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SECTION B.—EAST CAPE HEALTH DISTRICT. Dr. Tukbott, Medical Officer of Health. Infectious Diseases. Although this district was not actually constituted until the 16th July, the statistics are for the complete year 1928. Scarlet Fever. —Number of cases, 113. Rate per 10,000 of population, 21-50. Two deaths. In many instances the rash has appeared late—from four to seven days after the onset of temperature, sore throat, malaise, &c. The disease has otherwise been true to type, and throughout mild in degree. The rash, often evanescent, has been followed later in the majority of cases by marked peeling. Nephritis has been the most common complication, developing sometimes in the mildest of cases. Control by routine methods is negligible ; so far preventive inoculation has not been tried in this district. Coincident with the rise of scarlet-fever notifications towards the end of the year there developed slight increase in puerperal fever and erysipelas. Diphtheria.—Number of cases, 164. Rate per 10,000 of population, 31-20. One death. No immunization has been undertaken since 1927, when 40 per cent, of Gisborne Borough, Cook and Waikohu County children were inoculated. In 1926 188 cases were notified in these areas. A 1927 drop to eighty-six cases after preventive immunization of -40 per cent, of the children was followed in 1928 by a rise to 118 cases. It seems a. fair suggestion that this rise could have been prevented had a similar percentage of the young children who started school late in 1927 and during 1928 been immunized. Preventive immunization, to be effective, must be a continuous process among fresh susceptibles. An interesting case of long-continued Klebs-Loeffler infection was revealed through the occurrence at intervals of three cases of diphtheria, with one death, in a public-school primer class. A girl aged six years who had begun school in 1928 in this class was found to have discharging ears of five and a half years' duration. A swab taken in class was returned positive K.L.B. When aged six months, together with her father and sister, she was an aural diphtheria " carrier." At two years and again at four years the child was treated in hospital for Klebs-Loeffler ear-discharge. The bacillus had persisted and retained virulence throughout this long period. Typhoid Fever. —Number of cases, forty-three. Rate per 10,000 population, 8-18. Two deaths. Early in the year a small epidemic in Wairoa was thought to be due to faulty water-main ball valves allowing contamination of the water-supply with surface water. In the latter half of the year three Maori cases near Nuhaka were traced to direct and careless contact with a previous case. Again, near Gisborne, a Maori child who the year previously had two doses of T.A.B. vaccine contracted the disease. Contact was proven with a man who had been visiting the pa and house and who had had an attack of typhoid fever seventeen years before. From his feces similar typhoid bacillus was cultured. The endeavour to trace the source of infection ill every case, however, failed. Apart from attention to sanitation, a systematic preventive effort has been applied among the Maoris. In a few areas in the past, particularly Whakatane and Opotiki districts, regular anti-typhoid vaccination has been carried out. The plan has been extended so that now every Maori child of school age is being inoculated with the triple typhoid vaccine. Reinoculations will be done at two-yearly intervals. Tuberculosis.—Number of new cases, thirty-three. Rate per 10,000 population, 6-27. Pneumonia. —Number of cases, forty-nine. Rate per 10,000 population, 9-32. Acute ■poliomyelitis did not appear during the year. Other communicable diseases have a. normal incidence. General Sanitation. The conditions pertaining throughout the district are satisfactory. Visits of a supervisory nature have been made in each county and borough in company with the Inspector for the area,. Endeavour is being made to keep in close personal touch with those concerned with sanitary administration. Gisborne. —This borough maintains its own Sanitary Inspector, but seriously limits his usefulness by a burden of other work—e.g., noxious weeds, Dangerous Goods Act, &c. There is room for more house-to-house inspection. Rubbish removal and disposal fairly satisfactory ; replacement of an open rubbish-cart is being urged. Better facilities for washing and changing clothes for the sanitary staff are needed. Storm-water drainage work is making satisfactory progress. Sewerage system is in need of extension to include growing populous areas. Water-supply is unsatisfactory in respect to quantity and low irregular pressure. Representations have been made re increased storage at the impounding-area, and for the installation of a service reservoir. A loan for the latter is being applied for. Housing : Four old buildings have been demolished ; replacements and new premises are in conformity with regulations. Wairoa. —Steady improvement is being maintained in this growing district. The large floating population of Public Works Department employees has entailed much work, but health and sanitation have been satisfactory. Rubbish removal and disposal: A systematic collection is needed in closely-built areas. " Cleans up " week was energetically prosecuted, with good results.