H.—3l

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Scarlet Fever, 55. The course of scarlet fever in New Zealand is briefly shown in the table below. Scarlet Fever in New Zealand, 1924-28.

It will be seen from the above table that this disease has been definitely epidemic for the last two years, and that last year, although there were seventeen fewer deaths from scarlet fever than from diphtheria, over six thousand notifications of scarlet fever were received. IStafls have been kept busy in effecting isolation measures, and in many districts all available public hospital beds for infectious cases have been occupied. Latterly home isolation has been attempted where the domiciliary conditions were favourable. Fortunately, the virulence has been mild, the deaths per 100 cases notified producing a case mortality rate of under 0-9 per cent. There is no established inoculation method of preventing this disease. What is known as the Dick test and preventive-inoculation method is still in the trial stage, and entails a number of needlings of all the children of a district. In treating the disease hemolytic streptococcal serum has been freely used, with apparently favourable results. In order to more definitely gauge the import of the present epidemic, I present hereunder a columnar graph giving the death-rate per 1,000,000 of population since the year 1872.

Scarlet-fever Death-rate per 1,000,000 of Population from 1872 to 1928. (Note. —No figures available for year 1899.)

This graph shows from the annual deaths recorded that epidemics of scarlet fever tend to run a course of two or more years, and that up to the present this epidemic has been less fatal than previous visitations. All the health districts throughout the Dominion have been involved in the present epidemic. The incidence has now definitely reduced in some of the districts which were the first to be attacked, and, regarding the Dominion as a whole, although even in the first four months of the present year the notification rate is still high, it would seem, judging from the very large number of notifications that have been received and the fact that all the health districts have been affected, that probably a large proportion of the susceptible individuals have already been in contact with infection and the incidence may shortly be expected to reduce,

Notifications. Deaths. Year. — —; 7 — - Number Rate per 10,000 Number Rate per 10 ' 000 IN umber. of Mean Population. LNUmDer - of Mean Population. 1924 .. .. .. 1,176 9-05 13 0-10 1925 .. .. .. 1,025 7-71 7 0-05 1926 .. .. .. 1,583 11-70 8 0-06 1927 .. .. .. 2,185 15-89 16 0-12 1928 .. .. .. 6,127 44-06 55 0-40