first half

UNITED NATIONS NATIONS UNlES

W O R L D H E A L T H O R G A N I Z A T I O N

R E G I O N A L O F F I C E FOR T H E E A S T E R N M E D I T E R R A N E A N

G W T E REGIONAL POUR LA MEDITERRANEE ORENTALE Troisitme session

ORGANISATION MONDIALE D E LA S A N T ~

RENS3IGNEMENTG EPIDEMIOLOGIQIfEq

Le Directeur regional a l'honneur de presenter au Conit6 r6gional un rapport aur l ' i n d n c e , en 1949 e t durant l a premiere moiti6 de 1950, des maladies p e s t i l e n t i e l l e s e t autrea maladies transhissibles, concernant Lea pays de l a r6gion.

REGIONAL COMITTEE FOR THE HEDITERRANEAN

Rc3/EM/20 7 Auguet 1950

@3EIIDPIIOLOGICAL J N ! F E L L I ~ E

The Regional Director has the honour +<o submit t o the Regional Comittee a report on the incidence of p e s t i l e n t i a l and other communicable

diseases i n relation t o countries of the region, during 1949 am2 %e first half af _1950.

FcraL l c s f s n c t i o n s d o n t s ' a c q u i . t t c 1; S e r v i c e 2pidi;li:)logique du L3urcz.u dde l a M d d i t c r r a n i i o r i c l l t o . 1 ~ ~ f i g u r e n t l r r b u n i o n c t lc. d i f f u s i o n dc rcnscigne;l:l?ts r e l a t i f s nus p o u s s i ; . ~ d e r??lc,dics p c s t i - l c n t i e i l e s daps u.nc J c s o u e t r c r k g i a n s du conde. L i s t r o i s a u t r e s r e g i o n s sect

d e s s e r v i e s pcr l e s s c r v i c e s dpiddr.liolo- g i q u e s d e 1'01.15, 3. Gcnhvc c t

>.

Singirpour, e t du Burc,?.u S s n i t c i r e T m z x i r i c z i n .

LC zone qdi, sous lc r a p p o r t d c s r e n s e i g n c n e n t s < p i d 6 n i o l o g i q u e s 9 c s t d c s s e r v i c p c r ca S e r v i c e , ddpcssc l e s liiyiites d c 1- Xjgion d c l a M6ditcrrani.c o r i c n t c l e , e t s. t r o u v e n i n s i c n g l o b c r d'?.utres pzys &;clcl-:Aent. Pc,r c o n t r c , c l l e no co1:.prcn3 n i 191rz,r., n i l e Fe.kis- t a n , ni 1 2 T17.rq.lie9 l e s q u e l s , b i e n qu'ilpportcn:.nt 1 c e t t a rAgion, s o n t a s s o c i d s r s s e r v i c c s do r e m o i - g n e n e n t , ~ d p i d i r ? _ l o g i q u e s .

Durant 19'nnCc 1949 c t l e p r c n i c r s e n e s t r e dc 19: ^,, cucun c a s d c F i h v r c Jzunc n i de Po:,; n':; 6 t i sign,z.ld dcns un pays d~ l a L i ~ i o n . I1 ² d t 6 ccpen- d e n t n o t i f i i r r S e r v i c e d e s Renseigne- n e n t s Epid&i:io.ogique s d e c e 3urea.u, q u c l q u c s c a s d . Y i i v r e J a u n e survcnus dnns q u z t r c p:vs dc I n zone d9cndd!:icitt c a a r i l e d t l ' i f r i q u r

L a ?is& s 9 e s t n c n i f e s t i c . cn

:,frjquc, 2.u IprnXi)., u n e n i . dcns

-

1'Union dc l ' l a f r i q u e (111 Sud c t 2u -C

m;

^{s t i 0.1 & dcns}

19w

^{c t en}

Bimc.nje.

BLcn cuc c c s PL:YS

-

06 ^{1 2} Fib-crc

Jaune :t 1; P t ; s t c e n t i t 6 s i g n c l k s

-

^nc

se t r t u v c n t pcs d-ns 1::. r6;:ion d t l a M6dit:rr::nLe ? i i c n t z i c , l e u r s conditior.s

ipid.:riiolo;iquos i z i 6 r ~ 3 s c n t l c s pz.ys d e c ~ i t e ri..i,-?~

.. ,

s o i t p a r c e q u ' i l s l e u r sont linitropk<:;;, s o i t p-rce q u ' i l s s c t r o x v e n t e n co:.li-lunic;tion d i r e c t c c.vcc

C u x l

Depuis ddccmbrc 1947, d a t e h 1 r . q l ~ c l l ~ 1'6piddifie d e c!ioltrc. c n Egyptc p r i t f i n ,

E_PIDCi.IIOLOGICi,L INTELLIGENCE

l~:.ong t h e f u n c t i o n s d i s c h c r g e d by t h e E p i d c n i o l o g i c c l S e r v i c e of t h e E z s t e r n 1~Tcditcrrancz.n O f f i c e a r c t h e

c q l l e c t i o n 2nd d i s t r i b u t i o n of i n f o r n a t i o , ~ r c l n t i n k t o o u t b r e a k s of p e s t i l e n t i n 1

d i s e c s c ; i n one s f f o u r a r c c s of t h e worll.

T!ic a t h e r t h r e e a r c c s a r c s e r v e d by WHO,

Gcn.cv~. zna S i n g a p o r e , end PfSE epidonio- i o g i c a l s e r v i c e s .

Tho e p i d e r A o 1 3 g i c a l i n f o r n ~ t i o n n r e c which i s s e r v e d by t h i s S e r v i c e e x t c n d s beyond t h e c o n f i n e s of t h e WHO E z s t a r n Mc.diterrencan Region, and s o

c o v e r s o t h e r c o u n t r i i s a s w e l l . On t h e o t h e r hend, i t d o e s n o t i n c l u d e I r a n , P z k i s t a r , o r Tswkcy which, r.1though t h e y a r c c o u n t r i e s i n t h c Region, c r e a s s o - c i c t z d w i t h o t h e r c p i d c i f i o l o g i c a l i n t e l l i g e n c e s e r v i c e s .

INCIDEIJCZ OF PESTILENTILL QISELSES

---

T B 3 FCdGION.-FOR THE YEiJI 1949 :JJD

--

HiiLF-%IS.

--

P c i l o ~ r Fever nnd F l s g u e :

Durin; 1949 2nd t h e f i r s t 6 months of 1950, no Ycllolj Fevcr a r T1a;ue c l s e s were r c p o r t c d f r m r n y of t h c c o u n t r i e s i n t h c Region. i. few c n s e s a f Yellow F e v e r , howovcr, wcrc n o t i f i e d t o t h e

7 ~ p i d o r ? i 3 l a ~ c z l 1 n t t l l i ~ ; c n c c S e r v i c e of t h i s O f f i c e , fro11 f o u r c o u n t r i e s : i n t h e A f r i c a n Ycllow Fever endcr.~ic ?.rca.

P l z j u e e p p e a r ~ c ! i n

m.,

T::ni;rCi&&;, Union of S o u t h 1.frice. 2nd

&I.ii?.n Conc:o i n -3, c.nd i n

L l t h o u c h t h e s e c o u n t r i e s

-

^whore

Ycllow Fever 2nd P1a;uc wore r e p a r t e d

-

c r e n o t i n t h e E r ~ s t e r n Mdediterrz.nem p . ~ o g l o n ,

.

t h c i r e p i d c r . ~ o l o ~ i c a l c o n d i t i o n s i n t c r t s t t h e c a u n t r i e s of t h e Region, b e i n g e i t h e r a d j a c e n t t o o r i n d i r e c t com?unication w i t h t h e n .

S i n c e Dcccnber 1947, when t h e

c p i d c n i c of cholerc. i n Egypt c?.ne t o an

l e Pdkistan a Q t B l e s e u l pays de l a RQgion

oh

l e prbsence du cholera a i t

Q t k signalee. Le nombre de cas survenus e n 1949 a QtQ do 31.082 contre 4 . 5 0 9 durant ljnnn8e prQc6dente. L'incidence de c e t t e maladie a t t e i g n i t son point

culninant w cours dcs deux dernibrcs d e s , pondant l e mois d 9 a v r i l . C 9 e s t l e Beng:: e o r i e n t a l q u i

l e p l u s forterAc ?t a t t e i n t , t a n d i s que, pendant q i ~ e l q u ~ s annees, des Bpidenlcs peu i n p o r t m t e s se sont d i c l a r d e s d?ns l e s autre; p a r t i e s du pays. L i n s i l c s tableaux dJincidcnce indiquent que

2-36 c a s seulemcnt ont 6t0 signLd6s commo Q t a n t survonus dans l e Punjab occidental e t 2 cas dans l e ?:id.

Depuis l e mois d 9 s c t o b r e 1949 aucun nouveau cas n 9 e s t survenu d m s c e s provinces, ek :e c b l Q r a au Pakistan s e t r o u w confine ^EU Bengalc o r i e n t a l .

VARIOLE

On c o n s t a t e une augmentatiqn.

marquee des cas de v a r i o l e dons 12Union de l s l i f r i c ~ , c du Sud, au courS de l J & n e e 1949. Les c h i f f r e s 3es r e l c v e s a t t e i g n c n t presque l e t r i p l e de ceux de 13ann6e prQc6dente. Par centre, il y a eu un f l Q c h i s s e n e n t Qvideni dans l'incidcnce de l a maladie au Kenya st d-as ,'0ug?.nda.

Le nombre de c a s survenus ac Kenya, qui B t a i t de 834 en 1946, e s t tambe & 19 en 1949. Dans l90uganda, il 2 s t 6 signal6 39 c a s seulcment contre 386 :n 1947.

Les chiff: c s s i g n a l e s psur l a S v r i e d6notent &e . Fncidecce relatlvoment klevQe de l a ~ w - i o l e dans ce pays, au cours des deux d e r n j a r e s anndes. I1 s$av&re, cependant, qu'une climinution marquee s ' e s t produite en 1950: l3 c a s

seukemcnt: ont QtQ si.r;nalQs durant l e s 20 premiBres senaint.3 do l'annee.

En I r a n , l e s cas de v a r i o l e ont ,-- auyoente p.o~rbssivcme 15. En 1946, 1947 e t 19$8, 10s cas si&.nalQs ont Q t B , r e s p e c t i v - a e n t , do 1l.4, 849 e t 1134.

Toutefois, en 1949? 19incidence do l a maladie a 1otablemen.c f l d c h i , o t l e s

c h i f f r e s des r e l e v 6 s pour l a prenihre n o i t i e de.l'ann4e 1950 indiquent q u ' i l n'y a u r a pas de chnnpment dans l a r e g r e s s i o n de la v a r i o l e .

end, tho only country i n t h e Re i o n

#

where Oholera was reported was nkistan, The number of cases i n 1949 was 31,m against 43,509 t h e year before. Tho highest incidence of t h e disease during t h e p a s t two years occurred i n t h e month

i n some years. Thus, t h e incidence t a b l e s show t h a t , d u r i y 1949 only 234 cases were recorded fromWest Punjab an3 2 cases from Sind.

Since October 1949, no cases have occurred i n these provinces Md cholera i n f c c t i o n i n Pakistan has been r e s t r i c t e d t o East Bengal only.

1, marked increase i n t h e number of smallpox cascs during 1949 i s noticeable i n t h e Union of South Africa. The r c t u r 4 > s a r e n e a r l y t h r e e times a s high a s i n t h e p r e c e d i w yem. On t h e other hand, t h e r e was a marked decline i n t h e incidence of t h e disease i n m a m d Uaanda. From 834 cases i n Kenya during 1946, ^{t h e} i n f e c t i o n went down t o 1 9 cases i n 1949.

I n Ugmde, only 39 cases wore reported against 386 cases i n 1947.

Figures recorded from =a show t h a t t h e r e was a r e l a t i v e l y high incidence of smallpox i n t h e country during t h e p a s t two years. There i s evidence, however, t h a t a marked decline occurred i n 1950:

13 cases only were recorded during the first twenty weeks of t h e year.

I n t h e r e was a progressive i n c r e a s e i n smallpox durihg t h e years 1946, lq47 and 1948, t h e number of cases reported oelng

IU,

849, and 1U4 respectively. I n 1949, however, t h e r e was a marked decline i n t h e incidence of t h e disease and t h e r e t u r n s f o r t h e f i r s t h a l f of 1950 show no change i n this

trend.

Bien que l a v a r i o l e ait sensibleuent diminud a u &k-i.Ti, en 1949, par rapport

?l'annbe prdchdente i

-

l e s cas &ant tonbds dc 12.452 & 4.661

-

il e s t i n d C n i a b l e qu9en 1950 l e nonbre do cas aug- nente. 10.887 cas ont d d j i B t B signalds au c o w s des v:.nbt premi&res s e m i n e s dc 1'annBe.

Un flechi-.;.enent dr: l a v a r i o l e en I r a k r e s s o r t clairemcnt de l a conparaison

-

des c h i f f r e s totaux des premiers senes- t r e s des annBes.1948, 1949 c t 1950, l c s q u e l s s'Qli?vent, rcspectivcncnt, 2

659, 354 e t 133 cas.

1.u cours des 24 premihres s e w i n c s dc 1950, il $ e s t survenu que 7 1 cas dc v a r i o l e dans l e Soudan L n c l o - E m t i e n dont 29 dc v a r i o l a minor e t 8 d y a l a s t r i n . I1 c s t c l a i r quo 19incidencc de c c t t c maladic accuse une diminution marqude depuis l'annde 1948.

La Jordanie, c.pr&s avoir dtB exenpto de v a r i o l o zn 1947, en a cnre- g i s t r e 48 cas cn 1948 e t 188 en 1949.

La naladie a tondan:e & diminucr en 1950. Durent l c 10: scmestro do c c t t o annde, il n'est survcnu que 21 cas, dont 17 chcz unc t r l b u nomadc du dis- t r i c t du d e s e r t oriental, c t 1 cas parrrl l c s rdfi;;i&s du C r n ~ dc KBrmeh.

L ' e x i s t c n c ~ dc a v a r i o l c en 1-

Sdouditc a conmcnc6 k Btrc signd.de dans 10s dorniers n o i s dc 19annde 1949, .?I l a f i n do l a saison du Pllcrinagc. D'cctobrc 1949 & a v r i l 1950, 545 cas c t 198 dechs ont dtd n o t i f i B s pour J& e t l a Mecqucj l j i n f e c t i o n semblc n'gtrc apparuc que dons ccs doux l o c a l i t & s .

I1 n'y a pas cu do changenent

notamnent dans 19incid-.nce de l a v a r i o l c dans

I'm,

^{ac ?t} au Tanranyika, quclquos cas s?oradiques seulcncnt sont

signalds en Etniouie, cn I s r a e l c t en Turquie, duranc l'annke 1949 e t l e l c r semcstrc de 1C50,

Dcs cas sporadiques c t dc p e t i t e s poussBes l o c a l i s d e s sont survenus parmi l e s rkfigiBs dc Palestine, dans t o u t e s l c s zonce cxccptd l a zone dc Gzza, durant 10 l c r scnestrc de 1949.

L l t h o u ~ h smallpox i n Pakistan declined narkcdly i n 1949, conpared with tho year before

-

from 12,452 t o 4,661 cascs

-

t h e r e i s convincing evidence t h a t smallpox i n f e c t i o n i n 1750 i s increasing. 10,887 cases have already been reported d u r i y t h e first twenty weeks of t h e year.

1. docrcase of snallpox i n

Iraa

i s c l e a r l y shown by comparing tho t o t a l f i t u r c s f o r t h e f i r s t h a l f year periods of 1748, 1949 and 1950. The t o t a l f i g u r e s f o r thosc t h r e e periods a r c 659, 354 and 133 cases respectively.

During t h e f i r s t 24 weeks of 1950, only 7 1 cases of smallpox occurrcd i n t h e 1.n::lo-Emtian Sudan, 29 of which were v a r i o l a &nor and 8 were alastrim.

I t i s c l e a r t h a t t h e r e has been a rmrked f a l l i n t h e incidence of t h i s d i s e a s e s i n c e 1948.

After being f r e e from smallpox i n 1947; Jordan had 48 cascs i n 1948 and 188 casos i n 1949. Tho d i s e a s e i n 1950 i s tending t o d e c l i n e . During t h e f i r s half-year t h e r e wcre only 2 1 cases, of which 1 7 occurrcd i n a noliladic t r i b e i n t h e e a s t e r n d e s e r t d i s t r i c t , and one case anong t h e refugees i n Kereneh Camp.

Smallpox began t o be reported fron Saudi f n a b i a l a t e l a s t year, a t t h e end of t h e Pilgrimage season. From October 1949 t o iipril 1950, 545 cases and 198 deaths wcre recorded from

Jedda

and M

-

. The i n f e c t i o n seens t o be confir t o those two l o c a l i t i e s .

There has been no marked change i n t h e incidence of smallpox i n

my

Lebanon and Tanaanvika, and only a fcw sporadic cascs a r e reported from ~ t h i c u d I s r s c l and Turkey during 1949 ^and the f i r s t h a l f of 1950.

SWLLPOX I M N G PI,LESTINE REFUGEES

Sporadic casos and emall localised outbreaks occurrcd mong P a l e s t i n e

rcfugees i n a l l a r e a s oxcept t h c Gaza 4

during t h c first h a l f of 1949.

Lcs c a s ont Q t 6 s i g n a l i s rk@lihre- nent aprbs c e t t o pdriode, l a plus f o r t e incidencc (105 cas) & t a t survcnue en janvior 1950.

TYPHUS EXANTH2MATIQEZ I1 n'y a gas cu de changenent dans l'incidcnce du typhus en Los role- v6s du l e r s e n e ~ t r e de 1950 indiqucnt que l'incldencc de e c t t e ann6c senblo s e rapprocher do c c l l e d e s deux annBcs prk-

ckdentes,

En

, & E

l'incidence du typhus p a r a i t E t r e en ddcroissance constanto, 325 c a s ont Q t k e n r e g i s t r d s en 194.8.

L'incidencc c s t tombde & 181 cas on 1949, e t l o nombre t o t a l dc c a s pour l o l e r sonostre dc 1950 a QtQ dc 74.

Dcpuis 1947, l e typhus a marque un fldchissenont graduel dans laUnion de 191,friauc du Svd. Les c h i f f r c s totaux Dour 10s t r o i s dernikres annkes ont 6td.

respectivoncnt, do 773, 428 o t 220.

Durant 10s annBoe 1946 e t 1947, 19incidcnce du typhus en Erythrke a dtk r c l a t i v c n e n t QlevQe. .3/0 c t 842, t c l fut l o nonbrc dc cas crxcgistr6s, respoc- tivcment, pour c c s dcux anndes. Un f l k - chisscment narqu6 s'est ccpendant produit pendant l e s doux annQcs auivantes, e t il n9a kt6 e n r c g i s t r d quo I2cas seulement pour l e s 24 l b e s senainzs de 1950.

Durant l e s quatre dernieres annkes, l'incidcnce du typhus on

p &

^s'est

presque maintenue au m2mc niveau, C e t t e n&e i d e n t i t 6 de niveau Ee retrouve

kgalencnt dans l e s c h i f f r e s e n r o g i s t r 6 s j u s q u ' i c i pour l'annde 1450, q u i indiqucnt une incidence du n6nc o r i r e .

Lcs c h i f f r e s hebdomdaircs concernant l e s c a s de typhus survenus nu cours des 20 p ~ e m i h r e s s e m i n c s dc 1950, au Pakistan, rdvhlent une s i t u a t i o n plus f avorsble par rapport A 19ann6e prQce'denSe. I1 n'a kt6 c n r e g i s t r k que 58 cas contre 579 au cours de l a pdriode correspondan+e dc l'ann6e 1949.

L9incidence du typhus en Tursuic a accuse une diminution continue pendant l e s dcux d e r n i h r e s annkes. C e t t e d6croissance senble s e n a i n t c n i r en 1950, come l ' i n d i - quent l c s c h i f f r e s e n r e g i s t r d s jusqu'ici.

Cases were recorded continuously l f t e r t h a t period, t h e h i h e s t incidence

9

(105 cases) occurring i n anuary lY.50.

Therc has been no change i n t h e incidence uf typhus fever i n

m.

^The

r e t u r n s f o r t h e first h a l f of 1950 show t h a t tho incidence t h i s year seems t o be close t o t h a t of tho past two years.

I n

E & & ,

t h e incidence.of Typhus seems t o bc s t o a d i l y decreasi

7

³²⁵

cases were recorded i n 1948. he p c i d e n c e went darn t o 181 i n 1949 and t h e t o t a l f i w e f o r cases f o r t h e f i r s t six months 3f 1950 was 74.

Sincc 1947, t h e r e has been a gradual d e c l i n e i n typhus f e v e r i n t h e Union of s o u t h Africa. The t o t a l y e a r l y f i g u r e s f o r t h e p a s t t h r e e years were 770, 4.28 and 220.

During t h e years 1946 and 1947, t h e r e was a r e l a t i v e l y high incidencc of typhus i n E r i t r e a when I340 and 842 cases were recorded i n t h e twa years. There has been a marked decline, however, during t h e following two years while i n t h e f i r s t

24

weeks of 1950 only 12 cases were recorded.

During t h e l a s t four years, t h e incidencc of typhus fever i n Irap has been nearly t h e same. The r c t u r n s so f a r recorded f o r 1950 i n d i c a t e a s i m i l a r incidence.

The weekly figuresfol' typhus f o r the first 20 weeks of 1950 i n d i c a t e a more favourable s i t u a t i o n i n Pakistan than

ia

t h e preoeding year. -cases

were recorded, a g a i n s t 579 cases i n t h e sane period of 1949.

There has been a continuous dec i n e i n t h e incidence of typhus fever i n

$

^urkey

during the p a s t two years. This decline seems t o be continuing i n 1950 a s indicated by t h e r e t u r n s of t h e disease recorded up till nw.

RC3/P1/20 page 6

Le t o t a l des cas de typhus e n r e g i s t r d s The t o t a l f i g u r e s f o r typhus cases en 1949 e t au cours de l a p r e n i 8 r e y n o i t i 6 recorded during 1949 and t h e first half de 1950, h C b r e , en C n t h a i a u e , en J o r - of 1950 i n

m,

,,LSZC&l?

&&e, au e t en T r i ~ o l i t a i n e , d K n - Lebanon and a h a t e a t r e n t que l a maladie s'est d f e s t k e dans sporadic prevalence of t h e d i s e a s e i n ces pays sous une f 9 p sporadique. these countries.

LE TYPHUS PARMI LES REFUGIES DE PALESTINE TYPHUS FEVER AMONG THE PALESTINE REFUGEES Le typhus a f a i t son apparition,

durant l a moitie de 1949, dans deux regions 06 r e s i d e n t des re'fkgie's

p a l e s t i n i e n s , HQbron e t Gaza. Une pcussQe de 156 cas n eu l i e u 8. H6bron e t de 24 cas A. Gaza. Depuis l o r s , l a maladie s y e s t manifestee sporadiquement parmi l e s r6fu-

gigs. Les d e w types, Q p i d k q u e e t end&- mique, sont occasionnellement signal+%.

Typhus f e v e r appeared i n t h e f i r s t h a l f of 1949 i n two of t h e P a l e s t i n e Refugee areas, vebron and Gaza. An outbreak of 156 cases occurred i n Hebron and 24 cases i n Gaza. Since t h a t date, t h e d i s e a s e has appeared spor.adically among t h e refugees. Both types, epidemic and endemic a r e occasionally reported.

LA POLIOMYELITE EN ISRAEL POLIOMYELITIS I N ISRAEL La moyenne mensuelle des c a s de

poUcmy6lite en I s r a e l a

B$Q

de 2 jusqu'en octobre 1949, 6poque 06 l'on n constate une 618vation du t a w d'incidenpe. Au

cours de l a periode de 6 mois comprise e n t r e octobre 1949 e t mars 1950, 156 cas

(10 d6c8s) ont 6t6 signal&. L'augmen- t a t i o n mensuelle a Q t 6 constante, commc l'indiqqe l e tableau ci-apr8s :

The averags monthly f i g u r e f o r p o l i o m y e l i t i s i n I s r a e l had been 3 cases per month till October 1949, when a-

i n t h e incidence 01 the Cnsease was noticed. During t h e s i x months period:

October 1949

-

March 1950, 156 cases (10 deaths) were reported. The monthly rise continued s t e a d i l y as f o l l a r s :

&%2

C D

Octobre ( ~ c t o b e r )

15

1 Novembre (~ovember ) 24 2

a2.Q

J a n v i e r ( ~ a n u a r y ) 19

FQvrier (Februaw) 33 3

Mars ( ~ a r ch) - 39 1

u $ &

- C

Au cours de l a pQriode comprise e n t r e Between 1917 and 1930, t h e incidence 1917 e t 1930, l'incidence de l a m6ningite of cerebro-spinal meningitis was sporadic c6r6bro-spinale f u t eporadique, avec un with a m d m u m of 99 c a s e s i n 1930. Sincl maqnaun de 99 cas en 1930. B p a r t i r de 1931, the d i s e a s e took t h e form of an 1931, f a m&&e p r i t l a forme d'une epidemic. That year t h e number of cases 6pidBmie. Durant c e t t e annge, le nombre mounted t o 871 Again i n 1932, t h e do cas s'6leva & 871, De nouveau en ₁ number increased t o 4,508 cases. Then 1932, l e s cas augmnterent jusqu'a a t t e i n d r e it declined t o 1,603 i n 1933 and 626 i n 4.508. 11s b a i s s e r e n t e n s u i t e , en 1933, 1934. l i f t e r t h i s , i t continued t o d e c l i n au c h i f f r e de 1.603 puis, en 1934, 5 626. u n t i l it became sporadic again, a s shown Depuisl i l s continuErent & diminuer, i n t h e following t a b l e t

jusqu'a redevenir sporadiques, come il r k s u l t e du tableau ci-apr8s :

C s (cases) i.nn6es (years) o a s (cases)

1934 626 1937 172

193 5 240 193 8 189

193 6 153 193 9 2x3

LG MENINGITE CEREBRO-SPINLLE EN EGYFTE(suite) CEREBRO-SPINAL MENINGITIS IN EGYPT (contd)

Gas

(cases) AnnQes (years) Clig (cases)

1940 191 1945 65

19W 159 1946 88

19L2 212 1947 94

Q r 8 s l e mois de ddcembre 1949, l e nombre de cas eut tendance

h

augmenter, comme l'indique $8 tableau ci-bas. Lyin- cidence continua h s'Qlever, de semaine en smnaine, au point d'atteindre l e c h i f f r e do 214 cas durant l a semaine $inissnnt l e 18 mars 1950. E l l e c m e n g a ensuite &

d6croitre, pour tomber & 20 cas durant l a semaine f i n i s s a n t l e 2L juin 1950.

After

DerP.mbcr

lqkg, the number of cases tended t o increase as shown i n the following table. The incidence continued

to

r i s e week &er week u n t i l it reached

'LL& cases during the week ending 18 b r x b 1950 ^'Than € 3 ~ 3n-e Man t o decrease un%l i t f e l l t o 20 i n the week ending

24

J m e 1950.

Incidence hebdomadcjre de l a MQningite GQrBbro-Spinale en Egypte durant l e l e r semestre de 1950

Weekly incidence of Cerebro-Spinal Meningitis i n Egypt during the f i r s t half-year 1950

semaine f i n i s s a n t

week ending

as

semaine finissant

-

^cas

cases

-

week ending

cases

7 Janv. (JL~.) 11 1 Avril (April) u 7

U.

"

^{It 12 8 " I1}

11 It 119

21 11 15 15

"

I1 I1 UO

28 11 16 22 n

I1 98

29 tl 89

4 FQv. (Feb,) 1 1 " It

18

"

^II

25 ^{I1 I1} 4 Mars arch)

11 11

18 l 1 t t

3 Juin (June)

I1 W

10

"

I1

3 1

17 23

LL MENINCITE CEREBRO-SPINLLE DLNS LE CEREBRO-SPINLL MENINGITIS I N THE LNGLO-

SOUDliN IAGLO-EGYPTIEK EGYPTIW SUDlN

Le nombre approximatif de cas de The appro~dmate number of cases of m6ningite c6r6bro-spinale au cours de l a menineit3 ing t h e period periode comprise entre l e l e r janvier e t _1st January t o l a t July,% was :

l e l e r j u i l l e t 1950 a Q t 6 come s u i t :

Province Cas (cases1

D a r k 3,857

Khartoum 687

N i l Bleu (Blue ~ i l e ) 337

Kordofan

311

Kassda 114

B a h r E l Ghazal l03

Equatoria W

Prov.Septentrionale (Northern

Province.)

a

TOT&% 5.467

Le t a m global de m o r t a l i t & , y compris l e s cas qui se sont prQsent6s tr&s t a s d p o w l c traitement,

rut

cf'en- viron 10%.

hu Darfour e t au Kordofan, l'Qpid6mio a t t e i g n i t son point culminant au milieu du mois d ' a v r i l , e t diminua grandement par l a s u i t e .

Dans l a province de Khartoum, le c h i f f r e hebdomedaire- l e pLus Q l e G fit de 1U cas, rapport& pour l a semdne f i n i s s a n t l e 27 m a i 1950. Une diminution constante de 1'QpidF:mie s u r v i n t enouite.

Pour l'cnsqmble du pays, l e '(law hebdomadairo d'incidence l e p l u s Qlev6,

s o i t 630 cas,

rut

enregistrh d u r m t l a 3Bme semaine de m a i 1950.

1.u c o w s de l a semaine f i n i s s a n t l e l e r j u i l l e t 1950, t r o i s cas seulement f u r e n t s i g n d Q s pour t o u t l e pays.

The o v e r a l l mortality, including cases which c m very l a t e f o r treatment, was in +he-mighbourhood of

16.

I n IlarfVx and Kordofan, t h e o u t b r e d roached i t s peak i n t h e e of lpyil and has subsequently l a r g a u b s i d e d .

I n Khartoum province, t h e highest weekly f i g u r e was 1U. T h i s was reported f o r the week ending 27 M a 1950. A steady decline i n t h e out r e & then

f ollared.

1

The highest weekly incidence in ^the whole country, 610 cases, was recorded i n t h e t h i r d week of May 1950.

I n t h e week ending I & h l g 1950, three Cases only were reported f r o m tne whole country.

DONNEES RECDITULATIVES

('1

CONCERNANT L'INCIDENCE DES W I E S PESTILENTIELLES AU COOURS DE

L'lNNEE

1949 ET DU PREMIER SEMESTRF: DE 1950

CUMULATIVE DATA (+) ON THE INCIDENCE OF PESTILENTIkL DISUSES FOR THE YEILR 1949 lMD THE FIRST SIX MONTHS

OF 1950

(+) Sauf i n d i c a t i o n c o n t r a i r e , l e s c h i f f r e s c i t e s p o r t e n t sur une pgriode de q u a t r e semaines.

Four-weekly f i g u r e s , u n l e s s otherwise specified.

0 0

1

rld

ol ol

O 0

I

P E S T E

-

P L A G U E PAYS

COUNTRIES

2 T O T & J F M A M J

-

^{J A S 0 N}

YEARS I I1 111 I V V

: I

V I I V I I I I X X X I XI1 X i . 3

1949 C 778 310 122 99 4 6 42 17 38 18 8 5 22 16

615 254 35

D 96 77 35 22 17 31 19

7

6

16

-10 EL-.

CONGO BELGE 19423 C 22

BELGIAN CONGO D 11

1949 i; 13 2 0 1 1 2 0 2 1 2 0 ₀ 1 1

-

^{D 13 2 0}

^---

^{1 1 2 0 2 -- 1}

--

^{2 0 0 1 1}

INDE-ETATS 1948 C 32006

IMDIA-STATES D 11882

KENYA

UNION D E

L

tAFRIQUE IS48 C 21

DU SUD

-

^{UNION OF D 11}

SOUTH A F R I C A 26 0 10 12 1 0 0 0 2 1 0 0 0

1949 C

-

^{1 0 0 1 0 0 0 0 0 0 0 0 0}

PA%

COUNTRIES

kiuiTd3 TOTAL J F M k M

J -

^{J .- S 0 N D}

YEARS I I1 I11 I V V V I V I I V I I I I X X I XI1 X I 1 1

BIRMANIE 1948 C 53

B U W D 33

1949 C 219 0 1 1 6 1 9 95 68 1 7 1 0 0 0 2 0

-

^{D 125 0 1 9 11 6& 28 8 1 0 0 0 1 0}

( INDE-ETATS ) 1948 C 214274 ( I N D I A-STATES )

D

108750

1949 C 97573 11229 9040 7021 8 0 4 8974 5922 6769 7759 8382 5641 6424 6149 5649 D 49092 6200 5022 -- 3465 4b60 4292 2913 3251 3654 3957 2779,3053 3184

--

3202

PAKISTAN 1948 C 43509

D 23999

PROVINCES

(Bengal-&st-~hst_ 1949. C 30846 4914 2337 3322 5119 4337 1569 809 1239 840 492 1207 2221 2440

Bongall D 17944 3 0 7 l 1366i 1849 2848 2466. 853 449 697 479 276 705 134 9 1536

H

4

=i

o f t

mpc

4 3

H H

'an

>

I H H

*

'7 n

*

Z3s-

4 %

= z

H

E z

I

'aH

4

€4

0 H

8 i

-4

1

: a

9 8 i3g

- _a

..

C1

8 =

U 0 I

;a m

-3 _9"

as EiE

4 2

V A R I O L E . - S l ~ i i i T , T I P O X

J F M A

M

J J

A

S 0

N

D

PAYS L%~'@IESS TOTAL I I1 I11 IV _V V I V I I V I I I

IX

X X I XI1 X I 1 1

C O u N T R I a YEkHS

-- - ----

ADEN

ARLBIE SEOUDITE 1949 C 229a(d)

SAUDI W B I A D 73aId)

BIRldxrJIE 1948 C 5347

BUR MA D 1542

EGYPTE 1948 C 1 6

EGK? T.

D

8

PROVINCE EL 1949 C 1 0 0 0 1 0 0 0 0 0 0 0 0 0

D 0 0 0 ^r

G I =

-- --- -

^{0 0 0}

^---

^{0 0 0}

^{-- -}

^{0 0 0 +-0 -}

x

imp. (m) Chiff r e s mensuels ( d ) Toue c e s cas scnt survenus &r'a Meccfue et Djedda Monthly figur e s A l l t h e s e c a s e s occurred

in

Mecca and Jedda.

PAYS iiNNEES TO TAIL J F

M

d

M

J J A S 0 N D

CClUNTHEES, YKhRS I I I 111 I V V V I V I I V I I I I X X X I X I 1 X I 1 1

ETHIOPIE 1948 C 34

ETHIOPIA

INDE & EThTS 1948 C 72952

INDW & STATES D 19785

1949 C 73512 4424 7605 13194 14276 9435 4989 4186 2903 1915 1467 1216 2600 5302

D 17553 1083 1833 3259 3177 2255 1269 1077 713 422 298 266 5 2 1 1380

I R A Q / I ~ 1948 C 1773

( c h i f f r e s

D

1 5 6

men sue1 s

monthly 1949 C 702 154 50 3 6 1 7 4 7 50 48 18 48 28 66 14 0

f i g u r e s ) D 102 24 8 2 0 7 5 11 3 6 1 1 2 23

3 6 1 0 24 33 1 9 l l d

6 4 3 3 0 1

ARBIL

(d) d o n t 1 0 c a s i m p o r t i s

of which l L , cases imported.

NCO m o

t '

a

^rl

vfa

0,

*

0,

d

2 I

--

T A H r m I r ; ^*- 5.- f i l j - ~ ~ h ",;,m-I.T

PAX A W E S TOTnL J F

M

A

M

J J

A

S

u

iJ

D

COIJXT.RI&S ..EtiRS. ^.. ,.: ^,

I I1

. . _{~ . . .}

I11 Iv --- V VI VII VIII IX X XI ---- XI1

XI11

I w '

1948 C 1134

D X84

LIBhN 1948 C 169 LEBANON

1949 C 142 88 2 1 3 9 13 5 0 0 0 0 0 3 0

dont ( o f

which) 1949 C

B J R U T

(f

1

pnrmf l c s r e f u g i k s

[ m )

c h i f f r e s men s u e l s . Monthly fi@ r e s . ( d l T r i b u nomade dan l e d i s t r i c t ciu d e s e r t

amon$,

t

trle r e f u g e e s uriental-nomadic t r i b e eastern d e s e r t

d i s t r i c t

PAYS ANNEES TOTAL J F _--

-

Jt,, A M ^,7 J

-

^{J A S 0}

^N

^D

COUNTRIES Y3xRS

-

I L.0. I1

I

J V v

VI

VT.1 V I I I

IX ^X-

^{X I X I 1 X I T I}

i-ZzLLi

~~U-ANON (contd ) a u t z z s d i s t r i c t s ( s u i t e )

( 0 thBr

d i s t r i c t s ) 1 9 4 9 C 130 85 2 1

-

^{3 7 1 0 1 O}

-

^{0 0}

-

^{0 0 3 0}

D 1 0 0 0 0 0 1 0 0 0 0 0

--

0 ⁰

PxKISTAN &

ETATS & Z848 C 12452

STATES.

D

4065

P r o v i n c e s

BALUCHIS'I'IIN 1949 C

D Brn

GAL'

(Est-East ) 1949 C D

IWRKCHI

1949 C D

S I N IS 1949 C

D PUNJAB

PAYS

BNNEES

COIJNTRI ^{. - . . -. . -} hS ^-

Y M S

TOTAL J F

M

A

M

J

...

^{J A S 0 N D}

I I1 I11 I V

v -

V I V I I V I I I

Ix x

^{X I X I 1 X I 1 1}

P A K I S T A N iic ETATS

PAlrISTAN

(Agences- 1949 C 8 0 4 0 0 0 0 0 2 2 0 0 0 0

Agencies ) D 0 0 0 0 0 0 0 0 0 0 0 0 0 0

PROVIiiiC iS

BxHR

EL

GHZHL 1949 C 23 20 0 3 0 0 0 0 0 0 0 0 0 0 x imp.

b 1 minor

c 1 0 minor, 4 a l a s t r i l r d 4 minor, 3 a l a s t r i m e 1 4 minor, 1 a l a s t r i m g minor.

PhYS ANNEES TOTAL J F IvI

A

XI J

-

^J

^A

^{S 0 N D}

COUNTRIES YEAFiS

--

^{I I1 I11 M V VI} V I I V I I I I X X X I X I 1 X I 1 1

-

PROVINChS

HNKxFL4 1949(mJc 3 1 0 2 0 0 0 0 0 0 0 0 0

(m)D 1 0 0 1 0 0 0 0 0 0 0 0 0

(m)

Chif f r e s m a s u e l s Monthly figur e s

V n R I O L E - S I v I - + Y , T , P O X (Continued)

-..- ---- -

^-

^{--- --} ---- --.

PAYS hNNhES TOTxL J

F

M A M J

-

^{J A S 0 N D}

COUNTRIhS YhKRS

-

^{I I1 111 I V V V I V I I V I I I I X X X I X I 1 XI1}

TURQIJIE)TURKEY

U N I O N I1E L'AFFUQUE DU SUD

U N I O N OF SOUTH nFRICA 1948 C 382

D 1 7

1949 C 1461 44 37 60 66 104 1 7 1 164 223 142 204 120 1 2 6

D

--

115 13 1 7 9 0 20 8 23 11 1 0 5 8

REFlTGIhS DL PAUSTINE

PALESTINE; H E h U G h k S 1 9 4 9 ( i ) C Cas sporadiques e t p e t i t e s ous6es l o c a - 20 1 0 0 23 1 6 1 5 l i s h e s dans t o u t e l a zone,

s f

'exception d e Gaza.

sporadic& a s e s and s m a l l l o c a l i s e d o u t b r e a k s i n a l l a r e a s except Gaza.

(m) Chif fre s mensuels ( i ) Les r e l e v i s s o n t incomplets ( k ) Dont 20 ca? de J e r i c n o

Mohhly f i g u r e s Returns a r e incomplete 20 c a s e s of which f r o m Jericho.

PAYS A N N E E

COUNTRIB YEARS

TYPE

TOTAL J F M

A M a -

^{J A S 0 N D}

I I1 I11

IV v

V I

---

P I 1 V I I I I X X ^{--- X I 1 - - - - - - X I 1 1 --- -}

-

1948 C Exanth. 0

D 0

1949 C B t i q u e ll(m) i 0 0 0 0 0 3 3 4 0 0 0

D Tick-borm 0 0 0 0 0 0 0 0 0 0 0 0 0

CYFZNAIQUE 1948 C Exanth. 1 4

CY%NhICh D 0

(m)

C h i f f r e s mensuels ( c ) Premiere semaine 28/~11

-

^{3/1/49 ( i ) imp.}

Monthly Qgures F i r s t week 28/XI1

-

^3/1/49

c y w 0 2 0

co d

3"

coo

crcy (Do

d r4

C U O

n o

d

0 0 0 0 d o 00 3 0 0 0

40 0 0 0 0 00 rlrl CUO

M O 0 0 0 0 a 0 * d a 4

m o

0 00 00 O c y d o

0 u3

C U O CUQ 0 0 0 0 M r l 4 4 rl

40 O Q 0 0 Orr) '-rl 00

40 00 0 0 a 0 00 00

V O C U O d o CV" a m

d rf

- ---

T Y P H U S E X A N T H E M A T I Q U E - T Y P H U S F E V E R

--- (Continues. - ---

PAYS LLmlmS

-

^{---- - -}

COUNTIUES YEnHS TYPE TOT&

J

F

M

A M J

-

^{J A S 0 N}

^D

--- -

^{I I1 111 I V}

^v

^{V I V I I}

^{VIII rx X XI}

^XI1

^XI11

EGYPTE(suieT PROVIN: E S ( C o n t d . )

E L G I Z A 1949 C E x a n t h . 36 0 1 16 _{1 6} 3 0 0 0 0 0 0 0 0

D 2 0 0 0

L

1 0 0 0 0 0 0 0 0

G I RGA

PROVINCES

ACHELE; GUZAI 1949 C do 6 1 0 0 1 0 2 2 0 0 0 0 0

D 0 0 0 0 0 0 0 0 0 0 0 0 0

BAS SE-TERRES O R f l S L T U h S

EASTERN L O W L f d D S 1 9 4 9 C dc 10 0 1 2 1 0 3 3 0 0 0 0 0

D 0 0 0 0 0 3 0 0 0 0 Q 0 0

(m) C h i f fresmensuels M o n t h l y f _{igur es}

.

d'o

a 0

* O

*rl

I i

_H

I

I ,2!

- _a

5 3

^{z i}

3

^{O H}

21

X

0 0

( D o

1 0 r l

* o

GI

u3 3

x

C4

H

I

W

CS2i

H

- 3 *

I H H

k=

=

W

"

E-r 2

3)

bg

@

4zl

^In0

H

€4

4

s n

H H

s

*

a 4

- 0

a d

.-I*

u)

- _a ²

W

UFI

H m

2 %

^{G - r l}

-* a

@ c

42 0

3 :

I

^&,

u3

D

F4

*

El

Z

0 H

w

0 2

^coo

a x

^{w 0}

4 8

^{* o}

rlo

2

^{rga 40 -10 d o} N O N O d o a 0

rl

T U P H U S E X A N T H E M h T I W U E - T Y P H U S

-

F h V b R ( C o n t i n u t d )

PnYS ANVEES TYPE TOTAL

J

F M A M _J

-

^{J A S 0 N D}

C O U N T R I E S YE;kRS I I1 111 I V V V I V I I V I I I I X X X I X I 1 X I 1 1

I R h N 1948C Exanth. 150

D 1 9

KENYA 1948 C A t i q u e 100

D Tick-borne 3

1949 C Murin-Murine 3 1 0 0 0 0 0 0 1 0 1 0 0 0

PAKISTAN 1950 C Exanth.

D

( c ) Premiere s m a i n e f l n i t 6/1/1950 (m) Chlffres m ~ n s u e l e

F L q t

^{week eadr}

-

^- -&4/1060 n - s s a L - - I r .

Z H MCU

x"

H d'o

b H rl

0 C c o c.0 C h ) 0 C C c ' 0 0 0 0 O P h)

0 0 C C 0 C C C O t - C C ' w 0 0

C O a m ^{C > C} r C C C O P W 0 0

i-' P W

P P P P b' v I-' P I-'

0 w (D a w w a w w v

bP w

8

^a

$

^{bP LO bP} a ^rF. w ^bP w ^bP w ^b w ^bb w

u a u o u o u.3 u.3

ij.3 ijn ^{t j n}

C 0 C C O N C C C O C C C c O C C C C C

C ) O C C 0 0 C ' C C N C P 0 0 0 0 C C C C ,

0 0 P C O P 0 0 0 0 c v P C O 0 C C @

q c C C : C C C C C C C V 0 0 C O 0 0 C C

-

H

z i

0 2

,-id 0 0 0 0 0 0 * o ² 0 N O '30 0 0

0 0 4 0 0 0 m o 0 0 ( 3 3 0 0 0 3 0 0 0 0

0 3 0 0 0 0 4 0 0 0 0 0 0 0 0 0 3 3 0 0

rl m

::

m G G 5

0 a0

a c

m

0 k-2

& Z

Q Q

Ur,

2

-

^fi

-

0 0 0 0 0 0 0 0 4 0 0 0 4 0 d 0 0 0 3 0

d 3 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3

0 0 0 0 0 0 4 0 0 0 0 0 4 0 d o 0 3 0 0

0-3 3 0 r l c r l 0 r10 3 0 0 0 0 0 N O 0 3

0 3 3 0 0 0 9 4 r l 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 N d

0 3 0 3 0 0 A 0 N O 0 0 d O 0 0 0 3 0 0

0 0 0 0 0 0 w r l 0 0 0 0 O r l 0 0 0 0 0 0

N O 0 0 0 0 r l 0 4 0 0 0 d o 0 0 0 0 0 0

e 3 r l o ^{r l r 1} * w 1 0 O d N O N O c u d

rl

so

^rl

a

_{- A *}

d

m x

3 3 4 . 4 3 4 a" a"

fi

" G

d g u a u a u n

u a

u a ^{V Q} o n u a o n U Q

m (R m ⁰¹ o

*

^{Tt, -a}

*

^cr

^m

^{-a m m 0}

I o, 0, m m m m

+

01

+ *

d r l rl !-t rl rl d rl rl rl ⁰¹ rl ⁰

a I

u m

4 -

m I mm

V?

^N

55

H H

Ul a ^v3 R H >

1

a

.i

U

3

-

";

W

>

*

Fr

o x

4 H n

'JH

2

I H

2

El

x

*

PI

€-I

I kl 3 0

H Fi

<

%

m x

H

:

2

!4 m

b

F

% *

d?l

H

Z H H

&=1

h H

a

b 3

x

PI

T Y P H U S E X A N T H E I V I A T I Q U E - T Y P H U S F E V E R (Continued)

P'tYS liNNbhS TOTAL J F M

A

I ' J

-

^{J A S 0 N D}

COUNTRIES YEARS TYPE I I1 I11 I V V V I V I I V I I I

IX

X XI X I 1 X I 1 1

TURQUIE; suite-TURKE;Y cont Id PROVINCBS

zo r;rGuLI

jii4t ( s u i t e - c o n t ld) (m)

1944''

C Exan th

.

^{1 0 0 0 0 0 0}

EDIRNE 1949 C do 4 0 1 1 1 0 0 0 0 0 0 0 1

D 1 0 0 0 0 1 0 0 0 0 0 0 0

UNION Dh L'd?RIWE ( m ) DU SUD

-

^{UNIOI\I OF}

SOUTH AFRICA 1948 C do 420

D 33

REFWGIZS DL PALESTINE PALESTINE LIEW GEES

1949 C Exanth

(r 1

Murin

156 zone de Hebron Hebron area 24 Gaza

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