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SPECIFIC FEBRILE OR ZYMOTIC DISEASES.

The deaths from specific febrile or zymotic diseases were not so numerous in 1900 as in the years preceding, representing only 12:30 deaths per 10,000 of the population, as against 21.70 in 1898, accounted for by the comparative immunity from measles, scarlet ferer, whooping cough, and diphtheria during last year. Under this class are included the highly infectious diseases-measles, scarlet fever, whooping-cough, and diphtheria---which are especially fatal to children: diarrheal diseases, chiefly fatal to persons at the extremes of life ; and typhoid (enteric) fever, whose ravages are very severe.

It would be interesting to compare the fatality of these diseases in the various States in proportion to the number of cases occurring, but unfortunately the necessary information is lacking. In some of the States legal enactments provide for the notification of infectious diseases, but they are not rigidly enforced, and doubtless many cases

escape notice.

In New South Wales, since the beginning of 1898, under the provisions of the Public Health Act of 1896, notification of the three diseases scarlet fever, diphtheria, and typhoid has been compulsory, and careful record has been kept of the number of cases and deaths, the averages for the three years 1898 to 1900 being shown below :

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The experience of London during the nine years 1891-99 is also given.

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MEASLES. Measles, which is mainly a children's disease, was the cause in 1900 of the deaths of 140 persons, equal to a rate of 0.31 per 10,000 living. The following tables show the number of deaths in each State from this disease, and the death-rate per 10,000 living, in five-year periods since 1870 :

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* Four years, 1872-75. With regard to the diseases which are almost solely confined to children, the true rates are somewhat obscured by stating the proportion of deaths to the whole population, since the prevalence of the diseases will vary in each State according to the proportional number of young children in each. It has, however, been necessary to state them as above, because there is no means of making an accurate estimate of the numbers living at the ages most affected. Comparing the rates as they appear, it will be seen that measles has been more prevalent since 1891 than during the preceding fifteen years, and it seems to be most common in the tirst three States shown in the table. Although the disease is in evidence every year, it usually occurs as an epidemic, and, according to the records, the outbreaks occur with more or less regularity and severity about every five years. Measles was epidemic in nearly all the States in 1875 (when the attack was very severe), in 1880, in 1884 (when Western Australia suffered heavily) in 1889, in 1893, in 1898, and in 1899.

SCARLET FEVER.

The deaths resulting from scarlet fever during 1900 numbered only 60, or at the rate of 0.13 per 10,000. In the table below are shown the number of deaths and the death rates in each State arranged quinquennially since 1870:

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The rate of mortality from scarlet fever for the first ten years shown in the table was much higher than that recorded for measles, but, in spite of the highly infectious nature and difficulty of isolation of the former disease, the death-rate has since been consistently lower than that of the latter. From 1871 to 1880 the rate of mortality from scarlet fever was high, but during the next five years a great decrease was manifested, and later there was a further decline, while during the last fifteen years the rate has been practically constant, but with a tendency to rise in Victoria, Queensland, and Tasmania. In Victoria the extremely high rate for 1876-80 was caused by a very virulent outbreak of the disease in 1876, and in Tasmania an outbreak in 1877 largely increased the rate; in fact, during the three years 1875, 1876, and 1877 all the States were more or less affected by an epidemic of scarlet fever. In Queensland the disease has never been very prevalent, and in Western Australia it is virtually unknown.

WHOOPING-COUGH.

A curious fact in connection with whoopir.g-cough, the third of the diseases of infancy and childhood, is that the mortality resulting from it is higher in the case of girls than of boys. During 1900 whoopingcough was responsible for 401 deaths (182 males and 219 females), equal to 0.89 deaths per 10,000 of the population, the male rate being 0-74 and the female 1:03. The table below shows the number of deaths and the death rates in each State since 1870 :---

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* Four years, 1872-75. The death-rate from whooping-cough, which has never been remarkably high, declined after the second quinquennium (1876–80), and thenceforward remained fairly constant during the next fifteen years. For the last five years, however, the returns show a further gratifying decrease, in spite of the fact that the disease was mildly epidemic during 1898 and 1899. Generally speaking, whooping-cough seems to have been most prevalent in New South Wales, South Australia, and New Zealand; but it is gradually decreasing in these States, and, in fact, throughout Australasia, with the single exception of Queensland, where the tendency during the last twenty years has been towards an increase. On the whole, the rates up to the last period are very even amongst themselves in all the States. In Western Australia the rate rose regularly to a maximum during 1886-90- --a very severe epidemic being experienced in 1886—and then declined.

DIPHTHERIA. Diphtheria, the last of the febrile diseases mentioned which mainly affect children, caused, in 1900, a total of 374 deaths, at the rate of 1.07 per 10,000 persons living. In the following table are shown the number of deaths, and the death rates in each State since 1870:

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* Four years, 1872-75. The present rates for diphtheria, as compared with those of twenty or twenty-five years ago, show a decrease. The decline, however, has been by no means regular, owing to the fact that this disease, in common with the others affecting children, sometimes occurs as an epidemic. Thus the increase in the rates during 1886–90 over those prevailing in the previous five years was due to an epidemic in nearly all the provinces in 1890.

The decreased mortality during the last twenty years, from the four diseases just mentioned, together with croup, represents a gain of about 6 children to the population in every 10,000 persons living. This improvement is very gratifying, since it may be taken that cases of these diseases, which are particularly liable to be attended with dangerous after-effects in the shape of lung and other local troubles, are not so numerous, and that in consequence the general health of the people is better. Tasmania seems to have suffered most from diphtheria, until the last ten years, during which the death-rate was the lowest in Australasia, having declined from 2.76 to 0.79.

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