43

H.—3l

The following table shows the deaths in Wellington City for the months from August to December, inclusive, at the various ages given:—

The large adult mortality will occasion comment. Of the thirteen deaths recorded, twelve were those of " Britannic " troopers, in whom septic pneumonia developed within a few days of contracting the primary disease. Owing to the fact that some of the notifications were so loosely made, I am unable to classify the mortality at different age-periods in porportion to the cases notified; but it will be observed from the table that, despite the large adult mortality, 56 per cent, of the deaths were of children under five years of age, and 41 per cent, were of children under two years. As a rule 90 per cent. of the deaths from measles occur in children under five years of age. It would be difficult to show more conclusively how overcrowding and insanitary surroundings, combined with carelessness as to exposure, may turn a comparatively mild disease into one that exacts a heavy mortality. In spite of the preponderance of adult mortality, the death-rate (2-6 per cent.) compares very favourably with death-returns in the United Kingdom, which vary from 1/5 to 36 per cent, at times, even rising to 10 per cent. If the cases notified among the troopers, and the attendant mortality were eliminated, the death-rate would have amounted only to 1-8 per cent. Fifty-seven deaths from measles were reported in the entire district. This gives a mortality of 3-3 per cent., but against this it must be remembered that the statistics are not so reliable for the large area as for Wellington City alone. There is no doubt that many cases of measles that occurred in the up-country districts were not notified. Diphtheria. The number of cases of diphtheria which were notified in the district was 169. Of these, eighty-nine occurred in the City of Wellington. The total number of deaths registered in the district was eight, of which two occurred in the city. The death-rate, therefore, of the whole district amounted to 4-7 per cent., that of the city being 2-2 per cent. There is nothing special to be recorded about this outbreak ; the majority of cases occurred in the months of June, July, August, and September. There is no doubt that the disease was spread by school attendance. On examining the scholars at one school which I had reason to suspect, I discovered one child with diphtheritic membrane actually in the throat, and out of the swabs taken from some 170 children three gave bacteriological evidence of Loffler's bacillus. All the houses where the disease showed itself were carefully examined. In many insanitary conditions were found and rectified, such as faulty drainage arrangements, stagnating water, and absence of ventilation under the building. Enteric Fever. Seventy-one cases of enteric fever were notified; of these, twenty-four occurred in the City of Wellington. The total number of deaths registered in the district was ten ;of these, six occurred in the city. The death-rate in the city was thus 25 per cent., and for the district 14-08 per cent. The four deaths recorded in the city occurred in adults between the ages of eighteen and thirty-eight. The houses where the disease occurred were carefully examined. Though in the majority of cases insanitary conditions were found, yet only one case calls for special comment. In an upcountry town, where typhoid had been particularly non-existent, a case developed in the person of a child who, on the Inspector making the usual inquiries, it was found had recently been wearing some undergarments belonging to a trooper lately returned from South Africa. This trooper had had enteric fever when on service, and brought back to the colony some of the very clothes which he had worn when convalescing. These clothes he gave to his brother's child. This is a strange coincidence, if nothing more. Typhoid in the City. Typhoid was not a notifiable disease until the inauguration of this Department three years ago, and we have therefore no reliable data as to the attack-rate on the population. Through the courtesy of Dr. Ewart, however, I have been able to obtain some very interesting data from the case-books of the Wellington Hospital. In an accompanying chart is shown the admissions to the Wellington Hospital for _the thirteen years 1890-1902, inclusive. The diminution in cases admitted from the date of the installation of the drainage scheme is very striking, and a tendency to decrease is shown as the drainage system is extended. In the year 1892—immediately prior to the inauguration of the drainage scheme —193 cases were admitted to the Hospital. When this

Months. 0-2. 5-10. Ages. 15-20. Total. 2-5. 10-15. 20-30. August ... September October ... November December 1 9 5 5 4' 2 5 11 1 1 11 2 19 7 7 "i "i 20 13 46