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►
GIFT
from
U.S. PUBLIC HIALni SEi:VICT:.
r
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PUBLIC HEALTH
REPORTS
ISSUED WEEKLY
BY THB
UNITED STATES PUBLIC HEALTH SERVICE
CONTAINING INFORMATION OF THE CURRENT
PREVALENCE OF DISEASE, THE OCCURRENCE
OF EPIDEMICS, SANITARY LEGISLATION, AND
RELATED SUBJECTS
VOLUME 32— PART 2
NUMBERS 27-62
JULY-DECEMBER, 1917
WASHINGTON
GOVERNMENT POINTING OFFICE
1918
5SP;
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ADDITIONAL 00PIB8
or THIS PUBUCATION MAT BE PBOCUItKD FROM
THE SUPERINTENDENT OF DOCUMENTS
OOVEBNMEKT PRlNTIKa OiTICK
WASHINGTON, D. C.
AT
6 CENTS PER COPY
V
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.t,z
PUBLIC HEALTH REPORTS
VOL. 32 JULY 6. 1917 No. 27
VreULENT SMALLPOX AT DOUGLAS, ARIZ.
Acting Asst. Surg. Edward W. Adamson has reported that an
outbreak of smallpox began in Douglas, Ariz., in May. The date of
the first case is given as May 21. Up to June 25 there had been
repK)rted 46 cases with 10 deaths. The virulence of the infection is
shown by the fact that a considerable number of casds were in per-
sons giving a history of previous successful vaccination and pos-
sessing what appeared to be good vaccination scars. The disease,
however, ran a mild course in most of the cases having vaccination
scare.
POLIOMYELITIS REPORTED IN OHIO.
Mr. Jas. E. Bauman, Secretary of the Ohio State Board of Health,
reports! July 5 that there were 11 cases of polfomyelitis (infantile
paralysis) at Marlins Ferry and 6 case^ in Tease Township, both in
Belmont County, Ohio.
OUTBREAK OP DYSENTERY, ARKANSAS.
Passed Asst. Surg. Preble reports that there is an outbreak of what
appears to be baciUary dysentery in Mississippi County, Ark. Many
fatalitu^s have occurred » but owing to the absence of records of cases
and also of the registration ot deaths, the extent of the outbreak has
not as yet been ascertained. The outbreak seems widely scattered
and to have numerous foci. According to unofficial reports and
items in the newspapers, there have been many cases also in Poinsett
CJounty, Ark., and in Dunklin and Scott Counties, Mo. The local
undertakers' records indicate that there were 40 deaths during May
and June in the town of Bly theviUe and the neighboring communities.
It is probable that there have been at least 400 cases in Mississippi
County. Most of the cases have been in children under 5 years
of age.
It is reported locally that similar outbreaks have occurred in past
years but have been less severe and caused little attention. The out-
break this year is looked upon as being unusually virulent. The
fatality rate appears to be about 7 per cent. The present outbreaks
are being investigated.
77 (1075)
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45944 ^
July 6, 1917 1076
SEWAGE DISPOSAL UNDER RURAL CONDITIONS.
SOIL POLUmON AND THB PBACTICAL USB 09 THE L. H. 8. METHOD ffOB mKCWOBTA
DISPOSAL IN THE COUNTST AND SUBURBS.
By Cha8. T. Nksbttt, M. D., HeaKh Offlcer, Wflmington and New Hanover Goonty, H. C.
In our effort to find a means for the sanitary disposal of human
excreta where sewer connections are impossible and where sufficient
dilution for sewage in streams can not be foimd, especial attention
has been given to the system known as the L. R. S. method of excreta
disposal, as this method promised to give less need for scayenging
than any other. Suburban and rural dwellers have been encouraged to
install these tanks and especial attention has been given by the depart-
ment of health to designing and locating tanks for use with privies and
with plumbing installations. The construction of many was super-
vised by an officer of the department. In 1913 we designed for a
local contractor a set of L. B. S. tanks to be made ol reinforced
concrete, and since that time several hundred such tank sets Ukve
been constructed and installed in the county, and a great number
have been constructed for use in other sections of the South.
Observations made on the use of these tanks during the past four
years have led us to beheve that the L. R. S. method offers the most
satisfactory solution of the rural excreta disposal problem that has
yet been devised. When tanks of proper eo»»traction and properly
located are installed either for privy use or use with plumbing in-
stallations, we find that their continued use with proper care gives
almost perfect results with our soiL None of the tanks in use have
required scavenging except when connecting pipes have become
stopped or the tank sets have been used beyond their capacity. Our
experience during the past four years has led us to adopt in practice
the following standards:
The capacity of the sludge tank is determined on the basis of 3
cubic feet for each user under privy conditions, and 5 cubic feet
for eadi user wh^i the tanks are connected with a plumbing in-
stallation.
Waste from baths and kitchen sinks should not be discharged into
the sludge or the effluent tank. The waste from the kitchen sink
interferes seriously with septicization and the bath waste suppUes too
much water. A great number of our tanks receive the bath waste
and work satisfactorily, but no tank works satisfactorily that receives
waste from a kitchen sink. It is our practice to connect the kitchen-
aink waste into the drain from the effluent tank.
We have observed the best results in tanks that have a relatively
small sludge mat area. Diameters of from 30 to 36 inches at the
water line with a depth adjusted to the capacity desired in the cylin-
drical tanks work best. The effluent tank should be similarly de-
signed and should not be less than one-half the capacity of the
sludge tank.
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1077 July 6, 1917
Whto tanks are used with plumbing installations, the inflow pipe
from the house should discharge by vertical drop not less than 2
feet below the water line. The pipe discharging into the effluent tank
from the sludge tank should rise vertically from a point not more than
18 inches from the bottom of the tank and should discharge into the
effluent tank not less than 18 inches below the water flne. The
outflow from the effluent tank should rise vertically from a point not
more than 12 inches from the bottom of the effluent tank and should
discharge near the surface of the groimd into a tight line of tile pipe,
or other tight conduit, leading to a contact bed located with due
regard for the proximity of cisterns and weUs and some distance
away from the dwelling.
The contact beds that we are using are constructed of loose stones
or shells in a ditch 2 feet deep by 18 inches wide, near the surface of
which is laid a line of agricultural drain tile that is continuous with
the effluent drain. The extent of this bed is determined by the
amoimt of effluent to be treated. Wherever possible we persuade the
owner to refrain from covering the bed with earth, leaving it open for
the ingress of fresh air.
The tanks must be thoroughly waterproof both inside and out to
protect them from seepage from without in, and the bottoms in
concrftt^e tanks should be made continuous and in one piece with the
sides. If there is seepage of ground water into the tanks, the efl^ect
will bethat of overloading.
Both privy tanks and tanks used with plumbing installations should
be filled with water to the level that is reached when the tank is in
full use before beginning to use them. Two or three pails full of
fresh horse manure should be placed in tlie sludge tank.
Tanks used with plumbing installations should be tightly covered
and operated without other ventilation than the house stack. Hand-
holes should be located in the inflow pipe at the point of ingress to tho
sludge tank and in the horizontal pipe connecting tlie two tanks to
facilitate rodding in case of stoppage. These handholes should be
supplied with stoppers that can be tightly sealed.
Privy tanks should be constructed so that the seat with its lid shall
rest upon the top of the tank itself and the lid shoukl be made to
close automaticaUy when not in use and to cover the hole as closely
as possible to prevent the ingress of flies. A vent not less than 3
inches in diameter should be carried from tho tank through the roof
of tho privy house, and this vent should be screened to prevent the
possibility of flies finding their way down tho vent. Privy tanks
should be kept filled with water to tho levol of the outflow at all
times and when flies gain access kerosene should be applied to the
surface of the mat to prevent fly breeding and feeding. The kerosene
should be sprinkled on the mat in order that as little of it as possible
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July 6, 1917
1078
may reach the underside of the mat surface. In all other respects
privy tanks are installed in the same manner as tanks for use with
plumbing installations.
We have attempted to gain an idea of the extent to which the use
of these 'tanks protects the soil from widespread pollution. The
method used was suggested by Prof. Earle B. Phelps, of the United
States PubUc Health Service. The data secured is, of course, incon-
clusive and appUcable only to the soils of this section. We endeav-
ored to make the tests as severe as possible, taking samples of ground
water only in such locations as were so saturated that water could
be obtained by driving a pipe not more than 15 feet into the ground
and attaching the pump to the top. These shallow-driven pumps
were pumped only to the extent of determining that a supply of
water had been reached and were then permitted to stand two or
three days before samples were taken. When the samples were taken
only enough water was pumped off to clear the pipes of that which
was either put into them to start the pump or that which had re-
mained standing in the pipes since they were last pumped. Half the
samples were taken at plants using privy tanks and the remainder at
plants using septic tanks with interior {dumbing installations. By
reference to the table it will be noticed that in all cases the contact
beds were within 10 feet of the eflSuent tank, and none of these plants
had been in use less than six months.
Table 1 gives the essential physical data of the plants and Table 2
the data of the test wells and results of examinations. The B. eoli
are reported ag positive (-h) or negative (0) in the various dilutions.
Table I. —Description qf plants.
PRIVY TANKS.
PUntNo.
DaU.
8oil.i
Plant
inote.
iUmarkB.
1.
2. •
3. ■•-...
^-.""^
5../*- .
6 "■••-
S«pt. 18,1»1«
do
Dec. 15,1916
do
do
- Dec. 20,1916
D«(. 22,1916
8/C
sc
Soft 8C. . .
s
Mos.
24
24
18
24 +
24
6+
24
Dehrsdo School (boy«).
Railroad section hotiiie.
R*dden:e.
KinderiTjrten. Plant overloaded.
8
Delpodo School (girls).
7.'."!;;; •
SC
8C
East Wilmington School.
Residence.
SEPTIC TANKS.
Now.-:
Son poorly drained. Samples from near a drainage ditoli,
Nurserj farm. Soil heavily manured. Drainage poor.
Drainage poor.
Drainage poor. Drainage ditch nearby.
Swampy ground and undergrowth.
S-aand; C-clay; L-heavy loam; S/C-eand underlaid with day; SC-aand mod day.
distance from effluent tanlks to nttrlfleatkm bed generally 10 feet.
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1079
July 6, 1917
Table 2. — Remits of examinations of ground water from test wells driven near nitrifica-
tion oeas of privy tanks.
Plant No.
2
3
4
5
«
7
8
9
W
U
/I
12 ,...
13
14
WeU
No.
Distance
from
contact
bed.
FC€t.
0
10
20
0
15
30
0
10
20
0
10
20
0
10
20
0
10
20
0
10
20
0
10
20
0
10
20
0
10
20
0
10
' 20
0
10
20
0
10
20
0
10
20
Deptb.
Fe€L
9
7
7
8
8
8
10
10
10
8
8
8
8
8
8
11
14
10
10
10
10
12
13
13
10
10
10
7
7
8
7
7
7
7
7
7
10
10
0
7
7
6
Bacteria per c.c.
oh plates in-
cubated at—
aO". 38*.
183
72
39
2,200
1,700
1,100
145
120
120
60
45
60
80
60
42
160
m
145
600
800
600
»0
300
300
1,200
500
. 700
HI)
60
65
110
90
150
250
90
160
B.coll-
10 c. c.
60
30
10
40
20
20
80
26
8
1,200
600
450
85
40
30
5
3
12
40
25
15
90
15
110
250
350
300
100
130
80
800
120
150
15
30 '
10
00 ,
»K)
300
120
1 c. c. 0.1 c. c.
0
0
0
0
0
0
0
0
0
0
0
0
+
0
0
0
0
0
+
+
+
0
-f
0
+
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-»-
+
0
0
-f
+
-K
0
+
0
+
0
+
0
+
0
+
0
+
-f
+
0
f
0
0
0
0
0
0
0
0
0
+
0
0
0
-f
0
0
0
0
0
In presenting the results of this investigation it would be highly-
desirable to present a detailed investigation of the same sort on
ground waters taken from the immediate neighborhood of pit privies.
There being no pit privies in the county, such samples are not readily^
obtainable. We have, however, some striking evidence that the
sandy clay soil in this section does not present a filter medium j^hat
will protect ground waters from fecal pollution.
Tliere are in this city and in the county a great number of shallow-
driven wells. Of these we have examined bacteriologically about
seven hundred. The only wells of this kind that we have found
free from poUution are those which are located from two to five
hundred yards away from any concentrated source of pollution,
stables, privies, pig styes, etc. The l>acteria counts in water from
these wells not so located are extremely high and the presumptive
test for colon bacilli gives unfailing positive results. The drilling of
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Jalj6,191T 1080
deep xrells in the city and near dwdlings in the county must be
conducted with great care and these wells must find in the coiu^e
of their descejit a perfectly impervious protecting stratimi of lime-
stone through which the casing must be carried and into which an
outer casing must be imperviously seated, in order to assure a con-
tinuous supply of impoUuted water even from these deep sources.
Before the introduction of the use of septic tanks at the rural
schools in this county which were supplied with water from shallow-
driven pumps, every such pump was found to produce polluted
Water. Since the introduction of the use of septic tanks at the
schools, it has been necessary only to move the driven pump to a
new location to obtain a supply of ground water that is free from
pollution and that remains free. In two instances shallow-driven
wells that were polluted when surface and pit privies were being
used at schools and which we could not have removed, cleared up
after the installation of the tanks and are now producing impolluted
water.
These facts lead us to deduce that where a concentrated solution
of excreta is apphed to the soil, as is the case with pit privies and
badly kept surface privies, there is more or less widespread poDutiou
of groimd water, and wherever the protecting stratum is imperfect
there is pollution of the deeper water deposits. The ground water
about a dwelhng or schoolhouse is very generally polluted in this
section irrespective of the presence of privies and stables, as in other
soils in other sections of the country. This fact must be taken into
consideration in connection with the investigations herewith sub-
mitted. It is remarkable that any water samples taken in the loca-
tions from which these samples were obtained shoidd prove to be
unpolluted in any of the quantities used for investigation.
Perhaps the only deductions that are warranted from this investi-
gatioQ are that the use of these L. R. S. tanks has made no material
addition to the normal soil pollution about the buildings, and, in the
light oi the experience quoted above in connection with unprotected
^excreta disposal, that the amount of septicization accomplished in
them produces an effluent very much less liable to pollute soil than
any. other process of treatment that it is possible to use with se
UtUe expense and trouble. In our experience we have had no reason
to regret having encouraged the widespread use of the L. R. S.
tanks. There have been, of course, numerous complaints about their
action, but these complaints have invariably arisen from the st^idi
iiduch results from leaving privy tanks open, failure to keep the water
at the proper level in the tanks, and failiure to provide proper ven-
tilation for the tanks. Trouble with tanks used in connection with
phimbing installations has invariably arisen from two sources — over-
crowding and the admission of kitchen sink waste to the sludge tank.
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1081 July 6, 1917
In a number of instances, contact beds have been badly located, the
tend^icy bemg to locate the contact bed too near the tank and, as
foflows, too near the dwelling. This is evidently in order to save
the expense of installing a line of tight pipe to convey the effluent
to a more favorable plac^ of deposit. Notwithstanding this, no com-
plaints have reached this office in which the contact bed was the
source of complaint.
ANOPHELES PUNCTIPENNIS.
A NOTE ON rrS ABILITY TO SERVE AS A HOST FOR PLASMODIUM FALCIPARUM.
By M. Bkton Mitzmain, Tecbnical Assistant, United States Fublic Health Service.
The snsceptibihty of Anopheles punctipennis Say to infection with
the parasites of subtertian malaria has heretofore not been estab-
lished in studies in connection with malarial investigations by the
United States Public Health Service. In a previous intensive
study/ negative results were obtained, following attempts at trans-
mission through repeated bitings of two human subjects by mos-
quitoes previously given multiple feedings of blood of gametocyte
carryifig patients: these experiments also included the dissection of
219 specimens, all of which wove negative.
On account of tlio apparent ease with which Anopheles punctipen-
nis coilld he infe'jt( vl with the parasites of tertian malaria, it might
be infoiTcd that this mosquito exhibited a specific predilection similar
to tliat rc}M)rtcd fen- Anopheles qiLadnmaculaius and Anopheles
crucicuis by local invesilii:atoi's. In a further series of experiments
recently conducted in Xew Orleans, Anopheles pundl pennis has
proved ea.^ily infe?tible with Plasmodium falciparvm Welch. Of
one scrie^s of 16 mosquitoes, given a single feeding, one became
infectc:i; in a second gi'oup of 36, given a variable number df feed-
ings, 15 infections resulted; in the 'two groups, 27 per cent of infec-
tions were observed. Of 8 examples of Anopheles quadrimaculatus
used as controls, 4 developed infections.
» Anophfles punctipennis Say: Its relation to Iho transmission of malaria. Report of experimental
data relative to subtertian malarial fever, by M. Bruin Mitzmain, United States Public Health Reports,
Feb. n. J91fi.
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July e, 1917
1082
The following table summarizes the positive findings; and gives the
developmental period in each mosquito:
Date or
dissection.
Devekm-
nMntal
period—
(days).
Oct. 28,1916
Nov. 15.1916
Nov. 18,1916
Nov. 19,1916
11
13
15
17
Nov. 20,1916
Nov. 25,1916
Dec. 3,1916
Do
19
24
31
31
Do
Doc. 24.1916
3a
37
Dec, 25,1916
53
Dec. 25,1916
47
Dec. 29,1916
57
Jan. 1,1917
50
Btaee of devetopraent.
18 oocysts; sire 20-22 n finely pigmented.
8 oocysts without protoplagmic dilTorentiation: size approximately 25 nTS/i.
Approximately 250 oocysts in all stages preceding the sporoblastic.
8 oocysts, 2 of wldch still retaining pigment, remainder granular without
sporoblasis.
Approximately 200 oocysts in all stages up to sporoblastic.
43 oocysts; size 25^0 n, mostly with malarial pigment, a few with sporoblasts.
About 120 oocysts, hJalf of them retaining pigment, only 1 with sporoblasts.
Approximately 250 ooevsU, oC which 50 were quit« small (I5>20;i) with mala-
rial pigment; remainaer various sizes, but more matured. Few with sporo-
blasts.
30 oocysts in various stages; few, however, with ygung sporobbists.
1 oocyst rcprespntcd by shrunken capsule, without content^}; oocyst appa-
rently full sized and firmly attached to gut wall.
5 oocysts- 4 with contents cxi)ened, 1 with sporoblnsf dc\'clopment barely
commencing (only 4 segments discernible). Remainder of body of oocyst
undifforenliated and grannlar. Size, TO /* x 33 m-
3 oocysts with ccuueuts nipturci all torn from gut wall daring diss x?t ion. No
evidence of sporozoitcs m mounting liquid surroun ling the gut wall or in
the glands.
2 ruptured shrunken oocyst raembranes on p<Kjtcrior end of mid gtit. No
inoicatioos of sporobl ists or sp jt jzoite^.
1 oocyst, 22 25m, ^f>ntiininic griuul'^s only. And 4 ruptured oocj^st capsules
still attached to stomach wall. No sporozoites present.
One control specimen of Anopheles quadrimacnlatus which proved
infoctod was oxamincd on the twelfth day aft^r biting the blood donor.
The gut wall was coverexl by at least 200 oocysts. These were not
over 35 m in size, the majority exhibiting malarial pigment ai^d aver-
aging 20-25 M in size. No mature oocyst was seen, and the glands
were devoid of sporozoites.
The second control Anopheles gtuidrimaculatus found infected was
examined 40 days after biting the blood donor. On the gut wall of this
specimen were seen 3 oocysts and 3 shnmken capsules devoid of
sporozoites or other bodies. The oocysts measured 59 m to 67 m in
size, with undifferentiated granules lacking evidence of sporoblast
development. A prolonged search was made of the mounting fluid
surrounding the gut wall, but sporozoites were not found. The six
lobes of the sahvary glands were hkewise uninfected.
Another specimen of Anopheles quadrimaculatus was found infected
on the fortieth day of development. Here were seen three empty
oocyst capsules and three large oocysts, one of which measm^d 59
by 65 M and the other two were as much as 67 m in diameter. The
development of these oocysts was apparently abortive, as sporoblasts
were absent and sporozoites were not present on stomach wall or in
the six gland lobes.
The fourth specimen of this species to be found infected was dis-
sected 54 days after its initial blood meal. The only indication *of its
infection was the presence of two apparently full-sized oocyst en-
velopes devoid of contents except for a few sporoblasthke bodies in
Digitized by
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1083 July 6, 1917
one of them. The glands were negative, except for a moderate inva-
mon of sporozoites m the mid lobe of one gland.
Throughout this series no mature forms of oocysts or gland sporo-
zoites were encountered, except in the one instance noted. This is
ascribed to the relatively low temperature in which development took
place rather th&n to other factors.
Discussion and summary.
TTie experimental determination of the r61e of Anopheles punctir
pennis as a potential host for the common forms of malaria has been
established, as ascertained by King.^ No additional findings have
been developed whereby previously reported negative results with
this anopheline and Plasmodium falciparum might be accounted for.
In the present series, 52 specimens of Anopheles punctipennis were
fed upon the blood of cases of subtertian malaria, and 14 infections
lasolted. Of 8 specimens of Anopheles qwdrim4icvlitus\ used as
coiiti*ols under identical conditions, 4 became infected.
Anopheles punctipennis, while highly susceptible to infection with
Pl%6modMLm vivaXf exhibits no especial predilection toward this
apttciee; but it has been shown to be a sufficiently receptive host of
PUtsmodium falciparum to be held of sanitary importance.
From the writings of Beyer and his coworkers,' Craig,* and others,
it has been concluded that a specific relation exists betweea American
anophehnes and the several varieties of malaria. The transmission
of tertian and quartan malaria has been held to be effected by Ano-
fheUa qwdrimaculatuSf while to Arhopheies crucians has been ascribed
the incidence of subtertian malaria. Craig concluded that: ^'The
tbeorrations noted explain cleariy why certain localities suflter more
avrerely than others from certain types of malarial infections. Given
a locality in which only Anopheles crucians occurred and we could
hmrm nothiag but estivo-autumnal infections; but if Anopheles quad-
fimmmlrtfus were the only Anophdes present, we mig^t have either
tertian or quartan infections, but no estivo-autumnal malaria.'^
The present status of the common American anophelines with
reference to their susceptibihty to infection with the several species
ol malarial parasites is as follows:
Anopheles quadrim^iculatus may serve as a host for all three para-
site of malaria.
Anopheles puncUpenms and Anopheles crucians are susceptible to
infection with Plasmodium vivax and Plasmodium falciparum.
*' King (1014): Erparii—itt on tbt derelopiiieiit of aftlaiia pwasites In tbree Ameiioan species of ano-
pheles Tbe Journal ol Ezperimeatal Medicine, June, 1916, volume 23, No. 6, pp. 703-716.
• Befer, Potbier, Coaret, and I^mann (1902): Rxperimental Inyestigations with zoaloria in conoeetioo
with the mosquitoes of New Otleans. New Orleans Medical and Surgical Journal, vol. 50, -No. i;
January, 1002.
» Craig (1»14): The prophylaxis of malaria with speotel reference to the military service. War Depait-
i Bulletin No. 0» August, 1914, pp. 43-44. ^ i
Digitized by VjOOQlC
PREVALENCE OF DISEASE.
No health department^ State or heal, can effectively prevent or control disease mthoui
knowledge of when, where, and under wJiai conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended June 30, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended June
30, 1917, as follows: Of cerebrospinal meningitis, 2 cases occurred
in San Francisco, 1 case in Stockton, and 1 in Santa Clara County.
One case of poliomyelitis was notified at Los Angeles. Diphtheria
increased a little, 34 cases having beort notified, 12 of these in Los
Augeles, 7 in San Francisco, and 4 in Sacramento. Ten ca?es of
smallpox were reported, 7 in Fresno County, 1 each in Oakland,
Los Angeles, and Needles. Eighteen cases of typhoid fever were
notified, 1 each in Alameda, Martinez, Glendale, Los Angeles, Placer
County, Sacramento, San Diego, Stockton, vSanta Barbara, and
King City, 3 in Santa Clara County, 5 in San Francisco. Scarlet
fever showed a slight increase of cases over the previous week.
Cases of measles, mumps, and whooping cougli continued to decreafe^
in numbers.
The details of notifiable disease cases reported in the State during
the week ended June 23 are as follows:
Cerebrospiual meningitis 4 I Piieumonia 31
C'hioken pox 74 j Scarlet fever 56
Diphtheria 32 j Smallpox 4
Dysentery 15 Syphilis 19
Erysipelae 9 | Tetanus 1
German measles 26 j Trachoma 1
Gonococcus infection 23 , Tuberculosis 119
Malaria 2 Typhoid fever 19
Measles 358 ! WTiooping cough 68
Mumps 145 1
(1084)
Digitized by vJOOQIC
1085
CEREBROSPINAL MENINGITIS.
July 6, 1917
Ccmnecfticiit
Collaborating Epidemiologist Black reported June 27, 1917, that
cases of cerebrospinal meningitis were present in Connecticut as fol-
lows: Two cases at Camp Dewey and one case each among the
militia at Hartford and Norwich.
Stete Reports for May, 1917.
Place.
lit
Place.
New
cases
reported.
California:
Abmedft Ommty
1
1
1
3
Iowa— Continued.
Pottawattnraie Comity.^ ..........*.
1
Contra Costa Caantv
Total.
Los AogeJes Coamy^
4
New York:
AU)ftT>y Co^inty
Bm Fnndseo County-
Ban Francisco
1
Erie County
9
Total
0
Greene County
1
3
3
1
2
Rensselaer County
1
Marion County '.
Schenectady County
1
Kanflolph Cpifniy
Steuben Cooocv
1
8t. Joecph County
Sutf oik County.
1
New York Citv
60
Tot4l
6
Total
78
^Fae:© County
2
1
Wyoming:
Campbell County
Polk County
1
Oregon Report for AprU, 1917.
During the month of April, 1917, 1 case of cerebrospinal menin-
gitis was reported at Portland, Orog.
Ctty Reports for Week Ended June 16, 1917.
Place.
Oas«».
Deaths.
Place.
Cases.
Deaths.
micnnore, JAa...k..
Berkeley. Col
Bingbamton, N. Y.
Boston, Mass
Bridgeport, Conn. . .
Canton, Ohio
Chicago, 111.
ClDcinnati, (
Oivalaiid. Ol
Da}-ton, Ohio..
Detroit. Mich
Dubuque, Iowa....
Dtihitb, Mhin
Dunkirk, N.Y....
Eliiabeth,N.J....
Erie, Pa
Oahreston, Tex
Hartford, Conn...
Tndianapolfe. Ind. ,
Lawreooe, Mass...
I^xington, Ky
Los Anfetes, Cal
Milwaukee, Wis 1
Minneapolis, Minn
Newark, N. J
NewYork, N. Y
Niagara Falls, N. Y
Omaha, Nebr
Philadelphia, Pa
Pittsburch, Pa
PittsfieM, Mass.
Richmond, Va
Rochester, N. Y
St. Louis, Mo
Salt Lake City, Utah
San Diego, Cal
South Bethlehem, Pa
Springfleld , Mass
Toledo, Ohio
Washington, D.C
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July 6. 1017
1086
DIPHTHERIA.
Massachusetts — LoweO.
CoUaborntiug Epidemiologist Kelley reported that during the pe-
riod from Juno 1 to 27, 1917, 52 cases of diphtheria were notified at
Lowell, Mass. During the month of May 47 cases were reported in
the same city.
Set* also Diphtheria, mcaHlcs, scarlet fever, and tuborculosis, page 1094.
DYSENTERY.
Arkansas — Mississippi County — ^Bacillary Dysentery.
Passed Asst. Surg. Preblo reported June 30, 1917, the occurrence
of a disease outbreak, regarded as bacillary dysentery, mainly
among children, in Mississippi County, Ark. The same affection
has been reported present in nearby counties in Arkansas and Mis-
souri.
ERYSIPELAS.
City Reports for Weeic Ended June 16, 1917.
riace.
Cases. Deaths.
Place.
Cases.
Deaths.
Alanip*lo , Cal
1 1
1
0 1
1
KansasCUv. Mo
Lawrcnc<». Xla^js
2
Ann \rtH)r. Mirh
1
Ballii.u) f Mil . .. ..
Ix>s Aniroh'S Cal
3
1
B») 'on. M isN
Melrotie, Mass
1
Hui; lUi N V
4 1
1
21 ' 1
1
Mjlwanicpe. Wis
Newark. N.J
New York, N.Y
Niajj-ira Falls, N. Y
rhilad^lphia. l*a
4
5
2
7
15
i
Hiith't \'i\
n i ..' ♦ III
10
iUv iivciti, « »hio
i'U ^ .>1 .1'.l. (>hn>
2
1
(Ill : ii VJa.^
PittslmrRh, Pa
Provi<Ionc^. U. I
Koarlmp Ta ...
2
|),-i' i Mu!i
r 5
2
1
2 •
1
1
1
I»m1 .(I- Minn .
KLm HI
Richmond. Va
1
K"- . I'l
; RcKhr.for. N. Y
St. Loiu-, \Io
i
13
1
1
Kl'. • Mi t
4
yor\ Wo ih. Trx
San Dioco, Cal
!K
Ii , H lui, ' I'a
San Frunt'isLO, Cal
Hit '-.' il < 'Mn
2
2
1
SvniMiso, N. Y
....,..,..
Jv.^ > » ilv, N. J
Kalnin i/v>o, Mifh
1 Troy. N. Y
2
LEPROSY,
aty Report for Week Ended June 16, 1917.
Dnrinp the week ended June 16, 1917, one case of leprosy was
reporlrd in New York, N. Y.
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1087
MALARIA.
OaHfornia R^»ort for May, 1917.
July 6, 1M7
FlM*.
New cases
reported.
Place.
Newcaaee
reported.
Catifornia:
AkmedAOomitj—
Berkeley
California— Continued.
Ban Joaquin County-
Stockton
Butte C<ffl]ii^ .. r
BhaiftA npinity . . , , . . ,
Fresno County—
Iteedley
Reddinff .'.
Sierra County
Qleim County—
Orland
Sutter County ....•
Trinity County
Lo0 Angeles County—
l/os Angela*
Tulare County
Tuolumne County
Nevada Couiity
Yolo County
Rocklin
Yuba County
2
Total
Ban Francisco County—
San Franciaoo
33
aty Reports for Week Ended Jane 16, 1917.
Place.
C«MS.
Deaths.
Place.
Qases.
Deaths.
Berkeley.Cal
1
12
3
1
1
Memphis, Tenn
1
Binninf ham, Ala .
Morrfstown, N. J
I
2
Boston, Maa
New Orleans. La
1m( Orange, N J '..
Richmond, va
1
l^Ang^]^ Cal
•
MEASLES.
See Diphtheria, meaeles, scarlet lever, and tuberculosis, page 1094.
PELLAGRA.
CaHfomia Report for May, 1917.
During the month of May, 1917, three cas3s of pellagra wore
reported \a California: one case each in San Bernardino County, out-
side of San Bernardino, one case in San Bernardino, and one case in
San Diego.
Oty Reports for Week Ended Jme 16, 1917.
Place.
Cases.
Deaths.
Place.
Coses.
Deaths.
9
1
Nashville, Terai
3
Gbarleston,S C
New Orleans, La
1
2
fSMtoea, Ma<w
1
Norfolk, Vft
1
H Paso, Tex
1
1
1
1
3
Savannah, Oa
4
1
Port Wirth, Tex
Somerville. Mass
1
1
1
2
ImichlMire,' Va.
Taunton Mass
Wemph^ff, ^Min.
Washington, D. C
lCobife,X]m.
WUmington, N. C
PLAGUE,
CftUfomia — Alameda County — Plague-Infected Squirrels Found.
Passed Asst. Surg. Williams reported that during the period from
June 13 to 23, 1917, eight plague-infected ground squirrels were found
in Township 2, within a radius of 6 miles to the east and northeast
Digitized by VjOOQIC
July 6, 1917
1088
PLAGUE— Continued.
of Altamont, Alameda County, Cal. One of the infected squirrels was
found on the Amelia Webber ranch, one on the Annie Owen i:anch,
one on Flynn Brothers ranch, three on the Frank Floyd ranch, one
on the John Egan ranch, and one on the M. J. Crocker ranch.
California — San Benito County — Plague-Infected Squirrel Found.
Passed Asst. Surg. Williams reported that on June 19, 1917, a
plague-infected ground squirrel was found on the B. D. Sindel ranch,
3 miles southeast of Paicines, San Benito County, Cal.
PNEUMONIA.
City Reports for Week Ended June 16» 1917.
Place.
Baltimore, Md
BinghamtOD, N. Y
Boston, Mass
Braddock, Pa
Brockton, Mass
Chelsea, Mass
Chicago, 111
Chicopee, Mass
Clevelanq. Ohio
Dayton, Ohio
Detroit, Mich ^
Dubuque, Iowa
J)uluth, Minn
Fall River, Mass.:
!• itchburg, Mass
Flint, Mich
Haverhill, Mass
Jackhon, Mich
Kalamazoo, Mich
Kansas City, Mo ,
LawTence. Mass
Los Angeles, Cal
Cases.
Deaths.
4
n
2
25
8
4
1
3
2
HO
68
1
22
23
3
2
8
16
1
1
5
1
3
1
1
1
5
3
1
1
C
1
10
1
7
8
Place.
Cases.
Deaths.
Lowell. Mass
1
2
1
2
1
i
3
2
59
Lynn, Mass
Milden, Mass
"•
Manchester, N. H
2
Medford, Mass
Meln^e, Mass
1
Newark, N.J
3
New Bedford. Mass
2
Pasadena, Cal
Philadelphia, Pa
26
Pittsburgh. Pa
Pittsfield, Mass
^t
16
Reno, Ncv l
Rochester, N. Y < 12
San Diego, Cal ' 1
San Francisco, Cal ' 3
Saginaw, Mich 1
3
1
3
Sandusky. Ohio ' 2»
Sc-henectadv, N. Y i 4
2
South Rethlchem, Pa 1
Springfield, Mass ' 5
Worcester, Mass ' 4
4
POLIOMYELITIS (INFANTILE PARALYSIS).
Ohio— Belmont County.
The State Board of Health of (31iio reported July 5, 1917, the ocwiT^
renco of 17 cases of pohomyehtis in Belmont County, Ohio; 11 of
them at Martins Ferry and 6 in Tease Township.
Stote Reports for May, 1917.
Place.
Xcw cases
I reported.
California:
Kanta Crur County-
Santa Cruz
1
Tulare County
1
Total
2
Indiana:
Jackson County
1
Iowa:
C-arroll Coiiiitv •..
1
Fayel tc County
1
Total
2
riace.
New cases
I reported.
New York:
Dull licss County
Eric County
Fulton County
Saratoga Comity
lister County
Westchester County
New York City
Total
10
10
Digitized by VjOOQlC
1089
July 6, 191T
POUOMTELrnS (INFANTILE PARALYSIS)-<:k)ntlnued.
Oregon Bepori for April, 1917.
During the montii of April, 1917, one case of poliomyelitis was re-
ported in Clackamas Comity, and one case in Portland, Oreg.
City Reports for Weeic Ended Jane 16, 1917.
Place.
Cases.
Deaths. 0 Place.
Cases.
Deaths.
BnMwl:, Ffr......,-.T
1
1
fl 1x18 Anceles, Gal
1
TfiiflUo « . T
::..;::.:. NwarklTj^::::::::::...:
fMrm ni
:... New York. N. Y
nmAiati, Alifi>
Port«^mmith* N, TT
T^rrnw*. wh
SpringOeld, kass
1
Lima Ohio
1 U 'mntoo,N. J
RABIES IN ANIMALa
City Report for Weelc Ended June 16, 1917.
During the week ended June 16, 1917, one case of rabies in animals
was reported in Detroit, Mich.
ROCKY MOUNTAIN SPOTTED FEVER.
Nevada.
During the period from June 1 to 20, 1917, cases of Rocky Moun-
tain spotted fever were notified in Hmnboldt County, Nev., as fol-
lows: One case each at Winnemucca, Rebel Creek, and VThiskey
Creek.
Wyoming Report for May, 1917.
During the month of May, 1917, one case of Rocky Mountain
spotted fever was reported in Gillette County, one case in Carbon
County, one case in Sweetwater County, three cases in Natrona
Chanty, and two cases in Washakie County, Wyo.
Oregon Report for Aprfl, 1917.
During the month of April, 1917, one case of Rocky Mountain
spotted fever was reported in Grant County and one case in Jefferson
County, Oreg.
SCARLET FEVER.
See Diphtheria, meades, scarlet fever, and tuberculosis, page 1094.
SMALLPOX.
Arizona — ^Douglas — Virolent SmaHpoz.
Acting Asst. Surg. Adamson reported that during the period from
May 21 to June 25, 1917, 46 cases of smallpox, with 10 deatlis, were
notified at Douglas, Ariz.
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July 0, 1017
1090
SMALLPOX—CofuUnued.
DHsoifl— Cairo.
Acting Asst. Surg. Barrows reported that during tho week ended
June 23, 1917, two cases of smallpox were notified at Cairo, IIL,
making a total of 31 cases reported since January 1, 1917.
Minnesota.
CoUaborating Epidemiologist Bracken reported that during the
week ended June 30, 1917, throe new foci of smallpox infection were
reported in Minnesota, cases of the disease having been notified as
follows: Bigstone Comity, Ortonville, 1; Renville County, Franklin,
1 ; Stevens County, Donnely Township, 1.
State Reports for May, 1917.
Now
cases re-
ported.
Vaccination history of cases.
Plaoe.
Deaths.
!
1
Number
novrr suc-
cessfully
vatiinaled.
VftO'inaiiou
b 1*^1 cry not
ohiMiri'Hi or
uniH Tt^in.
CuIifornU:
Aliini«*<lr\ Cotmty
1
1
3
1
AIujiuhIu
Iiiit^Ti^I Count v..
1
Kl (Viitro
Iah Ant'r!'"-* Count y—
I'dllloilU
4
1
I
Marin < <;nn:\ -
Saii^ali'o . .
'
San H<r itar'lino County
i (
1
I
Stilt t'l CUuii County ......
I
8ba'*ta(VMuity—
KtMlMiiij,'
1
1
1
SoUnoComuv—
Vallojo
1 1 ■
I
Total
16
14
2
New Yf»rk:
Ml iiwy County
8
3
2
1
2
1
1
13
1
1
5
3
1
3
Ch iiit.utouti Countv
1
I>ut( lic^N County
1
1
h'tic Ciiiint V
t
X
Mont k'omcry County
1
I
N;i*<.'sau Countv
1
Tiopn County
i
6
Wa'-hinj'ton County
1
«
Wcvtchp>t^r County ..•«..
1
New N'ort Citv . .
1
1
I
1
Total
33
1
3
17
12
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1091
SMALLPOX— ConHnued.
Miscdlaneons State Reports.
July e, 1917
PlAce.
Oases.
Deaths.
Place.
Cases.
Deaths.
Indina (Mav 1-31):
Macklord County...
Boaoe County
CkT County
mbartOountr.
Bflbntaln County....
Qibeon County*^
Qtant County
Qreeoe County
Hancodc County
Hendricks County. . .
Howard County
HunUx^ton County . .
JiMkion County
liy County
Knox County
Lacransc County....
Lakr County
Lapofte County
Lawrence County
Madison County
Marion County
Morgan County
^vkeCounty
Vokakl County
UipWy County
BmUvM Comty.
Tippectnoo County..
Tipwo County
Vanderburc County.
Vermilion County. . .
Vigo County.........
Wirren County
Wirrick County
Wells County
Total.
low* (May 1-31):
Adair County
Apponooso County..
AudufKW County
Benton County
Bhfkhawk County. .
CWhonn County
OmtoII County
Cedar County
Cerro Gordo County .
Cherokee County
^awford County....
Dalia* County
^ Moines (Wity. .
Jjjnklinc^wnty....
"Dtiirif County
g*Qll7tiin County...
Harrison ^^>nty —
^ttuyO^iy
JtHtiJoxi County....
36d
Iowa (May 1-31)— Continued.
Johnson County
Lee County
Linn County
Bfahaska County
Mills County
Mitchell County
Monona County
Osceola Coimty.
PageCxmnty
Plymouth County.
Polk County
PottawaHamie County.
Riuf^old County
Sac County
Scott County
Shelby County
Sioux County
Tama County
Van Buren County
Wapello County
Webster County
Winneshiek County
Woodbury County
Wright County
Total.
Nevada (May 1-31):
Humboldt County..
North Dakota (May 1-31):
Bowman C«uniy
• Biu-ke County
Foster County
(lOlden Valley County.
Orand Forks County. .
OriRits County
Hettinger County
McKenzie County
Morton County
Mountrail County
Nelson (3ounty
Pembina County
Bamsey County
Richland County
Stutsman County
Wells County
Williams County
Total.
Wyoming (May 1-31):
Campbell County
Sweetwater County..
Albany CJoimty
Total.
43
Oregon Report for April, 1917.
During the month of April, 1917, 23 cases of smallpox were reported
in Clatsop County, Oreg., and 4 cases in Portland, Oreg.
78
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Jaljr 6, 1»17 1092
SMALLPOX--Ck)utiniied.
City RepOTis f«r Week EMed June 16» 1917.
Pteee.
Ctms.
Deaths.
1 Ptooe.
Cms.
Deaths.
Akron, Ohio
13
1
1
3
1
1
2
2
2
9
1
10
1
2
1
8
1
3
1
3
2
3
3
2
1
1 Indianapolis, Ind
9
18
8
13
3
30
7
2
3
2
9
5
1
8
1
1
11
5
10
4
2
4
2
1
AlnmHft <>I
1 Kansas (^ty, Mo
Albimy, ^.Y
; Little Rock, Ark
Alton. lU
Memphis, Tenn
Ann Arbor. Mich
' Milwaukee, Wis
Braddock, Pa
Minneapolis, Biion
Butte, Moot
' New Britain, Conn
Cairo. Ill .
NewCa.stle, Pa
I'Anton, Ohio
New Orleans, La
(Tiitaj»o, 111.
New York, N. Y
Oklrtlioma City, Okla
Omaha, N©br
Cincinnati, Ohio
Cleveland, Ohio
CofT«n'ville, Kans
Pittsburgh, Pa
Cohmibus. Ohio
C^uiiicv, 111
Da\ ton, Ohio
Houuoke, Va
Denver, Coki
Ro.'k IslancL 111
Detroit, Mi(h
Si . Louis, Mo
Dubuflue, Iowa
Salt I>Jik<^Citv, Utah
Duluth, Mum
4
iSioox Cit V, Iowa
Elgin, 111 .. . ...
.siuiii^nord. Ill
Krie, Pa
SHnih*^n\ ilie. Ohio
Kvan«>ville, Ind
T;von».i, Wu li
FUni, Mich
Terro ll.i ite, Ind
Fort Wji>Tie, Ind
AVorfOslcr, Ma s
Grand Rapids, Mich
TETANUS.
City Reports for Week Ended June 16, 1917.
PlUA-C.
Bo<;ton, Mass
Cbariovton, S. C.
Ckn eland, Ohio.
Cases.
Deaths.
Place.
Cases.
l*ittslmTt:h. Pa..
Kirli-nond. Va..
Spnir;iicM, .Ma^-
Deaths.
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculoj^Ls. pa^'o 1094.
TYPHOID FEVER.
State Reports for May, 1917.
Place.
New
ca -t^ ; re-
p;rt(Ml.
Place.
Now
cases re-
ported.
California:
Alameda County —
Alanioda
1
1
12
1
1
2
1
1
3
2
1
, California -Continued.
Kiiitr-^ Cotinlv —
H^iftini;
1
Ua vward
Los .Vngele ; County
Alhanibra
3
Oakland
1
Cohvm c^oiinty ^ .. .
El Monte
1
Contra CostA County—
Pittsburg
Long Beach
1
Lo.; -Vngeles
8
Richmond
Monrovia
2
Fresno County—
Reedley
Pasadena
4
Watts
1
Imperial County
Monterey County
1
El Centro
Orange Oounty
1
Kern (^ounty —
Bakerslield
Fullcrtou
1
Placer Coimty—
Auburn
Delano
1
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Google
1093
July 0, 1917
TYPHOID FEVER— (%>nthuipd.
State Reports for May, 1917 -Contimied.
Plac«.
CttU/omJa- rontinued*
SacTftineuto Ccijjity—
SaiTamenlo
San Diego County-
Ban Diego
6^ Francisco
Stn Joaquin County^
Lodi
Stockton
Bsnta Clara County^
San Jose
Santa Clara
Tehama County-
Coming
Yolo County
Total.
XiidiaBa:
CaasCounty
Clark County
Delaware County ... .
Elkhart County
Fayette County
Howard County.. ., . .
Huntington County..
Jennings County
Lake County
Manor County
Owen County
Ripley (^ouHty.
St. Joseph Cotrnty . . .
Sollivanrouniy
Tipton ( 'ounty
Vanderburg 0)unty..
Warrick County
Wadiington County..
Wells County
Total.
Narada:
HombokltC^xmty.
New York:
Albany County
Allegany County
Cattaraugus County . .
Cayuga County
Chautauqua County.
Clinton County
New
cases re-
ported.
70
71
riace.
Now
I ca ■ .\s re-
port cd.
New York— CiPtinued.
('•Miiiil'i \i I uiUy
Diitvhos Cftinty
KrioC'Mmty
IJreeno County
Herkimer County
JelTersr.n County
Madison County
Monroe County
Montgomery County.
Niagara County
Oneida Coimty
Onondaga County
Ontario County
Orange County
Orleans County
Rensselaer County . . .
St. Lawrence County
Saratoga County
Schenectady County .
Schoharie County
Suffolk County
Sullivan County
Tioga County
Ulster County
Wayne Coimt v
Westchester (\)unty . .
Yates County
New York City
North Dakota:
Cass Coimty
Mclnt osh C oimty . . . .
Pembina Coimty
Ransom Coimty
Richland i'ounty . . . .
Stutsman t^ouuty
Ward County
Total
Wyoming:
Wash ikie Coimty
Uinta County
Fremont County
Albany County
Total
2
2
17
2
1
6
1
5
1
3
4
6
4
4
1
3
2
4
4
1
1
1
1
1
1
3
1
106
24
10
Oregon Report for April, 1917.
During the month of April, 1917, one case of typhoid fever was
reported in each of Clatsop, Jackson, and Wallowa Counties, Oreg,
City Reports for Week Ended June 16, 1917.
Piara.
AflgUn^Ttx
Baltimore. Md
B«iT«rF^Pa...
Birmingham, Ala..
BMton^lCan
BoflWo,N.Y
QMndan,N.J
Cblcaffo.m
Cases.
Deaths.
Place.
Cincinnati, Ohio..
Cleveland, Ohio..
ColiunbiLs, Ohio..
PanvilKIIl
Detroit, Mich
Diiliith, Minn....
El y&Ho, To\
I Everett, Ma-ss....
Everett, Wa-h . . .
Cases.
Deaths.
Digitized by
Google
July 0, 1»17
1094
TYPHOID FEVER— Continiwd.
City Reports for Week Ended Jvne 16, 1M7— Oontmued.
Place.
JUltvw, Mai: .. .
-^mt Mjx:]^
Fnrt \VVHb Tc't...
Ga]o&tHir& lU. . . .
GdveqtotJ, Ttj^
Iridifiniipolk. Ind. ..
JoJiti^jjwQ, i'a
Liiiidiliter, Pn.. .,..
LyGclibtiry. V'a
MormftiltiT win . . . , .
IJc^phii^p Ttiim
M^blfp, Alft...,. ,.
NU.Hbi,4Up. TeiDBL. - . .
Nf^wsttLj K. J*
Kew CasUc, Pa.
K&w Hai'iai, Oonn..
New OrleftM^ La . .
Him York^, Y . . .
HbrrrlsUifm, Fa,
Omi^er K J
Deaths.
Place.
Pasadena, Cal
Passaic, N. J
Philadelphia, Pa
Pittsburgh, Pa
Providence, R. I
Quincy, III ^
Reno, NeT
Roanoke, Va
Rutland, Vt
St. Louis, Mo
Salt Lake City, Utah.
Sau Franci^i o, Cal
Sacramento, Cal
Savannah, (Ja
South Bend, Ind
Springfield. Mass
Superior, Wis
Toledo, Ohio
Trenton, N.J
Washington, D. C...
Wilnungton, Del
Winston-Sttlem, N. C.
Cases.
Deaths.
DIPHTHERU, MEASLES, SCARLET FEVER. AND TUBERCULOSIS.
State Reports for May, 1917.
Cases reported.
State.
Cases reported.
State.
Diph-
theria.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
California ...
228
197
32
4.011
3,908
422
443
194
8
1
Now York
1,606
23
1
11.446
221
356
1,779
Indiana
! Nort'i Dakota
Wyoming
48
Iowa
65
Nevada
43
Oregon Report for April, 1917.
During the month of April, 1917, 9 cases of diphtheria, 688 cases of
measles, and 112 cases of scarlet fever were reported in Oregon.
City Reports for Week Ended June 16, 1917.
Popula-
tion as of
Julv 1,1910
(estimated
&?•
Bureau).
Total
deaths
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
from
all
causes.
1
Q
i
1
i
i
s
p
1
1
Over 500,000 inhabitants:
Baltimore, Md
589.621
756, 476
2,407,722
674,073
671.784
508,812
5,602,841
1,709,518
579,090
767,309
177
227
ftSl
196
189
"i,'36i"
497
136
200
3
91
96
36
98
6
241
58
16
67
1
8
24
2
11
a
20
10
2
4
233
238
755
85
36
142
1,089
280
213
95
3
2
6
'"3'
1
26
3
2
10
23
3«7
17
63
5
116
33
16
74
1
......
"■3*
"2
49
72
227
3d
27
33
343
95
31
48
27
Boston, Mass
24
Chicago, 111
«7
Oleviland, Ohin,
18
Detrait,Mich
2S
hm Angeles, Cal
21
New York, N.Y
179
Philadelphia. Pa
70
Pittsburgh, Pa
6
St. Louis, Mo
0
Digitized by
Google
1095
July 6, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Jane 16, 1917— Continued.
Popula-
tion as of
July 1, 1916
(estimated
by U.S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
lever.
Tuber-
culosis.
City.
27
13
8
12
1
1
1
2
......
'i'
Q
i
1
From 300,000 to 500,000 Inhabit-
ants:
Buffalo,N. Y
468.558
410,476
306,345
436,535
363,454
408,894
371,747
463,516
363,980
214,878
260,800
271,708
297, 847
295,463
254,960
256,417
104,199
181,762
121,579
106,233
127,224
128,366
104,562
128,291
110,900
100,3)
113,24.5
102,425
148,995
117,057
118,158
149,685
198,604
165, 170
109.381
156,687
117,390
105,942
155,624
112,770
191,554
111,693
163,314
85,625
63,505
58,65©
57.660
69,893
57,653
53,973
67,449
60,852
60,734
57,144
94,495
86,690
63,705
75,195
76,078
54,772
76,183
72,015
77, 21 4
68.529
99,437
207
121
82
120
"iiV
""m
97
66
84"
44
70
76
88'
29
"'2
2
2
55
43
62
118
40
59
2
63
10
iJ
59
15
16
2
12
4
8
8
10
14
11
3
16
6
1
4
2
16
1
3
1
2
3
1
1
5
' i*
46
25
13
20
28
OfnrinnAtl^ Ohio , , , .
14
JersevCitv, N. J
Milwaukee, Wis
Minneapolis , Minn
20
16 1 2
7 1
Newark.N.J
44
30
18
22
7
12
New Orleans, La
21
San Francisco, Cal
9
9
17
2
Washington, D. C
160 '
From i200,0db to 390,000 inhabit*
ants:
Columbus, Ohio
6
38
129
23
10
14
189
30
46
18
16
42
"*3*
t
Denver, Colo
6 '
23
5 ,
9 1
12
Indianapolis, Ind
......
'i*
30
1
12
50
16
8
21
3
3
4
11
Kansas bi ty ,' Mo , ,
10
Portland, (3reg
Providence, R.I
11
5
3
2
1
Rochester, N. Y
From 100,000 to 200,000 inhabit-
ants:
Albany, N . Y
Birmingham, Ala
10
Bridgeport, Conn
6
2
CainUen,N.J
Dayton, Ohio
38
31
21
36
45
21
28
22
41
27
33
63'
49
26
41
19
36
49
74*
36
33
26'
■ ■■2'::::::
2
Fall River, Mass
3
76 j 2
Fort Wortn.Tex
2
Grand Rapi'ls, Mich
Hart lord , Conn
1
9
1
6
1 61
1 1 22
i2
3
6
2
4
15
5
9
5
2
2
Lawrence, Mass
•S
Lowell, Ma-js
6l
2
Lynn, Moss
?::;:::i I
2
li^mphis, Tenn
7
Nash\ ille, Tenn . .
1
4
3
3
New ned/orJ,Mass
.K)
4
New Haven, Conn
'
120
1
Oakland. C^il
12
58
.]
3
Omaha, i^ebr
i
6
Reading, Pa 1.
9
5
4
1
Richmond. Va ... , .
..
8
Salt Lake Cltv, Utah
1
18
2
1
8
2
6
24
1
4
* '4*
5
44
39
......
15
10
11
1
24
1
4
7
3
Syracuse N Y
4
Qraooma 'Wash
CTcdedo, bhio
1
46
7
18
U
'
2
1
8
7
4
Trenton, N.J
4
Worcester, Mass
1
From 50,000 to 100,000 inhabit-
ants:
Akron, Ohio
Allentown, Pa
4
8
1
5
Altoona,Pa
4
42
Atlantic City, N. J
Baycmne, N.J
4
1
3
7
1
" Berkeley, Cal
14
U
10
17
29
12
25
• 23
63
1
49
2
4
2
......
......
Binghftintftn, N. Y
i
4
2
3
1
5
1
2
Brockton. Mass
Canton, Ohio .
1
3
Charleston, S. C
4
Covington, Ky
1
3
6
1
Duluth, Minn
1
32
1
2
4
1
1
Elizabeth, N.J
4
El Paso, Tex
7
9
7
20
27
18
24
25
6
3
8
Erie, Pa
6
1
22
ic-vnii<t7fne, Tnd X .
is
12
12
18
15
25
3
5
4
2
4
2
-L- J J.
2
17
4
1
2
Hi
......
1
FMntJMldi
Fort Wayne.lnd
1
2
Harrisbirrg, Pa
2
Hoboken,^^. J
SrSr
2
T 3
2
76hnstown, Pa
1
Kansas City, Kans.
J nr^eo uy x^j v^ ^^^ "-^^
Jul? e, i»iT
1096
DIPHTHERIA, MEASLES* SCARLET FEVER, AND TUBERCULOSIS-
Oontinued.
€hy Reports Hk Week Bii4«4 Jwie 16, 1917~0ontinued.
Popute-
tion as of
July 1, 1916
(estimated
by U.S.
Censua
Bureau).
Total
deaf^
from
all
CftUSCS.
DtphtherlB.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
1
1
P
i
1
1
From 60,000 to 100,000 Inhabit-
ants—Continued.
60,853
57,343
51, l.'i.'i
78,283
68,221
58,794
89,612
92,943
71,744
59,411
63,867
55.18.5
00,895
55,042
53,330
68,805
90,519
57,078
87.039
68,946
61,120
ae,0R3
77.916
70,722
70.776
94,26.5
51,656
27.732
37.3H5
34,814
32.730
27,632
. 43, 425
46, 192
29,319
26,074
32. 261
39.873
28, 7«
42, -IM
28,203
39, 233
35,486
41,781
41.SH3
25, H79
40, 4yti
48. 177
35.368
48,SS6
31,576
26,771
38,676
31,677
41,097
35,3«y
46, 515
27, ?tS7
36,9^
32,9-10
30,699
47, 521
26,234
26,318
27,327
29,603
41,133
30,108
ii*
8
38
31
12
1
25
4
41
6
5
1
4
1
3
3
3
Little Rock, Ark
MftMon Mf^sH , .
9
1
1
2
Miuiph'^Vw, N, tf
2
Mobile, Ala'
1
1
"
3
Nflw Piitain, Conn
8
3
Norfolk, Va.'
4
6
Oklahoma City, Okla
13
16
12
15
16
19
ao
21
33
17
1
18
24
14
17
1
6
4
2
1
1
1
•pftss^ir» N J ■"
4
3
Pawtucket, R. I
2
1
3
Portland, Me
23
35
7
2
67
10
40
1
2
Rockford,lll
Sacramento. Old.
5
1
4
3
4
Saginaw, Mich
4
SanDiojro, Cat
1
Savannah,' Ga
1
1
2
Scheuectadjr, N. Y
2
4
1
8
2
4
Sioux City,'towa
Somervillc, Mas'?
4
1
20
26
9
6
19
1
63
7
6
4
South Brud.Ind
3
Springfiel;],IIl
1
Terre Haiitp, Ind
1
2
*** i*
3
Trov, N. Y....
4
4
3
2
4
2
3
2
2
13
Wicliita, Kans
"Wilkes-Barre, Pa
12
28
3
9
14
6*
1
16
4
6
6
3
4
I
6
8
16
Wilmington, Del
3
1
York, Pa
From 25,000 to 50,000 inhabit-
ants:
A lameda, Cal
3
Aubiu-n, N. Y
. 1
1
2
1
1
4
1
;
3
2
Austin, Tex
1
2
4
Brooklme, Mass
;;;;;;
8
1
4
8
1
6
6
1
11
Wutlor, Pa
Butte, Mont
9
1
Chelsea, Mass
5
1
4
1
Chicopce, Mass
Cumberland, Md
1
Danville, III
1
2
3
0
Dubuaue, Iowa
1
1
1
1
East Cnicago, Ind
2
East Orange,N. J
40
3
a
1
Elgin, lU :...
1
4
3
20
Everet t, Mass
1
Everett, Wa-h
2
2
Fltchbiirg, Moss
9
Galveston. Tex
2
Haperstown, Md
.../.'.""
1
Hamilton, Ohio
6
11
13
12
8
4
1
2
1
1
2
a
1
1
1
Haverhill. Mass
;;;;;;
41
5
2
2
1
Jackson, Mich
Kiianiar«o. Mich . .
90
1
Kenosha, Wis
41
4
1
2
1
1
King<:fnn, N Y ,
Binorrilte, Tenn
3
3
Lii Cross*, Wis
3
18
9
13
5
6
1
1
Lexington, Ky
8
4
14
8
1
18
3
1
U
4
8
3
1
1
2
T^mn, Ohio
1
IJncoln, N«*b«*
1
2
Long B«ach, Cal
Ijorfun, Ohio
3
1
4
1
LynchSurff, Va
18
0
flidiff^n. WiTi
MeKeesDort, Pa
7
4
6
ft
7
io
1
2
1
Mtd/offf Mnn^
1
3
1
libntclair, N. J
N^5d»n» T* FT
Newburgh,N. Y
1
1
1
1
4
1
NiwCartIe.Pa
Newport, K.I
Digitized by
Google
1097
July (J. 1917
DIPHTHERIA, MEASLES, SCAKLBT FEVER, AND TUBERCULOSIS-
. Gontinued. *
City Reports for Week Ended June 16, 1917— Continued.
Popula-
tion as of
July 1,1916
(estimated
bv U. 8.
Census
Bureau).
Tote!
deaths
trom
all
causes.
Diphtheria.
Measles.
Bcarlet
fever.
Tuber-
culosis.
aty.
1
1
1
1
1
i
1
1
1
Tram XLOQO to 100,000 Inhftbit.
ants— CoDtinaed .
Mewton.Mass
4S,715
37,353
31,401
31,404
33,080
40,450
41,185
38,629
39,651
36,798
38,136
46,486
43,2ai
28,926
27.445
46,226
30,283
48.726
30,570
29,891
43,139
43,377
29,892
31,15.>
30,803
22,874
15,010
13. '.32
13.599
21,&H.5
15, 794
» 13.075
17,518
22,t.cq
20,743
24,276
16,950
23,539
20,930
15,395
114,610
17,445
13,284
17,500
23,126
15,243
20,985
122,019
19,926
23,805
11,666
14,869
12,067
14,831
20,193
13,821
24,2(M
21,618
15,969
7-
10
7
0
0
10
10
7
14
13
6
6
13
11
8
5
8
8
1
4
ao
31
2
3
4
\
42
6
3
2
2
2
1
Niasara Falls. N. Y
2
Norristown, Pa
Ogden, Utan
1
3
7
Orange, N.J
1
1
3
2
Pai»Jeiia, Cal
1
Perth Aniboy, N. J
i
1
Pitf^fiAl<1, Mas^
i
5
1
PortAOMoth, Va
Quincy, Mass
2
3
2
3
1
Rxianoke, Va
3
5
5
1
R<M*Ts1»Tiit m
2
Bteobanville', Ohio
•
Sopericr, Wis
3
.......
:::::::::::
Taimton{lifas9
1 :
2
2
TnppVn , ICans. , . . ....
G
19
9
9
3
3
3
2
3
40
Walthain, Ma«
1
1
Watertcrwm.N. Y
W&tt Hoboken, N.J
Wheeling, W. Va
6
12
17
15
1
5
3
Wilmington, N.C
1
2
1
Winston-Salem, N. C
4
3
Zanesville, Ohio
From 10,000 to 25,000 inhabit-
ants:
Alton. Ill
3
8
4
6"
4
M
2
1
4
1
Ann A rbor . Mich
1
Bea\ er Falls, Pa
1
1
Berlin, N.H
!"■;;:
1
3
Braddock, Pa
1
7 i-
1
Cairo, ni
1
9
1
40
1 i
Clinton. Mass
1 : ' :
CofTevWUe, Kans
""2
.'./...
1
1
Concord, K. H
1 1
Dunkirk, N.Y
11
32
9
12
1 1
Oalesbunr.Ill...
7
2
!
Harrison, N.J
2 '
Kearny, i^. J
6
2
1
4
4
4
,.
1
KoJconu), IxtA
2
1
2
Lonj( Branch, N. J
6
Mftrfjiptf^, Wis
2
Melrose, Mass
3
6
2
Morristowp. N. J.
Muscatine, towa
1
Nantlcoke,Pa
8
4
0
7
5
4
' 7'
0
8
1
Newburyport, Mass
1
.1
5
North .\dains, Maw.
Northampton, Mass
....
2
0
1
PlainOfllff N J .
.....!..:::;
PortSBontfa N. H
1
1
2 '
2
1
Rime, Nut..,
Rocky Mount, N. C
3
3
0
Rutland, Vt.!..
1
Pandi^sVy. Ohio
Saratoea'dprings, N. Y
South Bethlehem, Pa
....
2
3
10
1
1
Wft!|h|figtnn, Pft
4'
1
Woburn, Mass
I Population Apr. 15, 1910; no estimate m«d«.
Digitized by
Google
FOREIGN.
CORRECTION.
Tho report of epidemic prevalence of cerebrospinal meningitis
at Chihuahua, Mexico, appearing in the Public Health Reports,
Jime 22, 1917, page 1000, has been officially stated to be erroneous.
CUBA.
Commiinicable Diseases — Habana.
Communicable diseases have been notified at Habana as follows:
f
June 1-10, 1»17.
RemAin-
ing under
Disease.
Now
cases.
Deaths.
treatment
June 10,
1917.
Diphtheria
7
1
13
lu^prasv -
10
Mahirid
6
31
34
MOL slcs
36
Pftrat vphoid fever
3
Typhoid fever
14
49
Varicella
4
CHOLERA, PLAGUE, SMALLPOX, AND TYPHUS FEVER.
Reports Received During the Week Ended July 6, 1917.^
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Rangoon
Apr.29-May5
6
3
PLAGUE.
Ceylon:
Colombo.
Chinas
^oy
Egypt..
Prordno
jieh.,
Siout
India:
Mftdras Presidency. .
Rangoon
May 6-12
Apr. 29-May 5..
May 12-17..
May 11-17..
May 17
M&y 12-15..
May 12
May 6-12
Apr. 29-May 5..
Present and in vicinity.
Jan. 1-May 17, 1917: Cases, 231;
deaths, 116.
1 From medical officers of tlie Public Health Service, Airerican consuls and otlier sources. For reports
received from Dec. 30, 1916, to June 29. 1917, .see Public H xilth Reports for June 29, 1917. The tables oC
' epidemic disease are terminated semiannually and new tables l>egun.
(1098)
Digitized by
Google
1099 , July 6, 1917
CEOLERA, PLAGUE, SMALLPOX, AND TYPHUS FEVER— Continued.
Report Received During the Week Ended July 6, 1917— Continued.
SMALLPOX.
Place.
AostraUa:
New South Wales
Brewarrina
Quambone
Queensland-
Thursday Island Quar-
antine Station.
Canflda:
Manitoba-
Winnipeg
Nova Scotiar—
Port Hawkesbury..
Ceylon :
Colombo
CTiina:
Amoy
Chungking
Harbm
Ilongkong
ICaschuria Station ....
M.uJcden
Sbanfbai ,
Tsitshar Station
Tsinjjtao
Date.
Apr.27-Mayl0.,
do ,
May 9.,
Alexandria
India:
Madras
Rangoon
Portu^:
Lisbon
Rus»a:
Riga
Vladivostok
Turkey in Asia:
TrcliTond
Union of .'^outh Africa: •
Johannci-burg
June 10-16.,
June 17-23..
May 6-12...
Apr.
May
Apr.
May
Apr.
May
May
Apr.
May
29-May5..
6-12
23-May6..
6-12
23-29
20-26
H-30
16-22
22-29
Apr.30-May27..
May 6-12
Apr. 29-May 5.
May 13-26
Mar. 11-May 5..
Mar. 15-21
Feb. 25-Apr. 13.
Mar. 12-24
Cases.
Deaths.
Remarks.
Apr. 27-May 10, 1917: Cases, 6.
From s. s. St. Albans from Kobe
via Hongkong. Vessel pro-
ceeded to Townsville, Bris-
bane, and Sydney, in quaran-
tine.
Present in district.
Present and in vicinity.
Present.
On Chinese Eastern Railway.
Do.
Present.
On Chinese Eastern Railway. At
another station on railway, 1
case.
Jan. 1-31, 1917: Cases, 7.
TYPHUS FEVER.
China:
Tsingtao
Alexandria...
Russia:
Riga
Vladivostok.,
May 20-29
Apr.30-May27.,
Mar. 29-Apr. 4 .
1
830
232
Jan. 1-31, 1917: Cases, 1.
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PUBLIC HEALTH REPORTS
YOE.32 JULY 13, 1917 No. 28
TRACHOMA AND THE ARMY.
THE DANGERS INCIDENT TO ENUSTING RECRUITS AFFECTED WITH THE DISEASE.
By John McMullkk, Surgeon, Unitad States Public Health Service.
Now that our country is engaged in raising a great army; it is our
duty to prevent the admission to the Army of recruits who may
spread disease.
The history of European wars shows that trachoma has been a
grave menace to the efficiency of the fighting forces* invaliding
thousands of men and bUnding hirge nimibers of its victims. So
great has* been the prevalence in the armies that trachoma was at
one time termed "military ophthalmia'' and believed to be confined
to soldiers. Various articles of their equipment were condemned as
being the cause of the disease.
Trachoma has been said to be ''as old as the Nile, the simoom, and
the desert.'' It has an historical importance as an epidemic disease
of both military and civil life and has made fearful ravages in prac-
ticaUy every European coimtry.
Despite the confusing and contradictory statements in connection
with trachoma, the contagious character of this disease is unques-
tionable.
During the first half of the nineteenth century 1 soldier in every 5
of the Belgian Army is said to have suffered from trachoma. It is
alleged that upon the recommendation of a noted authority at that
time the trachomatous soldiers were discharged from the army to
their homes. This procedure cleared the army of trachoma at that
particular time, but carried the disease directly to the homes and
the civilian population, where it •previously did not exist. This
removed all doubt as to the contagiousness of trachoma, which at
that time was denied by some, and subsequent cases in the army
werfe isolated in special hospitals, which caused a diminution in the
disease.
It is stated that in some countries there were frightful epidemics of
trachoma, and that the English, Prussian, Russian, and other armies
suffered from the ravages of this disease.
79 (1101)
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July 13, 1917 1102
During the Russo-Japanese War trachoma was a formidable enemy
to be reckoned with in the Japanese Army and large numbers of
troops were isolated and treated for this malady.
Some months since it was reported that an epidemic of trachoma
was causing considerable anxiety in France, the disease haying been
brought to that country by African soldiers and laborefs. In tlie
army the disease was checked l)y the quick isolation of all victims
and other drastic measures. Among the civiUan population, howler,
the epidemic was still spreading, especially in the larger cities, and
the health authorities were taking every precaution. All persons
whose eyes showed any inflammation were examined by specialists
and isolated if suspicious.
Statistics from the medical inspection of aliens at United States
ports indicate that trachoma is found most extensively among the
Syrian, Armenian, Hebrew, Italian, Polish, and Greek races. Trar-
choma, however, extends more or less over the whole world and
exists in many places in the United States as an endemic disease.
Lasting aslt does for years, it is a constant irritation and discomfort to
the patient, impairing his earning capacity and efficiency as a work-
man and soldier, ruining the life and happiness of entire families
and finally terminating in many instances in total blindness. After
nearly a lifetime of misery the patient is often seen dwarfed in mind
and warped in body with the trichiasis, entropion, and other sequelae
still remaining to harass and irritate the now sightless eyesc
Several years ago the Pubhc Health Service instituted an investi-
gation into the prevalence of trachoma in the United States. Inves-
tigations were made among the Indians, and the residents of the
Appalachian Mountain range and other sections of the country.
The Indians were found to be almost universally infected and on
some reservations 90 per cent had trachoma. This survey showed
that the disease exists more or less throughout '* Appalachian
America" and, in some portions the infection was found to be as
high as 10 to 12 per cent of the population and in some communities
oven a higher rate of infection was found. In sections of Minnesota
trachoma was found. The disease is also reported from Ohio,
Indiana, Kansas, and other States. In fact, it is found to be widely
distributed in om* country. It is not an imcommon thing to see
in one family several generations with trachoma. So prevalent
and widespread is the infection in some sections of the United States
that the Pubhc Health Service has estabhshed and maintains in
those sections six ophthalmic hospitals for the treatment of tra-
choma, which is classed by the Government as a dangerous contagious
disease.
These hospitals have now been in operation for several years and,
during the past year, a total of 19,530 patients were treated; 1,880
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1103 Jaly 13. 1917
patients were admitted to the hospitals and 1,687 operations were
performed. Of this number, 1,153 were under local and 534 under
general anesthesia. The records show that at least one-half of our
trachoma patients have impairment of vision, ranging all the way
from slight defects to total blindness. Ulcer and corneal opacity
occur in 25 per cent of the cases; pannus is present in 20 per cent; and
photophobia was recorded in 33 J per cent; entropion and trichiasis
in 10 to 15 per cent of the cases. Entire famihes are found suffering
from trachoma, including both extremes of Ufe.
The diagnosis of trachoma is still based on cUnical evidence,
since the causal organism is as yet unknown. Diagnosis, therefore,
is in many cases difficult. There are many cases which are found
only by careful examination as but few if any symptons may be
piesent at the time of examination and the condition may be said
to be latent or dormant. Sooner or later, however, by reason of a
foreign body or other excitant, there arises a condition analogous
to- acute granulations with the watery secretion so characteristic of
the disease and the other famihar symptions. In this stage the
disease is highly infectious.
Trachoma is transmitted from the sick to the well by the secretion
which is conveyed to the healthy eye by means of such infected
articles as towels, handkerchiefs, bed linen, etc.
Like most communicable diseases, trachoma spreads where people
are crowded together, as in barracks, penal establishments, orphan
asylums, etc.
Armies originally get trachoma from the infected civil population
in the areas from which recruits are accepted, and give it back to the
people, often with interest, when men are discharged who have served
their enhstment or become incapacitated.
Trachoma is essentially a chronic disease, and untreated lasts ordi-
narily the better part of a hfetime. It is a surgical affection and,
if anything hke satisfactory or permanent results are to be obtained,
it must be by properly and skillfully conducted surgical proceedings,
and, in many cases, hospital care.
With the proper surgical procedure followed by the after care and
treatment, any case of trachoma can be cured, the length of time
required to effect a cure depending upon its duration, severity, and
other factors. In children, when seen early, the disease is usually
readily eradicated and they can return to school in a short time.
While occasionally cases of trachoma continue for years with but
comparatively small damage to the cornea, others produce corneal
compUcations early and persistently and the eye is lost in a short
time.
The results that are being obtained in the 6 Public Health Service
trachoma hospitals are exceedingly satisfactory. Durin^^ the past
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Jnly 13, 1917 1104
fiscal year about 1,500 cures have been effected. Adults who have
suffered from trachoma for years and were dependent upon their
friends or the county for support, some being inmates of the
poorhouse, have been reUeved, are no longer foci of mfection, have
taken their places in the community, and are earning a hvelihood for
themselves and family. Children unable to attend school because of
the constant physical suffering and impaired vision are now securing
the education which would have been impossible but for timely
interference.
There is no lack of evidence that we have a great deal of trachonna
in this country, and that it is a public health problem to be dealt with
before the disease establishes foci everywhere.
As previously stated, trachoma often exists in a latent or dormant
stage, and there is grave danger that recruits may be enlisted su^iar-
ing with this disease unless the greatest rare is exercised.
The eyehds of all soldiers and apphcants for enlistment should in
every instance be everted, the examination to include the retro-
tarsal fold, and the condition of the membranes noted in a space
on the blank form reserved for this purpose. If the eyelids are not
smooth and pink, if there is any redness or secretion, especially in
the retrotarsal fold, such cases should be segregated for examination
by those trained in the diagnosis of trachoma. An apphcant who
is found to be suffering with a weD-marked trachoma, should not
be immediately rejected, but should be given treatment and his
trachoma cured. He can then be again examined to determine
whether ho has resulting visual defects suflicient to cause his rejec-
tion. In this way a case of contagious disease will be ehminated
and probably a good soldier gained.
Any case of trachoma or suspected trachoma detected among
soldiers or sailors should be immediately isolated under care and
treatment imtil cured or until the suspected diagnosis is found to
be in error.
POLIOMYEUTIS IN JAPAN.
The following information regarding the occurrence of poliomye-
litis in Japan has been furnished by the American consul general
and was obtained through the courtesy of the Japanese authorities
and medical men. While the data are essentially fragmentary, as
is true for this disease in most countries, they show that poliomyehtis
has been present in Japan and in a measure the degree of the
prevalence.
Reports made to the section of pediatrics of the Fourth General
Congress of the Japanese Medical Association give the following frag-
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1105 Jaiy i:{. 1917
mentary information regarding the prevalence of poliomyelitis in
Japan:
FvJcuoka Prefecture. — ^During the period from 1904 tx) 1913, 243
cases of poliomyelitis were admitted to the pediatric clinic of the
Imperial University. Most of the cases were of children of from 1
year to 2 years of age. The disease prevailed most severely during
the month of May.
Kagawa Prefecture. — In 1913 a small epidemic occurred, chiefly
affecting children.
Kumamato Prefecture. — ^An epidemic of poliomyelitis with 28 re-
ported cases occurred in 19 12, the greatest prevalence being in May
and June.
Kyoto Prefecture. — Since the year 1911 poliomyelitis has prevailed
sporadically but on a small scale and within a restricted area. The
greatest prevalence has been observed in June and July. Children
of from 1 year to 2 years have been found most susceptible to the
infection.
Kyushu Prefecture. — No severe epidemic has been reported.
Niigata Prefecture. — From March, 1912, to the close of 1913, 22
cases of poliomyelitis were treated at the Niigata Medical College.
Most of these cases were in children between the ages of 1 year and 2
years. The greatest prevalence was during the period from April to
August.
Okayama Prefecture. — In 1912 an outbreak of poUomyelitis oc-
curred, the period of prevalence being the months of May and June.
More than 500 children were attacked and a comparatively large
number of cases occurred among adults.
Tokyo. — During the past 26 years 449 cases of poliomyeUtis have
been diagnosed at the Imperial University. The disease prevailed
most severely during the months of June, July, and August, and among
children between 1 year and 2 years of age.
In July and August, 1916, five cases of poliomyelitis were notified
in Japanese and foreign children at the summer resort of Karuizawa.
EXPERIMENTAL TYPHUS FEVER IN GUINEA PIGS.
A DESCRIPTION OP A SCROTAL LESION IN GUINEA PIGS INPECTED WrTH MEXICAN
TYPHUS.
By If. H. Neill, Passed -Assistant Surgeon, United States Public Health Service.
It is well known that the intraperitoneal inoculation of guinea
pigs, with 2 to 4 ec. of blood containing the virus of typhus fever,
is followed by a rather characteristic elevation of temperature which
will be observed about 10 days subsequently. Not many descrip-
tions of pathological changes as a result of the above procedure have
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July 13, 1917 1106
been reported. Baehr and his coworkers consider certain changes
in the spleen, "wliich is enlarged and congested, with its maliMghiaa
bodies prominent,'^ * as typical of typhus fever in the guinea pig.
Aside from the above, most workers seem rather to have insisted on
tlie absence of gross lesions, due to the typhus virus, in these experi-
mental animals.
The striking similarity, in many respects, of typhus fever and
Rocky Mountain spotted fever, led to the examination of the scro-
tuins of typhus-fever guinea pigs, since very definite lesions of the
scrotal tissues are almost uniforndy present in the former disease.
These changos have been described by RicT^etts 'and other workers.
While the observations recorded in this paper luive been in progress
there has been ample opportunity for comparative study, as a strain
of Rocky Mountain spotted fever has been carried on by traaster
from guinea pig to guinea pig.
Lest there be any possibility of misunderstanding, it seems (k^ir-
iihle to state that the nonidentity of the two diseases has apparently
bc(Mi thoroughly established by immunological studies.
The guinea pigs on whicli tlie observations were based were
those inoculated with Mexican typhus directly from human cases
or from other guinea pigs or monkeys in which the strains of Mexican
ty[)hus were being propagated. The ol>servations were made
during 19H) and 1917.
A series of guinea pigs infected with a strain of the so-called
''endemic typhus ' or I^rilPs disease, which had been propagated in
monkeys and guinea pigs for several yeaiN, was examined before
attention wtus focused on the s^-rotal lesions. While it is possible
that a mild type of the lesion may have been present, it certairdy
was not sniiiciently conspicuous to attract attention.
hi well-developed male gninea pigs, which had been intraperito-
neally injedtul with the Mexican typhus virus, the fallowing changes
have been observed: From 9 to 15 days after inoculation, the tem-
perature of the animal becomes elevated to from 40.5° to 41® C, and
if the scrotum, with the testicles in place, be examined, a definite
swelling is observed. If the skin be of a light color, some redness
may be noted. These external changes subside in a few days. If
the animal be killed whcMi the fever and scrotal changes are at their
height, diss(»ction reveals the following gross findings: The skin of
the scrotum looks apparently normal, but if it be carefully dissected
from the tissues immediately beneath, definite hemorrhages appear
in the cremasteric fascia, just external to the parietal laminae of the
tunica vuginalLs. If the.se structures be incised and the testicle and
epididymis exposed, hemorrhages of a similar nature will be noted
I OntBky, Doner and Husk, J. Am. U. Ass., 1917, vol. 08, No. 16, p. 1167.
I J. Am. II. Asi., 1900, 47, p. 33.
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1107 July 13, 1917
inuacdiately beneath the visceral laminse of the tunica vaginaUs. The
extent of these hemorrhages varies, from a few minute petechias to
nearly complete envelopment of the testicles by hemorrhagic areas.
If the animal be examined at the height of the process, i. e., one to
two days after the swelling is first noted, the lesions above described
are indistinguishable in their gross appearances from the lesions of
Rocky Mountain spotted fever at the same stage of development of
the disease, that is, one or two days after the sweUing of the scrotum
is first noted. In the spotted fever animals, in contradistinction to
the typhus animals, the disease becomes progressively more severe.
Hemorrhages into the skin of the scrotum take plac^, and in some
cases typical necroses of the scrotum, paws, and ear tips are observed
before the death of the animal, which usually follows. On the other
himd, the lesions of typhus fever rapidly clear up and soon the animal
is as well as ever.
Twenty-six out of 37 male guinea pigs killed at the height of the
febrile reaction showed the lesions to be as described. These animals
represent several strains of typhus received from El Paso, Tex., and
Laredo, Tex., this year.
Lecount * and Wolbach ' have emphasized the significance of vas-
cular lesions in the pathology of Rocky Mountain spotted fever, both
in human cases and in guinea pigs. These lesions consist of various
grades of reaction to injury of the cells of the endothehum, i. e.,
endarteritis, and of rather peculiar and characteristic perivascular
accumulations of cells.
E. Frankel,' AschofI,* and Poindecker,* and apparently several
other workers Whose pubUcations are not now available, have de-
scribed certain histological changes in typhus fever, especially as re-
gards the exanthem. These writers all describe as characteristic,
lesions of the smaller arteries consisting of necrosis of the intima and
the perivascular accumulation of cells among which, as in spotted fever,
the mononeuclear elements predominate.
In the present study the writer reports that: In guinea pigs in-
fected with Rocky Mountain spotted fever and typhus fever, and
killed at about the same stage of development of the lesions, sections
of the testicles, epididymis, and their envelopes revealed similar
changes. They were as follows:
A. Subperitoneal hemorrhages, presumably due to,
B. Vascular lesions, characterized by degeneration of the intima,
proliferation of the endothehum and connective tissue of the vessel
walls. Pronounced perivascular infiltration, as noted above, was
1 Journal of Infectious Disease, 1911, vol. 8, p. 421.
s Journal Med. Research, 1916, vol. 34, p. 122.
• ICOncb. ICed. Wclmschr., 1914, vol. 61, p. 57.
« Med. KUn, 1915, p. 798.
* Mflncb. Ubd. Wchnschr., 1916, vol. 63. No. 5, p. 176.
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July 13, 1917 1108
found in both diseases. This consisted chiefly of cells of the lympho-
cyte series and of endothelial leucocytes. Polyneuclear leucocyteB
were present, but distinctly in the minority. The changes were par-
ticularly abundant in the small vessels. Thromboses were occasion-
ally observed in the early lesions.
The lesions in spotted fever showed more necrosis, exudation, and,
in older specimens, more proliferation in the vessel walls than oc-
curred in the typhus-fever animals.
Summary.
1. Definite, gross, and minute pathological changes in the genitak
of male guinea pigs reacting to Mexican typhus-fever blood have been
described. The gross lesions occurred in about 70 per cent of such
animals examined.
2. These depend. on lesions of the blood vessels.
3. The lesions are similar in process to, but milder in character
than, those occurring in guinea pigs infected with Rocky Mountain
spotted fever.
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PREVALENCE OF DISEASE.
No heaUh departmerU, Stale or local, can effectively prevent or control diseoBc xoithout
hnowUdge of when, where ^ and under what conditions cases are occumng.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended July 7, 1947.
The California State. Board of Health reported eonceming the
status of preventable diseases in California for the week ended July
7, 1917, as follows: The cases of reportable diseases, with the excep-
tion of typhoid fever and cerebrospinal meningitis, were greatly re-
duced <lijring the week. Of typhoid fever, 21 cases were notified*
from scattered points in the State. Four cases of cerebrospinal
meningitis occurred, 2 in San Diego, 1 each in Snn Francisco and
Placer County. One case of dengue was reported in Kem County.
Mumps cases were mostly in the southern part of the State. Diph-
theria was notified principally in northern California. Of scarlet
fever 53 castas were notified, mostly in San Francisco and Ijos Angeles.
The details of ngtifiable disease cases reported in the State during
the week ended June 30 are as follows:
On?brr>si>inal meningitia 4 1 Pneumonia 30
Chicken |)ox 60 ' Poliomyelitis 1
Diphtheria 38 I Bcarlet fever 68
Er>tui)elas 10 Smallpox 10
German meafiles 32 S>T)hilis 12
Goaococcus infection 18
Malaria 6
Measles 266
Mimipe 417
Trachoma 1
Tuberculosis 119
Typhoid fever 20
Whooping cough 52
CEREBROSPINAL MENINGITia
Massachusetts.
Collaborating Epidemiologist Kelley reported that during the week
ended July 7, 1917, cases of cerebrospinal meningitis were notified
in Maasachusetts as follows: Boston, 1 ; Northampton, 1 ; Pittsfield, 2.
(1109)
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July 13, 1917
1110
CEREBROSPINAL MENINGITIS— Continued.
State Reports for May, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Alabama:
Jeflorson County
2
1
1
1
Connecticut— Continued.
Hartford County— Continued.
New Britain
Leo County
4
Monroo Count v
IMainvillo
2
Walker County
South Windsor
1
Windsor
2
Total
5
New Haven County—
Naugatuck
1
1
1
27
3
New Haven
4
Fairfield County—
nHdmnort
Waterbury
2
Total
strS^ :
48
Hartford County-
Hartford
Washington:
King County
Manchester
5
City Reports for Week Ended June 23, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
Atlantic City, N.J.
Baltimore, Md
Binghamton, N. Y .
B^on, Mftss
Bridgeport, Conn. . .
Buffalo, N.Y
Chicago, Ul
Cincinnati, Ohio —
Cleveland, Ohio
Columbus. Ohio —
Davenport. Iowa . . .
Dayton, Ohio
Du>)uque, Iowa
Elgin.lU
Klitabeth, N. J
Erie, Pa
Harrisbure. Pa
Indianapolis. Ind. . .
Jersey Cit^N. J
Kenosha,
t^r^:
Lowell, Mass
Milwaukee. Wis....
Minneapolis, Minn.
Newark. N.J
New Britain, Conn .
Newburyport, Mass.
New York. N. v.. .
Norfolk, Va
Omaha, Nebr
Pawtuckot, R. I....
Philadelphia, Pa. . .
Pittsburgh, Pa
Pittsfteld, Mass
Providence, R. I. . .
Quincy.Ill
St. Louis, Mo
San Diego. Cal
San Francisco, Cal..
Springfield, Mass...
Supwlor, Wis
Troy,N. Y
DIPHTHERIA.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1117.
ERYSIPELAS.
City Reports for Week Ended June 23, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Binghamton, N. Y
1
2
New York, N. Y
2
Boston, Mass
Oakland, Cal
1
1
6
13
2
1
1
1
10
3
1
1
1
1
Buffalo, N.Y
3
22
1
4
?
1
Oraaha. Nebr
Chicago,lll
Cincinnati. Ohio
Philadolphia. Pa
2
Pittsburgh, Pa
Cleveland, Ohio
Portland. Orcg
Dayton, Ohio
Detroit, Mich
Readinji. Pa
1
Rochest<r NY
Duluth, Minn
St. Jos-ph. .Mo
El iPaso, Tex
1
St. Lori^. lo
San Fr.inc isc.^, Cal
Harrisburg, Pa
1
2
\
2
5
9
Kalamazoo, Mich
1
Seattle. Wash
T/ancaster, ^a
South Bolhli'hom, Pa
Los Angeles, Cal
Tak nm:\. Wiish
McKeesport, Pa
Toledo, Ohio
Milwaukee, Wis
1
Trenton, N.J
1
Newark,N. J
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1111
MALARIA.
Report for May, 1917.
Jnly 13, 1917
Place.
New cas«^
reported;
Place.
New cases
reported.
Blount County. . . .
BuUook rounty. . .
Butkr County
Calboan County...
Ctioetaw County. .
Clarke County....
Coffee County
Gran^aw County.
Coilman County . .
Escambia County.
Etowah C^wnty. .
Geneva County...
Greene County
HaleCoimty
Jeflo'son County . .
Alabama — Continued.
Lawrence Coauty.
Madison (Vmty. .
Marengo County..
Marion County
Mobile County....
Monroe County . . .
Perry County
Pile© County
Shelby County
Sumter County...
Tallapoosa County
Tuscaloosa County
Total
1
1
4
1
1
1
1
2
10
1
1
67
City Reports for Week Ended June 23, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Tl irm fnir^rn AIa.
» 7
Lcog Branch, N. J
1
Boston. Mass
Memphis, Tenn.
1
Brockton Mass
Mobit<^, 4)a , , ,
1
Bro^llne Mass
Newark, N. J
2
0obokMi. N.J
Washington, D. C
1
» The reason that Birmingham had so many more cases of malaria reported than any other city is not
becau^ the disease Is more prevalent in Birmizigluun than In other cities of Alabama and neighboring
Stat^, but undoubtedly because of the succcssfufefforts the health department has made in securing the
coop^ution of the practicing physicians in reporting eases.
MEASLES.
See Diphtheria, measlee, scarlet fever, and tnberculoeis, page 1117.
PELLAGRA.
SUIe Reports for May, 1917.
PhMse.
New
cases re-
ported.
Place.
New
cases re-
ported.
A&bama:
Antanra Cotmtv
2
1
2
2
3
4
1
6
1
1
• 1
1
1
2
6
1
2
2
2
5
10
14
Alabama— Continued.
Lee Coimty
1
Barbour County
IJmc srone County »
Macon Count v
1
Butler Count V
4
Calhoun C'Ounty t . -
Ma'U'^on County
7
fS*(tnih<»r<j Coiintv
Marenjrn County . . *
I
Mobile County
35
Choctaw Countv
Mont K'omery County
1
CtMike County . ......... ^ .., ^
Perrv County
1
Clay County
Pickens ( 'ount y
3
CleSume County
Pite County
2
Coffee County
Randolph County
6
Colbert County
St . Clair ( -ounty
1
Coosa County
Sumtor County
1
Crenshaw County
Tallaclec^a County
3
DnllA<$ fVMintv -
Tallajxiosa County ....
7
P«kalb County - - - , «
Tuscaloosa County
14
Walker County
15
Stovah County r ...... .
Washington (V>imt.y. .....
1
Payette County
Wilcox County....'
3
QrwMLQ Countv
Total
175
Jefferson County
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July la, 1917 1112
PELLAGRA— Continued.
City Reports for Week Ended Jnne 23, 1917.
Place.
Cases.
Deaths. •
Place.
Cases.
Deaths.
Binningham, Ala
»13
2
1
5
2
Mobile, Ala
5
Buffalo NY
Now Orleans, La
2
1
1
Charleston, 8, C
Roanoko, Va'.
1
El Paso, Tox
Wilmington, N. C
3
Haferstown Md. .
i
1
4
Winston-Salem, N. C.
1
Kafaniazoo, Mich
1
1
1 Worcester, Mass
1
Memphis, Tenn
!
1 The reason that Birmingham had so many more cases of pellagra reported than any other city is not
because the disease is more prevalent in Birmingham than m other cities of Alabama and neighboring
States, bat undoubtedly because of theituccessful efforts the health department has made in securing the
cooperation of the practicing physicians in reporting cases.
PLAGUE.
California — Plaffne-Infected Squirrels Found.
Passed Asst. Surg. Williams reported the finding of plague-infected
ground squirrels in California as follows : In Alameda County during
the period from June 16 to 27, 1917, 5 infected squirrels were found
in township 2, all having been foimd within a radius of 4 miles of
Altamont. In Santa Cruz County, on June 27, 1917, a plague-
infected squirrel was found 9 miles east of Watsonville, on the
G. F. Silliman ranch.
PNEUMONIA.
City Reports for Week Ended June 23, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
DMths.
Akron, Ohio
1
14
1
1
3
73
10
10
1
2
2
2
4
1
3
1
8
2
1
Memphis, Tenn
2
Boston, Mass
16
Muscatine, Iowa
1
16
2
1
1
40
11
1
9
2
8
1
1
3
1
3
5
Braddock, Pa
i Nowarlc,N. J
' Newport. Kr
4
Cambridge, Mass
2
Chelsea , Mass
2
57
23
21
3
1 Nortn Aaanis Mass
Chicago. Ill
] Northampton. Mass
Cleveland. Ohio
1 Philadelphia. Pa
29
Detroit Mich
1 Pittsburgh Pa
16
Duluth, Minn
' Heading, Pa
Everett, Mass
Uochester, N. Y
San Diego, Cal
3
Fall River, Mass
1
1
1
Fiichburj;, Mass
' San Francisco, CaJ .
5
Flint. Mich
i Schenectady. N. Y '.'.'.'.
Somerville, Mass
Haijerst own , Md
1
Haverhill, Mass
1
1
4
2
Terre Haute, Ind
1
Lawrence, Mass
Wichita, Kans
1
Los Anj^clos, Cal
Wilmington, Del
Lynn, Mass ;
McKeesport, Pa
Worcester, Mass
POLIOMYELITIS (INFANTILE PARALYSIS).
Illinois.
The State Board of Health of IlUnois reported that during the period
from July 3 to 9, 1917, four cases of poliomyeUtis were notified in
Illinois; one case each in Chicago, Joliet, Zion City, and Melrose
Township, Adams County.
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1113
jQly 13, 1017
POUOMYEUnS (INFANTILE) PARALYSIS— Continued.
Bfasmehiisefts.
Collaborating Epidemiologist Kelloy reported that during the week
ended July 7, 1917, cases of poliomyelitis were notified in Massachu-
setts as follows: Haveriiill 2, Medford 1, Beverly 1, Springfield I,
Lowell 1.
Minnesota.
CoUaborating Epidemiologist Bracken reported that during the
month of June, 1917, four cases of poliomyelitis were notified in
Minnesota, making a total of 21 cases reported since January 1, 1917.
New York— New York City.
The Department of Health of New York City reported that during
the month of June, 1917, 66 cases of poliomyelitis were notified in
the city of New York, making a total of 99 cases reported since
January 1, 1917. In 1916 the nxunber of cases reported during June
was 380, with a total of 409 cases notified from January 1 to June 30.
VermoKt.
CoUabcwating Epidemiologist Dalton reported the occurrence of
cases of poliomyelitis in Vermont as follows: In the toMTi of Barre,
from June 16 to July 7, 4 cases; in Fayston on July 7, 1; in Mont-
pelier, from June 19 to July 7, 29; in Waitsfield, from June 16 to
July 7, 6; in Washington, from June 27 to July 7, 2 cases.
State Reporte for May, 1917.
Place.
New rase?
reported.
Place.
New cases
reported.
Alabama:
Clebome Ccwinty
i
1 ,
1!
:\ ^
1
1
Conn€it lout— Continued.
New Haven County— Continued.
XauKituck
JcUer^iMi Countv
1
1
5
Tuscaloosa County
New Haven
TotjJ
Total
Hawaii:
Oabu-
Honolulu........... .
rpnnoclicut:
rairfidd County—
Stamford
1
Hartford Co- inty -
Bout bins ton .................
Washington:
Island County—
Langley
New Haven County—
Branford -
1
Place.
City Reports for Week Ended June 23, 1917.
Deaths. \\ Place.
Hiicago.Hl
Cincinnati, Ohio..
Cleveland, Ohio..
Covineton, Ky...
Haverhill, Mass..
Jersey City, N.J.
Cases.
NowarV, N. J
Now V'ork. N. Y..
rortsraoiHli, N. H
St. Louis, Mo
Worcestt r, Mass . ,
Cases. ' Deaths.
8
{|::::::;:::
I i
I
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July 13, 1917
1114
RABIES IN ANIMALS.
City Report for Week Ended June 23, 1917.
During the week ended June 23, 1917, 4 cases of rabies in animals
were reported at Detroit, Mich.
'ROCKY MOUNTAIN SPOTTED FEVER.
Nevada — Humboldt County.
The State Board of Heallh of Nevada reported July 10, 1917, that
five cases of Rocky Mountain spotted fever had been notified in
Humboldt County, Nev.
Washington Report for May, 1917.
During the month of May, 1917, 3 cases of Rocky Mountain spotted
fever were reported at Odessa, Lincoln County, Wash.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tuberculosb, page 1117.
SMALLPOX.
Minnesota.
Collaborating Epidemiologist Bracken reported that during the
week ended July 7, 1917, 5 new foci of smallpox infection were
reported in Minnesota, cases of the disease having been notified as
follows: Chisago Coimty, Rush City, 17 (cases occurred in May and
June) ; Crow Wing County, Manganese, 1 ; Polk County, Angus Town-
ship, 1; Todd County, Moran Township, 1; Washington County,
Marine, 1.
Miscellaneous State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Alabama (Mav 1-31):
Calhonp County.
1
24
5
13
4
4
U
1
5
1
a
Washington (May 1-31):
Chelan County—
Wenatchec
1
1
3
2
1
1
1
1
3
9
1
22
5
1
3
3
1
2
Chambers County
Vfft^tih Coiint.v
Clark Ck)untv
Jackson C^iiTity
P.idge«eld
Limestone County
Macon County
King Coimty—
Scittic
Madison Countv
Kit^ip County—
Cnarleston
Mjirflhftli County . . .
MontKomenr County
Talladega County
Tallapoosa County
Kittitas County—
EHensburg
Klicld tat C!oimty
Pftfdflc Coirntv
Total
71
Pend Oreille County
Pierce (bounty-
Tocoma
Connecticut (May 1-31):
Fairfield County —
2
22
2
1
1
7
1
1
2
2
4
1
55
Snohomish County
Spokane County
Norwalk
Hartford County —
Spokane
Berlin
Walla Walla Coimty-
Waitsburg
Bristol
Hartford
Whatcom County—
New Britain
Southington
Yakima County
Litchfield County—
North Yakima
Toppenish
Torrington
Winchester
Total
New Haven County —
59
New Haven
Oxford
Southbury
Wallingford
Waterburv
New London Ck)unty—
Oroton
Total
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SMALLPOX— Oontihued.
te Week Ended ime 23. 1917.
July la, 1917
Place.
Akroo, C%io
Alton, m.
Austin, Tex
Cairo, III
Canton, Ohio
Qiicago.Iil
Cincinnati, Ohio. . .
Clev<«lan4,Ohio...
CafiefviJle. KoDS..
CoJombus, Ohio
09fiaglmi.Ky
Danville, III
Dayton, Ohio.
Detroit, Mich
DabaqiM, Iowa....
Dohith.Minn
Erie, Pa
ETansvlfle,Iiid....
FitchbuiF. Mass...
FlintJCkh.
FortWorth-Tex..
Green Bay. wis...
Indianapolis, Ind..
Kansas Oty,Kans
Kansas City. Mo...
Kenosha, wis
LUtJe Rock, Ark..
Madison, Wis
Memphis, Tenn....
MUwau]Dee,Wis...
Cases.
Deaths.
Place.
MInnea|)oli.'^, Minn... .
Miiscdtine. lima
Kash\ille. Tcnn
Newcastle, Pa
New r>rleen.s. La
Okiahoraa (Ity, Okla.
Omaha, Xebr
Philadelphia. Pa
Pidsbuirh. Pa
Pontiac, Mich
Portland. Orog .......
Quincy,IIl
Roanoke, Va
Kork Island, 111
8t. Joseph. Mo
St. I>ouis, Mo
Salt Lake nty,rtah.
Sioux Citj'. Iowa
Sprinirfiold, 111
Sprintfield, Ohio
Steelton. Pa
Superior, Wis
Tacoma, Wash
Terro Haute, Ind
Toledo, Ohio
To| eka. Kans
Wichita, Kan5,
Worcester, Miiss
Zaneh.ille, Oliio
Cases.
Deaths.
N TETANUS.
City Reports for Week Ended June 23, 1917.
Place.
Casea.
Deaths. 1
Place.
Cases.
Deaths.
Boston Masn
1
1
Lone lieach. Cal
1 -
Charleston, S C
i '
Xo\v.R)..N. J
1
Chicago Hi
X
1
1
i; I'iti.shurgh. Pa
1
DanvFlle, IH . . 1 . ! !
1 1 St. L.>i:is. Mo
3
Evans\ille, Ind.,
1 1
Whtvling, W. Va
1
TUBERCULOSIS.
See Diphtheria, meaales, scarlet fever, and tuberculosis, page 1117.
TYPHOID FEVER.
Slate Reports for May, 1917.
Pkce.
1
New eases 1
reported.
Place.
NewcMes
reported.
Alabama:
Bibb County
2
7
Alabama— Cont inued.
Elmore Count v
5
Butler County
E.Ncambia (^3Ui^y
4
niiJtoa County
Etowah County
3
Cboctsw County •.
Franklin County
1
dartre ronnty
Grci'no County
1
Ooffie Comity
IIalc(\)untv
1
Cenecoh County
JclTerson County
62
Cooaa County
Lamar C-mmty
1
Ooviafltmi County. t r -
Loe Cotjntv
1
Orpimliaw Countv r
Llmci'tone Coimty
1
Galtean County,
Madi.son County
1
Dilteromity. ...
Mnrenjfo County
5
IMaOk County
MifcTsball County
2
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July 13, 1917
1116
TYPHOID FEVER-<k)ntmued.
State Reports for Maj, 1917— Continued.
Place.
Alabama — ("ontinued.
Mobilo (V)iinty
Montgomery County . . .
Morgan County
Piko County
Randolph County
Russell Cojinty
Sbolby (bounty
St. Clair County
Sumter County
Talladega County
Tallapoosa County
Tuscaloosa Coimty
Walker County
Washington County. . . .
Wilcox County
Winston County
Total
Connecticut:
Fairfield County-
Bridgeport
Danbury
fireenwich
Norwalk
Hartford County—
Enfield
Cilastonbury
Hartford
Litchfield County-
Canaan
New Ilavon County —
Now Havon
New I/ondon County—
(•riswold
Jowclt ('ily
Windham County-
Woodstock
Total
Hawaii:
Howail-
Haraakua TLstrict.
Hilo
Puna District
New cases
reported.
189
Place.
New cases
reported.
Hawaii— Continued.
Kauai—
Hanalei District.
li—
Hana District....
Oahu—
Honolulu
Total
Washington:
Bentoo County
Prosser
Chelan County—
Wenatcfaee
Clark County-
Vancouver
Franklin County
King County
Seftttle
Lincoln County
Davenport
Odessa
Okanogan County. . .
Conconully
Pierce County—
Tacoma
Skagit County-
Snohomish County —
Edmonds
Everett
Index
Spokane County —
Spokane
Stevens County
Wahkiikum Count v.
Walla Walla CoiuitS'.
Whitman County—
Colfax
Yakima County
Total
City Reports for Week Ended June 23, 1917.
Place.
Akron, Ohio
Albany,N.Y
Baltimore. Md
Beaver Falls, Pa...
Birmingham, Ala..
Boston, Mass
Sridgeport, Conn. .
rockton, Mass
Cambridge, Mass..
Charleston, B.C..
Chelsea, Mass
Chicago, 111. -
Cleveland, Ohio...
Columbus. Ohio...
DanviUe,ill
Dayton, Oliio
Detroit, Mich
Duluth, Minn
East Orange, N.J.
Erie, Pa
Fall River, Mass...
Flint, Mich
Fort Worth, To-,.
Cases. • Deaths.
2 l(
Plac*.
(Jrand luipids, Mich
Hamilton, Ohio
ImUumipolis, Ind
Kunsiis Cit\ , Mo
Little Uoik. Ark
Long Branth. N. J
Los .\ngoles, Cal
Jyowcll . Mass
Cases.
LynchburK, Va..
Madison, \Nis
Memphis, Tenn
Milwaukee, Wis
Minneapolis. Minn...
Mobile, Ala ^...
Nashville. Tcnn
Newark, N. J
New Haven, Conn.. .
New Ix)ndon, Conn..
New Orleans . La ... .
New York, N.Y....
Niagara Falls, N.Y.
Norristown, Pa
Oakland, Cal
Deaths.
1
2
1
3
1
1
1
i
20
3
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1117
TTPHOm FEVER— Continued.
CKy R^iNMls for Week Ended June 23, 1917— Continued
July 13, 1917
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
np^ Utah .
2
1
32
2
1
1
4
1
3
10
4
4
Schenectady, N. Y
2
2
OElahomaClty.Okla.
Ptmncket.R.I
Seattle. Wwh
South bond, Ind
Phfladfihrfifa. Pa
2
1
Tauoton. Mass
Httsburfei, Pa
Toledo, Ohio
1
PttnPf MVk J
Trenton, N. J
2
1
PWtl«»»4,'H«
Troy,N.Y
Washington, D. C
RorkTlfonnt NO
Willianwport.Pa
St Louis, Mo.'. \V.
Wilmington, t>el
2
8iit Lake CitT. IJtyi
2
Winaton-Salem, N. C
8tn Fymrifpo, Cal
Worcester, Mass
mfritiM>nto, C^l . .
Zanesville^ Ohio
1
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for Maj, 1917.
Cases reported.
State.
Cases reported.
state.
Dlph-
tbcria.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
AUhama
21
142
2,050
1,430
25
140
HawaiL
3
36
16
201
1
Coonasticut
Washington
68
aty Reports for Week Ended June 23v 1917.
City.
Over SOOUXn inhabitants:
Baltimore. Md
Boston, Mass
(liiOM50,ni
aevAnd. Ohio.
Detroit. Mich
Los Anceles. Cal
NewYork,N.Y
Phitodelphia,Pa
Pittstnirgh. Pa.
St. Look, Mo
From 300,000 to SOO.OOO inbabit-
ants:
Boflalo,N. Y
CiDdnnati. Ohio
J«eyaty,N.J
Milwaukee. Wis
MhuMapolfe, Minn
Nfwark.N.J
New Orleans, La
Ban Fcanciseo, Cal
Seattle, Wash
Wachi^Um, D. C
l^roDi 200^ to 300,000 inhabit-
uu:
Columbus, Ohio
Denw, Colo
tndiamjnolis, Ind
KansaaCity, Mo
Portland, Or«
ProTklenoe, R. I
RoetMater. N. Y
80
Popula-
tion as of
July 1, 1916
(estunated
bvU.S.
Census
Bureau).
589,621
756,476
2,497,722
674,073
6n,784
503,812
5,602,841
1,709,518
579,090
757,309
468,358
410,476
306,345
436,535
363,454
408,894
371,747
463,516
348,639
3e3,980
214,878
2fM),«)0
271,708
297, M47
295,465
254,960
256,417
Total
deaths
from
all
causes.
160
242
629
181
184
1,339
462
103
189
138
123
74
92
91
147
67
67
Diphtheria.
4
74
181
36
97
7
245
60
23
75
Measles.
166
192
450
69
22
79
843
175
149
73
52
12
128
Scarlet
fever.
14
26
246
11
81
18
113
17
14
71
Tuber-
culosis.
56
54
243
45
29
56
248
94
28
51
20
32
56
22
14
25
221
52
18
10
18
16
6
12
5
6
6
15
11
4
10
7
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Julj 13, 1917
1118
DIPHTHERIA, MEASLES, SCARLET FEVER, AMD TUBERCULOSIS—
Continued.
City Reports for Week Ended June 23. 1917— Condnued.
Popula-
tion as of
July 1, 1916
(estimated
by U. S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
«Q
1
i
1
J
1
i
1
yrom 100,000 to 200,000 inhabit-
ants:
Albany, N.Y
KM, 199
181,762
121,579
112,081
106. 2 J3
127,224
128,366
104.562
128,291
100,560
113.245
102,425
14^/^95
117,057
llh,l.'i8
140 ftHo
li:s,n>l
10;.. i7(»
10:',3M
15(>.ris7
Ii7,;ty3
105. 942
15.'),G2i
112.770
i<,i,:>rA
lujm
163,311
W, «•);{
57.r«*>;
5{.y7.i
(•".119
m, N52
CO. 731
57, 144
94,495
ST), 090
G3, 70o
75, 195
76, ()7S
54.772
76.1 S3
72,015
77,214
68,529
99,437
50,S53
57,343
51.155
78,283
58.221
53,791
89,612
92,943
71,744
69.411
63,867
55,185
66,89,'i
55,642
8,^236
53,330
99.519
57,07H
87,039
..
36
14
8
18
18
27
37
......
1
1
"2
4
1
2
2
2
8
9
34
4
8
3
4
15
Birmingham, Ala
92
2S
22
46'
39
26
30
19
31
19
GO
31
41
."^9'
no
25
37
42
ns'
37
42
ii"
11
Bridgeport, i onn
5
3
8
1
2
2
3
17
1
Cambridge, Mass
Camden, N.J
Dayton, Ohio
Fall River, Mass
Fort Worth, Tc\
«rand Uapids, Mich
37
1
5
7
6
29
3
6
8
3
4
3
Lowell, Ma,s.s
1
6
11
Lynn, Ma.ss
7
3
1
1
Mtemphis, Tcnn
Nashville, Tenn
1
32
72
New Bedford, Ma-w
"■3
3
1
1
New Haven v'onn
o?\l:lftnd, Cal.
3
15
3
Omaha, NoLr
Heading, l*a
1
5
23
1
13
3
18
50
Richmond, Va
Salt lakcCitv, I'tah
i 1
6 1
2 1
16
5
12
2
21
I
U
Springfield, Maw
9
3
Svracuse, N . Y
Tiicoma, Wash
1
4
Toledo, Ohio
1
51
4
8
9
1
......
1
1
5
5
12
II
Trenton, N.J
Worcester, Mais
From 50,000 to 100,000 inhabit-
ants:
Akron, Ohio. .
2
2.5
2 '
2.
AllentoMii, Pa
3
Altoona, I'ti.
4
22
1
S
1
1
2
Atlantic ( ity, N.J
Bayonne, N.J
Berkeley, (al
1
8
23
17
14
36
15
14
24
56
■■". ie
10
22
29
14
24
1
Binghamton, N, Y
7 , 3
lai
8 1
2
3
1
1
::::::
1
Brockton. Mass
3
1
3
Canton, Ohio
Charleston, S.C
3
Covington, Ky
2
3
2
2
1
8
'..'.'.'.'.
1
3
3
5
Dulutn, MJnn
.30 i
52
4
EUtabeth.N. J
4 1
2
El Paso, Tex
9
Erie, Pa
2
5
4
4
6
21
3
6
3
2
30
P.vfuvsvllk. Tnd
2
4
Flint, Mich '..
2
2
3
2
26
23
12
12
12
2
8
i3
2
1
4
7
3
1
1
Fort Wayne, Tnd
Harrisburg, Pa
Hobokcn,Tsr. J
1
Johnstown, Pa
3
1
Lancaster, Pa .
Little Uock, Ark '..
9
7
28
31
13
Maiden, Mass
5
1
1
......
30
2
2
3
3
2
1
Bianchester, N. H
1
3
Moblle,Ala
3
Now Britain, Conn
Norfolk, Va
4
2
Oklahoma City, Okla
17
17
i9'
13
28
23
18
33
10
3
Paaaaic.N. J
10
1
2
2
1
2
4
2
1
......
2
3
Pawtuckct, R. I
1
Portland, Me
19
23
8
3
3
33
55
2
Rockford, 111
2
2
7
5
1
1
2
Sacramento, Cal
8
Saginaw, Mich
a
St. Joseph, Mo
2
9
5
3
San Diego, Cal
3
Schenectady, N. Y
3
3
Sioux City, Iowa. .. .
3
2
Somerville, Mass
22
6
1
20
4
3
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1119
July 13. lOlT
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS^
Continued.
at7 Reports for Week Ended June 23, 1917~Continued.
Popula-
tion as of
July 1, me
(estimated
bv U. 8.
Census
Bureau).
ToUl
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
aty.
1
1
1
1
1
1
1
From 50,000 to 100,000 inhabit-
ants-Continued.
Soath Beod, Ind
68,946
6i,iao
61,550
66,083
77,916
70,722
76,776
94,265
51,656
27,732
34,814
32,985
32,730
27,632
43,425
46,192
29,319
26,074
32,261
48,811
39,873
28,743
42,458
28,203
39,233
35,486
41,781
41,863
29,353
25,679
40,496
48,477
35,363
48,886
31,576
26,771
38,076
31,677
41,097
35,384
46,515
27,587
36,904
32,940
30,099
47,521
26,234
26,318
27,327
29,603
41,133
31,927
30,108
43,715
37,353
31,401
31,404
33,080
46,450
41,185
38,029
39,651
36,798
38,130
46,486
43,284
28,U20
38.902
16
0
15
39
1
3
3
......
17
9
16
9
11
1
32
3
1
1
2
3
1
1
2
1
**pH|^«»M, 111
Sprin^eld, Ohio
2
2
TferelHaute, Ind
Troy.N. Y
1
6
2
7
3
4
Wichita, Kans
1
Wilkes-^arre, Fa
18
28
3
11
J
10
7*
7
3
10
1
2
1
2
Wilmington, Del
York, Pa....'
3
3
From 25,000 to 50,000 hihabit-
ants:
AUnieda.Cal
1
Austin, Tex
1
2
BeUinghom. Wash
1
4
1
1
4
2
3
7
5
Brookline, Mass
2
1
1
3
2
1
......
1
Butlor,Pa
1
Butt«, Mont
3
Chelsp«,Majw
2
1
1
1
Chicopw, Mass
1
1
Cumljerland, Md
Danville, Ul
Davenport, Iowa
.
Dubuque, Iowa
1
3
2
2
1
2
1
East Chicago, Ind
6
12
2
9
2
1
Kast Orange, N.J
6
9
6
4
6
11
12
1
Elgin, III....
1
Everett, Mass
3
............
5
1
Everett, Wash
4
1
Fitchburg, Mass
1
1
32 ' ' 1 3
2
1
1
Galveston,' Tex . . .•
... .'::::::i.... i;:::::
1
Green Bay, Wis
Ha^nstown, Md
3
1
Hamilton, Ohio
7
is'
25
4
7
1
1
1
2
.
1 !::::::
2
2 2
Haverhill, Mass
1 :::::.
28 !
4
2
4
Jackson, Mich
1
Kalamasoo, Mich
59
1
3
2
Kenosha, \<ris
15
6
Kingston,N.Y
1
KnoxviUe, Tenn
2
1 ,!!!".!!
3
LaCiosse, Wis
11
10
8
17
8
ii'
1
1
2
Lexington, Ky
2
I
6
Lin»,Ohio
3
2
2
2
2
Uncohi, Nebr
1
2
1
Long Beach, Oal
Lorain. Ohio
1
2
1
3
1 '
Lynchburg, Va
7
3
1
6
3
Sidison.wis v..:.:.:.:
McKeesport, Pa
7
5
8
8
10
1
1
MedtoKLMass
2
Montclair, N. J
1
1
1
Nashua,N. H
Newburgh, N. Y
0
1
2
New Castle, Pa
Newport, Ky
12
8
8
15
5
5
12
14
7
16
11
9
0
10
12
10
1
1
Newport, R.I
2
Newton, Mass
1
11
5
i
Niagara Falls, N. Y
2
2
1
Ogden, Utah
1
1
3
1
39
1
2
;;;;;;
2
2
Orange, N.J
Pa»Kna,Cal
3
1
1
1
1
5
Perth Amboy, N. J
1
1
PittsfTdd, Mass
2
4
Portsmouth, Va
1
1
1
Quincy.ID.'.
Qtiin<^' Mass
5
1
1
Radne,'Wls.
1
Roanoke, Va
2
2
3
7
I
1
Rock Island, ni
1
8anJose,Cai
::::::i:::::;
3
i
Digitized by VjOOQIC
Jtrijr 13, 1917
1120
DIPffTHERIA, MEASLES, SCABLET FBVSt, AND TUBS8CIfL08»-
Ooaitlaiied.
CUtf BcvMte f^ Week Ended Mwme tZ, ISlT-CooiaimL
Popula-
tion as of
July 1,1916
(estimated
by U.S.
Census
Bureau).
Total
deaths
from
aU
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
1
1
1
J
1
1
From 25,000 to 50.000 iBtoabit-
ants—Continued.
SteubenFille, Ohio
£7,445
46,226 J
36,283
48,726,
80,570
29,894
43,139
43,377
33,^09
29,892
31,155
80,863
22,K74
15,010
13,532
13,591
21,685
15,794
113,0Z5
17,548
22,669
24,276
16,950
23,539
20,930
15,395
U4,610
17,445
13,284
17,500
23,126
15,243
20,985
122,019
19,926
23,805
17,524
11,666
12,067
14,831
20,193
13,621
24,204
15,548
21,618
28,228
16,969
ID
14
8
9
I
Superior wU
2
1
Taunton, Ma&s
3
3
28
23
16
3
Toneka. Kaiu
1
wStham, Mass
- . ..
2
1
i
1
2
Watertown. NY
West Hoboiwn, N. J
Wheelii^, W. va
8
19
W
23
7
7-
r
1
3
i
Willi^MntTM^rt, Pa , ' ' *
6'
Wilmin^n "S C
3
Winston-Salem N C
1
2
1
3
1
Zanesvillo, Ohio
1
1
1
From lO/no to 25,000 inhabitants:
Alton, ni . .
. .....J
Aim Arbor lOch""
1
Beaver Falls, Pa....,
Berlin, N. H
Braddbck. Pa. .1
1
^
Cairo, 111 .
7,
1
Clinton, ifass. . . * *
'
2
Coffey v'lUe. K£uu
2
Concord, N. H.*
7
6
30
6
6
10
1
Oatesbufg, III
Harrison, N J
Kearny, N. J....""][,l/...
4
1
-^....
Kokomo, Ind
1
Long Branch, N. J.*.,
1'
6
4
1
5
1
Marlhette, Wis. .
1
Melrose, Mass
5
6
1
Morristown, N. J. .
1
Muscatine, Iowa ,...
1
NantlwAe, Pa
5
4
8
4
4
3
Newburynort, Mass
New London, Conn ...
5
2
23
4
North Adams. Mass
2
PlalnftH'CN. /
1
1
1
PonttftC, lifich
12
9
3)
Portsmouth, N. H
Rocky Mount, N.C.'
6i
SI
«
2
1
....„
1
1
6
Rutland, Va..
2
1
i?Andusk'y AMo
flaratoa'^prinp, N. Y
South B^ehem, Pa
1
Steelton, Pa .'
3
6
2
2
WashiDgton, Pa.
Wilkinabure, Pa
10
5
1
1
1
W^bura, Mam , .
1
"POi
A|irU 15^ 1910; no
Digitized by
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FOREIGN.
PLAGUE ON VESSEL.
FnrOier ReUtire to Steamship "Sardiitia'*— Port of London.^
Two additional cases of plague occurred among members of the
crew of the steamship Sardinia at the port of London during the
period from May 3 to 8, 1917.
CHBiA.
Enininatfcm of Bats — Shanghai.
During the period from May 6 to June 2, 1917, 1,186 rats were
examined at Shanghai. No plague infection was found. The last
plague-infected rat at Shanghai was reported found May 6, 1916.
MEXICO.
Yellow Fever — Peto, Yucatan.
A fatal case of yellow fever was reported Jimc 23, 1917, at Peto,
State of Yucatan, Mexico. The patient had recently arrived from
Mexico City.
Peto b the terminal of a railroad connecting the town with Merida
and Progreso.
CTOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEYER.
R^iorts Recehred During the Week Ended Jnly 13, 1917.'
CHOLKRA.
Ptoof.
Dat«.
Cases.
Deaths.
xMwancs.
Indto:
Apr. 1-21
7
56
1
7
Cafcotta
Apr. 29-May 5
MMdns
Apr. 22-2S
Apr. 21-28
1
19
RincoQn ...
TklBninilslmnds:
rroviooes
May 20-20, 1917: Cases. 191;
deaths, 88.
AlhftT
May 20-36
19
43
42
1
10
43
15
1
B<iboI
do
O^ba
... .do
do
TilyaKs
do
I PobUo Health Reports. June 22, 1917, p. 1000.
* From medical ofBcers ot the Public Health Service, American consuls, and other soiu^es.
(1121)
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Google
July 13. 1917
1122
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received Daring the Week Ended Jal j 13, 1917— Continued.
PLAGUE.
Place.
Dat€.
Casos.
Deaths.
Remarks.
Arabia:
Aden
May 3 14
24
30
Ceylon:
C'oiombo
Apr. S May 14...
June 2
33
China:
Kwangtune Province -
Ta-pu district
Present.
Great Bntain:
London
May 3-8
2
2
In hospital at port. FVon s. s.
Sardinia from Australian and
Oriental ports.
India
Basseln
Apr. 1-21
31
96
10
20
214
88
1
41
1
51
2
8
Bombay
Apr.22-2S
115
C-alcutta
ADr.2»-May 5....
Hcntada
Aprii^r.^. ;:::r- ■•
Karachi
Apr.22-May5
Apr.22-28
229
100
Madras Presidency
Mandftlay
Apr.»-14
1
Houlmeln
Apr. 1-21
If yingyan
Apr, 1-7
Rangoon
Apr. 15-28..
52
Toungoo .'
Apr. 8-14
8iam:
Bankok
Apr.22-Mayl2....
8
SMALLPOX.
Canada: *
ilaltiax
June 18-23
2
1
Varioloid.
Present.
Do.
Cases foreign;
natives.
Varioloid.
China:
Antung
May 21-27
Chefoo
May 20-28
1
Chiingkiiig.
May 13-26
Mukden
May 27- June 2
Shanghai . .
May 21-Juno 3. . . .
May 13-26
6
5
26
9
deaths amtiOf
Tientsin
India:
Bombay
Apr.22-28
9
7
2
11
3
8
7
Calcutta
Apr. 29— Mays....
Karachi
Madras
Rangoon
Apr.22-May5
Apr.23-May5
Apr. 15-28
4
19
17
20
19
1
114
5
5
1
lUly:
Turin
Japan:
KotH?
Nagasaki
May21-June3....
May 27- June 10...
May2*-Junc3
May 1G-June5
May 13-19
Osaka
Philippine Islands:
UHnllft
37
Straits 8culements:
Penang
Sweden:
Stockholm
Mar. 18-May 12....
Mav 20-26
2
TYPHUS FEVER.
Oreo or:
Saloniki.,
May 6-12..
12
YELLOW FEVER.
Me\»ro:
Yiimlnn Slate -
IflO
June z;
1 I In person recently arriTed I
Me.xi "•
de.xico City.
Digitized by VjOOQIC
U23
July 13, 1017
GHOLBA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW FEVER—
Gontiiiued.
Reports Received From June 30 to Jtdy 6, 1»17.^
CHOLBBA.
Pltfoe.
Date.
Cases.
DMths.
Remarks.
Indift:
Apr.2»-M»y5
5
3
PLAGUE.
Gokmibo
CMoa:
Amoy
EOTPt
fioci
Prorinces —
Fayoum . ,
Girjwh . . .
Minieh...
Siout
Madras Presidency. ,
Rangoon
May»-12
Apr. 20-llay 5..
May 12-17. .
May 11-17.
May 17
May 12-15.
May 12
May 6-12
Apr. 29-May 5.
53
Present and in vicinity.
Jan. 1-May 17, 1917: Cases, 231;
deaths, 116.
SBfALLPOX.
Australia:
Netr South Wal«
Brett-anlna
Q(iamlx>ne
Queensland -
Thiirsday Island Quar-
antine Sution.
Canada:
Manitoba -
Winnlj>e?
Nova Scotia
Port Hawkesbury.
Ceykm:
Colombo
China:
Amoy
Chunf;king
Harhin
Hongkong
Manchuria Station
Mukden
Shanghai
Tsitshar Station
Tsingtao
n^
lexandria..
Madras...
Rangoon.
Portugal:
Lisbon...
Riga
VladlTostok..*
Turkey in Asia:
Treblzond
Union of South Africa:
J(diann«burg
Apr. 27- Ma V 10..
do
Biay9..
June 10-16...
Jqne 17-28.
May 6-12...
Apr. 29- May 5..
Mavr.-12
Apr. 21- May 6..
Ma> (.12
Apr. 23-29
May 20 26
Mav 14-20
Apr. IG 22
May 22-29
Apr. 30-May 27....
May6-12.
Apr. 29- May 5..
May 13-20
Mar. U-May5..
Mar. li>-21
Feb. 25-Apr. 13.
Mar. 12-24
Apr. 27- May 10, 1917: Cases, G.
From s. s. St. Albans from Kobe
via IlonslronR. Vessel pro-
ceeded to lownsville, itris-
bauc, and Sydney, in quaran-
tine.
Present in dislrlct.
Present and in vicinity.
rrcscnt.
On Chinese Eastern Railway.
Do.
Pre.sent.
On Chinese Eantorn Railway.
At another station on railway,
1 case.
Jan. 1-31, 1917: Cases, 7.
* From medical offlcers of the Public Health Service, American consuls, and other sources. For rep<«ta
rtcrtved from Dec. 30, 1910, to June 29, 1917, sec Public Health Reports for June 29, 1917. The tables of
•pidemic diseases are terminated semiannually and new tables begun.
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July 13, 1917
1124
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVEB-
Continued.
Reports Received From June 30 to Julj 6, 1917— Continued.
TYPHUS FEVER.
Place.
Date.
Cases.
Deaths.
Remarks.
China:
Tsingtao
May 20-29
1
890
Alexandria
Apr. 30-May 27....
232
Russia:
Riga
Jan. 1-31, 1917: Case, l;
Vladivostok
Mar. 2^Apr.4....
2
Digitized by VjOOQIC
PUBLIC HEALTH REPORTS
VOL. 32 JULY 20, 1917 No. 29
MEDICAL CARE OF INJURED FEDERAL EMPLOYEES.
HOSPTTALS AND STATIONS OF THE PUBUC HEALTH SERVICE TO FURNISH FREE
BfENCAL TREATMENT TO EBfPLOYEES OF THE UNITED STATES INJURED IN THE
PERFORMANCE OF THEIR DUTKS.
Washington, June 27 , 1917.
To commissioned medical officers, acting assistant surgeons, customs
officers, and others concerned:
Section 9 of act of Congress approved September 7, 1916, entitled
**An act to provide compensation for employees of the United
States suflfering injuries while in the performance of their duties,
and for other purposes,'' reads as follows:
Sec. 9. That immediately after an injury sustained by an employee while in the
performance of his duty, whether or not disability has arisen, and for a reasonable
time thereafter, the United States shall furnish to such employee reasonable medical,
suigical, and hospital services and supplies unless he refuses to accept them. Sucl^
services and supplies shall be furnished by United States medical officers and hos-
pitals, but where this is not practicable shall be furnished by private physicians
and hospitals designated or approved by the commission and paid for from the em-
ployees' compensation fund. If necessary for the securing of proper medical, sur-
gical, and hospital treatment, the employee, in the discretion of the commission,
may be furnished transportation at the expense of the employees' compensation
fund.
The commission referred to above has been created and is known
as the '^United States Employees' Compensation Commission."
This commission has immediate jurisdiction over matters pertaining
to the medical and surgical relief of Government employees who arc
injured while in the performance of their duties.
In accordance with the provisions contained in the above quoted
section of the act of Congress approved September 7, 1916, civil
employees of the United States who are injured while in the per-
formance of their duties, shall be furnished, upon appUcation and
without personal charge, reasonable medical and surgical treatment
by all medical officers at first, second, and third class relief stations
of the service, in accordance with rules hereinafter prescribed :
1. An injured civil employee of the United States, in order to receive treatment,
shall present to the medical officer a certificate stating that he is a Government em-
ployee and that he was injured on a certain date while in the performance of hia
81 " (1126)
Digitized by VjOOQ IC
July 20. 1917 1126
duties. Such certificates must be signed by the employee's superior officer, or by
the medical officer, United States Employees' Compensation Commission.
2. An injured civil employee of the United States, in order to obtain the benefits
of the service, must apply in person (or by proxy if too seriously injured so to do) at
the local office of the Public Health Service, or to a medical officer of said service.
3. At marine hospitals, no charge shall be made for services or supplies furnished
injured civil employees of the United States. Expenditures incurred at said hos-
pitals for the care and treatment of such injured employees are payable from appro-
priations for the Public Health Ser\ace.
. 4. At second and third class relief stations of the service, expenditures incurred
on account of either office or hospital treatment furnished injured civil employees of
the United States shall be taken up in special vouchers rendered against the United
States Employees' Compensation Commission. The rat^s charged for the care of
seamen, as approved by the department, shall be charged for the care of injured
Government employees at all contract hospitals of the service, and vouchers for such
care should be rendered against the above-named commission. All vouchers for
services or supplies furnished in the treatment of said injured employees will be paid
direct by the irnited States Employees' Compensation Commission, and such vouchers
should be forwarded to the bureau for reference to the proper officer of that commis-
sion, unless otherwise instructed. In preparing said vouchers, the words ''Em-
ployees' compensation fund" should be written in at the station after the word "ap-
propriation" appearing on voucher forms, and 8tul)6 attached to such vouchers should
be altered to show that payment is made on account of the United States Compensa-
tion Commission. Until further notice, vouclu rs for said services or supplies should
be rendered on blanks issued by the Public Health Service, Forms lf)26 and 1949.
Expenditures payable from the above-mentioned fund should not be listed amon^
the exix'nditures noted in monthly schedules of encumbrances. Form 1955. No
charges shall be made for professional services furnished said injured employees by
medical officers of the serNice, nor shall any charge be made for supplies in slock
furnished such persons.
5. Treatment furnished injured employees of the United States, in accordance
with the above-mentioned act of Con<.^ress, shall be taken up in monthly reports of
patients admitted to and discharired from ho.-pital treat niont at first and second
clavss relief station?, and relief certificates and hospital permit.^ shall be issued in case
of treatment furnished such patients at third-class relief stations of the service. On
such reports the class of patient should be designated or shown and authority for said
treatment should be cited as "Act of September 7, 1916." Treatment furnished said
patients shall also be taken up in "Medical officer's monthly report of relief. Form
1922," and in annual reports of medical and surgical relief furnislied office and hos-
pital patients, Forms 1923, 1924, and 1925.
6. Upon the termination of both office and hospital treatment, a copy of the clinical
record of treatment furnished injured employees of the United Staters shall be for-
warded, through the bureau, to the medical officer. United States Employees' Com-
pensation Commission. Such clinical records shall include the history, diagnosis,
treatment, and other pertinent information connected with each case, and shall be
prepared on service Forms 1946 A, B, C, and D.
7. When it is in the interest of economy and to the welfare of injured employees of
the United States, the above-mentioned commission will order the transfer of such
patients from one station to another, including authority for the necessary expenses
involved in such tmnsfers. No injured employee should be so transferred without
special authority from the Unit(^d States Employees' Compensation Commission.
Upon the transfer of an injured einployee from a second or third class relief station to
a marine lK)S})ilal, for the purpose of receiviiiLr further treatment, a copy of the clinical
record should be forwarded to the medical officer in charge of said marine hospital;
Digitized by VaOOQlC
1127 July 20, 1917
and upon discharge of the employee from the marine hospital a complete clinical
record (covering his treatment at both the contract relief station and marine hos-
pital) shall at once be forwarded, through the bureau, to the medical officer. United
States Employees' Compensation Commission.
Officers in charge of second and third class relief stations are
directed to obtain letters signed by the proper authorities of the
local contract hospitals to the effect that civil employees of the United
States, injured while in the performance of their duties, will be
received at said hospitals and furnished quarters, subsistence, nurs-
ing, and necessary medicines, during the fiscal year ending June 30,
1918, at the same rates as named in their proposals submitted for
the care of seamen during said fiscal year; the services to be the same
as that furnished seamen. These letters should be addressed to the
chairman. United States Employees' Compensation Commission,
Washington, D. C. They should be obtained without delay and for-
warded through the bureau.
Receipt of this circular should be acknowledged.
Rupert Blue, Surgeon General.
QUARANTINE STATION, PHILIPPINE ISLANDS.
EXECUTIVE ORDER DESIGNATING THE ISLAND OF CAUIT, CEDU, PHILIPPINE ISLANDS,
FOR USE AS A QUARANTINE STATION.
Whereas by Executive order dated October 25, 1904, Luke E
Wright, civil governor of the Philippine Islands, set aside and re-
served the Island of Cauit, Province of Cebu, Philippine Islands,
'^For the use of the Quarantine Service and the Marme Hospital
Service,'* and said island is now used as a United States quarantine
station; and
Whereas the act of Congress approved August 29, 1916, provides
that all the property and rights which may have been acquired in
the PhiUppine Islands by the United States under the treaty of peace
with Spain, except such land or other property as has been or shall
be designated by the President of the United States for military and
other reservations of the Government of the United States * * *
are hereby placed under the control of the government of said islands
to be administered or disposed of for the benefit of the inhabitants
thereof,
I hereby designate, confirm, and set aside the island of Cauit,
Province of Cebu, PhiUppine Islands, for use as a quarantine station
under the Treasury Department of the United States.
(Signed) Woodrow Wilson.
The White House,
28 June, 1917.
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July 20, 1917 1128
MALARIA IN NORTH CAROLINA.
PREVALENCE AND GEOGRAPHIC DISTRIBUTION.
August 1, 1913, the poriodical circularization of the physicians of
North Carolina was begun to determine the prevalence and geographic
U. S. Marine IXospital, New Orleans, La.
Dear Doctor: The UniU»d States Public Health Service has under-
taken to collect information of the prevalence and geographic distribution
of malarial fevers in the United States. In order to obtain such informa-
tion, this form of postal card, which requires no stamp ^ has been prepared
for your reply.
Your report will be of value whether you have had cases or not. In
every instance, please fill in your post-office address, county, and State,
with your signature, as all data thus furnished will bo tabulated and used
in a report on the prevalence and geographic distribution of malarial fevers
in your State.
Please keep a record of your cases of malaria, as postal cards will be
sent you every quarter.
Thanking you for yoiu" cooperation, I remain,
Respectfully,
R. H. VON EzDOiiF, Surgwn, U.S.P.H.S.
(Post oflire.) (Counly.) (State.)
(Onto.)
The following numbers of new cases of malarial fevers occurred in my
practice? durini,' the nioiilhs uatnt^d. of tin* year 1915:
July. Au(jlm. ' SLPTKMiiKa. I
__ _. l_^ _^l t
White. Colored. White. < Colored. I Wliile.
I
Colored.
The (lia'/nosos won; coulirined by tli<- use of the inicrosroiMvin
of thes** cart*'.^.
NoTK. Any a'lditionjl infomiiilion Ijcariir.: <»ninilnrial i'ner<. their (\t-<»s. the l;iiid of
nin-.iiiit'M^ in the I'ivulilx. ^Uf i i.-^!»nrc of brc, iin/ cl-i'.e^cf ttv-^ .lit'-f^', pr >ph'. l.vtie
HK'-u'in >. ilir <!Hc m;ii/i:i. i»n>(» )rlijii ol ..hilduii aik U'J, a.ijil li.i :n -. 1-' iaiTU iovers,
vhnul'l »'<- ^t' u^d iinflcr n'lnirks.
Remarks-
., }f.D.
Vv] : li.cti' t] nf rfj'ly )>' .:;il '/.ird.
di-ii! ii)uti()n of mahiria inf(Mli(>n in \]\o Sf;<t(\ This was a continua-
tion of tho work ^vUi'h lia'l Ix* 'ii K-mmi mnn* limn two years boforo
Digitized by VjOOQIC
1129
July 20, 1017
July 20, 1917
1130
with the State of Alabama, and which had been carried out in the
meantime in a number of other States. At regular intervals reply
postal cards were sent to the practicing physicians in North Caro-
lina. Those cards were at first sent out each month. During 1915
and 1916 they wore sent out quarterly. A reproduction of the card
used in 1915 and 1916 is given on page 1128, showing the instructions
sent to each physician and the schedule which ho was requested to
fill out and return.
The work of circularization and of compilation of the data on the
returned cards was carried on by the late Surg. R. H. von Ezdorf up
to the time of his death in September, 1916. Since then it has been
carried on by Asst. Surg. Derivaux and Asst. Surg. Gen. Carter.
Jan.
Fab,
Mar.
Apr.
Ma7.
Jon.
Jul.
Auff.
Sep.
Cot.
Hov,
Deo.
A
-^^,
A
r
>
V
y
^ \
/
\
CO
o
/
V J
f
\
8
/
\/
^
/
V
\
\
/
\
>
V,
y
>
<
V-
■— ^
\
Kelatir.e prcvalon-o of malaria in North (^arolina. by m.»n;hs, as indicated by the numbers of
case.^ rop rled.
The collection of data by circularization of physicians is not en-
tirely satisfactory in the results it gives. Only about 16 per cent of
the physicians fill out the schedules and return them. It is impossible
to know the controlling reasons why these 16 per cent return the
blanks and 84 per cent fail to do so. One is likely to wonder whether
the 16 ])cr cent represent the more cnpable and conscientious physi-
cians. It is probable that tliey do and that the replies re[)resent the
information of th(^ bettor practitioners. Tlie number of cards sent
out and numl)ers of schedules returned, and the other results of the
circularization, are shown briefly in Table 1.
The results of circularization in this way, depending as they do
upon voluntary cooperation of the physicians, do not show the actual
number of cases of the chsease that occur. The method, however, is
dependable and furnishes quite satisfactory information regarding
Digitized by VjOO
1131
July 20, 1917
the ge(^aphic distribution of the disease. The replies fr( m the
various localities also serve as a convenient and sufficiently accurate
index of the relative prevalence of malarial fevers. The data re-
turned by the physicians are probably as dependable an index of the
relative prevalence of malaria in the several counties as are the mor-
tality records which it has been customary to use as an index of the
relative prevalence of typhoid fever and other diseases.
The numbers of cases reported by months for the entire State are
given in Table 2, the cases reported by counties in Table 3, the types
of infection reported to have been diagnosed microscopically in Table
4, and the counties in which hemoglobinuric fever was reported in
Table 5.
The map on page 1129 shows the relative prevalence of the disease
in the several counties, the heaviest shaded counties being those in
which the infection is heaviest, the unshaded those in which the
infection is lightest. The relative density of infection was determined
by ascertaining the number of cases reported in each county from
August 1, 1913, to December 31, 1916, per 1,000 population. The
population used was that of the 1910 census.
It will be noticed in Table 4 that tertian infection was reported as
having been diagnosed microscopically in 57 counties, quartan in 18
counties, and estivo-autumnal in 34 counties. Hemoglobinuric
fever was rpj)orted in 4 counties, namely, Johnston, Martin, Person,
and Bertie.
Table 1.— Results of circularizallon of practicing physicians.
Period.
1913.
August to November..
1914.
Jaooary !o December.
1915.
January lo Mart'h
April to June
July to j'pptemljer
October lo De:emljer.
Inqriry
i (Ar<\< Replies
I fo u o I received.
I)hy.^i i ins.
1910.
Jtnoary to Manh
April to June
Jimr to September
October to December.
,849
21, I2G
5,547
1,SI9
1,849
1,819
1,849
1,849
1,849
1,849
408
3,320
780
268
331
:^8o
300
304
220
26C
Pouc
of ic.'lie
I Counties
*■ 'reprevsente<l
in replies.
15.72
14.06
14.49
17.90
20.55
16. 24
16. 45
11.89
14.4ti
Count ie"?
not iH'Hnl
from.
Coses of
miilaria
reported.
«3,901
82C
1,144
2,(V44
1,844
465
1,363
1,524
1,081
Year.
Jan.
B13
1914
867
1915
351
19W
lao
' Includes 500 cases estimated.
Table 2. — Cases of mntnria reported by montfis.
Feb.
579
205
125
Mar.
476
2W
201
Apr.
619
228
280
May.
1,004
350
434
June.
July.
Aug.
Sept.
Oct.
Nov.
Dec.
>i,a3i
1,050
797
,502
U,160
678
1, la-i
649
«783
8S9
554
»427
425
653
292
l,2»i')
444
373
314
302
235
500 additional cases estimated; not distributed by raonthfj.gi^j^g^j ^^ CjOOQIC
July 20. 1917 1134
Table 4.— Types of infection reported diagnosed microscopically y by counties— ConxA
County.
Forsyth
Franklin.,.
<}a5ton
<iatct
Ciraharn
tiranviUo...
iJrecno
(Jullford....
HBlifAX...
Harnett
Haywood . .
Hcndonon .
Hertford...
Hoke..
Hyde
Iredell
Johnston
!>«»
I^enoir
Lincoln
McDowell
Martin
Mecklenljurg..
.Montpomery. .
MtxH^
Nash
Vcw Hanover..
Northampton..
Oii^slow ,
<)r.»nire ,
i'ainlico
fa-^'iu^tank
!'<'f',nimaa!?
l'« n;nn
I'm
Tolk-
i^.iiMloIph
Knhmond
U<>t»esoB
U(MkJngham..
UoMon
Uiitherford
^amiwon
^ootland.
Total..
Tertian.
August- .January-
Novem- Septem-
ber, 1913. ber,1914.
15
Quartan.
Estivo>«utuinnal.
August- 'January-
Novem- ! Septem-
ber, 1913. ber,1914.
+
+
August- I JanoaiT-
Noven>' Septem-
ber, 1913. ber,1914.
I
10 ;
5 '
3S
1
4 '
10 I
+
+
+
10
22 1
I
I
10
I
13
2 ! -f
3 1
13
1
,
+
-4-
+
4-
■f
-}-
+
' i
4-
2
4
3 '
. .. . 1
+
-t-
4-
-1-
I
1
33
I
3 ...
1
4
.^tAnly
Stokei
■*-
3
1 .
+
4-
1
4-
1
+
1
•
1
TraiKvl VAnia '
I .
T>rr»'ll
r nu*n
9
1
4
4
+
2
14
2 .
5 ,'
2.-. '
4-
4-
4-
+
3 i
Vance
Wake
+
1
1
■f
4-
I !
+
1
7
W.irrcn
Wn-^hington
Wa\ne
4-
13
H-
4-
4-
1
5 ,'
4-
1
3
\Vilki-«
Wilsiin
+
4
4
12
+
^
+
^'*'* -^
116
The (igurci intlicato the niirii> .r- «)f fa-e^ reported 'liatrnosed microscopic illy. The si:in + indic»t«l
that < v^'.w*r. Tv\>>r\i 1. l-nt •!,. in.': . ua. not i-onUimcd l>y the i')Krost.o|)c. Thi>^ informiitlon Wi«
oo!le<lo<J during ihr year-; lyii ^h1 Vj\\ -nly.
Tahi e 5- -If*inoglohinuric/ei€r reported, 1916.
Coiniiv.
Period.
Second quarter....
C«»8.
j(,>,. vton
1
>1 if' in
Third quarter
Third quarter
Fourth quarter....
s
!'• r <>n
1
ItctUc
1
1135 July 20, 1917
HAY FEVER.
ITS CAUSE AND PREVENTION IN THE ROCKY MOUNTAIN AND PACIFIC STATES.
By WiLUAM SCHKPPEORXLL, A. H., M. D., New Orleans
The pollens which cause hay fever in the Eastern and Southern
States have been the subject of considerable investigation, and the
principal poUens have been identified. West of Kansas, however,
this subject has received little attention, most writers having con-
tented themselves with the vague statement that hay fever in this
repion is uncommon.
Investigations during the past year, however, have shown that
hay fever in this section, wliile not as common as a whole as in the
Eastern and Southern States, is by no means infrequent and is,
moreover, constantly increasing. Reports from Cahfomia and
Colorado show that hay fever is a common disease in these States.
A correspondent in Santa Fe, New Mexico, states that there is a
'gKiat deal'' of hay fever in that section. .Vnother from the State
of Washington claims that hay fever is exceedingly common. Re-
ports also show that hay fever is common in Montana, Orecjon, Idaho,
Arizona, Wyoming, Utah, and Nevada. In view of thi^ prevalence
of hay fever in these States the need for a careful investigation of this
subject is clearly indicated.
The main difficulty in estabhshing the exciting cause of hay fever ^
in this section is that the common and giant ragweeds (Ambrosia
daiiar and irifida), which are the usual cause of autumn hay fever
(85 per cent) east of Kansas, are found west of the 100th meridian
in insufficient quantities to be of importance in hay fever except in
a few localities.
In correspondence with the various State boards of health of the
Pacific and Rocky Mountain States, we found uniform interest in
the subject of hay-fever prevention, but a lack of information as to
the exciting causes of the disease. With a view, therefore, of ob-
taining definite information on this subject, we have conducted a
series of investigations during the past 18 months, which has enabled
us to determine the principal hay fev er plants of this section.
Hay Fever Plants.
The identification of hay fever plants in general is simplified by
the fart that they are all wind-pollinated. Many insect-pollmated
and self- pollinated plants contain pollen which will produce the
hay fever reaction in the biological test, but as their pollen is not
' The biolocicaJ propertie^of the pollens dejicrJbed in this article have all been determined b5' direct te^ts
oo bij'fovw Mibjects. In th« unimportant pollens which have pro\ed uepiitive or, not being wind-
*WM, can cause hay fever only on direct inhAlation, only a few tests have been made. In the important
^Ufrfcrer pollens, however, many hundreds of le>l^ (in the ra'4 weeds several thousands) have been mad«
teerdtr Codetttmint both qualitatively and quantitatively their responsibility in hay fever.
Digitized by VjOOQIC
July 20, 1917 1136
found in the air and can not therefore reach the nasal passages in
ordinary respi'uiion, they are not responsible for hay fever.
Wind-pollinated plants arc chai'acterized by inconspicuous flowers,
which are without bright co^or? or scent, and by the large quantity of
pollen which they generate.* Many wind-pollinated plants, however,
have pollen which does not produce hay fever (pines, sedges, etc.), or
which causes reactions of a mild character (amaranths (AmarantJius),
docks {Rumex)y chenopods (Cheriopodium), etc.). These efiFects can
be determined only by means of the biological test.
Biological Test for Hay Feyer.
The method of making the biological tast for hay fever is as follows:
For the pollen of botanical genera which have not yet been tested, a
weak saline extract (1 to 20,000) of the pollen is first used. Care
should be taken that the saline solution used is a one-half of 1 per
cent solution, as a stronger or weaker solution causes irritation of the
nasal mucosa independent of the action of the pollen extract. When
the subject fails to react to this weak extract, stronger extracts are
applied. When these also prove negative, some of the poUen is
applied directly as a final test.
The pollen extract is prepared by adding 1 centigram of the speci-
fied pollen to 10 c. c. of 5 per cent salt solution. After the soluble
extracts have been dissolved, the liquid is filtered and 7 per cent
aicohol added. When used for testing the reaction of a patient, or
fov immunizing, this is diluted so as to represent a pollen extract of
1 to 10,000 to 1 to 200,000 or more according to the toxicity' of the
pollen used. In our research work, we are using a unit representing
0.001 milligram of pollen extract which has proved of practical
value.
For the conjunctival reaction, the extract is applied to the con-
junctival sac, the reaction being indicated by the hyperemia pro-
duced. The skin reaction is secured by making a number of
fight scratches on the skin and rubbing in a drop of the pollen extract
to be tested. A positive reaction is indicated by reddening and edema
of the area surrounding the abraded surface, accompanied by itching.
In the hay-fever clinic of the Charity Hospital of New Orleans we use
individual syringes in capillary tubes, by which a drop of the extract
is injected into (not under) the skin. The reaction is similar to that
obtained by scarifying the skin. The cutaneous tests have the ad-
vantage of being available when the patient is suffering from hay
fever, when the conjunctival reaction is not practicable.
> "Hay fever and its prevention," Wm. Scheppeprell, l*iiblic Health Reportu, July 21, 1916.
• ** Toxicity " in conne?lion with poUen.-* refers to the posit ive reaction in hay-fever subjects. The exist-
CDce of a true toxin in hay-fever poIlen« is still under invent igation.
Digitized by
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1137 Joly 20. 1917
Before enumerating the hay-fever plants of the Pacific and Moun-
tain States, it will be well to make a brief resum6 of the principal
hay-fever plants of the Eastern and Southern States.
Principal Hay-Feyer Plants of the Eastern and Southern States.
In this section, we have two distinct seasons of hay fever, which
differ in the various States only in their dates and duration. The
average dates for the two seasons of these States are May to July for
the early form, and August to October for the autumnal form.
The early form of hay fever in this section is due principally to the
pollen of the Graminese, which includes the grasses, both wild and
cultivated, and some of the cereals such as rye, oats, and wheat.
Theoretically, com also is included, and is frequently referred to as
a common cause of hay fever. The size of its pollen, however, is
relatively so great (80 microns) that it causes few cases of hay fever
and then only in close proximity to such crops. Rye and wheat also
have large heavy pollen grains (50 microns) which gives them a
limited potential area of distribution by the wind.
The trees, which are largely wind-poUinated and frequently dis-
tribute their pollen in enormous quantities, usually bloom in the
spring, but are rarely responsible for hay fever. The pines (Pinus
scopylorum and other species) are especially prolific in their pollen
(fig. 1) but have always given a negative reaction in our biological
tests. The pollen of some of the oaks, willows, ailanthus, and other
trees give a mild reaction for hay fever, but not sufficiently to be of
importance in a general consideration.
The autumn hay fever which forms about 65 per cent of all the
cases, is due usually (85 per cent) to the pollen of the common rag-
weed {Ambrosia elaiioTj fig. 2), this being replaced in some sections
by the giant ragweed {Ambrosia trifidaj fig. 3). The remaining 15
per cent of cases are due to the pollen of other plants, of whicli the
various species of cockle bur {Xanihiums) and the marsh elder {Iva
cUiata) are the most important.
Hay-Fever Seasons in the Pacific and Rocky Mountain States.
In this region there are also two hay-fever seasons, but these have
a greater tendency to merge and the fall hay fever usually comnionccs
earUer. The cause of this will be understot)d wlion the pollinating
periods of the hay-fever plants are examined. The dates of the hay-
fever seasons in these States are as follows:
Digitized by
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July 20, 1017
1138
State.
Spring and summer
form.
Autumnal form.
Arizona
May 5-June 5 . .........
July 15-Oct. 1.
July 15-Sept. 15.
July 2(>-Sept. 15.
Aug. 1-Sept. 16.
Aug. 5-Sept. 15.
California
May 5-July 5
Colorado
Mav lO-Julv 1
Idaho
May 5-June 10
Montana
May 15-Jiilv 15
Nevada
May 1-July 15
Aug. 12-Sept. 15.
New Mexico
May 3-Jiily 5
July 12-Sept. 28.
July l-'Sept. 1.
Orej^on
Apr. 25-May29
June 22-July 27
Utah
Aug. 5-Sept. 15.
Washington
June 12-Julv 1
.July o-Oct. 7 (fall rains.
Wyoming
May 1-May 15
Aug. 5-Sept. 15.
Early Hay-Fever Season.
As in other sections of the United States, the early hay fever is due
principally to the pollen of the grasses (Graminese), including both
the wild and cultivated grasses. Other pollen which contribute to
vernal hay fever in this section are those of the following plants in
the locahties in which they are found: Bud-brush, Ariemi^ spine-
scens; poverty weed, Ii>a axillaris; sand-bur, Gxrtneria dumosay and
Gsertneria hipinnatifida.
While all the grasses give a positive hay-fever reaction in the
biological test, these naturally vary in different sections. The prin-
cipal grasses responsible for hay fever in CaUfornia * are as follows:
Johnson grass, Holcus halepensis; GaiUeta grass, Pleuraphis rigiJa;
crab grass, Syntherisma sanguinalis; knot grass, Paspalum distichuin;
barnyard grass, EcJiinocliloa crus-galli; velvet grass, Nothoholcus lana-
tus; Bermuda grass, Capnola daciylon; salt grass, Distichlis spicula;
walk grass, Poa annua; blue grass, Poa pratensis; broncho grass,
Bromns villosus; rye grass, Lolium perenne, and barley grass, Hordeum
murinum.
In Oregon, the most common grasses are the following: ^ Sweet
vernal grass, AnthoxantJium odoratum; velvet grass, Nothoholcus lana-
tus; brome grass, Brortius carinatus; orchard grass, Dactylis glomeratn;
rye grass, Lolium perenne^ and blue grass, Poa pratensis.
In the State of Washington ': Velvet grass, Nothoholcus lanaius;
early hair grass, Aira praecox; rye grass, Lolium perenne; squirrel-
tail grass, Iloi'deum juhatum; chess, Bromus secalinu^, and other
species of Bromus,
In Wyoming: * Western wheat grass, Agropyron sinithii; hair grass,
Sporobolus airoides; blue grass, Poa pratensis; timothy, Phleum pra-
tense; crested hair-grass, Koeleria cristata; squirrel-tail grass, Hor-
•Report of Professor H. M. Hall, University of California.
* Ueiwrt of Professor Howard S. Hammond, University of Oregon.
• He[X)rt of Professor (leornc B. RigR, Univerhity of Washington.
*Tirj)ort of I'rofcssor Aveu Nelson, University of Wyoming,
Digitized by
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8
Digitized by VjOOQIC
Digitized by
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1139 July 20, 1917
dewm jubatum; reed meadow grass, Panicvlaria grandis; tall fescue
grass, Festuca eJoHor; smooth lymo grass, Ely^mus condensatuSj and
tufted hair grass, Deschampsia caespitosa.
In Colorado:^ Short-awned chess, Bromtis hrizaeformis; downy
brome-grass, Bromus tectorum.; western wheat grass, Agropijron
smithii; Kentucky blue grass, Poa pratensis; orchard grass, Daciylis
glomerata; crested hair-grass, Koeleria cristata; grama grass, Bouieloua
gracilis; silk grass, Agrostis hiemalis; timothy, PMeum pratensej and
squirrel-tail grass, Hordeum jubatum.
In Arizona:^ Annual fescue, Festuca octoflora; six weeks grass,
Bouieloua ariMidoides; mesa grama, Bouieloua rothroclcii; annual
poverty weed, Aristida bromoides; blue grama, Bouieloua gracilis
and silver top, Andropogon sacckaroides.
The most common grasses in Idaho, Western Nevada, Now Mexico,
and Utah are the following:^ Hungarian brome grass, Bromus inermis;
wild odt* grass, Stipa viridula; long-awned grass, Arisfida longiseta;
sleepy grass, Stipa vaseyi; false oat grass, Trisefum spicaium; western
wheat grass, Agropyron smithii; bearded wheat grass, Agropyron
richard^omiif and other tall wheat grasses.
Important Hay-Fever Plants of the Pacific and Rocky Mountain States.
While the common ragweed (Ambrosia elatior, fig. 4), the principal
cause of fall hay fever in the Eastern States, is uncommon west of
Kansas, it is found in certain sections. In some parts of Colorado
it is .very abundant in the towns * being usually found in company
with the *' Great ragweed" {Iva xanthlifolia^ fig. 5). The latter
should not be confused with the Great ragweed of the Eastern and
Southern States, which, while belonging to the same family (Ambro-
siaceae), is Ambrosia trvfida. Their hay-fever reaction, however, is
similar.
The great ragweed {Ambrosia trifida, fig. 6) which is a cause of
autumnal hay fever in portions of the Eastern and especially in the
Gulf States, is also found in -a few sections of the Pacific and Mountain
States. It is found in Wyoming^ as well as the western ragweed
{Ambrosia psUostachyay fig. 7), but is not as abundant as Iva xanthii'
folia and sage brush {Artemisia tridentata).
In Arizona, some of the ragweeds are found, these being the
"great ragweed" (not Ambrosia trifida of the Eastern States but
Ambrosia aptera) and the ''small ragweed" (not Ambrosia elatior
of the Eastern States but Gxrtiuria tenuifolia).
» Report of Professor Francis RamAJey, University of Colorado.
* Report of Professor J. J. Thornbcr, University of Arizona.
'Report of Professor P. L. Ricker, Assistant Botanist, U. S. Department of Agriculture, Washington,
D.C.
« Report of Professor Theo. D. A. Cockrrell, University of Colorado.
* Report of Prof, Aven Nelson, University of Wyoming.
Digitized by VjOOQIC
July 20, 1917
1140
The western ragweed (Ambrosia psUostachya, fig. 7) is so common
in some parts of California; that it is an important factor in hay fever ^
in that State. It is found in moist, open soil from Illinois to Sas-
katchewan, Texas, Mexico and California. It is a perennial weed,
2 to 6 feet high, growing from running root stocks, thicker and
stouter than the common ragweed, covered with loose shaggy-
white hairs; loaves thick, much divided, the lobes of the leaves
lanceolate and acute; the staminate heads on short pedicels; the
fruit soUtary in the axils below.
Fig. 4.— Common rag weed (Avjbrosia datior). The principal cause of hay fever
in the Eastern and Southern States. (From "Illustrated Flora of North
America," by Britton and Brown.)
The most important hay-fever weeds of the Pacific and Mountain
States, and which give the most severe reaction, are the worm-
woods (Artemisias) , While their pollen is not produced in the same
profusion as that of the ragweeds (Ambrosias), they give a marked
hay-fever reaction which in some species is five times- as active as
» Report of Prof. H. M. Hall, University of California.
• The A rttmisia heUrophylla produces a reaction in dilutation of 1 to 100,000.
Digitized by
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1141
July 20, 1917
that of the ragweeds (Ambrosias). The pollens of all the Atiemisicis
examined are three-lobed, and are all smooth with exception of
Artemisia biennis, which is sUghtly spiculated.
In California, Artemisia heterophyUa (mugwort) and Artemisia
trideniaia (sagebrush, fig. 8) are the principal hay-fever plants.
In Oregon the Artemisia^ are also the principal cause, being far
more abundant than other hay-fever weeds, such as the Ivas, Xan^
HiiumSf Gstrtnerias and Amhrosia psUostachya,^ and this is the case
Fia. S.—Bur marsh elder, also known in the West as the ''groat
ragweed'' ilvaxanthii/olia). Grows In moist soil and is a cause
of baj faver from Idaho and 8askat<^hewan, Iowa to Mexioo,
but b not found on the Pacific Coast. (From "Illustrated
Fktra of North America/' by Britton and Brown.)
in most of this section except in the moist region near the Pacific
Coast. In Colorado ' on the western slope of the mountains, Arte-
misia tridenUUa covers vast areas almost to the exclusion of other
plants. In the sagebrush district persons suffer a great deal from
what is popularly caUed ^'moimtain fever." This has all the symp-
toms of severe hay fever and is prevalent from August to November,
the period of pollination of the sagebrush, and is evidently due to
the pollen of the Artemisia tridentata.
» Report of Prof. Howard 8. Hammond, Univendty of Oregon.
I Report of Prof. Theo. D. A. Cockerell, University of Colorado.
82
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In view of the importance of the Artemisias from a hay-fever
standpoint a description of the most common varieties is given:
The Artemisias in the Rocky Mountain and Pacific States.^
Artemisia is a genus of meetly bitter and aromatic herbs and shrubs, of which the
European wormwood is perhaps the best known. It belongs to the mayweed section
of the Compositae family, but, unkke the mayweed, the flower heads of .4rtem«ta are
small, inconspicuous, and without rays. In some cases the flowers are apparently
self-pollinated; in others the pollen is wind-carried, and in those it is produced in great
abundance. There is no reason to suppose that insects aid in their p>ollination.
Only those which are wind-pollinated are important from a hay-fever standpoint.
Fio. C— Giant rag weed (Ambrosia trifida). Replaces the conunou rag weed (Ambrosia elaiior) in most
parts of the Eastern and Southern States and is also (oiind in some sections of Nebraska, Colomdo, and
New Mexico. (From "lUustnUed Flora of North America," by Britton and Brown.)
The genus comprises some 200 species. Its greatest development is in the Mediter-
ranean region and in arid North America. Aljout 50 species are found native in the
Rocky Mountain and Pacific States, but most of these are of limited distribution,
or occur only at high altitudes, or because of some other peculiarity are not important
as causes of hay fever. On the other hand , a few of the species grow in great abundance
in the neighborhood of towns and in agricultural districts, where they constitute a
serious menace. The (]^alifomia mugwort {ArtemUia heterophylla) is perhaps the most
common of these on ditch banks and in waste places, while the Sagebrush {Artemisia
tridentata) is the most abundant shrub in the Great Basin area. Both of these have
been tested in the Biological Laboratory of the American Hay-Fever-Preventioa
Association and have been found to give a marked hay-fever reaction.
« Report of Prof. H. M. Hall, University of California,
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July 20, 1917
California mugwort, Artemisia heterophylla. ThiB name includes several forms,
some of which arc considered as distinct species by some botanists, but they are all
much alike and the properties of the pollen are probably the same for all. The mug-
wort is an erect perennial herb 3 to 8 feet high. The leaves are rather broadly oblong,
2 to 4 inches long, either cleft or entire, and green above but white beneath. The
plants are in bloom from about July 1 to late autimin. They grow either scattered or
in masses, often forming thickets on river banks or along ditches. They are especially
common on low, moist land.
The banks on which mugwort grows are usually too uneven to permit cutting by
mowing machines, but it could be cut by hand with a scythe. The plants would grow
up again from the roots, but by cutting the tops occasionally the amount of pollen
Fhs. 7.— We3t«m rag weed (Ambrosia psiloitaehifa), western representative of the rag weeds (A mhraiiat),
Mobt open soil from Illinoia to Saskatchewan, Texas, Mexico, and California. (From "Illustrated
Flora of North America," by Britton and Brown.)
could be greatly reduced. In suitable situations, the mugwort may be expected
•nywhere from southern California to British Columbia, and east as far as Nevada.
It does not grow above an altitude of about 5,000 feet, but from Oregon to Alaska it is
replaced by the closely-related ArtemxHa tilesii, wtiich ranges higher.
Dark-leaved mugwort, Artemisia ludovicUma. In general habit this species is much
like the mugwort, but the leaves are usually narrower and are whitened on both faces
by t woolly pubescence, at least when young. (In Artein isia g^naphalodes, a very closely
related species and likewise common, the leaves are permanently and densely white-
Ittiry.) It grows in waste places, especially in dr>'. stony stream bods. In California
rt is quite scattered, only occasionally growing in masses, but it is much more common
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1144
in the Northwest and in the Rocky Mountains, where it grows both on the plains and
on slTeam banks. Its period of bloom and the method of control are similar to tlwie
indicated for the mugwort.
''Indian hair tonic," Artemma dracunculoide$. The stems of Uiis perennial herb
are stiffly erect and grow to a height of 4 to 6 feet. Unlike most artemisias the herbage
is glabrous and green . All of the other species here described, except Ariemima biefmit
have a gray or whitish herbage. The leaves are mostly entire, 1 to 3 inches longuid
less than J inch wide. June to September is the period of bloom. Next to the sage-
brush, this is perhaps the most plentiful species in western North America. It grows
in mountain valleys and on the plains, but is generally absent from the deserts. Some-
times it forms dense stands. In such cases its subjection by mowing would i
feasible.
Fig. 8.— Sagebrush (Artemisia tridentala). A cause of hay fever over an extended area, as it grows from
New Mexico and Lower California north as far as Washington and Montana. (From "Illustrated Flora
of North America," by Britton and Brown.)
Sagebrush (Fig. 8), Artemisia Iridcntata. The sagebrush is an erect, much-branched,
gray shrub with a distinct trunk and shreddy bark. The narrowly wedge-shaped
leaves are only J to IJ inches long and mostly 3-toothed across the summit, although
some of the upper ones are narrower and not toothed. The pollen is produced from
August to November. This shrub grows from New Mexico and Lower California,
nortli across the high plains of the Great Basin States, extending even into Washington
and Montana. It is by far the most abundant and best-known shrub in this whole
region, forming the principal vegetation over thousands of acres. It belongs to the
arid districts of plains and mountains but does not grow near the coast nor in the hot
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1145 July 20, 1917
deeerts of the south. In Califomia it is scarcely known west of the Sierra Nevada.
The sagebrush is sometimes known as '*black sage/' but it ie not to bo confused with
the true black sage nor with the white sage, both natives of Southern California*
These true sages belong to the mint family and do not cause hay fever. Because of its
woody, almost arboreous habit and great abundance, the elimination of sagebrush will
form a difficult problem.
Bud brush, Artemina spinewens. This is a low, gray shrub with many stiff branches
ending in spines. It grows ) to 1) feet high. The very small leaves are densely
white-hairy and much lobed. The flowering period is earlier than that of most
Artemisias, the pollen being produced from March to June. The bud brush grows on
sandy or somewhat alkaline soil from the Mohave Desert of Califomia, north and east
to eastern Oregon, Wyoming, and Colorado. It is especially common in Nevada and
Utah. Eradication is difficult because of the woody natiure of the stems.
"Califomia old man," or hill-brush, Artemma cali/omica. This is a gray, highly
aromatic shrub. 2 to 4 feet high, best identified by its leaves, which are parted into
almost thread-like segments. It blossoms from June to October. Geographically it
is restricted to the hills of the Coast Ranges from middle Califomia southward, but
^lere it often forms dense growths of considerable area« especially in southern Cali-
fornia. Since the stems are decidedly woody the eradication of this plant is also
difficult.
Wormwood sage, Artemisia frigida. The stems of this plant are woody at base and
mostly 1 to 11 feet high. The herbage is gray and soft because of the many short hairs
which cover it, and the leaves are finely cut into linear lobes. The plant blooms
from July to October. It grows from Idaho, Nevada, and New Mexico, to Minnesota
and Texas, and is especially common on the plains of Utah and Colorado. There is
much of it around Denver. In Estes Park, Colo., hay fever is coincident with the
blooming of the wormwood sage.
Biennial wormwood, Arttmisia biennis. This is an erect herb 1 to 3 feet high.
It grows from a slender annual or biennial taproot, whereas all others here described
have tough, perennial roots, many of them more or less woody. The leaves are green
and scarcely at all hairy. They are I to 3 inches long and deeply cleft into narrow
bbes which are sharply toothed. The pollen is shed from July to December. This
plant occupies open places, especially ditch banks and neglected yards, throughout
wwtem North America, b iit is not often present in large amoimts. 1 1 can be destroyed
easily by pulling, especially when the ground is soft, since the root is not deep.
Artemisia cana, Artemisia canadensis, and Artemisia discolor, as well as a few others,
may be found in quantity at a few places but usually not in proximity to closely
populated districts.
Artemisia absinthium, the common wormwood, seems to have been introduced with
seed into eastern Washington, adjacent to Idaho and Oregon, it is spreading rapidly
throughout those localities.^
The Iva8« GflBrtnerias and Cockleburs.
Next in importance to the Artemisias are the burweed marsh elder, or ''Great
ng^weed " {Iva xanthiifolia), and the rough marsh elder (Iva axillaris).
Their pollens, which are spiculated like those of the rag- weeds (Ambrosias), also
give a similar reaction for hay fever.
IVAS.
Western elder or poverty weed, Iva aodllaris. (Fig. 9.) The povertyweod belongs
to the rag:weed section of the Composite family but is unlike all the ragweeds in its
leaves, which are only an inch long, sessile, and not at all toothed or cut. The
> Report of Prof. Howard S. Hammond, University of Oregon
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1146
1
Btems are not woody but prow from perennial creeping root^tocks, so that eradication
would be extremely difficult. Cutting close to the ground at the beginning of the
flowering season would greatly reduce the amoimt of pollen produced, but the stems
would again shoot up from the same
root?torks. The plants grow in alka-
line or saline soil from the Rocky
Mountains to the Pacific Coast and
from Canada to Mexico. The blocmi-
ing period is March to September.
Biu^eed marsh elder or great rag-
weed, Iva ranthiifoHa. (Fig. 5.)
This is a tall, coarse, annual weed
with ovate, sharply toothed leaves 2
to 6 inches long. In habtt and foliage
it resembles the common sunflower,
although it is not so large, hut the
small, homely heads of flowers are
borne in long terminal clusters. It
grows from Idaho and Saskatchewan
south to New Mexico but is absent
from the Pacific coart. It blooms in
late summer and autimin. Since the
root is of only annual dtu^tion, any
practice which will prevent the plants
px)m going to seed will be effecti\'e as
a method of eradication. Mowing is
adxdsable where the plants grow in
dense stands.
Next to the Artemisias and Ivas,
the GiTrtnerias were foimd to bo im-
portant as an active cauec of hay fe-
ver. Their pollen, which resembles
that of the common ragweed {Ambrosia elatior) so closely that it is difficult to dis-
tinguish microscopically, also gives a similar reaction.
G^RTNERIAS.*
Gartneria (sometimes called Frnnseria) is a genus of herbs and low shrubs with
alternate leaves which are often gray with short stiff hairs and usually lobed or toothed.
It belongs to the ragweed section of the Compositee family and has pistillate and
staminate flowers on the same plant as in the ragweeds. The Gajrtnerias differ from
the ragweeds in the biu^ which surround the pistillate flowers; these burs are armed
with several rows of spines or prickles, while those of the ragweeds have the prickles
arranged in a single circle. It is probable that the species are all wind-pollinated,
but some of them may be self-pollinated. The most common species in the West are
the following:
Sand bur, Gxrtntria dumosa. The sand bur is a low, spreading, white-stemmed
shrub, with brittle, woody branches. The leaves are less than an inch long, parted
into many small lobes and white with minute hairs, which cover the surface. It
grows in great abundance on the hot, dry deserts from southern Utah to southeastern
Galifomia and southern Arizona. It is very common along some of the railways croes-
FiG. 9.— rover 1 y weed or western elder ( Im arillam). A
cause of hay fever. Alkaline or saline soil from the
Rocky Mountains to the I*aclftc Coast and from Can-
ada to Mexico. (From "Illustrated Jlora of North
America," by Britton and Brown.)
» Report of Prof. H. M. Hall, University of California.
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1147
July 20. 1017
ing the southwestern deserts. The flowers shed their pollen from about the first of
Ifarch to the end of June.
False ragweed, Gxrtneria acanthioatpa. (Fig. 10.) This is a spreading and bushy
annual or biennial weed. The leaves are ashy gray, ovate in outline, but cut info
short, rounded lobes somewhat as in ragweed. The flat spines of the bur are straight
or only slightly curved. This species inhabits sandy plains and stubble and is com-
mon in arid sections from the Rocky Mountains to the Pacific coast. In California it
is restricted to the southern and eastern parts of the State, and similarly in Or^on and
Washington it is found only in the drier parts away from the coast. It is reported as
one of the commonest weeds in New Mexico. The blooming period is August to De-
cember. Since the roots are short-lived, the weed may be easily held in check by
July-Sept.
Fn. 10.—" False rag weed " {Omrtnerin acanihkarpa). A common cause of hay fever. In sandy plains and
■tabWe on the arid sections from the Roclcy Mountains to the Pacific coast. (From " Illustrated Flora
of North America/' by Brittonand Brown.)
mowing or burning before the burs ripen. Hand pulling is very effective, and may
be practiced where the area covered is not too large.
Qsatneria ienuifolia. This perennial very closely simulates the western ragweed in
general appearance, but may be distinguished by the burs, which have more than one
low of spines, and these are incurved or hooked. It grows in warm, dry districts from
ti« westerly part of the Mississippi Valley to Colorado, Nevada, and southern Cali-
faniia, and ranges south to Texas, but it is not so common as the other species. The
pollen is produced during late summer and autumn.
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July 20, 1917 1148
Osertneria hipinnatifida. The stems of this plant spread along the ground from t
perennial root. The white-hairy leaves are much cut into spreading lobee. The bun
form in dense clusters toward the ends of the branches, and each cluster is eunnounted
by a fingeriike projection made up of the staminate heads, which yield the poUen.
This pollen is produced from April to December. The species grows only on the sea-
shore, usually on the beach sands or dunes, and extends from Lower California to
British Columbia. From middle California northward it is accompanied by Gasrtnerk
ehamisaonis, a very closely related species with merely toothed or cut leaves. Either
sort would be diflicult to eradicate because of the deep, perennial roots.
COCKLEDURS.
The cockleburs (Xanihium) give a positive reaction for hay fever, but less marked
than the ArtemisiaSf Ambros^ias, Ivas, and G'^tncrias. The p>ollen is also spiculated,
but their large size (36 microns) reduces their potential area. It is abundant in some
localities, especially on bottom lands along the rivers. It is a cooroe annual, with
branching stems and alternate petioled leaves. Leaves broadly ovate, cordate,
usually three-lobed, and simply or doubly dentate. Sterile and fertile flowers in dif-
ferent heads, the latter clustered below, the former in short spikes. The fruit, a rough
bur, usually has two curved beaks and ie covered with prickles straight-tipped or
hooked, 2 to 6 feet high. It blooms from June to December.
Other Hay-Fever Plants of the Pkclfic and Mowitain States (Minor Importance).
The hay-fover plants of minor importance in this region are the
following: Dock, Rumex conglmrueratus and obtusif alius; sheep sorrel,
Rumex aceiosella; goosefoot or lamb's quarters, Chenopodium ambro-
sUndes; tumbleweed, Amaranthus grsecizaiis and salt bush, Hymmo-
clea salsola. Most of these plants generate poUon in abundance, but
the\so produce only a mild hay-fever reaction similar to that of the
docks, Rumex crispus, and amaranths, Amaranthus s-pinosus of the
eastern States.
Among the trees, the pollen of the majority have proven either
negative or so slight in reaction as to be of little importance in hay
fever. An exception, however, is the cottonwood (Populus). Of the
varieties tested, the pollen of Populus sargentii (fig. 11) gives a
marked reaction and is responsible for hay-fever cases in localities
in which it is found in sufficient quantities. Populus angusiifolia
gives a much milder reaction, and also the Arizona cottonwood,
Populus arizonica.
Plants Not Responsible for Hay Fever.
While describing the plants which are responsible for hay fever, it
is also opportune to say a few words regarding the much abused
roses and goldenrods. The rose is insect pollinated and could,
therefore, cause hay fever only on direct inhalation, as the pollen is
never found in the atmosphere. In addition to this, its reaction is
practically negative, so that in spite of the common term applied to
the early hay-fever rose cold it is not responsible for hay fever.
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1149
JuJy 20, 1917
The goldenrod has a spiculated pollen (20 by 22 microns), which
gives a positive hay-fever reaction. The flowerS; however, are in-
sect poUinated and cause hay fever only on direct inhalation or when
used for ornamental purposes, as in room decorations. In most sec-
tions the goldenrod continues to bloom many weeks after the hay-
fever season is over. In the atmospheric-poUen plates exposed in
New Orleans during the whole of the past hay-fever season the pollen
of the goldenrod (Solidago) was never found.^ In spite of its repu-
Fio. 11.— Western Cottonwood {Populua Mtrgentii). One of the few trees whose
poHen Cfluae hay fever. River bottome Saskatchewan to North Dakota, Ne-
braska, Kansas, and New Mexico. (From "Ulustrated Flora of North Amer-
ica," by Britton and Brown.)
ttticrai, therefore, the goldenrod is an insignificant factor in hay
fever.
Another falsely accused plant, whose reputation, however, is lim-
ited to the Rocky Mountain States, is the resin weed, Grinddia
gquarrosa (fig. 12), which is blamed in Wyoming and the adjoining
States for the prevalence of hay fever. Specimens of this were sent
to a Uologifeal laboratory by Dr. W. A. Wyman, of the Wyoming
> "Hay-fever and Hay-fever PoHens," W. Scheppegrell, M. D, The Archives of Internal Medicine,
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July 20, 1017
1150
State Board of Health. The pollen was found to be spiculated and
measures 20 microns in diameter, which is the size of the Trifida rag-
weed pollen, which it also resembles very closely microscopically.
The pollen, however (fig. 13), hke the flowers, is sticky and resin--
like, as imphed by the popular name. The pollen itself gives a posi-
tive reaction, but as it is not wind-borne, and therefore not in the
atmosphere, it is not a cause of hay fever. The probabihty, there-
fore, is that the resin weed, on account of its prevalence and con-
spicuousness, was selected in the same manner that the goldenrod
Fig. 12.>-Resin weed {Qrindelia tquarroaa). Popularly supposed to b«
the cause of hay fever in Arizona, Wyoming, and the adjacent Statea.
The plant is harmless, as it is not wind-pollinated. (From "Illustrated
Flora of North America," by Britton and Brown.)
has been so long held responsible for hay fever, while the real but
insignificant hay-fever weeds were unsuspected.
Potential Area of Pollen Distribution.
In regard to the responsibUty of the noxious plants for hay fever,
this depends, first, on the proximity of these plants and, secondly,
on the size of the pollen, which has a marked effect on their buoy-
ancy. As already stated, the pollen of corn, in spite of its toxicity,
is rarely responsible for hay fever, as its relatively S^y^kpWlX^O
■. as ^ tt o
''^ 3 CO .b c
*- Bj « 0) 3
MM oaf E
u.
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1151 Joly 20. IJ)17
microns, fig. 14) reduces its potential area to a short distance from
the plant. Ite other extreme is the poUen of the common ragweed
{Ambrosia datior), whose poilen measures 15 microns (fig. 2) and
whose buoyancy is so great that a wind velocity of 20 miles or more
will carry it several miles.
Mostof thegrasseshave pollen of consid^able size (35 to 55 microns,
fig. 15), so that their pollen is not carried to a great distance. On
this account, municipal efforts for ihe control of the early hay fever
due to these grasses have been attoidod with considerable success.
While the pollen of the Artemisias (fig. 16) gives a severe reaction,
their pot^itial radius is reduced by the size of their pollens (average
24 microns) to about one-eixth of that of the conunon ragweed (15
microns). Their pollen also, although produced in great quantities,
is many times less abundant than that generated by the ragweeds,
and the resiilting infection of the air is, therefore, proportionately less.
The bur marsh elder, Iva xanthiifolia, has spiculated pollen (fig. 17)
which gives a reaction sindlar to the Ambrosias. Its pollen \diich
is ovoid, measures only 15 by 20 microns, which gives it a considerable
potential wea. The western ragweed, Ambrosia fsHostachya, has a
pollen (fig. 18) similar to the common and great ragweeds (Ambrosia
datior and trifda), but as the pollen is larger (25 microns) it has a
much more restricted potential area.
TTie Omrtnerias give a reaction similar to the ragweeds (Ambrosias).
The poUen is also spiculated and their small size (average 17 microns)
gives them a considerable potential area.
Preyention.
«
The prevention of hay fever by the eradication of the weeds that
produce the noxious pollen is a more compUcated problem in the
Pacific and Rocky Mountain States than in the Eastern States.
llus is due to the fact that the fall hay fever is caused by the poUen
of a larger number of plants.
In the early (vernal) form of hay fever, which in all the States is
due principally to the poUen of the grasses (Graminex), this presents
no great difficulty. The potential area of the grass pollens is not
great and the enforcement of suitable grass-weeds ordinances should
be sufficient practically to eliminate grasses as a factor.*
The fall hay fever, however, which is due principally to the pollen
of the Artemisias, Ivas^ and Gsertnerias, presents greater difficulty
both on account of the larger number ol these plants and the greater
buoyancy of their pollen.
While the fall hay fever of the eastern States is due almost entirely
(85 per cent) to the pollen of the common ragweed (Ambrosia elatior),
> The N«w Orleans grass-weeds ordinance, adopted Jan. 25, 1916, was published in the Public Health
ReporU of Aug. 25, 1916, p. 23ia
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July 20, W17 1152
the fall hay fever of the Pacific and Rocky Mountain States is due to
many varieties of the ArtemisiaSf as well as of several of the Ivas and
Gsertneri/is and also to the western ragweed (Amirosia psUostachya).
Tlie larger number of plants^ however, is offset by the far greater
buoyancy of the pollen of the common ragw eed ot the Eastern States.
Measwing only 15 microns in diameter and having a spiculated
surface, which adds almost 50 per cent to its buoyancy, the potential
area of the common ragweed pollen is so great that it will traverse
several miles in a wind of 20 miles per hoiu*, as has been frequently
demonstrated by atmospheric-poDen plates.
The ArtemisiaSj however, on account of the size of their poUen,
which average about 24 microns, will traverse only about one-sixth
of the area of the common ragweed, this area being still more reduced
by the fact that their surface is smooth instead of spiculated, as in
the ragweeds. In spite of the great prevalence of these plants,
therefore, legislative measures for their eradication from the vicinity
of municipalities should prove quite eflFective. This also applies to
the western ragweed (Ambrosia psUostachya) whose pollen measures
25 microns, which also restricts its potential area of distribution.
The GaertneriaSj however, which bear a resemblance to the rag-
weeds both in the spiculated poDen and in their hay-fever reaction,
also have a light buoyant poDen (average 17 microns) which give
them an extended potential area. On this account special efforts
should be made to eliminate them from the neighborhoods of com-
munities.
The education of the public in the noxiousness of these weeds
from a hay-fever standpoint is of the greatest importance. When
this has been accomplished, suitable legislation will be* enacted.
When we observe the stringent laws enacted by various Statee for
the exclusion of parasites injxu*ious to their agricultural intereatSi
suitable legislation for the protection of the large number of hay-
fever sufferers should present no great difficulty.
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PREVALENCE OF DISEASE.
No health department J State or local, can effectively prevent or control disease without
knowledge of when, where, and under what coriditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIE&
CaOfoniia Report for the Week Ended July 14» 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended July
14, 1917, as follows: The prevalence of cerebrospinal meningitis
increased. Six cases were reported in San Diego County, one case
each in Oakland, San Francisco, and in Alameda County. There
was a sharp increase in typhoid fever. A total of 53 cases was re-
ported, well scattered over the State. Of measles, mumps, and
chicken pox, the numbers of cases continued to decrease. Diph-
theria cases were shghtly reduced.
The details of notifiable disease cases reported in the St^te during
the week ended July 7 are as follows :
r-erebroepinal meningitis 4 , Mumps 101
Chick on pox , 50 Pellagra 1
Diphtheria 27 Pneumonia 22
I>enf;iie 1 Scarlet fever 57
EryBip)ela9 7 Smallpox 2
(ierman measles 36 Syphilis S2
Gonococtu» infection 23 j Tiihertulosis 87
Malaria 4 Typhoid fever 21
Mcaalee 184 • Whooping cough 38
ANTHRAX.
Bfassachnsetts.
During the month of June, 1917, 9 cases of anthrax were notified
in the State of Massachusetts.
CEREBROSPINAL MENINGITIS.
Kansas.
During the period of two weeks ended July 14, 1917, cases of
cerebrospinal meningitis were notified in Kansas as follows: Two
at Kansas City, one each at Independence and Leeds.
(1153) ^ .
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July 20, 1917
1154
CEREBROSPINAL MENINGITIS— CV>ntiniied.
State Reports for June, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
District of Columbia
3
Massachusetts— Continued.
Suffolk County-
Boston
Maryland:
KAltimore Citv
23
2
1
0
Chelsea
2
Baltimore County—
O&Tflenvillfi
Worcester County—
Templeton
1
8t)arrows Point
Worcester
2
Total
Total -..
26
36
West Virginia:
Marshall County-
MoundsviUe
Massachusetts:
Berkshire County—
Plttsfield
6
1
Essex County-
Beverly
Wisconsin:
Bavfield County
OIotioestAr . .
1
Douglas County
Haxnpden County—
Chicopee.
SnrinEfield . ... . . ... . . .
Kenofba C^ounfy ,
Ifftnltnwnc C>0»intV, ,^-,-,-^ ,-
Milwaukee C<mnty
Palmer
Racine County
Middlesex County-
Oracut ...
Sheboygan County
TrempcAleau County
Lowell
Winnebago County.'
Total
WatertowiL. '..
10
Virginia Report for Maj, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Virginia:
AnTMinattox Countv ••••..
2
1
Virginia— Continued.
Orange County. -,-.r-
2
Buchanan County
Pulaski County
1
Charlotte Countv
Rockbridge C<junty—
Buena Vista
PYanklln Countv . • • • .
1
Gravson Countv
Russell County
2
Greene Countv •
Warren County
1
Total
Liinenburc Countv
16
Citj Reports for Weeic Ended June 30, 1917.
Place.
Cases. Deaths.
Place.
Cases. Deaths.
Akron, Ohio
Albany, N.Y
Altoona, Pa
Baltimore. Md
JJoston, Mass
l,uffalo, N. Y
( htcago, 111
(lev eland. Ohio
Dayton, Ohio
Dubuque, Iowa....,
Duluth, Minn
El Paso, Tex
Hartford, Conn
Kansas City, Mo...
Kokomo, Ind
Lincoln, Nebr
Madison, Wis
McKeesport, Pa....
Minneapolis, Minn.,
10
Nashville. Tenn
Newark, N.J
New Britain, Conn . .
New London, Conn..
Newport, R. I
New^ork, N, Y....
Philadelphia, Pa....
Pittsburgh, Pa
PittsfleldTMass.
PlainfleM, N. J
Providence, R. I
Quincy, 111
Rochester, N. Y
St. Louis, Mo
San Diego, Cal
San Francisco, Cal...
Springfield, Mass
Wilkes-Barre, Pa. . . .
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1155
July 20, 1017
DIPHTHERIA.
See Diphtheria, meaeles, scarlet fever, and tuherculoeis, page 1165.
DYSENTERY.
Arkansas, Missouri, and Tennessee.
Passed Asst. Surg. Ridlon reported July 13 and 17, 1917, concerning
the outbreak of dysentery in Mississippi County, Ark., and vicinity
as follows: The epidemic of dysentery is rapidly decreasing in this
vicinity. The virulence of the infection is much lessoned, and it is
difficult to find acute cases. There are no official records of cases or
deaths. Have epidemiological histories of 75 cases, and 300 case
reports from six physicians. The disease is most prevalent in Out-
lying districts, and has also been reported prevalent in southern
Missouri and western Tennessee. The disease has been reported
prevalent in Mississippi County, and adjacent counties in Arkansas,
and in Dunklin, New Madrid, Scott, and Stoddard Counties, Mo.
ERYSIPELAS.
City Reports for Weelc Ended June 30, 1917.
PhM».
BaltinM>re, Md
Birmini^ham, Ala..
Boston, Mass
Buffalo, N.Y
Cambridge. Mass. .
Chicago, nl
Cincinnati, Ohio...
Cleveland^ Ohio...
Dayton. Ohio
Denver, Co^o
Detroit, Mi-h
IHiluth, Minn
Harrisburgj Pa
Jackson, Mich
Kalamazoo, Mich. .
Lancaster, Pa
ttos Angeles, Cai...
Cas«9.
Deaths.
Place.
Lynchburg, Va
MeKeesport, Pa
Milwaukee, wis
Newark, N.J
New York, N.Y
Northampton, Mass.
Oakland. Cal
Orange, N. J
Philadelphia, Pa
Pittsbureh, Pa
Racine, Wis
Rochester, N.Y
St. Louis, Mo
San Fmacisco, Cal...
Seattle, Wash
Wilkinsburg, Pa
Cases.
Deaths.
LEPROSY.
California— Los Angeles.
A case of leprosy was reported July 13, 1917, in a Japanese woman
at Los Angeles, Cal., where the patient has resided one year.
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July 20, 1017
1156
MALARIA.
State Reports for June, 1917.
Place.
Maryland:
CbarlM County-
Bel Alton, R.D
LaPlaU
Port Tobacco
White Plains, R.D. .
Harford County—
Abingdon
Prince Georges County—
Aocokeek, R. D
Piscataway, R. D....
Wicomico CouBty—
Clara
RockawaDcing
Salisbury
Total
New cases
reported.
PlaM.
Massachusetts:
Bristol County-
Fall River
Norfolk County—
Brookline
Dedham
Plymouth County-
Brockton
Suffolk County-
Boston
Franklin County—
Enring
Montague
Total
New oases
reported.
16
Virginia Report for May, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Virginia:
Accomac County
Chincoteague
GreenbackvOle
, Albemarle County
Alexandria County
Alleghany County-
Clifton Forge
Amelia County
Appomattox County
Augusta County
Bedford County
Brunswick Coimty
Buckingham County
Campbell County
AltaVista
Brookneal
Caroline Coimty
Carroll County
Charles City County
Chesterfield County
Wlnterpock
Clarke County
Cumberland County —
Dinwiddle County
Eliiabeth City County . .
Phoebus
Essex County
Fairfiax County
Floyd County
Fluvanna County
Gloucester Count v
Greensville County
Emporia
Noiih Emporia
Halifax County
Houston
South Boston
Hanover County
Henrico County
Richmond
Isle of Wight County. . . .
Smithfleld
James City County
Williamsburg
King and Queen County
KlngWilliam County. . .
WestPoint
Lancaster County
Irvington
Lee County
Virginia— Continued.
Loudoun County
Leesburg
Louisa County
Limenburg County
Victorfe
Mathews County ,
Mecklenburg Countv
Clarksviile
Middlesex County
Montgomery County
Christiansburg ,
Nansemond County
Suffolk
Nelson County
New Kent County ,
Norfolk Countv
Northampton bounty. . . ,
Cape Chariot
Northumberland County
Nottoway County
Blat'kstone. .*.
Orange County
Page County
Pittsylvania County . . . . .
Powhatan County
Princess Anne County . . ,
Prince Edward Counly . ,
Farmville
Prince George County
Prince William County..
Richmond County
Rockingham County
Davton
RusseU County
Scott County
Southampton County . . . ,
Franklin
Spottsylvania (^ounty —
Fredericksburg
Stafford County
Surry County
Sussex Coimty
Warwick County
Washington County-
Damascus
Westmoreland County . . .
York County
Total
1
3
4
6
S
1
9
I
3
2
1
8
23
1
6
21
16
1
7
1
1
1
2
35
12
28
4
3
12
3
1
1
1
2
3
23
3
4
2
1
14
13
10
1
2
8
548
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1157
July 20, 1017
MALARIA— Continued.
City Reports for Week Ended June 30, 1917.
Plaoe.
B«keley,CaL
SIxinixi^tiAni. AIa.,
Charleston, S. C . . .
Kansas Ci^, ICo...
M€mnhis.Teim....
NewMk.kj
Cues.
DflHtbs.
Place.
New Orleans, La. .
Orange, N.J
San Frandscq. Cal,
Sacramento, Cal . . .
Savannah, Ga
Cases.
Deaths.
1 Tlie reason that Birmingham had so many more cases of malaria reported than any other citv is not
that the disnse is more prevalent in Birmingham than in other cities of Alabama and neighboring
States, bat ondoabtedly because of the suooessml efforts the health department has made in securing the
oooperatlon of the practicing physicians in reporting cases.
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1165.
PELLAGRA.
State Reports for June, 1917.
Place.
New
cases
reported.
Places.
New
cases
reported.
Dfetrict of Cohimbia
3
Massachusetts— Continu ed.
Essex County-
Dan vers
Marylind:
'^fertem iLryland Hospital
Qiarles County—
Bolton, R. D
Lynn
Middle^x County-
Somerville
Suffolk County-
Chelsea
Dorchester County-
Pishing Oxwk
Worcester Coimty—
Worcester
Washington County—
Total
Nanticoke
West Virginia:
Lewis Coimty—
Total
5
2
Massachusetts:
Bristol County—
Tauntcn
2
Virginia Report for May, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Virginia:
J^c*winac CouPty. ............... .
}
1
1
1
2
1
2
2
4
1
4
1
1
1
2
2
Virgtaia-Continued.
Hftnov^r Coiuity -
2
Albemarle County
Henr V Countv l
2
Am<^ County . . .^\
James City County
2
Amhmt County
WilHftmshiirg
1
Amhetat . . .'.
King and Queen County
1
Angusta County
Mec^enbufg County. . '
2
Campbell Countv
Pitt^ylvffnJA PoiiTity ...
1
GarroU County
RockWidge County—
Buena Vista
Charlotte County
1
Qiesterfield County
Russell Coimty
1
Colpeper Count V
Scott County
1
Wnwiddie County
fimyth Cou»)ty , .....
3
Greene County
Washington County-
Damascus
Greenesville County—
1
Bmporla
Wise County
1
Nocth Emporiar
York County
1
Hriite County
Total
Sooth BosfOTi.".!!!"!]!'.]!!'.!!!'.
IS
83
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July 20, 191T
1158
PELLAGRA— Oontinued.
City Reports for Week En^ed June 90, 1917.
Place.
Gases.
Deaths.
PJaon.
Caset.
Deaths.
Birmingham, Ala
»8
Mobile. Ala
2
1
1
i
Galveston, Tex
i
1
Nftshvlllft, Tfinn,,..... ..,
I
Kalaraaroo, Mich
1
1
New Orleans, La
Kan5as('ity, Mo
Savannah, Ga
s
Memphis, Tomi
2
> The reason that Birmingham had so many more eases of pellagra reported tbmn any otbw citv Is not
that the disea^^e is more prevalent in Birmiiii^ham than in other cities of Alabama and neignborins
States, but undoubtedly boeau.^ of tiic successful elTorts the health department has made In securing tbi
cooperation of the practicing physicians in reporting cases.
PLAGUE.
California — Alameda County — Plague-Infected Squirrels Found.
On June 29, 1917, a plague-infected ground squirrel was found on
the H. B. Goechen ranch, 3 miles west of Altamont, Alameda County,
Cal.
California — San Benito County — Plague-Infected Squirrel Found.
During the period from June 22 to 28, 1917, plague-infected ground
squirrels were found in San Benito County, Cal., as follows: Two on
the Blanchard & Whitman ranch, 3 miles south of Hollister, and
ohe on Dooling brothei-s' ranch, 7 miles northeast of Hollister.
PNEUMONIA.
City Reports for Week Ended June 30, 1917.
Place.
Atlantic City, N.J
Baltimoro, Md
Boston, Mass
Cambridge. Mass
Chicago, 111
Cleveland. Oliio
Detroit, Mich
Duliith, Minn
Everett, Mass
Fall Ki V or, Mass
Flint, Mich
Grand Rapids. Mich
Haverhill, M;*ss
Kalaraa/oo, M ich
LawTcuce, Muss
Cases. I Deaths. |
1
3
2
12
4
1
61
51
22
17
1
14
1
1
1
1
1
3
1
a
?
1
1
1
Place.
Cases.
Deaths.
lyexlnpton, Ky
I /OS Virole.-, t'al..
u
30
12
5
2
17
1
1
McKf^c^|)ort, Pa
M(>rnsto\\-n. N. J
New ark, N.J
Wnv Hfdford, Ma.'^s
OakLuid Tal
I'tiilu'lrlphia. Pa
22
i iUsl'tjr 'li, I'a
14
Roflu'^U'r \ S'
Siin 1 io ,o, Tal
San I'Vaii eisco, ( 'al
SonuTsilic, >.Iass
Toledo, Oliio
POLIOMYELITIS (INFANTILE PARALYSIS.)
Kansas — Kansas City.
During the week ended July 14, 1917, one case of poliomyelitis
was notified at Kansas City, Kans.
Massachusetts — HaverhilL
At Haverhill; Mass., cases of poliomyelitis were notified as follows:
One case each on July 10 and 11, two cases July 17.
Digitized by VjOOQIC
1159
Jaly 20, 1917
POUOMTELrnS (INFANTILE PARALYSIS)— CJonUnued.
Missouri— ^lohmibia.
On July 13, 1917, three cases of poliomyelitis were notified from
Ooltmibia, Mo.
Yermoiit.
Dnring the week ended July 14, 1917, cases of poliomyelitis were
notified in Vermont as follows: MontpeUer 8, Waterbury 2, Barre
(town) 1, East Montpelier 1, Worcester 2, Duxbury 1, Rochester 2.
Virginim— Theological Seminary.
On July 14, 1917, a case of poliomyelitis was reported from Theo-
logical S^ooinaryi Alexandria County, Va.
West Virginia.
During the week ended July 14, 1917, four cases of pohomyehtis
were notified in the State of West Virginia, two of which were in
Marion County, one in Jackson County, and one in Ohio County.
Wisconsin— Cottage Gro?e.
On July 1, 1917, one case of poliomyehtis was notified at Cottage
Grove, Dane County, Wis.
State Reports for June, 1917.
Place.
New
cases re-
ported.
Place.
Now
cases re.
ported.
MtnrkDd:
Gamtt County—
DtvPErk.
1
1
Vermont:
Orange r^inty. , . r
2
Washington f'-onn^y
31
Jnminfs
Total ....
33
Total
2
WestVirylnia:
Tucker County—
EsnxCotmty —
1
5
1
2
2
1
8
1
Amesbtinr
Wisconsin:
Juneau Countyr , r ,.,,,. r ....,,,,.,. .
H*T»hIlf
Hiinpden County—
^riii^14
La Crosse County ;
Ifiddksef County—
OunMdf*...
Manitowoc rounty - . , , .
Milwaukee County
*X£S^-
Shawano County.".
Total
Woreester Coimty—
Sotton
5
Worcester
Total
15
Idaho Beports for January and February, 1917.
During the month of January, 1917, 1 case of poliomyelitis was
reported at Twin Falls, Twin Falls Coxmty, Idaho, and in February
2 cases were reported at Payette, Canyon Coimty, Idaho.
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July 20, 1917 1160
POLIOMYELITIS (INFANTILE PARALYSIS)-Oontiniied.
Virginia Report for May, 1917.
During the month of May, 1917, cases of poliomyelitis were notified
in Virginia as follows: One case each in Bath, Campbell, and Craig
Counties.
City Reporte for Week Ended June 30, 1917.
Place.
Cases.
I
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
3
I /OS Angeles, CaL
1
2
9
1
1
Boston, Mass
• Newark, N.J
' NewYork, N. Y
East Orange, S.J
a
Haverhill, Mass
' l^hiladelphia, Pa
Jersey City, N.J
Wheeling, W. Va
1
Kansas City, Kaus
RABIES IN MAN.
Tennessee — Mempliis.
During the week ended June 23, 1917, a fatal case of rabies was
notified at Memphis, Tenn. Tiie health ofTicer of Memphis was un-
able to secure a history of the case as to the manner of infection or
the attendant circumstances prior to the development of the disease.
City Report for Week Ended June 30. 1917.
During the week ended June 30, 1917, 1 case of rabies in man was
reported at Cincinnati, Ohio.
RABIES IN ANIMALS.
City Reports for Week Ended June 30, 1917.
During the week ended Juno 30, 1917, one case of rabies in animals
was reported at Detroit, Mich., and two cases at Kansas City, Mo.
SCARLET FEVER.
See Diphtheria, meawles, scarlet fever, and tuberculosis, page 1165.-
SMALLPOX.
Minnesota.
During the week ended July 14, 1917, four new foci of smallpox
infection were re])ortcd in Minnesota, cases of the disease having
been notified as follows: Carver County, Chanhassen Township, 2;
Kittson County, Karlstad, 1; Mower County, Lyle Township, 9;
Scott County, Glendale Township, 1.
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1161
SMALLPOX— CJontinued.
State Reports for June, 1917.
July 20, 1917
New cases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
Within?
years pre-
ceding
attack.
Number
last vacci-
nated more
thanTvears
preceding
attack.
Number
never suc-
cessfully
vaccinated.
VaoeinaUon
history not
obtained or
uncertain.
Maryland:
Baltimoro County—
1
1
Uanachosetts:
Worcester County—
Blackstooe (Town)
1
2
Pltchburg..^ .'.
Shrewsbury
2
1
1
webstttr?!:;.;:::::';;::
Worcester
2
1
2
Total
10
2
4
4
2
MiflceUaneoos State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Idaho (Kay 1-31):
Bannock County—
PocateUo
6
Virginia— Continued.
Isle of Wight County
Northampton County ....
Prince George County ....
Richmond County
Stafford County
27
9
4
1
3
*
Vennoot (June 1-30):
1
1
6
Chitt«oden County
Kntlann CrOimf v
Total
WashhigtOD County
105 '
Wisconsin (June 1-30):
Total
8
I
6
West Virginia (June 1-30):
Barbour County . . ..
1
1
1
2
2
2
1
1
2
1
8
Brown County
1
1
1
14
1
2
1
2
6
4
1
7
23
3
1
12
5
1
2
Chippewa County
Clark (^unty
Hancock C^untv
Kanftwh^ C-ounty
Dane County
McDoweU County
KanhallConntv
Douglas County
Green County
Manon Countv
Jackson County
Ifason Cotmty
Juneau County
Afinco Countv
Kenosha Ck>unty
Ohio County
..........
La Crosse (bounty
Pntnam Countv
Manitowoc County
Marathon (bounty
Milwaukee County
Portage CJounty
Wood County
Total
22
....
RaHha Countv
Virginia (May 1-31):
AocDmaAnonntv .
6
1
40
13
1
Roclc Countv
St. Croix County
Botetourt County—
Trootville..
fiawver (Countv.
Wood County
CarTDll nonntv
Total •
Qravnn OomtT
94
Halifax County^
Houston.
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July 20, 1917
1162
SMALLPaX— Continued.
City Reports for Week Ended June m, 1917.
Place,
Akron, Ohio
Alton,Ill
Butte, Mont
Chicago, HI
Cfleveland, Ohio
Cofleyville, Kans . . . .
Columbus, Ohio
Danville.lll
Denver, Colo
Detroit, Mich
Dubuque, Iowa
Duluth.Minn
FUnt,Mich
Fort Worth, Tex...,
Galesburg, 111
Grand Rapids, Mich
Indianapolis. Ind —
Jackson, Mich
Kansas City , Kans . .
Kansas City , Mo
La Crosse, Wis
Lincoln, Nebr
Los Angeles, Cal
Deaths.
Place.
Memphis, Tenn
Minneapolis, Minn. . . .
Muscatinej Iowa
New Britain, r^nn...
New Orleans. La
Nov York. N.Y
Norfolk. Va
Oakland, Cal
Oklahoma City, Okla,
Omaha, Nebr
Pontiac, Mich
Quincy,Ill
Racine, Wis
St. Louis, Mo
Salt Lake City, Utah.
Sioux City, Iowa
Springfield , Ohio
Tacoma, Wash
Toledo, Ohio
Topeka, Kans
Wichita, Kans
Zanosville, Ohio
Cases.
Deaths,
TETANUS.
City Reports for Week Ended June SO, 1917.
Place.
Cases.
Deaths,
Place.
Cases.
Deaths.
Birminpham, Ala
1
2
Mobile, Ala
3
Charleston S C .. .
Omaha Nebr ...
1
Chicago, 111
Philadelphia, Pa
1
Dayton, Ohio
Pittsburgh, Pa
1
Kansas Cit v , Mo
Savannan, Ga
1
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1165.
TYPHOID FEVER.
State Reports for June, 1917.
Place.
District of Columbia.
Now f a^^
reported.
Maryland:
Allc^'any County —
Mcjrantown. ,
Parlon
Western Mnrybnd Ilosjntal.,
Allc;,any Hospital
Anne Anin<lcl County—
McKcji'lrce
8u<lley
Cilcnl)ui nic ,
Baltimore t ity
Baliin.oro County—
WoDdla r/n
II i ''hia nd town
Hillyjulc
JuHcrton
8hei)piir<l Pratt Hospital
Luthorville
Towson
HoflniansviJle, K. D
Place.
'New cases
reported.
Maryland— Continued.
iJivItim^ro ('- idity- Continued.
KnUind I'ark
Kelay Sanitarium
Cecil (ounlv
Ui^in^! ■^nn, R. D
Charles ' (vjutv —
Poui^rol. ll, D
Wl.ile ; Irtins
HuehcsMllo, U. D
Dort'ho.-: IT County—
LakcsMlle, II. D
T(Kl(l\ilIc
Ilurlock, R. D
Frederick County—
Middle! own
Maryland School for the Deaf. .
Garrett County -
Hlooinin^ton
Harford County—
Joppa, R. h..^.
Digitized by VjOOQIC
1163
July 20, 1917
TYPHOID FEVER— Continued.
State Reports for June, 1917— Continued.
Place.
New cases
reported.
Place.
Newc
reported.
Itorriand— Continued .
Howard County—
EUicottCity
SlmpsonTilfe
Kent County—
Bcttcrton, R. D
Oalaia,R. D
M oDtfomery County—
BetbesOa
Takoma Park
Cabin John, R. D
Brighton
Friendship Heists . . .
Prince Georce County-
House of Reformation.
LandOTer
Croom Station
Bladensburg
Buena Vista ,R. D....
Piscataway, R. D
Seat Pleasant
Queen Annes County-
Hay den, R. D
Somerset County—
PoGomoke City, R. D .
St. Marys County—
Chaptico
Washington C<iunty—
Hancock
Ha^eisUiwiA.
Hancock, R. D
Dargan
Wicomico County—
Fruitland
Worcester County-
Girdletroe
Snow Hill R.D
Stockton
Snow Hill
Berlin, R.D
Welboume
Total
Massachusetts:
Berkshire County-
Adams
Hinsdale
North Adams
Pittsfleld ,
Bristol County—
Attleborougb ,
FaU River
Taunton ,
Essex County—
Andover
Beverly.
Danvers ,
GlcucestCT
Havwhill
Ipswich
Lawrence
Lynn
M^blehead
Middletcn.
Peabody
Selem
Fnoklin County—
Ashhdd
87
Massachusetts— Continued.
Hampden County—
Brimfield
Hoi yoke
Ludlow
RiL<^sell
Springfield
Middlesex County—
Cambridge
Chelmsford
Everett
LoweU
Maiden
Somerville
Waltham
Watertown
Norfolk County—
Braintree
Brooklino
Quincv
Stoughton
Plymouth County-
Brockton
Waroham
Suffolk County-
Boston
Chelsea.
Revere
Worcester County—
Sout hbrldge
Sterling
Total
Vermont:
Addison County
Franklin County
Orleans Coimty
Rutland County
Total
West Virginia:
Kanawha County —
Charleston
Dunbar
Lewis County
McDowell County
Marion County
Raleigh County
Randolph County
Total
Wisconsin:
Dane County
Dodge County
DouKlas County
Fona du Lao County...
Juneau Countv
Kenosha County
Marinette County
Milwaukee County
Sheboy ran County
Waukesha County
Waupaca County
Total
1
1
1
1
3
6
1
3
4
1
1
1
1
1
1
1
2
1
1
n
2
3
5
1
105
79
10
2
1
3
1
1
OT
23
Idaho.
During the month of January, 1917, 1 case of typhoid fever was
reported at Wallace; in March, 8 cases at Harrison; in April, 17 cases
atHaFrison; and m May, 1 case at Pocatello. Digitized by GoOqIc
July 20, 1917
1164
TYPHOID FBVER— OontinuedL
Virginia Report tiift May, 1917.
Place.
Ne^v cases
reported.
Place.
NewcuM
reported.
Virginia:
Accomac rounty
2
Virginia- rontinued.
Leo County
ChiucotcaKiio. .
Lunenburg County .-
Grftcnbaokville
Middlesex Conn tr
Albemarle rounty
Nansemond County—
Suffolk
Alleghany Coanty—
Clifton Korco ...... ..
Norfolk County-
Norfolk
A mclia Count v
\upusta County ... .
Oranjro County
IJasic <.'ity
Pac;e County
Bedford County
Shenandoah
Bedford C^ity
Powhatan County
Botetourt County
2
•
2
1 Prince (Jeorpe County.......
Buchanan County
Prince William Coanty—
Potomac
Camplxjll County
Lynchbiirg
1 Roanoke County—
' Roanoke
CarrollCounty
Clarke County
1
2
1
1
4
1
1
2
2
1
2
2
1
2
1
\ Vinton
Culpeper County
Rockingham County
Culpcper
Russell County
Dickenson County
Honaker
Elizabeth Citv County—
Scott County
Phoet)Us
Shenandoah County
Essex County
Sou thampton County
Tanpah'vnnock
TazoweJl 'County ...'.
Floyd rouut V
Graham
Fluvivnna <'ountv
Warren Coimty
Franklin County
Wise County—
Appalachia
Halifax County
South Bo uon
St. Paul
Hanover <'ounty.
Wythe County
Isle of Wiu'hi. I'ounty
Total
Lancaster Ooimiy. .".
S
City Reports for Week Ended Jane 30, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deftths.
Bait imore, Md
3
21
1
2
3
1
14
7
2
4
2
2
2
18
3
1
1
2
f.
2
2
1
1
3
2
1
2
1
2
i
i
2
Nashville. Tenn
9
2
13
20
1
Newark. K. J
New Orleans La
Brook lino, Mass
6
BulT:ilo, N. Y
Now York, N. Y
4
Cambridge, Mass
Camden, N. J
Niag.ira Falls. N. Y
1 Pn-:;i(lena Cal
i
Charleston, S. C
' Philadelphia. Pa
10
6
1
2
1
1
8
1
I
1
8
Q
1
5
1
2
3
1
1
2
3
1
1
1
1
1
10
1
6
Chio:\go, 111 ;..
Pittsburgh, Pa
1
Cincinnati, C)hio ...
Piftsfield Mass
Clevoluid, Ohio
PlamJiold, N. J
Colli hihus, Ohio
1 PoTili.ir. Mich
Davton, Ohio
Portsmouth, Va.. . . ...
Den V er, ( olo
Providcufo. li. I
i
Detroit, Mich
1
Rich niond , Va
Duluth, Minn
1 Roanoke, Va
Elgin, 111
1 Rockv Mount, N C .
El Paso, Tex
2
St. Louis, Mo
Salt Lake City. Utah
1 8.in Dio.uo.Cal
1 San Fr.inci-^'o, Cal
Evansville, Ind
1
1
1
Hiiii, :.li. jj,. .
yOft \\ Ll^'tU" If
1 SacranKnto, Cal
,Sar:itou'aSi)rin}:s, N. Y
' Sav.'.niiah, <;a
Se-attir. Wash
Soutii iJfnd Ind
(Iflh <^>Un), Tf ■*
Gnind liapid>', Mich
Hiirt ifi If 1 1 1 '{jna
1
i
1
IndiaUkjirxJUs, lud
K»i*>Ija, Wii .
1
1 SprintfK'ld, Ma-<s
SnrinLlif>ld Ohio
LflXing^toPj ICy
1
Sieubcnvilic Ohio....
Uttle Rm*. \rk
1
2
1
4
8
4
3
Toledo Ohio
i
Lcu£ Hraueh, N. J
Tope k. I, Ivans
1
LCM AJiJ4e|o;«» C ftl
Troy. NY
Wli.Mlin^' W Va...
LvnE-hbufv:, Vii
1
1
1
Rf p'tn phji, Ton n
MUwttwlfoc, W'h
Wiiiuiiijjton Del
MinmaiiOliJi, Mjpi^
Win.stun-Salem, N. C
Zanesville Ohio
i
Mo*»mAla,..
1
Digitized by VjOOQiC
1165 July 20, 1917
TYPHUS FEVER.
Utah— Ogden.
During the week ended June 30, 1917, 2 cases of typhus fever,
with 2 deaths, were reported at Ogden, Utah,
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for Juie, 1917.
Cases reported.
State.
Cases rei)orted.
state.
Diph-
theria.
Measles.
Scariot
feTer.
Diph-
theria.
Measles.
Scarlet
fever.
DistofCoIambca..
Maryted
18
£5
793
573
1,648
3,786
28
66
413
Vermont
West Virginia
Wisconsin
26
16
159
905
115
1,143
37
7
473
Idaho.
Two hiindred and nineteen cases of measles and 2 cases of scarlet
fever were reported in Idaho in January, 1917; 1 case of diphtheria,
63 cases of measles, and 30 cases of scarlet fever in February; 1 case
of diphtheria, 30 cases of measles, and 6 cases of scarlet fever in
March; 2 cases of diphtheria, 19 cases of measles, and 13 cases of
scariet fever in April; and 2 cases of diphtheria, 15 cases of measles,
and 4 cases of scarlet fever in May.
Virgiiiia Report for May, 1917.
During the month of May, 1917, 81 cases of diphtheria, 2,206
cases of measles, and 33 cases of scarlet fever were reported in
Virginia.
City Reports for Week Ended June 30, 1917.
CUf.
Ovtr ilftOM ItilmiiCcaiita:
Ite^berv. Mil,.
Sfia.i"'.::::::::;:::
midUfiiiKrii..,„
' fwfl«iifvK,.. ..,,.
^SI. Louiji, lfo...„_ .,
msD im^rm to .^oogooo inbabti-
lTO«y*U4y, N.I.,, ,,.„„,.
MiBDMipdI&.ICicm
^mrfmmm, Im. ..»..„
Sao Ptwirtwo, Ctrt. „..„..,
FopolA-
tiiTii as of
July 1,1916
rcsilzaatied
C«uiys
' Burt>t&u},
T.5fs
1,703,
S7ft,
4m,sm
dm,
136.
SET J,
m,
34t«,
Total
deaths
from
nil
caijscs^
19(5
IW)
Dlphilieria.
l,2lJrt
I 1711
211}
m
«V
m
Tit'
m
in
7i>
7i
12
Measles.
10
I
0
2
iii
pi
m
to
I \ Xi
Scjirkrt
1 I i
5
7
s
m
a
m
n
R2
I* '
l.H
ifll
:*
L>
\
f
I
4i
7
1
3
1
10
4t
1
., ,.
10
2
la
D
il
I ^
Digitized by VjOOS
TiibflT-
^ P
21
IIQ
77
25
24
27
V4
ia
'JOl
u
17
10
to
July 20, 1917
1166
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Contlnued.
City Reports for Week Ended June 30, 1917— Continued.
'
P4>ptila-
tion as of
July IJ9W
(cstUrmted
Ccmm
Bureau).
Total
deaths
from
all
PipM^erla.
U^All^,
lever .
Tub«jr-
CulOEifl.
City.
i
1
i
1
Q
u
1
1
i
Vrem 200,000 Uf 300,000 Jntuibtt-
Columbus, Ohio
214,878
260,800
271,708
297,847
295,463
254,960
256,417
104,199
181,762
121,579
112,981
100,233
127,224
128,366
104,562
128,291
110,900
100,560
113,245
102,425
148,995
117,057
118, 168
149,085
198,004
165, 470
109,381
156,087
117,390
105,942
155,624
112,770
191,554
111,593
163,314
8.5,625
63,505
58,659
57,060
09,893
57,653
53,973
67,449
60,852
60,734
57,144
94,495
86,690
63,705
75,195
76,078
54,772
76,183
72,015
77,214
68,529
99,437
50,853
67,343
51,155
78,283
58,221
53,794
89,612
92,943
63
44
84*
40
75
63
3
4
16
6
3
9
6
1
......
3
17
66
5
9
2
107
19
21
6
20
13
19
24
14
2
13
6
7
7
4
Denver, Colo
13
Indianapolis, Ind
16
KanstiiS City, Mo .
Portland, Oreg ......
10
2
9'
'1
7
'%'
7
1
6
6
1
9
5
4
8
Providenco. R. T
Rochester. N. Y
2
' 'i'
1
15
8
2
3
2
1
2
2
1
2
3
1
2
From 100,000 to 200,000 inhabit-
ants:
Albany, N.Y
96
38
62'
35
30
29
48
15
20
17
59
56
16
34'
44
23
68
21
43
40
6
Bridgeport, Conn
2
9
3
4
1
2
8
9
4
24
'i'
' i'
2
Cambridge, Mass
4
Camden, N.J
Dayton, Ohio
3
Fan River, Mass
4
Fort Worth. Tex
0 rand Rapids, Mich
Hartford, Conn
1
21
11
1
2
Lawrence, Mass.
3
Lowell, Mass
1
2
Lynn, itfass.
3
Mijmphis, Tenn
1
7
"i*
1
19
5
10
5
2
10
NashVille, Tenn
5
New Bedford, Mass
2
3
1
1
6
1
39
20
2
New Haven, Conn
1
3
Oakland Cal
4
9
7
2
15
8
13
1
18
1
Omaha, Nebr
23
2
6
4
7
40
5
Reading, Pa
"1
9
8
'"'3'
2
3
Richmond, Va
3
Salt Lake City, Utah
Springfield, Mass
1
2
1
4
Syracitee, N. Y
. 2
Tacoma, Wash
Toledo, Ohio
76
32
55
iV
5
3
4
19
3'
2
1
1
7
1
12
8
10
Trenton, N.J
9
11
1
Worcester, Mass
From 50,000 to 100,000 inhabit-
ants:
4
2
1
3
Ailpntown, i^ft
Altoona:^ !^
3
17
AlbmdcCitTr N.J
4
Buvonnj?, N" J
2
2
2
4
2
Berkoby VqI
11
24
8
19
23
19
13
23
70
23'
17
16
19
12
21
4
23
5
3
1
BrocktODj Mo^
4
1
1
Canton, 6hJo.
1
1
2
3
11
1
1
1
Chiu-]cst<m, 8. C
1
......
2
Ct)v[n;^on, Kv.
2
28
1
5
2
1
7
6
5
1
Diiliuh^ Minn,
Eli Babe til. N. J.
i
El Vam Tex
3
3
5
13
6
2
4
13
2
17,
6
tt
Ktiif, Pa...„ .,.
11
1
13
1
7
2
2
1
::::::
1
7
4
1
5
3
3
6
20
EviinsvilJe^ Ifid
?
Flint Mich.. _
1
Fori WajniiS. Ind
1
2
HjifrLsibufgj Pa
HobQkoii,"N. j"
3
1
KaaaosCity, Kmns
2
X
1 jm^cL^lAp, V^L
IJttln Uort Ark
16
10
19
23
8
25"
Maiden, Mass
3
2
27
1
1
Miuwihcsler N H
Mobile .Vltt
1
4
1
2
1
2
'ti^w {iritAJci t^orui
1
Norfolk. Va
OWahtimaniv' Okla
1
Digitized by
Google
1167
fuly 20, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continued.
CUy Reports for Week Ended Jane 30, 1917— Continued.
Popula-
tion as of
July 1, 1916
(esthnated
by U. S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
Y ctty.
1
o
1
1
1
1
J3
1
1
1
Tnm SOfiCO to 100,000 inhabit-
ants— Continued.
Pw^mir V J
71,744
50,411
06,895
53,330
68,805
57,078
87,039
68,946
61,120
61,550
66,083
77,916
70,722
76,776
94,265
51,656
27,732
37,385
32,730
27.632
43,425
46,192
29,319
26,074
32,261
48,811
39,873
42,458
28.203
39.233
35,486
41,781
41,863
29,333
48,477
35,383
48,886
31,576
26.771
38,670
31,677
41.097
46,ol5
27,587
32,940
30,609
47,521
28,234
26,318
27,327
29,003
41,133
31,927
30,108
43,715
37,353
31,401
31,404
33,080
46,450
41,185
38,629
39.^51
36.798
38. 130
46, 486
43.284
20
20
15
20
36
34
3
4
1
5
3
Pawtucket, R. I
Sacramento, Cal
8
22
2
2
San T*{^, ^'ftl
1
2
Ravannah, G«i,..
5
Sioux City, Iowa
4
1
6
19
17
13
17
21
U
36
3
1
2
......
17
10
13
5
3
5
2
36
3
8
1
SUiIh Bend, Ind
8ihnKfleM,ni
SMingneld, Ohio
3
1
Ivre llauto, Ind
1
Titoy.N. Y
3
1
2
1
4
WlcWta. Kans
Wllkes-Barrc, Pa
1
11
Wilminffton. Del
Yark.Pa.
2
2
- 2
1
From 3S,000 to 50,000 inhabit-
Alameda, Cal
5
10
6
3
ii'
7
4
6
1
4
1
AolMtm. N. Y
Bfookllne, Moss
1
2
3
2
1
11
1
1
8
BitlCT, Pa
Be Ue. Mont
3
1
1
1
Chelsea, Mass
2
ITiicopee, Mass
2
Cumberland, Md
9
1
16
1
18
4
9
3
13
1
2
l>anville, III
I
Davenpovrt , Iowa
1
2
Dtituique, Iowa
1
2
1
Ra&t Orann. N. J
6
8
9
4
10
14
10
10
14
15
7
3
3
Etob^inT.... ..:::::::::::
Etvctt.Mass
2
1
6
....'.
Etofett,Wash
4
1
rar^bini:. Mass
4
0$lve<ton, Tex
1
(Jrnen Hay, Wis
HtterhUl, Mass
1
2
1
1
2
6
1
2
2
1
JKtson, Mich
16
67
8
2
2
1
I^iamazoo, Mich
1
K «nosha, Vi'is
KTir«ton, N. Y
1
Knoillc, Tenn
............
, ! 1
1
2
LaCfosse. Wis
7
18
11
8
17
1
22
3
3
7
8
H
9
3
7
7
10
7
13
4
4
15
6
6
14
14
3
' 1
1
Lr\lneton, Ky
3
1
4
J
2
Uifoto, Nebr
2
i '
1
1
1
1
Long Beach, Cal
Lynrhburc, Va
1
2
2
5
3
1
8
1
5
2
kSi^V^S,
UeKaemort, Pa.
1
1
1
Medlortf, Mass
Montclalr, N. J
1
NmHiis N h
2
1
1
Ncwbureh, NY
1
NewCmstle. I*a
'
Newport, Ky
1
1
NewiiHi, Mass
1
1
2 1 1 2
Ni««arB Falls. N. Y
3 1 1 2
5
Nontrtown, I*a
1
Ogden, rta^
1
3
2
2
2
Or»n«, N.J
3
Pasajena, r«]
6
1
9
1
2
PlBTth Amboy, N. J
Pittsfield, Mass
3
1
Portsmouth, Va...
2
2
Qoincy.ni
1
(^ilnr>' Mafts
i
1
1
2
3
Barine.'Wls
1
2
1
2
Roanoke, Va
1
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Google
July 20. 1917
1168
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSI&-
CJontinued.
City Reports for Week Ended June 90, 1917— Continued.
Popula-
tkmasof
July 1,1916
(estimated
bv r. S.
Census
Buroau).
ToUl
deaths
from
all
causes.
Diphtheria.
MflASlM
Scarlet
fever.
Tuber-
cnlosis.
City.
u
a
1
1
i
1
1
1
From 25,000 to 50,000 inhabit-
ants— Continued.
Rock Island Di
28.926
38.902
27. 445
46.226
• 36.283
48.726
30. .570
29.894
43. 1.39
43. 377
33.809
29,892
31,155
30,863
22,874
15,010
21,685
13,163
l.'>,794
I 13, 075
22.669
20. 713
24.276
16.9.S0
23,.')39
20,930
15.395
U4,610
17.445
13.284
17, .500
23,126
15,243
20.9S.>
» 22. 019
19,926
23,8a5
17,524
11,666
12,067
14,831
20,193
13.821
15,548
23,228
15,969
13
1
2
5
San Jose, Cal
5
'" 1 '
Steubenville Ohio
10
8
11
10
4
I
Superior, Wis . '..'..
1
1
IwHiton Mass
3
1
TonAkA KAT14
2
1
3
15
12
5
1
3
1
WnlthAin, Mn^<:
1
1
Watcrtown, N. Y
1
2
West Hoboken, N. J
Wheeling, W, Va
7
16
i9'
15
5
8
15
1
3
1
1
1
Willlamsport, Pa
1
Wilmington N. C
Winston-Salem, N. C . .'.*!...
5
I
1
Zanesville, Ohio
1
3
1
17
2
From 10,000 to 25,000inhabitants:
Altcm, m....
Ann Arbor, Mich
....
1
Braddock. ^a.
1
Brownsville Tex.
3
6
2
10
r>airo, HI..
1
Clinton Mass
1
Concord, N. U.'.
2
20
4
Dunkirk, N. Y !".".'.!....
I
2
(Jalcsburg, 111
2
2
1
Ilarrison, N. J
4
1
1
5
Kearny, N.J
7
8
9
10
4
5
2 I
Kokomo, Ind
5
2
Lonjr Branch, N. J
1
Marinette, Wis
1
Melrose, Mass
3
3
i
Morristown, N. J
1
1
i
1
Muscatine, Iowa
1
Nanticoke, Pa....
9
4
4
7
6
3
. ...
^^
Ncwburyport, Mass
4
7
40
10
New London, C^mn
3
1
1
2
1
1
North Adams, Mass
2
1
Northampton, Mass
Plainfield, N. J
Pontiac, Mich
6
1
6
2
1
Portsmouth, N. H
Rocky Moimt, N. C
7
4
7
6
5
6
6
1
Rutland, Vt..
1
2
1
Sandusky, Ohio
^*
Saratoga Springs, N. Y
Steclton. I^
2
I
3
2
Wilklnsburg, Pa
1
Wobum, Msss
1 Population Apr. 15, 1910; no cstimate'made.
Digitized by
Google
FOREIGN.
ARABIA.
Further RelatiTe to Plague— Aden.'
From May 3 to 14, 1917, 24 cases of plague were notified at Aden,
Arabia, making a total from the beginning of the outbreak, April 8,
1917, of 69 cases.
)i AUSTRIA-HUNGARY.
I- ■
r.
Typhus Fever.
The following information relative to the occurrence of typhus
fever in Austria-Hungary was taken from the Bulletin of the Inter-
national Office of Public Hygiene for May, 1917:
Austria, — During the period from October 22 to December 17,
1916, 2,371 cases of typhus fever were reported in Austria, the great-
est prevdience being in the Province of Galicia with 809 cases, Bohemia
with 634 cases, and Styria with 243 cases.
Hnngary. — From February 19 to March 25, 1917, there wore
notified in Hungary 1,381 cases of tjrphus fever, of which 83 occurred
at Budapest and 12 in seven other urban communities, the remainder
being distributed in 11 counties.
CUBA.
Communicable Diseases- Habana.
Communicable diseases have been notified at Ilabnna as follows:
;
Disease.
June II-
New
20, 1017.
Deaths.
..........
Remain-
ing under
treat-
ment
June 20,
1917.
TJlphthem
8
u
l/ftMosy
10
^larift
IS
19
15
Measles -. .
19
Paratyphoi d fe ver
1
scarietw :: ....::.: :.:....:...:
13
I
"^pholdfever
.....
33
y&ik :
1
» Public Uealth Reports, May 2.'), i'U7. \\ 822, and June 15, 1917, p. 901.
(1169J
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July 20, 1017
1170
GERMANY.
Smallpox — ^Typhus Fever.
The following information relative to the occurrence of smallpox
in Germany, was taken from the Bulletin of the International OflBce
of PubUc Hygiene for May, 1917:
Smallpox. — During the period from March 18 to April 28,~1917,
715 cases of smallpox were reported in Germany. Of these, 241" were
urban cases, the greatest prevalence being at Berlin with 106 cases,
Hamburg with 50 cases, Leipzig with 20 cases, Charlottenburg with
18 and Bremen with 16 cases. The cases occurring outside of cities
were reported from 32 government districts and other divisions of
the empire.
Typhus fever. — From March 18 to April 28, 1917, 40 cases of t^^phus
fever were notified in Germany. Of these, 13 occurred among the
civil population, mainly in the district of Oppeln, and 27 in prison
camps.
PERU.
Plague.
During the period from May 16 to 31, 1917, 15 cases of plague were
notified in Peru. The cases were distributed according to depuir
ments as follows: Arequipa, 4 cases occurring at MoUendo; Ckllao,
1 case at city of Callao; Lambayeque, 2 cases at Chiclayo; libertad,
7 cases at Salaverry, San Pedro, and TrujiUo; lima, 1 case «t the
city of Lima.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FJEiVER.
Reports Received During the Week Ended July 20, 1917.^
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks. \''
India:
Calcutta.
Apr. 15-28
97
Java:
East Java
Apr. 2-8
1
West Java
Apr. 13-19, 1917: 1 case.
Batavla
Apr. 1^19
1
Philippine Islands:
Provinces .^
May 27-June 2, 1917: Cases, 166;
deaths, 116. ^^
Albay.
May 27-Jun6 2. .
do
do
22
37
66
40
5
14
26
33
40
3
Bohol
Cebu
Sorsogon
Tayabas
do
do
1 f^m medical officers of the Public Health Service, American consuls, and other sources.
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1171
July 20, 1917
CaOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Recehr«d Dwiag the Week Ended July 20, 1917— Continued.
PLAGUE.
Place.
Date.
Cases.
Deaths.
Remaiics.
Hongkong
CataitU
Java:
East Jara
Sunbaya
Sorakarta
Peru
Departments—
tLambayeque..
Xibertad
MayS-14..
May 13-». .
Apr. 15-28..
Apr. 2-22-.
do
Mayl&-dl..
do
do
do
.do.
Apr. 8-May 14, 1917: Cases,
deaths, 51.
Apr. 2-22, 1917: Cases, 18; deaths
18.
May 16-31, 1917: Cases, 15.
At MoIIondo.
At Callao.
At Chiclayo.
At Salaverry, San Pedro, and
Trujillo.
At Lhna.
SMALLPOX.
BruH.
Bahia
May&-12
1
35
RiadnJaneiro
May 13-26
8
Ouada
atoraBcotia-
Port Hawkesbury
Oiina:
Amoy
June 24-30
Present in district.
May 13-19
Present.
mossha I
Dalren
May 27- June 2
Mayl3-June2....
May 20-20
5
11
6
4
1
5
1
Ho^^ong
Tslngtao
May30-June»....
Gtfmany. ...
Mar. 18- Apr. 28, 1917: Cases, 715.
Bertln.
Mar.Vs^Apr.is...
do
106
16
18
50
20
2
10
1
In cities and 32 States and
Bremen
districts.
Char lotten burg
do
Haabtire
.. . do
LeilSSy^::::::::::::::::::
do
lAirfMdC
.. ..do
Munich
do
fibitt#mrt ---
do
India:
Calcutta
Apr. 15-28
3
8
18
1
1
Japan:
Kobe
June 11-17
31
48
Osaka-
Junel-10
Yokohama ,,,..-, ,.
May 21-27
J»Ta:
Ea^t Java
Apr.2-29
11
16
Mid- Java
Apr. 1-21
West Jara
Apr. 13-May 10, 1917: Cases, 40;
Bats via
Apr.l3-May3
June 3-16. .,
11
95
2
deaths, 7.
Mexico:
Mrxico City
Monterey
June 18-21
24
Russia: ^
Petroerad
Feb. t8-Mar. 10. . .
Apr. 29-May 21...
May 1-31
186
12
Vladivostok
3
3
5
Spain:
MadrW
Seville
do
Valencia
June 3-16
2
2
Tunisia:
Tunis
June 2-8
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July 20, 1917
1172
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW PEVEE-
Gontinued.
Reports Received During the Week Ended Joly 20, 1917— Continued.
TYPHUS FEVER.
Place.
Bate.
Cases.
Deaths.
Remarks.
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 191^ Gastt,
2,371.
Bohflmia
Oct.22-Dec. 17....
do
634
809
47
617
10
243
5
Galicia
Lower Austria
do
Moravia
do
Silesia
do
Styria
do
Upper Austria
do
Hungary
Feb. 19-Mar. 25, 1917: Cases,
Budapest T..
Feb. 19-Mar. 25. . .
May30-June9....
May 15-19
83
1
1,381.
China:
Tsingtao
(Jreeco:
SalonUd
3
2
Java:
Mid-Java
Apr. 1-30
7
West Java
Apr. 13-May 10, 1917: Om«, 36.
Batavia
Apr. l^May 10...
June 3-16
22
193
16
3
Mexico:
Mexico City
Russia:
Petrograd
Feb. 18-Mar. 10...
May 15-21
3
Vladivostok
Spain:
Madrid
May 1-31
2
Reports Received From June 30 to July 13, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bassein
Apr. 1-21
7
66
1
10
Calcutta
Apr. 29-May5
Madras
Apr. 22-28
1
24
Rangoon . .
Apr.2l-May5
Philippine Islands:
Provinces
May 20-26, 1917: Ctm, l^I
deaths, 88.
Albay
May 20-26.
19
86
43
42
1
10
42
20
15
1
Bohol
do
Cebu
do
Sorsogon ;
dp
Tayabas
do
PLAGUE.
Arabia:
Aden
Ceylon:
Colombo
China:
Amoy
Kwangtimg Province:
Ta-pu district
Egypt
Suez ^
Provinces—
Fayoum
Oijngeh
MfaSeh
Siout
Great Britain:
London
May 3-14
Apr. 8-May 14..
Apr. 29-May 5..
June 2.
May ii^i?.' !!!.*!
May 11-17. .
May 17
May 12-15..
May 12
May 3-8. .
37
Present and in vicinity.
Present.
Jan. 1-May 17, 1917: Cases,
deaths, 116.
2 In hospital at port. IPrtgaB.S.
Sardima from Australian and
oriental ports.
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1173
July 20, 1917
CHOLERA* PLAGl^, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER*
(Continued.
Reports ReceiTed From June 30 to July 13, 1917— Continued.
PLAGUB— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
iDdU
''5«th.fsri5»'"='*^'"'"*
Bftssetn
Apr. 1-21
31
96
10
20
214
126
1
41
1
72
2
8
Bombay
Apr. 22-28.
Apr. 29-lf ay 5 . . .
115
CakutU
nfiiiadii
Apr. 1-21
KMfchI .,.
Apr. 22- If ay 5.....
Apr. 22^ May 12....
Apr. 8-14....
229
153
Madras Presideiicy.
IfaiMfalfty
Umilm«in
Apr. 1-21
ICyingyan.
Apr. 1-7
RangioDii
Apr. l^May6
Apr. 8-14
75
Tounfoo
Slam: "
Rttfi^kok
Apr. 22-lfay 12....
8
81IALI1H>X.
Australia'
New South Wales.
Brewairina
Quambone
QuMusland—
Thursday Islaiid Quar-
antine Station.
Maaitoba—
Winnipeg
IJovaSootla—
HaUlax
Port HawkealMiry..
Ceykn:
Colombo
China:
Amoy..
Anti
Chn
Hoogkong
Manchuria BUtioo.
Mukden
Timtsin .*.*.' *.**!!!.'!
Taitahar BUtioo....
Taiuetao
, Alexandria..
Bembay.
Calcutta.
Karachi..
Madras..
Bangoon,
Italy:
Turin...,
Japan:
Kobe....
Migasaki.
^ Osaka....
Philippine
^ ManUa,
Portinl:
^ iSbOD
Riga
_ Vladivortok
StnitsSettleme&ts:
fvouig
84
Apr.27-liaylO..
do
May 9..
June 10-16.
June 18-23.
June 17-28.
May6-lX
Apr. 29-May 5...
ICay 21-27
May 6-26
Apr. 23-May 6...
May 6-12.
Apr. 23-29.
May 27-June 2. .
May21-JuDe3..
May 13-26
Apr. 16-22.
May 22-29
Apr. 30-May 27..
Apr.
Apr.
Apr.
Apr.
Apr.
22-28
29-May 5..
22-May5...
22-May 12..
lS-May5...
May21-June3.
May
May
May
May
May
27-June 10.
28-June3..
16-June5..
13-19
13-26..
Mar.
Mar.
Mar. 18-May 12.
. Il-May5..
.15-21
4
30
17
20
19
1
114
5
4
2
11
Apr. 27-May 10, 1917: Cases, 6.
From s. s. St. Albans lh>m Kobe
via Hongkong. Vessel pro-
ceeded to Townsville, Bria-
bane, and Sydney, in quaran-
tine.
Present in district.
Present and in vichiity.
Present.
Do.
On Chinese Eastern Railway.
Do.
Present.
Cases foreign; deaths among na-
tives.
On Chinese Eastern Railwaje
At another station on railway,
lease. '
Varidoid.
Jan. 1-31, 1917: Cases,?.
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1174
CHOLERA, PLAGUE, SMALLPOX, TYPHUS PETfiR» AND TBLLOW FEVERr-
Continued.
Reports Received From June 80 to July 13, 1917-— Continued.
SMALLPOZ-ContlniMd.
Place.
Date.
Cases.
Deaths.
Romaics.
Sweden:
Stockholm
May 20-26. . .
1
Turkey in Asia:
Trebixond
Feb. 25-Apr. 18...
15
Union of South Africa:
Johannesburg
Mar. 12-24
4
TYPHUS FEVER.
China.
Tsin?tao
Egypt:
Alexandria. . ,
Greece:
Saloniki ,
Russia:
Riga
Vladivostok.,
May 20-29
Apr. 80-May 27.
MayG-12
Mar. 29- Apr. 4 .
1
830
232
12
Jan. 1-31, 1917: Case, 1.
YELLOW rEVER.
Mexico:
Yucatan, State—
Peto.
In person recently arilTed from
Mexico aty.
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PUBLIC HEALTH REPORTS
VOL. 32 JULY 27, 1917 No. 30
DYSENTERY— ARKANSAS-MISSOURI.
Passed Asst. Surg. Ridlon reported July 22 that the dysentery
outbreak in northeastern Arkansas and southeastern Missouri was
subsiding. It will be difficult to ascertain how extensive the out-
break has been, as the disease is not notifiable, and most of the
physicians do not keep case records, nor is the registration of deaths
such as to give any useful information. The undertakers' records are
also of little value in this connection.
The disease has been widespread in southeastern Missouri and
northeastern Arkansas and probably few communities in this area
have escaped. Statements of physicians indicate that the disease
has also existed in near-by territory in Tennessee and Mississippi.
It seems to be the experience of physicians that similar outbreaks
of enterocoUtis are of annual occurrence, usually beginning in May
and extending into June. The outbreak this year is believed to be
more severe than usual. Certain physicians in Dunklin Coimty esti-
mate that there have been several hundred cases, with probably 50
deaths, in the county. Measures have been taken to ascertain defi-
nitely the specific organism causing the outbreak.
MENINGOCOCCUS CARRIERS.
THEIR RECOGNITION AND TREATMENT.
The "meningococcus carrier" is an individual who harbors the
meningococcus without exhibiting symptoms of meningitis. He is of
hnportance to us at this, time because of the prospective concentra-
tion in camps of a large number of young adults of a susceptible age.
These young men are brought into intimate contact with one another
and furnish ready material under conditions which have been shown
to be favorable for the spread of epidemics of meningitis. The
iiasopharynx is the location in which the meningococcus is most f re- *
quently found, and is the site affected ; a fact which is of practical
importance in the dissemination of the organism. Here it flourishes,
86 (1175)
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July 27, 1917 1176
sometimes in great numbers, and probably is expelled by talking,
sneezinjLT, or coughing, or is mixed with the secretions of the nose
and imphinted. by indirect contact, on the mucous membrane of
another indi\ i(hial.
SeA eral careful analyses conducted during an epidemic and for a
period of two or more years in the absence of an epidemic, have
shown that meningococcus carriers are of wudespre^d distribution
among the general population, the numbers varying from 1 to 13
per cent of those examined. The higher of these figures has been
found in the examination of troops quartered in barracks, except in
one study to be referred to later. These analyses exclude those in
whom there was a history of contact with a case of meningitis,
'* Carriers" are of three general tyi>es: Individuals convalescent
from an attack of epidemic cerebrospinal meningitis, or posterior
basilar meningitis: "contacts" with a case of the disease; and per-
sons who can not he shown to have had any previous contact with
the disease. The seccmtl and third groups are frequently classed as
one. These groups may be subdivided into temporary and per-
sistent, or " chronic." carriei-s, dependent upon whether they exhibit
cultures of meningococci for from a few days to three weeks, or for
several weelcs or months.
During the first w^ek of convalescence the meningococcus is present
in the nasopharynx of the patient in from 60 to 80 per cent of
the cases, the number of those carrying the organism progressively
decreasing with the convalescence; but in some series of cases there
have been as many as 6 per cent positive after two months.
In convalescent cases the meningococcus in the nasopharynx is
usually not accompanied by many contaminating organisms, and
yields nearly pure cultures. In contacts, however, the numl>er of
meningococcus colonies developing from a swab varies, from two
or three to a plate to an approximately pure culture.
The recognition of meningococcus carriers is difficult, chiefly be-
cause of the parasitic nature of the organism, and because of its very
great sensitiveness to drying. Hence the technique adopted should
provide for a rapid transfer of the material collected from the
patient or contact to a medium which is moist, at approximately
body temperature, and containing plasma or other animal fluid.
The collection of material from the nasopharynx is best accom-
plished with a sterile cotton swab, mounted on a piece of iron wire,
which is bent for a half to three-quarters of an inch, at the swab
end, through an angle of approximately 45°.
The swab is carried horizontally through the mouth to the
pharynx, avoiding the buccal surfaces and the tongue; upon reach-
ing the pharynx the swab is tilted upw^ard, rotated across and against
the posterior nasopharynx, and brought out through the mouth in a
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1177 JuJy 27, 1017
horizontal position, but with the bent part pointing in the opposite
direction to that in which it entered.
The buccal surfaces and secretions should be avoided because of
the numerous contaminating organisms, many of which seem to be
antagonistic to the growth of the meningococcus. The saliva also,
probably, has an inhibitory effect on the meningococcus growth.
The avoidance of contamination from the mouth may be accom-
plished by the use of a West swab. This consists of a swab made
as above, using a pliable wire, inserted in a metal or glass tube of
about one-quarter inch diameter, bent as indicated for the swab.
This tube shield is plugged with cotton, sterilized in dry heat or in
the autoclave, and used by withdrawing the plugs, introducing
through the mouth as above described, and when it reaches the
pharynx, pushing the swab out past its end to make the sweep over
the posterior nasopharynx, and drawing it back into the tube before
withdrawing through the mouth.
Phonation by the patient frequently aids in making the swab of
the posterior nasopharynx. The area swabbed should be the same as
that covered by the curette in the removal of adenoid vegetations of
the nasopharynx.
Tlie material collected should be planted immediately on the media
on which the organism is to be grown. The time elapsing between
the collection of material and its implantation on media affects the
results: the longer the "time the poorer the results in obtaining
cultures; even though the swabs be kept moist, there is a marked
falling off in the success of cultivating the meningococcus.
The medium on which the material is planted should, preferably,
be at body temperature, or but slightly below it, and should be
incubated promptly at 35°-37° C. after sowing.
The medium should include some animal fluid, such as ascitic
fluid, hydrocele fluid, blood serum, or laked blood. In the absence
of such fluids, the addition of an extract of peaflour serves well.
A medium which has been found very satisfactory is made as fol-
lows:
To five parts of a nutrient, 2 per cent neutral agar, made of beef
infusion, with 1 per cent glucose, is added at 50°-52° C. one part of
sheep serum water (sheep serum, 1; water, 2). Neutrality is tested
to phenolpthalein.
The glucose agar is sterilized for one and a half hours in stream-
ing steam. The sheep serum water is autoclaved for 15 minutes
with 15 poimds pressure. The mixture of serum water and agar is
made shortly before using, with aseptic toclmique. The tubes of
the finished medium should be incubated previous to use, and should
be kept moist at all times.
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July 27, 1917 1178
This medium is comparatively clear, and permits easy recognition
of the colonies on the plate. It is well adapted to the growth of
the meningococcus, so that visible colonies develop with six to eight
hours' incubation, and colonies develop to two to three millimeter
size overnight.
In the absence of sheep serum, an excellent medium can be made by
the addition of laked rabbit, or human, blood to the agar above
described. The blood is laked in distilled water, 1 part of blood to 4
of water, and added to the melted agar at 45° to 50° C., in the pro-
portion of 1 part of laked blood in (> to 10 parts of the agar. Rabbit-
blood agar (1 part of blood in 20 of agar) affords a good growth, but
has the disadvantage of being opaque, and masking the color of the
colony as well as its structure. ,
The various serum agars are made by the addition of the animal
fluid to the agar, in the proportion of from 1 to 3 to 1 to 20.
The English workers exhausted their supply of Witte's peptone,
and, finding it difficult to get animal fluids, improvised a medium
containing an extract of peaflour, added to a trypsinized meat agar.
The method of its manufacture, as given by Gordon, Hine, and
Flack,^ is as follows:
Formula for Trypagar.
1, PEAFLOUR EXTRACT.
Take 100 grams of ijeaflour and add 1 Hter of distine<l water with 100 grams
of salt. Mix and steaiu for one-half hour, stirring constantly. Allow to setUe
and fiUer. thon sterilize and Ial>el "saline pea extract." This peaflour extract
should preferably be freshly made for each batch of agar.
2. TRYPSIN BROTH.
Take some fresh bullock's heart, free from fat and vessels, mince the meat
very finely and weigh. To each one-half kilo add 1 liter of water and make
faintly alkaline to litmus with 20 per cent KOH solution. Heat this slowly to
lo" to 80° C. for 5 minutes. Cool to 37° C, add 1 per cent of liquor trypsina
comp., and keep It at 37' C. for 2i to 3 hours. When trypsinizing is finished,
te<t for peptone with copper suli>hatc and KOH, as holow, tlien render slightly
acid with glacial acetic acid, and bring slowly to the lM)il for one-fourth hour.
I>eave overnight in a cm»l ])lace. and siphon ofi* the clear liquid in the morning.
Make faintly alkiline to litmus, and sttMilizc in an autoclave at 118** C. for 1
hour on each of 2 days (if not to ho used at once).
TO MAKK TUYPAGAR.
Take a nj-asured quantity of the tryi)siniz«il broth. ad<l 2 per cent of agar
fiber, ami 0.125 grams of calcium chloride per liter. Autoclave at 118° G. for
throe-1* urths hour to dissolve the agar. Mix together in a Siiucei>an; titrate
with X/IO KOH to give an absolutely neutral nniction. Cool to 60° C, add
* Gordon, Uino, and Flack. 1016. Brit. Mrd. Jour. No. 291C, p. 078.
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1179 July 27, 1017
white of two eggs beuteu up with the crushed shells, autoclave again at 118** O.
for 75 minutes (or in the steamer for 2 hours).
Filter, add to the filtrate 5 per cent of the sterile pen extract, and sterilize
in the ordinary way.
BIURKT REACTION FOR PEPTONE.
Take 5 cubic centimeters of broth, add 0.1 cubic centimeter of 5 per cent
solution of CuSOi, mix, and then add 5 cubic centimeters of normal NaOH. A
true pink color indicates that trypsin ization is sufficient; a blue-purple shade
that it Is incomplete.
PREPARATION OF FIBER AGAR.
Weigh out the required quantity, cut up small with scissors, place in a flask,
and wash quickly, twice, In water. Drain thoroughly; add water just to
cover, and put in glacial acetic acid, 2.5 cubic centimeters per liter of water.
Mix thoroughly and leave for one-fourth hour. Pour off the liquid and wash
thoroughly, four or five times, to make sure that all the acetic acid is washed
out Drain carefully and use as above.
Having grown the colonies overnight, they can be recognized by
their lack of color^ translucency, regularity of contour, uniformly
granular structure, and ease of homogeneous suspension in salt solu-
tion.
The organism is Gram negative, exhibiting usually many "ghost,"
or " invohition," forms in a young culture ; the diplococcus form pre-
dominates, this arrangement showing even when fished from solid
cultures.
The fiuther identification of the organism can be divided into two
stages — that for the immediate detention of a suspect carrier, and
that for the definite identification of a carrier.
The first is accomplished by making an agghitination test on an
8 to 18 hour culture with a polyvalent antimeningococcus serum,
controlled always in equal titer, with a normal serum, from an ani-
mal of the same species as that producing the antimeningococcus
serum. The suspension of the meningococci should be sufficiently
heavy to facilitate the reading of the test. A turbidity in the final
dilution should, as a minimum, be equivalent to that of the typhoid
vaccine made by the Army Medical School or the Hygienic Labora-
tory of the Public Health Service, This is equivalent to 500 parts
per million of silica, made in accordance with the standard methods
for turbidity determination in water analysis. This turbidity is
usually obtained by suspending tlie overnight growth of a serum agar
slant, seeded over the entire surface, in 2 to 5 cubic centimeters of
saline solution, and using equal parts of the saline suspension and
serum dilution to be tesled. The agglutination should be carried out
at 55° C. for a i^eriod of 12 to 20 hours.
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July 27, 1917
1180
The polyvalent semin should have a titer of at least 1 in 300 for
control meningococci of various types.
Agglutination with the antimeningococcic senmi in titer of 1 to
100, and the failure of agglutination in the normal serum at half
this titer, are suflicient evidence on which to detain an individual as
a carrier; but proof of the identity of the organism must be sought
in order to avoid detaining those who are not carriers, since the ag-
glutination test on meningococci is irregular and is not specific.
The second stage of identification is accomplished by fermentation
tests on sugars.
A solid medium, such as the agar above described, but with a reac-
tion of +0.2 to -|-0.5 and without the glucose, to which enough pure,
sterile litmus solution is added to give a blue tint, serves as the most
rapid differential base. The sugars to be selected are glucose, mal-
tose, and mannose. The 10 per cent solutions of each of these should
be sterilized in distilled water in the autoclave at 15 pounds pressure
for 15 minutes (or better by heating in the Arnold sterilizer for half
an hour at 100° C. on three successive days) and 1 cubic centimeter
of the solution is then added to 10 cubic centimeters of the agar.
The reaction of the (iram negative organisms common to the naso-
pharynx is as follows:
[+
-Acld; -
- -No acld.1
Glu-
cose.
Mal-
tose.
Man- 1
nose. 1
Chi- Mal-
cose. tosc.
Man-
nose-
M. pharyngis siccus
M. flavusl
+
4-
+
+
4-
-i-
-f
+
-f
M.flantifni
'+.+
4-
+
Menin^CKHMTUs
M flaws II
Af. caiurrhfjiis ..........
__
Stock cultures of the meningococcus must be transferred every 48
houi^s in using serum media ; but a 1 per cent cornstarch nutrient
agar, of neutral reaction, sterilized for 15 minutes in the autoclave
at 15 poimds pressure will preserve the organism at the top of a stab
culture for a longer tinie. in event further work in differentiation is
desired.
In the present state of our knowledge, the examination of all prob-
able contacts with carriers or patients should be made. However, we
do not know just what the value of this procedure is.
Mayer, Waldman, and Gruber^ examined i),000 men in barracks,
when the garrisons were free from the disease, and found that the
number of carriers in the ditferent contingents varied from '2 to 8
per cent. Reexaminations of the various contingents showed more
carriers in toto each time, but with wide fluctuations in the indi-
vidual contingents. In one regiment, l,iK)0 men were examined dur-
' Mayer, WaMman, Fiirst & (Jnibcr. 1910. Milnch. McU. Wchnschr. VoL LVIII, p. 1584.
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1181 July 27, 1917
ing an epidemic, and the carriers isolated. This measure seemed to
have no effect on the number of carriers or on the spread of the
epidemic.
W. M. Scott* found tluit K3.7 per cent of 138 noncontacts, in an
outpatient dispensary, carried organisms similar to meningococci.
(Scott's agglutination tests were not controlled by normal serum.)
On the other hand, there is circumstantial evidence to the effect that
carriers are responsible for the dissemination of the disease, and that
they in turn may develop the disease.
The treatment of such carriers is by isolation from contact with
others in quarters, in the mess hall particularly, and 'n\ gatherings
indoors. They should not be hospitalized, but should be kept in the
open air, be well nourished, and given such exercise as will maintain
a good physical condition. Occasionally, removal to another climate
seems to clear up the condition quickly. They may be isolated in
groups, but these groups should not be large, since carriers may de-
velop the disease and infect other carriers, or may harbor meningo-
cocci which are virulent for the other individuals.
Xo reports of satisfactory results in treating the carrier by the use
of sprays, swabs, or irrigation have been confirmed.
Gordon's method of the inhalation of chloramine vapors is in the
experimental stage, though it has shown some promising results.
Summary.
A routine examination of probable contacts should be made by
means of post nasal swabs.
The material can best be collected through the mouth by swabbing
the posterior nasopharynx.
The swab should be immediately seeded on a recently prepared
solid meilium containing sheep serum or laked human, or rabbit, blood
in from 5 to 10 per cent strength. The medium should be at body
temperature when seeded, and incubated at this temperature for 12
to 20 hours.
To identify the organism, fish the colonies and stain by Gram's
method, selecting those colorless, translucent colonies wliich yield a
Gram negative coccus. Subculture such colonies on a slant of the
serum agar and suspend the 8 to 18 hour growth in salt solution.
Test the agglutination of the suspension against a poly\ alent serum
at 55° C. overnight.
Continue the identification by sugar fermentation tests on glucose,
maltose, and mannose.
Treat carriers by isolation from indoor contact with others and by
general hygienic measures.
» Scott, W. M. 1916. Jour, of Hygieno, Vol. 15, No. 3. ^-^ ,
Digitized by VjOOQIC
July 27, 1917
1182
MALARIA IN LOUISIANA.
PREVALENCE AND GEOGRAPHIC DISTRIBUTION.
The periodical circularization of the physicians of Louisiana tc
determine the prevalence and geographic distribution of malarial
infection in the State was l)egun May 1, 1914. At regular intervals
rej)ly postal cards were sent to the practicing physicians. These
cards were at fii*st sent out each month. Beginning April 1, 1915,
they were sent out quarterly. A reproduction of the card used during
Relative prevalence of malaria in lyouisiana, by pwishes in proportion to the population, as
indicated by the numbers of cases reported.
1015 and 1010 will be found on page 1128 of the Public Health
Keports of the issue of July 20, 1917.^
Of the cards sent to pliysicians less than 10 per cent of the total
were returned. Presumably those returning the cards represented
the better class of practitioners, those best able to understand the
^ Tho work of circulari/alion and of compilation of the data on the return cards WM
carried on by the lato Siirt'. K. JJ. von Kzdorf up to the time of his death in September,
191G. Since thon it has been carried on by Asst. Surg. R. C. Derivaux and Asst. Surft
Gen. U. R. Carter. ^^^^^1^
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1183
July 2T, 1017
value of the work and what was wanted. The number of cards sent
out, the number of schedules returned, and the other results of the
ckcularization are shown briefly in Table No. 1.
The return of the schedules by the physicians being a matter of
voluntary cooperation, the data are undoubtedly reliable to an
unusiial d^ree as regards the experience of the physicians who
coopemted and the number of cases seen by them. It is to be borne
in mind; however, that the cases reported represent only those
occurring in the practices of the physicians who cooperated. The
total number of cases of malaria occurring in the practices of all
the physicians of the State must have been many times greater,
also the number of cases that occurred in which no physician was in
attendance or consulted was probably much greater than the
number coming under medical care.
«HmB*
Fob.
Ifar.
Apr.
May-
Jan.
Jul.
A««.
Sep.
Oct.
lov.
09C*
-»
f
•
A
A
/
\
/
\
^
y
y
/
\
/
\,
/^
V
v_
_^
^^
^J
N
y^
>•
•Ns
^
BflktiYo preralence of malaria In I^uisiana, by months, as indicated by the numbers of
cases reported.
The physicians who cooperated wore distributed as to locality
throughout all sections of the State, so that the data of the occurrence
of malaria furnished by them show the geographic distribution of
the disease and reasonably accurately its relative prevalence in the
various localities.
The cases reported throughout the State by months are shown in
Table Xo. 2. The relative numbers of cases reported by months are
shown in the above chart.
The number of cases reported from tlu» several parishes of the
State are given by race and year in Table Xo. 3.
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July 'l7, 1917
1184
The map on puge 1182 shows the relative prevalence of the dis-
ease in the several parishes of the State, the heavier ^aded parishes
being those in which the infection is heaviest, the unshaded parishes
those in which the infection is lightest, as indicated by the numbers
of cases reported. The relative density of infection was determined
by ascertaining the number of cases reported in each parish from May
1, 1914, to the end of the calendar year 1916 per 1,000 population.
The population used was that of the 1910 census, it being impracti-
cable to estimate populations for the period of the circularization.
Tlie types of malarial infection reported to have been diagnosed
microscopically are shown in Table No. 4. It will be noted that
tertian infection was reported to have been so diagnosed in 47 par-
ishes, quartan in 17 parishes, and estivo-autumnal in 34 parishes.
The total number of parishes in the State is 64. ,
By Table 5 it will be noted that hemoglobinuric fever was i'eported
in 5 parishes.
Table 1^ — Results of circularization of practicing physicians.
Period.
Inquiry
cards
sent to
physi-
cianfs.
Replies
received.
POTcent-
ape of
replies.
Parishes
repre-
sented in
replies.
Parishes
not
heard
from.
Cases of
malaria
reported.
1914.
May to December
1915.
January to March
April to June
July to September
October to December. .
1916.
January to March
April to June
July to September
October to December...
19,981
7,500
2,070
2,070
2,070
2,070
2,070
2,070
2,070
1,603
692
320
191
191
142
128
188
136
R02
9.23
15.46
9.23
9.23
6.86
6.18
9.08
6.57
^1
.16
20.
13,016
1,456
2,754
5,133
3^249
2,239
3,17»
7,040
2,460
Table 2. — Cases of uuilavia reported hy months.
Year.
Jan.
Feb.
Mar.
Apr.
May. June.
July.
2, 2(15
Aug.
2 171
Sept.
Oct.
Nov.
Dec.
19M
659 i 2,58S
493 , 1,(0
967 1,543
2,291
17.4
704
1,070
789
584
1915
415
578
57-t 1 167
577 1 084
1,252
668
1,180 1,579
1 977 2 4F,\
2,374 i!439
2 612 1 OSQ
740
1910
672
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1185 July 27, 1017
Table 3. — Cases reported hy parishes, hy years, and'^y color.
May 1 to Dec. 31, 1014.
Calendar yew 1916.
Calendar year
1916.
Pariah.
White.
Col-
ored.
CJom-
bined.
White.
Col-
ored.
Com-
bined.
White.
• 330
370
112
11
73
83
50
3
479
14
23
Col-
ored.
7
265
145
6
74
41
61
16
613
30
17
Com-
bined.
^jpadia * '* *
a05
325
110
41
162
115
144
27
275
56
179
3
173
43
38
41
20
49
82
285
27
90
2QR
498
153
79
203
135
193
109
560
83
269
152
313
131
39
106
146
251
65
394
63
49
'*'"27i'
9
6
1
48
168
32
632
26
53
152
584
140
45
107
194
419
97
1,026
89
102
337
inMi
635
AS^w/r;:;;.:
^(fpituntLmn ,, -.
257
17
147
BcftUiftiwd • -........-.-•-
124
Bi«*n' ille
111
19
C^tjo
1,092
44
Caldwfll
40
d^tftkKMlI'^ ..--
66
34
190
400
95
50
84
131
67
460
85
180
88
8
121
118
192
36
115
335
S8
195
256
363
323
28
62
228
37
34
00
4
16
40
135
63
80
94
47
103
104
27
118
74
254
107
68
104
56
13
2
70
ii
15
353
348
53
106
94
39
37
234
51
148
46
3
18
2
IM
13
35
56
103
184
95
117
220
29
81
113
90
31
33
ii"
19
100
75
45
72
33
63
92
569
63
35
33
57
33
106
83
3
1
55
96
49
543
748
147
156
178
170
1(M
694
136
328
\M
11
139
120
298
49
150
391
161
379
351
480
543
57
143
341
127
65
93
4
50
m
235
138
125
166
80
166
196
596
181
109
287
164
161
210
139
16
3
125
23
16
9
421
80
58
76
14
11
191
14
317
123
3
110
(>')
23->
10
1S2
177
5
301
103
427
205
29
29
99
1
45
213
i4'
67
279
21
109
57
1
3
121
14
149
78
2
9
81
86
4
98
57
11
472
46
152
132
63
14
30
ie'
71
23
30
76
700
101
167
133
1')
14
31=i
28
466.
291
.>
119
149
321
14
280
234
10
773
149
579
337
92
43
129
1
61
281
161
61
87
446
266
31
96
160
90
184
254
198
102
102
330
151
Om<xm\\iy.i
D^Sto^Q
271
700
v-att n-nrnn RcMMrn.
464
East r.irral) -.- *
133
East Fi nMtna. . ,1 . ^-,-,
196
Esaii'** lio6
Frar. Un..
20
11
262
251
12
11
101
112
360
1
38
235
11
'■■'266"
116
6
46'
64
137
16'
63
31
(truDt -
11
Ibrria
468
Ibcfxi:io '.
367
Jftckrofi ..
18
it^tTMa,
14
J^fTrtTf'M Davis
141
LaSaUc
176
l^ato^fl^f..
497
lAioitrr^r
1
LbKTi*n .,
48
IJ^in^^tfBi ........
298
MiKli-tkn
MOIT''<ri'r
669
57
115
206
"iis"
103
852
42
53
363
4
136
89
1.521
Na^r- itnrhcs. .*
99
OrUn^Tuv
168
i.)\Lv tta -
569
Pliiqi:naiiio8 ..
4
Pointc ('oupee
249
RupifHrt 1
192
Rf4 I'.lM-^
Richland
27
168
42
43
69
SaHiir
211
8( HrniATd
St.Clar'^
ii
53
28
117
85
148
164
137
202
156
245
217
149
20
72
102
28
14
18
16
27
124
57
87
149
198
106
89
24
m
20
no
121
24
166
139
34
11
29
69
55
241
142
235
313
335
308
166
71
340
265
327
270
50
238
241
62
25
24
37
45
108
91
116
450
101
437
97
21
24
411
260
90
63
12
120
11
263
32
15
121
131
66
96
276
108
238
181
1
10
52
207
84
65
45
52
23
101
56
Fl. HrWrut'..
5?
St.Jamft'.'
166
8t. John ih* Bnptist
239
8t. tandry^»
157
St. Martin
212
St. Mary
726
fit , Timimany . . ^
209
Ttotcipoboa.'.
675
Tensa^.
278
TefTtbonne
22
Union
34
Vennilbn
463
V'fmon
467
Washington
174
Webdti^r
128
Wtot l^iton Kotige
57
H«.tfVirrolI
172
Wttt Feliciana
34
Winn
364
Total
7,716
5,300
13,016
7,379
5,213
12,592
8,352
6,555
14,907
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July 27, 1917
1186
Table 4. — TypcH of infection reported diaf/HOMcd wieroscopicaUy by panshes,
May to December, 19 L^.
Parish-
Tertian.
Quartan.
Estivo-
autum-
nal.
Parish.
TerUan.
Quartan.
Estivo-
autum-
nal.
Acadia
2
24
10
+
6
+
+
42
3
16
+
45
50
17
2
35
+
+
19
7
2
29
10
103
8
8
175
55
9
+
2
+
+
+
1
6
+
10
2
+
15
1
I]
3|
+
+
15
31
5
4
23
+
+
+
Natchitoches
Orleans >
8
54
158
9
3
2
18
4
22
+
5
65
8
10
20
23
29
1
20
12
4
+
13
+
+
+
10
Allen
37
Ascension
Oifa^hita
12B
Assumption
A voy oUes
Plaquemines
Pointe Coupee
Rapides
3
+
1
+
+
10
1
Beauregard
Bienville
22
Red River
7
BoK.sier
Richland
2
Caddo
Sabine
4
Calcasieu
St. Bernard
St Charles
1
CaldwcU
4
Catahoula
St. Helena
+
Claiborne
St, James . .
11
+
+
+ ...
+
+
2
6
^ 3
CH)ncordia
St. John the Bap-
tist«
DeSoto
4.
East Baton Rouge.
St. Landry
^ 3
East Carroll
3
St Martin
■*■ 2
East Feliciana
St. Mary
E\'ageline
+
+
Tangipahoa*
Tensftfl
1
Franklin
5
C.rant
3
Iberia
Terrebonne
Union
2
Iberville
+
+
5
+
+
1
15
+
+
+
+
Jack^n
Vermilion
8
JefTerson
Vernon
+
Jefferson Davis
I.ii Salle
+
+
+
+
1
2
19
+
+
14
+
Washington
Webster -
8
Lafayette
West Baton Rouge.
West Carroll
West Feliciana
Winn
1
Lafourche
+
Lincoln »
Li virjfjston
+
Total
Morehouse
+
1,187
89
4(H
1 125 confirmed but type not stated.
> 20 eonftrracd but type not slated.
8 30 confirmed but type not stated.
Th" flKurcs indicate the numbers of cjisps diacnosed microscopically.
The sign + indicates that eases were reported, but the diagnosis was not confirmed by the microscope.
This information was collected during 1914 only.
Hemoglobin uric fever reported, 1016.
Parish.
Period.
Cases.
Caddo
Third quarter.
do
2
l)c Soto
2
Iberville . . i
do
3
West Carroll
do
3
St. Landry : ..
Fourth quarter
1
MEASLES.
RECORDED PREVALENCE BY STATES, 1916.
The table whicli follows show^s the recorded prevalence of measles
in the several vStates (hirin<i; the calendar year 1916. The data were
furnished by the health departments of the respective States.
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1187 ^Jaly 27, 1917
Measles Reported During the Calendar Year 1916.
state.
Arisona...;.,
California. :>.
Colorado...
Ck>nne;ticut
District ol Columbia.
Hawaii
Indiana
Iowa
Louisiana
Maine
Monrlaiid
Massachusetts..
Michigan
MinncsotaJ
Mississippi'. . . . . ,
Montana..'
New Jersey....
New York. J
Ohio
Oregon
Pennsylvania- -.
Rhode Island...
South Carolina .
Tejas
Vermont
Virginia
Washington....
West Virginia..
WiaconsiD
Wyoming
Ca-ses
re-
portod.
219
94
4,2ti8
4,14H
10,426
2,642
1,614
22,765
13,836
4,037
1,342
14,670
25,460
10,744
19,480
1,691
3,aoo
67,010
53,966
1,790
99,421
2,133
1,850
2,548
35,964
16.924
•10,822
16,153
552
Death.<;
regis-
tered.
131
204
218
158
13
106
388
344
2^
13
11
344
913
10
134
25
63
25
400
78
172
2
Indieatedj Indicated
case ralr death rate
(>cr 1,0(11
inhalnt-
ants.
\KiT 1,000
inhabit-
ants.
0.094
.36K
1.452
4.312 t
s. ;?7>i
7.259
7.481
8.082
7.563
2.207
1.737
10. 7a-.
6>J«i
3. 517
4.159
.806
7.182
6.523
10. 478
2. 142
11.667
3.472
1.144
7.006
11.845
11.031
7.808
6.460
3.074
0.001
'*' .014
.96
.112
1.33
.016
.23
.607
8.12
.072
.90
.098
.066
1.14
.007
.32
.078
.101
.113
.111
.007
.024
.117
.218
.015
.014
.069
.182
.051
.060
.011
Indicated
fatality
rate jht
100 cases,
1.37
Esti-
mated
popula-
tion July
1, 1916.
.72
1.52
3.20
2.68
.77
.33
1.36
'*66
6.28
1.34
.98
1.54
.46
1.06
.36
2,332,608
2.V..M4
2, 93s, 654
962.060
1,214,179
363,980
215,741
2, 816, 817
2, •220,321
1,829,545
1,829,130
772,1X9
1,362, S07
3,719,155
3,051, S54
2,279,r4)3
1,951,674
459,494
2,948,017
10,273,375
5, 150, 356
83.-.. 741
8,522,017
614,315
1,625,475
4,429,566
363,699
2,192,019
1,531,221
1,386,038
2,500,350
179,550
1 The health ofBcer states that cases are known not to be completely reporte4.
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PREVALENCE OF DISEASE.
No health deparimenl^ State or local, can effectively prevent or control disease vnthout
knowledge o/vhcn, where, and under what conditiofis cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Weelc Ended July 21, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended July
21, 1917, .as follows: Nine cases of cerebrospinal meningitis were
reported, 8 of these in San Diego County and 1 in wSan Francisco
city. Scarlet fever showed an increase; 56 cases, scattered widely
over the State, were reported. Typhoid fev(*r was reduced; 35 cases
were report<*d, mostly from rural districts. One case of poliomye-
litis was reported in Berkeley. Of diphtheria, Los Angeles and San
Francisco both showed increases, with 24 cases report<?d in the State.
^\n outbreak of paratyphoid fever occurred in Sausalito, Marin County.
The details of notifiable dist^'use cases reported during the week
ended July 14, are as follows: <
Cerebrospinal meningitis 9' Pneumonia 19
Cliicken pox 25 Ophthalmia neonatorum 1
Diphtheria 27 Scarlet fever 35
Er>'sipelaH 5 Smallpox 2
German meai'les 13 Sypliilis 21
Gonococcufl infection 21 Tetanus 2
Leprasy 1 i Trachoma 1
Malaria 10 Tuberculosis 99
Measles 165' Tyi)hoi(l fever 54
Mumps 81 ' Whooping cough • 47
(1188)
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1189
July 27, 1017
RECIPROCAL NOTIFICATION.
Minnesota.
ClM8i o/ communxeable dtseases referred during May, 1917 j to other State health depart-
ments by department of health of the State of Minnesota.
DiMftM and kxaUty of noU-
ficatiai.
Referred to health authority (
Why referred.
Diphtheria:
MbmeapoUa Hesltii De-
nt, fieimepin
Dty.
GamuB PaDs, Goodhue
County.
MtamcapoUs Health De-
nartment, Hemupin
County.
BmaUpox:
idnoMipolis Health J)^
partrnvnt, Hennepin
County.
Special noUOcatlon of
p«sona exposed to Tir-
uieaiC amallpox at St.
MftTv'S Hospital, Du-
Tnbcrrulo»u(:
Mayo Clinic. Rochester,
Ofaosted County.
Pokegama Sanatorium,
Pine County.
Chlcaeo, Cook County, lU.; Adjutant Gen-
eral s office, headquarters Central De-
partment, Ctiicago.
Kalamazoo, Mich., R. F. D. No. 2; Kala-
mazoo County.
Farm 5 miles from Windsor, Stutsman
County, N. Dak. ,
SpartaR. F. D. No. 1, Monroe County, Wis .
Weyerhauser, Rusk County, Wis I
Davenport, Scott County, Iowa.
Huron, Beadle County, S. Dak..
Nerada. Story County, Iowa; Kenton,
. Houghton Cjiinty, Mich.; Ironwood,
CM);jebic Cjunty, Mich.; South Kau^e,
lloujjhton Cjuntv, Mich.: A^hlc , Mc-
IntoshCjnnty, N. Dak.: Graft jn.VVi:l-h
County, 2^. Dak.; Lake Neba^amon,
Dmiplos Ciunty, Wi^.; Cumberland,
Barron County, Wis.: Superior, Doug-
las County, Wis. (10 person^); Iron River,
BayfieM Count v. Wis.; Uurlev, Iron
County, Wis.; Ila^ra, I>ougIas County,
Wis.; (J rand Raj ids, Wood County,
Wis.; llayward, Sawyer County, W i^.;
Frederic, I'olk Cjunty, Wis.; "Plover,
Portage County, Wis.; Maiden Rock,
Plorte Count V, Wi.^.: Stone Lake. Siw-
yerCjunty, wi^.; Winnipeg, Manitoba,
Canada (2 persons).
Rcdlands, San Bernardino County, Cal.;
Cjloraoo Springs, El PasoCDunty, Colo.;
Kewanee, Henry County, 111.; "Fulton,
Whiteside Count V, 111.; Indiana Jfarb >r,
Lake County. Ind.; (iary, LakeCjunt>,
Ind.: I>akotah,HumboldtCountv.b)\v:i:
Alchi-jon U. F, D., Atchisj?i (jimty,
Kans.: Kansas Citv, Jackiion Cjunt'v,
Mo.; New Ilonkford, Eddy Cjuutv, N.
Dak.; Marietta. Washinpton County,
Ohio; <irand Rapids, Wood County,
Wi'i.; Jano^ville, Rock County, \\h.;
Curaberl'ind, liarrcn CMinty, Wi'^.;
Denzel, Saskatchewan, Canada; Port
Artha-, Ontario, Canada.
Estherville, Emmet County, Iowa; Wool-
dridge, Valle; Count v, Mont.; (jrand
Forks, Grand Fork.s Count >. N. J>ak.;
Klldoer. Dunn Cotnitv, N. Dak.; Par-
shall, Mountrail Cjiintv, N. Dak.;
Minot, Ward C nintj , N. Dak.; Den/cl,
Saskatchewan. Canada. (KeiK)rted al>o
by Mayo Clinic.)
Boy 9, developed diphtheria en
route from CaUfomia to
Minnesota. Exposed 4 chil-
dren of oflieer of Regular
Army en route to Chicago.
Transient left Minnesota for
Michigan before it was known
that liis throat culture
showed diphtheria bacilli.
Patient broke quarantine and
went from Minnesota to
North Dakota.
Patient developed diphtheria
on arrival home after spend-
ing vacation in Wisconsin.
Patient developed diphtheria
after attending funeral of
■ brothor-in-law who died after
having a tonsillar abscess
opened: case diagnosed as
twisillitis.
2 persops exposed to smallpox
in MinneapolLs went home to
Iowa.
Patient exposed to smallpox in
S3uth Dakota developed dis-
ease in 4 days after arrival in
Mirmesota.
29 persons di^harged from St.
Mary'< Hospital Apr. 22-
Juuo 15 returned to homes
outside of State.
9 advanced; 4 moderately ad-
vanced; I far ad\-anred; 1 ap-
parently arre-ted; 1 dia.^nosia
not niven; cases left Mayo
Clinic for homes.
3 far advanced; 2 open casee; 1
moderately advanced; 1 diae-
nosed negative, improved;
ca^es left Pokogama Sanato-
rium for homes.
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July 27, 1917
1190
RECIPROCAL NOTIFICATION— Continued.
Minnesota — Conti nued .
Cases of conimunicahle diseases referred during May, 1917, to other State health depart-
ments by department of health of the State of Minnesota — Continued.
Diseases and locality of noti-
flcation.
Tuberculosis— Continued.
St. Paul Bureau of
Health, Ramsey
County.
Typhoid fever:
Two Harbors, Lake
County.
Duluth Health Depart-
ment, St. Louis
County.
Columbia Heights,
Anoka County.
Minneapolis Health De-
partment, Hennepin
County.
St. Taul Bureau of
Health, Ramsey
County.
Referred to health authority of—
Bear Creek, Outmagle County, Wis.;
Wausau, Marathon County, wis.
United States Public Health Service; Con-
neaut, Ashtabula County, Ohio.
United States Public Health Service ,
Norma, Renville County, N. Dak
Farm near Max, McLean County, N. Dak
Spooner, Washburn County, Wis
Why refened.
2 open cases moved from Mifr
nesota to Wisconsin.
Working as fireman on Great
Lakes steamship 3 weeks pre-
vious to first symptoms. Ill
In Minnesota; home in Ohio.
Worked as seaman on ship
Castalia, plying Great Lake&
3 wesks previoos to first
symptoms.
Visithij; friends in North Da-
kota 3 weeks previous to first
symptoms.
Working on farm in North Da-
kota 3 weeks {vevioas t« first
symptoms.
Lived at Spooner, Wis. , 3 weeks
previous to first symptoms.
ANTHRAX.
Kansas — ^Reno.
During the month of June, 1917, one case of anthrax was report^
in Reno, Hutchinson County, Kans.
New Jersey.
During the month of June, 1917, two cases of anthrax wore re-
ported in the State of New Jersey.
CEREBROSPINAL MENINGITIS.
Massachusetts.
During the week ended July 14, 1917, new cases of cerebrospinal
meningitis were notified in Massachusetts as follows: Boston 3,
Haverhill, Maiden, New Bedford, and Pittsfield, 1 each.
State Reports for June, 1917.
Place.
Now ctises
reported.
Place.
New cases
rex)orted.
Kansas:
Jewell County —
1
1
3
I/Ouis.ana:
Ascension Parish
1
Formf)sa (R D.).
MinnP'^ntiV
Bro\Mi County —
Reno County—
Hutchinson
1
1
Wyandotte County—
Kanfias City
Cass County—
npna
Crow WiuK' County—
Bruinord
Total
5
1
Rlverton
1
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1191
July 27, 1917
CEREBROSPINAL M£NIN6ITIS--Continued.
State Reports for Jane, 1917— Continued.
Plice.
New cases
reported.
Place.
New cases
reported.
IfiniMsote— ContinoAd.
Faribault County—
1
12
1
1
1
1
7
1
1
1
2
2
1
Ohio:
Clermcmt County
1
Jfw Davis Town?Aip ,,,.... ....
Coshocton County-
Cosbooton
Hennepin County—
1
Minne»pnK?. .
Cuyahoga County
23
BtoomioKton Township
Franklin County-
Columbus
Martin County—
Rutland Township
2
Guernsey County—
Cam n^ Idge
Wavwiy Township
1
Mower County—
Bamilton County ',.
4
AnMin
Lucas County-
Toledo...
2
St. Paul..:.
Mabnninpr County
9
White Bear Township
Medina fV>untVTTT.. ...... .
1
ncnviUe County—
Wang Township
Mont^raery County-
Dayton
1
Rice Coimty-
Pirkaway County
1
Wanow Township
Portage County
3
Stearns County —
Stark County
2
St. Cloud..
St. Louis County—
Summit County-
Akron
6
Dulotb
Van Wert County
1
Vindnia
Total ....
58
Total
dR
South Pakota:
Turner County
NewJersev:
1
15
8
1
Atlantic County
Rsw\ County.
Union County.-
Totfll ^
24
Oregon Report for May, 1917.
During the month of May, 1917, 1 case of cerebrospinal meningitis
was reported at Portland, Multnomah County, Oreg.
City Reports for Week Ended July 7, 1917.
Pbwe.
Cases. Deaths.
Place.
Casen.
Deaths.
BaUlmore^Md
fifiKhamton.N. Y.
Bo^w.Mass
Bridftport, Conn...
Btttte.Mont
Cuiton,Ohio
Qika«o,IU
gBdnaatt.Ohio...
Oeveland.OhJo....
g«rott,Wldi
vabouu«, Iowa. . . •
Dohith, Mian
Sittbith.N.J
KPtoo.fex
E"rtWayna,Iad...
Htnli«i,N.J
Birt*ml,(>»mi
JWByOty.N.J...
|««8Cay.lUni.
XvumC^.ICo...
Little Rod[, Ark
Manchester, N. H ..
Newarlc.N.J
New Britain, Conn
New Haven, Conn
New York. N.Y
Northampton, Bfass
Philadelphia, Pa
Pittsburgh, Pa
Pittsfield,Mis8
Providence, K.I
Kacfae,Wb
St. Louis.Mo
St. Paul, Minn
Salt Lake City, Utah
San Diego. Cal
San Francisco . Cal
Saginaw. Mich
Zanesville, Ohio
DIPHTHERIA.
See Diphtheria, measles, scarlet fever, and tuberciilods, page 1205.
86
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July 27, 1917
1192
ERTSIPELAa
Oitj R^^orts for Week EMed J«l7 7, 1M7.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
AUentown, Pa
1
Milwaukee, Wis •
2
3
6*
4
2*
8
1
1
2
1
Boston, Ma"^s
M
Newark, N.J
New York. N.Y
Philadelphia, Pa
Brockton, Mjvss
i
1
8
2
4
2
2
?
1
8
Buffalo, N. Y
1
1
Chicago, III
Pittsburg, Pa
Cincinnati, Ohio
Provi<!cnee,R-I
Kochester,N. Y
1
Cleveland. Ohio
Davton, Ohio
gt. Louis, Mo
1
Denver, Colo
Kt PfinI, Vffinn
Detroit, Mich
San Diejro.Cal.
Duluth , Minn
San FrAnei.«5Co . Cid
Kansas Citv, Mo ....... . .
Schenectady, N. Y
LEPROSY.
Lonisif BartyHle— E«at Baton Rtaf e Pariah.
Collaborating Epidemiologist Deeding reported that dunng the
month of June, 1917, one case of leprosy was notified at BurtviUe,
East Baton Rouge Parish, La., in the person of F. J., a colored male,
about 55 years old.
MALARIA.
State Reports for June, 1917.
Place.
New cases
reportad.
Place.
Newcasw
reported.
Kansas:
Butler County-
Douglas
1
1
1
1
1
Ouaddta Parish
Pla<]nemJne.s Parish
Crawford County —
Pittsburg
Rapides Parish
Geary (^oimty—
T^i<^Iand Parith
Junction City
Sabine Parish
T,.eAVAnwnrth County-
8t Charles Pari-sh. , ,
Leaven worth ..I
St. John Parish
Monteomory County —
St. Landry Parish
16
Coffejrdne
fit. Martin Parish
8t Marv Parish
le
Total
£
St. Tanimanv Parish....
TnTwHriAhnn Pnrf«h
22
8
5
1
1
3
3
3
11
19
2
1
6
2
5
1
2
5
Union Parish
Acadia Parish
Verrnflfon Parish
D
Allen Parish
Vernon Parish
Ascension Parish
Washington Paiisli *
Avoyelles Parish
West Carroll
Beaur^urd I*arish
West Feliciana Ptolsh.
Caddo Parish
Total
Claiborne I'arish
313
Concordia T^arish
New Jersey:
Bnriin^on County ..........
DeSoto Parish
East ('arroll Parish
East Feliclnna Parish
Essex (5oimty....r
Jackson I'arish
Hudson County
Jeirerson Davis Parish
Mercer County '.'.
Lafavettc Parish
Monmonth County.
Lincoln Parish
Somerset . . .'. . ....
Livingston l*arish
Sussex
Morehouse Parinh
Total
Natchitoches Parish
22
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1193
MALAMA— Continued.
GHy Reports for Week Ended July 7, 1917.
July 27, 1917
Ptem.
Cases.
Deaths.
Place.
Cases.
Deaths.
Rimiin^m Atft
1
1
New Orleons. La
1
Hoboktt.N.'J
New York, K. Y !
1
wip*<^ rity, iro
1
Richmond, Va
1
1
iiSnS,N:i":.
1
Savannah, Ga
1
> The nasoi that Binningham had so many mora cases of malaria reported than any other city is not
that the disease is more prevalent in Blrmiosham than in other cities of Alabama and neighboring States,
tat ondaiibtediy because of the successful efforts the health department has ixfade in securing the coopera-
tioD of the praeneiiig physiclaiis in reporting cases.
MEAI^LES.
See Diphtheria, meMke, ecarlet fever, and tuberculosis, page 1205.
PELLAGRA.
SUte R^^orto for June, 1917.
Place.
New
r^xnted.
Place.
New cases
reported.
Cherokee County—
Galena
Cowley County —
Wbield..
Oiwford County —
Plttsburjt (R.D.)
Jackson County —
Holtcn.....
Ubette County —
Parsons
Miami County—
Osawatomie (SUte Hospital)
MoDtfomery County—
Ckney
Bcno County—
Hutchinson
Total
Acadia Parish
Beaarecard Parish
Caddo Pariah
Louisiana— Continued.
Cald wen Parish ,
De Soto Parish
East Baton Houzo Parish
East Carroll Parish
East Felidana Parish
Franrlin Parish
Iberville Parish
Jackson Parish
Lincoln Parish
Madison Parish
Morehouse Parish
Natchitoches Parish
Orleans Parish
Ouachita Parish
Rapides Parish
Sabine Parish
St. Mary Parish
Tangipahoa Parish
Tensas Parish
Vernon Parish
Washington Parish
Total
2
1
3
2
4
8
1
4
2
1
16
1
6
1
3
1
2
6
1
6
2
79
aty Reporto for Week Ended July 7, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
AiKttn,T»x
gnringham, AhL
a»«teten,g.C..
Gtlv««t«LTBx..
BatOty Mo.
>8
MohUe.Ala
NashTtUe, Tenn
New Orleans. La
New York, N.Y
Sacramento. Oil
Savannah, Ga
Syracuse, N.Y
Winston-Salem, N.C.
J* The reaioo that Binningham had so many more cases of pellafra reported than any other city Is not
J«*t the diMase is more pre\'aient in Birmingham than in other cities of Alabama and neighboring States,
^^Uadoobtedly beoauae of the suooeanul efforts the health department has made hi securing we coop-
*>«0Q of the pnotietog phyaftJans hi repcrthig cases.
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Jaly27,lMT
1154
PMGUE.
Oalifonda-TAIameda County-— Ptefpe-Iiifeete^ Stprirrels Found.
During the period from July 3 to 12, 1917, 5 plague-infected
ground squirrels were found widiin a radius of 5i miles of Alta-
mont, Alameda Coimty, Cal., one each on the following ranches:
Flynn Bros., Frank Floyd, F. Rahmstorf, C. W. Carroll, and Mary
Klesorth.
Hawaii— Paaii]imii-~Fhic«e-bifec(ed Rat Found.
A plague-infected rat was foimd July 15, 1917, at Paauhau, Hawaii.
PNEUMONU.
City Reports for We^ Ended Jnly 7, 1917.
Pltc«.
Cases.
Deaths.
Place.
Oases.
Deaths.
AluiMtla, <V.
74
14
GrMid Bapids, Mleb
Fftv^rhni MftM ,
1
3
1
4
3
18
31
13
1
3
U
3
1
3
Atlmtichty N.J
BaltliBora Md
10
Kfi^in**^ Mi'^b
1
BlmrhttniDton N.Y
I^ Am^wW C>l.. _ _ .
s
Boston, lipss
4
T.ynn MaS?^ ^ . * . x x . .
Braddock Pa .
Newark, N. J
8
Cam bridge, Mass
1
Philadelphia, Pa
f
rbpi<s^fi fiim..
Httsburgh,Pa
13
Chicafo, HI ',
63
Reading, Pa, ,
nfio^tand Ohio
Rochtfter.N.Y
3
Detroit, itoi
San Franosco, Oil
10
PnUith'^ Minn
Bandiisky, <^hio . .
1
Kvcrett Mass
Sooth Bethlfthem, Pa.
Flint, ^cb
2
POLIOMYELITIS (INFANTILE PARALYSIS).
Connecticat
During the week ended July 21, 1917, 4 cases of poliomyelitis were
notified in Connecticut, 1 case each at Bristol, Derby, Thompson^
and West Havai.
Massadiasetts.
During the period from July 8 to 23, 1917, cases of poliomy^tis
were notified in Massachusetts as follows: Groveland (town) 3,
Groton (town) 1, Hadley (town) 1, Haverhill 2, Lowell 1, Maiden 1.
Minnesota.
During the i)eriod from July 1 to 22, 1917, 4 cases of poliomyelitis
were notified in Minnesota as follows: One case each in Keene
Township, Clay County; Long I^ake Township, Watonwan Coimty;
Lyons Township, Lyon County; Minneapolis, Hennepin Coimty,
OMo— Uliridisville.
Durin<i: the week ended July 21, 1917, 'two cases of poliomyelitis
were notified at UhrichsviUe, Tuscarawas County, Ohio.
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1195
July 27, 191f
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
Vermont
During the week ended July 21, 1917, cases of poliomyelitis were
notified in Vermont as follows: One case each at Barre, MontpeUer,
and Waterbury.
Virginia— Rockingham County.
The State Board of Health of Virginia reported July 18, .1917^
that 4 cases of poUomyeUtis had been notified at points near EHkton,
Rockingham Coxmty, Va.
West Virginia— Mononga.
During the period from July 15 to 20, 1917, 6 cases of poliomyelitis
were notified at Mononga, Marion County, W. Va., making a total of
8 cases reported at that place since July 7, 1917.
State Reports for June, 1917.
Place.
New eases
Place.
New cases
reported.
Kansas:
Ckrad County^
01asco(K. D.)
1
1
1
New Jersey:
Berwi Owintv..
Essex County
Uncohi County-
Sylvan Qrore (R. D.) . . .•.
Hudson County
Hunterdon County . , ^^
Wyandotte Coanty — ' •
Mercer County ...'.
Kansas City
Middlesex County
Total
Total
3
15
Ohio:
Belmont rnunty
Louisiana:
BienriUe Parish
1
jj
Cuyahoga Coimty—
Cleveland
liichigan-
1
1
Lenawee County—
HudMm Township
Franklin County-
Columbus
Wai^tenaw County-
Qallia County
Hamilton County—
Cin<innati . . ....
Total
2
Lucas County-
Toledo
-lOttDisota:
Pine County-
1
1
1
Pickaway County—
CInlcvillc
Stark County—
Massillon
Pope County-
LancheiToirnahip
Summit County-
Akron
WilWn County-
Bradford Township
"Williams rv>iintv..
Total
Total
3
23
South DakoU:
Corson County
I
Oregon Report for May, 1917.
During the month of May, 1917, 1 case of poUomyelitis was
rqx)rted in Clackamas County, Oreg.
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jTi1y2T,V©l7
1196
POLiOMYELmS <INFANTILE PARALtSISV-CSMttiised.
City Reports for WeekCadc^ Jtily 7, 1917.
PUoe.
Cases.
Bcatlis.
Pbce.
Cases.
Deaths.
Albany, N. Y
1
1
fi
1
NcwYork. N. Y
Philadelphia, Pa
2
S
Chioai:o 111
Haverhill, Mass
8cb«Bi£H'tadr, N. Y
1
Lowell Mass.
SiiringD<M,'Mai«s
1
1
Mcdford, Moss
RABIES IN MAN.
City Report for Weelt Ended Jidy 7, 1917.
During the week ended July 7, 1917, 1 death from rabies was
reported at Cincinnati, Ohio.
BABIES IN ANIMALS.
City Reports for Week Ended July 7, 1917.
During the week «ud^ July 7, 1917, 4 cases of rabies in inimah
wrere reported at Detroit, Mich., and 1 case at St. Paui, Minn.
ROCKY MOUNTAIN SPOTTED FEVER.
Orecwi Report for May, 1917.
During the month of May, 1917, 2 cases of Rocky Mountain
spotted fever were reported in Baker County, Oreg.
SCAttLET FEVER.
See Diphtheria^ measles, ecariot ferer. and tubenculosis, page 1205.
SMALLPOX,
rt for May, 1917— Correction.
The report of a death from smallpox in Hancock Coimty, IihL, m
the State report for May, 1917, pobhshed in the Public Health Re-
ports of July 6, 1917, was an CTror. One death occurred in Hendricks
County in May.
Minnesota.
Dxiring the week ended July 21, 1917, five new foci of smallpox in-
fection were report-ed in Minnesota, rases of the disease having been
notified as follows: Carver Coimty, Chaska I; Dakota County, Em-
pire Township 2; Hennepin County, Riclificld Township 5; Itaska
County, Deer River 1 ; Martin County, Silver Lake Township 1.
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1197
July 27, 1917
SMALLPOX— Continued.
Stole Reports for June, 1917.
Dmths.
VaeelUfltlon history of caset.
Vhc^,
Nuralj«r
t"ftCcl«atBd
withlii T
years pri*-
eodinif
attack.
Number
last Tacci-
njkti!>d more
lUan T yoars
pntceaiixg
Number
(M?5s fully
vocdDatcd,
Vsccfnotioti
history not
flbtaltip-l or
uncertain.
1
5
2
2
2
1
3
2
1
1
1
5
4
1
2
2
7
6
4
27
1
2
i 4
1
1
12
3
I
5
2
2
2
1
1
2
Muscotah
Barton County—
HoRJnrtnn ,
1
Bourbon CSbunty—
Fulton
Broini County—
Horton
Butler County-
Augusta
Cherokee County-
Baxter Springs (R. D.)....
Chetopa (R. u.)
Cohiznbus.
Galena
1
McCune (R. 1>.)
Cowley County—
Cambrldg©
Win6cld
(^wford County-
Anna .... , . . ,
Breezy lUU (R. D.)
CherokeeCR. !>•)
FninVlln
Girard
Hulberry
Pittsburg ( R D.)
1
Da^han County—
Elwood
Hlis County—
Hays(l R. D.)
Pimiey County-
Ford County—
SDearville^R. D.)
Oow County—
Grinnell
Greenwood County-
Fall River
2
Jefferson County—
Oskaloosa (R. D.)
Johnson County—
Eudora(R. D.)
• 1
Labette County—
Oswego
1
5
4
1
2
2
7
PftTS^J*
LeaYenworth County—
I^iRvenworth
Uncoln County—
Unooln (2 R. D.)
Marion County—
HiUsbcro (R. D.)
Marion .
MePheraon Coiinty—
Marquette...... .
Miami County-
Paoto...:
Montgomery County—
Coffeyville
1
1
5
3
27
1
a
1
ifidependenoe
Morris County—
CouncU unnre
N«nahaCounty-
Oentralla (R. D.)
Coming (R.D.)
1 ..,.::
Neodio County—
Channte
4
Erie (R.D.)
,
l\
Shaw
1
i i\ ^
South Mound (R. T).)
I i
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Julj 27, 1917
1198
SMALLPOX— Omtinoed.
State Reports for June, 1917 — Continued.
Newcasea
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
witWn7
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack.
Number
never suc-
cessfully
vaccinated.
Vaccination
history not
obtahiedor
uncwtain.
Kansas— Cont inued.
Osborne County—
Osb<MTi©
1
30
1
6.
OtUwa County—
Mlnneftpnfis ,^T-T
1
Pawnee County-
Lamed
Pratt County—
Pratt (I R. D.)
Reno County—
Hutchinson
Republic County—
Belleville
Rlee C^xinty—
Sterliii
BUey County-
Manhattan (3 R. D.)
Rush County—
Timken r r.,..
Scott County—
BcottCitv
Sedgwick County—
ChenoT (I R. D.)
*
Valley Center
Wichita
Seward County—
Liberal
1
Shawnee County—
Topwa
Stafford County—
8t. John
Sumner County—
Caldwell
Wabaunsee County—
McParland
Wallace County-
Wallace
Wilson County—
Altoona
Buffville
Wyandotte County-
Total
229
0
220
Michigan:
Alpena County—
Alpena Township
1
a
3
2
2
14
5
1
3
1
14
2
14
r-^ 14
Green TowiLship*
Long Rapids Township...
Alpena.
Benzie County—
Weldon Township
Berrien Countv—
Bertrand 'township
Nile.... ..:::::
Chippewa County—
SaiiltSte. Marie
Emmet County-
Bliss Township
Pelhton
Ar^entujp 'Town'ihip
Ociift^ce Township
Flint
Gratiot County—
Lalavctte Township
North Star Township
Alma
Ingham County—
Williamston
Lansing
• • +
Digitized by'
1199
SMALLPOX— Contlntied.
State Reports fbr June, 1917— Con tinned.
July 27, 1917
New cases
reported.
Deaths.
Vaccination history of cases.
France.
Number
vaccinated
within?
yeare pre-
ceding
attack.
Numl>er
last vacci-
nated more
than 7 years
preceding
attack.
Number
never suc-
cessfully
vaccinated.
Vaccination
hi torynot
obiainedor
uncertain.
Mkhjsaii— Conttnaed.
£ast(Hi Towoahip
13
15
46
1
Jtttaon County —
TUv^n Tnwmhfp
1
Jftckson
2
4
1
1
K«it Countv—
Grand Rapids
MarquetU County—
laiipeming
HMon County—
Ludinston
Mecosta County-
Big Rapids TowMhip
Fork Township
1
1
1
13
4
1
Hintoo ToivTubip.
Big Rapids *
IfidlandCounty-
lIuBkagan County—
Oakland bounty—
Pontiac Township...*
Southfield Town&ip
Watarford Township
Pontiac
1
8
1
7
15
3
2
2
1
1
1
a
1
Ottawa County—
Bleodon Township
OU\e Township
WriAt Township
Pr«fiqo«nsle County—
AIH^ Tnwnshfp
Onaway T
Bajinaw County-
Brant Township
3
Frenumt Township .. 1 . 11 .
St. Clair County-
Emmet Township
Grant Township
1
Port Huron ... .^ .. I m 1 m
3
Sanilac County—
DeckaryllJe ..
1
Sanilac Township
2
fihiawasBea County-
Rush Township
Shiawassee Township
Owosso
1
I
3
8
2
1
1
9
VaD Buren County—
Decatur Township
Washtenaw County-
Ann Arbor
Wayne County—
DearbcHrn . ....
St. Clair Heiriits
Detroit
1
37
.......
Total
2M
3 1 4 1 158
39
lOmesota:
Bigstone County—
Ortcnviil©
17
17
Bhie Earth County-
Lake Crystal
Chisaco County-
Rush City . .
Chisago Lake Township...
Oay County—
Hawley
Uoorbaadi. !'!!!.!
Digitized by VaOOQ I
r
July 27, 1817
1200
SMALLPOX— Continued.
State Reports for Jane, 1917— C)ontmued.
New cases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within 7
yeare pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack.
Number
never suc-
cessfully
vaccinated.
VacdnatiflB
history not
obtained or
uncertain.
Minnesota— Continued.
Crow Wing County—
Brainerd
3
2
1
17
116
23
1
I
2
o
3
2
1
1
1
1
16
4
1
IrontrOn . .■
Dodgo County—
Wasioja Toxmshlp
Fillmore County—
Rushlord
Newburg Township
Freebom County—
Alden Township
..
London Township
i"
Goodhue County-
Pine Island
Hennepin County—
Edina
1
1
8
ExcelsicH'
1
Minneapolis
108
3
1
2
Wayzata
West Minneapolis
Maple Grove Township . . .
Minnetonka Township
1
Plymouth Township." ....
1
Hubbard County—
Arago Township
0
1
W Wte Oak Township
4
3
1
1
2
1
2
8
5
7
Itasca County—
Bovey
Martin County-
Fairmont
Pleasant Prairie Township
1
Tenhassen Township
Morrison County-
Belle Prairie
Mower County-
Austin
1
Lyle Township
1
Olmstead County—
Rochester
Pennington County-
Thief Kiver Falls
Polk County-
Angus Township
1
Ramsey County—
St. PauL
9
1
1
Renville County-
Franklin ....
Olivia
Roseau County—
Huss Township
1
1
St. Louis County—
Dulutb
7
1
14
1
Proctor
Sherburne County—
Orrock Township
1
1
1
Steams County-
Eden Lake Township
Steele County—
BloonUng Prairie Town-
ship
Stevens County-
Donnelly Township
1
Todd County-
Staples
1
2
1
1
6
6
Bruce Township
Hartford Township
Wadena County—
Vcmdale
Wadena
Watonwan County—
St. James
Digitized by
Google
1201
July 27, lOlT
SMALLPOX-— Coutiuued.
State Reports for June, 1917— Continued.
New cases
reported.
Deaths.
Vaccination history of cases.
If
Number
vaccinated
within 7
years pre-
ceding
attack.
Number
last vacci-
nateil more
than 7 ycirs
prece<lin(;
attack.
NumlxT
never siic-
cossfally
vaccinated.
Vaccination
history not
obtained or
imcertain.
Hhmesols-Continued.
Winona County—
Winona
1
3
1
1
1
WriAt County—
rnuokfort Township
Ytlknr Medicine Coonty-
Vergeland Townalilp
Total
279
5
21
250
s
Ohio:
AllenCounty
7
1
5
30
18
11
12
1
48
17
4
2
6
11
4
15
1
2
10
7
3
33
2
8
23
5
6
1
1
2
1
6
1
13
8
64
8
2
2
2
2
4
1
3
28
3
Ashtabula County
Athens ('oimtv
2
But'er Cmintv
2
Behnont County
18
Clark Couutv
6
4
0
Columbiana "Coimty
1
7
Coshftcton County—
i'oiho'^ton
1
48
Darke C^ounty. ..'.
15
3
2
Dela\far« County
1
Fairiie'd Coimty
2
Franklin County
4
2
Greene County/.
11
HamUton County-
Cincinnati
4
Hancock County—
Flndlay
3
14
1
8
Hardin County
1
Henry County
Jackson County—
WeUston
2
Jefferson County
1
16
1
2
LogaTi County
A
Lucas County
3
Mahoning County—
Youngstown
33
Mercer Coun t y
2
Miami County
1
5
19
2
, MontnMnery County
4
Morrow County
5
Muskingum County—
Zanosville
6
Perry County
1
Portage County
1
Preble Count y
2
Rkhland County-
Mansfield
1
Scioto County
5
Seneca County—
Fostoria
1
10
8
12
2
Shelby County
1
2
Stark County-
Canton
Summit Coujitv
1
51
TrnrabnU Couritv
6
Van \\ ert County
2
Warreu County
2
Washin^on County—
2
Williims County
2
Total
410
1
6
!fl7
M!i
Digitized by
Gc
July 27, 1917
1202
I
SMALLPOX— Continued.
Miscellaneotts State Reports.
Place.
Louisiana (Jun? \-?,0):
Assumption Tarisli.
Livingston Parish..
Orleans Parish
Rapides Parish
St. Lcmdry Parish..
Tangipahoa Parish.
Union Parisli
Vermilion Parish . . .
Winn Parish
Total
New Jersey (June 1-30):
Hudson County
Oreeon (May 1-31):
Clatsop County
Douglas County
Multnomah County ~
Portland
Washington County
Total
Cases.
2
1
6
7
1
11
1
5
1
reaths.
35
1
^==^—
r — ^=^C=r
23
1
3
3
29
Place.
South Dakota (June 1-30);
Bon Homme County.
l>av Iscn County
(JranK ounty
< Jregory County
Han J County
Hughes (.k)unty
Jerauld County
I-awrcnce County . . . .
Miner County
Minn?haha County. . .
Sanborn County
Spink County
Tripp County
Turner County
Yankton County
Ziebach County
Total
City Reports for Week Ended July 7, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Alton, Ul
25
Muscatine Iowa
1
6
11
1
2
5
4
4
2
5
10
2
5
0
5
5
1
1
3
2
4
1
2
Ann Arl>or,Mich
New Orleans La
Butte. Mont
Oklahoma ( ity Okla '.
Chicaco,lll
Omaha, Nebr . "
Cleveland, Ohio
7 1..........
Philadelphia, Pa.
Columbus, Ohio
Pittsburgh. Pa...
DaiiviUc. Ill
Pontlac Mich
Davenport, Iowa
6
14
Portsmouth Va
Dayton, Ohio
Quincy, 111.'.. '.
Denver, Colo
Ilichmond Va'
Detroit, Mich
St.Josenh Mo
J
Dubuque, Iowa
St. Louis. Mo....!..*."!.";!!.'";
St. Paul, Minn
Erie, Pa
Flint, Mich
Salt Lft'xc Citv Utah
Fort Wayne, I nd
Sioux (ity, Iowa...
C.rand Rapids, Mich
Sprlneficld, 111
Indianapolis, Ind
Sprinjjfleid, Ohlo.I^
Kansas City, Kans
S«ip»rior, Wis
Kansas City, Mo
Tacoma, Wash
Kokomo, Ind
Terre Haute Ind
Lln^ln. Neb
Toledo, Ohio'
Memphis, Tenn
Whoelmii W Va
Milwaukee, Wis
Wichita. Kans
Minneapolis, Minn
Zanesville, Ohio
TETANUS.
City Reports for Week Ended July 7, 1917.
Place.
Baltimore. Md..
Chicfttro, 111
Harri:jburp, Pa.
Cases.
ths.
Place.
C««e8.
Deathi.
1
Providence, R. I
1
1
2
1
Trenton, N.J
1
TUBERCULOSIS.
See Diphtheria, measles, pcarlet fever, and tuberculosis, page 1205,
Digitized by VjOOQIC
1203
July 2'*'» 1»1T
TYPHOID roVER.
State Re^rts for Jvne, 1917.
FlaoQ.
AtchisHi- ,,„.,
> Bourboti CdEinlT^ —
Fort ScQtt.. .,,»,.,.
BtiLler County^
Cberokee roiinty —
FmlkDer
Cowler County —
AdnnsasCitT
N«wS«lem(R. D.).
WinfieM
Cnwiard County—
PitUburg
Djckinson Gmxnt7r->
Htrincton
Hope
flimey County —
Garden City
G«ai7 County—
Fort Riley
Greenwood County—
Qoincy
Medison -..
Kearny County —
Deerfleld.
1 County—
LebeUe County—
Edmond
Leavenworth County-
Leavenworth
Montflomery County—
Cnenyvale
Riky County-
Leonard "*
vil]0 (B. J>.).
Sedgwick County —
wichiU....:,
Shawnee County—
Tepeka
Somner County—
CaldweU
Washinrton Oeunty—
Wa^ihicton (H. D.). .
WDson County—
Fredonl* (R. D.)
VFoodaon County—
Yates Center (K. D.>,
Wjaadotte County—
^wincs.
City....
Total.
Looi^ana:
Acadia Parish
Allen Pariah
Ascea^on Parish ,
Assumption Parish
Avoyefles Parish
Bossier Parish
Caddo Parish
Calcasieu Parish
CaldweH Parish
Catahoula Parish
Caaibome Parish
Concordia Parish
East Baton Ron^ Parish.
East Fclidana Parish
Pranldin Parish
Iberia Parish
Iber\aic Parish
Jackson Parish
JeCtraon Parish
Jefferson Davis Parish
Lalayette Parish
Laloorche Parish
ropart-eJ ,
-i
r'bc«.
12
Louis rainfl—Cniitfnued«
L^ Saitc Piirtsh., „„.„.,,
Li V i nrst iJTi I 'afiih ,
NfltHjilwhrs Pariah,,.....*
Orlesirui Parlih - _ _
Oror'utn Parish. .„,,,..„.
Fli. ,.r-,Li::L-- Pftfiih,*......
T'l i -r ' .> .,A'c Parish..,,.-
Kapkles Parish
Red River Pariah
Richland Parish
Sabhie Parish
St. (Charles Parish
St. James Parish ,.
St. T/andry Parish
St. Martin Pariah
St. Mary Parish
Tangipahoa Parish
Union Parish
Vermilion Parish
Washinirtoa Pa^ah.
West Baton Bou^ Pariah.
West Carroll Parish
Winn Parish
Total..
Michigan-
Alpena County—
Alpena
Bay County^
Bay City
Berrien County—
Niies
Branch Ccuntr—
Bronson Townddp..
Calhcaa County-
Battle (Yeek
Chippewa Coimty—
Santt Ste. Marie
Clinton County-
Bath Township
Viitcr Township
De Witt Township..
Dickinson I'ountv—
Iron Moimtam
Geneve County—
FKnt
Hillsdale Coimty—
Wright Township...
Ingham County —
I.anNinji
Kalk:i> a ( fiinty-
oiiser Towiiship —
Kent Ci'uiity-
(JiMiid liai
28
4
3
pids
Lapeer C< iinlv—
Hurnsi(]t' Yownship...
Maiii->teeC 'iiuty—
Maiii^foo
Marmietle Ci unty—
Ncj^iiuie?
MeCi ^la C( iinly—
Bfirrylon
Mis.>.iu:.c.><\ iinly—
<'lani rni'.n TowTiship
Montcalm r ii'ify-
Ilowanl <'ity
Muskegon C'liuly —
Musk<»s n
Ogeinav. 'Ounty —
l{()^(» TounNhip. ...-,.
Sagiiiiv.'(\)unty -
Oak.cy
^apin »\v
Shiaw:i- ;ooC( iiniy—
Woodhiill 'l\)\vnihip
Ru^i Towp-.lij;^
New cases
reported.
I
4
i
81
8
1
4
10
1
6
1
4
10
13
5
5
13
1
5
1
1
2
3
242
80
2
3
1
10
Digitized by
July 27, 1017
1204
TYPHOID FEVERr -Continued.
State Reports for June, 1917— Continued.
Place.
M kshlpui— Continued.
Van Buren C( uuty—
Almona luwiiship.
Wayne Ccuiity—
Hamtram-k
Detrclt
Wyaifkite
Ypsi.auti
Total.
Minnesota:
Anoica County -
Columbia lIoiKhts
Blue Earth County-
Lake Cr/slil
Mapleton
Brown County -
New Ulm
Carloton County—
Cloquet
Crow Wing County—
Croaby
Hennepin County—
Minnoapoiis
Jackson County—
Tleron Lake
McLeod County—
riato
Marshall County-
Oslo
Morrison County—
VitTT Township
Polk County—
Mcintosh
Johny)n Township
Pope County—
Olenwojd
Rice County—
FarUailt
Roseau County—
Roseau
St. Ixjuis County—
Duluth
Aneora Township
lading Town.ship
Scott County -
Belle I'loine
Sherburne County—
Livonia To'A-n.Hhip
Steams County—
Wakefield Township. . .
Steele County—
Owatonna
Watonwan County—
Madelia
Roaendale Township. . .
Yellow Medicine County—
Omro Township
Total.
New Jersey:
Atlantic County
Berren County
Burlinfton County. . .
Camden County
Cai»e May County
Curalierland County.
Eh'Wx County
01ouc*^ler County . . .
Hunterdon (bounty...
Mercer County
Monmouth County. . .
Morrb County
Oceiin County
Pa «ts-ic County
New cn.scs
reported.
30
Place.
New Jersey— Continued.
Salcm County
ITnion County
\N'orrcn County
Total.
Ohio:
Adams County
A.shland CM'n'y
Ashtal ii.a County—
C^nrnaut
Belmont County
Brov n Coimty
Butler County—
ITamiltrn
Clark County—
."'pring.leld
C4)lunili*na Cvunty
Crau' ford Count ,
Cuyahoga County—
Cle el»ind ,
Delavt-are County-
Delaware
Erie County—
Sandusky
Franklin County
•Oallia County
Hamilton County-
Cincinnati
Henry County
Hiut»h County—
Norwalk
Jefferson County
Licking County
Lognn County-
Belief »ntnine
Lorain Ckwiniy
Lucas Count y—
Toledo
Mahoninc County
Medina t ounty
Molps County
Miami County—
Piquo
Monroe Coonty
Montgomery County—
Da>-ton
Morrati County
Muskingum Connty—
Zanes\ ille
Noble County
Ottawa County
Perry County
Pickaway County—
Cirdovillo
Bos'? Connty
Sanilusky County
Bcioto Countv
S^noca County
Stark County—
Massill^n
Summit County
Trambull County
Tuscarawas County ... .
Warren County
Wa '-ne County
Williams County
Wood County
New a
Total.
South Dakota;
Lawrence County. . .
Minnehaha County..
Total .
Digitized by
Google
1205.
July 27, 1917 .
TYPHOID FEVER--Oondiuied.
Oregon Eeport for Maj, 1917.
During the month of May, 19^17, 5 cases of t} j^hoid fever were
rqK)rted in Oi*egon, as follows: Columbia County, 1; Multnomah
County, Portland, 4.
aty Reports for Week Ended July 7» 1917.
Place,
Deaths.
Place.
Cases.
Deaths.
Albaay.K.Y
ADent^wn, r» _..
Altoaoa,Pa ^
AllantfcCttjr, N. J
Baltimor»,M
"irniWM***^^ Ala. -•••••
BrownsnlliL Tex
BiilWo,N. V
Botta.Mont-
Cundn^N. J
Canton, Ohio
Charli^oii, 8. C
Ctettnaoea, Tom
ChkioTlB^.
CiDci^Mti, Ohio
Gleveiand, Olno
(Mervflle, Kans
ODhnalHia, Ohio
Corington, Ky
Deaw, Cola _
Detr(dt,Kicli.
B^m
SlFfloa^Tex
Brie,Pk
SvaniTiUe, Ind
Ever^Man
Fall Bivcr, Mass.....
Fort WsyiH^ Tod
Hacostown, Md
BartfMd,GMm
HavarWU, Maai
Indiatt^lj^liid.. ..
lohostovii, Pa
KansMCity, Mo
LoDS Branch, N. J..
Lo8.\Bgelea,CaL..„
Loved, Mass
lUlrQn,MaM.
Mt'inpnrs 1 «.!nn ..»..
MirLTi««{^lifs Miiin
"' Ir, AfeL...
■ -^ilK J
■ WJ...
HftvpE, 0>na*^.
■ OH -in-. In
1
M
M
N
N.'
N.
Norfolk, Va
Omaha, Nabr
Philaddphla. Pa
Pittsburg^TPa
ProvidcDce, R. I
RichawwLVa
Roanoke, va
Ro?ky Mount, N. C
St. Joseph, Mo .
St. Louis, Mo
St. I»Bui, Mian
Salt Lake City, Utah
San Francisoo, Cal
Sa vamnah, Ga
Schenectadv, N. T
South B«nd. liid
South B«thMheni« Pa.
8prinKflald,Ohio
Syracuse, N. Y
Taunton, Mass
Toledo. Ohio
Top<da, Kaas
Trenton, N. J
Washington, D. C
Wheeliag, W. Va.
WicSiita, kans
Winston-flatom, N. C
Worcester, Mass
Yorli, Pa
IHPHTHESU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for June, 1917.
Casei reported.
3t»ta.
Cases reported.
fltela.
Diph-
theria.
UMslee.
Bevlet
fcver.
Diph-
C^ieria.
Measles.
Scarlet
fever.
^«rt^
82
30
611
299
1,110
101
1,739
1,287
157
13
814
277
New Jersey
Ohio
351
519
13
690
2,303
74
354
Louisiana
539
Michipui
South Dakota
55
tfhnmttn.
Oregon Report for May» 1917.
During the month of May, l6l7, 10 cases of diphtheria, 515 cases of
measles, and 124 cases of scarlet fever were reported in Oregon.
/Google
Digitized by'
July;
, 11)17
1206
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continued.
City Reports for Week Ended July 7,
1917,
Popola-
tionasof
July 1,1016
(ostimated
by U. 8.
Census
Bureau).
Total
deaths
Irom
all
causes.
Diphtheria.
Measles,
Scarlet
fever.
Tubi^
City.
s ^
1
1
J
1
1
i
•J
1
i
1
OTor 500.000 inhabiUnts:
naltimoro. If d
589.631
766,476
2,497,722
674,073
671,784
603.812
5,602,841
1,709,518
679,000
767,309
468,558
410.476
306,345
436.535
363,454
408.894
371,747
463,516
363,980
214,878
280.800
271.708
297,847
295.463
254.960
256,417
247,232
104,199
181.762
121,579
112,981
106,233
127,224
128.366
128.201
110,900
100.560
113.245
102,425
148.996
117,057
118. 158
149.685
10S,W>4
165, 470
109.:i81
156.087
117,399
105.942
155,624
112,770
191,554
111,593
163,314
63,505
58.aS9
.•>:. OfiO
69.Kg3
57.653
.•i3.973
e7.449
«n.<«2
«0.7:J4 .
W) ()7.*i '
144
211
588
" "iw
370
156
197
99
106
72
106
90
128
123
90
63
62
62'
41
56
44*
' m
36
7*
28
40
16
26
22
53
38
30
36"
42
28
66
31
21
27
fli*
40
40
14
3
68
140
27
77
0
255
65
17
55
15
7
29
2
12
12'
3
......
1
75
128
258
37
14
36
456
74
76
27
21
16
3
"is*
......
1
9
U
129
6
47
16
76
10
7
29
6
6
* ••3
11
......
""4
......
2
49
n
(U^ct^^ti, MaKi
m\ J7
Chicago, lU
307 a
(levelaiKi, Ohio
S3 ' tt
Detroit, Wich
22 ' U
Ix)s Ancelfs, C'al
46 11
Now York. N. Y
803
lis
24
81
35
83
Ul
PhiladeJDbia. Pa
Fittsbmxh, Fa
7
St. Louis. Mo
a
From 300,000 to 500,000 iobabit-
ants:
Bunralo,N. Y
IT
Cincinnati, Ohio
u
Jersey (Ity, N.J
• 7
Milwaukee, Wis
14
9
8
9
11
4
?
7
4
6
6
4
r
1
2
52
12
27
84
6
4
1
12
2
2
12
14
9
Minneapolfa, Minn
Ncwark.N.J
New Orleans, La
36
29
17
San Francisco, (^
'"2*
" i'
43
70
4
12
47
3
5
1
n
37
20
16
2
13
5
17
22
16
5
1
16 11
Washincton, I), r
From 200,000 to 300,000 inhabit-
ants:
('olumbus, Ohio
20| tt
1
8' i
Denver, Colo . . . .
14
In<li:inai>olis, Ind
9
Kansas City, Mo
2 |. .
Portliuid, OrcR
2
■*2'
' i
• 2
3
2
16
6
4
1
4 3
rro\ idonce, U I
11
1
Rochester, N. Y
1
12
St. TauJ. Mhin
13
5
13
7
3
3
1
7
2
4
3
1
2
16
6
11
6
3
1
1
7
:
From 100,000 to 200,000 inhablt-
Itii'n.ini'hani, *t.t» ,
9
BrJilrfOfiH , '•'*i'Qi>
6
7
1
1
1
6
6
3
31
2
1
......
8
1
8
2
3
1
4
Trtfrj tii' Mfv MiMLi ,
3
f'iH!nr!*Hj S J
TJ^rt^n, Oh(n
5
Fafir^iT^r. Wtvj
Onuul RtiiiU^. Uuh
HarilcKil, i 'tmn
3
4
1
t^lktlfSlCC, M^XJ. ,,
1
I.^rrrftt, UuS
3
7
1
4
ii^ijkik.TmnlV^V.','.'.'.'.''.
'.'.'.'.'.'.
1
2
1
1
3
1
Hm^^lXhttmn ■■■
N#w iliiibf^, Moi^
2
1
2
2
9
1
......
1
25
35
2
10
2
6
2
9
89
1
21
1
14
1
4
9
......
3
S«w HamMi. tmm
3
'Hklan^^rKV
2
4
8
3
OnuJ^Hifcr
8
3
RJchntutH] Va
8
Sfth Utr<1tv, I^Li«h
1
......
10
11
12
1
8
1
8
1
2
6
1
9
7
7
4
3
2
• Y
1
nirfMm#, tt^ i.^^h. ,.••••••»•
8
3
|ejjj^0g»«j
36
8
U
8
11
3
Vfm^/Uv^
Vn*m rnxm to mm tnhablt-
bdh:
Alleniown, Pa
3
Altoona Pa.
1
Atlantic City , N. J
33
4
1
8
8
I
Davonne, N.J
8
1
Berkeley. Cal
7
14
9
15
28
1
10
Ilin'hamton NY . .
3
1
2
2
nnx'k'tcin. Mass
1
1
^ ant n Ohu
:":::'::::::i
1
Chnrt^k^lnn H C
M
( hatt inooira Tenn
7
4
Co\iti;:ton, K.y
57.144
»4.4\t.S
10
••"•2"i::::::|
1
AJ'^A**,
8
I>iil«itb. Mmo
i
25! ' r»'
T^»
Digitized by*
1207
July 27, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
Qty Reports for Week Ended July 7, 1917— Continued.
PopiiJft-
lioQ as of
JyJ7l,We
(c^lhiiated
Total
deaths
Diphtheria.
Mf3l£tPS.
Seurlot
fever.
Tubor-
ritf.
ffota
all
CftllB«S.
1*
QJ
1
Pi
is
i
1
t3
en, 705
7©,07S
75, 1S3
72,015
77, 2H
68^539
S7,M.l
7K,2!<J
5^,231
89,613
B2,&I3
7L744
59,411
63,867
fi5,l»5
m,m
55,IM2
85,236
53,330
68,HU5
HO, £19
fi7/07S
Sr,D39
61,1^
Si,5M
m.fm
77.9ie
70,722
70,T7fl
94,2fl5
51,656
27,732
34,!I14
32,7^6
37,633
43,i25
40,li>3
3^,074
33,201
4!^, Mil
3t*,Krj
43, 4o^
2S,2aj
3y,2:j3
3.^4^4
4K7hL
41.^
^,:j&3
35,670
4S,477
ai,576
2»\,771
:L*i,*;7(V
31hI»77
41,OJ7
411. rit J
3:j5H7
1«
39
i4'
15
17
as
.......
4
3
1
1
2
6
......
r
4
1
i
1
13
3
5
a
si P^ tei
Jl
Erf**, Pa .„..*,.
E vBriisTUIt!, Lnd , . _,
10
2
2e
in«"fL Mif'h J.. , ■
1
3
I
4
3
Fort W ayii«, lad,
1
3
i
5
2
H:iJTi^bu.rf ^a +*.- **,+
3
HobottD, N, J ,
JohtistflTFii^ Pa , ^ „ ,
1
10
1
E
I
1
Kan^s City, Kacs.. ........
n
Little Rock, Ark. .... ^ - ... ,
25
15
24
3i
s
5
30
n
""n
13
14
IS
30
25
IS
Ma.ldcn Masa
4
1
30
3
...„.
1
:;::::
4
6
2
M^iiii^lif^icT N H
%
Mobile. AUi,., ...,
1
......
%
Jifw 1! rrt^n, C^inii. . .,*.„,
1
3
......
Norfolk V»
1
" ii'
2
3
4
DIdaliv-ma City, OUa. . .....
Pnssaic N J
......
""\'
^i!i^"
3
3
3
Fawtuckct, H. l....,,,,..„
(
J
Fofll^ficL Mo . . . „
. .
10
1
3
3
2
1
4
1
Bockford, 1H» .-..-„.,,,*,. .
a
BftannDfUC^^ r^]
2
suiQflv, Midi. .;;//. ;;;;;;;
Bt Ja»pht Ma
1
1
1
13
1
17
1
3
&n Diceo Dil
I
1
i
Hifc^^mHrMli, Q^ ^ ^ _ .
1
3
IMMrwetwIy N Y
1
3
4
3
2
1
noox City, Iowa **/. . .^.
1
BoraerTllte^ Mass
" io'
21
a
14
!1
7
1
13
ft
13
......
4 1......
ffonth T^'^Tid Ind
Spriu^ield^ Ohio
7i::::;;
4
Tare Haute Ind
2
4
......
1
a
Troy, N* Y.. ...!*[[..
7
3
1
3
3 1
Wilktti^^ifto. P^
15
i
10
6
3
7
7
7
7,
&
3
9
""'io'
13
10
10
17
5
4
I
I
1
16
1
I
Wllmi^op, M.. ...... ...
3
3
1
n«il SSgOOO to SOiOodin^bltanta:
Alsmeda, C&l
1
Aostln "t^ex
3
1
HrfWi^cJi-nfS WiUtS
3
3
I
I
1
3
2
ButJcT Fa
5
1
3
5
""i"
BDtt«, Mcrot... _.„...
3
3
::;:::
1
3
Cbdsea, Mass. ......,„„,
C!h.LmnfH^ M.a£S
2
C^imbcrland Md
2
TtanviJle 111
3
1
i
1
.„„.
Dubunu^, Iowa. . ,
East Dranee N J
"h
1
4
1
7
......
"....
1
1
Elpti, UK.
3
1
...„.
EvpTf*tt Wash
FilcbUnrgj, Mass. .....,,,...
1
.„...
3
2
f 5 iron Hav Wis
'
3
HBffintnrt nh^n
3
ffavHPiiiii hrn.^4
1
1
5
2
11
43
7
3
4
3
7«cksan iSich
1
Kakun-oxoo Mk:li
1
3
i
King^f^T! N. Y
1
3
1
31
LaCtoffip^'Wb..
9
17
8
s
1
1
3
1
&
lima Ohio
1
1
1
...... 1
1
lininm Nebr
1
'**i»,%*
Lcog B«ach Oil
1
:,... , . -^
J
87
Digitize
dbyC
3OC
July 27, 1W7
1208
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Oontinned.
Wli.-.!.'..., x'c. \a.
V\ '111 11- [>. rr. I'a ,
^\ .iii'.i. ' ■,!. < r j
V. >;. . •— .1 •••■1. N. (' i
y.-'^ !<•.- I" I
I'r. ru l().'i»<» to 2'>.«>») inh^l.il- -
4;i,.
:vt,s.»'.i
Alt .1,111
AUU \r\H>T, Ml<'h
r4..\.r 1 all>. J'a
i .ri I.. N H
] M»^ i\W. To\
( .. r>., :il
(h'U. I . M ..
(■ : .Mllr, K ui>
Vonf'T^l, \. II
<;: 1.' l''iri:.lll
II .rr.. n. N. J
K« rru, N. r
K > -en In I
L' I ii •.r.i:,.K.N. J
\i . [.■■t<' W .^
M. 'n ,, \i
M- ['. •.-• II, N.J
N ." ' VI . ] 1
N* ^ ;.^i. 't. M . ,
N.-' '..:.:,« - -i
N^ 'h \.l -.-, M -
N "! ' -■ • n. \! ,
11.'. ... \ J
!■<.,,■ I. . '< -h
} 't: i/'./'i. .\. H
l: ' . M...',i, N. <'
It-.*';- 1. \ I
- • 1 . V, <•) .M
* II :..-, N.Y.,.
\ PI'
, l\i.
22, ST*
l.-.,<)10
li. '.12
1.1. vt»
l.i.l«.{
» l.t.i)..,
17,:, IS
22.M,',>
•j\ /,(,
If'! o
IH ..
1|
' ni'.io
1 :.--»
j' • '. 'i
^■l"^
-' ^ '•'
1 1 . " '•.
i-'.'" ;
11 -;i
i***, ' i
r . M H
7
2
4
4
'2 '
fi
i>
4
H
3
1
14
aL
8
4
10
City Reports for Week Ended July 7,
1917— Continued.
Popula-
tion as of
Juhr 1,1916
(estimated
bvU.S.
Ocnsufl
Bureau).
Total
deaths
from
• all
CSUS08.
Diphtheria.
McAsles.
8ca
fev
rlet
er.
city.
i
1
il
1
•a
1
1
Fum 25,000 to 50,000 inhabit-
ants—< 'out inued.
Lorain, Ohio
3«,964
33,940
30.690
47,521
26,234
27,451
3<i,:iis
27,;i27
29,003
31,927
30,108
43, 715
31,»01
31. 101
33,»iS0
40, 150
41, IM
38. <ij^»
.19,*.' I
34i. T'JS
as. i;k)
¥>. l^J
4f.2s|
o^. '->*)_'
27, U.
4»..l>l>«i
.31 ». -'^^i
7*
1
1
3
2
LynchbiiTK, Va
2
Madison, \^ is
5 1
1
McKccsiKJTt, Pa ^
11
10
4
4
7
12
3
6
14
6
6
8
9
4
13
8
10
13
6
1
__
...
1
"i
Medford, Mass 7.
■**ii'i:::::T "
1
Molino.fn
2)
I
Montcluir, N. J
2 1:::::: ::::::»
2 .
Nasl)na, N. H
.- --.'
NcwburKh, N. Y
**:; .1
13
1 :
S
1
New|H)rt, Ky
:....j
Ne\vi)ort, K. I
2
,..,...
j
Newton, Mass
3J./....
1
NorrMown. Ta
1
3
()j;(hii, I t.ih
t
()iaP,o. N. J
1
2 ! ■ *.i
rav.drriii. I'al
3
»,
I'eith Arn*'OV, N. J
1 ::::::
Pill tuhl. .Mii>s
17 1
1 1 1 ! 9
^rt^inouih, Va
1
! :
Quin- \. Ill
1
giijru \ , M.i^s
4
.. .-
,::'"'T""2 i
I{;. 'iru', Wi.
1
1 : i 2 , I
...1 3 1 I
l{o.ai^.p, Va
Ro k 1 hill. Ill
1
5 )
'"•i 1 '
Snn 1.- .'.( ;1
1
i •::*i ::
Men vn\ilU'. * )lao
8
11
12
9
10
Kai-Mor, W 1-
3 . . I 1
TiuuiK.n, M.- ^
1 2 ' 1
'ro|'»'»^'i- *^;" • 4s.:j»i
\\.il'h.rt!. M.. ^ 1 :«»,'.:.i
W '.Ttowii. \. V 2»<«,^'.M
4
4
2 1
1« 1
n
2
1 1 1
1 1 ' 1
2 1 2 '
A\, -• lloi.o^, n. N.J -J.i. i t»
7
I t 1
1 1-
1 .
3 .
31
il.
I 1 u\ ul .uoti Ai»r. 15, I'jlO. not'tinruU' niivJo,
Digitized by VaOOQlC
FOREIGN.
VENEZUELA.
Mortality, 1916.
During the year 1916 there were notified m Venezuela, 66,186
deaths from aU causes, including 5,132 deaths from dysentery; 2,366
from infantile tetanus; 10,442 from malarial fevers; 3,261 from
pneumonia; 4,266 from puhnonary tuberculosis; and 2,149 from
typhoid fever. (Population of Venezuela, 2,824,934.)
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received During the Week Ended July 27, 1917.'
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Basein
Apr. 2i>-May 5
1
98
1
2
1
5
Calcwtta
May 6-19
tfomlahT
May6-12.
Moalnwfn .
May 13-19
Pakokko
Apr. 29-May 5....
lUnfcom
May 6-19....
6
Phmpp^ Islands:
Ptorinoes
Jane 3-9, 1917: Cases, 162; Deaths,
Albay
Jane 3-9
20
2
84
1
11
44
17
1
61
Ambos Camarines
do
Bobol
do
CapU
do
C«Bu;
do
do
10
28
PLAGUB.
AnbU:
Ad«n
May24-«).
May 13-19
1
11
2
CeytaST
Cotofflbo.
iwBi-... .^.....:...::...;..i;
May (V-19. 1917: Cases, 10,000;
deaths, 8,144.
Btsfin
Apr. 29-May 19....
8
146
13
13
285
45
8.
Bombay I
MVy 13-26...
Mi^y ^19
164
Cafcatta.
^nnada
Apr.29-Ma7l9....
Khrarhi . . , .
May ST:.....:::
307
67
Vidrai Pmideooy.
May 13-26.
Apr. 29-May 12....
UmdalaT
ii-iinitta : :::
Apr. 29-May IX...
Jtwimm
MSy^9.....\T..:
40
3
1
Oipe oC Good Hope State-
May 13-26.
Jan* 6.......
* fJTom BMdloaloffloersof the Public Health Service, Amerkan consriN, and oth«r nourcm,
(1209)
Digitized by VjOOQIC
July 27, 1917
1210
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW PEVEE^
Continued.
Reports Received During the Week Ended July 27, 1917— Continued.
SMALLPOX.
Place.
Date.
Cases.
Deaths.
Remarks.
Brazil:
11 io dc Janeiro
May 6-Jimel6
July 1-7
78
1
16
Canada:
Nova Scolia —
Halifax
China:
Amov
Mav2a-2«
Shanpliai
June 4-10
2
17
13
42
3
2
1
16
1
3
15
Cusos, (oroicn; doaUtt, naUft.
Tsin^atao
May30-Junon...
Mayl4-JanolO...
Mav 13-20
Egypt:
A le xan<l ria
India:
Hornl>f\v
(M uMa
Mav 13 19
K '^ii hi
M;iv6-19
9
26
8
1
Malrt^
Mav 13-20 .. .
11 iivj.xui
May 0-20
riiilli.piM' islands:
M u.il
Jiuic 3-9
Portn.ruis*- KasJ Africa:
L uriMK^o Muniuor
Ar^li'Ui^rcl
Mar. 1-31
1
2
May 1-14
1
1
Si)ain:
N'altMicia
Juno 17-23
Apr. 22-28
B\\'i"U\\:
Mai mo
TTPHl'S FEVER.
Epypt:
Aloxindrta ' May 14-June 10...
Jajf':!
\iM :ki ^ Juae 11-17
Tor! I. ' .. ^r I,. I-' ArTra:
I,' ii.' I' u M iKini'z Mar. 1-31
At.u.M'id May 1-14
591
1
ISl
Reports Received From June 30 to Jaly 20, 1917.
CHOLERA.
rhoo, ! Date.
Ca<:c5. Deaths.
1
Remarks.
In.liT 1
i5. Miii Apr. 1-21 *
( .: .fi \pr. 2(^May 5. . ..
7
153
I
10
i
24
1
li *'n \nr 'M Miv S
1 >la..i \pr. 2->
\\i' ' I \
Apr. 13-19. 1917: 1 casa.
]', ,l...i \i)r. I'i I'J.. .
1
1 r ■ ,
May 20-june 2, 1917: CaMS. >^'.
deaths, 204.
A' Mn .^' Jii:io2
}■ ! 'do
iV 21
123 ' <m
( ' ' do
1
15
I
1.. .1 ......!"!!!.. !.!!M')!!""!!]!'.*
Digitized by
Google
1211
July 27, 191f
CHOLERA, PLAGUE, SMALLPOX, TTPHUS FEVER, AND YELLOW PETER—
Oontinaed.
Reports Receif<ed ProM Jane M «• Joly 20, I^IT—Oontinued.
PLAGUS.
Piao».
DAto.
Cases.
Deaths.
RobatIcs.
Anfeia:
Aden
Ceylon:
Colombo
China:
Amoy
Hongkong.. ^^...^
Kwanj^ttmp Province—
Ta-pu district
F.f>-pt
AoM
Provincw —
Fa>oam
Oiripeh
>flnJeh
SiMlt
Gtmi nn:ain:
Ixmdon
May 3-14
Apr.^MayU.
Apr.29-Msy5.
May 13-26
Jime2
May 12-17..
May 11-17..
May 17
Mav 12-15..
May 12
liay3-8..
India
IJa^-'pin
bt^nhn*
Calc-Ua
H^..::.ii
Ki^ri'hi
M' r - I'residencv.
M^ iliv '..
M.- i.'in
Mi. an
};.•>'; >m
TfliDgOC
Java:
Ea-^t ^ava
^anr»avn
I^nnuarta
Tmi
Ai. juipa
falU*
Lan:l r o |ue...
Libt^riiid
Lima
Siui:
Bangkok
Apr. 1-21
Apr. 22-2<<
Apr. 2&^May5
Apr. 1-21
Apr. 22- Mav .5
Apr. 22-Mavl2...
Apr. S-14
Apr. 1-21
Apr. 1-7
A or. 1.' May o
-\pr.,s U
May ie-31.
.«lo..
.do..
'I'
.do..
Apr. 22-Miy 12..
"uh'\
22*)
ISi
13
5t
n
20
214
12(i
1
41
1
Apr. 8-May 14. 1917: Cases, 09;
^pr. 8-May
deaths, 51.
Present and In vicinity.
Present.
Jan. 1->!av 17, 1917: Cases, 231
deaths, 116.
2 In hospital «t p-vrt . Fnm <?. 8.
Sanji'jia fr >ni ».»;><* ruian ind
orio'it.'.] rut' t^.
Apr. !.•- V iv * 1 H7: Caof,>, JO.-O-J;
deaths, 21,409.
Apr. 2-?2.ni7: nr-^'.T*!; f!oatIis,
May 10-31,1 i)l 7
,15.
4'.
1 .
2 .
At Mollondo.
Af <\i!h^.
At ( (u -'a ->.
At .■ il ■ .-11 •, Sun re if), and
Tt-1 ill ..
At I ina.
SMALLPO.\.
Austr.i'h:
.\ev.- >.vifh Wales
Jtrt-warrina
Qiumbooe
Quwn-liPd -
Tlu.r.i..yTsl;md Quar-
antine Station.
Brazil:
Bahia
Rio dc Janeiro -.JK
Canada:
Manitol)a~
Winnipeg -
Nova S- .
Hol.f.x ^..
_ . I'ori Hawkosbury..
Ceykm:
Cotombo
AiJT. 27 May 10. .
do
May 9.
May r,^ 12..
May 13 2tJ.
JunelO-lG.,
Juno 1^ ?:{..
1
3:i
1
Apr. 27 May It). l'.»17: Catm, 6.
4
2
1 1
Frr m ^. :. «♦. AUkuis fr'un Kobe
1
\'\\ n>.i I'kMi . Vo i,l ino-
c, < (1 '.■. V ns ill-', liijs-
b- i)»\ and Js^dnt-y, in cpi.^KiU-
tiue.
Juni' 17 .JO ' I'rosent in district.
MuyC-12 1 1 , I
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Jnly 27, 1917
1212
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER*
Continued.
Reports Received From June 30 to July 20, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
China:
Amoy
Apr. 2^Mayl9....
Present and in vicinJty.
Present
Antunf ,
May 21-27
K
Chungking
May 6-26
Do.
Changsha
May27-June2
May 13- Jane 2
Apr.23-May6....
May 6-26
Apr. 23-29
May 27- June 2
5
11
7
7
1
Dairen
1
Harbin
On Chinese Eastern Railway.
Hongkong
6
Manchuria Station
Do.
Mukden
Present.
Shanghai
May21-June3....
May 13-26
8
5
1
8
20
16
Cases foreign; deaths among na-
tives.
Tion tsln
Tsitshar Station
Apr. 16-22
On Chinese Eastern Railway.
Tsingtao •
May 22- June 9
Apr. aO-May 27. . .
1
6
At another station on rai]Vay>
Alexandria
lease.
Mar. 18-Apr. 28. 1917: Casoi, 715
in cities and 32 SUtes and
districts.
Berlin
Mar.18-Apr.28...
do
106
16
18
50
20
2
10
1
26
Bremen
Charbttenburg
do
Hamburg
do
lyciprig
do
Liibeck
do
Munich
do
Stuttgart
do
India:
Bombay
Apr. 22-28
9
10
2
8
15
Calcutta
Apr. 29-Mav5 . .
Karachi
Apr. 22-May 5....
Apr. 22-May 12....
Apr. 15-May 5....
May21-June3....
May27-Junel7...
Mav 28-June 3 . . . .
May 16-June 10...
May 27-June 1
Apr.2-29
4
30
17
20
50
1
161
11
16
Ma'Iras
Rangoon
Italy: ^^
Turin
Japan:
Kobe
Nagasaki
Osaka
55
1
1
Yokohama
Java:
East Java
Mid-Java
Apr. 1-21
WestJava
Apr. 13-May 10, 1917: Cases, 46;
Batavia
Apr. 13-May3....
June 3-16
11
95
2
deaths, 7.
Mexico:
Mexico City
Monterey
June 18-24
24
Philippine Islands:
Maiiili
Mav 13-19
6
4
186
2
23
Varioloid.
Portugal:
Lisbon
Mav 13-26
Russia:
Petrograd
Feb.l8-Mar. 10...
Mar.ll-May5....
Mar. 15-21
Riga
Jan. 1-31, 1917: Cases, 7.
Vladivostok
7
3
5
Spain:
Malrid
May 1-31
Seville
do
Valencia
June 3-16
2
5
1
2
Straits Settlements:
Pcnang ••
Mar. 18-Mayl2....
, May 20-26
2
Sweden:
Stockholm
Tunisia:
Tunis
June 2-8
Turkey in Asia:
Trebirond
Feb. 25- Apr. 13...
15
Union of South Africa:
Mar. 12-24
4
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1213
July 27, 1917
CHOLERA. PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW FEVER-
Continued.
Reports Received From Jnne 30 to Jnly 20, 1917— Continued.
TYPHUS FEVER.
Place.
Date.
Cases.
Deaths.
Remarks.
Aostria-Hungary:
Au5trii ............
Oct. 22-Dec. 17, 1917: Cases,
Bohemia
Oct. 22-Dec. 17....
do
634
809
47
617
16
243
5
2,371.
(rulj'ia
Lowfr Austria
. .do
Moravia
do
SUesia . . - .
do
St\ria
do
Upper Austria
do
Hunjarv
Feb. 19-Mar. 25, 1917: Cases,
Budapest
Feb. 19-Mar. 25...
May 30- June 9
Apr. 30-May27....
May 13-19
2
830
1,3S1.
China:
Tfingtao
jfl^xundria
232
15
2
SaloQJkl
HM-Java
Apr. 1-30
7
We>t Java
Apr. 13-May 10, 1917: Cases, 36.
Batavia . ....
.\pr. 13-May 10....
June 3-16
22
193
16
1
5
Mexiro:
Mp\icoCity
Bmsia:
Vh ro^ad
Feb. 18-Mar. 10...
Jan. 1-31
3
Ki,'u....
_ Vladivostok '.
Mar. 29-May 21....
May 1-31
Spain:
Madrid
2
YELLOW FEVER.
In T)or>on ro^onily arrived from
Mexico ( ity.
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PUBLIC HEALTH REPORTS
VOL 32 AUGUST 3, 1917 No. 31
HEALTH DEPARTMENT LABORATORIES.
THE NEED FOR THEIR CAREFUL SUPERVISION.
Recently in a city in New England an unusual number of cases of
diphtheria were recorded.
Study of the cases showed that the diagnoses were based upon
laboratory examinations. Further inquiry revealed that dining the
period of the unusual prevalence the examination of diphtheria cul-
tures in the laboratory had been carried on by two different men,
the usual bacteriologist and a temporary substitute who did the work
part of the time. The findings of these men differed widely. The
substitute bacteriologist did the work from May 27 to June 2, and of
46 specimens submitted for diagnosis he found 33 positive, 12 nega-
tive, and one liquefied.
¥rom June 4 to Jime 16, inclusive, the regular bacteriologist was
on duty, and of 51 specimens examined he found 8 positive and 43
negative.
From June 18 to July 7 the substitute was again on duty, and of
104 specimens examined he reported 77 positive and 27 negative.
From July 8 to 10, inclusive, the regular bacteriologist was on duty,
and of 18 specimens examined he found 2 positive and 16 negative.
The apparent prevalence of a considerable outbreak of diphtheria
was evidently due to the inexperience and lack of training of the
substitute. In this connection one is reminded of the bacteriologist
of the health department of a lai^e city who, instead of examining
his diphtheria specimens, threw them into the waste basket and
marked the reports negative, a practice that was without serious
result until a diphtheria epidemic assumed unusual proportions and
was discovered only by accident.
MALARU IN KENTUCKY.
PREVALENCE AND GEOGRAPHIC DISTRIBUTION.
The periodical circuJarization of the physicians of Kentucky to
determine the prevalence and geographic distribution of malarial
infection in the State was begun July 1, 1914, and continued to the
end of the calendar year 1916. At regular intervals reply postal
cards were sent to the practicing physicians. These cards were at
88 (1215)
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August 3, 1017
1216
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Google
1217
August 3, 1917 •
first sent out each month. Beginning v\dth April 1, 1915, they were
sent out quarterly.* A reproduction of the card used during 1915
and 1916 will be found on page 1128 of the Public Health Reports of
the issue of July 20, 1917.
Of the cards sent to physicians an average of less than 15 per cent
were returned. Those returning the cards with the requested data
filled in undoubtedly constituted the better class of practitioners —
those who understood most clearly what was wanted and the value of
the work. The number of cards sent out, the number of schedules
returned, and the counties represented at each circularization are
shown in Table 1.
It is to be borne in mind that the number of cases reported by the
physicians by no means shows the number of cases that occurred, for
Jan.
Feb.
Mar.
Apr.
May.
Jun.
Jul.
Aug,
Sep.
Oct.
Bov.
Deo.
,^
'\
/
\
•
•
/
\
s
/
\
y
\
/
V
/
— N
V
y
\
,,^0-^
"-"^^
--^
^
»
Relativ« prevalence of malaria in Kentucky, by months, as In Ji-utad by tha uumbors of c.:i.>i r p jrted.
an average of less than 15 per cent of the physicians returned the
schedules.
Tile return of the schedules by the physicians being a matter of
voluntary cooperation, the data arc undoubtedly reliabl-? to an
unusual degree as regards the experience of the physicians who
cooperated and •the number of cases seen by them. However, the
cases reported represent only those occurring in the practices of the
physicians who cooperated. The total number of cases of malaria
occurring in the practices of all the physicians of the State must have
been many times greater, also the number of cases that occurred in
* Hm work of aroularixation and of compilation of the data on the return cards was carried on by the late
Smg. R. H. von Eidorf up to the time of his death in September, 1916. Since then It has been carried on
l>yAs8t.Siirg. R.C.D«lYaux and Asst. Surg. den. H. R.Carter.
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. August a, 1917
1218
which no physician was in attendance or consulted was probably
much greater than the number coming under medical care*
The physicians who cooperated were cUstributcd as to locality
throughout all sections of the State, so that the data of the occur-
rence of malaria fiimished by them show the geographic distribu-
tion of the disease and reasonably accurately its relative prevalence
in the various localities.
The cases reported throughout the State by months are shown
in Table 2. The relative numbers of cases reported by months are
shown in the chart.
The number of cases reported from the several coimties of the State
are given by race and year in Table 3.
The map on page 1216 shows the relative prevalence of the disease
in the several counties of the State, the heavier shaded counties being
those in which the infection is heaviest, the unshaded coimties those
in which the infection is lightest, as indicated by the numbers of cases
reported. The relative density of infection was determined by
ascertaining the number of cases reported in each county from July 1,
1914, to the end of the calendar 3^ear 1916 per 1,000 population. The
population used was that of the 1910 census, it being impracticable
to estimate populations for the period of the circularization^
The types of malarial infection reported to have been diagnosed
niicro3coi)ically are shown in Table 4. It will be noted that tertian
infection was reported to have been so diagnosed in 42 counties,
([uartan in 13 counties, and estivo-autunmal in 15 counties.
Table 1. — IU\<iults of circuhirization of practicing physiciaris.
Period.
1914.
July to December
1915.
JantiHry to March....
April to June
July 10 September. ..
October to December.
1916.
January to March
A])ril to June
July to Soptemlior. . .
October to Deceiul^r
Inquiry
cards sejit
to physi-
ciaris.
20,990
10. rm
3, ")!)(>
3, "-(>*•
3,500
3. r.oo
.^..-00
3. ''K)
3,5(X>
Replies
received.
PeroentARe
of replies.
3,3.34
1,798
.-.{0 !
(hJO I
4b- I
45<i
37:>
273
15.88
17.12
13. 2(i
l.->. 43
18.00
11.85
13.02
10.71
7.80
Counties
Counties !
represented! notheanl I
in replies.
from. 1
120
0
110
10
110
10
U3
7
94
26
100
20
98
22
78
42
Cases of
malaria
reported.
6,648
800
2,751
1,560
642
1,331
2,123
£64
Table 2. — Cases of malaria reported, by months.
Year.
J«L
Feb.
Mar.
Apr.
May.
June.
July.
Aug.
Sept.
Oct.
Nov.
Dms.
1914
1,552
742
632
1,071
907
756
955
1,102
735
07
744
220
1,909
5ai
187
834
191.')
263
162
33t
183
263
297
219
314
272
396
403
621
au
1916 . . .
157
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1219 August 3, 1917
Tablb 3. — Oases reportedf hy counties, by years ^ and by color.
July 1 to Dec. 31, 1914.
Calendar year 1915.
Calendar year 1916.
County.
White.
Col-
ored.
Com-
bined.
White.
Co..
ored.
Com-
bined.
White.
Col-
ored.
Com-
bined.
Adttir
33
23
2
79
64
18
3
1
1
i7'
0
1
34
24
3
96
73
19
2
41
60
8
253
56
22
1
85*
7
5
41
60
8
338
63
27
1
^%n
12
1
13
mnmA.
242
43
24
41
9
14
283
Btnrtn
62
B«tb
38
BeU .
B«nt
9
3
11
8
22
141
65
101
165
139
6
110
27
11
3
923
6"
5
6
s"
11
7
11
41
13
io*
"*525*
2
15
3
11
8
27
152
72
112
206
152
5
126
27
11
3
1,448
8
5
3
3
16
4
3
3
20
1
2
4
1
BOTd.
2
B<^1*
4
Breathitt
4
80
153
24
54
131
10
186
6
6
33
93
6
18
io'
5
26'
12
■" M*
1
69'
4
108
158
24
80
143
10
224
7
6
33
162
6
18
1
34
2
is*
1
1
Breckinridge
49
BdUtt.
3
Batter .•
CUdveU
94
132
3
112
8
8
9
28
1
4
26
6*
48*
120
C*lIo«»y
132
Cunpbdl
3
Carlisle
117
(VUTOU
8
Cftrtf r
8
Ctsfj
9
rhrlstUm
76
Clark
1
Clay
4
runton
r-ritientirn
'8
36
162
1
1
18
9
36
180
15
44
418
7
2
7
11
38
8
32
177
is'
107
3
i'
3'
58'
15
62
525
10
2
8
11
41
8
32
235
24
40
418
4
10
141
28
ruin> <*rl:ind
50
DaiK^s
559
Edinon*(in.
Elliott
F<l,||
7
6
17
4
14
213
10
16
12
165
4
3
15
35
66
7
15
41
101
27
85
59
18
403
13
1
2
4i*
3*
3
39
i*
5
4*
36
8
17
12
84
8
6
19
4
14
254
10
19
15
204
4
3
15
36
71
7
Jt
137
35
102
71
18
487
13
13
6
32
1
35
226
5
3*
1
79'
1
18
Fayette
6
Flemimr
Floyd
35
a
Franklin
35
Falton
306
Onjhilln
1
(•amrd
26
2
28
<^rant
Onxts. .\\ ., ............... .
214
20
1
14
28
2
242
22
1
14
270
21
14
284
Ony«m
21
^•rptnap
Huicock
1
1
Uardin
108
10
4
83
96
16
82
100
22
549
45
9
12
62
8
63
8
3
4
4
3
17
25
0
158
10
125
8
39
9
12
8
6
3
3
23
15
8
7
73
40'
7
i
17
3*
1
3'
4
28'
10
3
23'
i'
114
13
100
111
24
89
173
22
589
52
9
13
79
8
63
8
3
7
5
29
(i
18,i
20
128
8
r.2
0
12
y
66
2
4
1
i'
67
Btrlan
2
Hwrtsoo... .. ..............
5
Hart
Henderjon.. . ! i i .!!!!!.! 1 ! i !
96
1
17
45
30
213
32
1
3
7
8
4
4
1
4
18
6*
22
34'
3
i"
1
i'
114
Hoir\'
1
Hfckman ... .
23
Hopkins ,
67
iftdSoo..:;: :
30
247
levtmiiM
35
iSn^.. :.::::;:::...:
1
Keotoo. ,[
7
3
0
12
7
2
57
i9'
7
3
9
7
2
76
4
Xnon
8
Knox.... ::
8
Uroe. . . . ..
4
u*eL.. ::::::::::. :::::::.:
4
Uwr«ic«
2
Let. .
4
usue..; :
Letcher :.'.
Lewis ,
4
1
32
2
124
51
181
6
?i
4
24
i2'
ii'
21
4
1
44
2
158
72
209
5
99
14
4
30
40
8
23
3
130
46
211
1
11
(i
2
1
20
i*
1
35
33
12
2
60
8
Ltacoto..:: ::*::::::::: ::::
24
LWacston
LfllMl
4
165
Ltoo
79
lfcCr»ck«n...l
223
ItcCntrT..
1
}fc^...::::::::::;::::::.
13
6
ManAii
a
KflT::::::;;:::::::::::::
G
1
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Jtnctt»t 3v 1917 1220
Table ^. — Coses rrported, hy counHes^ ky jwant, wmd by foior — CcatiTiiu<l.
County.
Marliii....
July 1 to Dec. Jl, ttl4.
White. ,
238
fnl-
ored.
37
Cnra-
binrd.
Calendar 7esrl4>15. Calendar year 1910.
White- 1 ^rot
Com- \vhite , ^^t
bined. ^^'^'f«] ored.
ai8 I
Mason
4
24
2S
40
%\
4
4
183
4
2
54
2
a
1
6
2
2
4
4
2
4
4
7*
2*
i'
1
s"
1
2'
5
3
5
Moidp
Monifce
20
Mer.or
30
M'*tPftlfr
44
Monroe
27
NfoiitfjQflwry
C
^^v■^an
NfiililontxM-f
N*-l>ort
4
8
Nicholas
2
Oliio
61
Oldham
2
Ou'on
2
0\\ nIcV
2
2
P<Mi.lI(ion..
•>
11
12
0
18
5
2
3
40
<>
. IS
17
I'PITV
12
Flip*. ;..
13
INnv-M....:
6
Pulaski
28
G
Ru '<»u' tie
Ho .'.an
Kn^^dl
SrH
Slu'lhy
vMiui'son
S*^ <Mii pr
8
3
40
8
18
ao
Tnvlor
14
21
17
5.-»
lOi
(i7
G
6
*4
2
13
12
10
14
3
60'
9
2'
17
24
Toihi
Tii-'i:
'rriinl)le*
35
20
55
Viiioii .
163
Wiirreri.
70
Wii^hin^ton
6
Wuvne
8
Wchvtor
VA
Whiiloy
Wt.lfe
Woodford
2
13
12
4
32
10
U
9
47
2
7
6
15
203 I
1
Total 5,361 [ 1,2S7 6,648 5,110
7 !
aaa
4
29 ,
2.5
1
as
40;
8
48
-^1
10
86 ,
4 ,
1
5
a ..
2
sc
B
1
0 1..
6;
136 ,
t4
140
3 1
2
•■i
1 L.
11
1 |..
1 i
3 1
1
4
u
18
31
12 ..
12
5|..
&
8
34 .
10 .-
8 >.
53
3 -
3D.
3I
l!
Cora-
bined.
3S7
10
13
3
91
3
6
90 ^
U
C i
28 I
6
31
i3r
11
:::::r
10
9
fti
2
7
7
15
1
75
252
34
10
39
7
II
18
12
2
5 <
7
134
42
* --
1 '..
21
19
29
2
11
2
1 ..
6,065 ■ 3,809 ,
791
n
12
22
18
13
176
5
1
31
It
1
*.«»
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Google
1221 Augugt 3. 1917
Table 4. -Type* o/infecHon reported diagnosed microscopically, by counties.
fThe tigans Indicate the numbers of cases reported diagnosed microsoopically . The sixn + indicates that
CUBS were reported, bat tlio diagnosis was not confirmed by the microscope. Tms information was
coQected lor tliree numths ooly.l
July-Septembef
, 1914.
County.
1
July-September
, 1914.
Goiiaty.
Tertian.
Quartan.
Estlvo-
autum-
nal.
Tertian.
Qtiartan.
EstiTO-
autum-
nal.
AdMr
+
+
+
3
+
+
+
+
t
5
+
24
10
+
7
+
1
+
+
+
+
+
6
+
2
4
1
4-
+
+
+
4
+
1
5
+
6
+
+
8
4
1
1
1
48
+
1
+
+
+
+
1
+
+
+
+
I Knox.. . .
+
1
2
+
2
+
6
4
1
20
+
+
+
+
3
+
+
2
+
+
2
+
15
+
+
+
Allen
Larue
0
Ballard
, Laurel
Banwi
' l>awrence
+
Bath
Lee
-1-
BelL
Lewis
4-
4-
4-
3
+
Lincoln!.
Bo>Ti
IxH^an. . . .
4-
1
1
Boyle
Lvon
4-
1
Brackt^n
McCriicken
BrwtJuti
+
+
+
+
4-
+
13
Mc'Yeary . . ..
BrecLinridge
1 McL^u
:
+
Ballitt
' Madison
Butler
+
+
3
1
+
5
+
+
' MazoTm.
Caldwefl
1 Marion
4-
4-
Calloway
Marshall . . .
+
Campbell
Mason
Carlble
3
6
Meade. •..
+
+
4-
4-
+
Carroll
Menifee .
^.
Carter
Mercer... •••;•••
+
Chru^ian,
Metcalfe..
1
Clark
Monroe
4-
CUy
1
Montgomery
Morgan
Chnton
Cntt^nden
+
+
Muhlenberg
Ohio
5
+
12
Ciimf^land
+
+
Davle^
Oldhftin....
EstiU
Owen. .
Fayette
Owsley
+
Fleming
2
1
Pendleton
"2
4-
6
+
1
+
+
2
+
+
1
+
+
+
+
20
3
+
+
4-
4-
4.
Floyd
Perry
+
Franklin
Pike . . .
Fulton
Powell
fi*n*tin , .
..._....,
Pulaski...
Robertson
+
Grant
+
14
2
+
6
Kowan.. .
Gmves
Russell
Ciraysim
Scott
Green
1
Shelby
Greenup
Simpson
Haocock
+
Tavlor
Hardin.
+
Todd
+
+
4-
4-
4-
+
Harrison
Tri^j;
Hart
+
4-
+
+
Trimble
4-
Henderson
I'nion .
4-
Henry
Warren
2
Hickman
Washington
Wavne
Hopkins
+
+
13
1
JacKson
2
26
+
+
Webster . .
4-
4-
Jefferton
Wnitley
4-
Jftoaniine
Wolfe..
2
+
Kenton
Total
Knott
246
50
87
DIRECTORY OF CITY HEALTH OFFICERS.
CONTAINING THE NAMES AND OFFICIAL TITLES OF THE HEALTH OFFICERS OF CITIES
HAVING A POPULATION OF 10.000 AND OVEB IN 1910.
During 1916 a directory of city health officers was compiled and
published in the Public Health Reports of June 30, 1916, and as
reprint No. 346.
The foUowing is the directory for 1917, and was obtained by send-
ing blank forms requesting information to the health officers of
Digitized by
Google
AngUHt J, i9rr
1222
cities m the Uiiited States having a population of 10,000 an<f orer in
19'1'0. The cities listed below are Ae ones from wfaieb the- iafoom-
tion was returned, and the data are as given by ti» respeda£V9 henlth
departments.
Full-time officers are indicated by an asterisk (*). For the pur-
pone of this directory, a full-time officer is defined as c«ie who does
not engage in the private practice of medicine or in any occupation
other than his official duties.
City.
Name of health officer.
Oficial title.
Alabama:
fUrminghara
♦F. E. Harrington, M. D.»....
Chas. A. Mohr, M. D
Health officer.
Mobil©'
CHy health offictr.
Health officer.
Arizona;
Phoenix
H. K. Beancliamp, M. D
Meade Clyne,M D
Tucson
City health offlow.
Do.
Arkausiis:
Argeiita -
Ardan Thomas McKinney,
Cons. P. WUson, jr,, M. D
Johns. Wood, M- D
Fort Smith
City health ofTicer and bafltfidologirt.
City health officer.
Health commi.Si^nen
Hot Spring's
lattle Rock
Mjlton Vaughan, M. D
A. Hieronvmus, M". D
California:
Aiain wla
Healfch officer.
Bakersfield
P. J. Cuneo, iL D
City health officMr.
Berkeley . . •.
Fresno
LonR Hfia^h
Los A up'los
J. J. Benton, M. E)
A. H. Sweoncy, M. D
♦liaji.h L. Taylor, M, D
*L. 5r. Powers, M. l>
Health officer.
City health officer.
Healtli officer.
Health commissioner.
Oakiaml
Pasadena ^
Pomona
Kirby B. Smith, M. D
Stanley P. Blak,>l. D
Nowton J. lUce M D
Health officer.
Do.
Do.
Redhm<ls
Riversifle
Sa<raniento
San Hernaniiuo_
*F. n. Folkins, M. D
Chas. W. <;inllcstonfl, M. D...
♦0. C. Simmons, M. D
Fr.iJik M. Cardner, M. D
Alfred E. Banks, M. D
*Wm. C. Hastier, >LD
D. A. BeaiLie, M. D
City health physlciaii.
City health officer.
Acting liealth officer.
Health officer.
San I)!e\'n
San Kran-lt^o '
Do.
Da
San Jovp
Do.
Santa Barbara
C. S. Slovens, M. D
H. E. Piper, M. D
Do.
Santa Cniz
Do.
Stockton
Linwood Dozier, M. D
OmerR. (Ullctt. M. D....
*Wm. H. Sharpley, M. D.» ...
a. W. Kobinsmi, M. D
♦Walter H. Brown, M. D
Ar\rinW. Klein, M. D
*Ghaa. P. Botsford, M. D. . . , .
Louis F. Wheatley, M. D
♦T. E. Reeks, M. D. .. .
Do.
Colorado:
Colorado Springs
Do.
Denver
Manager health and Hiarlty.
City physician.
Health officer
Trinidad
Connecticut:
B r id j^'oport
G rcenwich
Do
Hartford
Supwlntaiident Of healdL
City health officer.
Superintendent of health.
Health officer:
Meriden
New Britain
Iforwalk
Wm. J. Tratey, M. 0
* Fnll-thne officer.
1 Also health officer for Jefferson County and aU cities and towns in the county.
> Also health officer for Denver County.
Digitized by
Google
1223
AQfcuat S, ^^17
aty.
Name of health oflOco'.
Official title.
Oonnecticnt— Continued.
Orangv
Stamford
WalliQ^rord
Water bury
WUUmantie,
Piitrict of Colambia:
Washington
Florida:
JaelwmTillc
KeyWest
Tampa
AtlanU..
Augusta..
Bmnswick..
Macon
SsTannah
DlinoU:
Alton
Aoi«ra.
BeDewUe
CWro
Champaign......
Chicago
ChioAKo Hf ights.
DaaviBe
Decatur
East St. Louis..
Elgin
Efanston
Galesburg
QrHiit«nty....
Jacksonville
U&iU«
Oak Park.
Ogletbf..
Peoria...
Bock Island...
Springfield...,
Indiana:
Andersoo . , • « ,
Elkhart
El wood
Part Wayne,.
Hammond...
Hmtingtoo..
IndiaaapoUs.
C. A. Beran, M. D
£. Everett Rowell, M. D....
Wm. J. Riordan, M. D
Tbomas J. Kilmartin, M. D.
Qias. A. Jenkins, M. I>
•Wm. C. Woodward, M. D..
♦C. H. Dobbs, M. D
J. N. Fogarty, M. D
Sheldon Stringer, M. D..
♦J. P. Kennedy, M. D
Eugene E. Murpbey, M. D
•Thomas F. Abercrombto,
M. D.»
O. H. Weaver, M. D
♦Wm. F. Brunner, M. D
A. P. Robertson, M. D.
O. B. Schwachtgen, M> D
B. H. Portnondo, M. D
W.C. Clarke, M.D
W. B. Schowengerdt, M . D. . .
John DiU Robertson, M. D.»..
IraC.Harman, M. D...
Seiward L. Landaner, IC D. . .
Wm. J. Harding
R.X.McCracken,M. D.
A.J.Volstorfl
darenoe T. Roome, H. D
FredG.HaU,M.D
L. D. Darner, M. D
A.M. King, M.D
•O. P. Roediger, M. D.«
F.E.Ben, M.D
♦Carl E. Buck
•O. 7. Ruediger, M. D.t.. . .
E. A. Oarrett, M. D
♦O. F. Roediger, M. D.t.. . .
C. G. Poster, M. D
Otto H. Deichmann, M. D.
Town health officer.
City health officer.
Health officer.
Aeting health officer.
Health officer.
City health officer
Do.
Do.
Health officer.
President board of health (ex-offleia
healOi officer).
Commissioner of health.
Chairman board oX health.
Health officer.
Health commiaslonac.
Do.
President board of health.
'City physician and health oOoer.
Health officer.
Commiasioner of health.
Do.
Health oonunisaionei.
Health officer.
Health oommissionec.
Health officer.
Commissioner of health.
Health commissioner.
Cttyi^ysician>
City health physician.
Health commisHJoner.
Health officer.
Commissioner of health and h)M] rcf
istiar.
Health commissioner.
Commissioner of health.
Health commissioner.
Do.
Superintendent public health.
l.aLong,M.D
L. A. Elhott, M. D
J. P. (MnB, M. D
J. H. QUpio, M. D
Wm.D.Weis,M.D
B. H. Grayston, M. D
♦Herman G. Morgan, M. D.
♦ Full-time officer.
> Also health officer for Olyim County.
> Health officer for La Salle, Oglesby, and Pern.
Secretary city health board.
Secretary board of health.
Do.
Secretary.
Secretary city board of hoaltbi
City sanitarian.
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Google
Aocust 3, 1917
1224
City.
Name o( health officer.
Official Utle.
Indiana— Continued .
JefTcrsJnvlUc
O. P. Graham, M. D
Edgar Cox, M. D
City health officer.
Kokomo
Do.
La Fayette....
D. C. McCleUand, M. D
Harry J. Thompson, M. D
Rodney E. Troutman, M. D..
Merrill S. Davis, M. D
C. A. Dresch, M. D
Secretary board of health.
(Mty health officer.
Laporto
Logans{>ort....
Secretary board of health.
City health officer.
Marion
Mishawaka
Health officer.
Muncie
Clarence G. Rea, M. D
Chester C. Funk, M.D
S. G. Smolser , M. D
Secretary board of health.
NewAlbany
Do.
Rlchniopd
Da
South Bend
Charles S. Bosonbury , M. D
T.W.Moorhead,M.D
Da,
Terre Haute
Iowa:
Burlington
O.W. Boatman, M.D
H.R.Sugg.M.D
Chas. H. Bower, M. D
♦Thomas P. Kennedy
charity.
City health officer.
Clinton
Health officer.
Council BliifTs
Do.
Davenport
Do. •
I>ubuque
Chas. M. Linehan. M. D
C.H.Fegers,M.D
Aaron C. Conaway , M. D
*A. L. Wheeler, M. D
Do.
Keokuk
Physician to board of health.
Marshallto>%'n
Health officer.
Mason City
Superintendnent department of health
Muscatine
Arthur S. Weaver, M. D
B. Caurshon, M. D
City health physician.
Sioux City
Health officer.
Waterloo
J. E. Ridenour, M. D
Do.
Kansas:
Hutchinson
W.F.Schoor,M.D... .
City physician and secretary board of
health.
City physician.
Indepen<lenoe ,
W. B. Kelly, M. D
Kansas City
C. W. McLaughlin, M. D
Chas.J.McOec.M.D
Commissioner board of health.
Leavenwortli
City physician.
President board of health and city phy-
Parsons
George W. Gabriel, M. D
Chas. A. Dudley, M. D
♦Herbert L.Clark, M.D
Joseph M. O'Maley, M. D
R.M.Cohlin.M.D
W.A. Poole, M.D
♦John D. Ma^uire, M. D
♦W.Ed. Grant. M.D
John To.l<i,M. D
A. McKcnney, M.D
Pittsburg
sician.
Health commissioner.
Topeka
City physician and health officer.
Health officer.
Kentucky:
Covington
Frankfort
City health officer.
Health officer.
Da
Henderson
Lexington
Louisville
City health officer.
Da
Newport
Owensboro
Do.
Pa*lueal\
H.P.Linn, M.D...
Health officer.
Louisiana:
Alexandria
Monroo
LA. White, M.D
F. C. Bennett, M. D
W. 11. Robin. M. D
President city board of health.
President board of health.
New Orleans
Superintendent of public healUi.
President board of health and health of*
Shreveport
G. C. Chandler. M D
Maine:
Augusta
George .\. Coombs, M. D
F. C. Tliuyer, M. D
fleer.
Health officer
Water\ille
Da
' Full-time officer.
Digitized by
Google
1225
iiuguRt 9f ittn
Ctfcy.
Nanw of h«aMb oflkm*.
Official tltto-.
llarylaod:
Baltimore
Camberland.
Frederick....
MassBthtj setts:
Attlebcat)
B««rlr
Boston
Brockton....,
Brookllne
Chelsea
Chicopee
Clinton.
Everett
Fall River..,
Fitchburg...
Gardner
Greenfield...
Lawxenco...
Leominster..
LoweU
Lynn
Medibrd
Uclrose
Xcw Bedford..
J^ewbaiyport.
Newton
North Adams.
Northampton .
Peabody
PittsfieW
Quincy
Salem
SoMwffle....
Springfield....
Waltham...
Watcrtown.,
Webster
Westfleld...
WInthrop...
Itictdgan:
Adrian
Alpena
Ann Arbor
Battle Creek...
Bayaty
Dirtraft.
Flint
Grand Rai^ds..
Jadoon
Kalamazoo.....
Ishpeming
J«hBF>. Bkri»,»I>
Comm issioner of health
<«axJ.Colfcan
Health oiflcer.
Ir»J.McCttrdy,M.D
1 City health officer.
IUtpbP.KMi«,]f.I>
Hetfthofieer.
AlonxoO.Weadbtffy
Clerk and agent.
Health commisBiOTWi.
ExecuUve officer of the board ofBealtb
Ag^t and health offiaae.
Health officer.
*Piwwis X.liahoaer.M. D....
♦George M. Gifford
Froncia P. Denmy, M . D
*^m. J. RaodaU
♦Chas. J. (ySfiaii
Agent board of health.
*edward De Cour«7 ,.
Do.
*J)olm W. SMver
Agent heakh department.
Agent board of health.
•SwnuelB.Morrias
♦Fred R. Brigham
Do.
Win. P. (VlXmneU
Heirithofleer.
George P. Moore
Board of health agent.
♦Hfm. T. Sellen
Clerk of pubUe health.
A nmt (md nhiiBhinfr inantetor. '
♦BHchael J. Bntler
•Frederick A. Bates
Agent.
♦John W. Tapper
ChairouuL.
Chas.E. Prior,Br. D
Chairman beard of health.
PaolJ. D. Haley, M. D
Clarence P. ITolden, M. D
♦Wm. G. Kirschhanm,. ........
♦Wm. Thurston^
Medical InstMw tor.
Chairman board of health.
Agwit and executive offloer.
Health offioar.
♦Francis George Curtis
•D.W.Hyde
Chairman.
Agent board of health.
George R. Turner
De.
jMfVW 7 ^P^
Agent.
Maurice 8. Eisner, M. D
•Edminl J. LenoDOv
Medical agent board of health.
♦John J. McG rath
Agent board of health.
Flrank L. Morae, M. B.
Ifo^eal inspector.
♦Wm. T. Ya^»0
Agent board of health.
TbonBU J. KoUnsOB, M. D....
•A. L. 8tw», M. D.
B^erett B^ JohoflOB
Chairman beard of hMOth.
AgottboMMlofhealttu
Da.
OttoK. Ooiolw
Agent.
Walter HL JenklM
Agent board of bealtlk
♦Smith A- Mowry
Agent.
Ja««BC.Cofley
E M>cuti veoffieer.
J. P. BiRikd, M. D
Health offioat*
James KiridM, M. I>.
Dot
WtaA.Wei8liigeF,M.I>v
Fngene Milter, M. I>
Doi
D«i
JakBA.Kah»>M.D
•AnNvW.IiMhea^M.IX
•Wfcv DeKIcinc, M. D
•C. C. SlemoBay M. D
D«.
Da
Do.
Deu
♦r. G.Pftn»ll>1#. T>
Dev
R. GenungLeiand, M. D
OeargeG. Bar»ett,M.D
•Chat. F.Lysofa
Do.
D«
Do.
♦Full-time officer.
Digitized by CaOOQ I
August 8, 1917
1226
City.
Name of health officer.
Official Utie.
M ichlgan— Continued .
Manistee
Marquette
Muskegon
Pontiac
Saginaw
Sault Ste. Marie
Traverse City ,
Minnesota:
Mankato
Minneapolis
St. Cloud
SUllwater
Vii^inia
Winona
Mississippi:
Hattiesburg
Jackson
Meridian
Natchez
Missouri:
St. Joseph ,
Springfield
Webb City
Montana:
Billms3
Helena
Nebraska:
Grand Island
Lincoln
Omaha
Nevada:
Reno
New Hampshire:
Berlin
Concord
Dover
Kecoe
Manchester
Nashua
Portsmouth
New Jersey:
Asbury Park ^
Atlantic City
Bayoone
Bloomfi^ld
Bridge ton
Camden
East Orange
Elitabeth
Hackenvick
Harrison
ilolKiken
♦ Full-time ofllcrr.
KUsworth S. ElUs, M. D
♦Arthur K. Bennett, M. D...
Arthur B. Egan, M. D ,
Chas. A. Ncafl% M. D
Wm. J. O'Ueilly, M. D
J. J. Orimn, M. D
♦Qeorga A. HoUiday
A. V. Denman, M. D
H. M. Guilford, M. D
P. E. Stangl, M. D
J. H. Hain?s, 1^. D
John H. Crowe, M. D
Donald B. Pritchard, M, D. . .
Bobert Donald, M D. »
Nolan Stewart, M. D
T.J. Houston, M. D
Richard D. Sessions, M. D....
♦Hasbrouck Delamater, M. D.
♦Edwin F. James, M. D
O. 8. Wilfley, M. D
Louis W. Allar.l, M. D
Wm. C. Ridddl.M. D
Leo Phelan, M. D
♦Chauncpy F. Chapman, M. D.
R. W. ConneU, M. D
W. L. Samuels, M.D.
♦Lawrence P. Geer
Chas. E. Palmer
♦Hubert K. Reynolds
John J. Brosnahan, M. D..
♦Robert N. Hoyt
♦Frank B. Shea
♦Daniel J. Scott
Health officer.
Do.
Do.
Do.
City health offiotf.
Health officer and milk inspeetor.
Health officer.
Health oommissioocr.
Do.
City physician.
Health commissiooer.
Health officer.
Do.
City health officer.
Do.
Do.
Do.
Health offloer.
Commissioner of health and aaaJtatiOL
City physician.
Health officer.
Sccr.'tary city board of health.
City physician and health officer.
Huprrinten 1 ^nt of health.
Health commissioner.
Secretary city board of health.
Health office and milk inspector.
Sanitary officrr.
Executive officer, board of health.
Member board of health.
Health officer.
Do.
♦B. H. Obert..
Health officer and registrar oC vital sta*
tistics.
Health officer.
Do.
bo.
Sanitary Inspector.
Health officer.
Health officer and registrar of viul st*-
tisUcs.
♦Louis J. Richards Health officer.
George W. Finke, M. D
•John T. McCliue, M. D Do.
Joaeph F. X. Stack, M. D Health commissiooer.
I Also health officer for Forrest County,
•Talbot Reed, M. D
John T. Connelly, U. D.
Joseph C. Salle, M.D...
♦Chas. E. Bellows
John F. Leavitt.M. D..
♦John Hall
Digitized by
Google
1227
Aogast 8, 1817
/
aty.
Name o( health ofikxr.
OflOdalUtle.
^Wew Jwsey— Continued.
Jtnt'jCiij
♦FrtnkH. EdsaU, D. P. H....
*H. V. Amerman
Saperintcndemt of health.
Health inspector.
Health effioer.
Kcwny
Long BrftDch
♦JR. C. Errlckson.
;inivi»^
Fmnk BiillnRV
He^th inspector.
Montolair
♦OiesterH. Welk
HtMtlth oUcer.
Mcrristown
♦John J. Belbey
Sanitary inspector.
Health officer.
New Brunswick
E. L Croak, M. D
♦Chas.V.Craster,\£J).,D.P.BL
♦T. P. Ballinger
NewiTk
Da
Ortnge
Do.
Pissaic
John N. Ryan, M. D
Da
PatcTwn
OnriUe Reed Hagen, K. D. . . .
»Wm.J. WiUsey
Do.
Perth Amboy
Da
Phfllipsburg •
Alma L. Wilist^, M. D
•N. J. Randolph Chandler. . . .
Alton 8. Fell, M. D
Health inspector.
PlainCcld
Titnton
Health officer.
Do.
Wff hawken
♦Rudolph Kunze
Cliief inspector.
West HobokoD
•Frank A. Frederick
Health officer.
West Orange
♦James A. Tobey, 8. B
Arthur Sautter, M. D
Do.
New York:
>Vlbauy
Da
Amsterdam
H. M. Hidks, M. D.
Da
Aubom
Thomas C. Swaycr, M. D
Victor M. Rico, IL D
Da
Batftvia
Do.
Btagharaton
Buffalo
C.J. Longstreet, M. D..:
♦Francis E. Fronczak, M. D...
Clarence H. White, Af.D
Frank 6. Swain, M. D
AlbCTtC.Knapp,M.D.......
George E. Ellis, M.D
Da
Health romtnissioner.
Coboes
Health officer.
Coming
Health officer and registrar.
Cortland
Health officer.
Dunkirk
Da
Elmirt
Reere B. Howland, M. D
Albert L. Hall, M. D
Floyd Palmer, M. D
Da
Ftaton
City physk!ian and health officer.
Glens Falls
Health officer.
OloversvlHe
Alex. L. Johnson, M. D
H. H. Crum, M. D
Da
Ithaca ^
Da
Jamestown
♦John J. Mahoney, M. D . ». . . .
Frank M. Neuendorf, M. D....
FrankA. J6hniton,M.D
Augustus B. Santry, M. D . . . .
F. A. Watters, IC D
Superintendent of public health.
Johnstown
City physician and health officer.
Kinoton
Heaith officer.
Uttle Falls
Da
Loekport
City i^ysfcian and health olBoer.
MJddletown
J. L. Hanmer, IL D
Health officer.
^UnaX Vernon
Chas. M. guinn, M. D
♦Edwin H. C^dney
Health officer and registrar of vital sta-
NewRochelie
tistics.
Health officer.
NewYorkCily
♦Haren Emerson, M. D
Tfaoiiia>J.Burke,M.D
Manias P. C^Daraard, U. D .
JcAn A. Johnson, M.D
Robert T. Irvine. M.D
James K. StockweU, M. D . . . .
E. D. M. Lyon.lLD
Commisaiooer of health.
Newborgh
Health officer.
North Tonawanda
Otem
Da
Da
Osiining
Da
Oswego
Do.
Peekskffl
Da
PUttJburgh.
Joseph fl. La Rocqne, H. D ..
Wm. J. Sheehan, M. D
Jeha 8. Wilson, M. D /
Richard B. Gray, M. D
♦George W. Goler, M. D.i
officer.
Da
Port Chester
Da
PfflighkffpBli a . s
Do.
Kenaelier......
Boehetter
Da
Da
• Full-time
'Dtwnote
'''^'^!XCooQ\e
August 3, 1917
1228
aty.
Nam« of health officer.
Official title.
New York— Continued.
Rome
Saratoga Springs
Schenectady
Syracuse
Troy
Watertown
\VTiite Plains
Yonkcrs
North Carolina:
Asheville
Durham
Greensboro
Wilmington
Winston-Salem
North Dakota:
Fargo
Grand Forks
Ohio:
Ashtabula
Bellaire
Cambridge
Canton
Chilllcothe
Cincinnati
Cleveland
Columbus
Dayton ,
Elyria
FIndlay
Hamilton.
Lakewood
Lancaster
Lorain
Mansfeld
Marietta
Masslllon
Middlctown
Newark
Norwood *.
Piqua
Portsmouth
Sandusky
Springileld
Stcubcnvillo
Toledo
Warren
Youngstown
Zanesville
Oklahoma:
Enid
Muskogee
Oklahoma City
Tulsa
Chas. R.Mahady, M. D....
A. Sherman Downs, M. D..
Joseph B. Garliok, M. D. . .
Frederick W. Sears, M. D. .
♦Calvin E. NIthoLs, M. D...
PageE.ThorahiIl,M. D..,
Edwin G. Ramsdcll, M. D .
Wm. 8. Coons, M. D
C. V. Reynolds, M. D
*A. Cheatham, M. D.»
F. C. Hyatt, M. D
♦Chas. Torrence Nesbitt, M.D.«
♦John Thames, M. D
Paul Sorkuen, M. D..
Alfred Dean, M. D...
A. W. Hopkins, M. D
D. W. Boone, M. D
O. F. Lowry, M. D
F.M.Sayre, MD
J. M. Hanlcy, M. D
♦J. H. Landis, M. D
♦R.H. Bishop, jr., M.D..
Louis Kahn, M. D
♦A. L. Light. M. D.»
G. E. French, M. D
♦Amos Beardsley
♦A. L. Smedley, M. D
W.J. Beimer, M. D
C. H. Hamilton, M. D
Valloyd Adair, M. D
Guy T. Goodman, M. D...
F. S. McGeo, If . D
T. Clarke Miller, M. D
O. D. Luramis, M. D
W. H. Knauss, M. D
Frank Perry, M. D
J.H. Lowe, M. D
W. W. Smith, M. D
H. C. Schoepflc, M. D
♦E. B. Starr, M. D
♦Theodore W. Smith
Clarence D. Selby, M. D . .
George N. Simpson, M. D.
H. E. Welch, M. D
G. W. McCormick, M. D..
Health officer.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Superintendent of health.
County health officer.
City health officer.
Health officer.
Do.
Do.
Do.
Do.
Do.
Do.
Commissioner of health.
Health ofTloer.
Commissioner of health.
Health officer.
Do.
Do.
Inspector of health.
Health oflicer.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Do.
Director of public health.
Do.
Health officer.
Commissioner of health.
City health officer.
Health officer.
Do.
C. E. Thompson, M. D.. .
John Reynolds, M. D
George Hunter, M. D
S. DeZell Hawley, M. D..
* Full-time officer.
> Also health officer lor Durham County.
* Also health officer for New Hanover County.
3 Does not engage in the practice of medicine except consultatloDf.
City physician.
Superintendent of health.
Health commissioner.
Superintendent of healtli*
oogle
1229
August 8, 1017
aty.
Official title.
Oregon:
Portland
*Jcim 0. Abelo, If. D
Acting city health officer.
CHy physician and heal; h officer.
Uealth officer
Salem-
O. B. Miles, M. D
Pfflinsylrania:
Allmtown
J. Treichler Butt, M. D
♦LB. CriUy
k]iDmA
Health officer and bacteriologist.
Health offioer
Bethlehem
♦Edgar E. Hauser.
Braddock
^a*n«»F WiiLi
Do.
Bradford
Wm. RoedelL
Do.
Butler
*R. B. Fowzer
Do.
Carbondale
♦M. E. Gallagher
Sanitary officer.
Health officer
Carlisle
♦A T». T.ifR'rian .
Carn'i;!?
A. A. Tart?r
Do.
Charcbrrsburg
Rotxrt v.*. Walker
Secrrtary and health officer.
H«*alth officer and assi^^tant seeretary
board of health.
Health officer
Coat^sriBc
•G. B. Boyd
Coan-lLsville
♦George Hetsel
DuBoif?
JamwE. Ginter, M. D
John Helfrick
Do
Du<}u?sne ,
Henlth and ordinance officer.
Easton
J. James Condrao, M. D
J. W. Wright, M. D
Health officer
Erie
Do
Farr^l
♦Ffwik ChuUck
Board of health officer.
Harrisbui^
Jotan U. J. Baonick, M. D. . . .
♦P. J. Bonner
Health officer and director of bureau*
Hatelton
Health officer.
Holiest ^d
W. E. Lawson
President board of health.
Johnstoivn
L. W. Jones, M. D
E. H. Gingrich, M. D
Health officer.
Lel^anon
McKe^Dort
♦Fred W. Hooper
Health officer.
Mabanoy
^ohn Sullivan
Mealville
Frank Dakc
Do.
Mon%s'^n
B. H. Clendeoan
Do.
Nanticoke
♦Philip Edmunds
Do.
New Castle .
W. L. Steen, M. D. ... .
Do.
NoTistown
*Chas. E. White
Secretary and health officer.
OUCity
♦E. M. Voochies
Health officer.
PhomixTille
JohnJ. Horria.
Pittsburgh
*J. F. Edwards, M. D
Director department of health.
Pittston
♦Thomas P. Tracey
Health officer.
Plynwotti
H. O. Timpleton, M. D
♦Oscw L. Kleckner
Do.
Pottsville
Do.
Reading
♦Chas. Roland, M. D
Do.
Scranlon
O.J.V8nVechten,M. D
E. G. Butler
Director department of publio health.
Steelton
Health officer.
Sunbury i
Victor A. Koble.
Do.
VvimkUmn
♦Ifiss Elixabeth V. Haney,
R.N.
•H. J. Bieroe
Do.
Warrm
Do.
Washington ..
♦W.B. Winter
Do.
Wifliamsport
J. Harrison F»ber, If . D
♦Wm. A. Schk)88W
4
City health c^Bcer.
York :
Sanitary officer.
Khode Island:
Central Falls :
Adolph. R. V. Fenwick, M. D.
R»ynonWoodh««i,M. D
Georgs F. Allison, M. D
♦J. W. Sampson
Superintendent of health.
Cumberland
East Providenoo
Health officer.
Newport
Executive officer board of health.
PawtuckBt
Gtes. H. Holt, If . D
SuperiDtMMlfloi of health.
♦ Full-time officer.
Digitized by
Google
Aagust 3, 1917
1230
City.
Rhode Island "Continued.
Providence
Warwick
Woonsjclcet
South Carolina:
Charleston
Columbia
Greenville
Spartanburg
South Dakota:
Aberdeen
Sioux Falls
Tennessee:
Jackson
Knoxville
NashvlUe
Texas:
Austin
Beaumont
Brownsville
Cleburne
DaUas
Denison
El Pasa
Fort Worth
(lalveston
Houston
MarshaU
Paris
San Angelo
San Antonio
Tyler
Waco
Utah:
Ogden
SaltLakenty
Vermont:
Barre
Burlington
Rutland
Virginia:
Alexandria
Danville
Lynchburg!
Newport Xcws
Norfolk . . . .
Petersburg.
Roanoke . . .
Richmond .
Washington:
Abcrtleen..
Belli ngliam
Name of health officer.
♦Chas. V. Chapin, M. D
Ralph F. Lockwood, M. D . . . .
Thomas J. McLaughlin, M. D.
*J. Mercelr Qreen, H. D
Skottowe B. Fishbume, M. D
*Clarence E. Smith, M. D
*Chas. £. Low, H. D
•Carl F. Raver, M.D.
W. F. KeUer,M.D...
W. Q.Saunders, M.D...
Wm. R. Cochrane, M. D.
•Wm.E.Hibbett,M.D.
S. A. Woolsey, M. D
Wie T. WUUams, M.D
E. E. Dlckason, M. D
A. D. Yatcr, M. D
•Chas.SaviUe
A. B. Gardner, M. D
Hugh 8. White, M. D
Webb Walker, M. D
Walter Kleberg, M.D
P. U. Scardino, M.D
Chas. K . UcartsiU, M.D
Perry Pinson, M. D
J. P. McAnulty, M. D
♦W. A. King, M. D
Albert Woldert, M.D
R. F. MInnock, M. D
♦(loorge Shorten
•R.W.Ashley, M.D.
J. W. Stewart, M. D
•Francis J. Emus, M. D
Frederick H. (Icbhardt, M. D
Kdward A. Gorman, M. D
•('. C. Hud.son, M. I)
Mosby (J. Perrow
R. A. Davis, M.D
P. 8. Schenck, M. D
Robert A.Martin, M. D
•W. Brownley Foster, M. D..
•Roy K. Flannagan, M.D...
J. B. Kinne, M. D
Wm.W. Ballaine.M. D..
E verett L. <] . Wood fortl , M . D . . . .
North Yakima *Henjamin S.Ccrswcll.M. D.».
•FuU-ttme officer. > Also health
Offldal Ui\*.
Superintendent orhealtn.
Health officer.
Do.
Do.
Do.
Commissioner of health*
Director of health.
Health officer.
City health offloar.
Health officer.
Director department of hMltt
Health officer and rogistni*
City health offloar.
Health officer.
City health officer.
Do.
Director of public health.
Health officer,
aty health officer.
City physician.
City health officer.
Do.
Do.
Do.
Do.
Do.
Do.
Health officer.
J^onitary inspector,
liealt h commissioner.
Health omcer.
Health officer and milk inspeoCor.
City health officer.
Health officer.
Do.
1)0.
Health officer and president board •!
Iiealth.
Health commissioner.
Health officer.
I>o.
Chief health officer.
City health officer.
Do.
Health officer.
City and county health offlo«,
officer for Yaktma County.
Digitized by
Google
1231
Aug08t8,iei7
city.
Name of hetlth officer.
Official tide.
s» WMbingloii-Ooiittnaed.
Bitttle
•J. 8. McBride, M. D
CommiKiioner of health
gnoktlM
♦John B. Anderson, M. D
J. E. HtnrjfU.T)
Health officer.
l^oma
Health officer, bacteriologist and chemist.
WftDftWalfai
Wallace A. Pratt, M. D.>
Edwin M. Easley, M. D
Eugene Davis, M. D
City and county health officer.
WMtVlrginiA:
BhwAeld
President board of licalth.
ChwlMtan ...
Healtli commissioner.
Mirtiiuibcirf
C. E.Clay.M.D
Commissioner of health.
Pirker^rarg.
Wm. Richardson, M. D
W. C. Etzler,M. D
City health officer.
WhMlinf
Health commissioner.
Wisoaosiii:
ADDleUm
Frank P. Dohearty, M. D
C. 0. Hertiman, M. D
H. E. Burger, M. D
Do.
Ashlmd
Chahman board of liealth.
B«]oit
Health officer.
fiiin^ink
J. F. Farr,M. D
Executive officer board of health.
Food 4q t^
F. M. Harris, M. D
Health commissioner.
Onm B%y
T. J. Oliver, M. D
C>ommissloner of health.
JanesviUe
Samuel B. Buckmaster, M. D.
♦Herbert L. Wright, M. D. . . .
♦J. M. Furstman, M. D
Harry E. I»urceU, M. D
J. E. Meaiiv,M. D
Health officer.
KeDosha
Health commissioner.
UCroisse
CommLvsloner of health.
yadisoD
Health officer.
Manitowoc
Do.'
Marinette
MOwauk»e
8. P.Jon*»s.M. D
♦ficorge C. Ruhland, M. D. . . .
♦A. H. Broche, M. D..
Do.
Commissioner of liealth.
Oshbosh
CommLssionor of hmhli and city physi-
cian.
Commissioner of public health.
Sfaeboyinia
H. C. Reich, M. D
^pcrior
D. R. Searle, M. D
Health (oramlsslonor.
^«san....
Wm. E. Zilisch. M. D
Health oirH*er.
♦Full-tfane officer.
» Also health officer for Walla Walla County.
Digitized by
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PREVALENCE OF DISEASE.
No health department, State or local, can effectively prevent or control diaoie wUkoui
knowledge of when, where, and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended July 28, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended
July 28, 1917, as follows: Seven cases of smallpox were notified in
Fresno County, focus at Pineflat. Of poliomyelitis, one case was
reported in Santa Clara County and one at Belvedere. Two caa^ of
cerebrospinal meningitis occurred at San Francisco. Of typhoid
fever, 21 case-s were notified, 1 each in Oakland, Fresno Countj,
Fresno City, El Centre, Stockton, Santa Barbara, Santa Qara
County, Hercules, and Santa Clara; 2 each in Stanislaus County, and
Walnut Creek; 3 in Los Ajigeles, and 5 in San Francisco. There was
a marked reduction in the prevalence of reportable diseases.
The details of notifiable disease cases reported during the week
ended July 21, are as follows:
Cerebrospinal meningitis 9 Pellagra 1
Chicken pox 20 Pneumonia M
Diphtheria 26 Poliomyelitis 1
Dysentery 1 Ophthalmia neonatorum 2
Erysipelas 12 j Scarlet fever 61
German measles 27 j Smallpox 2
Gonococc us infection 22 | Syphilis 20
Leprosy 1 ! Tul;erculogis 115
Malaria 24 \ Typhoid fever 38
Measles 100 1 Whooping cough - 32
Mumps 59 I
CEREBROSPINAL MENINGITIS.
Louisiana — ^Doyle.
One case of cerebrospinal meningitis was notified at Doyle, li'v*
ingston Parish, La., on July 27, 1917.
(1232)
Digitized by VjOOQIC
1233
AugOHt 'S, 1917
CEREBROSPINAL MENINGITIS— (Vnjt limed.
State Reports for June, 1917.
PhM.
ConzMcticat:
Ftirfiekl County-
Bridgeport
Htrtfordi oimty—
Hartford
Mancbester
New Britain
PlainviUe
Windsor
Kiddlesex County—
Middletown (town)
New Haven County —
New Haven
Orange
WaUmgford
New l-ondon County—
Mont\-iDe
Total
lodiuia:
Blackibrd County
Delaware County
Howard County
Lake County
Marion County
Total
Iowa:
Scott County
Kisi^asippt:
Copiah County
Harrison County
Total
Newca^es
reported.
35
Place.
Pennsyh'Jinla:
Allegheny County
AmiUrons County
Bedford ( oimty
Berks County
Blair County
Bradford County
Butler County
Cambria County
Carbon County
Clearfield County
Crawford County
Cumberland t ounty. . .
Dauphin County
Delaware County
Erie County
Fayette County
Indiana County
Jefferson Counly
Lawrence County
Luiernc County
Mercer County
Montgomery (ounty . . .
Northampt-on 'ounty. .
Pbllaielphia ''ounty. . .
.Schuylkill County.". .. .
Snyiifi ( tmnly..!
Vc'nanpo (^ouiily
West nioieland ('ounty .
Total .
Wa.'^hlnKton:
Kit<ap Coimly.
Bremer ton.
I'kTce Count v..
Total .
New cases
reported.
30
2
Arkansas Report for May, 1917.
During the month of May, 1917, 2 cases of cerebrospinal menin-
gitis were reported in Arkansas, 1 each in Craigliead and Izard
Counties.
City Reports for Week Ended July 14, 1917.
Place.
Cases.
Baltimore, Md
Boston, Mass
Brockton, Mass
Buffalo, N. Y
Canton, Ohio
niicago.Ill
Rncinniti. Ohio
^HeveLind, Ohio
l^ayton. Ohio .'
•Mroit.Mich
HamU/tiri:, I*a
Haver ill. Mass
iohnsiown, Pa
Kansas City, Ktms
Kansas Citv, Mo
Lynn, Mass
Halden, Mass
Manchwter, X. H
JlcKeesport, Pa
Deaths.
IMaco.
3 I
J
Mihvankoo, "Wis
Miunc ipoli-^, Minn. . .
Nt'^^arV, K. J
New Hrifurd, M!L-)S...
Now York, X. V
NorfoU. Va
Xorri-loi\n, I 'a
Oinalm. --.'cljr
PhilA/JoloMia. I'a
I'ittsbiir! h. I'a
Kacinr. W i^
Hi. Loiii*, Mo
Halt 1 a"' r ' ilv, Clah.
San r-irrM, (ij
San Fr.iiici-:(o, ('a|
Sprinu.U'M, Mass
Toledo. Ohio
Wluvliti^. W. Va
Ca>cs. I Deaths
I
4 I
Digitized by
G(
AiigaBtd«1917 1234
DIPHTHEBIA.
See Diphtheria, measles, Bcarlet fev^, and tuberculoeis, page 1244.
ERYSffELAS.
City Reports for Week Ended July 14, 1917.
Place.
Cases.
Deaths.
Place.
ClMS.
Deaths.
Boston, Mass
1
Lynchburg, Va ,.
1
BiiTalo N Y
Maiden, IkUss
1
Chioaco, III
2
McKecsport. Fli..
cievciand Ohio . .
Milwaukee, Wis
Clinton, Mass
1
Nashville. Tenn
Ifavloii Ohio
Newark, N.J
Denver, Colo
Now York, N. Y
I
i^otroit, aich
Oakland. Cal
Duluth Minn
Omaha, Nebr
Fort Worth, Tex
1
Philadelphia, Pa
Harrison, N.J
Pittsburgh, Pa
J
Jersey City, N. J
Kulumazoo, Mich
1
1
Rochester, N. Y
St. Louis, Mo
I
Los Angeles, Cal
2
LEPROSY.
New York— New York City.
On July 26, 1917, a case of leprosy was notified in New York City,
in the person of G. K., a native of Greece, 53 years old, who came to
the United wStates in 1913.
City Report for Week Ended July 14, 1917.
During the week ended July 14, 1917, 1 case of leprosy was re-
ported at Los Angeles, Cal.
MALARIA.
State Reporto for June, 1917.
Place.
Mississippi:
A<latns Coiinty
Alcorn <'o«uity
Amite County
AtiaUCoMJitv
»oIi arC i:n"»v...
Culhotni County...
Carroil ( omiiy
Clvk'ka.^a\» County
(Uiociaw County..
Claiborno County.
Clarke Coun'y
Clay Couniy
Coaiionia ( uunty.,
CopiiUi C«tunty.' ..
Co\in.4i»'n Coiniiy
I)e ^«.t^)<'own y...
Forrest ('oi.niy . ..
Krati ln' '>Mnty..
Ci>(/r (M .. 'iiLy
(iroe' «• C.un'y
<''ir' :• la < i»unty . .
1 aiivf i ^ ' ounty..
IJairi-oi! < 'ounty..
Ilir.us t (Mimy
Holmes County...
Now
cases
reported.
53
71
84 I
14G
87.;
203 ,
93
S2
CI
21
13,
7l'.>
H3
ye.
rni
142
43
4U
42
11.5
370
4.".0
Place.
Missis.sippi — Tont iniied.
ls>n'iuena Couniy
It ( a v\ ainba t 'ounty
Jark>on Coinitv
Je or.son Cour»iy
Jo; (»rson l>a\ is ('ounty
I J (iTir.-^ County
Kiinj.er County
Lafayelti' Ciwuity
' Lair ar Count y
I l«kuJ<»rd:i!e < V»unty
I u^ri'inc*' Couni y '.
I oaV(. County...
l^o ( ouniv
Lci1or« County
I.ini-oln County
Lowndes Comity
I, Mattison County
;l Marion Coimty
i| Marshall County
jl Monroi> County
[; MontKonuwy Coiuity...
I I Neshol»a Comity
j N<'A ft. n County
i No\ 11 Ix'o Count V
I, Uklibbuha County... /m
litized ' ~
New
oaws
rcporte<l
&
W
CI
«7
3t.
WH
92
1&)
47
IIJ*
14*.
?i
802
687
91
103
85
137
179
103
72
109
41
ibyGoog-te
1235
MALARIA— Ck>ntiiiued.
State Reports for June, 1917— Continued.
AugU8t 3, 1»17
Place.
New
cases
reported.
Place.
New
cases
reported.
Misissippi--C0Dtiiiii«d .
PanlokCoanty
188
87
45
108
64
95
92
145
110
85
35
796
235
45
115
123
23
384
469
70
38
Mississippi-Continued.
Yalobusha County
03
Pearl RiTor Comity
Yazoo County
483
PttryCoonty
Total
PUreCoanty 11II!;!I.'I.*III.!!;'
11,349
Pontotoc County
Pennsylvania:
Philadeh)hia Countv
Pren^ss County
1
Sharkey County
YorkCounty '.
1
Simpson County
Total
Smith County
2
BtcoeCounty
South Carolina:
Beaufcvt County
Sunflower County
TateCounty
18
Tippah County
Chester County
6
Tisnaminco County
Dorchester County
32
Union County '.
Marion County
20
Walthall Countv
1
Warren County'.
Spartanburg County
4
Washington County
Williamsburg County
5
Wavne Coimly
Total
WeKster County ..!]....!!!..!.!.!!!
86
Arkansas Report for May, 1917.
Place.
New
cases
reported.
Place.
New
reported.
ArkaiuaK
.\sbley County
7
1
12
26
1
5
5
5
2
Arkansas— Continued.
Monroe County
2
Oarroil County..
Newton County
:i
(Vaiwav Countv
Perry Countv
3
<irt€ne County.
Scott Countv
10
Hnnpstead County
Sevier Cotint v
100
I?artl Cotmtv. . ...
St. Francis Countv
34
Jetic rs<«i County
Washington County
1
Johnson County
Total
I-aCavctle County
275
Mississippi County
City Reports for Week Ended July 14, 1917.
Place.
Cases.
Deaths.
Place.
Case^.
Deaths.
Binnin^ham, Ala . •
«6
Newark. N..T
New Orlonns, La
I*ort5.mouth, \'a
1
1
Hiarie^tan, S. C !
'I
1
Coirv\'\ ille. Kans
1
1
Memphis. Tenn
i
1
Richiiionci, Va
i
Mowie.AU .:.:.:
SjivaJifuih, Ou
i
Nashville, Tenn
Trenton, N.J
3
'The reason that Birmingham had so many more ca*<es of malaria reported than any other city is not
that the disease is more prevalent in Birmingham than in other cities of Alahania and neigliViorin^j Siate>,
n?itandoobtedly because of the siiccevNfnl efforts the heaUh dep-irtment ha< made in set^uring the coopora-
^•ffli of the practicing physicians in report ins civ^e>.
MEASLES.
See Diphtheria, measles, .srarlel fever, and tiil)er<'ulo^i8, pai^e 1244.
Digitized by
Google
August 8, 1917
1236
PELLAGRA.
State Reports for June, 1917.
Place.
New
cases
reporter! .
Ncv
Connecticut:
Uartford Comity--
.Simsbury
Missbsippi:
Adams County
Alcom County
AmlteCounly
Attala County
BoIi\-ar County
Calhoun County
CiUToll County
Chickasaw ( ounty
(%octaw County
Claiborne County
ClarkB County
ClavCoimty
Coahoma Cwmty
Copiah County
Co\*ington < bounty
Do Soto'ojnty
Forrest County
Franklin County
OeorRo CoT'uty
(Ireenc County
Hancock County
Harrison County
Ilinds ('ounty
Holmc'it'o.-iity
iBBaquonuCoTinty
UtAwanil)a<'o'.nity
Jactscm ( 'oanty
Jolfcrson Coanty
JciIor^on !>ii>i^ County.
JonosCownty
Keniper Tooulr
Liilayrt t^^^"^t ul y
I«a«i«r Coi-iily
Lau<l«M-«l'^l(' If) nty. . ..
Law Tvuer i o;aity
Ix»ttkc( 'ounty
lJir> Cn .iitv
I,ol^«-o('oun»v
Linroln bounty
Lov^ii<ii'> ("«n-nty
Mndfnn ♦oinity
MiMon ''ountN
M.ir,) ;kll 'ounty ,
M«itr«H' {'oMi'v
Mujit4;uniiT> t ouuty....
N<'^holm County ,
36
10
5
10
26,-)
14
6
30
4
8
9
11
200 I!
36 ,
20 1
39 I
40 '
16 j
3 II
31
3.S ^
2 ''
I" >
n !
16
ir.
10
13 I
2*\
Hi '
12 ,
41 '
66 ;
31 I
37 I
* I
IT!
Mississippi — Continued.
NcntonCocnty
Noxubee County
Oktibbeha County
Panola County
Pearl Ri\aer County
Perry County
Pike County
Pon t otoc ( 'ounty
lYentiss County.
Scott County
Sliarkcy (^mmty
SinuwOTi County
Smith Cormty
Stone rwmty
Sunflor. or (^ounty
TatoCVinty
Tippah (^TOintv
Tisbomiiyio ( ounty
Cnion County i
Wall hall County
Warren Coimty ■
Washinirtan County i
Wa\'ne County :
Webster County j
Yalobusha County
Yaioo County !
Total.
f
IT
U
U
%
«
M
1
II
If
17
U
I
u
14
12
U
0
Iff
«
«:
2jn
South Carolina:
Re-.iufoTl County
t 'herokco Coimt y
Chftvter <'«unty
I>orcbo'-ter Coimty . . .
FairfteJd County
<)reonviI!p(^o»rlv. . .,
(Jreenwood Co nty. . ,
K«T<hnw County
I^uurcns County
Majinn Count v
Marlboro (oonty
Onuuji'Hurp ( ounty. . .
Ilic jI'Ui'I Coi'.nty
Si» u t!uit)in: i 'ounty . .
l'ni>>n '"o iilT
Willhni.^h- m County .
YocK t ounly
Total.
Place.
Arkansas Report for May, 1317.
Now
en .PS
rep«r»e«l.
Arkan^a*' I
nr;Hll^v CjMUitv I 4
Cnir % < .-t'htv 3
1).. I I '■' •!• t\ ■ < 1
F:i' • ruf( npiity } 7
(.I'liii ! ' oM.tv' i 6 t!
(if. ' ■ < oiiiUv 2 ■
H«-:n' '. mK oimty ] 1
T/ .r I ' *>':ntv 1 1 (
I,.:.^»lt^' irmly I 1
I>(VJJi ' ')'inlr j 1
Place.
.\rk.tnn''— Continued.
MiMcrCmiTiiy. ...
>Ii^ is^il*pi ( ounty
Protf Coniitv
S<i\ irr C<»im!y
Hi . Kr iiu 1^ < ounty
W-i-!iiiu:t(«n ("«>unt
White County
Total
N«*
Digitized by
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1
9
I
2
U
«
Hooo.
1237
PELLAGRA— Oontinued.
City Reports for Week Ended Juiy 14, 1917.
Cases. Deaths. Place.
August 8, 1917
AiBtiii,Tex
Bimlndiam. Ala..
ClnrkstaLS.C...
Fort Wortt, Tex..
Oahestoo, i^.
««-saty,Mo..
LexiDftoii, Ky.
Memphis, Tenn.
Mobile,;'
,Ala..
>8
Cases.
Nashville, Tenn
New Orlcajis, La
New York, N. Y
BlchmoiKl. Va
Roanoke, va
BacraMento, Cal
Wichita, Kans
Wilmington, N.C
Winston-Salem, N. C.
Deaths.
1 Tbfi reasoo that Birmingham had so many more cases of pellagra reported than any other city is not
that ttad disease is more prevalent in Birmingham than in other cities of Alabama and neighboring States,
tnt nsdoobCedly because of the successftil efforts the health department has made in securing the coop-
ciatioQ of the precticing physicians in reporting cases.
PLAGUE.
California— Alameda County— Plague-Infected Squirrels Found.
The finding of two plague-infected ground squirrels in Alameda
County, Cal., has been reported; one each on July 12 and 14, 1917,
within a radius of 3 miles of Alt,^mont. One was found on the
Frank Floyd ranch and the other on the Peter Barthe ranch.
PNEUMONIA.
City Reports for Week Ended July 14, 1917.
Place.
BsWmore, Md
Bingiamtoo, N. Y
Boston, Mass
Chica<?o,UI
Ckvcland, Ohio. . .
Detroit, Mich
DTilath,Minn
Erie, Pa
M River. Mass...
Htveriiill. Mass....
{•ebon, Mich
Los Angeles, Cal...
Cases.
Deoths.
2
6
2
3
3
50
47
r,
14
7
19
2
1
1
1
1
1
1
9
2
Place.
Lynn, Ma«?s ,
i>ewark, N. J ,
rhila^elphia, Pa..
Pitts] •urgh. Pa
Rochester, N. Y...
Sari Di(^o, Cal
San Francisco, ("al
Sprinpiiold. M iss.,
Toledo, nbio
Woburu, Ma?s
Worcester, Mass . .
Cases.
Deaths.
1
1
25
3
16
8
11
12
5
1
3
4
5
2
1
1
1
2
1
2
POUOMYELITIS (INFANTILE PARALYvSIS).
Alabama — Raf^Iand.
On Jidy 16, 1917, one case of poUomycUtis was notified at Ragland,
St. Clair County, Ala.
California.
During the week ended July 28, 1917, two cases of poliomyelitis
were notified in California, one each in Belvedere, Marin County,
and in Santa Chira County.
Comecticiit — New Britain.
During the we^k (i.c'd July 28, 1<H7, one case of poliomyelitis
was notified at New Briiain, Conn.
Digitized by
Google
AiigaBt8,1917 1238
POLIOMYELITIS (INFANTILE PARALYSIS)— CJont I nued,
Illiiioi^-Chicago.
During the week ended July 28, 1917, 6 cases of poliomyelitis werc
notified in Chicago, 111.
Kaims.
During the week ended July 28, 1917, poliomyelitis was notified
in Kansas as follows: Kansas City, 3 cases; Fall River, 1 case.
Maryland.
During the period from Jime 1 to July 28, 1917, oases of poliomye-
litis were notified in Maryland as fellows: In Allegany Conjity, 13
(July 15-28); Anne Arundel County, 1 (July 22-28); Baltimore
County, 1 (July 8-14); Dorchester County, 1 (July 1-7); Garrett
County, 4 (June 1-July 28); Baltimore city, 3 (July 8-28).
Masgachwaette— Hi»v6rhill and Lynn.
During the period from July 24-27, 1917, 3 cases of poliomyeKtis
were notified at Haverhill, and from July 24-31, 5 cases were notified
at Lynn, Mass.
Minnesota — Pope County.
During the week ended July 28, 1917, 8 cases of poUomyehtis were
notified in Pope 0>unty, Minn., 7 being in Bluemoimds Township
and 1 in Langhei Township.
Vermont
During the week ended July 28, 1917, cases of poliomyelitis wew
notified in Vermont as foUows: Barre, 2; Bolton, 1; Waterbury, 1.
Virginia.
The State Health commissioner of Virginia reports that during the
month of July, 1917, cases of poliomyehtis were notified in Virginia
as follows: Rockingham County, 22 cases with 7 deaths; Page County
3 cases; Rappahannock County, 4 cases; Albemarle County, 1 case;
Louisa County, 1 case: Goochland County, 1 case; King and Queen
County, 2 cases; and Pittsylvania County, 2 cases.
West Virginia.
During the week endetl July 28, 1917, cases of poliomyelitis were
notified in West Virginia as follows: In Marion County, Monongah 8,
Anabelle 1, Wliiterock 1; in Jackson County, Kenna 3; in Tucker
County, Davis 2; in Pro-itoii County, Nowbiirg 1; in Braxton County;
Mapleton 1 ; and in Upshur ("ounty, Buckhannon 1.
Digitized by VjOOQIC
1239 A<irist8,l«17
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
State Repflrte for Jane, 1917.
Place.
New cases
reported.
FlBOt.
New cases
reported.
Zafina:
mhart^^fra^
3
1
1
1
PeoDSYlvania:
Alie0)eny County
T4fk<» rnnnty . .' , . , . _,
Br&dlord Count>\.
Kuion County .........^
Oambria County
Wayne County.... ;
Clearfield County *!
Faretie Coontv .
Total
5
I«anca^ter County
Montsomerv Countv .
>I2?r«iiitr
5
1
2
1
Philadolphfa County
Bdkuylkiil County.'
Choctaw CoimtT
Total
IS
Smiti County .'...—
South CaroUna:
WIIHamshnrg C^mty
TOW
9
1
Wyoming:
Natrooft Coimty
1
€Hj S^eite fcr Week Ended Joly 14, 1917.
in Arbor, Mich...
BDBhi0iazn, Ala...
B«lon,Ma6s
|(Alo,N,Y
<aicKo,ni
<S«»«tod,Ohio....
DeWt.Mich
HwertiiD ijass
I"«sCity, Kans..
Gases. Deaths.
S
Place.
Kesny, N.J
Lowell, Mas*
Maiden, Mass
Newark, N.J
Newcastle. Pa
New York, N.Y....
Perth Amboy, N. J.,
1 PhiladOpbia. Pa
Pittsbnrgh, Pa
RIchmDnd, Va ,
Cases.
Deaths.
EABDES IN ANIMALS.
CttF Reports for Week Ended My 14, 1917.
During the week ended July 14, 1917, 2 cases of rabies in animals
ware reported at Detroit, Mich., and 2 cases at Memphis, Tenn.
ROCKY MOUNTAIN SPOTTED FEVER.
State Rtporis for June, 1917.
During the month oi June, 1017, 5 case^ of Rocky Mountain spotted
ferer were reported in Humboldt County, Nov., 1 in Golconda, and
4 in Paradise Valley; and in Wyoming, 1 case was reported in Camp-
bell County.
SCARLET raVER.
See Diphtheria, measlee, scarlet fever, and tuberculosis, page 1244.
SMALLPOX.
Massaclinsetts — Virulent Smallpox.
During the period from January 16 to July 2K, 1917, 48 cases of
«nallpox, with 9 deaths, were rep<)rte<l in Massacnusetts, as follows:
Wwjester 38, Fitchbiu-g 4, Shrewsbury 3, Webster 3.
Digitized by VjOOQIC
August 3, 1917
1240
SMALLPOX— Continued.
Minnesoto.
During the week ended July 28, 1917, five new foci of smallpox
were reported in Minnesota, cases of the disease having been notified
as follows: Crow Wing County, Einily Township, 5; Pilmore Cotmty,
Mabel, 4; Houston County, Spring Grove, 1; Itasca County, Deer
River, 1; St. Louis County, Rice Lake Township, 11.
MisceDaneons State Reports.
Flaoo.
Cases.
Deaths.
Place.
Oues. Dcttte.
Arkansas (May 1-31):
Brndlcv C'ounty
3
6
r>
40
3
3
1
5
6
1
21
1
4
7
2
4
27
1
43
7
6
13
0
1 Indiana (June V-3e)-Coiitd.
Ft Joseph County
Sulliyan Oounty
43
Carroll Tounty
CoTiwav Count v
Tipp-- anoo County
NanderburR County
VerPiilioii Countv
Craighead County
Dulhis Counlv
Drew Count v
ij VixoCountv
Fatilknfr County
i, ^V!1]•;lsh CoTittty . .
i lorland Count y"
li "NVarv'it'k Couniy
4 1 1
i 1 rccnc (^ounty
'1 "VVhHi» roiintr
1 1
H«nipstead County
Hot springs County
Ijard County
]
Total
229' 1
J cirrn^on County. .
Iowa (Juno 1 3o):
Adfiir (\kiinir
Lo?an County
. . , , ^ .- , . ,
3D '
Marion County ..
* Aiifliil)cin (>»iintv . _
Miilor County
1 rJonton County
1 \""
Mi^-i>MpT)i (ounty
Monrot' ( cnmt v
' Bremer County
1 '
1 nutier t <->iint»
rtil.i^ki < ijMtit V
■' Carroll C)tiniy
S('\ irr Count v
1 C^^d'ir County
St . Francis < ount y
Wahiucton County
1 CIterokcp Cjunty
) Clav County
Wlutt' ( ounty
! Diifkiv (\iiiniv
\ \
2<.)
1 Doi-:itnr County
Total
Dcs MDJiies (\mnl y
' Frrfuklin <y»unt V
ii :::
3
K
1
36
ft
2 1
Connorllnit (Jump 1-30):
' Frewwrnt County
1 '
FairfirKl County-
1 Hnmihon <'onntv
« 1
Norw.Jk
' liar lin Cotinl y
14
Ilartforfl Co\mty--
Henr V Cunt v
2
C
1
TUrlin
J:vk'" »n C-);intv
Nt w firitain..
J;i >( t r • Vniut '.'
1
lAlohlifhi < (Kinty
Torriueion
\ Fi'.M .- »iH oiiiily 5
1 <*• f otrnty i
\Vm^hi^ur
I.iim i Diiuiy
J
New llrtNon ( ounty—
1 LyoTi <■■> int'y
Water hury
Miln^k I { ounty
^
] Mill { ouiit ' ...!
2 t
Total
r-'"i ■--
Mit- iwll Crmt V
Indiuna (June 1-30):
! O'Hrirn C..;in(y
I'lviiMiiil h ' ■ iiinfv
r
All<'ti < ount V
2 Vih horiJ ..CMUTlfV ' 2
■J VuWi t , iri.v ■ 7
B.utholorrii u County
Klkharl CoMiitv. . ...
-,
j
4
pof t'twril t'l'nic Co'H't V ' *
K«>unta]M < vniiiiy
FiiUon Coiiru v
1 Srnll ( ,in., » .'
S''fM|\ CO'f! tv
Van hiir«-ri ('.•iiiity
\V ipf l!o < <>nrr v'
\
2
31
12
3
1
4
• If .ml Coil 111 N
« ,i,...np Cu'i'ifv
il >':iitt«n t 'Mjptv
1
\Vet'<trf County
lit U'lr^k .( or.iiiv
4
1
24
10
1
1
1
4
■i
1
-
i
AVinrir !i>(k ( ounty
"Worth <>>unl y
11 Ml' ii»rt*»M <'■)■.! nty
J H K •!! i OMIlt V.
1 Wnpht Courity
Kji >^ Cf'UMl >
Total
l/.iki < f>:iiifv
j->s 1
l..i|'ort) r<.'ii.t\
I/*u r«*t" *' t (uini y
M ■, 1 >'i < o'lnf \ '
1 Mi.^si<: ippi(Junel 30):
' I'.olnar <'()Mi(\
■"^=^
M ^ ' ■!!• ".:"V..
I lu iciLViw <'>mity
CI rke< M'iMt
i Cov tnuf >n < '<»uiuy
l'\>ru i Cviiu t ■. . .'
<.r. M'l.' * . iMiy
Itni.,.' i ,' M,
Mm' , r ..■ 1^
!..'/. . .1 ••
]' r » <• . 1 ,•
1. .: , - ■ ■ •
I*'. , . .
^1 <
Il<.l:n.',> HiiU\
^]» 1 « 1 t «'il»!\
iss iqiienn County ..... .(7
iitizeo by v.
r
1241
August 8, 1917
SMALLPOX— Continued.
MiBceOuieoiui Slate Reportft-^ntinued.
piaoa.
Caais.
Deaths.
Place.
Cases.
Deaths.
Mississippi (June 1-30)— Coil
luwamtia County
Jackson County
Joocs County
Kemper County "....
Lafafette County
Lauderdale County
Leo County
IfadLson County
IIarshallC\>unty
Montgomery County
Panola County
Pike County
Pontotoc County ,
Sterkey County
Sunflower County
Tate County
Union Countv
Washington County
Yalobusha County
Total
NcTada (Juno 1-30):
Elko County
Humboldt County
Total
North Dakota (June 1-30):
Benson County ,
Burlei^ County
Cass County ,
Qoidcn VaOey County. . . .
Grant County ,
Grists County
U Moure Co»mty
Pembina Coiuity
Ramsey County
Richbnd County
Traill County
Ward County ,
Wells County
Total
12)
Pennsylvania (June 1-30):
Allo/Jheny County
Beaver County
Bedford County
Crawford County
Dauphin County
Erie County
Indiana Count y
Lawrence ( ount y
Lurorno ( ount y
Mercer ( ouuty
Philadelphia County. .
Warren County
Total
South Carolina (June 1-30):
Berkeley Count y
Grcen\ iUe ( ounty
Kershaw (^ounty
Marlboro ConntV
Sumter (otiniy
York County
Total
Washington (Jiuie 1-30):
Adams County-
find
Franklin Coimty—
I*asro
King < ounty--
Seattle
Pierce County
Tacoma
Spdkane Coimty -
Spokane
Yakima County
TofJl
V yoaiinj? (June 1-30):
Carapl)ell County
City Reports for Week Ended July 14, 1917.
Place.
Akron. Ohio
BeUmsham,Wash...
Buffalo. N. Y
Butte.Mitnt
Cairo,Ill
(hicaKo.Ill
Clerelsnd.Ohio
Columbus, Ohio
Danville. 111.
Davenport, Iowa
Denver, Colo
Detroit, Mich
Dulath,Minn
Flint, Mich
Fort Wayne. Ind —
Grand Raoids, Mich
Indianaoolls, Ind. . . ,
KansasCity, Kans..
Kansas City, Mo
Little Rock. Ark....
Madison, Wis
Memphis, Tann
Cases.
Deaths.
l*lACl«'
^JinnonrolU, Wttiti„._„
Miisrni ill ", Iowa.,.,.,.,
! Nashvid*'. Tfum., ,..►.
Nor *J I AUs^ t»...,,, .
I'itio.
I'oMiii
p.) tlA'
FOi-l.-i
St. I.o
Salt L.
Sioux
Sprin-
8f rini;
'ifihr...,,.
, *rMi. ,. .
,i^<.\'a
ri
\(o,
itv, titih.
■uAi
- -I ni .....,,
<. ■Mila......
i.ln
•I
Wi<-!'i I. :
I Zau<'s\ LJi^
n
I
1
5
0
4 '
;!
I
3 1
V
2
I
I
I>«fttJlK
Digitized by
cboai^
Aagost 3, 1917
1242
TETANUS.
City Reports for Week Ended July 14, 1917.
Place.
Chicaw), HI
Lincoln, Nebr
Los Angeles, Cal--
Newark. N.J
New Orleans, La.
Cases.
I
Deaths.
PteM.
Norfolk, Va
Philadelphia, Pa.
Quincy,III
Sacramento, Cal..
Trenton, N.J
Cases.
Deaths.
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1244.
TYPHOID FEVER.
State Reports for June, 1917.
Place.
New casps
reported.
Place.
Now ewes
reported.
Connecticut:
Fairfield County—
IJrid;;eport
1
1
2
1
1
1
4
1
1
2
1
3
1
1
2
1
1
1
Mis'^issippi:
A dums County
Alcom County
Danbury (town)
Amite County
Norwalk
Attala County
Weston
Bolivar County
Hartford ( ounty —
Calhoun County
Hri'^tol
Carroll County
Farminrlon
Chickasaw Coimty
..
Hurt ford
Choctaw County
New Britain
Claiborne Coimty
latchneld ( oimty -
Clirkc Coiuitv
Salibburv
Coahoma Coimty
Middlesex County —
Copiah County
Kiist Hauij)ton
Covington County
UeSoto County
Forrest Count v
New Haven ( omity —
New Haven
\Vaterb\iry
Franklin Countv
New l.oiulon County- -
Fran^iln
(Jeorfje County
Greene County
Jewett ( ity
Hancock Cou nt y
New IvOndon
Harrison (^ounty
Tolland Coimty —
Hinds CotmtT
Man •afield
Holmes County ,
Windham County—
Ittawaraba Coimty
I'liiuf'eld
Jactson Countv
\\ i 1 .i man tic
JctTerson Countv
Jefferson Davis Countv.
Total
2G
1
1
6
2
1
1
2
2
2
2
5
7
4
1
1
1
1
10
1
:{
Jones County
Kemper County
Indiana:
Lurayettc County
iJocatur Coiuity
T>amar Count v
Fountain Count v
Liuidordule ( 'ount v
Hen<lricks County
Lawrence County
Honrv (^ountv
Le lie County
Hunt in;4ton County
j Lee t^ount V
Jav ( 'ouiU V ,
lyoMore County
Johnson Count V
Lincoln Countv
Ko<k iu^ko ( Ount v
Lowndes Countv
Lake Conntv
Mafliv)n County
Laporte Countv
Marion County
I^au renco Cotintv
Monroe Count y
Marion Conntv
Marslmll County
Marl in Couni v
Neslutba Countv
M(»r»»;:<)ii!orv < onntv
Newton County
\
Oraiii r Count V
<) k t i 1 » W^ha ( ounty
Hit !o\ (\)iuitv
Cr-nola County
Kcot I « ouni V
I f u 1 l>i er i oihUv
Hi. ,'(* «■: >h Countv
1 e r\ f"o'.uji\
Suit t rhmd Coniitv
1 i «' Countv
Vaii'iorl lui Ii < > . ,i v
1 |^o-'n'o/C(Vihlv
Wa lunuton Co uit V
1 I'rrni i'^s <"ounl V
1 hcot! Countv
'Jot U
1 Sinv,>on C(»untv
\
» Sniiil» County .' ^^-^
i
Digitized by VjOOQ
le
1243
August 3, 1917
TYPHOID FEVER— <)ontlnned.
State Seporttf for Juie» 1917— Continued.
Place.
Mississippi— Continued.
Stone Coontj...^
Sunflower County.
Tate County
Tipfieh County
TisIuRuingo County.
Uni on County
Warren County
Wadiln|ton County
Wavne County
Woteter County
Yalobu3ha County
Yazoo County
TotaL
Nevada:
Washoe County
White Pine County
Total
North Dakota:
BurtoCoimtv
BnrWsh County
OBttsCwmtv
Bddy Cojinty
McT^ean ('mn'r
MorUm CoiiDty
W oantrail County
Ndson County
BirMond County
R<^ett4> Coimtv
Stctsman County
Ward County
Wrlls County
Total
Aiudns r!>finty
AMe^fftittiy CotJOtt .. .'..'/.
JifiBstrcin''; i 'ounty
^^ ~T t '(HJt*t v., '..'..'.
_d CcHinlly.,^..]*.'!]
«,--*t*Oljn!v.,_.
WMr €mmt%\ _ , ,
UraftfiT'ii <VttntT
Btirka C Vjimt v . ' ....!!!!!
Untlf 'f < ^f^ i ri I y . ....'...,,.
Vtiesitar i ounty . ........
Clarion C mm ty....
Clearfield County
Crawtord County. .,,', ,,]
Bauplun County
DelAvaro County . ..[
Erie County
Favette County
Fraokiin County
Orecnc County
HmtincdaD Oounty .' ',.'..
Indiana County
Joflfcrson (^ounty .'...'.
Juniata County ,.,,
Lancaster County
lAwrence County
LelMBMn County
Lehigh County
Luzerne County
Lycoming County
Mercer County
Mifflin County
Montgomery County
Montour County
Northampton County
Northumberland County.
Perry County
New cases
reported.
495
Place.
I New cases
reported.
Pc nnsy lyania— Cont inued .
PhiladHpWa Coimty . . . .
SchiiyJiiU County ......
Snvdcr County
TioRa County
Venango County
Washington Coun ty
Westmoreland Coimty . .
York County
Total.
South rwoiiiui:
Utsmiion fVrfiiitv
Ber kflif y < ^10 a t V
1JbmrSi*»Cchii rmin i v
I^ijrolii'jJ* f I wuily
Fairaiid ( uimty .\
(3 rf **nw(»cii i oiini y
K^r:.lifi.w f^tajnty /.
hiUlttUf i'QMTXlf , .
If aXioCl ( IfElTit J ._'_.,.
ll>%Jit>r>rH ( nuilty
Ni'Wl«-fTj < OiiOly,,...
I h-oiiae 1 1)1 J n I V ,...,., .
PSctjpDj * naD I y . . . _ , .
Hi r- tilttk I ( t*iimy . . [ [
3kj]JLid<i Coun! V »..
lifiiilsmJ'itiif TiituiTy..
:feijiLl4ir 'fumty , ....
Total.
Wa5hlnf!;ton:
Benton Coimtv
Clarke Count V
RldRefield
Cowiitz Count V—
Woodland"
Klnu County—
Seattle.'.
Kltaap Count y—
Chariest on
LiBC<dn ( 'ounty
Davenport
Pacific Cminl y—
Dwaco • . .'
Pierce Coimtv—
Tacoma
Skagit Count y-
Mauit X'enion...
Snohomish ("onnty-
Everett "...
Monroe
Spokano Coimty—
S|X)kane
SterensCoinUv
Walla WalliWountv.
WuUu Walla..;..
Whitman County
St. John
Yakima County
Total.
Wyoming:
Uinta County..
Carbon (ounty.
Total.
92
1
1
2
2
11
7
10
Digitized by ^
29H
6
1
4
30
0
2
1
2
10
4
7
1
1
5
20
3
10
13
2
IK
3
12
1
1
IftS
1
2
9
5
12
1
2
2
2
1
6
Gbogk
AuffUHt 3, 1917
1244
TYPHOID FEVER— CoutiHued.
Arkansas Report for May, 1917.
Place.
Newciscs
reported.
Place.
NewciM
reported.
Arkansas:
Garland County
8
2
1
4
1
1
Arkansas— Continaed.
MKsissijnpf Coanty. . . .
S3
Greene Count v
Sev ier (^cHint v... .'. ; .
8
Hempstead < ountv
Washington County
8
Hot nnrins C ountv
Total
Jefferson Coi.nty
56
Marion County
City Reports for Week Ended July 14, 1917.
Place.
Albany, N.Y
Baltimore, Md
Beaver Falls, Pa
Birmingham, Ala
Boston, Mass
Buffalo, N.Y
Cairo, ill
Cambridge, Mass
Charleston, S. C
Chelsea, Mass
Chicago, 111
Cincinnati, Ohio
Cleveland, Ohio
ColToy\illc, Kans
Columbus, Ohio
Cuml)erland, Md
Danville, lU
l>en\er, * olo
Dolroit, Mich
El I'lLSo, Tex
Everett, Mass
Fort Worth, Tex
(Jalvc>^ton, Tex
Grand Rapids, Mich..
HarrLsburg, Pa
Hartford, ( onn
Hol)o}>en, N. J
Imllanapniis, Ind
Jaclson, Mich
JohnsUnrn, Pa
Kansas < ity, Mo
Knowille, Te.nn
Little Rock, Ark
Los Angeles, < al
L>^lchburg, Va
Lynn, Mass
M'em[)his, Tenn
MihvanKee, Wi^
Mobile. Ala
Nashville, Tenn
Newark, N^. J
New lied ford. Mass...
Cases.
Deaths.
Place.
New Britain, Conn
Newcastle, Pa
New Haven, Conn
New Orleans, La
Newton, Mass
NewYork, N. Y
Niagara Falls, N. Y
Norfolk, Va
Norrlstown, Pa
North Adams, Mass
Oakland, (al
Oklahoma ( Ity, Okla
Philadelphia, Pa
Pittsbiu^h, Pa
Portland, Me
Providence, R. I
Qnincy , Mass
Richmond, Va
Rocky Mount, N. C
Rutland, Vt
8t. Louis, Mo
Salt Lake ( ity, Utah
San Francisco, Cal
Sacramento, ( al
SandiKky, Ohio
Savannah, Go,
Schenectad v, N.Y
Seattle, Wash
South Hend. Ind
SpriTigficld, Mass
Stcelton. Pa
SteubenTiile, Ohio
Syracuse, K. Y
Toledo, Ohio
Trenton, N. J
Troy, N.Y
Wa.shington, T>. C
Whe<'linp, W. Va
Wichiia, Knn^^
Wilmington, N. (^
Wjjision-Salem, N. C '
Worcester, Mass ]
Cases.
Deaths.
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for June, 1917.
Place.
Connecticut
In !i ma
Iowa
Mi ;. is.-;ippi .
Nevada
Cases reported.
Cases reported.
1 diph-
theria.
Measles.
137
9.S-1 i
Scarlet
fe\er.
114
22
Place.
I>iph- I vp.^i„^
I
North Dakota. .
IN'miv' h -ani;^ . .
Soiiih aroiitia.
WaUiin-tcn....
Wyomiiii;
33
<^1
94
'jitized'
ed-ByXl^j'
HI :
4,3S9 1
7^ t
48.5 I
oo ^1
1_
Scarlet
fever.
32
564
4
89
94
1245
Aufost S» 1917
DIPHTHBRIA* MBASLBS, SCARLET FEVBR, AND TUBratCULOSIS—
Continued.
\ Report te Miqr, 1917.
During the month of May, 1917, 6 cases of diphtheria, 474 cases of
metries, and 8 cases of scarlet fever were reported in Arkansas.
City Reporta for Week Ended My 14, 1917.
City.
OrtrSaOJOOO
Baltimof
Md
Baltimore^ If
Bostoo, Ibw
Chiewo,Dl
C]rrAiid.Ohla..
D«tr»lt,Mieli....
L« Aneales.Oal..
New rock, N. Y.
PhgMlelphi».P«k.
Ftttsbur^Pa...
BtLouli,
Vnb 90O»O0e to MO/XM>
.N.Y....
CfeKimMti, OhM.
I<f»y City, N.J.
— ^ ;Wto..
Newark, N.J
NewOrteus,].*..
8an FraacteOpCal
Seattle, Wsili
yfttttiaetm^D.C
Vnn »D^ to 300,000 inbabit-
m,Ohk)
Dcavet.Coko
ZMiKHAoUs, Ind
JCuKsstltv, Mo
yoryjMid, Ow^
Piorktooce, £L I
Roebcstcr N Y
Flea 100,060 to 10Q|,000 'iaimiaii-
aotK
Albu&y,N. Y
Birmiactuun, Ala
BridRMMft, (^<iiin
Ca^dS^lL
OamdeaTN J
r^ River. Mast ^
Fort Worth, Tex j
Grand Baoids, Mich
HarUord, roirn.
Lawraxoe,Mi
I'ffvelLlUBS.
LrnD.MMas
Meaphia, Tenn
MadiTiOe, Tenn.
Mew Bedford, Mass..
Ntnr Ila>F«ii,Cotm...
Oakkad.Cal
Oaaba,Nebr
Reading, Pa
BiDhmouL Va
fcttXakeCIty, Utah.
ss«4-
1V)Mo,6kio.
TT«ntoo,N.J ,
_ Worceetar, Mass
hmk 20.000 to 100,000 inhabit-
ants:
Akron, Ohio ,
Afientown, Pa ,
Atlantic city. N.J
Bayoon^N.^
Berkeley. Cal
BJnghamtoiv M. Y
Popul*-
tkmasoC
Julv 1,1916
(estimated
by V, 8.
Boreao).
750,479
2,407,722
674,073
671,784
503,812
5,602,841
1,300,518
579,000
7S7,300
408,558
410,476
300,345
416,535
303,454
408, 8M
371, 747
403,516
348,639
363,980
214,878
flO,80D
271,706
2n,847
2K,463
254,960
260,417
104,199
1^1.768
1M,579
Ut,981
101,213
117,224
128,306 ,
104, Mft ;
II^SSO
100,000
U3.M5
10t,42S
140,915 I
117.057 I
U8,158
140, 6)15
198,604
165.470
109,381
I56,G.S7
117.;iW
155. (i24
191,554
in,5W
163,314
!l.5,625
63.5a'» ;
57,r.oo .
69. SW |.
U,97i
Total
deaths
from
all
oausei.
183
597
187
194
1,134
430
161
156
114
77
80
101
143
100
83^
27
28
2S
44
19
16
26
37
47
22
Diphtheria.
5
57
149
29
57
4
257
44
15
40
V
12
17
16
11
7
8
17 "
Measles.
93
173
34
16
26
355
72
63
20
Scarlet
fever.
6
24
159
7
53
9
58
18
4
30
DigitiiJdHay'
Tuber-
culosis.
64
131
394
44
23
45
326
151
30
54
3l
23
6
12
7
5
13
26
74
14
18
16
162
60
10
11
12
11
4
10
18
27
11
3
16
11
4
4
gk
August 8, 1017
1246
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUSratCULOSIS-
Continned.
City Reports for Week Ended July 14, 1917— Contmued.
Popula-
tion as of
July 1,1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
Scarlet
lever.
Tuber-
culosis.
City.
1
1
1
i
1
1
1
1
From 50,000. to 100,600 inhabit-
ants—Continued.
Brorliton, Ma"W
67,449
60,852
60,734
57,144
M,495
63,705
75, 195
76,078
54,772
76,183
72,015
77.214
6S,529
99,437
50,8r>3
57,343
51,155
78.283
58.221
.'>3,794
89.612
92.943
71.744
00, S9.'i
55,042
53.;i30
68,Ha>
99..') 19
57,078
87,039
6S.946
6L120
3l.a,-i.l
6(i,OS3
77,916
70, 722
76, 776
94,265
51.6.16
27.732
37.3S,>
34.204
34,814
32, HW
32, 730
27.632
43,425
46. 192
29.. -^19
26,tt:4
32. m
4<.Ml
3'* >»73
17
18
36
10
14
48
1
4
1
1
1
1
2
Canton, Ohio
1
Charleston, S. C
1
1
Covintrton. Kv
1
2
Duliith, Minn
19
I
El Paso, Tex
6
Erie, Pa
1
5
1
3
28
E vansviUe, Ind
17
16
23
18
14
22
30'
6
21
21
12
3
Flint, Mich
6
4
2
3
2
1
1
1
2
......
3
5
5
4
6
8
1
]
Ft. Wavne, Ind
2
Harrisburg, Pa
1
5
1
1
5
7
1
2
Hoboken, N. J
Johnstown, Pa
2
2
Kansas Citv, Kans
Lancaster, ^'a
3
Little Rock, Ark
...
Maiden. Mass
1
15
3
1
3
2
Manchester, N. H
1
2
Mobile, AH
New IJritaiD, Conn
Norfolk, Va
1
i
1
2
4
Oklahoma City, Okla
Pa^^aic N J
19
17
11
27
6
11
33
14
2
i6
1
1
1
1
2
Rockford, 111 . ....
5
5
2
1
2
1
2
Sacramento. Cal
6
Saginaw, M ich
1
42
1
4
San I>icgo Cal . .
40
1
15
4
Savanniui. CJa
3
Schenectady. N. Y
Sioux City, lowa
5
6
1
Somerville, Mass
9
12
17
11
13
7
■"•s" ::::::
3
2
1
Soiith Hend, Ind
4
5
9
1
46
3
17
5
1
Springfield, III
2
Spriii^'field, Ohio
1
5
1
Terre Halite, Ind
Troy, NY
Wichita, Kans
5
3
2
1
1
1
1
11
2
2
5
3
4
1
Wilke>-Barro, Pa
15
27
4
10
U
4
9
9
1
13
;
9
2
1
1
1
W'ilininjjtou, Del
5
York, Pa
From ri.'JOO to .^ OOOinhabitanUs:
Alameda, Cal
1
1
Anbiim N Y
1
1
Aurora 111
4
1
Austin. Tex
liellingham, Wash..
Brookline, Mass
1
1
4
5
4
1
2
3
2
1
Butler, I'a
Butte, Mont !
1
4
2
6
2
1
Chelsea, Ma^s
1
Chicopec, Mass
2
5
2
2
2
Ciiml>erland Md
1
Danville, III'.
2
1
2
l)ubu<jiio lowa
E.L4 Orange, N.J
FlL'in III
■12.1.VS
2^.2.'.?
;<'),2.j.{
3.'>, J.Mi
41.7S1
4l.Sf;:j
4S.477
3'.,.'^(Vi
31.. '.70
3N.676
31,077
4LO'.»7
!6.:,i:»
27. .s7
5
6
I
10
15
11
8*
13
6
22
15
12
1 S
1
1
1
12
1
'!
3
1
1
1
E\ orrtt Mns»5
Evervlt, Wa^h
1
2
I
3
Fitch' >nrg, M jss
1
1
1
(iaIve>ton Tex . ..
1
Haverlii 1 f. 'Mass
1
1
1
1
2
1
2
33
4
Kaliiiiiaz'K) .Mich.....
4
1
1
2
Kenosha, Wi-;
1
......
1
Kno.wille, Tenn
....^.
La (rosso ^^'ls
1
Lexington. Kv
1
1
1
2
1
2
Lima Ohio
3
Lincoln. .NpIt
■ ■
Long Wt'irh, « al
Lorain, Ohio
t
i;:::::
......
Digitized by
Googfe
1247
August 3, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Goutlnued.
City Reports for Week Ended July 14,
1917
— Continued.
Popula-
tion as of
July 1,1916
(estimated
by U. S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scariet
fever.
Tu
culc
1
1
ber-
)sis.
City.
1
i
1
a
0
1
From 2SJX30 to 50,000 inhabit-
ants—Continued.
I/Tiidibiire. Va
32,940
30,699
47.521
26,234
26,318
29,603
41.133
31,927
30,108
43,715
37,353
31.401
31,404
33,080
46,450
41,185
38,623
39.6.51
.36.798
38,136
46,480
43,28^1
28,926
38,902
27,445
46,236
36,283
48,726
30.570
29,8^
43, 139
43,377
33.800
29,892
31,155
30,863
22.874
15,010
13,59J
21,685
15,794
» 13,075
17,518
22,669
20,743
24.276
• 16,950
23,. 539
20.930
15,395
« 14,610
17,445
13.284
17,500
23, 12»)
15,243
20, 9H.)
> 22,019
19.926
23.S05
17,524
ii.o»;g
12,007
14.831
20.193
13,821
15. .548
21.618
23,228
10
2
13
9
0
12
1
li^adison, Wis......
2
1
3
1
7
1
7
1
1
2
1
Medfonf Mass
1
Montclalr, N.J
1
3
2
Newbnrgb, N. Y
4
New Castle, Pa
12
3
Newport, Ky
8
10
10
20
6
5
7
7
5
5
6
6
8
13
11
9
3
Newport, R.I
2
1
I
Newton, Mass
0
1
......
Niagara Falls, N. Y
1
Norrlstown, Pa
Ogrt«»n, TItfllh
Oraiige, N.J
.
2
2
1
4
8
1
Pasadena, Cal '
1
1
5
1
1
3
1
Perth AmlM>y N. J
Pilt«fleld, Masi
1
Portsmouth, Va.
2
G
Quincy, ni.l
Quincv, Mass ...
2
1
1
Racine, Wis ',
i
1
Roanoke, Va
1
*
Rock Island. Ill
1
2
5
1
1
1
1
San Jose. Cai
1
1
Steubenville, Ohio
8
10
7
3
10
Superior, Wis
2
Taunton, Mass
2
3
1
Topeka, Kans
'I
1
Waltham, Mass
4
17
11
1
1
1
1
W&lertown, N. Y
V«*tHoboken, N. J
VSTweling, W. Va
2
13
is"
15
10
11
5
5
.......
1
ii"
3
3
e'
5
3
2
7
4
1
! 2|
1
1
I
>Vi/iiam^>ort,«Pa
3
]
mimington, N . C
1
U inston-Salem, N C
1
! ft
2
Zancsvi lie, Ohio
2 :::::: i
2
From lO.or^Uo 25,000lnhabitants:
Alton, 111 :
s
6
1
Ann A^^o^, Mich
1
...::j '2
BerUn. N. H
1.
Kraddock, Pa
1
1
»
. .. 1
Cairo. lil
1
Clinton, Mass
2
CkrfTejrvUIe, Kans
1
1
1
Concord, N. H
2;
1
Dunkirk. N. Y
'
(JaJesburg. Ill
5
1
1
1
' \
Harrison, N.J
::;:::!. ..::j.:::.:i...::: .::.::
Keamy,N. J
1
III.
Kcdf^omo, Ind
1
i 1 r
Long Branch. N.J
Mannette, Wis
11
1
1
Melrose, M ass ....
1
"
'
Morristown, N. J
2
Muscatine, 1 owa
1 1 ::;■■■
1
1
Nantlcoke, Pn
2
2
8
8
6
4
Newburypwt, Mass
2
1
1
New London, Conn
11
2
1
(
North Adams, Mass
1
3
1
Northampton, Mass
1 '
1
Plainfield, N J
Pontlac, Jkfich
7
; 11
Portsmouth. N. H
5'
2
5
2
4
2
Rocky Mount, N. C
'
2
Rutland, Vt
1
1
Sandusky, Ohio
2
Saratoga Springs, N. Y
8teelt(Mi,}^
1
1
1
•^
2
Washington, Pa
Wilklnsburg, Pa
1
7
1
90
1 Population April 15, I'UO; no ^
Digitized by
Google
FOREIGN.
CUBA.
Communicable Diseases — Habaiuu
Communicable diseases have been notified at Habana as follows:
Disease.
June 21-80, 1917.
Remain-
ing under
IVI -
June 21-ao, 1917.
Remain-
ing under
Cases.
Deaths.
treat- ^™««.
ment. i
Caaes.
Deaths.
treat-
mmt.
Diphtheria
6
1
6 Paratyphoid fever. .
10 1 1 T vDhofd fever
2
13
2
Leprosy
3
38
Malaria
9
8
1
1
19 1
19 •
1
Varicella
I
Measles
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received During the Weeic Ended August 3, 1917.'
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Prtloiitta
May 20-26
22
108
m
Indochina:
Saigon
Apr. 23-M:ay27....
Feb. 3
163
1
4
1
3
Persia:
Mazanderan Province—
\nilr Kela
Jan. 15-17
Jan. 17
Mwhidpssitr ....
Jan 31
Philippine Islands:
Provinces
June 10-16, 1917: Cases, 134;
deaths, 96.
Albav
Jime9-16
16
44
3
32
6
31
2
11
34
4
27
.1
2
Bohol
do
Capiz
. .. do
Cehu
do
Lcvtc
Sorsogon
do
do
Tayaoas
... do
PLAGUE.
Arabia:
Aden
China:
Hongkong.
India
Bombay
Calcutta
Indo-1'hlna:
Saigon
Cnion of South Africa:
Orange Free State .
June 5-11
May 27-Jane 9.
May 37-June2
May 20-36
Ai«-. 23-May27..
27
15
May 20-26, 1917: Cases, 4,339;
deaths, 3,423.
Apr. ie-22, 1917: 1 <
Apr. 9-22, 1917;
deaths, 17.
Total,
26;
> From medical officers of the Public Health Service, American consuls, and other sources.
(1248) ^ ,
Digitized by VjOOQlC
1249
August 8, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER--
Continued.
Reports Received During the Week Ended Angnst 3, 1917— Continued.
SMALLPOX.
Place.
Dat«.
Cases.
Deaths.
Remarks.
ChlnA:
Aotiiiif
June 11-24.
May 27-June2
3
Varioloid.
Chungiriof
Present.
Dairen
June 3-23
15
1
4
7
10
20
3
1
11
June 9-16
siianghalT
June 11 24
Juno 3-9
Cases foreign; deaths native.
Ttentsiii
Tsingtao .
Juno 12 16
May 27- June 2
Mav3(V26
2
?
42
4
iDdla:
Bombav
Calcutta
Indo-China:
Saigon
Italy:
Tiuin
Apr. 23 May 27. . .
June 1» 24
June 18-24
Juno 17- 30
May 27 June 9
Apr. 15'May 12. . ,
May 13-19
132
12
2
67
4
145
1
Japan:
Kobe
Mexico:
Mexico City .
Portugal:
Lfebon
Ru5.sia:
Petrocrad
RiRa; .
Sweden:
Stockhcdm
MaT 27 -June 2 . . . .
1
Venezuela:
Maracalbo
June I8-July 1 . . . .
TYPHUS FEVER.
China:
Hankow I June&-16
Gr«t Britain: |
Cork • June 17-23
Orewe: I
Salomki May i» June 16.
Japan: I
Nagasaki I June lH-21
Mexico: i
Mexico (lly I June 17 30
Xctherlan^U: t
Rotterdam ' June 9 23
Rus^:
Tetrograd Apr. 15 May 18. . .: 68
Reports Received From June 30 to July 27, 1917.
CHOLERA.
Place.
1 Date.
Cases.
Deaths.
Remarks.
India-
BassiHn
Cakuttfi
... Apr. 1-Mav 5
. .. Apr. 2" M ly VJ ..
8
251
1
1
2
1
15
Madrid
Apr. 22 2^
i
Maiii.Uy
... M;iy r>-i2
Mmilrrc.ii
...! May ir< 19
i*a',..>-ku
.., Apr. .".'-.Miu .-
..! Apr. 21-May lU....
..j Apr. 2-8
1
Rangoon
Ja\*a:
Ea>l Java
30
1
West Java
Apr. 13-19, 1917: 1 case.
r.;il ivia
..' Apr. 13^19
1
Philippine I>lands:
l*ro\incc.>
• 1- •
May 20-Juno 9, 1917: Cases, 519;
deaths, 321.
All»y
.VmljosCamarlncs...
.. Mav2i)^Junc9
..! Juiio.i 9
61
2
207
1
111)
I
41
1
129
Bohol
C-apiz
..I May 20-Juno9
. . June ;}-9 . . .
Cebu
.lo
43
1
Sorsoeon
Tayaoas
do
1 dn
, , I i^r\r^\^
August 8, 1017
1250
CHOLERA, PLAGUE, SMALLPOX, TTPHUS FEVER, AND YELLOW
Continued.
Reports Receired From Jnne 30 to July 27, 1917— Continued.
PLAGUE.
Place.
Date.
Cases.
Deaths.
Remarks.
Arabia:
Aden
Hay 3-30
35
82
^Siffl."''"'='^'''=
CJeylon:
Colombo
Apr.8-Mayl9
Apr. 29-May5
39
Amoy
Presrait and in vicinity.
HonEkonc .... .
May 13-26
8
5
Kwangtiuip Provinee—
Ta-pu district
June 2
Present
Egypt
Jan. i-May 17, 1917: Cases, 2S2;
* Suez
May 12-17
4
12
2
6
1
2
1
deaths, 116
Provinces —
Fayoum
May 11-17
(f ir^eh
May 17
Minieh
May 12-15...
2
3
2
Siout
May 12
Great Britain:
London ;
May 3-8
2In hospital at port. From 8. 8.
Sardinia from Australian and
oriental ports.
Apr. 15-May 19, 1917: CSasM,
30,206; deaths, 39,613.
India
Bassfin
Apr. 1-May 19. ... .
39
242
30
33
411
171
9
52
1
110
2
Bonihay . , .
Apr. 22-Mav26....
Apr. 29 May 19. . ,
Apr. 1-MUV19
....f*.
Calcutta
Uenzada.
Karachi
Apr. 22 May 26. . .
do
400
210
Madras Presidency
Mandalay
Apr. *-Mayl2
Moulmein
Apr. 1-May 12
Myin^van
Apr. 1-7 !
Ran^bon . . .
Apr. 15-Mayl9...
Apr. 8-14
115
Toungoo
Java:
East Java
Apr. »-42, 1917: cases; 18; deaths,
Siirabava
Apr. 2-22
13
5
13
5
Siirakarta
do
Peru
May 16-31, 1917: Cases, IS.
At Mollendo.
At Callao.
AtChiclayo.
Departments—
ArtMjui|ta
May lG-31
4
1
2
1
11
1
callao
do. ..*. .'
]vainl)a vcqiie
do
Libertad
. ...do
Lima
do
Trujillo.
At Lima.
Siara:
Bangkok
Union of South Africa:
Cape of (iood Iljpe Stale-
ly uecnstown
Apr. 22 May 20. . .
10
SMALLPOX.
Australia:
New South Wales I
Brcwarrina i Apr. 27- May 10...
QiiamlKmc.
Queensland -
Tlmrsday l^lnnd Quar-
antineVtulion.
MayO 12
May 6-Junel6..
Brazil:
Bahia
Uio de Janeiro
Can-Ida:
Manitoba-
Winnipeg
No\ a Scolia—
Halifax
I'ort llawkesbury i June 17-30
Cc.vlon: I
' Colombo I May6-12..
.do.
May 9. .
June 10-16
June 18 July?.
16
Apr. 27-May 10, 1917: Cases, «.
From s. s. St. Albans 1mm Kobe
via Hongkong. Vessel pro-
ceeded to Toamsville, Bris-
bane, and Sydney, in «
tine.
Preseotindistilet.
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Aufust 3, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Reedred Prom June 90 lo July 27, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
China:
Amoy„
Apr. 29-May 26. . .
Present and in vicinity.
Present.
Antiipg, . . . , . ......--
May 21-27
1
rhiingkfng. ^ . _
May6-26
Do.
rhangsha - r - -
May 27- June 2
May 13-June 2....
Apr.23-May6....
MayO-26
5
11
7
7
1
Dairen
1
Harbin
On Chinese Eastern Ry.
Hongkong . . .
6
Manchuria Station
Apr. 23-29
May 27-Jime 2
Do.
Mokden...
Present.
Shanghai
May 21- June 10...
May 13-26
8
5
1
25
33
16
Cases foreign; deaths among na-
tives.
Tientsin
Tsitshar Station
Apr. 16-22
May22-Junell...
Apr. 3a-JunolO...
On Chinese Eastern Ry.
At another station on railway,
lease.
Tsingtao.
3
7
Alexandria
G«rmanv
Mar. 18 Apr. 28, 1917: Cases, 715
in cities and 32 States and
Berlin
Mar. 18- Apr. 28...
. . .do
ioG
16
18
50
20
2
10
1
68
Bremen
districts.
Charlottenburg .
do. ..
Hamburg
. . .do
Leipzig . . ..
do
Lobeoi- :::.:::::.:....
. ...do
Munich
do
Stuttgart
do
India:
Bombay
Apr. 22-May 26...
Anr. 2^Mav 19
35
11
5
35
4
8
15
Calcutta
Karachi
Apr. 22-May 10....
Apr. 22-May 20....
Apr.l5-May26....
May 21 -Juno 3
May 27- June 17...
May 2?v-June 3
May 1(3-June 10. . .
Mav 27-June 1.. .
13
66
25
20
50
1
161
Madras
Rangoon
Turin
Jipan:
Kobe
Nagasaki
o^a^.. ..:.:::::::. :
56
1
1
Yokdiama
Java:
East Java
Apr. 2-29
11
16
Mid-Java
Apr. 1-21
West Java
Apr. 13-May 10, 1917: Cases, 46;
deaths, 7.
Batavia
Apr. 13-May3
June 3-10
11
95
2
Mexico:
Mexico City
Monterey :
June 18-24
24
Philippine Islands:
Manila
May 13-June 9
May 13-26
Mar. 1-31
6
4
Varioloid.
Portugal:
Lisbon
Portuguese East Africa:
_ Lourenco Marque*
1
2
Russia:
Archangel
May 1-14
7
186
2
23
Petrograd
Feb.18-Mar.10....
Mar.ll-May5
Mar.15-21
Riga
Jan. 1-31, 1917: Cases, 7.
„ Vladivostok
7
3
5
Spain:
Madrid
May 1-31
Seville
do
„ Valencia
Jnne3-23 ..».
3
5
1
1
2
Straits Settlements:
Mar.l^Mayl2....
Apr. 22-28- .. .
2
Sweden:
Malmo
Stockhohn
May 20-26
Tunisia:
Tunis
Juno 2-8 .
Turkey in Asia:
Trcbizond
Feb. 25- Apr. 13
15
IJnion of South Africa:
Johannesburg
Mar. 12-24
4
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1252
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FFTER, AND YELLOW PEVER-
rontiiiu**d.
Reports Received From June 30 to July 27, 1917— Continued.
TYPHUS FEVER.
Place.
Date.
(ases.
Deaths.
Austria-Hungary:
Austria
Bohemia
Oct.22-Dec.l7....
do
(34
soo
47
617
10
243
5
Galicia
Lower Austria
do ....
Mora\ ia
do
Silesia
do:::::
Stvria
do
Upper Austria
Huntrarv
do
:'
Butiapcst
Fob. 19-Mar.25....
May 30- June 9....
Apr. 30- June 10....
May ia-19
83
2
1,421
China:
Tsingtao
Alexandria
413
15
Greece:
Saloniki
Japan:
Nagasaki
Jmie 11-17
1
7
Java:
Mid- Java
Apr. 1-30
2
West Java
Batavia
Apr. ii. May in....
June;j-lt;
22
1H3
1
2
10
5
Mexico:
Mexico City
Portuguese Kas* Vfrica:
Louren^o Marquez
Mar. 1-31
Russia:
Archan^^cl
Mav 1-14
Petroia"a(.l . .
I>|). is-Mar. 10....
•Ian. 1-31
Mar. 29 .May 21....
May 1-31
... .
3
Rira
Vladivostok
.
Spain:
Madrid
2
Remarks.
Oct. 22-Dcc. 17,
2,371.
1917: Cuei,
Feb. 1&-Mar. 25, 1917: Cases.
1,381.
Apr. 13-May 10. 1917; Cases, 26.
YELLOW FEVER.
Mexico:
Yucatan, State-
Polo
June 23.
In person roceiUly arrived from
Mexico nty.
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PUBLIC HEALTH REPORTS
VOL 32 AUGUST ie» 1917 No. 32
POUOMYEUnS (INFANTEiE PARALYSIS) SITUATION.
A statement of the cases of poliomyelitis reported since Jmie 1,
1917, appears in this issue, b^inning on page 1283. Up to the first
of June the disease had not been reported in unusual prevalence in
any locality.
In June an outbreak developed in Washington County, Vt. Up to
August 4 there had been reported in the coimty 57 cases. Many of
the cases were in the city of Montpelier, which is in this county.
In Ohio an outbreak was reported in Belmont County, with the
principal focus at Martins Ferry.
In West Virginia an outbreak began in July in Marion County, with
the principal focus at Monongah.
In Maryland 15 cases were reported in Allegany County between
July 15 and August 4.
In Massachusetts 18 cases were reported between June 1 and
August 4 at Haverhill, a city of 44,115 population.
In Minnesota seven cases were reported in Blue Moimds Township,
Pope County, between July 22 and 28.
In Virginia 22 cases were reported during July in Rockingham
County.
These are the only localities in which it can be said that outbreaks
have occurred. For the most part the localities involved have had a
comparatively small population and altogether the number of cases
has not been large. While cases of the disease have been reported in
small numbers from most parts of the country, this can not be con-
sidered other than usual.
TYPHOID FEVER AT NASHVILLE, TENN-
There appears to be an imdue prevalence of typhoid fever at
Nashville, Tenn., the number of cases reported during the five weeks
ended August 4 being 7, 10, 40, 24, and 40, respectively.
01 (1253)
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August 10, 1917 1254
EXTRA CANTONMENT ZONE REGULATIONS.
BEGULATIONS GOVERNING THE SALE OF FOOD AND DRINK IN THE SPECIAL SANTTAST
ZONE AROUND CAMP PIKE. NEAR LITTLE ROCK, ARK.
The State Board of Health of Arkansas, on July 24, 1917, adopted
the folloTving regulations **govemmg the establishment and conduct
of all food and drink stands in the special sanitary zone around the
Twelfth Division Army Camp.''
Section 1. The word person used in these regulations shall be confltrued to include
and moan the word person, firm or society, association, copartnership, corporation,
or individual.
Sec. 2. The word food used in these regxilations shall include all articles used by
man for food; food products, drink, liquor, confectionery, condiment, whether sim-
ple, mixed, or compound.
Sec 3. The regulations hereinafter described apply to those persons whose placet
of business are located >\-ithin 5 miles of the cantonment site or the training camp
area in Pulaski County known as the Twelfth Division Army Camp: Provided^ That
nothing in these regulations shall be construed to apply to the cities of Little Rock
and Argenta.
Sec. 4. No person shall engage in the business of restaurant, hotel, lunch counter,
grocery, delicatessen, fruit store, ice cream parlor, refreshment stand, push cart,
wagon, or any place where food or food products, within the meaning of the word
as herein described, are stored, prepared, handled, sold, exchanged, offered for sale,
given away, or intended for human consumption, without first obtaining permit for
the conduct of said place of bu.^'iness as above enumerated, from the health officer
of the State of Arkansas: Prondcd, That any person engaged in the above business
at the time of the promulgation of these regulations within the territory described
in section 3 of these regulations shall procure permit for the continuation of said
business from the health oflicer of the State of Arkansas within 10 days of the date
of the promulgation of these regulations.
Sec 5. No person shall hereafter engage in the business, as herein described, nor
in the business of any hotel, lodging house, rooming house, or public inn, in any
manner or in any capacity and no person shall engage for employment in any of the
above enumerated businesses, any person not in possession of a certificate from a
regular licenced and practicing phj-sician, who is approved by the State health officer,
certifying that the person so employed in the bubiness has been examined by him
within the last 30 da>^ and at that time was free from any contagious, infectious, or
communicable disease of any nature. No person shall engage in the business as herein
described, in any capacity, who is exposed to or has come in contact with any com-
municable disease. Each person engaged in any capacity in the business herein
described shall be vaccinated against typhoid fever and smallpox in a manner ap-
pro\t?d by the State hoalth oflicer.
Skc. G. No person shall etigage in the businoFs herein described or shall maintain
on the premises, cart, wagon, stand, or shall prepare, store, handle, sell, offer for
sale, or give away, barter, or exchange any food within the meaning of the word as
herein described which is not clean, pure and wholesome, and suitable for human
consumption within the broadest meaning of these terms.
Sec. 7. Each person engaged in the business as herein described shall at all times
maintain the premises of the place of business in a clean and sanitary condition.
The place shall be well illuminated and ventilated, free from vermin, foul odors,
dust, dirt, accumulations of wastes and refuse of all character.
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1255 August 10. 1017
Sic. 8. All food within the meaning of the word as herein described, maintained,
or offered for sale or exchange, within the meaning of the words as herein described,
shall be covered by some permanent means such as glass, wood, metal, or pasteboard,
or paper or other suitable material in such manner or means as to adequately protect
it^m flies, dirt, dust, or contamination. No covering other than that of fixed and
permanent character will be recognized as conforming to the requirements of these
regulations.
Sec 9. All utensils used in the preparation, sonice, and sale of any food or drink
within the meaning of these words as herein described, shall be properly and ade-
quately cleansed after being used and no such utensil shall imder any circumstances
be used a second time unelss it shall have been, after such use thereof, so cleansed.
In such cleansing the use of water which has become insanitary from previous use
or water which has not been certified as safe and suitable for human consumption
by the Stat^ health officer is prohibited.
Sec. 10. Watcr-do^ta and privies. — All persons engaged in the business shall provide
a privy which is amply illuminated, ventilated, properly and adequately screened
and otherwise made fly-proof, and the receptacle bo constructed and maintained
water-tight. The dispopal of excreta shall conform to existing State laws regulating
Mune. All privies shall be located at a proix^r distance from the place of business.
Sec 11. Washing fad lilies.— AW such persons engaged in llie business shall provide
waehing facilities, ample for the use of the employees, and these facilities shall at all
times be maintained in a clean and sanitary condition. Running water from an
elevated container, soap, and individual clean towels shall be liimished those employed
therein.
Sec. 12. Persons engaged in the business as herein described shall provide suitable
receptacles for all garbaj^e. refuse, and waste. Such re( cptacles shall be ample in size
and sufficient in quantity to meet the needs of the business; constructed with a tight-
fitting cover of metal. They shall be placed at least 9 inches from the ground, and be
amply removed frorsi the place of business, and emptied at least once every 24 hours.
All garbage, wa.sic, refuse, or other matter within the meaning of these terms shall be
rCTttoved, burned, buried, or otherwise destroyed in a manner conforming to the re-
quirements of existing State laws.
Sec. 13. Water supply.— The water supply for all places of business, as. above de-
scribed, shall be ample in quantity and obtained from a source which has been cer-
tified by the hygienic laboratory of the State of Arkansas as safe and suitable for hiunan
consixmption. The water pupply, if drawn from the di?tributing system of the com-
munity or <nher source and stored in such places of business, shall be drawn, stored,
and maintained in such a manner as to preclude all possibility of iwllution or con-
taminaiifui l»y any matter or by any means which will render the water uncleanly
in its broadcH meaning, or unsuitable for hiunan consumption.
PUBLIC HEALTH ADMINISTRATION IN SPRINGFIELD,
OHIO.
By CAijROLL Fox, Surpeon, United States Public Ilenlth Service.
The following report gives the results of a study of health or-
ganization and administration in the city of Springfield, Ohio. The
study was carried on throughout a period of approximately two
months, from February 19 to April 14, 1017, and included investiga-
tions in both tlie office and the field.
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I
AngoBt 10, 1917 1256
Springfield is a prosperous city, situated in the southwestern sec-
tion of the State of Ohio, 80 miles north of Cincinnati, 25 miles
northeast of Dayton, and 45 miles west of Columbus. It is the county
seat of Clark County. A small stream, known as Buck Creek, passes
through the city. This creek empties into the Mad River just with-
out the city limits.
Springfield is a manufacturing community, surrounded by agri-
cultural country. Among the industries of magnitude may be men-
tioned the manufacture of road rollers, agricultural implements, gas
and gasoline engines, steam radiators, windmills and pumps, auto-
mobile trucks and pleasure cars, emery wheels, chemicals, flour mills,
steel structural work, house furnaces, electric fans and motors,
coffins and caskets, productive machinery, piano plates, and motor
washers. Springfield is also noted for its horticultural industries.
The city is served by four railroads (the Big Four, the Pennsyl-
vania, the Erie, and the Detroit, Toledo & Ironton), in addition to
five traction lines.
The population figures used in this report were obtained from tJie
United States Census Bureau, which estimates the population as of
July 1, 1916, at 51,550. The colored population of the city is 5,350.
For assistance and information received during the coui-se of this
study acknowledgment is made to the officials of the health and
other city departments and to other citizens connected with various
charitable organizations or otherwise interested in public health.
ORGANIZATION AND ADMINISTRATION.
The city of Springfield is under the commission-manager form
of government. The commission is composed of five members,
elected from a nonpartisan ticket. This commission appoints the
city manager as the administrative head of the municipal govern-
ment. He in turn is authorized to appoint certain of the city officials
as deputies in departments over which he has immediate control.
Among these deputies is the health officer, who is officially known as
the director of public health.
The activities engaged in by the health department are the regis-
tration of births, deaths, and diseases; the control of diseases, in-
cluding the operation of an antituberculosis dispensary and field
work in connection therewith; the maintenance of a diagnostic labo-
ratory; the inspection of milk and other foods; the abatement of
nuisances; plumbing inspection; and the treatment of the indigent
sick.
Personnel, — The personnel of the health department, together with
their respective salaries, is at present as follows:
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1257 August 10, 1917
1 director of healUi (full time) $2,500
1 assistant director nud city physician (full time) 1, 500
1 public-health nurse * 1, 080
1 public-health nurse 960
1 dairj' aud focxl inspector aud city veterinarlau 1, 400
1 sanitary inspector 900
1 plumbing inspector 1, 400
1 clerk 840
1 poundmoster (six months) ' 480
1 laboratory attendant, paid at the rate of 15 cents per hour for not more
than 100 liours per month.
The director of health. — The director of health is a physician, ex-
perienced in public-health work. The city manager makes the ap-
pointment and it is to him that the director is responsible for the
work of the health department.
The powers and duties of the health officer are defined by State
laws. In addition he is required to enforce the city oi-dinauces per-
taining to health and sanitation and to perform such other duties
as the city manager may direct.
The duties of the director may be defined as administrative, epi-
demiological, bacteriological, and professional, the latter furnished
at the dispensary for the treatment of the tuberculous and the indi-
gent sick.
The assistant director of health. — The assistant director is in
reaUty the. city physician. His duties are mainly concerned with
the treatment of the city's poor, and professional services furnished
to the city jail. He is I'equired to respond to night calls. He is em-
ployed on full time and, therefore, is in a position to assist the di-
rector in work of a strictly public health nature as well as to perform
the duties of a city physician.
During the year 1916 the work performed by the health depart-
ment on account of diseases other than those affecting the public
health included 792 visits made to homes of sick persons, 335 treat-
ments given at the dispensary, and in addition there were 37 physi-
cal examinations made for the police and fire departments.
The clerk. — ^The clerk of the department has numerous duties to
perform. He is telephone clerk, vital statistics clerk, complaint clerk,
order clerk, license clerk, record clerk, bureau of information, and
stenographer and typewriter.
The sanitary inspector. — The sanitary inspector is engaged in the
customary duties of that office, including the posting of placards and
fumigations.
Office hours. — The office, dispensary, and laboratory are located in
the city hall. The official hours are from 8 a. m. to 5 p. m.. with one
* The salary of this niirso is psild by Iho FMloraUMl (Mul)S.
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Anguit 10, 1917 1258
hour for lunch every day except Saturday, Sunday, and holidays.
On Saturday the office closes at noon. On Sundays and holidays it is
closed, but burial permits may be secured from the residence of tiie
dii*ector or the clerk.
The dispensary is open to the tuberculous from 1 to 3 p. m.
on Tuesdays and Fridays, and for the treatment of the indigoit
suffering from other ailments frcnn 8 to 9 a. m. and 1 to 2 p. m., daily.
Each employee may be granted two weeks' vacation a year with
full pay.
Transportation. — The director, the assistant director, and the dairy
inspector are each furnished with inexpensive automobiles. This
form of transjiortation enables these officials to perform a large
amount of work efficiently and expeditiously at a reasonable figure.
During the year 1916 the cost of operating the three machines was
$()30.90, or $210.30 for each machine, including gas, oil, tires, and
repairs. Tliis amounts to but 67 cents per machine per working day.
The phimbing inspector is furnished with street-<;ar tickets. TV
sanitary inspector and nurses ride free on the street cars.
Dissemination of information, — Except for the annual report, there
is no bulletin published by the health department. On a few occa-
sions public health exhibits, including the State board of health
exhibit, have been shown, and talks on public health subjects arc
occasionally given. Articles of a public health nature are published
in the newspapers from time to time.
In order that bettor cooperation may be obtained between the vari-
ous local health officers throughout the county and that uniform
procedures may be established, the director of health has been instru-
mental in organizing the Clark Coimty Health Officials' Association,
which meets once a month at the health department in Springfield.
Here talks are given and there is an interchange of ideas. It is an
educational feature that should be productive of great good. Very
frequently a representative of the State board of health is in attend-
ance at these meetings.
Discussion, — The system of government in the city of Springfield,
when considered with the efficiency of the officials in charge, may be
said to be one approaching the ideal. Under this fonn of govern-
ment there has been developed the nucleus of a health department
which requires only a little financial aa^istance and the cooperation
of the people to expand into a highl}'' efficient organization.
The cooperation of the people can be obtained only after a cam-
paign of education, which has not in the past been carried on to an?
great extent. It is thought that the scheme of education which will
produce the best results is that which will instruct the school children
on the subject of disease prevention. To accomplish this it would
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1259 August 10, 1917
be advisable for the board of education to place the health officer
on its staff, he to give lectures on public health once a week in the
high school, and if time will permit, in the grade schools as well.
The health department shouhl then publish a small weekly bulletin
to be distributed to the children at the close of the lecture and to
contain briefly the subjects v. hich have been lectured upon.
This course in public health ^should be made a part of the regular
curriculum and the pupils should be made to pass an examination
upon it, as in the case of other subjects taught.
The health department has been making very conunendable efforts
to keep accurate statistics on births, deaths, diseases, etc. Such sta-
tistics, together with the record of expenditures, are the bookkeeping
of the public health, and it is only by comparison of these various
records that the health department can determine its profits and
losses. It is a difficult matter to keep accurate figures with continual
interruptions, and it is thought advisable to employ an additional
clerk, who could act as telephone clerk and bureau of information
and thus permit the clerk already employed to devote his time purely
to clerical matters.
As is usual in most health departments, the sanitary inspector is
engaged to a large extent in the abatement of nuisances which have
little or no bearing upon the public health. He should be in a posi-
tion to devote his entire time to the elimination of those nuisances
which are really important from a public health standpoint, such as
surface privies and surface wells, accumulations of manure, and
mosquito breeding centers, and to the enforcement of the requirement
that householdei"s provide themselves with garbage cans.
The abatement of such nuisances as bad odors, ash heaps, dead
dogs, chickens, slop water, etc.,^ should be left to the police. The
cleaning of alleys is as much a duty of the btreet department as is
the cleaning of streets and should not be made a duty of the health
officer. An ordinance requiring the cutting of weeds is needed, but
this matter should be placed in the police depnrtment for its enforce-
ment.
It is necessary that the work of the employees of the health depart-
ment be systematized and it would be wise to formulate a book of
instructions, so that each employee of the department would know
exactly what were his or her duties, authority, and jurisdiction.
REGISTRATION OF BIRTHS AND DEATHS.
The registration of births and deaths is carried on under the
authority of State law. The health officer of Springfield is the local
registrar for the city and the adjoining townships. The registrar's
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August 10, 1917
1260
fees paid by the county to the registrar are transferred to the city
treasury and may be made available for carrying on public-healA
work.
Registration of deaths. — During the year 1916 there were reported
as occurring in the city of Springfield 849 deaths, exclusive of still-
births, making a crude death rate of 16.4 per thousand.
Of the above deaths, 417, or 49 per cent, were due to diseases or
conditions which might be classed as preventable, according to the
information contained on the death certificates.
During the same year there were 95 deaths of infants under 1 year
of age. The infant mortality rate was 80.3 per 1,000 births.
The number of stillbirths reported during the year was 59.
Among the colored population there were 98 deaths, exclusive of
stillbirths, making a death rate of 18.3 per thousand. Of these
deaths, 11 occurred in children under 1 year of age. The infant
mortality rate for colored was, therefore, 98.2 per 1,000 births.
Registration of births, — During the year 1916 there were reported
as occurring in tho city of Springfield 1,183 births, exclusive of still-
births, making a birth rate of 22.9 per thousand.
The number of births among the colored population was 112,
making a colored birth rate of 20.9 per thousand.
Recapitulation.
White.
Colored.
TotaL
Population
46,200
751
16.2
5,350
98
18.3
51,550
849
Number of deaths
Death rate per 1 ,000
16.4
Deaths duo to preventable causes
417
Deaths In infants under 1 vcar
84
78.4
1,071
23.1
48
a
08.2
112
20.9
11
95
Infant mortality rate per 1,000 births
803
Number of births
1.183
Birth rate per 1,000
S.9
StiUbirths
59
The following table gives certain statistics relative to morbidity
and mortality compiled from death certificates filed in the health
department during the year 1916 :
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1261
Anpjst 10, 1917
Diseases.
Total
deaths,
aUages.
Death
rate per
100,000.
Number
ofcaso«5
reported.
Ca.«»e
fatality
per 106.
Death!
under 1
voar
o^age.
TnNvc9il<k5is, pilrncff^fUT'.
61
11
74
17
35
7
t
10
7
11
1
4
1
118.3
21.3
143.5
32.9
48.4
13.5
7.7
5.8
19.3
105
Ti^herailadK, oth^r fomu
1
fWmnonia. .' .. , x^ , x
12
SO
14
TrplKrfdfeYCT
21.2
fnoiKIlza
Meiries
919
51
105
246
.7fl
7.8
2.8
4.0
t
Diphtheria
Scarlet fever
WhocntiDs cou£h
3
Mci5Ss.^T.;/.:::::::::::::::::::::::::::::::::
2
Septicemia
Kmiprias
SypMlis
8
1
302
9
5
7
4
4
2
Trcanus
Chicken pox
Oooorrhea.
Mumps
'
Smallpox
Trachoma
Diarrhea and entwiUs
29
7
38
6
47
18
13
23
17
Other inlectlotu
..................
MaUfnant growth 3
73.7
1
Occupatioo accidonto
Other accidents
Premature
18
Convulsions, malnutriti(m, etc
13
Other causes peculiar to early infancy
S3
Total
417
05
EPIDEMIOLOGICAL ACTIVITIES.
Report of Diseases.
The notification of diseases is required by law and by the regula-
tions of the State board of health. These regulations are baaed on
the model law for morbidity reports.
Methods of procedure, — In reporting diseases physicians usually
make use of the telephone. The information reported is noted tem-
porarily on a blank form, which is referred for necessary action to
the official responsible for the enforcement of the regulations to pre-
vent the spread of the disease. It is likewise entered on a card for
the permanent records of the department, ns well as on a morbidity
report card, which is forwarded weekly to the State board of health.
Control of Diseases.
Requirements of laws and ordinances, — The reciuirement*? of State
laws have been summarized in a previous report. It is not thought
necessary to summarize the local ordinances.
Methods of procedure, — ^The State laws form the basis on which
are applied the preventive measures for the control of the communi-
cable diseases.
A record of certain data, as for instance the date of release of quar-
antine, date of fumigation, number of children in household, etc.,
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Ausust 10, 1917 1262
is made on the morbidity report card filed as a permanent I'ecord of
the department.
An epidemiological history is obtained of each case of smallpox
and typhoid fever, the former by the health officer or his assistunt,
the latter by these officials or by one of the nurses.
At least one follow-up visit is made by a nurse to each case of
typhoid fever and diphtheria, and some supervision is maintained
over tuberculosis.
In the case of scarlet fever and diphtheria houses are placarded by
the hen 1th officer or his assistant, who at the same time gives the
necessiiry instructions relative to isolation of the patient, quarantine
of contacts, etc. In the case of other disease, placards are posted
by the sanitary inspector, who also performs the fumigations re-
quired by law.
After recovery from a communicable disease a certificate is fur-
nished to the patient, stating that he has had such a disease. This
is not only of value for future use in determining immunes but also
serves as authority to return to school.
A monthly record sheet, to serve as a " daily reminder," is kept,
shoAving the name and address of patient and the diagnosis for each
disease requiring quarantine, together with the date on which quar-
antine is due to be raised.
The school is notified whenever a pupil has, or is exposed to, a
quarantinable disease.
The following table shows the amount of work engaged in by the
health department during 1916 in matters relating to quarantine and
kindred subjects:
Total number of houses quarantined 1,150
Total number of throat cultures taken 400
Total number of persons given antitoxin 22
Total number of vaccinations made 108
Total number of certificates of Immunity issued 980
Total number of medical examinations made for differential diagnosis.. 306
Total number of houses fumigated ^ 196
Total number of rooms fumigated 563
Typhoid fever, — Typhoid fever is endemic in the city of Spring-
field. During the year 1916 there were 80 cases notified, with 17
deaths, making an indicated death rate of 32.9 per 100,000, and a
case fatality rate of 21.2 per cent. The number of cases of typhoid
fever reported during the years 1914, 1915, and 1916, as well as for
the combined periods, is shown in charts 1 and 2. The records for
the years previous to 1914 are not complete and have, therefore,
not been used.
The health department is now making a careful epidemiological
study of v\\r\\ case of t\ plioid fever as it is reported, but as yet there
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1263
August 10, 1917
is not sufficient data on which to base conclusions. Previously the
investigations as to the source of the infection were confined almost
entirely to the milk and water supply of the households
Houses are not placarded for typhoid fever.
d6
34
51
30
Jan.
Feb.
Mar.
Apr.
MAY
June
July
Au&
Sot
Oct.
Nov.
Dec.
•
'
%
\
/
\
2t
"/
\
26
Zt
20
/
V
\
Si23
ft
lb
14
It
10
8
6
4
9
\ '
1
\
\
'9
\
A
A
w
J
r 1
Vy
r\
J
y
Y/
H
^
J^
A
1
CnAOT I.' — OMes of typhoid (erer reported by months, three-year period, 1914-1910.
Diphtheria, — ^During the year 1916 there were 51 cases of diph-
theria notified to the health department,* with four deaths. This is
an excellent record, meaning an indicated death rate of but 7.7 per
100,000 and case fatality rate of but 7.8 per cent.
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August 10. 1917
1264
When a case of diphthoria is reported the house is placarded and
quarantined, a culture from the wage earner is taken, and an im-
munizing dose of antitoxin given to contacts, either by the attend-
ing physician or a physician of the health department. Antitoxin
is issued free of charge, both for treatment and prophylaxis. At
2e
If
16
n
It
10
8
4
2
• 0
Jan.
Fea
Mak.
Apr.
May
June
July
Aud
Sept.
Oct.
Nov.
Dec
*^
b
V
\
X
W
6
\
\,«
\
'
V
\
/
>
V
A
/
\.
y
r \
V-
A
J
i-_
*^
N/
10
8
6
♦
z
J?
19
6
U'
>-
^\
v
^
\
/
V
5_
3
..i
.y
\
^
N
L.
-^
n/
to
8
4
2
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W
r
Chart 2. — Cases of typhoid fever reported by months, 1914, 1915, 1916.
the same time cultures are also taken of contacts outside of the
household, including pupils of public and parochial schools. The
patient is released from quarantine after two successive negative
cultnros are obtaim d, taken not less than 48 hours apart. At the time
of taking the kccoik] cnlture, swabbings are also made of contacts
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1265 AQfost 10. 1017
in the household. Routine cultures are taken either by one of the
physicians of the health department or one of the nurses.
If practicable, cases of diphtheria are isolated in the hospital,
when adequate isolation can not be obtained at the home. In this
case, all contacts are released without quarantine immediately after
finding the nose and throat free from diphtheria bacilli.
The isol<ition hospital. — ^The isolation hospital is conveniently lo-
cated on the grounds of the general hospital, operated by the city of
Springfield. It is a brick and wooden structure, formerly a residence,
and is now out of repair. It contains two bath rooms and eight other
rooms, one of which must be used by the nurses in attendance and
one for a diet kitchen, which leaves six rooms for ward purposes.
Fourteen patients may be isolated without overcrowding. The pres-
ent condition of the building makes its use as a hospital undesirable,
and taking into consideration its age and construction, as to material
and design, to remodel would be impracticable. The building at pres-
sent is not in use. Plans are completed for a new building which will
be constructed in the near future.
Tttbeimdosis. — During the year 1916 there were reported to the
local registrar 61 deaths from pulmonary tuberculosis. During the
same period there were notified 105 cases. The indicated death rate
was 118.3 per 100,000. There were also reported 11 deaths from
other forms of tuberculosis, making a death rate from tuberculosis,
all forms, of 139.6 per 100,000.
The antituberculosis dispensary. — ^The city health department op-
iates an antituberculosis dispensary, which is open twice a week with
a doctor and a nurse in attendance.
Patients are referred to the dispensary from various sources, in-
cluding phyacians of the city, the city hospital, and the visiting
nurses.
Such information as may be necessary subsequently to identify an
applicant for relief is entered in a ledger. The personal and family
history and the results of physical and laboratory examination, to-
gether with the advice and treatment given are entered on a filing
card devised for the purpose. On another card is noted the informa-
tion relative to temperature, pulse, weight, etc., obtained from time
to time at subsequent visits.
Patients are provided with paper napkins and medicines free of
charge.
Each case is followed up by a visiting nurse, who gives the neces-
sary advice as to the right way of living to effect a cure and to pre-
vent the spread of the disease to others.
A record of her visits, together with the social history of the
patient, is kept by the nurse in a separate file.
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August 3. 1917
V2
•J
CHOLERA. PLAGUE, SMALLPOX, TYT
Coiiti
Reports Received From June ^
TYPHI'S
i-.^Bf^^^ -■* *'-*J
Place.
Dntc.
AusUia-Huniniry: i
Austria
Bohoraia I 0<jt.23-D©c.l7..
(•alicia I <lo
Lower Aastria j do
Maravia i do
SUesia I do
Styria ! do
Upper Austria i do
HuniTiu-v.
Klai
Bu(lape5)t I Fell. 19-Mar.25.
China: ,
TsiiiKtfto : May 30-Jujic y
Alexandria ! Apr. SO-Juno lo.
Greece: !
Sttloniki May la-lU....
Japan: !
Nagasaki Jiine U-17....
Java: I
Mid- Java 1 Apr. 1-30...
\Vest Java
Batavia ' Apr. la-.Muv i
Mexico: I
McxlcoClty t Junc3-1«/...
PMtugiicsc I.a>' \frica: !
Loiirertvo Morqiiex Mar. 1-31. .
Rua^ia: I
Archan^l Mav 1-14..
PeiroKia*! IVii.ls Mor.
Ki'a ' .lau. I.il..
Vladivostok NLir. 2«J - Mn\
Spain: \
Madrid ' Ma> U3I..
YK.
Mexico: ,
Yucatan, State— '
I'cto June 23.
m*
•It
_— -^*
^■t
^ ■■■•
Digitized by VjOOQIC
1267
AngoitlO.lftlT
PtBllCIL:_
an infant welfare camp, at which are em*
ndniits and nurses.
■y where the parents can not afford to buy it.
i€t4^d to pay if only a small part of the actual
A nurse», — There are two public-health nurses
I errision of the health officer, one of whom is
. 1 tinent funds and one by the federated clubs.
me nurse employed by the board of education,
i, iQ Life Insurance Co., and the, antituberculosis
inve>;tigator, who is not a nurse. These em-
►PT the eontnil of the health department.
f!n«Mit nurs.s are engaged in practically all of
'.a iii a 1 nltlic-health nurse, including prenatal
work, communicable disease nursing, some school
and di^pen^ijii'v work in the health department.
i» made to each case of typhoid fever and diph-
rrigion is omintained over cases of tuberculosis.
I'k i?^ carrit'd on during the winter. During the
'f this clas^i of work is performed by the infant
^'(1 ilivitU^d inlro two districts, one for each nurse.
" [aiixni to kt'up daily records of visits made, with
^ isits puid tii cases of tuberculosis, together with
"f'iiil ^tutti^ of the family.
' '^^ pnpil n^irst s are detailed from the city hospital
'Hment to receive instruction and practical ex-
J"*u lu^siltli nursin^f;. This is an excellent idea.
•iri|p tflbtt^ indicates .he field work performed by the
ctf the henlfch depurtment during the year 1916. One
'"fv fhirini!: the entire year. The second nurse did not
r •. -nei^ until Otober, so worked only during the last
'•f tiw year.
•i^r**_
— — ^ 879
-— ~^— ., 90
^-----,_^,_ _ _ _ 183
fci dl|ihl|ii.rl«^ " ~ Q7
^vf^r. ______ ;_;~^^- ^^
^"*u^U^^^l '
^^ -— — ^-^„ JL 78
^^''———^^-^ 162
—~ ^. 7
— — ^^ ^ ^^ 60
^— — ^-^_ 25
tUi^
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August 10, 1917 1266
During the year 191C the following work was clone in the anti-
tuberculosis dispensary :
Nuuil)er of new cases treated IDS
Number of oUl ciises treatnl W
Total visits to dispensary 238
Number of patients referreil to tuberculosis bospital 41
The tuberculosis sanatorium, — The tuberculosis sanatorium is t
four-county institution, pleasantly located just without the limits of
the city of Springfield. It is composed of a community cottage for
both male and female patients, 14 small cottages, a nui'ses' quarters,
and an administrative building, originally a private resilience, in
which are located a dispensary, office, the main kitchen and dining
room, quarters for the help, and rooms for the care of advanced cases.
The physician in charge docs not reside on the premises.
The normal capacity of the institution is 40 patients. There are
at present 41 inulergoing ti*eatment, most of them citizens of Spring*
field.
The water supply is deiived from a drilled well and is furnished
to the buildings and grounds under pressure from a pi'essure tank.
Sewage is disposed of by means of a sci>tic tank and filter beds.
The community cottage, administration building, nurses' quarters,
and laundry are connected to the sewer.
The sanatorium operates its own dairy and chicken farm, and
products are raised from the soil.
The antituberculosis leagu4^, — This league is a charitable organiza-
tion which employs one field agent or investigator whose duty it is io
mvestigate the social status of families in which there is a case of
tuberculosis and who have applied for material assistance. Supplies,
including milk, eggs, coal, etc., are issued free of charge to worthy
applicants. The paper napkins used in the dispensjiry of the health
department are furnished by the league. The league will also support
patients in sanatoria. While most of the public-health activities con*
cemed with tuberculosis are now carried on by the health department,
a certain amount is still performed by tlie investigator of the league
who has not the qualifications of a public-health nurse.
A portion of the income of the antituberculosis league is derived
from a percentage of the profits accruing to moving picture houses
at Sunday shows.
The infant welfare society, — During the period from April to
September, inclusive, the infant welfare society, a charitable organi-
zation, employs a nui*se to do infant welfare work in the field and
operates a dispensary located in the courthouse, where children may
be taken for a<lvicc aiul treatment. Physicians give their services
free of char^'o. The s<)cioty also maintains during the hot months of
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1267 August 10, 1917
the year, July and August, an infant welfare camp, at which are em-
ployed the necessary attendants and nurses.
Milk is issued free only where the parents can not afford to buy it.
Otherwise they are expected to pay if only a small part of the actual
price.
The pubUc-health nurses. — There are two public-health nurses
working under the supervision of the health officer, one of whom is
paid from health department funds and one by the federated clubs.
In addition there is one nurse employed by the board of education,
one by the Metropolitan Life Insurance Co., and the antituberculosis
league employs one investigator, who is not a nurse. These em-
ployees are not under the control of the health department.
The health department nurses are engaged in practically all of
the activities required of a public-health nurse, including prenatal
and infant welfare work, communicable disease nursing, some school
nursing in the field and dispensary work in the health department.
At least one visit is made to each case of typhoid fever and diph-
theria, and a supervision is maintained over cases of tuberculosis.
Infant welfare work is carried on during the winter. During the
summer the bulk of this class of work is performed by the infant
welfare society.
The city has been divided into two districts, one for each nurse.
The nurses are required to keep daily records of visits made, with
special record of visits paid to cases of tuberculosis, together with
a card giving the social status of the family.
When practicable, pupil nurses are detailed from the city hospital
to the health depaitment to receive instruction and practical ex-
perience in public-health nursing. This is an excellent idea.
The following table indicates .lie field work j^erformed by the
nursing staff of the health department during the year 1916. One
nurse was <mi duty during the entire year. The second nurse did not
enter upon her duties until October, so worked only during the last
three months of the year.
Visits made on acoount of —
Tuber< iilosls 879
Typhoid fever 90
Diphtheria 183
ExiH>sures t<» diphtheria 97
Scarlet fever 159
ExiKisures to soarlot fever « 18
Whooping cough 69
Measles 78
Chicken pox 162
Mumps 7
Sore throats 60
Trachoma 25
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August 10, 1917 1268
Visits made on account of — Continued.
Ophthalmia neonatorum 22
Varltws diseases of the eyes 119
Prenatal 170
The puerperal state 91
Infant welfare 186
Medical and surgical 210
Miscellaneous 446
Total - 3.071
Number of throat cultures taken ^ 307
The Diagnostic Laboratory.
The city health department maintains a bacteriological laboratory,
equipped to perform all necessary examinations of a routine nature.
A part-time laboratory assistant is employed, but most of the teclini-
cal work is done by the health officer, the assistant health officer, and
the milk inspector.
In the laboratory are performed examinations for the diagnosis of
diphtheria, the release from quarantine, and the detection of carriei's;
examinations to determine the Widal reaction and the presence of
tuberculosis, gonorrhea, and ophthalmia neonatorum. Analyses of
urine are rarely made. The milk inspector examines, bacteriologi-
cally and chemically, all milk samples collected. Well and city
waters are also analyzed bacteriologically, the former when it may
bear some relation to a case of typhoid fever, the latter only occa-
sionally.
Three specimen outfits are furnished to the physicians of the city.
These may be obtained free of charge from various drug stores
designated as distributing stations.
The outfit to be used in suspected typhoid fever contains an alumi-
num foil and a small wire loop. In the case of suspected tuberculosis
a wide-mouth bottle is furnished, while for diphtheria the outfit con-
tains two sterile swabs in a sterile tube.
Each outfit is accompanied by a card on which to note the necessary
data, and which contains directions for the collection of the speci-
men.
A record is kept by the filing-card system of all examinations
made.
During the year 1916 there were made in the laboratory 3,791
examinations, as follows :
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1269
August 10, 1917
Positive.
Negative.
Total.
For tobgfcniorig ^ . ^ . . u .. x ^ . ^
75
29
26
16
4
164
214
119
295
19
2
2
239
FordipfatherU:
DiafDOfiS ••• .......X..XXW ax wxxxxax X
243
Bftlease of quarantine
145
Contacts..^
311
Fort7plioidr«Ter(Wldal)
23
r-_ .Xit-Tjl— jT /.-xxaa.xx.a.x**.*.x_**.**.* *
2
Fflropbtlnhnianecnat<mni xx.x.x*x.*xxxx..x . . , ..
2
Urtae'analiTihi..ax....,.xx x.xx ....xx.,....u..*.a...... x..*.* x x
8
Water analysis:
Wallorsprins......
55
aty;!^^!^?^ii:;i;i!ii;;:::;:::;;;;:;::;:;::;;:;::::;:;;:::::;::::::
24
Biver
1
Milk analysis:
Bacteriolodcal
872
chwnkai^ . ..".. r ;r II 11
928
Visible dirt
928
Grand total
150
815
3,791
Disciissioii.
According to the modem view, a proper supervision over the
individual who is sick or who has been in contact with one who is
fiick is of more importance than a supervision over the environ-
ment, for it is the animate and not the inanimate things which are
most concerned in the spread of the communicable diseases.
A very important factor in the control of disease is, therefore,
the public-health nurse. It is the nurse who reaches the homes of
those persons who are most in need of instruction and nursing care
and who can ill afford to pay for it. The work of two nurses in
a city the size of Springfield must necessarily be superficial, and
it is therefore believed advisable for the city to employ two addi-
tional nurses, who, with the one already employed and nurse paid
for by the federated clubs, woiild make a staff of four nurses.
The city should then be divided into four districts and a nurse placed
in each district to carry on within her district all of the duties
required of a public-health nurse.
It would be still better if the school board could be induced to
employ an additional nurse and then to combine its nursing staflf
with that of the health department. The antituberculosis league
should employ a nurse instead of an investigator and attach her to
the health department. This would give the health department
seven nurses, and the city could be divided into seven districts,
making the work still more effective.
The work performed by the child welfare society is of great im-
portance. It pertains strictly to public health and is therefore a
governmental fimction and should be taken over by the city and
made a duty of the health department, which could carry on the work
during the entire^ year. Steps in this direction have already been
taken, since for the year 1917 the city has appropriated to the society
the sum of $2,000, which will be spent under the direction of the city
manager.
92
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10. 191T 1270
It is planned to add a wing to the present city hospital, and ampk
provision should be made for an airy ward for the care of diildPHL
To carry on the child- welfare work extensively every birth re-
ported should b? followed up by a visit to Uie home. Upon the first
visit the nurse should be provided with a " certificate of registration''
to be presented to the parents. Such certificates would have to be
provided by the health department.
The typhoid- fever death rate in the city is very high. All of tiie
factors concerned in its spread are present in the city, including the
surface privy, the surface well, flies, contacts, a water supply which
at times shows evidence of contamination, and a milk supply which,
though 95 per cent is pasteurized, is not always of certain purity
because the " flash " method is used in some cases, and this method
is unreliable. All of these things should be corrected without delay.
Typhoid fever should be made a placardable disease, and dis-
infectants should be issued free of charge.
All children should be required to be vaccinated against smallpox
before they are permitted to attend public or parochial schools.
A bacteriologist should be provided for the laboratory of the
health department, and it is suggested that the laboratory might be
made available to all of the physicians and health officers of the
county, and that financial aid might be received toward its main-
tenance from the various townships, or the county commissioners.
It is highly satisfactory to know that the city of Springfield has
plans completed for the construction of a modern isolation hospital
for the isolation of the communicable diseases, including smallpox,
to occupy the site of the present hospital. It should contain not
less than 30 beds. It should be operated by the city general hos-
pital, but the admission and discharge of patients should be left to
the health officer.
MUNICIPAL ENGINEERING ACTIVITIBS.
The water supply, — The municipal water supply is a ground water,
obtained from a large dug well located in a valley about 3 miles
from Springfield. Through this valley runs a stream, known as
Buck Creek. The actual water-bearing stratum consists of a natural
gravel bed on each side of the valley from 16 to 20 or more feet in
thickness and extending down to clay. That part of the gravel
basin from which the water supply of Springfield is obtained has
an area of about 35 acres and is limited above by an outcropping of
the hardpan, while below a curtain wall of concrete has been con-
structed extending from the creek to high groimd to conserve the
ground water, causing it to back up into the well instead of flowing
on down the valley.
During warm weather, when the ground water is low and the
amount of v nter pumped is excessive, not enough water filters into
1271 August 10. 1917
the well to supply the demand, so that it has been necessary to
resort to an underdraining system extending up the valley as far
as the outcropping of the hardpan and having its outlet into the
well. In addition to this it is necessary at times artificially to
augment the natural ground-water supply by flooding the surface
of the ground with water from the creek by means of a sluice way.
The underdrain has the effect of diminishing the amount of filtration
and percolation that naturally takes place and forms a more or less
direct means of communication between surface water and the well.
Flooding the land with a polluted water places an added burden
on the natural filter bed between. the surface of the ground and the
underdrain and is a dangerous procedure.
In order permanently to increase the supply of water for present
and future needs, it has been suggested that the system of under-
drains be extended above the outcropping of the hardpan, and then
cm up the valley where water may be obtained in abundance. This
extension would include the utilization of water from a number of
springs, one of which is said to flow about 7,000,000 gallons per day.
The advisability of such a procedure must be left to the sanitary
engineers, and it is therefore suggested that before taking any action
a comprehensive study be made of the situation with a view to
securing a permanent supply that will be satisfactory both as to
quantity and quality. Certain it is that the quality of water from
surface wells and springs in a limestone country is uncertain.
The Springfield water is always clear, but bacteriological exami-
nations made at infrequent intervals show at times evidence of the
presence of colon bacilli. Daily examinations should be made cover-
ing a long period through varying conditions. It is also thought
that it would be good practice to install a chlorine plant and treat
all water before furnishing to the consumers. Such a plant could
be installed at little expense and would serve until such time as a
more permanent source of supply can be developed, to coimteract
the ill effects that may occur through occasional pollution.
In addition to the public water supply there are in the city a
number of privately owned surface wells of varying depths, many
extending down to bedrock (limestone) .
During the year 1916, 55 samples of water from as many different
wells and a few springs were examined, and 28 showed positive
evidence of pollution. There were also made 24 examinations of the
city water, with the result that 10, or 41 per cent, of the samples
examined showed evidence of the presence of colon bacilli in 10 cubic
centimeter amounts. Similar results have been obtained at the lab-
oratory of the State board of health, and in addition the colon
bacillus has occasionally been detected in 1 cubic centimeter.
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10^ mr 1272
Disposal of sewage, — The city is fairly well provided with sew^rs^
both storm water and sanitary, and the system is being ext^ided
rapidly. Storm-water sewers empty into Buck Creek and the con-
tents of sanitary sewers pass into the Mad River and into Back CnA
untreated. Plans are already laid for the installation of a modern
disposal plant.
There are still a number of insanitary privies in the cit^ but
these are being abolished as rapidly as possible. During the year
1916 there were 954 premises connected with the sewer, 254 in new
and 700 in old buildings.
The disposal of garhage wnd refuse. — Garbage is collected by con-
tract from residences only, and is fed to hogs. Hotels, restaurants,
and commission houses must have their garbage removed by private
contract.
The supervision over the system of collection is under the juris-
diction of the city manager's office. The rules adc^ted to expedite
the collection require that all garbage be kept in a metal can witii
fly-proof cover and that the cover be kept on, that the can be put
in a place where it may be easily found by the collector, and that
no water, glass, tin cans, grass, etc., be put into the garbage can.
The system of garbage collection used in the city of Springfield
is not to be recommended. The city realizes its deficiencies and has
plans under way eventually to take over the collection and to erect
an incinerator. At the same time a collection of rubbish will be
instituted. At present rubbish is collected annually instead of
weekly.
FOOD INSPECTION.
The inspection of foods, including milk, and the inspection of
pltirc^s handling foods are carried on by the dairy and food inspector,
who is a doctor of veterinary medicine. He also performs the labo-
ratory examinations of samples collected. Samples of milk are col-
lected and examined once a week. With but one inspector for food
inspection it is not practicable to exercise a thorough supervision
over the sale of foods' from all of its various angles. The ante and
post mortem inspection of animals killed in the local slaughterhouses
is not attempted. Of all foods, milk is by far the most important
from the standpoint of the public health, and the inspector has
therefore very properly devoted much of his time to the control of
the milk supply.
The fninis supplying milk to Springfield vary, from those with
no oqnijuuent, primitive methods, and poor stock, farms that score 0
to (I:., e- modern in equipment and methods with tuberculin-tested,
registend stock, and which would score 90 or above. There are,
in all, about 350 farms producing milk for sale in Springfield, most
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1273 August 10. 1917
of tbem operated by farmers who carry on the dairy business merely
as a side issue.
Milk is brought to the city in unsealed cans, much of it by wagons
or autotrucks. Some is shipped by interurban electric and a small
I>art by railroad. The longest haul is about 12 miles.
It is estimated that about 95 per cent of the raw milk is pasteurized
before reaching the consimier. There are four pasteurizing plants,
two using the holding and two the flash method. The latter is im-
reliable and should be supplanted by the holding method, meaning
briefly that the milk should be heated rapidly to a temperature of
145° F. and held at that temperature for 30 minutes. To secure
accuracy each plant should be equipped with a temperature recorder
and a thermoregulator and the technique should be checked fre-
quently by the milk inspector by bacterial counts made during the
different stages of pasteurization. After pasteurization the milk
should be immediately cooled and bottled. All milk should be de-
lirered to the consiuner in machine-capped bottles. 'At present there
is no law prohibiting the sale of dipped milk.
All milk sold in the city should be pasteurized as above and a
bacterial standard should be set for pasteiu-ized milk, which should
contain not more than 50,000 bacteria per cubic centimeter when de-
livered to the consumer.
There are 7 slaughterhouses located in and around the city of
Springfield. In none is there any inspection of animals slaughtered.
One has permission from the Federal authorities to carry on an
interstate business. An additional inspector in the city health de-
partment could devote some time to meat inspection under the veteri-
narian of the department, and it would be wise for the city to estab-
lish a municipal slaughterhouse, so that slaughtering could be carried
on in one place and a better supervision maintained.
The following is a summary of the inspection work carried on by
the dairy and food inspector during the year 1916, together with the
results of the examinations of milk samples.
Number of samples of milk having 100,000 bacteria or less :
Raw 421
Pasteurized 34
Number of samples of milk having over 100,000 bacteria :
Raw 397
Pasteurized 20
Number of Inspections made :
Dairies 437
Ck)W8 4, 480
Milk plants 53
Groeori*^. meat stores, restaurants, abattoirs, etc - 1, 683
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AmgoMi 10» IdlT 1274
THB HEALTH SUPBRYISION OF £tCHOOL8.
The health supervision of schools is paid for and is under the
jurisdiction of the board of education, which employs one nurse for
field and dispensary work. There are no medical inspectors em-
ployed. A di^)ensary is maintained in one of the schools, well
equipped for medical and dental work. The medical work consists
chiefly of the diagnosis and treatment of diseases of the eye, ear,
nose, and throat. A specialist gives his services free of charge. TTie
dental work is performed alternately by different members of tbe
dental society, whose services are furnished without cost.
It has already been suggested that the board of education add to its
nursing staff and then attach its nurses to the health department
This would be in line with modem views and should result in great
benefit to all concerned.
BXPBNDITURBS AND APPROPRIATIONS.
There was allotted to the health department for use during the
year 1916 the sum of $1^,450. This allowance is elastic and may
be increased or decreased from time to time by the city commission.
During the same period there was expended for operaticxi and
maintenance the sum of $10,785.95, as determined fr<Mn the records
on file in the health department The cost of operation is shown in
more or less detail in the accompanying table.
In addition to the above, the auditor's statement shows tiiat there
were certain sums paid out during the year as reimbursements for
the payment of bills contracted during the previous year. These
expenses have not been included in the itemized statement as not
being connected with the actual cost of the department during the
year 1916.
During the year there were collected in fees $2,552.35.
That part of the income of the city for the year 1916 which could
be used for expenses incurred in ordinary operation and maintenance
of city government was $409,045. From this amount there was ex-
pended for the protection of the public health but 2.6 per cent as
against 12.9 per cent for fire, and 10.2 per cent for police protection.
The amount allowed for the protection of the public health during
1917 is even less than Uiat allowed for 1916, although the presence
of smallpox has made it necessary to appropriate an additional sum
for emergency purposes.
The city of Springfield may take just pride in the fact that it has
the foundation of an excellent health department which, by a little
rearrangement and some additions, could be made a highly eflBcient
organization. As it is, it is only possible to take up the various
problems in a more or less superficial manner.
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1275
August 10, lOlT
To carry on the work, as outlined in the foregoing report, would
require a mmunum expenditure of $17,000 a year, which figure
represents about 4.1 per cent of the available revenues of the city,
and which is little enough to spend in the prevention of disease.
The sum might be expended as follows :
health officer $2, 500
assistant health officer and city pliysician ' 1, 500
bacteriologist 1,000
dairy and milk inspector 1, 400
food inspector 900
public-health nurse 960
public-health nurses, at $900 1, 800
sanitary inspector 900
Tital statistic clerk 840
telephone clerk 480
1 laboratory attendant (part time) 180
Total 12. 460
Transportation, office, and dispensary supplies, etc 4,540
17.000
It will be noticed that the above scheme contemplates the employ-
ment of 5 additional employees, namely a bacteriologist, 2 public-
health nurses, a food inspector, and a telephone clerk and stenog-
rapher ; the transfer of the plumbing inspector to a building division
of the engineering department; the continuance of the work of treat-
ing the indigent sick, which the health department is now required
to do; and the transfer of the poundmaster.
Is
1
1
1
6
•
ad
i
1
1
9i
^
Badns
$5.50
$2.75
$8.25
Ilhwfln*
$6.00
6.00
Soto!:::::::::::::::;
15.00
5.00
DniB, chemicals, and
$257.40
$17.14
$128.12
402.66
Ktactrkal supplies
iBMnraocT services. .. .
8.00
$3.73
6.73
3.00
3.00
IxuSt...
.
$11.50
11.50
In :.;:::::::::::;
'
21.00
100.02
21.00
itborttory supplies . . .
100.02
liaiiiteitt]iceoTp«>ple
taiqn^rantiTif. . . . .
57.03
57.08
Ibdical supplies
4&10
45.10
MbMllaneoas
0.33
9.33
Mming suppUes
laoo
4.50
10.00
OlBw ^dd1&
4.00
85.00
1.20
1.50
.60
12.70
Poitatt^:..
laoo
101.50
i,4oaoo
4.5.00
pS^ :
33.90
1 621.22
ia75
153.00
14.00
0.80
SM'ii
$2L25
i,3oaoo
83i.'59
11.75
793.12
179.15
bnuj...:
2,143.37
» 621. 23
8,658.74
14.00
Bdnrtiftc apper^us. . .
Ipiciiiien outfits
0.80
KSd^!:. .;:;::;;
45.45
2ia30
7.70
15.00
» 105. 15
L25
Z75
U05.15
64.45
TliospoHatian
•617.97
flaoo
1,098.57
Typivmen and ra-
ptiii...
7.70
vffirii
16.20
ia2$
Total
2,454.73
1,113.43
326.81
914.61
1,839.22
840.34
807.62
1,576.23
11.50
902.95
10,785.98
> OnMialf of salary ai^ transportation charged against epidemiology and one-half agalnst4ceatment oi
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ABffiUiil0^1917 1276
RECOMMENDATIONS.
As a result of the foregoing study and after careful consideration
of conditions, certain conclusions have been reached which have been
made the basis of the following recommendations :
1. That a full-time bacteriologist be employed at not less than
$1,000 a year.
2. That the nursing staff be increased by the addition of two public-
health nurses, each to receive a salary of not less than $900 a year.
8. That a telephone cleric be added to the staff of the health de-
partment.
4. That a food inspector be employed at not less than $900 a year
to work under the supervision of the milk and dairy inspector.
5. That the board of education employ one more nurse and attach
its staff of nurses to the health department.
6. That the antituberculosis league employ a nurse instead of an
investigator and attach her to the health department.
7. That the city be divided into seven districts and a nurse placed
in each district to perform within that district all of the duties re-
quired of a public-health nurse, including post and prenatal work,
infant welfare work, school nursing, and services required in the
control of the communicable diseases.
8. That the work of the infant welfare society be taken over by
the health department.
9. That a nurse follow up every birth reported to the health de-
partment, and that she be provided with a " certificate of registra-
tion " to present to the parents, this certificate to be furnished by the
health department ; and that activities concerned in the conservation
of child life be carried on during the entire year.
10. That provision be made in the new wing of the city hospital
for the care of infants.
11. That an isolation hospital of not less than 30 beds be con-
structed on the site of the old hospital ; that it be used for the isola-
tion of all communicable diseases (including smallpox) except tuber-
cidosis.
12. That the isolation hospital be under the supervision of the city
hospital, but that the admission and discharge of patients be placed
under the control of the health oflScer.
13. That typhoid fever be made a placardable disease, and that
disinfectants be issued free of charge to families in which there is a
case of that disease.
14. That all children be required to be vaccinated against small-
pox before entering the public or parochial schools.
15. That all surface wells and privies be abolished within the city
limits.
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1277 Ansust 10. 1917
16. That the city water supply be treated by chlorination before it
is delivered to the consumer.
17. That daily bacteriological examinations be made in the labora-
tory of th& health department of the city water supply.
18. That all of the milk of the city of Springfield be pasteurized
before delivery to the consumer.
19. That the standard for pasteurized milk shall be as follows:
That it be heated rapidly to a temperature of 145"^ F. and held at
that temperature for 30 minutes; tiiat it be cooled immediately to
a temperature of 50° F. or lower and promptly bottled: and that
it contain not more than 50,000 bacteria per cubic centimeter when
delivered to the consumer.
20. That milk from dairies which do not score 60 or above be
excluded.
21* That milk be transported from producer to distributor in
sealed cans, and that only bottled milk be sold to consumers.
22. That the board of education appoint the health officer as a
member of its teaching staflf to lecture to the pupils of the high and
granunar schools on the subject of public health, and that the pupils
be required to pass an examination on that subject upon the com-
pletion of the course.
23. That the health department issue a weekly bulletin on the
subject of the lecture, a copy to be given to each pupil.
24. That the city install as soon as practicable a modern disposal
plant for the treatment of sewage, a chlorJhe plant for the treatment
of the water supply, a municipal abattoir and an incinerator for the
disposal of garbage.
25. That thorough and comprehensive study be made looking
toward the development of a satisfactory water supply for the city.
26. That ordinances be passed requiring the proper disposal of
manure and stable refuse and the cutting of weeds.
27. That the sanitary inspector be authorized to devote his entire
time to those matters which have a direct bearing on the spread of
communicable disease, including the abolition of surface wells and
surface privies, the proper disposal of manure, and the requirement
that all householders provide themselves with a garbage can.
28. That the police department lend its cooperation by making
it a duty of the patrolmen to abate those nuisances which have no
direct bearing on the spread of communicable disease, such as ash
piles or other accumulations of rubbish, unsightly matters in general,
weeds, chicken yards, slop water, bad odors, etc.
29. That the plumbing inspector be transferred to a building di-
vision or the engineering department.
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August 10, 1917 1278
30. That the poundmaster be transferred to the service depai-tment
31. That as soon as practicable the city inaugurate a system of
garbage and refuse collection, including manure.
32. That not less than $17,000 be appropriated to the health de-
partment to be spent as outlined in the body of the report.
33. That in the building code, now being written, ample provision
be incorporated to prevent block congestion and overcrowding of
houses ; to regulate the construction and use of tenement and lodging
houses, etc. ; to require ample toilet and bathing facilities and sewer
connections, etc.
34. That certain changes be made in the system of filing records
in the department and that there be added to this file a record of
expenses.
35. That the work of the department be systematized and that rules
be published showing the exact duties, authority, and ]uri9diction
of the various employees.
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PREVALENCE OF DISEASE.
No "kedlQi department^ State or local, can effectively prevent or control disease withotU
hnpwledge of when, where, and under what conditums cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
^^^ California Report for the Week Ended AugUBt 4, 1917.
Th6^ California State Board of Health reported concerning the
status of preventable diseases in California for the week ended
August 4, 1917, as follows: Two cases of anthrax in man were notified
at Dos Palos, Merced County, contracted in skinning a cow. Fifteen
cases of anthrax in animals were notified on 7 ranches in the central
part pf Yolo County. Preventive measures, including vaccination,
were employed to control the spread of the disease. One case of
pohomyeUtis occurred at San Francisco. Of cerebrospinal menin-
gitis, two cases were notified, one at Oakland and one at San Fran-
cisco. Thirty-three cases of typhoid fever were reported, scattered
over the State, four cases having occurred in a mining camp in
Nevada County. Four cases of smallpox wore notified near Selma,
Fresno County.
The details of notifiable disease cases reported during the week
ended July 28, are as follows:
Owtbrotpinal meniogiUs.
Chlck«npoz
Dipfatbtfk
Dji^aierj
Erysiptias.
0«rman measles
Oopococcus iofection
MalariA
Xuiops.
One*.
2
»
18
1
5
4
41
24
68
43
Oatet.
1
10
Pellagn
Pneumonia
Poliomy-elltis 2
Scarlet fex^er. 41
Stnallpox 9
Syphilis 18
Tetanus I
Tuberculosis 1 18
Typhoid fever 28
Whooping cough 22
CEREBROSPINAL MENINGITIS.
Massaehaseits.
During the week ended August 4, 1917, new cases of cerebrospinal
meningitis were notified in Massachusetts as follows: Boston, 2;
Gloucester (Town), 2; Springfield, 1; New Bedford, 1.
(1279) ^ T
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▲ngust 10, 1017
1280
CEREBROSPINAL MENINGITIS— Continued.
Minnesota.
The outbreak of epidemic cerebrospinal meningitis in Minnesota
seems to have subsided, if we may judge from the reported cases,
which are shown in the accompanying table. The crest of the
outbreak seems to have appeared in April.
Cases.
January, 1917 5
Frt)ruary, 1917 81
March, 1917 75
April, 1917 103
Casai.
May, 1917 ; «
June, 1917 S7
July, 1917 IS
August 1 to 6, 1917 I
State Reports for Jane, 1917.
Place.
New cases
reported.
Place.
NewciMS
Alabama :
Hou?rton County
1
1
1
New York— Continued.
Erie County
10
Jackson County ,
Essex Countv
Limest<ffle County
Greene County
Monroe Countv
Total
3
Nassau County
Niatf^ra Countv
New York:
2
1
1
Onondaga County
Albany County
New York City
37
Total
Delaware County
57
City Reports for Week Ended July 21. 1917.
Place.
Akron, Ohio
Baltimore, Md
Borton, Mass
Brockton, Mass
ChunKO, 111
Cleveland, Ohio
Coin minis, Ohio
Dayton, Ohio
Detroit, Mich
Duluth, Minn
EIl7a»cth, N. J
El I'lvso. Tex
K\ am VI He, Ind
Galveston, Tex
Grand Ranids, Mich.
Hartford . C/Onn
Haverhill, Mass
Jersev City, N. J
Lexington, Ky
Cases.
Deaths.
Place.
I Los Anpeles, Cal
1 Milwaukee^ Wis ....
Minncanolis, Minn. .
1 New Bedford, Mass.
I New Britain, Conn..
I New Haven, (^onn. .
Now Yor!:.N. Y....
I Niairarafalls, N. Y.
j Passaic. N. J
' Philadclnhia, Pa
! Pittsueld, Mas5
I Pro\iienrc, R. I
Raci'.e, AVis
I St. L'.iii^ Mo
I Ban Pio-^o^Cal
San Frauci.sco, Cal. .
Stcui>envillc, Ohio. .
Washington, P. C...
Wheeling, W.Va...
Cases.
Deaths.
DIPHTHERU.
Rhode Island — ^Newport.
The Secretary of the State Board of Health of Rhode Island
reported August 6, 1917, that there w^as an outbreak of diphtheria
in Newport and vicinity.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1288.
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1281
ERTinPELAS.
City BepoHs for Week Ended Mf 21, 1917.
AQcntt 10. 1017
Plaoe.
ADcntowo, P»..
BaltlBora.Md..
BnflWo, N. y...
Ctaitco, Ohio. . .
Cbkseo,!!!
Ctoretiod. Ohio,
DeoTCT, Colo. . .
Flint, lOdi
ItAiostowtif Fft.
Deaths.
Place.
Gases.
Lancaster, Pa
Lone Beach, Cal....
McKeesport, Pa....
lCilwau&ee,Wis....
Newark. NT. J
Philadelphia, Pa...
Pittsburgh, Pa
Rochester, N.Y....
8t. Joseph. Mo
St. Loafs, Mo.
San Frandsoo, Gal..
Deatha.
'sX ;
LEPROSY. '
Cttf Report fer Week Ended Jolj 21» 1917.
During the week ended July 21, 1917, 1 case of leprosy was reported
at Los Angeles. Cal.
MALARIA.
Alabama Report for June, 1917.
Place.
New cases
Place.
New cases
reported.
RlMTnt Coonty ^
3
2
1
1
4
1
1
3
1
1
1
1
7
3
25
2
30
Alabama— Continued :
Lauderdalo t ounty
Bultoclr Pwinty
Madison rrHinty ....
Qierokcx^ County
Marmgo County
ClMKftaw County
MithnmCif^mty " , , , , , ,
Clarke County .'.....
Monroe Co^iniy ,
C/kfliM Cnunty, . - , -
Montfomery ('bounty
ColtM^ County
M<M^an County
riMMM«iih (^miritv
Ferry ( 'mmty « . r , -
PaHaJi County
Pickens County
Ktowah County
Russell County
V%jr4r^ rmuity . - , - . ,-.,.,-,,
Shelby County
Franklin CounV
Sumter County
^'•wiTa County!
Talladega County
RfwffM^ Pounty
Tuscaloosa County . . „
17
Hate County . '. . .
WfilkfT county , .'.
2
Houston County
Washington County
1
TiU^Vonn Prumtv
Total
Jefferson County .
133
City Reports for Week Ended July 21, 1917.
Place.
Oases.
Deaths.
Place.
Cases.
Deaths.
Bfrmfai^bfim, Ala
16
4
1
New Orleans, La
2
1
5
1
Columbia. S.'C
San Francisco, Cal
Little Rock, Ark
Savannah, (Ja
Monphis. Tenn
3
Schenectady, N. Y
Newark,k.J
1
^ The reason that Birmingham had so manv more cases of malaria reported than any other city is not
that the disease is more prevalent In BIrralngham than in other cities of Alabama and nciphhorinj; States,
but tmdoobtedly because of the successful efforts the health department has made In securing the coopcra^
tioD of the practicing physicians in reporting cases.
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1288.
Digitized by
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August 10, 1917
1282
PELLAGRA.
AJabama Report for June, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Alabama:
A utaugft ^'OUT}ty ,
3
2
1
33
1
5
8
60
4
Alabama— Continued.
Lauderdale County
Barbour Countv
j T impstone County . - , , ^ - . , - - x - . - , .
Bullock County
! Leo County
Butler Countv .
I-K)wndes County
Calhoun County
1 Macon County . !
Chambers Countv
1 Madison County
14
Cherokee County
1 M.irongo County , . , r - . -
Choctaw Countv
1 Marshall County
Clarke Countv ....
Mok ilo County .'.
30
Coffee Countv
Monroe County
Colbert Countv . . .
Montgomery (Jounty
10
Conecuh County
Morgi^n Cwinty . , , ^ . .
Coosa County
Perry County ' , - . ,
Dallas Countv
Pickens County
,.., M
Dekalb Countv
Randolph (V)unty
Flmore Countv
Shelbv Countv r
\' 2
Escambia Countv
St. Clair County
Etowah County
Sumter County .-.
' 1 A
Favette C/Oiintv , . . r
'rgiiadeea Co«»nty ■.
^ 5
Geneva County
Tallapoosa County
3
Greene County
ao
Hale County
"Waiver Cmmty ..',..... x
15
Henrv County
WMhinptftfi C-ounty
5
Houston C'Ounty . r , . . r
Wilcox County....'
15
Tftckson C-ountv
Winston C-oun'ty - x
1
Total
T<A.mAr Countv
303
City Reports for Week Ended July 21, 1917.
Place.
Birmingham, Ala..,
Colombia, 8. C
Kalamazoo, Mich. .
Lexington, Ky
LynchburK, Va
Memphis, Tenn —
Mobile. Ala
Na8hyiue,Temi...
Cases.
Ul
Deaths.
Place.
New Orleans, La
New York, N.Y ,
PhUadolphia. Pa
Richmond, va
Washington, D. C
WichiU, Kans
Wilmington, N.C....
Winston-Salem, N. C.
Cases.
Deaths.
1 The reason that Birmingham had so many more cases of pellagra reported than any other city is not
that the disease is more prevalent in Birminriiam than in other cities of Alabama and neighboring States,
but undoubtedly because of the successful efforts the health department has made in Fo?urlng the cocp-
cration of the practicing physicians in reporting cases.
PNEUMONU.
City Reports for Week Ended July 21, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Boston Mflffif
46
12
2
1
5
Griiad HapiJ"^ Bfich
11
16
1
Braddock. Pa
K;iliiniiiK[K3', Mit'li
1
Brooklhifl Ma.ss
1
Lf'^^ \nKr!r--; r-il
X
Chelsea, Uass
N '
e
Chicaffo'. ni
49
12
1
17
P
9
Clevemnd. Ohio
Q
T>Avtnn. Ohio
R.w fuy U-^r^ N . \'
2
De&x>it,Mich
Stfi Franclwo. TfiJ
1
Brie Pa
Sjiringflclc], Mij;H
1
TEvansvllle, Tnd--XT r--,-
2
■VVorcpstflr^ "il^R^ -
1
Fort Wortn. Tex
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1283
▲agQitlO.1017
POUOMTELinS (INFANTn£ PARALYSIS).
GMes B^«rted to die Publie Haftltli Seniee fWim Jane 1 to Antf. S, 1917.
Ptoca.
Period.
Cases.
Pboe.
Period.
Oases.
AMbvnm:
Ctobume County
9fiI«rsQo County—
Bifminirhain.
St. OafrOocmtyr
Janf
1
13
1
2
Masaacbosetts— Con.
Essex County— Con.
Haverhill r
June
JnlyO-Aoff. 4...
June
Julyl6-2L
do
g
Do
July.
10
Do
Aug. 1-1
July
do
3
RuchoHl ,' . .
Lawrenoe
Lynn
3
CWitomia:
5
Alameda Coonty—
Do
Aug. 1-1
July.
1
BerkBliyT?..
Salem
1
LoaAnfelas'Coanty—
Long Beach
June 3-0
8augus(Town)...
Hampden County—
fipringfldd
Do
do
June
3
Los Annlei
MitfinCoiSy-
„ BeJvedere.
8«n Frandsoo
June 10-30.
July 23-281
July»-Ang.4..
July 22-28
July 15-21
do
1
July
3
Hampehire County-
July
1
SttitaOiara County...
CoooKticut:
Middlesex County—
Cambridw
Groton (Town)...
Lowell
June
3
New Hikwi County-
Derby
July
1
July
3
W^stHsveiL
IfAlHmi
July
1
Htftford County—
Brkiol :
do
Medford
July
1
Natick(Town)...
Norfolk County—
Quincy
Aug. 1-4
do
1
Kecr Britain.
July 23-28.
July 16-21
July 34
1
WindlMun County—
Thnmpsoa
July
1
Delaware: '
Weymouth
Plymouth County-
Brockton
July
1
Kent County-
Dover
July
1
BUnofe:
July 3-0
Do
Aug. l-«
June
3
Adams County—
Melrose Township.
Cook County-
Chiraco.
Suffolk County-
Boston
2
June lO-Aof.4..
July20-Aug.4..
July 3-0
Worcester Coonty-
SuttOD
June
1
WUuMtte
Worcester
do
3
Lake County—
Do
July
1
ZiooCity
Do
Aug. 1-1
July 20- Aug. 4..
June
1
BMBunon County—
^^,^in«fleld
Will County—
June 3-0
Michigan:
Jackson County-
Jackson
July 3-0
1
Joliet...
Lenawee County-
Hudson Township
Washtenaw County-
Ann Arbor
ladlaiia:
June
1
SIkhart County
do
Leke County...
do
1
EastChJkaco
July 2^28.
June
Do
July h-14
. ...do .
1
Marion County
Wayne County—
"Detroit
. Wayne County
do
1
Iowa: '
Woodbury County—
Cloiid County—
o:asooR. D
Oreenwoo;! County—
Lincoln County-
Sylvan Grove
June 3-0
June
July 23-20
June *
MinnesoU:
Clay County—
Keeno Township.
Hennepin County—
Minneapolis
Lyon < onnty—
Lyons Township.
Pine County-
W i n rf 0 m c re
Township
Pope County—
B 1 u 0 ni o u n <1 s
Tovnsliip
Lanrlu'i Town-
^''jP
Do
Wash In <» ton County—
.^tillwatrr
Watonwan ( ountv-
Lon^'liiko Town-
ship
Wilkin < Oiinlv—
linvlfnnJ Town-
•ihip
July 1-22
July r-21
July 1-22
Juno
1
1
1
1
R.D
July22-2S
June
Wyandotte County—
Kansuaty......
Kentucky;
Kenton County—
June 24- July 28..
June 17-23
June
7
1
, Bienville Parish
July :^2-2S
JuIylVLl
July 1-22
June
1
1
Mwyland:
Allemy County
July 15-21
July 22-Auf. 4,.
Julv 22-28.
July 8- 28
July}^-28
July 1-7
I
Anne Arimdei County
Baltimoro County....
Baltimore City
1
Dorchester County ... .
Mississippi:
Amilo County
Oo
Oarrett Coimty
July 22-28
Jiipp . ,
5
Deer Park
Ch«icti\v County, , .
.. ,5o
I
Jennings
do..
Konipor County
do . . .
2
Worcester County
July29-AuR. -1..
Junf
Smith County . ...
do
1
Mtsaachusetts: ^
Essex County—
Amesbu^
Missouri:
U< one ' ot!nty—
( ohinibi.i
Julv Vi
8
Beverly
July
Cnllnn .iv Ci»'int\ —
AuT.2
Grovelanj
July:::::::::::::
3 Fulton.....*
1
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August 10, 1917 1284
POUOMTEUnS (INFANTILE PARALTSIS)--Go]itinued.
Cases Reported to the Pnblic Health Serrice from June 1 to Avf . 8, 1917— Gontd.
Place.
Missouri— ConUnoed.
Jacksoo Coonty—
iDd*: '
BClty
St.LooJs
Ifantana:
Carbon County
Cascade County
Custer County
Granite County
Nebraska:
DouKlas County-
Omaha
New Hampshire:
Rockizigham County-
Portsmouth
New Jersey:
Bergen County
Essex County
Newark
Hudson County
Hunterdon Coimty . . .
Mercer County
Middlesex County
Perth Amboy
New York:
Albany County-
Albany
Cayuga County-
Auburn
Chautauqua County. .
Dunkirk
(*olumbIa County
Erie County-
Buffalo
Jefferson County—
Watcrtown
Now York City
Do
Do
Do
Do
Do
Onondaga County —
Syracuse
Orange County
Saratoga County-
Saratoga Springs. .
Schenectady County—
Schenectady
Sullivan County
Tompkins Coimty. . . .
Westchester County. .
North Carolina:
Edgecombe County-
Rocky Mount....
Ohio:
Allen County-
Lima
Belmont County-
Martins Ferry....
Do
Tease Township..
Cuyahoga County-
Cleveland
Do
Franklin County-
Columbus
Gallia County
Hamilton County-
Cincinnati
Lucas County-
Toledo
Montgomery-
Dayton
rickawav County—
Circle villc
Period.
July
Aug. 2
July 13-18..
June 17-23. .
June...
....do.
....do.
....do.
July 22-Aag. 4.
June 3-23
June
....do....
July 8-21..
June
....do....
....do....
....do....
July 8-14..
July 1-7....
June 17-23.
June
July 22-28..
June
June3-July28..
July 15-21
June
July 1-7
July 8-14
July 15-21
July 22-28
JuJy2^Aug.4.
July22-Aug.4.
June
July2»-Aug.4,
June 24-30.
June
....do
....do
July 29-Aug. 4.
June 10-16
Reported July 5.
July 22-28
Reported July 5.
June
July 8- Aug 3...
June...
....do.
....do
....do
Julyi:-28.
June ,
Gases.
Place.
Ohio— Continoed.
Stark Cotmty—
Canton.
Summit County—
Akron
Do
Tuscarawas County—
UhriebsvfUe
Williams Coun^
Pennsylvania:
Allegheny County . . . .
Pittsburgh
Bradford County
Butler County-
Butler t.
Cambria County
Clearfield County
Dauphin County—
HarrisbuK
Fayette Counfy
Lancaster County . . . .
Lawrence County-
New Castle
Montgomery Comity. .
Phikulelph& County.
Philadelphia
Schuylkill County....
Rhode Island:
Provkience Coimty-
Providence
South Carolina:
Williamsburg County.
South Dakota:
Corson County
Vermont:
Chittenden Coimty—
Bolton
Orange County
Washington County. .
• Barro
Barre (Town) . . . .
Duxbury
EastMontpelier..
Fayston
Montpelier
Waterbury
Worcester
Windsor County-
Rochester
Vlrgtoia:
Albemarle County
Alexandria County-
Theological Sem-
« inary.
Goochland County. . . .
Henrico Coimty—
Richmond
King and Queen
County.
Louisa County
Page County
Pittsylvania County. .
Rappahannock
Coimty.
Rockingham County.
Washington-
King County-
Seattle
West Virginia:
Braxton County
Mapleton
Gilmer County
Jackson County
Kcnna
lycwis County
Psriod.
Oues.
July 2^38..
Jane
....do...
July 1-21.
July 15-21.
lane
.do..
JnlyS-Aog. 4..
June
July2»-Aug.4.
June
.....do
July 8-14.
June
.....do....
Jnly8-Aiig. 4.
June
.....do
July 1-14
June
July 15-21.
June
do
July 22-28
June
do
July 15-Aug. 4 .
July 8-14
.....do
do
July7
July 8-21
July8-Aug4...
July 8-14
.do.
July....
July 14.
July....,
July 8-21.
July
..do...
..do...
do...
..do...
..do...
July 22-28.,
July
July 22-28
July 29-Aug. 4.
July 8-14
July 22-28
July 29-Aug. 4,
Digitized by
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1285
Aurust 10. 1017
POLIOMTELinS (INFANTILE PARALYSIS) Continued.
Casta Reported to the PabUc Health Service from Juae 1 to Aug. 8, 1917— Contd.
Ptoce.
Period.
Cases.
Place. Period.
Cases.
West Virginia— Contd-
UarionCounty—
AnnbcU...
July 22-28
July 20
1
1
1
10
1
1
1
1
1
a
West VIrginia-Contd.
Upshur County
Buckhannon
Wisconsin:
Dane County-
Cottage 'Grove
Juneau County
La Crosse County
July 29- Aug. 4..
July 22 -28
July 1
1
1
FHirmont,. x
MoiioRgah(braiich
of Fa&mont).
July29-Aug.4..
July8-Aug.4...
Jaly2»-28
Julyfr-n
June 24-30
July 22-28
June . . . r , r . T - r T
1
June
1
White Rock
do
1
Ohio County
Manitowoc County . . .
do
1
WhMlfp^
Milwaukee County. . . .
do
1
FrwtonCoimty—
Newborg
Tmbker CoontT—
Shawano County
Wyoming:
Natrona County
do
do
1
1
BaTfa.
July 22-28
State Reports for June, 1917.
Place.
New oases
reported.
Place.
New cases
reported.
Alabama:
1
1
New York-Continued.
Cohii'ibift bounty
Rt. Clfllr C<nin^
Orange Coun t y . '
Sullivan Count v
Total
2
Tompkins County
Wcstbhcster Conntv
New York*
1
1
New York City '.
32
Cavtimi Pnnntxr
Total
C^wniaiKina Coimtv , . . . .
40
City Reports for Week Ended July 21, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron Ohio
2
1
1
1
1
2
1
Newcastle. Pa
Borvefey, Cal
New York. N.Y
2
Bfi^ififiham, Ala
GiBveland, Ohio
Philadelphia, Pa '.
1
I^yton ^hio ......,-,,
Providence, ft. I
Hav^ririn Mass
Q^ilncy, M^..... "'" \.
Kanmff Citv. Mo
^Inhm<>nd, Vft. ..,; /
Lo»^,M&...
1
Watertown,N.Y......:
irimwMmnll* Iflitn
1
1
Wilkes-Barre, Pa
1
NeSuSNT'j^TTT:::::::::.::
Worcester, Mass.. ^. .^.....
1
RABIES IN ANIMALS.
City Reports for Week Ended Joly 21, 1917.
During the week ended July 21, 1917| 1 case of rabies in animals
was reported at Covington, Ky., and 3 cases were reported at Detroit,
Mich.
SCARLET FEVER.
Sec Diphtheria, measles, scarlet fever, and tuberculosis, page 1288
93
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August 10. 1017
1286
SMALLPOX*
New York Report for Jme, 1917.
Plfice.
New
reported.
Deaths.
Vaccination history of
Number
vacci-
nated
within
eeven
years
preceding
attack.
Number
last vac-
cinated
than
preceding
attack.
Number
fiiUy
vaod-
VacdDA-
tionhii-
torynot
obtaiiMd
orun-
cotain.
New York:
Albany County
Dutchess County . . .
Steuben County
Waahington County
New York City
Total
AJabama Report for June, 1917.
During the month of June, 1917, 6 cases of smallpox, with 1 death,
were reported in Jackson County, Ala.
City Reports for Week Ended July 21, 1917.
Place.
Akron, Ohio
Austin, Tex
BulIalo.N.Y....,
Butte, Mont
Chicago, III
Clevefand, Ohio.,
Columbus. Ohio..
Davenport. Iowa.
Dayton, Ohio
Denver, Colo
Detroit, Mich
Duluth, Minn....
Erie, Pa
Evans\ille, Ind-.
Flint. Mich
Ilamiiton, Ohio..
Indianapolis, Ind
Cases.
Deaths.
Place.
Kansas City. Kans...
Kenrsha, Wis
Little Rock, Ark
Minneapo:is, Minn....
New Orleans, La
Oklahoma City, Okla.
Omaha, Nebr
Pontlac, Mich
Rocky Mount, N.C..
St. Joseph, Mo
St. Louis. Mo
Seattle, Wash
Sicux City. Iowa
Steubenvilie, Ohio....
Superior, Wis
Wichita, Kans
Worcester, Mass
Cases.
Deaths.
TETANUS.
City Reports for Week Ended July 21, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Allentown, Pa
1
2
Jackson, Mich
1
BufTalo, N. Y
Loratn, Ohio
1
1
1
Cbicapo, 111
Los Aixgolos, Cal
Columbus, Ohio
1
New York, N.Y
Detroit, Mich
*
_
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1288.
Digitized by VjOOQIC
ot
1287 August 10, 1917
TYPHOID FEVER.
Tennessee — Chattanooga.
Burmg the month of July, 1917, 22 cases of typhoid fever were
notiSed at Chattanooga, Tenn.
State Reports for Jute, 1917.
Flftce,
New cases
reported.
Place.
New cases
reported.
Aataoia County
Bakdwm County
BarboorCouniy
BibbCoonty
Bkxint County
BnDock County
ButterC^Mnty
Calhoun County
Cberokee County
(Mton County
Clwctaw Ceunty
Chrkc County
Coffee County
j Colbert County
Conecuh County
CooeaCounty
Covington County
Cunman v'ounty
1 Da!c County
I>«Bas f 'ounty . . . ,
\ DeKalb < 'ounty . .*. .' .
1 'EtauvcGounty
J Escambia County
I EtowahCounty
- » rranklin County
^Qeaeva County . 1 1 1 1 !
Greene County
HaleCounty
HouT County
BwBuni County ... .
Jackson County
Jenerson County
Laniar County ,
leukrdale County . .
Ifwrence County...
Limestone Coumty . .
. wonCounty
J 5&AboiiCounty
Jfarengo Comity
Jurion County ,
"^giall County
I,* ilo\>flfcCounty
JfonrocCounfy
"ootgomery County
MprganCounty
-^ JteVena County
Pike County...
Bt.C\aIrCounty....
Sumter County
1
1
1
2
3
1
1
8
3
7
4
4
3
1
4
2
1
3
1
20
8
1
1
10
2
1
1
2
1
3
4
87
1
7
1
1
7
2
6
3
1
21
4
6
2
4
1
5
1
10
1
A labMua— Continued.
Talladega County —
Tallapoosa County . . .
Tu9caloo6a County. . .
Walker County
WashingtonCounty .
Wilcox County
Total
New York:
Albany Coimty
Allegany County
Broome County
Chautauqua County.
Chenango County
Clinton County
Columbia County
Cortland County
Dutchess County. . . .
Erie County
Essex County
Franklin County
Fulton County
Genesee County
Greene County
Herkimer County
Jefferson County
Lewis Coimty
Montgomery County,
Niagara County
Oneida County
Onondaga County . . .
Orange County
Orleans County
Otsego County
Ren^elacr County. . .
Rockland County
St. Lawrence County
Saratoga County
Schenectady County.
Schoharie County
Steuben County
Suffolk County
Ulster County
Warren Coimty
Wayne County
Westchester County.
Yates County
New York City
Total
4
1
24
11
1
1
313
15
12
1
4
5
2
3
1
3
12
2
1
2
1
4
1
2
1
1
2
3
1
1
1
3
4
2
5
5
1
1
2
4
2
4
1
fi
1
84
205
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iagti«tio,mT 1288
TYPHOID FEVER— Continued,
aty Reports for Week Ended Jvljr 21, 1917.
Plioe.
Omm.
DeaClia.
PiBoa.
f^
BwUm.
AJcnm, Ohio
1
4
S
22
3
McKeemort, Pa
1
Albany.N. Y.--.
IfMnphi^'TWfn
1
Baltimore, ICd
2
Milwaokee. Wis •
B^fV--li V. Cal
Minneapolfif, Minn ...
Binuuijihain 'lift
0
1
2
Mobile, Ala.
f
B<wk!i, Mmu
Mociistown, N. J
NartiTlUe, Tcnn
40
31
t
BoffiJo, M. Y.
1
Cimbiidst, Mass
1
2
4
1
6
1
1
6
8
6
2
1
0
Newark. U. J
Canton, filiJo.-
New BodfDTd, lUts
Oiirrestoii, S. C
New Britain/Cwin
(>^L^a, UiLHf
Maw trkven/ronn
Oskaio. IIL
X ...... New Orleans. La . ..
3
^ctADfttx, Ohio ;.
New York. N'.Y..:.:
3
divelvKl, Ohio
Norfolk, Va
rdTcfviik KaJis
Norristown, Pa...
CoJiuohi*, a. r
1
Oakland, Cai
CoJtimNiMf Ohio
Oklahoma City. Okla
rumbftrJaail, Md
PhihMlelphia, Fa
2
Dtylon Obio
Pittsburgh, Pa..
8
Dcfrwt. Mltih
2
1
Portland, Me
1
PiiiijMi, Minn
Portland^ breg
ICuir '^r^tiri'. V J
1
1
PortsmouUi, "^a
RliE»ij<*th, N'. J
1
2
Providence, 'R. I
Bl FJWi>. Tt^s,
Reading, Pa
Kri*, V% .
1
1
3
1
4
2
1
2
1
1
2
1
2
11
2
5
1
6
1
15
4
2
Richmond. Va
K¥iiM¥tl]^, lad
1
1
Roanoke, Va
2
PiJI Rivpf Mass
Rochester, N. Y
Rocky Moimt,N. C
Flint, MjUih
Ffirl Wcifth, Tex
St. Louis, Mo
3
Qitivn'Himf TVw
Ban Francifico, Cal
Im^rntuvii Md
Sacramento, Cal
ffarnjitiurft. Pft
Seattle, Wash
1
U^vtwhiU, Mass
Somcrrille, Mass
K^lotio N J
1
Syracuse. 1^. Y
Ijifi Ijitf r Af flII* , I nd
Toledo, Ohio
Jol>ii.rtuwTii, Pq
Trenton, N.J
EaJAmanxj, Mii'h
Troy,N. Y
K^BavviHer Tvnn
Washington, D. C
1
Lao^^j^'M^ Pa
Wheeling. W. Va
1
L*ttl# lUv.k, Ark
Wiehil*. Kwis ....
Loriuii , Ohio
Wilkinsburg, Pa
Los AnRelea, Cal
..
Wilmington, Del
LowHl.Mass
Wilmington, N. C
Whiston-Salem, N. C
1
Lynchbnrf, V»
3
1
York, Pa
Madison, Wis
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCULOSia
State Reports for June, 1917.
During the month of June, 1917, 21 cases of diphtheria^ 525 cases
of measles, and 37 cases of scarlet fever were reported in Alabama,
and 1,571 coses of diphtheria, 9,384 cases of measles, and 1,070
cases of scarlet fever were reported in New York.
Digitized by
Google
1289
AumiBt lu, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Wetk Ended July 21, 1917.
Julvl,1tl6
(«it4tflAted
liy U. B.
C«QSIIS
Buteau).
Total
dcAtbs
aU 1
Dipblb^ria.
MfSfilea.
Scariat
Ttibttw
frosts.
aiy-
1
1
1
1
1
ii
1
OmiOOJMVl inh«li|t4uaU;
560,1121
7^.479
3,407,732
«74^073
S7r,7S4
SGT.«12
5,W2,>U1
l,7frj,.'>l8
57^, (Ml
7S7j303
4«S,5£«
410,476
306,345
43i),53^
36.1, 4.S4
40S,894,
371,747
463,516
348,639
3«3,0^
214.^78
271, 70H
387, S47
2&l,9CiO
256,417
104. 1B«
im,7«2
121,57$>
112, D!^]
106,233
127,224
128,366
104,503
12S,291
110,900
113,245
102,425
I4».9tf5
117,057
149, 6S5
I9!t,604
105,470
100,3*1
156,6§7
105,942
]fi5,634
113, 770
191,554
]11,J^
16;}, 314
55,625
fl3,e05
57, (MO
m,m3
57,«53
53,973
07,440
m,im
90. ^34
m
IS4
6J3
17S
lai
"iilBO'
444
1S3
199 1
133
US
7S
99
' ios
" IM
40
04
fll
52
is"
58
57
1 g
50
148
38
00
3lt
7
8
R
10
18
11
11
11
IS
4
&
19
6
«
0
48
74
lOS
19
11
31
426
45
11
3
0
30
10
33
1
3H
10
39
3
......
1
1
......
1
1
1«
114
3
39
6
40
15
1
29
74
m
3S
3a
ft2
203
m
371
21
16
16
!6
Bostoa, ]4>s$. .^.* .
3R
n^ji^rn, m
OH
Ocr^uid Ottfa ,
liolTQlt^lCch^ >.-.-..
15
I>^ADr*I<» cil * ,•-.
19
Kew Vork, N. Y.,
PJiiiadeJplila Pa *....*»*
146
<E3
HtUbunb, Pa.*. ,
fi
Si. LdR!9,lC^..,..„....,.w
29
a
4
M
17
3
1
1
1
" i
25
Tnm 300p€b0'lo 500,000 inhatdt^
aat$:
BuffoJo^N. Y.....,.„.
10
IS
J«»^aty,N, J. ,„........
8
lOJvaiito. Wis., „
7
NoBrarli, N/J.„..,
:h
so
15
15
5
as
26
Smn VruiQiscQ, CaJ
1
4
1
16
S^Hp, Wft&h .,....*
4
Wmsiyins^toa^ r>. C . . .
FtttfQ aO0,00(} to 300,000 inbfthlt- 1
mts:
Octjumbufr Ohio *. ^„,
1
6
3
12
1
i
1
3
2
8
5
4
13
19
4
Denver Tfjlo
1
4
Ifl
2
I
3
54
14
2
3
2
3
7
0
"**i"
0
lndJ^inapolLs Ind _ **.,'
' i
22
a
(I
1
20
7
ft
4
14 I
3
FortlaiKl , Ore^
11
3
PtOviJenire, R.I, . _ ...
s
1
1
10
RocJ:e??ter, N. Y ,
Fr:tm 100«€00 to 20O,OOO Inliftblt'
Altwa^pX V
3
liiTTQjJxghaifi A la * „ . .
79
33
27
si"
23
20
33
»
19
3
BrideeporE, Ctsm ...,.....„
5
2
3
1
4
a
]"!"
3
ft
OamBrldm, SCafiS... „„,..,.
1
t^m^att, N. J.,.
......
^^
1
9
1
1
3
1
DajtiBj, Ohio,.. ....„,.,..
3
Fort W«th. Tei.. ..„,...,.
nrMtrl Raplrl*j MIcJi
3
7
i
3
1
1
14
10
e
^ ^ ^
■ 3
2
Ljnn, ltii6« .,
4
(j
1
Mwnplrti!, Tenn.,.
11
XaahTilJe, Tenn....,,„
40
m
51
24
46
4?"
41
37
■ 19
1
6
16
2
10
5
1
1
3
2
2
2
6
5
2
10
1
Now MMYim, Coiju .*».».,*»,
1
i.. ,'; 5'
B
3
Omaha, N6br........„ . ..
1
a'
t
10
3
1
B
6
3
SO
3
■**2
2
3
3
6
1ft
1
a
I
3
3
J
V
t
nm4tog Pa
a
RidiJii5iif,Va,,,.,„.,,.„.
s^ritutfltld , M&99
I
2
7
8
Toledo, Ohio........ .,.
•M
4
Trcnion, N. J ...
r*
5
Worci&ter, Uoss. . ..........
From 50,000 lo 100,000 inhabit^
antp;: '
1
;;;;;;
4
3
1
1
2
2
... .
ID
1
.^Jlentown, P& .„,..,......
::. .,
4
1
a
1 3
a
AtknUcCltr.N J*
Ba jonnc N' J
22
12
11
30
1
Berktfey Cal. *.\
0
3
3
2
Bix^^taintaa N Y
1
1
t
Brockton Mils^
1
Cli»rl<^ton, 8, C ,.....„
1
1
* * ' " ■ r "
t
Digitized by
GoogI
▲iiCiiBtlO,1917
1290
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continued.
aty Reports for Week Ended J«b^ 21, 1917— Continued.
Popula-
tion as of
July 1,1916
by U.S.
Census
Bureau).
Total
deaths
Irom
all
causes.
Diphtheria.
Meules.
Scarlet
fever.
Tuber,
culosb.
city.
1
1
1
1
1
1
1
1
From 60,000 to 100,000 in-
habitants—Continued.
CoviniEtan. Kv
67,144
04,495
86,690
63,705
75,195
76,078
64,772
76,183
72,015
77,214
68,529
99,437
60,853
67,343
61,155
78»283
68,221
63,794
89,612
92,943
71,744
69,411
63,867
65,185
66,895
55,642
85,236
63,330
68,805
99,519
57,078
87,039
68,946
61.120
51,550
66,0K3
77,916
70,722
76,776
94,265
5L656
27,732
34,814
32,«i5
32,730
27,G32
43,425
46, 192
29,319
34,611
26,074
48,811
30,873
42, 458
28,203
39,233
41,781
41,^G3
29, 35.3
25, 679
40,496
48,477
35,363
4*J.S86
31,576
3^.G7G
31,677
41,097
35,3^4
46, 515
27,587
94
24
13
68
28*
11
ao
18
16
16
2
1
7
8
1
1
T>nhi|n^yinn
18
8
Ellxabe'tb. N. J
6
4
a
El Paso, Tex
14
Erie, Pa
8
2
0
•
2
u
Rvansvilip, Ind r . ,
t
FlintjMic^
4
2
2
2
1
1
7
C
FortWayne, Ind
1
HarrisbuTE. Pa.
2
8
1
1
2
Hoboken,N. J
3
3
4
1
Johnstown, Pa
Kansas City. Kam
t Ancastffr, Va . ^ . . . . x
2
Little Rock, Aiki....'.
16
9
14
18
9
2
Mft1d«n Mm^ .
4
2
1
4
8
1
Manchesto-, N H
2
Mobile, Ala... . .'.'.'.'
1
Naw Tt'ritAin Onnn
2
Norfolk, Va.
3
Oklahoma City, Okia .......
17
26
19
17
19
20
23
,?
25
20
8
10
4
2
2
Pawtucket, R. 1
1
1
Portland, Me
17
6
3
1
Rockford, 111 ...!!!!'.*.*.*.! *. '. *. !
1
3
......
1
6
Sacramento, Cal
Saginaw, Mich..."!]!!!!!!.!!
2
1
St r Joseph, Mo..
1
1
1
1
6
2
San V'Wfao, Ch].
16
1
11
1
6
1
Savannah,' Ca
4
Schenectady, N. Y
1
1
Sioux Citv/lowa.
3
1
Somerville, Mass ! . . ! !
i6
12
14
13
16
2
4
2
15
6
1
1
1
south IJend, Ind
2
Springfield III
2
Springfield, Ohio.!!!!!!!!!!!
3
1
2
2
1
2
4
I
Terre Haute, Ind
1
1
Trov,N. Y
1
14
2
5
1
3
8
2
6
1
S
Wichita, Kans
• 2
WUkesBarre, Pa
17
60
9
1
Wilmington, Pel
York, Pa
From 25,000 to SO.OOO iiihaMtan'ts':
AlAiTiodA Cal
3
14
Austin. Tex
2
Bellincham, Wash . .
3
1
2
Brookline, Mass !!!!!!!
9
3
ii*
10
12
2
• •
Butte, Mont
Chelsea, Mass
1
......
1
......
1
1
4
1
1
2
4
1
""4*
8
8
i
Chicopee, Mass.
1
Ccriumbia, S. C !!!!!!!!!
1
1
Cumberland Md
Davenport, Iowa
Dubuque, Iowa .
1
"i'
■ 2
East Orance. N. J
3
3
3
9
9
9
9*
11
17
8
1
i 12'
21
1 10
1 8
2
1
3
2
8
......
15
......
2
2
Elghi, 111 !!!!!**"!
Everett, Mnss
Fitchbiwg Mass
1
Galveston Tex
1
1
......
1
1
3
4
Green Bay, Wis
Hagerstown, Md
Hamilton, Ohio
Haverhill, Mass.
1
1
7
37
3
1
Jackson, Mich.. ' '!
Kalamazoo, Mich
Kenosha. Wis
2
""z
s
Jijioxviiie, lenn
La Crosse, Wis
Lexington, Ky
1
3
3
Lima, Ohio
Lincoln Nebr
......
i
i
2
Lont! Beach Cal ...
2
i
Die
itized t
)yG<
00^
!le
1291
August 10, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
(Continued.
aty Reports for Week Ended July 21, 1917— Continued.
Popula-
tion as of
Joly 1,1910
(esUmated
by U. B.
Bnreaa).
1
ToUl
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tubcr-
cii'osis.
otj.
1
1
1
1
1
1
1
1
a
1
Trom 35J0OO to 100,000 inbabtt-
ADts— Continued.
Loratn. Ohio
88,984
82,940
47*821
28,818
27,827
29 005
81,987
80,106
48,716
87^368
81,401
31,404
38,080
48,450
41,185
38,029
39,6.'>l
36,798
38,136
46,486
43,284
28,926
38,CQ2
27,415
46,226
36,283
48,720
30,570
29,894
43,139
43,377
.33,809
29,892
31,156
30,863
22,874
15,010
21,685
15,794
1 13,075
22,609
.20,743
24,276
16,950
23,539
20,930
15,395
1 14,610
17^445
13,284
17,500
23 126
15,243
20,985
1 22,019
19,926
2),805
1 7, .'524
11,666
12,067
14,831
20,193
13,821
15.548
21,618
23,228
U
I
3
LTDcbbon. V*
1
1
1
1
2
2
i^discm^is.... ..::::..::;
3
McKaesport, Pm.
16
6
9
8
9
7
6
15
8
1
17
12
11
10
10
9
11
12
4
Mont<*]JrrN, 7
'JMhrni, N. H
NewbaTKh,N.Y
6
2
1
NewporTfey;...::::::::;::
Newport, R.L
1
Vmmhwi\t^^
5
3
1
1
4
1
Niagara'FaU*, N. Y
2
2
NoiTistown, ?•
2
Ogden, Utah
1
OiwA, N. f
1
6
1
1
1
1
4
2
FM»Jexia,CaI
3
Perth Amboy, N. J
Pittsfield, Maas
7
1
"
Portsmoath, Va
1
2
Qolncy, Dl.r
QuKncy. Van
5
3
1
1
2
1
1
Radne,'wir. ..;..;:.;;:...
3
Roanoke, Va
2
l^nrV T«Vii7H^ Tl|
7
1
f^Ttl^^^Cfl^
6
2
"
1
1
Steubenvine, Ohio
5
10
3
3
14
2
1
1
TwnrtonL>fa!<3 . .w
3
1
2
2
1
TopB^a, ^am
1
8
8
3
2
WaJtham, Maw
3
Watertown. N. Y
1
2
1
West Hoboken, N. J
5
17
1
11
17
7
11
12
5'
6
5
4
10
2
Wheeling, W.Va
2
Williamsport. Pa
9
1
1
2
WnTnlT,p/^« N 0
1
2
WhKton-Salem, N. C
1
1
3
Zaneaville, Ohio
From 10,000 io 35,000 inhabit-
ants:
Alton, lU
Ann Arbor. Mich
2
3
9
1
'31....:.
1
1
1
BraddocV, W
Cairo, ni
t
1
C^inUm, Mftjff . ^ , _ , ,
1
0
...
1
2
Concor<i,N.H
1
1
Dunkirk,N.Y
.
Oatesburg, HI
8
1
3
2
. . .
Harrbmn, N. J
Kearny,^. J
6
4
4
2
7
6
1
.. . .
2
Kokomo,ind
3
LongBrandh, N. J
4
Uelro-A itavf
1
lCflrristown.N.7
Muscatine, towa
2
Nanticoke', Pa
5
1
10
5
6
7
2
Newburynort, Mass
2
{
2
2
New London.'Comi
3
1
3
8
2
North Adams, Mass
1
Northamptoni Mass
3
4
Plahifl€Uf,N.'J
PonUac,Mich
1
2
4
1
Portfmonth, N. H
6
6
8
5
0
1
1
1
Rocky Mount. N. C
^ii^Xvt.
1
1
1
SandnakT, Ohio.
flaral'Ha'HnrfiiM. N, v
1
4
8te^5i,Fa......
2
2
1
Wwhfmrtffli. ^a
'*:::i::::::
2
WOkiivjburr, Pa
6
2 1
1
1
« Fopulalion Apr. %\ I'UO: no estimate madv.
Digitized by
Google
FOREIGN.
CHINA.
Pbigne — Hongkong.
During the two weeks ended June 9, 1917, 5 cases of plague with
3 deaths were notified at Hongkong.
Pfaigiie-Infectod Rate— Hmii^ontf.
During the six weeks ended June 16, 1917, out of 11,339 rats exam-
ined at Hongkong, 14 were found plague infected. The last plague-
infected rat at Hongkong was found during the week ended June 2,
1917.
CUBA.
Commnnicabie Disease* — Habana.
Communicable diseases have been notified at Habana as followB:
July 1-10, 1917.
Remain-
Ine under
Diseases
July 1-10, 1917.
BsBMin-
Disease.
New
casee.
Deaths.
treat-
ment
N«v
Deaths
Diphtheria
4
7
10
23
MeasiM
10
18
1
2
4
Leprosy
Typhoid fever
47
Malaria
8
_
INDO-CHINA.
Cholera — ^Plafne — Smallpox — ^February, 1917.
During the month of February, 1917, 20 cases of cholera, 101 cases
of plague, and 593 cases of smallpox were notified in Indo-China.
The cases were distributed by Provinces as follows:
Oholera, — ^Province of Anam, 3 cases; Cambodia, 8 cases; Cochin-
China, 8 cases; Tonkin, 1 case.
Plague. — Province of Anam, 31 cases; Cambodia, 67 cases; Cochin-
China, 13 cases.
SmdUpox. — Province of Anam, 297 cases; Cambodia, 36 cases; Co-
chin-China, 193 cases; Tonkin, 67 cases.
Cholera showed a decrease in the month of February, 1917, as
compared with the preceding month, only 20 cases being notified in
(1292)
Digitized by VjOOQIC
1293
▲ncnst 10. 191f
Fabmaiy, 1917, as against 52 in January, 1917. In January, 1916,
915 cases of cholera were reported, and in February, 1916, 417 cases.
The plague cases rq>orted in February, 1917, exceeded the number
reported for January, being 101 as compared with 82.
SmaU^x increased considotibly during the month of February,
1917, 593 eases being reported as compared with 174 in January
TIm prevalence was much greater than in the corresponding month
of 1916, when 96 eases were reported. The greatest incidence during
the month of February, 1917, was in Anam with 297 cases and
Cochin-China with 193 cases.
UNION OF SOUTH AFBIGA.
Plaf«e— -Orange V^ee State.
JL fatal case of plague was reported May 28, 1917, in Winburg
jtataici, Orange Free State. The case occurred on Strydfont^>in
faim.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS RYES, AND YELLOW FEVER.
Repwte BeceiTed Dartet the We^ Ended Amgmai 10, iai7.«
CHOLBBA.
Place.
Data.
Cases.
Deaths.
Remarks.
Mk^
llay27-JunB2....
do
1
I
1
RttifiKm
Feb. 1-28, 1017: Cases, 20; deaths,
12.
^""^^
Anam
Feb. 1-M
a
8
n
1
1
C^rabodia.^
do
6
6
CociHD-Cliina
do
T(H\ldn
do
Fbflhwtne Islands:
June 17-23
ftovinces
June 17-23, 1917: Coses, 143;
dCAlh* MO.
Albav
Jun© 17-23
do
27
1
29
35
31
10
18
Batangas
1 '
Bohol
do
26
10
10
ft
Capiz
do
Cebu
do
BorsogOQ
do
PLAGUE.
India:
Bombay
June 3-0
38
57
0
25
33
62
12
28
KwftchL -r
do
Ifay2?-June2.....
do
Ranroon . '
Indo^iilpa:
Feb. 1-2S, 1917: Cases, 101. deaths
Anam
P(Bb. i-28
31
57
13
20
1
1
i5*
47
0
11
1
71.
Cambodia
... .do
Ccchin-ChiTMi
do
Saigon
May2K-Junea.....
May 27- J una 1....
iirm ?-«...,
Stem:
i^angVoV T r ,.,..,. .
BtialtsScttlements:
Singapore
Unlcm of §outh Africa:
Orange Free State—
Winburg district
lfay^28
1
.—
VFn
offiaen of the Public Health Service, Am^rtenii coastals, and oiIkit t^irmt.
Digitized by VjOOQ;
I
AugUHt 10, 1917
1294
CHOLERA. PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW RSVBR-
Continued.
Reports ReceWed Dnrinf tke Week Ended Avfosl 10, 1917— Conlioiied.
SMALLPOX.
PlMf.
Date.
Ouet.
Deatba.
ReiiiArks.
AustraUa:
New South WalM
■J-
May 37-JiiiM at, mr: cum, 14.
nrcwftirirm. ............
Juneg-21
May2S-June7....
June 10-23
a
13
CoooabarAbniL.
Cbongklng
Present.
Dairen...T
June 34-30.
June25-Ju]7l....
June la-JuJy 7. . . .
4
1
flhAll^hM _
5
3
Tsingtao
France: "
Paris
May 6-12.
1
35
7
13
3
India:
Bombay
Junea-0
0
irftny»ii|
do
MmJrM .
May27-June2.....
do
3
Rangoon
Indo<aiIha:
Provinces
Feb. 1-38, 1917: Cases, 593; dcetts
Anam.
Fib. 1-38.
307
30
103
67
67
1
8
1
7
1
53
1
31
'>inibodia„ X X X X X
do.
(ochln^aiina.
Tonkin
do
do.
BaiKon
May28-JunelO....
June25-Julyl....
June 36-30.
June25-Julyl....
July 11-17
Japan:
Kobe
Osaka
4
Yokohama
Mexico:
M^ffAtlftn... ...
3
.1
Portujsal:
Usboo
June 10-30.
May 13-10.
6
38
1
Peirocrad
Riga
Mpy ^17, .
Venexuela:
Maracalbo.
July 2-8.
3
Algeria:
Algiers
China:
Antung...
TslnU>..
Russia:
. Pctrograd.
Riga
Switxerland:
Basel
Tunisia:
Tunis
TYPHUS FEVER.
June 1-30
June 2>-July 1
JuneK-JuJy 7....
May 13 19. .
May&12...
June 17 23
June 30 July 6.
Place.
India:
B»-^in
Calcutta....
Mr.lri.
Ma-^'liliy...
I'll', -kku...,
Hu'' ' .-on. ...
li»»l- - 1 .fi i:
J.i\
Reports ReceiTed from Jane 30 to Aug. 8, 1917.
CHOLERA.
Date.
Apr. 1-May5...
Apr.2^M^a9..
Apr. 23-28
May 6 12
May 13 19
Apr. 20 May 6...
Apr. 21 May 19..
Ai»r. 23 May 27....
Vi.a \pr a H...
' na
..' IMI \1»T. 1 { P».
Cases. Deaths.
30
t«3
8
273
1
1
3
1
15
108
Remarks.
^^^J^t^ogte
'S^
1295
August 10, 1917
CBOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEYERr-
Continued.
Reports ReeeiTed from Jiue 30 to Aug. 3, 1917— Continued.
CHOLERA— Continued.
Ptece.
Date.
Cases.
i)eaths.
Remarks.
Amir Kels
Fab.S
1
4
1
S
Barfouroodie
Jan. 15-17
Wain«ft Kela
Jan. 17
UtrhfdffKnr x .
Jtn.81
PUUppliw Islands:
Hay 20-June 16, 1017: Cases, 653:
deaths, 417.
All»y
HayaO-JunelO...
J^me 3-9
77
2
251
4
142
117
S
52
163
4
00
2
50
3
Bohol
Mayao-Junel«...
Jun6»-16
Canis
CBbu
do
Lerte
June 10-16
June 3-10
TftTaoas
do
..
PLAGUB.
AnbU:
Aden.
Ctjkn:
Colombo
Ctett:
Aney
BoD^kDOg
I Kwao^tung Province—
Ta-pu di-itrict
?roi<nees—
Fayocun.
Oirrefa...
8loat.
t Britain:
Bombay
CUcotta
Heozada
EarMiii
IWras Presidency. .
Uandalay
Moulinein.
Jylncyan.
lUo«oon
, Toangoo
8ii|oo
fcu:
EwtJtva
8unbaja
Surakarta
nri
IJtp^rtmnits^'
SZ"*
Ufi^:?"!::::
ta:""-
^'»*««8oath Africa:
Ch» oC Good Hope State-
^Qmenstown
^>«*a«»Fre«SUto
)Cay3-JuneU.
Apr. »-lCay 10.
Apr. 2»-iay 5.
Mayl3-June0.
June2
May 12-17..
Hay 11-17..
Hay 17
Hay 12-15.
Hay 12
Hay 3-8..
Apr. 1-Hay 10. .
Apr. 22-June2..
Apr. 20-Hay 26.
Apr. 1-Hay 10..
Apr. 22-May 26. .
do
Apr. 8-May 12. .
Apr. 1-May 12. .
Apr. 1-7...-
Apr. 15-Hay 10.
Apr. 3-14
Apr. 23-May 27..
Apr. 2-22..
do
Hay 16-31.
....do....
.....do....
....do....
....do
Apr. 22-Hay 26.
June 6.
13
343
460
210
115
27
39
297
37
33
411
171
0
52
1
110
2
A^^Iay 14, 1017: Cases, 60;
Present and in rldnity.
Present.
"m.l-lL
deaths
Jan.l-Hay 17, 1017: Cases, 231;
^"-•^-, 116.
2 In hospital at port. From s. s.
Sardinia from Australian and
oriental ports.
Apr. 15 -May 26, 1017: Cases.
34,545; deaths, 23,036.
Apr. 2-22, 1917: Cases, 18; deaths,
18.
May 16-31, 1917: Cases, 15.
At Mollendo.
At CaJlao.
At Chidayo.
At Salavcrry, San Pedro, and
TrujiUo.
At Lima.
Apr. 16-22, 1917: 1 ease; Apr. 9 -22;
1917: Cases, 26; deiths, 17.
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August 10, 1917
1296
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW PEVER-
Continued.
Reports Received from June 90 to An^. 3, 1917— Continued.
SMALLPOX.
Place.
Date.
Australia:
New South Wa 1 .\«
Brewarrina
Quamljone
Queensland-
Thursday Tsl ind Q uar-
antiucStitlon.
Brazil:
Bahia
Rio de Janeiro
Canada:
Manitoba-
Winnipeg
Xo\'a Scotia-
Halifax
Tort Hawkesbury.,
Ccjlon:
Colombo
China:
Amoy..
Antune.
Chungking
Changsha
Dairen
Harbin
HonskonR
Manchuria Station.
Mukden
Shanghai :
Tientsin
Tsitshar Stat ion...
Tsingtao
Egypt:
Alexandria
(icrmany
Berfin
Bremen
Charlottenburg
iramburg ,
Lcipiig ,
Labeck
Munich
Stuttgart ,
India:
Bombay ,
Calcutta
Karachi ,
Madras ,
Rangoon ,
Indo-Chnia:
Saigon
Italy:
Turin
Japan:
Kobe
Nagasaki
Osaka
Yokohama
Javrt:
East Java
Mid-Java
West Java
Batavia
Mexico:
McNicDCity
Monterey
Philippine Islands:
Manila
Portu^:
Lisbon
Portuguese East Africa:
Louren^ Mar<iucz. .
Apr. 27-May 10.
do
May 9..
MavO-12
May G-June 16.
June 10-16
Junolft-July 7..
June 17-30
May 6-12
Apr. 29-May 26.
May21-June24.
May 6- June 2...
May27-June2..
May 13-Juno23..
Apr. 23-May 6. . ,
May ^Junel6..
Apr. 23-29
May 27-Juno2..
May 21-Juno 24.
May 13- Juno 9..
Apr. 16-22
May 22-June 16.
Apr. 30-Jimo 10. ,
Mar. 18-Apr. 28-
.do
do
do
do
.do.
.do-
.do.
Apr. 23- June 2...
Apr. 29-May 26..
Apr.22-Mayl9..
Apr.22-May26..
Apr. 15-May26..
Apr. 23-Ma7 27. .
May 21-Jmie 24. .
May 27- June 24. .
May 28-June3...
May 16- Juno 10. .
May 27- June 1...
Apr. 2-29.
Apr. 1-21.
Apr. 13-May 3. . .
Jiiiiea 30..
June IS 24.
May 13- June 9..
do
Mar. 1 at
Cases.
Deaths.
33
106
16
18
50
20
2
10
1
13
56
25
132
32
52
1
161
11
162
16
Remarks.
Apr. 27-lCay 10, 1917: Cas^^'e.
From s. 8. St. Albans from Kobe
via Hongkong. Vessel vn-
ceoded to Townsville, Bris-
bane, and Sydney, in quaran-
tine.
ny'^.
Present in district.
Present and in vicinity.
Present.
On Chinese Eastern Ry.
Do.
Present.
Cases foreign; deaths among ot*
tives.
On Chinese Eastern By.
At another station on raflway,
lease.
Mar. 18-Apr. 28, 1917: Case?, 715
in cities and 32 Statear. and
districts.
Apr. 13-May 10, 1917: Cases, 4«;
deaths, 7.
Varioloid.
Digitized by VjOOQIC
1297
August 10, lOlf
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVEI
Continued.
Reports ReceiTad from June SO to Aug. S, 1917— <bntinaed.
SMALLPOZ-Contlnoad.
Plaoe.
Date.
Cases.
Deaths.
Remarks.
Arc4ianrn]
ICavl-li.
7
331
3
23
2
PMrosrad
Feb. lS-Ma7l2...
Mar.ll-Mayl»...
Mar. 15-21
lCavl-31
rS!!vv..:.:.:.:..::::::::
Jan. 1-31,1917: Cases, 7.
Vladivostok
7
3
5
Spain:
Madrid.
Serine
do
VfilfAd*
June 3-23
3
5
1
1
2
Straits Settlements:
Peoanr
Ifar. IS-May 12. . .
Apr.22-28.
Iiay20-June2....
June 2-8
2
Sweden:
Malmo
Stockholm
1
Tunisia:
Turkey in Asia:
Trebiioad
Feb. 25-Apr. 13
15
Union of South Africa:
Johannesburg
liar.12-24
4
Vanezoela:
Maracaibo
June 18-July 1
5
TYPHUS FEVER.
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 19IC: C^ses, 2,371.
nAh#tmlft
Oct.2J>-Dec.l7....
do
634
809
47
617
243
Qalicia
Lower Austria
do
- Monvia
do
Silesia
do
Styria
do
Upper Austria
do
Feb.l9-Mar.2o, 1917: Cases, 1,38L
Honeary
Dudaiiest
Feb.19-Mar.25...
June9-lfl
83
1,421
China: *^
n«ikow
Tsingtao
May30-June9....
Apr.30-JunelO...
June 17-23
Alexandria.
413
1
26
Great Britain:
Cork
Greece:
Saloniki
May 13-16.
Japan:
Nagasaki
June 11-24
Apr. 1-30
Java: "
Mld-Jara
2
WestJava
Apr. 13-May 10. 1917: Cases, 86.
Batavia
Apr. 13-Moy 10. . .
June 3-30
22
431
84
Mexico:
Mcxicoaty
Netherlands:
June 9-23
2
Portuguese East Africa:
Lourenco Marqaes
Mar. 1-31
Boasia:
Ar(4iance1..
May 1-14
Petrograd
Feb. l^May 18....
Jan. 1-31
3
Biga
Vladivostok
Mar.29-May21....
May 1-31. .
Spain:
Madrid
2
YELLOW FEVER.
Mtxioo:
Yucatan, 8tat»-
Peto.
In person recently arrived from
Mexico (Ity.
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PUBLIC HEALTH REPORTS
VOL. 32 AUGUST 17, 1917 No. 33
CERTAIN MILITARY ASPECTS OF HOOKWORM DISEASE.
By Ch. Wardell Stilus, Professor of ZooIog>', United States Public Health Service.
A uewly formed militia unit, recently mobilized for war service, was
quartered temporarily at a Government reservation where the writer
was conducting some experiments. Within less than two days after
reaching their quarters one of the recruits was suspected of trymg to
shirk his duty and the commanding officer planned to place him in
confinement for discipline. The man claimed that he was not feeling
Will, and the lieutenant, as a matter of justice to the recruit and of
protection to himself, requested me to pass upon the case medically.
Tho diagnosis of light hookworm infection was made upon the basis
of symptoms and was immediately confirmed microscopically.
Treatment was instituted, and the patient promptly gained about
8 pounds in weight.
On the third day after reaching quarters a second recruit was
brought for examination. He had stood guard the night before, was
unable to sleep later, and complained that without sleep he was unable
to drill. He gave a history of insomnia, for which he had been under
treatment that had not given satisfactory results. The writer again
diagnosed light hookworm infection from general symptoms and con-
firmed the diagnosis microscopically. After treatment this man re-
covered completely from his insomnia, changed remarkably in ap-
pearance and disposition, and became one of the leading spirits in the
unit.
A tentative diagnosis of hookworm infection was then made of ten
or more other men from their general appearance, as noticed on the
most casual observation, and specimens were collected for micro-
scopic examination.
In a total of 75 miUtia recruits recently examined by the writer at a
Government reservation, 47 men (63 per cent) showed hookworm
infection, 3 Ascaris lumhricoides, 1 Hymenolepis nana, and 1 a heavy
infection with Sirongyloides',^ two recruits had double infections; 25
examinations were negative.
' Hec(kiniQeiidAti<ni was made that the recruit (who was in the galley) with the StrongyloHes infection l)o
discharged, on the groonds that: (o) No satisfactory treatment is known for this condition and {b) the
rtsUofan early breakdown and resulting pension were so great as not to be justified.
W (1299)
Digitized by VjOOQIC
August 17. 1917 1300
Treatment of the infected men was instituted, and although the
writer left the reservation for another station before this was com-
pleted, the physical improvement and the gain in weight and efficien-
cy among the recruits were so marked as lo procfuce commait €fv«i
from the nonmedical men.
One of the hookworm patients was an ex-cadet from W^t Point, who
had been ^'foimd'^ by a very narrow margin in his midyear examkukr
tions. Theoretically his infection was ample to account for his
failure and the financial loss incurred thereby by the Government.
The foregoing experience has its lessons in the |Hresent war con-
ditions, and the following important points in particular should be
noticed :
(1) These recruits represent an unselected instance of what may
be expected in certain portions of the country among average en-
listments.
(2) Two volimteers were rejected because of remediable conditions
clearly due to hookworm infection, and these men represent instances
of a very large number of cases that will probably soon be noticed in
many counties in both the Gulf-Atlantic and the southern Pacific
regions.
(3) Several recruits were rejected because of underweight, and in
the forthcoming selective draft there wiH imdoubtedly be hundreds
of similar cases. If the regulations permit, numerous cases of this
type might justifiably be accepted provisionally, subject to the results
of treatment as respects probable increase in weight.
(4) A failure to treat the hookworm cases and to eliminate at lea^t
the severe infections of Strongyloides will undoubtedly result in unjust
and preventable punishment for oflFenses due to remediable condi-
tions, considerable physical and mental inefficiency, an imnecessarily
high daily *'sick call,*' and premature and preventable pfehsions.
(5) If even light cases of infection with hookworms are sent to the
trenches in Europe the danger is present of causing a widespread
epidemic similar to the St. Gothard Tunnel epidemic, or fer^en to the
Andersonville stockade epidemic.
(6) The danger is also present that our military forces may cause
a widespread infection in Franco and Belgium that it will take yeara
of work and large expenditures of money to control and eradicato
after the war.
(7) The dangers referred to (inefficiency, sickness, epidemics, etc.)
can be prevented to a very great extent if all the recruits (or at least
those from certain States) are systematically examined for intestinal
parasites and either treated in the American training camps or dis-
charged, as necessity indicates.
(8) The examination can best be a "3-shde" C'lO-cover glass")
test, preferably by the centrifuge method. If an examination for
hookworms only is made the work will be materiaUy lessened.
Digitized by VjOOQIC
I
1301 August i7. 191T
(9) This examination could be made more economically, more
efficiently, and more rapidly at a central laboratory than at the
separate conoentrktion camps. The specimens could be collected at
the camps and sent by parcel post, imder proper precautions, to the
central laboratory. This plan is evidently not free from objection
from certain administrative points of view, but if adopted it would
save the duplication of equipment and unnecessary training of many
assistants and it would make for uniform examination.
10. As a preliminary and tentative estimate, subject to revision if
necessary, it may be said that the examinations suggested would cost
somewhere between 20 cents (possibly 15 cents) and 30 cents (pos-
sibly 40 cents) each. Certain factors in the expense can not, however,
be definitely foreseen at present.
11. The writer's experience indicates that girls are better for this
work than men, but existing circumstances make it more feasible to
train men enlisted in the hospital corps to make the examinations.
It takes about 1 to 8 weeks to tram a person to bo trustworthy in the
examination. The best results are obtained if tlio microscopist (^oes
not have to work more than half a day at a tune.
12. It would be wise to begin promptly with all units at present
organized. , ^
, 13. While the hookworm and Strongyloide>i examinations are the
most important ones involved, the other parasites should be con-
sidered. Accordingly, the examination of recruits from the warmer
portions of the country is at present more pressing than the examina-
tion of mpn from colder localities. The question of extending the
iBspectioi>: to all recruits Is, however, an important one to be con-
skjered and it would be wise to extend it if time permit.
I 14. It secerns highly probable that, even leaving out of considera-
tion the money value of increased efficiency, the entire expenditure
iftvolved in the examination would bo saved in the reduced pension
roll
• 15. It would be well to consider the question whether it would not
be wise to combine the examination with a newspaper campaign to
induce prospective recruits to take the initiative to have themselves
examined and treated.
MALARIA IN EASTERN TEXAS.
PREVALENCE AND GEOGRAPHIC DISTRIBUTION.
The periodical circularization of the physicians of eastern Texas
to determine the prevalence and geographic distribution of malarial
infection in the eastern part of the State was carried on during the
last nine months of 1915, and the first, second, and fourth quarters of
Digitized by
Google
August 17, 1917
1302
1916. At regular intervals reply postal cards were sent to the prac-
ticing physicians. These cards were sent out quarterly.* A repro-
duction of the card used during 1915 and 1916' will be found (m
page 1128 of the Public Health Reports of the issue of July 20, 1917.
Of the cards sent to physicians an ayerage of less than 14 per cent
were returned. Those returning the cards with the requested data
filled in undoubtedly coi^tituted the better class of practitioners,
those who imderstood most clearly what was wanted and the yahe
of the work. The number of cards sent out, the number of schedules
returned, and the counties represented at each circularizaticm are
shown in Table No. 1.
It is to be borne in mind that the number of cases reported by the
physicians by no means shows the number of cases that occurred, for
an average of less than 14 per cent of the physicians returned the
schedules.
Apr.
Itoy.
JniiA
i^tti.
Aof.
Sep.
Oot.
Hov.
Deo.
A
A
f \
n
y
V
/
\
y
\
y
\,
'
,-^
s,
'"^^^
.
Eelativc prevalence of malaria in eastern Texas, by months, as
indicated by the numbers of cases reported.
The return of the schedules by the physicians being a matter of
voluntary cooperation, the data are undoubtedly reliable to an
unusual degree as regards the experience of the physicians who
cooperated and the number of cases seen by them. It is to be home
in mindy however, that the cases reported represent only those
occurring in the practices of the physicians who cooperated. The
total number of cases of malaria occurring in the practices of all
the physicians of the State must have been many times greater,
also the number of cases that occurred in which no physician was in
attendance or consulted was probably much greater than the
number coming under medical care.
> The work of drcularizatlon and of compilation of the data on the rettim cards was carried on by tii0
jate Surg. R. H. von Esdorf up to the time of his death in September, 1910. Since then it bas been KXcAfA.
oD by Asst. Surg. B. C. DeriTiux and Asst. Sure. 0«n. H. R. Garter.
Digitized by
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1303
August 17, lOlf '
The phyfiicians who cooperated wore distributed as to locality
throughout all sections of the State, so that the data of the oc<;urronce
of malaria furnished by them show the geographic distribution of
the disease and reasonably accurately its relative prevalence in the
various locahties.
The casoK reported by months arc b-hown in Table No. 2. The rela-
tive uumbors of cases reported by months are also shown in the chart
herewith.
LA.
Behlirr iir<->To Vnc » of miUriu iu caslern 'i\\.s, by counlif.-:, in pr.»{v»rlion to the pojnllutlon, as
inrlicated by the numbers of cat.e> rcp3r(e 1.
The number ot cases reported from the bcvoral counties arc given
V race and year in Table No. 3.
The map on page 1303 shows the relative picvalence of the disease
8» the several^counties, the heavier shaded (ounties being those in
Digitized by VjOOQIC
Avgoflt 17, 1917
1304
which the infection is heaviest, the unshaded countieB those in which
the infection is Ughteet, as indicated by the numbers <rf cases reported.
T^e relative density of infection was determined by ascertaining the
number of cases reported in each coimty during the entire period (or
which reports were received per 1,000 population. The population
used was that of the 1910 census, it being impracticable to estimate
populations for the period of the circularization.
By Table No. 4 it will be noted that hemoglobinuric fever was
reported in seven counties.
Table 1. — Results of circularizcUion of practicing physidanB.
Pwlod.
Inquiry
cards
sent to
pliysi-
R«plles
raoHv
ved.
replies.
Countitt
repre-
sentMl
in re-
plies.
Ooontiefi
not
from.
rasas o(
inalanA
reported.
1915.
Aprilto June
July to September
October to D«oeinber . .
1916.
January to March
Aprilto June
October to December. .
3,450
3,450
3,450
3,450
3,450
3,500
584
676
492
450
368
402
1«.P3
16.70
14.26
13.04
10.67
11.49
6,7:3
21,259
11,5%
2,4i5
5,9«
3,5»
TABtB 2. — Cases of jnalaria reported by -months.
Year.
Janu-
ary.
Feb-
ruary-.
MartJh.
April.
May.
June.
Jnly.
Au-
gust.
Sep-
tem-
ber.
Octo-
ber.
No-
vem-
ber.
De-
own-
ber.
1915
1,606
1.179
2.161
1,752
3,006 ! 4.129
6,455
10,675
5,525
1,515
3,771
1,233
2,280
1916 1 74«
700
907
3:977
Table 3. — Cases reported by counties, by years, and by color.
County.
Apr. 1 to Dec. 81
, 1915.
Jan. I to June 30 and Oct.i
to Dec. 31, 1916.
White.
ColoncL
103
Com-
bined.
White.
Colored.
Com.'
bined.
Anderson
236
90
339
90
lOG
52
15
121
Angelina
52
Aran.<as
Archer
i
380
671
5
1
747
770
5
Austin .
367
99
187
%
52
58
1
239
IJastiop
155
Bavlor
4
Beo .
BpII
iin
71
206
381
d»
100
22
12
118
78
216
488
73
104
56
14
57
31
65
137
1
15
2
62
M
Bexar
7
10
104
35
4
34
3
46
Bosque »
67
Bowie
199
Brazoria
Bruzos
25
19
14
25
Biirlo'^on
48
11
67
Caldwell
Calhoun
25
Camp
Cass
74
121
44
28
118
149
8
56
6
40
4
38
12
Chambers
M
Cherokee ..
250
34
180
3
439
87
6
Clay
4
»
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1305 August 17. 191T
Table 3. — Caus reported by counties, by years, and by color — Continued.
County.
Apr. 1 to Dec. 31
, 1915.
Corn-
Lined.
JSLD. 1 to June 30 and Oct. 1
to Dec. 31, 1916.
White.
Colored.
White.
^o»o"^- binSd.
ColUn
402
87
101
204
41
548
352
301
61
60
38
6
10
2
113
58
25
47
462
125
110
214
43
661
410
326
111
180 11
191
Colorado
CooaJ
Cooke
21
43
14
33
8
54
51
14
Coryell
Dallas
Delta
7
7
418
110
138
11
56
22
3
5
474
133
Denion
DeWitt
141
16
Eftstland
Ellis
350
63
233
352
i7i
37
51
.172
521
100
287
52-1
255
62
46
109
40
37
11
47
295
Falls
89
Fannio
57
Fnrettf
156
Foard...
13
13
FoctB«iui '. .
98
126
224
266
24
2
338
173
87
18
19
60
16
24
Franklin
83
Freestone
1,504
20
14
56.5
149
102
217
17
1
106
96
168
1,721
37
15
671
245
270
326
G(*ad
40
Gonzailes
2
Grayson
24
128
116
362
Gic^ :::::.:.:.:::.:.....:.:...
301
Gnmes
203
Guadalupe
Hardeman . .
11
167
1,.'j1U
3H
16
169
2.^H
463
6:m
614
2.>
192
286
28
■V)
733
11
211
2,027
67
17
211
287
644
1.112
662
30
263
700
.36
63
856
3
3
Hardin.
44
.)0S
29
I
42
49
181
488
71
414
8
8
123
4
2
6
Harris
298 1 29
22 ( 35
11 1 10
550 1 133
327
Hamson
57
Hav5
21
Hendenon
683
Hill
3
91
103
152
29
85
11
28
88
14
3
H<^kins
45
71
29
136
Houston
174
Hunt
181
Ilcksan.. ..
7
Ja5*r ;.;.!. .!..".!...!.!.!;..!.'.!
25
9
.54
Jeaerson
W
Johnson
11
Karnes
Kanlman '.
Klehenj
I
31
1
29
119
15
Knox
12
i,09
99
326
1.74.1
110
1.731
270
1,012
■;
i2
1.378
119
390
2,4.36
140
2,013
321
l.OKJ
Lamar . .
.'69
70
691
30
282
51
81
119
33
101
235
325
28
111
92
62
39
82
24
44
1
28
177
73
7
52
14
ia3
Lavaca.
Lee •
lmo ..:..::.:...: :..;:::::::
Liberty
31
129
412
39S
Limestone
McLennan
35
163
Madison
Marion
106
62
iSSf"'!.:".:'.:::::::;:::..:::-
Mwta^ic
MontRoni TV . .
' 115
3-13
' 18
133
148
218
491
18
22
53
61
135
24
MorTg...^.::::::::::::::::::::::::::::::
Xacogdothi:-
NaTarro
Nerion.
1,493
, 474
23.1
I7r.
' ins
! 7
800
308
2.2".^:?
7S2
1 291
170
192
0
1
90 70
234 92
86 45
160
320
131
Ofancc
24
1 1
Panob '../^['.'.y/^//^y/^ .['...[['.'.'.[
Polk.
67
13'
100
209
49
116
13
Rains...
100
RedHixcr .' .'....*.
Refocb
877
) 210
1 i,as7
1
34
243
Roben5ton
280
I.Vi
754
182
189
20
2
340
VA)
220
i 372
\ 79
! 337
5U
283
22
28
27
1 017
245
1,037
204
217
! 53
; 2
3,-.0
' .-.84
290
382
84
i 238 1 66
7 , 3
130 1 68
304
Rock\Ta!l
10
Rosk
204
flrt)ine V..V.:[V.
199
575
19
26
218
8tn \n^\%t ine
001
8anJarintn. . , .
SanPatTirio
' 3'
3
Bhelbv
io
128
70
10
i 5
, G3
: -jii
1 k:
8mwK :.;::::...::.:::::::":
, 197 1 \V\
1 5,3 1 111
51 , a
* 21U
Tarrant
J OS
Titns
M
Travis ::::::::::::: :■:";■
30 1 19' m
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AugVfft 17, 1917 1306
Table 3. — Ca#«s reported 6y counties, hp ytan, and bf coior — ContiBued.
C<unty.
Apr. I to D«c. 31
, 1915.
Jan. 1 to June 30 and Oct. 1
to Dec. 31<1916.
White,
Colored.
Com-
bined.
White.
Colored.
Com-
biBcd.
Xiinlty
180
179
624
64
34
26
96
112
6
37
9
477
37
850
215
16
458
16
4
25
119
29
2
19
395
195
80
38
51
215
141
8
56
9
534
42
1.076
60
54
83
78
4
14
24
28
30
7
Tyler
Upshur. . ..►
m
Van Zandt
Victoria
Walker
is
Waller
WAshinirt(m
6
25
11
Wharton .
19
1
44
Wichita
12
Wilbarger
W illiarason
57
5
217
159
2
190
78
1
106
B7
Wilson
3
Wood
m
Total
29,504
10,104
39,608
9,073
2,809
ii,aB
Table 4. — Hemoglobinuricfevar reported, 1916,
County.
Period.
i Casn.
Denton
Hopkins...
Wood
Delta
Henderson .
Men- is
Titus
First quarter....
do
do
Second quarter..
Fourth quarter.
do
....do
TYPHOID FEVER.
EPIDEMIC AT CHARLESTON, W. VA., APRIL-JUNE. 1917.
By A. W. Freeman, Epidemiologist, Unltel States Public Health Service.
During the month of May, 1917, an unusually large mmber ef
cases of a fever, diagnosed by the local physicians as typhoid, began
to be reported to the health commissioner of the city of ObarlestoB.
The dates of report of these cases are given in Table 1.
During the months of May and June, 127 cases were reported,
and early in May the matter attracted the attention of the West
Virginia State board of health. An investigation was immediately
begun by the board. Shortly afterwards request was made of the
Surgeon General of the Public Health Service that an investigation
be made into the causes of the epidemic. This investigation, df
which the following is a report, was begun on the evening of June 16,
and completed on the evening of June 26. It was conducted in
cooperation with the city and State boards of health, and much of
the information used in this report was obtained from these
authorities.
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1307
August IT, 191T
Scape of die iareofigslion.
The investigation included the collection of the usual epidemi-
ological evidence regarding all reported cases, and regarding alto a
number of unreported cases which were discovered during the
investigation. In addition, investigation was made of the public
water supply, the milk supply, and the general sanitary environ-
ment of the commimity. Associated with the writer were Prof.
Earl B. Phelps, professor of chemistry in the Hygienic Laboratory,
and Sanitary Bacteriologist E. E. Smith. Prof. Phelps conducted
the investigations into the public water supply and sewerage sys-
tems, and Mr. Smith made bacteriological examinations of the raw
and treated water from the public supply.
Table 1. — Dateof report of ca$es, typhoid fever, Charleston, May 1- June 25, 1917.
. Date.
Cas«.
Date.
Cases.
MftTl
2
1
1
2
1
8
2
\
1
1
1
i
1
Xonel
i
s;:::. :::::::. ::.::.:..!
2
I
9
4
9
11
7
13
14
8
«
15
9
4
16 i
11
2
17
n
7
Ig.
13
s
20.
14
. 1
28.
16
0
as
17
3
as
Ig
2
27
19 :
1
a.
20.*.
3
29
21
s
M.
23
1
31
23
3
25
2
ToW
Total
43
83
May 43
June 83
Unknoini 1
Total.
127
Epid««i«logktl bFe^CigalkMis.
Epidemiological investigations were made of 141 cases of reported
and probable typhoid fever. Of these, 1 13 were cases reported to the
health comnussioner by physicians, and 28 were cases occurring in the
neighborhood of reported cases* which were not reported, but were
discovered during the course of the investigation. The homes of
tbese 141 patients were visited and the data collected at first hand.
For the detailed work of investigation of these cases, the writer is
indebted to Dr. Harold B. Wood, Assistant Commissioner of Health
ior West Virginia, who personally visited most of the cases and
supervised the visiting of the remainder.
Diftfnoiis.
Of the 127 reported cases, 120 were diagnosed as typhoid fever by
the attending physician. The remaining sevwi were diagnosed
"paratyphoid" or "probable paratyphoid." The diagnoses u^
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August 17, 1917
1308
I
'^ paratyphoid^' and *' probable paratyphoid'' were aU made by two
physicians. The remainder of the physicians who reported cases
agreed that the disease was true typhoid fever. Positive Widals were
obtained on numerous cases by the city chemist and by other physi-
cians who made laboratory tests, and the cases seen by the writer
were apparently true typhoid fever. There seems, therefore, no rea-
son to doubt the fact that the epidemic was one of typhoid fever.
Clinical Course.
The clinical course of the disease was apparently imusually mild.
Many cases had fever for only a few days, and severe ( ases were
apparently rare. In at least one instance, however, three cases in
children, members of one family, who were attacked at the same time
had strikingly different combes. One child had fever for one day
only, another had fever for three or four days, while the third went
into a typical course of prolonged fever with the usual picture of
severe typhoid infection. Only three fatalities had occurred at the
time of closing the investigation.
Age Distribution of Cases.
The age distribution of the cases was quite striking, by reason of
the preponderance of children among those attacked. Of the 141
cases investigated, 4 were imder 1 year of age, and 29 were under
5 years of age, while 37 were between 5 and 9 years, 30 were between
10 and 14 years, and 16 were between 15 and 19 years of age. Of
the 141 cases, only 29 were 20 years of age and over. The age dis-
tribution of the cases is shown in detail in Table 2.
Sex Distribution.
As is usual in typhoid outbreaks, the males were attacked in
marked excess as compared with the females, 80 males being com-
prised in the present scries as against 61 females. The preponderance
of males is found at all ages, except for the group between the ages of
15 and 19, in which there were 5 males as against 11 females.
Table 2. — Typhoid fever, Charleston, W. Va., April -June, IV 17 Age and se>' Oi^tri-
hution of cases.
Age in years.
Number
of
males.
Number
of
females.
Both
sexes.
Number i Number n^.u
Age in years. of , of *ijlj
1 ' males, 'female.. '^•^'^^-
1
Under I
4
14
0
n
4
25
i 25 to29 1 3 <
lto4
\ 2(\tnU 1 :t I « ' 6
. |l -jn ♦.. -in 1 o I 1 3
Total under 5
18
23
18
5
7
11
14
12
11
5
29
37
30
i 40to44-!!!!.!!!!!!.! i i o ! i
6to9
' 45 and over 2 ' 1 3
10 to 14
15 to 19
U, 1 Tolal ' 80 1 61 1 m
20to24
12 ii . 1 ,
1 1 ' 1
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i;
1309
Ausuat 17, 1917
TABtB 3. — Occupation of fMiUnt9.
School 57
Noiie* 4^
Ho^iiwwife
10
Booitkeepcr
Nur*^
Clerk
Tgilor
Real estate
Ccal deader
Toftcher
Ax grinder
Re^auT&Dt
Servant
Park manager 1
Waiter I
Bankderk 1
Telephone* ojx^rator 1
Klaehimst,
Collector
Solcli«F
Groe«r
Street car caoductor
I
I
1
2
,.. 1
Unknown 5
Tot»} 141
Table 4. — Onset of asm, by days.
•
Dat«.
Cases. ,
Date.
Cases.
3
1
I
3
5
1
2
a
. 4
s
5
5
4
5
3
5
i
Date.
Cases.
Apr. H
20
1
1
If
Maylfe.
June 1 ,...
i 1.
1
11
• 8
29
M
1 3
g
19
t 4: :
1
3
20
5
0
2L
0
1
May 1
4
22
3
2
4
1
4
3
]
23
8
6
3
24.::::.::::::::.:
9
3
4
36
10
14
6
5
26
1
6
2;
! 15
1
7
28
18
1
g
3
2
V
'i
29
j Date uuknovn.
1
10
30 :
46
11
31
12
I
IS-
91
aUMMART.
A pril cases 3
May cases , 91
June cases 46
Unknown date 1
Total.
141
OfCttpadan.
As might be expected from a study of the age distribution, a krge
Bvxnber of o«se» occurred in school children, and in children without
occupation. The occupations ol the remainder of the patients,
however, were widely diversified, and inchided practically all grades
and classes of society in Charleston. The occupations of the various
cases are given m detail in Table 3.
Chronology.
Tha chronology of the cases is given in detail in Table 4. The first
c^^es appeared cm April 14^ 20, and 29, while the epidemic proper
may be said to have begun on May 1 . Between May 1 and 15 occurred
* Mof tly cbildran under sobool ^^.
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August 17. 1917 1310
a group of caseS; 36 in number. This period was succeeded by a
period of four days in which only a few cases occurred, and this in
turn by a period, lasting from May 19 to June 10, which was the
most severe of th<^ entire epidemic, and in which 93 cases occurred.
Location of the Cases.
The location of the cases was quite striking, in that the best
residential districts of the city were most severely attacked, the
outlying territory being almost free from the disease. In particular,
cases occurred mainly in those portions of the city covered by the
public water and sewerage systems. That portion of the city in
which are found the majority of weUs and privies had but few cases.
The major portion of the cases were in the thickly built up sections,
where general sanitary conditions are best.
Food.
Careful investigation was made into the sources of the water used
regularly and of other water used occasionally for drinking by the
patients, and into the source of ice, butter, ice cream, shellfish and
fresh vegetables used by the patients. The results of this inquiry
are summarized in the following paragraphs.
Water Supply.
There are available as sources of water supply in the city of Charles-
ton, the pubhc water supply, which is said to be used by approxi-
mately 90 per cent of the population, 172 private wells which serve
approximately 600 families, or 10 per cent of the population, and sev-
eral spring waters which are vended in the city for drinking.
Of the 141 cases, all occurred on premises supplied with the public
water supply. One case, an infant of six months, was said to have
drunk only boiled water, the remaining 140 having used the city
water regularly for drinking. Eleven cases had been out of town
during the period of probable infection and had drunk other waters
at that time. Of the 141 cases investigated, however, 129 had drunk
no water other than the city supply. No cases occurred in a family
which used well water for domestic purposes, and no cases occurred
in the users of the vended spring waters. .
MUk.
There are 135 dealers supplying milk in the city of Charleston.
Most of these are located in or near the city and furnish only a few
gallons of milk a day. A small amount of milk is shipped in from a
distance, but is pasteurized before delivery. The local milk is sup-
phed without pasteurization. There are no large dealers, the largest
dealer supplying only about 5 per cent of the population of the city.
Digitized by VjOOQIC
1311 August 17, 191T
Of the 141 cases investigated, the source of milk supply could be
determined accurat-ely in 129 cases. In 10 eases the' source of vthe
supply was not known, and in 2 cas^ the supply. came from various
sources. Of the 129 cases whose source of supply was accurately
determined, 14 used no milk whatever, 16 used only condensed milk,
9 kept a cow on the premises and 7 purchased milk from a neighbor
who kept a cow.
Of the 129 cases, therefore, 46, or 35.6 per cent, did not use milk
from the general supply. The 83 cases using milk from the general
supply were distributed among 41 different dealers, and not more
than 7 cases bought milk from any one dealer.
Ice.
Of the 141 cases, the source of supply of ice was determined in 103
cases. The supply in these cases was as follows :
lU&it€Krtm«r"A" 46
Manufacturer **B" 23
No ice prior to illness 34
"A" and **B" are the only two manufacturers of ice for domestic
purposes in the city. Their daily eapacity is as follows:
Tons.
Pilot * A" 42
Plant **B" 25
The ice supplied by these manufacturers is all made from distilled
water uader the Gonditioofi usual in sueh plants.
Ice Cream.
There are no large manufacturers oi ice eream in the city, and
most of the cream manufactured is made from pasteurized milk or
cream. Of the 141 cases c^ typhoid, 25^ stated positively that they
liad not eaten any ice cream other than that made at home during
the probable period o£ infection. Tiie history of the remainder was
doubtful as to having eaten any cream, and no evidence pointing to
the \ise o£ any common source of supply could be obtained.
SftelUfoh.
The epidemic came at a time of the year when little or no shellfish
was on the market at Charleston, and no history of having eaten
any raw shellfish could be obtained from the cases.
Fresh Vesretables.
Theireah vegetables used in Charleston are almost entirely shipped
m from a distance. At the time of the outbreak practically no fresh
vegetables of local origin were on the market. The som-ces of supply
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August 17, 1917 1312
of the coses were distributed through the various dealers of the city,
the large majority purchasing at the nearest greengrocery. There
was no evidence of any common source of supply.
Public Entertainments.
The extent of the epidemic, lasting over a period of nearly two
months, in itself precluded the possibility that the outbreak might
have arisen from infection received from any single public gathering.
Early in the epidemic the suspicion was aroused that the coming
of two circuses, on April 28 and 30, respectively, might have given
rise to the epidemic. The outbreak came too soon after the coming
of these circuses, however, and lasted too long after their departure
to make this supposition tenable.
Absences from Home.
Of the 141 cases, only 11 had been away from Charleston during
the probable period of infection. The infection of the majority of
the cases, therefore, was undoubtedly received in Charleston.
Sununary of the Evidence.
The evidence presented above may be summarized as follows: The
infection was evidently contracted in Charleston. The chronology
and distribution of the case^ would indicate that the infection was
present in repeated instances in some medium of food or drink of
general distribution throughout the city.
The infection was confined to those parts of the city which are
supplied by the pubUc water supply, and the sections of the city
supplied by wells were markedly free from disease. The sections of
the city which are unsewered, and in which surface privies are com-
mon, were also spared to a marked degree.
Tlio infection was confined to the habitual users of the public
water supply.
Milk, ice, ice cream, shellfish and fresh vegetables could be definitely
excluded as possible causes of such an outbreak.
The absence of the disease in the unsewered sections of the city, the
al)sence of flies at the beginning of the outbreak, and the general
chronology of the outbreak would tend to exclude spread from
insanitary privies by fUes and other mechanical means as possible
causes of the epidemic.
Conclusion from Epidemiological Evidence.
The conclusion to be drawn from a study of the epidemiological
evidence, is that the outbreak was caused by infection conveyed by
the public water supply.
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1313 August 17, 1917
Recommendations Made.
Recommendations were made to the water plant regarding the
proper operatiwn ol tke fttrnt to tormr theimmccKfttci emergency, and
further recommendations were made thdt a competent bacteriologist
beat once employed, and that the €>per»tion of the plant be placed in
his hands witlx daily bacteriologieal controls of the raw and filtered
water, cMitmuous appIieatiMi ol coagitlants and it dose of chlorine
approximately 0.5 parts per million. It is believed that these
recommendations, if faithfully carried out, will prevent a similar
outbreak in the future.
In view of the large number of surface privies in the city, recom-
mendations were made to the acting health commissioner that the
effort be at once made to secure the fly proofing of all privies in the
city, the immediate removal of all accumulations of manure, and the
general cleaDing up of the coiismumty, for the purpose of preventing the
access of fliea to potentially inf eeied feces a&d also, as far as possible,
to prevent the breeding of flies* Unlesfl these precautions are taken^
aseeoiidary outbreak of typhoid fever, caused by fly transmission, is
la view of the kigffr number of dairies supplying the city the danger
of a McoAdary raSk outbreak of lai^e proportions is not as great as it
ought be. Small outbreaks nu^y be expected, however, and can be
prerented only by the installation of a pasteurizing plant for the
ptatettrizatioiiv of all milk sold in the city*
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1
PREVALENCE OF DISEASE.
No health department^ State or locals can effectively prevent or control disease uilhoui
knowledge of when, where, and under what conditions cases are occurring.
UNITED STATES,
CURRENT STATE SUMMARIES.
California Report for tlie Week Ended August 11, 1917.
The California State Board of Healtli reported concerning the
status of preventable diseases in California for the week ended August
11, 1917; as follows: Two cases of anthrax in man, one fatal, were
notified in San Francisco, contracted near Sonoma, Sonoma County,
where there is an outbreak on ranches. Of cerebrospinal meningitis,
four cases were notified, one each at Oakland, San Diego, San Fran-
cisco, and Stockton. One case of poliomyelitis was reported at Oak-
land and one case at Pasadena. Cases of typhoid fever were notified
as follows: Sacramento, 6; Modesto, 5; San Francisco, 3; Oakland, 3;
Turlock, 2 ; San Diego, 2 ; Long Beach, 2 ; Colusa, 2 ; Pinole, 1 ; Rich-
mond, 1 ; Los Angeles, 1 ; Stockton, 1 ; Rio Vista, 1. Slight increases
were noted in measles, mumps, chicken pox, and whooping cough.
The details of notifiable disease cases reported during the week
ended August 4, are as follows:
Cases.
Anthrax 2
Cerebrospinal meningitis 2
Cases.
Pneumonia 10
Poliomyelitis. 1
Chicken pox , 11 ! Scarlet fever 2S
Diphtheria 17 ' Smallpox 4
Erysipelas 3 Sj^ihilis 30
German measles 17 1 Tetanus 1
Gonoooccus infection: 61 Trachoma 1
Malaria 14
Measles , 48
Mumps 47
Pellagra 2
Tuberculosis 95
Typhoid fever 33
Whooping cough 15
ANTHRAX.
Mississippi — Harrison County.
On August 10, 1917, 4 cases of anthrax were reported from Harri-
son County, Miss., 2 cases having occurred on June 25 and 2 cases
on July 12.
(1314)
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1315 AnguBt.rv.iwr
ANTHRAX— Continued.
New York— Endkott.
On August 1, 1917, a case of anthrax was reported at Endicott,
Broome County, N. Y. The patient contracted the disease on June
25, probably in handling India hides.
South Dakoto— Mitchell.
On August 9, 1917, a case of anthrax was notified at Mitchell,
S.Dak.
Texas.
On July 20, 1917, a case of anthrax was notified on a ranch in
Refugio County, Tex. The patient contracted the disease on July
18 while skinning dead animals.
CEREBROSPINAL MENINGITIS.
Kansas.
During the two weeks ended August 11, 1917, new cases of cere-
bfospbal meningitis were notified in Kansas, as follows: Kansas
City, 1; Newton, 1; Waverly, 1; Wellington, 1.
Louisiana — ^Jackson.
On August 7, 1917, one case of cerebrospmal meningitis was
reported in Jackson, East Feliciana Parish, La.
Massachusetts.
During the week ended August 11, 1917, new cases of cerebrospinal
meningitis were notified in Massachusetts as follows: Boston, 1 ; Pitts-
field,!.
State Reports for July, 1917.
New cases
reported.
Ptaoe.
New cases
reported.
DWrktofColamWa
2
MassachuseUs- Continued.
Plymouth County-
Brockton
MtMdnittit*:
3
1
BeftahlreCoonty-
WtUfleM......
Suffolk County-
Boston
Bristol County—
Attteboroirii
Total
16
NewB«jSd
West Virginia:
Kanawha County
EMexCoontT—
HtTerbffl
^JSSLS^
Ohio County—
Wheeling
IWg^jCouS^-
Roane County-
Reedy...
2
Malden...'!'.
Total
5
■ —
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August 17. 1917
1316
CEREBROSPINAL MENINGmS-Continued.
State Iteparts for June, 1917.
Place.
New cases
reported.
Place.
Nevcws
rcponid.
Montana:
Ca"*riidc County
2
Vireini a— Continued.
Montgomery County
Virginia:
1
1
1
1
Russell County
Ailephanv County
Smvth Count V
Apihprst {''nniily . . , .
8taff<w<i County
Carrol 1 Coiui t y .'
Total
Lunenburg County
10
City Reports for Week Ended July 28, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
DetUa.
Baltimore, Md
1
1
6
2
2
Newark, N.J
1
Bridpepor t , Conn
New Bedford, Mass. . .
Chicuf-'o, III
4
NewDort.R 1.
{
Cleveland . Ohio
New York, N.Y .'.*" .
1
Detroit, Micli
1
1
Omaha, Nebr . .
a
Duluth, Minn
I»hiladelphia, Pa '.'".'..
J
Eliiabeth, N.J
2
1
Pittsburgh, Pa,
3
Everett, Mass
Pittsflela, Mass
1
Haverhill. Mass
1
1
1
1
1
Providence, R. I. .'.'.'.'.'.'.'.'.'//.'.
San Francisco, Cal
Kenosha, Wis '
1
McKeesport , Pa 1
1 .Sftpni^w, M>f*h , , ,
2
Memphis, Tenn
Syracuse, N. Y... .
M
Milwaukee, Wis
1
Washington, D. C
.
DIPHTHERU.
Rhode Island — Newport.
An outbreak of diphtheria began at Newport, R. I., July 24, 1917,
reaching its climax between August 1 and 5. Surgeon McCoy, of the
United States Public Health Service, reports that indications point
to contaminated dairy products, principally ice cream, as the means
of distribution. A large proportion of the patients are adults. There
have been no deaths reported. Since the beginning of the outbreak?
281 cases have been notified in Newport, 50 cases in Portsmouth, and
21 cases in Jamestown.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1327.
ERYSIPRIAS.
City Reports for Week Ended July 28, 1917.
Place.
Cases.
Deatlis.
Place.
Cases.
Deaths.
Baltimore, Md
I
1
1
1 Kalamazoo, Mich
I
Boston, Mass
' Long Beach, Cal
1
2
BridfiTCDort. Conn
1
2
Los Angeles, Cal
•
BuffSuTN.YlT:: :::::.::
Maiden . Mass . . .........
Cambridge, Mass
i
1
Milwaukee. Wis
S
2
4
1
1
...••••1
ChioaRo,lif --
9
Philadelphia, Pa
»
Cincinnati, Ohio
2
. Pittshiifffh. I'a --
Denver, Colo
1
3
1
I St. "i^iih. ka.
Detroit, Mich
1
Springfield, 111
Harrisburg, Pa '.'.
Wichita. Kans
____^,^
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1317
August 17, 1917
GLANDERS.
Massachasett^ — Human Case.
CoDaborating Epidemiologist Kelley reported the occurrence, dur-
ing the month of July, 1917, in Massachusetts, of a case of glandei-s in
the person of a stableman.
LEPROSY.
Nevada— White Pine County.
On August 13, 1917, a case of leprosy was reported in White^Pine
County, Nevada.
MALARLi.
Massachusetts Report for July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
UsmAnxits:
Hampden Count y—
Chloopee
2
1
2
Kassaehusetts -Continued:
Suffolk County-
Boston
0
Middlesex Coun^y-
Natick(towTi)
Total
11
Karfclk Coonty—
T)fdh)^ni (To'nii) . .
Vbginia Report for June, 1917.
Place.
AccomacCotinty
Chincotea^ue Island .
Oreenbackvillc
Albemarle County
Akiandria County-
Alexandria
Amherst County—
Amherst
Appomattox County
Bedford Coonty
Bnmsvick County
LawreDoevllle
Backinyhnm County
Cimpbell County
AltaVista
Brookneal
Caroline County
Charles aty County
Charlotte County
Drakes Branch
Oiesterfieki County
Winterpock
Comberlaod County
IXckeiisoii County
Dinwiddle County
Eliabethaty County-
Hampton
EssexCounty
Ftiriax County
FluTsmia County
Otawester County
wMosrllle County
Emporia
„ NorthEmporia
Halliu County.
HoQston ,
Stnth Boston
New cases
reported.
Place.
Virginia —Cont J nued.
Hanover County
Henrico County
Henry County
Martinsville
Tsle of Wight County
Smithilcld
James City Coimty
King and Queen Coimty .
King George County
King William County
West Point
Lancaster County
Loudoun County
I^esburg
Louisa County ,
Lunenburp County
Victoria ^-
Mathews County , -
Mecklenburg County — .
Clarksville ,.
South mn -
Middlesex County
Urban na ^.
Nanseraond Coimty ,
Suffolk
Nelson County
Norfolk County—
Norfolk
Northampton Coimty. . . .
Cape Charles
Northum)>crland County.
Kecivillc ,
Nottoway ( ounty
Burkevillc
Orange Counly ^
Page County
Lnr.jy
New cases
reported.
Jii
;j
1
11
10
13
1
13
13
4
,1
n
i
III
2
LT
m
lit
)
li
Iti
I
1
Digitized byi
August 17, 1917
1318
MALARIA— Ck>iitmued.
Virginia Report for Jose, 1917— Continued.
Place.
New cases
reported.
Phoe.
reported.
Virginia— Continued.
Patrick Comity —
1
32
2
11
1
15
22
1
3
1
I
Virginia— Cont inued .
Shenandnah Crmnty -,--r
I
Stuart
Southampton County --
2B
Pittsylvania County
Franxiin
u
(Iiatham .'
Spotsyl vania County
3
Powhatan County
Stafford County
9
Princess Anne County
Surry County
8
Prince Edward County -
Claremont .........
2
Farmville
SussexConnty
22
Prince George County
Warwick County.... ..............
»
Hopewell
West more land County
»
Richmond County
Colonial Beach
2
Rockbriifje County
York County
11
Scoi t Count V
Total
Gate City
m
Colorado Report for May, 1917.
During the month of May, 1917, 1 case of malaria was report^
in Montezuma County, Colo.
City Reports for Week Ended Jvly 28, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Dcatiis.
Baltimore, Md
1
5
Memphis, Tenn
1
Birmingham, Ala
Newark. N J
1
1
Boston, Mass
4
5*
1
3
New Orleans, I>a
1
Charleston. S. C
Columbia, S. C
1
1
New York, ?/.Y
Portsmouth Va .
I
1
East Oranw, N.J
Richmond, Va l.!.!.l'!""'
2
2
Little Rock, Ark
Savannah, Ga
f
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1327.
PELLAGRA.
State Reports for July, 1917.
Plaee.
New cases
rcporled.
Place.
Newcascs
reported.
District of Columbia
2
1
Vermont:
RiUlaod County
I
Massachusetts:
Middlesex County —
Natick (town).,.
West Virtioia:
Randolph Coimty—
Mill Creek
Worcester County—
1
MiUord (town)
1
Total
2 ;
1
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1319
AugBst 17. 1917
PELLAGRA— Continued.
Yindnift Beport for Jiuie» 1917.
Place.
New cases
reported.
Placf.
Newcasee
reported.
Vifrinla:
Alflxandrift Conntf
Virginia— Continued.
Henry County ... ....... ... . .
Amelia Cotrnty...!
James City County
Ambf rst County
WiUiamsburgl
Amherst ,
King and Queen County
AuKQSta County
Lee County
B<)9(6rd COiiiitV'—
Mecklenbure County
B«dl6nlClty
Middlesex County-
TTrhann*
Bniiuwfck County —
lATnwwvllte, r
Nottoway County—
BurkeviUe
Bockiof ham County^
Bocklnithiim
Patrick County
Campbell ONinty
Rti?f^ . . ,
OMoIlne Cbuntyl
Pittsylvania County
Chasterfiekl Coun^—
Povfiatan County ,'.
Winterpock
Kichmond County
Dinwlddie ODonty
RoAHOkA County .,.,,...
Fkhtix County .'.
Rockbridge County
Flnranna Ooontv
BuenaVisto
QreeosrlUe County
Spotsylvania County—
Fredericksburg
Emporia.
1
North Bxhpoiia
Taj&ewell County ......
Halifax County . '
Wa^lngton Count}'
8
Sooth Bofl^n
Total
Banovw County .
69
City Reports for Week Ended July 28, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Mrmfmrlia^. AH|
19
New Orleans, La
1
1
Charlcrton,8.C
3
1
1
New York, N.Y
1
CohunWa^S.C
Philadelphia. Pa
1
Kiltinaroo, Mich
1
1
Richmond, Va
1
KfloTTille, Tenn * ....
Rocky Mount. N. C
Rutland, Vt
1
1
I^Bohbonr. Va
1
2
M^ASi :: vz:::v.:..
Savannah, Ga
2
T'MhTfIku Tenn - » .
1
Wilmington, N.C
1
.
* The reason that Birmingham had so many more cases of pellagra reported than any other city is not
thai ibo dbease is more prevalent in Birmingham than in other cities of Alabama and neighboring States,
batuadoottfedly because of the snooessful efforts the health department has made in securing tnc coop-
entioo o( the practicing physicians in reporting cases.
PLAGUE.
Washington— Seattle— Plftgne-Infocted Rats Found.
During the period from March 16 to 28, 1917, 3 plaguo-iiifected
rats were found at the Pike Place Market, Seattle, Wash.
PNEUMONU.
CHy Reports for Week Ended July 28, 1917.
Place.
AgiBtfcClty,N.J
5«Wey,CaI
Cases.
Deaths.
56
39
9
18
2
7
Place.
Case^.
Lvnn, Mas 2
Maiden, Mass 1
Manchester, N. H 1
McKeesport, Pa 1
Newark, N.J 12
Newport, Ky 1
Philadelphia, Pa 21
Pittsburgh, Pa :«
Pontiac,Mlch 2
Rochester, N. Y ' 4
San l-Yancisco, Cal | 6
Worcester, Moss 1
Deaths.
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August 17, 1917 1320
POLIOMYEUnS (INFANTILE PARALYSIS).
Cases Reported, Avgrnst 9 to 15, 1917.
The foUowmg table shows the number of cases of poliomyelitis
reported to the United States Public Health Service from August 9
to 15, 1917. This is an addition to and continuation of the table
pubUshed in the PubUc Health Reports, August 10, 1917, pages
1283 to 1285.
Place.
Period.
Cases-
Place.
Period.
Cam.
California:
Alameda County-
Oakland
Los Anpeles County—
Pasadena
Connecticut:
Middlesex County
Delaware:
New Castle County—
McClellandsvIlle. . .
niinols:
Cook County
Hancock County
McT can County
Will County
Kansas:
Allen County—
Elsmore
Aug. 6 to 11.
....do
,...do
Aug. « to 12.
Aug. 6 to 11.
do
....do
....do
Moran
Riley County-
Randolph
Shawnee County —
Topeka
July 2» to
Aug. 4.
do
Sumner County-
Milan
Kentucky:
JeiTerson County—
Louisville
Marylaiid:
A lie -'any County
»';.it iraore County
T ri . 0 George County....
MaNsa hiisfttts:
EsscK County—
Haverhill..
SauRiH,
Middlose Couity—
Lowell
Marlboro
Natitk (town)
Stoneham ( town)
Plymouth County—
East Bridgewater
(town)
Ohio:
Behnont Coimty—
Martins Ferry
Bridpeport . .*
Morristown
Pultney Township. .
Wayne Township. . .
Cuyahojra County-
Cleveland
Middleburg Town-
ship
Defiance Coimty—
I'elaware Township.
Franklin County—
Grand\iew Heights. .
Quemsev County—
CamoridKe
Jefferson Coimty—
Stcubenville
Mahoning County—
Youngstown
Aug.Stoll.,
July 29 to
Aug. 4.
Aug. 5 to 11..
Aug. 3 to 9..
Aug. 6 to 11.
do
do
Aug. 5 to 15.
Aug. H
Aug. 5 to II.
do
....do
do
.do.
July.
.do.
.do.
.do.
.do.
.do.
.do.
July..
.do.
.do.
.do.
.do.
Jaly.
.do.
.do.
..do....
..do....
.do.
.do.
Ohio— Conttoued.
Montgomery Caanty —
Dayton
Monroe County—
Jenisalem
Perry County-
New Lexington
Pickaway County—
I'eercreek Township.
Por^^ County-
Stark County—
Canton
Summit County—
Cuyahoga Falls
Tuscarawas County—
Uhrichsville
Wood County-
Plain Township
Troy Township...
Virghila:
Alexandria Coimty—
Alexandria
Amherst County
Augusta County-
Fisher ville
Mount Meridian . .
Fauquier County —
Hume
Greene ('ountv —
Ruckersviile
StandardsviUe
Middlesex County — ,
Saluda ' Aug. l2tol4.
Page County I do.
Roanoke County I do.
.do.
.do.,
.do..
Aug. 12 to 14
do
do
Aug. 1 toll..
....do
}•■••
do
Aug. I to 11.
Aug. 12 to 14
....do
Aug. 1 toll.
Aug. 12 to 14,
Aug. 1 toll.
do.
do.
do.
Rockhngham County,
Dayton
Shenandoah County—
Conicville ."
Quick.sburg
Warren County
Front Royal ,
West Virginia:
Qilmer County-
Duck Run
Harrison County-
Bristol
Clarksbiu-g
Lewis County—
Wc-ton
Marion County—
Middloton
Monongnh I do
Near Monongah ' do
Mineral County—
Ke>NOf
Monroe County-
Laurel Brandi..
Tucker County—
Davi<»
Upshur County-
Crawford
Wetzel Count y—
Kodal
Wood County—
Parkersburg. . . .
Aug. 5toll..
...do
do.
do.
do.
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1321
August 17, 1917
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
Stote Reports for July, 1917.
Haw.
New cases
reported.
Place.
New rases
reported.
IbMdiosetts:
Esaex County—
Bererly. . .
2
3
10
2
5
1
2
2
1
8
1
1
1
1
1
1
1
WestVirrinIa:
BraTf on Comity
10
Qilmer County ....
2
Grovf land
Harrison County—
Stealy Heights
Hav#rh(n r-- , . . . ,
I^wniiOQ . T ,.,-,,-
Jacksnn Cwinty * ,
Lynn
Kanawha County
Salem
Marion County—
Monongah
Sancus (Town).
14
Hampden County—
Bpdngfleld
Fairmont
2
Annabell
Hamnshire County—
White Rock
1
liineral County—
Keyser
MkkQesex County-
Lowell
Ohio County :
Medrord
WheeUng
MiMen
Patterson
nroton (Town).................
Preston County
Narlolk County-
Qnincy . .•■.■■■.«..
Turker Cotmty ^
Thomas
Weymouth .....................
Davis
Plymouth County-
Brockton
Parsons
Upshur County—
Buckhannon
Worcester Countjr—
Worcester •■
Wetzel County
Total
Total ....
3S
54
Vtimoat:
Chittenden County
1
1
22
2
Oraoge County-
Washington ^..rr...
WtshliiPtoii'Countv
Windsnr County t r
Total
20
State Reports for June, 1917.
Place.
Now cases
reported.
Place.
New cases
reported.
MflDtana:
(^rboo CoontY
1
2
1
2
Vii^iia— Contfaiued.
lialifax County-
Houston —
Onrade C-ouniy
Coster CountyT 1
Nelson County
Qnnite County
Orange C^ounty . r ..... ^
PaceX^untv " .
Total
6
Shenandoah
Bedford County —
Bedford Cltv
■■ . ,
1
2
1
Pittsylvania County
Princess Anne County
RodciDgham County
Total
CSiarles Qtv Conntv
10
I^h^enson Ckmnty . . .
aty Reports for We^ Ended July 28, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
BdtiiBore,Md
2
Haverhill, Mass
B«teley,Gtl
1
1
Kansas City, Kans
5ni«iniam^Ato;::;
T^wr^nce. Ma.«s
S^^mm V.::::::::::
1
2
1
5
1
1
Lowell. Mass
J<*lo,* Y^
Lyno. ^ass
^^Ohio
New Britain. Coim I
2
Newcastle, Pa
1
gjiad, Ohto
New York/N. Y
1
w2Jo&>"^;*
Pittsburgh, Pa
5**!iii,lowa.*l*.
1
2
Seattle, Wash
aHaS(a|o.lnd..*.V
3
1
Syracuse, N.Y
1
*SS|^™.::;.:
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Ansast n, 1017 1322
RABIES IN MAN.
City Report for Week Ended July 28, 1917.
During the week ended July 28, 1917, one death from rabies in man
was reported at Kansas City, Mo.
RABIES IN ANIMALS.
City Report for Week Ewled July 28, 1917.
During the week ended July 28, 1917, two cases of rabies in animals
were reported at Detroit, Mich.
ROCKY MOUNTAIN SPOTTED FEVER.
Montana Report for June, 1917.
During the month of June, 1917, cases of Rocky Mountain spotted
fever were reported in Montana as follows: Carbon County, 2; Fer-
gus County, 1; Musselshell County, 2; and Stillwater County, 1.
Nevada — ^Humboldt County.
On August 13, 1917, a case of Rocky Mountain spotted fever was
reported in Humboldt County, Nev.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tubtTculoeis. page 1327.
SMALLPOX.
Minnesota.
During the week ended August 11, 1917, a new focus of smallpox
infection was reported at Galena, Martin County, Minn., two cases
having been notified.
Arkansas — ^Pulaski County.
On August 11, 1917, 11 cases of smallpox were reported near
McAlmont, Pulaski County, Ark.
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1323
August 17, 1917
SMALLPOX— Continued.
Colorado Reports for May and June, 1917.
New cases
reported.
Deaths.
Vaccination history of cases.
Flac«.
Number
vaccinated
within?
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack.
Numl)e: Vaccination
never su?- history not
ccssfiilly ol>Uiiied or
vacciuttted.; uncertain.
;
Odfcndo (May 1-31):
Denver County —
Denrer
1
1
1
1
5
9
i
1 ....
El Paso Cotmty—
Cokndo Springs
1
Kit Carson CountyT
1 1
Mesa CooBty
1
ii:::: :
OtCTOCminty—
1
1
5!..
Sedgwick Count-y
9 ,
1
Total
18
1
J,
..
C(dorado(Jimcl-30):
Arapahoe CfHinty .
1
6
1
2
1
1 1
DenVer County—
Dnver
4 1 2'
1
El Pas© Count y—
Colorado Spriog;;
FresBoaC Count V
M }
Jeflieison C^onnty
LariicorC'Ountv
1
1
t
1 ,
Sedj5wick Count v
1
wSSntv..:
Total.
MisoellMieous State Reports.
Place.
Ifootana (June 1-30):
BeavdliPttd County
Blains County
Cascade County—
Gm^ Falls
Cii8l«r County
Dawson County
Fen^us County
HO! County
Lincoln CountT
Missoula Cotuity. . .
Ravalli County
Sanders County
Yellowstone County
BiiUngs
Total
Owfon (June 1-30):
ClackantBS County . .
Clatsop County
Harney County
Multnomah County-
Portland
Total
Vermont (July 1-31):
Franklin County...
Cases.
Deaths.
1
3
I
2
1
2
1
8
1
2
28
====—
1
6
1
2
10
4
1 lace.
Virginia (June 1-^):
rarroll County
Halifax ( onnfy
lioi'stoii. ."
Foiilii Ho Ion
Wo of >\ iT< t • oinity
Pavco '^ oi ]ity
SLcia;! !oa"i
PriiKr (ico ;.v ' ounty
Pulaski ( ij\ ntv-
1 rlj'^ki..;
Roanoke ( ounty-
Hoanokf
Total
Deaths
32
West Vircinia (Jiilj
Fayi ttc « ounty
HancocK: Count
Kanawha ( oiin-
( hario.ston.,
Lincoln ( ounty .
Marion County. ,
Mingo County . , .
Ohio fount y—
Wlioflinj;
Putnam < ounty -
Mercer County 1
Digitized by
<idgU8tl7, 1917
1324
SMALLPOX—Contiuued.
Citjr Reports for Week Ended July 2S, 1917.
P1EC5.
Cases.
Deaths.
Place.
Cases.
Deaths.
Butte, Mont
10
10
MUwaokee.WIs
1
9
1
4
1
4
2
1
5
3
1
2
8
6
2
1
22
ChlcaKo,IIl
Mfnneapnifjf, Minn
Cleveland, Ohio
Ofdpn trtflli
Payton, Ohio
Oklahoma City. OkllL
Philadelphia. Pa
1
Tetroit, Mich."
I
Dubuque, Iowa
Pontiac.Mich
Duluth. Minn
2
Portland, Oreg
Evan«rsine,Ind
Qiilncy, 111
Flint. Mich
St. Joseph, Mo
Fort Wayne. Ind
St. Louu, Mo
Galesburg, III
Salt Lake City, Utah
Indianapolis Tnd
Seattle. Wasli.'
TTanfmic "^f^ y, K"ftns - t ....... .
Sioux City, Iowa
Kansas City j Mo
Springfield. Ill
Lima, Ohio
Springfield. Ohio
Lincoln, Nebr
Tacoma, wash
Little Rock. Ark
Zanesvllle, Ohio
TETANUS,
atjr Reports for Week Ended July 28, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Boston, Mass. ...•......•• .
1
1
1
Detroit, Mich
1
Buffalo, N.Y
MobUe,Ala
1
Chicago.Ill
1
New York, N. Y
1
Columbus, Ohio
1
Philadelphia, Pa
1
1
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculoeis, page 1327.
TYPHOID FEVER.
Stete Reports for July, 1917.
Place.
New cases
reported.
Place.
Newcasw
reported.
District of Columbia
26
Massachusetts— Continued.
Hamnshire Coimty—
Williamsburg (Town)
Massachusetts:
14
3
Berkshire County-
North AdAms
Middlesex County-
Arlington (Town)
Bristol County-
Fall River
(Cambridge
Everett
Dishton (Town^ ... ...
Hudson (Town)
New Bedford '.'.'.'.'.
Lowell...
North Altleboro (Town)
Somerset (TownK . . . .
Medford
Mebose
Taunton
Newton
\\estport (Town)
Somerville
Essex County—
Amesbury (Town)
Norfolk County—
Dedham (Town)
Beverly
Milton (Town)
Gloucester
Norfolk ( Town) .
Hf^vf^rhitl^ ,
CJuincy
Plynaouth' County-
Plymouth (Town)
Rockland (Town) ,
Ljmn
Newburyport
North Andover (Town)
Suffolk County-
Boston
Peabody (Town)
IS
Franklin County—
Chelsea ^.^
Colram (Town)
Revere
Montague (Town) ]
Worcester County —
Athol(Town)
Hampden County—
(Tiicopoc
Fitchburg
Springfield
Gardner (Town)
Digitized by
Google
1326
August 17, 1917
TYPHOID FBVER— Continued.
State Reports for July, 1917-— Continued.
I
Place.
New cases
reported.
Place.
New cases
reported.
MiflsachTiaetts— Continued .
Wore^feter County ~Ck>ntiiiued.
1
1
4
West Virginia— Continued.
Kanawha "ounty
9
Upton (Town)
Charleston . .". t..
16
mi)ster (Town)
Dunbar
13
Worcester ^
McDowoU County
2
\
Total
109
Marion County-
Dakota Mines
14
VenDQQt:
2
2
2
7
Mercer Comity
1
Mineral (^ounly .,
1
Clutt(»)den County
Mingo County
3
OrM»gf< Tffl^nty , , , . ,
Monongalia cfounty
3
i^^itlniv) f'-ounty
Ohio County—
Wheeling
65
Total
13
Prest<Hi County
1
Putnam County . . .
4
West Vtf^iia:
Berketev County
3
4
6
6
1
1
Raloi^h County
2
Randolph County
2
Brooke County
Roane Counly
4
Orpfnhrier County
Tyler County
2
Hancock C><ftinty '.
Total
Hardy County
164
JadcsoD Counly
SUte Reports for June, 1917.
Place.
Colorado:
Boulder County-
Boulder
Chaflee County
Denver Coimty—
Denver
Bade County
ElFasoCounty
Colorado Springs.
Fremfflit County
Larimer County
Otero County—
aocky Ford
0 County—
PteWo....
WeldCounty
Total.
MoQtana:
Cascade County
Great Falls....
dioteau County . . .
Custer County
Fergus County
Flathead County..
KattspeU
OaBaHn County-
Lewis and Clark County .
Helena
Madison County
Musselshell County
Park County
Ravalli County
Mhrer Bow County
Yellowstone County
BOMngs
Tbtal.
Oreun:
Beotaa County .
Clatsop County.
Oregon— Continued.
Linn Counly
Marion County
Multnomah (oiinty—
Portland
Total
Virginia:
Aocoraac County
Parksloy
Albemarle County —
Chark)ttesville
Allcehaay County —
Clifton Forge
Amherst County
Augusta C.unty
Basic City
Bedford County
Hcdf rdCty
Bototuurl (V)nnty
Brunswick Count y . . . ;
Buckini;ham Cjiinty..
Oampl)ell County
LAnchbtirg
Chestorfiold County . . .
Culpcpcr Cjimty
CnmlxTland Coimty. .
Dinwidd.o (\)unty -
retersbiirK
Elizftl)oth ("tty County
I^Ikp'mi^. .'.
Faumiicr (' unty
Warnnion.!
Floyd Cjutiiy
Franklin C Minly
Frederick ( \)unty
(iray.Hon County
flrceno C )unty
(Jrcensvillo County
North Emporia...
Halifax County
Hou^ston
South Boston
1
G
. 1
1
8
1
1
U
1
3
32
1
1
1
3
1
1
2
2
Digitized by
rGoogle
Angust 17. 1917
1326
TYPHOID FEVER— ContJniied.
State Reports for June, 1917— Continued.
Place.
New cases
reported.
PUkw
New cases
reported.
Virginia— Ckmtlnued.
HftPover County
6
3
1
2
1
2
2
2
1
4
1
3
1
1
1
2
\
1
2
1
3
4
1
1
1
2
Virginia— Continued.
Rockbrldgf Comity
Henry County .'.
Lexington
Rn^ir jnphfiin County
Martinsville
Isle of Wight County
EUrton ;..
James City C- iinty
Rii{f!tAll c>ouTity , ,
Lancaster County
Sooti County.'
Lee County '
Gate City
Loudoun County
Smyth County
Mathews County
Marion...„::::..:::::::::::::::
Mecklenburg County
Southampton County
ChascCity
FranMin '...
MlddleMX Coimty
Spotsylvania C<oiiiity..
Montgomery County
Fredericksburg
Ctristliuisburg .'.
Stafford C<innty , , . ...
Nansemond County —
Surry County ........ 1
1 «
Suffolk
Sussex County
3
JiJclson Coimty
Tazewell County
' ' 3
Nor/olk County—
Portsraoutn
Pocahontas
Richlands...
Orange County
Washington County
Page County
Westmorelsmd County ...
Patrick County
Wise Coimty.. .
J
Pittsylvania County
Wj-the County .
3
Princess Anno County
York County
1
Prince Edward Countv
Total
Prince George County
m
Pulaski County
Richn>npd County
Roanoke County.'.
Roanoke
'■'
Colorado Report for Aifay, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Colorado:
Alamosa County
3
10
2
1
1
Colorado— Com inued.
Logan County
2
Denver County —
Mesa County
1
Denver
Montrose County
1
Fremont Countv .
Total
Huer&no County
21
Jackson County.'
CItjr Reports for Week Ended July 28, 1917.
Place.
Cases.
Deaths, j
Place.
Cases.
Deaths.
Albany, N. Y
1
1
6
4
7
25
7
1
3
2
1
1
Columbia, S. C
5
3
1
1
1
Alton, 111
Columbus, Ohio
Altoona Pa .
Covington, Ky .. .
Atlantic City, N. J
Cumberland, Md
Baltimore, Md
2 i
4 ;
Dayton, Ohio
Birmingham, Ala
Denver, Colo . .. .
1
Best on, Mass
Detroit, Mich
22
1
2
Braddock, Pa
Duluth, Minn
Bridgeport, Conn
East Chicago, Ind
1
Buffalo. N. Y
El Paso. Tex
2
Butte, Mont
EAT^insviliei Tnd
1
8
1
1
11
2
3
3
Cairo. Ill
1
Fall River, Mass
(^araden , N . J
3
Fitch burg,' Mass
Canton, Ohio
Fort Wayne, Ind
Charleston, S. C
Fort Worth, Tex
Chelsea, Mass
Galveston, Tex
Chicago, 111
Hagerstown, Md
Cincinnati. Ohio
i l\
Harrisburg, Pa
Cleveland, Ohio
Haverhill, Mass
1
Cofrey^ille. Kans
1
Hoboken, N.J
1
Digitized by VjOOQIC
1327
August 17, 1917
TYPHOID FEVER— Continued.
City Reports for Week Ended July 28, 1917— Continued.
Place.
Cases.
Deaths.
Place.
Cases, i'
f
1 1
4 1
3
ii
1
2
1
I
3
Deaths.
TfMlian^polls^ Tnd .............
1
1
3
2
3
2
7
1
1
1
5
3
1
8
2
1
Pittsburgh, Pa
Johnstown, Pa
Portland, Me
Portland, Orej?
irftn^<irit - Kftn« . ,..
Portsmouth, V'a
Vim^S nt r' Kn
1
ProvldcmH?, U.I
Reading, Pa
Keootba, Sfis
Knoxvine, Teirn
Rlchracmd. V^a. . .. ...
Kokomo. tnd
Roanoke, Va
Lsncaster, Pa.
Rochester, N. Y
Rockford, 111
2
1
littlcllock.Ark
Rock Island, 111
Los Anseles,Ca]
1
St. Joseph, Mo
i.flw©n,lfft«,
St. Louis, Mo
1
Lynchburg, Va
Salt Lake City, rtah
Lynn. Mass
Sail FrancLst'o, Cal
2
ifcKeesport, Pa
Sajonaw, Mich.
2
Saratoga Springs, N. Y
1
Minneapolii, Minn
2
' Seattle, Wash
1
1
1
MolMle/AlZ
i
1 Somerville, Ma^s
Montdair, i.J
1
2A
1
1
3
20
1
31
1
8
Sfliith Rpnd. ItuI
1
Nashville. ' 'emi
i I South nethlbhem. Pa
SDrinefiold. Ill
2
3
1 1
1 '
I 1
s ;
11
7 <
3 i
1
1 [
9 1
'J.
Newark,N J
1
New Castle, Pa
■' Springfield, Mass . .
New Haven, Conn
; T lodo. Ohio
1
New Orl^ns. La.
6 '! Trenton. N. i. . . ._.
Newton, Mass
; Washington. I). C
i Wjilortown. N. V
New York, N. Y
7
Niagara Falls. N. Y
\\ Wh«'plin2. WW A
NOTfolk,VA..'
I
1
Wichit a, kans
North Adama, Mass
Wiliiamspwt, I'u
Oftklaf»<l Cftl
1
2
8
! Wilmington, N. C
Oklahoma Mty, Okla
1 Winston-Salem. N. C
! York, Po
Philadelph a, 1^'a
i
1
TYPHUS
Colo
FEVER,
rado.
During the month of June, 1917, 1 case of typhus fever was reported
in Colorado.
DIPtlTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for July, 1917.
Cases reported.
Cases reported.
State.
Diph-
theria.
Measles.
Scarlet !
fever.
15
241 ,
1
SUte.
^^P*»- \CAfLslP<; Scarlet
theria. ; Mea.sles. j^^.^,.
Distrkt of Columbia
16
507
192
1,347
Vermont
20 321 ' 59
■assachusetts
West Virginia
IH 1 59 1 19
1 1
State
Reports for June, 1917.
State.
C
Diph-
theria.
ises report
Measles.
Scarlet
fever.
State.
Cases reported.
^*I»^- Measles ' ^^^^^^
theria. «^as'<*^ fever.
Colorado
36
19
419
207
37
7H '
Oregon
Virginia
24 139 I 58
Montaoa
52 1,119 , 73
,^
Digitized by VjOOQIC
AugUHt 17. 1917
1328
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continued.
Colorado Report for May, 1917.
During the month of May, 1917, 53 cases of diphtheria, 1,355
cases of measles, and 52 cases of scarlet fever were reported in Colo-
rado.
Ciiy Rerr0.t3 for Week Ended July 28, 1917.
I*opula-
tion as of
July 1,1916
(estimated
by U. S.
Census
Bureau).
ToUl
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
City.
1
i
1
M
.
1
1
1
1
Over 500,000 inhabitants:
Baltimore Md
589,621
750.476
2,4»7,722
674,073
571, 7d4
503,812
5,602,841
1,709,518
579,090
757,309
468,558
410,476
306.345
436,535
363,454
408,894
371,747
463,516
348,639
363,980
214,878
280,800
271,708
297,847
295,463
254,960
256,417
104,199
181,762
121,679
112,981
106,233
127.224
128,366
104,562
128,291
100,560
113,245
102,425
148,995
117,057
118,158
149,685
198,604
165,470
109,381
166,687
117,399
105,942
155,624
112,770
191,o,S4
111,593
163,314
m,:iOo
.'J8,6.'>9
.''.7.660
69,893
200
188
585
186
206
'*i,'2i6*
469
167
225
133
126
60
92
""m
150
123
38
121
61
65
33'
71
68
5
49
125
16
62
1
152
33
6
M
4
5
2
9
11
12
10
4
1
7
3
2
8
4
1
4
12
1
4
"12
7
1
7
2
""2
""2
......
1
......
42
52
108
19
12
10
242
47
38
8
8
2
7
22
5
19
4
9
3
31
1
......
1
1
1
3
12
76
4
29
10
39
......
29
7
4
5
16
3
6
......
a
■ '2'
......
......
109
c 63
^m
V34
.. 17
W
442
89
'35
24
20
33
19
Boston, Mass
U
Chi'^zo. Ill
71
Cleveland, Ohio
0
Detroit, Mich
13
I/03 Aneeles, ("al
IS
New York, N.Y
143
Philadelphia. Pa
(0
Pittsburgh, Fa
15
St. I.ouis, Mo
17
From 300,000 to 500.000 inhabit-
ants:
Buflalo,N.Y
12
Chidnniati, Ohio
18
Jersey City, N. J
Milwaukee. Wis
5
8
Minneapol^*^ Minn
Newark. N.J .".'.'.'.'.'....
1
49
37
7
23
6
17
19
San Francisco, Cal
1
8
2
4
3
3
6
1
4
6
12
5
2
2
1.1
Seattle, Wash
8
Washington, D. C
9
From 200,006 to '300,000 Inhabit-
ants:
Columbus, Ohio
3
Denver, Colo
6
6
3
2
2
32
15
6
3
......
13
......
40
4
5
......
Kansas lity,' Mo
7
Portland, Ofeg
Providence, r" i
4
15
6
Rochester, N. Y
From 100,000 to 200,000 inhabit-
ants:
Albany, N. Y
4
Binninghain, AiB...........
71
30
26*
29
22
26
9
21
11
30
6
3
4
3
6
6
Bridgep<)«^^, t'onn
2
6
2
4
3
CambrMw. Mass
4
nfltn^^en'W T
2
6
5
Davton. Ohio
"l
3
1
3
FfiOl River, Mass
6
Fort Worth, Tex
2
Grand Rapids, Mich
Lawrence, Mass
1
3
2
2
2
1
2
6
6
3
2
2
LoweU.MW ""..
1
4
f'jim, Wftss . .
10
Ufemphis, Tenn
7
Nashville, Tenn
33
30
34"
69
31
22'
29
35
2
1
1
3
""2
5
1
"4'
...
i
1
I
8
10
1
S
New Bedford, Mass
'i'
......
5
5
.>
4
2
6
New Haven, Conn
5
Oakland. Cal
3
Omaha, l^ebr
1
4
4
3
7
3
2
1
12
6
Reading Pa . .
1
Richmond, Va
* *"i'
14
6
Salt Lake City, Utah
Sorincifield. Mass
' i'
5| 1
14
•?
7
synwSse,N.Y!::: ::
1
Tacoma, Wash
Toledo. Ohio
60
41
52
15
2
10
3
8
12
3
6
Trenton, N.J
4
4
3
1
Worcester, Mass
1
2
2
6
From 50,000 to 100,000 Inhabit-
ants:
\.llentown Pa
Altoona Pa
1
Atlantic City N.J
3
::::::::::::'
■■■'i':::...
Bayonne, N'.J
'.'.'.'.'.'. :.'....
;^
1
t2'
Digitized by VjOOQlC
1329
AnriBt IT. 1917
DfPflTHraiA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Oontinaed.'
Guy Reports for Week Ended July 28, 1917--Continu
ed.
riot
er.-
Popula-
tioaasof
July 1,1916
(estimated
by U. 8.
Census
Bureaa).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
Sea
fe\
Tuber,
culosis.
aty.
1
i
2
2
1
1
3
i
1
from 50000 to 100,000 inhabit-
ants -Conftinaed.
57,653
67,440
60.862
60,734
57,144
M,495
86,690
63,705
76,078
54,772
76,183
73,015
77,214
68,580
90,437
50,853
57,343
61,155
78,283
58,221
63,794
80,612
02,043
71,744
50,411
63,867
55,185
66,895
55,642
85,236
53,330
68,805
09,510
87,039
68,046
61,120
51,550
66,083
77,916
70,722
•
14
17
24
15
11
20
35
19
14
15
17
12
26
)
!
I
Prw^tflo, M4»i^. .[..
2
1
1
1
1
Owiton Ohio
1
:i
<^>ark»ton 8 C. " . . . r ,
2
CoA'inftan ' Kv
1
1
5
T>Qi^itlh >^inn
1
2
2
5
6
Ki^f^heth N. /.
......
4
1
7
4
£iPaso fex. '
g
'Rv»n7vllb» Irwl
1
I
FlinrMicb
3 '
2
4
Port4Vayne,IiKi....
4
3
1
1
1
t
1
1
iM^Xfn, N. J
3
4
5
1
4
1
1
4
2
Jofaasiovii, Fa
ITaahi Tfty. Kaiu
'
1
Z4»fafiter ra
1
1
LftHe Rock, Ark...'
M«M^, Ua^
81
8
20
20
17
1
4
1
1
1 ]
t 1
2
KoWle, AJa' . ..'.,"....,..
4
,
3
NffV Bruain. rinnn
I
i
9
2
Noriolk.Va . ... ',
1
,
1
12
Oklahoma Cit'y/Okla
24
19
18
10
It
23
11
26
19
32
23
12
10
19
11
14
1
... .
p.....^......
3
2
Fftw^jokrt. R f
3
•
3
3
Pr^t]fkii4 ^f
i2
4
::::::::::::
1
Bocadbnl, HI
2
..:;:;i::::::
%!Taii»wito, Cal
5I
2 1 4
^Inaw, Mich
1
St J<^^ph Vo
j
San DicKO, Call.. ....!.. 1 1
11
1
3
6
3
2
1
::::::•:::;:.;
4
Rrh4»Tvo<la}lr. N. Y
10
2
SomarvWjiaw..:: .:.
Rnnth RatuI Trwf
3
! '
2
i
1
• i" ::::::! i
1
1
^^HnxIMd Ohiio.
5
1
2
1
8
1
TrtreHantp Tnd
1
1
1
3
Trov NY
j
3
Wichita, Kaos .
2
Wilkca4iarre,Pa...]
76,776
26
2
i
1
1
^Omfngti>n V>fi
0«,265
51,656
27,732
37,385
32.085
32,730
27,632
43,425
46,102
29,319
34,611
26,074
32,261
48.811
39,873
28,743
42,458
28,203
39,233
41,781
41,863
29,353
33
0
14
7
4
4
1
1
yoSpSl!:
2
1 J .
1 1
1
Anbmn-'N. Y.. .'.I
1
2
2 2
BtOinrhan, Wash.
j
2
2
S^^tiiau
1
2
1
2
Btitkr , Pi
"i'::::::
Butt^/Mont
3' 1
3
2
5
2
1
1
Ghdsea^Mass
7: 3| 1 4
15 1 1 - ! 2
1
Cduinbla,S C
10 1 1
i
'
1
Comhertabd, Mdl rr
1
7
« ! '
nanrU)f» fll'
1
1
DarnniMrt, Iowa..
::::::::::::
1
1
Dufauotie, Iowa
3
■Mt Oilram liiii' '*
1 .**"'::
1
2
iMt Oranse. N J
4
9
6
5
13
8
1
10
1
EWn, TH 7
•i
I
3
4
f^wrett, Mnitn ,
1
2
2
ntrhhuv Mast
Oalvestan^Tax. ..." . .
1
Gram Bay.Wk
!
1
40,490 6
i
1
2
3
4
1
HaTnrhffli Mam
48,477
::::::;::::::
JM!k«on iiich
35,363
48,886
31,576
38,676
31,677
41,097
35,384
46,515
10
22
10
1 ■"]
4
12
7
3
1
Kaiatnacoo, Miefe
KeooshiLlll^fc. :_
Kno^^^Hn. ToBn .. ......
i
1
1
1
1
1* Crowe,' Wis...:
Lexinfton, Kt
11
12
15
11
5
1
X
1
1
LbnaJOhib '
2
1
2
t
Lbacoiii,Uehr.... v. '.','.'.'.. y.'j
2
V
Digitized by
Google
Augu«t 17, 1917
1330
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continued.
City Reports for Week Ended Joly 28,
1917— Continued.
Popula-
tion as of
Julyl.im
(esUmatBd
by U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
MeMlM.
Scarlet
feTer.
Tobv-
calNh.
aty-
1
1
J
1
1
1
1
1
From 26,000 to 50,000 inhabit-
ants-Continued.
27, a?
36,9C4
32,040
30,690
47 521
26,234
26,31g
27,327
31,»27
30,108
43, 716
37,353
31,401
31, 4W
33,080
46,450
41,185
38,629
39,651
36,798
38, 130
46,486
43.284
2.S92a
38.902
27,445
46,226
36,243
48,726
30,570
29,894
43,139
43,377
33,809
29,892
31,155
30,863
22,874
15,010
13,532
13,699
21,685
15,794
> 13,075
17,548
22,669
24,276
16,950
23,539
20,930
15,395
1 14,610
17,445
13,284
23,126
15,243
20,985
122,019
19 036
23,805
17,524
11,666
12,067
14,831
20,193
13,821
24,204
15,548
23,228
15,960
8
14*
1
1
1
T.nra1n Oh in
1
......
4
1
I
ludkon Wis
1
2
1
lff>Kf>Afmort Pa
13
5
3
6
7
4
11
10
8
3
10
8
12
10
17
16
5
1
Mndfrir^ WftM
1
1
31
MAntcl&»- N J
2'
Uiuhiia. N H
NpWBATt Kv
a
2
N«WD4Vt It. T
1
1
2
1
Npwton Uaas
7
1
NiAffAra FaIU N Y
4
a
Offdf^n ITtjUi
1
Oramrp N J ....
1
6
2
I
Pasadena, Cal
2
1
3
Perth Amboy, N. J
PitL<;fieId Mass
2
13
1
1
Portsmouth Va . . .
5
2
Ouincv III
1
5
Racino WL->
9
•10
7
2
Rnnnnkf^ Va
1
2
1
Rock Island HI
1
1
San Jose ( 'al
3
Stfiubonvillc Ohio
10
3
10
7
Siinfirfnr Wis
1
"l
8
1
1
1
2
. .
Waltham. Mass
1
1
Watcrtown N. Y
4
4
West Hobokcn N J
5
16
1
11
17
7
8
15
1
3
1
1
Wheeline W.Va
1
4
1
WilliamsDort Pa
1
2
1
Wilminfffon N C
i
Winston-Salem, N. C
1
3
2
Zanesville Ohio
1
From 10,000 to'25,000*lnhabitante:
Alton III
3
Ann Arbor, Mich
Beaver Falls, Pa
1
1
1
1
4
Berlin, N. H
Braddoclc,Pa
Cairo, III
3'
6"
!!!!!!
'.'.'/.'.'.
1
i
Clinton, Mass
CoflcjrviUe, Kans
Concord,N.H
......
i
.....
GaUMburg,IU
Harriston.N.J
Kearny, N.J
5
6'
7
2
4
1
3
......
.....
1 •
Kokomoylnd
Long Branch, N. J
Marfaiette.Wis
Melrose, Mass
1
5
2
6
9
8
1
3
.*."...
NanUcoke,Pa
Newburyport, Mass
......
......
3
2
2 .
3 .
2 .
N^AXtr T<nnnrtn Hnnn
North Adams, Wa<fi?
Northampton, Mass
2
Plalnflel<.N.'J
1
Pontiac, Mich,
Portsmouth, N. H
3*
3
4
4
7'
5
•'2'
1
2
Rocky Mount, N.C
Riitlfttwl Vt
.'.".'".
Sandusky, Ohio
Saratov Springs, N. Y
SouthBethtehem, Pa
1
7 '.
1 .
...••
1
2
1
..•••
Stoelton, Pa .'
......
..•••
WUklnsburg, Pa
Wobum, Mass
—
' Population Apr. 15, 1910; no estimate madib ^^ ,
Digitized by VjOOQIC
FOREIGN.
CUBA.
Commiuiicable Diseases — Habana.
Communicable diseases have been notified at Habana as follows:
DiSMM.
July U-20, 1917.
Remain-
ing under
treat-
ment
July 20,
1917.
D^iheria
1
1
4
I^DDsy
10
jSSS..
ii
8
4
'l^
Mttsies. .:.:::..:::.:;:;;;::::;;:::::::::::::::::::::::::::.: :.
f.
Pant v|tboid fever ... .
1
V.
Typhoid (ever
23 a
48
UNION OF SOUTH AFRICA.
Plague — Cape of Good Hope Siate.
A fatal case of plague occurred May 28^ 1917, in Tarka district.
State of Cape of Good Hope.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received During tlie Weeic Ended Aug. 17, 1917.^
CHOLERA.
Plice. 1 Pate.
Cases.
Deaths.
Remarks.
OricutU May 27-June 2*. . . .
30
1
1
1
Moolraein do 1
Pepj ' do
RiDi^oon ' June3-9
te>pme Islands:
Provinces
June 24 30, 1917: Cases, 2G1:
Albav ' Juno24-30
9
88
23
58
S
1
70
4
0
Bohol 1 do
02;
Capii ' do
17
C«DU 1 do
41
Leyto ' do
3
RlT^ '. .do
Sor;ogon • do
33
Tayabas . . do. . . .
4
1
» From m-^ii'Al <tfli'^'^rs of the Public Health Service, American consuls, and other sources.
96 (1331)
Digitized by
Google
August 17, 1917
1332
CHOLERA, PLAGUE, SMALLPOX, TYl^HUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received During the Week Ended Aug. 17, 1917— Continued.
PLAGUE.
Place.
DaU.
Gun.
Deaths.
RemadB.
Braxil:
Bahia
June 10-30
1
Ceylon:
(V)lonilx)
Jimp 3-fl
India '
May 27-June 2, 1917: CaiM,S,7QI;
Ba-ispfn
Bonibay
Cakutta
Madras Presidency
Mav27-June2
SO
20
2i
1
deaths, 3,050.
June 10-W
«7
May 27 -June 2
June 10-16
28
Moulmetn. !
Pepu
KaniTunn
May 27-Jiiiie 2
do
Jiino.VO
25
1
Union of South Africa: ^
Cape of Good Hope State—
Tarka district May 28
At SummerhU! Fann.
SMALLPOX.
Bracil:
Bahla
Riode Janeiro.
E,y^U
Alexandria
India:
Bombay
Madras
Rangoon
Japan:
Kobe
Osaka
Mexico:
Ven Cruz
Portuguese East Africa:
Lourenco Marquez. .
Russia:
Archangel
Petrograd
Riga
Spain:
Madrid
Valencia
Sweden:
Stockholm
June 10-30.,
June 17-30..
JunelS-July 1...
June 10-16..
....do
June 8-0....
July»^..
Julyl-«..
July 1-7..,
Apr. 1-30.
Jun€lfr-28.
May 20- June 2.
May 27-June 2.
June 13-10
June 24- July 7.,
June 17-23
16
lao
1
Mar. 1-81, 1017:20*909.
TYPHUS PBYBB.
•^li
Alexandria..
Greece:
Saloniki
Russia:
Archangel...
Petrograd...
Riga
Spain:
Almeria
Trfaiidad
Jtuaa^-Jaljrl.
June 17-30
June 15-28
May 20- June 2...
May 27-June 2. .
May 1-31.,
Jime 4-0..
227
Mar. 1-31, 1017: ic
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1333
August 17, 1917
CHOLERA* PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-^
Continued.
Reports Received from Jane 30 to Aug. 10, 1917.
CHOLERA.
Plaoe.
Date.
Cases.
Deaths.
Remarks.
India:
Fttfffif f n
Aor. 1-Mav 5 ...
8
273
2
1
2
1
15
Calcutta
Apr. 29-May 26...
Madras
Apr. 22-June2....
]lav6-12
a
MAPf^nlAY
MouhiM^
May 13-19
Pakokku
Apr. 29-May 5
Jtaojfoon
Apr. 21-May 19...
30
iBdo-Chiiia:
Feb. 1-28. 1917: Ca.«5es,20; deaths,
12.
A nam
Feb. 1-28
3
8
8
1
163
1
Cambodia
do
6
6
Cochin-Chfha
do
Tonkiii
do
Sairnn
Apr.23-May27...
Apr. 2-8
108
lEut Jtva
West Java
Apr. 13-19, 1917: 1 c«se.
Datavia
Apr. 13-19
Feb. 3
1
1
4
1
1
Pmtt:
Mazanderan Province-
Amir Kela
Barfourouche
Jan. 15-17
Hamze Kela
Jan. 17 .. .
Meciiidessar
Philippine Islands:
Provinces .
Jan. 31
June 17-23
May 2VJune 23, 1917: Cases, 795;
Albay
Ambos Camuincs
Bohol
l^apiz
Cebu
Leytc
SorswwMi
Tavabas
May20-June23...
June 3-9
1(M 70
2 1 1
deaths. .100.
June 17-23
May20-Junc 23...
June3-23
. . .do
I' 1
280 189
39 t 23
173 109
June 10-10
June 3-23
6 2
136 65
June 3-16 . .
3 1 3 1
.
PLAGUE.
Aratila:
Aden.,
Ceylon:
Colombo
China:
Amoy
Konjckong
KwauKtunc Province —
Pa-pu district
*«yp<
Suez
Pnninoes— -
Tayoum
Oirgeh
Minieh
Sioul
Great Britain:
London
Basisein
Bombay
CAknitta
Henaoda
|fftr|>/»hl
Madras Presidency.
Mandalsy
Moalmem.
Myingyao
Baocooo
QToongDO
May 3- June 11.
Apr. S-May 19. .
Apr. 29- May 5..
May 13- June 9.
June 2
May 12-17. .
May 11-17..
May 17
May 12-15. .
May 12
May 3-8.
Apr. 1-May 19
.\pr. 22- June 9
Apr.2&-Maya6....
Apr. 1-May 19
Apr. 22- June 9
Apr. 22-Jime2
Apr. K-May 12
Apr. 1-May 12
Apr. 1-7
' .\l)r. la-June 2....
i Apr. 8-14
379
467
219
39
306
37
33
411
183
9
52
1
no
2
Apr. S-May 14, 1917: Cases, 69;
deaths, 51.
l*rcsent and in vicinity.
Present.
Jan. 1-May 17, 1917: Cases, 231;
deaths, llf..
2 in hospital at i>ort. From s. s,
Sardinia from Australian and
oriental ports.
Apr. 15-May 26, 1917: Cases,
34,545; deaths. 23,036.
Digitized by
Google
Ausust 17, 1917
1334
CHOLERA, PLAQUE, SMALLPOX, TYPHUS FEVER, AND TQXOW
Continued.
Reports Received from Jane 30 to A«g. 10, 1917— Continued.
PLAGUK-Oonynued.
Place.
Dftte.
Cases.
Dwths.
KeflMAi.
Indo-China:
Provlnpcs
F^b. 1-28, 1017: Coses, 101;dsiCbs,
Anarn
Feb. 1-28
SI
57
13
47
16
47
0
35
71.
Cambodia
....do
Cochin-China
do
Saieon
Apr. 23-Jiine 8
Java:
East Java
Am. 2-22, 1017: Cases, l|;dasth9,
Surabaya
Apr. Z-22
13
5
13
5
Surakarta
do...*. .."!!..
May 16-31, 1917: Cases, U.
Departments—
Arequipa
May 16-31
4
1
2
7
1
12
1
AtMoIIendo. *
Callao
do
At Callao.
Lambayeque
. . do
At Chlolayo.
Libertad
do.. I. !*...'.!
At Salaveiry, San Pedro, mi
Lima
do
Trujillo.
At Lima.
Siam:
Bangkok
Apr. 22- June 1 . . . .
June 3-9
11
Straits Settlements:
Singapore
Union of South Africa:
Cape of (tood Hope State—
Quoenstown
June 6
Orange Free Slate
Apr. 16-22. 1917: 1 ca«e: Apr.9-»,
Winburg district
May 28
1
1917: Cases, 26; deaths, 17.
SMALLPOX.
I
Australia:
Sew v«onth Wnles
Brewarrina Apr. 27 June 21..
Coonabarabran Ma.v 2*-Jiiiic 7.. .
Qiiaiiihonc Apr. 27 June 21..
Queen.slaiKl i
Thursday Inland Quar> ' May 9
antine Station. i
Brazil:
Bahia
Rlode Janeiro ,
Canada:
Manitoba -
Winnipeg ,
Nova Soolui-
Uaiifax
Port llawkesbury.,
Ceylon:
Colombo
China:
Amoy
Antiing
Chungking
Chanysha
Duinn
Harbin
Hongkong
Mam-h uria St at ion ... .
Mukden
Shanghai
Tient.'«in
Tsitshar Station
Tsingtao
May 6-12
May 6^ June 16..
June 10-16.
June IH July 7..
June 17 30.
May 6-12. .
Apr. 29-May 26. ,
Mftv21 JunVaj.
May (» June ii . .
May 27 June 2..
Mav m June 30.
.Nr-r. 2.} May 0...
Mav (^ June 16. ..
Apr. 2J 20
Mav 27 Jnue 2..
Muy 21 July 1...
Mav Vi Juno 9..
Apr. 16 22
May 22- July 7...
Alexandria
France:
Paris
Germany
Berlin
Bremen
CharlottenbuTf . .
Apr.30-June 10..
May 6-12...
Mar. 18^ Apr. 28..
do.....
do ,
Apr. 27-Jun4' 21. 1917: Cases,*.
12 1
2 '
1 ' T'rom s. s. 8t . Alban.s from Kobe
i ; via Hongkong, ^'e5sel pn>-
' • r.eded to Towns. il!e, Bns-
baue. and Svdney, in quarsa-
tine.
rV
5 '
30 :
7 '
8
1
106
16
18
32
Present In district.
Present and in viclnHT
Present.
On Chinese Eastern Ry
Do.
Present.
Cases foreign: deaths i
tivos.
On Chinese Eastern Rf.
At another statien oo no^"''
lease.
Mar. 1»-Apr. 2i, 1017: ^O^S^l!*
in cities and 32 SUta^ <i" ^"^
tricts.
Digitized by VjOOQIC
1335
Aujfust 17, 1017
CflOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW FEVER—
Continued.
Reports Received f^om June 30 to Aug. 10, 1917— Continued.
SMALLPOX— Continued.
Pteee.
Date.
Cases.
Deaths.
Remarks.
Oennany— Continued.
IT*mhimr
Mar. 18-Apr.28...
do
SO
ao
2
10
1
m
Leipzig.
LQbeck —
do
do
liunkh
l9lQttiBkrt
do
India:
Bombfty
Apr. 2a-Ju]ie 9
Apr. 2»-May96....
48
U
5
38
4
Calcutta
Karachi
Apr.21-Juiie»....
Apr. T^hxm 2. . . .
Apr.l5-Junea....
60
Mf»iinv«
Rancoon .................
Indo-China:
I*rovinoes
Feb. 1-28, 1017: Crises, 503; dciths,
62.
An^m
Feb. 1-28
297
36
193
67
199
32
53
1
169
1
11
16
7
1
53
1
63
12
15
Cambodia
do
C^chin-t hina
do
Tj»kin
do
fltt«V»
Apr. 27- June 10. . .
May21-June24...
Mnv 27 July I
May 2^June«....
May I6-Jnne30...
May27-Julxl
Apr. 2-29 . .
Italy:
Tarfe
Jtpn:
Kobe
Nniwnki
OsaVa,
55
1
1
Ynkohaina -,,..-,, ^ .
Jan:
East Java
Mid-Java
Apr. 1 21
W«6tJ<i\*a
Apr. 13-May W, 1017: Cases, 46;
deaths. 7.
Batavia
-Vpr. I3May3....
July 11-17
June 3 30. .
11
"162'
ft '
14
7
3:)0
4
23 ;
1
2
2
Mexico
Mazatlan
Me\icj<Ity
M-mterev
PhOipcioc LsUiiis:
Mu»i
J0f» W 21
May 13 June 9
May 13 June 30...
Mar. 1-31
Mnvl 11
Feb. IS Ml. li>...
Mar. 11 Miiv lO. . .
Mar. 15-21.:
24
Varioloid.
Portnml:
Lisbon
Portui!aeBe East Africa:
Russia:
Archangel
1
• 2
PeUograd
WJW
\Tadivostok
'
3
5
2
H
L
%
..:i
Jan. 1 31, 1917: V.\-^, 7.
Spain:
Madrid.
Mayl-<il. .
Serine
do
-S
5 .
1
1
2'
4
Valen ia
StraiU SettJcnwfrtv:
Penang
Malino
Sto?klK>lm
Tnnisa:
Tunw
Junc3-2J
Mar. IH-Md> 12...
Apr. 22-28
Ml,- 20- June 2..
June 2 S
Turkey in A. via:
TreW/ond
Ciiio of South Africa:
idhanne^burs
Feb 2->-\pr. M..
Mar. 12-24
"Mill 111
Miracaibo
June IH-Julr H ._
TTPHIS
Alcwia:
Alciw*
June I ^)
5
Anatria-iitiQcary:
Aortria
*>'* 22 //♦' 17 ;V ' ' w**" 2J7U
JKWif IIMB.
Galtria.
Lower Austria
Meraria.
Oct. 22 Dec 17.. .
do
do
do
Digitized by VjOOQIC
August 17, 1917
1336
CHOLERA, PLAGUE. SMALLPOX, TYPHUS PEVER, AND YELLOW PEVER-
Coptinued.
Reports Received from June 30 to Aug. 10, 1917— Contiiiued.
TYPHUS FEVEB-Gontinued.
Place.
Date.
Cases.
Deaths.
Remarks.
Austria-Hungary— Continued,
Austria— Continued.
Silesia
Oct.22-Deo. 17...
.... do
16
343
5
8t\Tia
Upper Austrbi
do
Hungarv
Feb. 19-Mar. 25, 1917: Cases, l,SSl.
Budapest
Feb.19-Mttr.25...
June 25-July 1 —
June 9-16
83
3
1
4
1,421
China:
Antung
Hankow
Tsingtao
May 30- July 7
Apr. 30- June 10...
June 17-23
Alexandria
413
1
26
Great Britain:
Cork
Greece:
SaioniW
May 13-10
Japan:
Nagasaki
June 11-24
4
7
Java:
Mid-Java
Apr. 1-30
2
WestJava
Apr. 13-May 10, 1917: Cases 86.
Batavia
Apr. 13-MaylO....
June 3-30
22
431
3
1
2
98
1
5
Mexico:
Mexico City
Netlierlands:
Rotterdam
June 9-23
2
Portuguese East Africa:
Lourengo Marquez
Mar. 1-31
Russia:
A rchangel
May 1-14
Peirograd
Feb. 18-Mayl9....
May 6-12
3
Riga
Jan. 1-31, 1917: 1 casa.
Vladivostok
Mar.29-May21....
May 1-31
Spain:
Madrid
2
Switzerland:
Basel
Jiuie 17-23
1
Tunisia:
Tunis ,r r - - ,
Jiuie 30-July 0 .
1
YELLOW FEVER.
Mexico:
Yucatan, State—
Peto
In person recently arrived from
Mexico City.
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PUBLIC HEALTH REPORTS
VOL. 32 AUGUST 24, 1917 No. 34
POUOMYELITIS (INFANTILE PARALYSIS).
ITS PRESENT PREVALENCE IN THE UNITED STATES.
Occasional cas^ of poliomyelitis (infantile paralysis) are reported
from all parts of the country. This has been so for a number of
years. During the present summer, however, the only localities in
which the reported prevalence of the disease has been such as to
indicate the presence of outbreaks are: Washington County, Vt.;
city of HaverhiU, Mass.; city of New Castle, Pa.; Allegany County,
Md.; Br&xton Coimty and Marion County, W. Va.; Rockingham
County, Va.; Behnont County, Ohio; and Blue Mounds Township,
Pope Coimty, Minn. All these outbreaks have been comparatively
small and with but few cases. In no locality in the United States
is there an outbreak of any size, or one that seems Ukely to develop
into a serious epidemic.
Washington Couniy, Vt — ^In Washington County there were diu-ing
June, 31 reported cases, and during July, 22. Comparatively few
cases have been reported since the 1st of August. The main focus
of the disease was in the city of Montpelier, where there were four
cases reported between Jime 16 and June 22, and 29 cases between
June 19 and July 7. The next most important focus was in the town
of Barre, where there wore 15 cases reported between June 16 and
August 18. At Waterbury there were eight cases between July 7
and August 18. The outbreak seems to be on the wane since the
latter part of July. The population of MontpeUer at the time of
the 1910 census was 7,856. The population of Washington County
was approximately 42,000.
HaverhiU, Mass. — ^In Haverhill 5 cases of poUomyelitis were re-
ported in June, 10 in July, and 16 between August I and 22. The
outbreak here seems to be still on the increase. The population of
Haverhill, estimated as of July 1, 1916, is 48,477.
New Castle, Pa. — In New Castle 4 cases of poliomyelitis were
reported between July 1 and July 28. In the next two weeks, ended
August 11, 9 cases, and in the week ended August 18, 14 cases. The
97 (1337)
Digitized by VjOOQIC
August 24, 1917 1338
disease here is on the increase. The estimated population of New
Castle, as of July 1, 1916, is 41.133.
AUegany County, Md, — In AUegany County, Md., 23 cases of
poliomyelitis were reported between July 15 and August 18. For
the five weeks ended August 18, the nimibers of cases reported by
weeks were 7, 6, 2, 3, 5. The main focus was at Barton, where 10
cases were reported in July. The outbreak in this locality seems to
be diminishing. The population of Allegany County at the time of
the 1910 census was approximately 63,000.
Braxton County, W. Va. — ^In this county 10 cases were reported in
July and 7 cases during the first 18 days of August. The outbreak in
this county seems to be diminishing. The population of Braxton
County m 1910 was 23,023.
Marion County, W. Va, — ^Thirty-one cases of poliomyelitis were
reported in Marion County up to August 18. The first cases were
reported in July. The principal focus was at Monongah, where 14
cases were reported in July and 8 in August up to the 18th. The
disease in this locaUty does not seem to be increasing at the present
time. The population of Monongah in 1910 was 2,084. The popu-
lation of Marion County in 1910 was approximately 43,000.
BocTdngham County, Va, — ^The only county in Virginia in which
there has been a noticeably unusual prevalence of poUomyditis is
Rockingham County, where there have been reported since June a
total of 33 cases. There was 1 case reported in June, 22 cases were
reported in July, and 10 cases since the 1st of August. The cases
during July were reported at Elkton, Harrisonburg, Grottoes, and
McGaheysville. The disease does not seem to be increasing at the
present time. The population of Rockingham County in 1910 was
approximately 35,000.
In Greene County, Va., seven cases have been reported since the
1st of August, in Page County six cases since the 1st of July, and in
Warren County seven cases since the 1st of August. Of the cases in
Warren County, six were at Front Royal.
Belmont County, Ohio, — In Belmont County 11 cases were reported
in June and 15 in July. The main focus was at Martins Ferry, where
19 of the cases were reported during June and July. The population
of Martins Ferry in 1910 was approximately 10,000.
Pojye County, Minn, — In Blue Mounds Township, Pope County,
Minn., seven cases of poliomyelitis were reported between June 14
and July 19. This constitutes a markedly unusual prevalence of the
disease. The population of Blue Mounds Township in 1910 was 657.
The outbreak seems to be at an end.
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1339 August 24, 1917
MALARU IN TENNESSEE.
PREVALENCE AND GEOGRAPHIC DISTRIBUTION.
The periodical circularization of the physicians of Tennessee to
determine the prevalence and geographic distribution of malarial
infection in the State was begun in 1913, and continued during 1914,
1915, and 1916. At regulw intervals reply postal cards were sent
to the practicing physicians. These cards were at first sent out each
month. Beginning with April 1, 1915, they were sent out quarterly.*
A reproduction of the card used during 1915 and 1916 will be foimd
on page 1128 of the Public Health Reports of the issue of July 20,
1917.
Of the cards sent to physicians an average of less than 9 per cent
were returned. Those returning the cards with the requested data
filled in imdoubtedly constituted the better class of practitioners —
those who tmderstood most clearly what was wanted and the value
of the work. The number of cards sent out, the number of schedules
returned, and the counties represented at each circularization are
shown in Table No. 1.
It is to be borne in mind that the number of cases reported by the
phjTBicians by no means shows the number of cases that occurred, for
an average of less than 9 per cent of the phjrsicians returned the
schedules.
The return of the schedules by the physicians being a matter of
voluntary cooperation, the data are undoubtedly reliable to an
unusual degree as regards the experience of the physicians who
cooperated and the number of cases seen by them. It is to be borne
in mind, however, that the cases reported represent only those
occurring in the practices of the physicians who cooperated. The
total number of cases of malaria occurring in the practices of all
the physicians of the State must have been many times greater,
also the number of cases that occurred in which no physician was in
attendance or consulted was probably much greater than the
number coming under medical care.
The physicians who cooperated were distributed as to locality
throughout all sections of the State, so that the data of the occurrence
of malaria furnished by them show the geographic distribution of
the disease and reasonably accurately its relative prevalence in the
various locaUties.
1 Tbe work of circularixatioo and of compilation of tho data on the return cards was carried on by the late
Barf. R. H. yon Exdorf up to the time of his death, In September, 1916. Since then It has been carried on
by AagL Sorg. R. C. Derlvauz and Asst. Burg. Gen. H. R. Carter.
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AiiSU8t24,1917
1340
The cases reported throughout the State by months are shown in
Table No. 2. The relative numbers of cases reported by months are
shown m the chart.
The number of cases reported from the several counties of the
State are given by race and year in Table No. 3.
The map on page 1341 shows the relative prevalence of the disease
in the several coimties of the State, the heavier shaded coimties being
those in which the infection is heaviest, the tmshaded coimties those
in which the infection is lightest, as indicated by the niunbers of cases
reported. The relative density of infection was determined by asoa-
Jan.
Feb.
Mar.
Apr.
May;
Jun.
Jul.
AU^.
S«p.
Oct.
Hov.
Ue.
^
y
^^
/
V
/
\
/
\
y
\
/
i
1>
/
\
/
\
y
\
\
/
\-
^
V
/
«
V'
'
Relative prevalence of malaria In Tennessee, by months, as Indicated by the numbers of
cases reported.
taining the number of cases reported in each county during the entire
period for which reports were received per 1,000 population. The
population used was that of the 1910 census, it being impracticable
to estimate populations for the period of the circularization.
The types of malarial infection reported to have been diagnosed
microscopically are shown in Table No. 4. It will be noted that
tertian infection was reported to have been so diagnosed in 31 coun-
ties, quartan in 21 counties, and estivo-autumnal in 24 counties.
By Table No. 5 it will bo noted that hemoglobinuric fever was
reported in 5 coimties.
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1341
August 24, 1917
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Aufmit 24, 1917
Table 1.
1342
-Results of dreularization of practicing physictani*
Period.
Inquiry
cards
sect to
phyai-
CiSLDJ.
RopUfis
received.
Percent-
age o(
replies.
Counties
ropr»-
aeniedtn
replies.
Countiei Cass of
not beard I mtlirii
from.
1913.
August to NoTember. .
1914.
January to December. .
1915.
January to March
April to Juno
July to September
October to December. .
1916.
January to March
April to Juno
Jul V to September
October to December. .
3,338
39,594
10,014
3,338
3.338
3,338
3,338
3,33$
3,338
3,338
609
4,734
1,187
379
230
140
«3
164
287
449
18. ai
11.93
11.35
8.36
6.89
4.37
1.89
4.91
8.60
13.45
7,
31 <
m
3,fl07
2,^
Table 2. — Cases of malaria reported^ by months.
Year.
Jan-
uary.
Feb-
rtiary.
March.
Aprfl.
M»y.
June.
July.
Au-
gust.
Sep.
tem-
ber.
Octo-
ber.
vem-
ber.
ceo*
Ur.
1913
1
1
1,482
6M)
633
1,342
1,556
788
770
1,335
1,383
745
413
979
651
1914
735
1S9
17
289
177
31
396
206
31
362
132
103
597
223
163
757
3S5
333
554
336
940
443
lis
689
sy
1915
n
1916
3S
Tablb 3.— OtMct reported, by counties, by years, and by color.
Aug. 1 to Nov. 30,
1913.
Calendar year
1914.
Calendar year
1915.
Calendar y«r
1916.
County.
S
1
.0
5
1
1
1
4
103
1
s
1
.
i
Anderson
3
45
59
12
7
23
31
2
?J
2
IV
82
1
3
■'i?'
18
13
'■'5"
1
"22'
4'
33
3
*^
2o
7
2x
35
,0?
3
23
115
1
3
■39'
1
4
141
"23
132
3
9
16
3
1
151
3
......
48
■'2
Bctlford
17
38
1
6
18
44
u
Htnt.'n
m
}i\u\ -K'
i
jilohiit
6
3
6
3
1
9
}U ullov
39
2
6
74
2
20
93
3
*27*
"is'
33
42
2
5
101
2
44
136
»
CaiiipWMl
I
1
C:i'^.ll
( .ir. r
16
1
32
7
■ 28'
31
'23
1
83
63
iti
J
( hi t' h im..
Vfi
<■>.. '.r
154
IM
(') jK' rne
( 1,.' 1 ... '
6 1
6
5
14
22
36
76
58
176
13
13
276
95
2
14
272
34
o§
1 S
( .^ Vp
19
,i
19
4
338
7
6
18
36
U
35
3
S
66
150
* ii«'
.J
n
1<»11,«'
17
71
3
255
85
32
40
151
7
1
17
4K2
54
«
3
35
'**35*
8
3
7
5
18
■ '3"
151
13
1
20
106
3
290
93
35
47
I.5f>
25
1
20
6*1
7
%
('r.>» : f tt
118
35
18
53
Si
C'li. T'.inil
IM
Da 1 1 ')n
4H
43
6
152
54
6
13
77
1
23
6
«
"31'
36
......
39
3
179
54
49
6
173
90
5
17
116
2o
1
55
64
33
19
88
73
•
1»,. I* If
ai
!)<: 1'.
11
It. ,<n
52
166
4
7
38
S
69
194
7
i«
J, , ,
Ml
J •- 'o
1. r. ,
s
} r .... lu,
u
1,, <,:j
(,... ...',
74
19
28
1
103
30
Go
0
OtAiiiiieT
3
Digitized by
rr*
1343 August 24. 1917
Table 3. — Cases reported^ by counties, by years, and by color — Continued.
Aug. 1 to Nov. 30,
1913.
Calendar 3
1914.
•ear
Calendar year
1915.
Calendar year
1916.
County.
^
1
0
S
J
1
S
d
1
Xi
B
d
1
1
^
Greene
3
12
3
12
5
. 21
2
140
1
91
251
' "5'
"l5
"49'
44
5
26
2
155
1
140
295
3
10
......
3
11
2
36
*'2'
2
38
Gnmdy
Hamblen
niMnilton
73
6
15
45
18
'19'
91
6
34
45
53
13
66
95
25
* 120
Han'^rk
HaMAman
33
86
38
39
71
125
123
M
4
30
59
57
29
12
44
45
2
106
23
"io'
43
52
2
U
1
229
Hardin
107
Hawkins
4
Ha jwood
3
1«
9
54
48
10
9
1
9
4
36
9
58
57
10
9
7
42
67
18
22
37
15
1
10
9
3
7
2
8
52
76
21
29
39
15
19
20
IS
22
25
139
2
30
8
5
5
49
28
23
27
25
139
2
40
Henderson
102
Henry
109
girVman
31
&oust<ni
23
Dinnphrvy^ ... .
45
Jackson./.
45
JaiQfs.
3
Jeflersrai
11
4
53
30
121
53
. 2
......
15
91
13
4
57
45
212
53
21
1
201
16
95
16
12
107
18
5
84
7
144
67
31
16
2
8
100
""2
s
65
"25*
* "23*
3
48
......
4
......
113
21
1
203
24
100
16
12
132
18
5
107
10
192
57
32
20
2
11
213
1
2
6S
201
12
24
**"'5*
212
1
2
73
413
12
24
Johnson
Knox
46
60
224
108
5
47
Lake
113
Lauderdale
332
Lawrence
76
Lewis . ...
Linoohi
84
16
100
51
4
18
30
16
......
9
67
4
22
39
31
3
8
74
11
......
11
45
Lwldon
3
McMinn
1
1
u
McNairy
85
Ma*m?..::::: ::;;:;::
Madison
53
6
23
32
1
17
80
5
4
9
......
38
58
10
32
38
1
18
118
277
50
21
6
110
28
3
1
387
Marwn
270
56
11
136
9
5
406
65
16
78
Marshall
27
Maury :..;.:...:...
7
Meigs ......::: ::::::
Monroe
3
31
"23'
3
54
12 1
91 34
13
Montgomery
12.5
Moore
Morean
5
174
5
174
1
3 "".
3
OWon '.'..'..'.'"..
169
%
12
1
60
11
3
45
97
31
52
......
36
221
27
9
12
I
61
11
3
56
133
31
6
7
5
6
7
5
107
10
208
65
.... .
172
Orerton
10
Perry
17
17
210
Pickett
Polk
21
18
I
16
20
11
4
4
' "T
25
22
1
16
25
11
8
9
8
9
9
63
......
9
Putnam
67
Rhea ' '
Bone *../..'..*.*.
2
28
8
20
71
2
31
79
20
6
59
32
13
3
45
6
Robertson
62
Rutherford
77
Bcott
13
Sequatchie
1
Sevier
8
813
22
21
7
34
84
'746"
4
3
""6*
69
8
l,5.'i9
26
24
7
40
153
"'ie'::::::
16
Shelby
972
63
85
8
2
47
709
24
16
46
1,681
87
101
8
3
93
227
21
4
8
76
50
226
12
"2i'
52
4.t3
33
4
8
97
102
147
102
25
3
171
145
18
3
2
155
292
Smith :
120
Stewart
28
Sullivan
5
Sumner **
326
Tipton
Trousdale
6 1 20
^
Unicoi
""3
1
31
3
1
31
1 (
1
Union "**
5
8
22
17
100
31
36
5
6
3
5
""19
6
1
11
i
11
VanBuren ['.
17
19
15
6
46
17
7
18
4
4
9
10
7
jl,8U2
21
19
lo
9
50
26
17
2j
1
38
6
......
1
42
6
11
Warren
27
Waisbinrton
-■i-|:;:...
2
17
Wayne.:...::.:..:;;:::*"
94
Weakley ;'
132
5
10
'"'i'
132
5
11
37
6
22
13
'""2
2
37
6
24
15
106
White..
32
Willlams,7n . .
47
Wilson ■'
9
Total
3,560
1,514
5,074
J4,852
|o,G^J
2,467
X098
3,565
.4,iS3
I^SII
^^
Digitized by VjOOQIC
Anput 24, 1»17
1344
Table 4. — Types of tnfecHon reported diagnosed miaroseopieaUy^ by eountus,hy ywt.
fThe figures indicate the numbers of cases reported
oasee were reported, but the diacnoeis was not
collected during the years 1913 and 1914 <m]y.]
losed microscopically. The sign + indicates Uat
~ ' by the microscope. TtUs infonnstka w
Tertian.
Quartan.
EstiyoaatommL
County.
August-
NoTem-
b©r,1913.
January-
Septem-
ber, 1914.
August-
Novem-
ber, 1913.
January-
Septem-
ber, 1914.
August-
Novem-
ber, 1918.
ber,mi
Anderson ...••*••••
+
+
+
+
3
Bedford
+
+
+
+
+
+
+
+
Benton
+
+
Bledsoe
^
Blount
+
+
Bradley *-*^- *---*•
3
Campbeii ...-
Carroll li
+
Garter '. '."..'."."
1
+
+
1
Cbftfttham ....r.,....rTr
+
+
+
+
+
+
+
+
Chester
+
+
Claiborne
+
Clay
+
Cocke **
+
Coffee ,". I!
4
+
3
67
+
1
+
7
3
+
+
+
Crockett
ao
35
+
Cumberland
Davidson
44
+
+
+
+
41
+
+
+
+
13
1
+
13
7
I>ecatur . .
+
Dekalb
+
+
+
8
+
+
+
1
+
Dickson!;;!;
4-
10
+
+
Dyer
S
Fayette.
+
Fentress.....^
Pmnlclin
+
54
I
+
+
3
+
4-
6
+
+
+
Gibson
+
+
«
OUes ^
Grainger .....•........*................
+
Orwn© X ............_..<....
+
2
...«
Gnmdv ..^
Hamblen
+
+
1«
+
...
**
Ilamilton ,
18
3
4
+
7
3
+
+
" 6
Hancock
...•
TTardpTTian . ^
+
+
+
+
+
9
+
+
+
Hardin
+
3
+
+
Hay wood.... .••.••............. ..........
2
Hpndprson
+
+
+
3
3
+
+
+
+
+
Henry
+
Hickman.
+
+
+
Houston
+
+
+
1
+
Humphreys
+
+
+
1
Jack son
Jefferson
3
4
11
4
+
5
1
•" 2
Johnson.
Knox
49
+
9
+
4
t
+
1
15
+
+
10
0
3
+
+
13
63
Lake
Laiidprdale
2
3
+
La\\ roncc
+
Lcwi<;
Lincoln
+
+
2
+
+
Loudon
+
McMinn .
McNairy
+
+
Miicon , ,
+
^luiJi-on.,.,
4
+
4
Marion
+
+
+
+
+
+
+
+
Mar^iiall
+
+
+
+
+
+
+
Maury
+
MonrfK?
+
M on t u'omcry
+
S
Morgan
Obion
14
1
1
+
+
+
+
+
+
+
+
Ovv>rloD
1
Porrv
4
Pickett
+
Ptitnara
+
+
+
+
10
* +
i*"'
Koano
+
+
+
•f
KolKrJson
^1
1
Rut iicrford
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1345
August 24, 191T !
Table 4. — Types of infection reported diagnosed microscopically, by counties , by years—
Continued.
Tertian.
Quartan.
Esti vo-autumnal.
County.
August-
Novem-
ber, 1913.
Septem-
ber, 1914.
August-
Novem-
ber, 1913.
January-
Septem-
ber, 1914.
August-
Novem-
ber, 1913.
January-
Septem-
ber, 1914.
0eott
+
+
+
137
+
.f
flfnmtfhiff
Sevier
Shdbr
869
+
+
4
+
+
+
1
82
6
6
+
141
+
31
Hm'th. .,,
4.
Stewart
+
SnlUran,
+
1
1
4.
Homner r
4
2
+
TlptoQ
+
2
+
1
Unicd
Union.
Ven Rnren
4
+
5
+
+
-1-
1
Wsrren ■
4.
Wuhinstoo
+
4.
Wftyoe
WeakSey
2
+
+
+
1
+
1
White...
VilHnguKTn ......... t ... - - r , t , t ,..,..,,,. ,
1
+
1
4.
Wilson
Total
640
468
147
88
183
137
Table 5. — Eemoglohinuric fever reported, 1916,
Comity.
Period.
Cases.
Hv^-mRn
Thirfl quarter
Haywood ...•«• .
WttUev
do."
do
ctoT«a.....;::L.
Hvdmsn
do
l^ndfrdale
do
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August 24, 1917 1346
THE NOTIFIABLE DISEASES.'
PREVALENCE DURING 19IB IN CITIES OF 10.000 TO 100,000.
DIPHTHERIA. GONORRHEA. MALARU. MEASLES. EPIDEMIC CEREBROSPINAL MENIN-
Gins. PELLAGRA. POLIOMYELITIS. RABIES IN MAN. RABIES IN ANIMALS. SCARLET
FEVER. SMALLPOX. SYPHILIS. TUBERCULOSIS (PULMONARY). TUBERCULOSIS (AU
FORMS). AND TYPHOID FEVER— CASES AND DEATHS REPORTED. INDICATED CASE
RATES PER 1.000 POPULATION. INDICATED FATALITY RATES PER 1QN» CASES.
Pursuant to the practice which has been carried out for a number of
years, a schedule, of which a reproduction appears on page 1347, was
sent on January 15, 1917, to the health officers of cities of the United
States having a population of over 10,000, according to the census of
1910. With the schedule was sent a letter which is also reproduced.
The data of the prevalence of disease contained in the following tables
have been compiled from the schedules returned by the municipal
health departments. While not all of the cities returned the schedules
it will be noted that practically all of those with active health depart-
ments have done so.
The absence of figures in the "deaths*' column in the tables may
mean that no deaths occurred, or that the data as to deaths were not
furnished by the health department having jurisdiction.
It will be noted that some of the cities are apparently much more
successful in obtaining reports of notifiable diseases than are others.
This may be due to the greater activity of their health departments
or to a greater interest in the public welfare on the part of the prac-
ticing physicians. The completeness of the notification of disease
may be taken as a fairly dependable index of the efliciency of the
health department and of the sanitary knowledge and training of its
personnel.
To so great an extent is this true that the small number of cases
reported in some cities indicates grossly incomplete reporting of cases
and defective health administration, and not an actual freedom from
disease.
Another interesting point brought out in the tables is the illustration
of the extent to which the prevalence of disease may vary without
being manifest in the death rate. According to the typhoid table on
page 1374 Elgin, III., had 4 registered deaths from typhoid fever and
1 In studying these tables it should be kept in mind that a relatively large number of reported cases of
a communicable disease, as indfc-ited by a high case rate (and more especially when accompanied by ft
relatively small number of deaths, as indicated by a low fatality rate), usually means that the health
department of that city is active, and that the cases of the disease are being properly reported by the pno*
ticing physicians. It does not necessarily mean that the disease fs more prevalent in that city than in
other cities. A high fatality rate may mean that the disease was imusually virulent In a city, that tlw
physicians did not treat the disease in that city with the success usual elsewhere, or that the practicing
pkj'slcians did not report all of their cases to the health department. On the other hand, an unusually
low fatality rate may be due to the fact that the disease in the city was unusually mild, that the physicians
treated It with unusual success, that the practicing phjrsicians reported their cases satislactorily, or that
the registration of deaths was incomplete, or the assignment of the causes of death inaocoratt.
Digitized by
Google
1347
Aiicn8t24.181T
218 reported cases. Hazleton, Pa., had the same number of deaths
but only 13 cases. With the same number of deaths, Elgin had over '
16 times as many cases as had Hazleton. Both have approximately
the same estimated population, a little over 28,000. Tlie one, how-
ever, had an indicate case rate of 7.7 and the other a rate of less than
0.5. So far as known, the cases were as completely reported in one
commimity as in the other.
Another striking illustration of the difficulties frequently met in
using the number of registered deaths as an index of the prevalence
of a disease is to be foimd in the smallpox table. Newcastle, Pa., had
two deaths from smallpox. EvansvUle, Ind., had none. Neverthe-
less, there were 153 cases of smallpox reported in Evansville, while
there were only two cases in Newcastle.
Reproduction of Schedule sent to Cities.
ANNUAL MORBIDITT AND IfOBTALTTT SUMMABT.
City of , State of
NoTE.—In tliis blank the number of reported cases should be filled in of only those diseases that havt
been made notifiaUe by law, ordinance, or regulation. Known prevalence of other diseases can be noted
on a separate memorandum.
The numbers of fatal cases (deaths) registered should be filled in for all the diseases Ibted, excepting
gonorrhea and syphilis.
A lettered death of a case not previously reported is to the health department and the epidemiologist
simply a delayed report of a case and should be considered as a case as well as a death and included in the
cises recorded in this report.
Note with a star (*) tlie olBcialiy notifiable diseases 6/ which the cases are known not to be satisfactorily
reported.
Diseases.
Calendar year 1916.
Cases
reported.
Deaths
registered.
Do not use
this column.
Diphtheria
G<morTbea
Vahria
Measles
If eiingitis (epidemic cerel)rospinal) .
Pellagra
Poliimvelitis (bifantile paralysis) . . .
Ilables (in man)
Kabies (in animals)
Scarlet fever
&nallpox
SvDhilis .'.
Tttberculosis (pulmonary)
Tuberculosis (all forms)
Typhoid fever
I
I certify that the foregoing statement is made up from the official records of the
dty of and that the number of cases and deaths corresjwnd
therewith.
(Date).
, Health Officer,
, RegUtrar.
To the Surgeon Gbneral,
United 8uuei Public Health Service, Waehington, D. C,
Digitized by
Google
Aagost 24, 1917
1348
Treasury Departmentt,
Bureau of the Public Health Service,
Washington.
Dear Sir: It is desired to ascertain the reported prevalence of certain diseases
during the calendar year 1916.
For this purpose there is inclosed a blank, and it will be appreciated if you wiB
kindly have it filled in with the information for your city and returned in one of the
inclosed enveloi>es.
As the blank calls for a statement of the deaths registered, as well as of the cases
notified, space has been provided that both the registrar and the health officer may
sign the report. In those cities where the health officer is also registrar he should sign
in each capacity.
You will find also inclosed a separate blank prepared for data regarding the number
of cases of leprosy in your city. It is desired that special care be taken in the filling
out of this blank so that a complete census of the lepers in the country may be obtained.
Very truly yours,
Rupert Blue,
Surgeon General,
REPORTED PREVALENCE FOR THE YEAR 1916.
DIPHTHERU.i
City.
Estimated
popula-
tion July
1, 1916.
Cases
report-
ed
Deaths
regis-
tered.
Cases
report-
ed per
1,000
inhabit-
ants.
Indi-
cated
fatality
rate
per 100
From 50,000 to 100,000 inhabitants:
Atlantic City, N.J
Augusta, Oa
Bayonne, N. J
Berkeley , Cal
Binghamton, N. Y
Brockton, Mass
Canton, Ohio
Covington. Ky
Dululh, Minn
Elizabeth, N. J
El Paso, Tex
Erie, Pa
Evansville, Ind
Flint. Mich
Fort WajTio. Ind
Harrisburg, Pa
Hoboken.N.J
Holyoke, Mdss
Lancaster, Pa
Maiden, Mass •.
Manchester, N. H
Mobile, Ala
New Britain, Conn
Oklahoma City, Okla
Passaic.N.J
Pawlucket, R. I
Portland, Me
Rockford,IH
Saginaw, Mich
St. Joseph, Mo
San Diego, Cal
Schenectady, N. Y
Somerville, Biass
Tampa, Fla
Troy, N. Y.
Utica.N. Y.
Wichita, Kans..
Wilkes-6arrc. Pa
Yonkcrs,N. Y
York, Pa
From 25,000 to 50,000 inhabitants:
Alameda, Cal
Aurora, IIL
Austin, Tex
Battle Creek, Mich
Bay City, Mich
57,660
50,245
69,895
57,653
53,973
67,449
60,852
57, 144
94,495
86,690
63,705
75,195
76,078
54,772
76,183
72,015
77,214
65,286
50,853
51,155
78,283
58,221
63,794
92,943
71,744
69,411
63,867
55,185
55,642
85,236
53,330
99, 519
87,039
53,S.H6
77,916
85,692
70,722
76,776
99,838
51,656
27,732
34,204
34,814
29,480
47,948
41
22
104
30
357
161
117
88
111
343
80
116
153
144
28
124
248
85
79
173
82
21
60
47
137
162
133
67
77
100
128
113
159
92
72
86
47
138
166
71
26
45
07
27
79
11
1
11
15
11
8
11
9
1
8
3 I
12 1
• 10
8
1
6
15
8
8
21
1
10
5
8
6
14
3
0.711
.438
1.488
.520
6.614
2.387
1.923
1.540
1.175
3.957
1.255
1.543
2.011
2.629
.368
1.722
3.212
1.302
1.553
3.382
1.047
.361
.929
.506
1.^10
2.727
2.062
1.033
1.384
1.173
2.400
1.135
1.827
1.707
.924
1.004
.665
1.797
1.663
1.374
1.316
1.925
.916
1.648
9.76
4.55
10.00
11.48
3.73
12.82
4.65
7.21
7.29
90.00
5.17
7.64
8.57
8.87
6.05
12.94
iai3
6.36
10.98
4.70
16.00
6.3S
8.75
9.88
6.02
1.75
7.79
15.00
6. 25
7.08
13.21
1.09
13.89
5.81
17.02
4.35
8.43
4.23
3.85
*i6.'4S
"7.W
^ Cities in which no cases of this disease were reported are not Included in this table.
1349
August 24, 191T
REPORTED PREVALENCE FOR THE YEAR ISlS-Contmued.
DIPHTHERIA— Continaed.
aty.
EBtimatfid
populo-
Urn July
1, 1916,
Casps
rejxjTt-
reKis-
tPre<J.
rcporl-
1,0(X>
ant^. i
rated
fftluUty
rate
period
From 25,000 to 50.<X)3 lnhabH4«it5— Continued.
32,9SS
33,846
32,730
25,030
37,308
25,636
46,192
27,386
34,611
31.484
25,987
26,074
32,261
48.811
39,631
39,873
42,458
28,203
28,591
39,235
41,781
29,353
40,496
26,171
48,477
28,491
35,363
29,737
4S,S86
31,576
26,771
38,676
31,677
40,498
27,809
41,097
46,515
27,587
36,964
32,940
30,699
47,521
26,234
27,451
26,318
37,fX)9
25,424
26, KX)
41,133
31,927
30, 108
37, T.VJ
43,715
37,353
31,401
26,654
31,404
33,080
36,065
41,185
3S,f)29
36. 79H
38, 136
43,284
2S.92(3
48,562
38,902
27,415
46,226
36.283
2
1
26
4
19
66
58
15
131
14
35
57
17
33
43
8
64
9
38
9«
197
20
37
37
169
69
75
67
29
71
38
35
126
79
8
195
100
27
48
28
19
211
34
26
35
36
21
6
39
33
106
53
46
107
88
23
47
97
9
130
.•yi
45
CO
no7
37
47
»68
51
70
31
1
........
5
4
2
1
6'
2
1
h'
9'
1
22
2
1
2
14
3
7
3
io"
4
12
3
1
3
6
2"
i3*
1
1
3
1
1
2*
2
6
3
1
10
11
1
2
4
5'
8
6
1
7
3
2
4
4
3
e
0.061
.030
.794
.160
.609
1.755
1.2S6
.547
.896
.445
1.347
2.186
.527
.676
1.065
.201
1.607
.319
1.329
2.523
4.715
.681
.914
1.414
3.486
2.422
2.121
2.253
.503
2.249
1.419
.905
3.978
1.951
.288
4,745
2.150
.979
1.299
.850
.619
4.440
1.296
.947
1.330
.973
.820
.230
.918
1.034
3.521
1.404
1. 052
2.865
2.802
.863
1.497
2.932
.2:-o
3.302
1. 372
1.223
1.573
2.472
1.279
.968
1. 748
1.858
L5I4
.Sfi4
50.00
RAMII,^trlAllO , . .
BmnVliffe, M*MW
3 85
Burlington, Iowa
Cedar Rapids, Iowa
26.32
Ctotral Falls, R. I
6.06
Chelsea, Mass
3.45
Clinton, Iowa
6.67
Columbia, S. C
12.90
Cooncfl Bluffs. Iowa.
Cranston, R. l.
Cumberland, Md
10.53
Danvflle,IU.
11.76
Davenport, Iowa
3.03
Decatur, ni
Dubuque, Iowa .^
Bast Orange, N. J
Elgin, nT!.. .....
7.81
E^anston,Ill
23.68
Everett, Mass
1.01
Fitchburg, Mass
11.17
Green Bay, Wis
10.00
Hamilton, Ohio
2.70
Bammond, Ind '. ,.
5.41
flaverhill, \ffts« , ' , ',
8.28
Haxlcton,'Pa
4.35
Jtckson.Mich
9.33
Jackson, Miss
4.48
Kalamazoo, Mich
Kenosha, Wis
14.08
Kingston, N.Y
10.63
KnoKvflle, Tenn
laCrosse.Wis
9 62
Lansing, Mich
3.80
Lewfeton.Me
12.60
I'exington. Ky
1.64
Lincoto, Nebr
6.00
I^ong Beach. Cal
Lorain. Ohio
Lynchburg. Va '..
7.14
Madison, Wis
McKeesnort, Pa
6.16
Medfard.Mass
2.94
Moline,Ill
3.85
Montolalr. N. J
Mount Vernon, N. Y
8.57
2.78
Muncie.Ind...
4.76
Muskegon, Mich
Newcastle. Pa
5.13
Kevrport, Ky
6.06
JJewport.R.I
NewRochelle, N. Y
5.66
5. 66
Newton, Mas
2.17
Niagara Falls. N. Y
9.35
Norristown, Pa
12.50
or^pnrkJu. :::::::::.::::::;:::::::::::::::::::::;:
4.36
Oriieij. I'ta^
4.26
Omngt, N.J
4.12
S^^Kw^j::::::::::;:::::::::::::::::;::::::::::::
PfTtli Ainl.r.', N. J
Pnt5{i6iu, M^ ;
3.68
15.09
Sq1W7,113 .
13.33
gtiincy.MMi !
1.07
lawaKva.: ::;v;;:
6.54
f«kJskran,rii. .........
8.11
l*»e«i,MiE,...:: . .
4.26
Steabtnvnifl, Ohio
5.88
7.84
eppflrEor,Wh .
4.S9
Tauuujn, M iss
19.35
' The health olBcer states that cases arc known not to be completely reported,
Digitized by
f
August 24, 1917 1350
REPORTED PREVALENCE FOR THE YEAR 1916— Oontmued.
DIPHTEUSRIA--Continued.
aty.
Estimated
popula-
tion July
1, 1916.
Cases
report-
ed.
Deaths
regis-
tered.
Cases
report-
ed per
1.000
inhaUt-
ants.
Indi-
c»t«d
fatality
rate
p^lOO
cases.
From 25,0C0 to 50,000 inhabitants— Continued.
Tulsa, Okla
Waltham, Mass
Waterloo, Iowa
Watertown. N. Y ,
WestHoboken, N. J
■Wheeling, W. Va.
Winston-Salem, N. C
From 10,000 to 25,000 inhabitants:
Aberdeen, Wash
Adrian, Mich
Albuquerque, N. Mez
Alexandria. Va
Alliance, Ohio
Alton, 111
Ann Arbor, Mich
Appleton, wis
Argenta, Ark
Asbury Park, N. J
Ashevillp. N. C ,.
Bakersfield, Cal
Batavia.N.Y
Baton Kouge, La
Bellaire^dfiio
Beloit, Wis
Berlin. N. H ^
Beverly, Mass
Billings, Mont
Bloomfield, N. J
Bluefleld, W. Va
Bradford. Pa
Brownsville, Tex
Brunswick, Ga
Burlington, Vt
CairoTni
Carbondale, Pa
Champaign, lU
Chickasha, Okla
ChlUocothe, Ohio
Clinton, Mass
Coffeyville. Kans ,
Concord, N.H
Connellsville, Pa ,
Coming, N.Y
Cumberland, R. I
Danville, Va
Dover. N. H
DuBois, Pa
East Liverpool, Ohio.
Eau Claire, Wis
Elwood, Ind
Elyria, Ohio
Escanaba. Mich
Eureka, Cal
Farrcll, Pa
Fond da Lac, Wis
Fulton, N.Y.
CJardner, Mass
Grand Island, Ncl)r- .
Granite City, III
Grcenvillp, S. C
Grconwicli , Conn
Hatkensaok, N. J
Harrison, N. J
Hattio,>l)urK, Miss
Helena. Mont
Homestead, Pa
Hornell,N. Y
Huntington Ind
Irunwood, Mich
Ith-ua, N. Y
Jackson, Tcnn
Janesvillo, Wis
80,575
80,570
S5,559
29,804
43,139
43,377
31,155
20,334
11,458
14,025
17,S46
18,960
22,874
15,010
17,834
14,907
14,007
20,823
16,874
13,350
17,176
14,348
18,072
13,509
21,645
14,422
18,466
15,442
» 14,544
13,163
10,872
21,617
15,794
19,242
14,508
15,447
15,470
1 13,075
17,548
22,669
15,455
15,406
10,848
20,021
13,272
14,665
22,586
18,807
» 11,028
18,618
15,485
14,6S4
» 10, 190
21,113
11, 90S
17,140
12,826
15, 142
18, ISl
19. lo9
16,045
Hi, U50
16, 1S2
13,612
22.466
14,085
10, 880
14, 779
15, 848
17,807
14,339
22
49
23
31
52
54
128
2
5
39
6
20
44
33
10
12
15
23
8
0
30
24
19
15
33
2
45
36
4
3
7
73
0
38
23
6
15
5
21
50
15
6
16
30
19
47
17
20
11
35
3
1
10
4
23
96
3
31
13
13
15
13
17
4
30
5
2
122
5
14
6
0.720
L603
.647
1.037
L205
1.245
4.108
.008
.436
2L781
.336
1.055
1.9M
aLl1»
.661
.806
L071
L105
.474
.674
1,747
L673
L051
L103
L525
.139
2.437
23)1
.275
.238
.644
3.377
.570
1.975
L585
.388
.970
.3S3
L197
2.206
.971
.390
1.475
1.498
1.432
3.205
.753
L063
.997
L880
.194
.068
.981
.189
L931
5.601
.234
2,047
.715
.679
.885
.767
1.031
.294
1.335
.340
.184
1.489
.315
.786
.418
> Population Apr. 15, 1910.
^The health omcer states that cases are known not to be completely reported.
Digitized by
Google
1351
August 24, 191T
BEPOBTED PREVALENCE FOR THE TEAR 1916--Coiitinued.
DIPHTHEBIA— Continued.
■m.
Estimated
Tpopw Ga-
llon July
1, 10 IG.
rflport-
cd.
Vmihs 1
tared. '
1
CHJ503 1 Tndi-
rwort-l Gated
ed ptr ffltnlity
l^OOrj rate
TilwiUt^ Xm 100
tints, eases.
Frr ' • ' " » 25.«» Inhabitants-Continued
Johnstown, N. Y
10,648
14.230
23,539
20,930
21,286
12,221
» 19, 303
11.S38
13,451
19,879
21,046
15,395
U2,381
13,805
110,365
22,734
U4,610
19,sa4
13,712
15,310
12,582
IS.HIO
15, 625
14,110
21,630
13,284
23,126
23,629
20,562
122,019
19,926
13,768
20,951
22.2S6
16,624
13,705
24, 101
24.842
18,360
18,530
15,605
14,152
18,599
23,805
12,837
19,100
17,542
11.666
11.000
ll.sr.i)
l<», 7r);{
23. 737
li.sni
20.27S
16,9iri
20. 193
14.816
14..')^
13.S21
13,919
lo, 026
14,205
21,365
15,458
J 10, 198
13,875
20,780
15, 193
13,059
14.737
21,«il8
14,867
7
89
38
74
5
30
70
60
15
6
6
33
6
22
3
10
2
46
25
51
11
102
45
8
94
35
34
13
8
8
14
43
10
25
25
18
21
40
18
36
54
13
23
16
8
23
30
0
1
2
11
21
in
8
9
12
4
2
64
27
11
42
24
21
9
4
24
5
9
. 15
; 40
1
4"
2.
6
1
5
2
3
1
1
2
2
i
1
5*
4
5
1
1
5
3
2
1
1
3
1
2
1
2
4*
2
3*
2
2
i*
i"
i'
2*
4
1
4
1
3
i
■■■■■■,
2
1
1
0.667
6.2&4
1.614
3.536
.235
2.455
3.615
5.068
1.116
.302
.285
2.144
.485
L594
.290
.440
.137
2.319
1.823
3.331
.874
6. 452
2.880
.567
4.346
2.635
1.470
.550
.389
.363
.703
3.123
.477
1.122
L504
L313
.871
1.010
.980
1.943
3.460
.919
1.237
.672
.023
1.204
1.710
.771
.071
.135
.557
. 8S-,
.671
0.395
.531
.594
.269
KankAkeo Dl . - t
4.49
Kaarny. K. J
Vokomo. Ind.
6.26
8.11
LaFAVGtte. Ind.
20.00
LaSiile, UL
16.67
T/ea von wnrth, Kanx
2.86
Lincoln, ni .'.
6.00
Little Falls. N. Y
6.67
Lockport,N. Y
16.67
Loeansport , Ind
33.33
Loot Branch, N.J
0.06
K %»il^tf^, ^ifh -
Manitowoc, Wis
llnakoto, Minn
Ifqp^f^M ^hi"
Maiinettft' Wis
5a 00
Marion. Ind
2.17
Marshall, T***^ . .
Maasillon, Ohio
9.80
Mattoon.lil
36.36
Middletown, N. Y
4.90
Middletowii, Ohio
2.22
MiYf^rd, ^^<t
12.50
Monrssen, Va
5.32
Morristown.N. J
8.67
Nanticoko, Pa
5.88
New Albany, Ind
7.09
Newport News. Va
12.50
Kortn Adams, Mass
37.50
Norihampton! Ma<n . ... . . ...
7.14
North To'nawanda, N. Y
4.65
North VaVIttiii, Wash
10.00
Norwood, Ohio
Clean, N. Y
8.00
Owinlnr.N. Y
OswrgoTy, Y
19.05
Paducih. Ky
Pea>>ody, Mass
11.11
Peekskilf, N. Y
PhlJIipsburg, N. J
5.56
Plmia, Ohio
15.38
Pittston, Pa
Plalnfleld. N. J
Plattsburgh. N. Y
Plymouth, Pa
'"8*76
Pontlac, Mich
Portsmouth, N. H
11.11
R«dlaads,Cal
Reno. Nov
Rive^sid^Cal
Rome, N. Y
4.76
Rntland.Vt
Salem, Oreg
San nemardino, Cal
fiazidatky, Ohio
Santa Barbara, Cal
25.00
SanUCnu, ral
.137
Saratoga Springs, N. Y
4.631
1.940
.704
2.957
1.123
1.358
.88-3
3.13
Sault St. Marie, Mich
14.81
Behna. Ala
9.03
Boathnridge, Mass
9.52
Spartanbwg, 8. C
Steelton, Pa
4.17
11.29
Stillwater, Minn,
Trinidad, Colo
.288 , 25.00
Uniontown, Pa. v
1.1.% 1
Virginia, Minn
.320 1
Warren, Ohio ,
.089
1.018
1.850
3.632
33.33
Warren, I*a
6.67
Washinf ton, Pa
5.00
Watertown. Ma»a.
1.85
»Population Apr. 15, 1910.
Digitized by
Google
August 24, 1917
1352
REPORTED PREVALENCE FOR THE YEAR 191^— Continued,
DIPHTHERIA— Continued.
aiy.
Estimated
popula-
tion July
1, mt.
Cases
report-
ed.
Deaths
regis-
tered.
Cases 1 Todi-
rep(*rt- 1 catrf
ed per 1 faUlitT
1,000 nu*
inhabit- prr MO
ants. 1 ctet
From 10.000 to 25.000 inhabitants— Continued.
WauKegan, 111
20,244
19,239
13,210
13,176
18.391
18,773
13,550
22,465
» 18. 583
12.092
15,860
13
10
44
7
18
72
48
45
19
11
47
i
5
2
2
2
6
aM2
Wausau, \^l8
.5»'
Webster, Mass
3.331
West Chester, Pa
.531 • 14*
Westfleld, Mass
.»7» 1 r.Ti
West New York, N. J
zms, ...
Ww!t Orftnge, N.J
a 542 > i 17
White I'lains, N. Y
2.003 l«4
Wlnonn. Minn
1.022 las
Winthrop. Mass
.«7 ....
"Wobum, Mass
2.iH3 j ItLM
GONORRHEA.*
MALARU.S
From 50,000 to 100,000 Inhabitants:
Berkeley. Cal
57, «3
00,852
63,7«4
8'i,23«
99.838
47.942
25,030
37,308
27,380
31.484
48,811
39.873
2fl.l71
29.737
48,880
41,007
30,961
2«,3I8
31,927
38,902
35,559
14.318
in,4fA
15,794
15,470
22. :m
14,fi84
20,030
21, (M«
l.S,395
15.310
15,r,25
22,2Vi
14.152
20.1<«
n,avj
•67
»1
6
>34
12
10
78
7
23
•1
139
88
•7
752
53
3
13
n
30
•1
56
5
1
47
•5
13
.016
.113
Canton, Ohio
New Britain. C'Onn
St. Joseph. Mo.
....:::: :m2
YonkersTN. Y
.130
.309
3.116
From 25,000 to 50,000 InhaUtants:
Bay City, Mich.
BurlixLnon, Iowa
Cedar Kaoids. Iowa
.1S8'
Clinton, Iowa.
MO 1
Council Bluffs, Iowa
032 '
Davenport, Iowa
2! 848 1
Dubuque, Iowa ."
.953 1
.267
Jackson, Mis
35.2SM
Kalamaioo, Mich.
1.0H4 ;
Lexington, Ky
.049 '
Lorain, Ohio
452 '
Montclalr, N. J
Newport, Ky
.418
.940 ■
San Jose, Cal
.0»
1,575
.349
.054
3.9T6
.323
.576
L022
.191
.0B5
Waterloo, Iowa.
From 10,000 to 25.000 Inhabitants:
Bellalre, Ohio
Bloomfteld, N. J
Cairo, III
Chllhcothe, Ohio
East Liverpool, Ohio
Eureka, Cal
15 1
•4 1
•2]
•3 :::::::
•8
6
5
Kokomo, Ind
LoRansport, Ind
Long Branch, N.J
Massillon, Ohio
.195
.361 1
Middle town. Ohio
l.l.V>
Norwood . <^)nio
1.077 - --
ri<pift, Ohio
.565 .
.297'
Pan<I tLsk y, ( )hio
War rt 11, Ohio
From rjn.oiY) to 100,000 inhabitants:
|i<rtoIrv, ( al
57,653
86,090
7o,195
77,214
&H,22l
53, 7W
71,744
16
1
1
4
122
2
9
i5
0.989
.013
.013
.033
.37»
017
'125
I.'./ulHlh, N. J
Kr;..ra
llol oken. N. J
M<.biIo, Ma
* ■«.»
N«*w MriJain. t'onn
ra>^.i»c. N. J
' roTiuIatlon Apr. 15, 1910.
-Cilio"* in which no cases of thb' disease were reported are not included In thU tal4#>
>The health ofhcer sutes that cases are known not to be compIet«ly reported.
Digitized by
Google
1353
August 24, 1917
REPORTED PREVALENCE FOR THE YEAR 191G— Continued.
MALAHU-Continued.
aty.
Estimatod
popula-
tioD July
1, 1916.
CasM
report-
ed.
Deaths
regia-
tered.
inhabit- per 100
cnts. cases.
Cases
report-
ed per
1.000
Indl-
cated
fatality
rate
From 50^000 to 100,000 tnhabitants— Continued.
Tmrnpa^Pla
Wiehlta, Kans
Yonkcrs^N.Y
From aMQBD to 50,000 inhabitants:
Chelmo,Mass
East Orann, N.J ,
EventtrWash
HawMULMass ,
JaoksoQ, Miss
Lone Beach, Cal
Montflteh'.N.J
'H^mtmk.ibm
Oranffp. N. J ,
Pertti Amboy, N. J
Taunlon, Mass ,
WaUkara Mass
Wimtoo-Salcm, N.C
From 10,000 to 25,000 inhabitants:
AalWTiDe.N.C
Bakeraflt]d,Cal
BtoomlMd,N.J
CoOeTTine, Kans
Saatlirerpoo), Ohio.
OreiOTille, S. C
Greenwich, Conn
Hackensack, N. J
Hattie8burg,Miss
Kearny, N.J
Newport News, Va
Flalnfleid, N. J
Ran Bernardino, Cal
Sania Barbara, Cal
Seliaa,AU
Waleriown, Mass
West Chester, Fa
63,886
70,722
00,838
46,ltt
42,458
35,486
4K,477
29,737
27,587
26,318
43,716
33,080
41,185
36,2S3
30,570
31,156
20,K23
16.874
18,466
17,548
22.586
18. 181
19.159
16.945
16.483
23.:>39
20 562
23.806
16.»(5
14,846
15.626
14,867
13, 176
27
2
3
0
1
2,137
13
UO
1
2
122
12
.....'...
2,049
........
^3
53
11
0.501
7.41
.042
.090
.(M3
saoo
.071
.028
.021
71.863
.61
.109
.266
.229
.151
.073
.028
loaoo
.131
.160^
4a 00
6.86(r
.415
.05««
.114
.044
.066
.626
.118
24.317
.042
.049
.126
.060
.087
3.392
20.75
.067
.152
MEASLES.'
Fran 50,000 to 100,000 inhabitants:
Atlnntlr Oty, N J
67,660
60,895
57.653
53.973
67,449
60.852
57. 144
94,495
86,600
63.705
75.195
76,078
54.772
76,183
72.015
77,214
66,286
60.853
61. 1.S5
78,283
58,221
63,794
92,943
71,744
50,411
63,887
65,185
65,642
85,236
206
281
12
751
2,235
130
310
1.307
357
239
2,317
37
771
1,881
2.530
510
400
1.663
231
1,101
»5
1,270
232
574
1106
306
863
1.017
385
11
24
5
3
7
10
8
20
7"
1
21
3
3'
19
4
9'
4
3
2
3.607
4.020
.280
13.914
33.136
2.136
5.425
13.831
4.118
3.752
30.813
.486
4.131
24.691
35.132
6.G05
6.127
32.702
4.516
14.061
.0»^
23.009
2.496
8.001
1.818
4.791
15.63^
18.278
Bayonne, N^ J
Berkeley, Cal
Bingt^mntnn, NY
1.46
BroclctoD. Mass
1.07
Canton, Ohio ,
3.85
Ctjiyrinrtetn Ky
.97
Doloth.Minn
.54
IQii^bf ih N- J
2.80
El Paso, Tex
3.35
Erie, I^
.86
l?T|iiv?vill*», Tnd
Flint, Mich
.90
Fort wa3me,lnd
.05
HaiiisbarF, Pa
.83
Hoboken, N. J
.57
Holyoke, Mass
I^mflistpr, Pa
.18
VftldAn lliUM , .
Man^liMtAr N. H
1 73
Mobile, Ala.
New Britain. Ccnn . . , , , . . . , , , , ,
* .31
Oklahoma C(ty. Okla.i '.'.
Passaic, N.J...
Pawtuckct, R. I
Portland. Me
1.67
3.70
.65
Rockfortf.ni
fterinAw/Mirb...
.20
8t: Joseph, Mo
1.81
> The health officer states that cases are known not to bo completely reported.
* Cltios in which no cases of this disease were reported are not included in this tabl«.
98
Digitized by
August 24, 1917 1354
REPORTED PREVALENCE FOR THE YEAR 1916— Contmxied.
M E ASLES— ContimMd.
aty.
Estimated
popula-
tion July
1, 1916,
Cases
report-
ed.
Deaths
regis-
tered.
Cases
report-
ed per
1,000
inhabit-
ants.
Indi-
cated
fatality
rat*
per 100
cases.
From £0,000 to 100,000 Inhabitants— Conntinucd.
San Piceo. ("al
53.330
99.519
87. (m
77,916
85.692
70.?22
76,776
99,838
61,656
27,732
29,480
47, MS
32,985
33,846
32,730
25,636
46,ld2
34,611
31,484
25,987
26,074
32,261
48,811
39,031
39,873
42,458
28,203
28,591
39,235
35,486
41,781
29,3,53
• 40,496
26,171
48,477
28,491
35,363
29,737
48,886
31,. 576
20,771
38,676
31,677
40,498
27,.<«9
41,097
46,515
27,. 587
36,964
32,940
30,699
47,521
26,234
27,451
26,318
37,009
25,424
26,100
4i;i33
30,108
37,759
43,715
37,353
31,401
26,6^
31,104
33,0.*^0
36,065
41,185
38,629
817
259
119
22
28.3
1,640
lOS
200
785
1,345
20
582
355
9i
10
»121
45
250
»180
M6
20
1,125
2,211
2
956
150
654
00
55
58
176
678
40
683
296
123
71
1,003
58
160
853
15
625
82
100
3
• 186
101
8
307
1,539
177
1,467
89
10
399
239
>733
84
525
'207
la-)
'433
1,506
613
100
575
78,->
182
21
16
1
2.
2
15.320
2.«03
1.367
.13
Schoncctsuh N. Y
.77
Sonicrvillo,Ma.ss
1.®
Tanipn, Fla
1 .408
Trov.N. Y
1
11
1
6
11
3.632
19.138
1JI27
J. 685
7.96S
25.909
.721
.55
Utica.N. Y ;
.67
Wichita. Kans .
Wilkes 15arre. Pa
.55
Yonkers.N. Y
York. I'a
.64
82
From 23,000 to 50,000 inhahilanls:
Alameda, Cal
Battle Croek. Mich
2 i 19.742
15 1 7.-405
.34
Rftvritv,Mich
4.23
Bellinjrham , Wiush
2
1
i'
4
5'
3'
i*
3'
2
2'
4"
i*
1
3'
4*
2
4
i'
i*
3
1
i"
22
1
5*
13
1
1
2. SOT
.295
3.607
1.755
5.412
6.201
1.461
.770
43.146
68.535
.041
24.123
S.988
15.403
3.191
1.934
1.478
4.032
13.834
1.363
14.300
11.310
2.537
2.492
28.363
1.950
3.273
27.014
.560
16.160
2.589
2.469
.108
4.526
2.279
.290
8.305
46.721
6.766
30. sn
3.393
.364
15.161
6.458
28.831
3.218
12.763
6.875
2.781
9.905
40.318
19.522
3.752
18.310
23.730
6.046
.510
.414
Boise, Idaho .^ ,..
Brook] in e , Mass
Central Falls, K. I
Chelsea. Mass
SO
Colranbia.S. C
CduBcll Bluffs, Iowa .
.«
Cranston, R. I '..!.. .1.1. 1
Cumberland , Md
.09
Danville, ni ! !!!..;M.!
.IS
Davenport , Iowa
Decatur, 111
.a
Dubuque, Iowa
East Orange, N. J
Elgin, III
.46
Evanston,IU
1.82
Everett, Mass li*
Everett, Wash
Fit<5hburg, Mass
Green Bay, Wis
Hamilton, Ohio I.!;;!*'!"*.!....
.51
Hammond. Ind
.(S
Haverhill, Mass
Hazleton.Pa
2.82
Jackson, Mich
Jackson, Miss
Kalamazoo, Mich '. '.
Kenosha, Wis
.47
Kingston, N.Y !..!'.'!..*".'!!
Knoxville, Tenn
La Crosse, Wis.- WV
*' i.22
Lansing, Mich
1.00
Lewiston,Me .......'.' '.
Lexington , Ky
1.61
Lincoln, Nebr
Long Beach, Cal ',.[...
Lorain, Ohio
Lynch Dure? Va .1...
*" .26
M'adison, Wis [
1.13
McKeesport , I'a
.27
Medford.Mass
• Moline,Ill
Montclair.N.J
Mount Vernon, N. Y
Muncie, Ind
.42
Muskegon, Mich
l.W
New Castle, I*a
.57
Newport. K.I ',.'.'.'/.'."
New Kochelle. N. Y
Newton, Mass
.48
.'23
Niagara Falls, N. Y
1.46
Norristown , I'a
.16
Oak Park, 111 :.*;;
Ogdon,Utah
87
Orange. N. J ',.'"
1.66
Oshkosh,Wis
S
Perth Ambov. N. J [,"
Plttsfield.M^
4.78
J The health officer states that cases arc known not to be completely reported.
Digitized by
Google
1355 Auga8t24. 1917
REPORTED PREVALENCE FOR THE YEAR 191&— Continued.
MEASLE&-Coz.tiiiued.
aty.
Estimated
popula-
tion July
1, 1916.
Cases
report-
ed.
Deaths
regis-
tered.
•
Cases
report-
ed per
1,000
nl-' It
ants.
Indi-
cated
fatality
rate
per 100
cases.
From 25,000 to 50,000 inliabitants-Continiied.
QuincY.ni
36,798
38,136
43,284
28,926
48,562
38,902
27,445
46,226
36,283
30,575
30,570
35,559
29,804
43,139
43,377
31,155
20,334
11,458
14,025
17,846
18,960
22,874
15,010
17,834
14,007
16,874
13,350
14,348
18,072
13,599
21,645
14,422
18,466
15,442
» 14,544
13,163
10,872
21,617
15,794
19,242
14,508
15,470
113,075
17,548
22,609
15,455
15,406
10,848
20,021
13,272
14,665
20,743
22,586
18,807
« 11, 028
18,618
15,485
14,684
« 10, 190
11,908
17, 140
15,142
18,181
19,159
16,945
16,950
16,482
13,612
22,466
805
91
1585
23
142
»7
328
157
155
69
53
315
813
65
1,404
706
3
2,218
40
3
155
283
11
20
35
283
9
184
62
187
35
241
162
46
80
158
UO
422
45
190
44
234
81
91
382
326
370
15
346
81
236
1281
73
1351
86
127
166
24
266
23
456
21
1304
46
774
1178
21
20
215
2
h'
7'
4
1
1
1
7'
9*
•
i'
2"
6
i*
4
2
i'
2
i'
8'
i*
2"
8*
1
3*
9
i*
2'
6"
i'
1
1
1
5
i
9
21.876
2.386
13.515
.796
2.S84
.180
11.961
3.396
1.516
2.257
1.734
&859
27.196
L507
32.367
22.661
.096
21.644
2.852
.168
8L175
12.372
.733
1.121
2.499
16.771
.674
12L824
3.431
0.396
6.617
16.711
8.773
2.979
6.501
4.406
.920
19.522
2.849
9.874
3.033
15.126
6.195
5.186
16.851
21.093
24.017
.461
17.282
6.103
16.093
13.547
3.232
18.663
7.798
6.821
ia720
1.634
26.104
1.931
26.604
1.387
16.721
2.401
45.677
ia501
1.27i
1.409
9.£7U
25
qnini4;i'ft'm .
.85
^V»^ Inland /Til .. ...... .
SalMn, Iffum.
San Jose, Cal
SteobcoiTiUe.oKib *.
2.13
2 55
SiqwriQr,Wis
TfmfitoTi, Mass.
1.82
1.45
Tulsa, Okla
WftltKAm Mam . , ..... .
L80
Waterloo. Iowa
Watcrtown, N. Y
.86
West UobokoD, N. J
Wheeliiif;, W. Va
64
WinstGn-Salem, N. C
.85
Tnm 10,000 to 25,000 inhabitants:
AberdMm, W^h . . . . .x . ..
Adrian, ifaoh
.05
Albuquerque. N. Max
AJexaSSS.^^*. ™
Allianc5,oiiio.. . ; ..
1.29
Alton, III :::::::::;:::::.:::::::::;::;;;;::::::..
2.12
AnnArhnr U^rh
Applf'tflts ISTIs
^sbiiry Park, N.J
BatersO^ld, U]
BE^rtivk. N. Y
11 11
lie Ikirc, Ohio ..
2.17
Bcioit, Wis..
Berlin. >5.ii
2.30
H*ifwly,Masa .... . .
Binagi Moot I...;.::::::::::::::
.41
BbomS^M N. J
Bhi8feM/%.\^v:":;::::;;::::::::::;;:;;:;::::;;::
**'*i36
Bfadford^Ptt.
Bm^TiivUle, Tioc... .. .
1.72
Bnijuirkk, ^la.
BurliiiiKBi, Vt
L90
CairoTIiJ. '. , ..
Cftrbiind»l«, Pa,
Chsmpaign III ;;
Cbilifcotlie, omb
Clbitau, Mass
Coffcjvillp. Kaus
'"i.io
Cmcm^.ii. H
CaajwH^viJlf, Fa ',
"" .61
i>mTiiit,va,..".."**i;";[i"i"";'"*'
■"'i*3i
1>0VCT,N.H..
1.23
I^ubois, Fa '.'.'.'.'. ".'."
Ihinkifk, N. Y.
1.07
Etot Liverpool. Ohio !....* ."*
12.33
Eau Claire, Wis ",
llwood, lad
1.16
Elyrta, Obio... '..".'."
Eacanaba, Mlcb
1 20
surntB,cai... ! !. ;;;"**
FameU.Pa
2.26
FuJion, N. V. :;;:
Qardoer, lijiai, "
.22
subUii cuy. Ill : ;..;
4.76
OfBin¥tUe,aC ;
.33
2.17
BlKl[inviM%, 1^ J
.65
HaiT]aon,N:j :....' ::;;::
BattlHrtniri?, Miss
Bti604, MiSt.i. . ...:;••
JkUQ
4.19
1 The health oflBcer states that cases are known not to ba completely reported,
« Population Apr. 15. 1910.
Digitized by
August24,1917
1356
REPORTED PREVALENCE FOR THE YEAR 1916-€oiitmiied.
MEASLES— Continued.
City.
EsUmat«d
popular
tionJuly
1,1916.
Cases
report-
ed.
Deaths
regis-
tered.
Cases
report-
ed per
1.000
inhabit-
ants.
Indi-
cated
fatality
rata
per 100
cases.
From 10,000 to 25.000 inhabitants— Continued.
Homell, N. Y
14,6S5
10,KS0
14,779
15, MS
14,339
10,648
14,230
23,539
20,930
21,286
12,221
« 19,363
11,838
13,451
19,879
21,046
' 15,395
» 12,381
13,805
no, 365
22,734
•14,610
10,834
15,310
12, 582
15,810
15,025
14,110
21,630
13,284
17,500
23,12'j
23,029
20,562
« 22, 019
19,926
13,76S
20,951
22,280
16,624
13,705
24,842
18,360
18,530
14, 152
18,599
23,805
12,837
19, 100
17,542
11,666
14,000
14,860
124
26
1251
>527
131
37
136
291
434
25.5
112
30
412
3S8
947
555
U2
349
180
33
416
192
180
17
161
no
288
15
160
353
437
7
3
210
217
182
457
306
059
455
9*
21
113
16
t52
111
475
700
177
285
400
35
9
39
907
231
499
17
416
68
1
10
U27
584
US
4
294
106
79
491
107
2
2*
2
i
f
&444
2.3M
16.98*
33.253
9.136
3.475
9.55T
12.362
20.786
11. «W
9.165
LIS
Huntington, Ind ..
I ronwood, Mich \
.80
Ithaca,N.Y
.3S
JanesvUlo, Wis
Johastown, N. Y
2.70
Kankakee, 111 .
Kearny, hf.j '. '.'.'.'.'.'.".'.'.'.'..'.'...'.
.69
Kokomo, Ind
.23
La Fayette, Ind
LaSafte,Ill
lieAvenworth, Kans
1.85»
Lincoln, 111
) 3*4. S03 1
Little Falls, N. Y
1 t 28 S45
.26
Lockport.N. Y
Lopansport, Ind
7
47.638
26.371
.779
28,188
.74
l^cnc nranch .N.J
Manistee, Mich
2
Is
Manitowoc, Wis
4*
13.039
3.184
18.299
13.142
9.075
LUO
12-796
Mankato. Minn
Mansfield, Ohio
Marinette, Wis
Marion, Ind
.56
Massillon, Ohio
Mattoon, 111
2.48
Middletown, N. Y
i 6.958
3 18.432
........ 1.063
1 7.397
' 26.573
11 24.971
.303
1 .127
1 1 10.505
I g.jKi;
Middietown, Ohio
1.04
Milford, Mass
Monesscn, Pa
.63
Morristown, N. J
Muscatine, Iowa
2.53
Nanticoke, Pa
New Albany, Ind
Newport News Va
.46
North A dam s, Mass
Northampton, Mass
2
6
i'
3
2
3'
2
1
4'
i'
2
i*
1
9.134
33.193
14.606
29.570
27.370
.657
.845
6,155
.864
3.674
5.968
19.954
54.530
9.267
ia247
34.288
2,600
.606
1.973
38.210
15.575
24.608
1.003
20.601
4.920
.064
.704
5.944
37.777
L765
.288
14.148
6.977
&049
33.318
4.0S0
LIO
North Tonawanda, N. Y
LSI
North Yakima, Wash
Norwood, Ohio
.15
Clean, N.Y
.6S
Osslntoe, N. Y
Paducah, Ky
Peabody, Mass
Peekskm. N. Y
Piqua, Ohio
i'85
Pittston, Pa !...!.!!*!!!!
Plalnfleld, N. J
.63
Pittsburgh, N. Y :.,.;
.»
Plymouth, Pa
.56
Pontiac, Mich
Portsmouth, N. H
Redlands, Cal
Reno, Ncv
Riverside, Cal
Rome.N. Y
23,737
14,831
20,278
16,945
20,193
13,821
15,626
14,205
21,365
15,458
'10,198
13,875
20,780
15,193
13,059
14.737
21.618
Rutland. Vt...-.
Salem, Orcg
San Bemarclino, Cal
Sandusky, Ohio
Saratoga Springs, N. Y
Sehna.Ala [[',',
Scuthbridge, Mass
laoo
Spartanburg, 8. C
Stcelton, Pa
Stillwater, Minn ]
Trinidad, Colo
Uniontown, Pa *'*
Virginia, Minn
Warren, Ohio
""h»
Warren, Pa ',.',.'.',',','.'.'.'.
.»
Washington, Pa
.9S
1 The health officer states that cases are known not to be completely reported.
'Population Apr. 15, 1910.
Digitized by
Google
1357
Ausuftt 24, 1917
REPORTED PREVALENCE FOR THE YEAR 1916— (Continued.
MEASLES— Continued.
aty.
rrom 10.000 to 25,000 inhibitants— Contlnaed
Watertown, Mass
Waukesanum
Waioan, wis
Webster. Man
Wert Chester, Pa
Wsstflekl. Mass
West New York, N. J
West Oranise, N. J
White Platau, N. Y
WtaioiM, Mtam
Wlnthrop. Mass
Wobnm, Mass
Estimated
popula-
tion July
1, 1016.
14,867
20,244
19,239
13,210
13,176
18,391
18,773
13,550
22,465
1 18,583
12,602
15,060
Cases
report-
ed.
90
80
4
51
276
42
144
285
575
212
300
55
Deaths
regis-
tered.
Cases
report-
ed per
1,000
inhabit-
ants.
6.054
3.052
.208
3.861
20. M7
2.28t
7.671
21.033
25.505
11.408
23.637
3.444
Indi-
cated
fatality
rate
per 100
cases.
6a 00
1.96
.70
.70
.33
3.64
MBNINOmS (EProBMIC CESEBBOSPINAL).i
RmMimft, N J^
69,806
63,073
67,440
04,405
86,690
78,078
64,772
77,214
78,283
53,704
n,744
50,411
55,642
53,330
09,510
87,030
77,016
85,692
70,722
00,838
27,732
20,480
37,308
25,636
46,192
31,484
39,235
41,781
26,171
48,477
28,491
48,886
41,097
46,515,
36,964
26,318
37,003
26,100
41,133
31,927
43,715
31,404
33,080
38,629
36,798
48,562
38,902
27,445
36,283
30,575
43,130
43,377
31,155
4
i*
2
i'
21
2
14
2
4
1
2
3
7
5'
1
1
3
1
i
2
3
5
3
1
1
1
1
3*
1
2
1
1
1
2
1
7
3'
2
3
7
a 014
.074
.015
.063
.023
.030
.018
Bn?rkt4]n. Mms
i>ilQth, Alnn
20.00
KKabtth, N. J .
100.00
STtnsville, Ind
FUnt.Mioli
100.00
Boboken.N.J .
Manrhttitcr.N. H
.026
100.00
New Britain, Coon
Pamir, N.J
.014
.023
.018
.038
.040
.057
.013
.023
.067
.080
.036
PawtockM.R. I
100.00
Saginaw W|ch .
SonDiceo.Cal
5a 00
Schenectady, N Y ... .
SooifliTiUe.'liass ... ...
80.00
TroT.N.Y
100 00
tJti«,N. Y
100.00
WlnMta, K^n3
75 00
Yoiilnn,N. Y
87.50
From 25,000 to 50,000 inhabitants:
Alaoi«da,raJ
Battle Creek, Mich -
Cedar Rapids, Iowa
.027
.030
.065
.032
.025
.024
.038
.041
.070
100.00
Cntrml l4lls, R. I
100 00
riielMa, Mms
100.00
Coundl^BIuffs, Iowa.
100 00
ETerett,Ma8s
Ffk^bfirr. Kms
10 000
HammoncI, Ind
BaTorhiil, kass
50.00
HasleCoo, Pa
100.00
Kafauaaxoo, Mich
Uxincton/Ky
uwoEtnW)^:::::;::;:;:;::::::::::;::::::::::::::::
Lonln,Ohio
.027
.076
.054
.077
.024
.004
.023
.064
.030
.052
.027
.041
.026
100.00
Montchlr,N.J
5a 00
Mount Vernon, N. Y
5a 00
Mo^Mrao, Midi
50.00
NawcistVerS.;:::;::::;:::::::::: "':
Newport, Ky ].'....'..'.'.'"
100.00
N«wS;'i?;j;: :::::; . ;
100.00
Ofden.tJtah
100.00
Oi«ng»,N.J *"
100.00
vSS^Au^
50.00
QntDcy,Dl .'...;.;.".]."■■
10a 00
SierafUftss:.. ..:;::..:::::::;::;: ::::::::':
100.00
8enJcoe,C^
100.00
Steabsnrille, Ohio
Tatmum,^^, .
.028
.008
.046
Tuiaa^fcTTr.. ............: ..:.:.::..:.:.::;;;:;::::
10a 00
W«itHoboken.N. J
10a 00
^^»»«Hn«,W Va
WinstooSalem, N. C
> Population Apr. 15, lOia
scttlis In which no oases of this disease were reported are not
included
jSzl^y'^oogle
August 24, 1017 1358
REPORTED PREVALENCE FOR THE TEAR 1916— Continued.
MENINGITIS (EPIDEMIC CEREBROSPINAL)— Continued.
City.
Estimated
popula-
tion July
1, 1916.
Cases
report-
ed.
ants.
Indi-
cated
fatality
rate
per 100
From 10,000 to 25,000 inhabitants:
Bellairo, < hio
Billings, Mont
Dloomridd, N.J
Bluefield, W. Va
Bradford . Va
CHntonj Mass
Coffevville, Kans
Dover, N.H
Kau Claire, Wis
Elwood, Ind
Eureka, Cal
Fond da Lac. Wis
Gardner. Mass
Grecnnioh. Conn
HackensAck. N. J
Homestead. Pa
Ironwood. Mich
Ithaca. N.Y
Jackson , Toon
Leavenworth, Kans
Lincoln, 111
LoCkport,N. Y
Mansfleld, Ohio w
Morristown, N.J
Museatine, Iowa
Northampton, Mass
01oan,N. Y
Oswego, N.Y
PhilUpsburg. N. J
Ban Bemardmo, Cal
Saratoga Springs, N. Y
Southbridge, Mass
Warren, Ohio
Washington, Pa
Wausau,Wis
Wostfield , Mass ,
West New York, N. J
White Plains, N. Y
Winona, Mipn
14,348
14,422
18,46<5
15,442
»14,M4
> 13,075
17, MS
13,272
18,807
» 11,()2H
14,681
21,113
17, 140
19,15'}
16.tM5
22,466
14,779
15,84H
17,807
> 19,363
11, ^S
1£,879
22.731
13,2&4
17,500
19,926
16,624
24,101
15,605
16,945
13,821
14,205
L-J.059
21.018
19,239
18, 391
18, n3
22,465
» 18,583
0.140
.347
.182
.130
.344
.076
.057
.075
t
.091
.201
.261 ,
.015
.068
.063
.168
.103
.084
.050
.132
.075
.114
.050
.1 2.490 ;
.064
.351
.072
.070
.046
.156
.019
.107
.089
.054
PELLAGRA.*
From 50,000 to 100,000 hihabitants:
Augusta, Ga
Manchester, N. H
Mobile, Ala
Saginaw, Mich
St. Joseph, Mo ,
Wichita, Kans
From 25,000 to 50,000 inhabitants:
Columbia, S.C ,
Jackson, Miss
KnoxvUle. Tenn
Lincoln, Nebr
Long Beach, Cal
Lynchburg, Va
Newton, Mass
Taunton, Mass
Waltham.Mass
Winston-Salem, N. C
From 10,000 to 25,odo inhabitants:
Albuquerque, N . Mex
Ann Arbor, Blich
Argenta, Ark
Chickasfaa, Okia
Coffeyville, Kans
50,245
78,283
58,221
55,642
85,236
70,722
34,611
29,737
38,676
46,515
27,587
32,940
43,715
36,283
30,570
31,155
14,025
15,010
14,907
15,447
17,548
6
1
21
1
1
1
7
362
3
1
1
10
1
2
2
8
1
1
5
2
2
» Population Apr. 15, 1910.
« The health officer states that cases are known not to be completely rep
•Cities in which no cases of this disease were reported are not includea
0.013
100.0
.018
100.00
.012
100.00
.014
moo
12.173
4.43
.078
.021
loaoo
.036
100. 00
.304
3a 00
.023
.055
.065
loaoo
.071
.067
100.00
.335
.129
.114
Digitized by
xted.
in this table.
Google
1359 August 24, 191T
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
MKNINGrnS (EPIDEMIC CEREBROSPINAL)-<^ntinued.
City.
Estimated
popula-
tion July
1. 1916.
Cases
report-
ed.
Deaths
regis-
tered.
Cases
report-
ed per
1,000
inhabit-
ants.
Indi-
cated
fatality
rate
per 100
cases.
From 10,000 to 25flO0 inhabitants— Continued.
DanTille,Va.\T......
20,021
18,181
16,482
17,807
11,838
19.926
16,624
18,360
14,846
15,626
21,365
14
»10
191
»10
1
3
1
1
1
13
31
10
8
a609
.550
1L588
.562
.064
.151
.060
.054
.067
.832
1.451
42.86
0reenTille,8.C ?
llAttiMhnT^, Mi<f9 ,
100.00
Jtfksofi, Tenn.. . ....... x.x .... ..
5a 00
Lincoln; lU
loaoo
Northampton Ma59 . . . .
100.00
Clean, N.Y
loaoo
Pn^Kftrty Uftff,
loaoo
8anU Barbara, Cal
100.00
8elma,Ala
53.85
Spartanbui^, 8. C
25.81
POUOMYELinS (INFANTILE PABALYSIS).^
From 50,000 to 100,000 inhabitants:
Atlantic City, N.J
Augusta, Qa
Bayonne, N. J
Btnghamton, N. Y
Brockton, Mass
Covington. Ky
Dnhith.Minn
Blixabeth.N.J
El Paso, Tex
Erie, Pa
Evansville, Ind
Flint^ch
Fort Wayno, Ind
Hob(Aen. N.J
Holyoke, Mass
Lancaster, Pa
Maklen,Wius
Manchester, N. H
Mobile, Ala.
New Britain, Conn
Oklahoma City, Okla
PassaicN.J..
Pawtucket, R. I
Portland, Me
RocWoTd.ia
Saginaw, Mich
St. Joseph, Mo
Schenectady, N. Y
8on»ervUle,Mass
Tampa, Fla
Troy,li.Y
UUca.N.Y
Wichita, Kans
WUkes-iarre. Pa
YoQkers,N.Y
, York.Pa
Fwn* 25,000 to 50,000 Inhabitants:
Aurf»m.nr.._.
Batik OrwJc. Midi
5*7 City; Ml4iV
— I, ..riihrt
gentn]FflJI$,li.l...
jCiiirtfiit, IowHh
wAmnibtg^S. C.„...
Cfuaitoti, B>I
Camberland, Md....
Syyjliejll
™enport, lowft....
l't«^lMf 111
67,
60,
69.
53,
67,
57,
M,
86,
63,
75,
76,
54,
76,
77,
65,
60,
51,
78,
68,
53,
92,
71,
59,
63,
66,
66,
85,
99,
87,
63,
77,
85,
70,
76,
90,
61,
34,
29,
47,
83,
32,
25,
37,
25.
4^,
27,
34,
26,
26.
32,
48,
89,
660
27
1
0.468
245
2
.040
895
44
.630
973
7
3
.130
449
3
.044
144
2
.035
495
6
.063
690
71
21
.819
705
6
.078
195
7
.003
078
7
.002
772
44
9
.803
183
8
.105
214
10
4
.130
286
117
27
1.792
853
21
1
.413
155
46
12
.899
283
18
6
.230
221
10
1
.172
794
28
2
.521
943
2
.022
744
8
2
.112
411
13
1
.219
867
5
.078
185
1
.018
642
18
3
.323
236
1
.012
519
10
1
.100
039
48
9
.551
K86
1
.019
910
20
2
.257
692
36
7
.420
722
1
.014
776
6
1
.078
83S
140
42
1.402
65»;
1
.019
204
4
1
.117
480
34
5
1.153
918
25
9
.521
8Jrt
1
.030
73()
21
5
.M2
OSO
3
1
.120
308
5
.134
636
1
1
.039
192
8
1
.173
386
4
.14ft
Oil
»2
.058
987
12
.462
074
5
1
.192
261
2
1
.092
811
3
1
.061
631
15
4
.37S
3.70
'4i'86
'29.'58
'20." 45
'40.66
23.08
4.76
26.00
33.33
10.00
7.14
25.66
7.09
'i6.'67
*i6.'66
18.75
16.66
19.44
'i6.'67
30.00
25.00
14.71
36.00
'"23.81
33.33
166.' 66
12.50
20.00
50.00
33.33
2awfl7
^ The health officer states that cases are known not to be completely reported.
•Cities in which no cases of this disease were reported are not Inchided in this table.
Digitized by
G(
August 24, 1917 1360
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
POUOMYEUTIS (INFANTILE PARALYSIS)-Conimued.
City.
From 25,000 to 50,000 inhabitants— Continued.
East Orange, N.J
EIciTi, 111
K vanslon, 111
Everett, Ma«5S
1- itchburg. Moss
(ireen I'av, Wis
llaverliiir. Moss
Hazlet OD , 1 'a
Jackson, Mich
Jackson, Mis::
Kiilamaroo, Mich
Keno^hn, Wis
Kimiston, N. Y
La C'r(^^sc. W is
I.nn^ine, M icli
I,e\inKt(»n, Ky
Lincoln , Nebr".
Lyncbbl'r^;, Vo
Ma'iison. Wi.s
M,: ir.jrd, Shir...
M^iliie. U\
MunUliiif, N. J »..
Moimt %irii(Tit, N. Y
Kew I'ftit I* , i'n
Nc\vi!'^>tl< 1' . 1
l^i^vr it^Mh fl N.Y
K«?irtfm, M
NJar^Tt 1 * : "S'. Y
Korrlit^wu. la
OiikFuk.111
OranfP, N. J..
Oihfcwii, ^vis
Vfrth Atnl^y, N.J
I'ttuifleld. lift*
Qtjiriry, iir. ,
fiuinr V( M.T w .
kD«noki«, V(i.
Hf^ck htand, Ul
eUni3«M»A
TmnJtnn, U$M»
Tubm.Okln
Wiath4m, Unsa
H litwr \af\ If^Wtt
Tft a*m«*n. S Y
Vie0L IlDbDk«ii, N. J
W!i««r'lluit, W. va
Win ,N.C
10 10 inhabitants:
AAri.t^
Al»iJWid»i:t, ^ •*
A]ipiim.wit
A£Su^]%k,N.J
Anlifrrfltr.N r
li^iUvIn, N. V
npitf.it v^u
B»'k«U\ lfi^<t
HlllW;i< llufit
lUortttitlfH, N.J
I^niniwlrk, t;a
ftlifi*HCtr>ri, VI,
CflfljufidJitr, I'a
a3Ami«*i-ii. lU
VHntmi, Wfio
C^fk^Hl, SV It
C<im»rU^vl[ik'K i'a
C-ftrulnc, NY
C^mbfTia#i<i« U.I
IiidirJik.Va
pmm.S U
DtttMils,l*a
Estimat«d
popula-
tion July
1, 1016.
4?, 458
2«.203
28,591
3U.23.5
41, 7M
29.353
48,477
28.491
S5.363
29,737
31,576
2fi,771
31,677
40,498
41.097
46,515
32,940
30.699
47,521
26.234
27,451
26,318
37,009
41.133
30.108
37,750
43,715
37,353
31.401
26.^54
33.060
36,065
41.185
38,629
36.798
38.136
43.284
28,926
48.562
3^>,2<^3
30,575
30,570
35,559
29,891
43,139
43,377
31,155
11,458
17,S46
17,S34
14,007
20,S2:J
I3.:t:«
18.072
21.<i45
14,422
18, 4t'iO
10, H72
21,617
19,242
14,508
« 13, 075
17,548
22,0(39
15, 455
15, SOtj
10, MS
20.021
13,272
n,«i«v5
56
2*1
8
27
12
7
9
1
11
7
8
4
15
3
3
20
2
12
20
4
32
54
1
13
125
20
1
19
2
CasM
iBdi.
rai«d
^*"^ inhalil- per 108
I anu. i»*—
10
82
20
o
30
10
67
14
4
1
06
10
«5
4
1
8
2
4
1.319 ,
.on '
.2»
. 21 :.
.rs
.24S
.24<-.
.2S^ .
.034 .
.225
.223
.299 .
.12fi
.617
.073
.OW .
.007
.»>5 .
.253 .
.762
.146 .
1.216 ,
L43) ,
.024 .
.43J
3. 310 .
.458
.075
2.479
.055
.72V
1.731
.109
1.731
.116
.138
.165
.110
.(m
.910
.141
.100
.SU
.046
.082
.SM
.056
.449
1.856
.144
.IfiO
.055
L109
2.080
1.900
.092
.278
.156
.138
.076
.»5
.014
.130
.130
.m
.200
.075
.136
• The health officer states that cases are knomi
•ropulalion Apr. 15, 1910.
17.^
25^ 'JO
4.'.S4
<1 »
42-^
2:^00
3113
23.01
25. <«
2107
lh.«i)
'.<t.QO
ia59
24. S9
33. n
/IQO
24. :4
'25.00
2&.00
•6. 07
10 71
90 no
€<Kt7
SlOO
100. oo
100.00
34.02
35.00
anao
00. €7
».oo
100.00
iooJoo
not to be completely reported.
Digitized by VjOOQIC
1361 Aogust 24, 1917
REPORTED PREVALENCE FOR THE YEAR 1916 -Continued.
POUOMYEUTIS (INFANTILE PARALYSIS) -CoutJnued.
«^
Eiillm«C4rd
1, m&.
cd.
cA l^tT
1 1 /f 1)
Indl^
catfd
ratailty
rate
per log
caaeft.
From irf,ooo to 2S,qoa lohabiunts-rontinuftj.
Dunkirk, N.Y
20,743
22, .V%
18,H07
14,rj^J
« 10, 190
21,113
11,908
17, 140
1K,1S1
19, 159
16,945
16,950
16,4S2
14,685
15,S4S
10,648
U,ZVi
23,539
20,930
21.2^6
12.221
13, '.51
19, S79
21.016
15.:^9.-»
13,805
I10,36.'5
22,734
t 14, 610
19,834
12,582
15,810
15,625
14,110
21,630
13,284
17,500
23,126
23,629
20,562
« 22, 019
19,926
13,768
22,286
13,705
24, 101
18,360
18,530
14, 152
18,599
23,805
19,100
17,542
11,666
14,000
14,869
19,763
23,737
14,831
20,278
20, 193
14,846
13,821
14,205
21,365
no, 198
13.059
14,737
14,867
20, 244
19,230
16
1
5
1
1
2
31
4
5
46
21
36
4
4
26
10
3
46
2
2
6
3
2
2
25
6
1
3
3
2
1
18
1
4
4
6
2
2
2
2
38
22
1
2
23
69
3
16
2
3
45
6
9
1
1
2
4
1
2
7
1
2
9
5
1
1
1
2
3
8
1
2
2
2
10
i'
8
4
14
3"
6
1
.280
16 67
£ast Liverpool, Ohio
Kftii ClaiT**, wis ... . . . - r
.266
.068
.09S
.095
2.fxn
.233
.275
2. 401
1.239
2.124
.213
.272
l.(V41
40 00
Kiitrlrji^ f>l , . ,
FarreU/Pa .'
Fond a« L?ir. Wis .
100 00
Fulton, N.Y'.
32 26
Gardaer. Mass . .
Grwairille, S. C
Greenwich, Conn
20.00
17 39
Hackensark, N. J
19 05
Harristm, N. J
38. S9
Horncll,N."Y
75 00
Ithaca, N. Y
23 08
Johnstown, N.Y
10 00
Kankakee, III
211
Kearny, >/. J
Kokomo, Ind
11
i*
2
1
2
1
i'
i'
3
i'
2
i'
12'
4
1
3
9
1
2
i2'
2
3
i'
4*
i'
i'
i'
1.95»
.096
.094
.491
.223
.101
.095
1.6'24
135
132
i»5
101
rr79
J. 1,39
'»4
J83
l85
152
il4
1I86
.'185
197
1.104
.073
.090
1.678
2.448
.163
.863
.141
.161
1.890
.262
.513
.086
.071
.ia5
.202
.042
.135
.345
.050
.135
.661
.352
.047
.098
.077
.068
.135
.14^
23.91
La Fayette, Ind
rx) 00
1^ fi^ih 111
Little Falls, N.Y
C4\ 67
Lockport, N. Y
50.00
Lqgan<tport. Ind
100.00
Long Branch, N.J
MMatowoc, Wis ...
4.00
Mankato. Minn
Mansfield, Ohio
Marinette' Wis
33.33
Marion, Ind
Mattoon, III
100.00
Middletown, N. Y
16.67
Middletown, Ohio
Miltord, Mass
Mooessen, Pa
25.00
Morristown,N. J
33.33
Muscatine, Iowa
Nanticoke, Pa
New Albany, Ind
50.00
Newport News, Va
North Adams, Mass
31.58
Northampton^ Mass
18.18
North Ttmawanda, N. Y
100.00
Norwood, Ohio
Ossinin*, N. Y
13.04
Oswego, N.Y
15.25
Peabody. Mass
33.33
PeekskflJ, N. Y
12.50
Piqua, Ohio
mis ton, i^a ,. .........................
PhinfleW, N. J !!.!!"...
28.67
Plymouth, Pa
40.00
Pontiac, Mich
33.33
Portsmouth, N. H
Redhmds, Cal
100.00
Reno, Nev
Riverside, Cal
Rome, N.Y
Rutland, Vt
BAlem Onw ^ , , ^ ^ . , ^ . . ^
Sandusky, Ohio
Santa Barbara, Cal
Saratoga Springs, N. Y
44.44
Sottthbridge, liass
Spartanburg, 8. C
StillwatAT Wfnn
Warren, Ohio '.
100.00
Warren, Pa
Watertown Mivn . ^ ^ .,.^...^... .
m 00
Waukegan,Ili
Wausau. Wis
,4H' 1? 50
> The health officer states that cases arc known
tpopulaUon Apr. 15, 1910.
not to be completely repinrtwi.
_.Goo^
August 24, 1917 1362
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
POLIOMYEUnS (INFANTILB PARALYSIS)— Continued.
aty.
Estimated
popula-
tion July
1, 1916.
Oases
report-
ed.
Deaths
regis-
tered.
Gases
rep«t-
1,000
inhabit-
ants.
cated
fatality
rate
per 100
From 10,000 U 25,000 inhabitants— Continued.
Webster, Mass
Westchester, Pa
Westfleld, Mass
West New York, N. J
West Orange, N. J
White Plains, N. Y
Winona, Minn
Winthrop. Mass
Wobum,Ma8S
13,210
13, 176
18,301
18,773
13,550
22,465
118,583
12,002
15,060
aSTO
.076
.761
2.504
2.052
2.003
Z045
.315
.376
7.14
7.50
4.44
St5B
25.00
BABIBS cm MAN).
Ann Arbor. Mich -
15,010
32,261
75,105
58,221
21,365
0.067
.031
.013
.017
.047
100.00
Danville, III
loaoo
Erie, Pa
loaoo
Mobile, Ala
100.00
100.00
1 Population Apr. 15, 1910.
RABIES (IN ANIMALS).
City.
Arm ArbQf, Mlch. .
Anit^ustH, (ill
BliicMd, W. Va..
Cali-O, III...
CMekttsha, Okla. .
rh[lUrotbfl.<>Wo..
Uaii^HlU!, Vfl
Klwood, ind.
Erie, Pa
Everett, WiL^ih —
HEi^fiiisaek, N.J.
Imuwood, MKjh...
Cases
reported.
City.
Jackson, Miss
Little Falls.N.Y
Lockport.N.Y
Lorain, Ohio
NlaKara Foils, N.Y
North Tonawanda, N. Y
Ogden, Utah
Saginaw, Mich
San Diego. Cal
Steuben viile, Ohio
Warren, Ohio
Warren, Pa
Cases
reported.
SCARLET FEVER. I
City.
Estimated
popula-
tion July
1, 1016.
Cases
report-
ed.
Death.s
regis-
tered.
C-ases
report-
ed per
1,000
inhabit-
ants.
Indi-
cated
fataUty
raU
per 100
From 50,000 to 100,000 inhabitants:
Atlantic Ciiy, N . J
Augusta, Oa
Bnyonne, N.J
Berkeley, Cal
Binghamton, N. Y
Brockton, Mass
Canton . Ohio
Covington, Ky
Duluth,Minn
Elirabetb.N.J
El Paso, Tex
Erie, Pa
Evansville, Ind
FUnt.Mich
57,660
50,245
60,895
67,653
53,973
67,449
60,852
57, 144
94,495
86,690
63,705
75,195
76,078
54,772
60
6
100
123
56
70
265
39
254
207
90
75
67
* Cities in which no cases of this disease were reported are not included in4,^ tabl*.
Digitized by VjOOQIC
Li
.79
L45
l.ll
1.33
L20
1363
August 24, 1917
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
SCARLET FEVEB— Continuod.
aty.
from 50,000 to 100,000 inhabitants— Continued.
Fort Waj-ne; Ind
Hoboken,N. J
Holyoke, Mass
Lancaster. Fa
MfUden , M ass
Manchester, N.n
Mobile, Ala
Now Britain, Conn
Oklahoma City, Okla
Pasaaic, N. J
Fawiucket , R. I
Portland, Mo
Rockford.Ill
Sa^naw, Mich
St. Joseph. Mo
San Oieso.Cal
Schenectady, N. Y
• Somerville.Mass
Tain pa, Fla
Troy,N.Y
Utica.N.Y
Wichita, Kans
Wilkcs-Barre
Yonkcrs,N.Y
Y'ork.Pa
From 23,000 to 50,000 inhabitants:
Alameda, Cal
Aurora, lU
Austin . Tex
Battle Creek, Mich
Bay City, Mich
BeUin^iam, Wash
Boise/Idabo
Brookline, Mass
Burlington. Iowa
Cedar Rapids, Iowa
Central Falls, R. I
Chelsea, Mass
C1intoc,Iowa
Columbia. S.C
Coancil Bluffs, Iowa
Cranston, R.I
Cumberland, Md
Danville, 111
Davenport. Iowa
Decatur, nl
Dubiique, Iowa
East Orange, N. J
Elgin, ni
Evanston.UL
Everett, Mass
Everett, Wash
Fitcfaburg, Mass
QreenBay,Wls
Hamilton, Ohio
Hammond, Ind
Havertiill, Mass
Hasleton.Pa
Jackson, Mich
Jackson, Miss
Kalamazoo, Midi , .,
Kenosha, Wis
Kingston, N. Y
KDoxvflle, Tenn.
LaCroase. Wis.
Lansing, Mich....
L«wl8ton,Me.....
Lexington. Ky...
Iii]oom,Nebr....
Long Beach, Cal..
Lorain. Ohio
Lynchburg, Va...
I
Estimated ,
Cases
1, 1916. *^^-
7ft, 183
77,214
05, 2^)
5l,i:>5
78,283
5S.221
53.704
92,*Jt;{
71,744
59,411
63,. Vm
55, !*<.'.
55.042
85, XH'y
53,330
99,511)
87, («9
53, SST)
77,'.>16
8,=), m>2
70. 7*22
76,77(>
99,838
51,656
27,732
34,204
34,814
29,480
47,942
32,985
33,846
32,730
25,030
37,308
25,636
46,192
27,386
34,611
31,484
25,987
26,074
32,261
48,811
39,631
39,873
42,458
28,203
28,591
39,235
35,480
41,781
29,353
40,496
26,171
48,477
28,491
35,363
29,737
48,886
31,576
26,771
38,676
31,677
40,498
27,809
41,097
46,515
27,587
36,964
32.940
49
226
154
30
S3
94
21
25
173
45
54
.V.
210
201
133
71
IM
110
51
195
1(W
02
101
280
32
Denths
rc?i--
tered.
Cases
report-
ed per
1,000
inlmHt-
ants.
36
101
1
62
75
53
3
1
8
71
1
10
24
3
18
1
77
1
42
»40
298
is
55
34
40
1
206
1
57
1
70
2
83
1
29
1
178
7
81
2
32
1
62
45
51
1
72
87
1
32
282
6
8
48
3
42
2
79
1
31
24
265
20
1
106
1
121
6
24
138
2
21
1
Indi-
cated
fatality
rate
per 100
cases.
0.643
2. 927
2..H59 ,.
.5<K) |.
1.623 I
1.201 .
.361 (.
. 4*v'> ( .
l.Htil I
.627 1
.909 I
.h77 (.
3.914 I
3.666 I
1.5f>0 I
i.:yi
2.04
3.98
..58
2.22
3.70
.93
1.47
3.01
1.41
l.oH>i
i.:;t,7
1.27
l.«)S
i:^;
1.85
1.27
1.272
.92
.877
1.61
1.316
1.98
2.805
2.14
.619
1.298
2.953
.99
1.781
2.544
1.100
6.60
.030
.236
2.169
1.41
.400
.643
12.60
.702
6.56
1.667
1.30
1.534
1.156
9.465
5.03
2.116
1.304
1.240
2.60
4.220
.49
1.438
1.76
1.756
2.86
1.955
1.20
1.028
3.45
6.220
3.93
2.064
2.47
.902
3.13
1.245
1.533
1.259
1.96
2.751
1.795
1.15
1.123
7.974
1.77
.269
.982
6w25
1.330
4.76
2.951
1.27
.802
.758
6.544
.719
6.00
2.679
.94
2.601
4.96
.870
3.733
1.45
.638
4.76
> The health officer states that cases are known not to be completely reported.
Digitized by VjOOQIC
August 24» 1917
1364
REPORTED PREVALENCE FOR THE YEAR 1916— Continaed.
SCABLET FEVER— Continued.
Estimated
t!S?July
1, 1916.
Caaos
report*
od.
Deaths
regis-
tered.
Cases
Indl-
eated
Istality
rate
pfflOO
cases.
aty.
Inhabit-
ants.
From 25.000 to 50,000 inhabitants— Continued.
Madlflon Wis -.
30,099
47,521
26,234
27,451
•26,318
37,009
25,424
26,100
41,133
31,927
30,108
37,759
43,715
37,953
31,401
26,654
31,404
33,080
36,065
41,1S5
38,029
36,798
38, 1.16
43,284
28,026
48,562
38,902
27,445
40,220
36,283
30,575
SO, 570
r5,550
29,894
43,139
43,377
31,155
20,334
11,458
14,025
17,846
18,960
22,874
15,010
17,834
14,907
14,007
20,823
16,874
13,350
17,178
14,348
18,072
13,599
21,645
14,422
18,466
15,442
'14,544
21,617
15,794
19,242
14,508
15,447
15,470
: 13, 075
17,548
22,609
15,455
15,406
77
38
48
53
27
56
112
308
•34
21
23
72
42
107
125
50
66
31
29
7
249
119
75
36
131
24
67
47
20
57
56
5
46
37
208
20
9
43
62
22
32
28
20
6
25
24
8
24
5
5
47
3
12
14
19
5
9
3
3
50
29
10
20
38
1
18
40
18
2
1
1
i*
6*
i*
i'
3*
i*
1
1
1
3*
2'
■ 1
i'
2
2'
2
2"
5
i*
i*
;;;;;;;;
i'
2*
1508
.800
1.830
1.931
1.096
1.513
.472
11.600
.817
.658
.764
1.907
.961
.643
.223
4.014
3.900
1.511
1.830
.753
1.010
.190
6.529
.439
2.503
.741
.797
.874
1.449
1.205
.654
1.865
1.575
.167
1.066
.851
6.676
.984
.785
3.066
3.474
1.160
1.300
1.865
1.121
.402
1.785
1.1S3
.474
1.798
.291
.348
2.601
.221
.554
.971
1.029
.324
.619
.139
.190
2.598
1.999
.647
1.293
2.906
.067
.794
Z588
1.168
100
McKeesDort. Pa
1»
MAdffM-d Maas
106
MoIine,IU
Montclair. N J
3. 70
Mt Vernon, N Y
Mimcie.Iiia
Muakegon, Mtch
LOO
New Castle. Pa ...
NewDwt. Ky
NewDort. R I
L30
Newton. Masa
Niagara Falls, N. Y
4.17
Norriatown, I^a
Oak Park, ni
100
Ogden, Utah
Onnge, N.J.
100
Oshk<»h. Wis
LO
Perth Amboy, N. J
3.23
Pittsfield. Maes
150
Quincy, ill
Quinoy, Mass
1.20
Roanoke, Va .... .....--
Rock Island, ni
167
Salem , l(ass'.
17»
Saii Jose. Cal
Ste»ibenviIlo, Ohio
Biiperior, Wis
L40
Taunton. Mass
420
Tulsa, Okia
Walt ham, Ma«
151
Waterloo, lowo.-.
1S7
Watoftown, N. Y
West Hoboken, N.J
Wheeling, W. Va
&41
WInston-Salem, N. C
1«
From 10,000 to 25,000 inhabitants:
Aberdeen- Wash
Adrain, lilich
Albuquerque, N. Mex
Alexandria, v a
Alliance, Onio
Alton. Ill
lis
Ann Arbor. Mich
Applcton, Wis
ArKenta, Ark
Asburv Fark, N. J
Asheville, N. C
Bakcrsfieid, Cal
natavia,N.Y
Baton Rouge, La
Bellaire, Ohio
20lO0
Beloit, Wis :
Berlin, N H
Rcvcrlv, Mass
BJIlhips, Mi>nt
Bloomneld, N. J
BIuoHold, W. Va
"20.66
Bradford, Pa
Burlington, Vt
Cairo, 111
Carbondale, Pa
400
Ctmrnpalgn, III [.
Chlckasha, OkIa
Chiilicothe, Ohio
Clinton, Mass
Coffeyville, Kans
Concord, N.H !
Connellsville, Pa
Coming. N.Y
1 The health officer states that cases are known not to be completely reported.
'Population, Apr. 15, 1910.
Digitized by
Google
1365
August 24, 1917
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
SCARLET FEVER— Continued.
my.
vmmneriand (to-wn), R. I
DanviHe. Va ^
Dover, N.H
Dubois, Pa
Dunkirk, N.Y
East Liverpool, Ohio
Eau Claire, Wis
Elwood.lnd
Elyria, Uhio
Escanaha, Mich
Eurok:^, Cal.. 1
FarrclJ-Pa
Food du Lac, Wis
Fulto<i,N.Y
Gardoer, Mass
Grand Island, Ncbr
Graoit^ritv, lU
Greenville, S.C
Orecn^-ich.Conn
Hackcnsack, N.J
HarrBoa,N.J
Hattieshtirg, Miss
Helena. Mont
Homestead, Pa
Homcn,N.Y
Huntington, Ind
Ithaca, N.Y
Jackson, Tenn
Janesvflle, Wis
Johnstown, N.Y
Kankakee, 111
Kearny, N.J
Kokomo.Ind
LaFaTBtte.Ixid
Laaalle,m
. Leavenworth, Kans
Llnooin.111 ..•
Little Falls, N.Y
Lockport,N.Y
Losansport, Ind
Long Branch, N.J
Manistee, Midi
Manitowoc. Wis
Mankato.Minn
Mansfield, Ohio
Marinette, Wis
Marion, Ind
Marshaij,Tex
MasBillon.Ohio
Mattoon,Ill
Mlddl©town,N. Y
Middletown,Ohio
MilIord,Mass
Mooes9en,Pa
Morristown.N.J ,
Mnacaiine, Iowa ,
NaDticoke,Pa
New Albany, Ind
Newport News, Va
North Adams, Mass
Northampton, Mass ,
North Tonawanda, N.Y ,
North Yakima, Wash
Norwood, Ohio
Olean.N.Y
Ossintog.N.Y
Oswego. N.Y
Paducah,Ky
Peabody.Mass
PeekskilI,N.Y
Phillipsbarg,N.J
Piqua,Ohio
Pittston,Pa
EsUmaicd
popiila-
tI«Wi Jillj
I, m^.
W,n4S
20,021
13,272
14,665
20,743
22,586
18,807
«11,028
18,618
15,485
14,684
« 10, 190
21, 113
11,908
17, 140
12,826
15, 142 .
18. 181
19,159
16,945
16,950
16.4K2
13,612
22.466
I4,r,8.'>
10,S«0
15,848
17,807
14,339
10,648
14,230
23,539
20.930
21,286
12,221
1 19, 363
11,838
13,451
19,879
21,046
15,395
« 12, 381
13,805
•10,365
22.734
t 14,610
19,834
13,712
16,310
12.682
15,810
15,625
14,110
21,630
13,284
17,500
23,126
23,629
20,562
> 22, 019
19,926
13,768
20,951
22,286
16,624
13,705
24,101
24,842
18,360
18,530
16,605
14, 162
18,599
report-
ud.
20
20
10
9
6
2
18
1
7
60
3
34
7
60
30
16
99
43
44
36
S
4
20
6
10
13
61
20
5
37
17
23
181
25
15
24
16
49
2
13
7
6
53
62
12
8
16
20
25
9
19
49
.5
8
15
5
i
1
i
3
2
i"
1
i
"" i
4
'*'" "2'
fndl-
ralo
perlDQ
0.461
.400
.829
3.341
.f.20
1.595
1.632
.913
6.006
1.090
.393
.521 ,
3. 107
2. 859
.702
.462 !
1.100
1.044
.590
.531
.36*
.147
.801
.068
.643
3.786
.168
2.371
.657
4.216
1.274
.764
4.661
3.619
2.272
3.041
.505
.201
.950
.390
.808
.942
6.885
L144
1 , >4>:,
1 . 2A\\
1 , rnU
.ma
L701
. 740
3.080
.114
.5£A
.292
2. 407
3,112
.fi73
,718
1.203
LS34
/37S
*m5
2.069
Mi
1.00
1 The health oiBoer states that
tpopulaUon Apr. 15, 1910.
cases are known not to be completely feiiorfedt.
Diciitized by Vj
12.50
7.14
3.33
4.30
6.25
50.00
2.04
5.56
3.03
4.65
2.78
2.21
e,«:
&ia
s.n
mm
Jgle
August 24» 1917
1366
REPORTED PREVALENCE FOR THE YEAR 1916— OontiDued.
SCABLET FBTBB— Continued.
City.
Estimated
popula-
tioDjuly
1, 1910.
report-
ed.
Deaths
regis-
tered.
Inhabit-* per m
ants.
Cases
report-
ed per
1,000
Indl.
Citsd
rate
From 10,000 to 25,000 inhabitants— Continued.
Plainfleld,N.J
Platt8burg,N.Y
Pi ymouth . Pa
Pontiac,Mich
Portsmouth, N. H
Redlands,Cal
Reno, Nov
Riverside.Cal
Rome,N.Y
Rutland, Vt
Salem, Oreg
San Bernardino, Cal
Sandusky. Ohio
Santa Barbara. Cal
Santa Cruz, Cal..
Saratoga Springs, N. Y
Sault Ste. Mtiilb, Mich
Selma. Ala
Southbrldge, Mass
SOmratSrjBlnn. .*.'. *.
Trinidad, Colo
Uniontown, Pa
Virginia, Minn
Warren, Ohio
Warren, Pa.
Washington, Pa
Watertown, Mass
Waukegan,Ul
Wau8au,wi5
Webster, Mass
Westchester, Pa
Westfleld, Mass
West New If ork, N.J
West Orange, N.J
White Plains, N. \
Winona, Minn
Winthrop. Mass
Wobum« Mass
23,805
12,837
19,100
17,542
11,666
14,000
14,869
19,763
23,737
14,831
20,278
16,945
20,193
14,846
14,594
13,821
13,919
15,626
14,205
21,365
110,196
13,875
20,780
15,193
13.050
14,737
21,618
14,867
20,244
19,239
13,210
13,176
18,391
18,773
13,550
22,463
U8,583
12.692
15.969
1.680
.234
.576
.865
.006
.500
4.035
.455
.379
4.450
.481
1.003
.297
.337
.548
1.809
.287
.192
.211
2.940
S.236
2.523
.722
3.225
.689
.475
1.627
1.816
1.017
1.195
l.OSO
.152
4.296
2.034
2.140
.134
.915
1.024
2.943
9. OB
L«7
3.01
6.01
K»
153
SMALLPOX.)
From 50,000 to 100,000 inhabitants:
Augusta, Qa
Canton, Ohio
Covln£ton, Ky
Dulutn, Minn
El Paso, Tex
Erie, Pa
Evans vllle, Ind
Flint JMidi
Fort Wayne, Ind
Oklahoma City, Okla
Rockford,Ill
St. Joseph, Mo
8anDieeo.Cal
Tampa, Fla
WichiU, Kans
From 25,000 to 50,000 inhabitants:
Aurora, 111
Austin, Tex
Battle Creek, Mich
Bay City, Mich
BeUlngham, Wash
BolseTxdaho
Burlington, Iowa
Cedar Rapids, Iowa
Clinton, Iowa •.
Columblo. 8. C
Council Bluds, Iowa.
50,245
60,852
67,144
94,495
63,705
75,195
76,078
54,772
76,183
92,943
65,185
85,236
63,330
63,886
70,722
34,204
34,814
29,480
47.942
32,985
33,846
25,030
87,308
27,386
34,611
81,484
274
5.453
7
.115
5
.087
38
.402
111
19
1.742
2
.027
153
2.011
19
.347
15
.197
114
1.227
30
.544
74
.868
6
... .
.094
8
.148
103
1.456
9
.263
27
3
.776
3
.102
3
.063
12
.364
1
.030
12
.479
66
1.709
166
6.061
•3
.067
7
.222
17.12
1 Population Apr. 15, 1910.
'•Cities In which no cases of this disease were reported are not included in this tablai
^The health officer states that cases are known not to be completely reported. t
oogle
11.11
1867
August 24. 1917
BEPORTED PREVALENCE FOR THE YEAR 191^— Continued.
SMALLPOX— Continued.
CItv.
From 25,000 to 50,000 inhabitants- C?ntinucd-
Danvill<*, III
D3v6ni>ori . Iowa ,
D€oatur. Ill
Dubuqu*^. Iowa
El|;ln.Ill
FiUdiDui^, Mass
Green Bay, Wis ,
Hamilton. Ohio
Hammond, Ind
Jackson, Miss....
Kalamazoo, Mich. ,
Knoxville, Tenn
LaCVosse, Wis
Lansing, Mich
Lcxin^on, Ky
Llnooln, Nebr
Lon^ Beach, Cat
Lorain, Ohio
Madison, Wis
MoUnc, III
Munde, Ind
Muskegon, Mich
New Castfo, Pa ,
Oshkosh, Wis
Quincy, 111
Roanoke, Va
Rock Island, lU
Steubenville. Ohio
Superior. Wis
Tulaa,Okla.
Waterloo, Iowa.
Wheeling, W.Va
Winston-Salem, N. C
From 10,000 to 25,000 inhabitants:
Aberdeen, Wash
Adrian, Mich
Albuquerque, N. Mex
Alliance, Ohio
Alton- UL
Ann Arbor, Midi
Appleton, Wis
Asbury Park, N.J
AshevUle, N. C
Bakersfield, Cal..
Baton Rouge, La
Bellaire, Ohio
Belolt,Wi8
Billings, Mont
Bhiefield, W. Va
Drowns viUe, Tex
Brunswick, Ga ,
Qiampaign, 111
Chickasha, Okla.
ChiOicothe, Ohio
Cofleyville. Kans
Comtag,N.Y
Danville, Va.
East Liverpool, Ohio..
Eau Claire, Wis
Elwoodjind.
Elyria,Ohio
Eacanaba. Mich
Eureka. Cal
Grand Island, Nebr...
Granite aty, lU
Hattiesburg, Miss
Helena, Mont
Janesvillo, Wis
Kankakee, lU
Kokomo, Ind
LftFayette, Ind
La Salle, III
Leavenworth. Kans...
Loganiport, lad
T
Cas-s r„,i|.
rctorf- catod
e.l ler f.iu.iity
l/'X) raio
i-)U .hit- p-rl'j)
a-i-^- cas>-,.
4K.^ll
2S.'>Jt{
41,TSI
40, \m
26.171
29.737
4«.>K6
38.fi7ri
31,r,77
40,4<»S
41,097
4fi, 515
27, '^^1
36,90^4
30,600
27.4*1
25,421
26,10)
41,1.^3 I
3r>.(W»-,
30, Tn.H
43, 2*^4
2S, 926
27,445
46.226
30,575
35,559
43,377
31,155
20,334
11,458
14,025
18,960
22,H74
15,010
17,834
14,007
20,823
16,874
17, 176
14,348
18,072
14,422
15,442
13,163
10,872
14,50S
15,447
15,470
17,.';4S
15,406
20,021
22,586
18,807
*11,028
18,618
15,485
14, 6i^
12,826
15,142
16,482
13,612
14,339
14,230
20,930
21,286
12,221
s 19, 363
21,046
173 ,
210
UV3 I
2*»
4
39
5
3
6
6
t
12 I
52
19 !
1 '
2|
28
14 i
4 1
2
46
2 !
«16
75
1
16
57
275
1
1
1
1
2
1
18
12
3
1
8
3
19
1
2
11
1
1
1
7
3
20
24
1
1
21
»9
7
1
27
1
144
18
1 i
21
2 I
45 i
63 ,
2 I
1
5.?63 '
4. 1 P 1
'. 142 1
.263 1
.123 i
!202
.133
.1V>
.l-H
.20t>
.049
1.118
.689
.027
.065
1.020
.157
. 153
.(M9
1.275 1
.0:4
.370
2.593
.036
.346
1.864
7.734
.023
.032
.049
.087
.143
.053
.787
.799
.168
.071
.384
.178
1.106
.070
.111
.763
.065
"ioo.oo
•••
... ....a
.092
.483
.194
1.293
1.368
.065
.050
.930
.479
.635
.054
1.744
.068
11.227
1.189
.061
.147
.139
3.162
3.010
.282
.l&l
.052
.048
"■i'22
i::::::::
*The health officer states that cases are known not to bo com]
^Population Apr. 15, 1910.
'P^^^glg^trz^erb'yCoOgle
Augoflt 24, 1917
1368
REPORTED PREVALENCE FOR THE YEAR 1916— Gontmued.
SMALLPOX— ContiniMd.
aty.
From 10,000 to 25,000 inhabitants— Continued.
MMiitowoc, Wis
Mankato,Minn
Marinette, Wis
Marahall, Tex
Mattoon, 111
MIddletown, Ohio
Muscatine, Iowa
New Albany, Ind
North Yakima, Wash
Faduoah.Ky
Fiqua, Ohio
Pontlac.Mich
Redlands,Cal
Reno, Nev
Salem, Oreg
San Bernardino, Cal
Sandusky. Ohio
Virgtoia.Minn
Warren, Ohio
W«isau,Wis
Wi^ha,Minn
Estimated
popula-
tion July
1, 1918.
13,805
U0,305
U4,610
13,712
12,5S2
15,625
17,500
23,029
20,951
24,S42
14,152
17,542
14,000
14,860
20,278
16,945
20.193
15,193
13,059
19,239
118,583
Gases
report-
ed.
Deaths
regis-
tered.
Oases
report-
1,000
inhabit-'
ants.
4.636
4.9Xf
.411
.146
.9M
.064
2.857
.043
.048
.362
.980
.570
.143
.067
.247
.118
.248
.263
.536
.364
.484
Indi-
cated
Cstaljty
rate
per 100
8YPHILIS.X
From 50,000 to 100,000 inhabitants:
Berkeley, Cal
Brockton, Mass
Canton , Ohio
Holyoke, Mass
St. Joseph, Mo
ean Diego, Cal
From 25,000 to 50,000 inhabitants:
Battle Creek, Mich
Burlington, Iowa
Cedar Rapids, Iowa
Clinton, Iowa
Davenport , Iowa
Dubuque, Iowa
Jackson, Mich
Jackson, Miss
Kalamazoo. Mich
Lorain, Ohio
Moline.IU
Montclair, N. J
Newton, Mass
San Jose, Cal
Stoubenville, Ohio
Waterloo, Iowa
From 10,000 to 25.000 inhabitants:
Alexandria, Va
Bellaire, Ohio
Bloomfield, N.J
Cairo,IU
East Liverpool. Ohio
GrccnvUle, S. C
Greenwich, Conn
LaFayetto, Ind
Long Branch, N.J
Massillon, Ohio
Middletown, Ohio
Morristown, N.J
NewpOTt News, Va
Norwood, Ohio
Sandusky, Ohio
Trinidad, Colo
Warren, Ohio
West Chester, Pa
67,653
67,449
60,852
65,286
85,236
53,330
29,480
25,030
37,308
27,386
4H,Hn
39,873
35,363
29,737
48,886
36,9G1
27,451
26,318
43,715
38,902
27,445
35,559
17,846
14,348
18,466
15,794
22,586
18, 181
10,150
21,286
15,395
15,310
15,625
13,284
20,562
22,286
20,193
13,875
13,059
13,176
»15
131
»2
11
51
7
'1
7
5
3
42
7
1
388
27
G
1
29
1
»1
1
10
1.042
.033
.168
.598
13.73
.131
.034
.280
.134
20.00
.110
.880
.176
.028
100.00
13.048
.552
3.70
.102
.036
100.00
1.102
.023
100.00
.026
.036
.281
.056
100.00
.070
.162
2.650
1L91
.443
20.00
.110
100.00
.209
.141
100.00
.195
.131
.640
20.00
.151
100.00
.146
6&67
.045
.050
.216
66.67
.306
.076
100.00
titles in which no cases of this disease were reported are not included in this tablt.
sThe health officer states that cases are known not to be completely report
pulation Apr. 15, 1910.
irhich nc
Digitized
by Google
1369
August 24. 1917
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
TUBERCULOSIS (PULMONABY).i
Oly*
AtlanticCity, N. J
Augusta, Ga ,
Berkeley, Cal
Binghamton.N. Y
BrocktOQ , Mass
Canton, Ohio
Covinfton. Ky
Duluth,Mlnn
Erie.Pa
EvansviUe,liid
Flint.Mich
Fort Wayne, Ind
Hairisburp. Pa
Holyoke, Mass
Lancaster, Pa... ».
Maiden, Mass
MobilcAla
New Britain, Conn
OklahoniaCity,01cla
Passaic,N.J
RocWord.IU
Saginaw, Mich
8Senect«dy,N.Y
Somerrille, Mass
Troy.N.Y
WIrhlta, Kans
Wilkes-Barre, Pa
Y(mkers,N. Y
York. Pi
From 2S.00O to 50,000 Inhabitants:
Alanwda,CaI
Aurora, 111
Austin, Tex
BayCity,Mich
Brookline, Mass
Cedar Rapids, Iowa
Chelsea, Mass
Columbia, S. C
Cumberland , Md ^
Davenport, Iowa
East Orange, N. J
Elgin, m.:..
Evanston, HI
Everett, Mass
Everett, Wash
FttchburK,Mass
Green Bay, Wis
Hammond, Ind
Haverhill, Mass
Jackson , M ich : .
Jackson, Miss
Kalamasoo, Mich
Kenosha, wis
Kingston,N.Y
Knoxville, Tenn
Lincoln , Ncbr
Long Beach, Cal
Lorain, Ohio.
Lynchburg, Va..
ltodison,\V4s....
McKeesport.Pa.
MedfordLMass...
MoUne.lll
Montelair,N.J..
Muncie,Ind
Newport, Ky..-.
Newport, R.l...
Est imi Lex}
pcwuiatioti
July 1,
57,660
50,245
57,653
63,973
G7,449
60,852
57,144
94,495
75,195
76,078
64,772
76,183
72,015
65,286
50,853
51,165
68.221
53,794
92,943
71,744
66,185
66,642
99,619
87.039
77,91ft
70,722
76,776
99,838
61,666
Ca5?s
njport-
id.
102
4
43
107
128
«43
30
184
247
117
241
64
204
104
60
104
103
97
11
137
tll8
112
208
166
193
74
206
239
130
^ Cities in which no cases of this disease were reported
> The health officer states that cases are known not to
27. 732 21 11
34,204 2 31
34,814 M
47,942 146
32,730 62
37,308 7
46, 192 113
34,611 50
26,074 »91
48,811 5
42,468 68
28,203 13
28,591 16
39,235 105
36,486 33
41,781 88
29,353 0
2o,171 11
48, 477 83
35,363 142
29,737 234
48,886 161
31,676 35
26,771 65
38,676 64
46,516 a 18 16
27,687 17 32
36,964 12 10
32,940 79 51
33,699 20
47,621 18 25
26,234 26
27,461 16 16
26,318 60 23
25,424 3 3T
31,927 110 Tt} 3.445
33,108 40 30 1.
are not included ia l^ls. labia.
be completely repof tod.
£)«iths
t«mi.
108
21
79
46
43
41
60
74
73
68
25
132
43
50
76
40
29
46
86
148
20
27
113
15
rt'|n>rt-
JnimLiJt'
nuts.
1.769
.746
2.06
1.982
1.35
1.898
2.84
.707
1.00
.626
1.947
2.16
3.285
2.67
1.638
4.400
6.88
2.833
2.76
L693
L42
2.033
4.16
1.803
2.26
1.910
2.138
2.013
2.090
L907
2.4n
1.046
2.683
2.394
2.617
1.712
4.016
7.869
3.089
i.ias
2.064
1.655
.387
MnmEg..
berof
cases
r#iKirt'
ed lof
mch
death
reigls-
tired.
.325
2.398
.684
.991
.583
2.280
1.80
2.95
3.86
4.52
1.93
1.3J
3.70
7. 63
2.12
8.67
.757
1.91
.116
3.046
1.689
*' "3.04
1.93
2.446
1.445
3.490
.102
1.602
2.2,^
1.16
4.33
2.50
2.13
.625
2.670
.930
2.106
1.25
3.00
1.27
2.32
"
1.64
4.73
;-). iiTj
3 02
2.92
1.62
1.13
1.20
1.65
i.od
2.61
1,67
99
(o (hl& labia. J^il^hi
Digitized by Vn^^^pK
J
August 24, 1917 1370
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
TUBERCULOSIS (PULMONARY)— Continued.
aty.
Estimated
population
1916. '
Cases
ed.
Deaths
regis-
tered.
Cases
1.000
inhabit-
ants.
Nam.
berof
eadi
death
r^is-
tSS.
From 25,000 to 50,000 inhabitants— Continued.
Npw Rochel]f> NY -
37,750
43,715
31,401
26,654
31,404
33,080
38,629
38,136
43,284
28,926
48,562
3H,902
27,445
30,570
35,559
43, 139
43.377
11,458
17, M6
15,010
17,834
14.007
13,3.50
18.072
13,599
21,645
14,422
18,466
15,442
15, TIM
15.470
s 13.075
15, 4.55
15,406
20,021
13,272
14,065
22,586
1S,S07
Ml, 028
IK.OIH
15,4«5
14,084
« 10, 190
17,140
18.181
19,159
10,950
13,612
22,466
14,685
10,880
15,848
17,807
14,339
10,648
14,230
23,539
20,930
21,286
12,221
11,838
13,451
19,879
21,046
15,395
37
40
17
12
2
79
81
91
160
13
76
»64
3
29
4
106
23
6
15
166
12
16
24
15
4
40
4
36
6
40
10
26
1
29
52
15
4
i34
5
6
107
8
9
19
»25
25
M5
»4
54
19
3
56
M4
23
31
2
79
133
4
17
95
31
27
11
U9
20
17
33
13
2
32'
35
56
62
45
39
13
28
4
27
41
6
15
5
9'
i3*
I
8
9"
2
i2'
12
10
20
28
10
26"
5
is'
8
17
8
25
17
2'
14
1
2
13
26
11
4
18
19
26
n
95
11
13
23
9
0.960
.915
1.85
2.S
Nnrristown Pa ...••••••••
Oak Parle 111
Ogden Utah
.OM
2.388
2.097
2.386
1.386
1.00
OranjrcN.J
Pittsfleld. Mass
'"is
Ouincv . Mass
2.60
HofiJiOKG Va -. ... •• . *•••••••••
1.07
Rock Island .III
Salem , Mass
1.565
1.388
1.69
San Jose Cal ..
1.38
Sitpiiibenvillc Ohio ....
Waltham, Mass
.949
.112
2.457
1.04
Waterloo. Iowa
1.00
West Hoboken, N. J
WheeUng W. Va
3.93
From 10,000 to 25,000 inhabitants:
Adrian. Mich
.524
.841
11.050
.C73
1.142
1.780
.S31
.294
1.H48
.•>77
1.950
.3^
2.533
LOO
Alexandria. Va.
LOO
Ann Arbor. Mich
33.20
Appleton, Wis
Asbury Park. N. J
Batavla.N. Y
Bclolt, Wis
L78
""'i.'ii
Bprlin N H
4.00
Beverly, Mass
5.00
Billinps.Mont
Bloomflcld, N. J
Blueficld, W. Va
4.00
3.00
Cairo, III
Chillicollie.Ohio
Clinton. Miiss
1.989
2.17
Connellsville, Pa
Comi ne, N . Y
1.882
2. .597
1.133
.273
.133
1.808
.453
.322
6.910
.545
L45
Danville, Va
l.»
Dover, N.H
L50
DuBois, Pa
East Liverpool, Ohio
Eau Claire. Wis
L31
Elwood, Ind
LOO
Elvria, Ohio
Escanaba, Mich
7.13
Eureka. Cal
LOO
Farrcll Pa
Gardner. Mass
1.109
1.375
1.305
2.655
.294
2.537
L294
.184
3.534
2.471
1.604
2.911
2.38
Greenville. S. C
Greenwich , Conn
LOO
L47
Harrison, N.J
Helena. Mont
"' "i'oo
Homestead, Pa
4.07
Hornell N Y ,.
19.00
Huntinpton, Ind
LOO
Ithaca N. Y
4.31
Jackson. Tonn
Le9
Jancsville, Wis
2.09
Johnstown, N. Y ,,
7.75
Kankakee. Ill
Kearny, N.J
3.350
1.577
.188
1.391
8.025
2.305
1.358
4.16
Kokomo, Ind ,.'.
L27
LaFavette, Ind [[
La8allo,Ill
LOO
Lincoln, III
LOO
Little Falb. N. Y '„
2.82
Lockport, N. Y
2.06
Logansport, Ind
Long Branch, N. J
i.234
i'ii
1 The health officer states that cases are known not to be completely reported.
iPopulaUon Apr. 15, 1910.
Digitized by
Google
1371
August 24, 1917
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
TUBERCULOSIS (PULMONARY)— Continued.
aty.
From 10,000 to 25,000 inhabitants— Continued.
Mraktce^Mich
Manitowoc. Wis
Haakato.Mhin
Mansfield, Ohio
Marniette,Wis
Marion, Ind
Massillon. Ohio
Mflford,ltass
Monessen, Pa
Muscat QIC, Iowa
New Albany, Ind
Newport Nc ws. Va
North Adams, Mass
Northampton, Mass
North Tonawanda, N. Y
North Yakima, Wash
Olean.N.Y
Ossiniog.N.Y
Osw€«o,N.Y
Peabody.Mass
PeekskiltN.Y
Piqua,Ohio
Pittston,Pa
Plainfield,N.J
Plattsburgh.N.Y
Plymouth. Pa
Pontiac.Mich
R©dlands,Cal
Saiem, Oreg
Santa Barbara. Gal
Sault Sto. Marie, Mich
Selma,Ala
Southbridge, Mass
Steelton. Pa
Trinidad. Colo
Virginia, Minn ,
Warren, Ohio
Washington, Pa
Watertown , Mass
Wausau, Wis
Webster. Mass
West Chester, Pa
WeslfleW, Mass
West Orange, N. J
White Plains, N. Y
Winona, Minn
Winthrop. Mass
Wobum, Mass
Num-
Cases
ber of
Estimated
population
July 1,
1916.
Cases
report-
ed.
Deaths
regis-
tered.
report-
ed per
1,000
inhabit-
ants.
cases
report-
ed for
each
death
rt«is-
t^.
1 12,381
64
18
5.169
3.56
13,805
7
13
14
5
i 10,365
1.254
2.60
22,734
« 14,610
19,834
15,310
15
24
3
8
2
18
5
25
8
20
14,110
1.772
1.25
21,630
16
9
.740
1.78
17,500
13
13
.743
1.00
23,629
20,r62
4
. 34
46
39
2.237
1.18
122,019
«26
11
1.181
2.36
19,926
86
36
4.316
2L39
13,768
24
12
1.743
2.00
20,951
21
15
1.002
L40
16,624
28
16
1.684
1.75
13,705
31
2.262
24,101
62
13
2.573
4.77
18,360
44
10
2.397
4.40
18,530
36
14
1.943
2.57
14, 152
10
8
11
18,599
.430
23,805
54
16
2.268
iis
12,«37
18
7
1.402
2.57
19,100
35
3
1.832
11.67
17,542
40
4
2.280
laoo
14,000
37
21
2.643
1.76
20,278
14,846
13,919
5
12
4
10
70
7
5,029
laoo
15,626
»37
29
2,368
1.28
14,205
20
5
1,408
4.00
15,4r>8
85
13
5.498
6.54
13,875
18
18
, 1.297
LOO
15, 193
12
7
, .790
1.71
13.059
3
3
t .230
1.00
21,018
40
i7
1. 850
1.48
14,St57
13
8
.874
1.63
19, 239
3
11
13,210
19
10
1.438
1.90
13, 176
12
12
.911
1.00
18,391
34
6
1.849
5.67
13,550
30
16
1 2.214
1.88
22, 4(35
48
15
2.137
3.20
U8,58J
«1
1
.054
1.00
12,692
13
4
1.024
3.26
15,969
18
14
1.127
1
1.29
TUBERCULOSIS (ALL FORMS).*
from 50,000 to 100,000 inhabitants:
AtlanticCity,N. J.
Bayonne,N. J..
Berkeley, Cal....
Brockton, Mass.
Canton, Ohio..-.
Duluth.Minn...
Elizabeth, N. J..
Erie, Pa
Evansville, Ind.
FUnt,Mich
Harrisburg.Pa..
Hoboken,N.J..
Holyoke, Mass..
57,CG0
258
09,895
104
57,053
M7
07, 449
140
00, s:>2
51
94, 495
201
80,090
279
75,195
286
76,078
126
54,772
245
72,015
219
77,214
252
65,286
127
25
55
51
124
125
4.475
2.346
.815
2.165
.838
2.127
3. 218
3.803
1.050
4AT3
> Population Apr. 15, 1910.
> The health officer states that cases are known not to be completely rep
* Cities in which no cases of this disease were reported are not included
or ted
in this
itized by
5.86
1.88
2.65
1.00
2.25
2.29
45 I 4. 47J 5. 44
89 I X041 2.41}
91 j X2M %77 _
90 I LQ4S L4I ^^^^
ithistaWa. ,J^f
ized by VjOOS|^r^
J
August 24, 1917 1372
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
TUBEBCULOSIS (ALL FORBfS)— Continued.
City.
Estimated
1916.
Casts
ed.
Deaths
r««is.
tered.
Cas«s
report-
eaper
1,000
inhabitr
ants.
Norn-
bcrof
CMfa
death
tSS.
From 60,000 to 100,000 inhabitants-Continued.
New Britain Conn ^
53,794
71,744
85,236
53,330
99,519
87,039
53,886
77,916
85,692
70,722
99,838
51,656
27,732
29,480
32,730
46,192
32,261
42,458
41,781
40,496
26,171
48,477
35,363
29,737
48,886
31,576
26,771
38,676
31,677
41,097
46,515
27,587
26,234
27,451
26,318
37,009
26,100
41,133
43,715
37,353
33,080
36,065
41,185
38,629
28,926
48,562
38,902
36,283
30, 570
29,894
43, 139
31,155
20,334
17,846
15,010
17,834
13,350
14,348
21,645
18,466
M4,544
10,872
15,794
19,242
100
158
108
270
225
187
48
212
159
86
256
130
28
68
60
123
»70
82
110
58
11
104
153
272
169
37
67
69
14
118
U9
18
32
19
78
54
85
40
52
107
104
41
77
87
13
96
55
83
33
28
111
70
7
26
172
8
46
50
16
46
46
3
51
106
100
136
73
108
71
167
99
23
130
15
30
15
34
38'
36
46
36
24
65
40
50
59
14
52
45'
104
36*
14
19
27
18
13
29
25
52
51
25
32
33
89
50
47
80
38
20
32
93
7
26
5
18
22
9
10
i'o
20
46
5
L850
2.203
Las?
5.063
2.261
3,148
L96
Passaic, N.J
8t. Joseph, Mo
L4»
LOB
San Dieeo. Cal
L99
Schenectady, N. Y
3.06
Somerville.Mass
L73
TftiDfM Fla •.••••••••
Troy.K. Y
2.477
L855
L216
2.564
2.517
1.010
2,307
1.833
2.663
2,170
1,031
2.633
1.432
L30
Utica, N. Y
L6I
Wichita, Kans
8.74
Yonkers, N. Y
L97
York, Pa. . . . .
8.67
From 25,000 to 60,000 inhabitants:
Alameda, Cal
L40
Battle Creek. Mich
4.53
Brookline, Mass
L7B
Chelsea, Mass
• DanvUle.Ill
LSI
East Orange, N. J
2.S
Fitchburg, Mass
2.39
Hamilton,' Ohio
L61
Hammond, Ind
Haverhill, idass
2.145
4.327
9.147
3.457
M72
2.129
L784
Leo
Jackson, Mich
3,83
Jackson, Miss
5.44
Kalamazoo, Mich
180
Kenosha, Wis
2.64
Kingston, N. Y
LIO
Knoxville, Tenn
La Crosse, Wis
Lexington, Ky
2.871
.408
LIS
Lincoln, Nebr
Long Beach, Cal
Mcdford, Mass
L220
.692
2,964
1.459
3.257
.972
1.190
2.865
3.144
1.137
L870
2.252
2.39
Molino,Ill
LOO
Montclair, N. J
3.89
Mount Vernon, N. Y
3.00
Muskegon, Mich
6.54
New Castle, Pa
L38
Newton , Mass
2.06
Niagara Kails, N. Y
2.06
Orange, N.J
3.04
Oshkosh, Wis
1.64
Perth Amboy, N. J
2.41
Pittsficld, Mass
2.64
Rock Island, Ul
Salem, Mass
i.977
2.000
2.288
L92
San Jose, Cal
L17
Taunton, Mass
L04
Waltham, Mass
Watcrtown, N.Y
.937
2.573
L40
West Hoboiccn, N. J
Winston-Salcm, N.C
3.47
From 10,000 lo 2.').000 inhabitants:
A V)ordecu. Wash
.611
1.457
11.459
1.682
L948
1 00
Alexandria, Va ,
1 00
Ann Arbor, Mich '.'..'/.'.
34 40
Appleton, Wis
1 67
Batavia, N. Y ..',,.,
1.18
Bellaire, Ohio
Beverly, Mass
2,125
3. 70S
LlOO
4.231
2.913
4.00
Bloomfield, N. J
Bradford, Pa
1 80
Brunswick. Ga '..'.'".'
3.30
Cairo, Ul...
LOO
Carbondale, Pa '..'.'.'.
1 The health oifioer states that cases are known not to be completely reported.
* Population Apr. 15, 1910. r .r ■—
Digitized by
Google
1373 August 24, 1017
REPORTED PREVALENCE FOR THE YEAR 1916— CoiiUnued.
TUBERCULOSIS (ALL FORMS)— Continued.
City.
Cofim
eti.
I an 13.
Nanj-
berof
•dftar
«ech
death
rigts-
tend.
Fn;nn 10,000 to 2S,000 luliabJiancs^^Canlliiiied.
C<jfle¥t^iUe. Kaos
C^imiiiK,\. ¥..........„.......„.„....
Dunkirk, N. Y
Eacanaba, Mich
Eureka, Gal
Fulton, N.Y
Gardner, Mass
Granite City, 111
Greenville, S. C
Hackcnsack, N. J
Harrison, N.J
HatUesburs, Miss
Hontingt^Ind
Ironwood, Midi
Ithaca, N.Y
Johnstown, N. Y
Leavenworth, Kans
Lincoln, ni
LitUe Falls, N.Y
Lockport,N.Y
Long Branch, N. J
Manistee, Mich
Manitowoc, Wis
Middletown, N. Y
Middlctown, Ohio
MUI<ird,Mass
Morristown, N. J
Muscatine, Iowa
Nantiooke, Pa
Newport News. Va
Northampton. Mass
Norwood, Ohio
Oasfaiing,N.Y
Phniipsburg, N. J
Plainfield, N. J
PanUac,Mich
Portsmouth, N. H
Redlands,Cal
Rome, N.Y
Salem, Orcg
Sandusky. Ohio
Santa Barbara, Cal
Saratoga Springs, N.Y ,
Spartanburg. S. C
Trinidad, Colo
Uniontown, Pa
Virginia, Minn
Warren, Ohio
Warren, Pa
Washington, Pa
Watertown, Mass
Waukegan.in
Webster, Mass
Westfield, Mass
West New York, N. J
West Orange, N. J
White Plains, N. Y
Winthrop, Mass
Wobum,Mass
15,485
11,084
11,908
17,140
15, 142
18.181
1G,945
16,950
10,482
10,8S0
14,779
15,848
10,648
«19,3C3
11,838
13,451
19,879
15,395
« 12,381
13,805
15,810
15,625
14, 110
13,284
17,500
23,126
20.562
19,926
22,280
13,705
15, Wo
23,805
17,542
11,660
14,000
23,737
20,278
20,193
14,846
13,821
21,365
13,875
2a, 780
15, 193
13,059
14,737
21,618
14,8()7
20,244
13,210
18,391
18,773
13,550
22,4()5
12,092
15,909
21
53
'^
108
24
39
20
1
»29
23
54
»258
2
44
63
31
25
109
34
29
^23
66
7
72
8
27
17
21
23
eo
88
27
33
23
61
41
17
40
186
7
21
0
43
6
20
i 14
14
11
63
41
17
7
21
37
70
31
83
16
19
14
4
21
109
10
15
9
21
10
39
22
22
10
21
12
48
38
14
2
13
29
4
15
31
111
17
21
12
25
49
20
1.398
6.974
1.634
2.435
1.167
1.505
1.357
3.186
15.653
.184
2.977
3.975
2. 911
1.291
9.208
2.528
1.459
1.494
5.331
4.551 I
1.914
1.28
1.200
.995
2.018
4.416
L212
2.408
1.474
2.562
2.337
1. 4.57
2.S.'V7
7.836
SL18
3,21
1.53
5.14
1.00
2.23
L67
1.00
2.30
LOO
4.50
7.75
1.19
1.00
2.13
L93
2.56
3.14
L85
L23
L70
LOO
L92
L25
2.33
L93
16.50
L77
2.10
10.25
L13
129
1.C8
1.040
LOO
3.111
L72
L441
LOO
.674
.921
2.00
.842
2.20
4.275
4.50
1.897
L28
1.144
L55
L590
L75
2.012
5.29
3.729
2.288
L63
3.695
3.77
1.261
1.190
L36
> The health officer states that cases are known not to be completely reported.
* Population April 15, 1910.
Digitized by
Google
Angiiiit 24, 1917 1374
REPORTED PREVALENCE FOR THE TEAR 191&— Continued.
TTPHOm FEVEB.>
1
City.
Estimated
popuhi-
tionJuly
1, 191ft.
Caaes
report-
ed.
Deaths
regte-
tered.
Cases
report-
eaper
1,000
inhabit-
Indi-
cated
fatafity
rate
per 100
cases.
ants.
From 50,000 to 100,000 inhaWtanU:
Atlantic City, N. J
67,660
50.245
69.895
67,653
63,973
67,449
60,852
57,144
94,495
86,690
63,705
75,195
76,078
64,772
76,183
72,015
77,214
65.286
60,853
51.155
78,283
68,221
63.794
92.943
71,744
69.411
63,867
65.185
65,642
85,236
53.330
99,519
87,039
53,886
77,916
85,692
70,722
76,776
99,838
51,656
27,732
34,204
34,814
29,480
47,942
32,985
33,846
32.730
37,308
25,636
46,192
34,611
25,987
26,074
32,261
48,811
39,631
39,873
42,458
28.203
39,235
35,486
41,781
29,353
40,496
26,171
48,477
28,491
35,363
29.737
76
33
9
17
20
23
65
33
82
24
60
36
200
227
48
402
15
8
38
16
9
63
23
41
8
6
115
12
78
20
38
32
16
105
60
14
81
38
16
64
18
24
«19
18
186
4
6
6
20
6
29
«67
6
60
43
13
27
2
9
218
16
13
13
3
44
82
16
13
30
76
11
17
4'
6
2
7
9
6
2
29
6
26*
8
56
2
2
8
4
3
16
2
7
2
S
12
is*
9
5
4
1
9
10
1
3
4
1
7
4'
13
2
21
6*
3*
12
3*
6
7
6
4'
2*
3
3
7
27
4
4
6
9
1.318
.657
.120
.295
.371
.341
.838
.677
.868
.277
.785
.479
2.629
4.144
.630
6.582
.194
.123
.747
.293
.116
1.082
:12
.112
.101
1.801
,.^
.235
.713
.322
.184
1.949
.642
.163
1.145
.495
.160
1.239
.649
.702
.546
.611
3.880
.121
.177
.153
.536
.234
.628
1.936
.192
1.918
1.333
.266
.681
14.47
Aueusta Ga ..........•.•.••••
51.52
Bayonne, N. J
Berkeley Cal
219
aaoo
Brockton. Mass
8.70
Canton, Ohio. . . * '.'.'. '..'.
12.73
Covincton. Kv..
27.27
Dtiluth, Biinn
6.10
Elizabeth. N.J
8.33
ElPaso, Tex
58.00
Erie Pa. . .
13.80
Evansville, Ind....I.! *.!
Flint Mich . . .
11. 4&
Fort Wayne, ind. .'.'...'.....'..'.
16.67
Harrisburc. Pa. . .
13 68
Hoboken, N. J
13.33
Holyoke, Mass
25.00
Lancaster. Pa .. . ...
21. OS
Malden,Mass *
26.67
Manchester N H
33 33
Mobile,Ala-. ! ... .!
2181
New Britain, Conn
8.70
Oklahoma Cfty, Okla
17.07
Passaic, N.J '.'.
25.00
Pawtucket, R. I
SO. 00
Portland, Me 1
10.43
Rockford, 111
Saginaw, Mich
i9.23
St. Joseph, Mo
45.00
San Diego, Cal
13.16
Schenectady, N.Y
12.50
flomerville, Mass.....
6.25
Tampa, Fla
8-57
Troy;N.Y
20.00
Utica, N.Y
7.14
Wichita, Kans
171
Wilkes-Barre, Pa
lass
Yonkors,N.Y
6.25
York, Pa
laM
From 25,000 to 50,000 inhabitants:
Alameda, Cal
Aurora, III
16.67
Austin, Tex
68.42
Battle Creek, Mich
11.11
Bay City, Mich
11.29
RelHnghani,Wftsh.._
Boise, Idaho
Brookllne, Mass
Cedar Rapids, Iowa
25.00
Central Falls, R.I
Chelsea, Mass
'ioiss
Columbia, S.C
17.91
Cranston, R. I.. . .
Cumberland , Md
6.00
Danville, 111
13.95
Davenpcttl, Iowa
Decatur, HI
25.93
Dubuque, Iowa
East Orange, N.J
.212
7.730
.408
.366
.311
.102
1.087
3.133
.309
.456
.848
2.622
Elgin, 111 I.!
1.83
Everett, Mass
Everett, Wash [,[
15.38
Fitchbiu^, Mass
2101
Green Bay, Wis ',,'.'
100.00
Hamilt'^n, Ohio.
15.91
Hammond, Ind ..'..".'.'.'.
32.93
Haverhill, Mass '.'.'.' '
26.67
Hasleton, Pa
30.77
Jackson, Mich
20.00
Jackson. Miss
12.00
1 Cities in which no cases of this disease were reported are not Included in this table.
* The health officer states that cases are known not to be completely reported.
Digitized by
Google
1375 August 24. 1917
REPORTED PREVALENCE FOR THE YEAR 1916— Continued.
TYPHOID FEYER—Contlnued.
City,
Esrimaied
tfSfjiity
Cases
repOTl*
tensd.
l,Ol«
inhiibit-
ants.
ittdi-
rated
totality
rale
per 100
ams.
From as,00(Ji^ SO.OOO inlmbiUmU^-Contimifld.
31,5?S
38,676
31,677
40,498
41,097
46,515
27,587
36,964
32,940
47,521
26,234
27,451
26,318
37,009
25,424
26,100
41,133
31,927
30,108
37,759
43,715
37,353
31,401
26,654
31,404
33,080
36,065
41,185
38,629
36,798
38,136
43,284
28,926
48,562
38,902
27,445
46,226
36,283
30,575
30, 570
29,894
43,377
31,155
11,458
14.025
17,846
18,960
22,874
15,010
17, 834
14,007
20,82}
16,874
13,350
14,348
18,072
13,699
21,645
14,422
18,466
15,442
a 14, 544
10,872
21,617
15,794
19,242
14,508
15,470
43
ao
61
2
114
SO
33
19
14
90
50
9
97
8
15
137
4
60
19
10
• i
16
41
14
25
9
10
7
9
»70
16
6
»11
9
36
10
39
9
31
84
179
13
29
20
3
13
107
2
9
5
23
46
20
6
1
17
5
3
7
13
26
5
2
6
3
5
5
8'
7
7
3
5
11
8
8*
2'
5
5*
4
1
i'
5
4
2
5*
2
1
2"
7'
4
3
?
7
1
16
1
3
12
11
3
I
6
1
4
8
v.'.'.'.'.'.'.
4*
2
......
1
i"
1
3
1
i'
2
o.sso
-633
2.092
1.577
.063
2.815
1.217
.70)
.683
.379
2.732
1.052
.343
3.534
.304
.405
1.455
.153
1.459
.595
.332
.185
.595
.428
1.306
.750
.191
.423
.693
.219
.259
.190
.236
1.617
.553
.103
.283
.328
.779
.276
1.276
.294
1.037
1.937
5.745
1.135
2.068
1.121
.158
.568
7.129
.112
.643
.240
1.363
3.446
1.394
.332
.074
.785
.347
.162
.453
.894
2.391
.231
,127
.nt
6.98
35.00
8.93
KHU^vh^i. ^Vb..._, ,„ ,
Kir-^i i:i N, Y"^
Knoxvill«, Tenn. _
Ta f'TOffS**, Wi«| ... ,
T4ui«ing, Mirfi .
7 02
lAfxiDgi/on, Ky
14 00
I^iKMHn N^hr .
21 21
T.<mjrTUt|M^,rftI.
15 79
T>irain Ohio. . , , .
35 71
I^ynch(Hirg, Va. ...
11 11
kcKeesport, Pa.
16 00
^4^f^jr4^K<»
IfoliTlA.fl) . .. ..
8 25
ifont^iiair, N, J . ^ ,
Mount Vernon. N. Y
13 33
Mimcie,Ind....
13 51
If nvkaigm. If inh
New Castle, Pa.
8 33
Newport, Kt ,
21.05
Newport,R.I
10 00
New RocheUe, N. Y
ti^mrU^Usm^.
3 85
Ni^gw* FftlLs N Y
31.25
Narristown, I*a.
9.76
Oak Park, 111
10.00
Oeden. Utah
OrmiM V T
35.71
Oshkosh.Wis
8.00
Perth Amboy, N. J
11.11
Pitt8field,Mass
Qiiin«y, til . . .
28. 57
Qninflv! MaiB
Roanoke Vft.... ...
10.00
Rock Island, 111
25.00
8a]f»m, Mass . .,.
60 00
San Jose, Ca2 '.
18.18
Steubenville, Ohio
77.78
SuDerior. Wis
19.44
TMlllvOn. Mas??. . .. .. ,.„ ........ ,
10.00
Tulsa, Oida
41.03
Waltham, Mass
11.11
Watertown, N. Y
9.68
WhAAling, W. Vft . .
14.29
6.15
From 10.000 to 25,000 inhabitants:
Adrian, Mich
23.08
Albuquerque, N. Mex
3.45
Alexandria. Va
30.00
Alliance, Ohio
33.33
Alton, Dl
30.37
Ann Arbor, Midi
34.40
Asbury Park, N. J
Asheville, N. C
Bakersfield.Cal
Batavia,N. Y
8.70
R«n»iM Ohin ,
10.00
Beloit,Wis
Berlin,N. H
Beverly, Mass
Billings, Mont
Bloomfleld, N. J
5.88
Bluefield,W. Va
14.29
Bradford, Pa .
7.69
Brunswick, Ga
11.54
Burlington, Vt
20.00
Cairo,fll
Carbondale, Pa
l6Ji7
Champaign. Ill
ChilUcotho,Ohio
9,m
> The health oflicer states that casss an known
* Population Apr. 15, 1910.
not to be completely reported.
Digitized by CjOmSIC
w^
August 24, 1917
1376
REPORTED PREVALENCE FOR THE YEAR 191&— Continued.
TYPHOID FBTBB-^ODDtiiiued.
1 Population Apr. 1& 1910.
* The health officer states that cases are Imown not to be completely reported.
aty.
Estimated
popula-
tion July
1, 1916.
Cases
report-
ed.
Deaths
regis-
tered.
Cases , iDdi-
report- cated
edper (atalitj
1,000 rate
inhabit-jpcrlOO
ants, cases.
From 10,000 to 25,000 inhabitants— Continued.
Clinton Mass
» 13,075
17,54^
22,669
15,455
15,406
10,848
20,021
13,272
14,665
20,743
22,586
18,807
» 11,028
18,618
15,4S5
14,684
1 10, 190
21,113
11,908
17,140
15, 142
18,181
19, 159
16,945
16,950
16,482
13,612
22,466
14,685
10.880
14,779
15,818
17,807
14,339
10,648
14.230
23.539
20,930
21,286
12,221
» 19,363
11,838
13,451
19,879
21,046
15,395
112,381
13,805
» 10, 365
22,734
» 14,610
19,834
15,310
12,582
15,810
15,625
14,110
21,630
13,284
23,126
23,629
20,562
J 22, 019
19,926
13,768
20,951
22,286
16,624
13,705
24,101
24,842
1
53
8
16
34
1
45
5
40
tlO
19
10
1
9
13
1
6
4
14
14
6
15
7
18
n
61
22
5
8
24
19
19
«28
1
3
32
6
28
12
25
10
60
15
60
19
7
15
10
4
12
12
9
5
8
5
3
6
52
17
2
23
62
27
12
53
23
8
16
3
4
«16
6*
1
4*
i*
1
2
9
1
1
6'
5*
1
3
2
2
1
i'
4'
2
1
3
2
1
3
4
1
6
2
3
1
13
1
5
5
2'
1
i'
2
i*
1
i'
2
2
4
2
4
2
5
2
1
i*
1
a075
3.020
.353
1.035
2.207
.002
2.348
.377
3.341
.482
.841
.532
.091
.4S3
.840
.068
.589
.189
1.176
.817
.396
.825
.365
L062
.050
3.701
1.616
.223
.545
2.206
.600
L199
1.572
.070
.282
2.249
.255
L338
.564
2.046
.516
5.608
1.115
3.018
.903
.455
1.212
.724
.386
.528
.821
.454
.327
.636
.316
.192
.425
2.404
1.280
.086
.973
3.015
1.226
.602
3.850
1.098
.359
.962
.219
.166
.644
Coffeyville, Kans . .
U.SI
Concord N H " .
12. SO
ConnellsviUe. Pa
Coming, N. Y
U.77
Cumberland, R.I. .
Danville Va .
2.22
Dover, N.H
2a 00
DuBois, Pa
Dunkirk, N. Y
2a 00
East Liverpool, Ohio . ...
47.37
EauClah^e, Wis -.
laoo
Elwood, Ind
loaoo
Elyria, Ohio
Escanaba, Mich
4&15
Eureka, Cal
Farrell, Pa
8133
Fond du Lac, Wis
25.00
FultMi, N.V.
21.43
Oarr1n«r M^SS , , . , , ,
14.29
Granite (ity, 111
33.33
Greenville, S. C
6.67
Greenwich, Conn .*
Hackensack, N.J..
5.50
Harrison, N.J
HatUcsburg, Miss
Helena. Mont
18.18
Homestead, Pa
40.00
Homell, N.Y
12.50
Huntington, Ind
12.50
Ironwootl, Mich
22.22
Ithaca, N.Y
5.2S
Jackson, Tenn
ia7i
Janes\ille, Wis
Johnstown, N.Y
Kankakee, III "..
12.50
Kearny, N.J
16.67
Kokomo, Ind
21.43
La Fayette, Ind
16.67
LaSarte,!!!
12.00
Leavenworth, Kans
10.00
Lincobi,Ill
21.67
Little Falls, N. Y
6.67
Lockport, N.Y
8.33
Logansport, Ind
28.32
Long Branch, N. J
Marustee, Mich
13.33
Manitowoc, Wis
laoo
Mankato, Minn
Mansfield, Ohio
Marinette, Wis
&3S
Marion, Ind
22.22
MassiUan,Ohio
Mattoon.Ill
' ii'so
Middletown, N.Y
2aw
Middletown, Ohio
Milford, Mass
Monessen, Fa
i.93
Morristown, N. J
11.75
Nanticoke, Pa _ _
New Albany, Ind
100.00
17.89
Newport News, Va
3.2S
North Adams, Mass
Northampton, Mwn . ... .^.^ ^
14.«
lflu67
Nwth Tonawanda, N. Y '",
9.43
North Yakima, Wash _
Norwood, Ohio
&70
1%S0
01can7N.Y
OMln/ng^V.Y
3i'33
25.00
Paduci4,Ky ]][[
Digitized by
Google
1377 August 24, 1917
REPORTED PREVALENCE FOR THE YEAR 19ie-Continued.
TYPHOID FEVER— Continued.
City.
Estimated
popula-
tion July
1, 1916.
Cases
report-
ed.
Deaths
regis-
tered.
Cases
report-
ed per
1,000
inhabit-
ants.
Indi-
cated
fatality
rate
per ICO
Fh>in 10,000 to 25,000 inhabitants— Continued.
Peabody, Mast
Peekskfll,N.Y
PhilUpsborg, N. J
Piqua,Ohio
Ptttstoo, Pa....
PhUnfleW, N. J
Plattsburgh.N.Y
Plymouth. Pa
Pontiac, Mich
Portsmouth. N. H
Bedlands,dftl
Reno, Nev
Riverside, Cal
Rome, N.Y
Rutland, Vt
Salem, Oreg
San Bernardino, Cal
Sandusky, Ohio
Santa Barbara, Cal
Santa Cms, Cai
Saratcwa Springs, N. Y
Sault Ste. Marie, Blich
Selma. Ahi
Southbridge, Mass
Spartanburg, S. C
Stedton, Pa
StiUwater, Minn
Trinidad, Colo
Uniontown, Pa.
Virginia, Minn
Warren, Ohio.
Warrai, Pa
Washington, Pa.
Watertown, Bftass
Waukegan.111
Wausau, Wis
Webster, Mass
West Chester, Pa
Westfleld, Mass
Whit« Plains, N. Y
Winona, Minn
Wobam, Mass
18,300
18,530
15.605
14,152
18,599
23,805
12,837
19,100
17,542
11,666
14,000
14,860
19,763
23,737
14,831
20,278
16,945
20,193
14,846
14,504
13,821
13,919
15,626
14,205
21,365
15,458
no, 198
13,875
20,780
15,193
13,059
14,737
21,618
14,867
20,244
19,239
13,210
13,176
18,391
22,465
« 18,583
15,969
6
16
3
124
2
6
13
11
8
1
10
17
6
14
8
14
3
9
2
8
2
12
2
1
13
3
26
1
34
7
1
28
7
57
3
13
2
23
11
4
44
5
9
42
3
11
...
8
3
28
6
3
7
8
3
16
7
0
a 337
.809
.192
1.696
.108
.252
1.013
.576
.456
.086
.714
1.143
.304
.590
.539
.690
.531
.396
.808
.060
.941
1.868
2.176
.070
1.311
3.687
.294
.937
1.107
.921
3.369
.611
1.943
.740
.395
1.195
.454
.435
.n2
.377
.376
16.67
20.00
12.50
33.33
15.38
9.09
37.50
100.00
10.00
11.76
16.67
14.29
21.43
22.22
25.00
16.67
23.08
3.85
20.50
15.38
36.36
11.36
7.14
'37.56
37.50
1 The health officer states that cases are known not to be completely reported.
X PopulaUon Apr. 15, 1910.
Digitized by
Google
PREVALENCE OF DISEASE.
No health department ^ State or local y can effectively prevent or control disease wUkout
knowledge of when, where ^ and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended August 18, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the we^k ended
August 18, 1917, as follows: Two cases of anthrax in man were
notified in Kem County,, where three large herds of cattle are infected.
Three cases of poliomyelitis were reported, one each at San Fran-
cisco, Burlingame, and Santa Rosa. Thirty-six cases of typhoid
fever were notified, 14 of which occurred in Los Angeles. Nine of
these were not of local origin. Diphtheria increased, 25 cases having
been reported. Ten of these cases occurred in San Francisco. Five
cases of smallpox were notified in Fresno County. Other com-
mimicable diseases show a reduction.
The details of notifiable disease cases reported during the week
ended August 11 are as follows:
Anthrax
Cerebrospinal meningitis.
Cliicken pox
Diphtheria
Dysentery
Erysipelas
German measles
Gonococcus infection
Malaria
Measles
Mumps
Cases.
2
4
15
24
2
5
21
28
22
. 100
55
Cases.
Pneumonia 25
Poliomyelitis 2
Ophthalmia neonatorum 1
Scarlet fever 31
Syphilis 25
Tetanus 2
Trachoma 1
Tuberculosis 74
Typhoid fever 31
Whooping cough 73
ANTHRAX.
New Jersey — ^Jersey City.
A case of anthrax was notified July 6, 1917, in Jersey City, N. J.
The patient was a freight handler and had been unloading hides
from railway cars.
(1378)
Digitized by VjOOQIC
1379
August 24, 1917
ANTHRAX— €ontinued.
Texas— Victorku
A case of anthrax was notified in Victoria, Tex., July 2, 1917.
The patient had been engaged in the work of skinning cattle which
had died from anthrax.
CEREBROSPINAL MENINGITIS.
State Reports for July, 1917.
Plac«.
Now cases
reported.
Place.
New cases
reported.
ICtfTland:
B<imore City
1
5.
}
1
Ohio— Continued.
T.4>g|in r/mnty - - - , -
1
Baltimore County —
Lucas County
1
Rnarrow P(4nt ...•
3
Rehy
Stark County...'.
1
Total . .
26
Total
Pennsylyania:
Allegheny County
New York:
21
BmamA CouDtT.. ..*.....
Beaver County
1
Erie County
Cambria County
1
Ni&mra CountT...
Delaware Coimty
1
OnondftFft f'^nnty ,-.,^,,,
Lancaster C-ounty
3
0«wAffo County
Luzerne Count y
1
Wftstchester County
Mercer Countv
1
Montgomery bounty
2
Total
Philadelphia County
13
Washington County
2
Ohio:
Brawn County .....
Westmoreland County '.^...
Total
1
Cr&wford C-ounty
47
Wisconsin:
Barron County
Delaware County %
Fnuiklin r<wintv ^ . , . . ^ , . , ^
1
Hamilton <^^^»niy
Milwaukee County
4
Hitron County
Total
JrfTerson County
5
City Reports for Week Ended Aug. 4, 1917.
Place.
Baltimore, Md.....
Boston, Mass
Cbicai^, III
Cincinnati .Ohio...
Dayton, Ohio
Doluth, Minn
EUiabeth, N.J....
Hartford, Conn....
Indianapolis, Ind..
Lexincton, Ky...
UttleRock, Ark.
Mnwaokee, Wis
Newtrk,N.J
New Bedford, Mass..
Deaths.
Place.
New York, N.Y....
Norristown, Pa
North Adams, Mass.
Oakland. Cal
Orange. N.J
Passaic, N. J
Philadelphia, Pa....
Pittsburgh, Pa
Pittsfleld, Mass.
Portsmouth, N. H...
St. Louis, Mo
San Francisco, Cal.. .
Springfield, Mass
Cases.
Deaths.
DIPHTHERIA.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1388.
Digitized by
Google
August 24, 1917 1380
ERYSIPELAS.
City Reports for Week Ended Aug. 4, 1917.
Place.
Boston, Mass
Buffalo, N.Y
Chicago, 111
Cleveland, Ohio
Cumberland, Md
Detroit, Mich
Grand Rapids. Mich..
McKeesport, Pa
Newark, N.J
Cases.
Deaths.
Place.
New Orleans La. . .
New York, N.Y...
Philadelphia. Pa...
Pitt<?burgh. Pa
Portland, Oreg^
Rochester, N.Y...
St. Loui«, Mo
San Franci'^co, Cal..
Trenton, N.J
Cases.
Deaths.
MALARU.
State Reports for July, 1917.
Place.
New cases
reported.
Place.
Neweaaas
reported.
Maryland:
Charles County—
Bolton, R. D
1
1
1
1
1
Pennsylvania:
rh^^t^r Conxttj. , „ , ,
1
Westmorelancf Coun*^y
1
Malcolm R D
Total
White Plains..!!.!'...!!..! !
2
Frederick County-
Brunswick
Wisconsin:
Fond du I.#ac County... .
Somerset County—
Westover
1
Total
5
City Reports for Week Ended Aug. 4, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Boston Mass
1
1
Nashville, Tenn
1
Columbia 8 C
New York, N. Y
1
Kansas Citv. Mo
1
Oakland, Cal
1
Little Rock Ark
2
Savannah, O'a
2
M^'mphis, Tenn r-rr.........^.
2
Worcester, Mass
1
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1388.
PELLAGRA.
State Reports for July, 1917.
Place.
New
cases
reported.
Place.
New
cases
reported.
Maryland:
Allegany County—
Wcstcrnport
1
1
1
Pennsylvania:
Phlladelpliia County
1
Dorchester County-
Lower Hoopers Island
Fishing Creek
Total
3
Digitized by VjOOQIC
1381
Ao^Bt 24, 1917
PELLAGRA— Continued.
CUT Reports for Wedc Ended Aug. 4, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Austin, Tex
1
4
1
1
Mobile, Ala
1
1
1
»7
Nashville, Tenn
3
Cbarleston, 8. C
New Orleans, La
1
C(^mbia, S. C
New York, N. Y
1
KifHTni^«v)^ W}^h
1
Richmond, Va
3
Fanias Hty. Mo
1
1
Rutland, Vt
1
Lexln^on.'ky . ....
i San Diego, Cal
1
1
1
Little Rock, Ark
1
1
Washington, D. C
Wihnington, N. C
Winston-Salem, N. C
Los Angeles. Cal
1
Vnnphn, Tenn
4
1
1 The reason that Birmingham had so manv more cases of jiellagra reported than any other city is not
that the disease is more prevalent in Birmingnam than in other cities of Alabama and neighboring States,
but undoubtedly because of the successful efforts the health department has made in securing tno coop-
eration of the practicing physicians in reporting cases.
PLAGUE.
Hawaii— Plague-Infected Rats Foond.
The finding of two plague-infected rats in Hawaii was reported on
August 15; one was found in a mill camp at Paauhau and the other
in a store camp at Kukaiau.
PNEUMONU.
City Reports for Weelc Ended Aug. 4, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Baltimore, Md
1
3
1
34
6
3
1
2
1
1
2
Los Angeles, Cal
12
16
Boston. Mass . . .
Manchester, N. H
1
Chelsea, Mass
2
44
12
13
1 Nowark.N. J
Philadelphia. Pa
ti
Chicago, Bl
2t
Cteve^d, Ohio
! Pittsburgh, Pa
9
Detroit, Mich
1 Reading, Pa
Erie, Pa
' Rochester, N. Y
I
Evaasville Ind ...
' San Die-io, Cal
FaU Kiver, Mass
1
1 San Francisco, Cal
c
»
Grand Rapids Mich
1 Worcester, Mass
1 1
1
POUOMYELITIS (INFANTILE PARALYSIS).
State Reports for July, 1917.
Fket.
New CAMS
ri'p^jrtt^d-
Hacie.
rjjpnTinl.
MiiiTland:
Bulilmort City .„,,
AllcKiuiv County—
Barton
Barton, R. D
Mount Savage
Cumberland
Green Ridge, R. D...
Eckhart Mines
Anne Arundel County-
Lake Shore, R. D....
Baltimore County—
Bighlandtown
Dorchester County—
Federalsburg, R. D. . ,
Garrett County-
Merrill
Worcester County—
Pooomoke City, R. D
Total
22
New Yort!
Albany Coutiry.....,,
Chaiauqua uouniy
Columbia County
Erie County
Jefferson C/Ounty
Niagara County
Orange County
St. Lawrence County.
Saratoga County .
New York City.
3
1
2
1
5
1
1
2
1
1
24
Total.
Ohio:
Belmont County..
Cuyahoga County .
Deflanco County . .
Franklin County. .
Guernsey County .
Jefferson County.
15
8
1
1
'jifize'cT by
5.^60
gl^f
Ausu8t24,1917 1382
POLIOMYELITIS (INFANTILE PARALYSIS)— CJontinued.
State Reports for July, 1917—- Continued.
Place.
New cases
reported.
Place.
Newcaaes
reported.
Ohio— Continued.
Mahoniii£ County
2
1
2
1
1
1
2
2
2
2
Pennsylvania— Continued.
Dauphin County
7
Monroe County
Lancaster County
15
Montgomery County
Lawrence County
PerryCounty .'.
Lureme County
Pickaway County
Mercer County
Portage County
Philadelphia County
Stark County
Venango County
Summit County
Total
Tuscarawas County
41,
Wood County
Wisconsin:
Barron County
Total
43
Pennsylvania:
Allegheny County
6
1
1
1
1
Chippewa County
Pane County. .., ^. ^. ^ *4...*^.
Beaver County
Oneida CouRty
Butler County
POTtage County'! i..!!!!
Chester County
Total
Crawford County !..
5
City Reports for Week Ended Aug. 4, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deatiis.
Akron, Ohio
2
1
2
1
4
3
Newcastle, Pa
2
12
1
2
Birmingham, Ala
New York, N.Y.. . .
I
Brockton, Maw?
Omaha, Nebr
I
Butler, Pa
Pittsburgh, I*a
Chi(»go, 111
1
Quincv, Mass
I
Clevemnd. Ohio
Rocky Mount, N. C. .
1
1
1
1
1
Dayton, Ohio
1
San Francisco, Cal '.'.'..'
Havorhin, Mftss
3
1
3
4
Saratoga Springs, N. Y
Syracuse, N . Y.
Jackson, ilich
1
1
Lynn, Mass
"Worcester, Mass
......*•••
Newark, N. J
RABIES IN MAN.
Mississippi— Tishomingo.
On August 17, 1917, a case of rabies in a child was reported in
Tishomingo, Tishomingo County, Miss.
RABIES IN ANIMALS.
Florida — Jaclcsonyille.
During the month of July, 1917, examinations in the laboratory
of the State Board of Health of Florida showed 3 cases of rabies in
animals in Jacksonville, Duval County, as follows: In a cow, 1 case;
in dogs, 2 cases.
Mississippi— Tishomingo.
On August 17, 1917, several cases of rabies in dogs were reported
in Tishomingo, Tishomingo County, Miss.
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1383 August 24, 1917
RABIES IN ANIMALS— Ck)ntinued.
Washington.
During the period from October, 1916, to July 31, 1917, examina-
tions in the laboratory of the State Board of Health of Washington
showed 30 cases of rabies in animals.
The following table shows the localities in which the cases oc-
curred, the species of animals, and the numbers of persons given
antirabic treatment in the State of Washington during the period
stated:
County.
PosiUve.
Number
of persons
treated.
County.
Positive.
Number
of persons
treated.
Benton
4 coyotes. .
2 dogs. ....
4
Kittitas
2 coyotes. .
Klickitat
Iwolf
1 horse
2
^^h«lif
1
Chfiltn
1 coyote . .
Lincoln
2
Douglas
...do
2
3
Paciflc
Idog^. ...
Fnakiiii
3 coyotes..
1 sheep. - . .
Snohomish
1 cow
2 does
3
^Vhitman
Grant .
2 coyotes .
Yakima
.do
2dogs
...do
3
2 coyotes..
ir^nF ,
West Virginia.
During the period from January 1 to July 31, 1917, investigations
of the State department of agriculture of West Virginia showed 20
cases of rabies in animals.
The following table shows the localities where the cases occurred,
the species of animals, and the month:
Place.
PosiUve.
Month.
Place.
Positive.
Month.
Calhoun County:
Grantsville
Cows
Idog
Dogs
2 cows
.do
July.
June.
Do.
Do.
July.
Jime.
Tyler Coimty:
SistersvUle
Idog
1 cow
2 dogs
2 hogs
3 cows....'.
June.
Jackson County:
Ravenswood
Wirt County:
Palestine
Do.
ftrndyville
Do
Do.
Boane County:
Grace
Do
Do.
Wood County:
Washington
Do
Do.
Beedy
Scows
Icalf.
Hogs
I&::::::::::;:.:;::
Do
City Reports for Week Ended Angnai 4, 1917.
During the week ended August 4, 1917, cases of rabies in animals
were reported as follows: Atlantic City, N. J., 1; Chelsea, Mass., 1,
and Detroit, Mich., 3.
SCARLET FEVER.
See Diphtheria, measlee, scarlet fever, and tuberculosis, page 1388.
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August 24, 1917
1384
SMALLPOX.
Minnesota.
During the week ended August 18, 1917, four new foci of smallpox
infection were reported in Minnesota, cases of the disease having
been notified as follows: Bigstone County, Graceville village, 2;
Itasca County, Grand Rapids village, 1 ; Polk County, Tabor Town-
ship, 1; Washington County, Omeka Township, 1.
Wisconsin — Sparta.
During the three weeks ended August 14, 1917, 22 cases of small-
pox were reported in the State home for children at Sparta, Monroe
County, Wis. .
State Reports for July, 1917.
New cases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within 7
yejrepre-
• ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack.
Number
never suc-
cessfully
vaccina tei.
VacdnaUoo
history not
obtained or
uncertain.
Massachusetts:
Worcester County-
Worcester f
1
1
New York:
Albany County
8
1
1
2
1
7
Chautauqua < ountv
1
Erie County
1
St. Lawrence County...
2
i"" '
Total
12
3
%
Ohio:
Allen County
14
2
'\
'I
21
40
3
1
18
10
2
4
1
1
1
3
8
2
4
1
1
2
1
1
29
3
1
4
14
3
13
5
2
4
1
11
2
1
2
7
1
6
3
Athens County
Belmont County
13
Butler County .'.
2
Clark County
5
Clinton County
1
Columbiana County
15
Cuyahoga County
40
Darke County..."
3
Delaware County
1
Franklin County
1
15
8
2
Gallia County. .'
2
2
Hancock County
1
3
Hardin County. ... *
1
Highland County
1
1
HuronCounty... *\ -!
Jackson County. . ...
3
Jefferson County. ! ! * . '
3
1
5
Logan County. . . 1
I
Lucas County ....
4
1
Medina County
1
Mercer County
2
Miami County
Monroe County
1
1
Montgomery (5ounty
6
2
1
23
Muskingum County
1
PrebleCounty
Sandusky County
4
Shelby County
9
5
Stark County
1
3
2
Summit County.. .......a...
8
3
2
Trumbull County
8
Union County. /.
2
Warren County.... ...........
4
1
Wood County.
Total
252
h
98
149
tIj- -
uigitizea
DyGOO'
^W
1385
August 24. 1917
SMALLPOX— CJontinned.
MisceUaneoufl State Reports.
Place.
Cases.
Deaths.
Place. Ca%s.
1
Deaths.
FMm^lTania (July 1^1):
Aliei^eny County
3
1
2
5
1
1
1
1
Wisconsin (July 1-^1)— Coa.
Dou|flas County . .
35
Blair County
Eau Claire
Erie County
Juneau County
4
Luzenie County
KoQOsha Cour ty
Milwaukee County
Oneida County
Ifereer County
Philadelphia County
SchuyUffll County
St. Croix County
Sheboypan County
Walworth County
Washburn Cou ity
Winnebago Co inty
Wood County .... .
Total
14
WiseonMn (July 1-31):
15
21
3
1
BuflSalo County
Chippewa County
Columbia County
Total
115
^^ane County... T
City Reports for Week Ended Au^. 4, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akrcn.Ohlo.
6
1
1
4
17
1
9
11
2
2
1
8
1
2
2
1
10
1
Lincoln, Nebr
1
Altoooa^Pa
Little Rock, Ark
Belliotfluun, Wash
Milwaukee. Wis
Butte,Mont
Minneapolis, Minn
5
Chi(^,ni
Oklahoma City, Okla
3
2
1
2
1
2
5
7
2
CiDcinnati, Ohio
Omaha, Nebr.'.'.. .
Cicveland/Ohio
Pontiac, Mich
Dayton, Ohio
Portland, Oreg
Detroit, Mich
Portsmouth, Va
Erie, Pa
Quincy. 111....
EvansvUle, Ind
Rocky Mount, N. C
Flint,Mich.
St. Joseph, Mo
Grand Rapids, Mich
St. Louis, Mo
Harrisburg. Pa
Salt Lake City, Utah
Indianapolis, Ind
Sioux Citv, Iowa
3
1
Kansas City, Kans
Springfield, 111
Kansas City, Mo
SprinEfield. Ohio 2
Lima, Ohio.'.
TETANUS.
City Reports for Week Ended Au^. 4, 1917.
Place.
s City, Mo
LosAn^cs,Cal
Memph« , Tenn
Momstown.N. J
Oklahoma aty, Okla..
Cases.
Deaths.
Place.
Rockford.m
Schenectady, N.Y...
Springfield, Ohio
Syracuse. N.Y
Toledo, Ohio
Cases.
Deaths.
TUBERCULOSIS.
See Diphtherial measles, scarlet fever, and tuberculosis, page 1388.
TYPHOID FEVER.
Kansas — Leavenwortli.
During the week ended August 18, 1917, 26 cases of typhoid
fever were reported in Leavenworth, Kans., and 6 cases outside of
the city limits. During the week ended August 11, 1917, 18 cases
were reported in Leavenworth.
1^ Digitized by Google
August 24p 1917
1386
TYPHOID FEVER— Continued.
Tennessee — Chattanooga.
From August 1 to August 18, 1917, inclusive, 56 cases of typhoid
fever were notified at Chattanooga, Tenn.
State Reports for Jnly, 1917.
Place.
New cases
reported.
NevQun
reported.
Maryland:
Baltimore City
Allegany County-
Cumberland
Allegany :
Westemport
Western Maryland Hospital
Midland
Anne Arundell County—
Marley
Drury
Glenbumie
Fairfield
Crownsville
Eastport
Elkrfdge, R. D
Annapolis, R. D
Admiral Junction
Annapolis
Best Gate
Skidmore
Baltimore County-
Thistle Mills
Sparrow Point
Towson
Woodlawn
G ovanstown
Roland Park
Highlandtown
Upper Falls
Rosodale
Hereford
Woodbrook
Rossville
Lansdowne
Baltimore Highlands
Summerfleld
Middle River
Calvert County—
Sunderland
Caroline County-
Ridsely
FederaJsburg
Cecil County-
Rising Sun, R. D
Elkton, R. D
Elk ton
Charles County—
Ripley
Brentland
LaPlat^
Waldorf, R.D
La Plata, R. D
Bryantown, R. D
Hughesville, R. D
Bryantown
Dorchester County—
Crapo
Reids Grove
Taylors Island
Vienna, R. D
Hurlock
Reids Grove, R. D
Chu rch Creek
Linkwood
Toddvllle
East New Market
Cambridge
Hawk Eye
36
1
6
1
2
1
1
2
1
1
1
1
1
1
1
1
1
1
1
2
1
3
1 i
3 I
1
1
1
1
1
1
1
1 !
1 I
Maryland— Continued.
Frederick County-
Peters ville
Frederick
Brunswick
Union Bridge, R. D
Garrett County—
KitxmiUer
Bloomington
Harford County-
Dublin
Howard County—
Elkridge
Clarks ville, R. D
Marrlottsville
Kent County—
Mlllington :
Montfiomcry County—
Dickorson
Rockville, R. D
Prince Georges County—
Sik.sia
RosaryviUe, R. D
Tuxeao
Laurel. R.D
Scat Pleasant
Quocn Annes County—
Ilayden
Stovensville, R. D
Somerset County—
Princess Anno
Hopewell
Deals Island
West
Crisfield, R. D
St. Marys County—
St. Marys City
Talbot County—
Bcllevuo
St. Michaels
Tilghman
Washington County —
Hagcrstown
Bro\>TisviIlo
Security
Wicomico County-
Pennsylvania General Hospital.
Eden, R.D
Salisbury
Bivalve
Worcester County —
Bishopviile
Snow Hill
Pocomoko City
Pocomoke City, R. D
Berlin, R. D
Total.
New York:
Albany County
Allegany County
Broome County
Cattaraugus County..
Cayuga County
Chautauqua County.
Chemung County.
Clinton County . . .
Columbia County.
Cortland County..
Dutchess County..
173
20
5
1
3
1
5
3
2
4
1
5
Digitized by
Google
1387
August 24, 191*r
TYPHOID FEVER— Continued.
State Reports for Jnly, 1917— Continued.
Place.
Kew York— Continued.
Erie County
Essex County
FoltoQ County
Oenesoe County
Oreene County
Herkimer County . . . .
Jefferson County
Lewis County
LlriQgston County. . .
Ifodiaon County
Monroe County ..... .
Nienre County
Oneida County
ODOodaga County....
Ontarfo County
Oimnge County
Orleans County
Otsego County
R«QSBelaer County . . .
St. Lawrence County
Saratoga County
Schenectady County.
Schoharie County —
Steuben County
Suffolk County
Sollivan County
Tioca County
Ulster County
Wayne County
Westchester County..
New York City
ToUl
Ohio:
Alko County
Ashubula County . . .
Athena Count V
Belmont County
Brown County
Champaign County. .
Clark County
Clermont County . . . .
Clinton County
Columbiana County..
Coihocton County....
Crawfard County
Cayahoga County ... .
]>arke County
Erie County
Fiirflcld County
Fayette Coimty
rtanklin County
Oieene County
Oormsey Cmmty . . - .
Hamilton County....
Hancock County
Hardhi County
Harrison County
Highland County....
Horon County
Jefferson County
Kaox County
Lawrence County. . ..
Licklni County
Locas County
Mahoning County.. . .
Medina County
Miami County.
Montgomery County.
Morrow County
Maiklngum County..
Jtekaway County..,.
^ottaga County
Richland County....
Roes County
gMwJnsky County....
gdoto County........
SoecaCoon^
New cases
reported.
242
Place.
Ohio— Continued.
Shelby County
Stark County
Summit County
Trumbull County
Tuscarawas County
Washington County
Wood County
Wyandot County
Total
FennsylTania:
Allegheny County
Armstrong County/
Beaver County
Bedford County
Berks County
Blair Coun.ty
Bradford County
Bucks County
Butler County
Cambria County
Carbon County
Center County
Chester County
Clarion County
Clcarrjeld County
Columbia Ccninty
Cumberland Coimty
Dauphin County
Delaware County
Elk County
Erie County
Fayette Ccwnty
Franklin County
Greene County
Uuntingdon County
Indiana Countv
JcHerson County
Lackawanna County
Lancaster County
Lawrence County
Lebanon County
Lehigh County
Luzerne County
Lycoming County
Mercer County
Mimin County
Montgomery County
Montour County. . .*
Northampton County
Northumberland County
Perry Ccunty
Philadelphia County
Potter County
Schuylkill County
Somerset County
Venango County
Washington County
Wayne County
Westmoreland County
York County
Total
Wisconsin:
Bayfield County
Dane County
Dunn County
Eau Claire County
Fond du Lac County
Kenosha County
Milwaukee County
Sauk County
Sheboygan County
Washington County
Winnebago County
Wood County
Total
Digitized by
New cases
reported.
165
119
3
2
5
13
24
2
8
1
0
1
1
7
1
3
2
8
7
4
2
2
5
4
5
4
1
6
1
9
3
1
7
3
1
15
3
17
12
7
4
1
36
1
S
13
2
10
1
11
21
22
Google
Ansu8t24,1917 1388
TYPHOID PEVBE— Contiiiued.
City Reports for Week Ended Aug. 4, 1917.
Place.
Akron, Ohio
Allentown, Pa
Alton, D!
Altoona, Pa
Atlantic City, N.J
Austin, Tex
Baltimore, Md
Berkeley, Cal
Birmingham, Ala
Boston, Mass
Braddock, Pa
Bridgeport, Conn
Buflalo.N.Y
CaiTt),Ill
Cambridn. Mass ■
Camden, N.J
Charleston, S. C
Chicago, 111
Cincinnati, Ohio
COffeyville, Kans
Columbia, S.C
Columbus, Ohio
Covington, Ky
Davenport, Iowa
Dayton, Ohio ,
Detroit, Mich
EUiabeth.N.J
El Paso, Tex
Erie, Pa
Evansvillo, Ind
Everett, Mass
Fall River, Mass
Flint, Mich
Fort Wayne, Ind
Fort Worth, Tex
Oreen Bay, wis
Harrisburg, Pa
Hoboken.N.J
Indianapolis. Ind
Jersey nty, N. J
Kansas rily. Mo
Kokomo, Ind
Lancaster, Pa
Lax^rence. Mass \.
Lima, Ohio
Lincoln, Nebr
Little Rock, Ark
Cases.
Deaths.
Place.
Il
Long Beach, Cat
Los Angeles, CaL
Lynchburg, Va
lUnchester, N. H
IfcKeesport, Pa
Memphis, Tenn
MUwaukee.Wis
Minneapolis, Mlmi
Nashville. Tenn
Newark, N.J
New Bedford. Man
Newcastle, Pa
New Orleans. La
NewYork, N. Y
Niagara FaUs, N. Y
Oaiaand,Cal
Oklahoma City, Okla....
Passaic, N.J
Perth Amboy, N. J
Philadelphia. Pa
Pittsburgh, Pa
Portland, Oreg
Portsmouth, va
Providence, R. I
Reading, Pa
Richmond, Va
Roanoke, Va
Rochester, N. Y
Rockford. Ill
St. Joseph. Mo
St. Louis, Mo
Salt Lake City, Utah...
San Francisco, Cal
Sacramento, Cal
Saginaw, Mich
Saratoga Springs, N. Y.,
Savannah, da ,
Seattle, Wash
Springfield, Ohio
Symnise, N. Y
Toledo, Ohio
Topeka, Kans
Trenton, N.J
Wa-ihiriRlon. D. C
Wheeliiij;. W. Va
Wirhita, Kans
Wilmington, Del
Wiu^tou-Salem, N. C...
TYPHUS FEVEB.
New York CHy Report for July, 1917.
During the month of July, 1917, 2 cases of typhus fever were
reportinl in Now York City.
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSia
Sute Reports for July, 1917.
Bute.
Mar\I ind.
New > (irk
Ohio
Casoi rpportc<l.
W- ! Measles.
theria. |
1/2x9 I
317 I
602
vl.
State.
Cases rvportad.
Scarlet
fever. 1
thlffi: M^***-^
BttrW
39
572
Pennsylvania
Wixoiisin
1,8X1
338
m
Digitized by VjOOQIC
1389
Angust 24, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Aug. 4, 1917.
jQiyl.lWO
(e^limaeed
bvU.S.
C*n*i»
Bure*a}»
Tofal
a«atbs
DlphtbCTJn.
Hearts?.
SLWlet
fever.
Tuber-
cuJoals-
aty.
aU
CflU5S9,
1
1
1
i
1
1
j_
J
1
Otbt mm tnhsN lants:
Baltimore Md
589,621
756,476
2,497,722
674,073
571,784
503,812
5,602,841
1,709,518
579,090
757,309
468,558
410,476
306,345
436,535
363,454
408,894
371,747
348.639
363,980
214,878
260,800
271,708
297,847
295,463
251,960
256,417
104,199
181,762
121,579
112,981
106,233
127,224
128,366
104,562
128,291
110,900
100,560
113,215
102.425
148,995
117,0.57
118,158
149,GJ'5
198,604
165,470
109,381
156,687
117,399
105,942
155,624
191,554
111,593
163,314
85,625
63,505
58,659
57,660
69,893
57,653
53,973
67,449
60,734
' *249'
719
2«5
383
*2,'i7i'
677
.271
235
133
128
153
109
"**i69'
147
28
156
60
51
42
81
96
5
41
130
21
38
4
140
31
7
31
13
6
10
7
8
6
10
2
13
1
1
"16
4
3
1
" i"
' "i
38
43
73
8
8
8
169
19
27
8
4
1
9
17
3
25
19
78
179
28
24
44
339
67
13
52
34
31
11
17
2A
Boston Mass
12
74
2
15
1
28
8
3
14
2
1
1
76
Chictgo. 1 11
83
Cleveland. Ohio
13
Detwit.Mich
14
Los Angeles, Cal •
22
NewYork.N.Y
Philadelphia, Pa
195
04
Pittsburgh, Pa
13
St. Louis Mo
13
From 300.000 to 500,000 inhab-
itants:
Buffalo.N. Y
9
Cincinnati Ohio
17
Jersey City, N.J
5
21
3
3
1
1
1
1
2
1
3
4
3
3
'"l
5
Milwaukee Wis
4
Minneapolis. Minn .,,-.,-
Newark.N.J
New Orleans, I->aT
43
37
18
25
5
8
27
Seattle, Wash
1
5
16
5
Washington, D. C
9
From 200,000 to 300,000 inhab-
iUnts:
Columbas, Ohio
1
4
24
4
I>cnver,Colo
i
44
0
*
10
Indianapolis, Ind
7
Kansas City, Mo
'1
7
Portland, Orcg
1
1
13
5
6
I
1
2
1
2
9
2
Providence, R. I
6
15
1
3
1
Rochester,N.Y
From 100,000 to 200,000 Inhab-
itants:
Albany.N. Y
1
10
2
17
4
3
9
6
8
18
RirminfhaTn, Ala
98
68
28
1
1
2
2
1
8
Bridgeport, Conn
" •5I
2
Cambndce .Mass
4
3
Camdcn,N.J
Dayton, Ohio
49
49
19
32
34'
50
19
5
4
1
4
FallRiverMass
1
5
1
4
Fort Worth, Tex
3
Grand Rapids, Mich
Hartford, Conn
1
9
3
3
4
1
1
1
6
2
1
1
8
2
3
5
3
Lawrence.Mass
5
LowcU,Mas8
2
Lyrni, Vfftcs
3
3
Memphis, Tenn
5
Nashville. Tenn
48
55
26'
49
54
87
23
61
50
78
48
67
i8*
1
1
1
I
3
I
4
3
3
New Bedford, Mass
1
1
1
2
1
1
2
1
""i*
3
10
4
1
1
'" i
6
New Haven, Conn
4
Oakland, Cal
3
3
Omaha, Nebr
^1
4
Reading, Pa
2
Richmond. Va
2
6
6
Bait Uke Citv, Utah
Springfield, Mass
1
1
(
3
fiyracuse.N Y
6
3
4
19
......
......
5
1
8
2
5
12
3
Toledo. Ohio
5 ':::'■■
7
Trenton.N. J
3
6
3
3
..:.::..::::::::
3
From 50.000 to 100,000 inhab-
itants:
Akron, Ohio
2
. ..
Allentown, Pa
t
Altoona.Pa
7
1 1
1
2
3
1
7
I
...
AtlanticCity,N.J
1
3
Bayonne.N:^
7'
11
9
26
1
1
1
1
3
1
^^keley,Cal
2
4
•
i
BInghamton, N. Y '.['.[
He;;
Brockton, Mass
1 1
ch«rie8tai,8.c....::::r.;;
1
Digitized by
Googfc
August 24, 1917
1390
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continued.
Citr Reports for Week Ended Aug. 4, 1917— C!oQtmued.
Popula-
tion as of
July 1,1916
(estimated
bv U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria
. Measles.
Scarlet
fever.
Tube-
CUkKil
City.
1
1
1
1
1
1
1
From 60,000 to 100,000 inhabit-
, ants-Continued.
Covin£ton. Kv, ,..^,..,^
67,144
94,495
86,690
63,705
75,195
76,078
54,772
76,183
72,015
77,214
68,529
99,437
50,853
67,343
51,155
78,283
58,221
92,943
71,744
59,411
63,807
55,18.5
60,895
&).<)42
85,236
53,330
C8,sa5
99,519
57,078
87,039
68,946
61, 120
Sl^.'iSO
66,083
77, 9K.
70,722
76, 770
94,265
27,732
34, SU
32,9S.>
32,7.30
27,632
43,425
46, 192
29,319
a4,Gll
26, 074
4S.S11
30 S73
15
16
28
45
24'
i9'
29
40
22
28'
7
20
28
12
39
27
1
1
6
1
8
3
1
2
1
1
1
4
1
2
8
i
T)n|utn, Mint)^ .^. .^^
i
Klixabeth. N.J
El Paso, Tex
Ene Pa
6
11
2
V
Ev^nsvllle, Ind ...r..-
1
1
I
Flint, Mich
1
1
2
Fort wavne. Ind
1 I 3
HarrisbuTK, Pa
1
1
1
2
2
2
21 1
Hoboken, r»f. J
3
1
1
1
7 ; i
Johnstown. Pa ....
2I ..
KAnsas City. Kans
3
Lancaster, "Pa
1
1
2
1 1:..:.:
Little Rock. Ark
Maiden, Mass
2
2
1
3
I
1
2
MftTi'>he«»ter N. Tt
1
Mobile. Ala'
1
1
3
1
Oklahoma City, Okla
Passaic N J
1
8
1
......
Pawtucket R I
Portland Me
6
3
2
2
1
1
Rockford 111
20
28
11
29
19
24
22
Sacramento, Cal.
3
1
3
2
2
1
1
4
1
Sa£lnaw Mich . .
St Joseph Mo
San Diego, Cal
2
3
4
Savannah, Qa
Schenectady, N. Y
2
2
Sioux Citv, Iowa
2
2
1
SomerviUe, Mass
18
22
17
19
17
1
1
1
1
4
3
South Bend, Ind
Springfield, 111
Springfield, Ohio
2
3
Terre Haute, Ind
1
3
Troy, N. Y
1
3
4
5
5
3
Wichita, Kans
2
2
Wilkes-Barre, Pa
31
50
I
20
2
6
9
i9'
23
14
3
5
4
1
Wilmington, Del
From 25,000 to .50,000 inhabitants:
Alameda, Cal
Austin, Tex
1
4
Beliin£ham Wash
Brookline, Mass
2
Butler, Pa
1
2
1
2
■ Butte, Mont
■■'2'
1
1
3
Chelsea, Mass • • * • * * ^ ^ ^
1
4
Chioopoe, Mass
i
3
Columbia S C
1
Cumberland Md
2
1
1
Davennort Iowa
1
2
2
2S, 743
42, m
2H, 203
39. 2.13
3.J,-ISG
41,7.S1
41,8fi3
29,353
48,477
3.5,363
48,RS6
31,576
26,771
31,677
41,097
3,5,3H-4
46,515
27,.5S7
36,9&4
3
6
6
12
2
7
10
9
is'
15
6
10
7
24
16
14
12
1
Eiist Orange, N.J
5
1
1
T"~- 'M
i , . ' " ■ " -
3
KVt'JHt t . ^V Lfcill ,
Fltirhbnnt, Mtki^s
1
1
3
tialr**^U3n, Tt* ,^
2
Grcon Buv, Wis
Iltivi'thSd. Miisj
1
1
2
16
1
1
2
3
1
Jackson, Jlith.
1
K^I&m.a£(H^ Mich
1
2
Kenoshfi, Wis
KlHL^^totl, K. Y
La Ofosdo^ Wjj
1
1
IjCTEiiiRt^i* Ky
8
Umti, uNo
3
1
1
1
1
2
Lincoln* N#br
1
2
1
Lane lieat'h, Cil
LonOD.Ohio..
i
Digitized by
Google
1391
August 24, 1017
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCULOSIS—
Coiitinueil.
City Reports for Week Ended Auf. 4, 1917— Continued.
City.
rrom 2S.0Q0 to 50,000 inhabit-
ants—Continued .
Lynchburg, Va.
Madison, Wis.
McKeesport, Pa
Medlord. Mass
Montdair, .^I. J
Newbur-h. N. Y
Newcastle. Pa
New3»rt, Ky
Kt'wtoTj, Mji.%^.
Nuucivri Fill, N. Y....
IftttttMowu, l^il.
Otan», N. J_.
PtMe^a. Cal ,
Pinh Amh(>>% N. J....
Vl%tc&(^d, Ua.^
PortainoTith, Va
QiTitiry, nL,_,
Qulnty , Mass ,
Tlaiiiic , W is - . . , ,
Koonokf?'. %'a. ,
Roc* tslantl. Ill
Sail Jot* , C't L
eteub^tiviU? . Ohio
Suipwior, Wis.
TkWfltfiTI , M 05.^ ,
TtiTK:ka, Katii
Wall^»Oi. Mits.^
Wciit lIulhjkcri.N.J..
miw>liui:, W. Va
^'vniim^jJOT T . Pa
Wilminctf-ti, S'.C
Popula-
tion as of
July 1,1916
(estimated
bv U. S.
Census
Bureau).
Ttum lu.wAi M> zo,000 inhabit-
ants:
Alton, 111
Berlin.N. H
Bnvddock, Pa
c*»iro.iih ;;,.
' ' ••-'ti^ M'1,S5.. '..
UiU-yvllJc, Kalis
I'ftiureff] , N . n..
(jiJwUuf lU,
WittTison. %'. J., ,
Kcjuny, S'. J.,
U&kattto, Tnd..
Uti^ BniDrh. N. J
lUriiirtt,', Wi^.
Mf ko*, M jiiiS _
^oniito^-n, N. i
Nintieulr, l*A._
Nfwbtipviiof t , Mass
Jpw Lcindon, C*mui
^_^b. \thim, '-^.ss
JvufUumiittmi, Mass
mnn*kl. N^J
i;imikf.liieh,.
TmUtujKiOi.N.H..
li^k} Mi>titit,N^C
RulliUjcj.Vt.,.
SiTidiiaky, oHio
5s*ltllD,lfft..,^:
^i«li]tietcrft, Pa
^obuni,Mass
32,940
30,099
47,521
26,234
26,318
29.G03
41,133
31,927
43,715
37,353
31,401
33,080
46, 4M
41,185
38,629
39,651
36,798
38,136
46,486
43,284
28,926
3K,902
27,445
46,226
36,283
48,726
30,570
43, 139
43,377
?}.S09
2<J,J'92
31,155
30,863
22,874
21*685
15,794
M3,075
17,548
22.669
24, 276
16,950
23,539
20,930
15,395
1 14, 010
17,445
13,2S4
23.126
15,243
20,985
122,019
19,926
23,S05
17,524
11,666
12,067
14,^1
20,193
13,821
15,548
21,618
23,228
15,969
» Population Apr. 16, 1910; no estimate made.
Digitized by
Google
FOREIGN.
EGYPT.
Plague.
During the week ended June 27, 1917, 6 cases of plague with 4
deaths were reported at Alexandria. Of these, 1 case occurred in a
European. In the government of Port Said from April 30 to May 19,
4 cases with 3 deaths were reported and at Port Said, June 25, 1 case
was reported. In the government of Suez, from April 30 to June 2,
23 cases were reported, of which 5 were septicemic, and at the port
of Suez, from June 22 to 28, 34 cases with 21 deaths, 3 of the cases
being pneumonic and 12 septicemic in form.
In the provinces, 2 cases were reported in the Province of Fayoum,
June 26; 1 case was reported in the Province of Galioubeh, June 28;
and in the Province of Minieli, from June 25 to 28, 2 cases were
reported. The total number of cases reported in Egypt from January
1 to June 28, 1917, was 564, with 313 deaths. During the correspond-
ing period of the year 1916, the total number of cases reported was
1,634, with 792 deaths.
GREAT BRITAIN.
Anthrax— Bradford and Vicinity.
Two fatal cases of anthrax have been reported as occurring in
July, 1917, at Bradford, England, and the suburl)an town of Shipley.
The first case, reported July 9, occurred in a workman eng^ed in
sorting gray wool, alpaca, white goat hair, etc. The second case,
occurring at Shipley and reported July 14, was in a workman em-
ployed by a wool-combing finn, the wool handled being a blend of
low mohair, goat hair, and Egyptian and Scotch wool.
Durmg the year ended Octob.T 31, 1916, 19 cases of anthrax were
reported in Bradford and vicmity, and for the 10-year period pre-
ceding the year 1916, 127 cases in Bradford district and 15 cases
m adjoining districts.^
UNION OF SOUTH AFRICA.
Plague — Glengrey District.
Plague was reported August 13, 1917, in Glengrey district, Cape
of Good Hope State, 100 miles inland from Port Elizabeth.
I Public Health Reports, May 4, 1917, p. 675.
(1392) '
Digitized by VjOOQIC
1393 ' Ausust 24. 1017
GHOUBBA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received Daring the Week Ended Aug. 24, 1917.^
GHOLEBA.
Place.
Bate.
Cases.
Deaths.
Remarks.
India:
GUcQtta
June 3-9
32
1
"^j&."'
do
1
PhiUppiDe Islands:
novixioes
1917: Oases, 315; deaths,
Albay
July 1-7
2
66
19
54
7
4
79
1
82
1
1
46
16
38
4
4
54
Bobol
do
Ctoix
do
Cebu.
do
nollo
do
Leyto
do
Nocroe Oriental . .
. ..do
Rl«^l
do....
8orsos<m
....do
39
1
Tayabas
..do
PLAGUE.
^gypt.
Alexandria
Port Said govt .
Port Said..
Provinces—
Fayoum . . .
Gatioubeh . .
Minieh
Suez g07t
Suei
India
Madras Presidency
Siam:
Banked
8trait9 Settlements:
Singapore
Union of South .\frlca:
Cape of Gocd Hope State—
Glengrey district
June 21-27
Apr.3(KMayl9.
June 25
June 26
June 28
June 25-28
Apr. 3(>-June2.
June 22-28
June 3-9..
July 3-23..
June 9-16..
Aug. 13.
Jan. 1-Juna 28, 1917: Cases. 564:
deaths, 313.
June 3-9, 1917: Cases, 2,708;
deaths, 2,101.
Present.
SMALLPOX.
Bradl:
Rio de Janeiro..
China:
Mukden
Shanghai
Alexandria
India:
Madras
Russia:
Petrograd
Siam:
Bankok
Spain:
Valencia
Straits Settlements:
Penang
Uruguay:
Montevideo
July 1-14.,
July 8-14 .
July 2-15.,
July 2-8....
June 3-9.-..
June 3-9...,
June 9-23 ..
July ^14...
June 17-23..
May 1-31...
50
Present.
Among Chinese.
1 From medical officers of the Public Health Service, American consuls, and other sources.
Digitized by
Google
Auffust 24» 1017
1394
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received Daring the Weelc Ended Ang. 24, 1917— Continued.
TYPHUS FEVER.
riace.
Dat«.
Cases.
Deaths.
Remarks.
China:
Antune
July 9-15
2
1
73
12
13
2
1
Tientsin
June 17-23
Egypt:
Alexandria
July 2-8
23
1
Japan:
Nagasaki
July 9-22
Rufisia:
Petrcgrad
June 3-9
Switzerland:
Basel
July 8-14
1
Reports Received from June 30 to Aag. 17, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
ReniArks.
India:
na"isein
Apr. 1-May6
8
303
2
1
3
1
1
16
Calcutta
Apr. 29-June2
Madras
Apr. 22-June2
Mav6-12
2
Mandalay
Moulraein ' Mayl3-Jimo2
Pakokku ' Anr. 29-Mav5
Pegu
Ranpoon
Indo-China:
Provinces
Mav27-Juno2
Apr. 21-June9
30
Feb. 1-28, 1917: Cases, 20; deatbf,
Anam < Fob. 1-28
3
8
8
1
163
1
Cambodia •- -do.. .
6
6
Coch in-China
Tonkin
Saigon
Java:
East Ja\-a
West Java
do
do
Apr. 23-May27....
Apr.2-8
108
Apr. 13-19, 1917: 1 case.
Batavia i Apr. 13-19
1
1
4
1
3
1
Persia:
Mazanderan Province—
Amir Kola
Feb. 3
Barfourouche
Jan. 15-17
Hamxo Kola
Machidossar
Jan 17
Jan. 31
Philippine Islands:
Manila
June 17-23
Provinces
May 20-June30, 1917: Cases,l,W»;
deaths, 673.
Albav
May 20-June 30. . .
June 3-9
113
2
1
368
62
231
14
1
196
7.
76
1
1
251
40
150
5
Ambor> Camarincs
Bat;iug<is
June 17-23... .
Bohol
May 20-June 30. . .
Juno 3-30
Capiz
Cebu
. ...do
Levte
June l«KiO
Rizal
June 21-30
SorsoRon
Juno 3-30
88
7
Tayabas
...do
PLAGUE.
Arabia:
Aden
Bratil:
Bahia
Ceylon:
Colombo
China:
Amoy
Hongkong
Kwangtune Province—
Pa-pu district
May 3- Juno 11.
June 10-30....
Apr.8-Junc9.
Apr.29-May5...
May 13-June9..
Jime2
13
Apr. 8-May 14, 1917: Owes, 69;
deaths, 51.
Present and in yloinity.
Google
Present,
Digitized by
1395
August 24, 1917
CHOLEBA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Oontmued.
Reports ReceiTed from June 30 to Aug. 17, 1917~Oontinued.
PLAGUE--Continued
Place.
Date.
Cases.
Deaths.
Remarks.
ECTOt
Jan. 1-May 17, 1917: Cases, 231;
deaths, 116.
^^:::::::::::::::::::::::
If^y 12-17
4
12
2
6
1
2
1
Prov'izioes —
F^Toum ...
May 11-17
Oireeh
May 17
Minfeh
May 13-15
2
3
2
Siout
Iffty12
GrcBt Britaixu
London
May3-«
2 in hospital at port. From s. s.
Sardinia from Australian and
orientalports.
Apr. 15-Juno 2, 1917: Cases,
38,250; deaths, 26,092.
Indk
Bassein
Apr. 1-June 2
42
326
38
33
• 411
203
9
59
1
2
134
2
Bombay
Apr.22-June 16...
Apr.2»-June2
406
Calcutta
Hfltii*4o . . ...
Apr. 1-May 19
Karachi .....
Apr.22-June9
Apr.22-Junel6...
Apr.8-Mayl2. . .
467
247
Madras Presidency
MandAlay
Moalmeiii
Apr. 1-June 2
Mying3raii .
Apr. 1-7
May 27-June 2
Apr.l5^une9....
Apr.*-14
143
Toungoo
Indo-ChmaT
Provinces
Feb. 1-28, 1917: Cases, 101: deaths,
71.
Anam^, ,,,
Feb. 1-28
31
57
13
47
15
47
9
26
Cambodia
do
Cochin-Chlna
do
Saigon
Apr.23-June3....
Java:
East Java
Apr. 2-22, 1917: Cases, 18; deaths,
Surabajra
Apr. 2-22
13
5
13
5
Surakarta
do
Peru
May 1&-31, 1917: Cases, 15.
At Mollcndo.
Departments—
Arequipa
May 16-31
4
1
2
7
1
12
1
1
1
CaUao
do
At Callao.
Lambayvque
do
At Chiclayo.
At Salaverry, San Pedro, and
Trujillo.
At Lima.
Libertad
do
Lima
do
Slam:
Bangkok
Apr. 22-Junol....
June 3-9
11
Btiaits Settlements:
Union of South Africa:
Cape of Good Hope Stat©—
Tarka district
May 28
1
At Sununerhill Farm.
Quoenstown
Juno 6
Orange Free State
Apr. 16-22, 1917: 1 case; Apr. 9-22,
1917: Cases, 26; deaths, 17.
Winburg district
May 28
1
SMALLPOX.
Australia:
New South Wales
Apr. 27-June 21, 1917: Cases, 20.
Brewarrlna
Apr. 27-June 21 . . .
May25-June7
Apr. 27-June 21...
May 9
6
12
2
1
4
126
1
3
Coonabarabran
Quambone
Queensland-
Thursday Island Quar-
From s. s. St. Albans from Kobe
antine Station.
BradI:
Bahia
May6-June30....
do
via Hongkong. Vessel pro-
ceeded to Townsvllle, Bris-
bane, and Sydney, in quaran-
tine.
^ RiodeJaneiro
31
Ctaada:
Manitoba—
WinnipAg ^
June 10-16
Nova Scotia—
Halifax... .
June 18-July 7
June 17-30
Port Hawkesbury
Present In dlstriclv^ t
gitized by
Coogle
I
August 24, 1917
1396
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVElt-
Ck>ntinued.
Reports Received from June 30 (o Aa^. 17, 1917— Continued.
SMAIJLPOZ-<>mtinued.
Place.
Date.
Cases.
Deaths.
Remarks.
Ceylon:
Colombo
China:
Amoy
Antung
Chungking
Changsha
Dairen
Harbin
Hongkong
Manchuria Station .
Mukden
Shanghai
Tientsin
Tsitshar Station
Tsingtao
Egypt:
Ak
Alexandria
France:
Paris ,
Germany
Berlin
Bremen ,
Cliarlottenburg
Hamburg ,
Leipzig ,
Ltlbcck
Munich
Stuttgart ,
Indii:
Bombay
Calcutta
Karachi
Madras
Rangoon ,
Indo-China:
Provinces ,
Anam
Cambodia ,
Cochln-China
Tonkin ,
Saigon ,
Italy:
Turin
Japan:
Kobe ,
Nagasaki ,
Osaka ,
Yokohama ,
Java:
East Java
Mid-Java ,
West Java
Batavia ,
Mexico:
Mazatlan
Mexico City ,
Monterey
Vera Cruz
Philippine Islands:
Manila
Portugal:
Lisbon
Portuguese East Africa:
Loureuco Marquez . .
Russia:
Archangel
Petrograd ,
Riga
Vladivostok
Spain:
Madrid ,
SeviUe
Valencia
Straits Settlements:
Penane
May 6-12..
Apr.
May
May
May
May
Apr.
May
Apr.
May
May
May
May
29-May26..
21-June24..
6-June23..,
27-June2..
13-June30..
23-May6...,
&-Junel6...
23-29
27-June2...
21-JulyL..
13-June9...
16-22
22-July7...
Apr.30-JulyL
May 6-12
Mar. IS- Apr. 28.
....do.....
....do
....do
....do
....do
....do
....do
Apr. 22-Jime 16.
Apr. 29-May 26..
Apr. 22-June9..
Apr. 22-Junel6.
Apr. 15-Junc9..
Feb. 1-28
....do
...-do ,
....do
Apr.27-June 10.,
May21-June24.,
May 27- July 8...
May 2S-June3..
May IG-July 5..,
May 27-July 1..
Apr. 2-29..
Apr. 1-21..
Apr. 13-May3.
July 11-17..
Juno 3-30...
June 1*^24..
July 1-7....
May 13- June 9..
May 13-Junc30.
Mar. 1-Apr. 30..
May 1 -June 28..
Feb. IS- June 2..
Mar. Il-June2..
Mar. 15-21
May 1-June 19.
May 1-31
June 3- July 7. .
Mar.l8-Mayl2..
39
106
16
18
50
20
2
10
1
149
297
36
193
67
199
32
56
1
177
1
11
IG
162
"i
6
14
23
Present and in vidnity.
Present.
On Chinese Eastern Ry.
Do.
Present.
Cases foreign; deaths among na^
tlvcs.
On Chinese Eastern Ry.
At another station on raflway,
lease.
Mar. Ifi-Apr. 28. 1917: Cases, 715
in cities and 32 States and dis-
tricU.
Feb. 1-28, 1917: Cases, 593; deaths.
62.
Apr. 13-May 10, 1917: Cases,
deaths, 7.
Varioloid.
Jan. l-Mar.3l, 1917: Cases, 9.
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1397
August 24, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received flrom June 30 to Aag. 17, 1917— Continued.
SBIALLPOZ— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Sweden:
Apr. 23-28
1
2
2
Stockholm
May 20- June 23...
June 2-8
1
Tunisia:
Tunis
Turkey in Asia:
Trebizood
Feb. 2S-Apr. 13...
15
Unioo of South Atrica:
Johannesburg
Mar. 12-24
4
Veneracla:
Maracaibo
June 18-July 8
8
Mexico:
Yxicatan. State—
Peto
TYPHUS FEVEB.
Algeria:
Algiers
June 1-30
6
3
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 1916: Cases, 2,371.
Rnh^mia . . ,
Oct.22-Doc.l7....
do
634
809
47
617
16
243
5
Galicla
Lower Austria
do..
Moravia
do
SOesia
do
Styrla
do
Upper Austria
do
HuMarr
Feb. 19-Kar. 25, 1917: Cases, 1,381.
BudaDest
Feb. lfr-Mar.25...
June 25- July 1
June 9-16
83
3
1
4
1,648
China: ^^
Antung
Hankow
Tsingtao
May30-July7
Apr.30-Julyl
June 17-23
Alexandria
478
1
32
Great Britain:
Cork
Greece:
Saloniki
May 13- Juno 30. .
Jspan:
Nagasaki
June 11-24
Apr. 1-30
4
7
JtTa:
Mid-Java
2
West Java
Apr. 13-May 10, 1917: Cases, 86.
Bata\ia
Apr. 13-MaylO....
June 3-30
22
431
3
1
4
113
2
5
Mexico:
. MexicoCity
Nethwlands: ^
^ Rotterdam
June 9-23
2
Portuguese East Africa:
_ Lourenco Marques
Mar.1-31
Bussia: *"^ ««
Archangel
Mav l-June2S
Feb. 1^ June 2....
.May G -June 2
Mar. 2i^Iay2l....
May 1-31,
Petrograd
3
Riga .
Jan 1-31. 1917- 1 case
Vladivostok
Spain:
Almeria
5
2
Madrid
do
Switzerland-
. Basel
June 17-23
Juno 4-9.. .
1
2
Trinidad
Tumsia:
Tunis.
June 30-Julv 6
1
YELLOW FEYEB.
In person re?ently arrived from
Mexico City.
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PUBLIC HEALTH REPORTS
VOL.32 AUGUST 31, 1917 No. 35
POUOMYELinS IN CHOSEN (KOREA).
The following information in regard to the prevalence of polio-
myelitis in Chosen (Korea) was received from the American consul
general at Seonl, under date of May 26, 1917.
No definite history of epidemic poUomyelitis in Chosen is available.
Reports from physicians resident in five localities for periods of from
5 to 21 years indicate that no acute case of the disease occurred in
their practice. Cases of poUomyelitis have been reported by Provinces
as follows:
Heian Nando. — ^Three cases examined at hospital and one case
examined by the pubUo physician in Shukusen district.
Emkyo HoJcudo. — One case treated in hospital in February, 1915.
KanJcyo Nando. — ^Two cases occurring in persons 11 and 39 years
old, respectively. Both cases were treated in hospital, 1 in 1915
and 1 in 1916.
Keikido. — ^Twenty-two cases have been reported, of which 2 were
treated, in 1915, 6 in 1916, and 2 in 1917 to date of report (May 26,
1917). These cases were treated in the Government hospital and at
other points in Seoul. The remaining 12 cases were reported at
Songdo, the former capital of Chosen, 25 miles distant from Seoul.
The patients were for the most part between the ages of I and 5
years. The character of the disease was light.
Keisho HoJcudo. — Number of cases reported, 17, occurring in persons
between the ages of 2 and 22 years. Paralysis of lower hmbs was
present.
Keisho Nando. — Seven cases reported, of which 4 were treated in
1916 and 3 in 1917. No special area of prevalence in the Province
was indicated.
Kofjendo. — Three cases reported in Kanjo district.
Zenra Nando. — ^Thi*ee cases present at date of report, the ages of
the patients being between 2 and 5 years. Paralysis of the lower
limbs was noted.
101 (1399)
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August 81, 1917 1400
THE MALARU PARASITE IN THE MOSQUITO.
THE EFFECTS OF LOW TEMPERATURE AND OTHER FACTORS ON ITS DEVELOPMENT.
By M. Bruin Mitzm am, Teelmical Assistant, United States Public Health Serrioe.
In accounting for the geographic distribution of malarial fever
early investigators realized that temperature was an important
factor. Following the incrimination of the mosquito as the carrier
of malarial parasites, writers on the epidemiology of the disease were
of the opinion that thermic conditions were in part responsible for
the infection. The influence of temperature on the developmental
cycle of the malarial parasites was fully recognized by the Italian
workers, an<l their first experiments to establish the insect r6le took
this important correlation into consideration.
HIstorieaL
BastianoUi and Bignami (1899)* in experiments with 50 s[>ecimens
of Anopheles maculiperwiis and Plasmodium falciparum attempted to
transmit the infection at alow room temperature, 18° to 22° C. Dur-
ing a period of 20 days these mosquitoes when dissected showed only
forms of early development. When they were removed to a teiinpera-
ture of 30° C. lor two days or more, however, sporozoites developed.
''Evidently at a temperature of 18° to 22° C. the life cycle of tiie
parasite {Plasmodium falciparum) is completed very slowly.''
Marchiafava and Bignami (1900) ^ noticed that the temperature
exerted a certain influence upon the time necessary for the completion
of the cycle. At a temperature of 20° to 22° C. the development was
foimd to be much slower in estivo-autiunnal malaria and it appeared
from their observations that development did not occur at all at 14**
to 15° C.
Giles (1902) ' pyrites relative to geographic distribution, *' Itis a long-
established fact that the northern limit of malaria corresponds
roughly with tlie summer maximmn isotlierm of 76° F., or, according
to Ilirsch, to a mean summer temperature of 15° to 16° C. (60° F.),
\^hich is much the same thing. Recent Itahan researches show that
the dovelopmeut of the hirmosporidia witliin the mosquito can not
take place at a lower temperature than 20^ C. (GS^ F.), or at a higher
temperature than 30^ (\ (SO^ F.), and in the existence of this upper
limit we find an explmiution of ilie fact that tlie hot dry weather in
northern liuha. vl)ei\^ for inoiUbs t()<:ollau- the temperature falls
1 )?:iyliHnolli. (r. wrA l>!„':'?.n i, A. ( 1< ''t\ S- il )svil'!|)yH)<l"i [>.irasitod«>Ii' tpr/,\ii;i noli' Ari'^f^trU^ clqHyir.
Hull. d. U. Acc;..l. Mt-U. .1. K.>,. -i, .\r/ > z'j t-^>\: o, A}>r. I'.i. ^uoiod from < rai;;. Iho niaUrial iexta.
\^f\ Win. A\ ood <V Co', > .■•,< > )iv, j) k^
'■ M>irilii;ifav.i. V. . and W :iii..i, A. ( I.. );. Mai iria. Twtn'iptli couti ry pnuli(t». Wm. Wood d- Co.,
New ^'(irT<, j). >^*^.
"(/ilcs, <;. M. fl"'L«. \- K tii'iijjok oj the f:uuis or moi'iuitoes. Kciond cdiiiun. Jolm Balei Sons &
DanieUson, I^otido'i, j.p. 1 4 It/J.
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1401 Angust 81. 1917
rarely as low as this, is, in spite of the unbearable heat, by far the
healthiest season of the year, and during it, primary cases of malaria
are practically imknown.'*
Braun (1906)* states that the development of the sporonts in mos-
quitoes is dependent on the atmospheric temperature and the species
of parasite; that the Plasmodium of the malignant tertian completes
its development within eight days at a temperature of 28*^ to 30° C;
below 18** C. the development ceases.
Stephens (1908)^ quotes Grassi by stating that the sporogonic
developmental cycle requires, in the case of the malignant tertian
parasite, an optimiun temperature of about 27° C. and ceases at such
lower temperatures as 15.5° to 17.5° C. In the case of the simple
tertian, however, provided a suitable initial temperature has been
maintained, development will still go on at temperatures as low as 12°
or 9° C. But the appearance of sporozoites is then delayed for 21
days. Further, the lowest temperature at which the simple tertian
parasite will develop in the mosquito is 20° to 22° C. and in the case
of the quartan parasite, 16.5° C.
Craig (1909) ' writes: '*Wo know that the malarial plasmodia will
undergo development oxdy in stomachs of mosquitoes hving under
proper conditions as regards temperature, it having been proved by
Jansco that the oocysts develop best at a temperature of between 20°
and 30° C, while if the temperatiffe be lower than 16° C. the organ-
isms perish."
Ross (1910) * in accounting for the number of ingested sexual para-
sites which reach maturity and develop protospores (sporozoites)
asserts that it depends among other things upon temperature. He
agrees with Jansco, who finds that the zygotes develop best at 24° to
30° C, temperatures above and below these hmits retarding the
process; and that they die if the mosquito is kept constantly below
16° C. after feeding. On the other hand, Ross finds that they often
continue to grow if the mosquito carrier is subjected merely to an
intermittent low temperature.
Howard, Dyar, and Knab (1912) * discussing the incubation
period of the sporogonic cycle as influenced by temperature, state
that the most favorable temperature Ues between 22° and 28° C.
and beyond these conditions the development of the parasite goes
forward more slowly, ''and there are observations which show a
period of more than 50 days.^'
I Bzami, M. (1906). The animal parasites of man. Third edition. Balo Sons St Daniolsson, London, p. 98.
« Stephens, I. W. W. (1908). Malaria In its relation to the mosquito. Nothnagel's Eueycl jpedia of Prac-
Ueil liodidne. I^ainnders Co., Philadelphia and London, pp. 129-130.
•Craig, C. F. (1909). The malarial fevers. Wm, Wood & Co., Now York, p. 109.
< Rob, R. ( 1910). The prevention of malaria. John Murray, London , pp. «7-S 8.
»Howard,L.O.,Dyar,H. G., and Knab, F. (1912). The mosquitoes of North and C^sntral America. T^
Ovnegie Institution of Washington, Vol. I, p. 194.
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A»ia8t81,1017 1402
Castellani and Chahners (1913) ^ write that the results of experi-
ments tend to show that temperature has most effect upon the ookbete
before it pierces the wall of the stomach of the mosquito and becomfis
encysted; and that it would appear that if the temperature is below
15° to 16° C. no further development of the oocyst will take place in
any form.
Hindle (1914) ' writes, '*At lower temperatures the development k
very much prolonged, and cojisequently the mosquito does not be-
come infective imtil after a much longer incubation period."
Walker and Barber (1914)^ in the Phihppines found that during
the warm season Anopheles could be infected with sporozoites of
P. falciparum in 12 dayB, while in the cool season sporozoites ap-
peared to require from 13 to 15 days to develop.
Grassi * was probably the first among the early investigators <rf
the etiologjvof malaria to appfreciate the correlation of the influence
of temperature on the development of the exogenous cycle with the
seasonal variation of endemic malaria. The epidemiological signifi-
cance of temperature relations was brought early to his notice when
he attempted unsuccessfully to produce infection in mosquito6s4ield
at 14° to 15° C. in the firat hours after biting. Infection resulted
imder the same conditions at a tetnperature of 20° to 22° C. Follow-
ing the extension of these observations, in a series of carefully con-
trolled experiments, Grassi came to the following conclusions:
If The development of the tertian and subtertian parasites can
not be produced at temperatures varying from 15.5° to 17.5° C, but
after the development of the parasites in the insect's midgut has
begun, the temperature can without jeopardy be lowered to 9° to
11° C.
2. The tertian parasite in tho Anopheles will develop at a tempera-
ture at which subtertian crescents will not develop.
3. The important epidemiological factor of the effect of low tem-
perature during the first hours after biting is ascribed to the fact
that oxflagellation and fertilization are not produced at these low
temperatures. After these phenomena take place and the ookinete
is formed mature development ensues, even in the presence of low
temperatuies.
4. The minimum temperature for exflagellation of crescents was
cstabhslied at 17*^ C, aUliough at this temperature exflagellation is
by no"*mcans frcciiient. At 18° to 20° C. exflagellation is certain.
1 CustoUani, A., and Chaimcis, A. J. (,1913). Manual of tropical medicine. Wm. Wood & Ca, New
York, p. hiio.
Ulindlo, E. (1914). Flirs and disease. The blood sucking flics. Cambridge University Press, Caoh
bridge, Englaud.
2 Waikcr, K. h., and Barl cr, M. A. (1911). Malaria in the rhilippines. The Philippine Journal of
Science, Vol. IX, No. 5, soc. H., S«:]aenii>or, iyl4.
* Cuussi.i, B. (1901). l)ic malaria. Stud ion cincs zoologen. Jena. Quoted from Jansco.
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1403
August 81. 1917
5. The minimum temperatures for development of the various
sporogonic types r*^ parasites were established as 16.5*^ for quartan,
17.5° for tertian, and IS** C. for subtertian.
These findings of Grassi have been confirmed by the several authors
whose work is detailed in the table presented later.
Jansco (1904)* repeated the experiments of Grassi and coworkers
with essentially different results. Grassi's conclusion that tem-
peratures under 16° C. during the first hours after biting prevent the
formation of oocysts on account of the inhibited fertilization of
macrogametes is held as imtenable by Jansco. The latter's experi-
ments indicated that fertilization occurred even imder 16.0° C, not
under artificial conditions on a glass slide, but in the stomach of the
anopheline where the blood is supposed not to cool so quickly.
Experiments showed that Anopheles became infected with tertian
and subtertian gametes when kept from the moment of biting for 24
hours at a t«mperatiu*e of 11° to 13° C. and then exposed to a tem-
perature between 20° to 30° C. However, when maintained at the
original low temperature, infection did not result. Jansco concluded
that greater importance should be attached to that stage in which
the blood is already digested and the ookinetes are in the act of
penetrating the gut epithelium than to the first hoiu^ after biting.
The essential principle in the difference in results obtained by
Jansco and.. Grassi may be ascribed to their interpretation of the
eriticdl temperature involved. Grassi holds the critical temperature
to be that immediately after biting — the temperature favoring fer-
tilization; Jansco establishes the critical temperature as that favoring
penetration of the ookinete preliminary to cyst formation.
The following table summarizes the experiments of these investi-
gatore:
Table No. 1. — Details of experiments of various authors relative to low temperature and
development in the mosquito.
Author.
Ex-
peri-
ment
No.
Type of
malaria.
Initial
temperature.
Time held.
Second
tempera-
ture.
Time held.
Results.
Grassi
1
2
3
4
6
Tertian.
Subtertian
with A.
claviger.
Tertian.
Subter-
tian.
Quartan
Subtertian..
Tertian
Quartan
•c.
15.^17.5....
Sufficient for
ookinete
formation.
do
18 and above
17.5 and
above.
16.5 and
above.
Immediately
after bit-
ing.
After foki-
pete forma
tion.
do
Immediately
after biting
do
•c.
Nodevelop-
mtnt.
Developed nor-
mally.
Do.
Full develop,
ment.
Do.
n.9
16.5
Indefinite.
...do
do
Do.
^}usco,N. (1904). Zur Frage der Infection der Anophdt* claviger mit Malariaporasiten bei niederef
^mpwto'r. CentralbL f. Bi*t Vol. XXXVI, p. «24. ^ I
Digitized by VjOOQIC
August SI, 1917
1404
Table No. 1. — DetaiU of expenmenU of various authors relative to low temperatwend
development in the wioa^tto— Continued.
Author
V.x-
reri-
mjnt
No.
Type of
malaria.
Initial
temperature,
TimehekL
Second
tempera-
ture.
Time held.
Remits.
Van der Scheer
1
2
1
2
3
1
2
3
Tertian
do
Subtertian..
do
do
Tertian
do
do
•c,
14.5-16.5
do
•c.
Negative.
4 oat of 5 be-
and Van Ber-
lekom.
18-21.5
do
Martirono
17 and below
18
do
Several
hours.
25-30 min-
utes.
20-30 min-
utes.
12 days....
18 days....
10 days
came inieetr
©d.
Negative.
do
Development
18-20
do
observed.
C r es cents
Schoo
15
do
(changed to
round bod-
ies).
Negative.
18..
.do ...
Oocysts mi-
Sufliclentfor
oocyst for-
mation.
...do
ture.
Do.
Table No. 1A. — Details of temperature experiments of Jansco.
Ex-
peri-
ment
No.
maErto.
Ini-
tial
tem-
pera-
ture.
Time
held.
Sec-
ond
tem-
pera-
ture.,
Time
held.
Third
tem-
pera-
ture.
Time
held.
Results.
1
2
3
4
5
Subtertian.
Subtertian
with A.
daviger.
do
do
do
do
do
do
do
do
do
do
do
do
81-
31
30
30
11
11-1.3
:«)
13
30
1.3
.3v3
c an
21
30rain
30min
30min
30min
^ ho;irs
lUd.i vs
13
13
11
11
30
7 hours..
22 hours.
6 hours..
8 hours..
10 days. .
30
24
30
30
4 days 16i
hours.
6 days 21 J
hours.
5 days 17i
hours.
5 days 15i
hours.
2 of 4 raosquitoes'with oocyst,
size 17 m.
2 of 6 mosquitoes with woDft-
003 ooc^^ts 6-8 M ^ size.
4 of 10m(»qultoes with oocysts
22-28 M.
1 of G mosquitoes found in-
fected.
1 w ith oor v'sts to size of 44 ih
(5
Noqc infprtod (13 used).
8 of 12 infociod.
7
10 diVs
8
2 hoars
4 (la vs
22'
4 days
1 of 5 infw^ted with oocj-sts
9
6-9 M.
1 of 8 Infected.
10
11
22 hrs .
2 days.
!■' d l''^
22
8
21 hours.
5da5-s...
»22
30
9 da>-s 14
hoiirs.
5 days
2 of 4 mosquitoes infected— 1
with 1 ooc\3t (sporoblast), 1
with 12 orx'-ysts, siie ^)t^-
.r— al: ne-^ative.
.3 of 7 inf tufted
13
14
1 duy.^.
8
4 days...
20
38
3 days
5 days
1 witii 1iV5() oocysts 7-9/1 in siM.
Several infected \<\V\ oocysts
15
Tcrliui witli
A.ciV I'JCT.
do '
<lo
do
11
13
22 hrs.
■I d.rs
21
22
5 days. . .
i;]> (0 11 p in ii-o: son)©
ookint'lo found iL.o!'.:npod.
Tl.o MTiK'f i;>'.> <.vVna' used
1*)
lOdavs .
fo 111 I with G oDcvsli 7 jt in
7 r.«-Mi i\T».
j7
20
ltd' V
•) ( .LI'. C
IS
1 i d.l "si '
2i) o ii of 40 infeoted.
•■ 1 1
1 After iK.Mim^ 12 hours at 10°.
2 After Loldiug 3 days at 2(»*.
In analyzing: the H'-^uUs of leinperatiire oxperimontSj it is apparent
that no cou'iiizimcc is tak'^n of the lack of sporozoite development
either in oocysts or in glanfl cells at low temperatures. This may be
Digitized by
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1405 August 31. 191f
due to the fact that the infected mosquitoes have not been kept ahve
long enough to pennit the development of mature forms, or the
workers may have assiuned that the presence of oocysts up to the
development of sporoblasts was sufficient evidence of the infcctibility
of the mosquito.
In this connection, the epidemiological appUcation of the ex-
periments of Jansco and Grassi is open to question, as the exposure
of anopheline mosquitoes to a change of temperature of 8 to 22° C.
immediately after engorgement could not be expected to occur under
natural conditions.
The writer has attempted to extend the low temperature experi-
ments of previous writers in order to determine what changes occur
in the malarial parasite within the body of the mosquito during the
period of hibernation under natural conditions. Mosquitoes were
kept at living room temperature during 10 to 13 days following the
initial gametocyte bearing blood meal. They were then subjected
gradually to outdoor winter temperature (New Orleans) in a large
cage protected from wind and rain. They were removed from time
to time in order to permit them to obtain a blood meal from rabbits
kept for this purpose.
The specimens were laboratory-bred anophelines kept individually
in commoaious lantern chimneys fastened at both ends with bobinet
held by tape and rubber bands. Moisture was provided in the {;auze
pad in a tray in which four of the cages were placed on end and
raisins were placed on the upper ends during the intervals of blood
feeding. As many as three bites were taken by each mosquito
when applied to the patient and subsequently a rabbit was employ^^d
to supply blood to increase the longevity of the mosquitoes. It
was observed that blood was taken more readily when the raisin
diet was withheld.
A ^adual adaptation to low temperature was attempted by the
following precautions:
The mosquitoes after biting were kept in the room with the patient
for several houre, then transferred to a living room for the period
stated during wliich time the temperature was maintained at 20° to
26° C. At this itime the outdoor temperature being much lower, i he
specimens were retained for several days in the low-temperatuic
incubator regulated through the use of ice and electricity, at 15° to
18° C. Then the outdoor cage was used; the temperature being
recorded as shown in table No. 2.
The following table represent*^ the temperature and humidity to
which the mosquitoes were exposed in the outdoor cage dui-ing tho
period of the experiment, November 1 to January- 11.
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Aotost 81, 1»17
1406
Table No. 2. — Record ofdaiiif lemperm^ures and avenge relalive hvmidiijf Now. 1, 29il,
to Jan. 15, 1917.
November.
December.
Jaanary.
Pate.
Maxi-
mum.
Mini-
mum.
»C.
19
17.5
18
IQ
19
17
19.5
20.5
19
18
18
19.5
21
6
3
4
7
ie.5
10.5
13
16
17.5
13
10.5
7
7
13
IG
15.6
15
Mean.
•c.
23
23
23
23
23
22
24
25
23.5
20.5
23
24
25
14.5
7
8.5
13.5
14
16.5
18
21
22.5
16.5
14.5
10.5
15.5
21
19.5
18
Hu-
mid-
ity.
Maxi.
mum.
Mini-
mum.
Mean.
Hu-
mid-
ity.
Mazi-
tntiTti-
Mtai-Mean.
muHL^^^
mid.
tty.
1
•c.
27
28.5
28
2S.5
28
27
2S
29.5
28 .
21
27
28.5
28.5
22.5
12
13.5
20.5
18
22
25
27
27.5
19.5
17.5
15
17
19
27
25
21
64.5
48
54.5
76
84.5
91.5
89
89
88.5
84.5
85.5
95
93.5
77
52
55.5
75
56
78
83
86
87
72.5
61.5
64
72.5
87
93
95.5
84,
•c.
21
23
24
28
27
26.5
26
25
11.5
15.5
16
11.5
16.5
22.5
10.5
17
19.6
20.5
15.5
2S'.5
24
10.5
17
22.5
22
26.5
27
24.5
20.5
20.5
19.5
•c.
9.6
10.6
15
19
19
18
19.6
9
6
6.5
9
3
7
Id. 5
2.5
5
11.6
6.6
i
16
6
2.5
5
13
15.5
19
23.6
20.5
17
15
16.5
•c.
15.5
16.5
19.5
23.5
23
22
23
17
8
10.6
13
7
12
16.5
6.5
10.5
15.5
13
9.5
22
15.5
6.5
10.5
17.5
18
23
25
22.5
18
17.6
18 1
70
80.5
84.5
84.5
87.5
96.5
95.5
88.5
63
79
75.5
63.5
74
8.5.5
75.5
67.5
97
71
83
91.5
89
71.5
93
97
99.5
94.5
94.ir
96.6
87
•97
•c.
35
27
28
29
20
17
1H.5
22
25.6
27
13
18
24
11
11
•c.
18
10
».5
21
17
11
12
13.5
16.5
21
9
7.5
16.5
3.5
7
•c.
21.5
18.5
24-2
25
18.5
14
15.2
17.2
21
24
11
13.2
20.2
7.2
9
m
2
M7
3
7S
4
n
5
MS
6
51
7
587
8:
59
9
7R
10
ffl
11
42.7
12
Ma
13
m
14
MS
15
fits
16 ^
17
18
>
19
20
21 ... t
*
g:::::::::::::::::::::::::^
24.:::::::::::..::.:::::::..
25
26
27 .<
28
29
30
31
_
Monthly averages
24
14.5
18.5 j 77.6
20.6
11.5
16
84.7
21
14.9
17.3
30.6
In order to detormine the effect of transferring to much higher
temperatures, at the close of the experiment 8 specimens were removed
from the outride cage and placed in the room incubator, which, during
the two weeks of the test, registered 20"^ to 32° C, with a mean tem-
perature of 24. p° C. The mosquitoes wore dissected at intervals with
the following results: Two of the 8 specimens were found infected.
One of the infected moscjuitoes was found with 2 empty oocysts
shrunken and ruptured and containing only gianules of residual proto-
plasm. The glands proved negative. The infection of the other
specimen was represented by empty oocyst capsules, apparently fuM
sized-, devoid of contents except for a few sporoblast-Uke bodies in
one -oocyst. The glands were not inf<>cted in this specimen.
;Tho results of su])jecting mosquitoes to low temperatures after
feediilg are dctailcd^in the foUowmg table:
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1407
Tablb No. 3.
▲ogostSLloir
Spni-
meoNa
Nam.
berof
bUes.
Dale of
disseo.
Uoo.
meot.
Result.
Speoi.
men No.
Num-
ber of
bites.
Date of
dissec-
tion.
velop-
meot.
Result.
1
2
2
2
2
2
S
2
3
8
3
9
3
3
2
t
Nov. 15
Nov. 17
...dQ
Nov. 18
...da....
...do
Nov. 19
Nov. 20
...da....
Nov. 22
...do
...do
Nov. 23
Nov. 25
...da....
Nov. 28
Nov. 29
Dec. 1
Dec. 2
Dec. 3
...do
...do
Dec. 4
...do.....
Deo. 5
Dec. 8
...do.....J
13
15
15
15
18
1«
17
18
20
10
5
20
23
8
25
26
27
29
30
31
31
33
32
32
33
35
36
Positive.
Negative.
Da
Positive.
Negative.
Da
Positive.
Negative.
Positive.
Negative.
Da
Do.
Da
Do.
Positive.
Negative.
Do.
Do.
Da
Positive.
Do.
Da
Negative.
Do.
Da
Do.
Da
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48.
49
50
61
52
53
54
3
2
Dec. 9
Dec. 10
Dec. 12
...do
Dec. 14
Dec. 17
Dec. 21
Dec. 22
Deo. 24
...do
Dec. 25
Dec. 26
Dec. 28
Dec. 29
Dec. 30
Dec. 31
Jan. 1
...da....
Jan. 3
Jan. 4
...do
...do
Jan. 5
Jan. 11
...do
...do
...da....
30
88
40
40
35
46
34
52
53
37
53
47
41
57
58
44
59
45
47
48
62
48
49
70
69
70
70
Negative.
Do.
2
3
Da
4
Do.
f
Do
6
Do
7
Da
1
Do
9
Po
10
11
12
13
14
U
It
17
18
19
30
31
»
n,
21
31.
28
27
Positive,
Do.
Nc«ative.
Positive.
Negative.
Da
Positive.
Negative.
Positive.
Negative.
Da
Positive.
Negatiye.
Do.
Da
Da
Da
A total of 15 infections resulted among 54 specimens of AnopThdes
functipennis fed 10 to 70 days previoiisly on blood containing many
subtertian gametocytes. The resulting infections are described in the
following table:
Table No. 4.
Date of
dissc^
tlon.
Day«or
develop-
ment.
Stage of development.
Not. 15
Nov. 18
Nov. 19
Not. 30
Nov. 25
Dec. 3
Do..
Da.
Dec.* 24
Dec 25
Dee. 26
Dee. 29
1017.
Jan. 1
Jen. 3
48
8 oocysts without protoplasmic differentiation, size approximately 25|< to 2^.
Approximately 250 oocysts in all stages preceding the sporobiJastic.
8 oocysts, 2 of which still rotoining pigment, remainder graaular without spdroblasts.
Approximately 200 oocysts in all stages up to sporoblostic.
143 oocysts, site 2o/i to 40;* mostly with miliriai pigment, few with sporoblasts.
About 120 oocysts, half of them "retaining pigment, only one vith sporoblasts.
Approximately 250 oocysts, of which .'jO wore t]uile small (15p to20^), vith malarial
pigment , remainder various sizes but more raaturwl. Few with sporoblasts.
3<> oocysts m varioua stages, a few with immilure sporoblasts.
One oocyst represented by shrunken capsule witliout contents, oocyst apparently full
V sized and nrniH- attachecj to gat wall.
5 00C5-Nt8~4 with contents expelled. I with spnroblast development barely com-
meming (only 1 soirment.s dist*a-nil»le). Kem.ander of body of oocyst undllTeren-
llated aii<i granular, t^ite .iOn by a:V-
3 0'>?\sts witli (oTients ruptured, all torn from ijut^wull d'lfinT dissection. No evi-
derice of rpoio oiles in moiintin-: lijuid surrounding the piU wall or in the ^^laii.ds.
2 ni|»luri'<l h'lr'iiut n uj yst mLuiliiaiU's oa posterior tnd of uud^ut. No indications
of sporobla~»t s or sporo foiUis.
I oocj-st 22>itn2.Vcontainin2: jrranul'^s only. Aho 4 ruptured oocyst capsules still
attached lo.Nfoni i<-h Wi:M, no <i)oro'oti('>: prryi-nt .
23 o6?\iti, iDt ninJont> of wlua: wm- Uv. ^e, k\-*' up to fVV; 2 ho lic^ still retained
smaM uuiuunl uftiaVut.'nt: 1 very sm I'l '-ibt) u 2')m>. !l;nnin .- - _'l (K)"y-(.. of tho
u.<itol jJort wil^j luidiifiTcTitiatrd.proiopi.um except t!iat 'i of iwuii \.'»Tedi"^ eloped
to.sporobl'i tr^.ij;*!. No' anyX)f tjh-in ' oatuiu 'd sporo/.oilt's. on'i » inpty sliriuiken
capsule was srrii. Midlobc or e.iou .i^.^iiil para>ili/rd wiih a mo I'Tute number of
Kporo;.oile-'.ike .ilanients (n'>.Mii<»ti'i - an.i «l!'1 not <i.v'i \vi*ii dU-ni-.i.
Inlectloh reprosrulcd ouly by iwo empty oo.'yst shells attached to gut wall. No
sporo :oites on gut or in glaii Is.
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August 31, 1917 1408
The eight control specimens of A. quadrimoLCvlatus yielded 4 infec-
tions as follows: One specimen of A. qiuvdrimaailcUus which proved
infected was examined on the 12th day after biting the blood donor.
The gut wall was covered by probably at least 200 oocysts. These
were not over 35m in size, the majority exhibiting malarial pigment
and averaging 20m to 25m in size. No mature oocysts were seen,
and the glands were devoid of sporozoites.
The second control -4. quadnniaculaius found infected was examined
40 days after its bite of the blood donor. On the gut waU of this
specimen were seen 3 oocysts and 3 shrunken capsules devoid of
sporozoites or other contents. The oocysts measured 59m to 67m
in size with undifferentiated granules lacking evidence of sporoblast
development. A prolonged search was made of the mounting fluid
surroimding the gut wall but sporozoites were not found. The six
lobes of the salivary glands were likewise uninfected.
Another specimen of A, quadrimaculatus was found infected on
the 40th day of development. Here were seen three empty oocyst
capsules and three large oocysts, one of which measured 59m by
65m and the other two were as much as 67m in diameter. The
development of these oocysts was apparently abortive as sporoblasts
were absent and sporozoites were not present in the mounting fluid
about the stomach wall or in the six gland lobes.
The fourth specimen of this species found to be infected was dis-
sected 54 days after its initial blood meal. The only indication of
its infection was the presence of two apparently full-sized oocyst
envelopes devoid of contents except for a few residual sporoblast-
like bodies in one of them. The glands were negative except for a
moderate invasion of sporozoites in the midlobe of one gland.
The single specimen of A. quadnmacnlaius in which sporozoite
development was demonstrated had been kept at room temperature
(gas heated, mean temperature of approximately 22"^ C). The other
three specimens were subjected to the same conditions of temperature
and humidity as the specimens of A. punctipennis.
The mosquitoes employed in these experiments were allowed a
maximum period of 70 days in which to produce gland sporozoites.
Only one of the scries kept at low temperatures showed bodies which
resembled sporozoites, but because of their pecuUar character and
unusual behavior their identity is questionable. These bodies,
found in a specimen of A. pundipennu after an interval of 47 days
following a single infective bite, were of the usual filamentous type,
of normal size but with no appearance of nuclei. Only the two mid
lobes of the glands contatned a moderate number of the filaments.
None of the oocysts ijivaduig the stomach wall contained filaments,
although sporoblasts were seen in 3 of the 23 oocysts, the majority of
which were of mature size. The salivary glands of this mosquito
Digitized by VjOOQIC
1409 AiisnEt81,1917
were given a prolonged study, but no evidence of the characteristic
writhing movement or other sign of viabihty was observed in the
spindle forms present. Slight warming to 30® C. caused no change
in the material placed in normal saline, and when the inland cells were
ruptured by pressure and macerated, no activity followed. When
stained with Giemsa solution, the bodies smeared from the glands
did not take the stain so as to be recognizable.
The contents of the salivary glands of two other specimens were
also suspected on account of the presence of sporozoite-like bodies,
but in these instances one could feel fairly confident that they were
only the pecuUar threadUke crystals described by Stephens as
artifacts.
FACtors Other Than Temperature Influencing Parasitism.
It has been shown that other factors besides temperature may
influence infectivity, but aside from the degree of parasitism in the
human host and the nxunber of gametocy tes ingested by the mosquito,
little is known.
Daniels (1901) * emphasizes the fact that infection is directly
dependent on the number of bites the mosquitq takes from the patient
and has shown that the infection varies from 26 per cent to 66 per cent,
depending on the number of times the mosquitoes were permitted to
lite the gametocyte carrier. He reported 21? infected mosquitoes of
57 appUed, distributed as follows:
Nombo- Percentage
oTbitei. infected.
1 26
2 46
3 62
4 66
In the work prfesented here analogous results were obtained. The
percentage of infections was proportional to the number of bites the
insects took. In the foUowing table 19 mosquitoes of two species are
accounted for in relation to the number of infective bites obtained
from the human host, a subtertian case:
Table No. 5.
-4..
il#
Nmnhrr ' NdWlnf .
Vutrifutrl ^'*^'
pKfinrt,
I
aa
12,4
3
tn
1H.<
a
'M
»! 4
I '
r»
a^p
L! 1
4
mo
;t
1
J IiiUiiQU, C, Vf.^mih MilnfU^ mnuu Mo^ycul Jonrml. Muu n Uiea trj IHAsLibL, W. tt il«
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August 81. 191T 1410
The elimination of gametes through digestive activity of the mos-
quito may be considered another factor, relative especially to the
loss of infection in certain Anopheles j and is discussed because it has
bfeen ignored or overlooked heretofore.
Darhng (1910) ^ has ingeniously accounted for the failure of infec-
tion in the mosquito host to the extent of 97 per cent mainly throu^
the phenomenon of phagocytosis. He concludes that the ga^etocytes
accruing from three successive blood meals are retained by the insect
and that the fertihzed gametes, if they do not become phagocytized
have abundant time to wander out of the blood clot and reach the
gut waU.
In addition to this, one must take into account the peculiar habit
of the mosquito to ** clear'' itself, by discharging blood per anum
during and for some time following a blood meal. It should be
considered as an important source of gametocyte elimination. This
means of hmiting the number of zygotes is demonstrated in the finding
of as many as 12 crescents in a single field of the bloody dejecta.
This process takes place at the time most opportune — before fertil-
ization and subsequent encystment of parasites. The early excre-
tions— during perhaps the first 24 hours — are the most important in
this regard, as the clearing process is a mechanical oi^e and the phe-
nomenon of exflagellation does not get an opportunity to establish
itself. To be sure, this elimination process requires 1 to 5 days or
more for completion, depending on the temperature. Later defeca-
tions are associated with normal degenerative changes, so that this
elimination is not significant after the early hours of biting.
In a study of the contents of excreted blood nmncrous crescents
have been encountered possibly just as relatively abundant as, or
more so than, those contained in the peripheral blood of the human
host. The forms seen are similar to those in the patient's blood
except that in addition to deformed crescents, many fragmentary
bodies suggestive of active phagocytosis or changes due to insect
alimentation arc commonly seen. A scries of counts made of stained
film's of this excreted material, taken from 10 to 30 minutes after the
moscjuitoes had bitten, indicated that the crescents were somewhat
concentrated. There were present 87 crescents to each 100 leucocytes,
while in the blood film taken previously to the biting, 63 crescents
per 100 leucocytes were counted.
A true valuation of this observation could be obtained only in
careful weighings of mosquitoes at various stages after biting, and in
blood counts and estimations such as Darling has employed in his
studies.
Concentration of the gametes in the dejecta, if it does occur, may
be tentatively explained by the rise of these bodies in the same way
> Darling, S. T. (1910), Studies in relation to malaria. Bulletin Isthmian Canal Ca{Qmis8ion|Prca.
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1411 AsgostSl.lOlT
thai the (crescents rise when a tube of infected blood is centrifuged in
Bass and Johns' (1915) ^ method of concentrating the parasites for
diagnostic and cultural purposes. These workers discovered that
when blood containing crescents was centrifuged the parasites
rose to the top of the cell coliunn so that a mass of almost pure
crescents coidd be thus obtained. The alimentary canal of the
mosquito may be compared to a centrifuged tube in which the blood
is agitated through the processes of biting and subsequent peristalsis.
It is suggested that the action may be aided by the raising of 'the
caudal end of the abdomen which is done by the anopheline in biting
and rating.
This theory may be further strengthened by the fact, observed
by all investigators- of the mosquito cycle, that there is a decided
concentration of oocysts on the gut wall toward the anal end.
Especially is this the case when only few oocysts are present. We
may presume that the developed bodies appear in thiis location on
accoimt of the presence of the greatest nmnber of gametes at the
distal end of the gut.
Interpretation of Results and Summary.
In the work presented here it is indicated that development of the
exogenous elements in the mosquito is restricted or prevented
during an intermittent low temperature even when temperatures
favorable to parasite development are present in the early stages
and subsequently.
That the presence of even great niunbers of oocysts in various
stages does not give assurance of subsequent maturity and infectivity
is evidenced in these experiments.
Of the 18 infected Anoptidines kept at low temperature only one
appeared to giv6 rise to mature parasites, while the one control
specimen of .4. quadrimaculatus retained at room temperature reached
nomial maturity relative to sporozoite development. Plasmodium
Jdciparam was the species of parasite used.
The oocyst stage was maintained up to 59 days in the mosquitoes
employed in these experiments. A peculiar appearance of these
bodies gave the impression that dewlopmeni would not be carried to
maturity even if at this period rfiosquitoes were ex})osed to salubrious
temperatures. Sporozoites were not .produced in eight mosquitoes
of this series which had been exposed as much as 60 days to inter-
mittent low temi^erature, then transferred to an ^optimum tempera-
ture for two weeks longer. Two of the eiglit mosquitoes proved to
be infected by only a variable number of shrunken and ruptured*
oocyst capsules.
. ^»
• Bass, C. C, and Johns, F. M. (1915). A mcthcxl of con oont ratine; nmlarla plasmodla for diagnostic and
^^^ paipoatB. Am. Jour, of Trop. Dis. and Prev. Med., Vol. Ill, No. 6, November, pp. 298-303.
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I
Aagost31,1917 1412
A suggestion of the mode of evolution in the growth and subsequent
degeneration of the bodies found in the mosquitoes may be given as
follows:
The nature of the oocyst throughout the incubation period was
such as to indicate that development was practically negligible after
about 19 days and up to 59 days. Taking as an illustration the
development produced in a mosquito during 47 days of incubation,
we find bodies indistinguishable in morphology and size from similar
bodies seen in mosquitoes during 13 to 19 days of development.
Even up to 31 days the presence of malarial pigment could be
demonstrated in numerous oocysts. This of course may be inter-
preted as aborted development brought about by low tempera-
tures. Also up to this time (31 days) few sporoblasts were seen
among the oocysts encountered, possibly another influence of low
temperature. Begimiing with the thirty-seventh day it was found
that oocysts conMnenced to degenerate, rupturing prior to sporozoite
development. Numerous ruptured oocysts were seen up to the fifty-
ninth day, and not in a single instance was the presence of sporozoites
revealed. During this interval many oocyst capsules were found
unattached to the gut wall, probably having been dislodged in the
process of dissection.
The absence of sporozoites, with one exception, in the 18 specimens
infected is significant. In the one exception it is to be noted that
the presence of sporozoites is open to question on account of the
uncharacteristic form and behavior of the bodies seen.
The loss of infectivity tlirough temperature change is significant in
relation to hibernation of infected mosquitoes. Much can be ex-
plained if it should be definitely proved that low temperature pre-
vents sporozoite development in mosquitoes inactive during the
winter.
It is indicated in the results of these experiments that an inter-
mittent low temperature does interfere with sporozoite formation;
consequently it is expUcable that mosquitoes procuring gametocyte
bearing blood before winter sets in, may become sterile or innocuous
during the hibernation period.
The writer has obtained a partial confirmation of the results of
Daniels in the relation of infection to the number of bites which the
mosquitoes obtain. Fifteen examples of A. punctipennis gave the
following results relative to infection with the parasites of malaria:
One, two and three bites gave 12.5, 18.8 and 34.8 per cent respec-
tively. The results obtained with 4 specimens of A. gu(idnmaculahi8
were 20, 50, and 100 per cent relative to one, two, and three bites
obtained.
Another factor besides low temperature which possibly influences
infectivity was found to be the loss of gametocytes through the
Digitized by VjOOQIC
1413 August 31. 19ir
"clearing process'' in the mosquito. This is indicated in the blood
count of the mosquitoes' dejecta, in which numerous crescents were
found. In one instance blood from the human host yielded 63
crescents to 100 leucocytes and in the blood after passing through
the mosquito 87 crescents to 100 leucocytes were counted.
AddendunL
In a recent paper Bang (1917),* working in New Orleans, has shown
some interesting results relative to low temperature influsnce on the
sporogonic development. He shows that the parasite of tertian
mdaria in Anopheles quadrimaciilatns is able to survive exposure to
a temperature of 30° F. for a period of 2 days, 31° F. for 4 days, 45°
to 69° F. for 6 to 7 days, and in two mosquitoes 38° to 59° F. for 17
days. In a smaller series of tests the sporonts of P. falciparum
showed a resistance to 35° to 57° F. for 1 to 2 days.
In these experiments the parasites in the mosquito were permitted
to develop during 7 to 23 days at room temperature before the insects
were exposed to temperatures of 29° to 69° F. for periods ranging
from 1 to 16 days, following which they were maintained at room
temperature for an additional period of 1 to 19 days.
It is indicated from these tests that exposure to low temperatures,
for a limited period at least, did not affect the viability of sporo-
zoites assuming that provision had been made for the mosquitoes
to develop sporozoites at room temperature.
> King, W. V. (1917), The effect of cold upon malaria parasites in the mosquito host. The Journal oT
Experimental Medicine, VoL XXV. No. 3, March, pp. 495-408.
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PREVALENCE OF DISEASE.
No health depcartment. State or locals can effectively prevent or control disease withoul
knowledge of when^ where , and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended August 25, 1917.
The California State Board of Health reported that during the
week ended August 25, 1917, there were few changes m the preva-
lence of communicable diseases in the State of Califomia. The
reporting of venereal diseases has been stimulated by the new bureau
of venereal disease in the State department of health. Fifty-eight
cases of gonococcus infection were reported during the week. Forty-
one cases of typhoid fever were notified, scattered throughout the
State. One case of poliomyelitis was notified in Yuba Coimty, one
case of smallpox in Oakland, and one case in San Francisco.
The details of notifiable disease cases reported during the week
ended August 18 are as follows:
Cases.
Anthrax 2
Chicken pox 13
Diphtheria 26
Dysentery 1
Erysipelas 2
German measles .' 29
Gonococcus infection 34
Malaria 17
Measles 38
Mumps 33
Gises.
Pneumonia 15
Poliomyelitis 8
Rocky Mountain spotted fever 2
Scarlet fever 85
Smallpox 5
Syphilis 18
Tetanus 1
Tuberculosis 135
Typhoid fever 39
Whooping cough 33
RECIPROCAL NOTinCATION.
Minnesota.
Cases of communicahle diseases referred during July, 1917 ^ to other State health depart-
ments by department of health of the State of Minnesota.
Disease and locality of noti-
ncation.
Diphtheria:
Minneapolis Health De-
partment, Hennepin
County.
it. Paul Bureau of
Health, Ramsey
County.
Referred to health authority of—
Webster, Burnett County, Wis.
Phillips, Price County, Wis
(1414)
Why referred.
Patient came from Wl^coodn
sick, to consult MinneapoUi
physician.
Cmture from mother positive
after she had left for Wisooo-
8in. her child haying died or
diphtheria at atyHospitilt
StTPaul.
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1415
▲ucost 31, 1917
Caui of communioahU diseases, referred during JtUff, 1917 ^ to other State health depart'
menu by department of health of the State of Minnesota — Ck)ntinued.
Diseue and locality of noti-
flcatlon.
Referred to health authority of—
Why referred.
MhiTif poUii City, Hen-
nepin County.
Scarlet fever:
Savage VfUage, Boott
County.
Smallpox:
Landon Townsliip,Free-
bofn County.
MinneapoUs Health De-
partment, HenneplD
County.
Tuberculosis:
Mayo Clinic, Rochester,
Olmstcad County.
Pokegama Sanatorium,
Pine County.
Thomas Hospital, Min-
neapoUs, Hennepin
Ckwnty.
IChmeapolis Health De-
partment, Hennepin
County.
St. Paul Bureau of
Health, Ramsey
County.
Typhoid fever:
Star buck village, Pope
County,
liumeapolis Health De-
partment, Hennepin
County.
LeMars^Plymouth County, Iowa; Her-
man, wasnlngton County, Nebr.
Lake Mills, Whmebago County, Iowa
Hartford, Hartford County, Conn
Mobridge, Walworth County, 8. Dak.
Chicago, Cook County, HI.; Uttle York,
Warren County, 111.; Toledo, Tama
County, Iowa; Orange City, Sioux
County, Iowa; Conrad, Grundy County,
Iowa; Dubuque, Dubuque Coimty, Iowa
(2 cases); Shell Rock, Butler County,
lf,^r Fort P.-,!;:.-^, Webst^rr County,
kiv I, iJdU CoiiT^iv, M.- h.;
Kr ■ : • n I oiJlify; M*-.'. < "i , d,
Tf U .li t ou n 1 V ., MuUt . ; I*ali5in Sr , i 1 1 1 1 :h-
cock t-Ujun t V , N c br . i l>e V I [s T-Ji ke, K - m-
sey CouDty N. Pflk.; Kermlt, M.ide
County, N. Dak.: Winr* Biirkifrti ( 'un-
tvi N* Dak*: Shawnee, Potrnwir- niie
CSjnnly, OklOi.: Merrick, (jrfpiry ' mm-
ty» a. Dak.; Wcllctte, Bplok Omnlj, 8.
Dak. J Florctieo, Cculingloii County, 8.
I>»k4 Becrfleld, Dane Countv, Wis.;
CamdnH. Saskat^^bewBii, rftna-b. .Pun-
itory district Dol Kivcii, Ssi^ktslrln^tin,
(>mdEi,
BelptrftUe, (;;uJla1iti CfMintv, Moot.L Ilay-
wtirdi, ^aiTTer Coimty, Wis.
Hat ton, TtWII C- nut v. N. innk . Dr^^^cer,
I'olk Couniy, ^\
Spring Brook, Williams County, N. Dak.
Grantsburg, Burnett County, Wis .
Bancroft, Kossuth County, Iowa.
Conde, Spibk County, S. Dak....
Working in NcbrasVa, came to
Minneapolis broken out with
measles; stopped off at Le-
Mars, Iowa, 10 hours.
Mother and 2 children exposed
to scarlet fever in Mixmesota;
went to Iowa.
Left Minnesota for Connecti-
cut after extensive exposure
to smallpox; vaocinatian his-
tory imknown.
Case developed smallpox in
Minneapolis. Contracted
while visiting daughter in
South Dakota, who also had
smallpox.
4 advanced, 14 moderately ad-
vanced, 3 apparently ar-
rested, 2 diagnosis not given;
cases left Mayo Clinic for
homes.
1 death, 1 open case discharged
from Pokegama Sanatorium.
2 open cases left Thomas Hoa-
pital for homes.
Sputum examined while \W\U
ing in Minnesota; posilivp;
patient returned to North
Dakota.
Open case left City Hospital,
St. Paul, for home in Wiscon-
sin.
Suspected typhoid carrier from
Iowa visiting in Minnosnta.
Patient from South Dakota
died of typhoid fever at St.
Barnabas Hospital, Minne-
apolis.
ANTHRAX.
Kansas — Hutchinson.
During the month of July a case of anthrax was notified in
Hutchinson, Reno County, Kans. The patient was a Mexican
employed m a raihoad camp.
102
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Aiikli8t81,l»lf 1416
ANTHRAX— Gontmuod.
Loyisiaiui Report for Julj, 1917.
Dming the month of July, 1917, six cases of anthrax were reported
in the State of Louisiana.
Marylaiid — Harnej.
A case of anthrax was notified at Harney, Carroll County, Md.,
August 13, 1917. The patient was taken ill August 10. It is believed
that the infection was acquired while handhng boards on which the
carcass of a hog had lain.
CEREBROSPINAL MENINGITIS.
Minnesota— Fort Snelling.
During the week ended August 25, 1917, a case of cerebrospinal
meningitis was reported at Fort Snelling, Minn.
State Reports for Jnly, 1917.
PlaOA.
New
oases
reportad.
Place.
New
cases
reported.
California:
Alameda County ,.
17
V. PAifcftrm Vi^T\*h
1
Oakland
Livingston Parish. . .
1
Los Angeles County—
Wmttier
Total . .
i
PlftCftT Countv
Minnesota:
Carlton County-
Moose T4kk«
San DioKO County
San Diego
1
Ban Francf !«rt, . . . .. x . ....
Veotura County ......
Chippewa County—
Lonetree Townshlo
1
Total
38
Crow Win* County—
Riverton
1
Connecticut:
4
2
1
1
1
2
1
Fataileld Township j
1
Fairfield County-
Bridgeport
Freeborn County-
Albert Lea Township
1
Hartford County-
Hartford
Hennepin County—
Minnwpolis..
3
New Britain
Koochiching C-ounty—
Rat Root Township
Plainville
1
New Haven County-
Cheshire
Ramsey County—
St. Paul
3
New Haven
St. Louis County—
Duluth
Orange. . , . , . ....... .
1
Sherburne C-oimty—
Haven Township
Total
12
1
Total
Iowa:
1
U
Montana:
Silverbow Coimty
Kansas-
1
1
1
1
1
3
1
Crawford County—
Pittsburg
New Jersey:
Essex County
Elk County —
9
Leeds (R. D.)
Hudson County
3
Harvey County-
Newton
Passaic County
3
Uni; n County
3
Montgomery County —
Independence.
Total
17
Sunuier County-
Well i n jrt on
1 South Carolina:
York County
Wyandotte County-
Kansas City
1
South Dakota:
1 Charles Mix Coimty
-
Total
8
1
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1417
CEREBROSPINAL MENrNCITIS^^onHnued.
City Reports for Week Ended Aug, 11, 1917.
August 31, lOlT
Place,
Cases.
Deaths,
Vlmx.
ra.r^.
Deaths.
Akron^ Ofaio.. . ....... ^ . , .
1
1
4
5
Manchester, N.H....
1
AlilflSiti^wTt Pa . **...,.
1
Mllwaukoe Wis .. .».i
I
Bdtimore^ Ifd. . ^,.,,._^.
Musc^tiofi^ Iow9 .., ^...
1
Boston, Mass..,,.., *,..
1
Newark, N.J.,. „:
NflW York, N.Y.. ...........
Norfolk Va .,**.*.*»..*»
Brirf^ri^rt ^ rofiTi . . . „
I
Buffalo K Y .
1
1
CSitlse^ Ma^........
1
a
Onin^ii, N.J ,
1
Clti<tu»n ni
9
1
Phnivli^iphia. Va ,
t
Clerclartii . Ohio . . .,.
I'dishiimh, I'q
I
I>ftf toD Ohio * , * * * *
2
1
ntiTtadLcl Mss^.. , . . ..
Betroit.Mldi........
SI. Louis, Mo....
1
Tii^tmnirp<^m,ln'i T < .
i
1
1
1
Hun Diejjo. Cat .... . .
Sua Francisco, Cal ....
liC»ni***^*v' Xan5 t ..l
Stockton Cal-. . .
t
Kansas CUf^ Ho
DIPHTHERIA.
See Diphtheria, measles, Ecarlet fever, and tuberciilotua, page 1433,
DYSENTERY.
Kentucky— War Creek.
All outbreak of dysentery was reported August 25. 1917, at War
Creek^ Breathitt Comity j Ky, Sixteen deaths oceurred between
August 1 and 25, and 5 new cases were notified August 24*
Mas^chugetts.
A report dated August 24, 1917, states that there had been an
outbreak of dysentery in the Grafton State Hospital, 45 cases ha\'ing
occurred in the Worcester department, with three deaths , and 30
cases in the Grafton colony. With the exception of the tliree ciines
which proved fatal, all recovered rapidly and without difficulty.
Laboratory examinations of fecal specimens from several of the more
typical cases proved absence both of amebaj and also of any of the
known strains of haeiUi dysenteris^,
ERYSIPELAS.
City Reports for Week Ended Au£. It, 1917.
Flan. '
Cws.
Deaths. '
Pliu»,
CmKa.
Deaths.
B«rton,MAss . . ........
3
1
Passaic, N. J
SSSSi.lnr' ::::::::::,::::
6
1
1
1
1
i
PWIudelphia, Pa -
Citiciniiatl Ohio * *.*,*.-**
PlU>hur»!h, Pa.. ...,
1
2
i
Cleveland Ohio
i
FltimflcH, K. J.
Ilo^hc^Ier, N. Y....... .....
"""■"■
t>mutli Minn . . *,.,p..
Kinsas'City, Mo ,..
: Bt, LonU, Mo
Lotic Bcicfi. Cal .
Ban Francis ""o^ Cal. ,., p. ...... .
MUw.iukce Wis
Scat lie, Waah
Ntw BritaLo. rtmo . . ,
I
1
BprLiiille[4, Ul
N«wY«rk, N. Y./.;.;;;i;...
1
.....,-
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1418
MALARIA.
State Reports for July, 1917.
Place.
California:
Butto County
Biegs
CWco
Calaveras County
Colusa County
Colusa
Fresno County—
Firebaugn
Olenn County—
Orland
Kern County
Bakersficld
Merced County.
Placer County —
Rocklin
San Francisco
San Joaquin County-
Stockton
Tehama County-
Red Bluff
Tulare County
Tuolumne County . . . .
YoloCoimty
Total
Kansas:
Crawford County—
Pittsburg
Miami County—
Loulsburg
Sumner County—
Conway Springs...
Wyandotte County-
Kansas City
Total
Louisiana:
Acadia Parish
Allen Parish
Ascension Parish
Avoyelles Parish
Beauregard Parish
Bienville Parish
Bossier Parrlsh
Caddo Parrish
Calcasieu Parish
Claiborne Parish
Concordia Parish
De Soto Parish
E. Carroll Parish
E. Feliciana Parish...
Evangeline Parish . . . .
Franklin I'arish
Grant Parish
Newckscs
reported.
75
Place.
NewcMii
reported.
Louisiana— Continued .
Iberia Parish
Jefferson Davis Parish. .
La Salle Parish
Lincoln Parish
Livingston Parish
Natchitoches Parish
Ouachita Parish
Plaquemines Parish
Rapides Parish
Red River Parish
St. Charles Parish
St. James Parish
St. John Parish
St. Landry I'arish
St. Martin Parish
St. Mary Parish
St. Tanmiany Parish....
Tangipahoa Parish
Union Parish
Vermilion Parish.
Vernon Parish
Washington Parish
Webster Parish
W. Baton Rouge Parish.
W. FcUdana Parish
Total..
New Jersey:
Bergen County
Burlington County..
Essex County
Hudson County
Mercer County ,
Middlesex Coimty...
Morris County
Passaic County
Somerset County.. . .
Sussex County
Total.
South Carolina:
Beaufort County.
Chester County . .
Laurens County..
Marlon County...
Pickens County..
Kichlaod County..
Snartanburg County. .
Union County
Williamsburg Coimty.
York County
Total.
20
10
«
S
1
»
S
4
4
1
City Reports for Week Ended Aug. 11, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Desths.
Birmingham, Ala
136
1
1
1
3
Memphis, Tenn
1
Boston. Mass
New Orleans, La
2
1
Brookline, Mivss
Orange, N. J ,''.
Cambridge, Mass ^
1\ ichmond. Va
Columbia 8 C
San Francisco, Cal
Fort Wayne, Ind
1
Sftvannf^h, ^^a . . . . t
Little Rock, Ark "'
I
1
Stockton, Cal
Los Angeles, Cal .■
1
_
> The reason that Birmingham had so many more cases of malaria reported than any other city is not
that the disease is more prevalent in Birmingham than in other cities of Alabama and neighboring StaUii
but undoubtedly because of the successful efforts the health department has made insecuiing thecooptft*
Uon of the practicing physicians in reporting cases.
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1419
August 31. 1917
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1433.
PELLAGRA.
State Reports for July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Cdifornja:
lios Arg3les County-
1
1
1
1
Louisiana— Contlnu>d.
De Soto Parish
1
Los Angeles
East Daton Roufe Parish..
5
Merced Connty x ....... .
East Carroll Pafish ....
1
Onnge County. . . .. ... ... .
East Feliciana Parish
1
Morehouse Parish
6
Sftcramento. . .'
Orleans Parish
8
Ouachita Parish.. .
12
Total
4
Pointe Coupee Parish
1
RaDides Parish
1
Connecticut:
'
Richland Parish
2
Hartfoiti County-
St. Martin Parish
1
Hartford
St. Tammany Parish
2
Union Parish
3
2
4
1
1
1
Vernon Parish
1
Cowlev Coiinty—
Wuui Parish
1
Wlnfleld
Labette County—
Total
V)
Chetopa. . /.
South Carollno:
Abbeville County . .
Montgomery County—
Cnaney , ,
2
Independence
Beaufort County
1
Sedrwick County—
>¥iclilta.
Chester County
2
QreenviUeCounty. . .
1
Laurens (5Winty "..
2
Total
0
Pickens County
6
Richland County . . .
s
T^nlstanft:
1
2
2
Spartanburg County
5
Allen Parish
Sumter County
1
Oiddo Parhh
Total
CaWwell Parlih
23
City Reports for Week Ended Aug. 11, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Binninf^hani, A la ,,....--
»8
Nashville, Tcnn
2
Charleston 8 . C
1
1
New Orleans, La
2
1
ChattanoofTA, Trnn
New York, N.Y
Columbfai "s. C
1
Norfolk, Va
Fort Worth, Tex
1
2
1
Richmond, Va
Memphis, Tenn
32
Wilmington, N. C
Winston-Salem, N . C
Mobile Ala
* The reason that Birmingham had so many cases of jiellagra reported is not that the disease is more
prevalent in Birmingham than in other cities of Alabama and nciKl»l>oring States, but undoubtedly l)e-
caose of the successful efforts the health department has made in securing the cooperation of tiic "prac-
ticing physicians in reporting cases.
PNEUMONIA.
City Reports for Week Ended Aug. 11, 1917.
Place.
Allentown. Pa...
Auburn, N.Y...
Baltimore, Md..
Boston, Mass....
Cte^famd, Ohio.'
Detroit, Mich....
Fan River. Mass.
uncDfai, Nebr...
Us Angeles, Cal.
Cases.
Deaths.
Place.
Cases. Deaths.
Newport, Ky
Oakland. Cal
Philaflelphia, l"a. .
Pittsburgh, I'a
Rochester, K. Y...
Rcckford, III ,
8an Dicgj, Cal
San Franciscj, Cal
Topeka, Kans
Worcester, Mass . . .
2
2
I
3
23
12
11
11
1
I
1
I
T
10
(
'J
Digitized by'
August 31, 1917
1420
POUOMYEUTIS (INFANTILE PARALYSIS).
Cases Reported, August 16 to 2$, 1917.
The following table shows the number of cases of poliomyelitis
reported to the United States Public Health Service from August 16
to 29, 1917. This is an addition to and continuation of the tabk
published in the PubUc Health Reports, August 17, 1917, page 1320.
Place.
Period.
Cases.
Place.
Period.
Cms.
Alabama:
Jefferson County —
Dooena
Montgomery County-
Montgomery
Connecticut:
Hartford Connty—
Bristol
Delaware:
New Castle County—
McCIellandsyille . . .
Illinois:
Coles County
CookCoimty
Kankakee County
Knox County
Lake County
La Salle County
Madison County
St. Clair Connty
Iowa
Kansas:
Allen County —
Moran
Lyon County—
Emnoria
Morris County—
Wilsey
Sedgwick County—
Pe<*
W3randotto County-
Kansas City
Maryland:
Aug. l»-25.
do
•do.
Aug. 1»-18. . .
do
Aug. 12-25.
Aug. 12-18.
do.
Aug. 19-25.
Aug. 12-18.
Aug. l»-25.
do
Aug. 1-22. .
Aug. 19-25.
Aug. 12-18 .
....do
Allegany County.
Garrett County...
Massachusetts:
Bristol County-
Fall River
Essex County—
Haverhill
Lynn
Saugusftown)
Plymouth County—
Hingham (town).
Worcester County—
Winchendon (town) .
Missouri:
Jackson County-
Independence
Ohio:
Wayne County—
Ck>ngress Township. ,
Chip|)ewa Township
Plai n Township
Pennsylvania:
AUe«honv County-
Pittsburgh
Texas:
Angelina County—
Luflrin
Vermont:
Franklin County—
St. Albans
Enosburg Falls
Fairneld
Orange County—
Orans^e
Washington County—
Barre
Barre(towii)
Aug. 19-25. .
Aug. ^18..
Aug.l3-K..
do
Aug. 12-18..
Aug. 1^-28..
Aug. 25-27..
Aug. 12-18..
....do
....do
Aug. 14.,
Aug. 12-18 .
do
Aug. 1-28. .
Aug. 16-23..
Aug. 22
Aug. 19-25..
Aug. 12-18..
Aug. 19-25..
Aug. 6-11...
Aug. 5-18..
do
Vermont — Continued.
Washington County —
Continued.
Calais
Montpelier
More town
Waltsfteld
Waterbury
Windham County-
Bellows Falls
Brattleboro
Windsor County-
White River Jono-
tion.
Virginia:
Albermarle County-
Ivy
Fauquier County-
Near Orlean
Greene County
Near Quinque
Standardsviile
Halilax County—
Ingram
Rockbridge County—
Raphlne
Rockingham County..
Grottoes
Harrisonburg
Penn Laird
Warren County-
Front Royal
Washington:
Whatcom County—
Bellingham
Whitman County—
Colfiix
West Virginia:
Barbour County—
Belington
Volga
Braxton County—
Knawl
Gilmer County-
Peter Creek
Harrison County-
Broad Oaks
Clarksburg
Shinnston
Marion County—
Edgemona
Ida May
Mannington
Mlddieton
Monongah
Plum Itun
Minora 1 C^>unty
OhioCo,unty—
Edgowood
Greggs\ille
Preston County—
Eglon
Taylor County
Grafton
Tucker County
Davis
Upshur County—
Buckhannon
Wood County—
Parkcrsburg
Aug. 13-18...
Aug. 12-25..
Aug. 19-»..
...^do
Aug. 5-25....
Aug. 12-18.
Aug. 19-2S.
Aug. 12-18.
Aug. 21-27.
Aug. 15-20.
do
....do
Aug. 21-27.
.do.
....do
....do
Aug. 15-20. .
Aug. 15-27. .
Aug. 21-27. .
Aug. 15-20..
Aug. 12-18.
....do
....do
....do
.do..
.do.,
.do..
Aug. 12-25.
Aug. 12-18.
....do
Aug. 1^25.
Aug. 12-18.
Aug. 1^25.
Aug. 12-25.
Aug. 19-25.
....do
.do.,
.do..
.do.,
.do..
Aug. 12-18.
Aug. 19-25.
Aug. 12-18.
Aug. 19-25.
Aug. 12-2S.
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1421 Aagust 31. 1917
POUOMYELITIS (fNFANTILE PARALYSIS)-0>ntinue(l.
State Reports for Jaly» 1917.
Place.
New cases
reported.
Place.
New cases
reported.
CaUfoniia:
Afatmeda Comity—
Berkeley
Marion County—
Belvedere
Orange County
Santa Clara County
ToUl
Connecticut:
Hartford County-
New Britain
New Haven County-
Derby
Windham County-
Thompson
Totel
Iowa:
Fayette County
Marion County
Pago County
Total
Kansas:
Allen County—
Elsmorc(R. D.)
Wyandotte County—
KansasCity
Total
Maine:
Knox County—
Rockland
Michigan:
Washtenaw C-ounty—
Ann Arbor
Wavne County-
Detroit
Total
Minnesota:
Aitkin County-
Rice River Township
Minnesota— Cont inued.
Clay County—
Kecne To.vnship
Hennepin County-
Minneapolis ,
Lyon County-
Lyons Township ,
Pope County-
Blue Mounds Township.
Ramsey County—
St. Paul
Watonwan County-
Long Lake Township —
Total.
Montana:
Carbon County
Cascade County-
Great Falls...,
Fergus County
Granite County...
Total
New Jersey:
Essex County
Hudson County
Middlesex Coimty.,
Passaic County
Sussex County
Union County
Total
North Dakota:
Grand Forks County.
Williams County ,
McLean County
Emmons County
Total.
South Dakota:
Clark County .
Wyoming:
Natrona Coimty .
City Reports for Week Ended Au|f. 11» 1917.
Place.
Cases.
Deiths.
Place.
Cases.
Deaths.
Akron, Ohio
3
1
9
1
4
1
Mobile. Ala
1
Boston, Mass
I
Newark, N.J
New Castle, Pa
1
Oi^CA^ ni
7
Qncinnati, Ohio ../.
New York. N.Y
Oakland, ('al
5 1 2
CleTeland 'dhlo . .
1
1
Evansriile, Ind
Omaha, Ncbr
4
1
3
I
1
Haverhin, Mass
1
Pasadena, Cal
Sioux City, Iowa
KfknmsritT Mo
1
Lorain, Ohio
}
Troy, N.Y
Lowell, Mass '.
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▲aciist81,1917 1422
RAMBS IN MAN.
City Report for Week Ended Aug. 11, 1917.
During the week ended August 11, 1917, a fatal case of rabies in a
child was reported in New Britain, Conn.
RABIES IN ANIMALS.
City Reports for Week Ended Aug. 11, 1917.
During the week ended August 11, 1917, 1 case of rabies in animals
was reported in Detroit, Mich., and 4 cases were reported in New
Britain, Conn.
ROCKY MOUNTAIN SPOTTED FEVER
Stete Reports for July, 1917.
Place.
New cases
reported.
Place.
Neweasei
reported.
Colorado:
Moffat County
1
4
Nevada:
F|lro Cntnity ^ x . ...
1
Rio Blanoo County
Fuvnhntdt ^-omity ....
I
Total
Total
5
i
Wyoming:
Campbell County
Montana:
Fergus County
1
2
2
i
Madison County
Sweetwater County
1
StillwAtAr Cotmtv
Total
s
Total
5
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1433.
SEPTIC SORE THROAT.
Massachusetts.
An outbreak of septic sore throat was reported August 24, 1917,
in Massachusetts; 39 cases having been notified in Natick; 74 cases in
Wellesley, with 2 deaths; and 6 cases in Dover.
The disease was believed to have been distributed by milk.
SMALLPOX.
Minnesota.
During the week ended August 25, 1917, two new foci of smallpox
infection were reported in Minnesota, cases of the disease having
been notified as foUows: Hennepin County, Fort Snelling, 1; Ramsey
County, North St. Paul, 1.
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1423
-Aiifmie81.1917
SMALLPOX-rOontinued.
SMe Reports for July, 1917.
New cases
reported.
Deatbs.
Vaccination history of cases.
Plaoew
Number
vaccinated
within?
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack^
Number
never suc-
cessfully
vaccinated.
Vaccination
history not
obtained or
uncertain.
CUUaniia:
Amador Countv—
Sutter Creek
1
7
1
1
1
1
1
1
l^i*snA County .......... ^ ..., ^
Fresno .. . .....
Selma -
1
Riverside County
San Bernardino County—
San Bernardino
Ban Mateo County-
South San Frandjico
1
Yxiba C<Hinty
, 1
Total
14
3
Denver County-
Denver
3
4
2
2
Garfield County—
Glenwood Springs
4
WeW County-* ~
Greeley
2
Total
9
2
0
Kanaas:
Allen County-
La Hame
2
1
1
3
1
3
1
6
1
1
2
1
2
5
1
1
2
10
3
1
1
2
1
6
1
1
4
2
i3aT\ .:::.:.::::::...
AtchisQa County—
Atdiisan
Brown County—
Horton
BrtterCountjr-
Bl Dorado
Cberokee County—
CohlmbllS r - - r - -
HaUowell
West Mineral
Cowley County—
CMn^iridge r ,
Geuda Springs
Crawford County—
Glrard(R.D.)
1
1
Hepler (R. D.)
McCmie(R.D.)
%-
Mulberry
Doniphan County—
T)oniphan .
Sparks (R.D.)
<
Troy (R. D.)
Douglas County—
Eudora (R. D.)
Vinland
Ford County—
Spearville (R. D.)
Geary County—
^ortRUey
Harvey County-
Newton
Jefferson County-
Valley Falb
Jewell County-
Lebanon (R. D.)
Lyon County—
Emporia
Marion County-
Marion (R. D.)
Mcpherson County—
Marquette
Miami County-
Paola....
^,..4At0
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Alikt>&t81,1017
1424
SMALLPOX— Continued,
State Reports for July, 1917— Continued.
New cases
reported.
Deaths.
VacdnatioD history of cases.
Plato.
Number
\'accinated
within?
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack.
Number
never suc-
cessfully
vaccinated.
VacdnatioD
history not
obtained or
uncertain.
Kansas— Continued .
Montporacry County—
Independence (R. D.)
Neosho Ccunty—
2
1
8
5
3
6
1
8
1
1
19
2
1
8
5
3
C
1
1
8
1
1
Norton C-ounty-
AlniAnn ^ R Ti \
Ottawa County—
Russell County—
RussclKR.D.)
• Bedew ick Cx)unty—
Wichita
Sumner Ccunty—
Milan
Mulvanc
Wilson county—
Covvilln fR D ^
1
1
Woodson Coimty—
Tnmntn ^R. Ti \
Wyandotte County—
RosedaJe (R. D.)
1
Kansas City
19
ToUl
122| I i 2| 120
Michigan:
Alleean County-
Hopkins Township
Alpena Cx)unty -
Long U lipids Township...
Antrim Ccninty—
3
1
3
2
3
1
2
1
2
23
3
7
1
1
2
2
0
2
1
1
3
1
3
11
3
1
1
2
Chippewn CouiHy—
Dctcur Township
2
Sault Stc. Maric
Crawford County—
OraylinK I ownship
Emmet Count v—
Bliss Township
3
1
2
1
rcllsti.n
Gcnpftc Count y—
( : jimos Township
1
1
2
FlintCity
Ingham C< imly—
William ton
1
;_;; \
23
3
7
1
Lansa-KCity
Jackson (^ouiity —
Jx»cni Twwnship
Kent Comity—
Alpine i ownship
1
1
1
1
2
2
G
1
(Jrand liap.ds
Livingston (\iinty—
Ccnway Township
Mackinac ("oiinty—
I'crtaro I'ownship
Mace ml) C\ unty—
Mt. Clemens
1
1
i
t .
1
1
Marquette County —
1
1
1
Mecosta County—
1
Montmorency County—
Rrilev Towni'shin
1
3
1
3
11
Oakland County-
Pen tiac Township
Watcrf . rd Township
Pcntiac
1
1 1
::::::::::!::::::::::::i::::::::::::
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1425
A«<«st«1.1917
SMALLPOX— Oontlnued.
State Reports for J11I7, 1917T-Ck);atiiiued.
New cases
reported.
Deaths.
Vaccination history of cases.
Piano.
•
Number
vaccinated
withm 7
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
attack.
Number
nevor suc-
cessfully
vaccinated.
Vaccination
history not
oltained or
uncertain.
MiAigan-Conttaued.
Pre^ue Isle County—
Belknap Township
6
2
3
20
1
2
1
RogErs..
Onaway
Saginaw County—
Sttfnnaw
1
St. Clair County—
Kimball Township
1
3
1
6
1
Sanilac County—
Sanilac Township
1
Shiawassee County—
Durand
Tuscola County-
Wayne County-
Ford
1
Hi0ilandPark
3
Detroit
20
Total
127
4
\(A
15
MimiesoU:
Becker Cdunty—
Detroit
3
10
2
52
2
10
Blue Efcrth County—
^ Rapidan Township
Sleepy Eye
Albme Township
Carver County—
ChosVft
Chanhassen Township
Loketo wn Townshin ... .
Clay County- ^
Moorhiad
Crow Wing County—
Braincrd
Crosby
1
::::::::::::::::::::::::
1
Emi^Townshlp
50
Dakota CJounty—
Farmington
Empire Township
Donidas County-
Carlos Township
KUmore County-
Mabel
Freeborn County—
Froebom Township
Goodhue County-
Pine Island . . .
Hennepto County-
Minneapolis..
1
2
Richfield
Houston County-
Spring Grove
Itasca County-
Deer River
Jackson County-
Jackson....
"^'"^^'r,. .
Lyon County-
Tracy
Martin County-
Fairmont
Pleasant Prarie Township.
Silver Lake Township
1
1
!!!;!!!!!>!!!!!!!!!!!!'!!!!.! '.
1
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August 81, 1917
1426
SMALLPOX— Contiuned.
State Reports for July, 1917— Continued.
New cases
reported.
Deaths.
Vacdnatioo history of cases.
Place.
Number
vaccinated
within 7
years pre-
ceding
attack.
Number
natedmore
than 7 years
preceding
attack.
Number VacdrntioB
no Tsuc- history not
ceisfully obtained or
vaccinated. | uncertain.
Minnesota— Continued.
Mower County-
Austin .. .
2
11
U
C
2
Murray County—
Hollv TownshiD
1
1
3
10
Olmsted County-
Rochester
New Haven Township
Ramsey County—
St. I'aul...
1
Rico County—
Farit)ault
S
St. Louis County—
Duluth
6
4
2
1
3
HibliinR . . .
Rico I»ako Township
Scott County—
Olendalo Township
Todd County-
Hartford Township
Momn Townshin
11
1
2
1
1
1
1
6
2
Wadena County—
Wadena
Washington County-
Forest I^ko
Marine
Forest Lake Township
Watonwan County—
St. James
1
1
3
Total
IfiS
7| 5
6
149
8
Montana:
Beaverhead County
5
10
2
3
3
3
1
2
2
1
3
1
2
1
4
11
6
5
Cascade County .
10
2
2
Chouteau County
.
Custer County . .'.
1
Dawson County
8
Flathead County
3
Gallatin Coimty—
Bozeman
1
Jeflfcrson Coimty
i
2
Lewis and Clark County
Lincoln County
1 1
1
3
Musselshell County
Rinhli^nd rouTlty
1
Sanders County .
2
1
Sheridan County
^^
Silverbow County
4
Butte
1
10
2
Yellowstone County—
Billings
8
Total
59
1
1
34
0
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1427
SMALLPOX-^Oontiniied.
MiseeOaiieoiis State Reports.
'liogim 81.1917
Tha.
Cases.
Deaths.
Place.
Cases.
Deaths.
Connaeticut (July 1-31):
UtobiOeld County—
Winchester , . . ,
5
1
Matae (June 1-30)— Contd.
Washington County-
Forest Station (Town)
MiUbridgo(Town)....
Vanceboro (Town) . . .
Letter A (Town)
Total
1
6
2
1
New Haven County—
Waterbury
••* ••••••
Total
6
■
40
Iowa (July 1-ai):
Adair County
7
1
1
3
Maine (July 1-31):
Aroostook County-
Fort Kent (Town)....
Frenchville (Town)...
Linneus (Town)
Penobscot (bounty—
Hampden (Town)....
Oldtown
1
1
17
4
1
1
4
1
1
1
17
■
Appanoose C!ounty
Audubon County
Boone Countv
Ceno Qordo County
2
Crawford (Countv
3
1
1
Dallas County
Decatur County
Dubuoue County
2
4
3
Somerset County—
Anson (Town)
Hartland (Town)
Palmyra (Town)
Pittsfield (Town)
Steams County—
Brookton (Town)
Wasbinjrton County—
Steuben (Town)
Vanceboro (Town)...
Total
TranVlIn County t.--
Ida County
Jefferson County
2
0
3
1
4
::::::::::
Lee County
Linn County
Lyon (bounty.
Mahaska County
6
Mitchell County
1
0
1
5
1
3
4
7
1
5
1
1
Monona County
O'Brien County
60
pftfA County
Nevada (July 1-31):
Humboldt County
North Dakota (July 1-31):
Burleigh County
...
Pak) Alto County
1
Plymouth County
Pottawattamie County. . .
1
2
1
1
3
2
1
8
2
Poweshiek County. ...'....
ScottCounty ...'.
Cass County
Story County
Golden VaUey Ckmnty. . . .
Grand Forks Ck>unty
Grant County
Wapello County
Wairen County
5
Webster C<MinCy . .
6
1
2
6
Olirer County
Winnebege County
Ramsey County
Winneshiek Count'y
Ward County
Woodbury County'.
Williams County
Total
Total
110
21
South Carolina (July 1-31):
Aiken (%>nnty. .... ....^
Loaitiana( July 1-^1):
Aeadia Parish
1
2
1
6
AUen Parish
Berkeley Ck)unty
Total
r^lMciMi P^rtalt
? ::::::::::
17
?i::::::::::
8 '
2 !
Jadraon Parish . ...
7
Orleaii!^ Parish
South Dakota (July 1-31):
Clark County
Bapides Parish
7
13
2
5
1
4
3
1
1
6
3
2
3 ;
8l. Tammany Parish
Tangipahoa Parish
Winn Parish
Davison County
Day County. . .1
Deuel County
Total
«l
Grant County
Jerauld County
Maine (Juna 1-30):
?
Lake CJounty
Aroostook County-
Fort Kent (Town)....
Hodcdon (Town)
Lawrence County
Roberts County
Spink County
Hancock County-
Hancock (Town)
Tripp Crounty
Wal A'ortb County
Yankton County
Ziebach Coimty
3
Penobscot County—
Bangor .'.
Eddmcton (town) . . .
Knfleld(Town)
Total
1 1
13 ,
ll
'\
^1
67 1
3
Hampden (Town)....
Howund (Town)
Wyoming (July 1-31):
Crook Cour.ty
1
1
3
Lee (Town)
OrQoo(Town)
Piscataquis County —
Naircna County
.
Campbell County
^ Green vUle (Town)....
Somerset County—
Total
5
Anson (Town)
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August Zt, 19X1
1428
SMALLPOX— Continued.
City Reports for Week Ended Avf. 11» 1317.
Place.
Akron, Ohio
Butte, Mont
Chicago, 111
Cincinnati, Ohio
Cleveland, Ohio
Columbus, Ohio
Dayton, Ohio
Denver, Colo
Detroit, Mich
Flint. Mich
Grand Rapids, Mich
Kansas Citv, (Cans..
Little Rock. Ark....
Memphis, T%nn
Cases.
Death?.
Place.
Minneapolis, Minn...
Oklahoma dty,Okla
Omaha, Nebr
Pittsburgh, I*a
Pontiac,lflcb
Rocky Mount, N.C..
St. Joseph, Mo
St. Loub,Mo
Salt Lake City, Utah.
Seattle, Wash
Sioux City, Iowa
Tolodo.Ohio
Zanesville, Ohto
TETANUS.
City Reports for Week Ended Aof. 11, 1917.
Place.
Chicago, ni
Clevehmd, Ohio.
Columbus, Ohio.
Lexington, Ky..
Cases.
Deaths.
Place.
New York. N.Y.
Norfolk, Va
Sacramento. Cal..
St. Louis, Mo
Deaths.
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1433.
TYPHOID FEVER.
Arkansas— Paragould.
A report dated August 22, 1917, states that there had been 80
cases of typhoid fever in Paragould, Greene County, Ark., within the
preceding six weeks, and that from 3 to 5 cases daily were being
notified.
Kansas — Leayenwortlu
During the week ended August 25, 1917, 16 cases of typhoid fever
were reported in the city of Leavenworth, Kans., and 5 cases in
Leavenworth County.
Massachusetts — Gardner.
On August 24, 1917, an outbreak of typhoid fever was reported
from Gardner, Mass., 5 cases having been reported on that day, and
31 cases previously. All cases were traced to one milk route. It was
found that an intermittent carrier of the typhoid bacillus was supply-
ing milk to the distributor. Both the carrier and the distributor
have discontinued selUng milk.
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1429
Aiisa9t81.X91T
TYPHOID FEYER-^kmtinTied.
State Reports for J«ly, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
CaIilomi&:
Aiamoda County —
Berkeley ,
Hayward ,
Oakland
Batte County —
Chioo ,
Colusa County
Contrft Costa County—
Ctmcord
Ri<dinioxHl
El Dorado County
Fresno County
Fresno
Imperial County
El Centre
Imperial
Kern County—
Bakersfleld.....
Los Angeles County ,
IxM Angeles
Pomona
Napa County
Nevada County ,
Placer County—
RoseviUe
Riverside County
Corona ,
Sacramento County
Sacramento
San Bernardino County. .
San Bernardino
San Francisco.
San Joaquin County-
Stockton
San Mateo County—
I>alyaty
Santa Barbara County-
Santa Barbara
Santa Clara Ck>unty
Palo Alto
SanJose
Santa Clara
Siskiyou County—
Dunsmuir
Montague
Solano County
Soaonia County
Healdsburg
Santa Rosa.
Stanislaus County
Modesto
Tehama County
Tulare County—
Dinumba
Tulare
Yuba County
Total..
Colorado:
Archuleta County
Boulder Ckmnty
Chaffee County
Denver County—
Denw
El Paso County-
Colorado Springs.
Qunnison County
Larimer County
Mesa County
Otero County
Rocky Ford
Puebk) County-
Pueblo
Routt County
San Miguel County. . .
Total..
165
Connecticut:
Fairfield County—
Brid|»eport.'
Fairfield...
Fa
Oreenwich.
Norwalk
Ridgefield
Trumbull
Hartford County-
East Hartford
Hartford
New Britain
Litchfield County-
Salisbury
Winchester
Middlesex County-
Old Saybrook
New Haven County—
Branford
MUford
New Haven.
Waterbury
Tolland County-
Ellington
Tolland
Windham County —
Plainfield
Windham
Willimantic
Total.
Kansas:
Allen County-
La Harp€(R. D.)..
Anderson County-
Harris (R.D.)
Westphalia
Bourbon County-
Fort Scott (R. D.). .
Brown County-
Hiawatha
Butler Countv-
Augusta (R. D.)
Douglas
Eldorado
Potwin
Chautauqua County-
Elgin
Teed5(R. D.)
Sedan
Cherokee County —
Columbus
Cloud County—
Concordia
Gla^co
Coffey County-
Burlington
Comanche County—
Coldwater(R. D.)..
Protection (R. D.)..
Cowley County —
Arkansas Citv
Atlanta (R. D.)
Burden
-WinTield
Crawford County—
Cirard (ir. D.)
Mulberry
litt'^burRCR. D.)...
Decatur County—
Hcmdon
Norcatur
DicVinson County—
IJerin^on
Doniphan C junty—
46
Wathena
Douglas County-
Ualdwin
Lawrence
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Aucast 81, 1917
1430
TYPHOID FEVER-^Continned.
State Reports for Jnlj, 1917— OontiDued.
Place.
New cases
reported.
Place. ,
Newctto
reported.
Kansas-Continued.
EIlswoiHi County—
FlUwnrth fK D ^
1
74
32
2
7
Kansas— Continned.
Republic County—
Belleville
Franklin County-
Ottawa (R. D.)
Geary County-
Junction City
Rice County-
Chase (R. D.)
Sterling
Riley County—
Riley (lU D.)
Graham County—
Morland (R. D.)
Gray County—
Cimarron ..........
SaUne County—
8alin*
Sedgwick County—
In^ls
Greenwood Coxmty-
SedgwTckjfR. D.)
Wichita (R. D.)
U
Hamilton
Shawnee County—
Topeka
\f AHLqon fR D )
Quincy(R.D.)
Severy
Smith Coimty—
Smith Center (R. D.)
Stafford County—
RjtHiiini
Virgil (R.D.)
Harvey County-
Newton
Sumner County-
South Haven (R. D.)
WelUngton
Haskell County—
Satanta
Jewell County-
Burr Oak
Waphlnpton Coimty—
Washlnirfon (R, D.)
Formosa (R. D.)
Wyandotte bounty-
Ronn^r Springs. . .
Ionia (R.D.)
Johnson County—
Olathe
ITfmiffts rfty, .*;
Total
Kearny County—
Lakln(R. D.)
Kingman County—
Kinpraan
291
Louisiana:
Acadia Parish
Labette County—
Chetooa
•
Allen Parish .
F-<lTif^(R Ti,) ,
Assumption Parish
Leavenworth County-
Lea venworth (R D )
A vnyellM PAriith . . , .
I
Caddo Parish
1
Tonpanoxie (H. n,)' *'
Caldwell Parish
Linn Coimty—
La CvKne (R. B.)
Catalioula Parish
Concordia Parish
(
Lyon County—
Olpe....
De Soto Parish
East Baton Rouge Parish
rivmouth
Franklin Parish
Marshall County-
Blue Rapids
Iberia Parish
1 bcrville Parish
(
Vermillion
Jefferson Parish
Mcpherson County —
Lindsborg...
' Jefferson Davis Parish
1
Lafavetlc Parish
i
Mcpherson
Lafourche Parish
Miami Coimty—
Osawatomie (R. D.)
La Sallo Parish
Livingston Parish
Paola
Madison Parish
Montgomery County—
C'anov...
Morehouse Parish
Orleans Parish
13
Cherry vale
Ouachita Parish
ColTeyville (R. D.) .
I Plaquemines Parish
1
Independence
Rapides Parish
1
Lil>crtv (R. D.). ]
Richland Parish
Nemalia County-
Seneca
St. Charles Parish.
St. James Parish
Neosho County—
St. Paul.
St. Landry Parish
St. Martin Parish
Ness County—
NessCity
1 St. Mary Parish
1 St. Tammany Parish
Norton County—
Norcatur (R. D.)
Tangipahoa PaVish.
Terreljonne Parish
Norton
Tensas Parish
Osage County—
I/vndon
Union Parish
VermiUon Parish
]
Olivet (R. D.)
Vernon Parish
Osborne County—
Osborne
]
Webster Parish
Pawnee County-
Lamed (R. D.)
West Baton Rouge Parish
West Carroll Par&h
Pratt County—
Cuiliscm fR D ^
W*nn T*<kHsh
Total
Reno County—
Hutchinson (R. D.)
2i
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1431
August 31. 1917
TYPHOID FEVER— Continued.
State Reports for July, 1917— Continued.
Place.
Maine:
Androsoogsin County—
Durham (Town)
Aroostook County —
Fort Kent (Tfown)..
Portaf^ (Town)
Cumberland County-
Portland
Penobscot Coun^ —
Hampden (T^wn) . . .
Eomerset County —
Madison (Town)
Total
Xl^an County —
Clyde Township
Bay County-
Bay City ,
Benzie County—
Blaine Township
Franklort
CaQioon County—
Albion
Battle Creek
Ctere County —
Garfield Township . .
Clinton County-
Bath Township ,
Emmet County—
Petoskey...
Otnceee County-
Argentine Township.
FHishinE
FitotTT :.
Ingham County—
Lan^ng
Jackson County-
Jackson
Kalamasoo (>>unty—
Slalanuuoo
Kent County-
Tyrone Township. . .
Lapeer County-
Oregon Township. . .
Unawee County—
Fairfield Township. .
Madison Township. .
Macomb County-
Richmond
Manistee County—
Manistee
Monroe County-
Bedford Township . .
Dundee Township. .
Montcalm County-
Day Township
Newaygo (bounty-
Goodwell Township.
Oakland Ck)unty—
Holly...:
Baginaw 0)unty—
Brady Township
St. Charles
Saginaw
St. Clair County-
Wales Township
Sanilac County-
Marion Township. . .
Sandusky
Tuscola County—
Wisner Township. . .
Washtenaw County —
Ypsilanti
103
New I
reported.
18
Place.
M ichican — Continued .
Wayne County-
Huron Township.
Ford
Highland Park....
St. Clair Heights..
Wexford County—
CadUlac
Total.
Minnesota:
BocVcr Coimtj'—
Fraaee
Beltrami County—
Spooner
Blue Earth Count v-
Vemon Center. .
Brown Count V—
Comfrev.*
NewUim
Carlton County—
Cloquet
Clav County—
Ulen.
Dakota County-
South St. taul ,
Hennepin County-
Minneapolis
Lincoln County—
Hendricks ,
Lyon County-
Balaton
Coon Creek Township. .
MOle Lacs County-
Princeton
Nicollet County—
St. Peter ,
Nobles County-
Adrian
Olmsted County—
Quincy Township ,
Ottertail (bounty—
Clitherall
Leaf Lake Township. . ,
Pennington County—
Thfef River Falls
Polk County-
Hill River Township.. .
Ramsey County—
St. Paul
Rice County—
Faribault
Northfleld Township.. .
St. Louis County—
Duluth
Ely
Sherbtune County-
Elk River
Stearns County—
St. Cloud
Brockway Township. . .
Steele County—
Owatonna
Stevens County-
Morris
Wabasha County-
Elgin
Wadena County—
M^idow Township. . . .
Wilkin County—
Donnelly Township.
Wright County-
Otsego Township
Total
New cases
reported.
. ugust 81. 1017
1432
TYPHOID FEVBRr-Oontintied.
State Reports for July, 1917— Contmued.
Place.
New cases
reported.
Place.
New aw
reputed.
Montana:
Carlxm Countv
1
9
2
2
2
2
1
2
1
5
North Dakota:
Burleigh County
Dawson County
Cass County '.
Flathead Countv
Richland dounty
Lewis and Clark County-
Helona
Rolette County .'
Williams County ,,.,,,,_-- ,
Total
Musselshell County
Park- County—
Liviiigston
South Carolina:
Aiken County
==
SDverbow County—
Butte
ChMtAr noiin'ty - . ,
Stillwater County
Chesterfield County
Yellowstone County-
Billings
Dorchester County.
Florence County /.
Greenville Coimtv
s
Total
27
Laurens County
Marion County
Nevada-
2
Orangeburg County ! . !
Churchill County
Pickens County. . .^
RirblAnH Coiintv
14
New Jersey:
Atlantic County
4
6
7
3
3
10
1
8
5
3
4
2
4
1
4
4
Rpartanbiire County .
13
Sumter County
Bersen County
Williamsburg County
Btirlinirton Countv
Total
Camden Countv
92
Cane Mav C^mtv ...^.-.
South Dakota:
Jackson County
Cumberland County ,r-r
Essex Countv
1
Oloucoster Coiuity ,...Tr
1
Hudson Countv
Spfnk C^mty . ..'... V.
TotaL
Middlesex County ..»-^t
3
Monmouth Countv
Wyoming:
Washakie rvrnnty .
Morrifl County .•••.••••••••*••.••
Passaic County
2
Salem Coiuitv' ,t r
Natrona County
1
Somerset County
Uinta County ',
3
Total
6
TotaL
74
Maine Report for Jnne, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Maine:
Androscoggin County-
Durham (town)
2
7
Maine-Continued.
York County-
Water borough ( town)
1
Cumberland County-
Portland
Total
10
City Reports for Weelc Ended Aug, 11, 1917.
Place.
Cases.
Deaths.
Place.
Caaes.
Deaths.
Akron, Ohio
1
2
1
15
2
36
3
Charleston, 8. C
3
27
1
5
3
8
1
3
3
2
2
Alton, 111
ChftttAnnrkVA- Tmin
4
Atlantic City, N. J
Chelsea, l^iss
Baltimore, Md
4
1
2
2
1
2
1
Chicaeo 111
Beaver Falls, Pa
Cincinnati, Ohio
1
Birmingham, Ala
Cleveland,' Ohio ... . . . .
1
Boston, Mass
Cnff^yvf lie, Kans
Bridgeport, Conn
Columbia, 'S. C
Buffalo, N. Y
6
2
1
Columbus, Ohio
Cambridge, Mass
Covincton. Kv. . ...
»
Camden.V.J
Dayton, Ohio
1
Digitized by
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1433 August 81. 1917
TYPHOID FEVER— Continued.
aty Reports for Week Ended Aug. 11, 1917— Continued
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Dforer, Colo
4
11
1
2
1
Orange, N.J
Phi'adelphia, Pa
1
19
3
3
3
Detroit, Mich
1
Eist Chicapo, Ind
Pittsburgh, Pa
3
Elkab€th,N. J
3
28
6
4
1
3
1
1
3
1
3
5
0
3
1
Portland. Me
ETan^ville, Ind
2
Pcrtland Oreg
1
Fill River, Mass
Pcrtsmt uth, Va
1
FliDt^ch
1
Providen-e, U. I
1
Fort Wayne, Ind
Qulncy, III
Fcrt Worth, Tex
Reading, Pa
Grand Rapids, Mich
Richmond. Va
2
Bartibrd, tonn
Rockfcrd, III
iDdianarolbf . Ind
Sacramento. Cal
KfthinaFoo Mich
1
St. Joseph, Mo
KflKtff ntv, Kan<?
St. Lcuw, MO
3
Kin<w nx'y, Mo
Salt Lake City, Utah
San Diego, Cal
Kokoiso,Ind
San PraH'^isco, Cal
I<tnf«n«r Pa
Savannah, f^n'.
Lawrence Mass ^ .
1
2
1
Seattle, Wash
1
Uxlngtcn. Ky
Springfle'.d, III
1
LoQf Beach, Cal
2
1-
1
12
1
1
16
1
3
1
14
1
1
13
35
1
10
2
5
SpringAeld, Mass
2
3
3
1
2
1
3
3
2
1
8
2
8
13
3
5
4
2
Um Annies, Cal
Springfield, Ohia
loimcmmIp . ::: :
Steubenville. Ohio
LrnehSurc. Va.
Stockton, Cal
1
McKMsport. Pa
1
Tacoma, Wa^
MMtfonfJur^ff .
Taunton. Mass
Memphis. Tenn
2
Toledo, 6hio
Milwaakee, Wis
Topeka, Kan^
lOnncapolb, Minn
Troy,N. Y
MoWle.AIa
1
1
Wa.tham, Mas;
NtahTllIe, Tenn
WashiTTtn, D. C
Watertovm, N. Y
4
Neirark.N.J
N*v Haren Conn
Wheeling, W. Va
2
New Orleans. La.
2
3
1
Wilmin^t^n, Del
1
NewYork,!^. Y. ,..
Wilmington, N.C
Winst n-Sa'.om, N.C
Nlsttia rails, N. Y
1
Norfolk, Va.
Worcester, Mas>
1
Otkknd.Cal...!
Zanesville, Ohio
0klahainaCity,6kJa
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for July, 1917.
Caees reported.
State.
Cases reported.
Bute.
Diph.
thetia.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
OiUforaia^...
97
24
142
55
65
55
5
471
665
66
327
199
21
41
74
99
5
3
371
Minnesota
444
29
303
64
12
359
27
2
24
27
161
Colortdo '.",[
Montana
55
GannecUcnt.
Nevada
11
lowi...
Now Jersey
North Dakota
South Carolina
South Dakota
Wyoming
323
46
48
8
170
Kamas..::
328
41
119
526
15
Lonisiana..
15
Mtine....::::::::"
14
Miehigui
18
Maine Report for June, 1917.
During tho month of Juno, 1917, 18 cases of diphtheria, 374 cases
of measles, and 7 cases of scarlet fever were reported in the State of
Digitized by
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vAnffust 81, 1917
1434
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Coutinued.
City Reports for Week Ended Aof. 11
, 1917.
Popula-
tion as of
July 1,1916
(estimated
bv U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
ctUoeiB.
City.
1
1
1
1
1
1
1
i
1
Over 500,000 inhabitants:
Baltimore. Md
589,621
756,476
2,497,722
674,073
571,784
503,812
5,602,841
1,709,518
579,090
757,309
468,558
410,476
306,345
436,535
363,454
408,894
371,747
463,516
348,639
363,980
214,878
260,800
271,708
297,847
295,463
354,960
256,417
104,199
181,762
121,579
112,981
106,233
127,224
128,366
104,562
128,291
110,900
100,560
113,245
102,425
148,995
117,057
118,158
149,685
198,604
1&5, 470
109,381
156,687
117,399
105,942
155,024
112,770
191,. 554
111.593
163,314
85.625
63,-505
58,(159
57.660
69,S93
57,tl.>3
.53,97.^
67,449
60,852
60,734
261
'"'628*
'"'»7*
125
1,448
668
199
171
91
'"'iio*
116
100
39
100
61
50
42'
75
52
7
49
96
26
45
3
129
39
20
28
8
7
4
14
8
12
11
15
a
2
5
5
30
3
1
12
7
2
4
16
3
3
2
15
3
• -J
1
1
•j*
"2
19
40
28
8
6
9
111
32
20
3
4
3
3
2
4
"'i'
1
1
69
70
254
34
23
32
302
74
18
58
38
23
17
23
31
Boston, Kass
7
43
2
18
0
18
7
5
23
5
2
1
12
2
.. 6
......
......
19
Chicago. Ul
56
Clfivetand Ohio
a
Detroit Mich
16
L.OS Angeles Cal
9
New York. N. Y..:
168
PhiladriDhia Pa
SI
Pittsburch. Pa
9
St. Louis, Mo
From 300,000 to 500,000 Inhabit-
ants:
Buffalo N Y
S
IS
Cincinnati Ohio
16
Jeraev Citv. N. J
to
Milwaukee, Wis
4
Mineaoolis. Minn.
1
13
2
20
4
5
Newark. N.J
......
U
26
38
9
15
7
* "57*
17
New Orleans. La.
16
San Francisco. Cal
12
5:iAatflA WiL«h.
2
Washington, D. C
From 200.000 to 300,000 inhabit-
ants:
rnlnmhns. Ohio
7
5
Denver Colo
'
......
1
14
2
1
1 . ...
5
4
2
4
3
1
Indianapnlis, ind
TTftn^AJi Citv.' Mo
%
Portland Orec
3
5
Providence. R.I
7
Rochester, N. Y
13
2
11
U
11
18
5
11
3
4
4
4
From 100,000 to 200,000 inhabit-
ants:
Albany,N. Y
1
BlrmlnghMP, Ala. -r --.,....
60
39
36
48*
47
15
21
46
24
50
17
37
37
27
5
Bridgeport, Conn
3
2
2
1
9
1
3
8
2
1
3
2
1
1
1
6
Cambridge, Mass
1
2
4.
3
10
Camden, w. J *. ..
Dayton, Ohio
2
4
Fall River. Mass
2
Fort Wortn,Tex
Grand Rapids, Mich
Hartford , Conn
2
2
2
1
1
7
5
8
5
5
18
6
10
4
3
1
1
3
Lawrence, Mass
4
Lowell. Mass
4
Lynn, ^ass
1
3
1
1
1
1
4
Memohis. Tenn
4
Nashville, Tenn
2
New Bedford, Mass . . .
4
11
2
New Haven, Conn
4
Oakland . Cal
34
38
18
47
33
30
37
1
3
2
Omaha, ^ebr
3
Readine Pa
3
4
3
5
6
......
......
2
1
2
Richmond, Va
4
4
2
4
1
3
2
1
1
5
Salt Lake City, Utah
Springfield, Mass
1
9
10
3
Syracuse, N. Y
2
Tacoraa, Wash
Toledo, Ohio
53
48
45
i9*
4
2
8
11
2
2
7
4
4
Trenton, N, J
Worcester, Mass
3
From 50,000 to 100,000 inhabit-
ants:
Akron, Ohio
2
A lien town, Pa
1
2
4
Altoona. Pa.
1
1
Atlantic City, N.J
1
1
Bayonne, N.J
Berkeley , Cal
9*
12
11
19
27
1
1
1
1
1
2
5
5
Binghamton, N. Y
3
1
2
1
Brockton, Moss
1
Canton . Ohio
Charleston, 8. C
2
1
D^
ti'z'e'd b*
Gt
kyg
k-
5
1435
August 81. 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS^
Ck>ntinued.
aty Reports for Week Ended Aug. 11, 1917— Continued.
Popola-
tkmasof
July 1,1916
(estimated
by U.S.
Census
Bureau).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
1
1
1
1
From 50,000 to 100,000 inhabit-
ants—Continued.
Chmttanooga, Tenn.
60,076
57,144
94,495
86,690
63,705
76,195
76,078
54,772
76,183
72,015
77,214
68.529
57,343
51,155
78,283
58,221
53,794
89,612
92,943
71,744
63,867
55,186
66,805
55,643
85,336
53,330
68,805
99,519
57,078
68,946
61,120
51,550
66,083
77,916
76,776
94.265
51,656
37,733
37,385
34,814
32,730
37,633
43,435
46,193
39,319
34,611
39,074
33,361
39,873
38,743
43,458
38,203
39,233
35,486
41,781
41,863
29,353
40,496
48,477
35,363
48,886
31,576
26,771
38,676
31,677
41,097
35.384
46,515
27,587
36,964
2
1
CoTinKton, Ky...
15
4
30
39
1
7
7
1
3
3
1
4
DnluCh, lUnii;.'.! ;.....;. ;
......
2
3
1
1
2
1
EUzabeih. N. J
1
EIPaao.Tex
0
Erie, Pa
3
7
3
6
14
ETBns\iUe, Ind
34
19
32
11
19
5
8
19
24
34
2
4
2
1
1
2
Flint, Mich
3
Fort Wayne, Ind
5
HarrisburR, Pa
1
5
1
4
2
1
Uoboken, N. J..
2
Johnstown, Pa
little Rocfc, Ark...
1
4
8
1
1
Hailden, Mass
4
1
3
1
j'
3
Manchester, N.H..
1
3
MobUe. Ala
f 1
2
New BriUin, Conn..
1
1
2
Norfolk, Va..
1
Oklfttioma City, Okla. .
17
28
13
19
31
20
33
14
30
13
1
13
14
16
35
Passaic, N.J
5
1
1
3
1
6
3
3
Portland, Me
1
Rockfordf,!!!,...;::;:::'::::
fliK«r4ni«n?^. OU
4
1
5
3
6
4
Saginaw, Mich... .11. i;.;;!*
3
St. Joseph, Mo
5
San Diego, Cal
4
1
4
1
8
5
8sTannab,Ga
1
SebcnectaAy . N. Y. ...'."!.'! "
3
eioax City, Iowa
2
1
•
South Bend, Ind
,
2 ,
Bpringaold,lll ;...;
1
4
1
Springfield. Ohio
3
1
1
3
1
T%rre Haute, Ind
1
TK>y,N.Y.. .
3
3
4
WUkes-Barre.Pa
35
32
1
3
Wilmington, Del
1
1
2
1
York.A...: ::::::::::
1
2
FrQma5,000to50/)00inhabitants:
Alameda, cy
4
14
10
6
8
is'
1
1
Auburn, N.Y
Austin, Tex
1
1
2
Brookline, Man
2
: 1
Butler, Pa
3
3
1
Butte. Mont
2
1
1
5
1
Chelsea, Mass '
1
■ 1
1
Chicopee, Mass
1
OplumbU,8.C :
17
2
7
1
1
Cumberland, Md
1
Danville, ni
•
Dubuque, ni
....
1
' 1
4
8
4
3
...
..
2
Eut Orange, N. J
1
1
4
1
2
Elgin, 111.. . .
1
Everett, Mass
1
1
Everett, Wash
3
7
8
9
10
Fttchburg, Mass
....
1
Galveston, Tex
....
1 1 3
Green Bay, Wis
1
nanUton Ohio.
1
Haverhill, Mass
..
2
Jackson, ttlch
8
18
3
9
n
17
11
11
13
1
20
.*..
2
4
Kalamaioo, Mich
1
Kenosha. Wis
2
Kingston, N.V
i
Knox\1ile, Tenn
1
1
1
3
1 1 '
UCro68e,Wls
1
1 . 1
Uxlngton,Ky
1
............
3
2
lima, Ohio
2
1
1
1
. 1 1
Uncob,Nebr
Lcng Beach, Cal
1
1
1
1
.....i.
Lorsin, Ohio
1
....^
I^^U
August 81, 1917
1436
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBBRCUL0SI8-
Ck>ntiiiT]ed.
aty Reports for Week Ended Anfl
. 11.
1S17— Continued.
Popula-
tion as of
July 1, 1916
(esiimatod
by U. 8.
Census
Bureau).
Total
deaths
Diphtheria.
Measles.
Soarlat
fever.
Tubf^
coksit
City.
from
all
causes.
1
1
1
.a
1
1
1
1
1
From 25.000 to 50,000 inhabit-
ants—Continued.
32,040
47.521
20,234
20,318
27,327
20,603
31,027
43,715
37,353
31,401
31,404
33,080
46,450
41,185
38,620
30,651
36,708
38,136
46,486
43.284
38,026
38,902
27,445
36,358
46,226
36,283
48,726
80,570
29,894
43.139
43,377
33,809
29,892
31,155
30,863
22.874
13,532
21,685
15,794
U3,075
17,548
22.669
24.276
16.950
23,^9
20.930
15.39:>
114.610
17.445
13.284
17.600
23.126
15.243
20,98.')
»22,019
19.926
23.>05
17, 524
ii.fiea
12.<»fi7
14.S3I
20.193
13. 821
24.204
15.:.'K
2I.«»18
23.22N
15.969
0
11
4
6
13
9
0
12
18
0
6
12
10
13
6
12
8
0
8
9
7
-
1
4
3
1
MMfArd Mft«i..
1
Ifontclafr N.J
1
Nashua, N.H... "*
'
]
Newburgh, N. Y
1
'
'
}
Newport. Ky ,
2
Newton ^ass. ...!
1
:::::'i :::::
3
Niagara FaUs-NVYl '.
Noirtstown, ^
1
Ogden, Utah.. **!!!...
1
Oranro, N.J.....'.'.'.'.;
Paadena,Cal.
*
1
3
1
I
Perth Amboy, n! j" "
pittafleid, Mass ....'.'..;;;;! ;
2
1
2
4
1
1
Portsmouth Va
Quincy, ni..
,
I
2
1
1
1
Radne.'WIs..
1
Roanolce, Va."
1
1
Rocic Island. HI
San Jose, Cai..
1
1 2
Steuben ville. Ohio
5
1
Stockton, OU . .
I
1
3
I
Superior, Wis
5
17
9
5
Taunt on'^ais
1
5
3
Topeka, iKans -------
1
Waltham Mass
2
2
1
1
..........<-
Watertown N Y
2
3
West noboken. N.J '.V.V.'.'.'.
WhecUng, W. <ra
4
13
10
1
1 1
1
WilUamsDort Pa
3
1
..I ! !
Wilmington, N. C
1 !
Winston-Salem n"c
1
3
..»
Zanesville Ohio
1
From 10,000 to 25,000 inhabitants:
Alton, ni
10
1
1
4
Reaver Falls Pa
:;::;:i:::::..:. ..
Braddock Pa.
2
Cairo, m..
"3
1
I
Clinton. Mass.
1
4 '
CofTo yviUe, Kans. .1 ]
I
I
Concord, I^. II.....' V.V.V..'.
I
1
2
2
1
2
Oalesburg. Ill . . .
1 1
ilarrison, N.J
1
Kearny N J
4*
4
4
2
3
5
2
4
Kokomo Ind.
1 1
I
Lorn Branch N J
1
3
Marinette Wis
1
1
Melrone, Mass... ] !
2
1
Iforrittown N J
.' ... 1
Muscatine, Iowa
1
1
Nantocolcc l*a
1
Ne^burvDort Moss
3'
9
7
9
1
1
New Lxindon Conn
.. 1
North Adam.<< Mass
1
Northampton, Moss
2
2' 4
3
Plainflcld. N. J...
;;::::
1
Pont too Mich
2
.1
1
Port.MntHil h N. il
1 1 ■... .
Rock V Mount N C
" 3
5
9
5
2
1
Rutland, Vt..'..
I
1
1 J
1
Hsndusky Ohio
1
_. • "Vj
t
Karat OKU t^prinRs, N. Y. '.'.'. '. '.
HoiitJi lirthlchrm. Pa
Htf^Mon l*a
. ..
::;;::: :::i::::
1
1
1
......
'i
Washington, Pa
.(
1
{
Wilkin^liiirfj I*a,.
3
1
1
1
i
Woburn Mom
1
-
r^
> Poputation Apr. 15; 1910; no estimate mad^j
jrfrzed by
Google
FOREIGN.
CHINA.
Examination of Rats — Slianghal.
During the period from June 3 to July 14, 1917, 1,666 rats were
examined at Shanghai. No plague infection was found. The last
plague-infected rat at Shanghai was reported found May 6, 1916.
Plaifoe-Infected Rats — Hongkong.
During the period from June 17 to 30, 1917, out of 3,709 rats exam-
med at Hongkong, 3 were found plague infected. -During the week
ended July 7, 1917, 2 plague-infected rats were found at Hongkong
out of 2,015 examined.
CUBA.
Commnnicable Diseases — ^Halmna..
Communicable diseases haye been notified at Habana as follows:
July 11-20, W17.
July 21-31, 1017.
Re-
maining
Disease.
New
cases.
Deaths.
New
cases.
Deaths.
under
treatment
Dfphtberia ,
1
1
2
5
LmrofT
10
fflbX: ;;;:;;;:;;;;;;:;;:::::::;; ;
11
* 8
4
16
11
1
29
2
31
mSS;::::::::::::::::::::::::::;::::::::::;:::::::
10
Pvityphoid fever
1
3
sctrkJBSiw.r.T!.;;::"::.™:::::"::":::::::^
1
Typhoid feTer
23
6
7
64
viSwn*..!!.;:;::;;;;:;;:;;;;;;;;;;;;;:;:;:;;;;:;;:
2
INDO-CmNA.
Cholera — Plaifoe — Smallpox— March, 1917.
During the month of March, 1917, 41 cases of cholera, 97 cases of
plague, and 1,023 cases of smallpox were notified in Indo-China.
The cases were distributed by provinces as follows:
Cholera. — ^Province of Anam, 3 cases; Cambodia, 1 case; Cochin-
China, 36 cases; Tonkin, 1 case.
Plague. — ^Province of Anam, 41 cases; Cambodia, 35 cases; Cochin-
China, 20 cases; Tonkin, 1 case.
Smallpox. — ^Province of Anam, 491 cases; Cambodia, 37 cases;
Cochin-China, 461 cases; Kwang-Chow-Wan, 2 cases; Tonkin, 32
cases.
(1437)
Digitized by
Google
August 31, 1917
1438
The numbar of cholera cases occurring during the month of March,
1917, was double that for the preceding month, being 41 as against
20. For the month of March, 1916, the number was 685, of which
457 were reported from the Province of Anam. For March, 1917, only
3 cases were reported in Anam.
The number of cases of plague was the same as for the correspond-
ing month of the year 1916. For the month of February, 1917, the
number of plague cases was 101.
The number of smallpox cases reported during March, 1917, was
almost double that for the preceding month, being 1,023 as against
593. During the corresponding month of the year 1916 the number
of smallpox cases was 266. The increase in the prevalence of small-
pox is beUeved to be due to the discontinuance of vaccination tours
throughout the country during the past two years.
ITALY.
Deratizadon of Vessels — ^Naples.
Fumigation of vessels to destroy rats was ordered at Naples to be
put in force from July 23, 1917, for all vessels having traversed the
Suez Canal and destined for ports in the United States, option being
given of fimiigation at Naples or at United Stages port of arrival
MEXICO.
Yellow Fever— Peto, Yucatan.
During the two weeks ended August 11, 1917, six cases of yellow
fever were reported at Peto, State of Yucatan, Mexico. The cases
occurred in soldiers brought into Yucatan during the past year.
A fatal case of yellow fever was reported at Peto June 23, 1917.*
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVEB.
Reports Received During the Week Ended Aug. 31, 1917.^
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bombay
Jane 24-30
1
1
Madras
do
IndoChina:
Provinces
Mar. 1-31, 1917: Cases, 41; deaths,
28.
Anam
Mar. 1-31
36
1
1
26
Cambodia
do
Cochin-China
do
Tonkin
do
Java:
West Java
Hay 11-June 28, 1917: Cans, U;
deaths. 6.
Batavia
May n-June28....
2
t Public Health Reports, July 13, 1917, p. 1121.
* From medical officers of the Public-Health Service, American consuls, and other sources.
Digitized by VjOOQIC
1439
August 31. 1917
CHOLERA, PLAGITE, SMALLPOib TYPHUS FEVfiS, AND YELLOW FEVER^
Continued.
Reports Receired Dnriiig the Week Ended Aug. 31» 1917— Continued.
PLAGUB.
Place.
Date.
Cases.
Deaths.
remarks.
Chtna:
HooEkflie ,
June 17-30
7
6
cSr!^::::::;:::::::::::
July 1-7
Tivli» -
June 24-30, 1017: Cases, 1,482;
deaths, 1,002.
Bombay -
June 24-30
35
2
33
K»ni^*^l
do
Madras Presidency
do
Indo-Chixia:
Provtnoes
Mar, 1^1, 1017: Cases, 97; deaths,
70.
Anam
Mar. l-s]
41
35
20
1
Cunbodf^
do
rVK!bin-Oftim
do
Timktfv
do
Jara:
East Java
Apr. 23-May 20. 1017: Cases, 11
deaths, 11.
DJociakarto R«8idaicy.
KedWResideiicy
Bamanmg Residancy. . .
Surabaya Residency . . .
Sorakarta Residency. . .
Apr.23-May«
do
Apr.28-May»....
do
Kay 7-20
1
1
3
5
1
SMALLPOX.
AostfBUa:
New South Wales
June 22-JuIy 5, 1917: 48 caaet.
June22-July5....
do
1
47
1
Warren district
Canada:
Ontario-
Ottawa
July30-Aug.5....
July 1-7
China:
Chrniffkinc.
Present.
Dairen
..!^do........::::
I
Hankow , , . . r . r
June2+-30
July 15-21
Mnkden -t^.t
Chosen (Korea):
Chemulpo T...r...-TT,-
May 1-31
1
14
2
5
bidia:
Bombay ...•...•••••......
June 24-30
do
4
2
5
Karachi
Madras
do
Indo<nilna:
Provinces
Mar. 1^31, 1917: Cases. 1,023;
deaths 178
Anam . ^.-..-r....
Mar. 1^
491
37
461
2
32
9
18
36
56
16
105
Cambodia..
do
Cochio-China
Kwanj?-Chow-Wan
do
do
do
Topf^in .
1
Japan:
^5>be -
July 16-22
May6-Juncl7....
May5-Jiir.„'10. ...
Java:
East Java
1
3
Mid-Java
WestJava
May 17-J.une 28. 1917: Cases, 160;
deaths, 23.
Batavia
May 17-June 28. . .
Aug. 1-7
18
4
7
Mexico:
Maratbin
Mexioo
June»-28
09
20
Do
Aus.5-11
6
Spain:
Sevine
June 1-30
Straits Settlements:
Rinjapon*
June 24-30
1
Digitized by
Google
Ausnst 31, 1917
1440
1
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW PBVER^
Continued.
Reports Received During the Week Ended Aug. 31, 1917— Oontinued.
TYPHUS FBVER.
Place.
Date.
Cases.
Deaths.
Remarks.
China:
Antung
July 16-22
July 9-15
July 1-14
2
72
^'^Jfticandrl.
27
10
'
Greece:
Saloniki
Java:
East Java
May6-Junel7....
6
Bild-Java
May 5-June 10, 1917: Cases, 21;
deaths, 2.
Samarang
May&-JunelO....
14
2
West Java
May 17-iune 21, 1917 Cases. 57;
deaths, 6.
Batavia
Mayl7-June21...
June S-28
44
340
105
3
0
1
6
Mexico:
Mexico City
Do
Aug.5-U
Netherlands:
Rotterdam
July 15-30
Norway:
Bergen ••..
July 8-14
Switzerbnd:
Basel
July 14-21
YELLOW FEVER.
Mezioo:
Yucatan, State—
Peto
Reports Received from Jane 30 to Aug. 24, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bassefn. ....•■.••••••.**.rT
Apr. 1-May 5
8
335
3
1
3
1
1
16
Calcutta -----
Apr- 29-Jime 9
Madras. ......•••••••••••■•.
Apr. 22- June 0....
3
Mnndatay ,.,.,,„
Moulmefii.. ••«••••••••••• IT
May i3-Jtme 2
Pakokku
Apf.20-May5
Pegu
May27-June2
Rangoon... •...•••••••••...
Apr. 21-June9
30
Indo<:hfea:
Provinces •......••.•.
Feb. 1-28, 1917: Cases, 20; deaths,
Anam ■..■■.■■•«>t
Feb. 1-28
3
8
8
1
163
1
Cambodia
do
6
6
C-och in-China - .
do
Tonkin .....r
do
Saigon..
Apr.23-May27...
Apr.2-8
Java:
East Java
West Java
Apr. 13-19; 1917: 1 case.
Batavia
Apr. 13-19....
1
1
4
1
3
1
Persia:
Mazanderan Province-
Amir Kela
Feb. 3
Barfourouche
Jan. 15-17
Jan. 17
Machldessar
Jan. 31
Philippine Islands:
June 17-23
Provinces
May 2a-Junc 30, 1917: Cases, 795;
Albay
May 2O-June30....
July 1-7
113
2
2
1
368
66
76
1
1
1
251
45
deaths, 500. July 1-7, 1917:
^ ::::::
Cases, 315: deaths, 201
June 3-9
Batangas
June 17-23
May 20- Juno 30...
July 1-7
Bohol
Do
r^^^^T^
1441
August 81. 1917
CHOLEBA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-^
Continued.'
Reports Received from Jane 30 to Aag. 24, 1917--^ntinued.
CHOLESA— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
PhlUppine Islands— Contd.
Prorinces— Continued.
Capit
Do
Cebu
Do
noao
Lejrte
Do
Negros Oriental
RitaL
Do
Sorsogon
Do
Ta]rabas
Do
June 3-30..
July 1-7....
June 3-30. .
July 1-7,...
July 1-7....
June 10-30..
July 1-7....
July 1-7....
June 24-30.
July 1-7....
June 3-30. .
July 1-7....
do..
July 1-7..
19
231
54
7
14
4
4
1
1
196
82
7
1
40
15
150
38
4
5
4
4
PLAGUB.
Arabia:
Aden..
Brufl:
Babia
Ceyloo:
Colombo
China:
Amoy
Hoogkoog
Kwangtunf Province—
Pa-pu district
Alexandria
Port Said government . .
Port Said
Provinces—
Fayoum
Galioubeb
Girgeh
Mlnieh
Siout .-
Sues govemmenf
Suet
Great Britain:
London
India
Bassein
Bombay
Calcutta
Hentada
Karachi
Madras Presidency.,
MandaUy
Moulmein.
Myln^yan
Pepi-
Rangoon
Tounicoo
lodo^hlna:
Provinces
Anam
Cambodia
Coehin-China. . .
lava:
East Java
Surabaya. .
Surakarta..
Hay 3-June 11.
Juno 10^.
Apr. 8-June 9. .
Apr. 29-May5..
Iirayl3-June9.
June 2
June 21-27
Apr.30-Mayl9..
June 25
May 11- June 20..
June 28
May 17
May 12-June 28..
May 12.
Apr. W-June 2. .
Ifoy 12-June 28..
Maya-8
Apr. 1- June 2...
Apr. 22-JtmelO.
Apr. 29-June2..
Apr. 1-May 19. .
Apr. 22-June9..
Apr. 22- June 10.
Apr. 8-May 12. .
Apr. 1-June2...
Aor. 1-7
May 27-June 2. .
Apr. 15- Juno 9..
Apr. 8-14
Feb. 1-28
....do
....do
Apr. 23-June 3 .
Apr. 2-22..
....do
13
0
4
4
3
1
14
7
1
406
467
268
143
42
326
38
33
411
233
9
59
1
2
13 1
2
Apr. »-May 14, 1917: Cases, 60;
deaths, 51.
Present and in vicinity.
Present
Jan. 1-June 28, 1917: Cases 564;
deaths, 313.
2 in hospital at port. From s. s.
Sardinia from Australian and
oriental porta.
Apr. 16^ Jane ft, 1017: Cases,
40,958; deaths, 28,193.
Feb. 1-28. 1917: Cases, 101;
deaths, 71.
Apr. 2-22. 1917: Cases, 18;
deaths, 18.
Digitized by
Google
August 81, 1917
1442
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Gontinued.
Reports Received trom Jnne 30 to Aug. 24, 1917— Oontinued.
PLAGUE— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Peru
May 16-31, 1917: Cases, 15.
Departments—
Arequipa
May 16-31
12
2
At Moltondo.
canio.: ....:..:!!
do
AtCaUao.
Lambayeque
do
AtChiclayo.
TnijiUo.
At Lima.
Libertad
do
Lima
do
Siam:
Banslcok
Apr. 22-June2
July 3-23
11
3
1
r>o. :::::::::::::::::::
Straits Settlements:
Singapore
June 3-16
Union of South Africa:
Cape of Good Hope State—
Glengrcv district
Aug. 13
Present.
Tar ka district
May28
1
1
1
At Bnmmerhill Farm.
Queenstown
June 6
Orange Free State
Apr. 16-22. 1917: 1 case; Apr. 9-22,
1917: Cases, 26; deaths; 17.
Winburg district
May 28
1
SMALLPOX.
Australia:
Now South Wales
Brewarrina
Coonabarabran
Quambone
Queensland-
Thursday Island Quar-
antine Station.
Bra?il:
Bahia
Riodo Janeiro
Do
Canada:
Manitoba-
Winnipeg
Nova Scotia—
HaUfax
Fori Hawkesbury.
Ceylon:
* Colombo
China:
Amoy
Antting
Chungking
Changsha
Dairen
Ilarliin ,...,
Hongkong
Manchuna Station
Mukden
Do
Shanghai
Tsitshar Stotlon.
Tsingtao
E?yr.f
Alexandria
Do
Fr^rice:
i'uris
Co n.any
i'crlm
I-romen
Charlottenburg.
Hamburg
Leipzig
Labock
Mimich
Stuttgart
Apr. 27-June 21 .
May 25-June7
Apr. 27-June 21 . . .
May 9
Mav6-June30. .
...:do
July 1-14
June 10-16
Junel8-July7..
.Tune 17-30
May 6-12..:.
Apr. 29-May26.
May21-June24.
May 6-June23..
May 27-June 2..
May 13-June30.
Apr. 23-May 6. .
May 6-Junel6..
Apr. 23-29
May 27-June 2.-
Julya-14
May21-Julyl...
Apr. 16-22
May 2?-July 7..
Apr. 30- July 1.
July 2-8
May 6-12..
Mar. 1»-Apr. 28.
.do...:.
.do.
.do.
.do.
.do.
.do.
.do.
4
126
50
13
106
16
18
50
20
2
10
1
Apr. 27-June 21, 1917: Cases, 90.
From s. s. St. Albans from Kobe
via Hongkong. Vessel pro-
ceeded to Townsvllle, Bris-
bane, and Sydney, in quarsO'
tine.
Piiesent in district.
Present and m vidnitj.
Present.
On Chinese Eastern By.
Do.
Present.
Do.
Cases foreign; deaths among Qi"
tives.'
On Chinese Eastern Ry.
At another station on railwayi
lease.
Mar. 18-Apr. 28, 1917: Cases, 715
in cities and 32 Stotes and dis>
tricts.
Digitized by VjOOQIC
1443
August 31. 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from June SO to Aug. 24, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Cases.
.Deaths..
Remarks.
India:
Bombay
Apr. 23-Junel6...
Apr. 29-May26...
149
SQ
12
5
43
4
CalcutU
Karachi
Apr. 22-June9....
Apr. 22- June 16...
Apr. 15-JuneO....
20
78
SO
Madras
Raneoon
Indo-Chuia:
Provinces
Feb. 1-28, 1917: Cases, 583; deaths,
Apftin . . . ,
Feb. 1-28
297
36
193
67
199
32
S6
1
177
1
11
16
7
1
53
1
63
12
16
CAmhfMliA.
do
Corhin^hioA ... ..^ ... .
do
Tnnkit, , .
do
Saigon
Apr. 27-JunelO...
May21-June24...
May27-July8
May28-June3....
Maylft-JulyS
May27-Julyl
Apr. 2-29
ItalyT^
Japan:
Kobe
NamaaU
oaSka... ..::::::;::::::::::
55
1
1
Yokohama a
Java:
East Java
Mid-Java
Apr. 1-21
West Java
A^lg-ltoy 10, 1917: Cases, 46;
BatavU
Apr. 13-May3....
July 11-17
11
2
2
Mexico:
Masatlan
Mexico City
JuneS-ao
162
Monterey
June 18-24
24
VeraCrax
July 1-7
1
6
14
PhiUnpine Islands:
Mayl*nJune«....
Mayl3-June30...
Mar. 1- Apr. 30.,..
Variokiid.
Portugal:
Usbon
Portagueso East Africa:
Lourenco Marques
2
2
Russia: *
Archangel
Mayl-June28....
Feb. 18-June9....
Mar. Il-June2....
Mar.l&-21
23
495
4
23
6
Petrograd
Riga
Jan. 1-Mar 31, 1917: Cases, 9.
Vladivostok
7
3
4
5
Siam:
Bangkok
June 9-23
Spain: ^
Madrid
May 1-Junel9
Seville
Mayl-31
Valencia
June 3-23
5
2
6
1
2
2
Do
July 1-7
Straits Settlements:
Penang
Mar. lg-Juno23...
Apr. 22-28
3
Sweden: ^
Malmo
^ Stockholm
May20-June23...
June 2-8
1
Tunisia:
Tunis
■^key in Aria:
Trebizond
Feb. 25-Apr. 13...
15
Union of South Africa:
„ Johannesburg
Mar. 12-24
Mayl-31
4
2
Uruguay:
„ Montevideo
Venetoela:
Maiacaibo
June 18-July 8
8
Digitized by VjOOQIC
August 81, 1917
1444
CHOLERA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received from June 30 to Aug. 24, 1917— Continued.
TYPHUS FEVER.
Place.
Date.
Cases.
Deaths.
Remarks.
Algeria:
AlgiOTS
June 1-30
'
3
Austria-Hungary*:
Austria
Oct. 22-Dec. 17, 1916: Cases, 2,371.
Bohemia
Oct.22-Dec. 17....
do
617
16
343
5
Galicia
Lower Austria
do
Moravia
do
Silesia
do
Btyria .
do
* Upper Austria
do
Hungary
Feb. 19-Mar. 25, 1917: Cases, 1,W1.
Budapest
Feb.19-Mar.25...
June25-Julyl....
July 9-15
83
3
2
1
1
4
1,648
73
China:
Antung.. ..
Do . ..
1
Hankow
June 9-16
Tientsin,,..
June 17-23
Tsingtao
May ?(>-July7....
Apr.3a-Julyl
July 17-23
^^exandria
478
23
1
32
Do
Great Britain:
Cork
Junel7-23
Greece:
Saloniki
Mayl3-June30:...
Nagasaki
Junell-24i
4
12
7
^r:::::::::::::::::::
July 9-22
I
2
Java:
Mid-Java .
Apr. 1-30
West Java
Apr. 13-May 10, 1917: Cases, 90.
Batavia
Apr.l3-MayiO...-
June3-30
22
431
3
1
2
5
Mexico:
Mexico City
Netherlands:
Rotterdam
June 9-23
2
Portuguese East Africa:
Lourenco Marques
Mar. 1-^1
Russia:
Archangel
May 1 -June 28
Feb. 18-June9....
May31-June2
Mar.29-May21....
May 1-31
3
Riga
Jan. 1-31, 1917: 1 case.
Vladivostok
Spain:
A Imeria
5
2
Madrid ;
do
Switzerland:
Basel
June 17-23
1
2
2
Do
July 8-14
1
Trinidad
June4-9
Tunisia:
Tunifl
June 30-July 6
1
YELLOW PEVEB.
Mexico:
Yucatan, State—
Pcto,
June 23..
In person recently arrived from
Mexico City.
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PUBLIC HEALTH REPORTS
VOL. 32 SEPTEMBER 7, 1917 No. 36
TETANUS IN COURT-PLASTEB.
A report just received from the Director of the Hygienic Labora-
tory of the Public Health Service states that out of 13 specimens
of court-plaster examined, 2 were found to be contaminated with
tftanus bacilli. The specimens were secured from drug stores and
were in original packages just as the product goes to the consumer.
There is no ground for beUeving that the contamination was an
intentional one. Whether contamination occurred during the process
of manufacture through the use of infected ingredients, or subse-
quently by careless handling remains to be determined by further
investigation.
It was also found that coiui;-plaster is not ''clean'' in the surgical
sense.
The report of the laboratory findings in the examination of the
specimens of court-plaster appears elsewhere in this issue.
RODENT DESTRUCTION ON SHIPS.
A RBPORT ON THE RELATIVE EFFICIENCY OF FUMIGANTS AS DETERMINED BY SUB-
SEQUENT INTENSIVE TRAPPING OVER A PERIOD OF ONE YEAR.
By R. H. Creel, Assistant Surgeon General, and Fbiench Simpson, Passed Assistant Burgeon, United
States Public Health Serrice.
Much has been written of the effectiveness of various agents used
in the fumigation of ships for the purpose of destroying rats, but thus
far practically all definite data have been obtained from experimental
studies performed imder artificial conditions.
For many years arbitrary standards for the strength of sulphur
dioxide as a fumigant have been provided in the United States quar-
antine regulations and the length of exposure has been Ukewise
indicated. Although based on experimental investigation, the effec-
tiveness of these standards has been supported to some Extent by the
general observations of quarantine officials. It has frequently been
nojted that a very large nimiber of rats have been killed on ships as a
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result of sulphur fumigation, but regardless of the number d^troyed
it has alwajrs been a matter of speculation as to how many survived.
In more recent years tentative standards have been adopted for
the cyanide fumigation of vessels, both as to strength of the gas and
duration of exposure. It is repeated, however, that both the stand-
ards for sulphur dioxide and cyanide gas were based on experimental
studies, and, as is well known, artificial conditions rarely coincide
with the natural, however painstaking the attempt may be to simu-
late the natural. A true test of efficiency would be that applied to
the procedure as carried out in routine practice. Generally speaking,
an opportunity for such practical test has been wanting until recently
During the past year the combination of conditions at New Orleans
made such a test feasible. These favorable circumstances were, first,
the fumigation of a large number of vessels at the port of New
Orleans and at the Service quarantine station at the mouth of the
Mississippi River; second, the availability of a large and experienced
force of trappers at New Orleans. The Public Health Service, in carry-
ing out plague eradicative and preventive measures in the city of New
Orleans, has maintained an adequate force of trappers throughout
the entire city, and during the past year or two those men trapping
along the wharves and river front have been specially selected for
their efficiency and reliability, and their work has had the very
closest supervision. The pattern of trap generally employed (almost
exclusively so) was the snap trap, and on the various vessels trapped •
the number used has varied from 20 to 140, according to the size of
the vessel. The nimiber of days trapped varied from one to ten,
depending on the length of the vessel's stay in port.
Accordingly, therefore, it was planned to make careful record of
the intensive trapping of all vessels subsequent to their fumigation,
and in this way to obtain a fairly reliable estimate of the efficiency
of the fumigation. Re<iord was maintained of the results on 214
vessels, the inclusion of a gr-eater number of vessels fumigated being
precluded by inability of trapping on account of the departure of the
vessel immediately after fumigation.
The results obtained are divided into groups, according to the
nature of the fumigant employed, and the part of the vessel where
the rats were either destroyed by the fumigation or were subsequently
trapped. The proportion of cyanide used was 5 ounces per 1,000
cubic feet of space with duration of exposure of IJ hours for holds
and one-half hour for superstructures. Some 10 vessels fumigated
with cyanide at the New Orleans quarantine station were not taken
into consideration as they varied somewhat in the proportion of
cyanide and duration of exposure from those fumigated at the city
of New Orleans. Throwing out of consideration these 10 vessels,
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September 7, 1917
however, produced no material change in the estimate of efficiency
of that gas. Sulphur when used was in the proportion of 3 potmds
per 1,000 cubic feet of space, with duration of exposure of 6 hours
for holds and superstructures alike.
Scries 1.
TE8SBL8 FUiaOATBD BrTHER WITH CYANIDE OAS OR SULPHUR DIOXIDE.
In this group the results of fumigation are considered in respect to
the entire vessel, regardless of the condition of the ship (loaded or
empty) or location from which rats were taken.
Table 1.
Nature of fumigant.
Number
of vessels
treated.
Number of
rats killed
by fumi-
gant.
Number
of rats
trapped.
Peroentage
ofofflciency
of fumi-
gant.
Sulphur dioxide..
Cyanide gas
62
183
747
2,811
223
121
Percent.
n
95
Table 1 affords a fair estimate of the relative efficiency of cyanide
gas and sulphur dioxide. It would appear that whereas cyanide
fumigation of 182 vessels resulted in the destruction of 95 of each
possible 100 rodent inhabitants, sulphur dioxide destroyed only 77
of a possible 100 in a series of 62 vessels treated with that fumigant,
and this notwithstanding that the duration of exposure to sulphur
fumes was 6 hours, in contrast to li hours or less when cyanide
was used.
Series 2.
Tablb 2.
Nature of fumigant.
Number
of vessels
recorded.
Compartment of
Tessel considered.
Number of
rats idlled
by fumiga-
tion.
Number of
rats subse-
quently
trapped.
Percentage
of eflScien-
cy of fumi-
gant.
Sulphur dioxide .
Cyanide ns
Sulphur dioxide.
Cyanide gas
Soiphor dioxide.
Cyanide gas
Superstructure!
...Tdo.»
Holds (empty).
do
Holds (loaded).
do
133
729
702
854
101
107
45
28
9
89
20
55
94
90
99
64
80
> Soperstmcturos include storerooms, crews' quarters, cabins, poop deck, etc.
Table 2 represents the efficiency of fumigation as appUed to
various compartments, such as superstructure3 and holds, both empty
and loaded. The various groups recorded in Table 2 are those taken
from Table 1 in all cases where rodents were reported with reference
to compartment of ship as either destroyed by fumigation or captured
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September 7, 1017 1448
by trapping. The groups in Table 2 do not represent partially
fumigated vessels, since all vessels were fumigated throughout,
excepting ei^ine rooms of some vessels. The comparatively smaller
number of vessels in Table 2 is due to the fact that during the first
six months, reports included only total number of rats without refer-
ence to compartments from which taken, and also that on a con-
siderable number of vessels n^ative residts were reported both as to
trapping and fumigation. The grouping was made from records
where available and thus can not be considered as ''selected cases."
The residts obtained from the two methods of fumigation are
contrasted and indicated in the table, and it will be noted that there
is a very marked disparity in the efficiency of sulphur dioxide as
compared with cyanide gas, in the treatment of superstractures.
These compartments, such as store rooms, poop decks, crews' quar-
ters, etc., are generally partially filled with suppUes, stores, dunnage,
etc., and it would appear that the greater effectiveness of cyanide
gas is due to its greater penetrating powers, as well as toxicity. It
may also be that sulphur dioxide, on account of its odor, may pro-
vide more of a warning to the rats and enable them to secure greater
protection; whereas cyanide with less odor and without the physically
irritating properties of sulphur dioxide, may result in the destruction
of the animal before it can secure available covert.
In the fumigation of the empty holds of vessels there is no material
difference in the results obtained, although here as elsewhere there
should be considered the difference in the length of exposure. Con-
sidering the respective gases, the results on vessels fumigated with
cargo-laden holds indicate a greater efficiency for cyanide gas,
although the number of vessels tabulated is rather small for the es-
tablishment of any general coniclusions. Conditions in storerooms,
crews' quarters, poop decks, etc., are more or less similar to those of
loaded holds, and on the basis of the results of the fumigation of
these superstructures, it is behoved that it can safely be asserted
that cyanide gas is far more effective in the fumigation of loaded
holds than is sulphur dioxide.
Rodent Infestation of Engine Flreroom.
The question frequently arises in the minds of quarantine officers
as to the advisabihty or necessity of including the engine fireroom
of a vessel when performing fumigation for rodent destruction.
Inasmuch as there is very limited harborage in the engine fireroom,
and very httle in the way of food to invite rat infestation, it is gener-
ally considered that the fumigation of this compartment is of ques-
tionable value. Aside from this aspect of the case, the thorough
fumigation of the engine fireroom entails a very considerable increase
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1449 September 7, 1917
in the detention of vessels undei^oing fumigation; since the fires have
to be either drawn or banked, and the funnels carefully covered over
with tarpaulin in order to prevent the escape of the fumigating gas.
Subsequent to the fumigation of these compartments there is a
further dday incident to renewing the fires or raising steam.
From the records maintained during the past year opportunity
has presented for estimating the amount of rodent infestation of
engine firerooms. In the case of 99 vessels fumigation of these
compartments was omitted. The total number of rats killed in
otiier parts of vessels by fumigation was 2,026. The trapping of
these 99 vessels resulted in the capture of 31 rats in engine fireroom,
the total being taken from 1 1 vessels. Computed on the total number
of vessels considered it woxild appear that the rodent infestation of
tiie engine fireroom compartment was one-third rat per vessel. Com-
puted on the total infestation, the number infesting the engine fire-
room compartment was 1^ per cent.
The number of days each vessel was trapped varied from 1 to 13,
and the average niunber of days trapped for each vessel was 3.6
days. The number of traps placed on. the vessels ranged from 16
to 140, according to the size of the vessel. The average number of
traps placed was 37 traps to each vessel. On one vessel on which 172
rats were destroyed by fumigation, and on which the engine fire-
room was not fumigated, three days* trapping of this compartment
failed to demonstrate any rodent infestation. The same applies
to two other vessels, on one of which 109 rats were taken and on the
other 140 rats. On the other hand, of the li vessels on which rats
were trapped in the engine fireroom, one ship yielded 8 rats captured
in this compartment during the 13 days 'of trapping, although only
3 rats were killed in the other parts of the vessel. This was a very
exceptional case, as in most instances where rats were trapped in non-
fumigated engine fireroom compartments the number was generally
one or two.
General Conditions.
The writers have considered two sources of error in presenting
these figures: First, notwithstanding the thorough search of vessels,
it is probable that a certain number of rats destroyed by fumigation
were not recovered by the searchers, and to this extent, therefore,
the percentage of efficiency woxild be greater than that indicated;
second, while it is believed that the trapping results were fairly
dependable, and for the most part represented (with the exception of
a negligible figure) the total number of rats that escaped fumigation,
it is nevertheless apparent that trapping results can not be considered
as perfect, and to this extent the percentage of fumigation efficiency
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September?, 1917 1450
woxild be less than that indicated. After thorough ccmsideration of
both factors, knowledge of the dependability and effici^icy of the
trappers and fumigators, and the general conditions attending bodi
the fumigation and trapping of vessels, the writers are of the belief
that the one source of error will offset the other, and that the per-
centages of eflficiency indicated in Table 1 and Table 2 are trustworthy.
It is apparent that sulphur fumigation is not effective for tiie de-
struction of rats on loaded vessels or in superstructures. Whether
this deficiency can be remedied by an increase in the amount of sul-
phur used or in prolonging the exposure, or whether a change in the
procedure woxild be justifiable in the face of results of cyanide fumi-
gation, are problems requiring further consideration.
The effectiveness of cyanide gas when used according to the
tentative standards now in practice seems sufficient for empty holds
and superstructures. It woxild seem probable, however, that in ves-
sels with cargo-laden holds either a greater strength of the gas is re-
quired or a more prolonged duration of exposure. It is not to be
expected, however, that any method of fumigation can result in 100
per cent efficiency.
Judging from the results of our observations it would appear that
the fumigation of engine and fire rooms can, under ordinary condi-
tions, be omitted, without materially reducing the effectiveness of the
destruction of rodents on vessels. The omission of the fumigation ot
these compartments on 99 vessels apparently resulted in the escape
of H P^r c®^^ ^f ^^^ rodent inhabitants, but inasmuch as it seems
probable that in ordinary practice the efficiency of fumigation can
not be expected to exceed 96 per cent, the addition of H P^r cent in
effectiveness seems immaterial. In exceptional cases, such as
demonstrable plague infection on board vessels, it is believed that the
engine and fire rooms should be included in the procedure.
TETANUS IN COURT-PLASTER.
RESULTS OF THE BACTERIOLOGICAL EXAMINATION OF 14 SPECIMENS.
By O. W. McCoy, Director, Hygienic Laboratory, 3. P. Leake, Passed Aaeistaiit Surgeon, and B. B.
CoRBiTT, Sanitary Bacteriologist, United States Public Health Service.
So much has appeared in the public press about alleged intentional
contaminations of court-plaster with tetanus, and so many inquiries
have reached this laboratory on the same subject, that the following
record of our experience with the examination of court-plaster is
presented.
We have no evidence whatever that any specimen we examined was
deliberately contaminated. Indeed, so far as our work goes, we do
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1451 September 7, 1017
not have clear evidence that the court-plaster as it leaves the manu-
facturer carries the organism of tetanus; but we have proved that
when the plaster reaches the user this oi^anism may be present.
Source of Material.
The first specimen submitted for examination came from a State
department of health. This specimen did not bear the name of the
maker, though it did bear that of the distributor.
When work on this specimen indicated that tetanus was present,
but before the results could be considered conclusive, we secured 13
other specimens by purchase from local pharmacies. Two of these
specimens showed the presence of the tetanus organism.
Technique.
The medium we used for the cultivation was plain broth made from
veal. The reaction was +0.5 per cent to phenolphthalein. The
broth was sterilized in Smith fermentation tubes* by streaming steam
for H hours at 100® C. Just prior to use, thes* were steamed for 30
minutes at 100*^ C. in the Arnold sterilizer and the air was removed
by tilting.
The court-plaster was cut into pieces about 1 centimeter square, or
a little larger, and one piece put into each fermentation tube. After
incubating for three or four days, smears were riade from the growth
at the bottom of the bend of the tubes in which gas was present in the
closed arm. When the Gram staining showM that characteristic
drumstick-shaped organisms with a terminal sporo were present, the
cultiure was incubated for three days longer, At which time it was
used to inoculate mice. In the majority of cises two series of ani-
mals (mice) were used, one having been given a protective dose of
antitetaniis serum.
A pure culture of the tetanus bacillus was is(»iated from one of the
tub(^ by planting dilutions in deep tubes of melted agar and picking
characteristic colonies.
Summary of Experimentii.
Specimen 1. In all, 64 fermentation tubes torero inoculated with
small pieces of court-plaster, using three sheets. Thirty-three of
these showed gas in the closed arm of the tube after three days.
Smear preparations showed tetanuslike organisms in the great
majority of the tubes showing gas.
A small amoimt of the culture, 0.01 cubic centimeter to 1 cubic
centimeter from each tube^ was used to inoculate each white mouse.
llurty-eeven of the animals died during the ensuing night, but it
was not known whether characteristic symptoms preceded death.
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1452
However, four showed distinct symptoms of tetanus in from 18
to 42 hours.
While we felt certain that the tetanus geim was present, it was
reaUzed that the evidence was not wholly convincing, and resort was
had to protection tests, as is shown by the following protocol. Tlie
most promising tubes, judged by gross and microscopical appear-
ance, were selected for the test. Each of the "protected'' animals
was given 10 iinits of commercial antitetanus serum about 30 minutes
before the inoculation with cultures.
Guinea pigs.
White mice.
Volume
Protected (10
Controls (no anti-
toxin), symp-
toms, and re-
sults.
Volume
Protected (10
Controls (no ami-
Tube No.
of culture
given.
units of anti-
toxin), results.
of culture
given.
units of anti-
toxin), restUts.
toxin), synap-
suJts.
e.e.
f 0.1
No symptoms:
Tetanus; died
e.€.
0.1
No symptoms
Tetanus under
discharged
second day.
of tetanus;
17 hours; die-i
well twenty-
died sixth
18 hours.
second day.
day.
do
.01
do
Tetanus; died
third day.
.01
Tetanus; died
B6 1
second day.
1
.001
do
Remained well...
.001
Died under 17
hours; symp-
toms not ob-
Sli]Erbt symptoms
44 hours; se-
vere later;
served.*
chloroform od;
moribund
.1
do
Tetanus; died
second day.
.1
No symptoms
of tetanus;
sixth day.
Died under 17
hours; symp-
toms not ob-
died four-
1
teenth day.
served.
1
1
.01
do
Tetanus; killed
second day
while mori-
.01
No symptoms
of tetanus;
Do.
i
died sixth day.
PSa 1
1
bund.
.001
do
Tetanus; died
.001
No symptoms
Tetanus; died
third day.
of tetanus;
died seventh
day.
No symptoms
second day.
.0001
do
Remained well...
.0001
Symptoms
fourth day;
of tetanus;
died fifteenth
marked sixth
.1
do
Tetanus; died
second day.
.1
day.
No symptoms
of tetanus;
day.
Dead under 17
hours: symp-
toms not ob-
died sixth
...'^Si
stfrred.
P9
.01
do
Tetanus; killed
.01
Tetanus under
third day while
17 hours; died
moribund.
second day.
.001
do
Remained well...
.001
do
Symptoms seo-
ond day;
marked sixth
day.
» Cause of death unknown. Had the cause of death been tetanus, the mouse receiving the largest dose
of culture should have died, not the one on the smallest dose.
3 Later this tube yielded a pure culture of the tetanus organism.
Specimens 2 to 14 (inclusive).: Tliesc specimens were purchased
at various drug stores in Washington. Culture tubes were inocu-
lated as in the preceding experiment; however, but two fermenta-
tion tubes were inoculated from each package. On the third day
after planting smears were examined, and on the sixth day the
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material was used to inoculate a series of "proteetod'' and a series
of normal white mice, with results which are shown in the following
(aUe. On account of shortage of mice, fewer were used than in the
preceding examination.
Mice.
firoon faniMii-
tation tubes on
tlOrdday.
Dose of
calture
(sixth
day).
' Protected » ( 10 units of nn-
titoxin), results.
Controls (no antitoxin),
symptoms, results.
9
Nei^ative !
Tetamislikeorganisms . j
ao H
Negative
TetanusUkcorganlsms. !•
do
do
-do..
10 i Negative...
11 I Suspicious.
12 do
13 Negative...
14 i Suspicious.
Ce,
None.
None.
0.1
.01
None.
.1
.01
.1
.01
.1
.01
None.
None.
None.
None.
.1
.01
Negative; dischar^ fif-
teenth day.
....do
Negative; dischar;^ fif-
teenth day.
do
.do.
.do.,
.do..
.do.,
.do..
.do.,
Negative; discharged fif-
teenth day.
do
Negative; discharged fif-
teenth day.
Do.
Dead under 18 hours; symp-
toms not observed.
Symptoms of tetanus after 24
hours; died third day.
Negative; discharged fif-
teenth day.
Died seventh day; not teta-
nus.
Negative; discharged fif-
teenth day.
Do.
Dead under 18 hours; symp-
toms not observed.
Do.
Negative; discharged fif*
teenth day.
Do.
This series demonstrated that specimen 6 was contaminated with
tetanus. The symptoms in the mouse given 0.01 cubic centimeter
of culture were quite characteristic.
As both of the control mice inoculated with culture No. 9 died in
the night following the day of inoculation without symptoms being
observed, a series was inoculated with the seven-day culture and
included smaller doses than in the preceding experiment. The
"protected'' mice received the usual dose, 10 units of antitetanus
senim.
Dose of
culture 9.
Protected (10 units of antitoxin), symptoms
and results.
Controls (no antitoxin), symptoms and results.
cc.
0.1
.01
Symptoms suggestive of tetanus 2, 3. and 4
days; recovered. Discharged well four-
teenth day.
Pronounced symptoms tetanus, 18 hours; died,
between 28 and 42 hours.
Pronounced svmptoms tetanus, 42 hours; dead,
.001
do
45 hours.
Slight symptoms tetanus fourth to eighth day;
recovered.
No symptoms.
.0001
do
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September 7, 1917 1454
It would seem that the antitoxin failed to neutralize coin[de(dy
the 0.1 cubic centimeter dose of cidture.
This series demonstrated that culture 9 also contained tetaniB,
which with the positive results from culture 6 gave 2 positives among
the 13 specimens. We consider it not improbable that had a laiger
number of pieces of plaster been planted, as was done with specimen
1, a larger number of positive results would have been secured.
Note. — In order to determine approximately the degree of contamination of cowt-
plaster with aerobic organisms, four specimens were examined in the following maniMr:
A single sheet of the size found in the package was shaken with 100 cubic cenUmetm
of sterile 0.6 per cent sodium chloride solution, and 1 cubic centimeter of the suspo-
sion plated on plain agar. Colonies were counted after three days. The numbcc
of organisms per sheet was estimated as follows:
Specimen 1 1.300
Specimen 2 2,700
Specimen 3 1^500
Specimen 4 7,0(10
No attempt was made to identify the organisms.
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PREVALENCE OF DISEASE.
No health department, State or locals can effectively prevent or control dUease withotU
knoicledge of when^ where ^ and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended September 1, 1917.
The California State Board of Health reported concerning the status
of preventable diseases in California for the week ended September 1,
1917, as follows: The cases of typhoid fever showed an increase
during the week, with 52 reported cases in the State. The disease
was unusually prevalent in Riverside County, in Hemet and vicinity,
and in IjOs Angeles, where" 12 cases were reported. Five cases of
cerebrospinal meningitis were reported, 3 of which were in San
Diego and 1 each in Contra Costa County and Oakland city. Scarlet
fever and pneumonia showed some increase, while other reportable
diseases showed reductions.
The details of notifiable-disease cases reported during the week
ended August 25, are as follows:
Chicken pox 17
Diphtheria 23
Dysentory 2
Eryeipelas 8
German measles 28
Gonococcus infection 60
Malaria 33
Pneumonia 15
Poliomyelitis 1
Scarlet fever 33
Smallpox 2
Syphilis 30
Tetanus 2
Trachoma 1
Measles 38 Tuberculosis 106
Mwnps 37 I Typhoid fever 47
Pellagra 1 I Whooping cough 29
CEREBROSPINAL MENINGITIS.
Minnesota.
During the period from January 1, to September 1, 1917, 338 cases
of cerebrospinal meningitis, with 165 deaths, were reported in the
State of Minnesota.
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CEREBROSPINAL MENINGITIS— Continued.
City Reports for Week Ended Aug. 18, 1917.
Place.
Cases.
Deaths.
Place.
Cuts.
DHtta.
Boston, Mass
1
1
1
3
2
Milwaukee. Wis
s
1
I
4
J
Buffalo, N.Y
Minncipnii;«, Minn
Chicago, HI
8
Newark, N.J
New York, N. Y
T
Cleveland, Ohio
}
Columbus. Ohio
Passaic, N.J
. .
t
Detroit, Mich
4
1
1
1
1
1
Philadelphia, Pa 1 4
Pittsburgh. Pa i 1
Saginaw, Mich '
1
Fvorett, Kass
3
Fall River,Mass
1
Fort Wayne Ind
St. Louis, Mo
3
1
1
Hartford, Conn
Salt Lake City, Utah
1
Kansas City. Mo
Wlnston^lem, N. C
1
McKeesx>ort, Pa
DIPHTHERU.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1460.
ERYSIPELAS.
City Reports for Week Ended Ang. 18, 1917.
Place.
Bnflalo,N.Y
Chlca^.ni
Cleveland, Ohio...
Denver, Colo
Detroit, Mich
Kalamazoo, Mich.,
Kansas City, Mo..
Los Angeles X^al..
Milwaukee, Wis...
Cases.
Deaths.
Place.
1 I Newark, N.J
1 New York. N.Y...
.. I Philadelphia. Pa...
1 , Pittsburgh. Pa
3 RochoUer.N. Y....
1 . St. I^uis.Mo
1 I I San Francisco, Cal.
2 I I York, Pa
1
DMtta.
MALARU.
City Reports for Week Ended Aug. 18, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Baltimon, Md
ll
1
1
Mitmnhi^ TVinn , , , . ,
4
1
I
1
3
Birmingham. Ala
»47
i'
4
Newark, K. J
Charlestoo, 8. C
New Orlfans. Ia.
Columbia, 8. C •..*.
Stockton, Cal
Little Rock, Ark
t The reason that Birmingham had so many more cases of maUria reported than any other dty b net
that the disease is more prevalent in Birmintnam than in other cities of Alabama and neighboring Statas,
but undoubtedly because of the successful efforts the health department has made in securing the ooopaor
ticn of the practicing physicians in reporting oases.
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1460.
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PELLAGRA.
City Reports for Week Ended Aug. 18, 1917.
Place.
AnstiD, Tn
Binnio^hai&, Ala.
Boston, Mftas
Qarle8toD,8.C...
CUagcTm
CQh2mUft,S.C
Fert Worth, Tex..
Cases. Deaths.
U4
1
Place.
MemphKTemi
Moblte, Ala
Nashville, Tcnn
Oklahoma City, Okla..
Washington, D. C
Winston-Salem* N. C .
Cases. Deaths.
13
> The reason that Birmingham had so many more cases of pellasra reported than any other dty is not
that the disease is more prevalent in Birmingham than in other cities of Alabama and neighboring States,
bat undoubtedly because of the sucoesBful efforts the health department has made in securing the coop-
fltatiflD of the practicing physicians in reporting cases.
PLAGUE.
Hawaii—Kiikaitii.
On September 2, 1917, two fatal cases of plague were reported at
Kukaiau, Hawaii.
POLIOMYELITIS (INFANTILE PARALYSIS).
Minnesota.
During the period from January 1 to August 31, 1917, 47 cases
of poliomyelitis, with 4 deaths, were reported in the State of
Miimesota.
City Reports for Week Ended Aug. 18, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
CWcago^U
Darenport, Iowa...
Dftroll,MXch
FaU River, Mass...
UtvcrhULMass....
KaosasCity, Kans.
Kansas aty. Mo. . .
Newark, N.i
New Castle, Fa. . . .
New York, N.Y..
Omaha, Nebr
Pittsburgh, Pa...,
San Francisco, Cal
Sioux City, Iowa. .
Washington, D.C.
Wheeling, W. Va, .
PNEUMONIA.
City Reports for Week Ended Aug. 18, 1917.
Place.
Baltimore. Md...
Boston, Mass
Chtatto,Ill
Clsvetend, Ohio. .
Detroit, Mich....
ntdibuig.Mass..
Flint, Mich
Hcksoajfioh....
Kansas City, Mo.
Cases.
Deaths.
1
5
2
5
32
29
10
12
3
9
2
1
1
1
1
3
Place.
Lawrence, Mass
Los Angeles, Cal . . .
LowoU, Mass
Manchester, N.H..
Newark, N.J
Philadelphia, Pa. . .
Pittsburgh, Pa
Rochester, N.Y....
San Francisco, Cal .
Cases.
Deaths.
1
1
1
1
1
13
9
2
3
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RABI£S IN ANIMALS.
City Reports for Week Ended August 18, 1917.
During the week ended August 18, 1917, one case of rabies in
animals was reported in Alameda, Cal., two cases were reported in
Detroit, Mich., and one case was reported in Los Angeles, Cal.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever,' and tuberculosis, page 1460.
SMALLPOX.
City ReporU for Week Ended Aafi. 18, 1917.
Place.
Cases.
DeatJis.
Place.
Coses.
Deaths.
Akron, Ohio
Austin, Tex
Buffalo. N.Y....
Butte, Mont
Cleveland, Ohio..
Dayton, Ohio
Denver, Colo
Detroit, Mich
Dubuque, Iowa...
FUntVMich
Indianapolis, Ind.
Kansas City, Mo..
La Crosse, Wis
Little Rock, Ark
MUwaukoe, Wis
Minneapolis. Minn
Oklahoma Cfity, Okla..
Omaha, Nobr
Rock Island, HI
St. Joseph, Mo
St. Louis, Mo
Salt Lake City, Utah..
Sioux City, Iowa
Terre Haute, Ind
TETANUS.
City Reports for Week Ended Aafi. 18, 1917.
Place.
Canton, Ohio
Chicago, 111
Detrdt,Mich
Erie, Pa
£vansYiJle,Ind...
Kansas City, Mo..
Cases.
Deaths.
Place.
Ixw Angeles, Cal..
New Orleans, La.
Norfolk, Va
Oakland, Cal
Pittsburch, Pa...
Springfield, Mass.
Cases.
Desths.
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1460.
TYPHOID FEVER.
Kansas — ^Leavenworth.
During the week ended September 1, 1917, 16 cases of typhoid
fever were reported in the city of Leavenworth, Kans., and 3 cases
in Leavenworth County.
Tennessee — Chattanooga.
The outbreak of typhoid fever which prevailed at Chattanooga,
Tenn., during July and the first half of August has subsided. Only
10 cases were reported between August 20 and September 1 and
none since September 1.
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September 7, 1917
TYPHOID PBVER—Contlnued.
Oty Reports for Week Ended Aug. 18» 1917.
PfaMt.
CasM.
DmUu.
PhM.
Cases.
Deaths.
ikroD,Ohfo.
iBBBtovn^Pa
JUUB^m
AlUNDt, Pa
Athatic City, N.J.
Baltimore, Md
BiaTer Falls, Pa....
Brtdfeport, Conn
Buflalo,N.Y ,
Ound«i,N.J
GhntOQ,Ohio
Charlaston, 8. C
QMttanoqga, Tenn. . .
ClKla«.Mass
ailci80,ni
CtDctaDati, Ohio
Oereknd. Ohio
Oofl«yYiUe, Kans
Columbia. 8.C
Cokiinbos, Ohio
CumbcrlaDd, Md
DttTllleJII
Dajtoo,Ofalo.
Dcnwr.Colo ,
Detroit, Mich ,
Dultith. Minn
EMtOrangr.N. J...,
EUxabelhTN.J
ETamvillc, Ind
Everett, Mass
PallRlm,Mass
Port Wayne, Ind
Fori Worth. Tex
Qnod Rapids. Mich..
HvTisbure,Pa
HtftlOrd.Conn
lUverhill.Mass
Hobok«i. N,J
iDdlsnapolls. Ind
Jwsry CltyTN. J
Johnstown, Pa
Kansas City, Kans...
Kansas City. Mo.
Knox vflJe, Tenn
Uncastcr.Pa
Ltxington.Cy
Uffla,Ohio
Uttle Rock, Ark
Us Angeles, CaL
Uwall.Ma88
LTnohburg, Va. ,
Lvnn.llass
luncbester, N. H...
McKMsport, Pa
Memphis, Tenn
Mihrmikee.Wis
Minneapolis, Minn
MohUe,Ala
Montclair, N. J
Nashville . Tenn
Newark,N.J
New Bedford, Mass...:
New Haven, Ccnn
New Orleans, La
Newtcn, Mass...,
New York, N.Y
Norfolk, Va
Oakland, Cal
Oklahoma City, Okla..
Omaha, Nebr
Philadelphia, Pa
Pittsbureh.Pa
Plalnfleld,N.J
Portland, Ores
Portsmouth, va
Providence, R.I
Quincy, Mass
Kadne,Wb
Reading, Pa
Richmond, Va
Rcanoke,Va
Rockford,Ill
Rock Island, III
Rocky Mount, N.C...
Sacramento. Cal
St. Joseph. Mo
St. Loms,Mo
Salt Lake City, Utah..
San Francisco, Cal
Savannah, Ga
South Bend, Ind
Springfield, 111
Springfield, Mass
Steelton,Pa
Stockton, Cal
Topeka. Kans
Troy,N.Y
Washington, D.C
Washington, Pa
Watertown, N. Y
West Hobokcn, N.J...
Wheeling, W. Va
WichiU, Kans
Wilkos-Barre.Pa
Wilmington, Del
Wi'mtngton, N. C
WlnstoD-Selom, N.C
Worcester, Mews
York, Pa
TYPHUS FEVER.
CItr Report for Week Ended August 18, 1917.
During the week ended August 18, 1917, a case of typhus fever
was reported in New York, N. Y.
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DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
City Reports for Week Ended Aug. 18, 1917.
Popula-
tion as of
July 1,1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
Diphtheria.
Measlflo.
Scvkt
ferer.
Tobif.
colosis.
City.
from
all
causes.
1
1
s
1
1
i
1
1
i
1
Ovor500,000inliabitants:
Baltimore, Md
689,621
756,476
2,497,722
674,073
671,784
603,812
5,602,841
1,709,518
679,090
757,309
468,658
410,476
306,345
436,535
363,454
408,894
371,747
463,516
863,980
214,878
260,800
271.708
297,847
295,463
254,960
256,417
104,199
181,762
121,579
112,981
108,233
127,224
128,330
104,562
12S,291
110,900
100,560
113,245
102,425
148,995
117,057
118,158
149,685
198,604
165,470
109.381
156,687
117,399
105,942
191,554
163,314
85,625
63,5a5
58,659
57,660
69,893
57,653
53,973
67,449
60,852
60,734
60,075
67,144
94,495
86,680
165
173
625
41
"i,'359'
476
205
180
"*"i65"
75
76
""'iso'
117
123
50
58
... .
42*
63
64
6
63
95
20
67
4
178
25
15
26
5
7
. 4
14
?
12
10
2
3
12
30
4
......
15
3
7
■ 'ii'
4
3
4
2
1
1
14
15
46
8
8
3
101
6
9
1
3
"4"
1
1
1
S
9
46
3
35
5
19
7
4
14
4
4
1
11
4
1
""3
1
1
18
65
323
38
26
37
403
66
31
40
38
16
23
17
u
Boston, Mass
30
Chicaeo.Ill
»
Cleveland, Ohio
30
Detroit,ldlch
13
L.OS AnEoIos.Cal
IS
Now York, N.Y
174
Phlladelnhia Pa
43
Pittsbureh. Pa
16
St Louis Mo
18
From 300,000'to 600,000 Inhabi-
tants:
Buflalo.N.Y
17
Cincinnati, Ohio
17
Jersey aty.N.J '...
Milwaukee, Wis
7
3
7
7
UinriAttnnliQ Minn .
Newark.N J
1
......
14
2
37 19
New Orleans La
1
14 1 15
San Francisco. Cal
23
13
2
9
1
1
6
3
1
1
4
1
2
1
3
1
1
33
23
7
7
Washington, D. C
From 200,000 to 390,000 inhabi-
tants:
Cohimbus, Ohio,
T)AnvAr Colo
11
Indianaoolis. Ind
7
71
5
KansasCitv. Mo
14
Portland Ore*' .. ...
4
11
1
1
1
8
1
2
Rochester, N. Y
From 100,000 to 200,000 inhabi-
tants:.
Albftnv N Y
1
14
5
17
8
11
2
4
14
7
TllrmincrhATn AIa
80
25
3i"
49
26
34
43
33
3
4
4
1
2
3
2
3
Bridfenort. Conn
2
PAmnridiFn Mfun
5
2
Camden N J
Dayton, Ohio
2
4
1
6
1
Fall River Mass
1
Fort Worth Tex
1
Grand Rapids, Mich
Hartford, Conn
2
6
1
1
i
1
15
9
2
2
5
18
6
8
4
4
1
1
1
2
T^well Mass
3
14
48
3
3
3
Memphis, Tenn
1
4
1
4
1
2
1
6
Nftshvillo Tenn
5
New Bedford, Mass
28
31"
46
45
52
23
28
67
68
i?'
8*
20
8
24
24
4
2
i
1
6
1
3
4
3
4
1
2
2
1
1
1
3
8
4
1
'.'.'.'..'.
1
New Haven, Conn
2
Oakland. Cal
3
2
Roadine Pa
......
1
1
2
' 1
1
7
Salt Like City, Utah
Snrin?field Mass
2
3
2
3
3
1
1
""2
6
19
Tolodo Ohio
9
Worcester, Mass
From 50,000 to 100,000 Inhabi-
tants:
AVrnn Ohio
3
3
1
1
3
1
4
3
Allnonfi Pa
AtIanticCity,N.J
2
1
1
1
Berkeley, Cal
1
1
Binglmmton, N. Y
2
Canton Ohio
1
3
Charleston 8 C
3
S
ChftttAnooea Tenn
S
Cnvinffton Kv
14
6
18
4
3
4
1
Dnlutn Mfain . ..
3
4
Eliiabeth. N. J
i
9< 3
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1461
September 7, 1917
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City RepoHs for Week Ended Aug
.18,
1917-
-Continued.
Popular
tkmasof
Julyl,;si6
(estimated
by U. S.
Census
Bureau).
Tolal
deaths
from
an
causes.
Diphtheria.
Heaskj.
fever.
Tub»r.
CulffiCiB.
city.
1
1
1
1 1
M
i
1
From 50^030 to 100,000 bihabit-
snts— Cantinaed.
Erie, Po
76, IW
76,078
54,772
76,183
72,015
77,214
68,529
99,437
.50,853
57,343
51,155
78,283
r>8,221
53,704
89,612
92,943
71,744
63,867
5.5,185
66,895
55,642
85,236
53,330
68,805
99,519
57,078
87,039
68,946
61,130
51,5.50
66,083
77,916
70,722
76,776
94,265
51,656
27,732
34,814
32,730
27,632
43,425
46,192
29,319
34,611
26,074
32,261
48,811
39,873
28,743
42,458
28,203
39,233
41,781
41,863
29,353
25,679
40,496
48, 4n
35,363
48,886
31,576
38 676
31,677
41,097
35,384
46,515
27,587
32*
7
17
19
24
21
3
1
3
11
1
2
1
1
1
2
2
26
Evansville Ind
1
2
Flint. Micli.. ../.
1
Fort Wavne Ind
Harrisbnrg, Pa.
2
2
Hob<d;en 1^ j"
1
5
2
l^aruras CitV Ktutn . . .
1
T^anraster Pa
»
IJttleRock Ark
12
6
22
21
15
22*
22
20
21
20
13
20
iS
27
22
1
Halden, Mass. ..!
4
ICanchcster N H
2
'
Mobile Ala'
4
Nf>w Britain " Ckmn
Norfolk Va
1
.. |..
i
4
Oklahoma City, Okte . ......
PtwwHifr N J
1
1
2
1
2
2
1
1
1
1 3
1
PortlanVl, UV» , ,
1 *
1
1
RoddcHti III
1
Sacramento, Gal .../.
2
2
1
4
1
2
4
•Sarinaw Mich
3
St. Jo%ph, Mo
1
1
4
San Diego Cal .. -... .
4
SarwiYflUl, <tA *
2
1
1
2
Sioux Citv Iowa
2
Somervilto M^ ^ .. .
1
1
South Bend, Ind ... '.
15
19
19
16
1
1
....:.|-2-
Sprinjarfield 111
1
Springfield, Ohio*'. ...'.
1
4
1
Terns Haute, Ind
Trov,N. Y
WirhitA, ITanr?
3
2
1
3
4
4
Wilkes-fiarre.Pa
30
54
7
22
5
11
ii'
12
15
4
12
3
1
1
1
1
1
Wilmln'^ftn T>»1
::::::::::::
5
York, Pa....'....!.
2
2
From 25,000 to 50,000 inhabitants:
2
»•
1
.\ustin, Tex
2
Brook line, Mass
2
:::::: ::::::i
Butler Pa
1
3
1
Butte, Mont
2
3
1
1
1
7
Chelsea, Mass . •••••
1
1
r>i{onpM> Mf|<i9 ,, "7
1
4
Colombia, S. C
5
Cumberland. Md
1
Danville, III
2
Davenport. Iowa
1
1
Dubuque, Iowa
2
East Qiicago, Ind
1
1
1
3
1
3
2
1
1
East Oraneo. N. J..,.^
2
4
4
8
10
7
Elgin, 111.....
1
Everett, Moss
3
2
1
1
1
Fitchbu'rg, Mass
Galveston, Tex
1
2
Hagcrstown, Md ,^..
1
TTftmntnn Ohio
7
s'
18
7
9*
16
12
J3
12
:::::::: ""I
1
4
1
1
H^kvPrhfii. Mafw .. .
2
1
1
4
Jackson, Mich
Kalamar.oo, Mich
1
3
Kenosha, Wis .
1
Knox villc, Tcnn
1
1
1
1 4
La Crosse Wis . .
Lexington, Ky '.'.
1
1
I
Lima, Ohio
1
1
Lincoln, Ncbr
1
1
1
2
Long Beach, Cal
.
.....J .3
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Invest In the SECOND LIBERTY Ltl
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S^ptembei* 7, 1917
1462
DIPHTHERIA, MEASLES, SCARLET FBVBR, AND TUBERCULOSIS-
Continued.
City Report for Week Ended Aog. IS, 1917— Continued.
City.
From 25,000 to 50,000, inhabit-
aDts— Continued.
Lorain. Ohio
Lynchburg, Va
McKeesport, Pa
Medford, Mass
Montclair.N.J
Nashua, N.H
NewburKh,N.Y
Newcastle. Pa
Newport, Ky
Newton, Mass
Niagara Falls. N. Y
Norrlstown. Pa
Ogden,Utah
Orange, N.J
Fasaaena, Cal
Perth Amboy, N.J
Pittsfleld, Mass
Portsmouth, Va
Quincy, 111
Quincy, Mass
Racine,WIs
Roanoke, Va
Rock Island, ni
San Jose, Cai
SteubenvUlc, Ohio
Stockton, Cal
Superior, Wis
Taunton^Mass
Topeka, Kans
Waltham, Mass
Watertown, N. Y
West Hob<*en, N.J
Wheeling, W. Va
Williamsport. Pa
WihnIngton,N.C
Winston-Salem, N. C
Zanesville, Ohio. . *
From 10,000 to 25,000 inhabitants:
Alton, 111
Beaver Falls, Pa
Berlin,N.H
Braddock, Pa
Cairo, ni
Clinton, Mass
Coffeyville, Kans
Concord, N.H
Galesburg.Ul
Harrison. N.J
Keamy,N. J
Kokomo, Ind
Long Branch, N. J
MarSiette, Wis
Melrose, Mass
Morristown, N. J
Nanticoke, Pa
Newburyport, Mass
New Lonaon, Conn
North Adams, Mass
Northampton Mass
Plainfleld, N. J
Pontiac, Mich
Portsmouth, N. H
Rocky Mount, N. C
Rutland, Vt
Saratoga Springs, N. Y...
Steelton, Pa I
Washington, Pa !
Wilkinsburg, Pa I
Wobum, Mass
Popula-
tirn as of
Julvl 1910
Total
deaths
from
all
causes.
Diphtheria.
"«»•- '' 1^';*
Ttiber-
ctilosis.
(esiimated
by r. S.
Census
Bureau).
1
i
1
u
Deaths.
Cas«s.
i
1
36,964
7
10
4
2
9
13
3
i ,
32,940
47,521
26,234
1
8
1
1
1
26,318
27,.?27
29,603
41 133
1
1
1
1 2
2
'
1 1
2
1
31,927
8
6
17
5
6
7
8
13
t 1
J
I
43 715
2
1
5
3
37,353
! 2
1
1
31,401
1
31,404
1
33,060
46,450
2
3
2
:::::;! I
2
41,185
1
1 3
1 2
38,629
1
I
39,651
7
16
5
7
17
8
1
36,798
1
4
1
2
1
38,136
2
' 1
1 4
46,486
]
43,284
28,926
38,902
2
2
4
2
•27,445
35,358
46 226
U
5*
18
8
5
1
1
1
1 *
1
36,2*^3
1 3
1
48,726
3
30,570
2
1
29,894
3
2
1
1
43,139
2
> 4
43,377
*i
33,809
is'
7
1
1
1
1
29,892
31,155
1
1
1 2
30,863
8
4
2
4
7
2
2
1
22,874
13,532
13,500
21,685
15,704
» 13,075
17,648
22,660
24,276
16,950
23,539
1
1
::::::r'""i
1
1
2
1
1
1
7
11
6"
6
2
1
6
5
2
6
5
5
8
10
7
6
5
3
2
::::::i:::":i
1
1
1
:::::::::
I
2
'
1
20 930
1
15,39.5
^ 14,610
1
.. . .
*■ 1
i
: ::"i r::...
17 445
4
1|
13! 284
23 126
1
t '
15 243
.'.".'.J'.'.'.'..
' 1 "I
20 9K.'.
\
1"::..
> 22.01<»
2 1
2 1
2
19.9.0
1
2:i, >«o.'i
2
2
1
17.524
2
6 1 2
11,666
2
\
12,067
1
I
14.831
1
".*'
1
13,821
......^. ............
15,648
1
1 1
1
1
4 1
21,618
1
23. 22X
4
2
1
' 1
l.->.Mi»
i:...:.
' 1 3
• Population Apr. l'», 1910; no estimate made. ^
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FOREIGN.
PLAGUE ON VESSEL.
Steamship ''Matiana"— Graresend.
The steamship Matiana arrived at Gfavesend, England, August 13,
1917, with three cases of plague on board and a history of the occur-
rence of nine cases of plague, with six deaths, at sea during the period
from July 14 to 18, 1917. The disease occurred among members of
the crew.
CUBA.
Communicable Diseases — Habana.
Communicable diseases have been notified at Habana as follows:
Disease.
Aug. 1-10, 1917.
New
cases.
Deaths.
Remain-
ing under
treat.
ment
Aug. 10,
1917.
Diphtheria
Cerebrospinal meningitis. .
irg:::::::::::::::::::
Measles..
Pirttyphoidfjver.
Typhoid fever
4
2
10
22
7
7
74
ECUADOR.
Plague— Yellow Fever— February, March, April, 1917.
Plague and yellow fever have been reported in Ecuador as follows :
Plague. — Month of February, 1917: Guayaquil, 56 cases; Estancia
Vieja, 1 case; Nobol, 2 cases; Salitre, 1 case; Taura, 3 cases. Month
of March, 1917: Guayaquil, 33 cases; Milagro, 1 case. Month of
April, 1917: Guayaquil, 9 cases; Milagro, 1 case.
Yellow fever. — Month of February, 1917: Guayaquil, 18 cases;
Babahoyo, 1 case;MiIagro, 1 case. Month of March, 1917: Guayaquil,
17 cases; Babahoyo, 2 cases; Chobo, 1 case; Milagro, 1 case. Month
of April, 1917: Guayaquil 17 cases; Milagro, 1 case.
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September 7, 1017
1464
MADAGASCAR.
Epidemic Cerebrospinal Meningitis.
Epidemic cerebrospinal meningitis was present in Tananarive,
Madagascar, dm'ing the latter part of the year 1916. The outbreak
was almost wholly confined to the native population, occurring prin-
cipally among native soldiers. The disease also appeared in Tama-
tave, on the east coast, where it is believed the infection was carried
by soldiers. The total number of cases reported at Tananarive from
the beginning of the outbreak, about October 1, to December 31,
1916, was 212, with 138 deaths, and from January 1 ta February 4,
1917, 199 cases, with 149 deaths, the greatest numberof cases reported
during this period for one week being 58 and the lowest number 20
cases. No report of nonfatal cases has been made since February 4,
1917. From February 25 to March 31, 16 fatal cases were reported,
and from April 1 to June 3, 23 fatalities. The native population of
Tananarive is 62,410. At Tamatave, where the native population
is 6,701 and the European 3,200, there were reported during the
month of January, 1917, 21 cases, with 14 deaths.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received During the Weeic Ended Sept. 7, 1917.'
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Calcutta
Jane 24-30
12
3
4
1
4
7
1
Do
July 1-7
Madras
July 1-7
6
Ma'i'ialfty
June 24-30.
Pegu '.
June 25-30
Do
July 1-7
June 24-30
1
Java:
West Java
June 29-July 5, 1917: C^ses, 52:
deaths, 25. July 6-12, 1917:
Batevia
June 2^July 5
July 6-12.
1
2
Do
PLAGUE.
BrasU:
Bahia
July»-21
4
1
56
33
9
1
1
2
1
1
Ecuador:
EstandaVieja....
Feb. 1-28
G uayaquil
do
29
18
4
1)0
Mar. 1-31
Do
Apr. 1-30
MilaiiTO
Mar. 1-31
To...::::::::;:;:;:::.:
Apr. 1-30
1
Nobol
Feb. 1-28
Salitre
do
Do
Mar. 1-31
1
2
Taura
Feb. 1-28
3
^ From medical officers of the Public Health Service^ American consuls, and other sources.
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1465
Beptember 7. 1017
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW FEVER—
Continued.
Reports Received During the Week Ended Sept/ 7, 1917— Continued.
PLAGUE— Continued.
Place.
Date.
Cases.
Deaths. ' Remarks.
Great Britain:
Cravewnd
Aug. ia-34
3
1 ' From S. S. Mati&na.
India
June 24-33, 1917: Cases. 1,4H2
Basvin
Juno 24-30
1
25
2
2
58
15
16
35
42
denths. 1,002. July 1-7. 1917:
Cases, 1,870; deaths, 1,322.
Do
July 1-7
Romljay
do
36
Ucniada • .....
Juno 25-30
Karachi
June 2a-July 4
July 1-7
. 3
70
Madras Presidency
Moulmcin
June 17-30
Do
July 1-7
Rancoon
Juno 24-30
July 1-7
40
46
1
9
tS^
straits Settlements:
Sin^pore
do
Atfea '.
July 14-18
6 i 8. 8. Ifatlana en route for nort of
London.
SMALLPOX.
Brasil:
Bahia
China:
Amoy
Chungking..
Dairen
Mukdrn
.^hinghai
Etuador:
Guayaquil . .
oo.![;.*:
AlcKandria..
(^iro
Do
India:
Bombav . . .
Karachi
Ifadras
Itancoon
T)o
Java:
East Java...
Mid-Java....
West Java..
Batevia
Mexico:
Vera Crur
Philippine Islands:
Manila
Portnnl:
Lisbon
Russia:
Archangel
BfNdn:
Malaga.
Valencia
Venezuela:
Maracaibo
July 22-28.
Jtme
July
July
July
July
17-33.
Jt-14. . .
8-28...
22-28..
2-29...
Feb.
Mar.
Apr.
July
Feb.
Mar.
July
June
July
Jime
July
June
June
1-23..
1-31..
1-30..
23-29
12- Mar. 4.
5-18
1-7
28- July 4.
17
24-30
1-7
18- Julv 1.
11-Julyl.
June29-July5...
Aug. 5-11
July 8-21
....do
May 15- June 14 .
Apr. 1-30..
July 2-2H. .
July 17-2:J.
36
Present.
Do.
Present.
Among Chinese.
June 29- July 5, 1917: Cases, 33;
deaths. 11. July 6-12, 1917:
Cases, 9; deaths, 1.
TYPHUS FEVER.
China:
Hankow I July 8-14
^Iwcmndrla. I July 16-29
CWro. -^ I Jan. 22-Mar. 18....
75 1
96 I
34 I
40 I
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September 7, 1017
1466
CHOLERA, PLMHJfi, SMALLPOX, TYPHUS FBVER, AND YELLOW FEYEB—
Continued.
Reports Received During the Weel( Ended S^t. 7, 1917— Continued.
TYPHUS FEVER-Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Japan:
Hakodate
July 22-28
1
7
Nagasaki
July 23-Aug. 5
Java:
East Java
June 2^ July 1, 1917: 1 case.
Surabaya
June 25-July 1
June 11-24
1
7
Mid-Java...
1
WcstJava
1
June 30-July 5, 1917: Cases, 4;
July (>-12, 1917: Cases, 8.
Batavia
June2^Julyl2...
May 15-June 14 . . .
11
7
Russia:
Archangel
2
YELLOW FEVER.
Place.
Date.
Cases.
Deaths.
R^narks.
Ecuador:
Babahoyo
oaouiioyo.. ..............
Feb. 1-28
1
2
1
18
17
17
1
1
1
1
1
1
7
9
9
Mar. 1-31
Chobo
do
tiuavaauil
Feb. 1-28
D^!^.:::. ..:::.::::.
Mar. 1-31
Do
Apr. 1-30 . .
• BiUagro
Feb. 1-28
X.::::::;:::::::::::::
Mar.1-31
Do
Apr. 1-30
1
Reports Received from June 30 to Aug. 31, 1917.
CHOLERA.
Place.
Date.
.Cases.
Deaths.
Remarks.
India:
Bassein
Apr. 1-May5
8
1
335
4
1
3
1
1
16
Bombay
June 24-30
Apr. 29-June 9
1
Calcutta
Madras
Aj)r.22-June30...
May6-12
5
Mandalav
Mnultnfiiii • • . •
May 13-June2
Pakokku
Apr. 20-May5
Pegu
May 27-June 2 ....
Rangoon ,,-,--,-,.,..- r
Apr. 21- June 9
30
Indo-Chma:
Provinces
Feb. 1-Mar. 31. 1917- Cases 61
A naTT» . . , . r T - - r , . , . . . r , -
Feb.i-Mar.31....
do
6
9
44
2
163
1
i
7
32
deaths, 40.
Cambodia
Cochin-China
do
Tonkin
do
SaiKon ^,,
Apr.23-May27...
Apr.^-«
108
K>CU5WU
Java:
East Java
West Java
Apr. 13- June 28, 1917: Cases, 19;
Batavia
Apr. 13-June28...
Feb. 3...
6
1
4
1
3
1
2
deaths, G.
Persia:
AmirKela
Barfourouche
Jan. 15-17
Hamze Kela.
Jan. 17... .
MA<rhidfx*«ftr . .....r
Jan. 31
Philippine Islands:
Junel7-23
Provinces
May 20-June 30, 1917: Cases, 795;
Albay
May 20- June 30...
July 1-7
113
2
2
1
76
1
1
1
deaths, 506.
Do-.....:::.:::::::
JiUy 1-7, 1917: Owes, 315; deaths,
Ambos Camarlnes
June 3-9
Batangas
June 17-23
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September 7, 19171
CHOLERA, PLAGUE, SMALLPOX, TTFRUS FEVER, AND YELLOW FEVER^
Oontinued.
Reports Recehred ftrom June 90 to Aug. 31, 1917— Continued.
CHOLBRA— Continued.
Pteoe.
Date.
Cases.
Deaths.
Remarks.
Philippine Islands— Continued.
Frovinoes— Continued.
BohoL
Do
Capi*
Do
Cebo.
Do
Uoik)
I-eyte
Do
Negros Oriental
Riial
Do
Sonc^n
Do
Tayabos
Do
May 2&-June30.
July 1-7
June 3-30
July 1-7
June 3-30
July 1-7
.-..-do
June 10-30
July 1-7
do
June 24^30
July 1-7
Jime3-30
July 1-7
do
....do
368
66
02
19
231
54
7
14
4
4
1
1
196
82
7
1
251
45
40
15
150
38
4
5
4
4
PLAGUE.
Aniliia:
Aden
May 3-June 11
38
3
33
Apr. 8-May 14, 1917: Cases, 69;
Seaths,6i.
firuU:
Bahia
June 10-30
6
40
Ceylon:
Colombo ....*.
Apr.8-June9
Anr.29-May5
•
China:
Amoy . ^
Present and in vicinity.
Hom&rong
Ifayl9-June30. ..
July 1-7
20
6
•1
^0^ . :.:::::
Kwangtnnf ProTlnoe—
Pa-pndistriot
JtiDe2
Present
Egypt.....^
Jan. 1-June 28, 1917: Cases, 564;
deaths, 313.
Alexandria. . . .. ........
June 21-27
Apr.30-Mayl9....
Jtme25.....
6
4
1
14
1
4
3
Port Said government
Port Said
PioTiucea
Fayum
Mayll-June28...
June 28
7
Oa!loabd)
May 17
1
3
1
0
23
i2Seh:::::::::::::::::
Mayl2-June28...
May 12.
4
3
23
38
2
Siout
Suez government
Apr.30-June2....
Mayl2-June28...
May 3-8
Suei
Oreat Britain:
London
2 in hospital at port. From s. s.
Sardinia from Atistralian and
oriental ports.
Apr. l^-June 30, 1917: Cases,
42,440; deaths, 29,193.
India.
Bassein
Apr. 1-Jnne2
42
363
38
33
413
250
9
59
1
2
134
2
Bombay
Apr.22-June30...
Apr. 29-June 2
441
CaJcutU...
Henzada..
Apr. 1-Mayl9
KarachL
Apr.22-June30...
do
468
301
Madras Presidency
MandalAy
Apr.8-Mayl2
Mttiimehi .
Apr. 1-June2
Mylngyan.
Apr. 1-7
Pegu.7
May27-June2
Rangoon
Apr. 15-June9....
Apr.8-14
143
Indo^toa:
Provinces
Feb. l-Mar. 31, 1917: Cases, 19S;
Anam,
Fcb.l-Mar.31....
.do
72
92
33
47
39
SO
21
26
deaths, 141.
Gtoibodia
Coehln-China
do
Saigon
Apr. 23-June3
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September 7, 1017
1468
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEYER, AND YELLOW FEVER—
Continued.
Reports Receired fh>iii June 30 to Aug. 31, 1917— Oontiniied.
FLAG UE— Ckintinued.
Place.
Date.
Caaes.
Deaths.
Remarks.
Java:
East Java
Apr. 2-M^ 20, 1917: Cases, 2»:
Dj-cJakarta Residency .
Kediri Residency
Samarang Residency. . .
Surabaya
Apr. 23-MayO
do
Apr. 23-May 20. . .
Apr.2-May20
.do
1
1
3
18
6
1
1
3
18
6
Surakarta
Peru
May 16-31, 1917: Cases, 15.
Departments—
Arcquipa
May 16-31.
4
1
2
7
1
12
4
2
At MoUendo.
Callao
do
AtCallao.
Lambayeque
do
do
At Chidayo. •
Libertad
Lima
do
Tnijiiio. "
At Lima.
Siam:
Bangkok
Apr. 22-June2
Juiya-23
11
3
1
^0 .:::::::::::::::::::
straits Settlements:
Singapore
Juno 3-16
Union of §outh Africa:
Cape of Good Hope State—
Glengrcy district
Terkadistrlct
Aug. 13
Present.
May28
1
1
1
At Summerbill Farm.
Queonstown
June 6
Orange Free State
Apr. 16-22, 1917: 1 case: Apr.9-a,
1917: Cases, 26; deaths, 17.
Wlnburg district
May 28
1
SMALLPOX.
Australia:
New Sonth Wa'.es
Brewarrina
Coonabarabran
Quambone
W arrenili Jtrkt
Queensland-
Thursday Island Quar-
antine Station.
Brazil:
Bahia
RiodeJaneiro
Do
Canada:
MaiMtoba—
Winnipeg
Nova Scitia—
Halilax
Port Hawkcsbury.
Ontario —
Ottawa
Ceylon:
Colorabo
China:
Amoy
Antune
Chungking
Do ,
Changsha
Dairen
Do
Hankow
Harbin
Honglcong
Manchuria Station
Mukden
Do ,
Shanghai
Apr. 27-June 21 .
May2.VJuly5...
Apr. 27-June 21 .
June 22- July 5..
May9
May d-June30..
do
July 1-14
June 10-16
June IH- July 7..
June 17-30
July 30- Aug. 5..
May(>-12
Apr.20-May26..
May 21-June 24 .
May 6-June 23 . .
July 1-7
May 27-June 2..
May 13-June 30.
July 1-7
June 24-30
Apr. 23 May 6...
May H-Juno 16..
Apr. 23-29.......
May 27-June 2 . .
JulyR-21
May21-July 1...
4
126
50
13
32
Apr. 27-July 5, 1917: Cases, 68.
From s. s. St. Albans from Kobe
via Hongkong. Vessel pro-
ceeded to Townsville, Bris-
bane, and Sydney, in quaran-
tine.
Present In district.
Present and in vicinity.
Present.
Do.
Do.
On Chinese Eastern Ry.
Do.
Present.
Do.
Cases foreign; deaths among i
tlves.
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September 7, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Receired lirom June 90 ito Aug. 81, 1917— Continued.
SMALLPOX-Oontinued.
Pter«.
China—Continued.
Tsitshar Station..
Tsingtao
C'bomn (Korea):
Chemulpo..
Uexondria
Do
France:
Pari*
Germany
Berlin
Bremen
Charlattenburg..
Hamburg
Lelpiiij
LObeck
Munich
Stuttjtart
India:
Bombay
Calcutta ,
Karachi
Madras ,
ft^mpwii
Indo^niina:
Provinces ,
Anam ,
Cambodia
Cochin-Chlna
Kwang-Chow-Wan.
Tonkin
Saijton
Italv:
Turin ,
Japan:
Kobe
Nagasaki
Osaka
Yokohama ,
Jav-a:
East Java ,
Mid-Java
We?t Java ,
Batavia
Mexico:
V«^»fttk>n
Mexico City
Do »
Monterey ,
Vera Crux
PhiUppine Islands:
Ptftugftl:
Lbbon
Portuguese East Africa:
Letirenco Marques ,
Russia:
Archangel
Petrograd
Riga
Vladivostok
Siam:
Bangkok
Spain:
M«Wd
Seville
Do
Straits Settlements:
Pcnang
Stngapore
Date.
Apr. 16-22
^y22-July7..
Cases.
May 1-31
Apr.30-July 1 1
July2-«
May&-12..
Mar. IH^Apr. 2H.
do
....do
....do
....do
....do
....do
....do
Apr. 22-Jiuio30...
Apr.2»-May26....'.
Apr. 22-Juno30...!
do ;
Apr. 15-June»
106
16
18
:iO
20
2
10
1
163
Feb. 1-Mar.31...
do
do
Mar. 1-31
Feb. 1-Mar. 31...
Apr. 27-JunelO..
May21-June24..
May27-July22...
May28-June8...
Mayl6-July5....
May27-Julyl....
Apr. 2-Junel7..
Apr. l-JunelC.
Apr. 13-Juxie 28.
Julyll-Aug. 7..
June 3-30
Aug. 6-11
Junel&-24
July 1-7
May 13-June9..
May 13-June 30.
Mar. 1-Apr.30..
May 1-June 28. .
Feb. 18-June9..
Mar. lWune2..
Mar. 15-21
June 9-23
May 1-Junel9.
May l-JunedO.
June 3-23
July 1-7
Mar.l8-June23.
Juno 24-30
788
73
654
2
99
199
32
66
1
177
1
29
52
162
69
23
495
4
Deaths.
63
17
158
24
Remarks.
On Chinese Fastern Ry.
At another station on railway,
lease.
Mar. IH-Apr. 2K, 1917: Ca^es. 7i:»
in cities and 32 States and dis-
tricts.
Feb. l-Mar. 31, 1917: Case,, 1,010;
deaths, 240.
Apr. 13-June 28, 1917: Ca5^s, 20ft;
deaths, 33.
Varioloid.
Jan. l-Mar. 31, 1917: Cases, 9.
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September 7, 1017
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CHOLERA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Reeeiyed from June 30 to Aug. 31, 1917— Continued.
SMALLPOX-<»ntinued.
Place.
Date.
Cases.
Deaths.
Remarks.
Sweden:
MftlmO r . r - -
Apr.22-28
Kay 20-June23...
June 3-R
1
2
2
Stockholm
1
Tunisia:
Tunis . . r . , . r r r - r
Turkey in Asia:
Trebizond
Feb. 25- Apr. 13...
15
Union of South Africa:
TnhnnfUMhiinr
Mar.12-24
May 1-31
4
2
Uruguay:
MontevldM
Venezuela:
Marm^bo
June 1&-July 8 . . .
8
TYPHUS FBVER.
Place.
Date.
Cases.
5
Deaths.
Remarks.
Algeria:
Algiers.
June 1-30
3
Austria-Hungary:
Austria
Oct. 22-Dcc. 17, 1«16: Cases, 2^1
Bohemia . .
Oct.22-Dec.l7....
do
634
809
47
617
15
243
5
.:::::::::
<?a1icia
Lower Austria
.do
Moravia
do
Silesia
do
Styria
do
Upper Austria ....
do
Hungary ..^
Feb. 19-Mar. 25, 1917: Cases, l^L
Budfapest
Feb. 19-Mar. 25...
June25-July 1
July 9-22
83
3
4
1
1
4
1,648
145
Cliina:
Antuug
Do
1
Hankow . . . '.
Juno 9- 10
Tientsin
Juno 17-23
May30-July7
Apr. 30- July 1....
July 17-23
June 17-23
Tsingtao
Alexandria, r ^ . . ,
478
50
32
10
Do
Great Britain:
Cork
Greece:
Saloniki
May 13- June 30. ..
Do
July 1-14
Japan:
Nagasaki
June 11-24
July 9-22
4
12
5
7
14
^dT
1
Java:
East Java
May 6-Juiiol7
Apr. 1-30
Mid-Java
2
2
May 5-10, 1917: Cases, 24; deaths,
Samarang
Mtty5-Junol0
2.
West Java
Apr. 13-Juue 21, 1917: Cases m*
Batavia
Mexico:
Mexico Citv
Apr. 13-MaylO...
June3-30
60
431
324
3
3
6
1
4
126
2
5
•6
deaths ,6.
Do.. _:;.;::::::::::::
July i>- Aug. 11
June 9-23
Nelherlands:
UoUerdam
2
Do
July 15-30
July ^14
Norway:
BcrKcn
Portuguc'c East Africa:
LoureiHO Marques
Mar. 1-31
Russia:
Archangel
.
Mayl-Juno28....
Feb. 1H-June9
May31-Junc2
Mar. 29-May 21 . . .
Pet rograd
Riga
Vladivostok
3
Jan. 1-31, 1917: lease.
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1471
Septeiul'e>- 7, UMI
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from June 30 to Aug. 31, 1917 — C'Ontiuued.
TYPHUS PEVER-Continuod.
Place.
1 Date.
Cases.
Deaths.
Rcmorks.
Spain:
Almwia
1
1 Mavl-31
5
2
Madrid
....!do
Switierland:
Basel
1 June 17-23
i JulyJi-21
' Junc4-9
1
3
2
Do
Trinidftd
1
Taniiia:
Tunis
June30-July6
1
YELLOW FEVER.
Mexico:
Yucatan ,Statc —
Peto
Juno 23
July 2g- Aug. 11...
In perspn recently arrived fr<te
MexeioCiiy.
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PUBLIC HEALTH REPORTS
VOL. 32 SEPTEMBER 14, 1917 No. 37
DYSENTERY OUTBREAK IN KENTUCKY.
By John McMullen, Surgeon, United States Public Health Service.
Pursuant to telegraphic orders of August 27, 1917, to investigate
an outbreak of suspected dysentery in Breathitt County, I left Lex-
ington on the morning of the 28th, and proceeded to Jackson.
On the morning of August 29 I went to Oakdale, a distance of 0
miles from Jackson. From there I rode on horseback to the home
of Mr. M. on War Creek, a distance of about 5 miles, and ascer-
tained from him that there had probably been about 25 to 30 cases
of what is described locally as '^flux". The history, as obtained
from the patients and their neighbors, there being no physicians in
attendance on practically any of the cases, is that the patients were
attacked suddenly with severe diarrhea, sometimes accompanied
with chill and vomiting, and severe tenesmus, succeeded shortly by
the passage of blood and mucus described by them as ^'jelly'' and
blood. Some fever was present at the onset, but the patients soon
became cold and clammy.
At the time of my visit tliove wore only a few cases in existence,
as the majority had died, and as stated by the citizens of the com-
munity the disease appeared to have lessened. It appears that
the entire outbreak in this community was confined to a radius of
about 3 mUes, near the mouth of War Creek, and on Rock Lick
Creek on the north fork of the Kentucky River, and about 12 miles
below Jackson. Practically none of these cases were attended by
physicians, and I was therefore imable to gain any information
from the physicians in regard to the present epidemic. However,
I am informed by Dr. Bach, of Jackson, Ky., that a very similar
outbreak occurred last summer up the north fork of the Kentucky
River from Jackson about 20 miles, at a community called Crocketts-
ville, and on Long Branch which empties into the River at Crocketts-
ville.
I am also informed by Dr. Bach that he has learned on very
reKable authority that this Long Branch neighborhood has, within
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September 14, 1917 1474
the past month or two, had a large number of cases of this same
trouble, which is termed '^flnx'' by the local community, and that
18 deaths have already occurred. During the epidemic on Long
Branch last summer there were about 20 deaths, a majority of the
cases, according to Dr. Bach, proving fatal.
It appears that the first case in the War Ci'eek neighborhood
occurred about June 25 of tliis year in the family of Rev. W. M., a
local minister. In conversation with Mr. M., he informed me that
his child, about 2 years of age, was taken sick on or about June 25,
with aU the symptoms of dysentery which he observed in aU the
subsequent cases.
The family of Mr. M. consists of about 13 members, and five
other cases occurred immediately after that of the small child, who
died in nine days from the onset of the disease. Mr. M. further in-
formed me that he had seen every case of the disease which had
occurred, and in every case the patient was taken sick in the same
manner, with precisely the same symptoms, and about every other
one died in from a week to 10 days after the onset.
He further informed me that his family had used the water from a
spring, situated practically in the creek bed, for drinking purposes
and he feds confident that this is the cause of the sickness in his
family. All of the other families in which the sickness occurred had bad
drinldng-water suppUes, many of which were springs similar to the
one used by Mr. M., and the wells were shallow and polluted from the
stream. Since the death of his baby he has prepared a well on the
hillside and suflBiciently deep to supply good drinking water.
The next group of cases which occurred was among neighbors of
Mr. M., and of the same name. They visited the minister during the
sickness in his family and several of their children promptly con-
tracted the disease and some of them died. One boy about 11
years of age died the day previous to my visit. Visiting and assist-
ing in caring for the sick are customs in the mountains, and the
neighbors visited and assisted at all of the cases.
I visited two of the patients who were sick at the time of my visit
to Breathitt County. One was a woman about 40 years of age,
who was recovering after an illness of about a week, and the other
was an elderly woman about 60 years of age. This patient had
considerable prostration, no fever, constant desire to go to stool, at
which time only mucus and blood was passed. A specimen of tiiis
was collected and forwu*ded to the Hygienic Laboratory for exami-
nation. This patient had been ill about five days. The tongue was
red, rather dry, and the prognosis was imf avorable.
In the opinion of a nnmber of people with whom I talked this is
not an imcommon infection in the moimtains during the months of
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1475 September 14. 1017
July and August, and it has been usually a fatal disease. The
locality affected in the neighborhood of War Creek is a sparsely
settled one, with a total of possibly 25 houses, and the majority
of these had cases of the disease. A widow and her three sons all
contracted the disease and all the boys died.
A tentative diagnosis of bacillary dysentery was made pending
receipt of the findings of the specimen submitted to the laboratory.
In addition to the polluted drinking water used by practically all of
flie families there is an entire absence of hygiene, and they all live
under the most imsanitary conditions.
In addition to this there are swarms of flies everywhere, particu-
larly on the dining tables at the time of meals. No precaution, with
the possible exception of occasionally burying the stools, is taken to
prevent the flies having access, the stools being emptied not very far
from the house. The flies, therefore, have access to the stools and to
the dining tabl^ during meals. It is therefore not a very difficult
task to ascertain how the disease is spread.
The local registrar (Mr. T. L. M.) was absent from his home at the
time of my visit and I was therefore unable to see him, but the local
minister, Mr. M., I bcUeve probably has more definite information
than anyone whom I was able to interview, and he states that there
were 13 deaths and about 30 cases.
One patient, the son-in-law of Mr. J. M., on War Creek, whom I
visited, was sick for a number of weeks, and his case was diagnosed
by his physician as typhoid fever. This diagnosis appears to be
accepted by the community.
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A NEW WATER SAMPLE SHIPPING CASE.
WTTH SOMJI OBSBRTATIONS ON THK CHANGBS THAT TAKK WhACM DC nOKBD
SAMPLES OF WATEB.
By R. R. BmrcxB, Assistant SorfeoB, and H. P. Lnrov, Sanitary Kwginatr, Uatad Stataa
Public Health Service.
vShortly after the establishment of the laboratory of the sanitarf
district of the Great Lakes at Chicago in 1915, it was found that for
the proper carrying on of the work of this district it would be neces-
sary to ship water samples from points as far away as Buf!ak>, N. Y*^
and Duluth, Minn. This necessitated a shipping case whii^ would
maintain the samples at a low temperature for a period of at leAsi
48 hours.
Information was obtained from several State boards of health as
to the type oi shipping case used by them and the results obtained
therefronL It was found that most of the cases in use were co»-
stnkcted of wood and insulated with hair felt. The majority ol them
would not hold a sufl&eient amount of ice to keep the samples below
10° C. for 48 hours. Furthermore^ as a general rule, they were not
designed to hold more than two 4-ounce sample bottles or four
2-oimce sample bottles. The only case which would maintain a low
temperature for the requisite time was patented, and the main
objection to this case was that it was designed to hold only four
2-ounce sample bottles.
The work to be carried on at the Chicago laboratory consisted
largoly of bacteriological examinations of samples of water collected
from lake vessels, and it was important that a considerable number
of these samples bo collected from the larger ports during the few
months during which navigation was at its maximiun intensity.
It was therefore evident that a shipping case to answer the purpose
should be' capable of holding at least eight 4-ounce sample bottles,
and should have a sufficient ice capacity to maintain them at a tem-
perature of not more than 10® C. for 48 hours.
With these requirements in mind, a case was designed which has
proved entirely satisfactory.
The experience of other laboratories using wooden cases showed
that these cases went to pieces rather rapidly undor the severe hau-
ling received from express companies. It was therefore deemed ad-
visable to (le.^ign a case wholly of metal which would stand up imder
the s(^vero traffic conditions to which it would be subjected. A
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SeptoinlK I- 14, 1017
study of insulating materials showed that pressed rorkboard would
provide the greatest amount of insulation with the least, amwuit of
space.
Tho details of constructii)n as finally worked out are us follows:
The CJ180 is construct<?d of 'XJ'ivanized iron with presided eork])oard
insulation. The outside of (he lave is made of 20-gauge galvanized
iron and measures 15 inches in length, 8 inches in width, and 13
inchc*s in depth. Tho pressed corkhoai'<l is 1 inch in tliickness and
is inclosed within an inncn- lining of •i4-gauge galvanized iron, which
make^ a water-tight joint with the outer casing. Tho inside dimen-
sions arc 1 inch less than the outside dimensions. Tho insulated
^^^/■^
^
T
\ I..
^jB4<y/^
<«Vc''/-
v^-
/J -
'i
/^sff^ C0r/r^i!wr</
FiGUEE 1.
tapering cover of the dimensions shown in figure 1 drops into the
inside of the case. Over this cover fits a second cover of 22-gaugc
galvanized iron, hinged on one side and with a padlock hasp on the
other. This outside cover is wired entirely aroimd its lower edge to
stiffen it. Within the outside case, held in place by a circular band
of galvanized iron, is a second can. This can is made of 26-gauge
galvanized iron, is 5 inches in diameter and 10 inches in depth. It
has a slip cover, the sides of which are 2 inches in depth. The de-
tailed dimensions and form of construction are shown in figures 1
and 2. On each end of tho case is riveted a heavy piece of strap iron
tJirough which is inserted a rope handle. This handle makes the
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September 14, 1917
1478
case convenient to carry (see fig. 3). The inside can is jxist larg»
enough to hold eight. 4-ounce ground-glass stoppered sample bottfes
in two layers of four each.
As ordinarily shipped out, in the inner can are placed the eight
bottles, protected from breakage by paper or cotton. Outside of the
1,
lj>fjj^ (/y^M^an/;-
'A^i
^ ::-v-
FiouKX a.
bottle can are placed eight descriptive blanks and eight manila en-
velopes, together with a shipping tag for the return of the case to the
laboratory (see fig. 4).
When the sample is collected the descriptive blank is filled out and
placed with the bottle in one of the envelopes, which is then placed
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Public Health Reports. September 14, 1917.
FIG. 3.— PHOTOGRAPH OF CASE.
FIG. 4-— PHOTOGRAPH OF CASE AND CONTENTS AS SHIPPED OUT FROM
LABORATORY.
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] 479 September 14, 1017
within the inner can. The space around this can is filled with broken
ice and requires about 13 pounds to completely fill the case.
Numerous tests have shown that the case will maintain eight
4-ouuco samples at a tempenUuro below 10** C. for a period of 48 hours.
The shape of the inner can is such that instead of the eight 4-ounce
bottles, a Uter bottle can bo (»asily packed within it.
The first 25 cases purchas< <l in 1915 cost complete $6.50 each. A
similar lot purchased in 1917 cost $8 each, the additional cost being
due to increases in the cost of galvanized iron.
In designing a shipping case, the importance of accomplishing the
bacteriological examination of drinking water at the time of collec-
tion was fully appreciated. Immediate analysis, however, is not
always practicable. In fact, at the present time a large proportion
of all samples are not analyzed at once but are shipped to a central
laboratory, either city or State. In order to minimize the bacterial
change, all such samples should, of course, be well packed in ice.
There is no doubt that this chilling process greatly lessens the prob-
ability of an erroneous interpretation, but, on the other hand, it is
a well-known fact that the results are not entirely dependable, es-
pecially when the analysis is to be delayed a period of 24 hours or
longer.
In the above connection, the 1917 issue of the ''Standard Methods
of Water Analysis" of the American Public Health Association gives
the following directions: ''The time allowed for storage or transpor-
tation of a bacterial sample between the filling of a sample bottle and*
the beginning of the analysis should bo not more than six hours for
impure waters and not more than 12 hours for relatively pure waters.
During the period of storage the temperature shall be kept as near
10® C. as possible. Any deviation from the above limits shall be so
stated in making reports."
A knowledge of the changes that take place both in the total count
and the B. coli content of waters when kept for various lengths of
time under different conditions is certainly a matter of great im-
portance.
The results of Whipple's experiments to determine the changes in
total count that take place in stored waters caused him to draw the
following conclusions: "After the collection of a sample in either a;
large or a small bottle, there is a slight reduction in the number of-
colonies that can be obtained uj>on the gelatin plate, due apparently]
to the effect of changed environment upon the bacteria present.
This re<luction is perhaps somewhat greater when a small volume oft
water is collected, as its temperature change is naturally more rapid.
The subsequent growth takes place more rapidly when the bottle is
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September 14, 1017 1480
but partialiy filled than ^en it is completely full. With bottles of
the same size the growth is more rapid in small vdumes of water
tiian in large v<dumes. The explanation of this is not wholly dear^
but undoubtedly the supply of oxygen is an important factor, and it
is probably the controlling factor." In his experiments the changes
in coli content were not considered.
Jordan and Irons have shown that considerable changes take place
in the total count of ice-packed samples, even within a few hours,
and state that ''The initial temperature determines to a lai^e extent
the course of events. * * * The influence of ice packing upon
such colon bacilli as may be present in polluted water does not
appear to be injurious. We have not been able to observe any
marked disappearance of B, c<ili, either in ice-packed waters or in
those maintained at a higher temperature during a period such as
may ordinarily lapse during transportation." In a later publication
Jordan states that ''Our own experiments are too few in number to
warrant generalization, but so far as they go, they indicate that no
material change occurs in ice-packed samples within 48 hours, a
period longer than that usually consumed in transportation."
Since the work of this district required long periods of storage,
investigations were carried on to determine just what changes actually
occurred in the bacterial content of the water. Observations were
tabidated on some 30 series of water samples which contained or
were inoculated artificially with strains of B. coK. The organisms
selected for inoculation were obtained by fishing characteristic
colonies from Endows medium.
The three tables given below are in some d^ree typical of the
results in ail cases. However, the oondusions are based cm the
entire smes.
Table No. 1.
A portion of a colony of B. coli was emulsified in 10 cubic centi-
meters of normal salt solution, and 1 liter of sterile distilled water was
inoculated with 2 drops of this emulsion. The water was then
thoroughly shaken to give an even distribution of the organisms and
apportioned into nine sterile 4-ounce ground-^ass-stoppered bottles.
The water from one of these was planted iBMnediately as control
(samjde 0-5). Four others {OS, 0-7, 0-8, and 0-9) were placed
in the 37® 0. incubator and the remaining four (0-10, 0-11,0-12,
and 0-13) kept on ice at a temperature below 6° 0.
AftS TOU 8A¥lli« laur K^mbj ta Imrmi im ikt S£€OND UBEETf LOAKt
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1481
September 14, 1917
''
Time of
analysii.
T0tel
FenBM
Btatiiia of Iftcton broth an
dconfin
nation 0)
Beadou
Samp]« No.
0.00001
e.c.
0.0001
o.e.
0.001
cc
0.01
CO.
0.1C.C.
ic.c.
10 e.c.
C-5
Immediately..
24 hours later..
48 hours later..
71 hours later..
«tlwaTS later..
14tLourstater..
48 hours later..
Tlhoors later..
96 hours later..
64,000
44,500
53,700
30,000
»,500
1,250
+
+
+
-*-
+
+
+
+
+
+
+
+
+
+
+
+
+
+
Kept at ZT C:
C-«
+
C-7
C-8
4.
C^
^X-W
+
C-11
+
C-«
4.
C-13
■1-
Hie colonies developing on agar plates from the incubated samples
WMB quite small, even after several days' incubation. The colonies
from the corresponding iced samples were large and healthy in .ap-
peanmoe, resembling the colonies from the control sample (C-5).
TlMr loss of fermenting power in dilutions of 0.1 c. c. and lower is
noted, although the total number of viable organisms remains high.
Sudi a result seems to demonstrate the sensitivity of the B. coli
group to a 37° C temperatiu-e in the absence of food. Likewise,
under the same food conditions, the preserving power of ice, as far
as fermenting quaUty is concerned, is shown in samples C-10 to C-13.
Table No. 2.
About two liters of Chicago tap water, known to cont^n small
amounts of JB. coli, wore thoroughly shaken and distributed into
eleven sterile four-ounce bottles. One sample was planted immedi-
ately, five samples were kept at room temperature (20° C), and five
below 6*" C.
anvKH..
TtmeofaiialyBia.
Totml
count oa
ForTrentation of IsKtoso
hrath ATKi eoQfirmaliDn
on oiKlo.
«.l«.c^ Ice.
MC.C
O-MO
Taiin«diate.ly ,
13
60
fin
31
I
+
t
5+
C-101 1
14 hours later
H-
<M«.::. :::::::::::::.:
«lliouT9later
4- 1+
04(B
72 hours later
4- H-
C-IOI
98 hours later
m. -
lo ■ -
14 - ,
15 -
26 - i
a§ -
31 —
S-
C-llK
129 bourn latar
5-
Bn* below «*C.:
C-106
M hoon lat^^r
5+
C-107
4B hoars later
s+
C-108
72 boon later
4+ 1-
c-wi.:::::::::::::::::::::: ::
•1 houn later
1+ 3~
c-uo
120hoon?l*tiM-. ., .
5-
Ti^ samples kept at room temperature showed a slight increase
in total count up to the fifth day, while in the ice-kept samples there
w«s practically no change.
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1482
B. coli was demonstrated in the samples kept at room temperature
in only one of five 10 c. c. portions of water on the third day and
was entirely absent on the fourth and fifth days.
In the ice-kept samples B. coli was present in two 10 c. c. portions
until the fourth day and absent on the fifth day.
Table No. 3.
About one hter of lake water, after being thoroughly shaken, was
distributed into seven sterile four-ounce bottles. One was planted
as control, two were kept below 6® C, two at room temperature,
and two at 37"* C.
Sample No.
Time of analysis.
Total
count on
agar at
37' C.
Fermentatioii of lactose, broth
and confirmation on «wo.
0.01 cc.
0.1 cc.
ic.c.
10 cc
C-252
Immediately
60
170
140
340
5,000+
5,000+
10,000+
+
+
+
+
+
+
+
+
Kept below 6' C:
C-253
24 hours later
+
C-254
48 hours later
+
Kept at room temperature:
34 hours later
+
C-2^0
48 hours later
+
Kept at 37° C:
r-257
24 hours later
+
C-2.5S
48 hours later
+
The above table shows a marked increase in total count that
usually takes place in stored waters that are not chilled. A de-
crease in B, coli content somewhat indirectly proportionate to the
temperature at which the samples were kept is noted.
No consistent increase of the B, coli content was noted in the entire
series of 30 tests, regardless of the conditions under which the water
was kept.
On four occasions a sliglit increase was indicated by the fermen-
tation of lactose broth, l)ut it is to be recalled that this is not con-
clusive, since the methods of dilution which are necessarily employed
to carry out the fermentation tests are only roughly accurate.
Usually there was a marked decrease of B. coli in natural samples
of water kept at 37° C. and room temperature. Ice-kept samples
also showed a slight decrease in B, coli. It is a recognized fact that
J5. coll out of its natural environment will die out. This is more
marked when the temperature is above 20° C.
The changes that took place in the total count were very irregular,
and the indications are that neither an increase nor a decrease can
be predicted. Low temperatures exercised an inhibiting effect, and
usually enormous increases occurred in all samples not packed in ice.
Erratic and unreUable results are to be expected since there are so
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1483 September 14. 1917
many varieties of organisms that might be present in any given
sample. On the other hand, one family or group such as the
B. colL might be reasonably expected to follow very nearly the same
biological changes when the samples are subjected to the same
conditions daring the period between collection and analysis. The
above tests indicate that this is the case in delayed samples that have
bepn kept below 10° C. Such a sample could reasonably be stated
to have had B.'coli present at the time of collection in at least the
amounts present at the time of analysis, and very likely in greater
amounts. If B. coli were absent on analysis, it was probably
absent when the sample was collected. However, it may have been
present in very small amounts and have died out during the period
of 3,tprage.
The results obtained in these experiments are in conformity with
what Uttle has been published by other workers along the same
line. In view of the enormous number of analyses made on shipped
samples, the necessity of knowing what changes take place during
storage is of great importance, and further study along these lines is
suggested as a profitable line of investigation.
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PREVALENCE OF DISEASE.
No health departmejit^ Slate or local, can effectively prevent or control disease mthout
knowledge of when, where, and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended Sept. 8, 1917.
The California State Board of Health reported that during the
week ended September 8, 1917, 1 case of typhus fever was notified at
Perrys, Rivereide County; 3 cases of poliomyelitis, 1 each at Oakland,
Pomona, and Potter Valley; 1 case of smallpox in Los Angeles and
1 m San Francisco; 38 cases of typhoid fever scattered over the
State; 1 case of leprosy in El Monte, Los Angeles County; 1 case of
cerebrospinal meningitis in San Francisco. The prevalence of other
reportable diseases showed a decrease during the week.
The details of notifiable disease cases reported during the week
ended September 1 are as follows:
Cerebrospinal meningitis 5 Pneumonia 25
Chicken pox 26
Diphtheria 20
Erysipelas 7
German measles 21
Gonococcus infection 50
Poliomyelitis 2
Scarlet fever 40
Syphilis 19
Tetanus 1
Trachoma 1
Malaria 15 I Tuberculosis 108
Measles 50
Mumps 20
Pellaora 2
Typhoid fever 53
Whooping cough 35
ANTHRAX.
Colorado — Hugo.
On Septembor 10, 1917, 4 cases of anthrax in man were re-
ported in llujjo, Liiir-oln County, Colo. A large number of cases of
tlie disi'Jisc jiro it porlt'd to liavo occurred in cattle in Lincoln County.
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S^tember 14. IttlT
ANTHRAX— Continued.
New Hampshire — ^Manchester.
During the period from January 1 to July 20, 1917, 4 cases of
anthrax were notified at Manchester, N. H., all of the patients having
been employees in a shoe factory and three of them engaged in the
tannery department of the factory while the fourth case was in the
person of a steam fitter who received anthrax infection through a
bum on his hand.
CEREBROSPINAL MENINGITia
State Reports for July, 1917.
Place.
New cases
reported.
Place.
Now «\\se3
rrporloi.
Hawaii:
Oahu —
2
Mississippi:
Hint'.s County
1
Honolulu
Snxith County
1
Total
1
2
1
2
Fulton CCHmtj ,-r-.r,-,-.rr.
Qibson County
Wabf^<fh County
• Total
4
City Reports for Week Ended Aug. 25, 1917.
Place.
Akron, Ohio
Baltimof*. Md
Boston, Mass
Chicago, m
Cincinnati, Ohio...
Oeveland. Ohk>...
Davenport, lom%. .
DttroltMWi
Dobuque, lowm...
Kalamaioo. Midi..
Lawrence, MMi...
L»xini;ton, Ky.
Low«U,r
Cases.
Deaths.
Place.
Cases. ' Dciths.
Lynn. Mass ,
M^pmphis. Tenn
Milwaukee, Wis
Newark, N. J
New Bcdfofd, Mass..
NewbufRh, N. Y....
Newport, R. I
New York, N. Y
Omaha. Nebr
Philadelphia, Pa....
Pittsbi:rKh, Pa
Racine, Wis
St. LouL^Mo
DIPHTHERIA.
Wyoming— Fort RusselL
On September 6, 1917, 44 cases of diphtheria were notified at
Fort Russell, Laramie County, Wyo.
See also Diphtheria, meaaleB, scarlet fever, and tuberculoeiB, page 1493.
ERYSIPELAS.
City Reports for Week Ended Aug. 25, 1917.
Place.
teWo, N.T
Qfcago.in
Oevefimd.Ohio .
5rtroit,llldi
Dobuque, lowm...
5 Paso, Tex
Xalamaxoo, Midi.
IfsAnttles.Cal..
JiMai^.Tonn...
Newark, N.J
Deaths.
Place.
New York, N.Y...
Philaciclphia, Pa...
Pittsburgh, Pa
Rochester. N. Y....
Sacramento, Cal
St. Louis, Mo
San Diego, Cal
San Francisco, (al.
Wilmington, Del. . .
Caiee.
Deaths.
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LEPROSY.
New York — Syracuse.
On August 11, 1917, two cases of leprosy were notified in Syracuse,
N. Y., in the persons of D. V., aged 30 years, and N. V., aged 23
years, brothers, natives of Greece, both having been in the United
States for a number of years and having resided in New York Gty
previous to going to Syracuse. The patient D. V. has been isolated
at Syracuse, but N. V. left Sj^racuse August 13 and is supposed to
have returned to New York City.
Hawaii Report for July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
HawaU:
Hawaii-
Puna District
!
1 !
I 1
' i
Hawaii— Continued
Oahu—
Honolulu
4
Knrth Fliln District
Total
8
Lihuo District
Koloa District
MALARIA.
Mississippi Report for July, 1917.
Place.
Mississippi;
Adams County
Alcorn County
Amite County
Attala County
Bolivar County
Calhoun County
Carroll County
Choctaw County
Claiborne County
Clarke County
Clay County
Coahoma County
Copiah County
C^vinRton Conn ty
De Soto County
Forrest County
Franklin County
Georcc County
(5reeno Cotnity
Grenada County
Hancock County
Harrison County
Hinds County
Holmes County
Tssfifiucna County
Itawamba County
Jackson Count y
JcfTcrson County
JcITcrson Davis Coimty
Jones Coimty
Kemper Coiinty
i-afuyrtfc Tounty
Lamar County
I '.in-'eriliilo County
1 nwr'^'Ui' C(,unty
I {\x\ V rM.iif y
; (o (\.w)U-
1 rilnro ( ir.r.iy
! '! ti>ll: '(.IHiiv
New cases
reported.
G8
115
83
1S7
1.7S2
223
190
99
122
47
nn
l,as:j
173
UH
1.71
162
iXl
42
.*0
'A)
\m
147
M(\
4.55
44
S5
174
49
194
93
116
90
78
2:iti
124
313
775
121
Place.
Mississippi— Continued.
I -owndes County
Madison County
Marion Coimty
Marshall County
Monroe Countv
Montgomery County.
Neshoba County
Newton County
Noxulxje Coimty
Oktibbeha County . . .
Panola Countv
Pearl River County..
Perry County
Pike County
Pontotoc Coiii'ty
Prcnl i-^s ( ounty
Qui'nian Couniy
K;in ill County
Shar' oy Coimty
Simpson ( "ounty
.Smith Cctmlv
Stone County
.Sunflower Countv
Tallahatchio County.,
Tate County
Tishomingo County. .
Ttmica County
Union Coimtv
AV a 1 thai J County
Warren County
Wasliin^trn County..
Wavne <«unty
Webster County ,
Wilkin V p County....
Wins' M ' ounty
Y:jlol)i:slia County
Ya70o Coimty
Tctal.
New cases
reporiod.
63
115
231
151
122
70
131
60
60
127
341
78
92
230
2S0
99
246
112
205
151
95
35
791
423
196
121
442
47
22
446
4(B
103
41
02
234
225
617
15.959
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1487
MALARIA— Oontinued.
GIty Reports for Week Ended Aof . 25, 1917.
September 14. 1917
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Bftmingfaani, Ala
156
1
Nashville, Tenn
1
RoKtpn, tf A« ......
New Orleazu, La
3
5*
5
3
n»ir*<«Vin^s ci ,, ,
1
NewYoric,N.Y
Riclimond, Va.
1
Ea9tO»oee, N.J
1
3
1
53
3
Uttl* Kock, Ark
8aviiHTiah, (la ................
L08AnMl«,Cal
Stockton, Cal
Ifnnphfat, TftT^Ti
5
> The nMon that Birniingham had so many more cases of malaria reported than any other city is not
Oat the disease h more prevalent in BJrmtiigham thsoi in other cities of Alabama and neighboring States,
bot undoubtedly because of the succoesfuleuorts the health department has made in securing the coopera-
tioQ of the practicing physicians in reporting cases.
MRASLFA
Bee Diphtheria, measles, scarlet ferer, and tuberculosis, page 1493.
PELLAGRA.
Mississippi Report f^or Jwitj, 1917.
Place.
New coses
reported.
Place.
New oases
reported.
Mississippi:
Adams County
0
33
7
Id
385
16
8
' 3
8
4
34
250
31
14
M
14
7
5
»
2
3
38
59
39
6
16
3
n
3
81
13
4
8
9
17
13
86
44
28
Mississippi— Cont inued.
Lowndes C-ounty
14
Ahroni County
Ma.Iison County
24
Amite County ..... . . ..
Marion County
19
Attala County
Marshall County
37
Bolivar County
Monroe County
3
Oilhwin County
Montgomery County
9
Carroll County
Neslioba C<>unty
20
Choctaw County
Newton County
13
ClniboTDO County
Noxuboc County
7
Clarke County
Oktibbeha County
56
Clay County
Panola Cmmty
52
Coihoma County
Pearl Itiver County
21
OoplihCoaiitr
Perry County .'.
15
Covinctcn Coonty
PikeCounty
30
ut ooco County
Pontotoc Cmmiy
35
Forrest County
Prentiss County.
13
Frankttn Comtty
Quitman Coimty
80
OeorgeCounty
Rankin C^^nty'
11
OfeeSSmSF::::::::::::::::::::::
Sharkey Oouniy
31
Grenada Coisaty
Simpson Coimty
9
Hancock Coon^
Smith County. .'
7
Harrison Oounty ....................
Stono County
3
HiBdsCoatttT
Sunflower County
248
HoimmCouttLy
Tallahntrhie Cmnty
66
Issaquana Cotmty
Tale County
16
Itawamba Coonty
TisiMmiofo County
19
Jackson County
Tunica County '.
108
Jeflerson r^^mty
Union County
8
JeOenon Davit Oranty
Wamiall Cocmty
3
JonesCoimty
Warr<^n f^-ounty ,t t--t-
15
Kenper Gocra^. .
WMhineten County
33
LalayettaCoairtT
Wayne County
S3
Laicoen^?:::::::::::::::::::
Webster County
4
I^'B'WiB)f^^^mty
Wilkinson County
Winston County
3
LavreneeOoimtTr
19
i-JSS!^:..:::::: : :
Yalobusha County
5
LeeOooity..
Yasoo County ^ .
59
Leflore Countv
Total
Unooln County
3,534
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1488
PELLAGRA— Continued.
Ciiy Reports for Week Ekided Aii£. 25. 1917.
Place.
Birmingham, Ala..
Charleston, S.C...
Chicago, HI
Lcxincton.Ky....
Memphis, Tenn....
Mobile. Ala
Nashville, Tenn...
NewOrleaas, La..
Cases.
»7
Deaths.
Place.
New York, N.Y..
Norfolk, Va
PhiladelidiJa.Pa...
Richmond, va
San Diego, Oal
Washington, D. 0.
Wihnington, N. C.
Cases.
Destbf.
1 The reason that Birmingham had so many more cases of pellagra reported than any other city Is not
that the disease is more prevalent in Birmingham than in other cities of Alabama and nei^boring States,
but undoubtedly because of the successful efforts the health department has made in secunng the cooperi-
tion of the practicing physicians in reporting cases.
PNEUMONU.
City Reports for Week Ekided Aug. 25, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Detths.
Baltimore. Md
1
1
2
I
54
1
1
1
1
3
6
2
Newark, N.J
II
13
12
I
X
3
Berkeley, Cal
Newcastle, Pa
Binehamton. N. Y
Newport, Ky
1
Boston, Mass
4
2
30
6
4
1
1
2
Philadelphia, Pa
11
Cambridge. Mass
Pittsburgh, Pa
10
Chicago, 111
Reading, Pa
1
Clevemiid, Ohio
Rochester. N. Y
San Francisco, Cal
Detroit , Mich
9
Fall River Mass
Steclton, Pa
KalnmatoOj Mich. ...... ^ .... .
Worcester, Mass
3
Los Angeles, Cal
POUOMYELmS (INFANTILE PARALYSIS).
Cases Reported— Aug. 30 to Sept 12, 1917.
The following table shows the number of cases of poliomyelitis re-
ported to the United States Public Health Service from August 30 to
September 12, 1917. This is in addition to and continuation of the
table pubUshed in the PubUc Health Reports, August 31, 1917,
page 1420:
Place.
Period.
Cases.
Place.
Period.
Cases.
Alabama:
Elmore County
Marshall County—
Guntersville —
Arizona:
Greenlee County
California:
Alameda County-
Oakland
Los Angeles
County-
Pomona
Mendocino County-
Potter Valley...
Connecticut:
Fairfield County-
Greenwich
New I^ o n d o n
County—
Groton
Sept. 2-8.
do...
Aug. 23...
Sept. 2-S.
.do.
.do.
.do.
do.
Illinois:
Coles County
Cook County
Chicago
Fulton County
Livingston County .
Ogle County
Rock Island County
Vermilion County . .
Will County
Kansas:
.Mien County—
lola
Brown County—
Powhatan
Gray County—
Montezuma
Jewell County-
Webber .
Aug.25-Sept.8.
do
....do
do
.....do
do
do
....do
....do.........
1
Sept. 2-8 ,
Aug. 25-Scpt. 1.
Sept. 2-8
Aug.25-Sept. 1.
3
5
63
1
1
3
1
3
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1489 September 14. 1917
POUOMYELinS (INFANTILE PAftALYSIS)— Continued.
Cases Reported— Aug. 30 to Sept. 12, 1917— Continued.
Place.
Period.
Cases.
Place.
Period.
Cases.
Kansas— Continued.
Pratt County—
Pratt
Sept. 2-8
do
I
2
1
Virpinla- Continued.
Nanscmond
County-
Magnolia
Richmond County—
Aug. 27-8ept. 4.
Sept. 4-10
-do.. .
Republic County-
Republic
Rllev <^HUity—
Uandolph
Smith County—
Oavlord
Aug. 2o-Scpt. 1..
do
Rocki^nnham
County—
Davton
Wyandotte County-
Kansas City....
Maryland:
Sept. 2-8
Aug. 27-Sept. 8..
Sept. 3-8
Aug. 27-Sept. 8.
Sept. 3-8.. .....
Brmgewater
Harrisonburg. . .
North River
Aug.27-Scpt.4..
do
do
AUeeany Countv. . .
Balumore County..
Garrott County
liont'omery County
Massachusetts:
Essex County—
West Virginia:
Barhoiir County—
Philippl
Braxton County-
Exchange
Knawl
Sept. 2-8
Aug. 25-Sept. 1 .
do
Havorhifl ' Aug.l9-Sept. 1..
Lynn Aug. 25-Sept. 1..
Harrisan County—
Adamslon..
do
Bridgeport
do
Northampton..
Middlesex County—
Aoton(Town)..
Plymouth County —
Aug. 19-25
.do
Clarksburg
Lewis County-
Jane Lew
Kemper
Aug. 25-Sept. 8..
Sept. 2-8
do
Brockton 1 do
Weston
. do .
Suffolk County-
Boston
Ohio:
do
do
Marion County-
Fawn Run
Olover Gap
Aug. 25-Sept. 1..
do
Medina County —
Middleton
do
Harrisv'ille
Monongah
do
township.
Robinson Run .
Marshall County—
Moundsville....
do
Wa^B Ooointy—
wTooeter
Aug. 30-30
Aug.20-Sept.l..
do
do
Vermont:
CSiittfindenOnnnty^
Mineral County—
BeryL
do
Burlington .....
Washington
County—
Barre
Frankford
Ohio County—
WheeUng
Preston County-
Denver
Sept. 2-8
Aug. 25-Sept. 1..
Sept.2-S
do.
Middlesex
Moretown
Hudson
^
Waterbury
Windsor County—
Bridttwater....
Woodstock
Virginia:
Amherst County-
Alto
Aug.2*-Sept.l..
Sept. 2-8
Aug. 26-Sept. 1..
Aug. 27-Sept. 4.
Sept. 4-10
do
Aug. 27-Sept. 4..
Sept. 4-10
Ritchie County-
Cairo
Aug.25-S8pt.l..
Sept. 2-S
do
McFarland
(rural).
Tucker County—
St. George
Upshur County—
Buckhannon...
Kanawha Head.
Wood County—
BeUevUle
Parkcrsburg
Aug. 25-Sept. 1..
Aug. 26-Sept. 8..
Sept. 2-8
Aug. 25-Sept. 1..
Aug. 25-Sept. 8..
Amherst
Augusta County—
Wajmesboro....
Fauquier County—
warrenton
Frederick County—
Orimes
1
State Reporte for July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Indiana:
TiOke CotmtT . ...
5
Mississippi— Conthiued.
Nesnoba Countv
1
YftlnliiiJchACntintv . ....
1
Mississippi:
1
3
Yazoo Countv . .............
1
Total
Bolivar Coimtv . . .
7
ABE TOU SATING Tour Money to IiiTest in the SECOND LIBERTY LOANt
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8eptmberl4,l«17 1490
POUOMYELinS <IKFANTILE PARALT8IS)-X}oiitiiitt6d.
PlBoe.
Coses.
Deaths. | Ptoee.
Cans.
Deaths.
Akron, Ohio
19
Kansas City, Mo
Newark, N. J
Bellingham, Wa^
Boston, Mass
Newcastle Pa -
New Yob*, N. Y
Proctton, M«n , .,
Chicago, til
7
NorthanrntOQ, Msss
Clevetand, Ohio
Omalia, ^f^br'. .*...... a
1
Davenport, Iowa
Rochester. N. Y
Kvnrfttt, Wfish
Rock Island, 111
TTftVArhIn, M^-^
1
Washington, D. C
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tuberculoeia, page 1493.
SMALLPOX.
Minnesota.
During the week ended September 8, 1917, one new focus ot small-
pox infection was reported in Minnesota, 5 cases of the disease having
been notified in Farley Township, Polk County.
Wyoming — ^Lusk.
On September 6, 1917j 6 cases of smallpox were notified at Lusk;
Niobrara County, Wyo,
Biiso^laneous State Reports.
Place.
CBMS.
Deaths.
Plaa.
o^
Deaths.
Indiana (July 1-31):
1
1
3
1
4
1
6
Mississi0pi'<Jol7 1-91):
BoUvar County
8
19
Cass CountT
Calhoun County
Daviess Ooonty
Clarke CouHty
Delaware County
Dc Soto County
Hinds County
Fountain County
Fulton County .'
Holmes County^
Jackson County
Gibson County
Grant Cnntfity -^^ ..,,
1
1
Jones County — .
Greene County .. . . ....
3
2
1
1
5
22
13
2
28
3
8
1
1
6
3
4
U
9
3
10
Madison County
Hancock County
Marxian County
Howard Countv -
Neshoba County
Johnson County
Panola County
Knox Countv .1 ... .
1
Pike County.
Lake County
Poototoe Count y
L«aDorte Coiintv ....
Simpson County
Madisan Countr
TateOMmty...!
Marion County
1
I^nion County , ,
Total
Morgan County
66
Orange Couoty
Oregon (July 1^1):
Multnomah County-
Portland . .
4
Shelby County .'
St. Joseph County
Sullivan County
Tippecanoe Coimty
Vanderburg County
Vermilion County
Vigo County ....'.
Total
154
4
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1491
SMALLPOX— ContimieJ.
City Reports for Week Ended Aug. 25, 1917.
September 14. 1917
Place.
Cases.
Deaths.
Pla<^.
Cases.
Deaths.
Akron, Ohio
3
12
1
1
1
2
3
5
2
1
2
1
1
Little Rock, Ark
1
4
1
2
1
Butte, Mont
Minneapolis, Minn
QiicaKo, 111
1
Oakland, Cai
ClevcantJ, Ohio
Coffey villft, Kans
Pittsburg, Pa
Denver, Colo
Portland, Oree
2
Detroit, Mich
RnnkTslftml.fu
2
3
1
3
I
2
Flint, Mich
St. Joseph, Mo
Grand Rapids, Mich
St. Louis, Mo
Salt Lake City, Utah
Jackson^Mi<^
San Francisco, Cal
Kftnsas nty. Mo
Seattle, Wash
La Oosse, Wis
Sioux City, Iowa
TETANUS,
aty Reporte for We^ Ended Aug. 25, 1917.
Place.
Cases.
Deaths.
Ptoce.
Cases.
Deaths.
Newtfk N J
1
1
Portland, On^g
1
New Bedford. Mass
1
1
San Jose, Cal
1
1
New York M. Y
Springfield, Mass
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1493.
TYPHOID FEVER.
Stote Reports tw Jnly, 1917.
Plaoe.
New cases
reported.
Place.
New cases
reported.
Hawaii:
Hawaii-
YTanMiAmA THxtrffit
Indiana— Continued.
Jefferson C'Oimtv.. ^
I
2
Km^h Kana District
JohTwoi™ County ......r,.,..TT.^.rT-
0
Soath HUo District
Enox County
1
Maui-
Waihikn District
Kosciusko County.
1
Lake County
4
Oahu—
ITMikmlfW TMjttriflt .
4
IdtkA isnn Conn tv'
2
Marion County
8
Total ■ . .^.Tr.^-
12
Martin County
4
Morgan CoimCv
2
Indiana:
1
Cirantftk C/Oimtv
2
Owen County
12
RlnAkfnrd Cmmtv
Pike County'.
2
Posey C-ounty. .,,...,,-.,
4
PiorV Countv
Pulaski County
6
Dacatur Countv - -.■■.- .......
Randolph County
2
DaIawata Conntv
Ripley bounty . .'
3
ThihAl« Cmtntv
Scott County
2
mirhArt Ctnmtv
Spencer County
1
FlOVd CffllDtV ^^-^^^--^-r-rr-r^r
St. Joseph County
4
nihvoi r!niintv .
Tippecejioe County
2
QrMne Countv
Vanderburgh County
10
Harrison Conntr
Vermilion County
2
TTmvAT*! fVinntv
Washingt<m County
8
Total
JacksQD County
127
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1492
TYPHOID FEVER— Oofttlnued.
Stole BepMto for J«lj. IMT-Ooirtmiied.
Place
Mississippi:
Adams County
Alcorn County
Amite County
Bolivar County
Calboon County
Carroll County
Chortaw County
Claiborne County
ClarkeCounty
Clay County
Coahona Coimty
Copiah County
Covington County
Do Soto County
Forrest County ....... .
Franklin County
rireene Cwmty
Hancock County
Harrison County
Hinds County .........
Holmes County
Itawamba County
Jackson County
Jefferson County
Jefferson Daris County
Jones County
Kemper C^nmty
Laiiayette County
Lamar County
Lauderdale County . . . .
Lawrence County
Leake County
Lee County
Leflore County
Lincoln County
Lowndes County
Ma'lison County
Marion County
MarNhall County
Monroe County
MontRomery County...
Neshoba County
13
PlMe.
Neva
MistteipnA-ContiinMd.
Newton County
Noxubee County
Oktibbeha County...
Panola County
Pearl River County..
Perry County
PIktCounty
Pontotoc County
Premiss C<nmty
Quitman County
Rankin County
Simpson County
Smith County
Stone County
Sunflower Countv
Tallahatchie Coimty.
TauCwmty/
Tishoainiio County. .
Tunica County
Union County
WalthaU Coimty
Warren County.
WasbtawUnCoaMy.
Wayne County
Webstar Coimty
Winrton County . .
Yalobusha County.
Yaioo County.....
Total.
Brecon:
Banion County
Clackamas County
Clatsop County ,
Multnomah County-
Portland
Union County
WaaMnniitt County.
YamhUTCounty
Total.
n
IS
4
n
n
V
<
s
M
1
s
II
ft
•
IS
I
I
o
7
8
H
W
city Reports for Week Ended Ang. 2S, 1917.
Place.
Akron, Ohio
Alameda. Cal
Albany,N. Y
Alton, ni
Altoona, Pa
Atlantic Citr, N.J
Baltimore. Md
Bayonne, N. J....
Berkeley, Cal
BirminKham, Ala.
Boston, Mass
BrwMock, Pa
BrldKriiort.Conn.
Brockton. Maas...
Buffalo. N. Y
Cairo, III
Camhridm, Mass. .
Camden, N. J
Canton. Ohio
Charleston, 8. C,
Chelsea, Mass
Chicago, III
CiDcionati, Ohio. .
Cleveland, Ohio. . .
Deaths.
Ptoot.
Coffe v\illc, Kans
Columbus. Ohio
Concord, N. H
Dan\nllc,lll...
Davenport, Iowa
Dayton, OWo
Denver. Colo.
Detroit, Mich
Dululh,Mintt
East Chioaco, lad
EvansviUe. Tnd
Kali River, Mass
Kltchbunj, Mass
Flint, Mich
Fort Worth, Tex
(Jalcsburg, Ul
Grand Rapids, MIek
Harrisbuni. Pa
Hartford, Cof—
Haverhill, Mi
Indianapolis, Ind.
Jersey dty, N.J.
Johnstown, Po
Kansas City
ABE YOU SATING Tonr Money to Inrest in the SECOND UBEBTT LOAN!
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1493
September 14. 1917
TYPHOID FEVER— Continued.
City Reports for Week Ended Aug. 25, 1^17— Continued.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Kansas f^ity, Mo.
2
2
2
1
5
2
9
2
2
1
1
9
3
1
18
0
1
2
4
21
60
3
5
2
1
2
3
1
32
26
1
1
1
2
Providence, R.I
Quincy, Mass
5
KPO"*^ne, Temi..--
1
1
Kokomo, Ind
Rcadinjj, Pa
1
Tj«'"Ten w, Mass
1 Richmond, Va
4
1
Tiflxin#rtofn, K^y r r . , ,
Rochester, N.Y
1
Little'Rock, Ark
1 Sacramento. Cal
1
5
28
13
4
1
2
2
I>os Anjreles, Cal
Si. Joseph iio
1
LyiiTi, ttiiffs' .
St. Louis, Mo
5
Iffaidf'n.i^'M*
Salt Lake City, Utah
Manaiester^N.H
San Francisco, Cal
1
McKeesport, Pa
►Savannah, Oa .,.,.....,,.....
1
If Ainp>>i«, Teim . , . ^ . . . T . . , , ^
1
Settle. Wash
lIlnTMdmnliji . Mtl^II ...... T '
' South Bend, Ind
2
Mobile. Ala.'
Springfield, 111
1
N Afthviila. Tenn . . *
1
Springfield, Mass
1
1
1
1
1
2
1
2
1
32
1
7
4
2
2
3
8
2
1
1
Newark, K.J
1 Stockton, Cal
1
New Bedford. Mass
Syracuse, N. Y
Newcastle, Pa
I'acoma, wash
New Haven. Conn . , . , ^ .
1
4
6
Taunton. Mass
KA'vr OriAAns. Ta. .
Toledo, 6hlo
1
NewYork.K.Y
Topeka, Kans
•Kimrnrn. VaIIb NY
t Trenton, N.J
Norfolk, Va
1 Troy.N. Y
1
Norristown. Pa
Washington, P. C
2
Northampton, MfMK. ^
Watertown, N. Y
OakJaod Cal
Wheeling, W. Va
nviAhnmiirHtv. OklA .
1
Wichita, Ka"?? , ,
Passaic, N.J. 11
Wifkes-6arrc, I'a
PhiladalDldA. Pa.. .
Wilmington, Del
2
Pittabure Pa
1
1
Wilmington, N.C
Pftt*ll*l<f IfMS
W Inston-Salem , N . C
4
Piainfleld,N.J
Worcester, Mas.<t
York, Pa.'.
Portsmottth, Va
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for July, 1917.
Cases reported.
State.
Cases reported.
State.
Diph-
theria.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
Hawaii
10
153
3
249
Misstssippi
19
9
946
32
19
'Indiana
129
Oregon
27
Qty Reporte for Week Ended Aug. 25, 1917.
FopalHF
timiasor
Julyl.ime
(eaiiinfited
bjU.8.
BUTCati).
Total
detttb5
(rom
all
causes.
Dlpbtborla-
Meaales.
Scarlet
fever.
Tuber-
, miiosla.
CatF.
J
1-
1
i
1
1
1
1
Ofcr Smjm iJihaljJtttat«:
756.47<!1
203
1,370
m
5
m
n
m
«
103
in
'J2
19
2
7
1
1
9
34
3
7
m
n
2
i
1
1
n
3
11
3
n
3
I
S7
33
121
37 :
m
2J
IkttUm.Mftvi *.-.,..,..
m
'diiiMi, tji ,.„..,
eo
Cle^dbnd « Ohio. . , -..,.,„,.
m
lMi3ii Sit leb
17
New York, K.Y
in
111
hi
St. L«il9,Mo...
'M ' i
II
13
ARE ¥0U iATINQ Your Money to Inrest in the SECOND LIBERTY LQ.
Digitized by VjQ^^lC
September 14, 1917
1494
DIPHTHERIA, MEASLES, SCARLET FEVER, AMD TUBERCULOSIS-
Continued.
City Reporte for Week Ended Aug. 25, 1917— Continued.
Pojiiila^
tirtrjftsof
July 1, Ifllfl
(esUotated
by U. B.
Total
deaths
frntu
fltl
DJpbiheria.
Measlef.
mkala.
city.
1
1
1
1
1
a
1
j
Fmhh 300,000 to 500,000 InMbit-
ants:
Buffalo. N. Y
468,558
410,476
306,345
436,535
363,454
406, 8M
871,747
463,516
848,639
363,080
214,878
260,800
271,708
29«,847
295,463
254,960
256,417
104,190
181,762
121,570
112,081
106,233
127,224
128,366
104,562
128,201
110,900
100,660
113. 245
102, 425
14«,9»5
117,057
118, 158
149, ('So
198,004
165, 470
109,381
156,687
117.399
ia%942
155,624
112,770
191,55-1
111,593
163,314
85,625
63.50i>
58,659
57,660
69,893
57,653
53,973
67,449
60,852
60,734
57,144
04,495
86,690
63,705
76,078
54,772
72,015
........
66
70
""m
""in'
34
99
61
71
82'
34
51
68
6
11
4
21
13
6
ao
9
2
1
22
1
......
36
13
13
15
M
ninpJnn&ti Ohio
2
Jersev Citv N J -.
*"*3'
......
2
7
2
11
8
Milwaiikeo. Wis
5
MinTMmnnli^ MhiD
Newark. N. J
2S
r
26
7
16
12
Naw Orleans La
20
Sttn Pfancisco. (^ --
17
2
7
1
8
1
1
12
8
Seattle, Wash
6
Washington, D. C
From 200,000 to 300,000 inhabit-
ants:
Coliunhns Ohio .......
10
8
9
13
4
4
Denver Colo
17
Tndianapoli.s, Tnd . . . - . r , r -- -
6
Kansas t^tv. Mo
7
PnrtlAnd Orec . •••••
1
2
3
......
2
Providence R. I
3
4
1
3
Rochester, N. Y
From lOOfiOO to 200,000 inhabit-
ants:
Albanv NY
1
3
6
15
9
7
1
7
2
5
7
6
3
4
22
6
7
5
7
2
78
38
29
30*
43
10
18
37
35
37
19
59
37
30
46"
33
48
44
23
32
55
4
4
8
1
1
5
4
1
1
7
BrldgRport, <V>nn
5
Okmbmgff, Mars ..,r
6
Camden N J . ...
Dayton, Ohio
......
h '
1
::::::
2
Fail River. Mass
3
Fort Worth Tex ..
'
3
Grand Rapids, Mich
Hartford, Conn
1
2
1
1
1
2
1
1
2
2
3
2
11
4
14
5
1
'
1
3
X<awrcncc. Mass
5
T^well Mass . . .
:::;::::::: ::::::i
2
Lynn, Mass
1
4
M^mnhis. Tenn
1
1
1
3
11
Nashville. Tenn
5
Now Bedford, Mass
6
1
4
2
New Haven , C^onn
' 1
3
Oakland, Cal
1
6
3
Omaha, Kelir
3
RpAHfnfr Pji . _ _ .
1
.
1
10
1
Richmond Va
""2
2
4
3
3
2
1
1
7
Salt Lake City, Utah
Springfield . Mass
1
1
4
5
5
Syracuse, N. Y
4
1
Tacoma, Wash . ....
Toledo, Ohio
65
46
46
n'
i2'
13
10
15
16
12
12
Ji
28
20*
1
6
2
6
1
8
1
1
2
6
Trenton, N. J
5
7
1
5
Worcester, Mass. . . .*.'
From 50,000 to 100,000 inhabit-
ants:
Akron Ohio
4
4
Aliontown Pa
Altoona Pk
1
Atlantic Citv N J
1
5
1
Bayonne, Nr J . . . r
2
Berkeley, C*U
1
WJnphftmtnn. W Y ..- .
3
4
2
1
1
Brockton, Mass.
Canton, Ohio
1
1
5
3
7
1
f^harleston, s. c ...--...,„..
1
1
7
1
3
rnvinrtnn. Kv
3
Duliitn, ¥»nn
9
4
2
Eliabeth.N. J
7
'.'..'.'.'.
3
£1 Paso. Tex
9
'Rvftn«v1llA Tnd
5
3
Flint Midi
2
4
Harrisburg, Pa
'....'.'.
7
2
i
ABE YOU SAYING Y»ar Money to Inrost in the SECOND IIBB&TY LOAMt
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1495
September 14, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports tar Week Ended Aug. 25, 1917— Continued.
Popula-
tion as of
July 1, 191 >
(estimated
by U. S.
Census
Bureau).
Total
d^^aths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
V)
1
CJ
1
S
3
o
i
1
u
1
From 50,000 to 100,000 inhabit-
ants-Continued.
Hoboken, N. J
77,214
68,520
99,437
57,343
51,155
78,283
58,221
53,794
89,612
92,943
71,744
63.867
55,185
66,895
55,642
85,236
53.330
66,805
99,519
57,078
87,099
68,946
61,120
66,063
77,916
86,973
76,776
^,265
51,656
27,732
32,985
32,730
27,632
43,425
46, 192
29,319
26,074
32,261
48,811
39,873
28,743
42,458
28,203
39,233
35,486
41,781
41,863
29,353
25.679
48,477
35,363
48,886
31,576
26,771
38,676
31,677
41,097
46,515
27,587
36,964
32,940
30,699
4/, 621
26,234
26,318
23
19
is"
11
16
23
22
2
1
1
5
3
2
Johnstown, Pa
1
1
1
Kansas City, Kans
Little Rock, Ark
1
3
Maiden, Mass
1
5
Manchester, N. H
Mobile, Ala
2
4
New Britain, Conn
2
Norfolk, Va
2
OUahoma City, OUa
19
16
20
13
25
17
20
15
20
26
is'
20
23
14
1
8
' "i"
1
4
Pa«aic,N.J.:;
1
1
'
Portland. Me
2
2
BoCWbrd,!!!
2
2
1
4
3
2
Sacnmanto, Gal
2
8aginaw,Midj
1
3
1
St. Joseph, Mo ::::
1
San Dim, Gal
i
1
4
1
3
2
8aTBni2i,Ga
............
5
Schenectady. N. Y ,...
I
1
1
1
Sioox City, Iowa !...
1
2
Somenrilfe, Mass
1
1
Sooth Bend, Ind
1
1
8prinrfeld,IU
'mreHaute, Ind
1
1
1
2
2
2
1
Troy,N.Y
1
3
Waterbnry, Conn
2
Wilkes-Borre^Pa
26
18
6
5
1
4
2
2
......
I
Wihnington, Del
3
York, 1%...'.. ...:::::::::::
1
2
From 25,000 to 50,000 Inhabit-
ants:
Alameda, CaJ......
2
1
B«JlXii£ham,WBah..
Brw*fioe.iia«i_, :::::::
**
&iztier.Pa. ._
1
1
6
J
Btttt#,lioQt
ahelafta.BCa9i, ,
11
15
10
12
2
1
1
2
2
1
4
1
CIUoopee,MMs„..
::*:*:::::
2
Ciimbarliid. Md.,
1 :::
1
Di»rille,m ;.,„,.
*
2
Dfffenporltlowa,*,..
1
1
1
Dnboqnfl , Irjwa ^
J
Bast ChiL-ai.'c.. lad.
*"
1
lia-t. Orange, M. J„
6
6
2
5
0
10
6
1
3
1
3
1
Klein, tu...:.. ...,.,.
.... :
1
Bverett, Haw
1
1
ETerett, Wtdi.„,._
FJtrl!bll3-Sr,MfWS
2
1
2
2
GftJvRston, Tei,
1
1
Owen Day, Wia.,,
1
HagflfBlowB, M<1.
1
1
2
2
2
"'■:*;i./""'
H»5iiiH,i4^.;::::::;;;;:
0
8
16
6
8
3
1
1
Jkat*oii,iCkih„..,,
'
Kalanuusoo. Mich^
1
Keoa*hap WL^,.
Km^^ton, K. Y.
1
EjKKErilletpTenfl...
7
1
1
1
LaCiwwi^Wia..^,..
8
25
20
9
8"
5
^Z^^&hfzy^ii'.'.v.'.v.
3
*
I^nj; Bciaah.Cal.--..
1
1
1
1
Loraia.Ohio.........
....
1
ludibiQiii Wis
1
1
tJoK^wJjjit Fft
17
3
4
10
1
2
MwlfaiVf fcfiMii
\
ICan|d|alr,N< J.,..
1
ABE TOU SATING Tour Money to Inrest in the SECOND LIBEBTT LOANt
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Creptember 14, 1U7
1496
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TDBERCULOSIfr-
Gontlniiecl.
Oty Repcrts f«r Week Emfod Avf. 2S, 1917— Ctantmiied.
Popala.
tionasof
JuW 1,1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
colosis.
city.
1
1
1
1
1
1
1
1
rrom 25,000 to 50.000 inhabit-
ants—Continued.
Nashua N H
27,327
29,603
41,133
81,927
30,108
43,716
37,353
31,401
31,404
33,080
46,450
41,185
38,629
39,661
36,798
38,136
46,486
43,284
38,926
37 445
46,236
86,283
48,726
80.570
39,894
43,139
33,809
29,892
31,156
30,863
32,874
13,599
31,685
15,794
» 13,075
. 32,669
24.276
33.539
20.930
15,395
17,446
13; 284
33,126
15,243
30.986
122,019
19,926
23,806
17,624
11,666
12,067
14,831
13,821
16,648
21,618
23.228
16.969
g
Newburrfi, N. Y
1
Newcastle. Pa..*
1
Newport, Ky
10
34
10
17
12
13
13
16
4*
18
U
13*
16
16
Newport, R. I
7
3
3
3
1
1
1
1
Newion.MasH
3
1
Niagara Falls, N. Y
NorristOfWTi. I'a
1
Ogrt^n, Utah
1
Oraxise,N. J
3
Pasadena, C^
8
Perth Amboy, N. J
1
PlttuflfiM, M^
1
1
Portsmouth, V»
2
Qnl"«y, n) '. '.\
r
On^r^' Man a ^ . , a . . .
2
2
1
Racine, Wis
1
Roanoke, Va
3
Rock Island^ 111 ......
Steubenville^ Ohfo. ...,...—
1
Superior, Wfa
TauP ton (Mass ............. .
......
1
3
Waltham, Haas
1
Watertown, N. Y
3
6
3
West Hoboken. N. J
1
1
WheelinR. W. Va
2
6
1
Wflliam^moTt. Fa
1
WnmWnn,Vj r: 7-^;:
1
3
Winston-Salem, N. C
......
1
1
1
ZanesviUe, Ohio
1
From 10,000 to 25,000 inhabit-
ants:
Alton, ni
Berlln,N. H
Braddock, Pa -
2
4
Cairo, in
1
Clinton. ICass
1
Concord, N. H
1
3
......
Oalesburg. ni _
Kearny, N. J
1
1
1
8
1
Kokomo, Ind
Long Branch, N. J
1
8
2
Heh-08e,Maas
Morristown, N. J
Nanticoke,P» _.
4
....
1
1
1
3
Newburyport, Mass ^,
New London, Conn.........
3
1
1
1
4
1
Knrth Adurn*. Mfff<,
Northampton, Mass.........
Plahifiekf, N. J
Pontiac, liUch
1
6
1
3
Portsmouth, N. H
1
Rocky Uount. N. G.V.V.V.W
1
nmhiFyl, Vf ...,
8
Baratoga'Sprittfi, N. Y
Steelton, Pa
1
1
1
3
Washington, Pa
1
WiUdzMbarg' Pa
' *
......
1
Wobum,Uaw
• Populatioo Apr. 16. 1910; no e
ABE TOU SATING lew Meiey to ImTest im ilM SSCOliD LDEBTY LOAN!
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FOREIGN*
MEXICO.
Yellow Ferer— Merida.
A case of yellow fever was reported at Merida, State of Yucatan,
Mexico, September 1, 1917. The case occurred in a person resident
at Merida during the past two years.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER
Reports Receired Ddrfaig the Week Ended Sept. 14, 1917.>
CHOLERA.
Plac^
Date.
Oases.
Deaths.
Rcfmarks.
fsT»:
West Java .^..^....
'%^^': ""^'^ **
BaUrta
July 13-19
1
1
PMHppfne Islands:
Irovinces •....
't.t.J:^^""=°^' **
Albay
July 8-14
19
1
60
13
144
13
36
25
117
64
12
Bt?Sii
do
Bobol
do
53
8
97
9
28
7
77
39
Oapis
do
CebiL
do
lioilo
^
Leyta....
do
MitamH
do
N«gro8 Oriental
do.
Sonogon
do
July 15-21, 1917: Coses, 820;
Afosan
July 16-21
6
17
23
12
73
7
62
SI
4
23
1
11
2
9
18
9
62
3
41
14
34
2
16
deaths, 2^7. ^^
Albay
do.
BobcA V.
do
Gapii
do
csfc.. .;::;:;;;::;;;;;
do
IloUo
do
Levta
do
Uik^ipi*
do
Negroa Oriental
do
Samar. ... s.....
do
Sonoffon
do
Tayabas .^.....
do
do
7
PLAGUE.
Olylon:
Alannihrialli
Port Said.
July 6-12..
July 81
July 28-29..
July 20
May 13-26, 1917: Cases, 6;
deaths, 4.
Jan. 1-Aojr. 2, 1917: Cases, 687;
deaths,m
1 Frasi medical oAeeis of tlie PubUe Health 8ervloe» American consuls, and other souroae.
ABE lOU SATINO Your Money to InTest in the SECOND LIBERTY LOAN!
(1497)
Digitized by VjOOQIC
September 14, 1917
1498
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVEB-
Continued.
Reports Receired Daring the Week Ended Sept 14, 1917— Continued.
SMALLPOX.
Place.
Date.
Cases.
Deaths.
Remarks.
Brazil:
Rio do Janeiro
Julyl5-Aug.4....
July 1-21
M
19
China:
Amoy
Present.
Java:
East Java
July 2-8
10
5
37
1
0
Mid-Java
. ...do
West Java
July 13-19
0
Portugal:
Lisbon
July 22-28
Spain:
Valencia
July2»-Aug.4....
TYPHUS FBVEB.
Algeria:
Algiers
July 1-31
1
1
1
Brazil:
Riode Janeiro
July29-Aug.4....
Java:
Mid-Java
July 3-S, 1917: Cases, 5.
Bamarang
July 2-8
5
West Javar. •....
July 13-19, 1917: Oases, 17; deaths,
Batavia
July 2-19
11
1
1
1
Switxerland:
Basel
July 22-28
Zurich ^
July26-Aug.l....
YELLOW PETES.
Mexico:
Yucatan, State—
Merida
Sept. 1.
Reports Recehred flrom June SO to Sept. 7» 1917.
CHOLEBA.
Place.
Date.
Osses.
Deaths.
Remarks.
India:
Bassein
Apr. 1-May5
347
17
Bombay
June 24-^..
Apr. 2^ June 30...
1
Calcutta
Do
July 1-7
Madras
Apr. 22-June30...
JiUy 1-7
6
6
Do
May &-June30....
Moulmein...... , ........
May 13-June2
Pakokku
Apr. 20-May6
Pogu
May 27-Juzie3b...
Do
July 1-7
Rangoon
Apr.21-June30...
31
Indo-China:
Feb. 1-Mar. 31, 1917: Ctees, 61;
deaths, 40. ^^
Anani.............x^^
Feb. 1-Mar.31....
do . .
0
9
44
2
163
1
32
CAmtvyliik ,,.^
Cochin-China
Tonkin
do
do . .
Saigon '/. ..
Apr.23-May27....
Apr.2-8
108
Java:
East Java
West Java.
Apr. 13-July 6, 1917: Owes. 71;
Seaths, 31. July t-^^TmT:
Batavia
Apr. 13-July6
JiflyO-U
7
2
2
Do
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1499
8e9tc9ibwl4^1ftt7
FUlGini; SMAUPOX, TTFHUS F6¥EB» AND TBLLOW FB?BB—
Oantunied.
wammtm Sept 7, If 17— C(Hituiiied.
Pboe.
D.U.
Cases.
Deaths.
Remarks.
FMa:
Amir Kfia
Pteb.3
1
4
I
3
1
Jan. 15-17
Hamze Kela
Jan. 17
¥^Md4tf?^ftr > . .
Jan. 31
PhiUppbie Islands:
Jmw^ 17-23
ProTinoes
May ao^luoe 30, 1917: Casw, 796;
deaths, 506. July 1-7, 1917:
Gases, m; dmths, 202.
Albay
Il^j2(>-Juiia30...
113
2
3
1
368
06
62
19
2S1
51
7
U
4
4
1
1
196
82
7
1
7«
1
1
2S1
45
40
15
150
38
4
5
4
4
&:::::::::::.:::::
Ambos Camarines
Jane 3-9.
Jane 17-23
May 2a-Juiie 30. . .
July 1-7
Bohoir.
Do
Qipli
Jane 3-^
Do
July 1-7
Cebu
Jane 3-30
Do
July 1-7
HoUo
do
•ni:::r.::::.::::::
June 10-30
July 1-7
Negros Oriental
do
Riml
June 24-30.
July 1-7
Do
Sorsogon
June 3-30
88
39
7
1
Do
July 1-7
Tkralms
June 3-30
Do
July 1-7
■'•
PLAGUE.
Araliia:
Aden.
May3-Janell
88
3
1
33^
Anr*-May 14, 1917: Oases, 69;
finiU:
IWife
June 10-30
July 8-21
6
4
40
Do
Ceyton:
Colombo
Apr.8-June»
Apr. 29-May5
Chtna:
Amoy
Present and tBTlebiity.
&:::::::::::::::::::::
jiSyK7.^.. ..::
6
20
6
13
Hons^orv;
Mayl3^une30...
June 2
Kwsmgtunf Province—
Tarpudistrict
PresoU.
Ecuador:
i^fftanriaVitlft. .
Feb. 1-28.
1
56
33
0
1
1
3
1
8*
6*
4
1
14
1
On^ramdt ..'....
do
20
18
4
fio^
Mar. 1-31. . . .
Do
Apr. 1-30
Mm". 1-<?I....
""152^::;:;;;::;;;;::;:::
Apr. 1-30. —
Feb. 1-28
1
Mobol
(Mitre
do.....
Do
Mar. 1-31....-
Feb. 1-28
1
2
..
3
Taora.
^AtewKhriV *""'
*Jnne21-27V."""I
Apr.30-Mayl0...
Jime2S.....
Jan. 1-June 28, 1917: Oases, 564;
deaths, 313.
Port 8aki eoremment
*>vtf&M
Ptevlnoea—
Fayoum
MayU-JonelS...
June 28
7
n4(otit¥«f«, ,..
Oinreh
May 17
I
3
1
0
23
1
wSS;
Mayl2^ane28...
May m.
4
3
23
38
8
2
HDat
"-SK^irif:.-:::::::::
Apr. 30- June 2....
Mayl2^UDe28...
Aag. 13-24
WaylM
QiMtMsin:
Oitveeend
From s. s. Matiano.
I^Oidiii
2 in hospital at port. From s. a.
SardMk from AusttOba mi«
oriental ports.
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September 14. 1917
1500
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER- P
Continued.
Reports Received from June 30 to Sept 7, 1917 — Continued.
PLAGUE— Continued,
Place.
Date.
Cases.
Deaths.
Remarks.
lQ(]i3
Apr. 15-June 30, 1917; Cases,
Basse in
Apr. 1- June 30
54
6
363
25
38
35
413
2
250
58
9
74
16
1
2
169
42
2
43,922; deaths, 30,197. July 1-
Do ...
July 1-7
7, ' 1917: Cases, 1,870; dci^
Bombav
Apr. 22-June30...
July 1-7
441
36
1,322.
Do
Calcutta
Apr. 29-June 2
Ilenzada ...........
Apr. 1-June 30 ... .
Karachi
Apr. 22-June30...
June2i^July4....
Apr. 22-June 30. . .
July 1-7
Apr. »-May 12
468
3
301
70
Do
Madras Presidency
Do
Mandalay
Moulmein
Apr. 1-June 30 ... .
Do
July 1-7
Mvinffvan
Apr. 1-7
PCKU
May 27- June 2
Raneoon
Apr. lS-June30...
July 1-7
183
46
So! :..:::::::....:::..
Toungoo
Apr. 8-14
Indo<^hina:
Feb. 1-Mar. 31, 1917: Cases, 199;
Anam
Feb. 1-Mar.31....
do
72
92
33
47
39
80
21
26
deaths, 141.
Cambodia
Coohin-China ....
.do
Balron
Apr. 23- June 3 —
Java:
East Java ...
Apr. »-May 30, 1917: Cues, 9;
deaths, S.
Djoclakarta Residency.
Kediri Reaidencv
Apr.23-May6....
. ..do
1
1
3
18
6
1
1
3
18
6
Samarang Residency.. .
Surabaya Residency...
Surakarta Residency..
Apr.23-Mayao...
Apr.2-May20....
do
Peru .'.
May 16-31, 1917: Ctesw, 1&
Departments—
Areauipa
May 16-31
.do
4
1
2
7
1
12
4
2
1
At MoUendo.
cai2o.\;. ....::.::::
AtCallao.
T-«ml>ftyequo ^ ^ ^
do
AtChidayo.
Llbertad
do
At Salaverry, Baa Pedro, and
T.fma.T.
...do
TniJIUo.
At Lima.
Siam:
Banskok
Apr. 22-Iune2....
July 3-23
June 3-16
11
3
1
1
™o^:....:::::::::;;:::
straits Settlements:
Singapore
July 1-7
Union of South Africa:
Cape of Oood Hope State—
Olengreydisfrict
Terka district
Aug. 13
Present.
May 2ft
1
1
1
At RnmniArhiii Farm.
Queenstown
June6
Orange Free State
Apr. 16-22, 1917: 1 case; Apr. 9-
^, 1917: Cases, 26; deaths, 17.
Winburg district
At sea:
8. B.MfttiftOt
May 28
1
0
July 14-18
9
SMALLPOX.
Australia:
New South Wales.
Brewarrina
Coonabarabran.
Quambone
Warren district
Queensland —
Thursday Island Quar-
antine Station.
Aor. 27-June21.
MAy25-July6...
Apr. 27-June21.
June 22- July 5..
May9
Apr. 27-July 5, 1917: Cases, 68.
From 8. 8. St. Albans liroin Kobe
via HongkoDg. Vessel jvo-
oeeded to TownsviOe, BriS'
bane, and Sydney, }n qneiaD-
tine.
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Sept^berl4,m7
CBKNBUt PLAGUE SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER--
Contmued.
Reeetfed frmn Mvme 80 to Sept. 7, 1917--Coiitmued.
SMALLPOX-Oontfaiiied.
F1M90.
DAli.
Cases.
Deaths.
Remarks.
Bnxil:
R^H
Maye-JuncSO
Jiily2a-«.
4
Do
1
31
8
Rio de Jai^iro
May e^untao....
July 1-14
126
1
S
Do
C«Dada:
Manitoba-^
Winnip«:
JmiolO-16L
June 18- July 7
June 17-30.
liovaScotC-
Port Hs wkosbur y.
Ontario-
Ottawa
Present in district.
July 30- Aug. 5....
May ^12
1
1
Ceylon:
CoJombo
Qilna:
Amoy.
Apr. 29-MayM...
PrewDtandlnTidnlty.
Antnng.,.,
May 21- June 34...
May 6- June 23
4
Ghung^g ... 1 ^ . m ^ [..... .
Present.
Do "
July 1-14.
Da
Himinha
May27-Jane2....
Mayl»-Ji]xie30...
J«ly*-28.
6
80
6
3
7
8
1
Data™::::::::::::::::::
4
1
Do
Jnly 1-7, 1917: Present
Hankow.. . .
June 24-30.
Harbin.
Apr. 2*-May ......
Maye-Junel6....
Apr. 23-29
May27-Jane3
On Chinese Sastem Ry.
Hongkong
7
ifAnrhiirm Rtation
Do.
Mukden. :
Do
July 8-28
Do.
<*N»ifhal
May21-Julyl
July 2-29
13
83
8
Do
ttves.
AmoBffQriDeae^
On Chinese Eastern Ry.
Tsltshar Stati(»u
Apr. 16-22.
May23-July7
May 1-31
1
85
1
1
1
6
80
80
19
1
Tsingtao
7
At anotber ttation oo railway.
QuKCT (Korea):
Chemulpo
lease.
Ecuador:
Guayaquil
Feb. 1-28
SoT.. .::::::::::;::;:::
Miw. 1-31
Do
Apr. 1-30.
^^'SLttndrlft
Apr.ao-Julyl....
July 2-29
Feb. 12-Mar. 18...
May 6-12
9
4
1
Do
Cairo
Fiance:
Paris
Gennany
Mar. 18-Apr. 38> 1917: Ctees. 715
Berlin
Mar. 18-Aiir.28...
do
106
16
18
60
20
3
10
1
m
14
Bremen
triets.
Charlottenberg
do
Hambun
do
Lcipiig
do
Lflbecl
do
Munich
do
Btutteart
do
Apr.22-JaiMao...
JtUyl-T
Apr. 29-May26....
loaa-
Bombay
63
8
12
8
48
4
5
Do
CUentto
Karachi
Apr.22-July4....
Apr. 22-Jaiie30...
Ji5y 1-7.....
27
80
11
33
2
Madras
Do
i^anrmn.
Apr. IS-JtmeSO...
JiOy 1-7
»o...::::::::::::: :
iDdiHChina:
Provlnoes ,
Feb. 1-Mar. 81, 1917: Gtaes, 1,616;
Anam
Feb.l-Mar.31....
do
664
2
00
190
83
63
17
158
deaths, 24a
Cambodia
Cochin-China
..do
Kwang-Chow-Wan
Mar. 1-31
Feb. 1-Mar.31....
Apr.27-JnDalO...
M^21-JtiM3l...
3
G
13
8aig«.. .!:.... .,.:::::::
'CT.
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1502
CHOLERA. PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW FEVER-
Conlinued.
Reports Received from June 30 to Sept 7, 1917— Coatinued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Bemarks.
Japan:
HKobe
May 27-July 22....
May 28-Juno3
May 1G-July5
May 27-July 1
Apr. 2-July 1
Aprj 1-July 1
65
1
177
1
38
88
16
Nagasaki
Osaka
55
1
2
7
Yokohama
Java:
£ast Java
Mid-Java
West Java
Apr. 13- July 6, 1917: Cases, 2»;
Batavia
Apr. 13-JuIy 5
July 11-Aug. 7
30
G
0
deaths, 44. July 6-11 19U:
Mexico:
Mazatlan
Cases, 9; deaths, L
Mexico City
June 3-30
162
69
Do
Aug. 5-11
Monterey
June 18-24
24
VeraC^ut
July 1- Aug, 11....
Mayl3-June9....
July 8-21
2
6
3
14
3
Philippine Islands:
Varioloid.
Do
Do.
Portugal:
tIRt^ti
May 13- June 30...
July 8-21
Do
Portuguese East Africa:
TiOiirenco Maraues . . . r r - 1- - -
Mar. 1-Apr. 30
2
4
Russia:
Archangel ^ , - -
Mayl-Juno28....
Feb. 18-June9....
Mar. Il-June2....
Mar. 15-21
June 9-23
56
495
4
23
0
Riga
VladfvosUA
7
3
4
12
11
Jan. 1-Mar. 31, 1917: Cmbi,!
Slam:
Bangkok •....•••••••.
Spain:
^Madrid
Ifayl^unel9
Malaga
Apr. 1-30
SevUTe
Mayl-June30
Valencia
Juno 3-23
5
4
6
1
1
2
2
Do
July 1-28
Straits Settlements:
Pc>Tiang ......--
Mar. 18-June23...
Juno 24-30
Apr. 22-28
May20-June23...
June 2-8
3
SinEanore
Sweden:
Mahno
Stockholm ...,...- t t , ^
1
Tunisia:
Ximls ....r.T,--
Turkey in Asia:
Tiebisond
Feb. 25- Apr. 13...
15
Union of South Africa:
Mar. 12-24
May 1-31
4
2
Uruguay:
Sfcmte video
Venezuela:
Maracaibo
June 18-July 8....
8
1
Do
July 9-23
TYPHUS FEVEB.
Algeria:
Algiers
Austria-Hungary:
Austria
Bohemia
GaUcia
Lower Austria
Moravia
SUesia
Styria
Upper Austria
Hungary
Budapest
June 1-30.
Oct. 22-Dec. 17.
do
....do
....do
....do
....do
....do
634
809
47
617
16
243
5
Oct 22-Dec, 17, 1916: Cases, 2,371.
Feb. 19-llar. 25, 1917: Cases, 1,38L
Feb. Ifr-Mar. 25... i
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September 14, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
ContiDued.
Reports Received lh>ro June 30 to Sept. 7, 1917— Continued.
TYPHUS FEVER -Continued.
Plttoe.
Date.
Cases.
Deaths.
Remarks.
Antimg
Juno 25-July 1
July 9-22
3
May e^uly 1, 1917: Cases, 6.
Do^
1
Hankow
Juneft-15
Do
July 8-14
1
Tk«nt.^n ,
June 17-23
May 30- July 7
Apr. 3Q-Julyl....
July 17-29
1,048
220
96
Tsingtao
^^Jexandria
478
84
40
32
10
Do
(tiro
Jan. 22-Mar. 18....
Juno 17-23
Great Britain:
Cork
Oreece:
Saloniki
May 13-June 30. . .
Do
July 1-14
J^)an:
Hakodate
July 22-28
1
4
19
Nagasaki
June 11-24
July9-Aug. 5
"Do
1
Java:
East Java
Surabaya
June 25-July 1....
1
Apr. 1-June 24, 1917: Cases
ICid-Java
, 38;
R&rriarang
May 5- June 10
14
2
deaths, 5.
Apr. 13 July 5, 1917: Cases,
deaths, 6. July 6-12,
Cases, 8.
Jan. 1-31, 1917: 1 case.
West Java
147;
BaUvia
Apr. 13-July5
July 0-12
70
7
431
524
3
3
6
1
11
126
2
5
6
1917:
Do
Mexico:
Mexico City
June 3-^
Do
July8-Aug.ll....
June 9-23
Netherlands:
Rot^fdnm
2
Do
July 15-30
Norway:
Bergen
July 8-14. .
Portuguese East Africa:
Louren^o Marques
Mar. 1-31
Russia:
Archangel
Mayl-June28....
Feb. 18-Jane9....
May31-June2....
Mar.29-May21....
May 1-31
2
3
Petrograd
Vladivostok
Spain:
Almeria
6
2
Madrid
....do
Switzerland:
Basel
June 17- 23
July 8-21
1
3
2
Do
1
Trinidad
June 4-9
Tunisia:
Tunis
June 30- July 6. . . .
1
YELLOW FEVEB.
Ecoadon
Babahoyo
Feb. 1-28
1
2
1
18
17
17
1
1
1
1
6
1
1
1
7
9
9
Do.:.:::::::.:;:;::: :
Mar. 1-31 . ..
Chobo
do
Guayaquil
Feb. 1-28
fio?!^::;:;:;;;:;:
Mar. 131
Do
Apr. 1-30
Milagro
Feb. 1-28 .
Do.::::::::::::::::::::
Mar. 1-31
Do
Apr. 1-30
1
1
2
Mexico:
Yucatan Stato—
Peto
June 23
In person recently arrived from
Mexico < it V.
Do
July29-Aug.ll....
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PUBLIC HEALTH REPORTS
VOL.32 SEPTEMBER 21, 1917 No. 38
EXTRA CANTONMENT ZONE REGULATIONS.
REGULATIONS GOVERNING THE SALE OP FOODSTUFFS IN THE ZONE AROUND CAMP
DDC, WRIGHTSTOWN, N. J.
On September 4, 1917, the State Board of Health of New Jersey
adopted the following regulations, which constitute Chapter VII of the
State Sanitary Code of New Jersey.
Regulation 1. — Zone around Wrightstown Cantonment defined.— The provisions of
the following regulations shall apply to all premises which lie v/ithin a distance
of 7 miles in a direct lino from the Pembcrton-IIightfitoAn Railroad station at
Wrightstown and to all persons who conduct any of the businesses referred to in
regulation 2 of this chapter witliin such distance, exclusive of the land included
in the National Army cantonment known as ra)r.p Dix and located in Burlington
County.
Regulation 2. — Permits required to sell food and beverages.— 'So person shall establish
or conduct any hotel, boarding house, restaurant or eating house, lunch counter,
stand, vehicle, store, delicatessen, or other place of business for the sale or distribu-
tion of food or drink intended for human consumption on the premises unless such
person shall first have secured from the director of health or from his duly authorized
representative a written permit so to do; and no person, without first having secured
a permit as herein provided, shall establish or conduct any grocery store, market, or
other place of business for the sale or distribution of any food or drink which is pre-
pared for human consumption without further cooking unless such food or drink is
received, stored, sold, and distributed in sealed packages or containers which will
effectually protect such food or drink from contamination. Such permit, unless
revoked, shall be gobd for one year and shall be consi^icuously displayed in the plate
of business for which it was issued. Permits issued under these regulations are not
transferable.
Regulation 3. — Permits only isstied after laivs and regulations complied with. — No
permit shall be issued under regulation 2 for the conduct of any of the businesses
referred to in said regulation unless the building, room, stand, vehicle, or place in
which it is proposed to conduct such business, together with the yard and appur-
tenances thereto, have been made to conform in all respects to the requirements
of the existing State laws relating to the conduct of such business and to the pro-
visions of regulations 1, 2, 3, 4, 5, and 6 of Chapter I of the State Sanitary Code, and to
all rules and regulations of the State department of health; provided, however, in
the case of businesses already established at the time these regulations become effec-
tive, the persons conducting such businesses shall, within 10 days thereafter, secure
a permit as provided for in regulation 2.
Regulation 4. — Permits revocable for cause. — The violation of any of the provisions
of the existing State laws or of any of the provisions of regulations 1, 2, 3, 4, 5, and G
of Chapter I of the State Sanitarv' Code, or of any rule or rca:ulation of the State depart-
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September 21, 1917 1506
meut of health, by any person holding a permit issued under authority contained in
these regulations, shall be deemed suflBcient cause for the revocation of such permit
by the director of health or his duly authorized representative.
Regulation 5. — The regulations contained in Chapter VII of the State Sanitarj-
Code shall take effect on the 4th day of September, 1917.
THE NOTIFIABLE DISEASES.
PREVALENCE DURING 1916 IN STATES.
ANTHRAX. DIPHTHEBU. DENGUE, MALARU, MEASLES, MENINGirXS. POLIOMTEUTIS.
RABIES IN MAN. ROCSY MOUNTAIN SPOTTED FEVER, SCARLET FEVER. SEFHC SORB
THROAT, SMALLPOX. TUBERCULOSIS (PULMONARY). TUBERCLLOSIS (AIX FORMS),
TYPHOID FEVER, AND TYPHUS FEVER— CASES AND DEATHS REPORTED. INDICATED
CASE RATES PER 1.04M POPULATION, INDICATED FATALITY RATES PER 100 CASES,
AND INDICATED MOBTAUTY RATES OF DIPHTHERIA, MEASLES. SCARLET FEVlQt.
TUBERCULOSIS (PULMONARY), TUBERCULOSIS (ALL FORMS). AND TYPHOID ^VER,
PER 1,000 POPULATION.
Pursuant to the practice that has been carried out for a number of
years schedules were sent on January 15, 1917, to the healtii officers
of the several States. The data of the prevalence of disease con-
tained in the following tables have been compiled from the schedules
returned by the several State health officers and rc^t^ars. While
not all of the States returned the schedules, the failure to do so was
perhaps in all instances due to the fact that the necessary data were
not available.
The absence of figures in the '^deaths '^ column in the tables may
mean that no deaths occurred or that the data as to deaths were not
famished by the State authorities having jurisdiction.
The populations used in computing the case rates were those esti-
mated by the Bureau of the Census as of July 1, 1916.
It will be noted that some of the States are apparently more suc-
cessful in obtaining reports of the occurrence of the notifiable diseases
than are othei-s. This may be due to the greater activity of their
health departments or to a more intelligent interest in the public
welfare on the part of their practicing physicians. The effective
grasp of the control of disease possessed by the health departments
in certain States Ls indicated in a number of instances by the large
numbers of cases reported as compared with the numbers of deaths
registered from the same causes.
The manner of collecting data of the prevalence of disease in
Mississippi and Virginia differs from that employed in the other
States, and the rt^sults, though included in the tables which follow,
can not be considered as strictly comparable with those of the other
States. This difference is brought out, for example, by the lai^e
number of cases of malaria reported in Mississippi and Virginia.
Malaria is probably no more prevalent in these States than it is in
Louisiana and South Carolina. In Mississippi the regulations specify
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1507
September 21, 1917
that physicians shall report to the county health officer on the first
day of each month the number of cases of the notifiable diseases
'which occurred in their practices during the preceding month. In
Virginia the reports are made in the same way. Presumably these
reports are made out in many instances by the physicians from
memory and not from case records. In Mississippi the* regulations
specify that physicians shall also report to the county health officers
within 24 hours cases of diphtheria, epidemic cerebrospinal menm-
gitis, acute poliomyelitis, rabies, smallpox, and typhoid fever.
These immediate reports are in addition to the monthly reports.
Tuberculosis is required by law to be reported within seven days to the
State board of health and ophthalmia neonatorum within six hours to
the local health officers. The records of these diseases in Mississippi
are probably, therefore, comparable with data for the other States.
In relation to Rocky Mountain spotted fever, a special survey was
made by Surg. Fricks, who reported cases, located by States, during
the calendar year 1916 as follows: CaUfomia 11, Colorado 5, Idaho
151, Montana 19, Nevada 20, Oregon 26, Utah 29, Washington 3,
and Wyoming 26, making a total of 290^ cases in the far Western and
Northwestern States.
The tables ^ contain data furnished by and relating to the following
States:
Alabama.
Ari?ona.
California.
Colorado.
Conncclirut.
Ditstricl of Columbia.
Hawaii.
Indiana.
Iowa.
Kansas.
Louisiana.
Maine.
Mainland.
Ma-sachusetta.
Michigan.
Minnesota.
Mississippi.
Montana.
New Jersey.
New York.
DENGUE.
Ohio.
Oregon.
Pennsylvania.
Rhode Island.
South Carolina.
Vermont.
Virginia.
Washington.
Wisconsin.
Wyoming.
A case of dengue was reported during the year in Arizona, 5 cases
were reported in Hawaii, and 969 cases in Texas. The Texas out-
break occurred during the last five months of the year, reaching its
maximum during September.
» Th<*-c«3e*» reported in the schedules of the States will be found in the table on page 1519.
« In studying these tables it should bo kept in mind that a relatively large number of reported cases of
a communicable disease, as indicated by a high case rate Tand more especially when accompanied by a
i«Uti vely small number of dcath^s. as indicated by a low fatality rate), usually means that the health depart-
ment of that Stale is active and that the cases of the disease are being properly reported by the practicing
physicians. It does not necessarily mean that the disease is more prevalent in that State than in other
States. A high fatality rate may moan that the disease was unusually virulent in a State, that the physi-
cians did not treat the disease in that State with the siiccess usual elsewhere, or that lb? practicing physi-
cians did not report all of their cases. On the other hand, an unusually low fatality rate may be due to
the fa^t that the disease in Uio State was unusually mild, that the physicians treated it with unusual suc-
cess, that the practicing physicians reported their cases satisfactorily, or that the registration of dc*lh
was incomplete, or the aswigmncnt of the causes of death inaccurate.
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PREVALENCE OF DISEASE.
No health department^ State or locals can effectively prevent or control dueage wiAout
knowledge of when j wherCy and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended September 15, 1917.
CURRENT STATE SUMMARIES.
California Report for the Week Ended September 15, 1917.
The California State. Board of Health reported concerning the
status of preventable diseases in California for the week ended
September 15, 1917, as follows: Three cases of smallpox were noti-
fied in the State, 1 in Fresno County and 2 in the city of San
Francisco. The numbers of cases of diphtheria, scarlet fever, and
whooping cough indicated mcreases in the prevalence of those diseases.
Of 28 cases of diphtheria notified, 13 were in San Francisco and 6 in
Los Angeles. Forty cases of typhoid fever were notified during the
week. The prevalence of other notifiable diseases continues about
the same as during the previous week.
The details of notifiable disease cases reported during the week
ended September 8, 1917, are as follows:
Cerebrospinal meningitis 1
Chicken pox 26
Diphtheria 24
Dysentery • 3
Erysipelas 2
German measles , 15
Gonococcus infection 45
Hool; worm 1
Le})roay 1
Malaria 35
Measles 117
Mumps 44
Pneumonia 25
Poliomyelitis 3
Scarlet fever 23
Smallpox 2
Syphilis 19
Trachoma 1
Tuberculosis 144
Typhoid fever 43
Typhus fever 1
Whooping cough 30
ANTHRAX.
Massachusetts Report for August, 1917.
During the month of August, 1917, 3 cases of anthrax were reported
in the State of Massachusetts.
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CEREBROSPINAL MENINGITIS.
State Reports for August, 1917.
September 21, 1017
Place.
1 New cases
reported.
Place.
, Massachusetts— Continued.
Middlesex County-
Lowell
New cases
reported.
District of Columbia
■■.
ySikS9aciuxsetts:
Berkshire County—
1
1
2
1
2
1
1
1
1
•
2
Somer * ille
1
Pittsfield
Suffolk County-
Boston
Bristol Countv—
5
FallRi\pf. .
1 Total .
New Bedford
19
Barnstable County A
Essex County-
Gloucester
Wisconsin:
Mftni towoc County ». .., .
1
Lawrence
' Milwaukee County
5
Lynn ^.
) Shebovpan County.
2
Peabodv (towh)
Waukesha Coimty
1
Hampdm bounty-
SpHngnAld , . . . . ,
1 Totol...,
9
!
State Reports for June and July, 1917.
Place.
Now cases
reported.
Place.
New cases
reported.
CaHfomiB (June 1^30):
Alameda County —
1
4
2
3
1
3
Virginia (July 1-31):
Carroll County
1
BerVeley
Flu . anna County
1
Los Angeles County-
Los Anee>.s
Franklin County
;j
Mecklenburg County—
Clarksvflle .-
San Die^o (^-ounty —
1
San Dief;o
Nelson County
2
8an Francisco ;
Orange Ckjunty
1
San Joaquin County-
Stockton
Scott County
1
Total
Ventura County —
10
Oxnard...r
Total
14
City Reports for Week Ended Sept. 1, 1917.
Place.
Boston, Mass
Chicago, 111
Cleveland. Ohio
Duluth, Minn
Hartford, C^nn
Kansas Citv. Kans.
Lawrence, Mass
Lowell, Mass
Xewark. N. J ,
New Haven, Conn.
Cases.
Deaths.
Place.
New York, N. Y. . . .
Niagara Falls, N. Y.
Philadelphia, Pa
Pittsburgh. Pa
Saginaw, Mich
St. Louh. Mo
San Diek'O. Cal
Superior. Wis
Washinaon, 1). C...
Washington, Pa
Deaths.
DIPHTHERIA.
^ Mississippi.
During the period from September 10 to 15, 1917, cases of diph-
theria were notified in the southern part of Mississippi as follows:
Biloxi 5, Columbia 3, Gulfport 3, Hattiesburg 1, Leakesville 2, Pass
Christian 6, Picayune 3, Saucier 6.
- See also Diphtheria, measles, scarlet fever, and tuberculosis, paue 1545.
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September 21, 1917
1534
ERYSIPELAa
City Reports for Week Ended Sept 1, 1917.
Place.
Cases.
Deaths.
1 Place.
1 Cues.
Deaths.
hulllmniu, Md
1
1
2
5
2
(1
Newark.N.J
1 Oniaha, Nebr
1 1 PhiladelDhia. Pa
1
1
E ■!
V.'/j i"
,',,', 3
llMiHiln, S Y
Mik-i^'o, 111
PltUsburgh, Pa
j Portland, Oreg
i tv pJufnJ , 1 H' M
1 >;'k'. N?||, Ohio , «
3
I
[irlr'ii!', UiKVi
'
2 ,| Reading, Pa
1 |l RochMUtf. N. Y .
I
I ttjbiinj;nfl, Intt(%
I
FA I'ikno, Ti>x .
1
1 San Francisco, Cal
lUftroftl,l'ijim
i"
1
1
1
SiiiXTior. Wi/
1 '
K iMmiiiiK'Twi , M ii'h
Tacoma.' Wash
1
KnEi^iOfr l*ii I H Mo
' Washinpton, Pa
' Wilmington, Dal
1
* *'l
]
LEPROSY.
Rhode Islaad — Providence.
On Scptemher 14, 1917, a case of leprosy was reported at ProTi-
dence, R. I., in the person of an Italian who had lived in the United
States for a period of five years.
MALARIA.
Stale Reports for August, 1917.
Place.
New cases
reiwrted.
1
Place.
NevoMi
reported.
Marvland:
Baltimore County—
Halethorp
Ma.ssa(-hu<<etts:
llamjKhire County—
Norlhnmptan.
1
Benpies
j l>:mvers'(U)Tra)
Calvert Countv—
1
Port Uepublic
Middloscx Coimty -
1 Cambridpe
Charles Cotinty—
«
1
Malcolm
Norfolk County -
B rook line ( town )
Indianhoad
1
Waldorf
l>edham (town)
4
Pomlret
' Foxborouch (town). . ..
1
Berrv
Medfleld (town)
1
Prince (Jeor^'es County-
Tow n.vhcnd
j SufToIk County -
' Boston
S
Accokwk -
Wor( oster County—
1 Milford (town)
SomerH<»t County —
1
1
Maiiokln..
Total
Worct'ster Countv—
Berlin, K. D'.
u
Total
12
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1535
MALARIA— Continued.
SUte Reports for June and July, 1917.
September 21, 1U17
Place.
California (June 1-30): ,
Alameda f ounty—
Berkeley ,
Butte rcHinty
Chioo ,
Colusa County
CohLsd
Fresno Coimtv
Firehau«!b ,
Jleodlev
Ktm Coiintv
Bakersfleld
J>el«vno
Los Aneeles County-
Los Anreles
Mero^ <'ounty ,
ModorCountv
iSecramento County—
Attrraraento
San Francis"© ,
Santa Clara County-
San Jose
Solann Cotmty—
VaravUlc
8tanbilaas C-ounty—
Oakdole
Turlork
Tulare t'otinty—
Tulare
Vi-Milia
Tito!umn«» County . . ,
YoJoC-ounty
Total
Virginia (July 1-31):
Accomar County
Chlnf^teacue
Albemarle County. . .
Alexandria County. .
Alexandria
Aik>ghany C«mty—
Clifton ForRc
A melJa County
Appomattox County
Bedford Cotmty
Bedford City
Bnmswick County. .
Buekinrhara County
C-ampbell County
Alta\hta
Caroline C ounty
Bo^ilini; Green..
rh««t«rf)eld County. ,
Wint4N-pock
Cumberland County.
Dinwiddle County . . .
Eli«ab«th City
Hampton
Phoebus
K$sex County
Tappabannock..
Fairfax County
Fauguler County
Fluvanna County ...
Gloucester County. . ,
cioorhland County. .
GreanesvUle County.
Emporia
North Kmporia..
New cases
reported. |
Place.
N'ew cases
' reported.
7&
11
2
1
10
1
3
2
2
2 ■!
6
8 *'
12 I
2 ,
32 1
16 i
10 I
11 .1
15 .1
1 >l
7 >
5 i
11
2
1 I
1
2
25 ■
2 ;
24 '
16 ,
10
Virginia (Julv 31)— Continued.
Halifax County
Hou.ston
South Boston
Hanover County
Henrico County
Richmond
Henrv Count v
Martensviile
Isle of Wijrht County
James CIt v Cwinty
WillJamsbnrp
Kinc and Queen County. . .
Kine WilUam (^ountv
West Point '.
Lancaster County
Loudoim County
Louisa County
Lunenhurt; County
Victoria
Mathews County
Mecklenburg County
Chase Citv
Clarksville
South Hill......
Middles«x County
Crbanna
Nansemond County
Suffolk
Nelson County
New Kent County
Norfolk (k)unt V
Northampton Coimty
Care Charles
Northumberland County., .
Reedvllle
Nottoway County
Bla'^cptone
Burkeville
Crewe
Orange County
Pittsylvania County
Powhatan County
Princess Anne
Prince Edward County
Farmvillc
Prince George Coimty
Hopewell
Prince William County. . . .
Richmond Count y
Roanoke C^oimty
Rockbrldw County—
Lexini^ou
Rockinfiham Coimty—
BridKOwal^r
Southampton County
Franklin
Spotsylvania County
Stafford County
SiuTV Coimty
Claremont
Sussex County
Wakefield
Warwick County
Wasliington County
Westmoreland County
Wise County
York County
Total.
24
3
9
;U)
36
4
7
1
15
9
1
4
4
6
G
9
' 4
30
1
4
1
17
33
7
12
17
47
U
K
9
I
2
2
1
IK
2
W
1
2
22
3
2
7
3
1
t
56
14
12
1
IH
2
17
15
2
3
987
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September 21, 1917
1536
MALABIA— Continued.
City Reports for Week Ended Sept. 1, 1917.
Place.
Cases.
Deaths. 1' Place.
1
Cases.
Deaths.
Birminghiun, Ala
»50
1
2
2
5
2 ' Memphis, Temi
13
\
BastonriCass
. .. . \\ Mobile, Via
1
Cleveland, Ohio
, New Orleans, La ,...•.
2
1
East Orange, N. J
....... 1 NewYork, N. Y
1
Keamy,N. J
' ' Northampton, Mass
1
5
Little Rock, Ark
|i ^avannalT, Oa'
ll
1 The reason that Birmingham had. so many more cases of malaria reported than any other city is not
that the disease is more prevalent in Birmingham than in other cities of Alabama and neighboring States,
but undoubtedly T>ecau.se of the successful efforts the health department has made in securing the coopera-
tion of the practicing physicians in reporting cases.
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1545.
PELLAGRA.
State Reports for Autfiist, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
District of Columbia
4
Massachusetts:
Essex County—
Danvers(town)
Maryland:
Dorchester County-
Finch ville
1
1
Peabody (town)
Middlesex County—
Tewksbury State Infirmary
Suffolk County-
Boston
St. Marys County—
Leonardtown . . ...........
Total
2
Total
Virginia Report for July, 1917.
Place.
New cases ,
reported. |
Place.
New cases
reported.
Virginia:
Arcomsic County
1
1
1
1
1
2
1
1
I
3
1
1
1
3
1
2
1
1
1
3 !
1
1
1 1
^ i
Virpinia— Continued.
King William County-
West Point
Albemarle County
Amelia Coimtv
Lee C-ounty
** 2
Amherst Count v
Louisa County
AppomQttox County
Montgomery t-ounty
Ben ford Count v
Nelson (Countv
Botetoui t County
Nottowav County
Bu^kincham Countv
Blarkstonc
Buckingham
Pittsyl vimia County
Campbell County
Powhatan Coimty *
Princess Anne County
(Viroline Count v
Chesterfield Countv
Prince Edward County
Wtnterpock
Roanoke County
Culpei)er County —
Cvill>eper
RockinKham County—
McClahevsville
Cumberland County
Southampton County-
Franklin
I)inwi<ldie County
Kssex Count V
Spotsylvania County-
(iloucester County
dniyson County
Sussex Countv
Fries
Warren County
Greensville County —
Washington County
4
Emporia
WiseCountv
I
North Emnoria ..
Wythe County—
I vanhoe
Ilalifax County
Henrico Countv
Total
Henry Countv
74
Martinsville
James City County—
1 |I
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1537
PELLAGRA^Continued.
City Reports for Week Ended Sept. 1, 1917.
September 21, 1917
Place.
Cases.
Deaths.
Place.
Cases.
1
1
1
Deaths.
BirnilnghAm Al^, ,,.,,...
5
2
1
2
1
1
Mobile, Ala^
2
Buffalo, N.Y
Nashville, Tenn
Charleston, S. C
New Orleans, La
1
CUcago.ni
Savannah, Ga.
2
HartiSrd. Conn
Washington, I). C
Wilmington, N. C
1
1
Los Annies, Cal
1
5
1
MemphYs, T^nn
1
PNEUMONU.
City Reports for Weelc Ended Sept. 1, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
k\tw^^r^i
46
Los Angeles, Cal
1
1
7
1
33
7
3
12
1
1
1
Auburn, >4.Y
Morristosen, N. J
Berlin, N.H
1
Newark, N.J
Rhightimri»n, K, Y, ,.
Newport, Ky
Rov&m Uass
42
10
Philadelphia. Pa
14
ChicaK6,Ill
Pittsburgh, Pa
Clfv^lAiifi Ohio
Rochester, N. Y
Dnlutb, liiinn
San Francisco, Cal
10
Grand Rapids. Mich
1
Springfield, Mass
iCalanaioo, Mich . , ^
Worrester, Mass
2
K»?ww City, Mo
2
POUOMYELITIS ONFANTILE PARALYSIS).
Illinois— Chicago.
During tho week ended September 15, 1917, 57 cases of poliomye-
litis wero"" notified in Chicago, 111. Nine cases of the disease were
also notified in Cook County outside of Chicago.
Massachusetts.
During the week ended September 15, 1917, cases of poliomyelitis
wfere reported in tho State of Massachusetts as follows: Fall River 2,
Haverhill 1, Maiden 1, Reading (town) 1, and Somervillo 1.
Vermoiit
During the week ended September 15, 1917, cases of poUomyelitis
were notified in Vermont as follows: Barre 11 (including 10 cases in
which the diagnosis was delayed), Bridgewater, Calais, and St. Albans
1 case each.
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»epteml>er 21, 1917 1538
POLIOMYELITIS (INFANTILE PARALYSIS)— OontinuedL
State Reports for Avtgasi, 1917.
Place.
New cases
reported.
Place.
Newcaaes
reported.
District of Columbia
Kebmska:
Dakota County
Douglas County
Knox County
Lancaster County
Nemaba County
Saunders County
Total
Maryland:
Allegany County-
Water Cliff
Wcstemport
Luke
Lonaconing
Lord
Gilmore
Moscow Mills
Cumberland
Froslburg
McCool
Baltimore County-
Blenheim
Govnns
Carroll County-
New Windsor, R. D
Garrett County—
Swanton. R. D
, Frlendsville
Dodson
Jennings
KiUraiUer
Steyer
, ' Meuntain Lake Park, R. D
Prince (ieorge C<»unty—
ChiUum, R. D
Total
20
Massadiuaetts:
Bristol County-
Fall River
Essex County—
Haverhifl
Lynn
Saugus(town)
BLamnshire County-
Northampton
Middlesex County-T
Acton(town)
Lowell
Natick(town)
Stoncham (town) . . .
Marlboro
Plymouth County-
Brockton
HiDgliam(towii)....
Soilolk County-
Boston
Worcester County—
Wlndienden (town).
Worcester
Total
Wisconsin:
MoTAthon County
Milwaukee County
Trempealeau County.-..
Vernon County
Total
'. i
I
State Reports for June and July, 1917.
Place.
New cases
reported.
Place.
New cases
r^MCtMl*
California (June 1-30):
Los Angeles County-
Long Beach
1
2
Virginia— Continued.
1
Mecklenburg County—
ClarksvUle
Los Angeles
1
Middlesex (bounty ^
Page County
1
Total
3
9
TlAnnAhAnTinnir CountV
12
V^nia (July 1-31):
Accomac County—
Bloxom .. ,
1
1
2
1
11
2
Rockineham CJoontr •••
10
Elkton.
5
Harrisonburg
4
AlfiATnArlA nnnntv
Scott County
1
Augusta County
Spotsylvania County
1
Grayson County ........
Washington County................ •
1
Total
King and Queen County
M
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1539
September •• 1017
POLIOMYELITIS (INFANTILE PARALYSIS)— Coatlnued.
City Reports for Week Ended Sept. 1, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron. Ohio
5
1
1
1
23
3
3
2
2
Lynn, Mass
1
AJbmny.N. Y
Newark, N.J
1
Ann -Vrbor, Mich
Newcastle, Pa
4
3
2
1
1
1
1
Bridgeport,' Conn
1
5
New York, N. Y
Chicago, ni
Portland, Oreg
Clcve&nd, Ohio
Rock Island, fil
Davenport, Iowa
St. Louis, Mo
San Francisco, Cal
1
narrisburg. Pa
TT^vArhlU, M^^SS ., .
Washington, D. C
SCARLET FEVER.
See Diphtheria, meaf-les, scarlet fever, and tuberculosis, page 1545.
SMALLPOX.
Minnesota.
During the week ended September 15, 1917, 2 new foci of smallpox
infection were reported in the State of Minnesota, case3 of the dis-
ease having been notified as follows: Roseau Coimty, Roseau 1; Scott
County, Savage 1.
Oreiton — Portland — Correction.
The report of 2 deaths from smallpox in the city of Portland, Oreg.,
pubhshed.in the Public Health Reports of September 14, 1917, paj^o
1491, was an error. It is stated that the 2 deaths were duo to«yplulis
instead of smallpox.
State Reports for June and August, 1917*
*
New cases
reported.
2
1
7
1
4
3
1
1
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within 7
yeirs pre-
ceding
attack.
Nu '.iher
lost vacci-
nate<l more
tlian 7 yeirs
prct'ciin^
ttUuck.
Number
ne .cr sue-
co^^^illy
v„coin.itcd.
Vaccination
history not
obtainel or
uncertain.
ealifomia rJnnc 1-^):
Abmcda County—
Alameda
2
1
7
1
3
Oakland ....
Fresno County
Fresno . .
Los Angeles County-
Los AnRcIc?.
1
Marin County—
S\u'?dlito. . . ,
3
Snn Bernardino County—
Needles ... .
1
4
l^pland
Total
23
1 I
19 ! 4
Massachusetts (Aug. 1-31):
Ilaxnpshiro County—
Ware Ctown)
1
1
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1540
SMALLPOX— GonUnued.
Miscellaiieetts State Beporta.
Place.
Cases. 1 Deaths.
I
Ones.
Deaths.
Nebraska (Auc 1-31):
Deuel County
13
Wisconsin (Aug. 1-51):
Barron County
7
S
3
3
2
5
5
34
1
2
1
5
9
Wayne County
Chippewa County
Grant Count v
** •••*•••
Total
14
Juneau County
La Crosse County
Virginia (July 1-31):
8
2
Marathon County. 1^ ......
Carroll County
Milwaukee County
Monroe County
King William County-
West Point
Rock County
Mathews County
Sauk County
Norfolk Count V
Shawano County
Portsmouth
Wood County
Southampton County—
Boykins
TotaL
«Q
2
Total
24
City Reports for Week Ended Sept. 1, 1917.
Plaee.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
4
8
3
4
2
1
1
1
1
3
4
.3
1
Milwaukee. Wis
3
3
f
BSto, Mont.ili
Mhineapolis, Minn...
ChicaKO.ni,
Nashville, Tcnn
Cleveland. 6hio
Oklahoma Citv, Okla
Dayton, Ohio,
Oroaha, Nebr.'
Denver, Colo
Pontiac. Mich
Detroit, Mien.., ^
Fliht, MicbVj:!
Rock Island, 111.. . .
St. Louis, Mo.
Grand Rapids. Mich
Salt Lake' City, Utodi . . .
Indianapofls, Ind
Sioux City, Iowa
Kansas City, Kans
Tcnr Haute, Ind.^
KartsftsCitY. Mo
Wichita, Kans..
La Crosse, Wis
/
TETANUS.
City Reports for Week Ended Sept. 1, 1917.
Place.
Coses.
Deaths.
Place.
Cases.
Deaths,
Baltimore, Md
1
1
1
3
Phih»delp*»ia, Pa. .
2
1
1
1
2
Birmingham, Ate
1
1
8
1
St. Louis, Mo '..'.'.'..'.v..
Brockton, Mass
Sprini^ield, Mass. . .
Chicago, 111
1 Toledo. Ohio
1
Los Angeles^ CaL
1 Trenton, N. J.
1
1
TUBERCULOSIS.
See Diphtheria, measles, scariet fever, and tuberculosa, page 1545.
TYPHOID FEVER.
Ir.diana — South Bend — Outbreak.
Septohibor 17 a report was received of the existence of an outbreak
of t^T^hoid fever at South Bend, Ind. Surgeon Cobb of the United
States Public Health Service was immediately ordered to South
Bend \\ith the laboratory car, Wyman, and its complete personnel.
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1541 September 21, 1017
TYPHOID FEVER— Continued.
Surgeon Cobb reported September 19 that 88 cases of typhoid had
been reported since September 1. The first group of ca<os was re-
ported September 12. Of the cases 76 were reported during the
7 days September 13 to 19.
Kansas — Leavenworth County.
During the week ended September 15, 1917, 5 cases of typhoid
fever were notified m Leavenworth County, Kans., making a tetal of
216 cases reported hx the county, including the city of Leavenworth,
since January 1, 1917.
Mississippi — ^Moselle.
During the period from September 2 to 13, 1917, 22 cases of typhoid
fever were notified at Moselle, Jones County, Miss. Moselle has a
population of about 250.
, Tennessee — Chattanooga and Vicinity.
During July there were reported to the health department of Chat-
tanoogia 25 cases of typhoid fever, during August 71 cases, and during
the fir^t 7 days of September 2 cases. This number of cases in a
city the size of Chattanooga constituted an unusual prevalence.
The following conclusions are taken from the report of Surg. L. L.
Lumsden, of the Public Health Service, who investigated the out-
break: jThat there was in Chattanooga in July and August of 1917 an*
iinusuapy high prevalence of typhoid fever constituting not what
should be regarded as a ^'severe epidemic'' but which may be con-
veniently designated as an ''acute outbreak''; that the outbreak
began about July 15, and practically terminated by August 15;
that from August 15 to September 7 the occurrence of typhoid fever
in Chattanooga had not been in excess of the usual local rate for this
period of the year; that in the period of the outbreak there devel-
oped in the city from locally spread infection about 75 cases in excess
of the average number for corresponding periods of the last several
years; that the period of causation of the outbreak was between
June 25 and August 1, with its maximum between July 10 and
July 20.
The outbreak of typhoid fever in Chattanooga in July and August
of 1917 may have been contributed to by scattering cases caused by
infection conveyed by various agents from various sources, but the
vast majority of the cases constituting the excess or the outbreak
proper were beyond reasonable doubt caused by infection distrib-
uted through ice cream, the principal ingredients of which werv.*
prepared and distributed from one of the dairy and ice-cream estab-
lishments in the city of Chattanooga.
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September 21, 1017
1542
TYPHOID FEVER— Continued.
1
In a densely settled section, geographically continuous with the
city of Chattanooga but outside the incorporated limits of the city,
known aa *'East Lake," typhoid fever was found to be highly prev-
alent. In a population of about 2,500, over 30 cases were known
to have occurred in the months of July and August. According to
the evidence obtained it appeared that the typhoid fever in East
Lake had resulted largely from local insanitary conditions in respect
to the disposal of human excreta. At most of the homes open
insanitary privies were in use and at the remainder there were cess-
pools or poorly constructed and poorly operated "septic tanks."
East Lake is on the road between Fort Oglethorpe and Chattanooga.
State Reports for Avfost, 1917.
Place.
District of Columbia
Marvii\Qd:
Allegauy County
Anne Arundel v. ounty. .
Daltimoro County
Cal\ert( ountv
Caroline County
CarroJl County
Cecil vounty
Charles County ,
L) orc}^»at er \. ounty ,
Frederick County
Garrett County ,,
narford ( ounty
Howaid C ounty
Kent « ounty
MoiJtgonicry < ounty
Prin.e <;eor)ie.s County.,
Quctn AniU'S c ounty. . ,
St. Marys . ounty
Somerset ( ounty
Tuihot I ounty
Wa-ihi if^ton i ouaty....,
W'i.-omi .0 i ounty
Wor *.4er C ourity
Baltimore ( ity
Total.
Massachusetts:
Berkshire County—
PiUs:;oM
Bristol County -
Atuslinet Uown)
Partmmnh (town)..
Fall Ui\er
Now Bedford
Taunton
Essex County—
Andover (town)
(noucpstor
Haverhill
Ipswii'U (town)
Lawrence
Lynn
Mcthuen
Rockport (town)
Sakm
Swami^scott (town).,
FranMin C ounty-
(■ h.iin tto.vn)
• lu'cnlieM (town).. .
' ;'.nce (town)
Hatn;. Icn County-—
< t.i-tpee
Sp-ir-fiold
Wi.l'uld (town)
Place.
Newcasos
i«port«l.
Maasachusetts— Ccnlinued.
Rampshtre County—
KnQeld (town)
Norihamptoii
Middlesex County—
Cambridge .-..
Everett." :.
Lowell
Maiden
MHford .....'
Melrosj
Nowtou
SomerviUe
Tewksbury State Infirmary
Wakefleld (town)
Wahham -
Watcrtown ftownt ^^
Wobum :
Norfolk County—
Canton (townX
Qulncy
Plymouth Cotinty—
Bridge water (town).
Brockton . .^ ».
Hanson (town)
Marahfleld (town)
Sallolk Cwmty—
Boston
9
Chelsea
Revrr*
VVinthrop (town)
Worcester County^
Gardner (town)
56
Northbrldite (town>
Royalston (town)
8hrei*-shury (town)
Teraideton (town)...
wT<5e8tir. ......::::::::::;:::
13
Total
%n
Wisconsin:
BroAfcTi County ,...
DodKO County
Eau Haire County
Fond du I^c County
Juneau Coimtv 1 '.
Milwaukee...'.
Oconto County . .
Pierce County
PolkCountv
Portage Coimt y
Racine < 'ountv. ... ^ 4^* ^^^ *
Rock County^
Winncljago County
Wood (ounty
18
Total ;
36
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TYPHOID FEVER— Continued.
State Reports for Jane and July, 1917.
September 21» 1917
Place.
Cilitomia (Juno 1-30):
Alain^'da County
Alameda
Bcrkclcv
Oakland
Contra Costa County
Martinez
Fresno Cormty
FrcMio
Imperial County
Hrawlcy
Oalexico
ElCentro
Kera County
BakersBeld
Lessen County —
Sti$ianville
Los An^rctcs County
cicnJate
I>08 Angles
ritmd<»na
Uoaietty County
KlA?(lty...
Sallniw..
Oranw County—
Brea
Placer County
Riven»(do County —
mnhe
Sacramento C<iunty—
Kaoramcnto
8an DlfeRo County—
Saf Diego
San Francisco
San Joaquin County
Stockton
San Lub ObLspo County.
SADta Barbara County—
Saata Barbara
Santa Clara County—
8a4 Jose
SolanoCoonty
Sanoma County
Petakuua ....
SaUtaRosa....!!!!!!
Stanislaus County
. YoloCouoty
Total.
Virginia (July 1-31):
Accuma? C ounty
Albcmarli? County
(harloUesvilto...
Alcvnndrfa County. . .
AUcgbouy County—
t Hfton Forge
Amelia 1 ounty
Amherst County
Amherst
Appomattox County.
Augusta County
Ba-tl? .♦
Bath < 'ounty
Bedford County ,
Ik»df«^l ,
Bland County ,
Botetwurt ( ounty
Trout vlllc
Bruuswi :k ( ounty. . .
Buchanan t'oimty
Btickineham County.,
Campbell County
Brookneal ...,
Lynchburg ,
CaroUiM County ,
Carroll County
New cases
reported.
Place.
Vhrginia (July 1-31)— Conthiued.
I'hesterficld ( ounty
Culpeper (^ ounty
Culpeper
Dickenson County
Clintvrooi
Elizabeth i ity County-
Hampton
Phoebus
Essex County
Fauquier C ounty
Warrenton
Floyd County
Fluvanna County
Franklin County
Frederick ( ounty
Giles County
Oloucciter . ounty
Grayson (ounty
Galax .'
Greensville i'ounty
Emporia
HaUfax C ountv
South BoHon
Hanover County
Henrv County
Martinsville
Highland i ounty
Isle of Wipht ' oanty
James L ity County
King and Quocn « oimty
King William i ounty. .'
West Point
LeoCounty
Loudoun t ounty
Lunenburg ( 'ounty
Madison County
- Mathews County
Macklenburg i ounty
Chasotity
Clarksvlllo
Middlesex ( ounty
Montgomery County
Blaclcsburg
Nansemond County
Suffolk
Nelson county
Norfolk County
Portsmouth
Northampton ( bounty
Northumoerland County-
Reed ville
Kottoway County—
Blaekstone
Crewe
Orange ( ounty
CTordousville
Page County
Patrick County
Stuart
Pittsylvania County
Powhatan ( ounty
PrlncciH Anne County
Prince Edward i ounty
Prince George ( ounty
Pulaski County
Dublin
Rappahannock County
Richmond County
Roanoke County
Roanoke
Salem
Rockbridge County
Buena Vista
Rockingham County
Elkton
McQaheysviUe
New cases
reported.
2
4
1
2
2
1
1
6
9
2
11
6
6
3
4
3
3
3
4
1
5
8
17
1
2
7
4
1
1
1
2
8
1
3
3.
3
9
.1
4
9
2
1
6
5
12
11
2
1
2
1
5
1
7
1
1
12
1
6
2
6
1
1
10
7
9
12
0
3
5
11
1
1
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September 21, 1917 1544
TYPHOID FEVER— Continued.
State Reports for Jime and July, 1917— Continued.
Place.
New cases
reported.
Place.
New cases
reported.
Virginia (July 1-31)— Continued.
Kussoll Coiinly
6
1
10
12
4
2
8
3
0
12
3
3
8
1
10
2
1
Virginia (July 1-3 1>— Continued.
Tazewell Counts
«
Ix'banon
Graham -^
Vorahontao ^ . ^ . . . . ^ . ^ ^ . . ^ ^ ^
Scott Coanty
Shenandoah County
Richland
Smyth County
Warren County-
Front Royal
Marion..
Southampton County
Washington County ^
Dorktns
Franklin
Wise County .'.
13
8pot»yKanift C-wmty
Bfg Btone Own
Ffedffrioksburg
Norton .\
Stafford County
Wythe County
Surry County
' Wythftvitf^
Ocntlron
l^Ul
Sussex Co«intv
€10
Wakotleld
Wavcr4y^ .
CUy Reports for Week Ended Sept 1« 1917.
Place.
Cases. Deaths.
AVron, Ohio
Alameda, ( al
Albany, N.Y
Alton III
Ann Arbor, MIcIi
Atlantic (ity. N.J
Baltimore, Md
Bayonnp. N. J
Dlrmiiif:ham, Ala
Boston, .M;\*|J
Bridgeport, Conn
Buffalo. N.V
Combridge, Mass
Camden. N. J
Canton, Ohio
Charleston, 8. C
Chebca. Mass
Chicago. Ill
Chicopcc. Mass
Cincinnati, Ohio
Cleveland, Ohio
(^ffey\ille. Kans
Columbus, Ohio
Covlogton, Ky
Cuml>crland, Md
Davenport, Iowa
Dfvton, Oliio
Den\or, Colo
Detroit, Mich
Dulutli, Minn
E».st ( hi^ajjo, Tnd
Eli/abelh. N.J
EvansNille, Ind
Fall Kiver, Mass
Flint. Mich
Fort Wavne. Ind
Fort V.'urth. Tex
(lalve.lnn. Tex
Grand Kapids. Mich
Hamilton. Ohio
HaniKhuFK, Pa
Hartfoni, i onn
Hobolen. N.J
Indianapolw. Ind
Jehn.vt own, Pa
Kansas ( ity, Kans
Kau.sab (ity. Mo
Knox\ille, Tenn
Lancaster, Pa
LcNinj^ion, Ky.
4i
2 1
6 !
1
1
8
17
1
S2
13
4
3
2
1
3
1
1
4
1
3
10
5
10
4
1
1
3
1
16
1
3
3
1
7
3
4
2
1
5
1
4
5
1
C
5
1
4
9
1
2
PhMje.
lima, Ohio
1 illt HoV, Ark
Jo:it: MranA, N.J
I o^ Au^'cU";, I al
lovi'.l. .\a^s
L>.. * iilnir;j, Va
L^". i. juusj
ks.i, hcsler, N. H
y< .5. >rd, .Va.ss
y,i i.\>se. Ma.'^s..'. -
i:< :7i]»hi.s. Term
>'i.,»ioap(>lis, >*lnn..
N;;-Inlflc, Tcmi
Nc ...^k. N.J
No • i:c.Jford, I'c^s
Nevr i::Hii.n, Conn
Nov C isilo, I'a
Scy Iia''. cn.Conn
N\- r (); leans, La
Ne.v Vurk, N. Y
}s u para Falls, N. Y
N'nr>!K, Va
0.'.kl*i'a,Cal
OkJdimiaCity, Okla
Pa^tt (ket.U. f
Pc.ih .* inl)oy, N. J
Pbiladi pJiia. I*a
l*ilt Inu^h. \'j
I'orfi ... V.k-h
PonJaiid, Orej:
Providt nr e. 1: . I
Quiaey, 111
(i^uiiuy , M iv^
1 eadiiip, Vfn
Richmond. Va
Roanoke, Va
]io(l»esler, N. Y
J.ockford, U!
Rocky Mount, N.C
Sacramento. C al
Saginaw, !iich
St. Joseph, Mo
St. Louis, Mo
Salt Lake aty, Ttah
Sandusky, Ohio
San Fraiicisco, Cal
Savannah, Ca
South Bethlehem, Pa
Springfield, Mass
Springfield, Ohio
Oases.
20
Destlis.
^
ABE YOU S A VINO Yonr Money to Inrest in tbe SECOND LIBERTY LOAN?
Digitized by VjOOQIC
1545 September 21, 1917
TYPHOID FEVER— Continued.
Cttj Reports for Week Ended Sept 1, 1917— Continued.
Plaee.
Cases.
Deaths.
Plfice.
Cases.
2
4
1
2
2
13
5
1
Deaths.
Srncuse, N. Y
1
16
3
2
1
WaahinrtAn, Pft ,
T'uintftTi Mass
Wichita, Kaiis
Tfltofki Ohh
Wilkos-Barre, Pa
1
ToHka, Ki\m
1
WUmlngt^", TV',,
2
TrSlon, N J
WilmingtoiJ, N. C
1 Winston-Saltm, N. C
1 Worcest4>r, Mass ....... . .
Troy, N. Y
1
1
1
Wfff^h^m^ M#9^
1
WittW»ct™i T>, r...
10
lYork, Pa.'
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for August, 1917.
Cases reported.
State.
Clues reported.
Diph-
Meesles.
Soariet
fever.
Diph-
theria.
Measles.
3W
04
Scarlet
ro\-er.
MiMMCetainbla
0
34
154
3?
1
Massadmsetts
Wisconsin
502
105
145
151
State Reports for Jwe aad J«ly, 1917.
During the month of June, 1917, 129 cases of diphtheria, ^,703
cases of measles, and 258 cases of scarlet fever were reported in
California; And during the month of July, 1917, 40 cases of diphtheria,
511 cases of measles, and 26 cases of scarlet fever were reported in
Tirginia.
CRT Reports for Week Ended Sept 1, 1917.
City.
Popula-
tion as of m-.-,
(estimated 'V!*i!j*
by United, ';7
S^^^"^ causes
Census »»"s«s-
Bureau),
Om 500,000 Inhabitants:
Baltimore Md
Boston, Mass
Chicago, ni
deveiand, Ohio ,
Detroit, Mich
Los Angeles, Cal ,
NewYork, N. Y
Philadelphia, Pa
PittstuTBh/Pa
St. Louis, Mo
ftm 300,000 to 500,000 taihab-
ttants:
Buffalo, N.Y
Cmdnnati, Ohio
JwseyCity, N. J
Milw»ukoe, Wis
Minneapolis, Minn
Newark, N.J
New Orleans, La
San Francisco, Cal
Washington, 1).C
'021
,476
722
073
.7*4
k812
841
> 518
'090
^300
468,558
410,476 1
306,345
435,535
363,454 !
im,iidi i
371,747
463, .)16 !
363, OSO ;
217
650
341
110
1,353
481
167
154
106
87
78
102
143
1U6
123
Diphtheria.
11
58
101
30
50
2
118
30
22
31
Measlei.
Scarlet
fc\cr.
Tuber-
culosis.
7
17
18
1
2
3
i
2
71
i
5
1
3
1
1
1
1
1
3
1
11
2V
10
5
28
52 !
4
21
5
- -
-
_ _ _
s
.
B
_l_
^
_l_
.
47
23
1
77
37
2
2S6
73
31
13
1
64
19
43
19
812
139
114
55
36
10
00
12
41
0
21
11
14
8
'
21
6
50
15
26
21
21
11
24
13
1
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September 21, 1917
1546
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Coutiuued.
City Reports for Week Ended Sept I, 1917— Continued.
-
Popula-
tion as of
July 1,1916
(estimated
by United
States
Census
Bureau).
Totel
deaths
from
aU
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tubw-
cuiosis.
City.
1
1
1
1
1
i
1
j(l
From 200,009 to 300,000 Inhab-
itants:
('olumbus. Ohio
214,878
260,800
271,708
297,847
295,463
254,960
256,417
104,199
181,762
121,579
112,981
106,233
127,224
128,366
104,562
128,291
110,900
100,560
113,245
102,426
148,995
117,057
118,158
149,685
ias,60t
Hi.5.470
109, 3Sl
1.50. (iS7
117,;VJ9
ia},in2
155, tm
112.770
191,5.^
111,. -id.!
163,314
85.62.-)
63.50.-)
57. iKiO
69. S93
57, 0 Vt
5.3,973
67. 449
(M), S.02
00, 734
.57,144
94,495
S»i,69()
fi3,705
70,078
54,772
76,183
72,015
77, 214
6H,529
91», 437
57,343
78,283
&«<,221
53,794
89,(>12
92,943
71,744
.59,411
C3,st;7
61
58
77'
39
84
72
3
3
17
6
1
8
2
6
5
Denver Colo
4
2
9
Indianap>olis, Ind
2
24
Kansas Citv. Mo
13
rortland, Oreg
1
9
0
2
Providence. K . I
6
Rochester N. Y
1
13
l;^
\
6
7
^'. 11
From 100,000 to 200,000 inhab-
itants:
Albany, N. Y
1
;->
Birniinghani, Ala. .
79
33
28
6
7
4
1
3
'? 7
Bridgeport, Conn
1
2
■' 4
Cambridge.' Mass. ....
'< 2
Camden w . J
2
Davton, Ohio
54
45
16
28
41
37
37
30
49
33
31
"'"so'
? 48
■ 38
41
' 19
.30
1 32
6
5
2
1
1
Fall ^iver, Mass..*.
1
2
1
1
2
"" 3
Fort Worth, Tex
3
Grand Rapids, Mich
Hartford, Conn
4
5
1
7
6
6
2
1
■\
4
2
10
3
7
9
3
1
a
T^f4wn»npo. \fAR<t
n
l«ovi'cIl, Mass. .
1
-Lvnn Mass *
1
1
1
2
3
Memphis, Tenn.
4
NaitiiV'ille. Tenn
1
1
2
1
2
LVL
2
New Bedford , Mass
6
2
1
3
2
4
2
6
8
1
- 8
3
2
New Haven, Conn
7
Oakland. Cal
a
Omaha, Nebr
2
Keadine. Pa
■''
7
3
......
-|
3
Kichraond, Va
2
1
2
7
1
2
4
..,..,
1
Salt Lake Citv, IHah.
1
Springfield, Mass
1
2
7
•;.••••
sSTacuse, r^. Y
1
Tacoma, vVash
Toledo, Ohio
5t)
38
55
i'i
3
5
1
13
......
2
7
Trenton, N J .
3
Worcester, Mass
4
9
From 50,000 to 100,000 inhab-
itants:
Akron, Ohio.. .
Allentown, Pa
- **
Atlantic City, N. J.
1
9
Bayoime, N.J
Berkeley, Cal
1
1
7
13
11
21
20
14
15
21
31
22
25
11
18
18
26
\K
26
27
19
Binghamton, N. Y
Brockton, Mass
3
5
4
2
Canton Ohio
1
2
1
Charleston S C
.
Covlncton. Kv
1
7
1 ,"
1
6
2
2
4
4
3
Duhith.Minn
1
2 ;
6 !
Elizabeth, N. J
5
El Paso Tex
- ,
10
E vans vi lie Ind
1 >
1
Flint, Mich
4
2
3
Fort Wavne Lnd
2
4
2
IIarrist)urg, Pa
1
4
\
1
......
1
1
IIoloken,N. J
1
1
1
Jolinstown Pa
1
1
2
Kansas Citv, Kans!.!
1
Little Rook, Ark
Manchester, N. U
3
3
Mol i'e, Ala
2
3
New Britain, Conn
1
14
3
1
2
2
Norfollv, Va
S
Oklahoma Citv, Okla
15
16
17
23
1
I'assaic, N J '
s
1
a
l*uwtiiciiet. R. I
a
I'orfland, Me
.
7
3
ARE YOi; SAVING Yonr Money to Inrest in the SECOND LIBERTY LOAfit
Digitized by VjOOQIC
1547
September 21, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCULOSIS—
Continued.
atj Reports for Week Ended Sept. 1, 1917— Continued.
Popala-
tion as of
Jalyl,191«
(estimated
by United
Stat-^
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
(over.
Tuber-
culoeis.
, city.
1
2'
s
Q
I
1
1
o
1
From 50.000 to 100,000 inhabit-
ants-Continued.
Rockfard.ni
55,1R5
06, W5
55,642
S5,230
53,330
•8,«)5
99,519
67,078
87,030
ei'iao
51,550
«,083
77,916
70,722
75,776
iM,2R5
51,656
r,732
37,3S5
\ 32,730
27,632
43,425
46,192
29,310
2fl,074
32,261
39,«73
28,743
42,458
28,203
39,233
35,486
41,863
29,353
40,496
48,477
35,363
48,886
28,771
38,676
. 31,677
41,007
35,384
46,515
27,587
32,940
aO,C99
26,234
26,318
27,327
29,G03
41,133
31,927
30,108
43,715
37,353
31,401
31,404
33,080
41,185
38,f.29
39,P51
36,798
38,136
18
27
19
30
20
23
24
»
1
1
1
4
3
2
3
1
4
I
a
^
fiUftoaw.Mlch
8t. Joseph, Mo
3
SanDiw.Cal
' 4
Ba^atmab, Oa
2
Soheftectadv, N. Y
1
1
1
2
Siofix CUT, Iowa
8<io«rvlIle,Mas8
8
16
23
U
21
.6
d
4
2
1
South Bend, lod
2
1 j::;;::
SpgluKfleld, III
Swdm^f dd. Ohio
1
Tcrr«Hante, Ind
1
",""\
2
Tror.N.Y
8
2 ^
\Mrwta.Kans
»
37
1
7
1
{
1
2
1
W! Ict^^^Barre, Pa
1
1
Wl minimum. Dirt
4
York, ft..;
rtim 2^.000 to 50,000 tnhab-
ttants:
Atemeda-Cal
6
U
3
7
1
1
1
1
1
I
1
AubinrnTK.Y
•
BrookUne.Maai
**
Butler.Pa
1
Butte, Mont
2
1
Clicl«a,Ma8s
8
0
4
7
6*
8
3
8
&
14
0
17
14
15
2
2
CWcopee.Mass
1
1
Oumberktld, Md
,
"
Danville, in
r
..,-.
3
Duboqua, Xowm
1
■""*.
2
Bartrblca«o,Iiid.
1
Itit Oraog©, N. J
2
1
Jlrin,lir:
1
5
BTenct.Man
2
3
3
KTeertt, Wash
X
Oahrejitoo, Tex
2
Oraeh Bar, Wla.
1
HamHtoB, Ohio
2
1
3
Hatwhi«,M«8
1
1
1
lMkMQ.MSoh
•••t
I
Uunasoo. Ifieh
12
{
5ln«»ton.*.Y
12
7*
20
9
13
5
7
1
1
4
17
14
Kaoxvitle, Tmn
2
4
1
2
2
1
2
"i
1
1
LaCroa8e,Wle
2
Uringtan,Ky
1
1
2
LhSroSi... :.
""]
Uaeota, Wabr
1
......
2
La« Beach, Cat
2| j 3
1
LTBcWwre/Va
1
MadiMo,Wls
2
Medford.Maas
.. .
MoDCdWr.N.J
::::: 1'"""
4
Nashua,*. H
1
1
Newbun?h,N.Y
2
New Castle. Pa
1
Newport.Ky
9
14
7
20
6
10
7
11
6
12
12
7
NewSSt,R.'l
Newlon,Ma»
4
*
1
2
1
2
Niaeira Falls, N.Y
1
1
1
1
2
Nonistown, Pa
t
Ofden.Utah
1
I
OTaMe.N.J
Perth Amboy, N. J
PiUtfield, Mass
,,'
Portamoiith, Va,
2
Qirfnoy, ni
..
1
Quincy.Maffl
* 2
......
4
I
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September 21, 1917
1548
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
(Continued.
City ReporU for Week Ended Sept I, I9I7— Continued.
Popula-
tir.nasof
Jul V 1,1916
(estimated
bv United
States
Census
Bureau).
Total
deaths
from
all
causes.
11
17
9
9*
12
25
13
5
Diphtheria.
KeaslM.
Scarlet
fever.
Tuber-
culosa.
City.
1,
1
1
2
1
i
1
1
From 25,000 «D 50,000 inhabit-
ants—Continued.
Harlne Wl'^
40,4Rfi
43, 28 J
28,02fi
.38,9^)2
27,415
4t>,22«
3fi,283
4K,72»i
30. 570
29,894
43, 139
43,377
a3,S(i9
29,892
31,155
30,863
22,874
15,010
13,599
21,<i85
15,794
•13,075
22.6f<9
24,270
23,5:^
20.930
15,385
» 14.610
17,445
13, 2M
Z\ 126
1
3
Roanoke, Va
1
1
1
Rock Island. Ill
San Jose Cal
1
1 •
Steuben vi 1 Ie, Ohio
A i....:.
Superior, Wis
1
1
..:::.L.:... !!...::
Taunton, Ma.-NS
1
*T- '
Topeka, Kan.s
1
1
1
Waltbaan , Mass
1
1
::::::i::::::i::»"'::
Waterlown. N. Y
1
1
' M
\j, 3
West Ilobokcn, N.J
3
13
i2'
17
9
12
8
11
4
3
C
7
8
6
3
2
0
4
9
6
8
8
7
7
1 1
1
'
- o
Wheeling, W. Va
4
3
i
•
1
Williain.''nort. Va
1
i
1
#n .
Wilmington, N. C
1
.-■•■)
4
Winston-Sa'cni, N. C
j
1
1
4
3
ZanesvlUe. Ohio
t
1
-1f^
r, S
From laoDO to 25,000 inhab-
itants:
Alton. Ill
1
1
Ann Arbor. Mich
2
1
1
1
•••'•*l
Berlin N. II
t
//^:x.''''.
Braddock, Pa
2;
2
1
Cairo, III
1
C-linton Mas.*^
"y"\
..
Conconl , N . U
2
9
1
1
( Jale^burc, 111
1
Kearnv. N. J
"■■2!:::;::
Kokoino. Ind
\
'
!
Long Hmncb. N. J
Marinette, Wis
1
L. . :
Mo^rose, Mass
5 1
1
1......
2
IfrtrrijStown N J
1
Nant iroke Pa
4
......
....
Kewhur>7)ort, Mass
Now London, Coin
15! 243
20,985
•22,«lI9
"
i
1
1
North Adams, Mass
3'::::::
Northampton, Mii.'^s ..
19,93()
23,saN5
17,524
11,066
12,067
14,831
20,193
13,821
24,204
15,548
23,228
16,969
1
1
I
.1 1.:::
Plainfield. N. J
1
Pontiac, Mich
1
2
1
Portsmouth. N. II
b
6
11
4
2
3
6
6
1
Rocky Moimt, N. C
Rutland, Vt
2
1
Sandiisk V. Ohio
1
t
Sarulopa Bprings. K. Y
South Bethlehem , Pa
1
::::::i:::.;:::::-:
y.'.y.c :"
i
-
1
1
Steelton. Pa
3
Wilkinsbursi, Pa
1
Woburn, Mass
»
2
i
1
» Population Apr. 15, 1910: no estimate made.
ARE YOU SATING Your Money to Inrest in the SECOND LIBERTY LOAN?
Digitized by VjOOQIC
FOREIGN.
CUBA.
I Contunuiicabie Diseases — Habana.
Communicable diseases hare been notified at Habana as follows:
Disease.
Aug. 11-20,
1917.
Remain-
ing inilBr
treat-
ment
Aug. 20,
1917.
•
Disease.
Aug. 11-20,
1917.
Remain-
ing under
treat-
New
Deaths.
Now
cases.
Deaths.
ment
Aug, 20.
1917.
Diphtberia
3
5
2
10
35
Measles
9
1
11
, gitis. .
Lei»x>sT. I
Paratyphoid rsTsr
Scarlet fever
7
1
28 7
1
1
Typhoid fever
68
IffErT/
18
VttrktUft
1
CHOLERA, PLAGUE^ SMAUPOX, TYPHUS FETEB^ AND YELLOW FEVER.
Reperto Becehred Dminf Ok Week Ended Sept 21, 1917.^
CHOLERA.
Place.
Date.
Casr.
DisaChs.
RiiBftrks.
Java:
East Java..;..;
Juty 9-15
1
1
Jnly 20-20, 1917: Cmss.
deaths. 31.
July 22-28, 1917: Cases,
deirths,246.
July 29-Aug. 4, 1917: Cases,
deaths, 276.
West Java
fiO,'
Batavia
J«lv 20-26. "
3
Philippine Islonds:
Provinces
473;
Agusan
July 22-28
6
12
11
19
17
m
6
119
130
42
1
27
3
Albay
db
5
3
19
rr
59
3
70
34
24
1
13
3
Ambos Camarines
do
Bohol
do
C^niz
(h)
CeBti...
Hollo
do
do
Levte
do
Misarafa.^
do
Ncgroe Oriental
^0
Romhion
:*:::do:..::::::::::
Sorsogon
.do
Tayabas
do.
Provinces
464;
Albay
July 29- Aug. 4....
■ -do ,
do
3
9
35
3
37
8
113
12
151
G3
20
4
6
3
8
K
I
28
3
80
11
62
38
7
4
5
Ambos Cam artnes
Bohol
Caplz
.do
Cebn
....jdo
Iloilo
do
I/eyte
do
UindftriftO , ,
do
Misamis
do
Negros Oriental
do
Sorsogon
do
Suiigao
do
do
» From medical officers of tlie Public Health Service, American consub, and other .sources.
ABE YOU SAYING Year Money to InTest in the SECOND LIBERTY LOAN!
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1550
CHOLERA. PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received During the Week Ended Sept 21, 1917~Continued.
PLAGUE.
riaie.
Date.
Cases.
1
1
Deaths.
Hcmarlu.
Bm7ll:
Rahia ;
July2J-Aug. 4....
June 24-30
•;"•
Siam:
Bangkok
1
SMALLPOX.
Australia:
New South Wales —
(Vssnoc\
AVwTcn
Brazil:
Bahia
Canada:
Manitoba-
Winnipeg
China:
Amoy
Antnnj?
Ch^mekinf
MuUUen
Shanghai
France:
Nantes
(Ireece:
Athens
Italy:
Turin
Java:
Kft&t Java
Mid-Java
W»j.«rt Java
Mexico:
Vera Cruz
rhilippinc Islands:
Manila
Torlugucsc Kttsl \frica:
Louren^o Martjuez. .
Siam:
Bangkok
Spain-
Valencia
July 2r.-2S.,
July 12-17.,
July 23- Aug 4.
Sept. 19-25.
July22-2S
Aug.ft-12
Julv 15-21
July 2'>Aug. 11 .
Julv30-Aug. 5..
July 30-Aug. 5
July25-30.v
July 12-Aug. 5
July 9-15.-.
...fdo
July 20-26.,
Aug. 12-18.
July29-Aug.4....
May 1-31....^
June 24-30.
July 11-17..
Aug. 12-18.
Present.
Do.
Do.
Among Chinese.
July 12-28, 1917: Cases, 7.^.
roh-
TYPHUS FEVER.
China:
Antung
Japan:
Na.^asiki —
Java:
Ka^t Java...
Mid-Java —
West Java...
Biita.ia.
Nethorhuuls:
KoUerdam..
July30-.\ug 12..
Aug. 6-12
Julv9 15
...Ido
July 20-26
do
July 29-Aug 4...
2
3
1
3
1
15
13
1
1
1
2
Mexico:
( um| (ch«\ .Stale—
( irip(ch«'
YELLOW FEVER.
Aug. 19-25.
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September 21, 1917
CBOLERA, BLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Reeeired from Jane 90 to Sept. 14, 1917.
CBOUBBA.
PlM*.
Date.
Omw.
DeatlM.
lUmarks.
India:
3}IS9f){l| ..,....»-
Apr. 1-Ma7 5
8
1
347
8
4
4
2
3
1
5
7
17
lV>inhfty .............. -rrr--
June 24-30
Apr. 2»-Jaae30...
1
C^lcutta
Do
Jifiyl-?
Madras
Apr.2»-Jiine30...
Ji5yl-7
6
6
Do
liandalay
May6-Jnne30
Moulmf ill ,..
May 13-June3
Pakokku
Apf.aa-May5
Peai
May27-Jtine30...
Do
Jolyl-7
Rangoon
Apr. n-Jane 30. . .
81
Indo-China:
Provinces
Veb. 1-lCar. 81, 1917: Oues, 61;
Anam ,
Feb.l-Mar.81....
do
0
9
44
3
193
1
1
7
33
deaths, 40.
f cM*hm-nifii» .
do
Tonkin
.....do
Apr.23-liay37....
Apr.2-8
Saifn>n
198
Java:
En st Java
West Java
Apr. 18-July 5, 1917: Ouee, 71;
deaths, 31. July 8-19, 1917:
Batavia
Apr.l3-July«
July 5-19....
7
8
1
4
1
8
1
3
Do
CtMt, 44; deaths', 30.
Persia:
Maionderan Provinofr—
AmlrKela
l^b.3
Barfouroueho
Jan. 15-17
Hamxe Kela
J^n 17..
Machidessar
Jan. 31
Philippine Islands:
June 17-23
Provinces
May 30nJane 80, 1917: Oases, 795;
deaths, 506. July 1-31, 1917:
Cases, 1, 127, deaths, 749.
Aeiuan ,
July 15-21
6
113
38
3
1
1
388
149
82
44
281
271
27
14
102
66
171
1
4
196
169
7
3
11
2
76
23
1
Albay
)Cay20-June30...
July 1-M
&........:.:::.:::
Ambw raiMrinM
June 3-9
Bataan
July»-14
Bataneas
June 17-23
May 20-June 30. . .
July 1-21
1
251
116
150
197
16
6
73
21
115
Bohol
Do
Capia
June 3-30
Do
July 1-21
Cebu
June 3-30
Do
July 1-21
iJoilo
July 1-21
Levte
June 10-30
July 1-21
Do
Iflc^mtf
Jaly 8-21
Nejnros OrientaL
July 1-21
RiaU "'""^••
June 24-30
July 1-7
Do
Samar
July 15-21
3
' 88
94
7
1
7
Sorsognjx
June 3-30
^*o >
July 1-21 .
TayabM
June 3-30
Do
July 1-21
Zamboanga . x . x . . . . . .
July 15-21
"
PLAGUE.
Arabia:
Aden.
Brazil: •
Bahia
Do...
CeykMi:
Cok>mbo.
Do...
May 3-June 11
June 10-30
July 8-21
Apr. 8- June 9
July 6-12.
38
Apr. 8-May 14, 1917: Cases, 69;
deaths, 51.
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Vo'
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER- ^ -vi
Continued. q^jitfOl,^;;
Reports Received from June 30 to Sept. 14, 1917— Continued.
PLAGUE— Continued.
Place.
China:
Amoy
Honjrkong
Kwao^une Province—
Ta-pu district
Ecuador:
Kstancia Vioja
Guayaquil
Do!!!!!!;!!!;!!!!!!!
Mlla«ro
l^alitre
Do
Taura
Egjpt
Alexandria
Do
Port Said government...
Port Said
Do
Provinces—
Favoum
Galioubeh
Girpeh
Minieh
Do
SlQIlt
Suez government
Suez
Great Britain:
Gra> cscnd
London
India
Basscin
Do
Bombay
Do..
Calcutta
Ifcntada
Karachi
Do
Madras Presidency
Do
Ifandaiay
Moulmein
Do
Myingyan
Pegu
Ran goon
Toungoo
Indo-Cliina:
Provinces
Anara
CaralKxlia
Cochln-China
Saigon
Java: i
East Ja\'a 1
l)jocJ3Varta Uc-i«loncy.|
Kcdiri ile^idoncy '
Siiniranj! Uo^idoiicy...
SuraMya lie >idt'ncy. . .
Surakarta iie>i(lonc>',..
Date.
Apr. 2^May6..
July 1-7
May 13-June 30.
June 2
Feb. 1-2R
do
Mar. 1-31
Apr. 1-30
Mar. 1-31
Apr. 1-30
Feb. 1-28
do
Mar. 1-31
Feb. 1-2S
Jime 21-27
July 31
Apr. 30-May 19.
June 25
JuIy2S-29
May 11- Juno 2B.
Juno 28
May 17
Mav 12- Juno 28.
July 29
May 12
Apr. 30-Juno 2. .
May 12 JiinoW.
Aug. 13-24.
May 3-8....
Apr. 1-June 30.
July 1-7
Apr. 22- June 30...
July 1-7
Apr. 29-June2
Apr. 1-Juno30
Apr. 22-June30...
June28-July 4
Apr. 22-Juno30...
July 1-7
Apr. 8-May 12
Apr. l'Juue30
July 1-7
Apr. 1-7
May 27- Juno 2
Apr. 15 Juru«3U...
July 1-7
Apr. a-14
Cases.
441
36
408
3
301
70
Fo'o. 1-Mar. 31.
do
do
Apr. 23- Juno 3.
Peru.
Apr. Z\ May 6. .
do
Apr. Zi May 20.
Apr. 2 May 20..
do
Departments— 1
Are-iuipa • Mav 16 31.
Callao '....".do
LamlKiyoque ♦' do. . . .
Lil>ortad do
Lima.
183
46
.do.
Deaths.
54
6
363
25
38
35
413
2
250
58
9
74
16
1
2
169
42
2
Remarks.
IM*
Present and in vicinity.
Present.
Jan. 1-Aujg. 2, 1917: Cases, 1,K1
deaths, 606. i
From s. s. Matlana.
2 in hospital at port . From s. s.
Sardinia frcm Australian and
oriental ports.
Apr. 15 June 30, 1917: Cases,
43,922; deaths, 30.197. July 1-
7, 1917: Cases, 1,870; death.-*.
1,322.
Feb. 1-Mar. §1, 1917: Cases, 198;
death", 141.
Apr. 2-May 20, 1917: Cases, 29;
deaths, 29.
May 16-31, 1917: Cases, 15.
At Mollendo.
At Callao.
At Chiclayo.
At SaLi\erry, f^m Pedro, and
Trujillo.
-\t Uina.
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September 21, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVBR, AND YELLOW FEVER-
Continued.
Reports Receired firoin June 30 ttf Sept 14, 1917— Continued.
PLAGUE— Continued.
Place.
i:^te.
Cases.
Deaths.
Remarks.
Sam:
Banekok
Apr. 22-June2....
July 3-23
12
4
2
1
11
8
1
1
Do :....:....:..
Straits Settlements:
ginpaoore
June 3-16
-
^S!: :::.:.::::::::::::
July 1-7
Union of South Africar
Cape of Good Hope State—
Glengrey district
Terka district
Aug. 13..:
Present.
m^TS
1
1
1
At Suramerhill Farm.
Queenstown
June 6
Apr. 1(^-22, 1917: 1 ease. Apr. 9-
^, 1917: Cases, 28; deaths, 17.
Winburg district
At sea:
s s, Mattana. . , , r
May 28
1
6
July 14-18
9
En route for port of London.
SMALLPOX.
Australia:
New South Wales
Apr. 27-JuIy 5, 1917: Cases, 68.
BrewftiTiii&
Apr. 27- Juno 21...
May 25- July 5
Apr. 27- June 21...
June 22- July 5
May 9
6
13
2
47
1
4
(^oonabarabran
Qnambone. ....
Warren district
Queensland—
Thorsday Island Quar-
antine Station.
Brazil:
Bah^a
From s. s. S.t. Albans from Kobo
Mayft-June30....
July 22-28
/
via Hon^kons. Vessel pro-
ccedcd to Townsville, Bris-
bane, and Sydney, in quaran-
thie.
Do . .
1
31
27
R io de Jan*»iro
do
126
• 158
3
Do. .. . ..:....
July 1-Aug. -1
June 10 16
June IJt- July 7....
June 17 30
Canada:
Manitoba-
Winnipeg
-
Nova Fcotia—
Halifax
Port Hawkcsbury
Ontario-
Ottawa
Present in district. .
July 30-Aug. 5
May ^12
1
1
Ceyton:
Colombo
China:
Amoy..
Apr. 29-May 26- . .
Present and in vicinity.
Do
July 1-31
Do.
Antuns
May2l-June24...
May 6-June 23
4
ChnngKiiig ,
Do.
DO...T
July 1-14
Do.
Chnnjpiha
May 27-June2
May 13-Jime30...
July 8-28
5
30
6
2
7
8
1
Daircn
4
1
Do
July 1-7, 1917: Present.
Hankow
June 24-30
Apr.23-May6....
May6-Junel6....
Apr. 23-29...
Harbin
On Chinese Eastern Ry.
Hnngkone ,
7
Manchurfik Station
Do.
Mukden...........
MaV27-June2
Present.
Do
July 8-28
Do.
ShMp^hftl,
May21-Julyl
July 2-29
13
32
8
Cases foreign; deaths among na-
Do
ti>-es.
Among Chinese. ^
On Chinese Eastern Ry.
Tsitshar Station. . .
Apr. 16-22
1
35
1
1
1
5
Tfingt^n ....... ,.,....
May22-July7
May 1-31
7
At another station on railway,
Chosen (Korea):
Chemulpo
lease.
nifAviionn
Feb. 1-28
So! ...::;:::;::::;;::
Mar. 1-31
Do
Apr. 1-30
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September 21, 1917
1554
CHOLERA, PLAGUE, SiULLPOX, TYPHUS FEVBR, AND YELLOW ¥EnXi-
Oontinued.
Reports Received from June 30 Ur SepC 14, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Egypt:
Al^x&ndrift -
Apr.SO-JiUyl
July 2-29
Feb. 12-Mar. 18...
May 6-12
39
30
19
9
4
1
Do
Cairo
Franco:
Paris
-
CKTmanv
Mar. 18-Apr. 28, 1«17: Cases, 715
in cities and 32 Stales and dis-
Berlin
Mar. 18- Apr. 28...
do
106
16
18
50
20
2
■
163
tricts.
Chariot tenbere
do
Hftmhiirfi' ... ......
.. ..do
:::::do:::::::.:...
Liibeck
do
Munich .'.'
do
Stuttuart
do
India:
Bombav
Apr. 22-Jimc30...
July 1-7
63
8
12
8
18
4
5
Do
Apr. 2i)-May 20...
Karachi .........
Apr. 22-July *
Apr. 22- June 30...
July 1-7
27
80
11
33
2
Madras
Do
Rangoon
Apr. 15-Juno30...
July 1-7
Do
Ifido-China:
Feb. 1-Mar. 31, 1917: (^«ses, 1 ,616;
Anam
Feb. 1-Mar. 31....
do
78H
73
654
2
9J
19y
32
65
1
'1
38
10
88
5
63
17
158
deaths, 240.
Cambodia
Cochin-c iiina
Kwang-tiiow- Wan
Tonkin
do
Mar. 1-31
tci). 1-Mar. 31
Apr. 27-JunelO...
May21-June24...
May 27-July 22....
May28-June3....
May HV-July5
May27-Juiy I
Apr. 2-July 1
July 2-H
2
63
12
16
Saigon.
Italy:
Turin
Japan:
Kobe
N agasaki
Usati.a
55
1
2
YoKohama - . - . r . ,
Java:
Kast Java
Do
Mid-Java
Apr. 1-July 1
Juiy2'8
7
Do..
West Java
Apr. LVJuly 5, 1917: Cases, 239;
deaths, 44. July 6-lU, 1917:
I ases, 46; deaths, 10.
Watavia
Apr. 13~July5....
July 11-Aug. 7
30
6
9
Mexico:
Ma/allan
Mc.vico - ity.
June .i .H)
Hj2
6y
Dq ../.
Aug..Vll
June ls-21
Monterey
24
V era - ruz
Juiy 1-Aug. 11
May 13 Jane 9
Julys 21
2
6
3
14
4
56
4y.5
4
23
6
Thilippine Lslands:
Manila ....
Varioloid.
Do
I'ortugal:
LisJ>oii
May n- June 30....
Julv?> '2s
Do
I'ortuguc^ Eiwst Africa:
l.ourcnvo Manjues
Mar. 1- Apr. 30
May l-Jnno28
teb. 1H-Jiuie9
Mar. Il-Juuc2
Mar. ir)-21
June 9 2.?
2
4
Archangel
Potromad
Riga
\'la«livoytok
Jan. 1-Mar. 31, 1917: Cases, 9.
7
3
4
12
11
Siaiu;
l^angkok
Spain:
Malrid
May 1 June 19
Maln^'a
Apr. 1-:J0
May I- June TO
,',
Sr\ illo
\'alcncia
June .{ 2J
5
10
6
1
Do
July 1 -Aug. 4
Mar, 18-Jimo23...
June 21 30
Straits Scttlcoicnl?:
I'onang
3
Singapore
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Reptoinl>er 21, 191T
CHOLEBA, PLAGUE. SMALLPOX, TYPHUS FEVER. AND YELLOW FEVER—
Continued.
Reports Recehred from Jane 30 lo Sept. 14. 1917— Continued.
SMALLPOX— Continued.
Place.,
Date.
Cases.
Deaths.
Remarks.
Sweden:
Bfalmo
Apr. 22-28
1
2
2
Stockholm
May 20- June 23...
Jime 2-8
1
Tunis
Turkey in Asia:
Trcbiiond .
Feb. 25- Apr . 13 . .
15
Vnion of South Africa:
Johannesburg
Mar. 12-24
4
2
Umguav:
May 1-31
Venezuela:
Maracaibo
June IS- July 8
8
1
Do -
July 9-2}
TYPHUS
FEVEi
t.
Place.
Date.
June 1-30
Cases.
Deaths.
3
1
Remarks.
Algeria:
AlgttTS
5
1
.
1»)
July 1-31
.\ustrifl- Hungary:
Austria
Oct. 22- Doc. 17. 1910; t'a^-s. 2,371.
Bohemia
Oct.22-Dec. 17....
do
634
809
47
617
16
243
5
Galicia
Lower Austria
dj
Moravia
do
Silesia
do
Styria
Upper Austria
do
do
Hungary
Pel). 19-Mar. 2n. 1917: Cft«^*!, 1.3^^1.
Buoapest
Feb. 19-Mar. 25...
July 29 Aug. 4....
June 25- July 1....
July 9-22.
83
1
3
4
1
' ' •
Bnwll:
R io de Jaueiro
China:
Antung
I)o
1
Hankow
Judo 9-15
Do
Julv X 14
1
Tientsin
June 17-23
1
4
1,G48
221)
96
T^Dgtao
May 30 -July 7
Apr. 39- July 1
July 17 29
Alexandria
478
84
40
1
32
10
Do
Cairo
Jan. 22-Mar. 18....
JuDe 17-23
Great Britain:
Cork
Greece:
Saloniki
May 13- June 30...
Do
Julv 1-14 '
Japan:
Hakodate
July 22- 2S
1
4
19
Nagasaki :
Do
JaTa:
East Java
Juno 11 21
JulyO-Aiig.S
^
May 6-Julv 1, 1917: C'a.scs,0.
Surabaya
Mid-Java
June 25-July 1
1
Apr. I Juno 24, 1917: Ciises, i-X
Bamarang
May ,>-Juno 10
July 2 8
14
2
deaths, r».
Do.7.
West Java
Apr. n Julv .-.. 1917: Ca^'s. 147;
de:ith?, t>. Julv <> 19. 1917:
Batavia
Apr. l.t-Julvo
July«>-19
June 3 :J0
70
18
431
:.24
3
3
6
6
1
Do
( !iso^.2.">: <U'.v\i<. 1.
Mexico:
Mexico City
Do
July H-Auj^. 11
June 9-23
Netherlands:
Rotterdam
2
Do
July l.V3()
July 8 14
Norway:
Bergen.
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CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from June 30 to Sept. 14, 1917— -Continued.
TYPHUS FEVER-Continued.
Place.
Date.
Cases.
Deaths.
RtBiarks.
Portuguese East Africa:
LourenQo Marques
Mar. 1-31
1
11
126
2
5
Russia:
Archangel
May 1-June28
Feb. 18^June9....
May31-June2
Mar. 29-May21...
l^«y 1-31 ,
2
3
PctroCTad
Riga
Jan. 1-31. 1017: 1 case.
Vladi vostok •. ...
Spain:
Almcria
6
2
Madrid
!do
.Switzerland:
Basel
June 17-23
July 8-21
1
3
1
2
Do
1
Zurich ,...
July26-Aug. 1....
June4-»
Trinidad
Tunisia:
Tunis
June 3(K-July 6
1
YELLOW FEVER.
Ecuador:
Babahoyo.
Do....,
Chobo
Guay
Do
MilaCTO
Do'.'.'.'.'.'.'.'.'.'.'.
Mexico:
Yucatan State —
Merida
reto
Do
Feb. 1-28.
Mar. 1-31.
do....
Feb. 1-28.
Mar. 1-31.
Apr. 1-30.
Feb. 1-28.
Mar. 1-31.
Apr. 1-30.
Sept.l
Juno 23
July 2^ Aug. 11.
1
1
2
1
1
1
18
7
17
9
17
9
1
1
1
1
1
1
1 1
6
21
In po^on recently arrived from
Mexico C
> City.
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PUBLIC HEALTH REPORTS
VOL. 32 SEPTEMBER 28, 1917 No. 39
THE ACCURACY OP CERTIFIED CAUSES OP DEATH.
ITS RELATION TO MORTALITT STATISHCS AND THE INTERNATIONAL LIST.
Rerlsed report of a committee of the Vital Statistics Section of the American Pabllc
Health Association, composed as follows: Committee — Haven Emerson, chairman;
William H. Ooilfoy, E. H. Lewlnski-Corwin, Louis I. Dublin, Charles Norris, Warfield
T. LoDgcope, W. R. Williams, William H. Davis, George H. Van Btiren, executive sec-
retary.
Tliis report is a summary of the conclusions of a committee
appointed by the Section on Vital Statistics of the American Public
Health Association to consider the question of the accuracy of cer-
tified causes of death and their relation to mortality statistics and
the International List of Causes of Death.
At the meeting of the Section on Vital Statistics, held September
10, 1915, at Rochester, N. Y., Dr. Haven Emerson, commissioner of
health of New York City, read a paper, a synopsis of which follows :
RBLIABn.rrY op statements of CAUSE OF DEATH FROM THE CLINICAL AND
PATHOLOGICAL VIEWPOINTS.*
- AVhile completeness of records of death is desirable, it is of no more impor-
tance than the accuracy of the causes themselves as stated on the death
certificates.
The primary necessity for reliable and adequate statement of cause of death
is obvious. The high percentage of inaccuracy in certificates of death is well
known to registrars, to Ufe insurance companies, and to pathologists, who can
compare clinical diagnoses with the demonstrated cause of death at the
autopsy.
If the 189 titles of the International List are studied in the light of present-
day knowledge of clinical and pathological experience, it will appear that there
is no plausible guarantee of accuracy in at least 41 per cent of the certificates
as now presented to the registrar of records of the New York City health
department.
In this 41 per cent we find 2,875 deaths in 1914 attributed to causes that can
be accepted as reliable only after autopsy and 27,995 which are capable of
verification by exact observations, as by chemical, bacteriological, and biological
tests before death, but falling such specific proof, represent no reliable state-
ment of death without autopsy.
^ For the full text of this paper sec the American Journal of Public Health, July, lOlC.
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Bepteml>er 28, 1917 1558
It is proposed to separate the reliable or probably correct statements of
cause of death from the remainder as another step forward in the evolution of
accurate statistics of deaths.
After the discussion of Dr. Emerson's paper the chairman was
authorized to appoint a committee to consider the reliability of the
causes of death as specified in the International List of Causes of
Death. The committee is as follows :
Haven Emerson, chairman.
William H. Guilfoy.
E. H. Lewinski-Convin.
Louis I. Dublin.
Warfield T. Longcope.
Charles Norrls.
W. R. Willlatas.
William H. Davis.
George H. Van Buren, executive secretary.
Meetings, at which the chairman presided, were held in New York
City in November and December, 1915; also in January, February,
March, April, May, and June, 1916.
The committee submitted a report to the section on vital statistics
at the annual meeting of the American Public Health Association at
Cincinnati in October, 1916. The section devoted parts of three of
its sessions to the consideration of this report. At the final meeting
of the section it became evident that there would not be sufficient time
to consider all of the recommendations submitted. It was voted,
therefore, to continue the committee for another year and to instruct
it to submit its recommendations as published in Reprint No. 363
of the Public Health Reports to all members of the section on vital
statistics and to others well qualified to criticize and suggest, with the
request that they give the committee the benefit of their opinions.
This was done. Letters were received from many of those through-
out the country most interested in the subject of classification of
causes of death. The committee desires at this point to express its
thanlcs for the interest manifested in the subject by those who gave
to it of their time and thought. Four meetings of the committee were
required to consider the suggestions which were received.
The present report, therefore, is, in reality, a revised one. It repre-
sents not simply what may now be considered as the preliminary
recommendations resulting from the committee's deliberations of last
year but also its concKisions in the light of criticisms and suggestions
received during 1917 from those who are best qualified to make them.
The committee desires. to express its thanks to the following,
who have made suggestions which have been considered in con-
nection with its report: Dr. Lewcllys F. Barker, Baltimore, Md.;
Dr. C. A. Carter, statistician, Indiana State Board of Health; Dr.
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Charles V. Chapin, superintendent of health, Providence, R. I. ; Dr.
F. S. Criim, assistant statistician, Prudential Insurance Co. of
America; Dr. Arpad C. Gerster, New York Academy of Medicine;
Dr. Juan Guiteras, director of health, Habana, Cuba ; Dr. C. Floyd
Haviland, superintendent Connecticut Hospital for the Insane, Mid-
dletown, Conn.; Dr. J. H. Landis, health officer, Cincinnati, Ohio;
Dr. Howard Lilienthal, New York City; Dr. Grace L. Meigs, Chil-
dren's Bureau ; Dr. Adolph Meyer, psychiatrist in chief, Johns Hop-
kins Hospital; Mr. Aubrey Meyerheim, statistical bureau, Metro-
politan Life Insurance Co.; Dr. A. J. Eosanoflf, Kings Park
State Hospital, Kings Park, N. Y.; Dr. H. H. Shoulders, State
registrar of vital statistics, Nashville, Tenn.; Mr. Benjamin Siegel,
statistical bureau. Metropolitan Life Insurance Co. ; Dr. Charles G.
Wagner, medical superintendent Binghamton State Hospital, Bing-
hamton, N. Y. ; Dr. William A. White, superintendent St. Elizabeth
Hospital, Washington, D. C. ; Dr. W. F. Willcox, college of arts and
sciences, Cornell L^niversity.
The committee was appointed primarily with the idea that it
would make recommendations covering the 189 titles of the Inter-
national List- of Causes of Death with a view to separating them into
two classes :
(a) Those not to be accepted as reliable, without autopsy, or with-
out specific supporting data upon which accurate diagnosis is possible.
(b) Those to be accepted as reliable without autopsy, other veri-
fication, or supporting data.
It was pointed out, however, that as the committee was one on the
accuracy of certified causes of death it should also consider:
(o) The valltlity of lerius iiulmled under each title, i. e., the probabUity
that each term, when reported as a cause of deatli, represents the exact morbid
condition covered by the title lieadiug. It was agree<l that this phase of the
subject be considered secondary to that of determining the question of the
reUability of tlie titles as described above. In the course of the committee's
discussions, however, it frequently became necessary to discuss the question of
reliability on the basis of each included term. This is particularly true of
titles under which are included both diso.ises that are seldom fatal and those
that are surely fatal or In which the prognosis is grave.
(6) The fact that a term's reliability as a statistical entity when reported
as a cause of death depends, not only upon the fact that the disease which it
describes was surely present, but also upon its status as descriptive of the
primary cause of death. As an instance of this there are a number of titles
which the committee might assign to the reliable class, because diagnosis of the
conditions covered by them are certain ; nevertheless, statistics based on these
very returns would be grossly inaccurate, because there would be inaccuracy in
the statement of cause of death through the omission of the primary cause, even
though the terminal condition, and the only one reported, were one that is
reUable without autopsy. It was agreed that this is a phase that has an im-
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portant bearing on what constitutes a reliable statement of cause of death and
that the committee should give it consideration. It was decided, however, that
It should, so far as possible, be discussed as a separate and distinct problem
upon which the committee should make recommendations.
In considering the International List from the viewpoints outlined
above, and in making its recommendations, the committee has been
mindful of the fact that, as is plainly set forth in the " Introductory "
of the manual issued by the Bureau of the Census, " The International
List of Causes of Death makes no pretension of being a proper
nomenclature of diseases, or of including a scientific classification of
diseases. It is only a practical working list whereby statistical com-
pilers can assign medical terms reported by physicians as causes of
death to certain more or less definite titles representing individual
diseases or groups of diseases of similar character." The committee
realizes that such a list necessarily contains many terms that are
unscientific, inaccurate, and indefinite, as well as some that are ob-
solete. It has borne in mind, however, that many of these expressions
are now, and will continue to be, encountered in the practical ex-
perience of registration offices, and that since it is not always prac-
ticable or possible to obtain more satisfactory statements, it is
necessary for registration and compiling offices to use a list like the
International List of Causes of Death in order that such expressions,
together with the definite and scientific terms, may be compiled
uniformly and under th'^ titles which are most likely to cover the
conditions reported. When it recommends, therefore, that titles or
terms in the list be " eliminated " it means that they should not be
mentioned in any official publication of statistical or registration
offices in such a way as to convey to physicians in general the im-
pression that their use is sanctioned by these offices. Whenever it is
necessary to include such terms they should be printed with some
identifying sign to show that they are not approved as statements
of cause of death, as was done in the 1902 Manual of the International
Classification (list) of Causes of Death, issued by the Census Bureau.
The committee does not propose that mortality statistics along the
lines it recommends be substituted for those now published annually.
However, it does believe that additional information should be asked
for upon the death certificate as to whether or not an autopsy was
performed or as to what tost confirmed the diagnosis. Moreover, it
believes that as a purely supplemental study this additional informa-
tion when sufficiently complete should be tabulated to show the num-
ber of deaths compiled on the basis of specific supporting data.
The committee, however, wishes to emphasize the fact that to
secure accuracy of all certified causes of death is absolutely beyond
the power of any statistical bureau at the present time.
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Two educational movements are needed befoi^ this can be ac-^
complished :
(1) The physicians must be educated to ask for post-mortems
when needed to determine the cause of death, and to base their
diagnoses, where possible, upon specific laboratory evidence of the
cause of disease.
(2) The public must be educated to permit post-mortems when
requested to determine the cause of death.
Only by such means can a satisfactory percentage of accuracy in
mortality statistics be obtained.
Moreover, this day of accuracy of certified causes of death should
arrive much sooner for a city, with its hospitals, than for a State,
and much sooner for some States than for others.
The committee, therefore, recommends that the Vital Statistics Sec-
tion indorse the educational propaganda which so clearly shows the
unreliability of so many death returns as now reported; that it
indorse educational propaganda which shows both physicians and
the public the importance of post-mortem examinations and of labo-
ratory aids in diagnosis; that it indorse the proposed changes in the
International List of Causes of Death, together with the reliable
inclusions under each title, and that it advocate the publication of
tables, as a purely supplemental study, showing the number of deaths
compiled on the basis of specific supporting data whenever these
data shall become sufficiently well reported.
The Detailed International List of Causes of Death.
I. — Genkkal Diseases.
1. Typhoid fever.
2. Typhus fever.
3. Relapsing fever.
4. Malaria.
4a. Including: Malarial cachexia.
5. Smallpox.
6. Measles.
7. Scarlet fever.
8. Whooping coQgb.
0. Diphtheria and croup.
9a. Jncludina: Cronp.
10. Influenza.
11. Miliary fever.
12. Asiatic cholera. •
13. Cholera nostras.
14. Dysentery.
15. Plague.
16. Yellow fever.
17. Leprosy.
18. Erysipelas.
19. Other cpidc.nlc diseases.
20. Purulent infection and septicemia.
• 21. Glanders.
22. Anthrax.
I.— Oenebal Diseases— Continued.
23. Rabies.
24. Tetanus.
25. Mycoses.
26. Pellagra.
27. Beriberi.
28. Tuberculosis of tlio lungs.
29. Acute miliary tuberculosis.
30. Tuberculous meningitis.
31. .\bdominal tuberculosis.
32. Potfs disease.
33. White swellings.
34. Tuberculosis of other organs.
35. Disseminated tuberculosis.
30. Rickets.
37. Syphilis.
38. Gonococcus infection.
30. Cancer and other malignant tumors of
the buccal cavity.
40. Cancer and other malignant tumors of
the stomach, liver.
41. Cancer and other malignant tumors of
the peritoneum, intestines, rectum.
42. Cancer and other malignant tumors of
the female genital organs.
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46.
47.
48.
L—Obnkkal DmAns— CoDtlooed.
43. Cancer and other malignant tamors of
the breast.
44. Cancer and other malignant tumors of
the skin.
45. Cancer and other malignant tnmors of
other organs br of organs not
specified.
Other tumors (tumors of the female
genital organs excepted.)
Acute articular rheumatism.
Chronic rheumatism and gout.
49. Scurvy.
60. Diabetes.
51. Exophthalmic goitre.
52. AddifH>n'8 disease.
53. leukemia.
54. Anemia, chlorosis.
65. Other general diseases.
56. Alcoholism (acute or cbroBic).
57. Chronic lead poisoning.
58. Otker chronic occupation poUoDlngi.
59. Other chronic poisonings.
II. — Diseases of the Nrrtous System
AND or THE OBGANB OF SPECIAL SBNSa
60. Encephalitis.
61. Simple meningitis. ,
61a. including: Cerebrospinal ferer.
62. Locomotor ataxia.
03, Other diseases of the spinal cord.
64. Cerebral hemorrhage, appoplexy,
65. Softening of the brain.
66. Paralysis without specified cause.
67. General paralysis of the lnf«ane.
08. Other forms of mental alienation.
69. Epilepsy.
70. ConvulHlons (nonpuerperal).
71. Convulsions of Infants.
72. Chorea.
73. Neuralgia and neuritis.
74. Other diseases of the nervous system.
75. Diseases of the eyes and their annexa.
76. Diseases of the ears.
III. — Diseases of tiik Circulatoby
Systkm.
77. Pericarditis.
78. Acute endocarditis.
79. Organic dlseasos of the heart.
80. Angina pectoris.
81. Dl.«;oasos of the arteries, atheroma,
aneurism, etc.
82. Embolism and thrombosis.
83. Diseases of the veins (varices, hemor-
rhoids, phlebitis, etc..
84. Diseases of the lymphatic system
(lymphangitis, etc.).
85. Hemorrhage; other diseases of the
circulatory system.
lY. — ^DlSBASBS or THE RSSPIBAXOBX
System.
86. Diseases of the nasal fo
87. Diseases of the larynK.
88. Diseases of the thyroid body.
89. Acute bronchitis.
90. Chronic bronchitis.
91. Bronchopneumonia.
92. Pneumonia.
93. Pleurisy.
94. Pulmonary congestion, poimoBsry
apoplexy.
95. Gangrene of the lung.
96. Asthnuu
97. Pulmonary emphysema.
98. Other diseases «f the respAimtMy i^E-
tem (tuberculosis excepted).
y. — ^Diseases or the Dioestits Stsyvic
99. Diseases of the mouth and Bnoexa.
1(X). Diseases of the pharynx.
101. Diseases of the esophagus.
102. Ulcer of the stomach.
103. Other diseases of the stommch (can-
cer excepted).
104. Diarrhea and enteritis (under 2 years).
105. Disrrhea and enteritis (2 yenrs and
orer).
105a. Including: Due to alcoholism.
108. Ankylostomiasis.
107. Intestinal parasites.
108. AppendidUs and typhlitis.
109. Hernia, Intestinal obstmctlofi.
110. Other diseases of the intestines.
111. Acute yellow atrophy of the liyer.
112. Hydatid tumor of the liver.
113. Cirrhosis of the liver.
113a. Including: Due to alcoholism.
114. Biliary calculi.
115. Other diseases of the liver.
116. Diseases of the spleen.
117. Simple peritonitis (nonpuerperal).
118. Other diseases of the digestive system
(cancer and tuberculosis excepted).
VI. — NONVENERBAL DiSEASKS OF THE GENI-
TouRi.NAnv System and Annbxa.
119. Acute nephritis.
120. Bright's disease.
121. Chylurla.
122. Other diseases of the kidneys and
annexa.
123. Calculi of the urinary passages.
124. Diseases of the bladder.
125. Diseases of the urethra, urinary ab-
scess, etc.
126. Diseases of the prostate.
127. Nonvenereal diseases of the malt
genlral organs.
128. Uterine hemorrhage (nonpuerperal). ,
129. Uterine tumor (noncancerous).
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VI.— NON VIWKSBAL DeSEASSS Of THE OlNl-
TOUBINABT StSTEM A3HV ANNEXA-€01ltl
130. Other diseases of the utcrus.
131. Cysts and other tumors of the orary.
132. SalpiDgitis and other diseases of the
female genital organs.
133. Nonpuerperal diseases of the breast
(cancer excepted).
VII. — The Puehperal State.
134. Accidents of pregnancy.
135. Puerperal hemorrhage.
136. Other accidents of labor.
137. Puerporal septicemia.
138. Puerperal albuminuria and corvul-
sions.
130. Puerperal phlegmasia alba dolcns,
emt)olus, sudden death.
140. Following childbirth (not otherwise
defined).
141. Puerperal diseases of the breast.
VIII. — Diseases of the Skin and op the
Cellular Tissue.
142. Gangrene.
143. Furuncle.
144. Acute abscess.
145. Other diseases of the skin and annexa.
IX. — Diseases of the Bones and of the
Organs of Locomotion.
146. Disease of the bones (tuberculosis ex-
cepted).
147. Diseases of the Joints (tuberculosis
and rheumatism excepted).
148. Amputations.
149. Other diseases of the organs of loco-
motion.
X. — Malformations.
150. Congenital malformations (stillbirths
not included).
XI. — Early Infancy.
151. Congenital debility, icterus, and scle-
rema.
152. Other causes peculiar to early Infancy.
153. Lack of care.
XII. — Old Age.
154. Senility.
XIII. — External Causes.
155. Suicide by poison.
150. Suicide by asphyxia.
157. Suicide by hanging or strangulation.
158. Suicide by drowning.
159. Suicide by firearms.
160. Suicide by ctittfng or piercing Instru-
ments.
1C1. Suicide by Jumping from high places.
162. Suicide by crushing.
163. Other suicides.
164. Poisoning by food.
165. Other acute poisonings.
166. Conflagration.
167. Burns (conflagration excepted).
108. Absorption oi deleterious gases (con-
flagration excepted).
160. -Vccidental drowning.
170. Traumatism by firearms.
171. Traumatism by cutting or piercing in-
struments.
172. Traumatism by fall.
173. Traumatism in mines and quarries.
174. Traumatism by machines.
175. Traumatism by other crushing (ve-
hicles, railways, landslides, etc.).
176. Injuries by animals.
177. Starvation.
178. Excessive cold.
179. Effects of heat.
180. Lightning.
181. Electricity (lightning excepted).
182. Homicide by firearms.
183. Homicide by cutting or piercing in-
struments.
184. Homicide by other means.
185. Fractures (cause not specified).
186. Other external violence.
XIV. — Ill-Defined Diseases.
187. Ill-defined organic disease.
188. Sudden death.
189. Cause of death not specified or ill
defined.
In the conclusions which follow relating to each title of the Inter-
national List it is understood that terms marked approved are recom-
mended for use in the United States. It is not intended to imply
that there are no other terms which adequately state the various causes
of death, but for the sake of uniformity and clearness it is believed
that it would be well for physicians, so far as possible, to limit them-
selves in maldng out certificates of death to the use of the terms
marked approved,
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These conclusions, or as many of them as are approved by the
section, will be submitted to the International Commission charged
with the revision of the International List, which will meet in 1919.
CONCLUSIONS.
1. Typhoid Fever.
1. Typhoid fever is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Enteric fever ^ typhoid fever^ typhus abdomi-
nalis,
3. Paratyphoid fever should be transferred to title No. 19 {Other
epidemic diseases),
2. Typhus Fever.
1. Typhus fever is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Typhus exanthematicus^ typhus fever.
3. Tabardillo and Mexican typhus should be transferred to this
title from title No. 10 (Other epidemic diseases).
4. It is recommended that the term " Brill's disease " be included
in a list made up of terms that are no longer acceptable.
3. Relapsing Fever.
1. The title heading should be changed to Relapsing {Spirillum
ohermeieri) fever^ and this statement is a reliable one without au-
topsy only when the statement of the cause of death is accompanied
or supported by a record of the finding of the etiological factor; that
is, the spirillum, (spirochaetal) ohermeieri before death.
2. Of the terms now included under this title heading the follow-
ing only are approved. Recurrent fevcr^ relapsing {spirillum or
spirochaetal) fever,
3. It is the opinion of the committee that a new title in the Inter-
national List should be created under the caption of Malta fever (a
form of prolonged fever due to the micrococcus melifensis) and that
under this new title should be included the terms fehris m^litensisj
Malta feve7\ and Mediterranean fever,
4. Malaria.
1. Malaria is not a reliable statement of cause of death without
the supporting statement that the etiological factor, the plasmodiu/m
malaricB^ was found in the blood before death or at autopsy.
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2. Of the terms now included under this title headmg the follow-
ing only are approved: Estivoautumnal fever y hlaekwater fever^
malarial hemoglobinuria^ malignant tertian malaria^ quartan ma*
larioy tertian malaria,
3, The following term should be added to the list of inchisions:
Palfidism.
5. Smallpox.
1. SmaUpox is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Hemorrhagic smallpox^ malignant smaUpasOy
smallpox, variola.
6. Measles.
1. Measles is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing imly are approved : Hemorrhagic measles^ measles, morbiUi,
3. The term rubeola should be used only as a synonym of German
measles.
7. Scarlet Fever.
1. Scarlet fever is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Nephritis following scarlet fever, scarlatina,
scarlatina angiosa, scarlatina m/zligna, scarlatinal (any disease or
condition so qualified), scarlet fever,
8. Whooping Cough.
1. Whooping cough is a reliable statement of cause of death, with-
out autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Pertussis^ whooping cough,
9. Diphtheria and Cronp.
1. It is recommended that the title be changed to Diphtheria and
that this be regarded as a reliable statement of cause of death,
without autopsy.
2. Of the terms now included under this title heading the follow-
ing ofdy are approved: Buccal diphtheria^ cutaneous diphtheria^
diphtheria of bronchi, diphtheria of conpmctiva, diphtheria of
fauces, diphtheria of larynx, diphtheria of month, diphtheria of nose,
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diphtheria of esophagus^ diphtheria of palate^ diphtheria of pharynx^
diphtheria of skin, diphtheria of tonsil^ diph4^heria of trachea^
diphtheria of vulva^ diphtheria of wound, gangrenous diphtheria
(state site of lesion), nasal diphtheria, postdiphtheritic nephritis.
The terms diphtheritic neuritis, diphtheritic paralysis and post-
diphtheritic neuritis should be accepted only when the nerves or
muscles involved are specified. When possible, the site of the lesion
in the nervous system should be stated.
10. Influenza.
1. It is the recommendatiop of the committee that influenza be
considered unreliable as a statement of cause of death unless con-
firmed by autopsy, with the understanding that an autopsy would
either indicate influenza, or, at least, be negative; that is, would show
no other cause of death.
2. Of the terms now included under this title heading the follow-
ing only are approved : Bronchial influenza, bronchitis due to grip,
bronchopneumonia due to grip, grip, influenza, influenza followed by
pneumonia, influenzal pneumonia, la grippe, pneumonia due to grip,
3. The committee recommends the addition of the term influenzal
meningitis and influenzal encepfvalitis (Wickman) to the list of in-
clusions.
11. Miliary Fever.
1. It is the reconunendation of the committee that miliary fever
be considered unreliable as a statement of cause of death, without
autopsy; that the title be abolished, and that the terms now listed
under it be transferred to the list of terms under title No. 19.
12. Asiatic Cholera.
1. Asiatic cholera is a reliable statement of cause of death, with-
out autopsy.
2. Of the terms now included under this title heading the following
only are approved : Asiatic cholera, cholera (where Asiatic cholera is
prevalent), epidemic cholera (where Asiatic cholera is prevalent).
13. Cholera Nostras.
1. The committee recommends that the title Cholera nostras be
omitted from the International Classification on the ground that it is
merely a symptom of a severe gastrointestinal irritation, from what-
ever cause, and that reports under this title, if encoimtered on death
certificates, be included under titles 104 and 105, according to age
of decedent. The committee, however, is of the opinion that the
present inclusions are all indefinite or obsolete and they are not, there-
fore, approved inclusions under any title heading.
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14. Dysentery.
L Dysentery is not a reliable statement of cause of death unless the
specific cause of infection has been identified.
2. Of the terms now included under this title heading the follow-
ing only are aproved : Amebic dysentery^ hacillary dysentery^ halan-
tidic dysentery^ dysentery^ entamebie dysentery.
8. The committee recommends that the title be subdivided into
(A) Amebic dysentery^ (B) BaciUary dysentery^ and (C) Dysentery ^
unqualified or due to other protozoa. The inclusions under (A) are
Amebic dysentery^ entamebie dysentery; under (B) baciUary dys-
entery; under (C) dysentery (unqualified), balantidic dysentery.
The committee recommends the transfer to this title of the term
tropical abscess of the liver from title No. 115 {Other diseases of the
Uver).
15. PUffne.
1. Plague is a reliable statement of cause of death, without autopsy.
2. Of the terms now included under this title heading the following
only are approved : Bubonic plague, pest, plague, plague (pulmonary
form), plague (septicemic form), pneumonic plague.
16. Tellow Fever.
1. Tellow fever is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the following
(Mily are approved : Febris fiava, yellow fever.
17. Leprosy.
1. Leprosy is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included imder this title heading the following
only are approved: Anesthetic leprosy, leprosy, nodular leprosy,
tubercular leprosy. The location of the lesion should be stated and
all specifications of such location should, of course, be regarded (in
addition to those noted above) as approved inclusions.
is. Erysipelas.
1. This is a reliable statement of cause of death, without autopsy,
inasmuch as autopsy is not necessary to verify the presence of
erysipelas.
It is an unreliable statement of cause of death if there is no
qualifying statement, because the site and occasion of the infection
should be given, particularly in cases of accident or injury.
2. Of the terms now included under this title heading the following
only are approved: Erysipelas after vaccination, erysipelas neona-
torum^ surgical erysipelas, erysipelas of [any site].
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3. The following term should be added to those noted above:
Erysipelas after operation.
4. The note under title No. 18, in so far as it relates to excluded
terms should read :
"This title does not include puerperal erysipelas (137).''
18A. Acute Poliomyelitis. (Tentative title.)
1. It is the opinion of the committee that a new title should be
created (this may, for the present, be designated 18A), and that the
caption should be Acute poliomyelitis. This should be considered a
reliable statement of cause of death, without autopsy. It is the
judgment of the committee that the term epidemic infantile paralysis
may be considered an approved inclusion under this title.
2. The following terms should be transferred from present title
No. 63 to this title: Acute atrophic infantiU paralysis^ acute infantile
paralysis^ acute anterior poliomyelitis^ acute poliomyelitis^ epidemic
poliomyelitis, acute ascending poliomyelitis, acute ascending anterior
polioTnyelitis, acute ascending spinal paralysis, acute polioen-
cephalomyelitis, progressive ascc7iding anterior poliomyelitis.
3. The committee recommends that the term Heine-Mcdin disease
be added to the list of approved inclusions.
18B. Epidemic Cerebrospinal Meningitis. (Tentative title.)
1. It is the opinion of the committee that a new title should be
created (this may, for the present, be designated 18B), and that the
caption should be Epidemic cerebrospinal meningitis. This should
be considered a reliable statement of cause of death, without autopsy,
if the specific organism, namely, the meningococcus, has been recov-
ered from the cerebrospinal fluid.
2. It is the sense of the committee that the terms cerebrospinal
fever, epidemic cerebrospinal meningitis, and meningococcic cerebro-
spinal meningitis be transferred from present title No. 61, subtitle
o, to this title.
18C. Malta Fever. (Tentative title.)
1. It is the opinion of the committee that a new title in the Inter-
national List should be created under the caption of Malta fever (a
form of prolonged fever due to the micrococcus melitensis) and that
under this new title should be included the terms febris melitensis,
Malta fever, aiid Mediterranean fever. This is a reliable cause of
death, without autopsy, if there is an accompanying record of the
finding of the etiological factor {micrococcus melitensis) before
death.
2. The committee recommends that the term undulant fever be
added to the list of approved inclusions.
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19. Other Epidendc Diseases.
1. The inclusions under this title heading cover so many conditions
that no " blanket *' recommendation can be made as to its reliability
or unreliability without autopsy.
2. It is recommended that the caption of the title be changed to
Other endemic^ epidemic^ arid infectious diseases.
3. Of the terms now included under this title heading the follow-
ing only are approved : Chicken pox^ dengue^ dengue fever^ framhesia
(if etiological factor has been found), flariasis (if etiological organ-
ism has been found), German measles^ mumps^ milk sickness^. Pap-
pataci fever^ rotheln^ rubella^ Rocky Mountain spotted fever ^ tick,
bite fever^ trembles {milk sickness)^ varicella^ yaws (if etiological
factor has been found).
4. The committee recommends that the terms Chagas^ disease^
trypanosomiasis am^rncanay epidemic jaundice^ phlebotomus fever^
rat bite fever^ and sandfly fever be added to the list of inclusions.
5. The committee recommends the transfer of the following terms
from other titles to this: Paratyphoid fever from title No. 1 {Typhoid
fever) ; miliary fever^ sweating fever from present title No. 11
{Miliary fever) ; cowpox, vaccinia froni title No. 20 {Purulent in-
fection and septicemia) ; kala-azar from title No. 54; {Anemia^ Chlo-
rosis) ; sleeping sickness^ trypanosomiasis from present title No. 55
{Other general diseases); acute infectious jaundice ^ WeiTs disease
from title No. Ill {Acute yellow atrophy of the liver). Muguet
from title No. 99 {Diseases of the mx)uth and annexa).
6. The committee recommends the transfer of the following inclu-
sions to other titles : Mexican typhus^ tabardiUo to title No. 2 {Typhus
ferer) ; acute parotitis [parotiditis] (not mumps) to title No. 99
{Diseases of the mouth and annexa) ; glandular fever to title No. 189
{Cause of death not specified or ill-defined).
7. The term rubeola should be used only as a synonym of German
measles.
8. It was further voted to recommend that whenever any disease
among the approved inclusions under this title is found to be par-
ticularly prevalent, such disease should be segregated statistically
by a subtitle, and deaths therefrom be separately recorded.
9. Recommended that paratyphoid fever be made a subtitle of this
title, and deaths reported therefrom be separately tabulated.
20. Purulent Infection and Septicemia.
1. The committee recommends that this be considered reliable,
without autopsy, if there is an accompanying statement of the site
and nature of the original infection. The committee also reeom-
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mends that where additional information justifies the assignment of
a death in which septicemia was a factor to other titles (e. g., to No.
137, Puerperal septicemia^ or to any of the titles covering deaths due
to external violence), it should be assigned according to standard
practice.
2. Of the terms now included under this title heading the follow-
ing Only are approved : General sepsis^ general septicemia^ hospital
gangrene, pyemia, pyogenic infection, sepsis, septicemia.
3. Cowpox and vaccinia should be transferred to title No. 19
{Otfier epidemic diseases),
21. Glanders.
1. Glanders is not a reliable statement of cause of death, without
autops}', unless there is an accompanying record of the finding of the
etiological factor; i. e., the hacillus mallei,
2. Of the terms now included rndor this title heading the following
only are approved: Equinia, farcy ^ glanders,
3. The following term should be added to the list of acceptable
inclusions: Infection hy hacillus mallei,
4. The reports should include a statement as to whether the infec-
tion was acquired in the course of occupation or industry.
22. Anthrax.
1. Anthrax is not a reliable statement of cause of death, without
autopsy, without determination of the etiological factor; i. e., the
hacillus anthracis,
2. Of the terms now included under this title heading the following
only are approved : Anthraa\ charhon, malignant pustule, wooUorters^
disease,
3. The following term should be added to the list of acceptable
inclusions: Infection hy hacillus anthracis,
4. The reports sliould include a statement as to whether the infec-
tion was acquired in the course of occupation or industry.
23. Rabies.
1. Rahics is not a reliable statement of cause of death unless veri-
fied by autopsy, or proof that the infecting bite was by a proved
rabid animal.
2. Of the terms now included under this title heading the follow-
ing only are approved : Hydrophobia, hite of mxid dog, rabies,
3. The committee recommends that the term lyssa be added to the
list of inclusions.
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24. TeUnm.
1. The committee recommends that this be considered a reliable
statement of cause of death, without autopsy, when it is accompanied
by information as to date, site, nature, and means of injury.
2. Of the terms now included under this title heading the following
only are approved : Lockjaw^ tetanus^ tetania neonatorum.
25. Mycoses.
1. The committee recommends that this title be considered reliable,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Actinomycosis^ aspergillosis^ blastomycosis^
madura footj mycetoma.^ mycosis^ mycosis fungoidesj sporotrichosis^
streptomycosis.
3. The committee recommends the transfer to this title of the terms
psilosis and spjnie from title No. 110 {Other diseases of the intestines).
4. The committee recommends that the term trench foot be added
to the list of approved inclusions.
26. Pellagra.
1. Pellagra is a reliable statement of cause of death, without
autopsy.
2. Of the terms now under this title heading the following only
is an approved inclusion : Pellagra.
3. The committee voted to note in its report the frequent compli-
cations of pellagra as listed in the manual. They are : Cachexiaj der-
matUiSj diarrhea^ insanity^ suicide.
27. Beriberi.
1. Beriberi is a reliable statement of cause of death, without au-
topsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Benbein^ kalche,
28. Tuberculosis of the Lungs.
1. Tuberculosis of the lungs is a reliable statement of cause of
death, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Chronic phthisis^ chronic pneumonic phthisis^
chrome pneumonic tuberculosis^ chronic tuberculosis^ chronic tuber-
culous pneumonia^ congenital tubercxdosis^ fibroid phthisis^ fibroid
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tuberculosis^ laryngeal tuberculosis j phthisis^ phthisis pulmonalis,
pneumonic phthisis^ pulmonary phthisis^ pulmonary tuberculosis^
tuberculosis^ tuberculosis of bronchi^ tuberculosis of larynx^ tuber-
culosis of lunffj tuberculosis of pleura^ tuberculosis of trachea^
tuberculosis pulm/>nalis, tuberculous bronchitis^ tuberculoids broncho-
pneumonia^ tuberculous empyem/i^ tuberculous hemoptysis^ tuber-
culous hydropneumothorax^ tuberculous laryngitis^ tuberculous
phthisis^ tuberculous pleurisy^ tuberculous pneumonia^ tuberculous
pneumothorax,
29. Acute Miliary Tuberculosis.
1. This is not a reliable statement of cause of death, without
autopsy, unless tubercles have been found in some accessible part of
the body (e. g., the retina) during life.
2. Of the terms now included under this title heading the follow-
ing only are approved: Acute general miliary tuberculosis^ acute
miliary tuberculosis^ general miliary tuberculosis.
30. Tuberculous Meningitis.
1. The committee 1-ecommends that the name of this title be
changed to Tuberculosis of brain and cerebrospinal meninges, and
that it be considered a reliable statement of cause of death, without
autopsy, for children under 10 years of age, but not for decedents
of older groups, unless there is confirmatory bacteriological proof
of the presence of the tubercle bacillus in the spinal fluid.
2. Of the terms now included under this title heading the follow-
ing only are approved: Tuberculosis of brain^ tuberculosis of cere-
bellum^ tuberculosis of cerebral m^eninges^ tuberculosis of cerebro-
spinal meninges^ tuberculosis of cerebrum, tuberculosis of meninges,
tuberculosis of spinal meninges, tuberculous encephalitis, tuberculous
fneningitis, tuberculous inflammation of brain,
3. The following term should be added to the list of acceptable
inclusions : Solitary tubercle of brain,
31. Abdominal Tuberculosis.
1. It is the recommendation of the committee that this be consid-
ered unreliable, without autopsy, unless proof of an abdominal opera-
tion or recovery of tubercle bacillus from the abdominal fluid is
presented.
2. Of the terms now included under this title heading the following
only are approved: Abdominal tuberculosis, intestinal tubci*culosis,
tabes mesenterica, tuberculosis of abdomen, tuberculosis of alimen-
tary canal, tuberculosis of anus, tuberculosis of appendix, tuberculosis
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of intestine^ tuberculosis of viesenteric gland^ tuherculosis of omen-
tum^ tuhereulosis of peritoneum^ tuhcrculosls of rectum^ tuherculosis
of stomachy tuberculous appendicitis^ txtberculous colitisyttiberculotis
enteritis^ tuberculous ileocolitis^ tuberculous peritonitis^ tuberculous
tdcer of bowel, tuberculous ulcer of intestine,
3. The terms tuberculosis of cecum and tuberculosis of retroperi-
toneal lymph nodes should be added to the list of inclusions.
32. Pott's Disease.
1. It is the recommendation of the committee that the name of this
title be changed to Tuberctdosis of the vertebral column^ and that it
be regarded as a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Caries of spine, caries of vertebrae, Potfs
disease, psoas abscess, psoas and lumhar abscess, spinal caries, spinal
tuberculosis, tuberculosis of spinal column, tuberculosis of spine,
tuberculosis of vertebrae, tuberculous abscess of vertebrae, tubercu-
lous caries of sacrum, tuberculous lumbar abscess,
33. White Swellings.
1. The committee recommends that the caption of this title be
changed to Tuberculosis of joints and considers the title in the re-
liable class, without autopsy.
2. Of the terms now included under this title the following only
are approved : Articular tuberculosis, tuberculosis of hip, tuberculosis
of joint, tuberculosis of knee, tuberculous abscess of knee, tuberculosis
arthritis, tubercidous coxalgia, tubercxdous disease of hip, tuber-
ctdous inflammation of knee, tubei'culous swelling of joint, tuber-
culous synovitis.
34. Tuberculosis of Other Organs.
1. The committee recommends that this title be subdivided as
follows: (A) Tuberculosis of the skin and subcutaneous tissue, (B)
Tuberculosis of kidneys and genitourinary system., (C) Tuberculosis
of bones {except vertebral colum^n), (D) Tuberculosis of organs of
special sense, (E) Tuberctdosis of lymphatic system {except mesen-
teric glands), (F) Tuberculosis of other organs,
2. The committee recommends that statements of cause of death
listed imder present title No. 34, which relate to organs or parts of
the body which are accessible to direct vision, be considered reliable,
without autopsy, and that in other cases they be considered unre-
liable, without autopsy.
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3. Under subtitle (A) the approved inclusions are: Lupus, lupus
vulgaris, etc.^
Under subtitle (B) the approved inclusions are: Genitourinary
tuberculosis, etc.^
lender subtitle (C) the approved inclusions are: Osseous tubercu-
losis, etc.^
Under subtitle (D) the approved inclusions are: Ocular tubercu-
losis, etc.^
Under subtitle (E) the approved inclusions are: General glandular
tuberculosis, lymphatic tuberculosis, etc.^
Under subtitle (F) the approved inclusions are: Cold abscess,
ganglionic tuberculosis, etc.*
4. The committee further recommends that a note be added to the
title to the effect that wherever possible the location, extent, and
character of the tuberculous lesion should be specified.
35. Disseminated Tuberculosis.
1. The committee recommends that this be considered a reliable
statement of cause of death, without autopsy.
2. Of the terms now inchided under this title heading the follow-
ing only are approved : Chronic general miliary tuberculosis, chronic
general tuberculosis, chronic miliary tuberculosis, disseminated tuber-
culosis^ general tuberculosis, general tuberculous infection, general-
ized tuberculosis, multiple tuberculosis, systemic tuberculosis,
36. Rickets.
1. The committee recommends that the caption of this title be
changed to Rickets and other softenings of the bones. It considers
the title in the reliable class, without autopsy.
2. Subdivisions are recommended as follows: (A) Rickets, (B)
Other softenings of the bone. Under (A) the approved inclusions
are: Rachitis, rickets; under* (B) they are Mollities ossium, osteo-
malacia.
3. The committee recommends the transfer of achondroplasia,
hypertrophic osteoarthropathy, and puhn/mary osteoarthropathy to
title No. 146 (Diseases of the bones — tuberculosis excepted).
37. Syphilis.
1. It is the conclusion of the committee that Syphilis is not reliable
as a statement of cause of death, without autopsy, unless diagnosis
was based on lesions superficially situated or visible through body
> Where tuberculosis of, or tuberculous abscess of any given tissue Is stated as the cause
of death, and the case is one that is not classifiable under either of titles 28 to 88, It sboiild
be assiicned to one of the six subtitles of title No. 34, according to the anatomical loca-
tion or functional system to which the tissue belongs.
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orifices, or confirmed by unquestioned specific test; further, that
where syphilis is given as a cause of death, a statement of the site,
extent, and character of the lesion should be given.
2. Of the terms now included under this title heading the follow-
ing only are approved : Congenital lues, congenital aypkilis^ gumma
of hrain^ hereditary lueSj hereditary syphilis^ inheinted syphilis, lues
infantum., secondary syphilis, syphilis (unqualified or of any organ
or part of the body), syphilitic (any affection), tertiary syphilis.
3. The term acquired syphilis should be added to the list of
inclusions.
4. The committee reconmiends the transfer of the term hepatitis
of newborn from present title No. 151, subtitle 2 {Congenital debility)
to this title.
38. Gonococcus Infection.
1. The committee considers this an unreliable statement of cause
of death, without autopsy, unless a gonococcic lesion has been demon-
strated by the recovery of the gonococcus from the site of the lesion,
or by specific serum reaction, and unless the lesion was an adequate
cause of death.
2. Of the terms now included under this title heading the following
only are approved: Gonococcic arthritis^ gonococcic endocarditis,
gonococcic infection^ gonococcic ophthalmia, gonococcic peritonitis,
gonococcus infection (of any organ), ophthalmia neonatorum,
3. The following terms should be added to the list of inclusions:
Gonococcic salpingitis, gonoccoccir septicemia.
Conclusions on Prefatory Note on Cancers and Qther Malignant Tumors.
1. The caption of this prefatory note should be changed to Forms
of tumors and subdivided into (A) Cancers and other malignant
tumars and (B) Nonmalignant tumors.
2. Under (A) the following terms should be retained as acceptable
inclusions: Adenocarcinoma, alveolar cancer, alveolar sarcoma, angio-
sarcoma, cancer, carcinoma, carcinama myxomatodes, chondrosar-
coma, colloid carcinoma, columnar-celled carcinoma, cystosarcoma,
endothelioma, epithelioma, fibrosarcoma, giant-celled sarcoma, hem-
endothelioma, hypernephroma, hjmphendothelioma, lymphosarcoma,
malignant tumor, melanosarcoma, metastatic cancer, myeloid sarcoma,
myxosarcoma, osteosarcoma, papuliferous carcinoma, plexiform sar-
coma, sarcoma, scirrhous carcinoma.
3. The committee recommends that the following terms be added
to the above list : Multiple myeloma, gliosarcoma, liposarcoma, myo-
sarcoma, chorioepithelioma,
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4. All terms now included in the list of Cancers and other TnaHg-
nant tumors^ on page 63 of the Manual of the International List of
Cause of Death, except those noted above, should be eliminated.
5. Under (B) Nonmalignant tumora^ the following terms (now
included under present title No. 46, on pp. 66-67 of the Manual)
should be retained as acceptable inclusions: Adenofhroma^ adenoma,
adenomyjcornay angioma^ cavei^ruyus lymphangiomOj cavernous nevus^
chondroma^ cystadenoma^ cystic hygroma^ cystic lymphangioma^
cystoma^ dermoid cystj enchondroma^ myoma, myxochondroma, m^yxo-
fibroma^ Tnyjcoina^ neurofhroma^ fibroid, fibroid tumor, fibrolipom/in
fibroma, fibroma molluscum, ganglionic neuroma, glioma^ hemangi-
oma, he^natoma (nontraumatic), leiomyoma, lipoma, lymphangioma,
lymphatic nevus, lymphoma, papilloma, rhabdomyoma, sebaceous
cyst, sebaceous tumor, teratoma, tumor (nonmalignant or unqualied}.
6. The committee recommends that the following terms be added
to the above list: Adenomyoma, cholesteatoma, chordoma, melanoma^
neuroma, osteoma, odontoma, xanthoma.
39. Cancer and Other Malignant Tumors of the Buccal Cavity.
1. The committee considers this title to be in the reliable class,
without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Cancer and other malignant tumors of buccal
cavity, cheek, gum, jaw, lip, maxilla, mouth, palate, salivary gland,
soft palate, tongue, tonsil.
40. Cancer and Other Malignant Tumors of the Stomachy Liver.
1. It is the opinion of the committee that reports of cause of death
listed under this title are unreliable, without autopsy, unless an oper-
ation was performed or the neoplasm was otherwise visible or acces-
sible for direct observation.
2. Of the terms now included under this title heading the following
only are approved : Cancer and other malignant tumors of bile duct^
cardiac orifice of stomach, gall bladder, gall duct, liver, esophagus^
pharynx, pylorus, stomach, and carcinoma ventriculL
41. Cancer and Other Malignant Tnmors of the Peritoneam* Intestines,
Rectum.
1. It is the opinion of the committee that reports of cause of death
listed under this title are unreliable, without autopsy, unless an
operation was performed or the neoplasm was otherwise visible or
accessible for direct observation.
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2. Of the terms now included under this title heading the following
only are approved: Cancer and other malignant tumors of anus^
appendix^ cecum^ colon^ duodenitm^ ileum, intestine, jejunum, mesen-
tery, omentum, peritoneum, rectum, retroperitoneal gland, sigmoid
-flexure, and lymphosarcoma of jyeritoneum,
3. The following terms, in the opinion of the committee, should
be added to the above list of inclusions : Cancer of mesenteric gland,
cancer of retroperitoneal space,
42. Cancer and Other Malignant Tumors of the Female Grenital Organs.
1. It is the opinion of the committee that reports of cause of death
listed under this title are imreliable, without autopsy, unless an oper-
ation was performed or ther^eoplasm was otherwise visible or acces-
sible for direct observation.
2. Of the terms now included under this title heading the following
only are approved: Cancer and other malignant tumors of broad
ligament, cervix, fallopian ttihe, ovary, uterine ligament, uterus,
vagina, vulva, chorioepithelioma, deciduoma malignum, and syncy-
tioma.
3. The committee recommends the transfer of the following terms
now included imder this title : Hydatid mole and hydatidiform mole
to title No. 134 (Accidents of pregnancy).
43. Cancer and Other Malignant Tumors of the Breast.
1. It is the opinion of the committee that this title should be placed
in the reliable class, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Cancer and other malignant tumors of tlie
breast, mammary gland, nipple; cancer en culrasse,
3. The committee recommends the transfer to this title of the term
Pagefs disease of nipple from present title No. 133 {Nonpuerperal
diseases of the breast).
44. Cancer and Other Malignant Tumors of the Skin.
1. The committee recommends that the terms assignable to this
title be regarded as reliable, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Cancer and other malignant tumors of auricle
(of ear), chin, ear, face, head, nose, scalp, skin, umbilicus ; epithelial
tum,or (location not indicated), epithelioma (location not indicated),
rodent ulcer. -
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45. Cancer and Other Malignant Tumors of Other Organs or of Organs Not
Specified.
1. It is the opinion of the committee that reports of cause of death
listed under this title are not reliable, without autopsy, unless an
operation was performed or the neoplasm was otherwise visible, or
accessible for direct observation.
2. Of the terms now included under this title heading the following
only are approved: General caf^cinomatosis^ general sarcomato^is,
miliary carcinosis^ multiple cancer (accept, but query for type,) «arc^-
7nat08is (unqualified) ; also cancers of organs or parts of the body not
included in titles 39 to H^ if the seat of the cancer is definitely de-
scribed in the statement of cause of death.
46. Other Tumors (Tumors of the Female Genital Organs Eh^cepted).
1. The committee recommends that the name of this title be
changed to Benign tumors (site ill-defined or not stated), that it be
considered in the unreliable class, without autopsy, unless an opera-
tion was performed, and that to the footnote in the manual beginning
with "This title does not include" be added tumors of the female
genital organs.
2. Of the terms now included under this title heading the follow-
ing only are approved : Tumor ^ rcith location not stated; tumor of
abdomen^ ax^illcy blood vessel^ chesty connective tissuej gland, hip,
mediastinal gland^ mediastinufiij muscle, neck, thorax,
3. The inclusions under " Forms of tumor," pages 66 to 67 of the
Manual of the International List of Causes of Death, so far as ap-
proved, are referred to the new prefatory note on nonmalignant
tumors recommended in this report.
47. Acute Articular Rheumatism.
1. The committee recommends that the name of this title be
changed to Acute rheumatic fever and that it be considered a reliable
statement of cause of death, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Acute articular rheumatism, acute rheumatic
arthritis^ acute rheumatic fever, rheumatic arthritis, rheumatic car-
ditis,^ rheumatic endocarditis,^ rheumutic fever, rheumatic m,yO'
carditis,^ rheumatic pancarditis,^ rhemnatic pericarditis, rheumatic
pleurisy.
3. The committee recommends the transfer of Schonlein^s disease
to title No. 55 {Other general diseases).
^ The cardiac lesions doe to acute rheumatic iDflammatlon and not the chronic soqaella}
arc referred to by these inclusions.
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48i Chronic Rheumatism and Gout.
1. If is the recommendation of the committee that this title be
changed to Chronic arthritis and gout and be subdivided into (A)
Chronio arthritis and (B) Gout, Each is unreliable, without autopsy.
2. The following terms are approved inclusions for A: Arthritis
deformans^ chronic articular rheumatism^ chronic inflammatory rheu-
matism, chronic rheumatic arthritis^ chronic rheumatism^ chronic
rheumatoid arthritis^ Heberden^s disease, osteoarthritis^ rheumatoid
arthritis, spondylitis deformans.
3. The committee recommends that the terms chranic infectious
arthritis and chronic hypertrophic osteoarthritis be added to the list
of inclusions under subtitle A.
4. The following terms are approved inclusions for subtitle B:
Gout, gout of joint, gouty iritis, gouty synovitis, podagra,
49. Scurvy.
1. The committee considers this title in the reliable class, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Barlow^s disease, infantile scurvy, scorbutus,
scurvy.
3. The committee recommends that Werlhofs disease be trans-
ferred to title No. 55 {Other general diseases).
50. Diabetes.
1. The committee recommends that this title be considered a cause
of death that is reliable, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Acidosis (diabetic), diabetes, diabetes mel-
litus, diabetic coma, diabetic gangrene.
51. Exophthalmic Goiter.
1. The committee recommends that this title be discontinued (see
new tentative title to follow).
51A. Diseases of the Thyroid Gland. (Tentative title.)
1. The committee recommends that this title be transferred to
Class I {General diseases) from its present place under Class IV,
and that it be considered reliable, with autopsy.
2. Of the terms now included under this title the following only
are approved: Adenoma of thyroid gland, atrophy of thyroid gland,
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Ba8€dow^8 disease^ colloid gaiter^ cystic goiter^ cretinism^ cretinoid
degeneration^ endemic cretinism^ endemic deaf-mutism^ enlaraemenf
cf thyroid^ exophthalmic goiter^ hypothyroidism^ myxedema^ pachy-
dermic cachexia^ Parry^% disease^ sporadic cretinism.
8. The committee recommends that deaths reported from exoph-
thalmic goiter and synonymous terms be separately recorded, consti-
tuting a subtitle under this heading.
51B. Diseases of the Thymus Gland. (Tentative title.)
1. The committee recommends that a new title be created with thr
above caption; that it be given a place among the titles under tht
class of General diseases. The statements of cause of death under
this title should be considered unreliable, without autopsy.
2. It further recommends that the following terms be transferred
from present title No. 84 {Diseases of the lymphatic system"^:
Atrophy of thymus,^ lymphatism^ status lymphaticus^ staftts thy-
micolymphaticus^ thymic asthma^ status thymicus^ enlargement of
thymus glandj persistent thymus gland.
51C. Diseases of the Parathyroid. (Tentative title.)
1. The committee recommends that a new title be created with the
above caption; that it be given a place among the titles under the
class of General diseases. The statement of cause of death under this
title should be considered n^liable, witliout autopsy.
2. It further recommends that under this title be included the term
tetany, now under title No. 74 (Other diseases of the nervous system)*
Specify if following operative procedure.
52. Addison's Disease.
1. The committee considers this title in the class that is reliable,
without autopsy. It recommends that the title heading be Disease
of the adrenal glands.
2. Of the terms now included under this title heading the follow-
ing only is approved: Addison'^s disease.
52A. Diseases of Pituitary Body. (Tentative title.)
1. The committee recommends that a new title be created with the
above caption; that it be given a place among the titles under the
class of Gcneial diseases. The statements of cause of death under
this title should be considered unreliable, without autopsy.
2. It further recommends that the following inclusions be ap-
proved: Acromegaly^ dyspituitartsm^ gigantism^ hyperpituitarism^
hypopituitarism, tumor of pituitary body.
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52B. DiseMes of the Spleen.
1. This title is placed hei-e tentatively pending action on the com-
mittee's recommendation that it be transferred to this class from
Class V {Diseases of the digestive system). See recommendation
under present title No. 116. This statement of cause of death is
considered unreliable, without autopsy or operation.
2. Of the terms now included under this title heading the follow-
ing only are approved: Enlargement of spleen (nonmalarial),
megalosplenia (nonjnvAvivmX) ^ tumor of spleen (nonmalignant).
3. The committee recommends the addition of the term spleno-
megaly (nonmalarial).
4. The committee recommends the transfer of BantVs disease and
splenic anemia to this title from title No. 64 (Anemia^ chlorosis).
5. The committee recommends the transfer of the term hydatid
cyst of spleen to title 107, the new tentative title of which is Diseases
due to parasitic worms.
53. Leukemia.
1. It is the opinion of the committee that the statement of Leu-
keima as a cause of death should not be considered reliable, unless
verified by confirmatory blood examination.
2. Of the terms now under this title heading the following only
is an approved inclusion : Leukemia.
3. The committee recommends that the following terms be added
to the list of inclusions : Acute lymphocytic leukemia^ acute lymphoid
leukemia^ chronic lymphocytic leukemia^ chronic lyTnphoid leukemia,
acute myelocytic leukemia^ acute myeloid leukemia^ chronic myelo-
cytic leukemia, chronic myeloid leukemia, lymphochloroma,
Tnyeloch loroma.
4. The committee recommends that EodgkiiCs disease with its
synonyms be accorded a separate title in the International List (see
next title).
53A. Hodgkin's Disease. (Tentative title.)
1. The title is accorded this position tentatively (see recommenda-
tion under title No. 53). This title is unreliable, without autopsy,
unless accompanied by a record of microscopic proof of the char-
acter of the lesion, as shown by specimens removed from the tumor
or tumors during life.
2. The committee recommends that the following terms be listed
as inclusions under this title heading: Lymphadenia^ hjmphadenomih
lymphadenoma of lymphatic glands^ lymphadenoma of spleen^ lym-
phadenosis, malignant hj m phaihno^ma^ midtiph lymphadenoma,
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54. Anemim, Chlorosis.
1. It is the opinion of the committee that statements of death from
anemia or chlorosis should not be considered reliable, without au-
topsy, unless supported by confirmatory blood examination.
2. Of the terms now included under this title heading the follow-
ing only are approved: Anemia^ chlorosis^ pernicious anemia^ pro-
gressive anemia.
3. In the opinion of ths committee the terms hemolytic anemia^
posthemorrhagic anemia^ aplastic anemia^ and progressive pernicious
anemia should be added to the list of inclusions.
4. It is the opinion of the committee that the following terms now
included under this title should be transferred: Banti's disease and
splenic anemia to the tentative new title No. 52B (Diseases of the
spleen)^ kala-agar to title No. 19, the proposed caption of which is
Other epidemic^ endemic^ and infectious diseases,
55. Other Creneral Diseases.
1. The title includes so many and such unrelated conditions that
no recommendation is made as to its reliability or unreliability, with-
out autopsy.
2. Of the terms now included imder this title heading the follow-
ing only are approved: Acidosis (nondiabetic), adiposis dolorosa^
chronic polycythemia, diahetes insipidus, hemochromatosis^ hemo-
philia, hemophilia neonatoruju, Ilenoch^s purpura^ crhronosis^ poly-
cythemia, purpura, purpura rheumatica, sul ph< jnoglohinemut,
3. The committee recommends the following transfers of included
terms: Acromegaly to new tentative title No. r»2A Discmcs of the
pituitary hody; methemoglohinvmia to title No. 1(58 {Absorption of
deleterious gases — Confag ration crrrpted) ; sin ping sirkjuss and
trypanosomiasis to title No. 10 {Other epideinic disensis),
4. The committee has recommended the transfer to this title of
Srhonlein^s disease from title No. 47 {Acute articular rheumatism)^
of Werlhofs disease from title No. 49 (Scurry)^ of amyloid degene-
ration of liver, amyloid liver, lardareous degeni lation of liver, tarda-
ceous liver, large wa*ry liver, waxy degeneration of liver, waxy liver
from title No. 113 {('irr hotels of the liver), amyloid deg< ncration of
kid Hi y^ lardan ous d( g( nrration of kidney, xra,ry dt generation of
kid my from title No. 120 (I* eighths dii<ease), hemophilia jieonatontm
from title No. 152 {Other diseants of early infancy).
56. Alcoholism (Acute or Chronic).
1. The coininittee rorominends that this title be considered reliable,
without autop>y.
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2. The committee approved the following inclusions: Alcohol
ptmoning^ alcoholic delirium^ delirium tremens^ dipsomania^ ethy-
lisni^ mania a potUj temulentia.
3. The committee suggests the addition to the list of inclusions of
the terms acute alcoholism^ alcoholic psychosis^ acute ethylism. and
chronic alcoholism.
4. It is the recommendation of the committee that the terms alco-
holic neuritis and alcoholic polyneuritis be transferred to this title
from present title No. 73 {Neuralgia and neuritis) ^ and that alcoholic
edema of brain and alcoholic wet brain be transferred from title No.
64 {Cerebral hemorrhage^ apoplexy),
57. Chronic Lead Poisonhif •
1. The committee recommends that chronic lead poisoning be re-
garded as reliable, without autopsy, if there appears a statement of
an occupation in which decedent would be subject to lead poisoning,
or if the source of the poisoning is specified and complications accom-
panying, sufficient to cause death, are described.
2. Of the terms now included under this title heading the following
only are approved: Chronic lead poisoning^ colica pictonwmy lead
cachexia^ lead oolicj lead encephalitis, lead encephalc(pathy, lead
paralysis, lead poisoning (not acute), morbus pictorum, painters*
colic, plumhism, saturnism.
3. The committee recommends the addition of the following terms
to the list of inclusions: Lead gout, lead nephritis.
58. Other Chronic Occupation Poisonin^^
1. The committee considers this title reliable, without autopsy, only
in cases where the occupation or source of poison is specified and it
is indicated that the poison was absorbed as a result of occupation;
or the characteristic lesions are superficially located or accessible to
direct inspection; or there is chemical or microscopic proof of the
presence of poison within the body.
2. The committee did not formally approve as inclusions any of
the terms which now appear under title 58; the great majority of
those now listed in the Manual of the International List of Causes of
Death are approved.
59. Other Chrmik PotBonings.
1. The committee considers this title reliable, without autopsy, only
when the source of the poison is specified, or when there is chemical
or microscopic proof of the presence of the poison within the body.
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2. The committee did not formally approve as inclusions any of the
terms which now appear under title No. 59; the great majority of
those now listed in the Manual of the International List of Causes of
Death are approved.
60. Encephalitis.
1. The committee recommends that the caption of this title be
changed to Abscess of brain. It is not reliable, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Abscess of brain, abscess of cerebellmn, ah*
scess of pons Varolii, encephalitis, inflammation of brain, intracranial
abscess, suppurative encephalitis,
3. The transfer of the terms traumatic encephalitis and traumatic
inflammation of brain to title No. 186 {Other external violence) is
recommended.
61. Simple Meningitis.
1. It is recommended that the name of this title be changed to
Acute infectious meningitis and as such be considered reliable, with-
out autopsy, only when the infecting organism is declared, or witli
autopsy, and that where the death is the result of a trauma or a lesion
elsewhere that it be referred to its appropriate heading according to
standard practice.
2. It is recommended that the present subtitle 3 {Cerebrospinal
fever) be transferred to Class I, under the title Epidemic cerebro*
spinal meningitis, (See tentative title 18B.)
3. Of the terms now included under present subtitle 1 {Simple
meningitis) the following only are approved inclusions: Cerebral
meningitis, cerelrral pachymeningitis, cervical pachymeningitis,
chronic cerebrospinal meninigitis, infectious meningitis,^ internal
pachymeningitis, pachymeningitis, pncumococcic meningitis, puru-
lent meningitis, suppurative meningitis,
4. The committee recommends the addition of the following terms
to subtitle 1: Pachymeningitis externa, pachymeningitis interna
hemorrhagica, pachymeningitis externa suppurativa, pachyineninr
gitis interna suppurativa, leptomeningitis suppurativa, suppurative
cerebrospinal meningitis, pncumococcic cerebrospinal mejiingitii,
slreptococclc cerebrospinal meningitis,
5. Of the terms now included under present subtitle 2 {Cerebro-
spinal meningitis — undefined) the following only are approved:
Acute cerebrospinal meningitis, cerebrospinal meningitis,
1 If infectious meningitis Is used as a synonym of acute infectious meninffUis tbc in-
fectious organism must be indicated.
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6. The committee recommends the transfer to this title of the term
hemorrhagic pachymeningitis from title No. 64 {cerebral hemor-
rhage^ apoplexy).
7. The note in the Manual of the International List of Causes of
Death under title No. 61 should be chai^^ed by adding epidemic cere-
hrospinal meningitis and sypJdlUic meningitis.
62. Locomotor Ataxia*
1. The committee recommends that Locomotor ataxia be considered
reliable only when accompanied by a statement of the contributing
and determining cause of death.
2. Of the terms now included under this title heading the following
only are approved : Locomotor ata^eia^ tabes dorsalis.
3. The committee recommends the transfer of the terra Duchenne'^s
disease to title No. 63 {Other diseases of the spinal cord).
63. Other DiseasoB of the Spinal Cord.^
1. The committee recommends that this title with all its inclusions
be placed in the unreliable class, without autopsy.
2. It is recommended that a new title be created, Acute poliomye-
litis. (See tentative title No. 18A.)
3. Of the terms now included under this title heading the follow-
ing only are approved: Acute ascending myelitis^ acute myelitis^
amyotrophic lateral sclerosis^ amyotrophic paralysts^ combined
sclerosis of spinal cord^ disseminated cerebrospinal sclerosis^ dis-
seminated myelitis^ disseminated sclerosis^ disseminated sclerosis of
spinal cord^ ErVs disease^ Friedreich'^s ataxia^ Friedreich's disease^
Broton-Sequard's paralysis^ bulbar paralysis^ Charcot's disease^
chronic myelitis^ myelitis^ myelitis from pressure, myelitis of spinal
c^rdj new growth of membrane of spinal cord (nonmalignant), new
growth of spinal cord (nonmalignant), paralysis agitans^ Parkinson's
disease, primary lateral sclerosis, progressive bulbar paralysis, pro-
gressive multiple paralysis, progressive muscular atrophy, progres-
sive muscular dystrophy, hematomyeHa, hematomyeUtis, hemator-
rhachis, hemorrhage of spinal cord, hemorrhage of spinal membrane,
hereditary ataxia, hereditary spastic paraplegia, labioglossolat^yngeal
paralysis, labioglossopharyngeal paralysis, Landry's disease, Lan-
dry's paralysis, lateral sclerosis, Morvan's disease, multiple sclerosis,
syringomyelia^ transverse myelitis, pseudohypertrophic paralysis,
spastic paralysis of spinal cord, spastic spinal paralysis, trembling
paralysis, tumor of spinal cord, tumor of spinal meninges.
^EzcIuslTe of acatc poliomyelitis (epidemic Infantile paralysis).
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4. The committee recommends the addition of the following terms:
Hereditary spinal ataxia^ Friedreich/s or combined syntemic disea»e^
progressive spinal amyotrophy^ Broxcn-Seqnard^s syndrome,
5. The committe recommends the transfer to this title of Du-
chenne^s disease from title No. 62 (Locomotor ataxia).
6. The committee rec(^mmends the transfer of the following terms
now included to other titles: Acute anterior poliomyelitis^ acute
atrophia spinal paralysis, acute infantile paralysis^ acute ascending
poliomyelitis^ acute ascending anterior poliomyelitis^ acute ascending
spinal paralysis, acute polioencephalomyelitisy progressive ascending
anterior jwliomyelitis, anterior poliomyelitis to new tentrftive title
18A; viyasthcjiia gravis to title No. 149 (the proposed caption of
which is Diseases of the muscles, tendons, and their anncxa).
64. Cerebral Hemorrluige, Apoplexy* ,
1. It is i^ecommended that the name of this title be changed to
Intracranial hemorrhage^ and that it include terms indicating the
various anatomico-pathological processes that bring about the apo-
plectic death ; if the contributing preexisting conditions or lesions are
stated, statistical assignment according to standard practice is recom-
mended; also that the title be placed in the reliable class, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Apoplectic stroke^ apoplexy,^ apoplexy of
brain, apoplexy of meninges, bulbar apoplexy, bulbar hemorrhage,
cerebral apoplexy, cerebral hemorrhage^ {Im-]-), epidural hemor-
rhage, hematoma of dura mater, hematoma of meninges, hemorrhage
of brain^ {lm-\-), hemorrhage of cerebellum, hemorrhage of cere-
brum^ hemorrhage of medulla, hemorrhage of meninges, hemorrhage
of pons^ intracranial hemorrhage, paralytic shock, paralytic stroke,
pontine hemorrhage, ventricular hemorrhage.
3. The committee recommends the following transfers of included
terms: Ahoholic edema of brain, alcoholic wet brain to title No. 50
{Alcoholism, acute or chronic); hemorrhagic pachymeningitis to
title No. 61, the present caption of which is Simple meningitis.
65. Softening of the Brain.
1. Tt is recomnicndcMl that this title be eliminated as a main title
nnd that the terms now classified under it l)e transferred to title
No. 74 {Other disdjses of the nervous sysf< m).
2. Of the terms nr)w included under this title heading the follow-
ing onlv are approved : Cerebral softening, encephalomalacia, soften-
* iH'attiH of Infantn undor 1 month of ntce arc nwilfni^^ to titio No. lo'J, nubtltle 1 (/«.
JmHcb at birth i.
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ing of hrcdn. These should be queried when received by registration
offices or by the Bureau of the Census to determine whether they
were not actually cases of general paresis of the insane, in which
event they should be listed under title No. 67 {General paralysis of
the insane) ; inquiry should also be made to determine if the condi-
tion was due to arteriosclerosis^ embolism, thrombosis, alcoholism^
traumatism^ or to any other discernible cause.
66. Paralysis Without Specified Cause.
1. It is recommended that title No. 66 be in the unreliable class,
without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Congenital hemiplegia, hemiplegia.
3. The committee recommends that reports of paraplegia be
queried unless specified as of spinal origin.
4. It is recommended that hereditary hemiplegia be added to the
list of approved inclusions.
67. General Paralysis of the Insane.
1. This is in the reliable class, without autopsy, provided it is ac-
companied by a statement of the contributing and determining cause.
2. Of the terms now included under this title heading the follow-
ing only are approved : Bayles^s disease, dementia paralytica^ general
paralysis (insane or reported from asylum), general paresis, general
tubetic paralysis, generalized paralysis {insane), paralysis of insane,
paretic dementia, progressive general paralysis.
3. The committee recommends the addition of the terms chronio
diffxise meningoencephalitis, and taboparesis.
68. Other Forms of Mental Alienation.
1. This is in the unreliable class, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Circular insanity, dementia, dementia praecox^
exhaustive psychosis, infective psychosis, Korsakoff's disease, Kor-
sakoff's syndrome, manic depressive psychosis, paranoia, primary
dementiaj terminal dementia, toxic psychosis, traumatic psychosis.
3. It is recommended that the term schizophrenia be added to the
list of inclusions.
69. Epilepsy.
1. Epilepsy is an unreliable statement of cause of death, without
autopsy, unless death occurred in an epileptic attack and was wit-
nessed, and there was a previous history of epilepsy.
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2. Of the terms now included under this title heading the follow-
ing only are approved : Epilepsy^ epileptic convulsions^ epileptic de-
inentia^ epileptic psychosis^ grand mal^ status epUepticus.
3. The committee recommends that the term idiopathic epilepsy
be added to the list of inclusions.
70. Convulsions (Nonpuerperal). — 71. Convulsions of Infants.
1. The committee recommends that these titles and included terms
be transferred to title No. 189 {Cause of death not specified or ill-
defined).
2. The following inclusions are approved for this transfer: Con-
vulsionSj infantile convulsions, spasms.
72. Chorea.
1. Chorea is a reliable statement of cause of death, without autopsy.
2. Of the terms now included under this title heading the following
only are approved : Chorea^ chorea insaniens, chorea major^ rheumatic
chorea^ Sydenham's chorea.
3. The committee recommends that electric chorea be added to the
list of inclusions.
73. Neuralgria and Neuritis.
1. It is recommended that the term Neuralgia be omitted from the
title and be included under title No. 189 {Cause of death not specified
or ill-defined) and that Neuritis be considered a reliable statement of
cause of death, without autopsy, preferably with statement of the
nerve or nerves involved and of the etiological factor.
2. Of the terms now included under this title heading the follow-
ing only are approved : General neuritis^ multiple neuritis^ neuritis
(of any nerve) ^ peripheral neuritis j polyneuritis.
3. The committee recommends the transfer of alcoholic neuritis
and alcoholic polyneuritis to title No. 56 {Alcoholisnfi^ acute and
chronic). The transfer of tic douloureux and trigeminal neuralgia
to title No. 74 is recommended.
4. The committee recommends the transfer to this title of the terms
paralysis of diaphragm^ paralysis of phrciuc ncrve^ and paralysis of
pneumogastnc nerve from title No. 74 {Other diseases of the nervous
system) .
5. The committee recommends that the term infectious nettritis be
added to the list of inchisions.
6. It is further recommended that registration offices and the
Bureau of the Census query returns of neuritis and its synonyms to
determine the nerve or nerves involved and the etiological factor.
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74. Other Diseases of the Nervous System.
1. The inclusions under this title heading cover so many condi-
tions that no "blanket" recommendation can be made as to its
reliability or unreliability without autopsy.
2. Of the terms now included imder this title heading the follow-
ing only are approved: Acute hydrocephalus^ acf/nhed hydro-
cephahiSy cerebellar tmnor^ cerebral cyat, cerebral dipleyia
of children^ cerebral glioma^ cerebral tumor^ chronic j)rogre88ive
chorea (Huntington's chorea)^ cyst of brain^ cyst of cerebellum^ cyst
of membrane of brain^ cystic tumor of brain, diffuse cerebral sclerosis,
glioma of brain, glioma of cerebellum, hereditary chorea, Hunting-
ton's chorea. Hunting ton^s disease, infantile cerebral diplegia, in-
fantile cerebral paralysis, infantile imbecility, infantile spastic
paralysis, internal hydrocephalus, intracranial tumor, Jacksonian
epilepsy, Little^s disease, meningeal tumor, ntw groirth of brain
(nonmalignant), new growth of membrane of brain (nonmalignant),
paramyoclonus multiplex, polioencephalitis inferior, polioenceph-
alitis superior, psammojna, symptomatic epilepsy, traumatic epilepsy,
tumor of brain, tumor of corpora quadrigemina, tumor of meninges,
tumor of meninges of brain, tumor of motor tract, tumor of nerve,
tumor of pans Varolii,
3. The committee recommends the addition to the list of inclu-
sions of the following terms: Lobular cerebral scUrosk, von Reck-
linghausen'^s disease, polioencephalitis superior (Wernicke).
4. The committee recommends the transfer to this title of the fol-
lowing: No. 65 (Softening of the brain), all inclusions; fie doulou-
reux, and trigeminal neuralgia from No. 73; myotonia congenita and
Thomsen's disease from present title No. 149 (Other diseases of the
organs of loeoniotion).
5. The committee recommends the transfer of the following inclu-
sions to other titles: Cretinism to new tentative title No. 51 A (Dis-
eases of the thyroid gland); systicerus of brain and hydnfld of
brain to title No. 107, the new tentative caption of which is Dis-
eases due to other parasitic worms; paralysis of diaphragm, par-
alysis of phrenic Turve, paralysis of pneumogastric nerve to title
No. 73 (now Neuralgia and neuritis, but the committee has recom-
mended that it be changed to Neuritis) ; tetany to new tentative title
5lC (Diseases of the parathyroid) ; tumor of pituitary body to new
tentative title No. 52 A (Diseases of the pituitary body) ; Caisson dis-
ease, bends, divers^ pulsy, divers'^ paralysis to a new title to be known
as Caisson disease and which, for the present, may be designated 74A.
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7iA. CfttMon Disease. (Tentatiiw tide.)
1. Tbe cooimittee recommeods that a riew title be caeetAed under
the above caption and that under it be Included the fallowing teraiB
now listed under title No. 74 (Other diseases of the nervovs system):
Bends^ caisson dise^ise^ divers'* palsy ^ divers* paralysis.
2. The committee recommends the inclusion of this title in the re-
liable class, without autopsy, if the character of the work during
which the disease was acquired is specified, and if the deadi occurs
within six hours after the release from pressure.
75. Diseases of the Eyes and Their Aiuiexa.
1. The committee recommends that this title be oonsid»:ed rdiable,
without autopsy.
2. It is the opinion of the committee that glaiueoma^ abscess of
cornea^ cataract^ and ophthalTnia are the only terms now listed under
this title heading that ^<)uld be approved.
76. Diseases of the Ears.
1. The conditions covered by this title are, Avhen reported in defi-
nite terms, reliable, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Caries of middle ear^ l<ibyrinthinc suppura-
tion, labyrinthine vertigo, otitis media, purulent otitis media, sup-
purative otitis m^dia, , . .. •
3. The committee recommends that the following terms be added
to the list of inclusions: Acute suppurative mastoiditis, chronic sup-
purative m^astoiditis, acute suppurative otitis m^ia, chronic suppu-
rative otitis m^dia^ otitic meningitis.
4. The committee recommends the transfer to this title of the
following terms : Abscess of mastoid process, disease of nuzstoid cells,
empyema of nuistoid process, mastoid abscess, mastoiditis, necrosis of
m^astoid — all from title No. 146 {Diseases of the boTies — tuberculosis
excepted) .
5. The footnote should contain a statement to the effect that where,
on inquiry, either tuberculosis or sypMlis is admitted as the etiologi-
cal factor the death should be compiled as due to tubercul'Osis or
syphilis*
11. Pericarditis.
1. Pericarditis is an unreliable report of cai^e of deaths without
autopsy, unless accompanied by a statement of primary cause or of
the character of exudate obtained by paracentesis.
2. Of the terms now included under this title heading the follow-
ing only are approved: Adherent pericardium, adhesive pericarditis^
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effxision of pericardium^ fibrinous perkavditis^ he moperfcnrdium (in-
quiry should be made as to source of blood — traumatic ? Aneurism ? )
hydropericardium^ hydropneumopericardium^ media.^tinopericarditis^
pericarditis^ pericarditis with effusion^ pneumopericardfum^ piindent
pericarditis^ pyopericardimn^ pyopneumopcricardium^ suppwativc
pericarditis.
78. Acute Endocarditis.
1. The committee recommends that the title heading be changed
to Acute infectious endocarditis and myocarditis^ and is of the opinion
that it is a reliable statement, without autopsy.
2. The committee recommends that whenever the original site of
the infection is specified the death be classified according to standard
practice.
3. Of the terms now included under this title heading the following
only are approved: Acute endocarditis^ acute interstitial myocarditis^
acute myocarditis^ acute ulcerative endocarditis^ congenital endocar-
ditis^ malignant endocarditis^ mycotic endocarditis^ septic enda^
carditis^ ulcerative endocarditis^ vegetative endocarditis,
4. Tlie connnittee recommends that the following terms be added
to the list of inchisions: Acute valvular endocarditis^ acute infectious
endocarditis.
79. Organic Diseases of the Heart.
1. It is the recommendation of the committee that the name' of this
title be changed to Other organic diseases of the heart and that it be
subdivided into (A) Affections of the myocardium and (B) Affec-
tions of the valves of the heart.
2. The committee recommends that the title be put in the reliable
class, without autopsy.
3. Of tlie terms now under this title heading the following only
are approved inclusions under the tentative subtitles:
Tentative subtitle (A) : Amyloid degeneration of hearty aneurysm
of hearty brown atrophy of hearty chronic intei^stitiul myocarditis^
chronic myocarditis^ fatty degeneration of hearty f^^tty degeneration
of myocardium^ interstitial 7nyocarditis^ myocardial degeneration^
myocardial insufficiency.
Tentative subtitle (B) : Aneurysm of valve of hearty aortic incom-
petency^ aortic insufficiency^ aortic obstruction^ aortic regurgitation^
aortic stenosis^ aortic valvular disease of hearty cardiac mitral disease^
chronic endocarditis^ chronic mitral endocarditis^ chronic rheumatic
endocarditis^ chronic ulcerative endocarditis^ chronic valvular endo-
carditis^ chronic valvular heart disease^ incompetency of aortic valve j
incompetency of mitral valve, incompetency of tricuspid valve^ in-
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sufficiency of aortic vcdve^ insufficiency of mitral valve^ insu^ldenojf
of tricuspid valve^ mitral incompetency^ mitral insuf^eiency^ mitral
obstruction^ mitral regurgitation^ mitral stenosis^ mitral valvular
disease of hearty pulmonary insufficiency (ly+), pulmonary regurgi-
tation^ pulmonary stenosis^ puhnonary valvuhr disease of hearty tri-
cuspid incoynpetency^ tricuspid' insufficiency^ tricuspid regurgitation^
tricuspid valvular disease of hearty valvular cardiac disease^ v>ali'ular
disease of heart.
4. The committee recommends that the following terms be added
to the list of inclusions: Chronic cardiac hypertrophy and dilatation
(A), chronic degenerative myocarditis (A), fatty infiltration of
heart (A), tricuspid stenosis (B).
80. Angina Pectoris.
1. The committee recommends that this title be considered reliable,
without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Angina of hearty angina pectoris^ cardiac
a/ngina^ stenocardia,
81. Diseases of the Arteries, Atheroma, Aneurism, Etc
1. The committee recommends ' that the name of this title be
changed to Diseases of the arteries and that the title be subdivided
into (A) Aneurism and (B) Other diseases of the arteries. Aneurism
is not a reliable statement, without autopsy, unless the anatomical
location of the enlargement is specified. Subdivision B should be con-
sidered a reliable statement of cause of death, without autopsy.
This decision is made not because it is free from error, but because
it would be impractical to exclude the title under present clinical
conditions.
2. Of the terms now included under this title heading the follow-
ing only are approved: Aneurism of (any specified site), aortitis^
arteriocapUlary fibrosis^ arteriofibrosiSy arteriosclerosis^ arterio-
sclerosis of brain^ arteriovenous aneurism^ arteritis^ arteritis obli-
teranSj atheroma, atheromatous degeneration of artery , cerebral ar-
teriosclerosis, diffuse arteriosclerosis, endarteritis, endarteritis de-
formans, general arteriosclerosis, general atheroma.
3. The committee recommends that tl^e terms thromboangitis obli-
terans, atherosclerosis^ and arteriolar sclerosis be added to the list of
inclusions, and thnt the qualifying word nontraumatic be inserted
after the term rupture of artery.
82. Embolism and Thrombosis.
1. It is the recommendation of the committee that Embolism and
Thro-ttihof^ifi be considered reliable causes of death, without autopsy;
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and the comiriittee also desires to emphasize the fact that it is desir-
able to specify the site of obstruction (name of vessel obstructed) and
whether the obstruction was embolic or thrombotic, and, if embolic,
the source of the embolus.
2. Of the terms now included under this title headin": the follow-
ing only are approved: Adam-St()kes disease^ hrarhycardia^ hrady-
hral thrombosis, eniboUsm of artery, embolism of coronary artery,
embolism of mesenteric artery, embolism of pulmonary artery, ob-
struction of artery by clot, o( htsion of artery by clot, pulmonary
embolism, pulmonary thrombosis, thrombosis of artery, thrombosis
of cerebral sinus, thrombosis of iliac artery, thrombo,sis of lateral
sinus, thrombosis of portal vein, thrombosis of pulmonary artery,
thromhosis of splenic vessel, thrombosis of uterine vein, thrombosis
of vein.
3. The committee recommends the addition of the terms air em-
holism, and fat embolism to the list of inclusions.
4. The committee recommends the transfer to this title of the terms
infarction of lung and pulmonary infarction from present title No.
£'4 {Pulmonary congestions, pulmonary apoplexy),
83. Diseases of the Veins (Varices, Hemorrhoids, Phlebitis, Etc.).
1. The committee recommends that this title be considered reliable,
without autopsy, if there is an accorppanying statement of the site
of the lesion or name of the vessel or vessels involved.
2. Of the terms now included under this title heading the following
only are approved: Aiieurismal varix, endophlebitis, hemorrhoids,
periphUbitis, phlebitis (of a specified vein or sinus), pylephlebitis,
rupture of varicose vein, thrombophlebitis, varices (location should
be specified), varicocele, varix of bladder, varix of esophagus, varix
of pharynx, varix of vulva, venous angioma,
84. Diseases of the Lymphatic System (Lymphangitis, Etc.).
1. This is a reliable title, without autopsy.
2. In giving adenitis, lymphadenitis, or lymphangitis as the can.se
of death the exact location of the glands or lymph vessels affected
should be stated together with, if possible, the etiological factor re-
sponsible for the inflammation.
3. Of the terms now included under this title heading the following
only are approved : Adenitis, lymphadenitis, lyinphangitis, nonfilarial
chylocele, nonfilarial chylous ascites, obliteration of lymphatic vessel,
polyadenitis,
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4. The committee recommends the transfer to other titles of the
following inclusions: To new tentative title No. 51B {Diseases of the
thymus gland) : Atrophy of thymus gland^ enlargement of thymus
gland^ lymphatism^ persistent thymus gland^ status lymphaticus^
status thymicus^ thymic asthma,
85. Hemorrhage; Other Diseases of the Circtilatory System.
1. This title is reliable, without autopsy^ but the site of the hemor-
rhage or name of vessel should be specified — also the cause. Any
report of Hemorrhage should be queried by registration offices and by
the Bureau of the Census as to cause and site of lesion.
2. Of the terms now included under this title heading the follow-
ing only are approved: Adams-Stohes disease^ hrachycardia^ hrady-
cardia^ epistaxis, hemorrhage (cause and site should be specified —
see above), heart bloeky paro.cysinal tachycardia^ Stokes- Adam^ dis-
ease^ tachycardia,
86. Diseases of the Nasal Fossae.
1. Names of diseases listed under this heading are reliable reports
of cause of death, without autopsy.
2. Of the terms now included, under this title heading the following
only arc approved: Adenoids^ cerebrospinal rhinorrhecu, foreign body
in nose,
3. The committee recommends the transfer of the term ft>reign
body in nose to title No. 186 {Other external violence),
4. The committee recommends the transfer of the following terms
to this title from present title No. 146 {Diseases of the bones — tuber-
culosis excepted): Abscess of antrum of Highmore, of ethmoidal
sinus J of frontal sinuSj of maxillary sinus^ of sphenoidal sintts^ disease
of frontal sinus^ empyema of frontal sinus^ ethmoidal sinusitis,, eth-
moid itis^ frontal sinusitis ^ maxillary sinusitis ^ necrosis of antrum j
sphenoidal sinusitis^ sphenoiditisj supptiration of frontal sinus.
5. The committee recommends that coryza and coryza of newborn
be queried by registration offices to determine whether the coryza wus
caused by syphilis, diphtheria, or other specific infection, in which
event it should not be tabulated under title No. 86 but under appro-
priate headings such as Syphilis or Diphtheria,
87. Diseases of the Larynx.
1. The committee recommends that statements of the diseases in-
cluded under this title be considered reliable statements of cause
of death, without autopsy.
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1595 September 28. 1917
2. Of the terms now included under this title heading the follow-
ing only are approved : Catarrh of larynx^ catarrh of throaty catarrhal
eroup^ catarrhal laryngitis^ congestion of glottis^ epiglottiditis^ gan-
grenous laryngitis^ infective laryngitis^ inflammation of larynx^
laryngismus stridulus^ laryngitis^ edema of glottis^ edema of larynx^
paralysis of glottis, paralysis of larynx, phlegmonous laryngitis^
spasm of glottis, spasm of larynx, spasmodic croup, spasmodic laryn-
gitis, stenosis of larynx, stridulous croup, stridulous laryngitis, tumor
of larynx (nonmalignant), ulcerative laryngitis.
88. Diseases of the Thyroid Body.
1. The committee is of the opinion that this title should not be
classified under the class Diseases of the respiratory system, and
recommends its transfer with reliable inclusions to Class I (General
diseases). (See tentative title of same name No. 51 A.)
89. Acute Bronchitis.
1. This title is not reliable as a cause of death, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Acute bronchitis, acute hronchorrhea, acute
capillary bronchitis, acute pulmonary catarrh, acute purulent bron-
chitis, capillary bronchitis, croupoirs bronchitis, fibrinous bronchitis^
subacftte capillary br&nchitis, tracheitis, tracheobr&nchitis, • ■
90. Chronic Bronchitis.
1. This title is a reliable statement of cause of death, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Bronchial catarrh, bronchiectasis, bronchor-
rhea, chronic b^'onchitis, chronic broncharrhea, chronic capillary
bronchitis, chronic catarrhal bronchitis, dilation of bronchi, fetid
bronchitis, peribronchitis, purulent hronchorrhea, subacute bron-
chitis, ulcerative bronchitis.
3. The committee recommends the addition to the list of inclu-
sions of the term chronic purulent bronchitis.
4. The committee recommends that a footnote be added to this
title stating that the return '^chronic bronchitis'^^ frequently masks
pulTnonary tuberculosis and chronic organic heart disease, as well as
other conditions.
91. Bronchopneumonia.
1. The statement is a reliable statement of cause of death, without
autopsy.
2. It is the understanding of the coannittee that the Bureau of the
Census has been testing returns of this disease by asking physicians
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in several thousand cases whether bronchopneumonia was the pri-
mary cause of death or whether it occurred as a complication or
sequel of some other disease or abnormal condition. The result of
this has been the collection of supplemental data, not on the original
certificates, on the basis of which the bronchopneumonia was shown
to have been the terminal and secondary condition in other diseases.
This was found to be the case in about 20 per cent of certificates
queried, all of which were those of children under 10 years of age.
It is the sense of the committee that the practice the Bureau of the
Census now pursues of bringing before the physicians concrete ex-
amples of what kind of information is necessary for accurate sta-
tistics of cause of death, showing them wherein they have failed to
supply such information, is a practical step in the right direction
in that its immediate effect is correction of faulty data, and its
ultimate effect, if persevered in, will be the improvement of basic
facts at their source.
Although hronchopneumonia is only one of the many returns cov-
ered by letters of inquiry now being sent to physicians by the Bureau
of the Census, this committee on the accuracy of certified causes of
death and their relation to mortality statistics wishes to register here
its unqualified approval of the procedure.
3. Of the terms now included under this title heading the follow-
ing only are approved: Aspiration pneumonia^ hronchopneumonia^
broncho pulmonitis^ catarrhal infl^ammation of lung^ catarrhal pneu-
monia^ croupous bronchopneumonia^ deglutition pneumoniay inhala-
tion pneumonia^ inspiration pneumonia, lobular pjieumonia^ septic
bronchopneumonia (query for cause of sepsis).
92. Pneumonia.
1. It is recommended that this title be subdivided ; that a subtitle,
Lobar pneumonia be created, which will be considered reliable, with-
out autopsy, and that this be numbered 92A; subtitle 92B should have
the caption Pneumonia (undefined), and will be considered unre-
liable, without autopsy,
2. Of the terms now included under this title heading the follow-
ing only are approved. The letter following each indicates the
tentative subtitle under which each should be listed: Acute hepatiza-
tion of lung (A), acute inflammation of lung (A), acute interstitial
pneumonia (A), acute pleuropneumonia (B), bilateral lobar p^ieu-
mania (A), bilateral pneumonia (A), central pneumonia (A), con-
solidation of lung (A), croupous pneumonia (A), diplococcus pneu-
monia (A), double plcurojnummonia (B), double pneumonia (A),
flbrinaus pneumonia (A), hepatization of lung (A), lobar pneu-
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1597 September 2g, 19iT
monia (A), septic pUurojmeumonia (query for cause of tlie ^e]>sis)
(B), solidifieaiiQn of lung (A), suppurative pneumonia (B), unre-
solved pneumonia (A).
3. It is recommended that pneumocoecus pneumonia be added to
the list of inclusions of subtitle A.
4. Inquiry should always be made to determine whet In r the
^ pnettmonia'*'^ was bronchopneumonia or lohar ]meinnonia und
whether it was the primary cause, or occurred in the course of or
following ^me <^er disease. " Pn^wwu^ma," unfortunately, is
sometimes used in cases where hypostatic pneumonia occurred as a
terminal condition, and the primary condition in such cases is often
not described.
9S. Plenrisy.
1. Pleurisy^ in the opinion of the committee, is a reliable cause of
death, without autopsy, but if returned as a cause of death without
specified cause, inquiry should be made to ascertain whether it was
due to lobar pneumonia, acute rheumati^Hm, tuberculosis^ or trauma-
tism, and, if the last, whether the violence was accidental, suicidal, or
homicidal, and what was the means of injury.
2. Of the terms now included under this title heading the following
only are approved: Chylous hydrothorax, diaphragmatic pleurisy^
double empyema^ double hydrotliornx, double pleuritis, em/pyema^
estudative pleurisy, fibrinous pleurisy, fibrous pleurisy, hemopneu-
mofhorax, hemothorax, hydropneumothorax, hydrothordx, plastic
pleurisy, pleurisy with effusion, pleuritis, pleuropencarditis, pneu-
mothorax, purulent pleurisy, pyopneumothorax, pyothorax, serofi-
brinous pleurisy, seroptirulent pleurisy, subacute pleurisy, suppura-
tive pleurisy, thoracic fistula.
94. Pulmonary Congestion, Palnonary Apoplexy.
1. It is recommended that title No. 94 be called Pulmonai^ con-
gestion (3 months and over), and that the other name included in the
present title, pulmonary apoplexy, be listed among the terms below.
Pulmonary congestion is considered reliable, without autopsy, (Maly
when the cause is specified — as for example, accidental inhalation of
irritating fumes, or accompanying lesions which are known to lead to
congestion of the lungs.
2. Of the terms now included under this title heading, tlw follow-
ing only are approved : Apoplexy of lung, congestion of lung^ hypos-
tatic congestion of lung, hypostatic pneumonia, edema of lung^
passive congestion of lung, pulmonary apoplexy, pulmonary conges-
tion, pulmonary edema, pulmoTiary stasis.
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3. The committee recommends the transfer of the following terms
to other titles : Infarction of lung^ pulmonary infarction to title No.
82 {Embolism and thrombosis),
4. The committee recommends that an age qualification be placed
upon this title, namely, 3 months and over^ and that deaths of infants
under 3 months of age reported from any of its included terms be
classified under present title No. 152, subtitle 2 {Other diseases of
early infancy).
5. Reports of the conditions listed under this heading should
always be queried for the primary cause.
95. Gangrene of the Lung.
1. Gangrene of the lung, is, in the opinion of the committee, in the
reliable class, without autopsy.
2. Of the terms now included under this title heading the following
only are approved : Gangrene of the lung^ pulmonary gangrene.
96. Asthma.
1. The committee recommends that this title be considered not
reliable, without autopsy, and that it be queried in every instance
for cause.
2. Of the terms now included under this title heading the following
only are approved: Asthma^ asthmatic bronchitis^ bronchial asthma.
cataiThal asthma^ Curschrnann's disease^ spasmodic asthma.
97. Pulmonary Emphysema.
1. In the opinion of the committee this is a reliable statement of
cause of death, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Congenital ( niphysenia^ emphysema of lung ^
hypertrophic emphysema^ interlobular ettiphi/Hana., pulmonary em-
physema^ senile emphysema^ vesicular emphysema.
98. Other Diseases of the Respiratory System (Tuberculosis excepted).
1. The inclusions under this title heading cover so many condi-
tions that no "blanket" recommendation can be made as to its
reliability, without autopsy.
2. The committee recommends that the pai*enthetical expression
(tuberculosis exeepted) be omitted from the title heading and that to
the note now following the list of inclusions be added or tuberculosis
of respiratory organs.
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3. Of the terms now inclnded under this title heading the following
only are approved inclusions: Ahacess of lung (only with cause
stated), anthracosis of lung^ aspergillosis of lung^ ousoe-g Anders^ dis-
ease^ chronic hepatization of lung, chronic inflammation of lung^
chronic interstitial inflammation of lung^ chronic interstitial pneu-
moniOf chronic pleuropneumonia ^^ chronic pneumonia, chronk: pneu-
monitis, colliers^ lung, grinders^ asthnui, hay asthma, hay fever, hernia
of lung, interstitial pneumonia, miners^ asthma, pneumoconiosis,
potters'* asthma, pulmonary abscess (only with cause stated), pul-
monary anthracosis, stenosis of bronchi, stenosis of trachea, stone-
masons* lung, tracheostenosis, tumor of lung (nonmalignnnt), tumor
of pleura (nonmalignant), tumor of trachea (nonmalignant), ulcer
of bronchi, 'ulcer of trachea,
4. The committee recommends that the following terms be added
to the list of inclusions: Metal polishers'* disease, tmnor of bronchi
(nonmalignant).
5. The committee recommends the transfer of the term hydatid
cyst of lung to title No. 107 {Intestinal parasites).
99. Diseases of the Mouth and Annexa.
1. It is recommended that this title be considered reliable, without
autopsy.
2. Of the terms now included under this title heading the following
only are approved : Glossitis, Mikulicz's disease, pyorrhea alveolaris,
Riggs^s disease, stomatitis, thrush,^ tumor of gum (nonmajignant),
tumor of lip (nonmalignant), turnor of mouth (nonmalignant),^
tumor of parotid gland (nonmalignant)/ tumor of salivary gland
(nonmalignant), tumor of tongue (nonmalignant), ulorrhagia.
3. ^he committee recommends the transfer to this title of the term
a^eute parotitis (parotiditis) [not mumps] from present title No. 19
{Other epidemic diseases),
4. The committee recommends the transfer of the following terms:
Muguet, to title No. 19, the proposed caption of which is Other epi-
demic, endemic, and infectious diseases; odontoma, to the prefatory
note on nonmalignant tumors preceding title No. 39.
100. Diseases of the Pharynx.
1. It is recommended that the caption of this title be changed to
Diseases of the pharynx and tonsils and be considered reliable as a
cause of death, without autopsy.
2. Of the terms now included under this title heading the following
only are approved inclusions: Abscess of pharynx, abscess of tonsil,
angina Ludoviei, cellulitis of pharynx, follicular amygdalitis, fol-
»Wlth speciflcatioD of nature and exact site.
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licular tonsillitis^ Lxidxcigh angina^ Ludwig^s disease, nasopharyngeal
abscess^ parenchymatous tonsillitis, peritonsillar abscess, postpharyn-
geal abscesH, quinsy, retropharyngeal abscess, septic disease of throat,
septic sore throaty streptococcic sore throat, stricture of pharynx
(with cause of stricture arid manner of death stated, e. g., starvation),
suppurative toni^illitis^ tonsillopharyngeal abscess, tumor of pharynx
(nonmalignant), tumor of throat (nonmalignant), tumor of tonsil
(nonmalignant), tumor of uvida (nonmalignant), Vincenfs angina,
3. The committee recommends that the term tumor of fauces (non-
malignant) be added to the list of inclusions.
101. Diseases of the Esophagus.
1. The committee is of the opinion that this title should be con-
sidered reliable, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Abscess of esophagus, obstruction of esophagus,
stenosis of esophagus, stricture of esophagus, tumor of esophagus
(nonmalignant).
3. Keturns of stricture of and stenosis of the esophagus^ without
qualification, should be queried to ascertain whether due to congenital
stenosis, cicatricial contraction or tumor of the esophagus, to pressure
from surrounding parts, or other discernible cause.
4. The committee recommends the transfer of the term foreign
body in esophagus to title No. 186 (^Other cjcternal violence),
102. Ulcer of the Stomach.
1. The committee recommends that the caption of this title be
changed to Ulcer of stomach or duodenum, and that it be considered
unreliable unless verified by autopsy or operation.
2. Of the terms now included under this title heading the following
only are approved: Gastric ulcer, g astro-duodenal ulcer, gastro-
esophageal ulcer, peptic ulccr^ perforating gastric ulcer, perforating
ulcer of stomiich, round ulcer of stomach, ulcer of pylorus^ ulcer of
stomach, ulcus rotundiim, ulcffs ventriculi,
3. The committee roconmiends that the terms duodenal ulcer and
uh(r of duodenum be transferred to this title from titles Xos. 104 and
lO.") (Diarrhea and enteritis).
103. Other Diseases of the Stomach (Cancer Excepted).
1. The committee recommends that the caption of this title be
f lianged to Other di^yeases of the stomach and that to the footnote
bv^<j:inning 7 his title dots not include, he added tlie words tuberculosis
of the stomach ('H ). In the opinion of the committee the title is not
reliable nnle.-s vci-iHcmI Ik autopsy cr operation.
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2. Of the terms now included under this title heading the follow-
ing only are approved: Abscess of stomachy cardiospasm (for chil-
dren under 1 year of age), gangrene of stomachy hematemesis (with
etiology), hemorrhagic gastritis^ hypertrophic stenosis of pylorus^
laceration of stomach (not external violence ; with etiology and fatal
symptoms), obstnwtion of pylorus (with etiology), perforation of
sto7nach (nontraumatic; with etiology), p/degmonous gastritis^
pylorospasm (for children under 1 year of age), rxipture of stomach
(nontraumatic; with etiology), stenosis of pylorus (nonraalignant;
with etiology), stricture of card! a of stomach (nonmalignant; with
etiology), stricture of pylorus (nonmalignant; with etiology), stric-
ture of stomach (nonmalignant; with etiology), vomiting of blood.
3. The committee recommends that the term tumor of stomach
{nonmalignant) be added to the list of inclusions.
4. The committee recommends that the term foreign body in
stomach be transferred to title No. 186 {Other external violence).
104. Diarrhea and Enteritis (Under 2 Years).
1. The committee recommends that this title be placed in the
reliable class, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Catarrhal colitis (state whether acute or chronic),
catarrhal diarrhea (state whether acute or chronic), catarrhal en-
teritis (state whether acute or chronic), catarrhal gastroduodenitis
(state whether acute or chronic), catarrhal gastroenteritis (state
whether acute or chronic), catarrhal ileocolitis (state whether acute
or chronic), croupous colitis^ croupous enteHtis^ diarrhea due to food^
endemic diarrhea^ enteritis^ enterocolitis (-2y), gastroenteritis (-2y),
hemorrhagic colitis^ hemorrhagic enteritis^ hemorrhagic gastro-
enteritis^ ileocolitis (-2y), infantile diarrhea^ infantile enteritis^ mem-
branous colitis j membranous enteritis^ membranous enterocolitis^ fnem-
bra^wus ileoditis^ mucoenteritiSj necrotic colitis^ perforating ulcer of
intestine (with autopsy), phlegmonous enteritis^ sarciruil infection
(with proof), sigmoiditis (with proof), ulcer of colon (with au-
topsy), ulcer of intestine (with autopsy), ulceration of colon^ ulcera-
tion of ileum^ ulceration of vrUestine^ ulcerative colitis^ ulcerative
enteritis^ ulcerative enterocolitis^ ulcerative ileocolitis^ ulcerative per-
foration of intestine.
3. The committee recommends that all reports of conditions now
listed under title No. 13 {Cholera nostras) be classified under this
title if encountered on death certificates of children under 2 yenr.s of
age. It is also recommended that the term pseudomembranous
enteritis be transferred to this title from title No. 110 {Olhiv dh-
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eases of the infestiues) when reported for cliildren under 2 years
of age.
4. The committee recommends the transfer of duode^iaZ ulcer and
xdcer of duodenum to title No. 102 {Ulcer of the stomach) ; fhigellate
diarrhea to title No. 107, the new, tentative caption of which is Dis-
eases due to other parasitic worms,
105. Diarrhea and Enteritis (2 Years and Over).
1. The conclusions for the preceding title are in force for this title
with the following exceptions: The terms enterocolitis^ gastroenter-
itis^ and ileoeo/itis^ without further qualification, are not approved
inclusions without autopsy for decedents 2 years of age or over.
106. Ankylostomiasis.
1. The committee recommends that this title be placed in the reli-
able class, provided the infectious parasite ankylostoma duodenale
or its ova have been demonstrated.
2. Of the terms now included under this title heading the follow-
ing only are approved: Ankylostomiasis^ hookworm, disease^ neca-
toriasis^ uncinariasis,
3. The committee recommends the addition of the following terms
to the list of inclusions: Infection hy ankylostoma duodenale^ infec-
tion by uncinaria americana^ necator a?nericana,
107. Intestinal Parasites.
1. The connnittee recommerids that the caption of this title be
changed to Diseases due to other parasitic worms and be considered
reliable only with demonstration of the parasite or its ova in the
tissues or discharges. Also tl)at llic title be transferred to the class
of General diseases after present title No. 19.
2. The committee recommends that the title be subdivided into
(A) Infection by cestoda^ (B) Infection by trematoda^ (C) Infection
by nematoda^ (D) Infection by coccidia.
3. Of the terms now under this title heading the following only
are approved inclusions:
(A) Infection by cestoda (Tapeworm) —
Dibothriocephalus latus.
Bothriocephalus latus.
Tenia echinococcus.
Tenia saginata (Taeniasis; Teniasis).
Tenia solium (Taeniasis; Teniasis).
Cysdcercus cellulosae (Taeniasis; Teniasis).
Other cestodes.
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(B) Infection hy trematoda (Distomiasifl)-^
Fasciola hepatica (Fascioliasis).
Distomum hepaticum.
Paragonimus westermani (Paragonimiasis).
Distomom pulmcmale.
Schistosomiim hematobium (Bilhai*ziasis) (Schistosomi-
asis).
Distomum hematobium (Schistosomiasis).
Bilharzia hematobia (Schistosomiasis).
Schistosomum ja];>onicum (Schistosomiasis),
Other trematodes (Schistosomiasis).
(C) Infeciion by nematoda (Sound worm) —
Ascaris lumbricoides (ascariasis).
Oxyuris vermicularis (oxyuriasis).
Trichocephalus tiichiura (Tricocephaliasis).
Trichocephalus dispar.
Trichinella spiralis (Trichinelliasis, Trichiniasis),
Trichina spiralis.
Filaria (several species) (Filariasis).
Filaria (microfilaria) sanguinis hominis.
Strongyloides stercoralis (Anguilluliasis).
Anguillula intestinalis or stercoralis.
Rhabdohema strongyloides or intestinale.
Other nematodes.
(D) Infection by coccid}^-^ .
Coccidiasis.
4. The committee recommends the transfer to this title of the
terms hydatid cyst of lung from title No. 98 {Other diseases of the
respiratory system) ; cystieercus of brain and hydatid of brain from
title No. 74 {Other diseases of the nervous system); echinococats
cyst of liver from present title No. 112 {Hydatid turner of the liver) ;
flagellate diarrhea from titles^ 104 and 105 {Diarrhea and enteritis) ;
hydatid cyst of spleen from present title Na 116 {Diseases of the
spleen); hydatid cyst of kidney from title 122 {Other diseases of
the kidneys and annexa); hydatid cyst of breast from present title
No. 133 {Nonpuerperal diseases of the breast).
108. Appendicitis and Typhlitis.
1. This title is considered unreliable, unless verified by operation
or autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Abscess of appendix, abscess of iliac fossa^
aiscess of vermiform appendix^ appendicitis^ appendicular abscess^
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fulminating appendicitis^ gangrenous appendicitis^ perforatwe ap-
pendicitiSj pericecal abscess, perityphlitic abscess, perityphlitis^ post-
cecal abscess, recurrent appendicitis, ruptured appendix, sloughing
appendix, suppurative appendicitis, typhlitis, typhlodicliditis.
3. The committee recommends that the term foreign body in ap-
pendix be transferred to this title from title No. 110 {Other diseases
of the intestines).
109. Hernia, Intestinal Obstruction.
CONCLUSIONS ON SUBTITLE 1 — HEBNIA.
1. This subtitle is considered reliable if the hernia is external,
or is exposed on operation or autopsy, when internal; also when
conditions adequate to cause death, together with type and location
of hernia, are specified.
2. Of the terms now included under this subtitle the following
only are approved: Gangrenous hernia, herniotomy, incarcerated
hernia, strangulated hernia (each with site specified).
CONCLUSIONS ON SUBTITLE 2 — INTESTINAL OBSTRUCTION.
1. This subtitle is considered unreliable, unless the obstruction is
demonstrated on autopsy, or operation, or is accessible by examina-
tion through the body orifices.
2. Of the terms now included under this subtitle the following
only are approved: Ileus, inteUinol obstruction (site and cause of
obstruction to be specified), intussusception, strangulation of bowel,
telescoped bowel, twist of bowel, volvulus,
110. Other Diseases of the Intestines.
1. The inclusions under this title heading cover so many condi-
tions that no " blanlcet " recommendation can be made as to its relia-
bility or unreliability, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Abscess of MecheVs diverticulum, diverticulitis,
enteric paralysis (with adequate etiology), fecal impaction, gangrene
of rectum, impaction of feces, ischiorectal abscess, paralysis of colon
(with adequate etiology)^ paralysis of intestine (with adequate eti-
ology), perforation of bowel (with adequate etiology), perforation
of intestine (with adequate etiology), periproctitis, perirectal abscess,
perirectal cellulitis, procidentia recti, rupture of duodenum (with
adequate etiology), rupture of rectum (with adequate etiology),
stricture of anus (with adequate etiology), stricture of rectum (with
adequate etiology), tumor of anus (nonmalignant), tumor of rectum
(nonmalignant).
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3. The committee recommends the transfer of. the foUoAving inchi-
sions to other titles: Foreign body in appendix to title No. 108
(Appendicitis and typhlitis) ; foreign body in iiitestine^ foreign body
in rectum to title No. 186 (Other external vioUnce) ; psilosisj sprue
to present title No. 25 (Mycoses); melena (under 3 months) to title
No. 152, subtitle 2 (Other diseases of early infancy); pseudomem'
branous enteritis to title No. lOl or 105 (Diarrhea and enteritis).
111. Acute Yellow Atrophy of the Liver.
1. It is recommended that this titlo be placed in the reliable class,
without autopsy.
2. Of the terms now included under this tttle heading the follow-
ing only are approved : Acute atrophy of liver ^ acute parenchyrnat&as
hepatitis^ acute yelloxo atrophy of liver^ icterus gravis^ malignant
hepatitis (ly-f-), malignant icterus (ly-|-), malignant jamuUce
(ly-|-), pernicious icterus.
3. The committee recommends that the terms acute infective jaun-
dice and WeiPs disease be transferred to title No. 19, the proposed
caption of which is Other epidemic^ endemic, and infectious diseases.
112. Hydatid Tumor of the Liver.
1. The committee recommends that this title be eliminate<l and
that the term echinococcus cyst of liver be transferred to title No. 107,
the now tentative title of which is Diseases due to other parasiti
worms.
113. Cirrhosis of the Liver.
1. It is recommended that this titlo be considered in the reliable
class, without autopsy, it being understood that where cirrhosis is due
to S3rphilis deaths should be classified under titlo No. 37 (Syphilis) ;
also that in the arrangement of the included terms a subtitle should
be established to comprehend alcoholic cirrhosis and synonymous
terms. None of the terms listed under this subtitle should be used
unless there was a definite history of chronic alcoholism.
2. Of the terms now included under this title heading the follow-
ing only are approved, those followed by the letter (A) to be listed
imder the subtitle covering alcoholic cirrhosis: Alcoholic cirrh^sU
(A), alcoholic cirrhosis of liver (A), atrophic cirrhosis (A), atrophic
cirrhosis of liver (A), cirrhosis of Laennec, cirrhosis of liver, con-
genital cirrhosis of liver (ly-f-), congenital hepatic cirrhosis (ly^-),
Hanoi* s disease, hepatic cirrhosis, hobnail liver (A), hypertrophic
cirrhosis, hypertrophic cirrhosis of liver.
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3. The committee recommends that returns of eongenUal drrTiosis
of liver be queried for syphilis. .
4. The committee recommends the transfer to this title of the term
hyperti^phie hepatitis from title No. 115 {Other diseases of the
liver).
5. The committee recommends the transfer of the following terms
to title No. 56 (Other general diseases): Amyloid degeneration of
liver ^ amyloid liver ^ lardaceous degeneration of liver ^ Inrdaceous liver ,
large waxy liver ^ waxy degeneration of liver ^ waxy liver.
114. Biliary Calculi.
1. It is recommended that the caption of this title be changed to
Cholelithiasis and that it be placed in the reliable class, without
autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Biliary colic^ biliary Ufhiasis^ cholelithi^iHs^
colic from gall stones^ impacted gall stones.
115. Other Diaeasels of the Liyer.
1, It is the recommendation of the committee that the name of this
title be changed to Other diseases of the liver and biliary sysfe?n, and.
be considered unreliable, without autopsy.
2. Of the terms now included undca: this title beading the follow-
ing only are approved : Abscess of gall bladder^ abscess of Urer (etio-
logical factor must be specified), acute catarrhal jaundice (ly+),
angiocholecystitis^ angiocholitis^ biliary fistula^ caiarrh of bile duct^
catarrhal cholangitis^ catarrhal icterus (ly-f-), catarrhal jaundice
(ly+)> cholangitis, cholecystitis, choledochitis, chro7iic catarrhal
jaundice, diffuse suppurative^ hepatitis, em^ema of gall bladder^
gangrene of gall bladder, gangrene of gall duct, hematogerwus icterus
(ly+), hematogenous jaundice (ly+), infectious cholecystitis, ne-
crosis of gall bladder, perforation of bile duct (with cause), per-
f oration of gall bladder (with cause), perforation of gall duct (with
cause), rupture of bile duct (with cause), rupture of gall bladder
(with cause), rupture of gall duct (with cause), stenosis of bUe duct
(with cause), stenosis of gall duct (with cause), stricture of corwmon
duct (with cause), stricture of gall bladder (with cause), stricture
of gall duct (with cause), suppuration of gdU bladder^ suppurative
cholangitis, suppurative cholecystitis^ suppurative choledoehitis^
tumor of bile duct (nonmalignant), tumor of gall bladder (non-
malignant), tumor of gall duct (nonmalignant), tumor of Uver
(nonmalignant).
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3. The committee recommends the transfer of the following in-
clusions to other titles: Hypertrophic hepatitis to title No. 113 (Oir-
rhosis of the liver) ^ tentative subtitle (B) {Other cirrhoses); tropical
abscess of the liver to title No. 14 {Dysentery),
116. Diseases of the Spleen.
1. The committee recommends that this title be considered unre-
liable unless verified by operation or autopsy; it recommends, fur-
ther, that the title be removed from Class V {Diseases of the diges-
tive syston) and be inserted between titles No. 52 and No. 53 in the
class of General diseases, (See tentative title No. 52B.)
117. Simple Peritonitis (Nonpuerperal).
1. It is recommended that the name of this title be changed to
Peritonitis {nonpuerperal) and tliat it be placed in the unreliable
class, without autopsy; also that all reports under this heading be
queried by registration offices and by the Bureau of tlie Census in
order to secure statement of the p.rimary cause.
2. Of the terms now included under this title heading the follow-
ing only are approved: Acute general peritonitis^ general purulent
peritonitiSj acute fibrinous periionitis^ acute serafihrinotis peritonitis,,
acute suppurative peritonitis^ acute hemorrhagic peritonitis.
3. The committee recommends the addition of the term acute
fibrinopurulent peritonitis to the list of inclusions.
4. The committee recommends the transfer of the terms foreign
body in peritoneum and traumatic peritonitis to title No. 186 {Other
external violence) ,
5. The committee recommends the transfer of the term subdia-
phragmatic abscess to this title from present title No. 118 {Other
diseases of the digestive system),
117A. Diseases of the Pancreas. (Tentative title.)
1. The committee recommends that a new title with the above
caption be established to follow present title No. 117, and that the
new title be placed in the unreliable class, without autopsy.
2. The committee recommends the transfer to this title of the
following terms now listed under title No. 118 {Other diseases of the
digestive system) : Acute pancreatitis^ acute suppurative pancreatitis^
acute hemorrhagic paticreatitis,, chranic suppurative pancreatitisy
chronic interstitial pancreatitis^ tumor of pancreas (nonmalignant),
abscess of pancreas^ acute gangrenous pancreatitis,
3. The committee recommends the addition of the terms calculus
of pancreatic duct^ fai necrosis of pancreas.
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118. Other Diseases of the Digestive System (Cancer and Tabercnlosis
excepted).
1. It is recommended that this title ba eliminated because of the
transfer of all its approved inclusions to more appropriate title
headings.
2. The committee has recommended the transfer of many inclu-
sions from this title to the new tentative title 117A {Diseases of ths
pancreas) J which see.
119. Acute Nephritis.
1. This title should not be accepted as a primary and exclusive
cause of death, without autopsy. In all such cases the physician
should report the primary condition which led to the nephritis.
Reports of it should be queried, therefore, to ascertain whether it
appeared as a complication or sequela of some other disease or ab-
normal condition, and if so the exact nature of the same ; it is
especially imix)rtant to queiy suspected puerperal cases.
2. Of the terms now incKided under this title heading the following
only are approved: Acute alhuminous nephritis^ acute diffuse neph-
ritis^ acute exudative nephritis^ acute Brigki^s disease^ acute glomerdlo'
nephritis^ acute hemorrhagic nephritis^ acute interstitial nephritis^
acute nephritis^ acute parenchymatous iiephriHs^ acute tubular neph-
ritis^ glomerular nephritis^ glomerulo-nephritiSy subacute nephHtis,
3. The committee voted to recommend the transfer to this title of
the terms we/>A7vYi? (unqualified) and BHghPs disease (unqualified)
in children under 15 years of age when no information definitely de-
scribing the condition as either acute or chronic can be obtained.
120. Bright's Disease.
1. It is recommended that this title be considered in the rehable
class, without autopsy,* but suggested that the caption be changed to
Chronic nephritis,
2. Of the terms now included under this title heading the following
only are approved: Cardiorenal sclerosis^ chronic Brighfs disease j
chronic diffuse nephritis^ chronic exudative nephritis^ chronic glome-
rulo-nephritisy chronic interstitial nephritis^ chronic nephritis^
chronic parenchymatous nephritis^ chronic tubular nephritis^ diffuse
nephritis, diffuse interstitial nephritis, gouty kidney, granular kid-
ney, hypertrophic interstitial nephritis, large white kidney.
1 It was agreed that in preparing its report on this title the committee would cmll
attention to the very considerable error in diagnoses, without autopsy, of deaths reported
from chronic nephritis, with the suggestion that there are good reasons for excluding
this from the reliable class.
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8. The committee recommends the ii*ansfer to other titles of the
following terms: Amyloid degeneration of kidney^ lardaccoxis (Uu/en-
eration of kidney ^ waxy degeneration of kidney to title No. 55 {Other
general diseases) ; purulent nephritis^ septic nephritis to title No.
122 {Other diseases of the kidneys and annexa).
4. The committee recommends that when 7wphritis (unqualified) or
Brighfs disease (unqualified) are reported as causes of death for
children under 15 years of age, and when no infc»rmation definitely
describing the condition as either acute or chronic can be obtained,
the deaths be compiled under title No. 119 {Acute nephritis),
121. Chyluria.
1. It is recommended that this title be placed in the reliable cla&s,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Ohyluria. galacturi<iy hematochyluria ^ lipemia^
lipuriay nonfUarial chyluria^ piarrhemia^ tropical hematvria,
122. Other Diseases of the Kidneys and Annexa.
1. It is recommended that this title be <^nsidered unreliable unless
operation or autopsy was performed.
2. Of the terms no^ included, ^nder this title heading the follow-
ing only are approved: Abscess of kidney^ cyst of kidney^ cystic
degeneration of kidney^ cystic, disease of kidney.^ floating kidney^
hydronephrosis^ infarct of kidney^ nephritic abscess^ perinephric
abscesSj perinephHtic abscess, perirenal abscess., jyyeUtis^ pyelone-
phritis^ pyonephritisj pyonephrosis^ renal abscess^ renal cyst^ suppura-
tive nephritis^ suppurative pyelitis^ tumor of kidney (nonmalignant).
3. The committee recommends that the term tumor of ureter (non-
malignant) be added to the list of inclusions.
4. The committee recommends the transfer of the terms purulent
nephritis and septic nephritis to this title from title No. 120 {BrighPs
disease).
5. The committee recommends that the term hydatid cyst of kidney
be transferred to title No. 107, the proposed caption of which is
Diseases due to other parasitie worms.
123. Calculi of the Urinary Passages.
1. It is recommended that this title be placed in the reliable class,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved : Calculus of bladder^ calculus of kidney, calculus
of peVois of kidney^ calculous pyelitis^ calculous pyelonephritis^ cal-
culous pyonephrosis^ calculus of ureter., calculus of wrethra, impacted
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calculus of kidney^ impacted calculus of ureter, impacied ealeuhis
of urethra, litkotrity, nepkrolithiasiSj pyonepkrotis from ealcuhtSj
renal calculus, renal colic, stone in Madder, stone in kidney, urinary
calculus, ureterolithotomy, urinary lithiasis, vesical calculus.
tZL Diseases •£ the BUdder.
1. It is recommended that Diseases of the bladder be put into the
reliable class, without autopsy, and be subdivided into (A) Cystitis
and (B) Other diseases of the bladder,-
2. Of the terms now included under this title heading the following
only are approved : Gangrenous cystitis, purulent cystitis, pyocystitisj
suppurative cystitis, under subtitle (A) ; and gangrene of bladder,
papilloma of bladder, rupture of bladder (nontraumatic), tumor of
bladder (nonmalignant), and vesical abscess under subtitle (B).
3. The committee recommends the transfer of the term foreign body
in bladder to title No. 186 {Other external violence).
125. Dtsases of the Urethrm Uiuwry Absccai, Btc
1. It is recommended that this title be placed in Ae reliaUe class,
without autopsy.
2. Of the terms now included nnd^r this title headii^ the f oUowmg
only are approved: Laceration of urethra (not accidental viok&ce),
rupture of urethra (not accidental violence), ^ricture of mretkroj
tumor of urethra (nonmalignant).
3. The committee recommends the transfer of the term foreign
body in urethra to title No. 186 (Other accidental violence).
4. A footnote should follow this title stating that it does not
include cancer, tubercidosis^ or syphilitic or gonococcie lesions of the
gcJiital organs.
126. Diseases of the Prostate.
1. It is recommended that this title be placed in the reliable dass,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Calculus of prostate, enlargement of prost&le,
hypertrophy of prostate, prostatitis, prostatocystitis. tumor of
prostate (nonmalignant).
3. The committee recommends that the following terms be added
to the list of inclusions : Abscess of prostate, inflammation of prostate,
adenoma of prostate^ n*'w growth of prostate (nonmalignant).
4. The committee recommends that a footnote foUow this tiile
stating that it does not include cancer, tuberadosis, ix sypkOitic «r
gonococcie lesions of the genital organs.
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127. Nonvenereal Diseases of the Male Genital Organs.
1. The committee recommends that this title be -placed in tlie re-
liable class, without aiitops3\
2. Of the terms now 'included under this title heading the following
only are approved: Kpididymith^ hydrocele^ hydrocele of spermatic
cord^ hydrocele of tunica vaginalis^ orchitis^ phimosis (not con-
genital), spermatocele, tvmor of penis (nonmalignant), tumor of
scrotum (nonmalignant).
3. The committee recommends the addition of the term tumor of
spermatic cord (nonmalignant) to the list of inclusions.
4. The committee recommends the transfer to title No. 171 (Trau-
matism; by cutting or piercing instruinents) of the term drcumcisiony
and to title 186 {Other accidentul violence) of the term traumatic
orchitis,
5. A footnote should follow this title stating that it does not
include cancer, tuberculosis, or syphilitic or gonococcic lesions of the
genital organs.
128. Uterine Hemorrhage (Nonpuerperal).
1. It is recommended that this title be stricken out and that all
approved inclusions be transferred to title No. 130 {Other diseases
of the uterus).
2. Of tho terms now included under this title heading the follow-
ing only are approved for transfer as noted above : Hemorrhage of
uterus (nonpuerperal), hemorrhage of womb (nonpuerperal), hemor-
rhagic metritis (nonpuerperal), intrauterine hemxyrrhage (nonpuer-
peral), w^eWn^ hemorrhage (nonpuerperal).
129. Uterine Tumor (Noncancerous).
1. It is recommended that this title be placed in the reliable clnsh,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Fibroid of body of uterus, fibroid of cervix of
uterus, fibroid of uterus, fibroma of utemis, fibromyoma of uterus,
polypus of uterus, tumor of uterus (nonmalignant).
3. The committee recommends the transfer of the term deciduoma
to title No. 42 {Cancer of the female genital organs).
130. Othpr Diseases of the Uterus.
1. It is rex'ommondod that this title be placed in the reliable class,
without autopsy, with the understanding that when the specific cause
is described the death is to be classified thereunder.
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2. Of the terms now included under this title heading the following
only are approved : Endometritis^ inflammation of uterus^ retroversion
of uterus^ procidentia of uterus^ purulent endometritis^ pyometra^
septic endometritis {norv^\\&vi^QYK\) J septic metritis (nonpuerperal),
septic phlebitis of uterus (nonpuerperal), suppurative metritis,
3. It is recommended that all approved terms under present title
No. 128 {Uterine hemorrhage — nonpuerperal) be transferred to this
title. (See conclusions on title No. 128.)
4. It is recommended that the terms traumatic nietritis and rupture
of uterus (nonpuerperal) be transferred to title No. 186 {Other ex-
ternal violence),
131. Cysts and Olher Turners of the Ovary-
1. It is recommended that the caption be changed to NonmaHg-
nant Ovarian tumor. It is the opinion of the committee that the
title should be in the unreliable class, without operation or autopsy.
2. Of the terms now included the following only are approved:
Cyst of ovary^ cystic ovary^ dermoid cyst of ovary^ fibroid of ovaryj
hematoma of ovary^ ovarian cyst^ parovarian cyst^ tumor of ovary
(nonmalignant).
132, Salpingitis and Other Diseases of the Female Genital Orjgans.
1. The committee recommends that this title be considered aa un-
reliable statement of cause of death, without autop^.
2. In the opinion of the conwnittee there should be two siiblittes:
(A) Salpingitis^ and (B) Other diseaf^s, Under (A) the following
are approved inclusions: Purulent salpingitis^ pus tube,, pyosalpimff'-
itisj pyosalpinx^ rupture of pus tube, rupture of tubal absress. rup^
tured pyosalpinx^ salpingitis, sal ping o-oophoritis, salpingo-oraritis^
septic salpingitis^ suppuration of fallopian tube. Under (B) the
following are approved inclusions: Cystic oophoritis^ cystic ovaritis,
hematosalpinx J oophoritis^ ovaritis^ jyyo-oophoritis^ rupture of fal-
lopian tube^ nonmalignant tumor of broad ligament^ of vagina^ of
vulva,
133w Nrnpuerpcral Diseases of the Breast (Cancer Excepted).
1. It is recommended that this title, with a footnote to indicate
that it does not include cancer^ be placed in tlie reliable c lasK, with-
out autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Suppuration of breast, suppuration of manh-
mary gland, tumor of breast (nonmalignant), tumor of mammary
gland (nonmalignant).
^All conditions under this snbUtle refer to nongonococcic inflammation of tbe tubes.
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8. The committee recommends the transfer of the term hydatid
eyst of breast to title No. 107 (the proposed caption of which is Dis-
eases due to other parasitic v>orms)^ and of Paget^s disease of nipple
to title No. 43 {Cancer and other malignant tumors of the breast).
Oass YU. The Puerperal State. (Present titles 134 to 141.)
The committee recommends that the titles under this class be as
follows :
Abortion — ^reliable, without autopsy.
Puerperal hem/)rrhage — ^reliable, without autopsy.
Puerperal septicemia — ^reliable, without autopsy.
Puerperal albuminuria and convulsions — ^reliable, without autopsy.
Puerperal phlebitis and embolism — reliable, without autopsy.
Other diseases of pregnancy^ labor^ and the puerperium — reliable,
without autopsy.
The committee recommends that the following terms be included
under tlie title to be known as Abortion: Abortion^ accidental abor-
tion^ tiiduetion of abortion^ induction of premature labor ^ miscar-
riagcj tubal abortion.
The committee recommends that the following terms be included
under the title to be known as Puerperal hemorrhage: Accidental
hemonhage of parturition^ dccidental hcTnorrhage of puerperiun^
adherent placenta^ detachment of placenta^ hem/>rrhuge after labor^
hemorrhage during parturition, hemorrhage from detachment of
placenta, hemorrhage from uterus after parturition^ hemorrhage
from uterus during parturition^ hemorrhage {pusi*perium), mal-
position of placenta, placenta praevioj postpartum hem^orrhage, puer-
peral hemorrhage, retained membranes, retained placenta, retained
secundincs, retention of placenta, separation of placenta.
The committee recommends that the following terms be included
under the title to be known as Puerperal septicemia: Postpartum
pyemia, postpartum, sepsis, postpartum septicemia, puerperal cellu-
litis, puerperal endoTuetritis, puerperal eri/sipelas, puerperal fever,
puerperal inflammation of uterus, puerperal lymphangitis, puerperal
metritis, puerperal metroperitonitis, puerperal metrosalpingitis,
puei'peral pelric cellulitis, puerperal pelvic peritonitis, puerperal
peritoneal infection, puerperal peritonitis, puerperal periuterine cel-
lulitis, puerperal purulent endometritis, puerperal pyemia^ puerperal
salpingitis, puerperal sapremia, puerperal sepsis, puerperal septic
endometritis, puerperal septic fever, puerperal septic infection, puer-
peral septic metritis, puerperal septic peritonitis, puerperal septi-
cemia, puerperal suppurative metritis.
The committee recommends that the following terms be included
under the title to be known as Puerperal albuminuria and convul-
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sions: Eclampsia gravidarum^ eclampsia of Inhor^ eclampsia of preg-
nancy^ postpartum eclampsia^ postpuerpcral nephritis^ puerperal
albuminuria^ puerperal convulsions^ puerperal ecUimpsia^ puerperal
nephritiSj puerperal toxemia, puerperal uremia, toxemia of preg-
nancy, uremia of pregnancy.
The committee recommends that the following terms he inchided
under the title to be known fis Puerperal phlebitis and embolism:
Puerperal embolism, puerperal embolism of lung, puerperal phle-
bitis, phlegmasia alba dolens, sudden death from cardiac emhoVmn
after delivery, sudden death from cardiac thrombosis after delivery,
sudden death from cerebral hemorrhage after delivery, sudden death
from entrance of air into vein after delivery, sudden death from
pulmonary embolism after delivery, sudden death from pulmonary
thrombosis after delivery, venous thrombosis consequent on
parturition.
The committee recommends that the following terms be included
under the title to be kno\\'Ti as Other diseases of pregnancy, labor,
and the puerpei^um,: Abdojninal pregnancy, antepartum hemor-
rhage, ectopic gestation, ectopic pregnancy, emesis gravidarum, hy-
peremesis gravidarum, hyperemesis of pregnancy, persistent vomit-
ing (pregnancy), puerperal vamiting, tubal pregnancy, uncontrol-
lable vomiting of pregnancy, vomiting of pregnancy, breech presen-
tation (mother), Ccesarian section, delayed delivery (mother),
difficult labor (mother), dystocia (mother), laceration of cervix
(parturition), laceration of perineum (parturition), laceration of
peritoneum (parturition), laceration of urinary bladder (parturi-
tion), laceration of uterus (parturition), laceration of vagiyia (par-
turition), laceration of vulva (parturition), prolonged labor
(mother), jrrotrartcd labor (mother), rupture of bUulder (parturi-
tion), puerperal insaiiity, puerperal mania, puerperal melancholia,
rupture of uterus, and all terms listed under pre^nt title 141 {Puer-
peral diseatics of the breast),
142. Gangrene.
1. The committee recommends that this title be considered in the
reliable clti-s, without autopsy, if there is an accompanying state-
ment of the site and nature of the original infection.
i. The following terms are approved inclusions: Cancrum oris,
dermatitis gangrenosa, dry gaiigrene, gangreiie (nontraumatic —
site of lesion must be specified), mulignant edema, moist grangrene,
noma of mouth, noma of vulva, phagedena of penis, phagedena of
. vulva, Raynaud"* s disease,
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3. The ccmmittee recommends the transfer to this title of the term
otnAum from title No. 148, the present caption of whidi is Other
diseases of the organs of locomotion.
143. Furuncle.
1. The committee recommends that this title be considered in the
reliable class, without autopsy, if there is an accompanying state-
ment of the site and natui'e of the original infection.
2, The following terms are approved inclusions: Carbuncle (site
must be specified), furunctdosisy multiple cai*bwicle,
144. Acute Abscess.
1. The committee recommends that this title be considered in the
reliable class, without autopsy, if there is an accompanying state-
ment of the site and nature of the original infection.
2. Inasmuch as an abscess at any specified location may be insuffi-
cient to cause death by itself, supplementary data as to the site and
nature of the original infection should be supplied. Hence, a list of
ai^roved terms to be included imder this title is omitted, as there
is no limit to the number of places or the variety of organs which
may be afflicted by inflammatory abscess processes.
14S. Other Diseases of the Skin and Annexa.
1. In the opinion of tlie committee this title should be considered
in the reliable class, without autopsy*
2. Of the terms now included under this title heading the follow-
ing are approved: Bedsore (site must be specified), chronic ulcer
(site must be specified), decubitis^ devmaiitis venenata^ ecthyma^
herpes zoster^ eczema^ malignant p^mphii/us^ pemphigus,^ pemphigus
neonatorum^ sderodemiia^ shingles^ zona.
3. The committee voted to suggest the addition of the following
footnote to this title: Inasmuch as any one of the great number of
skin diseases may lead to death through the development of second-
ary sepsis, it has seemed inadvisable to extend further the list of
inclusions under this title, since it would be necessary to include a
very great number of dermatological terms to make the list complete.
146. Diseases of the Bones (Tubtrcnloais BzceptodI).
1. A footnote should follow the title explaining all it does not in-
clude rheumatism and tuberculosis; also that where diseases of the
bone affect structures connected with the special senses — nasal fossae,
ear, orbit — they are to be referred to the appropriate headings cover-
ing diseases of these organs of special sense. The title is in the
reliable class, without autopsy.
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2. Of the terms now included under this title heading the following
only are approved : Caries of bone, circumscribed periostitis^ diffuse
periostitis, gangrene of bone, infective osteomyelitis, infective perios-
titis, necrosis of bone (site specified), osteitis deformans, osteo-
myelitis, osteoperiostitis, periostitis (site specified), spontaneous
fracture of bone, suppurative osteomyelitis (site specified), suppura-
tive periostitis (site specified), tumor of bone (site specified).
3. The committee recommends the transfer of the following terms
to title No. 76 {Diseases of the ears) : Abscess of 7)iastoid process, dis-
ease of mastoid cell, empyema of mmtoid process, mastoid abscess,
mastoiditis, necrosis of mastoid; it further recommends the transfer
of the following terms to title No. S(j (Diseases of the nasal fossae) :
Abscess of antrum of Highmore, abscess of ethmoidal sinus, abscess of
frontal sinus, abscess of maxillary sinus, ahscess of sphenoidal sinus,
disease of frontal sinus, empyema of frontal sinus, ethmoidal sinusitis,
ethmoiditis, frontal sinusitis, maxillary sinusitis, necrosis of antrum,
sphenoidal sinusitis, sphenoiditis, suppuration of frontal sinus; it
further recommends the transfer of the following terms to title
No. 186 {Other external violence) : Foreign body in antrum of Iligh-
more. foreign body in frontal (and other sinuses) ; it further recom-
mends the transfer of the term osteoma to the list of nonmalignant
tumors, given in the prefatory note on cAncers and tumors.
4. The committee recommends the transfer to this title of the fol-
lowing terms from title No. 36 {Rickets) : Achondroplasia, hyper-
trophic osteoarthropathy, pulmonary osteoarthropathy.
147. Diseases of the Joints (Tuberculosis and Rheumatism Excepted).
1. The committee recommends that this title be considered reliable,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Abscess of joint (specify joint), infective syno-
vitis (site specified), polyarthritis (nonvertebral) (site and etiologi-
cal factor to be specified), pui^lent arthritis, purulent synovitis, sep-
tic arthritis, suppurative synovitis,
148. Amputations.
1. The committee recommends that this title be eliminated. The
terms included under it are vague and unsatisfactory returns of
cause of death. If encountered, they should be queried for the
causes for the relief of which the operations were performed and
assigned on the basis of information so secured; if no further data
can be obtained, they should be classified as deaths of which the
causes a,re not specified; i. e., under present title No. 189.
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149. Other Diseases of the Organs of Loeomotion.
1. In the opinion of the committee this title should be under the
heading of Diseases of the muscles^ tendons^ and their annexa. The
new title is reliable, without autopsy, but in the case of each inclu-
sion except spasmodic torticollis and torticollis the site of the lesion
and the primar}' cause of the inflammation should be specified.
2. The committee recommends the transfer of myotonia congenita
and Thomsen's disease to title No. 74 {Other diseases of the nervous
system) and of ainhum to title No. 142 (Gangrene).
3. Approved inclusions are: Abscess of bursa^ abscess of muscle^
abscess of tendon^ amyotonia congenita^ bursal cyst^ bursitis^ infective
myositis^ inflammatio7i of bursa^ inflammation of fascia^ of muscle^
of sheath of tendon^ muscular dystrophy^ myositis^ myositis fibrosa^
myositis ossifl<ians^ new groxcth of bursn (nonmalignant), new
growth of tendon (nonmalignant), polymyositis^ progressim ossify-
ing myositis^ spasmodic torticollis^ ienontosynoritis. tenosynovitis^
tenotomy^ thecal abscess^ torticollis^ tumor of bursa ^ tumor of sheath
of tendon^ tumor of tendon.
4. The committee recommends the transfer of the term myasthenia
gravis to this title from title No. G3 {Other diseases of the spinal
cord).
150. Congenital Malformations (Stillbirths not incladed).
1. The committee recommends that subtitle No. 1 {Hydrocephalus)
be considered in the reliable class, without autopsy.
2. The following inclusions are approved : Chronic hydrocephalus^
congenital cerebral tumor^ congenital hydrocephaltts^ congenital
tumor of brain^ hydrocephalus of brain^ megalocephalus.
3. The committee recommends that the subtitle Congenital mal-
formations of the heart be placed in the reliable class, without au-
topsy.
4. Of the terms now included under subtitle 2 {Congenital malfor-
mations of the heart) ^ the following only are appix)ved: Atelocardia^
congenital heart disease^ congenital malfor^nation of hearty congenital
valvular heart disease., cyanosis (due to malfoftnation of heart),
cyanosis (pei'sistence of foramen ovale), cyanosis (from nonclosure
of ductus arteriosus or duct of Botalli), morbus caeruleiis^ patent
ductus arteriosus^ patent foramen ovale.
5. The committee recommends that subtitle No. 3 (Other congenital
malformations) be considered in the reliable class, without autopsy,
except that for certain inclusions data should be supplied as indi-
cated in the following list. Of the terms now included under sub-
title No. 3 the following only are approved: Cerebral hernia (con-
genital), cerebral meningocele^ cleft palate^ congenital amputation
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(reliable if part designated), congenital atresia (reliable if part
designated), congenital cystic disease of kidney^ congenital fracture
(reliable if designated fully), congenital imperforate urethra^ con-
genital intestinal obstruction^ congenital laryngeal stenosis^ congenital
pyloric stenosis^ congenital spina bifida^ congenital stenosis^ congenital
stenosis of intestine^ congenital stenosis of larynx^ congenital tumor
(reliable if location and nature of, are stated), ectopia (reliable if
part stated), ectopia of bladder^ ectopia vesicae ^ encephaloceic, ex-
strophy of bladder^ extroversion of bladder^ fissure of lip (harelip),
fissure of palate^ fissure of spinal column^ harelip^ hemiccphalus^
hydroencephalocele^ hydromyelia^ hydromyelocel^y hydrorrha^his^ im-
perforate amiSy imperforate pharynx^ imperforate rectum^ malforma-
tion (reliable if specified), meningocele^ meningoTnyelocele^ m^icro-
cephaly^ o^nphalocele^ podencephalus^ spina bifida^ spinal hernia^
spiifial meningocele^ syringomyelocele,
151. Congenital Debility, Icterus, and Sclerema.
1. The committee recommends that the title heading be changed to
Premature birthj infantile diseases of (Ae liver and jaundice^ and
7nalnutrition.
2. Further recommendation is that the following subtitles be estab-
lished: (1) Premature birth, (2) Infantile diseases of tlie liver and
jaundice, (3) Malnutrition, (4) Ill-defined diseases of nutrition, mal-
nutrition from unknown cause. The approved inclusions under Sub-
title No. 1 are : Accidental abortion,inimaturity, miscarriage, premature
birth, prematurity. Subtitle No. 1 is considered reliable, without
autopsy. The approved inclusions under subtitle No. 2 are: Actite
catarrhal hepatitis- (under 1 year), acute catarrhal jaundice (under
1 year), BuhVs disease, congenital cii^rhosis of liver (under 1 year),
congenital cirrhosis, congenital icterus, hematogcTWUs jaundice
(under 1 year), hematogenous icterus (under 1 year), icterus (under
1 year), icterus neonatorum, icterus of 7ie wborn, jaundice (under 1
year), jaundice of newborn. Subtitle No. 2 is considered unreliable,
without autopsy. Under subtitle No. 3 the approved inclusions are:
Artificial feeding^ bottle feeding, improper food, mal^ssimilation^
want of breast milk, marasmus. Subtitle No. 3 is considered unre-
liable, without autopsy. The committee did not approve a list of in-
clusions for subtitle No. 4. This is the residual subtitle, and the
terms included under it are all of a more or less vague and unsatis-
factory character. It is in the unreliable class.
3. The committee recommends the transfer of the following terms :
Hepatitis of the newborn to title No. 37 (Syphilis) ; sclerema, scle-
rema neonatorum, and congenital sclerema to title No. 152, subtitle 2
{Other diseases peculiar to early infancy),
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152. Other Causes Peculiar U Early Infancy.
!• It is recommended that subtitle No. 1 {Injuries at birth) be
placed in the reliable class, without autopsy.
2. Of the terms now included under the subtitle Injuries at birthj
the following only are approved inclusions: Breech presentation^
CcBsarean operation^ cephalematoma^ cephalic hemorrhage (at birth),
cerebral compression (injury at birth), cerebral hemorrhage (injury
at birth), cerebral pressure (injury at birth), compression during
birthj compression of brain (injury at birth), com^pression of umbil-
ical cord J delayed confinement^ delayed delivery^ dystocia^ foot pres-
entation^ forced delivery^ forceps operation^ hematoma of brain^ hem-
orrhage of scalp (injury at birth), instrumental delivery^ malpres-
entation^ placenta prcsvia^ podalic version^ prolapse of funis^ prolapse
of umbilical cord^ prolonged labor j protracted dry birthj protracted
labor, rupture of brain (incident to birth), strangulation of umbilical
cordj transverse presentation, i)ectis (lise'of), version.
3. Of the terms now included under the subtitle Other causes pecu-
liar to early infancy, the following only are approved: Atelectasis,
atelectasis neonatorum, atelectasis of newborn, ceUuUtis of umbilicus
(under 3 months), gangrene of umbilical cord, hemorrhage of funis,
hemorrhage of navels hemorrhage of newborn, hemorrhage of umbil-
ical cord, hemorrhage of umbiUcus, infected navel, infected umbilicus,
infectious omphalitis, melena neonatorum, (see 110), omphalitis,
phlebitis of umbilicus, postnasal asphyxia, septicemia from navel,
septicemia of umbiUcus, WincheVs disease. Theee inclusions should
be considered reliable, without autopsy.
4. The committee recommends the transfer of the following terms
from other titles: AU terms now listed under title No. 94 {Pulmo-
nary congestion, pulmonary apoplexy) when reported for infants
under 3 months of age; m^dena from title No. 110 when reported for
infants under 3 months of age, sclerema, sclerema neonatorum, and
congenital sclerema from present title No. 151 {Congenital dehility,
icterus, and sclerema),
5. The committee recommends the transfer of the term hemophi-
lia neonatorum from this title to title No. 55 {Other general dis-
eases).
153. L4ick of Care.
1. It is recommended that this title be considered reliable, without
autopsy.
2. Of the terms now included under this title heading, the follow-
ing only are approved: Desertion (newborn), exposure to cold
(under 3 months), lack of care.
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154. Senility.
1. The committee considers this a very unsatisfactory title and not
reliable as a cause of death, without autopsy. It should always bo
queried for the disease causing deaths as it is too often used on death
certificates of elderly pei-sons whose deaths should have been reported
as due to diseases of various organs.
2. It is recommended that this title be subdivided into (1) Senility
accompanied hy dementia or hy other forms of mental alienation
(over 70) ; (2) Senility — others of this class. Under subtitle No. 1
the committee recommends as approved inclusions the terms dementia
of old age^ senile dementia^ senile insanity ^ senile paresis^ senile psy-
chosis^ senile melancholia, Undfer subtitle No. 2 the approved terms
are morhvs senilis^ old age^ and senility. The committee declares its
reason for recommending that these subtitles be established to be as
follows: It believes that many of the deaths reported from hospitals
for the insane as due to senile idementiay senile insanity y senile partsis
and similar terms are more properly chargeable to title No. 68
{Other fonns of mental alienation) tiian they are to Senility. These,
however, are so numerous that the transfer of all such cases to title
No. 68 would make a very great difference in the number of deaths
classified under both titles 68 and 154, and a corresponding difference
in the published death rates. The subdivisions, as now recommended,
will enable anyone who so desires to ascertain the number of deaths
i-eported from senility accompanied by mental alienation.
Conclusions on Suicides as a Class.
The committee has been advised that no death is classified in the
annual mortality statistics published by the Bureau of the Census as
a suicide unless the fact of suicide is shown, either on the transcript
of the death certificate as received by the bureau or throu<rh informa-
tion obtained by an inquiry sent out to determine the matter. The
committee desires to express its approval of this practice.
155. Suicide by Poison.
1. It is suggested that the name of this title be changed to Suicide
hy ingestion of poisonous solids and liquids. It is in the reliable class,
without autopsy, if the character of the solid or liquid is specified.
2. Of the terms now included under this title heading the following
only are approved: Poisoning (suicidal), ^w/e^Vfc hy poison (any solid
or liquid).
156. Suicide by Asphyxia.
1. It is recommended that the name of this title be changed to
Suicide hy inhalation of poisonous gases and that it be placed in the
reliable class, without autopsy, if the character of the gas is specified.
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2. Of the terms now included under this title heading the following
only are approved: Suicide by asphyona (any gas or \npov) ^ suicide
hy carbon monoxide^ suicide by chloroform (vapor), suicide by gas
(any gas), suicide by illuminating gas^ suicide by inhahifion of gas
(any gas or vapor), suicide by suffocation (any gas or vapor).
157. Snidde by Hanging or Strangulation.
1. The committee recommends that this title be placed in the
reliable class, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved : Suicide by hanging ^ suicide by strangulation.
158. Suicide by Drowning.
1. The committee recommends that this title be placed in the
reliable class, without autopsy.
2. Of the terms now included under this title heading the following
only are approved: Suicide by drou^ning^ suicide by submersion,
159. Suicide by Firearm.
1. The committee recommends that this title be placed in the
reliable class, without autopsy.
2. Of the terms now included under this title heading the following
only are approved : Suicide by firearms^ suicide by shooting.
160. Suicide by Cutting or Piercing Instrument.
1. The committee recommends that this title be placed in the
reliable class, without autopsy.
2. Of the terms now included imder this title heading the follow-
ing only are approved: Suicide by cutting instrument^ suicide by
cutting throaty suicide by piercing instrument,
3. The committee recommends the addition of the following terms :
Suicide by cutting arto'y^ suicide by cutting blood vessel,
161. Suicide by Jumping from High Place.
1, The committee recommends that this title be considered reliable,
without autopsy.
2. The committee approves the retention of the only term now
listed, suicide by jumping from high place,
162. Suicide by Crushing.
1. The committee recommends that this title be in the reliable
class, without autopsy.
2. Of the terms now included under this title heading all are
upproved: Suicide by crushing^ suicide by jumping before train ^ sui-
cide by jtmiping before other vehicles,
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163. Other Suicides.
1. Tlie coniinitteo recommends that this title he (-(msiHertHl reliahle,
without autopsy.
2. The coiumittee reeommemls that registration and compiling
offices query all reports of N^//^vV/^, without further (jufllification, to
ascertain the manner of death or the means employed. With this
information each death covered by this return can be classified under
one of the titles relating to suicide by specified means.
3. Of the terms now included under this title the following only
are approved: Suicide (unqualified), mlcide bt/ hums^ suicide hy
fve^ suicide hy sc(dds,
164. Poisoning by Food.
1. This title should be considered unreliable without supporting
data either as to a group of accompanying cases or the ingestion of
the particular poisonous substances.
2. Of the terms now included under this title heading the follow-
ing only are approved: Botulism^ cheese poisoning^ egg albumen
poisoning y fish poisoning^ meat poisoning^ milk poisoning^ mushroom
poisoniiuj^ porlc poisoning (not due to trichinosis), potato poisoning^
sausage poisoning )t due to trichinosis), shellfish poisoning.
tG5. Other Acute Poisonings.
1. It is recommended that the caption of this title be changed to
Other acute accidental poisonings (gas excepted). This title, in the
opinion of the committee, should be considered unreliable, without
autopsy, unless there are supporting data. All returns which do not
specify that the poisoning was accidental should be querie<l by regis-
tration and compiling offices. In this way many reports will be
found to represent cases that ai*e properly chargeable to suicide or
homicide.
2. In the opinion of the committee there should be two subtitles:
(A) Poisonous bites^ to include the approved terms, bite of insect^
bite of venomous serpent^ bite of viper, snale bite^ venom of animal,
venom of C( ntipede, venomous bite; and (B) Other acute a/'cidental
poisonings (gas excepted), to include the approved terms: Acci-
dental poisoning (only when kind of poison is specified), acute
ergotism, acute poisoning (only when kind of poison is specified),
opium narcosis, poisoned wound (not simply septic poisoning),
poisoning^ serur/i intoxication, serum poisoning,
N. B. All of the aljove to be qualified to show accidental character.
3. It is recommended that the following footnote be added: This
title does not include septic poisoning.
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166. Conflagration.
1. The committee recommends that this title be considered re-
liable, without autopsy.
2. Of the terms now included under this title heading the follow-
ing only are approved: Confagrathn (to include all injuries of
whatsoever nature resulting therefrom), crushed at -fire (conflagra-
tion) , inhalation of smoke (burning building), /w/n/^e^rZ from lurning
huilding^ suffocation (burning building).
3. The committee recommends that the following terms be added
to the list of inclusions : Prairie fire^ forest fire,
4. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
167. Bnrna (Cooflasration Excepted).
1. The committee recommends that the name of this title be Acci-
dental burns and that it be placed in the reliable class, without
autopsy, but that returns of Burns be queried to determine whether
they were received in burning buildings or otherwise; also that a
footnote be added stating that it does not include deaths from
burns received in burning buildings.
2. Of the terms now included under this title heading the follow-
ing only are approved: Bum (conflagration excepted, of any organ
or part), hum by boUing liquid^ hum by boiling water ^ burn by coal
oilj burn by coiTosive substance^ hum by fire^ burn by gasoline^ burn
by kerosene^ bum by petroleum^ bum by steam, burn by sulphuric
acidy burn by vitriol, effects of corrosives, explosion of lamp, lamp
accident, scald (of any part of body), scald by steam.
3. The following terms, now listed under this title heading, should,
in the opinion of the committee, be classified under title No. 186
{Other external violence) if encountered; they are seldom, if ever,
causes of death: Dermatitis aciinica, dermatitis amhustionis, effects
of radium, X-ray hums.
4. The committee recommends that the term burn by molten metal
be added to the list of inclusions.
5. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
168. Absorption of Deleterious Gases (Conflagration excepted).
1. It is recommended that the name of this title be changed to
Suffocation and accidental inludation of poisonous gases: that it be
placed in the reliable class, without autopsy, and that it be followed
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by ?i footnote stating that it does not include deaths in burning build-
ingh?. The connnittee also recommends that all reports that do not
specify that the ]>ois(ming was accidental be queried by registration
and compiling offices. In this way many returns will be found to
represent cases that are properly chargeable to suicide or homicide.
2. The committee recommends that two subtitles be established,
namely, (A) tohe called Suff oca ft on and (B) Acchletitol inhalation of
poisonous gases. Of the terms now included imder this title heading the
following only are approved; and all are assignable to subtitle (B)
with the exception of those specified as coming under (A) : Accidental
asphyxia (gas to be stated) , acetylene poison iny, acute etherisni^ ammo-
nia poisoning^ aniyl nitrite poisoning^ chloroform anesthesia^ anes-
thetic^ anesthetic for operation (unqualified), asphyxia (accidental),
asphyxia by fumes^ asphyxia by gas (accidental), asphyxia by smoke
(conflagration excepted), bisulphide of carbon poisoning^ carbon
bisulphide poisoning^ carbon dioxide poisoning^ carbon monoxide
poisoning^ charcoal funics^ chloroform (vapor), choke damp poison-
ing (not in mines), coal-gas poisoning^ cordite poiso7iing (vapor),
cyanogen poisoning ^ delayed chloroform poisoning (vapor), ether
(vapor), hydrogen sulphide^ illuminating gas^ laughing gas^ ntarsk
gas^ nitrous oxide^ noxious vapors or effluvia (including those pro-
duced by explosives), sewer-gas poisoning^ sewer poisoning^ suffo-
cation (unqualified), (A), suffocation by smx>ke (conflagration ex-
cepted), sulphuretted hydrogen^ water ga>s^ overlain (A), suffocation
by abnormal atmospheric pressure (A).
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
169. Accidental Drowning.
1. The conmiittee recommends that this title be placed in the
reliable class, without autopsy, but suggests that returns of Drown-
ing be queried to determine whether the death was accidental,
suicidal, or homicidal.
2. Of the terms now included under this title heading the follow^ing
only are approved: Accidental drowning^ accidental submersion^
asphyxia by drowning^ drowning (unqualified), found drowned
(open verdict), lost at sea^ suffocation by droxoning^ suffocation by
submersion.
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
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170. Traamatism by Fireaim.
1. In the opinion of the committee the name of this title should be
Accidental traumatism hy -firearms. This title is unreliable, without
supporting data, such as site and extent of injury. The committee
nlso recommends that all reports that do not specify that the trau-
matism was accidental be queried by registration and compiling
offices to determine whether death was accidental, suicidal, or
Iiomicidal.
2. All of the following terms as now included are accepted as
l)ix)perly chargeable to this title if no further information be obtain-
able, but each should be defined as accidental; otherwise there Is
always doubt as to correct classification: Accidental wound hy- fire-
arms (of any part of body), firearms^ gunshot^ pistol ivound^ shoot-
ing^ shoty traumatism by firearTris, wound by firearms.
171. TraumatiBm by Catting or Piercing Instrument.
1. The committee recommends that the title be called Accidental
traumatism by cutting or piercing instrument^ and that it be con-
sidered unreliable, without supporting data, such as site and extent
of injury. It is also recommended that all reports that do not specify
that the traumatism was accidental be queried by registration and
compiling offices to determine whether death was accidental, suicidal,
or homicidal.
2. All of the following terms, as now included, are approved as
properly chargeable to this title, if no further information is ob-
tainable, but each should be defined as accidental ; otherwise there is
always doubt as to correct classification. Cut (of any part of body),
incised wound (of any part of body), knife cut, knife stab (acci-
dental), punctured wound (of any part of body), stab wound (of
ttny part of body, accidental), traumatism by cutting instruments
Iraum/itism by piercing instrument^ wound by cutting instrument (of
tiUy part of body), wound by piercing instrument (of any part of
body).
3. The committee recommends the transfer of the term circum'
vision to this title from present title No. 127 {Nonvenereal diseases
of the male genital organs) .
4. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
172. Traumatism by Fall.
1. The committee recommends that the name of this title be
changed to Acidcntal fall and that it be placed in the reliable cla.^s,
without autopsy.
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2. All of the following terms as now included under this title are
approved: Accidental fall^ fall down stairs^ fall from horse^ fall in
sliip^ fall into hold (ship, etc.), injury by dicing^ injury fram fall,
tramnatism by falling,
3. The committee recommends that a footnote be added stating that
this title does not include accidents connected with traflSc, in buraing
buildings, or in mines or (juarries.
-4. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent, so far as the reports make this possible.
173. Traumatism in Mines and Quarries.
1. It is recommended that this title be called Accidents and injuries
ill mines and be placed in the reliable class, without autopsy.
2. It is further recommended that a new title be established to be
called Accidents and injuries in quarries; for the present it may be
referred to as 173A, q, i\
3. Of the terms now included under present title No. 173 the fol-
lowing are approved for the title Accidents and in Junes in mines:
Accident in mine^ asphyxia by gas in mine^ choke damp (unquali-
fied), explosion of fire damp, fall in pit (mine). ^all in shaft (mine),
fall of coal (mine), injury by mining machinery , injury by wagon in
mine^ injury in mine, mining accident, traumatlstn in mine.
4. The committee recommends that this title be subdivided into
(a) Injuries by falls, (b) Injuries by falling bodies, (c) Explosions,
asphyxia, and suffocation, (d) hijuries by mining machinery and
vehicles, (e) All other accidents and injuries in mines,
173A. Accidents and Injuries in Quarries. (Tentative new title.)
1. It is recommended that this tentative new title be placed in the
reliable class, without autopsy.
2, Of the terms now listed under present title No. 173, the fol-
lowing are approved for the title Accidents and injuries in quarries:
Accident in quarry, fall in pit (quarry), fall of stone (quarry), in-
jury in quarry, traumatism in quarry,
174. Traumatism by Machines.
1. The committee recommends that this title be placed in the re-
liable class, without autopsy.
2. It is the further recommendation of the committee that two sub-
titles be established. One should have the caption Traumatism by
elevators with the following approved inclusions: Elevator accident,
traumatism by elevator, accident on moving stairway. The second
subdivision should have the caption Other traumatisms by m/achines,
and under this subtitle the following terms are approved by the com-
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1627 September 28. 1917
mittee: Accidental fall of machinery^ caught M shafting^ crushed hy
traveling crane^ injury by machinery^ traumatism by machinery.
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
the decedent.
175. Traumatism by Other Crushing.
1. The committee recommends that the name of this title be
changed to Other crushing and transportation accidents; that it be
placed in the reliable class, without autopsy, and be subdivided as
follows: (A) Railroad accidents (steam) ^, (B) Street railway acci-
dents^ (C) Automobile accidents^ (D) Water transportation acci-
dents^ (E) Other vehicular accidents and injuries, (F) Other crush-
ing.
2. Of the terms now included under present title No. 175 (Trau-
matisfn by other crushing) the following only are approved for the
several subtitles noted above: Automobile accident, bicycle accident,
bicycle injury, crushing by bu?npers, cycle accident, derailment,
earthquake, electric railway accident, elevated railway accident, fall
from car or engine, fall from carriage, fall from or with aeroplane,
fall from or with balloon, fall from or with parachute, injury getting
off car or engine, interurban railway accident, kiU'Cd on railroad,
landslide, motor-cycle accident, railroad accident, run over by auto-
mobile^ run over by car, runaway accident, street car accident, street
railway accident, struck by automobile, struck by car or engine, sub-
way accident, surface car accident, thrown from automobile, trau-
matism, by aeroplane, traumatism by automobile, traumatism by
balloon, traumatism by electric railroad, traumatism by landslide,
traumatism by otJier crushing, traumatism by railroad, traumatism,
by street railroad, traumatism by vehicle (carriage, wagon, bicycle,
etc.), trolley accident.
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon occupation of
decedent.
176. Injuries by Animals.
1. It is the recommendation of the committee that this title be
placed in the reliable class, without autopsy.
2. All of the following terms, as now included under this title
heading, are approved: Bite {of any animal), dog bite, gored, injury
by any animal (due to viciousness) , kick (by horse or other animal),
traumatism by horse (due to viciousness).
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
1 Inolades accidents on roads haying portions of their systems electrifl d.
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Beirtembcr 28. 1917 1628
4. The committee i-ecommends that the following footnote be
added: This title does not include bite of insect or bite of serpents
(165).
177. Starvation.
1. It is reconiniended that the name of this title be changed by
adding parenthetically the words deprivation of food or water; it is
a reliable statement of cause of death, without autopsy, but, owing to
the fact that the word is sometimes used on death certificates in cases
where the "^ starvations^ was due to malnutrition from disease, the
report should always be queried by registration and compiling offices.
Only deaths from actual privation (deprivation of food or water)
are assignable to this title.
2. Of the terms now included under this title heading the following
only are approved: Deprivation of water^ hunger^ inariition (starva-
tion), insufficient nourishnient^ privation^ starvation^ thirst.
178. Excessive Cold.
1. In the opinion of the committee this is a reliable title, without
autopsy.
2. ( >f the terms now included under this title heading the follow-
ing only are approved: Effects of cold (temperature), exposure to
cold (3m+), freezing^ frostbite, frozen.
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
179. Effects of Heat.
1. It is recommended that this title be placed in the reliable class,
without autopsy.
2. Of the terms now included under this title heading the following
only are approved : Effects of heat in engine room, effects of heat in
laundry^ etc.^ excessive heat^ heat apoplexy .^ heat cramps^ heat pros-
tration^ heat stroke^ insolation^ overheated^ sunstroke^ thermic fever.
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
180. Lightning.
1. It is recommended that this title be placed in the reliable class,
without autopsy.
2. The term lightning^ the only inclusion listed under this title
heading, is approved.
181. Electricity (Lightning Excepted).
1. It is recommended that this title be placed in the reliable class,
without autopM'.
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1629 September 28, 191C
2. All the terms now included uader this title heading are ap-
proved: Accidental electric shock ^ accidental electrocution^ electric
shocky electricity (lightning excepted), injury by electric shock.
3. The committee recommends that a separate tabulation be made
of all cases in which death was dependent upon the occupation of
decedent.
Conclusioiis on Homicides as a Class.
The committee has been advised that no death is classified as a
homicide in the annual mortality statistics published by the Bureau
of the Census unless the fact of homicide is shown, either on the
transcript of the death certificate as received by the buretiu, or
through information obtained by inquiry sent out to determine the
matter. The committee desires to express its approval of this
practice.
182. Homicide by Firearms.
1. It is recommended tliat this title be placed in the reliable class,
without autopsy.
2. All of the terms now included under this title heading are ap-
proved: Assassination hy firearms^ gunshot (homicidal), homicide hy
firearms^ homicide hy gunshot^ shooting (homicidal), shot (homi-
cidal), shot hy burglar^ shot in duelj wound hy firearms (homicidal).
183. Homicide by Catting or Piercing Instruments.
1. It is recommended that this title be placed in the reliable class,
without autopsy. It is further recommended that the last word in
the title be changed to the singular form.
2. All of the terms now included under this title heading are ap-
proved : Assassination hy cutting or piercing instrument^ cut (homi-
cidal), homicide hy cutting instrument^ homicide hy jnercing instru-
ment^ knife cut (homicidal), knife stah (homicidal), wound hy cut-
ting instrument (homicidal).
184. Homicide by Other Means.
1. The committee recommends that this title be placed in the
reliable class, without autopsy.
2. The committee desires to call attention to the fact that, strictly
speaking, no term at present listed under this title heading is ap-
proved unless the means or instrument used and the fact that the
violence was homicidal are specified. If these data are not specified
the report should be queried to determine whether the death was not
one assignable to title No. 182 {Uomicide hy firearms) or to title
No. 183 {Homicide hy cutting or piercing instruments) . With these
restrictions, and with the understanding that some of these terms are
approved only as methods of violence that may be homicidal, the fol-
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September 28, 1917 1630
lowing list under this title is printed here: Assassination (without
further explanation), bite of human being, duel, homicidal poisoning,
homicidal wound, homicide (unqualified), incendiarism, infanticide
(unqualified), kilhd in fight, hjnching, manslaughter, murder (un-
qualified), thromng of sulphuric acid, throwing of vitriol, trauma-
tism (homicidal), wound (homicidal).
3. The committee recommends the addition of the following term
to the list of inclusions : Homicidal strangulation,
4. The committee recommends that a new title be established to be
known as Criminal abortion. For the present this may be numbered
184X, q. V. It is recommended that the term criminal abortion
(death of mother or child) be transferred to this title.
184X. Criminal Abortion (Tentative new title).
1. The committee recommends that a new title be established
under the above caption and that it be subdivided into (A) Induced
by instrument or drug, (B) Self-induced by instrument or drug, (C)
Induced by another person by instruvient or drug, and that each sub-
title be considered reliable, without autopsy.
2. The committee recommends the transfer to this title of the
following term from present title No. 184 (Homicide by other
means) : Criminal abortion (death of mother or child).
185. Fractures (Cause not specified).
1. The committee recommends that this title be eliminated and
that such reports as can not, on iuqui^3^ be classified under more
definite titles, be assigned to title No. 186 {Other external violence).
186. Other External Violence.
1. In discussing this title the committee desires to call attention
to the following headnote in the Manual of the Intemationfil List
of Causes of Death.
"Note. — This is the residual title for external causes. Many
indefinite returns found here could be assigned elsewhere if the
means of death and the character of violence (accidental, suicidal, or
homicidal) were stated. Deaths from legal execution and war are
also included and may be stated separately if deemed desirable."
It is evident that no "blanket" recommendation can be made as
to its reliability or unreliability, without autopsy.
2. Of the terms now included under this title heading the com-
mittee approves as inclusions only such terms as, first, are so defined
as to identify them, when used on death certificates, as covering
cases of death by legal execution or death incidental to war, and,
second, such terms as are so defined as to identify them, when used
on death certificates, as both accidental and caused by means, deaths
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1631 September 28, 1917
from xohich are not assignable to any title of the mterfiational list
relating to any other specified form of violence. In oth^r words, no
inclusion under this title heading is approved that might conceal
a death from homicide, suicide, or well-defined accidental violence
assignable elsewhere. The following are approved inclusions:
Battle, capital punishment^ electrocution (legal execution only),
execution^ football ac&ident, hanging (legal execution only), killed
in cyclone,
3. The committee realizes, in making the above recommendation,
that as this is a residual title, and as such necessarily a more or less
indefinite title, deaths reported from ill-defined violence concerning
Avhich no definite information is obtained on inquiry must be asirigned
thereto.
4. The committee has been advised that it is the practice of the
Bureau of the Census, so far as practicable, to query all of the unsat-
isfactory statements listed under this title heading in an effort to
obtain data justifying their classification under more definite head-
ings, and desires to express its approval of this practice.
5. The committee recommends the addition of the following terms
to the list of inclusions : Boating l)out^ foot race^ competitive athletics^
athletic competition.
6. The transfer of the following terms to this title from other titles
is recommended: Foreign body in nose from title No. 86 {Dis-
eases of the nasal fossae); traumatic pnev/monia from title No. 92
(Pneumonia); traumatic peritonitis^ foreign body in peritoneum
from present title No. 117 {Simple peritonitis) ; traumatic encepha-
litis and traumatic inflammation of brain from present title No. 60
{Encephalitis); trauviatic metritis^ rupture of uterus (nonpuer-
peral) from title No. 130 {Other diseases of the uterus); foreign
body in bladder from title No. 124 {Diseases of the bladder) ; foreign
body in esophagus from title No. 101 {Diseases of the esophagus) ;
foreign body in stomxnch from title No. 103 {Other diseases of the
stomxich); foreign body in urethra from title No. 125 {Diseases of
the urethra^ urinary abscesses^ etc) ; foreign body in accessory sinus^
frontal sinus^ maxiUary mius^ antinim of Highmore from present
title No. 146 {Diseases of the bones); foreign body in intestine^
rectum^ from title No. 110 {Other diseases of the intestines) ; trau-
matic orchitis from present title No. 127 {Nonvene7*eal diseases of
the male genital organs).
187. Ill-Defined Organic Disease.
1. Under this title are listed a number of terms, all of which are
indefinite and unsatisfactory as statements of the primary cause of
death. The committee recommends that the title be considered in
the unreliable class, without autopsy.
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September 28, 1917 1632
2. The committee is advised that the Bureau pf the Census and
many State and municipal registration offices are making determined
eftorts to secure more definite data when such returns are receive^l,
and desires to express its approval of this practice. It realizes that,
until all such reports are eliminated, they must be classified some-
where. This, in the opinion of the committee, is the sole reason for-
giving this title a place in the International List.
188. Sudden Death.
1. Under this title are listed a number of terms, all of which are
indefinite and unsatisfactory as statements of the primary cause of
death. The committee recommends that the title be considered in
the imreliable class, without autopsy.
2. The committee is advised that the Bureau of the Census and
many State and municipal registration offices are making determined
efforts to secure more definite data when such returns are received,
and desires to express its approval of this practice. It realizes that,
until all such reports are eliminated, they must be classified some-
where. This, in the opinion of the committee, is the sole reason for
giving this title a place in the International List.
189. Not Specified or Ill-Defined.
1. The committee recommends that this title be placed in the un-
reliable class, without autopqr.
2. The committee recommends that this title be subdivided as fol-
lows: (A) Convulsions^ nonpuerjyeral ; (B) Convulsions of infants;
(C) Other* unspecified or ill-defined causes of death,
3. The inclusions constitute a mass of ill-defined and imsatisfac-
tory terms, none of which is approved in the ordinary sense, but all
of which, in view of their very indefiniteness, the committee realizes
jimst be included here when no definite information can be secured
on inquiry.
4. The committee is advised that the Bureau of the Census and
many State and municipal registration offices are making determined
efforts to secure more definite data when such returns are received,
and desires to express its approval of this practice. It realizes that,
until all such reports are eliminated, they must be classified some-
where, and that, therefore, under present conditions, this title must
remain in the list.
5. On account of their indefiniteness it recommends the transfer
to this title of the term n<^uralgia from title No. 73 {Neuralgia and
Tieuritis) and of the terms now included under titles 70 and 71 {Con-
vulsions^ nonpuerperal^ and Convulsions of infants),
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PREVALENCE OF DISEASE.
No health departmcnty State or local, can effectively prevent or control disease without
knon ledge of when, vhcre, and under what conditions cases arc occurring .
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended Sept. 22, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended
September 22, 1917, as follows: An outbreak of smallpox occurred at
Columbia mine, near Washington, Nevada County, 13 cases being
reported. A case of anthrax in man was notified at Stockton, San
Joaquin County. Anthrax among animals was reported in the
San Joaquin and Sacramento Valleys, near Modesto, Stanislaus
County ; and in the vicinity of Stockton, San Joaquin County. Scarlet
fever increased in prevalence, outbreaks being reported in Alameda
City and Monterey County. Typhoid fever continues prevalent.
The details of notifiable disease cases reported during the week
ended September 15, 1917, are as follows:
Cases.
Cerebrospinal meningitis 1
Chicken pox 41
Diphtheria 28
Dysentery 4
Eryfdpelas 8
German measles 40
GonococcuB infection 78
Malaria 35
Measles 98
Mumps 84
Pellagra 1
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(1633)
Cases.
Pneumonia 35
Poliomyelitis 3
Scarlet fever 41
Smallpox 3
Syphilis 53
Tetanus 2
Trachoma 6
Tuberculosis 145
Typhoid fever 41
Whooping cough 30
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September 28, 1917
1634
RECIPROCAL NOTIFICATION.
Minnesota.
Cases of communicable diseases referred during August, 191", , to other State health depart-
ments by departmint of health of the State of Minnesota.
Disease and locality of noti-
fication.
Referred to health authority of—
Why referred.
Diphtheria:
Minneapolis health de-
nartment, Hennepin
County.
Sprfaigfleld v.. Brown
Ckmnty.
Measles: . . ^
Minneapolis health de-
partment, Hennepin
County.
Smallpox:
Minneapolis health de-
Sartment, Hennepin
ounty.
Tuberculosis:
Mayo Clinic, Rochester,
Olmsted County.
Thomas Hospital, Min-
neapolis, Hennepin
County.
Fokegama Sanatorium,
Pine County.
St. Paul bureau of
health, Ramsey
County.
Typhoid fever:
Milaca V., Mille Lacs
County.
Whooping cough:
St. Peter C,
County.
Nicollet
Qrantsburg, Burnett Coimty, Wis.,
Prussia, Saskatchewan, Canada . . . .
Chippewa Falls, Chippewa Coimty, Wis.
Scarville, Winnebago County, Iowa.
Aguilar, Las Animas CounU', Colo
Boulder, Boulder County, Colo
Goodland, Sherman County, Kans
Savanna, Carroll County, 111
Abingdon, Knox County, HI
FranJrton, Madison County, Ind
Clear Lake, Cerro Oordo County, Iowa . . . .
Mason City, Cerro Oordo County, Iowa...
Boone. Boone County, Iowa
Carroll, Carroll County, Iowa
Ottimiwa. Wapello County . Iowa
Bigfork, Flathead County, Mont
Redstone, Sheridan County , Mont
Scobey , Sheridan County .Mont
St. Paul, route No. 3, Howard County,
Nebr.
Dawson, Kidder County, N. Dak
Gladys. W illlams Count>', N . Dak
Plaza, Mountrail County, N. Dak
Bacone, Muskogee County, Okla
Belvidero, Stanley County, S. Dak
Colville, Stevens County, Wash
Racine, Racine County, Wis
Black Creek, Outagamie County, Wis
Turtle Lake, Barron Co., Wis
La Crosse, La Crosse County, Wis
Glenn Haven, Grant County, Wis
Hurley, Iron County, Wis
Granton, Clark County, Wis
Hortonville, route No. 2, Outagamie
County, Wis.
Sault Ste. Marie, Ontario. Canada
Claydon, Saskatchewan, Canada
Wey bum, Saskatchewan, Canada
Gwmner, Sargent County, N. Dak.;
Bryant, Hamlin County, 8. Dak.
McGregor, Williams County, N. Dak
Turtle Lake, Barron Coimty, Wis
Sioux Falls, Minnehaha County, S. Dak.
Grantsburg, Burnett County, Wis
2 fatal cases, infected at Grants-
burg, died in Minneapolis.
Mother also quarantined in
Minne^: polls.
A very severe type of diphthe-
ria dcvclop<Kl in Canada,
where 1 child died. Case
came to Springfield.
A case of measles left Minneapo-
lis for Chippewa Falls with-
out permission of health de-
partment.
After contracting smallpox in
Minneapolis, patient visited
friends In Iowa and returned
home sick with smallpox.
13 moderately advanced, 13 ad-
vanced, 3 incipient. 1 api>ar-
ently ctired, and 2 stage of
disease not given— cases left
Mayo clinic for homej.
One oi>en case and 1 fatal case
removed from Thomas Hos-
Sital to homes.
Dproved case left Fokegama
Sanatorium for home.
1 open case left St. Paul for
Turtle Lake, Wis.
Employed 3 weeks previous to
first symptoms at Sioux
Falls, S. Dak.
2 cases of whooping cough
brought from Uisconsin to
Minnesota.
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1635
September 2K iiUT
ANTHRAX.
Louisiana.
During tho period from September 3 to 11, 1917, 2 cases of anthrax
were reported in Louisiana as follows: One case in Scott Township,
Lafayette Parish, and 1 case in Kaplan Township, Vennilion Parish.
Louisiana Report for August, 1917.
During; the month of August, 1917, 3 cases of anthrax were re-
port e<i in the State of Louisiana.
CEREBROSPINAL MENINGITIS,
State Reports for August 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Connecticut:
Hartford County —
2
1
1
1
1
Ohio:
Cuyahojya County
11
Uartfonl
Franklin County
1
Now Uaven County-
New Haven
HaiTiilt4>n County
1
Mahoning County
3
Wallingford
Medina County
3
Waterhiiry...
Montgomery Coiuity
1
New London County-
New London.
Muskingum County.....
1
Summit County
4
Total
Total
6
25
Pennsylvania:
Allegheny County
Kansas:
Coffey County—
waverly
i
1 1
ll
2I
6
LaUtte County-
Parsons ,
Berks County
Cambria County
1
1
Wyandotte County-
Kansas aty
Elk County
Fayette County
1
1
Total
4I
ivenign county
Montgomery County
1
1
22
1
Hinnc ota:
1
1'
1
2
1 '
1
Washington County
Brown County-
New rim
Total
35
Dakota County-
South St. Paul
Khode Island:
Kent County-
Warwick
Hennepin County—
Mlnncaprlis
1
Fort Suelling
Newport County-
Newport
Mjnnetunka Township
1
Ramsey County—
St Paul
Providence County—
ProNidcnco ................
1
Total
Total
7
3
West Vh-gJnia:
Marshall County-
Mounds iiillc....*....
New Jersey:
Essi^x County
.2I
1 1
2
j
Hudson County
1
8alem County
Total
15,
Alabama Report for July» 1917.
Place.
New
cases re-
ported.
Place.
New
cases re-
ported.
Alabama:
Cherokee County
1
1
6
Alabama— Cont inued.
Limestone County
1
Clarke Countv ... . .
Tuscaloos;^ ('ounty •
1
Total
10
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September 28, 1017
1636
CEREBROSPINAL MENINGITIS— Continued.
City Reports for Week Ended Sept 8, 1917.
Place.
Cases.
Deaths.
Pla?e.
Cases.
Deaths.
Akron, Ohio
Cambridge . Mass
ChicaKo.llI
Cleveland, Ohio
Dubuque, Iowa
El Paso, Tex
Indianapolis, Ind. . . .
Lynn, Mass
Mllwaukeo, Wis
New Bedford, Mass..
New York, N.Y...
Norfolk, Va
Omaha, Nebr
Philadelphia, Pa...
Pittsbitfgh, Pa
Providence, R. I...
St. Louis, Mo
San Francis?o, Cal..
SteubenviUe, Ohio.
DIPHTHERIA.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1651.
DYSENTERY.
Kentucky — Qnidcaattd.
The presence of 6 cases of dysentery was reported September 19,
1917, at Quicksand, Ky., where 86 cases of the disease have been
reported since July 20, 1917.
Montana — Sand Conljee and Stockett.
On September 12, 1917, the occurrence of epidemics of dysentery
were reported at Sand Coulee and Stockett, Mont. At the former
place 1 physician had treated about 70 cases, and at Stockett 1
physician had treated 10 or 12 cases of the disease.
Virginia — ^Narrows.
A small outbreak of dysentery is reported at Narrows, Giles
County, Va.
ERYSIPELAS.
City Reports for Week Ended Sept. 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
2
1
7
5
1
2
' Milwaukee, Wis
1
3
1
Birmingham, Ala
1
! Newark, N.J
Newcastle, Pa
Cbi-aso, III
Clcveldud, Ohio
1
New York, N. Y
1
Denver, Colo
Philadcjlphla, Pa
1
6
1
4
1
Detroit, Mich
Pittsburgh, ra...
Dubnnue, Iowa.....
1
Rochester, N. Y
fit. Louis, Mo
*
Little Rock, Ark
1
2
1
Los Angeles, Cal
1 Steclton, Pa
Memphis, Tcnn
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1637 September 28, 1917
L£PROSY.
- ■ LoiitoiMia--G«nrville.
During the month of August, 1917, one case of leprosy was re-
ported at GaryviUe, St. John Parish, La., in the person of S. L.,
white, male, about 25 years of age. The father and three brothers
of this man had previously been sent to the State Lepers* Home.
MALARIA.
State Reports for August, 1917.
Place.
New
cases
reported.
Place.
New
cases
reported.
Kansas:
BourboD County—
FortScott
1
1
1
1
Louisiana— Continued.
St. He'ena Parish
8
St. Landrv Parish
9
Montgomery County—
Indepond^nc*.
St. Martin Parish
9
St. Mary Parish
12
Sumner County—
Corbm
8t. Tammanv Pansh ,
23
Tangi pohna 'Pftrish -,r-rr. .».,.,..,»
8
Milan
Terrebonne Parish
2
ITnlon Parish - . .......
2
Total
4
Vennilicn Parish
20
W<>h<^tAr Pnri<;h
3
18
6
6
12
1
8
5
1
4
6
26
2
18
59
5
2
31
1
1
2
2
6
3
West Feliciana Parish
1
Total
Allctt Farub
317
Afnfftsinti Pd.riAh ^^ ^ ^,
New Jersey:
Bereen CountT %
AHumjoiUm Parv^.
AvovfltiH P^iiaHi
5
TlMkiiripciirrl PuiAh
Kssesx County
6
raddo Parkih. ».
Hudson County
2
rali*MiiB Parbh ............
Mercer County.......
2
riAltponwr Piirhh ....................
Middlesex County
1
'^t»R'*oriM* Parigb .««
Passaic C-ounty .....................
2
Dfl Suttf Faiista
Sussex County
11
PvukfiffflBMi Pnrivh
Total
East rjMIl Fm-lib
29
Vt^fSt FbiH^flim Tan^i
Ohio:
Cuyahoga County
TN^ria Pwn^h . , .
JefTorson Davis Parish ..
1
Lafayette Parish. r.
Mononing County
1
Liinco n Parish
Total
Liivincstnn Parish
2
Ouachita Parish
Pennsylvania:
Allegheny County
PI iquemmes Parish
Red* River Parish
1
St. Charles Parish
City Reports for Week Ended Sept. 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Berkelev Cal
1
139
1
2
18
1
1
New Orleans, La..
1
3
Newton, Mass
Clevelftnd Onio
Philadelphia, Pa
Haverhill' Mass...
Sacramento, Cal
1
IfemDliis Tenn
2
1
Savannah, Oa
1
Mobile Ala
Springfield , Ul
MmtHAir N I
Trenton , N . J
» The reason that Birmingham had so many more cases of malaria reported than any other city is not
that the disease is more prevalent in Birmingham than in other cities of Alabama and neighboring States,
but undoubtedly because of the successful efforts the health department has made in securing the coopera-
tion of the practicing physicians in reporting cases.
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MEASLES.
^fi Diphtheria, measles, scarlet fever, tind tiib^rctflosis, page 1651.
PELLAGRA.
Stote Reports for August, 1917;
Place.
New
cases re-
ported.
Place.
i
New
cases re-
ported.
Connecticut:
Hartford Coiinty—
Hartford
2
1 Louisiana— Continued.
1 St. Martin Parish
1
1 St. Mary Parish
1
1 Tensas Parish
1
Kansas:
Cherokee County —
1
1
1
1
Total
10
Galena •
Maine:
Cumberland County-
South Portland
Labette County—
Chetopa
Moimd Valley
1
Reno County—
Hutchinsoii
Minnesota:
Olmsted County—
Rochester ,.,.
Total
4
1
West Virginia:
Braxton County. .
Louisiana:
Allen Parish
1
1
1
4
1
E. Carroll Parish
Mingo County '..'.'.
1
Iberia Parish
Total
Orleans Parish
2
City Reports for Week Ended Sept. 8, 1917.
Place.
Austin, Tex
Birminpham, Ala.
Charleston. S.C...
Fort Worth, Tex..
Kansas City. Mo..,
Knoxville.Tenn...
Cases.
»5
Deaths.
Place.
Memphis, Tenn
Nashville, Tenn
Norfolk, Va
Northampton, Mass.
Savannah, Oa
Washington, D.C...
Cases.
"l
Dcftths.
» The reason that Birmingham had so many more cases of pellagra reported than any other city is not
that the disease is more prevalent in Birmingham than In other cities of Alabama and neighhoring States,
but undoubtedly because of the sucoe.s.sfnI efforts the health department has made in securing the coopera-
tion of the practicing physicians in reporting cases.
PNEUMONIA.
City Reporte for Week Ended Sept. 8, 1917.
Place.
Akron, Ohio
Bftltimnro, Md
BinRharaion, N. Y
Boston, Mass
Chelsea, Mass
Chioac<», 111
Cleveland, Ohio
Detroit, Mich
Everett, Mass
Fori Worth. Tex
(Jrand Rapids, Mich
Cases.
Deaths.
Place.
Ilaverhill, Mass. .*.
Kalamazoo, Mich . ,
Lancaster, Fa
Los Angeles, Cal...
Newark, N. J
Ne\N'port, Ky
Philadelphia, Pa. .
Pittsburgh . Pa
Rochester, N. Y...
San Francisco, Cal
Cases.
Deaths.
1
1
2
1
6
5
7
3
3
2
14
10
8
5
1
6
6
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1639
September 28, 1917
POUOBfTELmS (INFANTILE PARALYSIS).
niinois^-Cook Connty.
During the week ended September 22, 1917, 73 cases of poliomyeli-
tis were notified in Cook Coimty, 111., of which 65 cases were in the
city of Chicago.
PennBybraiiia—- Pittsburgh.
During the period from September 17 to 25, 1917, 9 cases of polio-
myelitis were reported in Pittsburgh, Pa.
Virginia.
From September 11 to 24, 1917, the following cases of poUomyelitis
were notified in Virginia:
Cases.
Stuart, Patrick County 1
Near Doewell, Hanover County 1
Near Bridge water, Augusta County. . 1
New Hope, Augusta County 2
Augusta Springs, Augusta County. . - 4
Near Aylor, Madison County 2
State Reports for August, 1917.
Cases.
Crigler8\'ille, Madison County 2
News Ferry, Halifax County 1
Near Linden, Fauquier County 4
Harrisonburg, Rockingham County. . 1
Near Goshen, Rockbridge County. . . 1
Place.
New cases
reported.
Place.
New cases
reported.
Connecticut:
Fairfield County-
Bridgeport
Michigan:
Calhoun County-
Battle Creek
Greenwich
Gogebic Countv—
Bessemer Township
Hartford County-
Bristol
Ingham County-
Lansing
Middlesex County—
Ea9t,Haddam
Jackson County—
JacV'son
New London County-
New London :
Lenawee County—
Adrinn
Total
Oceana County—
Colfax Township
Kansas:
1
Total
Allen County—
Moran .*
Minnesota:
Aitkin County—
Brown County—
Powhattan
Jewell County-
Webber
Cass County—
Lyon County—
Emporia
Grant County—
Morris County-
Wilsey....
Ottertail County—
Beno County—
Hutchinson
Polk County—
RUey County-
Randolph
Rock County—
Shawnee County—
TopekaR. D
St. Louis County—
TTihhin<r
Smith County—
Oaylord
Wrif*t County—
Sumner County—
Total
Mulvane...
11
PeckR. D
Wyandotte County-
Kansas City
New Jersey:
Total
17
Essex Coimty
Maine:
1
Hunterdon County
Middlesex County
Aroostook County—
Benedicta (town)
Total
11
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POLIOMYELITIS (INFANTILE PARALYSIS)— Cont limed.
State Reports for August, 1917—-Coutiiiued.
Place.
Ohio:
Ashland County
Belmont County . . . . .
Cujrahoga County
I>arke County
Guernsey County
Hamilton County
Lake County ,
Lorain County
Mahoning Couii ty. . . .
Medina County ,
Muskingum County. ,
Ottawa County ,
Paulding County
Summit County
Trumbull County .. .
Wayne County ,
Total.
Pennsylvania:
Allegheny County
Armstrong Cruii ty
Bea-cr County
Bedford Comity
Butler County
Cambria Cour ty
Chester County
Clearfield County
Crawford County
CuralMjrla' d County. . .
Daup}iin County
Krie County
Favette County
Jerferson Cou n ty
Lancaster County
Lawrence County
Leliigh ('ounty
Mercer County
SehuyiVill County
Someiset County
Susquehanna County. .
Washinpt'*n County
Westmoreland County.
Total.
l:hode Island:
Providence County-
Providence
New cases
reported.
3
1?
10
1
2
1
2
li
1 I
22 I
1
15
77
Vermont:
Franklin C<iunt\'—
Ensburg Falls
FaSrflek!
St. Albans
Orange County-
Orange
Washington C. nnty—
Barre
Baire (town)
Calais
M ntpeler
M^rot -wn
Wait>flc)d
Watcrbury
Wtndham County—
.Brattiebcro
Rockingham
Windsor County-
White Kiver Junction-
Woodstock
Newcasc«
reported.
1
4
1
1
7
1
1
1
1
Total.
West Virginia:
Barbour County
Braxton C unty
G ilmer County
Harrison County
Clarksburg
Lewis County
Marshall County
Maricn County
Ml n^ngah"
Manninirt. n
Minera! C.unty
Monroe County
Ohio Caunty
Prest n Cc lint y
Ritchie County uj.
Taylr County '
Tucker Count y
Upshur Coimty
Buckhannon
Wetfel C .unty
Wotxl Ci.unly
Parkersburg
Total.
34
2
S
2
7
5
1
1
8
6
3
3
1
4
2
1
3
4
2
5
1
4
4
72
Alabama Report for July, 1917.
Place.
New cases
reported.
Alabama:
('hambers C^^unty...
JplTorsm County
MontpL)mery C ^unty
Place.
Alabnma— Continuetl.
Tuscaloosa County,
Total.
Newcaaes
reported.
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POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
City Reports for Week Ended Sept. 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron Ohfo ,.,,.,,-, ^
5
37
New Castle, Pa
2
3
1
G
2
1
1
1
1
2
1
Ann Arbor Mich
Now Orleans La
1
Chicago 111'
10
Nogy York.N.Y...'
2
Colmnbiis Ohio . .........
Oakland, Cal
Davenport, Iowa
2
Omaha, Nebr
Davton Ohio
Pittsbm'fi^Pa
El raso, Tex
PortlanoTOreg
Haverhill. ICasfl
Providence, R.I
Kan^Hui City, Kftim. . . . ^ . - ^ - . . .
Rock Island, 111
Lacrosse 'Wis
Somcrville, iiasa
Lowell ickss ...
Troy.N.Y'
Milwaukee Wis
1
Wilkinsburg, Pa
Newark N J
RABINS IN ANIMALS.
Oty Reports for Week Ended Sept. 8, 1917.
During the week ended September 8, 1917, 1 case of rabies in
animals was reported in Newark, N. J., and 1 case was reported in
San Diego, Cal.
SCARLET FEVER.
See Diphtheria, meaeles, scarlet fever, and tuberculosifl, page 1651.
SMALLPOX.
Minnesota.
During the week ended September 22, 1917, three new foci of small-
pox infection were reported in the State of Minnesota, cases of the
disease having been notified as follows: Mower County, Grand
Meadow Village, 1 case; Pleasant Valley Township, 4 cases; Pine
Coimty, Brook Park Township, 1 case.
Wisconsin — ^Barron County — Correction,
The report of 2 deaths from smallpox in Barron County, Wis.,
published in the Public Health Reports of September 21, 1917, page
1540, was an error, no death from smallpox having occurred in the
county.
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1642
SMALLPOX— Contlntted,
State Reports for Ammst, 1917.
New oases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within?
years pre-
ceding
att^k.
Number
last vacci-
nated more
than 7 years
precening
attack.
Number
never suc-
cessftiUy
vaccmated.
Vacoinatioa
history not
obtaizied or
uncertain.
Kansas:
Brown County—
Horton
1
1
8
1
Cherokee County—
C olumbus R. D
1
1
5
1
1
1
West Mineral. . .
Cnwford County—
Doniphan County—
Denton R. D
Harvey County-
Newton
Jefferson County—
Valley Falls
Labette County—
Oswego
1
Logan County-
Wallace
1
1
1
2
1
1
Marlon County-
Marion R. D
Montgomery County—
Cofleyville
Republic County—
Hubbell, Nebr., R. D. ...
Russell County—
Liiray R.I)
Sedgwick County-
Wichita..... .
Woodson Count V—
Toronto R. 1)
Wyandotte Coimty—
Kansas City
Total
28
2
W
1 > ^
.
1 T
Michigan:
Berrien County—
Royalton Township
1
1
8
3
3
2
5
1
1
1
1
1
3
1
4
3
1
4
2
5
1
Genesee County-
Mount Morris Township...
1
6
3
2
2
3
1
1
Flint *:..
a
Huron County—
Harbor B»mch
Ingham County—
Lansing. . .*
1
Jackson County-
Jackson
Kent County-
Grand Rapids
2
Lapeer County—
Metamora
Macomb County—
Motmt Clemens
Mason County- -
Kivrrton'Township
1
Ludin?ton
1
I
Montmorrncy County-
Ax erv Township*.
lUlhmn Towiisliip
1
Oakland County —
IiideiK'ndeiict; Township. .
1
Pontine
1
1
3
2
1
4
Presque Isle Count y
Bi:>murk Township.
Sanilac Coimty- -
Bridghampton Township.
Marion Townsliip
Wavne Countv—
Highland Park
t
Detroit
5
Total
61
3
33
- 15
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SMALLPOX— Ck>ntlnaed.
State Reports for Aagast, 1917— Continued.
New cases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within?
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack!^
Number
never suc-
cessfully
vaccinated.
Vaccination
history not
obtained or
tmcertain.
Minnesota:
Big Stone County—
Oraoe\ine...:
2
3
1
1
1
2
1
5
1
19
1
1
?
2
1
2
1
5
1
1
2
3
1
Blue Earth County—
Mankato
Chisaifo County—
Taylors Falls
Clay County—
Moorhead
1
Crow Win? County—
Deerwood.....
1
2
1
5
1
17
1
1
2
2
1
2
1
5
Dakota County-
South St. l>aul
Douglas County-
Orange Township
Fillmore County—
Ifabel
Hennepin County—
MinneapoMs..
2
FortSnelUng
Itasca County-
Grand Rapids
McLeod (^ounty—
Hutchinson.
Martin County—
Galena Township
Mower County-
Austin
Lyie Township. .',','.'.
Olmsted County-
Rochester
Polk Coimty—
Farley township
Quf>en Townsbip
1
1
1
Tabor Township
Ramsey roimtjr—
North St. Paul
1
7
2
1
1
1
1
4
St. Paul
2
St. I/onis County—
Hibbinj!.....
Steams County—
Sauk CyQutevr
1
1
1
1
4
Washington County—
Oncka Township
Watonwan County—
Madelia....
Long Lake Township
Riverdale Township
Total
n: 1 1 5l 66
Ohio:
Belmont County . .
2
6
1
,
2
Butler County
1
2
2
3
4
Clark County
2
5
17
Columbiana County
...
2
Cuyahoga County ."....
::::::::::::::::::::::
17
Franklin County. .
I
2
9
9
4
10
1
16
3
"
2
1
Gallia County
Greene County. . .
2
Hamilton County
..
1
8
Jackson County.'. .. . .
9
Lucas County
::::::::::::•::::::;:::::
4
1
10
Medina CbunU'
1 ::;:;
1
Montgomery County
1
3
3
1
13
Muskingum County . .
Perry COlmty '.
1
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1644
SMALLPOX— Continued.
State Reports for August, ISIT—Continued.
New cases
reported.
Deaths.
Vaccination history of cases.
Plaoo.
Number
vaccinated
within 7
years pre-
oedinj?
attack.
Number
last racci-
nited more
than 7 rears
preceding
attack.
Number
never suc-
cessfully
vaccinated.
Vaccination
history not
obtained or
Ohio— Continued.
Sandiukv Count v
7
3
3
13
1
7
Scioto Count V - ....
2
Shelby County ^
2
1
Snmnjlt County . ......
13
Trumbull Countv
1
Total
n.
1
26
89
MisceUaneouB State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
DeatlB.
Alabama (July 1-31):
Jackson Conntv
Maine (Auc. 1-31)— Contd.
Lincoln County—
Wi9t^<»?et (town)
Penobscot County-
Old Town
1
1
2
3
T .ofrifif Conntv
Lee Coimtv
Madiwn Countv
Mobile Countv
Piscataquis County—
Rockwood
Montpomerv' County
Shelby Count v
Washington Countv—
Vanceboro (town)
Total
Talladega County
Total . . .
18
12
Pennsylvania (Aup. 1-31):
A iWhen V County
Cambria C^>iuitv
Connecticut (Anp. 1-31):
Litchfield County-
1
S
I
2
2
4
Winchester
Dftimhin Crtimtv
Loul«4ana (Aup. 1-31):
4
7
1
Erie Countv
Acadia Parish
Lehiph County
Ascension Vanish
Perry County
Da Soto Pftrish
Total
19
Total
12 1
West Virginia (Aug. 1-31):
Brooke Conntv
3
2
7
9
Maine (Aujj. 1-31):
1
2
3
Androscopcin County —
Kanawhrt County
Charleston
Lewi?ton
Franklin C-oiuitv —
Ohio County
Coplin riantation
Strong (town)
Total
21
City Reports for Week Ended Sept. 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
1
2
1
11
17
3
1
2
4
H
1
1
Minneapolis, Minn
6
2
2
Alton. Ill
Oklahoma ( itv, Okla
Austin Tex
Omaha Nebr.... . . .
Huttp. Mont
Portland, Orce
Cleveland. Ohio
Rock Island. Ill
Davton, Ohio
St. Joseph, Mo
'•
Flint Mich
St. Louis. Mo
Fort Wavne, Ind
Salt Lake('ity, TTtah
IndianaDolid. Ind
San Francisco, Cal
Kan«5as div. Mo
Tacoma, Wash
Los AuRcles, Cal
Toledo, Ohio
Milwaukee, Wis
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TETANUS.
City Roports for Week Ended Sept 8, 1917.
September 28, 1917
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Blnniiighaiii, Ala.
2
1
MobUe, Ala :
1
Braddock, Pa
New Orleans, La. .
1
Oiicago, 111
2
1
2
PHtsburch, Pa
1
ColumtHis, Ohio
Savannah, Ga
1
Detroit, tfich
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1651.
TYPHOID FEVER.
Indiana — South Bend.
Since September 1, 1917, 120 cases of typhoid fever have been noti-
fied in South Bend, Ind., 12 new cases having been reported Septem-
ber 23 and 24.
State Itepofts for August, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Connecticut:
Fairfield County—
Bridzenort
16
72
Kansas— Continued.
Barber County—
Hardtner...
1
Danbury '..
Bourbon County-
Fort Seott R. D
Greenwich
8
Norwallc
Garland
1
StamI(Hd.*
Mapleton R. D
1
Stratfoid
Brown County —
Hiawatha R. D
Hartford County—
Hartlbrd
3
Morrill
1
New Britain
Butler County-
Augusta R. D
Litchfield County-
Pivmouth
2
El Dorado R. D
20
Torrington
I/atham R. D
1
Middlesex County—
Cr(«nwell
Chautauqua County—
GrenolaR. D
2
New Haven County-
Derby .
Cherokee County—
Bax ler Springs ,
1
Guilford
Galena.. t...r
4
Hamden.......
Weir
1
Milford
Cloud Cx)iintY —
Cymorditt R. D
NallgatUCV r ^r.-r^-r
1
New Haven
ColTev Count \ —
Cridlov R. D
OranEc . ....... .
1
Waterburv
Hall Summit R. D
1
New London County-
New London
Le Roy K. D
1
Cowlev Cjuiitv—
Winfipld
Norwich
1
Tolland County-
Stafford SDrinffs . .
Crawford Crnmly —
Girard R. D
a
Roekvilio
MuD.orrv R. P
4
Totiff.
Pittsburg R. D
10
Radlev
1
Kansas:
Allen County—
lola....:
6
5
1
9
Dickinson Count v —
Chapman R. D
2
Herinirton ..*...
4
Moran
Doniptian County—
aW R. I)
Anderson County-
Harris R. D
10
WathenaR. D
1
Atchison County—
A tchison
Edwards County—
Kinsley R. D
1
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TYPHOID FEVER— Continued.
State Reports for August, 1917— Continued.
Kansas — Continued.
Elk Countv—
Fall River R.D
Piedmont R.D
Ellsworth County—
Holyrood
I>orraine
Ford County—
Bucklin
Dodge City R.D... .
Franklin County-
Ottawa R. D
Graham County-
Hill City R.D
Gray County—
Cimarron R. D
Ingalls
Greolev County—
Seckirk
Greenwood County—
Eureka R.D
Madison
Harper County-
Bluff City
Harper R.D
WaldronR. D
Harvey County—
Burrton
Newton
Jeffwson County —
MerldenR. D
Jewell Coimty—
MankatoR. D
Johnson County—
Lenexa R.D
Olathe
RidcU
Kingman County—
Belmont
Cali't4i
Kinpman
Labette Countv—
Altamont R. D
Chetopa
McCune
Parsons
Valeda
Leavenworth County—
Easton
Lowcmont
Lansing R. D
Leavenworth R. D..
Tonganoxie
Lincoln County-
Lincoln R.D
Lyon County—
Dunlap
Emporia
Marshall County-
Frankfort R.D
Miami County —
Fontana K. D
OsawatomieR. D...
Montgomery County—
Canoy
Cherryvale
Coffey viUe R.D,...
Elk City
Havana
Independence R.D.
Liberty
Morris County—
Dunlap
Morton County—
Elkhart R.D
Kansas— Continued.
Neosho County —
Chanute R. D
Erie R.D
GalesburgR. D
St. Paul R.D
Ness Coimty—
Arnold R.D
Norton County—
AlmenaR. D
Noiton
Osoco Countv—
Lyndon K. D
QuenomoR. D
Pawnee County-
Lamed R. D
Pratt County—
Pratt
Rawlins Coimty—
At«-oodR. D
Reno County —
Hutchinson R. D
Republic <'ounty—
Bcllo V illo
Republic
Scandia
Rico County-
Raymond
Riley County-
Manhattan
Ogden '. —
Rooks County-
Stockton
Russell County-
Russell
Saline County—
Gvpsum R.D
Salina
Sedgwick Coimty-
Derby R.D
KechiR.D
Wichita
Shawnee County—
Topeka
Shcridm County—
Hoxie
Smith County-
Smith Center R. D
Stafford County—
^st. JohnR. D
Stevens County—
II ujioton
Sumner County-
A r^on\
1 )alton
Maylleld
M ul vane
WolUngton
Trego County—
vVakecney
Wabaunsee County —
H arvcy ville
P.ixico
Washington County—
(Jreenleaf
Washington R. D A.
Wichita Coimty-
LcotiR.D
Wilson Count V—
Benedict R. D
Fredonia
NoodcshaR. D
Woodson County-
Ross
Toronto
Yates Center R. D
3
3
1
2
1
5
1
2
27
12
1
2
1
2
1
1
1
1
2
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1(547
•fYPftOID F^teVER— CVmlinued.
State Reports for Au^st, 1917— Continued.
September 28, 1917
Place.
Kansas— Continued.
WyandJtte County-
Kansas City
Total.
Louisiana:
Acadia Parbh *.
.yien Parish
Ascension Parish
Asiumpthn Parish
AvoyeMes Parish
Deaurci^ard Parish
Bossier Parish
Cadd^ Parish
Calcasieu Parish
Claib ^me Parish
DcS tj Parish
East Baton R uc^ Parish
East Carroll Parish
Grant Parish
Iberia Parish
IbervUle Parish
Jackson Parish
Jefferson Davis Parish
Lafavette Parish
Lafourche Parish
La Salle Parish
Moreb juse Parish
Orleans Parish
Ouachita Parish
Plaquemines Parish
Pointe Coupee Parish
Rapides Parish
Red River Parish
Richlani Parish
Sabine Parish
St. Charles Parish
Si. Janie> Pjirish
St. Landry Parish ,
St. Martin Parish
St. Mary Parish
St.Tammanv Parish
Tangipahoa Parish
rnion Parish
Vermil'on Parish
Washington Parish
West Baton Rou^ Parish
West Carroll Parish
Winn Parish
Now cases
reported.
Total.
Maine:
AndroscoK$!ln County-
Durham (town)
Aroostook County-
Mars Hill (town)
Cumberland County-
New Gloucester (town). .
Portland
Lincobi County—
Damarisootta (town)
Penol^soot County—
East MUllnocket (town).
Somerset (Bounty-
Madison (town)
Waldo County—
Searsmont (town) ,
York County—
Kennebunkport (town) .
Total.
lOchican:
Alger County-
Montsfau;..
7
445
4
3
3
3
4
5
15
3
1
1
2
1
1
3
4
1
9
4
5
1
1
77
2
4
1
26
1
2
2
5
8
2
2
1
2
2
14
3
1
1
2
239
Place.
}|lchiffan— Cont inued.
Alpena County—
Alpena
Antrim County-
Banks Township. ,
Bara^ County—
L'Anse
Benzie Coimty—
Wcldon Township
Berrien County -
Denton Township
Calhoun County—
BattleCreek
Charlevoix County-
Norwood Township
ChippcAa County—
i:ault Ste. Marie
Clare County—
Redding Township
Clinton County -
Watcrtowh Township. . .
Genesee County-
Flint
Gogebic Coimty—
Ironwood
Gratiot County—
Area la Township
Ithaca
Hillsdale C^nty-
Ransom To ivushlp
Ingham County -
Lan'sln^ Township
East Lauiing
Lansin?
Ionia C^Minty—
Beldin-
Jackson County—
Rives Township
Kalamazoo County—
Kalamazoo
Kalkaska County—
Oranjre Township
Kent County-
Byron Township
(irand Rapids
Lapeer County—
Almoot
Leelanau County—
Kim wood Township. . . .
Lcnaweo Coimty—
Adrian Townsliip
Fairfield Township
Rome Township
Livinsrston County—
Howell
Macomb County-
Mount Clemens
Marquette County-
Marquette
Ncpaunco
Montmorency County—
firiley Towashlp
MuslvO.'on County—
Muskegon
Oakland County—
BloomQeld Township. .
Pontiac
Osceola Countv-
Hart wick Township....
Ottawa County—
Holland Township
Saginaw County-
Marion TOA\TlShlD
St. Clair Countv
Columbus Township...
CottrellvUle Township.
New cases
're];)orted.
18
10
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September 28, 1017
1648
TYPHOID FEVBR— Continued.
State Reports for Au^nst, 1917— Continued.
Place.
Michigan— Continued.
St. Joseph County—
Constantine ,
Mottville Township.,
Van Buren County-
South Haven ,
Washtenaw County-
Saline
Ann Arbor ,
Ypsilanti
Wayne County-
Ecorse Township
Ford
Hamtramck
Highland Park
Wexford County—
Cadillap
Total.
Minnesota:
Anoka County-
Columbus Township. . . .
Bigstone County—
Orton\ille
GrarevUle Township
Brown County—
Comfrey
Carlton Coimty—
Wrenshall Township
Clay County—
Moorhe&d
Clearwater County-
Pine I ake Township. . . .
Cottonwood County—
Windom
Fillmore County-
Holt Township
Goodhue County-
Red Wine
Hennepin County-
Minneapolis
Itasca County-
Marble
Kandivohi County—
Willmar
Lac qui Parle County-
Madison
Lyon County-
Fair view Township
Marshall County-
Holt Township
Meeker County-
Swede Grove Township.
Mille Lacs County—
Milaca
Mower County-
Austin
Olmsted County-
Rochester
Ramsey County —
St. Paul
Redwood County-
Redwood Falls
Sundown Township
. Louis County—
Chlshohn
Duluth
Ely
Eveleth.
St.
Sibley County-
Green Isle, .
Stearns County-
Grove Township
Steele County—
Owatonna
Medlbrd Township.
New cases
reported.
12
Place.
Mlnn'^sota— Continued.
Wadena County—
Rockwood Township. .
Total..
New Jersey:
At lantic Cqpmty
Bergen County
Burlington Coimty...
Camden County
Cape May County
Cumberland County..
Essex Coimty '...
Gloucester County. . .
Hud.««n Coimty
Hunterdon Coimty...
Mercor County
Middlesex County
Monmouth Coimty...
Morris Coimty
Ocean County
Pa<isalc Coimty
Salem County
Somerset Coimty
Union Coimty
Total..
Ohio:
Adams County
Allen Coimty
Ashland County
Athens County
Auplaixe Coimty
Belmont County
Brown County
Butler County
Carroll C4)unty
Champaien Coimtv...
Clirk County ' . . .
Clermont County
Clinton County
Columbiana Coimty..
Coshocton Coimty
Crawford Coimty
Cuyahoga Coimty
Darke County
Defiance County
Delaware County. . . .
Erie County
Franklin Coimty
Gallia County
Greene County
Guernsey County . . . .
Hamilton County
Hancock County
Harrison County
Ucnrv County
H i.(;hland County
Hocking County
JetTerson County
Knox County
Lawrence County
Lickfaip Coimty
Logan County
Lorain County
Lucas County
Madison Coimty
Mahoning Comity
Medina County
MeJg3 Coimty
Mercer Coimty
Miami C-ounty
Monroe County
Montgomery Coimty .
Morrow County
Nexv oases
reported.
63
13
13
14
7
1
3
33
1
lO
2
S
18
10
1
1
53
2
1
8
199
5
31
1
7
2
29
1
5
2
4
7
2
1
3
1
1
33
7
2
3
5
25
1
3
4
11
6
1
3
1
5
5
2
3
14
4
1
31
1
12
1
2
3
0
9
20
1
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1649
September 28, 1917
TYPHOID PBVER— Oontlnued.
State Reports for Angnst, 1917— Continued.
Place.
Ohio— Continued.
Muskin^ium County
NoMf County
Paulding County
P err y County
Pickawav County
PikeCounty
Portage County
RiciUiUid Co'mty
Ross County
Scioto County
Seneca County
Shelby Connty
Stark County
Siunmit Count y
Trumbull Cotraty
Tuscarawas County
Union County
Warren County
Wayne Coimty
Woodf'ounty
Wyandot County
Total
Pennsylvania:
Anams Coimty
AlleRhcny County
Arms' rong Coimty
Beaver County
Be i ford County
BerksCounty
Blair County
Bra Iford C«)umy
BucksCoimly
Cambria County
Cameron County
Center Coimty
ChestreCounty
Clarion County
Clear, old County . . - .■ —
Cra vford Coun' y
Cumberland C unty
Dauphin County
De»a "» are County
Erie Count y
Fayette County
Forest Cmmty
Franklin Couiity
Fulton County
G reene Coun ty
Hunt ingflon County
Indiana Cmmty
Jefferson Coimty
Juniata Coini v
Lac\awBnna Coimty
Lancaster Coimty ,
La M^jnce Coimty
Lebanon County
Lehi)^ County
Luzerne Coimty
Ljcominif County
Mercpr County
MifflinCoiutv
Montgomery County
Montour Cmmt y
Northampton County
Northumberland Connty
Philadelphia County
Potter County
Schuylkill County
New cases
reported.
434
24
115
16
14
7
25
15
2
4
18
1
5
16
2
4
1
6
11
6
4
15
1
7
5
1
2
3
10
1
6
9
3
5
13
4
3
5
1
13
5
10
3
97
1
14
Place.
Pennsylvania— Continued.
Snyder County
Somerset Coimty
Tioj;a County
Union County
Venim^o Coimty
W ashington ('ounty . . .
W^av'no v'oimty
Westmore!and County
Wyoming County
York Coimty
Total
Rhode Islond:
Provi Ipnce County-
North Pravidcnce.
Proviienoe
Johnston
Total
Vermont:
Chittenden County
Lamoille County
Oranj'o County
Orleans County
Washington County...
Windsor County
Total
West Virginia:
Barbour County
Berkeley County
Braxton County
Brooke C>ounty
Cabell County
Cl:iy County
Fayet te Coimty
Oreenbrler County ... .
ITamp ;hire County... .
Hancock County
Hardy Coimty
Harrison County
Jackson County
Kanawha County
Charleston
Lewis County
Lo^n Coun t y
McDo;\ellC >iinty
Mari*«n County
Mercer Cojin ty
Prince t<)n
MinoD! I County
MinM> Coiintv
MtmtHik'nHu County. . .
Ohio County—
WhCidinf!
Putnam County
Ralciph County
Ritchie C<»unty
Wood County
Pendleton County
Pocahontas County....
Tyler County
Wayne County
Webster County
Total
New cases
reported.
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September 28, 1911
1650
TYPHOID FEVER— ConUnued.
Alabama Beport for July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Alabama:
Baldwin CoimtT
il
5
11
3
2
5 :
3 1
5
1
5
li
9 i
« 1
3 ,
22
4
Jl
1 1
5 ,
1
9
Alabama— Continued.
Jefferson County
205
'Rar'hntir nonntv .
Lamar Coun ty
5
Bibb County
Lauderdale County
13
Blount Countv
Ti-awrcncc County . . . x
3
Bullock County
I^e County .^
Limestone County
3
Calhoun Countv
2
Ohambflrs County , t r
Macon County
1
Chflrokw^Coiintv' -.r.--
Madison County
2
Chilton County
Marengo County
4
Clarke County'.
Marion County
16
Cleburne County
Marshall County
2
Coffee County
Mobile County
20
Colbert County
Monroe County
19
Cone<nih County
Montgomery County
2
Coosa CJounty
Morgan County
3
Cullman C-ounty «
Pickens County
4
Dallas County
Pi kc Coun ty
1
DekalbCounty
Randolph County
3
Elmore Coun ty
Shelby County
11
Escambia County
St. (Mur County
14
Etowah County.'.
Talladega C.unty
8
Fayette County
Tuscaloosa County
25
Franklin County
Walker County
17
Geneva County
Washington (/Ounty
1
Greene County
Wilcox County
1
Hale Countv '
Total
Hou!*ton County . -,^.,.-^-,^^r,-,-r
620
Jackson County r .
City Reports for Week Ended Sept. 8, 1917.
Place.
Cases.
Deaths. '
Place.
Gases.
Deaths.
Akron, Ohio
10
1
2
3
1
1
3
25
2
1
1
48
13
1
1
2
6
1
3
1
Eliwibcth,N.J
Eric, Pa
3
18
8
16
Alameda, Cal
Albany, N. Y
Evansville, Ind '. ..
3
Allentown, Pa
E vorpf t , Mas'^ ....
Alton, 111
1
Fall Uivcr. Mass
Ann Arbor, Mich
Flint, Mich..
1
Atlantic City, N. J
Fort Wa>'nc. Ind
Baltimore. Md
5
Grand Rapias, Mich... .
Pj^ynnno, N , J. .............. .
Hagcrstown, Md
Berkeley, Cal
Hartford Conn
1
Berlin, N. H
Haverhill, Mass
1
1
Birmingliam, Ala
io
3
Hobokcn,N.J
Indianapolis. Ind.
Boston, Mass
Braddock, Pa
Jersey City, N. J
Johnstown , Pa
1
Brideeport, Conn
Brockton, Moss
Kalamazoo, Mich
..........
E -■",,. N.Y..
Kansas City, Kans
taiiii'ii'.
Kansas City! Mo
1
t'^ni'ltML.
Kearnv, N- J '....'.",
6
rankiij.i' ^
1
Kenosha. Wis
ru^rte^l.ti, is. c
4
4
15
6
8
2
5
^ 1
-^-^ 2
14
Knox\ilIe, Tenn
ChHswi. Mass...,
Lawrence, Mass
fhicaKD.lll
1
Lexington, Ky
1
ClneltiiioM, Ohio.
Lima, Ohio
X
rievMbntl, f»hlcj,
1
Lincoln, Nebr
Co(Ii'Yr|J|p, KjuM
Long Branch, N.J
Coliim bus, Ohio
Los Angeles, Cal
1
Covingt un, Ky
1
Lowell Mass
Cumberland. Md
Ljrnch burg, Va
DanvlUij.nL...
Lynn, Mass
1
Dei-tnport. \qw&
Maiden, Mass
Day Ion, Ohio,...
1
Modford, Mass
iHinviT, C-okJ--.
Memphis, Tenn
4
I>i?tri:iit,Mk'i5..,.
2
Minneapolis, Minn
liubirrj, Minn. .,
Mobile^'Ala ' .
1
1
East Chicago, Ind
1
1
Nashville Tpnn
lilfin.IJLr.;
Newark, N.J... '..!!!'.!;!!!!;;
a
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1651 September 28, 1917
TYPHOID FEVER— Continued.
City Reports for Week Ended Sept. 8, 1917— Continued.
Place.
Cases.
Deaths.
Phice.
Crises.
Deaths.
New Bedford, Mass
3
1
2
4
3
2
10
99
13
4
2
3
1
St. Joseph, Mo
27
14
22
13
New Britabi, Conn
1
St.Loufe,Mo
1
Newburgh, N. Y
Salt Lake City, Utah
NewCastte, Pa
San Francisco, Cal
Now Haven, Conn
1
San Jose, C'al
New London, Conn
Saratoga Springs, N.Y
Savannah, Ga
New Orleans, La
4
8
1
New York, N.Y
Springfield, 111
2
Niagara Falls. N. Y
Springfield, Mass
Norfolk, Va..
1
Springfield, Ohio
Nwristown, Pa.
Tacoma, Wash
Oakland, Cal
Toledo, Ohio
1
Ogden, Utah
Topeka, Kans
1
Oklahoma City, Okla.
1
1
Trentcm, N.J
Omaha. Nebr".
1
10
1
10
3
1
Troy, N.Y
Perth Xmboy, N.J
Waftham, Mass
PhiladelphliLPa
3
3
Washington, D. C
2
Pittsburgh, ^a
Washington, Pa
Portland, Me
Watertown, N.Y
1
Providence, R. I
4
1
Wheeling, W. Va
1
Quincy, 111
Wichita, kans
Quincy, Mass
Wilkes- fearre, Pa
2
Racine, Wis
i
Wilraington, Del
R Afldln'g, Pa
2
9
1
Wlnston-Salem, N. C
Ridimond. Va
1
1
1
1
Worcester, Mass
Roanoke, ^a
York, Pa
Rochester. N.Y
Zanesvllie, Ohio
Sacramenio, Cal
2
DIPHTHEBU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
Stote Reports for August^ 1917.
Casea reported.
8tat«.
Cases reported.
State.
Diph-
theria.
Measles.
Scarlet
fever.
DIph.
theria.
Measles.
Scarlet
fever.
Connecticut
Kansas
102
43
165
15
186
49S
108
34
69
53
202
39
41
08
10
New Jersey
Ohio
246
398
934
72
15
70
164
114
436
11
81
29
102
194
T^iiisiana. ......'...
' I'pnnsvl vnniA
2.:5
Maine
6 ! Rhodp Island
10
Michigan
151
147
Vermont
18
Minn^uintA.,,
West Virginia
27
Alabama Report for July, 1917.
During the month of July, 1917, 18 cases of diphtheria, 193 cpses
of measles, and 23 cases of scarlet fever were reported in the State of
Alabama.
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Hepi ember 28, 1017
1652
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Sept. 8
, 1917.
Popular
tion as of
July 1, 1916
(estimated
by U.S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever. *
Tuber-
culosis.
City.
1
1
u
1
1
i
1
1
Over 600,000 inhabitants:
Baltimore. Md..
5m,m
756,476
2,497,722
674,073
671,784
603,812
6,602,841
1,709,518
679,090
757,309
468,558
410,470
306,345
436,535
363,454
408,894
371,747
463,516
363,980
214,878
260,800
271,708
297,847
295,403
254,960
256,417
104,199
181,762
121,579
112,981
106,233
127, 'm
128,366
104,562
128,291
110,900
100,560
113,245
102,425
148,995
117,057
118,158
149,685
198,604
165,470
109,381
156,687
117,399
105,942
155,624
112,770
191,554
111,593
163,314
85,625
63,505
57,660
69,893
57,653
53,973
67,449
60,852
60,734
""'236'
670
216
173
"'i,*332"
410
203
180
'"127"
45
77
89*
■"*i32*
107
70
61
8i'
24
50
66
8
48
129
34
58
7
141
34
15
31
13
10
4
14
19
5
68
8
4
9
2
30
1
"*6'
16
2
7
1
15
1
2
3
"'i'
......
11
13
12
2
2
2
49
0
2
2
1
'■"2'
"'"6*
""2
1
7
9
79
3
16
2
22
5
5
16
2
5
5
14
5
3
1
37
12
3
3
4
1
3
2
3
......
35
60
220
37
40
29
278
76
9
35
29
24
6
8
26
Boston, Mass
26
Chicago, 111
58
Cleveland, Ohio
23
Detroit, Bi^ich
17
Los Anseles. Cal
14
New York, N.Y
Philadelnhia. Pa
179
47
Pittsburgh, Pa
14
St. Loul*' Mo
16
From 300,000 to 500,000inhahit-
ants:
Buffalo, N.Y
5
Cindnna ti. Ohio . . . .
24
Jersev Citv. N.J
1
2
2
5
1
39
3
Milwaukee,Wis
4
MfnneADolia. Minn .
Newark.N.iJ
23
21
30
16
7
18
New Orleans, La
14
Rah FrAnHsnn. Cnl
12
Washington. P. C
From 200,000 to 300,000 Inhabit-
ants:
Columbus. Ohio
14
5
Denver Colo
1
4
1
8
Indianapolis? Tnd ^..r,,.
8
K&n<^s Citv Mo . .
6
Portland , Oreg
2
1
1
2
3
51
8
4*
9r
3
8
1
4
5
2
10
4
2
3
3
13
3
5
8
2
3
Providence. R.I
6
2
1
4
Rochester, N. Y
From 100,000 to 200.000 inhabit-
ants:
Albany.N. Y
6
Pinnlnghani, Ala^ ^,
89
33
24
4
1
1
2
2
2
1
4
2
8
BridecDort. Conn
4
Cambridge, Mass
3
6
Camden. N.J ;.
Dayton, Ohio
32
28
10
22
40
48
33
22
54
42
33
43'
33
10
55
19
22
44
67'
34
41
io'
1
3
3
1
Fall River. Mass
2
1
Fort Worth, Tex
Grand Rapids, Mich
Hartford, Conn
1
3
1
1
4
3
1
""2'
2
4
6
4
""q
6
5
1
1
1
1
■*
2
3
2
1
Lawrence, Mass
8
Lowell. Mass
Lynn, Mass
2
5
6
4
8
1
1
5
1
Memphis, Tenn
12
Nft«;hviMA' T«»nn . ,, ,
'"'2'
1
1
8
New Bedford, Mass
New Haven, ()onn
Oakland. Cal
2
1
Omaha. Kebr...
4
Reading, Pa
1
5
3
Richmond, Va
2
3
2
2
8
Salt Lake City, Utah
Springfield, Mass..
1
'
1
3
5
2
SjTacuseJs. Y '.....
«
2
2
Tacoma , Wash
Toledo, Ohio
1
5
3
1
4
7
4
0
Trenton, N.J
8
W orcester , Mass
1
6
From 50,000 to 100,000 inhabI^
ants:
Akron, Ohio
7
3
1
Allentown Pa
1
Atlantic City, N. J
9
2
1
2
7
1
Bayonne, N. J
BerkeIey,Cal
8
20
16
16
19
1
Binghamton, N. Y
3
1
1
Brockion. Mass
1
Canton, Ohio
1
1
1
(3iarleston,S. C.
1
::::::i::::::i::::::
1
i
1
ABE TOU SAYINO Tour Money to Inrest in the SECOND LIBERTY LOAN!
Digitized by
Google
1653
September 28, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Sept. 8,
1917— Continued.
Popiilft*
tlon a^ of
Jiily 1,1016
(^^tiJiLited
hy IK S.
C«I13IIS
Bureau),
Total
dt^ibs
trom
all
DIiibtbprM.
Measles.
Scarlet
Tuber-
any.
0
1
1
Q
1
1
1
1
From 50,000 to 100,000 inhabit^
CovlnEtoti Kv
£7, 144
^,4^
m,090
63,705
75, 105
7G,07S
M,r72
76, tm
72,015
n,2U
tt<t,529
W,137
50,^^53
57, 3 a
51,1 JO
7ft,i'^J
ji,22l
53,7^
^,0f2
trJ,043
71, 7«
55, lit
03,^07
55,6^2
ai,?3d
53,3:30
fl8,hOo
M,5ig
57,078
S7,*^J
61,120
51, 5M
W,t>^
77,916
T0,?J3
70,776
94,205
51,656
37,732
34,^14
32,730
27,fi32
43,435
441,192
29,311*
31,311
afl,074
32,261
48,^11
^,873
2S,743
43,4S8
28,203
39,233
35»4Sd
41,SG3
3i,3£3
25,fS79
48,477
^,3«3
48,S«6
31,576
»,ni
3S,676
41,007
35,38*
IM
12
13
41
U
17
14
14
Z3
1
2
10
t
Piiliitli Hioji
3
2
1
2
El Piiso TftX i. << 1
3
3
7
Erie, Fa ... ..,,,,*
4
2
3
2
1
3
S
4
S3
ETftTisviUc^Iiid**. .,,,4L
3
Flint, Midi...., . ».,
1 1
Fwt WayriB Ind
1
Harrislrtifi! Prt
1
3
Hobot^n N J*
3
I
2
1
a
JnihuR)nwii, I'li^ ,^^
1 1
2
1
2
1
TCmuii*^ ^if-V" fCans
f.diint.«t:Ar i'^
::::::»::::::
lAiUc Rock \rk
27
5
22
IS
1
4
Maiden, U(i^«i^-,
2
2
2
3 ,
.»,,.-,
1
1
Marictir^lPT N. H
1
Motiile A]4... ' ' 1
3
New Britaia Conn
I
Norfolk, \'a.
^
3
OtUhcmiEi City, Okla.,._..
H
23
16
15
20
25
31
22
24
25
H
16
10
21
3
9
3
......f
a
X
Pfeirliifik«^t R. I,. *
....J
3
PortUnd.Me....
3
1
2
SftfT^m'PdilOj Cal»4*
•
Siijpinmir Mirh
1
1
1
1
t
St. JiM«pll Ua«-
1
1
1
I
1
X
1 1
13
3
San ^'leTO, Cal..
:..../..:
3
3airafttiai]:, On
4
3db(HiertMl\- N/Y.. \
3
SktouxCttv lowB
1
HgrotTvillri, Mass.,
1
5
17
2
4
7
1
2
1
1
1
aTirin«AA|[],IIL.,
3
9iirincf^ld,OhfD..
3
9
i !
1
Thtc Haute , Ind, ,,..,..... .
1
Ttov, N. Y. ,.
1
1
1
1
Wichita, Kam . , * . . . .
"Wflkffg^tJarTe, Pa.
33
31
7
10
3
7
^_
7
24
9
4
1
1
3
1
WllniliiiEton, ueL
3
1
Yort, P».„. . ,..
l^QQi 35,000 to 5(f ,000 inbabi tauU:
Alameda, Cd.,.„ „.„
1
*-V"-
3
1 1
Austin Tnc
1
BroakUnR, Mo^,
2
1
1
3
Bniler, Pa ..^... * ^ .
7
Butte, Mont *..„..,...
2
1
2
C&fiL'^qa. Masd, *.*.*. . *..*,
3
CMfopw, Mo^ ,.,-,.....
4
4
ColtimbLa S C
'.....^
Cimibfirland, Md> *. *
1
1
Danville, HI
BaTonportr Iowa..***,*......!
2
3
DiibiiCLiia Iowa
<
a
Bast C3iicaflo. Ind.,. -,«..,, -
1
1
'i.„...
Bast Orange, N. J.. ....... ..
Elgin 111 '
S
13
fi
3
11
5
13^
11
ao
4
........
19
14
1
**'**'
1
...... 1
t
Ev«r*lt, Mass... ,,.«.. ......
3
BTtri4tj Wasb
Qil^Htim, T«t.,„, ,.*,.,., J
2
QpMo Bay, Wis ,,...,..'
"■"'
Ifaicvttn^VTi Md ^»x,i ^ .
I
3
2
HaT«rbii],Mns;i. ,.,,,,......
1
3
Jsi^tsiiin^ Mirh , . i .
1
1
7
3
1
'"-J-
.„...
3
3
Kflnofibo,, Wi9 ,,..,,.
HTTft^tiQ^^ NY" X . X
XjtMi^iiO^r Tmn... »-...-...
3
4
S
1
1
13
1
Ia C3r(3i»," Wis, ,,........,. .
t
""
1
Lintarohlo ..'.. i ^ ^ i I ..,.., .
" "3"
'"*]_
i
I
lEE YOU SATINO Your Jfoaejr W liiTeBt In the SECOND LIBEBTI I/OAK^
^^ Digitized by Google ^'
September 28, 1017
1654
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCULOSIS--
Continued.
City Reports for Week Ended Sept 8» 1917~Continued.
Popula-
tion as of
July 1,1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
city.
1
i
1
1
2
a
Cases.
Deaths.
1
i
From 25.000 to 50,000 inhabit-
ants—Conthiued.
Lincoln, Nebr
48,515
27,587
32,940
25,234
26,318
27,327
29,^3
41, n3
31,927
30,108
43,715
37,353
81,401
31,404
33,080
40, »50
41,185
38,r.29
39,r^i
36,798
38,130
4S,48fl
43,2^
28,93fi
38,902
27,445
35,358
46,220
36,283
48,726
30,r>70
29,894
43,139
43,377
33,S09
31,155
30,863
22,874
15,010
13,599
21,r.85
15,794
113,076
22,669
24,276
23,530
20,930
15,395
» 14,010
17,445
13,284
17,500
23,126
15,243
20,985
122,019
19,926
23,805
17,524
11,666
12,067
14,831
20,193
13,821
15,548
23,228
15,900
14
9
0
7
4
6
16
1
Long Boach.Cal
1
. 1
1
4
1
L^'nrhburR,Va.
. ^ ....
1
IkTedford, Mass
. 1
Montrlair. N. J
i:::;-';
«
i
Na«?hua. N. H
Newburgh, N.Y
3
2
New ( astle, Pa
2
4
Nen-p )rt,Ky
5
3
7
.. *l •
Newport, R. I
2
Newton, Mass.
2
4
1
Niagara Falls N. Y
1
Norristown, Fa
7
7
11
ii'
2
11
12
8
12
5
......
Ogden, Utah
1
1
1
1
i
Oranre. N. J
Pasauena, Cal
Perth Ambov, N. J
2
1
2
2
1
1
Pittsfield, Mass
2
1
Portsrao<ith,V8
Qiilncy, III ,.....*....
1
«
Quim^-. Mass
1
2
Racine, Wis
Roanoke, V'a
1
2
Rock Island. Ill
1
3
San Jo^e, Cal
Steuben\ille, Ohio
7
2
Stockton, Cal
5
1
Superior, Wis
5
14
7
8
3
9
ii'
10
12
6
6
4'
8
13
12
7
6
1
2
4
1
3
4
8
8
12
6
1
1
Taunton jMass
Topeka, Kans.
2
Waltham.Mass
■ Watertown. N. y
2
We*^t Holwken, N. J
4
1
6
1
1
2
Wheeling, W.Va
....
Williamspcrt, Pa.
1
Winston-Sa'em, N. C
1
1
2
1
Zanfts\ille, Ohio
From 10,000 to 25,000 inhabitants:
Alton, III
2
3
1
Ann Arbor, Mich
1
1
1
Berlin. N. 11
Braddock, Pa
6
2
1
Cairo, III
Clinton. Mass
1
Concord, N. H
6
1
1
Oa!esburg,lU
K«irnv, N. J
....
1
Kokomo, Ind
.
1
Long Branch. N. J
Mannette,Wls
1
7
1
Mel ro(<e. Mass
Morristown, N. J
I
Muscatine. Iowa
....
Nantiroko, Pa
3
. '"
1
Newhurv-port, Ma«Js
New London, Coim
1
1
North Adams, Mass
Northampton, Mass
1
4
1
Plalnfield, N. J
Pantiac.MIch
1
8
1
Portsmouth, N. H
e"
4
7
7
3
5
2
1
1
1
Rocky Mount, N. C
Rutland, Vt
1
1
1
Sandusky, Ohio.
1
Saratoga Springs, N. Y
Steel ton. Pa.
1
1
1
Wilklnsburg, Pa
Wobom, Mass
1 PopnlatlOQ Apr. 15, 1910; no estimate made.
ARE YOU SATING Your Money to Inrest in the SECOND IJ«F'?TV L0.4N!
Digitized by VjOOQIC
FOREIGN.
CHINA.
Examinatioii of Rats — Plague Rate — ^Hongkong.
Examination of rats has been reported at Hongkong as follows:
Cwo weeks ended July 21, 1917, 4,405 rats examined; no plague in-
eotion found. Week ended July 28, 1917, out of 1,993 rats exam-
ned, 1 rat found plague infected. Week ended August 4, 1917, 2,060
•ats examined; no plague infection found. The last plague-infected
•at at Hongkong was found during the week ended Ju^y 28, 1917.
CUBA.
QnaranUne Against Venezuelan Ports Removed.
The quarantine measures imposed at Cuban ports against ports in
Venezuela comprised between Puerto Cabello and Ciudad Bolivar,
)oth included, was removed by order of the Cuban quarantine service
lated September 10, 1917.
UNION OF SOUTH AFRICA.
TyphuB Fever — ^East London.
Typhus fever was reported present, September 10, 1917, at East
Jondon, Cape of Good Hope State, Union of South Africa.
i"
1.
"""J-
......
t
;.'.'*.
....J.
:;;::;
.....
.>'"'i
3H0LEBA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received During the Week Ekided Sept. 28, 1917. >
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Madras
July 8-14
2
8
3
153
2
1
2
2
80
Indochina:
-Aonam. .
Adt. 1-30
Cambodia
. .^doT?!^:::::::::.
Cochln-China
Tonlcin
do
do
1 From medical ofllcors of the Public Health Service, American consuls, and other sources.
ABE YOU SAVING Year Mo«y to Inrcst in the SECOND LIBERTY LOAN!
(1655)
Digitized by VjOOQIC
HeptemUr 28, 1911
1656
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW FEVER-
0/ontinued.
Reports Received Darini; the Week Ended Sept. 28, 1917— Continued.
PLAGUE.
Place.
China:
Hongkong
India:
Karachi
Siam:
Bangkok
Indo-Chlna:
Annam
Cambodia
Cochin-Chlna..
Tonkin
Date.
July S Aug. 18.
July»-14
JulyS-21
Apr. 1-30..
do
do
....do
Cases.
Deaths.
I
Remarks.
8BCALLPOX.
Canada:
Manitoba-
Winnipeg
Aug. ac-8ept. 1....
Jiilv 22 28
1
China:
Vh ungVing
Present.
Hongkong'.
Au;^'. 5-18
1
Tjiingtau
July 30- Aug. U...
July 8-14
4
1
6
481
33
2bi
3
5
138
1
1
1
2
t8
7
8t>
India:
Karachi
Madras
do
Indo^'Wna:
Annam
Apr. 1-30
Cambodia *
do
rochiiwChfn^ .. .,.
dn
Kwang-Chow-Wan do
Laos
do
1
96
Tonkin
. ..do
Japan:
Yokkaichi
July 26-31
Mexico:
Coo t epoc
Jan. l-Jone 30.....
110
Do
Aup. 1 14
1 Jan. 1-Anif. 14. Iftlfr 111 dMtha.
Jalnpn ,
July 1 13
33
— '
Orizat>a
Jan. 1-Juneao...
1)0
July 1-23
V>ra Crui....
Sept. 2-8
2
1
2
Netherlands:
Amstfrdam.... ..ax...
Aog. 1»-18
Jtily8-14
I
3
Biam:
Bangkok
•
TYPHIS PEVEB.
China:
Anttmg Aug. 13-19.
Tslnglau Aug.&-ll.
Orroci?:
SalonikI July 22 \ug. 4.
Jap'Ui:
'^arwaki I Aug. 13^19
MfMr.: I
I <'iter«c ' A'iF. 1 H
Jaiai>a Apr. IJuiw*).
Vn Jul". I M
OriitJA Jai.. I June 30..
I'w Jul\ I M
Nof|urlan<N: \
I .tuniam Aop. V 11
Not '-^ ^i\ . '
iVrrrn ,. ' Joly **2 'JS
Ztirich , ; Au«. 12 IS
Vt\\t*n of s<>'"h aMca
{ aiJ<» f*t <toof\ il<T<» 8!at«— '
k x-i i.ondoa i 8cpl. 10
Preeent.
ARE YW HWISU Yoitr Mone j to Inrent in the HECOND LIBERTY LOAN?
Digitized by VjOOQIC
1657
September 28. 191T
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER^
Continued.
Reports Receired from June 30 to Sept. 21, 1917.
CHOUERA.
Plac*.
Date.
Cases.
Deaths.
Remarks.
IndU:
Btssein
Apr. l-lfay 6
8
1
347
3
4
4
2
3
1
5
7
17
Bombay
Juno 24 30
Apr. 2»-June30...
1
Cmkutta
Do
July 1-7
Madras
Apr. 22- June 30...
Ji5yl-7
ICay 6-June 30. .
5
5
Do
ITiMKif^l^y
MoulmeizL
May 13-June2
Pakokku
Aof. 20-May5...
Pegu
May 27-June 30. . .
Do :.;...;.:.:
July 1-7
. ..
Ranroon. ^ ^
Apr.21-June30...
31
Tndo<,hE^:
Feb. 1-Mar. 31, 1917: Cases, 61;
deaths, 40. ——,
Anam
Feb. l-BrCar.31....
do
6
9
41
2
163
1
1
1
7
32
nAn|)>odi#. .
Cochin-china
Tonkin
do
do
Saigon
Apr. 23-May 27. . .
Apr. 2-«
108
Java;
East Java
Do
JiuyJ>-15...
1
West Java
Apr. 13-July 5, 1917: Cases, H
deaths. 31. July 6-26, 1917:
Batavia
Apr. I3-July5....
July 6-26....
7
6
1
4
1
3
1
2
1
Do
Cases^ M; deaths, 51.
Persia:
Maxanderan ProvlDO^—
Amir Kela
Feb. 8
Barfouroache
Jan. 15-17
Hamte Kela
Jan. 17... .
MiK4iidessar
Jan. 31
Philippine Islands:
June 17-23
Provinces ,
May 20-Jan6 SO, 1917: CaMi, 79f(
Agusan
Julv 15-28
12
113
53
1
1
368
203
62
61
231
388
41
14
334
237
12
276
106
216
11
11
2
76
30
1
11
deaths, 506. July l-Ai». 1^
1917: Cases, 2,064; deaths7l,27L
Albay
Ma*y20-June30...
Julyl-Aug.4
June 3-9
Do.......:::::::::
Ambos Camarines
Do
'uly22-Aug.4....
JulyS-14. :..
Bataan ....>,,.
"nnfaneiii
June 17-23
1
251
161
40
45
150
284
22
5
223
117
11
177
bSoi^..::.... ........
May 21- June 30...
Julyl-Aug.4
June3-30 . ..
Do
Oapis.
^fc:::::::::::::::::
Julyl-Aug.4
JuDe»-S0
Cebu
Do
Julyl-Aug.4
HoUo
Leyte
Junelt-30.
Do
Julyl-Aug.4
July»-Aug.4
Jiily2^Atig.4....
Julyl-Aug.4
in«MM,
Negros Oriental
Do
July 1-7
BomUon.
July22-2S
1
2
88
114
4
7
9
7
flamar
Julyl5-2L
Juno 3-30
Sorigao
Julyl-Aug.4
July2»-Aug.4....
June 3-30
Tayabu
Do
Julyl-Aug.4
July 15-21
PLAGUE.
Arabia:
Aden.
May3-Junell
38
3
1
Apr. 8-May 14, 1917: Casses, 69;
Biasil:
Bahia
June 10-30
6
5
deaths, 51.
Do
July8-Aug.4
ARE YOU SATING Yoar Money to Inreai Im the SECOND LIBERTY LOAN!
September 28, 1917
1658
CHOLERA, PLAGUE, SMALLPOI, TYPHUS FEVER, AND YELLOW FETER-*
Continued.
Reports Received from June 30 to Sept 21, 1917— Continued.
PLAGUE-^Continued.
Place.
Dftte.
Cases.
Deaths.
RemailDB.
Ceylon:
Colombo
Apr. ^June9
July C-12
40
33
1
Do
China:
Apr. 2^ May 5
Present and in vicinity.
i5^::::::::::::::::::::
July 1-7
May 13-June30..^
June 2
6
ao
6
13
Honskonc
KwangtoDR 'Province—
Present.
Ecuador:
RstAHf^iA Vieia
Feb. 1-2S
1
56
33
9
1
1
2
1
l^iiftvnniiU --
do
29
18
4
Mar. 1-ai
Do' '
Anr. 1 3)
Utkiero '*
Mir. i~3l
*^S^ ;:;.:::....
Apr. l-^)
1
Nol>oL
Feb. 1-2S
gaiitre
do
Do v.'.../..
Mar. 1-31
1
2
Taura . .......
Feb. 1-23
3
Egypt ..'
Jan. I-Aiig. 2, 1917: Cases, 1^;
AlATAtirlriA
June 21-27
6
1
4
1
1
14
1
4
deaths, 696. '^
Da
July 31
Port Said g j vemment
Port Said
Apr. 30-May 19....
June 25
3
D)
July 28-29
7
Prov;n;x?s —
Fayoiim
May Il-June26...
June 28
CaU)ulieh
Gircph . .
May 17
1
3
MiniPh ' .',',.'
BiAVl2-JuDe28. ..
July 29
4
1
3
23
3
2
Do
Sioiit
May 12
1
9
23
1
Suez gC/vemnicnt
^T)i•. TV-lMno ?.
11:., ;: h : '2'^...
Aug. 13-24
May 3-8
Suez
Great Britain:
Gravescnd
From s. r. Matfana.
London
2 in ho<?pltaI at port. Fmm s. s.
India
Sardinia from Aa^tralian and
oriental pjirta.
Apr. 15-J»me 30, 1917: Cases,
Bassein
Apr. l-Jnne 30
M
6
363
25
38
35
413
2
250
68
9
74
16
1
2
160
43
2
43,922: death.s, 30,197. July 1-
Do
Ji5y 1-7
7, 1917: Cases, 1,870; deaths.
BoniI>ay
Apr. 22-June30...
Ji5y 1-7
Apr. 23-June 2
441
36
1,323.
Do
Calcut ta
Hcnztula
Apr. 1-Jimc 30
Karachi
Apr. 22- June 30...
June 28- July 4....
Apr. 22-Jime30. ..
July 1-7
468
3
301
70
Do
Madras Presidency
Do '
liandalay
Apr. 8-M;\y 12
Monlmcin
Apr. 1-Jime 30
Do
Ji5yl-7
My insrvan
Apr. 1-7
Pegu
May27-Jinie2
Rangoon
Apr. 15-Juno30...
Jifiy 1-7
183
46
b)
Touncfoo
Apr.8-U
Indo-Chiua:
Pru V inccs
Fbb. 1-Mar. 31, 1917: Cases, 198;
Anam
Feb. 1-Mar.3l....
do
72
92
83
47
39
80
21
26
deaths, 141.
C^amlwdJa
Cochin-China
do
Bakmn
Apr.23-June3....
Itva:
Kast Java
Apr. 3-May 20, 1917: Cases, 39;
D|oGJakarta Residency.
Kjedirl Residency
Apr.23-May6
do
1
1
3
18
6
1
1
3
18
6
Samarang Residency...
Borabttya Residency. . .
Burakarta Rosideiicy...
Apr.23-May20....
Apr. 2- May ao
do
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1659
September 28. lAlT
CMOLERA, PLAGUE, SMALLPOX, TTPHU fXVEB, ANI>SaJLOW WKWEM^
Contimied.
Seporte Becehred fr»iii June dO to Sept. 21, 1917— Continued.
PLAGinB--C«mtinQML
PlM0.
Date.
Cases.
Deaths.
Remarks.
May 16-31, 1917: Cases, 15.
At Moilondo.
Departments—
AreourDtt .............
May 16-31
4
1
a
7
1
13
4
2
1
Collao
do
AtCallao.
T Am^yoow r r , ,
do
AtChidayo.
At Salaverry, San Pedro, and
Truiillo.
At Lima. •
LIbertad
do
Lima
do
Apr. 22- June 30...
July»-23
Slam:
Bangkok
12
3
1
1
Do
Straits Bettlcraents:
BineaD.'ro
June 3-16
^ :::::::;::.::.
July 1-7
Union of South Africa:
Cape of Good Hope State—
Glengre y district
Terka district
Aug 13
Present.
May 28
1
1
1
At Summerhill Farm.
Quecnstown
Juno 0
OrftTiffo PnN» 3t.iit«--. .
Apr. 16-22, 1917: 1 case. Apr. 9-
22, 1917: Cases, 2^: deaths, 17.
Winburg district
At sea:
8.S. Mntiftna
Uav28
1
6
July 14-18
9
En route for port of London.
SMALLPOX.
Australia:
New South Wales
Apr. 27-July 28, 1917: Cases, 7^.
Brewarrina
Apr. 27-June21..-
July 25-28
6
4
13
2
iX)
1
4
2
126
158
i
3
Ceasnock
Coonabarabran
May2.>-July6
Apr.27-June21...
June 22- July 17...
May 9
Qnamlxnv^
Warren district
Queensland-
Thursday Island Quar-
antine Station.
Brazil:
B^la
From s. s. St. Albans from Kobe
May6-June30....
July22-Aug.4....
do
via Hongkont;. Vessel pro-
ceeded to TownsvIUe, Bris-
bane, and Sydney, in quaran-.
tine.
Do
1
31
27
Rlode Janeiro
Do
Julyl-Aug.4
June 10-16
Canada:
Manltoba-
Winninee
Do
Sept. 19-25
June 1&-July 7
Juno 17-30
Nova Scotia-
Halifax
Port Hawkesbury
Ontario-
Ottawa
Pitwnt in district.
July30-Aug.5....
May 6-12
1
1
Coylen:
Colombo
China:
AmOV..r-..T^--T-Trr-T
Apr. 29-May 26...-
Present and in vfeinJty.
^^i5o :;;:::::;::.:.:
Jmy 1-31
Do.
Antnng ......,.,....,.
May21-Jane24...
Aug. 6-12
4
1
^ ::::::::.:::;:::
tThnnvVinr
Mav6-June23
< Do.
Do
July 1-21
Da
l?liftner«hA . . .
May27-June2....
May l^June30...
July 8-28
5
30
6
2
7
8
1
Di^fen
4
1
Do
July 1-7, 1917: Present.
Hankow .,,.......,.,-,
June 24-30
Harbin
Apr. 23-May«
May tV-June 16....
On Chinese Eastern Ry.
Hongkong
7
Manchuria StaUon
Mukden
Do
Apr. 23-29
Do.
May27-June2. .
.........
Present.
Jnly8 Aug. 11....
"] [ 1
Do.
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1660
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from Jane 30 to Sept 21, 1917— Continued.
SMALLPOX-Continued.
Place.
Date.
Deaths.
Remarks.
China— Continued .
Shanghai
Do
Tsitshar Station..
Tslngtao
Chosen (Korea):
Chemulpo
Ecuador:
Guayaquil ,
Do
Do
Alexandria
Do
Cairo
Franco:
Nantes
Paris
Germany
Bernn.
Bremen
Charlottenhwg..
Hamburg
^,»:
Lubeck
Munich.
Stuttgart
Greece:
Athens
India:
Bombay
Do
Calcutta
Karachi
Madras
Do
Rangoon
Indo-ChinaV
ProTtnees
Anam
Cambodia ,
Cochin-China
Kwang-Chow-Wan. ,
Tonkin
Saigon
Italy:
Turin
Do
Japan:
Kobe
Nagasaki
Osaka."
Yokohama.
Java:
East Java
Do
Mid-Java
Do
West Java
Batavia
Mexico:
Mazailan
Mexico City....
Do
Monterey
VeraCrat
Philippine Islands:
MMiila
Do
May21-Julyl..
July2-Aug. 5..
Apr. 1&-22
May22-July7..
May 1-31.
Feb. 1-28.
Mar. 1-31.
Apr. 1-30.
Apr. 30-July 1 . . .
July2-29
Feb.l2-Mar.l8...
July30-Aug.5..
May6-12
Mar.18-Apr.28.
do
do
do
....do
.....do
....do
....do
July 25-30.
Lpr.22-C
July 1-7
Apr.29-May26.
Apr. 22- July 4..
Apc.22-June30....
July 1-7
Apr.l5-Juno30...
July 1-7
Feb.l-Mar.3l....
do
do
Mar.1-31
Feb.l-Mar.31....
Apr.27-Junel0...
May21-June24..
Julyl2-Aug.5
May27-July22.,
MayM-June3..
Mayl«-Ju]y5...
May27-Julyl..,
Apr.2-Julyl.
July2-15
Apr. 1-July 1. .
Jifly2-15
Apr. 13-July6.,
July 11- Aug. 7...
June 3-30
Aug. 5-11
JunelS-24
Julyl-Aug. 18...
May 13-Jane9...
July8-Aug.4....
13
106
16
18
50
20
2
10
1
163
14
788
73
654
2
99
199
32
8
65
1
177
1
38
13
88
10
30
162
69
32
63
17
158
16
Cases foreign; deaths among na-
tives.
Among Chinese.
On Chinese Eastern Ry.
At another station on railway,
lease.
Mar. 18-Apr. 28, 1917: Cases, 715
in cities and 32 States and dis-
tricts.
Feb. 1-Mar.31, 1917: Cases, 1,616;
deaths, 240.
Apr. 13-July 5, 1917: Cases, 239;
deaths, 44. July 6-26, 1917:
Cases, 66; deaths, 14.
Varioloid.
Do.
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September 28. 1917
CHOLERA. PLAGUE. SMALLPOX, TYPHUS PETER, AND YELLOW PEVEIt-
Continued.
Reports Received ttom June 30 to Sept 21, 1917— €ontinued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Portugal:
lisbon
May 13-June30...
July 8-28
14
4
Do
Portuguese £ast AMca:
Lourengo Marques
Mar. 1-May31
3
4
Russia:
Archangpi]
Mayl-June28....
Feb. 18-June9....
Mar. Il-June2....
Mar. 15-21
June 9-30
66
495
4
23
16
1
Riga
Jan. 1-Mar. 31, 1917: Coses, 9.
Vladivostok
7
Slam:
Bangkok
^Do.. ::;:::::;:;:::;:;::
July 11-17
3
4
12
11
SpiOn:
jtfadrid
May 1-June 19....
Malaga
Apr. 1-30 .]
Bevilfe.
May 1-June30....
Valencia
June ^23
5
12
6
1
1
2
2
•
Do
Julyl-Aug. 18....
Mar. 18-June23...
June 24-30
Apr. 22-28
May20^une23....
June 2-8
Straits Settlements:
Penang
3
Sweden:
Stockholm
1
Tunisia:
Tui>i?»
Turkey in Asia:
Trebizoad
Feb. 2^Apr. 13...
15
Union of South Afdca:
Johannesburg .
Mar. 12-24
May 1-31 , .
4
2
Uruguay:
Montevideo
Venezuela:
Maracaibo
June 18-Julv 8 . .
8
1
Do
July 9-23
TYPHUS FETEB.
Place.
Date.
Cases.
Deaths.
Remarks.
Algeria:
Algiers
June 1-30
5
1
3
1
"Do
July 1-31
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 1916: Oases, 2^n.
Botiemia
Oct. 22-Doc. 17....
do
634
809
47
617
16
243
5
Gallda
Lower Austria
do
do
Moravia.
Silesia.
do
do
Styria
Upper Austria
do
Hungary
Feb. l^Mar. 25, 1917: Cases, 1,881.
Budapest
Feb. 19-Mar.25...
July 29- Aug. 4....
June 25-July 1
July 9- Aug. 12
June 9-15
83
1
3
6
1
Brazil:
Rio de Janeiro
China:
Aotung . .
Do".
1
Hankow . .
Do
Julys- 14
1
Tientsin.
June 17-23
1
4
1,64S
220
96
Tsingtao .
May 30- July 7
Apr/ *>- July 1
July 17-29 .
Alexandria ....x..
478
84
40
1
Do
Cairo
Jan. 22-Mar. 13....
June 17-23
Great Britain:
Cork
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1662
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from Jiuie>30 to Sept. 21, 1917— Continued.
TYPHUS FEVBR-<:<mtiiiaed.
Flace.
Date.
Cases.
Deaths.
Remarks.
Greece:
Saloniki
Mayia-Juno30...
32
10
Do
July i-14.
Japan:
Hakodate
July 22-23
1
4
22
Nagasaki
June 11-24
i>aggaia.... ...........
July&-Aug. 12
2
Java:
East Java . » .
May 0-Julyl, 1917: Cases, 6. July
9-15, 1917: Cases, 3.
Surabaya
June25-Julyl....
1
Mid-Java.
Apr. l-June 24, 1917: Cases, 38;
Samaran?
May5-Junel0
July2-8
14
5
2
deaths, 5. July 9-15, 1917:
Cases, 1; deaths, 1.
Do
West Java
Apr. 13-July 5, 1917: Cases, 147;
Batovia
Apr. 13-July5
Jiay^2«
70
31
431
524
3
5
11
126
6
2
deaths, 6. July »-26, 1917:
Do
Cases, 40; deaths, 2.
Mexico:
•MexicoCity
June 3-30
Do....:.::::::::::;;:::
July8-Aug.ll....
June 9-23
Netherlands:
Rotterdam.
2
Do
Julyl5-Aug.4....
July 8-14
Norway:
Bergen
Portuguese East Africa:
T ourenco Marques
Mar. 1-31 . . .
J'
2
3
Russia:
Archangel .*
May 1- June 28....
Peb.l8^une9....
May31-Jun6 2....
Mar.29-May21....
May 1-31
Petrogiad I
RigaVT.
Jan. 1-31, 1917: 1 case.
Vladivostok
Spain:
Almeria
5
2
Madrid ;
Ido
Switzerland:
Basel
June 17-23
July 8-21
Do
1
Zurich
July28-Aug.l..;.
June 4-9. .7: .
Trinidad
Tunisia:
Tiiniii ...
June3(>-July6..
1
YELLOW FEVER.
Ecuador:
Babahoyo..
Do
Chobo
OuayaquH.
Do::"*
Mil^ffo.
Do.
Mexico:
Campeche State—
Oampeche
Yucatan State—
Merida
Peto
Do
Feb. 1-28..
Mar. 1-31..
....do
Feb. 1-28...
Mar. 1-31..
Apr. 1-30...
Feb. 1-28..
Mar. 1-31..
Apr. 1-30..
Aug. 19-25.
Sept.l
June 23
July29-Ang.ll.
1
1
3
1
1
1
18
7
17
9
17
9
1
1
1
1
2
1
1
1
1
6
2
In person recently arrived from
Mexico City.
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PUBLIC HEALTH REPORTS
VOL. 32 OCTOBER 5. 1917 No. 40
POLIOMYELITIS IN AUSTRALU.
The information contained in the following statement was taken
from a publication issued in the current year by the quarantine
service of the Commonwealth of Australia, entitled *'A Review of
Recent Literature on Typhus Fever and Acute Anterior PoUomyeli-
tis/' by F. E. Cox, chief quarantine officer, Victoria, Australia:
First recognized occurrence of poliomyeliiis in Australia, — It is
probable that sporadic cases of poliomyelitis occurred in Australia
during a considerable period before any outbreak of the disease was
recorded. The first sporadic cases noted occurred in the year 1887.
These were a case, presumably poUomyelitis, recorded by Hood as
occurring on the Clarence River, New South Wales, and a case, type
not specified, recorded by Altmann as occurring at Port Lincoln,
South Australia. In 1890 three sporadic cases, all fatal, were
recorded in New South Wales. In 1893 Stokes recorded three cases
occurring in one family at Port Macquarie, New South Wales. The
first recorded outbreak of poliomyeUtis in AustraUa occurred at
Port Lincoln, South AustraUa, in 1895.
New South Wales. — The outbreak of poUomyeUtis at Sydney, the
second to occur in AustraHa, began in the sumimer of 1903-1904.
From Sydney the disease spread over the greater part of New South
Wales and Queensland. Tliirty-five cases were recorded at Sydney
by Litchfield between November, 1903, and March, 1904, most of
which occurred in December and January. The season was unusually
wet and cool. During December, 1903, and January, 1904, 34 cases
were noted in Sydney by Wade. These cases were of the spinal type
and most of the patients were children under two and a half years of
age. Six cases were recorded by Blackall as occurring at Queanbeyan
early in the year. A fatal case (Landry's paralysis) was noted at
Grafton. Eight cases were noted at Young.
Cases were reported in two other country districts of Ncw^ South
Wales — Amiidale and Glen Inncs.
In 1909 12 cases occurred at Sydney in March. Toward the end
of the year, 20 cases occurred on the Richmond and Tv\^ecd Rivers,
New South Wales.
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During the period from 1891 to 1913, 206 cases of infantile paralysis
were admitted to the Royal Alexandra Hospital for Children, Camper-
down, Sydney. From 1891 to 1908 the greatest number of cases
admitted in any one year was 7, in 1895. From 1909 to 1913^ the
admissions were as follows: 1909, 29 cases; 1910, 22 cases; 1911, 16
cases; 1912, 46 cases; 1913, 50 cases.
During the year 1914, 79 cases (of which 64 occurred at Sydney),
with one dcr.th, were notified in New South Wales,
Queensland, — The infection previously stated as present in the
country districts of Armidale and Glen Innes, New South Wales, was
conveyed in April, 1004, to Toowoomba, Queensland. The com-
missioner of public health for Queensland noted that 104 cases of
poliomyelitis occurred in Queensland during that year. The out-
break was widely scattered, cases being reported at Brisbane, Ipswich,
Maryborough, Toowoomba, and Townsville. The epidemic ended
in February, 1905. Most of the cases occurred in October. One
fatal case of Landry's disease was noted at Brisbane by Byrne.
An outbreak occurred at Brisbane in 1914 (described by Thomson).
A few sporadic case^ were observed in July and September and early
in October the disease became epidemic. The outbreak ended in
December. In all, 207 cases with 29 deaths wore reported. The
cases appeared in the central part of the city; the infection spread to
the outlying suburbs, and finally to towns situated at some distance
from Brisbane, such as Sandgate and Ipswich, which are directly
connected with Brisbane by railway. Thus this outbreak ran the
typical course of epidemic-s of poliomyelitis (infantile paraljrsis). It
is of interest to note that this epidemic and that of 1904-5 in Queens-
land, occurred during the dry season. The climate is better
divided into wet and dry seasons than into the spring, summer,
autumn, and winter of temperate regions. It is therefore com-
parable with that of the Pacific coast of the United States.
Outside the metropolitan area of Brisbane 125 cases were reported
for the year July, 1914, to June, 1915. During the preceding year
6 cases were notified in Queensland, of which 3 occurred in Bris-
bane, while for the 12 months preceding that period 16 cases were
notified in Brisbane and 22 throughout the rest of the State, a total
of 38 cases.
South Australia, -The first outbreak of poliomyeUtis recorded in
Australia occurred at Port Lincoln, South Australia, in March and
April, 1895. Fourteen cases, all of the spinal type, were noted.
There were no fatalities.
Tasmania. — In March, 1909, 41 cases of pohomyelitis, of which
2 were regarded as doubtful, were reported as occurring in coimtry
district^ of Tasinania. (Reported by Elkington in annual report to
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the department' of public health.) Twelve oases were reported by
Purdy in the Upper Huon district, Tasmania, in January, 1912.
Victoria. — In the autiunn of 1908 an outbreak of poliomyehtis
occurred in Victoria (described by H. D. Stephens), 108 cases with
6 deaths being recorded. Most of the cases occurred in densely
populated districts. The season was exceptionally dry and warm.
The outbreak began in April and ended in Jime. One case resembled
Landry's paralysis. A small outbreak occurred at about the same
time at Bondigo.
PUBLIC HEALTH ADMINISTRATION IN QUINCY, ILL.
By Carr'jll Fox, Sorg^jon, United States Public Health Service.
The following report gives the results of a study of public health
organization and administration in the city of Quincy, 111. The
study includes investigations in both the office and the field and wi^
carried on throughout a period of about two weeks, from April 16,
1917, to May 1, 1917.
Quincy is situated on the Mississippi River and is the county seat
of Adams Ounty. It is about 202 miles southwest of Chicago and
about 100 miles west of Springfield.
' It is served by two systems of i^ailroads— -the Chicago, Burlington
& Quincy Railroad, and the Wabash — and by steamboat packets
plying on the Mississippi River.
Quincy is provided with a beautiful park system and its topog-
raphy is such that from the standpoint of city planning and the
city beautiful the possibilities are great.
Quincy is a maimfacturing center, and is sUn-ounded by agricul-
tural country. Among its industries of magnitude may bo men-
tioned the manufacture of stoves and ranges, governors and pumps,
farm machinery and implements, elevators, strawboard, incubators,
furniture and fixtures, wagons, automobile bodies, breakfast foods,
flour, shoes, boilers and structural steel, etc.
The population of Quincy, as estimated by the United States
Census Bureau for July 1, 1916, is 36,798, there being an increase of
population over the census of 1910 of but 204.
For information and assistance received while making the study,
I am indebted to tlio officials of the health and other city depart-
ments, and to other citizens interested in the welfare of the com-
munity.
ORGANIZATION AND ADMINISTRATION.
The city of Quincy is governed by a mayor and council.
The health organization of the city is known as the health depart-
ment, and is under the control of a board of health, comprising two
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physicians aad two coundlmen^ aj^ointed by the mayor^ and the
chief of police, idio is pre^dent of the board. Subordinate to the
board of healtli, there are a commissioner of bealtii, who is ap-
pointed by the mayor, and a clerk, appointed and paid by the com-
nussioner. The employees engaged in the collection of garbage are
paid from health-department funds* In addition, the switchboard
operator of the police department is classified as secretary of the
board of health and paid from health-department fmids, but his
duties are in no way concerned with the health department* Tlie
chief of police, as president of the board, receives an allowance of
$150 per anniun from health funds.
Commissioner of health, — ^The commissioner of health is a full-time
official who receives $660 per annum. In addition, he is given cer-
tain allowances amounting to $460, out of which he must pay the
salary of his clerk ($360). As local registrar, he receives the ci»-
Ibmary fees from the county.
The commissioner is not a physician, and his experience has been
gained during the four years in which he has occupied the position.
His duties are principally concerned with the enforcement of law
and regulations relating to the control of the communicable diseaaee,
the abatement of nuisances, and food insp?ction.
Office hours of ih^. health def)aftmefd. — ^The health department is
provided with two rooms in the city hall. The office remains open
from 8 a. m. until 5 p. m. every day except Sundays and boUdajs.
At such times the commissioner is usually present at least a part of
the day. By arrangement, undertakers may secure burial permits
when the office is closed.
Ttunsportaiion. — The commissioner of health has provided himself
with a horse and buggy which is maintained at the expense of the
city in the barn provided for the housing of the equipment used in
garbage collection.
Dissemination of information. — The campaign of education in
public health so necessary in every community has been overlooked
in Quincy. With a reorganization of the health depailment, this
matter should be gone into intensively.
Discussion, — It is certain that the health department of Quiney
is not in a position to perform the duties required of a modem health
d^artment. Its organization is bad; it is without money and men.
The board of health should be abolished and a fuU-time health officer
appointed to be directly responsible to the mayor, and to hold fak
office during efficiency. He should have previous experience in pub-
lic health work, and should be a physician in order to carry on the
professional work that will be referred to later on. He should not
be permitted to engage in the private practice of medicine. The
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October 5, 1017
health oflBcer should have the same standing in the city government
as other officers in charge of departments, as, for instance, the chief
of police, the chief of the fire department, etc.
He should immediately inaugurate a campaign of education by
talks at various places and newspaper articles, so that the people
may become familiar with the work and aims of the health depart-
ment and their cooperation be secured. Without the cooperation
of the people a health department can accomplish little.
The health officer shoiild bo made registrar of births and deaths,
REGISTRATION OF BIRTHS AND DEATHS.
The registration of births and deaths is carried on imder the
authority of State law. The commissioner of health has been ap-
pointed local registrar for the city of Quincy and the township of
Riverside.
Original certificates are transmitted to the State board of health,
copies are made in a book for the files of the local health depart-
ment, and transcripts are filed with the county clerk annually.
RegistrcUion of deaths. — Six hundred and ten deaths were reported
as occurring in the city of Quincy during the year 1916, making an
indicated crude death rate of 16.5 per thousand. Three hundred
, and seventeen deaths, or 52 per, pent, wore due to causes that might
be classed as preventable.
There were registered during the same period 57 deaths in children
imder 1 year of age, indicating an infant mortality rat-e of 96.6 per
thousand registered births.
Registration of birtJis. — Five hundred and ninety births wer<? re-
ported as occurring in the city of Quincy during the year 1916,
making an indicated birth rate of 16 per thousand. The birth rate
is less than the death rate, signifying that not all births occurring in
the city are reported. This is a matter for careful investigation by
the health authorities.
ni5eases.
Toberculosis, pulmonary..
Tuberculosis, oi lior forms.
Typhoid fever
Diphtheria
IfoislesL
Scarlet fever
Whooping cough ,
Influenxa
Tetanus
Inlantilc paralysis
Erysipelas
Pneumonia
Total
prevent-
able
deaths,
all a-'cs,
roTislor-
Indicat-
ed dcith
rate ix5r
11)0,010
popula-
tion.
170.6
6.4
16.3
32.6
0
43.4
Number
oases re-
ported.
0
0
7
45
H04
7
0
Fatality
rale per
100 cases.
Total
rotrister-
ed deaths,
inf'ints
under 1
year.
23.5
13.3
1.5
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Total
prevent-
able
deat.s,
all at;es,
«« leer-
ed.
IndiOftt-
Number
cases re-
ported.
Fatality
rate per
100 cases.
Total
Dismses.
ed death
rate per
100,000
eddaaUis
infants
under 1
year.
Chiokeopox.
0
0
4
6
9
4
13
3
15
42
14
5
19
54
2
0
Snudlpox.
0
Septk^Binl* ^
Meningitis •.
o
1
1
Diarrhea and entoxitis
8
Syphilis
0
Broztchitia.
4
Occupational accidents and diseases
0
0 ther accidents
o
Malignant growths
114.1
0
Premature
14
Malnutrition.
6
Other causes.
19
Total
817
87
BPIDEMIOLOGICAL ACnVITIES.
The Report of Diseases.
Diseases are reported under the authority of State law and regu-
lations of the State board of health.
Physicians report the occurrence of a notifiable disease by tele-
phone. The information obtained is entered in a book which shows
the name of the disease, date, name, age, sex, color, and address of
patient and the physician's name.
In the case of smallpox, scarlet fever, diphtheria, epidemic cerebro-
spinal miningitis, poliomyehtis, typhoid fever, bubonic plague,
cholera, yeUow fever, and typhus fever, a report is made to the State
board of health on a special form or by telegraph followed by letter
within 24 hours after notification by the physician. Other diseases
ere reported to the State board of liealth monthly.
The Control of Disease.
The reportable diseases arc placed in two classes as follows:
TO BK QUAEANTINED AND PLACARDED.
Smallpox.
Scarlet fever.
Scarlatina.
Diphtheria.
Membranous croup.
Chickenpox.
Meaalee.
Whooping cough.
Poliomyelitis (acute inf.).
Cerebrospinal fever.
Meningitis (epidemic).
Asiatic cholera.
Bubonic plague.
Leprosy.
Typhus fever.
Yellow fever.
Rocky Mountain spotted fever.
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Typhoid fever.
Paratyphoid fever.
Dysentery-amebic .
Dyaentery-bacillary.
German mesLsles.
Mumps.
Septic sore throat.
Malaria.
"Continued fever. 7
Hookworm disease.
Tuberculosis.
8UBJBCT TO A MODIFIBD QUARANTmS.
Ophthalmia neonatorum.
Trachoma.
Pellagra.
Puerperal fever.
Rabies (hydrophobia).
Tetanus.
Glanders.
Anthrax.
Trichinosis.
Actinomycosis.
Typhoid fever is a placardable disease.
There is practically no epidemiological study made of any disease
and there are no epidemiological records on file in the board of health.
The commissioner of health placards the house, enforces the quaran-
tine, and performs the terminal fumigation and other procedures
required by regulations of the State board of health.
A certificate is furnished to cliildren giving them authority to
return to school after quarantine has been raised.
Typhoid fever. — During the year 1916 there were seven cases of
typhoid fever reported with but two deaths. One death occurred in
a case that was introduced froja, the outside. Including this case,
the death rate from typhoid fever was but 5.4 per 100,000. The
city has used filtered water for n^^ny years, but previous to 1914 the
plant was of an old type and the intake was badly located with ref-
erence to a sewer outlet, and typhoid fever was more or less preva-
lent. During the year 1913 there were 24 dcatlis from typhoid fever
apparently originating in the city, making a death rate of 65.4 per
100,000 population. Upon investigation, sewage was found to jt>e
gaining admission to the intake pipe; this was corrected by extend-
ing the pipe out some distance into the river. In 1914 a new filter
plant was put into operation. Since the institution of these changes
the typhoid death rate has steadily decreased. At the present time
Quincy is fortunate in having a good city water supply and but few
surface wells. The insanitary privy and the manure pile, however,
are common, and it is believed that by eliminating, the two latter
sources of danger and requiring the pasteurization of all milk, Quincy
could establish an enviable record as regards tj^jhoid fever.
Tubevcfulofiu. — The registered death rate from pulmonary tuber-
culosis during the year 1916 was 176.6, there having been 65 deaths
reported. During the same period there were 8 registered deaths
from other forms of tuberculosis, making an indicated death rate
from tuberculosis, all forms, of 198.3 per 100,000 population. This
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death rate is very high and shows the necessity for the health depart-
ment to carry on active work along the line of tuberculosis prev^ition.
There is at present no place for the isolation of the tuberculons,
but plans are laid for the construction of a county sanatorium in the
near future.
At one time the local Antitubercidosis Society operated a dia-
pensaiy and employed a nurse. This commendable effort to do
something for the people was not appreciated, however, and for lack
of support and patronage the work was discontinued.
Other diseases.— ^Qxt to tuberculosis, all forms, pneumonia gave
the highest number of registered deaths, with a death rate of 187.5
per 100,000 population, foHowed by malignant growths with a death
rate of 114.1; influenza 43.4; measles 32.6 and diphtheria 16.3.
There were but two cases of smallpox reported during 1916,
although during the year 1916 there were 300 i-eported cases. Tliere
were no deaths.
The isolation hosintal.- -The isolation hospital is a 10-room brick
structure, pleasantly located in one of the city parks. Its capacity
is about 30 beds and segregation could be readily secured. It is
now used for the Isolation of smallpox only*. It is not provided with
modem plurabiPg; water is derived from a cistern but is not supplied
under prensuie. Sewage is disposed of in an insanitary privy. At
present there arc no patients undergoing treatment in the hospital.
At the tune of inspection the building was in a disgi'acefuUy dirty
condition. No caretaker is provided.
One of the local hospitals of the city has constructed an isolation
hospital on its grounds to be used for the isolation of any communi-
cable disease that may develop within the institution. Outside
cases are occasionally taken at the rate of $5 per day. Tliis isola-
tion hospital will aeeommodate about eight patients.
Public healtJi nursing -Thovc is but one nurse in the city engaged
in work of this kind and she is employed by the Cheerful Home, a
charitable organization which cares for children whose mothers go
out to work during the day. This nurse Ls principally engaged in
prenatal and child welfare work and to some extent in the activitieB
concerned with antituberculosis work.
Diagnostic Laboratory.
There is no diagnostic laboratory, but a laboratory for the bac-
teriological examination of water has been fitted up in the building
occupied by the water purification plant. Water examinations are
now made by the superintendent of the water works.
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Having provided for a health officer it then becomes necessary to
famish him with machinery and men to carry on the work of his
department efficiently and effectively.
In order to control the communicable diseases it is necessary to
exercise careful supervision over the sick person, for it is the indi-
vidual suffering with a communicable disease or harboring the causa-
tive organism who is the real danger to the community. He it is
who spreads his infection through the fresh discharge from his
mouth, nose, throat, intestines, etc., to those with whom he comes
in contact.
TTiere are therefore needed, a bacteriologist and a staff of public
health nurses. This staff should be composed of two nurses to be paid
by the health department, one nurse to be paid by the school board,
and the nurse employed by the Qieerful Home. A combination of
this kind, a correlation of public health nursing fimctious so that
all are centralized under one directing head, is in line with modem
ideas on the subject.
The equipment in the water laboratory at present used by the
water department should be added to and the laboratory trans-
formed into a diagnostic laboratory to be used by the bacteriologist
for tho mutual benefit of the water and the health departments.
In addition to the above, there is also required a sanitary h\spector,
whose duties are the abatement of nuisances which have a direct
bearing on the public health, as for instance insanitary privies and
accumulations of manure. In a report of this kind, it is not prac-
ticable to go hito details as regards the duties of the various officials.
There are also needed two hospitals, one for the isolation of the
tuberculous and one for the isolation of cases of other communicable
diseases. Plans are already laid for the first. The second could
readily be obtained by utihzing the hospital at present used for small-
pox only. The building needs some repairs and a modem sewage
disposal system and water supply. It could readily be converted
into a very satisfactory isolation hospital.
The health department should also operate an antituberculosis as
well as a child-welfare dispensary, with the health officer and a nurse
in attendance during dispensary hom^.
MUNICIPAL E3ifC»N££BING ACTIViriBS.
Tht Disposal of GttrbB^e and Retase.
Garbage is collected by the city and disposed of by dumping into
the Mississippi River.
The equipment consists of five covered wooden wagons of about
2J cubic yards capacity each^ The number of wagons actually in
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use depends upon the time of year. There are also 10 horses
maintained by the city. These have been transferred from the fire
department and are stabled in a rented barn. The number of men
employed on the wagons depends upon the number of wagons in
use. Each receives $2 per day while actually employed. The bam
man receives S40 per month.
Collections are made rather irregularly, perhaps once a week, from
residences only. The service is discontinued during bad weather.
Commission houses, grocer)' stores, butcher shops, and the Uke must
have garbage removed at their own expense. Garbage from hotels
and restaurants is usually taken by farmers and fed to hogs
During the year 1916 there were removed 1,930 loads of garbage.
This is the only figure available, but for practical purposes it may be
estimated to represent about 3,136 tons, or about one-half of the
, garbage actually produced in the city. During the same period there
was spent by the board of health for garbage collection, $5,229.13,
or $2.70 per load, approximating $1.60 per ton collected.
Inspection of the city shows that many householders have neglected
to provide themselves with proper garbage receptacles.
The health department is also made responsible for the removal of
dead animals. Carcasses of large animals are removed by a private
I rendering establishment. Carcasses of small animals are removed
by the health department.
There is no ordinance providing for the care and disposal of manure.
In the stables inspected, manure was found to be handled in a very
careless mamier with every opportunity for the breeding of flies.
There is no provision made for the collection of rubbish except at
the annual clean-up.
Discussion, — The city should organize a service department to
^have charge of the cleaning of streets and the collection and disposal
of garbage and rubbish, dead animals, and night soil.
The present methods of garbage collection should be improved and
ampUfied. All garbage should be collected and disposed of by
incineration. This would mean an increase in equipment and the
erection of an incinerating plant. The provisions of State law
authorizing cities under 100,000 to levy a 2-mill tax for this purpose
should be utilized. At the same time a system of rubbish collection,
including manure, should be inaugurated, and rubbish collected
regularly. Rubbish should be used to fill in the low places within
the city limits. Valuable land may be reclaimed in this way. A man
should be employed to supervise the dumping so that a nuisance may
be avoided.
The State board of health is in a position to give valuable advice
relative to matters concerning garbage and rubbish collection and
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disposal, and it should be called upon for assistance before any final
action is taken.
Water Supply.
The water supply of the city k derived from the Mississippi River,
The intake is located well away from any sewer outlet. The water
is pumped into coagulation basins, of which there are two used in
series. From two and one-half to seven grains of alum are used as
the coagulant, part of it being inti*oduced in the first basin and part
in the second. There avo six filter beds, modem in oonstruction.
The plant lias a capacity of six million gallons a day. For present
needs one and one-half million gallons suffices. Water is furnished
to the city under direct pressure and from a storage and distributing
reservoir with a capacity of eighteen million gallons. Filtration is
supplemented by the use of chlorine. By this combined method of
treatment the efficiency of the plant nms from 97 to over 99 pjr cent.
Daily bacteriological checks are kept on the process in a laboratory
which has been fitted up in the building occupied by the plant.
These bacteriological examinations are made by the superintendent of
the water works. Monthly examinations are made in the State
laboratory at Urbaua.
Cistern water is used in th*? city, but the surface well is the excep-
tion rather than the* rule.
Disposal of Sewage.
Hio city of Quincy is elevated well above the level of the river
aind natural drainage is therefore good« It is fairly well provided
with sewers, both storm water and sanitary, except in a section
which, because of its topography, can not be drained into the present
system and which will require the construction of a separate sewer
system. The storm water and waste from this section of the city
are at present being carried off by natural channels. Sewers empty
their contents mto the Mississippi River imtreated.
There are throughout the city a number of hoiuses using cess-
pools, and also a number connected to the sewer through the catch-
basin system similar to the method that has been described for Toledo,
Ohio.' A sewer connection of this kmd is no better than a cesspool;
both should bo eliminated and pn>p:M- sewer connections insisted
upon.
A pliunbing inspector has been ejnployed by the city since June
30, 1914. During this time there have been 485 buildings comiected
to the city sewers with complete bathroom installation, flush closet,
'Public Health Refwirts, June 25,1915, p. l«oo Heprfnt Xo.2M, p. 22.
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tub, and lavatory. Two hundred and eighty of those connections
were in new and 205 in old buildings.
In requiring sewer connections for houses owned by the poor it
might be pointed out that such could bo made by the city and plumb-
ing installed, using the same procedure as that used in street con-
struction, namely, charging the cost of same as a lien against the
property and peimitting the property holder to pay on easy install-
ments.
It is a common practice to connect down spouts with the sanitary
sewers. This should be discontinued by city ordinance, as these
sewers have not been planned to carry the additional burden.
HEALTH SUPERVISION OF SCHOOLS.
At one time the board of education employed a school nurse in
an attempt to exercise some health supervision over the pupils of
the pnblic schools, but because of the discouraging attitude of the
people the work was discontinued and has never been resumed.
Work of this kind is not likely to be received with favor until the
people are educated up to it; then they would not do without it.
The work should be carried on again by the school authorities in
cooperation with the health department. The school board should
operate a dental and an eye, ear, nose, and throat dinic and engage
the services of a dentist and a specialist to perform the necessary
work for pupils whose parents can not afford to pay for it.. The
school board should also employ a nurse and attach her to the
health department, this nurse and tho other nurses of the health
depiurtment, together with and under the supervision of the health
officer^ to exercise a general supervision over tho health of pupils
of public and parochial schools in addition to performing other work
of a public-health nature.
It would also be well for tho school authorities to establish an
open-air school, or at letist an open-air class.
FOOD INSPECTION.
The commissioner of health, in addition to his other duties, exer-
cises some supervision over the milk supply as well as over other
foods and places handhng foods. It is obvious, however, that one
man can not carry on all of the activities of a health department
except superficially.
The milk supply. — An ordinance has recently boon passed by the
city council providing for the maintenance of tho purity of milk.
In this ordinance provisions are made for tho Ucensing of milk
dealers; for the inspection of producing farms or other places
handhng milk; for the collection of samples; and for the labehng
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of cans, bottles, wagons, etc. It is required that milk must be
sold in original containers; that barns must be properly Ughted and
ventilated; that they must have a floor of impervious material, etc.;
and that there must be a separate milk house. Adulterated milk
is defined and provision is made for exclusion where milk comes
from diseased cows or where a person handling the milk is suffering
from a commimicable disease, etc.
There are said to be 125 farms supplying milk to Quincy. A few
of these farms were inspected. None of them would score very
high; some were very primitive. The impression was obtained,
howevCT, that most of the producers were willing to accept sugges-
tions, and that a good dairy inspector, through cooperation, could
succeed in getting them all to apply the principles of cleanliness,
thus producing a clean milk with a minimum expense for equipment,
alteration, or new construction.
To produce a milk free from tlie possibility of transmitting disease,
pasteurization should be insisted upon. At present there are three
pasteurizing plants in tho city, all using the holding method. By
careful technique, all should be able to fm'uish a safe milk.
Other foods, -There arc three slaughterhouses located within and
just without the city Umits. The^e were inspected. No ante or post
mortem inspection of cattle is performed. Butchers are permitted to
do some slaughtering on their premises.
Various places handling foods, including restaurants, butcher shops,
and bakeries, were inspected. Generally speaking, sanitation was
fairly good within the establishments except that occasionally a toilet
in bad condition was encountered or a poorly located toilet compart-
ment. Inadequate and improi)er means for the disposition of garbage
and rubbish was a common observation.
Discussion. In addition to the employees that have already been
mentioned, there should be provided a dairy and food inspector, whose
duties it would be to maintain a general supervision over foods, espe-
cially milk, and places handhng foods. This would include the
inspection of the producing farms, transportation of milk to the milk
plant, the supei-vision over the methods used in the pasteurizing
plants, and the collection of samples for analysis in the laboratory.
Producing farms should be scored, laying more importance upon the
methods than equipment. All places handling food products should
be scored at irregular inten ids. All scores should be published in the
daily papers.
All milk should be pasteurized by the holding method before being
ddivered to the consumer.
A municipal abattoir should be erected in which should be slaugh-
tered all animals killed locally for human consumption.
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APPROPRIATIONS AND EXPENDITURES.
There wtis appropriated to t-he helath department for the fiscal 3'ear
1917 the sum of $7,550.
This may seem like a fair appropriation to the health department
until it is explained that of the al)ove amount $840 represents the salary
of a switchboard operator for the police dei)artmeut; S150 is an allow-
ance made to the chief of police for services lus president of the board
of health; $5,350 is to defray the expenses of garbage collection.
This loaves but $1,210 actually spent in the prevention of disease and
represents but one-half of 1 per cent of that part of the revenues of
the city appropriated for ordinary operation and maintenance of city
government ($234,857), as against 21.3 percent for fire and 15.8 per
cent for police protection. The health department of the city of
Quincy has never been properly oi:ganized, nor has it ever received
sufficient money or encouragement to perform active public health
work' along modern lines. The health department is entitled to at
least 5 per cent of the available revenues of the city, which would
amount to about $12,000. With this sum there could be organized
a small but efficient health department as follows:
1 commissioner of health and local registrar $2, 000
1 dairy and food inspector 900
2 public-health nurses, at $900 each i 1, 800
1 bacteriologist 1, 000
1 sanitary inspector 900
1 clerk and stenographer 720
To maintenance of office, transportation, laboratory, dispensaries, etc 4,680
To^ 12,000
It wiU be noticed that the above amount does not provide for the
collection or disposal of garbaj^e. Tnis activity should not be paid
for out of health department funds. Tlierc is a law in the State of
Illinois which permits a municipality to levy a special tax of not to
exoeed 2 mills to be expended in the collection and (Hsposal of garbage.
This privilege should be made use of by the city.
RECOMMENDATIONS.
As a result of the foregoing study and after careful consideration of
conditions, certain definite conclusions ImAe been reached and are
made the basis of the following recommendations:
1. Tliat the board of healtli be abolished.
2. That there be appointed a full-time health officer, to be made
diiectly responsible to the mayor; that he receive not less than $2,000
per annum; that he hold his ])osition as long as he renders efficient
services to the city; that he be a physician who has had previous
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experience in public-hedlth work; that lie be required to porfomi the
administrative, epidemiological, and professional duties rec^uired in a
health department, and that he be prohibited from engaging in the
private practice of mcdicuie.
3. That the health oflScer be permitt^^d to enforce the health ordi-
nances of the city and to carry on his work untrammeled by political
considerations and without fear or favor.
4. That he be furnished with the following assistants: One bac-
teriologist, at not less than $1,000 per annimi; two public-health
nurses, at not less than $900 per annum each; one dairy and food
inspector, at not less than $900 per annum; one sanitary inspector,
at not less than $900 per annum ; one clerk and stenographer, at $720
per annum.
5. That as soon as appointed the health officer start an educa-
tional campaign by lectures, talks, newspaper articles, etc., so tliat
the people may be informed as to the aims of the health department
and their cooperation secured.
6. That the laboratory equipment in the building occupied by the
filtration plant be increased and used jointly by the water department
and the health department.
7. That the bacteriologist be required to perform the daily exami-
nations of the water supply of. the city, the bacteriological and chemical
analyses of milk, the examination of samples submitted in suspected
cases of typhoid fever, diphtheria, tuberculosis, gonorrhea, etc., and
such examinations as may be necessary to detect carriers, or to deter-
mine the release from quarantine.
8. That the school authorities institute a health supervision of
schools, including the operation of a dental and an eye, ear, nose, and
throat clinic, and the employment of a visiting nurse. That the
visiting nurse be attached to the nursing staflF of the health depart-
ment to work with and imder the supervision of the health officer.
9. That the nurse employed by the Clieerful Home be attached to
the health department to work with and under the supervision of the
health officer.
10. That the city then be divided into four districts, and a nurse
placed in each district to perform within that district all of the duties
of a pubUc health nurse, i. e., the activities relating to the control
of the conmiunicable diseases, including tuberculosis, and the work
involved in the conservation of child life, including school n irsing.
11. That the health department operate a child welfare and anti-
tuberculosis dispensary for the benefit of the poorer population of
the city. That this dispensary be open at a definite hour of the day
as many days in the week as may be necessary and that one of the
nurses be in attendance during such time as the dispensary is open.
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12. That the professional services at the dispensary be furnished
1)V the health officer.
K^. That the health officer be not required to furnish professional
seniles at tlie city jail, or at the homes of the indigent sick, but that
the present arrangement with the county physician be continued.
14. That section 165 of Article V of the Revised Ordinance of the
City of Quincy, requiring vaccination of cliildren as a prerequisite to
admission to school, be enforced.
15. That in the case of diphtheria, quarantine be released only
after finding two successive negative cultures from the throat and
nose.
16. That antituberculosis supplies be issued free of charge in the
case of tubercidosis and that disinfectants be issued free of charge in
the case of typhoid fever.
17. That the physicians of the city make every eff'ort to report
promptly all notifiable diseases, including tuberculosis, and all births
and deaths occurring in the city.
18. That the present isolation hospital be renovated, placed in
good sanitary condition, and used for the isolation of all communi-
cable diseases that can not be properly isolated in the home.
19. That the county tuberculosis sanatoriimfi be erected without
delay, and that it have not less than 50 beds.
20. That the duties of the dairy and food inspector be, to have
supervision over the milk supply of the city (producing farms, pas-
teurizing plants, collection of samples, etc.), and in general the
inspection of foods and places seUing foods.
21. That the milk supply of the city of Quincy be pasteurized by
holding it at a temperature of 145^ F. for 30 minutes, followed imme-
diately by cooling and botthng.
22. That the sanitary inspector be made responsible for the elimi-
nation of the insanitary privy, the proper handling of manure, the
requirement that all householders furnish themselves with a proper
garbage tin, and the elimination of stagnant water, breeding mosqui-
toes.
23. That the abatement of all other nuisances wliich do not have
any direct bearing on the public health bo made a duty of the police
department.
24. That the sewers be extended to all parts of the city as soon as
possible and that where a sewer is available, proper sewer connections
be required without delay.
25. That in houses owned by the poor the health department be
authorized and money appropriated to have the ne( essary plumbing
installed and sewer connections made, the cost of same to be charged
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as a lien against the property, permitting the house owner to pay in
easy instalhnents.
26. That where a sewer is not available the construction of a ''san-
itary" privy be permitted; the type of privy to be approved by the
State board of health.
27. That the citizens of the community cooperate actively with the
health department in its effort to control disease and enforce sanitary
measures.
28. That inexpensive automobile transportation be furnished to
the dairy and food inspector and to the health officer to be used in
the field work of the department.
29. That there be appropriated for the support of the health de-
partment $12,000 per annum.
30. That there be organized in the city government a service de-
partment to have charge of the cleaning of streets and alleys and the
collection and disposal of garbage, rubbish, manure, dead animals,
and night soil.
31. That as soon as practicable the city erect an incinerating plant
for garbage and a municipal abattoir.
32. That the system of garbage collection be improved and ampli-
fied and that a system for the collection of rubbish be inaugurated.
33. That the provisions of the State law authorizing a city of less
than 100,000 population to levy a tax of 2 mills to be used in the
collection and disposal of garbage be utilized by the city of Quincy.
34. That a building division be organized in the engineering de-
partment to have supervision over the construction of new buildings
or alterations made to old buildings.
35. That before any such work can be started, plans must be sub-
mitted to and must receive the approval of the buildbig division.
36. That a housing code be adopted by the city regulating the
construction of all buildings, including tenements, hotels, apartment
houses, etc., as to the toilet facihties, light, ventilation, drainage, and
all matters relating to the health and safety of the occupants.
37. That the plumbing inspector be placed in the building division.
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PREVALENCE OF DISEASE.
No health diiMirtmt at, StaUor local, can cffcctivdy piertul or control rfwr </.*<, f ithout
Jcnofclrdge of when, vhere. and under what conditions cases arc ocntrring
UNITED STATES-
CURRENT STATE SUMMARIES.
California Report for the Week Ended September 29. 1917.
The California Slate Board of Health reported conex^rning the
statiLs of preventable diseases in California for the week ended
vSepteniber 29, 1917, as follows: Two cases of anthrax in man were
notified, one in San Joaquin County and one in Solaiio County.
Anthrax continues prevalent in animals. Two cas(s of poliomyelitis
were notified in San Diego. Thirty-three cases of diphtheria were
re])ort<*d, scattered throughout the State. Typhoid fever con-
tinued prevtdent, 35 cases having been reported, with minor out-
breaks in Calaveras County and Eldorado. Eighty-five cases of
scarlet fever were reported, most of the cases of this disease being in
small cities. Five cases of smallpox were reported in Nevada County.
The details of notifiable disease castas reported during the week
ended September 22, 1917, are as follows:
Anthrax 1 | PntMimoiiia b5
« hicucn iKiX 43 i Ophthalmia neonatorum 1
IHphtboria 26 t Scarlot fever 48
I>y8t«nt(»r>' 2) SraaIIi)OX 15
Ensiip^lai^ 3 | Syphilid* 26
(fcrmun nieartlcH 29 Tclamir* 2
(lOiinjM'^c:!.^ ijiwvtion 29 Tiarhoma. .! 1
Malaria 12 Tul)(•r<Mllc)^is 148
M':^A*^fl 45 ' Typhoid fovor 42
M'lrupM 77, Wh(M)pini: cough 47
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CEREBROSPINAL MENINGITIS.
Stote Reports for Anciist, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Colorado:
Las Animas County—
New York:
Albany County
Trinidad .'
Broome County
Thitchnm Conntv . .
Indiana:
Erie County
Allen County
N^ftgara County
Marion c^>nnty. ....... ^ . . x . .
Weiftchmter county
Steuben County
New York City../. '.
13
Total
Total
22
Wyoming: ^
Fremont County
Iowa:
Harrison County
1
Bootl County
Total
2
City Reports for Week Ended Sept. 15, 1917.
Pl«e.
Bridgeport, Conn. . .
Chelsea, llass
Ghicago,Ill
Cleveland, Ohio
Detroit, Ifioh
Erie, Pa
Flint, Mich.
Ft. Wayne, Ind
Indianapolis, Ind. . .
Kansas City, Mo....
Kansas City, Kans.
Lowell, MaA5
Uanrhestcr. N. H...
Memphis, Tenn
Cases.
Deaths.
1
Place.
Milwaukee, Wis
Minneapolis, Minn,..
New Bedford, Mass..
New Haven, Conn.. .
New York, N.Y
Northamnton, Mass. .
Omaha, Nebr
Philadelphia. Pa.....
Pittsburgh, Pa
Bacine,WIs
St. Louis. Mo.
Springfleld.ru.
Wheeling, W.Va....
Cases. Deaths.
DEPHTHERU.
Massachusetts.
Outbreaks of diphtheria were reported in Massachusetts September
26, 1917, as follows: Erving (town), 12 cases; Ayer (town), 5 cases
in school children.
See also Diphtheria, measles, scarlet fever, and tuberculodi^, page IG'Jl.
DYSENTERY.
Massachusetts — Medfleld.
An outbreak of dysentery was reported in the State insane asylum
' at Medfleld, Mass., October 2, 1917, 57 cases having been notified.
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ERYSIPELAS.
City Reports for Week Ended Sept. 15, 1917.
Place.
Cases.
Deaths.
I
1 Place.
1
Casef.
Deaths.
1
Newark, N.J
2
1
3
2
3
1
1
1
1
Riiiralo N 1
Oakland, Cal
****"**■
rhif-iL'o 111
rhihidolphiu Pa
Clovoianrt Ohio
I'iitslmrRh, Pa ,
I
D*»troif Mich- ..........
St. lyouis, Mo
Eric Pa
San Francisco Cal
Johnstown Pa ..........
1
Schenectady, N. Y
lvO<* An;?plos i^&l ........
4
2
W.tshlngton, Pa
**
WilliamsDort. Pa
ll ^
Place.
MALARIA.
Mississippi Report for August, 1917.
Mlssbsippi:
Adams County
Alcorn County
Amite County
Attala County
Bolivar County
Colhoim County
Carroll County
Choctaw County
Claiborne County
CI trke County
Clav Count y *
Coaiioma County
Copiah County
Covinpton County
De i^oto County
Forrest Comity
Franklin County
Georjre County
Greene County
Orcnftda County
Hancock Coimty
Ilarr ison County
Hinds County
Holmes Coimty
rso-a(}uena County
Itawumba County
Jackson Coftnty
Jasper County
Jenerson County
JefTerson Davis County .
Jones County
Kemper County
Lafayette Coimty
Lamar County
Lauderdale County
Lawrence County
Leake Coimty
Lee County
Leflore Coimty
Lincoln Coimty . . . . .
LowTide.s County
I'
New cases 't
reported. !
Place.
IfiS
241
190
110
2,01.')
243
14.-^
30
128
I,54«
367
460
205
342
731
90
110
110
22o
200
666
873
147
163
116
222
282
253
622
108
304
194
116
370
241
624
1,273
230
12S
Mississippi— Cor tin ucd.
Madison County. . ,.
Marion County.
Miir^hMll t oiirity
Monroe County"
Montpomery County
Nc^hol)a County
Newton County
No^ut)e«> ( ounty
Oktibbelia County..
Panola County
Pearl River County.
Perry County
Pike County
Pontotoc County.. . .
Prentiss County
Quitman County.,..
Rankin County
Fcott Comity..'
Sharkey County. . ..
Himp«on County
Smith County.."
Stone County
Sunflower Comity...
Tallahutchio County
Tate County
Tippah County
Tlshominco County.
Tunica County
Union Coimty
Walt liall County....
Warren County
Wn:-hint,'ton County.
W a vne County
Webster County
Wilkinson County..
Winston Coimty . . . .
Yalobusha County..
Yazoo Coimty
Total
New cases
reported.
201
4r»5
:ioO
102
153
265
165
176
228
696
125
295
180
263
241
744
107
276
312
301
182
42
056
847
373
244
152
586
352
216
665
044
188
43
137
3S4
187
809
28,234
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MALARIA—Contiuued.
City Reports for Week Ended Sept. 15, 1917.
October 5. 1917
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Alameda, Cal. ................
1
il«
1
2
18
Newton, Mass
Bkmingliam, Ala ~
Boston Mass •
Richmond. Va
.••
Rockv Mount, N. C
Cleveland, Ohio
San ^ranciscol Cal
IfemnhH Tonn
2
2
^vannah, Oft......
Mobile, Ala
Worflwrtw) Maiw
...»
New < Jfleans, i-a, ,, - , ^ ,.,,,,. .
2
. . .
1 The reason that Birmingham had so many oases of malaria reported is not that the disease is more
prevalent in Birmingham than in other cities of Alabama and neigh boring States, bnttmdoubtedly because
of the su^vessfiil efforts the health department has made in securing th« cooperation of the practicing
physicians in reporting oases.
MEASLES.
See Diphtheria, measled, scarlet fever, and tuberculoei^, page 1691.
PELLAGRA.'
Mississippi Report for Angnst, 1917.
Place.
New
cases
reported.
r,.ce.
New
cases
reported.
Mfc«H?ipnI:
13
22
3
206
14
3
8
5
133
45
14
37
19
G
4
4
1
15
36
\n
13
7
3
5
61
4
2
7
5
11
9
60
13
19
6
15
MissLssippi— Continued.
Marion Cot Hit y
26
Aloom County
Marshall County
21
AttnlaCountv
Monroe Countv
6
Bolivar County
MontjTomery Coimty
n
Calhoun County
Neshoda County
22
Carroll County
Newton County
7
C hortaw County
Noxubee Coiuity
7
C'lailbome County
Oktibbeha County
20
( larke County
Panola County
35
Clav County
Pearl River County
3
Coahoma County
Perry County '..'..'.
9
Copiah Cotmty
Pike County
17
Covington County
Pontotoc County
17
Pe Coto County
Prentiss Countv
5
FoTPst County
Quitman Coimtv
71
I'runklin County
Rankin County.'
6
( ; eorcc County
Scott County
Sharkey County
Simfv^jn Coimty
12
<iircehfl Countv
9
Ormada Count V
R
-II;*rrison County
Sn\ith County
3
Hinds County
Stone County
4
Holmes Countv
Sunnowor Count v
53
Itawamba County
Tall iliatchi'^ Cotmty
20
Jasper County
Tato ( ounl v
14
JemTson County
Tippah C'otintv
7
JefTerson Davis County
Tishomlnjio County
14
Jones County
Tunica < 'mmty
2i
Kemper County
Union County
21
Walth ill Coimty
3
T^ftrrmr CnnT)ty. . . . ......
Warren (^ountv
6
Lauderdale County
Wasliin^rton tk)unty
31
I^awrence County
Wayne County
40
Leake County
Wcb^-lcr County
ft
Lee County
Winston Countv ,
0
Leflore County '.
Yalol)u.sh;i County
4
Linooh) County
Yazoo County
49
Lowndes Countv..
Total
Madison Coimty
1.4Sfl
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PELLAGRA— Continued.
City Reports for Week Ended Sept 15, 1917.
riaoc.
Cases.
Deaths.
Place.
Cases.
Deaths.
Birmingham, Ala
»5
4
1
3
1
2
Nashville, Tenn
1
2
1
1
Charleston, S. C
New Orleans. La
2
Columbia 4S (' .
Richmond, va
1
Kansas (it y, Mo
Savannah, Ga
1
Los Angeles Cal .
Topeka, Ivans
1
2
Memphis, Tcnu
2
3
1
Washington, D. C
1
Afobife, Ala
I The reason that Birmingham had so many more cases of pella^ reported than any other city is not
that the disea.se is more pre\'aient in Birmingham than in other cities of Alabama and neighboring States,
but undoubtedly because of the^ucce^ ful efforts the health department has made in securing the coop-
eration of the practicing physicians in reporting cases.
PNEUMONIA.
City Reports for Week Ended Sept. 15, 1917.
Place.
Alameda, Cal
Bait more, Md
Binghamton, N. Y
Boston, Miuss
Braddock, Pa
Brockton. Mu.ss
Conibridpo, Mass..
Chicago, ill
(^loveluml, Ohio...
Fail Kivcr, Mas.^...
Fitchlnirg. Mtiss...
Flint. Mich
ilrirrison, N. J
Tackson, Mich
KiUaniiixoo, Mich..
Cases.
Deaths.
1
2
io
1
-1
9
1
2
i
1
r»3
.39
12
10
2
1
1
3
1
Place.
Kansas City, Mo
Lo8 ^ngolcs, Cal I
LowoH, Ma.^^ I
.Mai (le 11 , M as^ |
Munche.sler, N. 11
Newark, N. J !
New Castle, Pa ,
()aMimcl,(nl
Pbilaflelrbia. Pa
litt'^burph, i^a
8an Diego. Cal ,
San Krancisco, Cal
Wiishlngio!!, i*a
Williamspurt, Pa
I
s.
Deaths.
.1
6
a
5
1
1
1
1
1
1
12
3
1
1
4
24
13
9
12
2
2
11
10
1
1
POLIOMYELITIS aNFANTILE PARALYSIS),
Illinois — Cook County.
During the week ended Septeinl>er 29, 1917, 80 cas<^ of poliomye-
litis wore notified in Cook County, 111., of which 65 oases were in the
city of Chicago.
West Virginia.
During the two weeks ended September 29^ 1917, the foUowing
cases of poliomyehtis were notified in West VirgUiia:
C4ise.s. ; Cases.
braxtou Comity li I Icmlt. Marion C<jimiy 2
Huntiiitjlon, Cabell C'ounty H* Moundsvillo, Marj^hall County • 2
i^alhoun County 2 ' Mason County 2
Hampshire County 2\ Mineral County • 2
Hancock County 1 i Wait land, Monroe County 1
Clarksburg, Harrison County 1 I Wheeling, Ohio County 1
Meadowbrook, Harrison County 1 Uichey ('ounty 1
Sherman, Jackson County 4' Parkersburg, Wodd County 4
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POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
State Reports for Asgnst, 1917.
Place.
New cases
reported.
Plaee.
New cases
reported.
IndJana:
Delaware County
1
2
1
9
2
1
1
New York:
Albany County . .
Clinton County .. .
Grant County'
Columbia County...'.'! ••y------'^-
Lake County
Delaware County . .
LapcMte County
Krle County !..!!!'!
Wabash County
Fulton County. . .
Warren County
Genesee County ! . .'.' ".'
Groene Countv
Total
17
Jefferson County
Monroe Countv
Iowa:
1
1
2
I
3
1
10
1
Nassau County
Black Hawk County
Onondapk County
Grundy County. . . .'.
Otsego County
Lucas r'ounty.'.
Honsselacr County
If arlon County
fit. Lawrence County
12
Mills County
Washington County
Ilonona County
New York City '."
19
Pottawattamie Count v
Total
Bcott County
55
Story County
North Dakota:
ilurlfiph County
Total
21
2
Waljh County
2
Mississippi:
Choctaw County
1
1
1
1
Total
4
Itawamba Countv
SoHth Dakota:
Moody County
Jackson County
I^o^ndes fxMinty
3
Tishomingo Cotmty
Turner Comity
3
Union County .
I
1
Total
5
Yankton County
Total
Montana:
I
1
7
Cascade County
Great Fails
Hill County
Total
7
City Reports for Week Ended Sept. 15, 1917.
Place.
Deaths.
Akron, Ohio
Albany, N.Y...
Ann Arbor, Mich
Chicago, 111
Cleveland, Ohio.,
Davenport, Iowa,
Denver, Colo
Detroit, Mich
Duluth, Minn . . .
Erie, Pa
Fail River, Mass.
Kansas City. Mo.
Lancaster, Pa . . .
Place.
Cases.
Deaths.
Maiden, Mass
Newark, N.J
New l^ritain, Conu
1
3
1
3
1
2
2
1
1
1
1
New Cast le , Pa
New York, N.Y..,.,
1
Onuiha, Nebr
Pittsburgh. Pa
I
Portland, ()rcg
Providence, It. I
Sioux City, Iowa
Somer\ille, Mass
Toledo, Ohio
1
RABIES IN ANIMALS.
City Reports for Week Ended SepL 15, 1917.
During tho week ended September 15, 1917, 1 case of rabies in
animals was reported at Newark, N. J., and 1 case was reported at
Niagara Falls, N. Y.
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SCARLET FEVER.
Kentudcy — Mason Connty.
Seven cases of scarlet fever were reported from Mason County, Ky.,
September 26 and October 2, 1917. Four of the cases were notified
in Helena and three in Mayslick.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1691.
SMALLPOX.
Minnesota.
During the week ended September 29, 1917, three new foci of
smallpox infection were reported in the State of Minnesota, c^es of
the disease havmg been notified as follows: Kittson County, Norway
Township, 1 case; Marshall County, Stephen Village, 2 cases; Mocker
County, Kingston Township, 1 case.
State Reports for August, 1917.
New cases
reported.
1
1
3
Deaths.
Vaccination history of cases.
Place.
Number
\-accinated
within 7
yo;irs pre-
reling
attack.
4
Number
last vacci-
nal c<i more
than 7 years
preceUnj,'
attack.
Number
never suc-
cessfully
vaccinated.
Vaccination
history not
obtained or
uncertain.
Colorado:
Denver County—
Denver
1
1
1
1
2
El Paso County-
Colorado Springs
Garflold Count v
3
Kit Carson C(»unty
Otero County-
Rocky Ford
1
■
Total
14
8
6
_!.
Montana:
Beaverhead County
3
2
3
1
2
29
3
Broadwater County
1
1
2
Cascade County
1
Groat Falls
1
Custer County
2
Dawgon (^ounty
1
Gallatin County
1
Bozeman
1
HDl County
5
Mis wala County
1
Park County—
L i vin gs ton
t
Sanders County
1
Silver Bow County
9
Butte
1
28
Total
62
1
8
53
New York:
Albany Coimty
1
1
1
1
Cattaraugus I'ounty
1
1
ErJeC^ounty. . , , '.....,,,
Total
•^
2
1
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Octo1»er 5. 191T
SMALLPOX— Continued.
MisceUmiMoiis State Reports.
Ptaoo.
Cams.
Deaths.
Plaoe.
CaiMB.
1
1
."*
2
3
7
2
8
2
3
2
:i7
1
3
4
Deaths.
iDdluia (Ane. 1-31):
Adams County. ..........
1
1
4
3
4
1
1
a
5
7
1
22
7
5
1
6
1
4
2
3
Mississippi (Aug. 1-31):
Calhoun County
Allen ODonty
Cla\ County
Daviess Coaiity.....
Harrison County
Delate are County
If olmc-s County
Fountain County
Jasper County'.
Fulton County.'
Jones County
(Irant County
Lalayctto County
Greene County
1 Monroe County "
Jennln^ County
Newton Coiinty
^ '
Tolinson C-ounty
Tallahatchie Coimty
Yalobusha County
Yazoo County
Knox County
T/ake (k)untv
l4iwrenoo County
Total
Marion t^ounty
Miami County
Nevada (Aug. 1-31):
^Tilte Pme County
North mkolu (Aug. 1-31):
(Jrijtgs (>)nnly
Monroe County
Noble County
Parte County
_
Posey (^ounty
Tippecanoe County
Vermilion County. ........
Nelson County
Vigo County... ...
Richland (^ounty.
Total
Total
92
1
i
19
15
!
South DakoU (Aug. 1-31);
Aurora Count}'
Iowa (AOK. 1^1):
Appanoose County
Dobonuo County
1
1
1
3
1
1
2
1
1
1
1
2
3
1
8
2
5
2
Custer County
Fran^ Itn County . . *
Dayjson (Viniity
Harrisfm Coimty
V>i\\ ('(Hint V
1
Jasper i'oiwty
, Deuol County
Koaaulti (^oiinty
(j fSnnt (V'lntv
T^ce County
!| I.:iko(>nntv
MlU>(^ounty.
1
Walworth Cwinty
Total
MitdicH County
1
Monona County
. . 1
1
Muscatine County
WycjniuK (Aug. 1-31):
Niobrara Count v ._
* )3rf ola Conn! V
Plymoutli <V(rinfv
1
Potto^rattamlr County . . .
'ihclbv Coun* v
'j Natrona County ,.
', I^ramlc Toiintv ._.
Total.
,
"•; 1
17
Woodburj' County
1
Tbtol
37
1
City Reports for Week Ended Sept. 15, 1917.
Place.
Gases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio.
Altoona, Pa
Austin, Tex
Butto,Mont
Cbicaco, nj
Cleveland, Ohio. . .
Dayton, Ohio
Detroit, Mich
El Paso, Tax
Erie, Pa
Fllnt.Mldi
Port Wayne, lod..
Indianapolis, IikL .
Kansas City, Mo
Kansas City, Kaus
Minncapolb. Minn
Oklahoma City, Okla.
Omaha, Nebr
St. Joseph- Mo „
St. Louis, Mo
Salt Lake aty, Utah..
San Frandsoo, C«l.....
Seattle, Wash
Terro Haute, Ind..
Toledo. Ohio
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TETANUS.
City Reports for Week Ended Sept. 15» 1917.
Plioe.
Cases.
Deaths. Fteee.
Cases.
Deaths.
ChJcaco^IU
1
1
i*
Los Ancelfls, Gal
1
1
Cincinnati. Ohio
New York, U, Y
1
JwMy City, N. J
l/on£ B^wh, C*\
1 8t. T^onis, llo i
York, Pa
1
TUBERCULOSia
See Diphtheria, measles, scarlet fever, and tuberculoeia, page 1091.
TYPHOID FEVER.
Georgia — Macon.
During the period from August 8 to September 28, 1917, 57 cases
of typhoid fever were notified in. Macon, Ga.
Massachnaetta— Tewksbury and Glonceater.
An outbreak of typhoid fever was reported October 2, 1917, in
the Massachusetts State Infirmary at Tcwksbury, Mass., 27 cases
having been notified.
Eight cases of typhoid fever were reported from Gloucester, Mass.,
October 2, 1917. The cases were scattered.
Mississippi — Greenwood.
During the week ended September 29, 1917, 11 cases of typhoid
fever were notified in Grt^enWood, Miss.
State Reports for Aagust, 1917.
rhco.
Ctilurado:
AliinosaCouiitv. ...
Ara|>uhi*f»Ji]' ly...
ItiHil-irr Count >
C'osler CounC)
Denver Coiinly.....
I)uu.'li% t'ounty
lA l\t^> (\»uiiiy
Frt'iiiunt t'oimtv....
Kil (. at Mill C.^uiHy,.
Tun ^ mill I > ('oiiiily.
La I'lit iCiiintv
\l' mrt/M> ( I ijiity....
Mt r.'aii Ct i>iJ>
< ..in,
1'.. I .t .-.my..
WiM ruiint> ...
Tit .1.
I ..C-l-.-lN
. ' 1 ■ ■» t* •'itiiy.
N'p vcaso^ I'
rcpurli'd I)
V]ict
•.Vewc
reponed.
3
2
2
13
1 »
2 t
4 I
3
3 !
HI
6 'I
IK
;m
Ind inna -C^mt inucd.
C\iri. II C'oiiuly
< ■ > (V.ntiiy
(^1 .rk CuiiiUy
Ci.i - lord I'oiinly...
l).J.u■^^ ('•iiinly....
I)i\ir *<rii C.'Uiily. .
1 «f itur ('oijtit V
IH-Iv ll.Co'.nty
l»t'l iA jr»' (utility. .
D'J •■ii( u :iif\
KlkharKo iiit'y
Fl'»yd <'oiiiit >
F«(in! in (\, iiity ..
Fr .mHiii r,. ;..rv...
F..|l.'nC.-t(n»y.*....
('ii» uii County
(.r I! I ( ountj
<.r»vni' County
llHinilton i\ninty ..
II;inrA>rk (\»unly...
ll.uii «in r,.!ii)t> ...
Il4ntlri« k County.
Henry County
ARK \0{ SWISU Yonr Money to Invrtit in the 8LC0ND LIBERTY LOAN!
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Octobers. lUl 7
TYPHOID FEVER— CoutlmiCHj.
S<ate Reports for Aninist, 1917— (•ontinued.
Place.
Indiana- Continued.
Howard County
UuntiogtoD County..
Jackson County
Jay County
Jefferson Conn ty
Jen nings County
Johnson County
Kosciusko County
Lake County
LaiK)rle County
Lawionce County ....
Madison County
Marion County
Miami Counly
MontiX) County
Montgomery Coimty .
Morcan County
No'ilo County
Ohio County
Omngi? County
DwenCoKiilv
raikcl^tunly
IVrry County
Pike County
Po ey Coimty
Putnam County
Kuu(l( Iph County
Kush Coimty
Hcott County
8hcll)y County
Spi-nCrr County
SlL'iibfn County
h"t. Josoph Couiity....
Switzi rland County..
Tippecanoe (^unty . .
Union County
VanderburK Coimty..
Warrlejc County
Wu^hinglon Couoty..
Wayne County
Whltloy Coimty
Total.
MiH^Ksippi:
Adair ? County
Alcorn (ounty
A in i» ••-County
Attrl.i County
H«*U\ar County
CulhoiinCoiniiy
Carrt. II County
Choctaw <'ounty
riaihome County
Clarke County
Cla\ County
Cojinoma County
Cop rhCainly
Co\ injcton Cr.unty
Doi^otoCcunty
Vorrcst County
FmuklinCourity »
Ciffcne County
Grenada County
Harrison County
HindjCounty
Holn.es County
Itawamba County
JficlcToo County
Jasper County
Jener.^on Coimty
Jones County
Kemper County
Lafayette Count y
New cases I
reported. I
1
10
-* 1
1 I
17 /
i\
i>
1
1
2
2
1
3
2
6
4
2
1
10
3
1
«
2 I
8 :
1
2 i,
2 1
63
3
10
1
Place.
4
12
12
67
22
2
15 t
6
5
6 ,
20
26
1
28
8
12
4
4
25
17
10
9
3 I
33 >,
28 i'
5!!
Mississippi— Cent inued.
Lamar County
Lauderdale County . .
Lawrence County....
LeaVc County
Lee County.*.
LefoTo County
Lintolnt'ouniy
Lowndf.; County...,.
Mad i.^c n Count y
Marion County
Mar'^hnll County
Moi»r(e County
Moi » },' ornery ( ounty .
Ne'^hol a County
Ncu ton t'cunty
No \i:bfo County
OktiMfhiii ourity...
Par rlHCounty
I'e "I KiNcr ( oiuly..
Periy iV.unty
Tike ("mini V
Poultice ( .r.uily..*..
Prentiss Cmiuly
<vuil'. anC«.uniy
HanUnCounty
So^.li I (n'uy
ritr.i . ','11 1 <.rni y
Smiili •. < ■ (.IN .."
Slort'v ( ,Miy
SunHdwrr ( <,nDlv
Talblu.t liN- County.
TatcC'ur.t\
TiMr''»< f»'5> ly
Tishon^nj?ot tiMity..
Tunica t cui ty
* T'nfon County
WalthalHVuuty
W;^rr»'n ' (.uuty
^Vas^ iijRlont uinly..
\\uvne<."<iii'ty
WVKMcrCrJirly
WU lrsonC(»i'iity...
Winston County
Yal',» I : ha County...
Yaioo Crunt y
Total
MouiMi a:
mail t Coimty
CaMadt'Cdinty
Clrcat I- alls
Dawson Ctrnly
Fo^pJ^ Count V.
Flathead ( (uhty—
Kalbull
Hill County
Park County
Silver How County...
It ion ( onnty
Yelk wstone County-
billings
Total
Nevada:
CKurctnll County. . .
Ki- raeraida Conn t y . .
Hitinboldt County..
Wa.s hoe County
■\M \to 1 inr Count V.
TotiU .
'Ncwt-ases
iropo:ted.
ID
10
4
2
43
IK
18
2
12
4
22
15
3
7
4
ii»
111
1
9
8
24
r>
6
2
21
0
11
1
28
11
20
35
27
4
!9
.')
2
IK
12
«t
2
11
IS
970
1
1
2
9
6
1
1
1
1
3
27
ABE YOU S.iVINO Yonr Money to Inrest In the SKrOND LIBKKTV 1J).\N?
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Octolwr 5, 1917
1690
TYPHOID FEVER— Continued.
Stole Reporto for Angnsl, 1917— Continued.
Place.
New cases
reported.
Place.
New cases
reported.
New York:
Albany County
13
3
2
11
5
2
10
3
2
3
4
1
3
6
1
2
•?
3
11
2
12
3
7
1
5
3
6
6
7
2
11
15
•J
i
2«
2
New York— Continued.
4
Cattaraugus County
Ulster County
13
WAimn Cniitity u .. x x x . .
1
Chautauqua County . .
Washlnj^on County
1
Chemuni? County !!!.!!.!!..
Westch&iter County
18
ChpnnnjfO Coimty .
Now York City....
185
Clinton 'Countv
Total
Columbia County . .
468
Cortland County'
North Dakota:
Barnes County
Delaware County
DiifrhMs Cnnnty,.,^ ^ ^
1
Krio County '
Bottineau County
2
Essex County
Burleigh County
2
Franklin County
Kidder County
1
Fulton Count V
Morton County
Genesee County
Nelson County
1
Hamilton County
Ramsey County
1
Herkimer County
AViiliams County
u
Jefferson County
Total
Lewis County. '. '..'.',
20
Madison Cx)imty
South Dakota:
Day County
Monroe County
Nassau Countv
3
Niagara County
Hand Cou n t y
2
Oneida County
Lawrence (k)unty
1
Ononda^ Coimty
Miner County ' "
1
Ontario County
Ti 1 pp Cou nty
1
OranffP Tountv .. .
Total
Orleans County
8
Osweeo Countv
Otsepo Countv
Wyoming:
Washakie County
?^reraont County
Rensselaer Coimty
6
Rockland ( 'oun t v
1
St. Lawrence County
Coslien County
1
SaratoRa Countv
Campliell Countv
2
Schenectady County
(?arbon County. '.
1
Steuben ( 'ount y
Natrona County
3
Suffolk County
Total
Tioga County
14
City Reports for Week Ended Sept. 15, 1917.
Place.
Albany, N.Y
Alton, 111
Altoona, Pa
Auburn, N. Y
Austin, Tex
Baltimore, Md
Berkeley, Cal
Birmhipham, Ala
Boston. Mass
Braddock, Pa
Bridgeport , C^onn
Broo' lino, Ma^s
BuffiUo. N. Y
Butte. Mont
Cambri<igo, Mass
Cam<lcn. N. J
Canton. Ohio
Ch:ir!e«ton,S.C
Chchop., Mn>s
CMfnuo. Ill
Ci ifinnali, ^>hio
CI» velind. oliio
Cfil'oyvilh', K'lns
Co!n^1l-ll^^. <ibio
CovinKlo'K Kv
Cuml'i il i!i<l. Md
Cases.
Deaths.
Place.
Dayton, Ohio
Denver. Colo
Detroit, Mieli
East ( hicago, Ind. . . .
East OranRC, N.J
El Paso, Tex
Erie, Pa
Evansville, Ind
Fall River. Mass
Flint. Mich
Fort Worth, Tex
Galveston, Tex
naRcrstown, Md.. ..
Hartford , Conn
Jersey City, N.J
Johnstown, Pa
Kansas City, Mo
Kansas CitVj Kans
Kenosha, Wis
Kno\\iIle,Tenn
Lancaster, Pa
Lawrence, Ma.ss.
Lexington, Ky
Lima. Ohio
Lincoln, Nebr
Little Rock, Ark
Cases.
Deaths.
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TYPHOID FEVER— Continued.
City Reports for Weelc Ended Sept. 15, 1917— Continued.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Long Beach, Cal
1
9
1
1
1
2
6
2
5
1
1
1
8
11
2
1
1
3
1
4
g
97
1
1
4
1
1
1
i
32
■
4
Quinov. Mass
1
1
1
"Los Angoles, Cal
Rafclne, Wis
Lowell, Mass
Reading. Pa.
4
5
4
3
1
3
43
10
6
1
1
1
3
38
7
1
2
7
1
4
1
5
12
1
3
6
1
Lynn, Mass
1
Richmond, Va
1
Maiden, Ma»
lioanoke. Va
Medford. Mass
Rorkford, III
1
Memphis, Tenn
Hock Island, III
Ml)wauk€«, Wis
1
St J{Kcph, Mo.
MlnneanoUs. Minn
St Loiib, Mo, _
i^a J Luk^nty, Utah
3
Mobile, Ala
Montclair, N. J
Sa ' I F rauctsco, CaU
Morristown, N. J
Fa Iwm, CaL..,..,
Nashville, Tenn
2
1
Newark. N.J
Sc.i r«. W^sT>„..._
New Bedford. Mass
Sc 1 Mfif viM^^ if iiss. p,
New Britain. Conn
Fc jii hend, Ind
Newburvport, Mass
Sr m^fifiM, JIL..
Fi ! ui^flfiH , Mft5S
Fr. !,j^,>.1.1, Ohln.,..
Now Castlo, Pa
New Haven, Conn
New London, Conn -.
S\ \. V
New Orleans. La.
2
7
T( ■ ,.,.!:■£!, lni"i
1
NewYork, N. Y
Toledo, Ohio '..
North Adajns, Mass.Y...'.
Trenton, N. J
Oklahoma. Okla I
Troy, N. Y
Omaha, Nebr
1
WaRliington, D. C
2
Orange, N. J
Washington, Pa
Pasadena. Cal
Wheeling, W. Va
Passalr, N. J
Wichita, Kans
Pawiucket, R. I
1
Wllkinsburg, Fa
Perth Amboy, N. J
Wilmington, Del
1
1
1
Philadelphia, Pa
3
Wilmington, N. C
1
4
3
2
Pittsburgh, Pa
Winston-Salera , N. C
Worcester, Mass
Plainfield. N. J
Portsmouth, Va
York, Pa.'.
Providence, R. I....
"
TYPHUS FEVER.
Mississippi Report for Amrnst, 1917.
During the month of August, 1917, six cases of typhus fever were
reported in the State of Mississippi.
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for August, 1917.
Cases reported.
State.
Cases reported.
state.
Diph-
theria.
Meaalee.
Scarlet
fever.
Diph-
theria.
Meaales.
Scarlet
fever.
Colorado
44
207
32
64
17
100
87
21
71
24
50
£6
1
Nevada
1
992
34
10
5
1
942
2
12
7
1
Indiana
NewYork
260
Iowa
North Dakota
22
Mississippi
406
20
South Dakota
Wvoming
25
Vfontfmn ...
10
ABE TOU SAVING Your Money to Inyest in tlie SECOND UBEBTT LOAN!
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October 5, 1917
1692
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
OoDtinued.
City Reports for Week Ended Sept 15, 1917.
Popula-
tion as of
Julv 1, 191«
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
aU
causes.
DiphtherU.
Measles.
Scarlet
fever.
Tuber-
culosis.
aty.
1
i
1
i
1
J
1
1
Over 500.000 inhabitants:
Baltunore, Md
589,021
756, 476
2,497,722
674,073
571, 7g4
50:), 812
6,602,841
1,700,518
679.090
757,309
468,558
410,476
306,345
436,535
363.454
408,894
371,747
463.516
348,639
363,980
214,878
260,800
271,708
297.847
295, 403
254,9tiO
lfVI,199
lM,7f^2
121.579
112, '.^81
lO'SZW
127,224
128. H«Va
101, .V>2
12V, 2'a
110,tHK)
lOK'ity)
113.245
102,425
118.1X15
117,057
118,1.58
14'J,C.8.5
108.«i()4
16.5, 47«y
109, HSl
117, :m
10.5. •M2
155,r)24
112.770
iyi,rK>4
111,593
103,314
85,625
68,6.50
57.6«iO
69,893
57,r,.5.3
53,973
67,449
60,852
6<\734
.57, 144
224
206
666
193
213
109
1,320
""m
184
118
111
75
84
'ios*
lae
123
60
140
67
64
-io'
CO
7
59
147
69
64
6
160
60
31
44
11
21
4
16
26
15
72
13
i
14
6
55
5
5
20
1
2
15
5
8
2
15
6
3
7
......
'"'i'
......
......
4
22
9
1
1
1
62
5
9
3
2
2
4
3
1
3
1
20
6
11
1
2
2
2
......
1
" i'
5
12
85
4
28
5
37
9
6
14
6
2
......
3
......
......
43
58
301
28
29
43
373
103
18
43
32
32
12
25
24
Boston. Mass
32
Chicago, ni
63
Cleveland, Ohio
20
Detroit, Mich
14
Los Angelo^i, Cal
New York, N.Y
Philadelphia, Pa
24
144
43
Pittsburgh, Pa
13
St. LouLs, Mo
17
From 300,000 to 600,000 hihabit-
ants:
Buffalo NY
18
Cin^InnatJ, Ohio
17
Jersey City, N. J
Milwaukee Wis
g
23
6
1
1
7
Minnennnlu Xfinn
Newark. N.J
30
23
32
17
19
9
13
New OrleatLs La
23
San Francisco, Cal
5
6
12
7
1
6
4
4
4
......
1
6
Seattle, Wash
6
Washington, D. C
From 200,000 to 300,000 Inhabit-
ants:
Columbus, Ohio
11
3
Denver Colo
13
Inflimipolls, Ind
......
28
1
5
20
5
19
4
6
10
I
«
Kansas City, Mo
Por Jniui, (Jrojj
"*2'
3
1
2
PrOi i ieme, U. I
6
From 100,000 to 200,000 inhalv
itants:
Albany, N. Y
Birralii'»ham, Ala
69
24
40*
9'
25
33"
3.5
24
50'
34
39'
48
2^)
47
a3
45
6i"
38
42
i"
'9"
15
13
9
16
19
.?
5
3
9
8
1
1
4
1
10
1
1
5
Brid^'cport , < 'onn ...
2
Cambridge, Mass
1
3
7
(Camden N J
Pa vton,'oh io ...!!!!!!'!!"
1
^
3
Fafl River. Mass
1
4
l^ort Worth, Tex. . ..
Grand Rapids, Mijh '.'.'.
Hartford, i onn
1
2 1 9
2
. 6
4
3
3
1
Lawrence, Mass
2 1 2 '
2
I^well Muss
3
6
8
3
0
1
. . J
4
I Tun, ^ass
I '
1
Memphis, Tenn
1
3, 1 12
3I 6
5
Na.v'hvillc Tenn
3
New Bedford, Mass
......
7
3 1 tl
1 ! 6
2 1 ' 8
7
New Ha-eii Conn
2
Oakland. «'al
3
2
Omaha Nebr
3
3
19
1
1
4
Reading Pa
3
Rifhraoiid, Va
::::::'::::::
'"4;.. .:;
K
3
Salt I alv«M'itv Utah
2
1
4
7
6
SpringQcld. \tnss
Syracuse, N. Y
6
8
1
7
5
5
12
7
4
2
......
4
8
......
8
6
3
4
Ta'oma Wa*-'!!
Tolndo, Ohio
5
2, 2
5
Trenton, N. J
I
6
12
1
Wor ester M;is«
3
3
7
From .50,000 to lOO,^) in]ial>-
itants:
Akron, Ohio
4
Altoona Pa
AtJantir Citv N.J
..;.;.i
3
5
1
5
2
1
Bayonne, N. J
Berkeley, (al
1
!!::::::
2
,V. V.
i
Tiini'hnmtoa N Y
2
1
4
Brj) "kton Mass .........
t . ...
Cnnlnn Ohio
....:;t
Charleston S C
2
2
2 1
1 '
1
1
i
Co\ ington. Ky
4
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1693
October 5, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Sept 15, 1917— Continued.
Popula-
tion as of
July 1, 1916
(estimated
by U. 8.
Census
Burcuu).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
aty.
3
6
1
6
2
5
6
3
1
5
1
1
1
1
m
xi
1
1
5
1
0
JO
1
From 50,000 to 100,000 inhab-
itants—Continued.
DiUuth, Minn
94,495
S8,B00
63,705
75, 195
7fi.07S
54,772
7f>, 1S3
72,015
77,214
6S,529
99,437
57,343
51,155
78,2Ki
58.221
63,794
92, W3
71,744
60,411
63,867
55,185
66.895
55.642
85,236
53,330
68,805
99,519
67,078
87.039
6S,9t6
61,120
51,5'iO
66,083
77.016
70,722
76,776
61,655
27,732
37.385
»4,«14
32,730
27,fv32
43,125
46,192
29,319
34,611
26,074
32.261
48,811
39,873
28,743
42,458
. 39,233
35,486
41,781
41,S63
29,3.53
25,679
40,496
35,HH3
48,H«6
31.576
, 26,771
3K,676
31.677
41,097
35.384
46,515
27,587
19
26
21"
17
16
21
16
23
9
8
34
29
19
11
16
19
17
27
22
14
22
15
17
23
iV
16
19
IS
20
6
7
3
1
1
Eli^aljeth, N. J
«
El Paso, Tex
1
Erie, Pa
2
4
4
8
1
16
21
2
1
1
3
2
E%an,svllle, Ind ....I
Flint, Mirli
1
Fort Wavne, Ind
Bamsburg, Pa
1 "2
.
2
2
HoboVen N.J
4
....:.
Johnstown, Pa
1
Kausas<1ty, Kans
3
1
little Rock, .\rk
}
Maiden, Mass
i
4
2
4
1
..
2
2
2
1
2
1
Manchester, N. H
1
....
5
Mobile, Ala
1
2
New Britain, Conn
OHahoma City, Okla
Passaic, N.J
18
1
1
Pawtucket, R.I
Portland, Me
2
1
2
3
1
6
1
2
1
RocVlord, 111
1
3
4
Sarmmento. (a!
Saginaw, Mioh
1
St. Joseph, Mo
3
3
3
2
1
1
I
4
3
1
San Diepn, Ccd
1
Savannah. Oa
Schenectady. N. Y
Sioux ( Ity, Iowa
2
2
1
Somervillc, Mass
2
1
6
1
1
South IJend, Ind
Sprint'lield, 111
1
1
4
1
2
Sprinnacld, Ohio
2
1
1
1
1
1
Iiprre Haute, Ind
2
1
Trov. NY
Wl:-bita, Kans
«
4
Wilkes-Barre, Pa
17
6 1
1
1
1
Yori, Pa
From 25,000 to 50,000 Inhab-
itants:
Alameda, Cal
11
12
7
4
3
1
9
8
23
11
6
i*
7
6
2
7
6
0
7'
10
12
9
7
2i
8
8
15
19
1
Auburn, N.Y
1
..""1
Austin. Tex
1.. ■'
1
i
5
3
6
1
■
Butler, Pa
1
3
1
1
Butte, Mont
Chelsea, Mass
1
A
Chicopee, Mass
1 i
Columbia, S.C
1
Cumbcrtond, Md
3
Danville, 111
2
DavenpOTt, Iowa
4
3
1
1
Dubuque, Iowa
East (l)i<<af(o, Ind
EastOranw. N. J
1
3
2
Everett, Mass
2
Everett, Wash
1
2 {
Fitchbtirf, Mass
2
1
4
1
1
GaJvesttm, Tex
1
Green Bay, Wis
Hai*ersU>wn. Md
1
1
"1
. . ..
Hamilton, Ohio
.
Jackson, Mioh
1
1
Kalamazoo, Micfa
5
1
1
1
5
Kenosha, Wis
:...:.!
Kingston, N.Y
5
6
2
4
1
5
i i
La CToesft, Wta
.=»
Lextngten, Ky
1
2
lima, Ohio
1
1
Lincoln, Nebr.
1
1
Long Beach, Cal
i
2
ABB TOU SATING Your Money to Inrest in tbe SECOND UBEBTY LOAN!
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October 5. 1917
1694
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Sept 15, 1917— Continued.
Popula-
tion as of
Julv 1, 1916
(estimated
bv U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
5
1
1
1
2
1
1
1
From 25,000 to &D,000 inbab-
Itanta— Continued.
Lorain Ohio
36,964
.32,940
47,521
2«i,23l
27,327
29,603
41.133
.31.927
43.715
37,3.VJ
31.101
31,401
.33,*fS0
4r»,4.'i0
41.^5
3S,^.29
39,r>5i
;tj',79H
3*^,136
4',4S'>
43,2S.l
2^.*^20
27,445
3*'>,2H;
4S,T2..
30,570
2'i,S94
45,139
4.'^, 377
33,S09
29,S92
31,l.^'i
30,SG3
22,*n74
15.nii)
13,5-i2
13,f*K)
21,Ks5
!5,794
« n,n75
22,r^,9
2l,27rt
1(),P.7»
23.539
2U,9.3»>
15,395
» 14,r.I0
17,445
13,2H1
17, .x**
2:m2.>
15,243
20.9S.J
» 22,019
19,920
2.'.,^)5
17,. ^2 4
ll,r><Vi
12,0«i7
14.8;}!
20,193
13, K2I
24.2i)4
i5.r4K
21. lis
2-3, 22S
LvnchDurp Va ..... ... .
8
15
7
4
11
10
k'
.5
17
5
7
0
10
16
9
H
5
10
17
17
7
1
2
McKeesport, Pa
6
1
Mpdford, Mass
2
Monlrlair, N. J
1
2
1
Nashua. N. H
3
1
1
I
1
2
2
Newburph, N. Y
1 .
New C-ast Ic. Pa
Newport, K v
1
1
1
1
2
2
Newton, Mass
Niagara Falls. N, Y
Norrlstown, Pa
1
ORdon, Utah
::::::'::::::::::::::::
Orange, N.J
Pasadena, Cal
1
2
*..!!.'.! ■"■
1
2
5
Perth Ambov, N.J
1
1
1
..
Pit tslleld. Mass
.
1
4
Portsmouth, Va
." "1 "*•
Qiii'iov, HI
2
1
1..
1
4
(Juiiicv, Mass
11
■ s
Rapine. Wh
'1 ""i
1
4
l{(ranoke. Va
2
3
1 1
4
Roik Is'and. lil
SriTi .lo''»e, Cal
2
Stoiilenville. Oliio
11
14
14
3
1
2
19
9'
12
13
5
4
1
6
9'
5
7
10
1
1 1
Taunton. Ma<-;
1 1
1 1 2
To|icka. Kiins
1
2 :
\V'»Hlinm, Mass
1 1
1
AVat«rto\Mi. N. Y
''
We^t llol'oK on. N. J
2
4
i.
3
1
Wbee'i'ip, W. Va
1 M
1
1
1
AViLiamsport. Pa
Wi!n)in"!t(*i». X. ('
1 1
1
Wiii'^to'i-.^a'pni, N. C
: r 1
2
1
3
1
1
1
2
Za.'O ^il!p. oMo
1 ,
From 10.000 to 25,<Winha) It int-;:
AKon. II!
1 !
Ann Arbor. Mich
I
t 1
Pra\or Talis, l*a
1
*
Berlin, N. II
......j..
Braddock, Pa
7
3
Cairo. Ill
1
Clinton. Mass
Concord, N. IT
6
3
1
1
1
Ca'eslaire, III
1
1
Ilarrhon, N. J
....!'. ..;.;.!;.;!!!
1
Koirnv, N. J
0
4
1
6
7
9
1
3
3
7
11
4
9
i
Kokoriio, Ind
1
Lone Branch. N.J
Marinette. Wis
!
!.... 1..
Melrose, Mass
1
! 1 :;
1
Morri^'town, N. J
1 1
1
1
Mii^f'atir.e, Iowa
",""\ t
1
Nar'iicoke. Pa
.....j::..
New bur' [kort, Mass
New London. Conn
2
1
2
1
North Adams. Ma^s
Nortliamt)ton, Mass
1
1
Plain!ie!u. N, J....*
1
Poiiliao, Mif*h
1
1
Portsmouth, N. 11
6*
7
8
4
2
5*
1
Rockv MoMnt, N. C
Rutland, Vt
Handii^k' , 0>'io
Faiato^^a t-^prin^N, N. Y
Po a'i BcJlilcleni, Pa
1
1
1
' 1
Sto<»'.tori, I'a
*.
5
W'a-'4.i;:t(>n, l*a
1
1
Wilkui^i'iUi! Pa
1
1 Population Apr. 15, 1910; n« estimate made.
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FOREIGN.
CUBA.
Communicable Diseases — Habana.
Communicable diseases have been notified at Habana, as follows:
Pisp-osp.
Cerebrcs]iinril ineniiiRili?.
Diphtherifl
Leprosy
Malaria
Measles
Paratyphoid fever
Scarlet fever
Tjrphoid fever
Sept. 1-10, 1917.
New cases. Deaths,
2
1
3)
Remaining
under
treatment
Sept. 10,
1917.
1
9
10
27
12
8
70
VENEZUELA.
Yellow Fever — Cora and Vicinity.
In September, 1917, yellow fever was reported present at Coro,
Venezuela, and iu the vicinity.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW FEVER.
Reports Received During the Week Ended Oct. 5, 1917.^
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bombay
July »-28
11
55
i>
1
3
6
38
7
1
2
July 15- Aug. 4....
Jiilv8-28
Rangoon
Java:
Mid Java
July 1&-22
West Java
July2^Aug. 2....
PLAGUE.
Arabia:
Aden I Juno5-July 4.
Ceylon:
Colombo.
if...
D(
China:
Amoy,
lexandria.,
June 10-23..
July 8-21...
Aug. 13-19
July 31-AuK. 19.
Present.
» From medical officers of the Public Health Service, American consuls, and olhcr sourtc -.
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121 (1695)
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October 5, 1917
1696
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER
Continued.
Reports Received During the Week Ended Oct. 5, 1917— Continued.
PLAGUE— C^nt iimed.
Place.
Date.
Cases. Deaths.
Remarks.
India:
Bombay
Do
Karachi
Rangoon
Java:
East Java—
Surabaya.
Jiifiel? 23.
July S-28.-.
July 15-28..
JnlvS-2S...
.do.
45
118
6
171
34
102
4
163
SMALLPOX.
Brazfl:
Bio da Janeiro.
China:
Amoy
India:
Bombay ^
Da.
Madras
Rangooa
Italy:
Turfai
Java:
East Java-
Surabaya..
Mid Java
West Java
Mexico:
Mexico City....
Russia:
Fetrograd
Do
Aug.5-U..
Aug. 13-10.
June 17-23
July ^21*
July 1&-Aug. 4.
July 15-28
Aug. 20^3^.
July 16-29
July 16-22
Juiy28 Aug. 2..
Aug. 12-Sept. 1 .
June 10-23.
July 2-8....
46
10
23
12
34
14
14
0
5
1
1
5
13
■ 3
51
1»
14
Pre.'iem.
TYPHUS FEVER.
Brazil:
Rio de Janeiro.
China:
Autimg
Egypt:
Alexandria....,
Java:
East Java-
Surabaya..,
Mid Java
West Java
Mexico:
Aguascalientes.
Mexico City
Kussia:
Petrograd
Do
Aug. 5-11
Aug. 20-20
July3l-Aag. 19.
July 16-29
July 10-22
Julv28-Aug. 2..
July 10-10
Aug. 12 Sept. 1.
June 10-23.
July 2-8....
1
2 I
I
66 I
246
YELLOW FEVEB.
Mexico: |
Yucatan Slate— i
Moiida { Aug. 1-7 .
\'enexuela:
Coro
I
Present Sept. 5.
ARE YOU SATING Yonr Money to InveH4 im tlir M€ONU UBEim L0ANf
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1697
October 5, 1017
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports ^Received from June 30 to Sept. 2S, 1917.
CHOLERA.
Place.
India:
Bassein —
Bombay...
Calcutta...
Do
Madras
Do
Mardalay.
Houlmeln.
Pakokku..
Pegu
Do
Raneoon...
Indo-China:
Provinces..
Anam
Cambodia
Cochin-China
Tonkin
Saigon
Java:
EastJava
Do
West Java
Batavia
Do
Peniia:
Mazandcran Province-
Amir Kela
Barfourouche
Hamze Kela
Machidcssar
Philippine Islands:
Manila
Provinces
Agusan
Albav.....
Ambos Camarincs. . .
Do
Bataan.
Batangas
Bohol
Do
CapU
Do
Cabu
Do
Hoilo
Lcyto
Do
Mis amis
Mindanao
Negros Oriental
Rizal
Do
Romblon
Samar
Sorsozon
Do
Hurigao
Tavabas
"Do
Zamboanpa
Date.
Apr. 1-May 5...
June 24-30
Apr. 29-Jime30.
July 1-7
Apr. 22-Jimo30.
July 1-14
Mayfi-JunoSO. .
Mjy 13-Jimc2. .
Apr. 2(>-May5..
May 27-Juno30.
July 1-7
Apr. 21-June30.
Feb. 1- Apr. 30..
do...
do
do
Apr. 23-May 27.
Apr. 2-S..,
July 9-15.
Apr. 13- July 5..
July 0-2-3
Feb. 3
Jan. 15-17.
Jaa.l7....
Jan. 31.-..
.1
June 17-23 .
Julyl^2H
May 20- Juno 30.
July 1-Aug. 4..
June 3-0
July 22-Aug. 4
July 8-14
June 17-23
May2a-June30.
July 1-Aug. 4..
June 3-30
July l-.Vug. 4..
Juno 3-30
July 1-Aug. 4..
do
June 10-30
July l-Aug. 4..
July .H-Au», 4..
July 2j>-Aug. 4.
July 1-Aug. I..
June 21-30
July 1-7
Jul> 22-28
July 15-21
June 3-30
July 1-Aug. 4..
July 29- Aug. 4
June3-<M)
July l-Aup. 4..
Julyi:>2l
Cases.
31
14
12
m
4
163
1
I
12
m
53
2
20
I
1
368
203
62
64
231
388
41
14
334
237
12
276
1
1
4
196
2ie
4
7
11
11
Deaths.
8
1
347
3
4
5
2
3
1
5
7
17
3
9
112
108
1
251
161
40
45
150
284
22
5
223
117
11
177
1
2
88
114
4
7
9
Remarks.
Fob. 1-Apr. 30. 1917: Cases. 227;
deaths, 124.
Apr. 13-July 5, 1917: Cases, 71;
deaths, 31. July 6-20, 1917:
Cases, 94; deaths, 51.
May 2(K-June 30, 1917: Cases, 795;
deaths, 606. July 1-Aug. 4,
1917: Cases, 2,064; deaths, 1,271.
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OclobcrS, 1917
1698
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVBR^-
Continued.
Reports Received from Jane 30 to Sept. 28, 1917- Ooudnuod.
PLAGUE. .
Place.
.\nibla:
Aden.
Bmzil:
Bahtft
Do
OyJon:
Colombo
Do
China:
Araoy
Do
Hoiuikoiig
Do
KwunKtune Provlnoo—
Ta-pii (Ibtrict
KcJiador:
E^tancla VIcja
Uuav:i(|uil
MOaKTO
Salitre
Do
Taura
EKVpt
Alexandria
Do
Port Said Kovemraent . . .
Ptirl S,iid
Do
Provincts—
Fuvoura
(lalioiibeb
• Jlrnch
Miuieh
l>o
Sicmt
Siu'7 Kovrmniont
Knof
(Jieat Britain:
(Jravesoud
London
Deaths.
Remark!.
A|>r. ?^-Juno 9
July ft 12,
Apr. -ii^MayS....
July 1-7
May I a- June 30..
July K Aug. IS...
5uiie2..
Feb. I 2H..
....do
Mar. 1-31..
Apr. 1-30..
Mar. 1 31..
Apr. 1-30..
Feb. 1-2S..
....do
Mar. 1-31..
Feb. 1-28..
June 21-27
July 31
Apr. 3*1- May 19...
June 2.')
July JH 2i)
May 11 June 2*...
June ;*?<
Miy 17
May 12-JuiiP 38...
Jidy29
May 12
Apr. 30-June2
May 12 JuriP 2V...
Aug. 13 24.
May 3 s. . .
June,W.
Apr.
July
.\pr. 22 Jiinrao...
July 1 7
Apr. 2*> June 2
Apr. 1 Jiine:»
.\pr. 22 June 30...
JunP2> July 14. ..
Apr. 22 J'iae30...
India
li.u^eln
lh>
liombay
l}o
Caleutta
Ileniada
Kanuhi
Do
Madra PrrNJdency
Do t Jid> I 7
Maud iliv j Api. ^•Mav 12.
Moiilin.-in ' \pr. 1 June 30
Do I July I 7
M\in;;\.m ' Apr. 1
l'«Kii May 27
K.iiiv'"<»n
\h,
r'»'»iu'-)) ,
Indo < hina:
I'lijiim-^ ,,, I
\:nm 'Fob I \pr. rio.
<anji«Hli I «|o
Co I ,'. ■ ;i(iia '.. ..,io
n."i.i'i .«!()
■**'»:. Ill \pf. ,il June .J.
n June 7.... I
Apr. ir> J line 30... I
July 1 7 '
Apr. s H '
I
441
30
301 '
70 (
IH3
117 I
VtH .
70
17
M Apr. 8-Mav 14, 1917: i'ttsw, m:
deaths, rd.
Pre"*»nl and in viciiufv.
.' Pn-^nt.
Jan. l-Aug. 2. 1917 ras*-> K25i
MH I
2o ,
JK
35
413
4
Mi
9
74
16
1
2
42
2
From >. s. Maliund.
2 In hospital at i^jrf From b. s
Sardinia from \iiN>i.i]ian and
oriental i>oit>.
Apr. 1.') June .H\ !«17; CaatP,
43,922; deaths, 30,197 July 1
7, 1917; Cases, 1.^70; d«aUi«.
1,322.
Feb. 1-Apr. 30, 1917: t;
d«^th«, 199.
3U;
AKF Vm S \VIN<; Your .Hone) to Inrent In tho SKt'tlMI LIBERTY LOAN!
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1699
October 5. 1017J
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from June 30 to Sept. 28, 1917— Continued.
PLAGUE-Ooatinued.
Place.
Date.
Cases.
Deaths.
Remarks.
Java:
East Java
Apr. 2-May 20, 1917; Cases, 29;
deaths, 29.
Djociakarta Residency.
Kedire Uosi'len^r
Apr. 23 MayC
do
1
1
3
18
G
1
1
3
18
6
Samarang Kesidency . . .
Sura> aya Residency . .
Surakui ta Ilebidency . . .
Apr. 23 May 20....
Apr. 2 May 20
do
/
Peru
May 1&-31, 1917: Cases, 15.
l>epartmenl.s—
Areuuipa .
Mav 10-31
4
1
2
7
1
13
6
2
1
At MoUendo.
rallao..
.do...].!." .
At Callao.
Lambaveaue
. ...do..
At Chiclayo.
Labertad
do
At Salaverry, San Pedro, and
Lima
Trojiilo.
At Lima.
Siam:
Bangkok
Apr. 22 JunraO...
Jiilv.lW
12
5
1
1
Do. . . ...
Straits Settlements: i
iringarore.. ... . ..' June 3-16 . ..
Do
Union of South Africa:
Cape of tf ood Hope State -
(iiengrey district
Terka district
C^ueenstown
' Orange Free State ....
July 1-7
Atig. 13
Present.
May28
1
1
1
At Summerhill Farm.
June 0
Apr. 16-22, 1917: 1 case. Apr. ^
22, 1917: C ases, 2G; deaths, 17.
Winbiirg district
Mjiy28
1
0
At sea:
S.S. Matiana
July 14 -18
9
En route for port of London.
SMALLPOX.
Australia:
New South Wales
Brewarrina
Ces.snock
Coonabarabran
Quambone
Warren district
Queensland-
Thursday Island t^i'.ir-
antineStalioo.
Braiil:
Bahia
Do
Rio de Janeiro
Do
Canada:
Manito}>a ~
Winnipeg
Do
Nova Scotia -
Halifax
Port Hawkesbury..
Ontario-
Ottawa
Ceylon:
Colombo ....,
China:
Amov
AEtung.!".!!I!!II!!I!I!
Do
Cbtmgking
Do
Changsha ,
Apr. 27 June 21.
July 25 28
May 2.> Julys...
Apr. 2/ June 21.
June 22 July 17.
May 9.
May 0 June 30. .
July 22 Aug. 4..
do
July 1-Aug. 4.. -
June 10^16
Aug. 19-Sej*t. 1.
June 18 July 7..
June 17-30
July 30 Aug. 5.,
May 6-12
Apr. 29 May 26.
July 1-31
May 21- June 24.
Aug. 0-12
May 6-June 23. .
July 1-28
May 27-June2..
4
2
I2r.
158
Apr. 27-July 28, 1917: Cases, 75.
From s. s. St. Albans from Kobe
via Hongkong. \'essel pro-
ceeded to Townsville, Bris-
bane, and Sydney, in quaran-
tine.
Present in district.
Present and in vicinity.
Do.
Do.
Da
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« VtoJHM- ."►, 1»17
1700
THOLERA. PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continned.
Reports RereWed from June 30 Co Sept. 28, 1917 — Continued.
SMAIXPOX-Contlnncd.
IMaci'.
Da to
Casi'S.
C'hinu— Continued. '
l>atrpn I May 13^ Juno 30. . .1
I)o Julys 2V I
ilaiikow ' Juiio^l iO I
llarliiii ' Apr. Ji May i; I
lIouKkoni? ' M'ly <» June IG i
1)0 \ti;.'.:> is I
Miimhuri.iSfaiion ' V|>i.2'{ 1*9
Mukden Mav'j; June 2 '.
Do Jiily n Auk. 11. ..J.
shtUKi.^j I May 21 July I |
Do I July 2 Auj.'. .'>..
Tsil>hdrSlHtion ' Apr. Kl ri
Tvirvtao ' May 22 July?..
Jul\ :m \UK. 11-
Ma> I II
Kol>. ] '2x
Mur. I ;{I
\|>r. 1 10
Do
(Tio-oii ' Kore.i);
( l.t hull} V)
Eruufloi :
<;ii.ivmji!il..' ,
ho.
Do
Knvpi. j
Alexandria ' Apr. M\ July
l^o I Juh 2 2,»
I'.iiio
Krauir:
N int<M
r -:■
• H'fmiuiv
h>l.. li Mar \s.
M \ '. 12 ...
M . '
'>'if,i
I.n ■ k..
Mui.hh..
SJMii:'irt.
M.it In Vpr. 2^...
d')
. d<. '
.d..
do
do
. do
. . do
J.jh 2.". Ui
AIImh-
Iiidiu:
HouilMy \p. 22 J')»r »M. _
Do J.ii\ I
ralcuMa \l'r 2'* M >' 2<. ...
Ka».i(»ji \pi .'2Jil\i. ...
Do J.jIv s II...
Madras Vci "22 Johp .10. ..
l>o i.'t\ ill
KuiiK'oon Vtr !.'» Jurn».10. ..
IHj Iul\ I 7
Indo-Chun
l'n>, rn f ■
Xi'MU T>»». 1 \pr 3»)
inw K-li I do
To. t II ( t -111 do
Kw.Ki'-( !i i^-Win M-^r J Npr.TU
I.jo-^ Mr I ;<u
Tonkin l«' ' \pr. .TO
> Uv'on \f>r 27Jun<»lO...
Il.iU.
Turin M u 'I Juno24...
Do Jidj 12 Vug.:,
I i;»ur
KoU' Mn 27 Itdy22....
N ipuaJd M*v ^H JunV3
n '* I ' Miy Ih July 5
V<.ki.Or>'l J.ilviV U
y li: 'h ona Mij 27 July 1
13
Deaths.
R«mai1c8.
30
1
4
0
1 1
7
7
8
7 "
1
1
IH
l»W{
If
17
2 '
237
•12 I
ft.'* j
I
177
1 I
1 I
.35;
7
4
t
I 1...
1 [
t
19
9
4
1
1 1 July 1-7, 1»17: 1
On Chln^w Rastctn Ry.
Do,
I Present.
Do.
32 Cases for«ign; deaths anions na-
tl%es.
9 AmonKChtnese.
... On Chinese Eittern Ry.
At another ^^atlon on railway,
1 ca«e.
Mar. IS Apr. », 1917: (?a9«% 716
In cities and 32 States atid dl9-
trkts.
s
12
>
I
IS
u
Ml
21
.....
2s
m '
12
iJ !
16 I
' Ml
IrM I ^pr :*M»17: < am^,, 2,&
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CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from June 30 to Sept. 28, 1917— Continued.
SMALLPOX— Continaed.
Place.
Date.
Cases.
Deaths.
Remarks.
Java:
East Java
Do
Apr.J^-Jnlyl
Jtily2-15...
38
13
88
10
2
Mid-Java
Apr.l-Julyl
July 2-15
7
Do
West Java
Apr. 13-July 5. 1917: Cases, 239;
Batavia
Apr. 13- July 5
Jan. 1-June30
30
6
116
1
1
9
deaths, 44. July 6-26, 1917:
Mexico:
Coa topee
Cases, 65; deaths, 14.
Do
Aug. 1-14
Jan. 1-Aug. 14, 1916: 118 deaths.
Jalapa
July 1-13
MazUlan
July 11-Aug. 7
Mexico City
June 3-30
162
69
Do
Aug. .VII
Monterey
June IS 34
24
23
1
1
1
Orizaba
Jan. 1-Junc ."^o
Do
Julvl-23
VeraCruB
July 1-Scpt. 8
Aug. 13 18
5
1
6
4
14
4
Netherlands:
Amsterdam
Philippine Islands:
Manila
Mayl3-June9....
July8-Aug.4
May 13- June 30. . .
July 8^28
Varioloid.
Do
Do.
Portugal:
Lisbon
Do
Portuguese East Africa:
Loureiiro Marques
Mar. 1-May31
3
4
Russia:
Archan?*^l
May l-June2S
Feb. 18- June 9....
Mar. Il-June2....
Mar. 15^21
56
495
4
23
10
3
Petrogratl
Riga
Jan 1-Mar. 31, 1917: Cases, 9.
Vladivostok
7
Bangkok
June 9-30
Do
July 11-17
5
11
Spain:
Madrid ..
May 1-Jimel9
Mala^
Apr. 1 30
May 1- June 30. . .
Seville
Valencia
June 3-23
12
6
1
1
2
3
Do
July 1-Aug. 18
Mar. 1*-June23...
June 24-30
Straits Settlements:
Pcnaug
3
Singapore
Sweden:
Malmo
Apr. 22-28
Stockholm
May 20 -June 23...
June 2-*
1
Tunisia:
Tunis
Turkey in Asia:
Trebizond
Feb. 2&-Apr. 13...
15
Union of South Africa:
JohannA-shnrg x
Ujtr- 11-04
4
2
Uruguay:
MonteWdeo
May 1 31 .
Venezuela:
Maracaibo...;
Juno 18-July 8 .
8
1
Do
July 9-23
TTPHUSf
•EVER.
5
1
Algeria:
Algiers
June 1-30
3
1
!
"Do
July 1-31
Austria-Hongary:
Austria
Oct. 22-Dec. 17, 1916: ( U^es, 2,371.
Bohemia
Oct. 22 I>ee. 17....
do
634
809
47
OaUcia
Lower Austria
do
1
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1702
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Received from June 30 to Sept. 28, 1917— Continued.
TYPHUS FEVER— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Austria-Himparv— Cont inued.
Austrirt— (""htinued.
Oct.22-Dec. 17....
do
617
16
243
5
Silesia
Stvria
do
do
Feb. 19 Mar. 25, 1917: Cases, 1381.
Feb. 19 lVCar.25...
July 21^ Aug. 4....
June 25-Jnlv 1
July9-Aug. 1»....
June 9-15
July 8-14
83
1
3
7
1
Brazil:
China:
Antiinff • - .
I>o
1
Hankow . . .
Do.
1
Tient'^in . ...
June 17-23
May 30- July 7..-..
Aug. 5-11
1
4
1
1/48
220
96
Tsin^t^io
Alexandria
Apr. 30- July I
July 17-29
478
84
40
1
32
19
Do..
Cairo
Jan. 22-Mar. 18....
June 17-23
Great Britain:
Cork
Greece:
Saloniki
May 23- June 30. ..
Do
July 1-Aug. 4
Japan:
Hakodate..
July 22-28
4
24
Nagasaki
June 11-24.*.".*.'!.*!!
July 9- Aug. 19....
2
Java:
East Java
May 6-July 1, 1917: Cases, 6. July
fr-15. 1917: ( ases, 3.
Apr. 1-June 24, 1917: Cases, 3ft
deaths, 5. July 9-15, 1917:
Cases, 1; deaths, 1
Surabaya
Mld-Javn
June 2.5 July 1
1
Sarnarang
May 5-JunelO
July 2-8
14
5
2
Do.. ...:.:.:::::.:
West Java
Apr. 13-July 5, 1917: Cases, 147:
deaths, 6. July 6-26, 1917;
Cases, 40; deaths, 2.
Batavia
Apr. 13 -July 0
July 6-26
70
31
6
2
1
5
3
Do
Mexico:
Coatep c
Aug. 1-14..
Jaiapa
Anr. 1-June30
1)0 ::::::
Ju y 1-31..
Mexico City
June 3 30
431
524
Do.....
Juiy8-Aui?. 11
Jan. 1-June 30
Orizaba
6
1
2
Do
July 1-31
Netherlands:
Rotterdam
Juno 0-23
3
8
7
1
U
126
2
5
Do
July 15- Aug. 11...
July 8-28. .
Norway:
Bergen
Portuguese K:jst .\frica:
Lourent'o Mnniues
Mar. 1-31
Russia:
Archangp I
May l-Jimo28
Feb. 18-Juno9
May 31-June2
Mar. 29-May21...
May 1-31
2
3
Pelrc grad
Ri^a
Jan 1-31 1917' 1 rase.
VJudivcsr- k
Spain-
Ahneria
6
2
Marlrid
do
Switzerland:
Basel
June 17-23
July 8-21
1
3
3
2
Do
1
Zurich
Juiy26-Aug.*l8!!!
June 4-9
Trinidad
Tunisia:
Tunis
Juno 30-Juiy 6
1
Union of South Africa:
Cape of (fOod Hope State-
East Liondon
Sept 10
PreMnt
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CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER -
Cominued.
Reports Received from June 30 to Sept. 28, 1917 Coniiuued
YELLOW FEVER.
Place.
Date.
Ecuador: I
nal>ahoyo I Feb. 1-28..
Do I Mar. 1-Jl..
(hobo [ do
<;uayaqiin " Fob. 1-2S..
Do Mur. 1-;{1..
Do Apr. l-'\»..
Mi!ii^i.) I'Vb. 1 2s.,
Do.
Do
( iimTw 'ho
Vncatan relate—
Merirl.i
Poto
Dfj
Mar. 1-31
Apr. 1 30
Aiitr. m-w
.... .^f -pi. 1
...I hv^v2^
...I .In \ 2^) Autr. n.
Ca.ses.
DiMlIis.
1
.
2
1
1
1
IH
7t
17
••> 1
17
«!
1
1
t
1
2
1
1
I
1
1
6
2
Remark ^.
In Derson rwently arrived from
McxLnriiv.
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PUBLIC HEALTH REPORTS
VOL. 32 OCTOBER 12, 1917 No. 41
QUARANTINE SERVICE IN THE VIRGIN ISLANDS.
EXECUTiVfi ORDER PLACING THR ADMINISTRATION OP THE QUARANTINE SERVICE
UNDER THE PUBUC HEALTH SERVICE.
- Whereas an act of Congress approved June 19, 1916, provides " that
the Secretary of the Treasury shall have the control, direction, and
management of all quarantine stations, grounds, and anchorages,
established by authority of the United States * * *,"
Now, therefore, I, Woodrow Wilson, President of the United States,
by virtue of the authority in me vested, and pursuant to section 1 of
the act approved March 3, 1917, entitled "An act to provide a tem-
porar}^ government for the West Indies islands, acquired by the
United States from Denmark, etc.," do hereby order that the pro-
visions of the act of Congress approved February 15, 1893, entitled
"An act granting additional quarantine powers and imposing addi-
tional duties upon the Marine-Hospital Service," and all rules and
regulations heretofore prescribed by the Secretary of the Treasury
under this act are to be given full force and effect in the islands of St.
Thomas, St. Croix, and St. John, West Indies, and all public property
of the former government of the Virgin Islands, ceded heretofore to
the United States, consisting of quarantine reservations, buildings,
wharves, docks connected therewith, and equipment, be, and hereby
ar^, taken for uses and purposes of the United States, and the Secre-
tary of the Treasury, through the Surgeon General of the PubHc
Health Service, is hereby charged with all administrative duties
relating to said quarantine service, and the Secretary of the Treasury
shall have estimates prepared by the Surgeon General of the Public
Health Service and submitted to Congress for an appropriation for
the maintenance of said quarantine service, and securement of reser-
vations where necessary, and additional facilities for the proper
enforcement of quarantine preventive measures.
Woodrow Wilson.
The White House,
September 27, 1917.
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THE CONTROL OF COMMUNICABLE DISEASES.
REPORT OF THE AMERICAN PUBLIC HEALTH ASSOCIATION COMMITTEE ON STANDARD
ntGULATIONS, APPOINTED IN OCTOBER, 1916.
In the following report the terms used are first defined. Each
disease is briefly described with regard to the infective agent, the
source of infection, the mode of transmission, the incubation period,
and the period of communicability. Following this are given the
methods of control — first, those affecting the individual patient and
his immediate environment, and second, general measures bearing
upon the control or prevention of the disease in question.
Inasmuch as the laws under which various boards and departments
of health operate require differences in the legal phraseology of rules,
regulations, or sections of sanitary codes dealing with the control
of communicable diseases the committee has refrained from preparihg
formal regulations under each disease. As the report is at present
submitted any health officer, board of health, or legislative Dody
having the power to make rules or regulations* or pass sections cf
sanitary codes dealing with the control of communicable diseases can,
by reference to the description of the disease and recommendations
for methods of control herewith proposed, easily prepare the neces-
sary text upon which the educational and administrative acts of the
health officer will be based. The Hst of diseases considered by the
committee and herewith reported upon are those given in the Public
Health Reports, Vol. 30, No. 27, July 2, 1915, of the Public Health
Service in ^'A Model State Law for Morbidity Reports. ''
The committee is indebted for expert opinion and critical comment
upon its tentative conclusions to Dr. Simon Flexner, Dr. William H.
Park, Prof. Theobald Smith, and Dr. Bertram H. Watere, and
acknowledgment of their contributions to the report in its presenf
form is herewith gratefully expressed.
Dr. Haven Emerson, Chairman.
Robert N. Hoyt. ^
Dr. F. M. Meader.
Dr. J. C, Perry.
Dr. C. E. A. WiNSLOw.
List of Diseases.
Actinomycosis. Denjj^e.
Acute infectious conjunctivitis. Diphtheria.
Anchylostomiasis (hookworm). Dysentery (amebic).
Anthrax. . Dysentery (bacillary).
Cerebrot^pinal meuiugitit?. Favuft.
< hicken pox. German meaalea.
t'holera. Glanders.
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Qonorrhea. Septic sore throat.
Leprosy. Smallpox.
Malaria. Syphilis.
Measles. Tetanus.
Mumps. Traclioma.
Paratyphoid fever. Trichinosis.
Plague. Tuberculosis (pulmonary).
Pneumonia (acute lobar). Tuberculosis (other than pulmonary).
Poliomyelitis. Ty[)hoid fever.
Rabies. Typhus fever.
Rocky Mountain hpotted ur tick fever. WTioopinfj cough.
Scarlet fever. Yellow fever.
The committee adopted the following definitions of terms:
1. Cleaning- This terra pi£jnific.« the removal. 1 y s(Tu'>Mng and washiug, of organic
matter on which and in which Imcteria may find fa\ora' lo conditions for prolonging
life and virulence : also the removal by the same means of bacteria adherent to surfaces.
2. Contact. — A * contact" is any person or animal known to have been sufficiently
near to a human infected person or animal to have been exposed to transfer of infec-
tious material directly, or by articles freshly soiled with such material.
3. Delousing. — By delousing is meant the process by which a person and his per-
sonal apparel are treated so that neither the adults nor the eggs of pediculus corporis,
pediculus vestmenti, or pediculus capitis siu^ve.
4. Disinfection. ~hy this is meant the destrojing of the vitality of pathogenic
micro-organii^ms by chemical means or by heat.
When the word concurreni is us^ as qualifying disinfection, it indicates the appli-
cation of disinfection immediately after the discharge from the body of an infected
person, of infectious material, or of articles soiled with such infectious discharges.
When the word terminal is used as qualifying disinfection, it indicates the process
of rendering the personal clothing and iomiediate physical en\ironment of the pa-
tient free from the passi' »ility of conveying the infection to others, at the time when
the patient is no longer a source of infection.
5. Education in personal cleanliness. — By this phrase it is intended to include all
the various mean:? availa' le to impress upon all momSers of the community, young
and old, and especially when coramunica' le disease is i>revalent or during epidemics,
by spoken and printed word, and by illustration and sugj^estion, the neces-^ity of:
(1) Washing the body daily with soap and water.
(2) Washing hands in soap and water after voiding bowels or bladder and always
before eating.
(3) Keeping hands and unclean articles, or articles which have been used for toilet
purposes by others away from mouth, nose, eye.s, ear?, and vagina.
(4) Avoiding the use of common or unclean eating, drinking, or toilet articles of
any kind, such as towels, handkerchiefs, hair Inrushes, drinldng cup^, pipes, etc.
(5) Avoiding direct exposure to the spray from the no^es and mouths of people who
cough or sneeze, or laugh and talk loudly, and with wide open mouth, or in explosive
manner.
6. Fumigation. —By fumigation is meant a prores^ by which the destruction of
insects, as mosquitoes and ) ody lice, and animals, m rats, is accomplished ]>y the
employment of gaseous agents.
7. Isolation.^ — By isolation is meant the separating of persons suffering from a
commimicable disease, or carriers of the infecting organism, from other persons, in
* In view of the various ambiguous and inaccurate usos to which the wordi isolation and quarantin? arj
not infrequently put, It has seemed host to adopt arbitrarily the word isolation as describing the liniitalion
pot upon the movements of the known 5ick or "carrier" individual or animal, and tho word quaranliuo
to the limitations put upon exposed or "contact " individuals or persons.
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such place? and under such conditions as will prevent the direct or indirect ccmve^rajoce
of the infectious a^ent to susceptible persons.
8. Quaront'ne.^- By quarantine is me^t the limitation of freedom of mov^nent <rf
persons or animals who have been exposed to communicable disease for a period of
time equal to the incubation period of the disease to which they have been exposed.
9. Henoiation. -~By renovation is meant, in addition to cleansing, such treatment
of the walls, floors, and ceilings of rooms or houses as may be necessary to place the
premises in a satisfactory sanitary condition.
10. Report of a d(sots( - By report of a disease is meant the notification to the health
authorities, and, in the case of communicable disease in animals, also to the respective
departments of agriculture who have immediate jurisdiction, that a case of commu-
nicable diseaise exists in a specified person or animal at a given address,
11. Susceptibles. — A susceptible is a person or animal who is not known to have
become immime to the particular communicable disease in question by natural or
artificial process.
The items coiisidered necessary for presentation by the committee
with regard to each disease are the following:
1. Infective agent. ' ^
2. Source of infection.
3. Mode of transmission. '
4. Incubation period.
5. Period of communicability.
6. Methods of control.
(A) The infected individual and his environment:
. 1. Recognition of the disease.
2. Isolation.
3. Immunization.
4. Quarantine.
6. Conciurent disinfection.
6. Terminal disinfection.
(B) General measures.
Actinomj€oai&
!• Infective agent' Actinomyces bovis.
2. Source of infectiorv The natal and bowel discharges, and the infected material
from lesions in human and animal cases of the disease. Uncooked meat Irofn
infected animals may serve as a source of infection.
3. Mode of (ratismission: By contact with the discharges or with articles freshly scaled
with discharges from animal or human cases.
4. Incubation period: Unknown.
5. Period of communicahiUty: As long an open lesions remain, as proved by presencv
of infective agent on microscopic or cultural test^.
6. Methods oj control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by micro-
M-'opio examination of discharges from the lesions.
2. Isolation —None, provided the patient is under adequate medical
supervision.
3. Immunization — None.
4. Quarantine — None.
5. Concurrent diyiufectiou - -Of diachargtis from lesions and articles soiled
therewith.
0. Terminal diyinfoction- -By thorough cleansing.
» In view of the \ uriou' anil ipious and inareurate uses to \vlu«li the words Isolation and quarantiue are
not inlrequcntly ptu , it \v\s sevmed best to adopt .irfitrarily the woid isolation as describing the UmitatloQ
put ufon the nio\OTnents of tho known sick or "carrier" indj\idniU or animal, and the word qiiarantioo
to tl'.e 'iniil'i'ionspDl upon exposed or "contpot'' IndivldiMlsor per^on^.
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6. Methods of control— Con tin ued .
(B) General measures —
1. Inspection of meat, with condemnation of carcasses, or infected parts
of caixrasses, of infected animals.
2. Destruction of known animal sources of infection.
Acute Infectious Coi^unctivUis.
(Not including (nirhonuu)
(Ihis title to replace the terms gonorrheal ophthalmia, ophthalmia neonatonmi,
and babies' sore eyes.)
1 . Infectious agent' The gono<?occu8 or seme member of a group of pyogenic organisms,
including the hemoglobinophilic bacilli.
2. Source of infection: Discharges from conjunctivae, or adnexed, or genital' mucous
membranes of infected persons.
3. Modes of transmission: Contact with an infected jiei-JKjn or x^ith articles freshly
soiled with dii-ohargos i}f such prrpon.
4. Incubation peiiod: Irregular, but usually 3(j to 48 hours.
5. Period of communicabil it }j: During the course of the disease and imtil the discharges
from the infected mucous membranes have ceased,
6. Methods of control:
(A) The infected individual a.iA his puvironment —
1. Recognition ol the diHea5<' -Clinical symptoms, confirmed where
possible by bacteriological examination.
2. Isolation Nt>n<'. provided patient is under adequate medical
supervision.
3. Immunization — None.
4. Quarantine — None.
5. Concurrent disinfection — Du'infootion of conjunctival discharges and
articles soiled therewith.
6. Terminal disinfection- Thorough cleansing.
(B) General measures—
1. Enforcement of regulations forbidding the use of common towels
and toilet articles. Education ai to porsonal cleanliness.
2. Use of a .^'olution of silver nitrate in the eyes of the new born.
Anchylostomiasis.
(Hooliworm.)
1. Infectious a<7c/i/.— Anchyla^loma (^Xecator Americana duodenale).
2. ^"^ource oj infection.— h'ecea of infected persons. Infection generally takes place
through the skin, occasionally by the mouth.
3. Mode of transmimoi}., - By drinking water containing hrvse, by eating soiled food,
by hand to moutli li-anc^init-dion of the eu^^ or larv» from objects soiled with
infected flitM.harijo.M. The larval forms pierce the skin, and passing through the
lymphatics to thc^ vena oava and the ri<:bt heart, thence in the blowl stream to
the lungs, thoy pi^rm tho capilhir) walls and pass into the alveoli. Then they
pass up the bronchi ai»d i.aclica to the throat, whence they are swallowed and
finally lod.^e in ih<^ nnvill in(»'-nne.
4. Incubation jtfiod.- Steven u* 10 wcr^kn.
5. Period of communicability.—A^ lom^ as the parasite (.r itf ova aiv found in tlio bowel
discharges of an infected individual. Contaminated s il romiins infective for
five months in the ab^'uce of freezing'.
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6. Methods of CO. Urol -CoutiuucJ.
(B) General measures — Continued.
7. A physician should be constantly employed by every company
handlinnr raw hides, or such companies should operate under the
dired supervision of a medital representative of the hedth de-
partment.
8. Every employee haiidliog raw hides, hair, or bristles who has an
abrasion of the skin should immediately report to a physician.
9. Special instruction should be given to all employees handling raw
hides in regard to the necestiity of personal cleanlinee^.
10. Tanneries and woolen mills should be provided with proper venti-
lating apparatus ro that dust can be promptly removed.
11. Disinfection of hair, wool, and bristles of animals originating in known
infected centers before they are used or a8e«)rted.
12. The sale of hides from an animal infected with anthrax should be
prohibited. A violation of this regulation should be immediately
reported to the State commissioner of agriculture, by telegram,
stating the time, place, and purchaser to whom the hide was sold.
The rej>ort should also be sent to the person purchasing the hide.
Carcasses should be disposed of under the supervision of the State
department of agriculture. The inspection and disinfection of
imported hides are under the supervision of the United States
Bureau of Animal Industry. In the event that infection is intro-
duced the State agrieultiu^l authorities have jurisdiction over
infected animals and the local or State health authorities have
jurisdiction over infected persons.
Cerebrospinal Meningitis.
1. Infective agent: Diplucoccus intracellularis meningitidis (the meningococcus).
2. Source of infection: Discharge from the nose and mouth of infected persons. Clin-
ically recovered r-ase^, and healthy perpons who have never had the disease but
have been in contact with cases of the disease or other carriers, act as carriers
and are commonly found, especially during epidemics. Such healthy carriers
are not uncommonly found independent of epidemic prevalence of the disease.
3. Mode of tramnnlssion: By direct contact with infected persons and carriers, and
indirectly by contact with articles freshly 8c>iled with the nasal and mouth,
dis< barges of such persons.
4. Ineuhation period: Two 16 ten days, commonly seVen. Occasionally for longer
]>eriod8 when a pernon is a carrier for a time before developing the disease.
5. Period of commuuiiuhlity: During; the clinical course of the disease and until the
specific orj^ani.HiJi i« no Ioniser present in the nasal and mouth discharges of the
patient. The isame applies to healthy carriers so far as affects persistence of
infectious discharges.
6. Methods of control:
(A) The infected individual and his euvironment —
1. Recognition of the disease — Clinical symptoms, confirmed by the
microscopic and bacteriological examination of the spinal fluid, and
by bacteriological examination of nasal and pharyngeal secretions.
2. Isolation of infected persons and carriers until the nasopharynx is
free from the infecting organism, or, at the earliest, imtil one week
after the ft^ver has subsided.
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6. \f4ffu)ds of con (ml -Cuniinyxed.
(A) The infoctod individual and his environment— Continued.
3. Immunization may prove of value. Immunisation by the use of
vac cinos Ftill in the experimental stage.
1. Quarantine None.
5. ( onciUTenl disinfoction of dic3<?harges from the nose and mouth and of
articles aoili I therewith.
6. Terminal disinfection — Cleansing.
(B) General meaHures —
1. Search for carriers among families and associates of recognized cases
by bacteriological examination of posterior nares of all contacts.
2. Education as to personal cleanliness and necessity of avoiding con-
tact and droplet infection.
3. Prevention of overcrowding such as is common in living quarters,
tian8}>ortation conveyances, working places, and places of public
assembly in the civilian population, and in inadequately ventf-
lated closed quarters in barracks, camps, and ships among military
unit«.
Chicken Pox.
1. Infectious agent: Unknown.
2. Source of mfection: The infectious agent is presumably present in the lesions of
the skin and of the mucous membranes; the latter appearing early and rup-
turing as soon as they appear, render the disease communicable early; that is,
before the exanthem is in evidence.
3. Mode of transmission: Directly from person to person; indirectly through articles
freshly soiled by discharges from an infected individual,
4. Incubation period: Two to three weeks.
5. Period of communicabilitg: Until primary scabs have disappeared from the mucous
membranes and the skin.
6. Methods of control:
(A) The infected individual and his environment—
1. Recognition of the disease— Clinical symptoms. The differential
diaguoFis of this disease from smallpox is important, especially in
people over 15 years of age.
2. Isolation — Exclusion of patient from school and prevention of con-
tact with nonimmune persons.
3. Immunization — None.
4. Quarantine—None.
5. Concurrent disinfection of articles soiled by discharges from lesions.
6. Terminal disinfection — Through cleaning.
(B) General measures— None.
Cholera.
1. Infectious agent: Vibrio cljolera'.
2. Source ofinfcrlion: Bowel discharges and vomitus of infected persons, and feces of
convalescent or healthy carriers. Ten per cent of contacts may be found to
be carriers.
3. Mode of transmlsston: By food and water polluted by infectious agent; by contact
with infected persons, carriers, or articles freshly soiled by their dischaiges;
by flies.
4. Incubation period: One to five, usually three, days, occasionally longer if the healthy
carrier stage, before development of s\Tnptomp, is included.
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5. Period of eommunieability: Usually 7 to 14 days or longer and until the infectious
organism is absent frojaa the bowel discharges.
6, Methods of control'
(A) .The infected individual and his environment—
1. Recognition of the disease — Clinical symptoms, coniirmed by bacte-
riological examination.
2. Isolation of patient in hoepital or screened room.
3. Immunization may be of value by vaccination.
4. Quarantine — Contacts for five days from last exposure.
5. Concurrent disinfection — Prompt and thorough disinfectioii of the
BtoolB and vomited matter. Articles used by and in connection
with the patient must be disinfected before removal from room.
Food left by the patient should be bmned.
6. Terminal disinfection- Bodies of those dying from cholera should be
cremated if practicable, or, otherwise, wrapped in a sheet if©t with
disinfectant solution and placed in water-tight caskets. The room
in which a sick patient was isolated should be thoroughly cleansed
and disinfected.
(B) General measures—
1. Rigid personal prophylaxis of attendants by scrupulous cleanliness,
disinfection of hands each time after handling patient or touching
articles contaminated by dejecta, the avoidance of eating or drink-
ing anything in the room of the patient, and the prohibition of
those attendant on the sick from entering the kitchen.
2. The bacteriological examination of the stools of all contacts to deter-
mine carriers. Isolation of carriers.
3. Water should be boiled, if used for drinking or toilet purposes, or is
used in washing dishes or food containers, unless the water supply
is adequately protected against contamination or is so treated, as
by chlorination, that the cholera vibrio can not survive in it.
4. Careful supervision of food and drink. Where cholera is prevalent,
only cooked foods should be used. Food and drink after cooking
or boiling should be protected against contandnation, as by flies
and human handling,
(C) Epidemic measures-
Inspection service for early detection and isolation of cases; examination
of persons exposed in infected centers for detection of carriers, the
isolation or control of carriers; disinfection of rooms occupied by the
siftk, and the detention, in suitable camps for five days, of those
desirous of leaving for another locality. Those so detained should
be examined for detection of carriers
Dengue.
1. Infections agod: Unknown.
2. Source of infection: The blood of infected persons.
3. Mode of transmimion: By the bite of infected mosquitoes, probably the culex
fatigans.
4. Incubation period: Four to five days.
5. Period of eommunieability: During the febrile ^ta^e of the <li.M'a<<'
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6. Methods of control:
(A) The infected individual and his onvironmeDt —
1. Recognition of the disease — C linical symptoms.
2. Isolation — ^The patient must be kept in a screened rootn.
3. Immunization — None,
4. Quarantine— None.
5. Concurrent disinfection — None.
6. Terminal disinfection- None. Upon termination of the case, fumi-
gation of the room and house, to destroy mosquitoes.
(B) General measures —
Measures directed toward elimination of mosquitoes. Screening of
rooms.
Diphtheria.
1. Infectious agent- Bacillus diphtheria (the Klebs-Loeffler bacillus).
2. Sottrce of infection: Discharores from diphtheritic lesions of noee, throat, conjunctiva,
vagina, and wound aurfacos. Secretions from the nose and throat of carriers
of the bacillus.
3. Mode of transmission: Directly by personal contact, indirectly by articles freshly
soiled with discharges, or through infected milk or milk products.
4. Incubation period: Usually two to five days, occasionally longer if a healthy carrier
stage precedes the development of clinical symptoms.
5. Period of communicability: Until virulent bacilli have disappeared from the secre-
tions and the lesions. The persistence of the bacilli after the lesions have
healed is variable. In fully three-quarters of the cases they disappear
within two weeks. In exceptional cases virulent bacilli remain in the throat
and discharges for from two to six months.
6. Methods of control:
(A) The infected individual and his ^environment —
1. Recognition of the diseaee— By clinical symptoms, always to be con-
firmed by bacteriological examination.
2. Isolation — Until two cultures from the throat and two from the noee,
taken not less than 24 hours apart, fail to show the presence of
diphtheria bacilli. Isolation may be terminated if persistent
diphtheria bacilli prove virulent.
3. Immunization — Ex}xxsc(l susceptibles to be promptly immunized by
antitoxin. (By susceptibles is meant such individuals as are
found to be nonimmune by the Schick test.)
4. Quarantine — All exposed persons until shown by bacteriolc^cal exam-
ination not to be carriers.
5. Concurrent disinfection of all articles which have been in contact
with the patient and all articles soiled by dL«rharges from the
patient.
6. Terminal disinfection- At the end of the illness, thorough airing of the
sick room, with cleansing or renovation.
(B) General measures — *
1. Pasteurization of milk supply.
2. Application of the Schick test to all contacts, and imnuuii/ation of
all susceptibles.
3. Application of the Schick test to all children.
4. Immuni'/ation by toxin-antitoxin inoculation of all susceptibles.
5. Detcnuine presence or absence of carriers among contacts, and, so far
as practicable, in the community at large.
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Dysenteiy (Ain<ebic).
1. Hfiffetiou^ agent: Amoeba hi-^tolytica.
2. Smtrce of in/eriton: The 1 owel discharges of infeoted pefsona.
3. Motif €^ iraiumistion: By drinkiDi^ rontaminated water, and by eating infected
foods, and y hand to mouth transfer of infected materia) ; from o jects soiled
with discharges of an infected individual, or of a carrier; by flies.
4. Incubation period: Unknown.
5. Period of commitnicabiiily: During course of disease and until repeated microscopic
examination of stools shows a! sence ol amoeua histolytica.
6. Methods of control-
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confinned by micro-
scopic examination of stools.
2. iFolation — None.
3. Immunization — None.
4. Quarantine — None.
5. Concurrent disinfection of the bowel dischargea.
6. Terminal disinfection — Cleansing.
(B) General measures —
1. Boil drinking water unless enppky is known to be free horn contaminar
tion.
2. Water supply should be protected agsiitst cootamination and supei^
vision should be exercised over all foods eaten raw.
Dysentery (BadUary).
1. In/eclious agent: Bacillus dysenteriae.
2. Source of infection: The bowel discharges of infected persons.
3. Mode of trawmimon: By drinking contaminated water, and by eating infected
foods, and 1 y hand-to-mouth transfer of infected material; from objects soiled
with discharges of an infected individual or of a carrier; by flies.
4. Incubation period: Two to seven days.
6. Period of commumcahUitg: During the febrile period of ihe disease and untfl the
organism is a sent from the 1 owel discharges.
6. Methods of control:
(A) The infected individutl and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by sero-
logical and I acteriolcM2:ical tests.
2. Isolation — Infected individuals during the commimicable period of
the disease.
3. Immunization — Vaccines give considerable immunity. Owing to
severe reactions their use is not universal, nor should it be made
compuleoiry except under extreme emergency.
4. Quarantine — None.
5. Concurrent disinfection — Bowel discharges.
6. Terminal disinfection — Cleansing.
(B) General measures —
1. Rigid personal prophylaxis of attendants upon infected persons.
2. No milk or food for human consumption should ^ e sold from a place
occupied by a patient unless the persons engaged therein occupy
quarters separate from the house where the patient is sick, and aD
utensils used are cleaned and kept in a separate iuilding, and under
a permit from the health officer.
3. All attendants upon persons affecUnl with this disease .should Ue pro-
hi ited from having anything to do with the handlinsr of food.
4. Nece8>!ary precautions n^ain^t Hies.
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Fams.
1. Infectious agent: Achorion Schoenleini.
2. SovTce of infection: Lesions of skin, particularly on Ecalp.
3. Mode of transmission: Direct contact with patient and indirectly throtifrh toilet
articles.
4. Incubation period: Unknown.
5. Period of communicability: Until skin and scalp lesions are all healed.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms confirmed by iDicn>-
scopic examination of crusts.
2. Isolation — Exclusion of patient from school and other public plat'c*9
until lesions are healed.
3. Immunization — None.
4. Quarantine — None.
5. Concurrent disinfection — TuiUa aiiicles of patient.
6. Terminal disinfection — None.
(B) General meapures-
1. Elimination of common utensils, such as hair brushes and combs,
2. Provision for adequate and intensive treatment and cure of cases of
favus at hospitals and dispensaries, to abbrevate the period of in-
fect ivity of the patientfl.
German Measles.
1. Infectious agent: Unknown.
2. Source of infection: Secretions of the mouth and possibly of the nose.
3. Mode of transmission: By direct contact with the patient or with articles freshly
soiled with the discharges from the nose or throat of the patient.
4. Incubation period: From 10 to 21 days.
5. Period of coniinum'cohility: Eight days from onbet of the disease.
6. Method of control:
(A) The infected individual and his environment —
1. R{'cogriition of the dinea.se — Clinical symptoms.
2. Isolation — Separation of the patient from nonimmune children, and
exclusion of the patient from s( hool and public places for the period
of presumed infect ivity.
3. Immunization — None.
4. Quarantine — None except exclusion of nonimmune children from
school and public gatherings, from the eleventh to the t\\eiity-
second day from date of ex})osiire to a recognized case.
5. Concurrent disinfection — Discharges from the nose and throat of the
patient and articles soiled hy discharges.
6. Terminal disinfection -Airii^.g and cleansing.
(B) General measures —
None.
Note.— Tlio reason for attempting to cornrol (bis di . dc is that il may Ix' coiifused with soiirl-'! fe- er
during its early .<:ta?ps: ca?h person hann^ ,'^;. :npK»;iis of \h^ distiiro . houM f1i:^rcroro Ic pla'x^d un«J^r tlie
carcof a physician nnd the '.^..>;' -Ju/uM l>e report '^d to *h ^ ^. :i] '\ ;: rtn^on' cf'rj:'h.
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Glanders.
1. In/fctious agent: Bacillud mallei.
2. Source oj in/tclion: Dificharges from open leeione of mucous membranes, or of the
skin of human or oqume cases of the disease (i. e., pus and mucous from the
nose, throat, and bowel discharges from infected man and horse).
3. Mode of transmission: Contact \iith a case or with articles freshly soiled by dis-
charges from a human or equine case.
4. Incubation period: Unknown.
5. Period of communicabililif: Until bacilli disappear from discharge^ or until lesions
have healed.
0. Methods of control:
(A) The infect<?d individual and his environment—
1. Recognition of the disease — By specific biological reactions, such as
the complement fixation test, the mallein test, the agglutination
test, or by nonspecific reactions, such as the Straus reaction, if
confirmed by culture, or by identification of the bacillus mallei,
or by autopsy of doubtful cases.
2. Isolation— Human case at home or hospital; for infected horses de-
struction rather than isolation is advised.
3. Tmn^mization— None of established value or generally accepted.
4. Quarantine of all horses in an infected stable until all have been tested
by specific reaction, and the removal of infected horses and termi-
nal disinfection of stable have been accomplished.
5. Concurrent disinfection Discharges from human cases and articles
soiled therewith.
a. Terminal disin fetation— Stables and contentii in horse cases of the
disease.
(B"; (ieneral measures
1. The abolition of the conuuou drinking trough for horses.
2. Sanitary supervi'^ion of stables and blacksmith shops.
NoTR.— In this disea.so, as in all infectious orcommuoicablc diseases from which both uiimftlsaudhumaua
siifler, cases occurring in aniniois .should be reported to the Department of .\pricalture and human cases
should bo reported to the Doparlment of Health, recipro^l notification thereafter to be accompUfhed
through oHicial intenlopartmenJ channels.
Gonorrlioea.
1. In/ectious agent: Gonococcus.
2. Source of injiction: Dischai-j^es from lesions of inflamed mucous membranes and
glands of infected per*>n8, viz, urethral, vaginal, cervical, conjunctival mucous
membranes, and Bartholin's or Skene's glands in the female, and Cowper's and
the prostate glands in the male.
3. Mode of transmission: By direct personal contact with infected persons, and in-
directly by contact with articles freshly soiled with the disiharges of such persons.
4. Incubation period: One to eight days, usually three to five days.
5. Period of commnnicahility: As long as the gonococcus persists in any of the dis-
charges, whether the infection be an old or a recent one.
6. Methods of control:
(A) The infected individual and hie environment —
1. Recognition of the disease — Clinical symptoms, confirmed by ba<'-
teriolor^ical examination or serum reaction.
2. Isolation— WTien the lesions are in the genittvminary tract, exclusion
from sexual contact, and when the lesions are conjunctival, ex-
clusion from school or contact with children, as long as the dis-
charges contain the infecting organism.
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6. Methods of control — Continued.
(A) The infected individual and his environment- Continued.
3. immunization — None.
4. Quarantine -None.
5. (Joncurrent disinfection- Diprhargo? from lesions and articles S4»iled
there\vith.
G. Terminal disinfection — None.
(B) General measures -
1. Education in matters of sexual hygiene, particularly as to tUe fact
that continence in both sexes at all ages is compatible with health
and development.
2. ProWsion for accurate and early diagnosis, and treatment in hospitals
and disj^onsaries of infected persons with consideration for privacy
of record and provision for following cases until cured.
3. Repression of prostitution by use of police power and control of use of
living promises.
4. Restriction of sale of alcoholic beverages.
6. Restrictions of advertising of services or medicines for the treatment
of sex diseases, etc.
6. Elimination of common towels and toilet article^ from public places.
7. Use of pro{)hy lactic silver solution in the eyes of the new born.
8. Exclusion of persons in the communicable stage of the disease from
participation in the preparing and serving of food.
9. Personal prophylaxis should be ad\ised to those who expose them-
selves to opportunity for infection.
Leprosy.
1. Infectious agent: Bacillus leprer.
2. Source of infection: Discharges from lesions.
3. Mode of transmission: By close, intimate, and prolonged contact with infected
individuals. Flies and other insects may be mechanical carriers.
4. Incubation period: Prolonged, undetermined.
5. Period of communicabilUy: Infectivity exists throughout the duration of the disease.
Under ordinary conditions this disease is but slightly communicable.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease— Clinical symptoms, confirmed by bac-
teriological examination.
2. Isolation for life in national leprosarium when this is possible.
3. Immunization — None.
4. Quarantine— None.
5. Concurrent disinfection— Discharges and articles soiled with dis-
charges.
6. Terminal disinfection — ^Thorough cleansing of living premises of
the patient.
(B) General measures —
1. Lack of information as to the determining factors in the spread and
communication of the disease makes any but general advice in
matters of personal hygiene of no value.
2. As a temporary expedient, lepers may be properly cared for in local
hospitals, or if conditions of the patient and his environment war-
rant, he may be allowed to remain on his own premises under suitable
regulations.
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Malaria.
1. Infectious agent: TIr- vHovoral hpeoiea of malarial orgaiiiauis
2. Source of infection: The blood of an infected individual.
3. Mode of trnnsmissiou: By bite of infected anopheles mosquito. The mosquiu) is
infected by biting an individual sufferint? from acute or chronic malaria. The
parasite develops in the body of the mostjuito for from 10 to 14 days, after whirh
time the sporozoites appear in its salivary gland.
4. Incubation period: Varies with the type of sj>ecies of infecting organism and the
amount of infection; usually 14 days in the tertian variety.
5. Period of communicabiUiy: As long as the malaria organism exists in the blood.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical sjinptoms, always to bo con-
firmed by microscopical examination of the blood.
2. Isolation — Exclusion of patient from approach of mosquitoes, until his
blood is rendered free from malarial parasites by thorough treatment
with quinine.
3. Immunization — None. The administration of prohylactic doses of
quinine accomplishes the same result, and should be insisted upon
for those constantly exposed to infection and unable to protert
themselves against anopheles mosquitoes.
4. Quarantine — None.
6. Concurrent disinfection — None. t)e8truction of anopheles mosquitoes
in. the sick room.
6. Terminal disinfection —None. Destruction of anopheles mosquitoes
in the sick room.
(B) General measures —
1. Employment of known measures for destroying larvaj of anophelines
and the eradication of breeding places of those mosquitoes.
2. Blood examination of persons living in infected centers to determine
the incidence of infection.
3. Screening sleeping and living quarters; xise of mo^fiuito nets.
4. Killing mosquitoes in living quarters.
Measles.
1. Infectious agent. — A filterable virus.
2. Source of infection. — Buccal and nasal secretions of an infected individual.
3. Mode of transmission. — Directly from person to person; indirectly through ariifles
freshly soiled with the buccal and nasal discharges of an iuio( tod individual.
The most easily transmitted of all communicable diseai'es.
4. Incubation period. — Seven to eighteen days; usually 14 days.
6. Period of communicability. — During the period of catarrhal symptoms and until the
cessation of abnormal mucous n.embrane secretions — minimum period of seven
days; from two days before to five days after the appearance- of the rash.
6. Methods of control:
(A) The infected individual and hk enviromnent —
1. Recognition of the disease — Clinical syn ptoms. Special atleutiuu lo
rise of tenperature. Koplik spotH and catarrhal symptoir..- in
exposed individuals.
2. Isolation — During period of communicability.
3. Immunization — None.
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6. Methods of control— Contmucd.
(A) The infected individual and his environment — Continued.
4. Quarantine — Exclusion of exposed susceptible ecliool children and
teachers from school until 14 days from la^t exposure. This applies
to exposiue in the house hold. Exclusion of exposed susceptible
children from all public gatherings for the same period.
5. Conciurent disinfection — All article.*? soiled with the secretions of the
. nose and throat.
6. Terminal disinfection Thorough cleansing.
(B) General measiues-
1. Daily examination of exposed children and of other possibly expaeted
persons. This examination should include record of the body tem-
perature. A nonimmune exposed individual exhibiting a rise of
temperature of 0.5° C. or more should be promptly isolated pending
diagnosis.
2. Schools should not be closed or classes discontinued where daily
observation of the children by a doctor or nurse is available.
3. Education as to special danger of exposing young children to those
exhibiting acute catarrhal symptoms of any kind.
Mumps.
1. Infective organism. — Unknown.
2. Source of infection. — Secretions-of the mouth and poasibly of the nose.
3. Mode of transmission. — By direct contact with an infected person or with articles
freshly soiled with the discharges from the nose or throat of such infected person.
4. Incubation period. — From 4 to 25 days. The most common period, 14 days, ac- ,
cepted as usual. Ther maximum common period 21 days.
5. Period of communicability. — Unknown, but assumed to persist until the parotid
gland has returned to its normal size.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Inflammation of Stono's duct may be of
assistance in recognizing the early stage of the disease. The diag-
nosis is usually made on swelling of the parotid gland.
2. Isolation — Separaticm of the patient froia iionininiune children and
exclusion of the patient from school and public places for the period
01 presumed infectivity. (Sec V).
3. Immunization — None.
4. Quarantine — Limited to exclusion of nonimmune children from school
and public gatherin<,'s for 14 days after last exposure to a recognized
case.
5. Concurrent disinfo< tii)n All articles soiled with the discharges from the
nose and throat of the patient.
6. Terminal disinfection — None.
(B) General measures- -•
None.
Paratyphoid Fever.
1. Infectious agent: Bacillus paratyphosus A or B.
2. Source of inftction: Bowel discharges and urine of infected persons, and foods con*'
taminated with such discharges of infected persuus or of healthy carriers.
Healthy carriers may be numerous in an outbreak.
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3. Mode of transmission: Directly by personal contact; indirectly by contac!t with
articles freshly soiled with the discharges of infected persons or through milk,
water, or food contaminated by such discharges.
4. Licubation period: Four to ten days; average, se^•en days.
5. Period of communicability: From the appearance of prodromal symptoms, through-
out the illness and relapses, during convalescence, and until repeated bacterio-
logical examination of discharges show absence of the infecting organism.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by specific
agglutination test, and by bacteriological examination of blood,
bowel discharges, or urine.
2. Isolation— In fly-proof room, preferably under hospital conditions of
such cases as can not command adequate sanitary environment
and nursing care in their homes.
3. Immimization of exposed susceptibles.
4. Quarantine— None.
5. Concurrent disinfection — Disinfection of all bowel and urinary dis-
charges and articles soiled with them.
6. Terminal disinfection— Cleansing.
(B) General measures—
1. Purification of public water supplies.
2. Pasteurization of public milk supplies.
3. Supervision of other fcod supplies and of food handlers.'
4. Prevention of fly breeding.
5. Sanitary disposal of human excreta.
6. Extension of immunization by vaccination as far as practicable.
7. Supervision of pamtyi)hoid carriers and their exclusion from the
handling of foods.
8. Systematic examination of fecal specimens, from those who have been
in contact with recognized cases, to detect carriers.
9. Exclusion of suspected milk supplies pending discovery of the per-
son or other cause of contamination of the milk.
10. Exclusion of water supply, if contaminated, until adequately treated
with hypochlorite or other efficient disinfectant, or unless all
water used for toilet, cooking, and drinking purposes is boiled
before use.
Plague.
(Bubonic, Septicemic, Pneamonlc.)
1. Infectious agent. — Bacillus pestis.
2. Source of infection. — Blood of infected persons and animals, and sputum of human
cases of plague pneumonia.
3. Mode of transmission.— Direct in the pneumonic form. In other forms the disease
is generally transmitted by the bites of fleas (Loemopsylla cheopis and cera-
tophyllus fasciatus), by which the disease is carried from rats to man, also by
fleas from other rodents. Accidental, by inoculation, or by the bites of infected
animals. Bedbugs may transmit the infection; flies may possibly convey the
infection.
» The human disease paratyphoid fever shorild not Ije confused \>ith cases of food poisoning, or Infection
doe to paratyphoid enterilidls bacilli uf unimal origin.
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4. Incubation ^xriod. — Commonly from 3 to 7 days, although occasionally proloBged
to 8 or even 14 days.
6. Period of cam inunlcnbUity . — Until convalescence is well established, period unde-
termined.
6. Methods of control:
(A) The infectod individual and his environment —
1. Recognition of the disease — Clinical 8\'niptomB, confirmed by bac-
teriological examination of blood, piid from glandular lesions, or
sputum.
2. Isolation — Patient in hospitaf if practicable; if not, in a screened
room which is free from vermin.*
3. Imraunizati(m-^ Passive immunization of known exposed contacts;
active immimization of those who may be oxpoeed.
4. Quarantine — (V)n tacts for seven days.
5. Concurrent disinfection — All discharges and articles freshly soiled
therewith.
6. Terminal disinfection — Thorough cleansing followed by thorough
disinfection.
(B) General measures —
1. Extermination of rats and vermin by use of known methods for their
destruction; destruction of rats on ships arriving from infected ports;
examination of rats, ground squirrels, etc., in areas where the infec-
tion persists, for exidence of endemic or epidemic prevalence of the
disease among them.
2. Supervision of autop^^ies of all deaths during epidemics.
3. Supervision of the disp«>sal of the dead durini? epidemics, whether
by burial, transfer, or holding in vault, whate\-er the cause of death.
4. Cremation, or burial in quick lime, of those dying of this disease.
Poltomyelitis.
1. Infediou* ofient: Not definitely determined. Believed to be a filterable virus.
2. Source of infection: Nose, throat, and bowel dischargee of infected persons or articles
recently soiled therewith. Healthy carriers are supposed to be common.
3. Mode of troTifmission: By direct contact with an infected person or with a carrier
of the virus, or indirertly by contact with articles freshly soiled with the nose,
throat, or bowel discharge's of such pi'rsons.
4. Jnnihation pcritni: From 3 to 10 da>'8, commonly 6 days.
6. PeruMi of cnmmunicability: Unknown; apparently not more than 21 days from the
onset of disease.
6. Methods of ont ml:
{A) The iufoctetl individual and his en\-ironment —
1. Reroj^ition of the di-n^a-^e — Clinical sjinptoma, asm^'tcd by chemical
and micros' opirai examination of the spinal fluid.
2. Inolati(»n of all recognized cases in screened rooms.
3. Iminunization — None.
4. Quarantine of exposed children of the household and of adults of the
hous<'hold whose vocation brings them into contact with children^
or who are food handlers, for 14 da>*B from last exposure to a retxig-
ni/,« <l (a^e.
• In plAKiM pDr^imoria, prnwwttl pmphyhixls, to avdd dropJrt tnrertian. must be carried oat by
torn who iHjmc In t<»m:i t wiih iho ^i< k. Ma^ks or vfAis of rtitfso ckHh should be
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6. Methods of control — Continued.
(A) The infected individual and his environment — Continued.
5. Concurrent disinfection — ^Nose, throat, and bowel discharges and arti-
cles soiled therewith.
6. Terminal disinfection — Cleansing.
(B) General measures during epidemics —
1. Search for and examination of all sick children should be made.
2. All children with fever should be isolated pending diagnosis.
3. Education in such technique of bedside nursing as will prevent the
distribution of infectious discharges to others from cases i^^olated at
home.
Rabies.
1. Infectious agent: Unknown.
2. Source of infection: Saliva of infected animals, chiefly dogs.
3. Mode of transmission: Inoculation with saliva of infected animals through abrasion
of sldn or mucus membrane, almost always by bites or scratches.
4. Incubation period: Usually 2 to 6 weeks. May be prolonged to 6 months or even
longer.
6. Period of communicahility: For 15 days (in the dog; not known in man) before the
onset of clinical symptoms and throughout the clinical course of the disease.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by the
presence of Negri bodies in the brain of an infected animal, or by
animal inoculations with material from the brain of such infected
animal.
2. Isolation — None if patient is under adequate medical supervision, and
the immediate attendants are warned of possibility of inoculation
by human virus.
3. Inmiunization — Preventive vaccination (Pasteur treatment) after ex-
posure to infection by inoculation.
4. Quarantine — None.
6. Conciurent disinfection of saliva of patient and articles soiled there-
with.
6. Terminal disinfection — Thorough cleansing.
(B) General measures —
1. Muzzling of dogs when on public streets or in places to which the
public has access.
2. Detention and examination of dogs suspected of having rabies.
3. Immediate antirabic treatment of people bitten by dogs or by oiher
animals suppected or known to have rabies, unless the animal is
proved not to be rabid by subsequent observation or by microscnpio
examination of the brain and cord.
Pneumonia.
Acnte Lobar.
1. Infectious aj^CTi/.-r- Various pathogenic bactt^ria commonly found in the nose, throat,
and mouth, such as the pneumococcus, the bacillus of Friedlander, the influenza
bacillus, etc.
2. Source of infection. — Discharges from the mouth and noge of apparently hoalthy
carriers, as well as of recognized infected individuals, and articles fn i^lily
soiled with such discharges.
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3. Mode o/lransmisftion. — By direct contact with an infected person, or with uticlei
freshly soiled with the di8chai:ges from the nose or throat of, and poesibly from
infected dust of rooms occupied by, infected persons.
4. Incubation period. — Short, usually two to three days.
5. Perioit oj communicahility . — Unknown; presumably until the mouth and nasal dis-
charges no longer carry the infectious agent in an abundant amount or in a
virulent form.
6. Methods of control*
(A) The infectod individual and his environment — ■
1. Recognition of the dis^^ase — Clinical symptoms. Bpooific infecting
organisms may bo determined by serological and bacteriological
tests early in the course of the disease.
2. Isolation — Patient during clinical course of the disease.
3. Immunis^ation — None; vaccines are worthy of further careful txiaL
4. Quarantine— None.
5. Concurrent disinfection — Discharges from the noue and throat of the
patient.
G. Tor ninal disinfection — Thorough cleansing, airing, and sunning.
(B) General measures —
In institutions and camps, when practicable, people in large numbers
should not be congregated closely within doers. The general re-
sistance should be conserved by good feeding, fresh air. temperance
in the use of alcoholic beverages, and other hygienic measures.
Note.— Th« carl> reportlnji of pneamonia Is hi::hly flcsimHlo in vlttr o( Its oommuui^.'ahillty and lbs
possibility ofellectiro lrc«tment of cerUio lypes with ctinUvc wra.
Rocky Mountain Spotted or Tick Fcror.
1 . Injectio us agent. — U nkno wn .
2. Soitrce of injtction.- -Blood of init^cted animals, and infected ticks (Dermacentor
ppeciej*).
3. Mode oj transmi.ssion. — By bites of infe<'letl tiekn.
4. Incubatioti period. — Three to ten days, usually wven dayp.
6. Period of communirahility. — Has not been definitely detennined, probably during
the febrile st:\go of the disease.
6. Methods of control :
(A) The infe<'ted individual and hl^ environment -
1. Recoi^nition of the di^^ea.-*© —By clinical symptom^ of the disease in
arenas where the diseai*<» is known to Ikj endemic.
2. Isolation — None other than care exercu*ed to prutcct patients from
tick bitort when in endemic areiis.
3. Immunization — None.
4. Quarantine — None.
6. ('oneiirrent disinfection- -.\one. All ticks on the patient should be
de-troyed.
6. Terminal diMufertion —Ntnie.
(B) General miMii'un*-
1. Terminal pn-phvlaxi^ of fM»n*c»ns entering the infected aooes during
tho w«mn of tirks, by w<^rin£r tick-proof clothing, and careful daily
pearch of the fM>dy for tieks whieh may have attached theoMelves.
2. The dennirtion of ticks by olmring and burning vegetation on the
land in inf<*f*tefl zone-*.
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6. Methods of control — Continued.
(B) General measures — Continued.
3. The destruction of ticks on domestic animals by dipping, and the
pasturing of sheep on tick-infested areas where the disease is prev-
alent, with the object of diminishing the number of ticks.
4. The destruction of small mammalian hosts as ground squirrels,
chipmimks, etc.
Scarlet Fever.
1. Infectious agent. — Unknown.
2. Source of infection, — The belief at present is that the virus is contained in the secre-
tions from th,e nose and throat, in the blood and in the lymph nodes, and that it is
given off in the discharges from the mouth, the nose, the ears, and from broken-
down glands of infected persons.
3. Mode of transmission. — Directly by personal contact with an infected person; indi-
rectly by articles freshly soiled with discharges of an infected person, or through
contaminated milk.
4. Incubation period, — Two to seven days, usually three or four days.
5. Period of communicahiiity . — Four weeks from the onset of the disease, and until all
abnormal discharges have stopped and all open sores have healed.
6. Methods of control. —
(A) The infected individual and his environment—
1. Recognition of the disease — By clinical symptoms.
2. Isolation — In home or hospital, maintained in each case until the
end of the period of infectivity.
3. Immunization — None.
4. Quarantine — Exclusion of exposed siis'^eptible children and teachers
from school, and food handlers from their work, until five days
haye elapsed since last exposure to a recognized case.
6. (.'oncurrent disinfection — Of all articles which have been in contact
with a patient and all articles soiled with discharges of the patient.
6. Terminal disinfection— Thorough cleansing.
(B) General measures —
1. Daily examination of exposed children and of other possibly exposed
persons for a week after last exposure.
2. Schools should not be closed where daily ob83rvation of the children
by a doctor or nurse is available.
3. Education as to special danger of exposing young children to those
exhibiting acute catarrhal Hymptonis of any kind.
4. Pasteurization of milk supply.
Septic Sore Throat
1. Infectious age at.- Streptococcus (hemolytic typo).
2. Source of mfrrthn.^- The human naso-pharynx, usually the tonsils, any case of
acute streptococcus inflammation of these stnictures being a potential source
of infection, including the period of convalescence of such caaoa. The udder
of a cow infected by the milker is an occasional source of infection. In such
udders tho physical signs of mastitis are usually absent.
» Direct human contamination of milk is only rarely, if ever, a cause of infection. Mastitis in the cow,
dtie to bovine streptococci, is not a cause of septic sore throat in humans unless a secondary infection of
the udder by a human type of streptococcus takes place.
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3. Mode of transmission. — Direct or indirect human contact; consumption of »w milk
from an infected udder.
4. Incubation period. — One to three dsys.
6. Period of communicability. — In man, presumably diuing the continuance of clini-
cal symptoms; in the cow, during the continuance of discharge of the strepto-
cocci in the milk, the condition in the udder tending to a spontaneous subsi-
dence. The carrier stage may follow couvaleecence and persist for some time.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms. Bacteriological ex-
amination of the lesions or dischai^ges from the tonsils and naso-
pharynx may bo useful.
2. Isolation — During the clinical course of the disease and convalescence,
and particularly exclusion of the patient from participation in the
production or handling of milk or milk products.
3. Immunization — None.
4. Quarantine — None.
5. Concurrent disinfection — ^Articles soiled with discharges from the nose
and throat of the patient.
6. Terminal disinfection — Cleansing.
(B) General measures —
1. Exclusion of suspected milk supply from public sale or use, until pas-
teurized. The exclusion of the milk of an infected cow or cows
in small herds is possible when based on bacteriological examina-
tion of the milk of each cow, and preferably the milk from each
quarter of the udder at frequent intervals.
2. Pasteurization of all milk.
3. Education in the principles of personal hygiene and avoidance of the
use of common toilet, drinking and eating utensils.
Smallpox.
1. Infectious agent. — Unknown.
2. Source of infection. — Lesions of the skin and mucous membranes of infected persons.
3. Mode of transmission. — By direct personal contact; by articles soiled ^ith dis-
charges from lesions. The \dru8 may be present in all body discharges, includ-
ing feces and urine. It may be carried by flies.
4. Incubation period. — Twelve to fourteen days.
5. Period of communicability. — From first symptoms to disappearance of all scabs
and crusts.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms. Laboratory tests
for immunity may prove useful.
2. Isolation — Hospital isolation in screened wards, free from vermin,
until the period of infectivity is over.
3. Immunization — Vaccination.
4. Quarantine — Segregation of all exposed persons for 14 days from
date of last exposure, or until protected by vaccination.
5. Concurrent disinfection of all dischai-ges and articles soiled there-
with.
6. Terminal disinfection — Thorough cleansing and disinfectioii of
premises.
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6. Methods i>f control Confinucd.
(B) General measures —
General vaccination in infancy, revaccination of children on entering
pohool, and of entire i)opulatien when the disease is prevalent.
NoTE.—Tht3 time of vjiccination of infants to avoid teething or other mild and common indispositions,
the time of vaccination of children of the runabout age and older with preference for Ihc cool months of
the year, and the maimer of vaccination with preference for the single puncture or small area scratch
method throti;;h the droplet of virus are important to observe in order to avoid possible complications or
secondary and subsequent infections at the site of vaccination.
Syphilis.
1. Infectious agent. — Treponema pallidum.
2. Source of infection. — Dischargee from the lesions of the skin and mucous mem-
branes, and the blood of infected persons, and articles freshly soiled with
such discharges or blood in which the treponema pallidum is present.
3. Mode of transmission. — By direct pergonal contact with infected persons, and
indirectly by contact with discharges from lesions or with the blood of such
persons.
4. Incubation period. — About three weeks.
6. Period ofcommunicability. — As long as the lesions are open upon the skin or mucous
n^embranes and until the body is freed from the infecting organisms, as shown
by microscopic examination of material from ulcers and by serum reactionp.
6. Methods of control:
(A) Hie infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by micro-
scopical examination of discharges and by serum reactions.
.2. Isolation— Exclusion from sexual contact and from preparation or
serving of food during the early and active period of the disease;
otherwise none, unless the patient is unwilling to heed, or is inca-
pable of observing, the precautions required by the medical
adviser.
3. Immunization— None.
4. Quarantine — None.
5. Concurrent disinfection of discharges and of articles soiled therewith-
6. Terminal disinfection — None.
(B) General measures —
1. Education in matters of sexual hygiene, particularly as to the fact
that continence in both sexes and at all ages is compatible with
health and development.
2. Provision for accurate and early diagnonis and treatment, in hospitals
and dispensaries, of infected persons, with consideration for privacy
of record, and provision for following cases until cured.
3. Repression of prostitution by use of the police power and control of
use of living premises.
4. Restriction of sale of alcoholic beverages.
6. Restriction of advertising of services or medicines for treatment of
sex diseases, etc.
6. Abandonment of the use of conmion towels, cu})s, and t(»il f nrtifloH
and eating utensihj.
7. Exclusion of persons in the communicable stai^o of the diseast* from
participation in the preparing and serving of food.
8. Personal prophylaxis should be advipod to tboso who expose them-
selves to opportunity to infection.
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Tetanus.
1. Inftctious agent- Bacillus tetani.
2. Source of infection: Animal manure, and soil fertilized Tnth animal manure, ftnd,
rarely, the discharges from wounds.
3. Mode of trantmimon: Inoculation, or wound infection.
4. Incubation -period: Six to fourteen da>^, usually nine.
6. Period of communicahility: Patient not infectious except in rare inntanccs when
wound dischargee are infectious.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Qinical fiymptoms; may be confinned
bacteriologically.
2. laoUtion — None.
3. Immunization — By antitoxin, eingle or repeated injection*
4. Quarantine — None.
5. Concurrent dinnlecticm — None.
6. Terminal disinfection — None.
(B) General measures —
1. Supervision of the practice of obstetrics.
2. Educational propaganda such as ^'safety-fint" campaign, anj "safe
and sane Fourth of July '* campaign.
3. Prophylactic use of tetanus antitoxin where wounds have beea
acquired in regions where the soil is known to be heavily contami-
nated, and in all cases where wounds are ragged or penetrating.
4. Supervision of biological products, especially vaccines and sera.
6. B^oval of all foreign matter as early as possible from all wounds.
Trachonia.
1. InfecHout agent: * The chief, although not yet known to be the only, infectious
agentfl are the hemoglobinophilic bacilli including the so-called Koch-Weeks
bacillus.
2. Source of infection: Secretions and purulent discharges from the conjunctivae and
adnexed mucous membranes of the infected persons.
3. Mode of transmission: By direct contact with infected persons and indirectly by
contact with articles frej*hly soiled with the infective discharges of such penons.
4. Incubation period: Undetermined.
6. Period of cftmmtniicnhility: During the peraistonce of lesions of the conjunctivae
and of the adnoxc*d mucous membranes or of dischargee from such lesions.
6. Methods of cf)n trot:
(A) The infected individual and his environment —
1. RfHOfjnition of the dii*ease- Clinical symptoms. Bacteriological
examination of the conjunctival secretions and lesions may be use-
ful.
2. Inolation Exclusion of the patient from general echoed classes.
3. Immunization —None.
4. Quarantine -None.
5. Concurrent disinfection of discharges and articles soiled therewith.
6. Terminal di-^in feet ion- None.
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6. Methods of control — CJontinued.
(B) General measures —
1. Search for caaee by examination of school children, of immigrants,
and among the families and asdociates of recognized cases; in addi-
tion, search for acute secreting disease of conjunctivae and adnexed
mucous membranes, both among school children and in their
families, and treatment of such cases until cured.
2. Elimination of common towels and toilet articles from public places.
3. Ekiucation in the principles of personal cleanliness and the necessity
• of avoiding direct or indirect transference of body discharges.
4. Control of public dispensaries where communicable eye diseases are
treated.
Trichinosis.
1. Infectious agents. — Trichinella spiralis.
2. Source of infection. — Uncooked or insufficiently cooked meat of infected hogs.
5. Mods of transmission. — Consumption of undercooked infected pork products.
4. Incubation period. — Variable; usually about one week.
6. Period ofeommunicabilit^. — Disease is not transmitted by human host.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by micro-
scopicai examinatioQ of muscle tissue containing trichinea.
2. Isolation — None.
3. Immunization — None.
4. Quarantine — None.
5. Concurrent disinfection — Sanitary disposal of the feces of the patient.
6. Terminal disinfection — None.
(B) General measures —
1. Inspection of pork products for the detection of trichinosis.
2. Thorough cooking of all pork products at a temperature of 160^ P. or
over.
T«bcraUo8i0 (PobnoMury).
1. Ifrfectious agent. — Bacillus tuberculosis (human).
2* Source of infection. — The specific organism present in the discharges, or articles
freshly soiled with the discharges from any open tuberculous lesions, the most
« important discharge being sputum. Of less importance are dischaiges from
the intestinal and genito-urinary tracts, or from lesions of the lymphatic glands,
bone, and skin.
5. Mode of transmission. — Direct or indirect contact with an infected person by
coughing, sneezing, or other droplet infection, kissing, common use of unsteri-
lized food utensils, pipes, toys, etc., and possibly by contaminated flies and
dust.
4. Incubation peruxf.— Variable and dependent upon the type of the dinease.
5. Period of communicability. — Exists as long as the specific oi^ganism is eliminated
by the host. Commences when a lesion becomes an opan one, and continues
until it heals or death occurs.
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6. Methods of control:
(A) The infected individual and his environment^ —
1. Reception of the disease — By clinical symptoms and by thorouf^
physical examination, confinned by bacteriological examinatloa
and by seroloj?ical tests.
2. Isolation of such **open" cases as do not observe the prermutions
necessary to prevent the spread of the diseaw.
3. Immunization —None.
4. Quarantine— None.
5. Concurrent disinfection of sputum and articles soiled with it. Par-
ticular attention should be paid to prompt disposal or disinfecticm
of sputum itself, of handkerchiefs, cloths, or paper soiled thero-
with, and of eating utensils used by the patient.
6. Terminal disinfection— Renovation,
(B) General measures —
1. Education of the public in r^^ard to the dangers of tuberculoma and
the methods of control, with especial stress upon the danger of
exposure and infc^ction in early childhood.
2. Provision of dispensaries and visiting-nurse service for discovery ol
early cashes and pu pervasion of home cases.
3. Pro%i«(ioD of honpitals for isolation of advanced cases, and sanatoria
for the treatment of early cases.
4. Pro\i.'don of open-air schools and preventoria for pre-tuberculoua
children.
6. Improvement of hoit*ing conditions.
6. Ventilation, and elimination of dustfi in industrial establishments and
places of public &<«embly.
7. Improvement of habits of penwnal hygiene and betterment of general
living <x)n(iinonfl.
8. Separation at birth of babies from tuberculous mothers.
Tubercnloeis (Other than Pulmonary).
1. Jn/ectioui aoent.~-hAv\\\\v* tul)erculo^is (human and bo\'ine).
2. Source of inpctinn.- -I)i«*rharg«»"* from mouth, nose, boweL*, and geni to-urinary tract
of infect^Kl humans; arti« I(»8 fr(»i<hly soiled with swch. <li^chargM; milk from
tuberculou<i t*attlc; ranly th<» discharging lce>ion of bone*-*, joints, and lymph
nodes.
3. Mode of tronsmissinn.-Wy dircn-t (X)ntact with infected pen*ons, by contaminated
food, and im^vihly by contact with articles fr<»shly soiled with the discharges
of infc( UhI pi^rsons.
4. Incubation ptriitd.- -Unknown.
5. Period of cf>rtimunimb}lity.~ Tntil lc^ion.•^ ar<» healed.
(J. MHhoiig ff cont'^tl:
(A) Tho inf«'< t^nl in<lividual and hl^ environment —
1. U«M «>;;niti()n of the din-oM-' — Minical symptoms confirmed by bac-
t^Tiolo^ical and t*orol«>pf al examinations.
2. I-ola!i()n.- None.
3. Immuiii/ation.— None.
4. (Quarantine. — None.
5. Com urrcnt dt^infct tion. — Di«< barges and articled freahly soiled with
them.
6. Tonninal <li>*info<'tion. — CloanMing.
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6. Methods of control — Continued.
(B) General meastires —
1. Pasteurization of milk and inspection of m^ftts.
2. Eradication of tuberculous cows from milcli herds used in supplying
raw milk.
3. Patients with open lesions should be prohibited from handling foods
which are consumed raw.
Typhoid Ferer.
1. Infectious agent. — ^Bacillus typhosus.
2. Source of infection.— BoweL dischaiges and urine of infected individuals. Healthy
carriers are common.
3. Mode of transmission. — Conveyance of the specific organism by direct or indirect
contact with a source oi infection. Among indirect means of transfnisaion are
contaminated water, milk, and shellfish. Contaminated flies have been com-
mon means of transmission in epidemics.
4. Incubation period, — From 7 to 23 days, averaging 10 to 14 days.
5. Pariodofoommunioabiliiy. — From the appearance of prodromal symptoms, through-
out the illness and relapses during convalescence, and until repeated bacterio-
logical examinations c^ the dischaiges show persistent absence of the infecting
oxganism.
6. Methods <i/ control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, confirmed by specific
agglutination test and bacteiiolpgicai examination of blood, bowel
discharges, or urine.
2. Isolation — In fly-proof room, preferably under hospital conditions, of
such cases as can not command adequate sanitary environment and
nursing care in their homes.
3. Immunization— Of susceptibles who are known to have been exposed
or are suspected of having been exposed.
4. Quarantine — None.
6. Concurrent disinfection — Disinfection of all bowel and urinary dis-
chaiges and articles soiled with them.
6. Terminal disinfection — Cleansing.
(B) General measures —
1. Purification of public water supplies.
2. Pasteurization of public milk supplies.
3. Supervision of other food supplies, and of food handlers.
4. Prevention of fly breeding.
5. Sanitary disposal of human excreta.
6. Extension of immunization by vaccination as far as practicable.
7. Supervision of typhoid carriers and their exclusion from the handling
of foods.
8. Systematic examination of fecal specimens from those who have been
in contact with recognized cases, to detect carriers.
9. Exclusion of suspected milk supplies pending discovery of the person
or other cause of contamination of the milk.
10. Exclusion of water supply, if contaminated, until adequately treated
with hypochlorite or other efficient disinfectant, or unless all water
used for toilet, cooking, and drinking purposes is boiled before use.
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Typhus Fever.
1. Infectious agent: Bacillus typhi exanthematici is claimed to be the causative agent;
not yet definitely detennined or generally accepted.
2. Source of infection: The blood of infected individuals.
3. Mode of transmission: Ipfectious agent transmitted by lice. (Pediculus corporis,
p. capitis, p. vestimenti.)
4. Incubation period: Five to twenty days, usually twelve days.
6. Period of communicability: Until 36 hours have elapsed after the temp^^ture
reaches normal.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms. (Confirmation by
bacteriological examination of blood claimed by Plotz.)
2. Isolation— In a vermin-free room. All attendants should wear ver-
min-proof clothing.
3. Immunization— Claimed to be practicable by use of vaccine (Plotz,
Olitzky, and Baehr). Not yet generally accepted or adopted.
4. Quarantine — Exposed susceptibles for 12 days since last exposure.
5. Concurrent disinfection — None.
6. Terminal disinfection— Destroy all vermin and vermin ^gs on body
of patient, if not already accomplished. Destroy all vermin and
eggs on clothing. Rooms to be rendered free from vermin.
(B) General measures —
Delousing of persons, clothing, and premises during epidemics, or when
they have come or have been brought into an uninfected place from
an infected community.
Whooping Congh.
1. Infectious agent: bacillus pertussis (Bordet, Gegnou).
2. Source of infction: Discharges from the laryngeal and bronchial mucous mem-
branes of infected persons (sometimes also of infected dogs and cats, which are
known to be susceptible).
3. Mode of transmission: Contact with an infected person or animal or with articles
freshly soiled with the discharges of such person or animal.
4. Incubation period: Within 14 days.
5. Period of communicability: Particularly communicable in the early catarrhal stages
before the characteristic whoop makes the clinical diagnosis possible. Communi-
cability probably persists not longer than two weeks after the development of
the characteristic whoop.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptoms, supported by a
ditlerontial leucocyte count, and confirmed where possible by
bacteriological examination of bronchial secretions.
2. Isolation— Separation of the patient from susceptible children, and
exclusion of the patient from 8<hool and public places, for the
period of presumed infect ivity.
3. Immunization — Use of prophylactic vaccination recommended by
some observers. Not effective in all cases.
4. Quarantine — Limited to the exclusion of nonimmune children from
sdiool and public gatherings for 14 days after their last exposure
to a recognized case.
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6. Methods of confrof— Continued.
(A) The infected individual and his on\aronmont — Continued.
5. Concurrent disinfection — Discharges from the nose and throat of the
patient and articles soiled with such discharges.
6. Terminal disinfection — Cleansing of the premises used by the patient.
(B) General measurea —
Education in habits of personal cleanlinea? and in the dangers of associa-
tion or contact with those showing catarrhal symptoms with cough.
YeDow Feyer.
1. Infectious cufent. — Unknown.
2. Source of infection, — The blood of infected persons.
3. Mode of transmission. — By the bite of infected aedes calopus mosquitoes.
4. Incubation period. — Three to five days, occasionally six daj's.
6. Period of communicabitity. — First three days of the fever.
6. Methods of control:
(A) The infected individual and his environment —
1. Recognition of the disease — Clinical symptons.
2. Isolation — laolate from mosquitoes in a special hospital ward or thor-
oughly screened room. If necessary the room or ward should be
freed from mosquitoes by fumigation. Isolation necessary only for
the first three days of the fever.
3. Immunization — Nona
4. Quarantine — Contacts for six days.
5. Concurrent disinfection — None.
6. Terminal disinfection — None. Upon termination of case the premises
should bo rendered free from mosquitoes by fumigation.
(B) General measures —
Eliminate mosquitoes by rendering breeding impossible.
(C) Epidemic measures—
1. Inspection service for the detection of those ill with the disease.
2. Fumigation of houses in which cases of disease have occurred, and of
all adjacent houses.
3. Destruction of aedes calopus mosquitoes by fumigation; use of larvi-
cides; eradication of breeding places.
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PREVALENCE OF DISEASE.
No health department, State or local, can effectively prevent or control disease tcithoiU
knowledge of when, where, and under what conditions cases arc occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended Oct. 6, 1917.
The California Stiitc Board of Health reported that during the
week ended October 6, 1917, two cases of anthrax in man were
notified in the State, one each in Kern and Fresno Counties. The
prevalence of anthrax among animals was slightly increased during
the week. Two cnscs of smallpox occurred in Nevada County.
Typhoid fever showed an increase, 51 cases having been notified.
Diphtheria increased to 38 cases. One case of leprosy was reported
at Oxnard.
ANTHRAX.
Massachusetts — Lynn.
During the week ended October 6, 1917, two cases of anthrax
were notified at Lyim, Mass.
CEREBROSPINAL MENINGITIS.
State Reports for August, 1917.
Place.
New cases '
reported. ,
• Place.
New cases
reported.
HawaU:
oalm—
1
1 1
1
1 '
1 '
1 '
1
!
Virplnla— Cont iiuicd.
i'rinx^ Ceorpo ( ounty...
Honolulu _.__ _ .
Ro'Wltridt^c * ounty...
TUionu Visln
Virginia:
Inland ronntv _
Ro 'kinpham vounty
Scott I ountj' .. _ -
Total .... . - _-
I-oiidoiin rouniv.,..
9
Norfolk (.'ounty ._
(1734)
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CEREBROSPINAL MENINGITIS— Oontiiuied.
City Reports for Week Ended Sept. 22. 1917.
Place.
Cases.
!
Deaths. | Place.
Cases.
Deaths.
Akron, Ohio
1
' Lowell, Mass
1
Baltimore, Md
1
1
5
1 MilwiiuKee, Wis
1
1
Buffalo, N. Y
2
12
2
4
1 Minneapolis, Minn
Chicaco, 111
New i<eilford, Mass
1
Cleveland, Ohio
New York, N. Y
2
3
Detroit, Mich
Philadelphia. Pa
1
Oale^sburji, 111
1
PittsbiiTk'h, Pa
1
1
1
Hartford, Conn »
1
1
Providence, R. T
Kansas City, Mo
ftan T)ief»o, Ca|
DIPHTHERIA.
Illinois — Edwardsville.
Diphtheria was reported as unusually prevalent at Edwardsville,
111., during the week ended October 6, 1917.
Maryland — Gapland.
During the week ended October 6, 1917, seven cases of diphtheria
were notified at Gapland (unincorporat.Kl), Washington County, Md.
West Virginia— Pern.
On October 8, 1917, an outbreak of diphtheria was reported at
Peru, Hardy County, W. Va., at which place 75 cases were reported.
The popidation of Peru in 1910 was 79.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1743.
ERYSIPELAS.
City Reports for Week Ended Sept 22, 1917.
Place.
Cases.
Deaths.
Place.
Oases.
Deaths.
Chicaro, 111
PhiMplphift P» _. ,
1
Cleveland, Ohio
PittsburMi, i^a..-
1
Detroit, ^ich
Portland. Greg
1
Dnlnth, Mhifi ,
Quincv, 111
HairisbufK, Pa
Rochester, N. Y
Jersey City^ N. J
1
St. Louis, Mo
Kenosha, Wis
5
3
San Francisco. Cal...
Los Angeles, Cai
1
1
1
Schenectady, N. Y
1
Memphis, Tenn
Seattle, Wash
Mflwaukee, Wis
South Bend, Ind
Newark, N.J
bteolton, Pa
NewYork, N. Y
1
LEPROSY.
Hawaii Report for Augnst» 1917.
Place.
New cases
reported.
Place.
Newcasea
Hawaii:
Hawaii-
North Kohala District
Smith Hiln Distrir^t
1
2
1
Hawaii -Continued.
Maui-
Wailuku District
Total
I
West Kau District
6
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1736
MALARIA,
Virginia Report for August, 1917.
Place.
Virginia:
Accomac County
Chiocoteami*
Gre«nbaclr\llle
Onanrock
Albemarle « ountv
rharlottesAilie *.
Alexandria' ounty
Ale\andria
Allcffhany County
Amelia ( ounly
Amherst < ounty
Appomattox * otmty
Auioista County -
iJetlford 'ounty
Brunswick i ounty
lawren f \ille.
BucVlnffham (ounty
Campbell County
Caroline County
Charles City County
Charlotte! ount^
Chesternold < ounty
Winierpock
Clarle « ounty
Cumtterland < ounty
Dtnwiddie County
Es?*ex ( ounty
Fairfax
Fau luier County
FIUN-anna County
Fran' lln County
Ro-Vv Moimt
Winliesier
Olou-esier I ounty
Ciooirfand ' ountv
(Jrcrn-j illo « oiiniy
Kmptwia
North Kmporla
Halifax < o'inly
Hojusion
So'ith KoKton
Hanovrr . oimiy
Avhiand
H«*nri'<) County
llcnrv • o-intr
Blartlrus flic
Isle of Wl/hl » ounty
Smithfield
Jamrs Hy<«inly
\Vllllamst>nrK
Kin^and Qikm'u < ounty.
KinK'Iror-oi ouniy
KiMi; Willi un * oiiniy
WrMpui'il
I>an*T»ster* ounty
I-ee « oimty
Loudon < ounty—
Round Uin
New cnses
reported.
Place.
|Kewc«Mi
reported.
I
18 ,
19
7
1
6 I
i;
13
1
1
«
7
12
1
4
2
35
.■>
16
10
4
2
5
42
16
3
1
8
3
1
,J'
3
2« jl
25 y
&
37
14
37
2
31
6
2
14
7
24
10
16
3
13
6
18
2
Virginia— C4)ntlnued. '
1 ouLsa County I
Lunenburg ( ounty |
Vi"tona. „i
Malhcws oim
MecVlenhpri: ' cm .ty I
ClarVs\ille i
Middiovo\ Coiuity
Cr) mna
Naawmond ( ounty i
Suiloiv _ I
Nelson County ,
New Kent* ounty
Norfolk County
Norfolk
NortliamptoD County
i ape Charles
Northumberland County
Rcehlllc ,
Nottnway < o'mty
HIaokstone _
Crewe
Oranee ' ounty :
Pittsylvania ' ounty I
Powlialan * o'inty '
Princes'* Anne< ountv —
Prln-e Edward County I
Farmville )
Prlnoo C.eori.'e Cormtv '
Prinze William ( ounty I
Ri hmond « ounty I
RoanoVe ounty— |
RoonoVe
Rock iTidt'e County
Riiena Vl^ta ]
Rockin.'ham County ,
Brid 'e Abater I
Dayton
Scott Ciimty—
• OateCity
Shenandoah County
Southampton County
Franklin
Spotsylvania County
Stafford (%)iinly
Surr V Cou n t y i
t>endron
8u^,sex County
Jarrait
Wi ,-!•■
Warron County
Warwick County
WistWu-'t on County
Wesimorrl ind County
W> the Count V—
Wvthe ille
York County
Total.
14
5
4
U
\i
21
1
\i
3
»
41
3
e
2
»
1
4
1
S
S4
5
»
to
3
21
1
7
2
1
1
3
4
1
I
»
I
4
S
a
s
41
1
a
I
u
1
a
«
It
1,1S1
PUre.
Birr"i'i/lKifn, M.i.,
Ho t ,n. M.
Br...,; I.IH' M i^ .. .
( hl'l •nu. ^ C...
Xf< 't!' I ' . I • un
Now i »il>*vn>. i-a. .
City ReporU for Week Ended Sepl. 22, 1917.
I . ' ' .. '. I . . . .>
Caess. Deaths. I;
»3S
1
2
Place.
19 1
2 I
1 j New York, N. Y..,
.. ! Uirhmnnd, V'a. . .,,
.. J S.uT.inuM'to, ("il...
1 , Siviihii.ili. <ia
3 ■ Wilmiii^luii, N. C.
Cas«s. D«ftthi.
.•M 'lit ') rri ' 1 ' tnofo '-a •- r.f - i .-m ro;.oried ttrui anv ot' cr riiy l^ not
*'' ,M H '".;.', im tf.i'i 1 1 rt' f I'-t <t' \I i'«imt ind neiKliborlm Mai**.
. '-■ «■ .1 «*>i'.r!- t:.o I I*, ifi <1« ,Mf "nci • h'l' n I'Je in *4*-urinB lh« «
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1737 October 12, 1917
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1743.
PELLAGRA.
Vir^nia Report for August, 1917.
Place.
New cases
reported.
viara iNewcases
^"^*- 1 reported.
i
Virginia:
Aocomac County
•
1
Vireinia— Com Inued.
Isle of W ight County
1
Albomarle County
James City County—
Williimsburg
Alleghany County-
iron Gate
1
^ ing and (^ueen c<Muity r - - r
1
Amhemt County ^ , . , - ^ . , -
King William County
1
Augusta County—
Staunton
Westpoint
1
T.unenburp County . . T r ,
1
Peiford Conntv ,-. ...,..-..,
Mecklenburg County
2
'^nfn-'fwick County - . . -
Montgomery County—
Radford
Caroline County '.
1
Clarke County
Nelson County
2
Ciimherland County - -.-..... r
New Kent County
2
Dinwiddle County
Nottoway County—
JJurkoville
Elizabeth City County-
1
Hampton
Patrick County
3
Essex County i
Pittsylyania Cfounty
1
Fau juier County
Prince Edward County—
I'^armyille
Franklin County—
1
Roclcy Mount. , r . . . ,
Kichmond County
1
(treensviUe County
Rockbridge County
1
Kmparia
2 '
^1
Ru-i-iell County . :
{
Ha!i.\ County-
Washington County
2
South iJoston
Wythe County . . .' *
1
• Hanover County
Total
H«nry County .. r .--.,......
71
Mftrtifi-^ytUft , . . , .
City Reporte for Week Ended Sept. 22, 1917.
Place.
Cases.
Deaths.
Place.
Ca.ses.
Deaths.
Birmingham. Ala
15
1
2
1
1
Nashville, Tenn
2
Boston. Mass
Richmond, Va
1
Fort Worth, Tex. . .
Winston-Salem, N. C
1
Memphis, Tenn ....
9
^The reason that Birmingham had so many case^; of pellagra reported is not (hat the disease is more
prevalent in Birmingham than in other cities of Alabama and ncighborum Staters, but undoubtedly
because of the succes:>(ul efforts the health department has made in seciuing tlie cooperation of the prac-
ticing physicians in reporting cases.
PNEUMONIA.
City Reports for Weels Ended Sept. 22, 1917.
Place.
Cases.
Deaths.
2
6
1
1
2
2
1
106
60
10
1
1
5
2
2
2
11
2
16
7
1
Place.
Baltimore, Md
Binghamton, N. Y
Brockton, Mass
Chelsea, Mass
Chicago, ni
Cleveland, Ohio
Jackson, Mich
Johnstown, Pa
Kalamazoo, Mich
Kansas City, Mo
Los Angeles, Cal
Manchester, N. H
Newark. N.J
Philadelphia, Pa
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124
Pittsburgh, Pa
Pittsfipld, .Vfass
Pontiac, .iich
Rochester. N. Y....
Saginaw, Mk"h
San Diepo, Cal
San Francisco. Cal . ,
Schenectady. N. Y.
Someryillp/Maf s. . .
Springaeld, 111
Springfield , M ass . . .
St.ockton, Cal
Worcester, Mass
Cii^tw.
li«ltln«
n
U
n
4
1
2
19
n
T «.*.*.«
L
T
■%
ms^i
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1738
POLIOMYELITIS (INFANTILE PARALYSIS).
IHnofe.
During the week ended October 6, 1917, 70 cases of poliomyelitis
were notified in Cook County, 111. Of these Cook County easels, 64
were in the city of Chicago. Four cases were notified in Rock Island
County, two canes each in Dupage and Kankakee Counties, and one
case each in Brown, Kane, Livingston, Macoupin, Moi^an, Schuyler.
Stephenson, and Winnebago Counties.
Kansas.
During the week ended October 6, 1917, cases of poKomyelitis were
notifi^ in Kansas as follows: One case each in Kiowa, Kansfias.Qty,
Horton, Preston, Hugoton, Lamar, McDonald, Severance, and Smith
Center.
Vennont.
During the week ended October 6, 1917, cases of poliomyelitis
were notified in Vermont as follows: Barre 3, Calais 1, Stowe 1.
West Virginia.
During the week ended October 6, 1917, cases of poliomyelitis
were notified in West Virginia as follows: In Cabell Count^^, at
Hunthigton 2; Preston County, at Kingwobd 1; Taylor Coupty,
Grafton 3; Wood County, Parkei^burg and Belleville 1 case each.
State Reports for August, 1917.
Plaop New cases
1 i
?^^
Hawaii:
Hn wail—
1
M
Virginiar-rontinued .
MivlJlese.\ County ,
ililo
N lU ©iiiond Countv
Nel-iv nCo'inty
Virginia:
t
3
l*age County
2
.iloemarle Comity
K ichm«>D(i County
AiTilier.st O'lunt-y ^ . ^ - r - ,
llookbridLG Countv
Aujjusta Conn ry
Ro<*kiui,'liain County
18
Boalord County
Dayton *
Fuu.-iiiier ('»)uiity
1 1
Harris nburg
*v .irrenion
Shftnsntid.ih (bounty. ... , -
Fre ( lerick Count y
Snivth County
*Vinf*iie iver
Warren Countv
Gr«'ene t\>unt v
1 runt iloyal ...
2
llaliloACouin'v
1 1
Wa-shinj^ton County
1
Total
Me ' .lenb»irp County ! 1 '
85
1 .
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POLIOMYELITIS (INFANTILE PARALYSIS)— Oontinued.
City Reports for Week Ended Sept 22, 1917.
•
I lA?0.
Cases.
II
I>ciths. riiw.
Oases.
Deaths.
Akron. Ohio
I
1
1
1
66
I
T^!^\ All worth , Kans
1
1
3*
3
3
2
3
1
1
I
Cambridge, Mass
II Lincohi, Nebf
Camden. N.J
Canton. Ohio, ■.-.
1 '^'^'' f .rk, N. J
2
1 New Castle, Pa
Chicago. Ill
27 li New York. N. Y
:t ri**-> rgh. Pa
4
Cleveland. Ohio
Davenport, Iowa
8
1 li Rock Island, lU
Erie, ra 1
1 St. Loab. Mo
Oalesburjc. HI , 1
' Topeka.kans
Johnstown, Pa ' 1
A\Tioeling. W. Va
1
K'ftif5A5r:ity, Mo 1 R
l
RABIES. IN ANIMALS,
aty Reports for Week Ended Sept. 22, 1917.
During the week ended September 22, 1917, two cases of rabies
in animals were reported in Newark, N. J., and one case was reported
in Niagara Falls, N. Y.
SCARLET FEVER.
Montaim — Helena and East Helena.
On October 8, 1917, outbreaks of scarlet fever were reported at
Helena and East Helena, Mont. Since September 1, 1917, 12 cases
have been notified at East Helena, and since August 10, 1917, 21
cases have been notified at Helena.
6ee also Diphtheria, measles, scarlet fever, and tuberculosis, page 1743.
SMALLPOX.
Arkansas.
On October 8, 1917, cases of smallpox were reported in the State
of Arkansas as follows: In Franklin County, near Cass, 3 cases; in
Yell County, Gilkey Township, 4 cases.
Illinois.
During the week eiule<l () MobtT 6, 1917, smallpox was reported as
unusunllv prevalent at Rosiclare, Cave in Rock, and Murphvsboro,
lU. ^
\iiui.eNota.
During the week ended October 6, 1917, four new foci of smallpox
infection were reported in the State of Minnesota, cases of the disease
having been notified as follows: Douglas County, Osakis, 2: McLedo
County, Ilassou Vidley Township, 1; Polk County, Keystone Town-
ship, 1 ; Sibley County, Severence Township, 1.
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October 12, 1917 1740
* SM ALLPOX— Cont inaed.
Tlrginia Report for Augmt, 1917.
Plac6.
Cases.
Deaths.
■ ■ r^
Place.
Cases.
rteithi
Virginia:
Albemarle Countv—
Charlottesvilie.
t
4
2
Virginia— Continued.
Soutbamrton County—
Bovkins
3
Total
Halifax County
18
^fathewfl Cotintv
City Reports for Week Ended Sept. 22, 1917.
Place.
Akron, Ohio
Alton, III
Birmingham, Ala.
Buffalo, N.Y
Butte, Mont
Chicaeo, 111
Cleveland, Ohio..
Coffey\111e.Kans,
I ayton, Ohio
Tenver, Colo
letroit, Mich
Evansville, Ind...
Fort^.'ayne, Ind,
Indianapolis, Ind.
Cases.
Peaths.
Place,
I Kansas City. Kans
I Leaven worth, Kans . . . ,
I Milwaukee. . .'is ,
I I Mimieapolu. Minn.....
ll Muscatine, Iowa
Nashville, Tenn
New Orleans, La
Oklahoma City, Okla..
Omalia. Nebr
Rocky Mount, N.C...
St. Louis, Mo
Salt Lake City, Utah,.
Seattle, ". ash
Toledo, Ohio
Cases.
Deatbs.
8
•-•7T-
16
-r-
....
82
...M.
....
1
2
3
2
4
TETANUS,
aty Reports for Week Ended Sept. 22, 1917.
Place.
Baltimore. Md....
Canton, Ohio
Clucaj^o, 111
Ciiicimiati, Ohio..
Los Angeles, Cal..
Mobile, Ala
Cases.
Teaths.
Place.
New Orleans, La .
Philadelphia, Pa.
St. Louis, Mo
San ie^o.Cal —
8>Taciise, N. Y...
\ Wilmington, 1 el.
Deaths.
TUBERCULOSIS,
See Diphtheria, meiit^les, scarlet fever, and tuberculosis, page 1743.
TYPHOID FEVER.
Maryland — Maryland School for Boys — ^Loch Raven.
Dui-ing the week ended October 6, 1917, 12 cases of typhoid fever
were notified at the Maryland School for Boys, Loch Raven, Md.
Massachusetts — Tewkesbury State Infirmary.
During the week ended October 6, 1917, 52 cases of typhoid fever
were notified at the Tewkesbury State Infirmary, Mass.
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0«^tober 12, 1917
TYPHOID FEVER -<:^onthiuiiil.
State Reports for August, 1917.
Place.
Hawaii:
HawaU -
Hamakua I istrict . . .
Hn-»
South Uiio i istrict . .
South Kzna T Istrict .
Oahu -
Eu-ari5t:ict
Honolulu
New cases
reported.
Total.
Virginia:
Aocomac County
Aoccmac
Groan boctvlllc
Onancrck
Albemarle Countv
Charlottes.! lie....
Alexandria County -
Mexandrii
Alleghan y Coimty
Amelia County
Amherst Coir {y
Appomattox County. .
Augusta County
Basic City
Staunton
Waynesboro
Bath County
Bedford County
Bedford
Bland County
Botetourt County
Troutville
Brunswick County
Alleghany County-
Clifton Forge
Covington
Buchanan Coim* y
Buckingham Coimty. .
Campbell County
Alta\ista
Brookneal
Lynchburg
Caroline County
Bowling Green
Carroll Countv
Charles City County . .
Charlotte County
Keysville
Chesterfield County . . .
Clarke County
Culpeper County
ICulpeper
Dickenson County —
Din wlddie County....
Petersburg
EUtabeth City County
Hampton
Phoebus
Essex County
Fairfax County
Falls Church
Fauquier County
Vv'arrenton
Floyd Coimty
Floyd
Fluvanna County
Franklin County
Rocky Moiml
Frederick County
Winchester
QUes Coimty
Narrows
Qknioester County —
Grayson Coimty
Oalax
Place.
2 I
u
1
I
I
1
8
i
3
9
3
6
3
2
2
12
12
1
1
23
17 j
I
3 t
5
1
3
1
5
1
n
2
19
2
6
2
4
21
19
10
1
Virginia— Continued.
Greene County :
Greens vilb County
North Emporia......
HaliCax County
South Boston
Hanover County
Henrico Ccinl y
Henrv Countv
Mariino , ilb
Highlar.fl Cov.r t y
Isle of . ,'icht ("ounty
Smilhlicld
James City Countv
KiuR and '^..c ou County
King George (^mnty
King William County *
\7est Pu.U
Lancasici County
Ir\ ington
Lee Ctiuil v
Loudoun County
PnrccllTlUe
Louisa i^oimty —
Lirtjiia
Lun<'i.b»!rg County
\'i?torla
Madison Count y
Mathews Couaty
Mcfklenburg County
( la^Vs^ille
Middlesex i ounty
Urbanna. _ -
Montgomery rounty -
( nristiaosburg
Radford
Naiisemond County
Suffolk
Nelstm (, ouiity
New Kent i ounty
Norfcdk County
Norfolk....
Portsmouth - -.
Northampton t'ounty
Northumberland County
Roedville -
Nottoway ( oimty
BlacVstone
Orange ( ounty
Gordon3\ille. .-
Orange
Page Coimty
Luray
Shenandoah
Patrick t ounty -.-
Pittsylvania c ounty
Dan\ille
Powhatan County .—
Prince Edward (ounty
Prince George County
Prince William County
Manassas
Pulaski lounty
DubUn
PulasVi
Rappahannock County
Rlcnmond County -
RoanoVe County..
Roanoke _
Salem. -- -..!
Rockbridge County *
Buena Vista
Icxington '
Rockingham County -.
Briagcwater j
Elkton I
Russell County - !
2
1
13
3
24
ABE lOU SAVING Your Money to Inrest In the SEOONl) I.^BKJITY LOAN!
Digitized by VjOOQiC
nrtof)or 12, 1»17
1742
TYPHOU) FEVER— Continued.
SUte Reports for Aui^st, 1917.
Place.
\>w cases
ri'iwrtcd. |
ni
1 ..
5 t
,11
2 :
3!
2
il
2 *
15
Place.
New esses
reported.
Virginia— Continued.
Soott ' ountv
Hate ity
Sh6naT»«iofih ■ "oii"t.y
Vlrpinla— Cont inued.
Tazewell iVunty— Continued.
Po ^ahoiUas ,.
Riiilanls
Mount Ja'^Vson
Taiewell ^ _.
Warren ( ounty .... - - _
Smyth' ounty
Marion
Front Koyal
Saltvillo
Warvvi-k County
Washington* ounty
Abinpdon
r)amas''us
SouthamDton Countv -
Frant-lin
Spotsylvania County
Fredericksburg
Westmoreland County
Surry ounty—
Dondron ._._...
Wise 4 ounty
Appala^hia _
Norton
Wythe ountv
Sussex Tounty
Jarratt -
Wa'-cfleld ,x
Kural Retreat —
Ta?c\rell * ountv
Total
Orahsm ...-.- ^ .-
957
City Reports for Week Ended Sept. 22, 1917.
Place.
AVron, Obk>
Albany, N.Y
A lion town, Pa
Alton, 111
Altoona, Pa
Atlantic City, N.J.
Aiistfai, Tex
Baltimore, Md
Bayonne, N.J
Birminrham, Ala...
Boston, Mass
BraddoeU, Pa
Bridreport, Conn...
BiJtTaJo. N. Y
Cairo, 111
Carabrid*'e, Ma^.. .
Camden, N . J
Ch irlpstoD, S. C
( lifl^wi. Mass
Chioa o, lU
Circirnati, Ohio
( leveland, (^hio
Columbus, Ohio
(^ovin<'ton, Ky
Cumberland, Md.. .
Davton, Ohio..
Detroit, Mich
Pulnth, Minn
East ( hiearo, Tnd
EI? ahelh, N.J
E\aiisville, Ind
Extrett, Mass
fall River, .Ma.ss
Flmt, Mich
Fort W.ivne, Ind
Fort Worth, Tex
(ialfslnire. 'II
CJalve^ton, Tex..
Oran*l Uapitl-;. Mich
Haior^towii. Md
Harri>buru. I'a
Hi^rri^oii, N. J
Hart lord, ( oiin
Ila\prbili. M.iss
India ii.iI*oli>, Ind
Jersey* ity, N. J
JoIln^^o\\'n, I'a
Kim- ' < ity, Mo
Cases.
Deaths.
Ploce.
Knoxville, Tenn
KoVomo, Ind
; Lancaster, Pa
Leavenworth, Kans
I I.exinUon, Ky
I Ion e rli. ("al
Los AiK'olcs, <'al
Lowell Ma.ss...\
, Lynchburn, Va.
L>nri, Mass
Madison. Wis
I Marinette. Wis
I Muiiphis. Tenn
; Milwaukee Wis
Minneapolis. Minn
Mobile Ala
; N;u^hville Term
I Xe.vark.N.J
I NewUiri'h. N. Y
. Newr:u,tl.\ Ta
. New London, Conn
New Orle^uis. La
I Nc'Ai)ort K\
, New York.N. Y
Niauara Falls, N. Y
Norfolk, Va
Norri^'towu, Pa
Oakland, Cal
Oeden. Utah
Oklahoma tntv, Okla
Omaha. Nobr
Oranre. N. J
F;i.^^,iir N.J
Perth AmI>oy, N. J
Philadelphia, Pa
PiUsburiib, I'a
Po!it Lu\ Mirh
i'onlmd.M.'
I'nrlland.Ore:
PoriM^.iuuth, Va
I'rov i tiiue, U. 1
Cases.
Ke
ticv.
Pa.
Rocl:ester. N. Y.
Koekford 111....
S.icran'rnio,Cal.
Sn ;ina\v , Mich. .
1
5
5
2
4
16
i
1
1
2
6
1
102
2
2
2
1
1
2
2
I
1
3
20
15
Deaths.
iRE YOU SAVING Yonr Money to Invent In the SECOND LIBERTY LOAN!
Digitized by
Google
1743
October 12, 191 7
- f TYPHOID FEVER— Ooiitlnnf^l.
City Reports for Week Ended Sept. 22, 1917— Continued.
Place.
St. Joseph, Mo
St. IxMits. Mo
Salt Lake City. Utah...
Sandusky, Ohio
San Francisco, Cal
San Jose. Cal
Saratoga Springs, N. Y .
Seattle, Wash
Somerville, Mass
South Bend, Ind
Springfield, 111
^ringfield, Mass
ft)rlngfleM. Ohio
Steuben ville. OMo
Syracuse, N. Y
T^coma, Wash
Cases. Deaths.
Place.
Taunton, Mass
Terre Haute. Ind
il Topeka. Kans
Troy.N.Y
I Washinjrton, D. C...
' Washlimton. Pa
j Watertown. N. Y
, WfestHoboken, N. J..
, Wheelin*;. W. Va
I Wichita, Kans
I Williamsport, Pa
Wilminslon, Del
I Winston-Salem, N. C.
I Worcester, Mass
I York, Pa
Zanesville, Ohio
Cases. Deaths.
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Rcporte for AiiKust, 1917.
Cases reported.
State.
Cases reported.
state.
Diph-
theria.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
Hawaii .
13
1
2
Virginia
149
173
41
aty Reports for Week Ended Sept. 22, 1917.
Popula-
tion as of
JiUv 1, 1910
(estimated
by U. 8.
Census
Bureau).
Totcil
dealh.-i
from
all
causes.
DlphtheTia.
Umsks.
Scarbt
lever.
Tuber-
culofiiji.
aty.
K
1
1
in
1
1
1
1
1
Over 600,000 Inhabitants:
Baltimore^ Md
589,021
750, 476
2.497,722
074,073
571,784
m
§71
IT
73
71
H
I'i
57
13
19
a2
Itt
fi3
1 9
3
18
I
1
*i
I
li
A
a
32
1^
1
\
3^ 15
1 n
2
57
323
44
51
31
255
25
44
29
25
12
22
m
Boston, Mass
1^
Chicago, 111
m
Cleveland. Ohio
Detroit, Mich
i 1 ' U5
22
17
Los AngoU s, Cal
503, 812
5,002,8U l,%\h
1,709,518 4Sr
579,090 m.
767,309 171
1
1
408,558 \H-
410,470 Ifif*
3o<i. 345 ; sa
43), .535 T HI
3r;{,4.'>4 1 .,
4rS,894 ' liH
371,747; 11 «
403,510 m
348,039 37
30:^,980 ........
I .... ' 4 . -^
46; ;i fO .
15
New York, N. Y
m
Philadelphia. Pa
'{
m
Pittsburgh, Pa
13
St. Louis, Mo
1
94
t&
From 300,000 to 500,000 inhabit-
ants:
Buffalo N Y
11
Cincinnati, Ohio .. . ..
1
a
0
34
11
•s
16
Jersey City, N. J
1
2
MUwaukee. Wis ".','.'. '.
if 1--.,..
3
0 1.,.,..
9
Minneapolis, Minn
Newark. N.J .'..'.'..'.'/.'.
IV.IZ
21
as
37
1»
S
New Orleans, l^a.
10
San Francisc "), Cal
...-,.
'}!::::::
It
Seattle, Wash
1 ^
Washingtcn, D.C
4f..-.*.i ©
s
ARE YOU SAVING Your Money to Inf <*st In tiK' WECONn LIBflBTT lOAji f
„,„^
oogle
Octohorl2, 1917
1744
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Coutiuued.
City ReporU for Week Ended Sept. 22, 1917— Continued.
Popula-
tion as oC
Jol 1,1910
(estimated
bv U.S.
Census
Bureau).
Total
deaths
Irom
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tober-
culods.
aty.
1
1
1
i
J
1
1
i
From 200,000 to 300,000 Inhabit-
ants:
(\*lunibus, Ohio
214,878
2(i), >vjO
271,7«sS
297, H47
29o, 4ta
2.>i,9«^)
250,117
104,199
181,762
121.. VO
112, 9S1
106, 2.«
127, z2A
l^, 66
104.562
12«,.91
110,900
100,. -.00
ll.i.l45
10., 11")
14"i,99:i
Il7,0o7
11N,15S
149, 6n5
19H,Gul
16 , 170
109. 81
1.>6,6H7
117, 99
10.', 911:
15''. '^Vt
11.770
19I..V4
lll..'9.{
I6i.;'it
6 . o:>
.5h.<» \i
57, (iOo
69,v<i{
.n7,r. ;;.
5 »,','(' ■
67.-;S«»
6J.S L ,
60,731
57, IH
91, 195
8o,f,yO '
7. . IM.-)
76.07S
51.772 '
76. Ki 1
77.. n 1
68,5'.<( '
9'». }.7
50, s. 3
71
78
si'
47
81
49*
38'
42
27
27
44
26
42
2,5
«
47
. 28
31
53
l\
il
'76"
12
16
'19"
9"i
io"'
21
7
u
"i
29 '
17";
22 ,
21 !
18
12
21 ;
3
7
51
15
2
10
2
1
1
7
8
1
I
2
7
5
4
7
7
t
t
:n
1
10
4
8
6
6
6 1
2h
s i
H
2 ,
1
1
1
2
2
1
4
1
1
9
5
4
2
2
4
15
......
* "i*
1
9
......
4
6
I
12
I«
17
3
4
13
2
5
6
Denver, CuK)
16
Ind anapol s, Ipd
Kan.-ias t'lty. Mo
Portland, Oreg
4
Providence J U.l
U
Htchcslcr, N. Y
From 100,000 to 200,000 inhabit-
ants:
Alban>',N.Y
2
3
Birmingham, Ala
2
2
1
7
2
2
1
2
Bridge port, Conn . .s
Camnridge, Mas."^
8
6
rarn.lcn,N.J
2
1
IMvton, Ohio
1
3
4
Fall Uiver. Mass
3
Ft-rt Worth, ox
1
t
(Jrand Rapid.s, Mich
v.'.'M.::.:
......
7
10
5
3
7
5
11
10
2
Hat tford , Conn
1
'\-
. 3
Lawrence, Ha^... .
2
Lowell, mW
>
3
Lynn, Ma-^>
.1 .:.
. 1
Moraphis, >an
1
.....
• ■•2'
1
3
Nashville, "onn
i t* *7' .'
3
Nrw tie If ml. Ma^s
4
Now Ha , en Conn ,
6
Oakland. Cal
2 I '3
3
Omaha, Xuur
i------; '
2
Ilea ling, Pa
....
1
5
2
Richmond. Va
Salt Lake Citv, Utah
1
......
....:.i ! "h
' • 2
; 2
•> 1
..'..'.'.
3
1
SprinKneld, Mass
2
Syracuse. N.Y
5
13
1
9
3
1
I
Tacoma, Wasli
- , '
Toledo, Ohio
1
2 ' 10 1
7
Trenton, N.J
4
Worc^Mtcr, Ma V-:
3
i
1
From .'iO,000 to 10 l.OOO inhabit-
ants:
Akron, Ohio
* 1
1 :
12
Allentown, Pa
1
Altoona, Pa
1
AtlanticCity.N.J
'"'I /*
2
1
Bayonne, N.J
1 1
BcrJvC.ey,Cal
]
2
......
""i'l
1
1
Binphamton.N.Y
' 3
... ■ -
1
BrocKton, Mass
1
3
1
Canti.n.Ohio
h
6 '
.J'
1
1:
3 '
4 '
' 7 j
rhar.oston,S.C
7
Covington, Ky
, 1
2
4
3
4
1
1
«
DulutTi, Minn
. -■••,■--■4-, 1
Ell a)clh,N.J
Frio. Pa
^1 ;
10 1
5
30
Kvansvl le.lnd
1
Flint. Mich
1
1
i'l ' "'1
Fort W'avne. Ind ].
.... ::••••;._ "i::-'-i
5
Harrisburg. l*a
1
1
■ f . ""
Hobolen.N'.J
1 1
5
1
Johnstown, Pa
1
l\
Kaii>asCitv, Kinis
1 1
3
3
I
3
(..ancvst er. Pa
"1
............ .-....^......j
Litt rl.ock. .Vrft
57. .'13 '
7S. : M '
5h,:-ji ,
V , 7U4 '
N9.612
91\913
15
0
27 .
17
7 '
ii :
1
1
1
2
MaMt'n.Ma'>;s
'1
Munelirstei.N.lI '
3
M< 'A e, Ala \
1
1
2
Sew Jritain.Conn 1
Nnrrolk. Va '
S t
1
2
1
4
<»klihoraaCity,(>Jcla !
1
1
1
1
ARK YOr S.WINO Your Monoy to Invent in the SECOND LIBERTY LOAN!
Digitized by VjOOQIC
1745
October IX 1»17
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS--
CoDttnued.
a^ Reports for Week Ended SepC, 22, lS17~4}cmtmited.
L
CUy.
Popid»-
tian as of
July U 1916
(estimated
by U. 8.
Ccmns
Bureau).
Tolal
deaths
from
all
Diphtberfs.
Scarlet
fever.
Tuber-
culosis.
From SOjOQO to 100,000 inhabtt-
ants— Gontinuad.
Passaic,N.J
Portland, Mei
Rockford,U
Sacramento. Cal
8agInaw,Micb
St. JoseiMi, Mo
' SanDiego^Cal
Savami^b^Ga.
Bdiei]eetady.N. Y
Doiuervi><ef buiss ............
8«utb Bend.Ind
SpringHeid,!!! ,
8prlnCTeid,Ohio
TerreBattt^ylnd
Trov,N.Y
We^es-Farre.Pa
Wilmington, Del
Yort.Pa.
From 2n,0t etooOJOOO inbabitants:
Alameda, Cal
Austin, ex
Broo Une,Mass.
Bmler.Pa
Bntte,Mant
C!helse« , Moss
Chkopee,. Mass
Cmnberlandf Md
Danville, ill
Davenpoirt, lam
East CiiteagD, Ind
East Orange, N.J
Elgin, 111
Everett, Mass
Bvcrett.Wash
Eltchburg. Mass
GolTestou, ^cx
Green Ray. Wis
Hagerstown, Md
Haverhin.Mass
Jackson, Mich
Kalan^a 00. Mich
Kcno?ha, Wis
Kingston, N.Y
KnoKvIllc, "enn
La Crosse, Wis
Lexington, Ky
Lincoln , Nebr
Leng Beacb.Cal
Lorain, Ohio
Lynchburg. Va
MaiL'ion.. Wis
Ifcdford ' Mass : . .
Mont&'air. S.J
Nashua, N. H
Newburgh, N. Y
Newcastle. Pa
Ne•^^porl, Ky
Newport, H.I
Newton, Mass
Niagara Falls, N.Y......
Norrislown, Fa
Ogdcn, Utah
Orange. N.J
Pasadena. Cal
Perth Arabov, N. J
Pittsfield, Ma-^s
Portsmouth, Va
Quincy, HI
71,744
6.i,867
56,185
66,805
56,643
85,216
5;i,330
68,805
09,519
87,0 9
68,946
61,110
51, 5M
66,083
77,916
76,776
94,165
51,6C6
27,7:^2
34,814
32,7. 6
27,632
4'<,425
46,1«
20,310
26,074
32,:«1
48,811
28,743
42,458
28,203
39,2 3
35, IF6
41,781
4I,F63
29, .'53
2r»,679
48,477
3,303
48,>-^6
3J,67«
2h,771 '
38,676 i
31,677
41,097
46,515
27, 5S7
36,ti64
31\940 i
30,f^J I
26,234
7ft. 31 S '
■27,317
29,»M^3
41,1.13
31,9'. 7 i
3(>,1(S
43,715 ,
37,3:3
31,401 ,
31.101
.■i3,t)S0
16, 4:^0 '
11, IV. 1
3.H,«2U i
:w,t:'i I
14
10 1
3 .
4 I
15 1
-i'i,'
fi I 8
6 ,
10 1
5 1 4
14
1
...1 2
12 I t>
0 ;
U 3 I
li:
15
12 I
I
■"i'l
10,
ARE YOU SAVINO Yonr Mouey to 1
nrent In the SKCOND MBKRTY LOVNI
Digitized by VjOOQIC
October 12, 1917
1746
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS--
Continued.
City Reports for Week Ended Sept. 22, 1917— Continued.
Popula-
tion as of
Jnlv 1, 1916
(estimated
by U. S.
Census
Bureau).
Total
deaths
from
all
causos.
9
10
9
11
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
aty.
1
1
1
i
1
1
i
1
1
1
From 25.000 to 50,000 InhabiU
ants— Continued.
OllITlOV M&ss
38,136
46,4Hi
43,281
28,92-i
38.902
3
2
1
5
1
9
T^AHnA Wis
TtnAnnlre Va
1
4
1
1
1
Rock Island III
San Jose, Cal
2
4
»
RfpiibAnvillA Ohio . .
27, 145
35, 3r,H
46,22>
36.283
4b, 726
30,:70
20,894
43. 1.39
43,377
33,809
29,892
31,155
30,803
22,874
15,010
13,. ^^2
13,599
21, 6H.')
15, 794
U3,(i75
22,069
21.276
16.9.T0
23,. ',.39
20,^^30
» 19,363
114,610
17,445
13,2S1
23, 136
15,243
2:1, 9h:,
« 22,019
19,926
2.J,NV)
1T,:21
11.P66
12, (XJ
14,8.31
20,193
13.821
24,204
16,548
21,618
2:1,228
15,969
10
3
.14
13
10
10
2
6
16
1
10
9
7
11
5*
4
1
8
6
6
4
2
5
4
4
5
5
14
9
11
9
10
1
1
3
Stockton Cft! *
2
• I
Siirftrinr Wis
1
1
7
a
Toneka Kans . . . .
1
2
1
3
Wa'tham , Mass
1
2
1
1
Wntertown N. Y
1
1
1
West Hoboken N.J ...
1
Wheellni?, W. Va
2
9
1
1
s
Wi'Iiamsport, Pa
Wilmington. N. r
Winston-Salem. N. C. ..
1
1
2
s
Zan^ville Ohio
From 10.000 to'25.000Vnhabltants:
Alton III
2
2
2
1
Beaver Fiills Pa
Berlin N 11
1
Braddopk Pa
6
2
2
Cairo III ....
1
. .
Concord, N . 11
6
Ga'e^bure. Ill
Harrison, N. 1
1
1
1
1
1
3
3
Keamey.N. J
Kokomo Iiid
*■•%•*
1
1
Leavenworth, Kans
Marinette. Wis.
Melrose, Muss
3
2
1
Morristown, N. J
1
Nanticoke. Pa
1
Newburvport. Mass
1
1
New London, Conn
1
1
3
Nwth Adam**, Miiss
3
2
1
Northampton. Ma<s
.. . .
1
Plainfield, N. J
2
1
Pontlac, Mich
2
1
Portsmouth, N. H
2
Rocky Mount, N. C
Rutl^d, Vt
9
1
3
6
6'
3'
5
1
1
Sandusicy, Ohio
1
2
4
Saratoga Springs, N. Y
South Bethlehem Pa
1,
2
' 1
1
Steelton, Pa
1
1
Washington Pa
1
1
! 3
Wilkinsburj». Pa
Wobum, Mass
1
1
1
1
* 1 •
» Population Apr. 15, 1910; no estimate made.
ABE YOU SAYING Your Money to InYest in the SECOND LIBERTY LOAN!
Digitized by VjOOQIC
FOREIGN.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVfiR«
Reporte Received During the Week Ended Oct 12, 1917.^
CHOLERA.
Place.
Date,
Cases.
Deaths.
Remarks.
Indo-ChinA:
Provinces—
Anajn
May 1- June 80
do
219
77
681
1
82
188
42
431
Cambodia
Cochin-china. . . .•
do
Laos
June 1-30
Tonkin
Mayl-June30. ...
21
PLAGUE.
Brazil:
Bahia
Pemambuco.
China:
Amoy
Indo-China:
Provinces—
Anam
Cambodia
Cochin-China
Kwang-Chow- Wan. . . .
Tonkin
Adr. 19-Sept. 8..
July Ift-Aog. 15..
July 30-Aug. 11 .
May WunoSO..
do.
do
do
do
95
24
149
34
98
Present.
SMALLPOX.
Argentina:
BuenoH Aire.^.,
Netherlands:
Rotterdam
Russia:
Archangel
China:
Amoy.. ..
July 29- Aug. 11 . . .
Present.
Indo-Cuina:
Provinces—
Anam
May 1- June 30
do
361
30
322
37
1
4
76
2
133
2
Cambodia
Cochin-China
Tonkin
do
do
Jamaica:
Kingston
Sept. 0-15
Russia:
Archangel
Aug. 1^28
TYPHUS FEVER.
Aug. 12-18
Aug. 19-Sept. 1.
Aug. 15-2H
» From medical officers of the Public Health Service, American consuls, and other source?!.
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October 12. 1917
1748
OHQLERA* PLAGUB. Mi/OLPOX, TYPHUS VSVEE. AND YELLOW FEVEIU-
Continued.
Reports Received from Jone 30 to Oct. 5, 1917.
CHOLERA.
Place.
Date.
Deaths.
Remarks.
India:
Bassdin
Apr. 1-May5
8
1
6
347
3
4
43
2
\
5
7
17
Bombay
June 21 30".
1
11
Do
JulvH-28
Calcutta
Apr. 29- June 30...
Do
July 17.....
Madras
Apr. 22 June 30...
July 1- Aug. 4
May 6-June 30
5
63
•
Do
^'andalay
Moulni4iii ..-..--,
May li Juno2
Pakokku
Apr. 2(^May 5
Pem ."."
Mav27-June36...
July 17
Do
Racuroon -
Apr. 21-Junc30...
July H 28
31
9
tS!^:::::::::. .::::....
Iiido4:btna:
Feb. l-Apr. 30. 1917: Cases, 227;
udtlu^ 124.
Anam
Feb. 1 .\pr.30....
do
11
12
197
4
163
1
1
1
3
0
113
Cambodia
Ckichin-Chiiia
do
Tonkin
do
Sai£on
Apr. 23 May 27....
Apr. 2-S
108
Java:
East Java
Do
July9-1.>
1
1
Mid Java.
July 16-22
West Java
Apr. 13-July 5, 1917: Cases. 71;
deaths, 31. July 6- Aug. 2, 1917:
Cusc3, 100; deaths, 52,
Batavia
Apr. 13- July 6
July&-Aug. 2
Feb. 3
7
9
1
4
1
3
1
2
3
Do
Persia:
Mazandcran Province-
Amir Kela
Barfo»rou''ho
Jan. 15-17
Hamzo Kela
Jan. 17
Machidessar
Jan. 31
Philippine Islands:
June 17-23
Provinces
May 2a-Juno 30, 1917: Cases, 795:
Agusan
JulV \}y-'2^
12
113
C3
2
2)
1
1
36-1
2W
62
04
231
3vSS
41
14
.334
2:i7
12
276
1
1
1
4
196
216
i
11
11
2
w
ll
i'
?51
161
40
45
\H\
2S4
22
5
223
117
.ii
1
2
H.S
114
4
9
7
deaths, 500. July 1-Aug. 4,
1917: Cases, 2,064; deaths, 1,271.
Albav
May2>-Juno30...
July 1-Aug. 4
Jun-^ 3 9
I>o
Ambos Cftraarincs
Do
July 22- Aug. 4....
July.s-14
Jun? 17-2?
Mav21 June 30.. .
July 1-AuK. 4
June 3 31
July 1-Aug. 4
Jiuic3-3>
July l-Aug. 4
do
Juno n 3)
July l-Aug. 4
Julvs Aut:. 4
July 2 » Aug. 4....
JuJV I Aug. 4
June 2! -31
July 1-7
Hatrfi^n
Batangaj
Bohol
Do
Cuplt
Do
Cabu
Do
Hollo
Lcyte
Do
Misamls
Mindanao
Negros Oriental
Riial
l>o
Homlilon
July '^ 2*
Som«r
Sorsogon
l>o
Surit'iT ....
July r.v2i.* !!!!!!!!
June :j-30
July I- Aug. 4
July 2J \ug. 4
June 3 31
July l-.\ng. 4
July 15 21
Taval a?
■ Do
Zumboaupa
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1749
OeiDber 12, 1917
CHOLEBA, PLAGUE, SMALLPOX, TYPHUS FEVER* AND YELLOW FEVER-
Continued.
Reports Received from Jue 30 to Oct. 5, 1917-~0ontinaed.
PLAGUE.
PteM.
Date.
Cases.
Deaths.
Remarks.
Arabia:
Aden..
May3-July4..
Brazil:
Babia
Do
Ceylon:
Colombo...
Do
China:
Amoy
Hon^Urong..
Do.
JtinelO<}0
JoIy8-Aug. 4..
Adt. 8-June23.
Juiyft-21
Kwangtung I'rovince—
\lUtTict
Apr.2^1fay5....
July 1-7
Miayl3->June30..
July 8- Aug. 18...
June 2
Feb. 1-28
do
Mar. 1-31
Apr. 1-30
Mar. 1 31
Apr. I 30
Feb. 1-28
do
Mar. 1-31
Feb. 1-28
Ta-pu
fikniador:
E^tanclaVieJa
Oaayaqoil
Do!!!!]!!!!!!!!!!!
. MUagro
Noboi.!!!!!!!!*!!!!!!!
Sal tre
Do
Taura
Ale xandr ia
Do
Port Said Kovemment
Port Said
Do
Provinces—
Fayoum
Oaioobeb
(Jirgeh
Minieb
Do
Siout , Mayl2
Suez government Apr. 30 June 2
Su«z
Oreat nhlain:
firavesend
June 21-27
July 31- Aug. 19..
Apr. 30 May 19...
June 2.^
July 28-29
May ll-June2G..
June 28
Mayl7
May 12-Juue 28. .
July '29
6
3
4
1
1
'li
May 12 June 28.
AuR. 13-24.
London..- | May 3 s..
23 i
fndla -
Bassein »
Do
Bombay
Do -,-_-
Calfnitta _
Hen ada __
Kara' hi
Do
Madras Presidency
Do.- -
Mandalay _.
Mouimein
Do -
Myingyan
Pegu
Rangoon
Toungoo
Tndo-C hina:
Provinces
Anara
Cambodia
Cochin-^ hina
Tonkin
Saigon
Apr. 1-Jun^30..
July 1-7.
Apr.22-Juno30.
Julvl-28.. .
Apr. '29-June2..
Apr. 1-Juno30. .
Apr. 22- June 30.
Juno2S-July 28.
Apr. 22-Juno30.
July 1-7.-
.Apr. 8-May 12...
Apr. 1-Juac30..
July 1-7.
Apr. 1-7 -.-.
May 27- June 2.
Apr. 15-J.'no30.
July 1-28 -
Apr 8-14
486
154
468
11
301
70
Feb. 1- Apr. 30..
--.do .-
.-.do —
.--.do
Apr. 23- June 3..
137
108 f
70 I
15
47 I
43 ! Apr. 8-May 14, 1917: Cases, 69;
deaths,!
....| Present and in vldnitr.
6 Present Aug. 19.
13
3
Present.
1
3
. . . . Jan. l-Aug. 3, 1917: Owes/ 1,251;
4 I deaths, 099.
1
3
1
9l
23
54
6
397
127
38
35
413
8
250
58
9
74
10
1
2
169
205
2
From s. s. Matiana.
2 in hospital at port. From s. s.
Sardinia from Australian and
oriental ports.
Apr. 15-June 30, 1917: Cases,
43.922; deaths, 30,197. July 1-
7, 1917: Cases, 1,870; deaths,
1,322.
50 ,
95 I
*^ I
12
26 '
Feb. l-Apr. 30, 1917: Ca^o. «o
deaths, 198.
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October 12. 1017
1750
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND VELLOW PEVEU^
Continued.
Reports Received from June 30 to Oct. 5, 1917— Continued.
PL AGUE— Cont inucd.
Place. '
Date.
Cases.
Deaths.
Remarks.
Java:
£«ast Java
Apr. 2-Mav 20, 1917: Cases, 2»;
DJocjakarta Residency .
K^dLri Residencv
Apr.io^Mayd
... do
i
1
3
18
4
6
1
1
3
18
4
death:), 2^.
Samarang Residency. . .
Surabaya Residency. . .
Do
Apr.23-May20....
Apr. 2-May20....
JiflvK-M
Surakarta Residency do
6
Peru . . .
Mav 16-31, 1917: Cases, 15.
Departments-
Area uina
May 16-31
do
4
1
2
7
1
13
6
2
1
At MoUendo.
cSm ...'...!.:::::::
At Calla^.
Lambaveauo
do
At Chldayo.
Libertad
do
At Salaverry, San Pedro, and
Lima
do
TrujiUo.
At Lima.
Slam:
Bangkok
Apr. 22-June30...
July 3-23
12
5
1
Do :..:.:.:::...:.:...
straits Settlements:.
June.Vld
Dm^re... ...... .........
July 1-7
Union of South Africa:
Cape of Good Hope SUte—
Olengrey district
Terka district
Aug. 13
Present.
May 28
i
1
1
At Summerhill Farm.
Qneenstown
Jtuio 6
Orang^^ Free Rt4vt^
Apr. 16-22, 1917: I case. Apr. 9-
22, 1917: Cases, 26; deaths, 17.
l^inburg district
At sea:
8 8. Mfttianft
May 28
1
6
July 14-18.
9
En route for port of London.
SMALLPOX.
Australia:
New South Wales
Brewarrlna
Cessnock
Coonal)arabraii
Quambone
Warren district
(Queensland-
Thursday Island Quar-
antine Station.
Brazil:
Bahla
Do
Rk>de Janeiro
Do
Canada:
Manitoba-
Winnipeg
Do
Nova Scotia-
Halifax
Port Hawko^l)ury..
Ontarto—
Ottawa ,
Ceylon:
Colombo
Chinn:
Amoy
l>o
Antung
Do
Chungking
Do
Apr. 27- June 21 .
July 25-28
May 25- July 5...
Apr. 27-June 21 .
June22 July 17.
May 9
May 6- June 30..
July 22^-Aug. 4..
do
July I Aug. 11..
June 10 16
Auk. 19 Sept. 1.,
June IH July 7..
June 17-30
July 30- Aug. 6
May G 12
Apr. 2n-May 26...
July 1-Aug. 19...
May 21 June 24..
Aug. r. 12
May t> June 23...
July 1-28
4
2
126
20«
Apr. 27- July 28, 1917: Casee, 7S.
From s. s. St. Albans from Kobe
via Hongkong. Vessel pro-
ceeded to Townsville, Bris-
bane, and Sydney, in quaran-
tine.
.' Present in distrfct.
Present and In vicinity.
Do.
Do.
Do.
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1751
October 12, 1017
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received rrom Jane 30 to Oct 5, 1917 — Continued.
SMALLPOX— Oontinaed.
Place.
Date.
Cases.
Deaths.
Remarks.
Ch ina— Cont inued.
C^t&nc^ha , r r -
May 27- June 2....
May 13- June 30...
July 8-28
5
30
6
2
7
8
1<
1
Dairen
4
1
Do
July 1-7, 1917: Present.
Hankow
June 24-30
Apr. 23^ May 6
May 6- June 16....
Aug. 5-18
Harbin
f>n Chines^ l?ftst<»rn Ry,
Honelcons t , -
7
5o ........
Manchuria Station
Apr. 23-29
Do.
Mukdm
May 27- June 2
Present.
Do .*
July 8-.\ue. 11
Do.
Shanghai
May21-Julyl
July 2-Au?. 5
13
32
9
Cases foreign; deaths among na*
Do
tlves.
Among Chinese.
Tsitshar Station
Apr. 16-22
1
35
4
1
1
1
5
39
30
19
1
1
On Chkiose Eastern Ry.
Tsfaifitao
Do
May 22- July 7
July 30- Aug. 11...
May 1-31
7
1
At another station on raflway,
lease.
Chosen (Korea):
ChomutDO .............
Ecuador:
Qoavaauil
Feb. 1-28
t>o
Mar. 1-31
Do
Apr. 1-30
Alexandria
Apr. 33- July 1
July 2-29
9
4
1
Do
Cairo
Feb. 12-Mar. 18..,.
July 30- Aug. 6....
May 6-12
France:
Nantes
Paris
Oemianv
Mar. 18-Apr. 28, 1917: Cases, 716
in cities and 32 States and dis-
Berlin
Mar. 18-Apr.28...
do
106
16
18
50
20
2
10
1
Bremen
tricts.
Charlottenberg
do
Hambure
do
LeiDzie
..do
lXS'.......:::.::.:::::::
do
Munich
.do
Stuttgart '.
do
Oroere:
Athens
July 25-30
23
75
22
12
8
1
48
15
5
India:
Bombay .,
Apr.2Mune30...
July 1-28
186
48
27'
I
80
31
33
7
Do
Calcutta
Apr. 2^May 26. . .
Apr. 22-July4
July &-14
Karachi
Do
Madras
Apr. 2-'-June30...
July 1-Aug. 4
Apr. 15-June30...
July 1-28
Do
Raneoon
^0. :...:;::::;....::::
Indo-China:
Provinces
Fob. 1-Apr. SO, 1917: Cases, 256;
An^m
Feb. i-Apr.36....
do
1,269
106
945
4
5
237
199
32
9
65
1
177
1
1
38
IS
S8
161
Cambodia
24 '
Cocfain^^hina
...do
244 :
Kwang-Chow-Wan
Mar. 1-Apr. 30
Apr. 1-30
Laos
I
63
12
3
16
Tonkin
Feb. I- Apr. 30....
Apr. 27-JimclO...
May21-Juno24...
Julyl2-Aug.26...
May27-July22....
May28-Juno3....
May 16-Juiyo
July 25-31
Saigon'.
Italy:
Turin
Do
Kobe
Narasaki
Osaka
Yo'kaichi
55
Yokohama
May27-Juiyl
Apr.2-Julyl
July 2-29
1
2
Java:
£a£t Java
Do
Mid-Java
Do
Apr. 1-July 1
Julv2-22
1 7
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October 12, 1917
1752
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW PEV^-
Oontinued.
Reports Received from June 30 to Oct. 5.^ 1917 — Continued.
SMALLPOX-^Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Java— Continued.
West Java
Apr. UJuly 5, 1917: Cases, 239;
B.Uavia
Apr. 13- July 5
Jan. 1- June 30. . . .
30
6
lie
1
1
0
deaths, U. July G-Aug. 2. 1017:
Casiy",68j deaths, 14.
Mexico:
Coatepec
Do .
Aug.l-ll
Jan. 1-Aug. 14, 191C: US deaths.
Jalapa
Jiilvi-:3^
Maaatlan
July ll-Aug. 7
Mexico Citv
June3-3fl
1G3
120
Do . :::::.
Aug. 5-^ept. 1 . . . .
June lJ<-2 1
•
Monterey
24
23
1
1
1
Orizaba
Jan. 1-June 30. . . .
Do
July 1-23
Vera Cnw
July I Sept. 8
Aug. 13-18
M-iy 13-June9
July 8- Aug. 4
May 13- June 30...
JulyH^2x
Mar. l-Mav 31
5
1
6
4
14
4
Netherlands:
Amsterdam
Philippine Islands:
Manila*.
Varioloid.
Do
Do.
Portugal:
Lisbon
Do .
Portuguese East Africa:
Lourenco Bfarques
3
4
Russia:
Archangel
May 1 -June 28
Feb. 18-June23...
July 2-8
56
543
14
4
23
16
3
Petrograd-.
Riga
Mar. Il-June2....
Mar.lo-2l.l
June 9-30
Jan. 1-Mar. 31, 1917: Cases, 9.
Vladivostok
■ "^
Slam:
Bangkok
Do
July 11-17
5
4
12
U
Ppain:
Madrid
Mavl-Junel9
Malapa **
Apr.1-30 •
Seville
May 1-June 30
Valencia
June ^23
5
12
6
1
1
2
2
Do ',.'
Julyl-Aug. 18....
Mar. ia-June23...
Jime 24-30
Straits Settlements:
Penang
3
SingapK)re
Sweden:
Malmo
Apr. 22-28
Stockholm
May20-Junc23...
June 2-8..
1
Tunisia:
Tunis
Turkey in Asia:
Trcbizond
Feb. 2^Apr. 13...
15
Union of South Africa:
Johannesburg
Mar. 12-24
4
2
Uruguay:
Montevideo
May 1-31
Venezuela:
Maracaibo.
June 18-July 8
8
1
Do
July 9-23
TYPHUS FEVER.
Algeria:
Algiers
Do
.\u.slria -Hungary:
Austria
Bohemia
Galiria
Lower Au."<tria.
Moravia
Sllo-ia
St> ha
Lppcr Austria.
June l-.3().
July 1-31..
Oct. 22-Dcc. 17....
do
do
.:..do
do
do
do
6
1
3
1
034
S09
47
017
If,
243
5
::::;
Oct. 22-Dec. 17, 1916: Cases, 2,371
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1753
October 12, 1917
CHOIERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER^
Continued.
Reports Received from June 30 to Oct. 5, 1917 — Continued.
TYPHUS FEVER— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Austria-Hungary— Continued.
Hiin£?arv
Feb. 19-Mar. 25, 1917: Cases, 1,3SL
BudaiiBSt
Feb. r>-Mar. 25...
Jul''2^Aug. a...
Juno 2.VJulv 1. . ..
Julv9 Aup.26....
Jniip i^l5
S3
2
3
9
1
Brazil:
Rio do Janeiro
China:
\nlung
Do
1
HflnJcow
Do
July S-H. .*. .'.
1
Tientsin
June 17-23
Mav3/KJnly7
Aug. 5-11
i
1,648
286
96
T«*ln^tao
Do
Alexandria
Aug. 3(y-Julyl....
July 17- Aug. 19...
Jan. 22-Mar. 18....
Juue 17-23
478
103
40
32
19
Do
Cairo
Great Britain:
Cork
Greece:
SalonikI
Mr»v23-Juue30...
Do
Julv 1-Aux. 4
Japan:
Hakodate
Julv22 28
1
4
24
Nagasaki
Junell-24
""'Do
July9-.\ug. 19....
2
Java:
East Java
May 6-July 1,1917: Cases, 6. July
0^29, 19lt: bases 6.
Surabava
June 25- July 29...
4
Mid-Java. ' ...
Apr. 1-June 24, 1917: Cases, 38;
deaths, 5. July ^22, 1917:
Cases. 7: deaths. 1.
Samarant;
Mnv5-JunelO
Julv 2-8
14
5
2
West Java
Apr. 13-July 6, 1917: Coses, 147;
deaths, 6. July 6-Aug. 2, 1917:
Cases, 46; deatns, 2.
Baiavia
Apr. 13-Julv5....
July ti- Aug. 2
Julv 10-16
70
37
6
2
1
1
5
3
Do
Mexico:
Agoaseaiientes
Coatepec
AuR. 1-14
Jalapa
Apr. 1-June 30
bo
Jul V 1-31
Mexico City
Jun«;^30
Julyh-Sept. 1
Jan. 1-J une 30
431
770
Do
Orizaba
6
1
2
Do
July 1-31
Netherlands:
Rotterdam
June 9-23
3
8
7
1
11
138
10
2
5
Do
July 15-Aug. 11...
July >^28
Norway:
Bergen
Portuguese East Africa:
Lourcnro Marques
Mar. 1-31
Russia:
Archangel
May 1-J une 28
Feb. 1K-June23....
Julv2-S
2
3
Petrograd
Do
Riga...
May31-June2....
Mar.29-May21....
May 1-31
Jan. 1-31, 1917: 1 case.
Vladivostok
Spain:
illnieria
5
2
Madrid
do
Switterland:
Basel
June 17-23
July 8-21
1
3
2
2
Do
i
Zurich
July 26- Aug. 18....
June 4-9
Trinidad
Tunisia:
Tiuiis
June30-July 6
1
ITnlon of South Africa:
Cape of Good Hope State-
East London
Sept. 10
Present.
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0«Mo»)or U. 1W17
1754
CHOiXRA, PLAGUE, SMAU.POX, TYPHUS PEVER, AND YELLOW PEVKR-
Continued.
Reports Received from June 30 lo Oct. 6, 1917 -Continued.
YELLOW FBVBR.
Place.
Date.
Cases.
Deaths.
Remarks.
Ecuador:
Datuhoro
Fob. 1 28
Mar. 1 ai
....(Jo
1
3
1
18
17
17
1
1
1
a
7
1
0
1
1
1
7
9
0
Do.'
Chol-o
(iiiit .ii|uil
Fol.. 1 2S
Miir. 1 31
Do
Do
Apr. 1-30
Mil.icro
hPh. 1 2S
1 Jo
Mar. 1-31
Do
Apr. 1 30
1
1
3
1
2
H«.xi(t):
t.uiii oi'lio^fato-
V ariij r ho
Aug. I»^25
Aug. 7 Sfpt. 1
June2.J
Mori J a
I'eto
In person rerently «nlr«d fron
MeAU-o ( Ity.
Present Sept. 5.
J)0
Jtilyin^ \ug.ll....
VeneztK'Ia:
( nro
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PUBLIC HEALTH REPORTS
VOL.32 OCTOBER 19, 1917 * No. 42
A MILK-BORNE OUTBREAK OF TYPHOID FEVER.'
ASSOCUTED WITH A CHBONIC AND A NORMAL OR CONTACT CARRIER OF B. TYPHOSUS.
By Charles F. Bolduan and Cuarlxs Kruhwiede, Jr., Department of Health, City of New York.
Since first demonstrated by Conradi and Drigalski, many observers
have shown that some mdividuals exposed to infection subsequently
excrete typhoid bacilli in their stools without developing any symp-
toms of disease. These persons are termed normal or contact car-
riers. Probably they are mostly temporary carriers. Some un-
doubtedly become chronic carriers, as evidenced by the existence of
chronic carriers with no history of typhoid fever, although many
without such history may well have had mild and, therefore, over-
looked or forgotten infection.
The interest in the milk-borne outbreak that we report is that a
normal or contact carrier and a chronic carrier were found on one
of the farms supplying the milk and the former was at first assumed
to be the source of the infection.
The facts concerning the outbreak are briefly as follows: Eleven
cases of typhoid fever were directly traced to milk from the '^B'*
dairy. Two additional cases were probably infected from the same
source. The dates of onset of the cases extended from October 15
to November 16. This dairy distributed about 880 quarts of
milk a day, obtaining its supply from six farms. About 160 quarts
of the milk from one farm was distributed as ^'Baby's milk."
The mUk received at the dairy was bottled and placed in ice boxes
in the order of the numbers given to the farms supplying the milk.
An exception was the ' 'Baby's milk," a late afternoon milking, which
was usually bottled on its arrival in the freshly sterilized bottling
apparatus.
When the drivers started out in the morning, driver 'Teter"
took his supply first and usuaUy took nearly all of the milk of farm
No. 1. The other drivers then took their supply in the order of the
farms given. All took their share of ^'Baby's mUk," but 'Teter"
took as much as the other three drivers together.
All the cases of typhoid fever were on Peter^s route, which is
explained by his supply coming exclusively from Farm No. 1, the
1 The authors ar« indebted to the Board of Health of Morristown, N. J., for the opportunity of studying
this outbreak and for permission to report the results.
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October 10, 1917 1756
source of the infection, as subsequently determined. The oontamina-
tion of the bott-ing tank bj this milk was ev-idently not marked, as
the milk subsequAtl^- bottled was not infectious.
One case of typhoid fever was a child 1 J years of age who, it was
claimed, received '' Baby's milk'* only. As the only mark of identifi-
cation 'was a penciled "B'' on the cap, accidental substitution of
bottles of the oitlinary milk was easUy possible and probably occurred
in this case. The driver, Peter, had worked in the dairy for years,
and denied all illness both of himse'f and members of his family.
All the farms were inspected and blood and feces obtained of all
individuals at the farms as well as of those working in the dairy.
AU examinations were negative except of the specimens of two men
on Farm No. 1, S. M. and L. M. The data on these two men at the
time of the investigation is as follows:
S. M., employed at the dairy for three months, denies ever having
had typhoid fever. Widal reaction November 12, suspicious;
fecal examinations, November 17, negative; November 26, negative.
L. M., employed for four months, gives no history of having had
typhoid fever. Widal reaction, November 12, negative. Fecal
examinations, November 17, positive; December 2, negative.
The above findin<::s, coupled with the mode of distribution of the
milk, seemed to us conclusive evidence as to the source of the infec-
tion. This deduction, however, was shown by subsequent events to
be erroneous. Although we were not quite satisfied with the Widal
result in S. M., the two negative fecal examinations seemed to inihcate
that the slight Widal reaction was probably due to an exceptionally
high content in normal agglutinins, a not infrequent finding.
Tlic carrier L. M. left the farm, but we were able to locate him and
examined further fecal specimens for a period of six months, none
of wliich was positive. A most rigid inquiry of both L. M. and of
his parents failed to elicit any history of an illness wliich could be
considered typhoidal in charact<^r.
The hel])er S. M. left the farm about the same time but returned
to work in February. In March wo were notified that two cases
of typhoid fever had developed, both children receiving milk directly
from Farm No. 1, the milk not passing thi*ough the dairy. The
fact that 8. M. had returned and his previous Widal record raised
our suspicions at once. A fecal examination revealed the presence
of typhoid bacUli. Four other cases were subsequently reported,
all attributable to milk from Farm No. 1. The absence of S. M. and
not the exclusion of L. M. was the reason that no cases had occurred
after the resumption of cU&tribution by the dairy following our
investigation.
We beUeve the following to be the interpretation of these unusoal
findings. The Widal reaction of S. M. indicates that he was a chronic
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bacillus carrier, but at the time of our investigation was excreting
no bacilli or too few to be found by the bacteriological methods
employed. Later, on his return, he was excreting baciUi more
freely and no difficulty was encountered in isolating them. He then
disappeared and we could not observe him further. L. M. wro a
transient normal carrier infected by the milk or more probably
through contact with S. M.
We were in error, therefore, because the carrier first found was a
normal carrier, a fact unsuspected at the time. The presence of
such a carrier raises interesting .possibihties. Had we reUed wholly
upon the Widal reaction for the selection of fecal specimens and had
S. M. given positive fecal results at the time, we would have excluded
him ard ajrced to the resumption of the mQk supply. Should L. M.
have continued to excrete bacilli, the excretion by normal carrier
being not necessarily as transient as it was in his case, we should have
left an unsuspected carrier, who might have been the source of infec-
tion for subsequent cases.
Although a positive Widal reaction may be absent in chronic
carriers, the results indicate that even if a farm helper is found to
be excreting typhoid bacilli, any other individual giving a partial
or positive Widal reaction should be held under suspicion. At
least, fecal examinations should be made over a period of time, as
excretion even with clu^onic carriers is intermittent and negative
examinations arc not infrequent, and may extend over months or
even for a year.
Summary. — The presence on a farm of a normal carrier and a
chronic carrier, temporarily fecal negative, is a possible source of
error in tracing the source of infection of a milk-borne epidemic of
typhoid fever.
VENTILATION AFTER FUMIGATION.
ARTIFICIAL Vrr.TILATION OF SniPS AFT2B FLMIGATION WriH HYDROCYANIC ACID GAS.
By 8. B. OBUBBS. Surgeon, United States Public Health Service.
The spread of bubonic plague to oil parts of the world in recent
years has emphasized the necessity of improving the means used for
the destruction of rats on board ships, as it is through these animals
that the disease is transmitted. It has been shown that rats are
great travelers, and that they may be found in all parts of a ve ?el,
from the costly saloons of the Uner to the deepest hold of the
freighter/ and consequently that no part of a ship should be ex-
cepted when fumigation is done.
> Grubbs and Ho'^ndorf, Public Health Reports, June 20, 1913.
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Sulphur dioxide and hydrocyanic acid gad are ihe fomigants now
most used. Sulphur dioxide has be^i used for many years to d^troy
the animal carriers of disease. The objecdooa to tins agent are the
time required and the possibihties of damage by the sulphur fumes.
Including the time for dissipation of the fumes, sulphur fumigation
consumes rarely less than 16 and often as much as 24 hours.
Hydrocyanic acid gas quickly destroys animal life, does no damage
to inanimate objects, and is of but shghtly more expense than sul-
phur, since it tas been shown to be efficient in smaller quantities
than pr^cribed by the present quarantine regulations.^ It is color-
less and practically odorless, but, following the rule now in force of
testing with small animals,' may be considered fairiy safe, especially
if a rat is used or other animal sufficiently susceptible to the gas.'
The time necessary to ventilate a ship is variable. On an average
the hold of a vessel will be clear of HCN gas in from one to two hours
after removing the hatches. This time depends upon the depth and
size of the hold, area of the hatchway, velocity of the wind, humidity,
etc. With httle wind and high himiidity a deep hold may easily bo
unsafe for many hours and Faget has observed that 12 per cent of the •
vessels fumigated by him were not free from gas at the end of three
hours.^ It is important that both the quarantine officers and the
steamship agents shoidd know in advance when persons may safely
return on board. By employing a system of artificial ventilation we
secure independence of weather conditions, a saving of time will be
eflfectcd, and once fumigation has begun the exact time at which the
working of cnrgo may bo resumed can be determined.
Acting under biu*eau instructions an investigation was undertaken
at the Boston quarantine station to find, if possible, an efficient means
of removing cyanide gas from ships' holds after fumigation so that the
uncertainties and delays of natural ventilation couJd be replaced by
a reUable and practicable system.
The plan of pumping the gas from an outside generator into the
hold and then aspiratingit through the same pipes was first considered.
This method, according to Heiser,* is used for house fiunigation in
India. On accoimt of the difficulty in handhng a large rubber hose
the apphcation of this method was not attempted; neither was t^e
plan to force in the gas and, after the necessary exposure, to replace the
gas by fresh air pimiped through the same hose. Studies made on
both these principles indicated that they were impracticable for ap-
phcation to ship fimiigation.
» Creel, Faget, azul Wrightson, Public Health Reports, Dec. 3, 1915.
* Bureau circular letter of Nov. 4, 1916,
• Gnibbs, Public Health Reports, Apr. 20. 1917.
< PersoDtti eommimlcatioiL
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1759 October 19, 1917
Our first experiments were with two electric fans, one a 15-mch
ventilating fan propelling 1,500 cubic feet^per minute, and the other
a blower propelling 600 cubic feet per minute, which were placed
in various parts of the holds and operated by the dynamo of the
quarantine steamer. Small as they were, these fans shortened the
time in which both. cyanide and SO3 fumes could be cleared from
compartments, as was shown by using the fans in one hold only of a
ship being. fumigated. These electric blowers possess little power
and the wires are troublesome to handle, consequently they have
been abandoned in favor of a gasoline driven air propeller designed
to propel boats and sled^. This is a two-cylinder, two-cycle, air-
cooled, 3-horsepower gasoline engine', driving a two-blade propeller,
32 inches in diameter, at about 1,600 revolutions per minute. Ac-
cording to measurements made at this station it delivers about 22,700
cubic feet of air per minute. This fan has been tried within the holds,
where it served the double purpose of circulating the gas and in-
creasing its penetration, but as it must be operated in a vertical
position it was most eaectively used for ventilat'.on when attached
to the hatch combing, the air be'ng introduced into Ih? hold through
a muslin shute 28 inches in diameter. Two shutes were tried, one
20 feet and one 30 feet in length. Tlio shorter one delivered 8,340
cubic feet of air per minute at the outlet. It will be seen that this
machine will in 10 m.nutei deliver into the bottom of the hold an
amount of air equal to the aerial content of the average ship's hold,
but it has been found that gai is rarely expelled in this short time
sufficiently to make tlie hold safe for persons entering.
The original vertical machine has at our suggestion been changed
so that it will operate in a horizontal position, thus driving the air
directly downward. Mounted on a wooden frame the horizontal
machine weighs less than 100 pounds and may be easily hoisted aboard
a vessel. When operated it is placed across the comer of an open
.hatchway and may bo carried from 0110 place to another without stop-
ping the motor. Furthormoro, it may bo used with or without a shute.
Li holds of less than 30 Teet depth it is probably as efficient without as
with a shute, but as this latter can be easily attached by means of four
snap hooks it may be advisable to use it when the hatchways are
small and the holds deep. J^nemometer readings at the bottom of an
18-foot phut: gfiTc approximately 8,500 cubic feet per minute and
practically tli ? same reading was obtained when the anemometer was
hold tho sanij distance honoath the machine without the shute.
The following experiment will suffice to show that there shoidd be
no attempt to substitute artificial for natural ventilation, but only to
supplement nature especially when conditions are not favorable.
After fumigation of a hold two hatch covers at opposite corners were
removed, the remaining covers being left in place. The machine
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with shute was operated at one opening, the other being left open for
the escape of gas. Rata were lowered at intervals up to 45 mintites,
but all were dead when withdrawn after exposure for 5 minutes.
In this interval fresh air to the amount of over four times the cubic
capacity of the hold had been delivered at the bottom of the hold,
and yet the cyanide persisted in dangerous proportions. Ten minutes
after the removal of all the hatch coverings rats lowered into the hold
were not affected.
In our experience, a hold has always been safe after most of the
hatches have been removed and the aerothrust operated 30 mmutes.
With two machines, one used aft and the other forward, it is then
always possible to have a four-hold vessel ready for release in one
and one-half hours or a six-hold vessel ready in two hours after
removal of the hatches. Naturally if the hold^ blown out first
require 30 minutes the next one will need less time, as it has been
ventilating naturally for a half hour. Since we know that in the
foggy weather so common in Boston this gas will remain in the
holds for from three to eight hours unless removed by mechanical
means, this advantage is evident.
All vessels fumigated at Boston now have their entire super-
structiu'e treated with hydrocyanic acid gas. Usually this is venti-
lated easily without any artificial means, but occasionally, owing
either to the structure of the vessel or to weather cond lions, con-
siderable delay results unless a fan is used. Large ventilator?,
when available, are made use of by removing the top and placing
the horizontal machine over the opening. The large volume of air
thus introduced promptly removes the gas in any kind of weather.
In the superstructure and in certain other places the machine which
operates vertically and dtivas the air horizontiiUy is of great service.
By d recting the air current against the open door of a ship's cabin
it acts as a strong wind. Frequently the forecastle or store room
when below deck and reached by a companion way is d fficult to
clear of gas. The blast from the machine if d rected down the
companion way will do more in a few minutes, frequently, than
natural ventilation will do in several hours.
Even more time may be saved l)y the machme when sulplmr
dioxide is the fumigant. As it is not probable that a man wiU enter
a hold full of sulphur fumes it is not neccssar}' for the quarantine
officer to safeguard sulphur fumigation, but the sh'p loses rarely
less than 6 and frequently as much as 12 hours waiting until it is
possible for men to work below deck. This is also especially true
on hum d calm days. An example may be cited. The steamship
Memphidu was fumigat< d April 12, 1917, HCN being used for super-
structure and sulphur (2 pounds for 12 hours' exposure) in the holds.
The latter were opened at 3 a. m. April 13, a foggy day with httle
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1761 October 19, 1917
wind. At 9 a. in. the agents telephoned to the station that the
sulphur vapors were apparently as thick in the holds as ever, that
they had planned to begin loading at 8 a. m., and consequently
desired assistance. A man with the aerothrust fan was sent to the
ship and in three hours the vessel was dear of fumes. Had the fan
been used as soon as the holds were opened loading would have been
possible at 8 o'clock as planned. On the other hand if the machine
from the station had not been available, loading would undoubtedly
have been delayed until the following morning, entailing on the
owners a loss of several hundred dollars.
Several times it has been demonstrated that a hold full of sulphur
fuines could be cleared in 30 to 40 minutes when other holds, not blown
out, were after the same interval apparently as full of the gas as when
first opened. On a warm dry day with a good breeze, artificial ventila-
tion isof doubtful advantage aftereither cyanide or sulphur fumigation,
but if any of these conditions are lacking artificial ventilation will
save time for all hands. At Boston quarantine the machine is used
as a routine after cyanide fimiigation regardless of weather conditions,
and our experience allows us to recommend the same procedure for
other stations. In addition, it is behoved that each steamship com-
pany whose vessels require fumigation should have at least one
horizontal machine for use after sulphur fumigation, as it will save
time for their vessels and pay for itself many times over.
Conclusions.
Quarantine stations at which HCN fmnigation is practiced should
be equipped with mechanical means for artificial ventilation.
The gasoline driven fan as. adapted for this use is satisfactory for
the prompt ventilation of compartments of vessels after fumigation.
For the expeditious handling of large vessels thrco machines are
recommended, two of the horizontal pattern (downward thrust) and
• one of the vertical pattern (horizontal thrust).
THE UGHTING OF INDUSTRIAL ESTABLISHMENTS.
THE NEED FOB SUPERVISION, WITH A SUGGESTED SYSTEM OF MAINTENANCE
RATING FOR ARTIFICIAL UGHT EQUIPMENT.
By Davis H. Tuck, Assistant Physicist, United States Public Health Service.
The importance of an adequate, hygienic, and well-distributed
system of artificial illumination in industrial establishments is well
imderstood. After such systems have been installed, however, the
part played in the upkeep of the illuminating system in maintaining
its efficiency at the original level is often slighted. The lack of
proper maintenance may reduce the amount of available Ught by as
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October 19, 1917 1762
much aa 50 per cent. At the present tune, when the industrial
world is being mobilized, the adequate maintenanoe of systems of
artificial lighting becomes doubly important in view of the increasing
necessity for night work and the favorable effect of abimdant li^t
upon production.
It is clear, therefore, that not only must the physical lighting
equipment of industrial estabhshments be considered, but atten-
tion must be paid also to its maintenance. The importance of ade-
quate upkeep for artificial Ught equipment may not at first sight
appeal to the user. A consideration of the points involved, however,
will indicate that if such work is neglected excessive losses of other-
wise usefid light are bound to residt
The following system of maintenance rating for artificial hghting
equipment has been devised by the writer. It is thought that it
should prove of distinct utility in enabUng manufacturers to keep
their hghting systems efficient.
Carbon, metalized, and tungsten filament, mercury vapor, arc,
and open-fiame and mantle lamps become inefficient, due to the
following causes:
1. Continued use.
2. Dirt and dust accumulations on lamps and reflectors.
3. Bum outs and breaks.
4. Reflectors becoming cracked, broken, or missing.
5. Mechanical injury to connections.
Various other items of deterioration take place so gradually that
in many cases they are given no special attention in the practical
economy of the shop.
1. Continued use. — ^The hfe of a lamp is not, as generally supposed,
the elapsed time between entering into service and when it bums
out. The life of a lamp as given by its manufacturers is its economic
life. Thus when a lamp burns a certain number of hours it may be
shown that its energy consumption per light unit has increased to
such a dogree that it is economy to replace it with a new one.
2. Dirt and dust accumvlations on hmps and rejhctors, — It has
been shown by actual mea:rirement that the loss of light due to
absorption by dust and dirt for average conditiciis is about 50 per
cent for equipment that has not been cleaned for four months; also
that a small quantity of dust, so small as to be hardly noticeable, wiU
cut down the light by 20 per cent.
3. Bum outs and breaJcs, — It is evident that a burn out or break
may cut down the light by 100 per cent. Often, however, a burn
out or break may be of such a nature that the light source does not
fail entirely, but that the Ught is greatly diminished.
4. Reflectors crorckedy broken^ or missing. — ^The addition of a reflec-
tor to a lamp generally adds about 50 per cent to the light delivered
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Public Health Reports, October 19, 1917.
CARRYING THE FAN. THIS MAY BE DONE WITH MACHINE
RUNNING.
SHOWING DETAILS AND SIMPLE METHOD OF ATTACHING
MUSLIN CHUTE.
MACHINE PLACED OVER SMALL HATCH IN AFTER PART OF
SCHOONER— AIR FORCED IN HERE.
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Public Health Reports, October 19, 1917.
MACHINE WITH MUSLIN CHUTE IN OPERATION SET UP AT STATION FORTESTING;
CHUTE HAS BEEN DOUBLED BACK AT BOTTOM TO CLEAR.
HOISTING ABOARD SHIP. GASOLINE
TANK SHOULD BE LESS THAN HALF
FULL.
HORIZONTAL FAN OPERATING IN
CORNER OF .HATCH WITHOUT
CHUTE. ^'9'^'"^^
1763 October 19, 1917
in useful difectiona. When a reflector is cracked or broken the light
from the unit is diminished according to the nature and extent <^ the
damage to the reflector.
5. Mechanical injury to connections. — ^The logs of light due to me-
chanical injury to the connections will vary with the nature of the
injury. Often the injury is of such a nature €ts to cause a flickering
or intermittent light. It may cause a total failure of the light or it
may be a source of danger to the workman due to electric shock.
Lighting installations are designed to give desirable initial inten-
sities of illumination at the work and it is assumed that the equip-
ment wiU be so maintained as to produce this intensity. From cost
considerations the initial intensity is made as low as possible for work
to be done efficiently, and for prevention of eye strain and accidents.
It is readily seen that when deterioration of the Ughting equipment
sets in, the intensity of illumination falls off and if this deterioration
is not arrested, serious efficiency losses follow. Often Ughting sys-
tems are allowed to deteriorate to an extreme point and nothing is
done unless complaints come in from employees after the lighting
facilities throughout the shop have become so poor that work has to
be temporarily discontinued. The production loss from such cir-
cumstances when added up throughout the year greatly exceeds the
expen e of systematic attention to maintenance in advance.
In making illumination surveys of shops it was found desirable to
note how w( 11 the lighting equipment was maintained and to arrive
at an approximate figure, by inspection, that would denote the
degree of maintenance. The term efficiency of maintenance is usid
to designate the percentage of the initial intensity that a lightirg
equipment will give, the loss in intensity being due to the lack of
proper maintenance.
Tlie following table shows the method adopted of rating artificial
lighting equipment. The efficiency of maintenance in each case
represents approximately the percentage of light given by the equip-
ment after the loss of light duo to the corresponding condition is
deducted.
Condition.
Lamp dirty
Lamp very dirty
Lamp blackened duetoaeincr
I.arap too laree or small ktr refler'tor
Lamp raissinjj, broken, or filament shortened.
Reflector dirty
Reflector verv dirty
Reflector crack ed
Reflector broken or missing
Connections loose or drop cord bare
KfRciency of
maintenance.
Per cent.
80
70
80
80
50
80
70
80
50
80
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There follows an example taken from one department of a shop
recently inspected.
GENERAL OVERHEAD UNITS. SHOP NO. 3.04, TOOL ROOM.
12 unite, lamps dirty, reflectors dirty.
3 units, lamps dirty, reflectors missing.
2 unilB, lamps dirty, reflectors very dirty.
9 units, lamps ver>' dirty, reflectorp very dirt>'.
1 unit, lamps very dirty, reflectors missing.
1 unit, lamps dirty, reflectors clean.
2 unit«. lamps dirty, reflectors dirty, l^ps blackened.
To arrive at the efficiency of maintenance for shop No. 3.04 tool
room, it is necessary to multiply the number of units having a given
condition by the values of the efficiency of maintenance for those
conditions and take a mem.
12x0.80x0.80 7.68
3x .80x .50 "..... 1.20
2x .Six .70 1.12
9x .70x .70 , \ 4.40
1 X .70 X .50 35
1 X 83. 80
2x .80x .80x0.80 1.02
30 ^ ^ 16.57
- -«.. =55.2 per cent efficiency of maintenance.
By measurement with an illuminometer the average illumination
was increased by 100 per cent by bringing the efficiency of mainte-
nance up to 100 per cent.
A department of maintenance of artificial lighting equipment
shouM be inaugurated in every factory and workshop. This main-
tenance work should be made a part of the electrical department,
which i3 in the best position to make periodic inspections of lighting
equipment. Reports of inspections, using a system as outlined
above, should be made to the factory manager and efficiencies of
maintenance of 100 per cent maintained. The ratings given above
are Mbera^ end an efficiency of maintenance of 100 per cent is not
unre:.sonab!c.
By adopting such a practice a large economic waste could bo
avoided and losses due to decreased production, inferior products,
j>ccidents, and defective eyesight minimized.
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PREVALENCE OF DISEASE.
No health department^ State or local, can effectively prevent or control disease mthout
knowledge of when^ where, and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Wcelt Ended October 13, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended October
13, 1917, as follows: Anthrax in animals continued prevalent. Five
cases of cerebrospinal meningitis were notified in the State, one in
Solano County, three in San Diego County, and one in the city of San
Francisco. Of poUomyeUtis, one case each occurred in Berkeley,
Marysville, and Oakland. Two cases of smallpox were notified in
Fresno County; and one case of leprosy in San Francisco city.
Typhoid fever diminished during the week with 25 cases scattered
throughout the State. There was a minor outbreak of scarlet fever
in Monterey County.
ANTHRAX.
Massachusetts.
During the month of September, 1917, 6 cases of anthrax were
notified in Massachusetts. The source or suspected source of infec-
tion in all cases was the handling of imported hides. Five of the
patients had handled hides imported from China and one had handled
hides imported from Argentina.
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CEREBROSPINAL MENINGITIS.
State Reports for August and September, 1917.
Place.
New cases
reported.
Place,
reF>ort«d.
Alabama (Aug. 1-31):
T/awTPPce County .r, ............... ,
Massachusetts (Sept. 1-30)— Continued.
Hampshire County—
N orthAmntan ^
J
Washington (Aug. 1-31):
Lincoln County
Middlesex County-
Cambridge
1
Lowell . .
3
Maryland (Sopt. 1-30):
Mftltlmore Citv
Norfolk County—
Brookline (town)
1
Allegany County—
Frostburr
Suffolk County-
Boston
1
Baltimore County—
Chelsea
1
Total . . .
9
Total
Nebr.v^ka (Sent. 1-30):
Douglas County
Massachusetts (Sept. 1-30):
Essex County—
Lynn
} 1
1
Salem
City Reports for Week Ended Sept. 29, 1917.
Place.
Cases.
Deaths.
1 Place. 1 Cases.
Deaths.
Baltimore. Md
1
1
7
1
1 Memphis, Tenn
1
Boston, Mass
1 NewVork.N. Y 7
ritlsbiugh. Pa ,
2
Chicago, 111
9
1
2
1
Columbns Ohio
SaRinaw, Mich
1
Flint, Mich
Toledo, Ohio
1
Tndiftnapolis, Ind - .-,-,---,--
1
1
Troy,N. Y
1
McKoesport, Pa
DIPHTHERU.
Indiana.
On October 15, 1917, diphtheria was reported to be epidemic at
Fort Wayne, Indianapolis, Richmond, and Rushville, ind.
See also Diphtiicria, measles, scarlet fever, and tuto.culosis, page 1774.
ERYSIPELAS.
Ci'.v Reports for Week Ended Sept. 2r, 1917.
Place.
Otis-
1
1
De.it hi.
Place.
Cases.
DeVh-.
Alanicda,'Cal...
Newark, N.J
New Ycrk, N. Y
■
Baltim re Md
1
1
2
Boston, Ma i>
NinjT.irii Falls. N. Y
Brockton Mass
1
0
1
3
1
1
1 Oakland. Cal
1
Chicagj, 111
CJn'^innnt', Ohio
1 1 Omah.^. Nobr
Phbdelph'a, Pa
Pittsburgh, Pa
Cleveland Ohio
Detroit, Mich
Quincy, 111
Liuicii it ; r, Pa
i^t. L)irs, M)
1
Lincoln \c')r
1
Los Angeles, Cal
2
1
2
Son Francisco, Cal
Nashville, Tenn
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1767 October 19. 1917
LEPROSY.
aty Report for Week Ended Sept 29, 1917.
During the week ended September 29, 1917, one case of leprosy
was reported in New Orleans, La.
MALARU.
State Reports for September, 1917.
Place
N«w€«ses
reported.
Place.
Now cases
reported.
Maryland:
Carroll County-
Oakland Milb
Charles County-
La Plata
Dorchester County-
Cambridge
Howard County-
Annapolis Junction, R. D
Prince (Jeorge Coimty —
Piacataway, R. D
Xownsbend
Total
Massachusetts:
Essex County—
Haverhill
Middlesex County-
Newton
Norfolk County—
iirooklino (town)
Dedham (town) .
Suffolk County—
Boston
Worcester County-
Worcester
Total
12
Alabama Report for Angust, 1917.
Place.
New cases
reported.
Placf).
New cases
reported.
Alabama:
Autauga County
' Alabama— Continued.
1 JcJTer.ion Coimty
282
1 Lamar I'ounty
Barbour Coimty
Limestoos County
BibbCoonty
' Macon County
Blount County
S3
< Madlwn County
Bullock County
1 Marrn^o County
ButliT County .
1 Marion C/Ounty
Calhoun (Joanty
Marshall Co jnty
6
2
5
Chilton County
II
13
1
Moi>ilc County
Cho/ta.v County
Monroe County
Co.reeOwinty
Montgom'Ty ikHinty
Conecuh County
Morgan (^oanty
Cooosa County
Pickens Comity ! 2
Cronsha »v County
Rus3 11 County 1 2
Klmorc County
Sh-^lby County
10
H
3
20
1
4
Escambia County
G
' Sumter Co anty
Eto vah County
j Tftlladf ffa Coauty
Fayi^tte County
, Tu;icaloooa Co luty
WalktT County
Franklin County
Geneva Count v
1 Washincton County
Greene County
3 1 Wilcox County ' 4
400
Jft'^kson CountF ....
19
i Total
..
!
City Reports for Week Ended Sept. 29, 1917.
Place.
Cases.
Deaths. 1
1
Place.
Caacs.
Peaths.
Birmingham. Ala
124 1 ^
Portsmouth. Va
1
Los Angles, Cal.. ............
3
23
1
Richmond* Va
2
4
5
Memohls. Tenn .......... ..
A J Sa.ftnnah, Cn.
Mobile, Ala ;
2' 7'
Stockton, Cal
Newark, N.J
2
> The reason that Birmini^am had so many cases of malaria reported b not that the disease is more
prevalent in Birmingham Uian in other cities of Alabama and neighboring States, but undoubtedly becaiise
of the succe^uJ efforts the health department has made in securing the cooperation of tlio practicing
physicians in reporting cases.
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MEASLES.
See Diphtheria, measlee, scarlet fever, and tuberculoeda, page 1774.
PELLAGRA.
State Reports for August and September, 1917.
Place.
New cases
reported.
Place.
Newc^aes
reported.
Maryland (Sept. 1-30):
torch ester Coiuity —
'
Alabama (Aujj. 1-31)— Continued.
rjreene C^inty. . . _
1
Fishing Creek
Hale County
3
Jackson Corintv
2
Massacbu5;ett^ (Sept. 1-30):
1
1
1
Jefferscffl Conn f y . . .
61
Hampshire County-
Is orthampton ,.
Lauderdale County
6
Lawrence (bounty
2
Middlese>f County—
Tewksbury State Inflrmary
Lee County .'.
4
I/Owndes Coimty
2
Suffolk County—
Maoan County
2
B oston
1 Marenpo County
3
1 Mobile Countv
26
Total
3
1 Mcmroe Countv
4
1 Montirnmerv Coiintv
9
Alabama (Aug. 1-31)-
1
5
1
2
4
6
1
1
3
1
2
1
2
1
t Morpan County ... . ........
1
Autaufra County
Perry Coimty
1
BibbCounty
Pickens County :
2
Bullock County
Russell County
1
Butler Coun t y
Shelby Countv
1
Calhoun County
Sf. Clair County
1
Colbert County
Sumter County
4
Conecuh County.
Talladega County
3
Coosa County . '.
Tallapoosa County
3
Crenshaw County
Tuscaloosa County
14
rekalb C-ounty. .' .
Walker County
2
Elmore County !
Washington County , . . X . . . ......
2
Escambia County
' WUcox County.....
1
Etowfth Count V '
Total
Fayette County
192
City Reports for Week Ended Sept. 29, 1917.
Place.
Birmingham, Aia.
Lynchburg, Va —
Kforaphis.Tenn...
Mobile. Ala
New Orleans, La..
Coses. Deaths.
Place.
Norfolk, Va
Roanoke,Va
Wilmington, N.C....
Winston-Saiem, N. C.
Cases. Deaths.
PNEUMONIA.
City Reports for Week Ended Sept. 29, 1917.
Place.
Alameda, Cal
Baltimore, Md
BJnghamton, N. Y
Boston, Mass
Cambridge. Ma«..
Chicagj.III
Cleveland, Ohi«. . .
Detroit, Mich
Fall Uivcr, Mass...
Flint. Mich
Haverliill, Mass...
Jacks, n, Mich
I^ncR-itf r, J*a
Lawrence, Mass...
Los AngelCvS, Cal...
Cases.
Deaths.
1
4
2
3
1
6
15
2
1
70
41
13
12
1
22
1
3
1
1
1
1
1
1
10
6
Place.
Lowell. Mass
Lynn, Mass
Mtinchesler, N. H..
Newark, N.J
Newburypcrt, Mass
Newp rt, Ky
Phiimlclphia, Pa...
PItt-iburgh, Pa
Pcntiac, Mich
Rochester, N.Y....
San Francisco, Cal..
Somerville, Mass...
SpringOeid, Mass. ..
Worcester, Mass —
Cases. Deaths.
34
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1769
October 19, 191T
POLIOMYELITIS (INFANTILE PARALYSIS),
minois.
During the week ended October 13, 1917, cases of poliomyelitis
were reported in Illinois as follows: One case each in Carroll, Dewitt,
Ford, Hancock, Henry, Kane, Mason, Ogle, and Schuyler Counties,
2 cases each in Rock Island and Will Counties, and in Cook County
65 cases were notified, 63 of which were in the city of Chicago.
Yirsbiia.
Dxuing the period from October 1 to 12, 1917, cases of poliomyelitis
were notified in Virginia as follows: In Rockingham County, Perm
Laird, Pleasant Valley, and North River, 1 case each; in Tazewell
County, Asberrys, 1 case.
West Virginia.
During the week ended October 13, 1917, cases of poliomyelitis
were notified in West Virginia as follows: Huntmgton 1, Rock Oak
1, Parkeisburg 2.
Slate Reports for September, 1917.
Place.
Maryland:
Aiienany ("oimty—
Uiirrollville ,
1 ro4b':rK
(jre^n Rit.pe
Mount Su\ace
OM Town. R. D ,
Wc^ternrort
Baltimore t ounty —
St. Dennis ,
Garrett ( oi.nty —
Acci'icnt ,
A(ci ent.R. D
Do son ,
Grunts \ille V
GranUs\ilIc. R. D
Mountain Lake Park.
ViD4.cjt ,
Montgomery Tounty—
Tal.oma Park ,
Total.
Massachusetts:
Bristol ( oimtv—
Kail R, er
Essex (o" nty—
HaxerhiJl
Merrimac (town)..
Franklin ( ounty—
OrpenAekl (town).
Middl«>sex ( onnty—
Cambridge
Lowell
Maiden
Reading (town)...
Somervillc
New cases
reported.
Place.
Mas5achusetts— Continued.
Norfolk County —
Quincy
Plymouth Connty—
Whitman (town)...
Suffolk County —
Revere
Total.
Nebraska:
Boy. I County
Bi;tlrr ( oi nty
(lav County
Colfax County
Oiminp County
Doirplas County
Hamilton ( ourity....
Merrick (ounty
Otoe County
Polk County
Richanlson County..
Sr.rpy ( ornty
Tliaver < otjcity
Washington County.
Total.
Vermont:
Caledonia Coiinty
Chittenden ( ointy . .
Franklin County
OranRe Coimty
Orleans County
Washington ( ounty.
Windsor County
Total.
New oases
rei>crted.
16
2
1
2
1
1
7
1
3
1
2
1
5
2
1
1
2
2
1
28
10
45
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POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
Alabama Report for An^^t, 1917.
During the month of August, 1917, cases of poliomyelitis were
reported in Alabama as follows: Elmore Coimty, 2 ; Jefiferson County,
4 ; and Mobile County, 1 ; making a total of 7 cases.
City Reports for Week Ended Sept. 29, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron Ohio
2
2
70
4
6
1
1
1
1
•
New York N. Y
3
Canton, Ohio
Norristown, Pa
Chicago, 111
25
1
2
1
1 Omaha Neor
Cleveland, Ohio
' Philadelphia. Pa
Davenoort. Iowa
' Pittsburgh Pa..
1
Dayton, Ohio
1 Providence, K. I
Erie, Pa
Quincv, Mass
Kansas Citv, Kans
i Reck Island, 111
Lincoln, Ne6r
San DIcgj, Cal
Los Angeles, Cal
1
1 Wheclinc, W. Va
1
Newark, N.J
1
2
' Wilkinsburg, Pa
Newcastle, Pa
RABIES IN ANIMALS.
City Report for Week Ended Sept. 29, 1917.
During the week ended September 29, 1917, one case of rabies in
animals was reported in Detroit, Mich.
SCARLET FEVER.
Nebraska — Cedar County.
On October 15, 1917, scarlet fever was reported prevalent in Cedar
County, Nebr.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1774.
SMALLPOX.
Arizona — ^Navajo and Moqui Indian Reservations.
On October 16, 1917, outbreaks of smallpox were reported on the
Navajo and Moqui Indian Reservations, Ariz.
Indiana — ^Fort Wayne and Eiwood.
On October 16, 1917, epidemics of smallpox were reported at
Fort Wayne and Eiwood, Ind.
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SMALLPOX— Continued,
Miscellaneous State Reports.
October 19. 1917
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Alabama (Aug. 1-31):
Chamrxirs County
1
1
14
Washington (Aug. 1-31):
King County—
S^tle..
6
1
1
6
2
1
2
9
2
Pike County ....'.
Talladega CJounty
Lewis County
Pend Oreille County
Total
16!
Nebraska (Sept. 1-30):
Boyd County
1
1
1
1
1
36
WahJdakimi County
Whatcom County
Bellin?ham
Burt County
Colfox County
Yakima County
Cuming County
North Yakima.
Total
Dixon ?V>unty
Douglas County
30
Total ,...
41 1
City Reports for Weelc Ended Sept. 29, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
2
6
Evansvllle, Ind.
2
5
3
4
2
6
Alt n, 111
Fort Wayne, Ind
Austin, Tex
1
Indianap)lis, Ind
Buffalo, N. Y
1
8
3
17
3
1
1
8
1
Kansas City, Kans
Butte, M nt
Le.wenWvirth, Kans
Chicago, 111
Minneapolis, ^Inn
Cleveland Ohio
Omaha' Ncl>r
Columbus, Ohio
at. J.isnnh- Ml
Dayt »n Ohio
St. T^oiils. \f 1 --.
Denver, C>lo
Salt Lake City, Utah
Detroit, Mich
Si.)UxCitv, Iowa
Erie, Pa
Toledo, 0 hio
TETANUS.
City ReporU for Week Ended Sept. 29, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Buffalo. N.Y
1
1
New York, N.Y
1
Charleston, S. C
St I,nnls Ml ' 2
Chicag.i, 111
2
1 Sjin b'cff'). Cai i...
1
Cleveland, Ohio
1
1
1
2
Savannah, Ga '
1
Columbus, Ohio
Trent n, N. J \
2
Mobile, Ala
Wilmington, Del '
I
New Orleans, La
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1774.
TYPHOID FEVER.
Indiana — Bartholomew County.
On October 15, 1917, typhoid fever was reported present in epi-
demic form in Union Townsliip, Bartholomew County, Ind.
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TYPHOID FEVER— Continued.
Massadiiisetts.
During the week ended October 13, 1917, cases of typhoid fever
were notified in Massachusetts as follows: Tewkesbury State In-
firmary 7, making a total of 59 cases reported since August 23;
Gardner, 6 cases, making a total of 64 cases reported in the present
outbreak; Erving, 3 cases, making a total of 17 recent cases.
State Reports for September, 1917.
Place.
New oases
reported.
Place.
New eases
reported.
Maryland: •
Baltimore nty
153
25
31
71
5
33
7
0
10
3K
14 i
8 1
S'l
6
22 1
36
lii
1
13 1
22
22 ,
21 '
Mas5achu5e!ts— ContlBUfd.
Hampden County— Continued.
Palmer (town)
Allegany Toimt v
2
Anne Anmdcl County
Sprinefiold
11
Baltimore County
west Springfield (town)
Hampshire County-
Fielchertown (town)
1
Calvert Coimtv
Caroline County
1
Carroll County
Prcscott (town)
1
Cecil Countv
Midd lose K Coimty-
Arlington (town)
Charles County
1
BOTchester County
C 1 nibrid^e
2
Frederick County ....
Everptt
5
Garrett County
Lowell
4
Harford County
Maiden
Marlboro
Ma \ mrd ( t own )
Mcdford
3
Howard Coimty
1
Kent County
1
Montgomery Count v
2
Prince (iCorRPs County .
Nat irk (to\^•n)
1
Queen Annes County ! !
8nmer\ i!le
5
Somerset Conn t y . . . .
TcwKshurv State Inflrniarv
\V:jtthnin .' . .."
22
8t. Marj^s County.
1
TalbotCountv .
Westford (town)
1
Washin^on Count v ^
Winchester (town)
2
Wicomico Co\mt v.
Norfolk County—
li rook !i no "(to^vn)
Worcester County
2
Podlmm (town) .
2
Total
596 '
Frail Min (to'\n»
I
Quincv.... . , .
1
Massachusetts:
Berkshire Countv—
5
1
"
52'
1|
2
?i
8
5
1
5
3 '
I--
1
1
1
2 i
2
2;
Ply raout h' Count V—
Brockton
2
Adams (town)
1 1 in^hj^m (to^vTi)
1
Great Barrin^ton (town)
Lenox (town)
SufTolk County—
iJostou
32
Nort h Adams
Cholso4i
11
Bristol County —
Wiuthrop (1'nvn)
1
Attleboro
Woro<^st or (ounty—
Filchburp
( 1 ardncr ( t own)
FallKivcr
i
New IJcdlord
9
Taunton
Leominster ( to\\'n)
I'pton ft own)
1
Dukes Countv—
1
Oak Bluffs (town)
Worcester
9
Essex County—
Andovcr (town)
Total
2&1
Beverly
Nebraska:
J ouplus County
Dan vers (town)
Gloncestfr
9
Haverhill
C^ e County
1
Ipswich (touTi)
Sci^Its Uhiff Comity
Seward Count y
York Coimty
2
I >awrc nco
1
Lvnn
2
M'cthutn (town)
Total
Newbury port . . .
15
Peahodv ftow7i>
Vermont:
Addison Count v
RoL'k port (town)
Saugus (town)
1
Swarapscott (to'.ATi).
Chit t enden Cotinl y
1
Franklin( ounty—
Greenfield (town)
Grange (\)ant v
4
Orleans Cou'itv
2
Hampden Countv—
Agawam (town)
Rutlaid Countv
1
Windham County
3
Holvoke
Total
I^udlow (town) .
12
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October 19. 1917
TYPHOID FEVER— CJontluued.
Slate Reports for August, 1917.
Place.
AlftlMuna:
Aq t auKa Coonty . . . .
Baldwin County....
Barbour County
Bibb County
Blount County
Bullock County
Butler County
Calhoun County
Chambers County. . .
Cherokee County
Chilton County
Choctaw County
Clarke County
Cleburne County
Coffee County < .
Colbert County
Conecuh County
Coosa County
Corineton County . .
Crenshaw County .. .
Cullman County ....
Tale County
Pelf alb County
Elmore County
Escambia County. . .
Etowah County
Fayette County
Franklin County
(Jeneva County
Hale County
Greene County
Henry Coimly
Houston County
Jackson County
Jefferjcn C :unty —
Lamar County
Lauderdale County .
Lawrence County . . .
LeeCoimty
Limestone County . .
Macon County
Madison C ^t nty
Marengo County
Marian County
Marshall County —
Mobile County
Monroe Carp/ V
Montgomery Oounty
Morgan Couut>
Perry County
Pickens County
Pike<'ountv
Kandolph Oounty. . .
Mu'll y Co- r'y
St. Clair Coimtv
Sumpt^r County
Talladcpa County . . .
New cases
reported.
1
2
2
7
2
5
2
21
2
4
6
1
6
8
3
6
1
5
2
5
7
1
25
16
4
24
4
2
3
3
1
1
7
15
425
7
5 I
1 ,
6 i
8 i
6 I
10 ;
2
«l
10 I
l\
V
3
2 I
Alabam a— Cont inued.
Tallapoosa County
Tuscaloosa County
Walker County
Washington County...
Wilcox County
Total
Washington:
Adams County—
Lind
Benton County
Kcnnowick
Prosscr !.
Chelan County
Cashmere
Wenatchee
Clarke County—
Camas
Washougal
I Yocolt
Columbia County
Payton
Cowlitz County
Island County
King Count V—
issaquah
Kent
.Seattle
ICiltilus County
Lewis County—
ChchalLs
Okanojran County
Brewster
Oinak
Pacific County
Pierce Coimty—
Sumner
Tncoma
iSVacit CojMity
S{-o anc County—
Koc'/forJ /
Spancic
Spokane
Stovrns County
Colvillc
Thi r ton Cointy—
T( ufno
Walla Walla ( oinUv—
Wait ' -T". ...;...
Walla Walla
Va iJ '. . ' o nty
(ipjuflvipw
!><> lii Va...uu
Zilhh
Total
New cases
reported.
15
31
21
1
4
831
1
3
1
1
3
2
4
1
1
1
1
2
2
1
1
1
16
1
i
12
10
1
2
1
4
2
1
2
12
10
I
Pl:ice.
Akron, Ohio
Albany, NY
Allentown, Pa
Alton. Til
Ann Arbor, Mich.,
Baltimore, Md
Berkeley, Cal
Birmingham, Ala..
Boston, Mass
Buffalo, N.Y
Butler, Pa
City Reports for Week Ended Sept. 29, 1917.
Cases.
Deal lii.
.1
^. • • -
31
4
24
9
?
4
1
Place.
1 (\v->ei.
1
Deaths.
Camden, N. J
:::::i I
1 1
Canton, Ohio
Charleston, 8. C
1
Clielsca, Mass....
1 3
Chicago. Ill
1 1(]
Ciminuati, Ohio
do eland, Ohio
:;::: 3
9
Coiroy\illc, Kans
1
Columbus, Ohio
Concord, N H
Covinglou, Ky
4
::::;! ?
2
2
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October 19, 1917
1774
TYPHOID FKVKKr-Contlnuea.
City Reports for Week Ended Sept. 29, 1917— Ck>ntmued.
Place.
CMes.
Dcttths.
Pteett.
0MB.
Deaths.
Cumberland, Md
1
Nashvflle. Tenn
6
7
4
1
3
9
61
2
1
1
5
3
1
22
12
1
5
2
6
3
4
2
2
1
2
5
21
6
2
6
1
29
2
2
1
2
1
2
6
ft
2
11
22
2
3
t
DaiiA-ille, 111
1
4
13
25
2
1
1
2
1
4
2
18
3
I
10
2
Newark, N. J
1
Dayton, Ohio
1
New Bedford, Mass
Denver, Colo
Newcastle, Pa
Detroit, Midi
2
New Haven, Conn
1
Thiliith, Mltm . , ,,
New Orleans, La
1
East Orange, N. J
NcwYork, N. Y
5
Elizabeth, N. J
Niagam PfllH, N. Y
El Paso, Tex
Norfolk, Va..'
Erie, Pa
1
Norristown, Pa
Evansville, Ind
3
Oakland. Cal
1
Everett, Mass
Omaha, Nebr
Fall Ri\ cr, Mass
2
1
1 1
1
Perth Amboy, N. J
Flint, Mich
Philadelphia. Pa
3
Fort Wayne, Ind
Pittsburgh, Pa
7
Fort Worth, Tex -
PiltsfleldVMass
Golesbiirg, 111
Portland, Orog
3
Gnhc^ton, Tex
Portsmouth, Va
1
Crand Rapids, Mich
1
Providence. R.I
Hagcrstown, Md
1
Roanoke, Va
Hartford, Conn
P
Rochester, N. Y
1
Havcrliill, Mass
1
12
2
?
Rockford, 111
1
Indianiinolis. Ind
Jersey City, N. J
Johnstown, Pa
'
Rocky Mount, N.C
Sacramento, Cfal
Saginaw, Mich . .
Kalamazoo, Midi
1
St. Joseph, Mo
Kjimas C-ity, Kans
2
(
St. T.ouis, Mo
1
Kearny. N.' J
1
3
2
2
2
1
4
2
j
Salt Lake City, Utah
I
Knox\ ille, Tcnn
Savaimali, (Ja
Kokomo, Ind
Scull Ic, W'ash
1
Lancaster, Pa
Somerville, Mass
.1
Lawrence, Mass
!
South Hend, Ind
2
Leavenworth, Kans
1 1
Springfield, 111
1
Lc.xingt on, Ky
Sprin-'field, Mass
Lima, Ohio
1
SpriuKf'ield, Ohio
Lincoln, Xebr
1
'
SjTacu>e, N. Y
Tacoma, Wash
1
Long iJcach. Cal
i|::::::::::i
8 1
1 ' 1
2' 1
2
Long Branch, N.J
Terre Haute, Ind
2
Lorain, Oliio
Teledo, Ohio
Los Anpcles, Cal
Tojx'ka, Kans
1
Lynchburg, Va
Trenton, N. J
Troy. N. Y
Washington, I). C
Ii\iin, Mass
2
M";iMcn, Mass
3
Manchoter, N. H
Watertowr, N. Y
Mc Kecsport , Pa
l\
Whcehng, W. Va
J
Memphis, Term
6
Widiitj, Kans
WiIVo -Harre, Pa
Wilnuiigton, Del
Milwaukee, Wis
3 ' '
15 ' 1
Minneapolis, Minn
1
Mobile. Ala
1
Wiusloii-Sali^m, X. C
Worceter, Mass
York, Pa
7
\ I
3
Montclair, N. J
1
1
1
Morribtown, N. J
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for September, 1917.
Cases reported
State.
Diph-
theria.
Measles. I
Maryland
Massachusetts..
123
728
82 I
241
State Reports for Augast, 1917.
During the month of August, 1917, 56 cases of diphtheria, 157
cases of measles, and 47 cases of scarlet fever were reported in the State
of Alabama; and 25 cases of diphtheria, 37 cases of measles, and 30
cases of scarlet fever were reported in the State of Washington.
ARE YOU SAYING Your Money to Inrest im the SECOND UBEBTY LOANt
Digitized by
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1775
October 19, 1017
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Sept. 29, 1917.
Populii-
tjnti $is of
JuJv t, tgiQ
(csfimatcd
BURAU).
Total
deat!is
imm
nil
Dlphtheila.
Uciisles.
Scarlet
favw.
Tuber-
cuIokIa.
city.
■
1
1
i
5
IS
a
0
1
1
1
1
0 ver SOD, 000 J Tihii bl t: jnt s :
iialtimoro, Md
588,621
756,470
2,4»7,722
674,073
571,784
503,812
5,602,841
1,709,518
579,090
757,309
468,558
410,476
306,345
436.535
353, 454
408,894
371,747
453,516
348,639
363,980
214,878
260,800
271,708
295,463
254,960
258,417
104,199
181,762
U2,mi
106. 2 13
127,224
12'<,166
104.562
128,2)1
110, 00
loa, vio
llL2t5
102. l2->
148. 'n5
117.0')7
11S.15S
14».<^'*5
i:.s,r)Oi
16"). 470
10>,<'<1
l.-)fi.fiS7
117.^^0
10". 142
15J.021
112,770
191,5:>4
111,5)3
16J,314
85,625
03,. W^
57,660
61. 8 »3
67,653
53, 071
67, 449
60,8,52
«0,7{4
67,144
94,495
80,890
218
230
621
181
184
102
1,322
475
193
179
221
102
85
90
" ii2'
149
48
119
70
53
TO
72
15
78
190
54
86
9
190
53
38
46
30
19
18
11
35
22
31
9
5
33
6
2
94
3
12
3
1
3
14
5
6
2
11
2
8
4
2
'■'2
'"l
11
15
24
4
1
"l
5
16
54
6
29
10
61
12
12
15
7
3
3
19
11
5
1
3
7
5
14
4
12
3
9
14
• •'4'
"'i'
....„
""2
1
i
30
72
277
29
41
32
287
84
15
43
24
25
10
23
35
24
Boston, Mass
Chicago, 111
47
Cleveland, Ohio
16
Detroit, Mich
10
17
Los Angeles, Cal
2
64
6
3
2
4
"l
New YorV, N. Y
ISO
Philadelphia. Pa
53
Pittsburgh, Pa
10
22
St. T ouis. Mo
From 300,000 to 600,000 inhabit-
ants:
Biiffalo,N. Y
21
finrtnnati, Ohio
Jersey citv, N. J
6
5
1
9
1
4
2
4
Milwau' ee, Wis
g
Minneapolis, Minn
NewarV.N. J
40
24
26
15
17
New Orleans, La
San FranMs'^o, Cal
Seattle, Wash
4
Washington, D.r
19
8
11
4
From 200,000 to 300,000 inhabit-
ants:
Columbus, Ohio
Denver, ( 'olo
""2
3
2
5
1
2
1
2
3
11
9
Indianapolis, Ind
""3*
1
16
10
1
8
6
8
7
4
6
4
''
Portland, Oreg
5
12
Pro "idoncc R. I
Rochester. N. Y
From 100,000 to 200,000 inhabit-
ants:
Albany,N.Y
6
Rirminj^ham, Ala
66
24
47"
36
21
30
.54
2S
33
15
5?
42
35
35'
19
35
53
20
36
52
49'
44
55
26*
6
6
4
5
7
5
5
2
5
Cambridge, Mass
3
Camden , N . J
Davton, Ohio
2
2
2
Fall Liver. Mass
2
1
4
Fort Worth, Tpx
2
Grand Ranldr,, Mich
Hartford , Conn
..
6
3
5
2
8
2
4
30
4
11
12
8
15
3
5
8
2
3
2
19
7
3
5
■!
22
2
La vroncc, Mass
2
Lo veil, Ma;.
3
Lvnn. Ma.: *.
2
2
7
3
1
5
4
2
M'cmphb, Tenn
....„
6
Xa-.h . illp. Tonn
2
No .V Hcdiord, Ma'JS
1
2
4
2
New Haven, ('onn
;j
Oakland. f\i!
1
2
Omaha, Ncbr
4
Kca'lin',', Pa
1
2
Richmond. V^a
2
3
2
2
......
7
Salt Li\oCiiv, Utah
S irin 'ir-Id. Mar-
8yraoiis^, \. Y
Trt< oma, Wa,^h
11
25
1
5
7
10
13
1
1
3
r,
11
2
3
2
3'
ToUnlo, OhiD
......
2
'
6
1
7
2
4
6
Trenton, N. J
6
Worce.-tpr, Maw
■{2
3
From 50,00'J to 100,000 inhabit-
ant.:
A Jrron, Ohio
4
Allento'A'n, Pa
1
4
3
1
1
2
Atlantic City, N.J
Bayomie, N. J
4
2
1
Berkelev, Cal
1
1
Binghaiiiton, N. Y
17
U
19
32
20
19
37
2
1
1
1
Brockton, Mass
Canton, Ohio
1
1
1
Charleston, S. C
7
7
10
15
1
1
Covington, Ky
1
1
11
2
3
5
4
Dtiliith, Minn . ^
2
1
1
1
2
Elttabe'th, N. J
9
ABE YOU SATING Your Money to Inrest in the SECOND LIBERTY LOAM
October 19, 1917
1776
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Contmued.
City Reports for Week Ended Sept. 29, 1917— Continued.
Popula-
tion as of
July 1, 1910
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria,
Measles.
Scarlet
fever.
Tubor-
culods.
aty.
1
1
i
• 3
i
1
1
Prom 50,000 to 100,000 inhabit-
ants—Continued.
El Paso Tex
63,705
75.1^5
76.078
54,772
76.183
72,015
77,214
68, 52^
99, 437
50, 8,') {
51,1.>5
78. 28 J
58.221
53.7v:t
89,012
92, M3
71,744
59,411
6^867
5.5.18.5
66.8 5
55,012
85, 2 ;o
53,s:{0
68,805
!*9,5h)
57.078
87 OVi
1
3
5
2
1
1
2
Erie,Pa
i2'
5
17
7
26
24
2
1
5
15
7
3
2
2
5
18
Evansvlllo Ind .
Flint Mirh
Fort Wavne Ind.
1
1
IT&rrisbiir? Pa .•-
4
3
3
3
2
IIoboken,N J
1
3
Johnstown Pa
2
1
1
Kansas (Mty, Kans
1
Lancaster, Pa
r
Maiden, Mass
12
25
16
19
12
20
15
10
17
25
15
21
17
2S
19
i?'
16
3
3
2
1
1
4
2
Manchester N IT
............
3
Mobile, Ala
1
New Britain, C<mn
1
4
2
11
1
4
2
::::::i::::..
i
10
1
Norfolk, Va
1 1
2
1
2
Oklahoma City, Okla
Passaic, N.J
' 1
3
:..::.i 5
1
3
1
Pa>vtucket, R.I
»
Portland , Me . ...
1 '
. 1
1
Rocicford, ni.. . .
1
.1
Sacramento. CaL
4
2
3
Sarinaw, Mich .
1
4
:::::: a-
St JoscDh Mo
2
1
San Picpo, ('a!
2i....:.
1
21
s ; 3
Savannah, (ia
15 1
4 1
1
!• ' 3 3
Schencctad>\ N. Y
Sioux City, Iowa.
2 1 4 I 1
1
3
1
2
1 7 ' 2
South Bend, Ind
08. MO, 24
61.120 1 11
51. "a) 1 21
2 t
Sprinjrfiold, ill
1
3
1 1
*
1
2
Sprincncifi, Ohio
2
8
2
13
1 1 4 1
Terrc 1 faute, Ind
00. Oh'.
77,'ilO
70. 722
76, 77«)
54,205
27.732
37, 385
34.814
32. 1 85
32. 7.U)
27,0.2
4i, 423
40,1 '-2
29,:-il9
26.074
.32.261
48.811
39. 873
28, 74 {
42. 4.58
28,20i
39. 2 13
41.781
41,80}
2i), .3.53
25, (179
48, 477
35, 3(vJ
48, SH^.
31,. 570
38, 070
31,077
41,097
35,384
46, ,515
27, 5S7
36,964
32,940
20
i4"
.•;o
2
10
13
4
6
6
io'
3
10
8
1.:. ..
1 ' 3'
Trov N y
1 ••'
1 1
1
Wichita, Kans
i ' '
WilkevHarre, Pa
:::;::'::::::i::::::
1
2 1 1
Wilmington, Del
.-
1
1
1
From 25,000 to 50,000 inhabit-
ants:
A lameda, Cal
.
i 1
12; 1
Auburn, N. Y
1
ii \ ii 1
Austin, Tex.. .
1
Bellincham, Wa.sh
1
■"■e"::::::^:::::?
Brookline, Mass
i "■■;:
2 I
Butler, Pa
3
3
.... ^
1
1
Butte, Mont
1
""h'\ '
Chelsea, Mass . . .
2 1 '2
1
I •
} i
Chicopee, Mass
Cumberland. Md
2
,
::::::i i;;::::
1
; 2
1
..! 1
Danville, 111
1
Davenport, Iowa
i 1"::"
i
«"
5
3
9
10
12
8
1
1
1
1
7
5
4
2
1
. . 1
4
East Chicairo ind
1
1
Eiist Orange, N.J
Elgin, 111
:::::t" i"
.1
1
••••i 1::::.:
1
1
3
Everett, Mass
.. .)
Fitchburg, Mass
1
4
Cal vest on, Tox
1
2
Green Bay, Wis
1
HuKerstown, Md
■•••i
3
Haverhill, Mass
17
12
12
11
i4
29
10
9
10
14
r.""
1
2
Jackson, Mich
1 ' '
1
Kalamazoo, Mich
4
2
1
6
I
!...!.| 3
1
Kenosha, Wis
7
15
2
Knox ville, Tenn
I
1
La Cro<?se, Wis
....
"1
1
1
Lexington, Ky ,
»l
1
2
1
1
3
Lima, Ohio
Lincoln, Nebr
1
2
2
1
I>ong Bettch, Cal
1 1
1
Lorain, Ohio
13
1 1
Lynchburg, Va
j* ■ " 1'**
1
ARE YOU SATING Yen
r Money to InT<
98tii
ithc
SEC
OND
Digiti2
LIB
^ed by ^
EBT^
Go
rLOAJNt
OQle
1777
October 19, 1017
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Sept. 29, 1917— Continued.
Popul».
tionasof
July 1,1916
(esiimated
by U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
aty.
1
1
J
1
1
1
1
Fwm 25,000 to 50,000 inhabft-
ants— Continued.
MoReesport, Pa
47,621
26,234
26,318
27,327
2»,603
41,133
31,927
30,108
43,715
37,?53
31, iOl
31,^04
33,080
40,460
41,1S5
38,029
39, 061
36,798
38,136
46,486
43,284
28,926
38,902
27,445
35,358
46,226
36,283
48,726
30,570
29,894
43,139
43, 3n
33,809
29,892
31, 155
30,863
22,874
15,010
21,f;H5
15,791
> 13.075
17,5t<<
22, (;t.9
21,270
2i, 539
20, TA)
19,363
15,395
> 11.010
U, 281
21, 120
15,213
20,985
'22.019
19,921'.
23.>o:>
17,:.21
11, <><■>(■,
12,007
1«,S31
20. 193
13. 821
15, 548
21,618
2J,228
15,969
14
6
5
7
6
i2
0
10
r
4
14
16
7
5
G
8
8
7
18
9
18
1
1
1
1
MedfordlMass
2
2
1
1
Montclair, N. J
..... ^
2
1
Nashua.N.H
Newburgh,N.Y
4
1
1
1
1
1
Newcastle, Pa
Newport, Ky
1
2
2
Newport, R.I
Newton, Mass
5
4
2
1
2
1
I
1
1
Niagara Falls. N. Y
1
Norrlstown, Pa
......
1
Ogden, Utah
1
3
3
1
Oranze, N. J
Pasadena, Cal
1
1
2
5
: ::::
1
1
2
1
1
Perth Amboy, N.J
PittsOeld, Mass
Portsmouth, Va
Quincy,IlI
1
1
8
1
1
*i
Quincy, Mass
1
1
Racine,' Wis.
Roanoke, Va
6
1
1
Rock Island, ni ...
1
8an Jose , C-al
1
2
3
Steubenville, Ohio
5
7
10
13
5
2
9
19
5
24
12
8
5
6
2
1
2
■
Stockton, Cal
Superior, Wis
1
TauntonLMaso
1
1
1
Topeka, Kans
1
1
1
1
1
2
1
1
Waltham, Mass ; .
1
Watcrto^ , N . Y
5
3
8
1
1
West Hoboken, N. J
Wheeling, W. Va
2
2
1
5
1
1
WilUamsport, Pa
1
Wilmington, N.C
WhLston-Salem, N . C
1
4
1
3
Zanesville, Ohio
From 10,000to25.000inhabitants:
Alton, lU....
1
2
5
1
1
Ann Arbor, Mich
Braddonk, ra
1
Cairo, HI
2
Clinton, Mas;
Coffevville, Kans
1
1
Concord, N.U
13
9
8
7
9
8
3
7
5
2
12
8
6
8
7
9
Cralesburg.IU
Kcamy,K.J
3
..
2
1
2
1
Kokomo. Inrl
2
Leavenworth, Kans
Long Branch, N. J
1
1
1
2
Marmcttc, Wis
Morr Lst own , N .J.
Nanti-oke, ra
3
1
1
Newburvp<M^, Mass . . .
New London, ( 'onn
1
1
1
North Adams, Mass
1
Northampton, Masi
1
1
10 ;
2
1
1
PlainnfM, N.J
Pontiiic, Mich
1
I'cvi mouth, ^. II
5
Rock V Mount, N. C
7
3
15
7
2
Rutland, Vt '.
San'lt)>!vv, Ohio
'
8arat oga^ Springs, N . Y
Sle?Iton, I*a . . . .
2
'
1
1
1
1
Washington, Pa
2 1
Wilkinsburg, Pa
Wobum, Mass
...
4
1
a
■ ' "I 1
• Population Apr. 15, 1910; no estimate made.
ABE YOU SATING Tour Money to Invest in the SECOND LIBERTY LOAN!
Digitized by VjOOQ IC
FOREIGN.
MADAGASCAm.
Cerebrospinal Menihtffe TaummLke.
During the period from June 24 to Jidy 15^ 1917, 25 fatal cases of
cerebrospinal meningitis were notified at Tananarive, Madagascar,
and from July 22 to August 5, 55- fatalities. The cases occurred
mainly among the native population. The disease was reported
present in epidemic form at Tananarive daring the period frcnn Octo-
ber 1 to December 31, 1916, with 212 cases, and in January and Feb-
ruary, 1917, with 199 cases. It continued to be reported present
from February 25 to June 3, 1917. The native population of
Tananarive is 62,410.^
UNION OP SOUTH APRICA.
Plague — Cape of Good Hope State.
An outbreak of plague was reported August 23, 1917, at Cradock,
Cape of Good Hope State, Union of South Africa.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
ReporU Received Daring the Week Ended Oct. 19, 19X7. '
CHOLERA.
Flaw.
Date.
Cases.
Deaths.
Bemarks.
India:
Bombay
July 29- Aug. 4
July 15-28 . .
2
1
11
16
Calcutta ,....
Madras
Aug. 5-21
Aug. 19-25
30
2
Pliilinpiiie Islands:
Manila. . ...
Not previously reported, 1 ease.
Aug. 19-25, 1917: Cases» 309;
deaths, 137.
Provint-cs
Albav
Aug. 19-25
do
8
12
19
02
40
29
24
8
6
1
5
8
14
44
20
24
12
5
4
1
nohol
Ccbu
do
I>ovt*? -
do
Mindanao
Nt'pro? Oriental
do
do
Samar
do
Sorsogon
Snripao
do
do
Tavabas
do
Philippine "Islands:
Manila
Aug. 26-S«pt. 1, lOtT: 1 case not
Provinces
previously reported.
Aug. 26-Scpt. 1, 1917: Cases, 293
Albav
Aug. as^SeptJ. 1....
do
2
10
22
111
68
11
68
1
2
6
14
48
39
7
40
1
deaths, 157,
Bohol
Cebu
do
Loyto .
... .do
•
Miiidanno
Nej,Tus Oriental
do
do
•
8amar
.do
Tavabas
do
» Public Honlth Reports, Sept. 7, 1917, p. 1464.
' From medical olbcers of the Public Health Service, American consuls, and other souroes.
ARE YOU SAVING Tour Money to Inrest fir tile SECCTNI^ L»ERT¥ L^ANl
(1778)
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1779
October 19, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Receiyed During the Week Ended Oct 19, 1917— Continued.
PLAGUE.
Plaoo.
Date.
Cases.
Deaths.
Remarks. '
India
July 15-Aup. 4, 1917: Cases, 10,014;
deaths 7 S21
Bombay
Jaly2»-Aug. 11...
July 1^21
77
ei
1
451
81
3
Calcutta
Madras Prosidfincy
Aug. 5-21
651
88
8
Rangoon
July29-Aug.ll...
July 29- Aug. 11...
Aug. 23
Siam:
Bangkok
Union ofSouth Africa:
Cape of Good Hope State-
Cradock
Present.
**"!
SMALLPOX.
Brasil:
Rio de Janeiro
Canada:
Ontario-
Windsor
China:
Chanpsha
Chuneklng
Mukden
Shanghai
India:
Bombay
Madras
Mexico:
Moxi<*oCity
Vera Cruz
Philippine Islands:
Manila
Spain:
Malaga
Valencia
Union of South Africa:
Johanneeburg
Aug. 12-Sept. 1 .
Sept.30-Oct.«..
Aug.
Aug.
Sept.
Aug.
July
Aug.
Sept.
Sept.
Aug. 36-Sept. 1 .
11-17
12-18
2-8
2«-Sept.9.
29-Aug. 11.
5-21
lft-22.
9-15..
Apr.
Sept
1-May31.
9-15
July 1^1.
124
1
... Present.
Do.
2 ' Among native population.
4 I
3 I
29
Varioloid.
I
TYPHUS FEVER.
Algeria:
Aljjiers
China:
Anlung
Alexandria..
Japan:
Nagasaki
Mexico:
MexkroCity.
Aug. 1-31
Sept. 3-9
Aug. 19-Sept. 2.
Sept. 10-16
Sept. 16-22
1
2
20
5
100
YELLOW FEVER.
Mexico:
Yucatan State —
Merida
Peto
Aug. S-Sept. 30....
Julyl-Sopt.25....
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October 19. 1917
1780
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received fh>in June 30 to Oct 12, 1917.
CHOLERA.
Place.
India:
Bas lOin
Bombay
Do
Calcutta
Do
Madras
Do
Maudalay
Moulmein
Pakokku
Pegu
Do
Rangoon '.
Do
Indo-Cbina:
Provinces
Anam
Cain})oJia
Ck)chin-China
Laos
Tonkin
Saigon
Java:
East Java
Do
Mid Java
West Java
Batata
Do
Persia:
Mazandoran Province—
Amir K"la
Barfouronchc
Uamzo Kela
Machldossar
Philippine Islands:
Manila
Provinces
Auusan
Albav
Do
Ambos Camarinei
Do
Bataau
Batin ,'as
Bohol.
Do
Capiz
Do
Cebu
Do
Iloilo
Tx»vte
Do
Misamis
Mindanao
Nc>-Tos Oriental
Rizal
Do
RomMoTi
Saraar
Sorso ,'on
Do
Suricao
TayanU"!
Do
Zambo^nga
Date.
Apr. 1-May5
June 24-30
July8-2H
Apr. 2^June30..
July 1-7
Apr. 22- June 30..
July 1-Aug. 4
May G- Jure 30...
May 13-June2...
Apr 20-May 5...
Mav27-June30..
July 1-7
Apr. 21-June30..
July8-2S
Ca-je^.
Feb. 1- June 30..
do
....do
Juncl 3D
Feb. 1 June 30..
Apr. 23- May 27.
Apr. 2-8...
Julv9-15. ..
Julv 16-22. .
Apr. 13- July 5...
July6-Aug. 2
Fo... 3
J;:i.r> 17.
Jan. 17....
Jan. 31....
Juno 17-23.
230
79
878
1
36
163
1
1
1
jui> 1 ) J-^
Ma 2tVJur. 3")...
July l-Au:^. 4
June 3 -9 1
Julv 22- Alii?. 4 I
Julv S 14
Junn 17-23 1
Mav 20- Juno :«)...
Jul-. l-.Vu;. 1
June 3-30 |
July 1-Aug. 4 1
Juno 3-30 1
Julv 1-Aug. 4 1
...:do
Juno 10-30 !
July 1-Au'.^. 4 1
July 8- A ur. 4 '
July 2i)- A UK. 4 j
Juiv 1- Ani'. 4
Jurie24~:30 1
Julv 1-7 ,
.Tiil'-2V2S '
Julv 15-21 j
Juiie3-30
Julv 1-Aug. 4
Jurv29-Aug. 4 '
Juiio3-3') ;
Julv 1-Auc, 4 1
July 15-21
Deatlis.
12
113
53
20
}
3CS
CO J
02
64 I
3HS I
^^
334 I
?37 !
^'i I
1
1 '
4 I
196
216 ,
4 I
7
11 I
11
8
1
6
347
3
4
43
2
3
1
5
7
17
7
191
51
543
21
lOi
Remarks.
1
251
161
40
45
l^K)
284 I
1 i
117
11
177
2
ss
114
4
7
Feb. 1-Junc 30, 1917: Cases, 1,237;
deaths, 805.
Apr. 13-July 5, 1917: Cases, 71;
deaths, 31. July6-Aug.2,i917:
Cases, 100; deaths, 52.
May 20-Jan© 30, 1917: Cases, 795;
ilcitlis. :m. Julv 1-Aug. 4,
1917: Cases, 2.064; deaths, 1,271.
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1781
October 19. 191T
CHOLSSA, PLAGIFE, SMALLPOX, TYPHUS FETES, AND lElLOW FEVER—
Continued.
Repwts ReeeHed flmn Jane dt to Oct 12, 1917— Continued.
PULGUB.
PlMSL
Date.
Cases.
Deaths.
ReonrlB.
Acafaia:
Adni
Haya-Ju]y4
43
8
1
1
33
4
Apr. 8-Mair 14, 1917: Cases, 69;
deatha, 61.
BraxU:
Bahla
Juno 10-30
12
5
4
41
1
Do
July8-Sept. 8
July Ifr-Aug. 15...
Apr. 8-June23
July 6-21
Pemainbuco
C«ylon:
Colombo
Do
China:
Amoy . .
Apr. 2»-MaF6
Present and in vidalty.
Present Aug. 19.
Do
July 1-7
6
20
4
6
13
3
Pofu^^mg, „, , _ , , -,^,^ . . . .
May 13-June30...
July 8- Aug. 18
June 2
Do
Kwangtiir.e Province—
Tu-pu aistrict
Present.
Ecuador:
EstaiH i\ Vicju
l^b. 1-2S
1
fiC
33
9
1
1
2
1
Giiu\ tiuull.
do
29
1)0^ : ::
Mar. 1-31
18
4
Do
Apr. 1-30
MilaCTO
Mar. 1-31
X:;:::::::::::::::::::
Apr. 1-30
1
Nobol . .
Feb. 1-28
Salitrc
do
Do
Mar. 1-31
1
2
Taura
Feb. 1-28.
3
Egypt
Jan. 1-Aug. 2, 1917: Cases, 1,251;
deaths, 696.
Alexandria
Do
Port S'ijid RONcrnmcnt
Port ."^nid
June 21-27
Jiilv31-Aup. 19...
Apr. 3' '-May 19....
June 25
0
3
4
1
1
14
1
4
1
3
Da
July 28-29
1
7
Pro vim c —
f"a\ *>uni
Mav ll-June 26. . .
Jui.p 2*«
<iirj:e!»
Mi'V 17
1
3
MinW'ii ._ ,
Mav 12-June2h...
JulV 29
4
1
i
38
3
2
Do
Piout
May 12
i
9
Suez Ko\ eminent
Apr. 30-Junc2....
May 12-JuDe28...
Au?. H 24
May 3 H
23 t
Great Mrilain:
(Jra\osi ad
xd 1
1
1 From s. s. Matiana.
London
2lnhispitftlat port. From s. s.
Sardinia from Australian and
oriental per ts.
Apr. 15-Junt 30, 1917: Cases,
43,922: doatlis, 30,197. Julv 1-
India
Basseiu
-\pr. 1 Juno :io
■
54
«i
397
127
3S
:i,5
413
8
250
58
9
74
16
1
2
169
206
2
Do
Bombay
Do.
Julv 1-7
Apr.22 Jun<';0...
Julv l-2>
Apr. 29 Ju!»'2
" "4S6"
154
7, 1917: Cases, 1,870; deaths,
1,322.
Calcutta
Hrn^u'la
Apr. 1 June A)
Karai 111
Apr. 22 Juun.io...
June 2< Julv 2H...
Apr. 22 June 30...
Julv 1-7
4fts
11
301
70
Do
Do .;::;:::::
Mandalav
Apr. H- May 12
Moulmcih
Apr. 1-Junn 30
Do
July 1-7
Myingvan
Apr. 1-7
Pegu.'
Mav 27 -June 2
Rangoon
>pr.l5 June 30...
Julv 1 2s
1K3
217
Toungoo
Apr. 8-14
Indochina:
Provinces
Feb. l^une 30, 1917: Cases, 730;
Anam
Feb. I June 30....
do
232
132
219
34
113
47
131
115
133
23
89
36
deaths, 491.
Cambodia
Cochin -China
do
K wang-t how-Wan
Tonkin
May 1-Junc30
Feb. l-JuneiJO
Apr. 23- June 3
Saigon
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Digitized by'
October 19. 1917
1782
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Continued.
Reports Receiyed from June 30 to Oct. 12, 1917 — Continued.
PLAGUE— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Java:
East Java
Apr. 2->Cay 20. 1917: Cases. »
Djocjakarta Residency
Kcdiri Residency
Apr.23-May6
do, .
1
1
1
1
3
18
4
6
deaths, 29.
Samarang Residency. . .
Surabaya Residency . . .
- Do
Apr.2VMay20....
Apr.2-May20
JulyR-28...
4
6
Surakarta Residency. . .
do
Pern
May 13 31,1917: Cases, 1.5.
At Mollendo.
Depart mcnts—
An- uipa
May 16-31
4
1
?
1
13
6
2
1
Callao
.....do
At Callao.
Lambavcque
do...
At Chiclayo.
Libertad
do
At Falaverry, 8an Pedro, and
TrujUlo.
At Lima.
Lima
do
S;am:
Bangkok
Apr. 22 -June 30...
July 3 23..
12
5
1
1
Straits Settlements:
Singapore
June 3-16
Do
July 1-7.
Union of South Africa:
Cape of flood Hope Ftatc-
Olenprey district
Aug. 13
Present.
Terkadistnct
Mav 2H
1
1
1
At Summerhill Farm.
Queenstown
June 6
Orance Free St ate
Apr. 16 22. 1917: 1 case. Apr.9-
22, 1917: Cases, 26: deaths, 17.
En route for port of London.
Winburg district
May 2S
1
6
At sea:
S.S. Matiana
July H-18
e
SMALLPOX.
Australia:
No A Sout h Wales '
Hron-:irrina I
Ct'ssno--!.- I
Co.) 1 1 iir.i'jraii I
Qrnmbono '
Warro'i disirict I
Quoon^l rid - '
Thur-^day Island Quar- May 9.
antiiU' Slilio.i.
Anr.27-.Tune 21....
July ^^-^\
Mav 2.>-JuIv o
Ait. 27-Jnne 21...
June22-July 17...
Brazil:
Haliia
Do
Uio d* Ja leiro ,
Do
Canada:
Manitoba-
Winnipeg
Do
Nova Scolia—
llaliiax
l*(»rl lla-.vke>')ury
Ontario -
Ottawa
Coylo.i:
Colombo ,
China:
Ainov
Do
Antin?
I»()
(M. fu-hi
Ch'P /king
Do
Dairon
Do
Mav n Tunc 30
Julv 22-AU7. 4
.....do
' July 1-A ;j. 11....
Juno 1'>-1''. I
Aug. VJ .-ci^t. 1....
June IH-July 7 '
June 17 -3J 1.
Apr. 27-July 28, 1917: Cases, 75.
From s. s. St. Albans from Kobe
via IIo:i;^":on;;. Vr^s?l pro-
ceeded to Towns ville. Bri^
bane, and Sydney, in qoaraa*
tine.
ProA^:it in district.
July 3a-.\ug. 5..
May 6-12
Apr. 29-May 2o. . . . I I ' Present and in vicinity.
Julv 1-Aui,'. v.).
Mav 21- Juno 21...
.\ni,'. r.-l2
Mav 27 hmf'2
Mav«) hinc23
Jnlv \-2<
M ivl{-Ji:ne30...
Jnlv S-2^
30
6 1
Do.
Do.
Do.
July 1-7, 1917: Present.
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1783
October 10, 1017
CHQI^RA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER—
Ckmtinued.
Reports Reeehred from J«iie 95 to Oct 12, 1917— Continued.
SMALLPOX— Contiaued.
Place.
Date.
Cases.
Deaths.
Remarks.
ChinA—Continued.
Hankow....
June 24-30
Apr.23-May6
I^y6-Junel6....
Aug. 5-18
2
7
8
Harbin
On Chinese' E a9tern R y.
Honckone
7
^0^.:::::::::::::::::
Mancharia Station
Apr. 23-29
Do.
Mukden
May 27-Jniie 2
Present.
Do
July H-Aug. 11....
Do.
8»n^nghftl,
May21-Julyl
July 2-Aug. 5
13
32
9
Cases foreign; deaths among na-
tives.
Among Chinese.
Do
Tsitsliar Station
Apr. 1&-22
i
35
39
:io
19
1
1
On Chinese Ka tern Ry.
At another station on raflway,
1 case.
Tsinetao
May22-July7
July30-Aug. 11...
May 1-31
7
1
Do...:..;::::.:::..;.::
Chosen (Korea):
Chemulpo
Ecuador:
Guavaqui!
Feb. 1-2S
bo
Mar. 1-31
Do
Apr. 1-30
Alexandria
Do
Apr. 3>>July 1
Julv2-29..
9
4
1
Cairo
France:
Nantes
Feb. 12-Mar. 1"^...
Jnlv30-Aug. 5
May 6-12
Pari^
Germany
Mar. iJ^Apr. 2^, vni: Cases 715
Herlii
Mar. 1K-Aijr.2«-.-.
do
lOf^
10
IS
50
20
2
10
1
in fities aud 32 tl ites and dis-
Brf'nipn
tricts.
Chirlottenbcrg
. .do
Hamburg
do
Lei])ziK
...do
I.ubor-k-
do
Miiniih
do
do
*
otuttgart
GriHxt*:
Alh'Mis
July 25-30.
23
75
22
12
s
1
4S
15
Indifi:
)U>iiihav
Apr. 22-Tnnp30...
Jnlv I-2-J
ISO
48
I>0.'
CuK'i i; tft
Ar;f.2.VMav26....
Karj'hi
Do
Aj>r.22-Iuly4
July ^-14..
27
1
«)
31
33
Madras
Do
Ran;,oon
Do
ATr.22-Ji'.ne30....
Jt'h l-Aui;. 4
Aif.15-.Iunc 30
Julv 1-2^
Indo-China:
rrovinoes
Feb. 1-Juno ."^o, 1017: Ca-^s G17,
Amra
Feb. 1-Jtine30
do
1,630
l.?0
1,267
4
5
274
ii»y
32
9
1
65
I
177
I
1
3S
18
88
23
237
26
377
deaths, 533.
CunNHJia
Cecil L'i-(hina
Kv. arit^-Chow- Wan
do
Marl-Apr. 30
Apr. 1-3)
Lao-
1
30
63
12
3
Tonkin
Saigon
Italy:
Turin
Feb. 1- June 30
Apr. 27- June 10....
May 2l-June 24 . . .
Julyl2-Aug.26...
Sept. 0-15
Do
Jamaica:
K in ?ston
Japau:
Kobe
Nat^asaki
May27-JiUy22....
M>»y2^June3....
Mavie-July5
July 25-31
16
Osaka
55
Yokkaichi
Yokohama
May27-Julyi
Apr.2-Julyl
Jiily2-29
1
2
Java:
East Java
Do
Mid-Java
Apr. 1-Julyl
Jiilv2-22.
7
Do
West Java .,...'- - -
Apr. 13- July 5, 1917: Cases, 239:
1 de.itbs.4!. Julv (V-Aue. 2. 1917:
Batavia
Apr. 13-July5
30
0
1 ' Cases, OS: deaths, 14.
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October 19, 1017
1784
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVES-
Gontinued.
Reports Received from June 30 to Oct 12, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Mexico:
Coatepec :..
Do
Jalapa
Mazatlan
Mexico City
Do.....
Monterey
Onaaba
Do
Vera Crui
Netherlands:
Amsterdam
Philippine Islands:
Manila
Do
Portugal:
Lisbon
Do
Portuguese Kast Africa:
l/ourenro Marqms. .
Russia:
Archangel
Do
Petrograd
i>o
Riga
N'ladivos'.OA
Siam:
Bangkok
Spain:
Madrid
Malaga
He\ilie
Valencia
Do
Straits JScltloments:
I'enang
Singapore
Swedt'n:
! i.lnio
^t;Mkh()!:n
Tinii;qi:
'1 luiis
Tu:Uev in Asia:
TrcM'tr.'l
Ur.ion of South Africa:
Johannesburg
Unit.':j> :
^!otltovi(:lo^
Venozucla:
Maracaibo
Do
Jan. 1-June30..
Aug. 1-14
July 1-13
Julyll-Aug.7.
Jimea-30..
Aug.5-Sept. 1..
JunelS-24
Jan. 1-June 30 .
July 1-23
Julyl-Sept.8..
Aug. 13-18
May 13-June 9 . .
July 8-Aug. 4 . . .
May 13-June 30....
JulyH-2S
Mar. 1-May31....
May 1 -June 28...
Aug. 15-2S
Feb. IS- June 23..
Julv 2-8
Mar. Il-June2^..
Mar. 15-21
June 9-31..
July 11-17.
May 1-Ji:. MO.,
Apr. l-.T' I.
May I-T,H.e:jj
June 3-23 ,
July 1-Aug. 18 j
Mar. IS-June 23... I
Jimo 24-3'J '
Apr. 22-^2*^ ;
May 2*)- June 23. . .'
June 2-8.:
Feb. 2.VApr. 13.
Mar. 12-24
May 1-31
June IK-July 8.
July i;-23
162
120
56
4
543
14
4 I
231
16 I
3
12
116
1
1
9
Jan. 1-Aug. 14, 1916: 118 deaUis.
Varioloid.
Do.
Jan. l-Mar 31, 1917: Cases, 9.
4
11 I
TYPHUS FEVER.
Ab'cria:
Al<;irr^ I June 1-30 i
Do ; Julv 1-31
Ar;:pn:ina:
Hueno'^ Airo? Aug. 12-18
Au-'^tri'i-llunparv: I
Austria ". '
liohcmia 1 Oct. 22- Dec. 17....
(lain in do
Lower Austria I do
Moravia ' do
♦Silesia | do
Sty ria do
Up|H»r Austria do
Himirarv '
iiudaiiost l*eb. 19- Mar. 25...
5I
11
634
809
47
617
16
243
5
83
Oct. 22- Dec. 17, 1916: Cases, 2,37L
Feb. 19-Mar. 25. 1917: Cases, 1,381.
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1785
October 19, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER-
Continued.
Reports Received frem Jane 30 to Oct. 12, 1917— Continued.
» TYPHUS rBVER-Oontlnued.
PlBce.
Date.
Cases.
Deaths.
Remarks.
Brazil:
Rio do Janeiro
July 2ft-Aug. 11 . . .
June 25-Ju1y I
Julv»-Aug. 26....
Jaae»-15
2
3
\
China:
Antung
Do
1
Hankow
Do *
Julv8-14
1
Tientsin
June 17-23
May30-July7
Aug. &-11
\
4
1
1,648
28B
9G
Tsinc:tao
Do
Alexandria
Auc. 30-Julyl....
Jalv 17-Auc. 19...
Jan. 22-Mar. 18....
June 17-23
478
103
40
1
32
19
Do
Cairo
Great Britain:
Cork
Qreeoc:
Saloniki
Mav 23-June 30.
Do
July 1- Aug. 4
Japan:
Hakodate
Julv2^28
1
4
24
NajrasaVi
June 11-24 . ...
Do
July 9- Aug. 19....
2
Java:
East Java ...
Mav 6-Jul V 1 , 1917: Cases. 6. July
Snrabavo
June 25- July 29...
4
9-29. 1917: Cases, 0.
Mid-J?iva. . ;
Apr. 1-Jiuic 24. 1917: Cases, 38;
SamarmK
Do
Mav r»-.Time 10. . . .
Julv 2-S
i4
5
2
deaths, 5. July 9-22, 1917:
Cases. 7; deaths, 1. ,
West Jn\ a
Apr. 13-July 5. 1917: Case*?, 147;
IJat^Mu
Do
Mexico:
Anias^Hentes
Apr. n- July 5
July 6-Aug. 2
July 10-lrt
70
37
0
2
1
1
5
3
deaths, 0. Julv e>-Aug. 2, 1917:
Cases. 46; deaths, 2.
('{.a'o e- »
\\\^. 1-H.. . .
Jahna
Arr. l-Jime 30
Do
Jnlv 1-31
MexkoCltv
Juno 3 to
431
770
Do....
JnlvS-.-cpt. 1
Jan. l-JMue30
Ori«*i')a
6
1
2
Do
Julv 1'31
Netherlnnfls:
Hott<»rdani
June 9- 23
3
11
1
11
9
13S
10
2
5
Do
Julv 15-Sept. 1 . . . .
July8-2« .
Norway:
Berpen .
Portuguese East .\frlca:
Louren<;o Marques
Russia:
Archangel...
Po
Petrojjrad
Do
Mar. 1-31
1
Mftv l-June2S
Auc. 15-28
' Feb. IR- June 23...
Jiily 2-8
2
2
3
Rlpa
Vladivostok
' Mav 31- June 2.'.!!
Mar. UK .May 21.. .
Mav 1-31
Jan. 1-31, 1917: 1 case.
Spain:
Almeria
5
2
Madrid
'.do
Switzerland:
Basel
June 17 :3
Julv H-21
1
3
2
Do
1
Zurich
July^G-Au?. IS...
June 4-9
Trinidad.
Tunisia:
Tunis
' June 30- Julv 6. . . .
1
Union of South Africa:
Cape of Good Hope State-
East London
1
! Sept. 10
Present.
...
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October 19, 1917
1786
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW PEVER-
Continued.
Reports Received from June 90 to Oct. 12, 1917— Continued.
YELLOW FEVER.
Place.
Date.
Cases.
Deaths.
Remarks.
Ecuador:
Babahoyo
Feb. 1-28
1
2
1
18
17
17
1
1
1
2
7
1
1
1
1
7
9
9
To
Mar. 1-31
Chobo . .
do
Qua vaouil
Feb. 1-28
uuajraqmi..... ...... ......
Mar. 1-31
Po.
Apr. 1-30
Feb. 1-28
*
Do
Mar. 1-31
Do
Apr. 1-30
1
1
3
1
2
Mexico:
Campeche State—
Campeche ,
Aug. 19-25
Aug. 7-Sept. 1....
June *3
Yacatan State—
Merida
Peto
In person recently arrived from
ilcxico City.
Do
July 29-.\uE. U . . .
ti
Venezuela:
Coro
1
Present Sept. 5.
1
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PUBLIC HEALTH REPORTS
VOL. 32 OCTOBER 26, 1917 No. 4S
DIPHTHERU.
AN BPIOBMIC. PBOBABLY OF MILK ORIGIN, OCCURKINc; AT NEWPORT, RHODE ISLAND
AND VICINITY.
I)y O. W. McCor, Director, Hygienic Laboratory, and Joseph Boltex, l^ssed Assistant Surgeon,
United States Public Hcaltli Scr%ioc, and H. S. Bernstein, Pathologist, Rhode Island State Boord
of Health.
During the latter part of July and the early part of August, 1917,
thero occurred in Newport, Portsmouth, MifUUetown, and James-
town, R. I., an outbreak of diphtheria which presented several re-
markable featiu'es.
The chief facts of interest were: (1) Tlie siuUh'ii *' explosive*' out-
break occmTing in the middle of summer, and the rapid decline in
the number of cases; (2) the imusual age incidence; (3) the high
incidence of cases per 1,000 population; (4) the mildness of the epi-
demic, and the lack of fatalities among reported cases; (5) the small
percentage of contact cases; and finally, and most, important, (6)
the apparent impUcation of milk products, especially ice cream.
Preparatory to the discussion of the outbreak, a few facts, as to
the localities involved, will be of assistance in imderstanding wliat
follows. (See map.)
The island of Rhode Island is about 17 miles long and from 2 to 4
miles wide. It consists of 3 municipaUties, viz, Newport, Middle-
.town, and Portsmouth. The land is of a slightly roUinj:: charactt^r.
The chief industry, outside the city of Newport, is agriculture. The
sanitary conditions are fair. The water supply is obtained from
rain water ponds and shallow wells, and is subjected to proper super-
vision and treatment. Newport is fairly well scnvered, while the
other towns depend chiefly upon privies and cesspools for the disposal
of sewage.
The island of Couanicut, which ako was affect ihI, is due west of
Newport and is reached by ferry in 20 minutes. It is about 8 or 9
miles long and 1} miles wide. The water supply and sewage dis-
posal are about the same as for Middletown and Portsmouth. The
center of population of this island is the town of Jamestown. The
128 (1787)
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October 26, 1917
1788
total population of the 2 islands, including the military and tran-
sients (summer residents), is estimated at 56,200.
1. Explostreness of Outbreak.
As is true for nearly any community having a population as large
as the one under consideration, a few cases of diphtheria occur
Newport. R.I, and Vicinity.
U.5 PVBLIC H6ALTH SCMVICC
tiffrfrtff4-
throughout the year, chiefly, however, in the cooler months, and New-
port is no exception. Thus, for the calendar year 1916, 106 cases
occurred in Newport; and for 1917 up to July 1, 36 cases had oc-
curred. In July, cases were reported up to the 21st of the month as
follows: July 1, 2 cases; and July 10, 1 case.
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1789
October 20. 1017
Tho outbreak may be regarded as having begun on July 21, and
as having terminated on August 15. A few cases, which are not
included in this report, occurred after tho latter date, and after our
special investigations were completed. Altogether there were 402
cases reported, of which 389 were studied epidemioiogically. Tho
13 cases of which Uttle knowledge was obtained occurred among
the Army forces. Of these 402 cases, 291 occurred in Newport;
45 in Portsmouth; 22 in Jamestown; 15 in Middletown; and 20
among the personnel of the Army and Navy. Table 1 shows tho
number of cases by dates of onset. The greatest number of cases
occiu*riug on any one day was 50 on August 1 ; and between July
28 and August 7 there were 354 cases, or Ss per cent of all that
occurred. As the table show&i, the epidemic in Jamestown preceded
that in Newport by a few days. We are unable to offer a satisfactory
explanation for this, unless it be that the Jamestown patients partook
Chart i:— Casc^ by dates or OnatT.
Diphtheria EpiOEfiic, 1917.
Aucu5'r"
11 It 13 h*
24 t7 {t 29 3§
91
of an infected lot of ice ciraui a few days prior lo i\\v iiileclion of
tho supply used elscwhcn^
In chart 1 the facts are nIiowu in graphic manner.
Chart 2 shows the course of an epidomic in H>1(), which ])resentod
no features of special interest; it was largely a school outbreak.
2. Age and Sex Incidence.
One of the first features that attracted attention was the largo
number of adults affected. In going through the wards of tho
hospitals, one was struck by tlie i^niparative absence of small
children. This peculiar age incidence alone was sufficient to show
that some unusual factor was at tho root of the outl)reak. See
Table 2.
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October 26, 1017
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1791
Table 1. — Voies by dates of onset.
October 26, 1917
New-
port.
Ports-
mouth.
James-
town. 1
■!
Middle-
town.
Navy.
Anny.
Total.
July 21
1
1
2
22
1
23 : :::::::.:..
1
;■ :j
1
24
2
::;..:..!.:.:.!::::::
2
25
I
i 1
1
20
3
0
13
9
20
U
;{9
:i9
:J4
29
9
7
4
::::::::::i::::::::::i::::::::::
•>
27
1 i .
5
28
5
0 '
3 !
0
i
1
1
1
13
20
3
I
2
1
25
30
18
31
?
2
2
2
3
43
AiJp. 1
1
50
2
1
47
3
1
3
3
1
2
2
2
1
1
49
4
42
5
^1
40
10
0
1
2
1
19
8
1
g
9
1
2
0
10
1 1... :
1
1
11
2
2
1
3
12
•*
2
13
1 1
1
1
7
14
1 * "* 1
15
1
3
.......................................
1
Oate of onset noi !»lven
2
1
1
6
Total
291
15
22 1
15
Hi
13
402
Table 2.- -Cases by age and sex groups.
Under 5 years.
6to 10 years.
11 to 15 years.
Over 15 years.
•
Male.
Female.
15
Male.
21
1
3
Female.
23
0
2
2
Male.
27
1
5
Female.
4
5
Male.
Female.
Newport
11
2
Hi
0
29
110
5
15
1
291
Jamestown
22
t*ortsmoutta
45
Hiddletown
1
15
NavaL
29
1 _
xi .in
Total
14
as
25
33
115
131
402
i i
A chart (No. 3) has been prepaiod showino; by ajjjo j^roiii)s the niiin-
bor of persons affected hi the various eitic»s. ft will be seen that the
eases over 10 years of age arc several tnues as numerous as those
under 10 years. These figures are contrary to tlie age gi'ouping in the
usual diphtheria epidemics. For comparison, another chart (No. 4)
lias been made, showing the age groups of the total number of pei'sons
affected in tliis epidemic, of peivons affected in Providence, R. I., in
1915, and of pei'sons affected in Newport in 1017 prior to this out-
break. The Providence cases of 1915, and the Newport cases of 1917,
up to the present epidemic, agree with other diphtheria outbreaks in
the distribution of cases in tlie age groups affected, while, in the 1917
epidemic, the age groups are, broadly speaking, reversed.
The sex incidence is also interesting. Up to 15 years of age, the
sexes arc about evenly divided, the females being slightly in excess.
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October 26, 1917
1792
In the age group over 15 in the Newport cases, the females are in
excess, almost two to one over males; in Portsmouth and Jamestown
they are equally divided; while in Middletown there were 6 males and
only 1 female affected. If we include the military cases in the New-
{
Chart 3
■_
Age -Group Cask
- IN NerfPORT.AN
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Ner#pofrr
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U 9 P1I6LIC HEALTH dCRVlCe
port epidemic, the females are in excess only in a sUght degree, but
there were from 10,000 to 12,000 males stationed here, which made
the male population almost double the female population.
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1793
October 2e, 1917
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October 26, 1917 1794
3. Case Inddence per 1,000 PopuUtioii.
The epidemic was a large one, as regards the incidence of cases per
1,000 population. A table (No. 3) has been prepared showing the
population, the number of cases, case rate per 1,000 population, and
the number of the population per case.
Table 3.
Newport:
Permanent residents
Transient (fivilian).
Military -Navy ....
Army
Total
rortsmouth
Middletown
Jamestown
Grand total
Population.
32.000
5,000
7,000
5,000
49,000
2,700
2,500
2,000
56,200
Number of
cases.
291
16
13
320
45
15
22
402
Rate per
1,000 popu-
lation.
2.3
2.6
6.5
16.7
6
II
7.2
Popolatioo
per case.
127
€18
153
60
167
91
140
It is evident that the communities of Portsmouth and Jamestown
had a greater relative prevalence than had Newport. An explana-
tion for the low incidence rate and the few cases among the military
will be given later, in a section devoted to the cases occurring among
the personnel of the Army and Navy.
In order to show the high incidence of cases per 1,000 inhabitants
in Newport, the following data (Table 4) taken from the PubUc
Health Reports of August 24, 1917, are given for comparison. The
population of the cities is as near that of Newport as possible.
Table 4.
Popula-
tion
Julyl
1916.
Newport epidemic (1917)».' 37,000
Newport (1910) I 30,108
Aurora, III ' 34,2(M
AiLslin. Tox < 34,S14
Cedar Hapids, Iowa I 37,308
Columbia, S. C I 34. fill
Decatur, 111 j 39,031
Dubuque. Iowa ' 39,873
Everett, Mass I 39,235
Jackson, Miss I 35,303
Knoxville, Tenn | 38,670
I
Cases
Cases per
re- I l,tx)0
ported.! poijula-
I tlon.
291
8 !'
IW
3.5 '
45
1.3
07
1.9
19
.51
31
.9
43
1.1
8
.2
90
2.6
75
2.1
35
.9
Lorain, Ohio
Mount Venion, N. Y..
Now liofhelle, N. Y..
Niagara Falls, N. Y...
Oshkosh. Wis
Pitt^field, Mass
Quiucy, Ili
Qiiincy, Mass
San Jose, Cal
Taunton, Mass
Waterloo, Iowa
Popula-
tion
Julv 1,
1910.
30,964
37,009
37,759
37,353
30,()Go
38,029
30,798
38,130
38,902
30,283
35,559
Cases
re-
ported.
48
36.
53
107
9
53
45
GO
68
31
23
Cases
per
1,000
popolft'
tion.
L8
.97
L4
2.9
.3
L4
1.3
L6
L7
.86
.65
1 Newport population obtained ficom figures of board of health. Other nopulations obtained fh>m tetir
mated population as of July 1. 1916, of the United States Bureau of the census. Newport cases only lor
period of epidemic. Other dties for entire year.
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1795 October 26, 1917
4. Mfldness ai E|>idemic and Lack of Fatalities of Reported Cases.
Another striking feature was the mildness of the epidemic and the
lack of fatalities among cases reported to the health authorities.
Among the 402 cases analyzed there were no deaths.*
All cases were diagnosed as diphtheria upon a positive culture, and
a very large majority were clinically diphtheria. Antitoxin was
administered freely, and the symptoms usually cleared up promptly
under this treatment.
A niunber of rather severe cases occurred, including about a dozen
with laryngeal involvement requiring intubation, but fortunately
with favorable outcome.
Probably three of the factors concerned in the relatively benign
character of the epidemic were: (1) the very large proportion of
adults attacked; (2) the early recognition of cases and the free use
of antitoxin; and (3) the fact that a considerable number of cases
were almost free from symptoms, and ordinarily would not have been
recognized as diphtheria; all of these were verified microscopically.
It may be that other factors, such as the season of the year, or some
attenuation of the organism due to the mode of distribution, were
operative.
The city of Newport is to be conamended for the prompt and effi-
cient manner in which hospitalization of the diphtheria patients was
effected. The Newport Hospital, the Naval Hospital, the Emergency
Hospital (used formerly for smallpox), and a school building, hastily
converted into a hospital, were used to care for the sick. Of 291 cases
in Newport 262, or 90 per cent, were cared for in the hospitals. Of
the 29 cases among the military all, or 100 per cent, were placed in
hospitals. Jamestown had 11 and Middletown 3 cases in the hos-
pital, while Portsmouth had none.
5. Contact Cases.
A total of 50 cases, or 12.4 per cent, was attributed to contact infec-
tion. All of these gave a definite history of association with a clinical
case. The incubation period ranged from 2 to 7 days, with the major-
ity of cases occurring 4 days after exposure. There were 42 of these
cases in Newport, 6 in Portsmouth, 2 in Jamestown, and 1 in Middle-
town. The contact cases occurred, for the most part, after the height
of the epidemic was reached. A chart (No. 6) showing Newport
cases by onset, clearly illustrates the situation. The crest of the
Newport epidemic, not coimting the contact cases, was reached on
August 1; while the crest of the contact curve was reached on August
> On the last day of our stay in Newport, August 19, a fatal case was reported to the health department.
This case did not have the services of a physician ontil moribnnd. The patient was a boy of 6 and tht
doratloo of the illness was 7 days. The source of Infection ooald not be determined.
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October 26, 1917
1796
5. The Jamestown cases wliicli occurred on August 5 (see Table 1),
gave a clear history of contact with cUnical diphtheria. Contact
infections were to be expected, on account of cases and carriers which
were not immediately diagnosed and at once isolated. It is remark-
able that a gi'cater number of contact info<*tions did not occur.
This we attribute, m part, to the fact that in many households where
a case occunod, immunizing doses of antitoxin were given to contacts,
and, in part, to the fact that so high a degree of hospitalization was
Chart 5.-
' NewPOAT Cascs or Oatcs or ONsrr, IQI?.
L: jocv
AUCUdT 1
If
tt
u
14
15
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ct
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to
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U.5. fUBUC HCALT»I^SCRVICC
effected in Newport. i\ju)ther probable factor was the warm wcatlier
which disct>uraged indoor association, and promoted frec^ ventilation.
6. Implication of MiJk Prcducls, Kspeclally Ice Cream.
The explosive eharacier of the outbreak pointed to some ('(^nnnon
source of infection. Jlasty epixlemiological studies, which later were
confirmed by a more tleliberate i n vest i'j^at ion, showed that probably
contaminated milk u^^ed in making ice cream was the cause. The
liistory of the milk and milk products epidemics usually shows
certain definite features more or le^s peculiar. These are an explo-
sive onset; a special incidence auK.ng the patrons of a certain pro-
ducer, dealer, or distributor; and lastly a greater i)ercentage of women
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1797
October 26, 1917
and children affected. This epidemic presents some of these charac-
teristics, but differs radically in the age incidence, as has been shown.
There can be no doubt regarding the explosive character of this
epidemic, 402 cases occurring in about 3 weeks, and more than 88
per cent in 10 to 12 days. The second characteristic, following the
distribution of a certain dealer or dairy, does not stand out so promi-
nently and is not so easily disposed of.
Considerable difficulty was experienced in obtaining the correct
histories of sources of milk. In the majority of instances the patients,
or their parents, were able to state definitely the source of their roilk
supplies; but frequently added that, when they were short of milk,
the comer grocery store was resorted to. The cases were distributed
fairly evenly and there was practically no imdue preponderance on
any one dealer's route. Table 5 has been prepared showing the deal-
ers who daily handled over 125 quarts of milk, with the number of
cases on their routes and the number of cases that would have oc-
curred per 1,000 quarts of milk sold. The latter method is the fairer
one, as it puts all the dealers on a conunon basis of calculation.
It is clear at a glance that, to have considered the outbreak a milk-
borne one in the ordinary sense, would have meant that practically
all supplies were infected. It was obvious that such a widespread
infection was most unlikely. Dipthheria was found on several dairy
farms, but in each case there was a history that indicated that the
infection had been acquired from the soiurce which we beheve was
properly^ chargeable with the outbreak.
Table 5.
Dealer.
Number
of quarts
of milk
handled
daily.
Number
of cases
among
his cus-
tomers.
Numl)er of
cases that
would have
occurred
per 1,000
quarts of
milk.
Dealer.
Number
of quarts
of milk
handled
daily.
Number
ol cases
among
his cus-
tomers.
Number of
cases that
would have
occurred
per 1,000
quarts of
milk.
H. C S
225
200
140
2t)0
150
125
200
500
175
150
150
1,200
200
15
21
6
0
4
7
6
16
10
6
6
34
5
06
85
43
23
27
56
30
32
57
40
40
28
25
O.I
200
460
350
200
140
150
150
130
150
250
125
140
130
4
2
3
4
2
2
2
3
2
6
3
4
3
20
J H B
U. p
5
M. M
W.J. P
9
J p. p .
p. H
20
H. H
0. A.S
H.S
14
C. A
13
Sn
C
13
D. M
H.C
23
c. «
F. P
13
J E
D. A. B
20
p. M
H. I. C
at
J P, F
R. W
28
J.E. K
M
23
Jamestown and Middletown showed no undue proportion of cases
on any one dealer's milk route. In Portsmouth there were 12 cases
charged to one dairy, but this dairy sold by far the greatest part of
the milk distributed in the community, and, if calculated on a 1,000-
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October 26, 1917
1798
quart basis, had fewer cases than some competitors who sold much
less milk.
These facts, we think, show that milk, as such, was not responsible
for the outbreak.
Ice cream early attracted attention by reason of the fact that the
patients, almost uniformly, gave a history of having used that
product.
The histories of the early cases pointed paiticularly to cream si*-
curcd from the largest dealer (A) in Newport. This led to as com-
prehensive an investigation of the cream and the ice-cream supplies
as w^e were able to make.
Newport, and the towns aflfocted, obtain their supplies of cream for
ice-cream purposes from 3 largo dealers. These we shall designaU^.
A, B, and C. A fourth group designated D, has been made to include
the few miscellaneous sources. Where the history of the source of
ice cream used by a patient was not definite, we included that case
imder the miscellaneous or D column.
The cream supply of the islands is about 580 gallons per day. The
sources of this cream, with the data pertinent in this connection, are
shown in Table 6.
When a patient gave a history of using ice cream from two or more
sources, one case was charged against each source named.
Table 6.
Amount
of cream
sold.
Per cent
of all
cream
sold.
Nmnber of
cases of
diphtheria
charpcd to
dealer.
Percent
ofaU
Cases.
Dealer A
Qcltons.
200
180
100
100
34.5
31
17.8
17.3
285
50
67
58
11
14.5
12.5
Dealer B
Dealer C ,.
(Miscellaneoa*:) D
Owing to the extremely hot weather, which prevailed generally
over the eastern part of the country on July 29, 30, 31, and August 1,
ice cream was partaken of in much larger quantities, and by more
persons than ordinarily. In fact, many patients stated that they
had not eaten ice cream during the summer until these hot days, and
they were able to state accurately when and where they had taken ice
cream. According to the dates of onset of the disease, the majority
of cases occurred a day or two after the hot spell began, and for four
days after the hot weather ceased.
In Newport, 51 patients gave histories of eating ice cream on cer-
tain dates only, and of becoming ill 2 to 9 days later, the majority
developing the disease about 3 days after eating ice cream. In
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J
1799 October 26. 1017
Portsmouth, 13 patients gave histories of eating ice cream only on
certain days (July 26, 27, and 28), and of coming down with diphtheria
from 2 to 6 days later. In Jamestown, 9 patients gave histories of
eating ice cream on only one occasion, and of becoming ill 2 to 5 days
later.
The histories of some of these cases are of sufficient interest to be
given briefly.
Ill Newport, Mrs. S. and a friend went to the beach one day and
while there bought ice cream cones from a source supplied by dealer
A. They had not eaten ice cream for several days prior to or after
this day. Mrs. S. developed diphtheria 3 days later. Her friend com-
plained of severe sore throat, but did not call a physician.
Two cases occuricd in Portsmouth on July 31. These patients
were young men from Brockton, Mass., who arrived in Portsmouth
July 27. On this day they purchased ice cream from u soiurce sup-
phed by dealer A. No history of contact with a case or any factor
except ice cream, could be obtained.
The case of S. R. of Jamestown is of interest. The family, consist-
ing of three small boys and their parents, made a trip to Worcester
on July 26. The father purchased for one of the boys (S. R.) an ice
cream cone from a vendor in Jamestown suppUed by dealer A* No
ice cream was obtained there for the other children. \V^hen the boat
reached Newport ice cream cones were purchased for the other two
boys from a source which coidd not be traced. On July 31 S. R.
was taken ill with diphtheria while the other children remained well.
No other source of infection could be impUcated.
A milk producer, who sold milk at retail to the extent of about 450
quarts, purchased the cream for his family's use from dealer A. One
of his children, the child who drank the cream, came down with diph-
theria.
It was rather significant that in the families of three ice-cream
dealers, all supplied by A, there occurred one or mor j cases of diph-
theria at about the same time; while ai- on^ the other dealers who
did not handle A's product, no cases occurred.
A study of instances in which mor^ than one case occurred in a
family, the onset bein^ simultaneous or nearly so, gave su^ojostive
results. We included only those famihes in which cases occurred
within 24 hours of each other. It was found that there werj 13 such
examples, and in all of theso there was a history of the use of ice cream
supplied by vendors who secured cream from dealer A; curiously
QBOMgh, the other two instances were famihes that secured milk from
dealer A, though there was no evidence that this dealer's milk supply
was infected.
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October 26, lOlT 1800
As soon as suspicion was directed to the cream supplied by dealer
A, an investigation was begun by the local healtli authorities to
determine the possible source of infection. It was found that on
one of the farms, which we may call Z, which supplied milk to
A, a case of clinical diphtheria was reported on July 25 and another
on July 29. The patients were both young men who milked the
cows or handled the milk. Both cases were microscopically positive
and, when other membei's of the family who were not ill at the time
were cultured, four additional positive throats were found. The
entire output of milk from the farm Z was sent to dealer A, who
used at least part, and sometimes all, of it for diluting heavy pas-
teurized cream furnished to ice-cream makers.
This dealer (A) had no miduc incidence among his milk customers,
though two cases occurred among a comparatively small niunber of
persons using his cream. He sold little cream except to ic^-cream
manufacturers.
Dealer A had a pasteurizing plant of the *' flash ^' type in more
or less regular operation, but the milk used for diluting heavy croum
was not pasteurized. The efficiency of the pasteurization of the
milk and cream was questionable, but on this point we have no
direct evidence.
Dealer A's plant was closed, and the sale of ice cream was forbidden
on August 4, too late, we beUeve, to have accounted for tho rapid
decUnc of the epidemic which occurred beginning August 6. It is
more likely that the discontinuance of the suspected supply from
farm Z, which occurred several days earlier (tho exact date is not
available), was responsible for the mpid fall in the nimaber of cases.
Infection of this milk supply on July 25 or later would not accoimt
for the earUor cases in the epidemic, though it might well bo regarded
as the origin of the cases with onset on and after the 28th of the
month. It is very hkely that one of the boys who developed diph-
theria, or one of the four healthy carriers on the farm, infected tho
supply i)ossibly as early as the middle of the month.
Tliere is anotlier source from which the infection may have origi-
nated, or wliich may have accounted for some of the cases, particu-
larly in Portsmoutli. Wlieii cultures weiv made from all ice-cream
handlei*s, it was found that a boy of 16, who may be designated X,
tlic son of an ice-cream vendor, gave a positive result. This boy
gave a history of having diphtheria two yeai*s previous, and it is
possible, but not probable, that he may have been a carrier for tfcis
))eriod and may have infected dealer A's supply through returnfift"
containers, as the X supply all came from dealer A. We think it is
more proba1)le that this l)oy was infected from A's supply. This
boy daily dispensed ice cream from a wagon to the inhabitants of
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1801
October 26. 1917
Portsmouth, and also waited on cnstomera in the store. If he had
been a carrier for so long a time, there should have been cases crop-
ping up among the customers he served. As a matter of fact, cases
occurred among them only during the time- that the epidemic was
prevailing, none prior to that time.
A total of 32 patients denied having used ice cream within 10 days
before becoming sick and gave no contact history. These cases we
consider as probably chargeable to contact with mild unrecognized
cases, or with carriers, and we believe that the cases using ice cream
from sources other than dealer A may be so accounted for.
Another chart (No. 6) has been prepared showing by, date of onset
the non-ice-cream-consuming patients in Newport alone, 28 in niunber.
It will be seen from this chart that the cases which did not consume
ice cream had their onset af terthe decline of the epidemic. The curve
of these cases approximates closely the curve of the contact cases, as
seen from the same chart. The source of the milk supply of these
Chakt6>
NCW^ORT EfiOCMIC,
1917.
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t
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4
t
a
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AUG u s r 1
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15
14
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17
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1
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7
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• . .. COMTACT C^SMS.
cases was carefuUv gone over, but no evidence was adduced incrimi-
nating any one milk dealer. Fourteen milk dealers supplied the 28
patients.
There were only three patients who did not use any milk or ice
cream. Of these, one had the onset very early in the epidemic,
July 22; one, during the height of the outbreak, August 3; and the
third on August 11, when the epidemic had almost ceased.
Of the 11 cases in Newport which gave a history of not using milk,
but of eating ice cream, 9 obtained their ice cream from sources
supplied by dealer A, 1 had ice cream supplied by both A and B,
and 1 obtained it from an unknown source.
7. CEses Among Military Forces.
There were stationed in Newport about 7,000 men belonging^ to
the Navy and about 5,000 to the Army. The men belonging to the
Narfjy were divided into two groups; the training station with a
personnel of 5,000 and the reservists about 2,000 in number. The
personnel of the former lived at the naval training station, while the
latter (the reservists) lived in a camp adjacent to the city or boarded
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October 20, 1917 1802
in town >fitli tlio riviliun population and had the same opportunities
for infection. There oceurred among the naval men 16 cases of
diphtheria. Of this number, only 2 occurred among the 5,000 men
stationed at the training camp, whereas 14 occurred among the
2,000 reservists. The reservists' incidence, 7 casc*s per 1,000, upproxi-
mates that in Newport. The explanation for ihe small number of
cases among the personnel of the training camp presented a diflficulty
inasmuch as our (ii*st information indicated that the ice cre^ini
supplied there was from a source which secured cream from, dealer
A. Closer investigation, liowever, showed such was not the case,
and that ice cream provided at the training station came from
dealer B. wlio had comparatively few cases charged to him, 11 per
cent of all, though he supphed 31 per cent of the cream used in
Newport and vicinit \ . Ice 4 ream wa.s served at the naval station on
Sundays only, so that, even had the supply been from an infected
source, there would have l)ecn but a fraction of the risk of acquiiin^
the disease which was inc urred by the community in general.
Another factor wlvidi must be considered is tlie jclative lack of
opportunity for acquiring infection by the men at the training station,
due to the restrictions ))lacctl on leaving the reservation. Liberty
was granted once a week to most of the men, so that the number
for comparative purposes should be but a fraction of the 5,000.
Wo must remember also that in this outbreak the proportion of
women afiFected was much higher than that among men, and of course
the personnel of the station was made up exclusively of men. On
August 1, an al)solute ciuarantine was established at the training
station. Tliis eff(»ctually pn^vented any new infections.
Considering all of these facts, the low incidence among this lai^e
group of men is in harmony with the ice-cream theoiy.
The 13 cases among the 5,000 soldiers occurred mainly among the
men of one regiment. Satisfactory histories were not obtainable,
])ecausc most of the men had already embarked for other ports at
the time when we attempted to get the necessary epidemiological
data.
At fii-st it seemed doubtful that the age incidence would accord
with the theory of the distribution of the infection by milk or milk
]n'oducts. By personal investigation, at places where ice cream was
dispensed, we found tliat by far the larger number of patrons were
adolescents and adults. A sanitary inspector foimd that only about
6 per cent of the patrons of ice-cream stands were children imder 10
years of age. The major portion of the business was done in the
evening hours, when the adults visited the downtown section and
the beach where the ice-cream dispensing establishments are located,
while children generally were at home.
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1803 October 2G, 1017
The occurrence of cases among residents of other cities who visited
Newport is very interesting and, while the data with regard to them
are not so complete as we might desire, they are worth presenting
here.
FbU River Cases.
In the early part of August there were 9 cases in the city of Fall
River, Mass. Six were in adults over 16, and 3 in children whose
agBB were 4, 6, and 8 years, respectively. One of the latter cases
proved fatal. Seven of these cases gave a history of eating ice cream
at either Newport or Portsmouth. The histories are incomplete
regarding dates of eating ice cream and the source of the same, but
all cases were reported in the period between August 2 and 9, when
Newport and the other communities were having their outbreak.
We were informed that there were very few cases of diphtheria in
Pdl River piioi- to these nine cases.
Provideiice Oases.
Through tlie courtesy of Dr. Cluirles V. Cliapin, city health oihcer,
m^ are able to present the data for the Providence cases. There were
5 cases in Providence, and 1 case in East Providence, chargeable to
Newport, 1 being a contact, the father of a child who probably acquired
the disease there. The facts are as follows: Of these 5 cases directly
chargeable to Newport, 3 were in persons over t6, 1 was a girl
of 13 years and 1 a child of 3 years. All gave histories of visiting
Newport, between July 26 and 31, and of eating ice cream from
a source which was supplied with cream by dealer A. In each case
the onset of the disease occurred from 4 to 5 days after eating the
ice cream. The factor operating to cause the Newport epidemic
was at its height at about this time (July 26-31).
A few cases of diphtheria were occurring in Providence which were
not related in any manner to those which could be traced to Newport.
According to Dr. Chapin, the former were of a distinctly severer type,
8 cases proving fatal among 62 which were reported in July and
August.
Location and Occnpation.
Wo have discussed above the noteworthy features of the outbreak
and will conclude this portion of the report with a very brief consider-
ation-of two circiunstancos which are often of prime importance in
epidemiological investigations, but which were not of special interest
in the present study.
Location, — ^A spot map was made of the cases, as they occurred
from day to day, and the locations agreed pretty closely with the
129
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October 26, 1917 1804
distribution of the population, the greater number of cases occurring
in the more thickly settled portions of the town. The wealthy class
was not seriously affected, probably because they purchased a goodly
part of their milk and ice cream from sources outside of Newport.
Ice cream that was purchased in the city (Newport) came largely
from one of the manufacturers supplied by dealer B.
Occupation, — ^As might be expected, a large number of these cases
occurred in school children, although the schools were not in session.
The occupations of the remainder of the patients were widely diversi-
fied, and no one occupation had a predominance of cases with the
possible exception of manufacturers and vendors of ice cream, among
whose families there occurred a total of 5 cases, all chargeable to
cream from dealer A.
Laboratory Features.
The virulence of the organism from three cases was tested by the
subcutaneous inocidation of guinea pigs with a suspension of the
24-hour LoeflHer medium slant directly from the throat/(L e., a mix^
culture was used), giving the same quantity of the sam^ suspension
to another guinea pig which had been protected by 10 units of com-
mercial antidiphtheric serum. In each case, the animal which did
not have the antidiphtheric serum died with the usual lesions of
diphtheria. Death occurred in 2 cases on the third day, and in 1 on
the fourth. All of the protected guinea pigs remained well.
All of the recognized types of diphtheria bacilli were encount^^.
On account of the press of work, no records were kept of the per-
centages of the different types.
Practical application. — ^We wish to conclude this study with the
expression of our opinion that diis epidemic of diphtheria could have
been averted by proper pasteurization of the milk supply, and to
emphasize the importance, if not the necessity, of pasteurization of
the milk supply of large communities.
AcJcri^ywledgments. — ^We wish to express our appreciation of the
courtesies extended by the State Health Department, by Mr. Frank
Greenlaw, president of the Newport Board of Health, the members
of the board, an*d the physicians of Newport and vicinity, par-
ticularly Drs. MendenhaU, Storrs, and Du Blois.
For much of the data used above we are indebted to Surg. A. M.
Stimson, United States PubHc Health Service, and Asst. Surgs.
Joslin, Merritt, and Poppin, of the United States Navy, who were
kindly detailed by Medical Director Gates to assist in the investiga-
tion. Drs. A. G. Gigger and A. W. Sweet, Messrs. G. F. Fasting,
C. A. Abele, E. D. Reynolds, Miss Whiffle, and Miss R. Tuthill,
bacteriologist of the Newport Board of Health, gave valuable assist-
ance.
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PREVALENCE OF DISEASE.
No health department, State or local, can effectively prevent or control diiease mthoui
knowledge of when, where, and under what coixditiom cases arc occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
CaUfomia Report for the Week Ended Oet. 20, 1917.
ITie California State Board of Health reported that during the
week ended October 20, 1917, 4 cases of anthrax in man occurred in
the State, 3 cases in San Joaquin County and 1 case in Los Angeles
County. There were fewer cases of anthrax among animals. One
case of cerebrospinal meningitis occurred in Sacramento and one in
Stockton. Six cases of smallpox were notified in Kern Coimty,
One case of poliomyehtis was notified in Los Angeles Coimty and one
case in the city of Los Angeles. Cases of diphtheria, mumps, typhoid
fever, and whooping cough showed some increase.*
The details of notifiable disease cases reported during the week
ended October 18, 1917, are as follows:
Anthrax 1
CerebrospiDal meningitis 5
Chicken pox 33
Diphtheria 37
Dysentery 2
Erysipelas 3
German measles 26
Gonococcus infection 30
Leprosy 1
Malaria 23
Measles 42
Mum]H 78
Pneumonia 27
Poliomyelitis 3
Scarlot fever 74
Smallpox 2
Syphilis 16
Tetanus 1
Tiibercula^is 73
T y phoid f e V.' r 31
Whoopinc: coivxh 47
ANTHRAX.
Iowa — Muscatine.
On October 17, 1917, a case of anthrax was reported in Muscatine
Township, just outside the city limits of Muscatine, Iowa, in the
person of B. F. E., female, aged 31 years, engaged in housekeeping
and truck fanning.
(1805)
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October 26, 1917
1806
ANTHRAX— Continued.
Wisconsin — Milwatdcee.
On October 19, 1917, a case of anthrax was notified at Milwaukee,
Wis., in the person of A. T., employed in the handlmg of hides at
the plant of a leather company at Milwaukee. The mfection was
probably received from imported hides. .
CEREBROSPINAL MENINGITIS.
State Reports for September, 1917.
Place.
Kansas:
Butler County—
Au^ta
Qeary County-
Junction City
Montgomery Coimty—
Inidependenoe
Riley County-
Camp Funston
Wyandotte County-
Kansas City
Total
Ohio:
Champaign County. . .
Cuyahoga County
Franklin County
Jefferson County......
Lucas County
Mahoning County
Ross County
Stark County
Summit County
New
cases
reported.
Place.
Ohio— Continued.
Trumbull County
Total
Pennsylvania:
Al legheny County
Blair Cwmty
Butler County
Colum bla County
Erie County
Greene County
Lancaster County
Northumberland County.
Philadelphia County
Washington County
Westmoreland County. . .
Total
West Virginia:
Ohio County-
Wheeling
New
cass
reported.
^
«1
City Reports for Week Ended Oct. 6, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Boston, Mass
Bridgeport, Conn.
Chelsea, Mass
Chicago, 111
Cincinnati, Ohio..
Cleveland, Ohio...
Columbus, Ohio...
Galesburg, 111
Hartford, Conn....
Maiden. Mass
Milwaukee, Wis
Minneapolis, Minn..
Newark, N. J
New York, N.Y...
Philadelphia, Pa...
Pittsburgh, Pa
Portland, Oreg
San Francisco, Cal..
DIPHTHERIA.
Alabama — Elmore County.
On October 22, 1917, an outbreak of diphtheria was reported in
Elmore County, Ala., where 8 cases of the disease, with 3 deaths,
had occurred. The cases occurred principally in the town of Speig-
eners, where from among 40 pupils in one school 35 carriers were
demonstrated by positive bacteriological cultures.
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1807
October 26, 1017
DIPHTHERIA— Continued.
Indiana.
On October 22, 1917, diphtheria was reported as epidemic at
Connersvillo, Princeton, Rochester, «nd South Wliitley, Ind.
See also Diphtheria, moaBles. scarlet fever, and tuberculos-id, page 1817.
ERYSIPELAS.
City Reports for Weelc Ended Oct. 6, 1917.
Pboe.
Birmingham, Ala. . ,
Buffalo, N.Y
Chicago, lU
Cleveland, Ohio...
Denver, Colo
Detroit, Mich
Kansas City, Mo...
Los Angeies.Cal. . .
Milwaukee, Wis...
Newark, N.J
Cases.
Deaths.
Place.
Philadelphia, Pa...
Pittsburgh, Pa
Portlaud, Oreg
Itcading, Pa.
St. Lotil'*, Mo
Ban Francisco, Cal..
Stockton, ral
Topoka, Kans
WfOiamsiwrt, Pa...
Cases.
Deaths.
5 1
3
2 1
1
1
6
1
1
1
LEPROSY.
Mississippi—BUoxi.
On October 18, 1917, a case of leprosy was reported at Biloxi,
Miss., in a person who had been employed a^ an oyster shucker at
Biloxi for a period of six years.
Montana — .\lberton.
On October 19, 1917, a case of leprosy whs iTported at Albortoii,
Mineral County, Mout.
MALARIA.
SUte ReporU for September, 1917.
Place.
New rases
report cd.
j
1
Place.
New cases
reported.
Kansas:
Anderson County-
Colony
Ohio:
Cuvahoca Countv
3
RossCountv
3
Gamett
'2
Van Wert (^ounty
1
Butler County—
£1 Dorado ••
2 >
1
6
Total
6
TAthftin '
Pennsylvania:
Allegheny County
Total . ....
1
Mont£omerv County
1
Philadelphia County
2
Total
4
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OctolKsr 26. 1917 1808
MALARIA— ^bntinued.
City Reports for Week Ended Oct. 6, 1917.
Place.
Cases.
Deaths.
Place.
Cues.
Deaths.
'BirminffhAin. AIa
»3«
2
New' Orlears, T^a
2
2
. 1
Boston, Mass.
Orange, N. J
Charleston. 8. C .
3
Pittsfieid, Mass
Chelsea, Mass
1
1
18
Richmond, Va
Los Angeles, Cai...
San Diego, Cal
Mpnii>his Tenn
2
2
Pavannan. <lft..r...
Mobile, Ala
Stockton, Cal ,
Newark, N.J
1
1 The reason that Birmingham had so many more cases of malaria reported than any other city is not
that the disease is more prevalent in Birmingham than in other cities of Alabama and neighboring States,
bnt undoubtedly because of the successful efforts the health department has made in seeming the coopeF*
ation of the practicing physicians in reporting cases.
MEASLES.
See Diphtheria, measels, scarlet fever, and tuberculosis^ page 1R17.- - —
PELLAGRA.
State Reports for August and September, 1917.
Place.
New
cases re-
ported.
-h
Place.
New
oases re-
ported.
Oregon (Aug. 1-31):
Malheur Coonty
1
1
Pennsylvania (Sept 1-30):
I
Multnomah County
West Virginia (Sept. 1-30):
McDowell Coimty.....
Total
2
I
Cowley County-
State Hospital at Winfield
Shawnee County—
Topeka
2
1
Total
3
City Reports for Week Ended Oct. 6, 1917.
Place.
Cases.
Deaths.
Place.
CMOS.
Deaths.
Birminghain, Ala
16
3
1
1
2
1
NewYork, N. Y
1
Charleslfon, d. C
Philadelphia, Pa
1
Denver, Colo
1
Roanoke, Va
1
Lexington, Ky
Wilmington, N. C
1
Long Beach, Cal
1
4
1
1
Memphis, Tenn
Wwwster, Mass
1
New Orleans, La
1
1 The reason that Birmingham had so many cases of pellagra reported is not that the disease is more
prevalent in Birmingham than in other cities of Alabama and neighboring States, bnt imdoubtedly
because of the successful efforts the health department has made in securingtbe cooperation of the prac-
ticing physicians in reporting c
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1809
PNEUMONIA.
City Reports for Week Ended Oct. 6» 1917.
October 26, 1917
Place.
Cases.
Deaths.
Place.
CasesL
Deaths.
Ann Arhor. MWh
1
6
5
5
1
1
1
114
4
13
3
2
2
1
4
1
1
4
Long Beach, Cal...
2
8
1
1
3
1
24
2
1
30
23
1
1
7
1
3
1
1
3
2
BAltimoi«, Md
7
2
U
los Angeles, Cal
f
Bincfaamton, N. Y
Lowell, Mass
3
Boston. Mass
Lvnn. Mass
Braddock, Pa
Man'^hcater, N. H
s
Cwnbridp*, Muss
2
Medford, Mass
1
Ctelsea, Mass
Newark, N. J
7
Chicago, 111
72
Now Bedford, Mass
1
Chlcopeo, Mass
New rustle, Pa
Cleveland, Ohio
16
2
n
1
Philadelphia, Pa
15
Dajrton, Ohio
Pittsburrfi, Pa
22
Detroit, Mi'Hj
Pontiac.Mich
Dohith, Minn
Kutland, Vt
Fltclibunr, Mass
San Francisco, Oil
2
Flint, Mich
Schenectady. N. Y
Hftve'rbill. Mfiss^.x.. ^
Sprlnefield, Mass
JacVson, Mich
Springflcld, Ohio
Tr«iAtnnrno, Mirli
2
Stoclrton, ( al
Worcester, Mass
1
POLIOMYELITIS (INFANTILE PARALYSIS),
niinoto.
During the week ended October 20, 1917, cases of poliomyelitis
were notified in Illinois as follows: One each in Dewitt, Macon,
McDonoughy and McHenry Counties; 3 cases each in Rock Island
and Whiteside Counties; 56 cases in Cook County, 49 of which were
in the city of Chicago.
Indiana.
During the week ended October 20, 1917, poliomyelitis was re-
ported in Indiana as follows: One ease eph j t Fort Wayne, Gary,
and Rensselaer.
Kansas.
During the week ended October 20, 1917, one case of poUomycUtis
was notified at each of the following places in Kansas: Benton,
Bigelow, Douglas, Herrington, McPherson, Tampa, and White Cloud.
Oregon — Portland.
Three cases of poliomyelitis were notified in the city of Portland,
Oreg., one case each on October 11, 13, and 14, 1917.
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October 26, 1917 1810
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
State Reports for AuKost and September, 1917.
Place.
Oregon (Aug. 1-31):
Clackamas County
Marion County
Multnomah County-
Portland
Total.
Kansas (Sept. 1-30):
Brown County-
Everest
Horton
Cowley County-
Dexter
Dickinson County—
Herington
Doniphan County —
Severance
Elk County-
Howard
Orav County—
Montezuma
I>eavenworth County—
Leavenworth
McPherson County—
Mcpherson (R. D.)..
Montgomery (bounty—
Wayside
Ottawa County—
Lamar
Pratt County-
Preston
Rawlins County-
McDonald
Republic County-
Republic.
Riley County-
Randolph (R. D.)
Sedgwick County—
AVichita
Shawnee County—
Topeka
Smith County-
Smith Center (R. D.).
Stevens C^ounty—
Hugoton (K. D.)
Washington County—
Greenleaf
Wyandotte County-
Kansas City
Total.
Ohio (Sept. 1-30): '
Allen County
Ashland County
Belmont County
Columbiana ( 'ounty. .
Cuyahoga County
Franklin County
Jackson County
Logan Coimty
Lorain County
Mahoning County
Medina County
Montgomery County .
New
cases re-
ported.
24
Place.
Ohio— Continued.
Morrow County...
Richland County.
Stark County
Summit County...
Wayne (^unty . . .
Total.
Pennsylvania (Sept. 1-30):
Allegheny (bounty
Beaver County
Butler County
Cambria County
Clarion County
Clearfleld County
Oawford County
Dauphin 0)unty.
Erie County
Fayette (bounty
Franklin County
Greene Ounty
Huntingdon County
JelTerson Ckmnty
Lancaster County
Lawrence County
McKean County
Mercer Comity
Mifn in County
Montgomery County . . .
Northampton County..
Philadelphia Coimty. . .
Schuylkill County
Somerset County
Washington Coimty
Westmoreland County.
Total.,
West Virginia (Sept. 1-30):
Barbour County
Braxton County.
Cabell County—
Huntington
Calhoun C^ounty
Hampshire (bounty
Hancock County
Harrison County
Jackson County
Lewis County
Marshall County
Marion County
Mason County
Mineral County
Monroe (bounty
Ohio County-
Wheeling
Preston County
Richey (bounty
Tucker County
Upshur County
Wood County
Parkcrsburg,
Total..
New
casas re-
ported.
2
S
4
17
7
71
24
1
1
1
1
1
5
1
4
0
2
2
2
2
20
29
2
10
8
1
2
1
2
4
8
4
"l»
1
1
2
2
2
1
«
4
6
4
2
2
3
1
2
2
3
1
3
2
8
SB
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1811
Ootober 26, 1017
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
City Reports for Week Ended Oct. 6, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Boston, Mass
65
2
2
i
Omaha, Nebr
2
1
Chi^i^o, 111
20,
Philadelphia, Pa :..
Clovefand, Ohio
Providence, u. I
Davenport, Iowa
1
Richmond, Va
Detroit! mch
1
Ro?k Island. Ill
1
Fort Wayne, Ind
2
1
1
1
3
St. I^ouis. Mo
Kansas City, Mo
Seattle, Wash
Minneapolis' Minn
South Bend, Ind. ..
Mobile/Ala.'.
Syracuse, N. Y
New ^aven, Conn
Washington, D. C
New York, N . Y
i 1
1
RABIES IN ANIMALS.
City Reports for Weeic Ended Oct. 6, 1917.
During the week ended October 6, 1917, cases of rabies in animals
were reported as follows: Detroit, Mich., 3; Newark, N. J., 1; and
New York, N. Y., 1.
ROCKY MOUNTAIN SPOTTED FEVER.
Kansas — Hoxie.
On October 20, 1917, the occurrence of a case of Rocky Mountain
spotted fever was reported at Hoxie, Sheridan County, Kiins. The
patient was L. H., aged 2 years, who was taken sick August 17, 1917,
and died October 1, 1917. The infection was.received in Colorado.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1817.
SMALLPOX.
Alabama.
On October 17, 1917, outbreaks of smallpox were reported in
Alabama, as follows: In Pickens County, from 30 to 40 cases; and
at Selma, Dallas Coimty, 5 cases; all of the mild form of the disease.
Minnesota.
During the week ended October 20, 1917, two new foci of small-
pox infection were reported in Minnesota, cases of the disease having
been notified as follows: Marshall County, Strandquist, 2; Ramsey
County, Rose Township, 1.
Ohio— ChiUicothe.
On October 17, 1917, the occurrence of 5 cases of smallpox were
reported at ChiDicothe, Ohio.
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October 26, 1917 1812
SMALLPOX— CoDtinuotl.
SUte Reports for September, 1917.
Place.
Now cases
reported-
Dent Ilk.
NumlMT
vaccinated
within 7
vcars pre-
ceding
attack.
accinadonhi
Nun:ber
last vacci-
nated more
than 7 year8
preceding
attack.
Istory of casi
Number
never suo-
PS.
Vacdnatlon
history not
obtained or
uncertain.
Kansas:
Atchison Count j^-
Atchison
t
t
19
BuUer County-
Augusta (R. D.)
Cowley County-
Arkansas City (R.D.)....
*
Oeuda Springs
1
Geary County-
Junction City
t
Jefferson County—
McLouth (R. D.)
' 1
Johnson County—
Shawnee (R. D.)
,
Leavenworth County—
Leavenworth
1
(
Lincoln County—
Barnard (R.D.)
1
Miami County-
Paola....
!
Montgomery County- -
Cofley\illc
1
Independence
1
•••
Norton County-
Norton
Riley County-
Fort Riley
Sumner County-
Oxford (R.D.)
1
Wellington (R. D.)
•;•: 1 i :::::::::::
.••
"Wabaunsee County -
McFarlanl
i"* "1
Wilson Coimtv
Fredonia (R. D.)
1 t
Wyandotte County -
Kan^jtts City
ly
1
Total
1 1
"1
Massachusetts:
Worcester County—
Winchendon (town)
1
_ J i
*
' _' ' * * " \
Ohio:
Butler County
5
2
69
1
ft
I
I
1
2f.
i
s
9
'?
I
2
1
1
'
Clark Coimty
2
Cuyahoga County
1 t
1
1
1
\
68
Darke County
1
Erie County
Fairfield County
2
Franklin County
I
2
Gallia County
5
Greene Coimty
1 .-.-----. .|
2
Guernsey County
1 J
M
Highland County
1 1
1
Knox County
: :: : 1 ::::...:... .::::i
I
Lucas County
>
25
Miami County
1
Montgomeiy County
g
Scioto Coimty
Shelby County
"■*'!'**"**
1
7
7
1
1
1
Summit County
10
Trumbull County
1*
1
Van Wert County
Warren County
3
Wayne County
Williams County
1
1
Total
169
2| 28
139
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1813
October 26. 1917
SMALLPOX— CJontinued.
Misceflaneoiis State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Pennsylvania (Sept. 1-30):
Allegheny County
Blair Countv
1
3
2
3
2
2
West Virginia-Continued.
Fayette County
1
2
2
1
1
2
2
Jackson County
PanpMn roiin^y , ,
Monongalia County
Pendleton County
Tyler County
Erie'Coonty . ..'
An vder CoimtT
Warren County.
Wirt Cou nt y
Wood Countv
Total
12
Total
20
West Virginia (Sept. 1-30):
Doddndge County. .
9
City Reports for Week Ended Oct. 6, 1917.
Place.
Alton, HI
Butte, Mont
Chicago, lU
Cleveland, Ohio
Coffeyville, Kana
Cphubbus. Ohio
Dajrton, Ohio
Denver, Colo
Detroit, Mich.
Evansvilto, Ind.
Everett, Wash
Fort Wayne. Ind....
Grand Rapids. Mich.
Indianapolis, Ind
Cases. Deaths.
Place.
Kansas City, Kans. . .
Kansas.Citv, Mo
I La Crosse, Wis
Leavenworth, Kans. .
Lincoln, Nebr
MinncapollH, Minn
Miiscatino, Iowa
Omaha, Nebr
Quincy, III
Richmond, Va
St. Joseph. Mo
St. Louis, Mo
Salt Lake City, Utah.
Cases.
Deaths.
TETANUS.
*Citj Beports for Week Ended Oct. 6, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Newborgh. N. Y
1
1
1
1
Portsmouth, Va
1
1
St. Louis, Mo
1
1
1
Pittsburgh. Pa
San Diego, Cal
1
PtttvftoldrMaffS
1
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, see page 1817.
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October 26, 1017 1814
TYPHOID FEVER.
Indiana— Michigan Cily«
Typhoid fever was reported as epidemic ut Mieliigan City, Ind.,
on October 22, 1917.
' State Reports for August and Septeml>er, 1917.
Plac©.
Oregon (Aug. 1-31):
Clatsop County
Douglas County.
Multnomah County-
Portland
PolkCoimty .*.
Tillamook Coimty
Yamhill County
Total
Kansas (Sept. 1-30):
Allen County
Anderson Count y
Atchison Coimty
Barton County
Bourbon Cotmty
Brown Coimty
Butler County-
Augusta (R D.)
Douglas (R. D.)
Eldorado (R. D.)
Potwin
RosehllKR. D.)
Chaso County
Chautauqua County.
Cherokee County
Cheyenne County
Cloud County
Coffey County
Cowley County
Crawford County
Decatur County*.
Dickinson County—
Abilene
Elmo(R. D.)
Ueringtou
Doninhan County
Douglas County
Edwards County
Elk County
Ellis County
Ellsworth County
Finney County
Ford County. .*
Franklin County
Geary County
Gove County
Gray County—
Cimarron (R. D.)
Greenwood County
Harper County
Harvey County
Jefferson County
Jewell County
Johnson County
Kearny County
Kingman County
Labette County
Leavenworth County—
Basehor(R. D.)
Easton
Jarbalo
Lansing ,.
Leavenworth (R. D.)
Lin wood
Lincoln County
Linn County
New cases
reported.
11 I
4 I
•I I
l\
•S
4
1
12
C
3
2
1
6
2
1
9
1
1
2
2
15
2
2
5
Plac«.
Kansas (Sept. l-?0)— Continued.
Lyon County
Marion County ,
Marshall County ,
McPherson County ,
Meado County
MiamiCxmnty
Mitchell County
Montgomery Count y
Morris County
Neosho County
Ness County
Norton County
Osage County
Osl>orne County
Ottawa County
Pawnee County.
Phillips County...
Pottawatomie County.,
Reno County
Republic County
Ri<oCounty
Rllev.
Pooks County
Russell County
Saline County
Sedgwick Coimty—
Wichita (R.D.).,
Seward County
Shawnee County—
Topeka(R. D.)..
Sheridan Count.v
Smith County..*.
Sumner County
Wash Iiipt on County. .
Wilson Comity
Woodson County
Wyandolte Coimt.v—
Kiin:;asCity.."..,
riper
Ro-^odak*
Wolcott
Total.
Ohio (Sept. 1 30):
Adaiu.A Coimly
Allen County
.\shland County
Ashtabula County. .
Athens County
Auplaizo ( oimly
Belmont County....
Brov.Ti County
Butler County
Carroll County
Champaign County. .
Clark County
Clermont Coimty
Clinton Count v
Columbiana County..
Coshocton County. . . .
Crawlbrd County
Cuyahoga County
Darke Coimty ,
Defiance County
Delaware County . . . .
Erie County
Fairfield County
New cues
reported.
34
3
2S
3
3
11
3
9
1
525
12
6
3
38
7
33
7
2
3
9
16
4
6
4
S
45
8
8
4
3
9
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1815 October 26. lOlT
TYPHOID FEVER— Continued.
State Reports for August and September, 1917— Continued.
Place.
Ohio (Sept. 1-^)— Continued.
Fayette County
Franklin County
Fulton County
OaUla County
Geauga County
Guernsey County.
Hamilton County
Hancock County
. HardinCounty
Highland County
Hocking County
' Jackson County..-.^
Jefferson County
Knox County
. Lawrence County
Licking County
LoganCounty
LoralnCounty
Lucas County
Madison County
Mahoning County. ^
Marion ( :ounty.. . .v
' Medina County
. Mercer County.*
. Miami County
* Monroe County...
Montgomery County
Morrow County
Muskingum County
Noble County
Ottawa County
Paulding County
Perry County
?ickaw&y County
. PaceCounty
Portage County
Putnam County
Richland County
RossCounty
Sandusky County
Scioto County
Seneca Coimty
ShelbyCounty
Stark County
Summit County
Tmmbcill County
Tuacarawas County
Union County
Van WertCounty
Warren County
Wayne County
Williams County
Wood County
Wyandot Coimty
Total
Pennsrlvania (Sept. 1-30):
Adams County
Allegheny County
Armstrong County
Beaver County
Bedford County
Berks County
Blair County
Bradlbrd County
Bucks County
Butler Ck>unt7
Cambria County
Carbon County
Center County
Chester County
Clarion County
Clearfield County
Clinton County
Columbia County
New cases
reported.
628
13
125
19
18
20
13
38
10
18
6
45
1
9
27
7
21
1
7
Place.
Pennsylvania (Sept. 1-30)— Contfaiued.
Crawford County
Cumberland County
Dauphin Coimty ..!!!!!!.!!!!.
Delaware County
EHi?r--^T^ __;;;;;;;;;;;;;;;
I ,^\ i'l Ln'' I ut.ilily,^ ^ !.!..,
I-.'' tfikijn i'ounty.]!!! ]!]!![]]][]]['
tj ffiene County, ..!.!!!!'!!!!!!
H imtingdon t'otuity '.".'
ludinjui i Olio ty ] . ] . ]
JiMT^f son County ....['.'.','.',['.['..'....
s noXiitu i 'oun t3^ !!!!!!]] !J !!!! !
LiiLkawiuiua 4 oiioty " ! ' ! ;"
Lancaster County. ....'.".'.".'....
Lawrence County ....!!!!].!!!!]!!.
Lebanon County
Lehigh County.. ..".'.!!!!! '.H! !.*!!! !
LuzemeCounty
Lycoming ('onnty.".] ! !!!!!.'!.!!!!!,
McKean County [
Me-cer County...
Miffl in Coun ty .,/////.'.'.'.'.'.'.'.'.'.'.'.. ,
Montgomery County ...........
Montour County ......'.
Northampton County. ........
Northumberland Countyl ..........
Perry Coun ty ,
Philadelphia County
PotterCoimty ,
Schuylkill County '..'.,.'.
Snyder County ,
Somerset County
Susquehanna County ! ,
Tioga Coun ty ,
Union County ,
Venango County ,
Warren County ,
Washington County
Wayne 4 ounty ,
Westmoreland County
York County ,
Total
West Virginia (Sept. 1-30):
Barbour County
Berkeley County ,
Brooke County ,
Cabell County
Dodderidge County
Fayette County ,
Gilmer County [
Grant County
Greenbrier Coimty
Hancock County
Jack.son County
Jefferson County
Kanawha County
c:harleston
Lincoln County
Mc Dowell County
Marshal I County
Marion County
Mason County
Mercer County
Princeton
Mineral County
Mingo Coun ty
Monongalia County
Morgan County ,
Ohio County-
Wheeling
Pendleton County
New cases
reported.
3
1
13
0
25
31
23
5
4
21
6
7
2
4
68
10
13
18
10
8
2
10
5
32
11
18
7
2
105
2
15
3
32
1
8
1
4
1
20
1
21
27
1,007
5
8
6
13
5
35
1
12
4
8
1
5
5
17
2
0
2
7
2
€
38
13
9
17
4
16
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October 26, 1017
1816
TYPHOID FEVER r4»!itimipd.
State Reports for August and September, 1917— Cuiitinued.
I'liK'e.
West Virginia (Sept. 1-30)--Continued.
Pocahontas County
Preston Cotuitv ,
Haleigh Connty
Roane County
Rummers County
Taylor Coinily
New eases
reported.
Place.
.New
reported.
West Virginia (Sept. 1-30)— Conttaned,
Tucker County
Tyler County
Cpshur County
Wood County
Total
2M
City Reports for Week Ended Oct 6, 1917.
Place.
Alton. lU
Arm Arbor, MicU
AtlantlcCity. N. J
Baltimore. MU
Birmingham. Ala
Boston, Miit^s
Bridgeport, ( onn
Buffttlo,N. Y
Cambridge, Mass
Camden, N.J
Canton, Ohio
Chelsea, Mass
Chicago, III
Cincinnati, Ohio
Cleveland. Ohio
Clinton, Mass
Columbus, Ohio
Concord, N. H
Covington, Ky
Cuml>crland. Md
Dayton, Ohio
Denver, Colo
Detroit, Mich
East t hicago, Ind
Erie. Pa
Evansville, Ind
Fall River. Mass
Flint, Mich
Fort wavne, Ind
Fort Worlli. Tex
Cialvest on. Tex
(jrand Rapids, Mich
Harrisburp. Pa
Hartford, Conn
Indianapolis. Ind
Jersey City. N.J
Johastown. Pa
Kansas C it v, Kans
KansiisCitv, Mo
Kenosha. Wis
Knox\illc, Tenn
Kokomo, Ind
Leavenwortli, Kans
Loxinrton, Ky
Long Branch, N.J
Lortdn, Ohio
Los Angles, Cal
Lowell. Mass
Lynchburg, Va
Maiden, Mass
Cases.
\ '
2 I
2 '
26
26
10
1
A
1
1
1
Deaths.
11 I
i!
Place.
;
1 6
1
i
2
2
5
1
4
7
:i
T)
1
.')
1
2
a
2
1
1
2
10
2
1
1
1
:.:.
2
::::::::::
1
1
1
Medford, Mass
MemphlH, Tenn
MjIwauVee. Wis
MluMoapoli^ Minn
Na>.i\ illc, Temi
Newark, N.J
New Bedford, Mass.. . .
New Haven, Conn
isew l.wulon, Conn....
New ( )rleans. La
New York, N. Y
Nia-ara Falls, N. Y...
Norfolk, Va
Oakland, Cal
Oklahoma aty. Okla..
Perth Amboy, N. J
Philadelphia, Pa
Pittsburgh. Pa
Plainfleld, N. J
Portland. Oreg
Pro\i(lence. R. I
Hradiiii:. Pa
liict.moiul. Va
ll«Kiiu»ke. \'u
S;)'^r;tni«nil n, Cal
t^uKiiiavv. Mich
81. Jo.^<M>h.Mo
S>. Louis. Mo
Suit Luke City. Ctah..
San DlcKo, Cal
San Fmncisco, Cal
Ka vaunali, Oa
Hentlle. Wash
i^'oiiK-rvire, Mass
South Bend, Ind
Springfield, 111
Sprin^rield. Mass
Stockton, Cal
Svraousc. N. Y
Toledo, Ohio...<
Topeka. Kans
Trov.N. Y
"VVa.shinKton, D. C
Washington. Pa
Wheeling, W. Va
Wichita, Kans
Williamsport. Pa
Wtnston-Salem, N. C.
Worcester, Mass
York, Pa..
Cases.
Dealta.
2 !
10
48
3
a
1
39
13
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1817 October 26, 1917
TYPHUS FEVER.
City Reports for Week Ended Oct. 6, 1917.
During the week ended October 6, 1917, one case of typhus fever
was reported in New York City.
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State. Reports for September, 1917.
Cases reported. :
State.
Cases reported.
state.
Diph-
theria.
Measles.
Scarlet
fever. |
Diph-
theria.
Measles.
239
8
Scarlet
ferer.
Kftn.'JA^s
75
771
50
80
79|
343 1
Pennsylvania
West Virginia
1,658
180
410
\ Ohio I
60
Oregon Report for Angust, 1917.
During the month of August, 1917, 13 cases of diphtheria, 9 cases
of measles, and 22 cases of scarlet fever were reported in the State
' of Oregon.
City Reports for WeelL Ended Oct 6, 1917.
Popula-
tion as of
July 1,1916
(estimated
bv U. 8.
Census
Bureau).
Total
deaths
from
an
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
Ctty.
1
1
1
1
1
1
1
3
.
1
Over 600,000 inhabitants:
BaHfmore, Md
689,621
766,476
2,497,722
674,073
571,784
603,812
5,602,841
1,709,518
579,090
757,309
468,568
410,476
306,345
436,635
363,454
408,894
371,747
463,516
348,639
363,980
214,878
260,800
271,708
297,847
296,463
254,960
180
185
686
175
178
114
1,342
406
194
188
137
106
64
80
........
109
119
57
116
SO
60
66'
40
54
23
72
230
56
87
11
254
58
48
74
H
21
11
21
44
13
27
10
7
85
8
4
141
10
5
U
2
1
24
4
9
*23'
7
6
6
2
■"'2
5
......
0
23
15
1
3
1
62
7
2
2
......
■"2
......
7
16
29
8
70
17
4
15
13
9
7
28
3
10
2
3
5
20
2
......
1
36
52
322
31
25
33
323
77
28
34
19
24
27
16
20
Boston Mnas .
21
CWcago, 111
62
Cknrefimd.OUo
Detroit. Mich
13
Los Angeles, Cai
14
New York, Jj.Y
175
Philadelphia^Pa
60
13
St.LoaisTMo
From 300,000 to 600/)00 inhabit-
ants:
Bollalo.N.Y
18
16
Oncinnatl. Ohio
12
11
- 13
Jersey aty. N. J
6
Milwaukee, Wis.
6
MifiiMapnHii. V\nn
Newark' N.J
......
29
22
24
16
New OrJeuis, La.
16
San Franosob. Cal
■"2
1
8
Seattle, Wa^!
2
From 200,006 to 300,000 inhabit-
ants:
Cohmibos, Ohio
23
10
17
4
Denver.Cok)
1
......
2
3
4
1
1
•
Indianapolis. Ind
8
0
Trai«i«hty'Mft . ...
1 :::...
4
3 13
Portland, Orgg
5 6
Providenbe, if. t
3
*
Digitized by
Google
October 26, 1017
1818
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
(\>iitlniied.
City Reporto for Week Ended Oct. 6, 1917 (onlinued.
"
I'opula-
lion as of .
Julyl,19Ui
(estimated
byr.S.
Census
Bureau).
181, 7r.2
121,.'>79
112, 9S1
ioa,23:J
127,224
12H,3«.(>
104, 5i 2
12S,291
110,»«>
113,2t-.
102, 42.'.
HX,00.'i
117,ft->7
118,1.-A
149, «X-,
198,104
KiT), 470
109, .-iSl
1.%, ( s7
117,3^i0
105,942
155,024
191,554
111,593
103,314
57,000
09,S93
57, 1 .'3
.'■.;^97:{
W), K.12
<iO, 734
57,144
94, 495
rv{,705
75, 195
7C.,07S
54, 772
7(1, l)-3
72, on
77,214
«>S,.52J
99,437
51, l.V.
78,2s;j
58,221
89,012
92,943
71,744
55, 185
06. 895
55,(;I2
K%ZM
r,3,:vM)
«8,8ft^.
99,519
57,078
87,039
08,946
61,120
51,550
66,083
77,916
70,722
76,770
51,05«>
Total
deaths
from
all
euuses.
53
:{9
29
34'
32
12
24
40
37
10
2.V
;«
57'
27
19
39
20
29
35
72
27
47
4*
10
18
30
10
15
Diphtheria.
Measles.
Boirlet
fever.
Til
Cllfc
1
i
6
9
ber-
ssis.
City.
4
3
0
4
7
2
3
1
8
6
3
21
2
3
4
0
14
4
12
13
7
11
2
1
2
2
2
3
9
15
1
14
1
1
1
1
1
From 100.000 to 200.000 Inhabit-
llirifjJijii!li>i).ii( Al»4
2
2
4
SrfdP'i^pcHi CTonjT
4
3
famdrTi N J
......
1
5
....
l^DTtOD ^ 'llit' . ... ....
a
1
4
2
4
3
Fjyn Ftivfir Mjii^
2
F^rt Wtifl h T^v .
amtiaKfipiili, Mich
HuxtfOT*!, L'l^QH
* i
......
2
1
2
1
3
6
3
5
18
4
S
i
2
3
!fii*iiiiphl?, TfilM
2
3
4
3
1
(i
2
1
3
0
::::::
7
Nfiahvflle.Tt'nii
4
Kew liedfurd Muss
......
1
■'2
1
4
1
;;:;;;
4
New liuvcn, Cf«n a
2
OntkuiJ^C^il
1
r.
Omahfl.Nebr.
BiiKline }'ti
1
2
'.'.I'.'.'} 9
Efchmoiicl.Vji
0
2
1
2
5
flftltLiilci'ntv.rtah
flprti«fielcl, Mikvi
8
3
6
1
6
7
15
2
3
6
4
Bi™U,i^.Y :::::::::;;
4
3
1
3
1
Toledo, Ohio.
a
Trcnlmi N J
2
^^'orLi^BWif , Mtts.'5
3
3
From 5(V«oto lOT^fnoinhablt-
ants:
Atlantic City, N. J....
1
Bnyonno, N' J
2
Berkeley , Cal
1
4
Binghamron, N. Y .'
2
1
3
Canton, Ohio
t
1
Charleston's. C. .
5
Covington. Kv '.'.
1
2
1
5
;::::.' 2
1
Dulnth.Minn
3
1
El Paso, Tex
s
Erie, Pa
22'
26"
22
31
13
io'
26
29
i?"
10
22
16
9
17
17
37
20
is"
11
17'
17
is*
43
7
2
4
2
5
»
Evansville, Ind
3
Flint. Miih
3
8
4
3
Fort Wayne, Ind
2
Ilarrisburg. Pa
7
1
2
3
2
2
2
Hoboken.N. J
2
Johnstown, Pa
i
6
6
1
4
3
2
15
1
2
1
4
1
Kansas City, Kans
Maiden, Mass
1
1
I
Manchester, N H
6
1
Mobile, Ala... . ' * '.'.'.'
1
3
Norfolk Va
2
1
Oklahoma City, Okla .'.'.'.'/..
Passaic, N. J.. .
1
1
1
4
Rock ford, Ul
Sacramento, Cal- . ] .'.'.'..
1
4
3
1
Saginaw, Mich
1
«t. Joseph, Mo
San Diego, Cal . .
2
7
3
2
4
Savannah, Ga .
5
1
1
5
1
1
6
Sioux City, Iowa...
6
Somervillc, Mass '.'.'.'.
I
1
3
2
1
1
2
3
South Bend, Ind
Springfield, 111..
1
4
5
1
1
8
Springfield, Ohio
4
1
7
11
3
3
TerreHaute, Ind
2
Troy,N. Y
3
3
Wiciuta, Kans
4
1
1
Wilkes-Barre, Pa
. ..
Wilmington, Del
6
York. 7a...:
3
i
Digiti
zed by Google
1819
October 26. 1017
DIPHTHERIA, MEASLES* SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Oct. 6, 1917— Continued.
Popula-
tion as of
July 1, 1916
(estimated
bv U. 8.
census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tul)er-
culosis.
City.
1
1
1
2
1
.
-^-
1
2
1
From 25,000 to 50,000 inhabit-
ants:
Alamf'fla, f^l
27,732
37 3S5
34,814
32 98.5
32, 73')
27;<.32
43 425
40,192
20,319
25,074
32,261
48,SI1
39,873
28,743
42,458
28,203
39,233
35,480
41,781
41,* 3
23, 3 ^a
4S,477
35,363
48,'<S0
31,576
38,676
31,677
41,097
35,384
46.515
27,587
36,964
3:..>r)
30. f!W
26, 'Mi
'.'.•/as
27,327
41.133
31,927
3(),1<)8
43,715
37, srxj
31, lot
3.i,(^)
r,\')
4I.IS.3
:>, .?.)
39, t>.')l
36, 7SJ
:?v. \x\
Vi.2S\
3H.!»oi;
2:,ij.-)
3:.. i'iH
46. 22n
•3<»,in:
■IS.:?-,
30. :>7o
?9..S9I
43,377
2'J, H/2
31, l.Vj
30,863
10
15
13
3
8
4
2
9
11
3
' Auburn N Y
5
2
2
Austin, Tex..
2
::::::i::::::
Brooklinc, Mass
2
1 j
Butler. I'a
9
::::::i::::::
Butte,Mont
1
2
5
i 1
Chelsea, Wa^s
12
5
7
7
i2'
11
6
4
3
14
13
8
12
17
4
ii*
16
9
11
13
io"
5'
3
6
10
H
2
9
'I
10
6
2 1
^i
3 f
CbicGi>oo, y.i\:
Cuml>crland, Md
1 1
4 1
1
2
1
1
Danville, HI
1
2
I
Davenport, Iowa
2
2
4
i;:::::
Dubuque, lov.a
,
2
4
Bast Ohicaeo Ind
'""i"
1
1
Bast Oraneo. N. J
1
Elgin, 111 " '
4
Everelf, Hms^
1
Everett, Wu.'^h
i
1
Pitch bi re M:iss
6
1
::.:::i
i
Oalv(i>toD . Xox ....
1 1 1
Groon Day . \\" i^
1
Haverhill. Mass
2
•
3
2
1
Jackson, Mich
1
7
1 3 1
Kalaniaxoo, M Ich
7 i'
1
Kenosha, U is
1
4
6
7
6
6
15
1
Knoxvilfo, Tonn
... . 3
1
' 0
La Crosse, Wis
1 1 1
T^xington^ Ky
8
..:;:;i.:.:::l.:. .1
2
Limarohio . .'.
3
\
Linmin, N^hr
::::::i:::::*i
Long Beach. Cal
1
1 1
....
i
Lorain. Ohio
6
1
i '
2
lATichburg, \*a
Marl|»{nTi Wi<
..;!.
1
s
Modford, Mass
1
1 * *
Montclair, N. J
2 1
Nashua. N. H
2
1
1
1
2
Newhurgh, N. Y
3
Newcastle. Pa
i
( 1
Ncwi>ort , K V
1 ] 1
Newport, R* I
2
4
Newton, Mass
,
1 2
1 1
Niagara Falls, N. Y
1
Ogden, rtah
••••^ V
0
Orange. N. J
Pasadena, ("al
1
1 2
'
I
Perth -Vml)ov. N. J
1
2
Piltsfeld, Mit>;
12
11
9
0
11
....^1
1
2
1 1
Portsmouth, \ a
2
1
1
1
Quincv, 111 ]
2
QulncV, Ma*<s..
5
'i\ i
4 , •• ••
Roano, p, V'a
..J.;::;:: ?
Roc!; Island. 111... .
San Ja^, C'al
1
Steuhcnville. (jIUo
Stockton, (\1 . . . ,
0
1
1
1
Superior, \Vi««
6
1
1
1
Taunton, Mans
::::::' :
Topcka, Kans
1
8
1
2
1
Wallham, Mass
'
i
Watertown. N. Y
2 !...:
' 3'i ..:'"
Whe*ih(iK'. vV. Va
{>"
I2
3
K
1 !
1
William >|. Tt, I'a
!
1
Wilniii»Kf<);j N. C
_ _ t i 1
Win.'«t;)-j-S:lrni, N. C
1
I
;
Zanesville, ohlo
......
......
' 1 2
130
Digitized by
Google
October 26, 1917
1820
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
CoQtiBued.
City Ri^arts to Week Eaied Oct 6, tfl7->Contiinied.
POpOflft*
tion as of
July 1, 1016
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
aD
cautea.
DiphUwrift.
Measles.
Scarlet
fever.
Taber-
culons.
atr.
1
1
1
1
1
1
1
1
From 10,000 to 25,000inhabitants:
Alton 111
22,874
15,010
13, 5W
21,685
15,794
1 13, 075
22,660,
24,276
16,950
23,539
20,930
19,363
15,396
1 14,610
17,445
13,284
23,126
15,243
20,985
122,019
19,926
23,806
17,524
11,666
12,067
14,831
20,193
13,821
15,518
21,618
23.228
8
14
a
2
7
4
7'
4
6
4
1
8
4
2
3
4
«*
6
3
2
3
Ann \rbor. Mich
1
Berlin, N. H
.... 1 - -
Brad«lock. Pa
8
'
1
1
Cairo, 111
1
1
Clinton, Ma*<s
::::* : :::::i::::::
1
1
Concord, N. H
6
1
3
1
1
1
1
Galesburg, 111
!
Harrison. N.J
].-.---
1
Kcamy,N.J
KokoiDo, Ind
8
4
1
4
1
3
Leavenworth, Kans
::::::c-s:
Long iiranch, N. J
**
3
Marinette. WU
*
Melrose, Mass
2
....
"l
Morristown, N. J.
...
Nauticoke, ra
3
2
1
1
1
1
Newburyport, Mass
1
i
New LMidoa Conn
1
L..«.«
North Adams, Mass.. . .
.. --
1
7
1
Northampton, Mass. ... I ... .
Plainfiekf. N. J
1
2
1
..!;!!!...!..
^ 1
pootiae MVh
3
Portsmouth N H
1
6
Kocky Mount, N. C
Rutland Vt
4
2
12
0
3
1
Sanitoga Springs, N. Y
Steelton, I^
1
«
1
3
1
1
Wu^hin^jin Pm.
"V','\::::::
Wilkinsburg, P»
0
1
1
' i
I
1 Population Apr. 15, 1910; no estimate made.
Digitized by VjOOQIC
FOREIGN.
CUBA.
Communicable Diseases — Habana.
Communicable diseases have been notified at Habana as follows:
Disease.
Sept. 11-20, 1917.
Sept 21-30, 1917.
Remaloing
under
Cases.
Deaths.
Cases.
Deaths.
treatment
Sept. 30, 1917.
CerftbTnsnlnftl mcfliziflitUr r . , r , - . -
1
Diphtheria
3
5
1
1
Leprosy
10
MfaArifl
12
3
2
2
1
2S
5
1
15
Measles
1
Paratyphoid fever
1
Scarlet fever
2
Tetanus in the newborn
1
6
Typhoid fever
2S
2
6
88
Varicella
2
Typhoid Fever— Habana—Comparative Statement, 1913-1917.
An increase in typhoid fever was^ noted at Habana during the
third quarter of the current year. The following comparative state-
ment shows the prevalence of the disease at Habana during the three
elapsed quarters of the year 1917 and the four years preceding:
Year.
. Cases reported.
"Year.
Cases reported.
First
quarter.
Second
quarter.
Third
quarter.
First
quarter.
Second . Third
quarter, quarter.
1913
99
72
148
Ill
86
149
135
1916
83
100 111
1914
163
1917
96 238
1915
1
1
ECUADOR.
Plague — Yellow Fever.
At Guayaquil, Ecuador, during the month of July, 1917, 2 cases
of plague were notified and during the month of August, 1917, 2
cases.
Yellow fever was reported present in Ecuador during the months
of July and August, 1917, as follows: At Guayaquil, month of July,
4 cases; month of August, 1917, 3 cases. At Naranjito, in July and
August, each 1 case.
(1821)
Digitized by
Google
October 20, 1917
1822
JAPAN.
Cholera — Plague — Xanuary-July, 1917.
Diirino; the period January to July, 1917, 391 cases of cholera were
notified in Japan. The jrieatest number of cases, namely, 106, oc-
curred in Yamaguchi Ken. The cases were distributed according to
provinces and districts as follows:
ChibaKen 1
EhimeKen 18
FukuokaKen 93
Hiroshima Ken 7
Tlyogo Ken 7
Kagawa Ken 7
Kochi Ken 1
Kumamoto Ken 1
Naj^a^dd Ken 62
Ohita Ken 3
Okayama Ken 4
Osaka Fu 15
Saga Ken 27
Shimane Ken 35
Tokyo Fu 4
Yamaguchi Ken 106
On September 12, 1917, an outbreak of cholera, with 252 cases, wis
reported in Japan. The greatest incidence of the disease was in
Toyama Ken, with 197 cases. The 252 cases were distributed ac-
cording to provinces and districts as follows: Gumma Ken, 9 cases;
Ishikawa Ken, 38; Kyoto Fu, 1 case; Niigata Ken, 5; ToyAma Ken,
197; and at Tokyo, 2 cases.
Pla^gue, — During the period January ^uly, 1917, 25 cases of plague
were notified in Japan, the distribution of the cases being as follows:
Aichi Ken, 22 cases; Miye Ken, 3 cases.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEYEB.
Reports Received During the Week Ended Oct. 26, 1917. ^
CHOLEBA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Mandalay
July 29- Aug. 11
1
1
Prome
do
Jaoan
Jan .-July, 1917: Cases, 391. Oc-
Tokyo . ...
Sept. 12
2
curring in Id provinces and dis*
tiicts.
Sept. 12, 1917: Cases, 252. In 5
provinces and districts.
Java:
West Java
Aug. 7-28, 1917: Cases, 71; deaths,
Bata\ia
Aug.2-23
6
1
1
Philippine Islands:
Manila
Sept. 2-8
Not pre vioosly reported .
Provinces
Sept. 2-S, 1917: Cases, 268; deaths
170.
Bohol
Sept. 2-8
3
10
10
54
183
8
3
5
7
37
111
7
C'ebii
do
Iloilo
do .. .
Leyte
do
Mindanao
do
Negros Oriental . . . i^r. . .
do
I From medical officers of the Public Health Service, American consols, and other souroet.
Digitized by
Google
1823
dctober26. 191^'
CHOLERA, PJ.AGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received During the Week Ended Oct. 26, 1917-— Continued.
PLAGUE.
Place.
Date.
Oases.
Deatbs.
Remarki.
Ecuador:
Oiiayftniill
Julyl-Aug.31
July20-Aug.ll
4
India: ^
Bass«in
17
3
20
^ 3
&
Mandalay
.do
Moulmein
:::::do:v:::::::::: •■""
Pegu
..do
Toun^oo
do
J^>an:
AichiKan
jftTi.-Jnly. . ... .
S2
3
8
S
MiyeKen
do./. ».
Java:
East Java
JulyaO-Aug.S....
Aug. 5-18
3
2
Straits SetUementa:
Singapore
SMALLPOX.
Canada:
Ontario-
Windsor.
China.
Chungking. . .
Ecuador:
Guayaquil...
^"^iiro
Japan :
Mexioo:
MejdcoCIty..
Portugal:
Lfibon
Russia:
Archangel....
Riga
Spain:
Malaga
Oct. 7-13
Aug.27-Sept.2..
Julyl-Aug.3l...
Mar.lD-Apr.S..
Sept. 2-15..
Aug. 11-18.
June 18- July 15.
Apr. 1-30
June 1-30.
14
Presoit.
Jan.^uly, 1017: Cases, 4,974. lo
. 37 prorlnces and districts.
TYPHUS FEVER.
'»^=,„, •.
Mar. 19 Apr. g....
Mar. 19 25;
July 23- Aug. 23...
92
1
6
36
Foresaid
Java:
Mid-Java
West Java
JulT 29-Aup. 23, 1917:
deaths, 9.
Cases 36;
Batavia
Aug. 16-23
Sept. 2-15
24
174
12
1
4
1
6
Mexioo:
Mexico City
Russia:
Archangel
July 1 -Aug. 14....
Apr. 1-30
6
•
Riga
Bwltterland:
Basel
Aug. IH-vSept. 22. .
Sept. 16 22
Zurich...,
«
Ecuador:
Ouasraquil.
Naranjito..
YELLOW FEVER.
July 1-Aug.31....
do
Digitized by
Google
Octeter2«,1917
1824
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Oontinaed.
Jotte M to Oct 19, 1917.
CBOUERA.
Ftaoa.
Date.
Casw.
Deaths.
Ronrks.
India:
Basspin . •
AfiT.l-UmyS
«
1
7
J47
14
4
»
2
3
1
5
7
17
7
•
Bombav
June 34^
JulvK Aue. 4
Apr. 2^ JuaeSO...
1
U
C^...:::::::::::.../..
Calcutta
Do
Julv 1-28
Madras
Apr. 22 June 30...
July 1 Aug. 21....
May fV Jime30
n
Do
Mandalay
Moulmein
May J3-June2
Pakokku *
Apr. aO-Mny 5
Pegu
Mav 27-Jime 30. . .
July 1-7
Do
Rangoon
Apr. 21- June 30...
July S 28
31
9
Do
Indo-China:
Provinces
Feb. l-Jone 30, 1917: Cases, 1,237;
Anara
Feb. l-JiiBe30....
do
230
79
878
1
36
163
1
1
1
191
51
543
deaths, 805.
Cambodia
Cochin-China....
.do..
Laos
June 1-30
Tonkin
Feb. 1- Juno 30
Apr.23-May27...
Apr. 2-S
21
106
Saigon
Java:
Kast Java
Do
Jnlv^lS
1
1
Mid Java
July 16-22.
West Java
Apr. IS-Jaty 5, IfIT: Gaset, 71;
deaths, 31. July 6-Aim.I, 1917:
Cases, Iffindastte, 3.
Batavia
Apr. 13-July5
Julyft-Aug. 2
Feb.3
7
9
1
4
1
3
1
2
2
8
Do
F«nia:
Mazanderan Provtnoe—
Amir Kela
Barfourouche
Jan. 15-17
Hamze Kola
Jan. 17
Machidossar
Jan. 31
Philippine Islands:
Manila
June 17-23
Aug. 19-25
Do
Provinces
May 2(VJune 30, 1917: Cases, 795;
Apiisan
Jnlv ir.-yi
Mav 20-June30...
Julv 1-Ane. 4
Aug. 1*>-Se{)t. I...
Juno 3-0
12
113
53
It
2
20
1
368
203
32
62
64
231
38S
41
41
14
334
173
237
12
itm
276
40
1
I
4
92
196
216
$
" 2
76
30
7
1
11
deaths, 9W. July l-Aug. 4,1917:
C^kses, 2,064; deaths, l,2n.
Aug. 19-Sept. 1, 1917: Cases,
502; deaths, 2J4.
Albav
Do
Do
Ambos Camarines
Do
Jnlv22-Ang. 4
Julv H-I4
Bataan
Batangas
Jun<^ 17-23
1
351
161
14
4')
45
15')
284
2K
22
5
223
92
117
11
It,
31
Bobol
May %)~Svmc 30 . . .
July 1-Au^;. 4
Aug. 19-Sept. 1....
June 3-:«
Julyl-Aug. 4
June 3-30
Julyl-Aug. 4
Aug. 1^-Sopt. 1...
Julyl-Aug. 4
June 10-30
Do
Do
Capir.
Do
Cebu
Do
Do
Iloilo
Leyte
Do
Do
Mlsamis
Mindauao
Do
Nepros Oriental
Do >...
Rital
Julyl-Aug. 4
Aujr. 19 Sept. 1....
July S-Aug. 4
July20-Ausj. 4....
Aul'. It^Sopt.l....
July l-Auc 4
Au'. 1» Sept. 1....
Juno 24-30
July 1-7
•
Do
Romblon
July 22-2S. ..
1
2
52
88
114
i
Samar
July 15-21
Do
Aug. 19-Hept.l....
June .3-30 . .
Sorsogon
Do
Julvl-Aug. 4
Aug. 19-25
Do
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1«25
OclAbM-^ 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVBE, AND YELLOW
FEVEit— OoBtivDed.
CHQLEBA-Omtinued.
Plaoe.
Date.
Cases.
•Deaths.
Bemarks.
Philippine Islands— Continued,
rro vlnc«s— Cont Inued.
SuriK£U)
Aug. 19-25
June 3-30
4
f
7
11
2
4
4
7
9
2
7
So.
Tsyubfts ... . .......
Do
July 1- Aug. 4
Aug. 19-8cpt. 1....
July 15-21
Do
Zamboanga .-,..,
PL443UE.
Arabia:
Aden.
Brazil:
Bahia
1)0
Penwmbuoo
Ceylon:
Colombo
Do
China:
Araov
floiyknng
Kwangtune Provinoe—
Ta-pu district.
Ecuador:
EstanciaVlq^
Ouayaqdil
Mitarro
SaltUre
Taura
Alexandria
Do
Port Said government...
Port said
Do- ^
Pwvtnces —
Favomn
Qalioub^^i
Oirgeh
Do
Siout
Suet government. .
Snes
Great Britain:
Oraveseod
IfOndon
India
Bassein...
Do...,
Bombay..
^Dol.,
^Mcutta. 11
Do...
Karachi..
Do...
May 3-Jdly 4..
June 10-30.^
July8-Sept. 8...
July 16-Aug. 15.
Apr. ^J one 23..
Ji5y6-ai
Apr. 29-May5-.
July 1-7,
May 13-Jnne30.
July8-Aug.l8..
June 2
Teb.1-28...
do
Mar. 1-31...
Apr. 1-30...
Mar. 1-31--.
Apr. 1-30...
Feb. 1-28...
do
Mar. 1-31...
Feb. 1-28. . .
June 21-27
JtilySl-Aog. 19..
Apr.30-Mayl9..
June 25
July!B-29
May ll-JmieSQ..
June 28
May 17
May 12-June J&. .
July29
May 12
Apr. 30- June 2...
Hay tl-Jtme 28. .
Aug. 13-24.
Hay 3-8 —
Apr. 1- June 30...
my 1-4
Apr. 22-Junc 30..
Jmyl-Aog. 11 —
Apr. 2»- June 2...
July 15-21
Apr. 1-June30...
Apr. 22- Juno 30..
June 28- July 28..
486
231
468
U
43
1
3
64
6
287
188
38
1
35
413
•
Apr. 8-MMr 14, tOli Cases, (
Present and in vicinity.
Present Aug. 10.
Present.
Jan. l-^Auc. ^ VKJ:
deaths, 696.
.1,^1;
From s. 8. Matiana.
2 in hospital at pcrL From s. 8.
Sardmia from Antrallan and
oriental ports.
Apr. 15-Junfi 30- 1917: Cases,
43,922; deaths, Mg©7. July 1-
7, 1917: Cases. 1^0; deaths,
L322. July 1&-A;pg. 4, 1917:
Cases, 10^014: deaths, 7,821.
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October 26, 1917
1826
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from Jane 30 to Oct. 19, 1917~Continued.
PLAGUB— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
India-Continued.
Madras Presidencv
Apr. 22-June30...
July 1-Aug. 21....
Apr. 8-Mav 12
301
721
250
509
9.
74
16
1
2
109
286
2
Do
Moulmein . ........
Apr. 1-Jfuiie30
Do
Jlfly 1-7
Mvinffvftn
Apr. 1-7
Pegu
May 27-June 2
Raneoon
Apr. 15-June30...
July 1-Aug. 11..:.
Apr. 8-14
183
303
Do. .:::::!.:..:.::::::
TOUngOO .-.r...r.T.
Indo-China:
Provinces
Feb. 1-June 30. 1917: Ca8ea,^738|;
Anam
Feb. 1-June 30
do
232
133
219
34
113
/47
131
115
133
23
89
26
deaths, 491 '
Cambodia
Cochin-China
Kwang-Chow-Wan
Tonkin
do
Mayl-Juno30
Feb. 1-Junc30....
Apr. 23 June 3
Saieon
Java:
East Java
Apr. 2-May », 1917: Caaei, «
Heaths, 2§.
Djocjalcarta Residency.
Kcdiri Residency
ApT. 23- May 6
do
1
1
3
18
4
0
1
1
3
18
4
6
Samarang Residency.. .
Surabaya Residency . . .
Do
Apr. 2^ ^f ay 20....
Apr. 2-May 20
July 8-28
Surakarta Residenor.. .
do
Peru
May 13-31, 1917: Cases, 1&
Departments—
ArecLiiua ....
May 16-31
4
1
2
7
1
13
9
a
1
At Mollendo.
Callao
do
At Callao.
Lamb^ycQue.. ........
do
At Chiclayo.
Libertad
do
At Salaverry, San Pedio, tad
TrujUlo.
At T/ima.
Lima
do
Slam:
Bangkok
Apr. 22- June 30...
July3-Aug. 11....
Jime3-16
12
8
1
1
Do
Straits Settlements:
Slngaiwre
J)o
July 1-7
Union of South Africa:
Cape of Goofi Hope State—
CradocJc
Aug 23
Present.
GlenKrey district
Terka district
Quc<'iislown
Aug 13.!
Do.
Mav2S
1
1
1
At Summerhill Farm.
June 6
Orange Froo 8t ate
Anr 16-22. 1917: 1 case. Apr. ••
Win burg district
May 28
1
6
22, 1917; Cases, 26; deaths. It,
At sea:
S H. Mntipnft T -r T-
July 14-18
9
En route forport of London.
SMALLPOX.
Australia:
New South Wales '
Brewarrina I Apr. 27-Juno 21 .
Ccssnock [ July 2.')-28
Coonaharabran I May 2'j-Ju ly 5. . .
Quambono I Apr. 27-Juri© 21 .
Warren district ' ' ""
Queensland-
Thursday Island Quar-
antine Station.
Brazil:
Bahia..
Do.
Rio do Janeiro .
June 22- July 17.
May 9..
May 6- June 30..
July 22- Aug. 4 . .
do.
Do I July 1-Sopt. 1.
4
2
126
328
Apr. 27-July 28, 1917: Cases, 75.
From s. s. St. Albans from KoM
\ia Hongkong. Vessel Pj"
ceeded to Townsville, Br*
bane, and Sydney, in qusra*
tine.
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1827
October 26, 1917
CHOLmtA, PLAGUE, SMALLPOX, TYPHUS FEVER,^ AND YELLOW
FEVKR— Continued.
Keporti Kecefred frmn hme 91^ to Get. 19, 1917— Continued.
SMALLPOX-ContiniwL
Plaoe.
Date.
Cases.
Deaths.
Remarks.
Canada:
Manitoba —
Winnipeg
Jane 10-16
Aug. 19-Sept. 1....
Junel8-July7....
June 17-30
1
6
3
Do
Novia Scotia-
Halifax
Port Hawkesbury
Ontario-
Ottawa
Present in distiiet.
July30-Aug. 5....
8ept.30-Oe*.6....
May ^12
1
1
1
Windsor
Ceylon:
Colombo
China:
Amoy
Apr. 29-May 26.-..
»
Present and in vlchiity.
136:::::::::::::::::::..
Jttlv 1-Aug.'l9
Antung
May21-Jane24...
Aug. 6-12
4
1
5
Do
ChanRsha
May27-Juiw2....
Aug. 11-17
Do
7
Chungking
May ft-Jnne 99 ... .
Do.
Do
Julvl-Aug. 18
Do.
Dairen
Mavl3-JuBe30...
JuIy8-28
30
ft
2
1
1
4
1
Do
July t-7» 1917: PitnBt.
Hankow
June 24-30
Farhm
Apr. 23-May6
May6-Junel6
Aup. 5-18
f^n nitrvuffft FAfftffr* f^.
Honskcoff
7
^^:.::. :::::::::::::
Manchuria Station
Apr. 23-29
Do.
Mukden
May *?7-Tnne ?
Present.
Do
July»-S<»pt. 8
Do.
Shanghai
May21-Julyl
July 2-Sept. 29
13
32
9
Cases foreign; deaths aaoog na>
Do
tfvee.
Among Chinese.
On Chmese Eastern Ry.
Tsitshar Station
Apr. 16-22
1
35
4
1
1
1
5
39
19
1
1
Tsinetao
May22-July7
July30-Aug. 11...
May 1-31
1
1
At another statical am lailway
fio : :::..::::::
lease.
Chosen (Korea):
Chemulpo
Ecuador:
Ouavaniiil
Feb. 1-28
boTi:.::::::::::::::::
Mar. 1-31
Do
Apr. 1-30
Egypt:
Alexandria
Apr. 30-July 1
July 2-29
0
4
1
Do
Cairo
Feb. 12-Mar. 18...
July 30- Aug. 5....
May 6-12
France:
. Nantes
Paris
Germany
Mar. la-Apr. 28, 1917: Cases, 715
Berlin
Mar. 1»-Apr.28. ..
do
ioe
16
18
m cities and 32 States and dis-
Bremen
tricts.
Charlottenberg
do
Hamburg
do
Leipzig
do
Lubeck
do
Munich
do
Stuttgart
do
Greece:
Athens
July 25-30.
23
75
22
12
8
1
48
I
India:
Bombay... .. .
Apr. 22-June30...
Julyl-Aiig. 11....
Apr. 29-May 26. . .
186
48
Do
Calcutta
Karachi
Do
Apr. 22- July 4....
July S^14
27
1
80
3
33
7
Madras
Do
Bangoon
Apr. 22 Jiijw:i0...
July 1-AuK' 21
Apr. 10 Juao30...
July 1-28
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October 26, 1917
1828
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Gunt Inued.
Reports Received from June dO to Oct 19, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Feb. 1-Junc30...
....do
....do
Mar. 1-Apr. 30
Apr. 1-30
Feb. 1-June30....
Apr. 27- June 10...
May 2l-June24...
Indo-Cbina:
Provinces
Anam
Cambodia
Cochin-Cliina
Kwang-Chow-Wan.
Laos
Tonkin
Saigon
Italy:
Turin
Do I July 12- Aug. 26...
Jamaica:
Kingston
Japan:
Kobe
Nagasaki
Osaka
Yokkaichi
Yokohama
Java:
East Java
Do
Mid-Java
Do
West Java
Batavia
Cases.
1,630
136
1,267
4
5
274
199
32
Deaths.
Mexico:
Coatepec
Do
Jalapa
Mazatlan
MexiooCitv
Do....*.
Monterey
Orizaba
Do
VeraCrur
Netherlands:
Amslordam
Philimunc l5hm<ls:
Manila
Do
Portugal:
Lisbon
Do
Portug\ieso Kast Africa:
Lotircn^o Marciucs. .
Russia:
Archangel
Do
Petrograd
Do
Riga
Vladivostok
6iam:
Bangkok
Do
Spain:
Madrid
Mai lira
HeuUe
N'aioTicia
Do
Strait < Set Ucmcnts:
IVn n..'
Sin;,Mi'(,re
Sweden:
MalMu
iStfX'kholm
Tunisia:
Tunis
Sept. 9-15
May 27- July 22....
May 28-June3
May 10- July 5
July 25-31
May 27- July 1
Apr. 2-July 1 .
July 2-29
Apr. 1-July 1.
July 2-22
Apr. 13-July 5...
Jan. 1- June 30...
Aug. 1-14
July 1-13
July 11-Aug. 7..
June 3-30
Aug. r>-Sopt. 22.
June lH-24
Jan. 1-Junc30...
July 1-23
July 1-Sept. 15..
Aug. 13-18
Mav 13-June9..
July i>-Sept. 1...
May 13-June 30.
July S- 2,^
Mar. 1-May3l.,
May l-June2S..
Aug. 15-28
Fob. lH-.Tune23.
July2-s
Mar. 11- June 2..
Mar. l.V-24
I June 9-30.
I July 11-17.
I
May 1-Juno 19..
Apr. 1-Way :n..
May l-Juno:ji>..
Juric;i-2.i
Julv l-Sopt. 15.
Mar. 18-:u:ieZ'J.
Juno 21 :V)
. Apr. 22 is
May 2«)-June 23.
' Juno 2-8
65
1
177
1
1
38
18
88
23
30
162 I
128 I
56
4
543
14
4
23
16
3
Remarks.
Feb. 1-June 30, 1917: Cas«, 617;
237 deaths, 535.
26 I
377 j
116
1
1
Apr. 13-July 5, 1917: Cases, m.
deaths, 44. July 6-Aug. 2,
1917: Cases, 6«: deaths, 14.
Jan. 1-Aug. 14, 1916: 118 deaths.
\'arioloid«
Do.
Jan. l-Mar. 31, 1917: Cases, 9.
Digitized by
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1829
October 26, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FBVBR, AND YELLOW
FEVratr-Oonttnued.
fnm Jme M to Oct 1^ 1917— Oontinaed.
8MALLPOX--0(mtiiiiied.
Pbwe.
Date.
Casn.
Deaths.
Reniarks.
Turkey in Asia:
Treblwnd
Feb. 25-Apr. 13...
15
Union of South Africa:
Mar.l^ai^
July 1^1
4
t
a
Do.
UroHiay:
Montevideo
Mayl-41
Venexue)a:
Maradabo
June 18-^J1llT 8
8
1
Do
Jolyg-23:
TYPHUS PBTUL
Algeria:
Algiers..
Do
Jnnel-«)
Julyl-Ang.31....
Aojs. ia-18
6
1
8
1
1
Argentina:
Buenos Aires
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 1916: Cases, 1,871.
Bohemia --r . ^-^r^,-
Oct. »-D«. n....
do
809
47
ftl7
16
M3
5
Oahda
Lower Austria
. ...do
do
Moravia
Silesia
do
Styria
do
Upper Austria
Hnngftry ,, r-,rT
... .do
Feb. li^Mar. 25, 1917: Cases, l,38t
nudftpeat
Feb.l9-Mar.2S...
July 2»- Aug. U...
Xme25-Julyl....
July9-Sept.9
June ^15
83
2
8
U
1
BrazD:
Rio de Janeiro r
China:
Antung
Do
Hankow
1
Do
July *-14
1
Tientsin
June 17-23
May30-July7
Aug. 6-11
1
4
1,648
306
96
Tshigtao
478
109
40
1
83
19
Alexandria
Aug. 30- July 1....
July 17-Sept. 2. ..
Jen.22-Mar. 18....
Jone 17-23
Do
Cairo
Great Britahi:
Cork
Oieeoe:
Saloniki
May 23-June 30 . . .
Do
July i-Aug. 4
Japan:
^TftkrwI^^iA -
July 22-28.,.
Jane 11-24....
1
4
29
NA^MftVI .
"Do
Java:
East Java
July9-Sept. 16....
2
May 6- July 1, 1917: Cases, 6. July
9-29, 1917: Cases, 6.
SurAbava
June 25- July 29....
4
Mid-Java
Apr. 1-June 24. 1917: Cases, 38:
8aTH aranE
May 5- June 10....
July 2-8
14
5
2
deaths, 6. July 9-22, 1917:
Dp
Cases, 7; deaths. I.
West Java
Apr. 13-July 5, 1917: Cases, 147:
Batavia
Apr. 13- July 6
July G-Aug. 2
Julv 10-16
70
37
6
2
1
1
5
3
deaths. 6. July O-Aug. 2, 1917:
Do
Cases, 46; deaths, 2.
Mexico:
C^tepec
Aug. 1-14
Jalapa.. -.!!..!!
Apr. 1-June 30
6o :.::::
July 1-31
Mexico Citv
June 3 30
JulyK-Scpt. 22....
Jan 1 Juno 30 -
431
870
Do
Orixaba
Do
6
1
July 1-31
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October 26, 1917
1830
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received fk'oro June 30 to Oct. 19, 1917 — Continued.
TYPHUS FEVER— Continued.
Place.
Date.
Cases. Deaths.
Remarks.
Netherlands:
Rotterdam
Do
Norway:
Bergen
Portuguese East Africa:
Lourengo Marques
Russia:
Archangel
Do
Petrograd
Do
Riga
Vladivostok
Spain:
Almeria
Madrid
Switzerland:
Basel
Do :..
Zurich
Trhildad
Tunisia:
Tunis
Union of South Africa:
Capo of Good Hope State —
East London
June 9-23
Julyl5-Sept. 1.
July 8-28.... 1..
Mar. 1-31
May 1-June28..
Aug. 15-28
Fob. 18-June23.
July 2-8
May 31-June2..
Mar. 29-May21..
May 1-31.
do....
Juncl7-23
July 8-21
JiUy 26-Aug. 18.
June 4-9
June30-July6.
Sept. 10.
3
11
7
1
11
9
138
10
2
5
Jan. 1-31, 1917: 1 case.
Present.
YELLOW FEVER.
Ecuador:
Babahoyo I Feb. 1-28
Do I Mar. 1 U
Chobo I do
Guayaquil I Feb. l-'is
Do I Mar. 1-31
Do Apr. 1-30
Milagro 1 Feb. 1 2S
Do ' Mar. 1-31
Do Apr. 1-3U
Mexico: |
Campechc 8 1 at c— i
Campccho I Aug. 19 23
Yucatan Slate - I
Mcrida I Aug. 8 Sept. 20....
Peto ' Juno 23
Do July 1 So{)t .25
Venezuela: [
Coro :
1
2
17
In per?ion recently arrived from
Mexico City.
Present Sept. 5.
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PUBLIC HEALTH REPORTS
VOL. 32 NOVGM tER 2. 1917 No. 44
THE DUGNOSIS OF POLIOMYELITIS.'
By J. P. Leake, Paaed Assistant Surgeon, United States Public Health Service.
Acute poliomyelitis is a name given to a specific infectious disease
which sometimes, but not usually, results in paralysis. The ability
to diagnose the disease in the absencQ^of paralysis has only recently
come to us, although Caverly of Am^ica in 1894 and Wickman of
Sweden in 1907 described such cases; if paralysis occurs, it is usually
after the disease itself is well on its way, so that diagnosis of the non-
paralytic stages and the nonparalytic cases is doubly important for
the protection of contacts and for the institution of measures of
treatment. Though preeminently a disease of children it is by no
means rare in adults, and the less urban the community the higher
the average age of those affected.
Draper and Haynes have emphasized two stages in the progress of
the disease; first, that of general systemic symptoms, and, second,
that of invasion of the central nervous system, by way of the men-
inges. They mention the interval of apparent recover}'- or improve-
ment, which frequently occurs between these two stages, but that is
not the whole story; the disease is very commonly one of remissions
at every stage. Though we can not speak with such assurance about
the systemic stage, it is probable that here also, as is repeatedly
observed in the meningitic and in the paralytic stages, there are
remissions and regressions.
The pathologic picture which will best convey the progress of the
disease is first that of a general infection, in a sick child or an indis-
posed adult; second, a meningitic invasion, from a very mild to a
severe meningitis; and third, in some cases an extension of the
infection into the anterior horns of gray matter in the spinal cord and
to a less extent into other parts of the central nervous system, with
weakness, paralysis, and definite localized nervous symptoms. The
stages may be clinically simultaneous, though usually meningeal
signs prec^e an evident paralysis. Any two of these three stages
may be absent, or at least so slight or transient as to pass undis-
covered.
> Read before the Augasta County Medical Society at Staunton, Ya., August 17, 1917.
131 (1831)
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Systemic Symptoms.
It must be admitted that the diagnosis in the systemic stage can be
made only rarely, usually only in the presence of an epidemic. The
sjonptoms may simulate any of the indefinite illnesses of childhood,
and in the presence of an epidemic it is well for parents and physi-
cians to treat sick children having fever without a definite proven
diagnosis as possible cases of poliomyelitis. Still, there are groupings
of symptoms which are very suggestive. Fever is the most common
single symptom and may be of any grade. It is usually of short
duration, and frequently accompanied by headache, sometimes by
flushing. It is remarkable that in this acute febrile disease which
occurs predominantly in the earlier years of life and which attacks
the nervous system, convulsions should be so infrequent; though by no
means unheard of, a history of convulsions in most epidemics inclines
one against, rather than toward, the diagnosis of poliomyelitis.
The onset of this systemic stage is frequently insidious, but in
many cases very acute and often accompanied with vomiting, as in
scarlet fever. The vomiting, if it occurs, is not usually prolonged, and
by many parents is attributable to an evident indiscretion in diet,
and not to the disease. Occasionally there are pains in the stomach.
Intestinal symptoms are very frequent, constipation more so than
diarrhea. In reports of some epidemics, but none in which I have
had personal experience, cases with diarrhea exceed those with con-
stipation. This brings out ^^o ^^ct that in different epidemics, in
different localities of the same epidemic, and in different periods in
the same locality, there may bo minor differences in symptomology,
fatality, and other characteristics of the disease, just as there are
evidently differences in virulence or infectivity. Thus in the Hessian
epidemic of 1909 respiratory s^onptoms predominated, while in the
neighboring Westphalian cases of the same year, and in the Stokes
River Devonshire outbreak of 1911, diarrhea was prominent; the
Verinont epidemic of 1894 and the Austrian of 1908 included a
considerable proportion of onsets with convulsions. But the general
picture throughout the world is so nearly uniform, and so different
from any other known morbid condition, that even without our
laboratory evidence we could not help regarding poliomyelitis as a
distinct clinical entity, a specific infectious disease, just as different
from other diseases as is diphtheria or tuberculosis.
One of the common symptoms which frequently aids in diagnosis
at this stage is drowsiness; the child falls asleep repeatedly in the day-
time. The opposite symptom, that of restlessness, or irritability, is
also encountered, even in the same patient; a naturally cheerful, play-
ful child becomes cross and resents interference, objecting some-
times to being petted by its own mother. This change in disposition,
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and the stupor, are referable to the sensorium, but, even though there
may be absolute delirium or coma, these do not constitute certain
evidence of cerebral infection. Two other symptoms, which are
very frequent and which when present tend to confirm the diagnosis,
are retention of urine and sweating out of proportion to the air
temperature.
Sore throat is not uncommon, but other symptoms referable to the
upper respiratory tract are rather rare, considering the fact that
according to the most generally accepted theory the virus enters the
body by this route. The same peculiarity is observed in epidemic
cerebrospinal meningitis.
This description covers the most common symptoms of this stage.
Other symptoms, such as chills, cough, dizziness, or rashes may occur
but are not particularly suggestive of the disease. Herpes labialis is
rare, an important point in differentiation from epidemic meningitis.
It may be ai^ed that there is nothing distinctive about this clinical
picture, and that the symptoms enumerated are merely those which
may occur in any sick child, and which may pass off without a defi-
nite diagnosis being made. But the combination of fever, vomiting,
constipation, drowsiness, and irritability, especially when combined
with headache, a transient flushing of the face, abnormal sweatmg, or
retention of urine, is enough to make a tentative diagnosis of poliomye-
litis if frank cases are occurring in the vicinity.
Cases with gradual onset, malaise and indefinite symptoms, can
not be diagnosed before the appearance of meningeal or paralytic
signs, if such signs do appear; but an onset with one or more remis-
sions is very suggestive of pohomyehtis. The more careful the
inquiry into the histories, the more frequently will such onsets bo
found. The remissions are of varying length, and may be as long as
one or more weeks.
Meningeal Symptoms.
The greater part of the symptoms which I have described as sys-
temic might also be included as evidence of involvement of the central
nervous system. But the chief definite symptoms of the slight degree
of meningitis commonly met with in poliomychtis are pain on spinal
flexion, hyperesthesia, and increased reflexes. Of those, pain on
anterior flexion of the spine as described by Wickman and by Peabody,
Draper, and Dochez, is perhaps the most frequent and characteristic.
Enough meningeal involvement to cause real opisthotonos or retrac-
tion of the head, is not the rule hi pohomyehtis; but pain on forward .
nodding of the head, and espeeially pain on forward bending of the
lower spine, is very frequent and characteristic. This latter sign is
elicited by placing one of the examiner's arms mider the flexed knees,
and the other under the patient's neck. On attemptmg to lift the
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patient in this way, a voluntary stiffness and a pain in the back are
elicited. In« testing for this sign, as in examining the reflexes and
motor functions to be mentioned later, it is of great importance to
deal with the utmost gentleness. The patient is usually a child, and
unless one can obtain his good will and confidence, much of the exam*
ination is useless. It is well, therefore, to proceed first with the exam-
ination of the strength of various muscles, and the reflexes, before
attempting manipulations which may cause pain. The degree oi
meningitis may or may not be suflBicient to give a positive Kemig's
sign: Inabihty to extend the knee fully when the thigh is flexed at
right angles to the body. .One of the most persistent signs of the
disease, often remaining after all acute symptoms have subsided, is
popliteal pain, which when investigated is found to be due to hyper-
tonicity of the hamstrings. Qther signs of meningitis and consequent
increased pressure of the oerebrospinal fluid, such as MacEwen's
and DeLepinay's, also more complex signs such as Brudjinski's,
might be eUcited. Even Babinski's sign, indicating involvement of
the upper motor neurone, may rarely be present.
Definite evidence of meningeal inflammation may be obtained by
lumbar puncture and examination of the spinal fluid. It goes with-
out saying that this procedure should be foUowed if t)ie meningeal
symptoms are at aU severe,^ ip. order to reUeve the prf^ure and in
order to rule out other forms of meningitis. The increased pressure
with a clear or nearly clear fluid containing no organisms, a cell count
over 10 per cubic milhmetejf, and increased albumen and globulin,
when found, are of great diagnostic value. But imless the puncture
is made by one with some skiU in the technique, and under proper
aseptic precautions, more harm than good may be done. Flexner
and Amoss have shown that even slight hemorrhage into the sub-
arachnoid space may possibly determine an infection which would
otherwise be warded off. A thorough examination of the patient and
consideration of the history will, in the usual case, enable a diagnosis
to be made as positively without as with a lumbar puncture.
One symptom attributed in part to meningeal involvement is pam,
or rather hyperesthesia. The tenderness may be of the skin, on deep
pressure of the muscles, or on motion of the joints. It is a most
characteristic symptom of the disease, yet has frequently misled
physicians into the diagnosis of rheumatism or of neuritis. The
hypersensitivcnoss may be general, or of one part of the body only.
This is very suggestive of peripheral inflammation, and one would
hardly look to the spinal cord for an explanation unless on the watch
for pohomyelitis. But no swelling accompanies the pain of polio-
myelitis. The distribution of the tenderness, moreover, is not con--
fined to certain joints or certain nerves, but involves areas corres-
ponding rather to segments of the spinal cord.
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One other word r^arding sensory disturbance deserves to be
emphasized for the sake of diagnosis. While the microscopic his-
tology of the disease shows some involvement of the sensory tracts
along with the predominant motor disturbance, and while at the be-
ginning we have this clinical evidence of sensory irritation just as
we have of motor irritation to be described later^ in the case of the
sensory system these changes only rarely go on to a degree of degen-
eration which is easily demonstrable in life. The " root fields" of the
skin, corresponding to different segments of the spinal cord, overlap
80 much that it takes a considerable cord injury to produce loss of
sensation in any area, and if posterior horn lesions were severe in
poUomyeUtis, herpes zoster would be more frequent in this disease.
To put it more plainly, anesthesia, if prominent, inclines one against
the diagnosis of poliomyelitis. Local loss of sensation is found in
some cases of the disease, but it is a minor feature. This is of especial
help in the diagnosis of paralysis in adults; if the anesthesia approxi-
mates the motor paralysis in degree and extent, with a history dis-
similar to that above outlined, the disease may indeed be anatomi-
cally poliomyehtis, that is, an inflammation of the gray matter of
the sp'mal cord, but it is not the specific infectious disease of which
we Kre speaking.
The motor phenomena of the meningttic stage may, like the sensory
phenomena, be attributed to irritative lesions of the nerve cells rather
than simply to a meningitis. One of the most noticeable of these
phenomena is a tremor, brought out especially if the limbs are extended
unsupported, or if muscular effort is attempted. The parents may
also at times notice twitchings, but the tremor is more characteristic
of the disease. Unsteadiness in action, in gait, or in standing, may
amount to a pronounced ataxia and has abundant explanation in
the pathological anatomy of the disease.
In these examinations in the acute stage it is to be remembered that
the chief therapeutic need is rest in bed, and a sick child should not
be made to walk across the room, or put through muscular exercises
more than is necessary to establish the dia^rnosis and to ascertain
indications for local treatment. Often the examination can be more
successfully made by prolonging it over several visits, difTorcnt por-
tions of the body being examined each time. Physiologic rest in the
proper posture often enhanced by supports or removable plaster casts
to prevent the stretching of weakened or painful muscles, is indicated
for the first month or two, any other treatment being subsidiary to
this. Later, passive movements, ma3sa<];e, and especially muscle
training, are to be begun; but for both these phases of treatment
accurate anatomical diagnosis is essential, in addition to the mere
knowledge of the existence and general distribution of the disease.
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Hardly any part of the examination of the patient gives more
valuable information in poliomyelitis than an examination of the
rei'exes, combined with which are testa of voluntary movement and
tonicity of the muscles. Electricity has not proven of much value
in either diofjnosis or treatment. In the irritative stage we are likely
to find irregular increases in the reflex response, with perhaps some
spasticity, and as a rule the earUest definitive sign of degenerative
changes in the peripheral motor neurone is a diminution in one or
more of the reflexes. This is especially important in young childrwi,
for in the age group most commonly attacked by pohomyelitis, it is
difficult to secure voluntary muscular effort at command, and one
may be in doubt of anything short of an absolute flaccid paralysis,
unless the break in the nerve conduction is revealed by definite
absence of reflex. However, in young children, over one year
of age, the reflexes are fortunately more regular, and more easily
elicited, than in adults; the adults seem to have more inhibitory
paths. But even here care must be taken, by repeated trials and by
testing imder the most favorable conditions, before a reflex is put
down as absent. A unilateral increase or decrease in reflexes, present
on different examinations, is of course more significant than a sym-
metrical absence. In this disease the deep reflexes, obtained by
striking tendons, muscles, or bones, are supposedly more important
than the superficial reflexes; but much valuable information can be
obtained from the latter.
To obtain thedeep reflexes,it is worth while to provide one's self with
a proper percussion hammer. The percussion hammers sold at present
are all imsuitable for this work. The rubber is usually too hard and
the weight in some cases insufficient for older children and adults.
The hammer which I use may be improvised from stout wire and two
rubber erasers. The rubber should above all be very soft, so that
one can demonstrate its pliability to the patient, and so that a sharp
blow really gives no pain. Into a slot at one end of the twisted or
soldered wire handle is inserted the smaller eraser, a common red or
green desk eraser with beveled ends about 2i by f by J inches, for
percussing the tendons of very small infants. For larger children a
larger eraser has been foimd to be more satisfactory. This may be
purchased at draftsmen's or artists' supply shops and is about 2 J by
f by i inches and very soft. To aid the precise percussion of a tendon
one end and one side may be beveled with a sharp knife. It is con-
venient to carry this heavier eraser separate in the pocket and to
insert it in the handle of the hammer, which is then reversed for use
when needed.
Of the deep reflexes one of the most important is the patellar, or
knee jerk. This is best elicited, not as is described in some text-
boolis by supporting the leg under the knee with the examiner's arm
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1837 November 2, 191t
or the edge of the bed or chair, but by allowing the quadriceps muscU)
to relax as completely as possible, the patient being recumbent, tho
heel resting on the bed, and the knee se.niex tended at an angle of
about 135°. The knee should be hit repeatedly jitst above the tibial
tuberosity and the response of the muscle ascertained by the exam-
iner's hand on the thigh; true contractions are thus distinguished from
mere jarring. Sometimes part of the nmscle may respond more
actively than the remainder. The reflexes in both knees should be
accurately compared together. Significant differences in response,
short of total abolition, may be obtained.'
In many adults and some young children there is need to reinforce
the reflexes, as it is called, by diminishing the inhibition and tonicity.
A method usually successful is to distract attention and cause muscular
effort to be made in another part of the body; thus if the knee jerks
are being tested the patient is directed to try to pull his clasped hands
apart, while looking in another direction. >
The Achilles tendon reflex, or ankle jerk, is no less important than
the knee jerk in this disease. Other deep reflexes which may be
obtained with greater or less regularity in young children are the
biceps, eUcited by a blow on the arm 1 inch above the fold of the
elbow; the triceps, obtained by hitting the back of the arm 1 inch
above the olecranon; the scapulo-humeral, giving adduction of the
arm on striking the inner side of the scapula with the hammer; the
radial, giving supination of the forearm in response to a blow on the
styloid process; the hamstring, giving flexion of the leg on percussion
of the tendons back of the knee; the tibialis anticus, a blow on the
tendon external to the lower third of the tibia causing flexion and
supination of the ankle; and the peroneal, a blow on the tendon
above and behind the external malleolus. It may be remarked that
some of these reflexes are not always obtainable in health, but we
have the two sides of the body for comparison, and even with the
lesser reflexes a constant discrepancy between the two sides is sig-
nificant. Increase of reflexes in the irritative stage is as important
as decrease in the paralytic stage.
Of the superficial reflexes, those of the trunk are of the greatest
importance in this disease, for they may give a hint of oncoming
paralyses in muscles of the back and abdomen. These paralyses
are often overlooked, but are of serious moment on itccoimt of result-
ant disabiUty and deformity. The lumbar reflex is a contraction of
the lumbar muscles in response to stroking the skin of the back
below the twelfth rib. A splintered wooden tongue depressor is a
good instrument for eUciting the superficial reflexes, a pin point is
somewhat too sharp. The epigastric reflex is a drawing in of the
epigastrium caused by stroking from either nipple downward. The
upper, middle, and lower abdominal reflexes consist similarly in
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localized contractions of the anterior abdominal wall on local irri-
tation of the overlying skin surface. The gluteal reflex, a contrac-
tion of the gluteal muscle when the fold of the nates is stroked, is
also of eonsiderablb importance in this disease. Other useful super-
ficial reflexes are the scapular, elicited by stimulating^ the skin in-
ternal or external to the scapula; the pectoral, an adduction of the
arm when the anterior axillary fold is stroked; the cremasteric in
the male, obtained by stroking the inner thio:h; and particularly
the plantar, a flexion of the toes when the sole is stroked. usoaDy
accompanied by a drawing up of the foot, thus demonstrating^ ac-
tivity on the part of the anterior tibial, hamstring, and hip flexor
muscles.
Some of these reflexes may be found to be exaggerated in the
irritative stage, and later diminished or abolished. Diminution of
reflexes is probably a step in the direction of paralysis; it is likely,
in fact, that if the muscular strength could be tested accurately,
some weakness would be made out in those cases where there is
definite reflex disturbance. One may be in doubt as to whether a
reflex not obtained may be due to natural inhibition or to the dis-
ease, but we always have the corresponding reflex on the other side
of the body for comparison and with this considerable list some
asymmetry is likely to be made out if there is any real motor dis-
turbance.
Even in the absence of an epidemic, a chain of gen^*al or sys-
temic symptoms such as those previously described, combined with
the spine sign, local hyperesthesia, and tremor, would be sufficient
for a tentative diagnosis of pohorayehtis. An asymmetrical reflex
disturbance would make this diagnosis definite, though if the menin-
geal signs were at all pronounced, other forms of meningitis should
first be ruled out by lumbar puncture. No one of these signs or
symptoms is necessary, however, and in the presence of an epidemic
diagnoses can be made on much less. The more characteristic
some of the symptoms are, the less is required in confirmation.
Pneumonia and some other severe acute illnesses of childhood may
cause meningeal symptoms ; the physical examination of the patient
should be thorough enough to discover these diseases if present.
From post-mortem findings and from most clinical histories it may
be doubted whether the paralysis of poUomyeUtis ever occurs without
some degree of meningitis; but the physician is frequently called to
cases where history and evidence of definite meningitic symptoms
are both lacking.
Paralytic Symptoms.
As the diminution in reflex responses is, strictly speaking, a part
of the paralytic phenomena, so also is a general weakness which is
often encountered. This weakness is out of proportion to the febrile
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1839 November 2. 191T
disturbance and may keep the patient from his usual activities for
some time without even being definitely localizable to certain muscle
groups. This is one of the reasons for the confusion, which has
arisen in some quarters, of poUomyelitis with influenza. It is need-
less to say that poliomyelitis is /a perfectly definite disease, proven
by the occurrence of typical paralytic cases with characteristic
pathology, while influenza is a name imder which we hide many
illnesses whose causation we do not know. It might well be that
many of our cases called influenza are really poliomelitis, but we
can hardly say that influenza is responsible for infantile paralysis
when we do not even know whether Pfeiffer s bacillus has any rela-
tion to the former disease. We do know the cause of poliomyelitis;
that is. we know that it is a filterable virus with certain definite
properties.
In regard to the paralysis in poUomyeUtis, I desire to emphasize
four points:
1. A great proportion of the cases, probably the majority, are
not recognized as paralytic. These nonparalytic cases have, in the
past, been reported in considerable nimibers only where epidemics
have been very carefully studied. In many instances, in fact,
paralysis has been the criterion for diagnosis.
2. Even in the paralytic cases, weakness is the rule, absolute paraly-
sis occurring in less than 20 per cent of the muscle groups affected.
If in the field we could apply to the transitory cases delicate tests
such as Lovett*s spring-balance test for muscle function, and Martin's
electrical sensory test, it is Ukely that we should find shght degrees
of impairment of motion and of sensation much more common than
at present.
3. The paralysis, when it occurs, is typically flaccid. There may
be increased tonicity in the early stages, but in poliomyeUtis, perma-
nent spastic paralysis is rarer than anesthesia.
4. Though examples are on record of involvement of the nucleus
of every cervical and spinal nerve, the distribution of the paralysis
is to some extent typical. Certain muscles are much more commonly
affected than others, and at times a slight impairment of a single
muscle determines the diagnosis.
The legs are more often paralyzed than any other region, the
occiurence of toe drop testifying to the frequent involvement of the
lower leg muscles. The toe muscles themselves arc usually spared.
Weight bearing appears to have a deleterious influence on recovery,
so that in the old cases, especially, leg paralyses are greatly in excess.
Arm paralyses follow next in frequency, particularly those involving
the deltoid muscle. In regard to paralyses in other parts of the
body, statistics vary in different epidemics and with different observ-
ers, not only on account of vwiations in the degree of delicacy iu
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November 2, 1917 1840
tests for muscle function, but also because in some series the obser-
vations are made early in the acute stage and in others later, when
muscle training or other orthopedic treatment is begun; some paraly-
ses are very traasient, and clear up before the period of quarantine
is past.
The commonest head muscle to be affected is the external rectus
of the eye, giving convergent squint. This paralysi-^ of the abducens
muscle is often incomplete, and the attempt to obviate double vision
may cause enough eye strain to produce ocular congestion. Sfight
degrees of facial palsies are very frequent, more so than the records
would indicate, because recovery is usually prompt in these bulbar
cases, and because the palsies are often so slight as to be unnoticed
even by the child^s parents. The paralysis may be detected only in
certain positions of the face; one eyelid or one side of the mouth may
droop. Forced movements, such as grinning, or whistling, or raising
the eyebrows, will at timas bring out tlie asymmetry, at othqr times
mask it. Throat paralysis, causing difficult swallowing, aphonia, or
regurgitation through the nose, is a very serious symptom. Many
such cases prove fatal, but whether the fatality is usually due to
paralysis of the bulbar centers of respiration, to extension of the
paralysis to the neighboring centers of the phrenic nerve in the cer-
vical cord, or to local paralysis in the throat and pulmonary infec-
tion, is still an open question. Poliomyelitis typically affects the
ganglion cell of the lower motor neurone, and not the highen* .centers;
certainly the great majority of fatalities from poliomyelitis are due
to paralysis of the muscles of respiration directly, that is, the spinal
nuclei of the phrenic and intercostal nerves.
Slight pareses of the neck muscles may be detected in an asymmet-
rical position of the child's head when upright or in an inability to
raise the head against pressure when recumbent. In the case of the
abdominal and back muscles the skin reflexes previously mentioned
may be of assistance, or lack of strength in certain trunk movements
and postures, even local bulging of the abdominal wall.
Like the facial and abdominal paralyses, slight degrees of inter-
costal paralysis are frequently overlooked. A child's breathing is
largely abdominal; but in poliomyelitis wards, cases of entire inter-
costal inactivity in ordinary respiration are very common. Diaphrag-
matic paralysis is the most serious phase of poUomyelitis, particularly
when combined with intercostal paralysis. It is easily detected in
severe cases, the abdomen moying inward in inspiration instead of
outward. Severe intercostal paralysis on the other hand, causes a
sinking of the chest wall in inspiration. A piece of cotton may be
held near the child's mouth to get the respiratory rhythm in these
reversed cases. With such severe paralysis the prognosis is very
bad. It usually forms a part of what was formerly called Landry's
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paralysis, an ascending or descending paralysis involving other mus-
cles as well. The respiratory difficulty, as a rule, is not like that in
laryngeal diphtheria or croup; there is little stridor, or evident
muscular exertion in breathing, the patient is too weak. Lesser
d^rees of intercostal or diaphragmatic palsy may be detected by
compressing the abdomen or the chest to watch for consequent
respiratory difficulty.
In some of the fatal cases death is so sudden that the cause is not
apparent. Indefinite symptoms may have preceded for one or more
days without the paralysis being evident to either parents or physi-
cian, especially in infants and younger children. Yawning has been
frequently observed as a very serious symptom. During the preva-
lence or suspected prevalence of poliomyelitis it is wise to require
necropsies with histological examination of the spinal cord and brain
in all the acutely fatal illnesses in diildren, unless the cause of death
can be clearly established to be other than poUomfelitis. Many
histories obtainable after death are not at all suggestive of the dis-
ease, though microscopic examination demonstrates poUomyelitis
changes in the cervical cord.
In the upper extremity the deltoid is the muscle most typically
involved. Tests for the function of this muscle may be made in the
upright position by allowing the baby to reach for the percussion
hammer or some other object held above his head, first with one
hand and then with the other, or byr playing up and down with the
arms until the tonicity and muscular strength in each may be esti-
mated. 'Except the opponens poUicis, which orthopedic tests have
shown to be very commonly attacked, the muscles most often impaired
in this section are those of the shoulder and upper arm.
In the lower extremity the anterior tibial and lower leg muscles
bear the brunt of the attack, though here no part is spared. It has
long been recognized that the virus of the disease appears to have an
affinity for the lumbar enlargement of the spinal cord. Trivial
paralysis or paresis of leg muscles is to be searched for by stimulating
the action of each group; with older children the different movements
can be asked for systematically, but in infants such reflexes as the
plantar must be used. Besides testing the strength of the flexors and
extensors of the hip, knee, ankle, and toes, one should not neglect
the abductors and adductors of the hip. Comparison of the strength
of the two sides is easily made by having the patient recumbent, the
knees flexed and the heels resting on the bed; slight degrees of weak-
nessin ability to bring the knees together or to separate them against
the pressure of the examiner's hands may thus be detected. One
peculiar circumstance is that paralysis of the rectal and urinary
sphincters is unusual except in completely paralyzed, fatal cases.
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All motions of the limbs should bo made by the examiner re-
peatedly, to detect lack of tonus and of resistive efforts which may
be very definite iu the youngt st baby, and even in an unruly child.
Gait, f^oing up and down staii-s and on the level, should be observed
in ambulatory eases; also the steadiness with which the patient can
stand with eyes clos.d. The older the patient the more complete
is the examination, and the less obscured are the slight degrees of
muscular impairment. It is not to be expected that all these tests
and reflexes will be made on every patient at the first visit, but
enough should bo completed to establish the diagnosis; and the
more data one has the more certani will the conclusions be. The
patient should in any case be stripped, and given an examination
thorough enough to exclude other diseases.
It is thus seen that the diagnosis of poliomyelitis is not a simple
matter, depending on a single factor or sign, but that the whole
history and physical examination must be taken into consideration;
and, when tliat is done, there are enough idiosjiicrasies and pre-
delictions of the disease to enable a diagnosis to be made with as great
certainty as is usual in the diagnosis of other diseases, even without
what was formerly considered the essential feature of the malady,
permanent paralysis.
EXTRA CANTONMENT ZONE REGULATIONS.
ORDINANCR8 ENACTED DY TUG CITY OF LOUISVILLE. KY.. COOPERATING WfTH THE
UNfTEU STATES PUBLIC HEALTH SERVICE IN THE SANITARY CONTROL OP THE CIT1L
ZONE AROUND CAMP ZACIIABY TAYLOR.
The ordinances printed below have been recently adopted by the
city of l^)uisville, Ky.. for the purpose of protecting the health of
the residents of the city and of preventing the spread of communicable
diseases to the troops now in training at (^amp Za**hary Taylor near
the city.
Tiiese ordinances were passed in pursuance of the plan of coopera-
tion by States and municipalities wijli the Public Health Service to
pnitect tlie military and naval forces of the United States from com-
munifabh^ disease^ which may exist or gain a footing in the zones
surroundinjx the mobilization camps. They will also protect the in-
habitants of the city.
The ordinance n^<juiring prompt notification of cases of pre-
ventable ili^ca^es will be e^pcr ially valuable at this time by giving
to tl>e ollicers in charge of the zone knowledge of the existence of
fo<i of infe( tion in time to enable them to take measures to check
tlie sprcMid (»f the <li«ni^e>.
Thesi* ordinance^ do not conipri^ie a complete health code, but
supplement ordinanrc*?^ |)revion<Iy enacted.
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1843
Norember 2, 1917
CoBUBOflicalile IMnmses— Nodllcmtimi of CSsses.
Section 1. It shall be the duty of every physician in the city of Louisville to
nport to the health department, in writing, the full name, age, and address of any
penon under his professional care who is afiUcted with any one of the diseases in the
following list, with the name of the disease, within 24 hours after the time it is
diagnosed, and it shall be the duty of the ma/ia^^er or mana^^ers, superintendents or
persons in charge of every hospital, institution, or dispensary in the city of Louisville
to make a similar report to the said health department within the same period, relative
to any person afflicted with any one of the said diseases, stating in each instance the
name of the disease:
Acute anterior poliomyelitis (infantile
paralysis).
Asiatic cholera.
Diphtheria (croup).
Dysentery (amebic and bacillary).
Continued fever lasting seven days.
Epidemic cerebrospinal meningitis.
Glanders.
Suppurative conjunctivitis.
Ophthalmia neonatorum.
Hookworm disease.
Leprosy,
Malarial fever.
German measles.
Mumps.
Paratyphoid fever.
Pellagra.
PneumpxMA„ , , .
Plague.
Pulmonary tuberculosis.
Rabies in man, dog, or cattle.
Scarlet fever.
Epidemic septic sore throat.
Smallpox.
Tetanus.
Sbc. 2. If the disease reported is typhoid fever, scarlet fever, diphtheria, or epidemic
sore throat, every such report shall also show whether the patient has been, or any
member of the household in which the patient resides is, enga^^ed or employed in
handling milk, butter, cream, or other dairy products for sale or preliminary to sale.
Sec 3. Cases of typhus fever, smallpox, or cholera shall be reported immediately
to the health office by telephone or messenger and not later than 24 hours thereatter
a written report shall be made to the health officer giving, in addition to the name of
the disease, the name of the patient ac^e, residence and other necessary information.
Sec. 4. Any person or persons violating or aasistino^ in the violation of any part or
parts of this ordinance shall, upon conviction, be fined not less than $10 or more than
150, and each day's continuance of the violation shall constitute a separate offense.
Convalescent Typhoid Ferer PlatienCs — Examination of Urine and Feces.
Section 1. Every physician attend in<? a case of typhoid fever shall at least 10 days
after the patient's temperature becomes normal, submit specimens of the patient's
urine and feces to the health department for bacteriolooncal examinatiun.
Trachoma.
Trichinosis.
Tuberculosis (all forms, specifying parts
affected).
Typhoid fev«r.
Typhus fever.
Varicella.
Whooping cough. ^
Yellow fever.
Occupational diseases and injuries.
Arsenic poisoning.
Brass poisoning.
Carbon monoxide poisoning.
Lead poisoning.
Merciury poisoning.
Caisson disease (compressed air illness).
Phosphorous poisoning.
Wood alcohol poisoning.
Naphtha poisoning.
Carbon bi-sulphide poisoning.
Nitrobenzene poisoning.
Any other disease of disability con-
tracted as a result of the nature of the
person's employment.
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November 2, 1017 1844
Sec. 2. If, in any caee, typhoid bacilli are found to be present in such urine or
feces the convalescent from whom the specimens were obtained shidl not resume his
or her occi pation without the permission ol the health department.
Sec. 3. Any person violating; or assisting in the violation of any part or parts of
this ordinance, shall, upon conviction, be fined not lees than $5 or more than $50,
and each day's continuance of the violation ^hall constitute a separate oCFenee.
Mosquitoes — ^PrevenCioji of Breeding.
Section 1. It shall be unlawful to maintain any vacant lot or other premises within
the municipality of Ix)uieville on which the rubbish is allowed to accumulate, weeds
or long gra88 is allowed to grow, or any water is allowed to collect and lie stagnant, in
which mosquitoes breed, or are likely to breed, and any such premises or vacant lot
on which such rubbish, weeds, long grass, or any stagnant water is allowed to remain
is hereby declared a nuisance and dangerous to the health of the people in the city
of Ix)ui8ville.
Sec 2. The collections of water referred to in section 1 of this ordinance dial! be
held to be those contained in ditches, ponds, pools, excavations, holes. depresBions,
open cesspools, privy vaults, fountains, cisterns, tanks, shallow wells, barrels, troughs,
except horse troughs in frequent use, caves, troughs, urns, cans, boxes, bottles, tubs,
buckets, or other similar containers.
Sec 3. The method of treatment of the collections of water specified in section 2,
80 as to prevent the breeding of mosquitoes, shall be any one or more of the following:
(a) Screening with wire netting of at least 16 meshes to the inch each way or any
other material which would prevent the ingress or egress of mosquitoes; (6) complete
emptying every seven days of the unscreened containers; (c) using a larvicide
approved by and applied under the direction of the health department; (d) covering
completely every seven days the surface of the water with paraffin oil, kerosene, or
petroleum in sufficient quantities to remain covered at least 12 hours each time;
(e) cleaning and keeping sufficiently free from vegetable growth and other obstruc-
tion, and stocking with mosquito-destroying fish, absence of half-grown or larger
mosquito larvae to be evidence of compliance with this measure; (J) filling or draining
to the satisfaction of the health department; (g) the removal of tin cans, tin boxes,
broken or empty bottles, and similar articles likely to hold water, at least once in
seven days. If not removed, it must be so completely destroyed as not to be able
to hold water.
Sec. 4. The natural presence of mosquito larvae in standing or running water shall
be evidence that mosquitoes are breeding there, and failure to prevent such breeding
within 24 hours or such reasonable period as may be specified in writing by the health
department shall be deemed a violation of this ordinance and regulation.
Sec 5. Should a person or persons responsible for conditions giving rise to the
breeding of mosquitoes fail or refuse to take necessary measures to prevent the same
within 24 hours or such reasonable period as may be specified in writing by the health
department, the health department is hereby authorized to do so, and all necessary
costs incurred by the health department shall be a charge against the property owner
or other person offending as the case may be.
Sec 6. The health department shall enforce the provisions of this ordinance and
for this purpose may at all reasonable times enter in and upon any premises within
its jurisdiction and any person or persons charged with any of the duties imposed by
this ordinance failing within the time specified by the health department, to comply
with any order thereof to comply with this ordinance, shall be deemed guilty of a
violation and each day after the (expiration of this time that said person fails to
comply with this order shall be deemed a separate offense of this ordinance.
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1845 November 2. 1M7
8»c. 7. The owner of the premises, and in his absence the a^-ent or occupant, shall
be held under this ordinance to be responsible for the prevention or correction of
conditions giving rise to the breeding of mosquitoes or likely to give rise to the breed-
ing of mosquitoes:. Prof'uM, Any tenant, trespasser or other person causing said
ccmdition without the consent of the owner or a:;ent. shall be held responsible therefor.
Sbc. 8. Any person or persons violating or assisting in the violation of any part or
parts of this ordinance shall, upon convicticm, be lined not less than $5 or not more
than 120.
Fnnts and Vegetables— Protection.
SBcnoN 1. No fruits, berries, or vegetables ordinarily eaten without cooking shall
be kept, offered for sale, or given away at any place or transported within the city
of Louisville unless covered, screened, or otherwise protected from insects, contact
with animals, and handling by the public. The placing of mosquito netting or similar
matmal in direct contact with such fruits, berries, or vegetables shall not be con- .
sidered covering, screening, or protection within the meaning of this ordinance.
Sec. 2. Any person or persons violating or assisting in the violation of this ordi-
nance shall, upon conviction, be fined not les^ than $5 or more than $50, and each
day s continuance of the condition shall constitnte a separate oflense.
City Water Supply — Connections with. Required when Possible.
Sbctiom 1. Every dwelling, 1 usiness esta* lishment, or other place within the city
of Louisville in which people live or transact ' usiness, and wherever the city water
supply a uts the property^ shall have city water piped into the premises at the ex-
pense of the owner, occupant, or agent, in order that a safe supply of drinking water
may be c<nistan^y availa le.
Sec. 2. Any person or persons violating or assisting in the violation of this ordinance
shall, upon conviction, ]>e fined not less than $5 nor more than $50, and each day's
continuance ^ifiall constitute a separate offens^
Water SupfiUes — Chemical and Bacteriological Examinations — Condenuiation wh^n
Unfit for Hnman Use.
Section 1. The city chemist shall make examinations of samples of water o' tained
from pu lie or private wells, cisterns, springs, or other sources of supply,. whenever
such water is used for human consumption.
Sec. 2. Upon receipt of information from the city chemist and 1 acteriologist, after
the application of standard chemical and I acteriological tests to the samples named
in section 1 , that such samples show evidence of organic pollution or contamination
and that such pollution and contamination is detrimental to human health, the 1 oard
of pu lie works upon notice from the health department shall at once close, fill, or
otherwise prevent the further use of the water from such water sources: Provided^
That '• efore any private well or any other private source of water supply is condemned,
a hearing shall > e held in the police court.
Sec. 3. It shall 1 e unlawful for anyone to use or attempt to use the water from a
well, cistern, spring, or other water source for human consumption after said water
source has een condemned y the health department.
Sec. 4. Any person or persons violating or assisting in the violation of any part or
pwrts of this ordinance shall, upon conviction, Le fined not less than $5 and not more
than $20. ^
Common Drinking Cups and Common Towels — Prohibited in Public Places.
SscnoN 1. It shall be unlawful to expose, keep, provide, or permit any drinking
vessel to be used in common in any public, private, or parochial school, or Sunday
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NoTcmber 2, 1917 1848
the above-described nuisances, the health department shall order the owner or occu-
pant thereof to remove same at his expense within a time not to exceed 24 hoon, or
such reasonable time as may be specified in a written notice iieued by the heaitfa
department. Said notice shall be served by a police officer or sanitary inspector by
delivering a copy thereof to the owner, occupant, or agent of such property. If the
owner or agent of the property is unknown or absent, with no known reprepeD tati ve
or agent upon whom the notice can be served, then the police ofBcer or aanitary
inspector shall post a written notice upon the property or premises setdi^ forth that
unless the nuisance, source of filth, or source of sickness is removed or abated widun
24 hours, or within such reasonable time as may be specified by the health depart-
ment, at the expense of the owner or occupant, the nuisance, source of filth, or source
of sickness will be abated at the expense of the owner.
If the owner, occupant, or agent shall fail to comply with requirements of said
notice, then the health departm^it shall proceed to have the nuisance, source of filth,
or source of sickness described in the written notice removed or abated from said lot
or parcel of ground and report the cost thereof to the proper authority, ifho shall
assess the sum against the property. ^
Sec. 3. Any person or persons violating or assisting in the violation of any part or
parts of this ordinance shall, upon conviction, be fined not loss than $5 or more thmn
150, and each day's continuance of the condition shall constitute a separate offense.
Gftrbace» ReAise, and AMies — Delfaiitioii — ^Reeeptades — CoDectiMi and
Transportation.
Section 1, The term "garbage" shall include all combustible matter which is
liable to ferment, decay, putrefy, decompose, or become offensive or a menace to
heiUth, and the refuse matter from kitchens, dining rooms, and other parts of hotels,
restaurants, boarding houses, tenement houses, dwelling houses, market houses,
private hotels, and club rcK^na, and the refuse fruit and \'^etabie6 from fniit stands,
conmiission houses, groceries, or any other places of business and all the refuse aniouJ
matter, excepting any portion of particle of meat or animal unfit or not intended for
immediate market and to be subjected to a rendering process from slaughterhouses,
butcher shops, meat fih<^, poultry or fiah stores, or any plac^ where meat is sold.
Sec. 2. The tenn ''ashes" shall include cinders and ail solid products of onuplete
combustion of wood, coal, or other combustible material, provided the same has been
completely bum^ and has not been mixed with any combustible ot insanitary
material.
Sec. 3. The term ''manuze" shall include all excreta of any domestic or other
animals, live stock, or fowl, and bay, straw, or other material when mixed with excreta
of any such animal, live stock, or fowl.
Sec. 4. The term "other refuse" shall include all yard scieeninea, dirt, raga, waste
paper, and all other unsightly materials.
Sec 5. Every housekeeper, re8tai:rant, <»" hotel keeper and all other keepers of
stores and places of business are hereby required to place garbage in a separate water-
ti^t, fiy-proof receptacle, and furthermore to place all ashes and other refuse in
another receptacle, which shall be so constructed aa to prevent the contents from
spilling, flying about, or otherwise scattering.
Sec. 6. The vessels for garbage as prescribed and required by the preceding section
(5) shall be water-tight and made of metal with a close-fitting met&l cover. Such
vessels shall be provided with handles, sufficient for the safe and convenient emptying
of same.
Sec. 7. The city of Louisville shall, as soon aa practicable, reorganize ths present
garbage collection system and provide for the separate removal of garbage in a special
water-tight wagon (which vehicles shall have covers) and the diiyoial of the farhnga
in such a manner as not to endanger the public health.
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1849 November 2. 1917
Sec. 8. No person or persooB shall engage in the collection or transportation of
garbage^ manure, aahee, or other refuse as a business, without a permit from the board
of public works or otherwise in accordance with the terms of the said permit.
Sec. 9. Any person or persons violating or assisting in the violation of any part or
parts of this ordinance shall, upon conviction, be fined not less than $5 or more than $50.
Members of Police Department Made Sanitary Inspectors — ^Abatement of Nuisances.
Section 1. The police departm^^nt of the city of Louisville shall constitute an
active adjunct to the health department. The individual members of the police
department shall be and are hereby authorized to perform the duties of sanitary
inspectors.
Sec 2. Patrolmen shall abate those nuisances which have no direct bearing on
the spread of communicable diseases, such as ash piles or other accumulation of
rubbish, unsightly matters in general, weeds, chicken yards, slop water, bad odors,
and aimilftr conditions.
Sec. 3* Patrolmen shall also investigate, report upon, and abate such other nui-
sances as may be directed by tho board of safety.
' Sec. 4. Members of the police department shall be furnished with copies of ordi*
nances relating to public health in the city ot Louisville, for their information and
guidance.
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PREVALENCE OF DISEASE.
No health department, State or local, can effectively prevent or control disease xciihouJt
knowledge of when, where, and under v^uU eondUioni €a$es are occtmmff.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Week Ended Oct. 27, 1917.
The California State Board of Health reported concerning the status
of preventable diseases in California for the week ended October 27,
1917, as follows: Diphtheria increased to 73 cases in the State during
the week^ Twenty of the cases were in rural districts. One case of
anthrax in man was notified in Los Angeles CouLty. One case of
poliomyelitis occiu^red in Butte County, and one case of leprosy was
reported in Los Angeles city. Typhoid fever cases in the State
showed a reduction, 27 cases having been notified during the week.
Cases of mumps increased in number, while measles, scarlet fever,
and whooping cough remained stationary..
The details of notifiable disease cases reported during the week
ended October 20, 1917, are as follows:
Anthrax 4
Chicken pox 72
Diphtheria 49
Dysentery » 6
Erysipelas 6
German measles 9
Gonococcus infection 60
Malaria 17
Mumps 91
Pneumonia 27
Poliomyeli tis 1
Scarlet fever 64
Small pox 6
Syphilis 28
Tuberculosis 113
Typhoid fever 41
Measles 71 \ Whooping cough 55
Indiana Report for the Week Ended October 27, 1917.
The State Board of Health of Indiana reported concerning the
status of preventable diseases in liidiana for the week ended October
27, 1917, as follows: Eight cases of typhoid fever were notified at
Muncie. Diphtheria was reported as epidemic at West Point, New-
castle, and in Tipton County. Two cases of poliomyelitis were
notified at Franklin, and one case at Fort Wayne. Five cases of
scarlet fever were notified at Anderson and the disease was reported
as epidemic at Romney, and in Montgomery County. Smallpox was
reported as epidemic at Greenwood, Decatur, and Savah, and in
Posey County.
(I860)
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1851
RECIPROCAL NOTinCATION.
November 2. 191T
Minnesota.
Cases of communicable diseases re/erred during September, 1917, to other State health de-
partments by department of health of the State of Minnesota.
Disease and locality of noti-
fication.
Referred to health authority of—
Why referred.
Diphtheria:
Minneapolis Health Depart-
ment, Hennepin County.
SmallTWx:
Minneapolis Health Depart-
ment. Hennepin County.
Tuberculosis:
Mayo clinic, Rochester, Olm-
sted County.
Fokogama Sanatorium, Pine
County.
Typhoid fever:
Mayo clinic. Rochester, Olm-
sted County.
MinneapoUs Health Depart'
mont, Hennepin County.
Mayo clinic, Rochester,
Olmsted County.
Mclntyro Hospital, Virginia,
8t. Louis County.
Fort Snelling, Minn.,
nephi County.
Marble, Itasca County.
Benson Hospital,
Swift County.
Hen-
Benson,
Wadena, Wadena County
St. Lake's Hospital, St. Paul,
Ramsey County.
Commanding o£Qcer, Fort Crook, Nebr.
Commanding
Iowa.
Beer, Fort Dodge,
Oak Park, Cook County, III.; Chicago,
Cook County, HI. (2 cases): Blairs-
burfT, Hamilton County, Iowa: Iron
Mountain, Dickinson County. Mich.:
Neiraunee, Marquette Comity,
Mich.; Balllc, Hourhton County,
Mich.; Lansing, In?ham County,
Mich.; St. Joseph, Budianim
County, Mo.; La Granre, Lewis
County, Mo.; Cairo, Hall County,
Nebr.; Bethany, Lancaster County,
Nebr.; C^wad, Dawson County,
Nebr.; Hurley, Qrant County,
N. Mex • Toledo, Lucas County,
Ohio; Hominy, Osape Countv,
Okla.; Grosse, Brule County, 8.
Dak.; Yankton, Yankton County,
8. Dak.; Hoover, Butte County, S.
Dak.; Vetal, Bennett County, 8.
Dak.
Milwaukeo, Milwaukee County, Wis.;
OshVosh, Winnebago County, Wis.;
Worland, WashaVie Coimty, Wyo.:
Battle Bend, Alberta, Canada: Fort
Francis, Ontario, Canada; Birch
Hills, Saskatchewan, Canada; Tu-
gasVe, Saskatchewan, Canada.
Chicaeo, Cook Countv, 111. (2 cases);
Estnerrille, Emmet County, Iowa;
Kiideer, Dunn County, N. Dak.;
Vienna, Clark County, 8. Dak.
Bedford, Lawrence County, Ind
Indianapolis, Marion County, Ind —
Miles City, Custer County, Mont
Wolfepoint, Sheridan County, Mont..
Lincoln, Lancaster County, Nebr.
Klmberly, Wliite Pine County, Nev.
Farm near Noonan, Divide Countv,
N. Dak.
Fullerton, Dickey County, N. Dak. .
Omaha Ry. between Hudson and
Knapp, St. Croix and Dunn Coun-
ties, Wis.
Sergeant, Truck Company
129, exposed to brother
quarantined in Minneapo-
lis left for Fort Crook,
Nebr.
Drafted man exposed to
smallpox in Minneapolis
left for Fort Dodge, Iowa.
7 advanced cases, 8 moder-
ately advanced, 2 incipient,
2 no dia^^nosis given, 1 ap-
Cirently arrested— casea
ft Mayo clinic for homes.
4 moderately advanced, 1 no
dlacmosis given, 2 ad-
vanced cases— left Mayo
clinic for homes.
2 incipient, 2 open cases,
1 apparently arrested—
cases felt Pokegama Sana-
torium for homes.
Engaged as stone drafts-
man in Bedford 3 weeks
prev ious to first symptoms.
Patient sick a few days be-
fore he left home in In-
diana for Minnesota.
Engaeedas a concrete worker
in Montana 3 weeks pre-
vious to first symptom.
Worthed as a laborer at a
camp at Wolfepoint, Mont..
3 weeks previous to first
symptoms.
Infection undoubtedly oricl-
nated at patient's home in
Lincoln, Nebr.
Patient feeling ill when he
leit Nevada for Minnesota.
Enqployed on farm near
Noonan, N. Dak., 3 weeks
previous to first syinptoms.
Employed as teamster at
Fullerton, N. Dak., 3
weeks previous to first
symptoms.
Working with bridf;o crew
on Omaha Ry. between
Hudson and Knapp, Wis..
3 weeks previous to first
sjrmptoms.
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NoTember 2, 1917
1852
CEREBROSPINAL MENINGITIS.
Arkansas — Eldorado.
During the week ended October 26, 1917, 4 cases of cerebrospinal
meningitis, with 3 deaths, were notified at Eldorado, Ark.
State Reports for September, 1917.
Place.
New cases
reported.
Califoniia:
San Dic^ County-
San Diea)
San Mateo rounty
Ban Frandsoo
Total
Iowa:
Dallas County
Humboldt County . . . .
Linn County
Scott County
Shelby County
Total
Ifaine:
York County—
Biddeford
Hlnnesota:
Anoka County-
Columbia Heights.
' Hennepin < "ounty—
HinneapoUs
Plaee.
Minreeotft— Continued.
Martin County—
Manyaska Towmbip. .
Ramsey County—
St. Paul
Total.
Mlssbsippi:
Jasper County .
Pike County...
Total.
Mcmtana:
Cascade County..
New Jersey:
Hddson County.
Rhode Island:
Providence Cninty—
Providence
South Carolina:
Spartanburg County.
City Reports for Week Ended Oct. 13, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Baltimore. Md
1
1
3
2
New York, N. Y
2
Buffalo, N. Y
Norfolk, va
I
Chicago, III
Norristown, Pa. . .
1
Clevemnd, Ohio
Omfthft, Nebr
1
Columbus. Ohio
Pittsburgh, Pa. . . »
3
3
1
1
1
1
2
Dayton, Ohio
St. Louis, Mo
Detr. iJL Mich
Ran Vrnn Isco, Cal .......... .
Fort w ayne, Ind
St<»ckt"n, Cal
I
Hartford, C tnn
Troy, N. Y '..
1
Milwaukee, Wis
1
York, Pa
New Castie, Pa
DIPHTHERIA.
Illinois — Joliet and Peoria.
During the week ended October 26, 1917, 9 cases of diphtheria were
notified at Joliet and 23 cases at Peoria, 111.
Massachusetts.
During the week ended October 27^ 1917, outbreaks of diphtheria,
with numbers of cases notified, were reported in Massachusetts as«
follows: Danvers 13, Great Harrington 17, North Attleboro 31.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1867.
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1853
ERYSIPELAS.
City Reports for Week Ended Oct. 13» 1917.
November 2. 1017
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron, Ohio
BuflWo,N. Y....
Chic>ago, HI
CiOiiimaU, Ohio..
Ctovetand, Ohio..
Dayton, Ohio
Denver, Colo
Detn)it, Mich
DuhJth, Minn....
Johnstown, Pa...
Los Annies, Cal..
Memphis, Tenn..
Milwaukee, Wis...
Newark, N.J
Philadelphia. Pa. .
Pittsburgh, Pa....
Providence, B. I..
^LotJs, Mo.**.;!!
St. Paul, Minn....
San Diego, Cal
Wheeling, W. Va..
York, Pa
LEPROSY.
City Report for Week Ended Oct. 13, 1917.
During the week ended October 13, 1917, one case of leprosy was
reported in San Francisco, Cal.
MALARU.
State Reports for September, 1917.
California:
Alameda County—
Alameda
Berkeley
Bavward:
Butt« County
Chloo
Gridlcy
Calaveras County
An^bCamp
Colusa County
Colusa
Fresno County—
Clovls
Firebaugh
Reedley
Kern County
Kings County
Los Angles County —
Los Angeles
Watts
Merced County
Modoc Coimty
Placer County-
Rocklln
Sacramento County . . .
Sacramento
San Joaquin County. .
Stockton
Santa Clara County—
* ' Santa Clara
Shasta County-
Redding
- SotanoCounty
Rio Vista
Stanislaus County—
Oakdale
Tehama County
Red Bluff
TolareCounty
Tuolumne County —
California— Continued.
Ventura County—
Oxnard
Yolo County
San Francisco
Total
Loubiana:
Acadia Parish
Allen Parish
Bienville Parish
Cadd^ Parish
Calcasieu I^arish
Cone rdla Parish
DeSoto Parish
East Feliciana Parish
Evangeline Parish
Iberia Piuish
Iberville I^arish
Jefferson Parish
Jefferson Davis Parish
Lafayette Parish
La Salle Parish
Lincoln Parish
Livingston Parish
Madlsn Parish
Natchitoches I*arlsh......
Ouachita Parish
Polnto Coupee Parish ....
Rapides Parish
Red River Parish
St. Charles Parish
St. Helena I'arlsh
St. John Parish
St. Landry Parish
St. Martin Parish
St. Mary Parish t
St. Tammany Parish
TaniUpah.a Parish
Union I»arlsh ^.
156
15
5
1
9
3
4
13
13
1
3
1
3
1
4
1
40
3
15
10
2
0
2
4
1
1
10
20
20
14
2
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November 2, 1917 1854
MALARIA— Contiiiued.
Stale Reports for September, 1917— Oontiiiiied.
Place.
New cases
reported.
Plaoe.
Newc
reported.
Looisfama— Continued.
VenaWon Tarisli
Webster Parish
Winn Parish
Total
Mteisripiit:
Adams Coantr
Alcorn County
Amite County
AtUla.ro uty
Bolivar (ounty
Calhoun County
Carroll County
Chickasaw County
Choctaw County
CIail>ome County
ClarteCounly
Clay County
Coahoma County
Copiah County
Covington County
^ De Soto County
Forn«t Coimty ,
Fran'^ lin County
Coor e Coimty
Cri'ene C^Minty
( J renada County
Hancock C-ounty
Farri^m Coimty
Hinds County
Holmes County
limanuena County
1 tau amba County
Jaci son County
Jasper County
Jefferson County
JelTerson Da>isCoanty
Jones County
Kemper County
Lalayette County
LamarCounty
I^auderdale County. . . .
l^wreooe County
lee County
lenore County
MncolD County
Lo^^ odes County
Marion County
If arshaJl County
Monroe CountT
Mont|KNnery Coonty ...
Neshoba County
Newton County
Noxubee County
no
164
20e
85
1,665
319
160
203
168
145
82
80
1,801
491
367
ۥ29
347
809
60
311
110
202
279
600
733
159
71
208
281
123
6*3
179
157
232
152
lh7
417
989
1S2
112
371
2J<
213
135
193
178
194
Mississlpnt-ConttoiMd.
Panola County
Oktibbeha C^muHy . . .
Pearl River County..
Perry County
Pike County
Pontotoc County
Prentiss County
QnitmaD County
Rankin County
Boott County
Sharkey County
Simpson County
Smith County
Stone County
Sunflovrer County, . . .
Tallahatchie County.
Tate Coimty
Tippah County
Tishorolnco County. .
Timica C/oimty
Union County
Walthall County
Warren County
Washington County. .
Wavne County
Wefrster County
Wilkinson County...
Winston County
Yaloousha County . . .
Yaioo County
Total
New Jersey:
Essex County
Merrer County
Passaic County
Somerset County
Sussex County
Total
South Carolina:
Beaufort County
Charleston County . . .
Chester C^ountv
Green vUle County . . .
Laurens County
Marion County
I irhland County
Spurtanbure County .
V illlamsburg Counly
York County
TotaL
M«
in
lit
161
sit
103
3M
l&i
60
i,wa
76J
440
2U
IM
743
U7
tM
•41 '
K»
m
40
lis
m
»,43S
19
18
140
1<
Citj Reports for Week Ended Oct. 13, 1917.
Plac^
Casea.
Deaths.
!
CMML
D«atl&
*1A
1
1 New Orleans, La
1
1
Boffton Mmm. ......a..
1
' New York, f4. Y
1
Oaixeston. Tex
1
. Norfolk. Va
1
Los Aoeelee. Cal
S
n
1
' Iichmood, Va
1
1
S
MrniphU, Teon
3
1
Sarramenlb, C4lI...I..I...IIII
Mobile. Ala.
1 Stockton, Oil.
1 The reuoD that Btrmlndiam had to many cases of malaria reported la not that tha dlsMM la mor*
prevaJeatia Rirmln-'hani than mother cities of AU^iama and nei^hhoriaK States but oodoabcadlT bvoauM
of the < i^cossful eiforu the bealti* department has made in securing the cooperation of the practiciQg
physicians is reportinc cases.
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1855
November 2. 191T
MEASLES.
See Diphtheria, meftries, scarlet fever, and tuberculoeis, page 1867.
PELLAGRA.
State Reports for September, 1917.
Place.
District of Columbia
Louisiana:
Caddo Parish
DcSoto Parish
p:ast Feliciana Parish . .
K vangeline Parish
La Salle Parish
Orleans Parish
Ouachita Parish
St. Mary Parish
Total
Mississippi:
A dam?; County
Alcorn County
Amit* County
A ttflla County
Bo' var County
Calhwin C/)unty
Carroll County . ,
Chickasaw C!ounty
Claibome Con nty
Clarke County
Clay County
Coahoma i^ounty
Copidh (^ounty
Covit>eton County
Dc Soto County
Forrest County
Franklin Coo nty ,
Gcor^ County «
Greene County
Grenada County
Harri.^n County
Hinds County ^
Holmes C^Minty
L^sttquena County
Itawamba County
JacVson County
Ja wr County
Je^erson County
Je"'ersf)n Pavis County
Joncjt (^unty
Kemper County
Lafayette County
Lamar Tounty
Lauder<lale County . . . .
Lawrence County
Lee County
Leflore County
Lincoln County
Lowndes County
Marion (bounty
Marshall County
New cases
reported.
3
8
2
6
67
5
4
13
2
9
6
67
23
6
18
16
1
1
12
2
H
20
11
1
9
2
16
8
4
40
5
»
1
9
3
31
10
16
15
8
10
Place.
Miss bslppi— Continued.
Monroe County
Neshoba County
Newton County
Noxubee C<Hinty
Oktibbeha County..
Panola County
Pearl River County.
Perry County
PitcCounty
Pontotoc County
Prentiss County
Quitman County
Rankin County
Scott County '. .
Simpson County ....
Smith County ,
Stone County
Sunflower County.. .
Tallahatchie County.
Tate County ,
Tippah County ,
Tishomingo County. ,
Tunica County
Union Countv ,
Walthall County
Warren County
Washington County.
Wayne rounty
Wefwtor County
Winston County .
Yalobusha County . .
Yazoo Coimty
Total
South Carolina:
A bbeville County . . . ,
Beaufort County ....
Charleston Co«inty . .
Chester County
Greenville County. .
Lancaster County. . .
Lanrens County
Marion County
Marlboro County
Newberry County...
Oconee Cotinty
Pic I- ens County
Richland County . . .
Spartanburg County
Union County
York County
Total
Newca-ses
reported.
IS
17
4
4
6
10
4
9
18
8
3
27
6
6
11
2
2
18
12
13
4
17
23
7
6
10
11
9
2
5
9
28
821
1
1
21
3
1
1
2
3
1
1
1
I
1
14
1
2
M
City Reports for Week Ended Oct. 13, 1917.
Flaee.
Cases.
Deaths.
j
Pboe.
Casts.
Deaths.
1
Memphis, Teim
4
1
1
2
1
New Orleans. La
1
Tl{r*nin9h*m Ala
»6
New York, K. Y
1
dhari' miwi ft P
Norfolk, Va
1
KanvLsCitT Mo
I
« The roMon that Blrmlnrham had so many cases of pellagra reported Is not that the disease Is more
iMwaleDt in Birmlncham than in other diles of Alabama and nei-^hborln? States. ''Ut undoubtedly be-
eause of the successfuleflorta the health department has made in securing the cooperation of the practldag
physician' In -."'» rln" ra^e<.
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NoTember 2, 1917
1856
PLAGUE.
Hawaii — Kukaiau — ^Pla^e-Infected Rate Found.
At Kukaiau, Hawaii, one plague-infected rat each was found on
October 18, 19, and 21, 1917.
Hawaii — ^Paauhau — ^Plague-Infected Rat Found.
On October 22, 1917, a plague-infected rat was found at Paauhau,
Hawaii.
PNEUMONU.
City Reports for Weelc Ended Oct. 13, 1917. \
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Ann Arbor, Mich
1
3
I
1
112
16
2
3
1
5
3
1
2
1
1
5
1
13
1
3
13
New Bedford, Mass
1
1
3
1
46
21
1
8
I
2
2
7
1
1
3
1
9
1
1
BinErhamton N. Y
Newcastle, I^a
BosioQ Mass
Newton, Mass
BradddcV Pa
Pasadma, Cal
Cambridge, Mass
1
66
21
3
24
Philadelphia, Pa
32
Chicago"! if
Pittsburgh. Pa
32
Cievf^nd Ohio
Reading, Ptk
Dayton, Ohio
Rocht«tr. N. Y
3
Detroit Mich
Rutland, Vt
1
Eri«, Pa
Sacramento, Cal
Fall Rivrr Mass
3
San Di«»go, Cal
3
Grand Ranids Mich - .
Jackson Mich
Schenctady, N. Y
KAlama oo Mich
2
SDrinjtflld.Mass
Lancast* r Pa
Stoclrton. Cal
1
Lc^xin^ton Kv
1
1
3
3
Wilkinsburp. I'a
Iros Ang 1 s Cal
Worc.stir, Siass
3
Lowell Mass
York, Pa.'.
Newark, N. J
POLIOMYELITIS (INFANTILE PARALYSIS).
Illinois.
During the week ended October 26, 1917, cases of poliomyelitis
were notified in Illinois as follows: One case each in Dewitt, Iroquois,
Morgan, and Will (k)unties;, 3 cases in Lake County, and 30 cases in
Cook County. Twenty of the Cook County cases occurred in the
city of Chicago.
State Reports for September, 1917.
Place.
I
New cases 1 „,
reported. *^*^-
New cases
reportwl
California:
Alumeda Cotmty—
Oakland
1 Colorado:
,| Denver County—
1 ij Denver
2
Lcs Angft!es County—
Lf s AntjpJcs
1;
1 ! Iowa:
1 1 Audubon County
= =
Pc m, na
• Mendofini Ccimty-
1 Black Hawk County
Pc 1 1 er Valley
1 ' Buchanan County.' ................
Placer tV unty —
1 Cass County
Colfax
1 ' Clinton County
San Diegi ('runty—
San DicKo ,
' Crawford County
2 Dallas Coimtv
San Matcc C cunty—
! Fayette County
R(irHngume ^, ,,,..,,,
l! fliithriA r«iintv
8onomaC<unty i l \ HainiTton Hoiintv /. . y.
Total
'i Ida Coimtv
9 i' JasperCounty
--- — '1 Johnson County
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1857
NoTember 2, 1917
POLIOMYELITIS (INFANTILE PARALYSIS)— OonUnued.
State Reports for September, 1917— Contiiiued.
Iowa— Cont Inucd.
Keokxik County
Linn (Vunty ,
Lucas Ccunty ,
Mari'n County ,
Monona County
Monroe C<Hmty
O'Brlra County
Osceiila County ,
Plymouth County
S<-ott County ,
fcirux County
Tama County
"VVarren Cnunty
Wus!iin<5ton County ,
Winnebago County
Wright C-ouuty
Total
Louisiana:
I>o Soto Parish ,
Orleans Parish
Total
Michigan:
Barry County—
Ijaltimore Township
Berrien County—
So«Jus To«ii5hip
, CaJhoun County—
riattle Creek
Genesee County—
i ' rand Kapids Townshjp.
Maruuctte County—
Ncijauneo Township
Ontonagon County-
Stan wood Towo5hlp
Sanilac C^Hinty—
Port Sanilac
Washtenaw County-
Ann Arbor
Wexford County—
Antioch Township
ToUl
Minnesota:
Cottonwood Coanty—
Storden
W eslhrook
Jackson ('ounty—
Alpha ,
Lyon County—
Amiret Township
90
Minne!4ota— Cont inued.
Mahnomen (^ounty—
Le(iardc Township
Martin County—
Manyaska Township. . . .
Ramsey County—
St. Paul
St. I.001S County—
Duluth
Linden Orbve Township
Todd County—
Wykeham Township
Winona County—
Winona
Total...'.
MiMisslppi:
Yazoo County
Montana:
Cascade County
Oroat Falls
Fallon County
Total ,
New Jersey:
Burlington County
Camden County
EsHe> County
Morris County
Total
North PalroU:
l^urleigh County
Emmons County
Ramsey County
Total
Ehode Island:
Pro\idenre County-
Providence
South Carolina:
(J reenville County
South Dakota:
Fall River County
1 awTon-^ e County
Turner County
l^nion County
Yankton County
Total
atj Reports for Week Ended Oct. 13, 1917.
Place.
Cases.
Deaths.
Place.
Casas.
Deaths.
Akron, Ohio
2
56
Evansville, Ind
1
Berkeley, Cal
KanssisCitv, Mo
}
2
3
1
1
Boston. Mttss ,
Lincoln, Ncbr
Canton, Ohio
Los Angeles, Cal
Chicago. Ill '..
20
Milwaukee. \>is
1
Onrinnati, Ohin
Nev York, N. Y
Oakland. Cal
2
Cleveland, Ohio
Columbus, Ohio
PItlsbtirKh, Pa
I>a\enport, Iowa
2
Poril.uid, Ore«
Den\er, Colo
Provideuce, ^,. 1
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November 2, 1917 1858
RABIES IN ANIMALS.
City Reports for Week Ended Oct. 13, 1917.
During the week ended October 13, 1917, 3 cases of rabies in animab
were reported in Detroit, Mich., and 3 cases were reported in St
Paul, Minn.
RABIES IN MAN.
CUy Report for Week Ended Oct. 13, 1917.
During the week ended October 13, 1917, 1 fatal case of rabies in
man was reported in Ann Arbor, Mich.
SCARLET FEVER.
Illinois — Carbottdale.
During the week ended October 26, 1917, 13 cases of scarlet fever
were notified at Carbondale, 111.
Montana — ^Helena and East Helena.
On October 26, 1917, 35 cases of scarlet fever were reported preset
in Helena, and 18 cases in East Helena, Mont.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1867.
SMALLPOX.
Arkansas — ^Truman.
During the week ended October 26, 1917, 20 cases of smallpox were
notified at Tnunan, Ark.
Illinois — Caseyville and Galatia.
During the week ended October 26, 1917, outbreaks of smallpox
were reported at Caseyville and Galatia, Dl., 19 cases of the disease
having been notified at each place.
Minnesota.
During the week ended October 26, 1917, a new focus of smallpox
infection was reported in Minnesota, 2 cases of the disease having
been notified in Preble Township, Fillmore County.
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1859
November 2. 1917
SMALLPOX— Continued.
State Reports for September, 1917.
•
N«w eases
reported.
Deaths.
Vaccination history of cases.
Plao*.
Number
vaccinnted
within 7
years pre-
ceding
attack.
Number
last vacci-
nated more
thon 7 yonrs
preceding
attack.
Nomber
ne-er snc-
cessfullv
vacdnated.
Vaccination
history not
obtained or
uncertain.
Gallfornia:
A lameda Conntv.
1
1
1
1
18
1
3
1
FrPSTiA Countv •.••«••••••
I
Los An^etes rounty—
1
1
15
1
San Marino
Nfivada f ount v .........••••«•
3
0 rass Val ley
Cten Francisco
1
Total
2ft
1
22
4
Colonido:
Denver County—
Denver -•••
1
.1
1
1
2
El Faso Countv—
Colorado S})rings
1
Oarfleld Countv—
Olenwood Springs
Larimer C-ouuty
1
If drsan Countv
2
1
Total
11
2
6
3
MIchifan:
Alcona County—
Harrisville TownsMp
1
3
6
a
Alpena County—
.\lpena
Bay County—
Pinconning
Clinton ( ounty—
Watertown Township
Genesee County-
Flint
1
Forest Tovvnship
1
1
,
Richfield Township
Huron County-
Chandler Township
1
Harbor Beach
s
4
4
1
Pointe aux Barques
Township
Port Austin Township
Ingham County-
Lansing
.
Kent County—
Courtland Township
liaoomb County-
Mount Clemens
5
1
1
8
5
6
Muskegon County-
Ravenna To wiisMp
Montcalm (ounty—
Oakland County—
Waterford Township
PiesQUe Isle County—
l5ismark Township
St. Clair County—
Marine Citv . .
1
1
Banilac County—
jiridgBhamptoo Township
Deckerville
1
2
1
8
3
1
1
Delaware Township
!
1
Wheatland To wfiship
Shiawassee County—
Wayne c ounty—
1
3
Total
66
1
! 53
12
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Noyember 2, 1917
1860
SMALLPOX— Continued.
State Reports for September, 1917— Continued.
New cases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within?
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack.
Number
never suc-
oessfully
vaccinated.
VacdnatJoo
history DoC
obtained or
unoertain.
Minnesota:
Crow Wine County—
Brainerd
3
1
1
3A
3
1
1
3
4
1
2
4
2
8
1
1
1
3
29
3
Ironton < •
Douglas I ounty—
AlAxandria.. ......
Hennepin ( ounty—
MinneaDolis
7
Orono Townshio
Itasca < ounty—
Grand Kapids
Kittson I oun^— •
Norway Township
Marshall (ounty-
Stophen
Meeker County—
KlniTston Township
Morrisrn County-
Little Falls . . .
^
Mower County—
Grand Me&dow
Pleasant Valley Town-
ship .
Pine Countv-
Brook Park Township
Ramsey County—
St. Paul...
Rico County—
Faribault
Roseau County-
Roseau
•
Scott (ounty—
Glendalo Township
Total
73
7
6G|
— ■
Montana:
Cascade County-
Great Falls
1
1
1
1
1
5
15
1
35
14
1
1
Chouteau County
Custer County
1
1
1
1
5
14
1
35
4
Gallatin Countv
Bozeman
H ill Countv
Park Coiuity—
Livin;:ston
1
Ravalli County
Silver Bow County—
Butte
Sil\er Bow
io
Yellowstone County—
Billines
1
Total
70
1
«3|
12
Miscellaneous State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Iowa (Sept. 1-30):
Blackhawk County
Cerro Gordo Coimiy
1
1
7
1
1
Iowa (Sept. 1-30)— Contd.
Johnson County
2
1
1
2
3
Mills County
, , .■•
Decatur County
Monona County
Onthrle C-ounty
Muscatine County
Page County
Jasper County
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1861
MoTeniber2. 1917
SMALLPOX—CJontinued,
Misceflaiieoiis Stale Reports — Continued.
Plac©.
Gaits.
Deaths.
Place.
Cases.
Deaths.
lowmJStpt. 1-3 *)— Contd.
Pmnon^ County
Poft County
Polf^-^a(^aT»»ift County ...
1
1
1
3
IfissisiiDnpi (Sept 1-30)— Con.
1
Total
22
North Dakota (Sept. 1-30):
Burleifrfa County
,
1
1
2
3
10
6
2
6
Total
3S
Louisiana (Sept. l-»):
4
S
1
I
McKende County. ...... .
Morton County
Nuirhit/WiAS PAri«h
Nftlmo County.....
Orleans Pailfli
Rolette County
Wnrd County .'.
WilliAmA OAimtv
Total
8
1
1
3
2
Total ....
Maine (Si^-l-a)):
Aroostook County—
Hodedon ^town). . . . .
30
South Carolina (Sept. 1-30):
Aiken County
1
Linneus (town)
Letter A.
South Pakota (Sept. 1^):
Charles Mix County
PftviMin CiMintv
Piscataquis County—
TowQsbip 5, ranse 10.
1
1
2
4
8
2
Total.
7
Pay C^ounty
PfLiilk Cnuntv
ICtejiasiiipi (Sept. 1-30):
Culrioiin (^nntv
1
1
1
5
1
8
2
1
Minoehaba County
Ziebach f^ountyrr^r.. . ..r
. .
Total
Jonfis County . ......
:::::::;
13
LA&TetteCountT ..
Wyoming (Sept. 1-30):
Bhoridan < 'minty . . .
Lauoerdale C-ountv
1
Monroe County
Newton County
Pike County
Total
Simpson County
2 1
1
City Reports for Week Ended Oct. 13, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron Ohio
1
4
I-ieiv(»n worth, Kans
3
!
2
3
2
2
2
7
3
I
3
2
Alton 111
Lincdn. Vebr
Minnff'^poUs Minn
BufTalo. N. Y
4
«
1
1
6
Butte, Mont
M us -aline Iowa
ChicBJ'o, III
Oklahoma City. Okla
( leveland. Ohio
Omaha Nobr
Columbus. Ohio
Rocky Mount, N.C
St. Joseph Mo
Denver Colo
2
14
I
13
5
9
24
1
Detroit Vflch
St. lx)uls Mo
l!.vansviLle Ind
St. Paul. Minn
Fort W avne Ind
Salt Lake( ity. Utah
Indianopolis Ind
Seattle \Vasb....
Kansiisritf. Kana
Sioux Cltv, Iowa
Kmisasi'ity. Mo
Taconia, ^ash..
La Crosse wis
TETANUS.
City Beports fbr Week Ended Oct 13, 1917.
Place.
Cases.
Deaths, j
Place.
Cases.
Deaths,
Charleston S C
2*
1
1 1
1
New York, N. Y
2
Chiftatfu 111
St. lx>uls. Mo
1
1
Cincinnati Ohio
San Die-'o. C^l *...
Detroit Mich
1
1
Toledo Ohio
1
Oalveston Tex.....
Wheeling, W. Va
1
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TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1867.
TYPHOID FEVER.
9tate Reports for September, 1917.
CattlorniA:
Alameda County—
Alameda
Berkeley
Oakland
Butte County
Calaveras County
Kl IKradaOunty
Fresno County
Fowler
Fresno
Olenn County
HumbuldtC unty
Imperial County—
Brawley
Klnn County—
Uanf rd
Laven County
SuaanvllK
LotAnKPlesC unty...,
Burlank
Compt u
Ung Beach
Lt« Anwles
Pasadrna
Ban l-emando
Madera Ci-unty
Ifend^cin ) County—
WUIits
Nevada Countv
Nevada < iiy
Orange County
Placer Cxjunty
Riverside County
Cvri na
Perria
Riverside
BIythe
Sacramento County—
HacramcDto
San Bemardlnj County
Chin) I
Onlarlj I
Son Bernardino I
San Diego County I
Con nad J I
San Joaquin County I
San Luis (>ril»p,i County—
PasaUoMes
San Mateo County-
San Brunj
Santa Clara County
San Juse
Stanislaus County <
M.destj
Turlock
Sutter County |
Tehama Count y
Tulare County—
Exfter
V isolla '
San Franciaoo
Total.
r
Colorado:
Boulder County -
l>mU8>-iIlc .. .
Clear Creek County
Idaho Springs. . .
DelU County
Denver County -
Denver
173
27
Colorado— Cont biued.
£1 Faao County—
Manltou
JefTerson County
Kit Oarann County
Flagler
Stratton
Lake County
Larimer i ounty—
FortColUns
Lincoln Coimty
Montrose County
Morgan County
Otero County—
Rocky l-ord
Pueblo County-
Pueblo
WeM<oimty
Creelcy
PUttsUlle
Total
Diatrk-tofCohimbla.
Loul<^na:
Acadia Pariah.
Allen Parl^
Aacendon Pariih.
Assumption Parish
AvoyelW Pari^
Beouret'arU Parlih ,
Piaoville I'arlsh
Caddo Parl^
Calcafleu Parish
Cluiboroe Pari*
C^ourordla Parith
PeBoto Parl^ih
Eaflt Baton Kotrue Pariih.
EoNt Felt' iana PariUi
Evangeline i*ari<«h
Iberia Parish
nienilie Parish
JefTen^n !>«> i'» l^arl^fh
l.alayetlc Pari*
Lafourche Parish
T Incoln Parlnh
I Ivinj^ston ParUh
Orleaus l*ari*
Uapide« Parish '. .
Red Klvw l»orish
8t . Charln Parish
St. John Parish
St. Mary Parish
St. Martin Pari*
St. Tammany Pariah
Tangipahoa I'arUh.
Terrebonne Parish
Vff rail ion Parish
Vernon Pariah
Washington ParWi
West Baton Rou^e Parish
Total
Androecogeln County—
DiU'ham (Town)
^Vrooeitook County—
Iloulton (Town) . . . . • .
CumberbuMl County-
Portland
10
3
U
1
14
1«
U4
Digitized by
Google
1863
November 2, 1917
TYPHOID FEVER— ConUnued.
State Reports for September, 1917— Continued.
Place. .
New cases
reported.
Place.
Newo4i«^^
reported.
lCaine>-Gontixiaed.
Kennebe< CJoimty—
AuruAta
2
Mich igan— Cont Inued.
Kent (3oimty— (•^)ntinued.
Grand Hapids
•
Chma (Town)
Spar ta Township
Knox County—
Rockland
Lapeer ('ounty—
Lapeer
Penobscot Ckiunty—
East Millinocket (Town)
Leelanau County—
ivmpire Township.
Bomeraet County—
Anson (Town)
Lena\» ec County—
Adrain Township
Starlc9 (Town;
Livingston County—
(Conway Township
York County—
JUttery
Marion TownshlD.
Macomb County—
1 rie TownsniD
Total
19
Michigan:
Afcona County—
2
1
2
2
2
2
20
Manifilee County-
Brown Township
Harrisville Township
Man uetU' County-
Mar mtte
Alger Count y—
Mud sing
Monroe County—
Becfofd lownship
Allegan County—
1
iieath Township
Ida Township
Salem Township
Montcalm C^mty-
lioward City
Alpena C>ounty—
Alpena '.
Ki-hUfid lownship
Bany County—
bastings
Muskegon County-
Ik uskegon
Bcnae County-
Rlalnft Township, , , . ,
Oakkind County—
Birmingham
Thompsonville.'.
Faraiinftflfi. .. ^ ..... x ... . . .
BerrianC^Hinty—
Foutiacl
Boinbridge Township
1 ochester
Benton Township
Oceana County—
(Srant Township
Be^trandToift-nsbip
Oronoko Township
Otto Township
Branch (bounty—
Dro&son Township
Ogemaw County—
Klacking Township
Calhoun County-
Battle Cffek
Saginaw Coimty—
hnginaw
Marshall Township '..
St. CkuT County—
lr»\ To'WDship
Maishall :.
Cass County—
DowaKittC
St. Jo«nh Ccunly—
Flov f rtieM Township
Cheboygan County—
Chebovgan
klott\illc Tou'oship
Sanilac County—
Kanduskv
Chippewa Count y—
SanltStc. Marie
Wa&hteniiw County—
-Aim Harbor
Dickinson County —
Iron Moantam
Y]»siLirt} , _
Eaton County—
Delkvue
WajLC Coimty —
Bfamtmnu-k Township
Genesee County —
H^nitmntrk . .
FUnt
ilijhland Park
Oratiot County-
V ayre
Alma
Wexibrd Ck>unty—
Cadillac
Arcada Township
Ithaca
Clam Lake Township
8t.Ix)nis
hpringville To^iiship
Hillsdale C^junty—
Jefferson Township
Total
157
Hansom Township
Mimiesota:
Becker County—
Fraxee ,
Somerset Township .'.
Wood bridge Township
Tnghani Co«nty—
" Lansing Township
Beltranu C>ounty—
Bemldii
Lansing
Isabella County—
Mt. Pleasant
Bigstonc County—
OrtonrilJe
Jackson County-
Rives Township
Blue Earth County—
Mankato
Kalamaxoo County—
Kalamaxoo . . ■ , ..x... ^ .
Chicago County-
Fish Lake Township
Kalkaska County-
Orange Township
Clay C-ounty—
Ilitlerdal
Rapid River Township , , , . .
Moorhcad
Kent Count y—
Alnino TownshiD
DakoU County-
South Bt. Paul
Cnsanovia Towniihip
West St. Paul
133
Digitized by VaOC
>Qle
NoTember 2, 1917
1864
TYPHOID FEVER— Coutiuued,
State Reports for September, 1917— Continued.
Minnesota— 0)ntinued.
Dodge County—
fiayflekl
West Concord
Faribault County-
Blue Earth
Bennepln County-
Minneapolis
Isanti County-
Maple T idse TowDflhip,
Kanabec County-
Arthur Township
Koochidiing County—
International Fails
Marsiiall County-
Stephen
Warren ,.
Meolcer County—
Dassel
• Morrison County-
Little Falls
Mower County-
Austin
Murrty County—
Fulda.
Olmsted County—
Uochester
Ottcrtail County—
BlulTton Township. . . .
Pui'C Priule Township
Polk C4 . nty-
Fis'er
Ramso\ C .anty—
Bt. I'aul
Bodwood County—
I edwood Kails,
Rice County-
Northflcld
Waiootl Townsliip
St. Louis County-
Aurora
niwabik
Chisholm
Duluth
Ely
Evelfth
Vlrpiiua
8tcam> County—
St Ctoud
Stwio t^mniy-
Owatunna
Trdvcrso C-ountv—
Browns Valley
Tliitali
WalKkslu County—
MdK'ppa
Wadoiiu t'ouoty—
Wadena
Meadow Township
Wrli?hi County -
Cuiuito Township
Tctal
Ml-B^l.-ippl:
A<lai.i-(\)unty
AlfiTi' County ,...
Att.iljC>iMUif V
Hu!i\.ir(\;.a.t>
C \]*u '.'1 <' >uhty
(' irr-'*; ( u .lA'
Ch. K i <iu r ,'!i,ly
ill > t IV.' Couii. y
CI i*'.«)rnr I tuintv
Cli-U'Couiily..'
CI ■% *' "II tv
C-» ii. II .It ■•,{y
(• >: n ( -.f.' ,
Cu.*:. ; J iC. A.U.
« i
5
2«» .1
in I
A ,
21
12
2
a
ai
7 1;
MlssLHsippi— Con tinned.
De&Jto County
Forrest County
FranWIin Cotinty
Greene County
(Grenada County
Harrbon County
Hinds County
H olmes County
Issaquena County
Itawamtm County
Jackson County
Jasper County
Jefferson County
JelTen»nn I>aTis County . . .
Jones County
Komper County
Lafayottp County
l.amar County
Lauderdale County
I ee County
Leflore County
Lincoln County
Lovi-ndp* County
Marion County
Marshall County
Monroe County
Neshoba County
Newton County
Noxubee County
Oktibbeha County
Panola County
• Pearl River County
Perry County
Pike County
Pontotoc County
PrentL* County
Quitman County
Rankin County
Scott County
Simpson County
SmithCounty
Stone Count y
SunQower County
Tal lahatclUe County
Tat«» County
Tippah (>>unty
Tlvhomiiujo County
Tuni' u County
Cnion County
WiuTcn County
W •i'^lilnk'tou County
Wa VTiP County
Web-tor County
WilViuM>n County
Win*'tr>n County
Yalubusha County
Yai 00 County
Total
Montana:
H<i\orhead County
li'uine t'uunly
CarNm Couuty
Cax-ade ( 'ounty
Great Falls
Chouteau (%.unty
Cusier County
I>a\rs n Tounty
Fei(?us County
lllil(%unly
Lewis and Clark County—
llekna
MKx u la County—
MJ-rtoula
Mij>s''i\hell r(»unty
Sltrruliui County
Silver ik>w County
S
7
19
4
4
•
17
7
1
6
S
21
2
C
a
f
»
7
34
14
ao
17
3
7
5
21
3
6
17
a
21
3
2B
10
12
11
7
26
4
19
1
24
16
IS
33
2S
10
ft
6
S
2
1
1
U
5
3
M>
Digitized by
Google
1865
November 2, 1917
TYPHOID FEVER— Continued.
State Reports for September, 1917— Continued.
Place.
Montana— Continued.
let nC*unty
Yellowst' ne Ccimty—
Billings
Total
New Jersey:
Atlantic Crnnty
Bergf n Crunty
Buningtrn County
Camden County
Cape MayCcunty
Cumberland Ccunty..
Essex C<unty
0 If u -ester i\ unty . . . .
Huds n Crunty
Hunterd' n Crunty....
Men er Ccunty
Middlesex Ci.unty
M( nraouth Ccunty....
MtrrisCtunty
Ocean Ccunty.^
Pa5sai?C<unty
Sa^em Ccunty
8<'merset ( < unty
Sussex Ccunty
Unlun Ccunty
Tctal
North Dalrota:
Uurlcigh County
Cajs County
Golden Vufley County,
LamotU'e County
McUonrv Coimty
Morton County
Nelson Couuiy
Pierce County
BenviUe County
Rolette County
StuUuuan County
Total
New cases
reported.
45
255
34
Place.
Rhode Ishnd:
ProA-idence Coimty—
North Proxidenoo (town) .
Pttwtuckct
Pro\idenoe
Washington County-
South Kingston (town) . . .
Total..
South Carolina:
A bbedlle County....
Ailren County
Charleston County . . .
Chester County
Chesterfield County..
Florence County
Green\ille County....
Greenwood County...
I aureus County
NcA lierry County
Pickens County
Richland County
Spartanbuf); County .
Suiutcr C-ounty
Lnion County
York Couuiy
Total..
South Pa](ota:
l>ay County...
FiiilV County.
j 'lYipji County.
TotaL...
WyorainiT
* (VunpbeJ I County
( ; i-btn (>Mmty
Fieuimil Coimty
}i*A Springs C-ounly..
JoioLsuii County
r'irita County
"NViiilUkkuj County
New cases
reported.
2
3
19
3
24
2
1
11
4
1
10
27
2
ft
8
5
2
10
7
2
1
105
Total..
City Reports for Week Ended Oct. 13. 1917.
Place.
Akron, Ohio
Albany. N.y
Alton, 111
Altoona. Pa
Ann Aroor, Mich. .
Baiamore,Md
Birmingham, Ala..
Boston, Mass
Buffalo, N.Y
Cairo,lil
Charleston, S.C...
Chicago, 111
Cindzmati.Ohlo...
Cleveland, Ohio...
Ooffeyville, Kans..
Columbus, Ohio...,
Covincton, Ky
Cumberland. Md...
Davenport, Iowa. . ,
Dayton, Ohio
Denver, Colo ,
Deaths.
I'lacc.
Detroit, Midi
DuliUh. Mirm
KiiFt ( likni-'o, JrA
El in, 111
Krie, I'a
I KraTj-Aill*. Ind ,
j Kvcrtit , Mar^s ,
, Kvcrt It, V.asli ,
' J bll t.ivfi, Mass
j (InkrauuT. Ill
(lahoMo*!. Tox
i Crancl Kuf i f, Mich.,
llartf< r(l,Cc)in ,
Indipuii'cli:; Ind
itTscy i ily, N. J ,
Kulaiiiazoo, Mich
Kan -{i,> Cir\ . Kiius. , .
Kaii.ias( ity. Mo ,
Koni.^ha, V\ i; ,
Kokoma, In.l
I/anciiler, l*a
Cases, i Deaths.
Digitized by
Google
2.1917
1866
TYPHOID FEVER— Gontimted.
City Bei^orts for Wwk Ended Oct 13, 1917— Continued.
Place.
Cases.
Deaths.
Place.
DaaihsL
Leavenworth, Kans. .
Lexlnnon, Ky
Lincoln, Nebr
Loni; Branch, N.J..,
Loa AnsroJes. Cal
Lynch bure,Va.
Lynn, Mass
Memphis, Tenn.
MilwaukM, Wii
Minneapolis^ liUm...
Mobile. Ala
Nashville, Tenn
Newark, N.J
New Bedford, Mass..
Newcastle, Pa. ,
New Haven, C<mn...
New Orleans, La....
New York. N.Y
Norfollc, Va ,
Omaha, Nebr
Orank'P, N. J
Perth Ambov, N. J..
Phila.lelphia.Pa
Pilt>hurfh, Pa ,
Pontiac, Mich
Portland, Me
Portland, Orec ,
Portsmouth, Va.....
Qtiincv, Mass ,
Rea-hiur, Pa. ,
Richmond, Va ,
Roanoke, va ,
13
Rock T!<Iand, 111
Sacramento. Cal
Saginaw, Mich
St. Joseph. Mo
St. L<mi9,Mo
St. Paul, Minn
Salt Lake City, Utah...
Sab Francisco, Cal
San Jose, Cal
Saratoea Sprino, N. Y.
Savannah, Ga
Seattle, Wash
Somervillt. Mass
South Bend.Ind
8primjreld,IU.
Sprinc^i'eld. Maas
Taoomi, Wash
Terre Haute, Ind.
Toledo, Ohio
Topeka, Kans
Trenton, N.J
Trov, N. Y
Waltbam, Maas
Washin<rton, D. C
Washington, Pa
WheeUn? . W. Va.
Wichita, Kans
Wilk«i.Barre,Pa
Wilmlncton, Del
WinstoD-Salem, N . C. . .
York, Pa
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for September. 1917.
Cases reported.
Btata.
Cases reported.
state.
Dlpb.
theria.
Measles.
Scarlet
lever.
Dlph-
theria.
Measlea.
Scarlet
fever.
California
112
28
«5
58
3(>6
27
2W
317
310
16
25
aoo
27
39
40
IS
17
arvs
151
Mlv*|sMppI
100
15
400
61
60
216
4
12
3«7
7
61
22
2
13
5
2
ae
Cttl')r:ido
Moutuna
65
Di irict of Colum-
bia
I New Jersey
North I>»kota
Rhode Wand
South Carolina
South Dakota.
, W yoming
ISO
12
lowii
9
|>tiiU|tin»
23
52
97
18
3S
Maine
19
Micluran.
u
Minnottola.
Digitized by
Google
1867
November 2, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Oc* 13, 1917.
Oty.
OvorWn.OOO InhabitantK
Baltimorp, Md
Boston, Mass
niicaMto.lU
Cleveland, Ohio
Detroit, Mich
Los Angeles. Cal
New York, N.Y
PhUadclphia, Pa
Pittsburgh, Pa
St. Louis, Mo
From 300,000 to 500,000 Inhabit-
ants:
BufTalo.N.Y
Cincinnati, Ohio
JerseyCitv, N. J
MUwaukoe,Wis
Minneapolis, Miim
Newark, N.J
New Orleans, Ia
San Frandsco, Cal
Seattle, Wash
Washington, D. C
l^m 200,000 to 300.000 inhabit-
ants:
Columbus, Ohio. . . .' ,
Denver, < 'olo
Indianapolis, Ind
Kansasntv, Mo
Portland, 6r««r
Providence. R. I
Rochester. N. Y
St. faul, Minn
From 100,000 to 200.000 inhabit-
ants:
Albany, N.Y
Birmingham, Ala
Bridi^p rt, Crnn.
Cambridge. Mass
Camden, N.J
Dayt n, OhlT
Fail River, Mass
Fort Wrth, Tex
Grand Rapids, Mi^i
Hartf rd, iVinn
Lowell, Mass
Lynn, Mass
Memphis, Tenn
Nashville. Tenn
New Bediord, Mass ,
New Haven, Conn
Oakland. Cal
Omaha, Nelpr ,
Reading, Pa
Richmond, Va ,
Salt Lake City, Utah ,
Springfield, Mass ,
SVramse, N. Y ,
Tacoma, Wash ,
Toledo, Ohio ,
Trenton, N.J ,
W( r -ester, Mass
From 60,000 to 100.000 inhabit-
ants:
Akron, Ohio ,
Altoona, Pa
Atlantic City, N. J
Bayonne, N. J
Berkeley, Cai ,
Blngbamton, N. Y ,
Gutoa, Ohio
PopulaK*
linn US «f
JiflvUWlfi
(tstltnafed
rv TT B.
Bureniii),
6^0,^21
75'^, 47H
2,4Q7.722
674,073
671, 7M
503, S12
5,fi02,K41
l,70Q.5l«
579, ogo
767,309
46«,55H
410. 47«
30r345
43«,5'«
3^.454
408. K94
371,747
4^,610
348,639
363, OSO
214.878
2iV),S00
271,708
Tan. 847
251,960
25'i.4l7
247,232
101,199
181,762
121,579
112, W81
106,233
127.224
128, 3aa
104,562
128,291
110,900
113,245
102,425
148, 995
117,057
118, 158
149,685
198,604
165,470
109,381
156,687
117,399
105. »12
155,621
112,770
191,554
111,593
163,314
85,625
58.650
57,660
69,803
57,653
63,973
60,852
Total
rfPiths
from
all
231
67fi
1B2
187
"i,'2i6
452
180
174
fiO
113
75
80
89
119
IM
62
119
Diphtheria
12
71
275
41
120
4
203
37
31
83
23
23
18
21
28
21
30
11
8
114
6
13
213
20
6
12
7
31
14 I
11 I
»i
1
7 '
4
Menslc^.
18
culo-.ils.
2 1
3
6
1
2
4
3
1
2
3
4
1
2
10
7
3
I
S
23
46
4m
2f>
79
15
321
87
21
30
i:
10 I
f.
H
1
10
3 !
3
r.)
I
10
^ i
3
3 I
3
24
22
SO
11
17
11
130
58
9
15
A
13
7
7
16
15
5
12
5
11
6
10
5
.5
10
2
Digitized by
Google
Norember 2, 1M7
1868
DIPHTHERIA, MEASLBS» SCARLET FEVER, AND TUBKtCULOSIS-
Continued. ^
City Reports for Week Ended Oct 13» 1917— Continued.
Popula-
tion 83 of
July 1,1910
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
all
caoses.
Diphtheria.
Ifeosles.
Scarlet
fever.
Tuber-
culosis.
City.
CD
1
1
1
2
1
1
•a
1
1
From 50.000 to 100,000 Inhabi-
tant's—Continued.
Chariest n, S. C
60,731
57. 144
94,495
75, 105
76,078
78, IS.3
72,015
77,214
68,ry>3
99, 437
50, H-Vi
51,ir,->
78. 2,S3
58, '221
8^,012
«2,1M3
71, 744
58,411
63.8(57
55, m
55 642
53.3.3)
68, SiW
99, 519
57,078
87,l«J
68, -J 16
61,120
51,r>.->;)
77. '.;!>)
70, .22
76, 77t;
94, 2n.T
51,65^
27,732
37,3So
34, M4
32. 73J
27;u32
43, 123
40, l'>2
29,3l'J
2t.,07'l
32, 2ttl
48, SU
39, H73
2s, 743
42, l.'H
2>,2l«
39, 233
35, 4 V>
41,M>.J
29,;).>]
6C>, Mi
4S, Vfli
31,576
2ti,771
3S,(.7<)
31,»)77
41,!t97
35,:{H4
40.51.5
27,5s7
3»»,9t)4
32,9t0
30, (.99
20
14
18
a'
22
17
21
16
3
4
12
?
8
5
1
3
4
4
9
1
2
1
Duluth Mtnu. ..........•••
1
2
::::::
3
5
Erie Pa
"Fvansvillp Ind . ....
Fort Wavne Ind
1
1
TTjuTrisburi? Pa - *.«•.•
1
4
3
2
6
1
1
Johnstown Pa . • • • • •
Tr]i.nsa5; (^Itv ICans ...
2
2
9
* *' " :
Maiden Mass
7
20
20
3
I
1
1
1
1
2
2
2
Manchest«r N. H
1
1
Mobile, Ala
1
Norfoll:. Va
4
Oklahoma City, Olda
Passaic N.J
11
24
17
13
15
24
11
29
21
?0
18
io"
20
17
21
17
i5
57
6
S
10
6
9*
0
3
7
2
9*
5
2
10
2 j
13 1 2
1
..
1
1
Pawturkei R 1
2
3
1
1
1
5
Portland Me
3
....
Rockford 111
'.'.'/.. .C'V.
7
9
1
Sacrainento Cal • . ••*•..••.
13 1
2 1
1
7
St J'l^eph Mo
3
1
1
1
3
San I)ieg<», Cal
2
. 3 ;
2
4
3
1
4
5
3
Brhenoitadv N. Y
i
5
3
SoQier\'illo, Miss
1
3
2
South 1 lend, ind
3
Sprinijileld, 111
:.i '
1
SprinjijrioUl, Ohio............
2
1
3
1
Terro Haute, Ind
1
1
5
Trov, N. V
2 t i
2
3
4
3
Wi'"hita, Kans
il
1
Wiikos-Harre Pa
1
Wilmingt .n, l)e!
.... :■ i
5
1
::::::' 3
York. Va
2
1
5
1
1
From 25/X)0 to 50,000 iubabit-
ants:
Alaincda, Cal
1
1
Auburn, N Y
3,
2
Austin Tox ... . .
Brooklmo, Mass
3
6
Bullcr Pu
4
2
0
1
1
Butte, .Mont
!
Chelsoa, M :i-«
^
1
Cliicopt'o, .Ma-.^
Ciiiuborland Md
1 "
1 1
2
Danvillo 111
1 1
Davenport, Iowa
Dubuuiie, Iowa
Ea^it C'nicnti'o, Ind
2
2
3
4
1
1
2
East Orange, N. J
Elf^n, III
12
1 1
1
1
...
I
1
Fiverctt, Ma.s^
4 3
... * J ::::..
Evorolt, Wiish
::::::t::::::'::::::i::::::
1
Galveston, Tex
H
13
8
17
2
2
1
1 1 1
1
1
2
(Jreen I Jay. Wis
.. . .. j. i J
Jackson Mich
' i
s
KaLiinazoo, Mich
15; 1
31
1
Kenosha Wis
10
Kini,'.slon, N. Y
::.:::::::::
3
Knox villc, Ttsm
is"
13
10
7
12
12'
3 1
12 ! 2
it:.:::
15
2
3
l^a Cro-ise Wis
1
Ix!xini?loii, K.V.. .,
7
17
4
Lima, Obit) . .'.
4
'
1
T.mooln \obr
1
1 1
Lorain, t)hio
7
2
Lvnchburi? Va
i
1
1
Madison. Wis
^v.v.cv.v.
4
Digitized by
Google
1869
November 2. 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Oct. 13, 1917— Continued.
Popula-
tion as of
Julvl,1916
(estimated
bv U. 8.
Oensus
Bureau).
T0t4ll
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fe;cr.
Tuber-
culosis.
aty.
1
1
1
i
1
1
1
From 25,000 to 50,000 inhabit-
ants—Continued.
MedCord, Mass
25,234
2R,31S
27,327
29,603
41,133
31,927
30,108
43,715
37,353
31,401
31,404
33, WO
46,4rj0
41,185
38,629
39,051
36,798
38,136
46, ISO
43,28^1
28,926
a8,9)2
27,445
36,358
46,226
36,283
48,726
30, .570
29,«9I
43,139
43,377
29,NJ2
31,153
30, KU
22,874
15,010
13. fK32
3
3
13
11
12*
4
12
5
7
5
15
4
15
12
9
10
10
11
9
6
3
1
3
Montcliir, N. J
3
Nashua, N. U
1 1
Ncwburgh, N. Y
2
2
14
.::::. i : ::::
3
Newcastle, Pa
3
i '
Newport, Ky
3| 3
Newport, R. I
5
5
2
1
1
1
::::::::::::)::::::
Newton, Mass
..._. 1
1 '..:...
^ j 1
Niagara Falls N. Y
I
I i
NoiTistown, Pa
1 1
Ogden, Utah
7
1 i ^l <
Orange, N. J
1
Pasadena, Cal
!'"::'
Perth Amboy, N. J
2
1 j ... .1 ' 1 . _ _ :
Pittsneld, Mass
2
1
1
2
2
, 2
Portsmouth, Va
1
"
Quincy, 111
1
!
1
Quincy, Ma'js
2
1
3
h
1
R;icino, Wis
1
1
1
RoonoVe, Va
1
3
I
1
Rock Islmd. Ill
San Jose, CJ
1
, -• ! • • •
Steubenvillc, Ohio
14
7*
12
11
4
1
3
15
i2"
23
5
14
11
y
3
6
10
. 6
t
1
7
2
7
1
4
3
7
13
3'
7
5
I
,
,
Stockton, Cal
I
1
5; 3
Superior, Wii
Taunton, Ma'^s
! ■ _ . 2
2
1
Topeka, Kam
M 1 »
3
Waliham, Ma>s
'
1 '- .-
Watertown. N. Y
. _-
1
; 1
1
West Iloboken, N.J
1
2
-.
1 1 . .. - -
Whoelini;, W. Va
' i
2
1
Willlamsport, Pa
■' ' 1
Wilmiuglon, N. C
•1
1
Win;uvn-Sal(?m, N. C
Zanes\ LIlo, Ohio
2]....,.
i ••*! 1; 3
From 10,030 to 25,000 inhabit-
ants:
AlU)n, 111
1
2
1
' •
. I 1 ; 1
Ann Arbor. Mich
Bea>t*r Fails Pa
1
I
Berlin, N.H
Brjvddock, Pa
Cairo, ni
13. -.90
2I.»Vv*)
15,791
» 13,075
17,548
22. »€'J
_ ' _ .
1
i
6
1
......
4
..1
2
......
3 ! i
1
Clinton Mas>
1
Cofleyvil le, Kan.s
Concord, N. H
' i i../..'. V ...'.'.'.
Oal€sbiu-g, 111 1 24,27*.
KerwTiy, N. J : Z<.:^
Kokomo, Ind 2ii,u;ii
1 3 ! ! h\
Leavenworth, Kans ! » 19. of/^
Long Branch, N.J 1 i:., :m
Melrose, Mans ' 17, 4^.",
MorristoTJvn, N. J 1 ix ?S4
::::::i....:.;:::::: :::::::::;:::::::;: i
1 I
1 '
Nanticoke, Pa
Zi, liO
1 ' 1 1
1 "*'*'!
Newburyport, M.ws
l.'i,'^l3
2l),il>;5
» 22,019
19,926
17,521
ll.tjWi
1 '
1 j
New London, Conn
... 1 1 '
North Adams, Mass
! , . 1
3 2
Northampton, M ass^
3
7
1
'1 ; 1 '
1
Fontiac, kldi'.
Portsmouth, N. H
9 i
1 !
Roc^ Mount, N. C
12.C«;7
1
Rutland, Vt i4!KU
I
R^^ndu^ky. Ohio .
a», iy-3
t
Saratoga Springs, N,Y
Steelton, Pa.VT?.
13,821
15,548
21,(ilb
23,228
::...|::...,.
; '. i
•i- :::::;
WaVhlnrton, Pa ... ^ ^
,
I
Wi|WP!»Tmrg, Pa
6*
7
rU 15, 191
1 i ' 1
1
Wobum, Mass
15,90y
! i
0; no estimate luii/lc.
Digitized by Va005
»Po
pulation Ap
lie
FOREIGN.
CUBA.
Communicable Diseases — Hahana.
Communicable diseases have been notified at Habana as follows:
Oct. 1-10, 1917.
Remain-
ing un-
der treat-
ment
Oct. 10,
1917.
Disease.
Oct. 1-10, 1»17.
lUmain-
inrun-
Disease.
Cases.
Deaths.
Cases.
DeaUM.
dM-traat-
ment
Oct. 10,
1917.
Dlptberia
7
5
10
24
8
Paratyphoid fever....
1
Lepr(»sy
Scarlet fe\or
1
29
1
Malaria
20
17
Tvpboid fever
Varicella
0
91
Measles
1
3
GREAT BRITAIN.
Typhoid Feyer— -Birmingham— Comparatire Statement, 1901-1916.
A decrease in the prevalence of typhoid fever was noted at Bir-
mingham, England, during the period 1901-1916. In the first year
of this period the number of cases notified was 842 and in the last
year of the period the number wa,s 19. The decrease was progressire
except for the year 1907 when an increase over the prevalence during
the pre(;eding year was noted and for the year 1911, when a similar
increase occurred. In 1912 and 1913 the number of cases was the
same, namely, 102. The following table shows the status of the dis-
ease during the period under report:
Coses recorded.
1 Hiito por '
Number. 1.000 poj> 1
> ulaliun. 1
Year.
Cases recorded.
Voir.
Number.
Rate per
1,000 pop-
ulation.
1901
S42 1. 11
71S , .92
M7 .07 ^
3.-4) i .-l.s ;
2'J2 • .37
':^\ ' . •;(>
3t.') , .4:> .
Ibl ' .32
1
19<H>
179
122
148
102
102
67
31
19
a22
VM)!
1910
.15
wy\
1911
.18
19<>4
1912
.12
igo.*)
1«»13
.12
190fi
1914
.08
1907
IVH.")
.03
190S
1910
.02
(18
;70)
Digitized
DyGoC
wle
1871
Movember 2, lOlT
CBOLEMk, PLAGUE, SBfALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Received During the Week Ended Nov. 2, 1917.>
CHOLEBA.
Place.
Date.
Cases.
Deaths.
Remarks.
( alnitta
Aug. 11-18
6
20
30
Indo-t hina:
Saieon
June 11-July 1....
July2-Sept.»
32
45
Do.:::.:..::::;:.::.::.
Philippine Islands:
Pro\iDoes .•
Aug. 9-15» 1917: Cases. Wl; deaths,
Bohol
Aug. 9-15
29
14
10
12
36
18
3
7
0
19
1
Cebu.
do
Iloilo
do
I-oyt©
do
Mindaiiao
do
Negros Oriental
do
PLAGUE.
Egypt
Jan. l-8opt. 30, 1917: Cases, 728;
deaths/393.
Alexandria
Aug. 24-Sept. 11..
Aug. 29-8opt. 11..
2
8
Provinoes—
Hinieh
India '.
Aug. 11-18. 1917: Cases, 2,823;
Siain:
BnnekoV
Aug. 11-Sept. 1...
8
7
deaths, 2,030.
SMALLPOX.
Australia:
New South Wales.,
Warren ,
Brazil:
Riode Janeiro....,
Canada:
Ontario-
Windsor ,
China:
( hungking ,
Indo-' hina:
Saigon ,
Do
Russia:
Moscow ,
Peuograd ,
Aug. 17-30.
Sept. 2-16..
Oct. 14-20.
Sept. 2-8..
June 11-July 1 .
July2-Scpt.9..
July 2-15..
July 9-29.
2
106
Aug. 17-30, 1917: Cascs^ 2.
Present.
TYPHUS FEVER.
Canary Islands:
Santa Crui de Tenerille. . .
China:
Antung
Alexandria
Japan:
Nagasaki
Russia:
Moscow
Petrograd
Sept. 23-29..
Sept. 10-23.
Sept. 4-10..
Sept. 17-30.,
July 2-15..
July 8-29..
1 From medical officers o( the Public Health Service, American conauls, ud other sources.
Digitized by
Google
November 2, 1917
1872
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from June 30 to Oct 26, 1917.
CHOLERA.
TMacc.
Pate.
Cases.
Deaths.
Remarks.
India:
Bas^*^in
Bombay..,
I'o
Calcutta...
l>o....
Madras
Jo. ..
liandalay.
1 o. ..
Motilmein.
Takokku..
Pegu
Do....
Promc
iioon. .
Ramjo
indo-Chinar
rrovincea
Anara
Cam*M>dia
Cochin-Criioa.
l.ais
Tonkin
Haigon
Japan
Apr. 1-May 5.-..
June 24- 3()
JulvK-Auu. 4...
Apr. 2"J June 30.
Julv 1 28
Apr. 22 -June 30.
July l-AtJc. 21..
May «v-Jiine30..
July 2» Aug. 11.
Mu\ li-Jiint»2..
Apr. 2')-Mav5...
May 2T-Jane30.-
Julv 1 7
Julv2J-Auc. 11.
Apr. 21-June 30.
JulyK-28
8
1
7
347
14
4
SO
2
1
3
1
5
7
1
17
Tokyo ,
Java:
Kast Java
Do
Mid Java
\>est Ja\u
iiaUiNia
Do
►•ersia:
Ma«nderan Province —
Amir Kela
Bju"f(»urou<'hr
Mam/4' Kcla
Ma'?in(l«'s.sar
FWIippino Islands:
Manila
l>o
Fol). 1- Jane 30..
do
....do
Junr 1-31
tch. 1-Junc3')..
Apr. 23- May 27..
230
79
878
1
3fi
1G3
191
51
543
21
108
Kept. 12.
Apr. 2 8....
Julvu-i:>...
July ltV22..
I Apr. 13 July 5
I Julv 0 Aui;.'23
u^.23.
. :i.
. Fob.
. Jan. 15 17.
.' Jan. 17....
.1 Jan. 31....
Juno 17 23.
Au^;. 1^25.
Provinr^'M
Airusan ,
Alluv
Do
T)«»
Amlms Camarincs.
Do
Hataan
Bat uu-aa
Bond
Do
Do
Capi/.
r>o
(cbu
Do
Do
Iloilo
I.^'yte
Do
Do
Mi«,arais
Mmdanao
Du
Noj»ros Oriental
Do
lUzal
Do
I July l.'V 28
! Ma\ 20-Jum>o^J..
! July I- Auk. 4
' Aup. ll»-Sept. 1. ..
; June 3-0
' Julv 22- Aug. 4....
' Julvh^ 14
' June 17 2:i
' Mav20 June 30. ..
I Julv l-Aiip.4
A up. la ."^^pt. 8...
Juno .'i^ 30
Julj l--\u};. 4
June 1-30
July l-Anc 4
Au*r. 19 Sept. b...
Julv I Ann. 8
June 10 3»)
Jidy l-Aiu:. 4
Aup. 10-Si'pt. 8
JulvK Auf. 4
Julv20 Aug. 4
Au/. 19 tH'pt.8...
July 1 Aiu'. 4
Aut'. 19 Kept. 8...
June 21-30
Julv 1-7
12
113
53
10
20
1
1
3rvs
203
35
♦^2
04
231
61
51
14
334 !
227 I
237 }
12 I
291
276 !
48 I
1 I
l!
1
'i51
K.l
17
40
45
150
284
33
29
5
223
129
117
11
170
177
38
Feb. l>Jane 30, 1917: QskseB, 1,273;
deaths, 806.
Jan.- July, 1917: Ca«s, 331. Oo-
curring In 16 provinoes and dis-
tricts.
Sept. 12. 1917: Cases, 252. Jn 3
provinoes and district«.
Apr. 13- July 5, 1917: Cases, 71;
deaths. 31 . Julj &- Aug. 23, ItlT:
Ca>e8, 171; deaths, M.
Sept. 3-8, 1917: 1 case. Not pce-
vlouf ly reported.
May 2^ June 30, 1917: Ca?;e«, 795;
deaths, 500. July 1- Aug. 4.1917:
{AX&, 2,004; deathb, 1,371.
Aug. 19 Sept. a, 191i: Cmbs,
77U; dtatlui, 401.
Digitized by
Google
1873
Norember 2, 191T
CHOLBRA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received fh>m June 30 to Oct. 26, 1917~Continued.
CHOLERA— Continue.
Place.
Phlllppin'* Islands— Continued.
Pro V in^ s— rontioued.
Romblon
Samar
Po
Sorsoson
Po
Po
Surigao
Tayabas
Po
Po
Zamboanga
Date.
July 22-28
July 15 21
Auc. 1»-S€pt, 1.
Juno 3-30
July 1-Aug. 4..
Auz. 19 25
July 2!)-Aug. 4.
Auc 10 25
Juno 3-30
July l-Au'/.4..
Auu. 19 Sept. 1,
July 15-21
Cases. Deaths.
1
4
92
190
216
8
4
6
7
11
2
11
1
2
52
88
il4r
5
4
4
7
9
2
7
Remarks.
PLAGUE.
Arabia:
Aden
Mmy3-July 4
43 Apr. 8-May 14, 1917: Cases, 60;
deattis,51.
Brazil:
Bahia
June 10-30
12
5
4
41
1
8
1
1
33
4
Do
Jul7S-Sept. 8
July 16-Aug. 16...
Apr. 8- June 23
July 6-21
Pemambuco
Ceylon:
Colombo
Do .
China:
Amov
Apr. 29- May 6
Present and in vicinity.
Present Aug. 10.
l5o
July 1-7 ,
May 13-June30..-
JulyJ^Aug. 18....
June 2
6
20
4
6
13
3
Hongkong ^...
KwanTtuns Province—
Ta-DU district ....
I*resent.
Ecuador:
Estancia Vieia .......
Feb. 1-28
1
56
42
4
1
1
2
1
GuavaaulL -
do
29
22
uuaj«iuu..... ............
Mar. 1-Apr.30....
July l-.\ug. 31
Mar. 1-31
Apr. 1-30
Feb. 1-28
Do
Mil3<T0
Do
1
Nol>ol
Saltitre
do
Do
Mar. 1 31
1
2
Taura
Feb. 1-28
3
Egypt
Jan. 1-Aug. 2, 1917: Cases, 687;
deaths, 564.
Alexandria
June 21-27.,
6
3
4
1
1
14
1
4
1
3
Do
July31 Aug. 19...
Apr.30-Mayl9....
June 2.5
Port Said covemment
Port Said
Do
July 28-29
1
7
Provinces—
Favoura-
May Il-June2«...
June 28
Galioubeh
GirReh
May 17
3
Minieh
May 12- June 28...
July 29
4
1
3
23
38
3
2
Do
Siout
May 12
1
9
23
1
Suez government
Apr. 30- June 2....
Mayl2-Juna28...
Au^. 13-24
May3-8
Suez
Great llriiain:
Gnivecsend
From s. s. Matiana.
2 in hospital at port. From s. s.
India
Sardinia from Australian and
orienul ports.
Apr. I5-June 30, 1917: Cases,
Bassein
Apr. 1- June 30....
54
23
397
188
38
1
3d
43,922; deaths, 30,197 July 1-
Do
July 1-Aug. 11
7, 1917: Cases, 1,870; deaths.
Bombay
Apr.22 Jime30...
July 1- Aug. 11
Apr. 29 -June 2
480
231
1.322. July 15-Aug. 4, 1917?
Ca^, 10,014; deaths, 7^821.
Do
Calcutta
Do
July 15-21
Hensada
Apr. 1- June 30....
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Google
NoTcmber 2, 1917
1874
CHOLERA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from June 30 to Oct. 26, 1917— Continued.
PLAGUE— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
India— Continued.
Kftrft/.hi ,
Apr. 22-June30...
June 28-July 28. . .
Apr.22-June30...
July 1-Aug. 21
Apr. 8-Mav 12
468
11
301
721
413
8
250
509
9
7?
16
1
2
8
1(9
286
2
5
Do
Madras Presidency
Do
Ifandalay
Do
Julv 2>-Aue. II .
Moulmcin
Anr. 1-June 30. . . .
I'o.
July 1-7
My ingyan
Apr. 1-7
Pceii
Iliy 27-June2
So! ..:::...:..:..
Julv 29-Aue. 11
Rangoon
Apr. 15-June3d'..
July 1-Aug. 11
Apr. 8-14...
183
3U3
Tounpoo
Do
Julv 29-Au£. 11.
Indo-China:
Provinces
Feb. 1-June 30, 1917: Oases, 730;
deaths, 491.
Anjni
Feb. 1-June30....
do
do. ..
232
1.32
219
34
113
47
22
3
131
115
133
23
89
2i>
Cambodia
Cocbin-Chin.!
Kw np-Chow-Wan
Tonkin
May 1-June 30. . . .
Feb. 1- June 30....
Apr. 23-Junc3....
Jan. -July
Baigon
Japan:
>Uchi Ken
MJyeKen
do
Java:
East Java
Apr. a-May 20, 1917: Csata, »,
deaths, 29. July 30- A us. 6,
1917: Cases, 3; deaths, 8.
Djoc Jakarta Residency.
Kcdiri Residency
Apr.23-May«
... .do
1
1
3
18
4
6
1
1
3
18
4
6
. Surabaya Residency...
Do
Apr.23-May20....
Apr.2-May30
July 8-28
Burakurta Residency.. .
do
Peru
May 1^-31. 1917: Cases, 15.
At Mollendo.
Departments—
Arequipa
May 16-31
4
1
2
7
1
13
9
2
4
Caltoo
do
AtCallao.
Lambayequo
.... do
AtChiclayo.
LIbcrta'd.T
do
At Salaverry, Ban Fedro, and
TrujiUo.
At Lima.
Lima
do....
SSam:
BansVok
Apr.22-June30...
July 3- Aug. 11....
June ^16
12
8
1
3
Do
Btraits SetUements:
Sincft|)ore
i^o
Julyl-Aug.l8-...
Aug. 23 -.
Union of Soutb Africa:
Cape of Good Hope State—
Cradock..
Present.
Glcn^ey district
Terta district
Aug. 13
Do.
May28
1
1
1
At SummeriilU Farm. ,
Quoenstown
June 6
Orange Free State
Apr. 16-22, 1917: 1 ease. Apr. %-
22, 1917: Cases, 26: deaths, 17.
Wiiibiirg district
May 28
1
6
Msea:
fi. R. MaUa»ia
July 14-18
0
En route for port of London.
SMALLPOX.
Anstralia:
New South Wales
Apr. 27-July 28, 1917: Cases, 75.
Brewarrlna
Apr. 27- June 21...
July 25-28
6
4
13
2
50
Cessnock
CooDabarabran
May 25- July 5
Apr.27-June21...
June 22-July 17. . .
May9
Quambone
Warren district
Queensland—
Thiu^day Island Quar-
From s. 8. St. Albans from Kobe
antine station.
via Hongkong. Vessel pro-
ceeded to Townsviile, Bris-
bane, and Sydney, in qaann-
tine.
Digitized by
Google
1875
NoTember2,1917
CHOLERA, PLAGUE^ SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from Jose 30 to Oct 26, 1917— Continued.
SMALLPOX-ContiniMd.
Plaoe.
Date.
Cases.
Deaths.
Remaria.
BrazU:
p^hif^
May6-June30....
July22-Aug.4
do
4
o
l-HI
3^
1
5
3
Do
1
31
68
Rio de Janeiro - .
Do
Jnlyl-Sept.l
June 10-16
Aug. 19-Sept. 1...
Janel8-July7....
June 17-30
Canada:
Manitoba-
Winnipeg
Do
Nova Scotia—
HaJifax
Port Hawkesbury
Ontario-
Ottawa
Present in district.
July30-Aug.5
8ept.30-Oct.l3...
May ^12
1
2
1
•
Windsor
Ceyloo:
Colombo
China:
. Amqy
Apr.29-May26..
Present and In Tiotnity.
Do.
Do
July 1-Aug. 19
Antung
May21-June24...
Aug. 6-12
4
1
5
Do
Changsba
May27-June2....
Aag. 11-17
Do
7
Chungking
May&-June23
Do.
Do
July l-Sept.2
Do.
Dairen
Mayl3-June30...
July 8-28
30
6
2
7
8
1
1
4
1
Do
July 1-7, 1917: Present.
Hankow
June 24-^0
Apr.2S-Kay6....
May6-Junel6
Aug. 5-18
Harbin
On Chinese Eastern By.
Hongkong
7
Do..!^.;.:::::::::::::::
Manchuria Station
Apr.23-29
Do.
Mukden
May 27- June 2
Present.
Do
July8-8ept.8
Do.
Shanghai
May21-Julyl
July2-Sept.29...
13
32
9
Cases roreign; deaths among na-
tives.
Among Chinese.
On Chinese Eastern Ry.
Do
Tsitshar Station
Apr. 16-22
1
35
4
1
1
8
12
39
30
80
1
1
Tsingtao
May22-July7
July 30-Aug. 11. . .
May 1-^1
7
1
At another station on railway
lease.
Do
Chosen (iCorca):
rhomulpo
Ecuador-
Quayaqull
Feb. 1-28
Do
Mar. 1- Apr. .30....
JuJyl-Aug.31....
Apr.30-Julyl....
July 2-29
Do
Alexandria
0
4
1
Do
Cairo
Feb. 12-Apr.8
July 30-Aug. 6....
MaV 'V-12. .
France:
Nantes
Paris
Germany
Mar. 18-Apr. 28, 1917: Cases, 71S
Berlin
Mar. IS^ Apr. 28...
do
106
16
18
50
20
2
10
1
in cities 'and 32 StufcAs ^nd'dij^
Bremen
. ...
tricts.
Chariot tenberg
do
Hamburg
do
Leipzig
do .'"
Liibcck
do
Munich
do ;"
Stutt<(art
do
Greece:
Athens
July 25-30
23
75
22
12
8
1
48
18
5
India:
Boral^y ,
Apr. 22- June 30...
Julyl--\ug. 11....
Apr.2i»-May 20...
186
48
i>o ...::::;:;;:;:::::::
Calcutta
Karachi
Apr. 22-July 4
JulyK-14
27
1
80
3
33
7
Do
Madra"*
Apr. 22 -June. T)...
July 1-Aug.2l....
Apr. 15-June30...
July 1-28
Do
Raneoon
Do. .::;;:;:.:;;;;;;:::
Digitized by
Google
J
November 2, 1917
1876
CHOLERA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports ReceWed from June 30 to Oct 26, 1917— Continued.
SMALLPOX— Continued.
PlaoA.
Date.
Cases.
Deaths.
Remarks.
Indo-Chlna:
Provinces
Feb 1-Jnne 80 1017* C^a^ 617-
Anam
Feb. 1-Junc30
do
1,830
136
1,207
4
5
274
199
32
0
1
237
26
377
deaths. 635. ' ' '
Cambodia
Cochin-* hi na
do
Kwong-Chow-Wan
Mar. 1-Apr.30....
Apr.l-^
I.aos
1
30
63
12
3
Tonkin
Feb. l~June30....
Apr. 27-Junc 10...
May21-June24...
July 12- A u^;. 26...
Sept. ^15
Saigon
Italy:
Turin
Do
Jamaica:
Kingston
Japan
Jftn.-JoIy, 1917: Csses. 4.974.
In 37 provinces and districts.
Kobe
MaT27-JulT22....
May 2it-Jurie 3
May 16-July6
July 25-31
C5
1
177
1
1
38
18
88
23
16
Nft^»?»aW
Osaka
55
Yokkalchl
Yokohama ................ ^
Mdy27-July 1
Apr.2-Julyl
Julv3-29
I
2
Java:
East Java
Do
Mid-Java
Apr. 1-Julyl
July 2-22
7
Do
West Java
Apr. 13-Jul7 6, 1917: Q»es. 330;
deaths, 44- July 6-Aug. 2,
1917: Cases, 68; deaths, 14.
Btttavla
Apr. 13-July6....
Jan, 1- June 33
8J
6
116
1
1
Mexico:
Coatepec
Do
Aun. 1-14
Jan. l-Au^. 14, 1910: 118 dt^tht.
Jalapa
July 1-13
Maiatlan :
July 11-Auf. 7
MexicoClty
June 3 3 J
162
142
Do
Auji. ^Sept. 22...
June lH-21
Monterey
24
23
1
2
1
Orixaba
Jan. 1 June 30
Do
July 1-23
Vera Crui
Julyl-8«pi. 15....
Aug. 13-18
May 13-June9....
July i^-bept. 1
May 13-June 30. . .
July b- Aug. 18
Mar. 1-May 31
6
1
6
5
14
8
Kethorlands:
Amsterdam
Philippine Islands:
Manila
Varioloid.
Do
Do.
Portugal:
Lisbon
Do
Portuguese East Africa;
l/ouren^o Marques
3
"
Russia:
A rchangol.
May 1-Jun« 28. . . .
July2-Aug. 28....
^eb. 18-June23...
July 2-8
6
543
14
7
23
16
3
Do
Petrotrad
Do
Rim
Mar. Il-iune2....
Mar. 15-24
Jan. l-Mar. 31. 1917: Cmm.9.
Vladivostok.
7
Slam:
Bangkok
Juntfr-30
Do
July 11-17
5
11
8pain:
Madrid
May 1-Junel9
Maluca
Apr. 1-June 30 . .
. S«vill*
Muv 1 June 30
Valencia
June 3-23 ....
5
13
C
1
1
2
2
Do
July l-tx'pt. 15...,
Mar. IR^ June 23...
June 24- 30
Apr. 22-28
Straits Settlements:
Penanp
3
-
Sinpipore ,
8woden:
Malmo
Stockbolm
May 20-June23...
June 2-8
1
TunLsiu:
Tunis
Turkey in Aiia:
TreUiond
Feb. 25- Apr. 13...
15
Digitized by
Google
1877
November 2, WIT
CHOLBEA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Recelred from Jane 30 to Oct 26, 1917 — Continued.
SBtALLPOX— Continued.
PbMW.
Date.
Cases.
Deaths.
Remarics.
Union of South Africa:
TnhAnnAshiirfi'
Mw. «t-?4
4
3
2
Do
Julyl-3L
May 1-31
Uropuay:
Montevideo
Venezuela:
Maracalbo
June l^July 8
8
1
Do
July 9-23
"■
TYPHUS FEVER.
Algeria:
Algiers
Jui»l-«
6
1
3
1
1
Do
July 1-Aug.31- —
Aog. 13-18
Argentina:
Riion s Aires ...........
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 19H: Cases. 2^1.
Bohemia
Oct.22-Dec.l7
do
634
809
47
617
16
343
5
OaUda
Lower Austria
do
Mora¥l&. •
do
do
Silesia
Stjrria
d)
lTnr>«r Austria
::::.do:: :::::;: :
Feb. t9-M«r. 25, 1917: Cases, 1,381
Uudaoest ....
FBb.19-Mar.25....
July 29- Aug. 11...-
Juno25-July 1
July 9-Sept.9
June 9-15
83
2
11
Bnuil:
Rio de Janeiro
China:
Antung
.
DcT.
1
HanVOW , ^ .,.-,,,, , r r r -
Do
JuJvS-14
1
Tientsin
Juiio 17-23
May30-July7
Aug.^U
1,648
30G
188
1
Tsinstao
D^..;::::::::::::.:::
Alexandria
Auf.30-Ju!y 1
July 17~SopL2
Jon. 22- Apr. 8
Mar.19-25
478
i09
76
Do
Cairo
Port Sakl
Great Britrun:
Cork
June 17-23
1
32
19
Saicniki
May 23-Jtine 30
Do
July 1-Aug. 4
Japan:
Hakodate
July 22-28
1
4
29
Nagasaki
Jime 11-24
July9-Sept. 16....
Do
2
Java:
East Java
May 6-July 1, 1917: Cases, 61
Surabaya
June25-July29.-.
4
July 9-29, 1917: Cases, 6.
Mid-Java
Apr. 1-June 24, 1917: Cases, 38:
5^Am^r^ng
May 5-June 10....
Jtily 2-8
14
5
2
deaths, 5. July 9-Auk. 23,
1917: Cases, 13; deaths, 1.
DO..T
West Java
Apr. 13-July 5, 1917: Cases, 147:
Batavia
Apr. 13-July 5
July6-Aug. 23....
July 10-16
70
61
6
8
I
1
5
3
deaths, 6. July 6-Aug. 23, 1917:
Cases, 82; deaths, 11.
Do
Mexico:
Aguascalientes
Cootepec
Au?. 1-14 '
Jalana
Apr 1-June 30. ...'
Bo....:::.:..:::::..::.
July 1-31 ---
Mexico City
June 3-30
431
1 044
Do
July 8-Sept. 22 .
Orizaba
Jan. l-Jirne 30 ' ..'
6
1
2
Do 1 Jiilv 1-31
Netherlands:
Rotterdam ,
June 9-23
3
11
Do
July l^Sept. 1....
Digitized by
Google
November 9, 1917 1880
It was suspected that the lactose broth made as directed in "Stand-
ard Methods'' (1917) would not be reliable by reason of a probable
breaking down of the lactose into simpler sugars, when sterilized at
15 poundij pressure for 15 minutes in the presence of organic matt*€r.
Consequently it was divided to run parallel tests of this new broth
and the laetos^e broth prepared according to the method used at the
Hygenic Laboratory for several years.
The ingredients used in preparation of the broth were Liebig'a
extract of meat, Witters peptone, chemically pure lactose, and dis-
tilled water.
The broth was prepared according to the directions given in Stand-
ard Methods and the reaction made neutral to phenolphthalein. It
was then divided into two equal portions. To the portion to be made
into Standard Methods broth, 1 per cent of lactose was added and
dissolved by shaking. The bi^oth was then filled into Smith fermen-
tation tubes and st*erilized in the autoclave for 15 minutes after the
pressure reached 15 pounds. This broth was in the autoclave about
1 hour, the time being divided as follows: 25 mmutes to raise the
pressure to 15 pounds, 15 minutes at that pressure, and about 20
minutes to allow the pressure to fall sufficiently to allow opening
without blowing out or wetting the stoppers. The color of the
medium treated in this manner was brown or yellowish-brown.
The portion of the original broth that was to be made into Hygienic
Laboratory lactose broth was sterilized in bulk. To this a sufficioit
quantity of 20 per cent solution of lactose in distilled water, pre-
viously sterilized in an Arnold sterilizer for an hour and a half, was
added to make 1 per cent lactose. This was then filled into sterile
Smith fermentation tubes with reasonable precautions to prevent
contamination in the filling process and the tubes were steriUzed in
the Arnold sterilizer for 30 mmutes -on one day only. This broth was
usually a very pale yellow, nearly colorless.
Tlie technique of the test was as follows: Samples of water were
taken in a sterile bottle of 125 cubic centimeters capacity. After
shaking the sample vigorously, five tubes of each kind of lactose
broth were planted with 10 cubic centimeters, one with 1 cubic
centimeter, and one with 0.1 cubic centimeter, using the same pipette
for scedbig both kinds of tubes. The planting of one kind of broth
was never com{)leted before the other was begun, it usually beiug
the custom to plant two tubes of one kind and then two of the other
until all wore planted. The tubes were then incubated at 37*^ C.
and the formation of gas was recorded at the end of 24 hours and
again at the end of 48 hours.
From each tube showing gas formation at the end of 48 hours an
Endo plate was made, which was incubated for 24 hours at 37° C.
If the Endo plate showed typical colonies of B. coli (a red colony
Digitized by
Google
1881 November 0, lOlT
with a greenish metallic luster) thia was recorded as a positive i^est
and further work deemed mmccessary. From all plates showing
colonies that were not typical B. coli one or more colonies were
fished to an agar slant, which was incubated 24 hours. The object
of this deviation from the Standard Methods procedure was to in^Mre
sufficient growth to inoculate two fermentation tubes from one
colony, or its descendants, as it was desired to transplant every
colony fished into two kinds of lactose broth. It was found in some
preliminary tests that it was not always possible to inoculate tw o
fermentation tubes directly from a colony and to get growth in both.
In the early tests smears were made to determine whether or not
spore-bearing organisms were present, but after some experience it
was found that the appearance of the growth was sufficient to deter-
mine this point in practically every case. At least one colony of
each type present, other than spore-bearing organisms, was fished
from each plate if the plate did not show typical B, coli colonies.
From these agar slants a fermentation tube of each kind of lactose
broth was inoculated and incubated for 48 hours. The Endo plates
were reexamined at the end of 48 hours at 37° C, but in no case was
there any appearance of tN^iical B. coli colonies as a result of this
additional incubation. They were then left in the dark for 48 to
72 hours at room temperature and reexamined. A few plates
showed a colonlike colony, but the one that was studied further
proved to be not B. coli.
With the exception of the first 11 samples, further intensive
work was done to determine if any B. coli were missed. The follow-
ing procedure was carried out: From the original presumptive tubas
showing gas formation, regardless of the amount of gas, a transfer
was made directly to a second fermentation tube of lactose broth which
was then incubated for 48 hours. If B, coli was not found in the
first Endo plate or confirmation test and gas appeared in this second
presumptive tube, a third fermentation tube and an Endo plate
were inoculated from the second presumptive tube. If this Endo
plate showed typical colonies of B. coli it was called positive. If
colonies were only suspicious, confirmatory tests were tried. After
48 hours an Endo plate was made from the third presumptive tube,
if gas was present, and this plate carried through the same procedure.
Comparison of Lactose Broth Made According to the Standard Methods Pr4>cedure
and that Made by the Hygienic Laboratory Method.
In the work done on comparing the ^ ^Standard Methods, \917,"
and Hygienic Laboratory lactose broth, 32 samples of water were
examined, which may be divided into four classes: (1) raw water,
(2) filtered water, (3) chlorinated filtered water taken at filter plant,
and (4) chlorinated filtered water from taps in the city. The results
of the presumptive test arerset forth in Table 1.
Digitized by VjOOQIC
November 9, 1917
1882
Table 1.
Oas in 34 hours
Gas in 49 hours.
B. €oli pftym la—
10 cc.
]
CC.
0.1 cc.
10 oc.
Icc.
0.1
cc.
10 cc.
Ice.
OJoc
Class of sample.
•^1
B i
O
-3
i
c!
^
1
■5
9
'3.
1
1
o
•9
1
1
1
1
i
J5
1
1
1
1
1
e
9
*^
■
^
^
s
^Mla i
si
^
^
h:]
s
^
s
1-3
a
^
%
.^•
5
1
5
I
|vi
r '
it
2
5
2
1
2
1
n""i "'
2 1 1 1 5
2 ' 0 ■ 0 1
CO
5
1
»t4
2
4
z6
2
5
a
1
1
CO
2
2
6
1
CO
5
1
a
3
ad
2
1
a
1
1
a
Raw
1
17
1
0
25
...
1
7
0
G
ll
12
0
1
2,00
T,T|1'
1
I
5l6
1
2
I
M^
1
0
0
Total
3 1 4
7
7
11 12
3
«
7|_7J6
Tj2^^
Filtered
3
IS
5
0
.2^
2
^^
y, 0
0 0
,"l ' 0 o'l 5
1 ; 0 1 0 4
5
5
1 1
2
1
0
I
3 2 0
2 2 10
0
0
0 0
0
0
26
S
0
2
^
Oj 0
. 1|0,0,5
5
1 1
1
0
ft 3 , 0
0
0
0
Total
15
1 5
4 t>
3
0 1 0
3 ; 0 1 0 14
15
4 4
4
1
10 1 7 0.
»
[O 0
Chlorinated
2
6
1 0
0
1
1 0 0
1 ' 0 0
3
6
0 0
0
0
0
Oi 0
0
0
0
19
5
0
0
1
' 0 0
1 0 0
3
5
0 0
0
0
0
0 0
0
0
0
27
5
0
1
1
0 0
10 0
4
5
0 0
0
1
0
IjO
0
0
0
Total
...
16
|0
1 1
5
ojo
3 1 0 0 10
15
ojo
0
1
o;i(o
0
0
0
Tan
4
5
5
0
1
0
1
1
\l
0
0
Tfo' 0 iT
1 1 0 0 14
4
0 0
0 0
T
0
"o"
0
0 1 1 i 0
0 , 1 ; 0
IT
0
0
0
n,
0
(1
h
0
0
1
i u
0
' 1 0 Oil
h
1 0
0
0
0
0, 0
0
0
0
7
h
0
0
1
0
0
1 0 0
2
h
0 0
0
0
0
1 0
0
0
0
8
5
0
u
1
0
0
, 1 0 0
4
h
0 0
0
0
2
o' 0
0
0
0
9
n
' 0
2
1
0
0
1 0 0
2
r>
0 0
0
1
0
01 0
0 0
0
10
.•i
! "
0
1
0
0
10 0
0
ft
0 1 1
0
0
0
0
0
0
0
0
11
5
I)
0
1
0
0
'10 0
0
ft
0
0
0
0
0
0
0
0
0
0
12
5
1 0
0
1
0
0
10 0
0
ft
0
0
0
0
0
0
0
0
0
0
n
5
I 0
1 0
1
0
0
1 0 10
4
ft
0
1
0
0
0
0
0
0
0
0
M
5
1 0
0
1
' 0
0
. 1 0 1 0
4
ft
0
1
0
1
1
0
0
0
0
0
15
5
' 0
0
1
'(Mo
1 0 : 0 ' 2
4
I
0
0
0
0
0
0
0
0
0
1!.
5
0
0
1
0 1 0
1 0 1 0 1 1
2
0 1 0
0
0
0
0
0
0
0
0
20
0
0
1
o' 0
1 0 ' 0
2
4
0 i 1
0
0
0
0
0
0
0
0
21
5
1 0
0
1
o: 0
' 1 0 10
5
0 1 0
0
0
0
0
0
0
0
0
'22
5
t 0
2
1
o' 0
1 0 ' 0
ft
0 ! 0
0
0
3
ft
0
0
0
0
23
«>
1 0
. 0
1
10 0
. 1 010
ft
0 0
0
0
0
0
0
0
0
0
21
i 0
0
I
0 0
1 0 ' 0
4
0 1
0
0
0
0
0
0
0
0
2s
1 »
0
1
0 0
1 0,0
6
0 1
0
0
1
0
0
1
0
0
29
5
<»
0
1
, 0 0
1 0 ' 0
2
2
0 1
0
0
0
0
0
0
0
0
3u
T}
, 0
1
1
10,0
' I 1 0 1 0
2
4
0 1 0
0
0
0 1 0
0
1
0
0
:^i
5
, 0
0
1
0 0
1 1 0 1 0
1
ft
0 0
0
0
0 0
0
0
0
0
32
5
h
0
i
0 0
1 0 ' 0 1 3
ft
05 0
0
0
1|0
0
0
0 0
Total
no
1
5
23
,0.0
2J < 0 : 0 '4K
104
Ml 7
0
'
Vi«
0
2
0 0
1
1
L^
Tablk 2."-Suvnnary of lotah of Table 1.
G'ds in 24 hours.
Gas in 4S hours.
B. cdi proven.
1 Ice.
f
0.1 t-c.
10 00.
1 cc. 0.1 oc.
10 CO.
loo.
0.1 cc.
o ;
si ' .
►J
K
3
0
0
0
4
0
0
0
6
3
3
9a
. 1
•^ ,2
»■]»•
ill
0 0
0 0
0 0
h4
7
14
10
73
H
00 i»
ad
a
QQ
at
od
Raw
3
3
3
7
15
11
6
6
1)
7 12
0 1 3
1 3
ft 23
7
15
15
104
11
lo 1 a
6
1
1
2
7
10
0
8
7
7
1
8
0
0
0
0
4
0
0
2
2
0
0
0
1
Filtered
4 A 1 ^
0
Chlorinated
0
2
0 0
7 0
0
Tap
23 lift 1 1
0
Grand total
32 152 \V2
19 41
8
4 SA
1
1
70
141
17 '23
7
10
25 [23
6
«
8
1
1
_
.
Digitized by
Google
1883 November 9, 1917
From 228 tubes of H. L. lactose broth planted, B, coli was con-
firmed in 33.
From 228 tubes of S. M. lactose broth planted, B, coli was con-
firmed in 30.
Of these 63 confirmed B. coli, 52 were proved by Endo plates
alone. Twenty-six of these plates were seeded from tubes of H. L.
broth and the remaining 26 from tubes of S. M. broth. vSeveh tubes
of H. L. broth and four of S. M. broth required a second lactose
broth tube, because typical colonies were not found on the Endo
plate.
From these figures it will be seen that owing to tlie greater in-
cidence of gas formation in the S. M. broth 71 more tubes had to be
carried through the confirmation test than when the H. L. broth was
used. Notwithstanding the increased amount of work thus neces-
sitated, the number of B, coli confirmed by plate or further fermenta-
tion test was sHghtly less than that obtained from the tubes of H. L.
broth. This difference, however, is too slight to receive considera-
tion. In other words, the lactose broth sterilized at 15 pounds
pressure for 15 minutes required 36 (dividing a plate between two
tubes) more Endo plates and 142 more tubes of lactose broth to
find the same number of B. coli that were found when lactose broth
sterihzed at 100° C. for 30 minutes was used.
Comparison of Standard McUiods Confirmed Test with that Required by the .
Treasury Department.
In the confirmation test another departure was made from the
Standard Methods procedure, in that at least 10 per cent of gas
(Treasury Department standani) in Hygienic Laboratory lactose
broth was required in order to record it as a positive rciiult. The
Standard Methods procedure classifies an a member of the B. coli
group any aerobic nonspore-forming organism that, fished from
Endo plates seeded from the original fermoutatiou tube to a second
fermentation tube of lactose broth prepared as directed in Standard
Methods, shows gas formation in the second fermentation tube
within 48 hours. Using the broth, prepared in accordance with
Standard Methods, the writer was able to use a pure culture of B.
proteua and obtain results that would necessitate classifying it as
B. coli by following the procedure advised in Standard Methods. /
Of course the colonies of this organism were far from typical on /
Endo plates. |
The table following shows the results of the confirmation tests in |
the two kinds of lactose broth.
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NovembCT 9, 1917
1886
In the comparison of these two media a plate of each (xrang half a
plate for each tube), was seeded from every fermentation tube showing
gas. At the end of 24 hours' incubation the plates were examiaed.
An additional 24 hours* incubation did not develop any typical
colonics on plates that did not show typical colonies at the end of
24 Iiours.
One hundred twenty-nine plates of each kind of Endo medium
wore inoculated from a like number of fermentation tubes showing
gas. The comparative rc^siTlts are shown in the following table:
Table 4.
Endo medium.
Number
plaUs
made on
each
medium.
Number
ahowinc
colonies.
Nuxbber
shovrinc
atypical
fterobio
coiomes.
Number
sbowiBc
no
aM9faie
colonlK.
Uypiciiic laboratory.
129
129
27
97
120
5
Staudard aiotliods
4
From tlie tubes showing atypical colonies, confirmatory tests and
routine .study demonstrated B, coli in 9. Three were from H. L.
Endo, 3 from S. M. Endo, and 3 from both.
When t>T)ical B. coli colonies were foimd on either kind of medium,
the sample was recorded as positive and the corresponding negative,
or doubtful, plates of the other medium were not carried further.
In no instance did the Standard Methods medium show typical
B, coli colonies when the Hygienic Laboratory plate seeded from the
same tube showed atypical colonies.
During the progress of the work, it was noted that the spore-bearing
aerobes were much more rcstiaincd on the Hygienic Laboratory
Endo medium than on the Standard Methods medium.
It is assumed that if the two media were equally good for the
demonstration of B. coli an equal number of plates should show
typical colonies. But 22 plates of Standard Methods Endo medium
failed to show typical B. coli colonies while the corresponding Hy-
gienic Laboratory plates showed typical colonies. In view of the
number of B. coli subsequently demonstrated from plates showing
atypical results, it would appear that the H. L. Endo medium shows
typical colonies in 75 per cent of the tubes in which the B. coH is
present and the S. M. Endo medium in 14 per cent. Since ^. cdi
is sought as the index of contamination it would appear to be good
poUcy in the examination of water samples to use an Endo medium
designed to demonstrate B, coli rather than one modified to demon-
strate some other intestinal oiganisnu
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1887 NoTemlKiP 9. X917
Condnsion.
The results of this work indicate that if the new Standard Methods
(1917) be adhered to, in the bacteriological examination of water,
time, labor, and material will be mmecessarily expended and mis-
leading results may be obtained.
THE SIMULATION OF DISEASE*
DBUGS. CHEMICALS. AND SEPTIC MATEBULS USED THEREFOS.
By A. O. Duicss, Teehnical Assistant, Bygienio Laboratory, United BtatM Public Health Service.
This paper is not intended to be an expos6 of all of the various
methods of effecting simulation of disease, but is restricted to that
phase of the subject involving the use of drugs, chemicals, and septic
materials. This phase is of special interest at the present time, as
it comprises the means most frequently employed by unscrupulous
individuals in attempts to evade military duty. For the purpose
of enhancing the value of the paper as a source of reference to the
medical examiner, the substances enumerated therein are grouped
under the diseases the diagnostic signs of which their use is intended
to simulate. For the same reason, brief outUnes of the methods
recommended for the detection of these frauds are also included,
where specific information of this kind has been available.
Substances used in the SimulatiMi of Dtoeases of the Skin and Subentanoouo Tiosoo.
Ebythema:^ Certain nettles, poison ivy, squills, and some plants
of the families Euphorhidces^ and Ranunculacese, These are applied
to the skin with friction.
Eczema: After abrading the skin, by scraping with a sharp-edged
instrument or rubbing with some rough material, one, or more, of
the following is applied: Croton oil, sulphur, acid substances, oil of
cade, ointment of mercury, or mezereum bark.
Detection: According to Blum (1916), the eruptions produced may
be distinguished from those of the true disease by the fact that they
are disseminated and do not form confluent masses. Furthermore,
the skin, after the removal of the crust, does not appear red, dry,
and hypertrophied, as in true eczema.
Herpes: Certain plants of the family EwphorbiaceXj appUed to the
skin.
iTbe presenee of tbe diacoostio sigBs simulating erythema is oot always an iodlcatioo ol (rand. Very
oftan vorkars in various tiades may have law erythamatous appearing bands. As examples of this kind,
Ceaie(lfie)eiv«s tha toUoartar. Hair dressers, throncb the ase of aikaline shampooing liquids; French
poiisbers, through the use ol potassium dichromate; carpenters, worldng with teak or rose wood; tanners,
handling arsenic; masons, through the handling ol silicates; photographers, through tbe action of liquids
croitatntng chlorine: painters, and those engaged in handling aniline dyes or strong alkalies.
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November 9, 1917 1888
Detection: The location and distribution of the lesions is usuaDy
so paradoxical as to indicate fraud at first appearance.
Impetigo: Cantharidal plaster, or ointment of tartar emetic,
applied locally.
Other Eruptive Diseases:^ Iodides, bromides, arsenic or mer-
cury taken internally. Phenol, cantharides, mustard seeds or croton
oil applied externally.
Ulcers: Potash or soda lye, sulphuric acid, hydrochloric acid,
nitrohydrochloric acid, or a strong solution of zinc chloride applied
externally. A case of sloughing ulcer caused by the repeated appli-
cation of a hot copper cent to the skin of the arm is reported by
Bispham (1914).
Detection: AscarelU (1917) states that the diagnosis of fraud is not
difficult in those cases. He, however, advises a general examination
of the suspect to exclude other conditions which might explain the
occurrence of the ulcer, namely: syphilis, diabetes, syringomyeUa,
varix, etc.
Abscess: Connnonly produced by inserting beneath the skin a
thread smeared with tartar from the teeth, saliva or faecal matter.
Detection: Blum (1916) states that the pus, obtained upon in-
cision, has an odor similar to that obtained from an abscess of the
alimentary tract, this being sufficiently characteristic to identify the
fraud.
Phlegmons: Gasoline, kerosene, oil of turpentine, or a solution of
chloride of Hme is injected subcutaneously.
Detection: Chavigny (1916), who has made a special study of these
artificially produced phlegmons, describes their characteristics as
follows: They generally occur in epidemics, and the site of the lesions
in these epidemics is usually the' sfune, namely, the knee or immediate
neighborhood. They resemble true phlegmons in outward appear-
ance, but are not painful. When in the region of the knee, the flexion
of the joint Is not hindered and lymph gland enlargement is absent
or only sHght. They rarely show a thermal reaction above 38.5° C.
The pus is asceptic. and shows a predominance of mononuclears.
The red blood cells are well preserved and show no evidence of auto-
lytic changes. When the phlegmon is the result of the injection of ■
oil of turpentine, the pus is a dirty red in color and contains numerous
granular masses. If due to use of gasoline the color is a dirty white.
It is homogeneous, and of the consistence of a viscous jelly. In
neither case does the pus have the odor of the injected liquid. When
The drugs wh ich are known to give rise to erupUoxis when taken internally are a host in number. Many
of them are administered for legitimate purposes, and caro should iherefoM bo exercised in pronouncing a
cue (raudulent.
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1889 Norember 0, 1917
kerbsene is the agent employed, however, the odor is sufficiently
pronounced to be jused as evidence of f raud.^
Lipoma: Paraffin injected subcutaneously.
CEdema of the Hands and Feet: Friction between the fingers
or toes with a stalk of a species of horsetail (Equisetum arvense).
The resulting inflammation is said closely to resemble oedema.
Substances used in the Simulation of Diseases of the Eye.
Inflammatory Diseases: The following have been placed under
the eyeUd: ipecac, castor-oil seed, can tharides, lime, silver nitrate,
red mercuric oxide, copper sulphate, acid lotions, urine, faecal matter
and putrid matter.
Mydriasis: Tlie preparations and alkaloids of belladonna, hyos-
cyamus and stramonium placed in the eye.
Myosis: Lobeline placed in the eye.
Detection: The simulation of mydriasis, or myosis, by the above
means, can be most easily discovered by isolating the suspect and
keeping him imder close observation.
Substances used in the SinalBtioii of Diseaaes of the Btr.
Otitis: Urine, faecal matter and chemicals (specific names not
mentioned) are reported as having been inserted into the auditory
canal for this purpose.
Detection: The presence of lesions in the meatus and concha may
reveal the artificial nature of the disease (AscareUi, 1917).
Substances used in the SimuUtlou of Diseaaes of the Throat
Acute Tonsillitis: Irritating solutions used as a gargle.
Detection: Febrile phenomena are absent. The inflammation m
not confined to the tonsils but extends to all parts touched by the
liquid (Blum, 1916).
Substances used in the SimuUtion of Diseases of the Respiratory System.
Hemoptysis: Colored substances, such as carmine or beet juice,
to color the sputunL The blood of animals (chicken) is also reported
as having been used for this purpose.
Detection: Fraud of this nature is, usually, readily detected by a
microscopical examination of the sputum.
Substances used in the Simulation of Diseases of the Digestive System.
Gastric Derangements: A mixture of oil and tobacco is fre-
quently imbibed for this purpose. Blum (1916) states that the gas-
tric symptoms which follow may be accompanied by a rapid heart
and icterus.
> A method (or the isolatioB of tbt saaottne. keraeane, or oU of tnrpeotlDe pfcsent Id the pos ohuined
from these artlflaiaUy prodnoed phtocmooa taM beeo reponed by S<L LMUttM <m QMmioal teeti f or
the identiflcatioii ol these substances have also been described by this author.
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November 9, 1917 1890
Detection: An examination of the stomach contents is the best
means of detecting this form of fraud.
Diarrh(ea: Purgatives are reported as having been employed
for this purpose. Another means of effecting simulation is the
dilution pf the fajces with urine or water. In attempts to simulate
dysentery, small pieces of meat and pork fat are added to the faeces
thus diluted.
Detection: Procedure of this kind can be most easily discovered by
isolating the suspect and keeping him under observation. During
this period, the f«ces and urine should bo collected in separate
vessels.
Icterus:* Walnut juice and liquid preparations of curcuma,
appUed externally, picric acid taken internally.
Detection: Attempts to simulate the diagnostic signs of jaundice by
the use of external applications are so crude that they may be detected
with ease.
For the detection of the use of picric acid, a number of methods
have been devised. Among the best of these are the methods of
Le Mithouai'd (1915), Derrien (see Grimbert, 1916), and Pecker
(1916), in which picric acid or its derivatives are identified in the
urine, and the methods of Pognan and Sauton (1915) and Tixier and
Bernard (1917), in wliich picric acid or its derivatives are sought for
in the blood. The la^t-mentioned method is given here because of
its simplicity and sensitiveness. It is carried out as follows: Add
15 drops of blood, drawn from the tip of the finger of the suspected
simulator, to 3 cubic centimeters of salt solution (0.95 per cent),
contained in a small glass tube, and shake two or three times. After
allowing the mixture to stand at room temperature for 24 hours,
draw oflF, by means of a pipette, 1 to 2 cubic centimeters of the salt
solution. The latter will be colored faintly yellow, in case the icterus
is due to the ingestion of picric acid. Add an equal volume of a
solution of methylene blue (1:50,000) and shake vigorously, then 15
drops of chloroform * and shako again. If picric acid derivatives are
present, the chloroformic solution, which separates on standing, will
appear light green to deep green (bottle green) in color, depending on
the quantity of the acid derivatives present.
Substances used in the Simidation of Diseases of the Circulatory System.
Rapid Heart: Cordite (an explosive consisting of a mixture of
guncotton and vaseline) is reported as having been chewed for this
purpose.
1 A recent report of the Royal Society of Medicine shows that toxic taundloe in munttloa workefs msy
be doe to the handling of trinitrotoluene or tetraohlorethane. A soffloient amooni of these nxbstaooesto
prodooe ihe symptoms of Jaundice is stated to be absorbed through the sUn.
>If ether is substituted for the chloroform, there is less danger of forming a troublesome emuMoB.
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1891 N<nrem!)€r 0, 1917
Note: Newspaper reports indicate that perhaps other substances
are being employed for this purpose. Attention is, therefore, invited
to some of the substances which might be used, namely: Nitrogly-
cerin in the form of the spirit or tablet, atropine or belladonna and its
preparations, or caflfeine.
Substances used in the Simulation of Diseases of the Kidneys.
Albuminuria: Sodium chloride and milk, consumed in large quan-
tities for several days. Blum (1917) states that this is the method
commonly employed by those who are predisposed to the disease.
Another method consists of the injection of albumin into the bladder.
Detection: Isolate the suspect and keep him under observation.
In case of fraud, the albumin will disappear from the urine in a few
days.
Substances used in the Simulation of Diseases ot MetalM^isnu
Diabetes Mellitus: Phloridzin taken "per os or injected gub-
cutaneously, ammonium oxalate per oa, or glucose injected directly
into the bladder.
Detection: Phloridzin is excreted in the urine, and may be iden-
tified therein by the method of Marcuse (1897), which is as follows:
To 5 cubic centimeters of the suspected urine, contained in a test tube,
add a few drops of ferric chloride test solution. The mixture will as-
sume a bright red color, if phloridzin is present.
Certain other substances give a similar color reaction, namely:
Acetoacetic acid, phenacetin, antipjrrin and salicylic acid.
In case the color is due to the presence of salicylic acid the mixture
will be decolorized on adding a few drops of hydrochloric acid and
shaking with ether.
To test for antipyrin, add a few drops of LugoFs solution to a small
quantity of the urine, previously diluted with 20 volumes of water
and acidified with hydrochloric acid. The presence of antipyrin will
be indicated by the formation of a characteristic precipitate.
To determine whether or not glucose has been injected into the
bladder, empty the latter and wash out with a solution of boric acid.
Collect a sample of urine two or three hours later and examine. The
absence of sugar indicates fraud.
General Debility or Physical Exhaustion: Vinegar consumed
in excessive amounts; tobacco (excessive use of); arsenious acid,
mercury, or lead salts, taken internally for a period of time suffi-
ciently long to cause the appearance of toxic symptoms.
Substances used in the Simulation of other Diseased Conditions.
Fever: A peeled tooth of garUc inserted into the anus and allowed
to reipain for 24 hours, or the same substance crushed and rubbed into
the axillae (Perez, 1917).
Hebnla: Paraffin injected into the scrotum.
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November 9. 1917 1892
Bibliography*
Anon.
1917. An abstract of a report of the Royal Society of Medicine on toxic }aimdice
in munition workers due to trinitrotoluene and tetrachlorethane. Brit.
Med. J., V. 1, p. 625.
Anon.
1917. Paris Letter. Skin eruptions. J. Am. M. Assoc, v. 48, p. 1568.
Ascarelli, Attilio.
1917. Self-inflicted injuries among soldiers. The Lancet, v. 193, p. 355.
Bispham, W. N.
1914. Malingering. Mil. Suig., v. 34, p. 210.
Blum, Egard.
1916. De la simulation. "La carotte." J. de M4d. de Bordeaux, No. 14, p.
274.
Bruce, Sir David.
^ 1910. Malingering, Brit. Med. J., v. 2, p. 1721.
Chavigny.
1916. Maladies Provoqu^es ou Simula en Temps do Guerre. Paris M^ical, v.
6, p. 150.
Collie, Sir John.
1916. Fraud and skin eruptions. The Lancet, v. 191, p. 1008.
1881. Dictionnaire Encyclop^^dique dea Sciences M^dicales, Paris, p. 705.
Editorial.
1917. Gasoline Phlegmon. Med. Rec, v. 91, p. 994.
Grimbert, L.
1916. Sur la recherche des d^riv^ picriquos dans les urines. J. Pharm. et
chim., V. 13, p. 177-190.
Lasuasse, Ed.
1916. Abc^ provoqu^s par injections de p^trole. Recherche et caracterisation
du p^trole dans le pus. Bull. Sc. pharmacol., v. 23, p. 82-84.
LeMithouard, A.
1915. Notes sur la recherche de Tacide picriquo dans lea urines des maladee
atteints d'ict^ro picrique. Paris M<kl. v. 17, p. 475-477.
Marcusc, Wilhelm.
1897. Der Eisenchloridreaction in der Praxis. Deutsch. Med. Wchnschr.
V. B., V. 23, p. 67.
Pecker, Henri.
1916. Sur la diazor^ction (picramique) dans Purine. J. pharm. et chim., v. 13,
p. 268-269.
1916. litude chimique de Tintoxication picrique. J. pharm. et chim., v. 14,
p. 152-154.
Perez, Geoi^.
1917. Allium. Med. Critic and Guide, v. 20, p. 309.
Pognan and Sauton, B.
1915. Des ict^res provoqu^s par absorption d'acide picrique. Recherche de la
simulation par I'analyse des urines et du sang. J. pharm. et chim., v.
12, p. 350-352.
Tixier, Leon.
1917. La recherche de Tacide picrique dans les cas d'ict^es simul^. Bull. Sc.
Pharmacol., v. 24, p. 158.
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PREVALENCE OF DISEASE.
No health department^ State or locals can effectively prevent or control disease withovl
knowledge ofwh^n, where, arui under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
Cattfornia Report for the Week Ended Norember S, 1917.
The California State Board of Health reported concerning the
status of preventable diseases in California for the week ended
November 3, 1917, as follows: A case of anthrax was notified in
Los Angeles and a case of leprosy in Oakland. A case of polio-
myelitis was reported from Pomona. Eight cases of smaUpox were
notified. Diphtheria and scarlet fever were reported more preva-
lent. Thirty-eight cases of diphtheria were notified in Los Angeles,
but only 11 cases were notified in San Francisco. Typhoid fever
continued to decrease, 24 cases being notified during the week.
Whooping cough was more prevalent, outbreaks being reported
chiefly from rural districts.
The details of notifiable, disease cases reported durmg the week
ended October 27, 1917, are as follows:
Anthrax
Chicken pox
Diphtheria
Dysentery
Erysipelafl
German measles
Gonococcue infection.
Leprosy
Malaria
Meiieles,
1
56
78
1
6
4
51
1
, 22
, 45
Mumps 139
Pellagra
Pneumonia
rolioniyelitis
Scarlet fever
Smallpox
S\ philis
Trachoma
Tuborculoalp
Ty[»lioid fever...
\M looping cough.
1
39
2
75
2
30
2
lao
29
47
Indjana Report for the Week Kndcd Nov. 3, 1917.
The State Board of Health of Indiana reported concerning the
status of preventable diseases in Indiana for the week ended Novem-
ber 3, 1917, as follows: Diphtheria epidemics occurred at Jcflersun
Township, Noble County, and Wcstpoiiit, Tippecanoe County.
Scarlet fever was reported epidemic at Sugarland School, Davies
County; Rankin, WTiite County; and Portland, Jay County; and an
epidemic of rabies was reported at Rockport.
(1893)
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November 9, 1917 1894
ANTHRAX.
Louisiana.
On October 23, 1917, a case of anthrax in man was reported in
Kaplan Township, Vemiilion Parish, La. On October 24, 1917,
another case was reported in St. Joseph, Tensas Parish.
City Report for Weelc Ended October 20, 1917.
During the week ended October 20, 1917, three cases of anthrax
wore reported in Stockton, Cal.
CEREBROSPINAL MENINGITIS.
Kansas.
During the week ended November 3, 1917, new cases of cerebro-
spinal meningitis were reported in Kansas as follows: Brown County,
Hiawatha, 1 ; Doniphan County, Troy, 1 ; Osage County, Osage City, L
Massachusetts.
During the week ended October 27, 1917, new cases of cerebro-
spinal meningitis were notified in Massachusetts as follows: Boston,
2; Fall River, 1; Worcester, 1.
State Reports for September, 1917.
Place.
New eases
reported.
1
1
1
Place.
New cases
reported.
Alabama:
linldwin County
New York-
Broome Countv
Chilton County.
j Columbia ( ounty
Cortland (^ountv
Tola!
2
1
2
1
3
2
1
I
i l^utt'bess < ountv
1 Krie Countv...*.
ConnccLicut: .
(Genesee Countv
Fairfiokl County —
1 Monti£omer V ». ounty
BrKk'Cport
' Steuben ( oinvty ' . ...
Hartford Countv —
Wa vue County ...,
Bristol
New York City
19
ITartford
Total
West Hartford
2S
Middlesex ( ounty—
Essex
Middletown
1 Wi-seonsin:
1 i 'outrlas County
1
Now Ha\Tn (ounty—
Meriden
1 Manitowoe Couaiky
3
; Milwaukee County
5
New Haven
Monroe ( 'ounty . .'.
1
Rock County
1
Tota'
12
1
1
3
Total
11
Indionn:
Founliiin County
Lake County
Marion ( ounty
Total
5
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1895
November 0, 1017
CEREBROSPINAL MENINGITIS— Continued.
City Reports for Week Ended Oct. 20, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Baltimore, Md
Jersey City, N. J
KansasClty, To
1
2
1
2
1
1
2
3
Bayoone, N.J
Boston iioss
1
Manchester, N . TI
Milwaukee, Wis :..
Buffalo, N. Y
2
Cam brid?6, Mass r..
Minneapolis. Minn
ChJcaKO, tl
4
2
4
New Britain, t onn
Cleveland. Ohk>
NewYork
2
Dayton, Ohio
Philadelphia, Pa
2
Petrolt, Mich
Stockton, al
Winston-Salem. N. C
1
1
1
Hartford, t onn. ..............
DIPHTHERIA.
Connecticut
Collaborating Epidemiolo^st Black reported November 3, 1017,
that diphtheria was more or less epidemic throughout the central
and eastern part of Connecticut.
Louisiana — ^Alexandria.
Four cases of diphtheria were notified in Alexandria, La., October
13 to 17, 1917. An examination of 169 students in St. Francis
Xavier College resulted in the finding of five carriers of the disease.
Bee also Diphtheria, meaeles, scarlet fever, and tuberculosiB, page 1904.
ERYSIPELA&
Qty Reports for Week Ended Oct. 20, 1917.
Place.
Allentown, Pa....
Boston. Mass
Buffalo. N. Y
Camden, N. J
Chlcaro, 111
Cincinnati, Ohio. .
Cleveland. Ohio...
Denver, (olo
Detroit. Mich
El Paso, Tex
Haeerstown, Md..
Jackson, Mieh
Jcrgeyrity, N. J..
Kalamazoo, Mioh.
iKxt Angeles, Cal..
Cases.
Deaths.
Place.
Memphis, Tenn
Milwaukee. Wis
Newark. N.J
NewYork, N.Y
Oklahoma ( ity. Okla.
Philadelphia, Pa
PlUsburKh. Pa
Reading, Pa
Richmond, Va
Rochester, N. Y
8t. Joseph, Mo
St. Louis, Mo
San Francisco, Cal
ZanesvlUc, Ohio
Cases.
Deaths.
135
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NoTcmber 9. 1917
1896
MALARIA.
Report for September, 1917.
Place.
New cases
reported.
Pltce.
New CMOS
reported.
Alabama:
Antauea County
2
2
3
8
3
2
C2
2
1
4
3
1
1
3
2
10
1
1
9
1
2
1
3
75
Alabtma—Contlnaed.
Jackson County ...••..
Jefferson Coaniy ,.
1
Baldwlii County
MS
Barbour County ,
T/«ni«r Owmty .' I .
BlouDt County
Lauderdale County
Bullock County
Butler County
Macon Coimty. , ................^...
Calhoun County
Marengo County
Chcroiceo Coun{y... ........ .........
Marion Coimty
Chilton Coimty
Marshall County ..
Choctaw County. ...................
Mobile County
Cbrko County.'.
Monroe County
CotTcc County
Montgomery County...
Cocsa County
Morgan County,.,. ............... .
Covinpton Ctunty
Perrv County.' ,.,1......
Crenshaw County
Pike' County
Cullman County
Fussell County
Dallas County «
Klmore County .•••..•..«.....•
Shelby County....^ ^
8t. Clair Owmty „
Sumter County
Escambia County
Etowah County
Talladega County
Fayet to ( 'oimt y
Tuscaloosa County ,
Walker County... !
u
Franklin County
Geneva County
Washington County... IT. ...IIII^III
Greene County
Wilcox Coimty....! IIIV.V"
Bale County
Total
Houston County. ...................
439
CUy Beports for Week Ended Oct. 20. 1917.
Place.
Cases.
Deaths.
Plaee.
Cases.
Deaths.
Birmincham. Ala
8
"i*
18
Norfolk, Va
1
1
Charleston, J^. C
1
PhUadelphia, Pa
Los Aneeies, Cal
Savannan, Ga
I
Mcmplib, Tenn
3
1
Stockton, 'Col
1
Mobile, Ala
MEASLES.
See Diphtheria, measles, Bcarlet fever, and tuberculosis, page 1904.
PELLAGRA.
Stmte Reports for September, 1917.
Place.
New cavs
reported.
Place.
New earn
Alabama:
Autaurra Cotmty...,
Bur hour Cmmty ...
Bibb Count'
Bullock (oimty....
Calhonn Co'inly....
ChamlxT^ ( ounty..
Chilton County
Choct aw ( oimt y . . .
Clarke (ounty
Cullman ( ounty...
Dftllir; Co'Uitv
Etowai; ( oimty
rinlr l'o\:nt f
Jik"^s(/n ( (*,iJitv
Jollor-on CoDnly ...
Laiui' nl:^'«' « onrity
I.ann n. <■ f ounty..
I>ce ( ouiil\ ". ..
J,imcsl(ii"'C4tiuUy.
Maron i emit v
Marengo ( oiinty . . .
Alabsm*^— Continued.
Mobile (oimty
Monroe Coimty
MontJ^omcrv ( ountj.
Morgan ( oiinty
Perry Coimty
Pic Wens Coimty ,
Pike (ounty ,
Randolph C^ounty....,
Kus^ll County ,
Sumter < ounty
Tallndeca i oimty....,
Tallapoosa (oimty...,
Tu^wloosa County...,
Walker ( ounty ,
WusitinKton County..,
14
1
6
1
1
a
1
s
1
2
5
1
16
4
3
Total.
107
Comr^etlcut:
New London County-
Preston
Google
Digitized by
1897
PELLAGRA—Cont in ued .
City Reports for Week Ended Oct. 20, 1917.
Nos''mlM*r 0, i;H7
Casea.
Deaths.
Place.
1
Cases. .
Deaths.
Birmingham, Ala.............
4
3
1
1
2
Mobile, Ah
1
V
BoAtoniMass
Nc-v Orleans, "^ a
Philadelphia, Pa
1
1
3
Charleston, 8. C.-.
Lexington. Kv
Riehrnond, Va
Lov^^u^MaK... .::;:.:;;;;;:;
1
1
3
Savannah (la
:v
Wilmington. N.c. :.;;:;:::;:
Winston-Salem, N. C
i
li
MAmnhLs Tenn
1
1
PNEUMONIA.
City Reports for Week Ended Oct. 20, 1917.
Place.
Casea.
Deaths.
Place.
Cases.
Deaths.
Ann Arbor. Mich
1
1
3
1
6
1
8
1
132
2U
3
4
2
3
1
1
2
1
1
1
8
1
Manchester, N. H
1
2
30
2
1
1
62
35
1
1
1
10
2
6
3
?
1
2
1
2
2
1
Atlantic City, N. J
Medford. Mass
Baltimore Md
13
Newark, N. J
4
BiDghamtbn, N. Y
New Castle, Pa
Boston, Mass.................
Newport. Ky
1
Braddock Pa
Oranpc, N. J.
Philadelphia, Pa
Cambridge, Mass..
66
19
13
27
Chebea, Mass
Pittsburgh. Pa
19
Chicago, ill
Piitsfleld, Mass
1
Cleveland. Ohio
Pontiac, Mich
Dayton, Ohio
Readin;:, Pa
Detroit. Mich
Rochester. N. V
4
Evansville, Ind
Saginaw, Mich
Fall Ri*er, Mass
Sail Francisco Cal
4
Grand Rapids. Mich,
Schencct^ly, N. ^
8on>er»ille, Mass
1
HarrisbuTE. Pa
2
HaverhUl, Mass
eprhigficld; Mass
Jackson, Mich
Stockton, Cal
InhiMtnim. Pr-_
Toledo, Ohio
2
Wilkinsburc, Pa
1
LfOs Anifelos. ^d.. ............
Worcester, Mas:i...
I/ynn, Mass
York. Pa
POUOBIYEUTIS (INFANTILE PARALYSIS),
nilnofe.
During the week ended November 3, 1917, cases of poliomyelitis
were notified in Illinois as follows: One case each in Dupage, Fulton,
Kane, Kankakee, Logan, McHenry, Ogle, Rock Island, and Winne-
bago Counties; 18 cases iu Cook County, of which 17 occurred in
the city of Chicago.
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NoYember 0, 1017
1898
POUOMYELmS (INFANTILB FARALYSIS)-Continiied.
SUte Reports for September, 1917.
Place.
New cases H
reported. [
PlMse.
Newc
rDported.
Alabama:
Cullman County. . .
Limestone C ounty.
Piko( cunty
Wilcox County.....
Totil
Connecticut:
Fairfield County-
New Fairfield..
Harlford County-
New Britain...
Tota
Indiana:
PeKalb County....
Fountain ( oimty..
Lake County
Porter County..'...
St. Joseph t ounty.
Total
New York:
Albany Couaty ,
CattariHiffus County
Clinton County ,
Columbia C ounty ,
Greene County t,
Lewis County
Monroe County
Nassau County
Niagara County
Rensselaer ( otmty ,
St. Lawrence County
New York City
Total
Wiaeosislii:
Douglas County
La Crosse County
Milwaukee ( ounty.... ...mi^
Rock County
Trempfolcau County
Venion county
Total
IS
9
a^ Beporta for Week Ended Oct 20, 1»17.
Place.
Cases.
Deaths.
Place.
CasM.
Deaths.
Akron Ohio
1
1
1
£0
1
1
Ix)well , Mass
1
Alioonn Pa ................
Piltsburch, Pa
Boston, Mass
Portlana, Mo
Chicato 111
17
Portland, Orce .............
Cleveland, Ohio
S:i! inuw, Mich
Erie Pa
Seattle, Wash
Los Angeles, Cal
RABIES IN MAN.
Kentucky — Louisville.
A case of rabies in man was notified in Louisville, Ky., November
2, 1917. The patient was bitten by a dog July 7, 1917. Antirabic
treatment was not administered.
RABIES IN ANIMALS.
City Reports for Week Ended October 20, 1917.
During the week ended Oct(^ber 20, 1917, cases of rabies in animals
were reported tis follows: Detroit, Mich., 2; Memphis, Tenn., 1; and
Newark, N. J., 1.
SCARLET FEVER.
See Diphtlieiia, measles, scarlet fever, and tuberculosis, page 1904.
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1899
NoTember 0, 1917
SMAf.LPOX.
Kansas — Learenwortli.
Ansifltftnt Surgeon Wilson reports that the outbreak of smallpox
at Leavenworth appears to be at an end. The first case .appeared
in the city of ^ Leavenworth during tbe week ended September 22.
Tliere have been in all 13 cases reported in tbe city and 8 cases out-
side the city. The disease has been of the mild type.
Minnesota.
During the week ended November 3, 1917, five new foci of small-
pox infection were reported in Minnesota, cases of the disease having
been notified as follows: Dakota County, Hastings, 1; Hennepin
County, Corcoran Township, 1; Kittson County, Haima, 6; Meeker
County, Darwin Township, 2; Rice County, Wells, L
Texas — Ea^e Pass.
During the period from October 11 to 30, 1917, 16 cases of small-
pox were notified at Eagle Pass, Tex.
Miscenaneous State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Alabama (Sept. 1-30):
IJloimt f'oimtv
1
1
1
1
1
1
8
2
1
Indium— CnntfnnM.
Jo mon < otmty
15
6
1
2
17
4
2
1
rbftrabers<<ninty
Conocnh rcKint r.w
K no t ( otint V
Iau-c coimtv
Pallax r'oiint V .'.
I^aporte Coimty
Jefferson rount jr
Morion ( oimtv
yontcromerr County
Vanderbnn^h Countv
VI«^('onntv
ric ^eIls C'aint »
Tftlladeea ('CHinty
Wliite County
Total
******
00
Total .- . . .
17
New York (Sept. 1-30):
Erie County
2
Owmecticut (Sept. l-SO):
Utcbrteld ( oimty—
WinchesUr
1
1
Wisconsin (Sept. 1-,10):
Calumet coiintv
3
3
2
1
2
4
1
2
1
■
MWdleaex Coimty—
Cromwell
Kan Claire <oimiy
Juneau ( 'ottnt r .
Total
3
lincoln County
Milwaukee County
Monroe ( 'ount v
Isdiaim (Sept. 1-30):
Adanu rouiitv... - .
4
.5
1
7
8
1
Portal County
Clay ConntT
Rock County.'.
Fountalii Cbtmty.
%Vasiiburu County
Total
rsKMon Coiititv
Greene County
18
Jefler8(H) County
City Reports for Week Ended Oct. 20, 1917.
Plsoe.
Akron, Ohio
Bune, Mont
Chicaeo, lU ,
Clevelaiid, Ohio
Cohun bus, Ohio.,...
Danville, tU
Dayton, Ohio
Denver, Colo
Detroit. Mich
Bverett. Wash
Grand Rapids. Mich.
Indianapolis, Ind....
Kansas City, Kans..
Cases. Deaths.
Place.
Kansas City. Mo
La Crosse, wis
Leavenworth, Kans.
Lincoln, Nebr
Milwaukee, Wis
Minneapolis, Minn...
New OrleHns, l^a. . ..
Niagara Falls, N.Y..
St. Louis, Mo
Salt Lake City, Utah
Sioux City, Iowa....
Toledo. Ohio
Cases. Deaths.
Digitized by VjOOQIC
Koveniber 0, 1017
1900
TETANUS.
City Reports for Week Ended Oct. 20, 1917.
Place.
Cases.
Deatlis.
Fteee.
Omb.
Dctttltt.
Bftltimora Md
1
1
Phikdelpliift. Pa.
1
1
1
S
D&nvine III
1
1
1
Rullandi Vt'
Galveston Tex ....
St. Louis, Mo
1
Mem Dills Tcnn
1
Troy, N. Y
1
TRACHOMA.
Alabama — Camden.
An examination of 205 school children in Caniden, Wilcox County,
Ala., disclosed two cnses of trachoma and one case which was classi-
fied as doubtful, trentnient and observation being required before a
positive diagnosis could be made. According to the United States
Census of 1910 the population of Camden was 648 persons. The
population of Wilcox County and the city of Camden is largely
native American, and has been but little influenced by foreign or
domestic immigration.
Florida.
Siu^. John McMnllen, of the United States Public Health Service,
in conjunction with officers of the State Board of Health of Florida
and assisted by local physicians, investigated and treated cases of
trachoma in the State of Florida during part of the month of October,
1917. He reports that cases of trachoma were found as shown in
the following table:
Place.
6«nford
Oveida
JacksoQTiUe,
loia
3,570
67, UW
Number of
cases of
trachoma.
ia=>
S
15
Plaoe.
Lakeland.
Plant aty
Tampa....
POrpoIft*
Uon,
19ia
Number of
cases of
trachomAi
3,719
2,461
37,783
30
94
48
TUBERCULOSIS*
Seo Diphtheria, mcayles, scarlet fever, and tuberculosis, page 1904.
TYPHOID FEVER.
HawaH — Castner.
A report from Honolulu, Hawaii, states that 52 cases of typhoid
fever were notified at Castner, Hawaii, duriufi; the two weeks ended
November 5, 4917, making a total of 95 cases with 5 deaths since
September 13«
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1901
November 9, 1017
TYPHOID FEVER— Continued.
Kansas — LeaTenworth.
Asst. Surg. Wilson reports that the epidemic of typhoid fever
which has existed in. Leavenworth and vicinity has come to an end.
The epidemic began last February. Tiiere have been in the city of
Leavenworth 205 cases and in the area outside of the city 69 cases.
South Carolina — Spartanburg County.
A report from Inman Mill Village, Spartanburg County, S. C,
states that 14 cases of typhoid fever had occurred there since June.
Six patients were confined to their beds at the time of the report,
eight being convalescent. Four cases of typhoid fever were reported
at Drayton Mill Village, near Spartanburg.
State Reports for September, 1917.
Place.
New
cases^
reported.
Place.
New
cases
reported.
Alabama:
Ai:taug» County ,.
1
3
2
1
1
2
40
10
4
4
1
4
3
1
3
3
6
5
3
7
6
4
2
1
13
I
6
1
3
15
266
3
I
;
5
1
(;
3
10
14
15
?!
7 i
I 1
1 <
la-
AJabara*i— Continued.
Siunter Coimtv
2
Barbour County ...
TallidcRTi Coiiiity
5
Bibb County " ....
Tttllapoos;i C-oimt y
13
Blount County \,'\V.".\\..'.
Tuscaloosi (>)unly
18
Bullock CounCy
Wjillccr Conn' v
U)
Butler County . .. .,
Washinjrton Coiuity..
1
OBlboun County !IIII!I '!*!!!
WiU«K Couuly M.
Winston County ,
6
Chambers County .....
1
Cherokee County UI.I!I!!I!!.
Chilton County
TotiU
£80
Choctaw County II1I!!II!.I.
Connecticut:
Fairfleld County—
Bridgci)>ri
Clarke County
Clcbumc County
Coffee County
Colbert County
Daubur^-
Conecuh County
flreen^'urh
Coosa County \ [**
Sholton
Covington County '.'.'..'.'...'...,
Non.alk
Tvid^-erield
Crenshaw County. , .
Cullman County
Stauiford
Dallas County. r.
S t ra I f jrd
DeKalb County \\'. SJ',\'.V.\'.'.'.V.
Hart furl C)i;nty—
Be-li.i
Ehnorc County. . . .
Escambia County .'..'.'.'.",".",".'."'
Bri:-: j1
Etowah County. ...
Ka ^ I J I;ir t : ri d
Fayette County ....
i:a.4 *.iu<jijr
Geneva County
V.nfitM
Hale County ...'."..!!!!!!! Ill ! 1 ! !
< Jla'Jl^nihary
Henry Coimty
llarlfol
Houston County
MtUlClK'.r M\"
Jackson County
Ke^v i>:i' liu
Jefferson County I..!!*'!!!!'
>\ ind> )r 1j k'I;s
LitehfioMCuuiio —
Morris
Lamar County
lAuderdale Coimty
Lawrence County ..,'.
rivmouiU
Lee County
Sali.st>ury
J
Llmestone'County '.',..'.'.
Thom«istou
Lowndes Coimty
\v'a tcrt>>N n
Macon Cotmtv
Middle st^x Coimty "
E5.^'X
Marengo County ..*.», **
Marion' County]! ,.,,.,.
SavbfxWk
MM^hall County .. . .'
New lluvoiiCoiKity -
Ansoiili '.
Mobile County .'.
Monioo County '..'.'
Bnmford
Montgnmcry County . . ^ . . . . .
Mudisj 1
Morgan Oouaty...^, .,.,,]],. ].[....
Mcrido:i
Pickens County
Nau^^tucJc
Pike County
Kr-.v lUvcu
Russell County
t )r!iti ,'0
Shelby County
Wii lUu;:rjrd
et Clair County
Watorbury
u
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►oqIc
NoTembCT^, 1017
1902
TYPHOID FEVER— Oontinued.
State Reports for Septaaber, 1917— Continued.
Place.
New
caaes
reported.
Place.
reported.
Coimectlcut— CoDtinued.
New London Ciotmty—
Groton
New London
Preston
8tonington
Tolland County —
WilUngton
Windham County—
KUllngly
Willimantlc
'Total
Indiana:
Adams County
Allen County
Bartholomew County . .
Blackford County
Carroll County
Cass County
Clark County
Ctoy County
Clinton Coimty
Crawford County
Daviess County
Dearborn County
DocatDT CouBty
DekalbCounty
Delaware County
Dubois County
Elkhart County
Floyd Coimty
Founi4»in County
Fm nklin Cotmty ,
Fulton (^unty
Gibson County
Grant Coimty
Greene County
Hamilton County
Hancock County
Harrison Cotmty
Hendricks Coimty . . . ..
Henry County
Howard County
Huntinplon County...,
Jack son County
Jay County ,
Jeilerson County
JcrninKS County
Johnson County
Knox County ,
Kosciusko County . . . . ;
Lake County ,
Laporte County
Lawrence County
Madison County
Marion County
Marshall County
Monroe Comity
MoutRomcry County...
Onm^c County
Owen Cotmty
Porkc County
Perry County
Pike County
Porter County
Posey Coimty
Putnam County
Kand jlph County
Hiplcy County
Hush County
Scott County
St. Jo:-eph County
m
Iiidiai»--CoiitinMd.
Sullivan County
SwitKerland County..
Tippecanoe Cbcmty . .
Tipton County
XJnioo County
Vanderbare Cbanty.
Vermilion County . . .
Vifo County
Wabash County ,
Warren Coonty
Warrtck County
Washington County.
Wayne County. .. . , ,
Wellb County
White County
TiDtal.
New York:
Albany County
Allegany County....
Broome County
Gayun County
Chautuiqua County.
Chemong County . . .
Chenango County...
Clinton County
Columbia County...
Delaware County .. .
Dutchess County....
Erie County
Essex County
Franklin County....
Genesee County
Greene County
Berkimer Coimty...
JefTeraon County....
Lewis County
Madison County
Monroe Countv
Montgomery County..
Nassau County
Niagara County
Oneida County
Onondaga County
Ontario County
OrangB County
Orleans County
Oswego County
Otsego County
Putnam County
B cns5:elaer County . . . .
Bockland County
St. Lawrence County..
Saratoga County
Schoharie County
Schuyler County
Seneca County
Steuben County
Suffolk County
Sulli wi County
Tioga County
ITlster County
Warren County
Washington County...
Wajme County
West rl»ester Coimty. . .
Yates County
New York City
Total.
»1
80
S
6
1
7
m
6
4
3
4
6
44
4
1
8
3
10
4
S
1
U
i
6
28
6
11
1
6
1
5
6
1
49
S
7
7
a
a
1
7
17
3
8
18
3
8
a
3
7W
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1903
Norember 9. 191T
TYPHOID FEYHt— Continued.
State Reports Car Sepiember, 1917— Oontinued.
Place.
•New
caacs Place,
reported.
New
'cases
reported.
Wisconslo:
Ashland Cotinty
W iscjonsin— Continued.
Marinette County
1
(Mark County..'
u
Pane County
Ontnganrie County.. ^^x ..
Fond du Tac County t^r. .............
ShAboy^^ County. ,.,,..].
Grant County '
Washington County...
*TTW<n l4»lmftninty '..,..
Juneau County...'. ,.
Wood County....! ]..
Kf>nrMhACoiintT
Total i
Marathon County .....,,..
4S
aty Reports for Week Ended Oct. 20, 1917.
PlMe.
CaMS.
Deaths.
Place.
Cases.
Deatha.
Alntm, Ohio
23
M
18
14
2
13
2
1
2
2
3
3
1
5
4
1
Alameda, Cat !....
Mobile, AU
*****"•
Albany, N.y
Allentown, Pa.
Muscatine, Iowa
i
Nashville, Tenn
2
ft
1
1
12
32
3
1
2
1
2
24
7
7
3
X
1
5
1
2
1
2
10
«
2
I
1
3
2
6
3
3
3
4
5
20
7
4
3
10
4
5
1
AltOOnfi, V9
Newark, N.J
New Bedford, Mass
Ann Arbor, Mioh
1
Atlantic CitT. N.J
Newcastle, Pa
Baltimore, Md
3
8
New Orleans. La
Blrmin^iain, Ala. ,.
Boston, Mass
New York, K. Y
i
Norfolk. Va
Buffalo, N.Y '.','...,
1
...•
Butler, Pa.
North AdanM, Mass
Cambridge, Mass
Oklahoma City, Okla.
Pawtncket, R. 1
i
Ch^l«ffli. 'Uiif^ . .....
Chicago, III.. V
2
Perth Amboy.N. J
Cincinnati Ohio
Phlladelphii^W
8
ClevelaDd, Ohio
Pittsburgh. Pa
8
ColTeyville, Kans
Portland, Oreg
Columbus, Ohio . * .
1
Providence, R. 1
Cumberland, Md
Quincy, Masa.
..•
DanvUle, 111.
Reading, Pa.
Daytoo, Ohio .
Richmond, Va
Denver, Colo. ........ .,...,..
RoanoUe, va
Detroit, Mich.
3
Rwl.cster, N. Y
Rock IMand, 111
Ell/abeth, N. J
E4 Paso, Tex . .
1
Scginaw, Mich
Erie Pa
St. Louis, Mo
1
Evan5\'ille. Ind
Salt Lake City, U tab
1
FaU Rf^fr, Ma«^
3
2
San Francisco, Cal
1
Flint. Mich
Savannah, Ga
1
Fort Worth Tex .
Seattle, Wash
Oalosborg, lU
Somcrvillc, Mass
Qalvei^taD, Tex
South Bend, Jnd
Grand Rapids, Mich
1
Springr.cld, 111
1
Hagcrstown, Md.
Springfield, M!i««
,
Harrisburg. Pa !!**!**!*
Springfckl, Ohio
Hartford, <tiasm
1
1
Stockton, C^
1
Haverhill, Mass .V.V"
Tcrrc Haute, Ind
Inriianapoliit, Ind^.^.
6
2
2
6
•
1
1
2
3
9
2
1
8
Topckft, K«n»
1
Jersey rtty, K.J......:::::::;
Johnstown, Pa
ToIedc'Ohio
Trenton, N. J
Trov, N. Y
Washinjrton. D. C
Wnshirigton. Pa
Kansa*! City, Kans . . . !
1
Kansas City, Mo :
1
1
Kokomo, Ind
Leavenworth, Kans
WatorfowD, N. Y
Lexington Ky . .
1
Wheeling, W. Va
1
Lima, Ohio i'l!"
Wichita, Kftn«
1
Linc^n, Nebr
WiRes Hjutc. Vi\
Ix)s Angeles, Cal .
2
Wilmington. I)ol
Lynn, Mass ]
Win^ton-Salein. S,C
Worcester. Mjuss
1
linden, Mas^ . .
1
Memnhis Tcsnn
Yoil, Pa
Milwaukee, Wis
1
Zanesville, Ohio
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November 9. 1017 1904
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for September, 1917.
Cases reported.
State.
state.
Diphthe-
ria.
Measles.
Scarlet
(ever.
Diphthe-
ria.
MeaslM.
Scarlet
fever.
127
162
608
64
64
85
102
67
179
New York
1,182
200
619
40
43S
Connecticut.
Wisconsin
190
Indiana
City Reports for Week Ended Oct. 20, 1917.
Popula-
tion as of
July 1, 1916
(estimated
by U. 8.
Census
Buroau).
Total
death.<t
from
all
causes.
Diphtheria.
Measles.
Scartot
fever.
Tulicr-
culosis.
aty.
1
1
1
i
1
1
1
1
1
Over 800.000 Inhabitants:
Baltimore, Md
589,621
766, 476
2,497,722
674,073
671, 7M
603,812
6,602,841
1,70.»,51S
679,090
-.67,309
468, 66R
410,476
306,346
' 436,636
863,464
408.894
371,747
463,616
348.639
363,980
214,878
260,800
271,708
21»7.847
295,463
264,960
266,417
104,199
181,762
121,579
112,981
106,233
127,224
128,366
104,562
128,291
110,900
\W, 5tiO
113.245
102,425
148,996
117,657
118,158
140, Gs')
198,004
lOii, 470
l()«*,3h.
156,087
117,390
193
196
660
200
200
132
1,348
606
161
200
132
123
90
97*
132
116
48
100
60
63
78'
62
68
71
14
73
286
46
106
10
230
74
48
81
18
27
17
25
39
83
30
16
4
110
4
11
56
18
2
14
4
1
9
28
5
12
16
8
3
6
6
1
1
3
......
2
1
2
41
15
2
17
3
C3
7
4
3
3
6
6
6
24
1
1
"".'2
20
26
104
6
42
11
71
22
13
48
9
10
7
41
9
12
3
6
6
19
20
7
11
3
3
6
13
2
11
3
4
2
3
2
1
* "2"
'3*
S2
(S
418
42
27
32
393
VI
31
88
26
16
13
24
96
Boston, Mass
13
Chicago, III
71
Clevoland. Ohio
2S
Detroit, Mich
17
Los Anecles, C^
19
New York, N.Y
Philadelphia. Pa
15ft
50
Pittsburgh, Pa.
10
St. LK>uis,Mo
16
Prom 300,000 to 500,000 inhabi^
ante:
Buffalo, N.Y
13
Cincinnati, Ohio
u
Jersey City, N. J
9
Milwaukee, Wis
0
MtnnMiDoin Minn.. .
Newark. N.'j V.V.']
61
29
26
8
32
9
u
Mew OrHttuns. La.
18
fian Francisco, Cal
10
5
7
2
14
Seattle, Wash'.
2
Washfaigton, D. C
From 200.000 to S00,000 inhabit-
ants:
Columbus, Ohio
0
4
Denver, Colo
18
IndiaiiapoiiB, Ind
'"V
1
2
7
5
2
5
Kansas rity, Mo
8
1
Providence, R. I
2
5
2
4
Rochester.N.Y
Prom 100,000 to 200,00^ inhabit-
ants:
Albany, N.Y
14
2
10
4
3
6
5
24
4
Rirmlnvham. Aln
69
36
26
42*
35
22
34
40
23
32
13
46
32
36
52
29
45
34
62
26
7
8
Bridgeport, Conn
12
8
3
4
8
I
4
Cain6rfdge.'Mass...I....] .
4
6
2
Camden, N.J
Dayton, Ohio
Fwl River, Moss
2
Fori Wortn, Tex
1
Grand Rapids, Mich
Hartford, Conii
7
15
I
4
20
4
2
2
12
5
10
8
3
4
6
2
4
4
17
5
7
6
8
1
1
4
1
Lawrence, Mass
1
Lowell. Mikss
1
1
1
3
5
1
1
6
3
1
5
U
2
hynn, M*w
5
llemphis, Tonn
" *i*
Ir
1
1
17
2
I
2
"i
7
>I^«h»iIK Tnnn
7
JNew Bedford, Mass
8
New Haven, Coim
a
Oakland ^''ftl.
4
Omaha, N«br
4
R4»^ln£, IV
1
IllChm^^ Vft . . .
7
10
Salt Lake City, Utah
5
2
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1905
November 9, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—ContdL
€»r Reports for Week Eb«M Oct 20, 1917— OontinQed.
Popala>
tion as of
July 1,1010
(esttnuited
by U. 8.
Census
Bureau).
Total
deaths
from
all
causal.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
aty..
J
1
1
1-
J
1
1
1
From 100.000 to 200.000 ishsbit-
antt— Continued.
Sorinefleld. Mast.
10S,M9
155, OM
101,554
111,803
103,314
85,025
09 SOS
58,050
57,000
00, 8»
57,053
53,973
07,440
00,853
00,734
57,144
94,495
88,600
03,705
75,196
70,078
54,772
72,015
77,214
08,529
99,437
50,853
51,155
78,283
58,331
53,794
80,012
92 943
71,744
59,411
03,807
55,185
00,805
55,^2
85,238
53,330
08,«)5
99,519
57,078
87,030
08,910
01,120
51,550
00,083
77,010
70,723
70,770
94,205
61,060
37,733
32,985
32,730
27,b32
43, 423
46, 102
29,310
20,074
33,201
48, m
39,873
38,743
43,458
28.203
S3
43
81
38
48
10*
19
13
9
13
17
18
0
IS
8
0
3
1
0
14
17
1
8
8ySc5s?,N.y!!:.:.i:i:!...
1
ivtledo. Ohio
13
TrAnton. N J
2
Worcester, Mass.
Vrom 50.000 to 100,000 inhabtt-
ants:
5
4
3
1
1
1
1
ADttotown Pa.... .........
A Itywma Pa
.. .
AtbntifiCftv N J
0
1
Bayonne, N. J
Berkeley Cal
io*
18
i7*
SI
17
18
SO
M
17
18
19
83
io'
30
30
4
ii*
13
13
33
10
34
11
33
10
28
34
3
ttnghampton, If. Y........
Bmrbtnn Ifiin
9
3
3
1
1
3
8
3
4
3
3
]
Canton Ohio .............
C%flrlAston 8 C ........
1
3
4
10
3
0
4
11
8
1
4
0
1
3
3
3
3
5
3
10
3
1
1
JbiilatTi, ifbin ••....•....*■•
1
2
6
1
;;;;;:
3
3
2
1
EI PasOki^ .....J
10
Brie Pa. * . .—
9
3
3
7
S
19
Rvarnvirie tnd
3
3
Flint. MteH .
......
11
4
7
1
3
1
Barrtibun. Pa...«
XTobokTO,N.J
1.
3
1
Johnstown. Pa, ........
9
3
KMinutntv. Kms
l^ancaster, Pa ••••....
3
3
10
Maiden, Wass.I.l.^.^.^.....
3
0
8
Manchester, N.H
Mobile, Ala ^
"Ntm Bri tahi^ Comi
3
5
1
3
1
^
4
Norfolk, Va '.
3
1
Oklahoma (Hty, Okla
Passaic, N.J...
I
1
1
Pawtncket, R. I
1
1
3
Portland, He
3
1
I
Roekford, HI
3
5
8AfTftni«nto, Cat, c. ....... .
flftfffnAW. iffnh
1
10
1
1
1
3
8t. Joseph, Mo
1
••••
1
3
1
1
2
San Pi«eo,( al
3
3
Savannah,' Oa
4
7
1
0
Schenectady. N. Y
ttoox r Ity , Iowa .... ..
3
0
8«nervilfo, Mass!!
33
15
33
10
10
80*
34
3
4
3
14*
5
7
10
7
4
5
1
3
South, Bend, lad
1
Springfteld, in
1
Snringflord, OWo
1
1
1
3
11
1
1
1
3
3
Terre uaute. Ind
3
1
Troy, N.Y ; :.
......
1
1
'
4
3
wnkavBarre, Pa.
1
5
WHmlMton, Del
4
8
5
3
York^..!. ...:.;.:;::;;::
fhm 35,000 tomooo inhabitants:
Alan^M^Cal
1
1
3
'
Beinngham, Wash
1
Brooknne, Mass.
1
4
3
9
3
1
5
Bntler, Pa
1
Butte, Mont
Chelsea, Mass
1
1
3
2
Chicopee, Mass
1
Cumberland, Md
1
Danville, m
2
7
3
1
Davenport, Iowa
Dubunne, Iowa
...
3
East Chicago, Ind
14
7
7
1
1
East Orange, N. J
13
1
1
Elgin, 111!?.......:.:;.:;;;:;
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Kovembor 9, 1917 1906
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS— ContcL
City Reports for Week Ended Oct. 20, 1917— Continued.
Popula-
tion as of
July 1, me
(estimated
by U. 8.
Census
bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Srarlet
fever.
Taber-
cttJosis.
City.
1
1
1
1
1
1
1
1
Prom 25.000 to 60,000 inhabit-
ants—Continued.
80,233
85,486
41,781
41,863
29,353
25,679
48, 477
85, .303
48,886
31,576
88,676
81,677
41,097
85,3H4
46. .M5
27,587
86,964
32,940
80.699
47,.S21
26,23t
26,31S
27,32/
29,6«vi
41,133
81,027
8U,1'»J^
43,715
37,3.53
31,401
31,404
33,080
46,450
41,185
38,629
39,651
36,79S
38,136
46,486
43,2H4
28.92.'.
27.145
35,3AS
46, 226
36,2>*3
48, 726
30,570
20,894
43,139
43,377
83,809
29,K92
81,155
80,863
22,874
15.010
2l,ttH.-»
15, 794
» 13,075
22,*;69
24,276
23,539
20.930
» 19,363
15,395
U4,G10
17,445
13,284
8
10
5
1
3
1
3
3
1
Everott Wash
1
Fitchburg, Mass
5
16
8
16*
17
24
7
3
1
1
Galveston, Tok
" *t ""'
!
Green Rav Wis
Haeerstown. Md
3
5
3 -— ::
Haverhill Mass
1
1
3
Jackson. Mich
1
TTAlftniAirnn Mlnh .
10
1
13
Kenosha. WU
. .
4 1
1
Knoxvllle Tonn - * ... .
1
17
1
" 2
4
La ( 'ro6!<e, Wis
6
81
6
6
6
6*
7
4
12
....
2
Lexington, Ky.. ...... ......
""2
10
4
I^nia, Ohio
9
Lincoln. Kebr
IxHig Beach, ("al
. .......
1 r-
1
Lor^n. Ohio ..............
6
1
Lynchburg, Va
1
::::::i:::::: '"::"":
li^son. wis
1 -
3
McKeesDort. Pa
12
6
5
7
13
7
2
' 1 ' '
2
4
MedfordMass
I
Montclair, N. J
1
1
Nashua. N H
1
Newburgh, N. Y
2
14
6
1
New CaAtle Pa
'
Newport, Ky
2
2
Newport, U. I
Newton, Mass
6
9
6
11
9
6
5
5
14
13
11
11
8
12
11
6
io'
16
4
7
8*
9
19
14
8
13
6
6*
5
8
7
7
9
10
1
4
3
4
26
2
4
6
4
1
3
3
2
Niagara Falls. N. Y
;
1 1
Norristo vu. Pa
1
::::::::
4
8
8
2
Ogden, Utah
Orange, N.J
Pa^auona, ( 'al
2
2
1
3
4
Perth Ambov, N.J
6
1 i:::::;
1
Pittsfield, Mass
:.'!::::.::::
1
Portsmouth, Va
1
7
a
Quincv, in
I 1
1
Quincy , Mass
1 1 1 a 1
1
I
Haoine, Wis
1
3
* 1
1
1
Roanoke, Va
1 1
1
Rock Islanl, HI
1
i
Bteubenville, Ohio
'
Stockton, (al
1
1 '
4
1
Buperlor, Wis
1 \" '
3
Taunton, Mass
1 1...-'.
1
2
7
a
a
Topeka, Kans
7
3
1
1
6
6
Waltham, Mass
1
1
*
Watertown, N. Y
1
1
West IToboken. N. J
Wheeling, W. va
:.*;:::i"""
1
6
Williamsport, Pa
1
1
3
1
4
Wilnilngton, N. C
8
Winston-Salem, N. C
4
1
1
Zanesvllle, Ohio . . .'.'.'!! . . .
.
8
1
4
From 10,000 to 25,000 inhabitants:
Alton. Ill
2
4
1
Ann Arbor, Mich
1
Bratldock, Pa
2
1
Cairo, III
.........,--
C*Unton, Mass ............
2
4
Conconl N IT
2
2
1
1
2
3
1
2
1
1
Oa1osl>urg, 111
Kearney, N.J....*
Kokomo, Ind . . ,
1
6
7
2
1
Leavenworth, Kans
1
Long Brjinch, N.J
MftTUiPtte, Wis
1
1
Melrose, Ma;n
i
Morristcvrn, X.J
iiiri
»•••••
JPotvilaUon Apr. 15, 1910; no estimate made.
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1907
NDvember 9, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-Contd.
City Reports for Week Ended Oct. 20, 1917— Continued.
Popula-
tion as ol
July 1. 1916
(estimated
by U. S.
Census
Bureau).
Total
deaths
from
aU
CMIMS.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
caty.
1
1
1
1
1
1
1
i
1
From 10.000 to 25.000 inhabit-
ants—Continued.
Muscatine, Iowa
17,500
23,126
15,243
20,985
122.019
19,926
23,805
17,524
11,666
12,067
14,831
20,193
13,821
15»548
21,618
23,228
15,969
13
13
Nanticoke. Pa
New Lon5on,'Conn
2
1
1
2
1
1
1
North Adams, Mass
1
1
Nortbamnton. Mass
8
1
PlainflekL N.J
1
4
4
1
Fortrniunith, N.H
Roeky Mount, N.C
Rutluid, Vt
2
StodiBky. OWo
******
SaratoKa'^rincs, N. T
8teelton» Pa.........
1
1
1
......
5
1
1
**"*••
WllkinsSurg, Pa
1
* Population Apr. 15, 19^10; no estimate mada.
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FOREIGN.
CUBA.
Comimuiicable Diseases — Habana.
Communicable diseases have been notified at Hnbana as folloTVB:
Aug. 21-31, 1917.
Remain-
ing under
treat-
ment
Aug. 31,
1917.
Disease.
Aug. 21-31, 1917.
Remaizk-
ing under
Disease.
New
ca5es.
Deaths.
New
cables.
Deaths.
treat-
ment
Aug- 31,
Cerebrospinal menin-
gitis
1
9
10
Measles
S
28
i'
4
16
Diphtheria
10
1
Paratypho:d fever
TyphoKl fever
6
Lenrosv
67
Malaria.:::.;::::.;::::
14
1
Varicella
1
CYPRUS.
Leprosy— Malaria— Typhoid Fever— Year 1916. *
The following statement of the occurrence of leprosy, malaria, and
typhoid fever in the island of Cyprus during the year 1916 was taken
from the annual report of the medical officer of the island: Leprosy,
4 new cases; remaining under treatment December 31, 1916, 90.
Malaria, 3,752 cases as compared with 4,537 reported cases for the
year 1915. Typhoid fever, 376 cases as compared with 267 in 1915.
The estimated population of the island was 298,775.
Paratyplioid Fever — Trachoma — Year 1916.
Paratjrphoid fever was recognized in the island for the first time
during the year 1916. Trachoma was reported present with 547
cases.
INDO-CHINA.
Cholera— Plague— Smallpox— Month of July, 1917.
During the month of July, 1917, 522 cases of cholera, 69 cases of
plague, and 525 cases of smallpox were notified in Indo-China. The
cases of these disi^asos were distributed by Provinces as follows:
Cholera, — Prf)vince of Anam, 86 cases; Cambodia, 74; Cochin-
China, 359; Tonkin, 3.
» PnMio Ifonlfh Roports, Feb. 23.. 1917. p. 33.5.
(190S)
Digitized by VjOQQiC
1909 Kovcmber 0, 1917
Plague, — ^Province of Anam, 13 cases; Cambodia, 10; Cochin-
China, 43; Tonkin, 3.
SmaUpox. — ^Province of Anam, 363 cases; Cambodia, 28; Cochin-
(%ina, 130; Laos, 10; Tonkin, 4. ^
As regards cholera the prevalence in July, 1917, was less than
that for the corresponding month in the year 1916, when 1,571 cases
were notified. The greatest prevalence was in the Province of Cochin-
China, the disease being generally diffused throug^ut the Province.
Plague declined in prevalence during July, 1917, 69 cases being
notified in that month as against 178 in Jnne, 1917, and 93 in July,
1916.
The number of smallpox cases notified in July, 1917, was almost
double that id the cases for June, 1917, namdy 525 as against 275.
In July, 1916, 57 cases were notified. Almost the entire occurrence
of the disease in July, 1917, was in the Provinces of Anam and
Cochin-China. In Anam, 112,313 vaccinations were performed (pop-
ulation of the Province, 6,513,700).
natsiA.
€holer»-J«lf-As<Mt, 1917.
Cholera was reported present in Perma during the period July 23
to August 6, 1917, the cases occurring as foUows: Barfouroucdie, 4
cases; D^navend, 11 cases; Sari, 179 cases; and at the village of
Ozoundeh in the- vicinity of Tabriz, 179 cases.
PEBU.
nagae-aone l-^M^ ZU 1917.
During the period June 1 to July 31, 1917, 36 cases of league were
notified in Peru. The cases were distributed by locality as follows:
Place.
New
OMM.
Place.
New
cases.
Ancachs Deportment:
(asma.
3
6
4
Lambaveque Department:
Chiieteyo.
Llbortad Department:
TruiilJo
1
Aroquipa Department:
Moitendo
3
CaUao Department:
CaUaaT. «
Lima Department:
Lima (city and country)
19
UNICW OF SOITTH AFRICA.
Typhma Feyer—Cape ef GomI Hope Stale.^
An increase in the area of prevalence of typhus fever in the State
of Cape of Good Hope, Union of South Africa, was repoited August
25, 1017. Sixteen districts were reported infected.
Pablio BnHOi Reports, S^rt. », ltl7, p. 1«5&
Digitized by VjOOQIC
November 9, 1017 1910
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Receiyed During the Week Ended Not. 9, 1917.^
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remartcs.
India:
Bombay
Aug. 12-18
Aug. l»-ti€pt. 1 . . .
1
9
1
4
Madras'
Indo-Thina
July 1-31, 1917: Cases, £22;
diaths, 314. ^^
Provinces—
Anam ,,,,,
July 1-31
85
74
869
3
4
11
179
47
53
214
Cam^ odia
do
Caihln-Cblna
do
TonUn
do
Persia:
barfourouche .......'.
July 28
1
6
98
Demavend.
July 29
Sari
July 25- Aug. 5....
Tabriz
Au(r. 4, 1917: To Tillage of Otoon-
deh, vicinity of l^ri*. alH)Ut7
casos daily.
PLAGUB.
Braxtl:
Bahia
Sepi. 9-15
I
1
India
Aug. 12-18. 1917: Cuaes, 0,403;
deaths, 4,3^.
Bassein
Aug. 12-18
6
48
2
8
Ml
7
3
3
2
Bom* -a V ....'
Aug. l»-^pt. 1...
Aug. 12-18
63
Uensada
Karachi
Aug. IH-^spt. I...
Aug. l9->*ept. 1 . . .
Aug. 12-18
10
478
Madras PresIdenCv
Mandalay
MouLmein
do
Panu
do
TWinKOO ......... n r .,,.. r -
do
iftdo^Chixia
July 1-31, 1017: Owes, 09, daatbs,
Pro\inoe»—
July 1-31
13
10
43
8
3
6
4
1
3
19
6
9
19
24
2
Cambodia
do
Cochin-China
Tonkin
do
do
Peru:
Deportments—
June l-Jnly 31 ... .
do
At Casma.
Areauina
At Mollendo.
caiiSo ..:...:...:
. , do
At Cailao.
Liiip^'ayeoue
do
At Chlclayo.
At Trujllto.
At Uma (city and comrtry).
Ll'ertad.!
do
Lima
do
Straits Settlements:
'Singapore ^, ,.,»., r^--
Aug. 28-Sept.«...
4
SMALLPOX.
Bra«il:
Bahia
Bcpt.^22
8
China:
Chnnridnff
Sopt.»-16
Presmt.
MuiSEn!:.;.;;;;;;;..;::::
Sept. 24-30
:;;::::::":::::"
Do.
India:
Bombay
Aug. 12-Scpt. 1 . . .
Aug. l9-8ept. 1...
do
7
4
8
8
1
2
Kararm.
Madras
lndo-(^hina
Julv l>3], 1917: Cam, 0»: deatlis,
ProYinces—
A nam. .................
Julv 1-31
353
28
130
10
4
3
A9
23
49
1
Cambodia
Cochin-Chlna
do
do
X/aos
do
Tonkin
do
ItaJy:
Turin
Popt. 24-30
Juno 1-30
1
2
Portuguese Kast Africa:
I^ourenQO Marqucz
'From medical olllecrs of (be Pnblic Health Serrioe, American eonsiils, and ether soorow.
Digitized by
Google
1911
November 0. lOlT
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received During the Week Ended Nov. 9, 1917— Continued.
TYPHUS FBYER.
PUMJe.
Date.
Cases.
Deaths.
Remarks.
Alexandria
Sept. 10-16
8ept.30-Oct.6....
June 10-16
July 22-28
6
1
5
5
3
f
Great BHtain:
Glasgow
Russia:
Ri£a
May 1-31, 1917: Cases, 4.
Do
Union of South Africa:
tape of Good Hope State...
Aug. 25
Present In 16 districts.
1
Reports Received from Jane 30 to Not. 2, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
India:
Ba!«ein
Apr. 1-May6
8
1
7
347
20
4
50
2
1
3
1
5
7
1
17
7
Bombay
June 24-30
July 8-Aiig. 4
Apr. 29-June 30. . .
1
13
Do
Calcutta
Do
JiUyl-Aug. 18
Madras
Apr. 22- June 30...
Jnlyl-.\ug.21....
May 6-June 30 ... .
5
93
Do
MandalaY
Do
July 29- Aug. 11...
Monlmein
.Mayl3-June2
Pakoklcu
Apr.20-May6
Pegu
May 27- June 30...
Do
July 1-7
Prome
July29-Aug. 11...
Ranitoon
Apr. 21- June 30...
JiUy8-28
31
9
Do!?.:..:.:.;::::,..;.:
Indochina:
Provinces
Anam
Feb. 1- June 30....
do
230
79
878
1
36
163
45
191
51
543
Cambodia.
Cochin-china
do
Laos
June 1-30. . .......
Tonkin
Feb. 1- June 30
Apr.23-May27...
Jifly2-8ept.9
21
108
30
Saiiron
^K:::;;;:;;::::;:::;;;;
Japftn. . .,.,..
Tokyo
Sept. 12
2
1
I
1
Java:
East Java.............
Apr. 2-8
Do
July 9-15
1
1
Mid Java
July 16-22.
West Java
Batavia
Apr.l3-July6
July6-Aug. 23....
Feb 3
7
14
1
4
1
3
1
2
2
4
Do
Persia:
Amir Kelt
Barfouroucbe
Jan. 15-17
HamzeKela.. .........
Jan. 17
Machidessar
Jan.31
Philippine Islands:
June 17-23
Do
Aug. 19-2$
Agusan
July 15-28
12
113
53
10
2
76
30
7
Aibay i.;i.i;;.
Ilay20-June30...
Jalyl-Aug.4
Aug. 19-Sept. 1....
^;:::::::;:::::::;
Do
Remarks.
136
Feb. l-June 30, 1917: Cases, 1,273: I
deaths, 805. ' ' • i
Jan.-July. 1917: Cases, 391. Oc» 1
curring in 16 provinces and dis-
tricts.
Sept. 12, 1917; Cases. 252. In 5 i
provinces and districts.
Apr. 13-July 5, 1917: Cases. 71; I
deaths, 31. July fr-Aug. 23, 1917: i
Cases, 171; deaths, 96.
Sept. 2-8, 1917: 1 case. Not pre*
viously reported.
May 20-JunB 30, 1917* Cases, 795;
deaths, 506. July 1-Aug. 4,
1917: Cases, 2,064: deaths, 1,271.
Aug. 10-Sept. 15, 1917: Cases,
871: deaths, 521.
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NoTemlier9,101T
1912
CHOLERA, PLA6UB, SMALLPOX, TYPHUS FEVER, AND THLLOW
PEVBR—Conttoued.
Reports Received from l«ae 30 te Nov. 2» 19i7--Coatim«ed.
CHOLERA-Obttttened.
Fliioe.
Date.
Cases.
Deaths.
Reante.
Philippine Islands— Continued.
Provinces— Continued.
A mhos Cftmarines .
June 3-9
2
30
1
1
3AS
203
64
62
54
231
388
65
61
14
S34
239
237
12
337
276
48
1
1
I
4
93
196
216
8
4
6
7
11
2
11
1
11
Do
Julv 22- Aug. 4
JiilV S^-H
DfltSATI . -
Batang.'*^
Juno 17-23.
May 2O-Jun©30...
July l-Auff. 4
Au«. 19-Sept. 15...
Juno 3-:i0
i
251
101
35
40
IM
2St
3<i
3G
5
2t3
138
117
11
189
177
S9
Dotiol
Do...
Do
Caoir
^Do'.:...:r.:::..:...
Julvl-Aup. 4
Juiie2-30
Cebu
Do
Jnlvl-Aue. 4
Aug. 19-Sept. 15...
July 1-Sept. 15....
Juno 10-30
Do
lloilo
jjeyie
Do.!-!
Julyl-Aue.4
Aug. 19-Sept. 15...
July 8- Aug. 4
July20-Aug.4..-.
Aug 19-Sept. 15. .
July 1-Aug. 4
Aug. 19-S.'pt. 15..
June 24^0
July 1-7
Do
I.
Misarals
Mindanao
Do
Do
"Riztd
Do
July 22-28
1
3
52
88
114
5
4
4
7
9
3
7
SftTTiflr *
July 15-21
Do
Aug. 19-Sopt. 1...
June 3-30
July 1-Aug. 4
Aug. 19-25
July29-Aug.4....
Aug. 19-25
June 3-30
Sorsoeon
^^oV.!!!!!!!!!!!!!!!
Do
gfjf jim/) ........
Tavabas
Do
July 1-Aug. 4
Aug. 19-Sept. 1...
July 15-21
Do
ZaDilwHintTA
PLAGUE.
Arabia:^
Aden..
Brarii:
Bahia .,...
Do
Pemambuco
Ceylon:
Colombo
Do
China:
Amoy
Hon^ong
Kwangtune Province—
Ta-pu Uislrict
Ecuador:
llsLancia V'ieja
Guayaquil
Do
Do
Mila^ro
Do
Nobol
SaJtitT.>
Do
Taurs ..m.—
Mey 3-JU17 4..
June 10-30
JulyS-Sppt. 8...
July 16-Aug. 15.
Apr. 8-J iin ' 23 . .
JlUy6-21
Apr. 29-May5...
JiOyW
May 13-June30.
Jaly8-Aug. 18..
June2
Feb. 1-28
....do
Mar. 1-Apr.30..
July 1-Aug. 31.-
Mar 1-31
Apr. 1-30
Feb. 1-28
....do
Mar. 1-31
Feb. 1-28
inr. ft-May 14.
SaiUis,d
1917: Cmm, 69;
Present and In vicinUr.
Present Aug. 10.
Present.
Digitized by VjOOQIC
1913
November 9, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Receired from June 3Q to Nor. 2, 1917— Continued.
PLAGUE--Contlnaed.
Plac©.
Date.
Cases.
Deaths.
Remarks.
Egypt
Jan. 1-Se^30, 1917: Oases, 733;
Alexandria.
June 21-37
July31-Sept.ll,..
Apr.30-Mayl9-..
June 25
6
5
4
1
1
14
1
4
1
3
Do
1 4HW.
Port Said government
Port Said
Do
July 28-29
1
7
Province's—
Fayoum
Mayll-June26...
Juno 28
Oaiioubeh
Qinrah
May 17
1
3
Mlnieh
Mayl2-Juno28...
July39-Sept. 11...
May 12-....
4
9
3
23
38
3
3
Do
Slout
1
0
23
1
Sum sovemment
Apr. 3()-June2...
Mayl3^une28...
Aug. 13-34
May3-«
8uw
Greet Britain:
Gravesend
From s. o. Matiana.
London..
2 in hospital at port. From s. 8.
Sardinia from Australian and
oriental ports.
Apr. 15-June 30, 1917: Oases,
43,993; deaths, 30,197. Julyl-
7, 1917: Cases, 1,870; deaths.
India
Basseln ,
Apr. 1-June 30
54
23
397
188
38
1
35
413
8
2S0
509
9
3
74
16
•1
3
3
169
386
3
5
Do
July 1-Aug. 11
Bombay
Apr. 22-June30...
Julyl-Aug. 11....
Apr. 29-Jime 2 . . . .
486
331
Do
CWcutta
Do
Jiuy 15-21
Henzada
Apr. l-Juno 30
E:arachi
Apr.22-Juno30...
June 28-July 28. . .
Apr.23-June30...
Julyl-Aug. 21....
Apr.8-May 12
468
11
301
731
Do
Madras Presidency
Do '.
Mandalay
Do
July29-Aug. 11...
Moulmeln
Apr. 1-June 30
Do
Ji3y 1-7.
Myingyan.. ^^ *
Apr. 1-7 ! !
p^rr
May27-June2 ..
Do
July 29-Aug. 11...
Ranicoon . . . X . ....
Apr. 15-June30...
Ji5yl-Aug.ll....
Apr. 8-141:..
183
303
^X?!;.:::;:::::;:::::::
Tonngoo *c a
Do ,....
July29-Aug. 11...
Indo-Cbina:
Provinces
Feb. 1-June 30, 1917: Oues, 780:
Anam.
Feb. l^uneSO....
do
233
133
319
34
113
47
33
3
181
115
133
23
89
26
deaths, 491.
Gambodia
CbohiD-aiina
:.::.do.. ;.:;:.::::
Kwang-Chow-Wan
Tonkin
Mayl-June30....
Feb. 1-June 30....
Apr. 23-June3
Jan. -July . . .
Saigon
Japan:
AlchlKen
MiyoKen
do
Java:
East Java
Apr. 2-May 20, 1917: Caset, 39;
BeathTISn. ivdj SO-Aug. 5^
1917rSaaBS,3;deaths,3.
Kedlrt Residency.......
Surabaya Rastdenoy . . .
Do
Apr.23-May6
do
Apr.23-May30...
Apr.3-May20....
Jmy8-28
1
1
3
18
4
6
1
1
3
18
4
6
Surakarta Residency. .
do
Pern
May 13-31, 1917: Oases, Id
Departments—
Arequipa
MayKWl
do
4
1
3
7
1
13
17
S
4
At MoUendo.
C^.V... .....
At Callao.
Lambaveone
do
At Chiclayo.
liSSST!;:::;::::::
do
At Salaverry, San Pedrs, and
TJma ,,,.,,
do
TrujlUo. ^' ^
At lima.
Siam:
Bangkok.
Apr.22-Jane30...
Ji5y3-flept. 1
June 3-16
Julyl-Aug. 18....
12
15
1
3
Eo ..:::.:::.;;;::
StnUts Settlements:
^S^.::::;:::::;;:::;::
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Noremberd, 1917
1914
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVERr-OoQtinued.
Beports Becelved ftvm Jwie 30 to Nov. 2, 1917 — ContiniMd.
PLAQUB-ConttaniAd.
Pboe.
Date
Cases.
Deaths.
Union of Sooth Afrioa:
Oipc of (iood Hope SUte—
Cradock
Olcnprcy district
Tcrka 'iKtrict
Qur<»nstown
Onmpo V no t^tato
Winburg district
At sf a:
8. S.Matlana
Aug. 28.
Aug. 13.
May 28.,
June 6..
May 28
July 14-18..
Present.
Do.
At Summcrhili VwrwL
Apr. 16-22. 1917: 1 OHt. Apr. »-
23, 1017: Oases, »; dcAths, IT.
En route for port of London.
SMALLPOX.
Australia:
New South Wales.
Apr. 37-Aaf . 30, 1917t Gtass, 77.
nrewarrina
Apr. 27- June 21...
July 25-28
6
4
13
2
1
4
S
136
4»
1
•
CcssnocJt
Coonabarahrso.
May 25^ July 5
Apr. 27- June 21...
June 23- Aug. 30...
May9
Quambooe
Warren district..
QueeuUand -
Thursday Island Quar-
antine BtatioD.
Braxll:
Bahia
From S.J. St. Albaoa tran Kobe
Tk noQgkopg. Vasmi pr».
»eded to TownsvUle, M-
^. and Bydnay, lii«osii»
Mayfr-JunaJO
July22-Aaf.4....
do
Do
1
81
•1
Rio de Janeiro.
Do
July l-Hept. 15....
June 10-16
Canada:
Manitoba-
WhrnlpAg
Do.."
Aug. 19-fcept. 1....
JHnel»-July7....
June 17-30
NovaBcotIa—
HalUax
Port Uawkesbury
PrsMDtindlstrkaL
Ontario-
Ottawa
July30-Aug.5....
8«pt.30-Oct.20...
May(V-12.
1
3
i
Windsor
Oykm:
Colombo •••
China:
Amor
Apr.2»-Maf 20....
Present sad Id vieteity.
Do.
^;::::::::::;;:::;::::
July 1- Aug. 19....
Antimt... ■.>■..
May 21- June 34...
Aug. 0-12
4
1
5
Do"!
rhannha
May27-June2....
Aug.11-17
BoT.. .:.....:.:
7
nrnnffkliic
May 6- June 23....
Do.
Do.^:. ;; ; 1. ;..
July I-Bepl. 8
Do.
Dakvn
May 1.V June 30...
JulvH-28.
30
6
2
7
8
1
1
4
1
Do
JnlT 1-7. 1917: Pi^rst
Hankow
June 24-30.
Apr. 23- May ......
May 6- June 16....
Aug. .VIS
Harbin
OaChiassaRailMBBy.
llonckc'ns ...,..,.. X
7
Do^.::..:::..::::::::
Manchuria Htation
Apr. 23-29.
May27-June2....
Do.
Mnkilsn
Present.
Do
Julyt^-Sept.8
Do.
Rhon^htl
May21-Julyl
Jaly3-Bept.29....
13
•3
0
Osses torelfB; iisihi among na-
tlvss.
Among CMasn.
On rhmfsit £srtnn By.
Do
Apr. 16-21
May22-July7
Julyao-Ang. 11...
May l-^L
1
36
4
1
1
8
13
Tsinftao
7
1
At another station on railway
Do...:.:.::::;::;:;:::
loass.
Qioscn (Korea):
Cliemulpo.
Ecuador:
Guayaquil
Feb. I-2I.
Mar. I- Apr. 30....
July 1- Aug 31....
tio! ;:::::;;...
Do
■ ■—••■■•y
Digitized by
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1915
NoTember 0,1917
CHOLERA, PLAOUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received frem Jane 30 to Nor. 2, 1917— Continued.
SMALLPOX— amtimied.
P1M0L
Date.
Cases.
Deaths.
Remarks.
A loxand ri* .......... ...-*t-
Apr.SO-Julyl
Jifiy3-29
80
30
80
1
1
0
4
1
Do
Oairo :
Feb. 12-Apr.8....
July30-Aug.5....
May 6-12.
Nantes
Paris
Ocnnany
Mar. 18-Apr. 28. 1917: Oases, 715;
in cities and 32 States and dte*
Berlin
Mar. 18-Apr.28...
do
do
106
16
18
50
20
2
10
1
Bremen
tricts.
Charlottenberg
Hamburg
ixjipiig
do.
do.
Lubc^
do.
do
do
Munich
, \
Stuttgart .
Greece:
Athens
July 25-30
23
75
22
12
8
1
46
18
5
India:
Bombay.. ...•.••..•..
Apr.22-June30...
Julyl-Aug. 11....
Apr.28-May26....
180
48
Do
Calcutta.
Karachi
Apr.22-July4.....
July ^14
27
1
80
3
38
7
Do
MftHras .„...---
Apr.22-June30...
July 1- Aug. 21....
Apr. 15-June80...
July 1-28L
Do
Haneoon........
fto! ::::::;;:::;.:::.
Indo-China:
Province......... .........
F^. lrJ"J» 80, 1917: Ossei, 617J
deaths, 535.
Feb. 1-June30....
do
1,630
136
1,267
6
274
100
33
82
237
36
377
Ciunbodla.
Cochln-Chlna
Kwang-Caiow- Wan. ....
l(flOS. ..
do.
Mar. 1-Apr.30....
Apr. I-SOT
1
30
63
19
12
3
Tonkin
Feb. 1-June30....
Apr. 27-JunelO...
JuJy2-SH>t.»
May21-JuneM...
Julyl2-Aug.2«...
Sept. 9-16
Saigon.. '.
Do.. .;;;;::....::".;.:
^•%^
Do
Jamaica:
Kingston...................
Japan
97 xToymoes ana cuBirvis*
' Kobe..!.. .1.^.11
May27-July22....
May28-Juiie3....
Mayl6-July5
July 26-31
May27-Ju!yL....
Apr. wrnlyl
JiUy2-9
65
177
88
23
16
l^ogasakl
Os^ft ,,
55
Yokkaidrf
Yokohama
1
3
Java:
East Java
Do
Mid-Java
Apr. Wulyl
July 1-22 .
7
Do
West Java
Apr. la-Joly 5, 1917: Cases, 289;
Batsvla.
Apr. 13-July6
Jaq, ]— June 80. ....
30
6
116
1
1
9
Mexico:
Coatepoc
^Do!^.::. :;;:;.;.:;:::::
Aug. 1-U.
Jan. l-Aog. 14. 1916: 118 iltmthi
Jalapa
July 1-13 !..
Mft4S»an
July Il-Auff. 7
Mexico City
June 3-30 -T.....*."
163
142
Do
Aug. 5-8ept. 22....
June 18-84.
Monterey
24
23
1
2
1
Orizaba
Jan. 1-Juno80.. ..
. .. .
Do
July 1-23
VeraCrur
Julyl-^pt. 15....
Aug. 13-18
Mayia-Jnne9....
July^-Sept. 1
Mayl3-June80...
Julyft-Aug.18....
Mar. 1-May81....
6
1
6
0
14
8
,
Netherlands:
Amsterdam
PhiUppine Islands:
Varioloid.
Do
dST
Portugal:
Lfebon
Do
Portnguese East Africa:
Loomico Marques
8
Digitized by
Google
NoTember 9. 1917
1916
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YBLLOW
FEVERr— Continued.
Reports Received from June 30 to Not. 2, 1917— Continued.
SMALLPOX-<Contiimed.
Place.
Date.
Coaes.
Deaths.
Bemarki.
Russia:
Archangel
Mayl-June28....
July2-Aug.28....
July 2-15
66
6
6
643
68
7
23
16
3
4
Do
Moscow ,
Feb. l^June23...
July 2-29
Do
Riga
Mar. Il-June2....
Mar. 1&-24
Jan. 1-Mar. 31, 1917: CMms, 9.
Vladivostok
7
Slam:
Bangkok
June 9-30
Do
July 11-17
6
4
44
11
Spain:
Madrid
Mayl-Junel9....
Apr. l-Juno30....
May l-JuneSO
Malaga
Senile '.
Valencia
June 3-23
5
13
6
1
1
2
2
Do
Julyl-Sept. 15....
Mar. 18-June23...
Juno 24-30
Straits Settlements:
Penang
3
Singapore
Sweden:
Malmo
Apr. 22-28
Stockholm
May 29- June 23...
Juno 2-8
1
Tunisia:
Timis
Turkey in Asia:
Trebixond
Feb. 2S-Apr. 13...
16
Union of South Africa:
Johannesburg
Mar. 12-24
4
3
2
Do
July 1-31
Uruguay:
Montevideo
May 1-31
Venezuela:
Maracalbo
Juno 18-July 8. *..
8
1
Do
July 9-23
TYPHUS FBYBR.
Algeria:
Algiers
June 1-30
6
1
3
1
1
Do
Julyl-Aug.31....
Aug. 12-18
Argentina:
Buenos Aires
Austria-Hungary :
Austria
Oct. 2»-I>eo. 17, 1916: Ctsos, 2,37L
Bohemia
Oct.22-Dec.l7....
do
634
809
47
617
16
243
6
Galicia
Lower Austria
do ,
Moravia
do •.
do
..;.;
Silositt
Styria
do
do
Upper Austria
I Iiingary
Feb. 19-Mar. 2S, 1917: Cwes, l,38L
Budapest
Feb.19-Mar.25....
July 29-Aag. 11 . . .
Sept. 23-29
83
2
BrarJI:
Kio do Janeiro
Canary Islands:
Santa i'vuz de Teneriffe ....
1
China:
Antunz
June25-Julyl....
July9-8ept.23....
June 9-15;
3
15
1
Do
1
Uankow
Do
July 8-14
1
Tientsin
June 17-23
1
4
1
1,648
412
188
1
Tsingtao
May39-Julf 7
Aug. 5-11
Aloxjuidria
Aug.39-Julyl....
Julyl7-Soptl0....
Jan.22-Apr. 8
Mar. 19-2»
478
112
76
Do
Cairo ..•••......
Port Said
Great Britnin:
Cor I;
Junel7-2i
1
33
19
Greece:
Salouiki
May 23-June 30. . .
July 1-Aug. 4
Do
y^-^ 1
1917
NoveiAber9, 1917
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Receiyed from June 30 to Nov. 2, 1917— Continued.
TYPHUS FEVEH— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Japan:
Hakodate
July 22-28
1
4
34
Nagasaki
Juno 11-24
July9-Sept.30....
^. :.::::.::..::..
6
Java:
East Java
May 6-July 1, 1917: Cases, «.
July 9-29, 1917: Cases, 6.
Apr. l-June 24. 1917' Coses 38*
Surabaya
June 25-July 29. . .
4
Mid-Java
Samarane
May5-June 10
July 2-8
14
5
2
deaths, 5. July 9-Aug. 23,
1917: Cases, 13; deaths 1.
Do^:::::;..:::;:.:
West Java
Apr. 13-July 5, 1917: Cases, 147;
deaths, 0. July 6-Aug. 23, 1917
Cases, 82; deaths, 11.
Batavia
Apr. 13-July5....
Julye^Aug. 23....
July 10-16
70
61
6
8
1
1
5
3
Do
Mexico:
Agua«?caHentes
Ccatcpcc
Aug. 1-14
Jalapa
Apr. 1-Junc 30
Do ;
July 1-31
Mexico City
Jiuie3-30.. .
431
1,044
Do.. _::::::::::;::::
July8-Sept.22....
Jan. 1-June30
Oriiaba
6
1
2
Do
July 1-31
Netherlands:
Rotterdam
Juno 0-23
3
11
7
1
11
16
10
138
33
3
5
Do
Julyl5-Sept. 1....
July 8-28
Norway:
Bergen
Portuguese East Africa:
Lourenoo Marqu js
Mar. 1-31
Russia:
Archang 1
Mayl-June28....
July2-Aug.28....
July 2-15.:. ...
2
5
Do
Moscow
Potrograd
Feb. 18-Juno23...
July 2-29
3
Do
Riga
May31-Juno2....
Mar.29-May21...
May 1-31
Jan. 1-31, 1917: 1 case.
Vladivostok
Spain:
Almeria
6
2
Madrid
do
Swilierland:
Basel
June 17-23
July8-Sept.22-...
July2&-8ept.22...
Juno 4-9
1
7
2
2
Do
1
Zurich
Trinidad
Tunisia:
Tunis
June 30- July 6. . . .
1
Union of South Africa:
Oapo of Good Hope State-
East Ixmdon. . . ^
Sept. 10
Present.
YELLOW FEVER.
Ecuador:
Babahoyo .
Do.....
Chobo
Guayaquil.
Do.'!.'.*.*
Mib
Naranjito
Mexico:
Camjpecbo State^
Campeche
Yucatan State—
Mcrlda
Peto
Do
Venetuela:
Core
Feb. 1-28..
Mar. 1-31.,
.do.
Feb. 1-28
Mar. 1-Apr. 30.
Julyl-Aug.31.
Feb. 1-28
Mar. 1-Apr. 30.
July 1-Aug. 31 .
Aug. 19-25
Aug. 8-8ept. 20.
June 23
Julyl-Sept.26..
In person recently arrived firom
Mexico City.
Present Sept. 5.
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PUBLIC HEALTH REPORTS
VOL. 32 NOVEMBER 16, 1917 No. 46
TRINITROTOLUOL.
PRACTICAL POINTS IN ITS SAFE HANDLING.*
By J. W. ScHERESCHEWSKY, ^uTgeoD, United States Public Health Service.
The great reduction in individual efficiency, the lost time, the ill
health, and the sometimes fatal results due to chronic poisoning from
the nitro and amido compounds of benzol and toluol in general, and
trinitrotoluol in particular, are now so well known, and the danger
of the occurrence of cases of such poisoning in the tremendously
developed mimitions industry is so manifest, that there can be little
doubt that attempts will be made by all firms engaged in handling
such poisons to safeguard their workers from chronic poisoning.
The safe handling of trinitrotoluol, however, can not be accom-
plished by the will to prevent poisoning alone. Poisonous com-
pounds like trinitrotoluol can only be handled with safety to the
workers concerned provided strict attention be paid to a considera-
ble number ol details, each of which is perhaps but a small compo-
nent factor in the defense, the integrity of which, nevertheless,
depends upon its unbroken front. This paper, therefore, is an
attempt to summarize the practical means for securing effective pre-
vention of poisoning by trinitrotoluol.
Channels of 'poisoning. — It is well known that trinitrotoluol, like
many of the other nitro and amido coal-tar compounds, is readily
absorbed through tlie skin. The next important avenue of absorp-
tion is the respiratory tract. Trinitrotoluol is absorbed with much
more difficulty thi-ough the mucous membrane of the intestinal tract.
The main channel of excretion is probably the urinary tract, although'
it is possible that a certain amount may also be excreted through
the intestines.
Like all other poisons, there is a minimum toxic dose, which varies
according to the susceptibility of the individual. As long as the
amount absorbed remains beneath these limits symptoms will not be
observed. While it is well-nigh impossible to prevent completely
the absorption of trinitrotoluol whenever this substance is handled,
nevertheless it is quite practicable, by attention to the points pres-
»Rcad before the section on industrial hygiene ol the American Public Health Association, Washington,
D. C, Oct. 18, 1917.
137 (1919)
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November 16. 1917 1920
ently to be discussed, to keep this absorption well below the mini-
mum toxic dose, except, perhaps, in the case of susceptible persons.
The following remarks are confined solely to the processes involTed
in the loading of shells with trinitrotoluol, for the reason that its
manufacture is mainly confined to a few firms, whereas loading proc-
esses are likely to be carried on by any manufacturer possessing the
requisite facilities, which, after all, are rather simple. For this rea-
son the number^ of work»s involved in loading operations is likely
to be very much greater than that concerned in the manufacture of
this substance. Besides this, long contact with the production of
other poisonous nitrated benzol products should have given manu-
facturers of trinitrotoluol the requisite experience to enable them to
handle the manufacture of this substance with safety to the workers
concerned. In addition to this, in the manufacture of trinitrotoluol,
except at the final sieving and packing operations^ the substance is
handled either in closed containers or in a moist condition, imder
which circumstances the risk of poisoning is very greatly reduced.
In loading operations, on the other hand, there is constant oppor-
tunity for nearly everyone connected with such work to become the
subject of chronic poisoning through either the fumes or the dust
of this substance.
Precantions to be Obserred.
If it is desired to reduce the risk of poisoning with trinitrotoluol
to a minimum, attention must be paid to certain details under the
fcdlowing general headings:
1. Planning and construction of workrooms.
(a) Separation of processes,
(b) Conveyor systems.
2. Methods and processes employed.
3. Sanitary precautions on the part of the workers.
4. Hours of labor.
6. Medical supervision.
^ Planning and construction of workrooms, — ^The planning and con-
struction of buildings used for handling trinitrotoluol can either
greatly simplify or compUcate the problem of its safe handling.
There is no doubt that great advantage, so far as both production
and safety to the health are concerned, is derived from correct loca-
tion of buildings in relation to each other, the general principle h&ng
that these should permit continuous routing of the raw materials so
that at no point are there any crosses in the route of the product as
it proceeds from the raw to the finished state. This permits th«
complete segregation of one stage in the process of loading
from another, and prevents the exposure of one set of workers to
hazards derived from a process with which they have nothing to do.
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1921 November 16. 1017
Type of hiildiTigs. — ^The type of buildings in which a dangerous
substance like T. N. T. is handled has also much' to do with the
facility with which sanitary conditions^ may be obtained. All such
buildings should be long, narrow, and of one story. Such construc-
tion lends itself readily to the installation of the conveyor system
and methods of progressive assembly; abundant natural ventilation
is readily furnished because of cross currents of air through opposite
openings. Moreover, monitors in roofs in conjunction with the side
openings will operate more effectively than similar installations in
rooms which are approximately square. Another favorable charac-
teristic of a long and narrow construction, which aids in the main-
tenance of sanitary conditions, is the abundant natural illumination
afforded. .This not only facihtates the work, thus preventing un-
necessary splashing and spills, but a well-lighted condition in a work-
room reveals accumulations of dust and dirt which otherwise lurk
unnoticed.
Separation of processes, — ^A fundamental tenet in all hazardous
processes is that the only persons exposed to the particular hazard
shoidd be the group of workers involved. The long narrow con-
struction of buildings renders the segregation of various processes
easy by the use of cross partitions. With the square building, this
is much more difficult to secure. Such partitions cut off needed
light, the greater length makes tliem expensive to erect, the necessity
for using all the floor area cither renders their erection impracticable,
or if erected, disturbs the routing of the material.
Conveyor systems. — There can be no question that a properly
installed conveyor system greatly facihtates the safe handling of
trinitrotoluol in loading operations, becaiise handling the substance
in the shells is reduced to a minimum. Again, as previously pointed
out, such conveyor systems are much more readily installed in long
narrow buildings than in square buildings.
Methods and processes involved. — There arc t\w) general ways in
which the explosive is introduced into the empty shell. The pow-
dered trinitrotoluol may either be pressed into the shell by power
presses, or poured into the shell in a molten condition.
The former process is used mainly for loading large shells, which of
course are used in much less quantities than small shells, in military
operations. Moreover, presses are installed in heavy concrete com-
partments to guard against the effects of possible explosions. Very
simple precautions are all that are needed to prevent any escape of
dust in handling the powdered trinitrotoluol prior to pressing the
charge.
In the average loading plant, however, we find that the charge is
usually placed in the shell by pouring it in in a molten condition.
Because of the ease with which poisoning may occur when handUng
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NoTeoil)er 16» 1M7 1922
/
melted trinitrotoluol, the following deals especially with the methods
for rendering such l^andling safe.
Precautions in fMiting trinitrotoluol. — ^The melting <^ trinitrotohM^
is carried on, as a general rule, in large iron kettles heated by steam
coils. Such malting kettles should be installed in a separate c(mipari-
ment; provided with abundant natural Ventilation, through oppo»te
openings, a monitor roof, and mechanical exhaust in the ndghborhood
of each kettle. Such kettles should be preferably broad and somewhat
shallow in form, rather than narrow and deep. The kettles should be
covered in, and provided with an exhaust pipe in which a gentle
upward draft is maintained by mechanical means, so that at all times
a slight negative pressure exists in the kettles. This prevents the
escape of trinitrotoluol fumes into the air of the melting i;oom. The
heat should be applied to the lower portion of the kettle rather than
uniformly over its area. This brings about the melting of the charge
from below upward, so that the trinitrotoluol at the top is distinctly
at a lower temperature than that at the bottom. In" this way the
amoimt of fumes which must be gotten hd of by the exhaust is
substantially less. Attention should also be paid to the temperature
maintained in the kettles, so that this is not unneciessarily high. The
application of too great a degree of heat in melting not only increases
the loss by evaporation of valuable material, but also increases
greatly the amoimt of fumes which may be present in the air of ^e
melting room.
In charging the kettles with fr^h trinitrotoluol, attention shoxild
be paid to the prevention of dust. The aperture in the kettle should
be provided with a Up to prevent spilling of the powder. A removable
hopper fitting tightly into the aperture would also assist greatly in
the prevention of unnecessary dust. The installation of permanent
hoppers above each melting kettle, provided with a cut-off, also
merits consideration, as a large quantity of the explosive could be
placed in the hopper at one time, and then gradually added in small
quantities to the melting kettle as needed. In this way tlife exposure
to trinitrotoluol dust would be reduced to a minimum.
Casting. — After the trinitrotoluol has been melted in the kettle,
it is usually drawn off in tubs, in which it cools, while being con-
tinuously agitated until near the point of solidification, whereupon
it is poured into the shells. The purpose of the agitation is to secure
uniform and more rapid cooling of the molted product. Very often
this agitation of the molted trinitrotoluol is carried on by the use
of wooden hand paddles by workers who sit continuously at these
tubs, doing nothing else. Obviously this is extremely hazardous,
as the trinitrotoluol is constantly above the temperature at which
volatilization takes place. Whore this process of hand agitation is
carried on, an attempt is usually made to reduce the risk of poisoning
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1923 November 16, 1017
by the installation of exhaust hoods oyer the tubs. Personal obser-
vations, however, have led to the conclusion that hand agitation of
melted trinitrotoluol can never be made safe; that the only permissi-
ble method is the use of mechanical agitators over hooded tubs.
All workers seen engaged in the hand agitation of melted trinitrotoluol
have presented a uniformly bad appearance.
Pouring in the shells. — ^Two methods are in general use. The first
consists in arranging a large number of shells in racks on the pouring
floor. The pourer takes a considerable quantity of the melted
trinitrotoluol in a spouted container, and walks along the rows of
shells filling each one as he comes to it. This method is inherently
bad. In order to fill an adequate number of shells at one pouring,
the pouring container is large, and when full, necessarily heavy.
This leads to awkwardness and inaccuracy in pouring the charges,
especially in the first shells, thus causing numerous splashes of the
trinitrotoluol on the exterior of the shells, the floor of the casting
room, ^e shell racks, and the person of the pourer. In plants where
this method of pouring is carried out, the writer has seen thick
incrustations of trinitrotoluol on all the localities mentioned, the
overalls of the pourers especially being fairly caked with trinitro-
toluol. Such methods not only greatly increase the risk of poisoning,
but are wasteful of valuable material. Such wasteful methods,
however, spring originally from poor design of buildings, as this is
about the only practicable method in workrooms of square con-
struction.
The only casting method which should be considered is the one in
which the shells are placed in racks on a conveyor and passed before
the pourer, who is stationed at the cooling kettle. There is no
danger in this position to the pourer if the cooling kettle is ade-
quately hooded with exhaust ventilation and provided with a me-
chanical agitator. It is needless to say that the charge in the cooling
kettle should be conveyed by gravity from the melting kettle above,
the opening in the coohng kettle being situated in its lower part,
so as to avoid splashing of trinitrotoluol while the charge is running
in. The proximity of the pourer to the cooling kettle permits the
use of a small pouring ladle. This enables the charge to be accurately
poured into the shell, because of the light weight handled.
Avoiding splashes on exterior of shell. — It is evident that all splash-
ing of the explosive on the exterior of the shell should bo avoided.
Such splashing is not only wasteful of material, but increases the risk
of poisoning in subsequent handling, as naturally all such deposits
must subsequently be scraped off. Such splashing on the exterior
of the shell may be reduced to a minimum by the use of the conveyor
system and a small pouring ladle. As an additional precaution,
however, the adapters, which are screwed into the shell orifice to
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Mof«mber 19, 1917 1924
protect the 8<^ew threads of the shell from being digged witJi melted
trinitrotoluol, and ako to hold the spout throiigh which the charge is
introduced into the interior of the shell, diould be provided "prith a
perforated square of tin or stiff paraffined cardboard, shpped over
the spout to catch any splashes which would otherwise be deposited
on the exterior of the shell. With careful work^it is quite posaibie
to poiu* charges into shells without any splashing of the exterior.
Wherever such methods are used the personal appearance of those
engaged in pouring is ail the evidence that is required to convince
the observer of the superiority of such methods.
Recessing the charge. — ^After casting, the charge is recessed for the
reception of the ''booster cha^e" of a more sensitive explosive,
required for the detonation of trinitrotoluoL The end of the chai^
must also be surfaced. Thk is usually accomplished in special drill
presses. In drilling out the charge, naturally considerable dust is
produced from the boring. There is also danger of a possible
"blowing" of the charge. For this reason the recessing of such
charges should be carried on in completely inclosed compartments,
provided with doors which may be automatically opened and closed,
and with the provision of some holder or jig to hold the shell in the
drill press. When carried on imder such conditions, workers operat-
ting these drilling machines are exposed only to a minimum extent
to any danger of poisoning.
The remainder of the operatioi^ concerned conasts mainly in
blowing out dust remaining after the boring, inspecting the shells,
introducing ''booster charges," capping the shell for shipment, and
painting the exterior when this is required by the specifications.
After casting and recessing the charge the degree to which workers
are exposed to trinitrotoluol poisoning will depend upon the care
with which these processes have been carried out, such subsequent
exposure being due for the most part to scraping off deposits from the
exterior of the shell and cleaning out the screw threads in the nose
or base of the shell, according to its type, from any trinitrotoluol
which may be adherent. The quantities of the poison involved are
natm^ally dependent upon the care which has been employed in the
foregoing operations.
Additional operations which bring the workers in contact with
trinitrotoluol consist in the recovery of trinitrotoluol which adheres
to adapters and casting spouts, and the squares of tin or pasteboard
which may have been used to catch splashes during pouring. Be-
sides this, dust from the floor of workrooms and from borings is
gathered up for recovery. Charges must also be recovered from
shells which have failed to pass the inspection. Such recovery is
simple and may be carried out safely by simple melting operations
in appropriate melting apparatus, in which the general principles
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1925 November 10, 1 917
described in the primary melting of trinitrotoluol are complied
with. Thei^e is no doubt that the recovery of trinitrotoluol from
sweepings, which is usually attended to by ordinary laborers, is
frequently accompanied by poisoning, as s'uch employees are usiftiUy
the least intelligent in the plant and are hkely to be careless. Duq
attention, however, to the loading methods previously described
reduces such need for sweeping to a minimum. Whatever sweeping
is necessary should be done by moist methods, all sweepings being
deposited in fiber or" tin paper-Uned boxes, with close-fitting covers.
The collection of dust from boring machines in tin or fiber boxes
provided with a tight-fitting Ud, which may be closed subsequently,
will also reduce exposure to a minimum. If tin boxes are used
these should be paper lined.
Sanitary precautions on the patt of the worlcers. — ^A Uvoly sense of
the poisonous qualities of trinitrotoluol and the wi^ to prevent
]>oisoning by the requisite cooperation with the management are
necessary on the part of all the workers. This means that all workers
should receive instructions from the plant officials as to the methods
by which trinitrotoluol poisoning may be avoided. These consist
obviously in reducing personal contact to the fumes and dust of
this substance to a minimum. There is no evidence that females
are more susceptible than males, but the yoimg of both sexes are
likely to be highly susceptible. For this reason persons less than
21 years of age should not be employed in processes in which the
worker is brought into contact with trinitrotoluol.
A complete suit of overalls, fitting closely at the neck, wrists,
and ankles, gloves, and a cap covering the hair, should be worn by
all the workers. Men should keep their hair short and bo clean
shaven. The overalls should be provided with drawstrings at the
neck, wrists, and ankles. The wristband of the overalls should be
pulled over the glove gauntlet, and a snug fit secured by the use
of a drawstring. Overalls shoidd be laundered weekly. There
should also be provided change and locker rooms with lockers or
other facilities of such nature that the street and working garments
do not come in contact with each other or with those of others.
The eating of lunches in workrooms and keeping of food in work-
rooms should be rigidly prohibited. Compliance with this rule is
best secured by providing attractive and commodious eating rooms
for the use of the workers.
The workers shoidd be especially instructed concerning the value
of scrupulous bodily and oral cleanUness, as a prevention of trini-
trotoluol poisoning. The hands and face should be thoroughly
washed and the mouth rinsed out before eating, and a full shower
bath taken at the close of the day's work. Proper facilities for this
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Ne¥«mter le, 1017 1926
dKmld be fumidied. T^ie teeth dioiald be bfnshad imcm daiiy mtk
a soft toothbrush and e good defntifirioe.
One of the chief difficulties in Avc»diiig panning s tiw rehictaxios
on the part of workers Us repent to the oompaay physeian
they begin to feel ^ck. This is due to ike relatiT^y high
which are paid to the wY»4^rB who load ammimition and the iMEtuiml
desire to keep on earning these wages as long as thay are able to «taiid
np. Much of this can be done away with by a system of rotalioEi of
jobs, workers being transferred from hasar<b>us to less haaEaitloaa
employment regularly at interrals of two weeks.
Hours cf labor. — ^Except in an emer^ncy no person ei3tgag>ed in *
process in which taimtrotolu<d is handled ehonld work longer thaa
eight hours a day. By thus limiting the time of exposure, the dcinger
of poisoning may be materially reduced. As preyiomdy stated,
workers engaged in hazardous processes should be rotated to leas
hazardous jobs at least <moe in every two weeks, and of tenar if
necessary.
Medical supervision^ — An efficient system of medical superviaioii
xmder the direction of a competent physician must necesearUy be
provided in all plimts engaged in the manufactiu*e and handling of
trinitrotoluol. The physician in charge ^ould be familiar with the
symptoms of poisoning and the precautions for preventing it. He
should ke^ a constant check upon the efficiency of the enf orcemdat
of sanitary precautions and be given the authority to transfer or
to lay off, as may be required, all workers who are showing syn^toiz^
oi poisoning. He should also make frequent rounds of inspection
through the workrooms, noting all workers showing the character^
istic appearance of trinitrotoluol poisoning, and requiring them to
report to the w^rks dispensary for further examination. Careful
records should be kept of all cases of poisoning and their subsequent
treatment.
TYPHOID FEVER SPREAD BY CHRONIC CARRIER&L
A REPORT OF SEVERAL SMALL OUTBREAKS OF WHICH THREE WERE MO^K BORNB.
By Wm. Rotal Stokes, M. D., Chief of Bureau of Bacteriology, Maryland State and Baltimore City,
Departments of Health, end F. W. Hachtix, M. D., Assistant Bactedoloeist^ Baltiner*, ltd..
Department of Health.
In order to emphasize the importance of the tjrphoid earner ia
the distribution of the infection through the bandUng o€ food ive
have thought it might be of interest to add the cases which follow
to the literature of this subject^ and we shall first briefly desmbe a
milk-borne epidemic in which the tyi)hoid bacillus was isolated fkom
the stool of a typhoid carrier on the dairy farm and also from the
milk which produced the outbreak of typhoid ferer.
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1927 Novwnber 1«, 191T '
In 1912, Stokes and Stoner^ obserred 56 cases of typhoid, during!
July, August, September, and October in a town of 2,500 inhabit-
ants, and 50 cases were found on the milk route of one milkman
furnishing 1,500 persons, while the four other milk m^i who served
about 1,000 persons had only 6 cases on their dairy routes. A further
inT6stigiU;ion disclosed the fact that a woman in the dairy, who had
be^i handHng the milk and dispensing it to customers had suffered
from typh^ id fever two years previously. An examination showed
that the feces from this woman contained the typhoid bacillus. A
later study of the milk for the presence of the typhoid bacillus
resulted in ihd isolation of an organism which in all respects re-
s^nbled the typhoid bacillus. The various confirmatory tests con-
sisted of morphology and staining properties, cultural characteristics,
agglutination tests with positive blood and immune typhoid serum,
eom|dem^it fixation tests and bactericidal tests.
During the past few years the departments of health of Baltimore
and ci Maryland have investigated a number of typhoid outbreaks,
which studies ^itailed the examination of specimens from a. number
of people for the detection of carries and resulted in the finding of
several of these.
The first of these outbreaks consisted of a series of 22 cases which
were traceable to milk. Ckmnected with the handling of this milk
was a woman who had had enteric fever about one year previously.
An examination of specimens of her stool and urine demonstrated
the presence of typhoid baciUi in both. No other carriers were de-
tected among the other people employed at this dairy.
Another outbreak occurred in a college with about 600 students,
of whom approximately from 200 to 300 were exposed to the source
of infection, a lunch room that had in its employ a cook who was later
found to be a typhoid carrier. Of those exposed to this source of
infection, 11 developed enteric fever within a period of one montii.
After the discovery and removal of the carrier no other cases oc-
curred.
Another outbreak was traced to a woman 75 years old, who had had^
typhoid fever in September, 1912. Before she entirely recovered
her granddaughter, living in the same home, developed typhoid fever,
and while the latter case was recovering this patient's 2-year old son
developed typhoid fever and later died of this disease. In May,
1913, the older woman's son-in-law contracted typhoid fever and
his daughter developed this disease in the latter part of July, 1916.
A child aged 13 developed typhoid fever in November, 1916, and all
of these three later cases were confirmed by the Widal reaction. In
November, 1916, a boy aged 9 and a married woman who obtained
thdr mUk from the dairy of the original case developed typhoid fever.
1 Jour. Amer. Med. Assoc., Pt. 1, Vol. LXI, Sept. 27, 1913, p. lOW.
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November 16, 1917 1928
Upon further investigation it was found that her son-in-law and his
three children had been drinking milk which had been obtained from
the dairy of the mother-in-law, being the original case.
In analyzing the above circumstances it wo^uld seem that the case
of the granddaughter and a great-grandson of the original case
might have been a house putbreak, although they very probably
drank milk which was handled by the original case. The other cas^
would seem to be due to milk furnished by the original case, since an
examination of the stools made five years after the attack of typhoid
showed the presence of numeroiis typhoid bacilli. .
In two other house outbreaks we foimd that there had been three
cases of typhoid fever within a period of three years in one family,
and upon examining the stool of the father of the household, who had
had typhoid fever five years previously, we foimd the typhoid ba-
cillus. In another case in which several members of the household
had developed typhoid fever within a period of three years we found
the typhoid bacillus in the stool of one of several sisters. Neither
of these typhoid carriers cooked or handled food as far as we could
learn, and it is difficult to trace out the exact method of causation of
these cases.
• The next investigation was that of four cases of enteric fever occur-
ring in one family over a period of several months. This resulted in
the discovery that the servant was a carrier, B. typhosus being iso-
lated from his urine. In the course of the investigation specimens
from the drainpipes of several refrigerators were sent to the depart-
ment, and from one of these an organism which culturally resembles
the typhoid bacillus was isolated. This baciUus is also agglutinated
by the blood of typhoid cases and by typhoid immune serum. Fur-
ther studies of this organism are being made and will be reported later
by one of the authors. It is interesting to note that this organism
was isolated from the material from the waste pipe of the pantry
refrigerator, which could readily have become contaminated by the
servant. In addition to the above-mentioned cases another was
traceable to this same man. This was the servant's grandson, who
Uved \^ith his grandfather.
Another famiUal outbreak studied consisted in all of three cases
out of a family of six persons. The first was the mother of the family,
followed four months after her recovery by her husband and four
years later by her daughter. Feces and urine of both father and
mother were examined in the course of the investigation and the
stool of the latter was found to contain typhoid bacilli.
In another family four cases of enteric fever occurred over a period
of four or five years. During the investigation suspicion was directed
toward the cook by the following facts: She had lived with these
people at the time of the first two cases, but later on left them for a
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1929 NoTember 16, 1917
period of two or three yeare, during which time no case developed in
this household. Almost immediately upon her return to the faoiily
in capacity of cook the other two cases developed. The examination
of her urine and feces resulted in ihe detection of B. typhosus in the
latter. This woman denied having had typhoid, but has had several
severe attacks of biliary colic.
Conclusion.
We boUeve that whenever possible domestics in4)rivate service and
particularly those handling food in large public establishments should
not be admitted to such positions until a careful inquiry has been
made into their previous medical history as to a possible former attack
of typhoid fever. If there is the slightest history of any continued
fever resembling typhoid fever the stools and urine should be ex-
-^amined for the typhoid bacillus, and if possible a second examination
should be made at the expiration of .a week.
These methods are not only important when applied to domestic
and public cooks, waiters, and other handlers of food or food utensils,
but should also be applied upon the dairy farm, in the city dairies, in
bakeries and bake shops, confectionery stores, green groceries, markets,
and other pIacQ^ where food is handled.
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PREVALENCE OF DISEASE.
No heaWi department, Stale or locals can effectively prevent or control disease without
hnou ledge of when, where , and under what conditions cases are occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California Report for the Weelc Ended Nov. 10, 1917.
The California State Board of Health reported 'concerning the
prevalence of communicable diseases in California for the week
ended November 10, 1917, as follows: Two cases of anthrax in man
were notified, one at Stockton and one at San Jose. A case of
poliomyehtis was notified at Berkeley and one at San Mateo City.
One case of leprosy and one case of smallpox were reported in San
Francisco. Diphtheria, measles, scarlet fever, and whooping cough
show reductions in the numbers of cases reported. Chicken pox was
more prevalent than during the preceding week. There was no
change in the situation as regards typhoid fever.
The details of notifiable disease cases reported during the week
ended November 3, 1917, are as follows :
Anthrax
Chicken pox
Diphtheria
Dysentery
Erysipelas
German meaelas
Gonococcus infection.
Leprosy
Malaria
Mea^^les. .'
Mumps
Cases.
1
65
78
2
4
8
67
1
22
51
79
Pneumonia
Poliomyelitis
Scarlet fever. . . .
Smallpox
Syphilis * .
Tetanus
Trachoma
Tuberculosis. . . ,
Typhoid fever . . .
Whooping cough .
Ctsts.
35
1
79
8
44
2
2
106
28
Indiana Report for the Week Ended November 10, 1917.
The State Board of Health of Indiana reported concerning the
prevalence of commimicable diseases in Indiana for the week ended
November 10, 1917, as follows: A scarlet-fever epidemic occurred at-
Athens, Fulton County. One case of poliomyelitis was reported at
(1930)
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MovendMrie, 1917
Wabash. D^htkoia 6i»deiiUGS were reported at Betiilehem, Clark
County, and in Noble County. Smallpox was notified at Princeton
and Portland.
Masmchosetto Report for the Week Ekided November 10, 1917.
Collaborating Epidemiologist Kelley reported concerning the
prevalence of commimrcabl^ diseases in Massachusetts for the week
ended November 10, 1917, as follows: Five cases of diphtheria were
notified at Templeton; 6 cases of scarlet fever at Hopkinton; ^9
cases of diphtheria at Amesbury; and 1 case of actinomycosis at
Westwood.
ANTHRAX.
LovifliaBft — ChauTiiL
On November 2, 1917, a case of anthrax was reported in Chauvin,
Terrebonne Parish, La.
Massachusetts Report for October, 1917.
During the month of October, 1917, 8 cases of anthrax were
reported in the State of Massachusetts.
City Report for Week Ended Oct. 27, 1917.
During the week ended October 27, 1917, one fatal case of anthrax
was reported at Milwaukee, Wis.
CEREBROSPINAL MENINGITIS.
Maasachnsetts.
Durinj? the week ended November 10, 1917, new cases of cerebro-
spinal meningitis were notified in Massachusotts as follows: Bos-
ton, 2; Brookline (town), 1; Wilbrabam (town), 1; Fall Ri^er, 3;
Springfield, 1.
State Reports for Septembifr and October, 1917.
Place.
Now
cases
reported.
FlM^
New
cases
reported.
Massachusetts (Oct. 1-31):
Bristol County—
1
1
1
1
Suffolk County—
Doston
Fall! Ivor
Chelsea
Franklin County—
Holyoke
Worcester County—
^^'orceste^
Middlesex County—
Ayflr (Camp I)6vons)
Total
11
Cambridec ...
Oregon (Sept. 1-30):
Clatsop County
ifflen .
/
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NoTember 16, 1917
1932
CEREBROSPINAL MENINGITIS-Continued.
City Reports for Week Ended Oct 27, 1917.
Place.
Cases.
Deaths.
Place.
Coses.
Deaths.
Akron, Ohio
1
1
2
5
Minneapolis, Minn.....
1
4
3
Altoona, Pa
NewYork, N. Y
s
Boston, Mass
i
5
1
2
Chicago, 111
Pittsburgh, l^a
1
Dayton, Ohio
Plaiufield/N. J
a
1
Detroit, Mich
2
1
1
1
Providence, R. I.*
St, l/oui'*. Mo............
Fall River. Mass
i
Hartford , Conn
2
2
Worcester, Mass
1
Milwaukee, Wis
DIPHTHERIA.
District of Columbia.
Cases of diphtheria have been notified in the District of Columbia
as follows :
October 21 to 27 35
October 28 to November 3 M
November 4 to 10 .^ 85
November 11 to 13 25
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 1938.
ERYSIPELAS.
City Reports for Weeic Ended Oct 27, 1917.
Place. .
Ann Arbor, Mich..
Baltimore, Md
Birmingham, Ala.
Chicago, 111
Cincimiati, Ohio...
Cleveland. Ohio...
Denver, Colo
Flint, Mich
Ilarrisburg, Pa
Kansas City. Mo..
Lancaster, Pa
Cases.
Deaths.
i\
'A
1
1
Place.
Los Angeles, Cal
Milwaukee, Wis....
Newark, N. J
Newton, Mass
NewYork, N.Y...
Omaha, Nebr
Philadelphia, Pa...
Pittsburgh, Pa
St. Lotiis, Mo
San Francisco. Cal..
Schenectady, N. Y.
Cases.
Deaths.
LEPROSY.
City Report for Week Ended Oct. 27, 1917.
During the week ended October 27, 1917, one case of leprosy was
reported in San Francisco, Cal.
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1933
MALARIA.
Massachusetts Report for October, 1917.
November 16, 1917
Place.
New cases
reported.
Plaee.
Now cases
reported.
Ifassadiaaetts:
Berksliire Ckmnty—
Pittsfleld
1
1
3
1
Massachuaet ts— Continued.
Worcester C-ounty—
Douglas (town)
1
Essex County—
Marblehead (town)
Total
7
Suffolk County-
Boston
Chelsea
Qty Reports for Week Ended Oct 27, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Blrmlnph^Tn, Ala . . ^
5
5
1
New York, N. Y
2
IfemDms. Tenn
"2
Philadelphia, Pa
1
1
Newark, N.J
Rkhmond, Va
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1938.
PELLAGRA.
State Reports for October, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
District of Columbia
1
Massachusetts— Continued.
Worcester County-
Worcester State Hospital
Total
Massachusetts:
Middlesex County-
Lowell
1
1
1
1
4
Tewksbury State Inflrmary
SnfloUc County-
Boston
City Reports for Week Ended Oct 27, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Birmingham, Ala.
Gharieston. 8. C...
Chicago, 111
Fort Worth, Tex..
Los Angeles, CaL..
Memphis, Tenn...
MobUe/AU
Nashville, Tenn
New York. N.Y
Roanoke, Va
Troy, N.Y
Wilmington, N. C
Winston-Salem, N. C.
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November 16, 1917
1934
PNEUMONIA.
City Reports for Week Ended Oct. 27, 1917.
Place.
Cases.
D^ths.
Place.
c^
DeaUis.
Allento^wn, Pa
120
32
KftlBTPftfoo, Mich ...
1
2
3
1
9
1
31
1
1
63
. 25
1
12
1
8
1
2
3
1
1
1
Atlantic Citv. N. J . .. .
TTf^Tis^s City. Mo
Baltimore, Md
12
2
18
Lincoln, Nebr
" 1
Binghamtbn, N. Y
Lorain, Ohio
Bostrai, Mass
Los Angles, Cad.
Brockton, Mass
Njwhrilif! T*i»nn ..............
Butler, Pa
Newark, N. J
Cambridge, Mass
1
2
69
31
3
29
2
Ndwburyport, Mass
Chelsea, Mass
'Newport, Ky
Chicago, HI
Philadelphia, Pa
»
Cleveknd, Ohio
Pittsburgh, Pa
s
Dayton, Ohio
Pontiac, Mich
Detroit, Mich
Rochester, N. Y
Duluth, Minn
San Diego, Cal
Fall River, Mass
San Francisco, Cal
Fitchburg, Mass
2
2
Schenectady, N. Y
Flint, Mich
Somerville, Mass
Grand Rapids, Mich
Springfield, Mass
Hagerstown, Md
Steelton, Pa
JaoKSon, Mich
2
Worcester, Mass
POUOMYEUnS aNFANTILE PARALYSIS).
State Reports for September and October, 1917.
Place.
New cases
reported.
Place.
New rases
reported.
District of Columbia (Oct. 1-31 )
2
Oregon (Sept. 1-30):
Marion County
1
Massachusetts (Oct. 1-31):
Bristol County-
Fall Liver
1
Multnomah County-
Port land
3
Total
Essex Covmty —
3
Washington (Sept. 1-30):
Chelan County
Ilaverliill
Hampdou County-
Springfield
1
( trant County
I
Middlesex County—
Ix)well
Orays Harbor County—
Aberdeen
I
Stoneham (town)
King Coimly
2
Norfolk County —
issaquah
1
WcUcslcy (town).
Okanogan County
4
Plymouth Ck)unty—
Abington (town)
Whatcom County —
BelUngham
3
Suffolk County —
Whitman "cQixniy
1
Chelsea
11
Total
Worcester County —
14
Hopedale (town)
Total
City Reports for Week Ended Oct. 27, 1917.
Place.
Cases.
Deaths. '
1
Place.
Cases.
Deaths.
Altoona, Pa ,
1
19
New York, N. Y
1
Chicago, III
10 1
Philadelphia, Pa
1
East Orange, N. J
Pittsburgh, Fa
1
1
1
1
3
1
Fall River, Mass
Richmond, Va
Los Angeles, Cal
ij
Saginaw, Mich
Manchester, N. H
Seattle, Wash
Milwaukee, Wis
Springtield, Mass
1
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RABIES IN MAN.
City Reports for Week Ended Oct 27, 1917.
During the week ended October 27, 1917, two cases of rabies in
man, with two deaths, were reported in Kansas City, Mo.; one fatc^l
case was reported in Pittsburgh, Pa.; and a fatal case in Milwaukee,
Wis.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1938.
SMALLPOX.
Indiana — ^Fort Wayne — Outbreak.
There is a sharp outbreak of smallpox of the mild type at Fort
Wayne, Ind. During the ten weeks ended November 10 there were
166 cases reported by weeks as follows: 2, 6, 5, 5, 29, 13, no report,
34, 42, 30.
Maine — Gardiner.
On November 6, 1917, an outbreak of smallpox of the mild type
was reported from Gardiner, Me.
Michigan— Detroit— Ontbr^.
At Detroit there have been 105 cases of smallpox of the mild type
Reported during the nine weeks ended November 10. These were
reported by weeks as follows: 1, 8, 8, 5, 14, 14, 6, 17, 32.
Nebraska — Omaha — Outbreak.
A few weeks ago there was a distinct outbreak of the mild type of
smallpox in Omaha. Then the disease seemed to be under control
for a time. It has again increased in prevalence. During the nine
weeks ended November 10 there were 115 cases. These were reported
by weeks as follows: 2, 32, 1, 5, 3, 0, 10, 7, 55.
Washington Report for September, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
WashlQgtoo:
"^l^'Z
3
2
2
7
1
Washington— Continued.
YaKuna County
4
4
Mabton
La wis Cotnitv
Total
Pend Oreille County
23
T&oooia
138
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November 16, 1917
1936
SMALLPOX--Coiitinued.
City Reports for Week Ended Oct 27, 1917.
Plaee.
Caees.
Deaths.
Plaoe.
DMtki.
Akron, Ohio
Ann Arbor, Mich
Butte, Mont
Chicago, m
Cincinnati, Ohio
Heveland. Ohio
Dayton, Ohio
Detroit, Mich
Flint. Mich
OalesburfE, ni
nrand Rapids, Mich,
Indianapolis, Ind
Kansas rity, Kans...
Kansas nty. Mo
LaCrosM.Wia
Leavenworth, Kans...
Lima, Ohio
MilA'auVee. Wis
Minneapoln, Minn. . . .
Nla-ara Falls, N.Y...
Oklahoma Ity^Okla.
Omaha, Nebr
St. Louis, Mo
Salt Lai e it v, Utah.
Sprhi?feld,rll
SprintrPeld , Ohio
Terre Haute, Ind
Toledo, Ohii
Wichita. Kans
TETANUS,
aty Reports for Week Ended Oct 27, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Dei^ks.
Cincinnati, Ohio
1
1
1
Memphis, Temi
4
1
Detroit, Mich
Mobile,Ala
TRACHOMA.
Arizona — Nc^lea
Seven hundred and seventy-three pupils in the public schools of
Nogales, Ariz., were recently examined and 20 cases of trachoma
were found. Similar examinations were made in 1915 and 1916.
The results are shown in the following table:
School year beginning-
Pupils ex-
amined.
Tra'rhoma
cases.
Per
cent.
September, 191.5
September, 1916
September, 1917
534
617
773
5.05
3.34
2.50
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 1938.
TYPHOID FEVER.
Mississippi — Greenwood.
An outbreak of typhoid fever has been reported at Greenwood,
Miss.
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1937
TYPHOID FEVER— ContinuecL
State Reports for September and October, 1917.
Noyember 16, 1017
Place.
District of Columbia (Oct. 1-31)
Massachusetts (Oct. 1-31):
Barnstable CooDty—
Falmouth (town)
Berkshire County-
Adams (town)
Rftremont (town)
North Adams
Bristol County—
Acushnet (town)
A ttleboro
Fall River
New Bedford
Rehoboth (town)
Somerset (town)
Taunton
Dukes County—
Tisbury (town)
Essex County—
Andover (town) . . . . ^
Beverly
Gloucester
Groveland (town)
Lawrence
Lynn
Rewley (town )
Franklin County—
Bueklond ( town)
Greenfield ( town)
Montague (town)
Hampden County—
Agawam (town)
Ludlow (town)
Palmer (town)
Springfield. »
Westfleld (town)
Hampshire County—
Enfleld(town)
Middlesex County-
Arlington (town)
Ashland (town)
Ayer (town)
Ayer (Cnmp Devens)
Cambridge
Everett
Hudson (town)
Jx>well
Maiden
Marlboro
Medford
Melrose
Natick(town)
Reading (town)
Somerville
Tewksbury State Infirmary.
Waltham
Watertown (town)
Westford ( town)
Winchester (town)
Wobum
Norfolk County—
Dedham(town)
Quincy
Walpole (town)
Wellesley (town)
Plymouth County-
Brockton
Wareham (town)
Suflolk County-
Boston
Chelsea
Revere
Worcester County—
Athol(town)
Auburn (town)
New cases
reported.
54
1
1
3
1
3
8
1
1
I
1
2
1
1
10
1
1
1
1
1 I
1
3
1
1 :
4
2
1 •
5
1
2
1
2
38
1
1 )
2
1
3
1
1 I
1
1
I
2!
2 I
1 i
1 »
Place.
Massachusetts— Con tinued .
Worcester County— Conttoued.
Fitohburg
Graftpn (town)
Hubbardston (town)
Uxbridge (town)
Webster (town)
West borough (town)
West Boylston (town)
Worcester
Total .^
Oregon (Sept. 1-30):
Clarkamas County
Clatsop County
Douglas County
Klamath County
Multnomah County
Portland
Yamhill County
Total
Washington (Sept. 1-30):
Adams County—
Lind
Benton County
Chelan County
Cashmere
Chelan
Vonatchee
Clark County
Columbia Coimty—
Dayton
Cowlitz Countv
Douglas County
Bridgeport
Waterville
Franklin County—
Connell
Grant County—
Wilson Creek
Grays Harbor County-
Aberdeen
KingCountv
Issoquan
Seattle
Kittitas County
Ixswls County
Otanogan County
Brewster
C>onconu lly
Okanogan
Pacific Count V ,
Ravipona
Pierce County—
Tacoma
Skagit County
Mount Vcmon
Spokane County-
Spokane
Stevens County
Colville
Walki Walla County—
Wal tsburg
Walla Wdla
\\liatcom County
Bellin^iam;
Whitman County—
Edicott
Yakima County
North Yakima
Total
New cases
reported.
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Jfovember 16, 191T
1938
TYPHOID FEVER-Contlnned.
aty Reports for Week Ended Oct 27, 1917.
PlMQL
Alnron, Ohio
Alameda, CaL
Allentown, Pa
Alton, 111
Ann Arbor, Mich
AtlanticClty, N. J...
Baltimore, Md
Bellingi^m, Wash...
Birmingham, Ala. .. . .
Boston, Mass
Brockton, Biass
Butte, Mont
Charleston, S. C
Chicago. Ill
Cincinnati, Ohio
Cleveland, Ohio
Coffey villo, Kans
Columbus, Ohio
Danville, 111
Dayton, Ohio
Denver, Colo
Detroit, Mich.
Duluth, Minn
EastCMcago, Ind....
El Easo,Tox
Erie, Pa
Fall River, Mass
Fitchburg. Mass
Flint, Mich
Fort Worth, Tex
Oalesburg, 111
Galveston, Tex
Grand Rapids, Mich.
Hagerstown, Md
Harrisburg. Pa
Hartford, Conn
Indianapolis, Ind
Jackson. Mich ,
Jersey Cfity, N.J
Johnstown, Pa
Kansas City, Kans . . .
Kansas City. Mo
Knoxville, Tenn
Kokomo, Ind ,
Lacrosse, Wis
Lawrence, Mass
Lexington, Ky ,
Lima, Ohio
Los Angeles, Cal
Lowell, Mass
MclCeosport, Pa
Melrose, Mass
Memphis, Tenn
Milwaukee, Wis
Caaea. DoaUis.
Pboe.
HiniMaDolis, Mism
Nashville, Tenn
Newark, N.J
New Bedford, Mass
New Britain, Conn
Newcastle, Pa ,
New Hav«n, Conn.
New Orleans
New York, N.Y ,
Niagara Falls, N.Y....
Oakland, Cal
Oklahoma aty, Okla..
Orange, N. J
Passadena, Cal
Passaic, N.J
Pawtucket, R. I
Perth Amboy, N. J
Philadelpliia.Pa
Pittsburgh, Pa
Portland, Me
Portland, Oreg
Portsmouth, N. H
Pro\idence, R. I
yu{hcy,lll
Richmond, Va
Roanoke, Va
Rochester, N. Y
Rutland, Vt
Sacramento, Cal
Saginaw, Mich
St Joseph, Mo
St. Louis, Mo .'.
Salt Lake City, Utah..
San Diego, Cal
San Francisco, Cal
Schenectady. N. Y
Seattle, Wash
South 1 Jcnd, Ind
Springfield, 111
Springfield, Mass
Springfield, Ohio
Superior, Wis
Tcrrc Haute, Ind
Toledo, Ohio
Trenton, N. J
Troy, NY
Wiishlngton, D. C
Wntertoun, N. Y
Wheeling, W. Va
Wici.ita, Kans
WilliuTTsport, Pa
WiiLston-Salem, N. C.
Worcester, Mass
Zanes ville, Oliio
^!4t^.jjL
Dealhi,
TYPHUS FEVER.
City Report for Week Ended Oct. 27, 1917.
During the week ended October 27, 1917, 2 cases of typhus fever
were reported in New York City.
DIPHTHERIA. MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
State Reports for September and October, 1917.
Cases reported.
State.
Cases reported.
state.
Diph-
theria.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
District of Colum-
bia (Oct. 1-31)....
Massachusetts (Oct.
1-31)
35V
1,153
34
589
61
441
Oregon (Sept. 1-30).
Washington (Sept.
1-30;
16
25
6
19
25
58
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November 16, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
«
aty Reports for Week Ended Oct. 27, 1917.
Fopula-
tion fti of
July l,19ie
by U S.
Ceiutw
Bureau).
ToteJ
deaths
from
&1)
t&iises.
Dfplithortft.;
VeasJi^
Scarlet
fever.
Tuber-
culoala.
City,
1
1
i
II
1
1
1
1
OTcr 500.000 lubabitatlls:
Baltimore, Md
589,021
756,476
2,497,722
674,073
571,784
503,812
5,602,841
1,709,518
579,090
757,309
410,476
306,345
436,535
363,454
408,891
371,747
463,516
348,639
363,980
214,878
260,800
271,708
297,847
295,463
2.S1,960
256,417
181,762
121,579
112,981
106,233
127,22*
12V, 366
104,. -362
US 291
110,900
100.. 560
113,245
102,425
14*<,995
117,057
1 IX, 158
149, 6S5
198,604
16'),470
109,381
156,687
117,399
105,942
IS'), 624
112,770
191,554
lll,.'H-3
163,314
85,625
63,505
.W, 659
57,«k>0
69,.sy3
57, iVy^
53,973
67, 449
60, 852
60,731
182
203
642
185
186
"i,"24i'
456
173
187
109
72
81
87'
144
116
58
117
62
50
4i'
58
64
59
28
4i*
29
31
27
40
29
29
28
63
35
21
is"
44
22
47
12
3S
46
ho'
35
42
is"
ii'
25
ii
24
22
93
276
60
114
14
248
82
47
58
20
16
16
30
30
23
16
4
35
-5
13
59
9
2
24
11
9
5
6
3
2
9
1
8
11
8
6
1
17
6
* *3'
34
4
10
2
18
7
8
3
*i"
2
......
5
34
29
2
8
1
96
18
10
8
6
11
8
3
15
■ "2*
■ "3*
'"4'
10
26
141
11
31
14
78
22
13
36
3
6
28
3
18
4
4
13
13
28
3
0
4
7
6
11
"3*
1
1
......
44
58
411
22
30
38
238
99
18
29
15
26
15
28
Boston, Mass
16
ChicMo, 111
64
Cleveland, Ohio
Detroit, Mich
16
Los Anfoles, Cal
16
New York, U. Y
133
Philadelphia. Pa
45
PittsboriEh, f*a
6
St.Toiiis.Mo
10
From 300,000 to 500,000 inhabit-
ants:
12
Jersey aty, N. J
10
MilwauVcc, Wis
6
Minneapolis, Minn
NewarV' N.'j
1
37
31
31
15
21
9
14
25
San Francisco, Cal
2
'■*3*
13
2
4
2
4
1
2
14
Seattle, Wash
6
Washington, D. C
From 200,000 to 300,000 inhabit-
ants:
Columbus, Ohio
14
6
Denver, Colo
10
Indianapolis, Ind
'i*
......
6
2
7
1
10
12
0
8
5
4
10
Kansas City, Mo
Portland, Oreg
1
Providence. R. I
1
2
1
2
10
13
1
5
Rochester, N. Y
From 100,000 to 200,000 inhabit-
ants:
nirmingham, Ala
4
2
Bridgeport Conn
3
Cambridge , Mass. ..... '. ...
......
4
8
2
2
3
1
3
4
3
4
Camden, N.J
Dayton, Ohio
2
Fall River. Mass
1
4
Fort Worth, Tox . *
1
3
. . . .,! !
Grand Rapids, Mich
Hardord, conn
. . . .
5
9
2
4
4
17
5
7
6
4
3
Lawrence, Mass
5
Lowell, ^iass ;
I
5
5
1
Lynn. Mass
""2
1
5
3
4 1
2
li^mphis, Tenn
0
Nashville. Tcnn
1
New Bedford, Mass
4
New Haven, Conn
0
Jl::::::'' ?i::::::
3
Oakland, Cal
2
Omaha, Nebr
\
13
20
G
10
8
23
16
5
7
1
2
......
1 • 1 2
2
Reading, Pa
1
1
t
2
Richmond, Va
' - ...
8
1
4
Salt Lake Cit v, Utah
' i"
16 i
7
12
20
1
5
Sprlngflcld, Mass
7
3
4
Syracuse. N. Y
2
Titcoma, Wash
1
Toledo, Ohio
""2
3 '
6
Trenton, N.J
1
3
2
1
3
6
2
3
1
Worcester, Mass
From 50,000 to 100,000 inhabit-
ants:
Akron, Ohio
1
3
2
7
Allentown,Pa.
1
Altoona,Pa...;
AtlanticCity.N. J
1
2
2
1
1
5
2
1
Bayonne,N. J
Berkeley, Cal
2
9
1
1 1
Ringhamtftn, N. Y
7
1
1
6
1
1 , 1
3
Brockton, Mass
1
Canton, Ohio
1
G '
Charleston, 8. C
1
1;:::::':::::.
1
1 3
Digitized by
Google
Korember 16, 19ir
1940
DIPHTHERIA, MBASLBS, SCARLET FEVER, AND TUBERCULOSIS—
Continiied. ^
City Reports for Week Ewled Oct. 27, 1917— Contiiiued.
city.
Populft-
tion as of
July 1.1916
(estimatod
by U. 8.
Census
Borcao).
Total
dMths
from
all
Diphtheria.
llMiles.
I
Scarlet
lever.
Tuber-
From^^ to 100,000 inhabit-
anto-^ntlno^d.
Covinrton. Ky
Dututh, Ifinn
El Paso. Tex
Erie. Pa
EransviDe, Ind
FUnt Mich
Harrtsburx, Pa
Heboken.N.J
Johnstown. Pa
KansasCitT. Kans
Lancaster. I'a
Maiden, kbsi
Manchester.N. H
MoWle.Ahi
New Britain. Conn
NorfoU.Va
Oklahoma aty.Okla
Pasaalc.N.J
Pawtucket. R. I
Porthmd. Me
Rockford.Ill !
Sacramento. Cal
Saeinaw. Mich
St. Joseph, Mo
flan Pie o.C«l
Schene-tady, N. Y
Sioux (Mtv, Iowa
SomerviUf, Mass
South Hend.lnd
Sprln-rneld.IlI
Rprlm^flold . < >hio
Terra Haute, Ind
Trov.N. Y
WichitB Kans
WIIVo?-n.irrc. Pa
From 25,0 O to .vi.oooinhaWtants:
Alamo ia.Cal
Auburn N. Y
Austin, Tex
Bro«)V lin^. Mass
Uullcr Pa
BiUtr Mont
('hpho.\ Mass
due ptM?. Ma"t3
riiTtvrhnd, Md
Danville. Ill
I>avpnporl. Iowa
I>uburjut» towa
Ka'»trh«''nro, Ind
I'nst «)nin.-\\ N. J
Klin, m
F.ven»tt M-\*«
Iv.onlt .\ I !i
I'ilrlil'iir ', ^1 t.^s
(Jilvc'kt* n Tox
t.n'^'n liav, .. ts
If..'rr^l ) .n. Md
ir.i .^! ,11. M.i-y
Im n.Mi.-h
K.l.ir I 'H) Mirh
K.Tl ^t I. '. •
kuo\ \\v.'l"in
I a < r t'-^*, .» t*
I.<""i 1 I »n. Kv I
Lira ). • '111 1
I.l»ir )ln, Nr'tr i
I-« t'/ Ilciih, « nl ;
I.itram, • 'Un '
I \ n. lihuTt, Va t
Mi-lwon. u IS I
57,144
M.495
83.7(15
75.196
76,078
54,772
72,015
77,214
68,529
99,437
90,853
51,155
7g.2F3
58.221
53,794
89,612
93,943
71.744
S*,411
63.867
55.185
66,895
5^.642
85.236
53,330
90.519
57,078
67,039
68,946
61,120
51. MO
66.(*^3
n,9l6
70,722
76,776
27.732
S7,3*<5
3I,«14
32.7o0
27,fi32
43. 425
46.192
2<»,319
2rt.n74
J2,'i6l
4**.''ll
3'). ^73
2H.7'3
42 I'.s
2H. -.1 -i
3V..r{
3*), l^'i
3s.
31.
4t,
27.
3*.,
32.
•♦V4
HO
30, t^
V
9
4 ,
4
S
10
12
n
6
21
8
10
I
12
1 ..
12
4
2
4
2
1
S
S
a
12
"3*
25
13
n
3'.
6
14
1 f.
il:
:l.
;r II.
Digitized by
Google
1941
November 16, lOlT
Diphtheria, measles, scarlet fever, and tuberculosis^
Continued.
City Reports for Week Ended Oct. 27, 1917— Continued.
Popula-
tion as of
July 1,1016
(estimated
bv U. S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
1
1
2
1
1
1
From 35,000 to 50,000 Inhabit-
ants-Continued.
McKeesport, Pa
47,521
28.234
2ft, 318
27.327
29,fl03
41,133
31,927
43.715
37,353
31,401
31,404
33,080
46,450
41.185
38.629
39,651
36,798
3><,136
46,486
43,284
28.026
27.445
46.226
36.283
30,570
29.894
43. f39
43.377
33.S09
29.892
SLIS-S
30,Wi3
22.874
15.010
2l.as5
15.791
> 13.075
17.548
22,669
24,276
16,950
23. 5.39
20.930
U9,3<13
15. 395
» 14.610
17. Ho
13.2S4
23.126
15. 243
2»). OS.")
'22.019
19.926
Zi.SOo
17.524
11,066
12.067
14,831
20,193
15. 5 IS
23,22S
15.9ti9
1
2
, 7
5
10
2
1
f
1
Med ford. Mass
i
1
2
2
2
Montclaff,N. J
......
Nashua.N.H
Newburdi,N. Y
2
1
29
2 1 1
New Castle, Pa
2
'
Newport , Ky
1
6
9
6
7
9
»?
\
A
If
4
2
I
1
"'i'
1
2
1
!
Newton, Mass
1
1
Niagara Falls. N. Y
1
.i !
Norristown, l^a
~i
Opden,Utah
1
! 8
1 2
1
1
Oranee, N. J
2
1
2
Pasadena , Cal
(
Perth Amboy, N. J
Pittsfield, Mass
2
1
1
2
3
ji--i
Portsmouth, Va
3
1
,
Quincv,Ill
'
4 ' I
(iulncy, Mass
1
1
1
1
Racine, Wis
1
2
Rcanokc, Va
I
2
2
...
! 2-
Rock Island, ni
1
Steubenville, Ohio
1
....^......
Superior, Wis !
:;::::::;:::
' ?
Taunton , Mtxs^
0
Waltham, Mass
"
Watertown, N. Y
1 1 1 1 < 2
West Hoboken, N. J
Wheelins, W. Va
3
• Yi::::::
1
K
: 1 I: i
Williamsport, Pa
3
1
: ::i....
Wilmington, N. C
14
8
4
5
4
6
5
1
. i..
1
1
Winston-Salem, N. C
2
1
2
2
6
:::"::i "i"
Zanesville. Ohb
From 10,000 to 25,000 inhabitants:
Alton, 111
Ann Arbor.Mich
j 2
1. .'
1
1
1
1 2
2
1
Braddock,Pa
1
Cairo, 111
t
t
2
Clinton, Mass
'
Co<TeyviUe. Kans
2
3
t
Concord, N. H
; 2
1
M
Galesburp , 111
I
Harrison, N.J
■
<>
1 1
Keamy.N.J
Kokomo, Ind
7
5
4
1
2
1
3
2
2
5
8
10
6
10
'2
h
5
;:;:::i-T!::::;:
LeavenwoYth, Kans
' 1. . ..'
1 1
Long Branch, N. J
1
Marhiette, Wis
5
1
Meht)sc,Mass
2
I
Morristown, N. J
1
Nantiooke, Pa
1
1
!
Newburyport, Mass
1
1
New London ,'Conn
3
1
1
t
North Adams, Mass
1
Northampton, Mass
2
12
1 1
3
r! i
Plainfield, N. J
Pontlac, Mich
i
Portsmouth, N. H
0 ::::::'....:.' :
Rocky Mount, N. C
Rutland, Vt
2
5
4
T)
0
' ' 4 '
Sandusky, Ohio
8teelton,Pa
4
1 1 I
1 '
M
Wilkinsburjf, Pa
' '2
Wobum, Mass
' 1
t 1
1 " '■
1
' Populdliou .\pr. 15, 1910; no esiimato made.
Digiti
zed by Google
FOREIGN.
CHINA.
Examinatloii of Rats— Shanghai. *
During the period from July 16 to September 15, 1917, 2,322
rats were examined. No plague infection was found. The last
plague-infected rat at Shanghai was reported foimd May 6, 1917.
Plagae-Infected Rat— Hongkong.
During the period from August 6 to September 15, 1917, out of
12,048 rats examined at Hongkong, 1 rat, examined during the week
ended August 11, was found plague infected.
CUBA.
Communieable Diseases — ^Habana.
Communicable diseases have been notified at Habana as follows:
Oct. 11-20, 1W7.
Romain-
ing under
treat-
ment.
Oct. 20,
1917.
Disease.
Oct. U-20» 1917.
Ramain.
li^ under
ment
Oct.ao,
m7.
Disease.
Cases.
Deaths.
Cases.
Deaths.
Diphtheria
4
2
10
34
Paratyphoid fever. .
Typhoid fever
Varicella
3
20
4
1-eprosy
8
94
Malaria
31
2
\
Measles
GREAT BRITAIN.
Examination of Rats — LJTerpool.
During the period from July 8 to October 6, 1917, 2,238 rats were
examined at Liverpool. No plague infection was found.
RUSSIA.
Typhus Fever — Poland.
Typhus fever was reported present in Poland during the period
April 23 to June 3, 1917, with 2,814 cases, and from June 17 to July 14,
1917, with 2,328 cases. Of these cases, 1,644 were notified at Warsaw
from April 23 to June 3, and from June 17 to July 14, 1,495 cases.
(1942)
Digitized by
Google
1943
NoTemberl6,191T
CSROLEBA, PLAGUE* SMALLPOX, TTPHOS F^YEB, AND YELLOW FEVER.
Reports Recced Daring the We^ Ended Nov. 16, 1917.^
CHOLERA.
FlAoe.
Date.
Cases.
Deatbs.
BMnarks.
India:
Calcutta
July 8-14
10
1
3
Iiido<3hina:
SaiKon
Sept 10-16
Aug. 20-36
1
2
'
Java:
EastJava
West Java
""S^t^'k ''''- "^^ "^
Batavla
Sept. 1-13
24
19
3
10
14
Persia:
Sabzevar
Aug. 20-30
PbOicpiiM Islands:
Aug. 5-11
Not previonsty reported.
Provinces
Am?. 5-11, 1917: Cases, 330;
Albay
Aug. 5-11.
3
6
33
40
148
11
68
10
13
6
2
2
4
27
27
87
6
30
10
4
3
3
Ambos Camarines. .
.do
*
Bohol
do
Cebu. . . .
..do
Levte
do
Mindanao . ...
. .do
do
Samar
. ..do
Sorsogon
do
Snrigao
do
Tayabas
do
Aug. 12-18. 1917: Cases. 203:
Albay
Ai^. 12-18
7
22
8
83
1
65
17
4
14
6
53
dMths, 121.
Bohol
do
Cebu. . . .
. ..do
Leyte
do
Mindanf^o
..do
Ne;TOS Oriental
do
34
10
Sorsogon
do
PLAGUE.
Bahrein Islands.
Egypt
Calcutta
Indo-China:
Saigon
Java:
EastJava
Persia:
Mobammera. . . .
Senegal
Straits Settlements:
8ingiq)ore
July 8-14. . .
Sept. 9-16..
Aug. 19-26.
Mayl...
Sept. 30.
Sept. 16-22.
Present Apr.
In Persian Oulf.
3, 1917.
Jan. 1-Oct. 4, 1917: Cases, 724;
deaths, 395.
July 8-14, 1917: Cases, 2,350;
deaths, 1,616.
Present.
Present in interior.
SMALLPOX.
Australia:
New South Wales. . .
Warren district .
Braril:
Uio de Janeiro
Canada:
Ontario—
Windsor
China:
Araoy
Chungking
Shanghai
Cuba:
Habana
Indo-Chliia:
Saigon
Java:
EastJava
ICid^ava.
WestJava
Sept. 25....
Sept. 16-22.
Oct.28-Nov. 3..
Sept. 9 22..
Sept. 1(V22.
Sept. 25-30.
Nov. 1
Sept. 10-10.
Aug. 19-29
Aug. 13 Sept. 4.,
Sept. 1-13
Sept. 25, 1917: 1 case.
Present.
Do.
From s. s. Alfonso XIIT. From
ports in Spain. For Ifexican
ports. I
^ From medical officers of the Public Health Service, American consuls, and other sources.
Digitized by
Google
November 16. 1917
1944
CHOLERA, PLAGUB, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER-<3ontinued.
Reports Received Daring the Week Ended Nov. 16, 1917— Continued.
SBfALLPOX-€ontinii«d.
Place.
Date.
Cases.
Deaths.
Remarks.
Philippine Islands:
Manila
July 29- Aug. 11...
June 24-30
2
22
Russia:
Petrograd
Spain:
Malaga
July 1-31
19
Straits Settlements:
Singapore.
Sept. 16-22
Nov. 1
1
1
On vessel:
S. 8. Alfonso XIII
At Habana. From ports in
Spain.
TYPHUS FEVEB.
Austria-Hungary:
Austria
Bosnia-Uerzegovina. .
Hung!
ingary
Budapest . .
Eiscnourg..
Alexandria
Japan:
Nagasaki
Java:
East Java
' Mid-Java
West Java
Batavia
Mexico:
Aguascalientes .
Russia:
Petrograd
Poland
Lodr.
Do
Warsaw
1)0
.\pr. 23-May27....
Apr. 23-Junel7...
Sept. 17-30.
Oct. 1-7....
Aug. 23-29
Aug. 21-Sept. 4..
Sept. 1-13..
Oct. 22-28. .
June 24-30..
Apr. 23-Jime3..
Junel7-July 14.
Apr.23-June3...
June 17-July 14 .
25
278
15
120
108
i,r>44
1,495
10
16
95
131
Dec. 24, 191C-Feb. 24, 1917:
Cases, 2,553.
Dec. 22, 1916-Feb. 24, 1917:
Cases, 110. .
Apr. 23 June 17, 1917: Cases, 406;
deaths, 72.
Sept. 1-13, 1917: Cases, 20; deaths.
Apr. 23-June 3, 1917: Cases,
2,814; deaths, 1S7. June 17-
July 14. 1917-. Cases, 2,328;
deaths, 211.
Reports Received from June 30 to Nov. 9, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Basscln
Apr. 1-May5
8
1
8
347
20
4
C3
2
1
3
1
5
7
1
17
7
Bombay
June 24-30
Julys Aug. 18
Apr. 29- June 30...
1
14
Do
Calcutta
Do
July 1-Aug 18 ..
Madras
Apr. 22 -June 30...
Julyl Sept. 1
May (>-Juno30
5
102
Do
Mandalay
July 29-Aug. 11
Moulmein
May 13-June 2
Pakokku
Ar»r. 2a-May 5 ...
I'CCll
May 27 -June 30. ..
Do :.:
July 1-7
Prome
July 29-Aug. 11...
Rangoon
Apr. 21-June30...
Julv8-28 .
31
9
Do
Indo-China:
Provinces
Feb. 1-June30, 1917: Cases, 1,37S;
deaths, 805. July 1-31, 1917:
Cases, 522; deaths, 314.
A nam
Feb. I -June 30 230
191
47
51
53
Do
July 1-31 . . .
86
79
74
Camboiia
Feb. 1-June 30....
July 1-31
Do
Digitized by
Google
1945
November 16, 1017
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Oontlnned.
Reports Recdred from June 30 to Nov. 9, 1917— Continued.
CHOLEBA--Continaed.
Place.
Date.
Cases.
Deaths.
Remarks.
Indo-China— Continued.
Provinces— Continued.
Cochin-Chinft
Feb.l-Jane30....
Jidy 1-31
878
350
1
36
3
163
45
543
214
Do
Laos
June 1-30
•
Tonkm
Feb.l-June30....
July 1-31
Apr.23-May27...
Jifiy2-Sept.9
21
Do
Seiffon
108
30
Do
JaiMui
Jan.-July, 1917: Cases, 391. Oo-
curring in 16 provinces and dis-
tricts.
Sept. 12, 1917: Cases. 252. In 5
provinces and districts.
Tokyo
Sept. 12
2
1
1
1
Java:
East Java
Apr. 2-8
Do
July 0-15
1
1
Mid Java
July 16-22
West Java
Apr. 13-July 5, 1917: Cases, 71;
deaths, 31. July fr-Aug 23,
1917: Cases, 171; deaths, 96.
Batavia
Apr. 13-July5
July 6-Aug. 23
Feb. 3
7
14
1
4
4
11
1
3
179
2
4
Do
Persia:
Mazanderan Province-
Amir Kela
Barfourouche
Jan. 15-17
Do
July 28
i"
6
Domavend
July 29
Hftmtfl Kola ...... .
Jan. 17
Machidessar
Jan. 31
Sari
July25-Aug.5....
98
Tabriz
Aug. 4, 1917: In village of
Ozoundoh, vicinity of Tabrls,
about 7 cases daily.
Philippine Islands:
Manila
June 17-23
1
2
Do
Aug. 19-25
Sept. 2-8, 1917: 1 case. Not pre-
viously reported.
May 20-June 30, 1917: Cases, 795;
Provinces
Agusan
July 15-28
12
113
53
10
2
20
1
1
308
203
G4
C2
r.4
231
388
Co
01
14
334
239
237
12
327
270
48
1
1
1
4
92
190
210
8
4
6
7
11
2
U
2
76-
30
7
1
11
deaths, 506. July 1-Aug. 4,
1917: Cases, 2,064; deaths 1 271.
Albay. . . .
May 20 -June 30. ..
July 1- Aug. 4
Aug. 19-5ept. 1....
June 3-9
Do
Aug. 19-Fopt. 15, 1917: Ca^bs,
Do
87ir deaths) 521. '
Ambos Camarinos
Do.. . .
July 22-Aug. 4
JulvS 14
Batangas
Juiie 17 23
1
251
161
35
40
45
150
284
36
30
• J
138
117
11
1S9
177
39
Bohol
May 20 June 30...
July I" Aug. 4
Aug.l9 Fept.l5...
June 3-30
July 1-Aug. 4
June 2-30
Do
Do
Capiz
Do
Cebu
Do
July 1-Aug. 4
Aug. 19 f opt. 15...
Julyl Fppt. 15....
June 10 30
Do
Ilollo
Ley te
Do
July 1-Aug. 4
Aug.l9 Popt.l5...
July 8-Aug. 4
Julv20"Aug.4....
Aug.l9-Fept.l5...
July 1-Aug. 4
Aug.I9-Fept.l5...
June 24-30
Do
Misamis
Mindanao
Do
Ncgros Oriental . . . .
Do
Rizal...
Do
July 1-7
Romblon
July 22-28
1
2
52
88
114
5
4
4
7
9
2
7
Samar
July 15 21
Do
Aug. 19-?ept.l
Juno 3-30
- Sorsogou
July 1-Aug. 4
Aug. 19 2.5
July29 Aug. 4....
Aug. 19 25 '..
June 3 30
Do
Surigao
ho :::::::...
Tayabas
Do
July 1-Aug. 4
Aug.l9-Sept.l....
July 15-21
Do
Zaniboanga
Digitized by
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November 10, 1917
1946
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVERr— Continued.
Reports Received from June 30 to Nov. 9, 1917 — Continued.
PLAGUE.
Place.
Date.
Cases.
Deaths.
Remarks.
Arabia:
Aden
May 3-July4
43
8
2
1
33
4
Apr. 8-May 14, 1917: Cases, «;
deaths, 61.
Brazil:
Bahia
June 10-30
July8-Sept. 15....
Julylfr-Aug.lS...
Apr. R- June 23
July 6-21
12
6
4
41
1
Do
Pernambuco
Ceylon:
Colombo
Do
China:
Amoy
Apr. 29-May5
Present and in vieinity.
Present Aug. 10.
Do
July 1-7
May 1.3- June 30...
JulyS-.\ug. 18
June 2
6
20
4
6
13
3
Hongkong
Do
Kwangtunfi Pro\ inco—
Ta-pu district
Present.
Ecuador:
Kstancia VIeja
Feb. 1-28
1
56
42
4
1
1
2
1
Gu3\'aquil
dn
29
22
i)o ! Mar. 1 -Apr. 30....
Do ' Julv 1-Aui?. 31
Milagro
Do
Nobel
Salitre
Do
Mar. 1 31
Apr. 1 30
1
Feb. 1 2^
do
-Mar. 1-31
1
2
Taura
Egypt
Feb. 1 28
3
Jan. 1-Sept. 30, 1917; Casts, 723;
deaths,393.
Alexandria
June 21 27
July31 Sept. 11...
Apr. 30-May 19...
June 25
0
5
4
1
1
14
1
4
I
3
Do
Port Said government
Port Said
Do
Provinces —
Fayoum
(Jalioubeh
Gir^eh
Minirh
Do
Siout
Suez government
Suez
Great Ilritain:
(ira.esend
London
India
JuIv2S 29
1
7
May Il-June26...
Juiie 2>*
May 17
1
3
May 12 June 28. . .
Julv 2^^ Sept. 11...
May 12
4
9
3
23
38
3
2
1
9
23
1
Apr. «) June2
May 12 June 28...
Aug. 13 21
5Iay3 8
Froms.s.Matiana.
2 in hospital at port . From s. 5.
Sardinia from Australian and
oriental ports.
Apr. 15-Juilc 30, 1917: Cases,
43,992; deaths, 30,197. July 1-
7, 1917: Cases, 1,870; deaths,
1,322. July 15-Au«. 18, 1917:
Cases, 19,330; deaths, 14,575.
Basscin
Do
Bombay
Do.'
Calcut la
Do
Hen nda
Do
Karachi
1>0
Miidnus 1 'residency
Do.. . . ' .
Apr. l-JuneSO !!.
44
23
397
236
3S
1
35
2
413
16
250
870
?
Julv 1 Aug. 18
Apr. 22 June 30...
July] .^ept.l
Apr. 20 June 2
48tt
294
Julv 15-2k
Apr. l-.?unc 30. ..
Aug. 12-ls
Apr. 22- June 30...
Julv 1 Sopt. 1
Apr. 22 June 30...
Julv 1 S<pt.l
Apr. 8 May 12
468
21
301
1.199
Mcndilay
1 o..'
Mo Imein
1 !o
JulT29-.\ug. 18...
Apr. 1- June 30
;J
Jlllv l-AiiP \R
M^ in nun 1 Anf. 1-7
1
2
6
169
286
2
7
Vvnn.'.
Do
Rangoon
Do
Toi:n,'oo
l>o '.'.'.'.'.'.'..
Indo-C'l ina:
Pro.incM'8
May27-June2
July 20- Aug. 18...
Apr. 1.>-June30...
July 1 -Aug. 11....
Apr.8-H
183
303
July 29- Aug. 18...
Feb. 1-Junc 30, 1917: Oases, 730:
deaths, 491. July 1-31, 1917;
Cases, 69; deaths, 45.
Anam
Feb. 1 -June 30....
July 1 31
■ ii32 1 i3i"
13 ' 9
Do
Digitized by
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1947
lfofeiidMrl6.191T
CHOLERA, PLAGUB, SMALUPOX, TYPHUS FEVIBR, AND YELLOW
FEVER-<>>ntiiiiied.
BepeHt Reeelrad fmn Jane M te Not. 9. 1917--Contuiu6d.
rLAGUB-ContinaDd. ^
Pteos.
Oases.
Diitths.
Remarki.
Iiido- China— Continned.
. Proylncefr—Contlnued.
Cambodia
Do
Cocbin-Ctalna ,
Do
Kwang-Chow- Wan
Tonkin
Do
Saigon
Japan:
AichiKen ,
MiyeKen ,
Java:
East Java ^
' DJocjakarta Residency
Kedfri Residency
Samarang Residency . . .
Surabaya Residency . . .
Do
Sunkarta Residency .. ,
Peru
Departments—
Ancaohs
Arequipa. ,
Callao
Lambayeque
LIbertad
Feb.l-JiiDe30.
Julyl-«1.
Feb. 1-June30.
Julyl-^
Mayl-Juneao.
Feb. l-JmM30.
July 1-31
Apr. 23-June3.
Ja&.-Jiily.
.....do.:..
Apr.23-May0...
do
Apr.23-May20.
Apr.2-Mayao...
July 8-28
.....do
July 1-31
May 15-Jttty 31.
do
....do
May 16-21
Lima..
.do..
Bangkok
Straits Settlements:
Singapore
Do
Union of Sooth Africa:
Capo of Good Hope State—
Oadock
fllensjey district
Terka district
QuocnstDwn
Orange Free State
Winbnrg district
At sea:
S.S.Matiana
Apr. 22-June 30.
JiflyS-Sept. 1...
June 3-16
July l-8ept. 6.
Aug. 23.
Aurr. 13.
May 28. .
June 6...
May2S
July 14-18.,
132
10
210
48
34
113
3
47
22
3
lis
10
133
24
33
80
2
36
Apr. a-May 30. 1917: CMes, 29;
deaths. 39. July 30-Aug. 5^
: Oa8fit,r ' ^
1917:
,3; deaths, 3.
May 13-31, 1917: Oases, 15. Juno
Wuly 31, 1917: Cases, 36.
At Casraa.
At Molkodo.
AtCaUao.
AtChiolayo.
At Salaverry, San Pedro, and
Trujillo. July 1-31, 1917: At
TrulUlo.
At Lima. July 1-31,1917: Lima,
city and oouBtry.
Present.
Do.
At Summerhill Farm.
Apr. 16-22, 1917: I case. Apr. 9-
23, 1917: Cases, 26; deaths, 17.
En route for port of London.
SMALLPOX.
Australia:
New South Wales
Apr. 27-Aug. 30, 1917: Cases, 77.
Brewarrina ,
Apr. 27- Juno 21 . . .
July25-2'i
6
4
13
2
52
1
4
5
126
433
5
CessDock
Coonabarabran
May25-Julyo
Apf. 27- June 21 . . .
June22-.Vug. 30...
May 9
Quambone
Warren district
Queensland-
Thursday Island Qu ir-
From s. 9. St. Albans from Kobe
antine Station.
Brazil:
Bahia
Miv r^Jiine 3"^
via ilongkong. Vessel pro-
cooded l«» Townsville, Bris-
bane, and Sydney, in quaran-
tine.
Do
July 22-St'p:. 22...
....Ida .
I
31
Rio de Janeiro
Do
July 1-Sopt. 15
June 10-10
Aug. l9-SopL 1...
Canada:
Manltobi—
Winnipeg
DoV.
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November 16, 1017
1948
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Reeelred from June 30 to Not. 9, 1917 — Continued.
SMALLPOX-ConUmied.
Place.
Date.
Cises.
Deaths.
Reoutflci.
Canada— Cont Inaed.
Nova Scotia—
Halllax
Port Hawkoslmry..
Ontario—
OtUwa
Windsor
Ceylon:
Colombo
China:
Amoy.
Antung ,
Do ,
Changsha ,
Do
' Chungking
Do
Dairen...
Do
Hankow
Harbin
Hongkong
^ Manchuria Statiim*!!!!
Mukdon
Do ,
Shanghai
June
June
July
Sept
18-July 7.
17-«)
30-Aug.6..
.30-0^.20.
May 6-12..
Apr.
July
May
Aug.
May
Aug.
May
July
U..y
July
Jlme
Apr.
May
Aug.
Z
July
May
a»-May26.
1-Aug. !»..
21-June34.
6-12
37-JuDe 2. .
11-17
6-June23..
l-8ept. 15..
la-Juneao.
»-28
21-30
23-May 6. .
6-June 16. .
6-18
2»-»
27- June 2. .
8-Sept. 30..
21-July 1...
Do
TsiUhar SUtion..
Tsinfftao
Choeen ( Korea):
Ch^ulpo
Ecuador:
(iuayaquil
Do.'!!!!!!!.*!.*
.Vicxandria
Do
Cairo
France:
Nantes
Toru
Ccrmany
nerlln
Bremen
Charl(»ltenbcrg...
Hamburg
July2-Sept. 29..
Apr. l6-2t
Itoy22-July7...
July30-Aug. 11.
May 1-31
Feb. 1-28
Mar. 1-Apr. 30. .
July 1-Aug.3l..
Apr.30-July I...
July 2-29
Feb. 12- Apr. 8..
July 30- Aug. 5..
May 6- 12
Mar. If^Apr. 28.
do...!
^o'div
LQb
Munich.
Stuttgart
(»reece:
Atbeu
India:
HumtHiy
Do
Calcutta
Kany'hl
Do
Miwlras
D.)
i{ant;oi>n
Do
Ind<>-f hioa:
r'ri>\ mces ,
Atum ,
Do
Cambodia ,
IM
Cochinl'hliid
IK.
Kwang.<'hou -\N an .
I
.do.
.do.
.do.
.do.
.do.
.do.
July 2^30
Apr. 22-June30.
July 1-Scpt. I...
Apr. 29- May 2C..
Apr. 22-JuIy4...
July »-Sept. 1...
Apr. 22 June 30.
July l-8opt. 1...
Apr. 15- June 30.
July 1-2S
100
16 1
18
50
JO
10*
1 1
I
1%
55
Feb. 1- June 30..
Julvl-3l
Feb. 1- June 30..
July 1-31
Feb. I-June30..
July 1-31
Mar. 1-Apr. 30..
130
28
,2n7
130 ,
4 I
Present in district.
Present and In vidnlty.
Do.
Do.
Do.
July 1-7, 1917; Prestnt
On Chinese Eastern Ry.
Do.
Present.
Do.
Cases foroigB; deaths i
Uves.
Among Chinese.
On Cmnese Eastern Ry.
At another statioa on ruilv^y
lease.
Mar. 1»-Apr. 28, 1017: Cms. TUc
in dti(« and 32 States aad dl»>
trtcto.
237
50
2A
23
377
49
Feb. l-June 30, 1917: Omw, OT;
deaths. SU. July 1-41, WIT:
Cases, S36: deaths, UL
Digitized by
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1949
NoTem1>er 16, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Contimied.
Reports Reeeired from Jnne 30 to Nov. 9, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Indo-China— Continu ed .
Provinces— Continued.
I^aos .
Apr. 1-30
5
10
274
4
199
33
32
12
1
1
1
30
63*
19
12
3
Do
July 1-31
Tonkin
Feb. I-Jime30....
July 1-31
Apr. 27-June 10. . .
July2-Sept.9
May 21-June 24...
July 12-Sept. 30...
Sept. 0-16
Do..^
Saigon
Do
Turin
Do
Jamaica:
japM^!^.::::::::::::::::::
Jan.-July, 1917: Cases, 4,974; fa
Kobe
M«y27-July22....
May2$-Juiie3....
May yj- July 5
July 25-31
65
1
177
1
1
38
18
88
23
16
37 ProvixiMs and districts.
Nagasaki
Osaka
55
YokkaichI
Vokohania
May27-Julyl
Apr.2-Julyl
July 2-20
1
2
Java:
East Java
Do
Mid-Java
Apr.l-Julyl
July 2-22
7
Dp . .
West Java
Apr. l^July 6, 1917; Cases, 239;
deaths, 44. July 6-Aug. 2,
Batavia
Aprl3-July6
Jan. t-JiiXM30
30
6
116
1
1
9
Mezko:
Coiit#iwc
1917: Cases, 68; deaths, 14.
]^:::::::::::::::::::
Aug. 1-14
Jan. 1-Aug. 14, 1916: U8 deaths.
jfiiftm _,
July 1-13
UflT^tl^n
Julyll-Aug.7
MexicoCity
June 3-30
162
142
Do ;..
Aug.5-Sept.22....
June 18-24
Monteref-
24
23
1
2
1
Orizaba
Jan. 1-June30
D(^.:::::::::::::::
July 1-23
VeraCnLB
Julyl-Sept.I5....
Aug. 13-18
Mayl3-June0
JulyS-Sept.l
May 13- June 30....
July 8- Aug. 18
Mar. 1- June 30...
6
1
6
6
14
8
Netherionds:
Amsterdam
Philippine Islands:
Mftnibi
Varioloid.
Do
Do.
Portugal:
Lisbon
Po
Portuguese East Africa:
Ix)ureniQo Marques
5
4
Russia:
Archftnirel ,
Mayl-June28
July2-Aug.28
July 2-15
60
6
6
543
58
7
23
16
3
i>of.::::::::::::::::::
Moscow
Petrograd
Feb.l8-June23....
July 2-29
Do. .
Biga
Mar.ll-June'2
Mar. 15-24
Jan. 1-Mar. 31,1917: Cases, «.
Vladivostok
7
Biam:
Bans kok
June 9-30
1)0.. :...:::::. :::::::::
July 11-17
5
4
44
11
^P^rld
May 1- June 19
Malaga
Apr. 1- June 30
Seville
Mayl-June30... .
Vftkncia . .
June 3-23
5
13
6
1
1
2
2
Do
Julyl-Sept.15....
Mar. 18- June 23....
Juno 24-30 ,
Straits SettlemeDtK
Penang
3
Singapore
Sweden:
Malmo
Apr. 22-28
Stockholm
May 20- June 23 —
June 2-8
1
Tunisia:
Tunis
Turkev in Asia:
Trcbliond
Feb. 25- Apr. 13....
15
Digitized by
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November 16, 1917
1950
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from June 30 to Nov. 9, 1917— -Continued.
8MALLPOZ--Continaed.
Place.
Date.
Cases.
Deaths.
Union of South Alrica:
Johannesburg
Mar.12-24
4
3
2
^
July 1-31
Urueuay:
Montevideo
Mfty i-ai
Venezuela:
Maracaibo....
June 18- July 8... .
8
1
Do ^
July 9-23
TYPHUS FEVER.
Algeria:
jy ^ers
June 1-30
6
1
3
1
1
Do!
Julyl-Aug.31....
Aug. 12-18
Argentina:
Buenos Aires
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 1910: Cases, 2,37L
Bohemia
Oct. 22-Dec. 17...
do .*
634
809
47
617
16
243
6
GalHa
I ower Austria
do
Moravia
. ...do
Silesia
do
Slyria
do
Upper Austria
do
Hun^arv -
Feb. 19-Mar. 25, 1917: Cases* 1^.
Budapest
Feb.19-Mar.25....
July 29- Aug. 11....
Sept. 23-20
83
2
Braiil:
Rio de Janeiro
Canary Islands:
Santa Cruz de Tenerlfle
1
China:
Antung
June23-July 1
July9-Scpt.23....
June 9-15
3
15
1
Do
1
HanVow
Do
July 8-14
1
Tientsin
June 17-23
May3(>-July7
Aug.o-lV
1
4
1
1,648
418
1
Tsinctao
Do
Alexandria
Aug.30-July 1....
July 17-Sept. 16...
Jan. 22- Apr. 8
Mar. 19-25
478
115
76
Do
Cairo
Port Paid
•
Great Britain:
Cork
June 17-23
1
Glasgow
Sept. 3(>-Oct. 6....
May 23-Juno 30. . .
I
Greece:
Saloniki
32
19
Do
July 1-Aug. 4
Japan:
Hakodate
July 22-28
1
4
34
Nagasaki
June 11-24 ....
Do
July9-Sept. 30....
6
Java:
East Java
May e-July 1. 1917: Cases, «•
Surabaya
Juno 25-July 29. . .
4
July 9-29, 1917: Cases, 6. _
Mid-Java
Apr. 1-June 24, 1917: Cases, 38;
deaths 5. July 9-Aug. 23, 1917:
Cases, 13; deatJis, 1.
SaniaranE
May 5 -June 10
July2-«
14
,5
2
Do
West Java
Apr. 18-July 5, 1917: Cases, IJJ:
deaths, 6. July O-Aug. 23, If W:
Cases, 82; deaths, 11.
Batavia
Apr. Vs^JulyS
July 6-Aug. 23
Julv 10-16
70
61
6
8
1
1
5
3
Do
Mexico:
A?:uascalicntcs
Coalejvec
Aug. 1-14
Jalapa
Apr. 1-June30
bo:....:.::..::::::::::
July 1-31
Mexico City
Juno 3-30
431
1,014
Do
JulyS-Rept. 22....
Jan. I -June 30... .
Oritaba
6
Do
July 1-31
1
Digitized by VjOOQIC
1951
November IG, 1917
CHOLERA, PLAGUE, SMALLPO^^, TYPHUS FEVER, AND YELLOW
FEVER—Continued.
Reports Received from June 30 to Nov. 9, 1917— Continued.
TYPHUS FEVER— Continued.
Place.
Date.
Cases.
Deaths. Remarks.
Netherlands:
Rotterdam
Juno 9-23
3
U
7
1
11
16
10
l.W
2
Do
July 15 Sept. 1....
JulvK-2?<
Norway:
DerfTon
rortuguese East Africa:
Loiuen^o Marques
Mar. 1-31
Russia:
Archangel
May 1-June28
July2-Aii^. 2S....
July 2-'l.^
2
5
.
Do
Moscow
Petrograd
Feb. IS- June 23...
July 2-2P
* ■ .i
Do...ik.
Riga
33
May 31-June 10. . .
July 22-28
8
5
Jan. 1-31. 1917: lease.
May 1-31, 1917: Cases, 4.
^; Do...'*
A'Jadivostok
Mar.29-May21...
May 1-31
Spam:
Almeria..»
Madrid
do
Switzerland: '■
Basel
June 17-2.^
JulvH-«cpt. 22
July 2<>-v''>pl. 22...
June 4-i»
1
Do
7 i
Zurich
2 '
Trinidad
2 *
Timi.<da:
Tunis
June 30-JuIv 0
I
1
Union of South Africa:
Cape of Oood Hope State. . .
Aug. Z>, 1917: Present in 16 dis-
tricts.
Prt'scnt.
East London
Sept. 10
1
-YELLOW FEVER.
Ecuador:
Babahoj'O
Feb. 1-28
1
2
1
18
34
24
1
2
2
2
8
1
6
1
Do
Mar. 1-31
1
1
lii
10 1
Chobo
do
Ouavaauil
Feb. 1-28
fc^ ....::..:...:.:..:
Mar. 1- Apr. 30....
July 1-Aug. 31....
Feb. 1-28
»
Do
Milaero
So ..;;;;.;....:..
Mar. 1- Apr. 30....
Julyl-Aug.31....
Aug. 19-25
Aug.8-Sept. 20...
June 23
Julyl-8ept.25....
1
Naranjito
J
Mexico:
Campeche State—
Campeche
1
3
1
1
In person recently
Mexico City.
Present Sept. 5.
Yucatan SUte—
Merkla
Peto
arrived from
Do
\'enesuela:
Coro
139
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PUBLIC HEALTH REPORTS
VOL. 32 NOVEMBER 23. 1917 No. 47
EXTRA-CANTONMENT ZONE HEALTH LEGISLATION.
In order to control the communicable diseases in the areas around
mobilization camps and cantonments, that the greatest possible pro-
tection may be given to the troops, it has been necessary in practi-
cally every instance to secure additional health legislation
The following ordinances and regulations have been adopted in
pursuance of the plan of cooperation by States and municipaUties
with the United States Public Health Service for the protection of
military camps and the inhabitants of extra-cantonment zones:
FORT LEAVENWORTH EXTRA-CANTONMENT ZONE.
City Health Officer— Appointment and Authority. (Ord. 3731, of Leavenworth,
Kans., Aug. 16, 1917.)
Section 1. There is hereby created the office of city health officer, who shall be
appointed by the board of city commissioners.
Sec. 2. The city health oflScer is hereby delegated police powers to be used in the
furtherance of his office. He shall have power to make arrests and to enter upon any
premises at any reasonable times in the furtherance of his duties.
Under the above ordinance Asst. Surg. J. G. Wilson, of the United
States Public Health Service, who is in charge of the work in the zone
around Fort Leavenworth, was appointed health officer of the city
of Leavenworth, Kans.
FORT OGLETHORPE EXTRA-CANTONMENT ZONE.
Milk and Milk Products — Methods of Producing and Handling Must be Approved.
(Ord. 1583, of Chattanooga, Tenn., Oct. 23, 1917.)
It shall be unlawful to sell or offer for sale in the city of ChattcCnooga any milk, ice
cream, or other milk products, or to manufacture ice cream, unless the methods of pro-
ducing and handling the same and the sanitary conditions attending such meet with
the approval of the commissionor of education and health of the city of Chattanooga.
Any person violating the provisions of this ordinance is hereby declared to be main-
taining a public nuisance dangerous to the health of the inhabitants of said city,
and the department of education and health is hereby empowered to take such action
as may be necessary to abate such nuisance.
140 (1953)
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::c\.'.abei- 23. 11)17 1934
r.Lm-n Ejccr.^.— ri::orci of. (Ord. ICZ4, of Cliattanooga, Teim., Oct 23, 1917.)
i\uTiCLE \.— Froiimvg for sanitary methods for dii^ pni^h^g of human excreta enjoined
upon occupui.is an'i ouners of prrniises. — Skctiox 1. '1 hat every residence and build-
ing in which hiiiuxn Kein^^a reside, arc employed, or congreij.iled shall be required
to have a sanilary method for the disposal of human excreta, namely, either a sanitary
wftler-clioflet or ik SLoi&yrv pnY>'.
Sxc. 2. That it shcUL b» lutUwfuI ta dispoas of sav kuttiaD ^Leteta widkin: the i»>
corpocatQ limits of Chattanooga^ Tena. , except ia a aaoitaxy watat cloaat or maidJtixj
fwivy.
Sec. 3. That it shall be unlawful for any person or persons, firm, or corporatka,
owning, leasing, or renting property within die city ol ( hattanooga, Tenn., to permK
tlie dis|K)8al ol amy human excrtte on any^ par^yctty owiked^ trnniwU or noted h^ such
person or persons, firm, or corporation, or the agent of any such, except in a sanitary
wa^OT-ckaet or saaitary pnvy, and it thajl b« ualawlul to peiaut the (MopoBftl ol any
material in a sanitary privy other than human excreta, paper, and diainiectaBt.
Sec. 4. Any building as defined in section I of tliis article, within 100 feet <tf>
sewer, ahaQ be required to connect therewith a samtery water-ckwH.
Sbc. 5. That BO ces^KX)! flhall be built or m»in tamed within tfie intwrpotate finnli
•f ChafflaMiign, Tom.
Sac. §v That no septic tank shall be constructed within the incorfiQcate limila «f
Chattaaasga, Tenn., without a panail from the boctrd of health.
Abticlk 2. — OferaHon of ordnance. — SacriON 1. The city of Chattanooga afaaS
provide one can for every privy box installed, and stK-h other equrpaMnt as may be
necessary to conduct the scavenger servic e. \\ hen more than one can is needed in
a privy box, the cost of same shall fce borne by the pro)>erty owner.
Sbc. 2. That the commissioner of education and health shall s4>point a city scavea-
ger under b<md at a salary to to determinetl by him, subject to the approval of tiie
board of commisBioners. It Amll he the duty of the city sc^avenger to have each
■Kiitary povy cleaned once every IV days as follows The cans shall be reoMyved
from the privy box, covered with tightly fitting Mds; dean cans shall be repJaced in
ihs privy boa and the contents of the tilled cans c^arried directly to the disposBl grounds
and dii^osed of in a sanitary manner approved by the department of educatioa and
health.
Sac. 3. That the cost of installing a sanitary privy for the disposal of human excreta
shall be borne by the owner of the property upon which the sanitary privy is to be
located.
Sac. 4. That the sum of 35 cents for one-can and 50 cents for two-can priviea* pay-
able one month in advance, shall be collec ted by the city scavenger from the oecv-
pant of premises on which is located a sanitary privy.
Sec. 5. That the city scavenger shall report to the chief sanitary inspector any
violation by any property owner or occupant of any property of any of the provisions
of this online nee. and it shall be the duty of any prop^ty owner or any occopaMl
of premises to rej>ort to the chief sanitary inspector any negligence en the part of the
cit>' scavenger to i)n)i'(Tly perform his duties as provided for in this ordinance.
Sec 6. That no can .«ha[I be allowed to bereme filled to overflowing in the privy
as herein provided, and when the same is in danger of puch it shall be the duty fi
the occupant of the promises to notify the city scavenger to remove the same at any
time such condition nri^e.", for which a proportionate' charge shall be made when the
can is removed other than at the regidar period for removing the same.
Sec. T. Tlvit alt sanitary privies shall be located on an aDey if possible and shall
be easily accessible to the city scaveiiirer. The city scavenger is hereby empowered
to enter all priN ies and premiics in the discharge of his duty.
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Abticle 3. — Declaring open privies to he a nuiwnce, and^ providing for the abatement
qftueh nuisance forthwith. SBcnou 1. That all privies within the incorporate limits
of Chattanooga, Tenn.. not constructed and maintained in conformation with the
provisions of this ordnance shall be, and hereby are, declared a nuisance, dangerous
to the public health of the inhabitants of said city, and shall be condemned and forth-
with abated in accordance with law or the ordinance of said city.
Sec. 2. The city shall have the further right to cause to be made such alteration
or construction to such privies as are nuisances as will render them sanitary; the
entire cost of such work shall be charged against the person creating or maintaining
the same. All such alterations or constructions are to be prescribed and approved
by the commissioner of education and health or his duly authorized agent.
Article 4. — Definition of terms.— Sectios 1. Human excreta. — ^That the term
"human excreta" as used in this ordnance shall be construed to mean the bowel and
kidney discharge of human beings.
Sec 2. Ce««poo/.— That the term ''ceespoor* as used in this ordinance, shall be
construed to mean an underground cavity without water-tight walls, in which is
pllK^ed human >^creta.
Sec 3. Septic tank. — That the term "septic tank" as used in this ordinance shall
be construed to mean an underground ca\'ity with water-tight walls into which flows
the effluent of a sanitary water-closet and from which the effluent does not come to
the surface of the ground.
Sec 4. Sanitaria water-closet.— ^haX the term "sanitary water-closet" as used in
this ordinance shall be construed to mean any flush type toilet which is properly
connected to a city sewer or to a septic tank of approved construction:
Sec 5. Sanitary privy. — ^That the term "sanitary privy" as used in this ordinance
shall be construed to mean a privy which is so built, rebuilt, or constructed as to
contain a privy box, which box shall conform to the following eper ifi cations:
(a) The privy boxes shall be of cither the "single" or "double" type, the double
type to be installed in all privies used by more than four persons. The boxes shall
be constructed of durable seasoned lumber, with tight joints and shall be fly tight
at all times when not in use.
(6) The single-type privy box shall bo 24 inches long, 17 inches high and 19 inches
wide, all inside measure men t**, and shall be provided with one seat hole about 9 inches
long, the front of which .-hall be about 4 inches from the front.
(c) The dolible-type box phall be 42 inches long, have two seat holes and otherwise
similar to the single box.
((/) Each seat hole shall be completely covered by a lid hinged to as to fall into
place when not being used and which shall at all other times be kept so as to pre-
vent the access of flies to the interior of the box.
(c) Each sanitary pri\'>' box shall contain a galvanized-iron receptacle for each seat
hole. One receptacle shall be furnished by the city for each privy box. Additional
cans shall be supplied by the property owner. The cans ehall be of 24 gauge gal-
vanized iron, 14i inches high and 15 inches in diameter, inside measurements.
(/) The privy box shall be ventilated by a flue not less than 4 inches square, inside
dimensions, which shall extend from the top of the privy box to 12 inches above the
roof of the pri\y. The top of the flue shall be covered to prevent the entrance of
rain but to allow the free egress of air. The box shall be further ventilated by an open-
ing 1 inch in width, extending the whole length of the box. Both openings shall be
completely covered with galvanized screen wire at least 14 mesh to the inch, tacked
to the inside of the box.
(jf) Either the top or the back of the privy box shall be hinged so as to allow for the
removal of the cans and to fit fly-tight at all other times.
Aeticlb S.—Pmo/ry.— Section 1 . That any person or persons, firm or corporation, or
agent of any person or persons, firm. or corporation, who neglects, fails, or refuses to
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comply with any of the pro>visioii8 of thi^ ordinance, AM be deemed guilty of • tub-
demeanor, and when convicted, shall be fined in the sum of not lesB than $5 nor toon
than $50, and each time such person or pereons, finn or corporation, neglectd cr
refuses to comply with any of the provisions of this ordinance, shall be deemed a
separate offense and punished as herein provided.
CAMP FUNSTON AND FORT LBAVtSWOKm EXTRA-CANtONMENT
20NBS.>
Venereal Diseasefr-CoBtral of. (Regs. Kmmw Steto Bd. ef HetHh. Not. 2. ttlTO
Rule 1. The deputy State health officers designated for the extra-cantonment
Eones are hereby authorized to use every available means to ascertain the fnifytenoe
of and immediately to investigate all suspected cases of ssrjdkilis in the inlectioos
stages and gonococcus infections within their cantonment zone and to ascertain the
source of such infection.
Rule 2. In such investigation said deputy health officers, or their/duly autboiued
representatives, are hereby vested with full powers of inspection, ezMninatioii, i^l^
tion, and disiniection of all persons, places, and thijigs, aad as such inapecton said
deputy State health offic^v, or their duly authonsed repiesentaUves, are Kexeby
authorized:
(a) To make examination of all persons reasonably suspected of having sypiHiia in
the infectious stages or gonococcus infection. Owing to the prevalence of sodi .dis-
eases among prsetitutes all such persons may be considered within the above cUms.
(b) To isolate such i>ersQns whenever in the opinion of said deputy State health
officer, the State board of health, or its secretary isolation is necesnry to protect the
public health.
In establishing isolation the health officer shall d^ne the place and the lunits of
the area in which the person reasonably suspected or known to have syphilis or gono-
coccus infection and his (or her) attendant are to be isolated, and no peieons, other
than the attending physician, shall enter or leave the area of isolation without the
permission of the health officer.
(c) In cafies of quarantine or isolation not to terminate said quarantine or isolation
until the cases have become noninfectious or until permission has been given by the
deputy Slate health officer.
Cases of gonococcus infection are to be r^farded as infectious until at least two suc-
cesaive smears taken not less than 48 hours apart fail to show gonococci.
Cases of syphilis are to be r^^ded as infectious until all lesions of skin or mucous
membranes are completely healed .
(d) Inasmuch as prostitution is the most prolific source of syphilis and gonococcus
infection said deputy State health officers, or their duly authorized ropresentattves
are authorized to use every proper means to aid in suppressing the same and not to
issue certificates of freedom from venereal diseases, as such certificates may be used
for purpoees of solicitation.
(e) Keep all records pertaining to said inspections and examinations in files not
open to public inspection, and to make every reasonable effort to keep secret the
identity of those affected by venereal diseases control measures inasmuch as may
be consistent with the protection of the public health.
» Tbo zone suiroundiup Camp Funston (and Fort Riley) Includes the counties of Riley and Oetry, Emm.
The zone around Fort Leavenworth consists of the county of Leavenworth, Kaos.
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FORT LEAVENWORTH EXTRA-CANTONMENT ZONE.
Manure — Care and Disposal. (Ord. 3739, of Leavenworth, Kans., Oct. 23, 1917.)
Section 1. Every peraon, persons, firm, or corporation owning, leasing, or using
any stall, stable, shed, bam, or other place in which any horse, horses, cattle, fowl,
birds, or other domestic animal or animals shall be kept, or any other place in which
any manure or refuse from horses, cattle, fowls, birds, or other domestic animals may
collect or accumulate, shall at all times keep or cause to be kept in a cleanly and
healthful condition such stalls, stables, sheds, bams, and the yards and appurtenances
thereof, and no offensiVe smells shall be allowed to escape therefrom.
Sec 2. Every stall, stable, shed, bam, or other place hereinbefore mentioned and
described shall be provided with a properly constmcted manure vault or box, which
shall be water-tight at all times, except that where a concrete container is constmcted
a drain pipe from the bottom to a sanitary sewer may be installed to carry away the
liquid portion of the manure. A heavy weight strainer must be placed over the outlet
from the manurobox and a trap placed in the sewer line. The box shall be covered
with a fly-prorrf'lid, which shall be kept closed at all times except when it is necessary
to firpen said box to deposit or remove the manure from said receptacle or box. Under
no circumstance© shall any manure be deposited in any place or receptacle other than
in a \*ault or box container, as hereinbefore described.
Sec. 3. No manure removed from any vault, pit, or bin, or any other place where
said manure has accumulated, shall be deposited io any place within the limits of the
city of Leavenworth without a penmt from the city health officer. When said permit
is issued the person remo\dng manure must be governed by the provisions thereof.
Ndthing in this section shall apply to the distribution and placing of manure on gar-
dens, private lawns, and parks if said manure is thoroughly dec omprpcd, so that its
distribution will give rise to no offensive or obnoxious odors.
Sec. 4. It shall be unlawful for any person, firm, or corporation to haul, transport,
or convey, or to cause or permit to be hauled, transported, or conveyed any manure
or stable, barnyard, or poultry yard refuse upon or along any public street, alley, or
other public place in the city of Leavenworth except in a vehicle, box, or other recep-
tacle 80 constructed and maintained that .such manure or stable, barnyard, cow yard^
or poultry yard refuse shall not escape from any vehicle, box, or other receptacle in,
into, or upon any such public street, alley, or other public place.
Sec. 5. Any person, firm, or corporation offending against or failing to comply
with any. or all of the provisions of this ordinance sliall be guilty of a misdemeanor, and
upon conviction shall be fined not less than $5 and not more than $20.
Sec. 6. All ordinances or parts of ordinances in conflict with this ordinance are
hereby repealed.
Sec. 7. This ordinance shall take effect and be in force from and after its passage,
approval, and publication.
Published October 31 , 1917.
Privies — Construction and Maintenance. Connections with Sewers. (Ord. 3738,
of Leavenworth, Kans., Oct. 23, 1917.)
Section 1. Cesspools, vaults: No person, firm, or corporation shall construct, per-
nait, or maintain a privy vault on any lot or premises where there is a public sanitary
sewer and city water in any street, alley, or highway adjoining such lots or premises,
except as provided for in the following section.
Sec. 2. Whenever there is a sewer in the street, alley, or highway adjoining prop-
erty where people live, work, or congregate for any purpose and it is impossible, on
account of limited space in the building, to install toilet facilities in the buildings
and there is city water adjoining the premises and available, outside toilets maj- be
connected direct to the sewer by the owner or owners of the property^ if frostJirooC
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NoTeinl)er 23. 1917 1958
flushing service ii installed. In no esse will direct connecCioofl to the sewers be
permitted in new installations where there is city water available for outEdde toilets
except as outlined above, and all services now in use on such promises without flush-
ing service devices must be discontinued within 30 days after the passage ol this
ordinance.
Sec. 3. Where there is a sewer in the street, alley, or highway adjoining property
where people live, work, or congregate for any purpose, and there is no city watfir
adjoining the premises and available, water-tight privy vaults or cesspoob shall be
constructed according to the provisions of this ordinance relating to privies and o8»>
pools and no connecti<m from the privy vault or cesspool to the sewer will be permitted.
Sec. 4, Every privy vault located on premises described under section 1 shall be
abandoned within 30 days after the pnnwge of this ordinance or 30 days after a new
•ewer is laid, and all abandoned privies and cesspools must be thoroughly cleaned
and filled with a^Ms, cinden, earth, or other material not subject to decay or liable
to cause a nuisance from any cause whateo^er.
8bo. 6. No person, firm, or oorpoiation, or iastitutitm of any IdiMl shall hewefler
construct, establiah, or lenodel a privy building or vault without ^written perttut
(rem the city health officer and upon oottpftetion of the coestructieB of a new itffvy
building or vault or the ranodeting of an old one it shall be insyectiid and a writtai
approval obtained from the health officer before it can be used. Such inspection
shall be made by the city health deparUneat within 48 houn, lyyuirfng at 8 a. hi.,
after recerviog written netice that it is ready for inspection.
Sao. 6. The side walls and betlens of all privy vaults shall be me<lo of any <^ IIm
following material: Waterproof brick laid in cement mortar, ooncrele, or concrele
blocks laid in eement DM>rtar. The sides and bottom must be seieoth, even, and
water tight.
Sec. 7. All privy vaults hereafter constructed must be at least 8} feet wide (front
and rear), 3 feet long, and 6 feet deep. The walk must extend 6 inches above the
ground snrlace and the privy building joined tightly to the walls. The sides of the
building shall extend 6 inches below top of vault wall. A ventilating pipe at IcmI
4 inches square, made of either wood or iron, shall extend through the roof and above
to the height of at least 2 feet above the privy building and covered at the top with
a brass or copper wire fly screen. The seat covers shall be self -closing and the seat
top removable for cleaning. The door of the privy building must be made self*
closing by means of a spring, weight, or other device, and must not be allowed to
remain open at any time.
Sec. 8. All privy vaults shall be disinfected whenever so ordered by the dty
health officer.
Sec. 9. No wash water, roof water, kitchen slops, or other liquid wastes, garbage,
rags, tin cans, crockery, or glass shall be emptied or thrown into any privy v^t.
Sec. 10. No bodily waste or excreta from any person suffering from typhoid fever,
smallpox, or cholera, or any other infectious diw^afM.' shall bo thrown or deposited
in any* privy vault or cesspool \vithout being previously disinfected in such manner
as may be approved by the city health officer.
Sec 11. All privy vaults without curbing or with foul or rotten curbing, or inade-
quate or partially caved, or otherwise defective, in the judgment of the city health
officer, and all pri\'y buildings too old or too dilapidated to be made to confcom with
the requirements of this ordinance, and all cesspools without curbing or inadequate
either in size or cover, or caved, or in any manner dangerous to public health, shall
be condemned by the city health officer and a now privy vault, privy building, or
cesspool shall be constructed by the owner or his agent within not less than 30 days
from the date uf condemnation. In either case, notice of condenmation must be
posted on the premisefl and a copy fier\'ed on the owner or his agent, or left at the
residence or office of either.
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1959 November 23, 1 917
Seo. 12. No person, finn, or corporation ehall abolish, abandon, or neglect any
privy vault containing excrement, filth, or other offensive matter, or fill up any such
privy or vault upon any premises owned or occupied by such person or persons, or
any premises whatsoever, unless such filth or excrement shall first have been removed
and the pit filled with ashes, cinders, or clean earth.
Seo. 13. All contractors or other persons emplo3dng men in constructing build-
ings, street improvement, or other similar work shall provide and care for such tem-
porary privies as will meet the approval of the city health oflficer.
Sec. 14. It is the duty of the owner or owners, or agents of property to keep all
privy vaults and privy buildings on property owned or managed by them clean and
to properly clean them whenever notified by the health officer to do so, and any
expense incurred in cleaning vaults or abating any nuisance shall be paid by the
person, firm, or corporation owning the premises where the said privy vault or privy
building has been ordered cleaned by the city health officer.
Sec. 15. No building shall be used as a dwelling house unless the same is provided
^th a privy v^t and building or is properly connected with a cesspool or sewer.
a^EC. 16. It/ shall be unlawful for any person, firm, or corporation to clean a privy
v^ult or cesspool until the equipment for cleaning said privy vaults or cesspools has
b^en examine^ ;and approved by the city health officer. Written approval by the
cipy health officer is sufficient guaranty of a proper equipment to perform the work
l^t the city health officer may revoke the privilege' of cleaning privy vaults or cess-
pools at any time if the apparatus is not maintained in a satisfactory condition.
Sec 17. Containers to bo water-tight. All carts, receptacles, containers, and im-
plements used in the removal of the contents of any vault, sink, or cesspool shall be
strong, tight, and so constructed that no part of the contents shall leak or fall there-
from and such carts, receptacles, containers, and implements shall be kept covered
and protected so that flies shall not have access thereto or to contents thereof.
Sec 18. Gleaning of containers after use: All carts, receptacles, containers, and
implements used in removing the contents of any vault, sink, or cesspool shall be
kept in an inoffensive and sanitary condition. Such carts, receptacles, containers,
and implements shall be thoroughly washed inside and outside after each use and
when not in use shall be stored and kept in some place where they shall not become
offensive or create a nuisance.
Sec. 19. The time of the day or year when cesspools or privy vaults shall be cleaned
will not be limited except in cases where a nuisance will be created by cleaning them
in the daytime and in all cases the city health officer shall be the judge. In every
and all cases where the city health officer orders a vault or cesspool cleaned at night
the time of cleaning will be limited to the time between 9 p. m. and 5 a. m.
Sec 20. The time, place, and manner of cleaning privy vaults and cesspools and
the disposal of the contents of the same shall be determined by the city health officer
and written permission will be given designating the time, place, and manner of
removal, and disposal of said wastes.
Sec 21. The city health officer or his representatives shall have the right to enter .
upon any premises and inspect the sanitary conditions therein.
Sec ^. Whoever shall violate any provision of this ordnance shall, upon convic-
tion, be punished by a fine of not less than $5 nor more than $25, or by imprisonment in
jail for not less than 5 days nor more than 30 days, or by both, at the discretion of the
judge having jurisdiction over the same, and each day's violation of any provision
of this ordnance shall constitute a separate offense.
Sec 23. All ordinances or parts of ordinances in conflict herewith are hereby
repealed.
Sec 24. This ordnance shall take effect and be in force from and after its passage,
approval, and publication.
Published October 31, 1917.
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Mnk and Milk Prodacta— Froducttoii, Ctre» asd Sale. MA Haapeeter. «M.
S735, of Leavenworth, Kans., Oct 8, 1917.)
Section 1. JnsjKctm: Qnalificatioiis.— There is hereby created the office ci mUk
inspector of the city of Leavenworth, Kane. Such milk inspector shall be i^
pointed by the board of commiasioneri of said dty. He nmet be a competent man
and prove his proficiency in one of the following ways:
First. By passdng an examination, both oral and written, which shall be preparod
and given under the direction of the State dairy commiflBioMr and pnrfessor of the
dairy husbandry of ^e Kansas State Agricultnral College, and a phymoMn to be
selected by the commissioner of parka and public property of ^be dty of hmfwm
worth.
Second. In the event that no one <iiialifies in the fliat namier, tiM city heaMk
officer may choose a milk inq>ector from a list of soch pewHM famished to IdHi 1^
the Surgeon General of the United States Pabhc Health Service, to serve nactil sodi
time as a duly qualified penon can be obtained in the manner betos specified <
In event that the milk inspector is diosen according to the pro^yisian wsurtyad
in 1 of this section; his sahury shall be fixed by ordinance. IfhebecfacMsiaeoafdinf^D
provision mentioned in No. 2 of this secticA he shall reedvo na
the dty.
Sac. 2. Permit, appUcant.-^li tfiall be unkwfnl lor any penon, Una, et <
to sell, or keep for sale, or offer ior sale, any ndlk, craaa or lee crsaai, or any dktt
product of milk or cream within the dty of Leavenworth, whhcvt pnniriag a pemit
therefor from the milk inspector of said dty. Said permit shall expire oa the lil
day of Maich of each year and shall not be transferable, botshattbe snhjeet to ro vesn
tion as heroin provided, Aid shall be granted upon the (oUowing conditsoBS, to wit:
Fiist. That, following upon an inspection by the milk inspect^sr of the cows sad
dairy or dairies from which applicant obtains his milk and cream supply, asid milk
inspector shall find that such cows are free from disease and soch dairy or dairies an
midntained in a clean and sanitary condition.
Second. All cow stables shall be kept clean at all times. Horses or oQh^ sniiaski
(than cows) shall not be kept in cow stables. Manuro shall be resMyved from the
stable at least twice a day to a distance of at least 100 feet from the stable and from the
source of the water supply used for washing milk vessels and for other purpoeeo of
the milk house. The place or places at which manure is deposited shall be appigred
by the dairy inspector.
Beforo milking, all manuro and other dirt shall be removed from the side, beDy,
and tail of each cow, but this riiall not be done so as to produce an excess of floating
material in the air, which will settle into the milk pail. Long hairs on the udder
and tail of each cow must be kept clipped. Immediately belore milking, the odder
shall be thorou^ly cleansed by first washing with clear water and then drying that-
oughly. The water used for this purpose shall be changed with sufldent frequency
to insure cleanliness.
The milker shall wash his hands thoroughly beforo milking, after which they sfaafl
be well dried; hands shall be washed after milking every two or three cows hefare
going to the next. The clothing of milkers shall be clean.
Third. That the applicant shall make written application to the milk inspector
for said permit, setting out the following:
(a) The name and residence of applicant, or, if a firm, the name and residence
of each of the members of said firm, or, if a corporation, the name and residence of the
president and secretary of said corporation.
(6) The location of the business place or places of the applicant, giving the street
and number of the same, and the number, name, and residence of the penon in <
of each place of business, if applicant maintains a place of businees.
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1961 NoTcmber 23. 1917
(c) The nmnber of cows owned or controlled by the applicant, and the location of
api^cant's dairy, if applicant has a dairy.
(d) The name of the owner or owners of, and location of, the dairy or dairies of all
persons from whom applicant obtains milk or cream supplies, and the number of
cows owned or controlled by each.
(e) An agreement by applicant that the milk inspector may at say time inspect ap-
plicant's dairy herd or herds, dairy or dairies, and the dairy herd or herds and dairy
and dairies of all persons from whom applicant obtains milk or cream, wherever
located. If upon such inspection any dairy be found to be inim unsanitary condition
or the method of handling the milk or cream be unsanitary, or any dairy herd be found
to be diseased, inspector diall send written notification thereof to the said applicant,
whereupon said applicant thereby agrees to disoontinue imaaediately his supply
of milk or cream from such dairy or dairy herd, and if such supply of milk or cream be
not so discontinued said applicant agrees that his permit shall be suspended or revoked
by said milk inspector.
TiiAt, all cows from which applicant obtains his supply of milk or cream shall,
at least once a year, be tested for tuberculosis and a cerdficate riiowing the result
•f such test furnished to said milk inspector from a reeognked veterinarian, who
kas a comHiission from the State live-stock sanitary ooMwiMinner; and that ap-
plicant will allow milk inspector or his agent or agents to take a sample of milk
•r cream, or their products, offered for sale by applieaat, suficient to enable the
loilk inspector to make Uie necessary tests that he may deeue te make.
The applicant hereby agrees to comply with all the provisions and requirements
•f this ordinance; and that, upon applicant's failure to comply with any of the pro-
visions of such agreement, his said permit must be suspended or revoked by the milk
Sospector. No retail dairyman or milk vendor AaH take on tbe supply of any new
dairyman wiUiout such supply being improved as herein provided.
6£0. 3. Permit isitud. — If the foregoing conditions are found to be complied with,
the milk inspector shall register such applicant and grant him such permit to do
business until the 1st day of March, following the date of issue of same, subject to
revocation or suspension as herein provided.
Sec. 4. PermU to be po«(ed.—- Said permit shall be posted in a conspicuous plac^
in applicant's place of business; and it shall be unlawful for any person, firm, or
corporation, procuring from the milk inspector of said city a permit to sell, keep for
sale or oSer lor sale, milk, cream« or ice cream or other products of milk or cream in
said city, to faU, neglect, or refuse to post said permit in a conspicuous place in said
place of business of said person, firm, or corporation.
Sec 5. Name #/ vendor. — Each vendor of milk, cream, or ice cream, shall, before
engaging in the sale of milk, cream, or ice cream, cause his name and place of busi-
ness to be placed, and to remain, in letter not less than 3^ inches in height on
each outer side of all wagons or other vehicles used by such vendor in the convey-
ance or ssde of milk, cream, or ice cream, or in lieu of this shall carry with him on
the vehicle a metal disk at least 4 inches in diameter with his license number engraved
thereon.
Sec. 6. UnwJiolesoTne milk defined. — Milk produced from cows kept in an unsanitary,
poorly lighted, or poorly ventilated stable or produced by cows not kept clean, or
any milk obtained from cows that are fed on city slop or refuse matter from any starch
factory, decomposed feed, stable manure, bedding, or any article of food which is
fermenting or fermented, other than clean, well cured ensilage; or milk stored in an
unsanitary place or milk kept or delivered in vessels not properly cleaned, or vessels
which are excessively rusted or in wooden vessels, or aiilk in which a sediment col-
lects on standing shall be deemed to be unwholesome milk. It shalji be unlawful
for any person to sell or offer for sale or exchange, milk known as "Unwholesome
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milk/' The milk inspector hereby has authority to condemn imwholeacnne milk
for food purpose**.
Sec. 7. Skimmed milk. — It shall be unlawful for any person, finn, or corporatioa
to sell, offer for sale, any milk from which any cream has been removed, or from which
any stripping? have been kept back or removed, unless the utensils in which said
milk is sold are marked in clear letters showing the per cent of fat which such milk
contains, or be marked "Skimmed milk."
Sec 8. Milk defined. — ^Milk is the fresh, clean, lacteal secretion obtained by the
complete milking of one or more healthy cows, properly fed and kept, excluding that
obtained within 15 days before and 5 days after calving, and contains not less than
eight and one-half (8.5) per cent of solids not fat, and not less than three and one-
quarter (3.25) per cent of milk fat, and contains no preservative, added water, or other
foreign substance. No milk shall be sold or offered or exposed for sale or delivered or
offered for delivery which does not conform to the foregoing standard unless the cap,
tag, or label on the container shall have plainly thereon the words *' Under standard*'
together with the percentage of milk fat in such milk.
Sec. 9. Modified milk dcfiiud. — Modified milk is milk modified in its compoeitioi]
so as to have a definite and stated percentage of one or more of its constituents.
Sec 10. Skimmed milk defined. — Skimmed milk is milk from which part or all ol
the cream has been removed, and contains not le&s than nine and a quarter (9.25) per
cent of milk solids.
Sec 11. Pasteurized milk defined. — Pasteurized milk is milk that has been main-
tained at a temperature of between 45 and 150 degrees F. for 20 minutes or of
between 150 and 160 degrees F. for 10 minutes, and immediately cooled to 50 degrees
F., or lower.
Sec 12. Sterilized milk defined. — Sterilized milk is milk that has been heated at
the temperature of boiling water or higher for a length of time sufficient to kill all
organisms present.
Sec 13. Condensed milky evaporated milk^ defined. — Condensed milk, evaporated
milk, is milk from which a considerable portion of water has been evaporated.
1. It is prepared by evaporating the fresh, pure, whole milk of healthy cows, ob-
tained by complete milking and excluding all milking within 15* days before cal\dng
and 7 days after calving, proWded at the end of this 7-day period the animals are in
perfectly normal condition.
2. It contains such percentages of total solids and of fat that the sum of the two
shall be not less than 34.3 per cent and the percentage of fat shall be not less than 7.8
percent.
3. It contains no added butter or butter oil incorporated either with the whole
milk or skimmed milk or with the evaporated milk at any stage ot manufacture.
Sec 14. Sweetened condensed milk defined. — Sweetened condensed milk is milk
from which a considerable portion of water has been evaporated, and to which sugar
(sucrose) has been added.
1. It is prepared by evaporating the fresh, pure, whole milk of healthy cows, ob-
tained by complete milking and excluding all milkings within 15 days before calving
and 7 days after calving, pro\-ided at the end of this 7-day period the nnimala are in
perfectly normal condition.
2. It contains such percentage of total milk solids and of fat that the sum of the
two shall be not less than 34.3 per cent and the percentage of fat shall be not less than
7.8 per cent.
3. It contains no added butter or butter oil incorporated either with whole milk or
skimmed milk or with evaporated milk at any stage of manufacture.
Sec 15. Condensed skimmed milk defined. — Condensed skimmed milk is skimmed
milk from which a considerable i)ortion of water has been evaporated.
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Bsc. 16. ButUmnlk defioid, — BtzttermUk is the product that remaina when butter
m removed from milk or cream in the proceee of churning.
Sio. 17. Cream defined. — Cream is thai portion of milk, rich in milk fat, which
roes to the surface <rf milk on standing, or is separated from it by centrifugal force, is
fresh and clean, contains not less than 18 per cent of milk fat, and contains no pre-
servative or other foreign substance.
Sbc. 18. Evaporated creamy dotted cream defined. — Evaporated cream, clotted cream,
is cream from which a considerable portion of water has been evaporated.
Ssc. 19. Bacteria. — It shall be unlawful for any person, firm, or corporatioit to sell,
ar offer for sale, any milk within the city oi Leavenworth containing over 300,000
bacteria to the cubic centimeter, or cream or ice cream containing over 500,000 bac-
teria per cubic centimeter; or milk, cream, or ice cream which contain any pathogenic
orgaBiflns.
Sac. 20. Ifrfedioti; contammatum: temperatwre. — It shall be unlawful for any penon,
trm, or corporation to adl or offer for sale any milk, cream, or ice cream which has
been milked or baiMiled by any perasn suffering from or exposed to any contagious
or infectious disease; or milk, cream, or ice cream handled in utensils washed in
walw from cieekfl, qmnga, or other places liable to contamination from surface dmiB-
ing, or milk havii^( a temyefatiure of more th^n 60 degrees one hour oi longer after
it is drwrn.
&ac. 21. Milk rwm.^-Ul milk rooms rt«ll have floors of cement, tile, or hard
ktmber, and shall be ceasUructed in auch a manner as to drain proj^oly, and shall be
tree fiom defects and in good taptjx. The wtalls and ceiling must be BBM>oth and
tight and gkss windows provided for light and ventilation; and all deors and windows
tim^ be screened from April 1 to Novessber 1, as must all plaees wheie the sale of
milk or mUk preducts is pemitted.
Vats or cooling tanks ^bail be constructed of impervious material and shall have a
smooth inner surlace. They diall be provided with dust-proof covers and shall
drain indirectly into the sewer or if in an unsewered district diall dra^ to a distance
of not less than 100 feet away from the wash room and milk room. TShe water in the
vat shall always be kept dean, free from slime, sediment, milk crust, or in any way
contaminated or polluted. The temperature of the water shall not be greater than
60** F.
Pasteuriaers and eeparators shall be constructed so that all parts, including pipes,
can be easily cleaned and steriliaed, and must be kept scrupulously clean, both
inside and outside at all times. The water used in connection with the dairy shall
be both convenient and abundant and of absolute purity, and the examination shall
be made from time to time by the city health officer to detcnnine this fact.
All shipping cans, dippers, bottles, measures, strainers, stirrers, -and other utensils
must be so constructed that all parts are absolutely free from spaces where milk can
soak in, so that it can be removed by siiBple washing. The surface coming in con-
tact with the milk, cream, or ice cream must be smooth and free from rust.
It shall be unlawful for any person to keep at any dairy within the limits of the
city of Leavenworth or at any dairy from which milk is shipped or brought into the
city of Leavenworth any milk or cream which is to be sold or offered for sale within
the limits of said city, at a temperature of not to exceed 60* F., or to keep or maintain
any such mflk or cream at a temperature exceeding 50** F. after it is delivered or
received at any milk depot, store, restaurant, or any building or establishment of
any kind within the limits of the city of Leavenworth.
It shall be unlawful for any person, firm, or corporation to sell, offer for sale, or
have in possession with intent to sell, any milk or cream bottled in any bam, living
room, wagon, genenJ store, or in any other room used for any purpose other than
the handling of milk and its products.
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Sec. 22. Closed conimnns. — It shall be unlawful for general stores to eell or offer
for sale, or have in their posflession with intent to sell, milk or cream in any but closed
containers, and such containers must not be opened in such stores, or for any retailer
of milk or other person, firm, or corporation to liave for sale milk or cream on any
street in any but closed containers, and such containers must not be opened for the
delivery of milk or cream or for any purpose other than procuring samples by the
milk inspector.
Sec. 23. Phi/sician's dxities. — Any physician finding a case of typhoid fever, para-
typhoid fever, dii>htheria, or scarlet fever, or ecptic sore throat, within the city shall
ascertain the name of the dairj'man furnishing the milk to the family in which the
disease occurs and report at once to the milk inspector the location of tlie diseased
person and the name of the dairyman furnishing milk to the family, and the names
of the vendors of ice cream eaten by the patient during a period of two weeks previous
to the onset of the disease, in so far as can be ascertained. Any veterinarian finding
any communicable disease in any cows furnishing milk sold or used in the city of
Leavenworth shall ascertain the name of the dairyman owning or keeping such cows
and report the same to the milk inspector.
Sec. 24. Infectious diseases. — Whenever typhoid fever, paratyphoid fever, scarlet
fever, septic sore throat, diphtheria, or other infectious disease exists among people
living in a family where milk or cream, or any product of milk or cream is produced
or handled for sale in the city of Leavenworth, the sale of such milk or cream shall
immediately cea^o and shall not be resimicd until the city health oflScer's certificate
is furnished to the milk inspector showing that all danger of infection from such
disease is over.
It shall be unlawful for any person, firm, or corporation to sell, or offer to sell, any
milk or cream, or any product of milk or cream, in the city of Leavenworth, that has
been produced or handled by any person who has typhoid fever, paratyphoid fever,
scarlet fever, septic sore throat, diphtheria, or other infectious disease, or that has
been produced or handled by any person who has recently been exposed to any such
disease, until the city health ofhcer's certificate shall have been furnished to the milk
inspector showing that all danger of infection from such disease is over.
Sec 25. Sanitary places and vtensils. — Every person, firm, or corporation handling
milk or cream or ice cream for sale in the city of Leavenworth shall keep such milk
or cream or ice cream in a clean, well-ventilated, and sanitary place, and it shall be
the duty of said person, firm, or corporation to cause all cans, bottles, and other re-
ceptacles used in the handling of milk or cream or ice cream to be thoroughly washed
and then sterilized with boiling water or live steam each time they are used, as soon
as they are empty. Cans used for delivery of milk or cream to depots shall be treated
as above at the depot and be returned empty to the shipper. It shall be unlawful
for any person or persons handling milk or cream to use any of the milk or cream
utensils for storing or transporting any substances other than milk or cream.
Sec 20. Ice cream; regulations. — It shall be unlawful for any person, firm, or corpo-
ration to sell, offer for sale, or have in possession with intent to sell, ice cream that
has been placed in cans not properly cleaned or in excessively rusted cans, or ice
cream made from unwholesome cream, or ice cream containing less than 14 per cent
butter fat: Provided ^ That fruit ice cream may contain as low as 12 per cent butter fat.
Sec. 27. Frozen custard. — Frozen custard, or any other frozen product of milk
other than ice cream, shall bear a label stating the percentage of butter fat which said
frozen product of milk contains. Such label shall be placed on the outside of the
packer containing said frozen product of milk.
Keepers of hotels, restaurants, drug stores, ice-cream parlors, and other places of
business where frozen custard or other frozen product of milk other than ice cream is
sold, shall keep posted in a conspicuous place, in their place of business, a sign stating
they sell such frozen product of milk and the percentage of butter fat which it contains.
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1965 NoT!»ber 28, 191T
It AiSl be imktwful for any person, fiim, or corporation, selling, or keeping lor sale,
fhxEen custard, or any other frozen product of milk oilier than ice cream, in the city
of Leavenworth, to fiul, neglect, or refuse to place a label on the outside of the packer
containing sudi frozen product of milk, stating the percentage of butter fat whidi
Buch frozen product of milk contains, or to fail, n^lect, or refuse to post in a con-
fpicuom place in their place of business a sign stating that they sell a f roaen product
of milk and tiie percentage of butter fat tAiat such frozen product of milk contains.
Sbc. 28. UnhoiUhy cows. — It riiall be unlawful for any person, firm, or corporation
to sell, offer for sale, trade or exchange, milk or cream produced by unhealthy cows
or by co^ milked or handled in the same stable, corral, or place of milking where
such diseased cows are kept. The health of the cow idiaU be determined by the
milk in^>ect(^, whose decision shall be final unless rtversed by 1^ State veterinumn.
Sbc. 29. TuhercuUn test. — It diall be unlawful for any person, firm, or cvporation
to sell or offer for side any milk or cream wiUun the city of Leavenworth unlees the
cows producing such milk or cream shall have passed tiie tuberculin tecrt admuristerod
under the direction of the State live-stock sanitary commasaioner, and shall be sabte-
quently tested under the saine autlKirity as frequently as may in ttke judgment of tiw
milk inspector be necessary, ne milk inspector shall have &e aa^K)rity to adsdn-
ister, whenever he deems it advisable, any approved test for tuberculosis, to any
cow producing milk or cfeam for sale witidn the city of I^ioavenwortk, and kis fiiwtingi
shall be final unless reversed by the State tive-slvek sanitary coniMiBBMSier.
Sec 30. Notice to rrdlk inspector of tubercuUn test. — Every x)erson making a
tuberculin test of any cow or cows producing milk sold or used within tiie city of
Leavenworth shall nsittfy ike milk imqi^^ctor of said city at least 48 hours before rnak-*
iBg such test, stating to said mific inspector the day when and the place where such
test is to bo ma^ and the name of the party who is to make such test.
It shall be unlawful for any pewon to make any tuberculin test on any cew or cews
producing milk sold or used within the city of Leavenworth without first notifying
the milk inspector of said city at least 48 hours prior to making such test of the day
when and the place where such test is to be made and of the name of the party who
is to make such test.
Sec. 31. Labels on cows standing tukercuUn tesU — Every cow that has successfully
stood the tuberculin test must have a label stating such fact, fastened to her ri^t
ear; and it shall be unlawful for any person to reaiove from the ear of any cow any
label showing that such cow has succoasfully stood the tuberculin test.
Sbc. 32. Preservatdves. — Any milk or the products made therefrom found to contain
any form of preservatives shall be condemned for food by the milk Inspector, and any
person, firm, or corporation offering for sale or selling any such milk or milk products
or trading or exchanging the same in the city of Leavenworth shall be deemed guilty
of a misdemeanor and upon conviction thereof shall be punished as hereinafter
provided.
Sbc. 33. Inspector to vi^ity score cards. — It shall be the duty of said inspector to
visit, or cause to be visited as frequently as he deems necessary, all dairies and in-
fljpect and score the same according to the score card authorized and used by the
Bureau ol Animal Industry of the United States Department of Agriculture, and he
shall have the authority to revoke the permit of anyone maintaining an unsatisfactory
dairy, and of anyone selling milk from such dairy. A copy of the score card shall be
left with the owner, and such information given as will assist the producer to im-
prove the sanitary conditions or remedy such defects as the score card indicates. A
copy of the score shall be filed in the inspector's office. The said inspector shall
make rep<H'ts to the city clerk annually or oftcner as the commissioner of parks and
public property may direct.
Sec. 34. Inspector, authority. — ^The milk inspector shall have authority to enter
without previous notice any dairy, milk depot, ice cream or milk salesroom or any
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November 23. 1917 1966
place where milk or cream or their products are kept, sold, or prepared for sale, ax^
take such amount of milk or cream or their products as will prove a suflBdent sample
to perform the necessary tests that may be desired by the said inspector; and it
shall be imlawful for the owner, keeper, agent, or employee of any dairy, milk de-
pot, ice cream or milk salesroom or any place where milk or cream or their prod-
ucts are kept, sold, or prepared for sale, to fail, refuse, or neglect at the requeet of
the milk inspector to furnish such amoimt of milk or cream or their products to the
milk inspector, as will be suflScient to enable the milk inspector to perform the neces-
sary tests that may be desired by him.
Where the said inspector finds any milk indicating the presence of water or the
removal of fat, it shall be his duty, whenever practicable, to visit the herd where
such milk is produced and see the herd milked, and the milk mixed, after which he
shall take a sample of milk and seal the same with the seal of his office, and keep the
sample locked in a cool place until he has secured a sample of next regular milking.
The sample must be in proportion to the milk given at each milking. The per cent
of solids not fat, and the fat of these collected samples shall be considered the stand-
ard of the said herd, provided these samples are, collected ^within four da>'s from the
time the suspected sample was collected and tested .
Sec. 35. Instruments for testing.— The city shall provdde the milk inspector with
proper instruments for testing the purity of milk, and he shall have authority to slop
any milk wagon, ice-cream wagon, or person carrying milk, or cream, or their
products for sale, or selling or offering milk or cream or their products for sale, in the
city of Leavenworth, at any time or place, and either lest such milk or cream or their
products or procure a sample of the same: provided, the milk inspector shall not
detain any wagon or person eugai^ed in carrying milk or cream or their products for a
longer period than is necessary to test the same, and may coufiscate such milk or cream
or their products, if found uuwhoUsome as specified in t'.is ordinance, and shall
cause the arrest and prosecution of any person found selling, exposing, or offering for
sale any milk or cream or their products in violation of this ordinance; and it shall
be unlawful for any person driving any milk wagon, or ice-cream wagon, or carrying
milk or cream or their products for sale, or selling or offering any milk or cream or
their products in the city of I^avenworth, to fail, refuse, or neglect to permit the
milk inspector to test such milk or cream or their products, or to fail, refuse, or neglect
to furnish to the milk inspector at the request of such milk inspector a sample of such
milk or cream, or their products.
Sec 3G. Unclean milk hottlrs. — Every person who shall buy milk or cream in a
bottle or container shall thoroughly clean such bottle or container before returning
the same. Any milk dealer shall have the right to refuse to receive unclean milk
bottles.
Sec 37. Summary of ordinance to be posted. — It shall be the duty of every person,
firm, or corporation selling or offering for sale any milk or cream or ice cream in the city
of Leavenworth to post a summary of this ordinance in a conspicuous position in every
place where such milk or ice cream is kept and on every wagon used in delivering
such milk, cream, or ice cream. Such summary shall be furnished by the milk
inspector. And it shall bo unlawful for any person, firm, or corporation selling or
offering for sale, any milk or cream or ice cream in the city of Leavenworth, to fail,
to refuse, or neglect to post a summary of this ordinance in a conspicuous position in
every place where such milk, cream, or ice cream is kept, or on every wagon uoed in
delivering such milk, cream, or ice cream.
Sec 38. Covered wagons. — It shall be unlawful for any person, firm, or corporation
retailing milk or cream in a wagon in the city of Leavenworth to use any other than a
covered wagon for such purpose.
Sec 39. Milk served in restaurants and hotels. — It shall be unlawful for any owner
or keeper, or any agent or employee of any such owner or keeper, or any restaurant
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or hotel in the city of Leavenworth to serve any milk to the patrons thereof except
from bottles.
Sec. 40. Labels on bottles. — ^All bottles containing milk or cream from cows not tested
for tuberculosis shall be labeled **This milk (or cream) is not from tuberculin tested
cows"; and it shall be unlawful for any person, firm, or corporation to sell or offer
for sale in any bottle any milk or cream from cows that have not been tested for tuber-
culosis unless such bottle bears the label: "This milk (or cream) is not from tuber-
culin tested cows.**
Sec. 41. Milk except whole milk. — It shall be unlawful for any person, firm, or cor-
poration to sell or offer for sale any milk or cream except whole milk cream in the city
of Leavenworth unless such milk or cream is sold within 48 hours after the same is
treated or prepared.
It shall be unlawful for any person, firm, or corporation selling or offering for sale
milk or cream within the city of Leavenworth to change any stopper or cap from one
milk bottle to another, or to use any stopper or cap on any milk bottle with another's
name thereon, or to use any milk bottles with another's name thereon.
8bc. 42. PenmUy.— It tthall be unlawful for any person, firm, or corporation, or any
ofiic^r, agent, servant, or enpko'ee of such person, firm, or corporation, to violate any
•f the provisions of this ordinance; and any person, firm, or corporatien, or any officer,
•gent, servant, or employee of such peraon, firm, or corporation violating any of the
proviaioas of thie ordinance shall be deemed guilty of a misdemeanor, and upon con-
viction thereof shall be puniflbed by a fine of not Ifim tiian $6 nor more than 1100 for
each offense, and the permit of such person, firm, or corporation shall be su^>ended
•r revoked.
8bc. 43. Smving clau$e. — No proeecution now pendii^ and no offenses heretofore
eommitted under ordinances heretofore eoacted shall be affected in any way by the
provisions of this ordinance: but all such prosecutions shall be conducted to final
judgment, and all such offeases shall be prosecuted in the same manner as if thia
erdinance had not been enacted.
Sec. 44. Repeal. — ^All other ordinances and parts of ordinances in conflict with this
ordinance are hereby repealed.
Bec. 45. Take effect. — This ordinance shall take effect and be in force from and
after its passage, approval, and publication.
Published October 10, 1917.
CAMP WAD6WOKTH EXTBA-CANTONMENT ZONE.
Garbage and Refase--€are and DtspoaaL (Ord. of Spartanburg, S. C, Oct. 10,
1917.
Section 1. That from and after the passage of this ordinanoe all persons occupying
premises for business or residential purposes must provide the same with adecjuate
water and fly tight garbage containers, in which all organic putresjible waste mate-
rials or garbage must be placed.
Sec. 2. Loose litter, trash, and combustible materials, whether at business or resi-
dential places, must be placed within a tight trash box, so that the contents may not
be blown about or otherwise unneceasarily distributed.
Sec. 3. Garbage cans and trash boxes must be so placed and maintained that they
create no nuisance and are easily ac<'eflsiblo to the colleciors.
Sec 4. No city waste can, placed in the street by the city or city authority, shall
be used by near-by residents or business concerns for the reception of trash or garbage
originating on such premises, it being distinctly understood tliat such cans are placed
for the use of pedestrians.
Sec. 6. Any violation of the foregoing ordinance will be punished by a fine of not
more than twenty-five dollars or by imprisonment for not less than thirty dayt.
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PREVALENCE OF DISEASE.
No health department, State or local, can effectively prevent or control disease without
knowledge of when, where, and under what cimditUms cases are occurring.
UNITED STATES.
PREVALENCE OF THE COMMUNICABLE DISEASES IN THE EXTRA-CAN-
TONMENT ZONES.
In the control of the communicable diseases in the extra-canton-
ment zones the first step to be considered is the securing of prompt
reports of all cases which occur. Without such reports adequate
control of these diseases is impossible. In some of the zones the
practicing physicians are cooperating voluntarily and reporting
• promptly their cases. In other zones enforcement of local and state
laws and regulations has been found necessary to secure satisfactory
reports. In still other zones it will be necessary to secure the adop-
tion of specific and enforceable ordinances or regulations requiring
practicing physicians to report the cases of communicable diseases
, in their practices.
The following shows the prevalence of communicable diseases in
the zone around Camp Pil:o, Ark. The cooperation of the physi-
cians in tills zone has been unusually good. The map on page 1969
shows the morbidity notification area from which reports of communi-
cable diseases are received.
Cases of communicable diseases reported in the morbidity notification area around Camp
Pike, Pulaski County, Ark., Oct. 1 to ^ov. IJ, 1917. '
Chancroid:
Little Rot k
Chicken pox:
LittloRock
Diphtheria:
LittloRock
Little Rock.R. F. D
North Little R ock
Dysentery:
Alexander
Fourche Township
North Little Rook
Follicular tonsillitis:
JacksonvUlo
Cases.
12
Gonorrhea:
Ashley Township
Fcrt Loj^an H. Roots
Cases.
2
.- . 1
4
Littlo Rock
4^
10
Little Rock. R. F. D. No. 3 1
North Little Rock 4
1
Seot t s 1
1
1
Malaria:
Ashley Township 1
Bauciiin I
1
Fields Plantation 1
2
Jacksonville ■. -. 1
I
Kco,R.F. D.No.l
Little Rock
I
105
(1968)
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1969
November 23, 1917
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?..-.f !iljcr23, um
1970
Little UiMk. II. r. I>. So.1
Casvs.
4
13
2
3
Smillpix r>nHnued.
North Little Rock
Cas«.
2
North l.ui;' tiuoW
Jk-otts
S<^tts, ]to»itc I
Stf)tt>, R. F. D. No. I
Syphilis:
JjK'ksonvlUe
I
I
Scotls. Route 2
Little Uook
l«
Swwl lionie
1
North Little Rock 3
To! tec
4
73
Trachoma:
Lilllp Uook 3
Little Rock
MartdM t
Mabelvalr
North LUtl© Rock
2
10
Tuberculosis:
Little Rock
11
llnmps:
Little Rock
2
Typhoid fover:
Levy
Little Rock
1
Pneumonia (loter):
2
n
Little Rock
Little Rock, F. F. D 1
North Little Rock
1
Little Rock, R. F. D. No. 3
North Little Rock
1
Scarlet fever:
18
... . 1
Little Rock
Bcolls, R. F. D. No. 1
Toltcc
I
Septic sore throat:
Little Rock
2
1
Whooping coufh:
Little Rock
Scotts, R. F. D. No. 1
3
1
Toltec
1
North Little Rock 1
Smallpox:
Little Rock
11
6eotU •
Uttle Rock, R. F. D
4
CURRENT STATE SUMMARIES.
The following state reports of the current prevalenoo of communi-
cable diseases have been received.
Callfoniia.
From the State Board of Health of California, telegram dated
November 20, 1917:
Sharp diphtheria iiicn'a*«<» la-^t w(»ek; 111 rai«»s reporKMl; Hp<MiaIly prrvah'nt in
lx)H .\ng<*l(*** city and Tiiluro (\>iinty. Two caw*!* poliomyrli tu^, I Pomona, 1 4'ontra
Cot^ta Couiily. Two ai^ct* anthrax in man. 1 HutK' ('<niuly, I TuUtp County. Ono
ei)id(»mio corebroHinnal men ileitis in On I land. Twoniy-two caws typhoid «ait»'rwl
o\or State. T>s-o ffniailjn»\, 1 Lot* .\n;.M'lj«s <ity, 1 Solano County.
Reported by mail for t!ie pn»' edini^ \\eek (ending Nov. 10):
2 ' IVlljurra 1
'2 rrif"ini'»ni:i 30
I'.li-n.; ■•'i.it' 2
t)i>htli,tli.>i.i n«* 'U.i' iiiin
"^'•-"Ict ic <T
>'. 'l.i».x
.'■^v piiiii>i • ,
T.t.UK!..
Anthrax
(VrcKrirt^pinal mc nin/iti-^
Clncki-n p'»x
I'iph*h<'ria
!>'. -.'nlpry
r- -i'M-L'-
<n t n an nn-l' Iti*
li M < .t ru.s inlf ' li n
li;-.^%
^' ■ .ri:i
\I. I,.-
17
1
17
1
T»ilM.r. til-
T', |.|. .iM !*■
..Uh.
1
62
1
22
1
H5
31
>
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Google
1971
Indiaiuu
NoTember 23. 1917
From the State Board of Health of Indiana, telegram dated
November 19, 1917:
Scarlet fever epidemic Kent, Jefferson County, Tyner, Marshall County, and
Jasper County. One poliomyelitis, Grant County. Diphtheria epidemic Gary and
FortviUe, Hancock County. Smallpox epidemic Nashville, Brown County.
Massachusetts.
From Collaboratmg Epidemiologist Kelley, telegram dated No-
vember 19, 1917:
Diphtheria, Greenfield, 12 since October 16; Amherst, Plymouth 7, Medford 8.
Scarlet fever, Brookline, 9.
Minnesota.
From Collaborating Epidemiologist Bracken, telegram dated
November 19, 1917:
Smallpox, Renville County, Cairo Township, 1; Todd County, Western Union
Township, 2. Three cerebrospinal meningitis cases and 2 poliomyelitis cases
reported since November 5.
Washington.
From Collaborating Epidemiologist Tuttlc, letter dated November
13, 1917:
Vancouver, Clark County, 8 cases scarlet fever. Wena tehee, C'helan County, 10
cases typhoid fevor. Leavenworth, 6 cases scarlet fever. Walla Walla, Walla Walla
County, 80 cases typhoid fever, 22 of these in penitentiary.
RECIPROCAL NOTIFICATION.
Massachusetts.
Cases of communicable diseases re/erred during October, 1917, to other State health de-
partments by department of health of the State of Massachusetts.
Disease and locality of noti-
fication.
Referred to health authority of—
Why referred.
Scarlet fever.
Plttsfleld..
Smallpox suspect:
Camp Dovens, Ayer..
Tuberculosis:
Plttsfleld..
Typhoid fef er:
Adams
State Department of Health, Albany,
N.Y.,onOct.30.
State Department of Health, Augusta,
Me., on Oct. 8.
State Department of Health, Trenton,
N J, on Oct. 18.
State Board of Health, Providence,
R. I., on Oct i».
Patient brought to House of
Mercy Hospital from Ca-
I, N. Y., on Oct. 28.
Soldier exposed In Whltney-
ville, Me. Went with sol-
diers to Ayer. Oct. 3. Sol-
dier did not develop small-
pox.
Patient was on his way from
Canada to his homo in Now
Jersey.
Date of onset about Aug. 15.
Left work Aug. 25 and
visited at Control FaUs,
R. I., returning to Adams,
Sept. 1.
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1972
Cases of communicable diseases re/erred ^ttf^Mf October, 1917, to other State health de-
partments by department of health of the otate of Massachusetts — Continued.
Disea*^ and Uicality of noti-
fication.
Referred to heaJth authority of—
Why
Typhoid lever-CoBttDued.
Falliyver
Rehoboth
Reboboth ,
Springfield
Springfield
Medica' omeer of hmX^ Wellaiid.
Ontario, on Oct. Sft.
State Board of Health. Providence,
R. I., OD Oct. 71.
8tate Bewd of Health, Provideooe.
R.l.,onOct.27.
Departmrntt of HMtlh. New Haven,
Cona., on Oct. 29.
State Board of HeaLth, Conoocd, N . B.,
on Oct. 30.
Pattont
Canada because of lADeB.
Probably infected at Wd-
land, Ontario, where bi
was emplo3red.
Case just across roadway
from headwaters ol Re>
serve Pond whiiA sap-
pMea reservoir of Bristel
and Warren wmter wapftj
in Rhode island.
Pati«Bt»age»y«an. Holber
employed at Narracansett
Rubber Works. finHd,
R.I.
Case was at Momangnin
Beach. New Haven, auz.
24 to Sept. 2 onset ^, T.
Case visiied at The Wein.
N. H.. July IS to 27; or
set of qtoeaaa Aog. SL
CEREBROSPINAL MENINGITIS,
State Reports for September and October, 1917.
Place.
New
cases
reported.
Place.
New
cases
reported
Idurvlan-I (fct. 1-31):
lialtimore Cit V
2
2
Virginia— Conttoued.
rrinoe«.s Aono County........,,.,.
1
Baltimore Count v—
Sussex County I........!.!.!..
1
Sparrows Tuiut ...
Total
g
Total
4
Wisconsin (Oet. 1-31):
1)o«Ikc County
Virpinui (f^opt. l-I^O):
1
1
1
1
1
1
AiiK":^''! rounlv
Manitowoc County
2
llncli.inaii ((jimt v
Milwaukee County II!!*!*'*
s
(i(K'thLiu<l ( 'o'lii V
Kock Count V
1
Lou* lot J M Count \
She boy gun County !!.!!!!!*'
1
Lunriihuru Coiiiily —
Victoria
Total
13
Madi.-^oii County
City Reports for Week Ended Nov. 3, 1917.
Place.
1 Cn-sos.
1
IVaths.
. Place.
Cases.
Heallis.
Hostf'P, Ma-^
1
1
\'< Ix^xinj:tf)n, Kv
I
S
liri l^cpoi I, Ct>nn
M Nv\\- \^ rk, X' Y
3
1
4
i"
3
1
•
Jirooklitu', >h4>s
i
1 Onii;I).i. Nrl)r
lUAhAo, N. V
1
2
1
1 Phiii l.lphm. Pa
diH-.a'o. Ill
Piilsbnrrli, Pa
Dr'.roi', Midi
T'rnv i ',1 r . T? T
1
>Uiii. Ill
1 li s*aiiio. wasii...'.*.!! !!!!!!!!!
lull lii\ir, Mass
;
' Svracusi* N Y
1
I
IJailforti, Conn
\ 1
1 AVin"-l(in-.^:ilem, N C.
1
DIPHTHERIA.
See Diphtheria, measles, scarlet fever, and tuberculoeip, page 1980.
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1973
November 23. 191?
ERYSIPELAS.
City Reports for Week Ended Nov. 3, 1917.
« Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Buffalo, N.Y
2
14
1
11
2
3
1
1
2
2
Philadelphia, Pa
6
8
t 1
Oh1<?ftfo, in
1
I
2
Pittsburgh, Pd
1
rinHnnRti, Ohin
Porfland, Greg
Cleveland,' Ohio
St. Louis, Mo
1
Denver, dolo
San Francisco, C^I
Detroit, Mich.
Seattle. Wash.'.
Hartford, Conn
Sioux nt y. lo *'a
K«n«w f ity . Kans
Superior, "Wis
Milwaukee,' Wis
Taoonia, Wash
Newark, N.J
Toledo, Ohio
^ 1
New York, N.Y
1
Wheeling,^ W. Va
Omaha, Nebr
1
Williamsport, Pa
LEPROSY.
Pennsylvania — Williamsport.
On November 19, 1917, a case of leprosy w^as reported at Williams-
port, Pa., in the person of F. S., a Sicilian, about 40 years of age,
who has been in the United States about 11 years. The patient first
noticed symptoms of the disease about seven years ago and has been
under the care of the Williamsport authorities for one year. He is
now isolated outside the city.
MALARIA.
State Reports for September and October, 1917.
Place.
Btoryland fOct. 1-31):
Anne Arundel County-
Birds ville
Prince Georges County—
Accokeek
Laurel
St. Mar>*s County-
Clements
Somerset County-
Kingston
Total.
Virginia (Sept. 1-30):
Accomac County
Bloxom
Chincoteanie
Greenbackville
Albemarle County
Scottsville
Alexandria County—
Alexandria
Alleghany County-
Clifton Forge
Covington
Amherst County
Appomattox County..
Bedford County
Brunswick County. .. .
Lawrenceville
Buchanan County
Buckingham County. .
Campbell County
Brookneal
Caroline County
Bowling Green
New cases
rei)oried.
Place.
I New cases
j reported.
Virginia (Sept. I 30)— Continued
• Charlf^; Cil y County
Charl AW. County
Che.stpr r>\^ County
Winterpock
Culpeper County
Cuml>erl^nd County
Dinwiddle Count v ."
Eli7.al>eth City County -
Hampton
Phoebus
Essex Cotmty ,
Fairfax Couiit y
Fauquier County
Fluvanna County
Gloucester County
Goochland County
Greensville County
Emporia
North Erap'jria
Halifax Cotmty
South Hoscon
Hanover Count y
Ashland.
Henrico County
Richmond".
Isleof WIcht County
Smithiield
James City County
Williamsburg
Kin:? and Qtieen County
Kins George Coimty
Kin-T William Cjunty
Weit IMnt
I>ancft^lPr County
I.ce County .
10
II
9
6
2
4
10
n
2
2
4
2
1
34
1
42
29
15
?5
9
14
12
2
18
1
27
2
9
4
Ci
7
8
4
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November 23, 1017
1974
M ALARU— Cantinued .
State Reports for September and October* 1917->Continucd.
Place.
Newca5es
reported.
Place.
NeT«««
Vinrfnlft (8«pt. 1-30)-Conttaa«d.
Lotidoim (Vuntv
1
5
15
1
1
2
IS
1
sa
13
22
57
6
43
7
- 8
1
8
1
18
2
15
66
' Virglnk (S«)t. l-^>-ContJaued.
Prince Kd wanJ County
4
Louisa Count y
FarmviJle
8
L.uii^nbiirtf C'oimtv
Pnncf Cleorve
8
Victoria A
Hopewell
4
IfM^kl^nbuTF (^otmtT
Prince wil Ho m County
1
tha^oHiiy
Richmond CountT
n
Clarksx'lle
Rockbridge County—
LexingtcHi
South llill
3
Middlesex County ^
Rookinjtham County
6
Crl>anna
Russell County
1
N(ni«?*niond < '.umtv
Smyth County..
1
SulToIk
Southampton County
19
Nelson Count V
FraiiKlIn
W
N6W Kent (^ounty
Bpotsylvin la County
1
Norfolk Count V
BlafTord County
K)
Northampton Cotinty
Surry Cou n(y ,
3»
CapeCharles
Clftreaont
8
Norihurabcrlund County
* Dendron
s
Nottowav Ciamiy
1 Sussex Couniv
88
Blackstone
Taxewell County—
Pocahootas ,
Crrwe
1
Onmre County
Warwick County
tf
Onuuie
Wa«<hInjton County
8
PittsylvAnla County
Westmoreland County
York County
10
iJanviile.r
11
Po whfttan Coi m t v
Total
PrinoMs Ann<> C-onntv
1,000
City Reports for Week Ended Nor. S, 1917.
Place.
Cases.
Deaths.
j Place.
1
Cases.
DMtha.
BirmtnKham, Ala,
6
New Orleans, La
1
!
CharlcsFon, ^. C
2 ;' New York, N.V
. SftpTAinwito. CftI
1
Lot Angele."', Cal
2
2
Ifemphl'^, Tenn
2
1
1 t^avannah, (Ii
Mot)ne, Ala
1 Wimlon-Salem, N. C
1
1
MEASLES.
Sc(? Diphtheria, meju"*l«\'*, tsarlet fever, and tuherculnnu*. pUKf* 1080.
PELLAGRA.
State Reports for September and October, 1917.
Place.
(•■ffi'v
•
ret
Mew
*e^ re-
"(•rted.
I
1
12
1
1
:i
1
1
I
1
Vlr
Nrl .)•! J <r't.<y
I'll' ' l\ v'l.i * <rinl r
New
cuei re-
ported.
Hi'i "! <
« (>■ ! 1 ( V . .
Jtt.." •. ! 5
1» ■". iMc. ..
l..inr.
I'{i'» \i ' • •H'f'iiPt^'
Di ) ■ l.)<li'
H-u- n ,• r,,..ni\
1 : t' » ! M
"tj ' ' \
y .rif ....
':• .'">'«r .. .
i;>. '. '
Hi. i 'I'll »i:i ♦ «»»'ni V
r.> hi.
' .. \U\
\\ , hi'iri'«*i Co*inly. ,
« "'ty
Tf/til .
< t ■ .'■ \ li.
a
t ;''i «
Wr -. -; ilr jI(/MifaK. . .
Mi.uu V o .til V
Tout
e ~
1 M <
M.Mii...
'•'J
it.' '1*1
....'
2
* ■' n
-'*•!' \
^. —
M. ...-i-.t
r^; » «nii'l\
3
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1975
November 23, 1017
PELLAGRA— Continued.
City Reporto for Week Ended Nov. 3, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Birmingham, Ala..
El Paso, Tex
Lexington, Ky
Memphis, Tonn...,
Mobile, Ala
Nashville, Tenn...
Savannah, Ga
Washington, D.C.
Wilmington, N.C.
PNEUMONU.
City Reports for Week Ended Nov. 3, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Baltimore, Md
2
3
.3
I
1
3
146
25
4
7
2
1
1
2
3
1
4
21
. U
Lonff Beach Cal
1
6
6
1
27
4
1
1
1
48
18
1
2
1
10
2
2
1
Binghamton, N. Y
Los Angeles
5
BMlbn, MaM :....
lATin.Mass
Biaddock, Pa
Cambridge Masn
50
17
2
Manchester, N. H
Newark, N.J
New Bedford, Mass
1
0
Chelsea, &iass
5
Chicago, 111
Nowburyport, Mass
Cleveland, Ohio
Newtf)n, Mass
Dtivton, Ohio
Norristown, Pa
1
Detroit Mich
Philadelphia, Pa
31
Duhith, Biinn
Erie, Pa,
Pittshurgh. Pa
Pontlac, Mich
16
Everett, Mass
Fall River, Mass
Grand Rapids, Mich
i
ReadinR, Pa
Roan >kc, Va
San Francisco, Cal
3
1
6
Jackson, Mich
Kalamazoo, Mich
1
Worcest or M;\'<s
1
1
POUOMYELITIS (INFANTILE PARALYSIS),
niinois.
During the week ended November 17, 1917, cases of poliomyelitis
were notified in Dlinois as follows: In Loe and WTiiteside Counties 1
case each, and in the city of Chicago 8 cases.
State Reports for September and October, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Maryland (Oct. 1-31):
Allegany County-
New Town
1
1
1
1
1
1
1
West Virginia (Oct. 1-31):
Cabell County—
Huntint^n . .
4
Midland
Hardy County
2
Ccdl County—
Elkton
Marshall County
Marion County-
Fairmont
1
Garrett County—
Avllton, R. D.
1
Preston County
1
Orantsvllle, R. D
Taylor County—
0 raf ton
WallmftTi
3
Prince Georges County—
Brentwood
Wood County
1
Parkersliurg
3
Totil
Total
7
10
11
16
Virginia (Sept. 1-30):
Aumsta County .^. .
Wisconsin (Oct. 1-31):
Chippewa County
Buckingham County
Dunn C^untv
Dickenson Coimty
Grant County
Fauquier County
Jackson Coimty
Greene County
Kenosha County
Hali^ County
Marquette Coimty
Hanover C'Ounty
Milwaukee County
Madison County
Portage County
Mathews Coun£y
Racine County
Patrick County—
Stuart
Walworth County
2
Waukesha Coimty
Total
RociHngham County
13
Harrisonburg !
Total
43
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NoTember 23. 1917 1976
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
City Reports for Week Ended Nov. Z, 1917.
Place.
Cases.
Deaths.
Place.
CMet.
Deafti.
Chicago, ni
17
1
1
1
1
Pittsbargb, Pa
1
Davenport, Iowa
Providence, R. I
1
Konosna, Wis
Richmond Va
1
3
Lancaster, Pa
Seattle, Wash
1
Los Angefes, Cal
1
1
Toledo,' Ohio
3
New York, N. Y
1
RABIES IN MAN.
Wieconils^Milwaukee.
On November 16, 1917, a fatal case of rabies was reported in M3r
waukee, Wis., in the person of J. S., who was bitten by a stray dog
September 10, 1917.
RABIES IN ANIMALS.
Wiicondn— Milwaukee.
During the period from November 6 to 16, 1917, 7 cases of rabieB
in animals were reported in Milwaukee, Wis.
City Reports for Week Ended November 3, 1917.
During the week ended November 3, 1917, one case of rabies in
animals was reported in Brockton, Mass., and one case was reported
in Orange, N. J.
SCARLET FEVER.
Montana — Bntte.
During the period from October 1 to November 16, 1917, 43 cases
of scarlet fever, with 1 death, were notified at Butte, Mont., 20 of
the cases having occurred during the first 16 days of November.
Sco also Diphtheria, measles, scarlet fever, and tuberculoeis, page 1980.
SMALLPOX.
Maryland.
Collaborating Epidemiologist C. Hampson Jones reported Novem-
ber 21, 1917, 6 cases of smallpox at Cumberland and 1 case at Carlos,
Allegany County, and 2 cases in Garrett County, Md.
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SMALLPOX— Continued.
Miscellaneoas State Reports.
November 23, 1917
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Virginia (Sept. 1^):
JLoudouD County
1
1
1
1
1
Wisconsin (Oct. 1-31):
Buffalo County
12
8
3
27
10
10
Mathews County
Calumet County
Norfolk County!
Clark County
RusseU County
t>ane County
Wise County —
Dunn County
Big Stone Gap
Eau Claire County
Grant Countv
Total
6
Jackson County
Ia (^nvuM Cniintv
West Virginia (Get. 1-81):
Cabefl Countv—
Huntin^n
8
1
8
1
2
2
1
12
8
Lafayette County
Manitowoc C^inty
Milwaukee County
Monroe County
Fayette County
Kaiiawha County
Pepin County
Marshall County
Rock County
Roane County. I
Trempealeau County
Total
Tavlor Countv
Tyler County
101
Wirt County
Wood County
Total
83
City Reports for Week Ended Nov. 3, 1917.
Place.
Cmes. D«a%h3.
Maai.
Cases.
DeathBL
Alton. Ill
Ann Arbor, Mich
BufTalo, N. y
Butte, Mont
Chicago, 111
Cle\ eland, Ohio
Coh.mbtis, Ohio
Dayton, Ohio
Detroit, Mich
Flint.MIch
Fort ^fVa.vne, Ind . . .
Grand Rapids, Mich.
Indianapolis. Ind
Jersey (ity, N. J
Kaii'^s Cilv, Kans..
La Crosse, W lo
Lincoln, Nebr ,
Memphis, Tenn
Milwaukee, Wis
Minneapolis, Minn...,
Nashville, Tenn
New Orleans, I^
NiagaraFalls, N. Y..
Norfolk, Va
Oklahoma City, Okla.
Omaha, Nebr
Pittsburgh, Pa
Portland, Oreg
St. Louis, Mo
Salt Lake City, Utah.
Sioux Citv, Iowa
Toledo, Ohio
TETANUS.
City Reports for Week Ended Nov. 3, 1917.
During the week ended November 3, 1917, one fatal case of tetanus
was reported in Cincinnati, Ohio; one death from tetanus was re-
ported in Cleveland, Ohio; and one case was reported in New Bed-
ford, Mass.
TUBERCULOSIS.
Sec Diphtheria, measles, scarlet fever, and tuberculosi«, page 1980.
TYPHOID FEVER.
California — San Francisco — On Steamship.
On November 16, 1017, 6 cases of typhoid fever were removed
from the steamship Nippon Mam upon the arrival of the vessel
from New York.
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November 23. 1 !> 1 7 1978
TYPHOID FEVER— Continued.
State Reports for September and October, 1917.
Plare.
Maryland (Oct. 1-31):
Baltimore ill v
Allegany Cojiit v
Amio Anind"! (V.mly
Baltimore t'onntv
Hlghlandlown
Maryland School for Boys
Calvert Coimty
Caroline Coimt y
Carroll County
Cori 1 Cwmly
Cliar'es Cmml y
Dorchesi er County
Frederick Coimt y
Garrett County
Harford I'ount y
Howard County
Kent County
Montgomery Coimty
Prince Oeorge 8 County
Queen Annes County
Somerset Coimty
St. Marvs Count v
Talbot bounty
Washincton County
Wicomico Count y. *
Worcester Count y
Total
Virginia (Sept. l-:w»:
Accoraac County
Bloxoni
Chinf oloaguc
Onancock
AUjcmarle Coun t y
Crozct
AllcEhaiiy Count y ,
Covington
Amelia County ,
Amherst Count y
Appomattox County
Augusta Coimt y
Betlford County
Bland Cmmt y
Botetourt Count y ,
Buchanan...
Finc}i«<t!p
Buchanan Count y
BuckinKluini t 'ount y
Campbell County
AltaVista
Bro<»kiicftl ,
Lynchburg
Caroline County
Carroll County
Charlotte County
Chosterflold ( ounty
Cul neper Count y
Dickenson Comity
Dinwiddle County
Petersburg
Eliial>cth ( iJy County-
Phoebus
E.ssox County
Fairfax County
Falls Church.
Hemdon
Fauquier Coimty
Floyd Count y
FlUNTmna County
Franklin County
Uocky Mount
Frederick Coimt y
Winchester
Giles County
Narrows
Glouce.^^ter Cotmty
357
Virginia (Sept. 1-30)-Contlnucd.
Goochland Coimty
Grayson Countv
Greene Count v
GroonesTllIe County—
Emporia
Halifax County
South Boston
Hanover County
Henrico County
Henry County
Martinsville
Isle of Wight County
SmithJield
James ( ity County.
Williamshui^ .
King and Queen County.
Lancaster County
11
( ounty
Lee County
■ Loudoun Coimty
Louisa Count y
Lunenburg County..
Madison County
Mathews County
Mecklenburg County
MHUhHiU
Midd'esex County
Moi»l«<omerv County
Radford
Nansemond County.
Suffolk I
Nelson County i
Norfolk Countv
Norfolk..: I
Northampton County
Northiminerland County
Not t oway Count y t
Blackstone I
Orange County i
(lordonsvl'lle '
Orange •
Pago County •
Luray )
Shenandoah i
Patrick County |
Pittsylvania County |
Chatham |
Danville
Princess Anne County. .
l*rlnte Edward County.
Prime (Jeorge County..
Hopewell
Princ« William County,
Potomac
I*ulaski County
l*ulaskl
Rappahannock County.
Richmond County
Roanoke County
Roanoke
Salem
Vinton
Rockbridge County
Buena Vista
Rockingham Coimty. ..
Elkton
1 larrtsonburg
Ru i-^cll County
Honaker
Scott Coimty
(JateClty
Shenandoah County
Strnsburg
Smyth County
>farion
Saltvllle
Southampton County..
1
11
<t
1
9
2
7
4
2
I
5
1
1
3
1
15
3
2
3
1
3
3
3
A
6
6
1
4
12
U
6
I
6
I
7
2
2
1
7
1
3
3
10
1
8
7
4
10
1
5
7
3
S
1
7
5
10
1
1
3
5
9
2
3
7
2
3
n
13
2
S
1
5
U
Digitized by
Google
1979 November 23. 1 017
TYPHOID FEVBR— ConUnued.
State Reports for September and October, 1917— Continued.
Place.
Vliginia (Sept. 1-30)— O ntlnued.
opotsylvania County
Fredericksburg
Stafford County
Surry County
Dondron
Sussex County
Tazewell County
Oraham
Pocahontas
Warwick County
Washinf^n County
AbiiiRdon
Damascus
Westmoreland County
Wise County
Cocburn
Norton
Wise
WytbeCoimty
Max Meadows
WytbeviUo
Total
West Virginia (Oct. 1-31):
Berkeley Coimty
Braxton County
Fayette County
Grant County
Hampshire County
Hancock County
Harrison County
Jackson County
Jefferson Coimty
Kanawha County
Charleston
Lewis County
McDowell County
Marshall County
Marion County
Men er County
Mingo CounU'
Monongalia County
New cases
reported.
640
3
26
13
7
1
1
1
3
3
1
3
18
3
3
3
2
14
Place.
West Virginia (Oct. 1-31)— Continued.
Morgan vuuiity
Ohio * ounty—
Wheeling
Pendclton County
Potahonta. County
Preston County
Putman County
Raleigh County
Richie County . . *.
Roane Cx)unty
Taylor Coimty
Tucker County
Upshur County
Wajme County
Wetiel C-ounty
Wirt County
Wood County—
Parkcrsburg.
Total
Wisconsin (Oct. 1-31):
Adams County
Ashland County
Barron County
Burnett Ceimty
Dane County
Dodge County
Eau Claire Coimty
Fond du Lac County
(irecn LakeCounty
Kenosha County
La Crosse County
Lincoln County
Milwaukee County
iSt. Croix County
Slicboygan County
Trempealeau County
Vernon County
Walworth County
Wood County
Total
New cases
reported.
ao
1
2
1
8
1
8
3
1
2
6
1
1
9
2
"l74
47
City Reports for Week Ended Kov. 3, 1917.
Place.
Cases.
Deaths, j
t
IMace.
Cases.
Deaths.
Albany. N. Y
4
3
19
1
20
6
1
1
1
2
7
10
3
1
1
16
3
1
3
2
2
1
14
Flint, Mi^h
6
Ann \rltor. Mich
1
Fort Worth. Tex
1
II;iM iiiir<i«\ Mfl . ...... .
2
C,:\U'^\ ufK HI
1
Diiipliainlon, N. Y..
llarri.sl i:i^. I'a
1
Hinnmfili'ini , Ala
3
llarlf<»r<l. ("onn
is'
3
2
Boston, Mii^<
Iii<iiana|.o.i.>, 1 nd
Jersey ( ily, N. J
Jouii^^town, I'a
Bri«ltjeporl , Comi
2'
Huiralo, N. Y
I
Cainbridce, Mass
I
Kansis ( it V. Kans
Keno'^ha. Wis
1
1
3
1
2
I
1
\
7
1
7
2
3
Oho Isca, Miiss
1
('Jiicaro III . .......
1 1
2 ,
Know i lie. Temi
Cleveland, Ohio
Lawrence , Mass
CoIiiml>ns Ohio
l.exi(JKton, Kv
Covlii^jton, Ky ,
1
Ivong Beaeh , C'al
Denver, C'olo . ............
1
Los Angeles, (al
3
I)etroii, Mich
!'
L\iiehl)urg. Va
I^ululh, Minn
Madison, Wis
Elgin, 111
Medford. Mass
Kl Paso, Tex
2 j
Memphis, Tenn
P^rlo Pa .
M i 1 wankec , Wis
K vansv i lie , Ind
il
. . . ^
Minneapolis, Minn
K%erett, Wash ... .
MoMlo, Ala
Fall River, Ma.ss
i
Nashville, Tenn
2
Digitized by
Google
November 23, 1917 1980
TYPHOID FEVER— Continued.
aty Reports for Week Ended Not. 3, 1917— Continued.
riacc.
Cases.
Deaths.
Place.
Cases.
Deaths.
Newark, N.J
ft
2
* 1
1
3
35
1
1
1
4
1
1
1
12
0
1
H
1
1
Roanoke, Va
•1
New Bedford. Mass
j Saginaw, Mk*h
New Cast 'e Pa
St. lyOuts Mo
2
New London, Tonn
Salt Lake City, Utah
New Oriearts, La
San Francisco, Cal
2
NewYork, N. Y
8
Saratoga 8pr bigs, N.Y
Savannah, G a
Noiristown, Pa
North Adams, Mass
1 Schenectady, N. Y
feittle, Wash
0(?den. Utah
2
2
Oklahoma City, Okla
South Bend, Ind
1
Orance, N.J
Sprlnpneld, HI
1
Possaic.N.J
Tacoma, Wash
Perth Araboy, N. J
' Taunt on jMass
PhiladelphLi, Pa
3
2
Topeka, kans
Pittsburgh, Pa
Toiwlo, Ohio
3
Portland, Me
Washington, V.C
2
J ortiand, Orep
1
Washington, Pa
5 ortsmouth, Va
Watertown, N. Y
! rovldence, R.I
1
Wheeling, W. Va
< uinev, 111
Winstoi-Salem, N. C
I
I eadihg. Pa
4
3
Zanesviile, Ohio
1 iehmond, \'n.
TYPHUS FEVER.
City Report for Week Ended NoTember 3, 1917.
During the week ended Novembers, 1917, one case of typhus fever
was reported in New York City.
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCULOSIS.
State Reports for September and October, 1917.
Ca;^^^ reported.
State.
Cas?5 reported.
state.
Diph-
theria.
Measles.
\
96
133
Scarlet
lever.
150
05
t^h?rS: Measles.
Scarlet
fever.
Maryland (Oct. 1-31)..
Virginia (Sept. 1-30)..
243
29li
West VirginU (Oct.
1-31)
125 1 17
25?J 152
47
Wisconsin (Oct. 1-31)..
330
City Reports for Week Ended Nov. 3, 1917.
Popula-
tion OS of
July 1,1010
(estimated
by U. S.
Census
Bureau).
Total
dcMhs
Irom
all
«111SCS.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
1
1
.a
1
1
1
Over 500.000 inhabitants:
Baltimore, Md
5K9,621
750, 470
2,407,722
074, (t73
571, 7Ht
.'i03,S|2
5,602, t^l
1,709,51S
579,090
757,309
218
238
603
163
199
■*i,'25i'
475
206
216
16
111
300
42
97
38
207
30
83
1
6
34
1
14
1
le
11
2
2
17
39
44
4
13
3
97
14
11
19
......
7
31
111
18
48
15
99
26
12
34
'2
5
* 3
1
......
18
51
408
31
25
22
357
115
28
39
37
Boston, Mass
23
Chicago, 111
79
Cleveland, Ohio
1ft
Detroit, Mich
21
Ia}s Angeles, C.al
13
NewYork, k Y
131
Philadelphia, Pa
57
Pittsburgh, Pa
11
St. Louis, Mo
17
Digitized by
Google
1981
M<yvember28. 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERGULOSIS-
Continued.
CHy Reports for Week Ended Nov. 3, 1917— Contmued.
*
P<5p<(to^
liott li-v [if
Jql>- J,1'J16
i<?di mated
bv V. B,
Canjsus
Bureau).
Total
deaths
from
all
c«usea.
Diphttiefia.
Measles.
Scwiet
Tevor.
Tuber-
culosis.
. a^*
1
1
1
1
1
1
1
1
jTQm 300,000 ta smsm inbal^
4fiS,5ia
410,476
30a,M5
436, S13
363,454
371,747
214, sia
271, 70H
3B5,4m
254,960
104,199
181,762
121,579
112,981
106,233
127.224
12X,:'66
104,. ';62
128,291
110,900
100,560'
in. 245
102,425
148,095
117.057
11«,158
14r.,6^5
19S,fi04
165,470
10* 3.S1
15' .6H7
117,:^99
ia-),{42
155,624
112.770
191 . .-.VI
111..^»1U
163, .U4
57,660
57,6.->^.
.'>^.07:i
67.410
q\ \52
«), 714
57.144
w. ;o.-.
h6.»>K>
fvi,7(\j
75, 1«C>
76,n7K
51.772
76, l.Vi
72.(»15
77.214
6.S, :,■J^\
9l». V.\7
51,155
Ill
m
73
100
117
00
ia2
»
'43"
45
TO
38
32
4i"
39
24
34
37
27
36
22
57
46
29
38*
27
34
48
21
35
32
67'
41
52
S2
27
10
21
n
13
U
34
5
13
&1
5
IS
5
5
1
J
8
3
2
14
12
3
6
1
37
1
4
2
4
3
9
18
3
13
19
2
s
1
1
1
1
' 'i'
......
I
!
0
14
I
6
33
1
B
4
a
10
0
7
ig
ao
a
11
4
......
li
»
10
11
7
cittclnniti, Ohio,,. „,„.,,.
15
3
lliniwapqlla, Hinti
N^&w Orleanis la, ,
:::::.
m
li
n
25
10
T4
12
ifcU Frivmi-lara. Cal.,..«^,...
12
Sctttik, Wash
7
from mnoo to 300,000 iotiAb-
17
Denver, Colo. ....,,,
T
1
1
13
liHllnmipoJis, tnd^.^„^„...
10
0
FiirtlEiad, Orefr
3
Provklenre^ HI „ . .
5
Jr^m 10u,iX)D to 2l»,Q00 tohab-
- Albany, N.Y
1
18
1
9
8
14
12
7
6
2
4
20
Birmingham, Ala
9
1
I
2
3
7
Bridpeport, Conn
4
Cambridge, Mass
5
Camden,">^. J
Dayton, Ohio
6 :::::
4
Fall River, Mass
2
3
Fort Worth, Tex
3
2
4
7
1
3
3
Grand Rapids, Mich
Hartford, Conn
3
4
4
6
4
16
2
18
9
7
2
Lawrence. Mass
1
Lowell, Mass
1
2
Lynn, Mass
4
l^mphis, Tenn
......
......
8
2
4
5
1
2
14
1
2
2
18
10
11
7
Nashville, Tenn
7
NewJ3edrord, Mass
6 1
4
1
1
New Haven, Conn...
3
Oakland, Cal
3
Omaha, Nebr
2
Reading, Pa
1
1
......
1
.'.'.'.'.'.
3
6
4
Richmond. Va
1
Salt lake City, Utah
Sprinirneld, Mass
18 1
3 -
2
6
3
Syracuse, N. V:
Tacoma, \V:i>*h
I
?
Toledo, Ohio
15 i 2
Hi ^
12 1
1
1
14
5
7
«
5
5
3
Trent on, N. J
2
1
5
Worcf'slor, Mass
1
6
5
From ."JO.MJO to 100,00(3 itihab-
itanl.'-:
Allantio ('it v. N. J
I^ttvoniie, X. J
A"
16
\2
2-.
16
IH
.IS
2s"
16
20
21
17
i-i"
'
HerVolrv, rni
2 I
1
7
2
2
i
Biiit'liumlon. N. Y
6 : 1
2
3
1
1
1
3
5
1
Bpx'kton. Ma>^s
4
'2U
. ...1
Civnton, Ohio
1
Charlo-'ton, S. C
1
Covington. Kv
1
2
4
.2
2
Duliit h, Minn'
1
s . .
Elizul>oth, N. J
Kl P:i^, Tex
16 , 1
IS
1
3
7
Erie. Pa
10
\
3
9
;i
4
1
4
2
2
10
39
Kvaii^ville, Ind
1
1
Flint, Mich
1
5
2
Fort Wavmi. 1 nd
I 1
2
1 larri>hur^', Pa
1
2
IIoboU«*». X. J
John^'.owti. Pa
i
2
2
:i
5
1 1
...I
1
2
Isnt5'-;i- Cil V. Kan.-.
2 ......
1
l.jvru ib-tc, I'a
Maiden, Mass
2
2
Digitized by
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November 23. 1917
1982
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Not. 3, ISIT— Continued.
Popula-
tion as of
Julyl.ll'lG
(estimated
bv U. 8.
Oensus
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
2
1
1
1
1
5
1
From 60,000 to 100.000 inbab-
Itants-€ontinued.
\f anrhAster N. H .
78,2S3
6«.221
m;7*h
89,«12
92,043
71.744
50, ni
ft^, '^67
rxj, ik:>
5.sr^2
r)3,:^:^o
9i). .MO
.'i7.07K
S7.(^<0
as.oto
61,120
51 . .V)0
70, 722
16
15
8
13*
20
8
23
11
22
18
22
2
2
5
4
3
5
4
1
7
1
8
4
MrtVtilA Ala
2
Naw Rritain Conn
1
4
2
9
Norfolk Va
2
6
1
1
1
1
OVlahoma City, Okla
Passaic N J .
1
3
1
4 ,
1
4
PawtucVet. R.I
Portland Me
1
25
3
llnrkford 111
2 ■
6 \[
1
3
1
flftrrAmAnto Cal
i
a
Sairinaw. Miob
1
8
3
3
4
1 !::::::
4
4
1
I
8t Jownh Mo ....
1
1
t
3
Savannah, (Ja
8chene<'tady. N. Y
1
:::."!ii;:::::i— ...i::""
2
1
3
1
,
t
Somerville, MtS'^'^
13
13
21
16
24
3 1
1
11
1
2
floiith T<<>nd Ind
1
. ....
RnHnfrn<>1d Til
2
3
Snrincrnpld Ohio
J
1
I
1
2
2
1
....::i
2
Wichita, Kail**
1
1 1
1
Wilkes- Uarre, Va
76, 776
27, 732
.32. 730
27. f.32
43. 42'>
46, l!>2
20.319
2«i.071
32. 261
. 4S, Kl 1
30. H73
2N,7Kt
42, r.S
2S, 203
3\\ 233
X^, 4S<i
41 , 7sl
4I,^rv.3
29, :i">:i
4S. 477
3rt, 36.3
4S, H.sti
31.576
3X,676
31,677
41,007
35, :iH4
46,515
27, 5H7
36,964
32, '^lO
30, 6<HJ
26,234
27,327
29, 6(X3
41,ia3
31.r<27
30, lOs
43, 715
37,353
31,401
31,404
33,0*^0
46,450
41,18,3
38.629
24
5
2
1
1
2
From 25,000 to 50,000 inhabit-
ants:
4
3
5
1
Urooklinc Mass
11
'I
5
1
1
..:..;!
Tliitlcr Pii
6
1
Butlo. Mont
""'"L"
121
i 1
Chelsea. Mass
s! ! 1' ! 6| 1
1
1
1 '-:....,
*
Ciitnherland Mri
;:::::i:;::. .!......■ - j >
D&nville 111
1 1
'\ ; M
Davrnport. Iowa
Dubumio, Iowa
Ka.<^t f nJoaPO Tnd
1
1
9*
S
I
9
4
10
24
3
9
7
19
0
12
6
1
9
i2"
9
11
I
10
9
10
7
10
9
8
12
■;|...,'
1 1 .
1
i
16
:::::: :::::;i::::::i;::r:i
East Orange. N. J
Flciu 111
1 1 1
I
I
1
K\T?rctt Mass
4
1
Everrlt Wash
:::::: .
1
Fitehburp, Mass
4
3
■"i'!::;:::' 4*:;.:.:
3
1
Gal vest on Tex
,
1
Green Bav Wis
1 — 1
Haverliill' Mass
(i
1
12
1
......
2
3
1
Jarkson Mifli
2
1
21
1
1
il
10
9
i
4
1
11
1
""2
'■ ■ 1
10
2
1
T^ima Ohio
1
3
1
4
......| 3
T.onp Ueafh Cal
IvOrain Ohio
1
......
:::::l....'.
1
1
1
1
Madison Wis
1
Met! ford Ma-^s
2
i
Nasliiia N H
p
Newbureh N Y
2
2
1
i*
1
4
1
New t'astle Pa
Newnort Kv .....
..
1
I
Newport, K.I
6
1
1
3
3
1
2
1
I
2
4
Niagara Falls N V
2
2
Oirden Utah
8
Orangc.N.J _
Pasadena, Cal
Perth Araboy.N. J
Pittsflcld. Mass
3
1
1
1
7
2
Digitized by
Google
1983
November 23, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reporte for Week Ended Nov. 3, 1917— Continued.
Popula-
tion as of
July 1, PIG
(estimated
bv V. S.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
lover.
Tul>er-
culosis.
City.
1
s
1
1
1
1
1
1
1
From 25.0 X) to 50,000 inhabit-
ants—''ontinued.
Portsmouth, Va
39,6S1
36,798
3S, 136
46,486
43.2ft4
2R.926
38,903
27,44S
46,226
36,?J<3
48, 72*)
SO.'STO
29, fW
43.139
43,377
33,809
?1. S02
31,155
30, '^r>3
22,874
15,010
13, -32
21 . «>X-)
15, 794
> 13, 075
17,54H
22. (V^y
24, 276
Zi, -39
> l9.3t-3
Ul.MO
17,115
13. 2M
23. IKt
15.213
2»>. S5
» 22. 1)1 'J
19. 1<2'1
2.{.sr,
17. -.21
11,'f/,
12,a;r
n.vn
2<), 1.'3
l.X, S2I
l">,.*.is
21. MS
2i.22S
I.-..'.-.."
8
14
7
10
11
8
Quiiicv ni
2
1
1
1
1
1
Qiiincy, Moss
2
1
1
Racine, Wi-:
Roanoke, Va
5
1
*
2
Rock Island, m
............
San Jose '^ al
2
1
1
6
2
1
1
Stcnbenvill*". Ohio
4
5
16
16
3
2
6
14
ii*
11
12
11
7
'i'
i
3
Superior Wi*?
Taiinton, M'vss
3
3
Topeka, Knns
1
1
Waltham SCass . .
1
WatertouTij X. Y
1
1
3
3
3
1
West noboifi»n. N J
1
1
2
1
1
^^TieeUn?. W Va
2
WilUoinsport. Pa.
Wilmington, X. ('
3
Winston-Salem, N C
4
1
Zanesvillo Ohio
2
From 10,000 to 2->,000 inhabit-
ants:
Alton HI .
4
1
2
1
1
1
2
Ann Arbor, Mich
Beaver Falls I'a
.3
1
Bra Mock, Pa
8
:* "1
1
1
Cairo 111
C linton Mass
2
CoflevNille. Kaus
i
1
1
Concor 1 V IT .. .... ..
9
4
6
4
5
7
5
G
5
G
8
6
11
2
1
5
t °
6 1
1
2
1
Galosbiirp, III
1
3
Kcamv \ J
1
Leavenworth Kiins
1
Lont^ Bniiioh N J
2
1 j
1
Marino it'T' ^^*is
3
1
1
M' 'Iro^ Ma'^s
1
4
MDr^isto^^u X J
Nanlic<)k'\ Va
1
1
'1
1
Newbnrvport Mu«;s
1
New LuJidon. ' «)rin
3
::::::i::::::::::::i::::::
1
North Ad:inis, M-iss
1 ' 1
Norlhiinpion Mass . . .
; L
1 1 \"""^""''
Plairilitll X J
4
2
i...:..L. :..:.:.:..!
1
Ponliac. ^^i( h
......
1 1
1 2
Portsinoi:! il X. U
1
1 2
■
Rot'kv >r(i!iiit, N C
Rutbn 1 Vt
1
..
1
Psuiih'.^kv Ohio
i i
t
1
;!!]!!t::::::
Sarilo^.t S|iriii'-s, X Y
1
Sit "It oil I'a
1
"i ..!!..! 4
AN'a'^!'iiit5''»n Prt
I
WUkifi"-!.! r/ l*a
1 «
2
1
2
Wobum Ma^j
1 1 1 1
1
i
1
1
» roi>ulaliun Apr. 15, IVIO; noesiini'^'e infile.
Digitized by
Google
FOREIGN.
CHINA.
Plague-Infected Rat— Hongkong.
During the week ended September 22, 1917, out of 2,089 rats exam-
ined at Hongkong 1 was found plague infected.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Receded Daring the Week Ended Nor. 23, 1917.>
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bombay
AuR. 2«VScpt.8...
Julv 2*>-Aug. 11...
b
2
12
4
4
J
1
1
Calcutta
Karachi
Sept.<>-15
4
6
Madras
Sent. 2-15
Mandalav . .......
Aut;. 19-20
Sept. 2-8
1
1
June 10-10, 1917: Cases, 1 ; deaths.
Indo-Chlna:
Saigon
Sept. 17-23........
Phil pplnc Islands:
Provinces
Sept. 16-22, 1917: Cases, 115;
deaUis, U^
Antinuc
Bohol
Ccbu
Sept. U>22
(\o
6
35
0
«
n
32
5
5
12
<o
11
do
Iloilo
Lcyte
Mindanao
Ncgros OrienlAl
Samar
ao
do
.do
do-
do
Sept. 23-29, 1917: Cases. 136;
deaths.. }>7.
Antique
BoJiol
Ccbu
Iloilo
I/€y te
Mindanao
Nccr OS Oriental .
Sci>t. 2i-2y
do
19
G
IG
6
€9
1
2
12
(.
•i
2
do
..do
do
do
. do
Tayabas
do
PLAGUE.
Ceylon:
Colombo . . .
India.
. Aug. 2fr-Sept. 1.
Basscln ' Aut;. 19-Sept. 1.
Bombay Aug, 2(V-Sopt. 8.
Au^. lU Sept. 1..
fc'epl- 2-15
do
Aug. iy-i>ept. 1.
do
AuJ!. 12-Sept. 8.
Aug. ly-Sept. 1.
Ilonzada
Karachi
Madras Presidency.
Mandalay
Moulraein
Rangoon
Toungoo ,
Indo-China:
Saigon
Sept. 17-2:1.
29
12
1,005
IM
3
1
27
3
12
710
11
14
142
1
Aug. 2G-Sept. S, 1917: C^tses,
15,^3; deaths, 11,735.
June 10-16, 1917: Ca-^s, 19; deaths,
16.
'From medical ollicers ol the Public Health Service, American consuls, and other sources.
(1984)
Digitized by
Google
1985
November 23. 1919
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Contlnueil.
Reports Received During tlie Weeic Epded Nov. 23, 1917— Continued.
SMALLPOX.
Place.
Date.
Cases.
Deaths.
Remarks.
Canada:
New Brunswick
Nov. 10
21
Chiefly in Carleton and York
Coimties. One case notified
in Northumberland County
Present.
China:
Mukden
Sept. 30-Oct. 6....
Shanghai .
Oct. 1-7
1
13
India:
Bombay
Aug. 26-Scpt. 8. . .
July 29- Aug. 4 . . . .
?
1
Calcutta..,
Madras
Sept. 2-8
4
9
Rangoon
Aug. l^Septl...
Sept. 17-23
June 10-16. 1917: Cases. 4: deaths.
Indo<3hlna:
Saigon
6
3.
TYPHUS FEVER.
China:
Tsingtao.,
Japan:
Nagasaki..
Sept. 23-29.
Oct. 8-14...
YELLOW FEVER.
Mexico:
Yucatan State
Meridfl —
Reports Received from June 30 to Nov. 16, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bassein
Apr. 1-May5
8
1
347
30
4
63
2
1
3
1
5
7
1
17
7
Bombay
June 24-30
1
14
Do
July 8- Aug. 18....
Apr. 29-June 30. . .
Calcutta
Do
July 1- Aug. 18
Madras
Apr.22-Jime30...
Julyl-Fcpt.l
May 6- June 30
5
102
Do
Do
July 29-Aug. 11 . . .
Moulmein
May 13- June 2
Pakokku.
Apr. 20- May 5
Peeu
May 27-June 30 . .
Do
July 1-7
Prome
July 29-Aug. 11...
Rangoon
Apr.21-June30...
July 8-28
31
9
tS!^::::::::::::::.::::
iDdo-China:
Provinces
Feb 1-June 30 1917" Cases 1 27?*
Anam
Feb.l-June30....
July 1-31
230
86
79
74
878
359
1
36
3
163
46
191
47
51
53
543
214
deaths, 805. July 1-31, 1917;
Closes 522- deaths 314
Do
Cambodia
Feb. 1-June30
July 1-31
Do
Cochin-China
Feb. 1- June 30....
July 1-31. . .
Do :
June 1-30 '"
Tonkin
Feb.l-Jime30....
July 1-31......
21
Do
Saison
Apr.23-May27....
July2-Sept.l6....
108
31
%:::::::::::::::::;;;:
142
Digitized by CjOOQIC
November 28, 1917
1986
CHOLERA, PLAGUE. SMALLPOX, TYPHUS FEVER, AND TBLLOW
FBVER— Continued.
Reports ReeeiTed fh>in June 30 to Not. 16, 1917— Continued.
CHOLERA— Gontiniied.
Ptooe.
Date.
Cases.
Deaths.
Remarks.
Janan ^
Jan.-Jaly, 1917: Cases, 391. 0».
eurring in 16 proviDoes and d^
tiicts.
Sept. 12, 1917: Cases, 2S2. In S
Tokyo •
Sept. 12
3
1
3
1
Java:
East Java
Apr.2-8
Do
July 9-26
3
1
Mid Java
July lfr-22
West Java
1917: Cases, «M; deaths, 307.
Batavia
Apr.l3-July6
July6-8ept.l3....
Feb. 3
7
38
1
4
4
11
1
3
19
179
3
14
Do
Persia:
Maianderan Province—
Amir Kela
Barfourouche
Jan. 15-17
Do
July 28
1
6
Demavend
July 29
Bamzc Kela
Jan. 17
Machidessar
Jan. 31
Sabzc var ,
Aug. 20-29
July25-Aug.6....
14
96
Sari
Tabri*
Aug. 4, 1917: In rill ace »f
Osoundeh, vicinity oC Tabfts,
about 7 cases daily.
Philippine Islands:
Manila
June 17-23
Aug. 5-25
1
4
Do
Sept. 3-S, 1917: 1 case. Not pr*.
viously reported.
May 3&-June 30, 1917: Cases, 796;
deaths, 506. July 1-Se^ 15,
1917: Cases, 3,408; deaths, 2,134.
Provinces
Agiisan
July 15-28
12
U3
73
2
26
1
1
368
322
62
64
231
501
61
14
804
237
351
447
1
1
1
106
196
254
16
7
15
11
2
76
43
15
Albay
May2(>-June30...
July 1-Sept. 1
Juno 3-9
Do
AmlxK? (^*mftrliv»flxT..^-
Do
July22-Aug.ll...
July 8-14
Bataan
Batangas
Juno 17-23
May20-June30...
July l-Sopt.l5....
June 3-30
1
251
247
40
45
150
353
36
5
501
117
208
289
Bohol
Do
Capir
Do
July 1-Aiig. 4
Juno 2-30
CcIhi
Do
July 1-Sopt. 15....
do
Hollo
Ley to
June 10-30
Jiilyl-Sept. 15....
JuIyH-Aug. 4
July 20-Sept. 15...
July 1 -Sept. 15....
June 24 -30
July 1-7
Do..:.:.:.:::.:.:..
Misamis
Mindanao
Nepros Oriental
Rizal
Do
Romblon
July 22-28.. .
1
61
88
133
10
7
14
7
Samar
July I.VSept. 1....
June 3 30
Sorsocon
Do
July 1 Aug. 25
Julv29-Aug. 25...
June i 30
Siiriirao
Tavalnis
Do
July 1-Sept. 1
July 15 21
Zambounga
PLAGUE.
Arabia:
Aden
May 3- Jul',' 4
43
Apr. R-May 14, 1917: Cases, 69;
deaths, 51.
In Persian Onlf. Present Apr,
3, 1917.
Bahrein Islands
Brazil:
Bahia
Juno 10^30
12
6
4
41
1
8
2
1
33
4
Do
Pemainhuco
Ceylon:
Colom bo
July s Sept. 15
July I(> Aug. 15...
Apr. ^ June 23
July t>-2l
Do
Digitized by
Google
1987
NoYemtM*23, 1917
CHOLBRA, PLA&UE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— CJontlnued.
Reports Receired from June 30 lo Not. 16, 1917— Oontinued.
FLAGUB-Continatd.
Place.
Date.
Oases.
Deaths.
Bemarks.
Ch&ia:
Amo;
%:
Hongkong
Kwazigtune Provfaice—
Ta-pu district
Ecuador:
Estancia Vieja
Qoajiiquil
Do!!;;;;i";!"i;!;!
Apr. 2^]i£ay 5..
Ji5yl-7........
May 13-Jane 30
July 8-Aug. 18.
June 2
Noboi
Salitre
Do
Taura
Egypt
Alexandria
Do
Port Said goveniment..
Port Saw
Do
Provinces—
Fayoum
Galioubeh
Girgeh
Minieh
Do
Siout
Sues government
Sues
Great Britain:
Gravescnd
London ,
Feb. 1-28
....do
Mar. 1-Apr. SO.
Julyl-Aug.31.
Mar.l-aC...
Apr. 1-30
Feb. 1-28
....do
Mar. 1-31
Feb. 1-28
June 21-27
July31-Sept. 11.
Apr. 30-May 19..
June 25
July 28-29
Mayll-June28..
June 28
May 17
May 12- June 28..
July29-Sept. 11..
May 12....
Apr. 30- June 2...
Mayl2-June28...
Aug. 13-24.
May 3-8....
India
Bassein
Do
Bombay
Do..
Calcutta ,
Do
Henxada
Do
Karachi
Do
Madras Presidency ,
Do
Mandalay
Do...
Moulmein
Do
Myingyan
Pegu
Do
Rangoon
Toungoo
Do
Indo-China:
Provinces
Anam
Do
Cambodia
Do
Cochin-Chlna
Do
Kwang-Chow-Wan. .
Tonkin
Do
Saigon
Do
Apr. 1- June 30..
Julyl-Aug. 18..
Apr. 22- June 30.
July l-8ept. 1...
Apr. 29-June2..
July 15-21
Apr. 1-June30..
Aug. 12-18
Apr. 22-June30.
JiUyl-Sept.l...
Apr.22-Jime30.
Jiflyl-Sept.l...
Apr.8-Mayl2...
Jifly2^Aug.l8.
Apr. 1- June 30..
Julyl-Aug. 18..
Apr.1-7
May27-June8..
July29-Aug. 18.
Apr. 15-June30.
Julyl-Aug. 11..
Apr.*-14
July29-Aug. 18.
486
294
468
21
301
1,199
183
Feb. 1-June30..
July 1-31
Feb. 1-June30..
July 1-31
Feb. 1-June30..
July 1-31
May 1- June 30..
Feb. 1-June30..
July 1-31
Apr. 23-June3..
Sept. 9-16
232
13
132
10
219
43
34
113
3
47
2
22
54
23
397
236
38
4
25
2
413
16
250
S70
9
9
74
19
1
2
6
160
286
2
131
9
115
10
133
24
23
89
2
26
2
Present and fin vfeinity.
Present Aug. 10.
Present.
Jan. 1-Oet. 4, 1917: Cases, 724:
dflath8,895.
From s. s. Matiana.
2 in hospital at port. From s. s.
Sordlnia from Australia and
orientalports.
Apr. 15-June 30, 1917: Cases,
43,992; deaths, 30,197. Julyl-
Aug. 18. 1917: Oises, 23,500;
deaths, 17,613.
Feb. 1-June 30, 1917: Cases,J30;
deaths, 491. July 1-31, ftl7:
Coses, 69; deaths, 45.
Digitized by
Google
NoTember28,iei7
1988
CHOLERA, PLAGUB, SMALLPOX, TYPHUS FEYmt; AND TBU/MT
FEVER-Oontinued.
Reports ReceWed from June 30 to Nor* 16» 1917— Oontiniied.
PL40UB— OoDtiiitMd.
Dtte.
Cmm. Deaths.
Japan:
AlchiKen
Miyo Kon
Java:
East Java
DJociakarta Residency.
Kc<liri Residency
Samaranc Residency. . .
Surabaya Residency. . .
Do
Surakarta Residency. . .
Persia:
Mobammcra
Peru
Departments—
Ancachs
Arequipa
Cnllao
Lambaycquo.
Libertad
Jan.-Ju'y.
do....
Apr. 23-May6...
do
Apr. 23-May20..
Apr. 2-May20...
JaIy»-28
do
Mayl.
Julv 1-31
May l(V- July 31..
do
....do
May 1(>-21
Lima.
Senegal
Siam:
Bangkok
I)o
Straits Setllpmpnts:
Sinpa|X)re
I>o
Union of South Africa:
Cape of nood Hope State—
Cradok-
Glonprev district
Tcrka district
Quecastown
Orange Free State ,
Winburg district
At sea:
8. S. Matiana
....do..,
Sept. 30.
Apr. 22- June 30..
JiUy.vSept. 1...
June.VlG
July 1-Sepl. 22.
AuR. 23.
AUR. 13.
May 28. .
June 6...
May 28
July 14-18..
20
Apr. 2-MaT 30, 1917: Cuas» Sfc
deaths. ». July ao-AiK. SL
IMT: Owea, 4; deaths, 4.
Presoot.
May 13-31, ldl7: Cases, 15. Jane
1-July 81, 1W7: Case*, 38.
AtCa^ma.
At Mollenda
At Caliao.
At Chiclayo.
At Balaverry, Ran Pedro, and
Trujilk>. July 1-31. 1»17: At
TruUUo.
At Lima. July 1-31, 1W7:
city and country.
Present in intcriw.
Present.
Do.
At Summerhili Farm.
Apr. 16-22, 1917: 1 case. Apr. ^
22, 1917: Cases, 26; deatlui, 17.
En route for port of London.
SMALLPOX.
Australia:
New South Wales
IJrcwarrina
Ccssnock
CoonalMirabran
Quamboue
Warren district
Queensland-
Thursday Island Quar-
antine Station.
Brazil:
liahia May JV-Jnne .30. . .
1)0 1 July 22 Sopt . 22. .
Rio dc Janeiro , do.
Apr. 27-June21..
July 2."> 2H
May 2:. Julv 5....
Apr. 27-Jun:' 21..
June 22 -Sept. 25..
May 9
. Do
( ma«la:
Manitoba-
Winnipeg
Do ,
NO'VTI SC(»{l;l —
llalif.i\
Fori llawkcsbury..
Ontario -
Ottawa
Windsor
Ceylon:
Colombo
July I Sept. 22..
June 10 in ,
Aug. 19 Sept. 1..
June IS Jnlv7..
Juno 17 -;:S0
Julv 30-Aug. 5
Sept.SO-Nov. 3....
Mayi-Wf
12';
blH
1
31
lOS
Apr. 27-Aug. 30, 1917: Cases, 77.
From s. s. St. Albans from Kobe
via Hon;;kon?. Vessel pro-
ceeded to Townsvillc, Bris-
bane, and Sydney, in quaran-
tine.
Present in district.
Digitized by
Google
1989
November 23. 1917
CHOLBRA, PLA6UB, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Beporls Reeefredfiroin Jvne 30 to Nov. 16, 1917— Continued.
SBfALLPOX—Continned:
PUwe.
Date.
Cases.
Deaths.
Remarks.
CUna:
Apr. 2»-Ma7 26....
Do.
^^0 :*;::::"/.:*.::!
Jdly 1-Sept'. 22
Antung
Kay21-June24....
Aug. 6-12
4
1
5
Do
rh|||^M^fk , ,
May27-Jnne2....
Aug. 11-17
^jM^im .............
7
Chunffkincf ...
May 6- June 23
Present
I>0
July 1-Sept. 22
Do.
Dairen.x.t.rr.
Mayl3-June30...
July 8-28
30
6
2
7
8
1
1
4
1
Do
July 1-7, 1917: Present.
HftTllf ow
June 21-30 .
Harbin
Apr.23-May«
M»y»-Junel«
Aug. 5-18
On Chinese Eastern Ry.
HonEkonK
7
nongKong....... .......
Mflnchnrin Station - r
Apr. 23-29 .
Do.
Mukden
May 27- June 2
Do
Julv 8-SeDt. 30 .
Do.
BbanEhaf ,
May21-July 1
Julv 2-SeDt 30
13
32
12
Cases foreign; deaths among n**
tives.
Among Chinese.
On CMnesd Eastern Ry.
At another station on railway,
1 case.
Do
TiitshAr Statimi
Apr. 16-22
1
36
4
1
Tsinetao
May22-July7
July30 Aug. 11...
May 1-31 ... .
7
1
Eo^ ::::;::::::::
Chosen (Korea):
ChemulDO .. . ........
Habana
Nov. 1
From s. s. Ahonso XIII, from
Ecuador:
Guayaauil
Feb. 1-28
1
8
12
39
30
80
1
1
ports in Spain.
So. /......: ..:::.:..
Mar. 1-Apr. 30....
JiUyl-AuR.31....
Apr. 30-Julyl....
July 2-29
Do
Alexandria
9
4
1
Do
Cairo
Feb. 12- Apr. 8....
July 30- Aug. 5....
May 5-12 .. .
France:
Nantes .•
Paris . . .
Qennany
Mar. 18-Apr. 28. 1917: Cases, TlSfe
in cities and 32 States and dis-
Berlin
MAr.18-Apr.28....
do
106
16
18
50
20
2
10
1
Bremen
tricts.
Chariot ten berg
do
Haniburfi
do
Leipzig
do
LUbeck
do
Munich
..do
Stuttgart
do
Greece:
Athens
Julv 25-30
23
75
25
12
8
2
48
20
6
India:
Bombay
Apr. 22- June 30
July l-Soj)t. I
Anr 29-Mav 26 . .
186
55
Do
Calcutta
Karaclii
Apr. 2^2- July 4
July S-8ept. 1
Apr.22-Juno3n. . .
July 1-Scpf.l
Apr. 1.>-June 30. . .
.Tulv 1-2H
27
5
80
11
33
7
Do
Madras
Do
Han^oon
Do
Indo-China: |
Provinces i
Feb. l-June 30. 1917: Cases, 617J
deaths, 53^. July 1-31, 1917:
Cases, 625; deaths, 132.
Anam
Feb. 1-June3)....
Jtilv 1-31
1.630
3.\3
136
28
1,267
130
4
5
10
274
4
199
5i
237
50
26
23
377
49
Do
Cambofiia
Feb. I-June:i0....
Julv 1-31
Do
Cochin-('hiaa
Feb. 1-Juni>:i0....
Julyl-.Hl
Do
Kwang-Chow-Wan ... .
Mar. 1- Apr. 30
Apr. 1-30
Laos
i
1
30
Do
July 1-31
Tonkin
Do
Feb. 1-Jiine3:). ...
July 1-31 .
Saigon
Do
Apr. 27- June 10.. .
July2-Scnt.l6
63
26
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1990
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continaed.
Reports Received tnm June 90 to Nov. 16, 1917— C!ontinued.
SMALLPOX-CooUnuad.
Place.
Date.
Cases.
Deaths.
Remarks.
lUly:
Turin
May21-June24...
Julyl2-SeDt.30...
Cept.9-15
92
12
1
12
8
Do
Jamaica:
Kington.. ...... ...........
Japan......
n^obe
May27-July22....
Mav2^Juiie3....
May 1ft- July 5
July 25-31
177
1
1
88
21
88
45
16
Naiasaki
Osaka
55
YokkaiphL
Yokohama.................
May27-J«ilyl
Apr.2-Julyl
July 2-Ausi. 29
Apr. 1-Julyl
July2-Sept.4
1
2
Java:
East Java
Do
Mid-Java.
7
Do
West Java
Apr. 13-July 6, 1917: Cases, 23B;
Batavia
Apr.l3-July6
Jan. 1- Jimo 30. ... .
30
6
116
1
1
9
Mexico:
Coatepec
Do
Aug. 1-14
Jan. l-Aug. 14, 1910: 118 deaths.
Jalapa
July 1-13
Maiatlan
July 11- Aug. 7....
Mexico City
June3 30
162
142
Do
Aug. 5-Sept. 22....
June 18-24
Monterey
24
23
1
2
1
•
Orizaba
Jan. 1-June 30.....
Do
July 1-23
Vera Cnir.
Julyl-8ept.l5....
Aug. 13-18
Mayl3-June9....
Juiy8-Sept.l
May 13- June 30...
July8-Aug. 18....
Mar. 1- June 30....
6
1
8
7
14
8
Netherlands:
Amsterdam
Philippine Islands:
Varioloia.
Do
Do.
Portugal:
l3fabon
Do
Portuguese East Africa:
Lourenco Marques
5
4
Russia:
Archangel
Mayl-Jujo28....
July 2- Aug. 28....
July 2-15
M
6
6
566
6.S
7
23
16
3
Do
Moscow
Petrograd
Feb. 18-June30...
July 2-29
Do
Riga
Mar. 11- June 2....
Mar. 15-24
Jan.l-Mar.31,l9l7:CMe8.9.
Vladivostok
7
biam:
Bangkok
June 9-30
Do..;;;.;:::::.:::::;.:
July 11-17
5
4
44
19
11
Spain:
Madrid
May 1-Junel9....
Malaga
Apr. 1-June30....
Do
Jiilvl-31
Seville
MaVl-Jone30
Valencia
Juno 3-23
6
13
6
1
1
1
2
2
Do
Julyl-Scpt.15....
Mor. lS-Juno23...
June 24-30
Straits Settlements:
Penang
3
Sincnporo
Do
Sept. 16-22
Apr. 22- 28
May 20- Juno 23...
Juno 2-8
Sweden:
Mahno
Stockholm
1
Tunisia:
Tunis
Turkey in Asia:
Treblzond
Feb. 25- Apr 13...
15
Union of South Afriw:
Johannesburg
Mi\r. 12-24
4
3
2
Do
July 1-31
Urufiuay:
Montevideo
May 1-31
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November 23, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Rep<Mrt8 Received from June 30 to Nov. 16, 1917 — Continued.
SMALLPOX— Continncd.
Place.
Date.
Cases.
Deaths.
Remarks.
Venezuela.
Maracaibo
Jnneia-July 8
1
Do
JuIyO-23
On vessfils:
S S Alfonso XIU
Nov.l
1
At Habana. Prom ports ia
Spain (or Mexican ports.
TYPHUS FEVER.
Algeria:
Algiers
Jmiel-30
1
3
1
Do
Julyl-Aug.31....
Aug. 12-18
Argentina:
Buenos Aires
Austria •••.•......
Oct.23-Dec.l7.1916: Cases, 2,37L
Bohemia
dct.22^i)ec.i7....
do
634
809
47
617
16
243
5
Dec. 24, 1916-Feb. 24, 1917:
Galicia
Cases, 2,553.
Lower Austria
....do
Moravia
do
Silesia
do
Styria
do
Upper Austria
do
Bosnia'Herzegovina
Dec. 22, 1916-Feb. 34, 1917: Cases,
no.
Feb. 19-June 17, 1917: Gases,
1,787. ^^
Hungary , r - . - r
Budapest
Feb. 19-May27....
Apr. 23-Juncl7...
July 29- Aug. 11...
Sept. 23-29
10
278
2
Eisenburg
46
BraxU:
Rio de Janeiro
Canary Islands:
Santa Cruz de Tencriffe
1
China:
Antung
June23-July 1
July9-acpt.23....
June 9-15
3
15
1
•
Do
1
Hankow
\
Do
July8-14
1
Tientsin
Jime 17-23
May3a-July7
Aug. 5-11
1
4
1
1,648
430
188
1
Tsinctao
Do
Alexandria
Aug. 3;VJuIvl....
July 17- Sept. 30...
Jan. 22- Apr. 8
Mar. 19-25
478
lis
76
Do
•
C^alro
Port Said
Great Britain:
Cork
June 17-23
1
Glasgow
8ept.30-Oct.6....
May 23 -June 30. . .
1
Greece:
Salonlki
32
19
Do
July l-Aug. 4.
Japan:
Hakodate.. . •.
Julv22'2<*
1
4
37
Nagasaki.
June 11-21
July9-Oct. 7
Do
7
Java:
East Java
May 6 July 1, 1917: Cases, 6.
Sura^)aya
June 25- July 29. . .
4
Julv O-Aue. 29, 1917: Cases. 7.
Mid-Java
Apr. "l-Jiinc 24. 1917: Cases. 38;
Sainarang
Mav 5-Junc 10
Julv 2-.H
"
2
deatiis. 5. Jnlv 9-Sept. 4, 1917:
Do
Cases. 15: de\tfis. 1.
West Java
Apr. 13-July 5. 1917: Cases. 147;
Batavia
Do
Apr. 13-Jiilv .'-...
July 6-Scpl. 13
Julv lO-O.n. 28 .
70
7G
6'
9
2
1
\i
deaths, H. Jnlv (>-Sopt. 13,
1917: Cui^ci. Ur2; deaths, 12.
Mexico:
Aguoscaliontes ....
Coatopcc
Jalapa
.\lu^ 1 U
.\pr. l-Iunr iO. ..
Do •
Julv \ M
Jiirr- ;^3!)
■ ■■-ni"
i,(m
Mexico City
•
Do.
j!ilvS-Sopt.-i-2
Jan. 1 June 60
Orizaba
I
Do
July 1-31 1
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1992
CHOLERA, plague; SMALLPOX, TYPHUS FEVER, AND YBLLOW
FEVERr-Continued.
Reports Received from June 30 to Not. 16, 1917 — Continued.
TYPHUS FEVBB— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Netherlands:
Rotterdam
June 9-23
3
a
7
1
11
16
10
141
33
. 2
Do
July 15-Sept. 1....
July 8-28
Bergen.
Portuguese East Africa:
Lourcii^o Marques
Mar. 1-31
Russia:
Archangel....
May 1-June28....
July2-Aug. 28....
July 2-1.5..
Feb. IJ^JuneSO....
July 2-29
2
5
Do.^.::::::::::::::::::
Moscow
Petrograd
3
Do
Poland
Anr. 23-Jiino 3L 1917: Cases.
Z814: dcath.s 1S7. Jane H-
?uly 14, 1917; Cwes, 2^
deaths. 211.
Lodi
Apr. 23-June3
June 17- July 14....
Apr. Z^JuneS
Junel7-Julyl4....
Mav31-Juncl6....
July 22-28
120
108
1,044
1,495-
8
n
5
16
16
95
131
Do
Warsaw
Do
Riga
Jan. 1-31, 1917: 1 case.
Do
May 1-31, 1917: C^ses, 4.
Vladivostok
Mar. 2S^May21....
MavI-31
Spain:
Almeria
5
2
Madrid ....
'do
Switzerland:
Basel
June 17-23
1
7
2
2
Do
Zurich
July Jv Sept. 22
July 2fr .Sept. 22...
June 4 3
1
Trinidad
Tunisia:
Tunis
Junc30-Julv6
1
I'nion of South Africa:
Cape of Good IIoi>e State...
Aug. 25, 1917: Present in 16 dis-
tncts.
East I.ondon
Sept. 10
YELLOW FEVER.
Ecuador:
liabnhovo ...
Feb. 1-28
1
2
1
18
34
24
1
2
2
2
8
1
6
1
1
7
18
10
i)cK^ ::::::::::::::::::
Mar. 1-31
CholK)
do
(juavaquil
Feb. 1-28
1)0
Mar. 1- Apr. 30....
July 1- Aug. 31....
Feb. 1-28
Do
Milapro
Do
Mar. l~Apr. 30....
July 1-Aug. 31-...
Aug. 19-25
Aug. 8-Scpt. 20....
June 23
1
2
1
3
1
1
Naranjito
Mexico:
Campeche ?tato—
( ami)ocho
Yucatan Slate—
Merida
Pcto
In person recently arrived from
Mexico City.
Do
July l-Sept.25....
Venezuela:
Coro
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PUBLIC HEALTH REPORTS
VOL. 32 NOVEMBER 30, 1917 No. 48
VACCINATION AGAINST SMALLPOX.
THE KIND OF VACCINB TO USB AND HOW TO USE IT.
The United States Public Health Service ftdvises the following
procedure in order to secure the best results from vaccination and to
prevent possible compUcations.
I. The Vaccine.
The freshest possible vaccine should be. obtained. All vaccine
packages, pending use, should be kept in a metal box in actual con-
tact with ice.
n. The Vaccination.
Vaccination should never be performed by cross scratching or
scarification, but by one of the methods described below. If a
prompt *Hake" is very necessary, as in case of direct exposure to
smallpox or if the first attempt has been unsuccessful, three or four
appUcations of the virus should be made, but the insertions should
be at least an inch apart. Whichever method is used a control area
may be first treated similarly, but without the virus, in order to esti-
mate the amount of pressure necessary for insertion and in order to
demonstrate a possible early immune reaction in previously vaccinated
individuals.
Preparation.
The skin of the upper arm, in the region of the depression formed
by the insertion of the deltoid muscle, should be thoroughly cleansed
with soap and water if not seen to be clean, and in any case with
alcohol or ether on sterile gauze.
After evaporation of the alcohol or ether, a drop of the virus should
be placed upon the cleansed skin. To expel the virus from a capil-
lary tube, the tube should be pushed through the small rubber bulb
which accompanies it, wiped with alcohol, and one end broken off
with sterile gauze; the other end may be broken inside the rubber
bulb. The hole in the latter should be closed with the finger as the
bulb is compressed to expel the virus.
The under surface of the arm is grasped with the vaccinator's left
hand so as to stretch the skin where the virus has been placed. The
skin is kept thus stretched throughout the process.
143 (1993)
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November 30, 1917 1994
Methods.
(a) The method of incision, or linear ainuion. — By means of a
sterilized needle or other suitable instrument, held in the right hand,
a scratch, not deep enough to draw blood, is made through the drop
of virus, one-quarter of an inch long and parallel with the humerus.
The virus is then gently rubbed in with the side of the needle or other
smooth, sterile instniment. Some blood-tinged serum may ooze
through the abrasion as the virus is rubbed in, but this should not
be sufficient to wash the virus out of the woimd.
(b) The drill method, — A sterile drill, such as is used for the von
Pirquet cutaneous tuberculin test, shaped like a very small screw
driver with a moderately sharp end not more than 2 millimeters wide,
is held between the thumb and middle finger, and with a twisting
motion and moderately firm pressure, a small circular abrasion, the
diameter of the drill, is made throu^ the drop of virus; this should
draw no blood.
(c) The multiple puncture method, — A sterile needle is held nearly
parallel with the skin and the point pressed through the drop of
virus so as to make about six oblique pricks or shallow punctures,
through the epidermis to the cutis, but not deep enough to draw
blood. The punctures should be confined to an area not more than
one-eighth of an inch in diameter.
With methods (a) and (b) it is advisable to expose tlie arm after
vaccination to the open air, but not to direct simlight, for 15 minutes
before the clotliing is allowed to touch it. With method (c) the
virus may be wiped off immediatdy.
m. The Vaccinatioii Wound.
1. The original vaccination wound should be made as small as
possible, and all injury to the vaccinated arm should be guarded
against. Any covering which is tight, or more than temporary,
tends to macerate the tissues during the ^Hake.'' This ia to be
avoided. No shield or other dressing should be applied at the
time of vaccination. Customary bathing and daily washing of the
skin may bo continued, so long as the crust does not break. The
appUcation of moisture to the vaccinated area should not be enough
to soften the crust.
If an early reaction of immunity is to be watched for, the patient
should report on the first, second, fifth, and seventh days after
vaccination. Otherwise, the patient should r^ort on the ninth
day, or sooner if the vesicle, pustule or crust breaks. Every effort
should be made to prevent such rupture. However, should the
vesicle, pustule, or crust break, and the woxmd thus become open,
daily moist dressings with some active antiseptic, such as mercuric
chloride or dilute iodine (one part tincture of iodine in nine parts of
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water) shoiild be applied. Under no circumstances should' any
dressing be allowed to remain on a vaccination wound longer than
24 hours, and no dressing should be applied so long as the natural
protection i» intact.
On account of possible fouling by perspiration and to lessen the
chance of exposure to street dust, primary vaccination should be
performed preferably in cool weatiier.
In order to encourage proper surgical treatment, ho charge should
be made for the aftercare of a vaccination nor for revaccination in
case the first attempt saould prove unsuccessful.
Although apparently trivial, vaccination is an operation which
demands skill in performance and care in aftertreatment in order to
avoid tiiC rare, but serious, complications. For the prevention of
these complications vaccination (a) suould be performed with strictly
aseptic technique, (&) should cover the smallest possible area for each
insertion, and (c) should be treated without any covering which per-
mits maceration.
A Ciiild should be vaccinated by the time it has reached the age of
6 months, and the operation should be repeated at about 6 years
of age and whenever an epidemic of smallpox is present.
WINTER OUTBREAK OF POLIOMYELITIS.
ELKINS, W. VA., 1916-17.
By J P. Leake, PasssU Assistant Surtjcon; Josepii Boltev, Passed Assistant Surgeon; and H. F.
Smith, Assistant Surgeon, United Statos Public Health Scrrice.
Particular attention was attracted to the West Virginia epidemic
of poliomyelitis because it occm'red in the winter and because it fol-
lowed so closely the New York epidemic as to be reallv an extension
of that general epidemic. At the time it was thought to be the first
winter outbreak in the United States; indeed it was the first to
assume anything hke epidemic proportions, but a search of the
records has revealed other outbreaks in this country during cold
weather. . vScandinavian observers had caHed attention to a few
winter outbreaks in Sweden and Norway although no definite study
had been made of the temperature conditions. A criterion must be
adopted as to what constitutes a winter outbreak; the mere months
of the year signify very different weather in different parts of the
globe. Fm*ther, we know that occasional poUomyelitis occurs
practically everywhere and in all seasons; these isolated winter cases,
however, are unimportant as regards a study of conditions of infec-
tion, for it has been known ever since the epidemiologic study of
pohomyeUtis began that some cases occur apparently without any
relation to each other, just as do cases of noninfectious nervous
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Norembor 80, 1917 1996
diseases. Therefore it is here assumed that to be considered a winter
outbreak, two or more comiected caaes must occur after the temper-
atiu^ has remained below freezing for 24 hours. A study of the
available Uterature reveals 38 such outbreaks (Table 1), not including
the West Vii^ginia epidemic. The official meteorological reoorda
were studied, Norwegian/ Swedish,' Austrian,* Prussian,^ Heasian,'
or American,'* as the case might be, and by interpolation from the
surrounding stations, the approximate temperatures of the places
where outbreaks occurred could be obtained. Besides mere db-
tance, there had to be taken into consideration altitude, proximity
to bodies of water, and direction of mountain ranges. Fortunately
there were meteorological stations at several of the places them*
selves, as at Elkins.
t Jahrbucfa des Norweglschen meteorolof^hen Instituts: Kristiania.
« MtteoroIocldB Tikttagelser i Sverige: Uppsala & Stockholm.
s Jahrbticher der k. k. Zentral-Anstalt (Or Meteorologie und Oeodynamik: Wieo.
«Ver5flentlichtiiigeD des KOnlgllchen Preusslschon Meteorloglschcm Instituts TOn CLadcJiag: Bcclfa.
• Deutsches Meteorlogisches Jahrbucfa, Qrossfacreogtum Hessen: Dannstadt.
< Records ol the U. S. Weather Bureau, published and unpublished.
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November 30, 191'i
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It is to be seen that some of these outbreaks were far north of the
Arctic Circle. In some, the thermometer went below freezing
nearly every day of the outbreak, and in some it remained below
practically the entire time. In 15 of the outbreaks the thermometer
went below zero Fahrenheit, the lowest temperature recorded being
29° below zero Fahrenheit — 34^ below zero Centigrade — at Misv&r,
Norway. The contagion was apparently of the most direct sort
in a few cases, i\ptably in some of a group south of Atvidaberg,
Sweden, and in the Mosjoen epidemic in Norway. The infrequent
communication between houses in cold weather, and the general
infrequence of sporadic, unrelated cases at this season, make it
possible to trace contact between individual cases much more
definitely than in summer, so that the absence in most instances of
clear histories of exposure to recognized cases, as we shall sec in
studying the West Virginia outbreak, is all the more significant in
showing the great importance of unrecognized cases and of carriers
in the spread of the disease.
Origin of (he Elkins Epidemic
The general origin of the Elkins outbreak was undoubtedly the
great New York epidemic of 1916.
It was shown at the Hygienic Laboratory that the West Virginia
and the New York diseases were the same, by finding monkeys
which had had an attack of poliomyelitis from the Elkins virus
immune to the New York virus.
No direct connection could be traced to previous epidemics as
i^ards the cases themselves, but it seems probable that the highly
infective virus reached Elkins through Somerset County, Pa., and
Garrett County, Md., in each of which a sharp outbreak occurred
during the summer and autumn of 1916, the Maryland cases being
on the whole later than those in Pennsylvania. From Somerset
County into Garrett County, and from Garrett County down to
Elkins, there is a highway, an automobile road, which carries much
local traffic. The cases in Garrett Coimty were strikingly distributed
along this highway, and not in accordance with the general popula-
tion distribution. No early cases were discovered along the road
north of Elkins, but much of the automobile travel from Elkins
goes directly into Maryland without stopping at intermediate points.
One or more unrecognized cases or healthy carriers would therefore be
assumed to be responsible for the Elkins outbreak.
Of the small outbreaks occurring in the United States during the
summer of 1917, five were in localities within or adjoining West
Vii^inia, i. e., those occifrring in Rockingham and Page Counties, Va.;
Allegany and Garrett Counties, Md.; Marion County, W. Va.; Bel-
mont Coimty, Ohio; and Newcastle, Pa.
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NoTemb«r 80, 1917
2000
In a house-to-house canvass of Elkins, search was made for old
cases of poUomyelitis; that is, cases with onsets in previous yesis.
Nine such were found in a population of 6,340. No relation of these
cases to the origin of the epidemic could be made out. At least dght
other old cases of paralytic disease in children were found whid
were not poliomyelitis. Of the nine poliomyelitis cases, four had their
onset in Elkins and five were in persons living elsewhere at the time.
The ages at onset were as follows :
Under 1 year.,
lyoar
Cases.
2 years.
4 II 3 vcars.
Cases.
4yMrs..
19 years.
Ctw.
The years of onset were as follows:
Cases.
2
0
1
Cases.
Cms.
1900
t 1905
2
0
1
1910
1
1901-1003
! 1905-1908
If 11
J
1904
1909
One case had its onset in spring, 4 had theil* onset in summer,
and 3 in autumn. From these figures, 9 cases in 16 years in a
population of 6,000, it would appear that a normal incidence of about
10 per 100,000, or 0.1 f>er thousand per year, is not an unreasonable
estimate. This is, of course, higher than the reported incidence in
any community during nonepidemic times, the New York City figures
for 1909-1915 giving about 0. 05 per thousand per year; but it is
recognized that in the absence of an epidemic rtiany cases are not
reported, and only by such a canvass of the total population can the
actual incidence be approximated.
No deaths from infantile paralysis were recorded for Elkina or
Randolph County during the six years preceding 1916. Under the
present system of recording deaths, a detailed analysis of the nnor-
tality statistics from other diseases could be of little value. '
The Elkins Cases.
The onset of the first case of the real epidemic in Elkins (see Chart 1)
was on November 25, the next on December 10, the midpoint on
December 24, and the onset of the last case January 13. Three
scattering cases were found to have occurred during the year previous
to this, and these are included *m the tables and charts, but of the
real epidemic 33 cases occurred previous ^nd 33 subsequent to
December 24, with 4 cases on that date — 70 in all. The maxinmin
temperature was below freezing on November 15 and 25, December 13
to 15, 18, and 19, 29 and 30, January 11 and 12, 15 and 16, 19 and 26;
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November 80, 1917
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that i3> twice before, and nine times during^ the outbreak. Tb*
highest temperature dming the outbreak, or for 15 days precediii
was 70^ F. (21^ C), but on that same day (Dec. 8) it fell to freezk.
There was a very cold snap just after the epidemic started, (k
December 13 the thermometer ranged between 31° and 14® F. (-0.^
and -10°C.); on the 14th between 27° and 4° F. (-S'^ and -15°C
on the 15th between 24° and 8° F. (-4° and -13° C); and on t:
16th between 39° and 1° above zero F. (4° and - 17"* C). T:
largest number of onsets for any one day was 6, on. December }
21, 26, and 27.
Table 2.-
—Age incidence t recognized poKomydit%8 at Elkins
, 1916^17.
•
•
Years. >
der
1.
2
3
1
2
A
2
6
9
3
2
4
4
6
6
7
8
0
7.
10 a "
Nonponilylic
•
7
6
2
5
2
1
3
0 ' 0 0 -
Pariil) tic ,
Oil 1 )
V 1 I i .
Total
5
2
8
1
14
3
0
0
10
1
7
0
7
0
4
2
4l 0
1 1 n
1 ! ■
Fatal
1 0
The age incidence is shown in Table 2. Sixty-six per cent r
the cases were under 5 years, 97 per cent under 10. The tou-
population of the city was 6,340, under 5 years of age 776, and 1,5^
under 10. Counting paralytic cases only, this gives a case incideij'
of 37 per 1,000 for the younger age group, 23 per 1,000 for tho^,
under 10, and 6.1 per 1,000 for the whole population. The ca^
mortality rate of the paralytic cases was 28 per cent.
Possible Modes of Transmissioii.
Chart 3 shows the range of temperature and the number of case-
on each day, tlio amount of snow on the groimd at 8 p. lu., tbt
days on which snow or sleet fell, the amount of precipitation (sno^
being counted as its melted equivalent of water), and the amount tf
sunshine in proportion to the maximum possible.
The preponderance of tcipperatures below freezing during tb.
c])idcmic proper may be scon by reference to the heavy line at tli<
level of 32"^ F. across the upper part of the chart. As indicated on
the chart, there were sc^veral inches of snow on the ground diirinj:
the period when the cases occurring at the height of the epidemic
pro1)ably received their infection.
The days on which the onset of the greater nmnber of cases occur-
red, though cold, were somewhat warmer than the days just preced-
hig; but the study of very large epidemics has not substantiated
the impression that warm days predispose to an immediate attack
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cjf tin- <lisi>nsi>. sin-li «s h the case with the diarrheas of infancr. It
r«i»ip"ri»!i '''"'• IVreniluT with the Dercmbers of previous yean, M
ahnijiiinlity was titiicd in maximum, miuimuin, or mean tompMi-
A u G u s T
SEPTEMBER
-.ti;! .h 1=1 If
JiiCli-" I^'Id'ti'MiiJi'
' // 'fl f *-•)• iMJn' M UftOiff*0
CiiAHi >, skiti«>n a.— Jik I'iiiiceuf poliomycliUs by (lays; daily maximum and minimum temperaturer,
raiiifail; eases; percent of suush inc.
tuns, fogj^'ii^css, wind, rainfall, or sno\vfall; but the mean evening
hull idity was low 07 per cent — the lowest for the 15 Decembers
piiHTcIinc: iMMUii; 71 per cent.
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2005
November 86, 191T
According to our obswvations of the surroundings of the patients,
however, and information obtained from the families as to dustiness
prior to onset, ordinary street or road dust is not likely to have
Ohabt 3, 8BCTI0N B.— Incidence of poliomyelitis by days; dally maximum and minimum temperatures;
rainfall; cases; percent of sunshine.
played a part in causation of the disease. The morning humidity
was normal for the month. Though poliomyelitis is universally
recognized to be an infectious disease, and though the consensus of
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Kov*'iiOn'r K-K^ 1!>L7
20O6
opuiinM, now ^till furthtT su)>8tajiiiated, aBcribes its spread taronirL,
clirt'ct <jr iiiilirrr^ it \ii\> ht^im tljought by some that peculiiir meltia^
lugirul ruitOiriMK^ nmy (in-JHpuiie to the disease and deteniitDes
DEC E M BE R__ .
J A N U A R Y
V 5 Pi liLic HEALTH Service
Chart :<. Si:( tion C.-liicidonc? of poliomyflifis by day-; <laily maxirauni and mmimum temperature^
rainfall; cases: pcrconi of mn^hine.
opideniic, the gorin itself being widespread in uoncpidemic times
It has also been thought that attacks of rhinitis may allow the riru-
a nidus on the mucous mem])rane of the upper respii'atoiy tract
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2007 • November 30, 1917
where it would otherwise be destroyed. The data collected for
EUdns hardly give support to these ideas. One of the phases of
this study to which particular care and much time was given was a
house-to-house canvas of the entire population of the city for sta-
tistics as to age, sex, occupation, visits and visitors, aitti morbidity.
In our canvas for all cases of illness occurring before, during, and
after the epidemic, no undue prominence of coryza appeared, and
the onl}^ abnormality noted in the weather conditions — an increased
winter dryness — would tend to inhibit respiratory disorders.
Further, dust or meteorologic conditions could hardly have been
factors of great importance, on account of the nature of the radial
spread of the disease, as has often been pointed out in other epi-
demics. The outbreak subsided in Elkins at the same time that it
was advancing in Grafton, and still later it spread to Fairmont,
though all these places were experiencing weather conditions which
at any one time were practically identical, but from first to last very
variable, as regards humidity, temperature, dustiness, rains and
snowfall, and wind. The 22 paralytic and 6 recognized nonparalytic
cases in Grafton occurred from December 20 to January 29, with the
height of the outbreak on January 7. The 15 paralytic and 4 recog-
nized nonparalytic cases in Fairmont occurred from January 2 to
February 11, with the height at this focus about the middle of
January.* The weather at both these points during the outbreaks
was fully as cold as that at Elkins.
Turning again to the temperature itself, below freezing 23 out of
the 30 days preceding, and 31 out of the 34 days during the EHkins
epidemic, and bearing in mind the 38 other winter outbreaks on record,
most of them during much colder and some during extremely cold
weather, it can be denied that summer insects play any necessary
rdle in the spread of the disease. Careful watch was kept for such
insects in Elkins. On five of the warmer days a few rather sluggish
houseflies and other nonbiting flies were seen in residences. Mos-
quitoes were observed outdoors on three days. Stables, manure
piles, and sunny walls were searched repeatedly for Stcmioxys cat-
cUranSf the biting stable fly, without success. Stable men affirmed,
that no biting flies had been noticed since before Thanksgiving Day.
It is inconceivable that such a sharp winter epidemic as this could
have been caused by any of these insects.
As noted in previous epidemics, the incidence in the most cleanly
homes, as well as in those less cleanly, is an effective argument
against spread by insects conmionly associated with filth, such as
bedbugs and lice. This argument is especially potent hero, for on
I Tto data Cor the Orafton and gairmoDt eaaes were obtftmed Crom the nf>oTi of Dr. C. kl. Weirick^ director
of the division of preventable diseases, West Virginm State Department of Uealth, to whom acknowledg-
ment is also made for assistance during the epidemiolegical study ia EllrtaM.
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November 80, 1917 2008
• I
the house-to-house canvass it can be affinned that tlie proportkm
of scrupulously kept residences was as great among the infected as
among the noninfected. Although bedbugs and lice may invadf
any home, if they were necessary carriers of the disease we should
have a noticeably increased incidence in houses most likely to b*
frequented by them.
Among other things investigated, in accordance with the sugges-
tion of Dr. Mark Richardson, of Massachusetts, were rats, but ve
found no evidence of an epizootic among rats, nor of particular
association of cases with rats.
Though inclvdod in the schedule used in the investigation of ^cb
case, and made the subject of other more detailed investigation in
certain instances, neither domestic animals nor ingested material
could be incriminated as causing poliomyelitis in Elkins. Of the
latter, milk and water were the two materials most susceptible of
study; the histories cUcited in each case compared with the general
data for the city showed no relation to the disease. One of the
babies — only 40 days old — had taken nothing but mother's milk
up to the time of onset. Many other exclusively breast-fed cases
have occurred in Elkins and elsewhere, but this is the youngest case
on record, confirmed by histological findings at autopsy and by
monkey inoculation.
As regards direct contact with recognized cases as a cause of the dis-
ease, our facilities for investigation were excellent, since by the house-
to house canvass all the cases which could, with reasonable degree of
certainty, be called poliomyeUtis were found. The list of these cases
was carried to each infected house, and questions were asked concern-
ing contact with each name on the Ust. . Every case was Wsited more
than once; some were visited several times. As a rule, about two
hours were spent in each house on the first visit. On the blank sched-
ule used particular attention was given to the acute chnical features
and to contact, many other questions being asked to check and
bring up from other angles answers to these questions. We can not
refrain from commending the sane helpfulness of the physicians and
people of Elkins. In a less homogeneous, or less thoroughh' American,
coinmunity, these studies would have been almost impossible. Even
with this opportunity, possible direct contact — that is, contact with
actual previous eas(^s through which the disease might have been
contracted — could be made out in only 2() per cent of the cases.
Quarantine of the cases could have had Uttle to do with this low
percentage of direct contacts, for the first nonfatal case was not
reported until December 26, after practically aU of the cases had
received their infection. Indeed it was oidy with the knowledge of
the presence of the epidemic that the early nonparalytic and fatal
cases could be diagnosed in retrospect.
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Indirect contact, through parents or acquaintances, occurred so
frequently that analysis would be without avail. The incidence of
the disease was heavy in Elkins, and the population mingled freely
up to the height of the epidemic, when the d.sease began to be recog-
nized. The greater part of the remainder of the cases were by this
time in their incubation period. In all cases, however, repeated
questions were asked concerning indirect conta<;t, in the hope that
additional opportimities for dii'ect contact — that is, contact with
patients themselves — might be remembered by the parents. Except
inmembersof the same family, where frequently the dates of onset were
so close as to suggest a common source of infection, the opportunities
for contact with recognized cases when they occurred were usually
not intimate, while in several cases mothers or other relatives of sick
children were stated to have fondled children of other famiUes who
afterwards became sick.
On the face of these returns, therefore, granting that poliomyelitis
is solely a human disease and is conveyed by contact (we have very
slender evidence to lead us to believe otherwise), 74 per cent of the
cases were occasioned by indirect contact through unrecognizable
cases or through carriers. The other illnesses, which might have been
imrecognizablo poliomyelitis and which we shall speak of later,
occurred for the most part in children. As regards possible carriers,
it is interesting to note that in each of the two successful experiments
on record (one * in New York and one ^ in Sweden) in which natural
carriers were clearly demonstrated, the pooled nasal secretion included
that from at least one adult. Furthermore, the usual history of
indirect exposure obtained in the Ellkins epidemic was through an
adult.
It might well be that opportunities for direct infection presented
themselves in Elkins which were not remembered by the parent, in
stores, in street play, or at other times. In some of the rural cases
studied, however, direct exposure to a recognizable case of the disease
could not have taken place. On account of the severe weather the
children had been kept close at home for weeks, and no other mem-
bers of the family had been sick.
Any explanation of the mode of conveyance of poUomyehtis must
assume that the relative susceptibiUty to the disease in all ages and in
all places is low. Only a very small proportion of those exposed are
attacked.
Ginical Features.
The general character of the epidemic, the age incidence, fataUty
rate, and chnioal symptoms correspond with the New York 1916 epi-
» Flexner, Clark, and Praser: 1912-J. Am. M. Ass., vol. 60, pp. 201-202. (Jan. 18.)
s Kling and Fettersson: 1914— Doutsdu m. Wchnscb., vol. 40, p. 321. (Feb. 14.)
144
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November 30, 1917 2010
demic, with the possible exception that some respiratory sympioms
rather frequently acoompaniod the other acute s3^ptoin8. Forty
per cent of the cases had onset with one or more remissions.'
Incubation period. — Some data are afforded by this epidemic as to
the incubation period of poliomyelitis. The periods formerly assigned,
as low as one or two days, are now generally admitted to be too short.
The possibiUty of simultaneous infection of two cases in one family
or in close association by an adult carrier was not generally taken
into account. We now recognize that two associated cases with onsets
within a few days of each other probably have received their infecti<m
from the same- source, instead of the later case from the former, the
difference in time of onset being due to variation in incubation period.
The figures based on the 1916 experience in New York and elsewhere
have been given as 4 to 14 days.
This corresponds to the incubation period in artificiaUy-infectfd
monkeys; 4 days is about the minimum of highly virulent strains after
having been passed through several generations of monkeys, while 14
days corresponds to the longer period, when a monkey is inoculated
with material of lower virulence, for that 8p>ecie6, direr t from a human
case. Incubation periods as long as 50 days, in monkeys, have been
reported imder these circumstances. The usual monkey inoculations
giving the shorter incubation periods are made directly intt> the brain,
and would be expected to produce the disease more quickly than in-
fection by natural channels. If we may draw an analogy from
rabies, a somewhat similar disease, the incubation period in the
laboratory tends to be much shorter than in nature. We have one
clear case in this epidemic giving an incubation period of at feast
nine days.
The child in question left Elkins after having been exposed directly
to cases of the disease some days previous, and to possible carriers, of
course, during the entire time in Elkins. Ho was out of contact with
people from Elkins or other infected localities for nine days, when he
was taken with the disoase. This is more significant than the usual
history of the sort, l)ecause, on account of the time of the year, polio-
myelitis being in abeyance everywhere except in West Virginia, posn-
ble carriers from other localities can be more clearly excluded.
Diagnosis »- -The question may be asked as to what constitutes a
case. Our criterion for ofririallv reporting a case, so that it would be
quarantintnl, was that it should be of the paralytic type, showing, in
addition to the acute symptoms, definite localized weakness (not a
simple febrile weaknt'ss) or a clearly demonstrable disturbance of
reHox<*s, a break in the reflex arc. Unless we base tbem on paralytk
casts, statistics from diflerent places are not comparable.
t Fubh. If. Alt h Hrpc^LN 1917: T}»c disKiKisis of poUomyeUUs, vol. 32. No. 44, pp. 1891, Ittt. (Kor.a)
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2011 Noyembcp 80. 191*
Th^^ were 39 paralytic cases in Elkins, an incidence of 6.1 per
1,000 of population. But, even of these 39, we believe that the
majority would not have been recosn^ized or would have been counted
as abortive in many localities. Of the 1 1 fatal cases, 6 were not recog-
nized as such at time of death; of the nonfatal paralytic, 2 were not
recognized until discovered in the house-to-house canvass, and 14
had such slight motor disturbance that recovery was complete in less
than 3 weeks from onset.
Lmnbar pimcture would enable positive diaopioses to be made for
quarantine purposes in such of the nonparal3?tic cases as are menin-
geal. But unless definite benefit to the patient can be promised from
the lumbar puncture, relatively few parents will consent to the opera-
tion on the mild cases merely for diagnosis, and we beheve that the
proportion of abortive cases which can be oflicially diasjnosed in this
way will always be small. The fatal cases which occurred after our
arrival in Elkins, thouejh the clinical history was usually not clearly
that of poliomyelitis (the symptoms being referred to the raspiratory
tract rather than to the musculature) were demonstrated positively
by histological examination, and in two cases by monkey inoculation.
This would indicate that very acutely fatal ilhiesses in chUdren during
the prevalence of poliomyelitis had best be considered cases of infan-
tile paralysis, unless another diagnosis is cloarly established.
In the diagnosis of the nonparalytic ca^es, we were sometimes
assisted by the similarity of symptoms, if there was a para'ytic case
in the same fami-y. In general, the nonparalytic cases which we
recognized gave a history of fever with digc-itive disturbance, consti-
pation and vomiting being two of the frequent symptoms, and either
meningeal symptoms (hyperesthesia, pain on forward flexion of the
neck, drowsiness, irritabi'ity) or a transient weakness out of propor-
tion to the febrile disturbance. Headache, sweating, and retention
of urine were often met with, A very cx>mmon histoiy in both
paralytic and nonpara'3^tic cases, when careful inquiry was made,
was an onset with remissions; t o chi'd would be better for awhile
and then worse again. We recognized 34 nonpara'ytic cases, seven-
eighths as many as the para'ytic. By far the greater part of the
nonparalytic cases were not recognized until the house-to-house
canvass was made, though some had been suspected previously.
One other question, to which we addressed ourselves, was whether
poliomye'itis can occur with neither meningeal nor para'ytic symp-
toms. In other words, are there many light cases of Ulness which
wo could not by any criteria, such as those just mentioned, class as
poliomyelitis, and yet which are duo to the same cause? It is
obvious that a definite, proved answer to this question can hardly
be given; if by a fortunate chance a positive monkey inoculation
should be obtained from the nose and throat secretions of such a
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M«TMaber 80. 1917 2012
case, it would still be pos^dble that the fMittent was a mere carriw.
and that his symptoms had nothing to do with poUomjeiitis; on tbe
other hand, the neutralization test, to determine whetiier the blood
serum destroys the vims, may give a positive result with those m«eh
exposed to the disease, or may conceivably give a negative resah
with those who have suffered from a very light attack, since monkey*
require a definite paralysis as a rule to become immune to the vinB
Our method of approaching this problem was to take a hnti
history of all cases of illness from August, 1916, to February, 1917.
that could be remembered by the members of the household encoim-
tered in our house-to-house survey of every home in Elkins. Doubt-
less many were forgotten by the mothers or omitted for one reason
or another; doubtless also those most vividly remembered were those
occurring when everyone was on the lookout for poliomyelitis. But
by a classification of these illnesses, and chronological companson
with the curve of the epidemic, it was thought that a t^itative sdn-
tion of our problem could be obtained.
At first, contact studies were made of the doubtful cases of
poliomyelitis, but these grew so complex that the question of ccm-
tact was finally confined to the 73 definite cases (39 paralytic and
34 nonparalytic).
Our 512 other cases of illness in the 1,370 families questioned w«re
divided into four groups, respiratory, digestive, nervous, and general,
according to their predominant symptoms. In the respiratory group,
we placed those complaining principally of cough, cold, or sore
throat; in the digestive, those with constipation, diarrhea, nausea,
or vomiting; in the nervous, twitching or irritability; the general
group comprised those with merely fever, malaise, skin, or urinary
trouble, and such definite diseases as measles. The greater number
of all those 512 cases were not sick enough to consult a doctor.
The result of the tabulation showed (see Chart 2), as was to be
expected, that, in general, the most recent illnesses were best remem-
bered. This is particularly the case with the respiratory, nw^vous,
and general groups. On account of the likelihood of illnesses being
caused by indiscretions of various sorts at Christmas, the cases with
onset on that day were counted separately. But even disregarding
these, a peculiar similarity is noted in the digestive cases and the
poliomyelitis cases, as regards their time of onset; instead of being
most numerous at the time of investigation (last of January and first
of February), these illnesses, not diagnosable as poliomyelitis from
the history, and some of them very trifling in character, show a tend-
ency to group themselves around the time when poliomyelitis was
prevalent. We were in entire ignorance of this result until the data
were finally assembled and the charting was completed. In fact, we
had supposed a priori that the nervotis and respiratory cases wouH more
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2013 November 80. 191T
nattirally show a relation to the poliomyelitis; conscious or uncon-
scious bias could hardly, therefore, have entered into the result.
A sununary of the chart appears in Table 3.
Table 3. — Illnesses in Elkins as reported in house-to-house canvass^ by i5-day periods.
Various finesses
Diposllve disturbances..,
Poliomyeatis
Nov. 15-Dec.9.
Dec. 10-Jan. 3.
Jan. 4-28.
172
34
5
If histories of digestive disturban^^es had followed the chronology
of the various illnesses, nervous, respiratory, and general, which were
presumably not poliomyelitis, wo should have had only 18 such for the
25-day period, December lOto Januarys, insteadof 54. It may, there-
fore, be assumed that if our data are correct, about 36 digestive cases
were unrecognized poliomyeUtis, approximately as many as there
were paralytic or recognized nonparalytic cases.
Thus wo are led to believe it probable that other types of non-
paralytic poliomyelitis than the meningeal do exist, and that in these
other types symptoms referable in the first instance to the digestive
tract are hkely to be prominent. Tliis is not saying, however, that
the digestive tract is the portal of entry of the virus. Digestive
symptoms in the paralytic cases come on only several days after
exposure.
Administrative ControL
The tentative conclusion reached above, that nonparalytic cases
of pohomyelitis occur, practically nonrecognizable on account of the
absence of meningeal symptoms and their slight severity (frequently .
no doctor was called), is borne out by chnical observation of the rec-
ognized cases themselves. In the acute symptoms of poliomyelitis,
as in the paralytic, we have all grades. It is a disease like scarlet
fever as contrasted with measles, for example. We do have very
light instances of the latter disease — measles— but they are the ex-
ception. A case of measles is usually definite and well marked.
With scarlet fever and pohomyelitis, however, the symptoms in a
considerable number of cases seem to trail off into nothing at all, to
diminish indefinitely or without limit, as a mathematician would say^
It is well known that cases of scarlet fever occur without eruption,
but for administrative purposes wo can regard only those which shov/
some such definite diagnostic sign as the characteristic eruption or
peeling. So in pohomyelitis we advised legal quarantine only for
those in which we demonstrated definite paralytic phenomena, or t\\^
chemical and cellular changes in the fluid obtained at luiTx\>ojf
puncture.
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I
November SO, 1917 2014 ,
What is to be done with the oiher caaes, most of which do not DfiT ^
come to the attention of the health officer t In the- first place, aur -
numerical increase in the instances of digestive disturbance in chi-
dren should be brought to the attention of the health officer fe
conference, particularly if slight meningeal signs are also present
disinclination to bend the body or neck forward, oversensitivenes
to the touch, increased reflexes, irritability, drowsiness, restlessDesE.
twitching or other nervous symptoms. Such an increase is said U
have been noticed in Fairmont before the outbreak of recogniad
cases. We have previously mentioned the importance also of takiof
cognizance of deaths from acute illness in children, unless the diag-
nosis is very plain. Physicians will the more readily confer abom
these cases, when they realize that quarantine restrictions wiU nc^
be oversevere. In our opinion, the suspicious and nonparalytar
cases should be urged to adopt a voluntary quarantine^ without
placarding. An explanation of the dangers of the disease, the promise
of immunity from paralysis if the case should actually be one of
nonparalytic poUomyeUtis, and a statement as to the reasonable
methods of prevention will often, except in large centers of popula-
tion, accomplish more thui a shotgun quarantine.
At the sanie time, watch should be kept for confirmation of suspi-
cions, and when a diagnosis is possible, the public should be informed
as to measures of self protection, and the State authorities notified.
At Elkins, before the first clearly paralyzed case occiured, there were
7 abortive cases, 2 fatal unrect^nized cases, and 1 slight paralytic
case, in which a definite diagnosis was afterwards possible solely on
account of the residual reflex aboUtion on one side — 10 cases which
in many communities certainly would go unrecognized.
The data derived from this epidemic as to the period of infectious-
ness of the disease give no instance of infection occurring from
exposure to a primary case longer than nine days after its onset.
It would thus seem that two weeks from onset, or three weeks at the
outside, is a reasonable period of quarantine. It must not be sup-
posed that any quarantine of the recognizable oases, however perfect,
will stop the spread of the disease. In the first place we have seen
that direct contact even with abortive (nonparalytic), as well as with
the paralytic, cases could account for only one-quarter of the out-
break. Further, it has been shown experimentally that the virus
may be carried in the nose and throat as long as five months after
the attack, an unthinkable period for quarantine. An additional
period of, say 14 days, after quarantine, dnring which the patient
and his family are kept from school or places of public assembly, is
therefore wise. Our main reliance, however, is in general prevention
of contact during the presence or threat of an epidemic. Parents
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should not fondle their children, lest the former should be unwittingly
carriers of the disease. Business is not to be stopped, but unneces-
sary occasions of bringing people together in close contact should
be warned against and prohibited as much as possible.
The interchange of nasal and throat secreti >n9, which takes place
when our neighbors talk in our faces, cough or sneeze, is to be brought
to a minimum. Personal cleanliness and the avoidance of hand con-
taminations should be observed. It is reco^ized that these oppor-
tunities for infection can not be entirely extinguished in any inde-
pendent community; but it is to be hoped that, just as reduction of
anopheline mosquitoes below a certain number will stamp out
malaria, so the general observance of the hygienic measxires outlined
above will tend toward preventing poliomyelitis.
Accoimt must also be taken of possible infection through the
digestive tract. If this takes place, and there is some reason to
believe that it does, the pollution of articles of food and drink is
probably not on so large a scale that the water or food supply of a
whole community is infected from one case, but rather as a part of
human contact, the articles placed in the child's mouth having been
soiled, probably invisibly, by the secretions of some infected person
in reasonably close contact with .the child. This still means that
the nose and mouth are the portals we must guard against infection
and that we must bear in mind the general public, unrecognized cases
and carriers, as more important factors than the officially reported
cases themselves.
Summary.
To summarize the important points of our studies in West Virginia:
1. Modes of spread other than by human contact are improbable.
Pei-sons and not things should receive our attention.
2. Even including all the nonparalytic cases which we could
recognize, direct contact with the cases themselves is responsible for
only one-quarter of the incidence.
3. As passive carriers adults are probably more important than
children.
4. There arc probably many imrecognizable cases of the disease
during an epidemic of poliomyelitis, about as numerous as the para-
lytic or the recognizable nonparalytic cases, and such cases are likely
to have symptoms referable in the first instance to the digestive tract.
5. Quarantine of the case for two or three weeks is long enough;
but another member of the family is just as likely to be dangerous as
the patient, and general intermingling, particularly contact with
children, should be prevented.
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Morember 80. 1917 2016
PUBUC HEALTH LABORATOKY SPBCIMBN&
THEIR PREPARATION AND SHIPMENT.
By H. E. Hassklune, Passed Assistant Sursfion, Unitod Statas PabUo Health Seryiee.
^Diis paper has been prepared for the purpose oi funuahing brid,
concise instnietions relative to the preparation and shipment ol flpeei-
mens for lal>oratory examination in order that the beet lesnlta maj
be obtained.
Pestal RegnlatlMM.
The shipping, through the United States mails^ of cfiseased iiaBUfls,
cultures, and other material capable of causing disease must be done
in accordance with the provisions of the Postal Regulatkms, issued bj
the Post Office Department. Sections 472 and 473, Postal Reg«-
lations, 1913, read as follows:
Sbc. 472. All kinda of poiBon^ and all articleB and compKMitionB containing |
and all poisonous animals, insects, and reptiles, and explosives of aU kinds, and in
mable materials, and infernal machtnes, and meriuuilcal, chemical, or otlier d«vk«i
cr compositioiis whidi may ignite or explode, and all dissass gtwnm or vaba, wmd al
olhtf natural or artificial articles, compositions, or materials of whatever kind whkk
may kill, or in anywise hurt, harm, or injure another, or damage, deiace, or otherwiat
injure the mails or other property, whether sealed as first-class matter or not, are hereby
declared to be nonmailable matter, and shall not be conveyed in the mails or delir-
ered from any post office or station thereof, nor by any letter carrier; bot the PMtmw-
Icr Genend may permit the tranamiasicm in the mails, under soch rules and r^gvlatHai
as he shall prescribe as to preparation and packing, of any articles hereiabefora da>
scribed which are not outwardly or of their own force dangerous or injurious to life,
health, or property: Provided, That all Bpirituoufi, vinous, malted, fermented, or other
intoxicating liquors of any kind are hereby declared to be nonmailable and shall not
be deposited in or carried through the mails. Whoever shall knowingly depoat or
cause to be deposited for mailing or delivery, or phall knowingly cause to be deJivcred
by mail according to the direction thereon, or at any place at which it is directed to be
delivered by the person to whom it is addrvme<l. anything declared by thie ee<ctio« Is
be nonmailable, imless in accordance with the rules and re^ulatianB hereby authorized
to be prescribed by the Postmaster General, shall be fined not more than one tk^mmmk
dollars, or imprisoned not more than two years, or both; and whoever shall knowia^ly
deposit or cause to be deposited for mailing or deliver>% or shall knowingly cause to be
delivered by mail according to tho direction thereon, or at any place to which it is
directed to be delivered by the person to whom it is addrce»ed, an>'thing declared by
this section to be nonmailable, whether transmitted in accordance with tha rules and
regulations authorized to be prescribed by the Postmaster General or not, with tks
design, intent, or purposo to kill, or in anywise hurt, harm, or injure another^ or dam-
age, deface, or otherwise injure the mails or other property, shall be fined not mot*
tb^n five thousand dollars, or imprisoned not more than ten years, or both.
2. Spirituous, vinous, malted, fermented, or other intoxicating Uqaen.ol any
kind, poisons of every kind, and articles and compositions containing poino (escipc
aa prescribed in the fourth paragraph hereof), and poisonou) animala, fisacN, md
reptile?, anrl exploflives of every kind, and in flammable materiak (including maadMa
gasoline, naphtha, l>enziDe, denatured alcohol, and all liquids having a flash poist
at or below 80"" F.), and infernal machines, and mechanical, chemical, or other dcricM
cfr compositions which may ignite or explode, and disease germs or acaba (axoapc m
preecribod in sec. 473), and other natural or artificial articles, compositions^ or aala-
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2Q17 N«Teniber 80. 191f
liala qI wbatanrex kind wbidik no^ kill^ or iu anyviae huxty hanu, or injure another,
(ff damage^ de£ace« or otherwise injure the mail or other property, live animals (except
as prescribed in sec. 476), raw hidea or pelts, guano, or any article AThali^g bad
odor, whether sealed as first-class matter or not, shall not be admitted to the mails.
3. Liqui(lB not spirituous, vinoas, malted, fermented, or otherwise intoxicating
(indudingflMupkeof ahar or comnnmioQ wine used in cburdi services), and not liable
to explosion oi wpaaJtaoMtmB combuatioa or igmtion by shock or jar, and not ioflam-
siable, fruits or vegetable matter liable to decomposition, comb honey, soft soap,
pastes or confections, ointments, salves, and articles of similar consistency, shall be
admitted to the mails for transmission in the domestic mails when inclosed in pack-
ages in conformity with the conditiona prescribed in sections 474 and 475.
4. Medicines and anesthetic agenta whkh are not oatwwdly or of their own kxee
dangsfoiis or injunoos to life, health, or prcq>eity, and not i& themselves unnaiUbble
(see sees. 454 and 480), may be admitted to the mails for transmission in the
domestic mails when inclosed in packages in conformity with the conditions pro-
scribed in section 474: Provided^, That the terms ** medicines'* and "anesthetic
agents ** shall not be construed to mean poisons: Provided further, That the article
mailed bears the label or supsncnp^on ol Ibe maaufietttyer theteof , ot dealer UiersiB,
or of the lioanaad f^ysidan, suigeon, dentist, or Yeteoaanaii preparing or prescrib-
ing the same.
8bc. 473. Specimens of diseased tiswes may be admitted to the mail for trans-
mis6i<ui to United States, State, municipal, or other laboratories in possession of per-
mits referred to in paragraph 3 of this section only when inclosed in mj^fling cases
constructed in acc<»dance with this regulation: Provided, That bacteriologic or path-
ologic specimens of plague and cbolsia shall under no circumstances be admitted to
themaUs.
2. Liquid cultures, or cultures of microocganisms in media that are fluid at the
ordinary temperature (below 45^ G. or 113° F.), are unmailable. Such specimexiB
may be sent in media that remain solid at ordinary temperature.
3. No package containing diseased tissue shall be delivered to any representative
of any of said laboratories until a permit shall have first been issued by the Postmaster
General, certifying that said institution has been found to be entitled, in accordance
with the requirements of this regolation, to receive such specimens.
4. (a) Specimens of tubercular sputum (whether disinfected with carbolic acid or
not disinfected) shall be transmitted in a solid glass vial with a mouth not less than 1
inch in diameter and capacity of not more than 2 ounces, closed by a cork stopper
or by a metallic screw top protected by a rubber or felt washer. Specimens of diph-
theria, typhoid, or other infectious or communicable diseases or diseased tissues
shall be placed in a test tube made of tough glass, not over three-fourths of an inch
in diameter and not over 7J inches in length, closed with a stepper of nibber or
cotton and sealed with paiaffin or covered with a tightly fitting rubber cap.
(6) The glass vial or test tube AM then be placed in a cylindrical tin box, with
soldered joints, dosed by a metal screw cover with a rubber or felt washer. The vial
or test tube in this tin box shall be completely and evenly surrounded by absorbent
cotton, closely packed.
(c) The tin box, with its contents, must then be inclosed in a closely fitting metal,
wooden, or papier-mftch^ block or tube, at least three-sixteenths of an inch thick in
its thinnest part, of sufficient strength to resist rough handling and support the weight
of the mails piled in bags. This last tube shall be tightly closed with a screw-top
cover with sufficient screw threads to require at least one and one-half full turns
belofe it will come off » and fitted with a Celt or rubber washer (See fig. 8.)
5. SpecimesM of blood dried on glass microscopic slides for the diagnosis of malaria
«t typhoid fever by the Widal test may be sent in any strong mailing case which is
not liable to breakage or loss of the specimen in transit.
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6. Upon the outsicle of every package of diseased tiasaeB admitted to tke lo.
shall bo written or printed the words "Specimen for bacteriological examiaek-
This package to be pouched with letter mail."
Letters of transmittal. — It is advised that a duplicate lette
transmittal, giving data for each specimen, be writtwi, one copy :
bo mailed to the laboratory as a letter, the other inclosed with ±
specimen. This is to guard against delay caused by loss of spe
mens or letters in transit. If both letter and specimen arrive at *:
same time, nothing is lost; if the specimen arrives before the ler.
the necessary data are at hand so that examination can be procee. .
with at once; if the specimen is lost and the letter arrives, after w:^
ing a reasonable time, the laboratory can notify the sender anti ;
second specimen may be forwarded.
The use of the form letter (seep. 2019) is recommended to save r.-
and labor necessary in preparation of letters.
Reports, — In case report is desired by telegraph, the sender shoi.
request that he be so notified.
Ijiterpreiation of result, — In general, it may be stated that positive
results obtained by laboratory methods are indicative of the disesit
or conditions found. On the other hand, negative results do iil:
necessarily mean the absence of the disease or condition suspected
A single negative result is of relatively little value. The examinati. *
of several specimens with constantly no^rative results is of s'Hr
value — the presumption of the al sence of the disease growincr stronuT
after each examination which j^ives a negative finding. In case oi c
negative result, the physician should feel no hesitancy in forwardinr
a second specimen for the same test, provided the case continues to
show symptoms warranting the original suspicion.
Labeling, packing, and shipping, and data to be forwarded with specimens.
Labeling, — Each specimen sliould be labeled or marked as soon as
prepared, so that no possible confusion of specimens can arise later.
Specimens may be labeled by use of a gummed label (written prefer-
ably with graphite pencil), by writing on container or slide with a
wax pencil, or with a pomt for writing on glass. The label should
state the source of the specimen and the character of examination
desired. Special considerations in labeling will be taken up when
discussing the class of specimens requiring them.
Packing. — Specimens of blood on slides should be packed so that
the specimen will not bo subject to friction. Postal regulations do
not prescribe any restrictions for this class of specimen except that
they shall bo packed in such manner as to insure their safety against
breakage en route.
Blood serum in sealed pipettes or in sterile vials, and feces, urine,
sputum, and tissues placed in bottles as specified in this pamphlet
should be \NTapped woU in cotton to insure against breakage and
placed in a double mailing case as specified by postal regulations.
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NoTember SO, 1017
Water specimens usually require packing in ice. Special containers
for this purpose may be had, but one may be improvised by placing
the specimen bottles in a water-tight wooden container (wooden
buckets or butter tubs are suitable), surrounding it by ice, and
placing sawdust over the ice.
Cultures must hejon media which Is solid at ordinary temperatures
and in test tubes of tough glass closed by a paraffined stopper or rub-
ber cap. Gfelatin cultures are unmailable, as these liquefy at ordi-
nary temperatures. Chiltures of plague and cholera are unmailable.
Shipping, — Nearly all specimens can be sent by maU, though s{>eci-
mens which have to be shipped on ice must be sent by express. All
materials capable of transmitting cholera or plague are unmailable
and must be sent by express. All specimens which are placed in alco-
hol must be sent by express, as alcohol is unmailable.
Data to accompany each specimen, — ^These data are set forth in the
form letter shown below.
(Station.)
(Dikte.)
Director, Laboratory.
Sir: The specimens indicated below are being forwarded to you to-day by
express.)
(MaUor
Numbor
of speci-
mens.
Nature of specimen.
Marks of
ea2h
specimen.
Check
space.
Td ba examined for—
Blood smears
Differential blood count.
Blood, dried
Malarial parasites.
Agghiti'>Ation against
(State organism.)
Othertests.
Aggliitlnfttlnn Against
Blood, serum
Wassermann.
Blood culture
(State disease.)
Cultures on
(State organism suspected.)
Diphtheria.
(State medium.)
Feces
Preparation of a vaccine.
Identifier I ion.
B. typhobiis.
Other organisms
(State organisms.)
Animal parasites or eggs i
Sputum
(State parasite.)
Tubercle bociitus.
Other organisms
Urine
(State organism.)
Chemical examination.
Typhoid bacillus.
Other organisms
(State organism.)
Bacterial count.
Water
Patholocic tissue for ex-
aminaiion.
Fixed in
Chemical examination.
Malignancy.
Other conditions
......
(State special ooodltions for wMch exami-
(State reagent.)
supped in.. rr?.
nation is desired.)
"' (State fliiid.)
SSoological specimens
For determination.
(State host and lo-
cality.)
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MoTember 80. lOlT 2020
DATA DK8IRBD FOR EACH SPSaMRN.
Specimen marked Collected on
Source
If from patient.
(Dau.)
(Name or No.) (Age.)
(Ra'^.) (Sex.) ♦Occupftllm.)
Duration of illnere
Quinine administered (For malaria suspccta only.)
(Dntp of last d'^se.)
Timues removed— ante mortem or poet mortem
Organ or portion of body from which ticsuee were taken
Duration of growth \ In rase of new. growth, only.
Previoiu removal, if any j
(Datf.)
Remarks
The following? list contains prnctically all the classes of specimens
that are suhmitted for laboratory examinations:
1. Bl( wl:
Smears, thin.
Smearp, thick.
Dried blood for a;r%dutinati'm teat.
Fluid blood for a^rr'utinatitm tt^st.
Serum for a.irirlutination to**l.
Serum for complement hxation te^tfl.
Cultures for D. ti^phom^ or other or^nmisraa.
2. Cultures (pure and mixed):
SuspiH'kHl diphtheria culture*.
Mixed culturefl from wliich \accine.s are U^ be made.
Culture* of organLsms for identiticmtion.
3. Feces:
For bacteriological examination.
For zooloi^ic al examination (for animal parasites or their ova).
4. Sputum.
5. Urine:
For bacteriological examination.
For chemical examination.
0. Water:
For bacteriological examination.
For chemical examination.
7. Pathol(v^i(*al tispuos for fleet ion«*.
8. EntomoUnrical ppeM-imens for determinatitm.
9. Ilelmintbologic al 8pe;'imens for det'Tiuination.
10. Mifcellaneoua.
Each cla.ss of specimens will be considered with reference to the
foUowinf^ penoral subdivisions:
A. Conditions in which the examination may j^ivo the desired result
B. Twhniquo of obtaining the si)ecimen.
C\ Special precautiuim to bo observed aiid reasons for same.
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2021 NoTcmber 30, 1917
1. Blood Specimens.
(a) Thin smears of blood are used in examining for the presence
of blood parasites (malaria, filariasis, trypanosomiasis, etc.), for
differential leucocytic count, and examination for the anemias or
' leukemias.
(6) Such smears should be made on clean glass slides. These slides
should be cleansed with soap and water, followed by immersion in acid
alcohol (HCl 3, alcohol 97) for several hours. If the slides are new
it is advisable to immerse them in strong sulphuric acid overnight
and rinse them thoroughly before placing in acid alcohol. It is con-
venient to keep the slides stored in acid alcohol, wiping them with a
piece of clean gauze or tissue paper just prior to using. In handling
ihe sUdes care shoiild be taken to touch only the edges, as touching
the flat surface leaves a thin film of grease from the skin upon the
glass. Tliis \vill interfere with the uniform spreading of the blood
fibn. Forceps for handling the shdes are an aid in keeping the glass
clean.
The specimen is obtained from the finger or the lobe of the ear in
the usual manner. The skin should be sponged thoroughly with
alcohol, followed by ether to remove grease from the surface. A ster-
ile needle or lancet should be used to make the puncture. The blood
should flow freely and hastening the flow by compression of the
parts shoiJd be avoided, especially if an examination for evidence of
the leukemias or anemias is desired. The first drop of blood should
be wiped away. A large drop of blood is not desirable as it will
make the film too thick. A drop the size of a pinhead, or a No. 6
bird shot, is sufficient for one smear. The drop of blood is touched
by the flat surface of the slide, near one end, the slide then placed
in such position that the drop is on the upper surface, and the edge
of a second sUde, held at an angle of 30 to 45 degrees, is placed in
the drop and pushed toward the other end of the first shde (see fig.
1, A and B). In this way the corpuscles are spread by capillary
action and not distorted by pressure between the edge of the spread-
ing shde and the surface of the specimen sUde. The movements used
in spreading the blood should be executed fairly rapidly with a steady
hand to insure uniform distribution.
Thin smears may also be made by touching the drop of blood on
the skin of the finger or ear with the edge of the spreading sUde and
then- smearing the other shde with it.
Allow the smears to dry without heating.
Several slides should be prepared from each case as some may
be failures, or it may be desirable to employ more than cme stAin in
HkB examination.
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(c) Cautions. — ^As the examination for the different typ^ rf tl
corpuscles and changes in all cellular elements of the blood is il-
from thin smears, it is important that the blood taken be as r^
representative of the case as is possible. On this account, c :
pression of the tissues to facilitate bleeding is to be avoided, a?*
procedure may increase or decrease the various elements of
blood. For example, squeezing the tissues may cause the exudi
of lymph from the tissues. This is poor in red cells but rich in wi
cells. The lymph is added to the blood, thereby decreasing
relative number of red cells and increasing the relative number
white cells. This is c-specially important if a differential coai'
to bo made.
The thin film is also necessary to determine the species of mak
parasites.
(a) The thick blood smear is used only in examination for
presence of malarial, or other, parasites. It need not be sent vd-
examination for parasites is desired. Its object is to enable t: •
microscopist to examine a large amount of blood in a shorter tin :
In thick smears only the presence of parasites can be detemmk- i
if determination of species is desired, thin smears must be sent.
(h) The following technique of Von Ezdorf is recommended :
making the thick blood smears:
Obtain a large drop, or two, of blood on the surface of a gla^ sL
1 inch from the end.
With the convex surface of a steel writing pen stuck in a cort
the blood is spread evenly over an area about one-half to tlir«'
fourths incli in diameter. The pen should be wiped clean immt
diatoly after using.
A second thick smear is made on the slide at the other end (sh
fig. 2).
{c) Cantions. — It is desirable to get specimens for malarial exjimJDa-
tion before quinine has been administered, as the use of this remedi
may make the finding of parasites more difficult or uncertain.
Fixation of blood smears need not be done, as the dried smear,
if properly packed for shipment, will reach the laboratory in good
condition. II eat should not be used on blood smears as it will ruin
the specimen for staining with the better blood stains. The method
of labeling of Von Ezdorf, writing on the edge of the blood smear with
a soft lead pencil, may be emplo3Td.
Blood for Agglutination (Widal) Test.
(a) Tliis te^st is applicable to cases of t^^hoid fever, paratyphoid
fever, baciUary dysentery, Malta fever, and cholera.
There are two methods of obtaining blood for this test, the dried
blood and fluid blood (serum) methods. The latter is much preferable
as it is more accurate and more certain of results.
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2023 November 80, 1917
(J) Technique, — In the dried blood method the blood is obtained
by pricking the finger or lobe of the ear and depositing several large
drops of blood on a dean glass shde; the drops are allowed to dry
without spreading. Five separate drops can be placed on one slide
without difficulty (see fig. 3).
(c) Cautions, — ^Do not use dirty, greasy, or rough glass; do not
collect specimens on tin, zinc, or other metal as the blood may not
adhere to the metal when perfectly dry. Such specimens are fre-
quently* jarred loose from the metal and lost in the wrappings upon
opening.
(6) For fluid specimens for agglutination tests the serum is all
that is required. The best results are obtained when the blood is
drawn from a vein with a syringe, placed in a sterile test tube, allowed
to clot, and the serum removed from the clot with a sterile pipette.
The technique of this procedure is given fuDy under collection of speci-
mens for complement fixation tests. Five cubic centimeters of blood
will be sufficient for the agglutination test.
Fluid specimens may be collected in capillary pipettes and shipped
without separating the serum from the clot. This procedure is not
as desirable as the syringe method but gives better results than the
dried-blood method (^ee fig. 4).
(c) Caution. — In sealing capillary tubes care must be taken not
to heat the blood, as this may destroy the agglutinating properties
of the serum, rendering the specimen worthless. To guard against
this, hold the tube with the fingers placed at the level of the blood
column nearest the portion of the tube to which heat is being applied.
Blood Spedmens for Complement Fixation Test (Wassermann).
(a) This test is at present applied chiefly in cases of suspected or
confirmed syphilis, though it is applicable in principle to certain
other diseases, such as gonorrhea, tuberculosis, and other infectious
diseases.
For this test a specimen of clear serum is essential for obtaining
good results. Sera which are discolored by laking of the red cor-
puscles may not give a definite result, and the reading of the hem-
olj^is may be interfered with if hemoglobin be present in the serum;
on this accoimt the serum should be separated from the clot before
shipment.
(J) Technique. — The following procedure is recommended: Ten
cubic centimeters of blood should be drawn from a vein with a
sterile needle and syringe, under aseptic conditions. Place the blood
in a starile test tube or a centrifuge tube, if a cmitrif uge be available.
The tubes should be stoppered by a sterile cotton plug or a sterile
^oA. After the clot becomes firm separate it from the wall of the
tabe with a sterile iJ^eedle, and tiiea set the tube in a cool place to
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NoTember 80. 191T 2024
I
allow the clot to contract. Placing it in an ice box untfl the kt !
morning is sufficient. If a centrifuge be available, a cleara* sp«- ■
men is obtained by centrifugalizing; if not, a satisfactory !^-
men can be obtained by removing the clear serum with a pipeiK. •
carefully decanting it into a sterile rubber-stoppered glass viaL Tj
stopper should be firmly inserted and, as a further precautk>£L .
strip of adhesive plaster passed across the top of the stopper ti.
down the sides of the vial (see fig. 5).
(c) Cautions, — The following points are necessary to obtain gooi
residts. Blood should be drawn before meals to avoid an excess i
chyle in the scrum, Sf)ecimens for the Wassermann test should i •;
bo taken after the ingestion of alcohohc beverages, as this interftra
with the test.
As specimens of this nature may be taken from more than oi*
person at one time, .it is necessary that each tube be marked »
labeled so that confusion of specimens may not arise later. T
guard against this, the labeling should be done as soon as a speeime:
is placed in the vial.
Blood Cultures.
(a) The use of blood cultures in the diagnosis of typhoid fern
furiiishes us a method of positive diagnosis prior to the appearan :
of the Widal reaction in many cases. When positive, this result t
absolutely certain, as the BaciUus typhosus is isolated and identifitv.
Blood cultures should be employed whenever possible, as the resiilr-^
are more satisfactory and obtained at an earlier date than when tli-
agglutination test is relied upon. The blood culture should be madt
early in the disease, as the following results of Buxton and Colemac
(Am. J. M. Sc, vol. 133, p. 896) show:
Cases examined in first week of disease gave 89 per cent positive.
Cases examined in second week of disease gave 73 per cent positive
Cases examined in third week of disease gave 60 per cent positive.
Cases examined in fourth week of disease gave 38 per cent positive.
Cases examined after fourth week of disease gave 26 per cent positive.
For typhoid blood ciJtures a special medium of ox bile is preferable,
though ordinary bouiUon may be used. About 20 cubic centimeters
of bile shoidd be placed in a bottle of 30 to 50 cubic centimeters
capacity, fitted with a ground-glass stopper. The bottles, with their
contents, are then sterilized in streaming steam for one and one-half
hours.
(6) Technique of ipmldn-g culture. — ^To obtain blood use a sterile
needle and syringe as in coUecting specimens for Wassermann test;
10 cubic centimeters of blood shoidd be drawn and at once placed
in two bottles of media, 5 cubic centimeters to each bottle. The
Btopper is then replaced and held in place by a strip of adhesive
plaster. The large amount of blood is used to insure obtaining the
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Public Health Reports, November 30, 1917.
FIG. la.-DROP OF BLOOD JUST PRIOR TO APPLICATION OF SPREADING SLIDE.
FIG. Ib.-METHOD OF SPREADING THE SMEAR.
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Public Health Reports. November 30. 1917.
FIG. 2.— THICK SMEAR OF BLOOD AND PEN USED FOR SPREADING SAME.
FIG. 3— SPECIMEN OF DRIED BLOOD FOR AGGLUTINATION TEST.
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Public Health Reports. November 30, 1917.
FIG. 4.— SPECIMEN OF BLOOD
IN SEALED CAPILLARY TUBE.
FIG. 5. -SPECIMEN OF BLOOD
SERUM FOR WASSERMANN
TEST.
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Public Hf^altl. Reports. Navembe'^ 30, 1917
FIG. 6. SPECIMEN OF FECES PACKED FOR MAILING.
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Public Health Reports, November 30, 1917.
7
C
1
1
1
1
FIG. l.—^Nf<^ER SAMPLE BOTTLE FOR BACTERIOLOGICAL SPECIMEN.
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2025 NoYember^O, 1917
organism sou^t, if present. This procedure is also applicable in
other bacteriemias.
(c) Caution, — ^As the shipment of cultures in flu'd medium is pro-
hibited by postal regulations, *these cultures should be shipped by
express. They should be wrapped in sufficient cotton to insure
absorption of all flud in case the containers are broken, and then
placed in a box or other container that will guard against breakage.
2. Cultores. Pore and Mixed.
(a) This class of specimens is used chiefly in suspected cases of
diphtheria but is also applicable to other d seases, particularly the
sending of a mixed culture from pus or other exudate, from which the
preparation of autogenous vaccines is desired.
(6) Technique, — ^A sterile swab should be used to obtain the speci-
men from the nose, throat, or lesion. These swabs should be pre-
pared and sterilized in test tubes. The swab is removed from its
tube and rubbed over the lesion, then rubbed over the surface of
the medium, and then replaced in its original tube. The inoculated
tube of med um and the tube containing the used swab should both
be forwarded.
(c) Caution. — ^Though most cultures taken in this way are mixed cul-
tures, it is essential that all extraneous organisms be avoided, as many,
especially the molds, will rapidly overgrow the pathogenic organisms
and prevent their development.
For use in diphtheria Lofflor's blood serum is the preferable me-
dium. For pus, or vaccine specimens, agar-agar or serum may be
used.
In case pure cultures are sent from one laboratory to another for
identification or confirmation, complete data concerning the culture
should be inclosed.
3. Feces.
(a) Feces are usually submitted for examination for evidence of
parasites, or to determine the presence of certain organisms, particu-
larly the typhoid bacilliis. The preparation of the specimen is the
same for both bacteriological and zoological examination.
(6) Technique of preparation of specimens. — A wide-mouthed bottle
having a capacity of about 50 cubic centimeters is the best container.
A well-fitting rubber or coric stopper is necessary. The bottle should
be filled to about one-third of its capacity with the feces to be
examined, the stopper inserted firmly and held in place by a strip of
adhesive plaster passed across the stopper and down the sides of the
bottle (see fig. 6).
The use of 20 per cent of glycerin in physiological salt solution has
been reported by Cumming (Jour, of Amer. Med. Assn., vol. 68,
145
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NoTPiiilMh- 30. 1917 2026
p. 1163) to have an inhibitory efifeot on the colon bacillus and olber
fecal organisms.
II(» recomraends the use of the foUowing solution:
Physiological salt solution (0.9 per cent NaCl) ^ 8D
Glycerin 20
To 25 cubic centimeters, add a mass of fec^s about the aize of a
split pea, and shake well to make a uniform suspension. Do not use
a greater amount of feces, as the inhibition of B. coli may ni»t be
obtained when large amounts are used.
This method gives admirable results on specimens artificially con-
taminated with laboratory strains of B, typhosus an<l should be appli-
cable in practice.
(c) Cautions. — Frequently specimens of feces are received for
bacteriological examination that have been subjected to the action
of disinfectants, which renders them useless for cultural studios.
This is probably the result of a misunderstanding on the part of the
attendant, or, perhaps, the patient.
The isolation of the typhoid bacillus from stools becomes more
difficult in direct proportion to the age of the specimen. For Uub
reason it is essential that the specimen be forwarded to the laboratory
without delay. This also has a bearing on the interpretation of results
of the examination, as a specimen that is in transit for a long period
may give negative results, although the same specimen at the time
of collection would give positive findings.
It is also quite definitely proven that in known typhoid carriers
the administration of a cathartic increases the number of typhoid
bacilli in the stools. In view of this fact a purge should be given the
suspect a few hours before the specimen is to be collected, and a
sample of the soft or semifluid stool resulting therefrom forwarded
for examination.
Tlie bottle should not be fiUed to more than one-half, preferably
one-third, of its ciq>acity. The reason for this b that a certain
amount of gas is formed as a result of fermentation. If a large
amount of fecal material be present a larger amount of gas is liber-
ated, and it may displace the cork, allowing the contenta to escape
and possibly causing disease in those handling the apeeimen. A
small amount of feces gives lees gas formation and the empty tmo*
thirds of the container's capacity allows space for a small amooni of
compression of the gas.
The cork should be large enough to allow at least 1 cePtimelg
(about one-half inch) of it to project above the mouth of the boilie.
A cork that is pushed in until level with the mouth ot the boHle ii
bard to remove with safety.
Feces of cholera patients or suspects are unmailaUe and ■net W
sent by express.
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2027 NoTember80,19ir
4. SpntuiL
(a) Sputum 19 usually forwarded for examination for the presence
of tubercle bacilli, though at times, examination for other organisms,
or for the ova of parasites, may be desired. As many of the patho-
genic organisms in sputum, other than tubercle bacilli, are easily
killed, the examination for such organisms may not be reliable, as
the particular organism may have died out in transit. Under ordi-
nary conditions the examination of sputum for tubercle bacilli can be
done by the physician or an assistant. As it may be desired to sub-
mit specimens from doubtful cases, for confirmation of diagnosis, the
following directions should be followed:
(6) Preparation of specimen. — ^The directions given above for the
preparation of specimens of feces for shipment apply also for speci-
mens of sputimi, except that glycerin should not be used.
(c) OauHon. — Specimens of sputum which have been disinfected
by carbolic acid will show the presence of tubercle bacilli under the
microscope. It is reconmiended, however, that specimens be sent
without disinfectant, in order that animal inoculations may be made,
if microscopic examination is negative. ^
5. Urine.
(a) Specimens of urine for chemical examination will usually de-
compose en route, so that this examination is not practicable unless
the distance to the laboratory is very short. The ordinary chemical
examination for albumen and sugar can be done by the physician.
If it is desired that an examination for some substance not easily de-
tected by ordinary methods be made, a specimen may be forwarded
by adding a preservative, such as chloroform, or by icing and ship-
ping by express.
(h) Urine for bacteriological examination, such as that of typhoid
patients, should be placed in a small vial closed with a rubber stopper
which is held in place by adhesive plaster. The viak (10 cubic
centimeters) used for shipping serum for Wassermann tests are
large enough.
(c) Caution, — No preservative should be added if a bacteriological
examination is to be made. Urine of cholera patients or suspects
is immailable.
6. Water.
In general terms, the results obtained by examination of water
at a distance from the source of the specimen are only approximate.
Time is the important factor^ and to obtain the most accurate results,
arrangments for examination of the water at, or near, the place where
samples are collected should be made.
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NoT«*iub«r 80, 1017 2028
(6) If a sanitary cliomical examination is desired the sasfi^
should be at least 2 gallons, placed in chemically clean bottks, c
should be not over 48 hoius old when received at the labonton
Examination for mineral content can be made from older sampisf
Specimens for bacteriological examination shoiild be placed i j
50 or 100 cubic centimeter ground-glass stoppered bottles, vL^- »
have been sterilized by heat, the stopper and necks of the boii^ ■•
being protected by lead foil (see fig. 7). The collection of the sam^ "
requires much care to prevent the addition of extraneous orgi&
isms to the sample. If a sample is taken from a tap, let the vats
run several muiutes, then remove the stopper from the sample botdr
and hold imder the tap until filled. Replace the stopper witiK^
touching the neck of the bottle or that part of the stopper whidi k
to come in contact with the water. Replace the lead foil, if it iut
been removed from the stopper. It is preferable to unwrap the k*
foil from the neck of the bottle and then remove the stopper in ie
foil covering.
If a sample is to be taken from a pun^), similar precautions ^(^
be taken. If from a stream, the mouth of the bottle is pointed op
stream. In general*terms, hold the mouth of the bottle so that watff
which accidentally touches the hands will not enter the container
Many specimens of water are probaMy grossly contaminated by
carelessness in the taking of the sample. After obtaining the sped-
men it should be at once packed and shipped in a container with ice.
There are two kinds of bacteriological te^ts for water samples— as
estimation of the number of bacteria per cubic centimeter and a tcsl
for the presence of the colon bacillus, which is presumptive evidence
of pollution. If a bacterial count is to be made, the specimen should
bo examined as soon as possible after the sample is taken^ and, At
most, not later than 24 hoiu« from time of collection. If a greater
time be required in transit, the bacterial coxmt may not be reliable,
especially if the sample be exposed to temperatures much above
10° C.
For testing for evidence of pollution (colon bacillus test), samples
may be as much as 48 hours old, but if the result is negative, it should
not be interpreted as meaning an absence of pollution, as colon
bacilli may have been present and died en route. In this, as in
all laboratory tests, a positive finding is much more significant than
a negative one. Repetition of the test for a number of times with
consistently negative results may warrant the deduction of a neg-
ative finding, but a single negative result does not necessarily mean
that the suspicion of contamination is not well founded.
(c) Cautions.-^^Aost of the precautions have been touched upon
above when considering collection of samples. It is neoesBary to
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2029 November 80, WIT
ship water samf^ on ice, and sufficient ice should be used to insure
tiie arrival of the specimen at its destination before the ice is com-
pletely melted.
A gummed label should be attached to each sample stating its
soiirce and date of collection. To guard against loss of the label by
reason of the moisture in the packing, place a rubber band around
tlie bottle at the level of the label.
7. Pathologic Tissue for Section.
The preparation of sections of tissues, and the results obtained,
depend largely on the fixing fluid used. There are Fovernl fluids that
may be used, but some are much superior to others.
Zeriker^sjluid. — ^This is the most satisfactory fixing fluid for general
\ise. Its formula is as follows:
Potassium bichromate 2 to2.5gm.
Corrosive BubUmate 5gm,
Water 100 cc.
Glacial acetic acid * 5 gm.
The first two ingredients are dissolved in the water and the acetic
acid is added just before using. (The original formula of Zenker's
fluid contained sodium sulphate, but this has been found unnecessary.)
The tissues should be placed in this fluid 12 to 24 hours; then
washed in running water 12 to 24 hoiu^ to remove the excess of fixing
fluid. Then place the tissues in 80 per cent alcohol for shipment.
Do not ship tissues in Zenker's fluid.
Formaldehyde solution. — ^A simple fixing fluid is 4 per cent for-
m.aldehyde solution, made by diluting one part of conimercial (40
per cent) formaldehyde solution (formalin) with 9 parts of water.
If great haste is desirable this is the fluid to bo chosen, as it allows
the making of frozen sections on receipt of the specimen. Further-
more, the tissue can be placed in it and mailed at once, fixation
taking place en route. If haste is not necessary, the fixing action
of formaldehyde is improved by adding 5 per cent of glacial acetic acid
to the fluid and after 24 hours transferring to a 4 per cent formalde-
hyde solution (without acid) for shipment.
Alcohol. — Alcohol, though the least efficient, is probably the most
popular of all fixing fluids, since it requires little or no preparation
before using. It is especially valuable for specimens in which it is
desired to determine the presence of bacteria. However, for purely
histological sections, it does not give as good fixation as the other
fluids and, as a result, poorer sections are obtained. Furthermore, if
tissues containing skin are placed- in alcohol, they "become so hard
before reaching the laboratory that sectioning is almost impossible.
The use of alcohol as a fixing agent is not recommended, except when
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Norembcr 80. 1917 2030
the presence of bacteria is to be demonstrated, though if necessitf
requires, it should be used hi SO per cent strength for 2 to 4 hom,
then in 95 per cent strength for 6 to 12 hours and then in 80 per cent
for shipment.
(b) Technique of preparation of sperimens.— On removal from
the body of the tissues that are to be examined small blocks cl
tissue, not more than 5 miUimeteis in one dimension, should be cot
with a sharp knife or razor from that portion of the specimen that
seems most involved and dropped into the fixing fluid at onre.
If the specimen be small the whole specimen should be fixed in the
chosen fluid; if large, place the smaU blocks in the chosen fixing
fluid and the remainder in 4 per cent formaldehyde solution and
forward the large portion of the specimen for macroscopic examina-
tion.
The attainment of fixation t)efore cell death has b^un is a most
important point in the primary treatment of pathologic spedmem.
To secure this it is essential that delay in getting the specimcna
into fixing fluid be reduced to a minimum. In order to avoid delsTB
it is suggested that autopsy rooms be stocked .with a quantity of
fixing fluids, glacial acetic acid, measuring graduates^ etc. Ai
autopsy the obtaining of the specimen is of primary importance. Ib
case of specimens removed at operation the specimen, of coutm, vi
subordinate to the welfare of the patient. If, however, an BBBirtiat
or interne can take the spernmen as soon as removed and place it ia
fixing fluids it will be much better than allowing it to remain in Um
air until the operation is completed.
The small blocks of tissue, after being treated as outlined under
tiie consideration of fixing fluids, should be placed in a wide-mouthid
bottle in the proper medium, securely corked, and the cork hdd ia
place by a strip of adhesive plaster.
The following considerations relative to certain tissues should be
ol)served in cutting small blocks for examination:
In case of new growths several blocks from various parts of tha
growth sliould be taken. At least one should be taken from Um
edge of the growth showing both normal and diseased tissue.
Blocks from the lung should be cut to include pleura and, if possible,
a bronchial lymph gland.
Blocks from the kidney, liver, and.s{deen should be cut to ]
a portion of the capsule.
Blocks fn>m the heart should be cut to include the base of a
lary musi'le.
Muscle tissue* should be preserved in 4 per cent fonnaJdchyda at
it is prone to become very hard in alcohol.
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2031 November 80, 1917
8. Bntomologieal Specimens.
MosquUoes. — ^Mosquitoes intended for shipping to a laboratory
for identification should be killed with tobacco smoke or chloro-
form vapor and packed, while st'dl soft, in pill boxes between two
thin layers of cotton, packed loosely, just enough cotton being used
to prevent shaking: in packing, the specimen should be handled as
little as possible and very gently. Tin boxes and glass vials are to be
avoided as the retained moisture causes the specimens to mold.
Pill boxes, the covers of which can be lifted off, should be used as
sliding covers usually ruin the specimen.
Collections made in moist climates must be well disinfected with
creosote or some similar substance. THe presence of a small amoimt
of gum camphor or naphthalene in the container will preserve over
great d'stances.
The pill boxes to be sent by mail should bo securely packed in
a strong outer box or mailing case, that will not be crushed in transit.
Larvae and pupaa are best preserved in 80 per cent alcohol.
Ticks and fleas can be killed and preserved by dropping them in
70 per cent alcohol.
9. Helmiathologieal Spedmens.
Helminthological specimens should be placed in 4 per cent formalde-
hyde solution or in 70 per cent alcohol to which 5 per cent of glycerin
has been added and shipped in these fluids.
10. MisceUaneoos.
Cerebrospinal, ascitic, hydrocele, or hydi'othorax fluids should be
collected in sterile glass-stoppered bottles, the stopper being pro-
tected by a sterile wrapping of lead foil, canvas, gauze, or paper.
The chief precaution to be observed is that of aseptic technique, so
that no extraneous infection may gain entrance.
The label should show the nature of the specimen, name of patient,
and character of examination desired.
Small specimens may be mailedi large ones should be sent by
express.
Complete data concerning the case are desirable.
As these fluids, especially hydrocele and ascitic fluids, when sterile,
are of value for the preparation of special media, it is suggested that
those taking specimens of such fluids collect them under aseptic
conditions and forward them to the nearest laboratory. Antiseptic
substances should not be added to the specimen, or used on instru*
ments employed in obtaining the specimen.
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N«T«n»l>er ao, 1017 2082
Anthrax, — ^Tissues from cases of suspected anthrax in man or «i:
maLs should be placed in a sterile glass container, securely ^oj^gk
packed in cotton* and mailed in a double mailing case with a ste-
ment of the history of the case and disease suspected. Bloorf .
animals dying of anthrax may also show the presence of the orgaaki
Rabies or hydrophobia. Tfie brains of animals suspected of rah-
may show microscopic evidence of the disease.
(b) The head of the suspected animal should be severed from tt.
body and the whole head packed in a suitable container and shippet.
by express. In warm weather it should be iced.
(c) Caution.-llQSidA should be sent as soon as ]X)ssible nhcf i:-
animal dies or is killed. Killing the animals by chloroform or drowih
ing is preferable to shooting or the application of violenrse about tk
head, as the latter is Uable to lacerate the brain and facifitat^ tt
entrance of putrefactive organisms.
The name, post-office address, and telegraphic address of xb-
sender should accompany the head, since an eariy report in these cis^
is important. If an examination other than for evidence of nlBe^
is desired it should be stated; otherwise, on receipt of an animals
head, the presumption is that examination for rabies m desired. Ii
case the brain is removed from the oraniom and shipped in a tsm-
tainer, the nature of tlie examination desired should be stated.
Plague. — It may be desirable to send dead rodents suspected d
being infected with Bacillus pesHs to a laboratory for exanunatkxL
If the presence of plague among the rodents of a community has boa
proven, a plague laboratory should be established at a convenient
point. In case plague is suspected but not proven, shipment to a
laboratory may be done. Dead rodents 3}K)uld be placed in an
insect-proof metal container as soon as captured and a small amount
of chloroform poured into the container to kill fleas or other ecto-
parasites. Each rodent should have a tag attached to the carcasi!
showing the locality where it was captured or found dead. The
total coDection of rodents for the day should be placed in a flei^j^roof
metal container or can which can be sealed to prev^it its bemg
opened en route. This is shipped \>j express. The use of ice in the
container is indispensable.
(c) Caviion. — ^The protection of the collector against ^as is a
point to always have foremost in Uie mind of those engaged m the
work. The attachment of the tag is very important as on this de-
pends the locating of the infected zone. Do not use too small a con-
tainer or attempt to economize on ice.
The shipment by mail ol plague cidtures, or materials capaUe^
transmitting plague, is prohibited.
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PREVALENCE OF DISEASE.
No health department, State or locals can effectively prevent or control diMose withmU
ttawttd^ of tukemy white, ami mnder uhat eonditions cauB are occurring.
UNITED STATES.
€AMP FUNSTON— EXTRA-CANTONMENT ZONE.
The following numbers of cases of communicable diseases were
reported in Riley and Geary Counties, Kans., between October 1
and November 20, 1917. These two counties constitute the special
civil morbidity notification area around Camp Funston. The map
on page 2(KJ4 shows the special civil notification area from which
reports of communicable diseases are received.
Cerebrospinal mcoingltls:
Manhattan 1
Manhattan (carriers) 3
Cliiokeo pox:
ManlMttan 8
RUay 5
Diphtheria:
Junction City 4
Manhattan « 13
Measles:
AltaVista 1
Junction aty 184
Manhattan 7
Ophthalmia neonatomxn:
Manhattan 1
Pneumonia;
Manhattan 6
PoHomyelitls (IntanOle paral^vls):
Cleburne
Scarlet fever:
dehor ne
JiUMtion CHy
Miohattan
Smallpox:
Junction Qty
Tuberculosis:
Junction City
Typhoid fever:
Junction City.
Mankattan....
Ofden
Randolph
Whooping cough:
Manhattan....
CURRENT STATE SUMMARIES.
CaUfomia.
From California State Board of Healthy telegram dated November
27, 1917:
One anthrax in Monterey County. One epidemic cerebrospinal meningitis, San
Diego city. One poliomyelitis, Moctovua. One smallpox, Kern County. Sbarp out-
break chicken pox in Stockton city schools and of German measles in Visalia city
schools. Marked increase in scarlet fever and whooping cough. Typhoid prevalence
decreased, but 17 cases reported.
Seported by mail for the preceding week (ending Nov. 17):
(2033)
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November 30. 1017
2034
rAwcv cuci*
RILEY AND 6£ARY CCXiNTICS KANSAS
CAMP FUNSTON AND
FORT RILEY RESERVATION
. EXTRA CANTONMENT CIVIL SANIIARY DlSTKCT
. I 1 4 1 ^ •
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2035
November 30, 1917
Anthrax 2
Cerebrospinal meninoitis 1
Chicken poK 118
Diphtheria K)2
Erysipelas
German measlea
GonococTua infection.
Malaria
Measles
Mump?
12
29
14o
9
62
69
Pneumonia 90
Poliomyeliti'^ 2
Scarlet fever 72
Smallpox 2
Syphilii^ 62
Tetanus 2
Tuberculosi-i 104
T\ phaid fever 23
Wh^H ping eough 56
ladlaiia.
From the State Board of Health of Indiana, telej^ram dated Novem-
ber 26, 1917:
# Scarlet fever epi'lemic, New Richmond, Montgomery County; Bates\'ille, Ripley
County; and Rarcoon Township, Parke County. One human hydrophobia, llonti-
cello. Diphtheria epidemic, Box ley town and Arkers Comer, Tipton County.
Kansas.
From Collaborating Epidemiologist Crumbine, telegram dated
November 27, 1917:
Week ending November 24, typhoid fever, Butler County, 60 cases, 55 of which
were in J' ^ lorado; smallpox, Kansas City, 30; epidemic meningitis, Manhattan,
4 cases, 10 carriers, Osborne, 1.
Massachnselts.
From Collaborating Epidemiologist Kelley, telegram dat«d No-
vember 27, 1917:
Unusual prevalence: Diphtheria, Greenfield, 8; Arlington, 6; Camp Devens, 8;
Amesbury, 37; scarlet fe>'er, Milford, 10; Montague, 14.
Minnesota.
From Collaborating Epidemiologist Bracken, telegram dated
November 26, 1917:
Smallpox: Fillmore County, Beaver township, 2; Itasca Coimty, Naahwauk village,
1; Kittson County, Grandville township, 2; Mower County, Udolpho township, 1;
Rock County, Kanaranzi township, 1. One case of cerebrospinal meningitis reported
since November 19.
RECIPROCAL NOTIFICATION.
California.
Cases of couijnunieabU dtseases referred during October y 1917, to other Stale fiealth depart-
menlt 6y the DeparimerU of BeaJUh of the State of California.
I>iseaseand locaUty of ootlfieaUoii.
RefeiTwl to healtli authority of-
Why referred.
Typhoid fers:
irif^«fiiY
Salt I^ke CitT, Utah
Patiant Just airived tsom
Salt Lake City whera
father was tjrphoid patioit.
Potknt Uist amred irom
ToDopah where typhoid
naraoMOt .......
Tooopah, Ner
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Kovember 30, 1017
2036
BECIPBOCAL NOTIFICATION-Cootmwei
CaDfoniia— Continued.
Cases of communicable diseases referred during October, /9/7, to other Rinte A^M depmu
ments by the department of health of the State of Coit/omia— Continued.
Disease and loc»1*^y of nottflcatlon.
Referred to health authority of~
Why
Typhoid (ever— Continued.
San Francisco
Do.
Epidemic cerebrospinal menin-
gitis:
San Piego County
Do
Do
Oonocoorus infection:
Solano County
Syphilis:
Solano County
Dysentery:
Solano County
San Francisco
Smallpox:
Kern County..
Do
Scarlet fever:
Los Angeles.
Los Angeles..
lialaria:
Merced Count r....
Qonococcus infection:
Monterey County..
Typhoid fever:
Watsonville
Qonococcus Infection:
Solano County
Do
Do
8. 8. Ventura.
Portland, Oreg..
Denver, Colo..
....do
....do
El Paso, Tex.
Philippines
do
New Orleans, La. .
Zephyr, Brown County, Tex .
.....do
Colorado Springs, Colo
Yuba City, Aril..
Mexico
Japan.
Klamath Falls, Oreg.
Acapulco, Mexico.
do
....do
Patient reM-led fan
nimed at time he fc
Inf^rted.
Do.
Do.
Do,
Do.
Do.
Do.
Do.
Patient hi^ arrired
NewOrieans.
Patient )Qst anrtred
Te^as.
Do.
PaUent resided In
named at time be fa«
inVted.
PaUcnt n^^ided at
naroad at time be h
infected.
Do.
Do.
Do.
Do.
Do.
Do.
Miimesote.
Cases of communicable diseases referred durina October, 1917, to other State hmllh
ments bp department of health of the State of Minnesota,
Disease and locality of notl-
DJphtberia:
Minneapolb health depart-
ment, Hennepin County.
Smalli
illpox:
Minneapolis health depart-
ment, Hennepin County.
Referred to health authority oC—
Black River Falls, Jackson County,
Wis.
Sweetrrase, Teton County, Mont.:
Great Falls. Cascade County, Mont.:
Helena, liCwis and Clark County,
Moot.: Big Sandy, Chouteau County,
Mont.: <nascow. Valley County,
Mont.: WiUlston, Williams County,
N. Dak.; New Rockford, Kddy
County, N. Dak.; Fargo, Cass Coun*
ty, N. Dak.
Brttton. MarshaU C^Nmty, S. Dak.;
Aberdeen^ Brown County, S Dak.
Why
Game to MlnmapotlB to c«»-
■ult phriMan: earn d^»>
noeed dlpbthffli teter.
Supertntradent ef coortm^
tlon company. Ant vna^
toros of smaupot Oci. n;
traveled In "^!*«^ smI
North Dakota Oci. I
Traveling ._
Suarantioe hospital on ir-
!val is Mhineap*^ rrwi
Britton. wbert he teA
stayed I days; steuttd dd
tl A herdscn on way to Ma^
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2037
Norembcr SO, 1917
RECIPROCAL NOTIFICATION— Continued
Minnesota— Continued.
w^a o/ cowimumatble di$eau$ referred during October, 1917, to other SuUe heaUh depetrt-
metUi by deparivMMt o/heakk of (he State of Jtftnwwoto— Continued.
Idiaeasc and locality of noti-
Referred to health tnthoritj of—
Wk7 referred.
"Z
and county hospital, St.
aul, namsey County.
riit>crculosis:
Mayo Clinic. '~S>chester, Olm-
sted C>)um3
PokeRHBa Sanatorhtm, Pine
County.
Northern Paciik» Hospital,
BraiMierd, Crow Wing County.
Lako Jnlia Sanatoriom, Po-
pofilcy, Beltrami County.
Typhoid fever
Rochester, Olmsted County. . .
Warroad, Roeeau County.
Northern Paeiflc Hospital,
Brainerd, Crow Wing
County.
8t. Qabners Hospital, Little
Falb, Morrison County.
Mayo Clinic, Rochester, Olm-
sted County.
Brown VaHey, Traverse
CooDty.
Webster, Btnuctt County, Wis..
Preseott , Yavapai County, Aria. ; Free-
port, Stephenson County, 111.; Mo-
une, Rock Island County, 111.; Rock-
lord, Wlnnel>ago County. Bl.; rttfk-
ersburg, Butler County, Iowa: Clare,
Webster County, Iowa; Bellevue,
Jackson County, Iowa; Mallard,
Palo Alto County, Iowa; Newberry,
Loco County, Mich.; Wakefield,
OobeMc County, Mich.; Kansas
nty, Jackson County. Mo.; Daves-
port,Thayer County.Nebr. ; Brockeiy
Ramsey County, N. Dak.; Kelsay
Traill County, N. Dak.; Lima, Allen
County, Ohio; Cottonwood, Stanley
County, 8. Dak.; Beresford, Union
County, 8. Dak. (2 cases); Colman,
Moody County. 8. Dak.; Timber
Lake. Dewey County, 8. Dak.; Strat-
ford, Marathon County, Wis.;
Thorpa. Clark County, Wis.; Aifjred,
Saskatuiewan. Canada.
Cleveland, Cuyahoga County, Ohio. . .
Bismarck. Burleigh County, N. Dak . . .
Bermudin. Adams County, Pa.
Lime Spring, Howard County, Iowa . . .
Drayton, Pembina County, N. Dak. .
Between Jamestown, Stuttsman
County, and Bismarck, Burleigh
County, N. Dak., with Northern
Pacific surveying crew.
Fessenden, Wells County, N. Dak
Wagner, Charles Mix County, S. Dak. .
Brookings, Brookings County, S. Dak.
14 miles from Minnesota line in Brown
County, S. Dak.
Resident of Wisconsin: came
home in Wisconsin. (Pa-
tient, mixed-blood Chip-
pewa Indian.)
10 advanced, 9 moderately
advanced. 3 (stage of dis-
ease not given), i ineMent;
cases left Mayo Clinic fbr
homes.
Open case leli Fodcegama
Banatorium for home.
Open case reoident in North
Dakota sick in Minneap-
olis hospital.
Open case left maatorium for
borne.
Detveloped first symptoms of
typhdd in Iowa, came to
Minnesota for 2 days, and
retmned to Iowa.
Worked as harvest hand in
North Dakota 3 weeks
orking witJi Northem Pa-
cific Railway surveying
crow in North Dakota 3
weeks before first symp-
toms.
Worked at Fessenden, N.
Dak., 3 weeks previous to
first symptoms.
Living at home in South
Dakota for 6 months pre-
vKHia to first symptoms.
Patltiit Uving at bome in
Bwitb DakoU 3 weeks
previeoi to first symptoms.
Running a thrashing eneine
Z weeks ptwlous to first
symptoms.
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November dO» l^lf
2038
ANTHRAX.
New Jersey — ^Essez County.
In October, 1917, a case of anthrax occurred at Verona Borough,
Essex County, N. J., in the person of A. H., female, aged 21 yew,
engaged m setting horsehair bristles in brushes. The first symptoioft
of the disease appeared October 4. Bacteriological examination of
scraping from the pustule showed the presence of B. arthrafis lod
a pure culture therefrom injected into a guinea pig caused death is
24 hours. The patient recovered after administration of antianthm
serum.
CEREBROSPINAL MENINGITIS.
State Reports for October, 1917.
Place.
New cases
reported.
riaoe.
jffpjrlil
Iowa-
Mills County
PolkCounty
Potuwattamio County...
Wapello County ■
Total
Kansas:
Brown County—
BlAwatha
Doniphan C-iMinty—
Trov (U. n »
OsaRp (5f>unty—
Osage aty ,
Total ,
(.oulsiana:
Lincoln Parish ,
Vermilion Parish ,
ToUl
Miimesota:
Ilcnnopin County-
Fort Snelling
Miiineap U> ,
Martin County—
Manyaska Township.
Ramsey County—
8t. I*aul
UockCoimty —
Magnolia Township. .
Total
Mlvti<viippl:
AltalaCmHUy ,
UhKU C<MUU r
Panola County ,
8c«tt County
Tate County ,
Total
Sf w Jersey:
Kr<ex County
UudsoD C-ounty
New Jersey— Continued.
Union County
Total.
North '' akota:
C.rand Fork^ County. .
Ohio:
Cuyah oca Count V .... ,
Franklin Cotmty ,
Hamilton County....
Jarkson County ,
Mahonlnir County
Mo'Uiromerv County.
Roii County
Summit (k)iinlv
Trumbull County....
Cnlon Coiuily
WaiTon Coun ty
Total.
Pennsvlvanli
AHeclieny CoiuUy
Blair CfMinty ,
Fayette Coimtv
I4iwrf»nce County
Lu7onip Coumj V.
Moiu innprv County...
IMiil* 1 ^lohii Coimty...
Wa-hiiiv'NMi County....
Wcslmon^land County.
York County
Total .
Rhode Island:
Bristol Cnmty—
Barrlnifton (town). . .....
I*ro%'idencc County-
North Hmithnekl (town).
Pa$coai? ( town)
Providence
Total.
South Carolina:
Spartanburg County.
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2039
November 30, 1917
CEREBROSPINAL MENINGITIS— Continued.
State Reports for June and July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Arkansas (July 1-31):
Pulaski County
1
1
Rhode Island (July 1-31)— Cont'd,
Newport (^unty—
Newport
1
Providence County—
Cumberland (town^
Total
2
1
GeoreJaville fiown)
1
Riiode Island (June 1-30):
6
Johnston (town)
2
Providence Ooonty—
Pawtocke^ '.
1
PrflnirMe»M^ .
Providence
6
Vallev Falls ftown)
1
Rhode Island (July 1-Sl):
KentCountf—
West ¥rarwick (town)
1
TotaL
14
atf Reports for Week Ended Nov. 10, 1917.
PUiott,
Deaths.
Pku«.
Gases.
Deaths.
Baltimore^Md
Birmingham, Ala.,
Boston, Mass
Buffalo, N.Y
Chicago, 111
Columbus. Ohio...
Dohith, Minn.
1^1 River, Mai
Jersey aty, N.J...
Kansas City, Kaos.
Manchester, N. H. .
Milwaukee. Wis....
Newark, N.J
New York, N.Y
Omaha, Nebr
PhiladetphiflLPa
Providence, R. I
Racine, Wis
Ban Diego, Cal
Savannah, Ga
South Bethlehem, Pa-
Springfield, Mass
Springfield, Ohio
Toledo, Ohio
Wichita, Kans
DIPHTHERIA.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 2056.
ERYSIPELAS.
City Reports for Week Ended Nov. 10, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
'R^Htmnr* ITrl . ...
1
L< ^Cal
Tlfrminirfiiun. Ala.r.--.
1
M - ..,\v£. :::::::::::::
Braddock. Pa
M-.iJ.L.'Jair, K.J,..,
NftstJviJte. Tcmi. ^. ........
Bnffalo. N. Y
nbiPAffn. Til - -
Niw^rk. ^.J.
N* ■■■•*• J"ie<ifnrd, Mass
Cincinnati, Ohio..............
2
1
Cleveiand, Ohio.........
Nc^.v t a^Ue, fa ,.
Nev Vtrk, K, V.,.,
Oniuho, Ntbr* .*.•
Columbus, Ohio. ...... .......
3
TtetMMir. Cnln
1
Detroit, Mich-
PiciittarKli. P4.,,,.
TlflTtforb, Conn ...............
St- l^niia, IJo,,.. .*
1
Jersey City, N. J
Johnstown, Pa. ........*.,*..
SaiJ l raodsco, CsU
Strtngdeld^ IlL .-*
ITfiffLfnficno, Midi ............
Ste^iinn, I'a..*.
TJntA OhiO....^
1
W irhil,t>, KiiAi
LEPROSY.
City'Report for Week Ended Not. 10, 1917.
Daring the week ended November 10, 1917, 1 case of lepnwy was
Teporteain San Francisco, Cal.
Digitized by VjOOQIC
November 80, 191T
2040
Steta Rcporto for OcMber. 1917.
Plaoe.
Ktnsas:
A Uhison County—
Potter
Cowlev County—
\V'lnneId
Pcoatur County—
Oberlin
Douglas County -
Richland
Monti^omory County—
Ind(»l>ond6nce
Scdfwick County—
AVIchiUi
Sh«»ridan County—
(JrinuoU (K. D.)---
Total.
LouUian:)-
Acailia TarKh
AllfU I*ari«<h
AssumptidU Parish
A voyolU'^ Parish
IK»diirom\r»l Parish
liionvillo Parish
Caddo Parish
CftlcasJou Parislj
Concordia Parish
Do Soto Pai ish ,
East Hat »n Uinuo Parish.
Kasl hVUciana Parish
Orant Parish
IlM'rvillo Parish
Jacki,i)ii Parish
.TolTorson Davis Parish
Lafayetto Parish..
Llvin«»stoii I 'arish
Morehouso Parish
Natchilochos Parish
Ouiwhita I'arlsh
Uapldos Parish
Sabiiio* Pari^!l
St. Helona Parish
8t. Landry Pari^li
St. Martin Parish
Ht. Mary Parish
St. Tatiiruanv Parv-.h
Tangipahoa Parish
Tens'is Parish
Torrel>onnc Parisli
Union Parish
Vermilion Parish
Washington Parish
We.st Feliciana I'arish
Winn Par ish
Total .
Mississippi:
Adams County
Alcorn County
Ami to County
Attala County
Bolivar County....
Calhoun County...
Carroll County
Chickasaw County.
Choctaw County...
Claiborne County..
Clarke County
Clav County
Coahoma County...
Copiah County
Covington County.
De Soto County
FoTTpst ( ounty
Fraokiin County...
New
CAWS
reported
120
58
109
09
1,000
85
137
45
335
123
21
62
1,106
204
194
164
165
142
Mls»!«ippl--Coatiini«l.
CeoTKe Coanty
Greene Coontj
Crenada Coanty
Hancock Ccnntj
Harrhion County
Hinds Coanty
Holmee Coanty
Issaquena Coanty
Itawamba Coanty ,
Jackson Omnty
Je^erson C-ounty
Je^erson Daris Coanty.
Jones County
Kemper Coanty
Lafsyette County
Lamar County
Lauderdale County
Lawrence Coanty
Leake Coanty
Loe County
Le^o^ County
Lincoln County
Lowndes County
Madison County
Marion County
Marshall County
Monroe County
MontRomcry County
Neshoba County
Newton County
NoTuliee County
Oktibbeha County ,
Panola County ,
Pearl River County
Pr y County
Pi cCounty
Pont toe County
Pre '>tiss County
Quitman County
RanWin County
Scott County
Sharkey County
8lmP!K>n County
Smith County
Stone Count y
SunPoT* or County : . .
Tallahatchie County
Tate County
Tippah Con-ty
Tishomingo County
Tunica County
I'nionC'ouuty
\Va-:p') County
Wa^hinRtoa County,
Way r.c County
Webster County....*
Wilkin ^n County
Win.4on County
Yalobusha County
Ya^oo County
Total ji^es
New Jersey.
Burlington County. .
KSSC5. Cdunty ,
Mercer Ccimty
Sussex County «
Union County
Total.
Pennsylvania:
Philadelphia County.
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' • '1
2041
MALARIA-Oontinued.
SUUe Reports for Oetober, 1917— Continued.
November 8U, 1917
Plao^
N«w oases
reported.
Place.
New cases
reported.
» Carolina:
5
11
13
18
43
1
South Carollna--Contlnue(L •
^partanbure County, .^..^..^^^^x^^^^
^^«anfort County ■.
umon County
4
~?li4jitcr Ckxinty' *»
WillifiTn^hurg Owinty - ....
12
Total
Mftrloti County. .»
108
** ictiland County
Arkansas- Reports for June and July, 1917.
Place.
New cases
reported.
Place.
New cases
kansas (June 1-30):
Arkansas County , . ,
8
116
6
30
2
3
5
4
2
25
30
3
8
25
7
1
3
3
1
20
15
31
30
52
10
ArlLansas (July 1 31):
Ashley County
153
Ashley County
Bradley County
7
Bradley Counly
Carroll County
2
Chicot tCknintyl...
Clay County
4
Cleveland County
n^rMnd Cniinty -
2
Cross County
Hempstfad County
25
I rew County . .......
Tiftifl County . ..
0
Faulkner County ! V.
Johnson Countv ,.,.,,
10
CarlaT'' Cn«i»»*y ,
Lafayette County
20
Greene County'
Lo?an County
25
Hempstead County
Madison County
Itard'Cfflinty . !, ^!.. .....^*.
Monroe County'
2
Jc^nson County -. *.
Perry Court V
3
Pope County
14
Miller County [
Pulaski County
s
\r !«<!{<»< ppi Cnm^y
Saline County ,
20
Monroe 'bounty . .1
Scott County ^...
5
Perry Counly
Sevier County
00
Pulasld County
St. Francis County
64
Saline Coiuity
White County
16
fi<>hfL<ctiRn Countv
Total
Sevier Coiuit y
44f
Rt. Fm"'"!' County,. , ,,,
Union County
White County
Total
440
City Reports for Week Ended Nov. 10, 1917.
Places
cases.
Deaths.
Place.
Cases.
Deaths.
lMrm»nph*m Al»
10
3
1
1
Ri<dimond. Va
,
MemphiSi Tenn
%n '^lancttco, Cal
i
2
Newark, N. J
Savannah, Oa'.
New Orimmt U
'
MEASLES.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 2056.
146
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l««T«aiber 80. 1917
2042
PELLAGRA.
State Reports for Octeber, 1917.
Place.
Kansas: *
Scdgwiek (ViuBty —
Cheney
Shautieo Oouirty—
Stale HosiHtal..
Newc
reported.
ToUl.
Louisiana:
Acadia Parhh ,.
Assumption Parish
Beauregard Parish
F.a5t Daton Uoug<» Parish .
Kast Feliciana Ptirish
MorehouM) Parish
Orleans Parish
RapWes Parish
Sabine Parish
St. Mary Parish
St. TunnaiiT Fwlsh
TensM Parish
WasUagtoB Pvish
"r-
Total.
Ili&<;i^ppl:
Adam Oounty
.\ Icjrn Comity
Amite County
Attalft CoontT
Bollvsr CoontT
Calhoun County
Carroll County
Chicka»w County
Clali)ome County
Clay County
Coahoma County
Copiah County
Covington County
De Soto County
Forrert Oounty
Cleorge County
Hancock County
Harrison County
Binds County
Holmes Coimty
Itawamlia County
Jackson County
Jcfferv)n County
Jeflerson Dayis County.
Jone» CxHmty .
Kemper Oounty...
Lalayette County.
r County.
Laoderdato County .
Lawrence County . . .
Place.
>«e«eb«s
irtpartfsi
Mississi]
dssippi— Continued.
Lcako Cuunty
Lee County
Lellure County
Linoln Cjunty ■
Lowndes CjUDty •
If adi«m County '
Marian County ,
Manihalt County
Monroe C< unty
Neshoha County
Newton County
Noxubee County
Oktlbbf ha County
Pan >la County
Pearl Uiver County
Pemr C ' nnt y
I*lke'C>uniy
Pintv toe County ■
l*Tentl'a Coimty '
OuitmanCjunty '
Hankln County |
SeittCtHinty -
SimpjonC..imty i
Smith C>un1> i
SunfluwerC. imty...
Tallahatchie County
Tale County
Tippah C tinty
Ti shaming > C )imty.
TunicaCjimty
11 nL a County...^.
Warren C-ounty
Washiilcton County,
Wavne County
Webster Cousily....
Yaroo County
Total.
1
u
li
«
1
It
I
ij
u
J7
II
Penaiylvania:
PhlladelpUa CM»ty.
Bauth Carolina:
AbbeinnaConnty
B^miv'ea Oounty. . . . .
Chester County
DordMstar County .. .
Laurens County
Uarion County.'.
Snartanburt Coaty.
UBJooCooBty.,
York County.
ToM.
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2043
PEULAGRA-— Continued.
Aikansas Reports for June and July, 1917.
November 80, 1017
Place.
New cams
reported.
Place.
New cases
reported.
Arkansas (June 1-30):
A shley Conn ty
33
2
3
4
8
2
6
2
3
2
3
1
1
28
23
1
Arkansas (July 1-31);
Ashley County
11
Bradley Ceonty
Calhoun County ..,.
2
Calhoun County
Clay County . . I
Cross County
Faulimer County
1
Drew County
Garland CV>nntv
2
Faulkner County
L«awrence County
g
Gad^d County
Logan County
2
Gr^ne County^
Ma^Uson County .
3
Miller County
MiUerCountv I'V' '"'"
3
Mississippi County
Monroe County
2
SflJine dounty . . . .'.
1
Selwstian County
Pope CJounty
8
Sevier County . .'.
Pulaski (3ounty
3
St. Francis County
Saline County !
4
Union County
Sevier Countv
1
White County
St. Francis County
8
White CountT
3
Total
lU
Total
64
City Reports for Week Ended Nov. 10, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Austin, Tex
1
2
1
Richmond, Va
1
1
1
3
3
Rocky Mount, N. C
1i4xingiAn, Ky
Washlngt n, 1). C
Winstun-Saiom, N. C
Ijns AnjfA.M. ^iil ,^.,,^,,^,-,--
1
1
1
Memphis, Tenn
PNEUMONIA.
City Reports for Week Ended Nov. 10, 1917.
Place.
CaMs.
Deaths.
Place.
Cases.
Deaths.
BaHimore. Md
17
85
28
12
i
11
1
22
New Bedford, Mass
3
1
2
2
2
51
25
1
1
2
2
2
1
2
15
2
1
2
1
1
6
2
4
ninffhafntrm N V ...
IJe» Britain, f^'Onn ...........
R#i«lr%n If AiBA
New Cast e, W
Braddock. Pa
Newt/^n. Mass
Brockton. Mass
Oakland, Cal
2
Chelseo, Mass
Philadelphia, Pa
27
Chicago, 111
67
17
3
26
Pittsburrii/Pa
26
Cleveland. Ohio
Davton Ohio . ....
Pitts lelarMass
P ntia\ Mich
Detroit Mich
Reading, Pa
1
Puhith, Minn . . ..............
R.;annke. Va
2
Fail River. Mass
'[[ Sajrtfmento, Cat
2
Grand Ranids Mich
'",'/./..., SturinAW. Mich
Haverhill, Mass
1
3
San Diego, C'ai
2
jAckaon. Mich
San ttanjsoo, Cal
15
flomerviile, Mass
2
KunsasCttv Mo
8
1
2
South BetSlehem, Pa
1/ong Beach, Cal... ..•>•••....
8prtngai»Jd, Mas!?
1
Los Angeles, Cat.. ....>>••....
Sleeitun. P^
Lowell/Mass.
Washington, Pa
Mandiester, N. H
Newark, N. J
4
6
Wichita, Kans
Worcester, Mass
1
1
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ii«T«Bibcr ae, lUT 2044
POUOMYEUTIS (INFANTILB FABALYSIS).
During the week ended November 24, 1917, cases of poHomyeEtB
were notified in the State of Illinois as follows: One case each in
Dapage, Kane, and La Salle Counties; 2 cases in Vermilion Goimtj;
and 6 cases in Cook County, of which 5 were in the cit^ of Qucago.
State Reports for October, 1917.
Plaoe.
N«w cases
ropofted.
PiMt.
Iowa:
Audubon County
Black Hawk County
Clintoo County
Crawtofd County
Dallas County
Hamilton Cbunty
Ida County
Johnson County
IfftrffFB County. .........
IfontiEdmery County
Pottawattamie County..
Scott County
Warren County
Total.
Kansas:
Butler County—
Benton (K. D.)
Douelas
Marion Couuly—
Tampa (R, D.)
McPhersun County—
OroTeland
Mcpherson
Pottawatomie County —
Bi^elow
Rooks County
Totol.
Ijoiiislana:
Hichland Parish.
Maine:
Ciimlierland County-
Portland
OxlordC-ounty—
Oxford down)
Penolxicot County —
Old Town
ToUl.
Michipn:
AlloKanC<'iiiity
Berrien County
Calhoun Counfy
Charlevoix County..
(Jem w« County
Ingram Cotnity
Mottfoe County ....
Mu<«kef(t>n C Minty...
Ha((lnaw County ...
TuMola County
Van Bitrin i ounty.
Wayna County
Total
Minncotftu:
Cass CnuMty
Walker
C)Idi5I«*«1 C«.iiiity
Koth^rrr
Minnesota— CoDtlnned.
St. Louis County-
Virginia.
TMaL.
Mississippi:
Alcorn County
Clay Count?
ItawamhaCooMty..
Pike County
1
2
1
I
I
3
1
'J
11
TotaL.
New Jersey:
Camden County..
Essex County....
Total.
North Takota:
Grand Forks Coonty. .
Kidder County ,
Morton Coimty
Ramsey County ,
Williams County ,
Total..
Ohkk:
Adams County
Anht«)HilaC4}unty —
A uglalte County
Belmont County
Carroll County
Cc lurabbna Cotmty .
Cn\uh(»sa CouJity
Franklin County
ii trniltoti Count jr.
I < luK"^ County
I I r ,n Coiinly
Mal.oninR Cfxuity
Mf ntffom^Tv County.
T'lr'are Cotinty
Stark ('oiuny
Summit County
Waiianrt.ai < otrnty..
Wayne Count y
Total
Pennsylvania:
A IlcKheny County.,.,
Armstronft County...,
Beavor County
Blair County
Braifonl County
KutlerC4>uoty
CI. «'>ier County
Clear. eldCtHinty. . ..
1 Via ware County
Klici otmty
Fnr County
FnyrttcC<Minty
Frruhrit ouuiy
I.ack4 wanna County.
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2045
November 30. 1917
POUOMYEUnS (INFANTILE PARALYSIS) -Continued.
State Reports for October, 1917— Continued.
Places
New cases
reported.
Place.
New cases
reported.
PamsylTMiia— Continued.
Lancaster Ck>anty ^.....
Lawrence Countv
I 1
6
2
Rhode Island:
Providen?e County-
Providence
1
Lebanon County
South Carolina:
Spartanburg County
^a
Luzerne County
H cKean County
1
Mercer County ,
Vermont:
Lamoille County
1- - — -J
IfifH in County •
Mon tgomery county
2
PhilaaolDiiia County
Orleans County
1
Schuyllrill County
Washington County . ,
6
Total
Warren Countv
9
Washington County
Yorlc County '
Total
75
State Reports for Jane and Jalj, 1917.
Place.
Now cases
reported.
Place.
New cases
reported.
Arkansas (June 1-30):
Cleveland County
1
Bbodo Istond (Juno 1-30):
Pro\ idence County—
1
Arkansas (July 1-31):
liOgan Cotmty :... .
1
Rhode Island (July 1-31):
Providence County—
Providence
1
City Reporto for Week Ended Nov. 10, 1917.
Place.
Cases.
Deaths. Place.
Cases.
Deaths.
Berkeley, CaX
1
11
1
New York, N. Y
3
1
2
a
Chicago, 111
4 Portland, Oreg
Cleveland. Ohio .'. .r
Seattle, Wash
RABIES IN MAN.
City Report for Weeic Ended November 10, 1917.
During the week ended November 10, 1917, one fatal case of rabies
in man was reported in Newark, N. J.
RABIES IN ANIMALS.
City Reports for Week Ended NoTember 10, 1917.
During the week ended November 10, 1917, one case of rabies in ani-
mals was reported in Akron, Ohio; one case was reported in Detroit,
Mich.; and two cases were reported in Kansas City, Mo.
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Noyember 80, 1017 2046
ROCKY MOUNTAIN SPOTTED FEVBR.
WashingUm—SpokaiM.
On November 20, 1917, a case of Rocky Mountain spotted ferw
was notified in Spokane, Wash., the onset of the disease having
occurred about October 10, 1917.
State Report for October, 1917.
During the month of October, 1917, one case of Rocky MountaiD
spotted fever was reported at Hoxie, Sheridan County, Kans.
SCARLET FEVER.
WMhinfton — Vancomrer.
During the week ended November 24, 1917, 5 cases of scarlet fever
were notified in Vancouver, Clarke County, Wash.
Bee aleo Diphtheria, measlee, scarlet fever, and tubercukMos, page 2006.
SMALLPOX.
Maryland.
Cases of smallpox were reported in Maryland as follovrs: November
22 to 24, 1917, 6 cases at Cumberland, ^llegany County; and 2
cases at Avilton, Garrett County.
State Reporto for.OetobM', 1S17.
Pifte«.
V^ftcdnaUoQ history of
NewoasM
reported
I
Bmler County -
Anfiu^ta
Cherokee County —
Columbus (1 R. D.).
Weir (3 R. D.)
Ckwd I'ounty—
OlftvooCR. D.)
Donli)hiin t otmtv-
Wttthena(5 ft. D.)
Doii£ltt-H( ounty—
Ovprbrook (4 R. D.)
Ellis (oiinty '
Hays
Franklin County—
rnnceton
Jefffrmii County -
(KkAi004tt
IVfTT(2 R. D.)
Johnson i oimty -
(>%,-( land Park (3 R. D.).
Spring IlilMR. D.)
Leavenworth County—
Liirivintt
L(>av(>n worth
Ijnwuod
Lincoln Cuuntr -
Barnard (ft. I>.)
Number ' Number '
Deaths, i vaccinated i last Taeoft- • Number tVi
. within? ,natedmore never sdc : hi v^c^vo*
' years r re- ithanTrear* readily ,obUiiM4«
ceding ' preoedint iTanrteatad | oaeenato^
attack. attack.
1
1
1
I
1
1
1
1
1 .»..»•——'
t — '
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2047
fiMALLPOX-~Gontinued.
State Beports far October, 1917>-Gontinued.
NoTember 80, 1017
New cases
reported.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinated
within?
years pre-
ceding
attack.
Number
last vacci-
nated more
than 7 years
preceding
attack^
Number
never suc-
cessfully
vaccinated.
Vaccination
hi3torynot
obtained or
uncertain.
Kansas— Continned.
Linn County—
Pleasanton (R. D.)
1
3
1
1
10
11
1
1
1
1
1
2
39
1
lUaml County—
PaolaCI R. D.)
3
1
1
10
Montgomery County—
CofTeyvllle
Independence (R. D.)
Osage County—
Burlingame
Quenemo
1
10
Reno County—
Hutchinson
1
1
. . .
Saline County-
Mentor
Salina
1
*
Sedewick County-
Wichita
1
1
1
39
1
Shawnee County—
Topcka
Sumner County—
Wellington
1
Wyandotte County-
Kansas City
' "
Rosedale...
Total
119
G
113
...
Michigan:
Alcona County-
Hayes Township
1
1
2
3
14
1
3
6
1
13
1
10
1
1
4
1
3
1
13
3
8
1
a
10
t
}
-
I
Lincoln
1
Alpena County—
Alpena
1
3
14
1
Bay County—
Pin?onning Township
Pin!X>nning
*
Bay City. r.
I
Calhoun County-
Battle Creek
3
6
1
13
1
5
Clare County-
Clare
CMnton County—
Watertown Township
Genesee County-
Burton Township
Vienna Townahin
Flint....... .7^..::::::;::
5
Huron Cotmty-
Coltkx Tnimnhln
1
*
Dwight Township
Fairnaven Township
Meade Township
Port Austin Township ....
Pointe Aux Barques
Township
Port Austin
i
4
1
3
1
13
Ubly.
2 'I
Ingham County— '**
Aurelius Township
Ionia County-
Lyons...
2
I
laabeila County—
Mount Pleasant .
n
Ktnt County—.
Grand Rapids ^
Lapeer County—
Alnnnt...
i»
Maoomb County-
LakaTowmhfn
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IMvrMticr aO. Itl7
2048
SAULUPOX-
8tele]
/-
Vaccxmtioc htatoy ^mt.
I'bce.
TS^MJMXkb^
II ichlpan— Tont Inued.
Mason Counlv—
Pere Marijuett© Township
Summit Townrfiip
Vidnry Township
Lu<lini;t('n
Sc<>tls\illc
Montcalm County—
BUnmor Town.sltlp
lIuskfKtjn (Vimly—
MiukeRon
Oakland reimlv—
Water fonl Township
Osceola Comity—
0»c«ola Township
Evart
Ottawa Onnty—
Spring Lake Township. . . .
Presquo IsN> County—
Hismnrk Ttiwnship
Baginaw County—
Mapl«> C.n.vc* Towmhip. . .
St. Clair (N.tinty-
Clydc Towiivliip
Hast ( hiirn Township
Sanilac County—
Cuslfr Townslilp
Frt»m( nl Townsliiu. . .
W hciit htud Townshiji .
8hiaNMUs.soe (Vimty—
WtHilland Township..
Owosso
Waslitenaw Crimty—
York Township
Ann Arbor
Wayne C(>unlv—
"Highland Park
River Uougo
Wayne
DeUoit
Total.
Minnesota:
Blue Earth County—
Mankato
Crow WinK County—
Klondyke Township .
Brainerd
Rlverton
Dakota County-
Hastings
Douglas County—
Osakls
Finmore County—
Newburg Township . .
Preble Township
Hennepin County—
Corcoran Township . .
Edlna
Minneapolis
Kittson County-
Norway Township . . .
Lyon County—
Lynd Township
Lyons Townsmp
idrshall
Tracy
Marshall County—
Lincohi Township . . .
Ste^n
witJiia 7
AttAdCL
Kumher !
last vacei- J^Hlff
fn^tedmore! atrfrgs-
than 7 rears cesfLTT
prr^ccding
Attach
I
L
It
lo-
3.
1 I...
2
18
2
4
2
1 .
2 ..
18 .
r«9
?
2
!
i
fV
: \
1
1
?
2|...:::::...
•iL.
1
4
1
?
»
1
1
1?
3
6
M
1
2
4
1
3
4
...•..•>••
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2M9
Noy«aiber30,1917
SMALLPOX—ContiiiQed.
State Reports for October, 1917— <)ontinued.
Neweaaaa
reported.
Deaihs.
Vaccination history of cases.
FUuse.
Number
vaccinated
within?
years pre-
ceding
attack.
Nirmber
last vacci-
nated more
than 7 years
preceding
rttadcT
Number
never suo-
oeesfuUy
vaccinated.
Vaeoiaation
history not
obtained or
uncertain.
MlniMsott — Continaed.
Darwin Township
Moww County-
Pleasant valley Township
Olmsted County-
Rochester
36
«
a
2
3
1
1
1
38
1
2
1
Polk County-
Keystone Township
Ramsey County—
8t. Paul
Rloe County-
Wells Township
•
Roseau County-
Roseau
Bt. Louis County—
HJbMng.
1
flberbume County-
Livonia Townriilp
Sibter County—
fleverance Township
Steams County—
St. Cloud.
S
6
1
Sauk Outer
5
3
Winona County—
Winona....
Total
175
2
5
166
2
Ohio:
Allen Coimty
2
3
5
2
2
57
4
5
13
1
2
16
15
2
2
ao
2
1
2
14
5
7
1
37
16
88
1
7
1
4
71
6
25
10
1
6
1
1
39
2
Butler County
1
2
Carroll County
5
Clark County ' .',
1
2
1
1
Clinton County
Cuvabocu f 'ountr
56
Darke Coiuity
1
3
1
2
2
14
Fairfield County
Fran IcJiii County
1
Oallia Coujity
CJeauga County
CJivonc County
14
Guernsey County. .'.
1
Hamilton County . . .
.
2
HigL land County.
1
2
Uockin;; County
1] 26
3
Huron Count V
2
Knox County
. * .• .
1
i.orain 4'ounty '.'.
1
2
33
30
1
Lueax County
12
Marion < 'ounty
Medina C'Ounty
Mercer County
MiaruA f 'opnty '
1
3
Montgomery ^^omty
15
Portagft County .
3
Putnein Connfy . ........
Rops County ..!!
3
fliraduilry (5ounty
1
Scioto County
71
3
Shelby County ^...
Stark County
1
8uiimlt Cotinty
^
21
Trambull Countv
1
TnenrEwiv f^'ounty
Van Wert i'oimtv.'
3
VlBlin County.....!
Wadbington County
Wavne ^'ountr
36
Tolal
453
1
6
254
in
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November SO, 1917
2050
SMALLPOX^-CoDtmoed.
Mlscellaiieoiis SUte Reports.
i
Place.
Cases.
Deatbs.
Place.
1
Arkansas (June 1-30):
Arkansas County
3
1
6
8
1
1
3
10
1
1
3
9
41
1
2
Maine (Oct. 1-31):
Aroostook County-
Fort Fairfield (town)
Presque Isle (town). .
Kennebec County—
Winslow vtown)
Penobecot Omnty—
1
S _
3.-
1 .
1 -
Ashley C-oimty
Calboun County
Chicot County.'.
Clay County
Cleveland C>Bunty
Faulkner County
Garlanil County
(J rccnc County
Macliias(tofkn). » 2 _ 1
Whltnervfllertnwii^ ' » 1
Hempstpud County
Marion County
Total
-!
MillorCounty
1 44
Mississippi County
Pulaski (\)unty
Mississippi (Oct. 1-31):
Calhoun County
I
8 -
IS
St. Francis County
White County
Chickasaw County. .V..V.
Clay County
Total
91
Arkansas (July 1-31):
1
1
3
1
4
1
3
4
10
De Soto County
Forrest County
i;..
2 -^
i
3 !-.-
1
: 1 ':::
; 5....
Drew County
Harrison County
Faulkner County
Hinds Countv
Garland County
Holmes County.
Lawrence County
Lee County.
Logan County
Simpson County. .....11'.
Warren Countv
Mluer County
Perry County
Yaxoo CotmlT
Pulaski County
Total
St. Francis County
64
White County
Total
»
North Dakota (Oct. 1-31):
Bottineau County
Burleiirh County
!
_ t
Iowa f Oct. 1-31):
Adair County
1
17
8
2
1
4
3
1
3
2T
1
3
14
1
1
0
1
4
2
11
0
2
1
2
1
1
2
2
2!...-
3 .
Apnanoose County
A udubon County
McLean Ck>untT
5'.... .
12 t
I—
1 i
J 1
Black Hawk County
OH ver County
RnloLtf> Cniintv
Boone County
Butler County
Ward Countv
Cass County
Willi'ims Cmintv
Cerro Gordo County
Clarke County
Total
3J
Decatur Count v
Delaware County
Pennsylvania (Oct. 1-31);
Allegheny County
niftir Pniintir
Dubuque County
Floyd County
i
Hancock County
1 I
1 1
Johnson County
Kossuth County
Monona County
•E=
Montgomery County
Page County
Cumberland County
Polk County
fl:::.::::
5 '
Pottawattamie County. . J
%•
Snyder Ck>unty
Scott County
Shelby County
Total
Sioux County
Washington County
Webster County..
South Carolina (Oct. 1-31):
Berkeley County
T
1
Woodbury County...'"....
Wright County
7
6
6
4
1
Total
128
uorcnesior M>uni;y
G reen ville County
Kershaw (Tounty
Louisiana (Oct. 1-31):
6
13
1
1
•3
4
2
1
2
Newberry (}ounty
Acadia Parish
Total
24
East Baton Rouge Parish.
Jetlerson Davis Parish
Wyoming (Oct. 1-31):
Carbon Coimty
1
5
■
Plaquemines Parish
St. Tammany Parish ,
'.''.'.'.'.'.'.'.'.
Tensas Parish
West Carroll Parish
Orleans Parish
Total "
6
Total ^
32
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2051
SMALLPOX--Continued.
City BeporU for Week Ended Nov. 10, 1917.
November 30, 1917
Place.
Cases.
Deaths.
Place.
Cases. ' Deaths.
1
12
5
8
1
X4
1
6
1
17
1
1
8
11
32
2
2
30
2
9
28
50
1*1 Cro>A>. Wis
L«';i\f nW'OrHht KQ<n^..
4
3
1
1
3
1
3
56
2
1
2
1
3
2
2
3
2
1
1
Alton, 111
Ann Arbor, Mich
Li r.i'ohi. Kcbr.
M-(JhL)!i, Wli ,...,
Buffalo. N. Y
Butte, Mont
Miluritiker, Wii
Nu'L-.ini FhUs, N. Y.,
Canton, Ohio
Chicago, 111
OkLiljurnfi Chv, OkUi
Cincinnati, Ohio
OrtLaha, X<?br .^
PiushurEJ*,Fii..
P«iri LiTui, Ortff , . = . »
Cleveland, Ohio
Columbui, Ohio
Davenport. Iowa
Rii.itJOkr' Vs.......
81 Joai^pb, Mo ,
St l^uL%Mo
Sfeit Lakprily, tTt.ll)
Dayton, Onio
Denver, Colo
Detroit, Mich.
Dubuque, Iowa
Flint, Mich
San Frilin'isn5, C«l. .
SiuiLX tit j.% Iowa
Ft. \^aync, Ind
Grand Rapids. Mich.
Si rincftcKl, OWo
Indianapolis, Ind
Tckdii. Ohio.. .
Tti Ftt^ta^ KiAns , . , , ."
W vi^:hin^ii, D. C.
Kansas (Sty.' Kflns
1
Kansas aty. Mo
TETANUS.
City Reports for Week Ended November 10, 1917.
During the week ended November 10, 1917, cases of tetanus wei*e
rei)orted as follows: Cleveland, Ohio, 1; Kansas City, Kans., 1;
Pittsburgh, Pa., 1 death; Worcester, Mass., 1 rase; and Auburp,
N. Y., 2 fatal cases.
TUBERCULOSIS.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 2056.
TYPHOID FEVER.
State Reports for October, 1917.
Place. ^
New cases
reported.
Kansas:
Allen County
Anderson County
Atchison County
Barljer County
Barton County
Bourbon County
Brown County
Butler County—
Andover(R. D.)....
AugusU(5B. D.)..
Benton (R. D.)
Beaumont
Douglass (R. D.). . .
Kl Dorado (1 R. D.)
Whitowater (R. D.).
Chaso County
Chautauqua County. . . .
Cherokoo County
Clay County
Cloud County
Coffey CouBlf
Cowlij County-—
Arkansas GUj
Burden (R.D.)
Qunbridci(R.D.)..
WinfleldT.
15
Place.
Kansas— Cent inued.
Crawford County—
Arma
Breety Hill
Croweburg
Fran V li n
(ilrard
Mi:l»icTry (1 R. D.)
Pittsburg (4 R. D.)
Rbago
Dickinson County—
Hcrlngton (1 R. D.)
DonlDban County
Douglas County
Elk (ounty
Ellsworth County
Flnnev County
Ford County
Franklin County
Geary C^Rinty
Gove County..;
Graham County
Grny County
(f ree i wood County
Hamilto:! County
Harder C^.mty
Harvey County
New cases
reported.
1
3
3
2
1
4
18
3
12
1
9
8
1
3
2
6
1
1
1
1
9
1
10
2
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Norember 80, 1017 2052
TYPHOID PEVrat— Gootinaed.
State Reports for October* 1917— Continued.
Place.
Kansas— Continued.
Hodgeman County
Jackson County
Kearny County
Kingman County ,
Labette County
Leavenworth County
Lincoln County
Linn County
Lvon County
Iferion County
Marshall County
McFherson County
Miami County
Mitchell County
Montgomery County
Morris Countv
Morton County
Neosho County
Ness County
Osage County
Osborne County
Pratt County
Reno Coiuity—
Abbeyrllle
Hutchinson (2 R. D.).
Sylvia
Republic County
Rice County
Riley County—
ManhaUan
Ogden
Randoli h
Rooks County
Balino County
Sedgwick County-
Cheney (IR.D.)
Wichita (3 R. D.)
Seward County
Shawnee Cotmty-
Topeka (2 R. D.)
Smith County
BtafTord County
Stevens County
Sumner County
Wabaunsee County
Washington Cotuity
Wilson I'ounty
Woodson I'otinty
Wyandotte i ounly—
Kansas City
Rosedaie
Turner
N<^ oases
reported.
Total.
Louisiana:
Acadia Parish
A»cen*i(n Tarish
Assumptl^.n Tarbh
AvoyeUes I'arish
Beauregard I'arish
BlenvUle Parisb
Caddo Parish
Caldwell Parish
Calcasieu Pariih
DeSoto I*ari>h
Evangeline I 'tirish
EastOaton Roii^o Parish.
EastCarruU Paruh
Orant Parish
ll*rla Parish
Iberville l\u-r»h
JarkM>n PlUl^h
JelTcnoa Duvi* Parish....
Lofuyelle I'orl'vlt
Latuurche P.»n»h
Orl«4iai I'aruh
Plac«.
G0&
Louisiana— Cootlnued.
Plaquemines Parish
PiinteCcupee Pariah
Rapides Parish
Richland Parish
St. Jamas Parish
St. J>hn Parish
St. Martin Parish
St. Mary Parish
St. Tammany Pariah
Tensas Parish
TerrelKunc Parish
Unl n Parish
VenniUon Parish
Vem n Parish
WehjOer Parish
West Bat n Rouge Parish.
West Carroll Parish
Total.
Maine:
Androscoggin County—
Durbam (t^wn)
Cumberland County—
P rtland
Knox Countv—
R^H^land
Oxl<>Td C^imtv—
rreenword (town)..
Piscataquis County—
Mile
Waldi Countv—
Searsm nt (town)...
Ycrk Coimtv—
Kit t<Ty (town)
1
•
I
1
n
1
1
Total.
Mtchi^^n:
Allegan Cwinty
Bav Countv
BarrvCotintv
Berrien Co'inty
Branch Coj'Ptvj*
Calhoun Count v
Che^oviran County . .»
Clare Co'inty ,^
Delta (^ointv
Dickinson Co-inty . . . .
KalonCo»mtv
flenesee Cotmty
Oo««'»»i«' Cot J nly
flrAtiotCointy
Hiirofi Cotinty
IIo"Khton Co'inty..,.
Inqham (^«mty
lo'il iJ'ounty
Jw'k* on County
KalkaHka County
Kent Cotinty
Lai»eer Countv
I,enawee Co'inty
Marquette Cotmty. . . .
Mo.iroe Cotinty
Montcalm Co- inly..,,
Oakland <'o'jnty
8o«iiia^v Cointy
81. Clair Cotmly
Hill »wuswe County .. .
Van it uren County...
W J h'onuwCuinty...
Wayne i ounly
We vJord CouJily
Total.
m
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2063
TTPHOro FBVElt— C6ntinued.
State Reports for October, 1917— Continued.
NoyemDer 80, IWT
Place.
New cases
reported.
Place.
New cases
reported.
nesotfki
Beclcer Comity —
1
3
1
1
1
3
1
28
1
1
1
1
1
1
1
1
1
1
1
'
13
1
1
1
3
1
2
6
1
2
1
1
5
11
2
1
1
3
1
1
1
1
Ulssissippi-GontiniMd.
AmitA County
4
I>«tTOlt...
Att4il%County
7
Fraxee
BoUvar Counly . . ..miriTL. ?"!"?
Calhom Couuqr —.-
CarroQ County. .*.....„,»•.. .^..
Chickasaw County.......^ „
27
BigstooQ County--
Ctneevflte...
Blue IBarth Comity—
6
7
9
IffsnlEftto TWnaUl)
Choctaw County «...»
Claiborne County
12
Cro'w vnng County— '
1
Bmfoani.
Clarke County . 7. .
2
Ctwby ^
£>od0« County-
Djdteo carter
Clay County Jllllir.IIIinil!!
CoohoBM county-
Copiak Cuuniy.
C-ovinftfli Cronty
4
14
12
HcTin^^iOKmty^
4
Da Soto County .".. .
14
HobbanI Cbonty^
Forrest County'. ... ^lllllll nil] ^ 1 1 !
3
StratgbtRtT«rTbWB8h^
Franklin roimty
5
Itasca Oounty—
Greene County.'. «.
t
Uarble
Grenada County ,^.
Hnnoack County. ^ X ..**.. ^ ^
2
Nashwaoit
1
Jackson. County —
Hinds County .1, .^^immm..^
0
T.&krflvM .
1 Holmes Onuity . . .
4
Klttsoa Coontr-
Donaldson
Itawanba County.. "....I]. 11111111
Jackson Oaunty
Jeffersm County..... ^..^
Jefferson PavisCouDJtT* >.•..... .
2
; 2
St. Vincent
1
Lake County—
2
Jones County 7^.....,..
Kemper Cotntty ..... ..»»««,i«.«,, ... .
i^fftvette County .................. .
21
Le SUeur County-
Cordova Township
5
5
LyonCoonty—
Tracy
Lamai Cocmty
Lauderdafc County
11
14
IC orrison County —
5
l*im. .
Lee County...
17
N icollct County^
T-eflore County. .!'!!!l?"!!!"r"!!!
31
North Mankato
Lhicoki County ^ ..
Madisen Cmmfj
11
St. Peter
8
Otter TaftCoraity—
Marion County'
7
FwgasFWb
Marshall County
8
Pcnnlnilon eoanty—
Thfcf Hirer FiJlB
Monroe Oounjhf ^.„
Monteomery County................
10
6
Pine County-
Neshoba County....
4
Mnnch Tawn^i%)
Nftwta^ County.
5
Pipestone County—
. Noxubee County .,
4
Rttthton
Oktibbeha County
16
Polk County—
Panola County
15
OooJoton. .. .
Pearl River CouiDLty
Perry County > ....
3
(inlty TVwmh^
2
Pope Oounty—
Pike Oounty !I. ..*!.!
20
Grove I^e Township
Pontotoc County.......
1
Ramsey County—
Prentiss County
SLl-ajil...
Q»»H mnn CfH»nfy .......
4
Kedwo^ Coonty—
Ilan kin County" '.'.
7
Uflchrood Falls,
Scott County .t
12
Renvtfle County —
Simpscn County
8
M^Q.
Smith County ...
8
RiceOtwnty— •
St'ino County ... . . ^ . . .
2
F»»rtb*nl«
Sunflower County
13
Roseau Omnty-
Warroad
Tallahatchie County
17
Tflt,^ f inpity . - . . ^ X . V
19
St.LonfcOiunty—
Buht
Tippak County
17
Ti<>imnln g^ Cwmty .
8
CWsholm
Timica County ^.. »
Union County.....
14
10
Ely
Warren County
Washinirton County «
Waynelkiunty...;
3
9
6
Toner
WIltliVMinrmlnty ... ...
2
Vkginfi
winstfln CmnTtyT. ^ . ..
5
Stearns County—
SLCkMid.
YasooOKmty.l.....
8
Total
SaokCuitBr
574
SteeleCwB^—
Anron Ivwnjftjp
New Jersey:
A tlanuc Countr
4
IMiL
114
Bergen Oounty
4
Burlineton Countv .......
17
Mississippt
Adams fbunty
6
8
CamdoD Count y ..... .
3
Cape Ma V County
1
Alcorn County
Cumberland County
5
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NoYember 30. 1917 2054
TYPHOID FEYER— €k>ntinued.
Stole Reporto for October* 1917— Continued.
Plaoeu
Plaoeu
New Jersey— Contlnuiid.
Essex County
Glouoecter County . . .
Hudson County
Mercer County
Middlesex Count v.. .
Monmouth Co«niy * .
Morris County
Ocean County
Passaic County
Salem County
Somerset County . . . .
Sussex County
Union County
Warren County
Total.
North Dakota:
Adams County
Bens, n County —
Bottineau Cuunty.
Burleigh County...
Cass County
Cavalier County . . . .
Morten County
Nels^nCounty
Pembina County..,
Pierce County ,
Richland County..
Stutsman County .
Walsh County
Ward County
WUliams County..
ToUl.
Ohio:
Allen County
Ashland County
Athens County
Auclaise County
Bemu nt County
Brown (Vunty
Butler (\>unty
raiTv-IKVuDty
Champiiitai (ounty. .
Clark t\>unty
Clcrm^ nt (\>unly
rUnlon (Vmnty
ColumMana (Xunty..
Crawfunl ('v»untv
CuyahoRa C-oimty —
Darke(oimty
DeOanoe C'ountT
Delaware C-ounty . . . . ,
ErieCotmty
FairncM County
FayttU* County
Franklin Cunty....,
(Iroone (.'oimly ,
(lUfmwy C^mnly..-.
limniltt n<\ iinty.,,,
liarritini Cx>uuty...,.
Ilonry County
Illt;tkLand County....
IhxkinRCoiUJty....,
Ilolro<viC4><inly
JjM'kMjn Cmmty
J«*IT» rnon Count v....,
Ij:wr('nrc(%>unty...
I.irkinp C utily ,
l^oK^n ConiiCy ,
1/ rain (Vnuity
I jn-a\ Comity
Ma<lium C'.iu'nty.
Mnh. nine County .
Mrdtn* < imty .
151
1
4
C
2
7
S
4
3
3
7 I
8
31
3
4
32
13
2
2
1
1
3
13
3
5
16
4
3
1
8
1
0
7
3
11
G
3
15
3
U
0
Ohio— Cnntlnoed.
Miami County
M ntffomeryCoimty.
iiiitkingiim Cotmty . .
Ottawa County
Perry County
Pickaway County. . . .
Pike County
Portace County
RossCoimtv
Sandusky County —
Sd^oCuuntT..
Seneca County
Shelby Ck>unty
Stark County
Summit County
Trumbull County
Tuscarawas County . .
Uni- n County
Van Wert County —
Vinton County
Warren C>ounty
Wasme County
WoodCA>unty
WyandJt County
Total.
Penn5vIv«nU:
Adams County
Allef^beny C^junly
Armstrone County. . . .
Bea\er County
Bedford County
Berks County
Blair County
Bradford Cmmty
Bupk5 equity
Butler County
Cambria County
Carb*>n County
Cantor County
Chpsier County
Clarion Cfninlv
Clearflt'ld County
Columbia Cnir I y
Crawford Count y
Cuml*'"! ind Cnuity..
Pauphin County
Delawarr County ,
ElkCouUy ,
Erir Cmmty
Fa wt i«» C-ount v ,
Fr in kiln County
Fulton County ,
Gre«*r.p CountT
HuPlinKdon County..
IndLina CoimtT
JefTerwn Cmmty
Juniata Count T
Larka wanna C^nly.
I jinr-.k^tpr (>Hmty ....
I^ ri'nc^ County
Lel»an(m County ,
LfhUh (>»untT
I ji«*Tne OxintT
Lvroralnif CMinty... .
McKoan Cmmty
M^^ri-pr County
MiflUn County
5I')nt -^cnnrry Connty .
M on '*»ur County.
Nc»r«harai>tfui (*ounly
Northtun norland County..
Pwry Crxmly
rhiMpll»hla County
Schnvlkill County
Siiy«l«T V mmty
9
S
11
1
i
i
1
)
I
c
u
1
t
»
i
i
1
9
4
I
H
1
m
I
I
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2055
TYPHOID FEVrat— Continued.
State Reports for October, 1917--€ontinued.
Movember 30, 1917
Plane.
New cases
reported.
Place.
New cases
reported.
PennsylvMiia— Continued.
Somenet County
23
2
1
2
1
87
2
13
4
28
Sooth Carolina— Continued.
Marion County. , , , .
1
1
2
5
SusQuehanna County
Oconee '..,.....» .1, ]
Tioga County
Pickens
Venango County
Pich land County ^,.
Warren County
Snartanhtir? Coantv
6
2
Washinrton County
Sumter County ,
WajmeCountv
Williamsburr ^jinntv
1
W<y?tinorp|ftnn -,»., ,^^..^,j,^,,,^^
Total
Wyoming County
46
York County....;
Vermont:
Chittenden County—
_______^__
TotaL
776
1
3
Rhode Island:
Bristol County-
1
3
2
1
6
10
1
Essex CJounty—
Brkhton
Bristol (town)
Franklin ODunty-
Bakersficld
Kent County— •
I
West Warwick (town)
St. Albans
3
Newport County—
Tiverton (town)
Orange County-
1
Providence County^
North Providence (town)
Orleans County-
Derby
1
Pawtucket
Rutland County-
Rutland
Providence
1
Washington County-
Hope Volley (town)
Windham County— *
Brattleboro -
1
Roofrinpham
1
2
Total
24
Wibni^n.
South (Carolina:
1
1
1
2
10
11
1
1
Total
15
Abbeville County
Wyoming:
Washakie Countv
Bamben? County
Chester County ,
2
Dorchrater County *.
Natrona County
0
Florence County .'.
Ufaata County
3
Greenville County.....
Total
Laurens County ,,.,.,. r r .., ,
u
Lexington County
State Reports for June and July, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Arkansas (June 1-30):
Bradley County
17
Ark^as-g^thiued.
3
Calhoun County
Madison Cratntv
1
Chicot 0)un ty .'
Miller (^nmty.. . '..7,[ViVi"l'' W
3
Conway County
Popfl County ........
3
Dallas County .'
Pulaski Cminty. * /**
16
Garland County
Saline Coimtyl
3
Greene County, ...........^.^^.TT^r
St. T^ranciis Ciiimtv . '/.... .. _
6
l2ardO>unty
White County
10
Total
Pulaski C>)unty
133
Saline (^untyr
Rhode Island (June 1-30):
Newport County-
Jamestown (town)
St. Francis Cibonty...
Union (Jounty
1
White Countv
Tiverton (town)
1
Providence County—
Total
49
1
Arkansas (July 1-31):
Ashley Co^inty.. •••...... •••....... .
2
1
10
1
17
7
29
2
2
15
2
Pawtucket
Providence
1
14
Total
Calhoun County
18
CarraU County
Clay County
Rhode Island (July 1-31):
Kent County-
West Warwick (town)
Fau*lmer County. . .........c......
(terkuid County'. ~.^»...^..
Greene County
1
Providence County-
Providence
HemDstead Countv ..............
17
TntKl rVnintv ..
Total
Johnifon County
18
lAwrence Cwmty. ^rr--r
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Novembctf 80, 191T
2056
TTPHOm raVEB— Continued.
City Reports for Week Ended Nor. 10, 1917.
Place.
Allentown. Pa
Altoona, Pa
Ann Arbor, Mich
Austin, Tex
Haltlmore, Md
Birmingham, Ala.....
Boston, llass
Buffalo, N.Y
Butler, Pa.
Camden, N.J
Chicago, 111
Cincinnati, Ohio
Cleveland, Ohio
Coffey ville, Kans
Columbus, Ohio
Cumberland, Md
Davenport. Iowa
Dayton, Ohio
Denver, Colo
Detroit, Mich ,
Duluth, Minn ,
EastOranre, N. J...,
El Pas«. l^x ,
Evansville. Ind
Everett, Mass ,
Everett, Wash
Fall River, Mass
Flint, Mich
Ft. Wayne, Ind
Ft. Worth, Tex
Oalesburg, 111
Grand Rapids, Mich..
Green Bay, Wis
Hagerstown, Md
Harrlsburg, Pa
Hartford, Conn
Indianapolis, Ind
Jackison, Mich
Jersey City, N. J
Kansas aty, Mo
Lancaster, Pa
Leavenworth, Kans..
Lexington, Ky
Lima, Ohio
Los Angoles, Cal
McKoesport, Pa
Memphis, Tenn
Milwaukee, Wis
Cases.
3
16
3
4
8
a
3
1
3.
1
10
1
1
Deaths.
Place.
Mobile, Ala
Nashville, Tenn
Newark, N.J
New Bedford, Mass....
New Haven, Conn.
New Orleans, La
New York, N.Y
Norfolk, Va.
Oakland, Cai
Oklahoma City, Okla..
Omaha. Nebr
Passaip,N.J
Perth \raboy, N.J....
Philadelnhia, Pa
Pittsburgh, Pa
Portland. Me
Portland, Oreg
Portsmouth, va
Rapine, Wfa
Reading, Pa
Rlch'nond, Va
Rockford, ni
Rocky Mount, N.C...
St. Louis. Mo
Salt Lake City. Utah..
San Diego. Cal
San Francisco, Cal
Savannah. Qa
S-^henectady. N. Y
Seattle, Wash
South Bend, Ind
South Bethlehem. Pa..
Springfield, Ohio
Steelton, Pa
Tacoma, Wfwh
Toledo, Ohio
Topeka, Kans
Trenton, N. J
Troy.N.Y
Washington, D. C
Washington, Pa
Watertown. N. Y
Wheeltag. W. Va
Wichita, Kans
Wil nlngton. Del
Winston-Salem. N.C.
Worcester, Mass
Zanesville, Ohio
Cases.
DeaUB.
DIPRTHEBU, MEASLES, SCARLET FEVER. AND TUBERCULOSIS.
State Reports for October, 1917.
Cases reported.
1
State.
. . Cases reported.
state.
Diph-
theria.
Measles.
Scarlet
fever.
Diph-
theria.
Measles.
Scarlet
fever.
Iowa
104
194
203
21
6C3
410
179
003
112
231
32
10
474
185
08
280
North DakotA
Ohio
27
1,020
2,270
163
258
27
10
11
194
505
26
30
18
0
33
Kansas . r -
180
304
48
411
40
i.2f;5
284
6(S
I/OuLsiana
Maine
Pennsylvania
1 Rhode Ishind
, South Carolina
Vermont
747
45
Uichigan
36
Minnesota
3i
Mississippi
1 Wyoming
ZJ
New Jersey
1
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2057
^iuveinhcr 30, 1017
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Coutiuued.
State Reports for June and July, 1917.
Cases reported.
Cbsqs reported.
state.
Diph-
theria.
Measles.
110
33
Scarlet
fovor.
State.
1
1
Diph-
theria.
Measles.
Scarlet
fever.
Arkansas (June
1 30)
4
4
2
G
1
1 Rhode Island (June
1 1-30)
C8
114
130
110
2C
Arkansas (July
1-31)
1 Rhode Island (July
1 1-31)
30
•
1 ^
New Hampshire Reports, June to October, 1917.
(^es reported. >
Cases reported.
Month.
'Diph-
theria.
Measles.
j; Month.
Scarlet
fever. i|
Diph-
theria.
Measles.
Scarlet
fever.
June
26
20
19
45\
119
32
17 September
3«
37
9
74
10
Juy
17 O.t-ber
44
August
.8;|
City Reports for Weelt Ended Nov. 10, 1917.
City.
Over STQ^OOO Jnha»>il*nli;:
Ball imore, Md
Bo(stoi, Mass
Chicago, III
Cleveland, Ohio
Detroit, Mich
Los Angeles, Tal
New York, N. Y
Philadelphia, Pa
Pittsburgh, I'a '...
St. i.onis, Mo
From 300,000 to 500,000 inhabit-
ants:
RufTalo.N. Y
Cincinnati, ouio. . . .
JcrseyCitv, N. J
Milwaukee, Wis
Minneapolis, Minn
Newark-. N.J
New Orleans, La
Ban Francisco, Cal
Seattle, Wash
Washington, D. C
From 200,000 to 300,000 inhabit-
ants:
Columbus, Ohio
Denver, Colo
Indianapolis, Ind
Kansas City, Mo
Portland, ()reg
Providence, R.I
From 100,000 to 200,000 inhabit-
ants:
Birmingham. Ala
Bridgeport, (jonn
Cambridge, Mass
147
Populft-
Tmal
Di|>htherift.
M«!4Ule3.
lover.
Tubef-
culosfs.
July I, lUKi
df*:alja
ft am
ie4Uiiuit»d
,
hy IK H.
C#a^]j
BUJt-AllK
III!
1
1
1
1
1
u
1
5^9,621
194
17
1
13
-
10
30
20
751,476
236
125
5
47
2
32
1
54
24
2,497,722
593
328
26
43
2
105
4
162
54
674,073
166
.50
4
1
11
24
10
571,784
187
75
8
22
00
1
41
15
503,812
12
1
2
8
24
16
.'i,602,>«41
1,390
233
25
129
2
85
176
171
1,709,:>IS
472
77
7
16
23
68
62
:>79,09()
212
51
6
29
1
7
1
24
12-
757,309
213
96
2
17
40
41
18
4^\ &VS
124
31
4
12
7
38
9
410,476
115
26
4
1
11
24
11
joo, .54a
16
4
0
9
12
7
43'5, :».35
88
11
3
13
36
12
7
363.451
*"*i28"
£2
27
6
13
7
8
40S894
39
20
371,747
132
16
1
2
6
26
20
463,516
134
9
15
4
29
10
34H.639
44
13
6
13
8
3
363,980
117
85
1
33
1
8
25
16
214,878
69
5
1
23
9
6
16
280,800
53
4
45
1
1
4
6
17
271,708
13
297,847
85
26
2
A
11
1
10
0
295, 463
70
2
2
K)
3
3
254,960
92
68
18
6
3
13
3
3
15
181,762
6
6
121,579
26
5
5
7
1
112,9$!
41
7
10
8
>.',,',[[
4
4
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November 30, 1917
2058
DIPHTHERIA, MEASLES. SCARLET FEVER, AND TUBBRCULOSIg^
Continued.
City Reports tor Week Ended Nor. 10, 1917— Continued.
Fopute-
lion aa Of
(B^iimated
br U. S,
BiiraiO)*
Total
dcnlhs
from
all
DIphlhFTk.
linalpi.
City,
1
1
1
1
J
1 1
1
1
From lOn-OOO ta 200,000 lahtbiU
an t5— Continued.
Camden,N.J
Davton, Ohio
106,233
127.224
128.366
101. 5«2
12S.291
110,900
100.560
113,245
102,425
14S.TO5
117, o."*;
11S,15S
14«,6«5
19^^,604
las. 470
109,3«il
156, 6S7
117,399
105. W2
155,624
112.770
191,554
111.593
163,314
85,625
63,505
5K,659
57.060
60,893
57,653
63,973
67, 449
60,S52
60,734
57,144
94, 495
8f>,r.90
63,7(15
76,n7M
54,772
76,1«3
72,015
77,214
6S.r29
99. 4.37
60,Kr'3
51,155
7S,2«3
5M,22I
53,794
«*.»'I2
92.^43
71,744
59,411
63,M>7
56, iKi
6ti,s9.')
55.M2
W..*ll>
ST.f'Ts
.''1..'.'0
(«.,IK!
iV
30
24
2i
26
20
46
32"
34"
49
39
41
22
27
27
' 3
4
1
6
15
11
1
24
1
20
8
3
6
1
2
8
25
2
9
37
......
1
2
1
......
17
8
4
2
3
Fall River. Mass
.7
1
Fort Worih, Tex
14
2
6
6
15
I
Grand Rapids, Mich
Hartford, Conn ;...
7
: 3
Lawrence. Mass
2
2
1
9
2
5
4
3
Lowell. Mass. . ^
3
L vnn, Mass
3
8
7
4
3
5
4
3
1
2S
10
15
3
w
3
9
9.
S
MeroDhfj'. Tpnn.
Nashville. Tonn
New Bedford , Mas5 , , ,
New Haven, Oonn
Oakland. Cal
Oroaha, Ncbr
Readlnr. Pa
V
Richmond, Va
.
Salt I ake Citv, Utah
......
4
43
13
""i*
Springfield, Mass
5'
3
Svraciise, N. V... ..........
Tacoma , Wash
Tolwlo, Ohio
63
39
42
26
14
14
15
8
7
IS
'•'2
8
1
5
8
12
U
«
Trenton, N. J
Wortv^ter, Mass
From 60,0()0 to 100,000 inliabit-
ants:
Akron, Ohio
i .
AUcntown, Pa
^
Altootna, Pa
1
Atlantic Citv. N J
3
4
Ilavonne. N.J
ii
u
is*
26
IS
IS
ao
31
15
6
22
30
19
16
W
26
• 11
15
is"
14
8
15
^
10
20
34
23
1:.
n»
1 i*^
29
2
1
7
1
9
3
6
7
16
2
2
9
3
8
3
3
9
2
6
3
3
6
8
4
3
3
4
1
1
1
2
3
Berkeley, Cal
......
3
1
1
Binch imt on , N . Y
• 2
; 3
1
Brofkton, Mass ,
Canton, ()hio. . , ., .
;
Charlolon, S. C....*!
1
3
3
16
11
9
3
4
3
6
t
3
1
3
1
1 3
4
('oNinRton. Kv
1
1
Diihith. Minn
10
6
KlitaVeth. N. J
1 '
«
F.l Pax). Tex
K
F.vnn^vl'k*. Ind
I
1
...#..
Flint Mich
Ft Wavne. Ind.
1
1
4
Harrishurjf . Pa
3
7
3
S
1
Holokpn, N. J
Johnstown, Pa
14
I
1
1
Kansu^ Citv, Kans
t
Lancaster. Pa
Maiden. Ma.Hs
"*" 1
1
1
1
8
1
3
Manrhevtor, N. H
Moli'c. \Iu
I "
I
3
Norfo'k Va
3
4
,.;...)
C)kln> oniA ( itv Okin
1
4
Pa-i^ui'-. N. J.!
PautiM ket H I
»
I
1
]
I'or' ! <t Mo
38
I
1
1
"1
I
Iv(¥ \ ;(.ril. Ill
1
7
3
3
3
5
]
1
26
4
6
3
'*9"
1
W.I JnviMih Mo
.^an 1 'M'i.'c) ( jl
......
I
1
4
'2
1
is
.*'ji\annnh. «tji
3
Mo \ « II Invva
.^•<in rr i\- M.m
i-ir T I.^mhI Ind
4
6
1
h| ri • •• .1 lli
"
Hi riMi' r «) ( «| |.)
•
3
1
'li'irt JIa.tt Ind
3
..••*«
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2059
Noyember 80, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Nov. 10, 1917-<9ontinued.
Popiil«y- ,
tion as of
Jul • 1, 1Q16
(estimated
bv U. S.
Census
Bureau).
Trtal
deaths
from
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tuber-
culosis.
City.
1
1
1
1
1
1
J
1
From SO/X ' to 100,000 Inhablt-
Troy N Y
7«,77«
94,?-5
61,F56
34,«14
27,'"r<2
4^,42.«;
4«,102
2^,^W
2^,074
4S«11
42,45«
2*^,203
30,2^3
.%S4W
4i,«^3
2" "^'vl
2.S 79
40, 40'^
4*<,477
4*<.R)W
2<^,771
3»,F76
31, '^77
41,097
35,3«<4
4«,n5
27,.^><7
32,940
30,«^99
47,r2l
2«,234
2%318
27,327
2Q,(m
41,133
31,927
. .30, 108
43,715
37, ^13
31,401
31,404
33,080
4fl,4.V)
41,18.')
3S,f^29
39,«^51
3fl,798
38,136
4fl,486
43,284
28,92ft
38,902
27,445
4«,226
36,283
48,726
30,&70
29, '^4
43, 139
43,377
1
1
4
1
2
1
7
2
WicHta I'lns
1
Wi'Ves Bart \ Pa.
1.1
37
3
10
12
6
8
ii'
7
6
8
8*
6
10
4
8
16
11
4*
12
11
15
0
h'
25
^
7
12
12
6
1
10
8
«*
4
14
6*
6
8
9
9
16
16
7
4
13
6
"*"6*
1
5
1
1
1
Wilmington. Del
3
York. Ta
1
2
1
1
3
4
2
1
From 25,000 to 50,000 inhalltants:
Alameda. Cat
1
1
Anhnm NY . .
Austin, Te*
2
Brook line. Mass
3
1
But er. Pa »
4
13
Butte, Mont
16
5
1
Che sea. Ma^
Chlro'^ee, Ma^^
Cumberland. M#
1
1
Dan%Me.in
1
3
Davonrort. Tow-a
1
1
2
1
2
4
Dubuciue, Towa
1
Ea'^t *»iiraifo. Ind
7
27
1
Fan Oran^je. N. J
Eljrtn. IP
2
2
1
1
4
2
1
Everett, Moss
1
4
Everett. Wash
1
OaK'e^-'ton, Tex ■:
1
1
4
Green Bav. Wh
Havjerstown. Md
6
5
HaTfil'ton, O^io
HaverMIl , Mass
6
2
6
1
......
1
6
......
5
7
3
Jark»<on, Mif**^
1
14
Ka'amaroo. Mich
1
Kingston. N. Y
1
KnoxviUc. Tenn
3
3
3
2
4
14
La Crosse. Wis
Lcxiiurton. Ky
......
11
i
2
3
2
17
2
Lima. Ohio
2
Lincoln. Nebr
Long Beach, Cal
L\Tiohbnre. Va
3
1
3
Madison. Wis
2
Mcdford. Mas^
1
1
2
1
MontPlair. N. T
Nashua, N. H
Newbiinrh, N. Y
1
1
....
14
3
2
2
1
Newcastle. Pa
2
1
Newport, Ky
2
Newpwt, R. I
2
1
A
3
2
1
I^vwUyn, Mo<:!;
......
1
1
Ni.-ara Falls, n.'y:::::::::
1
1
Noi ristown, ra
Ogdcn, Utah
2
4
1
Orancre.N. J
1
Pasadena, Cal
1
1
Perth Ambov, N. J
3
2
2
PiltsneM, Mass
3
1
Portsmc ilh, Va
2
I
1
Ciuincy, III
2
3
1
Quinev, M ^s
1
laclne.Wi^
1
Roanoke, Va
1
Rock Island. Ill
9
ii*
• 14
11
8
4
2
4
17
2
1
2
1
1
2
4
Ban Tose.Cal
2
Steuben ville, Ohio
Superior, Wis
Taunton, Mass
1
5
7
e
......
1
1
Topeka, Kans
Waltham. Mass
3
2
3
1
Watortown, N. Y
1
West Hobolcen. N. J
1
1
Wheeling, W. Va
3
...«.
1*
f 1
I
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Hmre
rM.l»17
20G0
DIPHTmSUA, MEASLES, SCAELBT FEVER, AND TUBBKCUUISI8-
GontiQiiecL
CItf
to WMk
N«f . !•, IMT-^CoaCuiMd.
Popular
tioB as of
Joly 1, 1916
(estimated
by U. 8.
Ctnsos
Bweaa).
Total
deaths
from
all
causes.
DipktiMrift.
MmuIoj
Scarlet
fever.
Tuber-
CUlOSiL
City.
1
1
1
1
1
1
1
i
From 25,000 to 50,000 inhabit-
ants—Cont inood.
Williamsport, Pn
33, MO
29,H02
31,155
30,863
22,874
15,010
13,532
13.599
21,6S5
15,794
13,075
17,54H
22,669
21,276
2:^,539
20,930
» 19,363
15,395
» 14,610
17,445
13.2H4
17,500
23,126
15,243
2-).9S5
» 22,019
19,926
:B,805
17,:.24
12,067
14,S3l
13,H2l
24,204
U,548
21,618
23,22S
15,068
h'
18
7
0
11
3*
6*
8
1
1
1
1
4
Wilmington, N. 0
Winston-Salem, N. C
Zancsville, Ohio
1
7
1
—
From 10,000 to 25.000 Inhabitants:
Alton, III
1
3
1
1
1
1
Ann Arbor. Mich
1
1
Beaver Fulli, Pa
"^
BerUn, N. H
Braddbok, Pa
3
.. . .
1
Ciilro,lil
I
ninton, Mass
1
2
Conrord, N. H
6
6
1
4
6
1
4
1
2
1
1
1
GaloHbut£.Ill
2
1
Kcamv.N, J
1
Kokoroo, Ind
TxM*venworth. Kans
Low; Branch, N. J
Mnnnette. Wis
1
2
1
2
'*•
Melrose. Mass
1
Monistown, N. J
Muscatine, Iowa
i
4
1
1
Nanticoke, Pa.
5
5
I
I
2
1
11
i*
3
1
1
7
Newbiuyport, Mass
1
New London, Conn
.
2
North Adftm*, M'^'is , .
Northampton, Moss
6
2
I
1
Plainfield. N. J
15
2
1
Pontiac. Miclu
Rocky Mount, N. C
1
Rutland, Vt
1
Saratoga Springs, N. Y
South Bethlebtm, Pa.
1
3
1
1
StceiUm, Pa.
Washington, Pa.
WiUdnsburg, Pa
1
1
2
4
1
'.'.'.'.'.'
1
1
1
Wobum, Mass ,
1
__._ t
I Population Apr. 15, 1910; no esOraate made.
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FOREIGN.
CUBA.
Gonunanicable Diseases — ^Habana.
Communicable diseases have been notified at Habana as follows:
Oct. 21-31, 1917.
Remain-
in? under
treatment
Oct. 31,
1917.
Disease.
Oct. 21-31, 1917.
Remain-
ini; under
Disease.
New
cases.
Deaths.
New
cases.
Deaths.
treatment
Oct. 31,
1917.
Diphtheria
7
1
3
10
26
1
Paratyphi Id fcjver
Scarle t fever
2
1
t23
1
2*
3
Lepr sy
1
lla&ria
»16
2
Tvph id fever
101
Measles :
Varicella
1
1 11 from outside Habana.
> 10 from outside Habona.
VENEZUELA.
Mortality— Jaimary-May, 1917.>
Deaths from all causes were notified in Venezuela during the period
January to May, 1917, as follows: January, 6,736; February, 5,217;
March, 4,947; April, 4,375; May, 4,399. Deatlis from certain dis-
eases during this period were reported as follows:
Year 1917, month of—
Deaths from—
InEEUitUe
Malarial
Tphoid
tetanus.
fever.
ISO
1,382
209
180
307
107
184
802
170
170
647
136
190
554
126
January..
February.
March....
April
May
1 Public Health Keporti, July 27, 1917, p. 1209.
(2061)
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November 80, 1917 2062
Mortality in Venezuela from Dysentery and Malarial Fevers, Janvary-May, 1117.
The following table shows the number of deaths from dysenteiy
and malarial fevers notified in Venezuela, by States, during the
period January-May, 1917:
Popula-
tfon.
Milftda.
Dymtery.
SUtes.
Janu-
ary.
Febru-
ary.
March.
April.
May.
Janu-
ary.
Febru-
•ry.
ICaich.
WtH ihj.
Federal District of
Caracas
135,504
102,374
28,653
113.666
68,757
200,342
106,«7
l«l,022
221,321
281,241
111,199
in.666
90,300
50,347
114,870
114,403
12fl^308
180,425
103,286
75,526
184,613
4
161
5
58
25
203
61
152
121
167
6
86
53
1
33
«7
23
27
38
34
87
2
117
10
37
14
143
51
109
74
103
6
66
31
1
82
4
22
26
117
8S
08
806
67
6
57
28
a
51
0
22
14
00
58
45
7»
5t
1
37
15
1
00
3
13
6
64
32
45
78
66
*** si*
14
2
20
16
17
27
22
12
32
If
6
7
It
11
72
23
2k
18
61
10
36
12
6
6
55
28
19
26
0
60
7
6
6
a
6
39
14
15
15
39
6
31
10
4
4
S7
39
10
17
3
41
11
9
S
8
34
10
12
11
14
12
32
10
4
4
16
M
17
U
11
3S
s, u
Anzoateinii
u
4
•
s
11
7
6
16
U
5
27
9
i"
B
M
m
11
4
S
S
Apuro
Aracm ........1..--.
Bolfvar
Carobobo
Falcon .,..,
Onarteo...^....^.. »..
Lme
liPrtds
Mimidft
Ifontfras
Nueva EsparU
PortuReaa
23
20
21
24
S4
26
57
20
24
18
31
22
34
38
18
31
18
20
17
25
27
Sucre
Tachire
Tnjjillo
Yaracuy,. ....•••..■•
Zamora
ZuHa
«
CHOLERA, PLAGUE, SMALLPOX, TTPHUS FEVER, AND YELLOW
FEVER.
Reports Received Daring the Week Ended Nor. 30, 1917.^
CHOLKSA.
PiMe.
Data. -
GkMi.
DmOu.
B«*.
IndU.
<>iinm» .. .........
Auc. 1^-Sept. L...
U
1
Indo-l hina:
SaifTon
Sept. 24-30
2
Philippine Islands:
Pro V Inces
*Jj»^.^WI7.C-**
Antique
8ept.30-Oct. 6....
do
15
14
2
9
31
17
U
1
8
14
1
S
18
•
•
1
Bohol
'
Capii
do
Obu
do
Hollo
...do
Mioifliiao
Noirn* Occi JcntaL
Npgroi OrieuUl
Provinoos •-.....
do
do
do
°S-i1t"^***' *
Antique
Oct. 7-18
27
10
4
2
30
36
3
19
8
3
1
13
21
1
Behol
... .do
Cchti _,
do ^
do...,,,,.
Uoilo
MiDdanao
do ^w
Nogros Occidental
do
Ncgros Oriental
do
1 From medical officers oi ibo Public Health Servioe, American consuls, and otber
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2063
November 30, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVERr-CJontlnued.
Reports Reeeired During the Week Ended Not. 30, 1917— Continued.
PLAGUB.
Place.
Date.
Cases.
Deaths.
Remarks.
India
Aue. 19-8cpt. 1, 1917; Oases,
16,161; deaths, 11,230. ^^
Indo-Hilna:
Qftlson...
Sept. 24-Oct. 7....
4
3
SMALLPOX.
Canada:
Ontario—
giuiila ,
Nov. 11-17
Oct. 15-21
Sept. 23-Oct. 13...
1
1
China:
Antunc . ............
CHiingirine
Present
RImiiphfti
Oct. 8-21
1
3
1
14
Cases among foreign population;
deaths among Chinese.
India:
Calcutta
Aug. 10-25
Indo-( hina:
Saigon
Sept. 24-Oct. 7....
Sept. 23-Oct. 27...
Oct. 7-13
35
34
3
1
Mexico:
Mexico City
Philippine Islands:
Manila
Portugal:
Lisbon . .
do
Portuguese Kast Africa:
Lourenco Marouex
July 1-31
7
*■
TYPHUS FEYEH.
China:
Antung
Greece:
Saloniki
Japan:
Nagasaki
Mexico:
Durango, State.
Mexiccaty.
Switzerland:
Basel
Oct. 13-28
Sept.tt-Oct. 13....
Oct. 22-28
Oct. 29
Sept. 29-Oct. 27. . .
Sept. 23-29
1
Prevalent on ranches in vidnity
of El Rio.
Reports Received ftwn June 30 to Nov. 23, 1917.
CHOLEBA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bassein
Apr 1-May5
8
1
10
347
42
4
4
07
2
2
3
1
5
7
1
17
8
Bombay
June 24-30
July8-8opt. 8
Apr. 29-June30...
1
19
Do
Calcutta
Do
July 1-Aup. 18
Karachi
Sept 1>-15
4
5
108
Madras ....,,
Apr.22-June30...
Julyl-Sept. 15....
May ft-June 30
Do
M%?!dalav r. r
Do •
July29-Aug 25...
Moulmein .••••
Mayl3-June2....
Apr. 20- May 5
Pakokku
Pegu •
May 27- June 30...
Do
July 1-7
Prome
July 2»-.\ug. 11
Ran coon
Apr.21-Junoa0...
July8-Sept. 8
31
10
^^ /^^v^^^^.
Jun« lA-lA 1017! Caa^A. ll
f deaths, 1. ' ' '
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2lo<T«Biber80,1017
2064
CHOLERA, PLAGUB, SMALLPOX, TYPHUS FBVKR, AKD TBLUf
FEVER--Ck)ntinaed.
Reports Received from J«iie 30 to Not. 28, 1917— CkmUnued.
CHOLBU— Continued.
PI...
Date.
Cases.
DMtths.
BMMfkS.
iDdo^hln*:
Feb. 1-Jtme 30, 1917: Caaci.1^
deaths, 805. Julr V4I, Mfe
Anflm
Feb. 1-Jmifi30....
July 1-31
230
86
79
74
878
359
1
36
3
163
47
191
47
51
53
543
214
Do
Cues, 522; deaths, 314.
Cambodia
Feb. 1- June 30....
July 1-31
Do
Cochin-China
Feb. 1=-June30....
July 1-31
Do
Laos
June 1-30
Tonkin
Feb. 1-June30....
July 1-31
21
Do
SaigOn
Apr.23-May27...
Jiuy 2-Sept. 23
108
32
Do
Japan
Jan.-July. 1917: Casm, »L »
currin^in IGprtrvineesiBd^
tricts.
Sept. 12, 1917: Ca3C« 2S3. h)
Tokyo ••••• .....
Sept. 12
2
1
3
1
Java:
East Java
Apr. 2-8
provinces aod districts.
Do
July&-2f>
3
1
Mid Java
Jiilv lfi-02
West Java
Apr. 13-July 5, 1917: Cases. H;
deaths. 31. July 6^SspL i.
1917: Cases, 501- deatltt,39r.
Batavia
Apr. 13-JiUy5
July6-Sept. 13....
Fob. 3
7
38
1
4
4
11
1
3
19
179
2
14
Do
Persia:
Mazanderan Province—
Amir Kela
Barfouroucho
Jan. l.Vl?
Do
Julv2S
1
6
Df mavend . .....
July 29
Hamzo Kela
Jan. 17
Machidc**sar
Jan. :n
AuK. 2f>-29
July 25- Aug. 5....
Sahzevar
U
98
8arl
Tabrit
AuK. 4. 1917- In villaffe«(
Philippine Islands:
Manila
June 17-23
Aug. 5-25..
1
4
OsDondeh. ridiutT ^ '^^^^
about 7 cases daily.
Do
fVitpt. 9-8, 1917' 1 oue Natpff-
vi ni-^lv reported.
May 3f>-Jime », I9I7: Cnsea. 7«:
deaths, 508. July l-Scpt *
mr. f ases, 3,819; deaths, V«
Acusan
Jnlv 1.V2H
12
113
73
2
28
3--.
1
I
3CS
363
62
?31
614
P5
14
819
237
51S
459
1
1
l
13H
196
254
16
7
17
U
2
7«
43
1
15
17
Albay
Mav2a-Jnn(*.'V)...
Jnlv 1-Sopt. 1
June 3-9
Do
Ambos ("amarincs
Do
July22-Au;^. 11...
Sent. 16-29
July 8^14
Antique
Bataan
Batanpas
Juno 17- 23
Mav 20.1 1 mo 30...
July 1-S pt. 20....
June 3-34)
1
251
281
40
4.'>
150
3fi2
59
5
512
117
295
297
Bohol
Do
Canii
^o:::::::::::::::::
July 1- ViiK. 4
June 2-30
Cebu
Do
July l-Sept. 29-...
(lo
Juno V) :V)
Jnlv 1 Sept. 29....
Julv K Aug. 4
July 2'K8opt. 2J...
July l-SopU 2'J
Jun.^2J 30
Julv 1^
Boilo
Loyto
Do
Mis}\tnis
Miii'liinao
Nci^TOi Oriental
Rizal
Do
Romblon.
Jrlv 22 3M .
i
75
88
133
10
7
16
7
Samar
Julv l.VSopt. 22...
Juno 3-3)
Sor.>of^oii ,
Do
Julv l-.\ug. 25
Julv 2C- A pp. 25...
Juno :{-'!>
Julv l-.Sti.'.29....
Jnlv I.V M
SuriiMo
Tayi*h:is
J»o
Zaiii v»u!ij;li ...
1
Digitized by
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2065
November 80. 191T
CHOLBHA, PLAGUB, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVim— Oontiiined.
Bepwf ReceiTei from Jane 30 to Not. 28, 1017— Continued,
PLAGTOL
PiMt.
Date.
Cases.
Deaths.
Remarks. *
AnbU:
Xdfln
ICaya^uly4
43
Apr. 8-May 14, 1917: Cans, 60
deaths, 51.
In DarsUui Quit Present Apr.
3, 1917.
Rnhmin Ttlanilll . •■■■■■•■•^
BrazU:
])ahia
June 10-30
Julys-Sept. 15....
July le- Aug. 15...
Apr. 8-Jime23....
July 6- Sept. 1
Apr. 29- May 5
13
6
4
41
2
8
2
1
33
6
P)0
Pprnflmbuco
Ceylon:
Colonibo ••••••••••••••••
Do
China:
Amov •
Present and in vicinity.
Present Aur 10^
"^"ifo :::
July 1-7
6
ao
4
6
13
3
Hongkong
May 13-JutM 30. . .
July8-.\ug. 18
June 2 ,
Do
Kwsngtunf! ProTioec —
T»-DU dtstrfct
Present
Ecuador:
Estanoia Viela
Feb. 1 28
1
56
42
4
1
1
2
1
do
S9
a
Mar. 1 -Apr. 30....
July l-Auic. 31....
Biar. 1-31.:
Do
Milacro
Apr. 1^
1
Xobol
Fob. 1-28
SftUtro
do
Do
^'ar 1-31
i'
Taiu^
Fob. 1-28
'
JTjrj'pt
,.
Jan. 1-Oot. 4, 19!r: Owes, 724;
deaths, ail. '
Alexandria
June 21-27
4
1
I
14
1
4
1
3
Do
July 31 Sept. 11...
Apr. 3(VMayl9....
Juue2'»
Port Said covemnient
l*ort Said
Do
July 28 29
1
7
Provinces—
FavooHi » •
May 11 June 26...
June 28
Galioubeh ...'.
Gir^ch ....... ..
May 17
i
s
Minieh
May 12 June 28...
Jqly2U Sept. 11...
May 12
4
9
i
38
3
2
Do
Siont
1
9
23
1
Suez government .'. .
Apr. .-w Jm>e2..-.
May 12-J!me 28. . .
Aun.l*-»4
May3-J*
Suez
Great Britain:
Gravcscnd
ITraiq f , s, MatlftnK
I«ondon
2 in hospital at port. From s. i.
Sardinia from Anetmlia and
oriental ports.
Apr. ly-^me 30, 1017: Cases,
IlKliB
Baww*ln
Apr. 1-June 30 . . .
M
24
997
263
38
4
35
5
413
28
280
20
74
33
1
2
6
109
428
»
43,992; deaths, 3b,197. July l-
Sept. 8, 1917: Cases, 30,391;
deaths, &9,3«8L
Do
July l-Scpt 1
Bombav
Apr. 22-JUIM30...
July l-«epi|, 8
Apr 29- June 2
486
323
Do'
Calcu t ta
Do
July 15-21
HensA'la
Apr 1- June 30
Do
Anr 13-f^t 1
Kar.vchi
Apr. 22- June 30...
Julyl-Sept. 15....
Apr. 22-Jiaie30...
Julyl-SeptlS
Apr. S-May 12
468
33
301
2,201
Do «.J
Madras Presidency ?
Do ::::.:::
MAndnlny ...
Do
July 29-Sept. 1
Moul meln
Apr. 1- June 10
Do
Jiuy 1-Bont. 1. .
Myincyan .^^.. .
Apri-T^.^.. :::::
PeguT .
May 27>June 2 . .
Uo «
July 29- Aug. 18...
Kangooo
Apr. 15-June30...
July l-8ept. 8
Apr.8-14
183
457
June 10-16, 1917: Cases, 10;
Do
deaths, 16!
1 tfuni'oo
l>o
JuJy29-8ept. 1....
........
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Korember 80, 1917
2066
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVBR, AND TELLOf
FEVER— 0>ntina6d.
Reports Received from Jmie 90 to Not. 2S, 1917 — OontiniKd.
PLAGUE-CcmtlniMd.
Plaoe.
Date.
Indo-Chlna:
Provinces
Anam
Do
Cambodia
Do
Cochln-China
Do
Kwang-Chow-Wan
Tontdn
Do
Saigoo
Do
Japan:
AlchiKen
MiyeKen
Java:
East Java
I^O'iakarta Residency.
Kedlri Residency
Samarang Residency...
Surabaya Residency . . .
Do
Surakarta Residency. . .
Persia:
Mohammcra
Peru
Departments—
Ancachs
Arequipa
Callao
Lambayeque
Libertad
Feb. l-Juneao.
JuJyl-31
Feb. 1-June 30.
JiUyl-31
Feb. I-Juoeao.
July 1-31
May 1-Jime 30. .
Feb. 1-June30.
July 1-31
Apr. 23-June3.
Sept. 9-23
Jan.-July.
....do.....
232
13
132
10
219
43
34
113
3
47
5
22
3
131
0
115
10
183
24
23
89
2
96
3
Feb. 1-Jime 30. I9I7: Cm& '
deaths, 491; July 1^ .
Oue8,e0:dartlis,4&.
Apr. 23-l£ay 0...
do
Apr.23>l£ay20..
Apr.2-lfay20...
July 8-28
....do
^S
2-lCAy ao, 1917: (i»
ths, a». July ao^Asi
1917: Oases, 4;deatlK,4.
Mayl.
July 1-31
May 1&-July31..
do
....do ,
May 1^21 ,
Lima..
Senegal
Siam:
Bangkok
Straits Sottlomenta:
Sinmporo
Union of South Africa:
Cape of Good Hope State—
Cradock
....do...
Sept. 30.
Apr. 22- June 30.
July3-Scpt. 1...
June 3-16
July l-Sept.22..
Ats
Qlengrey district.
Terka district
Queenstown ,
Orange Free State
Winburg district.
Aug. 23.
Aug. 13.
May 28..
Juno 6...
8. 8. MaUana.
May 28....
July 14-18.
Present.
May 13-31, 1917: Cases, IS. Jc
1-July 31, 1917: Ctaes. 3^
AtCasma.
At MoU«ndo.
At Callao.
At Chiclayo.
At Salaycrry, San Psdro. ^
TrojjU.. /oly Wl. BT: .
At lima. July 1^1, 1917: La
dty and countiy.
Present in interior.
Present.
Do.
At Summerhill Farm.
Adt. 16-22, 1917: 1 case, A^>
22, 1917: (^oes, 26; dcatteT-
En route for port of Loodoo.
SMALLPOX.
Australia:
New South Wales
Apr. 27-Au«. 80, 1917: Cases, f
Brewftirina. T,..,., ^,
Apr.27-Jane21...
Jifly 25-28.
May26-July6.....
Apr.27-June21...
June22-6ept.26...
MayO
6
4
18
2
63
1
4
6
126
819
Cessnock
Coonabarabran
Q!Tambnn4^ ,.,,,,.
Warren district
Queensland—
Thursday Island Quar-
antine Station.
Braill:
Bahift .....
From 8. 8. St. Albans finom Kobe
May6— Juneao...
July22-Sept22...
do
Jolyl-Sept.22....
Tia Hongkong. Vessel on-
eeeded to TownsvUIe, &
bane, sdA Sydney, in qm»
tine.
Do
1
31
199
Rio dc Janeiro
Do
Digitized by VjOOQIC
2067
NoTember 80. lOlT
CflOUSRA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW.
FEVER— Oontinued.
Raptrto Receif«d from Joe 90 to Not. 23, 1917~OoiiUnued.
SMALLPOZ-OontlmMd.
Flue.
mt&.
Go«a.
I3f«ltl5.
K«iiiar^.
Winnlmw — .
JuHBlO*I«.,...-„
Aug, ie-8»pt.K.„
Nov. 10.,. ....,„
July3fK\u(f>5...-
Mavfl-lX.
1
21
3
t
4
1
l»o»..._* ,.-»
Chiefly in Carleion and Ywt
Counties. One c&,9e notified
Is Northiimberland Couuty*
Haliriix.... ...*....
Ottaifra**..
Present in district.
Windsor _ „.
Ceylon:
CbUm:
AUIOV*. mm,** .^>.....
Apr. 20-M»y 2^. . -
Present md io Tiduity.
Do.
iio ...;,„„., J
Itkly l-Si?pt.2»....
An tting *«,_...,,,... ..*...,.
AUK.fl-ia .....
Msy2r-Jiine2....
Ami:, 11-17*.,.....
4
1
£
Po....,„„, .,,
QiflHEsho ..-.»*_.. ,.,,^ . ^ *. ^
r^. .,./;:::;;;;::;;;:
7
Ctumgldug, . ,..,., ._*-,*__**
Mny 6 Juneia...,
Prraent.
i ^...T,,^,^,^,.,,I
July l-i?Bpt,22
Vreaeiitaodliivtcinlty.
Dalrvii ,
May 13-Julie 30. , .
July.^m....;....
30
6
3
7
B
1
1
4
I
r'o., ..„„.„„„,..„,
Julj 1-7, 1917: FftseaL
Hankow ,
Aor.23r-M»yfi,..,
Mflyo-Jmjolfl,..,
HurbUi .-,„-,.„.
On Vhinmet East«ni By-
Ilciii^toiig.^,.,,,,^,*.,.,,,..
1
3 n._. ,*.,....,,.,*
Mjuidhuria St&tloc .•.,,.«..
Apr. 23-2CI.. ......
Id ay '-2T-Jiiiii2.,,.
Do,
Mukden..
Prftsent.
I 0 __
July .*- Oct. ©,._„
r 0.
Shanah*!.,. ,
May 21- July 1.....
July 2- Oct. 7..,,,,
Apr. l«^22. ,,..,.,
Muy23-Jul^7..,..
Julyao-Aoi^lK..
May 1-31....... „
Not. !.....„, .„.
IS
I
35
4
1
Casai rofdpi- deatbs awisig itf
C^ amonp rorelni poputoHon;
de^tZis anions CliUiDSQ,
On Chine w K^iitum Ky,
At i&fioiher siaUim on mUwifg
1 case.
Dd
Tslnirtao.....
7
I
i^S ,.,:::::;;:::::::::
Cuba:
Habana „
From s. i. Alfonso XIII, (t^m
Guayaquil.,.,,,.,. ,..
F«b,l-28..........
II»r. J -Apr. »?,...
July l-Aui^.ai...,
Apr, ;»-Julyi._.
July 2-2». .■:......
Feb, 13-Ajir. 8....
is? ?»*"!»•'■ •:
1 1
s
12
3»
30
m
I
.....,'.*•
porimSpftlB. ^*"'««o
i>o ...;:;;;;::;";:,'
Do...... ,
^Xlcxundrto
»
4
1
Dd., .....,.,..
Cutro....,-,
Fram^i
fiAmim
partsT, :;.::::::::;;; ;:;;:;
Oermuiy,.. „..
in dUes ■i]<ll3 States aoj dS
Berfin.. „„
Mar.l8-Apr.a».,.
.,.,,do*, ......
109
10
IS
flO
911
3
10
1
Bmiteji .... .„.,,,.,,..
CharloUt^Qbert „•,,,.,.
;::::do::: ;::
..,-..-.>.
Banibiirg. *♦*.*,,...-.*,„,
do...,
4o..,..
L(^ipde ,,...,,.
Lti&Mk
..*,.do. ,,.-,,,,
MuQii^h „,..
.,,,.<Io.
Slut^jart. „..,., „^,,,,,„,
do.. ......
""'*
Atbom ,.-., .,„
July 25-30.
39
13
L
4
31
India:
Bombay.. „,-.»*„,
Do ^^^^^ ,.
Anr.234una»...
July l-.'^mt, «....,
Apr 2-^ Mayas. ..
m
08
C^cutta.. ,.
X)o .„..
July 2S^^Auj|. 4, . ..
Kamrht.__, ,„„,
Do.,,.. „„»-.
Aj>r. Z2 Julyi
Ju]y 8-Scrpt. 1,.,,,
Apr. 22- June 30..,
fulyl-Sept.S
IT
80
13
Madtus...,.,.. ,
Do
Digitized by
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November 80. 1017
2068
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER-<Oontinue(L
Reports ReceiTed from Jnae 80 to Not. 23, 1917--Contmued.
SMALLPOX-Oontliiiied.
Place.
India— Ontinued.
Raneoon
Indo-Cbiaa:
Proviures
Anam
Do
Camborlia
Do
Cochin-china
Do
K wang-Chow-Wan . .
Laos
Do
TonUn
Do
Saigon ,
Do
Italy:
Turin
Do
Jamaica:
Kingston
Japan
Kobe.
Nagasaki
Osata
Yoldiaichi
Yokohama
Java:
East Java
Do
Mid-Java
Do
WcstJava
Batavla ,
Mexico:
Coatepec
Do
Jalapa
Mazatlan
Mexico City
Do
Monterey
Orizaba
Do
VcraCnit
Netherlands:
Amsterdam
Philippine islands:
Manila
Do
Portugal:
Lisbon
Do
Portuguese Kast Africa:
LK)uren(0 Marques. .
Russia:
Archangel
Do
Moscow
Petrograd
Do
Rica
Vladivostok
Slam:
iiangkok
1)0
Spain.
Ma^lrld
Malaca
lyo
Seville
Valensla
Do
Date.
Apr. 15-June 30.
Julyl-Sept. 1...
Feb.
July
Feb.
July
Feb.
July
Mar.
Apr.
July
Feb.
July
Apr.
July
May
July
l-JuDe30...
1-31
1-Juno30...
1-31
l-Juno30...
1-31
l-Apr. 30. . .
1-30
1-31
1- Juno 30...
1-31
27- June 10..
2-Sept.23...
21- June 34..
12-Sept.30..
Sept. 0> 15.
May
May
May
July
May
Apr.
July
Apr.
July
27-July 22,.
28- June 3...
Ift^JulyS...
2.V-31
2;-Julyl...
2-July 1....
Z-Aug. 20..
1-JuIy 1....
2-Bept.4...
Apr. 13- July 5..
Jan. 1- June 80...
Aug.l H
July 1-13
July 11-Aug. 7..
June 3-30
Aug.5-8cpt.22..
June 18 21.
Jan. 1-June30...
July 1-23
July l-8ept. 15. .
Aug. 13-18
May 13- June 9..
July8-8cpt. 1...
May 13-Jnne 30. .
July «- Aug. 18..
Mar. 1- June 30..
May 1-June 28. .
July2-Aug.28..
July 2- 15
Frb. lS-Juno30.
July 2 2a
Mar. 11- June 2..
Mar. 1V24
Juned-30..
July 11 17.
May I June 9.,
Apr. l-JuDc30.
July 1-31
Mav 1 Juue30.,
Juilea 23
July l-8epl. 15.
Caaes.
1,630
353
138
28
1,267
130
4
5
10
274
4
190
63
82
13
65
1
177
1
1
38
21
163
143
:6
6
•
565
58
7
23
16
3
Deaths.
337
50
26
23
377
40
13
116
1
1
9
Remarks.
June 10-16, 1917: Cases, 9; deaths*
3.
Feb. l-Jone 30, 1917: Cases, 617;
deaths, 535. July 1-31, 1917:
Cases, 525; deaths, 133.
Jan.-July. 1917: Cases, 4,974; in
87 PPOTiBess and districts.
Apr. 13-July 5, 1917: Cases, 3M:
deaths. 44. July ^-Sept. U,
1917: Cases, 149: deaths, 33.
Jan. l-Aug. 14, 1916: 118 d«attB.
Varioloid.
Do.
Jan. 1-Mar. 31,1917: Cases, 9.
Digitized by VjOOQIC
2069
N^Tenfrerao. UlT
diOLBRA, PLA6UB, SMALLPOX, TYPHUS FEVBR, AND YBLLOW
FSV^— Oontinoed.
Repwta ReceWed from Jane 30 to Nor. 2S, 1917— Continued.
SMALLPOZ-ConUmud.
PiMe.
Date.
Oases.
Deatlis.
UeuiaiiB.
P^UBDg
Mar.l8-June23...
Yune 34-30
1
1
1
2
2
3
BliMUMn.
"""^K^,.,.:.,;
Sept. 16-22
Apr.22-28.
May 20- June S3...
lane 2-8
^'•HSU
Stoekliolm ^
TuBbto:
1
Turkey in Asia:
Trobixond
Feb.25-Aprl3....
15
Union of South Africa:
Johannesburg
Mar. 12-24
4
2
00
July 1-31
Unmiay:
Montevideo
May 1-31
Voneiuela:
Maraeaibo
Juno IS- July 8. . . .
6
1
.
Do
Jaly»-23
On vessels:
8.8. Alfonso XIII
Nov.l
1
At Habana. From parti io
Spain lor liexicaapa^
TYPHUS FBfCK.
Algeria:
Do
ATipeotlna:
Buenos Aires
Austria-Hungary:
Austria
Bohemia
OaMcla
Lower Austria..
Moravia
Silesia
Styria
Upper Austria...
Bosnia-Herzegovina.
Hungary
Budapest
Eiicnburg
Brazil:
BiodeJaodro
Canary Istands:
Santa Cruz de Teneriffe.
ChlUa.
June 1-30
Julyl-Aog.31.
An«. 12-18
.1.
Oct.22-Dec. 17..
....do
do
....do
....do
do
do
Do
Hankow
Do
Tientsin
Tsingtao...,
Do
Egypt:
Alexandria..
Do
Cairo
Port Said...
Groat Britain:
Cork
Glasgow
Greece:
Saloniki
Do
Japan:
Bakodale...
Nagasaki....
Do
Feb. l^May27.
Apr. 23-JuBe 17.
July 20- Aug. 11.
Sept. 23-29
Jane 33-July 1 . .
Jul/ d-Sopi. 33.
JUD0&-15
July 8-14
June 17-23
May 30- July 7...
Aug. 5-Scpt.29..
Aug. 30-July 1 . . .
July 17-Sept. 30. .
Jan. 22-Apr. 8....
Mar. 19-25
Jane 17-23
8ept.30-Oct.6....
May 23-June30.
July 1- Aug. 4...
July 22-28
June 11-21
July ^Oct. 14.
(04
809
47
017
16
»3
5
10
278
1
4
3
1,648
430
188
1
478
118
78
Oat. 33-Decn, 1916: Caaea»^371.
Dae «, T916-Fcb. 34, 1917:
Case&.S^.
Dee.B,l«l»-F^.24.mr: Cases,
no.
Peb. n-Hm 11, nil:
1,787.
Digitized by
Google
Kovember 80, 1917
2070
CHOLERA, PLAGUB, SMALLPOX, TYPHUS FEVES, AND YHJ/)W
FEVER— Continued.
Reports RectWed from Jon 3 30 to Not. 28« 1917 — Continued.
TYPHUS FEVER— ContiniMd.
Place.
Java:
East Java ,
Surabaya
Mid-Java
Samarang
Do
West Java
Batavia ,
Do
Mexico:
Agua«5calientcs ,
Coatcpoc
Jalapa ,
Mexico city! '.'.'.'.'.'.','.'.'.'.'/..
Do
Orizaba
Do
Netherlands:
Rotterdam
Do
Norway:
Berpon 1...
Portugiipso Kast Africa:
I'Ourcn^ Marques
Russia:
Archangel
Do
Moscow
PctroRrad
Do ,
Poland
Lodi
Do ,
Warsaw ,
Do
Riga
Do ,
Vladivostok ,
Spain:
Almoria
Mailrtd
Switrcrliind:
Basel
Do
Zurich
Trinidad
Tunisia:
Tunis
Union of South Africa:
Cape of Good Hope State..
East London Sept. 10
Date.
June 2S-Ja]y 39. . .
May&-JunelO..
July 2-8
Apr. 13-July5...
July 6-8ept. 1-13.
July 10-Oct. 28. .
Aug. 1-14
Apr. l-JuQe30. .
July 1-31
June 3-30
July8-8opt.22..
Jan. l-JuoeSO...
July 1-31
June(^23
July 15-Sopt. 1.
July 8-28
Mar. 1-31
May 1-Juiie28..
July 2-Aug. 28..
July 2-15
Feb. l^June 30.
July 2-29
Apr. 23-June3..
Junol7-Julyl4.
Apr. 23-June3..
June 17- July 14..
May 31- Juno 16.
July 22-28
Mar. 2J^ May 21.
May 1-31.
....do...
Juno 17-23
July 8-Sept. 22. .
July 28-Sept. 22.
June 4-9
June 30- July 6.
Cased. Deaths.
431
1,044
II
16
10
141
33
120
108
1,644
1,495
8
5
5
16
10
96
131
Remarks.
May 6-JolT 1, IM7: (^e. i
Aug. 20. 19] 7: Casee, 7.
Apr. l-Jone 24, 1917: CkK >
deaths, 5. 3utj9-StpLth:
Oases, 15; deaths. 1.
Apr. 13-July 5. 1917: Cases, 1^"
deaths, 6. July «-Sept J
1917: Oases, 102; deaths, 11
Apr. 23-Juno 3, 1917: C*«
2,814: deaths, 1S7. June r
July 14. 1917: Cases. 2 /?
deaths, 211.
Jan. 1-31,1917: l cuse.
May 1-31, 1917: Casc^. 4.
Aug. 25, 1917: Present in 16 .
tricts.
Present.
Ecuador:
Hahahovo .
Fcl). 1-28
1
2
1
18
34
24
1
2
2
2
3
1
6
1
1
1
7
18
10
Do
Mar. 1-31
rhol)0
do
Ciiiavauuil ..............
Feb. 1 28
1)0
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Jiilvl-Aug.31
Feb. 1 2h
Do
MilaCTo
Do
Mju. I Apr.30
July 1 Ang.31
Sept. 23
1
2
Naranjito
Mexico:
Campoohp, Stat«—
Yucatan, i^tate—
Mirida
S I.I.I Oa.28
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2
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In person recently arrived fn,
Mexico City.
Present Sept. 5.
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PUBLIC HEALTH REPORTS
^OL. 32 DECEMBER 7, 1917 No. 49
ARSPHENAMINE (SALVARSAN).
JCENSES ORDERED AND RULES AND STANDARDS PRESCRIRED FOR ITS MANUFACTURE.
The Federal Trade Commission, on November 30, 1917, issued
)rders for licenses to manufactm-e and sell the product heretofore
mown under the trade names of "salvarsan,'' '* 606,'' " arsenobenzol,"
ind ''arsaminor* to the following-named manufacturers: Dermato-
ogical Research Laboratories, of Philadelphia; Takamine Laboratory
[Inc.), of New York; and Farbwerke Hoechst Co. (Herman A.
Vletz Laboratory) , of New York.
The drug will be manufactured and sold under the name of
'arsphenamine."
The following rules and standards, prescribed by the United States
PubKc Health Service, were promulgated by the Federal Trade Com-
mission November 22, 1917:
(1) Except as provided in paragraph 3 hereof, only the abbreviated chemical
term arsphenamine immediately followed by the descriptive chemical name shall
be used on packages to designate the preparation.
(2) Arsphenamine shall be offered for sale only in colorless glass ampules con-
taining an atmosphere of an inert gas.
(3) Each package shall be plainly marked so as to show the license number, the
lot number, the name of the preparation, the actual amount of arsphenamine in the
container, and the name and address of the manufacturer in the following manner:
License number , Ix)t number
This package contains grams of arsphenamine (hydrochloride of 3-diamino-4-dihydroxy-l-arseno-
bcnxene).
Prepared under regulations issued by the Federal Trade Commission and conforms with tc.sts approved
by the United States Public Health Service. Made by
No names of diseases or symptoms shall appear on any label or package.
(4) The licensee shall use the name arsphenamine, immediately followed by the
extended scientific name of the article, both printed in 10-point roman capitals when
used upon labels attached to packages and cartons. On ampules 8-point roman
capitals may be used.
The licensee may, if he desires, use upon labels and packages his particular brand
or trade name, provided that whenever any such brand or trade name is used it shall
invariably be accompanied without intervening printed matter with the name
arsphenamine and the extended scientific name of the article, both printed in 10-
point roman capitals when used upon labels attached to packages and cartons. On
ampules 8-point roman capitals may bo used.
Before placing on the market each lot shall be tested by the manufacturer as
regards toxicity and arsenic content, and shall comply with the requirements of
148 (2071)
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December 7.. 1917 2072
paragraphs (5) and (6"^ following?. Detailed and permanent records ol these i^^
shall be kept by the manufacturer and copies immediately furnished to thecoomusb:.
(5) The totaJ arsenic content of the air-dried drug shall not bo below 29.5 a aU^
31.57 per cent.
(6) The maximum tolerated dose for healthy albino rata phall not be be)ov30ffif
per kilo body weight when a 2 per cent shghtly alkaline solutioQ of the druginfrei!?
glass-distilled water is injected into the saphenous or tail vein of the animals ni:
rate of not more than 0.5 c. c. per minute.
For each toxicity test a series of animals of not leas than four flhall be und txAt.
least 75 per cent of the animals injected with the maximum tolerated doee ^l
survive 48 houn» from the time of injecticm.
The rats shall not be anesthetized for the injection and shall ^veigh betw^i. /*
and 150 gm. Pregnant animals phall not be used.
(7) In addition to tests by the manufacturer, tests AHl be made from time lorn-
by the United States Public Health Fer\'ice. For this purpose, samples of each i
shall be forwarded by the manufacturer to the United States Public Health J^ern^
and officers of said service or of the Federal Trade CommiaaioD, when duly deta^
may enter establishments for the purpose of aecuring samples and conducting iBi|)r
tions. The number of samples supplied shall be not leas than 10 ampules frotn ^
lot, and from lots of over 1,000 ampules, 1 per cent shall be furnished.
(8) When lots have passetl satisfactorily i^e prescribed tests, they may be offfl«
for sale, but the right is reserved to require the withdrawal from the market of aotk
designated by the Federal Trade Commission.
(9) Manufacturers shall retain 5 ]3er cent of the ampules from each lot for a p«5ai
of three months from the time the preparation is put in ampules.
APPROPRIATIONS FOR CITY HEALTH DEPARTMENTS.
SUMMARY OF EXPENDITURES OF 330 CITIES IN THE CENTRAL AND EASTERN HOTfS
STATES FOR FUBUC HEALTH WORK
By Paul Preblc, Possed Assistant Surgecm United Statej Public HealUi Serviee
Under the act of Congress of August 14, 1912, which authoriieJ
^,<,udie3 of conditions afifecting diseases of man, the United Statd
l*ubUc Health Service began, in July, 1913, extensive laboratory asl
field investigations upon two large watersheds, the Ohio and Potom*
Rivers, to determine the effects of stream pollution upon the hed:
of the communities located in these drainage areas.
In addition to elaborate and extensive laboratory studies^ continiHi
to about July, 1917, special epidemiological study was given totl
communities locat<*d upon the Ohio drainage area in order to sefC
as a(*curate record as possible not only of the effect of stream polh
lion upon those communities, but of the organizations establish^
for the protection of public health, their activities and efficienei^
Sanitary surveys of the Ohio watershed communities were heg^
in May, 1914, and included all towns and cities of any imptHrtaBe
located on the watershed in the States of New York, Pennsylvanii
Ohio, Indiana, Illinois, Kentuck}', Virginia, West Virginia, Tennessai
Xoith Carolina, and Alabama. During the next three years thes
surveys were extended to the eastern States of New Hampshire
Vermont, Rliode Island, Connecticut, Xew York, and New Jersey
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2073 December 7, 1017
In these States all towns and cities having populations of ahout 8,000
orovei* were visited by field parties consisting of a medical oflBcer and
a sanitary engineer.
In concluding these sanitary surveys, the basis of judgment as to
the effect of stream pollution upon the communities studied has been
the prevalence of typhoid fever. Local municipal health departments
were interviewed, and then- organization, activities and efficiency
noted in each instance.
From the data thus accumulated it is apparent that rather inter-
esting and valuable comparisons and tabulations can be drawn from
a fairly extensive and representative group of towns and cities.
Notes were taken concerning public-health organizations and their
activities, and a method of rating was devised for the various func-
tions on the basis of a valuation of the measures taken to prevent the
occurrence and spread of typhoid fever.
From the records of tho communities covered by sanitary surveys
it has been possible to abstract quite accurate data concerning the
gross expenditures made for public-health work. This data has been
compiled by population groups and is given in Table No. 1.
Difficulties in Comparing Health Departments.
Attempts to compare health departments generally fail because
there is no real standard or measure of comparison that can be uni-
versally applied. Mere statements of moneys appropriated or ex-
pended mean very little unless it is possible to apply a rather com-
plete analysis of organization, function, activity, and rated efficiency.
Health departments in cities of diflFerent size will be found to have
different functions related to public-health work. The larger cities
and those economically prosperous and abreast of the times will
usually provide laboratory facilities, medical inspections of schools,
and tenement-house inspection, and maintain hospitals for the isola-
tion and care of communicable diseases. Smaller cities, as a rule, do
not provide funds sufficient for these activities.
As it was necessary to collect certain of tho data secured from
printed reports, it seems pertinent here to point out and emphasize
the fact that there is a striking lack of imiformity in annual reports
published by health departments generally. Many of the larger
printed reports are verbose and replete with data that can not be
used for purposes of comparison with data from other cities. Smaller
cities and towns frequently publish only a page or two concerning
health activities in the annual municipal report, and give no really
valuable information concerning the organization or the activities
undertaken. Many of the reports studied give no idea of the various
functions assumed or of tho items of expenditures to be credited to
public health work. Pauper care, hospitals and institutions, garbage
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December 7. 191T
2074
and waste disposal, plumbing inspection, and even street deanke
are frequently taken over by health departments.
In attempting to compare expenditures made for health poiposs
it is obviously necessary to compare similar items or g^ross aOotrns^
covering similar functions. It is difficult and practically imposst-
in some instances to apply any comparison between expenditures f
different departpaents for the reason that statements of exp^isesr
frequently not itemized and different departments perform (Mrt?
functions. Fiscal year periods vary, but this fact does n^ kk
rially affect comparisons of yearly expenditures.
In presenting the data included in Table 1, absolute accuracy 'j
the figures taken to form the various group totals is not clam
because of the difficulties already mentioned. It is believed, i '
ever, that the aggregates for the different groups are quite r^*
sontative of average expenditures for the groups. The fiscal y-
periods vary for individual cities, but the populations used corresp
always with the period for which the expenditures were obtaisf^
Taule \.--]Tc(ilth department expenditures per capita by size groups with mwerafi
tary rafinfjs and typhoid death rates.
Cilii»s having popu-
lations of -
Thousands.
(1) 0-5
(2) .VIO
(3> 10-20
(4) 20-2.J
(:•) -jry-:*)
(r.) :»<noi»
(7) !(«' 300
^_
.
o
?
t.
^^
^ 2
o6
•cr
^.2
yo
g;i3
3
)e,
<
82
lff7,M0
^
-l.-U.^^Crfi
99
l,;iS6.ns7
21.
^u:i,m
Xi
1,134.637 '
h\
1,10^.409
IN
2,491,761 1
mi
2H). 167. 85
13t),8.H7.67
429. 770. 82
:{-2:5,124.08
^1.
I
Km. 00 I
2,951.83 I
40,713.f« I
16,sr>.30 '
143,410.00 1
36,286.81 I
106,131.05 !
114,904.21
52,266.67
239,461.16
120,062.37
280,300.82
2S6, 837. 27
983,506.50
Total 330 7,296,917 , 2,390,406.35 » 407,014.80 I 1,963,383.00
Avor.iKe cily L... 22,112' 7,243.65 j 1,233.37 6,010.28
lis
* 2 £ £ ^ "
3,045
7,707
14,000
22,090
34,383
60,279
138,431
23,113
CtnU
9.1
12.0
ia.8
au.6
25.7
39.1
27.2 I
22.7
31J
61,6
7D4
73.«
76-5
es.:
66.7
Table 2. — Salaries of health officers
Cities having population of—
Number , ApRropato
ofc-ilies. pupulatiou.
0-r.,(ion
6-H',0(»0
10 2(».(X10....
25 .-)(>.< KK)....
«>-10t»,000. . .
100-3rK),000..
0\Tr 300,009
I5t1. 4ns
412,573
1,345,901
576,015
1,196,580
1,250,390
2,129,476
380.106
TbUl salary
Averaee sAlary
Av^
. health officers.
health olllcets.
SUt'
19,471.00
1127. M i
23,499.50
41ft. «6 i
64,938.71
689.47 •
L'
27,005.50
l,0n.«7 1
£
41,715.00
i,iw,a5
y
33,150.00
l,7»ft.li 1
*
38,935.00
2,433.44
W,
5,000.00
*,ooo.oo}
t
aft-
In a certain numbei* of the cities included in Table 1 the gro
expenditures given included money expended for such purposes j
garbage disposal and other activities not properly functions d
health department. These items have been separated and dedocU
order to obtain a '* balance expended for public-health wort
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2075 December 7, lOlT
The final figure for comparison is that showing the average annual
group expenditure per. capita obtained by dividing the aggregate
group expenditure by the aggregate group population.
As might be expected, the smaller towns and cities generally make
smaller per capita expenditures than larger cities. The average per
capita expenditure varies fairly directly with the size of the com-
munity.
Of the conmiunities having populations imder 5,000, about 150
were siurveyed and fairly accurate data secured for the 82 included
in group 1. Expenditures per capita in this group varied from ap-
proximately nothing to 79 cents, with an average of 9.1 cents.
In this size commimity public-health work was found to be prac-
tically neglected as a rule, and very often the only item chargeable
to public-health activities was a small salary of from $2 to $500 paid
to the local health oflBcer. In Warwood, W. Va., bids are received
for the position of health oflBcer, and at the time of survey the in-
cumbent of this position was being paid $1,200 per annum. In more
than 40 of the total communities of under 5,000 population surveyed
there was reported to be no organization for public-health work.
Others made no appropriation for the health department. Many
health offioeis received no salaries or only small fees for certain
services.
Group 2, with populations from 5,000 to 10,000, shows but slightly
better conditions. Per capita expenditures varied from 0.8 cents to
48.8 cents, with the majority near the group average of 12 cents.
Salaries for health oflficers show but little advance over the previous
group.
In group 3 the average community has a population of 14,000 and
expends 16.8 cents per capita for public-health work. In this group
the per capita expenditures varied from 1.8 cents to 61.5 cents. In
28 instances the expense of garbage or waste disposal was credited to
the gross appropriation for the health department. There are a num-
ber of progressive communities in this group with fairly well organized
public-health work, with a few fairly efficient full-time health officers,
receiving fair salaries. The average for the group, however, is low.
Group 4 shows some improvement over the preceding groups, hav-
ing an average city of 22,090 population, with a per capita expendi-
ture of 20.6 cents. Health departments are somewhat better organ-
ized, with a few good examples of efiicient organization, such as
Montclair, N. J., and AsheviUe, N. C. Per capita figures for this
group vary from 2.4 cents to 52.3 cents.
Group 5 shows still further improvement, with more examples of
well-organized health departments. The average city has a popula-
tion of 34,383 and a per capita expenditure of 24.6 cents, varying
from 4.7 for Central Falls, R. I., to 46.7 for Salem, Maas.
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December T, 1917 2076
In group 0) the average city has a population of ^,279 and «
average per capita expenditure of 25.7 cents, with ranatioDs froa
13.4 cents to 40.5 cents. In respect to per c^nta ^cpenchturcB ui
average sanitary ratings, this group shows onky alight advanee ov^
the previous group.
Group 7 J with an average city of 138,431 population, shows g^
siderable progress over the preceding group, having a per c^
expenditure var}dng from 10.4 cents to 74.9 cents, with an $msnz
of 39.1 cents. Health departments in this group are, as a mk, im^
well organized and efficient, and their functions more varied. fxA-
time health officers are the rule*
Average Expenditures and Sanitary Ratings.
In attempting to compare the findings in the cities covered bj '±
sanitary 8iu*vey8 made as a part of the stream pollution investigation
a imif orm method of rating was devised and adopted and the varit^i-
factors responsible for the existing prevalence of typhoid f ev« wtp
given certain fixed weighted ratings which were appUed to percent^
ratings as determined for the conditions found to exist. The sum a
these weighted ratings was taken as the total sanitary rating for tik
connnunity in question. After considerable experience in this methoc
of rating commimities, it was found that there existed a very clot*
correlation between the sanitary ratings given and the average typhoi:
death rates, so that the conclusion seems warranted that the sanitan
ratings given are reasonably accurate indices of the general sanitar
status of the communities with respect to typhoid prevalence.
In Table 1 the average sanitary ratings for the groups are given. It
is quite apparent that these average group ratings vary directly wit:
the average group per capita expenditures, as might wdl be expected
The correlation here between the sanitary ratings and the average pc?
capita expenditures is fairly consistent, the lai^r cities with large?
per capita expenditures showing a hi^ier average sanitary rating.
The average per capita expenditure for the 330 communiti^ ii
Table 1 is 27.2 cents, varying from 9.1 to 39.1 cents. General oofr
census of opinion places the expenditure necessary for satisfactoir
pubUc health activities in a community at about 50 cents per capita.
The average city in the groups studied, therefore, is expending onlj
shghtly more than one-half the amount that is considered reasonable
for the control of health hazards. And for the avei*age expenditure d
27.2 cents, we find an average sanitary rating of only 66.7 out of a pes-
sible 100 per cent. Group 7 with an average expenditure of 39.1 cents
annually, gets an average sanitary rating of 80.8. Under efiicient man-
agement it might seem reasonable to expect that an expenditiue of
about 60 cents per capita annually would raise the sanitary rating of
the group to a point above 90 and result in a marked reduction in
sickness and a saving of Uves, a worthy return on the investment.
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2077 December 7. 1917
Average ExpendHares and Typhoid Death Rates.
The last column in Table 1 gives the averc^e typhoid death rates
per 100,000 for the groups studied. Here, too, is found a reasonably
close correlation between per capita expenditures and average death
rates from typhoid fever, the latter being accepted as one of the
important indices of the sanitary status of a community. The death
rates given vary generally indirectly with the per capita expenditures
and the sanitary ratings. In larger groups this correlation would
undoubtedly tend to develop a better coefficient.
Comparing average per capita expenditures with average typhoid
death rates in the commimities studied, evidence is quite convincing
that the smaller communities with meager appropriations for health
purposes may usually expect relatively high typhoid death rates.
In dealing individually with the small community, the remedy for
these unsatisfactory conditions may seem beyond the reach of pub-
lic finances, but the success of the cooperative plan of pubUc health
administration seems assured by the attempts already made in a
number of localities to pool interests in public health matters on a
cooperative basis. In estabUshing civil sanitary districts around our
National Army cantonments this cooperative plan has been adopted
in a number of instances with every assurance of success. In smaller
communities and in the rural districts cooperation between adjoining
civil units in pubUc health work will make possible a more efficient
pubUc health organization.
Health Officers Generally Poorly Paid.
Table 2 emphasizes the fact that health officers are not highly paid
pubUc servants. The traditional tendency has been to appoint to
these positions men from the medical profession who, from their
knowledge of the diagnosis and treatment of disease in the individual,
have been considered thereby competent to assume the responsi-
biUties of safeguarding the health of the pubUc at large. The major-
ity of these health officers are busy practitioners of medicine who can
and do give only a relatively small proportion of their time to their
public health duties.
Having in mind the prevention and control of communicable dis-
ease, the chief business of a health department, opinion may be divided
in the selection of the executive head of the department between the
skilled medical graduate and the nonmedical but trained sanitarian.
In any careful selection of an executive health officer the efficiency of
the individual chosen depends largely upon whether he serves on a
full-time or only a part-time basis. Part-time, poorly-paid, untrained,
inexperienced, and often disinterested health officers can not be
expected to establish any record for efficiency in public health work.
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nrcrmb«r 7, 1»17 2078
While it is difficult to compare the appropriations or expcn&tee:
of various health departments without a close study of the itcnirt
statements of each community, it is believed that the ditt gits
in Table 1 give a fairly accurate and reasonable approximation t
actual conditions existing to-day in average cities in the Ohio Vdfer
and the Northeastern States.
Lack of unifonnity in pubhshed statements and functions teRfflW
by different health departments has been emphasized. Stands?
forms for pubhshed reports should be adopted, and fiscal-year pen-
might be made uniform.
The functions assumed by health departments vary to a hr
degree, it is beheved, because of an absence of public sentiment is(
of knowledge necessary to properly appreciate the need for the cfi
trol of health hazards. Appropriations generally are too meager,©
health officers too often poorly paid, untrained, and unskilled in*
fundamentals of preventive medicine and hygiene. Consequentlyii*^
energy is wtisted or misdirected, even though intentions are gw^-
and satisfactory returns are not produced for even the small app
.priations made available.
PubUc health activities in small communities are generally flf
lected and health organizations in these communities are too oft«
inadequate, inefficient, and but poorly paid. On an average, v^
small conununity shows a relatively small expenditure for pin*
health work, a low sanitary rating, and a high death rate from typb^
fever as well as from other preventable diseases. The value '^
measures necessary for the reduction of sickness and deaths from t
common preventable diseases seems to be but poorly appredi^^
when mimicipal appropriations for the control of health hazards'^
compared with those for poUce and fire protection, even in sB^
communities.
The general conclusion to be drawn from the tables presented is ^
appropriations for health departments in the United States vary ([^'
directly with the size of the community and are in general insf
ficient for proper functioning of these departments. ConseqU^'^^
municipal health officials and their assistants are too frequently Q^"^'
paid, the salaries made available for responsible positions are too of^^'l
insuflBcient to attract eflBcient and trained men, health activities'^'
poorly organized and administered, the sanitary status of the ^j
munity remains low, and the death rate from preventable <fe^**^'
continues high. I
The remedy for this condition of affairs is to be found in a to^^
in a more general education in the science of preventive mecS^
and hygiene. Now, if never before, the population should b« ^^
physically fit and free from disease, and particularly the workers-
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2079 December 7. 1»1T
BXTRA^CANTONMENT ZONE HEALTH LEGISLATION.
The following ordinances and regulations have been adopted in
pursuance of the plan of cooperation by States and municipalities
with the United States Public Health Service for the protection of
military camps and the inhabitants of extra-cantonment zones:
CAMP ZACHARY TAYLOR EXTRA-CANTONMENT ZONE.
Venereal Diseases — Prevention. Prostltiition — Disorderly Honses. (Ord. of Louis-
ville, Ky., Oct. 6, 1917.)
1. Any person or persons who shall own, keep, or maintain, or who shall be an
inmate of, or in any way connected with, a disorderly house, or house of ill fame;
and any owner, proprietor, keeper, or manager of any hotel, <Hxiinary, or house of
private entertainment, boarding housoi lodging house, or other like place, who shall
knowingly allow prostitution or illicit sexual intercourse to be carried on therein,
and any person who shall engage in prostitution in any such place, or in any other
place, in the city of Louisville, Kentucky, shall be fined not less than $\0 nor more
than $60 for each oQenae. Every day that any person or persons shall maintain or
be an inmate of, or in any way connected with such disorderly house, or houses of
ill fame, shall be and constitute a separate offense.
2. This ordinance shall take effect from and after Its passage.
Venereal •Diseases— Prevention. Prostitotian — Use of Vehicles Prohibited. (Ord.
of Lonisvffle, Ky., Oct. 6, 1917.)
1. That any owner or chauffeur of any taxicab, jitney bus, or other vehicle who dudl
knowingly use the same or allow it to be used as a means of aiding or promotiiig pros-
titution or illicit sexual intercourse, or aid in any way in bringing persons together
for the purpose of prostitution, or illicit sexual intercourae, shall be fined not less
than $10 nor more than |50 for each offense.
CAMP BEAUREGARD EXTRA-CANTONMENT ZONE.
Foodstuffs-— Sale of— Permit Required— Sanitery Regolation. (Reg. Lonlslaiia
State Board of Health.) .
The following r^ulations are hereby promulgated to govern the establidunent and
conduct of ail places of business, such as restaurants, hotels, lunch counters, groceries,
delicatessens, fruit stores, ice-cream parlors, refreshment stands, pushcarts and
wagons, or any place where food or food products are stored, prepared, handled,
sold, exchanged, offered for sale or given away within 5 miles of the cantonment ate
or the training-camp area known as the Army camp, provided that nothing in these
regulations shall be construed to apply to the cities of Alexuidria and Pineville:
Section 1. The word "person" used in these regulations shall be construed to
include and mean the word person, firm, or society, association, copartneidiip, cor-
ponition, or individual.
Sic. 2. The word "food" used in these regulations shall include all articles used
by man for food, food products, drink, liquor, confectionery, condiment, whether
ample, mixed, or compound.
S£0. 3. The regulations hereinafter described apply to those persons whose places
of business are located within five (5) miles of the cantonment site or the training^K^amp
area in Rapides Parish known as Gamp Beauregard, also Camp Stafford, provided that
Bothing in these regulations shall be construed to apply to the cities of Alexandria
aad Pineville.
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December 7. 1917 2080
Sec. 4. No person shall engage in the bueineas of reetaorant, hotel, luncli comir^
grocery, delicatessen, fruit store, ice-cream parlor, refreehment stand, pus^or.
wagon, or any place where food or food products, within the meaning of the word m
herein described are stored, prepared, handled, sold, exchanged, offoed !» mk.
given away, or intended for human consumption, without first obtjdning penoit k
the conduct of eaid place of business as above enumerated, from the Louisiana S3'-
Board of Health: Provided, That any person engaged in the above business at ±*
time of the promulgation of these regulations within the territory described in ac-
tion 3 of the^e regulations shall procure permit for the continuation of eaid biei^S'
from the Louisiana State Board of Health within 10 days of the date of the promuki-
tion of these regulations.
(a) All hotels, restaurants, boarding houses, and other places storing, preparlL:
and serving food shall be properly constructed, lighted, ventilated, and scre«i?".
with wire mesh 18 strands per inch each way or other satisfactory pro\'ision to excl&i'
flies and insects. The requirements of the Sanitary Code with reference to ws'rr
supply, washing facilities, waste disposal, etc., shall be complied with. The pk:-
shall be kept at all times in sanitar>' condition.
Sec. 5. No person shall hereafter engage in the business, as herein described, i: ■-
in the business of any hotel, lodging house, rooming house, or pubHc inn, in in-
manner or in any capacity, and no person shall engage for employment in any of ti^
above-eniunerated businesses, unless such person is in possession of a certificiU
from a regular licensed and practicing physician who is approved by the LouisiaDi
State Board of Health, certifying that the person so employed in the busines 1*=
been examined by him within the last thirty days and at that time was free from aiii
contagious, infectious, or communicable disease of any nature. No person sfciii
engage in the business as herein described, in any capacity, who is exposed to c:
has come in contact with any communicable disease. Each person engaged in asy
capacity in the business herein described shall be vaccinated against typhoid fevr
and smallpox in a manner approved by the Louisiana State Board of Health.
Sec 6. No person shall engage in the business herein described or shall maintak
on the premises cart, wagon, stand, or shall prepare, store, handle, sell, offer Us
sale or give away, barter, or exchange any food within the meaning of the word a?
herein described which is not clean, pure, and wholesome and suitable for human
consumption within the broadest meaning of these terms.
Sec. 7. Each person enj^ac^od in the business as herein described shall at all time?
maintain the premises of the place of business in a clean and sanitary condition . Tk
place shall be well illuminated and ventilated, free from vermin, foul odors, dust,
dirt, accumulations of wastes, and refuse of all character.
Sec 8. All food within the meaning of the word as herein described, maintained cff
offered for sale or exchange, within the meaning of the words as herein described,
shall be covered by some permanent means — such as glass, wood, metal, or pasteboard,
or paper or other suitable material — in such manner or means as to adequately protect
it from flics, dirt, dust, or contamination. No covering other than that of fixed and
permanent character will be recognized as conforming to the requirements of these
regulations.
Sec 9. All utensils used in the preparation, service, and sale of any food or drink,
within the meaning of these words as herein described, shall be properly and ade-
quately cleansed after being used, and no such utensil shall under any circumstances
be used a second time unless it shall have been, after such use thereof, so cleansed.
In such cleansing the use of water Avhich has become insanitary from previous use or
water which has not been certified as safe and suitable for human consimiption by the
Louisiana State Board of Heallh is prohibited.
Sec 10. Walrr-dosets and privies. — All i>ei'sons on^^ged in the business shall provide
a privy which is amply illuminalod, vontilattHJ. pro]>erly and adequately screened
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2081 December 7, If IT
and otberwiie madt fly proof, and the receptacle be cimstnicted and maintained
water-tight| or a latrine on army plana, location to be approved by the Louisiana State
Board ci Health. The diapoaal of excreta shall conform to existing State laws regu-
lating same. All privies shall be located at a proper distance from the place of buBinen.
Sbo. 11. Wa$king/aciliiie$, — ^All such persons engaged in the business shall provide
washing facilities, ample for the use of the employees, and these facilities shall at all
times be maintained in a clean and sanitary condition. Running water, from an
elevated container, soap, and individual clean towels diall be furnished thoee em-
ployed therein.
Sec. 12. Persons engaged in the business as herein described shall provide suitable
receptacles for all garbage, refuse, and waste. Such receptacles shall be ample in
siae and sufficient in quantity to meet the needs of the business; constructed with a
tig^t-fitting cover of metal . They shall be placed at least nine inches from the ground^
and be amply removed from the place of business, and ^nptied at least once every
twenty-four hours. All garbage, waste, refuse, or other matter within the meaning of
these terms shall be removed, burned, buried, or otherwise destroyed in a manner
ocmfonaing to the requirements of existing State laws.
Sso. 13. WaUr suppjy.— The water supply for all places of business, as above
described, shall be ample in quantity and obtained from a source which has been cer-
tified by the laboratory of the Louisiana State Board of Healtii as safe and suitable
far human consomptian. The water supply if drawn from the distributing system
of the community, or other source, and stored in such places of business, shall be
drawn, stored, and maintained in such manner as to preclude all possibility of pollu-
tion or contamination by any matter or by any means, which will render the water
uncleanly, in its broadest meaning, or unsuitable for human consumption.
CAMP GREENE EXTRA- CANTONMEOT ZONE.
FoodstafTs — Scrying and Handlinie — Sanitary Regulation. Employees — Certtflcates
of Health. (Ord. of Charioile, N. Car., Ner. 10, 1»17.)
1. That any person, firm, or corporation operating or conducting a hotel, inn, res-
taurant, lunch counter, boarding house, bakery or bakery shop, creamery or ice cream
f^tory in the city of Charlotte shall, before employing or permitting any person to
work in such place in the preparation, serving, or handling of food, including milk,
cream, or ice cream, require of said person a certificate from a reputable phyddan of .
the city of Charlotte or from the health officer of the said city that he or she is at the
time of such employment free from any infectious, contagious, or communicable
disease. And no person who has recently recovered or been exposed to any such
disease shall be permitted to resume such work in such place until he or she has se-
cured a permit from the dty health officer to resume such woik.
2. The proprietor, manager, or person in chaige of any such business shall keep on
file in the place ol business for a period of twelve months from the date of such certifi-
cate or permit all certificates as to the health of employes or pemuts from the health
officer in regard thereto, and such certificates or permits shall at all times be open to
inspection by the health officer or food inspector of the city of Charlotte.
8. That the dty health officer diall, upon application and without making any
chaige therefor, xnake an examination of all persons who may apply to him with a
view <^ procuring employment or resuming work in any of the above-mentioned places
and diall certify as to the condition or health of such person as disclosed by such
examination.
4. That all such places of bnsinesB dudl be thoroughly screened so as to keep out
fliSB, and the premises, appliances, apparatus, and cooking utensils shall be kept and
maintained in a clean and sanitary condition.
5. That all employees handling foods or foodstuffs or working in the kitchen or
dining room at such places riiall wear clean and sanitary dothes and keep their hands
and persons in a cleanly condition. ^ I
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December 7, 1917 2082
6. That all bakeries ahall, when bread is cooked and as soon as cooled, wrap mm
in clean paper and deliver in dean baskets or packages.
7. That all dishes used in any such place shall be rinsed in clean hot water aftn
being washed.
8. That no toilet shall be located in or c^n into any room where food is prepared
stored, or served.
9. That it shall be the duty of the city food ijospecUx to inspect all mich. places oi
business from time to time, and it shall be unlawful ior any person to in any way ists-
fere with said inspector in the discharge of his duties.
10. That all restaurants ot lunch counters shall be scored according to the Unitei
States standard score card upon a card to be furnished by the city health d^itn-
ment. Such score card shall be posted in such place of business in a conspic^ss:
j>lace to be designated by the food inspectcM", and it shall be unlawful for anm^
other than the food inspector or such other person as the city health officer mj
designate to remoA^e the same.
11. That any person, firm, or corporation violating any provision or requirBmentd
this ordinance shall, upon conviction, pay a fine of not less than $5 and not moce tk£
$50. Each day that any violation is allowed to continue shall constitute and be a
separate and distinct offense.
12. That sections 120 and 121 and-every part thereof of the code of the city of Qar-
lotte and all ordinances or parts thereof in conflict with this ordinance az« hereby
repealed.
13. This ordinance being made for the preser\*ation of public health shall be pob^
hshed in a newspaper in the city of Charlotte and shall take effect on November 19
1917.
Barber Shops and Hairdressing Establishments— Sanitary Regulation. fOid. d
Charlotte, N. C, Nov. 10, 1917.)
1. That the owner or proprietor of any barber shop shall install and maintain thema
such plumbing and appliances as are necessary to provide running hot or cold water
and shall also provide such other appliances, furnishings, and materials as may be
necessary to enable persons employed in such shop to comply with the requiremene
of this ordinance and the said owner or proprietor shall at all times keep said barber
shop and all furniture, tools, appliances, and equipment used therein in a cleanly
condition.
2. Every owner or proprietor of a barber shop shall wash or cause to be wa^ed
thoroughly at frequent intervals and to be kept clean at all times all combs, hair
brushes, hair dusters, and like articles, and shall also sterilize or cause to be sterilized
after each separate use by immersion in boiling water all mugs and shaving brushes
and shall disinfect or cause to be disinfected, by a method approved by the health
officer of the city of Charlotte all razors, scissors, clippers, and tweezers after each
separate use thereof.
3. No barber shall use for the service of any customer any comb, hair brush, hair
duster, or like article that has not been thoroughly washed and is clean at the time of
service, nor any mug, shaving brush, razor, scissors, clippers, and tweezers that has
not been sterilized or disinfected in the manner hereinbefore mentioned.
4. No barber shall use for the service of a customer any towel, steam towel, or wash
cloth that has not been boiled and laundered since last used, and when cutting any
person's hair, every barber shall place a newly laundered towel about the neck of
said person so as to prevent the hair cloth from touching the skin.
5. Every barber shall cleanse his hands immediately before serving each customer.
(). No barber shall ust* alum or other material to stop the tiow ot blood unless same
be in powdered or liquid form.
7. No barber shall use a powder puff or sponge in the service of a customer.
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2083 December 7, 1917
8. No barber shall permit any person to use the headrest of any barber's chair
under his control, unless the headrest be covered with a towel that has been washed
Bince last used, or by clean new paper.
9. No barber shall shave any person when the surface to be shaved is inflamed or
broken out or contains pus, unless such person be provided with a cup and shaving
brush for his individual use, and every barber after such service must cleanse his
hands thoroughly before serving any other customer, and all tools, and appliances
used in shaving such person must be thoroughly sterilized before they are again used.
10. The use of wood alcohol (in any per cent) in the manufacture of any cosmetic,
hair tonic, lotion, or toilet preparation is hereby forbidden; and any cosmetic, hair
tonic, lotion, or toilet preparation containing wood afeohol (in any per cent) shall
not be used by any barber on any person.
11. The tenn ''barber shop" as herein used shall include every place where shav-
ing and haircutting is done for the public and every barber college or school where
harboring is done and every hairdressing establishment for either sex in the city
of Charlotte.
12. The owner of any barber shop shall keep a copy of this ordinance to be fur-
nished by the health officer of the city of Charlotte, posted in said shop for the infor-
mation and guidance of persons who are working or employed therein.
13. Any person, iirm, or corporation violating any of the provisions of this ordi-
nance shall upon conviction be fined not leas than |5 nor more than $50. Each day
any violation is allowed to continue shall constitute a separate and distinct offense.
This ordinance being made for the preservation of the public health, shall be
published once in a newspaper of the city of Charlotte and ^all take effect <ni Novem-
ber 19, 1917.
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PREVALENCE OF DISEASE.
No health department^ State or locals can effectively prevent or control disease vritkmt
knowledge oj lohen, where ^ and under what conditions cases ars occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
Arkansas.
From Collaborating Epidemiologist Garrison, telegram dated
November 30, 1917:
For week ended 24th, have to report measles 1 case Texarkana, 17 Thornton, 10
Camden, 24 Sebastian County. Diphtheria, 1 Camden, 1 Fort Smith, 1 Jefiexsaa
County. Scarlet fever, 1 Fort Smith.
California.
From the California State Board of Health, telegram dated De-
cember 4, 1917:
Two cases epidemic cerebrospinal meningitis, 1 Los Angeles city and 1 in San
Diego. Three cases po iomyelitis, 1 case each Riverside County, Berkeley, and
Chico. Ten cases smallpox, Porterville 8, Tropico 1, Grass Valley 1. Measles?, scarlet
fever, and whooping cough showed considerable increases last week. Other report-
able diseases not unusually prevalent.
Connecticut.
From Collaborating Epidemiologist Black, telegram dated Decem-
ber 3, 1917:
One case cerebrospinal meningitis fatal navy yard, New London. Measles epi-
demic Greenwich.
Indiana.
From the State Board of Health of Indiana, telegram dated
Decembers, 1917:
Scarlet fever epidemic Burket, Kosciusko County; Centerville, Tipton County;
Washington Township, Whitley County; Warsaw. Diphtheria epidemic Bainbridge,
Putnam County. Smallpox epidemic Knightsville, Clay County; Columbia City
and Whitley County and Anderson. Measles epidemic Knightsville, Clay County.
One death poliomyelitis Bluffton November 25. Elwood, E. W., age 7, died of
tetanus two weeks after smallpox vaccination, Dr. E. S., Madison County, coroner.
Rabies epidemic Washington, Jefferson Township, Pike County.
(2084)
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2085 December 7, 1017
From Collaborating Epidemiologist Crumbine, telegram dated De-
cember 4, 1917:
Week ending December 1, typhoid, £ldorado 32. Smallpox, Kansas C'ity 47,
Harris 18. Poliomyelitis, Junction City 1. Meningitis, Scott City 1, Manhattan 4,
Leavenworth 1. MeningiliB camon» Manhattan 3.
MamdittBetts.
From Collaborating Epidemiologist Kelley, telegram dated De-
cember 3, 1917:
Unusual prevalence disease past month: Diphtheria, Amesbiuy 4 additional
cases, total 41; Plymouth 3 additional, total 7; Springfield 65, West SpringfieW 2
additional, 11; Greenfield, 4 addit'(mal, total 11; Lowell 52, Medford 3 addi tonal,
total 10; Arlington 6 additional, total 9; Chelsea 27, Newburyport 6, Belmont 5.
Scarlet fever, Milford 3 additional, total 13; Montague 6 additional, total 20; Box-
ford 3, Franklin 6, Whitman 5, Taunton 12, Pittsfield 14, Everett 10, Winthrop 3.
Typhoid fever, Lynn 3. Whooping couj^, Brockton 34, Canton 11, Milford 11,
Uxbridge 5, Webster 20.
Minnesota.
From Collaborating Epidemiologist Bracken, telegram dated
Decembers, 1917:
Smallpox: Pine County, Sinlayaon Townahip, 4; Roseau County, Jabus TownAip,
1. Todd County, Brichdale Township, 2 cases of poliomyelitis reported since
November 26.
South Carolina.
From Collaborating Epidemiologist Hayne, telegram dated Decem-
ber 3, 1917:
Measles, mild epidemic throughout State. Sporadic cases meningitis in Green-
Aille. Rural diphtheria and scarlet fever very prevalent.
VlrgiiBla.
From Collaborating Epidemiologist Traynham, telegram dated
December 4, 1917:
Death from cerebrospinal meningitis reported at Chance, Essex County; no other
cases reported in county. Smallpox reported from Richlands. Tazewell County.
Waabington.
Prom Collaborating Epidemiologist Tuttle, telegram dated Decem-
ber 3, 1917:
Eight scarlet fever, Vancouver; 5 scarlet, Anacortes; 1 poliomyelitis Curlew and
Belhngham.
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December 7, 1917
2086
CEREBROSPINAL MENINGITIS.
SUte Reports for October, 1917.
Place.
New cases
reported.
Place.
repofffd
Alabama:
Calhoun Count V
4
1
Connecticut:
Hartford County^
Jefferson County
Hartford
4
Total
5
Mootana:
Cascade County
Cali/omia:
Alameda County
1
3
1
1
Lewis and Clark County—
Helena
1
San Diego County
Total
San Francisco (city)
,
Solano County
Total
6
State Reports for July and August, 1917.
Place.
Now cases
reported.
Place.
Newessr
reported
California (Aug. 1-31):
Alameda County —
3
1
4
2
San Joaquin County—
Stockton
OaV land
Total
Contra Costa County —
n
Pinolo
Washington (July 1^1):
Okanogan County—
Brewster
San Diego County-
San Diego
San Francisco (city)
]
City Reports for Week Ended Nov. 17, 1917.
Plaoo.
Cases.
Deaths.
Plaoe.
Cases.
Deaths.
Atlanta, Ga
1
1
1
5
2
Northampton, Mass
1
2
2
1
1
1
1
1
Baltimore, Md
PhlUdelphia, Pa
Boston, Mass
Pittsburgh, Pa
1
Chicago, 111
4
Providence, R. I
Cincinnnt i, Ohio
St. Louis, Mo
1
Jersey City, N. J
1
1
Saratoga Springs, N. Y
Seat t lo, Wash
I
Kansas City, Mo
Newark, N. J
1
2
Wichita, Kans
I
New york,N. Y
3
DIPHTHERIA.
Maryland — Emmitsburs.
During the week ended December 1, 1917, 7 cases of diphtheria
were notified at Mount St. Mary's College, Emmitsburg, Frederick
County, Md. Examination of nose and throat swabbings from per-
sons at the institution showed 20 diphtheria-positive cultures.
See also Diphtheria, measles, scarlet fever, and tuberculosis, page 2097.
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2087
December 7, 1917
ERYSIPELAS.
City Reports for Week Ended Nov. 17, 1917.
Plaoo.
Ann Arbor, Mich...
Bridgeport, Conn...
Buffalo, N.Y
Chicago, 111
aeveland. Ohio
Concord, N. H
Denver, Colo
Hartford, Conn
Johnstown, Pa
Kansas City, Kans.
Kansas City, Mo —
Los Angeles, Cal. . . .
Milwaukee, Wis....
Newark, N. J
New Castle, P»
Casee.
Deaths.
Place.
New York, N.Y...
Oakland. Cal
Omaha, Nebr
Orange, N.J
Philadelphia, Pa...
Pittsburgh, Pa
Reading, Pa
Rochester. N.Y... .
Sacramento, Cal....
Sagliaw, Mich
St. Louis, Mo
San Francisco, Cal..
Seattle, Wash
Tacoma, Wash
Wheeling, W.Va...
Cases.
Deaths.
LEPROSY..
City Report for Week Ended Nov. 17, 1917.
During the week ended November 17, 1917, one case of leprosy
was reported in New Orleans, La.
MALARU.
SUte Reports for October, 1917.
Place.
New cases
reported.
Place.
New cases
reported.
Alabama:
Autauga County
3
3
7
10
38
46
110
15
California— Continued.
Calaveras (ounty
5
Ball win Cmmty
Angels Camp
2
Bibb County
Colusa County
2
Bk>i*nt County '.
Colusa
3
Bullock County..
Contra Costa County—
Martinet
But Icr County ]
2
Calhoun County
Fresno County...
6
Chambers County
Firebaug^ !
6
Cherokee County
Reec'L^y
Olenn County—
Orland . ..
2
Chilton County
Choctaw County
2
Clarke County
Kern County
2
ColTee County
Kings County
1
Covington County
Hanford .'
2
Crenshaw Coiinty . '
Lemoore
3
Dallas County..'.
--08 Angeles County-
Elmore County
I
Etowah Cotmty ]
Los Angeles
Geneva County
Merced County -
Los Banos
Oreene C<Nmty
2
Hale County....
ModocCounty
1
Houston County ',','.,'.
Placer County—
RockUn
jpffpr^nn ro^inty . , . , .
4
Lauderdale County ,,..'...],
Sacramento County
1
Lowndes County
Sacramento
4
San Diego County-
San Diego
Marengo County
1
Mobile County
San Francisco (city)
6
Montgomery County
San Joaquin County
7
Morgan County .... ^ * .s^...
Shasta County-
Redding
Perry County! '.
4
Pickens Co<mty
Salano County
3
Pike County
Vacaville'
1
Russell Cminty ..,.., X » X . * » . . .
Stanislaus County—
Modesto.....
Shelby County
2
St. Clair County
Oakdale
]
Sumter County
Suiter County
1
Tall^egA CfflmtT
Tehf^mn County
2
Tuscaloosa Counly
Trinity County
2
Washington Cmmty
TuUre County
1
TiinliimnA (^mintv
]
Total
304
Yolo County
5
Yuba County-
Marys vine
California:
1
33
4
8
A nwMJor County ,.,.,,..
Total
Bntte County /,,,.. V//.V/.V... ......
141
Gridley .\
149
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Dcoember 7, 1917
2088
MALARIA— Continued.
Sute Beports for August and September, 1917.
Oallfonils (Aug. 1-31):
Alameda County—
Fcrkclcy
Butt* County
Biggs
Calaveraii Coi-nt ; . . .
AncelsCamp...
Gohina County
Colusa
Fresno County
HrebauKh
Kern County
Los AnRTlcs County.
Iah Anjjoles
Sierra Madre
Marin County
Merced County
Los Banot
Modoc County
Placer County—
Kocklin
Sacramento County.
San Francisco (city)
Ban Joaquin County
Stockton
Shasta County—
Bedding
Solano County
Benkia
Sonoma County—
Petaluma
Santa Rosa
CaiifornJa— ConUnofld.
Stanislaus Comity—
Oakdale
Sutter County
Tehama County
Tulare County—
Tulare
Vhalia
Tuohunne County. . .
Ventura County-
Ventura
Vote County
Woodland
Total.
Nevada (Sept. 1-^):
White Pine County.
South CaroUna (Auc. 1-Sl):
Beaufort County
Dorchester Coimty
Marion (^ountv
Spartanburg County. . .
WUUamsburg County. .
Total.
atf Reports for Week Ended Nor. 17, 1917.
r
Phwe.
Deaths.
Charleston. B.C..
Kansas City, Ma.
Memphis, Tenn..
1 MobUe.AJa
' New York, N.Y.
Savannah, Ga
MEASLES.
See DiphtherU, measlee, acarlet feTer, and tubercnlofif , page 2007.
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2089
December 7, 1017
PELLAGRA.
SCato Reports for October, 1917.
Place.
Now cases
reported.
Place.
New cases
reported.
Alabuna:
AiitatigQ County
1
1
1
2
2
2
1
1
1
1
1
1
4
1
1
3
1
1
2
1
1
21
1
1
1
Alab<ima— Continued.
Macon County
Barbour County
Mobile County
17
Bibb County
Montgomery County
Butler County
Morgan County
Calboun County
•Perry County
Chilton County
Pike County
Cboct&w County
Randolph County
Clebume County
Russell County
Coflfeo County
Shelby County
Colbert County
St. Clair County
Conecuh County
Sumter Countv
Covington County
Dallas County ..',.:
Tuscaloosa County
14
Elmore County
Wilcox County
Escambia County. -
Total
E towah County
110"^
Franklin County
California:
Los Angeles County-
Long Beach
Geneva County
G reene County -
Hale County
1
Jack son Count v
Los Angeles
1 •
Total
Lamar County
2
Lawrence Countv
LKxiestono Conntv ..... ^ ,,.,.,,,.,, ^
State Reports for Aoi^ist, 1917.
Place.
New cases
reported.
Place.
N?w cases
reported.
CaUfomia:
Los Angles Countv ..
I
2
1
South Carblina— Continued.
^airfield Countv
1
■ Los Angles
Greenville Couiity
2
San Bernardino County
Laurens County
2
San Diego County-
San Diego
Marion County
7
Nowberrv County
2
Saluda Countv
10
Total
5
3
1
1
Union County
1
Williamsburg County
2
South Carolina:
York County
1
Abbeville Countv
Total
Anderson County
33
rh«ttAr CfHiQty .\
City Reports for Week Ended Nov. 17, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Atlanta. Qa . . ....
3
1
1
1
Nashville, Tenn
1
2
1
Austin, Tex
New Orleans, La
1
Birmineham. Ala...
1
Richmond, Va.
3
El PasOf Tex
Winston-Salem, N. C
1
MempMS; Tenn
1
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December 7, 1917 2090
PNEUMONU.
aty Reports for Week Aided Ner. 17, 1917.
Place.
Cases.
Deaths.
Place.
Casei.
Baltimore, Md
ninghamton, N.Y..
Boston, Mass
Braddock, Pa
Brockton, Mass.
Cambridfle, Mass....
Chelsea, Mass.
Chicaco, 111
riovcland, Ohio ,
CoffoyylUe, Kans
Dayton, Ohio.
Detroit, Mich.
Duluth, Minn
EvansviUe, Ind
FaU River, Mass
Fitchburg, Mass
Flint, Mich
(Irand Rapids, Mich.
Harrisborg. Pa
HaverhiD, Mass
Kalamaaoo, Mich....
Kansas City. Mo.....
Lancaster, Pa
I^exingtoo, Ky
23
1
26
21
1
1
1»
T9
18
2}
4
14
25
1
1
1
a
3
11
3
Long Beach, Cal...
Los Angeles, Cal...
LoweUTlIass
Lynn. Mass
Manchester, N.H..
McKeesport, Pft...
Newark, N.J
New Castle, Pa....
Newton. Mast
Oakland, Cal
Pasadena. Cal
Philadelphia. Pa...
PlttsburStP*
PontiacMioh
Rochester. N.Y...
Sacramento, Gal...
San Diego, CaL
San Prandsoo^ Ori.,
SomerviDe. Maes...,
Springfield, Masa..
Springfield, Ohio..
Steeltoo, Pa
Taunton, Masa....
Woroestv.Maa...
12
(
I
«
1
1
I
i
I
1
POUOMYELinS ONFANTILE PARALYSIS).
During the week ended December 1, 1917, cases of poliomyciti
wore notified in Illinois as follows: Bureau and Clay Counties, 1 etch
Cook County, 2, both in Chicago.
Stete Reports for October, 1917.
Plaee.
Nev cases
reported.
Plaoe.
rtp«tp4
Alabama:
DoKalbCoontT
1
1
1
Colorado-CoaUnnart,
Las Animas CoBntj —
Trinfciad
Jefferaon CounEr
J
Lawrence County
Prowers County—
T Amar • •••••••
1
Total
3
<f^li^
-
J
Cslifomia:
Alameda County-
Berkeley.. ..
1
1
1
1
8
1
1
Oonoecticat:
New Haven County—
Hamdeo
Oaklana
1
I >M Annies County
New HarvD.T ................. -
I
Acusa
Total .xx......x.t*^» »..
Lob Angeles
1
Pai^adena
Montana:
Big HornConnty... «....
Yuba County—
Maryfviile , .
1
Cascade County^
Great Falls.
Total
»
1
VmrtiiM CountT . .
1
Colorado*
1
Sweet Grass County
1
Denver County-
Denver .. ..-•
Total ^.
1
-
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2091
December 7, 191T
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
Stale Reports for July and Amnist, 1917.
Place.
New cases
reported.
Place.
Newcasos
reported.
CaUfornla (Aug. 1-31):
Alameda County—
Oabland
California (Aug. l-31)-Continued.
Yuba County
1
Total
Humboldt County
11
Los Angeles County—
Pasftdena
Washington (July 1-31):
SpoKane County—
Spokane
Marin County—
Sausalito
1
San Francisco fcitv)
King County-
San Mateo County—
niirllDiTaino
2
Total
Sonoma County —
3
Santa Rosa
City Reports for Week Ended Nov. 17» 1917.
* Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Chicago III
6
1
1.
1
2
6
Pittsburgh , Pa
1
1
2
1
riflveiand Ohio . .
St. Louis. Mo
Seattle. Wash
Kans&a I itv Mo
1
Springneld, Mass
RABIES IN MAN.
City Report for Week Ended November 17, 1917.
During the week ended November 17, 1917, one fatal case of rabies
in man was reported in Milwaukee, Wis.
ROCKY MOUNTAIN SPOTTED FEVER.
Nevada Report for September, 1917.
During the month of September, 1917, one case of Rocky Mountain
spotted fever was reported in Washoe County, Nev.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tuberculosis, page 2097.
SMALLPOX.
New Mexico — San Jnan Navajo Reservation.
Dr. B. H. Frayser, of the United States Indian Medical Service, in
a report dated November 15, 1917, states that during the summer
a large nimiber of cases of smallpox were treated on the San Juan
Navajo Reservation, N. Mex., and that over 4,000 Indians were
vaccinated. At the time of the report five new cases were present
at Tsenospos and three at Aneth, Utah, both of these places being
OD the San Juan Reservation.
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BK»mktrT,19tf7
2092
New cases
reported.
Deitbs.
Vaodnation hisUry of oases.
Plaoo.
Nmnlier
vaccinated
within 7
years pre-
attack.
Number
lastvacci- IhiiiMi
natedmore sever siV'
than 7 gears oegf^.
pnee^BC: vwHriistrnf
attacdc.
California:
Fresno County
3
U
3
1
"*••-
2
8
3
1
Kem County...
I
Nevada Coiiht v
^
Nevada di^
,,,^^
Total
16
13
-
Colorado:
Chafleo County
3
31
1
11
1
1
«
1ft
1
2
1
Denver County-
Denver
f
Laa Animas County^
Trinidad
Sedffwick Countv
I
Total
85
3
4
19
^ 1
California Report for AngoBt, 1917.
New cases
reported.
Deaths.
Vaodnatioii history of eases.
Place.
Ntunber
vaccinated
WithiB?
years pre-
oedlng
attack.
Number
last vacci-
nated mora
than 7 years
preceding
Number
never sue-
oessfWly
vaixdnated.
California:
Alameda County-
Oakland
1
9
1
1
9
.•■-
FresnoCounty
fahm Fnuudsco (citT). . .
' 1*
Total
11
1
1*
C^-
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2093
December 7, 1917
SMALLPOX— Continued.
MisoeUaneous State Reports.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Alabama (Oct. 1-^):
Conecuh County
2
35
Montana (Oct. 1-31)— Contd.
Sliver Bow County
Butte
7
35
1
1
Geneva County'.
X>aniar County
Sweet Grass County
Teton county
L#ee Countv
Total
Montgomery County
Pickens Coimty
n
1
1
Nevada (Oct. 1-31);
Elko County
**
Russell County
Talladega County
Wilcox County
Washoe County
Total
Total
63
2
Connecticut (Oct. 1-31):
Hartford County-
East Windsor
Middlesex County-
Cromwell
1
2
South Carolina (Aug. 1-31):
OreenviUe (:ounty
Washington (July 1-31):
Cowliti (bounty
1
1
1
4
4
7
1
2
1
1
7
Jetferson County
King County
Total
3
X iifnim"
7
2
1
2
1
1
2
10
1
Seattle
Beaverhead County
Llncohi County-
Davenport . ,
Cascade County-
Great Falls
Pierce County—
Chouteau County
Custer County
Snohomish County-
Sultan
Dawson County
Anaconda
Whatcom. County—
Belllnghanu
Flathead County
Yakima County
Kallspell
Total
Hill County
29
City Reports for Week Ended Nov. 17, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
\ltoo. Ill
4
3
1
3
14
2
1
18
2
4
7
20
1
7
48
24
23
78
4
Leavenworth, Kans
2
2
1
3
9
17
1
1
1
17
1
5
5
5
Ann Arbor, Mich
Lincoln, Nebf
Austin. Tex
Los Angeles, Cal
Buffalo. N.Y
Memphis, Tenn
Butte, Mont
Milwaukee. Wis
Canton, Ohio
Minneapolis, Minn
Chl<»go, III
Muscatine, Iowa
Cleveland, Ohio
Newport, Ky
Columbus, Ohio
Oklahoma City, Okla
Dayton, Ohio
Omaha, Nebr
Denver, Colo
Pittsburgh, Pa
Detroit, Mich
Quincy, III
Dubuque, Iowa
St. Louis, Mo
Flint, Mkh
Salt Lake City, Utah
Fort Wayne, Ind
San Francisco, Cal
1
Indianapolis, Ind
Sioux City, Iowa
1
1
1
1
KaP.Wf ^'ity,' Kanji, . , , , ,
1
Sprineneld, 111
ITftn^Afi Citv' Mo
Toledo, Ohio
I^a Crosse. Wis.
Washington, D. C
TETANUS.
City Reports for Week Ended Nov. 17» 1917.
Place.
Birmingham, Ala.
Chlcaeo, lU
Cleveland, Ohio. . .
Harrlsburg.Pa...,
MashvUle, Tenn...
New York, N.Y..
Cases.
Deaths.
Place.
il
Oakland, Cal
Omaha, Nebr....
Phlladelphla.Pa.
Providence, K. 1.
Toledo, Ohio
Cases.
Deaths.
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D«c«mber T, 1917
2094
Bee Diphtheria, measles, scftrlet lever, and tabercaksiB, page 2097.
TYPHOID FEVER.
Teiuiessee— TaieweO.
On November 28» 1917, eight cases of typhoid fever were reports
at Tazewell, Tenn., where the first ease occurred early in September,
most of the other cas^ having occurred during the first thm WMb
of November.
State ReiNirts fot OcMer. 1917.
Plaee.
WwW CSSBS
reported.
Flam.
Atoboms!
BaMwio County
Barboai County
Bibb County
Blount County
Calhoun Coiuity.
Chambers County. . .
Cherokee Count y
CMItoa County
Cho-taw County
Clarke County
Colbert Coiuity
Coosa County
Covtnuton Cojmty...
Crenshaw County . . .
Cullman County
Bale County
Dallas County
DeKalb County
Elmore County
Etowah County
Fayette County
Geneva County
Greene County
Henry County
Houston County
Jackson County
Jefferson County
Lamar County
Lauderdale County. ,
Lawrence County . . .
LeeC«unty
Limestone County. .
Lowndes County. . . .
Macon County
Marenge County
Marion County
Marshall Coimty —
MobUe County
Monroe County
Montgomery County
Morgan County
Pickens County
Ptke County
RusseU County
Shelby County
St. Clah- County
Sumpter County
Talladega County...
Tallapoosa County. .
Tuscaloosa County. .
Washington County.
Wilcox County
Winston County
Total
California:
Alameda Cmmty —
Akuneda
Oakland
BotUCounty
Chlco
Calaveras County . . . .
2
2
3
4
55
2
3
1
5
1
2
3
2
3
4
1
2
7
1
15
3
5
4
1
I
2
180
3
2
1
2
5
3
5
3
1
2
e
4
10
2
1
1
1
17
2
1
3
e
12
1
1
6
Hi
GalUbmift— Cont inoed.
Contra Costa CooDty —
PiiDle
El Dorado County ,
Fresno County ,
Clovis
Fresno ,
Imperial County
Bnwrley
ElCtntro.......
Imperial
Kern County—
BakersneM
Kin^ CVmnty—
HanTord
Los Angeles Ccimty
Azusa.
Claremont
El Monte
LonfBeoch.
Los Angeles
Pasadena..
San Fernando
Montere V Park
Mendovino Oounty —
WUUts
Napa County-
Nape
Nevada County
Orange Ccimty
Santa Ana
Riverside County
Banning
Riverside
Sacramento County
Sacramento
San Bernardino County..
Ontario
San Diego County—
NatKjnalCity
Oceanside ,,.
San Diego
San Fran is:o (City)
San Joaquin Couaaty
Stockton
Tracy '.
Santa Barbara County-
Santa Barbara
Santa Clara Coimty
San Jose
Santa Cruz County—
^ SantACros
WatsonvtUe
Siskiyou County. . .
DoBsmuir
Sonoma County. . . .
Santa Roea
Stanislaus OonatT. .
Sutter Oouoty
Tehana County .
Tulare Oounty .... ,
Ventura County—
Oxnard
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209&
Pecember 7, 191T
TYPHOID PBVrat— Continued.
State Reports for October, 1917--€k>ntinued.
Place.
New cases
reported. U
Place.
New cases
reported.
Oalifomia — Contiiraed.
Yolo County-
Woodland
Total..
Colorado;
Bent County ,
Boulder Ckmnty
Chaffee County
Clear Creek County ... .
Denver County-
Denver
Huerfano County
JefTersnn County
Kit Carson County
Larimer County
Las Animas County—
Trinidad
Ix)gan County
Mesa County !.,
Montrose County
Morgan County
Otero County
Pueblo County-
Pueblo
Weld County
Total.
Connecticut:
Fairfif Ifl County—
Brid^port
Danburv
Monroe.*
Stamford
Hartford County-
Avon
Berlin
Bristol
Canton
East Hartford....
Farming on
Hartford
Manchester
New Britain
Sumcld
We^t Hartford...
Middlesex County—
CHnton
Essex
195
7«
25
Connectlcnt^-Continoed.
New Haven Coonty-
Mllidrd
New Haven.
S^rmour
mUin>!ford(baro)..
Waterbury
New London County—
Oroton(bcro)
New LcBidDD
Norwich
Norwich (town)
Preston
Windham County—
Ashford
Putnam
WilUmantlc
Total..
Montana:
Blaine Count/
Carbon Countv
Cascade Cwmty
Great Palls
Custer County
DaA^'scm County
Fer «iuB Count v
Oalhtfai County
HUl County
Lewis and Clark County-
Helena
Missoula Count y
Musselshell County
Ravalli County
Rosebud County
Sheridan County
Silver Bow County
Butte
Teton County
Yellowstone County
BUHngs
Total..
Nevada:
Lyon County
Nvc County
Washoe C<Mmty
White Pine County.
Total..
1
3
2
7
4
4
3
1
5
3
10
3
1
3
1
1
1
1
3
3
3
11
3
1
17
State Reports for July, Aufwet, and Septgwfcw. 1917.
Place.
New cases
reported.
New cases
reiMTted.
Oilifoniia (Aug. 1-31):
Alameda County...
Alameda
Berkeley
Emeryville
Oakland
Butte County—
Chico..
Colusa County
Contra Costa Count y-
Pinolo
Pittsburg
Fresno County
Fowler
Fresno
Bumboldt County
aatfamte CAor- l->l)-OndniMd.
ImpeKWOMiiy-
Los Anfeks Oaaiiy'.,
El Monte....
Glandora....
Loot rv^- •.
LoiAn-^l-'.
iiftom Mont^
S«wt4?U?....
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December 7, 1917 2096
TYPHOID FEVER— Continued.
State Reports for July, Angust, and September, 1917— Continued.
Place.
California (A up. l-31)-Contiiiu«d.
IajS Anreles County— Continued.
Fierra Madro
wnuttler
Mad era Count v , —
Mrndorino County—
WiJIlts ■.
Modo? County
Oran^te County—
Anaheim
Brea
R i verside Count y .-. .
Fernet
Riverside
Sacramento County
Sacramento
San Benito Countv
San Bernardino County
Needles
Redlands
San TMeeo County—
Oceanslde
SanDicf;o
San Francisco (citv)
San Joaquin County
Stockton
San Luis Obispo County—
Pasa Uoblcs
San Mateo County—
Hillsborough
Santa Barbara County-
Santa Barbara
Santa dara County
Lo^ (Jatos
Santa Crui Count y—
Santa Cruz
Shasta County
SisVivou County
>"tua
Solano County
RioVlsU
Sonoma Count V
Stanislaus County
Modesto
Turlock
Sutter County
Tehama County —
Tehama
Tulare County
Ventura County—
Oxnard
Ventura
Yuba Cotmty—
Marysvllle
Total
Nevada (Kept. 1-30):
Lincoln County
Lyon County ,
Storey County
Washoe County ,
While Pine County
Total
New cases
reported.
Place.
Xwo
226
12
. ^U£. 1
AbbeTlUe County. .
Chesterfield County. .
Florence County
OreenTillc County . . .
Marlon County
Richland County
Spartanburg County .
Sumt^ County
Total.
Washlnirton (July 1-31):
Adams County
Benton Cotmty
Kennewick
Chelan County—
Wenatdiee
ClallamCounty
Clark County-
Vancouver t
WashougaL
Columbia Cotmty
CowUtt County-
Woodland
Grant Cotmty—
Coulee City
Kinf County
Aubtim
Seattle
Kitsap County
Poulsbo
Kittitas County—
Cle Elum
Lewis County—
Chebalis
Lincoln County-
Davenport
Okanogan County—
Brewster
Pierce County—
Tacoma
Skagit County—
SedroWooUey
Skamania County
Snohomish County-
Everett
Spokane County—
Kocktord
Spokane...!.
Stevens County—
Chewelah
WaUa Walla County..
Walla Walla
Whitman County—
Oakesdale
St. John
Yak mu County
Urandview
Granger
Wapato
Sunnyside
North Yakima...
Total.
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2097
December 7, 1M7
TTPBOID fBVIEat— CoDtinned.
City. Reports for Week Ended Not. 17. 1917.
PEaoe.
Cases.
Deaths.
Place.
Cases.
Deaths.
Anwny.N.Y
Ann Arbor, Mich
Adanta, Gm
Aastfe, Tex
BiOtiindpe, Md.
BlTBiingham, Ala......
Boaton, Mass
BrIdfleiMrt, CoDiL
Buffalo, N.Y
Camden, N.J
Gharleaton^ 8. C
Cbicafo, In ^
Cleveland, Ohio......
Columfras, Ohio
Coioberland, Md
Denver, Colo ...,
I>etroIt,MIch....
Hl£abeth,N.J
TE\ Pa80,T«r
BvaxBvflle^ Ind.
Everett, Mass
Fall River, ICass
Flint^Mlph
Tort Worth, Tex
OalvestoD, Tex
Grand Rapids, Mich..
Honisburff. Pa
Hartford, Conn
Indianaoolis, Ind
Kansas City^Mo
I^exington, Ky
Los Angeles, Cal
Mompbis, Tenn
Milwaukee. Wis
Mlmieapolu. Minn....
Nashville. Tenn
Newark, N.J
New Orleans, La
Newton, Mass
NiBwYork,N.Y
Nlann Falls, M.Y...
0<£]uid,€al
Oklahoma City, Okla..
Passaic,N. J
Philadetpbia.Pa
Pittsbtuih. Pa
Porthod, Oreg
Providence, R.I
Readhig, Pa^
Richmond, Va
Rochester, N. Y
Rock(ard,Ill
Saginaw, Mich
8t. Louis, Mo
Salt Lake aty,Ut^..
San Diego, CttL
San Frandsco, Cal
Savannah, Qa
Schenectady. N. Y
Seattle, Wash
Somerville, Mass
South Bend, Ind
Springfield, 111
Springfield, Mass
Spriiqirfleld, Ohio
Steeftan, Pa
Toledo, Ohio
Trenton, N. J
Troy,N.Y
Washington, D. C
Washington, Pa
Wheeling. W. Va
Wichita, kans
Wilktobiirg, Pa.
WUmington, Del
Winston-Sanm, N. C. .
Worcester, Mass
DIPHTHERU, MEASLES, SCARLET FEVER, AND TUBERCULOSIS.
Stote Reports for October, 1917.
CaieBreperted.
State.
Caaea reported.
Stale.
Diph-
theria.
MeaskB.
Scarlet
fever.
Dtpb-
Measles.
Searlet
ftwer.
Alabama
148
aw
70
164
310
35
137
380
«5
ConnectlcTxt
Montana
387
31
0
aas
7*
7
124
OftUfomla
168
Colorado
Nevada
13
State Reports for My, A^Bst, aad September, 1917,
Cases reported.
State.
CasitrepoBfad.
«...
tho^
Measles.
Scfflet
frm-.
Dipi»-
SSL
MewlBs.
Searlet
tevcr.
JleYa«i(Sepl.l-dO)
»»
586
166
7
South Orolin*
WashS^ (July
1-31) .T.. .........
187
33
1
135
3
87
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December 7. 1017
2098
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBEBCULOSIS-
Continued.
City Reports for Week Ended Nov. 17, 1917.
Fnptiln-
tbij [IS o!
Ji]tyt,iPi(;
(fi^lEmJilc'd
by United
fltaies
C*n?iis
numau). ;
589,621
75fi, 476
2,497.722
674, orj
671. 7H1
603,812
5,602,811
1,709,618
579,090
757,309
•
468.568
410,476
306,315
436,653
363. 451
408. HW
371.717
463. 6n
3 '8.639
363,i>80
214.878
260, K'W
271.708
297.817
295. 4»53
251,960
256,417
104.199
190. .ViH
181,762
121,579
112.981
106,233
127, 224
12H.:W6
104,562
12S,29l
110,900
ioo,:>oo
113.245
102,425
14S.«)95
117,057
149, aK,-,
198.604
Km. 470
lO'»,:iHl
1541. «VS7
117,3'/9
1(V>,«>42
15.'>,624
112,770
191,. V>4
lll..Vri
163,314
58, rM
69, ^\t.i
57, '^'k;
53.973
67, 449
(jO,M5J
60,731
ST, 144
Total
(b-^Uhs
(roiTi
oil
Dil>li
tbffttt-
H4!aab».
torn.
im^
city.
32
109
332
51
95
13
261
86
37
83
23
??
16
16
18
19
10
5
64
5
5
54
18
.}
4
1
1
1 1
1
I'l
i
1
a
I
Over oOo,UW inliaUUnta:
Ba'timoro, Md...-w
■Rnst'^n Mass
210
223
653
184
189
112
1,291
'wo
193
176
152
119
84
93
143
128
59
148
63
54
fto'
54
60
48
1
7
20
4
4
,J
20
1
2
3
2
3
1
1
' "3*
■'3*
3
17 ; 1
82I
43 1 1
4
18 :
19
33
136
16
31
• 44
(«
rhipflffo III
6 il9 4»
riAvAland Ohio
■ fi '•
Dfitrcit Mich
2. il ^
l^M Anireles Cal
4
185
17
31
23
5
1
53
......
7' J) »
NewY6rk.N.Y
PhiifldAlDhia Pa
142
48
14
37
17
10
2; SJO l«^
7i ^
PittsbuTEh. Pa
» I'
St. ly>uis, Mo
From 300,000 to 500,000 Inhabit-
ants:
Buffalo. N. Y
» I"
• >' I«
Tin innati Ohio
5 »
Jafv^v Cilv N.J
m' r> ;
Mi waukM.'vVLs
25
4 1
33 1 2 10 :
WinnAflnoH)! Minn
6
19
li
NnwarkN. J
19
2
19
6
72
1
2
1
1
;:::.:
r:
Naw Orleans. La
8 1 ^M:
San Fran is h>, Cal
9 1, 31!
RAftttiA Wash
7 J, .
Washinetrn. T). r
From 200,000 to 300,000 Inhabit-
ants:
(V>lunibus, Ohio
15' ' 1«
1
19 •
»
8
•JO
Indianan'^'is. Ind
\s
Kansas rity. Mo
14 , !
Portland, Oreg
»«
»4
7
10
1
' 13
:
Providence. R. I
Rochester, N. Y
From 100,000 to 200,000 inhab-
itants:
Albanv.N. Y
12
1
9
14
1 T
i
Atlftntii Ga
1
* .
J *
- 1 1
BirrainRham. Ala
48
35
21
47'
21
30
26
is'
31
22
54
33
45'
51
20
58
23
29
30
73*
41
48
ii'
19
15'
24
12
3
9
7
4
10
8
6
4
10
1
5
3
6
4
10
1
1
7
10
2
19
20
1
14
14
10
8
1
1
2
......
ii
DridffpDort ( onn
1 » ;
CambridK<^, Ma»s
6
2
1. 1 I *
Camden N J ...
■ 1
Davton. Ohio
6
1
I
6
Fall River. Mass
' V :
Fort Worth Tox
■ '22*1..:::.
2 ;
2 1
Grand Rapids, Mich
Hartford. Conn
1 6
1
2
3
1 s
Lowell. M tv««
2!
I^vnn Mass . .
1
i :::::: i
0 '
»)
Memphis, Tenn
is '
Nashville, Tenn
11
2
2
Now Haven, Conn
Oakland . Cnl
Reading Va
1 1
liichmond V*a . .
1 1
Salt LakcCitv.rtah
Bprinefleld, Ndkss.
"2*
1
23
14
7
'"2'
1
3
Syracuse, NY
Tacoraa, Wash
ToliHlo.Ohio
Trenton, N. J
Worcesler, Ma.^;^
From 60,000 lo lou,()00 Inhab-
Hants:
13
1
14
\ 9
1 ...
a
7
Altoona, Pa
Havonne, N. J
Iicfkolcy,Cal
DlDKharalon. N. Y
Brockton \ltiS3
1
s
10
3
2
;;;:;:
3
7
2
1
3
13
5
2
3
6
1
::;:::
s
4
3
Charleston, f^.C
CovinxtoD, Ky
S
Digitiz
edby^
Zooole
2099
Dectmber J, 1917
DIPHTHEOUA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS^
Oontiniied.
CHy Reports for Week Ended Nov
.17,
1917— Continued.
Popula-
tion as of
July!, mo
(esUmatcd
by U. S.
Census
Bureau).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
fever.
Tuber-
culosis.
City.
1
1
1
1
i
1
1
1
\
From 50,000 to 100,000 inhab-
itants—Continued.
Duluth Minn.
94,495
86,600
63,705
75,195
76,078
54,773
76,183
72,015
77,214
68,529
99,437
50,853
51.155
78,283
58,221
53,794
92,943
71,744
50,411
63,867
55,185
66,896
55,642
85,236
53,330
68,805
99,519
57,078
87,039
68,946
61,120
51,550
66,083
77,916
70,722
76,776
94,265
51,656
27,732
34,814
32, 9»
32,730
27,632
43,425
46,192
29,319
26,074
32,261
39,873
28,743
42,458
28,203
39,233
85,486
41,781
41,86a
39,353
35,679
40,496
48,477
35,363
48,886
31,676
36,771
38,670
31,677
41,097
36,384
46,515
27,587
3<964
32,040
15
14
31
»*
7
14
20
18
21
6
17
1
7
7
6
......
......
7
22
8
14
2
5
r.t1n¥b4«ih. M J r
5
SI Paso, Tex
4
Erie, Pa
1
4
6
16
......
6
4
3
34
SvansvlUe. Ind....*..
4
Flint Mieh
2
Fort Wavne. Ind
Harrisburs. Pa..............
7
3
6
3
3
6
8
5
2
2
1
1
4
1
3
Hoboken^N. J
......
1
18
1
4
InhnstnWTl. Pft
Kansas City, Kans
T4\nci»st«i', 'Va
Mftkifin Blass
11
15
23
19
12
18
14
24
22
20
17
19
19
28
17
8
4
1
8
5
4
3
2
Manchester, N.H
Mobile, Ala'.
5
New Britain, Ccmn
1
2
Oklahoma C(ty,01da
3
13
1
1
3
1
2
Passaic N J '.'
1
"'2
3
3
Pawtuoket, R. I
i
44
1
Portland, Me
Rockfora, 111
2
Sacramento. Cal
1
1
10
5
4
3
1
1
1
9
2
3
2
I
2
3
4
Saginaw, Mich
StrJoseph, Mo
1
San Dieeo. Cal
3
4
3
I
Savannah o^, , ,»-.,..
Schcncctadv. N. Y
3
1
8
11
3
2
Sioux City, Iowa
Somerville! Mass
24
14
16
17
14
24*
37
3
9
4
5
3
ih'
e
3
12
4*
8
7
I
9
7
1
1
6
"1*
. ....
1
1
South Bond, Ind
Sprtogflold, lU
1
Springfield, Ohio
2
l^errellaute, Ind
1
3
1
13
3
3
3
3
1
1
4
6
1
7
2
\
Troy,N.Y....
WicWta.Kans
5
2
4
5
......
1
6
3
Wiikcs6arre, Pa
I
3
Wihnington, Del
Yorkjel^.. ::::::
2
2
From 25,000 to 50,000 ti^b-
itants:
Alameda. Cal
3
1
Austin, "^ex ^
BelHnK^iam. Wash
BrooUine, kass
1
3
3
3
4
3
Butler, Pa
Butte, Mont
12
3
1
I
J
2
Chelsea, Mass
1
13
1
2
Chicopeie, Mass
1
Cmnt^riand, Md
1
1
Danville, 111.'
2
1
4
^^%cago,'Ind
3
47
Bast Orange, N. J
3
3
6
1
1
1
Elgin, ni
I
2
2
3
Everett, Mass
18
Evwett. Wash ....
Fitdibmrg,Mass............
3
1
1
Oalvestoo, Tex
3
Green Bey, Wis
1
4
Bagerstown, Md
1
6
3
5
1
0
1
1
4
?
Hamilton, OWo
5
9
16
19
8
14
•'
17
10
13
4
is'
HaverfalHlMass
1
8
I
Jad»m,Micfa
1
Ealftiratf^, Mif^h , '
1
7
35
3
Kenosha, Wis
KlngfttMi, N. Y . .
i
Knoxvilie, T^^n . .
i
8
1
7
3
4
1
2
La Croose,' Wis
T/ezington, Ky. .
17
1
......
2 , 1
Unia,Ohlo
8
1
1
1
Uncoln, Ncbr
-., 1 .
Long Beach, Oal
Lonun . Ohio
..."
1
1
Lynchburg, Va
.*!!!!!'/.. 1..
.;;;;;; ;; ;;; ;; ^
Digitized by
Google
December 7, 1917
2100
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Contintied.
City Reports for Week Ended Nov. 17, 1917— Continued.
'
Popula-
tion as oC
July 1,1916
(estimated
by U.S.
Census
Bureau).
Total
deaths
Irom
all
causes.
Diphtheria.
Measles.
Scarlet
City.
1
1
1
^ 1
1
1-
1
Ijil
Fron 25,000 to 50.000 Inhab-
itants—Cont iniied.
Madison, Wis
30, «»
47, 521
26,234
27.327
29.603
41,133
31,927
30.108
43.715
37,353
31,401
31.404
33.080
46.450
41.185
38.629
39,651
30,798
38, 1.36
46,486
43,284
28.926
38,902
27. 445
46,226
36,283
30. 570
29,8^4
43. 139
43,377
33.809
29. 8U2
31.155
30,S(>3
22,874
15. QIC
13, .532
13. h-jQ
21,685
15, ;94
1 13, 075
22.b69
24.276
16,950
23,539
20.930
1 19, 363
15,395
17, 415
13,284
17,-500
23.126
15.243
20, 1(85
122.019
19,926
23.805
17,524
11,666
12,067
14,831
20.193
13, 821
15.548
21,618
23.228
15,969
ih'
14
6
6
6'
1
13
9
8
8
11
12
7
10
5
15
8
3
13
9
2
5
3
2
1
3
^
1
t
McKcosport, Pa
1
2
1
1 1
MedfordLMass..
1
1
i
Nashua.N. H
1
Newburgh, N. Y
25
NewCastle.Pa
5 ' * 1
Newport , Ky
!
1
Newport, R. I
1
.3
I
Newton, Mass
1
(
Niagara FalKN. Y
7
4
2
3
1
Norristown, Pa
•
1
Ogden, Utah
4
3
1
Oranec, N.J
Pasadena, Col
3
1 ' ■ 1
)
! :
Perth Amboy, N. J
2
1
3
5
3
2
2
Pittsflrld,Mass
3
3
Portsmouth, Va
i
1
2
t
Quincy, 111
,
Qulncy, Mass
4 ' 5
Racine, Wis ,
1
RoanoVe, Va
2
1
3
1
Rock I'^land. 111....
2
1
1
San Jose, Cal
.... .
8teuben\i!lr,Ohio
7
13
13
6
1
9
15
12*
11
12
6
9
2
4*
3
4
6
5'
4
7
5
5
2
2
1
1 ■
Superior, Wis
i
: i
Taunton, Mass
1
;
Waltham,Mass
3
Watertown, N. Y
4|
2i '
2 ' '
Wc^t Hobokcn, N. J
Wheeling, AV. Va
1
4
11
1
i
2
2
Williamsport. Pa
1
Wilmington, N. C
J
Winston-Salem, N. C
Zanes> illc, Ohio
1
5
4
2
2
'
From 10,000 to rj,000 inhabitants:
Alton. Ill
1
5
2
1 3
Ann Arbor. Mich
1
'
i
Beaver Fnl Is , Pa
'
Berlin,N. if
1......
f
Braddock.Pa
6
3
1
Cairo, 111
............
Clinton, Mass
1
Concord, N. H
1
1
Galesburg, 111
i
Harrison.N.J
1
1
Kearny, N.J
4
1
t *>
Kokomo, Ind
1
......
3
1
Leavenworth, Kans
•
Long Branch, N.J
Melrose, Mas.*?
.. .
1
Morristown, N. J
Muscatine, Iowa
1
Nanticoke, Pa
8
6
8
6
6
6
17
Newbury port, Mass
1
2
1
2
1 1 ..
New London, Conn
2T .-
North Adams, Mass
1
1
Northampton, Mass
Plainfleld, N. J
4
2
1
1
1
Pontlac,Mich
2
1
1
4
Portsmouth, N. n
Rocky Mount, N. C
3
4
6
8
3
!
Rutland, Vt
1
1
1
Sandusky. Ohio
1
1
Saratoga Springs, N. Y
.
I
8teclton,Pa
3
Washington, Pa
3
Wilkinsburg, Pa
11
4
1
1
Wobum,Mass
*""
3
I Population April IS, 1910; no estimate made.
Digitized by VjOOQIC
FOREIGN.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reporto Received During the Week Ended Dec. 7, 1917.*
CnOIERA.
Place.
Date.
Cases.
Deaths.
Kexnarks.
India:
Bombay
Sept. 16-22........
Sept. 16-29
do
1
3
4
1
1
2
1
1
Karachi
Madras
Java:
MklJava
8ept.2(V-Oct.2....
West Java
Sept. 14-Oct. U, 1917: Cases, 190;
deaths, 36.
Batavia
do
40
9
PLAGUE.
Oeylon: •
Colombo
Sept, 16-22
3
2
India
tkitsX^'' ^' "•'^-
Bassein .
Sept 2-16
3
44
2
6
976
14
1
4
Bombay
Sept! 9-22
56
HoQzada
Sept. 9-15
BTarpchi . , , . , » - r
Sept. 16-29
.....do ,
7
1.361
ICEulras Pr^dODcy
Mundftlay
Sept 2-15
Tegu ...*...
Sept' 9-15 -
Slam:
Bangkok. ..................
Sept 2-15
4
.
SMALLPOX.
China:
ChnngklDg
Mukden
Shanghai
India:
Bombay
Madras .*....
Indo-China:
Saigon
Java:
Mid Java
West Java
Batavia
Philippine Islands:
Manila
Portuguese East Africa:
Laurengo Marquez. .
Sept. 23-29.
Oct. 14-20..
Oct. ^14...
Sept. ^22..
Sept. 16-29.
Sept. 24-Oct. 14.
.Sept.5-Oct.2...
Sept. 14-20.
Oct. 14-20..
July 1-31...
14
Present.
Do.
Sept. 14-Oct. 11, 1917: Cases, 124;
deaths, 57.
TYPHUS FEVEK.
Egypt:
Alexandria..
Java:
Mid Java..-.
West Java..,
Batavia.
Sept.l5-0ct. 14...
Sept.5-Oct.2
Scpt.H-OctVi'.!!!
Sept. 14-Oct. 2, 1917: Cases, 49;
Jept. 14-Oc
deaths, 5.
» From medical officers of the Public Health Service, American consuls, and other sources.
(2101)
Digitized by
Google
December 7, 1917
2102
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from Jane -30 to Nov. 30, 1917.
CHOLEBA.
Place.
Date.
Cases.
Deaths.
Remarks.
India:
Bassein
Apr.l-lCayS
8
1
10
347
57
67
17
8
Bombay
June 24-30
July ?^-Sept. 8
Apr.29^une30...
1
19
Do
Calcutta %-
Do
Julv 1-Sept. 1
Karachi
8ert.fr-15
4
5
108
Madras
Apr.22-Juno30...
Julyl-Sept.l5.-..
May 6^une30
Do
Mandalav
Do
July 29-Aug. 25...
ICouImein
May 13-June2
Pakokku
Apr.2a-May 5
Peeu
May 27-J«mo30...
Do
July 1-7
Prome
July 2^AuK. 11 . . .
Raneoon
Apr. 21- June 30...
July8-Sopt.8
31
10
tS! :::::::::::..:.::::
June 10-16. 1917- Cases 1-
Indo-China:
Provinces
deaths. 1.
1
Feb. 1-June 30, 1917: Cases, 1.233;
deaths, 805. July 1-31. 1917:
Case*}. 522: deaths 314
Anam
Feb. 1- June 30....
July 1-31
230
86
79
74
878
350
1
36
3
163
49
191
47
51
53
Do
CamlxKlia
Feb.l-June30
July 1-31
Do
Cochin-China ,
Feb. 1- June 30
July 1-31
543
Do
214 !
I<«w» . ...
Juno 1-30
Tonkin
Fob.l-June30
July 1-31
21
Do
Sai£on
Apr.23-May27....
July2-Sept.30....
108
33
So.::::;:;::::::::::::::
Janan
Jan.-July. 1917: Cases. 391. oc-
curring in 16 provinces and dis-
tricts.
Sept. 12. 1917: Cases "252 la 5
Tokyo
Sept. 12
2
Java:
East Java
Apr.2-«
provinces and districts.
Do
July 9- 26
3
Mid Java
July 16-22
1 '
West Java
Apr. 13 July 5, 1917: Cases, 71;
dcjths, 31. Julv fr-^pt- U
1917: Cases. 501- do^hs 30T
Batavia
Apr. 13- July 5....
Julye^Sept. 13....
Feb. 3 . .
38
1
4
4
11
1
3
19
179
2
14
Do
Persia:
MaKanderan Province-
Amir Kcia
Barfouroucho /. .
Jan. 15-17
Do
July 28
I
6
Demavend
July 29
Hamze KcIa
Jan.17
Machidessar
Jan. 31
Sabievar
Aug.20-29
14
98
Sari
July25-Aug.5
TabrlE
Aug. 4, 1917: In villa ee of
Ozoundeh, vicinity of Tsbiix,
about 7 crises daily.
Philippine Islands:
June 17-23
1
4
Do
Aug. 5-25
Sept. 2-8, 1917: 1 case. Not pre-
viously reported.
May 20-June 30, 1917: Cases, 795;
deaths, 506. July 1-Oct. 13,
1917: C«ses, 4,032, deatlis, 2,453.
Agusan
July 15-28
12
113
73
2
26
77
1
1
368
387
62
66
231
W
2
76
43
1
15
34
Afbay
Mav20-June30....
Julyl-Sept.l
June 3-9
i5o: :...:::::
Ambos Camarines
Do
July22-Au?.ll....
8ept.l&-Oct.l3....
July8-14
Antique
Bataan
Batangas
Junel7-23
25i
293
40
46
150
369
Bohol
May 20- Juno 30.. «
Julyl-0ct.l3
June 3-30
Do
CaplE
Do J
Julyl-Oct.6
June 2-30
fuir*-0ct.l3....J
Cebu
Do .1
Digitized by
Google
2103
December 7, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from Jane 30 to Nov. 30, 1917— Continued.
CHOLERA— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
Fbflippine Islands-Contd.
Provinces— Continued.
IToilo
do
128
14
819
237
565
48
463
1
1
1
138
196
274
16
7
15
17
78
5
512
117
316
27
299
Leyte
June 10-30
July 1-Sept. 15 . . .
July 8-Aug. 4
July 20-Sept. 29...
Sept. 30-Oct. 13...
Julyl-Oct.lS
June 24-30
July 1-7
Do
Misamls
Mindanao
Negros Occidental
Negros Oriental
Rizal
Do
Romblon
July 22-28.
July 15-8ept.22...
June 3-30
1
75
88
133
10
7
14
16
Samar
Sorsogon
Do
Julyl-Aug.25....
July29-Aug.25...
June 3-30
Surigao
Tayabas.
Do
July 1-Sept. 29....
July 15-21.
Zamboanga ............
PLAGUE.
Arabia:
Aden
May3-Ju1y4
43
Apr. 8-May 14, 1917: Cases, 69;
deaths, 51.
In Persian Gulf. Present Apr.
3, 1917.
Bahrein Islands
Brazil:
Bahia
June 10-30
July8-8ept.l5....
July 16- Aug. 15...
Apr. 8-June23
JulyO-Sept. 1
Apr.29-May5
12
6
4
41
2
8
2
1
33
6
Do
Pemambuco . ............
Ceylon:
Colombo
Do
China:
Amov
Present and in vicinity.
Present Aug. 10.
i5o ::::.;::::.!!.
July 1-7
6
20
4
6
13
3
nonrknnir. , ^
May 13- June 30....
.Tuly8-Aug. 18
June 2
X :.:::
Kwangtung Province—
Ta-pu district
Present.
Ecuador:
Estancla Viela
Feb. 1-28
1
56
42
4
1
1
2
1
Qua vaauil
do
29
22
b^ ...::::..:
Mar. 1-Apr.30....
July 1-Aug.31
Mar. 1-31^.
Apr. 1-30
Do
Milagro
Do ....:::.:::.
1
Nobol
Feb. 1-28
Salitre
do
Do
Mar. 1-31
i
2
Taura
Feb. 1-28
3
Jan. l-Oct. 4, 1917: Cases, 72»;
Alexandria
June 21- 27
6
5
4
1
1
14
1
4
1
3
deaths, 395.
Do
July3l-8ept. U...
Apr. 30- May 19....
June 25
Port Said government
Port Said
Do
July 28-29
1
7
Provinces—
J'ayoum
May 11- June 26-...
June 28
Oaiioubeh
Girgeh
May 17
1
3
Mimeh
May 12-June28....
July29-Sept. 11...
May 12
4
9
3
23
38
3
2
Do
Siout
1
9
23
1
Suez government
Apr. 30-June2
May 12~Jime28...
Aug. 13-21
May 3-8
Suez
Groat Britain:
Gravesend
From s. s. Matiana.
London
2 in hospital at port. From s. s.
Sardinia from Australia and
oriental ports.
150
Digitized by
Google
December 7, 1917
2104
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— <)oDtlnaed.
Reports Received from Jane ao to Nov. 30, 1917— Continued.
PLAGUE— Continued.
Plaoe.
Date.
Cases. Deaths.
India
Bassein
Do
Bombay
Do..
Calcutta...;
Do
Henzada
Do
Karachi
Do
Madras Presidency
Do
Mandalay
Do
Moulmeln
Do
Mylngyan
Pegu
Do
Rangoon
Toungoo
Do
IndoChina:
I'rovlnces
Anam
Do
Cambodia.
Do
Cochin-China
Do
Kwang-Chow-Wan
Tonkin
Do
Saigon
Do
Japan:
AichiKcn
BilyeKen
Java:
East Java
Djoejakarta Residency
Kedirl Resldencv
Sam:irang Residency. . .
Surabaya Residency. . .
Do
Surakarta Residency
Persia:
Mohammera
Peru
Departments—
Ancachs
Arequlpa
Callao
Lambayeque
Liborlad ,
Apr. 1-June30..
Julyl-Sept. l..-
Apr.22-June30.
JiUy 1-Sept. 8. . .
Apr.20-June2..
Jifly 15-21
Apr. 1-June30..
Aug. 12-8ept. I..
Apr. 22- June 30.
Julyl-8ept.-15..
Apr.22-June30.
Julyl-Sept. 15..
Apr.8-Mayl2...
JiUy2V^-Sept.l..
Apr. 1- June 30..
Julyl-Sept.l...
Apr. 1-7
Iliky27-June2..
July 29- Aug. 18.
Apr. 15- June 30.
July l-Sept.8...
Apr.a-14
July2»~Sept. 1..
486
33
201
2,204
Feb. 1-June30..
July 1-31
tcb. 1-June30..
July 1-31
leb. 1-Jime30..
July 1-31
May 1 -June 30..
Fe6. 1-June:)0-.
July 1-31
Apr.23-June3..
8ept.9-Oct.7...
Jan.-July.
do
Apr. 23-May 6..
do. .".
Apr. 23-May 20.
Ai r. 2-May 20. .
Julv8-28
do
Mayl.
July 1-31
May 16- July 31..
do
do
May 16-21
Lima.
Senegal
Siam:
Bangkok .•
Do
Straits Settlements:
Singapore
Do
Union of South Africa:
Cape of (lood Hope State —
Cradock
G lengrev district
Terka district
Queensto%vn
Orange Free State
Winburg district
At sea:
S. S. Matiana
do..
Sept. 30.
Apr. 22-June30.
July3-Sept. 1...
June3-lfi
July 1-Sept. 22..
Aug. 23.
Aug. 13.
May 2S..
JuneO. .
May 2S
July 14-18.
183
457
232
13
132
10
210
43
34
113
3
47
0
22
3
20
54
24
397
263
38
4
35
5
413
28
250
1,586
9
1
2
6
160
428
2
12
131
g
115
10
133
24
23
30
2
26
6
Apr. IS-Jone 30, 1W7: C^m,
43.W2; defttbs, 30.tf7. J^l-
Sept. 8, 1017: Ones, S4.S5r
deaths, 40,478.
June 10-16,
deaths, 16.
1917: Gases, n
Feb. l-Juoe 30, 1917: CaseE, T»
deaths, 491: July 1-31, »r
Cases, 69; deaths, 45.
Apr. 2-MaT 30, 1917: Oases, »
deaths, 29. Jnlv SO-Aag. $
1917: Cases, 4; deatbs, 4.
Present.
May 13-31, 1917: Caaos, 15. Joa
1-JuIy 31, 1917: Cues, »
AtCasma.
At Mollendo.
At Callao.
At Chlclavo.
At Salaverry, 8«n P^dro, tmi
Tniiillo. July 1-31, 1917: .^t
TrujUlo.
At Lima. July 1-51, 1017:
city and country.
Present in interior.
Present.
Do.
At Sununerhlll Farm.
Apr. 16-22, 1917: lease. Apr.*-
22, 1917: Cases, 28; deaths, 17.
En route for port of Lcmdoo.
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^J
2105
December 7, 1017
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from Jane 30 to Nov. 30, 1917— Continued.
SMALLPOX.
Place.
Dote.
Cases.
Deaths.
Remarks.
Australia:
New South Wales
Brewarrina
Ccssnock.i
Coonabarabran
Quambone
Warren district
Queensland-
Thursday Island Quar-
antine Station.
Brazil:
Bahia
Do
Rio de Janeiro...
Do
Canada:
Manitoba-
Winnipeg
Do
NewBnmswick.,
Nova Scotia-
Halifax
Port Hawkesbury..
Ontario-
Ottawa
Samia
Windsor
Ceylon:
Colombo
China:
Amoy
Antung
Do
ChanRsha :
Do
Chungking
Do
Dairen
Do
Hankow
Harbin
Hong
Manchuria Station.
Mukden
Do
Shanghai
Do.
Tsitshar Station.,
Tsingtao
Chosen (Korea):
Chemulpo
Cuba:
Habana
Ecuador:
Guayaquil..
t)o
Do
Egypt:
Alexandria..
Do
Cairo
France:
Nantes
Paris
Germany
Berlin
Bremen....,
Apr. 27-June21..
July 25-28
May25-July6....
Apr. 27-June21..
Juno22-8ept. 25..
May 9
May 6- June 30...
July 22-Sept. 22. .
do
Julyl-Sept.22...
June 10-16
Aug. 19^ Sept. 1.
Nov. 10
June
June
July
Nov.
Sept
ia-July7.
17-«)
3(>-Aug. 5...,
11-17
. 30-Nov. 3...
Mayft-12.
Apr.
July
May
Aug.
May
Aug.
May
July
May
July
June
Apr.
May
Aug.
Apr.
May
July
May
29-May26...
1-Sept. 22...
21-Junc24...
^Oct. 21...
27-Juno2.rt,
11-17
6-June23
1-Oct. 13
13-June30...
8-2S ,
21-30
23-May6
6-JunolO
5-18
23-29
27-Juno 2
8-Oct. 0
21-Julyl
July2-0ct. 21.
Apr. 16-22
May 22-July 7.
July30-Aug. 11.
May 1-31
Nov. 1
Fob. 1-28
Mar. 1-Apr. 30..
July 1-Aug. 31..
Apr. 30-July 1...
July 2-29
Feb. 12-Apr. 8..
July30-Aug. 5..
May 6-12
Mar. 1*-Apr. 28.
do
4
5
126
518
106
16
31
108
Apr. 27-Aug. 30, 1917: Cases, 77.
From s. s. St. Albans from Kobe
via Hongkong. Vessel pro-
ceeded to Townsvllle, Bris-
bane, and Sydney, in quaran-
tine.
Chiefly in Carleton and York
Counties. One case hotificd
in Northumberland Coimty.
Present in district.
Present and in vicinity.
Do.
Present.
Present and in vicinity.
July 1-7, 1917: Present.
On Chinese Eastcni Rv.
Do.
Present.
Do.
Cases, foreign; deaths among na-
tives.
Cmcs among foreign population;
deaths among Chinese.
On Chinese Eastern Ry.
At another station on railway;
lease.
From s. s. Alfonso XIII, from
ports In Spain.
Mar. 1«-Apr. 28, 1917- Case?, <
in cities and 32 ^^i.Uo; and c
Iricts.
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December 7, 1917
2106
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND TBLLOt
FEVER— ContUmed.
Reports Received fh>m Jvne 30 to Nov. 30, 1917— Continued.
SMALLPOX-Continued.
Place.
Date.
Cases.
Deaths.
0 ermanv— Continued.
Chariottenberg
Hamburg
Leipzig
Lttbeck
Munich
Stuttgart
Greece:
Athens
India:
Bombay
Do
Calcutta.
Do
Karachi
Do
Madras
Do
Rangoon
Do
.do.,
.do.,
.do.,
.do.,
.do.,
.do..
July 25-30
Apr. 22-June30.
July 1-Sept. 8. . .
Apr.2»-May26..
July 29- Aug. 25.
Apr. 22-July 4...
July8-Scpt. 1...
Apr. 22-June30.
July l-8cpt. 8...
Apr. 15- June 30.
July 1-Sept. I...
186
Indo-China:
Provinces ,
Anam
Do
Cambodia.
Do
Cochin-china
Do
Kwang-Chow- Wan.
Laos
Do
Tonkin
Do
Saigon
Do
Italy:
Turin
Do
Jamaica:
Kingston
Japan ,
Kobe
Napa-iakl
O&ika
YokkalchI
Yokohama
Java:
Ka^t Java
Do
Mid-Java,
Do
West Java
Batavia
Feb. 1-June30..
July 1-31
Feb. 1-Junc30..
July 1-31
Feb. l-JuDe30..
July 1-31
M jr. l-Apr. 30. .
Apr. 1-30
July 1-31
Feb. 1-June30..
July 1-31
Apr. 27- June 10.
July2-()ct.7....
May2l-June24..
July 12- Sept. 30.
8ept.i^-15
1.610
35:1
130
24
1,267
130
4
5
10
274
4
199
98
82
12
Mav27-Jnly22..
May 2S-Jiine3..
May 1<V July*...
Julv 25-31
May 27- July 1...
Apr. 2-July L..
July 2- Aug. 29.
Apr. 1-July 1...
July2-Sept.4..
66
1
177
1
1
3S
21
45
Apr. 13-July 5..
Jan. 1-June30..
Aug. 1-14
July l-M
July 11 -Aug. 7.
Junp'3 ■*!)
Aug. :> (n-t. 27.
Juno \^ -21.
Mexico:
Coatepec
Do
Jalapa
Ma/Htlan
Mexico City
Do
Monterey
Orixaba Ja '. I Tctu* n
Do Jr I: I :; . . .
Vera Trut ', July I S'pt . Ut
Netherlands:
Amstrrdam
Phillppino Minds;
Manila
Do
Portugal:
Lisbon ! May 13 June30.
Do ' July V i <i.I3..
PortuRiit^' Kasi Africa: I
Louxenvo Marques ' Mar. I June 30.
Do July I 31
30
lrt2
17(i
Aug. 13 l*»
May 13 June 9
July s .Sept. 1
76
2
8
a
48
21
5
237
59
26
23
377
49
June 10-16. 1917:
3.
Feb. Wane », 1W7- Ohm, •£
deaths, 536. July 1-11. VC
Cases, 525; deaths, VSt
116
I
1
9
Jan.-July, if 17: Om*. t«. •■
37Pr9riiic«Paiiddiftrkt«
Apr. U-Juir 5, 1917! Ci^ >*
deaths. 44. Julv fr SerJ^ ft
19l7:Cases, I4r. diiaU».»
Jan. l-Auf. H, 19W: UM^m^
Varioloid.
Do.
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J
2107
December 7, 191T
CHOLBRA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER—Continued.
K^^MTto Recelfed from Jme 30 to Nov. 30/1917— Continued.
SMAIXPOX--CoiitiiiU6d. '
Ftaoe.
Date.
Cases. Deaths.
Remarks.
Bossia:
Archangel
Do
Moscow
Fetrograd
^.
RJga
Vladivostok
8iam:
Bangkok
Spain: "**
^Sadrid
Malaga
Seville*.".!!!!!.'!'.;
Vmtonda
Do
Stzatts Settlements:
Penaog
SinraiMre
Sweden:
Malme f
Stockholm
Tunisia:
Tunis
Turkey in Asia:
Trebizond
Union of South Africa:
J(^iannesburg
Do
Uruffuay:
Montevideo
Venezuela:
Maracaibo
Do
On vessels:
S.S. Alfonso Xm.
Mayl-June28...
July 2-Aug. 28. .
July 2-16
Feb. 18^ane30.
July 2-29
Mar. 11-June 2. .
Mar. 15-24
June 9-30..
July 11-17..
Mayl-Junel9..
Apr. l->June30..
Jiflyl-31
May 1-June30..
June 3-23
Julyl-Sept.lS..
Mar. 18-June23.
Jane 24-30
Sept. 16-22
Apr. 22-28
May20-June23..
June 2-8 ,
Feb.25-Apr. 13.
Mar. 12-24..
July 1-81...
May 1-31
Junel8-July8.
July 9-23
Nov.l.
66
0
6
666
68
7
23
16
3
Jan. 1-Mar. 31, 1917: Cases, 9.
15
At Habana. From ports in
Spain tor Mexican ports.
TYPHUS FEVEB.
Algeria:
Algiers
June 1-30
6
1
3
1
1
Do
Julyl-Aug.31....
Aug. 12-18
Acs^uUna:
Buenos Aires ^
Austria-Hungary:
Austria
Oct. 22-Dec. 17, 1916: Cases, 2,371.
Dec. 24, 1916-Fcb. 24, 1917:
notv^mt*
Oct.22-Dec. 17....
do
634
809
47
617
16
243
5
aali<ia
Cases, 2,563.
Lower Austria . . .
.. . do
Moravia
do
Silesia
do
Styria
do
Upper Austria
do
Bosnia-Herzegovina
Dec. 22, 191<^Feb. 24, 1917: Cases,
110. ^^
Feb. 19-June 17. 1917: Casei,
Hungary
Budapest
Feb. 19-May27...
Apr.23-Junel7...
July29-Aug. 11...
Sept. 23-29
10
278
2
1,787.
Eisenourg
46
Bradl:
Rio de Janeiro
Canary Talandy
Santa Cruz de TeneriSe
1
China:
Antune
June23-Julyl....
July9-Oct.28
June 9-15
3
20
1
iSk!!!!!!!!!!!!!!!!!!!!
1
Hankow
Do
July 8-14
1
Tientsin
June 17-23 ^
May30-July7
Aug.5-8ept.29...
1
4
2
Tsinirtao
*
KT:.;;:;;;:;:;:;:;::::
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JDecember 7, 1917
2108
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Contlnoed.
Reports Received fh>m June 30 to Not. 30, 1917 — Continued.
TYPHUS FEVrat— Cohtinaed.
Place.
I>ate.
Cases.
Deaths.
Remarks.
Alexandria
Do
Cairo
Port Said
Groat Britain:
Cork
Glasgow
Grcero:
SaloniVi
Do
Japan:
HaVodatc
Nagasaki
Do
Java:
East Java
Surabaya . . .
Mid-Java
Samarang...
T)o
West Js.va
Batavia
Do
Mexico:
Agu^iscalientes..
Coatcpec
Durango, State.
Aug. 3(>-July 1...
July 17-8ept.30..
Jan. 22- Apr. 8....
Mar.l»-25.
1,648
430
188
1
June 17-23
Sopt.3(>-Oct.«..
May 23-June30.
July 1-Oct. 13...
July 22-28
June 11-24
Julyl^Oct. 28..
June 25-July 29.
May 5-June 10. .
July 2-8
Apr. 13-July5..
July6~Sept. 13..
July 10-Oct. 28. ,
AuR. 1-14
Oct. 29
Jalana
Mexico City
Do
Oriraba
Do
Netherlands:
Rotterdam
Do
Norway:
Bergen
Portuguese East Africa:
I.ourcngo Marciues
Russia:
Arcliangcl
Do
Moscow
Pctrograd
Do
Poland
Lodz
Do
Warsaw
Do
Riga.
Do
Vladivostok
Spain:
Almeria
Madrid
Switzerland:
Basel
Do
Zurich
Trinidad
Tunisia:
Tunis
Union of South Africa:
Cape of Good Hope State. .
Apr. 1-June30.
Julvl-31
JuiielKW
July 8-Oct.27..
Jan. 1- J line 30. .
July 1-31
431
1,533
June 9-23
July l.V-Sept. 1.
July 8-28
Mar. 1-31
Mav 1-Junc 28. .
Jurv2-Aug. 28..
July 2-15
Feb. l8-Juno 30.
July 2-29
11
16
10
141
33
Apr. 23- June 3...
June 17-July 14..
Apr. 2^June3..,
June 17-July 14..
May 31-June 16. .
July 22-28
Mar. 2^May21..
May 1-31.
do
120
lOS
1,644
1,495
8
5
June 17-23 ,
July 8"Sept. 29...
July 26-Sept. 22.,
June 4-9
Jimc30-July 6.
East London Sept. 10
478
118
76
16
16
95
131
May «-July 1, 1917: C«se:,
July »-Aug. 29, 1917: Csse •
Apr. l-June 24, 1917: Cssf?
deaths, 5. Julv 9-Sept. 4, ;-
Cases, 15: deaths, 1.
Apr. L3-July 5, 1917: C^e? :
deaths, 6. July 6-S«pt :
1917: Cases,*lQ2: death.*. U
Prevalent on ranches in vit :
of El Rio.
Apr. 23-Junc 3. 1917; <^^
2,814; deaths, 1S7. Jur*
July 14, 191*: Cases. -
deaths, 211.
Jan. 1-31, 1917: 1 case.
May 1-31, 1917: Cases, 4.
Au^. 25, 1917: Present in 16 -'
tncts.
Present.
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2109
December 7, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YELLOW
FEVER— Continued.
Reports Received ft'om June 30 to Nov. 30, 1917 — Continued.
YELLOW FEVER.
Place.
Date.
Cases.
Deaths.
Remarks.
Ecuador:
Babahoyo
Feb. 1-28
1
2
1
18
34
24
1
2
2
2
3
1
6
1
1
1
7
18
10
Do
Mar. 1-^1
Chobo
do
Guajraquil ,
Feb. 1-28
bo! ::::::::::..:..
Mar. 1-Apr. 30....
Julyl-Aug.31....
Feb. 1-28
Do
Vilfgm
.
bo..
Mar. 1-Apr.30....
Julyl-Aug.31....
Sept. 25
1
2
Naranjito
Mexico:
Campeche, State—
YucaUn, State—
Merida
Sept.l-Oct.28....
June 23
2
1
2
Peto
In person recently arrived from
Mexico City.
Do
July2»-Aug.ll...
Venezuela:
Core .*
Present Sept. 5.
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PUBLIC HEALTH REPORTS
VOL. 32 DECEMBER 14, 1917 No. 50
MITIGATION OF THE HEAT HAZARD IN INDUSTRIES.'
By J. A. W ATKINS, Passed Assistant Surgeon, Unitod States Public Health Service.
The exposure of workers to excessively high temperatures and hu-
midity is one of the most serious of the health hazards incident to
occupation in many modern industrial plants, and the question of
measures of effective mitigation of such conditions is important.
Unusual conditions of temperature and humidity played but a minor
rftle among health hazards in industrial plants until steam was sub-
stituted for water power. Since that time exposure to atmospheric
conditions of high temperature and imusual humidity, coincident
with the marvelous growth of industry and the invention and intro-
duction of new machinery and various manufacturing processes, has
given rise to one of the most common and serious problems of in-
dustrial hygiene. In several of the large industries of the United
States, particularly in certain departments of those industries, the
temperature to which workers are exposed is exceedingly high and
in many instances is accompanied by imusual conditions of hxmtiid-
ity. Moreover, such instances are to be found not only in large in-
dustrial plants where many persons are employed, but in many
isolated working locations where heat as a health hazard is not gen-
erally considered, as, for example, in the kitchen of railway dining
cars, where, during the rush hour, excessively high temperatures
have been recorded. A partial hst of the industries in which those
employed arc exposed to exceedingly high temperatures, and in some
instances to extraordinary conditions of humidity, is as follows:
Sugar refineries, paper mills, flax mills, laundries, tanneries, large
kitchens, stoke holes and firerooms of ships, glass factories, steel
blasts, and chemical manufactories.
Exposure to heat exists often as a compulsory hazard because the
character of the manufacturing process carried on is such that a
high temperature is a necessary attribute. In other instances, how-
ever, the undesirable conditions of high temperature and humidity
to which many workers are exposed are due not so much to the char-
> Read before the Section on Industrial Hygiene of the American Public Health Association, Wash-
ington, D. C, Oct. 10, 1917.
151 (2111)
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December 14, 1917 2112
actcr of the industrial process as to lack of precautions. Tb?:
jurious operation of this health hazard can be either greatly"-
gated or practically eliminated in nearly all occupations if due
sideration be given the problem and the necessary steps takt:
the protection of workers. It would seem, therefore, that mi
by which this can be accomphshed should be of interest and 'j
to those interested in industrial hygiene and the acquisition d
efTicient working personnel
PHYSIOLOGICAL CONSIDERATIONS.
Heat Prodacticm, Heat Loss, and Heal Regnlaiion bj the Body.
Though the temperature of the body in health fluctuates
what during the day, it is maintained in rather narrow linu
reg\ilation of the amount of body heat produced and the ai
lost. The normal temperature of the body (about 98.5"^ F.'
expression of the resulting balance between heat production an
loss. Since the ill effects of high external temperature up^
body are the result of a disturbance of this state of equilibr
is necessary to consider the factors concerned in heat prod
heat loss, and their regulation.
Heat Prodmtl)!!.
The heat produced by the body is the result of the chemici
esses involved in vital activity in general or the metaboUsm
is supported by the food, drink, and air consumed.
Eighty per cent of the food eaten goes to furnish body Le
energy spent in the body finally becomes heat.
Variations in hfai production, — Wliile the amount of heat pr
within the body can never sink below a certain minimum, the i
will vary according to the character and extent of the mc
processes taking place witliin the tissues. Muscular tissue <
all others in the amount of heat produced because of its mj
activity. Therefore, an increase in muscular activity, i. e., p
work, will add much to the amount of heat produced by th<
The increase in tlie amoimt of body heat produced by m
activity is the most important from an industrial standpoint.
sources of heat production, however, such as glandular activi
similar physiological processes, should be kept in mind. The g
of heat produced by such activity depends upon the quanti
composition of food eaten.
Heat Loss.
The loss of heat by tlie l)ody is a physical process and takes
by conduction and coiivoction, by radiation, and by evapoj
Heat is also lost to some extent in (lie excreta (urme and fece
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2113 December 14, 1917
in raising food and drink to the temperature of the body, though this
loss is insignificant compared wiUi the losses mentioned above.
Without means by which the body heat could be lost as it is pro-
duced, the temperature of the body would soon rise to a degree at
which bioplasm is destroyed and Ufe must cease. When the loss of
body heat is only partially prevented, severe symptoms rapidly
ensue.
Variation in heat loss, — ^The amount of heat lost by the body, by
the means mentioned above, i. e., conduction, convection, radiation,
•^and evaporation, varies according to the several external physical
, conditions to which the body is exposed. Under ordinary conditions
of temperature and humidity, the percentage of total heat loss by
each of these means is as follows: By radiation, convection, and con-
duction and cutaneous evaporation, about 80 per cent; by pulmo-
*nary evaporation, about 15 per cent; by heating the air inhaled,
about 2.5 per cent; while about a similar amount is lost in heating
the food and diiuk and in the excreta. Abnormal conditions of
■ temperature and humidity alter the amount lost by each of these
means. The amount lost by conduction, for instance, will depend
' upon the relative temperature of the suifaco of the body and the
substance with which it is in contact. Should this substance be air,
another factor is introduced, viz, that of its rate of motion. The
rate of heat loss by radiation depends upon the specific radiating
power of the surface of the body and upon the difference in tempera-
ture between the latter and surrounding objects, wliilc that 'ost by
evaporation wiQ depend upon the amount of sweat evaporated,
which in turn depends upon the temperature, relative humidity,
and rate of motion of air. Radiation, conduction, and convection,
considered together, are sometimes called heat transfer.
The rate of heat transfer, other conditions being equal, diminishes
as the temperature of the air rises. The rate of heat loss by evapora-
tion diminishes as the relative humidity increases. As a general
effect of diminished 1 cat loss, the temperature of the skin is rai ed.
i. o., its specific radiating power is increased, which, besides aiding
in evaporation, faciUtates heat transfer. A decrease in the amount
of heat lost by one means is compensated, to a certain extent, by an
increase in the rate ot that lost by another.
Effects of High Temperature and Humidity on the Body.
While, if the loss of body heat be prevented, severe symptoms
rapidly ensue, it should be imderstood that the Ul effects of a dis-
turbance of the heat equilibrium do not become manifest solely
in acute illness, such as heat stroke or heat exhaustion, but that the
most common eft'ect of chronic exposure to excessive heat is lowered
physical efficiency of the worker so exposed and diminished resistance
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DMCfiBber 14, 1«17 2114
to fatigue and disease. While workers exposed to heal hood
eventually drop out because of decreased woiidng powers, poorhethk,
Of some d^enerative disease for which predisposition has beea
created by reason of the working conditions^ it b unusual to find the
heat hazard to which the workw has been exposed assigned its tme
rAle in the causation of this poor state of health. Yet the coodh
tions of heat and humidity in many working locations are such thit
it is a physiological impossibility for full bodily effidency to be main-
tained, not only because pf the attendant discomfort, but became tke
body encoimters physical and physiological problems with which it
was never constituted to cope continuously. Many of those who
have been continuously employed on the so-called "hoi jobs" will
state to a visitor that they have become "used to" the condilioai
present. In most instances, however, casual observation of tke
phjrsical condition of appearance of such persons is sufficient to sbov
that their statements are made to impress the questioner, who, m t
nJe, is much inconvenienced by the conditions present, and can not
be held to indicate true ph3rsiological toleration. In some instaJ!C«»,
however, limited adaptation apparently has taken place. This b
very probably a result of experience rather than the true physiofepicil
adaptation, for such exposed men soon learn to reduce the amovit
of physical exertion to a minimum, to dress to meet the conditioi»>
and in some instances instinctively to alter their diet.
While the body mechanism may for a time successfully cope wHh
abnormal conditions of temperature and humidity, there seMU
Uttle doubt that imless the upper range of temperature and humKiitr
and the length of exposure are kept within certain well-dehmd
limits, diseased conditions will result. These changes may become
acutely evident at the time of or soon after the exposure, or maj
be gradually produced.
SYMPTOMS PRODUCED BY EXPOSURE TO HEAT.
Acute Symptoms.
Acute symptoms ensue where heat is produced more rapidly bj
the body than it can be dissipated, resulting in heat exhausUon or
heat stroke.
Chronic Symptoms.
The effects of long continued exposure to this hazard are slow cod
insidious and are evidtncod in dogonorativo changes such as arthntr
and muscular rheumatism, chronic skin disorders, and art^oscfc-
rosis. In addition, long-continued exposure to excessire heat wiB
gradually but surely lower the general physical tone of a worinr
even though no special disease conditions become evident
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2115 December 14, 191T
Effect of Radiant Heat
Whore radiant heat is concerned, the effects are generally local,
i. e., the part affected is the part exposed. Changes in the skin
varying from a slight reddening to a bum of the second degree may
be caused without contact with the source of heat. Workers exposed
to intense radiant heat often complain of their eyes, and even tem-
porary loss of vision is a common complaint. Inflammatory condi-
tions of the conjunctiva are common among these men and the
causation of cataract has been assigned by some to exposure to
radiant heat. Swollen and painful feet and rheumatoid pains of
the legs and joints arc frequently complained of by workers who
must stand on hot surfaces.
MITIGATION OF HEAT HAZARD.
A. Removal of Source of Heat
The temperature is frequently high in working locations because
of faulty arrangement of machinery or improper housing of the
department. Due to lack of forethought, sources of heat such as
hot-water or steam pipes, boiler or fire rooms, steam-operated ma-
chinery, and the like, are often placed either near or in the working
location of employees not concerned in their care or operation. In
many instances there is no legitimate reason for this and they could
be removed elsewhere without interfering with the operation or
cflSciency of the department, much to the comfort and efficiency
of the men and the ultimate benefit of the employer. Occasionally,
those occupied in the control of steam operated machinery are placed
in a similar position, i. e., near the source of steam. In many cases
this is unnecessary, as the control mechanism could, without impair-
ing operation, be placed at some distance from the boilers. The
working zones of those employed at boilers or furnaces are in many
instances so restricted that the worker is subjected to the heat all
the time he is on duty, whereas duo consideration of this would have
resulted in a working zone so placed or enlarged that with the excep-
tion of the time actually consumed in stoking, the worker could
remain away from the heated zone without compromising efficiency
in the performance of his duty. Members of the clerical force are
sometimes subjected to high temperatures incident to some manu-
facturing process in which they are in no way concerned, because of
faulty arrangement of the buildings, as, for instance, where pro-
ducing departments are placed adjacent to those occupied by the
clerical force. Power houses are often placed unnecessarily close to
other buildings and are a source of much heat. An essential feature
of plant design is that, wherever practicable, all sources of heat
should be removed from working locations. In addition to this, as
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DeoealMr 14, 1917 2116
few workmen as possible shouW be exposed to heat wh^^ ?: '3
exposure is unavoidable. Whenever this removal of the soort*
heat is not practicable, it is necessary to protect the workss'j
other means.
B. Protectton of Workers.
The effects of undue exposure of workers may be mitigated
preventing the heat from reaching the workers after it h^ U**j
radiated. In order to minimize heat radiation, the source should >
insulated. This is most satisfactorily accomplished by suiroimdii:
the source of heat with a water jacket, a hollow steel covering thnx:-
which water is circulated. This method is especially useful at L
naces. Asbestos coverings have proved satisfactory in many .:
stances, though where high temperatures must be dealt with the wai :
jacket is better. When insulating a source of heat of large dim^
sions or covering extensive heat generating surfaces, such as the c:.-
duits of blast furnaces, double walls of fire brick separated by an 3J
space are very efficient. Where insulation of the source is not pn
ticable, other means of mitigation must be resorted to. The b
step in this direction should be taken in the beginning, when r.
buildings to house the various departments are designed. If d:
consideration is given the subject at this time, much expense s:
labor will be saved.
Buildings devoted to hot processes should be large, high-roof
with ample floor space, and provided with large openings in the v*l
and roof to facilitate natural ventilation. Such provisions will ^
greatly in carrying off superheated air. In some instances it is neee^
sary to aid natural ventilation by artificial means. Electrically dri^r.
supply and exhaust fans, if of sufficient size and properly placed &:^
operated, are excellent. In some locations the radiant heat will S
so great that the measures taken above for the protection of worko^
will prove inadequate. In such cases the installation of scret -
between the source of heat and the worker has been found to be ^
advantage. These screens are built of various materials acconlir::
to conditions existing in the working locations, foremost amot:
which is the character of the duties required of the worker. Brici
shields are efficient, but have the disadvantage of being permaaer:
i. e., stationary, which in many instances is undesirable. In such ca-^
portable screens made of steel or steel faced with asbestos are satis-
factory. In other casos where the worker must look at the source of
heat in the performance of his duties, it is necessary to install trans-
parent screens. For this purpose wire mesh may be used and iht
shield made either portable or stationary as the conditions demand.
Wire mesh screens intercept much heat. In some cases a fine sprar
of water falling between the source of heat and the worker is used.
Though efficient, this method should not be used except in locations
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2117 December 14, 1017
where the relative humidity is low. In some instances screens, besides
t being necessarily transparent, must be of such a character as to per-
! mit the worker to pass beyond them toward the source of heat. The
necessity of removing portable screens for this purpose and then re-
placing them would seriously interfere with the proper performance
of the work and in some locations would be impossible. A screen
.which wiP stop a great deal of radiant heat, yet which can be reaaily
displaced, is made of chains hung down in rows from a crossbeam.
When necessary, the worker pushes them aside and passes through,
but immediately upon returning to his working, is again protected.
Another method is that of causing a strong air current to pass from
below upward just in front of the sources of heat. This method,
while aiding ventilation to some extent, does not act as a very effi-
cient screen, ^hen any of the above means fail to meet the condi-
tions, a forced air current directed from behind the worker toward
the source of heat should be provided. This method has proved very
satisfactory at tube-welding furnaces. The air blast must be stong.
For this purpose it is necessary to install electrically driven fans of
about 3 feet in diameter. None of these methods is practicable in
the case of certain "hot jobs," and here it is necessary to place the
protective devices on the man himself. Among these devices may
be mentioned goggles, wire mesh face masks; asbestos aprons and
leggins. Where employees handle hot material, metal-faced gloves
give satisfaction. Wooden or green leather soled shoes, or shoes
which have a layer of asbestos, cork, or similar poor conductor
placed between the outer and inner layers of the sole, will greatly aid
in protecting the feet of workers who are required to stand on heated
surfaces, as for example, around the soaking pits in a steel plant.
The methods mentioned above are mainly of service in mitigating
the effects of radiant heat. In many working locations the condi-
tions to be met are of a different character. Here the entire working
location is superheated, often a high relative humidity exists and the
measures just indicated are not adequate. In these locations we
must facilitate heat loss and control the heat production of the body.
To Increase Rate of Heat Loss.
With the exception of the relatively small amount (5 per cent) of
heat lost in heating food, drink, and inhaled air, and that lost in the
excreta, heat loss takes place from the surface of the body. The
theoretical indications, therefore, to facilitate loss by this means are
to expose this surface by removing the body coverings. Under
ordinary conditions, clothing lessens the amount of heat lost by the
body by about 47 per cent. Experimentally, a man clothed and ex-
posed to a temperature of 64.4° F. will lose about 79 calories ^ an
hour; under the same conditions, but naked, he will lose 124 calories.^
Calorie (large), the amount of heat necessary to raise 1 liter of water 1 elegree centrigrade.
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DMember 14, 1»17 2118
dothing acts as an insulator and interfereB with both heat trus:
and evaporation of moisture becaxise it b usually made of subsUi-
of feeble conductivity which entangle air in the mesh. Thus, if -i
conductivity of silver be taken as 493, that of wool or cotton is il>
0.04, and that of air is 0.000288. Therefore, where high tem^:-
ture must be sustained, exposure of the body surface ^ indiar
This, however, can not be carried out in working locations when
abnormal conditions of temperature are due to radiant heat » >
the workers are forced to wear additional clothing to avoid &.:-
injury to the skin. In actual practice, however, it is found thti .
wearing clothing of a certain character, heat transfer is faciliU:
for the clothes become wet with perspiration ^d as wat^: b a br'
conductor than air, a more rapid loss of body heat takes plaoa -
has been shown experimentally, for instance, that an arm eocloeec ::
calorimeter and wrapped in flannel will lose in an hour about 4^ .
If the flannel is wet, however, this loss is increased to 22.7 caL '^
addition, evaporation takes place as rapidly from the siirfaoe o/ j
clothing if heated from beneath the body as it will from the sar^'
of the body itself. The type of clothing, therefore, indicated hfre -
thin, light, and with good absorptive properties. Cotton cloUi
meets these requirements. However, the use of such garments ;:
a hazard in that the worker, after leaving his place of work in^J
and wet condition, cools off too rapidly and symptoms of inter-:
congestion, such as muscular and arthritic pains and catarrhal c'
ditions of the respiratory tract, may ensue. Workers can not '
relied upon, eitlier from carelessness or ignorance of the dangt^. «
take the necessary precautions to avoid the hazard. Woolen cloib::.
therefore, is better, as it will perform most of the desired funcLJ
satisfactorly and yet does not allow too rapid cooling olT to occur
RetoCion of Humidity to Heat Loss.
The body depends upon perspiration and evaporation of sva
under normal conditions to remove about 15 per cent of the W
heat. The loss by evaporation must be considerably increased
for any reason tlie heat loss through other paths is diminished
The most important factor governing this means of heat loss is tb
amount that can still be taken up by the air. This depends upon Vi
temperature of the air. Thus at:
10° F. 1 cubic foot of air^wiU take up 1.1 ((rama.
32° F. 1 cubic foot of air wiU take up 2.13 gramB.
60° F. 1 cubic foot of air will take up 5.77 c^rams.
80° F. 1 cubic foot of air will take up 10.98 grams.
90° F. 1 cubic foot of air will take up 14.85 grams.
99° F. 1 cubic foot of air will take up 19.28 grams.
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2119 December 14, lOlT
The water out|iut of the body by evaporation varies inversely as'
the humidity of the air. The essential index, therefore, of the con-
ditions of a working location is the wet-bulb reading, i. e., the relative
hxunidity. Generally speaking, in no case should the air of any
location where continuous work is performed be above 70° F. by the
wet bulb. At 72° F., much body siuf ace must be exposed and a per-
ceptible air current passed over the body if work is to be performed
without imduly raising the body temperature; at 82° F., a maximum
amoimt of body sm-face must be exposed and a strong air current
passed over the body, while if the wet bulb registers 85° F., the body
temperature rises and work becomes impossible.
Air Motion.
As mentioned above, the rate of heat loss is also dependent upon
the rate of air motion. In hot working zones, if the air be still, even
though it be dry, the bidy bocomes quickly surrounded by an air
envelope, saturated with body moisture, which, acting Uke a blanket,
prevents the cooling of the body by evaporation. Means, therefore,
by which the air surrounding the workman on ^'hot jobs" can be
kept in motion are indicated. Proper building design and oonstruo-
tion with a view to adequate natural ventilation will in many instances
be sufficient, but the installation of either air exhaust or supply sys-
tems, or preferably both, will cause sufficient air motion to aid mat^
rially in heat loss. The large force fans previously mentioned are
very effective.
In all hot working zones the current of air should at least be per-
ceptible, as the rate of heat loss is proportional to the square root of
the velocity of the air current. Air moving at 1.5 feet per second is
imperceptible, at 2.5 feet per second, barely perceptible, while air
moving at the rate of 3.5 feet per second causes a perceptible draft.
Water Drinking.
Since so much body water is lost under conditions which provoke
free perspiration, it is important that an ample amount of water
be drunk to replenish the tissues thus deprived of their normal water
content. Without this, their proper functions will be hampered
and health and efficiency can not be expected. The worker should
be furnished an abundant supply of water together with drinking
faciUties which are clean, attractive, and placed so as to be conven-
iently accessible at all times. The water should never be below 55®
F. in temperature, as the drinking of cold water is Ukely to cause
gastrointestinal disorders. The jet sanitary fountain is the best'
drinking facility. Though under ordinary conditions the amount of
heat lost in bringing the temperature of water up to that of the body
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December 14, 1017 2120
is small, this amount, by judicious drinking, can be increased. Waui
should he drunk in small quantities and at frequent intervals, not h
large quantities at infrequent intervals.
Bathing.
In addition to drinking, the use of water as a bath is very benefid
in aiding heat loss by the body. These baths should be tepid, aboui
85° F., and the water should strike the body with force. A stroij
needle shower of tepid water, of short duration, followed by a bn^i
rub-dowD, will leave the skin in proper functioning condition andL'
addition reUcve fatigue. Physiological experiments have shown ih.
baths greatly accelerate the return to normal of the temperature
the body after it has been raised several degrees by exercise.
Reduction of tlie Amount of Heat Produced by tlie Body.
The amount of heat generated by the body may be diminished bi
first, reducing the amount of physical work and, second, by r^ulatio
of the diet. With the invention of new machinery and the introduf
tion of many labor-saving devices much physical work has been don
away with, as, for example, by mechanical stoking devices. There
still, however, much work of a laborious character to be done. Sue
activities produce a great deal of body heat. Thus it has been show
that a soldier weighing 154 pounds while at rest produces 1.3 calorii
per minute, but while ho marches with a load of 68 pounds, he produce
7.8 calories per minute. This amount of heat is sufficient to raise tt
body temperature one degree in less than nine minutes. Worker
therefore, exposed to abnormally high temperature or humiditii
should not be required to perform much physical work in the aggr
gate. This requirement has been met by having the men rest an
work in alternate short spells, a method which is practical and can \
successfully applied in nearly all instances where work must nece
sarily bo performed in hot locations.
Influence of Diet.
It is worthy of note that by means of diet the rate of heat produ
tion has been experimentally increased by 44 per cent. The hea
producing values of the foodstuffs concerned in this production var
the effectiveness of proteid, carbohydrate, and fat being as 20:10:
Where work must be performed under heated conditions, the intal
of meats and fats should be reduced and the consumption of starche
fruits, and green vegetables increased. By proper attention to tl
diet, therefore, the heat production of the body can be material]
reduced.
The final method of heat mitigation which con still bo applied,
the character of the manufacturing process is such that high tem
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2121 December 14, 1917
ptf ature is a necesscuy attribute and the existing conditions of the
working location are such that the exposure of the employees can not
be prevented, is the reduction of the length of exposure. Under such
conditions it is necessary to increase the forc^ in a given location, and
allow the men to work in short spells. In this way the short duration
of the exposure, combined with the greater period for recuperation
afforded by the long rest intervals, keeps the mechanism of the body
at its highest efficiency and permits it to endure to the best of its
capabilities the stress to which it is subjected during the working
intervals.
THE MASSACHUSETTS ENDEMIC INDEX.
By Waltbb H. BaowM, IL D., Epidemiologist, Massacbusetts State Department of Health (now
Health Officer, Bridgeport, Conn.).
The United States Public Health Service carries at the head of
its department on the ** Prevalence of Disease" in the Public Health
Reports this statement of fact:
No health department, State or local, can effectively prevent or control disease
without a knowledge of when, where, and under what conditions cases are occurring.
One might very well add to this statement that the information
should be received promptly, the cases investigated thoroughly, and
a complete record made of the findings.
The fimdamentals of the epidemiological control of disease are:
1. Prompt reporting of all cases of conmiunicable diseases.
2. Prompt and thorough investigation of all outbreaks of commu-
nicable diseases.
3. An adequate follow-up system to check the value And effici-
ency of the methods of control.
4. Complete records.
With this information, plus sufficient statutory powers, there
can be established an efficient, economic administrative control
of communicable diseases.
It is not the purpose of this paper to discuss reporting, investi-
gating and evaluating methods of communicable -disease control.
Tho writer merely wishes to call attention to a method of using
morbidity reports that has been adopted by the Massachusetts
State Department of Health. Tliis method has been developed
in response to the pecuHar needs of a state with a decentralized
form of health organization. As used in Massachusetts, this method
may not bo appUcable in other places, but the principle seems to be
one that may be serviceable, both in State and municipal health
work.
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Deoombor 14, 1017 2122
Thi^ prime essential for the satisfactory control of any aani
nicablo disease is the early detection of the unusual prevalence ci .
disease. This detection necessitates:
(a) A satisfactory S3'stem of morbidity reports.
(6) A standard by which to judge the variation in the prev&r
of the disease.
System of Reporting.
The systems of reporting cases of communicable disease? ^
widely in different States. In order to clarify the principle inr-v
in tlie use of the endemic index, the Maasachusetts system of l
bidity reports will be briefly described:
The State department of health fixes the list of reportaJ)le dis*^^
The physicians and householders are required to report such j
eases in the city and town where they are located. These report^
submitted on postal cards, furnished by the local board of hti
In a majority of places these postal cards contain little or no i
demiological data. The original report cards arc retained by
local board of health, who in turn, and within 24 hours, repor
cases of commimicable diseases to the State department of heoJ
These reports of the local health authorities are made upon p-
cards which contain no details except the character of the fc
and the name and address of the patient. A duplicate of this m
is mailed to the Siate district health officer.
Morbidity Standards.
In order promptly to detect incipient epidemics, it is neces^
for the health admuiistrator to have some sensitive indicator of
variations in the prevalence of communicable diseases. In Ma
chusetts this indicator is furnished by the endemic index.
This endemic index may be defined as a numerical standaru
judging the relative prevalence of any reportable disease in
commimity. It is based upon the amoimt of a given disease 1
has been endemic in a conunmiity over a period of years. By a
trarily separating the epidemic from endemic disease, it is possiW
use the accumulated endemic experience as a basis for detecting
onset of epidemic influences. The index may be either daily, woe
or monthly. In Massachusetts the monthly unit is the most p
tical.
Construction of the Endemic Index.
The details of constructing an endemic index for a given city
a given disease may be defined as follows: All reported cases (
given disease for a given month for the preceding five years are U
lated on sheets. From these sheets it becomes evident at once w
an epidemic of the disease has occurred. The total reports of a
during this (»]>idemic are excluded from the tabulation. The renii
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2123 December 14. 191T
ing figures are totaled and represent the endemic preyalence of the
disease. The average of these figures is the so-called endemic index.
This figure represents, roughly, the usual endemic experience of the
city or town with the pven disease for a given period of time.
This averf^e, or index, gives a health administrator an arbitrary
figure to be used as an indicator for epidemiological investigation.
It has the further advantage of being a numerical standard that can be
checked up by clerks who have no knowledge of communicable
diseases.
The endemic index can be criticized from a statistical point of
view. In constructing it we do not actually define an epidemic — we
merely arbitrarily exclude evident epidemics. In adopting this
course, some groups of cases may be excluded which sliould be in-
cluded in our tabulations. However, this raises the resulting index
and merely acts as a factor of safety.
An attempt is now being made to construct a practical numerical
standard for the definition of an epidemic. At present the data are
incomplete. We believe it can be accomplished by proper grouping
of our cities and towns on the basis of population and the total inci-
dence of communicable diseases. This information, plus the accu-
mulated experience with the endemic index, will furnish the basis for
this standard. From our practical experience with our present
method this numerical standard is not a necessity.
Application in Massachusetts.
Wo have applied the principle of the endemic index in the follow-
ing way:
A card has been devised for each city and town in Massachusetts,
showing the following information:
1. The daily incidence of each reportable disease.
2. The monthly incidence of each reportable disease for the corre-
sponding month of the previous year.
3. A monthly endemic index for each disease.
4. A weekly total of cases and deaths from all diseases.
5. A monthly total of cases and deaths from all diseases.
In addition, the population of the individual city or town is placed
upon the card. These cards are made sufficiently large to contain
this information for an entire year.
The method of procedure with these cards is as follows:
The daily reports of individual communicable diseases coming
from each city and town are recorded by the clerk who has charge of
the conmiunicable disease postal cards. As soon as any disease in
any city or town equals or exceeds the endemic index for that dis-
ease for a month, the endemic index card is at once placed in the hands
of the administrator. This saves the administrator the trouble of
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December 14, 1917
2124
looking over all the cards. It does not leave the unusual prevtkna
of any communicable disease to individual judgment and it fumishtt
at once the indication for administrative action.
The inclusion upon a single card of the cases of the previous yeus
and incidence of the dihcascs, and the weekly and monthly tmil
cases and deaths, furnishes all of the necessary data for the iDstilo-
tion of two of the fundamentals of epidemiological control of com-
municable diseaisos, namely, prompt and thorough investigation J
all outbreaks of communicable diseases and the evaluation of tif
correctness of our epidemiological diagnosis and administrative tnit-
ment of these diseases.
Conclusions.
1. That the administrative control of communicable distal-
demands a sensitive standard for judging the relative prcvalcuci* ••■
these diseases.
2. The endemic experience of a community with a disease fum^'"^
the ba.sis for construction of such a standard.
3. The endemic index, while not statistically accurate, is a prart:iL
administrative tool for the public health official.
SMALLPOX PREVALENCE-
During recent weeks an unusual prevalence of smallpox ha5> Ih>
reported in a number cf cities of the Ignited States. The (Usoiim'U-
been univ(»nsally of the mild type which has been so C()mni<»n in tl.-
country for 20 years. The cities in which the disea^^^e hfc; N-
prevalent and the numbei>^ of cases reported by wrek* are <lio»n'*
the folio winj:^ table:
I'tmsual small pfjj- ftrt mUnvt St pi, .)Vy to Dec. ,S', !UJ7
(ay.
' t i<n> :i^
'of J. Iv I.
VMt\ (c<-
. limate<l
. » V 1 . S.
* OiKllS
. . . . , •.'2. ^7 J
.-{, 11>.'»
Orf.
0.
.....
9
24
.....
1
."J
«
r
I"-!
il
I 1
•■•V;
14 >
5
24 ,
9
2
3
7 ,
Rse^ report
1
•iO. . 27.
1
3 1 10
pd dn
I
Nov.
3.
4
1
7
rinnv
Nov.
10.
reek*
Nov.
17.
IHkd-
No\. r>w.
24. j 1,
\kron. Ohio
Minn Fll
12 11
^ \ *
14 ' 14
17, IH
' il r *7*
111
:*i , 7j*
23 17
.V» ' 17
6 »
zed by Vj<
25' »^
4 9
nuilo Mnnt
7
16
H
1«
27'
M
K
■(■»)'
• nof
10
21
24 1 29
( li \ol.in*I, < 'Iti'*
.... «7i <:{
»' 21
i'nmlrrliiiHl. XUl t
l>rii\«>r Colo
1>,<I,HX)
' :.71,7M
10 I
prt'oit Vi« ii
6
4
34
^!
4
10
9
r(vf 1
17
2
42
1
19
19
33
h
4
7
19
cdin
Digiti
3H 41
Hi,,t Mi(h
.M 77 J
.' i:.
Ft rt N\ .i>rr, Ind
<ir P'l I ,'i'i*l'- Yuh
7»i. IM
30 37
7 10
In«ll.'!iaiH^li^. lud
Kalia- Cliv. K:;!'^
Kati«^ii^ (If V, S'o
Mime ip li \ iiiii
Oklitluttltl <'i'>, cklu
j /;i,70H
...J r», n7
1 197,^*7
'MA <M
yj.<M.t
30 47
•7 7*
28 l"*
2 10
OiiiilKi. N.» r
,... I'/., J7n
77 44
St. Tuiil. Mum
' Jil.jAJ
23 Zl
\n n|Hiri
Dogle
IV
2J
i«>
"1'
PREVALENCE OF DISEASE.
> health department, State or local, can effectively prcvcnf Ot- control diseases withatU
knoufledge of when, where, and under what conditions cases arc occurring.
UNITED STATES.
CURRENT STATE SUMMARIES.
California.
From the California State Board of Health, telegram dated Decem-
er 11, 1917:
Five cases poliomyelitis reported last week, one each in San Joaquin County,
(utte County, San Francisco, Tropico, and Yuba city. Four cases epidemic cere-
Toepinal meningitis, 2 in Los Angeles city and 2 in Los Angeles County. Three
ases suKxllpox, 1 each in San Francisco, Los Angeles, and Kern County. Typhoid
bows increase, 27 cases last week, 12 in ?an Francisco, only 4 of which local in
nigin. Reporting venereal disesaes stimulated ; 267 gonorrhea reported last week.
Reported by mail for the preceding week (ending Dec. 1):
Cerebrospinal meningi tis 2
^^hicken pox 104
Diphtheria 69
Dysentery 1
Erysipelas 5
German measles 51
Pneumonia 77
Poliomyelitis 3
Scarlet fever 88
Smallpox 11
S>7 hilis 60
Tetanus 1
!
jonococcus 55 j Trachoma 4
kialaria 10 I Tuberculosis 74
Measles 86 j Ty|hoid fever 16
Slumps 6 I V\ hooping cough 114
Indiana.
From the State Board of Health of Indiana, telegram dated Decem-
ber 10, 1917:
Scarlet-fever epidemic Angola, Blooraingdale, Decatur, Dayton, Clinton County,
Trenton, Randolph County. Diphtheria epidemic Sheridan. School children
ordered vaccinated, smallpox, Indianapolis, Fort Wayne, Shelbyville, Richmond,
Bloommgton.
Massachusetts.
From CoUaboratmg Epidemiologist Kellcy, telegram dated Decem-
ber 10, 1917:
Unusual prevalence diphtheria: What el y, 4; Amesbury, 6 additional; Foxboru, 14.
Scarlet fever: Montague, 5 a<lditi()iial; PitU^field, 6 additional; Brockton, 6; Oole-
rain, 3. Whooping cough: Webster, 8 additional.
(2125)
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December 14, 11)17
2126
Minnesota.
From Collaborating Epidemiologist Bracken, telegram dat^
December 10, 1917:
Smallpox Ottertail Coimty, Hobart Township, 1; Polk County, Fisher Township, 1
Granville County, Cairo Townsliip, 4. Two cases poliomyelitis reported since Decem-
ber 3.
Nebraska.
From the State Board of Health of Nebraska, telegram datd
December 10, 1917:
Smallpox at Pender; ecarlet fever at Lyons.
South Carolina.
From Collaborating Epidemiologist Hayne, telegram dated Decem-
ber 10, 1917:
Measles still prevalent; infantile paralysis 2 cases.
Virginia.
From Collaborating Epidemiologist Traynham, telegram dated
December 10, 1917:
Smallpox reported from Roanoke, Wise, and Tazewell Coimtics.
Washington.
From Collaborating Epidemiologist Tuttle, telegram dated De-
cember 10, 1917:
Two cases poliomyelitis, Seattle.
CEREBROSPINAL MENINGITIS.
State Reports for October and November, 1917.
Place.
Indiana (Oct. 1-31):
Grant County —
Hancock roimty.
I. ake County
Noble County
Total.
M-iNsafhusett'^ (Nov. 1.30)-
Bristol Counly-
Kall Hivcr
Essex County—
Salera ,
Hampden County—
Sprinpfield ,
Wilbriiham (town).,
Hampshire Couuty—
Northampton ,
Middlesex County—
Arlinpton (town)....
Lowell
Norfolk County -
Brockliiieit')\>n) ...
SulToIk County
Boston
NVorc«^>ter County—
Worcester
New ra^es
reported.
Place.
Sonth Pakota (Oct. 1-31):
Clark County
CodiuRlon ,
M inneh;iha County
I'nion County
Total..
Virpinla (Oct. 1-31):
Madison County
J'rinco Georg** County..
Total..
! \Vasbin>»ton (Oct. 1-31):
j Clallam County
I ( > kanogan County. . .
I Snohomish County-
Everett
Total..
New ra.-*.
reportti
Total..
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December 14, 1917
CEREBROSPINAL MENINGITIS— Continued.
aty Reports for Week Ended Not. 21, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Albany, N. Y
1
Newnrk.N. J
Now lla^en, Conn
1
A tianta. Oa
1
Baltimore Md
1
1
New York, N. Y
4
BiifTa'o. N. Y
PHadepWa, Pa
Cairo. Ill
1
1
1
rutslMirir'>. Pa
1
Chicago, HI
4
3
Pontlac.Mich
Cincinnati, Olio
PortsmotJth, Va
Cleveland. Ohio
Pro Idence.R. I
rt. 1.0 i<. Mo
3
Detroit. Mich
1
1
DubuQuo, Iowa
1
St. Paul, Minn
1
Fall Rl\er. Mass
1
1
Fan Dieffo. (a!
Fort Wwth, Tex
1
1
1
Schenectadv, N. Y
Spring "e d. Ill
1
Oa esbunr. Ill
1
Lima. Oh/o
Ftockton, Cal
Lowe il. Mass
1
1
1
, Was'-in^ton, D. C
1
Milwaukee. Wis
1
Whee.ing, W. Va.
1
1
MiriTiAAnn.ls. Minn
DIPHTHERIA.
See Diphtheria, meaales, scarlet fever, and tuberculosis, page 2135.
ERYSIPELAS,
aty Reports for Week Ended Nor. 24, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Brockton, Mass
2
8
16
2
4
1
New Bedford, Mass
1
Buffalo. N, Y
1
1
1
New Caste, Pa
1
Chicago. Ill
New Or eans. La
1
Cincinnati, Ohio
New York, N. Y
2
Cloe'and. Ohio
Oakland, Cal
2
1
1
8
Denver, Colo
Omaha, Nebr
Detroit, Mich
2
1
Philadelphia, Pa
El Paso, Tex
Pittsburgh. Pa
1
Erie, Pa
1
PorCand, Me
1
HartfcH'd, Conn
1
Portland. Oreg
1
Jersey City, N.J
1
2
1
3
1
1
3
Sacramento. Cal
1
Kalamazoo, Mich
St. Joseph. Mo
1
4
3
2
1
2
Lincohi, Nebr
St. Louis, Mo
Los Ambles, Cal
St. Paul,Mlnn
Milwaukee, Wis
Tacoma, Wash
Montclalr, I<. J
Wllkinsburg, Pa
Newark, N.J
WilliamsDort. Pa.
MALARIA.
State Reports for October and November, 1917.
Place.
New cases
reported.
Place.
New^aees
reported.
Massachusetts (Nov. 1-30):
Plymouth County-
Brockton
1
1
Virginia— Continued.
Allechanv Countv
2
Amelia Countv
4
Worcester County—
Sutton (town)
Bed'ord County
5
Brunswick County
2)
Lawrence iile
Total
2
Campbell County
Carolina Countv
Virginia (Oct. 1-31^:
31
1
8
5
Charles Citv Countv
Aocomac Couuty .
Charlotte (lount v. ,*
Albemarle County
Clarke Countv
Alexandria CounCy I '...!".!'. 1 ..' I
Cumberland County
Alexandria
1 Dinwiddle County
152
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MALARIA— Continued.
State Reports for October and November, 1917--Contiiiued.
Plat-c.
New casta
reported.
Place.
repoTH
Vlrelr ii— '^ortlroed.
f li/»\T>eth City Coanty..
Fs-c"^ (.'oiinty
Fair'rtx Couiity—
Hcrndon.!
Fftuquicr County
Clc:iror>tpr Coiintv
Goochland County
G ra\'};on Cofinty
Vrics
Gr<f nsMlle County
Ilali iix Coimtv
South 1^0 ton
Hflnovcr County
Henrico County
l.sle of Wight County
James City County
W illianisburg
KinR and Oueon County
Kiit>; f-coreo County
Kins William C^mty...
I anrnstcr County
I 01] d >i in County
I unenburg County
Madi'^on County
Mathews County
Mecl. lenburg County
M idtUasex County
Montf^omrry C-ounty....
NaiLseracnd County
Sujrolk
Nelson County
N ew Kent County
Vlrrtaia— Continued.
Northampton Oonnty
North uniDerland Coanty.-,
Nottowav County
Orange County.. .
ritt*;yh anla County.
Powhatan County
Princess Anne County...
J*rincc Fdward County..
Fann>1lte
Prince Oeorge County.. .
HonewelL
Prince William County..
Richmond County
Roanoke County
Rockbridge County
Buena Vista.
Rockingham County
•Southampton Coimty . ..
Franl lin
Spotsylvania County—
Fredericl.sburg.'.
8tafr<»-d County
Surry County
Sussex Count V
Taiewcll County—
Pocahontas
Warwick County
Westmoreland Cotmtv . .
York County .*...
Total..
City Reports for Week Ended Nov. 24, 1917.
Place.
Casog.
Deaths.
Place.
Cases.
Dea^
Broc' ton. Mass ,..,..
1
1
1
4
1
New Orleans, La. . ..
1
1
I
Lorain Oliio
Fan Francisco CaL
---..—..
Newarl-',N. J
Sftvannah^ <^a ,..,..».. ^
--"-——
Memphis, Tenji- - -tt ttt,--,-
MEASLES.
Sec Diphtheria, measles, scarlet fever, and tuberculosis, page 2135.
PEIXAGRA.
Slate Reports fbr October and November, idl7.
Place.
New cases
reported.
Place.
New rase
reported
Massachusetts (Nov. 1-30):
Harapshlrc County-
Northampton
1
Virginia (Oct. 1-31>— Contlmw*.
Lee County
Madison County '
Virginia (Oct. 1-31):
A mhcrst Coimty
2
1
2
2
Mec lenburg County
Nansemond County ^
Northaninton (jountv ...
Botetourt Ccunty
1 Pit ij^'lvania County .,
Campbell Count v
fc^iUctineld
lA'uchburp..'
Scott County -
(Jate t ity ,,
Charlr tte Ountv ,
Dinwiddle County
Bpotsj'lvania County—
Fredericksburg ..•...«.••
Fran) lin County
< J ra\son County
Washimrton County
Halifax Ccuntv
Total ._
Hanover County
4
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2129
PELLAGRA— Continued.
City Reports for Week Ended Nov. 24» 1917.
December 14, 1017
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Blminghani, A Is.
1
5
1
1
1
2
New Orleans, la
1
Fort Worth Tex
Nortbarart*"!! Vjiss
1
Le Inpt n. Kv
Favannah, '^'a
1
Memphis Tpnii......r.r.,.TTt
1
WasMn fn, P. C
WllmiDgtcn, N.C
1
1
Mobile, Ala
1
PNEUMONU.
City Reports for Weeis Ended Nov. 24, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
AITentown, Pa.
11
30
151
29
10
11
1
Lowell. Mass
45
90
43
14
15
1
3
Ann Arbor, Mich
L^im, ^(a!«
2
Baltimore. Md
8
Manchester, N. n
McKeesport, Pa
2
Berke'ev, Cal
2
Bin«hamton, N. Y
Newark. N.J
Newburvport, Mass
5
Boston, Mass
20
Braddock. Pa
Newton, Mass
1
Brockton, Mass
Nort^ arapton, Mass
Buffalo, N. Y
is
2
1
71
16
3
26
1
1
1
1
Phllade'plla, Pa
47
Camhridse. Mass . ...
ritts' rrj?h. Pa
47
CheUiea, Mass
litts ed.Mass
1
Chicago, 111
Fontiac, Mich
ClexeWd, Ohio
Reading, Pa
3
Da'ton, OHo ■>,...
Roanoke, Va
1
Detroit, Mich
Rochester, N. Y
2
Duluth, Minn
Sacramento, Cal
4
Kvansville, Ind
Paginew, Mich
Fall River, Mass.
San Francisco, Cal
13
Flint Mich
Schencctad , N. Y. .
2
Grand Rapids, Mich
Sprlng'^e d, Mass
3
Ha^erhiU,Mass
1
SpringOeld, Ohio
8
Jackson, Mich
Siee'ton, Fa
Kalamazoo, Mich.
1
Steuben ville . Ohio
Lanca^ster, Fa
Stockton, Cal
1
LexinKtoQ, Ky
3
1
1
8
Wirhitft, Kmi« ....
1
Lincoln, Nebr
Worcester, Mass
5
Long Beach, CaJ
York, Pa
Los Angeles, Cal
POLIOMYELITIS (INFANTILE PARALYSIS).
DUnois.
During the week ended December 8, 1917, new cases of polio-
myelitis were notified in Illinois, as follows: Henderson, Pike, and
Vermilion Counties, one each; Stephenson County, two; Cook Coimty
two, both in Chicago.
State Reports for October and November, 1917.
Place.
New cases
reported.
Place.
Newcaeos
reported.
Indiana (Oct. 1-31):
Johnson County
4
4
1
2
1
Massachusetts (Nov. 1 30):
BerVshire County—
Cheshiro (town)
Lake County
1
Marion County
Bristol County-
Somerset (town)
Tippecanoe County
1
\'ermllion County
Essex County
Lynn
Washington County
2
Hampdwn County—
Ludlow (town)
Total
13
1
Sprlngficia
1
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December 14, 1017
2130
POLIOMYELITIS (INFANTILE PARALYSIS)- Continued.
State Reports for October and November, 1^17— Continued.
Place.
Massac^rsrtt*^— '^ont Inued.
Middlesex County—
lo.voll
Norfolk County—
NenHlhain (town)...
Buff oil County-
Boston
Total
South PaVota ('"ct. 1-31):
Clay County
FaiilV (AMMity
Trip|) C(»uiny
Turner Cot uity
Union Couuty
Total
Vin!fnla(^ct. 1-31):
Au-zusta County
BucWln^hain County...
Culpcper County
New rases
ropoTKni.
Place.
Newf
10
Virginia -Co- tinned.
Pitn^Iddle County..
Nelson County
rraiM?cCoanly
- TftA" weJ I County. . . .
Warren Cotinty—
Front Ro)al....
Total
Wa^hin^ton (<^ct. 1-31):
KJni County—
Heaulc
Bpolome County—
Chenv
Sjjok.uiP
8t«veju County -
Col ille
Whitman County—
Colfax
Total
atjr Reports for Week Ended Not. 24» 1917.
Place.
Cases.
Deaths.
Pollipphnm Wash
1
Vfi^li n Mas'!
Pu'-alo. N. Y
C} if- I'M 111
4
Ci»»r'ni''ll Of io
Ilartli»rd,Conu
1
Place.
CasM.
I>«tta
Milwaukee, Wis
1
1
4
Ni'vurl ,N. J
• •*.
N>"- Yrn-- .N.Y
I'l-il ^li'li r ii. Pa
s
1
Pittsburgh, la
1
1
RABIES IN MAN.
aty Reports for Week Ended Nor. 24, 1917.
Durinj]^ the weok ended November 24, 1917, one fatal CAse of rabies
in man was reported in Nashville, Tcnn.; and one death from rabiee
in man was reportetl in Pittsburgh, Pa.
RABIES IN ANIMALS.
Alabama.
During the week ended December 1, 1917, five positive casee of
rabies in animals were reported in Alabama, as follows: One case
each in Colbert, Elmore, Montgomery, Morgan, and Shelby Counties.
aty Reports for Week Ended Nor. 24, 1917.
During the week ended November 24, 1917, two cases of rabies in
animals were reported in Eansa.s City, Mo. ; and one case was rq>ortod
in Newark, N. J,
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and luborculoeis, page 2135.
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2131
December 14, 1017
SMALLPOX.
Connectical— Bridgeport.
On December 11, 1917, the occurrence of one case of smallpox was
reported at Bridgeport, Conn., in an employee of the Remington
Arms Co. All contacts have been isolated and all exposed persons
vaccinated.
Marytand.
During the period from November 26 to December 10, 1917, cases
of smallpox were notified in the State of Maryland as follows:
Baltimore city, 10; Allegany Coimty, Cumberland 1, near Cumber-
land 5; Garrett County, Avilton 9, Grantsville 5. One death from
smallpox was reported at Westernport, Allegany Coimty.
New Jersey — ^Jersey City — Correction.
The report of two cases of smallpox in Jersey City, N. J., published
in the Public Health Reports of November 23, 1917, page 1977, was
an error, no case of the disease having occurred in the city during the
week ended November 3, 1917.
Ohio — Akron.
December 10, 1917, the health oflSicer of Akron, Ohio, reported
cases of smallpox notified in Akron as follows: Week ended November
17, 11; November 24, 25; December 1, 28; December 8, 5.
Miscellaneous State Reports.
Place.
Caios,
Dtatlw.
riaix.
CmsKm.
DhlIIis.
Indiana {Oct. Kll):
AcUkiiif T'ouiily . ,... .. *-■
13
10
31
Bouft] nalci^t-i Conlfnucd.
Minnchalia roTinlT
Wal wort li Couj^ty ........
Zif bnf h C^ounty ..........
11
1
3
Allen f'oijotv ^,.^>.,,-,.
Bf n ton Coiiiit y . . - , ....
Total ..
Clay County ,
'JK
........
Dekalb Ciiunt^
Virginia (Oct. Kill;
ADcomnc Coiinty . .**....
Arahcrt <'mmty
F&iint^l n ViiVn ij....
1
Z
2
1
OunlSngton Cciunly...—
Ja^ €ouniy. ..„...„
■--■"-
ImiRsO'jx County*., * - * ..,.---
Knox County.,, ...,*.* ..-
rheidprflcliL.,...
Gravson t'*}unty. . . .*.....
Law rencis Cotmty .. „.*,.*
Hiull^ti CdimtT. . , . - . .
Eoanokif County—
Koanolie. ............
Marion County < .......,«
25' .-..-,._,
MonTOCi CoiiiiL¥ - . * *._ ,
Wis* < ounty—
BigStonij Cap,
ToUL...
Wasbln^too f Oct, 1^1):
KLnjf * ounty ^
S^attk ,
Fend ' ri*Ui$ Fount y
Fltf€Oi oiint? . ........
Snohomish ^ burnt y —
Ivrriftt,
PttW V tkl Ullt V* .^*.*.
•!
Bhelby C^rmnly , ,
'-**""-'
TippecftfWJo County. .- . , . ,
Vaaderburg Cotmty.. _ * . .
» 1
Vigo County....- „J
1
1
li
1
' =
Total... ,.,
223 !
South Dakota (Oct. l-31)j 1
Aurora CoiULtv
1
2
13
1
1
I
^
Clark County...*.
epOliatiB I ountj—
!-l)o'i anc. ...........
•'*■
Cla V Count v . . . . .
1
Faulb Cfluiily.,*^....*,*^
Vaklmai dunty—
Mablon.... ...........
nnmli n C-fiiin Ij ^ ^ - , ,
^K
Kingsbury County.
Totai.,*.. .....
A'
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December 14. 1917 2132
SMALLPOX—Continuod.
City Reports for Week Ended Not. 24, 1917.
Plnoe.
Alton, ni
Ann Arbor, Mich....
Austin, Tex
Brltc, Mont
Cairo, 111
CHcago, m
Cincinnati, OMo.....
Cleveland, Ohio
Columbns, Ohio
Cumberland. Md
Dayton, Ohio
Denver, Colo
Detroit, Mich
Evans-villc, Ind
Flint, Mich
Fort Worth, Tex....
Grand Rapids, Micb.
Harri'H)urE. Pa
Indianapolis, Ind
Johnjstown, Fa
Kansas ( ity. Kins. .
Kansas ( ity. Mo....
l>a( rosse, Nvis
Leavenworth, Kans.
Cases.
Deaths.
Flsee.
Uneoln, Kebr
Lorain, Ohio
Momphis, Tenn
Milwaukee. W'n
Minneapoll'?, Minn
yiagara Falls, N.Y....
Oklahoma* itjr, Okla...
Omaha, Kebr
Phlladelphis. Pft
Pitf^bureh, Pa
Pontiao, Mlcb
Portland, Mc
Q«lncy, lU
St. Joseph, Mo
St. Lot is, Mo
St. Pari, Minn
Salt Ltt'-clity, UtAh...
Sioux ( Ity, lowm
Srrinjfftekl, OLio
Sniw^rior, Wis
ToKnIo, Ohio
T<>i •' a, Kans
Wlieiling, W. Va.
TETANUS,
City Reports for Week Ended Not. 24, 1917.
Pbot.
CMet.
Deaths. | Ptoet.
cw«.
v,^
Berlin, N.H
1 1 yowYork, N. Y
1
Chicago, 111
1 '■ ]'; ilrtWIphia, Pa
1
a
Cle\eland, Ohio
2
1
3 II RfW-m'HtiT, K. Y
W Uoiingloo, Del
. ••••..••
Long Uoach, ( al
1
liemphlSi Tnm
TUBERCULOSIS.
8ee Diphtheria, moaales, scarlet fever, and tuberculosis, p«^ 813(.
TYPHOID FEVER.
State Reports for October and NoTember, 1917.
Indiana (Oct. 1-31):
Allon Coiinfy
bUickford Coijnty.
Brown County
Carroll County
( ,iss Omnty
Cluk CouiUy
Cl:iy County.
Clinton County...
Cr I \ f<»r*l ♦ptTitT..
lV.\ir • Cm wy...
I i V HUI ( 'fuit v...
TrkiH. C..rfv...
1% llU, <^' « ,, t.tV..
T":l o.rn-t ^.,.,
i )l.hJiI to ji tv...
^ . .It ( .. 'My...
1 ;
11
I
1
2
.{
, Indlint— <'nntlnaed.
j Foun lain County...
I Ciil*»on I'ounty
Grant County ,
I On>»'ne Coimty ,
t H-umlton Coiuity . .
H inrock County. . . .
I Hiirrlaon County
Ht nMrioks County..
Huw ird County. .,.,
Hi I iit.rton County,
Jr.. >--<H' County
Ja Co .nt\ ,
J'-.rl (ivmly...
J li ■ < «' .<tv
K( 1 1 'orounty..
l.ii. ii> 1 I
I aporlr I o ifily . ..
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2133
December 14, 191fj
TYPHOID FEVER— Continued.
State Reports for October and November, 1917-~Ck>ntinued.
Place.
New cases
reported.
Place.
Indiana— Continned .
1 awrenoe County.
Marion County —
Marshall County..
Martin County
Miami County.
Monroe County
Montgomery County .
Owen County
Parke County
Perry County
Posey County
Putnam County
Rush County
Bhelby County
6t. Joseph County....
Sullivan County
Switzerland County..
Tippecanoe County . .
Tipton County
VanderbuTK County..
Vermilioij County
Vipo County
Wabash County
Warren Count v
Warrick Coimty
Washin^non Coimty..
Wavno County
Wells Cor ty
White County
Total..
Massochasetts (Nov. 1-30):
Berkshire County-
Adams (town)
North Adams ,
Pitt^field
Bristol County-
Fall River
New Bedford
Essex Coimty—
Haverhill
Lawrence
Lynn
Hampden County—
Efast Lonemeadow (town).
. Lonrmeadow (town)
Ludlow (town)
Springfield
Middlesex County-
Arlington (town)
Cambridge
Everett
Lowell
Maiden
Newton
Somerville
Wakefield (town)
Wobum
Norfolk County-
Avon (town)
Wellesley (town)
Plymouth County—
Abihgton (town)
Wareham (town)
Suffolk County-
Chelsea
Boston
Revere
Worcester County—
Athol (town)
Blackstonc (town)
Gardner (town)
Milford (town)
Norlhboroiirh (town)
Warren (town)
Worcester
266
2
4
3
SI
5
1
a
4
1
1
1
12
2
2
2
2
1
3
3
1
1
1
1
1
2
1
17
1
1
1
2
1
1
1
6
South Dakota (Oct. 1-31):
Charles Mix County. . .
Codington County ....
Davison County
Day County
Deuel County
Faulk County
Hand County
Jackson County
Jerauld County
Fingsbury Coimty
IfQnnehaha County
Robert? County
Spink County
Tripp Conntv
Walworth CJounty
Total.
Virginia (Oct. 1-31):
Accomac'O'nty...
Accomac
Blo^om
Chlncoteagiie...
Albemarle to! nty.
Alleghany ( ounty..
lowmoor.
ToUl.
121
An>clia< ON'nty
A ppomattox ro'nty
Augusta^ ounty
Bclforl f'ointy
Bland County
Boteto'Tt County
Buc'ianan
BrunswicV o^nty
Lawrence iUe
Buchanan ( o nty
BucVlngbam ('ounty
Campbell ' ornty
Brookneal
Lynchbnrg
Caroline County
Carroll Coimty
Charlotte County
Culpeper County
DicJcmson County
Dinwiddle Coi nty
Essex County
Fairfax County
Fauquier County
Floyd County
Franklin County
Giles County
Grayson County
Greene Coimty
Greenesville ( oimty—
Vortb Emporia
Halifax Coimty
Hanover County
Henrico County
Isle of Wight (V nty
James rity Coimty
Wtlliamsb''rg
King and Q"een c ounty . .
Lancaster County
Lee ( ounty
Madison * O' nty
Mathews Coimty
Mecklenburg CO' nty
Montgomerv Co' nty
Nansemond County
Suffolk
Kelson Coi nty
Northampton Co^ nt v
Kort'iumberland < o nty..
Nottoway '■ o nty
r lac' stone
OranRe o nty
Pago Coi nty—
Shenandoah
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Pccombor 14, 1917
2134
TYPHOID FEVER -Continued.
State Reports for October and November, 1917— Continued.
Place.
V Irp in Li— €ont inuod.
l'itt«?ylvftnia< o»'nty....
afehooJft«W
Prince Fdwanl Coi'Hty.
Princes (irorxe Cocmty...
i ity P«iint
Honewell
Princo William rwnty .
Pi'IobH < ouiHy
RoanoVeroonty
Roanoke
SfU«m
Roc^bridffp * or nty
Bi'rrm VWa
RocHnj!>>am ( wnty. . . .
HftiTi'^oTib' rg
Rtis.*i«ll< ounty
Panti-
HcnaVor
Scott ( ointy
GnX^i ity
Shenandoah f ot nt y
Smyth ( o«nly
Sftltvilk
Boi- tbamiMon i win' y ...
Stafford < ©"iity
Surrr (Wnly
Dendroo
TfltewHl < ounty
Graham
Pocahontas
Warreti ( wnt y
Warwick < ounty
WasMnirtnn County —
l>an>a*cti«
Westmoreland County . .
WIso Coinity
Korton
Big Stone Gap
WytbeCmnty
Total..
Woshlntfton (Oct. 1-31):
Adams Coonty—
LInd
Rcnton Comity—
Chelan Connty.,
CasfttDcre. . ,
Wcnatcbce.,
Now c.ksea
reported.
326
Wash higtoB— Ooatinned.
Columbia Cotmty
Dayton
Doiurtati County
Bridcvport
Prank iin C^ouuty—
PaJico
(iraya Harbor Comity—
Aberdeen
CoamopoMt.
Kinij Comity—
Beattle
K it titaa Canity
Ellensburr
KlickiUt Co!mty
LInro'n Coimty
Spraifuc ,
Okann^nn County—
Prewster ,
Omok
Ok-anonm
Paciflo Coontv—
Raymond.
Pierre (oimty
f^nmrier
Skm it Cewrnty—
* nsf'Oftcs
Motmt Vernon ....
Snoh6mish CooDty —
Kdmonds
Kverrtt
flpoVnno County —
Latah
Spofrane
Steven"? County
^'"*^^"^:aiii:
Thrir^on (*ounty
WuhViaHira County..
>\\. la Wftlln County..
Walla Waffa
Wli:jitom County
PHIhirhnm ,
Whllmnn County .... .
Kndfertt
P"iliinn
VaklmatViunly
(Iran^er
North YaWma....
Total.
City BeporU for Week Ended Nor. 24. IfH.
Pteoe.
AUnnv. N. Y
AI)«nlo\\-n, Po-
Ann Ubor, Mich
Au>fin. Tot
R.iititiiore, Md
litt.iM ham, W.ish....
Pirn i: ;him, Ala
P«. •..•1, Mx<w
lUi.l . ••ort.Coon
Hu'U\ ', N. Y
Cu.-.., Ill
Ciuiil>rii|pe. Mass
Cutii'I n. N. J
Chifk-um. rt.C
Chi. i.'u. Ill
C|o\».|;iiid, Ohio
Cotleyvillc, Kans
Cases. *
Deaths. !
Place.
I>enver, Colo
' ivtrolt. Itich
' Kd^t ( hlcafo, Ind
I Kliial>eth,N. J
. KI I'aso, TPX
Krli>, I'a
K\.iriKvine, Ind
Fall Ui^er. Maw
Kliiii. Mich
1 Fort Worth, Tex
[ (;:il«>sl»nrv, III
'I (;rjn.lKuplds, Mich..
[ llu't r>t(m'n, Md
( HarrLshiirr. Pa
' llirtford. Conn
' Hax'-rhill, Ma-«
Ilohokm, N. J
DcuhL
10
2
2
2
$
4
a
ft
I
a
1
4
1
I
Digitized by
Google
2135
December 14, 1917
TYPHOID FEVER— Continued.
City Reports for Week Ended Nov. 24, 1917— Continued.
Place.
Cas€s.
Deaths.
Pteoe.
Cases.
Deaths.
iBdIuispoQs.Ind.
Johnstown, Pa
Kansa»City, Rons
Kdramo, Ind
Lexhiirlou^ Ky
Lorain, Ohio
Los Amreles, Cal
Lyim, Mass
kemphls, Tenn
Ifinneapolts, Mfam.
Mobile. Ala
Nashville, Term
Newark. N.J
New Bedford, Mass.
New BritaliuConn
New Cast e, Pa
New Hav en, Conn
New Orleans. La
NewYork,N.Y
Norlolfr, Va
Norrlatown, Pa '
North Adams Mass
OJrlahonia ("ity, OUa-
Philadelphia, Pa
Pittsbarrh, Pa
Pittsfeld. Mass
Pontlac, Mirh
Portland, Oreg
Providence. R. I
Richmond, Va
RocMord, ID
Rock Island, 111
Rocky Mount, N.C...
Rutland, Vt ,
Sacramento, Cal
Saeinaw, Mich ,
8t. Joaeph, Mo
St. Louis, Mo.
Salt Lake City, Utah..
8anDte?o,Cal
San Francisco, Cal
Savannah, Qa
Schenectady, N. Y
Seattle, Wash ,
Snrlnefleld, Ma«a ,
Sprlncfleld, Ohio ,
Stoubenvillo, Ohio
Terre Haute, Ind
Toledo, Ohio ,
Trenton, N.J ,
Troy,N.Y
Washin-ton, D. C
Washin* ton, Pa
Watertown. N. Y ,
Wheelhir, W. Va
Wichita, Kans
Wllroin too, Del
Winston-Salcra, N. C.
Worcester, Mass
TYPHUS FEVER.
Ken tacky — ^LouisYille.
On December 11, 1917, one case of typhus fever of mild type was
reported in Louisville, Ky.
DH'irrHERIA, MEASLES, SCARLET FEVER, AND TUBStCULOSIS.
State Reports for October aad Nofembw, I9I7.
CttHf reported.
State.
Diph-
theria.
Ifeasles.
Scarlet
fever.
State.
Diph-
theria.
Meaalfls.
Scarlet
flBver.
Indiana (Oct. 1-31).
Hasaacbusetta
(Nov. 1-30)
Sooth Dakota (Oct.
1-ai)
788
i.m
8
58
1,333
39
371
687
76
VirRnila(Oct.l-31).
Washfa^ton (Oet.
1-31)_
281
42
m
35
104
M
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DeccmlKT 14. 11)17
•-^15t)
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS-
Continuetl.
City Report? for Week Ended Nov. 24, 1917.
Poptila-
tion as of
Julyl.fno:
(estimated
by C.S.
Census
Bureau).
.^W,f2l
75*5.476
2,497,722
674,073
671,784
50?, 812
5,602, «41
l,70!>,fl8
679,090
757,309
468, .Wi
410,476
306,345
4y>,.'V^5
3C3,4f^
408, S94
371,747
463,510
34«<,r39
363,9i«
214,878
2«o,sno
271,708
297. H47
295,463
254,900
25f..4l7
247,232
104,199
190, .V,s
l«l.7»'2
121,579
112.9*^1
10i.2U
127,224
IJ^.-VV',
ioi..vr2
12^,291
no,'>»W)
100,,V,0
lit. 245
102,425
14H,905
117.a'>7
lis,i:iH
149. ♦vs.',
19S.MH
165. 470
i(y>..>i
i:''».'i^7
117 i*»<)
\u'-,\>i2
IV. »24
112.770
191.154
111. :m
m,M\
m K* ;
57,'; <
r:-. ":\
117. 41' ♦
♦i*t, 7-^1
57,144
Total
deaths
from
all
causes.
' '216'
615
1T8
103
123
1,417
513
189
188
116
124
66
86
" "iio'
48
118
63
51
77'
46
80
75
58
3.^
30
4i'
10
.32
28
44
29
38
17
54
43
34
3fi'
38
40
45
24
;w
41
60"
41
4'J
l»
0
II
bi
2*.
21
Diphtheria.
Measles.
8earlet
(ever.
TntwT.
City.
1
1
1
1
1
1
i
xz
OT«r SOO.Ono inbft^Uants:
Rft'timore Ifd
26
107
3»4
60
90
14
278
«6
39
19
21
23
21
8
30
21
33
15
4
71
9
17
48
6
2
13
14
21
7
4
11
16
8
6
1
4
14
2
4
5
19
2
4
I
4
11
12
6
14
19
0
10
17
12
n
'"h
2
3
2
5
3
2
8
27
4
7
'»*
U
6
3
3
3
3
'**4'
......
1
2
......
......
1
2
1
......
1
......
14
55
49
2
45
5
TV,
90
88
15
7
5
13
36
6
19
6
11
13
40
4
2
5
8
"I'o*
3
" "s'
26
30
6
3
1
" 'i'
......
1«
107
17
51
7
1T7
41
13
4C
11
8
. 7
34
6
6
5
28
31
13
15
8
4
15
28
5
1
......
1
"'i'
... ..
'*'*i'
18
m
64 ! n
Chicago, III
ys «
Cle' e'and, Ohio
r . B
Detroit Mich
36 n
I «^ An^ ©5 f'fti •••••••••••
.'1 ts
NewYork. N. Y
Phi'adelnlila. Pa
4tH 141
8D ■ m
Pittnbiinrh I'a.
36 ' «
8t Lath, Mo
44 M
From 300,000 to 500,000 Inhabit-
ants:
Biifhio N Y
14
14
Cinrinnati. Ohio
w
Jersey ritv, N.J
MUwaiikee.Wh
9
4
MinneaDo'is. Minn
Newark, N.J
New Or eans, La
.....
r
U
99
Pan Franrlsro. t'al
y a
Seattle. Wash
1} ' %
Washlncton. D. ('
From 20^000 to 300.000 Inhoblt-
anU:
Coliunbus. Ohio
n, .
1
« 4
Denver. Colo
4
Indianapo'ls. Ind
11
Kansas rit". Mo
4 4
Portland, Ores:
3 , h
Pro\idonre. U. I
Rochester. N. Y
8t. Paul, Minn
V 9
fc 4
30 If
From 100,000 to 200,000 inhabit-
anL««:
Albanv,N. Y
Atlanta. Oa
«':'■•;'
3 • a
Birmingham, Ala
9
3
4
5
7
3
4
Brid^port, Conn
:
Cam brid«e. Mass
Camden, N.J
l>a\ Ion, Oliio
6
II 1
Kali River. Ma'is
} > i ^ ' i
Fort Worth. Tex
"l
»
7 ' 1 1 1
<;rand RanicH. Mich
Hartford, Conn
7 1 ft •
Lawrence, Mav^
6 %
Lowell.MoJis
1
3
4
8 3
I.yim, Mass
.
r I
Memphis, Tenn
......
1
7
6
6
3
2
3 t " 1 IT . 7
Na'<h\illo. Tenn
J!::::::
7
3I
1 51
3* ...
2 -
4 '. -
3 4
Now Bedford, M.1SS
H ft
Now Ha\cti. ( onn
7 1
OaKJ iiid. « il
6
O'Ti i' i. Vol r
34 S
I:- .d.nkv \\x
•I *
St I 1 :i' .• « It . Ct.»ll
......
58
2
15
39
1 3
3
1
Si !.n • «'M. M'lss
S-r.irt; e. N Y
1 If <.ii. I. Wu^h
"" r
13
12
2
3
7
1 ..:<><!<». (>»'i()
1
4
4'..:::
1 '
2 ... .
3'..
4
TMiituri. X. J
ft 3
n\ 3
,1
\\ f»r«f lor. Mt^*^
Froii ;^),uio to I(«),000 Inhablt-
aiil^:
\llonlow-ii V,\
1
1
3
Al'ar.tK ( Il ,, .N'. J
H.r (i!ino. N. )
2
.... :::
3
I .
» 1
t
}Urkc v\.l il
IliM-' milon. N. Y
llrix ktoi). Nt ivs
3
2
1
3 . ..
4
3
('nnlon, Ohio
2 ' 4 I
Ch irk t(,n. .<. C
3 .. 1 »
Covin,;! n, Ky
1
1' 1
Die
jitized 1:
DyG
00^
2137
December 14, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS--
Continued.
aty Reports for Week Ended Nov. 24, 1917— Continued.
t inu a^ of
July r.lgjB
(■^iUroat*d
by U.3,
foasua
Bureau).
Talal
dratha
froftj
ull
causes.
pipblheriA.
Mi'aslea.
Scarlet
lever.
Tuber-
culosfs.
city.
i
1
1
1
1
1
i
1
From 50.(100 to 100,000 inhabit-
ants—Cotitiiiiii>d .
Duluth, Xinn
W,4m
6.1, 7{1*
7BhC7H
72,iH5
T7.2N
S©, 437
m;m
51,155
5«,22I
6;i,7ft4
?«,m2
fia,W3
71,744
£tl,4tl
ai,ve7
65,fi42
ft«/tt5
57,07S
«7,0aB
75.776
1M,3ft5
27,7^
S4,M4
^.m
32,^0
4.x 4 55
4tK 193
2*!, 074
afi,74i
42,458
3^1. 4fifi
4i,:*ij
41,863
20,353
25,679
4H,477
35,363
iH,hiVi
31,576
26,771
3K, liTO
31.677
4I.()97
35.iS4
4<i. ->15
27, 5S7
36,964
W
20
21
7
31
16
u
S5
10
"n
IV
in
e
14
as
10
5
2
9
6
10
17
2
1
a
3
3
11
7
«
7
«
3
13
13
3
T
6
1
i
8
1
4
1
I
1
Flirabeth, N. J
i
ElPaao. Tex
5
Erie, Pa
I
■-- -
2
I
"*--
11
%
@
Evansville, Ind......
3
2
Flint, Mich
Barriflburc. Pa
S
a
HoboVen.N.j
j i
Johnstown, Pa
-'"-
4
Kansas ritv, Kans
"***'*
**'*
Lnn&ister, Fa
"
Maiden, Mtwia
^,*.--
17,
a
5
a
a
Manchester, N.H
Mobile, >la
1
3
New Mritain, Cann
1
5
4
7
T
3
1
3
Norfolk. Va
u
3
OUahoma < Uy, Okla
Pa^siiic.N.J
1
1
3
Pawtiic' ct, R. I
Portland, Me
104
1
4
Roc' ford. Ill
1
0
I
1
8
t
1
Sacramento, Ca\
3
4
g
4
9
1
6
fiaglntw. Mich
I
St. Joseph, Mo
El
1:
1 1
7
2
1
3
4
i
1
San Di.^po, Cal
S
Savannah, (U
i
Fchcu( ct.iUy. N. Y
Sioux ( itv, fowa
t
10
3
Soincrvillr. y^ss
14
l»
10
SL
SI
1
IS
9
IS
s
0
9
' " *l
t
3
South l?cnd. Tnd
'"""
3
3
8|ningf'eld,lU
1
1
1
*■ *
1
a
s
4
3
SpriiiK'-okl. Ohio
3
Tcrrc Hauto, Ind.
4 \
3
3
6
4
6
1
1
3
Troy.N. Y
4
3
1
3
a
I
&
WichlU. Kans
1
Wiltcs-r^arrc, Pa
«!
Wihnlngton, bel
1
York, Pa....
1
From 25,000 to 60.000 inhablt-
SDtB:
Alameda. Cal
3
Au5tln.Tex
1
BelUneham, Wash
; 1
Broo^Une, Mass
1
4
4
u
1
Butler, Pa
Butto, Mont
3
7
1 a
1
'
•
a
ChcL»ca, Mass
12
2
9
4
S
7
6
12
14
io'
17
IS
12
10
7
1
1
1
1
Chioopec. Mass
1
CumUrland, Md
**
a
1
Danville, 111
"
1
3
1
Davenport, Iowa
'"I'l
Dubuuue, Iowa
East Chicago, Ind.
I
44 1
1
East Orange, N.J
1
t
1
1
Elgin, 111....
1
1
4
3
Everett, Ma£s
1
10 i
1
I
3
Everett) Wash
Fltchburg, Mass
I
2
1
1
s
Galvceton. Tcv
1
2
^. ..
1
Green Bay, Wis
Hajrcrstown, Md
1
1
12
1
11
Uavcrlull, Mass
*
1
9
' i'
3
5
2
Jackson, Mich
1
3
8
Kalamatoo. Mich
..
I 12
2 ! 1
3
Kenosha, Wis
Kingston, N. V
1
Knoxvillc, Tenn
8
1
1
1
5
1
2
1
La Crosse, Wis
10
18
8
'.'.'.'I.
1
1
1
Lexington, Ky
V)
1
1
Lima, Ohio
7
2
Lincoln, Ncbr
1
Long Beach, Cal
3
Lorfln,Ohlo
4
3
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DecemlxT 14, lOll
2138
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBESCUU^IS>
Cootinued.
City Reports for Week Ended Not. 24, 1917-
-Continued.
Popula-
tion as of
July 1,1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
from
all
causes.
Diphtheria.
Measles.
Scartet 1 T <
fever. I c^-
City.
1
s
1
i
1
1
'1 \i
From 2.SO0O to 60,000 inhabit-
ants— ontlnued.
LvncNburg, Va..... -
32,940
47. 521
2^.2*4
2«,'*i«*
2 ','27
29,»0.1
41, r3
31, '27
30,10^
43,715
37, -^^5-?
31,401
3.^0^
4«,450
41,1«5
3K,*'29
39,051
3rt,79H
38,1^
46,4«*6
4'',2^^4
2H,«^2fi
38,902
2 ',445
35, -^58
46,226
3fi,2^
4R, :26
80,570
29,S94
43, 139
43,377
33,809
29,892
31,155
30,863
22,S74
15,010
13,699
21,085
15,794
» 13,075
17,548
22,669
24,276
23.539
20,930
» 19,363
15,395
1 14,610
17,445
13,284
23,126
15,243
20,985
» 22,019
19,926
23, S05
17,r>2t
11,066
12,067
14,s:ji
20,193
13,S21
21,204
15.548
21,618
2i,228
15,969
13
21
11
6
0
4
7'
4
S
11
6
12
9
10
7
3
6
8*
11
5
1
Mjc'soo-jport. Pa
5
3
......
1
2
Mcdf'tril, Mas;?
1
1
M'^Tilrlair N.J
NaslMTa. N. H
7
1
2
1
3
3
3
...' . .
Ne^vburph.N.Y
25
1. .. .
New ' aslle, I*a
NewDort Kv
""l .....
Newport, R. I
Ne\it"n, Mass
1
"i
Niapara Falls, N. Y
1
1 '
Norristown, Pa........
Oranec, N.J
3
1
t i
Pasadena, <' al
Perth j^rabov. N.J
1
1* " "
: r*-' '
Pitts'^cld. Mass
i
1
Portsmouth, Va.
2
7
3
......
1
f
Qiiincy. ill
;::.'::j '
1 '"
Quincv, Mass
3
1
1
1
Racine, Wis
Roanoke, Va
a
....
Roc'v Island. Ill
••"•il
Pan Jose, ' a)
2 1 1' V
Steiil)cnvllle, Ohio
11
72
13
14
6*
I
4
15
io*
10
10
10
14
6
6*
2
1
1
4
4
1
1
4;" •
Stnc' ton, < al
Fupcrior, Wis
Taunton , Mass
1
2
1
1
1
1
1
Toroi a, Kans
r
Waltham, Mass
Watertown. N. Y
1
1
4 '
West Hoboken, N.J
Wbeoling, W. Va
""6
1
1
......
1
i
1
WllUamsiwrt. Pa
l
1
5
1
i
Wilmington, N.C
. ....
Wlnston-vSalem, N. C
Zanesville, Ohio
12
From 10,000 to 25,000 Inhabit-
ants:
Alton. Ill
2
6
......
......
3
1
! ^
Ann Arbor, Mich
- ,
Berlin, N.il
Braddock, Pa
2
1
Cairo, 111
3 i
Clinton, Mass
CofTeyvtlle, Kans
1
4
. .... ..
Concord, N. H
9
5
6
6
6
1
5
7
3
7
8
8
4
11
7
9
2
1
1
J!
Galesbiu-g. Ill
2
25
Kearnv, N. J
3 \""a\'..
Kokoino, Ind
....:.: ! *l
I^eaveuworth, Kans ,
1
1
1
.......
Lonp Branch, N.J
Marinette, Wis
1 .
(
Melrose, Mass
1
1 1
Morristown, N. J
Nanticoko, Pa
2 .
Newburvport, Mass
3
2
1
1
...
New I.onaon, Conn
2
S
I
North Adams, Mass
Norlbampton, Mass
1
4
1
1 .
{
PbinOeld.N.J
2
2
Pontiac, Mich
1
6 .
8 .
I
Porti>mouth,N. H
Rockv Mount, N. C
6
4
5
3
2'
Rutland, Vt
1
Sanduskv. Ohio
3
1
Saratoea Springs, N. Y
South Bethlehem, Pa
1
8
Stcclton. Pa
1 ..
3 ..
1 .,
Wa'^hington, Pa
Wilkinsburg, Pa
5
4
1
Wobum, Mass
.
1
1 Population Apr. 15, 1910; no estimate
Digitized by VjOOQIC
FOREIGN.
CHINA.
Ezaminatton of Rate — Shanghai.
During the four weeks ended October 13, 1917, 888 rats were
examined at Shanghai. No plague infection was foimd. The last
plague-infected jat at Shanghai was reported found May 6, 1916.
CUBA.
CommuHieable Diseases — Habana.
Communicable diseases have- been notified at Habana as follows:
Nov. 1-10, 1W7.
Remaining
under
treatment
Nov. 10,
1917.
Dlseuo.
Nov. 1-10, 1917.
Remaining
under
Disease.
New
cases.
Deaths.
New
caset.
Deaths.
treatment
Nov. 10,
1917.
Dipbthoiia
8
4
10
45
1
Paratyphoid fever. .
Smallpox
3
1
28
1
8*
3
1
Malaria
27
Typhoid fever
93
Measles
NORWAY.
Leprosy— 1910, and 1911-1915.
At the close of the year 1910, 326 lepers were reported present in
Norway, 203 of these being domiciled in hospitals and 123 outside of
hospitals. The disease was reported from 76 communes. During
the period 1911-1915, leprosy made its appearance in 20 communes
and disappeared in 38. The total nimiber of new cases notified
during the period 1911-1915 was 51. At the close of the year 1916,
235 cases of leprosy were known to exist in the kingdom, 146 being
domiciled in hospitals and 89 outside of hospitals. Of the total num-
ber, 68 were affected with the tuberculous form of the disease, 160
with the anesthetic, and 7 with the mixed form.
TURKEY IN ASU.
PlBgue— Trebizosd.
Plague was reported present at Trebizond, Turkey in Asia, Decem-
ber 8, 1917.
(2139)
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Google
December 14, 1917
2140
CHOLERA, PLAGUE, SMALLPOX. TYPHUS FEVER^ AND YELLOW mil
Reports Received During the Week Ended Dec 14. 1917.>
CHOLERA.
Place.
Date.
Cases.
Deaths.
Bemarb.
India:
Rangoon
JuTW 3-9. 1917: Casa, I
PhUIprlnc Islands:
Provinces
17-», 1917: Cases, J: d2wi
Oct. 14-20, 1917: Csss, ;
^nti'iro
Oct. 14-20
31
22
CO
15
8
59
15
19
21
14
5
5
34
6
deaths, 101.
Bohol
do
Ceh'i
do
Ilollo
... .do
Mindanao
do
r'e(?ros Oci'l lontal
do
?*ecro-« Orient al
do
Provinces
Oct. 21-27, 1917; 0»fe S
Antinne
Oct. 21-27
15
18
4
45
41
... 43
12
13
deaths, 82.
Bohol
. . .do
Cebii
do
Mindanao
.. .do
27
22
8
Ne^ros Occidental
do
Negros Oriental
-do-
plague;.
Brazil:
rernambaco
Sept. 16-30
2
Egypt
Jan. l-Oct. 18, 1917: Ctse
Alexandria
Oct. 12-15
2
1
1
1
deaths, 397.
Suez
Oct. 14-16
India:
Rangoon
June »-9, 1917: Cases, 2S; is
June 17-23, 1917: Ct»
deaths, 26.
Present.
Turkey In Asia:
Trebizond
Dec. 8
SMALLPOX.
Australia:
Now vSouth Wales. .
Abermain ,
Warren
Braill:
Bahia ,
R lode Janeiro.....
China:
Mukden
Shanghai ,
Cuba:
Ilabana
India:
Hangoon
Indo-China:
Saigon
Moxino.
Mexico City
Philipf»i!ie Islands:
Manila
PortUK'al:
I isbon
Spain:
Seville
Union of South Africa:
Johannesburg
Do
Oct. 12-25.
Oct. 12-13.
Sept. 30-Oct. 13.
Sept. 23-29
Oct. 21-27.
Oct. 22-28.
Dec. 5..
Oct. 15-21
Oct. 28-Nov. 10.
Oct. 14-20
Oct. 28-Nov. 3..
Sept. 1-30
Aug. 1-31..
Sept. 1-30.
1
102
Oct. 12-25, 1917: Cases, 5.
Near Newcastle.
Present. _i,tit:
Cases among foreten p<«>ni^
deaths among Cbin^-
June 3-9, 1917: Cases, 2- ^^^
17-23, 1917: Cases, 7; o^'^*
Varioloid.
» From medical officers of the Public Health Service, American consuls, and other soorces.
Digitized by
Google
2141
December 14, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received During the Week Ended Dec. 14, 1917— Continued.
TYPHUS FEVER.
Place.
Date.
Cases.
Deaths.
Remarks.
China:
Tsingtao
Oct. 14-20
1
7
166
3
1
.
Japan:
Nai^asaki
Oct.»-Nov.4....
Oct.28-Nov. 10...
Oct. 14-27
Oct. 28-NOV.8....
2
Mexico:
Mexico City
Switzerland:
Basi'i
Zurich
YELLOW FEVEB.
Venezuela:
Coro...
Oct. 28-Nov. 7. . .
From the last part of July to Nov.
7, 1917, 10 cases reported.
Reports Received from June 30 to Dee. 7» 1917.
CHOLERA.
Place.
Date.
Cases. Deaths.
Remarks.
India:
Hassoln..
Bombay .
Do...
Calcutta..
Do...
Karachi..
Madras...
Mandalay.
i>o
Moulmein.
Pakokku..
Pegu
Do
Prome
Rangoon..,
Indo-China:
Pro.inces
Anam
Do
Cambodia
Do
Cochin-China..
Do
Laos
Tonkin
Do
Saigon
Do
Japan
Tokyo.
Java:
East Java...,
Do
Mid Java....
West Java..,
Bata^ia.
Do...
Apr I -May 5...
Jutieat-^i)
July ^SoiJi. 22....
Apr 20- June 3J
July I -Sept. 1..
Btpf. S>-2y
A{it 22-Jui]e30...
Julv l-SapL. 29...
May »vJuQe33...
JwlV 29- Aug. 25-.
May i:MitDe2...
Apr. St-May 5
M4V L?7 liJOeSJ..
Jul}- 1-7..
Juiv i^Aug. n..
Apr. 2l-JiiQe3J...
Jm]> H-E!t*pt.8..
Feb. 1-Jane30..
July 1-31
Feb. 1-Junc30..
July 1-31
Feb. 1-June30..
Juiy 1-31
June 1-3J
Fob. 1-Juno30..
Juiy 1-31
Apr. 23 -May 27..
Juiy 2-i3ept. 30. .
Sept. 12.
Apr. 2-^
July 9-26
JulylG-Oct.2..
Apr. 13-Ji]]y 6..
JulyO-Oct. U..
7
5
112
230
86
79
74
878
359
1
33
3
1C3
49
1
11
347
67
6
4
68
2
2
3
191
47
51
53
543
214
21
108
33
Jane 10-16, 1917: Cases, 1;
deaths, 1.
Feb. 1-June 30, 1917: Cases, 1,273;
deaths, 805. July 1-31, 1917:
Cases, 522; deaths, 314.
Jan.-July, 1917: Cases, 301. oo-
curringln 16 provinces ana dis-
tricts.
Sept. 12, 1917: Caws. 253. In 5
provinces and districts.
Apr. 13^uly 5, 1917: Cases, H;
deaths, 31. July 6-Cct. 11,
1917: (ksm, 601; deaths, 343.
Digitized by
Google
December 14, 1917
2142
CHOLERA^ PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received ft'om June 30 to Dec. 7, 1917— Continued.
CHOLERA-^ntlnued.
Place.
Date.
Cases.
Deaths.
Remarks.
PenU:
. lUranderwi Province—
Amir K.0IA
Feb. 3
1
4
4
11
1
3
19
1<9
Barfourouche
Jan. 15-17
July 28
Do
• 6
Demftvpnd . .......
July 2^
H&ni'fi Kelft ^..
Jan. 17
Maf^bidossar
Jan. 31
Sabzevar
Aug. 20 29
July2&-Aug.6....
14
98
Bar!
Tabriz
Aug. 4. 1917:InTlllare «r
Oftoundeh, vicinity d fabria,
about 7 cases daily.
Pblllnrlne Islands:
Manila
June 17-23
Aug. 6-26
1
4
Do
Sept. 9-8. 1917: 1 case. Not pr^
viouslT reported.
BUT 204une 30. 1917: ra.w«. 7«^
deaUis, 506. Jnlv l-Oct. IX
1917: Cases, 4,032, d«atlis,2,«St.
Provlnoes
i^K^tsan
Jiilyl* 28
12
113
73
2
26
77
I
3f.8
887
62
66
231
627
128
14
819
237
665
48
463
1
1
1
138
196
274
16
7
15
17
2
76
43
1
15
34
Albav
May 20 J line 30...
July 2 S«pt. 1
Jnne3 9
Do
Anibos c ama'^ino'* ....
Do
July 22 Aug. 11...
Feit. I6-0ct. 13...
July 8 14
Anti lie
Bataan
Baiangas.
June 17-23
Mav20 June 30...
July 1 Oct. 13
June 3 30
1
251
2^
40
46
KV)
3(9
78
5
512
117
310
27
299
Bohol
Do
Cariz
.
Do
July 1 Oct. C
June 2 30
Cebti
Do
July I Oct. 13
do
Hollo
I.cyie
June 10 30
Julv l-i^pt. 15....
July 8- An?. 4
July 20 Sept. 29...
be^r. 30-Oct. 13...
July 1-Oct. 13
June 24-30
July 1 7
Do
Mi^amls
Mindanao
No^ros Occidental
Negros Oriental
Rizal
Do
Romblon
Julv 22 2S
1
75
88
133
10
7
14
16
Samar
July 1.'. t-opt. 22...
June;* 30
SofMjjjon
Do
July 1 Auf.25....
July 29 Auc. 25...
June3 30
July 1 Fept.29....
Jnlv 1.1 21
Suricao
Tayubas
1)0 ..::::::::::.:::
Zamboanga
PLAGUE.
Arabia:
Aden .
May3-July4..
Bahrein Islands
Braiil:
Bahla June 10-30.
Do I July8-Sept. 15..
IVmambiiro ' July IG Aug. 15.
Ceylon: I
Colombo I Apr. 8 June 23..
Do I JulyO-St'pt. 22..
China: I
Amqy Apr. 29 May 5..
Do Jily 1-7
Honpkong ' May 13-Jiuie 30.
ho. July 8 Aug. IS..
K^aiict'.nr Province— t
'la-i'U dijtnct ' June 2
Ecuaflor: I
ts'-UH:! Vi«Ju Feb. 1 2K
(iuayaquil ' do
I>o I Mur. l-Apr. 30..
Do I Julv I-Aug. 31..
Apr. 8-Mav 14, 1917: Cases, «*
d«^^lhv5l.
In Persian Oult Present Afc.
3, 1917.
Present and in vicinity.
Pre«nl Aug. IflL
Present.
Digitized by
Google
2143
Oecember 14, 1917
LLPr^l -.
DLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports ReceiFed trom June 30 to Dec. 7, 1917— Continue<1.
PLAGUE-CoDtlnued.
Place.
j« dor— Continued.
MilaCTo
Vobol.'.'.y. '/,'.','.'.'.'.'.'.'.'.
Salitre
Do
Taura
.* Alexandria
Do
Port Said povcmmcnt .
PortSaiJ
Do
Provinces —
Favoum
' Galioubob
• Girgeh
Minieh
Do
Siout
Suez £OV.Tnracnt
iH^yll
Groat Britain:
Gra\ c Old
Loncon
India
Basscin
Do
Bomi.ay
Do
Calcutta
Do
Henzada
Do
Karachi
Do
Madras Presidency
Do
Mandalay
Do
MOulmeln
Do
Mylngyan
l*cg"
Do
Ranpoan
Do
Toun'oo
Do
Indo-China:
Provinces
Anain
Do
Cambodia
Do
Cochin-Cliina
1^0
Kwanc-Chow-Wan
Tonkin
Do
Saigon
Do
Japan:
Aichl Ken
MiyeKen
Java:
East Java „
DJocl-iVftrta Residonry
Kodiri Rc<»i<1encv. . , , ,
SamaranL' Rosjdonc} .
SuraJmva RasiUoncy . .
Do
Suraicarta Residency..,
153
Date.
Mar. 1^1 .
Apr. 1-30.
Feb. 1-28.
do....
Mar. l-^I .
Feb. 1-28.
Jrne 21-27
July3l-Sept. 11.
Apr. 30- May 1».
June 25
JLly 28-29
May 11- June 26.
Ji no28
May 17
May 12-June 28.
Jily2^Sept. U.
May 12
Air. »)-JLne2..
May 12-June 28.
Au?. 13-24
May3 8
-\pr. 1- Juno 30...
July 1- Sept. 10...
Apr. 22 June 30..
July 1-Sp] t. 22...
Apr. 2!)- J one 2...
July 15-21
Apr. 1-Junc30...
AujJ. 12 Sept. 15..
Apr. 22 June 30..
July 1-Scpt. 29...
-Vpr. 22-June 30..
Julv l-Sopt.29...
Apr. 8 Mavl2....
July 2'> Sept. 15..
Apr. 1-June30...
July l-Sojt. 1....
Apr. 1-7
May 27 June 2. ..
July 2<^Scr»t. 15..
Apr. 15- June 30. .
July l-Sopt.8....
Apr. K-14
Julv 29-Sept. 1...
Fob. 1-Juno30.
Julv 1-31
Fell. 1-June30.
July 1-31
Feb. 1- June 30.
July 1-31
May 1 -Juno 30.,
Feb. 1-Jimo30.
Julv 1-31
Apr. 23-Juno3.
Sept.9-Oct. 7..
Jan.-Jul7.
do
4S6
37J
468
40
201
3,565
f.
183
457
232
13
132
10
210
43
34
113
3
IT
t
Deaths.
54
27
3i»7
307
38
4
35
7
413
34
250
2,562
9
34
74
33
n
2
1
161
428
2
12
131
0
115
10
2r
Remarks.
Jan. 1-Oct. 4, 1917: Cases, 724;
deaths, Zdb.
From s. s. Matiana.
2 In ho^ital at port. From ». 8.
Sardinia from Australia and
oriental ports.
Apr. 15-June 30, 1917: Cases,
43,992; deaths, 30,197. July 1-
Sept. 22, 1917: Cases, 71,636;
deaths, 53,000.
Jime 10-16,
deaths. 16.
Fob. l-JoT!'
df'Hlh-. -1
1917: Ca«»«^. »
^^Kigitized by GoOgl(^
Decemlw^r 14, lOl*"
2144
CHOLERA. PLAGUE, SMALLPOX, TYPHUS FEVBR, AKD TELLC'«
FEVER— CoDUnued.
Reports Rec^ired from Jvne 30 to Dec 7, 1917 — Contiiiaed.
PLAGUE--OonUn(Md.
Place.
rersia:
Mohammore
Peru .
Antni'Jis
Ar-(".ipa
CulliK' ,
1 lUTl au'quo.,
l.il/(.runl ,
Lima.
S^nocal
Siam:
Han^'kok
1 o
Strait. s HoUloiiienUs:
t^iiu'aporo
] o
Union of f-'onth Afrirf
("aiK- of (IikkI lIo|>e Stato —
Cr;wi(K«k
(il( npnn- district
Torka<li"^trict
QiKviislown
Oranp' Free Ktate
Wijiburt? district
At sea:
8. 8. Maliana
Dale.
May 1.
July 1-31
May 16- July 31.
do
do
May 10-21
....do...
Sept. 30.
Apr. 22- Juno 30.
July 3-Scpt. 15..
June 3-16
July 1-Sept. 22.
Aug. 23.
Aug. 13.
Mav 28..
Juno G-.
May2S
July 14-18..
Cases.
Deaths.
PrcsffiDt.
May 13-31, 1017: C«nU -
l-JulySl. 1017; Ca*.* i
At Casnu. I
At MoUeiMlo.
I AtCallao.
At Chiclayo.
At Salaverrr, Sac P*fr^ ^
TruiUlo. Julj l^ZL N '
Trujillo.
At r ima. July 1-^1^^ 1:^
city axkd caaslrj. \\
Present in inienm.
Present-
Po.
At Sammertiill
Apr. 16-22, 1©I7: 1 ca«. w
a» 1917: Caaes, 2&; '1?^;^
En route for port of
SMALLPOX.
Australia:
New Smith Wales
Bre varrina ' Apr. 27-June 21 .
Ce> n„Hk July 20-2S
('ooMa''ar.ibran May 2.>-J\iIy 5.,
Quanil
Warrcti district
Quee'v-;!au>l -
Thursday Island Quar-
antine Station.
Brazil:
IJaliia
Do
Kio do Janeiro.
Do
Coita'h:
M;',ilitol)a —
Winnipe;';..
New Brunswick.
June 1H-Ju>>' '
Juno 17-33....
Nova Scotia-
llalif-.ix
Port Ilawkc8>nirv..
Ontario-
Ottawa
Sariiia
Wiu'lsor
Ceylon:
Colombo ,
China:
Amnv I Ajtr. JO Mav26..
Do 1 Ji.lv I S< pr' 22..
.Vn'Mui: M... 21 Ji!nc24..
Do At:-:, n ()ct.2l...
rhaii'/yha M iv 27-June 2...
Do I Au;r. 11-17
Apr. 27-JuT^2l....
JuDe22-Sept. 25...
Mayi
May 0- Juno 30...
July22-Scpt.22.
do
Jtdy 1-Sept. 22..
June 10-16
AiiK. U> Sept.l..
Nov. 10
4
6
126
518
Jidv30-Aup. 5...
Nov. 11-17
Sept. 3J Nov. 3..
May 6- 12
Chiuipking I May G-June 23 .
Do ' July l-Oct.29..
1
31
108
Apr. 27-Ati^. », 1W7: f^w '
From s. s. St. Albans fttra K>"
via Him^oor. V«wl i-
ceeded to TownsviUe -"
i^ne, and Sydney in quae-
ChieQy in Carietw and Y.Ti
in Mortnamberland Coamr.
Pr«sent in district
Present and in vicfailtT.
I>o.
Present.
Present and in ▼idoitT.
Digitized by VfiOOQlC
2145
D«H^pnilM?r T 4, 1*117
HOI^eRA, PLAGUE, SMALLPOX, TYPHUS FEVBRp AND YELLOW
FEVER— (.'t>ntiiiued.
Repc»ft£i Received from June 30 to Det. 7, 1917— C'onliiiued,
MMALLFOI—Coiitinuw! .
FliiW,
Bote.
Deatlis.
Eemorlis,
:jiiin — Criitlnupd,
r>alroT3 _,.,,--.
Do. ....*
Flanlcow... ........
Harbin...,,,.......
Hom'k on '?...,..,,.,
Do
Mukden .^ ..
Oq...
ShanglmL,.
Do.
TnUHfaaTStaaoD.,
Do
ChemulfK)
liuayMquU.. ^...
Do ,**.
Da...
AlAxancIriil. . . . .
Do....
Cairo.. ....
K'Mll^^ „,,,
Wii
Gwrnunv. . «.. ,
li^rlln.,
Drvmen..,.,,-.
CharlctlinbcrR.
Bftmbsij'^, .....
l*iiiii-', .......
l.iifcwk .......
Kiinkh..,,,..-
i^lulU'iirt
Greece:
AtbuLs....
I
|)M»nflli«y. ,
Do...
Cttlciiita. .
Ho...
Kflntdii..
nti...
KftD'iWIl.
1)0...
MuT 13-Tt]ni3 311'..
JiJivS-2^,..
JtJtio21-3'V
Apr 23-llftv a.,.
Auj:. 5-m.......
Apr. 2,1 29.
M»y27-Juwea..
Jttly S-0et.2tt..,
May 21 - July I,. .
JiiliT 2~0tU 21..
Apr. lri-32..,,,,.
May 2:i- J Illy 7,,,
Julya>-.\ug. ILh
May 131. ,„..,,
Nov. L, ,.,....,
Mar: l-Af^ ^*.
July l-Auy. ai..
Apr. ai'-JtjJv L .
ob. 12-Arr-»..
July a:'-A^ll^ 5..
Ma, C^12„,.,,,.
do.
.do.
.do.
*d^.,
July 25-30.......
Apr. Z!-June 3(J, .
Apr. SS-^k.ay 2(f,,
JiilV a^i'-.'Viu?, 25. ,
A|.f . il2-Julj 4. . .
Jiii> h^SeiiUl.,.
Apr, ^i-.iuii«sau. ,
July l-£!«irl. 2&..
Apr. lij-jijiiij jiJ.
July 1- Sept. l._.
ISO
72
rrovln(^\T.. — .,.
Ansm....
l>o.
fflmbodb., — ,.,,..,
1*^1
Cwiiiu-r hf 13 u .........
Do... ..,
Kwon^-Clmw-Waii.. , .
Laos, .,
l>o....
Tonkin.... _......
Do
^IgQn ................
Do......
Turin
Do....,-...,....
Feb. 1-Juii«;i0..,
Jiiiy i-.n.
!•(?». l-Jaiici jO. .
July 1-Jl..,„,,,
Kri. L-JuiiB.t(|,.
July 1-n.
Mar. ]-Apr. JO..
Apr.i-.a.....-.*
Julyi^i........
July 1-4. .
Apr. 37-ijfo»#«^
July^'Oei.lC^.^
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July 1-7, luiTr Prcwsout*
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Do.
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II ES.
dPHths amonc Chinese.
On i hiripjse K^torn By,
At lintjtlitjr .st4iUoo on fall^Jfiiy;
lease,
Froni &. b. Airofiso XtU, from
iMtrU in BiiaUip
ifar. l*i-Apr. ^, 1^7; Cases. TIS*
In iiii^ axid ^If BUt«s ftiid oli^
jtj »
n
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P.-nml-or 14. 1017
2146
CnOLEKA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND TEI1/&7
FEVER— fVntinued.
Reports Received from June 30 to Dec. 7, I9I7 — TontintiecL
SMALLPOX— Cent iniwd.
ru'c.
May 2H-Juno3
May 10 Julys
Jiily27-tl
Cases.
1
177
1
1
38
21
88
100
Deaths.
RdBsrks.
Japan- ^'ontinucd.
()<aV I
65
■\-,,l, Ij-^irhl
Y(<k(ili:ima
Java:
i' 'I t J.iVU
May 37 July 1
Apr.3JuIyl
July »-An . 2-»....
Apr. 1 Juiy •
July2-()cl. 2
1
()o
MM-Jx.a
|)0
7
Wi>st Jiwa ......•>..
Apr. 13 July 5, 1517: 1:^ .
li*17: CsiSi^ 27^; deal j v
Uatavia
Apr.H Sept. 2<>. ..
Jan. 1 Juno 30
82
6
1I«
1
9
Moxioo:
Do
AUiT. 1 11
iAtt. h-JLug, 14, !»•: lLs*u;
JillV 1 li
Ma/^ill.m
\io\.ii t) c itv .. . . .
^^^V 11 Aug. 7. ...
Jimc : .iO
All'. .V Oct. 27
.Iimo IK 24
.Ian I- Juno .{0
162
17ft
|>o
24
2J
I
a
1
Orizaba
[)0
Jfil\ 1 at
Vcrii ( rijz
Jniy 1-Sept. 15....
An;;. 1>M8
May H-Juneo
July S-Oot.20
Mavia-Jun€30...
July H-Oot.l3
Mar. 1-Jun*30....
•
1
f
8
14
9
Nethci bands;
A m -tordarn
Philippic*' Islands:
Variolaid.
1)0
IXk
Portn^l:
Lisbon.. . ...............
Do
Portngnc'T 1 n.< Africa:
Lmircnco Morciuos
ft
7
4
I>o
July 1-81
Russia:
Archancel
May 1- June 28....
J'lv2-Aug.28....
J: Iy2-15
Feb. I >^ June 30...
Ji lv2'2J
66
«
6
M8
.S8
7
23
M
I
Do ..
Moscow . . .
Pctrofixad . . ...........
Do
Kigrt
Mar. ll-JuxHs2....
Mar. 15-24
Jan. l-lUr. ai, HW: C^w.i
Vladivostok
7
Biom:
BangVo'iC
June 0-30
Do
July 11-17
6
4
44
19
11
Spain:
Madrid
May 1- Jim© 19
Malaga
Apr. I-June 30
July 1-31
Seville
May 1-Jime30
Valencia..
Ji.nc3-23
Julyl-8ept.l5....
Mar. 18-June23...
June 21-30
Sept. 15-22
Apr. 22-28
8
18
«
1
1
1
8
3
Do
Strait"' Sottlenicnts:
1 'c iiiing
3
Do
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Malino
StrK'Minlm
M^y 2t>-June23...
June 2-8
1
Tiuiiia:
Xuni ;
Tur cy i;i Asia:
Feb. 25- Apr. 13...
15
T'i!i()U of So t.i Africa:
Jo uiin"-1» TC. ...... .......
Mar. 12-24
July 1-31
4
8
3
Do
Un^« av:
f,;,i it ' ; 'oo
May 1-31
Vcn; ^' ( Iv
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t
1
Do
July 1^-23..... . .
On ^ci-cl :
S y AKonsoXlII
Nov.l
1
^,SmSS£tS'Sr"'^
Digitized by
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2147
O^Pi^fliWr 14. IM7
HOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER — ContiniietL
Reports Receiyed from June 30 to Dec. 7. I&IT—Continued,
TYPHUS FEVER.
Place.
Algiers
I>o
Argentina:
\^uciios Aires
A ust ria- 1 1 ii: i fary :
Austrifi
Hohoii.ia.
Galiciu
Ix)wer Austria
Moravia.
Silesia
btyria
Ui)])or Austria
Bosnia-lIcriegoYina,
Tivuirary
Budapest
Eisenburg.
Brazil:
Rio do Janeiro
Canary Islands:
i aula I "rill do Tcneriffc
China:
Aniunp
Iianl>o
T)..
I Tk'V/isin.
Tsinrlii)
Do
Egypt:
Alexandria.
Do
''-iD
) . rt Paid
(Jrea«. Uritain:
< ork I June 17-23
<Jla.sno\v I Sept. 30-Oct. 6 '
(Jrcccc: I
Sabniki 1 May 23-Juiio 30
Do I July 1-Oct. 13
Japan: I
V Hakodate I July 22-28.
Nnpasaki I June 11-24
Do I July 9-Oct. 28.
Jath:
East Java
Surabaya ( Juno 25-July 29 .' '
Mid-Ja;a \
."^ amarang l May 5-Junc id-
Do \july2-S
West Java .
Balavia
Do
Mexico:
AKuasealiontes
Cofitcpoo
Duran}:©, State
Jolapa
Mciicof ity
Do
Oriraba J^'
Do J--
Nfl\iorhuids:
Uottcrdam
Do --
Non*ay:
Hcrgcn -
PorliiiTucso Kast A/rkt.- _^
lA»ure«co Marque* "
Russia:
ArchangiJ
t Do
4
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Google.
©•comljor 14. um
2148
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER. AND YKiD^
FEVER— <iontlnue(L
Reports Receired from June 30 to Dec. 7» 1917 — Contmued.
TYPHUS FEVES-Continued.
Phce.
Date.
Cases.
Dcatbs.
Remaxks.
RiLssiii— Continued.
Moscow
July 2-15
10
141
33
3*
Pet rc^rnd
1-el). IK- June 30...
Julv 2 29..
Do.
Poland
( Apr. 2^ June 3, 1*17: Cass:
Lotlz.
Ar»r. r.i June3
Juno 17-July 14
Aj)r. 2^5 Junes....
Juno 17-July 14...
M:iv3l Juneie...
120
108
1,644
l,4C5
5
5
16
Do
Iff 1917: Ca^A* 2'r>5 4?6'^
WarMiw
Do
131
Hif:a
Jan. 1-31, 1917: 1 c»se.
Do
Julv 22 i8
May 1-31, 1917: C«es,i
Vladivostok
Mar. -N May 21...
Mav 1-31..
Spain:
Almcria
5
2
Madrid
.do. ...:..::: :
Switzerland:
Basel
Juno 17-23
Julv 8 Seit.29..,.
July 26 Sept. 22...
June 4-9
1
8
2
2
Do
1
Zurich
Trinidiid
Tuni i;i:
Tunis
June 30- July 6 . . . .
1
tTliion of South Africa:
Capo of (lood Hope State. .
Auff. 25, 1917; Present is 1* i
East London
Sept. 10
tricts.
Pre^^nt.
YELLOW FEVES.
Ecimdor:
Bal^iihoyo
Feb. 1 28
1
2
1
18
34
24
1
2
2
2
3
1
6
1
1
1
7
18
10
Do
Mar. 1 31
Chobo
... -do . ..
0 uayaqiiil
Feb. 1-28
Do ....:.;...::.:....
Mar. 1- Apr. 30
Julyl-Aug.31....
Feb. 1 28
Mar. 1- Apr. 30
July 1- Aug. 31
Sept. 25
Do
Mihisro
Do
1
2
Karanjito
iiexico:
Cimpc^he, State—
<'ami>cchc
V;;:!atan, State —
MoriUa
Sept. l-Oct.28....
June 23
2
1
2
Peto
In person rocentlj- trriTvi ts
Mexico City.
Present Sept. 5.
Do
July 29- Aug. 11...
Venezuela:
Coro
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PUBLIC HEALTH REPORTS
VOL. 32 DECEBIBER 21. 1917 N«. 51
KXTRA^ANTONMENT ZONE SANITATION.
CAMP SHELBY, NEAR HATTIESBURG, MISS.'
By J. A. Watoxs, Passed Assistant Surgno, United States Public Health S«rri.Y, OSLtt in Oursi.
The United States Public Health service has, by a cooperatire
agreement with existing state and local health authorities, assumed
chaise of sanitation and the control of communicable diseases
within the zone around Camp Shelby near Hattiesburg, Miss. In
carrying out this arrangement an officer of the United :>tates PubUc
Health Service has been made the legally authorized agc^nt of the
State board of health of the State of Mississippi, and, by executive
action of this board, has been delegated all legal authority possessed
by the State board of health xmder existing laws of the State of Missis-
sippi. For administrative purposes he has been given the title of
Director of Health, Civil Sanitary District.
Area Comprisiag Eztrm-Cantonment Zone.
No definite Umitations can be arbitrarily made for an extra-canton-
ment zone. While for administrative piu*poses it is dt^irahlo to have
the boundaries of such a zone coincide with those of the several civil
jurisdictions comprising the area, such boundary lines can not be
strictly adhered to where sanitary control measures must be prose-
cuted in order to render an area safe for troops. The extra-canton-
ment zone around Camp Shelby has been considered, for the purposes
of pubhc health administration, as comprising that area which,
because of means of communication, transportation, origin of food
stuffs, or any other factor, has a bearing either directly or indirectly
upon the state of the health and bodily welfare of the troops. iVn
area tentatively set aside for this purpose comprises the 14 southern-
most counties of Mississippi; that is, those counties south of Jasper
county, east of Pike county, west of the Alabama State hne, and north
of the Gulf. The estimated population of this zone Is 239,000. For
administrative purposes this area is divided into three zones, termed
zones No. 1, No. 2 and No. 3.
1 In cooperation with the Annj and the respective State and local authorities the United States Put>Uc
Saalth Service baa iindertalrwi the sanitary control of the ci\il zones around 26 of the .Vnnj mobilizatioQ
ctkXDps and cantonments. The xooe arotind Camp Shelby is one of thc5e.
154 (2149)
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Jtocc-iubor 21. 1017
2150
Zone No. 1. This is an area surrounding the camp sit* a
less than one niilo wiilo at any point. On the north of tbr
this zone is 11 miles wide, and inehides the city of HattieshiBs
Zone No. 2. Sxi area surrounding the above dft^^ribea :
approximately a distanee of 20 miles from the camp.
GULP OF IVfEXICO
The area around Camp Shelby under special health administration.
Z(me No. 3. — The area of the counties enumerate aboTe a^
hicluded in zones 1 and 2.
In zone No. 3 activities are Umited to (1) the sanitary regulatks
of the production and shipment into zone No. 1 of all food products;
(2) the prompt receipt of all information regarding the prevalence
of disease, and (3) the close cooperation with the health officere, d
the respeetive civil jurisdictions involved, in all pertinent heahl
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2151
December 21. 1917
matters. An exception was made in the case of Harrison County^
on the Gulf Coast, where there are many frequented resorts. Between
these resorts and Hattiesburg there is much communication by travel
and the shipment of food products (mainly sea food). The impor-
tance of safeguarding the health of soldiers visiting these locaUties
was strongly represented to the Harrison County board of super-
visors, who agreed to appoint a trained whole-time officer and in
other ways to provide means for the protection of the pubUc health.
There had long existed in the county a pubUc sentiment in favor of
such a provision.
Activities in zone No. 2 are the same as those carried on in zone
No. 3 except that closer attention is given to tais area. This is
especially true as regards the observation and control of communi-
cable diseases. The aiea is intended to include all surrounding small
towns, railroad stations, lumber-mill settlements, and farming centers
within one day's usual foot or vehicle travel. While funds and
personnel have not as yet permitted active prosecution of sanitary
measures in these locahties, sanitary surveys are made of them, and
their condition, so far as it relates to the health of the troops, is com-
municated to the military authorities in order that they may possess
information relative to the environs of the camp.
In zone No. 1 every branch of public health activity is Ixnng prose-
cuted. In the following discussion the activities referred to relate
to this zone, and particularly to Hattiesburg, in which 98 per cent of
the population of the zone resides.
The Sanitary Problems Existing at the Time the Public Health Service Took Charge.
1. Malaria. — ^The following extracts are quoted from a report of
Sanitary Engineer J. A. Le Prince, of the United States Public Health
Service, on the malaria situation in the area:
Malaria prevails in the area in v hirh Uattiesburg and Camp Shelby arc situated.
Anopheles are easily found, and conditioiiB at present arc fa\ordble to the spread of
this disease. The situation is serious. •«■ * * The topography of the zone is such
as to offer abundant opportunity for the breeding of moHquitoct*. * * *
In streams-, roadside ditches, and pools examined, larva* of AnophelcH were abun-
dant. A. quadrimaculatus is the species most commonly found. ♦ * ♦
The serious nature of this sanitary problem can be understood by
a study of the morbidity reports for Forrest County for the years
1914-1916.
Malaria.
Tota number
of ca.ses.
1014
1015
1016
1,705
2, ins
Case rate per
annum per
1,000 popu-
lation
81.901
101.851
99.049
Estimated
popiilatioD.
23,000
22,000
22,000
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December 21, 1917 2152
Disposition of human excreta, — Sanitary sewerage facifitiea wete m
use by about 28 per cent of the population of Hattied>urg, and w«e
available to an additional 6 per cent. The remainder of the popula-
tion, or about 66 per cent, were supplied with outside surface privies,
many in a grossly insanitary condition. In the surrounding rural
districts, surface privies and to some extent pit closets were in use.
MiR' problems. — ^There were but 2 or 3 so-<!alled dairies within this
area. Milk, however, was sold or disposed of by a large number of
the people. Within the city of Hattiesburg alone there were 635
cows being milked. Many households in the city kept a cow c^ach
which supplied the needs of the households. Surplus milk was dis-
posed of to neighbors and friends. Nevertheless, Hattiesburg had in
the past never completely supplied its own requirements and milk
had been shipped into the town from surrounding districts, at times
even from so distant a point as Rlinois. The milk probl^n, therefore,
was two-fold, first, the acquisition of a safe supply, and, second, the
acquisition of an adequate supply.
Meat. — ^There were in the town three distributing stations of large
packers and interstate shippers of meat. They supplied at this time,
about 30 per cent of the meat consumed in the area. Seventy per
cent of the meat sold was slaughtered and disposed of without reg-
ulation or restriction of any kind.
Places of business Thandling foodstujfs. — Many restaurants, eating
houses, soda fountains, fruit stands, meat markets, caf^s, and similar
places of business were being conducted in the insanitary manner
usual in the absence of official regulation. Among the insanitary con-
ditions most frequently met were the lack of screens, inadequate or
imsuitable facilities for the cleansing of utensils, improper disposition
of garbage and waste, inadequate or insufficient storage facilities for
foodstuffs, and general uncleanliness.
Manufacture of ice cream and other miUc products. — ^There existed
two ice cream manufactories and one creamery, while a number of
persons carried on similar activities on a small scale. In the ice
cream plants neither sterilization of cans or utensils nor pasteurizatioD
or refrigeration of milk was carried on, and there was no protection
from flies or other means of contamination. The one creamery in
town was imder the supervision of a man well informed in this fine
of business, and conscientious in the performance of his duties. Due
to lack of cooperation, however, he was unable to conduct the cream-
ery in the manner he desired.
Soft drink bottling. — ^There existed two bottling works in which soft
drinks were manufactured and distributed. As conducted, these
places were a sanitary menace.
Garbage disposition. — The garbage and refuse disposal of the poptt-
lation of this city had been in the past attempted by a dvilian
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2153 December 2 1 . 1017
tary inspector, supplied with one horse-drawn vehicle and two ne-
gro laborers.
Water supply, — ^The water supply of the city is derived from driven
wells, of a depth of about 400 feet. This source supplied approxi-
mately 47 per cent of the population, and was available to an addi-
tional 3 per cent. Of the remaining half of the population, about
12 per cent obtained water from 3 or 4 flowing artesian wells, and
38 per cent from shallow dug wells.
Health organization, — ^There existed at this time a very recently
appointed part-time health officer, who served both Forrest County
and the city of Hattiesburg, at a salary of $1,500 per annum. There
was in addition a sanitary inspector, at a salary of $85 per month.
In addition, the duties of ene of the three commissioners included
public health and sanitation, and upkeep of streets.
Reporting diseases. — ^Though an admirable percentage of the regis-
tered physicians reported the cases of communicable diseases occur-
ring in their practices, the reports were made only once a month.
Reporting at such infrequent intervals was of course of httle service
in the local control of the communicable diseases.
Special sanitary problems, — ^The sudden and large increase in popu-
lation in a sparsely settled area and small town, coincident with the
estabUshment of a cantonjnent, brings about a number of important
pubHc health problems, in addition to those previously existing.
Among these are: The estabhshment of civihan labor camps, the
strain placed on pubUc utilities, and scarcity of labor and materials.
The construction of a cantonment requires the immediate employ-
ment of a large number of civihan laborers. It is necessary that they
live in close proximity to the camp site, which is usually a number of
miles from the nearest town.
These laborers, each with a span of mules or a team of horses, came
from the surrounding country. All walks of Ufo were represented.
They encamped in the unsettled area adjoining the cantonment.
The encampment, on such an unprepai'ed site, of from 10,000 to
20,000 persons of this character, with as many animals, presented a
sanitary problem of major importance. The problems of the dis-
position of hmnan excreta; safe water supply; disposition of manure,
garbage, and refuse; the proper drainage and general camp sanita-
tion; the early recognition and reporting of the communicable dis-
eases; and the taking of necessary precautions to prevent their spread
require a constant and large amount of work. The sudden and com-
paratively great increase in population in Hattiesburg (almost 100
per cent) placed so great a strain upon public utilities, such as gas,
water, electricity; the sewerage, garbage, and refuse collection sys-
tem; streets; public buildings, toilets, etc., that existing faciUties
proved entirely inadequate to meet these unusual demands.
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December 21. 1017 2154
Established restaurants, hotels, eating places, barber shops, and ill
such places of business were suddenly submerged by a yohtme of
business for which they were unprepared and which they wore not
equipped to handle. During this time they were unable to maintiin
the required sanitary conditions and methods. This was particulariy
noticeable at pubUc eating places and barber shops and at railroad
stations.
Enlargement of the premises and installation of facilities and
improvements to meet sanitary requirements and at the same time
to take eare of the increased volume of business, called for much addi-
tional labor, equipment, and material. These could not be had
readily. Particularly scarce at this time was skilled labor, such as
carpenters, plumbers, and other artisans. Machinery and apparatus
were difficult to obtain or have shipped. Coal, lumber, and finished
wood were scarce and costly.
In addition to the problems above enumerated the establishment
of a camp is followed by a large floating population who estabhsh
many places of amusement and dispose of food to soldiers. SmaD
sandwich stands spring up here and there over the entire area: soft
drinks, ice cream, fruit, and other foodstuffs are sold promiscuouslj.
Not being of a permanent nature, no provisions for sewerage conne^
tions or permanent screening, adequate .washing or cleansing facil-
ities, water supply, or other necessities for the maintenance of sanitary
conditions, are provided for. The handling of these mushroom
growths presents a problem which requires a great deal of time and
is the source of much petty trouble.
Another problem of considerable importance met with in this
work was the lack of a general pubUc sentiment in favor of better
public health conditions and the absence of knowledge on the part
of the community as to the necessity for the acquisition and main-
tenance of a rigid control and for the adoption of measures for the
prevention of the spread of communicable diseases. While, of
course, as in other localities, the more educated and cultured resi-
dents of tliis area appreciated the need for sanitary improvements.
the bulk of the population did not. Difficulty was experienced at
times in assuring some that the rigid enforcement of the mles aad
regulations pertaining to public health were in fact not only oeoaa-
sary \mder existing conditions, but aimed toward the penna-
nent good of the community. Such a state of the pnUic mind
illustrated when there occurred an unusual prevalence of
The lack of information regarding the means by iriiich
cable diseases are spread was demonstrated by the oommon plea, in
attempting to evade quarantine, that the character of the eaaa it-
ported was mild. The lax methods of the past in the reportiaf if
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2155 December 21, 1917
diseases were made evident by the fact that approximately only 50
per cent (estimated) of the cases occurring were reported.
The lax quarantine methods of the past were demonstrated by the
almost universal attempt to evade requirements of the existing laws.
There seemed to be a general impression that these laws, having
never in the past been enforced, it was not necessary to enforce
them at the present time. Another factor having a direct bearing
upon the matter in point is the economic condition of the conmiimity.
Owing to the disintegration of the limiber industry in this particular
area the economic conditions of Hattiesburg and its immediate en-
virons were not good. 'The expense involved in meeting sanitary
requirements, owing to the scarcity and cost of labor and material,
was at times high. This made difficult the acquisition and main-
tenance of sanitary requirements.
Present Organization.
The present organization consists of a commissioned officer of
the Federal Public Health Service, in charge, having for execu-
tive pui-posos the title of Director of Health, Civil Sanitary District;
two additional commissioned medical officers of the United States
PubUc Health Service; a part-time city and county health officer;
and one Red Cross unit composed of 3 sanitary inspectors, 1 bacteri-
ologist, 1 laboratory attendant, 3 public health nurses, a business
manager, and 1 clerk. There are in addition 1 chief sanitary in-
spector of the United States Public Health Sorvice; 2 sanitary
inspectojs ; and a number of laborers and miscellaneous employees.
For administration purposes the activities are divided into divisions.
Fnnds Available.
The city of Hattiesburg, through its commissioners, agreed to bear
the expenses actually incurred in making the sanitary conditions of
the city of Hattiesburg and its immediate environs safe for troops.
Forrest County, through the board of supervisors, appropriated $7,000
for the prosecution of sanitary measures in the county, exclusive of
Hattiesburg; the American Red Cross, through the Bureau of Sani-
tary Service, appropriated $10,000, to be expended under the direction
of the officer in charge, for the salaries and expenses of the personnel
of the Red Cross unit and the care of the indi<rent sick of importance
from a public-health standpoint, and for the purchase of nonexpenda-
ble materials and equipment.
The United States Public Health Service has allotted an initial sum
in addition to the salaries and expenses of the officers stationed here.
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DoromlHir 21 , 1917 2156
Howe to House ImpeclloB.
Immediately upon assuming charge, a house to house caark^
was made by a corps of inspectors, who filled in a questionziaire care
These cards give all pertinent data regarding sanitary and he^
conditions of the premises. They are filed by wards, sectks:
streets, and niunbers. From the original cards a separate rnde
system is carried on, in which water supply, sewage disposal, tt£
other items of information are recorded. This is filed in socb ^
manner as to be available for prompt reference.
The data are available at this office, and are of immense valoe z
the control of communicable diseases and the prosecution of u^t^
sary sanitary measures.
System of Morbidity Reporting.
A basic requirement for the control of commimicable disea^ i
the possession by the health authorities of information as to wim
where, and under what conditions communicable diseases octm
Toward this end the cooperation of the practicing physicians wit
enhsted. In addition, the State board of health issued an executiTf
order requiring all physicians to report to this office. The countj
health officers of each of the 13 counties within the extra-cantoniD«ii
zone report to this office by mail, telephone, or telegraph, depending
upon the importance of the matter, the occurrence of the more m-
portant communicable diseases, or any event relating to the publk
health of the area.
Every registered and hcensed physician within zone 1, and thr
greater part of zone 2, i. c., all of Forrest County, makes a daily re-
port to this office of the occurrence of the following diseases: Chicken
pox, anthrax, Asiatic cholera, dengue, diphtheria, dysentery, [a
amebic, (6) bacillary, filariasis, German measles, gonococcus infec-
tion, hookworm disease, measles, malaria, meningitis, mumps, para-
typhoid fever, plague, pneumonia, poUomyelitis, smallpox, scariei
fever, septic sore throat, syphilis, trachoma, trichinosis, tuberculosk
typhoid fever, typhus fever, whooping cough, and yeUow fever.
Card forms are furnished for the purpose.
Upon receipt of the reports by this office they are tmrned over to «
clerical force, whose duty it is to classify and record same and preseot
the accumulated data and information to the officer in charge, in the
form of report, by means of spot maps, charts, plats, curves, and otha-
graphic or clerical methods. The cards are also given over to a medi-
cal officer who makes epidemiological investigations of conmiunicahie
diseases. Proper precautions are then taken to prevent spread of
these diseases.
A daily morbidity report of the entire arda is issued from this
office, copies being sent to the Surgeon General, United States Public
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21&7 December 21. 191?
Sealth Service, to the State and local health oflScers, and to the
^vision sanitary officer of Camp Shelby. In addition, daily mor-
1»dity and mortality reports are received from the division sanitary
officer of Camp Shelby.
Mosquito Eradication Measures.
The mosqmto-breeding areas were, for the purpose of instituting
measures of eradication, tentatively divided into two parts; first,
those in and within flight range of Hattiesburg, and, second, those in
and within flight range of Camp Shelby proper.
The problems presenting themselves within the camp itself were
handled by the Army.
The breeding areas in Hattiesburg and within flight range of
Hattiesbm-g were dealt with by the United States Public Health
Service, while those within fUght range of Camp Shelby were dealt
with cooperatively by the Army and the United States Public Health
Service, utilizing separate workmen and funds but coordinating the
work so as to procure the best results in the most rapid and eco-
nomical manner.
In the ditching work the usual procedure and the approved type
of ditching, according to the special problems presenting themselves,
were carried out. Oiling operations were carried on, using a truck
on which was mounted a 200-gaUon tank for the general distribu-
tion of oil, and by trained n^roes supplied with knapsack sprayers.
Drips were also employed where necessary.
The major portion of the work — that of channeling and cleaning
of ditches, cutting of new ditches, and drainage of breeding areas —
has been completed. Over 60 miles of ditches have been dug and
channeled and more than 50 ponds or swamp areas of various sizes
drained. Water courses breeding Anopheles have been cleaned.
Three weeks before the first killing frost, Entomologist C. W. Metz
was unable to find Anopheles larva^ within this area. In carrying
out tliis work there have been expended 3,418 man days and 2,603
gallons of oil have been used.
Though the mosquito season is over, eradication measures are now
being prosecuted to the extent of channeling and rechanneling cer-
tain large drainage ditches, the cutting of brush, and the removal of
obstacles from water courses, preparatory to the more detailed and
careful measures which will be instituted in the early spring after
the winter rains. There are at present employed in this work 20
men and 2 foremen, operating under the supervision of Asst. Surg,
L. L. Williams, jr.
Ite antimosquito measures have in the past been directed pri-
marily against A, quadrimaculatus. As the eradication of natural
breeding places neared completion, this species was found breeding
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DecoiiiiHi ji, i;»lT 2158
in artiliiiul coiituincrs. To prevent the breeding- of this species ace
to acconif lish the eradication of Culex and other specic^s, measons
were directed toward the ahoHshmont of artificial breeding pl«^
The ordinance appended >\as passe<l by the eity authorities andh
proved sat isf aciory.
Section 1. It ^litll bet unlawful to have, keep, maintain, caii^c or permit, wht^
the incorporate*! limitH of IlattieBburg, Mise., any collection of standing or flowt:*
water in which moe(iiiitoeH hwod or are likely to breed, unless such coUectiaj :■
water is treated ho aa to effectively prevent such breeding.
Sec. 2. The (olhK^tions of water considered by Bection 1 of this ordinance shall c^
held to be those contained in ditches, ponds, pooln, excavations, lioIee» depreamof
opeu ccaspools, privy \^ult8, fountains, cisternp, tanks, shallow wells, bair^
troughs (except horso tronglis in frequent use), urns, cans, boxes, botUes, ink.
buckets, defective house roof gutters, tanks of flush closets, or other similar wat^
containers.
Sec 3. The method of treatment of any collections of water that art* speciiSed h
section 2, directed toward the prevention of breeding of mosquitoes shall be approved
by the health officer and may be any ono of the following:
(a) Screening with w ire netting of at least IC me^he8 to the inch each way « loy
other material which will effectually prevent the ingress or egress of moequitoee.
(6) Complete emptying every seven da>'B of imscreened containers, together wii
their thorough drjing or cleaning.
(c) Ubing a larvicido approved and applied un<Ier the direction of the Jieili
officer.
(d) Covering completely the surface of the water witJj liertwcne, petroleum, ff
paraffin oil once every seven da>'8.
(c) Cleaning and keeping hufTiciently free of vegetable growth and other obstn;*'-
tionn, and stocking with mosftuito-destroying fish; abaenc<' of half-growTi moeqiiilc
larvye to be evidence of compliance w ith the measure.
(/) Filling or draining to the satbif action of the health officer.
(g) Proper disposal of tin canw, tin boxes, broken or empty bottles, and similar
articles likely to hold water and tin cans and tin l)oxo8 miut have a hole punctiin?d
in the bottom.
Sec 4. The natiual presence of mosquito larvte in standing or nmning water i-hjU
bo evidence that mosquitoes are breeding there, and failure to prevent such breeding
within three days after notice by the health officer sliall be deemed a Wolation of
this ordinance.
Sec 5. Should the person or persons rt^spoiLsiblo for i^nditions giving rise to the
breeding of mosquitoes fail or refuse to take necessary measures to prevent the same
within three days after duo notice has been given to them, the health officer is hereby
authorized to do so, and all necessary costs incurred by him for this purpose shall
be a charge against the property ow ner or other i)er80n offending as the case may be.
Sec G. The health officer shall enforce the provisions of this ordinance, and for
tliis purpose the health officer, person or persons acting under his authority may
at all reasonable times enter in and upon any premises within his jurisdiction; and
any person or persons charged with any of the duties imposed by this ordinance
failing within tlie time designated by this ordinance or within the time stated in
the notice of the health officer, as the rase may be, lo perform such duties, ot to carry
out the necessary measures to the satisfaction of the health officer, shall be deemed
guilty of violation of this ordinance, and for each day after the expiration of this
time that said person fails to comply with this ordinance shall be deemed guilty of
a separate violation of this ordinance.
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2159 December 21, 1917
Sbo. 7. The peraon held under this ordinance to be reeponBible for the correction
of conditions on premises giving rise to or likely to give rise to breeding of mosquitoes,
eliail be the owner, and in his absence the agent of owner of said premises; provided,
smy tenant, causing or permitting said conditions without the consent of the owner
or agent shall be held responsible. Where a trespat^^ser or other person is known to
cause or to have caused said conditions without the consent of owner, agent, or ten-
ant, then such person will be held responsible.
Sec. 8. Any person who shall violate any provision of this ordinance shall on each
conviction be subject to a fine of not more than $25, or be imprisoned for not more
than 10 days, or both, in the discretion of the court. All acts or parts of acts in con-
flict with this ordinance are hereby repealed.
Sec. 9. The public interest requiring it, this ordinance shall take effect and be in
force from and after its passage and approval.
Parsed and approved the 1st day of September, 1917.
Disposal of Human Excreta.
Starting on September 5; and as rapidly thereafter as the clerical
force permitted, notices were issued to property owners to install a
sanitary can in surface privies on their premises. The installation
of these sanitary cans has proceeded satisfactorily. About 0.1 per
cent of the privies yet remain in an insanitary condition.
A scavenger system of 3 trucks and 2 wagons has -been placed in
operation. The trucks carry clean empty cans which are sub-
stituted for those removed. When loaded the trucks haul -to the
disposal plant.
The construction of a disposal plant was found necessary to meet
the requirements for disposition of the contents of the sanitary cans.
A large hopper was set upright in a block of cement approximately
6 feet square, hollowed out to fit the hopper. The hopper is the
same height as a wagon bed, and is fitted with a coarse screen. The
whole equipment is suitably housed and connected with the sewer
system of the town and suitably located. Continuous water flow
through the hopper, sprays for the washing of the cans, and hose
connections for the proper flushing down of the premises were in-
stalled. The contents of the cans are dumped directly into the sewer
through the hopper after having been taken from the truck and
placed on the platform.
On September 3 the city of Hattiesburg issued bonds, and from the
money tiius obtained appropriated $7,500 for the extension of the
sewer system. By this extension about 2 per cent additional of the
population will be suppUed with sewer connections.
The toilet facilities provided by the local railroad depots were
found to be entirely inadequate to meet the demands of the sudden
and large increase in the population and traveling public. There
were no other public toilet f aciUties in tl^e city. Through cooperation
with the railroad compuiies it has been possrUe to provide adequate
toilet facilities at most of the railroad stations.
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December 21, 1017 2160
Ono public convenicuce station for each of the sexes Ixos been
established in Hattiosbiirg, and sanitary drinking fountains have
been placed on various street comers within the city.
Sanitary Rejnilation of Production and Distribution of MUk.
All persons disposing of niilk, in any quantity, whether sold,
bartered, or given away, have been classified as dairymen and regu-
lated according to existing laws or special sanitary requirements
deemed necessary because of the present unusual conditions in the
area.
Every such person is required to file in this office an application
for Ucense to dispose of milk or milk products. On these apphcations,
data such as the number of cows, amount of milk dispose<l of, and
other pertmont information are given. As rapidly as the personnel
permits the places are inspected by a milk-market expert or a gradu-
ate veterinarian assigned to dairy and milk inspection, and the blank
forms are filled in.
If in the opinion of the inspector sanitary conditions of the dairy
permit the production and distribution of milk in a safe manner,
such distribution is allowed to proceed. Directions and suggestions
for sanitary changes and improvements are given at this time. AD
places of business disposing of milk in largo quantities to homes or in
quantities to the pubhc eating houses, soda fountains, etc., are sub-
jected to frequent and careful inspection. Samples of milk for
bacterial examination and determination of butter fat and adultera-
tions are made at frequent intervals. Bacteria counts are generally
made 10 times a month. Milk entering Camp Shelby is examined bac-
teriologically each day. The milk sold in the zone at present is of
good quality, running high in butter fat and low in bacterial counts.
Much of it is equal to the standard of certified milk sold in urban
communities. An endeavor has been made to divert much of the
milk produce<l in the surrounding areas and previously shipped to
New Orleans to the local creamery, where under proper regulations it
is now being pasteurized and bottled and sold under very satisfactory
con(Utions. By education and persuasion, by the employment of farm
demonstration agents and milk-market experts and by other activi-
ties the milk supply in this zone has been successfully increased,
notwithstanding the rigid sanitary control. There has been a marked
and universal improvement in the sanitary condition under which
milk is produced in this area.
BegoUtioB of Slaughtering and Sale of Meat
The meat sold from the stations of interstate shippers in this
area Is, of course, subject to Federal inspection at the time of ship-
ment. An inspection of this meat, however, is made to detect
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2161 December 21, 191T
putarefaction. It is a regrettable fact that much meat has had to
' 1>o €u>]idemned and thereby lost^ at a time when the conservation of
this product is urgent, because of improper refrigeration systems
^ ira^liich have caused the meat to become unfit for human consump-
t^ion. All meat, as well as other perishable food products, is inspected
before being shipped to Camp Shelby. An attempt has been made
' to inject all locally butchered meat, but the difficulties presenting
tliemselves have to some extent been insurmountable. The farmers
and other people slaughter when and where they desire, bring the
meat to the city and sell it, frequently without the knowledge of
this ofBce.. Arrangements arc now being made whereby it is hoped
that these undesirable conditions will be removed. These arrange-
ments consist of the construction and operation of a municipally-
owned abattoir where animals may be slaughtered and meat refrig-
erated and distributed at actual cost to the butchers. As soon as
the abattoir is completed, laws will be passed prohibiting the sale of •
meat not bearing the stamp of a meat inspector, and all meat killed
at farms must pass through the abattoir accompanied by the neces-
sary viscera, to aid the meat inspector in determining the stat4> of
health of the animal so slaughtered.
The abattoir and pen will be situated on a 20-acre plat near a
railroad and within the city limits, and wiU be built and conducted
in conformity with the rules and regulations of the Bureau of Animal
Industry at a cost approximately of $15,000.
Hotels, Restaurants, Caf^s, Etc.
All places of business disposing of foodstuffs of any kind to the
pubUc are subjected to a daily inspection by a sanitary inspector
of this office. A score card on which are emmierated the various
sanitary requirements, each requirement being awarded a certain
numerical value, is used, and a weekly average is thus arrived at,
based on a daily score. Proper clerical methods are in force for the
recording of the data. Pertinent facts are brought to the attention
of the officer in charge. When a place of business presents a general
average below 75 it is closed until the necessary sanitary require-
ments are met.
Soda fountains are as a rule inspected twice daily. Rimning hot
and cold water, or whirling brush sprays, are required to provide
adequate washing and cleansing facilities for utensils. Milk is
handled only by milk pumps.
Ice Cream and Milk Food Products.
The manufacture of ice cream in one place of business was dis-
continued and a new building constructed. Alterations of the other
factoiy in compliance with requirements have been made. The
requirements consist in ihe main of impervious flooring, permanent
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December 21, 1917 2162
and adequate screening; steam sterilization of utensils, washing and
toilet facilities for employees, and pasteurization of all milk used.
Daily bacterial coimts are made of the products of these factories.
Milk food products are manufactured at the local creamery undo*
daily inspection and rigid sanitary regulations. Proceeding as
rapidly as personnel and equipment permit, all employees of such
places of business where foodstuffs are handled will bo examined
for typhoid carriers, and be required to possess a clean bill of health
from a recognized physician.
Hucksters and Stands Prohibited.
In the extra-cantonment zone of Camp Shelby (2^ne No. 1) there
has been absolute prohibition of the sale of all foodstuffs in any
manner or in any form to the public from carts, wagons, stands, or
other temporary or improvised arrangements. All places of business
must in this area be suitably housed, properly equipped, and all
necessary arrangements and appurtenances for the acquisition and
maintenance of sanitary conditions must bo supplied.
Gtft>ago, Waste, Refuse.
There^have been about two carloads of garl>age cans sold in the
city since August 17. Residents are encouraged to make proper
disposition of garbage and refuse, and a system of garbage collection
has been instituted, the efficiency of which is rapidly improving.
There are employed for this purpose 3 trucks and 3 wagons, with 9
employees.
Many of the residents in this community dispose of waste food
products to chickens, hogs, and other animals. Municipal disposal
at pros(»nt is made at a crematory which was previously in dLsuiw
and in need of repairs and alterations.
Street Police Worlc.
A street washer, with a force pump operated by a gasoline engine,
has been purchased, with which all paved streets are washed. A
** White wing" system has be^jn inaugurated.
Water Supply.
As rapidly as the personnel and equipment permit, the water
supplies other than the city supply, which has shown no con-
tamination, arc being examined bacteriologically for poUution.
Vaccinations.
It was the desire to take advantage of the opportunities present*
ing themselves for the immunization of as many of the population
as possible against typhoid fever and smallpox* To this end th«
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2163 December 21 . 1917
United States Public Health Service offered these facilities free of
charge to the public.
Medical Ezamiiuition of School Children.
With a view to both the control of communicable diseases and the
establishment of a very desirable and necessary public-health ac-
tivity, a system of medical examination of school children has been
inaugurated under the immediate direction of Acting Assist. Surg.
C. E. Gibbs. In the institution and prosecution of this work the
procedure followed by the United States Public Health Service in
school hygiene in other localities has been followed.
Laws and Regulations Pertaining to Public Health.
No ordinance or regulation is legal in the State of Mississippi which
is in conflict with existing State laws pertaining to public health.
In this work, therefore, existing State laws have been followed.
The city of Hattiesburg has no ordinances of importance pertaining
to public health. Tlie city has the commission form of government,
and can not under the particular form of commission granted try
or have jurisdiction over violators of the State sanitary laws. Such
cases must be tried before a justice of the peace.
An attempt has been made in this area to obtain sanitary require-
ments imder existing State sanitary laws. It appears better, imder
local conditions, to operate under existing laws, even though defec-
tive, imtil after an adequate time has elapsed to allow peculiar local
conditions to adjust themselves and an opportunity has presented
itself for careful thought and conservative passage of such laws.
Work has been prosecuted with the idea of enforcing existing laws
even though they be defective, and obtaining desired conditions by
appeal to civic pride and patriotism and by other means, rather
than by the passage of numerous new laws, to which there might
possibly be objection, with lack of cooperation, and of which there
certainly would be much ignorance.
The desirability of taking advantage of the present situation in
placing upon the statutes desirable laws pertaining to pubhc health
has not been overlooked, and will at the proper time be attended to.
Public Health Nursing.
As stated above, American Red Cross nurses have been assigned to
public health work. The homes of the indigent sick are visited with
a view to determining the quantity and kind of material aid which
should be rendered. In this work a questionnaire is filled in and
specific recommendations are made by the nurse to the officer in
charge as to the steps that in her opinion should be taken.
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iKHiember 21, VJ\7 2164
These cases arc cared for cither with the Americaa Red Cross funds
allotted to this unit for this purpose, or iu a cooperative manner,
with the local chapter of the Red Cross and the Kings Daughters,
churches, and civic organizations. The uninformed are instructed
as to the wa3rs and means of prevention of the spread of disease;
rigid bedside sanitation is instituted and carried out in the home.
The care and feeding of infants is given attention and professional
services are rendered. This service was particularly needed in this
area and has proved a very valuable adjunct to the work of rendering
the area safe for troops.
Public HealUi Laboratory.
There has been established a small, though completely equipped
laboratory, in which various activities connected with public health
administration are carried on. Particular attention is given to
bacteriological examinations of milk, ice cream, water, and all food
products. Examinations are made for carriers; diagnoses are cleared
up, and the early recognition of infectious diseases is facilitated.
Control of Venereal Diseases.
In cx)oporation with the . Army and tlie American Red Cross,
measures are bemg inaugurated for the establisliment of control
measures as regards the venereal diseases. It is proposed to a^tab-
hsh one or more dispensaries where early treatment will be given to
infected persons. In connection with the work of the dispensary it
is intended to provide for the hospitalization or otlier proper treat-
ment of carriers. The cx>operation of local practitioners will bo
obtained in the work. Salvarsan and other remedit^ will be tlis-
tributed to phjrsicians free of cost. Bacteriological and serological
examinations will be made.
Permanency of Results.
It is intended that the result of this work will not only be to render
the zone safe for troops and tlie civil population during the time when
unusua* conditions prevail, but to leave a sys^tem of adequate health
conservation in the zone after the present military net^fsssity for such
work shall have disappeared ; and to leave here a sentiment for better
pubUc health administration and to demonstrate its ailvantages in
such a manner as to creaU* a public sentiment which will make avail*
able the necessary funds ana personnel for the maintenance of sani-
tary conditions. It is hoped to leave here a skeleton healtli oi^aniza-
tion adequate to meet the conditions at ordinary times and as many
material acquisitions ap|>ertaining to public health activities as
possible.
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2165
December 21, 1017
MALARU IN ALABAMA.
PREVALENCE AND GEOGRAPHIC DISTRIBUTION— 1915 AND 1916.
The study of the prevalence and geographic distribution of malarial
fevers in the State of Alabama, through the circularization of the
practicing physicians, was begun in 1912. Previous reports on this
subject have been published in the Public Health Reports of October
25, 1913, and May 1, 1914, and issued as reprints Nos. 108 and 186.
During 1915 and 1916 the physicians were circularized every three
months, reply postal cards being used for the piu*pose.
Of the cards sent to the physicians about 12 per cent were returned.
The number of cards sent out, the number of schedules returned, and
the counties represented at each circularization are shown in Table
No. 1.
Jan.
Feb.
Har.
Apr.
May.
Jun.
Jul.
Aug.
Sep.
Oct.
Hov.
Deo.
A
•
A
^\
/
\
/
1
/
i
/
\
/
\
/
V
J
\
y
N.
^,,—
-—^
s
^
Kolailvc prevalence o( malaria in Alabama, by months, as Indicated by the number of
cases reported.
It is to be borne in mind that the number of cases reported by the
physicians does not show the number of cases that actually occurred,
for an average of only about 12 per c^nt of the physicians returned
the schedules. While there must have been many more cases of
malaria in the State, the reports of the physicians on which this study
is based are sufficient to show whether malaria was present or absent
in the several counties, and reasonably accurately the relative
intensity of the infection in the counties.
155
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1hv*muUm-21,1D1T
2166
The oases roportod throughout the State by months are sht*v:
Table No. 2. The relative numbers of cases reported by mofiUh
shown in the ehart.
The number of cases reported from the several counties f4
State are given by race and year in Table No. 3,
The map on page 2167 shows the relative prevalence of the d>.-
in the several counties of the State, the heavier shaded counties V
those in which the infection was heaviest, the unshaded cot:
those in which the infection was lightest, as indicated by the nxm-
of cases reported. The relative intensity of infection uvas detemc
by ascertaining the number of cases reported in each connty dnr.
till' tAvo years- 1915 and 1916 — per 1,000 population. The pop",
tion used was that of the 1910 census, it being impracticable to l
current estimates for the purpose.
Three cases of hemoglobiniu'ic fever were reported from M*r.\
County durnig the fourth quarter of 1916.
Table 1. — I^f^uJts a/ drcuktrualion of practicing pkt^i
Period.
191 r>.
January to March
AprU (o.I'MV'
Jiilv to .^'itJ<'mtH»r. . .
Octol^'r to IcctiiilxT
I9ir,.
January to March
April to Juno
JiiJv U) .'nptviulKT. ..
Oct/)! cr to ^'cceml>or
Inquiry
ojinls sent
to physi-
cians.
7,050
2.3.V)
2,r>o
2,3o0
2, Vfi)
2,^^)0
2,300
Replies
received.
936
307
257
2»4
254
279
2bl
266
o'^^ -S^
10.81
11.87
11.11
ia89
Tahl?: 2. — Coses of malaria reported by months.
Year.
Jan.
Feb.
Mar.
Apr.
May.
June.
July.
Aug.
Sept.
Oct,
870
Not. li-
1915
.302
140
402
181
466
333
427
483
493
(>&4
890
1.266
1,190
l.MO
1.406
2,024
1,939
2.5(97
en i .'^
1910
&I71 i
MTj
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2167
ijpmiiiiiiiiiiyiiiiiiiip
i*aa«wjiS34SS3yi tm TV
-■■■■am ■■■■juuijBM
— jeFrE^5<o»-
fill' ■".. =J=^
-ttOWAH
^ _j>- "Ht riiii^ 7/'
~^"^a*4ELirr
;;r 1 ^
\*^ T^^* CrMLTQN— if
:^>LCOK"
'*CL>ftltg.
'iMAAHtNOTDft
! ^ I
^ MOM ROC W \
^^
-f ..^> y OOHCCUH -v-
J ^p ^ •_ l_Z
.KKCAMmA.
,__ . V f — iOWNDEH — T " 1— S— h
:jJgWWDLB^
BUTtElt
Relative prevalence of malaria in Alabama, by counties In proportion io (ho population, as indicated
by the number of cases reported.
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December 21, 1917 2168
• Table 3. — Ca$^* reported 6y counties, hy years, and by color.
Ctlendtf yew 1913.
ClkBHlM 7«V X-.
County.
White.
Colored.
Cmn-
bined.
Whtte.
OoloRd.; /^
Autauga »
77
66
48
64
IS
48
70
12
60
41
S
11&
2
36
1
10
82
34
106
3
147
77
106
106
16
163
8
136
27
83
47
235
12
1
38
60
13
14
217
473
18
in
170
98
338
133
152
685
59
171
109
31«
0
153
225
318
94
115
423
25
88
161
39
105
239
54
16
516
138
331
81
22
126
203
6
15
61
218
327
178
17
299
168
22
83
58
62
43
47
SO
47
IC I
Bal'lwin
u
31
a
7
Barlwiur
Bibb
t
Blount
Bullock
Butlor
8
31
•
ralhouii. ,
100
26
23
142
13
119
9
1
31
37
7
9
138
220
18
66
102
46
172
97
81
599
51
141
27
140
174
192
09
&8
350
17
5S
59
10
99
135
50
15 '
(^harnlvrs
[
Cbt^rokoo
34
30
47
SI
10
5
74
136
7
14
13
334
42
24
65
26
124
1
rhilton
31
Ch(». taw
57
Clarke
9D
Clav
1
CloJuirnc
1
'1
ColToo
7
32
6
5
79
2»
4
Colbert
100
CoTii -uh
4 /
Coi) :\
^
Co\ iiu'tnn
J
Cren Iriw
378
Ciilliuan
5
108
2
147
I):.le
47
68
52
166
.36
71
80
8
30
82
218
1
13
51
126
25
27
73
8
30
102
29
0
104
4
n.i!'.
ink lib
KiMHjre
K unbia
83 22
51 1 7
Kt(m;ih
I'U\.Mt<^
Fri n kl in
C35
128
119
21
87
11
219
113
333
64
5
10
44
112
(Ii'iieva
<i ' oene
Jlalo
lleiirv
10
Hou'^ton
31
.Tin k -on
,2J
JeiVorson
Ijauuir
135 93
152 55
505 CT
Lau'lenlale
I.;\\VTence
.
\a<*
27
189
IJn\Pc.1oue
i«t
L*»\vntle<
1 6
49 liA
M.Kon
M MlKon
299
157
40
46
150
79
39
429
19
119
82
12
5 .
28
59
130
132
S
207
293
97
87
59
343^
416
7
4
133
S3
101
211
27
131
59
3
^
Mm npo
r
Mai ioi»
Marvhall
It)
201
W..bil.^
Af.mr.H^
315
81
s
Mon* gomcry
112
68
4
64
118
C
S
33
176
138
134
13
177
140
14
27
58
219
13
IS
02
85
v
Morgan
fr
1
ri kfus
f
I'iVe
'
K.iudolph
l{l|'i>cll
7
28
42
189
44
4
122
28
8
56
r
p
ir
i
St.<Mn»r
4
3
213
44
3
164
75
47
90
«
Shelby
Suniler
TallidoK^v
Tall.LjHKisa
Ti 1 ^ra loo'^a
Walker
WaNhiucton
Wilcox.:. :::..::::
AVinston
Total
5,703
3,741
9,444
6,678
4,330
M
Digitized by
Google
PREVALENCE OF DISEASE.
No health department, Stale or local, can effectively prevent or control disease tvithota
hnoivUdge of when, where, and under what conditions cases are occurring.
UNITED STATES.
EXTRA-CANTONMENT ZONES— CASES REPORTED WEEK ENDED DEC. 18.
Camp Dodge, Iowa. — Smallpox — Des Moines 44, Valley Junction 3, Bloomfield
Township 3. Scarlet fever — Des Moines 4. Diphtheria — Des Moines 3. Measles^
De8 Moines 3.
Camp Gordon, Ga. — In Atlanta, diphtheria 3, gtmococcus infection 35,* measles 17,
syphilis 11, scarlet fever 7, tuberculoeis 9, cerebrospinal meningitis 1. In Fulton
County, typhoid fever 1.
Camp Greene, N. C. — Measles 7, mumps 1, diphtheria 1, scarlet fever 1, whooping
cough 1, tuberculoeis I, chicken pjx I, gonorrhea 14, sjphilis 29, chancroids 6; all in
Charlotte Township.
Camp Hancock, Ga. — Kichmond County, extra-camp cases, measles, Augusta 7,
Blythe 9, DavisDns Crossing 1, Hoods Chupel 8, and German measles, Augusta 7.
Fort Leavenworth, Kans. — Smallp:>x, city 2, county 1. German measle.^, city 7,
county 1. Diphtheria, city 5. Chicken pox, city 4. Scarlet fever, county 4.
Camp I^, Va. — German measles, Peterj*burg 9. Chicken pax, Petersburg 2.
Diphtheria, Petersburg 3. Tuborculasis, Petersburg 2. Pneumonia, Petersburg 6.
Typhoid fever, Hopewell 1. Pneumonia* Hopewell 1.
Ccmip McClellan, Ala. — Annidton, smallpox 3, chicken pox 1. Precinct 1, t»mall-
pox 8.
Camp Sevier, S. C. — Four measles, Butler, rural; 4 measles, ('hick Spring.-, rural;
1 measlei*, Mills Mill.
Camp Shelby, Miss. — Chicken pox 2, diphtheria 1, German measles 8, measles 28,
malaria 1, meningitis 2, mumps 1.
Camp Sheridan, Ala. — Measles 20, German measles 17, scarlet fever 1, diphtheria 2,
smallpox 6, tuberculosis 4, chancroid 2, gonorrhea 1, typhoid 2; Cloverdale, German
measles 1; town of Chisholm, none; rural district in 5-mile zone, none; Capitol Heights,
none.
Camp Sherman, Ohio. — Diphtheria — Chillicothe, 1; measles -Chi II icot he. 12;
Frankfort, 1; smallpox — Chillicothe 1; Jefferson township, 1; Springfield Township,
1; typhoid fever — Chillicothe, 2; tuberculosLs — Chillicothe, 1.
Camp Zachary Taylor, ^y.— Jefferson County — measles, 1; mump-', 2; typhoid
fever, 1; Louisville city — chickenpox, 8; diphtheria, 6; mumps, 1: scarlet fover, 9;
tuberculosis, 17; typhoid fever, 1.
Tidewater Health District, Va. — Newport News — diphtheria, 1; measles, 5; typhoid
6; pneumonia, 2; syphilis, 1; Hampton— measles, 2; chickenpox, I: Phoebus—
typhoid, 1. • r- 1
(2109) Digitized byLaOOgle
December 21, 1917 2170
Camp Wadsworth, S, C. — Spartanburg city — German measles, 12; measles, 2; chicken-
pox, 2; whooping cough, 1; diphtheria, 1; malaria, 2.
Camp Wheeler J Ga. — Extra-cantonment zone. Gamp Wheeler — typhoid fever in
Macon, 2; t>T)hoid fever in Bibb Coimty, 2; diphtheria in Macon, 2; measles in Macoo,
68; measles in East Macon, 2; chickenpox in Macon, 12; tuberculosis in Macon, 2;
mumps in Macon, 2.
CURRENT STATE SUMMARIES.
Arkansas.
Fi-om Collaborating Epidemiologist Garrison, td^ram dated De-
cember 17, 1917:
For week ending 15th have to report 7 cases smallpox Dermott, 11 Jefferson County,
2 Cleveland County; 3 scarlet fever Helena; 29 measles Thornton.
From the California State Board of Health, telegram dated Decem-
ber 18, 1917:
Week ending December 15: Three cases epidemic cerebroepmal meningitis, 1 eack
Fresno County, Los Angeles, and San Diego; 2 cases smallpox, 1 each Solano Coimty
and Oakland; 8 cases hookwoim, Amador Comity. Prevalence of diphtheria dinnn-
iBhed throughout State except in San Francisco and Los Angeles. Genera] increue
noted in chicken pox, measles, and mumps. Twenty-three cases typhoid reported.
Reported by mail for the preceding week (ending Dec. 8) :
Cerebrospinal meningitis 4
Chicken pox 153
Diphtheria 62
Erysipelas 9
German measles 53
Gonorrhea 56
Malaria 5
Measles 78
Mumps 57
Pneumonia ^ 8S
Pol iom yelitis h
Scarlet fever 77
Smallpox 'I
Syphilis 7^
Trachoma i
Tuberculosis ififi
Typhoid fever 3D
Whooping cough ._. U
Connecticut
From Collaborating Epidemiologist Black, tdegram dated Be
cember 17, 1917:
Smallpox 1 Bridgeport reported 11th, poliomyelitis 1 Plymouth, dipktbeim m-
usuaUy pre\'alent Now London, Derby.
From Collaborating Epidemiologist Crumbine, tel^ram daAgt \
December 17, 1917:
Epidemic meningitis Canton 1, meningitis caniers Manhattan 10, typtliaid
rodo 6.
Kansas.
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2171
December lil, 1917
Massachusetts.
From Collaborating Epidemiologist Kelley, telegram dated De-
cember 18, 1917:
Foxboro 7 additional (total December, 15) unusual prevalence diphtheria Ashby
4 t>'phoid fever North Brook6eld 5 smallpox Maiden 1 Boston (total Boston December,
3) measles Camp Devens 30 additional and 23 German measles additional.
Minnesota.
From Collaborating Epidemiologist Bracken, telegram dated
December 17, 1917:
Smallpox Kittson County. Kennedy village, 1 : Polk Count v, Sanderville township,
3. Four cases poliomyelitis and 3 cases cerebrospinal meningitis reported since Decem-
ber 10. '
Nebraska.
From the State Board of Health of Nebraska, telegram dated
December 17, 1917:
Smallpox at Ericson. Gordon, Pender. Lei<?h. Eustis. Belgrade. Lincoln, Broken
Bow. Scarlet fever at Lyons. Ericson, Culbertson. Antioch, Shelton, Cairo, Wahoo,
Lincoln. Measles at Lincoln. Diphtheria at Lincoln.
Washington.
From Collaborating Epidemiologist Tuttle, telegrams dated Decem-
ber 17 and 18, 1917:
Six cases scarlet fever Leavenworth, one poliomyelitis Port Angeles.
Five cases cerebrospinal meningitis Port Angele.^, Clallam County.
CEREBROSPINAL MENINGITIS.
State Reports for November, 1917.
Place.
Now rases
reported. |
Plaoc.
New oases
reported.
daryland:
Baltimore
7 ,
1
1
West Vircinia— Continued.
Ohio Cotinty—
WheeUng
i
Vest Virginia:
Kanawha County—
Ct)arleston
Total
2
City Reports for Week Ended Dec. 1, 1917.
Place.
Ulanta, Oa
)altiniore, Md...,
Boston, Mass
iroci'ton, Mass...
Juflfalo, N. Y
Jairo.lll
Ihicago, 111
tacinnati, Ohio.,
leveland. Ohio..
)aytoii, Ohio
)ctroit, Bdich
Oizabeth, N.J...
Cases. Deaths.
Placv».
Oalcsburp, 111
Los Anseles, Cal....
Lowell, Mfiss
Maluen. Mass
Milwaurco. Wis. ...
Nesv Britain, Conn.
New Yorr. N. Y...
Philadelphia. Pa . . .
Pittsburgh, Pa
St. Louis, Mo
Worcester, Mass . . . .
Cases. Deaths.
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Doronilor-J' 1«>17
2172
DIPHTHERIA.
Sec l)ii)litlHria, incaslo^. scarlet fever, and tuberculoHis, page STITT.
ERYSIPELAS.
City Reports for Week Ended Dec. I, 1917.
Vhice.
.M.m'vl.i.nil
All iiit.i < -a
Cases.
_
1
1
3
1 !
1
6'
2 t
id j
2 '
■2
Deaths.
lio t n. Mas^
Bri(i/i';.()rt , Conn
Bull !o. N V
Cam!':i'l:o. M-.n-
rhica,'(», III.
1
1
Cinciim -Ai, Ohio
1
ricvelml. Ohio
ColT'*v\ iiH\ I^aJLS
Davion, Ohio
PcTUiT. Colo
l^olKiU, Mich
Full i;i\«M Ma-'^
1
Ilar:iNl .irtr. IV.
Jors*>\ Cii ; . X. J
}1
1
T^or.'ir!. ( fbio
L(» \ii^vlc>, Cal
Low oil, Mass
i
I
i' Place.
1
Cases. P«^
Milwaukee, Wis
1
t Ncwark.N. J
Xew Bedford, Mass
5
:
New Orleans, I>a
NcwYork, N. Y
Omaha, Nebr
1
' rill^l)iirt;h, Pa
S
I'ortbnd, Me
Providonw. R. I
Kochcster, N'. Y
' Hdtlimd, Vt
Sacramento. Cal
i
1
1
:
' St. Joseph, MO '
1
1 St. I^uis, Mo
St. Paul. Minn
2
Toledo, Ohio
I
i Trov.N. Y I "
1
I "
Washinijton, Pa
I
LEPROSY.
South Carolina — BennettsViUe.
On Doconibor 15, 1917, a case of leprosy in the person of J. P, N
was reported at Bcnnctt^viUe, S. C.
C ity Report for Week Ended Dec. 1. 1917.
During the week ended December 1, 1917, 1 case of lepmsy wa^
reported at Galveston, Tex.
MALARIA.
Maryland Report for November, 1917.
Place.
Maryland:
\nne Arundel County —
Curtis Ray
Camp Meado
Total
porbsi
City Reports for Week Ended Dec 1, 1917.
Place.
Cases.
Deaths.
Placo.
Cues.
I>«ul&
Birmingham, Ala
3
1
Jersey City, N. J
1
Boston, Mass
Memphis, Tenn
]
Charleston, S. C
1
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2173 December 21 , liDlT
MEASLES.
See r>iplitheria, measles, scarlet fever, and tuberculosis, page 2177.
PELLAGRA.
Maryland Report for November, 1917.
Place.
New
cases re-
ported.
Marytand:
Queen A nnes County—
liuthsburg
1
Centre V iUo
1
Total
2
City Reports for Week Ended Dec 1, 1917.
Place.
Coses.
1
Deaths.
Place.
Cases.
Deaths.
Atlanta. G a
1
1
2
2
1
1
Mashville, Tcnn
1
Aii'-'tin TcK
New Orleans, La
I
1
T^imiinf?hftin Ala •
4
Norfollc,Va
1
rharleston S C
Richraond, Va
1
Chiniuo, ni
Washington, D. C
1
^jj^jpnlijs, Trnn -
1
Winslon-Salcm, N. C
I
PNEUMONIA.
Chy Reports for Week Ended Dec. 1, 1917.
Place.
Caws.
9
1
29
1
i
1
130
20
1
8
1
1
2
3
3
1
1
2
1
12
3
1
2
2
1
Death.^.
16
Place.
Cases.
Deaths.
Ballimorp, Md
Maiden, Mass
2
1
2
1
46
7
2
1
1
109
32
1
1
1
14
1
1
1
13
2
2
4
7
2
1
3
4
Bcrlolov ("a!
Manchester, N. U
Montclair, N.J
Nivshxille, Tcnn
1
Boston Mas^'
23
Brocr ton, M'l-w ..........
2
BulTalo. N. Y
Cambri'^lKP Ma^
25
Newark. N.J
New Bedford, Mass
0
2
Chelsea Mas^
New Castle, Pa
Chica^fo ill
69
22
Newport, Kv
1
n<»\vl3n«l. Ohio
Newton. Mass
Clinlnn M-xss
1 Philidt'lphin, Pa...
09
Dctrrit M ich
20
1
3
1
Pitt^buri^h, Pa
35
FvjTptt Mas-?
I^oTjtiac Mich ............. .
1
Fall llivor Mass
; Quincv, Mass
' Ueadih;r, Pa
Fitohhiiri! Muss •..•• •••
4
Flint Mien
Rochester, N. Y
3
flmnil Ranids Mich
2
Sacramento, Cal
2
San l)icj;o, Cal
liavcrhill Mass
1
Randuskv, Ohio
Jftokson Mich .........
San Francisco. Cal.. .........
11
i
Schenectady. N. Y
3
KoasasCUv. Mo. ....••
Romcrvine, Mas?
2
Lancaster ^a.
Springfield. Mass
2
LiOrnin Ohio . • •••••••
Stockton, C^al ,
2
Los Angeles Cal.......
12
1
Wichita, Kans
LowcU.Mass
Wllklnsbure. Pa
1
Lynn Mas''
Woreester, Ma-"W
2
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Dccerai cr I'l, 11)1
2174
POLIOMYELITIS GNFANTILE PARALYSIS).
State Reports for October and No?ember, 1917.
Oregon (Oct. 1-31):
Marion county
Multnomah County.
Portland........
Total
Vermont (Nov. 1-30):
Franklin Connty—
St. Albans
New cases
reported.
Place
West VlrKima (Nov. 1-30):
(}rant( ounty ,
Oreenbncr C ounty . . . .
Hampshire County...,
Kanawha County . . . . ,
Marshall County
Monongalia Coimty . .
Total
reporc«^
aty Reports for Week Ended Dec 1. 1917.
Place.
Ca^e^.
Deaths, i
1
Place.
Cases. ; IVai1i3l
Berkeley. Cal
1
3
1
2
1
New York, N. Y
2
Chicago, 111
1
Omaba, Nebr
1
LancaFter, Pa...
Rochester, N. Y
1 '
Lowell, Mass
...; 1
bioux t Ity, Iowa
1
Milwaukee, Wis
* 1
1
SCARLET FEVER.
See Diphtheria, mooslee, scarlet fever, and tuberculosis, page 2177.
SMALLPOX.
Maine — Eastport
On December 14, 1917, 20 cases of smallpox wcn^ reported at
Eastport, Me.
Maryland.
On Dec^embcr 10, 1917, 4 ctisos of smallpox were notified at Wc»stera-
port, AUegany County, Md., and during the period iwrn December
13 to 17, 9 cases were notified at Cumberland, Allegany (\)unty. Md.
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2175
SMALLPOX— Continued.
State Reports for Noyember, 1917.
Deccml)er 21, 191T
Number
of now
cases re-
ported
during
month.
Deaths.
Vaccination history of cases.
Place.
Number
vaccinateil
within?
years pro-
ceding
attack.
Number
last vacci-
nated more
thanTyears
preceding
attack.
Number
never suc-
cessfully
vaccinated.
Vaccination
history not
obtained or
imcertaln.
Maryland:
Baltimore
1
11
1
1
1
2
2
1
11
1
1
1
2
2
Allepany County—
Cumbcrlana
Calos
Lonaconint;
Anno Anmdel County-
Camp Meado
Oarrett County—
Grantsville, R. D
AviltoD. R. D
Total
19
1
19 ;
.
Massachusetts:
Su-'olk County—
3ostoa
1
1
Miscellaneous State R^KNrts.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Oregon (Oct. 1-31):
Multnomah County —
1
West Virginia-Con.
Kanawha County— Con.
Charleston
3
3
1
1
2
1
3
Portland '
McDowell County
Ohio County
YfoM Vireina (Nov. 1-30):
1
13
2
66
Cabell Coimty—
Raleigh County
Huntington
Tyler County
Favette Coimtv
"Wirt C-ountv
Jeltcrson County
Wood County
95
Kanawha County
Total
aty Reports for Week Ended Dec 1» 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Akron. Ohio... .••.......•....
28
9
1
1
5
29
2
2
21
13
1
0
13
41
5
15
37
1
10
1
40
47
79
1
LaCros.^e, Wis
6
6
2
18
1
1
10
44
I
1
7
6
22
5
1
o
1
1
1
1
5
1
Alton 111
Memphis, Tenn
Baltimore, Md
Milwaukee, Wis
BcKtoB. Mass ................
Minneapolis, Minn
Buffalo. N. Y
New Orleans, La
Bntto. Mont
Newport, Ky
Canton, Ohio. ^., ,.
Oklahoma (ity, Okla.
Omaha, Xebr
Chicago, ni
Cloveland, Ohio
ritU^burgh, Pa
Cohiinbus. Ohio
PortlancT Oreg
Cumberland, Md
>.
Quincy, 111
Dayton, Ohio ,
St. Louis, Mo ,.
Denver, Colo
St. Paul, Minn
Detroit. Mich
Salt Lake C ity, Utah
Evonsvillo, Ind
San Francisco, Cal
Flint, Mich
Sioux ( ity, Iowa
Fort Wayne, Ind
Springfield, 111
Oalesburg, 111
Springfield, Ohio
Grand Rapids, Mich
Supcnor, Wis
Barrisburg, Pa
Tacoma, Wash
IndtaDapous, Ind
Toledo, Ohio
Fansfl!? rity, Kftm r , w . . r . . . .
WashUigtou, D. C
Wichita, Kans
KansasCitvlMo
2
Knoi'Tiii(',T9nii. .............
1
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DeccmlMM-ai.lOlT
2176
Place.
Clinton, MasH
Manbester, N. H.
New York, N.Y..
San Diego, Cal
TETANUS.
City Reports for Week Ended Dec. 1, 1917.
Cases.
Deaths.
Place.
I
Costs. I I>ntt
San Fran fijio. Cal.
Spring old, Ohio..
Wori ester, Mass...
{i-
TUBERCULOSIS.
See Diphtheria, meflslos, scarlet fever, and tuberculosis, page 2177.
TYPHOID FEVER.
State Reports for October and November, 1917.
Place.
Maryland (Nov. 1-30):
xtaltimore ,
A llogany <'ounty
Anne Arundel i ounty.
Baltimore County.-. ...
Calvert Count v
Caroline Counly
Charles County
C octl County
Dorche«!ter County
Frederick County
Garrett County
Harford County
Uovrard County
Kent County
MontKoroery l ounty . .
Prince (Joonjos County
Somerset Count?
Ft. Marys County
Talbot County
Washlnsrton ( ounty...
Wicomico Coimty
Total
Oreg->n (Oct. 1-31):
itakcr < ounty
PouRlas County
(Irani <'ounty
Harney County
Bowl River < ounty...
Jackson County
Linn County
Malheur County
Multnomah County-
Portland
Polk Coimly
Umatilla t ounty
Union < ounty ,
AVasTo Count V ,
Yamhill County
Total
New rases
reported.
Pb».
3
1
1
3
1
f>
22
18
2
7
8
8
83
irvporuo.
Vermont (Not. 1-30>:
Dennln^n <'ounty.
Fran Un i ounty
Oranjte rountv
Rutland County
Total
West Virginia (Nov. 1-30):
Barbour Count c
BerKeley ( ounty
Bra ton Counly
Brooke County
Doddridge * oimty
Fayett"* wmty
CrwnbriprC lunly
Hardy t ounty
Kanawha County
1 incoln < ounty
Mc I >owcll < ouhly
Marion i ounlv
Mercer County
Mingo County
Monongalia i ounty . . . .
Morgan i ounty
Ohio( ounty .'
Urn (irove
Wheeling
Pendleton I otmty
Putnam County
Richie County
R'wine Count y
hummers l mmty
Tucker (otmlv
tj»slmr( ounty
Total..
US
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Google
2177
Docembei-21,1017
Place.
AlbttiiT, N. Y.........
Ann Arbor, Micb
AO^nta, Oa.
Aug fn, Tex
Bu.Umoro, Md
BinLinxham, Ala.....
Bostcn, Mass
Brock toQ, Mass
Buffalo, N.Y
CWro.lil
Oundcn, N. J
CharlesUm, S. C
Chicago, 111
Cleveland, Ohio
Columbus, Ohio
Cumberland. Md
Detroit, Mich
Dulutb, Mimi
East Orange, N. J...-
Ellzaboth,>l. J
FaU River, Mass
Flint, Mich
Oalcsburg, lU
Crapd Rapids, Mich..
Haverhill , M ass
Indianapolis, Ind
Kansas City, Mo
KoWomo, Ind
Lexington, Ky
Los Angeles, ral
LynchburK, Va
Lytm, Mass
Maiden. Mass
Memphis, Tenn
Mimieapolis, Biinn —
MobUe.Ala
Mash vUle. Tenn
Kewark,N. J
Kew Bedford, Mass...
TYPHOID FEVER-Coit^ AND TUBERCULOSIS-
Cfty Reports for Week Ended Dec.
^^-Continuetl.
Cases.
Deaths.
Place. ""
New Orleans. La ,
NcwYork,N.Y .Y
Norristown, Pa ^
Oklahoma City, Okla .^
Philadelphia, Pa.
Pittsburgh, Pa.
PittsflelcTMass.
Pontiac.Mlch
Portland, Me.
Portland, Oreg
Qulncy.lll.-..
Richmond, Va.
Rochester, N. Y
Rockford, ni...
Rock Island, IB
Sacramento. Cal
St. Louis, Mo...
Salt Lake City, Utah
San FrancLsco, Cal
San Jose, Cal
Somcrvillo, Mass.
South Bethlehem, Pa.
Springfield. 111...
Springfield, Mass
Springfield, Ohio.
Stockton, Cal
Terre Haute, Ind
Toledo, Ohio.
Trenton, N.J,
Trov,N. Y
Washington, D C
Washmgton, Pa..
Waterlown, N. Y.
Wheding, W, Va.
Wichita, Kans...
WihningtoQ, Del
Winston-Salem, N. C
Worcester, Mass
DIPHTHERU, MEASLES, SCARLET FEYER, AND TUBERCULOSIS.
State Reports for October and November, 1917.
Cases reported.
State.
Cases reported.
State.
Diph-
theria.
Mea-
sles.
Scarlet
fever.
Dipb-
theda.
Mea-
sles.
Scarlet
fever.
llarytaad (Nov. l-ae^)
OresoD (Oct. 1-M>
228
22
290
2
165
36
Vermont (Now. 1-80)
West Virginia (Nov. MO)..
20
173
28
64
42
106
Digitized by
Google
iKcemlHir 21,1917
2178
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Dec. 1, 1917.
niy.
0«^ fM.(m luNhitanW:
llnltlmwi-. Mil
Iio^tmi, M4i«*
(liiaiEn. Ill
i Ir^ I'lAndn * ^ > lo
iJrlriil. Mtch.
I ,(jPi. Anc'i-Jf^', ' al
Xew ^«f>, ^ Y
rh llftilrj pH ;i Pa
rUt^b'TRti, \'i
m. Lo Is Mi.
From SCJU.OOO to NW.OOO ln»u»blt-
ants:
Buffalo, K. Y
C inciimati. Ohio
Jersey ( ity, N'. J
Milwaukee, Wh
MlimeapollH, Minn
KewarV. N.J
Tew Orleans, La
Ban Frand'ico, < al
Seattle, Wash
Was' Ineton, T>.«
From 200,000 to 300,000 Intiabll-
ants:
Colnmbns Ohio
Denver, rolo
ImUanapolH, Ind
Kan-sasi Itv, Mo
rortlaiid, OrpR ,
I*ro\l Wiice. R. I
Roc'^cr^iler, ^\Y
8t. Pa 1. Mbui ,
Prom 100.000 to 200.000 Inhabit-
ants:
Albany, V. Y
Atlanta. Oa
BirmlnR'^am, Ala ,
Bri li;»'m»rt, ' onn
Camhrl'^KP. Mass ,
Camilen, : '. J ,
Oavton, Ohio
FalllUver. Ma?s
(]rand llapi l^, Mlc^
I.a\vTcnci\ Muss
Lowell. Ma vs
Lynn, Mass
Memp»its, Tcnn
XashvUle, Tcnn
y«'W Bedford, Mass
New Haven, Conn
Oa'^liuul.rjil
Oma^n ^>br
RcallnK, Pa
H Ichiiiouil, Va
Sail l.u^o( Itv. T'lah
SprlnRfield, Mass
S>Tacnse, "^'. Y
Tacoma, Wash
Toledo, Ohio
Trenton. N.J
Worcester, Ma"»H
From 50,000 to 100,000 Inhabit-
ants:
Akron, Ohio
Bayonne, N. J
lUf»--eicv, <^al
BinK>«anUon. N. Y
BrocktoiK Mass
Canton. Ohio
Charleston, H. C
Covington, Ky
Dulutli. Mimi
t*ftpllls-
lion a% of
J*ilyl,lMtii
th^Dihd
(&4l1niut«^a
hnm
l.Yt\a,
all
IcriHi*
CftlLSPit.
llTiTi'lUiL
i^,m
204
7.'irt.47rt
216
2,4«7.7?2
eoi
674.073
571, 7H4
173
f03.H2
IRl
6,roi,^n
1,44.'>
1,70ft. MS
497
671>.(»W
213
757.309
197
4A<i.5.'W
144
410 47fl
12S
3()= 3<^
W
4.3".. -3r.
9S
3* 3. 4M
40H.vm
no
371.747
iH
4f3.f.l6
13S
.34^. • i )
3iJ.l'-^
115
214. R7S
51
2^0.^00
271. :os
C3
207. M7
73
2<».'>. 4« 3
62
i'M.ftfO
73
:^.V.,4I7
f.S
247,232
IM.IftO
GS
l<H»,.'»r»H
lM.7tV2
121.579
H2.»»Sl
10 •.. Z«
127. Zi I
12S 3'w;
12«< 2*U
100. V 0
113.215
102, 4i5
117.057
IIM.W
14W. <>>»5
ia'^.470
i.v..r>H7
n7..3t»t)
1U-..«M2
l.V,.n24
1 12. 770
191.554
lll.5«i;|
163,314
S5.f\25
(W.saj I,
57.0,'>3
53.1»73
67.449
f4». K.52
60. 734
57. M;
«4. m
DJ[iliLheTLi
31
111
24<t
.-W
111
13
247
Kl
45
85
It
6
4«
14
3 i
17
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13 I 1 ,
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3
11
2 •
r '
2
3
4
4
10
2
31
40
9
25
U '.
27 I.
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(ever.
2H I
101
12
59
10
132
57 -
11
4H
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i ^
I I
4
30
19 .
9 .
rj .
12 .
3 .
5 .
19 I
4 .
2 .
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4 .
12 .
15 .
19 .
2 ■-
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9l.
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i I 37i
... 29
2 29
3.i
3 2^41
92
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32
25
21
21 >
19
I
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4 .
2
12
6
4 -
f,
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5 '
16 3
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27
a
31
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H
142
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17
21
31 17
IH 14
13 > «
14
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4
4
13
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2
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2179
r)ccoml)er21, 1917
DIPHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Dec. 1, 1917— Continued.
Popula-
tion as of
July 1, 1910
(estimated
by U. S.
Census
Bureau).
Total
deaths
from
aU
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tiil)cr-
ciilosis.
City.
1
1
1
1
1
3
1
Prom 50,000 to 100,000 inhabit-
ants—Contlnoed-
EUtaboth, N.J
86, aw
76,078
64,772
7«.1«3
72.015
77,214
68,529
99.437
50.8.''»3
51, IM
78.283
5S,221
53.794
89.612
92,943
71,744
63,867
55,185
66.895
55,642
85.2.36
53.330
68,8ai
99.519
67.078
87.039
68,946
61.120
51.550
G6,0H3
77,916
70.722
76,776
94.265
51,656
27,732
37,385
34.814
32.9^5
32,730
27,632
43,425
46,192
29,319
26,074
32,261
48,811
39,873
28,743
42,458
39,233
35,486
41,781
41,863
29,353
25,679
48,477
35,363
48 886
31,678
36,771
38,076
31,677
41,097
35,384
27,687
36,964
32, MO
30,699
17
16
19
17
19
18
19
ie*
23
13
9
i7*
11
17
13
27
8
10
26
36
24
ii'
17
20
16
17
23*
30
5
8
i*
4
0
9*
5*
11
ii*
6
8
6
10
8
8
10
8
5
7
5
1
5
4
5
4
6
1
3
9
5
1
1
12
10
6
16
4
E vansvilie, Ind
3
FlIntLMich
3
4
1
Fort wavTiCj*fnd '
2
1
......
' '3*
2
Hairisbure, Pa
3
Hobolrcn.V.J
Johnstown, Pa
14
2
3
1
5
3
4
1
Kansas City. Kans
4
I
T4»n<>a'5t<'r, T*ft ....... ...^.
Maiden, Mass
Majichcster, N. H
!!!!!!
4
1
7
1
Mobile, Ma
1
New Tlritaln, Coon
1
Norfoiv,va .'.'!;!!!;!!
8
6
Oklahoma ( Ity, Okia
Passaic, N. J..
1
1
117
......
4
Portland, Mo
Rock ford, ni
2
Sacramento, Tal .**! '.'.'.'..
1
«
1
Saginaw, Mich
4
20
9
4
4
2
7
2
3
1
3
1
1
St. Joseph, Mo!"!!'!"!'*!!
1
2
4
San l>icgo, Cal
2
3
2
4
Savannah, Ga
1
6
Schenectady, N. V ! . . ! !
Sioux ( ilv, fowa .. .
1
2
10
3
3
3
0
4
1
Somcrvillc, Ma<s
24
1
2
1
Sonth Bend, Ind
SprlnKflold. Til !.
3
Springfield, Ohio
1
2
Tcrrc IIa"to, Ind
2
Troy. N. y
Wio'.iita, Kuns
" "i'
1
-7
2
1
2
3
WllVe«^-narro, Pa
1
Wilmington, Del
3
8
8
1
1
2
2
York. Pa
:!!!!!::::::
1
1
From 25,000 to 50,000 inhabit-
ants:
Alameda. Cal
1
2
1
AubiimJ4. Y
Austin, Tex
1 .. .
Bellingham,. Wash
1 1
1
Brookline, Mass
2
1
2
2
3
2
3
3
3
1
! !
1
Butler, Pa
4
C
6
1
Butte, Mont
Chelsea, Mass
*"*i*
15
1
1
1
1
Chlropeo, Mass
1
Cumberland, Md
1
Danville, Ul
Davenport, Iowa
*
1
1
Dubuque, Iowa
East Chicago, Ind
6
98
20
>
East Orange. N. J
2
3
3
2
1
2
Everett, Wash
Fltchburg, Mass
1
4
3
2
Galveston, Tex
4
!!!!!!
2
1
4
1
19
Grocn Bay, Wis
Bagerstown, Md
Hftverhlll, Mfiss. . ..
8
9
16
7
5
A
20
9
10
1
4
4
2
3
19
1
2
...
1
3
4
Jackson, Mich
Kalamaxoo, Mich
......
30
1
Kenosha, wis
9
Kingston, N. Y
TCpftTvfiifl, T\mn , ^
3
3
1
14
1
3
3
1
!!!!!!
3
4
LftCrosse, Wis
Lexington, Ky
5
1
1
l^fnift, Ohl^./ , ,
1
I
Long 'Beach, Gal
Lorain. Ohio ,.
2
1
I
3
LynchDorg, Vs.
1
lfedlson,WIs
1
* *
i
Digitized by
Google
I'occraber 2\, 1017
2180
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCrLOS!^-
Ooutlnued.
dij Reports for Week Eaded Dec 1, 1917— Continued.
Populft-
tion as of
Ju]yl.l9lC
(^stimated
by U. 8.
C<»nsus
Bureau).
».734
26,31S
27,377
41,133
30,108
43,715
37,3.53
31,401
31.404
33.*^
46,450
41, m
3S,629
39.651
36.79S
3H, 136
46.4S6
43,yi4
2«».92fl
3\9<r2
27.445
35.35S
46.226
36,2^3
29. ^W
43.139
43,377
33,809
Sl.l.V-)
30,S03
. 2?,S74
15,010
13. 5W
21.(VV,5
15.791
1 13. 075
17.54'<
22, a,o
21,'.'7ii
'Ai ,vw
»io,a 3
15. :«.'-.
> 14, 010
17.415
13.2S4
23,126
15. 243
2f>,9S5
122,019
19.926
23,S05
17,524
11,666
12,067
14,^31
20,193
13, H21
24,204
15, MS
21,618
23,22S
ToUl
deaths
from
all
causes.
DIphtherU.
ICcAsles.
fcvrr. 1 .-
riiy.
1
1
1
1
1
1 i:
From 2.S,0()0 to 50,000 Inhabit-
ants-<'onlliinod.
i'c<lford N^MVt. .... .........
7
3
3
3
2
Munl« lalr, N. J
Nn.shua, N. H
6
*,
New Ca.sllo, Pa
I
2
8
Newport, K. I
NeM* ton , Moss
3
.1
3
13
12
13
11
8
13
8
13
13
8
4
6
2
3
1
1
1
Niapara Falls, N. Y
Ncirlslown. Pa
:"**;r: :: >
i t
Otdrn I'tali . ............
1
......
Or.inre N.J
::::::!:::::: ....».!:::;;•
rt'Siuiena . Cal
Penh .\inboy, N. J
Pittsnrld, Mns8
3
2
t :::
1 2 i 1 'i
1
Portvmuiith, Va.
'......1 '
»
Qiiin( V, III
8 4
1 2
Quinfv, Miiss
J u(ipe, V|s
1 •■
'**'i
Koancko, Va
6 1 1
To* k Island. 111.....
1
8nn Jrse. (^u
»
8tei]len\ il!e, Ohio
'
1
5
Bto< kton, Cal
;;;.;; .:.::
1
Fiiperior, V.i><
7
19
1
S
13
is
13
13
12
2
s
7
1
Tuiinton, Muss
1
j
3
1 '
;
AVatertown. N Y
2 1
J!
AVest HolKiken. N. J
!
1
1
' \
AVheolinp. ^\^ Vn
2
3.
1
1
1
8
1
1 '
1 1
6 '
1 '
t
1 '
1
"Williiinisfnrt. Pn
::::::::::: 1
ViirloK-SaU-m, N. C
Zane^v illo. Ohio
14 ....[J
1
1
From 10,000 lo 25,000 inliatJt-
ants:
Alton, 111
2'...
1
Ann Arbor. Mi(h
1
•i
Eerlin. N. H
nr.iddock, Pa
.J.k::±..*.
(Viro, III
Clinton. >'^a.ss
i""
CclTov\ illo, Kans
' .
1 1 .
1 1 t?
Conrord. N. 11
13
10
7
2
2
7
3
6
6
2
t
7
13
12
e
3 1
Call bull!. Ill
......i::::::i :: r
KoMnv, N. J
'
18 10 .
K(knino, Ind
Leavenworth, Kans
' 1 i *
lyone Pranrh, N, J
2
1 1
Marinette. V|s
,
Mclro'^e, Afass
i 2 i ,.
Morristown, N. J
1 L
Nantii oke. Pa
' 1
Newburvport , Mass
1
2
1 1
New London, Conn
! 1
I . . 1
North Adams, Mass
{1 '
t
"",
Northampton, Mass
i • 9 1
•-1 5
Plainllcld, N.J
3
5
: ....:j
Pontiac. Mieh
1 1 A 1
..::i-Y,::;..
Portsmouth, N. H
....:j::::::i....:. ::::::t
5 r*
Roeky Mount, N. C
3
4
5
8
2*
h'
1 1 1
1 1
Kutlond, Vt
. . , ....j.
1 *i ••"
Sandusky. Ohio
.:::::::::::'.::;;: ::::::):
1 1
Saratoga Snrlnps, N. Y
South Bethlehem, Pa
1 1
i
3
1 1
1
! 5
Steelton, Pa
1
Washington, Pa
1
1
;;!!!!i!;i!!Ii:""'::""! 1 *.
Wilkinsburg, Pa
1 '
1 1\
• "I 'i
i
1
'i !
» Popiilaiion Apr. 15, 1910: no estimate made.
Digitized by
Google
FOREIGN.
CHINA.
Examination of Rats— HonglKontf*
During the five weeks ended October 27, 1917, 10,925 rats were
examined at Hongkong. No plague infection was found. The last
plague-infected rat at Hongkong was reported found during the
week ended September 22, 1917.
CUBA.
Commonicable Diseases — ^Habana.
Commimicable diseases have been notified at Habana as follows:
Diseases.
Nov. 11-20, 1917.
New
Deaths
Remain-
ing under
treatment
Nov. 20,
1917.
Diseases.
Not. 1I-», 1917.
New
Deaths.
Remain-
irui under
treatment
Nov. 20,
1917.
Diphtheria..
Leprosy
MfUaria
Measles
Paratyphoid (ever..
Smallpox
Typhoid fOYor
•2D
3
«1
84
1 From the interior. ' From the interior, 6 cases. • From Coruna, Spain.
MEXICO.
Cerebrospinal Meningitis — ^Vera Crns.
Cerebrospinal meningitis was reported prevalent at Vera Cruz,
Mexico, November 26, 1917.
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW FEVER.
Reports Receired During the Wedt Ended Dec 21, 1917. >
CHOLERA.
Flaoe.
Date.
Cases.
Deaths.
Remarks.
India:
Bombay
Sept. 23-30
8ept.2-15
4
4
11
6
CalcutU
Karachi
8ept.3a-0ct.l3...
6
Philippine Islands:
Iroxinces
Oct. 2a.Nor. 3, 1917: Cases, 172;
deaths, 129.
Bohol
Oct.28-Nov.3....
do
15
5
29
14
95
14
2
15
3
20
13
65
12
2
CaDiz
. lioffo;..;:::::::;:;;::::
do
Mindanao ....r
do
Negros Occidental
do
NcCTOs Oriental
Straits Settlements:
SineaDoro
do
8cpt.30-Oct.l3...
I From medical ofDccrs of the Public Health Scrvfoc, Ameriean consuls, and other sources.
156
(2181)
Digitized by
Google
December 21, 1917
2182
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received Dnring the Week Ended Dec. 21, 1917— Continued.
PLAGUE.
Plaoe.
Date.
Oases. Deaths.
Bemarki.
BraxU:
Bahia
India
Bombay....
Karachi
Madras
Madras FresidfiDoy..
Rangoon
Straits Settlements:
Singapore
Oct. 14-20.
Sept.23-Oct.6..
Sept.aO-Oct. 13.<
8ept.30-Oct.6..
do
Sept.9-Oct.6....
Sept.2a-Oct.6.
21
6
1
,923
118
2
18
6
1
1,400
109
X.
2^-OeC.
,376; deaths,
fl. 191
1917:
SMALLPOX.
Algeria:
Alders
Oct. l-«0
1
2
1
BraiU:
naMa
Oct.21-Nov.3....
Dec. 2-8
Canada:
Ontario—
China:
Amoj . . ...............
Oct. 15-21
Fiesenl.
Anting. ......^,^r^^.^ ,,
Oct.29-yov.4....
Oct. 14-27
3
..;
Chungking
Do.
Makden
Oct.2»-yov.3 ...
Do.
Shanghai
Oct.2»-Vov.4
Nov. 4-10
1
6
4
S
6
Tientsin .^.
^'^liro
May21-Juno3....
8opt.23-Oct.6....
Sept. 2-8
1
8
1
1
India:
Bombay
Calcutta
Madras
sopt.ao-Oct.o....
do
3
1
3
3
Kanroon
ItalJ^^
Milan
Sept. 10-10
Oct.2S-Nov.3....
Aug. 12-25
Philippine Islands:
Manila
Varioloid.
Russia:
Moscow
4
Pctrograd
Aug. 14-25
Sept. 30-Nov. 3, . .
Oct. 1-31
11
5
Spain:
Coruna
Madrid
3
1
Straits Settlements:
Sept.ie-Oct.l3...
7
TYPHUS FEVER.
Oct.29-Nov. 4....
Nov. 4-10
China:
Anttmg
Tientsin
•^•^.^iiro
Port Said
Japan:
Nagasaki
Rus-ila:
Mascow
Pctrograd Aii(c 14 2j
Spain:
Madrid Oct. 1 31..
May 21 -June 3..
May 2S-Junc3
Nov 5-11.
Digitized by
Google
2183
December::!. li»17
3BOL.ERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continned.
Reports Received from June 30 to Dec. 14, 1917.
CHOLERA.
FLacfl.
B&s««»iii . . .
Bombay •,
CalciiriB...
Do...,
Karachi...
Do...,
Manttolay.
Ftakrokbii]..
Po. „
Promt'
AnatTi,.. ......
I>ci
CttmlHHlIa ,
Da........
r^Qhiii-Chlnii .
Da
I^iiftOS . . , . -
Tonvtn,...
l>o,..„...
8iiKOn,. ......
l>o
JapeiT.
Tokyo...
East Javu
110.... ,,„
MiaJa.a... .,.
Wpst JEl^tt... ,,,,.
Hutruiii ,
Do.. _
AiiUr KilJ..
Uarroiiroiichir ...
Do..............
f>iiuiv^*inl. ..,,,,
MmchMrsaaif..^
!^T>a»vi^r ,
^fi,
riiliflf... ...... ..
Apr. 1-M»y 6.
Jitiii!24'3(J.,..,.
July ^B^jit. 22.
July 1-Sept. 1
Sept. 9-29
Apr. 23- Ji me 30...
July l-Scpt.2^....
May ft- June 30.
July 2tNAiiK. 25
Moy 13- June 2
Apr.30^Miij^5
Mjiy27-Jiiiie30
Mn]yl-7 _.
July 29-Aii(f. U
Apr, 21-Jiitiij:^
Jiily Ji-St?pt.S
I'rovlnccts,. .,. „
Airu.'wjii,... .,...-.*.
Alhiiy
Oo. JuiyM
A iiilsfi^ C luniuitles.. . ,. J Joiii* J^
Mo..-...- J^^*'
\iUUim? . ...... aiH^ i*^ '
tlttiaoEas ...,.,„,.... 4 A»^X^
Bohol.. ..,„,.....) ^t'*^
Do,. »..._- *f. •
Do„. ...^
Fi?b, l-Jiiup :w
J» ly 1-31.......
Fob. I'll i HI? ao.
Ji^iyl'3l .. .
Feb. l-Jiir» 'm
Inly 1^1.
Jutie l^rj,
1 VI I. r- J Line 30,
July 1-31.......
Apr. 23-Maya7.
Jiily3-Sepl.30.
Sepl. 12
Apr. 2-K
J< lyl^36.
Julv lt>'(Hi.2.
Feb. 3
Jl ly '£S.
juiv2y.
Juii'. 17
Juii. :h
A II jf, 251-29
July 2^ Aug. 5..
Do,.
2
I niiie. Apt. ^
4 Lntulrm
Digitized by
Gogg
le
December 21, 1917
2184
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND TELLOW
FEVERr-Oontintied.
Reports ReeeiTed fhun June 80 to Dee. 14, 1917--GoQtinued.
CHOLKSA--Oontlnaed.
Place.
Dste.
Caaes.
Deaths.
14
5
810
512
237
117
618
3W
148
83
S21
313
1
1
1
1
13^
75
106
SK
274
133
16
10
7
7
15
14
17
16
Philippine Islands— Cont Inued.
Provinces— Continued.
Lcvte
Do
Mlsamis
Mindanao
Ncros Occidental
Nc^-Tos Oriental
Rizal
Do
Romldon
Snmar
Sorsou'on
Do
Suri-^ao
Tava'>a3
Do
ZamlKwnga
Juno 10-30
July 1- Sept. 15..
Julys-AuK. 4...
JulT'J(VOct.20..
Sc^t. 3') -Oct. 27.
Juh 1 Or'. 27...
JunrlN 3')
Jul' 1 7
Jul\ 22 2S
Julv i:> Sept. 23.
Jui,e3 3)
Julv l-AuiT. 25..
Julv29-.\iig. 25.
Juno 3 nJ
July l-S»pt.29..
July 15-21
PLAGUE.
Arabia:
Aden..
Maya-July 4..
Bahrein Islands *
BrafU: |
Bftlila '
Do ^
Pern unbuco !
Ceylon:
ColomlH)
Do ,
China: j
A mov '
Do I
Honrkon^* I
Do
Kv.an- tun-' Provlnr* — I
lu-pu'li^lrn-l
Ktiiad.w:
h tin i;v \icja |
Ou i\ >i'tuil '
i)o t
Do -
Mllarro
Do •
Nobnl
Su.il'o
Do I
Taum
E*r>'pt
A!c\:Ul<llI»
D)
Port '-aid <Jf..ornnit nt
I'o". ^ iid
l»o '
I'rovln' '-• -
F:iv<"im
<i.i lo nxli
<.ir . h
Mll'!.-h
1) »
June 10 10
Juv ^ Srpt. 15..
Jii.\ lt> .M'pt.30.
Apr. H .'unr2K.
Jul\ t> S'pt.2i..
\ nr . 2 » Nf ay 5. . .
July I 7
Ma\ I { JunoiiO.
Juiy s Auk. is..
Juno 2
Feb. l-W..
lio..
Mar. I Ar>r. TO.
Jnl> 1 An-. 31.
Mar. I tl
Af»r. 1 u)
Fob. 1 Js
...do
Mar. 1 <
Frb. I 2S
Jrn.i'! •.':.
A.-r. V Si 1
J,. <■ .*' .. ,
I'....
.1
* rr'rn<^nt..
Do.
"ril iin:
ri <■, ml..
o:i.ion
JiirH'.N I
M I. \: ;.'
M i\ IJ JiMi- 2^...
Jti v-'» -■ {'Ml...
M,..» \J
Anr .'» ? u-'-j
Ml'- IJ 'imo 2^...
Oct 11 2«»
\nz I.] 2J.
M;i\ ! s. ...
Ji.
'Jl
.3
2.1 ,
IS •
2 !-
Apr. 8~||a7 14, 1917: C^v. ».
death-i. 51.
In P<>r3ian Oult Prcvat Aw. I
1017.
Pn^rwit and in Wclnity.
Present Aa|f. 10.
Present.
Jan. 1-Oct. 18, 1917: rw». W:
deaths. ;t«i7.
From ». ^. BCatiint.
. 2 in ha^pJtTl at port. Ffiun -.fc
M'dinU rrom ^ti<ril'i iM
I orlmtaJ portl.
Digitized by
Google
2185
December 21, lOlT
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER-T-Continned.
Reports Received from June 30 to Dec. 14, 1917— Continued.
PLAGUE— Continued^
Place.
Date.
Cases.
Deaths.
Remarks.
India.
Do
Bombay
Do..
Calcutta
Do
Henxada
Do
Karachi
Do
Madras Presidency
Do
Mandalay
Do...
Moulmein.
Do
Mylngyan
Pegu
Do
Rangoon
Toungoo
Do
Indo-Chlna:
Provinces
Anam
Do
Cambodia
Do
Cochin-China
Do
K wang-Chow- Wan. . . . .
Tonkin
Do
Saigon
Do
Japan:
AlchiKen
MiyoKcn
Java:
East Java
Djoc^akarta Residency,
Kediri Residency
Samarang Residency. . .
Surabaya Residency . . .
Sorakarta Reiidiaicyl ! '.
Persia:
Mohammera
Peru
Departments—
Ancachs
Arequipa
Callao
Lambayequc
Libcrtad
Apr. 1-June30...
July 1-Sopt. 16...
Apr. 22- June 30..
Jiflyl-fiept.22...
Apr. 29-June2...
July 16-21
Apr. 1-June30...
Aug. 12-Sept. 15.
Apr. 22-June30..
July 1-Sept. 29...
Apr. 22-June30..
Jiayl-Sept.29...
Apr.8^Mayl2...
July2*-Sept. 16-.
Apr. 1-June30...
Julyl-Sept.l....
Apr. 1-7
May27-June2...
July2»-Sept. 15..
Apr. 15-June30..
July l-Sept.8....
Apr.ft-14
July2»-Sept.l...
486
379
40
201
3,565
Fob. WuneSO...
July 1-31
Feb. 1-June30...
July 1-31
Feb. 1- June 30...
July 1-31
Mayl-June30...
Feb. 1-June30...
July 1-31
Apr. 2^June3...
8ept.9-Oct.7....
Jan.-July .
....do....
Apr. 23-MayO..
do
Apr. 23-May 20.
Apr. 2-May20..
July 8-28
...fdo
Mayl.
July 1-31
Mayl6-July81..
do
....do
May 16-21
Lima.
Senegal ,
Siam:
Bangkok
Straits Settlement:
Sh^apore
Turkey in Asia:
Trebizond
Union of South Africa:
Cape of Good Hope State-
Cradock
Olengrey district
Terka district
Queenstown
Orange Free State
Winburg district
do..
Sept. 30.
Apr.22-June30.
Jiay3-Sept.l5..
June ^16
July l-8ept. 22.
Dec. 8
Aug. 23.
Aug. 13.
May 28..
June 6..
Ats
8. S. Matiana.
May 28
July 14-18.
183
457
232
13
132
10
219
43
34
in
3
47
9
22
3
54
27
397
807
38
4
35
7
413
34
260
2,562
9
34
74
33
1
2
1
109
428
2
12
131
9
116
10
133
24
23
89
2
26
6
Apr. 15- June 30, 1917: Cases,
43,992; deaths, 30,197. July I- r
Sept. 22, 1917: Cases, 71,636; '
deaths, 53,000.
Jtme3-23, 1917: Cases, 72; deaths;
Fob. 1-June 30, 1917: Cases, 730; i
deaths, 491. July 1-31, 1917; i
Cases, 69; deaths, 45.
Apr. 2-May 20. 1917: Cases, 29;
deaths. ». July SO-Aug. 20,
1917: Cases, 4; deaths, 4.
Present
May ia-31. 1917: Cases, 15. Juno
1-July 31, 1917: Cases, 36.
AtCasma.
At Mollcndo.
At Callao.
At Chidayo.
At Salaverry, San Pedro, and i
TruiiUo. July 1-31, 19n: At
Trujillo.
At Lima. July 1-31,1917: Lima,
city and country.
Present in interior.
Present.
Do.
Do.
At Summerhill Farm.
Apr. l(i'22, 1917: 1 case. Apr. 9-
22, 1917: (\hcs, 26: deaths, 17.
En route tor port of London.
Digitized byVjOC)QlC '
December 21, 1917
2186
CHOLERA, PLAGUB, SMALLPOX, TYPHUS FEYBB» AND TBLLOW
FEVER— Continued.
Reports Recehred from June SO to Dec. 14, 1917 — ContmuecL
SMALLPOX.
Place.
Date.
CMOS.
Deitht.
HgniMlB.
Australia:
Now South Wales... ......
Apr. ar-JoIj- 5, 1917: Cata, ft
July l^-5ept . 35, 1»17: GMii^ B.
Near Kf^wrmstif^
Abormain
Oct. 13-25
2
0
4
13
2
fi6
1
4
0
126
620
1
5
21
3
Brcwarrina ,
Apr. 27-June21...
July^V2J<
May2S-July6
Apr. 27- June 21...
June 22-Oct. 13....
May9
C^c-^snock
Cooruiltarabran
Quatnbono
AV ar rcn district
Quconsland—
TluirMJav Island Quar-
yrtwri s. 1*. 8t. A Ibans fnn Tttt
antiue .Station.
Brar.il:
IJahia
May ft- June 30....
July22-Ocl. 13....
.do
via Dcmgkronx. V«sel B*
bane, and Bydnej, la qovm-
Une.
Do
2
31
183
Rio do Janeiro.....
Do
JuJyl-Sept.29....
JunelO-lC
Aug. li>-Sept. 1....
Nov. 10
Canada:
Manitoba—
\\ i luiipcg
Do
Now Brunswick .........
Chiefly In Carleteo and Tort
CoiinUtti. One case noCified tt
Northumberland County.
Nova Scotia—
Halilix
June 18- July 7
June 17-30
Tort llawkesbury
Ontario-
Ottawa
v*Te»nt in district.
Julv 30-Aug. 5
Nov. 11-17
8opt.30-Nov.3...
MavG-12
1
1
4
1
S.irnia
Wimlsor
Ceylon:
Col ombo
China:
Amoy
Apr.20-Mav26....
Present and In Tidnity.
Do.
Do
July l-Sopt. 22
AntiiuK
Mav 21 Juno 24.. -
Aup. 6-Oit.21
May 27- Juno 2
.\up 11 17
4
2
b
Do
Chnnir^ha
Do
7
ChtuT-:l-inj»
Mav G Juno 23
Trwent,
J>o
Juh l-Oct. 2^
PnMttit and in Tidaitj.
Dairon
May n Juno 30....
Julv 8-28
30
6
2
7
8
1
1
4
1
Do ... .
July 1-7, 1017: Pnsnt.
II an Vow
Juno 21-30
Apr. 2:j-.May 6
Mav C-Juno 16
Aup. ^18
Harbin
On Chinese Eastmi Ry.
Iloni^Vong
7
j)o
Manchuria Station
Apr. 23-20
Mav 27-Juno 2. . . .
Do.
Mill <lon
Present.
Do.
JulvK-Oct.27
Do.
Shaii^hiu
May21-July 1
July2-Oct.28
Apr. 16-22
Mav 22 July 7
13
5
1
35
4
1
32
31
Ca.M^s, foreign: deaths among na>
Do
tives.
Cases among foreien populatioo;
deaths among Chinese.
On Chinese Eastera Ry.
T-it-^bar Station
Tsin 'lao
7
1
At another station on railway; *
Do ;.
July ;iO- Aug. 11...
Mav 1-31
lease.
Clio*5on ( Koi-oa):
Choniiiipr) .................
Cilia:
Habana
Nov. 1
From 8. s. Aliboso XHI , from
Ecuador:
(iviava'iuil
Fob. 1-2S
Mar. l-Apr. 30....
July l-Aut;. 31
Apr. :W-Jiily 1
Julv 2-20
1
8
12
39
30
80
ports In Spain.
J)o
Do
Kj:\pt:
AU'xandria
Do
9
4
1
Cairo
P'eb. 12-Apr. 8....
Digitized by
Google
2187
December 21, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continned.
Reports Recelted from June 30 to Dec. 14, 1917— Continued.
SMALLPOX— Continued.
Place.
Date.
Caaes.
Deaths.
Remarks.
France:
July 30-Aug. 5. . . .
May 6-12..:.
1
1
Paris.
Mar. 18-Apr. 28, 1917: Casca. 715;
Berlin!;!;
Mar. 18-Apr.28...
do
106
16
18
50
20
2
10
1
in cities and 22 States ana dis-
tricts.
do
do
Leip/Ie
LUbock
do
do
Munich
Btutteart . . ^ »
do
do
Greece:
Athens.....
July 25-30
23
75
35
12
2
8
a
48
23
5
India:
Bomhay..
Apr.22-Junc30...
July 1— Sept. 22...
Apr. 29-Maya6....
186
72
Do
Calcutta.
po...r;
July 20-AiiK, 25. . .
KarachL
Apr. 22 -July 4
July8-?ept. 1
Apr. 22- June 30...
July l-Scpt.29....
Apr. 15- Juno 30...
July 1-Sept. 1
27
6
80
10
83
11
Do
Madras
Do
Ran^ooo...
Do
June 3-23, 1917: Cases, 18; deaths'
Indo-Chlna:
Provinces
5.
Fob. 1-Jnno 30, 1917: Cases, 617;
Anam.. ...,.,,,
Fob. 1-Jiino30....
July 1-31
1,630
353
136
28
1,267
130
4
6
10
274
4
199
141
32
12
1
237
50
28
23
377
49
deaths, 535. July 1-31, 1917:
Do
Cases, 525; deaths, 132.
Camliodla
Fob. 1-Juno30....
July 1-31
Do
Cochin-ChLna
Fob. 1-June30....
July 1-31
Do
Kwang-Chow-Wan
Laos
Mar. 1- Apr. 30....
Apr. 1-30
1
1
30
Do
July 1^1
TonHn
Feb. 1-June30
July 1-31
Do
Saigon
Apr. 27-JuiielO...
July2-0ct.21
May 21-June 24. . .
Julyl2-Sept.30...
Sept. »-15
63
06
12
3
Do
Italy:
Turin ,
Do
^Mnaica:
ICing«tMi
Japan
Jan. -July, 1917: Case?, 4,974; in
Kobe
May 27-July 22....
May 2S-Juno3....
May HWulyS
July 25-31
65
1
177
1
1
38
21
88
100
16
37 Provinces and districts.
Na?a'ald
OsaVa
YokkaichL
55
Yokohama
May 27-July 1
Apr.2-Jnly 1
July 2- A 1115.29....
Apr. l-.July 1
3u\y2-(Hl.2
1
2
Java:
East Java
Do
Mid-Java
7
Do
West Java
Apr. 13-July 5, 1917: Cases, 239;
Batavia
Apr. 13-Sept.20...
Jan. 1-June30
32
6
116
1
1
9
deaths, 44. July 6-Oct. 11,
1917: Cases, 273; deaths, 80.
Mexico:
Coatepcc
Do
Anj». 1-14
Jan. 1-Aug. 14, 1916: 118 deaths.
Jalapa
July 1-13
Ma .at Ian
July ll-Aug, 7
Mexico City
Jone3-sJ0
162
101
Do... :;;;:;;;;;;;;;;;;
Aug. 5-Nov. 10....
June 18-24
Monterey
24
23
1
2
1
Oriiala
Jan. 1-Junc30 1
Do
July 1-23
Vera Cruz
July 1-Sept. 15....
Aug. 13-18
May 13- June 9....
July8-Oct.20
6
1
6
8
Netherlands:
A m ^lerdam
Philippine Islands:
Manila
Varioloid.
Do
Do. _
Digitized by VjOOQIC
UeceinUn'21,1017
2188
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YBLLOW
FEVER— Continued.
Reports Received from Jane 80 to Dec 14, 1917-— Continued.
SMALLPOX— Continued.
Place.
Date.
Oats,
Deaths.
RemaricB.
Portural:
Lisbon
Mayl3-June30...
Juiy»-Nov.3
Mar. 1-June 30. . . .
14
10
Do
Portuguese Fan Africa:
Lourenyo Marques
5
7
4
Do
July 1-31
Russia:
Archangel
Mayl-Juno28....
July2-Aug.2«....
July 2-16
66
6
6
y&
58
7
23
16
3
Do
Moscow
Pctrograd
Feb. Ig-June 30. . .
July 3-29
Do
Rlea
3tar.ll-Junc2....
Mar. 15-24
Jan. I-Mat. 31, 1917: Caws, f .
Vladivostok
7
81am:
Banskok
Jmie<MO
Do....;.:.:;;..::.::!..
July 11-17
5
4
44
19
11
6
Spain:
Madrid
May l-June 19
Mftla^fr
A pr. 1-June 30. . . .
*
Do
July 1-31
Seville
x'av i-jime 3o
Do
Sep't 1-30
Valencia
June 3-23
5
13
6
1
1
1
2
2
4
24
2
Do
Julyl-Sept. 15....
Mar.l8-June23...
June 24-30
HtraiU Settlements:
Penanf
3
Singapore
Do
Sept. 16-22
Apr.22-2S
Sweden:
Malmo
Stockholm
Moy20-June23...
June 2-8
1
Tunl-ia:
Tunis
TurVcy in A^ia:
Trebi '.ond
Fcb.26-Apr. 13...
Mar 12-24
15
Tnion of South Africa:
Johannesburg
Do .1
Julyl-Sept.30....
May 1-31
rnufuay:
Mon t4» vi4lco
Venezuela:
Mtt^Acoibo
June IR-July 8....
8
1
Do
July 9- 23 •
On vcsM'ls:
S. S. Alfonso XUI
Nov.l
1
Spain for Mexican portj^
TYPHUS PBVBS.
Algeria:
A iKicr?
Jmie 1-30
e
1
a
1
1
Do
Julyl-Aaf.31....
Aug. 13-18
ArKcnilna:
IJiHTOs Afre«
A ust riu-ll un^jary :
\ustria ..."
Oct. 22-Dae. 17, 1916: Cmh, IJEH.
liohcmla
Oct.23-Dec. 17....
.....do
C34
809
47
•17
15
243
5
De«. 94, 19i6-F^b. 24.' mTi
(iuhcia
Cm»,i^.
lower AiLstria
do
M oravia
.. .do
Silosia
do
Styrii
do
do
f'pner Au'^tria
IJosiiia-iIerxcjjoN ina.
D«e. 2^ 1916-Feb. 94. 1917: Cwm,
iia
Fib. 19 Jam 17. 1917: C^^
Ilnnparv
Iiii<{.ir>c^t
Feb 19 May 27....
Apr. 23 -June 17...
July 2^Aug. U...
SrpJ 23 29
10
378
3
1,717.
Kibonntirs
46
Bmtil:
Kio <lo JaiM-iro
Conary Islands :
^'antu ituz dr Tcncrlffe
1
Digitized by
Google
2189
December 21, lOlf'
CHOLERA, PLAGUB, SMALLPOX, TYPHUS FEVER, AND YELLOllfi
FEVER— €ontlnned.
Reports Received from Jane 30 to Dec. 14, 1917— Continued.
TYPHUS FEVER— Continued.
Place.
Date.
Cases.
Deaths.
Remarks.
China:
Antung
June23-Julyl....
July9-0ct. 28
June 9-15
3
20
1
Do
1
Hankow
Do
July &-14
1
Tientsin
Juno 17-23
May3a-July7
Aug.5-Oct.20....
Aug. 30- July 1....
July 17-Oct. 14....
Jan. 22-Apr. 8....
Mar. 19-25:
1
4
3
l,ft48
447
188
1
Tsinetao
Do
Egypt!
Alexandria
478
123
76
Do
Cairo
Port Said
Great Britain:
Cork
Juno 17-23
1
Glasgow
Sept. 30-Oct. 6....
May 23>June 30. . .
1
Greece:
SaloniM
33
67
Do
July 1-Oct. 13
Japan:
Hakodate
July 22-28
1
4
51
Nagasaki
Juno 11-24
Do
July9-Nov.4
3
Java:
EastJava
May6-Jul7 1, 1917: Coses, 6.
July 9-Aug. 29, 1917: Cases. 7.
Apr. 1-June 24, 1917: Oases, 38;
deaths 5 Julv 0-Oct 2 lfll7*
Surabaya
June25-July29...
4
Mid-Java
SamAran? ,,,,,
Mav5-Junel0....
July2-8
14
6
2
i)o!^.::::::;::::::
Cases, 16- deaths 2
West Ja\a
Apr. 13-Julv 5, 19f7: Cases, 147;
deaths, 6. July 6-Oct. 2,
1917: Cases 151- deaths 17
Bata ia
Apr. 13-July5....
JulyC-Oct.4
Julv 10-Oct. 28...
70'
96
6
10
2
1
Do
Mexico:
Aqiiascillentes
Coatopec
Auir. 1-11...
Durango, State
Oct. 29.. ..
Pre VB lent on ranches in vicinity
of El Rio.
Jalapa
Apr. 1-Junc30.-
6
3
bo...::::::::: ::::::
Ji Iv 1-31 .
MexicoCity
Junc3->'?0. . .
4.11
1.099
Do.......::::::::::: .
July H-Nov. 10....
Jan. 1 -June 30
Orizaba
6
1
2
Do
July 1-31 .
Netherlands:
Kotterdam
June 9-23 .
3
11
7
1
11
16
10
111
33
Do :..
Julyl5-Sept. 1....
July 8-28 .
Norway: . *
B 0 r iren . . . i . s.
Portupueso Ea.st Africa:
I.oarentOHLirques
Mar. 1-31
Russia:
Archant?el
Mav l-June2S
Ji.l.-2-Aus. 28
Jiilv 2-1.3
2
5
1)0
Moscow
rctro.<rad
Feb. IS June 30...
Julv 2-29..
3
Do
Poland
Apr. 23-Jime 3, 1917: Cavs, 2,814;
deaths, 1S7. June 17-JuJv 14,
1917: (:isos. 2,:32S; deaths,' 211.
Lodr.
Apr. ■2.{-.Irnc3
June 17~Julv 14...
Apr. 2:i- J line .3....
Juno 17 Julv 11. ..
Mav31-Junc 16...
Julv22-2.s
Mai-. 29-May 21 . . .
May 1-31..
120
lUS
1.HI4
1,495
I
5
10
16
9.")
131
Do
Warsnv
Do
Riita
Jan. 1-31, 1917: 1 case.
May 1-31, 1917: Ciu^cs, 4.
Do
Vladivostok
Spain:
Almoria
5
2
Ma.Irid
.do....
Swit/trluid:
Bxstl
June 17-23
1
11
3
2
Do : •
Jul .S- Oct. 27
Julv2r,-Nov. .{..
1
Zurich
Trinidad
Juno M)
Tunisia:
Tunis
June 30-Julv 6
1
I'nion of South Africa:
Capeof (iooa lIoi>c State...
Aug. 23, 1917: Present in 10 dls-
trict.s.
Present.
East London
Sept. 10.
_
Deoenibfr 21, 1017
2190
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AM) YKLkl^
FEVER— ContinuecL i
i
Reports Receited from Jane 30 to Dec 14, 1917 — ContiniKd,
YELLOW FEVER.
Place.
Date.
Caaes.
Deaths.
BeoKks. ■
Ecuador:
I^almbovo
Feb. 1-28
Mar.l^l
do
1
2
1
18
34
21
1
2
2
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3
I
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(hobo
1
(lUavQoull
Feb. 1-28
Mar.l-Apr.80....
Julvl-Aug.3l....
Feb. 1-28
Mnr. 1- Apr. 30....
July 1-Aug.31....
Scpi.25
1)0.
Do
Milvcro
Do
1
2
Nuniii)i?o
Mexico:
Campoche, Stuto—
( umpcche
Vucatan, State—
Merida
8ept.l-Oct.28....
June 23
2
1
2
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Mexico aty. '
Preaent Sept. 5. Pnafr
^^of July t« So? : -
Do
Jnly2ft-Aui;.ll...
Oct.27-Nov.8....
Venezuela:
("cwo
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PUBLIC HEALTH REPORTS
VOL. 32 DECEMBER 28, 1917 No. 52
VACCINE vmus.
PROPAGATION AND SALE IN INTBBSTATE TBAFFIC OF VACCINE VIRUS ON OR WITH
POINTS PROHIBITED.
Under the provisions of section 4 of the act of July 1, 1902, para-
graph 29 of the Regulations for the Sale of Viruses, Serums, Toxins,
and Analogous Products in the District of Columbia and in Inter-
state Traffic, has been amended to read as follows:
29. The propagation and sale in interstate traffic of vaccine virus on or with " * points *'
are hereby prohibited. Vaccine \nni8 shall bo furnished only in glass capillary tubes
or in other jrlass container.
PUBLIC HEALTH ADMINISTRATION IN RUSSIA IN 1917.
By i\'V.. A. WiNsLow. Professor of Public Health, Yale School of Medicine, Member American Wv^\
Cross Mission to Ru'tsla.
The most unique and significant contribution which Russia has
made to the art of public health administration is the organization
of a combined system of free medical care and health protection for
her rural population tlirough the medium of the zemstvos, or local
representative assemblies. The problems of rural medicme and rural
sanitation are everywhere most pressing and most difficult ones. In
Russia, with 85 per cent of her population of some 180,000,000 living
in rural districts, these problems are even more urgent than they are
elsewhere. A brief consideration of the way in which their solution
has l)cen attempted is therefore fundamental to a conception of the
general system of health organization of the new Republic.
History of Zemstvo Medicine.
According to the excellent sketch of '*La M6decine du Zemstwo
en Russie," prepared by E. Ossipow, I. Popow, and P. Koiu-kine
for the XII International Congress of Medicine (Moscow, 1900),
the first hospitals in Russia were built in connection with churches
and monasteries after Vladimir embraced Clmstianity in 988.
Many monks and priests became famous as healers in the period
from the eleventh to the fourteenth century and lay physicians
157 (2191)
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December 28. 1017 2192
gradually made their appearimce. Ivan the Terrihle brought Eop-
lisb medical men over in the sixteenth century and Peter the
Great introduced many foreign physicians and sent Biwniam to
learn the art abroad. He studied medicine himadf and was par-
ticularly interested in its preventive side, personally prescribing
directions for controlling plc^e in Kiev and Little Russia in 17 IS
and for army sanitation during the war with Prussia in 1722. Under
Catherine the Great the Medical Faculty of Moscow was organized
and many hospitals were established. The Medical-Chirurgical
Academy (now the Military Medical Academy) was founded at
Petrograd in 1800.
In spite, however, of advances made in the great cities the rural
population of Russia lived and died practically without medical care.
They were treated, if at all, by midwives and occasionally by
feldschers, the latter being medical assistants of a type peculiar to
Russia who have completed four years in the Gymnasium (about
equivalent to our Grammar school graduation) and have then spent
three or four years in special training which includes elementary
anatomy, physiology, with a little bacteriology, pathology, and the
hke. Fidly trained physicians were known in the coimtry only as
Government officials who made their appearance on the occasion of
an autopsy or of some olficial inquiry.
The zemstvos or rural constituent assemblies were created in 1864
by Alexander II. They are elective bodies which conduct the local
government of Provinces and of the rural districts within the
Provinces and at present they exist in between 35 and 40 of the 50
Provinces of European Russia. Members of the zemstvos under the
old regime were chosen by a special electorate including owners of a
s}>ecified amoxmt of land or property, representatives of educational
and benevolent institutions, and commercial companiea. Under the
Republic the basis is of course universal suffrage and far-reachiiy
changes in personnel are taking place as a result. The assembliei
of Provinces and di^^tricts meet annually to legislate and to elect the
permanent zemstvo administrative organization. Zemstvo activities
deal with problems of local taxation, road construction and mainte-
nance, local postal service and the hke, as well as with education and
health protection. In 1 890 the original privileges of the zemstvos were
limited by giving to provincial governors wide powers of veto over
their act.<^. I'n ler the RepubUc, however, the provincial zemstvo wiD
oxercLsc powo:-s essentiaUy similar to those of oiu* State legislatures,
while the district zemstvos will constitute units somewhat analogous
to the county governments in certain of our Southern States.
Whoa the zemstvo organization was created there were hospitals in
the lar^rcr cctitors of population controlled by the provincial govomora
and there wore a few small hospitals, chiefly served by feldschcrs, Tr
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2193 December 28, 1917
the peasants of L'Etat and L' Apanage. The emancipated serfs were
wholly unprovided for, as were the industrial workers with the excep-
tion of the minors in the Province of Perm. Altogether there were
turned over to the newly organized zemstvos, 32 provincial hospitals
with 6,200 beds and 303 district hospitals with 5,100 beds. These
hospitals were for the most part in very bad repair, highly insanitary,
and grossly mismanaged. There was rarely provision for adequate
isolation of commimicable diseases and it is small wonder that ''the
necessity of entering a hospital was regarded as a chastisement from
God.''
The idea of fui-nishing real medical care, not only to the city
dweller but to the peasant in the remote rural district, seemed to
many observers in 1864 too Utopian even to be thought of. The
difficulties are indeed great. In some regions villages may be a mile
apart with 50 inhabitants per square mile. In other regions villages
may be 5 to 15 miles apart with 5 to 10 inhabitants per square mile.
Yet it was to this Herculean task that the zemstvos promptly
addressed themselves. At first a compromise was attempted by
confiding the routine treatment of disease in rural districts to fold-
schers under the supervision of itinerant physicians. About 1870,
however, (he waste of the time of the physician and the inadequate
service rendered by the feldscher led to the introduction of the
system of fixed medical districts each provided with a small hospital
>md a qualified physician. Itinerant service was defended as cheaper
jmd more democratic, but the stationary plan has gradually won its
way and become almost universal except in the very sparsely-settled
districts.
So successful were the zemstvos in the expansion of this side of
their work that by 1890 instead of the 335 hospitals with 11,309 beds
originally turned over to them, there were 1,422 zemstvo medical
districts with 1,068 hospitals of 26,571 beds, and 414 dispensaries.
Between the years 1870 and 1890 the number of zemstvo doctoi-s
increased from 756 to 1,805 and the number of nonmedical assistants
(feldschers, midwives, pharmacists, etc.) from 2,794 to 6,778. A
large part of rural Russia is now divided into medical districts,
each of which centers about a small hospital or dispensary. Medical
care is always given without chaise and there has been a steadily
increasing tendency to make all dispensary and hospital treatment
free as well. The care of the sick is recognized by the zemstvos as
a natural duty of society rather than as an act of charity.
The Work of the Zemstvos Along Preventive Lines.
Aside from this purely medical work, which was their original func-
tion, the zemstvo physicians in most Provinces are extending their
activities along preventive lines, while in such pi'ovinces as Moscow,
Pctrograd, and Kherson there are completely organized sanitary
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December 28, 1917 21M
bureaus aside from the regular zemstyo medical staff. Ttke relatkm
between the prevention of disease and the free medical care of the
poor is, however, throughout a very dose one, and it is interesting
to note that this has come about by the expansion of a State medical
service along preventive lines, while with us the reverse process is
taking place, health departments, originafly organized for preventira
work alone, developing as an offshoot provisions for medical exami-
nation and cUnical care of the individual.
By a law enacted in 1852, public health committees with district
physicians were created in the provinces, but those district physiciaiis
had also to perform all the duties of local legal medicine and the
machinery to be set in action was cumbrous in the extreme. An
epidemic in a remote rural district was reported by the Starosta
(village head) to the chief of the group of Volosts villages in ques-
tion, then to the district police, then to the committee on pafalie
health, and finally to the governor. After a month or two the dis-
trict physician would arrive, to find that the epidemic had nm its
course, to make a proper report thereon, and to assess his travel*
ing expenses against the aflSicted village.
Very soon after the establishment of the zemstvos it became dear
that their decentralized plan of organization furnished an opportunity
for far more effective public-health work than could be hoped for
from the bureaucratic provincial governments. In 1867 the pro-
vincial zemstvo of Poltava established a permanent medical com-
mission which presented a report in print in 1869. In the next year
the medical society of Kazan began active work along pubfic-health
lines. Both these groups of physicians, with many others — particu-
larly provincial assemblies of zemstvo doctors — strongly m'ged the
need of special sanitarians to supervise and develop the work of pre-
ventive medicine. ITie higher zemstvo officials were at first unsym-
pathetic with this program. In 1879 a first step was taken by the em-
ployment of a special sanitary expert to study problems of industrial
hygiene in Moscow Province. The Province of Kherson appointed
seven special sanitary officers in 18S6, while Petrograd iSrovince
created a sanitary organization with a director and nine district sani-
tarians only in 1896. Most of the provincial organizations are erest
to-day without special full-time sanitarians; but the regular zcmstTO
physicians are ox|>octcd to devote a certain proportion of their time
to school inspection, control of epidemics, collection of vital statis-
tics, and public-hcaltli ciincation.
Zemstvo Medicine in (he Provinces of Moscow and Saratov.
Thi' Provinto of Moscow has perhaj)s the must highly developed or-
ganization for the promotion of ztniistvo medicine to be found in
Russia. It supports at the present time approximately 100 hospitals — •
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2195 December 28, 1917
one for every 10,000 to 15,000 inhabitants. Each hospital has from
20 to 60 beds and a personnel on the average of two physicians,
four feldschers, and four sisters (nurses). The larger establishments
include 16 to 20 beds for general use, 5 to 12 for communicable cUs-
eases, and 3 to 4 for maternity cases. Mental cases are cared for
in special institutions maintained by the provincial zemstvos. Each
hospital has its dispensary (averaging 100 visits a day) and all medi-
cines as well, of course, as all medical care, are given free. Homo
visits are made by the regular zemstvo physicians only in serious
cases, Financial aid is often given to women in childbirth and to
invahds who can not be brought to the hospital.
For the special work of disease prevention Moscow Province is
(Uvided into thirteen sanitary districts, each with a sanitary super-
visor in charge and with two or tliree assistants to the supervisor in
the larger districts. These officials are fuU-timo medical men. It is
their duty to inspect and pass on plans for water suppUes, sewerage
systems, pubhc buildings, and the like, to inspect industrial estabhsh-
ments, to collect vital statistics, and transmit them to the provincial
office, as well as to deal with outbreaks of communicable disease.
The work of these sanitary supervisors is coordinated by the provuicial
sanitary bureau, which maintains a central statistical division, a
laboratory, and a vaccine institute. There is also a sanitary council
for the whole province and one for each district within it — the former
including representatives of the provincial zemstvo assembly and of
the sanitary bmeau divisions with the 13 district pliysicians — a dis-
trict council including representatives of the district zemstvo and of
the cities within the district as well as aU the zemstvo and factory
doctors of tlie district in question, ntimate control of sanitary work
belongs of course to the provincial and chstrict zemstvo assemblies,
with their respective administrative officers. The sanitary code which
was in force before the revolution was prepared by the provincial
assembly and promulgated by the governor.
The Province of Saratov offers a good example of well-organized
zemstvo medicine in a smaller and more rural district, which was well il-
lustrated by a special exhibit at the Dresden Hygienic Exposition (Er-
kliirung zu den Exponaton der Saratower Gouvernements Semstvo
auf der Internationalen Hygiene Ausstellung in Dresden im Jahre,
1911. Saratov, 1911). The provincial zemstvo in 1911 maintained a
general hospital of 200 beds and a psychiatric hospital of 460 beds
for a population of somewhat over 3,000,000. The district zemstvos
maintained 123 medical districts with 78 hospitals and 1,106 beds
(one hospital bed to 2,525 persons). In addition to the 123 medical
districts, each of which had its own physician, medical assistance was
offered by feldschers or other medical hclpei^ at 55 other points.
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December 28, 1917 2196
Forty-five of tlie medical districts had a polydimc only, 9 had 4-bed
hospitals, 30 bad 5 to 10 bed hospitab, and 2 had hospitab of more
than 40 beds; 525.9 clinic cases and 9.1 resident cases were treated
per 1,000 population; 33.2 per cent of the proTindal budget and
31.6 per cent of the district budgets were appropriated for mediottl
and sanitary purposes (total of both amounting, however, to only
about 50 kopecs per capita).
The regular zemstvo physician is supposed to exercise general
solitary supervision of his districti to combat epidemicB, inspeci
schools, and educate the public on health matters. The zeoMtvo
has provided also in each district a sanitary supervisor with laboratory
equipment sufficient for simple chemical and bacteriological exami*
nations and a central sanitary bureau which analyzes vital statistics,
publishes a monthly bulletin, maintains a Pasteur institute, and
employs emergency workers in case of epidemics (131 such workere^
13 of them physicians, were employed to combat scariet fever and
typhus fever in 1910, and 231, of whom 46 were phyaioiansy to deal
with cholera).
Before leaving the general subject of zemstvo medicine, a word
must be said about the splendid services which the zemstvo organi*
zations have rendered along army medical and sanitary Unes during
the war. Just as the zemstvos accomplished in civilian health*
protection tasks which seemed impossible to the bui^eaucretic authori*
ties, so, when the strain of war proved too heavy for the coostitated
agencies, the union of zemstvos, the union of municipalities, and
the Russian Red Cross stepped into the breach and assumed a large
share, not only of the medical care but of the clothing and pro*
visioning of the army. The zemstvo and municipal unions now
maintain 200,000 hospital bods in the rear for army .use, as well as
a large organization at the front, and they have an elaborate and
well-organized machinery for purchasing or manufacturing and dis-
tributing medical and surgical supplies. A central committee, repre-
senting the Imions of zemstvos and municipaUties, the Russian Red
Cross, and the sanitary department of the army, meets every night
in Moscow to plan for the evacuation of sick and woimded soldiers,
of whom 4,000,000 have been handled by this and other similar
committees since the beginning of the war.
In Russia, as elsowhore, the most intensive Advelopment along
public-health lines has taken place in the cities and particularly in
the two cities of Moscow and Petrograd, which are in the 2,000,000^
population class. Kiev, Lodz, Odessa, Riga, and Waisaw are the
only other cities with more than 400,000 population, with thirty-
odd cities with between 100,000 and 400,000 population.
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2197 Dcceiuber 28, lOlT
Moscow city health administration.
As in the case of provincial zemstvo organizations, Moscow leads
also in municipal health administration. An excellent description
of the sanitary machinery of the city was prepared for the Dres-
den Exposition (Die Stadt Moskau in gesxmdheitlicher Beziehung;
Moskau, 1911); and I found the general outline of the organization
was still essentially the same in 1917.
The water supply of the city (averaging in 1915, 10,100,000 vedros,
or 27,270,000 gallons, per day) is derived chiefly from the Moscow
TRiver, and is purified by slow sand filtration with chemical coagulation
when necessary. About one-sixth of the total supply is, however,
contributed by well waters from Mytiszczy. Bacteriological results
on the treated water are good, and the comparatively low death rate
of the city from typhoid fever is good evidence of the effectiveness
of the process.
Moscow is one of the very few Russian cities which have installed
comprehensive systems of sewerage and sewage disposal. I was
informed that not over a dozen cities in Russia have sewerage systems
which receive fecal wastes and that only four or five have any system
of sewage treatment. Nijni Novgorod has Imhoff tanks, Kharkov
trickling filters, and Moscow and Odessa irrigation areas.
Even in Moscow, only the central district of the city is at present
connected with the sewers, and in 1915, 572,442 cartloads of night soil
(averaging 28.5 poods or 1,026 pounds per load) were removed from
the outlying districts and dumped under highly offensive conditions
in areas of lowland. The sewage proper, which amounted in 1915 to
6,768,000 vedros, or 18,274,000 gallons, per day, flows to two separate
irrigation areas, one at Lublino which treats about two-thirds of
the total amount (about five and one-half million gallons in the sum-
mer of 1917) and another at Luberzy, which handles the remainder
and provides space for expansion in the future as the outer zone
of the city is gradually connected. The Lubline farms, which were
the only ones I visited, include about 1,000 desiatins (2,700 acres),
of which about a tenth is under cultivation, cabbages, r3'e grass, and
willows being among the principal crops. The main part of the
area is not cropped but is operated essentially on the plan of inter-
mittent filtration. Of the total area, about !)alf is clay, a quarter
peaty soil (tourbe), and a quarter sand, and operating results differ
materially, as would be expected, on the different soils. The clayey
and peaty areas treat about 3,000 vedros per desiatin: the best of
the sand areas about 25,000. (Since a vodro equals 2,7 gallons and a
desiatin 2.7 acres, vedros per desiatin and gallons i)er acre are
interchangeable terms.) Doses of sewage are applied to a given area
at intervals of from 4 to 10 days, depending on the chnrarter of the
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December 28, 1917 2198
soil. The sewage pumped to the sand beds, which are on a higher
level than the others, is submitted to bar screening (2i cm. mesh)
and brief sedimentation (10 minutes). The rest of the sewagft
receives no preliminary treatment.
The most interesting thing about the Moscow sewage-disposal
plant is the admirable experiments which are being conducted oa
various alternative methods of treatment under the direction of IL
Serge Stroganoff , who has made exhaustive large-scale studies of Im-
hofif tanks, contact beds, and trickling 61ters (the latter equipped with
rectangular and circular Fiddian distributors as well as with Americaa
type spray nozzles), and is now devoting particular attention to
activated sludge treatment. When I visited the plant four experi-
mental basins were in operation, treating 50,000 vedros (135,000
gallons) a day by the activated sludge process with excellent results.
The tanks are about 2.5 meters in depth and are operated on the
fill-and-draw plan with four hours' aeration and 20 to 30 minutes'
sedimentation. The air is distributed not t*irough filtros blocks but
from 2.5-millimeter openings on tae under side of 1 f-inca pipe. Trie
result of t is procedure seems to warrant its furt' er study. Forty
volumes of air per volume of sewage was being used at t .e time of my
visit, wLich is not bad for t'ae extremely concentrated sewage treated,
and M. Stroganoff believes t lat by improvements in distribution
which he lias worked out, t is amoimt of air can be cut to 10 volumes
of air for one volume of sewage. He hopes s'lortly to undertake the
construction of a 3,000,030-vedro activated shid^e plant Wiich will
release t ^ irrigation area or a considerable portion of it for use as
a municiy^al dairy farm.
Aside from tliese strictly sanitary engineering problems, the
health administration of t .e city is directed, so far as its general
pohcy and finances are concerned, by a board of health of 20 members.
There is also an advisory medical board, representing the hospitabi
district and scliool inspectorate, etc., wiiich passes on recommenda-
tions of bureau c.Jefs as to medical policies and nominates candidates
for medical posts, a sanitary advisory board wliich exercises similar
functions in regard to problems of ei)ideraiology and tae like, and
half a dozen smaller advisory boards wi.ica consider special problems
relating to ambulances, hospitals, obstetrics, psycaiatry, school
inspection, veterinary medicine, pharmacy, etc. Tiiis system of
advisor^' boards through which the expert staflfs express their views
on the problems of policy which concern them b very characteristic
of Ilussian health administration in all its phases and on account of
Its broadly democratic character is hkely to develop even further
under tlio Republic.
Executive authority is divided between three bureau chiefs who
deal respectively with hospitals, sanitation, and sanitary statii*tics,
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2199 December 28, lOlt
all of them being physiciana. This arrangementi with its close cor-
relation between hospitals and sanitation and the recognition of
statistics as an independent branch of cognate importance, is also
typical of general practice in Russia.
The statistical bureau of Moscow, under Dr. Mikhailovsky, is par-
ticularly well organized. It is equipped with a library of 50,000
▼olumes and its reports (summarized in the volumes of the Annuaire
Statistique de la Ville de Moaoou and Bulletin Recapitulatif de la
ViUe de Moecou) will repay careful study.
The routine sanitary work of the city is conducted. by 20 district
medical inspectors, who are chained with the general functions
which belong to the divisions of communicable diseases and sani-
tation in an American city health department; that is, they visit cases
of acute communicable disease, secure their isolation, study the
epidemiological factors involved, and inspect factories, lodging
houses, «nd the Kke. The work of terminal disinfection, which still
occupies a very prominent place in Russian sanitation (and with
some propriety in view of the prevalence of insect-borne diseases), is
cared for by a chief disinfector with some 25 assistants; and the city
maintains an elaborate disinfecting station for clothing and bedding
with steam and hot water disinfection and with a '^ Japanese chamber"
for combined heat and formalin treatment. For food contnd there
is a separate force of 20 inspectors and analytical work is carried out
in a well-equipped food and water laboratory. Diagnostic examina-
tions are made at the imiversity and the various hospitals. Finally,
there is a third group of 20 medical men for school inspection. Each
of these physicians has about 20 schools and some 8,000 children
under his care. He inspects the school buildings and at the beginning
of the year makes out an individual health card for each child and
keeps track of all who are in need of special attention. He attends
to the isolation of school children and the disinfection of the school-
room, instructs the teacher in the early signs of communicable dis-
ease, and sends children in need of treatment to the general hospitals
or to the special school clinics maintained for the treatment of dis-
eases of the eye, ear, nose, throat, and teeth. Vaccination is stim-
ulated by sending medical students out to vaccinate free of charge
in the poorer districts, but is not compulsory.
The city of Moscow maintained 24 public hospitals in 1915 with a
total of 6,992 beds, and the number of new patients entering during
the year was 72,830; 1,264,676 persons made a total of 2,969,806
visits to the public dispensaries. There is one special hospital of
over 400 beds and one special clinic, for venereal cases, while cases
of this character, if not in an infective stage, may be received at any
clinic. There are two sanatoria for tuberculosis with a capacity of
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December 28, 1917
2200
about 40 beds each, but tuberculous cases are also admitted to moot
of the general hospitals.
Mention should be made of the admirable municipal lodging houses
maintained by the city with over 5,000 sleeping places.
For dealing with the important problem of infant mortality the
city maintains three infant welfare stations at which some 3,000
infants are received during the year and about 100,000 quarts
of milk distributed. The principal station, in connection with the
Morosov Hospital, is the most perfectly equipped plant for the pur-
pose which I have ever seen. The rooms are light, airy, and tiled,
every possible equipment for the medical examination of the infants
and for the preparation of milk is provided, and the waiting room is
furnished with an admirable collection of models and pictures illus-
trating good and bad methods of infant care, the models of dangerous
foods and the pictures of objectionable methods of clothing and the
like being all labeled in red so that the most ignorant mother ran not
fail to grasp their signficancc.
There are also in Moscow three smaller infant welfare stations
maintained by a private society for the campaign against infant
mortality, which provided for 1,638 children in 1916.
Expenditures for medical purposes have risen from 5.2 per cent
of the total municipal budget in 1870 to 14.7 in 1910 and to 17.0 per
cent in 1914, and over 20 per cent in 1915, the last two figures being
unduly swollen by war conditions. Of what may be considered a
normal health budget of 5,078,730 roubles in 1910, 80.8 per cent
was for hospitals, 8.7 per cent for lying-in hospitals, 5.0 per cent for
clinics, 3.2 per cent for public health work, 1.2 per cent for grants
to private hospitals, and 0.9 [>er cent for veterinary inspection.
The table Mow for the 25-year period, 1886-1910, giv«»s an iiiter-
ostuig picture of the relative prevalence of various communieabk>
diseases indicated by the numbers of cases recorded.
Prevalence of various comiHunirablc duauct.
I>i-j*.i-c.
Per rent
('a.s<»i
of all
rfcordod ,
commu-
18«5 1910.
nicaMe
(liMTOi^CS.
Metuiles
Scarlet fever
Diphtheria
IUilap5ln« fever. . .
D vsentcry
WhoopinR cough.
Chicken pox
J go, 106
72, :ai
rt8,7tVS I
A\ VJl
45,158
;i2,G(i:>
2J*,-43
19.34
14.61
13. &S
9.24
9.09
6.58
5.79
IHhmso.
Typhoid fever ,
Typhus fc\Tr ,
Tjrphus or typhoid forer.
ParoUtla
Variola and wiolold . . . .
German measles ,
Cholera ,
Per cent
(Vucs olaU
recorded, commn
1M«-I9ia nicmUe
dh
23,494 '
21,M2 I
13,434
12,217
3^057
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2201
December 28, lOlT
Tbe death rates for 1915 as certified for various specific causes
calculated on an estimated population of 1,984,000 are as follows,
the total registered death rate from all causes being 22.4.
RegiaUred death rate from various causes in Moscow^ 1915.
Cause of death.
Rate per
100,000.
Cause of death.
Rate
100,
teper
i,o6o.
TypboM (ever.
Txpluu fever
gelapstng fever.
Undeter mined levers (any of 'above).
SmaUpox
Measles
Soarietfevsr
IMphtl^erla
Dysentery
Anthrax
Intermittait lever.
Iniluenza
Whooping cough
Cholera
Xcysipelas
14.9
1.9
.2
1.0
12.2
Other epidemic diseases
Ra'ies
SyphiUs
Puerperal fever
Pulmonary tu' erouUfiis
A. 0 n Other forms of tn* ercurosls. .
90l3 H Croupous pneumonia.
40l 6 Other respiratory dtseasss. . .
Diarrhea and enteritis*.
UnderS years *...
0\w2year8
HoTiIcide
Suicide
Other violent deaths ^.
Ail other causes
k5
.9
.2
11.7
17.2
«.7
0.7
lao
&0
8l9
19L1
S18
M.4
»L0
382.0
20.4
2.8
7.0
4&2
8B.0
It will be noted that measles, as is often the case with us, is the
most serious of the acute contagia, that typhoid fev^er is fairly low,
that diphtheria is high, and scarlet fever very high« lyphus and
relapsing fevers have been fairly well controlled in recent years,
though the central location of Moscow and its heavy railroad traffic
have in the past exposed the city to frequent infection with these
diseases, which have often made their first local appearance in the
lodging houses. Smallpox is still a s^ious factor in the death rate,
and dysentery constitutes a grave problem. Pulmonary tubercu-
losis is fairly high and b probably much hi^er than is indicated
on the face of the returns, since the figure of over 400 for pneumonia
and oth^ respiratory diseases, as compared with less than 200 for
pulmonary tuberculosis, suggests defective diagnosis. The rate
for diarrhea and enteritis under two years is appalling.
fiealUi OrganiiattoB of the CHy of Petrofnd.
The general sanitary organization of Petrograd is very similar to
that of Moscow, more higiily developed along certain lines, and less
complete in some other departments.
The water supply of the city is derived from two sources, a main
station on the southern mainland side of the Neva which supplies
about 25,000,000 vedros (67,000,000 gallons) a day and a smaller
5,600,000 vedro (15,000,000 gallons) plant on Petrograd Island.
The main plant originally consisted of 18 filters of the English
slow sand type but they have been reconstructed for use as Ameri-
can rapid mechanical filters by dividing each one into 12 sections.
On account of deficient capacity it has been the custom at this
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plant at times to filter part of the water without chlorinatioii
and to chlorinate another part without filtration. The bacterio-
logical results of these two methods as well as of the combined
treatment for the year 1914 were as shown below.
Bacteriological results of various treatments applied to Neva Jiiver water, averagc4, J'* J ;.
Raw water ,
Filtered water
ChJorioated water ,
Filtered and chlorinated water.
Mixtures as delivered ,
Pere«nt
B!f«?^l IS?,""
perc. c.
l«st«fcr
B.ooll
3«4
47.0
7S
X0
16
.C
5
«:
«
1 I
Great difficu^y has been experienced in procuring either alum or
bleaching powder since the war, and chlorinHtion is nmr effected by
the use of a sodium hypochlorite solution prepared on the spot by
the electrolysis of salt.
The smaller plant on Petrograd Island includes 10 settling basiii>,
49 American rapid filters, a storage basin, and a Siemens-Otto ozone
disinfecting outfit. The filters are of the mechanical wash type and
the ozone apparatus appears to be working very satisfactorily,
although at high cost. This plant, like the larger one, is now heiti^
strained beyond its capacity, and a resort to a wholly new supply
brought in from Lake Ladoga will probably prove the iltimato
solution of the problem.
The waste disposal system of Petrogrml is a curiont^ primiti%e
one for a great European capital. There is an extensive series of
sewers in the city, but, as in London and Paris 50 years ago, they are
not used for fecal wastes. The latter are collected in cessp<K)ls
which are pumped out at night (at intervals varying from 2 weeks
to several months) into special carts with cylindrical metal bo<lie.i
whicli convey the sewage liquids to a disposal station near the west
end of Vassiljcvsky Island. About 200 such carts reach tlie station
every day. The sewage matters are screened by passing them
through Riensch-Wurl screens, the liquid is discharged through a
10-inch sewer at a point 7 kilometei*s out to sea, and the screenings
are burned in the adjaooiit garbage dt^structor.
This destructor, it may be mentioned in passing, is one of two
lleenan and FroucK^ 1-unit furnaces, each of which destroys between
5,000 and 0,000 poods (1SO,000 to 216,000 pounds) a day. Tlioy
handle only about a (luartor of all the refuse pmduced by the city,
the rest hein;; ihinrped.
The hoaltli or^rauiz-alion of Petrograd is centere<l in the sanitary
bureau, wlii.h lui-; three* main divisions »^anitntion, epidemiology, and
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2203 December 28, 1917
sanitary statistics — although the pow^*s and responsibilities of the
three divisions are not sharply limited, the same employees in some
cases being responsible to two division heads. Thus the 40 district
physicians who form tixe backbone of the staff not only do the work
(A sanitary inspection, building inspection, and plumbing inspection
in their respective districts, but also the work of isolating cases of
communicable disease and studying the epidemiological factors con-
cerned. In addition to these men, the epidemiological division has
20 medical inspectors of food stores and 11 medical lodging-house
inspectors, or a total of 71 physicians in all. The very able head of
this division is Dr. Haffkine, a nephew of the bacteriologist who is
so well known for his researches on bubonic plague. Medical inspec-
tion of schools is now under another city department, 50 physicians
being employed, with 11 eye specialists and 20 dentists.
The city has a large contagious-disease hospital, built on the bar«
rack plan:, with 44 barrack buildings and some 1,200 beds. On the
hospital grounds there is an elaborately equipped central disinfecting
station for the treatment of clothing and bedding. It includes a
number of large sterilizers, some operated with steam and some with
formaldehyde, all controlled from a central glass-walled observation
chamber. There is also at this station an extensive equipment of
disinfecting apparatus for house disinfection, and sanitary ofircials
from all over Russia come here (to the number of perhaps a hundred
a year) to study the technique of disinfecting practice.
The sanitary bureau has an admirable chemical and bacteriological
laboratory (the latter under the direction of Dr. V. Yakovlev).
Three bactelriologists are employed, and in 1916 11,974 examina-
tions were made for diphtheria and 1,711 for tuberculosis, besides
examination for cholera, dysentery, relapsing fever, typhoid fever,
and glanders. In 1908-1910 five bacteriologists were employed to
deal with the cholera epidemic existing at that time, and during the
three years 26,000 examinations of feces were made and 13,000 of*
water. The highly significant results of these cholera studies have
been printed by the city in the form of a large monograph.
The city also maintains a vaccine institute under Dr. Gamaleia,
which turns out 300,000 grams of vaccine a year (each gram being
equivalent to something over 10 doses). Since the Revolution the
enforcement of vaccination is no longer possible and the institute
had over a million doses of vaccine on hand at the time of our visit.
The division of sanitary statistics (under Dr. Fedoroff) is excellently
organized. It was interesting to us to note that slips of paper are
still used in Russia instead of cards for the registration of births aijid
deaths.
Health ordinances are framed by a central health board, wliich
includes 30 health-department physicians and 30 city Duma members.
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December 28, 1017 2204
The hospitals of the city are at present under a completely distl&ct
bureau organization. Twelve general municipal hospitals are main-
tained in which on a given day in August, 1917, there were 12,311
patients. In 1914, the last year for which we were able to obtain
printed statistics, there were 11,930 beds and 144,704 patients treat^nl.
The city also carries on 11 free dispensaries, which average about 450
visits a day. There are 15 public maternity hospitals with 347 beds.
It may be noted in passing that in 1915 24,808 out of 40,141 births
in the city of Petrograd occurred in hospitals.
The total expenditure of the city for medical, veterinar3% ami
sanitary purposes in 1914 was a little over 9,000,000 roubles, 17.S
per cent of the total municipal expenditure. About one-seventh of
this, or 1,300,000 roubles, was for the sanitary bureau, whose work
has been specially discussed above. This amount will be just about
doubled for next year, not to provide for any expansion of work but
simply to allow an increase in salaries to compensate for the fall in
the value of the rouble and the increase in the cost of living.
Comprehensive plans are \mder consideration for the reorganiza-
tion of the whole system of health adminstration to bring the hospital
care and the preventive work more closely together on the one hand
and, on the other, to provide for greater decentralization in local
administration for the various districts of the city. The plan beluvi
has been recommended by a committee which was specially appoints!
to study the problem.
PROrOSED I'LAN OK PIBUC HKALTU UROAMZATION KUR PETRtKJRAD, ALL BRANCHES X*^
BE UNDER A COMMI8SI0X ON PUBLIC HEALTir WITH A MUNIHPAL MBPrCAL BOARD
Department:
I. .Sanitar>' -
Fnnrtioiia —
A. Sanitation—
1. Purificatiou of sewago.
2. Water supply.
3. Waste removal.
4. Industrial hj'gieue.
5. H>'gicno of transportation.
C. Difli>oeal of the dead.
B. Communicable diseasea-
1. Prevention of (communicable difvaso.
2. DL'trict sanitary inppecl ion.
3. Disin fort ion.
4. Isolation.
5. Vaccination.
II, Veterinary-
1. Difllrirt veterinary iiutpectioa.
2. Horw'Hlux'ing and medical care of hornei.
3. Inspection of sales Ptablog and of the health of horvct.
4. Removal of bo<lief> of <lead horses.
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2205 DMember 28, 19JV
Department— ContiQiied.
II. Veterinary— Continued.
5. Prevention of rabies.
6. Inspection of abattoirs and of imported meat products.
7. Inspection of stables, pig sties, etc.
ni. Sanitary-
Statistical--
1. Sanitary and medical statistics.
2. Sanitary records of dwellings, etc.
IV. Medical—
A. Outpatient service —
1. Medical aid in dispensaries and homes.
2. Midwifery.
3. Safeguarding of mothers and infants.
B. Hoepital service —
^ 1. General hospitals.
2. Special hospitals.
C. Pharmaceutical service—
1. Supplying drugs through city and hospital pharmacies.
2. Providing drugs.
Each subdivision of a department should, it is suggested, work
under the guidance of an advisory council, made up of the sanitarians,
physicians, veterinarians, statis^ticians, etc., themselves.
Of the two great problems of tuberculosis and infant mortality, to
which our own health departments are now devoting so much atten-
tion, the first is still almost neglected in Petrograd as a public^health
problem. There is one sanatorium in Finland with 60 beds and out
of 144,000 patients received in the general city hospitals during 1914,
10,605 wejre cases of pulmonary tuberculosb and 1,612 of tubercul >sis
in other forms. It is believed by many that tuberculosis has mate-
rially increased during the war, but on account of the heavy demands
placed upon the medical personnel of hospitab and dispensaries
accurate statistics are hard to obtain.
Infant welfare work is more fully developed in response to the ui^ent
need which exists for activity along this line, in Petrograd as every-
where in Russia. In 1915 one-quarter of the infants born in Petrograd
died before reaching the age of one year (as against less than one-tenth
in New York City, the excess corresponding to a loss of 6,000 Uves a
year). There is, however, the nucleus of an admirable organization
of milk stations and baby clinics in Petrograd, 1 being maintained by
the city itself, 8 by the district dumas, 5 by the AU-Russian Patronage
for the Protection of Motherhood and Childhood, and 12 by other
agencies. Between 5,000 and 6,000 children are cared for at these
various stations. The number should be doubled or trebled. The
work of existing institutions is at present seriously hampered by the
grave shortage of milk. There was available lost September oiJy
about 1 quart of milk for every 30 people in the total population,
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I>ecembcr 'JS, 1917 2206
one-third of the quantity available before tho war and one-tai:!
the amount deemed necessary by conservativo food experts. I
The birth pte of Petrograd has fallen from 30.7 per 1,000 iaC:
to 24.9 in 1914 and 22 in 1916, in which year it fell below thede. j
rate (23.2 per 1,000). I
The death rates as recorded by principal causes for 1914 are^^
in tho table below:
Recorded death rale^from various causes, Petrogreid. 19 lU
Rcgistcrctl rauscs of death.
Typhoid fever..
Typhus fever...
Smallpox
Measles
vScarlet fever...
Diphtheria.
Rate per
100,000.
33w8
1.0
16.6
88.4
40.6
ao.0
Dysentery ' 25.1
Epidemic gastroenteritis ; 2.6
Anthrax . 3
Influenza : 19.0 '
Whooping cough ao. 2 '
Erysipelas 14.2 I
Puerperal fever ' 4. 9 '
Pyemia and aepticomia 3o. 1
Rabies .2
Other cootaKia ' il. 0
I'ulmonary lulcrnilosis ' 2W. 5
Other forms tulH?reulosls , 51. 4
fx)bttr pneumonia • ^1. 7
Uc^stered causes of death. ^i „
Brooeho-pneumania
Other respiratory diseases
Cancer
Sarcoma and other neoplasms.
Alcoholism.
Cerebral apoplexy
Other cerebral disease
Diseases of heart and arteries.
(jastroent«rltis:
T'ndor 2
Ovor2
Other digfstive diseases
l^rlnarj' diseases
CoDjccnital dc^ llity
Senile marasmus
Suicide
Afpldent
Homicide
All other causes
In comparing these deatli rates with those for Moscow cited aboT-
it appears that the prevalence of the acute contagia is much (he^-
in the two cities, measles leading all the rest. Scarlet f ev6» was mi^^
more prevalent in Moscow in 1915 than in Petrograd to 1914. ^'
this was due to a special outbreak in the former yeat; On t-^
other hand the higher incidence of typhoid in Petrograd is eharacte
istic and very possibly (connected with imperfections in water pursj
cation, while dysentery is regularly higher in Moscow on account^
its warmer climate and closer proximity to regions where this disei-^
is very common. Cholera, which has disappeared from Petrog^*^
in recent years, still occurs periodically in Moscow. The fact tii|
the diarrhea and enteritis rate, which, while very high in Petrograd
falls short of the enormous figures reached in Moscow, is ^tiW
due in part to the cooler summer weather of the capital. Tubercu-
losis, on the other hand, appears to be far higher in. Petrograd than
Moscow, the figures being 299.5 as compared with 191.1 ^^^ P
monary and 54.4 as compared with 32.8 for other forms of tubercu-
losis. The combined rate for all forms of pneumonia and otn^
respiratory diseases is lower in Petrograd, 387.4 against 405.4. ^
that better diagnosis may in some part account for the difi^r^^ '
It would be unsafe to stress this point, however, without a studv o
age distribution in tho two cities, and we know that in <^^*^ ^
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2207 December -JH, 1017
country there are cities like Pittsburgh which arc actually character-
ized by low tuberculosis rates combined with a ver\' high incidence
of pneumonia.
The Central Bnreaa of Public HealUi.
There remains finally to be considered the government bureau
which corresponds in many respects to our United States Public
Health Service, a body which has been of some importance in tho
past and which, as in our own country, promises to play a much
lai^er part in the future.
The central bureau of pubhc health was endowed, theoretically,
with large powers before tho Revolution and had an inspector in
each Province with 10 or 12 subinspectors under him, in all a
force of nearly 2,000 physicians. The central organization at present
includes a division of administration; a division for the supervision
of hospitals, medical schools, schools for feldschers, and the like; a
division for sanitary and epidemiological work; a division for the
supervision of mineral springs, medicinal baths, etc. ; and a division
of statistics.
The reports issued annually by this bureau on the *' Condition of
the National Health and the Organization of Medical Service in
Russia^' contain much valuable material in regard to the current
status of medical and sanitary matters.
Thus the report for 1914 (the last which is in print) shows that in
that year there were in the Empire — excluding Poland and the three
Provinces of Vihia, Kovno, and Kholm — 18,320 physicians engaged
in civil practice, of whom 15,433 were men and 2,887 women. In
the cities there was 1 physician to 1,700 inhabitants and in the
rural districts 1 to 23,000 inhabitants. Of medical assistants
(feldschers, etc.) there were 25,310, of whom 18,577 were men and
6,733 women. There were 11,764 pharmacists, 4,706 physician-
dentists, 2,216 dentists, and 11,925 midwives.. There were 4,287
medical districts imder the direction of zemstvo or municipal physi-
cians and 4,952 additional points in charge of medical assistants.
For the same area (the Empire exclusive of Poland and the three
Provinces mentioned) there were 7,617 hospitals and dispensaries
with 217,806 beds for civilian use. Only 39 per cent of the hospitals
had more than 15 beds, 39 per cent had 6 to 15 beds, and 22 per cent
had less than 6 beds each, indicating tho growth of small rural
hospitals imder the zemstvo medical organization. There were
3,349,083 patients treated in the hospitals during the year with a
mortality of 4.5 per cent, and an average period of treatment of 19.4
days. Excluding obstetrical and psychiatric cases there were
2,924,539 patients treated with a death rate of 4.8 per cent and an
158
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December 28, 1917 2208
average period of treatment of 16 days. Of maternity hospitals
there were 908 with 7,591 beds. In these hospitals there were
311,937 births in 1914, 83 per cent of them normal, 6 per cent prema-
ture, and 11 per cent miscarriages.
The 4,791 registered pharmacies, registered in the area mentioned
above, filled 32,412,972 prescriptions for which they received
18,185,628 roubles, while they took in over the counter 13,816,025
roubles more.
Fifty-four hygienic laboratories for the analysis of food products
were registered with the bureau, 44 maintained by cities, 2 by zemstvos,
1 jointly by city and zemstvo, and the rest by Government bureaus or
private agencies. Thirty-four of these laboratories were directed by
physicians, 9 by chemists, 7 by veterinarians, and 3 by pharmacista.
There were 32 Pasteur stations in operation in Russia in 1914, in
which 35,462 preventive treatments were given with 90 deaths.
Excluding 3,490 cases not bitten, the mortality was 0.3 per cent.
As a result of the reconstruction called for by the revolution the
central bureau of public health is likely to have on the one hand leas
theoretical power and on the other hand more actual influence for
good than it ever had under the old regime. The functions of legal
and administrative medicine which it exercised in the past will no
doubt bo delegated to local authorities; but the central bureau
will be in position to guide and develop local health work through-
out the Republic witli wisdom and success.
The future central organization will probably bear to the provincial
zemstvo health administration much the same relation that the latter
now bears to the district sanitary organization. There will be a large
council of some 200 members chosen by the provincial zemstvos
and the municipalities, with representatives named by the
national government. This council will hold plenary sessions two
or three times a year and will it-self elect a small permanent council
of some 20 members. The work of the administrative bureau will
be directed by this permanent council and sanitary legislation will,
it is hoped, be enacted by the provisional government on its advice and
suggestion. It wil^. be the task of the council and the bureau to work
out comprehensive plans for the development and standardizatioo
of medic^ and sanitary work throughout the Republic and to pro-
vide as promptly as possible medical and sanitary care for those
Provinces which at present have no zemstvo organization.
The outline cite<l below is a proposed plan for the reoiganization of
the central bureau of pubhc health, which has been prepared and
printed and was being favorably considered by the authorities ia
August, 1917. It may be cited in full as an example of the general
sort of health organization which met with approval during the days
of reconstruction under the Kerensky government. It will be noted
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2209 December 28, 1017
that it calls for a high degree of deeeatralizatiou as is essential to meet
the demands of the revolution, while at the same time providing
a strong central staff of advisory experts.
Plan for the Organization of a Central Sanitary Medical Service.
I. All questions concerning the health and sanitation of the civilian
population shall be imder the jurisdiction of the central medical
sanitary service in accordance with the .following regulations and
corresponding State laws.
II. The duties of the central medical sanitary service shall include:
1. The preparation of new laws concerning questions of a medical,
sanitary, pharmaceutical and medico-legal nature.
2. The furnishing to local self-governing bodies in their work of
protecting the public health of assistance in the shape of money,
medical assistance, information and reports.
3. The sanitary protection of sea and land boundaries.
4. The collection and publication of statistical data in regard to
the movement of population, morbidity and mortality, the analysis
of statistical and scientific material in regard to general health condi-
tions, and the working out of a program for improving sanitary con-
ditions and the prevention of communicable diseases.
5. The supervision of local medical-sanitary work in provinces and
territories where it is not in charge of local self-governing bodies.
0, The working out of regulations concerning international sani-
tary agreements.
7. The execution of orders of the central medical sanitaiy council
in regard to medical supervision and all business concerning other
mimstries. In connection with these questions the central medical
sanitary service is the administrative oi^an of the central medical
sanitary council.
III. In matters of internal and general organization and also of all
sanitary matters under the ministry of the interior, the central
medical sanitary service is subordinate to the minister of the interior.
IV. The staff of the service shall consist of (1) head of the service;
(2) heads of divisions; (3) director of publications; (4) legal advisot;
(5) secretary; (6) senior and junior assistants to the heads, traveling
physicians and clerks.
V. The chief of the central medical sanitary service has control
and supervision of all his personal staff. He takes the place of the
minister of the interior in the higher Government institutions so far
as all business concerning the central medical sanitary service is
concerned; he is in charge of all current business of the central
medical sanitary service; and he has all rights appropriate to the
rank of assistant minister.
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December 28, 1917 2210
VI. Division heads are responsible assistants to the chief of the
centra] medical sanitary service, each in his particular field, and take
his place therein in case of need.
VII. The central medical sanitary service contains the following
divisions: (1) Governmental and public health, (2) medical and hoa*
pital help, (3) epidemiology, (4) supervision of health resortfi, (5)
supervision of pharmacies, (6) supervision of medical schools, (7)
legal and official medicine, (8) statistics, (9) office staff, (10) pubti-
cations, (11) legal advice, (12) secretary to the chief.
VIII. Tne duties of local sanitary medical control, of pharma-
ceutical matters and legal medicine, which according to present laws
are vested in the provincial government bureaus, are to be exercised
by the provincial zemstvos and in capitals and lai^e cities by tne
municipal organizations. To meet these obligations, provincial
zemstvos and dumas must provide new departments or reorganise
existing medical offices so as to provide in every province experts
competent to direct state medicine, legal medicine and pharmacy.
To fulliU the duties of legal medicine it will be necessary for Uie
zemstvos and dumas to create a new organization of medicolegal
experts. Such departments will be subordinate to their respective
zemstvos and diunas but will be required to transmit to the central
medical sanitfiry service all reports Wijch are req^iired by law and
such other information in regard to sanitary and medical matten
as the central medical sanitary service may require.
IX. In Provinces and territories in which there are difficulties in
the way of the immediate transfer of all the medical business previ-
ously carried on by provincial and district medical bureaus, munici-
pal and pohce physicians to the self-governing bodies there shall be
provided, imtil final organization of the zemstvo medical bureaua
can be accompUshed, organized medical-sanitary offices and medico-
legal exp0rtB at the expense of the central government and under
the direction of the Central Medical Sanitary Service such provincial
medical-sanitary offices to be acting organs of the provincial
medical-sanitary councils.
X. The functions of the provincial medical-sanitary offices shall
be as follows:
1. Registration of physicians and pharmacists, of pharmacies
drug stores, factories, and laboratories engaged in the preparation
of drugs, of medico-legal statistics, of statistical data in regard to the
medical inspection of recruits and of school inspection, of deotiate,
medical assistants, midwives, practitioners of massage and physical
culture, registration of hospitals.
2. Control of the practice of medicine.
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2211 Dminber 2S, 1917
3. Supervision of private hospitals and private diagnostic labora-
tories.
4. Censorship of medical publications concerning drugs and cura-
tive treatments.
5. License and control of private medical schools.
6. Licensing and control of pharmacies, shops, factories, and
laboratories, and preparing drugs, sera, vaccines, and other thera-
peutic preparations.
7. Granting licenses for the sale of cosmetics.
8. Management of hospitals and schools maintauied bv (Y»ntral
Medical Sanitary Service.
9. Approval of certificates submitted by court autliorities in regard
to examinations of sick persons or dead bodies and reexamination
of material proofs in cases of conflict of evidence and the results of
an inquest, or in cases of doubt as to the exact interpretation of
medical signs noted in the examination of a body.
10. Approval of results of medical examinations in (tases of pension
claims, sickness insurance benefits, divorce cases, or any personal or
property rights.
Such matters may be brought before the medical-sanitary office:
By official experts in cases of disagreement; by persons at whose re-
quest the original examination was made (if they doubt its regularity);
by the subject of the examination if he holds the physiciairs finding
to be unjust.
11. Control and siipeiTision of medico-legal niatteiv.
12. Provision of facilities for necessary laboratory examinations of
material proofs. Laboratories must be organized as branches of
the medical-sanitary offices; or one laboratory may be organized
jointly by several medical-sanitarj' offices; or by ajiproval of the
Central Medical Sanitary Service, the provincial medical-sanitary
oflicer can transfer this work to other public or private laboratories.
13. The certificates and actions mentioned in paragraphs 0 and 10
are passed upon by a board consisting of the provincial medical
sanitarian as chairman, three of his assistants, representatives of
the Public Health Society and any specialists ap|>ointed by the
board.
XI. In Provinces, territories, and cities where medical-sanitary
oflBces are mamtained at the expense of the central government
their staff shall be made up as follows: (1) Provincial medical sani-
tarian, (2) assistants in charge of medico-legal and pharmaceutical
divisions; (3) chief clerk; (4) medical inspectors.
XII. For the carrying out of medico-legal and administrative
investigations in cases prescribed by law there shall be constituted a
special institute of medico-legal experts.
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December 28, 1017 2212
Vita! Statistics <tf Riunia.
Russia has not had a general census since the year 1897, and there
is no general system of registration of births and deaths other than
the church records, which are reasonably complete and are carefully
kept and analyzed by the central statistical committee of the miiu»-
try of the interior. The Russian has a gift for statistics, and
statistical bureaus are well organized and directed by very comr
petent experts, so that such figures as are available are reasonably
reUable.
The central statistical committee published last year a vcdume on
^'Statistics of the Russian Empire; Movement of Population of Euro-
pean Russia for the Year 1910," some of the data from which may be
worth citation and analysis. The estimated population of European
Russia for that year was 118,700,000. The calculated marriage rale
was 8.2 per 1,000, the birth rate, 44, and the death rate, 30.8. The
birth rate by religions varied from 47.1 among the Orthodox and
Mahometans to 22.3 among the Protestants and 21.7 among the
Hebrews. The death rate varied from 33.4 among the Orthodox
and 27.5 among the Mahometans to 15.9 among the Protestants and
12.4 among the Hebrews. The Orthodox in European Russia make
up 83 per cent of the total population, and each of the other four
religions between 3 and 6 per cent.
Thirty-eight per cent of all deaths were under one year of age and
21 per cent between one and five years.
The mortahty rate in European Russia has decreased quite steadily
from 37.2 in 1867-1871 to the figure of 30.8 cited above for 1910.
Death rates by causes are wholly lacking except for the cities,
but cases of communicable diseases are reported by hospitals and
by zemstvo and factory physicians to the central council of pubho
health. The table below shows the incidence of morbidity from
certain principal causes in 1914 for 91 Provinces,
Morbidity raUsJbr certain communicahle diseases, 1914, in 91 provinces of Russim.
(Cases per 100,000 population.]
Scabies 3, 676
Influenza 2, 377
Malaria 2. 190
SyphiliB 747
Trachoma 602
Pulmonary tuberculoaia 516
Lobar pneumonia 328
Diphtheria 279
The annual reports of the central council of public health
contain tabulated data of death rates from certain causes for the
principal cities of Russia^ which are based on data collected bj the
Whooping cough 2C2
Measles 290
Typhoid fever 296
Smallpox 6S
TyphuB fever 9B
Scurvy 19
Relapsing fever *. U
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health bureaus of the cities on a system of registration similar to our
own. In the table below it wiU bo noted that the figures for Petro-
grad are somewhat lower than those cited above. They are evidently
based on a slightly higher population estimate than that obtained
by me from the municipal authorities.
RecorcUd death raUifrom certain causes per 100,000 population— Russian cities, lUl-t.
'
Petrograd.
Moscow.
Odessa.
Warsaw.
OthercItle.s
population
3,950,000.
AmAllpoiX, ................. ^ . . ^ .......;.. .
16
79
39
16
16
26
32
1
4
77
37
23
17
33
21
3
1
53
3
13
36
11
2
20
26
2
1
8
23
21
59
19
2
10
24
1
21
Measles... .l......:i.l ..,,'.
65
Scarlet fever
C2
Whooptr»ir cmiitli
21
Tnfln«fixa .... ..........^....^. *.*,*. 4,. .^
10
Diphtheria
• 41
Typhoid fever
40
T j'phtui fever
4
Reuipsing fever
2
Dysentery
25
24
oO
The Problem of Infant Mortality.
There is one pubhc-health problem which is ever^^where of such
importance as to deserve special consideration and which in Russia
jwssesses a peculiarly dominant importance, the problem of the
protection of the infant during its first year of life.
This question has rereived serious consideration from Russian
sanitarians and statisticians ever since the Russian £}conomic Society
at its meeting in Petrograd in 1835 called special attention to the
gieat mortality of infants among the peasants. In the report on
infant mortality in Russia, prepared by Drs. S. Gliebovskv and
B. Griebenshikov for the 1906 International Congress of Charities at
Milan (L' assistance pubhque et priv^e en Russie; Acad. Imp. des
Sci. Petrograd, 1906), the high infant mortaUty rate of Russia was
emphasized very forcibly and was attributed chiefly to the fact
that the agricultm-al labor of women, particularly among the Great
Russians, interferes with the breast feeding and maternal care which
are essential if a fair proportion of tlie infants l)orn into the world
are to survive.
I have been imable to find any very recent infant mortaUty sta-
tistics for Russia as a whole, but a study of the *' Statistics as to
Movement of Population in 1910," published by the central statistical
committee, indicates that in that year deaths under 1 j-ear made up
38 per cent of the deaths at all ages. The infant mortahty rate
(deaths imder 1 year per 1,000 births) was 266 for European Russia,
while at the same period the rates for certain other coim tries were:
Austria-Hungary, 207; Germany, 192; Italy, 142; England and Wales,
130; France, 111; Denmark, 106; Sweden, 75; Non^^ay, 67; and New
Zealand, 56.
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December 28, 1917 2214
The rates by Provinces in 1910 varied from 370 in Yiatka to 134
in Esthonia, the higher rates obtaining generally in the north and
east (Viatka, Olonetz, Kostroma, Simbirsk, Nijni-Novgorod, KalngA^
Smolensk, Novgorod, Vologda, Tver, Penza, Vladimir, Samara, aH
over 300), and the low rates almost universally in the west (Esthonis,
Courland, Vilna, Livonia, Minsk, Volhynia, Podolia, Poltava, Grodno,
and the Crimea, all under 200). This distribution for 1910 corre-
sponds f toly well to that reported by Ghebovsky and Griebenshikov
for 1895-1899, and it seems clear that the lower rates in the west are
due to the better care given to the children of the Finns and Lette of
the Baltic Provinces, and the Lithuanians, Poles, Jews, and G^mana
of the west as compared with the Great Russian peasants of the
central and eastern Provinces. By religions the authors cited above
give the following infant mortality rates: Hebrews, 128; Catholics,
150; Mahometans, 163; Protestants, 179; Orthodox, 285.
A valuable study of the ** Mortality of Nursing Infants in Petro-
grad dining the 10-year period 1906-1915," by V. E. Bienshtok, has
recently been pubhshed as Monograph No. 1 of the statistical bureau
of the city of Petrograd. It shows that the infant mortality rate of
the city was as high as 330.8 in 1882; since 1886 it has varied by years
between 218.8 and 277.7, and by five-year periods from 238.3 (1891-
1895) to 256.3 (1906-1910). The 1915 figure was 251, so that there
has been no appreciable decrease in these enormous rates for a quar-
ter of a century. The rates by districts varied for 1906-1915 from
122 in the Liteinyi and 123 in the Admiralty to 279 in the Alexander-
Nevsky (industrial) quarter.
Twenty-five per cent of the infant deaths occur during the first
month and 18 per cent during the first week. The second and third
months of life account for 16 per cent of the total, the fourth to the
sixth month for 24 per cent, the seventh to the ninth month for 19
per cent, and the tenth to the twelfth month for 15 per cent. Seasonal
differences are not as striking as might be expected, 25 per cent of
infant deaths occurring during the winter, 28 per cent during the
spring, 28 per cent during the simimer, and 18 per c^nt during the
autumn months.
Of aU the infant deaths in Petrograd 32.1 per cent were due to
digestive diseases, 21.7 per cent to congenital debility, 20.5 per cent
to pneumonia, 5.4 per cent to acute contagia (measles, diphtheria,
scarlet fever), 2.6 per cent to tuberculosis, and 17.6 per cent to other
causes.
The enormous infant mortality rate of Russia is of course due as
everywhere, to Dr. Emmet Holt's twin factors, "Poverty and Igiio>
ranee,'' in an accentuated form. Oliebovsky and OriebenahikoT
point out the close relation between the variation in infant welfare rats
and ilhteracy by races, 70 per cent of men and 91 per cent of women
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2215 fiecember 28, 1017
being illiterate among the true Russians as against 40 per cent of
men and 41 per cent of women among the Germans, 48 per cent of
men and 47 per cent of women among the Letts and Lithuanians,
and 51 per cent of men and 72 per cent of women among the He-
brews. In particular it is ignorance in regard to the principles of
infant feeding which contributes most conspicuously to the unfor-
tunate results observed. The Russian mother is apt to continue to
give breast milk to her infant for a considerable period; but unfor-
timately she gives the child other and less innocuous foods from a
very early age. Thus of a group of mothers in Saratov Province only
10 per cent were found by Dr. Minkh to be bringing up their babies
on breast milk only, while in another district only 1 .4 per cent nursed
their babies without the addition of other food up to the seventh or
eighth month. Of 2,000 women canvassed by one investigator in
the province of Orel, 49 per cent had begun artificial feeding by the
end of the first' month.
The remedy for all this is of course clear and obvious — ^the estab-
lishment of infant-welfare stations for the instruction of mothers in
the duties of maternity and such an improvement in their economic
condition as may enable them properly to fulfill those duties.
An admirable beginning has been made along these Unes, as has
been suggested in discussing the work of pubUc health administration
in Petrograd and Moscow. The first goutte de lait was established
by Dr. W. Hubert at Petrograd in WOl, and the more important edu-
cational work of Iho Consultation des Nourrisons, or baby cUnic, was
begun about 10 years ago. A most important factor in the develop-
ment of this work has been the All Russian Patronage for the Pro-
tection of Motherhood and Childhood, which maintains stations in
various parts of the country and which has its main offices and pub-
lishes an admirable monthly journal at Petrograd. This patronage
has a most exceUent Infant Welfare Museum on Kameny Ostrov
Island in Petrograd with a remarkable series of anatomical models,
charts and pictures, and a good hbrary; and a fund of 1,000,000
roubles contributed by the banks of Petrograd and Moscow on the
occasion of the Romanov Tercentenary was set aside before the war
to be devoted to the erection of buildings for the work of this society.
The splendidly equipped infant welfare station at the Morosov
Hospital in Moscow has been mentioned above. I had the oppor-
tunity of observing the work done here and at the other welfare sta-
tions in Petrograd and Moscow, and so far as the work at the cUnics
is concerned it appeared to be of a whoDy modern and satisfactory
type. The principal thing lacking is the home instruction by nurses,
which has proved so vitaJ a factor in such work in America. The
Patronage for the Protection of Motherhood and Childhood has made
a beginning along this line, having about 15 nurses doing home visit-
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Ih-irmbor 2.S, 1 1H7 22 IG
iug in Pctrograd, but the municipalities liavc not as yet any facilities
for such educational work. All the infant welfare work in Russia.
and particularly that in Potrograd, is gravely hampered at the present
time by the shortage of milk whidi has resulted from the war and
from the Revolution.
General Status and Future Needs of PuMic Health in Runia.
PubUc-health work in most countries has passed from a stage in
which the sanitation of the environment was its chief preoccupation,
to one in which the control of community infections by epidemiolog-
ical, bacteriological, and serological methods is predominant : and from
this second phase it tends to proceed to a third, in which emphasis i>
laid on the hygienic education of the individual.
The first of these stages, that of sanitary engineering, hiu* so far
been somewhat neglected in the development of Russian pubUt*
health. In 1912 out of 1,063 towns and urban settlements with a
population of over 10,000 only 219, or 20.6 per cent, had an organiz^nl
water supply of any kind, only 167 supplie<l this water to privat4»
houses, and only 59 had filters. As pointed out above there are t4>-4la\
not more than a dozen cities that have modem sewerage systems and
only half this number have systems of sewage tn»atmeut. The ru*-
tom of boiling water and cooking milk before use materiall\ assists in
preventing the epidemics that we should expect might folhiw. At
every raih'oad station, for example, there is a Kipyatok or tank of
boihng water with a tap from which water may be drawn for tea. and
the crowd of soldiers and other passengers runnuig out with their lea-
pots to tliese taps is the most characteristic feature of Riu^sian rail-
way life. As is the case all through the East, in China and .lapan.
one is struck with the (»xtent to which cookery may take the plain* of
sanitary engineering. From tlie standpoint of nuisance, too, it i--
somewhat remarkable that the night-soil removal system of Pi»tn^-
grad, for example, can be conducted with so little ofTi*nso to the
senses. It was only after several weeks of residence that I leanu^l
that the sewers of the city did not dispose of its fecal wastes.
^fodern sanitary engineering will of course have its day in Rus>ia,
and when the time comes its development will be a fniitful one. Rus-
sian engineering is solid and successful. 'Hie smaller water purifica-
tion plant at Petrograd, though costly botli in construction and in
operation, has interesting features in its design, while M. Stroganoffs
experiments at Moscow are probably the most extensive and impor-
tant sewage-treatment studies which are being conducted anywhere
in the world to-da}'.
Tlie principal develoj>ments of Russian public health have been
along medical and bactenological lines, in the control of the more acute
communicable diseases and in tlie field of vital statistics. The sta-
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2217
December 28, 1917
tistical bureaus of the central council of public health and of the larger
cities are better equipped with funds and with highly trained special^
ists than our own. The bacteriological and chemical laboratories are
also highly developed and in charge of high-grade men with leisure
and inclination for productive research as well as routine duties.
The control of commimicable diseases is in general reasonably effec-
tive in the large cities; and the leaders in this field are in sympathy
with the modem American view as to the supreme importance of bed-
side care of the individual and the detection of carriers ias compared
with the terminal disinfection of places and fomites. In current
practice, however, terminal disinfection still occupies a very large
place in mimicipal sanitation, a condition to sotae extent justified by
the danger of insect-borne diseases, such as typhus and relapsing
fever. The success with which these latter diseases are controlled in
the larger cities is a credit to Russian sanitary science. In certain
parts of the country, however, these diseases, and particularly mala-
ria, constitute grave public-health problems which must be dealt with
in the future.
Smallpox vaccine should obviously be used far more extensively
than at present. Scarlet fever is much more serious than with us
in spite of the rather common treatment with streptococcic vaccines.
Considerable attention is devoted to food inspection, mainly along
chemical lines. The supervision of milk supplies is, however, in its
infancy. There is little farm inspection and practically no bac-
teriological control.
Medical inspection of schools is general and well developed, the
school doctors in many districts undertaking the care of the sick
children in their homes as well as diagnosis in the school. School
nurses are not, however, utilized as with us and public health nursing
in general b a problem for the futile.
There are schools for training public health workers in Petrograd
apd in Moscow, the former at the clinical institute imder Dr. Gr^or
Khlopin being the most fully developed. The course at this institute
is a post-graduate course of three months' duration with about eight
hours of lecture and laboratory work a day, or 656 hours in all.
The program of the work as given in the last printed announcement
of the school is sufficiently interesting to be cited in full.
Lecture courses:
dimatology
Housing and clothing
Water supply and waste dis-
posal
Ifuthtdon
t^ood adulteration
Sanitary methods and results. .
Sdiool hygiene
HOOB.
6
12
20
8
6
30
16
Lecture courses — Continued. Hours.
Pnysical instruction and gym-
nastics 6
Industrial hygiene 16
General epidemiology 16
Epidemiology of typhoid 2
Epidemiology of malaria,
plague, syphilis, and tuber-
culosis 3
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HevomlH-r 2K ion 2218
Lecture courses — Contiuued. Hours.
Bacteriology and immunolog>'. 20
Chemism and relation of mi-.
crobe8 to (*irculation of cer-
tain elements 2
Disinfection 8
Public health oiiganization and
8anitar>' legislation in Russia
and abroad 16
Organization of zemstvo medi-
cine 8
Organization of municipal
medicine 8
Organization of 8anitar>' statis-
tics 16
Lecture couroes — Continued.
Technique of sanitary orgaa
nation ."
Clinical feature* of chotei
tjrplioid , and relapsing la^ ,
Patliolog>' of diphtheria, d»
era, plague, and typfeff
fever
Laboratory and practice course
Chemistry
Bacteriology
Pathological anatomy
School bjrg^iene *
Problems for the sanitjn
expert
Perhaps a hundred students a year on the average took thk «5?
before the war, 15 to 20 per cent of them bein^ -women.
The most important future developments of public hedtk ^
Russia, as elsewhere, must be along educational linet^ in connea^.
with the three major problems of venereal disease, tuberculosa >
infant mortality, for it is here that the great harvests of diseas€f^
vention are to be reaped and here that least has so far ^
accomplished.
In Petrograd Dr. Haffkine has opened six venereal clinics t(ffsstt-
veil and prophylactic treatment, but in many parts of the country
particidarly in Siberia and in the Caucasus, the lack of mcdic^^
makes this problem a very difficult one. The war, as everrroP
has increased venereal disease to a very serious degree.
The antituberculosis campaign is still in its infancy in R^
The Red Cross did some antituberculosis work before tbo wan^
there are a few sanatoria, but very few in proportion to the need, i^*
rograd has only one poorly organized tubercidosis clinic . 1 1 is probiok
that the Russian has a liigh natural resistance to tuberculosis; and this
fact combined with the rigorous examination of recruits for thesrBj
has prevented any such shocking increase as has taken place inFtance
in spite of the pccidiarly insanitary conditions under which so losaf
Russian troops arc housed in pheasant dweUings behind the fr<^^
There is little doubt, however, that tuberculosis is more preralent,
in both the civil and mihtary population, than is commonly r^^'
nized or than is indicated on the face of the statistics. ^'Cbro0
pneumonia'' is a commonly reported cause of death even in the anny*
A vigorous and comprehensive antituberculosis campaign rri^ ^
certainly one of Russia's first problems after the war.
The largest single task of public health in Russia is, hower-^^»
control of infant mortality. There are approximately l,5i^
infant deaths in Russia every year, of which two-thirds shorn ^
preventable according to such standards as have been set in New
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2219 December 28, 1917
York City. Even aDowing for the economic difficulties which must
interfere with prenatal precautions and infant care among the Eus-
dan peasants, it seems certain that a comprehensive campaign for
the prevention of infant mortality could save half a million lives a
year in Russia. The admirable infant welfare stations of Petrograd
and Moscow and those maintained elsewhere by the Patronage for the
Protection of Motherhood and Childhood need only to be multiphed
throughout the RepubUc and supplemented by the orgam'zation of a
staff of visiting nurses for domiciUary education in order to solve the
problem satisfactorily.
From the standpoint of administrative procedure there are t^o
points about Russian health organization which are peculiarly favor-
able for future progress.
In the first place, one is imfU'essed with the possibilities of the
numerous advisory boards, made up largely of active employees, with
which both zemstvo and municipal executives are surroimded. Such
organizations must often prove cumbrous and time consuming, but
they tend to favor initiative and esprit de corps on the part of the
^taff. It is interesting to note that even before the revolution Russia
was in this respect in position to give a lesson in democracy to the
rest of the world.
The great strategic point in the Russian health situation is, how-
ever, the remarkable development of social medicine along curative
L'nes and the consequent close connection between curative and pre-
ventive work. Russia, on account of the peculiarly acute needs of
her rural population, has already developed the State care of the sick
to a point of which we are only beginning to dream, and after the war
the new republican government will no doubt pursue this social
ideal to a much higher point of perfection. The opportunity for
developing preventive educational work in connection with such a
system is practically unlimited. In connection with infant mor-
tality, for example, the high proportion of deliveries in maternity
hospitals (in Petrograd nearly half of all births) is a most favorable
circumstance. We may therefore look in the future, as zemstvo and
municipal medicine develop and acquire the educational and pre-
ventive quality which is in accord with modem progress, for unprece-
dented successes in the control of preventable disease in the great
sister RepubUc.
MALARIA IN FLORIDA.
PBEVALENCE AND GEOGRAPHIC DISTBIBiniON— APRIL. 191S, TO DECEMBER, If It.
Hie study of the prevalence and geographic distribution of malarial
fevers in tiie State of Florida through the circularization of the
piactidng physicians was begun in 1913. Previous reports on this sub-
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December I'S, 1017
2220
ject were published iu the Public Health Reports of March 13, 1914,
and May 28, 1915, and were issued as reprints Nos. 172 and 277.
The physicians were circularized every three months from April,
1915, to December, 1916, reply postal cards being used for the
purpose.
Of the cards sent to the physicians about 13.5 per cent were
returned. The number of cards sent out, the niunber of schedulce
returned, and the number of counties represented at each cirrulariza-
tion are shown in Table No. 1.
It is to be borne iu mind that the number of cases reported by the
physicians does not show the number of cases that actually occurred,
for an average of only about 13.5 per cent of the physicians retunied
the schedules. While there must have been many more cases of
Jm.
P.b.
Har.
Apr.
"ay
Juo.
Jul*.
A>Jg.
S«p.
Oct.
Her.
Dto.
*
A
/\
L\
J
\
m
/
\
J
\
/^.
/
V
A
,/^
\y
V
S^
/
r ^
\>
/
^^
s
y
>^
Relative prevalence of ranlaria In Florida, by month?, as Indicated by lh;» number of cases repotted
malaria in the State, the reports of the physicians on which this
study is based are sufficient to show whether malaria was present
or absent in the several counties, and reasonably accurately the
relative intensity of the infection in the counties.
The cases rei>orted throughout the State by months are shown
in Table No. 2. The relative numbers of cases reported by months
are shown in the chart.
The number of cases reported from the several counties *»f the
State are given by race and year in Table No. 3.
The map on page 2221 shows the relative prevalence of the disease
in the several counties of the State, the heavier shaded comities
being those in which the infection was heaviest, the unshaded coun-
ties those in which the infection was lightest, as indicated by th«
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December 28, 1017
numbers of cases reported. The relative intensity of infection was
determined by ascertaining the number of cases reported in each
county during the period — ^April, 1915, .to December, 1916 — ^per
1,000 population. The population used was that of the 1910 census,
it beias: impracticable to use current estimates for the purpose.
During the first quarter of 1916 one case of hemoglobinuric fever
was reported in Columbia Coimty, and during the fourth quarter
two cases were reported in Duval County.
Rtfative prevalence ol malaria in Florida, by coonties. in proportion to the po^iiLaiion, as indicated by
the onmber of cases reported.
Table 1. — Results of circularization cf practicing physicians.
Period.
1915.
April to June
July to September . . .
October to December.
1910.
January to March —
April to June
July to September . . .
October to December
Inquiry
cards sent
to physi-
cians.
976
976
976
967
987
987
987
Replies
received.
106
108
155
133
131
125
109
Percentaeo
of replies.
11.07
17.21
15.88
13.75
13 27
12.66
11.04
Counties | Counties
represented not hc;vrcl
in replies. | from.
Cases of
malaria
reported.
S35
2,044
1.103
iJecrmbd^H, lOlT 2222
Table 2. — Ca$€9 of malaria reporUd by moriths.
Vear.
Jan. 1 Feb. | Mar.
Apr.
May.
June.
July.
Aug.
Sept.
Oct.
Nov.] Dec.
1
1915. .
226
187
244
264
S65
335
550
243
683
386
811
651
422
296
379| III
1916
m m \ 298
1
251 1 m
1
Table 3.— ra«« reported by counties, by years, and by color.
Apr, 1 to Doc. 31
, 1915.
Calendar year 1916.
County.
White.
Colored.
Com-
bined.
White.
ColoiM.
S5.
Alachua
37
6
43
19
4
3
a
7
11
10
92
11
8
26
14
71
28
64
64
S3
1
42
158
22
4
3
3
Baker
Bay
20
1
7
6
71
127
1
11
68
67
152
51
30
47
33
7
27
1
7
8
106
248
1
27
84
83
347
63
50
82
61
Bradford -
Brevard ,
3
Broward .
2
35
121
Calboun
9
83
i-itrus
174
Clay
(^lumbia
16
16
16
195
35
' 28
1
2*
44
10
Dade
36
DeSoto
M
Duval
lU
Escambia
s
Franklin
64 IflS
(Gadsden
40 m
Hamilton
30 n
I
Hillsboro
65
261
10
3
75
11
4
7
38
19
4
5
102
2
1
43
62
286
29
7
80
113
6
H
81
21
55
34
63
Holmes
2U
Jackson . . .
56
Jofiforson «
Lafayette
145
20
24
10
ii
73
15$
Lake
93
Loo
24
Leon
13
33
[x»vy
Liberty
17
4
41
288
4
43
1
12
340
6il
Madison
14
3
265
3
6
4
312
20
7
577
3
Manatee
53
Marion
63^
Monroe
4
Nassau
13
11
24
Okaloosa
23
28
3
18
50
41
78
3
41 22
23 , 13
63
Orange
3&
( )3ccola
I'alm Doach
I
23
48
-
I'asco
104
24
50
88
16
71
30
62
125
25
15
20
7
93
105
209
24
70
171
29
9.5
41
•101
328
50
19
30
7
170
4
l*inclias
23
Folk
20
83
13
24
11
39
203
25
4
10
32
^
Putnam
13 1 18
13 ' 7
88 1 55
31
St. John
aj
•St . Lucie
lis
Saiit a Rosa
Si'ininolc
66
90
27
74
284
21
4
63
7
51
1%^
Sumter
374
Suwannee
i<
Volusia ,.
4
Wakulla
108
33
33
166
Walton
40
Washiugton
77
^
Total
2,262
1,720
3,982
1,878
1,547
3.425
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PREVALENCE OF DISEASE.
No health departmenty State or localt can effectively prevent or control disease without
tnotvJedge o/vhenj irherc, and under what conditions cases are occurring.
UNITED STATES.
EXTRA-CANTONMENT ZONES-CASES REPORTED WEEK ENDED
DECEMBER 25.
Camp Beauregard, £a.— City of Alexandria, meaalcs 29, mumps 4, German measles
10, malaria 2, broncho-pneumonia 2, lobar pneumonia 1, amebic dysentery 1; for the
city of Pineville, measles 16, German measles 4, broncho-pneumonia 5, lobar pneu-
monia 1; city of Boyse, measles 18; callage of Libust, German measles 1; village of
Ball, broncho-pneumonia 2.
Camp Dodge, lowa.—Dea Moines, smallpox 25, measles 1, scarlet fever G, diph-
theria 5, cerebrospinal meningitis 1, chicken pox 1, malaria 1 ; Grimes, scarlet fever 1 ;
Polk City, whooping cough 1.
Camp Funston, Kans. — Manhattan, measles 50, meningitis carriers 2, paratyphoid
8, erysipelas 1, scarlet fever 5; Junction City, measles 8, muraps 1, chicken pox 1;
Ogden, measles, 6; Riley, measles 1.
Camp Gordon, Ga.— Atlanta, diphtheria 2, gonococcus infection 16, measles 11,
syphilis 6, scarlet fever 2, tuberculosis 1, cerebrospinal meningitis 1, Grerman measles
3, smallpox 1, whooping cough 2; College Park, cerebrospinal meningitis 1; Stone
Mountain, measles 2.
Camp Greene, N. C- Meadlea 16, whooping cough 6, tn^arlot fever 1, tuberculosis J,
syphilis 16, gonorrhea 12, chaucroid8*4.
Camp Hancock, Ga. — Cases measles, Augusta 2, Blythe 11, Uepzibap 1, Soods
Chapel 9, Tennilo several, North Augusta 2; and scarlet fever, Augusta 2; and German
measles, Augusta 1; and whooping cough, Augusta 1; and diphtheria carriers, Au-
gusta 3; and fatal case cerebrospinal meningitis, Augusta 1; and pulmonary tubercu-
losis, Augut^ta 1, baee hospital 1.
Fort Leavenworth, Kans. — Smallpox, city 2, county 5; chicken ix)x, county 1; scarlet
fever, city 1, county 2; German measles, city 6; diphtheria, city 1; lobar pneumonia,
city 1; gonoroccus infection, city 3.
Camp Lee, Va.- German measles, Petersburg 7; scarlet fever, Petersbiug 1, pneu-
monia, Petersburg 5, mea^ilos, Petersburg 2. mca;*les, ITopcwoll 4, epidemic menin-
gitis, Petersburg 1 .
Camp Lewis, IFiwA.— (Jerman measles, American Lake 2, Roy \, Custer J, Lake
View 8, cerebrospinal menin^tis, Dupont 1.
Camp Logan, Tex. — Chicken pox, 2 Houston; diphtheria, 4 Houston; German
measles, 3 Houston Heights, 19 Houston; measles 46, Houston; malaria 1, Brunner;
mumps 1, Houston; 1 Rosslyn, meningitis 1 Houston, pneumonia 3 Houston,
tuberculosis 5 Houston.
Camp MeVleUan, -4/a.— Auniston, typhoid 3, pneumonia 2, chicken pox 5, scarlet
fever 1, German meanles 4, measles 10, smallpox 8, mumps 3; Prerinct Four, smallpox
1; Precinct rifteon, pneumonia I.
150 (2223)
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December 28, 1917 2224
Fort Oglethorpty Ga. — Chattanooga, Gennan measlee 8, measles 5, mumps 11, acariet
fever 3, tuberculosis 2, pneumonia 7, whooping cough 3, syphilis 1; North Chattanoop,
measles 1, chicken pox 1; Misaonary Ridge, scarlet fevw 1; Alton Bark, pneumonal;
Last Chattanooga, tuberculosis 7.
Camp Pik€y ^rib.— Little Rock, measles 66, chicken pox 2, smallpox 25, ecaria
fever 3, tuberculosis 1, pneumonia 2, German measles 4, diphtheria 1, mumps l.mibra
1, syphilis 2, gonorrhea 1; North Little Rock, smallpox 11, measles 4, German meiaiei
2, tuberculosis 2; College Station, smallpox 1; Levy, measles 5; North Point, mahml,
measles 1.
Camj) Sevier y S. C. — ^Three scarlet fever, Chick Springs, rural; 1 pneumonis, Greoh
ville, rural; 1 pulmonary tuberculosis, Butler, rural; 4 measles, Green\ille, rural; 2
measles. Chick Springs, rural; 3 measles, Greenville, Mills Mill.
Camp Shell/y, Miss. — Diphtheria 3, German measles 143, gonorrhea 9, leprosy 1,
pneumonia 2, scarlet fever 1, meningitis 1.
Camp Sheridan^ Ala. — ( ity of Montgomery^ measles 17, smallpox 4, chicken pox I
mumns 1, German measles 18, scarlet fever 4, tuberculosis 2.
Camp Sherman^ Ohio. — Chicken pox, Chillicothe I, Hallsville 1 ; diphtheria, CMli-
cothe 1; measles, Chillicothe 22, Hallsville 1; scarlet fever, Chillicothe 7, SimngfieU
township 1; smallpox, Chillicothe 1; pneumonia, lobar, Frankfort 1.
Camp Zachary Taylor^ Ky. — t ity of Louisville, diphtheria 6, pneumonia 1, chickes
pox 5, measles 24, tuberculosis 4, scarlet fever 8, whooping cough 6, smallpox 1,
malaria 1.
Tidewater Health District^ Va. — Newport News, measles 12, chicken pox 1, tiibtf-
culosis lungs 1; Hampton, measles 1, chicken pox 3.
Camp Wadsworth, S. C, — Spartanburg city, scarlet fever 2, Gennan mea8l«5,
mumps 4, measles 4, chicken pox 9, diphtheria 1, roseola I; Spartanburg County,
chicken pox 2; Whitney, measles 1, pertussis I, tuberculosis 1, mumps 1; F^xih^t
German measles 2; Drayton Mills, typh >id 1; White Stone, pneumonia 1.
Camp Whuler, Ga. — ^Macon, measles 23, diphtheria 2, pneumonia 1, chicken pox I
CURRENT STATE SUMMARIES.
California.
From the California State Board of Health; telegram dated Deoem-
her26, 1917:
Diphtheria increasing slightly in prevalence, particularly in large cities, 66 cm*
in California last week, 24 in San Francisco, minor outbreak in Willits. Three cmbs
smallpox, 2 in Los Angeles city, 1 San Francisco. Three epidemic cerebroepin*^
meningitis, 1 each Los Angeles, San Diego County, and Sonoma County. Pwvir
lonco of measles doubled last week, 265 cases reported.
Reported hy mail for the preceding week (ended Dec. 15):
Cerebrospinal meningitis 5
Chicken pox 196
Diphtheria 64
Erysipelas 3
German measles 61
Gonococcus infection 129
Hookworm 8
Malaria 2
Measlee 136
Mumps 93
Pneumonia *^
Pol iomyeli tis ^
Scarlet fever ^
Smallpox *
Syphilis ^
Tetanus ^
Trachoma
Tuberculosis ^^
Typhoid fever ^
Whooping cough ^
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2225 Decembar 28, 1917
Indiana.
From the State Board of Health of Indiana, telegram dated
December 24, 1917:
Scarlet-fever epidemic, Roll, Blackford County; diphtheria epidemic, Owensville
and Millville, Henry County; smallpox epidemic, Huntington, school children ordered
vaccinated, Centerville, Wayne County, and Whiteland, Johnson County; measles
epidemic, Kingman, Fountain County; 20 cases typhoid, Edinburpr; epidemic rabie?,
dogs, Lake, Spencer County, and Terre Haute.
Kansas.
From Collaborating Epidemiologist Crumbine, telegram dated
December 24, 1917:
Epidemic meningitis, Auburn 1, Junction City 1; meningitis carriers, Manhattan 9;
smallpox, Kansas City 40; Barclay 27; poliomyelitis, Earlton, 1.
Massachusetts.
From Collaborating Epidemiologist Kelley, telegram dated Decem-
ber 24, 1917:
Unusual prevalence: Diphtheria — Lancaatcr 9, Chatham 4, Amesbiu-y 6 additional;
measles — Swampscott 29, Blandford 17, Ncedham 15; scarlet fever — Barnstable 7;
typhoid fever — North Brookiicld 4 additional; smallpox -Bevprly 1, Brookfield 1,
Springfield 1.
South Carolina.
From Collaborating Epidemiologist Hayne, telegi-am dated Decem-
ber 24, 1917:
Two cases cerebrospinal meningitis in Columbia; meask* and pneumonia still
prevalent in the State.
Virginia.
From Collaborating Epidemiologist Traynham, telegram dated
December 26, 1917:
One case cerebrospinal meninjfitis near Phoenix, (liarlotte ('o!mt\ : several ja^s
smallpox, Clifton Forge.
Washington.
Fi-om Collaborating Epidemiologist Tiittle, telegram dated Decem-
ber 24, 1917:
. Five typhoid, Wena tehee; no outbreaks of disease in State.
Digitized by VjOOQIC
necember 28, 1917
2226
RECIPROCAL NOTDICATION.
Cases of communicable diseases refened dwrina November, 1917 y to other Stat
ments by the department ofhealUi of the State of MassaekuuUa
November, 1917, to oAerStaU fttnfffc dhpwi.
DJsettw and looalfty of
Referred to hMlth authority of—
Wby
Malaria:
Pittsfldd.
Fneumonui (lol^ar):
3ld
Pittsfiold
PoUomyeUtis:
Lynn
Scarlet fever;
Pi ttsfleld.
Tul)errnIosis (pulmonary):
PittsfieJd
East Bridgevator.
T>'plioid fever:
Tiverton, R. I
North Adams.
Rowley.
Springfield.
Quincy....
Waroham.
North Adams.
State board of health. Bowling
Orcen, Ky., Nov. 30, 1917.
State department of health, Albany,
N. Y., Nov. 26, 1917.
State depaitment of health. Augusta,
Me., Nov. 16, 1917.
State department of health, Albany,
N. Y.,Nov. 10, 1917.
State department of health, Albany,
N. Y.. Nor. fi. 1917.
State department uf health, Augusta.
Me., Nov. 14. 1917.
State l>oard of health, Piovidenoe,
a. 1., Nov. 10, J917.
State board of health, Borlingtoo.
Vt., Nov. 10, 1917.
State board of health, CoDOord.
N. H., Nor. 21, 1917.
State department of health, Hart-
ford, Conn.. Nov. 21, 1917.
State board of health. Ooiicord,N.H.,
Nov. 23, 1917.
State board of health, Conootd,N.H.
Nov. 28, 1917.
State department of health. Hart-
ford, Conn., and department of
health. New York City, N. Y..
Nov. 30. 1917.
Patient eame to PittsSeU taa
Beaver Dam. Ky.; ts^pt- 2S ad-
mitted to Houae of Mercy HoepctiL
Pittsfield. with tnalaria: patuat
stated he had had previous attacis;
retmned to Kflotiieky Oet-S.
Came to House of ICeRX Hos^stti,
Pittsfield. ill rrom StepbrafftMV.
N. Y.: died Nor. 22, 1917.
Patient showed first symptoms K^r.
3, while in Foxcrofl. Me., where Ae
had been for G Vi-c«)r3; had brea i
Camp 1* His. Me., from Jooe I nstd
she went to Foxciof t.
Case was broacht to Um
Mercy Hospital, Pittsfield, Ul tnm
Canaan. N. Y.
Case eame from Nasaau. K. Y.. Oct
81: died at Pittsfield Nov. 5. 1«7.
Case reported Nov. 12 by fe^st Bhder-
water board of heaitfa at MiiM's
Sanatorium; home address Is Vi^
deford. Me.
Case reported by Fall RixTpr board of
health; patient lived oo StAte
Street, Tiverton, R. L
Omo reported Nov. 1: ill abeol I
month; first seen by r^ystctan Oct.
24; visited in Readsboro, Vt.. Sepc
20 to Sept. 24.
Patient was a achool-toocber at
Hampton. N. H.: when her Bh
began sbe retunied to Rowley.
Patient visited Madison. Conn., on
Oct. 24; date of onset. Oct. 25l
Patient spent vacation in Bristol.
•N. H.. in August: onset. Aug. tk
died Sept. 16. 1917.
Patient at Boys Camp, Dmnbvy.
N . H.. from Aug. 23 to Sept. 2: Cn»a
the camp he went to Bortaett,
N. H.. thence to Weirs, N. H.. re-
turning to Wartham bopi. ^; oosscl
durmg week encung be|.t. 29.
Patient was In South Norwaik. Conn.
Nov. 10 and 11, and Nov. 12 and IS
was in New York City, at kzwwa
addresses; onset, about Hov, 4.
Minnesota.
Cases of comviunicahle diseases referred during November^ 1917, to other State heakh
departments by department of health of the State of Minnesota.
Disease and locality of
notification.
Diphthrrin:
Miim-apolls henlth d^
piriinrnt, Ihnnepin
roiiniy.
W in f n a, Winona
County.
Referred to health authority of—
Division surgeon, Camp Dodge,
Iowa
Buffalo County, Wis. (exact loca-
tion not given).
Why referred.
Patient on leave from Camp Dodge
Nov. 15-20; developed diphtheria u
Minn««polis,Nov. 19.
l^hysicion from La Cro^c, Wis.,
brouRtit child to Winona, wbece
child died same day of diphtheria.
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2227
December ::», 1011
RECIPROCAL NOTinCATION— Continued.
Minnesota — continued .
Cases of conununicahle diseases re/erred during November, 1917, to other State health
departments by the department of health of the State of Mnruj^of a— Continued.
Disease and locality of
notiflcatioiL
Tuberculosis:
Mayo Clinic. Rochester,
Olmstwl (\nmtr.
Referred to health authority of—
Tn)hoid fever:
Miners Hospital Cras]»y,
Crow Wing Counly.
Thief River Falls, Pen-
nington County.
i'rior Township,
stone County.
Big-
Rog^en, Weld County, Colo.; Ur-
hana, R. No. 7, Champaign
County, 111.; Mount Vernon,
Jefferson County, HI.; Danville,
R. No. 6j Vermilion County, Ul.;
"— - M?imT rmirrtr JrA.;
MilrjMi, nr.WiLi- i^onnis, i':i.;
LoosooU'e', Murtln Coimly, fi! i.;
KverJy, t'lay rotmry^ ^ ■ a;
Ifvln^, Tnma County, mur. \ ^es
Moiu'"^! i'alk CmiDty, jir^^a;
Urm'ittfi . It.ku 1 1 n« Vaurnt y , K i f s. ;
AtJcMnscaiij Alc'hinsan df'i^n'y.
Kan?.; Nt-iv Orleans, <irJ ,ns
Parish, La.; fJFntmj JlLir'.ff,
IJ fTTien Cuiinly , M ids . : A ^ . . i ji,
A ip««nji Comity, Mich.; Hrmn'.U,
Mftritm County, Mo., S't. jv- ' h,
Baerhamini Ctjunty, Mo.; Kf.ry,
Custer l^OiJntj't MnJit.: l<kir. ilfe^
tiay County, NVhr; smiia liMa,
Ortmi r^mty, N, Wmx.; N.ll,
Kmmfnis CcHirity^ N. rafc." liit-
Jati'I, Ivaimoa^ Coonly, N. I^i'c,
rufjrflliti, Uiuisom Cfiimt^. . M.
r>ijk.; BrinjintidB, nenatviitM- ry,
N, Dak.; I'npthall, Mm i nil
I'oimty. N. Djik.; \Vi>.f. .-h,
^Simsraiui tYui^ty, ■■■ '' i.;
Law ton, Ramsey tk^taty, N.
Dak.; Utica, Yankton County
S. Dak.; Tu.shka, Atoka County,
Okla.; Westby, v'ernon County,
Wis.; Manawa, Waupaca Counly,
Wis.; Pen tang, Ontario, Canada.
Ilesnor, Vellov stone County, Mont.;
^\arIand, Washukio County,
Wya
Overly. Bottineau Counly, V. D.ik.
Dalton, Turner County, S. Dak.
Why referred.
1 advanced, 8 moderately advanced,
1 apparently cured, 2 apparently
arrested, 3 stage of disease not
given; left Mayo Clinic for homes;
4 apparently arrested, 4 modei*
atelv advanced, 7 advanced, 2 stage
of disease not given; left Mayo Clinic
for homes.
Working at a fump at lle,vp<r.
Mont., nnd Warland, Wye, '.
weeks previous to first .symptom-*.
Employetl at Soo depot, Ovorl\ .
N Dak., 3 weeks previous to fir;'
symptoms.
N'i.siting at Dalton, S. Dak., 3 wee» s
previous to first symptoms.
CEREBROSPINAL MENINGITIS.
State Reports for November, 1917.
Place.
California:
Alamoda County-
Oakland
I.os Augclcs County
Los Angeles
San Diego County..
San Diego
Total
Louisiana:
Rapides Parish
Minnesota:
Freeborn County-
Albert Lea
Hennepin County-
Minneapolis
St. Louis Count y—
Duluth
Total
New
cases re-
I ported.
Ohio: '
Allen County '
Clark County
Cuyahojja County
Franklin County
Hamilton County
Lucas County
Mahoning County
Ross County
Stark Coimly
Summit County
Total
Pennsylvania:
Allegheny Count y
Delaware County
Fayette County
Lackawauna County
I^uzerne County '
Nortluunpton
I'hilndclphia County
Total
Digitized by VjOOQIC
December 28, 1917
2228
CEREBROSPINAL MENINGITIS— Continoed.
State Reports for November, I9I7— Oontmaed.
Place.
Rhode Island:
Providence County—
Provldenoe.
South Carolina:
* Qroeo ville County .
New
oases
reported.
Wisooosin:
Forest County
Bfllwaukee County.
Waukesha County .
Total.
City Reports for Wedc Ended Dec 6, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
DestiL
Baltimore, Md
1
1
1
1
9
1
1
2
1
2
1
Leavenworth, Kans
1
2
I
I
Birmingham, Ala
Los Anceles, Cal
1
Boston, Mass
Nashville, Tenn
Brockton, Mass
NewYor^, N. V
5 .'
Chicaco, 111
8
1
1
Philadel!»hla. Pa
3 1
Clc\ eland, Ohio
Portlana, Oree
1 1
llarrisUurp, l*a
Portsmouth. Va
!
I
Hartford, Conn
RocVford, nj
i
1 .
1 1
Jersey nty.N. T
St. ' oiils, Mo
KansttsCHv, Kans
San Francisco. Cal
1
Lawrence, Mass
1
Washincton, D. C
3 1
" 1
DIPHTHERIA.
Sec Diphtheria, meaBlcs, scarlet fever, and tuberculoeis, page 2238.
ERYSIPELAS.
City Reporto for Wedc Ended Dec 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
D«Bthi.
BcrVelcy , Cal .
1
2
17
8
2
2
1
2
1
1
1
1
1
2
MUwauVee, Wis
3
3'
12
1
1
10
1
;
Buffalo, N.Y
Cbica"0, III
1
NewYorV.N.Y
Philadelphia, Pa
a
1
Cleveland, Ohio
1
1
2
Pittsburgh. Pa
Pcnver, C/Olo
Readinc;, Pa
Detroit, Mich
St. Joseph, Mo
Duluth, Minn
St. Louis, Mo
I
Elitabeth, N. J
St. Paul, Minn ,...
Hamsburpj Pa
Salt LaVoClty. Utah
j
Hartford, Conn
San Frandsco, Cal
4\
2 1
1
Johnstown, Pa
StocHon.Cal
* -•*•
Lca\enworth, Kans
1
Toledo, Ohio
Long Hranch, N, J
Troy, ^. Y
]
Los Angeles, Cal
MALARIA.
State Reports for November, 1917.
Place.
New
cases
reported.
Place.
Sow
eases
Toported.
California:
Butt* County
8
1
5
3
2
California— Continued.
Glenn County—
Orland
Colusa ("onnty
1
Colusa
Kem County—
Bakersfleld
Fresno ( ounty —
1
Clovis
Placer County—
Rocklln
Fircbaugh
1
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2229
MALARIA— Continued.
State Reports for November, 1917— Continued.
Detvmber J8, 1917
Place.
California— Continued.
Sacramento County—
Sacramento
San Francisco (city)
San Joaquin County—
Stoclrton
Santa Barbara County—
Lompoc
Solano County—
Vacavllle
Sutter County
Trinity County
Yolo County
Woodland
Yuba County—
Marys%iflc
Total
Louisiana:
Ascension Parish
Bossier Parish
Concordia Parish
De Soto Parish
East Feliciana I'arlsh..
Grant Parish
Iberville Parish
Jefferson Parish
Jefferson Davis Parish..
La Salle Parish
Madison Parish
Morehouse Parish
47
Place.
Louisiana- Continued.
Rapides Parish
Sabine Parish
St. Hekna Parish
St. Martin Parish
St. Mary Parish
St. Tammany Parish...
Tangipahoa Parish
Tensas Parish
Vermilion Parish
West Feliciana Parish.
Winn Parish
Total
Ohio:
Clark County...
Ix)raln County.
Total..
Pennsylvania:
Philadelphia Coimty. .
South Carolina:
Beatifort County
Chesterfield County . . .
Marion Count v
S^artajiburg County . .
A\ illtemslnirp County .
Total.
' New
I cases
[ reported.
_i
13
2
I
H
10
4
«2
:t
2
1
141
City Reports for Week Ended Dec. 8, 1917.
Place.
1 Case>
,
Deaths.
I
1 ,
1 1
Place.
Richmond, Va
Savannah (la
I
' Cases
r*-
'
Deaths.
Birmingham, Ala
Xew OriCiins La
'"l
3
2
-
1
Oklahoma Citv Okla
Tacoma, Weish. .
•
1
MEASLES.
8ee Diplithoria, meoslo.s, scarlet fever and tubereulosi->. ]ia^'e JJiW.
PELLAGRA.
State Reports for November, 1917.
Place.
California:
Los Angeles County-
Los Angeles
Louisiana:
Beauregard Parish.
De Soto Parish
Madison Parish
Orleans Parish
St. Mary Parish....
New cases I
reported. 1
Place.
New eases
reported.
, Soul h Carolina:
I Chostorfleld County..
1 (JreeiivilleCcMuty...,
= (Jreenwood County..
Marion County
SimrtanbufK Coiuily .
^orkl^onniv .'..
Total..
rntal.
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December 28, 1917
2230
PELLAGRA— Continued.
aty Reports for Wedc Gided Dee. 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases. , Beci
Baltimore, Md
BlrminKham. Ala..
Charleston, S. C...
Fall River, Mass...
Lexington, Kv
Ljnuhburg, va. . . .
Mohlle, Ala.
New Orleans, La
Portsmouth, Va.
Bavaimah, Oa
WUmiDfton, N. C
Winston-Salem, N. C.
::::::d
PNEUMONU.
aty Reports for Week Ended Dec 8, 1917.
Place.
Alameda, Cal
AJlertouTi, ^a
Baltimore, Md
Beaver ^ alls. Pa
Berkley, Tal
BinphaiPtmi, N. Y
Barton, Ma-s
Bu alo, N. Y
C-aml rid-'e. Mass
Chelsea, Mass
Chlcao, m
Cleveland, r hlo
Petroit.Mlch
Piiluth, Minn
Frie.Pa
Everett, Ma<<s
rail River, Mass
lilchbiirr, Mass
rum, Mich
Orard Kayiids, Mich..,
HarrlNbiir^', Fa
Haverhill, Mass
Jac' son, Mich
Ka'an^a oo, Mich.
Kaiva^rity.Mo
Levinpton, Ky
long Beach, Cal
Los Angoles, Cal
Cases. Deaths.
1
1
10
I
1
3
20
2
4
6
12R
38
6
2
4
2
1
1
4
2
2
7
1
4
4
1
3
11
Place.
McKeesport, Pa
Haldeji, Mass
Morri town, N.J
New Bedford, Mass..
New Ca- tie. Pa
NcwDTTt.Ky
yewtai.Ma<«
Pasadena, Cal ,
Philadelphia, Pa
Pittsl urgh. Pa
rittsW .Mass
Pontiac, Mich
Readine, Pa ,
Roanoke, Va ,
Rochester N. Y
Facramento, Cal ,
8andus y, Ohio
Pan Francisco, Cal
San Jose, <'al
Schenectadv, N. Y
Somerville, ]ia<«
South Bethlehem, Pa..
Springfield, Mass
Stoc' ton,Cal
Wichita, Kans
Worcester, Mass
YorV, Pa
Zanesville, Ohio
Cases, dm^
I
< •
1
7
'I
I
I
•1
M
4
3
I
11
4
I .
21
1 ..
4 ..
J
I ..
7
4
3 ..
POLIOMYELITIS (INFANTILE PARALYSIS).
State Reports for November, 1917.
Place.
California:
Alameda '^ounty—
HcrVclev
Butte County—
('hico
Contra ' o^ta County. .
Los Angeles County —
Monrovia
Pa-'adena
Riverside ( ountv
San Mateo County-
San Mateo
Total
Micbipan:
( alhoun County
Eaton County
(tratiot County
Menominee County . . .
Van Burcn County
Wayne County
Total
New cases
reported.
Place.
Minnesota:
Becker Comity—
Richwood Township.
Hennepin County—
Minn^polis..
TotaL.
Ohio:
Ashland County...
Coshocton County..
Crawford Coimtv...
Cuyahoga County . .
Franklin County . . .
Guernsey County. .
Hamilton County..
Lorain Coimty
Pilce County
Total
Pennsylvania:
Allegheny County..
Armstrong County.
Beaver County
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2231
December 28, 1917
POLIOMYELITIS (INFANTILE PARALYSIS)— Continued.
State Reports for November, 1917— Continued.
PiBce.
N«w cases
reported.
Place.
New^c
reported.
Pennsylvania— rontinued.
Butler* oimty
Cambrte County
Fayette County
Franklin ( oqnty
Indiana County
Lancaster C ounty
Lawrence County
Lu>emo( oontv
SchuylHIl ( ounty
Somer^t i ounty
Washington County...
Total
Rhode Island:
Providence County-
Providence
South Carolina:
Spartanburg County
Wisconsin:
MilwauVee County ,
Shawano County
Walworth County f,
Washburn County
Total
City Reports for Week Ended Dee. 8, 1917.
Ptaoe.
Cases.
Deaths.
Place.
Cases.
Deaths.
Brocktoo. Mass
Philadelphia, Pa
1
Chicago fll
San f^ancisco, Cal
1
3
1
Cincinnati Ohio
1
Seattle, Wash
Fall F»v»r Mn*? .
Springfield, Mass
1
"IrflnPftst^r, Pa , r . , , . . .
RABIES IN MAN.
Minnesota — ^Ramsey County.
A case of rabies in man was notified in Ramsey County, Minn.,
November 9, 1917. Death occurred November 11. Antirabic treat-
ment was not administered.
RABIES IN ANIMALS.
aty Reports for Week Ended Dec 8, 1917.
During the week ended December 8, 1917, 1 case of rabies in animals
was reported in Detroit, Mich.
SCARLET FEVER.
See Diphtheria, measles, scarlet fever, and tubcrculoeia, page 2238.
SMALLPOX.
Iowa — ^Decatur and Polk Counties.
During the period from December 1 to 17, 1917, 107 cases of
smallpox were notified in Grand River, Decatur County, Iowa, and
48 cases were notified in Polk County during the same period.
Maine.
During the period from December 1 to 19, 1917, cases of smallpox
were notified in counties of Maine as follows: Aroostook 60, Kennebec
21, Penobscot 2, Oxford 4, Somerset 13, Washington 53j^aldo 6.
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l>eicmber I'S, 1017
2232
SMALLPOX^C^ontiiined.
Maine — Eastport.
During the period from December 14 to 18, 1917, 31 cases of small-
pox were notified at Eastport, Me., making a total of 51 cases reported
at that place since December 1, 1917.
State Reports for Norember, 1917.
Plat^.
ralifarnia:
Kem County
Los Angeles County-
Los Angeles
Troplco
Nevada County
Grass Valley
San Diego County
San Francisco (city) . . .
Solano County—
Benicia
Tulare County—
PortefAillc
Total.
Michigan:
Alcona County
Alpena Coimty
Bay County
Berrien County
Calhoun County
Cvkv» Cmuity
Clinton County
Eaton Couuty
(iencsee County
Gladwin County
< I ratlot County
Huron County
Ingham Coiinty
Iosco County
Iron County
I<dl)cllii C*ninf y
Kent CoiuUy..'
I^jH.H'r County ,
I^uawcc Coutily
Livingston County. .
Macomb County
Mayin County
Mc<x>sta Comity
Montralm Couiily...
MKsuikce County...
Mu'>k<'pon County
Oakland County
Ot-cuna County'
<Kf>M)|.i Count V
<)M>xKi Count y
Otta\v;\ Couiiiy
Pn'^« no Klc I ounty.
Saptiaw C«nuify
St. Clair County
St, Joseph Couuty...
Sanilac County
Shlawa'^s<H^ County..
Washtenaw Coimty.
\Vayn<' County
Wexford County. ..
New cases
reported
Deaths.
79
1
'2
l.> I
9 I
I I.
H .
19 '.
9 '.
h:
'2S .
:* .
■'► .
a .
1 '.
1 \
u .
V.i .'
•2 ■.
i '.
IS .
Toi.l.
IM
40
1
4U)
Vaccination history of cas«s.
Number Number
vaccinated last vacd-
within 7 I nated more
years pre- ,than7yoars
ceding i preceding
attack. attack
Number
cessfuUy
vaccinated.
VacciAAtioo
history not
obtained or
uncrrtiin.
I
1
1
1
1
;;„
»
0
»
12
2
1
K1
I
1
UH
1
11
2
1
'2
I
.. ..^
1
I
I
'4
1
1
I
.1
.1
1
i
1
1
17
4H
1
1
16 1
41
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2233
December 28, 1017
SMALLPOX— Continued.
State Reports for Norember, 1917— Ck>ntinued.
New oases
reported.
Deaths.
Vaccination history of 08838.
naoD.
«
Number
vaccinated
within?
years pro-
ceding
attack.
Number
last vacci-
nated more
than 7 voars
attack.
Number
never suc-
cessfully
vaccinated.
Vaccination
binorv not
obtained or
uncertain.
Minnesota:
Crow Wuv County—
Brainerd .
86
10
6
3
9
1
1
78
1
1
Crosby
DouRlas Ojunty—
FlUmore County—
Bcever Township
Freeborn County—
Aldpn
Qoodhue County—
Ooodhue Township
Hennepin County—
Minneapolis
1
6
Medina Township
..........
2
Oronn Townidiip
ItasVa County— "
NashwauV
1
Kittson County—
Kennedy
5
1
Cranvlllo Township
Lincoln County—
Tvlor
1
1
Lyon Cnuntv—
Marshall
1
2
6
1
1
1
Tracv
1 . vons Township
Marshall County—
f'tephen
Mower County—
Austin
2
1
Fdoloho Township
Mnrrav county—
^lavton
mtnWH ^ountv-
North Mandate
Ottertall <^'ounty—
Hobart Township
1
Pine Tountv—
Flnlayson Township
Ramsey County—
Ft. Paul
4
72
9
1
4
1
5
1
2
3
2
1
Rose Township
*
Renville '"onnt^—
Cairo To^^Tiship
RocV Countr —
Kamrau'i Township
Roseau Count v—
Rosenn...*.
Jadls To^vnship
Steams Coimtv—
Saulr Center
Steele County—
Owatonna
Todd rountv-
Blrchdnlo Township
V...
Hartford To^vn-ihip
West Union Township
Buttcrfleld
Total
345
4
10
228
s
Ohio:
Athens County
10
14
83
10
3
20
4
Belmont County
1
Butler County
8
5
3
1
83
8
3
3
1
_ 20
3
Clark County
1
8
Clinton County
Coshocton C/Ounty
Cuyahoga County
Darke County
3
Defiance County
1
Fairfield County
Fayette County
2
Franklin County
..#.....•,.•
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Deceinl»er 'JS, lt»17
2234
SMALLPOX— Continued.
State Reports for Norember, 1917 — Continued.
Pbcc.
Ohio— Continued.
Fulton County
Greene County
Guernsey County . . .
ITamilton County . . .
Highland County . . .
Hocking County
Huron County
Lake County
Lawrence County . . .
Lorain County
Lucas County
Mahoning County. . .
Medina County
Mercer County
Miami
Montgomery County
Perry County
Piko County
Portage County
Putnam County
Ross County
Sandusky County. . .
Scioto County
iShelby County
.Stark County
Summit Co»mty
Trumbull County. . .
'riL>oarawa'< County.
Van Wert County...
Washington Couiity.
Wavno County
Williams County
Total
Deaths.
New cases
reported.
Number
vaccinated
within?
yeaMpre-
coding
attack.
Number
Itstvacd-
nUedmore
than7ve«rs
procodinc
attack^
1
Number Vaodnatkn
never soo* , hlstorr not
cessfoUy oUalnedor
1
8
35
4
7
3
29
1
\
3
26
20
1
2
23
20
I
66
139
17
4
•
1
'
7
23
1
1
3
1
1
1
1
4
U
*
1
1
21
::::::::;:i::::::::;;::
. . .
i
1 ;***
\" '
1
1
16
19
3
13
125
5
13
6
19
104
6
0
S
2
10
'
*r'*'**
4
1
1
5
1
1
:i7
1
5
460
TT2
Placo.
^ul alalia (Nov. 1 ;«)):
<iri»iii Parish
Jeilt'i>^n Davis Pari>h. ..
lAifourchc Pjiri>h
Ma^liNou Parish
Natchitoches I'arlsh
Orleatis l*arish
Kapidvs Pari^li
St. Tammany Parish
Miscellaneous State Reports.
r
(■asci*. Deaths. -» Place.
Total.
rcnn>vl\unia (Nov. l-.TO):
\\\ k'liotiv Coimtv
IUmINt*! ("ouiity."
Camlnia loiiiit y
(Viilci Coumy
Clearfield Coiiuiy
Clinton County
l>aiif)hin County
Krie (.oiitjiy
I'iiilailelplila County. .
Sonui-rt County
Total
8«Milli ( m<.iiiiH .Nov. I 'M\K
<;»tvii\ lilr fount \
l.iur.'n^ r(»Mui>
Spar'aiiluir^; (.Ot.ntv . .
Tot^
I
Wist-onsin: :
narron County '
HuHalo County I
Calunu»t Cotmty '
Chi p|X'w a County |
Dane County I
Douglas Coimty '
June^iu County l
\a Crosse CoiuUy I
Lincoln County 1
Manitowoc County J
Milwauke** (Xiunty |
Outagamie (\>unt y i
/ Ilaoino County , '
Rock County I
St. Croix County....
Saujc County
Sheboygan County. .
Vcrnou County
Total
C^nes.
rvuih.*
3
i
9 .
1
.t
>»
24
13
8!
I 1
1 3
12
3 1
113
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2235
SMALLPOX— Continued.
atf Reports for Wedc Ended Dec 8, 1M7.
December 28, 1917
Place.
Cases.
Deaths.
Plaoo.
Cases.
Deaths.
\kron, Ohio ,,„,.„,
33
32
12
11
46
J
23
54
37
140
1
La Crosse, Wis
1
Alton, III
l^^vQnworth, Kans
Baltimore. Hd.
Lincoln, Nebf
Boston, Mass
Los Angles, CaJ.
Buffalo' N. Y
Milwaukee, Wis
Butte. Mont J
Mlnnfmiv»li's. Minn
canton, Ohio.:
Muscatine, towa.
Cinoinnati, Ohio.
Nashville. Tcnn
Ciovcland/Ohlo
Now Orleans, La
Coffoyvllle, Kans
Newport, Ky
Columlius, Ohio
Oklahoma City, Okla
Omaha, Nebr
Cumberland, Md
Denver, Colo
Pontiac, Mi'h
.......(.•
Detroit, Mich.
Portland, Oreg
Dubuque, Iowa.....
Quinoy. tll...T
East (liioaKO, Ind
8t. Louis, Mo
Evansvillc, Ind
St. Paul, Mlrm
Flint, Mirh...i
Fort "Wayne, Ind
Salt Lake City, Utah
San Fran' ls«"0, Cal
Fort "Worth. Texas
Savannah, Oa
Orand Ranids. Mioh.
Seattle, AVash
Harrhburt. Pa
Sioux Citv, Iowa
Indi^inApoU'*. iPd .,,,.,,. t T -
iSiroma, Wash
Kansas rity, Kans
Toledo, Ohio
Kansiis City! Mo
Washington, D. C
KnnxvU'c, Tenn ^ . t
Wichita, Kans
TETANUS.
New Jersey.
During the month of November, 1917, one case of tetanus was
notified in the State of New Jersey.
City Reports for Week Ended Dec 8, 1917.
Place.
Cases.
Deaths.
Place.
Cases.
Deaths.
Baltimore. Md
1
New Yrrk, N. Y
1
Cbicagj, 111
1
1
Philadelphia, Pa
1
1
1
Lorain, Ohla
1
PltUfleld, Mass
1
TUBERCULOSIS.
Sec Diphtheria, measles, scarlet fever, and tuberculosis, page 2238.
TYPHOID FEVER.
State Reports for November, 1917.
Place.
New oases
reported.
Place.
New cases
reported.
California:
A InmndA Cniuity ...,...,
3
2
8
1
Cal ifomia— Contbiued.
Mendocino County-
Fort Bragg
Oakland
I
Piedmont
Monterey County—
Sft inas .,. ,
Butte County—
1
Chico
Orange County
1
Contra Costa County-
Richmond
Sat ramento County—
8a 'ramento
4
Eldorado County
San Diego County—
SanDiego
Fresno Coimty.r
4
l-resno
San Francisco (city) '.",
15
Reediey
San Joaquin County—
Lodi
Kern County
2
Dakersfield
Stockton
g
Kings County—
Honford
San Luis Obispo County
2
Santa Barbara County-
Santa Barbara... .
Los Angeles County
1
Los'^Angeles. . .'
Santa Clara County-
San Jose
Madera County
\
Digitized by VjOOQIC
December 28, 1917 2236
TYPHOID FEVBR — Continue*!.
State Reports for November, 1917 — Continued.
Place.
Oalifomia— Oontinoed.
Shasta County-
Redding
Solano County
Sonoma Coun t y . . . . »
Santa Rosa
Stanislaus County—
Turlock
Sutter County
Tulare County
Porterville
*Yolo County
Yuba County—
Mar>*svlUe
Total
L<Hilsiaua:
Assumption Parish
BlenviDe Parish
Caddo Parish
Calcasieti Parish
Do Soto Parish
E vangeline Parish
Iberia Parish
Iberville Parish
Jefferson Davis Parish
lAfayetle Parish
I^ourche Parish
Morehouse Parish
Orleans Parish
< )uachita Parish
Planuemines Parish
Uapides Parish
Rod River Parish
Sabine Parish
8t. James Parish
St. Helena Piiribh
St. Mary Puriih
Tangipahoa Parish
Union Parish
Vermilion Parish
West Baton Rouge Parish
Total
Mic'hican:
Alcona County
AlU'iran County
Hay County
Barry County
Berrien County
Branch County
Calhoun Counly
Choboycan County
Eaton County
( Jonesee Count y
(Jratiot County
• Huron County
Ingham County
Ionia Count y
1 sal)ella Count y
lasco Cotmty
Jackson County
Kalamazoo County
Kalkaska County
Kent County
lienawec County
Macomb County
Manistee County
Marquette County
Mecosta County. .*
Midland County
Montcalm Count y
Montmorency ( 'o'unty
MuskcRon County
Newaygo County
Oakland County
Saginaw County
Place,
Michigan — Continiied.
St. Clair County
Shiawassee County..
Van Buren Coanty . .
Wasntenaw County.
Wayne County
Wexford County
1
2
2
1
1 i
1
2
1
2
17
1
1
3
1
1
1
2
1
1
6
1
1
3
3
1
1
1
1
1
l\
4 I
Total
Minnesota:
Bigstone County —
Prior Township
Bhie Eortli County—
Mankato
Clay County —
Hoorliead
Crow Win^ County-
Iron ton
DodiR) County —
Dodge Center
Faribault County—
Brtcelyn
Hennepin County —
Minneapolis ,
Brooklyn Township
Hubbard County —
Porte
Isanti County —
Maple Rid|?c Township -
Jackson County —
Minneota Townsliip
Lake County —
Two Harbors
Nicollet County —
North Mankato
Ottertail County—
FergusFalls
Otto Township
Pennington County —
Thief River FWIs
Polk Countv —
Gully Township
Pope County —
Glenwood
Ramsey County —
St. Paul...
Redwood County —
New Avon Township
Rice County—
Faribault
Forest Township
St. I^uls County —
Buhl
Chisholm
Dulnth
nibbing
Virginia
Wadena County —
Vcmdale
Wilkin County—
Breckenridge
Winona County—
Winona
Total.
Ohio:
Adams County ,
Allen County
Athens C^mty
Belmont County
Champaign County . .
Clark County
Clermont County
Columbiana County.,
Crawford County. . . . ,
Cuvahoga County. . . ,
l>arko Countv
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2237
December 28, 1017
TYPHOID FEVER— Continued.
State Reports for November, 1917— Continued.
Place.
31iio— Con tinued.
Defiance ^'ounty
Fiie r"otmtv
Fa vette ("otint v
Fran' Un foiinty
Greeno Oountv
HamUtoo roiinty
HancocW roiinty
Harrbon County
Henr V roimtv
Huron Countv
Jac'-Ron Tountv
JefferMm Toimtv
Lawrence ronnty
LlcVin^ ronnty
Lo^n roiinlv
Lorain ^'onnty
Lucas Tountv
Mahonin? ^ 'oimty
Marion ('otmtv
Medina Poimtv
Merrer roimty
Montgomery roiraty.
Musi-ineum roimty..
PlC-awav County....
RichlnnH County
Ross « ountv
Bcioto Countv
Seneca Countv
Shelby County
StarK Countv'.
Summit ' oimtv
Trumbull Countv
Tuscarawas Cotmty..
Van Wert Coimty . . .
Vlntoo( ountv
"Warren County
Total.
Pennsylvania:
Adams o*mty ,
Alleg ^eny ( o"nty . . . .
Armstrong' o'mty...,
Bea\*er» oimty ,
Bedford < O'lnty ,
BerVsi o"nly
Blair" ounty
Bralfordt cmty
BucWsi ointy
Butler (otmty
Cambrian oimty
Centers ounty
Chester County
Clarion County
Columbia C ounty . . . . .
Cumberland v ounty . .
Dauphin county
Delaware (ounty ....
Erie' ounty
Fayette I ounty
Franklin ( ounty ,
Oreenei ounty ,
Huntingdon ( ounty . .
Indiana I ounty
Jefferson ( ounty ,
Juniata County ,
Lackawanna County.
Lancaster County ....
Lebanon County
Lehigb County
Now cases
reported.
I«3
Place.
Pennsylvania— Continued.
Luzcmo County
Lv coming (ounty
Mercer ( oiuity
Mi in Countv
M(»itgomcry bounty
Nort^ampt' n Count v
Northumberland County..
Porrv County
Philadelphia County
Potter County
Schuyllrin ( 0"nty
Snj'der Co- nty
So'norsetCo nty
Tlosa Co'nty
Union Co' nty
Venanw) <^o'inty
Wa ^hington f o- 'nty
Wayne* o nty
Westmoreland County
Wvoming' otmty
York County
Total.
Rhode Tsland:
NewTMMt ''o'^nty—
Ti crton aown)
Pro Hence '^o-'nty—
Fa't Pro i *,ence <'town>...
Korth Pro ilcnce (to'vn).
Nort»i Sn-ithfleld (town)..
Pro Hence
Washington f ountv—
Hope Valley (town)
Total.
Sooth Carolina:
Beaufort' ounty
Charleston ( ounty. ..
Florence County
Oreen illcl ounty...
Greenwood t otmty . .
Marion ( ounty
Orangeburg < o-mty..
RiC'huidi otmty
Spartanburg County.
Total.
Wisconsin:
Ashland Co'mty...
Brown Co mty
Chippewa ( o mty..
Door< omty
Do glas( 0 nty
Dunn^ ounty
Fau( lairo( ounty.
JacVson ( ounty
Langlaic( ounty..
Lincoln County
Marat non County..
Milwaukee ( ounty.
Outagamie < ochIt..
Racine ( o-jntv
Shawano o^-*-
Sheboyz^Ai.
Wa-f jra • -
T- -
Now cases
reported.
S
s
s
6
IS
S
5
S
86
1
4
1
S
s
1
1
12
4
8
1
10
315
5
11
40
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Detembcr 28, 1017
2238
TYPHOID FEVBRr-Coiitinued.
City Reports for Week Ended Dec. 8, .1917.
Place.
Albany.N.Y
Allentown, Pa
Baltimore, Md
Beaver Falls, Pa...
Berkeley, Cal
Birmingham, Ala..
Boston, Mass
Braddock, Pa
Bridgeport, Conn..
Buffalo, N.Y
Butler, Pa
Chica*jo,Ill
Cincinnati, Ohio...
Cleveland, Ohio. . .
Columbus, Ohio...
Detroit, Mich
KllMbcth.N.J....
El Paso, Tex
Erie, Pa
Evansville, Tnd
KallUiver, Mass...
Flint. Mich
Fort Worth, Tex..
(lalesburp, III
(ialvcNlon, Tex —
Uarrisburp, Pa
rittrtford,Conn.
Cases. Deaths.
Indianapolis. Ind
Jersey City, N. J
KansksCilv, Mo
''itJli^ -
Ivnnxvllle.Tenn.,
I. OS Aneelos, Cal —
Memphis, Tcnn
Miimeapolls, Minn..
Mobile, Ala
Nashville, Tcnn
1 I
Place.
Cases. Jj^sz
New Bodlord. ICass.
New Haven, Conii
New Orleans, L«
New York, N.Y......
N!-7:iraFans.y.T
Nc- ■■. .^■1
Oi I \l_... j
Oi .h._.. •
PI huj^Fa.. I
Pi ■. iTt^h, Pa.. I
Prr'liiKllMi? !
Pm, liiid. Oref
Qi. r]iyJlL„. I
Rm iiford.m...., I
Rm, iv Mounl, N.C
St lv*H?pii, Mo.,,
8t [^mikMo...
Self T.ikki^nty, riah
S& . lifi^kv.Cifijo.-.
8£ k 1 ranC(*ico, TsL
S( mcclvly * N.Y
StiJl^^ W*sli..,
8<.:; i i?r\tlle, Mass
Sc l] Itead, Ind
St ' kiort, r^l.,.-
.n^\N. v.,
p [laiite, lod
rlti, (iliio
,N.Y. ,.
'hinjjton^ 1>. C
■-Un«, W.Va,.
UTL^ll-Hl, LIpI,
cr, Mfi*f
& '
1 '..
U:
York, Pa.
Zancsvillc, Ohio.
DIPHTHERIA, MEASLES, SCARLET FEVER. AND TUBERCULOSIS.
State Reports for November, 1917.
Cases reported. |!
1 - . . •!
Cases reported.
Slate.
303 3G0
111 1.S71
1! State,
ficariet M
fever. 1
S^.\^c^
1 krr
('aliforuia
:^27 ,1 Pennsylvania
3o H Rhode Island
(.25 i; South CaroUna
260 !i Wisconsin
227
217
776
26
296
236
l-ouisiana
Michigan
714
413
966
28.5
210
420
'[.
Niiiincsola
^
oiiio
blO ;
ll
•
Digitized by
Google
2239
December 28, 1917
PHTHJBRIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS^
Continued.
City Reports for Week Ended Dec. 8, 1917.
PopuU-
tion as of
July 1, 1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
(rom
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tubercu-
losL<«.
City.
1
1
1
1
1
1
1
2
" "e*
1
*"*i'
1
1
v-er & Hj .000 tubal ^itants:
1J J. 1 1 t irri fxf *> \Ja\
5S8,G21
756,476
2,497,722
674,073
.•>71,7M
503,812
5,602,841
1,709,518
579,090
757,309
m,m
410. 4T0
a06,:Ji45
4:I6,:^35
?.7 1,717
4<U, .016
'ill.sTS
•JW.800
271.708
297, S47
295,463
254,960
25ti.4i7
247.232
liM,199
190,558
181,762
121,579
112,yKl
106, -233
128,366
104,562
128,291
110,900
100,560
113,245
102,425
148,995
117,057
118, l.W
149,685
198,604
165,470
109,381
1.56,687
117,399
105,912
155,624
112,770
191,554
111,993
163,314
85,625
63,505
57,660
00,^
57,663
53,973
67,449
60,852
60,734
221
240
606
158
177
133
1,417
627
201
201
149
121
91
82
* 'i52'
62
126
63
66
80"
59
60
49
53
72*
33
28
28'
29
29
51
16
37
20
46
40
37
40*
49
22
.-|6
32
37
6i'
50
46
is*
18
151
241
37
100
13
280
69
41
112
27
14
28
23
16
13
19
4
35
15
12
58
11
3
24
3
8
1
5
3
10
11
5
5
2
5
S
3
6
1
14
6
5
5
2
9
5
13
1
8
17
15
"ie*
5
12
5
1
5
4
6
4
19
12
1
6
3
* '3*
1
'"3*
""4"
1
......
......
......
1
......
""2
30
73
39
6
44
1
500
36
42
23
3
1
34
62
12
15
26
43
2
6
6
2
3
2
18
4
3
19
108
1
16
31
1
104
6
2
1
4
■■'2
......
18
31
122
9
57
6
153
64
11
32
15
11
13
59
8
4
8
8
18
21
8
26
36
51
300
34
22
38
272
116
27
39
31
26
18
18
23
B<
24
Ck
70
iZh. . : 1 lo
11
Dfe'LriAt. Micb
13
T.tCi'i AniTPlcB. f lal....
14
N<?w York, N, Y
Vh \ t:iirU 1 1 ^hlr* , Pa
147
1
PittOniriiiT,, IM
19
St. l-ouu,Mu
From 300,000 to 500,000 inhabit-
ants:
Buffalo, N . Y
22
14
Cincinnati, Ohio
12
Jersey City, N.J
7
Milwaukee, Wis
8
Minncai>oUs. MiTin , , . , , . . . ,
New Orleans
49
21
San Francisco. CaJ
15
3««tttlc,Wash
Washington, D. C
From ano.ono tn 300,000 inhabit-
ant h:
('LthtlllihUs, IJjiLO
....;.
14
27
9
7
17
5
10
Ini^L i^n uiuli -, ind
..
9
1
10
Kat^>iv.r)U, VIo
Vnrl,i:^:s.l. i^ ;
6 .....
10 '
7
4
.1
9 1 1
i
Uodicstor.N.Y
St. Paul, Minn
". F rom liii,ii'Ai f. vj ^30 .<IOO inhabit-
ant's:
Mbaiu, N\Y
\lt;l5ll^j,t;;i .
17
9
I
8
8
5
1
1
2
2
1
*.:::::
8
8
6
4
8
2
6
11
9
1
4
ft
i*inninj:h!uu , Ala
nridefriortpiutm
3
4
t mljrfelBe. Mass
» 1 ;ari#n,l*.J..
hiillllver.MMS
FOTlVVortb/rnc
. "imvl EriBii} Midi
*■ VtaHfopl.^.in,
5
6
8
11
1 '^
5
1>t»wtTintt', Mii-'-i
i.. ..
1 I
1
I
Uwdl.MiL-
3
3
6
1
2
I
VfiMttpbb. Ti*nn ......['.'..[[[
98
8
U
6
2
7
1 1 13
8
1 Xushiilb, Term
::;:::! Sc:::-
\ 2
3
2
1 M cw Bwllnrrli Siass
2
' StTf lJawn,vijim
U 1 3
OaklanO.Ciii
.. ::.r*"5"!
6 1 i
^ r^^miha, Kfibr
1 ft
■ i
1
6
13
11
4
Ruebrooml Vb
"'i'
I
""i
2
" *i'
2
43
6
27
2
. M •
Sail Ulc^c|ly, Utah
MrtKfl«l^,sfuss
" 'i'\ \
S¥rac:i^,N.Y ^.
TBrtMDIl,Wil5b
1
»
5. 2
T(itelo,Obi»..
..... ..
..
1
Tttatwi.NJ
I .
Wom^Ser.lTass
rrom 50,000 to 100,000 inhabit.
anls;
Akron, Ohio
9 ::...:i i4 *
2' . ^
AUentown, Pa
1
"^
Atlantic city, N.J
i
L '..
%
Bayonne,N;j
6*
15
10
16
34
2
I
i
1 *
BerSwSi...::;.::::::.:
«> • —
BlnSamton,N.Y
-
BrocWon.Mass
». -
Canton, Ohio
« -
Charleston, 8. C
« .- -
leo
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December 28, 1917 2240 1
DIPHTHERIA, MSA8LK8, SCARLET FEYER, AND TUBBECULOfiU
ContinoecL 1
City Reports for Week Ended Dec S, 1917— Ccmtinaed. 1
Popul^
tioaasoT
July 1, 1916
(estimated
by V 8.
census
Bureau).
Total
d««ths
DiphtiMrte.
M«MJes.
8cari€« Tiw 1
fever. kii 1
City.
from
all
J
1
1
1
1
2
?
1
From 50.000 to 100,000 Inhabit-
ante— Continued.
CoNitiBton, Ky
07,144
W.4o\
M.flQO
63.705
76,105
76,07K
64,772
7«,l«3
72,016
77,214
OR, 629
ge,4:?7
B0,H53
61,155
7»,2><3
6H,22l
63,7»4
»),612
92,943
71,744
89.411
63.»a\7
65,IS5
B6.W>5
65.ft42
85,236
63.330
68, '^OS
99,519
67,078
87.039
68,946
61,120
66.083
77.916
70,722
76,776
94,266
61,656
27,732
84,814
82.730
27,632
43,425
46,192
39,319
26,074
82, 261
48,811
89,873
38,743
42,468
38,203
39,233
35.486
41,781
41,863
39,363
48,477
35,363
48,886
31,576
88,676
31,677
41,097
35,384
46,515
27,687
36,964
32,940
9
22
18
23
is*
»*
22
U
28
6*
16
17
ii*
16
16
16
11
27
18
23
26
87
14
1
21
16
19
U
ii*
42
4
8
10
9
2
14
8
7
9
ii'
6
7
11
6
6
12
4
i«'
16
14
io'
21
8
8
6
7*
6
8
9
2
11
1
14
2
6
a
«
2
1
r
1
DiUuth, Minn
2
9
6
4
2
7
EU«lK»lh, N.J
111 1
El I'aso.Tex
I ---.-.
Erie, I'a
s
EvansAlIle, Ind
Flint, Mich
7
6
8
1
8
3
4
4
4
2
2
2
6
4
6
J
J;
Fort Wavne, Ind
1
1
1
2
1
......
1
......
2
HarrlsburK, ra.
•
8
1
3
e
2
HohoWcn, N. J
22
Johnstown, Pa
Kansas (Itv. Kans
1
1
4
6
Lancaster, Va
Maiden, Mass
1
9
a
1
1
Manchostor, N. H
Mo»»ilf, Ala
New HntalQ, Coon
4
19
2
2
Norfolk, Va
OUahoraaCUy.OkIa
1
Passiiir. N.J
I'avv tucket, R. I
»i ■
Portland, Me
149
1
1
8
•••i-h
Rook font. Ill
1
f|::::::|:
Bacramento, Cal
Baijlnaw, Mich
6
15
7
3
8
......
1
1
8
2
2
8
7
4
1
4
8
2
6
1
S
4
1
4
7
10
2
6l. Joseph, Mo
::::::•-,•, ,|
San lHet;o,('al
10
6
Savaniiuh, Ga
.....
Bchont'ctady, N. Y
BuKiN « iiv, Iowa
1
SoincrvUlc, Mass......
23
!!*" 1
Boiiih Hend, Ind
8prinKnpld,lU
.... ^
Tern' Haute, Ind
*'•' : 1
Trov.N. Y
>Vlcliiia, Kans
1
8
1
.... ^
\^llk^^s.|iar^c, Pa
1
1
6
4
2 J
>\ llmlnf^on, Del
\
York, la
1
From 25 ouo to 50.000 Inhabitants:
Alameda, < al
•-••••
1
2
1
6
1 ..
Austin, Tex
1
1
1
8 .
Brookline, Mass
1 ......
1
Butler, Pa
Butte, Mont
Chelsea. Mass
10
8
1 1
Chiroi^ee. Mass
2
Cumberland, Md
6
1
1
I ......
DaiivUle. Ill
1
1 .
2 .
1 .
2 .
t .
1 .
t .
1 .
Davenport, Iowa.
2
2
1
Dubuque, Iowa
1
1
i
East ( nic-aRO, Ind
'**47'
1
87
2
......
♦ -..
East Orange, N. J
ElKin. Ill
2
Everett, Mass
1
2 —
Everett. Wash
Fluhbuns, Mass
8
1
4
Galveston. Tex
1
1 .
1 «
Ormn Bav, Wis
Haverhill' Mass.
9
1
1
1
17
1 .
21
'"i*.-.
1
Jackson, ^ich
Kalamaron. Mich .......
6
17
8
2
1
6
6
1
4
1
""a*
2 1
Kenosha, Wis
. 7 .
4 .
La Crosse, Wis
1 .
.. ..
Lexington, Ky
18
2 .
1 .
2
B 1
Lima, Ohio
Lincoln, Nebr
......
18
1
0 .
LonE Beach, Cal
1 .
....
1
Lorein. Ohio
Lynchburg, Va
......
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Google
2241
December 28, 1917
PHTHERIA, MEASLES, SCARLET FEVER, AND TUBERCULOSIS—
Continued.
City Reports for Week Ended Dec. 8. 1917-
-Continued.
m
Popula-
tion as of
July 1,1916
(estimated
by U. 8.
Census
Bureau).
Total
deaths
Orom
all
causes.
Diphtheria.
Measles.
Scarlet
fever.
Tubercu-
losis.
City.
1
1
1
1
1
1
1
1
rom 25.000 to 50,000 inhabft-
Ants — Continued.
Madison. Wis
30,609
47,521
26,234
26,318
27,327
29,608
41,133
31,927
3o;io«
43,715
37,353
31,401
31,404
33,080
46,450
41,185
3S,620
39,651
36,798
38,136
46,486
43,284
28,926
38,902
35,358
46,226
36,283
48,726
30,570
29.894
43, 139
43,:t77
:n,809
29,892
:u,i:m
30,Hd3
22,874
15,010
13,532
21,685
15,794
113,075
17,548
22,669
24,270
16,950
23,639
20,930
119,363
15,395
114,610
17,445
13,284
23,126
15,243
20,985
122,019
19,926
23,805
17,524
11,666
12,067
14,831
20,193
13,821
24,204
15,648
21,618
23,228
15,969
2
9
5
3
McKeesport, Pa.
13
10
9
11
10
6'
4
15
11
4
12
10
13
11
13
12
10
12
12
8
11
3
1
1
::::::
1
2
2
Medford. Mass
4
1
Montclair, N.J
1
Nashua, N. H
3
Newburgh, N. Y
99
2
2
New Castte, Pa
3
2
Newport, Ky
Newport, R. I
3
2
4
13
2
3
1
1
Newton, Mass
Niaf;ara Falls, N. Y
2
1
Norrlstown, Pa
1
Ogden, Utah
4
2
Oranee. N. J
2
1
i*n«aden», f^al. ..............
2
Perth Amboy. N. J
3
6
3
PittsOeld, Mass
10
1
6
1
3
Portsmouth, Va
1
2
2
.
3
Quiney, HI
::::;:1 i
1
Quincy, Mass
6
Uacdne. Wis
.
Roanoke. Va
2
3
1 '
1
Rock Island. Ill
1
San Jose, Cal
1
Stockton, Cal
53
8
12
15
9
6*
10
n
IK
13
13
1
5'
3
ii*
4
2
BuDirior. Wh
1
2
3
6
Taunton. Mass
1
1
2
Topoka, Kan5
2
1
1
1
Waltham. Mass
1
1
Wfttertown. N. Y
V '1'
1
1
Wwt Hoboken. N.J
1
1
2
Wheeling, W. Va
. ..:.:::::!
WIUIam.sport. Pa
13
1
WilmiDRtfln. N. C
Wlnstou-Sttlem, N. C
Zanc«Nille. Ohio
1
2j
1
1
i
::::::::::::!
1
1
2
I
1
1
1
1
From 10,000 to 25,000 inhabitants:
Alton. Ill
Ann Arbor, Mich
3
2
4
2
1
Boaver Falb, Pa.
1
1
Braddock, Ptt
! 6
('airo.Iil
Clinton, Majw
1
2
Coffey villf, Kans
2
2
1
Concord, N. 11
\
(lalesburg, 111
narrlsou,N. J
0
13
1
Kearuey,N.J
7
6
5
1
3
10
3
4
5
4
2
8
6
13
1
.... I
Kokomo Ind . ..
2
LMvraworth, Kans
3
:::::: ::::::i
1
Ijoni! Branch. N. J ....
\\y.-W.
llArUiettA Wis
1
1
MelrosA. MasM
1
Morristown N J
Nantic<dce. Pa
2
2
NewburvDort Mat^s .
New London, Conn
3
North Adams Mass
1
1
2
1
Northampton Mass
3
'"2
......
1
1
1
2
4
6
......
1
PlainfielcfN.J
Pontlac, Mich
2
Port«tmoath N H
1
Rocky Mount, N. C
Rutland Vt
4
5
7
Sanditskv Ohio
1
2
SanitoaSprlngs.N.Y
S(Mith B«thl«hem Pa
1
1
4
Steelton Pa
5
1
WashtogtoniPa
1
1
Wilkinsbiirr Pa
6
6
Wobum,Mass
I Population Apr. 15. 1910; no estimate made.
Digitized by
Google
FOREIGN<
CUBA.
Commiiiikable Diseases — flfabaaa.
Communicable diseases have been notified at Habana asfdk?
DisBtm^
xsr."
NoT.2i-30, tun.
N*w
Deaths.
nemffclp-
IflT.
I
' *^ 1 *
■1 "^2^ I
s
Ht^w
r^niiyiilipid 4
FirvUlpiw'X
& From tbe interior, 52 cases.
• From tbe interior, 39c
INDO-CHINA.
Cholera— Pla^e — Smallpox — August, 1917.
Durino^ the month. of August, 1917, 328 cases of cholera, 50 r^-
of plague, and 234 cases of smallpox were notified in Indo-Ck'
For the month of July, 1917, the reported prevalence was asfoDo^-
Cholera, 522 cases; plague, 69 cases; smallpox, 525 cases. Thed
tribution of cast^ of these diseases during the month of Augu-
1917, by Provinces, was as follows:
Cholera. — Province of Anam, 134 cases; Cambodia, 19; Cocbu
China, 175; total 328. Total for the corresponding month oi t>
previous year, 870 cases.
Plague. — Province of Anam, 7 cases; Cambodia, 26; Cochin-CliK^
16; Tonkin, 1 case; total, 50 cases, as against 43 in the month '^^
August, 1916.
Stnallpox, — Province of Anam, 97 cases; Cambodia, 10 case^
Cochin-Chma, 124; Tonkin, 3; tot^, 234,cases. In August, 1916. )'
cases were notified.
Leprosy— Aagast, 1917.
During the month of August, 1917, 40 cases of leprosy werenotifi^
in Indo-China, as against 23 cases notified in July, 1917, and 26ui
August, 1916. Of the 40 cases notified in August, 1917, 36 occ^
in the Province of Tonkin, 34 of this number being at Hanoi, tk*
capital of the Province,
(2242)
Digitized by
Google
J
2243
December 28, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER.
Reports Recdred During Ihe Week Ended Dec. 28, 1917.^
CHOLEHA.
Placf.
Date.
oct.7-ao
Cases.
Deaths.
15
1
Remarks.
India:
Bombay
15
3
Madras.
Oct 14-20
Indo-Chiha:
Provinces
Aug. 1-31, 1917: ( a>os, 328;
deaths 182
Anam
Au^. 1-^1
134
19
175
73
11
98
Cambodia
do
Cochin-China
.... do
Philippine Islands:
Provinces
Nov 4-10 1S»17' Cuso-* 215*
Bohol
Nov. 4-10....
....do
9
7
24
32
134
9
8
1
10
23
75
2
deaths 119
Cobu
Hollo
do
M'indanao . .
do
Ncgros Occidental
do
Negros Oriental
do
Prov Inces
Nov II 17 1917- Cases 227:
Caplz
Nov. 11 17
do
2
44
27
35
96
23
2
26
18
27
50
11
deathn 134
Ilollo
Leylc
do ....
Mindanao
do
Mcgros Occidental
do
Ncgros Oriental ....
do
PLAGUE.
Cevlon : •
I olaralK) Sept. 30 Oct. (
In<iij.
Basiiein Sept. 30 Oct. 13
Bombav ] Oct. 7 20
Iv;ira<lu I Oct. 14-20
.Madras Presidency ' do
Miuidalay ' Sept. 16- Oct. 10
Moulmein Sept. 23-Oct. 10
PcKU Sept. 16-22
Haugoon i Oct. 7-20
In'io-China: {
Provinces '
Anam i Aug. 1-31 .-.
Cambodia j do •
Cochin-China • do '
Tonkin do I
32
4
1,302
30
Saigon.
Siam:
Bangkok.
Oct. 22 28
Sept.23-Oct.27.
2
28 '
2 '
061 ;
32
26 <
4 {
1 j
10
Oct. 7 20, 1917: Cases, 24,282;
deaths, 17,83^1.
Auk.
14.
31 , lUl 7: ( 'H«5e<, V»; deaths^
SMALLPOX.
British East Africa:
Mombasa
Canada:
Nova Scotia-
Sydney
Ceylon:
Colombo
China:
Chungking
Shanghai
^"Bliro
India:
Bombay
Madras
Baogoon
Indo-Ghma:
Provinces
Anam.
Cambodia.....
Coohin-China.
ToDkin
Saigon
Philipi^iifi Islands:
Bianib
Sept. 1-30.
Nov. 2;>-Dec. 1..
Sept. 30-Oct. 6..
Oct. 28-Nov. 10.
Nov. 5-18
Apr. 16-June 24 .
Oct. 7-20. .
Oct. 14-20.
Oct. 7-20..
Aug. 1-31..
do
.....do
do
Oct. 22-28.
Nor. 4-17.
97
10
124
3
7
l*ort case.
Present.
Jan. 1-21, 1917: Cii<cs,3.
Aug. 1-31, 1917: CaM\s 234;
death5«, 76.
Varioloid.
Prom medical officers of thf Public Health Service, American consuls, and other sources. ,
Digitized by VjOOQIC
December 28, 1017
2244
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YBLLOW
FEVER— Continued.
Reports Recehred Dvring the Week Baded Dec 28, If 17— Gontinued.
TYPHUS fWBR.
Place.
Date.
Gases.
Deaths.
ReaurlB.
A loTandriftu
Oct22-Nov.4....
Apr. l^Jonea*...
Apr. 16-JaDe24...
Julya-8.
17
351
8
1
2
100
0
Cairo
Jan. 1-21. 1917: Ctoea. !«: a«tta»
1111.1-7,1917: Qms.S; deetlii^L
Fort Said
Do
Ore<y«;
Salonikl.
Oct. 14-Nov. 10. . .
91
Japan:
NtmwftM
Nov. 13-25
Not. 3-0
3
Hexiro:
A TiiasoalicTitos
1
Bweden:
Ooteborg.
OdL 7-lS
1
Reports Received from June 30 to Dec 28, 1917.
CHOLERA.
Place.
Date.
Cases.
Deaths.
Femarka.
India:
Bassein
Apr. 1-May5
80
347
10
69
17
Bom^y
June 24-30
Juiy8-nct.20
Apr. 2&- June 30...
1
99
Do
Calcutta.
Do
July 1-Scpl. \S
Kararhl
Sept. 9 f rt. 13....
Apr.22-June30...
July 1-Ort.20
Mav ft- June 30
12
5
115
IfjI^PVt r... r...r
Do
Mandalay
Do
Julv29-Aug. 25...
Moulmrin
May I3-June2
PaVoklcu
Apr.20-Mav5
Pegu
Mav 27- June 30...
Do
Julv 1-7
Promc
July 2»-Aug. 11...
Rangoon
Apr. 21 -June 30...
July^-Sepl.S
31
10
g June 1-23. 1017: Ca^m. fi: dflbi 3.
Indo-China:
Provinces
Feb. 1-June 30. 1917: C9»*,\a7i;
Anani
Feb. I-June30....
July l-AuR. 31....
Feb. 1-June30
July 1- Aug. 31....
Feb. I-Junc30....
July 1- Aug. 31....
June 1-30
230
220
93
93
879
534
1
SO
3
163
49
191
130
A4
64
543
813
deaths. «KI5. July 1-Anjc U.
1917: Cases, 880; deelhs, tM.
Do
Cam^otiia.
Do
Cochin-Chlna
Do
Lao8
Tonkin
Feb. 1-Juno30....
July 1-31
31
Do
Saigon
Apr.23-May27....
July2-8ept.30....
108
83
Do
1
Japan
Jan.-Jtily, 1917: C«<«s, 891. oc-
Tokyo
Sept. 12
2
1
8
3
curring tn 16 lYovinoc^ aika <tt^
Java:
East Java
Apr.3-*i
iricts." Sept. IX 1917: Cawe.
353. In 5 Prorixiocs and dli*
tricts.
Do
July9-26
3
2
Mid Java
July IG Oct. 2
West Java
Apr. 13-Jiihr $, 1917: Omh. H;
Sealhs. sTl. inly ^-OeT IX
1917; Oases, 001: deMks, IK
Batavla
Apr. 13-July5
July&Ocl.ll
Feb. 3
7
78
1
4
4
11
1
3
19
179
3
28
Do
Persia:
Maiauderan Province-
Amir Kola
Barfouroucbe
Jan. 15-17
Do
July 28
1
6
Deniiivend
JiJy29
Hain/.r Ki'la
Jan. 17
Machnloxsar
Jan. 31
Sabicvar
Aug. 20-29
July 25- Aug. 5....
U
98
Sari
TabrU
Ang. 4, 191T: m YfllM il
•boilt7CMi<ltflF.
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2245
December 28, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Received from Jane 30 to Dec. 28, 1917— Continued.
CHOLEBA— Continued.
Place.
Dftt«,
Cases,
D«^a{lt5.
Kenmrk^.
PhiUppino Islands:
June 17-33
1
4
Do
Aug.5-2S
Sept. 2-S, 1»173 L Giae. Not pre-
vlotuly reported.
May 20- June 30, 1917: Cases. TftS;
ProTinoes
Agiisan .,...„,
July 15- 2H.. ......
12
m
n
2
1^
'1 i
m
TA
m
240
2
70
4;^
I
U
2cH
ISO
m
i:m
4
:m
UJ
411
V
7.T
m
133
IQ
7
14
tQ
2
dciiths. fiflftH July l-Nov. 17,
Albav ,.,
May30-Juapao. ..
JuJy2-a?pt. 1
June 3-9... ........
I&17: CtL^e^ ^,012, doatb^, 3,(H»*
Do ,,..
Ambos Cani&iine@ . .
Do
July22-Ang.lt...
Sept. 1ft Oct. 27...
JofySi-H ...,.
Antique
Bataan
Ratangas
June IT-KS.. ......
Bohol
M^y2tKJune30.,.
Julyl-No^. 10.„.
Juno a-30. „...„..
Do
Capiz
Do
July 1- Nov. 17....
June 2-30
July 1 -Nor. 10....
July 1 Nov. 17.,..
Cebu
Do
IloiJo
i^Tte ,
JvmelO-M
14
Do .„,,.....
July t-.Nos'. 17
Mlsamb , ,
July SL Aug, 4.....
Julyytf-NovM7...
6eTrt.30-Nov.17_
Jijy 1-Nov. 17
Jittie 'J*-^
237
m>^
47:t
S67
I
1
133
m
274
16
7
u
17!
3
Mindanao
NegrosOccidenlttl......
NegrosOrieni^J........
Klial
Do .,,.„..„.
July i-7.. .........
July 22 2H.,...,...
Romblon .,,
Samar .
July 15 Sept. 22...
Jime3 .H>......,..,
Sorsogon
Do
July 1. Vug. afl....
July ai^ A UK. 25.,.
JunrH :t(i, „.
JuJy iJlppt. 2&.„.
July I^^' 'ih
Surigao ,,..,.
Tayabas
Do
Zamboanga .,..,
Straits Settlements:
Singapore ..._..
PLAGUE.
Arabia:
Aden.,
Bahrein Tftlnnds
nrazil:
BahJa
Do
Pemambuoo
Ceylon:
Colombo
Do
China:
Amor.
Ilon^ong...!
Kwangtung Province—
Ta-pu district
Ecuador:
Estancia V^ieja
- Guayaquil
Do!!!!!!!!!!*!!!!!!!
Mil
Nobol..
Salitre..
Do.
Taura. .
May 5 -July 4..
June 10-30
July*-Oct. 20...,
July 10-Sept. 30.
.S- Juno 23.
O-Oct.e...
Apr.
JiOy
Apr. 20<May 5...
Ji3yl-7
May 13-June 30.
July 8- Aug. 18..
June 2
Feb. 1-28
do
Mar. 1- Apr. 30..
Julyl-Aug.81..
Mar. 1-31
Apr. 1-30
Feb. 1-28
do
Mar. 1-3
Feb. l-2<*
43
Apr. 8-May 14, 1917: Cases, 69;
deaths, 61.
In Pecsian CfiUf. Present Apr. 3,
I9ir
Present and in vicinity.
Present Aug. 10.
Present.
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December 28, 1017
2246
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER* AND TBLLOW
FEVER— Oontinoed.
Reports ReceiTed from Jmne 99 !• Dec 28, ItlT— Oontmiied.
PLAGUB-OootliiiMd
Ptaee.
Date.
Omos.
DMtbs.
B-^
'•3iiii:i»7'*""'**^"'
*^Xji;^iiidr'ii*.::*.'.*.r.!'.r//.*.i*.
Jnne 21-37
0
7
4
1
1
14
1
4'
9
3
Do
JuJySI-Oct. 15....
Apr. aO-May »....
June 25......
Port Said
Do
July 28-29
1
7
Prof biccs
Favouoi .............
Mayll-JimaM...
June 28
Oalioubeb
Oiireh
May 17
1
8
MinJeh
May I2-June2»...
JuJy2»-8ept. 11...
May 12. \7.
4
t
8
38
88
1
8
S
Do
gloy t
t
t
m
1
1
fiufis Oovemment
Apr. 30 June 2....
May 12^ June 28...
Oct 14-20
Sues
Do
Omt Brttafn:
Oravpsend
Aug. 13-24
FroB a. a. M atkii4.
May 3-8
fianitnia from Adstimlte aad
oriental oorta.
Apr. IVJime 80. 1917: Cm^
India
Bas.sein
Apr. 1-June30....
64
»
8B7
8S3
88
4
86
7
418
41
1
3fi0
3,971
0
M
74
30
1
2
2
100
563
2
13
48,W3. deaths, iQLi«7. Joj^ y-
I»o
July 1-oct. 13
Oct 30, mil tmm^ 4M83C
fiombav
Apr 22-June30...
July 1-Oct. 20
Apr. 2»-June2....
4««
432
iionioay.
Calcutta
Do
July 15 21
HcDzada
Apr. 1-Juneao....
l>o
Auk. 13 Sept. 15..
Apr. 22 June 30...
July I-()ct. »
Sept.3a()ct.6....
Apr. 22- June 30...
July l-(>ct.2»
Apr. K May 12....
40
I
»I
5. 490
Karachi
Do
MadTHS
Madras PresMeocy
Do
Ilandalay
Do
Julv20-()ct. 10.. .
llfHilniAfn , ,
Apr. I-Junei)....
Do
July 1-Oct. 10
If yingyan
Apr 1-7
Pcjfu
Mav 27-June2....
Do
July 29-S'pt. 22...
Raocooo
Apr. 15-June W...
July l-oci.20
Apr. S-H
1S3
OOo
June 3-33, 1917: Gasn, 73: deatta,
66.
Do. ;::::.;:::..::::.::
Toungoo
Do
Jiuy 2»-c>ept. i....
Indochina:
Feb. l-Jnna 80, WiT. Cmm. Wt
death.\ 491. Juir l-Ang. fl(
1917: Cases, 119; death*, m.
Anain
Feb. I-Jane 30. . . .
July l-Ang 31....
Feb I-June30....
JiUy 1-Aug 81....
Feb l-June»....
July 1-Aug 31....
Mav 1-June30....
Feb. 1-June80....
July l-Aug. 31....
Apr. 23-June3....
8«pt.»-Oct.2S....
Jan.-July.,.
232
20
132
88
810
59
84
lis
4
47
10
23
3
131
16
116
86
183
25
33
80
3
38
7
Do
Cfiin>»«d'»
Do
Cochln-Thina
Do
Kwang-Chow-Wan
Tonkin
Do
Bafgon
Do
Japan:
AlehlKen
MlycKcn
do...... . ..
Jara:
I'a-'t Jnva
Apr. »-Uay 30. 1917: Cttm, m
daatl^aL IuIt8»-Ai«. m
1917:CbMi»4;<kMH^
l>JocJakarta H^^ldencT.
Kedlrl Rejide-K-y
Hamarang Ursldimey...
Surabnya Residency...
I>o......
Apr. a3-May«
do
Apr 2»-MaylO....
ApT.2-MaylO
iidyfl-2a...
1
1
8
18
4
0
1
1
4
•
Per.-Irt'.
do.,..
Mayl
n—ii
Ptru , ,,,,.,.,.,,.,,.,...,..
AtCaima.
I>cpartiB«nt»—
AlMWJin
July l-«l
3
10
5
ArvQuipa.
May Itt-JuJyIl....
do
At MoUeodo.
cSSo.!^^ ;...
AtCallM.
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2247
December 28, 1917
LOUSRA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reports Reeefred Urom Jane SO to Dec. 28, 1917— Continued.
PLAOUB— Continiied.
PtaCD.
Date.
Cases.
Deatfefi.
Bemarks.
£*Oi-ti — Tontlnoed.
Depart men t5—Continoed.
Lam ha veq ue
do^
8
7
90
At Chiclayo.
Libertad."
May ItMl
At Saiaverry» Sao Pedns and
TniiUIo. July 1-31. 19l7: At
TniJUlo.
At Lima. July 1-31, 1017: Lima,
dty snd country.
Present In interloc.
L'ma.
do
Benet^
Sept. 30
BUun:
Apr. 72~JuDt90...
July3-Oct.27
June 3-lA. •••.....
13
tl
2
18
12
»
1
10
Do
Btralts Settlements:
Singapore
Do
July l-Oct.6
Dec. 8
Turkey in Asia:
Trebisond
Present.
Union of South Africa:
Cape of Oood Hope State—
Cmdock..
Aug. 23
^
Da
Olengrev district
Terkft district
Aiig. U
Da
IHIV2H
1
1
1
QuoenslONvn
Junett
Orange FYee State
Apr. 16-22, 1917: 1 ease. Apr. •-
22, 1V17: Cases, IB; deatns, 17.
wlnburg district
Mayas.
1
0
At sea:
8. 8. Matlana
July 14-18.
0
En route for port <4 Lendon.
SMALLPOX.
Algeria:
Algeria
Australia:
Now South Wales.
Abermain
Brewarrina
Cessnock
Coonabarahran
Onambono
Warren district
Quconsland —
Thursday Island Quar-
antino Station.
BrazU:
Bahia
Do
Rio de Janeiro...
Do
British East Africa:
Mombasa
Canada:
Manitoba-
Winnipeg....
Do
New Brunswick.
NovaSootla—
Halitax
Port Hawkcsbury..
Sydney
Ontario-
Ottawa
Samia
Windsor
Ceylon:
Colombo
Do
Oct. 1^1.
Oct. 13-25
Apr. 27-June21.
July2S-28
May25-July5...
Apr. 27-June21.
June 22-Oct. 13..
May 9
May 6-June 30. .
July 2^Nov. 8..
....do
July l-Sept. 29. .
Sept. 1-30
Juno 10-10
Aug. 19-Sept. 1.
Nov. 10
Jtme 18-July 7. . .
June 17-30
Nov. 25- Dec. 1...
July 30- Aug. 6....
Nov. U-Dea8...
8ept.30-Nov.8...
May 0-12. ^
8ept.80-OcC.C..J
4
8
120
C30
2
81
182
Apr. 27-July 8, 1017: Cases, 8.
Julv i2-8ept. 25, 1917: Cases, 10.
Near Newcastle.
Prom s. 8. 8t. Albans from Kobe
via Hongkong. Vessel pro-
ceeded to TownsvUle, Brl»>
bane, and Sydney, in quarao-
tlne.
ma Toifc
1
4 U.
:::::q
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Dorcml tr l»S. 1017
2248
CHOLERA, PLAGUE, SMALLPOX. TYPHUS FEVER, AND YSIXOW
FEVER— Continued.
Reports Received from Jane 30 to Dec. 28. 1917— Continued.
SMALLPOX-Continoed.
Plaor.
Date.
Cases.
Deaths.
Bcmaila.
China:
Vnioy
Apr. 39- May 36. ..
1
Present and In vlchiity.
Do.
Iki
Jifly l-Oct. 21
\iitun£
May31-June24...
Aug.C-Nov. 4
May 27 Juno 2....
Aug. 11-17
4
1 '
Do
ChaniEsIiti
l)o
7
Chunskinf
May 6-June23
Present.
Do
July 1-Nov. 10....
Pnsent.
Dairen
Mayl3-June30...
Julys 38
* '36'
6
2
7
8
t 1
1
4
1
Do
July 1-7, 1917: Prtse&t.
ilankow
June 21-30
Apr.23-May«....
Miiy6-Junel6....
Aug. 5-lH
Harbin
On Chinese Eastern Ry .
Honekonir
7
K .:::.::....;..:
Manchuria station
Apr.23-29
May 37-Juii«2...
Do.
Mukden
Prooant.
Do
July8-Nov.3.....
Do.
Fhnrurhai
May21-Julyl
July2-Nov.l8....
Not. 4-10
13
0
ft
1
35
4
1
33
38
Cases, foreign: deaths ■msag da-
tlTVS.
Do.
Do
Tientsin
Tsitshar Station
Apr. 1^22
Miiy23-July7
July3a-Aug. n...
Mfty 1-31
On ChlDMe Eastern By.
At another 5tatloa on railway.
TsinKtao . . .*
7
1
jK!^. ::.:::::::::::::::
lease.
Chosen (Korea):
Chemolpo ,
Culm:
Habona
Nov. 1
From s. s. AUoom) XIII. tnn
Kcnador:
Ci uavaquil
Feb. 1-2S
1
8
13
39
no
94
1
1
poriA in Spain.
ho
Mar. 1-Apr.80....
July 1 -Aug. 31....
Apr.SO-Julyl....
Julv 2-29
l>o
KK>pt:
.Vie\andria
0
4
3
l>o
Cairo
Feb. 12 June 24...
July 30 Aug. 5....
May G 12
Jan. I 21, 1917: Ci^se*, X
Knmee:
Nuiiles
Tar i^
Corinnnv
Mar. 18-Apr. 38, 1917: Casa*. 7U
In eitie^ and 32 8Ute«and dto>
Berlin
Mar. IH Apr. 28...
do
ioa
10
18
50
20
2
10
1
Jlremen
trict^.
(liar lot ten berg
. . .do
Hamburg
do
I.eip7,ig
do
LUbeok
... do
Munich
do
Stuttgart
do
fj recce:
AHjoiin
July2:>^30
23
76
43
12
3
8
a
48
36
5
Indin:
lk)ml»HV
Apr. 23-JI1D6 30...
Ji3yl-Oct.20
Apr. 29- May 36...
186
83
Do
(ulcuttu
Do
Jmyl» Sept. 8
Kunw*hi
Apr.22-July4....
Julv 8 Sept. 1
Apr. 22-Juno30...
July 1 Oct 20
Apr. i:>-June30...
Julv 1 Oct. 20
*
27
5
80
24
.•0
15
Do
Madrxs
Do
Hancoon
June 3 33, 1917: Casas, Ik death.*.
]n<it>-<'hi;ia:
6.
Fob. WuBO 30. 1917: Omh. ur.
deaths, SU, Mr I-Aol 31.
.\uani
Feb. 1 June 30....
July 1-Aug.3l....
Feb. 1 -June 30
July 1- Aug. 31....
Feb. 1 June3(K...
July 1 -Aug. 31....
Mar. 1 Apr. 30....,
Apr. 1 30
July 1 31
'"1,630*
4fiO
3H
1.367
2SI
4
5
10
.^,
190 '
237*
81
36
27
377
90
Do
< \\nilNxJia
Do
Cochin-^'luua
Do
Kwang-Chow-Wan
Laos
IK)
1
1
30
n*
69
Tonkin
Do
Saigon
Feb. 1 Juneau....'
July 1-Aug. 31....
Apr. 27 June 10...
Jnh * 0(t.2H
Do v.'.'.'.'..'.
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2249
December 28, 1917
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVER— Continued.
Reporto ReceiTed from Jue 80 to Dec. 28, 1917— Oontmued.
SMALLPOX-Continiied.
Plaoe.
Date.
Cases.
Deaths.
Remarks.
Italy:
Vilan
Sept. lO-W
Biay21-June24...
July l2-tiept.30...
Sept. 9-15
3
32
13
1
Turin
12
9
Do
Jamaica:
Kingston
jM[)an
Jan.-Joly, 1017: CaMs, 4.974; in
Kobe
May 27-July 22....
May 2K-Juiie3
May 15-July5
July 25-31
05
1
177
1
1
38
31
88
100
16
Nagasaici
Osak a
55
Yokkaichi
Yoicohania
May 27-July 1
Apr.2-July 1
July 2- Aug. 29....
Apr. 1-July I
July2-Oct.2
1
3
Java:
East Java
Do
Blid-Java
7
Do
West Java
Apr. 1^-Jnly 6, 1917: Cases. 389;
deaths, 44. July 0-Oet. U,
1917: Cases, 373; deaths, 80.
Batavia
Apr. 13-Sept.20...
Jan. 1-June 30
33
0
116
1
1
9
Mexico:
Coatcpec
Do
Aug. I-I4
Jan. Ir-Aog. 14, 1916: 118 deaths.
Jalapa
July 1-13
Mazatlan
July Il-Aug. 7....
Me>\ico i Ity
Juno 3-30
1A2
191
Do.....
Aug. fr-Nov. 10....
Juno lH-24
Monterey
34
33
1
3
1
Orizatm
Jan. 1-June30
Do
July 1-2^
Vera ('tuz
July l-tSept. 16....
Aog. B-18
May W-Juno9....
July 8-Nov. 17
May 13-June30...
July^Nov.3
Mar. I-Juneao
0
1
6
11
14
10
Nelberbinds:
Philippine Islands:
Manila
VarioMa.
Do
Do.
PortUjgal:
Lisbon
Do
Portuguese East Africa:
Louren^ Marques.
6
7
4
Do
July 1-31
Russia:
May Mane 38... .
July2-Aug.2«....
July 2- Aug. 25....
Feb. IK-JUDC30...
July2-Aug.25....
Mar. Il-Juae3....
Mar »'^24. . . ,
06
6
0
fiflfi
00
7
38
10
8
5
Do.".
Moscow
i
Petrograd
Do
Riga
Jan. l-Mir. 31, 19X1: Cues, 9.
Vladivostok
7
Slam:
Banelcok
June 9-30
Do..::::::::::;::::::::
July 11-17
5
Spain:
Coruna
Sept. 30-NOV.3...
May 1-June 19....
Madrid
4.
3
44
19
11
0
Do
Oct. 1-31
M^«ap?i
Apr. 1-June 30....
00.:..::::::;;::;:;;:::
July 1-31
Sevillo
May 1-June 30
Do
Sept. 1-30
Valencia
June 3-23
6
13
0
1
8
1
3
8
Do
July i-Sept.15....
Mar. IB-June 23...
June 34-30
Sept. 1^0ct.l3...
Apr.33-3A
Straits Settlements:
PenaoK
8
SineaDore -..
^^?!:::::::::::::::::;:
1
Sweden:
Mahno
fHoi^hoIm
May30^une33...
Jane 3-ft
1
TunMa:
Tunis ••
Turkey Id Asia:
Trebltond.
Feb. 2^ Apr. IS...
U
Union of Sooth Africa:
Johannesburg .«
Mar. 13-34
Julyl-Sept.30....
4
24
Do .":
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D<?cembcr 28, 1917
2250
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YKXOl
FEyERr-€k>iitinoed.
Reports Received from Jmae 30 to Dec. 28, If 17— Continued.
SMALLPOX-Contlniied.
riaoe.
Date.
CMes.
Dttths.
Rexiads.
Urupiay:
Montcvldoo
Uay l^\.
2
Venezuela:
Maracaibo
Juno 18-July 8. . . .
8
1
Do
July ^23...'
On vessels;
S. 8. Alfonso XIII ....
Nov. 1
1
At Habaoa: From ports a
Spain for Mexican ports.
TYPHUS FEVEB.
Algeria:
Algiers
Do
.Vrgentina:
Buenos Aires
Austria-Hungary:
Austria
Uoheraia ,
(Jalicia
Lower Austria. . ,
Moravia
Silesia
Styria
Upper Austria. . .
Bosnia-Herzegovina.
Hungary
Hudapest
Eiscnourg
Brazil:
Rio de Janeiro
Canary Islands:
Santa Crux de Teneriffe.
China:
Antung
Do
Hankow
Do
Tientsin
Do
Tsir^tao
Egypt:
Alexandria
Do
Cairo
Tort Said
Do
(.rcat Britain:
Cork
Glasgow
Greece:
Balonlki
Do
Japan:
Hakodate
Nagasaki
Do
Java:
East Java
Surabaya
Mid-Java
Bamarang
Do
AVest Java
Batavia
Do
Mexico:
AguascaUentes
Coatepec
Durango, State
June 1-30
July 1-Aug. 31. .
Aug. 12 18
Oct. 22-Dec.
....do
....do
....do
....do
....do
do
Feb. 1» Mar 27..
Apr. 23-June 17..
July 29-Aug. 11..
Sept. 23 29
June 23- July 1
July^Nov.4
June 0-15
July 8-14
June 17-23
Nov. 4-10
May30-July7
Aug.^oct.2o. :..
Aug. 30 July 1....
July 17- Nov. 4
Jan. 1-June 24..
Jan. 1-June 24..
July 2-8
June 17-23
8ept.30-Oct.6..
May 23-June 30.
July 1-Nov. 10. .
July 2^28
June 11-24
July^Nov.25..
June 25-July 29.
May 5-June 10.
July 2-8
Apr. 13- July 5.
July^Oct.4...
JulylO-Nor.9.
Aug. 1-14
Oct. 29
634
809
47
617
16
243
6
10
278
1
1
4
3
1,648
464
212
10
1
46
478
125
90
7
1
32
101
Oct. 22-Dec. 17. 1916: C^ase«.2^i
Dec. 34, 1016- Feb. 2%. m:
Cases, 2,553.
Doc. 22. 1916-Feb. 24, 1917; Ciaei
110.
Feb. l^June 17, 1917: Ct»
1,787.
May 6-July l, 1917: Ctses, J
July »-Aag. 29, 1917: Oases, i.
Apr. I-June 24, 1917: Cases, SK
deaths, 5. July 9-Oct. S; Wr:
Coses, 16; deaths* 2.
Apr. 13-July 6, 1917: Caaw, HJ
deaths, 6. Julv i-Od. %
1917: Cases, 151; deaths, 17.
Prevalent <m ranoliee in Yiddtf
of EI Rio.
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2251
December 28, 1017
CHOLERA, PLAGUE, SMALLPOX, TYPHUS FEVER, AND YELLOW
FEVERr-Contlnued.
Reports Reeeived from June 30 to Dec. 28, 1917— Continued.
TYPHUS FEVER-~Ck>Dtiimed.
Place.
Date.
Cases.
Deaths.
Remarks.
Hex f CO —Continued.
JaL[iD& . .. .........
Apr. 1-June30....
5
3
K;.;;::::::::::::::::::
July 1-31
Mexico City
Juno 3-30
431
1,699
Do
July8-Nov. 10....
Jan. l-Jimo 30
Orizala
6
1
Do
July 1-31
Norway:
Bergen
July 8-28
7
1
11
16
10
141
36
Portiwuesc East Alrira:
I/Ourenco Marques
Mar. 1-31
Russia:
Archangel
Mayl-June28.-..
July 2- Aug. 28....
July 2- Aug. 18...
Feb. 18-Junc30...
July 2- Aug. 25....
2
6
7
3
Do
Mosrow
Petrograd
Do
Poland
Apr. 23-June 3. 1917: Cases, 2,814;
Lodr
Apr. 23-June3
June 17-July 14...
Apr. 23-Junc3
Juno 17-July 14...
May 3l-June tfl. . .
July 22-28
120
108
1,644
1,495
8
5
5
16
16
95
131
deaths, 187. June 17-July 14,
Do
1917: Cases, 2,328; deaths, 211.
Warsaw
Do
Rira
Jan. 1-31, 1917: I case.
Do
May 1-31, 1917: Cases, 4.
Vladivostok
Mar. 29- May 21...
May 1-31
Spain:
Almeria
6
2
1
Madrid
do
Do
Oct. 1-31
Sweden:
fiotpl»or^
Oct. 7-13
1
1
11
3
2
Switzerland:
Basel
Juno 17-23
July8-0ct. 27
July 2tt-Nov. 3
June 4-9
Do
1
Zurich
Trinidad
Tunisia:
Tunis
Juno 30-July 6
1
Union of South Africa:
Capo of Good Hope State. . .
km. 25, 1917: Present in 16 dis-
tricts.
Present.
East London
Sept. 10
YELLOW FEVER.
Ecuador:
Babahoyo..
Do
Chobo
Guayaquil.
Do!!!!!
Mik
Naranjito
.Mexico:
Campeohe, State—
Campeche
Yucatan, Slate —
Merida
Peto
Do
Vcoeiuela:
Coro
Feb. 1*28
Mar. 1-31
do
Fob. 1-28
Mar. l-Apr. 30.
July 1-Aug. 31.
Feb. 1-28
Mar. 1-Apr. 30.
July 1-Aug. 31 .
Sept. 25
Sept. 1-Oct. 28..
June 23
July 29- Aug. 11.
Oct. 27-Nov. 8..
Id person recently arrived from
Mexico City.
Present Sept. 5. From the last
Dart of July to Nov. 7, 1917:
Cases, 10.
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INDEX.
A.
Page.
Accnracy of certified causes of death — Relation to mortality statistics and
the international list 1557
Alabama :
Camden — Trachoma 1900.
Cerebrospinal meningitis 1110,1280,1635,1766,1894,2080
Diphtheria. {See Diphtheria — State reports.)
Elmore County— Diphtheria 1800
Malaria 1111,1281,1707,1896,2087
Prevalence and geograpliic distribution, 1915 and 1916 2165
Measles. {See Measles — State reports.)
Pellagra 1111, 1282, 1768, 1896, 2089
Poliomyeli'tis 1113, 1283, 1285, 1420, 1488, 1640, 1770, 1898, 2090
Rabies in animals 2130
Ragland— Poliomyelitis 1 1237
Scarlet fever. {Sec Scarlet fever — State reports.)
Smallpox 1114, 1286. 1644, 1771, 1811, 1899, 2093
Typhoid fever 1115, 1287, 1650, 1773, 1901, 2094
Anopheles punctipennis — ^Ability to serve as host for Plasmodium fal-
ciparum— ^Technical Asst. M. Bruin Mltzmain 1081
Anthrax :
California— Stockton 1894
Colorado — Hugo 1484
Great Britain — Bradford and vicinity 1392
Iowa — Muscatine 1805
Kansas —
Hutchinson 1415
Reno 1190
Louisiana 1416, 1635, 1894
Chauvin lasi
Maryland — Harney 1416
Mas.sachu8etts 1153, 1532, 1765, 1931
Lynn 1734
Mis8t«:sslppi — Harrison County 1314
New Hampshire — Manchester 1485
New Jersey 1190
Essex County 2038
Jersey City 1378
New York— Endicott 1315
South Dakota— Mitchell 1315
Texas——
Refugio County 1315
Victoria 1379
Wisconsin— Milwaukee 1806, 1931
Appropriations — City health departments — Passed Asst. Surg. Paul Preble 2072
Arabia — Aden — Plague 1100
Arizona :
Douglas— Virulent smallpox 1075, 1089
Moqui Indian Reservation — Smalli)ox 1770
Navajo Indian Reservation — Smallpox 1770
Nogales — Trachoma 1936
Poliomyelitis 1488
Arkansas :
Cerebrospinal meningitis 1233, 2a39
Current State summaries . 2084
Dysentery 1075, 1155
J^ldorado — Cerebrospinal meniiT^itls 1852
Malaria 1235, 2041
Mississippi County — Bacillary dysentery lOSa
Paragould— Typhoid fever 1428
Pellagra 1230, 2(M3
Poliomyelitis 2045
2253
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2254 INDEX.
Arkansas — Continued. P*f«.
Pulaski County— Smallpox 1322
Smallpox 1240. 1739, 2050
Truman — Smallpox isTiS
Typhoid fever 1244. 2055
Army and trachoma — Dangers incident to enlisting recmlts affected with
trachoma — Surg. John McMullen 1101
Arsphenamine — Manufacture 2071
Australia — Poliomyelitis irrf«
Austria-Hungary — Typhus fever 1100
Bacteriological examination of water — Comparative studies of media
used — Passed Asst Surg. H. E. Hasseltlne 1879
Barber shops— Oamp Greene 55one , ._ 2tJ82
Beauregard, camp — Disease cases reported. (See fi2xtra cantonment
zones.)
Bernstein, H. S. — Diphtheria epidemic — Newport and vicinity, Rhode
Island 17H7
Bolduan, Chaa F.— A milk-home outbreak of typhoid fever 1755
Bolten, Joseph, passed assistant surgeon :
Diphtheria epidemic — Newport and vicinity, Rhode Inland 1787
Winter outbreak of poliomyelitis— Elklns, W. Vn., 1916-17 1995
Brown, Waiter H., M. D. — Massachusetts endemic Index 2121
C.
California :
Alameda County— Plague— Squirrels infected found.. 1087, 1158, IIM. 1237
Cerebrospinal meningitis 1085, 1416, 1533. 1852, 2»>8<;, 2227
Current State summaries 1084. 1109,
1163. 1188. 1232, 1279. 1314, 1378, 1414. 1455, 1484, 1532,
1633, 1680, 1734. 1765, 1805, 1850, 1930. 1970, 2033. 2084
Diphtheria. (See Diphtheria — State reporta)
Los Angeles — Leprosy 1155, 1234, 1281
Malaria 1087. 1418< 1535. 1853. 2087, 222S
Measles. {See Measles — State rejmrts.)
Pellagra 1087. 1419. 20s9, 2229
Plague — Squirrels infected found . 1112
Poliomyelitis.- 1088, 1237, 1283. 1.320. 1421. 1488, ITw'W, 1856, 2090. 2<l!»l. 22:^>
San Benito County-Plague— Squirrel Infected found lOSS, 115'*
San Francisco —
leprosy 1853. 1932, 2»U«)
Small|K)x on steMraship 1977
Scarlet fever. (See Scnrlot fever — Sinte reiiorts.)
Smallpox— Vaccination history lO'.K). 1423. 1539, 1859, 2092. 2232
Stockton— Anthrax . 18IM
Typhoid fever 1092, 143K 1.V13, IScrj, 2<>9I. 2UI5. 22:r.
Camps. (Sec EJxtra -cantonment zone legislation: Extra -cantonment w>ne
sanltntion.)
Carriers. — Menlngoeorms — Recognition and tretitinent 1175
Cerebrospinal menln;;itis:
Alnhanna 1110. 1280. 1635, 17(J0, 1894. 2<>s6
Arkansas 12:«. 2«>39
Eldorado -_.._. K»2
ralifornln las,-), 1410, 15:«, 1S52, 2086, 2227
Cltv rejMjrts for wtvk end*»<l —
\Tune 10, 1917 H»sr»
June 2:;, 1917 1110
,7nne :J0. 1917 llTvl
July 7, 11M7 1191
•Tiilv 14. 1917 12:R
.lulv 21, 1917 12Si»
.Inly 28, 1917 131d
AuL'Ust 4, 1917 i:<79
An;:iist 11, 1917 1117
Anu'UKt IS. 1017 14'rfl
AiiL'Ust 2."). 1917 US",
Sepieiuber 1, 1917 ^-^— ,, ir»33
/GooQle
Digitized by VjOOQIC
INDEX. 2255
Cerel>rofq)Inal meningitis — Continued.
City reports for week ended — Page.
September 8. 1917 1636
September 15, 1917 1681
September 22, 1917 1735
September 29, 1917 1766
October 6, 1917 1806
October 13, 1917 1852
October 20. 1917 1895
October 27, 1917 1932
November 3. 1917 1972
Noveml)er 10, 1917 2039
Novembei* 17, 1917 ^ 1_« 2086
November 24, 1917 2127
December 1, 1917 2171
December 8, 1917 2228
Colorado , 1681
Connecticut 1085, 1110, 1233. 1416, ia35. 1894, 2086
District of Columbia 1154, 1315, 1533
Hawaii 1485, 1734
Indiana 1085, 1233, 1485, 1681, 1894, 2126
Iowa 1085, 1233, 1416, 1681, 1852, 2038
Kansas 1153, 1190, 1315, 1416, 1635, 1806, 1894, 2038
Louisiana 1190, 1416, 2038, 2227
Doyle 1232
Jackson 1315
Madagascar , 1464
Tananarive 1778
Maine 1852
Maryland 1154, 1379. 1766, 1972, 2171
Massachusetts 1109, 1154, 1190, 1279, 1315, 1533, 1766, 1894, 1931, 2126
Mexico —
Chihuahua— Correction 1098
Vera Cruz ^ 2181
Minnesota 1190, 1280, 1416, 1455, 1635, 1852, 2038, 2227
Fort Snelling 1416
MissLssippl 1233, 1485, 1852, 2038
Montana 1316, 1416, 1852, 2086
Nebraska 1766
New Jersey 1191, 1416, 1635, 1852, 2038
New York 1085, 1280. 1379, 1681, 1894
North Dakota 2038
Ohio 1191, 1379, 1635, 1806, 2038. 2^27
Oregon 1085, 1191, 1931
Pennsylvania 1233, 1379, 1635, 1806, 2038, 2227
Rhode Island 1635, 1852, 2038. 2039. 2228
South Carolina 1416, 1852, 2038, 2228
South Dakota 1191, 1416, 2126
Virginia 1154, 1316, 15^3, 1734. 1972, 2126
Washington 1110, 1233, 1766, 2086, 2126
West Virginia 1154, 1315, 1635, 1806, 2171
Wisconsin 1154, 1379, 1533, 1894, 1972, 2228
Wyoming 1085, 1681
Certified causes of death — Accuracy — Relation to mortality statistics and
the international list 1557
Chinn :
Hongkong— Plague 1292
Rats examined 1292, 1437, 1655, 1942, 1984. 2181
Rats Infected found 1292, 1437, 1655, 1942, 1984
Shanghai— Plague— Rats examined 1121, 1437, 1942, 2139
Cholera ;
Foreign reports —
Cumulative table 1123,
1172, 1210, 1249, 1294, 1333, 1394. 1440, 1466, 1498, 1551, 1657, 1697,
1748, 1780, 1824, 1872 1911, 1944, 1985, 2063, 2102, 2141, 2183, 2244
Weekly table 1098 1121,
1170, 1209, 1248, 1293, 1331, 1393, 1438, 1464, 1497. 1549, 1055, 1695.
1747, 1778, 1822, 1871, 1910, 1943, 1984, 2062, 2101, 2140, 2181, 224?
2256 IKDEX.
Cholera— Continued.
Indo-China — P«f«.
February, 1917 12J)2
March, 1917 1437
July, 1917 l<K»s
August, 1917 2212
Japan — January-July, 1917 1SJ2
Persia— July-August, 1917 IIRH)
Chosen — Poliomyelitis K^Ki
City health officers— Directory 1221
Colorado :
Cerebrospinal meningitis 16S1
I>iphtheria. {See Diphtheria — State reports.)
Hugo — Anthrax 1 14*^
Malaria 131S
Measlea (See Measles — State reiwrts.)
Poliomyelitis 1856. 2()P<)
Rocky Mountain six)tted fe'ver 1422
Scarlet fever. (See Scarlet fever — State reports.)
Snialli>ox— Vaccination histoi-y 1323, 1423. ICSG. 18r)9.2i>92
Typhoid fever 1325, 1326, 1429. lasa 1802, 2«»I»r»
Typhus fever 1327
Common drinking cups — Camp Zachary Taylor rone 184'*
Common towels— -Camp Zachary Taylor zone 1845
Communicable diseases :
Control — Uefmrt of American Public Health Association committee „_ 1700
Cuba— Habana 1098, 1169, 1248. 1292, 1331.
1437, 1463, 1549, 1695. 1821, 1870, 1908. 1942, 2061, 2139. 2181. 2242
Notification of cases — Camp Zachary Taylor zone 1843
Connecticut :
Bridgeport — Smallpox 2131
Cerebrospinal meningitis 1085, 1233, 1416, 1635. 1894, 20S6
Current State summaries 2084
Diphtheria 1896
{See also Diphtheria — State reports.)
Measles. {See Measles — State reports.)
New Britain —
Poliomyelitis 1237
Pellagra 1236, 1419, 1638, 1896
Poliomyelitis 1113, 1194. 1283, 1320, 1420. 1421, 1488, 1639. 1898. 2<»J>0
Rabies 1422
Scarlet fever. {See Scarlet fever — State reports.)
• Small|>ox 1114. 1240, 1427, 1644, 1890. 2093
Typhoid fever 1116, 1242, 1429, 1045. 1901. 2095
Corbitt, H. B.. sanitary bacteriologist — Tetanus In court-plaster — Results
of bacteriological examination of 14 specimens 1450
Court-plaster — Tetanus In 1445
Results of bacteriological examination of 14 si)eclmens — Surg. G. W.
McCoy. PasstHl Asst. Surg. J. P. I^»ake. and Sanitary Bacteriologist
H. B. Corbitt 1450
Creel. R. H., assistant surgeon general — Rodent destruction on ships —
Re|M>rt on relative efficiency of fumlgants 1445
Cuba :
Ilabana —
(\nnmunlcahlo diseases 1098, 1169, 1248, 1292. la^l.
14,^7, 1463. 1549. l(tt)5, 1821. 1870. 1908, 1942, 20(51, 2139, 2181, 2242
Typh(»ld fever— Comparative statement. 1913-1917 1S21
Quarantine by, against Venezuelan iH)rts removed liV»5
Current State sununarifs:
Arkansas. (Sic Arkansas — Current State summaries.)
California. {Srr (^illfornia —Current States summaries.)
(\)nntH'tlcut. iSrc Connecticut- -Current State .summaries.)
Indiana (Src Indiana — (^urrent State summaries.)
Kansas. (See Kansas — Current State .summarif»,)
Massachusetts. {S(c Massaclius<»tts — (Current State summaries.)
Minnesota. {Sec Mlnn(*sota — Current State summaries.)
Nebraska. {Sec Nebraska—Current State summaries.)
South Carolina. {See South Carolina — Current State gummarlesJ^^T^
Virginia. {See Virginia— Current State summaries.) uu^iv^
Washington. {See Washington— Current State stuninarieflL)
INDEX. 2257
Cyprus! ^"^e.
Leprosy— year 1910 1^)08
Malaria— year 1916 1908
Paratyphoid fever— year 1916 1908
Trachoma— year 1910 1908
Typhoid fever— year 1916 1908
D.
Delaware— rollomyelitis 1283,1320,1420
Diphtheria :
Alabama — Elmore County 1806
City reports for week euded —
June 16, 1917 1094
June 23. 1917 1117
June 30. 1917 1165
July 7. 1917 1206
July 14, 1917 1245
July 21. 1917 1289
July 28, 1917 1328
August 4, 1917 1389
August 11, 1917 1434
August 18, 1917 1460
August 25, 1917 1493
September 1, 1917 1545
September 8. 1917 1652
September 15. 1917 ^ 1092
September 22, 1917 1743
September 29, 1917 1775
October 6, 1917 1817
October 13. 1917 1867
October 20, 1917 1904*
October 27, 1917 1939
November 3, 1917 1980
November 10, 1917 2a57
November 17, 1S17 2098
November 24, 1917 2136
December 1, 1917 2178
December 8, 1917 2239
Connecticut 1^95
District of Columbia 1932
Illinois—
Edwardsvllle 17^5
Jollet 1852
Peoria ^ 1852
Indiana 1766, 1807
Ix>uisiana — ^Alexandria 1895
Maryland —
Emmitsburg 2086
Gapland 1735
Massachusetts 1681, 1S.12
Ixjwell 10 6
Mississippi 1533
Rhode Island— Newport 1280, 1316
State reports for —
January, 1917 1165
February, 1917 1165
March. 1917 1165
April, 1917 lia5
^lay, 1917 1(K)4, 1117. 11(15, 1205. 1245, 1328
June, 1917 11G5, 1205. 1244, 12SS, 1.S27, 1433, 1545, 2057
July. 1917 1327, 1388, 14:^% 1493. 1545, 1651, 2057, 2097
August, 1917 1545, 1(551, 1(>01, 1743, 1774 ,1817, 2057, 2097
September. 1017 1774. 1817, 1S0(5, IJXM. 1917, lO^O. 2057. 2097
October, 1917 1938, 19S0, 2050, 2a57, 2C'97, 2135, 2177
November, 1917 2135, 2177, 223S
West Virginia— Peru 1735
Wyoming— Fort Kussell 1485
Diphtheria epidemic — Uhode Island — Newport and vlcinltj' — Surg. G. W.
McCoy, Passed Asst. Surg. Joseph Bolteu, and H. S. Berustein£r.^=w^=y^pl787
2253 IKDBX.
Directory— City health offlcers-., 1221
Disease simulation — Drugs, cheniical3» and septic materials used there-
for—Technical Asst A, G. DuMez 188T'
Diseases, notifiable — Prevalence :
In cities of 10,000 to 100,000 during 1916 ia46
In States during 1916 1506
District of Columbia :
Cerebrospinal menigitls '. 1154, 1315. 15SS
Diphtheria 1032
{See also Diphtheria — State reports.)
Measles. {Sec Measles — State reports.)
Pellagra 1157. 1318, 1586, 1855, 1933
Poliomyelitis 1538. 1934
Scarlet fever. {See Scarlet fevei' — State reports.)
Typhoid fever 1162, 1324, 1542, 18G2. 1937
Dodge, camp — Disease cases reported. {Sec Extra-cantonment zones.)
Drinks— Camp Pike zone .* 1254
DuMez, A. G., technical assistant — Simulation of disease — Drugs, chemi-
cals, and septic materials used therefor 1S87
Dysentery :
Arkansas 1075, 1155. 1175
Mississippi County — Bacillary dysentery 1086
Kentucky —
Quicksand 1636
Surg. John McMuUen 1473
War Creek 1417
Massachusetts^ —
Grafton State Hospital 1417
Medfleld 1681
# Missouri 1155. 1175
Montana —
Sand Coulee 1636
Stockett 1636
Tennessee 1 155
Virginia — Narrows 1636
E.
Ecuador :
Plague 1821
February, March. April, 1017 1463
Yellow fever 1821
February. March, April, 1917 1463
Egypt— Plague _ 13in»
Endemic index, Mnssachujvtts — I>r. Walter H. Hrown 2121
Erysipelas — City reports for week ended :
June 16, 1917 , 1(W6
June 23. 1917 1110
June 30, 1917 1155
July 7, 1917 1192
July 14. 1917 1234
July 21, 1917 12X1
July 28, 1917 1.H16
August 4, 1917 irtsi»
Au^cust 11. 1917 1417
Auirust 18, 1917 145«;
Auirust 25, 1917 14s-*
Soi>t<Mnher 1, 1917 15,^4
Scptriiiher 8. 1917 l*rV'»
Sc: tnnlKM- V\ 1917 lt>^2
Soj-umiiIkm- 22, 1917. lT:n
SrptrinlKT 2t». 1917 17»Vi
()«t«»lM'r r>. VMl 1*N"7
OcIoImt \X 1917 l^Vl
OctolKT 20, 1917 1^1*5
OrfolMT 27. 1917. VXVZ
NovtMiilHM- '^, 1917 1973
N(.\rnil»er 10. 1107 2<tfl>
Nowniher 17. 1917 ^^ 2i»S7
Noveiiil>er 24, 1917 .^l^edterCf>QC ^VJl
INDEX. 2259
Erysipelas — City reports for week ended — Page.
December 1, 1917 2172
December 8, 1917 2228
Excreta, human — Fort Oglethorpe zone 1954
Executive order:
Quarantine service — ^Virgin Islands , 1705
Quarantine station — Philippine Islands — Cebu — Cauit 1127
Experimental typhus fever in guinea pigs — Description of scrotal lesion —
Passed Asst. Surg. M. H. Neill 1105
Extra-cantonment zone legislation:
Camp Beauregard — Foodstuffs 2079
Camp Dlx — Foodstuffs 1.505
Camp Funston — Venereal diseases 1956
Camp Greene —
Barber shops ^ *^— 2082
i Foodstuffs . ^..__ 2081
Hairdressing establishments • ^ 2082
Camp Pike— Food and drink ,. 1254
Camp Wadsworth — Garbage and refuse 1967
Camp Zachary Taylor —
Common drinking cups and common towels 1845
Fruits and vegetables 1845
Garbage, refuse, and ashes 1848
Manure 1846
Morbidity reports 1843
Mosquitoes 1844
Nuisances 184'i 1849
Privies and cesspools 1846
Prostitution 20791
Sanitary inspectors ^ 1849
Sewer connections 1847
Typhoid fever patients, convalescent — Examination of urine and
feces 1843
Venereal diseases 2079
Water supplies - 1845
Fort Leavenworth —
City health officer 1953
Manure 1957
Milk and milk products 1960
Privies 1957
Sewer connections 1957
Venereal diseases 1956
Fort Oglethorpe —
Excreta, human 1954
Milk and milk products 1953
Extra-cantonment zone sanitation — Camp Shelby — Near Hattlesburg,
Miss.— Passed Asst. Surg. J. A. Watklns 2149
Extra-cantonment zones— Disease cases reported 1968, 2033, 2169, 2223
Federal employees — Medical care when injured in performance of duties. 1125
Florida :
Jacksonville — Rabies (In animals) 1382
Malaria — Prevalence and geographic distribution, April, 1915, to De-
cember, 1916 2219
Trachoma 1900
Foodstuffs :
Camp Beauregard zone 2079
Camp Dlx zone 1505
Camp Greene zone 2081
Camp Pike zone 1254
Fox, Carroll, surgeon — Public health administration :
Quincy, III 1665
Springfield, Ohio 1255
Freeman. A. W., epidemiologist — ^Typhoid fever — Epidemic at Charles-
ton, \V. Va., April-June, 1917 1306
71194* 18 2 Digitized by VjOOQ iC
2260 INDEX.
Fruits and vegetables — Camp Zachary Taylor zone lR4r>
Fumigation of ships with hydrocyanic acid gas — Artificial ventilation
after — Surg. S. B. Grubbs 1757
Funston, camp — Disease cases reported. {See Extra-cantonment sones.)
G.
Garbage and refuse — Camp Wadsworth zone ^ 1907
Garbage, refuse, and ashes — Camp Zachary Taylor zone ls4x
Georgia— Macon — Typhoid fever Itp^
Germany :
Smallpox 1170
Typhus fever 1 170
Glanders — Massachusetts — Human case 1317
Gordon, camp — Disease cases reported. {See Kxtra-cantonment zones.)
Great Britain:
Birmingham— Typhoid fever — Comparative statement 1901-1916 l>i70
Bradford and vicinity — Anthrax 18Sn2
Gravesend — Plague — On steamship Matiana 14<>:i
. Liverpool — Plague — Rats examined 1942
London — Plague — On steamship Sardinia 1121
Greene, camp — Disease cases reported. {Sec Extra-cantonment zones.)
Grubbs, S. B., surgeon — Artificial ventilation of ships after fumigation
with hydrocyanic acid gas 1767
Guinea pigs- Experimental typhus fever In — Description of scrotal
lesion— Passed Asst Surg. M. H. NelU liai
Hachtel, F. W., M. D. — Typhoid fever spread by chronic carriers 1926
Halrdressing establishments — Camp Greene zone 2082
Hancock, camp — Disease cases reported. {See Extracantonment zones.)
Hasseltine, H. E., passed assistant surgeon :
Bacteriological examination of water — Comparative studies of media
used 1879
Public health laboratory specimens — Their preparation and ship-
ment 2016
Hawaii :
Castner- Typhoid fever 1900
C-erebrospinal meningitis 1485, 1734
Dipbtlieria. (Sec Diphtlieria — State reports.)
Kukaiau — Plague 1457
Hats inftnttHl found 1381. isr>6
leprosy 34S6, 1735
Measles. (See Measles — State reiwrts.)
Paauhau— Plague— Rats infected found 1194, 1381, ia%
Poliomyelitis 1113. 17:W
Scarlet fever. {See Scarlet fever — State reiwrts.)
Typiioid fever . 1110,1491.1741
Hay fever — Rocky Mountain and Piiolflc States — Canst* and prevention —
Dr. Wm. S(hepi>ecrell , 113r»
Health department Inlmrntorles— NwmI for their careful supervision 1215
Healtii departments — (Mty — Appropriations- -PasstMl Asst. Surg. Paul
Preble „_ . 2072
Health oftict^rs— <'ity :
Direotorj' 1221
Fort I>eavenworth zone liC»3
Hent hazard in imlustries — M it inn t ion — Passtnl Asst. Surg. J. A. Wat-
kins 2111
Hookworm disease* — Ortain military asi>eets of — Prof. C W. Stiles 1299
I.
Idaho :
Diphtlieria. {Sec Diphtheria — State rejjorts.)
Measles. {Scr .Measles — State reiM)rt8.)
Poliomyelitis ._ 1159
Scarlet fever. {Sec Scarlet fever— State reportSw)
Smalli>ox ^.^^.^^wr^oo 1161
Typhoid fever T^gmzgn-^yVjee ^^^
INDEX. 2261
nUnols: l*«6e.
Cairo— Smallpox - ^ 1000
Carbondale — Scarlet fever 1858
Casey ville — Smallpox 1858
Chicago— Poliomyelitis 1288, 1537
Cook County— Poliomyelitis 1639, 1G84
Edwardsville — Diphtheria 3735
Galatia— Smallpox 1858
Joliet— Diphtheria 1852
Peoria— Diphtheria 1852
Poliomyelitis 1112, 1283, 1320, 1420, 1488, 1738, 1769,
1809, 1856, 1897, 1975, 2044, 2090, 2129
Quincy — Public health administration — Surg. Carroll Fox 1665
Smallpox 1739
Indiana :
Bartholomew County — Typhoid fever 1771
Cerebrospinal meningitis 1085, 1233, 1485, 1681, 1894, 2126
Current State summaries 1850, 1030, 1971, 2035, 2084
Diphtheria 1766, 1807
{See also Diphtheria — State reports.)
Elwood — Smallpox 1770
Fort Wayne —
Smallpox 1770
Smallpox outbreak 1935
Measles. (See Measles — State reports.)
Michigan City— Typhoid fever 1814
PollomyelltU 1088, 1239, 1283, 1480, 1085, 1809. 1898, 2129
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox ^ 1091, 1240, 1490, 1687, 1899. 2131
Correction 1196
South Bend— Typhoid fever 1540, 1645
Typhoid fever 1093, 1242, 1491. 1688, 1902, 2132
Indo-Chlna :
Cholera —
February, 1917 3292
March, 1917 1437
July, 1917 1908
August, 1917 2242
Leprosy— August, 1917 2242
Plague —
February. 1917 3292
March, 1917 1437
July, 1917 1908
August, 1017 2242
Smallpox —
February, 1917 1292
March, 1917 .. 1437
July, 1917 1908
August. 1917 2242
Industrial establishments — Lighting— Asst. Physicist Davis H. Tuck 1761
Industries — Mitigation of heat hazard In — Passed Asst. Surg. J. A.
Watklns 2111
Iowa:
Cerebrospinal meningitis 1085, 1233, 1416. 1681, 1852, 2a38
Decatur County— Smallpox 2231
Diphtheria. {See Diphtheria — State reports.)
Measles. {See Measles — State reports.)
Muscatine — Anthrax 1805
Pollomvelltls 1088, 1283, 1420, 1421, 10S5, 1856, 2044
Polk County— Smallpox 2231
Scarlet fever. {Sec Scarlet fever— State reports.)
Smallpox 1091, 1240, 1427, 1687, 1860, 20.50
Italy — Naples — Deratization of vessels 1438
J.
Japan :
Cholera— January-July, 1017 1822
Plague — January-July, 1917 1822
Poliomyelitis
Digitized by ^
jo^^
2262 INDEX.
K.
Kansas : P«c«.
Cerebrospinal meningitis 1153,1190,1315,1416,1635,1806,1894,2038
Current State summaries 2035, 2085
Diphtheria. {See Diphtheria— State reports.)
Hoxie — Rocky Mountain spotted fever 1811
Hutchinson — ^Anthrax 1415
Kansas City— Poliomyelitis 1158
Leavenworth —
Smallpox 1899
Typhoid fever 1385, 1428, 1468. 1901
Leavenworth County — ^Typhoid fever ir>4l
Malaria 1192, 1418, 1637, 1807. 2040
Measles. {See Measles — State reports.)
Pellagra 1193. 1419, 1638. 1808. 2042
Poliomyelitis 1195, 1238. 12S3
1320. 1420, 1421, 1488. 1639. 1738. 1809, 1810. 2<>44
Reno— Anthrax 1190
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox— Vaccination history U97, 1423, 1642, 1812, 20*6
Typhoid fever 1203. 1420. 1645, 1814. 2101
Kentucky :
Dysentery — Surg. John McMuIIen 1473
Louisville —
Rabies in man 1898
Typhus fever 213'»
Malaria — Prevalence and geographic distribution 12ir»
Mason County — Scarlet ffever 1688
PoUomjelltis 1288, 132i)
Quicksand — ^Dysentery 163.i
War Creek — Dysentery 1417
Korea. {Sec Chosen.)
Krumwiede, Chas., Jr. — ^A milk-borne outbreak of typhoid fever 1756
Laboratories of health departments — ^Need for their careful supervision.. 1213
Laboratory specimens, public health — Preparation and shipment — Passed
Asst. Surg. H. K. Hasseltlne 2010
Leake, J. P., passed assistant surgeon :
Diagnosis of iHiliomyelitis 1S31
Tetanus in court-plaster — Results of bacteriological examination of
14 specimens 14.'><)
Winter outbreak of poliomyelitis— Elkins, W. Va.. 1916-17 lOtXl
Leavenworth, Fort — Disease cases reported. {See Extra-cantonment
zones. )
Let*, (^amp — Disease cases reported. {See Extra cantonment ztmes.)
Leprosy :
California —
I^>s Angeles ' ll.">5. 1234, 1281
San Francisco 1853. ia32, 2i«9
Cyprus— Year 1910 lims
Hawaii 14S0. lT:r»
Indo-Chimi— August, 1917 2242
Louisiana —
Burtvllle 111»2
(Jaryvllie 16:<7
Now Orleans 17G7. 2»tsT
Mississippi— Hiloxi 1S<I7
Mnrituna — AilKM'dm 1^*7
Novada— White Pine County i:n7
Now York -
Now York City KJSG. VSU
Svraonso 1 <^^
Norway--llH() and 1011 1015 i.. 21^1*
INMinsylvania — WilHanis|M>rt — 11»73
IUkmIo Island— rrrividoiK'o . l.'».'U
South Carolina- -Bennettsvlllo _^ 2172
Texas-Calveston -^i^e^fe^i^OQgte^
INDEX. 226S
Letton, H. P., sanitary engineer — ^New water sample shipping case — Ob-
servations on changes In storetl samples of water 1476
Lewis, Camp — Disease cases reportetl. (Sec Extra cantonment zones.)
Lighting of industrial establishments — Asst. Physicist Davis H. Tuck__ 1761
Logan, Camp — Disease cases reported. {Sec Extra cantonment zones)
Louisiana :
Alexandria — Diphtheria . 1895
Anthrax 1416, 1635, 1894
Burtville — Leprosy 1192
Cerebrospinal meningitis 1190, 1416, 2038, 2227
Chauvin — ^Anthrax 1931
Diphtheria. {See Diphtheria-— State reports.)
Doyle — Cerebrospinal meningitis 1232
Garyvllle — Leprosy 1637
Jackson — Cerebrospinal meningitis 1315
Malaria 1192, 1418, 1637, 1853, 2040, 2229
Prevalence and geographic distribution 1182 '
Measles. {See Measles — State reports.)
New Orleans— Leprosy 1767, 2087
Pellagra 1193, 1419, 1638. 1855, 2042, 2229
Poliomyelitis 1195, 1283, 1857. 2P44
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1202, 1427, 1644, 1861, 2050, 2234
Typhoid fever 1203, 1430, 1647, 1862, 2052, 2236
M.
McClellan, camp — ^Disease cases reported. {See Extra-cantonment zones.)
McCoy, G. W., director Hygienic Laboratory :
Diphtheria epidemic — Newport and vicinity, Rhode Island 1787
Tetanus in court-plaster — Results of bacteriological examination of
14 specimens 1450
McMnllen, John, surgeon:
Dysentery outbreak In Kentucky 1473
Trachoma and the Army — Dangers incident to enlisting recruits
affected with trachoma 1101
Madagascar :
Epidemic cerebrospinal meningitis 1464
Tanaaarive — Cerebrospinal meningitis 1778
Maine :
Orebrospinal meningitis 1852
Diphtheria. {See Diphtheria — State reports.)
Eastport— Smallpox 2174, 2232
Gardiner — Smallpox 1935
Measles. {See Measles — State reports.)
Pellagra 1638
Poliomyelitis 1421. 1639, 2044
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1427, 1644. 1861, 2050, 2SS1
Typhoid fever 1431, 1432, 1647, 1862, 2052
Malaria :
Alabama 1111. 1281, 1767, 1896, 2087
Prevalence and geographic distribution, 1915 and 1916 2165
Anopheles punctipennls — Ability to serve as host for Plasmodium
falciparum — ^Technical Asst. M. Bruin Mitzmaln 1081
Arkansas 1235, 2041
California 1087, 1418, 1535, 1853, 2087, 2228
City reiwrts for week ended —
June 16, 1917 1087
June 23. 1917 1111
June 30. 1917 1157
July 7, 1917 1103
July 14. 1917 1235
July 21. 1917 12S1
July 28, 1917 1318
August 4. 1917 1380
August 11, 1917 1418
August 18, 1917 1456
2264 INDEX.
Malaria — Continued.
City reports for week ended — P*
August 25, 1917 148:
September 1, 1917 155;
September 8, 1917 163:
September 15, 1917 1^
September 22, 1917 lT3fi
Septeml)er 29, 1917 IX
October 6, 1917 1^«*
October 13, 1917 IVn
Octol>er 20, 1917 \m
0<tol>er 27, 1917 im
November 3, 1917 VfA
November 10, 1917 34:
November 17. 1917 i!»:«S*
Noveml>er 24, 1917 : 21>
December 1, 1917 217:1
I>ei-emlH»r 8, 1917 22:5'
Cyprus— Year 1916 lSi^
Colorado 15b
Florida — Prevalence and geographic distribution, April, 1915, to De-
cember, 1910 : 2219
KauHiis 1192, 141S, 1637, 3807, 2»^t
Kentucky — Prevalence and geographic distribution liM'i
Louisiana 1192, 1418, 1637, 1853, 2040, 222J^
Prevalence and geographic distribution IISI
Malaria parasite in the mos<iuito — Development — Effects of law tem-
perature and other factors on — Technical Asst M. Bruin Mitzmnin 14O0
Maryland 1156. 1380, 1534, 1767, 1973, 2172
Massachusetts 1156. 1317, 1534, 1767, 1933. 2127
Mississippi 1234, 1486, 16S2, 1854, 2(^>
Nevada ^ 20i^S
New Jersey 1192. 1418. 1637, 1854. 2040
North Carolina — Prevalence and gregraphic distribution 1128
Ohio . 1637, 1807. 2229
Pennsylvania 1235. 1380, 1637. 1807. 2O40, 2229
South Carolina 1235, 1418, 1854. 2041, 2088. 222»
Tennessee — Prevalence and geographic distribution 1S3&
Texas, southern — Prevalence and geographic distribution 13tU
Virginia 1156, 1317, 1535, 1736, 1973, 2127
Wisconsin 1 13^
Manure :
Camp Za chary Taylor zone 1846
Fort Leavenworth zone -BoT
Maryland :
Cerebrospinal meningitis 1154, 1379, 176G, 1972, 2171
Diphtheria. {Sec Diphtheria — State reports.)
Emmitsburg — Diphtheria 2086
Gapland— Diphtheria 1735
Harney — Antiirax 1416
Loch Raven — Maryland school for boys — Tjphold fever ^__ 1740
Malaria 1156, 1380, 1534, 1767. 1973, 2172
Measles. ,Scc Measles — State reports.)
Pellagra 1157, 1380. 1536, 1768, 2173
Poliomyelitis 1159, 1238, 1283, 1320, 1381, 1420, 1489, 1538, 1769, 1975
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1976, 2046, 2131. 2174
Vaccination history 1161. 2175
Typhoid fever 1162. 1386, 1542, 1772. 1978, 2176
Massachusetts :
Anthrax 1153, 1532, 1765, 1931
Brockton — Ralm^s in animals 1976
Cerebrospinal meningitis 1109,
1154. 1190, 1279, 1315, 1533, 1766, 1894, 1931, 2126
Current State summaries 1931, 1971. 2a35, 2085
Diphtheria 1<581. 1852
{See also Diphtheria — State reports.) ^-^
Erving— Typhoid fever ^^^t^C^^)^).-- 1772
Gardner— Typhoid fever . 1428, 1772
INDEX. . 2265
Maflsacliusetts — Continued. Page.
Glanders (human case) 1317
Gloucester — Typhoid fever 1688
Grafton State Hospital — Dysentery 1417
Haverhill— Poliomyelitis 1108, 1238
Lowell— Diphtheria 1086
Lynn —
Anthrax 1734
Poliomyelitis 1238
Malaria 1156, 1317, 1534, 1767, 1933, 2127
Measles. (See Measles— State reports.)
Medfield— Dysentery 1681
Pellagra 1157, 1318, 1536, 1768. 1933, 2128
Poliomyelitis 1113,
1159. 1194, 1283, 1320, 1321, 1420, 1489, 1537, 1538, 1769, 1934, 2129
Reciprocal notification 2226
Scarlet fever. (See Scarlet fever — State reports.)
Septic sore throat 1422
Smallpox— Vaccination history 1384, 1161, 1539, 1812, 2175
Tewksbury— Typhoid fever 1688
Tewksbury State Infirmary — ^Typhoid fever 1740,1772'
Typhoid fever 1163, 1324, 1542, 1772, 1937. 2133
Virulent smallpox 1239
Massachusetts endemic Index — Dr. Walter H. Brown 2121
Measles :
City reports for week ended —
June 16, 1917 , 1095
June 23, 1917 1117
June 30, 1917 1165
July 7. 1917 1206
July 14, 1917 1245
July 21, 1917 1289
July 28, 1917 1328
August 4. 1917 1389
August 11, 1917 1434
August 18, 1917 1460
August 25, 1917 1493
September 1, 1917 ^ ' 1545
September 8, 1917 1652
September 15, 1917 1692
September 22. 1917 1743
September 29. 1917 1775
October 6, 1917 1817
October 13, 1917 1867
October 20. 1917 1904
October 27, 1917 1939
November 3, 1917 > 1980
November 10, 1917 2057
November 17, 1917 . 2098
November 24, 1917_ 2136
December 1, 1917 2178
Decembers, 1917 2239
Prevalence— In States during 1916 1186
State reports for —
January, 1917 1165
February, 1917 1165
March. 1917 1165
April, 1917 1165
May, 1917 1094, 1117. 116.5. 1205, 124.5, 1328
June, 1917 1165, 1205, 1244, 1288, 1327, 1433, 154.5, 2057
July. 1917 1327. 1388, 1433, 1493. 154.5, 1651. 2057. 2097
August, 1917 1.54,5, 1(551. 1691, 1743. 1774, 1817, 20.57, 2097
Septenibor. 1917 1774. 1817, 1S66. 1904, 1938, 1980, 20.57. 2097
October. 1917 1980, 1938, 2056, 2057. 2097. 2135, 2177
November. 1917 2135. 2177. 2238
Medical care of Federal employees — When Injured in performance of
duties 1125
Meningococcus carriers— Recognition and treatment — p|g^,^^^(^0^)a|$175
2266 INDEX.
Mexico: ^
Chihuahua — Cerebrosplnai meningttlB — Ck)rrectioii i«e
Merida — Yellow fever 1^
Vera Cruz — Cerebrospinal meningitis 21S1
Yucatan— Peto— Yellow fever 1121, 1«8
Michigan :
Ann Arbor — Rabies 1®^
Detroit — Smallpox outbreak 135
Diphtheria. (See Diphtheria— State reports.)
Measles. (See Measles — State reports.)
PoIiomyellUs 1195,1283,1421, 1639, 1857.2044,223)
Scarlet fever, {f^cc Scarlet fever — State reports.)
Smallpox— Vaccination history 1198, 1424, 1642, 1859. 2047. 223S
Typhoid fever 1203,1431,1647. 1863,2052,2236
Milk — Pasteurization advocated IS^
Milk and milk products:
Fort Leavenworth isone 19®
Fort Oglethorpe zone 1S63
Milk-borne outbreak of typhoid fever— Chas. F. Bolduan and Cbas.
Krumwiede, jr 1755
, Minnesota :
Cerebrospinal meningitis 1190. 1280, 1416. 1455, 1635. 1852. 2038. 2227
Current State summaries 1971.2085.20®
Diphtheria. (iSVe Diphtheria — State rqjorts.)
Fort Snelling — Cerebrospinal meningitis 1416
Mea&les. (See Measles — State reports.)
Pellagra 1€38
Poliomyelitis 1113, 1194, 1195, 1283, 1421, 1457. 1639. 1857. 2044, 2230
Pope County — Poliomyelitis 1238
Ramsey County — Rabies in man 2:^
Reciprocal notification 1189,1414,1634,1851,2226
Scarlet fever. (/Sec Scarlet fever — State reports.)
Smallpox 1090, 1114. 1160, 1196,
1240, 1322, 1384, 1422. 1490, 1539. 1641. 1686. 1739, 1811, 1858, 189C*
Vaccination history. J 1199. 1425. 1643. 1800, 204S. 2233
Typhoid fever 1204, 1431, 1648. 1863, 2053, 2236
Mississippi :
Biloxi— Leprosy 1S07
Cerebrospinal meningitis 1233. 1485, 1852, 203S
Diphtheria 1533
{Sec also Diphtheria — State reports.)
Greenwood— Typhoid fever 1688, 1936
Harrison County — Anthrax 1314
Malaria 1234, 1486, 1682. 1S54. 2040
Measles. (See Measles — State rejwrts )
Moselle— Typhoid fever 1.541
Pellngra 1236. 1487. 1683, 18o5. 2042
Poliomyelitis 1239, 1283. 1489. 1685, 1857, 2044
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1240. 1490, 1687, 1861, 2<^
Tishomingo —
Rabies 1382
Itabies (in animals) 1382
Typhoid fever 1242, 1492. 1689, 1864, 2053
Tyi)bus fever 1691
Missouri :
Columbia — Poliomyelitis 1159
Dysentery 1155, 1175
Kansas City— Unbies 1322. 1935
Poliomyelitis 1283. 1420
Mitzmain. M. liruin, teobnionl assistant — Malaria parasite In the mos-
quito— Effects of low tenii>erature and other factors on its development- 1400
Montana :
Alherton — leprosy 1807
Butte— Scarlet fever 1970
Cerebrospinal meningitis 1316, 1416, 1852. 2086
Diphtheria. (See Diphtheria — State reports.)
East Helena— Scarlet fever ^^^ 1739, 185S
Helena— Scarlet fever ^^^e^4)y-V^- 1739, 1858
INDEX. 2267
Montana — Continued. Paca^
Measles. (See Measles — State reports.)
Poliomyelitis 12^4, 1321. 1421. 1685, 1867, 2090
Rocky Mountain spotted fever 1322, 1422
Sand Coulee — Dysentery 1638
Scarlet fever. {See Scarlet fever — State Reports.)
Smallpox 1323. 2093
Vaccination history 1426, 1686, 1860
Stockett— Dysentery 1636
Typhoid fever 1325, 1432. 1689. 1864. 2095
Morbidity reports — Communicable diseases — Camp Zachary Taylor
zone 1843
Mortality-r-Venezuela :
1916 1209
January-May, 1917 2061, 2062
Mosquitoes :
Anopheles punctipennis — ^Ability to serve as host for Plasmodium
falciparum — Technical Asst. M. Bruin Mltzmain 1081
Camp Zachary Taylor zone 1844
Malaria parasite in — Effects of low temperature and other factors
on its development — Technical Asst. M. Bruin Mltzmain 1400
N.
Nebraska:
Cedar County — Scarlet fever 1770
Cerebrospinal meningitis 1766
Omaha — Smallpox outbreak 1935
Poliomyelitis 1284, 1538, 1769
Smallpox 1540, 1771
• Typhoid fever 1772
Neill, M. H., passed assistant surgeon — Experimental typhus fevci* in
guinea pigs — Description of scrotal lesion 1105
Nesbitt, Cbas. T., M. D. — Sewage disposal under rural conditions 1076
Nevada :
Diphtheria. {See Diphtheria — State reports.)
Humboldt County — Rocky Mountain spotted fever 1114, 1322
Malaria 2088
Measles. (See Measles — State reports.)
Hocky Mountain spotted fever 1089, 1239, 1422
Scarlet fever. (See Scarlet fever — State reports.)
Smallpox 1091, 1241, 1427, 1687, 2093
Typhoid fever 1093, 1243, 1432, 1689, 2095, 2096
Washoe County — Rocky Mountain spotted fever 2091
White Pine County— Leprosy 1 1317
New Hampshire:
Manchester — Anthrax 1485
Poliomyelitis 1284
New Jersey:
Anthrax 1190
Cerel)rospinal meningitis 1191, 1416, 1635, 1852, 2038
Diphtheria. (See Diphtheria — State reports.)
Essex CoiMity— Antlirax ! 2038
Jersey City —
Anthrax ' 1378
Smallpox, correction 2131
Malaria 1192, 1418, 1637, 1854, 2040
Measles. (See Measles — State reports.)
Newark — Rabies in man 2045
Orange — Rabies In animals 1976
Polioniyelitis 1195, 1284, 1421, 1639, 1857, 2044
Scarlet fever. (See Scarl<^t fever — State reports.)
Smallpox 1202
Tetanus 2235
Typhoid fever 1204, 1432, 1048, 18C5, 20.")3
New Mekico — San Juan Navajo Reservation — Smallpox 2091
New York:
Cerebrcspinal meningitis 1085, 1280, 1379, 1681, 1894
Diplitberia. (Sre Diphtheria— State reports.)
En(li<olt-Anthrax T^^^^^^^^^egt^S
2268 INDEX.
New York — Continued .
Measles. {See Measles — Slate reports.)
New York City— ^••^
Leprosy 108C, 1234
roliomyelltis 1113
Typhus fever 138S, 1459. 1817. 1038, llts<)
Poliomyelitis 1088. 1284, 1285. 1381, 1GS5, 18JW
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1W«
Vaccination hLstory 1090. 12S6, 1384. lim
Syracuse — Leprosy 14sO
Typhoid fever 1093, 1287. 1380, 1090. 1902
North Carolina:
Malaria — Prevalence and geographic distribution 1123
Poliomyelitis 1284
North Dakota:
Cerebrospinal meningitis 2038
Diphtlieria. {Sec Diphtheria— State reports.)
Measles. {See Measles — State reports.)
Poliomyelitis 1421, 1685, 1857. 2044
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1091. 1241. 1427. 1687, 1861, 2aT0
TjDhoid fever 1093, 1243, 1432, 1690, 1865, 2054
Norway— Leprosy— 1910 and 1911-1915 2X20
Notifiable diseases — Prevalence :
In cities of 10.000 to 100,000 during 1916 1316
In States during 1916 1506
Nuisances — Camp Zachary Taylor zone 1847, 1849
O.
Oglethorpe, Fort— Disease cases reported. {Sec Extra-cantonmeDt zones,)
Ohio :
Akron — Smallpox 2131
Belmont County— Poliomyelitis 1088
Cerebrospinal meningitis 1191, 1379, 1635, 1806, 2038, 2257
ChllUcothe— Smallpox IHU
Cincinnati— Rabies 1160. 119«
Diphtheria. {See Diphtheria — State reports.)
Malaria 1637, 1807, 22»
Measles. {See Measles — State reports.)
Poliomyelitis 1075. 1195. 1281.
1320, 1381, 1420, 1489, 1640, 1810. atH4, 2330
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox— Vaccination history 1201, 1384, 1643, 1812, 2049, 22SS
Springfield — Public health administration — Surg. O^arroU Fox isTm
Typhoid fever 1204, 1387. 1648, 1814. 2054, 22W
UhrlchsvlUe— PollomyeUtls IIM
Oregon :
Cerebrospinal meningitis 1085, 1191, 1981
Diphtheria. {See Diphtheria— State reports.)
Measles. {See Measles— State reports.)
Pellagra IftOS
Poliomyelitis 1089, 1195. 1810, 1934. 2174
Portland —
Poliomyelitis !«»
Smallpox — Correction l.V?9
RcH'ky Mountain spotte<l fever 1089, 1196
Scmrlet fever. {Sec Scarlet fever — State reiK)rts.)
Sinalli>ox 1001. 1202, 1323. 1490. 2175
Typhoid fever 1093, 1205, 1325. 1402. 1814, 19C7
P.
Pacific States — Tlay fever — Tnuse an<l prevention — Dr. Wm. Scheppegrell. 1135
Paratyphoid fevor — Cyprus— Year 191G 19»1H
Pasteurization of milk advocated ^^ . 1ST9
Digitized by VjOOQlC
INDEX. 2269
^ellagra : Page.
Alabama 1111, 1282, 1768, 1896, 2089
Arkansas 1236, 2043
California 1087, 1419, 2089, 2229
City reports for week ended —
June 16. 1917 1087
June 23, 1917 . 1112
June 30, 1917 1158
July 7, 1917 1193
July 14, 1917 1237
July 21, 1917 1282
July 28, 1917 l 1319
August 4, 1917 1381
August 11, 1917 1419
August 18, 1917 1457
August 25, 1917 1488
September 1, 1917 1537
September 8, 1917 1638
September 15, 1917 1684
September 22, 1917 1737
September 29, 1917 1768
October 6, 1917 1808
October 13, 1917 1855
Octol)er 20, 1917 1897
October 27, 1917 1933
November 3, 1917 1975
November 10, 1917 2043
November 17, 1917 ^ 2089
November 24, 1917 2129
December 1, 1917 2173
December 8, 1917 2230
Connecticut 1236, 1419, 1638, 1896
District of Columbia 1157, 1318, 1536, 1855, 1933
Kansas 1193, 1419, 1638, 1808, 2042
Louisiana 1193, 1419, 1638,1855, 2042, 2229
Maine 1638
Maryland 1157, 1380, 1536, 1768, 2173
Massacluisetts 1157, 1318, 1536, 1768. 1933, 2128
Minnesota : 1638
Mississippi 1236, 1487, 1683, 1855, 2042
Oregon 1808
Pennsylvania 1380, 1808", 2042
South Carolina 1236, 1419, 1^55,2042,2089,2229
Vermont : 1318
Virginia 1157, 1319, 1536, 1737, 1974, 2128
West Virginia 1157, 1318, 1638,1808, 1974
Pennsylvania :
Cerebrospinal meningitis 1233, 1379, 16Ji5, 1806,2038,2227
Diphtheria. {Sec Diphtheria — State reports.)
Malaria 1235,1380.1637,1807,2040,2229
Measles. {Sec Measles — State reports.)
Pellagra 1380, 1808,2042
Pittsburgh —
Poliomyelitis 1C>?>9
Ilabies 10:V>.2i:V»
PollorayeUtis 1239, 1284, 1382, 1420, 1640, 1810, 2044, 2250
Scarlet fever. {Sec Scarlet fever — State reports.)
Smallpox 1241,1385,1644, 1813,20:^21^''^
Typhoid fever 1243,1387.1649, 1815, 2054. 21:'.-
Williamsport — Deprosy H'Tl
Persia— Cholera — July -August, 1917 H ii.i'*
Peru— Plague _ "' -,»
June-July, 1917 __ ,, -.
Philippine Islands — Cebu— Cault — Quarantine station— Executive «,r<i**» ^
Pike, camp — Disease cases reported. (See Extra-cantonment zou^js. > "^
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2270 INDEX.
Plague :
Arabia — Aden — _ 1169
California —
Alameda County — Squirrels infected found 1087. 1158, 11^ 1237
Plague-infected squirrels found 1112
San Benito County— Squirrel Infected found 1087, 1158
China-
Hongkong 1292
Kats examined 1292. 1437, 1G55, 1942, 1984. 2181
Rats infected found 1292, 1437. 1055, 1M2. 1984
Shanghai— Rats examined 1121. 1437. 1942, 2139
Deratization of vessels — Italy — Naples :. 1438
Ecuador 1821
February, March, April, 1917 1463
Egypt , 1392.
Foreign reports —
Cumulative table 1123,
1172, 1211. 1250. 1295. 1333, 1394, 1441. 1467. 1499, 1551, 1657. 16JW.
1749. 1781. 1825, 1873, 1912, 1946. 1986, 2065, 2103, 2142, 2184, 224«
Weekly table 1098, 1122,
1171, 1209. 1248, 1293, 1332. 1393. 1439, 1464, 1497, 1550, 1656. 1605,
1747. 1779, 1823. 1871, 1910, 1943, 1984, 2003. 2101. 2140, 2182, 2243
Great Britain—
Gravesend — On steamship Matlana • 146S
Liverpool — Rats exam4ned 1942
London — On steampship Sardtnia-^j. 1121
Hawaii —
Kukaiau 1457
Rats infected found 1381, 1856
Paauhau— Rats Infected found 1194, 1381. 18o6
Indo-China —
Febniary. 1917 , 1292
March. 1917 1437
July. 1917 1908
August. 1917 2242
Japan — January-July. 1917 1822
Peru 1170
June-July. 1917 1900
Rodent destruction on ships — Report on relative efBciency of fuml-
gants — Asst Surg. Gen. R. H. Creel and Passed Asst Surg. Frieoch
Simpson 1445
Turkey in Af^ia- Trebizond 2139
Union of South Africa —
Cape of Good Hope State 1331. 177K
Glengrey district 1302
Orange Free State 1298
Washington— Seattle— Rats infected found 1319
Pneumonia — City reports for week ended :
June 16, 1917 108S
June 23, 1917 1112
June 30, 1917 ll-'W
July 7. 1917 llIM
July 14, 1917 1237
July 21, 1917 12S2
July 28, 1917 1319
July 28, 1917 1319
August 4, 1917 13?n
August 11, 1917 1419
August IS. 1917 1457
August 25, 1917 14<«
Reptenibor 1, 1917 l.'»3T
Soptcmlwr 8, 1917 16?«
September 15. 1917 1^^
Septeuil>er 22, 1917 1*^
Spptpml)er 20, 1917 . 1768
October 6, 1017 - 1***
Octol)er 13, 1917 _— 1^**
October 20, 1917 1«6T
October 27. 1917 ^ lOM
INDEX. 2271
Pneumonia — Continued. P«g«.
November 3, 1917 1975
November 10, 1917 2043
November 17, 1917 2090
November 24, 1917 2129
December 1, 1917 2173
December 8, 1917 2230
Poliomyelitis :
Alabama 1113, 1283. 1285, 1420, 1488, 1640, 1770, 1898. 2090
Ragland 1237
Arizona 1488
! Arkansas 2045
Australia 16(53
. California 1088,
1237, 1283, 1320, 1421, 1488, 1538, 1856, 2090. 2091, 2230
Cbosen 1399
City reports for week ended —
June 16, 1917 1089
June 23. 1917 1113
June 30, 1917 1160
July 7, 1917 1196
July 14. 1917 1239
July 21. 1917 L 1285
July 28, 1917 1321
August 4. 1917 1382
August 11. 1917 1421
August 18, 1917 1457
August 25, 1917 1490
September 1, 1917 1539
September 8, 1917 1641
September 15. 1917 1685
September 22, 1917 ^ 1739
September 29, 1917 1770
October 6. 1917 1811
October 13, 1917 ia57
October 20, 1917 1898
October 27, 1917 1934
November 3. 1917 1976
November 10, 1917 2045
November 17, 1917 2091
November 24, 1917 2130
December 1, 1917 2174
December 8, 1917 2231
Colorado 1856, 2090
Connecticut 1113, 1194, 1283, 1320, 1420, 1421, 1488, 1639. 1898, 2090
New Britain 1237
Delaware 1283, 1320. 1420
Diagnosis — Passed Asst. Surg. J. P. Leake 1831
District of Columbia 1538, 1934
Hawaii 1113, 1738
Idaho 1159
Illinois 1112,1283,
1320, 1420, 1488, 1738, 1769, 1809,
1836, 1897, 1975, 2044. 2090, 2129
Chicago 1238, 1537
Cok County 1039, 1684
Indiana 1088. 1230. 1283. 14S0. lOSr*, ISOO, 1808, 2129
Iowa 1088, 12^3, 1420. 1421, 1(J85, 1856, 2044
Japan 1104
Kansas__ 1195, 12as, 1283. 1320, 1420, 1421, 1488, ia39, 1738, 1809. 1810, 2044
Knnsas City 1158
Kentucky 1283. 1320
Louisiana 1195, V2Ki, 1S.^>7, 2<M1
Maine 1421, 1689, 2044
Maryland 1159. 12.8S, 12S.% 1320, lasi, 1420, 1489, 1538, 1769, 1975
Massachusetts 1113. 1159.
1194, 128:5, 1320, 1321, 1420, 1489, 1537, 1538, 1769, IfKM. 2129
Haverhill -J158, 1238
Lynn ^^rt^^H,4.-.aO 1238
2272 INDEX.
Poliomyelitis — Continued. ^
MiclilBnn 1195, 12S3, 1421, 1G39, 1857. 2(m.t:
Minnesota 1113, 1194, 1195, 1283, 1421. 1437, 1639, 1857,3^1^
Pope County ^
Mississippi 1239, 1283, 1489, 16S5, ls:5T :-
Missouri 12S3. i:
Columbia
Montana 12S4, 1321, 1421, 168.'), IS^.:*'
Nebraska 1284, 15^ '
New Hampsliire '-^
New Jersey 1195. 1284, 1421, 1639, ISST -
New Yorlc 1088. 1284, 1285, 1381,1685,>
New York City
North Carolina -
North Dakota 1421, 1685, IS^T,:^-
Oliio 1075, 1195, 1284, 1320. 1381, 1420, 1489, 1G40, 1810. am. 1
Belmont County -"^
Urichsville 1-
Oregon 1089, 1195, 1810, I95tr
Portland -'
Pennsylvania 1239, 1284, 1382, 1420, 1G40, 1810, 2(m,r
Pittsburgh -;^ >5
Prevalence : ^^ ^^
Rhode Island 1284, 1640. 1857, 2(HS.r
South Carolina 1239. 1284, 1857. SHa :?
South Dakota 1195, 1284, 1421, 1685,18oZ:n
Texas ^'^
Vermont 111113^'
1195, 1238, 1284, 1321, 1420, 1489, 1537, 1640, 1738, 1769, 2Wo.:r^
Virginia 116a ^^
1284, 1320, 1321. 1420, 1489, 1538, 1639, 1738. 1769, 1^-^?:
Hoekingham C/Ounty ^j'^
Theological Seminary P;'
Washington 1113, 1284, 1420, 1934, 2091, ->
West Virginia ^]^ ^f,^
1284, 1320, 1321, 1420, 1489, 1640, 1684, 1738, 1769, 1810, 19^.'-;
Monongah ^^
Winter outbreak— El kins, W. Va., 191^17— Passed Asst. Sur^. J- P-
Leake, Passed Asst. Surg. Joseph Bolten, and Asst. Surg. H. F.
Smith '^
Wisconsin 1159, 1285, 1382, 1538, 1898, lPr5.^i
Cottage Grove % ^^
Wyoming 1239, 128^^^
Preble, Paul, passed assistant surgeon — ^Appropriations for city health
departments ^^:
Privies — Fort Leavenworth zone ^^'
Privies and ce&spools — Camp Zachary Taylor zone ^^
Prostitution— Camp Zachary Taylor zone •^'
Public health administration : ^
Illinois— Quincy— Surg. Carroll Fox J5r,
Ohio— Springfield— Surg. Carroll Fox *'
Russia. 1917— Prof. C.-E. A. Winslow 1
Public health laboratory specimens — Preparation and shipment — Passed
Asst. Surg. 11. E. Hasseltlne
Q.
Quarantine sei-vice — Virgin Islands — Placed under Public Health Service
2015
by Executive order.
0 f
Quarantine station — Philippine Islands — Cebu — Cault — Executive order- 11'-*
II.
\C
Rabies :
Connecticut — New Britain ^
Kentucky— Louisville ^^
Michigan— Ann Arl)or f^
Minnesota — Ramsey County •^;
Mississippi — Tishouiingo — . _«, * ^'^
Missouri— Kansas City f^^^e^^L^O-CX^Q^^
INDEX. 2273
»l3ieB — Continued. Page.
Kevv Jersey — ^Newark 2045
Oliio — Cincinnati 1160. 1196
I^onnsylvanla—Plttsburgh 1935, 2130
Tennessee —
Mempliis 1160
Niishville 2130
Wisconsin— Milwaul^ee 1935. 1976. 2091
ables In animals:
Alabama Z130
City reports for week ended —
June 16, 1917 10S9
June 23. 1917 1114
June 30, 1917 IIGO
July 7. 1917 1196
City reiK)rt8 for week ended —
July 14, 1917-, 12.39
July 21, 1917 J . 1285
July 28, 1917 1322
August 4. 1917 1383
August 11, 1917—^ 1422
August 18, 1917 1458
September 8, 1917 1641
September 15, 1917 1085
September 22, 1917 1739
September 29. 1917 1770
October 6, 1917 1811
. October 13. 1917 1858
October 20, 1917 1898
. November 10, 1917 2015
November 24, 1917 2130
December 8, 1917 2231
Florida— Jacksonville 1382
Massachusetts — Brockton 1976
Mississippi— Tishomingo 1382
New Jersey — Orange 1976
Washington 1.^83
West Virginia 1383
Wisconsin — Milwaukee 1976
Reciprocal uoflficatlon:
California 2035
Massachusetts 1971. 2226
Minnesota 1189. 1414, 1634, 1851. 2036,2226
Rhode Island :
Cerebrospinal meningitis 1635. 1852, 2038. 2039. 2228
Diphtheria. (Sec Dlplitheria — State reports.)
Measles. (iS'cc Measles — State reports.)
NewTwrt— Diphtheria 1280. 1316
Newi)ort and vicinity — Diplitherla epidemic— Surg. G. W. Mci^oy,
Passed Asst. Surg. Jost*ph Bolten, and H. S. Bernstein 1787
Poliomyelitis 1284, 1640. 1857. 204.5, 2231
Providence — leprosy 1534
Scarlet fever. {iScc Scarlet Fever — State reports.)
Typhoid fever 1049. 1865, 2055. 2237
Rockv Mountain spotted fever:
Colorado 1422
Kuns;is— Iloxie 1811, 2046
Montiiaa 1322. 1422
Nevnda 1089. 1239. 1422
IIuHiboldt County 1114.1322
Washoe County 2091
Ore;;on 1089, 1196
Wjishlngton 1114
Spokane 2046
Wyoming 1089. 1239, 1422
Rocky Mountain States — Hay fever — Cause and prevention — Dr. Wm.
Scheppegrell 1135 ^
Rodent destruction on ships — Report on relative efficiency of fumlgants — OOQLc
Asst. Surg. Gen. R. H. Creel and Passed Asst. Surg. Frlench Simpson- 144^
2274 INDEX.
Russia: . — *
Poland — Typhus fever-
Public health adminlstratioa in 1917— Prof. C.-E. A. Winslow
S.
Salvarsan — Manufacture
Sanitary inspectors — Camp Zachary Taylor zone
Scarlet fever:
City rei)orts for week ended —
June 16, 1917 K-
June 23, 1917 :
June 30, 1917 1
July 7, 1917 D
July 14, 1917 i:
July 21, 1917 L-
July 28, 1917 11'
August 4, 1917 :>
August 11, 1917 li-
August 18, 1917 1^'
August 25, 1917 M
September 1, 1917 :'^'
September 8, 1917 K.
September 15, 1917 >-
September 22, 1917 • 1"*'
September 29, 1917 3"
October 6. 1917 : '
October 13, 1917 1^'
October 20, 1917 ^^'■
October 27, 1917 IS&
November 3. 1917 ^'
November 10, 1917 3"
November 17, 1917 '-'^
November 24, 1917 -■'
December 1, 1917 5i"^
December 8, 1917 - '
Illinois— Carbondale ^'l
Kentucky — Mason County ^^'
Montana — _
Butte 1^*:
East Helena 1- 1739,1'^*
Helena 1739. iv
Nebraska— Cedar County l"'
State reports for —
January, 1917 H^
February, 1917 ^^"f,
March, 1917 ^^'::
April, 1917 1![^*
May, 1917 1094, 1117, 11 a5, 1205.1245,1^
June, 1917 1165, 1205, 1244, 1288, 1327, 1433, 1545.2^'^
July, 1917 1327, 1388, 1433, 1493, 1545, 1651, 2057, 2«|.
August, 1917 1545,1051,1691,1743,1774, 1817, 2097, 2iL^*
September, 1917 1774,1817,1866,1904,1938.1980,2(^7;-'*?:
October, 1917 1938,1980,2056.2057,2097,2135.21m
November, 1917 2135,2177,2^
Washington — Vancouver • ^
Scheppegrell, Wm. M. D. — Hay fever — Rocky Mountain and Pacific
States — Cause and prevention ^^
Schereschewsky, J. W., surgeon — Trinitrotoluol — Practical points in ItB
safe handling J^J;
Septic sore throat — Massachusetts ^^
Sevier, camp — Disease cases reported. (See Extra-cantonment zonea) .
Sewage disposal — Under rural conditions — Dr. Chas. T. Nesbitt ^^^
Sewer connections : ^^
Camp Zachary Taylor zone *^1
Fort Leavenworth zone ■ ^'
Shelby, camp:
Disease cases reported. (See Extra-cantonment zones.)
Near Hattiesburg, Miss. — Sanitation of extra-cantonment zone— ^.^
Passed Asst Surg. J. A. Watkins . 21«
INDEX. 2275
Sheridan, camp — ^Disease cases reported. (See Extra-cantonment zones.)
Sherman, camp — Disease cases reported. (See Extra-cantonment zones.)
Slilpping case for water samples — Changes in stored samples of water —
Asst. Surg. R. R. Spencer and Sanitary Engineer H. P. Letton 1476
Simpson, Friench, passed assistant surgeon — Rodent destruction on
ships — Report on relative efficiency of fumigants 1445
Simulation of disease — Drugs, chemicals, and septic materials used there-
for— ^Technical Asst. A. Q. DuMez 1887
Smallpox :
Alabama 1114, 1286, 1644, 1771, 1811, 1809, 2093
Arizona — ^
Douglas — ^Virulent type 1075. 1089
Moqui Indian reservation 1770
Navajo Indian reservation 1770
Arkansas 1240, 1739, 2050
Pulaski County 1322
Truman 1858
City reports for week ended —
June 16, 1917 1092
June 23, 1917_- 1115
June 30, 1917 1162
July 7, 1917 1202
July 14, 1917 1241
July 21, 1917 1286
July 28, 1917 j . 1324
August 4, 1917 1385
August 11, 1917 1428
August 18, 1917 1458
August 25. 1917 1491
September 1, 1917 1540
September 8, 1917 1644
September 15, 1917 1687
September 22, 1917 1740
September 29, 1917 1771
October 6, 1917 1813
October 13, 1917 1861
October 20, 1917 1899
October 27, 1917 1936
November 3, 1917 1977
November 10. 1917 2051
November 17, 1917 2093
November 24, 1917 2132
December 1, 1917 2175
December 8, 1917 2235
Connecticut 1114, 1240, 1427. 1644, 1890, 2093
Bridgeport 2131
Foreign reports —
Cumulative table 1123,
1173. 1211, 1250. 1296. 1334, 1305, 1442, 146S. 1500, 1553, lOoO, 1G99,
1750, 1782, 1826, 1874, 1914, 1947, 19.88, 2066, 2105, 2144, 2186, 2247
Weekly table 1090, 1122,
1171, 1210, 1249, 1294, 1332, 1393. 14.^59, 14C>5, 1498, 1550, 1650, 1696,
1747, 1779, 1823, ISH, 1910, 1943, 1985. 2063, 2101, 2140, 2182, 2243
Germany 1170
lihilio 1161
Illinois 1739
Cairo 1090
Caseyvllle 1858
Galatia 1S5S
Indiana 1091. 1240. 1400, 16S7, 1S99, 2131
rorroction 1196
Elwood 1770
Fort Wayne 1770, 1935
Indo-CUiina —
February, 1917 1202
March, 1917 14:^7
July, 1917 ' -_- IIMKS
August. 1917 ..„.^_. -
2276 INDEX.
Smallpox — Continued. ^
lown 1091, 1240, 1427, 1687, IJ!®::
IX^ratur County
Polk County -|
Kansas — Ix?avenworth H
Tx)ulHiana 1202, 1427, 1644, 1861, 2tftt r^
Maine 1427. 1044, 1861, 2«t>'l
Eastport 21Ti-.
Gardiner
Maryland 1976.2046,2151.
Massachusetts — Virulent smallpox -
Michigan — Detroit -
Minnesota 1090. 1114, 1160, 1196. 1240. 1322, l.^'--
1490, 1539. 1041, 1686, 1739, 1R11,1S.> >
Mississippi 1240. 1490. 1687, l$m.
Montana !?-» ;^
Nebraska 104it'.
Omaha ^
Nevada 1091, 1241, 1427, IGST..'
New Jersey ^:
Jersey City, correction -
New Mexico — San Juan Navajo Reservation ^'^^
New York ^'^'
North Dakota 1091. 1241, 1427, 1687, 1S6L>
Ohio-
Akron
Chllllcothe - ':
Oregon 1091,1202.1323,1490.:
Portland— Correction ^^
Pennsylvania 1241. 13S5, 1644, 1813.^. ^^
South Carolina 1241, 1427, 1861, 2050, 2068. --j
South Dakota 1202, 1427, 1687, 1861. 2U
Texas— Eagle Pass l^
United States — Prevalence -^
Vaccination against — Kind of vaccine to use and how to use It ^
Vaci^nation history — ^ww.***
California 1090,1423. 1539,1859,2082,--
Colorado 1323, 1423, 1686. 185©^5
Kansas 1197, 1423, 1042. ISir^'t
Maryland '^^^rl'--
Massachusetts 1161, 1384, 1539, ISlZ-i-
Michigan 1198, 1424, 1642, 1«59.3W<,^
Minnesota 1199, 1425, 1643, 1860,2048..-'^
Montana 1426. 1686. 1^'
New York 1090, 1286. TSSiJ^
Ohio 1201,1384, 1643. 1812, 2lM9.2g
Vermont IICIJ-^'
Virginia 1161. 1323, 1540, 1740, 1»'*;I'!
Washington 1114, 1241, 1771, 1935, 2093. U^
West Virginia 1161, 1323, 1644, 1813, 1977. -J'^
Wisconsin 1161, 1385. 1540, 1899. ^^" ^^
Barron County — Correction |r:
Sparta l^.
Wyoming 1091, 1241. 1427. 16S7, IS^LS*^
Lusk 1^^
Smith, H. F., assistant surgeon — Winter outbreak of poliomyelitis—
Elkins, W. Va., 1916-17 ^^
South Carolina : ^
Bennettsville — Ix»prosy *J4'
Cerebrospinal meningitis 1416. 1852, 2038, --^
Current State summaries 2^^>
Diphtheria. {See Diphtheria — State reports.) ^^
Malaria 1235, 1418, 1854, 2041,2088,22:^
Measles. {Hcc Measles — State reports.) ' _^
Pellagra 1236, 1419, 1855, 2(M2,2089.;^
Poliomyelitis 1239, 1284, 1857,2045,2^^
Scarlet fever. {Sec Scarlet fever — State reports.) ^^
Smalliwx 1241, 1427,^861, 2050.20^'^
Digitized by VjOOQIC
iiTOEX. 2277
South Carolina — Continued. Page.
Spartanburg County — Typhoid fever 1901
Typhoid fever 1243, 1432, 1865, 2055, 2096, 2237
South Dakota:
Cerebrospinal meningitis 1191. 1416, 2126
Diphtheria. {See Diphtheria — State reports.)
Measles. {See Measles — State reports.)
Mitchell— Anthrax 1315
Poliomyelitis 1195. 1284, 1421, 1C85, 1857, 2130
Scarlet fever. {See Scarlet fever — State reports.)
SmaUiwx 1202, 1427, 1687, 1861, 2131
Typhoid fever 1204, 1432, 1690, 1865, 2133
Spencer, K. U., assistant surgeon — New water sample shipping case —
Observations on changes In stored samples of water 1476
State summaries. {See names of States.)
Stiles, C. \V., professor of zoology — Certain military aspects of hookworm
disease 1299
Stokes, Wm. Royal, M. D. — Typhoid fever spread by chronic carriers 1926
T.
Taylor, Zachnry, camp — Disease cases reported. {Sec Extra-cantonment
zones. )
Tennessee :
Chattanooga— Typhoid fever 1287, 1386. 1458
Chattanooga and vicinity — Typhoid fever 1541
Dysentery 1155
Malaria — Prevalence and geographic distribution 1339
Memphis— Rabies 1160
Nashville —
Rabies 2130
Typhoid fever 1253
Tazewell— Typhoid fever 2094
Tetanus:
City rei)orts for week ended —
June 16, 1917 1092
June 23, 1917 1115 .
June 30, 1917 1162
July 7, 1917 1202
July 14, 1917 1242
July 21, 1917 1286
July 28, 1917 1324
August 4, 1917 1385
August 11, 1917 1428
August IS, 1917 1458
August 25, 1917 1491
September 1, 1917 1540
September 8, 1917 1645
Se|)tember 15. 1917 1688
September 22, 1917 1740
Septeml>er 29, 1917 1771
Oetober 6, 1917 1813
October 13, 1917 18C1
October 20, 1917 1J)00
October 27, 1917 : 1936
November 3, 1917 1977
November 10, 1917 2051
November 17, 1917 2098
November 24. 1917 2132
December 1, 1917 2176
December 8, 1917 2235
In court-plaster 1445
Results of bacteriological examination of 14 specimens — Surg.
0. W. McH::oy, Passed Asst. Surg. J. P. Leake, and Sanitary
Bacteriologist H. B. Corbitt 1450
New Jersey 2235
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2278 INDEX,
Texns: !•■«*
Eagle Pass— Smallpox 1«0
Galveston — Leprosy 217i
Poliomyelitis 1420
Refugio County — Anthrax 1313
Victoria— Antli rax K^79
Texas, Southern — Malaria — Prevalence and geographic distribution 13»ll
Tidewater health district — Disease cases reported. (<SVc Extra-cantonment
zones. )
Trachoma :
Alabama — Camden 1000
Arizona — Nogales IICW
Cyprus— Year 1916 !««
Florida lOuO
Trachoma and the Army — Dangers incident to enlisting recruits affected
with trachoma — Surg. John McMullen 1101
Trinitrotoluol — Practical points In lu safe handling— Surg. J. W. Scher-
eschewsky 1019
Tuberculosis— City reports for week ended :
June 16, 1917 inw
June 23, 1917 HIT
June 30, 1917 llft'i
July 7, 1917 rj«
July 14, 1917 1245
July 21, 1917 vy&
JuJy 28, 1917 1328
August 4, 1917 13S9
August 11, 1917 1434
August 18, 1917 14«i)
August 25. 1917 1493
September 1, 1917 l.'»44
September 8, 1917 lCr»2
Sei»tember 15, 1917 1602
Sei»tember 22. 1917 1743
September 29, 1917 1775
Oclxjber 6, 1917 1S17
October 13, 1917 1S67
October 20, 1917 .- 19(«
October 27. 1917 193»
November 3, 1917 lOSO
November 10, 1917 2iOT
November 17, 1917 2O0S
November 24, 1917 2136
De*:eml)er 1, 1917 2178
December 8. 1917 2230
Tuck, Davis H., assistant physicist — Lighting of Industrial establish-
ments 1761
Turkey in Asia — Treblzond — Plague 2139
Typhoid fever:
Alabama 1115, 1287. 1650, 1773. 1901. SnfM
Arkansas 1244. 2*Vir»
Parngould -^ - 1428
California 1092, 1429, 1543, 1802. 2094. 2U95. 2235
San Franclsc*>, on steamship 1977
City reports for week ended —
June 16. 1917 1093
June 23, 1917 111«
June 30, 1917 11<J*
July 7. 1917 12«>5
July 14, 1917 - 3244
July 21. 1917 12^
July 28, 1917 ^^
August 4, 1917 ]^^
August 11, 1917 JIJ;
August 18, 1917 IJJS
August 25, 1917 — ]^
September 1, 1017
1W4
September 8^ lk7"IIIIIIIIIIIIIIIIIIIIIIII™-.I-,^ »- ^^
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INDEX. 2279
Typhoid fever— Continued.
City reports for week ended — Vngfi,
September 15, 1917 1690
September 22, 1917 1742
September 29, 1917 1773
October 6, 1917 1816
October 13, 1917 1865
October 20, 1917 1903
October 27, 1917 1938
November 3, 1917 1979
November, 10, 1917 2056
November 17. 1917 2097
November 24, 1917 2134
December 1, 1917 2177
December 8, 1917 2238
CJolorado 1 1325. 1326, 1429, 1688, 1862, 2095
Connecticut 1116, 1242. 1429, 1645, 1901. 2095
Cuba— Habann— Comparative statement, 1913-1917 1821
Cyprus— Year 1916 1908
District of Columbia 1162, 1324, 1542, 1862, 1937
Examination of urine and feces of convalescent patients — Cuwip
Zachary Taylor zone 1843
Georgia — Macon 168S
Great Britain— Birmingham— Comparative statement 1901-1916 1870
Hawaii 1116. 1491, 1741
Costner 1900
Idaho 1163
Indiana 1093. 1242, 1491, 1688, 1W2, 2132
Bartholomew County 1771
Michigan City 1814
South Bend 1645
Outbreak 1540
Kansas 1203, 1429, 1645, 1814. 2051
Leavenworth 13S5, 1428, 1458, 1901
Leavenworth County 1541
Louisiana 12a3. 1430, 1647. 1862, 2052. 2236
Maine 1431, 1432, 1647, 1862, 2052
Maryland 1162, i:i86, 1542, 1772, 1978. 2176
I^Kh U;' v(Mi — Maryland school for boys. _ _ _ 1740
Massachusetts 1163, 1324, 1542, 1772, 1937, 2133
Erving 1772
Gardner 1428, 1772
Gloucester 1688
Tewksbury 1688
Tewksbury State Infirmary 1740,1772
Michigan 120:^, 1431, 1647. 1863. 2052, 2236
Milk-borne outbreak — ('has, F. Bolduan an«l <'hris. Krumwie<U», jr__ 1755
Minnesota 1204, 1431. 1648, 1863. 2053, 2236
Mississippi 1242, 1492, 16S9, 1864. 20.53
(Jreenwood iaS8, 1936
Moselle 1,541
Montana 1325, 1432, 1689, 1864. 2095
Nobra.ska 1772
Nevada 1093, 1243, 1432, 1689, 2095, 2096
New .Tcrsoy 12(M. 1432, 1648. 18^5, 2053
Now York 1093, 1287, 1386, 1690, 1902
North Dakota 1093. 1243, 14.32, 1690, 1865, 2054
Ohio 1204, 1387, 1648, 1814, 2054. 2236
Oregon 1093, 1205. 1.325, 1492, 1.S14, 1937, 2176
Pennsylvania 1243, 1387, 1649, 1815. 2054, 2237
Rhode Island 1049, 1865, 2055, 2237
South C^arolina 1243, 1432, 1865, 2055, 2096, 2237
Spartanburg County 1901
South Dakota 1204, 1432, 1690, 1865, 2133
Spread by chronic carriers — Dr. Wm. Koyal Stokes and Dr. F. W.
Hachtel 1926
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2280 INDEX.
Typhoid fever— Continued.
Tennessee — P^i*.
Chattanooga 1287, 1386, 14r»8
Chattanooga and vicinity IMl
Nashville 12:»3
Tazewell 2ktH
Vermont : 1163. 1325, 1649. 1772. 2(Wv», 2176
Virginia 1164, 1325. 1543. 1741. ll>78. 2133
Washington 1116. 1243. 1773, ia37. 21)06, 2134
West Virginia 1163, 1325, 1640, 1815, 1979. 2170
Charleston — Epidemic April-June, 1917 — Epidemiologist A, W.
Freeman 1306
Wisconsin 1163, 1387, 1542, IIKW, 1979, 2237
Wyoming 1093, 1243, 1432, 1690, 1865, 2055
Typhus fever :
Austria-Hungary 1169
Colorado 1327
Foreign rei)ort8 —
Cumulative tahle 1124, 1174, 1213,
1252. 1297. 1335. 1397. 1444, 1470, 1502. 1555. 1661, 1701, 1752,
1784, 1829. 1877, 1916, 1950, 1991. 2069, 2107, 2147. 21S8, 2250
Weekly tabTe 1099, 1122. 1172, 1210.
1249, 1294, 1332, 1394, 1440, 14a5, 1498. 1550. 1656, 1096. 1747,
1779, 1823. 1871, 1911. 1944, 1985, 2063, 2101, 2141, 2182, 2244
Germany 1170
Kentucky— Louisville . 2135
Mississippi 1691
New York— New Yprk City 1388.1459,1817,1938,1980
Russia— Poland 1942
Union of South Africa —
Cape of Good Hope State 1909
East London 1655
Utah— Ogden 1165
Typhus fever, experimental — In guinea pigs — Description of scrotal
lesion- Passed Asst Surg. M. H. Nelll 1105
U.
Union of South Africa :
Cape of Good Hope State —
Plague 1331. 1778
Typhus fever 1909
East Ixjndon — Typhus fever 1655
Glengrey district — Plague 1392
Orange Free State — Plague 1293
United States :
Employees — Medical care when injured in performance of duties 1125
Smallpox— Prevalence 2124
Utah — Ogden — ^Typhus fever 1165
Vaccination against smallpox — Kind of vaccine to use and how to use It.- 1903
Vaccine virus — Propagation and sale In Interstate traffic 2191
Vegetables and fruits — Camp Zachary Taylor zone 1845
Venereal disenst*s:
(^amp Funston zone 19fVI
("amp Zachary Taylor zone 2079
Fort I>eaven\vorth zone 1^***
Venezuela :
Coro and vicinity — Yellow fever l*****
Mortality. 1916 12^^
Mortality, January-Mny, 1917 20tn,2n<»-
Quaranline ajralnst. by Cuba, reniovcil !"*>*'
Ventilation of ships— After fumigation with hydrocjanlc acid gas—
Surg. S. B. Grul)bs • ^•***
Vermont :
Diphtheria, {f^re Diphtheria — State reports.)
Measles. (&Vc Measles — State reiwrts.)
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INDEX. 2281
Vermont — Continued. Page.
Pellagra 1818
PollomyeliUs 111.3, 1159. 1195,
1238, 1284, 1321, 1420, 1489, 1537, 1G40, 1738, 17G9, 2045, 2174
Scarlet fever. (Sec Scarlet fever — State reports.)
Smallpox 11(51. 1.S23
Typhoid fever 1163, 1325, 1649, 1772, 2055. 2176
Artificial ventilation after fumigation — Surg. S. B. Grubbs 1757
Deratization— Italy— Naples 1438
Rodent de.struction on — Report on relative efliciency of fumigants —
Asst. Surg. Gen. R. H. Creel and Passe<i Surg. Friencli
Sini|)son ^ 1445
Virgin Islands — Quarantine service — Placed under Public Health Serv-
ice by Executive order 1705
Virginia :
Cerebrospinal meningitis 1154, 1316, 1533, 1734. 1972, 2126
Current State summaries 2085
Diphtheria. («S'c<? Diphtheria — State reports.)
Malaria 1156, 1317, 1535, 1736. 1973, 2127
Measles. {Sec Measles — State reports.)
Narrows — Dysentery 1636
Pellagra 1157. 1319. 1536, 1737, 1974, 2128
Pollomeylitis 1160, 1238,
1284, 1320. 1321. 1420, 1489, 1538, 1639, 1738, 1769, 1875, 2130
Rockingham County — Poliomyelitis 1195
Scarlet fever, (i^cc Scarlet fever — State reports.)
Smallpox 1161, 1323, 1540. 1740, 1977. 2131
Theological Seminary — Poliomyelitis 115^
Typhoid fever. 1164, 1325. 1543, 1741, 1978, 2i:«
Yirus, vaccine — Propagation and sale in Interstate trattic 2191
W.
Wadsworth, Camp — Disease cases reported. (See Extra-cantonment
zones. )
Washington :
Cerebrospinal meningitis 1110. 1233, 1766. 2080. 2126
Current State summaries 1971. 2085
Diphtheria. (Sec Diphtheria — State reports.)
Measles. (See Measles — State reports.)
Poliomyelitis 1113, 1284. 1420, 1934, 2091. 2130
' Rabies (in animals) 13S,3
Rocky Mountain spotted fever 1114
Scarlet fever. (Sec Scarlet fever — State report.s.)
: Seattle — Plague — Rats Infected found 1319
8malli>ox 1114, 1241, 1771, 1035, 2093, 2131
SiX)kane — Rocky Mountain spotted fever 2040
Typhoid fever 1116, 1243, 1773. 1937, 2006, 2134
Vancouver — Scarlet fever 2046
Water — Bacteriological examination — C/omrmrative studies of me<lla
used— Passed Asst. Surg, H. E. Hasseltine 1879
Water sample shippnig case, new — Changes in stored samples of water —
Asst. Surg. R. R. Spencer and Sanitary Engineer H. P. Letton 1 176
Water supplies — Camp Znchary Taylor zone 1845
Watkins, J. A., passed assistant surgeon :
Extra-cantonment zone sanitation — Camp Shelby — Near Hnttlesburg,
Mis.s. 2149
Mitigation of heat hazard in Industries 2111
West Virginia:
Cerebrospinal meningitis 1154, 131.5, mS5, 1K(K5, 2171
Charleston — Typhoid fever — Epidemic April-June, 1917 — Epidemiolo-
gist A. W. Freeman 1306
Diphtheria. (See Diphtheria — State reports.)
Ellsius — Poliomyelitis — Winter outbreak, 1916-17 — Passed Asst. Surg.
J. P. I^ake, Passed Asst. Surg. Joseph Bolten. and Asst. Surg.
H. F. Smith 1995
Measles. (See Measles — State reports.)
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2282 INDEX.
West Virginia— Continue<l. Pm^
Mononfjuli — Poliomyelitis 1195
Peliagra 1157, 1318. 1638, 18<)S, 1974
Peru— Diplitl»eria 1735
Poliomyelitis 1159.1238,
1284, 1320, 1321, 1420, 1489, 1640, 1084, 1738, 1769, 1810, 1975, 2174
Rabies (in animals) 1383
Scarlet fever. (See Scarlet fever — State reports.)
Smallpox 1101, 1323, 1644. 1813, 1977. 2175
Typhoid fever 11^3. 1325, 1649. 1815. 1979. 2170
Wheeler, camp — Disease cases reported. {See Extra-cantonment zones.)
Winslow, C.-E. A., professor — Public health administration In Russia In
1917 2191
Wisconsin :
Barron County — Smallpox — Correction 1041
Cerebrospinal meningitis 1154, 1379, 1533, 1894, 1972, 2228
Cottage Grove— Poliomyelitis 1159
Diphtheria. {See Diphtheria — State reports.)
Malaria 1380
Measles. {See Measles — State reports.)
Milwaukee —
Anthrax 1806, 1931
Rabies 1935. 1976. 2(»1
Rabies in animals 1976
Poliomyelitis 1159, 1285, 1382, 1538. 1898. 1975, 2231
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1161. 1385, 1540. 1899, 1977. 2234
Sparta— Smallpox 1384
Typhoid fever 1163, 1387, 1542, 1903, 1979. 2237
Wyoming :
Cerebrospinal meningitis 1085. 1681
Diphtheria. {See Diphtheria — State reports.)
Fort Russell— Diphtheria 1485
Lusk— Smallpox 1400
Measles. ( iScc ' Measles — State reports.)
Poliomyelitis 1239, 1285, 1421
Rocky Mountain spotted fever 1088. 1230, 1422
Scarlet fever. {See Scarlet fever — State reports.)
Smallpox 1091, 1241, 1427, 1687. 18G1. 2050
Typhoid fever 1093, 1243, 1432, 1600, 1865, 2055
y. ^ *
Yellow fever:
Ecuador , 1^1
Februarj', March, April, 1917 1463
Foreign reports —
Cumulative table 1174. 1213. 1252. 1297, 1»W, 139T, 1444. 1471,
1503, 1556, 1662, 1703, 1754. 1786, 1830. 1878,
1917, 1951. 1992, 2070. 2109. 2148, 2190. 2251
Weekly table 1122, 1440, 1400, 1498, 1550, 1696. 1779, 1823, 1985. 2141
Mexico —
Merida 149T
Yucatan— Peto 1121. 1438
Venezuela — Coro and vicinity 1603
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LANE MEDICAL LIBRARY
To avoid fine, this book should be returned on
or before the date last stamped below.
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922
^''■^ -s.:3^3
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Ill U-S. Public health aervlce
B17 Public health reports
T.38>pt.a\ 45944.^
1917 »*l*^ I i>ATE l>UB I
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