55

H.—3l

Dysentery. —Four oases reported, but bacteriological examinations of stools did not discover presence of dysentery organisms. Pulmonary Tuberculosis. —The number of notifications (102) received, although not of itself a reliable indication of the incidence of this disease in the community, shows that the disease does not increase, but has probably declined in recent years. Pneumonia (including Pneumonic Influenza). —One hundred and thirty-one cases were notified during this year, a decided increase on 1927. There was a very marked rise, as shown on the graph, in October (eighteen cases for the week ending 22nd October). These cases were mostly from the Waipawa district, where, following the prevalence of mild influenza, a sequence of pneumonia cases occurred, more in the country than in the town, some of which the doctors said were distinctly of the pneumonic-influenza type. The mortality rate of the 131 cases notified was 12-2, which is not a particularly high rate. Puerperal Sepsis and Maternal Mortality. —There has been a gratifying decline in the number of cases (nine) of puerperal sepsis notified. This may be, and probably is, due to the fact that with a better understanding of our system of notification of cases of puerperal pyrexia by sisters in charge and licensees of maternity hospitals fewer cases of mild and doubtful sepsis are being notified. I regret, however, there is no diminution in maternal mortalities (eleven). Very few are due to puerperal septicaemia, but other complications of the pregnant and puerperal state —eclampsia and kidney-disease, &c. —are responsible for these maternal deaths. Tetanus Cases.—There were two cases (both fatal) of tetanus in the Wairarapa-Hawke's Bay Health District, and one in the Nelson-Marlborough District. Hydatid Disease. —This disease, which originates from infected soil, is probably not as common as it used to be, but it still exists. Eleven cases were notified in the Wairarapa-Hawke's Bay Health District. General Sanitation. In the general way one can see distinct progress in all branches of sanitary work. Hastings Borough has installed a destructor, in lieu of dumping, for refuse-disposal, and also improved its water-supply storage and capacity. Napier Borough has completed the water-supply of the Napier South extension —7,400 ft. of 6 in. and 4 in. cast-iron mains have been laid. Plans have been prepared for the sewerage of this extension of the borough and will shortly be put in hand. Sewerage is expensive on the Napier South Plain on account of pumping being necessary, and the erection of pumping-stations. This borough has also carried out improvements in the way of filling in a big area of swamp. Masterton has completed the relaying of defective sewers, and Dannevirke has made considerable improvements in the same way. The inspection and registration of food-shops, eating-houses, hotels, and private boardinghouses is well looked after by the local-authority Inspectors, who are always most willing to assist our Department and keen to keep up to date in all sanitary matters. There is one long-standing defect in sanitary engineering that I have referred to in previous annual reports —viz., the matter of the Hastings sewerage-disposal. The borough still discharges its crude sewerage into a non-tidal fresh-water river, thereby causing serious pollution. Continuous appeals from the Medical Officer of Health, supported by strong communications from the DirectorGeneral of Health, have failed to move the Borough Council to do anything in the way of improvement. The matter will now come before the Board of Health at the next meeting, and it is to be hoped that an amicable arrangement will be agreed upon and an end made of the dispute which has existed between the Department and the Hastings Borough Council for many years. Water-Supplies. Samples have been taken and submitted for analysis of the water-supplies, more especially where surface waters are used, of all towns in the Wairarapa-Hawke's Bay Health District. The results were uniformly satisfactory. There is no necessity in any supply to install mechanical purification treatment plants. Milk-Supplies. It is with much gratification that I note everywhere throughout the two health districts improvements in every direction in regard to the supply of milk for consumption. The standard of general cleanliness in the milking-sheds, transport, and delivery of milk is steadily improving, and, compared with conditions a few years back, shows not merely marked improvement, but much more intelligence on the part of the milk-vendors. Ice-cream. My remarks on milk-supplies apply equally to the manufacture and sale of ice-cream. The small ice-cream vendors who manufacture ice-cream under very unhygienic conditions are now practically obsolete. They have been replaced by the ice-cream factory with a good sterilizing and freezing plant, which distributes its products in properly insulated vans not only round the various ice-cream shops in the town, but also in the country.