL CLASSIFIED ACCORDING TO DIAGNOSIS, 1942-51.
Total
Syphilis
Gonorrhoea
Not Yet Diagnosed
Year
All
Clinics
Vancouver
Clinic
All
Clinics
Vancouver
Clinic
All
Clinics
Vancouver
Clinic
All
Clinics
Vancouver
Clinic
1942          	
36,410
36,170
46,961
46,898
56,385
51,129
43,871
36,551
31,150
24,372
28,046
28,929
36,069
35,657
41,856
38,180
32,480
27,934
22,000
15,953
24,173
22,389
24,766
26,297
30,047
28,291
24,894
16,335
11,685
8,109
18,686
18,573
19,468
20,084
23,158
21,986
19,166
13,139
9,301
6,606
7,584
9,331
13,021
9,692
11,382
9,799
8,480
9,102
8,548
5,904
5,927
7,366
10,580
8,065
9,297
8,051
7,014
7,858
7,418
4,964
4,653
4,450
9,174
10,909
14,956
13,039
10,517
11,114
10,831
10,178
3,433
1943
1944_	
1945	
1946     	
1947
1948
2,990
6,021
7,508
9,401
8,143
6,292
1949
6,937
1950
5,226
1951	
4,251
This table serves to show the steadily decreasing number of patient-visits made to
the Divisional clinics over the past few years. Some of this decrease is due to the
changing policy regarding the number of post-treatment examinations required.
With growing experience in the treatment of gonorrhoea, for example, it has been
shown that the methods now advocated by this Division rarely fail to produce a cure,
and, therefore, multiple follow-up examinations are unnecessary. G 30
DEPARTMENT OF HEALTH AND WELFARE
TABLE XII.—REPORT OF LABORATORY WORK DONE BY THE DIVISION
OF LABORATORIES RELATING TO THE DIAGNOSIS AND TREATMENT
OF VENEREAL DISEASE FOR ALL AGENCIES IN BRITISH COLUMBIA,
1947-51.
Examination
1947
1948
1949
1950
1951
11,219
34,589
854
152,437
10,322
33,990
605
167,816
10,508
33,851
454
173,092
9,179
30,710
378
178,375
6,352
26,837
Treponema pallidum microscopic examinations	
351
194,537
The number of blood tests carried out by the Division of Laboratories continues
to increase, the figure now representing an average of over 3,700 tests per week.
As was expected, the number of gonococcus cultures and microscopic examinations
has continued to decline. This is due, partly, no doubt, to the diminishing number of
tests of cure required following the treatment of patients for gonorrhoea.
CHART VI.—FREE MEDICATIONS DISTRIBUTED TO PRIVATE PHYSICIANS
BY THE PROVINCIAL DEPARTMENT OF HEALTH AND WELFARE
FOR THE TREATMENT OF VENEREAL DISEASE, BRITISH COLUMBIA,
1937-51.
No.  of Medications
LEGEND
Arsenical (ampoules)                   mammmm*
Bismuth (in c. c. 's)                    om   ■___» ^___>
Sulphonamide (100 grs.)            ^__h «_> ^_______>
Penicillin (1,000, 000 units)'       m __• «
/
\
\
4
/
/
**.   ^
\
\
/
/
/
/
\
\
\
\
00m^
/
/
1
^* *"
i
.
\
\
\
/
c
\
i
i
\
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m «„
**
/
*
X
*
\
\
t ^^_
t
i
i
i
i
i
i
V
1938 1939 1940 1941 1942
1943    1944
1946    1947    1948    1949    1950    1951 VENEREAL DISEASE CONTROL REPORT, 1951
G 31
TABLE XIII.—FREE MEDICATIONS DISTRIBUTED TO PRIVATE PHYSICIANS BY THE PROVINCIAL DEPARTMENT OF HEALTH AND
WELFARE FOR THE TREATMENT OF VENEREAL DISEASE, BRITISH
COLUMBIA, 1937-51.
Year
Arsenicals
(Ampoules)
Bismuth
(CC.)
Sulphonamide
(Grains)
Penicillin
(1,000,000
Units)
Penicillin
o. &W.
(100,000 Units)
Streptomycin
(Grams)
1937  	
1938	
1939 	
12,192
12,666
10,933
10,212
10,955
12,636
11,162
12,005
17,147
20,586   .
18,328
15,601
11,481
3,528
274
15,539
16,125
21,270
22,029
22,566
27,024
26,300
23,350
27,580
33,375
35,325
26,625
21,775
6,250
3,625
55,485
281,745
252,930
336,825
469,998
772,301
583,786
883,986
950,719
308,565
213,829
165,195
2,422
84,735
76,463
678
1,498
1,415
1,580
9,768
5,676
5,543
7^059
	
1940
1941
1942         	
1943        	
1944
1945
1946    —  -
1947 .   . 	
1948
	
1949  _
1950   	
1951	
567
155
95
Reference to this table will show the almost complete abolition of arsenicals from
the treatment of syphilis. This figure will probably be found to have dropped to zero
for 1952.
Penicillin is now being used exclusively for the treatment of syphilis and is the drug
of choice for the treatment of gonorrhoea. G 32
DEPARTMENT OF HEALTH AND WELFARE
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G 33
TABLE XVI.—CONTACTS TO VENEREAL INFECTION CLASSIFIED ACCORDING TO INVESTIGATING AGENCY AND RESULT OF INVESTIGATION,
BRITISH COLUMBIA, 1951.
i3
o
H
Investigated by—
Result of Investigation
73
p
u
a o
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2 tn
3 8
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rt
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o
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776
616
39
18
7
2
20
35
39
Examined by private physician	
495
89
11
94
36
168
86
3
8
Failed to report for examination-
69
54
3
2
	
8
	
1
	
	
1
Investigated, already diagnosed
or under care	
85
13
	
3
1
1
2
65
	
	
561
73
261
20
8
107
17
46
9
28
23
10
1
99
3
2
—
—
Found to be ex-Province	
22
1
1
	
20
Investigation not indicated	
2,185
3
	
1
	
	
	
833
147
1,200
1
240
2
1
1
195
29
	
9
2
1
Totals          . .
4,506
1,059
58
245
101
365
195
50
181
902
147
1,202
1
TABLE XVII.—CONTACTS TO VENEREAL INFECTION CLASSIFIED
ACCORDING TO INVESTIGATING AGENCY AND RESULT OF EXAMINATION, BRITISH COLUMBIA, 1951.
73
o
H
Investigated by-
Result of Examination and
Whether or Not Previously
Diagnosed
a
U
o_ _
a o
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Infected with primary syphilis—
—
—
—
—
—
Not previously diagnosed.
Not stated 	
—
Totals
|   ...... |   ______ |   .._..
.._..
__
_...
_____
______
_____
Infected with secondary syphilis—
Previously diagnosed	
Not previously diagnosed
3
—
	
i
—
	
—
—
2
—
—
	
Totals    	
3
..._
.._-
i
—
_         |     .._..   |     ......
2 |   ......
—
	
Infected with other syphilis—
56
64
14
2
i
2
3
4
—
1
35
52
—
Totals       .  	
120
14
2
7
—
5
4
—
36
52
—
—
Infected with gonorrhoea—
660
627
6
5
402
"it
2
38
16
~60
1
43
1
35
1
1
650
2
5
—
—
Not previously diagnosed	
Not stated	
—
Totals    	
1,293
407
31
40
16
60
44
36
2
657
—
— G 34
DEPARTMENT OF HEALTH AND WELFARE
TABLE XVII.—CONTACTS TO VENEREAL INFECTION CLASSIFIED
ACCORDING TO INVESTIGATING AGENCY AND RESULT OF EXAMINATION, BRITISH COLUMBIA, 1951— Continued.
3
0
H
Investigated by-
Result of Examination and
Whether or Not Previously
Diagnosed
"d
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Infected with chancroid—
	
—
—
—
—
—
—
	
—
	
—
Totals              	
_.... |   __..._
—
.—
-1      -1
—
.— |   .—
	
Infected with lymphogranuloma
venereum or granuloma
inguinale—
1
1
—
—
—
—
	
	
—
Not previously diagnosed	
—
Totals 	
1
1
......
—
...... |   ......
_.... i _ .
_
_
-
Incomplete examination—
3
1
—
1
l
—
—
	
-1   -
Not previously diagnosed	
—
Totals	
3
1
1
|      1 |  _....
......
.._.
......
Negative—
Previously diagnosed	
56
566
15
5
278
6
16
64
2
27
97
4
58
1
~ 3
21
1
51
2
1
	
—
—
Totals ....
637
289
16
66
27
101
59
3
22
54
......
..
Investigation not indicated—
11
3
1,377
	
	
"""l
	
..__..
	
	
~"1
11
34
1
145
" 2
1,196
Not previously diagnosed	
Not stated	
—
Totals	
1,391  1     - .
	
1
	
.._... |   ..   .
	
1
45
146
1,198
	
Infected with non-specific urethritis—venereal—
	
	
	
	
	
	
	
	
	
Not previously diagnosed	
—
Totals
  1     1     1   —
	
_
—
	
	
... |   .__.-.
______
Not stated—
Previously diagnosed  	
10
6
1,042
3
344
9
1
128
58
1
197
1
87
11
120
9
83
1
......
	
4
1
Not stated  ~          	
—
Totals
1,058
347
9
129
58
198
88
11
120
92
1
4
1
Totals—
796
1,267
2,443
10
698
351
......
49
9
4
109
132
43
58
2
161
202
1
106
88
1
38
11
2
56
123
775
4
123
i
146
2
1,200
1
Not previously diagnosed   .
Not stated
::::
Totals      	
4,506
1,059
58
245
101
365
195
50
181
902
147
1,202
i
Note.—The above figures cover the period of October, 1950, to September, 1951. VENEREAL DISEASE CONTROL REPORT,  1951
G 35
TABLE XVIIL—INCIDENCE AND RATE PER 100,000 POPULATION OF
TOTAL VENEREAL DISEASE, GONORRHOEA, AND SYPHILIS, BY
QUARTERS, BRITISH COLUMBIA,  1947-51.
Year
Total Venereal
Disease
Cases
Rate
Syphilis
Cases
Rate
Gonorrhoea
Cases
1947-
January to March__
April to June	
July to September-
October to December__
1948—
January to March	
April to June ._
July to September	
October to December..
1949-
January to March-
April to June _-_	
July to September-
October to December_
1950—
January to March	
April to June ._
July to September	
October to December.-
1951—
January to March	
April to June _
July to September	
October to December..
655
500
475
450
396
071
042
141
139
063
178
152
,206
887
,214
994
,030
,023
996
923
629.2
574.7
560.8
545.6
520.9
395.9
382.4
416.0
411.9
381.7
420.3
408.9
425.8
311.8
424.8
346.3
353.6
351.2
342.0
316.9
567
473
386
381
387
227
179
195
211
208
197
161
219.6
181.2
146.8
143.4
144.4
83.9
65.7
71.1
76.3
74.7
70.3
57.1
200
70.6
153
53.8
136
47.6
120
41.8
134
46.0
127
43.6
97
33.3
131
45.0
1,088
988
1,030
1,022
998
837
853
955
917
852
972
941
998
714
1,056
864
883
855
874
774
421.3
378.5
391.6
384.6
372.4
309.4
313.0
348.2
331.6
305.9
346.8
334.0
352.0
251.0
369.6
301.0
303.2
293.6
300.1
265.8
Note.—Total includes all types of venereal disease.
The purpose of this table was an attempt to determine whether or not there was a
marked seasonal fluctuation in the venereal-disease rate of the population.
In 1949 and 1950 a definite rise in the total venereal-disease rate was noted during
the first and the third quarter of the year. This was thought possibly to be connected in
some way with seasonal interference with working conditions; for example, interference
with logging and other operations during the periods of deep snow and frost in the winter
and fire-hazards in the summer.
Undue celebration and alcohol at the festive season may also have played some part
in the rise during the first quarter of the year.
In 1951 this pattern appeared to have completely disappeared, a steady decrease
being shown in each succeeding quarter of the year.
The significance of this change, although extremely satisfactory, is not yet apparent.
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the King's Most Excellent Majesty
1952
970-652-5666