H.—3l

64

I am sending herewith a chart showing the occurrence of notifiable diseases in Dunedin and suburbs, in Invercargill, and in the counties of my district. With it I also send a small chart of these diseases as notifiable for Greater Dunedin (town and suburbs taken as one), with the total number of cases, and the deaths, calculating the death-rate per cent. I have also added an outline map of my district, showing graphically the months at which the disease of scarlet fever attained its greatest number of cases, with an attempt to indicate how and from what points the disease appears to have radiated. From this map we have some indication that the disease, in what seems to me to have been a different phase, took a start from the northern border of my district in November, reaching Dunedin in January, and radiating outwards with a fair degree of regularity. You will be able to follow this from the map which shows the disease in November in Waikouaiti, Waihemo, and Maniototo counties; later, in January, in Dunedin ; then in Bruce and Clutha in February. It would appear from the map also that the disease was carried from the Lake County to Invercargill and Southland generally, there being a direct line of communication by' rail between these localities. This, which appears a new source of spread of infection, has some significance, as apparently the disease has this time assumed more the appearance of true scarlet fever, and not so much that of German measles which it formerly showed to my mind. The death-rate of scarlet fever and of measles shows again a curious correspondence (for Dun.edin), in the former being 3-2 and in the latter 3-1 of the recorded cases. Enteric fever shows a very high death-rate, 30 per cent., and diphtheria, almost as high, 28-5; but the number of cases recorded as having occurred is very low, ten in the former and twenty-one in the latter. Tuberculosis shows a curiously high death-rate, 115 per cent, of the recorded cases, indicating how imperfect the notification is. We had only seventy-three recorded, and eighty-four deaths appeared in the books of the Registrar of Deaths. Again only seven cases of blood-poisoning were notified, while the Registrar's books showed that eight deaths had taken place. I shall have to follow up these indications in future more closely, as they show that we are not getting the proper amount of information regarding these probably preventible diseases in our towns at least, Mr. Belcher, secretary to the Seamen's Union, having reported that the quarters provided for some of the sailors on board of some of the intercolonial steamers were in a filthy condition and neglected, I sent Inspector Gunn on board some fourteen of these as they arrived at Dunedin to examine into the truth of the allegations. He found that there were some grounds for them, but the neglect apparently was the result of a variation of opinion as to whose duty it was to keep the quarters clean while in port, so we contented ourselves by ordering that the quarters should be cleaned, leaving the decision as to whom the duty belonged to be settled between employers and men. You will see by my summary that a great deal of miscellaneous work has been accomplished difficult or useless to classify or to mention in detail, but which indicates that our Department is being found to be useful to the public, and that it is being made use of to inculcate and carry out sanitary work in many directions which had hitherto been frequently neglected for the want of any one to see that it was done. In accordance with your scheme whereby the various District Health Officers should pay attention to a special branch of sanitary science, I have been paying special attention to that relating to the storage, distribution, and general treatment of the food-supply of the colony ; but, though I have already collected a goodly amount of information on these points, it is not yet, owing to the many interruptions during the year which have taken me to pressing duties, such as will allow of being gathered together in the form of a special report. I shall, however, follow up the matter throughout this year, and hope to have, in a little time, some details worth presenting to you. Frank Ogston, M.0., Aber., District Health Officer for the Otago-Southland District.