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 C- h- z o u r < J* 3, z 6 > z o > Q i- S C *» ■£ Z 1 3 J. g -> 5 < 6 5 S ■=**£(£'_.< 8 X S £ ■? " V _• 7a * •* iii ! s -At.!- Vt 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 z o I—I H u w on 53 u i—i H cn H H cn CQ Z O t-H H < D Oh o in O o o cn .On O i O ft. 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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 11 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. rt o H Gonorrhcea Syphilis q w rt y s u N 0J C > u Hi ■5 O rt , H CS I >. u cs ■a 0 o u a. 1 I rt t-i B rt 1 § 3 H rt 3 U CO RI > o KB H rt u J3 D. >, CO O H s 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 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 oo -H CO o z O o H o z q O M oo O 1 _| H cl, H< o z a z X w PQ < o\ lo cn CS c" C r- o Tt vc VO CS r- m cn t-n Tt VO ■tf «n comin csr-rn WrHHrNinooH r-rnt-tov rj- ri n ri m n t> 0\ 9 n CD m rn rn rH r- n CS CS cs cs m cs cn n W 3 o H rt rt rf CD 00 n CS CN *n Ov i-h m rn cs rn m CS r- Ov 0\ Ih . o> as 9 rH rH ,H w pH " 1 §4 oj: o u vo m m rH m m cn rH Tt m cn cS m n rt in rl m tn n m cs m CS CS csr- cccncsvo>ncs CS cn rH o XL ta CXn >.-7-. oo Tf m HNHH rn rH 00 ^ vo i-h cS cn Ol -H vo *rj o H vo cn ON m co rn m m Tt cn vo cs Tt vocnen cs <-. m cS Tt CS cn Ovoo n so tS Os so cS (S in n VD o "n OS Ih . o> O VD §8 on CS vo en 9 as in n m cS cs t*- "* fl 'O '""' rs rn tn CS -H TH rH CS is O VO n rs n n n n 00 Tf Tt ON CS -H. cn 0 H ON O 00 1-H CN O rH rH (S VO CS m mr-cs r--=tcn tj- cs "^ vo r- rs Tj- rH rs 5 th rnm Ov -* Id o> Os in | §8 OSP 0 ■" rf t- 9 VD cn r- 9 in "t n n CS cs o cs cs rH Tt cn 9 n >n ^ (S Pa VO CS Tt cs CS rH rH Tt m rH Tt -H-H-H - 5 o Tt r- (N t£ Xr* in rs in vo tj- n-M m n rs TtcS cs "^ r-Tt Cni-trHVOrHrH cn CO Tt Ov Ih o> o cn 1 ! | §8 0 u oo n © rH VO cn rH in n m in *n CS tn vo tj- cs ^t ^t tn n CS CS rH in VO Ov rH (S rH cs cn m VO rH Ov 00 rn rn CS rH n n l> CS tn cs Tf m ** Tt CS Cn rH m ■st cs oo rH cn CS in r- in cs ^t ^t Cl H m Tt rH 00 00 m rH rn CJ >n ^ rs Tt 93 (_> c y -"2 o \% o w 0 1 C h j It t- R C X 4 E 0 C > i n, Cf l- R q X a. ^ Li cr e C ■c g i. R 0. It X R c J U . C E '- n C fl. < C c "a 2 > > t C l< C 2 a 4 < a | E a i- c 1 c Z a a. < 1 S3 8 s* °o 6 *■ Ilf&s ^'e_ < C cs0C ^crj-a-c cB . *j rt ■ m,s t o S5 « § Z% *1 c rt u c bj rt -a c < < Q CS rt . C on o c s 5 * x rt i- < s 0 a x U S a oo 1 s o a 55r^> VENEREAL DISEASE CONTROL REPORT, 1952 D 25 CO r- cs n cs cs ts r< ^H tn Tt -H - *■' m i ; cn as oo Tt — o\mcS ! rH ! i-h m Tt CS I cs rt ri tn i-H Tt m ffl ovOvocscScnTt-HOst-.cS"nvocsr~ !Ht^ Tt r- VO © rH Tt r- VO Tt 00 VO VO Tt rH ^ VO n CS CS rn rn i-H 00 ! rH f vd cn cn O Ov rs 1-1 rs n 1 ! n i-h CS 1 m : rn r- CS I Ov m m i-h rn tr- as i— f- Tt n CS rH vn rs r- vd r- i-h Tt Ov Tt in Ov cn Tt rn 1-1 CS as rn n n VD Ov cs 1-1 Tt rHTtrH—< !cScni-HOO ! [ n in in oc Tt : m : Tt : oo cs >^ cs , m m i-h i— cn o VD rn ts Tt co 9 rn rH CS cs i-h vd m Tt cn CS rH i- VD rH 1-H Tt 00 r- ts rH cN r- i-h cs o r- cs c^ Ov © in VD in Ov Tt © m Tt rH CS r1 cs rs ___< OV 1 : rn | r- Ov VO VD VC vo rs vo as m cs n vo : cn m r- m ^ cs ! n r- Tt CS r~l 1-H ON rH (T VD CS TI : cs CS 1 cs Tt — r- r- rH in VD in n n cn l> ; VD rn vo CS ! CS ts i : o VO t- cs m t> vc :m-no\t--!-<©mcscsvDcn tS OO O © Tt VC rn Tt ; VC VD cn o\ rs cn ov m i#- cs cs ' cs 1-H 0O rn i Tt ; rn 1 j Tt cs c CS v © O VD t- Tt o © vo ; vd © cn vo CS in ts (S cn r- r- Tt i t>a\ © as i cs rs ' cs n a- __, rH CS ! ! ! rH fS OS ! rH i-H Tt 9 t- © rl cs ; Tt : vn cn i : c CD ir © i-h VD OC ! m ts -h vo i r- cs cn cn r- cn ov rs t— cn vr © VD ' Tt Tt Tt cn . VD rs 1 CS tn ! ! : i i ! : ^ Tt CS r © r- m vo vd c- oo cc o\ rt ; r- imi-HTtTt t- tj Tt Tt rH C*- oo m i rn cn 9 in '""' CS r- m rn i- CS rH rH CS cn ; 0 Tt CS ' CS t» r- CO O in r- : 9 cn 00 i m Tt i-h m ts : Tt I? M m cs C* r- r- OC Ov VD Tt CO CS i— Tt CO ! t> rH Tt Tt r- m c Tt rH rH C i-h CS ! 0 t~- O r- CS CS i- Tt i-H r- cs rn CS rH r~- rH Tj- | VO t> ! in cs CS tn 00 > *a u L 1 C C i i- 0 ! it -- 0 C : it JL-S9 ft CO "t ttj ; a J I j t R C !• .S > ■n = > n cj rt > ft R rr C c. 4 j 1 I E < 1 a 1 1 ! c X i - c ■ 2 i t Jo 3 rt ; OJ c 111 w > ( _■ "i 1 j j > s\ cc i « C . * « C. I. ( 5 ( I c C ! I II < j ( i i 1 0 c ! 2 ° . rt 4 Lh 1 OC X < i • e 1 ■ R "tf ! 0 c \ % 1 « -0 ■0 5b o E cs c 25 Mission City Mission Disl New Westmi Pitt Meadow Port Coquitl Port Moody. t: X t ^ C ? ■> e i c ... r- 1 c Z R > R P s Of 02 a > sp t. O Z t -a B C E X t s X 1 a r- s p c t c > 8^ rt 5 > rt -*-> Ih s § < < « < < D 26 DEPARTMENT OF HEALTH AND WELFARE oo h-H tn O Z o < o H O z w Q oi o u u < Q a •SO 0> I CS Tt rn cs eg 0 * oo rn I m oo oo i ri ci r- vo h-h cs h (N "n I 00 150 < J.0 6> _-8 o ft;- [— I \0^»_ Hr^rH rs ! cs r- *# m r- • )H too n r--f ^ ts ;-h(NO\ vo vo 1 I — a\ cs cs --. -j < z o I-H H U w Ph Z P hh> o u 00 •-• H o> Q M •5 w ft'- >.pp vo ; CS CS VO CS ; cn cm VO-H — --HCS -a- -r ►J 2 H ft] WW r Q Ph CO o w Ch Ph o w o < ►J Oh § on Z o r—I H < U g HH H O z z j_q o> S8 o * IHH ICS VOCW WHfl CS 9 CS 1— rH OO OO m Tt rH CN, , © O t- 1 rH Tt OO m in cn ! r- h CS Ov tn i ^t — m vo ft'- 05 O h PQ PQ < rt ' 'S t_ 0 O ■ . s -a ?= r 1 ! B : Hj ««H c5Ul?8||112 i ft i -o .t_ 0 ° -1 i '3 I -a js«.a g » «UUUOWh'ZZObj>5 <3 0, •a w. 3 . CS o 00 z g o a Bfflr ! a-a - •._, _j hj g a fcjSflti I p a h 3 o s. •O H a I * I? ; rt ; a • .___■ i<_ Jr. 4) rt • rt .S3 o 3 C co S O O 3 B MOJS < < < rt ■—■ £< Z g rt £ VENEREAL DISEASE CONTROL REPORT, 1952 D 27 *"• - in in rn ov i-h cs cn m m cs vd oo m n cn cn cn ^ rH Ov CS m rH rH t> r- ts CS m rn rn i— Ov © O cn m m i-h Tt VD Tt 00 Tt cn cs (S rn co ; © cs i ^ r-r- '""' m r- — i- OV Ov rn j r- Tt TH m t- VO rH C ocsTtr-cncscs mm o vo cs Tt Tf CS Ov re r- r- n rs oo rs Tt c- 00 9 9 Tt cn VC i— >r — m CS Tt Tt CS r. in in rs oc o Tt cn rn m cs — CS n cs r vO VD oo r^ rn CS rH rH CS cs cs ts m c- m CS rH O vo Tt l- vo rs M © r- cs rn CS i-h m ts Tt m cs rn rn m m cn rS m ir ts ts Tt rH j n tS rH rn CO fc- m oc Tt oo cn Tt cn vc CS f VO VC cn CD m m rs — tS CN m vo vc Tt t* ^ "n»oa r- — vc oo r- r- cs Tt r-c CS i-H rH n CS rH (X Ov Tt OV rH iv rs c- Tt Tt VO VD cn f i- ov rs in Tt rH 00 cn rH Tt 00 rs i-h cs cs © Tf rH cn Tt Tt VO © VC CS rn r- Ov 9 ts r VO VC r~~ r- vd vd m r- rn Ov CO r- r- — vc CS CS 00 CS rn rH r- rH rH Tt tn cs : CS VO Ov : w oc ■ Tt j o m cr CS (S C CS rH r- Tt Tj Tt TJ VD 1-H V 0O t— r- H O r- m c CS Cs 00 r- rH © CS rH rH oo cn V © m VO oc rn IV n r- n m oc in ir Tt Tl Tt Tt cs cs m CS rH rs vo cs VI cs oo Tt © : c Tt n rn j Tl cs r rn c cn rn r- as o Tt Tl © — o- cn rs r- in ir cn r. i— Ov CS o cn n -— i-H rH 00 Tt cs o cs 00 r- vo rn : oo Tt ; cs r- t- r- in vc Tt 1- 'C < B C * £ i- < c c p t: R P 1 e i 3 C 7 £ 0 0 c s p c c ft 2 IS J- s X VC i C 7 [/■ B E i N C 0 Ot u it a vc o .7 It t « p •c a I c a a u 2 s I cc CJ k 8 OC C e l "t d> P Mr o_ a P U R C ■c 0. N c 0 c u u oc C 7 y t- 1 a. p CI it OC C z c 1 r* a tt E e 1/ t CC p •c a. 1 - Area Sah Sail TTn Si < < y 15 rt £ < rt c < a £ 8+3 < « £ < < ct i- 8<2 < p = < rt££ < < rt a § £ < D 28 DEPARTMENT OF HEALTH AND WELFARE Q I-H o« oo oo o r—< ft. HH H O z ft. z X ft. PQ < (S m Ov Ih . jq o> cs rs ort vo >— Tt m es cs cncn cs rs ovm m mm cscs ft-3 >>PP in Tt Tt rH rH on |i VD vo in r- cs vo tscs cscs Is o H SO 'SO CD Tt n Ov o> cs cs m cn ox 0 u cn-rtov vo es vo oo mm n n mm m h ts r- © O t-- mm O© cScs TtcnCSrH rHrH M 0\ H (S HH OIO •5 cn ftS OV OV fS rH rH m m rt r- in mm cs cs *rt csTtco co m r- co mm n n mm vornm i—ov©rs o© cscs mm VOmCSrH rHrH TtOvrHcnCSCSCSCS o Ov Iq o> 1-H rH §8 0 h ooTtTt r-©csm cs es cn m rH rH ri ri ! cn cn rn rn Tt Tt oooh r- oo rHrH mm Cn rH CS rH 1-H cs cs >,:3 m n ts m m oo co r-i ov CS rH CS CS cs cs rt O h n m so t~~ © cs m cscs m Tt rH rH rH rH 1 men vornm vococSvo ©O mm oooo TtTt vorsmrHrHcscs Ov Tt Ov Iq 6> §8 °-5 o u © m r- m r- Tt tJ- enrn TtTt mm r- m rH Cn rH 1-H t-. rH O rH O rHrH TtTt mm i-h l-Hoo m ri ri mm ■jia m rn Tt m cn cs cs Tt m CS rH Ov CS CS t- t-> "3 o H mTti— inc~-TtTt vo vo TtTt mm ov VO n m rH rH Ov in«nrHOv men h'h mm I HH mOV Cn rHl-H TtTt OO Tt Ov o> at §8 0 u mrHcs mr-rHin r-r- TtTt TtTt 9 Tt rn rn rn Ov vomm© vovd r- o cscs © t- m rs cs ftS m CS rH CS rH i-H j cs cs m m cn Tt m vo Tt Tt Tt CS rH "rt o H vomrn moorsm r- c- TtTt so so cS Tf rH co I— rH cs ov t— vo vo o© r~- t- tscs rn TtOv Tt n n CSCS o o Hi o Hi u d tt. et ft ■d u N ri o H rt ft •o u .a w es ft •a o .a rt a ft •o a .H X C ■0 u N o EH ■— rt ft •o 93 N T3 1-H p ft •a a Hi Cf, I-" ct a •o OJ N ts p a: N O v. - a •a 8 | 1 c i- -s X B. TJ 4 | | 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» ** y f / / r \ ^" ^ *^_> 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 93 *■> fe WMnvoinmriin © CS rH rH rH rH © Oi*W (L, O CS m Ov ■»"_! II mr-m ©>-Hr-~Tto. © rHOvVOTtrH-rJ-m© m •S cs rH m CS CN rH (N Tt HZ ^ ga 38 OvcSTtmTtmvom © (Vj rH r- rH rH © a1*-" P,0 m Ov "■5. 5§ (S m Tt ih © m Tt i-h o tn en m tn r- r- m m © :« e8 r-i m rs cs cn cs HZ ~ c"c3 H3 —> °J OcsmvoTtrnvcvo © rH CS rH rH rn rH o Url Ph O o Ov w*S f^rHrHO-. mTtVDt— VC TtOTt-HOvTtCNi— CO f- nj rH m CS rH CS CN HZ ** ^_, Grt u *-• fe ©cscsr-mmmoo £>Q WU 1 Oh tn W S H O 1-H H g t-j h-H < «n Ph ' ~ oo cn Jt <2 O t) a 2 c/_ O Oh X w O 00 PJ U < Ph > w 05 < ga §2 «_"p Q OJ HZ ft.° •II 1-4 ei HZ S3 Si*1 d 0 fH rt HZ ga ai OJ EE HZ ft, o »■_. m Hi Si HZ ov Tt oo cS m © Ov Tt r- rn rs m rs Tt i-h m i-h © Ov m i . — rs Tt t> r- ■ Ov CS Tt CS CO Tt cs m i cs r- r- © m n oo vo © r- © rn n 9 m Tt 00 m rn m rn c^ — m oc 9 m Tt Tt m co rs m Ov i— r» m Tt m ov m rs m -h m 00 rH o , o Ho g -- wi u ^2 O "r_ rt cs ■- o U >;> 0 u > 3 u o OJ p > 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 <_ §2 55 a || 55 ■a Hi H So OS P 1 5 ° 1 | i u _D W 'o 'in >, S3 ft, o ft, Hi 1 i p. <_> p § '■3 a o ii (B'o o §15 £E> go's Ul Hi o u o 1 _2 £ •ffi o a o-B O C rt TJ t_ M rt.rt+- Sgc q.2n " >£ Z&a 1 o •43 rt on o •_r__ ffl "5 £• o ci ol 4 rt o '-2 rt CO 93 !.« as ZO u rt W O Z 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 Si §2 >S I5 5 93 .2 w 11 55 SP *e3 o a a 2» •a 93 ll JJ ° 1 in a P 5 rt <_■ a 3 cs on M a OS 'tfl 1 Q 'cS > TJ ft, c a 1 Ih rt o. Hi O s n e a o il S5„ ISl §15 £E:> -S9L Ih fl o 14 o 1 .2 S S o a oa o e rt M 00 00 S2B J3° is Zft, 3 A .2 rt •■H Oi to O- I-3 As oj || +3 rt (O 0J £« C v. oS ZO •o Si rt W O Z Infected with primary syphilis— 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