81

H.—3l

Diphtheria. —Napier, 4; Hastings, 5; Dannevirke, 1; Gisborne, 9; Woodville, 1; Waipawa, 3; Norsewood, 3; remainder of district, 10: total, 36. Scarlet Fever. —Napier, 36; Hastings, 7; Dannevirke, 31: Gisborne, 16; Waipawa, 5; Porangahau, 11; remainder of district, 27: toal, 133. The following is a comparison of the number of cases of enteric and diphtheria notified during the present with previous years: —

Analysis of the Above. The number of cases of enteric remain about the same for the whole district, being the same for the year 1906, and 4 more than in 1907, 12 more than in 1905, 2 less than in 1904, and 27 less than in 1903. The great drop between the year 1903 and the present is most apparent in Napier, which in the former year had an excess of 30 cases over this year. It will be seen by this that Napier has progressed forward by leaps and bounds in its sanitary condition, as evidenced by the lesser number of cases of enteric notified during each year since 1903. I attribute this satisfactory condition partly to the extension of the drainage system and the increased number of the house connections, but chiefly to the improved character of those connections. This has been brought about by the excellent work done by Messrs. Kershaw and Pickering, the former Sanitary Inspector for the Department in this district, and the latter Sanitary Surveyor for the borough. It will be observed that, while the number of cases has decreased in those portions of the Hawke's Bay District where any intention has been paid to sanitation, enteric has increased in the outside districts and those towns in which sanitation is still in abeyance. Up to 1905 Dannevirke had an ample water-supply, but no drainage, and in that year and the two preceding ones there were 8 cases of enteric amongst them. Drainage is now installed, and is being largely taken advantage of, with the result that each of the three succeeding years since 1905 have had only one case of enteric in each year. Woodville, which has a supply of excellent water, and drainage of a kind, remains fairly free from enteric. Hastings has a supply of excellent water from an artesian source, each house having its own well; and drainage, which may be described as "indifferent good," is standing very much where it did. Those towns in which drainage is conspicuous by its absence, or is in a primitive condition, and the water-supply is in the future, show an increase in the number of cases. Gisborne had 19 cases, almost double those of last year. Wairoa had only 4 cases, less than half the number it had in 1907. There has been a slight the number of cases of diphtheria notified this year as compared with the previous ones—36 this year to 43 last, and 54 in 1905 and 1906. Gisborne has the unpleasant notoriety of heading the list with 9 cases. There has been a distinct and very satisfactory drop in Hastings, from 14 last year to 5 this. Hastings has less diphtheria this year than has been reported in any of my previous annual reports except that of 1903, but the population then was scarcely half what it is now. This may be, and I believe is, the result of cleaning up many places which w r ere in an insanitary condition. Napier keeps about level, and Wairoa has the proud distinction of having none. There has been a widespread epidemic of scarlet fever during the past year—l 33 cases — Napier leading with 36 cases, and Dannevirke having a higher number in proportion to its population—3l cases. That the epidemic has been of a mild type is evidenced by the small number of deaths—3 in all, 2 being in Napier, and I in Gisborne. There have been 52 cases of tuberculosis notified during the past year, against 46 the previous year, being an increase of 8 cases. Wairoa heads the list with 26 cases, nearly all of which are Maoris or half-castes living in Maori kaingas. Though they number a mere fraction of the pakeha population, half the notifications of tuberculosis in this district are of the Native race, This is a terrible indictment on the manner in which some of the Natives live,

n—h. 31,

Year. i Napier. Hastings. ! Dannevirke. j Wairoa. Woodville. j Gisborn, | J»-g£ Total.. Enteric. 1903 1904 1905 1906 1907 1908 35 19 6 12 3 5 3 7 2 3 5 5 3 1 5 1 1 1 5 13 * 5 9 4 2 . 1 26 6 12 14 to 19 10 11 16 19 .23 21 S2 57 43 55 51 55 1903 1904 1905 1906 1907 1908 5 5 7 15 5 4 4 7 19 ,8 14 5 1 2 1 Wiphtheru 3 6 9 7 15 9 22 4 3 13 6 16 34 29 44 44 4:5 36 6 * 4 3 1 1 * Not mention! id.