9

Akola is well known. This as well as the Murtizapur Muni-
cipal Committee, is so indifferent that they do not give any
help to their vaccinators. The Deputy Commissioner, Akola,
writes " If the Murtizapur Municipality continue to be slack in
helping vaccination, it will be fair for Government to withhold a
part of their grant to the dispensary. The same applies to the
Akola Municipality for their failure to prosecute guardians of
unprotected children".

It is evident therefore that apathy and indifference of the
Municipal authorities are the main causes for this state of affairs.
I hope energetic action will be taken to have the balance of
unprotected children vaccinated as early as possible, otherwise a
severe epidemic of smallpox will result. Proper vaccination stations
are required in every town and children should be collected at them.

25.    Mortality from small-pox,—Deaths from small-pox
numbered 373 against 1,216 in 1921-22 and 2,363 in 1920-21. The
mortality from this disease is very considerably less, but as
vaccination work has been dangerously neglected in recent years,
a severe epidemic of small-pox is apprehended sooner or later.

In the town of Mangrul Dastgir (population 5,511) in Amraoti
district there was a severe epidemic of small-pox in the last year
(260 attacks and 47 deaths) and it is reported that this outbreak was
due to apathy shown by the people there in getting their children
vaccinated. Although the vaccinator visited the place several
times he succeeded in doing very little work, the number of children
remaining unvaccinated (108) being very large. The village was
also visited by the Deputy Commissioner, Tahsildar, etc., but
little good came of their endeavours to persuade the villagers.
This case will serve as an example that continued deterioration
in work of vaccination must bring its own punishment.

26.    The deaths registered from this cause since the year
1896 clearly indicate that small-pox has a definite periodicity. It
recurs at fairly regular intervals of 4—5 years. A chart illustrating
these observations is attached.

27.    As a considerable percentage of children remain
unprotected each year and the results of vaccination wear off a
large and highly susceptible population gradually accummulates,
affording favourable ground for the spread of infection. Hence
the importance of securing as complete vaccination as possible
every year.

28.    General remarks.—It will thus be seen that in the
period under report there has been a most serious general falling
off in vaccination which means that a fatal epidemic is in store
as is instanced in the particular case of the village Mangrul
Dastgir. Supervision by Civil Surgeons has markedly declined