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 u \- z o u I1J 1/1 t < U D 5, Z 6 > o H U z o > a y < o 0 (J 1/1 Shi's S 2 M r i 11 •« 1 z s ■* ___ i. ■c a •£ £ "& < 31 S Si* x :■_ = .» ? ■5 ££ * Z 3 o 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 G 13 m I a. i—I H < P o Ph O o o" o 1—I Pi w Ch Ph H < Pi Q Z <c O l-H H U Ph < 2 pq z W > Ph O on Z o I-H H <c u )—i Ph HH H O z Z CQ < tW <~°2 1 i | o as i> tn Tt in ; i i o (N d ^ »-! ri c to >8. rt [ j | vo vo oo m cn m I ! ! rt vd ci in «ri co SO B. 111! i-1 £ o is I i i i vo cn © as © cr. i iTt,>nm«o\ ! 1 1 1 y-i (H V_°rt (St^^OOOviriqMDTf M £So MNMHHHrHHrtH o vooocSt-^ooint^ir^vicS 0) P. odvor^mooTt'dvct^co O^OO^MH^iolTn 5 "" ~~ 6s_ K.H^OiN'nh-tS'-nn insooscoasosv^cn-rf-^t I* oo a o. oo c],h « v m ■v »M m23 cncoi>r-;©cot--aNrtc4 & Hrlricnrnrirtddd 3 g o n't "o «3 in o i-| in \o oo a rt int^cooo\Dt^rn»-HO as 05 HMCSH W z mt^vD«nvor-i>oo\t?\ Tr\ooo\o\oi>mi-< »-_ ,-< r* «h «H v-2« OvCS^tvornoovotsOr-; rJTtinodc\vdcori*-<© b 1 u ■*tcicn,*tsoy-iCDCDT>cn rt i-ir-^t^r-^c-iovvSovcori s P. HHM^^fflH Ph 0\in^O00(»MONh OsmuimcACDsocD-ytci iMMf VOt THrt *4H °"3 Ph Ur_. vq^osooovovot^vor. oodooodr^ON^Ttiri t^vDr^r-vovof-ceoooo d 8 _!3 _ Ov^cnqn-vqvivqt^^- fl ydn'OHOoonHMio o § 0 * t^wvDavocomm'Hoo Mr.fnw^mnc.mN ", (JvmoO'HMVOOortt^VO |l onv.H HinOanm Tf <n cn r^ vd 0_ vo^ vo vo_ rn ci of cn cn Tt" Tt cn co cn cn O rlWP.hO^OOrt^'-1 *rt *i rA*no6c\t>-yta\so'\6s6 « o\r<ov.hhHor-m v a. M'tinmvowTttnm «G i ihoomoOO\ti-^os\o Es I* i-imc.TtO\0\tnMaiH o H ^.t*^c^_ric^>0i.lrl,rlri0i. cn cn *t <n vo" in Tt Tt".Tt" m" u rt <d I* fv Cr Tt V VC C~ CK a- a t] Tt Tt Tt rt Tt Tt Tt m m a a- o a C_* a- O- o- a- <Zf G 14 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. *rt o H Gonorrhoea Syphilis Si W rt si t/_ 5 rt 8 0) a > u Si 0 G __ a. Is o H S a o d a o o z d 1 3 A a O e3 u 0 y at -s o a o O I-l u o « Acquired 3 rt S _. S •a ! E V. aj u ■a 0 |3 Si >. H 5 Source of Referral h rt I a, & rt •O C o Ci Si 03 Ti d 1 a Id a rt 0 Si h3 u d 3 u rt > O ■6 i- d u •x % VI O i-i 3 <D Z 0) O s n n & o IB 'o u a xn a o Z 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 52 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 u . Os r_H ^_ CN go 01. 1 j j C/5 6> 1 ! : , : i 1 1 ! l-H s a vo m CO cn *h tJ- m cn cs m rH -<J •n cs cn cn ! CS CS ! CS I> oo m cs vo m cs c CO i-H 00 ! VO CiO §8 OJ! cn m cs cn CS cn rn ! i- cn o rr £ In O " m a < C-N is oe *n tH M tH y- rHW CO ■"< VO r- cs cn (S rH i ^ m ^ w l-H CO Q so CO C »iH IC. VT<t ^ VO CS tj vo cn c- cs cs cn i on oc — VO CS Os VO CS VC O rH O t- O q O Cs 1-1 *-l cn cS Tt ; cs m rH r- Tt H H f 0 g t-i . 6> o so i i 1 j Q s Oh __« §■8 0 M t- C\ O1 Os m »h fC (N C< l> Tt cr VO cs c*- cn cS r~ ih l-H C- VO in rH ON o Os cs cn ■5 a pa CJ CD SC rH ,- CA ^^ -- 00 Tt Tj Os CS Tt | C*" m a. v> Q^ Ph i-h "3 Os o c VO (M H- cn i-h fs r- Tt cr ■* vo r- CS Tt ! rH T-H l-H IT r- m i-h Tt OC Ci CN CS ; rn Tt o r H Tt K" <*> _S o0 Os j j i i o u Tt i> r- Os ; m tj- i ___, ^, CS ! Cv O CS 1 rH ! Tt cr o\ i-h : m i i-h ; cs O CS Tt 1 cs Os Ov CS m fLa r- VO cs ^ cs CN l-H t-> Tt cn r- Tt ^H 1-. l-H O rH Ci OH CO O Tt r- t- ID ! in VO ! Tj cn i-h o cn i-h cs Tt CS ! rH I r- Tj tflrt-iOHH | C r- cn Tt ! Tt £Ph r cs ; »-i cs ! ^ '"' in ! rH I p—i H t* 1 ^O ^9 .SO 6> o cn 1 i 1 ! ! ! i §8 ■ OB oc m : m m l v \oto ^t Tt trtr-t ! CS rH m vc Os rn : cs : rn cs cr on cs r- l xr~ a cn ; cn CS m SO j CO Os 0 M c~ ■ ■S B_ SO Os cn M r-l „- 1 » CS cn cs Tt cn m 1 ^ tt. £< oo CC 1 ' ^r cs r- co r- so >r r~- >n o *<t TJ- CS l-H Tt l-H OO OC m i-h »n rH CS TJ Tt CS C- 1 Tt co W c_ P cn CA cn W CS 1-1 l> Cl £^ o H TJ o< hEh t. . fl 1 ! ! 1 : 1 rH | 1 *P t- I 1 1 | ! j < S> 1 , . , 1 I i : i 1,11,1 . , I , , OQ H< sc CO C Os 00 vo w- cn cs i- Tt Tt cs Tt t- l-H SO m rH CS cn f» oc Os V" C cs cn 1" r- O lis c cn cr SO !H-t |i- o\ »n tj cn cn Tt ! ; (Sj I oo tJ r^ cn : oo rn i rn tj cn cs CS ! >n fc t- 1—1 l-H CS 1—1 ** cn *■* CO -^ o- vo vc m \ Os o i vc NMf t- r- VO ! i CO ! CS r- On On 1 CS cS Mir m in On ! cn rt & cn rH t—1 rH Tt cn r- Tt CS T- o cn % O H o- \ i V V [/ V t/- V t i- ■O e u. r e a B 0 '« c ti i C l< c k c 4 C C 4 PQ u - rt •C x\ ■o TJ t. ■d P=H g Q . i a a aj <U > OJ < « £ *«* > 4 N B p c N fi «. N u > N « g o l-H OJ H o 4> tH C . K 0 e rt J- i-h — 1 a 0 R j 6 s 'E « cs c oa.t U B c 5 d cs . c O 0 c o C c — 0 c 1 e 5 C i. ' "Si rt 0 rt i5 c 3 e St *I S Z S C d d ■- 0 £ p 1- c z i S £ y c Zg s 0 c h g£ rt a, gp. rt u£ C e CO c 5 at C « cS C 8< "3 M < < < < < < < G 24 DEPARTMENT OF HEALTH AND WELFARE on i—i &o O \Z o < o H o !z "^ O s O V ON Ih . o> rH W 1 ! i 1 2^ ! cn i H CS Tt cn cn | w >n cn hQ\ i-h CS ! 00 Tt incnrHrH r-ONrHCnTtrHl-Ht— TtrH(V)rHln ON l-H CS rH l-H ,-H 1 Tt rn ,-H cn ! * CS t- VO I— rH i-h t-i cn i-h cs" 1 CO CS rH Tf I m rH Tt " in [cnCSlnCSrHTtrHrH cs cn — oo "" mm oo Tt : O | cs rt O H oo m m on -H (N IrHl/-} y-j (*-] ,_( ,_, mOTtooovcncSi-HVOcnTtcnoorHVO-H^HTt !l-H ^D ,_ ,-H CS (NJ ,_| ,_ 00 CS t> cs r- rn cs rH (N [^ f^ cn cs" O •n Os tH . o> CS cs vo 1-1 cs ~ Ov cs §8 °& 0 H cn co rn l-H CS © l-H CS CS O VO ON VO VO VD Tt rH cs CSOv't-Tt-HVOCSOOCSVOCS rH OS vo cs vo on cn rn cn vo cs cn CN i;3 cn cn in cn cs tHHrtlH Tt I— VO rH rn . Tt rH CS ^ m vo m rn ,-h cs rt o H VO ri vo rH rH CS cn cn cs j cs vd r- cs cn r> vd ON rn CS CS cninONC-rHOcncscsvocn (S oo O O Tt cs cn on cn vq cs" OS Tt Ov o> t- rH ^ Tt l-H 0O Tt §8 OJ3 o H t-hcn-On omcsoom cs cs cs cs cs in o o vd r- Tt rH CS tN Tf O O vo | vo O cn vd cs Os m cs cs cn i i-h cn oo cs cn cs ; ■§,.3 </_ cn rn cn i-h CS rH rH rH OS VD *"■ 1-1 rH CS rH CS OS cs rH ^H Tt On r- O Tt *rt o H i-HinO cn vo CS oo r- rn CS rH CS en O m O rn \o oo rH (H l-H CS cn incsrHvo ir-cscncnc-cn i-H rH rn (N Ov cs t- cn i rn Tt Tt cn ! cn" '' 00 Tt ON 6> 1 ! m 1 §8 0 * (N rH VOInrHcnr- TfCS N-H Cn rH l-H cs o n <n vo vo cn cn t-h cs 00 00 Ov Tt ! c— cn t~ Tf Tt 00 t-» Tt ttH l-H Cn Tt i-H CN CN -a o, cnm 0\i-HinrHcs rn rn r- i-h cn m m *■* Tt CS ! l-H 1 Tt ; ^ i-h oo' ov in t> I oo Tt ! "-3 o H 1 to SO in vo vo Tt on incS 1 CS rH Tf r-H cn r- cs oo Os vo Tt 00 rH cs oorSrH^t co !r--HTtTt'-Hinm tHH rncsrH o cSTtmcs i *" ^ 1 ; cs" r- Tt ON Ih . .SO 6> j | t- rH | w 1 | *-* *~* CS rH Tt CS ! m i-i 81 oM olrnv^^o MnnoiO wnrtn \o cs \o vo eo cn cs *h in CM cs »H »-< cs cocnocnrHovOTti-HininrHvooo voh i rHrH rt r- HN ON ! m cs '• ov m i-h Tics •H VO cn cS i-H WthrtH rn in oo cn ^h Tt cn Tt cn cn ! r- t> cn i-h rn i-H OV rH ON "3 o H CslrHTt-H 00 0. C. O *D OO^OlCS .- r- C. _-. <3\ O c. cs r- *fr cs TtrHTH^H Ooocovocsmvooor-ooccrHinvo cnTti-i r-, ,_, r-, ^h« fsj^j.^,^ rH VD_ cn u c 3 « O o d E ■a 3 •5 c 0 o _ c d OJ < T C 1 E E GO c c E o > 7 t rt P ■d a rs. 1 R B C c - X c rt V < tl > c a. o 0 > 0 O c c t c u tt. 0 p TJ 4 _» 1 B C B o cn 0 rt a tH < 1/ A o Ph TJ rt M 0 o o a O o u. cs D TJ IS c w o c Tt 0 rt <u Ih o o .0 .c < > rt | X U C £ A R 3 _£ 0 s '3 o o 0 R "a 0 a a G 'C a CO o G O « X | c 0 X a > "5 c R 0- 0 TJ a rt 2 a e s > c 6 a 0 1 C f HI 2 1 o TJ rt i '3 5 0 U ts c Ph > TJ 0 o c Ph j rt £ 3 CO > £ t 3 CO h- d D. TJ N g a bi Ih O c D Tt 0 Z rt a •< > s EO c ■a c rt c o 5 K ^ 05 H 1/1 „ << o§ H O Go i-h H < PQ § go a* W pq >Q l-H on iz; ttn oo < u I—I Ph w H O ! w PQ < VENEREAL DISEASE CONTROL REPORT, 1951 G 25 T-* . r- Tt © 1 1 l-H ^H ! CS i Tf 1 i ! i 1 1 i ! i ! 1 l> ' IVOVOVOrHf-rtTtOVD CS CS m On i cc | CO rH VO CS Tf Tt m t^ r- vo on r- CS cs CS cn Ov ON CS cn r- 'rH Tt t OV CS rH CS Tt rH ! r- Cn rH cs 1 t- r- cn r- Os ___, — loccnr-TtTtcSrHcsov vo vc vtHHC rs Tt vo cs m Tt t- CO ! oc ON © Ov cs cs en Tt O CS V cn cn rH ON CS CS rH Tt cn i- cs JYH | | ___, | | , | WrH rH rH 1 i-h : t- CS ih\o | en ir r~ VD ICSCSVOCS !cn IOnootJ cn n or- i m or o Tt m m vr m i-h tj Ov vo c^ t> c- Tt t-i cn o cs rr VD 1-1 r rH r- 1 cs ! I> ! VD rH ! ! J Tf CS i-h ON 1 VD CS OO 1 cs __ , _____ cs l-H Tt 1 VO VC cr Icncsomi-Hcs imrHm cn fi~ rH m vr O vo m vo VO rH oc ov m tj rH VO V v- rH Tt Os Tt cs >n cs ^~ ^ Tt CN NHH 1 CS cr Tt 1 1 | j j C IrtHlnXrtOO ! ON CS OV m ir VO CN rH ff © vo i-h cs i-h : cn m i-h tj m oo i> V cn o CS tr ev i-H «H Ov vo cn rH r- 1-1 l-H 1- CS r- 1 cs cn i-h ! cn «r m cn CS VD i-h r- vc t> cn C*" Tt -< rt CN VD CS -rt m rH -^J VD m r- Tf hhqo wnt ioor~ m ir © rH cn IN It} O Ov i- VC rH Tf vo VL Ov cs rH CS : rH Tt OC XJ l-H 1- cs ; r- CS i- cn cn ' cs : i-h i Tt CN ! : cs cs 1 oo cn ! cn rr a- O ! VD VO 00 Tt CS I oo vo © VD VC CS VO rH ff c- r^ © : cs cs c VO CS tj vo on r- cr cn m CS cs cn m CS l-H 1- CS i- ' cs cn co : cn tj cn rn r- i vo o\ ov mm : t- i-h CS ov r- i : i cn cn Tt t- rn fN ! O t- <r r- ! VD 0\ OO m On ! Tt r- Ov r- t- OV rH »-l CS l-H Tj vo r- i cs cs rn cn cn Tj m r- cn CN -H r- in cn rH ! i- cn rn cs ' CS 1 : ! : i-h i ■ i : ■ rn rH ' -1 1 1 1 1 I- Tt J 1 rt cn ! m r- vo !Tti-H[--©cs»n icsr-oc VD VC i as c- ih cn 1 vo i- ! cn cr rn m cs rH ON Tf CS *■* cn cs cs c OO Tt 1 CN VC — Tt ! (N rn c- cn vo Tt CN VO c*- m v as cn t-i t- 1 TJ o ! ON Os l-H 0O C~ cn o ' cN r- Tl cs i vo cs Tt Tt oo on Tt cn cS r- cn cs oc : tj tj cn m _ cn r- m in CS 00 oc cs Tt CN CN CN l-H 1- Tt CS i~ 1 cn rfc * i n . I. a V a o u S rt > a fi r er R P > c c C R > U A\ P (- Li [ k > 2 ~< jo X a c P P 1- \i c i ! C -i a t F r > t TJ G C £ X X V E S 1- 1 I 0 Q d 0 c 3 Is ~d <* h s G ¥8 1 1 > c E ? C L 1 c TJ OJ IN n c C X v~ c fe T. 9 G a to .- 3 0 fe 1 ! 1 g x a tj 3 « O Qi % C s c > el C a | c F c K « IT 1 c Z c G TJ 1 c a c P v- ) C i x\ d C rM c S C 1 c •o Si N C rt eo o 2 z £ 5 > p rt O X UU O = M «j Z^LO> P fit rt C ttitt. 3 Jr rt rt 0 o0u o p d C S r C rt e < < < < < < < G 26 DEPARTMENT OF HEALTH AND WELFARE V-H VI O O o H O G rt o u o < g t-H Ph Ih . .SO : : j i i i j 1 ' 0> i 1 i i i 1 ] 1 1 ! ka m m cs a O cn i-h cn cN r- cs cn vo vc oo r- i- CS CN cn c cn cs i- © VO TJ CS I CS rH rH §1 l-H Tt CS r- (SH^ cs cn rH i- o vo m Ov 0 h cn cs rn TtmCSi-HrHm rHr- m cn cn m v cs cS Tt cn i- CO __. cc r- m oc Tt oo cn Tt cn vc cn cr VD VC cn o c r- t- m v- cn cs r- "t ON V cn ! cr rn i-h rt 1-1 tn cs «- cn CS r- CS CN co r- 0 H Ih . i_Q rtrt 1 6> Ih ^ §8 l> l-H VC r- r-- cs i-h cs ir I cs cs CS vo vc cn (*■ vo vc Tt ~H ff m vo ov c- rn vc ! ! vo cn o CS r- CS cs rn y- OO [— OJ5 © 0 h *"H D.-3 rn CS rn OC ON Tf ON r-t V | CS CN Tt Tf VO VC cn c rH OS CN >v^. CO *c3 o H oo cn i-h t t> CS rH CS CS C Tt Tj so CDSC Ov Os ■ vo vc o«h VC vo m r- l> — VC r- i- OO Tt rH f (N rH r- CS CN rH .- OS 00 r- Io j ■ «« o> i ' i i S8 Tt cn ! r- cs cS vo on : m ___, .__. cn c- cs cs © Tt Tj Tt tj VO rH IT 00 l> •- cn cr CS cs •"• 00 Tt Cx CS rH i- 1-i 1- r- © i- ON Tt ON o h £19 co cn tr © VD CO i-H cn V rH m oc m ir Tt •A Tt Tt CS CN CO 3 CS vo ! VC CS 00 Tt o C cs c^ cn c cn m oc ON O1 Tt Tj © l-H O* cn cs i- m i w cs cs CS rn rt I- rH Tj cn rH r- cn cs i- o H Ih . l-H r- .SO j ! 1 j 0> ■ 1 i 1 i i i §8 OO Tt CS CN cs r~ vd rn i cc ! t- t- -h io VC VD VC o c os i a- © OO CN m : v 00 Tf c% Tt rH CS CO C" rH vo m OJ3 i OO Tt Os 0 *- is on cn ! vc t-~ rH so cn it j ov cn vc ON Os Tt TJ © Ov «- Cn rH rn >i^5 CO i> r- cs cc ON 00 CS Tt IV f> t- O OO CN VO VC cn ', cr © C~ C*" m i w~ rt CS r- r- IO i-* 's m i-h rr Tt TJ cn C*" r- vo S Ih . ! 1 I ! 1 T-1 T- rH r- ^H rH |Q i I i i 6> 1 i I £ es Os 00 cs o> cn cn 1 Tt | vc i 00 oc t- rH VC © c Tt TJ OV i-H oc VO Tt CS inNf Tt Tt OJ3 l-H t— cn !fr cs cs cn cn rH rH m m i i ■ Ov o * X. u OS 00 i-h © cn m cn v- i tn cn cs vo vo © © vo cn cn r- r- l-H r- Tt rH (S . cn cn rH i-h 'i " rn rt >^ CO ______ oo vD cn a vo 00 It- ' ■— Os Os CS Tt X l> r- m m O* rH OC cn oo m cs CS c Tt Tt rt cn i-H r- rH Tt i t5 vo in Tt Tt rH i- CS CS o *o o H o t i Q G ? 'in ec V 1- V y cr f u r/1 eci TJ 55. a cc CC 9 B 0 r X R R rt Ll o c k c 4 c i C c < C 4 p 1 a c i P 4 a 4> p pi ■2-c TJ — TJ TJ TJ ~ o S TJ TJ Ph l*H X e, £ P S TJ a, a es a X 4 1 u a c X t o VC VO Wi i31 so '£ VD G vc E r- c » G f s e cc OS oc y £ oc 3 <u • a j- n • £ - « . a r a . « . cc • .a « . *o rt rt o o o p s oo e tl 0 c bi J O ci c o o a O cu o > a 0 U CJ 0 'C ci fe Ph C c be rt ls|| fe fe 11 nr t- fe C fe c c fe c fe c Z "S. c c5 g c fe O £ rt rt rt £ rt rt > •1 H 2rZ 8& d£ G * J5 itr- rt £ rt^ £ £h^^ rt -C = £0<rt rt^£ d£ cj p < < < < < < < < < < < •^3 vD a 0 O in I Tt 00 rn vy n << u« *§ W WH E 3h C on SP S^ |« rt w H y ^^ h-H °§ oo < U l-H l-H H O X m < VENEREAL DISEASE CONTROL REPORT, 1951 G 27 es cs j I \ cn m rn rn j j cn Tt o VDCSVDOO mm rH r- mm cn rn cs r«- © o r- tn in © © cS cS cs vo VO m Tt i-h cn CS r- CS rH , cn l c*" es r- i m mm cs cs . . i i i i i 1 CS OO CS Cn CSTtoo oocnr-oc cncn «-h r- mm vo rn m y->Os © es © © cs es mm cn t- vo c- m i es Tt CS i- VO m CS rn cs cs cs es i I i | | i ! i 1 I i i 1 i ! 1 Mill HH rn^H CO Tf Tj r- © es in cs cs cn m hh CO © rH f* © © rn i-h mm Tt Tt cn m cn ir t cn i-h cn ! I m IT 00 CO rH OV cs cs cs cs ___ , ___, ,___, i 1 m rr vo rn m VO 00 cs vo © O cn cn oo co cn rH 1 1 V TJ cn rH rH (S CS II II 1 cn cs i ! OOt^r- c c c r- V f Tl TJ c rr Td TJ V V ] r- c «- O 1 1 1 rH rH Tt Tj m m © CN H r- m rH rr rn rn cn cn CN CS cn in rH Tt cn c*- cs CN Tt m ON cs cs r- r- cn I cn O © IP* CS r- HttNC m Tt r- m r- rt tj vo vc Tt Tt m v Ov r> m in rn as cn cn i-h r- m w- cr VC r- IT 1 cn m m r. Ti t- r- Tt TJ ! Tt Tj o> vc rr c 1 © vo vc 1 1 CS y-i Tt rH ft- © r- cn es cn r Tt rH cn CS rH T-I cs r cn cn cn tj cn vo Tt TJ ___, , ,___, m t- i oc Tt CS rH CN es VD VC o c cn cs Tt rH f" i Tt ON Tt CS CS tn rH ON 1 i j | I ! ! II | 1 | || ""M 1 ! ! i i! 1 ! Ml ii i i I 1 ! I ! i CS CS © CS Tt m Tt m vo vc CS cs © m r- O f-- rH rH O ! © VO rH rH TJ C1HH m rH Tt ; on c- CS cs es I co cn Tt i-h f. l-H vo Tf CS rH rH rn r- cn cn cn m 00 Tt TJ cs (N © l> Cri vo cn cs m C\ rH CO oo t- m vo cs cs cn cn o cs <S VD 00 i-h rv. cn © cs o cs i tl tt u P c u D p p n tt ft P c c fl ft A r. ■a-g Tl TJ •c •d X Tl Tl T, -n T) TJ fl TJ a G c X « s CJ S to _s R 0> N X CJ t N i TJ 0 3 QJ N c a* N rt © QJ N X © QJ Is o © o QJ N TJ oc p rt e_ oc 1/ c °°.3s e oc fl ON fl ON fl r/ c c O1 C C • a •a ** « feg R< . rt . rt . R cd . « p 0 os « tl O oi O cj o a c S 0 o cj y _ -fl Ih d v_ CU £PhH bO o cj c ra O to tl c n S 1" fe ■ a o 0 ZE? 0 zs fe s Zc5 fe 0 zs fevO feS fe O fefo rt o A feS IB PhP rt rtS go £5 rt £ £co e P dig £°H> G rt A rt£ CD P 25 rt «P fl 0 2£ s£ 8£ rt OJ G rt iS RH < < K < < < <J «. < < < < < < 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 \ V 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 S3 - S3 fe ONcSTj-m-rj-mvom o ^S " rn © o\ cn m es © CS rn rH «rt o VD rH rH © ut. 4)«M rn PL, O & o <n ON m Ov ""S ^13 M CSfnTfrHOmTfrH © O 4> SE on rn cs Tt f- r- © mmmmrHr-mcn © rH OS fS Tt CS 00 ON ■~ rt rn cn cs es es cs ;3 M tt cs m rn cs Tt HZ -* HZ cs Q 0 < CIS < C "rt m fe ©cScnvcTj-mvovo o a : r- r- © m rn © p< rH fS rH rn rn -H © Pi 1 m cs rn © eu CJ <«H d, o Ph VI a i t/3 w © »n Ov X H m¥. M X H °."S_ « CJ CJ cnrHrHCjvm^vor- VO QJ 4) oo vo © r- o rn cs Ii Tr0^r.|>t(Nr. rn cn CS rH CS (S cn ii rn on cn Tl" CO m rH in rn CN 0 ^z *-* a Hz ^ cs S H < CJ *-> ©eScSt-mmmoo rH CS rH rH rH rH © o < 11 ^H rH cn 00 OS m Tt m rH rH o o H r"' H rt l-H Ph 0 HH PL, O l-H Ov 3. HH Ov Tt ON U rn *""* O rH " < "p VOmrHf-VOr-rH© cn < "7 So EE Tt m oo cs m ov cn pH.(i mTj-TrvD©mTfoo ON feci th r- m Tt cn ov cs ;S « rn m es cs cs es in c M m cs m rn cn o\ 33 HZ *""' oo Tf ON o 2^ <. rH HZ 1-1 es" Q m W oo S3 m co ! m m cs vo rn rH rH jrHH CS rH | o 'in 0 rq" 11 rH O 00 VD VD ON VO rH © © O £2 S3 00 2" IH^ ft|0 Oh rt rt pq o gg 00 TT ojo On "^ rt > rt Ov »-g H QJ OJ rH © ! rH 00 O m rH Tt a R ll ■tn d oo -H © (s r- vd Tt 3 J Ii m rn ■ in cs m ti- o 3 rt j rl (TJ CO 00 OV t- cs cn i cs cs Tf cs l> 00 CS Tt rH CS o_ is e rt HZ 1—1 tf] 4) 4) i- tf) tf) Ih . o 5 -* ^rt 1/3 S x> PhO HZ 1-1 cn" Ih o Oh Hrt T? £ cs f~ ! r- m tj- m m o © S3 ^H rn © ov m i m VO rH j rH o o ix, fe r- Tt ON (2° m 2 s P .s (fi « CJ — rt y Ih rt 5 Ph Tt OV c .2 ^d 'o rt Uh EE r- 00 ! 00 VD (S i Tt Eg CS © On vo ! cn o •* tt : m ■— co vo & [ o cs Tt Tt cs ; m Ov tf. Hz CS cn i cn cn 11- ©__ cs" ca o j-h rt C^ CS Tt ! Tt 00 cs t*H o w x & t/3 Ih u Tt d 2 1 r, a w rt i < u J 8 3 < * 3 7 'c S & 43 Ph > hH S § ■8 o > X O B X -Th" 4) rt « > rt a. o rt y rt u w PQ < ■a UH O 2 4J 1*1 rJ PQ < 4) Ih 3 Cfl O Oh X W «H O u 1 5 "1 rH C rt tH tf) o o 0 «H MH u ? O O 1+H rt "rt 4> O rt rt «« 0 o s 98 S d 4) 3 5 & 2« g 3 O v 0 £ 1^1 0 a fi : c i- « y E a -a c B a c X 9 - C OJ c D 5 c h (fi ri .8 coO g J? E >, c ■a c & t- ■a " tf • 4 E c X 4 E o u ■o c rt ca ■D o OJ 6 rt d C H s go go- s o q lis i L c cd Q c V- 4 4) CC Ih a £ U gj u 4 O EC fl a. ID u 1 H N W 5 4 c 0 > 'u rt 2 cr Cl u 4> u I i-i N CO VENEREAL DISEASE CONTROL REPORT, 1951 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 ■* a I8 5 4) 2 tn 3 8 > CO qS -a e3 S K |, ^H V Oti 11 a a So 1 to 1 a *rt o a °HH _o a 2* S"a •s «> ow eg '3 CL, o rt > i <u Q a ■3 a c o si uW ffitj 0 o ta o EP O 0 5 _= 0 o 1 S3 S So O OB o c « rt d'3 SSS ZB.3 1 O rt an a> H £■ 4> rt A £ oil ZH 4 rt 5 as ■s cu tfi 4) |« a v. ZO •a Si rt 55 o z 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 si t. _>£ oy oS '.2$ > » Sa J3 e3 S H 3, 11 So "I § *rt u a ^qt« _o d OK n C .rt 'P 'co >1 .s S a> rt t> 'u Oh 1 Ih rt 0. p Q 1 *3 5 e o il ■3 4> O sis &EO £E> go's lH S o tH o 1 S2 ^ S 2 a §53 O fl rt 3d OD CO d 5"£ !_•£__ H >■,£ z£§ ™ rt 3 u °l ZS 1 o (fl u s« C h ** <u ZO TJ al W O Z 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 g Ss 3 fi f J ss s CJ a a Jo a si OS o E So SS d 55 '3 U 'd X X a Si'Z ■S3 OK 1 'us s p rt > fi s o E t_ d D. Si Q c a a c o gi ss„ E*o o r an §»« -M 4) O |iq §1> So^ £ O Ih O if & fl O-S O C rt mZl COM rt.rt*j3 isl 3.2 u 1-1 >£ Zf.3 1 3 ,o rt — as "" rt I-1 a u o| ZH 1 fl o rt o a a cfl <U ■5 8 ZO •a flea 55 o z 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
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Division of Venereal Disease Control Department of Health and Welfare ANNUAL REPORT For the Year 1951 British Columbia. Legislative Assembly [1953]
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Title | Division of Venereal Disease Control Department of Health and Welfare ANNUAL REPORT For the Year 1951 |
Alternate Title | VENEREAL DISEASE CONTROL REPORT, 1951 |
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British Columbia. Legislative Assembly |
Publisher | Victoria, BC : Government Printer |
Date Issued | [1953] |
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Language | English |
Identifier | J110.L5 S7 1953_V01_08_G1_G35 |
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Sessional Papers of the Province of British Columbia |
Source | Original Format: Legislative Assembly of British Columbia. Library. Sessional Papers of the Province of British Columbia |
Date Available | 2017-05-11 |
Provider | Vancouver : University of British Columbia Library |
Rights | Images provided for research and reference use only. For permission to publish, copy or otherwise distribute these images please contact the Legislative Library of British Columbia |
CatalogueRecord | http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=1198198 |
DOI | 10.14288/1.0347417 |
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