63

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The last two years the rate per 10,000 of notified cases has increased. This is probably due to some extent to the greater attention paid to chest conditions through the T.B. clinic at the Wellington Public Hospital, and the consequent earlier recognition of cases. Occupations : Clerks and domestics show a high figure, comparatively. Control : The register is checked twice a year, and contact is kept with all notifiable cases. The question of sanatorium treatment is placed before every medical practitioner who notifies a case of pulmonary tuberculosis. Cases sent to sanatoria : Number of patients admitted to Pukeora, 59 ; number of patients admitted to Otaki, 38. Child Contacts : All child contacts are followed up by the School Medical Officer. As the years go by, the number of child contacts under observation is increasing considerably, and this work is now quite a definite part of the duties of the school medical staff. Our thanks are due to the Medical Officer in charge of the Wellington Hospital T.B. clinic for his kindly co-operation wherever desirable. Tuberculosis Other Forms.—ln cases of possible bovine tuberculosis we are indebted to officers of the Agriculture Department for their co-operation in investigating herds. Enteric Fever. —There were seventeen definite cases, with two deaths. This is the highest number of cases recorded in the Wellington Central District for some years. The case, which occurred in a farm-house in the Hutt County, was instrumental in causing four directcontact cases and at least one secondary-contact case. Another two cases of this disease occurred in a small cottage in an isolated seaside area. In this particular locality the local authority was requested to provide a nightsoil service and an improved water-supply. Two other patients received their infection as contacts of other isolated cases of enteric, one of which received infection in the country districts. Except in the instance of the contact patients, we were not able definitely to clench the source of infection, although all were investigated exhaustively. A study of the cases, however, directs attention to the following points :— (1) Confirmatory bacteriological findings may be considerably delayed. In such undetermined cases of febrile nature the presence of leukopenia should warrant further investigation re enteric. (2) The need for care in the disposal of nightsoil or sewage material on the sea-coast. (3) Precautions re spread of infection in the nursing of enteric patients. (4) Co-operation between Inspectors of the Agriculture and Health Departments and localauthority Inspectors in the prevention of the pollution of watercourses which flow through dairy-farm lands. Cerebrospinal Meningitis.—Number of cases, 5. No deaths. As usxial, the instances of this disease were isolated cases. Under ordinary living-conditions the infectivity of this disease always appears to be low. Poliomyelitis.—Number of cases, 7. No deaths. No apparent connection between the cases. The disease has exhibited its usual manifestations in non-epidemic periods —that is, occasional sporadic cases. Influenza (Pneumonic, Septicemic, and Fulminant). —Number of cases, 16. One death. Pneumonia. —159 cases notified. Rate per 10,000, 17-51. Twenty-three deaths. There was an increased rate in notification. This apparent increase can be explained to a great extent as due to improved notification from the Public Hospital. Puerperal Fever. —Full-time cases : Twenty-four cases notified. Five deaths. Of the twenty-four full-time cases notified, sixteen occurred in maternity hospitals, and eight in their own homes. Of the total births in the Wellington metropolitan area (2,491 for 1929), 1,915 took place in maternity hospitals, 589 of which were in St. Helens Hospital. Eclampsia. —Number of cases, 12. No deaths. Tetanus.—Number of cases, 1. No deaths. The desirability of obtaining a prophylactic dose of anti-tetanic serum after cuts, no matter how small, as the result of street accidents should be stressed. Where there is the slightest possibility that the wound has been fouled by street-dust the advice of a medical man re the administration of serum should be taken. Hydatids. —Number of cases, 2. No deaths. Chronic Lead Poisoning. —Number of cases, 5. No deaths. These cases of lead poisoning occurred in an industry new to this country. In conjunction with the Labour Department, very considerable improvements have been made to the premises concerned. The company employs its own medical man, who examines the employees monthly for commencing signs of lead poisoning. We are in hopes that there will be little further trouble with regard to the development of lead intoxication. Lethargic Encephalitis. —Number of cases, 4. No deaths. Measles and German Measles; Chicken-pox.—Although there was some incidence in these diseases, there was no widespread general prevalence. Infantile Mortality. —40-90 per 1,000 births. The Death Register has been perused re all deaths under five years of age. The findings do not indicate any particular infantile mortality in any one section of the city or suburbs. Puerperal State. —Fourteen deaths. Causes : Accidents of pregnancy, 2 ; puerperal septicemia, 7 ; puerperal phlegmasia alba dolens, embolus, and thrombosis, 2; puerperal albuminuria and convulsions, 3.