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Division of Veneral Disease Control Department of Health and Welfare ANNUAL REPORT For the Year 1953 British Columbia. Legislative Assembly 1955

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 PROVINCE OF BRITISH COLUMBIA
Division of
Venereal Disease Control
Department of Health and Welfare
ANNUAL REPORT
For the Year 1953
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1954
  Victoria, B.C., March 31st, 1954.
To His Honour Clarence Wallace, C.B.E.,
Lieutenant-Governor of the Province of 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/or the year 1953.
■" if r      w    F ERIC MARTIN>
Minister of Health and Welfare.
 Department of Health and Welfare (Health Branch),
1 Victoria, B.C., March 31st, 1954.
The Honourable Eric Martin,
Minister of 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, 1953.
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., March 31st, 1954.
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, 1953. |    I
I have the honour to be,
Sir,
Your obedient servant,
1    A. JOHN NELSON, M.D., D.P.H.,
Director, Division of Venereal Disease Control
and Consultant in Epidemiology.
 TABLE OF CONTENTS
Page
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  12
9. General  13
10. Statistical Section  14
 STATISTICAL SECTION
LIST OF TABLES
Tablb Page
I. New Notifications of Venereal Infection and Rate per 100,000 Population,
1944-53  15
II. New Notifications of Venereal Infection Classified According to Diagnosis,
Sex, and Source of Reporting of Notification, British Columbia, 1953  16
III. New Notifications of Venereal Infection Classified According to Diagnosis,
Sex, and Age-groups, British Columbia, 1953  17
IV. Rate per 100,000 Population for Total Venereal-disease Notifications, by Age-
groups, British Columbia, 1940-53  20
V. New Cases of Gonorrhoea Reported in British Columbia, by Age-groups and
•'■- Marital Status, 1953  21
VI. Patient-visits at All Clinics of the Division of Venereal Disease Control Classified According to Diagnosis, 1944-53  22
VII. New Notifications of Syphilis and Gonorrhoea by Health Units and School
M Districts, British Columbia, 1949-53  23
VIII. Places of Meeting Reported as Facilitating the Spread of Venereal Disease,
g 1949-53 -. 27
IX. Places of Exposure Reported as Facilitating the Spread of Venereal Disease,
1949-53  27
X. Contacts to Venereal Infection Classified According to Investigating Agency
j|| and Result of Investigation, British Columbia, 1953  28
XI. Contacts to Venereal Infection Classified According to Investigating Agency
|p and Result of Examination, British Columbia, 1953  29
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, 1949-53  30
XIII. Admissions to Provincial Mental Hospitals with Syphilitic Psychoses and
Admission Rates per 100,000 Population, British Columbia, 1929-53  30
LIST OF CHARTS
Chart
I. New Notifications of Venereal Infection by Diagnosis, Reported by All Agencies,
British Columbia, 1944-53 (Rate per 100,000 Population)  I4
II. New Notifications of Gonorrhoea by Age and Sex, British Columbia, 1953  19
III. New Notifications of Venereal Infection, Rate per 100,000 Population, British
Columbia, 1940-53 20
IV. Patient-visits at All Clinics of the Division of Venereal Disease Control Classi
fied According to Diagnosis, 1944-53 21
 Organization   Chart
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  DIVISION OF VENEREAL DISEASE CONTROL
ANNUAL REPORT FOR THE YEAR 1953
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
3,670, which total includes 462 cases of non-specific urethritis, compared with 3,914
in 1952. Infectious syphilis has now become a clinical rarity; there were only nineteen
cases reported as of December 31st, 1953. Late syphilis and prenatal syphilis, as
reported to this Division, have also shown a marked decline.
TREATMENT
This Division continued, as in the past, to overtreat gonorrhoea patients with massive
doses of penicillin, and the results to date have shown that such treatment has been most
successful in preventing concomitantly acquired syphilis. This overtreatment schedule,
as developed within the Division, has now been accepted by other Provinces as routine
therapy.
We are pleased to report that this Division has continued to receive excellent
co-operation from private physicians and other agencies within the Province in regard
to the matter of reporting clinical cases of venereal disease.
Prenatal syphilis has shown a notable decrease in the number of new cases
reported—four new cases during 1953, as compared with eight new cases in 1952. This
trend is encouraging indeed because prenatal syphilis for a number of years did not
decrease with the same rapidity as did new cases of acquired syphilis as reported to this
Division.
Due to the decreasing patient case-load, it was deemed advisable during the course
of the past year to avail ourselves of consultative service available from other agencies,
and we thereby have been able to terminate two consultant appointments within the
professional establishment of the Division. It should be emphasized that the calibre
and availability of this consultative service to all physicians within the Province have been
maintained at their usual high level.
The treatment schedule was again completely revised by members of this Division
and made available to all physicians practising in the Province. This new schedule was
drawn up with the following intentions: To simplify and standardize treatment and
follow-up procedures, and to present this material in a readily available manner.
Free drugs were again made available to all private physicians for the treatment of
patients with venereal disease. The newer types of antibiotics also have been made
available for treatment of those patients who have demonstrated previous penicillin
allergic manifestations. This Division has continued to supply all health units with the
necessary drugs in order that they can be dispensed locally to the private physicians.
Because of the increasing problem that non-specific urethritis presents, it was considered wise to retain the services of a genito-urinary consultant. |During the forthcoming year it is hoped that the Division will be able to devise a more satisfactory
schedule of diagnostic criteria and treatment for the management of this troublesome
condition.
9
 H 10 DEPARTMENT OF HEALTH AND WELFARE
During the past year several new developments have taken place within this Division.
A limited clinical assay was performed to determine whether or not the newer long-acting
penicillins would be of assistance for the treatment of female repeaters who make up
a goodly percentage of our problem. The consultant in epidemiology has advised that
females be treated after one naming as a contact, in order that a modified type of speed-
zone epidemiology could be instituted within this Division. The results of this change
and of several others, although it is too early to report any accurate figures, have shown
a very encouraging trend.    ,j| ft
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; Juvenile Detention Home;
and New Westminster clinic. The Vancouver clinic no longer remains open on Saturday
morning because of the marked decrease in clinic attendance.
f§'' Other forms of venereal disease, such as chancroid and lymphogranuloma venereum,
encountered during the year were mainly found among mariners entering the port of
Vancouver. There was no evidence of increased spread of these infections among the
general population.
EPIDEMIOLOGY
III It has continued to remain our belief that the key to the control of venereal disease
lies in the vigorous and enthusiastic application of epidemiological methods. With our
goal thus defined, it has been a constant and ever-increasing challenge to uncover new
productive avenues of approach which might help us more rapidly to eradicate our
reservoir of infection.
During this past year special studies have brought to our attention the part played
by the female in the transmission of gonorrhoea from the reservoir of infection to the
fresh male host. In order to deal with this, we have adopted the policy that all female
contacts to gonorrhoea be treated on their first visit to the clinic. The immediate problem
of bringing the contact to treatment more rapidly has resulted in a modified programme
of speed-zone epidemiology aimed at bringing a high percentage of our female contacts
to treatment within twenty-four or seventy-two hours following receipt of information.
The Vancouver City Gaol examination centre continued to function as a very
important part of the epidemiology programme. The number of newly diagnosed
gonorrhoea infections has decreased to an all-time low, and it is felt that this changing
index accurately reflects the prevalence of gonorrhoea in Vancouver. Treatment in the
centre is offered to all patients on epidemiological grounds or clinical evidence of
infection.
The clinic at Health Unit No. 1, Metropolitan Health Committee, now operates
twice weekly, 11 a.m. to 1 p.m. A public health nurse is in attendance, 2 to 4 p.m. daily,
to undertake serological testing for the U.S. Immigration, down-town cafes, and industries. Persons reporting here during the above hours may receive tests for gonorrhoea,
and treatment if indicated.
This year the Indian Health Services assumed almost full responsibility for the
epidemiological follow-up of all Indians. Health units have established policy on a local
level whereby the agency which is able to do the most rapid follow-up of the Indian
handles the referred case.
The epidemiological section continued to have a very satisfactory liaison with the
private physicians throughout the Province. The adequacy of contact information
obtained by the physician has improved so that we have been able to investigate many
more of these contacts. v '^tlp!
New approaches to the suppression of facilitators and facilitating premises has
required continuous study.   Where misdemeanours occur, a greater effort has been made
 VENEREAL DISEASE CONTROL REPORT, 1953 H 11
to pin-point responsibility on one individual. Three meetings were held during the
year-one with other interested departments and agencies, and two meetings with the
managers of hotels and rooming-houses which have been community trouble-spots over
q neriod of several years.
—° t  ~~tv wvvu vwxiiiiiunity uuuuic-suuLs over
period of several years.
The American Social Hygiene Association again sent a representative to survey the
mcilitating processes operating in Vancouver City. These objective reports have proved
helpful in giving us specific information regarding certain activities within the city.
Senior members of the Division made a total of six visits to the field staff to discuss
epidemiology techniques and assist with problem cases.
This has been a year of changing emphasis for the epidemiological section of the
Division. It is hoped a wise choice of activities on which to place emphasis will strengthen
our programme and eliminate unproductive case-finding and case-holding effort.
SOCIAL SERVICE
For a three-month period during the year there was no case-worker at the Vancouver
clinic, and service on a part-time basis was provided by Social Service staff from the
Division of Tuberculosis Control. In spite of this staff difficulty, counselling service was
continued for the patients reporting to the Vancouver clinic for treatment, and there were
805 patient-interviews carried out by the Social Service Section during the year.
In addition, this Section participated in the educational programme for student-
nurses, public health workers, and professional staff in allied fields undertaken by the
Division of Venereal Disease Control.
In our work with the patient-group, at the termination of each interview the clinic
social worker recorded her assessment of the patient and his capacity to utilize this
counselling service, and the following criteria were taken as a guide:—
Group I.—This person is capable of taking responsibility for himself;  he is
functioning adequately in his life situation and his infection has been
acquired as the result of an episode that is out of character with his
behaviour pattern.
jf Group II.—This person has capacity to take responsibility for himself but he
needs help in defining this; he also lacks knowledge about the venereal
diseases and about sexual behaviour in general.
Group III.—This person manifests real conflict in some area of his life, and his
promiscuous behaviour is symptomatic of this stress.   The pressure may
be external because of the life situation in which he finds himself, or it
may be within the personality structure of the individual.
Group IV.—In all of his personal relationships this individual functions on
a casual level, and his sexual behaviour follows the same pattern.    His
roots are shallow, and he does not want to or is not capable of assuming
personal responsibilities.    His goal in life is ill-defined, but he is not in
fl|   conflict about himself or his situation.
Group V.—This is the chronic-problem person whose life is disordered and
whose promiscuous behaviour is part of that way of living.    He exists on
%     the fringe of crime, and authority is his natural enemy.
In the twelve-month period under review, out of the total 805 patient-interviews,
rating of the patient by the social worker was recorded in 660 cases.    Of the remainder,
70 had been rated in a previous interview, 42 required no service other than referral to
some other medical resource, 14 were not venereal-disease patients, and 19 were not
given a rating. ::H
Of the 660 who were rated, 104 were considered to come within Group I. For these
patients the counselling interview was an opportunity for the patient to review his
behaviour in the light of his goal in life, and thus the total treatment process became sex
education with real meaning for the patient as a person.
 H 12 DEPARTMENT OF HEALTH AND WELFARE
There were 163 patients classified as Group II, and here again the social worker's
interview was geared to make the learning process a personal experience which would
enhance the patient's capacity to meet future situations in his life.
Among the 148 rated in Group III were most of the social ills, including marital
conflict, personality disorders, alcoholism, adolescent revolt against parental authority,
illegitimate pregnancy. With some, the basic problem was too deep-rooted for any
effective help to be given in one interview, but most of these people derived some comfort
from sharing their problems with the case-worker. The interview was a sorting-out
process, and the patient was encouraged to utilize the resources available in the community for meeting his particular kind of need. Some of these patients continued their
relationship with the clinic social worker after medical treatment was completed. It is
from this group of patients that most of the referrals were made from the Social Service
Section to the psychiatric consultant.
The 208 patients considered to come within the Group IV classification represented
almost one-third of the total number rated. While these people represent a continuing
problem in venereal-disease control because of their way of living, they can be helped to
assume more responsibility in the epidemiological control of these diseases. For these
patients the counselling interview was directed toward emphasizing the importance of the
infected person in the control process, since he alone has the vital information about his
sex partners that starts the epidemiological investigation. With this positive approach
to the patient, the control programme became a combined operation of patient and staff,
and this gave the patient some status. For many of them this is a rare and satisfying
experience.   E.   ■  - .■^.■■■'•-   - •   Sr
§ There were thirty-seven patients considered to fall in Group V. This number was
small because most of the chronic-problem patients report to the treatment centre at the
city gaol rather than to the Vancouver clinic. There is very little that counselling can do
for this group, except to give these people the experience of courtesy and acceptance.
Like children, they respond to kindness by co-operating to the maximum of their limited
ability.
IS In summary, the twelve months' experience in the use of this rating scale indicates
that about two-thirds of the patient-group derive benefit from the counselling service.
The other one-third corresponds roughly to the proportion of the patient-group who have
repeated venereal infection. 4
§,-.     :#-   ^      '    ■#• EDUCATION   '  ■:'■-■■$>.'   <
The Division of Health Education is primarily responsible for the health-education
programme to lay groups, while the Division of Venereal Disease Control has accepted
the responsibility for professional and staff education.
.f| Lectures were given to student-nurses in all nursing-schools on the methods of
control and the facilities available thoughout the Province. The regular course of
instruction was given to the students from the Vancouver General Hospital who come to
the Division for a two-week period during their training. Besides lectures, they receive
a thorough grounding in the clinical aspects of venereal-disease control and also take
part in the epidemiology programme. Students taking their course in public health
nursing at the University also came for a one-week period, to participate in all phases of
our work. .Lectures were given to the psychiatric nurses at Essondale, practical nurses
at the Vocational School, second- and third-year medical students at the University of
British Columbia, and to various other groups. J    |T
Youth groups have requested speakers on several occasions. I lr 11
m■•■" Fortnightly staff meetings were held at the Division headquarters. Lectures on
various aspects of syphilis and gonorrhoea were given, also a very interesting panel discussion, with the consulting specialists giving interpretations from their special fields. These
were attended by the consulting staff and members of the Division. IP
 VENEREAL DISEASE CONTROL REPORT, 1953 H 13
An exhibit was again presented at the Kiwanis Annual Fair and Trade Exhibition
in North Vancouver. " Corkie, the Killer " was the subject theme. Blood tests were
offered to the public and literature distributed.
At the annual meeting of the Health League of Canada a small display was put on
to show professional groups the continued need of an active programme for venereal-
disease control.    Pamphlets were obtainable and much interest was shown.
The manuals | Venereal Disease Information for Nurses " and " V.D. Control
Program of the Health Branch " were revised and reprinted during the year. These
manuals are widely distributed to student-nurses and other interested persons in the
Province. A new pamphlet has been obtained which gives an excellent interpretation
of the part played by the student-nurse in venereal-disease control during her hospital
training. |; .1 -.   -'4^-  ..—
The following is a list of papers given or published by members of the Division in
the course of the year:— |
(1) " Challenging Trends in V.D. Control," by Dr. A. John Nelson and Dr.
Ben Kanee, presented before the American Academy of Dermatology and
Syphilology in December, 1953.
(2) "Police and Health Department Co-operation in V.D. Control," by A.
John Nelson, M.D., D.P.H., was accepted for publication in the journal
of Social Hygiene.
(3) In the January, 1953, issue of the Vancouver Medical Association bulletin
T^x a paper entitled 1 Prophylaxis of Ophthalmia Neonatorum," by G. R. R j
f*                Elliot, M.D.C.M., D.P.H., and A. John Nelson, M.D., D.P.H., was
published.
(4) | Recent Advances in Venereal Disease Control," by A. John Nelson,
3f          M.D., D.P.H., was accepted for publication in the Canadian Nurse.
1       . ,j        GENERAL        ij '    f    '1
National health grants continued to prove most useful in assisting the Division to
maintain its ever-expanding services, as well as in affording opportunities fojr postgraduate training of medical and nursing personnel.
Funds from these grants were made available to assist in the development and
operation of the Bio-Medical Library, University of British Columbia. In the library,
up-to-date literature on venereal diseases is maintained, and the senior consultant to the
Division is an active member of the management committee. » ;
The Division is most appreciative of the co-operation and help Extended by ivarious
other groups and agencies with an interest in the promotion of social pygiene and control
of venereal disease. Special mention must be made of the Vancouver City Police, thg
Royal Canadian Mounted Police, the British Columbia Hotels' Associgttio^ the Liquor
Control Board, the Indian Affairs Branch of the Department of Citizenship and Immigration, the Armed Forces Disciplinary Control Board of the United States 13th Naval
District, and the American Social Hygiene Association. §     j
In addition, special appreciation is expressed to the Division of Laboratories, without
whose ever-willing services and co-operation this Division would j 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.
i s
 H 14
DEPARTMENT OF HEALTH AND WELFARE
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w                                   <■■■■)
:<
"&94m -Pfl- * H:
rf «n vo t- oc
•«+   T*   T*   1*,   Tf
On O i-i fS fn
Tf «n io *n «n
ti'rifmg^i
[ ds<^cj\ONONOON^a^o>
 H 16
DEPARTMENT OF HEALTH AND WELFARE
The total number of cases of venereal disease reported in the Province for 1953
showed a 6-per-cent decrease over the corresponding figure for 1952. The rate per
100,000 population also showed a further decline to reach a point which is now well
below the pre-war (1939) rate of 329.9 per 100,000 population.
Gonorrhoea was responsible for 92.5 per cent of all venereal disease reported during
the year. As previously, this disease must be considered the major problem facing our
Venereal Disease Control programme.
There were only 26 cases of infectious syphilis reported during the year—the lowest
number on record. In addition, the number of patients detected in the later stages of
syphilis decreased by 26 per cent.
TABLE IL—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED
ACCORDING TO DIAGNOSIS, SEX, AND SOURCE OF REPORTING OF
NOTIFICATION, BRITISH COLUMBIA, 1953.
l-H
ti
tt
o
H
Gonorrhoea
Syphilis
•ti
it
O
H
£
a
u
O
tt
ti
§
ii
Z
ti
•i-H
£
IS
m
xi
Q.
O
■d
o
• yt
fl
•1—i
0
a
8
xi
Ih
U
O
fl
o
O
O
i-H
ti
tt
o
H
Acquired
Prenatal
i
fl
• rt
£
Ih
<D
tt
a
•a
s
I
a
a
1
1
Source of Referral
tt
cs
£
•-H
Ih
Oh
Ih
ti
y
A
o
o
ii
Vl
1
t-t
fl
ii
tt
ti
a
it
ti
fl
§
tt
ti
Ih
rt
l-H
fl
o
tn
ti
r--
o
•yt
y
Ih
ti
u
to
yyt
rt
• rt
xi
a
>t
to
0
tt
fl
a
|
Ih
to
xi
it
0
>>
rt
tt
ti
w
a
i-t
ti
1)
09
•iH
I
l-H
«
Ih
>
U
ii
xi
t->
0
Totals     T.
M.
F.
Clinics, total  .T.
M.
F.
Vancouver  T.
M.
F.
Victoria T.
3,208
2,400
808
1,436
983
453
1,152
830
322
96
66
30
16
10
6
61
24
37
9
9
102
53
49
1,772
1,417
355
1,575
1,262
313
25
10
15
88
88
14
12
2
2,968
2,239
729
1,349
919
430
1,078
778
300
90
61
29
16
10
6
56
19
37
9
9
100
51
49
1,619
1,320
299
1,445
1,184
261
23
9
14
85
85
4
3
1
1
1
1
1
1
1
874
630
244
239
133
106
158
88
70
8
6
2
13
9
4
17
10
7
43
20
23
635
497
138
569
456
113
18
8
10
5
5
1
1
2,093
1,609
484
1,110
786
324
920
690
230
82
55
27
3
1
2
39
9
30
9
9
57
31
26
983
823
160
875
728
147
5
1
4
80
80
3
3
229
151
78
77
55
22
65
44
21
6
5
1
4
4
2
2
152
96
56
129
77
52
2
1
1
3
3
10
9
1
8
6
2
19
18
1
7
6
1
6
5
1
1
1
7
3
4
1
1
1
1
27
14
13
14
9
5
12
7
5
101
64
37
31
24
7
24
17
7
3
3
20
17
3
9
6
3
9
6
3
41
28
13
9
6
3
7
5
2
2
1
1
5
3
2
2
2
2
2
2
1
1
2
1
5
2
3
3
1
2
3
1
2
11
10
1
10
9
1
9
8
1
M.
F.
	
	
	
—
New Westminster  T.
M.
F.
Oakalla T.
M.
F.
Girls' Industrial School and Juvenile Detention Home T.
M.
F.
12
12
9
9
6
2
4
6
2
4
1
1
1
1
13
5
8
12
4
8
1
1
3
3
1
1
70
40
30
58
32
26
1
1
1
1
5
4
1
5
3
2
11
11
9
9
2
2
1
1
Metropolitan Health Committee Clinics       T.
M.
F.
Other sources    T.
M.
F.
Private physicians T.
M.
F.
Indian Health Services              T.
32
22
10
28
18
10
1
1
3
3
3
1
2
3
1
yl
2
1
1
1
1
1
1
1
1
1
1
2
1
1
2
1
1
1
1
1
1
M.
F.
Department of National Defence T.
M.
F.
Hospitals       T.
M
2
2
1
1
F.
Other1                                                          T.
701     62
45      39
I 42
 1 28
20
11
9
	
—
M.
F.
25
23
I
14
	
—
	
1 Includes one male gonorrhoea (clinical) case, source of referral not stated.
 VENEREAL DISEASE CONTROL REPORT, 1953 H 17
In 1953 there was a decrease of 6 per cent in the total number of cases of venereal
disease reported by Divisional clinics as compared with the previous year. Reporting by
private practitioners over the same period showed only a 3-per-cent decrease The net
result of these changes is that private practitioners are now reporting more cases of
venereal disease than the combined total of all Divisional clinics—a complete reversal of
the picture which obtained a few years ago.
So far as individual clinics are concerned, the main Vancouver clinic of the Division
continued to bear the greatest load in connection with the diagnosis and treatment of
venereal disease m this Province (approximately one-third of all reported cases). By
contrast, the much-reduced case-finding activities of the clinics at New Westminster and
the Girls' Industrial School, Vancouver, raise the question as to the advisability of
retaining these clinic services.
A noteworthy feature in the above table is the ratio of male to female cases reported
by clinics and private physicians. For cases reported by all sources, this ratio is 2.97,
as compared with a ratio of 2.17 reported by Divisional clinics, and 4.03 for private
physicians. These sex-differentials indicate that females are not being brought to treatment in the number that they should, a fact which probably explains the continuing high
incidence of gonorrhoea in the Province. The Division, in an attempt to bring more
female contacts to treatment speedily, has devised a " speed-zone epidemiology " project.
TABLE III.—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED ACCORDING TO DIAGNOSIS, SEX, AND AGE-GROUPS, BRITISH
COLUMBIA, 1953.
1-H
ti
it
O
H
Gonorrhoea
Syphilis
g
tt
o
H
1
fl
u
O
t-t
ti
fl
o
ti
•IH
s
T-H
ti
xi
tt
xi
ft
o
I-H
ti
u
•iH
c
•H
U
a
8
xi
Ih
Ih
o
fl
o
O
Ih
to
xi
tt
O
r-t
y
it
o
H
Acquired
Prenatal
T3
ii
C
•it
§
Ih
ii
it
ii
•yS
A
n
Ot
>>
H
GO
ti
to
to
'tt
Q
rt
ti
to
tH
a
fl
ii
>
u
ii
A
t-t
O
Age-group
>>
ti
a
y—t
tt.
ti
fl
O
3
to
VI
\t
ti
w
yt
fl
to
it
ti
I-I
a
it
ti
fl
to
it
ti
1-1
u
ti
rt
fl
u
tn
ti
>
O
Ih
ti
u
tn
•rt
t-H
•i-i
xi
ft
>»
GO
O
tt
fl
to
u
to
.fl
yi
o
>>
l-H
tt
ti
w
to
it
ti
I-I
Totals  .y T.
M.
F.
Under 1 year  T.
M.
F.
1- 4 years   T.
M.
F.
5-9                                                               T
M.
F.
10-14   ..    h                                        T.
M.
F.
15-19    ..    __                                               T.
M.
F.
3,208
2,400
808
2
1
1
2
2
5
1
4
5
1
4
215
106
109
2,968
2,239
729
1
1
1
1
874
630
244
2,093
1,609
484
229
151
78
1
1
1
1
3
1
2
6
3
3
19
18
1
2
2
7
3
4
27
14
13
1
1
2
2
101
64
37
20
17
3
41
28
13
5
3
2
1
2
1
1
1
1
1
1
2
1
1
5
2
3
11
10
1
1
1
1
5
1
4
2
1
1
1
1
5
1
4
1
	
2
1
1
2
1
1
2
208
102
106
1
74
34
40
1
134
68
66
1
1
 H 18
DEPARTMENT OF HEALTH AND WELFARE
TABLE III.—NEW NOTIFICATIONS OF VENEREAL INFECTION CLASSIFIED ACCORDING TO DIAGNOSIS, SEX, AND AGE-GROUPS, BRITISH
COLUMBIA, 1953—Continued. §
Gonorrhoea
Syphilis
£
a
tt
o
rt
Acquired
Prenatal
CO
oi
tt
cs
ti
o
•3
Age-group
fl
o
to
1
ti
•rt
£
• rt
c
»I-j
1
•y-
ti
8
.fl
>,
cs
rt
H
ti
w
1
a
tt
cs
1
Ih
ti
fl
U
CO
ti
cn
•IH
I-H
•IH
,fl
a
>.
to
fl
•H
s
Ih
ii
it
to
•o
fl
•iH
T-H
rt
ii
u
a
fl
0)
I-H
ti
tt
o
T-H
ti
t-t
o
ti
xi
tt
Tfl
ft
Ih
Ih
O
fl
o
u
a
xi
tt
I-H
ti
it
O
ti
£
yyt
tt
♦a
fl
o
o
a
it
fl
a
tt
ti
I
fl
a
tt
d
O
•rt
Ih
rt
tn
O
tt
fl
to
Ih
to
xi
tt
l-H
Ih
ti
a
it
ti
to
>
u
a
6
H
H
o
O
O
H
Ph
yy
H-l
yy
U
i
O
m
rl
H
0
20-24    „    	
 T.
M.
843
611
823
598
234
160
589
438
19
13
8
7
8
5
1    2
1
1
1
F.
232
225
74
151
6
1
3
1
1
1
25-29    |    	
 T.
744
725
211
514
12
1
6
5
7
M.
585
570
157
413
8
1
4
3
7
F.
159
155
54
101
4
2
2
30-34    „    	
 T.
456
429
129
300
25
3|
3
13
1
3
1
2
M.
333
323
101
222
8
3|
1
4
2
F.
... T.
M.
F.
  T.
123
259
214
45
169
106
238
203
35
148
28
74
59
15
50
78
164
144
20
98
17
21
11
10
21
1
1
1
2
3
1
2
9
11
6
5
9
1
2
1
1
1
3
3
1
2
7
1
35-39
40-44    „     	
1
1
•M.
136
126
40
86
10
1|
3
1
3
1
1
F.
33
22
10
12
11)
6
4
1
45-49     „
..... T.
M.
F.
 T.
M.
F.
1 T.
M.
F
121
95
26
123
104
19
66
58
8
99
80
19
86
73
13
34
32
2
18
12
6
27
23
4
5
5
81
68
13
59
50
9
29
27
2
22 i
15
7
371
31
1
32]
26
6|
2[
2|
2
1
1
10
6
4
23
18
5
16
12
A
1
1
3
2
1
7
7
6
4
2
9
9
7
6
1
1
1
50-59     „
60-69    „    	
1
1
70-79    1      	
 j T.
23
8
3
2
18|
I
8
5
3
M.
22
5
3
2
17|
1|
8
5
3
F.
1 T.
M.
F.
1
3
3
1
2|
2|
1
1
	
	
a
80 years and over	
1
1
1
1
Not stated r
 T.
M.
F.
I
172|
130|
421
1
163
125
38
48
36
12
115
89
26
9|
5|
4|
1
...... |
I
1
2
1
1
■31
I
2|
1
1
OI
tfl
I
	
—
	
—
—
 VENEREAL DISEASE CONTROL REPORT, 1953
H 19
The relative proportion of male and female ca<^Q r™™^ a ^ I    ^
ratio of 2.97, a figure similar to that obtS toS^f™8 the year WaS m *«
« Jh/-6T?Qt dHCreaSe iD *" t0tal number of case* notified during the year is
reflected in all age- and sex-groups. &       y
There was only 1 case of ophthalmia neonatorum reported during the year, while
4 cases of prenatal syphilis were diagnosed, as compared with 8 cafes in 1952
only
CHART IL—NEW NOTIFICATIONS OF GONORRHOEA BY AGE
AND SEX, BRITISH COLUMBIA, 1953
0-14        15-19       20-24      25-29      30-34      35-39      40-44      45-49      50-54      55-59      60-64      65-69       70*
 H 20
DEPARTMENT OF HEALTH AND WELFARE
CHART III.—NEW NOTIFICATIONS OF VENEREAL INFECTION, RATES
PER 100,000 POPULATION, BRITISH COLUMBIA, 1940-53
RATE
700
600
500
400
300
200
100
Rates per 100,000 Population
.
•
jo^
4
c
ii
pi
§!$*££
<r
^
V,
	
^^H
Ifl
PI
ii
i
5VPH\US
1 '   '"
li$s*$:—-—• -
m—- —-■ -
1940        1941 1942        1943        1944        1945        1946        1947        1948        1949        1950        1951 1952        1953
TABLE TV.—RATE PER 100,000 POPULATION FOR TOTAL VENEREAL-
DISEASE NOTIFICATIONS, BY AGE-GROUPS, BRITISH COLUMBIA,
1940-53.
Age-group
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
; 1953
iO- 4 years	
29
22
39
166
716
678
507
yy..45H,,
339
319
206
204
193
154
98
25
24
35
231
821
690
552
412
271
245
184
149
166
73
24
19
22
326
1,046
770
618
.-JUS.-
375
249
265
134
188
113
83
21
26
24
385
1,134
843
598
.y.5A3~y
474
272
218
193
141
80
74
23
17
43
614
1,383
953
619
-J532...
573
337
309
196
183
106
61
30
23
19
629
1,480
1,039
753
__699
587
446
305
211
188
169
53
35
25
33
709
2,057
1,547
986
737
565
457
292
232
215
157
83
25
20
9
697
1|923
1,306
689
609
479
439
324
231
207
172
81
16
10
11
533
1,460
1,044
555
481
361
308
240
124
120
101
62
9
8
9
465
1,489
1,021
544
.438
371
305
229
156
163
110
64
10
10
33
499
1,376
951
524
420
305
280
220
173
120
109
62
10
6
20
452
1,268
886
574
31&
277
230
163
152
101
102
52
7
3
6
327
1,203
783
491
278
243
204
176
85
109
64
56
3
5- 9 1 	
4
10-14 „ 	
6
15-19 „ 	
289
20-24 „ 	
1,088
25-29 „ 	
818
30-34 I 	
491
35-39.- plfelgi §1
40-44 „ 	
274
199
45-49 „	
173
50-54 „ 	
129
55-59 „ 	
80
60-64 „ 	
73
65-69 „ 	
51
70 years and over	
31
Totals	
310
336
392
415
508
553
677
575
419
404
373
329
286
261
The rate per 100,000 population of venereal disease for the combined age-groups
has continued to show a progressive decline over the years. The rate of 261 per 100,000,
as compared with 677 per 100,000 in 1946, gives some indication of the improvement
attained. This declining trend is evident in all the age-specific rates. The 20-29-year
age-group still represents the major portion of our venereal-disease control problem.
 VENEREAL DISEASE CONTROL REPORT, 1953
TABLE V.—NEW CASES OF GONORRHOEA pCDnDTrn T>T
COLUMBIA, BY AGE-GROuT^^™^,* ™
(Age-specific rates nt>r mn Ann . ..
H 21
(Age-specific rates per 100,000 population.)
Age-group
Single
Male
Female
No.
Rate
No.      Rate
15-19 years.
20-24
25-34
35-44
45-54
55-64
65-69
99
539
677
193
74
23
4
Widowed and Divorced
Male
Female
No.      Rate
258.5
1,392.8
772.8
215.9
105.6
40.4
13.7
100
127
93
5
No.      Rate
277.0
327.3
96.8
5.5
1
1
10
15
9
4
Married1
Male
Female
!
No.      Rate
2.6
2.6
11.4
16.8
12.8
7.0
No.
Rate
4
21
11
9
1
1 Includes separated.
10.3
21.9
12.2
14.7
1.9
1
52
195
116
52
11
5
2.6
134.4
222.6
129.8
74.2
19.3
17.1
6
89
140
39
18
5
16.6
229.4
145.7
43.2
29.5
9.7
|| The major problem, so far as gonorrhoea is concerned, presents itself in the 20-34-
year age-group of single males and to a lesser degree in the single females of a slightlv
younger age-group (15-24 years). Significantly, it will be noted that the rates for
married males are lower than those for single men, but that the rate for married females
in the 20-24-year age-group approximates to that for single females of the same group
and for the next two age-groups (25-44 years) actually exceeds the corresponding rates
for single females.
CHART IV.—PATIENT-VISITS AT ALL CLINICS OF THE DIVISION OF
VENEREAL DISEASE CONTROL CLASSIFIED ACCORDING TO DIAGNOSIS, 1944-53. I IP
PATIENT VISITS
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
 H 22
DEPARTMENT OF HEALTH AND WELFARE
TABLE VL—PATIENT-VISITS AT ALL CLINICS OF THE DIVISION OF VENEREAL DISEASE CONTROL CLASSIFIED ACCORDING TO DIAGNOSIS,!
1944_53.
Year
Total
All
Clinics
Vancouver
Clinic
Syphilis
All
Clinics
Vancouver
Clinic
Gonorrhoea
All
Clinics
Vancouver
Clinic
Other V.D.
All
Clinics
Vancouver
Clinic
Not Yet
Diagnosed
All
Clinics
Vancouver
Clinic
1944
1945.
1946
1947
1948.
1949.
1950.
1951.
1952
1953
46,961
46,898
56,385
51,129
43,897
36,685
31,107
24,315
20,721
18,307
36,069
35,657
41,856
38,180
32,495
27,970
21,976
15,943
11,798
9,732
24,766
26,297
30,047
28,291
24,894
16,425
11,685
8,109
5,754
4,503
19,468
20,084
23,158
21,986
19,166
13,139
9,301
6,606
4,314
3,494
13,021
9,692
11,382
9,799
8,480
9,102
8,548
5,904
4,511
3,551
10,580
8,065
9,297
8,051
7,014
7,858
7,418
4,964
3,606
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43
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125
88
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31
122
114
88
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10,909
14,956
13,039
10,497
11,114
10,831
10,178
10,331
10,165
6,021
7,508
9,401
8,143
6,292
6,937
5,226
4,251
3,764
3,392
1 Includes gonorrhoea epidemiological.
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.
 VENEREAL DISEASE CONTROL REPORT, 1953
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H 25
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 H 26
DEPARTMENT OF HEALTH AND WELFARE
As in previous years, the bulk of new notifications were received from the Vancouver
City area (47 per cent). The two other health jurisdictions which continue to present
control problems are the Cariboo and Skeena Health Unit areas, which were equally and
jointly responsible for 22 per cent of all new notifications received. In summary, these
three areas were responsible for nearly 70 per cent of all new notifications of venereal
disease received in 1953.
Reported cases of gonorrhoea have shown a further gratifying decline (8 per cent)
in the Vancouver City area over the past year. The Cariboo Health Unit on the other
hand has shown a 47-per-cent increase in the number of new notifications received in
1953 as compared with 1952. Gonorrhoea reporting from the Skeena Health Unit area
showed a 12-per-cent increase over the same period. It is apparent, therefore, that the
control programme, particularly against gonorrhoea, is not having the same success in the
northernmost areas of the Province as has been attained in the Vancouver area.
 VENEREAL DISEASE CONTROL REPORT, 1953
H 27
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 H 28
DEPARTMENT OF HEALTH AND WELFARE
The figures given in Tables VIII and IX 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
(29 per cent of all meeting-namings) and hotels and rooms (54 per cent of all exposure-
namings), chiefly in the Vancouver area. We have attempted to control the facilitation
process through such premises by meetings with their proprietors and managers, in an
attempt to secure their co-operation in this phase of the control programme.
jl Tables X and XI represent our efforts 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 2,385 of a total of 4,446 contacts.
Public Health and Indian Department personnel investigated 73 per cent of these
contacts, the remainder being investigated by private physicians or other agencies. Of
those investigated by Public Health and Indian Department workers, 61 per cent were
located, and 90 per cent of those located were examined. Of those examined, 56 per
cent were found to be infected. These ratios are essentially similar to those which have
obtained over the past few years.
TABLE X.—CONTACTS TO VENEREAL INFECTION CLASSIFIED ACCORDING TO INVESTIGATING AGENCY AND RESULT OF INVESTIGATION,
BRITISH COLUMBIA, 1953. I I
Result of Investigation
Investigated by—
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Examined by clinic	
Examined by private physician	
Failed to report for examination |
Investigated, already diagnosed or un
der care	
Not located	
Still under investigation	
Found to be ex-Province	
Investigation not indicated	
Not stated	
Totals	
549
596
52
119
869
58
5
2,056
142
4,446
435
69
38
48
361
16
2
969
12
6
1
19
16
147
9
12
240
18
2
1
1
446
30
1
1
5
161
2
2
1
17
1
2
1
120
3
168
25
52
20
4
1
284      268
75
39
1
28
196
2
21
362
2
1
855
860
255
255
945
"946"
 VENEREAL DISEASE CONTROL REPORT, 1953
H 29
TABSrXT^™^SSA™rES^ WFECnON CLASSIFIED ACCORD-
K COLUMB,lTIS3AGENCY AND MSULT °F EXAMINATION,
i-H
it
o
H
Investigated by—
Result of Examination and
Whether or Not Previously
Diagnosed
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rt
ti
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tt     to
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a
ti
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tn
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P
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n
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Infected with primary syphilis—
Prpviouslv diagnosed    	
3  |
1
i
1 |
2 |
Nnt nreviouslv diagnosed    	
Nnt stated    -     -
Totals  1    .
4
i
1
2
Infected with secondary syphilis—
Previously diagnosed— .    — ~
1   |      |
1   |     |
—
—
1
1
Not nreviouslv diagnosed	
Not stated     .               	
Totals
2
1
1
Infected with other syphilis—
Previously diagnosed 	
26
10
1
      |                  1
3
2
3
2
1 21
2 |
Not Dreviouslv diagnosed        	
Not stated	
Totals 	
36
1
4
2
5
3
21
Infected with gonorrhoea—
Previously diagnosed    	
723
639
3
24
275
8
10
94
2
4
1
87
9
91
3
17      662
73  |       4
  j       1
Not previously diagnosed	
Not stated
Totals   	
1,365
299
8
106
4
88
100
3
90
667
Incomplete examination—
Previously diagnosed  	
Not previously diagnosed 	
1
1
1
— |   _
— |   —
_ |   .—
  J   	
Not stated                 	
Totals--„   [ -   P   - -
1
1
—
Negative—
Previously diagnosed-	
91
489
12
227
10
1
65
2
2
71
10
78
1
9 j     57
35
Not previously diagnosed	
Not stated
Totals 	
580
239
10
66
4
71
88 |       1
44
57
Investigation not indicated—
Previously diagnosed 	
Not previously diagnosed .,.
1,303
1
— |   —
— |   —
m i    i
—
  |   102
255
—
Not stated	
945
Totals 	
1,303
1
102
255
945
Infected with non-specific urethritis—
venereal—
Previously diagnosed.	
Not previously diagnosed	
10
2
1  |   _
— 1   —
1
m
	
1     10
Not stated-
Totals 	
12
1
i
10
Not stated—
Previously diagnosed
1
1,142
1
427
_
......
1
—
268
22
122
223
Not previously diagnosed-	
1
Not stated-
75  |       3
Totals	
1,143
428
i
268
22
122
75
3
223
1
Totals—
Previously diagnosed	
Not previously diagnosed™	
854
1,143
2,449
36
505
428
18
1
12
163
271
2
6
22
1
161
122
22
171
75
i       4
3
28
111
223
753
1       4
[   103
255
946
Not stated-
Totals                      	
4,446
969
19
446
30
284
268
7
362      860
255
946
1
 H 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,
1949-53.
Examination
1949
1950
1951
1952
1953
Gonococcus cultures     	
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
283
232,270
7,080
Gonococcus microscopic examinations  	
27,349
Treponema pallidum microscopic examinations—
Serological tests for syphilis    	
257
253,756
During the year there was a slight reduction in the number of specimens examined
microscopically for N. gonorrhoea and T. pallidum by the Division of Laboratories.
However, this was counterbalanced by an increased number of specimens submitted for
gonococcus culture and for the serodiagnosis of syphilis. Much of this latter increase
can be related to co-operative research activities undertaken by the two Divisions into a
comparative study of the Kahn and cardio-VDRL tests in the serodiagnosis of syphilis
and into a new transport-medium for the cultural diagnosis of gonorrhoea.
TABLE XIII. — ADMISSIONS TO PROVINCIAL MENTAL HOSPITALS WITH
SYPHILITIC PSYCHOSES AND ADMISSION RATES PER 100,000 POPULATION, BRITISH COLUMBIA, 1929-53. #
Year
Admissions with Syphilitic Psychoses
Paresis
Other C.N.S.
Syphilis
Total
Provincial
Population
Admission
Rates
(per 100,000
Population)
1929.
1930.
1931.
1932.
1933.
1934
1935.
1936.
1937.
1938.
1939
1940
1941.
1942.
1943-
1944.
1945.
1946.
1947.
1948.
1949.
1950.
1951.
1952.
1953.
31
42
29
39
36
54
37
36
46
44
45
37
39
41
31
26
28
30
24
20
24
22
12
3
4
1
1
1
4
5
3
1
2
1
2
1
10
8
3
32
43
30
39
37
54
41
41
49
45
46
37
40
41
31
26
28
32
25
22
24
23
22
11
7
659,000
676,000
694,000
707,000
717,000
727,000
736,000
745,000
759,000
775,000
792,000
805,000
818,000
870,000
900,000
932,000
949,000
1,003,000
1,044,000
1,082,000
1,113,000
1,137,000
1,165,000
1,198,000
1,230,000
4.85
6.36
4.32
5.51
5.16
7.42
5.57
5.50
6.45
5.80
5.80
4.59
4.88
4.71
3.44
2.78
2.95
3.19
2.39
2.03
2.15
2.02
1.89
0.92
0.57
This table has been devised to study the effects of the syphilis control programme
for the prevention of the late disabling effects of syphilis. ;l
Specifically, with respect to syphilitic psychoses requiring admission to mental hospitals, it will be noted that the admission rate has fallen from 7.42 per 100,000 population in 1934 to an all-time low of 0.57 per 100,000 population for 1953.
 VENEREAL DISEASE CONTROL REPORT, 1953
H 31
It can therefore be een that our venereal-disease control programme, as well as
attacking the public health problem presented by infectious types of syphilis, is also
producing results in terms of preventing the long-term disabling effects of that disease.
VICTORIA, B.C.
Printed by Don McDiarmid, Printer to the Queen's Most Excellent Majesty
1954
500-754-9815
 

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