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Dr. B. Wyn-Irwin, Medical Officer of Health, Wairarapa - Hawke's Bay Health District, comments as follows on enteric fever amongst Maoris : — " Wairarapa - Hawke's Bay, with its 32 cases, showed the highest incidence for many years, almost entirely due to the continued primitive sanitation and superstition among the large 'Maori population of Hawke's Bay, for 23 of the total cases, and all the fatal cases, were of Maori blood, and of the 9 Europeans 6 were in contact with, or probably infected by, Maoris. "At least 18 of the cases here—as well as lin the East Cape district—were due directly or indirectly to the consumption of shell-fish from Westshore, in spite of augmented warning notices in Maori, and continual propaganda. It would almost seem that nothing short of destruction of the beds, or diversion of the Napier sewage away from this hereditary food-supply of the Natives, will put a stop to these cases and the consequent recruitment of potential carriers among the population. In the meanwhile reliance is placed on biennial T.A.B. inoculations of all Maori school-children in Hawke's Bay and as many possible contacts of cases, which process has been aided by issue of certificates of inoculation. The institution of bored-hole latrines at Porangahau, an endemic focus, also constitutes an advance on previous sanitation there. " Again, 9 cases resulted from the handling, &c, at a tangi, of the body of a child who died from the disease ; while 4 cases developing on a Wairarapa sheep-station were connected with an itinerant Maori shearing-gang from Hawke's Bay, though no carriers were detected ; in this instance crude sanitation prepared the way for such an outbreak. " All cases were hospitalized, eventually, though there was delayed medical consultation in many of the Maori cases. Clinical diagnosis was confirmed by Widal test alone in 15 cases, by isolation of organism in 5, and by both in 5. Seven of the cases (Maoris) had received T.A.B. inoculation within previous two years ; none of these was fatal, and only 1 severe. The sole case of Paratyphoid B infection was probably not of recent origin." Dysentery.— Dr. Hughes, Medical Officer of Health, Auckland, records 60 cases of this disease out of a total of 62 notifications for the whole Dominion. During June and July 1935, 50 cases were reported from the Avondale Mental Hospital. The cases occurred amongst a particularly troublesome class of patient with no sense of cleanliness. Only one of the staff was affected. The cases were all of the Flexner type. A further group of 8 cases, 7in one household, occurred in an Auckland suburb. These were attributed to the consumption of lettuce grown on soil where night-soil had been deposited. Influenza.— Influenza of the seasonal type became general throughout the Dominion in the winter of 1936. The death-rate of 0-94 per 10,000 represents a rise on the comparatively low rate of 0-74 in 1935. Poliomyelitis. —As already stated, the close of the year was marked by an outbreak of acute poliomyelitis in Dunedin, which in the first quarter of 1937 spread comparatively slowly to other parts of the Dominion. In view of this outbreak the time is opportune to review the history of poliomyelitis m New Zealand. Prior to 1914 there is little information about the disease, and apparently it was present only m sporadic form. Since that date, however, there have been three major epidemics, those of 1915-16, 1924-25, and 1936-37. Two other periods of increased prevalence of the disease have occurred, the first between 1920 and 1922 and the second in 1932-33. During the intervening years the disease has never been entirely absent, but only a few sporadic cases have been reported in any one year. The present outbreak began in Dunedin in the first week of December, 1936, a total of 81 cases and 6 deaths being reported during this month in the Otago-Southland Health District. These figures do not represent the full extent of the epidemic, for medical practitioners in Otago and Southland reported seeing many cases, particularly amongst children, of an obscure influenza-like condition which probably represented a minor phase of the disease. The epidemic in Dunedin was of an explosive type, the notifications by weeks being as follows : — Week ending 7th December .. .. ■ ■ ■ ■ .. 2 Week ending 14th December .. .. . ■ • • .. 16 Week ending 21st December .. .. . • •. .. 40 The measures which were taken by the Department to prevent the spread of the disease were as follows :— (1) As soon as it became obvious that poliomyelitis in epidemic form was present in Dunedin, the public were notified of this fact. They were instructed as to the importance of obscure febrile attacks amongst children, and were advised in all such cases to seek medical advice. (2) The medical profession were given early information as to the position. A memorandum which had been issued in connection with the epidemic of 1924-25 over the joint signatures of the then President of the New Zealand Branch of the British Medical Association and the Director-General of Health was brought up to date and a copy forwarded to every medical practitioner on the register. Such information as was available in regard to the use of nasal sprays and serum was also placed before the profession. (3) The public were urged to keep children away from places of entertainment, and from public gatherings such as pictures, &c. The picture-theatre proprietors co-operated in a most generous way, and voluntarily agreed to the exclusion of children from picture-theatres throughout the whole of New Zealand. (4) Schools throughout the whole of New Zealand were closed as soon as it was obvious that the disease was present in Dunedin in epidemic form.

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