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Private Hospitals and Work of Nurse Inspectors. This work, which includes many other duties besides visiting private hospitals, has been well carried out by the two Nurse Inspectors, Miss Broad and Miss Lea. General Sanitation op the Districts. The routine work continues to be efficiently carried out by both departmental and local-authority Inspectors. TARANAKI HEALTH DISTRICT. Dr. Mecredy, Medical Officer of Health. Part 4. The Taranaki Health District was inaugurated on the Ist May, and the following report covers the period from that date, except in regard to the statistics of infectious disease, which cover the year 1927. Infectious Disease. The notification of infectious disease for the year 1927 was above the average of the five preceding years in the case of scarlet fever, enteric, pulmonary tuberculosis, pneumonia, pneumonic influenza, and puerperal fever. Diphtheria alone showed a considerable drop from the five-year average, and the actual notifications were the lowest recorded. A small epidemic was, however, experienced in April-May, centred on Cardiff School. As in three of the previous five years, the maximum incidence was recorded in June. Scarlet Fever. —Monthly notifications gave some suggestion of an impending epidemic, and the total number noted (seventy-five) was the highest for five years. The disease was noticeably mild in type. In July the period of isolation in selected mild scarlet-fever cases was experimentally reduced from six to four weeks. No second cases were recorded as a result of this measure, which was taken advantage of, to a greater or less extent, in all but three of the cases admitted to hospital to the end of the year. The average duration of isolation in these cases was approximately four and a half weeks. The opinion of the Medical Superintendents of the three hospitals in the health district were entirely favourable to the change. The present mild type of scarlet fever is a difficult—almost impossible—disease to control effectively. It is possible that the increase in the numbers recorded for certain of the remaining notifiable diseases was due to the closer contact possible between the District Health Office in New Plymouth and the general practitioners. This was certainly the case in regard to pneumonia, the notifications of which shot up rapidly after a circular letter dealing with the necessity for its notification was sent to all medical practitioners. Enteric was responsible for sixteen cases, but only a few of these were shown to have relation to other cases of the disease. Pulmonary Tuberculosis was responsible for thirty-two notifications during the year. At present the school nurse has fifty-one school children and ten pre-school children, contacts of cases, to keep under observation. Twenty-five of these are in country and thirty-six in urban areas. In October an arrangement was made with the Taranaki Education Board by which each school reported, inter alia, the number of children and contacts absent with specific infectious diseases. This has proved a useful innovation, and has enabled a rough record to be kept of the general incidence of influenza, measles, German measles, mumps, chicken-pox, and whooping-cough in the district. It was obvious from these and other reports received that measles, and probably German measles also, has been extremely prevalent throughout the year. Chicken-pox was also fairly common, and mumps in a few schools assumed epidemic proportions. Whooping-cough was also responsible for a considerable loss of attendance in certain schools. One death from measles complicated by diabetes was recorded in the case of a mentally-defective woman. Three young children died from whooping-cough, which was complicated by bronchopneumonia- in one case. No other deaths were recorded from these infectious diseases. It is evident from this that the epidemic of measles was of a low order of virulence, as in certain schools over 50 per cent, of the children were affected, and the attack rate throughout the district as a whole was very high. Venereal Disease. At a meeting of the Taranaki Branch of the British Medical Association in August the incidence of venereal disease in the district was discussed, and it was agreed that all practising physicians be asked to notify to the Medical Officer of Health the number of fresh cases of this group of diseases seen each month. In the four months from September to December seven fresh cases of syphilis and thirty-five of gonorrhoea were reported. I hope to present a further report on this experiment at the end of the twelve months. Water-supplies. The water-supplies of all the towns in the district were examined chemically and bacteriologically at least once during the year. The chemical results indicated that practically all supplies were of good quality. The bacteriological examinations suggested that a certain amount of contamination was taking place in most of the watersheds.

B—H. 31.

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