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Division of Venereal Disease Control Department of Health and Welfare ANNUAL REPORT For the Year 1952 British Columbia. Legislative Assembly 1954

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 PROVINCE OF BRITISH COLUMBIA
Division of
Venereal Disease Control
Department of Health and Welfare
ANNUAL REPORT
For the Year 1952
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty.
1953  Victoria, B.C., June 24th, 1953.
To His Honour Clarence Wallace, C.B.E.,
Lieutenant-Governor of the Province oj British Columbia.
May it please Your Honour:
The undersigned has the honour to present the Report on Venereal Disease in the
Province of British Columbia for the year 1952.
ERIC MARTIN,
Minister oj Health and Welfare. Department of Health and Welfare (Health Branch),
Victoria, B.C., June 24th, 1953.
The Honourable Eric Martin,
Minister oj Health and Welfare, Victoria, B.C.
Sir,—I beg to submit the Annual Report on the work of the Division of Venereal
Disease Control of the Department of Health and Welfare for the year January 1st to
December 31st, 1952.
I have the honour to be,
Sir,
Your obedient servant,
G. F. AMYOT, M.D., D.P.H.,
Deputy Minister of Health.
Department of Health and Welfare (Health Branch),
Division of Venereal Disease Control,
2700 Laurel Street,
Vancouver 9, B.C., June 24th, 1953.
G. F. Amyot, Esq., M.D., D.P.H.,
Deputy Minister of Health, Victoria, B.C.
Sir,—I beg to submit the Annual Report on the work of the Division of Venereal
Disease Control of the Department of Health and Welfare for the year January 1st to
December 31st, 1952.
I have the honour to be
Sir,
Your obedient servant,
A. JOHN NELSON, M.D., D.P.H.,
Director, Division of Venereal Disease Control
and Consultant in Epidemiology. TABLE OF CONTENTS
1. List of Tables	
     6
2. List of Charts	
     6
3. Organization Chart
     7
4. Introduction.   _______
_   .        9
5. Treatment        __   	
     9
6. Epidemiology    _         _        	
_ 10
7. Social Service      _                 .   _
11
8. Education  __   	
    __ _     11
9. General      _ 	
         12
0. Statistical Section	
  14 STATISTICAL SECTION
LIST OF TABLES
Page
Table
I. New Notifications of Venereal Infection and Rate per 100,000 Population,
1943-52  15
II. New Notifications of Venereal Infection Compared with Reported Cases of
Certain Other Notifiable Diseases in Canada, British Columbia, and
Greater Vancouver, 1952  16
III. New Notifications of Venereal Infection Classified According to Diagnosis,
Sex, and Source of Reporting of Notifications, British Columbia, 1952___ 17
IV. New Notifications of Venereal Infection Classified According to Diagnosis,
Sex, and Age-groups, British Columbia, 1952  18
V. New Notifications of Syphilis by Age and Sex, British Columbia, 1952  20
VI. New Notifications of Gonorrhoea by Age and Sex, British Columbia, 1952  21
VII. Rate per 100,000 Population for Total Venereal Disease by Age-groups,
British Columbia, 1942-52  22
VIII. New Cases of Syphilis Reported in British Columbia by Age-groups and
Marital Status, 1952  23
IX. Total Primary and Secondary Syphilis, British Columbia, 1952  23
X. New Notifications of Venereal Infection Classified According to Diagnosis
and Place of Residence, British Columbia, 1948-52  24
XI. Patient-visits at All Clinics of the Division of Venereal Disease Control
Classified According to Diagnosis, 1943-52  31
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, 1948-52  32
XIII. Free Medications Distributed to Private Physicians by the Provincial Depart
ment of Health and Welfare for the Treatment of Venereal Disease,
British Columbia, 1938-52  33
XIV. Places of Meeting Reported as Facilitating the Spread of Venereal Disease,
1948-52  34
XV. Places of Exposure Reported as Facilitating the Spread of Venereal Disease,
1948-52  34
XVI. Contacts to Venereal Infection Classified According to Investigating Agency
and Result of Investigation, British Columbia, 1952  35
XVII. Contacts to Venereal Infection Classified According to Investigating Agency
and Result of Examination, British Columbia, 1952  36
XVIII. Incidence and Rate per 100,000 Population of Total Venereal Disease,
Gonorrhoea, and Syphilis, by Quarters, British Columbia, 1948-52  37
LIST OF CHARTS
Chart
I. New Notifications of Venereal Infection and Rate per 100,000 Population by
Diagnosis, Reported by All Agencies, British Columbia, 1943-52  14
II. New Notifications of Syphilis by Age and Sex, British Columbia, 1952  20
III. New Notifications of Gonorrhoea by Age and Sex, British Columbia, 1952  21
IV. New Notifications of Venereal Infection and Rate per 100,000 Population,
British Columbia, 1942-52  22
V. Patient-visits at All Clinics of the Division of Venereal Disease Control Classified
According to Diagnosis, 1943-52  31
VI. Free Medications Distributed to Private Physicians by the Provincial Department
of Health and Welfare for the Treatment of Venereal Disease, British
Columbia, 1938-52  32 o
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3      O    Q.  DIVISION OF VENEREAL DISEASE CONTROL
ANNUAL REPORT FOR THE YEAR 1952
A. John Nelson, M.B., Ch.B., D.P.H., Director, Division of Venereal
Disease Control and Consultant in Epidemiology
INTRODUCTION
During the year the number of venereal-disease cases reported in the Province was
3,914 cases, compared with 3,916 in 1951. Infectious syphilis has now become a real
clinical rarity; only 33 cases were reported as of December 31st, 1952. Late syphilis,
as reported to this Division, has also shown a marked decline.
TREATMENT
This Division continued to overtreat gonorrhoea patients with massive doses of
penicillin, thereby aborting any possible concomitantly acquired syphilis. This over-
treatment schedule appears to be of real importance in reducing the number of new cases
of syphilis in this Province, as elsewhere.
An important numerical change worthy of mention concerns the number of cases
of gonorrhoea that were treated and diagnosed by the private physician and other agencies
in the Province. The latter groups treated more cases of gonorrhoea than the clinics of
the Division.
Prenatal syphilis continued to show a decrease in the number of new cases reported.
In fact, this is the first report in which it could be stated that the number of new cases of
prenatal syphilis was falling with the same rapidity with which the new cases of acquired
syphilis are being reported to this Division.
Qualified specialists are still employed by the Division to act in a consultative
capacity on the various problems that arise in treating venereal disease. This consultative
service is extended to all physicians who need such services throughout the Province.
Due to the decrease of the patient-load in the various treatment clinics, there was a
real attempt made to discontinue certain services, but at the same time not sacrifice the
services to the patients.
Free drugs were again made available to private physicians. In some cases where it
was necessary to alter the type of antibiotic used, because of allergic manifestations,
alternate drugs were supplied. The policy of this Division was not altered with regard
to supplying the directors of all health units with the drugs so that they can be dispensed
locally to the private physicians.
The consultant in medicine to this Division continued to interest himself with the
problem of non-specific urethritis. The number of cases falling into this category did not
diminish, and as yet no satisfactory diagnostic criteria have been established to classify
this troublesome condition. The treatment of non-specific urethritis still remains an
unsolved problem.
The Vancouver clinic and the New Westminster clinic maintained the same hours of
service as in previous years, in spite of the decrease in the number of new patients
reporting. This service is still considered to be sufficiently important to allow no change
at the present time. D  10 DEPARTMENT OF HEALTH AND WELFARE
During the year, clinic and treatment facilities continued to operate at the following
centres: Victoria clinic; Vancouver City Gaol; Prince Rupert and Prince George City
Gaols; Greater Vancouver Metropolitan Health Committee, Health Unit No. 1; Male
and Female Oakalla Prison Farm; Girls' Industrial School; and the Juvenile Detention
Home.
There was a decline in the new cases of chancroid, although a number of these were
diagnosed and treated by the Division. The majority of such cases were found among
mariners entering the port of Vancouver, and there was no evidence of increased spread
of this infection among the general population.
EPIDEMIOLOGY
Although the greatest single factor in the control of venereal disease is penicillin,
epidemioligy is the other very essential weapon for a complete armamentarium in any
health programme. It is felt that such epidemiological programmes were responsible
indirectly for the steady decline in the reported incidence of venereal disease, both in this
Province and nationally.
Through continued efforts to find new cases, it should be possible to reduce further
the rate of venereal-disease infections in this Province and maintain a steady decline in the
reported incidence of the disease.   The Division is now pursuing such a course.
The epidemiology section is constantly seeking new methods and tools to assist
public health workers engaged in case-finding and case-holding, and thereby make their
programmes more effective. The techniques used in eliciting the necessary information
from contacts are undergoing certain changes which should make such measures more
effective.
Consultations on epidemiology are available to all local health units through the
epidemiological section of the Division. During the past year two field-visits were
requested—one for the purpose of studying the problem presented by venereal disease
arising from alleged bawdy-house activity and the other for consultation on epidemiological
procedures.
During the year a diagnostic centre was established in the down-town Vancouver area
(Metropolitan Health Unit No. 1). The establishment of such a unit proved most
helpful, both in case-finding and in case-holding. This new unit provides clinic service
every day from 11 a.m. to 1 p.m. for the purpose of interviewing male patients and making
diagnostic tests for gonorrhoea. Treatment is offered to these patients on epidemiological
grounds or clinical evidence of infection.
The epidemiology section works in close liaison with the private physician and is thus
able to interview contacts and follow up patients with unsatisfactory serologic reports
which appear on the confidential lists obtained from the Provincial Laboratory. This
technique has been beneficial to both the private physician and the Division of Venereal
Disease Control. The epidemiology worker at the Vancouver City Gaol examination
centre has been particularly effective, and the services rendered have been most worth
while. Through an interview on radio station CKMO (police broadcast), this worker
was able to make known the activities of this centre.
The Indian Health Service is assuming the largest part of the responsibility for
case-finding and follow-up of the British Columbia Indians. During the past summer
many Indians were concentrated in the hop-yards, and this proved to be advantageous
to this section because many former patients were located and follow-up examinations
were thus possible.
This Division continued to explore the facilitating processes, maintained constant
vigilance over potential community trouble spots, and made every effort to suppress the
spread of venereal disease. VENEREAL DISEASE CONTROL REPORT,  1952
D  11
Vancouver was again visited by a representative of the American Social Hygiene
Association, and the report made by this trained representative showed a marked improvement in the conditions existing in the city compared with the previous visit of one year
ago. Much of the information obtained from such a survey was of value to the Division
because it pointed up conditions which are frequently not drawn to our attention.
The Director of the Division of Venereal Disease Control was invited to attend the
annual convention of the British Columbia Hotels' Association. The subject of his
address to their representatives was entitled " The Facilitation Process in Hotels and
Rooming-houses."
The senior epidemiology worker presented a paper on " Venereal Disease Epidemiology " to the public health nurses at the Institute held in Victoria.
SOCIAL SERVICE
The activity of the Social Service Section was curtailed during the year when the
case-worker in the Vancouver clinic was given extended sick-leave, and no replacement
was available for three months. During this period specific problems were dealt with on
an emergency basis by social-work staff from the Division of Tuberculosis Control.
However, in the first eleven months of 1952 there were 733 interviews of patients carried
out by the Social Service Section.
Continued use was made of the rating scale devised in 1951 to get a general picture
of the kind of people who were reporting to the Vancouver clinic for treatment. An
analysis of the ratings for the twelve-month period from July, 1951, when the rating
system was instituted, to June, 1952, indicated that about half the patients interviewed
needed help in solving some of the more basic problems that were facing them. In this
group were the older adolescents who were in conflict over sexual behaviour, and who,
out of curiosity and lack of knowledge, were seeking solutions in promiscuous sexual
activity. It was interesting to note the number of new immigrants in the young adult
group who had not adjusted to their new environment and had become infected with a
venereal disease because they were susceptible to the only kind of female companionship
available to them; namely, the casual street pick-up. These patients responded well to
the counselling interviews, but the lack of community resources to which they could be
directed for more wholesome recreational outlets was a handicap in working with them.
In addition to those patients who could utilize personal counselling, there was a
fairly large group who seemed to drift from place to place, and job to job, and whose
personal relationships, including their sexual ones, were all on a casual basis. Although
most of these individuals could be helped to co-operate in the treatment plan, they had
no incentive to change their promiscuous behaviour pattern because it met their particular
needs.
Because of lack of staff, no specific studies were undertaken by the Social Service
Section during the year.
EDUCATION
The Division of Health Education has the major responsibility for health-education
programmes and activities and shares this with the Division of Venereal Disease Control
in the case of lay education. Education directed to professional groups remains the
prime responsibility of this Division.
Members of the Division presented a total of 177 lectures during the year. Lectures
on the methods of control of the venereal diseases were given to the following: Student-
nurses at all the main training-schools in the Province, students at Essondale, practical-
nursing students, student-barbers, and students in the foods department at the Vocational
School. In addition, practical experience, as well as regular lectures, was provided to
student-nurses from the Vancouver General Hospital. D  12 DEPARTMENT OF HEALTH AND WELFARE
Lectures were also given to students in various other fields, including medical students
at the University of British Columbia Medical School and residents of the Vancouver
General Hospital.
Fortnightly meetings were held in the Divisional headquarters for all attending
physicians, at which time lectures were given by members of the consulting staff on various
aspects of venereal disease. The consulting syphilologist presented a lecture entitled
" Present Treatment Status of Syphilis and Gonorrhoea" at the Vancouver General
Hospital refresher course for general practitioners held in November.
There was a continuation of the programme of talks to youth groups, which was
established in 1950. Speakers were provided upon request to HI-Y groups in Vancouver
schools and to youth groups at the Y.W.C.A. Groups addressed during the year were
the Britannia and King Edward HI-Y's and the GAI-Y groups at the Y.W.C.A. A talk
was also given at the Girls' Industrial School. As a result of a meeting with representatives
from the Greater Vancouver Health League and the First Aid Attendants' Association,
lectures on the venereal diseases and films on the subject are now being presented to each
class of first-aid trainees.
The following is a list of articles written and published and papers presented by
various members of the Division:—
Articles written and published:—
"Undiscovered Case—the Problem"  (the March issue of B.C.'s Health),
Dr. C. L. Hunt.
" Community Responsibility and Venereal Disease " (the First Aid Attendant,
official magazine of the Industrial First Aid Attendants' Association of
British Columbia), Dr. C. L. Hunt and Dr. A. John Nelson.
" Progress in Venereal Disease Control " (published in the Vancouver Medical
Bulletin), Dr. A. John Nelson.
" Co-operation Key to Control in Venereal Disease " (the Tuberculosis Society's
publication Your Health), Dr. C. L. Hunt and Dr. A. John Nelson.
Papers presented:—
" Some Considerations in Public Health Control of Gonorrhoea," presented by
Dr. A. John Nelson to the annual meeting of the Canadian Public Health
Association.
" Co-operation between Police and Health Departments in Venereal Disease
Control," presented by Dr. A. John Nelson at the annual conference of the
Pacific Coast International Association of Law Enforcement Officials.
" Present Status of Premarital Blood Testing," presented by Dr. A. John Nelson
to the Provincial Council of Women, New Westminster group.
An exhibit was presented by the Division at the North Vancouver Kiwanis Annual
Fair and Trade Exhibition.   The theme was " Corky the Killer."   The exhibit was well
received and created interest.   Literature was distributed, questions answered, and blood
tests were offered to the public.    Pictures of the exhibit were published in the British
Columbia Tuberculosis Society's magazine Your Health.
GENERAL
The year was marked by anticipation that some clear-cut policy would be enunciated
with regard to more satisfactory headquarters and clinic space for the Division; apparently
plans have again met with delay. This is indeed unfortunate because it is possible that
in the not too distant future the present space may become untenable due to its physical
characteristics. There is also the possibility that it may soon be required by the Vancouver
General Hospital for its building programme.
During the year Dr. A. John Nelson was appointed Director of the Division. Dr.
Nelson had previously been with this Department and left to become associated with the VENEREAL DISEASE CONTROL REPORT,  1952
D  13
Division of Venereal Disease Control in the State of New York. Besides being Director
of Venereal Disease Control, Dr. Nelson is also consultant in epidemiology to the Health
Branch, and it is felt that this is a most satisfactory arrangement.
Dr. W. Stuart Maddin, following three years' postgraduate training in syphilology
and dermatology, under the National health grants, returned late in the year as physician
in charge of clinics. Dr. Maddin's specialized knowledge and ability will be most valuable
to this Department.
Dr. C. L. Hunt, the former Director, is now employed on a part-time basis as
consultant in internal medicine.
National health grants continue to prove extremely useful in assisting the Division
to maintain its ever-expanding services, as well as in affording opportunities for
postgraduate training of medical and nursing personnel.
Funds from these grants were made available to assist in the operation of the British
Columbia Medical Centre Library, where up-to-date literature on venereal diseases is
maintained. The Divisional Director is an active member of the management committee
of this library.
The Division is most appreciative of the co-operation and help extended by various
groups and agencies who have contributed so much to the success of the venereal-disease
control programme. Special mention must be made of the Vancouver City Police, the
Royal Canadian Mounted Police, the British Columbia Hotels' Association, the Liquor
Control Board, and the Indian Affairs Branch of the Department of Citizenship and
Immigration.
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 the helpful advice and assistance
so freely given at all times. D 14
DEPARTMENT OF HEALTH AND WELFARE
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DEPARTMENT OF HEALTH AND WELFARE
The total number of cases of venereal disease reported in the Province for 1952
was practically the same as that recorded for 1951. The rate per 100,000 population,
however, showed a small decline to reach the lowest figure which has been obtained since
the peak year of 1946.
The figures show that gonorrhoea was responsible for 86 per cent of all venereal
disease reported during the year, and this disease must therefore be considered the major
problem in venereal-disease control.
The situation with regard to syphilis continued favourable. Only thirty-three cases
of infectious (primary and secondary) syphilis—the lowest number on record—were
reported during the year. There was also a decrease of 38 per cent in the number of
patients detected in the later stages of syphilis.
Reported cases of other types of venereal disease showed a marked increase during
the year. This increase was almost wholly due to increased reporting of non-specific
urethritis (venereal), mainly by the Divisional clinics. Whether this increased reporting
represents a true increase in the presence of this clinical entity or is due to increased effort
on the part of clinics to differentiate between the ill-defined group of conditions—clinical
gonorrhoea, gonorrhoea treated on epidemiological grounds, and non-specific urethritis
(venereal)—is a matter under study at the present time.
TABLE II.—NEW NOTIFICATIONS OF VENEREAL INFECTION COMPARED
WITH REPORTED CASES OF CERTAIN OTHER NOTIFIABLE DISEASES
IN CANADA, BRITISH COLUMBIA, AND GREATER VANCOUVER, 1952.
Notifiable Disease
Canada
British
Columbia
Greater
Vancouver
55,939
38,393
45,780
18,890
18,186
10,103
10,427
8,492
192
8,227
7,088
6,266
4,163
3,914
1,986
1,411
976
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2,344
1 727
2,145
1,284
2,035
272
Rubella. _ ,_	
568
125 VENEREAL DISEASE CONTROL REPORT,  1952
D  17
TABLE III.—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED
ACCORDING TO DIAGNOSIS, SEX, AND SOURCE OF REPORTING OF
NOTIFICATIONS, BRITISH COLUMBIA, 1952.
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IU
Z
Ih
4.
O
Totals  ,. T.
M.
F.
Clinics, total _   T.
3,914
2,808
1,106
1,801
1,182
619
1,567
1,058
509
108
71
37
25
17
8
83
35
48
18
1
17
1,734
1,362
372
24
15
9
355
249
106
3,367
2,384
983
1,576
986
590
1,384
898
486
81
49
32
24
16
8
70
22
48
17
1
16
1,526
1,233
293
8
3
5
257
162
95
	
269
32
237
146
14
132
132
9
123
4
4
3
2
1
7
3
4
675
531
144
166
100
66
138
81
57
6
3
3
7
7
13
9
4
2
2,423
1,821
602
1,264
872
392
1,114
808
306
71
46
25
14
7
7
50
10
40
15
1
14
988
831
157
6
2
4
165
116
49
309
191
118
75
49
26
51
31
20
12
7
5
11
11
1
1
192
114
78
16
12
4
26
16
10
22
18
4
3
3
2
2
1
1
16
12
4
2
2
11
5
6
6
3
3
4
1
3
1
1
1
1
~ 5
2
3
34
15
19
10
5
5
2
2
4
1
3
4
4
21
8
13
126
74
52
24
15
9
17
8
9
2
2
5
5
80
46
34
4
3
1
18
10
8
27
20
7
8
8
6
6
1
1
1
1
T.
ii
6
1
1
1
1
67
47
20
17
11
6
14
10
4
3
1
2
11
8
3
2
2
2
2
9
3
6
4
1
3
3
1
2
2
1
1
1
1
1
1
20
16
4
17
14
3
14
11
3
2
2
218
217
1
133
M.
F.
Vancouver _ -T.
M.
F.
133
118
118
13
M.
F.
	
13
New Westminster- — .T.
M.
F.
Oakalla _   T,
	
1
1
1
1
1
1
1
M.
1
F.
Girls' Industrial School and Juvenile
Detention Home T.
M.
39
28
11
9
7
2
2
1
1
8
5
3
1
1
5
2
3
1
1
F.
Private physicians    T.
M.
F.
98
15
83
1
2
440
387
53
1
1
68
43
25
15
15
M.
F.
	
1
24
3
21
Other   T,
1
1
3
2
1
1
1
	
	
2
2
70
M.
F.
69
1
Not stated. - - ' -T.
M.
F.
In 1952 there was a marked decrease (10 per cent) in the number of cases of
venereal disease reported by Divisional clinics, as compared with 1951. Inasmuch as
the total number of cases reported was practically identical for the two years, the decrease
in clinic reporting is balanced by a similar increase in reporting, largely of gonorrhoea,
by private physicians and other reporting agencies.
The decrease in clinic case-reporting is borne exclusively by the main Vancouver
clinic. D  18
DEPARTMENT OF HEALTH AND WELFARE
TABLE IV.—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED ACCORDING TO DIAGNOSIS, SEX, AND AGE-GROUPS, BRITISH
COLUMBIA, 1952.
_
Gonorrhoea
Syphilis
Hi
Ih
6
Acquired
Hi
>
1
c
CS
u
■3
rt
Si
"Eh
Age-group
c
rt
c
g
Q
d
Ci
Z
'So
O
>>
%
CO
s
"3
CJ
Ih
D
rt
o
H
*cs
O
H
a
I
rt
£
ft
o
fl
a q,
2w
8
__
o
et
o
O
u
■G
6
"cd
O
H
&
rt
1
b
CS
•a
a
o
u
Si
m
cS
I
a
rt
CS
i
q
Si
rt
i-l
CO
CS
O
•a
rt
0
X
ft
>>
X
O
rt
3
<U
2
O
"rt
rt
C
fl>
Ch
a
c
D
w
>.
H
li
C
93
>
SS
0
u
a
CO
c
o
Totals—	
   T.
3,914
2,808
3 367
269
32
675
531
2,423
1,821
309
191
22
18
11
5
34
15
126
74
26
19
68
48
llll
171    8     7.   70 7.18
M.
2,3841 .....
8|    3
1
16
217
F.
1,106
983
237
144
602
118
4
6
19
52
7
20
4     5
1
4
1
Under 1 year	
 T.
5
3
3
7
I
......     2
M.
F.
2
2
5
3
3
 T.
4
2
2
2
1
1
1
M
2
2
1
F.
2
2
2
5- 9    „    	
 -   T.
M.
3
2
2
1
1
F.
3|       2
....	
2
1
1
10-14    „    . 	
 T.
5
4
1
1
2
1
1
M.
F.
1
4
4
1
1
2
1
1
15-19    „          .             	
 T.
M.
300
259
36
4
63
38
160
70
11
7
3     1
2|..._
5
1
1
2
1
78
142|    112
27
F.
158
147
32
25
90
9
1!    1
5
1
1
1
1
20-24    „    -..-	
....    T.
1,095
989| .....
73
193
723
21     4|    2
10
3
2
 1	
7
78
M.
740
643
11[139
493
131    31    2
5
?,
1
6
78
F.
355
346
621 54
230
81    11 1    5
1
1
1
25 29    „          	
  T.
826
620
759
565
63
6
151
122
545
437
77i     41     3
8
3
3
?
2
2
1
1
1
44
M.
10
3|    1
44
F.
206
194
57
29
108
12
1|    2
5
1
2
1
30-34      	
 -. T.
499
462
32
95
335
19
3|	
7
5
3
1
3
15
M.
373
346| .....
3
78
265
10
2| .....
4
1
2
1
2
15
F.
126
116|	
29]   17
70
9
11	
3
4
1
1
35-39    „       	
 __ T.
302
2581 ....
221 48
188
211    11    1
17
1
1
2
7.1
M.
239
207
31 43
161
10
1
9
1
21
F.
63
51
19
5
27
11
1
8
ll    1_...
1
4CM4    „            	
 T.
223
176
191
151
16
40
34
135
116
21
14
1
1
2
7,
1
10
5
7
6
.....I......
2
2
9
M.
.....1   1
9
F.
47
40
	
15
6
19
7
1
5
1
45^(9    „     	
 T.
150
116
4
28
84
26
1
1
17,
1
9
1
1
1
7
M.
119
100
28
72
11
1|	
3
6
1
1
7
F.
31
16
4
12
15
.- -1    1
9
1
3
1
50-54
      T.
116
73
?
14
57
34
1
1
17
1
13
1
8
M.
104
66
	
14
52
29
2
16
11
1
8
F.
12
7
	
2
	
5
5
1
1
1
2
55-59    „ -	
 T.
51
38
22
18
2
1
7
6
13
11
25
16
2
2
10
5
7
6
6
3
1
1
3
M.
3
F.
 T.
13
61
4
27
1
1
5
2
22
9
3?
1
5
13
1
5
3
10
3
60-64    „     	
7,
M.
52
26
5
21
24
1
9
4
7
3
2
F.
9
____
	
1
8
4
1
3
65 69    „    	
 T.
34
9       1 -
1
8
75
1
17
4
5
7
1
M.
271       91 .....
11       8
18
1
10
2
3
1
1
F.
 .- T.
7
7
20
2
10
2
4
2
4
1
1
70-74    „     -
28
7
_
2
5
1
1
M.
24
7|-.„
2
5
16
8
3
4
1
1
F.
4
4
2
1
1
75-79    „     	
 T.
15
4
4
10
5
2
7.
1
1
M.
F
11
4
4
	
4
6
2
3
1
2
1
1
1
1
i\
--.   T.
4
1
1
3
1
1
M.
3
1
1
2
1
F
1
 I   ...
1
1
—
Not stated	
 T.
193
1791......
18
27
134
13
1
7
1
4
1
M.
137
129 j.	
3
21
105
7
1
1
1
4
1
F.
56
501......
15
6
29
6
	
6 VENEREAL DISEASE CONTROL REPORT,  1952
D  19
The relative proportion of male and female cases reported during the year was in
the ratio of 5:2, a figure similar to that obtained in previous years.
There has been a decrease in the number of cases of venereal disease reported in
the 10-19 age-group, with an increase in that reported among the older age-groups.
No cases of ophthalmia neonatorum were reported during the year, while only 8
cases of prenatal syphilis were diagnosed, as compared with 25 cases in 1951.
Reported cases of non-specific urethritis (venereal) increased sharply during the
year, from 82 cases reported last year to 218 cases reported in 1952. This increase
affected all age-groups 15 to 54. The fact that this disease is diagnosed almost exclusively
in males, and is presumably venereally transmitted, reflects the diagnostic difficulties
encountered in the investigation of that group of patients and contacts who do not satisfy
the strict bacteriological criteria for the diagnosis of gonorrhoea. D 20
DEPARTMENT OF HEALTH AND WELFARE
CHART II.—NEW NOTIFICATIONS OF SYPHILIS BY AGE AND SEX,
BRITISH COLUMBIA, 1952
CASES
100 _
10-14        15-19       20-24      25-29        30-34       35-39       40-44       45-49        50-54       55-59       60-64      65-69
TABLE V.—NEW NOTIFICATIONS OF SYPHILIS BY AGE AND SEX,
BRITISH COLUMBIA,  1952
Age-group
Male
Female
Age-group
Male
Female
Totals   	
191
2
1
2
13
10
10
118
2
1
~9
8
12
9
35-39 years -	
40-44    „ 	
10
14
11
29
16
24
18
24
7
11
7
Under 1 year   	
1- 4 years	
5-9    „         	
45-^.9    „    	
15
50-54    „	
5
55-59    „                     	
60-64    „    	
9
10-14    „                	
8
15-19    „                	
65-69    „     	
7
20-24    „                  	
70 years and over 	
9
25 29    „
a
30-34    „	
Of the six new notifications of syphilis in the under-15 age-group, five (two males
and three females) are in respect of a diagnosis of prenatal (congenital) syphilis. After
the age of 15 years there is a definite preponderance of syphilis in males notified. VENEREAL DISEASE CONTROL REPORT, 1952
D 21
CHART III.—NEW NOTIFICATIONS OF GONORRHOEA BY AGE AND
SEX, BRITISH COLUMBIA,  1952
CASES
LEGEND
Male
son
■
_>■.(.
0-4            5-9          10-14        15-19
20
24
25-
29
50-
34
35
39
40-44       45-49       50-54
55-59        60-64      65-69         70+
TABLE VI.—NEW NOTIFICATIONS OF GONORRHOEA BY AGE AND
SEX, BRITISH COLUMBIA,  1952
Age-group
Male
Female
Age-group
Male
Female
Totals              	
2,384
112
643
565
346
983
3
2
2
4
147
346
194
116
35-39 years 	
40-44    „	
207
151
100
66
18
26
9
12
129
51
40
45-49    „    	
16
50-54    „     _	
7
5- 9    „      	
55-59    „      	
4
10-14    „     	
60-64    „    -	
1
15-19    „                            	
65-69    „    .
20-24    „              _	
70 years and over	
25-29    „               	
50
30-34   „   .           :	
These figures demonstrate the preponderance of male over female gonorrhoea infections, the ratio in this table being approximately 5:2.
This preponderance of male infections is evident in all age-groups from 20 upwards. D 22
DEPARTMENT OF HEALTH AND WELFARE
CHART IV.—NEW NOTIFICATIONS OF VENEREAL INFECTION AND RATE
PER 100,000 POPULATION, BRITISH COLUMBIA,  1942-52
Rate
700
■i^^^
s
s
•>
++**0'
*r
*.
^
^
^"^™
4T
-.-.c.^5-
_—**-
*•»•■■
Other
* * ^^*
1951 1952
TABLE VII.—RATE PER 100,000 POPULATION FOR TOTAL VENEREAL
DISEASE BY AGE-GROUPS, BRITISH COLUMBIA,  1943-52
Age-group
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
0- 4 years 	
5- 9 „ 	
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
9
8
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
10
6
21
442
1,168
878
559
357
292
233
160
137
99
110
52
7
3
10-14 „  _	
6
15-19 „ 	
411
20-24 „
1,390
25-29 „  	
907
30-34 „
541
35-39 „
326
40-44 „  	
275
45-49 „ 	
219
50-54 „	
193
55-59 „ 	
94
60-64 „
112
65-69 „
65
70 years and over-   -
59
All ages —	
415
508
553
677
575
419
406
378
336
327
The rate per 100,000 population of venereal disease for the combined age-groups
has shown a progressive decline over the years; it now stands at less than half of the
figure recorded for the peak year of 1946. This declining trend is evident in all of the
age-specific rates.
Relative to last year (1951), the rates for teen-agers have continued to show a
favourable decrease, but increases have been noted in the specific rates for the 20-29
and some of the older age-groups. VENEREAL DISEASE CONTROL REPORT,  1952
D 23
TABLE VIII.—NEW CASES OF SYPHILIS REPORTED IN BRITISH
COLUMBIA BY AGE-GROUPS AND MARITAL STATUS,  1952
(Age-specific rates per 100,000 population.)
Single
Widowed an
d Divorced
Married1
Age-group
Male
Female
Male
Female
Male
Female
No.
Rate
No.
Rate
No.
Rate
I
No.   1  Rate
1
1
No.   1  Rate
1
No.
Rate
15-19 years _ 	
20-24    „
2
11
9
4
11
6
8
5.5
39.1
42.5
36.6
112.7
74.0
176.4
5
3
2
1
15.4
17.5
15.1
13.1
4
5
6
3
270.3
220.5
164.9
31.9
2
3
3
31.8
26.8
16.7
2
11
16
24
25
7
18.2
16.7
21.3
42.1
54.3
32.2
4
4
18
15
18
14
3
117.3
17.9
25-34    „
22.4
35-44    „	
20.1
45-54    „
36.8
55-64    „	
38.0
65-69    „     	
21.5
1 Includes separated.
Care is necessary in the interpretation of this table in view of the small number of
cases involved. In general, it will be seen that proportionately (1) more syphilis is
notified from the unmarried or single males as compared with married men; (2) syphilis
among married men tends to be discovered in the latter half of life, and probably represents the late tertiary stages of infections acquired in earlier years, probably even before
marriage; and (3) single females in later life have shown a striking absence of syphilis
in any stage, and this may be accounted for by the fact that those women who have
remained single up to and beyond the age of 45 represent a comparatively small group,
and possibly one which has always indulged sparingly in sexual experience.
TABLE IX.—TOTAL PRIMARY AND SECONDARY SYPHILIS,
BRITISH COLUMBIA,  1952
(Age-specific rates per 100,000 population.)
Age-group
Male
Female
Number
Rate
Number
Rate
0- 4 years     	
5- 9    „           	
2
5
4
2
1
3
1
2
1
1
5.4
12.8
9.1
4.6
2.2
7.2
2.7
7.1
3.4
3.4
2
1
3
1
1
1
1
	
10-14    „          _...      	
15-19    „                                                                                  ..	
5.6
20-24    „                                                                                      	
2.5
25-29    „                                                                                    	
6.3
30-34    .......               	
2.1
35-39    „                         	
2.1
40-44    „                                                                                      	
45-49    „
3.2
50-54    „                                                                                       	
3.5
55-59    „	
60-64    „                                                                             - 	
65 69    ,                                                                                       	
70 years and over -	
-.        |        	
1        1        -----
	
Totals                   	
23        |          3.7
1
10
1.7
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. D 24
DEPARTMENT OF HEALTH AND WELFARE
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z D 30
DEPARTMENT OF HEALTH AND WELFARE
Approximately 50 per cent of all venereal disease notified in the Province is reported
in the Vancouver City area. This is in accordance with previous experience and is to be
attributed to the high population concentration there, plus the fact that the city, by virtue
of being a large seaport, a great recreational centre, and, in addition, having a large
transient and seasonal population, is a focal point for the making of those casual
relationships which so frequently result in the acquisition of venereal disease.
Reported cases of gonorrhoea have shown a gratifying decline (16 per cent) in the
Vancouver City area over the past year. By contrast, sharp increases in the reporting
of gonorrhoea have occurred in the Prince George (100 per cent increase) and Prince
Rupert (67 per cent increase) areas. VENEREAL DISEASE CONTROL REPORT,  1952
D 31
CHART V.—PATIENT-VISITS AT ALL CLINICS OF THE DIVISION OF VENEREAL DISEASE CONTROL CLASSIFIED ACCORDING TO DIAGNOSIS,
1943-52.
Patient Visits
100.000
80.000
60,000
10,000
8, 000
—
—
-
-
-
t°^L«r^'
-
__
 —■
^^
—    —
-^PMi.S
\,
-
ttr   **^
	
•»  ^
\
--^
-°y
"•>«.
—
-
-
TABLE XI.—PATIENT-VISITS AT ALL CLINICS OF THE DIVISION OF VENEREAL DISEASE CONTROL CLASSIFIED ACCORDING TO DIAGNOSIS,
1943-52.
Total
Syphilis
Gonorrho-a
Not Yet Diagnosed
Year
All
Clinics
Vancouver
Clinic
All
Clinics
Vancouver
Clinic
All
Clinics
Vancouver
Clinic
All
Clinics
Vancouver
Clinic
1943	
1944 _	
1945	
1946   .. -
36,170
46,961
46,898
56,385
51,129
43,871
36,551
31,150
24,372
21,111
28,929
36,069
35,657
41,856
38,180
32,480
27,934
22,000
15,953
12,112
22,389
24,766
26,297
30,047
28,291
24,894
16,335
11,685
8,109
5,754
18,573
19.468
20,084
23,158
21,986
19,166
13,139
9,301
6,606
4,314
9,331
13,021
9,692
11,382
9,799
8,480
9,102
8,548
5,904
4,511
7,366
10,580
8,065
9,297
8,051
7,014
7,858
7,418
4,964
3,606
4,450
9,174
10,909
14,956
13,039
10,517
11,114
10,831
10,178
10,331
2,990
6,021
7,508
9,401
1947          	
1948
1949.
195ft
8,143
6,292
6,937
5 226
1951	
1952...	
4,251
3,764
This table serves to show the steadily decreasing number of patient-visits made to
the Divisional clinics over the past few years. The decrease is most obvious in the case
of patient-visits made in respect of a syphilis diagnosis, because of the marked decline
in the incidence of syphilis over the past few years and in particular the relatively short
courses of treatment now possible with depo types of penicillin. D 32
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,
1948-52.
Examination
1
1948        '         1949
1950
1951
1952
10,322
33,990
605
167,816
10,508
33,851
454
173,092
9,179
30,710
378
178,375
6,797
28,510
370
228,547
6,582
28,656
Treponema pallidum microscopic examinations...
Serological tests for syphilis	
283
232,270
The number of serological tests carried out by the Division of Laboratories continues
to increase, the figure now representing an average of over 4,400 tests per week.
The number of gonococcus cultures 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,
1938-52.
No, of Medications
37,500
LEGEND
Arsenical   (Ampoules)                  ^^^^iB!*
Bismuth   (inc.c.'s)                  «-__-___•   ^t*--tm   -m^-**
Sulphonamide   (100 grs.)        ■■____. <■_• -_______> tm
Penicillin   (1, 000, 000 units)   — — — — M
1
1
{
\
\
4
/
/
"•»»
\
\
/
/
/
\
\
\
\
/
/
f
\
\
4
\
1
1
\
\\
\ \
^* • a
^ w»
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y
f
/
/
r
\
^" ^
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1
1
1
1
t
1
1
\
*
*•*
N
1938 1939 1940 1941 194? 1943 1944 1945 1946
1947 1948 1949
1951 1952 VENEREAL DISEASE CONTROL REPORT,  1952
D 33
TABLE XIII.—FREE MEDICATIONS DISTRIBUTED TO PRIVATE PHYSICIANS BY THE PROVINCIAL DEPARTMENT OF HEALTH AND
WELFARE FOR THE TREATMENT OF VENEREAL DISEASE, BRITISH
COLUMBIA,  1938-52.
Year
Arsenicals
(Ampoules)
Bismuth
(CC.)
Sulphonamide
(Grains)
Penicillin
(1,000,000
Units)
Penicillin
o. &W.
(100,000 Units)
Streptomycin
(Grams)
1938 	
1939 	
1940
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
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
1,250
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
24,540
678
1,498
1,415
1,580
9,768
5,676
5,543
3,971
7,059
	
1941. ...    .     	
1942    .
1943 „ 	
1944 	
1945 . .	
—
1946    	
1947   	
1948...	
1949..	
1950	
1951    	
567
155
95
1952 	
32
This table reflects in part the changing concepts regarding treatment of venereal
disease, and in latter years the amounts of medication distributed have fallen off,
coincidently with the compression of treatment schedules and the declining incidence
of syphilis. D 34
DEPARTMENT OF HEALTH AND WELFARE
Crt
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> 3 VENEREAL DISEASE CONTROL REPORT,  1952
D 35
The figures given in Tables XIV and XV represent places of meeting and places of
exposure named by patients reporting with a venereal infection. It will be seen that the
premises most often named as facilitating the spread of venereal disease are beer-parlours
(meetings) and hotels and rooms (exposures), chiefly in the Vancouver area.
Places of meeting are naturally difficult to control, but some success in the control
of this phase of the facilitation process is being effected through liaison between the
Division and other interested professional and Governmental organizations. Hotels and
rooming-houses still constitute the outstanding problem as places of exposure, and much
remains to be done in tightening the control over certain constant offenders in this regard.
TABLE XVI.—CONTACTS TO VENEREAL INFECTION CLASSIFIED ACCORDING TO INVESTIGATING AGENCY AND RESULT OF INVESTIGATION,
BRITISH COLUMBIA,  1952.
3
o
H
Investigated by—
Result of Investigation
S
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619
510
38
8
2
4
4
15
36
2
Examined by private physician _.
511
66
4
134
21
134
137
3
10
2
	
Failed to report for examination.
73
50
15
4
3
1
Investigated, already diagnosed
or under care 	
72
27
2
17
5
2
9
1
8
1
	
696
327
7
177
27
3
20
7
127
1
Still under investigation	
91
27
1
32
2
1
25
3
Found to be ex-Province	
42
2
1
2
	
36
1
1,891
3
1
2
2
2
703
188
990
156
—-
3
145
1
	
2
1
4
Totals	
4,151
1,012
53
387
61
291
203
27
224
709
188
995
1 D 36
DEPARTMENT OF HEALTH AND WELFARE
TABLE XVII.—CONTACTS TO VENEREAL INFECTION CLASSIFIED
ACCORDING TO INVESTIGATING AGENCY AND RESULT OF EXAMINATION, BRITISH COLUMBIA, 1952.
"3
Investigated by
Result of Examination and
Whether or Not Previously
Diagnosed
IS
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9
4
—
2
1
	
—
1
9
—
Totals  -   '
13
.....
2
1
.__
1
»
......
....
	
Infected with secondary syphilis—
3
2
i
-■
1
—
—
3
—
Totals 	
5
i
	
__
1
—
-----
3
—
Infected with other syphilis—
Previously diagnosed 	
20
7
2
i
1
1
1
1
—
2
1
15
2
—
—
Totals 	
27
2
l
1
2
1
......
3
17
......
Infected with gonorrhoea—
530
590
8
15
356
2
2
30
1
5
52
i
7
5
58
1
1
48
1
13
5
25
1
496
1
2
Not previously diagnosed—
—
Totals                	
1,128
373
33
57
8
64
50
13
31
499
......
.....
..
Negative—
53
520
5
3
207
2
9
1
10
89
4
16
1
73
9
92
5
1
28
1
25
1
1
—
Not previously diagnosed	
—
Totals	
578
212
10
99
20
74
101
5
30
27
—
Investigation not indicated—
5
2
1,329
1
2
	
1
	
1
	
	
4
4
1
145
188
989
Not previously diagnosed	
—
Totals    	
1,336
3
......
1
......
1
-
	
4
150
188
989
Infected  with  non-specific urethritis—venereal—
3
3
	
	
	
=
	
	
Not previously diagnosed	
Totals	
3
3
_._
_
....    |            |     |      ...
	
—
Not stated—■
3
1,058
2
416
9
227
33
149
50
9
1
154
4
6
Not previously diagnosed	
Not stated	
1
Totals	
1,061
418
9
227
33
149
50
9
155
4
......
6
1
Totals-
620
1,131
2,400
18
572
422
2
40
11
16
143
228
5
23
33
8
133
150
11
141
51
18
9
8
56
160
552
5
152
188
995
1
Totals	
4,151
1,012
53
387
61
291
203
27
224
709
188
995
1
Note.—The above figures cover the period of October, 1951, to September, 1952.
No cases of chancroid, lymphogranuloma venereum, or granuloma inguinale found in contacts. VENEREAL DISEASE CONTROL REPORT,  1952
D 37
Tables XVI and XVII represent an attempt to study the efficacy of contact-tracing
as a method of finding new cases of venereal disease. From them, it will be seen that
investigation was indicated on 2,258 of a total of 4,151 contacts. Public Health and
Indian Department personnel investigated 77 per cent of these contacts, the remainder
being investigated by private physicians or other agencies. Of those investigated by
Public Health and Indian Department personnel, 67 per cent were located, and 80 per
cent of those located were examined. Of those examined, 57 per cent were found to be
infected.
TABLE XVIII.—INCIDENCE AND RATE PER 100,000 POPULATION OF
TOTAL VENEREAL DISEASE, GONORRHOEA, AND SYPHILIS, BY
QUARTERS, BRITISH COLUMBIA,  1948-52.
Year
Total Venereal
Disease
Syphilis
Gonorrhoea
Cases
Rate
Cases
Rate
Cases
Rate
1948—
1,396
1,071
1,042
1,141
1,139
520.9
395.9
382.4
416.0
411.9
387
227
179
144.4
83.9
65.7
998
837
853
372.4
309.4
313.0
195
71.1
955
348.2
1949—
I
211      |        76.3
208      1        74.7
917
852
972
941
331.6
1,063
381.7
305.9
July to September 	
1,178
1,152
1,206
887
1,214
994
1,030
1,023
996
923
960
1,034
982
938
420.3
408.9
425.8
311.8
424.8
346.3
353.6
351.2
342.0
316.9
320.5
345.2
327.9
313.2
197
161
70.3
57.1
346.8
334.0
1950—
200
70.6
I
998             352.0
153      |        53.8
136              47.6
120      |        41.8
134      1        46.0
714      1      251.0
1,056
864
883
855
874
774
842
895
835
795
369.6
301.0
1951—
303.2
127
97
131
88
91
71
59
43.6
33.3
45.0
29.4
30.4
23.7
19.7
293.6
300.1
October to December  	
1952—
265.8
281.1
298.8
278.8
265.4
Note.—(1) Total includes all types of venereal disease.
(2) Rated on a yearly basis.
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 third quarters 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. In 1951 this seasonal pattern virtually disappeared,
while in 1952 the seasonal upswing occurred in the second and third quarters of the
year, coincident with the fire season and a prolonged strike period which affected men in
certain types of employment. VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty.
1953
70O-653-4098  

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