H.—3l

22

It will be noted that there is a great increase over last year, chiefly due to scarlet fever. Scarlet Fever has increased from 309 cases in 1905 to 526 this year, principally in the boroughs, although counties and town districts also show a slight increase. Of boroughs, the greatest contributor was Masterton, with 111 (as against 8 last year), which, with increases of 32 and 20 at Wanganui and Wellington respectively, accounts for the greater part of the rise. Martou, with 16 cases, and Feilding, with 18, were also contributors. There has been, however, a fairly general epidemic of the disease, almost all the counties and town districts showing a few cases. The only notable diminution is in the Borough of Eltham, which has but half the number notified last year; also in the Town District of Maryborough, with no cases, against 9 previously. Apparently a great deal of scarlet fever was spread through unnotified cases and careless exposure of infected persons in public places. In six instances we were able to substantiate our suspicions, as will be seen in the return of prosecutions towards the end of the report. In these cases the patients travelled, or' were allowed to travel, in public vehicles while suffering from an infectious disease. The outbreak in Masterton began in July and remained for five months. There is a probability that the infection originated in some unrecognised cases, and was disseminated chiefly by direct contact by persons visiting infected houses, and in the schools. At no time, however, was it necessary to close any of the schools, as the number of infected children attending any one school was never high. There was doubtless a good deal of carelessness as regards isolation. We were fortunately able to take action in one such case, and obtained a fine with costs. This, I believe, had a very beneficial result. At Wellington there was oniy an average number of cases throughout the year until March, when a definite and widespread outbreak began, and is yet continuing. The most noticeable feature is the wide dissemination, no particular school or street being specially affected, and no milksupply markedly involved. The outbreak, however, is confined to the town, the suburban boroughs of Miramar, Karori, and Onslow completely escaping, while Petone shows a reduction over last year. At Lower Hutt there is a slight increase. lam inclined to believe that the disease is being spread largely by direct contact in trams, and in the patients' own homes. At Feilding and Palmerston North, during May, two slight outbreaks occurred, under circumstances pointing to school infection. The affected schools were accordingly closed and disinfected, when the outbreak stopped. At Wanganui, in October, a limited outbreak occurred among the boarders in a girls' privatt school. The boarders were isolated and the day scholars kept apart, with the result that the epidemic spread no further. A slight outbreak occurred at Featherston at the end of the year, probably from an unrecognised case going to school. The disinfection of the school and public buildings is now in hand. Enteric Fever. —This disease shows a diminution, as this year only 82 cases have been notified, as against 119 in 1905. This diminution is greatly marked in the counties and town districts, which have little more than half last year's number. In Wellington City there has been a satisfactory drop from 33 to 24, while at Wanganui only 4 cases are recorded, as against 30 last year, when there was a widespread outbreak of milk-borne origin traced to an unregistered dairy. This year a like source was proved to be responsible for 3 cases in Wellington, and the dairy was closed, and action taken by the Stock Department on our representations. The only notable increase shown in typhoid returns is at Stratford, where 7 cases occurred, us against no cases in 1905, and also in the Martinborough district, where 15 cases were notified during the month of June. These latter were all traceable, directly or indirectly, to oysters supplied by a Maori, who subsequently developed the disease. An inspection of the whare occupied by this Native showed it to be in such an insanitary condition as to allow of no doubt that the outbreak had its origin from these premises. Elsewhere the number of cases has diminished, and this is the more satisfactory when we consider the very dry, hot autumn—meteorological conditions which are generally favourable to the spread of this disease. Diphtheria was notified on 140 occasions this year, a diminution of 36 on the return of 1905. The decrease is chiefly in the boroughs, the counties and town districts remaining much as last year. The greatest diminution is at Pahiatua, where this year only 7 cases arose, as against 33 the previous year —a satisfactory result foretold in my last report, and due, doubtless, to the gradual substitution of modern drainage for the older and more primitive methods of disposal. In Wellington City 45 cases occurred, being 10 less than last year, chiefly in the older parts of the town, and, as before, without any discoverable cause, although one cannot but suspect the presence of so many small, illconstructed stables crowded among dwellinghouses in the manner so specially to be seen in this city. In the counties the returns are, as usual, low, the only notable outbreak being in the Hutt County, due to an epidemic at the Upper Hutt. Here the population is increasing too rapidly for the sanitary facilities, and the combination of foul cesspit and shallow surface well cheek by jowl is too common. A pure water-supply is here required. At Palmerstou North, during May, a limited outbreak occurred, when 8 cases arose among the children attending one school. There is a probability that the cause was to be found in the excavation-works for the new sewer in a neighbouring street, old polluted soil having been turned up. The school was closed and disinfected. The other notifications do not call for comment.