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late 1960's, this disease is not yet fully controlled. In 1968, for example, there was a serious outbreak of Type III strain. The outbreak, however, was reportedly associated with unpublicized clinical testing of a genetically unstable Type III strain vaccine of Czechoslovak manufacture supplied to Poland by the World Health Organization.

Conditions in rural areas are often substantially below those prevailing in urban centers. In some areas, diphtheria is prevalent, and tick-borne diseases are common. Despite the government's programs in adult health education, general inattention to personal, animal, and environmental hygiene and sanitation still prevails among the private peasantry and has been the basic reason for keeping animal health conditions and farm sanitation on a low level in comparison with most Western European countries. The incidence of diseases among the large cattle, hog, and horse population is relatively high, despite increasing remedial measures by the growing Polish veterinary service. Outbreaks of foot-and-mouth disease, for example, occurred fairly regularly during the 1960's, although they were rapidly and successfully confined.

The death rate among adults declined markedly in the postwar period, from 14.1 per 1,000 population in 1938 to a low of 7.3 in 1966, increasing again somewhat to 8.1 per 1,000 population in 1970 as a consequence of the slowly rising proportion of persons 75 years of age and older within the total population. The order of the leading causes of death among adults has not shifted appreciably since 1960, although their incidence shows marked changes, as illustrated by the following tabulation of death rates per 10,000 population:

Although Poland's infant mortality rate is still among the highest in Europe, standing at 33.4 per 1,000 live births in 1970, this represents a marked reduction from the rate of 139 per 1,000 live births in the immediate postwar period when it was Europe's second highest (after Romania). This reduction, together with the postwar decline in the death rate and greatly improved medical care, has resulted in a rise in life expectancy at birth from 48.2 years for males and 51.4 years for females in 1931 to the figures of 66.9 and 72.8, respectively, in 1966. Life expectancy at birth in several selected countries is shown below:

Wartime destruction of medical facilities, losses of personnel, shortages of medical supplies, and general social disruption significantly increased the incidence of disease, and food supply was inadequate to maintain or rebuild public health. Tuberculosis mounted rapidly during World War II, and venereal diseases became widespread during the immediate postwar period; both were also spurred by social changes inherent in rapid industrialization and urbanization. Both categories of diseases were objects of government anti-epidemic drives during the postwar decade, and their incidence reached a low point in the mid-1950's. Since then, the total number of registered cases of tuberculosis has continued to decline, but that of venereal disease has steadily and alarmingly increased, as shown in the following tabulation:

The total number of tuberculosis cases continues to decline, as does the death rate from tuberculosis, but public health officials attribute this abatement mainly to prompt and effective care and a high rate of cure, and not to a significant decrease in the number of newly registered cases. Indeed, in late 1969 these officials revealed that some 40,000 new cases were being registered annually; they were particularly alarmed at the slowly increasing rate of new cases among 15- to 18-year-olds.

The marked increase in venereal disease in the late 1960's generally parallels with the late adolescence and early adulthood of those born during the rapid industrialization and urbanization of the immediate postwar period. Although a breakdown by type of venereal disease is not available, the number of syphilis cases reportedly grew fourfold between 1964 and 1970. In the latter year, 23,646 cases of syphilis and 49,884 cases of gonorrhea were registered. These alarming increases prompted the

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