INFECTIOUS DISEASES

Dominion, Volume 22, Issue 212, 4 June 1929, Page 12

INFECTIOUS DISEASES

REVIEW OF PAST YEAR GREAT INCREASE IN DIPHTHERIA figures given in the annual report of the medical officer of health (Dr. W. F. Findlay) for Wellington and its suburbs show that during the past year there was only a slight increase in the number of cases of scarlet fever, whereas the diphtheria total was more than doubled. There was also a substantial increase in the number of cases of tuberculosis. Scarlet Fever.

During the year the cases of scarlet fever numbered 663, as compared with 637 notified the previous year. This, states the report, may appear a high incidence, but reference to reports, shows a rate of from 50 to 70 and over per 10,000 of population in London, and from 50 to 60 and over per 10.800 in Sydney, whereas in Wellington the rate was 46.49. In Wellington the disease has run true to known characteristics, as in London and Sydney, showing years of increased incidence f Bowed by years of comparative quiescence. The monthly incidence in Wellington was as follows: —January, 36; February, 39; March, 85,; April, 70; May, 77; June, .61; July, 65; August, 50; September, 61; October, 35; November, 48; December, 35. The epidemic showed signs of waning in the last quarter of the year, and subsequent figures show 7 that the crest of the epidemic is well over. The disease continues to be mild in type. The year’s experience further .increases the belief that many cases are so mild as to be missed. These “missed” cases are no doubt a potent factor in propagation. No localised epidemic of magnitude occurred, although certain schools show increased incidence compared with others. A study of the reports shows that overcrowding did not appear to be a factor. A table is given of the Incidence in the schools, the highest being Berhampore, 23; Petone Central, 21; Khandallah, 17; Waiwhetu, 17; and Johnsonville, 17. A nurse has not been employed full time upon infectious disease work, continues the report. In all cases where necessary, however, a schorl nurse visited affected schools and <1 amined the children, and in some crises the homes.

Diphtheria. The cases of diphtheria during the year numbered 396, as compared with 189 in the previous year. There were 132 cases of children of from 1 to 5 years, and 230 cases of children from 5 to 10 years of age. There were 14 deaths. Again experience shows that deaths are, in almost all cases, practically attributable to delay in obtaining a medical attendant, or in recognition of the cases. It seems undoubted that medical men should swab almost every sore throat, and if in doubt should administer antl-toxin in some cases when waiting for a bacteriological report. As to immunisation with toxin-anti-toxin, it is most regrettable that the fatalities in Queensland made it advisable to stop the campaign of immunisation in various institutions in the metropolitan area, commenced a few months before. Swabbing, however, still appears to be a useful method. jfptificatloss showed an ingiease in

tuberculosis—l 37 as compared with 84 in the previous year. The deaths numbered 68. As to control of this disease, Dr. Findlay says that contact is kept as far as possible with all cases. Every six months the register is checked. The Wellington Hospital Board has now a T.B. nurse of its own. A few months ago he endeavoured -e co-ordinate the duties of this nurse with those of the department’s nurses and inspectors, but under conditions as they are at present this was not practicable. . He is of opinion that T.B. work would be more satisfactory if the hospital board obtained the services of a full-time officer. Arrangements might then be made for the unification of control of patients and contacts. All child contacts are followed up by the school medical officer. This work is increasing and, as the years go by, there will be a considerable number of children under observation. It must be remembered, of course, he says, that a certain proportion of the citizens of Wellington and those of the surrounding boroughs and counties do not receive pasteurised milk. The arrangement with the superintendent of the Wellington Hospital, whereby cases of T.B. (non-pulmon-ary) are unofficially notified to the district health office, has been continued, and, where necessary, herds have been investbiated,