Annual report for the year 1940 [Oct. 1, 1941]

i~ . \lATE .OF GEORGIA . .

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DEPARTMENT OF

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~R~B~IC HEALTH

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ANNUAL REF'ORT . 1940

STATE OF GEORGIA
DEPARTMENT OF
PUBLIC HEALTH
T. F. ABERCROMBIE, M.D., Director
ANNUAL REPORT FOR THE YEAR 1940
State Office Building Atlanta, Georgia October I, 1941

Contents
Page Division of Local Health Organizations ____ ,-_______ 7 Division of Public Health Nursing_________________ 41 Division of Public Health Engineering_____________ 45 Division of Maternal and Child Health____________ 67 Division of Dental Health Education______________ 102 Division of Public Health Education _______________ 115 Division of Preventable Diseases:
Cancer Control Service _____________________ 119 Epidemiological Service _____________________ 128 Typhus Fever Control Service ________________ 146 Venereal Disease Service ___________________ 155 Division of Malaria and Hookworm Service________ 186 Division of Tuberculosis Control __________________ 186 State Tuberculosis Sanatorium __________________ 198 Division of Laboratories _________________________ 215 Division of Information and Statistics ______________ 258 Tabulations for Individual Counties: Population --------------------------------- 275 Natality ------------------------------------ 277 Mortality ----------------------------------- 281 Morbidity ---------------------------------- 299

STATE OF GEORGIA
DEPARTMENT OF PUBLIC HEALTH
T. F, ABERCROMBIE, M.D., DIRECTOR
ATLANTA
To His Excellency Hon. Eugene Talmadge Governor of Georgia. Dear Sir:
I have the honor to present to you the annual report of the work of the Department of Public Health for the year 194o.
The year 194o marks a. milestone in the record of mortality among Georgians, completing a. downward trend which began twenty years ago. That these two decades have witnessed great strides in the advancement of the public health is clear from the fact that the death rate
from all causes fell 7, 2 per cent between 1920 and 194o.
This decline in the general mortality has resulted in a. rich harvest of lives saved,
. a:.~~ Respectfully submitted
State Department of Public Health

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MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH APRIL l, l9L1l
&c-officio BoN. EuGENE TALMADGE
.Governor of Georgia
Name RoBERT F. MADDOX, Chairman __ Fifth District_________________Atlanta C. L. RIDLEY, M.D., Vice-Chnnn. Sixth_________________________ Macon
J. C. METTS, M.D. _____________ FirsL _____________________Savannah C. K. SHARP, M.D._____________ Second ____________________Arlington
R. C. ELLis ___________________ Third_____________________Americus
J. A. CoRRY, M.D,_____________ Fourth____________ :._______Barnesville
W. P. HARBIN, ]R., M.D, ________ Seventh _______________________ Rome H. W. CLEMENTS, M.D, _________ Eighth ________________________ Adel R. L. RoGERS, M.D.____________ Ninth-------------------- Gainesville D. N. THOMPSON, M.D. _________ Tenth ______________________Elhelton lVl. D. HODGES, Ph.G, _____________________________________Marietta W. T. EDMUNDS, Ph.G. ____________________________________ Augusta
J. G. WILLIAMs, D.D.S,____________________________________Atlanta
W. K. WHITE, D.D.S. ------------------------------------Savannah

STATE OF
GEORGIA


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Division of Local 1-Iealth Organizations

Guy G. Lunsford, M.D., Director

R. B. Griffin, M.D. L. M. Petrie, M.D.
W. D. Cagle, M.D. A. ]. Davis, M.D. G. V. Rice, M.D. J. D. Stillwell, M.D.

Northwestern Region Northeastern Region West Central Region East Central Region Southwestern Region Southeastern Region

Appended hereto is a summary of the work done in the organized counties during the year 1940, with a comparison with that done in 1939, and a summary of all local public health work, including the activities of the nurses in unorganized counties and the staff of the six regional health departments. In making the comparison of the total local public health work for 1939 and 1940, it must he borne in mind that the organization of the health regions was not accomplishd until July 1, 1939, and, therefore, the activities of the six regional departments in the unorganized counties covers only a six months' period for 1939. However, the work of the nurses in unorganized counties for the first six months of 1939 is included in this comparison.
The plan instituted on July 1, 1939, to decentralize to a certain extent the State Department by the establishment of six regional offices, with ' headquarters at Marietta, Gainesville, Griffin, Swainsboro, Albany and Waycross, was continued. The regional personnel makes most of the investigations of reported communicable diseases and complaints regarding insanitary conditions. This personnel also renders aid and advice where emergencies arise, and conducts promotional and educational programs in the unorganized counties; and supervises and directs the work of the public health nurses in those counties having only nursing service.
Expansion of Services in Organized Counties
Arrangements were completed for the reorganization of the Fulton County Health Department during the last quarter of 1939, and became effective January 1, 1940. Fulton County, exclusive of the City of Atlanta, has a population of about one hundred thousand. The budget provided for a health officer, an assistant health officer, a sanitary engineer, four sanitarians, a supervising nurse, and twenty staff nurses. Well-qualified personnel ~vas se'cured to fill these places.
Plans were completed during the last quarter of 1940, to become effective January 1, 19Ll.l, for the reorganization and enlargement of the Columbus-lVluscogee County Health Department. During 19L10, the personnel of that department consisted of a health officer, a sanitary engineer, a supervising nurse, who was assisted by the Public Health Nursing Association of lVluscogee County, and two clerks. During the year, Dr. J. A. Thrash, health officer for this county, entered the School of Public Health at the University of North Carolina for a full year's course in public health leading to the degree of Master of Public Health. Assistant Sur-

8

Georgia Department of Pztblic Health

geon Francis J. Weber was secured from the United States Public Health
Service to serve as acting commissioner of health during Doctor Thrash's absence. The enlarged department for Columbus and Muscogee County will consist of a commissioner of health, an assistant commissioner of health, a sanitary engineer, a sanitarian, one dairy inspector, one chief inspector, six other inspectors, a supervising nurse, four nurses, a secretary and two clerks. The health department wi!J be assisted by the Public Health Nursing Association, consisting of seven nurses. All professional personnel employed will meet the recommendations of the Conference of State and Territorial Health Officers.
It is planned to submit a bill combining the City of Columbus and Muscogee County health departments to the 19M session of Legislature, which bill will place the department on a firm foundation.
The extra-cantonment area of Fort Benning has increased the duties of the health department of Muscogee County, and for this reason the enlargement of this department at this time is very opportune.
During the year plans were completed for the organization of a district composed of Habersham, Rabun and Stephens counties, and the health department began operation on November l. Prior to that time, each of these three counties had a public health nurse.
increased Services
A comparison of the activities in organized counties for the years 1939 and 1940 shows a consistent increase in services rendered. For example, in counties having health departments, lLJ% more persons were vacci-nated against smallpox, 12:Y2% more babies under one year were immunized against diphtheria, and 26% more persons were given typhoid vaccine. In addition, 28% more persons were admitted to service for the control of venereal diseases, and 29% more to service for the control of
tuberculosis; and ll% more .field and office visits were made to patients,
suspects and contacts for the control of tuberculosis. To mention other senices, 27% more prenatal cases were admitted to service and 22% more clinic, .field and office visits were made to these cases; 22112% more babies were admitted to service and 122% more clinic, field and office visits were made to these babies; and 21% more preschool children were admitted to service and 27% more clinic, field and office visits were made to these children. The only section showing a material decrease in services was the cases of communicable diseases other than venereal diseases and tuberculosis admitted to service, which shows a decrease of 22.6%. However, the reported cases of these diseases also show a decrease in l9<W over those reported in 1939.
Nursing Counties
The plan of offering grants-in-aid for public health nursing service to the small counties unable to undertake the establishment of a full-time health department, which was instituted at the same time the six regional offices were established, was also continued. These grants-in-aid are made according to the population of the county, in the following manner: In

Local Health Organizations

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counties with less than 7,000 population, the State agrees to pay two thirds, in counties with a population of 7,000 to 10,000, the State will pay one half, and in counties within the population range of 10,000 to H,OOO, the State will pay one third of the nurse's salary and travel. In each instance the county must pay the remainder, plus a small amount, ranging from $15.00 to $25.00 per month, for a contingent fund, and furnish the necessary office space and equipment. For counties having a population above 1L1,000, no financial assistance is offered by the State Department, except toward the establishment of a complete health department. On December 31, 19Ll,O, nine counties in the lower population group, eleven in the second, six in the third, and nine in the group having a population above 14.,000 had this nursing service. Four other counties had nursing service paid for by other agencies.
Full-time nurses were employed in ten additional counties during the year. However, Harbersham, Rabun and Stephens counties, where public health nurses had been employed, were combined into a tri-county health department as of November 1, so the number of counties having public health nursing service on December 31, 19L10, was thirty-nine. The salary of the nurse in Taylor County is paid entirely by the county, and in Charlton County the entire salary of the nurse is paid by a publicspirited citizen. In addition to this, Putnam County is served by a nurse paid entirely by the Farm Security Administration. This nurse also serves the Resettlement Project in Jasper County. In Baker County there are two nurses and a sanitarian whose salaries are paid entirely by a citizen of Georgia who is interested in the health of that particular county. In Macon County, in addition to the public health muse paid entirely by the county, there is a colored nurse serving the Resettlement Project, and paid entirely by the Farm Security Administration. The two nurses in Greene County are also paid by the Farm Security Administration, hut are under the direction of the local health department. The nurses in all of these counties work in close cooperation with and under the direct supervision of the State Health Department and through the regional health department personnel, regardless of the source of their salary. They report regularly to the State Health Department.
In addition to the counties mentioned above, Lee County employed a qualified nurse to replace one who did not have sufficient training. The following counties also increased the nursing staff during the year: Chatham, DeKalb, Floyd, Fulton, Hall, Muscogee, Richmond, Troup, Thomas and Walker.
Status of Local Health Services
With the addition of Habersham, Rabun and Stephens counties on November 1, the total number of counties having full-time public health service was :fifty-five. The population served by these departments was 1,893,441, or 60.7% of the State's population. This is an inc1ease of 84,,356 over that served by county health departments in 1939, The addition of 430,502 persons in the nursing counties makes a total of

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Georgia Department of Public Health

1925

1930

1935

1940

GRAPH SHOWING INCREASE IN NUMBER OF PERSONS LIVING IN COUNTIES HAVTIIG FULL-TIME HEALTH DEPARTMENTS, 1915- 1940

Local Health Organizations

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2,323,943, or 7<1.5% of the population of Georgia having some local

health se1vice.

Although there has been an increase in the services rendered, there has been a slight decrease in the personnel of the county health departments. In 1939, there were 510 persons employed in organized counties, and in 194.0, there were i198. This is explained in part by the call to active military service of several men engaged in public health work.

When the enlarged public health department in Muscogee County begins operation on January 1, 194.1, all of the county health departments will meet the requirements of the Georgia Department of Public Health and the United States Public Health Service for financial participation.

National Defense
The advent of the National Defense Program brought an increase in the responsibilities and obligations of the Department of Public Health, which affected every division of the Georgia Department of Public Health. Several large defense projects and military camps have been located within the State, and existing ones have been greatly enlarged. A great influx of laborers created acute problems of housing and sanitation. Food and milk supplies were found to be inadequate and unsatisfactory in several places. These conditions called for increased services, and at Camp Stewart at Hinesville, in Liberty County, necessitated the establishment of a complete health department. Dr. C. 0. Rainey, commissioner of health of Mitchell County, was granted a leave of absence by his county and was sent to that area with two nurses, a full-time and several part-time sanitary. engineers, and a clerk. He and his staff, with the splendid cooperation of the local authorities and the military staff of the A1my Post, did splendid work, and although in this area the problems were most acute, it is very gratifying to report that no epidemics occurred, and that the camp has been completed without serious mishap. The same is true of other areas.
In addition to the increased responsibilities and duties resulting from the Defense Program, our problems have been further augmented by the loss of personnel. Many of the sanitary engineers and medical officers held commissions in the Reserve Corps of the Army and Navy. During the year, ten reserve officers employed as sanitary engineers were called to active duty, and thirteen others will probably be called at an early date. Twelve medical officers hold reserve commissions and may be called to service at any time.
The Army, and particularly the officers of the Fourth Corps Area, Teal ize the importance of continuing a public health program for the entire population as a defense measure, and have deferred calling those engaged in this work as long as possible, but the need of the Army is urgent, and we have no assurance that this deferment will be possible much longer.

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Georgia Department of Public Health

Personnel Training
The expansion of full-time public health departmel)ts and nursing service continued to be handicapped by the lack of qualified personnel. During the year, eight medical officers, eight sanitarians, ninety-one nurses, and two laboratory technicians were given public health training. Of the medical officers, four took additional t1aining in public health at Johns Hopkins University School of Hygiene and Public Health. In addition to the eight sanitarians mentioned above, who attended the University of North Carolina for a short course in public health, a class of five graduated from the Georgia School of Technology in Public Health in June, and after completing their field training in the regional health departments in Georgia, were assigned to county health departments as sanitarians.

Local Health Organizations

13

CoMPARATIVE STATISTICAL SmviMARY OF ToTAL LocAL PuBLIC HEALTH
WORK IN GEORGIA, l939-l9L10

Organized Counties

1939

1940

All Counties

1939

1940

COMMUNICABLE DISEASE CONTROL Admissions to medical service ___________ 13,698 Admissions to nursing service___________ 11,798 Total admissions to sel'vice______ . ______ 20,591 Consultations with physicians ___________ 2,320

Field Visits:
Diphtheria ---------- ---- ------------':ryphoid fever and paratyphoid fever__ _ Sculet fever __ -----------------------Smallpox ------------------------- ___ _ :i.\feasles _L ______ - - - - - - - - - - - - - - - - - - - - - - Whooping cough -----------------------1\IIalaria __________________________ _
Hookworm ---------------------------'l'yphus ------------------------------Other communicable diseases___________ _

3,798 1,309 1,727
H5 2,370
952 3,285 <1,716
691 5,495

12,706 8,537 15,908 2,151
2,331 1,260 2,106
8<1 6<17 679 2,888 6,783 306 <1,236

16;13<1 21,9<19 32,058
2,689
<1,3<19 2,173 1,798
l<l6 2,'130 1,006 17,401 16,207
771 6,258

15,378 11,532 19,641
2,556
2,495 2,098 2,213
98 693 7<11 13,770 9,333 33S <1,787

'l'otal field visits_______________________ 24;191 Persons treated for hoolnvorm___________ 11,085

21,320 9,121

52,539 13,290

36,563
11,62~

Admissions to hospitals:

-,

Diphtheria ---------------------------- 106

3<1

110

'l'yphoid fever and paratyphoid fever_ ___ _ 37

52

<12

52

Scarlet fever -------------------------- 136

128

136

130

Smallpox -----------------------------Other patients admitted________________ 2,035

921

2,036

'l'otal admissions to hospitals____________ 2,3H
lmnJUnizations (persons immunized): Smallpox ________ ____________________ 52;133
Diphtheria-under 1 year -------------- 8,702 Diphtheria-l through <1 years ---------- H,0<12 Diphtheria-5 yeaTs and over---------- 15,673

1,135
59,009 9,789
13,248 11,736

69,560 10,636 22,077 18,67<1

l,HE
76,293 11,665 17,656 13,550

'l'otal diphtheria immunizations_________ 38,<117
Schick tests given----------------------- 18,909 'lyphoid fever ------------------------- 111,250 Other imnnmizations ------------------- 1,639 Public lectures and tallm_______________ 072
Attendance ---------------------------- 29,505 Persons tested in surveys _______________ 49,138

VENEREAL DISEASE CONTROL Admissions to medical service _______ 33,921 Admissions to nursing senice __________ 16,978 'l'otal admissions to service ________ . ____ 3'!,762

Cases transferred to private physicians 1,000 Clinic visits (by patients) _____________ <199,081

Field visits (to patients)---------------- 26,009 Xumber of clinic treatments _____________ <139,277
Dismissed from service__________________ 7,464

Public lectures and talks --------------- 457

Attendance

33,380

34,773 17,925 178,681
2,35<1 310
20,661 36,690
<10,994 23,961 <13,596
1,105 536,52<1
33,773 <178;111
11,801 257
19,905

51,387 20,2l<l 209,582
1, 720 992
<1<1,621 57,163
36,804 19,557 38,858
1,l<l8 531,775
27,288 <158,956
7,6<12 <180
35,714

42,871 18,831 236,755
2,568 <182
29,72<1 <11,37-l
<17,000 29,262 50,060
1,287 610,116
37,681 538,259
12,169 366
26,860

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Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLic HEALTH WoRK IN GEORGIA, 1939-194.0-Continued

Organized Counties

1939

1940

All Counties

1939

1940

TUBERCULOSIS CONTROL Individuals admitted to medical selvlce __ _ 9,123 Positive cases ------------------------- 1,838 Suspicious cases ----------------------- 3,131 Contacts ------------------------------ '1,151 Individuals admitted to ntusing se!vice __ 11,179

Positive cases ------------------------Suspicious cases -------------------- __
Contacts -----------------------------'l'otal individuals admitted to service____

3,133 3, 709
7,637 16,095

Positive cases ------------------------- 3,312 Suspicious cases ----------------------- 4,672
Contacts ------------------------------ 8,111 Physical examinations in clinics_________ 10,869

X-1ay examinations ____ -------------- 11,06<!

Clinic visits (by patients)-------------- 23,539

Visits to State clinics (by patients)

7.642

Visits to private physicians (by patients) 1,536

Visits to private phys. (1!.0. or nurse)__ 1,237

Visits to others (health officer or nurse) 862

Field visits --------------------------- '18,825

Visits to cases of tuberculosis----------- 17,721

Visits to tuberculosis suspects ____

7,366

Visits to contacts _______________________ 23,735

Office visits --------------------------- 17,H6 Office visits of cases of tuberculosis ____ 1,983 Office visits of tuberculosis suspects ___ 5,211 Office visits of contacts________________ 6,952

Admissions to sanatoria---------------- U2

Number tuberculin tests completed__

16,772

Number positive ---------------------Numbet negative ----------------------Contacts brol<en ----------------------Contacts Jlartly brolmn ---------------- _ Helief secured for tuberculosis cases_____
Cottages, sleeping porches, etc. (No. built) Public lectures and talks____________

7, 708 9,06'1 1,119
262 581
18 460

Attendance -------------------------- __ 4'1,383

12,859 1,991 4,939 5,926 17,563 3,130 5,252 9,136 20,775
3,<1<16 7,382 9,9,17 12,136 15,733 21!,473 8,961 1,28'1 1,729 1,077 53,548 18,619 8,353 26,546 19.723 '1,587 7,432 7,70<1
!75 17,506
8,269 9,237 1,268
331 707
20
537 31,033

9,673 1,923 3,280 !,,!75 21,573 '1,399 5,010 12,134 23,<153 '!.622 6,052 12,731 10,962 H,761 27,<172 11,330 1,662 2,<!<15 2,326 62,91<1 21,201 9,993 31,720 18,316 5,168 5,60;) 7,513
539 17,<175
8,191 9,281 1,661
351 754
26 188 47,<!36

15,217 2,260 5,602 7,355
22,039 3,723 0,<17<1
11,812 25,333 4,069
8,800 12,961 12,213 19,318 28,002 12,<!89
1,<!30 2,058 1,<!16 61,810 20,,!90 10,230 31,120 21,571 5,006 8,077 8,<188
535 19,282
9,092 10,190
1,3<11 398 793 25 611
39,183

MATERNITY SERVICE Cases admitted to prenatal medical service 11,<1'16 Cases admitted to pl'enatal nursing service H,540 Total cases admitted to service__________ 15,009
Visits by prenatal cases to med. confs.__ 36,<101 Visits by prenatal cases to private phys. 835 Field visits to prenatal cases _________ 28,815 Office nmsing visits by prenatal cases___ 29,527 Cases attended by nurses fol' delivery serv. 317 Cases given postpartum med. examination 2,068 Postputum examinations by private Dr. 246 Cases adm. to postpartum nursing serv. 9,323 Visits to postpartum cases ______________ 27,698
Permanent health centers _______ -------- 17 2

1<1,301 17,956 19,H1 '17,<197
821 28,376 39,673
3'!0 2,663
209 13,809 32,61<1
179

13,77'1 17,621 19,381 42,181
968 31,261 33,304
329 2,085
252 10,059 29,252
21::1

16,529 21,229 22,530 52,75<1
837 31,730 45,226
393 2,856
232 H,909 34,630
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Local 11ealth Organizations

15

CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLic HEALTH WonK IN GEORGIA, 1939-19~10-Continued

0. uanized Counties

1929

1940

All Counties

1939

1940

Number of sessions
Itine1ant health centers ---------------Sessions held -------------------------:Midwives registered for formal instruction
Midwife meetings ---------------------Attendance at meetings _______________
Visits fo1 midwife supervision----- ____ _
Public lectures and tall<S --------------Attendance ---------------------------Enrollment in rnaternity classes ___ _
Attendance

11,51.)
H 23 1,466 925 9,061 3,503
:ho
5,635 :117
2,300

INFANT AND PRESCHOOL HYGIENE

Infants:

Individuals admitted to 1nedical service _ 7,60i Individuals admitted to nursing service 18,009 'l'otal individuals admitted to. service ____ 19,i13

Permanent health centers_______________ 222

Sumber of sessions _______ ------------- '1,717

Itinerant health centers----------Sessions held ------------------ _ -----Visits to mecl. conferences (by patients) Visits to private physicians (by patients) Field visits
Office llUl'Sing visits------------Consultations with parents _____________

100 288 16,885 362 13,901 15,031 31,225

Preschool:

Individuals admitted to medical service 9,253

Individuals admitted to nursing service - 15,511

Total individuals admitted to service---- 17,77<1

Pe1manent health centers--------------- 200

1'\umber of sessions--------------------- 1,052 Itinerant health centet's _______ . ______ _ 330

Sessions held ____ -------------------- 526 Visits to mecl. conferences (by patients) 16,584

Visits to med. conferences (by patients) 326

Field visits _____ ---------------------- 25,639

Office nursing visits (by patients)------- 15,77o

Inspections by dentists or dental hygienist 861

Prophylaxis by dentists or dent. hygienist

86

Consultations with parents------------- 23,908

Public lectures and talks--------------- 220

Attendance

5,427

Enrollment in infant and preschool classes 385

Attendance ---------------------------- 2,368

SCHOOL HYGIENE Inspections by physicians or nurses --- 270,600 Examinations by physicians ____________ l22,T10 Examinations with parents present_______ 1,721 Individuals admitted to nursing service __ 20,160
Field visits - ------------------------- 35,179

6,J~O
6
us~
093 8,636 3,720
254 ::1,982
778 1,826

5, 756 15 29
2,t179 1,8,13 15,093 5,071
369 7,167
517 2,378

0,271 22,863 24,222
2<17 :),605
26 02 21,206 275 -!6,265 18,013 37 ,53<1
12.318 20,72<1 22,97<1
21<1 5,124
226 392 22,688 332 29,2,17 21,495 89<1 183 33,036 13<1 4,180 693 1,882
202,038 113,460
2,812 22,35 11 36,02<1

8,29'! 10,'130 21,163
2;)1 5,098
100 288 18,325 16':> '15,906 1:>,976 32,156
9,956 16,9,10 10,265
227 '1,302
333 532 17,950 4,13 27,25! 16,760 917
87 2'1,793
235 5,619
385 2,378
280,043 12,1.487
1,751 20,<102 35,58,1

7,341 6
10 2,801 1,588 12,128 <1,821
300 6,687
701 1,830
10,1<JO 25,050 26;1SH
291 6,167
26 92 22,870 351 119,<121 19,913 30,722
13,06<1
~2,<192
2'1,780 2,10
5,,180 228 396
23,935 1195
3 1 . 2 1 11 23,120
038 200 35,52tj 152 5,186 693 1,883
305,<112 lli\,124
2,897 22,785 36,<1'11

16

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SUMlVIARY oF ToTAL LocAL PuBLic HEALTH
WoRK IN GEORGIA, 1939-1940-Continued

Organized Counties

1939

1940

All Counties

1939

1940

Office visits --------------------------- 2!,050 Inspect'ns by dentists or dental hygienists 84,711 Prophylaxis by dentists or cl'tl. hygienists 1,251 Public lectures and tallm________________ 620
Attendance ---------------------------- 41,968 C1assmom health tallm__________________ 5,83! Attendance ------------- _______________ 193,878

ADULT HYGIENE
Medical examinations:
Milk-handlers ------------------------- 2,024 Other food-handlers ____________________ 11,086
Midwives ------------------------------ 579 'l'eachers ----------------------------- 831 Other adult medical examinations _______ 10,751

'l,otal adult medical examinations~----- __ 25,27,1

MORBIDITY SERVICE

Admissions to medical service

5,194

.A.dmissions to nursing Se!'vice ___________ _ 7,392

~eotal admissions to service_____________ _ 9,533

Clinic vlsits (by patients)--------------- 70,558

lfield medical visits--------------------- 5,8!9

Field nursing visits -------------------- 2<1,138

Office nursing visits-------------------- 3,860

11ota.l admissions to hospita.ls------------ 5,071

'l'otal patient-days of hospital service___ _ 37,203

Individuals admitted to dental service__ _ 1,2<11

Refractions ___ ------------------------- 1,033 'l1onsil and adenoid operations __._______ _ 1,051

Other defects corrected _________________ _ 4,05!

CANCER CONTROL Admissions to medical service__________ _ 340 Admissions to nursing service __________ _ 135
Total admissions to services------------ 386
Office visits --------------------------- 631 Field visits ---------------------------- 465 Applications fM State aid _______________ 215 Cases diagnosed at State-aiel clinics______ 158
Cases t1eatecl at State-aid clinics_______ _ 176

CRIPPLED CHILDREN SERVICE Individuals reported Individuals examined at diagnostic clinics Individuals treated --------------------Individuals admitted to nursing service. __ Visits to diagnostic clinics (by patients)_ Nursing visits ------------------------Public lectures and tallm _______________ _
Attendance ___ ------------------------

851 883 785 297 133 1,961
22 1,131

17,256 92,159
9,373 497
21,977 5,585 195,213

24,6<]1 100,946
<1,256 723
48,055 6,175
206,569

1,705 26;181
603 810 19,711
19,310
1<!,374 8;188 19,827 68,070 6,655 32,161 6,176
11,231 76,888
3,028 76! 961
3,872
597 319 696 1,470 905 193 t!23 511
673 927 563 328 708 1,550
3 105

2,030 11,093
579 831 11,010
25,513
5,263 8,900 11,014 71,218 5,876 27,813 5,635 5,177 37,596 !,320 1,07<1 1,219 1,2<12
315 220 471 673 645 :io3 11;; 18!
915 888 788 363 436 2,062
25 1,184

17,803 105,060
9,!72 600
31,575 5,895 206,080
1,705 26,']83
616 87<1 19, 7<19
1<!,687 10,821 22,16<1 68;198
6,807 31.995
7,791 11,361 77,223
3,061 780
1,068 3,891
625 13<1 815 1,5<16 1,0.Jl 561 452 535
716 9<!1 571 388 728 1,636
3 105

Local Health Organizations

l7

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1939-194,0-Continued

Organized Counties

1939

1940

All Counties

1939

1940

OTHER ACTIVITIES
Conferences with physicians or dentists_ 16,389 Personal conferences with others ________ 106,531
Newspaper articles --------------------- 2,687 Bulletins distl'ibuted ------------------- 1<12,339 Circular letters ------------------------ 65,465 Miles traveled on duty_________________ 1,900,821

Days off duty _____ -------------------Conferences with official groups_________
Attendance ---------------------------Public lectures and tall<S---------------Attendance ----------------------------

710 23
H5 38 3,806

GENERAL SANITATION

Water:

Appro\ed individual water sup. installed Individual water supplies improved _____ _ Public water supplies improvecL _______ _ Connections to public water supplies ____ _

1,160 872 121
5,382

Sewage: New privies installed ____ ------------Wood PI'ivies installed at homes ________ _ Concrete privies installed at homes ______ _ Wood privies installed at schools _______ _
Concrete pl'ivies installed at school" __ Wood privies inst. at other public places Cone. privies inst. at other public places Privies repaired (or improved)----------New septic tanl;s installed-------------Septic tanl;s installed at homes________ _ Septic tanks installed at schools_______ _ Septic tanl;s installed at other places___ _ Septic tanks improved_________________ _ Connections to public sewer____________ _
Sewerage systems or plants improved ___ _

9,212 1,919 6,3!1
<17 B-13 122 170 2, 7<18 2,261 2,157
51 53 175 3,812 75

Field visits: Private premises ---------------------- 269,262
Camp sites --------------------------- 1,725 Swimming pools ----------------------- 781 Barber shops and beauty parlors ------- 352 Schools __ ----------------------------- 1,015 Public water sup. (plants and systems) 1,227
Sewerage plants ----------------------- 198 Other field visits_______________________ 18,281

19,892 115,573
2,11<! 141,336
6<1,558 1,968,951
872 655 10,708 519 34,095

21,301 121,887
2,983 165,231
69,916 2,4l<l,861
830 134 1,037 325 18,315

1,122 1,129
138 fl,731
3,557 87:l
6,667 95
116 176 300 1,688 2,753 2,578 ll 131 213 3,9<12
13
315,286 1,539 738 <181 3,508 983 526 37,191

1,202 961 159
6,1<!9
10,182 2,2 1111 6,905 17 674 132 180 2,829 2,<102 2,266 60 76 177 <1,365 113
271,715 1,767 800 351 1,530 1,363 621
18,517

25,428 139;187
2,339 165,881
69,098 2,869,501
1,703 973
1<!,935 981
55;176
1,593 1,793
239 6,118
11,<108 1,422 8,758 109 599 191 329 1,701 3,031 2,788 57 186 210 1,173 56
350,<139 1,865 730 131 '1,437 1,360 830
37,750

.rota! field visits for general sanitation_ 296,141
Insect Control: Buildings mosquito-rHoofed _____________ 1,222 Minor drainage-linear feet completed 1,166;113 Linear feet ditch cleared_____________ 3,832,682 Anopheles breeding places eliminated___ 1,619 Acres drained ----------------------- 8,886 Anopheles breeding places controlled ____ 12,625

390,253

299,672

1,119 582,627 1,021;103
1,240 4;152 1<!,325

1,300 1,191,1<!3 3,901,582
1,795 9,323 12,633

397,995
1,809 662,387 1,065, 783
1,278 5,7<15 1<1,329

18

Georgia Department of Public Health

CoNIPARATIYE STATISTICAL SuMMARY oF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, l939-l9LW-Continued

Organized Counties

1939

1940

All Counties

1939

1940

M iseellaneous: Public lectures and talks_______________ Attenclance _________ -----------------Postets, charts, exhibit models completecl Sanitation or malaria maps completed___

292 13,506
856 132

Rodent control: Premises smveyed for rodent controL____
Buildings rat-proofed -----------------Buildings improved -------------------Premises improved --------------------Pounds of poison bait distributed_______

9,670
222 113 1,961 6,922

PROTECTION OF FOOD AND MILl<

Food-handling places reg. for supervision 0.791

Field visits to food-handling estab,____ 79,815

Dairy farn1s registered for supervision___ 1,314

Field visits to dairy farms______________ 12,523

:c\Ii]l( plants registered for supervision___ 103

Field visits to milk plants_______________ 6,600

Cows tuberculin tested__________________ 4,'120

Animals slaughtered under inspection____ 159,963

Carcasses condeinned in whole or in part 47,L192

Public lectures and tallm_______________

66

Attendance

2,638

153 6,293
580 201
9,8H 502 347
2,238 2,632
7,166 81,879
1,505 12,!<12
130 3,905 19,973 566,268 65,039
<15 1,158

329 17,2<11
919 160
9,815 223 <151
2,006 7,022
6,791 79,819
1,31<1 12,515
103 6,601 <1,'120 159,963 <17,<192
66 2,638

202 16,'149
698 2<11
10,0H 530 104
2,355 2,65<1
7,260 82,2<11
1,509 12;169
132 3,909 19,973 566,268 65,039
16 1,183

LABORATORY Specimens examined:

ORGANIZED Year 1939 Positive Negative

\Vater-bacteriological ---------------------- 1,235

Water-chemical ---------------------------- 12 :\!ilk or mill' products______________ ________ 6,'105

Othet food --------------------------------- 73 'l'yphoid : blood cultutes ------------------ ____ 112

Typhoid: Widal ---------------------------- 59 'l'yphoid: stool cultures______________________ 2t16

'l'yphoid: urine culttll'es ---------------------

60

Diphtheria cultures ------------------------- 1,731

Syphilis-serological ------------------------ 33,719 Syphilis-darl<field ------------------------- 85 Undulant fever (human)-------------------- '19 Bangs disease (animal)---------------------- 105

'l'yphus fever ------------------------------- 297

'Tularemia ----------------------------------

<!8

:Malaria ------------------------------------ 1,225

Gonorrhea __________ ---------------------- 1,897

'l'uberculosis -------------------------------- 1,359 Feces for parasites-------------------------- 12,796 Urinalysis --------------------------------- 15,163

Rabies ------------------------------------- 267 Pneumococcus tYlJing ------------------------ 227

Dysentery ---------------------------------- 100 Other specimens examined___________________ 469

6,168 935
14,178 14 913
1,578 1,671 2,237 6,162 119,530
183 1,538 1,429 1;127
189 21,366
6,383 6,808 30,278 22,621
151 2<1
960 5,995

COUNTIES Year 1940
Positive Negative

1,091 H
1,058 1
113 82 180 52 1,H7 30,536 13,1
66 90 166 29 970 2,103 1,726 10,940 15,112 309 72 131 959

6,197 139
16,888 121
1,077 1,619 4,393 2,776 1,517 1<11,956
'167 1,676 5,089 1,698
2H 40,073
7 ,3<11 9,030 21,108 28,391
'1H 19 325 7,180

'l'otal specimens examined____________________ 77,739

258,741

67,084

306,071

I

Local Health Organizations

19

CoMPARATIVE S1AT1STICAL SuMMARY oF ToTAL LocAL Punuc HEALTH WoRK IN GEORGIA, 1939-19<10-Continued

LABORATORY Specimens examined:

ALL COUNTIES

Year 1939

Year 1940

Positive Negative Positive Negative

Water-bacteriological

1,281

Water-chemical ---------------------------- 12 Mill> or mill> Pl'OClltcts_______________________ 6,405

6,358 935
1<1,178

1,282 H
1,058

7,500 139
16,890

Other food --------------------------------- 13

H

1

121

1'yplwid: blood cultures--------------------- 120

939

126

1,090

'.fyphoid : Widal ----------------------------

67

'l'yphoid: stool cultures______________________ 366

1,600 5;ll3

90

1,656

311

5,083

Typhoid: urine cultures_____________________ 129

2,553

75

2,913

Diphtheria cultures ------------------------- 1,819

6;121

1,177

1,624

Syphilis-serological ------------------------ 31,562

122,7!3

32,656

151,051

Syphilis-darl<field -------------------------- 113

183

13<1

467

Undulant feve1 (human)--------------------- 19

1,519

66

1,680

Bangs clisease (animal)______________________ 105

<!,<129

90

5,113

'l'yphus fever ------------------------------ 30!

1,<136

163

1,713

'l,ularemia ----------------------------------

!S

195

30

215

:Malaria. ----------------------------------- 1,225

21;190

988

10;161

Gonorrhea __ ------------------------------- 1,912 '!'uberculosis ------------------------------- 1;136 li"eces for parasites-------------------------- 15,254

6;ll1 7,3!6 3<!,,!52

2,119
1,83~
12,926

7;173 10,131 29,313

Urinalysis --------------------------------- 15,230

22,931

15,510

29,858

Uabies ------------------------------------- 263

155

310

1H

.i
.'

Pneumococcus typing ----------------------- 227

21

so

32

Dysentery _______ --------------------------- 100

968

135

328

Other specimens examined___________________ 501

6,012

961

7,131

Total specimens examined ____________________ 81.603

263, 7<10

72,142

325,301

.:;

._. __ :

Year
1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 UJ25 1926 1927 1!Jt8 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940

Number Organized Counties
2 4 5 7 13 18 17 19 17 21 23 24 27 31 34 34 36 36 31 31 31 33 44 :i4 52 55

RECORD oF CouNTY HEALTH Wmuc IN GEoRGIA, 1915-1940

Number Persons Emuloyed
5 7 11 17 31 4.2 39 45
.41
8" 71 78 223 lUG 221 205 221 212 220 217 233 263 375 462 510 498

Po(JUiation Served
.
l7,:J4.5 56,509 132,105 170,0:18 1!l0,54u 436,106 HS,817 4!14,!1<11 !i21,987 669,78:: :i9S,HI7 670,397 689.0:l!J SiiG,HSH 1,024,849 1,011,974 995,728 998,037 1,055,209 1,314,663 1.327,018 1,394,076 1,580,669 1,777,129 1,809,085 1,893,441

Total Budget
$ 4.,637.00 7,960.00
17,290.00 t8,937.00 46,916.00 72,695.00 108,602.00 103,272.00 126,037.00 183,217.00 179,812.00 199,894.00 306,317.00 326,216.00 459,004.00 451,217.00 426,141.00 433,848.00 368,544.00 508,181.00 459,292.00 458,500.00 698,898.03 859,887.00 847,197.00 1,066,126.20

Per Cauita Expenditures
.26 .14
.1""
.17 .25 .21 .24
.2:) .~4 .'27
.30 .30 .H .38 .45 .45 .43 .43 .35 .39 .35 .33
.44
.48 .47 .56

l-..:1 0

County Budget

Ex(Jenditure By County

$ 4,637.00 7,960.00
16,790.00 22,337.00 38,186.00 . 70,89o.OO 103,:l<i:l.OO , !W,232.00 121,697.00 171,377.00 168,272.00 187,154.00 297,477.00 317,816.00 439,204.00 440,904.00 415,966.00 414,953.00 353,654.00 321,481.00 399,256.00 394,797.00 548,775.52 621,736.00 606,170.00 7SG,049.20

.26

<;")
Cl>

.14

0

1J'' .13

a"",'
~-

.20

t;;

.20

~

_j;)

:;:,

.22 .2:l .26 .28 .28

~.".".'.

-""'
0

.43 :J:i

.37

&-

.43 .44

~

4"

1::!:;

.42 .34. .24

s.:.C.;.:l>.,...

.30

.28

.35

.34

.34

.41

... :-~ : - ,.,,

CoNDENSED HEPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CouNTms-1940

--
COMMUNICABLE DISEASE CONTROL Admissions to medical service-----------------Consultations with IJllysicians -----------------l?ield visits ---------------------------------Smallpox immunizations ---------------------Diphtheria Immunizations ---------------------1'yphoid Ilnmunizations _----------------------

Atlanta, City of
298 9
654 3383 5613 .60M

VENEREAL DISEASE CONTROL Admissions t.o medical service _________________
Clinic visits ---------------------------------Jneld visiis ---------------------------------Ko. clinic treatments--------------------------

10915 152644
6419 150152

TUBERCULOSIS CONTROL Admissions to medical ser\rice ----------------Admissions t.o nursing service------------------
Clinic visits __ ---------------'""'---------------Field and Office visits--~---------------------

1637
255~
5116 15781

MATERNITY SERVICE Admissions to medical service __________________ Admissions to nursing service__________________
Visits by ante-partum cases to medical conferences
Field and Office visits ------------------------

193 5336
647 8280

INFANT HYGIENE Admissions to medical service __________________
Admissions to nursing service ----------------Visits to medical conferences -----------------Field and Office visits ------------------------

700 5847 2307 10<113

Baldwin
270 111 327 1371 256 2978
652 9287
344 9225
249 313 391 976
234 196 296 736
139 103 290 492

Bartow

DISTRICT

DISTRICT

-----...

Bibb

Jones Bleckley Dodge

22 19 79 793 251 2028

46
505 1609 1110 1600

285 4988
201 4979

975 26285
1014 27021

57

671

52

G71

so

2008

399

2396

22

1367

25

2174

32

4755

47

3395

14.

810

14

1066

18

2805

17

2312

G 1 25 194 215 1422
85 1286
103 1280
53 124 112 31J
81 150 162 318
53 129
so
238

336 37 73 256
227 1529
86 1003
157 1003
19
8~
99 570
72 10;1 199 270
55 62 98 135

122 13
100 39G 263 1122
289 3739
10 2806
lGO 201 213 481
134 137 311 369
81 86 104 126

Brooks Bulloch

430 72
593 825 715 2177
281 3601
701 2998
:~4
74 lOS 424
419 594 1265 1788
147 197 2<17 :129

501

42

24~

119:.

654 t--<

2858

0
":,;:_,

571 4910
59

i::t::!
;'~";.

4887 0

~
:;:,

22() 226 317

;::;
r:;
;~s

70G ;::;

"'

163 155 265 309

73

70

123

l:-17

l~

I-'

----~----

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1940-Continued

t-:l

l~

Atlanta, City of

Baldwin

Bartow

DISTRICT

Bibb

Jones

DISTRICT Bleckley Dodge

Brooks Bulloch

PRESCHOOL HYGIENE
Admissions to medical service ____ -----------Admissions to nursing service ------- --------
Visits to medica t conferences ----------------Field and Office risits________________________
Dental Ins11ections ----------------------------

1319 6238 3248 l30Ui
--

SCHOOL HYGIENE Inspections by nhysieians or nurses ---------Examinaiions by physicians __________________
Admissions to nursing service _ -------------Field and Office visits -----------------------Dental Ins!lections --------------------------- _

104195 40962 4199 10813 38500

ADULT HYGIENE Medical examinations -------------------------

22989

MORBIDITY SERVICE
I\fedical visits -------------------------------Nursing visits -------------------------------Admissions to hospitals------------------------

46747 574. 538

SANITATION
Water supplies ------------------------------Privies and septic tanks installed ______________ Food handling establishments reg. ______________
Dairy farms registered -----------------------Milk !llants registered------------------------Field visils -----------------------------------

--
168 3403
695 24
54804

LABORATORY SPECIMENS Specin1ens examined -------------------------- 32627

129 98
189 321
42
1486 Hi29
56 629 341
1369
539 181 60
22 338
26
---
1370
2844

llO 64 ll5 ll2
--
19 1208
1 42 733

520 1226 1959 34.54
--
23481 l29:i0 15fil 3832 ll327

325

379

26

--

104

--

--

--

--

1

5

464

46

--

--

106

--

7

639

33612

926

31543

52 107
'j;}
Hl3
1283 14fi4
67 448 1287
2R:i
44 109 38
--
15
--
78
345

23 21 24 40
--
2519 la70
6 lti
49
l7 lii
----
--
--
l26ti

124

154

122

128

147

242

154

374

--

--

42

44

"' 44 \0
ri5 8

20

~
1_5

t::::i

1127 Vi99

4164 3fi3

"' 917

ss

"<:::1
~ ...,

157

167

618

486

g 6
25

329 232

1802 92

-878 ;":'. 0
1731 ::P

:

3:-i

170

42 <=;

140 2

216 3:;

102 l

:::c
;"~:';.

--

3

--

261

lSi

7

3

:j

3167

1172

2391

ii042

3616

--.~$.: : . .-

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTlEs-194.0-Continued

Burke Calhoun Chatham

---

Clarke

C!inch

Cobb

Coffee

co:quitt

Crisll

COMMUNICABLE DISEASE CONTROL Admissions to medical smTice -----------------Consultations with physicians-----------------Field visits ---------------------------------Smallpox immunizations ---------------------Divhtheria Immunizations -------------------Ty11hoid Immunizations _________ --------------
VENEREAL DISEASE CONTROL Admissions to medical service ______________ ----
Clinic visits ----------------------------------
:Fteld visits ----------------------------------
No. clinic treatments--------------------------
TUBERCULOSIS CONTROL Admissions to medical service-----------------Admissions to nursing serYice -----------------Clinic visits _ -------------------------------Irield and Office visits ________________________
MATERNITY SERVICE Admissions to medical service---------------- __ Admissions to nursing service-----------------Visits by anievartum cases to medical conferences Field and Office visits------------------------
INFANT HYGIENE Admissions to medical service __________________ .Admissions to nursing service ___ -------------Visits to medical conferences ---------------Field and Office visits

42 61 55 324 566 1913
416 3082
13 3082
132 164. 10:1 4.84.
44;) 413 1074 798
278 277 568 5{);j

1052 7
2718 242 61
1199
425 5228
28 5194
76 119 141 306
126 2!J6 236 426
22 26 28 35

3H .254 2:136 l<!ojS9 l0fi9 1105
3481 35879
3129 234.24
472 512 1671 5740
2002 3004 6346 21806
635 3509
688 14254

84 24 293 464 777 2235
3.24 5112
442 HOJ
'iO 141
g!] tll:i
l!JO 1177 436 2234
219 394 793 2405

237 .22
296 38
112 878
132 1871
210 1419
84
1~7
86 391
83 191 lSI 728
61 lOS
47 441

135 39
293 404 319 4398
45 45 32
64 224 280 7:!2
20 46 26 79
40 35 40 47

347 71
441 1036 820 30iJO
281 5289
132 4372
97 177 115 841
193 271 438 574
205 260 648 4:)3

9fi4 67
103 410 34.3 1661
368 6041
93 5825
116 l!i4 133 246
196 211 861 912
liS 124 247
273

140

6

36 303

32S

1316

t-<
C)

:<,:":.::>>_

303 l:l:::

4316 42
3739

;";'....

a

53 116

~
:;:::::>:
~-

272

~

253

C";::)':

"'

211

231

650

679

90 117
113
14~
~~ ~'.,j

J

CONDENSED REPORT OF AcTIVITIES OF LoCAL HEALTH DEPARTMENTS, BY CouNTIES-194,0-Continued

l'-.:l lf:o..

-

Burke Calhoun Chatham

Clarke

Clinch

Cobb

Coffee

Colquitt Cris11

PRESCHOOL HYGIENE Admissions to medical service__________________ Admissions to nursing serv-ice-----------------Visits to medical conferences-----------------Field and Office visits________________________ Denial Inspections ----------------------------
SCHOOL HYGIENE Inspections by physicians or nurses ____________ Bxaminaiions by physicians ____________________ Admissions to nursing service__________________ l!'ield and Office visits -----------------------Dental Inspections ----------------------------
ADULT HYGIENE l\lledical examinations -------------------------
MORBIDITY SERVICE Medical visits -------------------------------Nursing visits -------------------------------Admissions to hospitals________________________
SANITATION Water supplies ------------------------------Privies and septic tanks installed______________ Food handling establishments reg. ______________ Dairy farms reg-istered-----------------------_ Milk plants registered------------------------neld visits -----------------------------------
LABORATORY SPECIMENS
Specimens examined ---------------------------- _

99 103 105 147
--
716 491
10 40
--
788
88 14
10 205
42 3
--
1710
:3251

16 19 16 22
--
54_ 100
4 8
7
30 H
--
--
30
18182

1046 1720 1111 4350
588
45Gfl3 4107 411'1
11804 3504
6395
18844 20353 7084
596 557 950
35 7
78701
49481

85 49
so
227 --
4661 5!16
79 157
--
799
1 91
--
14 365
95 36
8 16444
7017

34 41
9 124
2
3345 1801
5 286 655
25
45 14
--
--
3
--
--
196
842

141 67
159 94
122
2545 460 16 76
1477
161
189 71 15
133 453
--
25
--
1466
698

99 113 295 196
1663 :i14 22 116
231
39 287
1
86 2ti4.
3 1 467
4362

75 69 138 151
--
3181 143 268 181
361
5 9
12 57 21
7 2 866
5771

59

70

64 ~

86
--

~
8
uti

~-

213 b ~
e 207 ~ 35 92 ~ 2 ;~;:

,_0,_
17

;?

0"
171 ~ l4

24 i:l::

~

~

10

;::-<

66

91 !i60R

--- ---

----~-

.. . --.!..r.

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEA LTI-I DEPARTMENTS, BY CouNTIES-194,0-Continued

Decatur Dcl<alb Dougherty Floyd Fulton

Glynn

DISTRICT Mcintosh

Camden

Grady

COMMUNICABLE DISEASE CONTROL Admissions to medical ser\rice -----------------Consultations with physicians-----------------lneld visits ---------------------------------Smallpox immunizations ---------------------Diphtheria lnununizations ---------------------Typhoid Immunizations _----------------------
VENEREAL DISEASE CONTROL Admissions to medical service-----------------Clinic visits ---------------------------------Field visits ---------------------------------No. clinic treatments __________________________
TUBERCULOSIS CONTROL Admissions to medical service-----------------Admissions to nursing; ser,rice__________________
MATERNITY SERVICE Admissions io medical service---------------- __ Admissions to nursing service-----------------Visits by ante-partum cases to medical conferences Field and Office visits-------------------------
INFANT HYGIENE Adlnissions to medical service__________________ Admissions to nursing service-----------------Visits to medical conferences-----------------Field and Office visits ------------------------

318 31
1432 1426
491 1959
2096 8818
593 6797
239 263 238 908
258 258 1161 1242
56 57 127 167

76 28 149 1224 582 7968
782 10356
125 10356
243 437 416 938
97 568 68 928
73 331
73 579

210 22
367 990 657 2917
~1
869 118 849
147 155 llO 1248
454 805 1719 2922
194 445 290 1591

30 14 250 2283 856 8609
261 3623
322 3385
122 402 149
156~
2 115
--
257
1 139
374

186 169 495 1983 1043 11302
3557 20193
888 14455
829 1316 1473 5734
232 1117
550 3026
520 1520 998 3562

509 175 244 625 840 2293
974 18615
2913 16083
126 290
~34
880
265 451 391 789
199 298 294 882

8~
8 146 450 179 537
298 10238
2318 8728
6 21 30 161
23 121
38 376
57
283

9!1 10 129
~20
164 756
174 6309 2701 4809
53 61 67 386
27 231
27 574
104
409

1401 13
1083 208
395 t-<
"' 2447 0 :.;,:., _

301 ~
4108 "a'.
191 ;:;;:.

3001

C...., )

Q'q

127

151 r;

128 S.

350

0;:;

"'

146 357 324 815

7l

263

170

61~

l~

CJl

:-~".:

CoNDENSED REPORT OF AcTfVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-194,0-Continued

l-:J 0\

O!STRICT

Decatur Del<alb Dougherty Floyd Fulton

Glynn Mcintosh Camden Grady

P;;-Esct:OOL HYGIENE Admissions io medical service__________________ Admissions to nursing service-----------------Visits to medical conferences------------------
Ins11 ections ____________________________
SCHOOL HYGIENE Inspection; by 11hysicians or nurses ___________ Examinations by physicians ______ -------------Admissions to nursing service __________________ Field and Office visits -----------------------Denial Inspections ----------------------------
ADULT HYGIENE Thfedical examinations -------------------------
MORBIDITY SERVICE l\fedical visits -------------------------------Nursing visits -------------------------------Admissions to hospitals ________________________
SANITATION Waler sutl!llies ------------------------------ _ Privies and se11tic tanks installed ______________ Food handling establishments reg. ______________ Dairy farms reg-istered -----------------------Milk Jllants registered ----------------- _______ Field visits ----------------------- ------------
LABORATORY SPECIMENS Specimens examined --------------------------

41 4l 157 181
'i986
--
28 102
5G
5 1
22 533
1:> 4
1987
!iG13

331 402 303 2321
--
2903 5245 1013 1163
467
785 1292
148
53 428
--
1449
3003

373 520 954 3628
66
7r.70 1!i4 419 357
1533
176
48 348
23 9 1
2Hl7
4767

140 ISS 140 .:!:H
!i3li'i :1208
61 126
989
l:J 83 12
384 168
40
"
2686
1887

2034 2802 3040 4871
--
302G 7932 1202 2409 15003

360 380 428 50G
2806 69
2307 4264 1890

577

1;)50

2789

614

517

87

187

42 1462
273 73 31
1 :)083

--
75 12ti
15
142013

6141

11350

173 636
57G 1
282 733
20
114 281
--
---
:J 231
2314

67

43

281

200

(")

67 1201

"' 61

470

0
0'~

;;::

b

1278 3!i4

698
"e' 1193 '"""

688 978
--

~ 3
1:;
-- ~"'

-0 .

--

744 "ti

:;::

~

104

2ti'i <=;

219

11 :::t:;

s."',:;.::_

--

4

--

56

--

3;:;

2

17ti

13846

2846

6178

-:.:L,:

:.._-...;_.

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIES-194,0-Continued

DISTRICT

Greene Habersham Rabun Stephens

Hall

Jefferson Jenkins Laurens Lowndes

COMMUNICABLE DISEAS.E CONTROL

Admissions to medical service __________________

2

10

Consultations with physicians------------------

2

7

Field visits ----------------------------------

2

61

Smallpox immunizations __________ ---------- _ 1166

520

Diphtheria Immunizations ----------------------

486

213

Typhoid Immunizations . _______ -------------- 2752

2667

VENEREAL DISEASE CONTROL

Admissions to medical service__________________

249

54

Clinic visits ---------------------------------- 5115

839

l!"~ield visits ----------------------------------

179

37

No. clinic treatments-------------------------- 4252

828

TUBERCULOSIS CONTROL

Admissions !o medical service__________________

147

310

Admissions to nursing service__________________

2B4

42G

Clinic visits __ --------------------------------

l4:l

324

Field and Office visits ________________________

810

H9

MATERNITY SERVICE

Admissions to medical service__________________

238

4:J

Admissions to nursing service__________________

446

63

Visits b) ante-partum cases to medical conferences

52S

GO

Field and Office visits ------------------------

985

89

INFANT HYGIENE

.Admissions to medical service------------------

194

5

Admissions to nursing serYice ~-----------------

275

17

Visits to medical conferences------------------

225

5

Field and Office visits ------------------------

737

24

2

13

29

73

191

211

717

2

11

7

51

H

112

ll

8

26

111

210

101

100

308

469

489

481

116

144

sou

859

2915

3249

1305 320 2419

439 229 3512

840 517 11701

512

63G

[-,

1241 a

'"':::,
'"-

27

97

440

55S

1191

4341

98

114

352

552

1190

3901

167 1348
371 1290

187 1669
61 1669

140

939 ::t:

101 46

22127 255

"~'
:;:-..

4

9845

9

CT<:i

76

88

271

1S5

51

24

134

!;)
:;:l

131

113

301

l8ii

123

246

162 ~

76

Hi2

286

170

78

149

126 ~

200

1tJtl

1212

742

279

67U

1630

aNo

:;:l

"'

68

38

43

554

253

23

386

102

72

245

732

329

127

82G

109

50

140

1556

1276

8

1610

200

135

645

1798

H48

233

2567

18

13

43

109

73

64

213

46

43

188

109

117

46

377

22

25

66

192

183

4

719

175

80

440

247

253

164

15~G

~

-._)

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-194,0-Continued

1'-:l

00

DISTRICT

Greene Habersham Rabun Stephens

Hall

Jefferson Jenkins Laurens Lowndes

PRESCHOOL HYGIENE

Admissions" to medical service------------------

178

3

Admissions to nursing service -----------------

439

7

Visits to medical conferences "-----------------

507

3

Field and Office visits________________________ 1336

s

Dental' Inspections ----------------------------

--

--

SCHOOL HYGIENE

Inspections by physicians or nurses-----------

81

233

Examinations by physicians ____________________

459

Admissions to nursing service____ --------------

3

3

l!'ield and Office visits ------------------------

so

6

Dental Inspections ----------------------------

425

16

55

167

40

13

59

360

17

19

56

490

168

57

104

903

170

--

--

--

87

330

92

431

--

1 214
--

696 1401
--

<0
"C'l
~
~

I;:J

7

682

273!i

17

2523

1828 191

660 601

383 1H

G2fl 46:i4

~ ~

3

~02

7fi

135

47

4'i0 ~

20

26

:l28

HiS

196

183

18:i8 ;::;

--

--

--

812

2 ~"'

ADULT HYGIENE

Medical examinations -------------------------

134

---

---

---

904

MORBIDITY SERVI.CE

~{edical visits --------------------------------

21

--

4

Nursing visits --------------------------------

17

11

20

20

16

Admissions to hospitals________________________

--

--

--

1

SANITATION

Water supplies -------------------------------

22

--

--

--

57

Privies and septic tanks installed______________

129

9

32

381

l!'ood handling establishments reg" ______________

21

--

--

56

Dairy farms registered ------------------------

--

--

29

Milk plants registered ------------------------

--

--

Field visits -----------------------------------

534

55

33

54

3294

-Cl.

25

284

630

1387

~

283

13

2

1072

~
<"l

335

22

68

1504

1

28

1::!::
f":' .

;:;-.

1

--

15

110

85

186

65

--

41

5

3

4

97

763

182

787

LABORATORY SPECIMENS

Specimens examined -------------------------- 2823

302

816

213

2598

1623

5012

6710

6967

'::.~ ~ :

.. ---'~:

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1940-Continued

COMMUNICABLE DISEASE CONTROL Admissions to medical service__________________ Consultations with physicians __________________
Field 1'isits ---------------------------------Smallpox immunizations ---------------------Diphtheria Immunizations ---------------------Ty11hoid Inununizations -----------------------

Mitchell
822 113 1530 127 564 1814

VENEREAL DISEASE CONTROL Admissions to medical service__________________
Clinic visits ---------------------------------Field visits ---------------------------------No. clinic treatments--------------------------

372 3812 1096 3161

TUBERCULOSIS CONTROL Admissions to medical service__________________ Admissions to nursing service__________________
Clinic visits __ -------------------------------JJ'ield and Office visits ________________________

194 194 157 1045

MATERNITY SERVICE Admissions to medical service__________________ Admissions to nursing service__________________
Visits b) ante-partum cases to medical conferences
Field and Office visits ------------------------

994 6881057 1933

1NFANT HYGIENE

Admissions to medical service__________________

246

Admissions to nursing service---:----------------

246

Visits to medical conferences __________________

498

Field and Office visits ------------------------

797

Muscogee Richmond S11alding Sumter

140

7

3J

17

73

--

17

--

385

1595

115

224

1588

1454

833

367

935

1721

879

213

4682

9257

3777

4189

2744 28034
801 28570

1188 28235
4540 26552

455 8108
320 7289

837 6717
228 4749

496

2566

157

u4

449

1223

528

193

881

3525

354

156

1334

7448

1517

866

1010 1597 4209 4950

1437 2401 3783 14092

253

535

388

840

639

1259

658

1896

809

422

139

264

947

1487

261

389

1513

1288

308

726

2603

7933

485

972

DISTRICT Telfair Wheeler

Terrell Thomas

459 9
201 190 206 2062
190 2814
210 2665
53 86 62 275
105 175 411 534

259
296 107 183 1646
66 1039
163 711
18 55 48 213
123 167 201 469

21
30 72 82 2003
679 12810
14 12394
42 45 56 139
399 399 1637 1640

158

64

915

431

5320

1:--<
0

(")

~

487 6419 378 6419

~
s-!.;,.)_

0

162 '"'

186

~-

215

l;l

489

~0

~

"'

536

877

1936

2700

44

38

112

372

73

54

112

388

95

34

272

1343

198

55

272

952

[).:)

\0

. ... . -.~(

' ..:..

~

CoNDENSED H.EPOHT OF AcTIVlTlES OF LocAL HEALTH DEPAHTMENTS, BY COUNTlES-1940-Continued

0

PRESCHOOL HYGIENE Admissions to medical service __________________ Admissions to nursing service -----------------Visits to medical conferences-----------------Field and Office visits-----------------------Dental Inspections ----------------------------
SCHOOL HYGIENE Insvections by physicians or nurses ____________ Examinations by physicians-------------------Admissions to nursing service__________________ l'ield and Office Yisits -----------------------Denial Inspections ----------------------------
ADULT HYGIENE :Medical examinations -------------------------
MORBIDITY SERVICE Medical visits -------------------------------Nursing vtsit.s -------------------------------Admissions to hospitals ________________________
SANITATION Water snp11lies ------------------------------Privies and septic tanks installed______________ Food handling establishments reg. ______________ Dairy farms registered ----------------------- Milk plants registered -----------------------:Fteld visits -----------------------------------
LP.BORATORY SPECIMENS Sve:.imens examined --------------------------

Mitchell
325 325 410 814
--
3812 210 98 938 1.46
262
--
6 131
151
3229

Muscogee Richmond S11alding ~ utnter

976

695

272

187

1016

607

:124.

224.

1370

~Hl~

582

384

18~0

~139

~84

555

--

--

--

ll

602

1386il

58:1

130il

240

2690

748

5541

--

1175 4;)7 18 89
--

1247 1463
16 109

278

--

471

130

44<! 5008
--
7 518 239
63 5
37779

4037
--
2~
295 1000
90 5
23735

119 81 15
40 459
91 93
2 2128

1 41
4
5 81 45 ll
1833

109110

52462

5734

6985

DISTRICT Telfair Wheeler

Terrell Thomas

7

--

--

141

7

2

--

78

7

230

q':)

--

2

--

117 ;";0;' ~-

23 2093
1 14

418

1211

7GO

179

127

49

31

53

533 239
4 62

t;:::;
"''"1:::; g[.:.:.,.

533

--

55 1":':.

--a-...

30

--

20:1

~

~

1

4~

(:;

21

ll

21

--

--

"' -- 1::!::
[.:.:.,...

3

1

:.
4<!

206

76

13

189

525 1554

412 1447

756 3641

1747 5731

..- ' . -.~J!' .

- L~,:_

CoNDENSED REPORT OF ACTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIES-194,0-Continued

Child

D<STRICT

Health

,---------"---,

Demon

Tift

Troup Walker Catoosa Walton

Ware Washington Wayne Whitfield Worth stration

COMMUNICABLE DISEASE CONTP.OL Admissions to medical service----------- 152 Consultations with l)hysicians ---------- 7 li'ield visits --------------------------- 66 SmallJ10X immunizations -------- ------- 124 Diphtheria llumunizations ~------------- 398 rryphoid Immunizations _--------------- 1833
VENEREAL DISEASE CONTROL 204
Clinic visits ---------------------------3768 Field visits --------------------------- 111
3411
TUBERCULOSIS CONTROL Admissions to medical service __________ 76 Admissions to nursing service ---------- 100 Clinic visits ______ --------------------- 72 Field and Office visits ________________ 325
MATERNITY SERVICE Admissions to medical service ___________ 3!i0 Admissions to nursinc; service _________ ll34 Visits by ante-partum eases to medical eonferences ------------------ 1185 Field and Office visits -------~ __ ~ ---~ 2SG8
INFANT HYGIENE - Admissions to medical service ______ ____ 138
Admissions to nursinf:l: service ___ _______ 508 283
1717

91 43 504 1507 1100 738!i
G79 11448
178 9050
274 662 389 2266
282 477
74G 1218
87 138 112 214

60 13 180 227G 990 077
84 1557
29 1475
40 1080
983 14o1
8 4
G 19
24 27 39 25

22
--
85 57S H8l 14GII
24 628
44 577
10 97 Hi3 438
7 21
4
!'}()
33 GO 115 150

35 30 188 57G !i:14.
240~
144 2927
64 2927
67 138 147 447
49 riS
80 llfi
77 94 664 212

281 138
33 884 4!i2 3ri77

247 26 49
1201 fi:W aOS4

318

41

6819

32()

1

6736

320

130

125

130

125

144

122

:>79

868

177

3!i7

297

U02

20~

1137

418

1490

181

123

181

274

181

240

453

1141

114 18
182 702 2f:i() 2011
907 2620
217 2211
67 172 170 5!"i9
GG 109
13S 34G
48 70 125 190

75 101 459 487 10:14 313:0
504 9237
318 7785
501 611 672 2000
47 !i7
77 135
GG 64 136 160

125

33

52

539

57

48G

87:1

lOur.

466 t:--

37!iG

., 27fifi

0
"'

"-

107 2393
154

201 1792
96

i:l::;
s"~'-

2334.

a 1330

C.f,~

195 195 141

! 145 186

;::;
.,N"'
,.,.

141 c;

754

344

;::;

"'

289

421

338

684

2Sti

721

99!i

13()4

230

233

230

404

230

4.75

Ci~

576

1029

I-'

- .... ~{'.:

-' ..:.'.

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIES-194.0-Continued

Tift
PRESCHOOL HYGIENE Admissions to medical senice___________ 159 Admissions to nursing service ___________ 120 Visits to medical conferences___________ 208 Pield and Office visits_________________ 232 Dental Inspections ---------------------
SCHOOL HYGIENE Inspections by physicians or nurses______ 765 Examinations- by physicians Admissions to nursing service____________ Pield and Office visits ----------------- 187 Dental Inspections ---------------------
ADULT HYGIENE Medical examinations ------------------ 100
MORBIDITY SERVICE Medical visits ------------------------- 69 Nursing visits ------------------------- 10 Admissions to hospitals_________________ 3

SANITATION
Water SU[Jplies ------------------------ 30 Privies and septic tanks installed_______ 112 Pood handling establishments reg, ______ _
Dairy farms registered ----------------- 5 Milk plants registered-----------------Pield visits ---------------------------- 907

LABORATORY SPECIMENS S11ecimens examined

3033

Troup

DISTRICT ~ Walker Catoosa

77

98

44

98

93

33

95

130

103

135

132

152

33

11582 274 437 868
3750

1625 332 1 29 940

1284 216 183 323

614

43

47

371

18

19

516

8

35

146

20

28

12

146

236

56

2

18

95

10

1329

475

216

3849

1652

297

Walton

Ware Washington Wayne Whitfield

Health Demon Worth stration

59

140

222

65

140

219

126

680

269

178

265

361

19

168

100

237

21

162

100

386

20

272

123

377

22

274

238

655

10

350

5399

2410

1035

1718

4028

349

331

4838

2191

295

440

305

75

68

23

58

345

26

116

75

139

223

252

424

67

66

257

1985

4125

36

89

1165

832

87

496

262

140

46

827

124

103

39

38

20

46

57

30

28

21

2724.

14

34

6

211
502 1137

183 268 13
4 28645
15)50

2 279 80
4
2406
2278

128
92 1069

187 45 29 2
1665
3241

14 159
25 1 1
2554
1647

21 20
428 113fl

NOTE: Blecldey County without health officer March 31, to August 1, 1940. Bleckley and Dodge Counties formed a district August 1, 1940. Calhoun County without a health officer from June 30, 1940. Crisp County without a health officer from .June 16, 1940. Greene County without a health officer November and llecemller. Habersham-B:abun-Stephens began Ollerating as a district on N"ovemher 1, 1940. Nursing- counties prior to that time. figures brought fonvard. 'l'elfair-Wheeler Counties without a health officer from Se11tember l. 1940. Wayne County without a health officer from .Tune 16, 1940. S!lalding County eonunissioner of health g-iven leave of absence !o a! lend School of Public Heallh and Hygiene aL Johns Hopkins U11il'ersi!y,

eN
l~
~
"c '
~;s I::!
~ ~
' ~ -c . ~
~ ~-
-::.:::
~ "'
s.

CoNDENSED REPOHT oF SEnvrcEs IN CouNTIES W1 TH PUBLlC HEALTH NunsE, BY CouNnEs-194,0

Dade

N. W. Region

---'-----

Douglas

Fannin

Lu !niJkin

N. E. ReJion

,-----~--

Franklin

Jasper

COMMUNICABLE DISEASE CONTROL

Admissions io medical serYice ------------------

28

Consultations wiih vh~sicians __________________

Pield Yisiis ----------------------------------

12

::-;mallpox immunizations ----------------------

78

lHphiheria Immunizations ----------------------

72

Typhoid Immunizations

--------------

682

VENEREAL DISEASE CONTROL

Admi ;sions to medic>al service __________________

--

Field visits ----------------------------------

1

Xo. clinic treatments __________________________

TUBERCULOSIS CONTROL

Admissions io medical service~-----------------

1:l3

Admissions io nursing serriee -----------------~

19

Clinic visits

------------------------

133

Field and Office ,isits ----------------------- 171

MATERNITY SERVICE

Admissions io medical service________________

47

Admissions to nursing service__________________

76

Yisiis by ante-parium cases iO medical conferences

111

ll'ield and Office visits ------------------------

239

INFANT HYGIENE

Admissions io medical serrice __________________

41

Admissions io nursing service _________________

73

Visits io medical conferences __________________

89

Ji"ield and Offic>e YiRHs

189

1

117

10:l

11

2 2

2 31

2

8

H7

82

"30

436

680

20:1

842

47

116

245

178

289

;)4

757

397

1007

2375

201

15

2S

160

5:12

50

31

62

523

:H2 3210
25 3160

4~1
4844 18
4;)88

51

]II~

ll2

~

:w

129

13:l

:J2

(}:)

Hl

51

102

~ll

72

:~R

179

411

~0 I

140

ri9

141

39

61

16

249

132

25

78

284

67

156

21

597

261

411

209

72

34

12

161

130

28

16

84

62

12

26!i

2R6

,,,

]~

Putnam

:!0

-,tc.'-,<
:;:,
2iJ4 c::o:c 1493 ;~;..

1322 0

a-~

:;:,

;::;

1:!

r;
:;:,

"o"'

17 ;::;

"'

102 10:J 292 341

87
88 236
340 ww

CoNDENSED REPORT OF SERVICES IN CouNTIEs WtTH PuBLIC HEALTH NURSE, BY CouNTIEs-194,0-Continued

~ ~

Dade

N. W. Region

Douglas

Fannin

Lumpkin

N. E. Region

,--------"------,

Franklin

Jasper

Putnam

PRESCHOOL HYGIENE

Admissions to medical service__________________

81

--

61

71

--

--

10

Admissions to nursing service-----------------

99

--

98

121

3

1

10 (U

Visits to medical conferences------------------ 161

Field and Office visits ________________________

253

Dental Inspections ----------------------------

--

--

62

129

--

--

109

221

6

--

--

--

--

-1
--

"' 10 <:)
10 ~ -- ~-

SCHOOL HYGIENE

l:::;j

Insllections by physicians or nurses -----------

23

708

:HiG

ri5

~

Examinations by physicians ______ -------------Admissions to nursing service__________________

--

10

--

--

12

--

!..;..l

97

'

~"'ield and Office visits ------------------------

6

12

13

8

Dental Inspections ----------------------------

--

--

12

699

93

.";.:.:'.:.

ADULT HYGIENE

- .<:)

Medical examinations -------------------------

12

--

33

--

--

-- :'";:":;i:i

MORBIDITY SERVICE

...:.

Medical visits --------------------------------

--

--

--

--

27

22

~

Nursing visits --------------------------------

6

--

68

42

40

55

Admissions to hospitals________________________

--

--

--

--

--

6 i:J:::
"'.!,;_l

SANITATION

:";"z'"...

Water supplies

Privies and septic tanks installed--------------

85

--

Food handling establishments reg.--------------

1

70

3

Dairy farms registered

Milk plants registered

Field visits -----------------------------------

116

10

22

lOR

R4

6

20

LABORATORY SPECIMENS

Specimens examined ------------- ___________

484

so

1374

639

413

19

30

-- ..... .

--~_. ~~---.--...,.

._.

.:!~ ~ ~

~.

CoNDENSED REPORT oF SERVICEs IN CoUNTIES WITH PuBLIC HEALTH NURSE, BY Co UNTIES-194,0-Continued
____ West Central Region .,
Butts Coweta Crawford Harris Henry Lamar Macon Meriwether Peach Taylor U(lson

COMMUNICABLE DISEASE CONTROL Admissions to medical ser1Tice-----------------Consultations with physicians-----------------Field visits ---------------------------------Smallpox immunizations ---------------------Diphtheria Immunizations ---------------------Typhoid Innnunizations -----------------------
VENEREAL DISEASE CONTROL Admissions to medical service-------------- ____ Clinic visits ---------------------------------1'ield visits ---------------------------------No. clinic treatments--------------------------
TUBERCULOSIS CONTROL Admissions to medical service-----------------Admissions io nursing service-----------------_ Clinic visits ---------------------------------Field and Office visits ________________________
MATERNITY SERVICE Admissions to medical service-----------------Admissions to nursing service__________________ Visits by ante-partum cases to medical conferences Field and Office visits ------------------------
INFANT HYGIENE Admissions io 1nedical serYice__________________ .>l.dmissions io nursing ser\rice ___ -------------Visits to medical conferences __________________
Field and Office 1'isits ------------------------

3 1 9 1424 347 2947
56 1097 174 1020
56 63 56 165
58 86 69 205
19 65 Ei 127

3 2 10 36!1 182 1084
363 3552 357 2694
174 224 153 542
20 103 38 20()
15 55 24 76

22
--
Hi 111 127 1672
113 2041 141 1872
138 156 126 393
68 J04 123 23:l
18 63 40 132

.3, "
4 110
51 977
387 3347
16 2890
72 114 109 231
79 88 279 308
21 32 86 110

u
4
20
--
51
1117

11 6
lj5 1249
228
179~

10 3
29 180 3ii 1!198

186

445

.222

947

5401 2810

:nr

14:i

536

:!967

Hl:J~

--

112

ll1

6

:l:H

144

56

1fi6

110

87

559

325

--

137

151

16

218

222

--

233

329

31

460

890

9

33

11

104

81

35

87.

49

253

487

3 3
~5
130
1~:.
::i78
260 4837
142 451ll
82 214
so
562
66 157 113 279
31 84 45 121

!I 7 35 458 138 401
577 n66
38 3681
101 118 241 488
151 166 352 379
40 55 133 150

189

1~

14

.252

46

:!74

78

126 t-<

3:17

u~u

0
"',!;>_

:a
43~
7l

517 11417
251

1::!:::
"'!;>
:

138

a 979H

~

33

215 ~.

:>:!

378

!;>~

96 138

g 259 'J:r.
707

"'

108

52

152

97

247

122

276

203

1

29

27

67

53

50

136

C,J.:I

i:Jl

-..-.~~- :

CoNDENSED REPORT oF SERVlCEs IN CoUNTIEs WtTH PuBLtc HEALTH NURSE, BY CoUNTIEs-194,0-Continued

w
0\

,----Butts

West Central Region Coweta Crawford Harris Henry Lamar Macon Meriwether Peach Taylor UiJSOil

PRESCHOOL HYGIENE

Admissions to medical service ------------------

12

13

65

12

Admissions to nursing service ----------------- 186

36

115

10

--

Visits Lo medical conferences------------------

25

33

71

13

Field and Office visits------------------------ 238

104

164

16

--

Dental Inspections ----------------------------

--

32

--

SCHOOL HYGIENE

Inspections by nhysicians or nurses------------ 252

189

263

865

103

49

2

64

Admissions to nursing service~-----------------

4

3

28

1

Field and Office visits ------------------------

7

3

109

28

5

50

45

37

54

54

157

75

47

2

18

s

53

89

141

47

97

1

45 \j)

57 1136

150

110

23

89 "0'

12

--

--

--

--

-- O~ ""o"i

485

123

1344

75ri

953 ti

14

--

38

1

158

--
G
7

--
56

--
5

"' 35 ""~ .."., g 144

Dental Inspections ---------------------------- 914

ADULT HYGIENE l\ledical examinations -------------------------

MORBIDITY SERVICE

Medical visits --------------------------------

f)

~ursing visits --------------------------------

30

Admissions to hospitals ________________________

SANITATION

Water SUP!llies -------------------------------

3

Privies and septic tanks installed------------~--

15

615

1

5

3

74

72

21

6

14

57

26

--

--

863

137

1053 1455 :"::'.

2

54

415

25

--

1

26

21

-- -- -- --

1

17

2

25

528

131

11

-- so

--

50

16

132

1

52

177

--

--0
13
:;:s:?..

--
22

--
319

"""'

27 1:!::

19

1 s~ .".'....

53

10

1Cood handling establislunents reg--------------

Dairy farms registered

Milk plants registered

Field visits -----------------------------------

30

371

100

137

59

92

300

214

75

175

148

LABORATORY SPECIMENS

StJecimens examined -------------------------- 1038

407

1422

431

222

453

251

919

588

246

872

... ----' -- ------ ~- .

:~i:~_l!' ~

c._;.::_.,- ..

CoNDENSED REPORT oF SERVICES IN CouNTIES WITH PuBLIC HEALTH NuRSE, BY CouNTIEs-194,0-Continued

Candler

Effingham

East Central Region
~---
Emanuel Glascock Johnson

Screven

Twiggs

S. W. Region

Baker

Lee Seminole

COMMUNICABLE DISEASE CONTROL
Admissions to medical service ------------------ -Consultations with physicians-----------------Pield visits ---------------------------------- 56 Smallpox immunizations ---------------------- 604 Diphtheria Immunizations _-------------------- 463 1'ynhoid Ilnmunizations ---------------------- 1779

VENEREAL DISEASE CONTROL 48
Clinic visits ----------------------------------- 218 lj\ield visiLs ----------------------------------- 32
182

TUBERCULOSIS CONTROL

Admissions to medical ser\rice ---------------- __ --

Admissions to nursing service-----------------_ 83

Clinic visits ---- ----------------------------

53

Field and Office visits-----------------------~-

113

MATERNITY SERVICE

Admissions to medical service __________________

25

Admissions to nursing service------------------ 46

Visits by ante-partum cases to medical conferences 45

Field and Office visits ----------------------- _ 115

INFANT HYGIENE

Admissions to medical service------------------

6

Admissions to nursing service ----------------- 41

Visits to medical conferences ------------------

7

Field and Office 1'isits -------------------~-----

77

n --
30 808 428 1338
94 850
21 786
--
138 114 196
112 189 177 475
41 75 56 222

3
86 137 209 3005
2 5 8
--
103 82 304
--
40
--
105
1 13
1 24

62

437

15

12

3

253

--

--

2

1

2

5

10

--

20

806

136

10967

15

424

266

1437

647

232

541

70

394

241

729

568

595

136

180

85 1:--<

767

38'00

4808

1858

1706

567

-"'"' 1943

0

1

150

23

--

178

331

i::t:
ell

1
--

769

--

10

35

--

1565 115

"s': 3317 900

1

644

35

--

1325

9 3479

--

--

1

25

108

115

117

75

1

60

33

146

85

12 24 13

87 106
90

~
rt
"'~.

31

197

149

162

433

51

391

0 :;::1

"'

31

--

20

9

106

199

98

119

33

38

56

211

243

120

41

--

34

9

173

354

404

273

112

65

91

611

518

664

--

--

--

20

91

30

l4

3

6

76

92

20

--

--

--

13

176

84

47

4

14

291

178

47

CJ~

-._]

-.-.~~- :

CoNDENSED REPORT OF SERVICES IN CoUNTIES WITH PUBLIC HEALTH NURSE, BY CoUNTIEs-1940-Continued

East Central Region
__;,
Candler Effingham Emanuel Glascock Johnson Screven

PRESCHOOL HYGIENE

Admissions to medical service

Aclmissions to nursing service

14.

2

Visits to medical conferences-----------------_

8

Pield and Office visits _______________________ _ 14.

12

10

Dental Inspections

SCHOOL HYGIENE Inspections bJr physicians or nurses Exam!naiions by physicians Admissions to nursing service-----------------Field and Office visits IJental Inspections

568 16
3 7
9~7

46

36

ADULT HYGIENE Medical examinations

MORBIDITY SERVICE

~ledical visits

~ursing visits

4.

39

{j

102

22

Admissions to hospitals------------------------

SANITATION Water supplies a(Jproved______________________ _

Privies and septic tanks installed

1

19

40

1

2

Food handling establishments reg. _____________ _

Dairy farms registered-------------------------

Milk !llants registered -------------------------

Field visits ----------------------------------- 25

til

:!1:!

ll

23

24

LABORATORY SPECIMENS SIJecirneus examined

4.02

1126

380

367

450

853

S. W. Heg.: n

' Twiggs { Baker

Lee Semincl.

66

13

66

18

97

44

97

170

1

6

10

372

323

693

16

36

58

19

171

75

10

411

26

2

18

30

30

51

16

352

H~

:,Is

J6XX

CJ.:l 00
c<":l
~
0
~s
t;
~
!;:>
a~
-~
~
:
~
1:!::
s~.......

& - __ ~-

._.~;~>!' ~-

CoNDENSED REPORT OF SERVICEs IN CoUNTIEs WITH PuBLic HEALTH NURSE, BY CouNTIEs-1940-Continued

--
S. E. Region

----
Atkinson Bacon Brantley Bryan Charlton Echols Lanier Liberty

Long Pierce Toombs

COMMUNICABLE DISEASE CONTROL Admissions to medical service ___________ 358
Consultations with physicians---------- 4
Field visits ---------------------------- 359 Smallpox immunizations -------------- 1834 Diphtheria immunizations -------------- 244 Typhoid immunizations ---------------- ..2052

35
--
42 815
207 1551

VENEREAL DISEASE CONTROL

Admissions to medical service----------- 86

68

Clinic visits _________________________:__1491

715

~'leld visits ---------------------------- 175

49

No. clinic treatments --------------------1479

661

TUBERCULOSIS CONTROL

Admissions to 111edical service ___________ 75

60

Admissions to nursing- service -------- 165

79

Clinic 1'isits -------------------------- _ 163

61

Field and Office l'isits------------------ 344

105

MATERNITY SERVICE

Admissions to medical service ---------- 78

18

Admissions to nursing se1vice ---------- 153

31

Visits by ante-partum cases to

medical conferences ------------------ 153

24

Field and Office visits------------------ 461

41

INFANT HYGIENE

Admissions to medical service------------ 13

4

Admissions to nursing service___________ 71

5

Visits to medical conferences ----------- 17

6

Field and Office visits ----------------- 179

8

14 3
26 353 196 2121
27 159 39 86
69 142
69 215
15 91
19 205
--
45 1
77

10

64

38

--

--

13

llO

50

167

454

153

153

176

174

72!i

822

1308

28

135

72

38

2066

640

3

264

20

34

206(}

470

27

6.".

33

167

85

78

45

75

33

23"6

212

218

16

70

14

83

230

35

34

177

36

149

476

113

2

78

13

40

179

20

3

140

27

51

316

46

165

2fi

32

5

223

64

344

859

294

164

929

2208

107

168

917

2111

162

138

911

1703

132

74

242

27

155

162

387

79

31

150

123

133

81

209

207

22

7

106

37

21

7

128

63

71

37

--

8

1

--

205

58

--

256

33

4

94

206 [-<

6

2064

1343 0
C"l

~

40

73

197 t:t:

126

1305

"' 1977 .~......

1l

179

87 So

126

1248

1831

<:::l

~

32

84

2

78

156

f;t~

2 11

69 305

158 437

~
"0"'""'

;:!

"'

6

64

92

7

121

137

12

226

241

4

431

320

3

37

6G

5

66

77

6

57

125

2

138

202

CXJ

'D

--~..<.:

CoNDENSED REPORT OF SERVICES IN CouNTIES WITH PuBLIC HEALTH NURSE, BY CouNTIEs-194.0-Continued

;--
Atkinson

Bacon

Brantley Bryan

S. E. Region Charlton Echols

Lanier

Liberty

..,.
0 Long Pierce Toombs

PRESCHOOL HYGIENE

Admissions to medical service___________ 2

3

Admissions to nursing service___________ 33

3

Visits to medical conferences ____________

3

Field and Office visits------------------ 35

3

Dental inspections -------------------- - --

--

--

SCHOOL HYGIENE

Inspections by physicians or nurses ______ 440

39

1686

Examinations by Dh:Ysicians ----------- 421

Admissions to nursing service______________ 52

1

1

Field and Office visits ------------------ 83

1

1

Dental inspections ---------------------

62ri

1299

ADULT HYGIENE
!\tedical examinations ------------------ --

MORBIDITY SERVICE
Medical visits ------------------------- 15 N"ursing visits ------------------------- 51 Admissions to hospitals _________________ 3

4

129

6

SANITATION

\Yater supDlies approved --------------- 4

3

Privies and septic tanks installed ______ -- 24

2

2

~'ood handling establishments reg________ --
Dairy farms registered__________________

Milk Plants registered------------------_

ll'ield visits ---------------------------- 166

31

204

LABORATORY SPECIMENS

S11ecimens examined -------------------- 74.9

965

447

11

--

221

4

234

--

794

956

--

3

5

1267

s

13

11

--

4

--
2
6
--

57

:n

342

276

NOTE: Screven County began Olleration as a nursing county February 1, 1940. Liberty County began overa.tion as a nursing; county Allril, 1940. Bu.Us County began overaHon as a nursing county June 24., 1940. Candler County began operation as a nursing eounty July 22, 1940. Glascock and rrwigg~-; Couniies began operation as nursing eounties August, 1!!40. Douglas County began operation as a nursing eounty September, 1940. Long Couut;r began operation as a nursing counly October, 1940.

18

12

2

45

22

13

12

2

42

27

--

--

--

2:32

1237

1

73

12

33

4

H

H

7

770

7

96

<IS

:l

253

484

S!J

1

--

l4 478
88 4

Hi

10

810

545

818

1037

2

29

3

101

2

!lti

1

146

--

68

4!1

2

3

J

10

H

SH

--
l 4u
l

--
--

23

2R

;!:I

147tl

!j(i
u:-:
111 131

'7'"l

"0 '

520

~
ll"<i

2 :';":,'

2~

19

b
ct

:;

eg'"<;:j

~"'

4 --0....

21 ~

;~;:;

8 350

:::;::
"':;:,
~" -

04R

G3.J

Division of Public llealth Nursing

Abbie R. Weaver, R.N., Director Elsie Crosby, R.N.

Instructor

The year 1940 saw the addition of 57 public health nurses to the slate, city, and county health departments and an e::tension of service to 13 new counties. The year closed with a total of 258 nurses on the staffs of official health agencies as compared with 20 _ at the same time a year ago. New services were established in the following counties:

Bacon Bryan Butts Candler

Douglas Fulton Glascock Jasper Lee

Liberty Long Screven Twiggs

Sixty-five counties are still without nursing service of any kind. Of this number, three have completed arrangements for the employment of a public health nurse and are awaiting the assignment of personnel.

In addition to actual growth in service, there has been throughout the

....,

year a steady strengthening of existing services by the appointment of

supervising nurses in several of the larger counties and the cutting down

of the unit of population carried by a nurse in a number of counties.

On February 15th a supervising nurse was appointed to the lYluscogee County Health Department and on September lst a supervising nurse was appointed to the district composed of Glynn, Camden, and Mcintosh counties which is being seTVed by a staff of l l nurses. Hall, Thomas, and Floyd counties provided for an increase in staff from two to four nurses, one nurse to be designated as senior nurse. Hall and Floyd counties are still awaiting the assignment of the fourth nurse.
One of the outstanding developments of the past year was the provision on January lst by Fulton county for the service of 20 staff nurses and a nursing supervisor. By the end of the year this entire staff had been secured. An arrangement has been completed between the State Department of Health and the Fulton County Department of Health for the use of the county as a rural teaching :field foT public health nurse lTainees. Peabody College has accredited this field and the :first students will be assigned on January l, 1941.
On July lst pTovision was made by the State Department of Health for the assignment of a Reserve Nurse to each of the six regions, this nurse to devote a major portion of her time to the syphilis control program. At the close of the year nurses had been appointed to five regions. The nurse foT the sixth Tegion is taking a special course in syphilis control work and will report on March lst.

42

Georgia Department of Public Health

On August lst Miss Theodora A. Floyd joined the staff of the State Department of Health in the capacity of Maternal and Child Hygiene Consultant.
On December 31st Georgia had the following public health nursing staff connected with official agencies:
Director -------------------------------------- l Associate Director ------------------------------ l Maternal and Child Hygiene Consultant ___________ l Regional Consultant Nurses_______________________ 6 Regional Reserve Nurses_________________________ 5 Nurses in County and City Health Departments______ 200 Nurses in Unorganized Counties______ __________ 42 Nurses provided by Farm Security Administration___ 2

258

In addition to the above staff there were approximately 132 nurses connected with non-official agencies. Of this number about 70 are employed as industrial nurses and 23 serve on the staff of the Metropolitan Life Insurance Company. Georgia, therefore, has an approximate total of 390 public health nurses.
The turnover in staff during the year was comparatively small. Ten nurses, or 3.7 per cent of the total, resigned.
EDUCATION OF PUBLIC HEALTH NURSES
During the year, 91 nurses were chosen for training and were assigned to the following colleges for courses in public health nursing:
George Peabody College___________________________ 76 University of Michigan ____ ---------------------- l University of Pennsylvania------------------------ <1. Teachers College, Columbia University_______________ 3 Medical College of Virginia_______________________ 7
There is an increased tendency on the part of trainees to remain in college beyond the six months' training period provided by the State, in order to complete the work required for the certificate in public health nursing or Bachelor of Science degree. The academic and professional qualifications of the trainees of 19<1.0 were superior to those of any preceding year.
During the year Tift and Thomas counties in south Georgia have been used as accredited teaching centers. The first students were assigned by Peabody College to these two counties in January and in the course of the year 26 students have received training in these two south Georgia counties.
In-service education for the nursing staff was provided during the year through quarterly conferences of the staff nurses in the various re-

1

Public Health Nursing

43

gions. These conferences were supplemented by two-day institutes held the last week in November and the .first week in December in Atlanta, Augusta, Savannah and Albany. Miss Theodora A. Floyd served as leader of these institutes which centered around the topic "The integration of the Maternal and Child Hygiene Service into a Complete Family Public Health Nursing Program." The attendance was 301.
STATISTICAL REPORT 194-0
The report of accomplishment by the public health nurses appears in the statistical report submitted by the Division of Local Health Organizations.
A study of this report shows that marked gains were made in the volume of service rendered by the public health nurses of the stale in 19'!0 as compared with 1939. The services in which the most significant gains were made are venereal disease control, cancer control and maternal infant hygiene.
The number of cases of syphilis receiving care increased from 19,557 to 29,262 and the number of nursing visits made to these cases increased from 27,288 to 37,681, representing an increase of 50% in cases carried and 38% in service rendered.
In the maternal infant hygiene service the number of prospective mothers given nursing care increased from 17,622 to 21,229 and the visits to these patients from 64.,565 to 76,976; there was an increase of from 10,059 to 14,909 in mothers receiving postpartum care and from 29,252 to 3'1,630 in visits to these patients. Infants cared for by the public health nurses showed a gain from 19,430 to 25,050 and the visits in this service a gain from 48,032 to 59,635. The total number of cases carried in the maternal infant hygiene service increased 33% and the visits made in this service 20%.
In the cancer control program the nurses cared for nearly twice as many patients as in the preceding year, the number increasing from 220 to '13'1; the home visits to these patients increased from M5 to 1,0M.
Slighter gains than those commented on above are to be noted in the tuberculosis service and the morbidity service.
In looking ahead it is difficult to anticipate the demands which will be made for increased public health nursing during the coming year or to foresee the readjustments in the nursing service which may be necessary as a result of the withdrawal of both public health and private physicians to army service. It is quite certain that an increasing number of rural counties will be left with very inadequate medical care and that the services which will suffer most are those which are of the greatest concern to the public health muse, namely, maternal and child health and communicable disease control.
It would appear that midwife supervision would be more important than it has at any time in the past clue to the fact that, for lack of medical service, an even larger number of mothers will have to depend upon the

44

Georgia Department of Pnblic Health

midwife for care. This increased demand for service comes at a time when the actual number of pTacticing midwives is constantly decreasing and their efficiency is being steadily decreased due to advancing age and physi cal disability. It would appear that the provision of skilled and safe obstetrical service will constitute one of Georgia's major health problems during the coming year. Another important demand for nursing service
will be assistance in the health supervision of the civilian population in
the interest of communicable disease control, especially around army training camps. Nursing service will be increasingly needed in the control of venereal diseases.
In view of the fact that the army will require 4,000 nurses by July lst to staff military hospitals, it will probably be difficult to find a sufficient number of new nurses with all the qualifications desired. Every effort will be made to increase the number of nurses available for service and to make the service of every nurse as effective as possible.

1

Division of Public llealth Engineering

L. lVL Clarkson, C.E., Director

W. H. Weir, B.S.

Associate Director

The Division of Public Health Engineering is one of the twelve divisions of the Georgia Department of Public Health functioning as a highly specialized service to the Department. As in every state health department, this Division conducts investigations, studies, and planning of such projects involving engineering for health protection.

There are certain diseases which may be prevented by improvement of the local sanitary environment and also involving water, food, and insects: namely, typhoid, paratyphoid, the dysenteries, cholera, septic sore throat, undulant fever, scarlet fever, dengue, yellow fever, malaria, typhus, and hookworm. Public health engineering service must always be available in order to control those diseases which are now prevalent and others which may be potential in the future.
In the southern or Coastal Plain section of the slate, certain of these diseases constitute problems of exceptional public health and economic importance. Economic loss from these diseases amounts to millions of dollars annually.
The northern or Piedmont Plateau section embraces the area of predominating public water supplies derived from surface streams necessitating water filtration plants. This, of course, involves the correlated problem of returning to the streams, necessary as sources of water supply, the used water in the form of sewage. In this section of the slate, satisfactory progress has been made in properly treating sewage before discharging into the creeks and rivers.

i

In effectuating the objectives of the Division, it is necessary to have

I
I

connecting channels of interchange of technical and administrative thought and development with national professional and scientific organizations

I
I

for establishing public health engineering principles. These national organizations are composed of persons giving freely their time and ability in contributing to this common fund of recorded inormation. In receiving

the benefits there exists the obligation to participate in the constant

enlargement of this common store of available technical information.

Staff members consider it a privilege and duty to serve on boards and

technical committees of organizations whose influence on accepted prac-

tices is universally recognized. Members of the Division staff are cur-

rently serving on governing boards and technical or advisory committees

of the followin~ organizations:

Chairmanship, Governmental Relations and Engineering Sub-Committees, National Malaria Committee. Past Chairmanship, National Malaria Committee.
Water Works Practice Committee, American Water Works Association. Governing Board, Federation of Sewage Works Association.

<1.6

Georgia Department of Public Health

River Basin Sub-Committees, National Water Resources Committee. Mosquito Control Committee, Conference of State Sanitary Engineers. Membership Committee, American Public Health Association. Membership
Governing Council, Southern Branch, American Public Health Association.

""~ ' '
30
::::,.._,
2.,
K7
20
I!>
10
.,

"N
~
I
,. __ ~ /i\ r \ 7 r-~/

YEAR
c-----~ " ~ :---

0

OJ ~ ~
30

25

20

I

-~ ~

I0
-:_~
:-=: ~ -....,
0

w

w

1-
{ oc

TYPHOID DEATH RATE

~
cr:

!i

I

1-

{
w
0

DEATH RATE TREND 1921-1940

~
w
0

A general outline of the servlces rendered by the Division of Public Health Engineering:
Public health supervision of municipal, institLitional, public and semi-public recreational, and industrial village water works and sewerage. This includes the review and approval of engineering plans and specifications and the control of methods of water purification and sewage t1eatment plant operation.
Field work and recommendations to the United States Public Health Service for certification of drinking and culinary water used on interstate carriers.
Bacteriological examination of water samples hom public and semi-public water supplies.
Collection and utilization of stream pollution data.
Sanitary improvement to swimming pools through approval of design and assistance in operation.
Improved sanitary protection to private water supplies in rural areas. Annual school for instmction of water and sewage plant, and swimming pool operators. Construction of rural and urban sanitary privies and home sewage disposal plants. Assistance to local health depmtments for improvement of milk production and distribution. Malaria surveys resulting in plans, specifications and supervision of drainage projects and other methods of malaria control.

Pnblic fJealth Engineering

47

Control of impounded wate1 areas for malaria prevention, including hydroelectric development and othet impoundments.
Typhoid, hookworm, and malaria investigations preceding promotion and supervision of rural and community sanitation with assistance from Federal agencies.
Selection and nomination of engineers and sanitarians for assignments to organ ized county and district health departments rendering local service in planning and advice to such personnel in matters of public health engineering and general sanitation.
Cooperation with other divisions of the Department for investigations of disease prevalence and control measures.
Sanitation investigations, surveys, maps and reports for the purpose of future planning for public health engineering and disease prevention.
Improvement of water supplies and sewage disposal for schools. This includes a general school sanitation program.
Operation of slate sanitary bedding law passed in 1937 providing for inspection and licensing of manufacturers and renovators of mattresses and other articles.
Coope1ation with State and Fede1al Administration agencies in public works, homesteads, national resources developments, national parks, etc.
Other miscellaneous sanitation problems invo}yjng action necessary for health protection.

WATER SUPPLIES, SEWERAGE AND SWIMMING POOLS
The exercise of the general powers of supervision of the Department of Public Health in all matters pertaining to public water supplies and sewerage systems is one of the major duties of the Division of Public Health Engineering. Administrative, technical and instrucitve duties are required in this branch of public health supervision. This supervision covers municipal, institutional, recreational, and industrial village water supplies and sewerage systems. Swimming pool sanitation also receives the same kind of supervision rendered in an advisory and recommendatory manner.
There is being developed a program of assistance to new and prospective industries having stream polluting wastes to locate them where minimum waste treatment will be required. This program seeks to utilize to the best economic and public health advantage the natural stream resources in the industrialization of this state. Georgia's several geographic sections can supply raw materials and skilled workers for many types of industries. The proper choice of location for manufacturing plants producing objectionable liquid process wastes will eliminate many troublesome problems and reduce ultimate production costs. Proposed plant processses are studied and calculations made to determine the probable effect on streams of different flow and various usage characteristics. Adherence to a zoning plan of this nature will make for an orderly and rational location of those industries directly depending upon the streams for both water supply and disposal of process wastes. Protection to municipal water supplies will 1esult from the effectuation of such a long-range plan of new industrial plant location.
This plan dovetails with customary procedure in investigating streams proposed for use as municipal water supply sources. Stream studies are

48

Georgia Department of Pztblic Health

necessary in each case to determine present bacterial and organic loads as well as the volume of water available. When a stream becomes a municipal water supply source constant vigilance is required to maintain raw water quality and every effort is made to effectuate improvement.
The element of instruction in the maintenance of sanitary facilities is a part of all of the public relations of this Division. Trained and experienced personnel gives instruction in the operation and control of water purification, sewage treatment and swimming pool processes in the cities and towns of the state. Local personnel is trained in the operation of the particular equipment or process for which they are responsible. Reports of plant operation are submitted to this Division and are carefully and regularly reviewed to determine the efficiency of purification processes. Representatives of towns operating water and sewage treatment and swimming pools assemble once each year in Atlanta for group instruction.
Annual Water Works, Sewerage and Swimming Pool School
The Ninth Annual Water and Sewerage School conducted by the Division of Public Health Engineering in cooperation with the Georgia Water and Sewerage Association and the Public Health Department, Georgia School of Technology, was held in Atlanta. The classroom and demonstration work was supplemented by an observation trip to Marietta, Tubize Chatillon Corporation, Rome, Berry Shcools, and Cedartown to study water works and sewerage developments in the industrial section of northwest Georgia. A special feature was a demonstration of portable water purification equipment developed for Army .field use. The total attendance at this four-day course of instruction was 3L13, over 92 per cent of the men being either associated with water and sewage plants in Georgia municipalities and industrial villages or engaged in public service. Based on
written examinations and experience qualifications, the Georgia Water and Sewage Association isssued certificates to persons demonstrating a satisfactory knowledge of water purification and sewage treatment.
Certification of Water Sztpplies for Interstate Carrier Use
All investigations, studies, recommendations, and inspections regarding improvements to public, semi-public, and private water supplies used for drinking and culinary purposes on interstate railway trains, vessels and airplanes were made by the Division for the United States Public Health Service. Certification action was taken on 49 supplies in 1940. Of this number, L14 received favorable and 5 provisional certification.

GEORGIA SEWERAGE SYSTEMS
DEPARTMENT Of PUBLIC HEALTH DIVISION OF SANITARY ENGINEERING
JANUARY 19~1
LEGEND

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Pztblic fl ealth Engineering

49

Recapitztlation of Public Water Sztpplies to December 31, 1940

Number

Percentage PopL!lation Percentage Population Using Public Total State (1940 Census) Supplies Population

Supplies receiving both filtration and
chlorination (including softening and iron Temoval plants _______ 89

807,800

61.3

25.9

Deep wells, shallow wells and spTings chlorinated --------------------- 94

333,800

25.3

10.7

Deep wells, shallow wells and springs

not chlorinated ---------------- _ 182

177,600

13.LJ.

5.7

Total public water supplies ----~-- 365

1,319,200

100.0

42.3

Water from home wells and springs

in rural areas and villages without

public water si1pplies --------------------- 1,80LJ.,500

57.7

Total for State ---------------------- ------ 3.123,700

Tf7ater and Sewerage for Army, Navy, and Defense lndztstry Projects
The latter half of 1940 was the initial period in the greatly accelerated National Defense Program. This period witnessed the first stages of preparation of many new troop training camps and reception centers for the mobilization of the National Guard and to receive for army training recruits through enlistment and the operation of the Draft Act. The construction of Army camps under emergency conditions such as currently apply is an enormous undertaking and severely taxes all agencies and communities involved. Defense housing projects to accommodate the families of soldiers and defense iridustry workers are being developed near certain types of the new establishments. The influx of great numbers of construction and other civilian workers into communities near defense projects causes public health engineering problemstypical of sudden and unexpected population increases. Army camps in Georgia are being constntcted to train a relatively large portion of the armed forces of the United States. Camps in this state will receive men hom many ot}ler states and the number to be trained in Georgia far exceeds that to be. drawn from Georgia communities. There will be a large population increase concentrated in certain areas of Georgia.
At the close of 1940 the department is effectuating a close relationship with the federal agencies which will construct and administer defense housing projects to he built near troop centers and industrial plants. The protection affmded by adequate supplies of pure water and safe sewage treatment will apply to defense establishments in Georgia. Adjacent civilian communities will he protected against stream pollution. The Department will continue its active cooperation with all national defense agencies fm the mutual protection of both military and civilian populations against diseases which can be prevented through the application of public health engineering.

50

Georgia Department oj Public Health

A brief description of the current status of water and sewerage construction in the major national defense projects follows.
Camp Toombs~ near Toccoa, is being constructed for the Georgia National Guard to accommodate 2,500 men. Water is to be provided from a surface source. The purification system includes coagulation, sedimentation, filtration, sterilization, and chemical control laboratory. A complete distribution system for the camp area is prorided. Sewerage to be provided includes sewers and sewage treatment plant consisting of coarse screening, primary settling, separate sludge digestion, open sludge drying beds, trirl\ling filter and secondary clarifier.
Savannah Air Base, at Savannah, is being constructed fo1' use as an Army air base with housing facilities for 3,800 men. Water is obtained from deep wells and is cl1lorinated before purnping to distribution system and elevated storage. The area is completely se\l'ered and the sewage plant consists of comminutor, prinwry settling, separate sludge digestion, open sludge drying beds, activated sludge (diffused air), and secondary settling. Provision has been made for pre- or post-chlo1ination. Control laboratory equipment is to be provided.
Camp Stewart, near Hinesville, is under construction for use as au .A..rmy anti-aircraft fraining station for approximately 18,000 men. Water is obtained from two deep wells and pumped to extensive distribution system and elevated storage. 'l'he camp area is sewered and sewage treatment will include coarse sereening, primary settling, separate sludge digestion, open sludge drying beds, tricl<ling filters (bio-filtration), and secondary settling. Control laboratoi'Y is to be provided.
Camp Wheeler, near Macon, is under construction for the Army and will accommodate approximately 18,000 men. Water will be piped from the Macon city system, and additional elevated storage is to be constructed at the camp site. The sewer system will terminate in a sewage plant consisting of coarse screening, primary settling, separate sludge digestion, and open sludge drying beds. Pre- or post-chlorination will be possible. Control laboratory will be included.
Fort Screven, on Tybee Island-Regular Army post of the coast defense system will be provided 'iVith sewage treatment facilities.
Fort Benning, near Columbus. 4th Division Area-Camp constmction completed. Water is piped f1om tlle Fort Benning supply. 'fhe area is sewered and sewage receives primary treatment followed by a trickling filter.
Fort Benning, near Columbus, 2nd Armored Divjsion Area, is under construction and will PI'OYide facilities for 9,000 men. Wate1 is piped from the Fort Benning supply. The area will be completely sewered and the sewage plant will include coa1se screens, I1nhoff tanlm, open sludge drying beds, and tricl<ling filter. The effluent is to be pumped to Upatoi Creek discharging at a point below the Fort Benning water intal~e.
Navy Fuse Plant, near Macon, will employ approximately 1,000 men. Water is to be piped ?rom the l\Iacon city supply. Sewers and adequate sewage treatment will be requiled.
Avondale Air Base, Bibb County, to be used by the Army for about 2,000 men. Probably will 'use deep well water. Se'ivers and sewage treatment will be necessary.
Navy Air Base, Oel<alb County, is under construction aml when completed will house about 50~ men. \Yater initially will be supplied from Decatur and eventually from the De!{a!b County water system. Sewage service wlll be provided by the Atlanta metropolitan systems.
Lawson General Hosuital, Del<alb County, is under construction and will Pl'ovide SlJace for 2,000 beds. Watel' initially will be supplied from Decatur and eventually from the Del(alb County water system. Sewage service will be provided by the Atlanta metropolitan systems.
Georgia National Guard Air Unit, Del<alb County. Construction for this unit is contemplated. Water initially will be supplied from Decatur and eventually from the Del(alb County water system. Sewage disposal will be provicled by the Atlanta metropolitan systems.
Atlanta General Depot, near Atlanta, with 1,000,000 square feet of storage space under roof is being constructed. Water will be piped from the Atlanta metropolitan system and the sewage plant will consist of coarse bar screen, Imhoff tank, open sludge drying bed, triclding filter, and secondary settling.
Augusta Air Base, at Augusta, with quarters for appmximately 2,000 men will receive water and sewerage service from the Augusta systems.

Public Health Engineering

51

Albany Air Base, near Albany, for approximately 2,000 men will be supplied with water from the public water supply of Albany. A separate se,wer system and adequate sewage treatment .:will be necessary.

Progress in Water W arks, Sewerage, and Swimming Pool Constntction

Emphasis on the promotion of construction of new water and sewerage

systems and sanitary swimming pools in municipalities has continued in

19L1Q. These essential public health services are continually being strength-

ened, enlarged and extended in Georgia municipalities, suburban areas,

industrial villages and institutions. Additional safeguards have been pro-

vided to increase the factor of safety from water-borne diseases. Progress

has continued in stream pollution abatement through sewage and indus-

trial waste treatment plant construction.



Dming 19L10 the first rural waterfication projects were begun. Several rural communities under county sponsmship or cooperative e:ffmt have undertaken extensive water distribution systems to provide safe water service for rural homes. This is a great forward step in bringing protection and convenience to homes hitherto deprived of this service because of being too far from a municipal water supply to undertake the construction of an individual water line.

Plans and specifications have been examined and approved for 134 municipal or other community projects.

Water supplies and water purification________________ 67 Sewerage and sewage treatment_ ____________________ 65
Swimming pools -------------------------------- 2

TotaL _____ l34
There follows a descriptive list of projects currently planned, under construction, or completed during 194,0 in municipalities and other communities.

Water W odes for Towns Not Previously Having Water W arks
Chattanooga VaJiey-\Nater distribution system to be served f1om adjacent municipality, includes pipe system and elevated storage. Plans approved in 19<10. (W.P.A.}
Cobb County, Sanitary District No. 1---Water distribution system to be served from adjacent municipality, construction to begin early in 19<11. (W.P.A.}
Del<alb County-Preliminary plans approved for construction of water supply system to serve part of county and all of City of Decatur. Includes raw water pump station on Chattahoochee River; reservoir; coagulation, sedimentation, filtration, clear water storage, and transmission main extending to the Decatur citr limits. (W.F'.A.}
Holton, Georgia Power Company-'\Vater purification system including coagulation, up-flo\o.,, clarification basin, filt1ation, sterilization, ehemicttl laboratory. Supplying water to industrial plan& and village. Completed in 1940.
Irwinton-Deep well, pressure tank, and distribution system. P1irately owned public \Vater supply. Population 589.
J(ingston-Deep well, elevated tanl1:, and distribution system, under construction. nr.P.A.) Population 653.
Pine Lake-Plans and specifications for drilled well approved in 19,10. Construction not started. Population 88.

52

Georgia Department of Public Hectlth

Rhine-Deep well, elevated tank, and distribution s:rsten1, under construction. (W.P.A.) Population 463.
Walker County. Fairview Community-\Vater distribution system serred from adjacent municipality. Completed in 1940.
Additions and Improvements to Existing Public Water Supplies
Atlanta-New filter units added to present gravity filter plant. Chemical and bacteriological laboratories remodeled. Extensive \Yater main additions and improvement as "\Y.P.A. project. Population 302,283.
Austell-Improvement and addition to filtration plant. Plans amHored, construction not started. CIY.P.A.) Population 1,229.
BarnesvHie-\Yater main extensions. C\Y.P.A.) Population iL;-)35. BaxleY-Water main extensions. (IY.P.A.) Population 2,016. CarroiJton-Xew mixing and settling basin to replace inadequate facilities. lJnder construction. (\Y.P.A.) Also \.Vater main extensions. Population 6,211. Bulloch County-Water main extensions. (\V.P.A.) Columbus-Water main extensions. (W.P.I..) Population 53,280. Commerce-Complete reconstruction of filtration plant including coatnllation, sedimentation, filtration. sterilization, clear water storage and chemical laboratory. Construction begun in 19,10. (W.I'.A.) ropnlation 3,20'!. Dalton-\Yater main extensions to extend and improre distribution system. Also constructed concrete cover for existing elevated storage reservoir. (\Y.P.A.) Population 10;1<18. Darien-Sterilizing equipment installed on previously unsterilized water supply. Population 1,015. Del<alb County-\Yater main extensions. (W.P.A.) East Point-Plans on proposed surface \Yater supply approved. lncludes raw water storage basin, modern filtration plant and concrete ground storage, with complete bacteriological and chemical laboratory control. This treated surface supply is to replace inadequate ground water supply. (W.P.A.) I'opulation 12;103. Ellijay-Xew drilled well to supplement gravity spring supply. Sew sterilizing equipment with flow-meter control installed. Population 1;197. Fitzgerald-Watel' main extensions. (W.P.A.) Population 7,383. Fort Mountain-State Park-\Yater supply system for day-use area. Georgia School for Mental Defectives. Gracewood~'l1 wo new \Yells and two elevated storage tanJ.;:s. Also "ater distribution systems. Population 500. Hapeville-Water line extensions. (IY.P.A.) Population 5,059. Jefferson-Xew sterilizing equipment to replace inadequate installation. Population 1,839. LaFayette-Water main extensions. (W.P.A.) Population 3,509. Macon-Water main extension and one million gallon elevated storage. (W.P.A.) Population 57,865. Magnolia Sr1rings-State Pari<-Water supply system for parl< area. Monroe-:\'e\V sterilizing equipment to replace inadequate installation. Population 4,168. Milledgeville, Georgia Training School for Boys-\Yater main extensions. (W.P.A.) Population 500. Milledgevi1Je-:.\1odernization and enlargement of water purification plant completed in 19,10. (W.P.A.) Population 6,773. Milledgeville State Hospital-Water plant impronments completed in 19,10. Population 6,000. Rome-Inadequate filter plant replacecl by new purification plant providing pre-chlorination. coagulation. sedimentation, filtration, sterilization and new laboratory for chemical and bacteriological control. Completed in 19'10. (W.P.A.) Population 26,282. Sandersville-?-rew well with concrete ground water storage and new sterilizing equipment. Installation completed in 19,10. Population 3,566.

Public Health Engineering

53

SociaJ Cirole-\Vater }nuHication plant to include chemical treatment, coagulation, sedimentation, filtration, clear water storage and chemical laboratory control. This treated surface supply is to furnish the town which now purchases \Vater frmn an adjacent water supply system. Population 1,735.
Summerville-Water main extensions. Population 1,353.
Sylvester-Water main extensions. (W.P.A.) Population 2,191.
Union Point-\Yater main extensions. (W.P.A.) Population 1,566.
Washington-Complete reconstruction of water purification system to replace obsolete plant. Includes raw water storage, coagulation, sedimentation, filtration, sterilization, clear water storage and chemical laboratory. Plans approved in 19<10, construction not begun. (W.P.A.) Population 3,537.
Waynesboro-Water line extensions. Population 3,793.
West Point-Water main extensions. (W.P.A.) Population 3,591.
Sewer Systems in Towns Not Previously Hcwin.g Sewerage
Cadwell-Sewer system and primary treatment plant under construction. (W.P.A.) Population 291.
Cave Spring-Georgia School for the Deaf-Construction c'?mpleted on Peny l!'arm Annex sewers and sewage plant consisting of primary treatment and sludge bed. (\iV.P.A.)
Rochelle-Plans and Sl)eclfications approved for sewer system and sewage treatment plant to consist of }HllllPS, coarse bar sc1een, Imhoff tank, open sludge drying beds, and trickling filter. (W.P.A.) Population 1,115.
Savannah Beach-Plans and specifications apprO\red for se\ver system and sewage plant. Due to topography and ground water conditions the sewer system includes 8 pump stations. Sewage treatment will include coarse screening, primary settling, separate sludge digestion, and open sludge drying beds. It was necessary to provide, in the design, for unusual contributing population fluctuations as the winter population is 1,000 and the summer population is approximately 5,000.
Union Point-Constructing a se\ver system and sewage treatrnent plant consisting of coarse bar screen, Imhoff tank, and open sludge drying beds. (W.P.A.) Population 1,566.
New Sewage Treatment Plants on Existing Systems
Baxiey-Plans and sveeifications approved for extending the sewer system to serve an built up sections \rlthin city limits; and constntcting sewage plant consisting of pumps, coarse bar screen, Imhoff tank, and open sludge drying beds. (\Y.P.A.) Population 2,916.
Cornelia-Constlucting sewage plant to consist of coarse bar screen, primary settling, separate sludge digestion, open sludge drying beds, tricl<ling filter, and final clal'ifier. (W.P.A.) Population 1,303.
Demorest-Extending and combining outfall sewers and constructing sewage treatment l)lant consisting of Imhoff' tank and sludge drying bed. Provision is made for later addition of triclding filter. Construction completed. (W.P.A.) Population 320.
Fairburn-Construction completed on the north side sewage plant consisting of coars.e bar screen, Imhoff tanI\, open sludge drying beds, and tricl\ling filter. .A. similar nlant is under construction to serve the south side of town. (W.P.A.) Population 1,502.
Marietta-Plans and specifications approved for combining outfalls on the southeast side of town and construction of sewage plant consisting of coarse bar screens, primary settling, separate sludge digestion, trickling filter, and final clarifier. (W.P.A.) Population 3,667.
Tifton-Combination meat pacldng waste and sanitary sewage treatment plant consisting of pl'imary settling of the separate wastes, aeration and triclding filter for the meat pacldng waste, fonowed by a tricl\ling filter and final clarifier for the combined wastes. 'l~he sludge will be handled by separate sludge digestion and open sludge drying beds. Constnwtion completed. (P.W.A.) Population 5,228.
V/arm Springs Foundation-Extension of outfall sewer and construction of sewage treatment plant consisting of coarse bar sc!'een, Imhoff tan1;;:, and open sludge drying bed. Construction completed.

Georgia Department oj Public Health

Major Sewer Extensions in the Following

AC;worth

Cartersville

Fitzgerald

Ashburn

Columbus

Fulton County

Augusta

Dalton

Griffin

Bremen

Decatur

Hapeville

Cairo

DeKalb County Jesup

Carrollton

Dublin

Marietta

Millen Rome Savannah Summerville Waynesboro

New Public Swimming Pools and Improvements to Existing Pools
Adei-Conc1ete pool -.;;vith recirculating system and sterilizing equipment. Complete in 19<10. Population 2,134.
Atlanta-Fulton County, North Fulton Park-Concrete pool with recirculating system including chemical treatment, mechanical mixing, gravity filters, and sterilization equipment with laboratory. Complete in 1910.
Cedartown-Concrete pool \Vith recirculating system inclmllng chemical treatment, pressure filters, and sterilization. Completed in 1940. (negro} (\Y.P.A.} Population 9,02!i.
Clayton-Concrete pool \Vith recirculating equipment, chemical treatment, 11ressure fiHerg, and sterilization. Completed in 1940. Population 1,088.
forsyth-Concrete pool with recirculating system inelucling chemical tl'eatment, 11re;;sure filters, and sterilization. Completed in 19<10. Population 2,372.
Moultrie-Plans approved for concrete pool with l'ecirculating systHm including chemical treatment, pressure filters, and sterilization equipment. Population 10,147.
West Point-Concrete pool \Yith l'eclrculating system including chemical treatment, pressure filtel'S, and sterilization, under construction. C\Y.P.A.} I 'opulation 3,o91.

PUBLIC HEALTH ENGINEERING LABORATORY

This Laboratory serves to supplement the work of the Public Health Engineering Division by performing such tests, analyses or examinations of a physical, chemical or bacteriological nature as may be required in the general state-wide sanitation program. Most of the work done in this laboratory is coordinated with or related to :field inspections or data already on hand relative to the local situation involved.

The following examinations have been made during the year:

Bacteriological samples from public and semi-public

water supplies --------------------------- ll,22l

Bacteriological samples from private water supplies_ 8t18

Bacteriological samples from swimming pools____ 235

Chemical samples from various sources___________ 27

Sewage and stream pollution samples____________ 28

Miscellaneous -------------------------------

9

TotaL ________ 12,368
As in pTevious years, the large~ portion of the work performed consisted of the bacteriological examination of water samples from the public and semi-public water supplies throughout the State, including samples from many public schools.

100
v 95
/ 1\ I ""' 90
I \ v v"v" 85
v I r--v -- 80
- fz -
w
v (j
I v l 75
I I ""' 7 - a::
r---v w
a..
"" 70
v v I I 65
v I \ II 60 /

I

I

I

p:-- SURFACE. WATE.RS
FILTE.RE.D & CHLORINATE.D:::::

v.

~ 1'--...

v
,_

/
""-...V

~

GROUND WATE.RS CHLORINATE.D
1~1'---

' )..--

ALL SUPPLIE.S f--..---..j

J
' ...............
r--.

~OUND WATE.RS UNT:ATE.D

1---

1/

~

~v

1\

I

PER CENT GEORGIA WATER SUPPLIES

~.
g: r;: :::t::
E"':-
;:::-
1:>.-:i
~s
.""~.,''
!Jo.

55

v 1/

50 I'...

/

MEETING U.S.P.H.S. STANDARDS OF PURITY FOR YEARS SHOWN
IIIIII

1926 2'7

28

29

30

31

32

33

34

35

36

37

38

39

40

CJl CJl

YEAR

56

Georgia Department of Public Health

Water samples from all of the larger cities and towns and from many of the smaller towns were examined at monthly intervals. An attempt has been made to secure samples monthly from all public water supplies; however, as it is necessary to depend upon local officials for collection and transmission of samples to the laboratory, Iio samples or only a limited number of samples weTe received in some instances. This is shown as .follows:
Number of supplies submitting samples for:

10-12 Months 25L1,

6-9 Months Ll.l

1-5 Months 38

Total supplies submitting samples: 333 A study of the bacteriological quality of the waler produced by the public supplies in the State (based on samples examined in this laboratory) reveals that 276 supplies met the United States Public Health Service Standards of Purity. Fifty-two supplies failed to meet these "Standards." The population groups served by these fifty-two supplies were rather small in most cases.
As has been the case for the past fifteen years, that group of towns employing filtration and sterilization produced water of a better quality, as a whole, than was produced from otheT sources. This is shown as follows:

No. Supplies Supplies Meeting

Submitting U.S.P.H.S. Standards

Samples No.

%

Ground water supplies-untrea.tecL_____ 156

116

74.3

Ground water supplies-sterilized______ 94,

83

88.3

Surface supplies-filtered and sterilized 78

77

98.7

TOTAL_________ 328"

276

84.1

*Samples fl'orn five supplies were not inchJded in this table.

Several stream pollution studies were made during the year in connection with proposed water supply developments and to secure information on the efficiency of existing sewage treatment plants.
Laboratory personnel participated in a joint investigation of trade wastes from a large manufacturing plant in the State during the year.
Other activities included a study of some of the newer bacteriological media for detecting pollution in water; investigation of methods for collecting, dechlorinating and transporting swimming pool samples; and work on corrosion prevention, especially as applied to individual home water supplies.
No water-borne epidemics occurred in the state during the year.

Public Health Engineering

57

MILK SANITATION

Twenty-four communities and two counties in Georgia have adopted the U. S. Public Health Service Milk Ordinance and Code in which the standard method of conducting milk sanitation surveys by the milk sanitation engineer from the central office is being applied. This rating system provides an excellent method of determining improvements on a milkshed over a period of years and enables the citizens and officials to judge whether or not they are receiving health protection from milk sanitation. It also enables the dairy industry to inaugurate more effective campaigns for increased milk consumption. Nothing increases the prestige of and the demand for milk so much as a high rating, well publicized to the consuming public.
These ratings are compliance ratings and not safety ratings. The ratings do, however, represent the degree to which the community concerned has enforced sanitation requirements designed to make pasteurized milk and raw milk, respectively, as safe as these grades may practically be made. A high rating does not necessarily mean that all of the milk supplies sold in the community in question are safe, nor does a low rating necessarily mean that all of the milk supplies sold in a community are unsafe. Nevertheless, a pasteurized milk rating of 90 per cent or more determined by the Public Health Service method does mean that the pasteurized milk supplies in general of that community are as safe as a reasonably strict enforcement of the milk ordinance will make them.
The safest communities, from the standpoint of milk-borne diseases, are those in which all milk is pasteurized and in which the pasteurized milk rating is 90 per cent or more.
Milk sanitation surveys were made for the following cities in organized health counties:

City Atlanta Columbus Dalton Gainesville Hogansville LaGrange Milledgeville

County Fulton Musco gee Whitfield Hall Troup Troup Baldwin

City Millen Moultrie Quitman Statesboro Tifton West Point

County Jenkins Colquitt Brooks Bulloch Tift Troup

In addition, upon special request by city officials, surveys were made for Fort Valley and Sylvania in unorganized counties.
Cities and counties which adopted the Public Health Service Milk Ordinance and Code during 1938, 1939, and 19<1.0:

58

Georgia Department of Pnblic Health

1938
Griffin Millen LaGrange West Point Fulton Co.

1939
Statesboro Cordele Waycross Tifton Dalton Douglas Moultrie Crisp Co.

1940
Hogansville ___________Feb. 19 Rome ________________Mar. 18 Thomasville ___________Feb. 25

Total cities and counties operating under the Public Health Service Milk Ordinance and Code:

Americus Athens Atlanta Augusta Brunswick Cartersville Dalton

Douglas Gainesville Griffin Hogansville LaGrange Macon Millen

Moultrie Quitman Rome Savannah Statesboro Thomasville

Tifton Waycross Waynesboro West Point Crisp Co. Fulton Co.

During the past year assistance was rendeTed health depaTtments as follows:

Athens, Clarke Co. Atlanta, Fulton Co. Columbus, Muscogee Co. Dalton, Whitfield Co. Gainesville, Hall Co. Griffin, Spalding Co. Hinesville, Liberty Co. Hogansville, Troup Co. Jesup, Wayne Co. LaFayette, Walker Co. LaGrange, Troup Co. Macon, Bibb Co.

Milledgeville, Baldwin Co. Millen, Jenkins Co. Moultrie, Colquitt Co. Quitman, Brooks Co. Rome, Floyd Co. StatesboTo, Bulloch Co. Thomasville, Thomas Co. Tifton, Tift Co. Toccoa, Stephens Co. Waycross, Ware Co. West Point, Troup Co.

This assistance consisted of numerous conferences, surveys, and 106 pasteurization plant, 387 dairy farm, and 5 ice cTeam plant inspections.

Special investigations were made at one plant to determine the holding time and temperature compliance for a high temperature pasteurizing machine, resulting in the plant management taking steps to have the nee essaTy corrections made.
Plans for new plants, or ones that aTe to be remodeled, are being reviewed by this Division to determine compliance with Grade A requirements of the Public Health Service Milk Ordinance.

Public Health Engineering

59

Plans Examined:
Atlanta-Four new plants Jesup-Remodeling Rome-Remodeling Toccoa-Proposed combined retail raw milk house and pasteu-
rization plant.
The following literature, placards, and record forms relative to milk sanitation have been printed and are being distributed to local health departments:

Leaflets: Milk from the Family Cow Milk-borne Diseases and the Bacteria Count of Milk Mastitis in Dairy Herds
Placards: Intended for posting in milk house:Milking Methods Care of Milking Utensils Procedure to Follow During Milking Time
Report Forms: Milk Sample Report-For use by laboratory to record results of milk samples. Dairy Farm Inspection Record-Ledger sheet fOl" recording results of dairy farm inspections, 1esults of milk samples and personnel health examinations.
Milking Apron: Pattern and directions for making.

MAPPING PROGRAM
The value of the mapping program has been greatly emphasized during the recent period of national defense. Wherever military projects a1e involved and cantonment areas projected, these maps have been of inestimable value not only to the state and local health departments but to engineers who are developing the cantonment areas and national defense projects. This has been proved by the great demand upon the Division for copies of the maps.
During the year a bulletin entitled "Public Health Mapping Standards" was prepared by the Division. Preparation of this bulletin became necessary because of the demand from other state health departments, federal agencies, and the U. S. Public Health Service for an outline of mapping procedure as a guide to others interested in initiating a public health mapping program.

60

Georgia Department of Public Health

Mapping work accomplished:
Letterhead size maps _____ ------------------------- 2 Basic municipal maps____________________________ 2 Municipal sanitary maps___________________________ 6 Basic county maps_________________________________ 5 County malariometry maps________________________ I Exhibition maps -------------------------------- 3 Special maps and charts for bulletins and reports _ __ 32
TOTAL____________________________________ 51
TOTAL OF ALL lVIAPS TO DATE ________________________ 269
Standard maps partially complete: Basic county maps_______________________________ LJ County malariometry maps________________________ 3 County sanitary survey maps______________________ I
COMlVIUNITY SANITATION
Community sanitation, as the term implies, deals primarily with physical improvements of water supplies and sewage disposal devices in rural areas, community settlements, and suburban areas where public water and sewerage systems service is either impractical or economically unsound. For a safe means of sewage disposal in these areas of lower income group sanitary privies are the solution, whereas properly constructed water toilet systems are appropriate for the higher income group. Likewise properly protected individual water supplies are necessary for drinking wate1 in these areas not served by public water supplies. Here again the type of installation will vary according to type of residence.
Convinced that the greater portion of typhoid and other intestinal infections occur in the typical low class suburban and rural homes, and that in these homes there is the greatest need for health education, this Division has particularly stressed promotion and construction of sanitary pit privies for the past seven years.
The results obtained during l9L10 compare very favorably with previous years' accomplishments, considering the continued curtailment of WPA labor. During the calendar year 1940, 11,115 privies were constructed throughout the state as compared with an average annual construction figure of 10,281 over the previous seven-year period. Of this number 9,538, or 85.7 per cent, were concrete, thereby giving a higher percentage of more permanent structures.

Public Health Engineering

61

Year

Total Privies

1933 193<.1 1935 1936 1937 1938 1939 191,0

1,370 H,543 10,4.61
9,868 10,177 13,L.L7l 12,079 11,115

T otal-8 years ----- 83,08<.1

Per Cent Concrete
0.0 6.2 20.7 <10.0 60.0 70.5 77.1 85.7

Wood
100.0 97.8 79.3 60.0 <10.0 29.5 22.9 14.3

The most permanent type of sewage disposal device, other than the public sewerage system, is the individual home sewage disposal plant which utilizes a water-tight basin as a settling or septic tank, and a soil absorption .field as a means of septic tank eilluent disposal. If properly designed and installed, this method of sewage disposal should give continuous service with minimum maintenance and repair.
Although it necessitates a great deal of time to supervise installations of this type of sewage plant, this time is justified since the type of structure obtained is of a permanent nature, and if properly installed is never a menace to public health.
During the year, 2,586 septic tanks, employing approximately 463,3<12 feet of <1" open-joint drain tile were installed at private residences and on public property in 119 counties throughout the state following the plans promulgated by this Division and under the supervision of personnel of the Division.
In those areas not serviced by a public wateJ supply, much effort has been exerted toward improvement of individual private water supplies in order that people located in these areas might have a safe source of drinking water. Education, promotion, and construction supervision by this Division has resulted in gratifying results. Under supervision of personnel from this Division, and with private individual funds for labor and material, there have been 1,817 individual water supplies improved throughout 75 counties 1vithin the state. As a result of efforts by this Division 6,123 connections have been made to existing public water supplies.
COOPERATION WITH OTHER STATE AND FEDERAL AGENCIES
The Georgia Department of Public Health is the official sponsor of a WPA state-wide community sanitation project. On this project the WoRK PROJECTS ADMINISTRATION will supply relief labor for the construction and installation of sanitary privies on p1ivate property, without cost to

62

Georgia Department of Public Health

the property owner, provided the property owner will furnish necessary material for this construction.
The FARM SECURITY ADMINISTRATION is cooperating with this Division in improving the sanitary conditions at rural homes. This includes construction of sanitary privies, improvements to well and spring, and screening. In this program the FSA requires sanitary standards supplied by this Division. For the fiscal year 194.0-19LU Georgia's quota for FSA loans comprises 990 loans. Listed below are data relative to the Environmental Program of the Rural Rehabilitation Division for the fiscal year 1939-194.0. This report is of June 30, 19L10.
RuRAL REHABILITATION-1939-194.0 Total money for state_____________________$139,135.15
Avg. Cost Number families ________________________ 3844~$36.20 Number privies _________________________3296-$16.58 Number water supplies ___________________ 1200--$4L1.89 Number homes to be screened_____________ }L188-$20.58
TJ1ater Snpply improvements: Old dug wells_________________________________ 794 New dug wells________________________________ 97 New drilled wells______________________________ 68
Springs improved ----------------------------- 52 Improvements not identified_____________________ 189

TOTAL--------------------------------- 1,200
Prior to loan closure, the FEDERAL HoUSING ADMINISTRATlON requires approval on all private water supplies and private sewage disposal systems at residences requesting FHA insured loans. This insures properly protected water supplies and properly installed sewage disposal systems at these residences, and also serves as a model and tends to promote better sanitation on the property of adjoining neighbors. During the year, plans were furnished, construction supervision offered, and final inspection made on 9L12 private sewage disposal systems, and 154, private water supplies at these residences. In addition, as a result of this working arrangement, many water and sewer line extensions with subsequent connections were effected.
Arrangements have been perfected with the CIVILIAN CoNSERVATION CORPS of the U.S. Army whereby camp site locations, drinking water supplies, and methods of sewage disposal must hereafter meet State Health Department approval. A rep1esentative from this Division will accompany the Army Reconnaissance Officer to select camp site location, at which time recommendations for water supply and sewage disposal will be made.
A program with the RuRAL ELECTRIFICATlON ADMINISTRATION, very similar to that with the Federal Housing Administration, is being promulgated. This program when attempted on a state-wide basis will necessitate

Public Health Engineering

63

approval by this Division of all water supplies and sewage disposal systems at residences requesting funds from REA for improvement purposes. However, during the past year 1,500 rural homes have received approved water supplies, plumbing and proper sewage disposal.
The NATIONAL YoUTH ADMINISTRATION, which aids young people to acquire education by providing funds for part-time employment of needy secondary school, college and graduate students, depends upon this Division for sanitary surveys, advice and recommendations relative to sanitation at school projects serving as institutions for NYA youths of the state. Assistance is rendered by improvement of water supplies and sewerage for these institutions.
The Division has worked with local officials representing the U. S. HousiNG AuTHORITY in the program of low-rent rural homes, resulting in adoption of certain sanitary standards for the rural homes. This program now applies to eleven Georgia counties. These standards are applicable to such items as private water supplies, sewage disposal, and screening.
During the year, prison camp sanitation was attempted by an agreement with the STATE BoARD OF PENAL CoRRECTIONS whereby this Division made certain surveys of prison camps in the state. Reports are made to the Board of sanitary conditions found and some progress has been made in correcting existing insanitary conditions found at such camps.
Surveys have been attempted during the year at summer camps. A complete list of all such camps was established and numbers of surveys were made and sanitary corrections accomplished.
This Division acts as a clearing house for selection of engineers for development for assignments to regional and local health departments. An attempt is made to build up a reserve of qualified engineers eligible by training and experience for postgTaduate work in public health engineering. During the yeaT, fifteen engineers were selected for public health training and placed in important assignments.

SCHOOL SANITATION
This Division is engaged in an extensive state-wide school sanitation program. Through the cooperation of the State Department of Education all available Tesomces have been used in OTder to protect the health of approximately three-quarters of a million pupils and teachers at the public schools. Such federal agencies as WPA, PWA, and NYA have for the period of such agencies' operation fumished invaluable assistance in this program in terms of material and labor.
There are approximately 6,000 schools in the state, rural and urban, generally in need of improvement of water supplies and satisfactory sewerage. This program includes installations of school sewage-disposal plants, sanitary privies, safe water supplies, drinking fountains, connections to available municipal water and sewer mains, and bacteriological exmination of drinking water.

Georgia Department of Public Health

For the purpose of brevity, the names of these 656 schools, together with description of each sanitary improvement, must be omitted. However, a list. describing the improvements of each is being annually furnished by the State Department of Health and the State Department of Education, copies being retained with the Division of Public Health Engineering.

MALARIA CONTROL
During 194,0, approximately $700,000 was expended directly for malaria control, exclusive of related services on engineering mapping, and malaria investigations at state, county, and city expense, and exclusive of minor expenditures for malaria control by private citizens on private drainage and impoundment improvements. The following detail reports accomplishments on drainage and reservoir clearing on WPA proj eels.

Ditch footage Dtlg-feet
691,311

No. 110nds drained

Acreage drained
'1,173

Man hours WPA labor
1,305,556

WPA [JaYroll expenditures
$513;196.00

The slate-wide malaria control program on which advisory service is rendered by the engineers attached to this Division involves many separate functions and several methods of control. Principal functions may be divided into two classes, those directed toward preventing the creation of new malaria mosquito breeding places by man's activities, and those directed toward the suppression or elimination of existing malaria mosquito breeding places, both natural and man-made.
Preventive activities are largely of an educational and consultative character. They include the education and guidance of city and county governments, state highway forces, corporations, private individuals, park departments and various subdivisions of the Federal Government in methods of highway construction, pond and lake and artesian well development, etc., to prevent the creation of public health menaces causing illness and death to Georgia citizens from malaria. This service includes limited detail engineering consultation on individual construction projects and also takes expression in the administration of the impounded water regulations of the State Health Department.
Progress was made during the year in a census of artificial impoundments. Record is now possessed of the detail location of 53i1 impoundments, aggregating 58,658 acres and located in 95 counties. These consist of fish ponds, mill ponds, hydroelectric reservoirs and recreational lakes. The number on record is estimated at approximately 15 per cent of the state-wide total. Twenty-six preliminary permits were issued during the year, under the impounded water regulations, increasing the total number under preliminary permit to 87 impoundments of 28,870 acres. Eleven maintenance permits were issued, increasing the number outstanding to 29, totaling 15,447 acres.

Public Health Engineering

65

::

In the reduction and elimination of existing malaria problems by

controlling malaria mosquito breeding, various methods are practiced,

but of these drainage and filling are the most extensively used.

Particular emphasis has been paid by the advisory engineer over the past year to improvements in quality and permanency of drainage construction. A majority of counties operating at the year's close are using power excavating machinery (draglines) in the execution of heavy construction projects. Installation of concrete ditch paving, bank sodding, ditch checks, grade monuments, concrete pipe and related permanent types of drainage construction and structures has markedly increased.

The following tabulation of malaria drainage by counties is a tabulation of only those counties participating in the expenditure of WPA funds for the purpose and is by no means the total volume of work accomplished.

County

Ditch Worked Ponds Linear Feet Drained

Acres Drained

Man Hours WPA Labor

WPA Payroll

Brooks -------- 15,65,1

H

2.5

Bryan -------- 69,000

,10

1,610.0

Bulloch ------- 1,855

1

6.0

34,761 25,085

$ 10;170.70 8,19,!.88

Chatham ------ 8'1,572

280

283.5

473,682

186,217.8'1

<

Cobb --------- 110,33,1

1'!'1

618.0

:~

Crisp --------- 36,000

8

66.5

77,915 104,726

26,580.93 35,820.8'1

Dougherty ----- '1,300

5

Fulton -------- 37,308

'18

23.0 277

15,116 118,020

5,0,12.35 49,310.07

G1ady ---- ---- 330

2

.5

Lamar -------- 22,800

15

21.0

26,299

7, 772.87

Lee ----------- '1,790

1.25

19,887

5,871.'19

Lowndes ------ 6,600
:\lacon -------- 10,000

85.0

38,892

19,7<17.'16

3.0

Pulasl\i -------- 10,800

2

20.0

5,322

1,599.12

Richmond ______ 11,958

H

51.0

72,752

28,613.77

Spalding ------ 63,330

26

110.0

55,<!t18

18,<l<l7.15

Sumter -------- 88,935

20

270.0

63,073

21,253.0'1

Tattnall ------- 12,996

18

22.0

32,563

9,795.54

Terrell -------- 1,000

3.0

2,049

560.31

Troup --------- 81;129

80

epson -------- 1,200

692.0 2.0

103,193

35,100.57

Washington ---- 12,720

4

Worth --------

,100

4.0

16,773

5,047.78

2.0

'l'OTAL ---- 691,311

732

'1,173.2

1,305,556

$'175.'146.71

MATTHESS SANITATION
In March, 1937, the General Assembly of Georgia passed the "Mattress Sanitary Hegulations, Act. No. L172 Georgia Laws-1937", which was approved by the Governor March 30, 1937. This is an act to improve the sanitary condition of the manufacture of mattresses and to provide that the authority to enforce same shall be in the Georgia Department of Public Health. Provision is also made for collection of a license

66

Georgia Department of Public Health

fee and sale of revenue stamps for the operation of this law, which makes the service self-sustaining.
During the year, a total of 2,165 inspections was made and 125 samples were analyzed. The inspections included furniture stores, mattress manufacturing and renovating plants, and other establishments where mattresses were stored or sold. Mattress manufacturing and renovating plants are inspected on an average of once each four to six weeks.
During 1940, it was necessary in only two instances to institute legal action as a result of violations of the Bedding Law. The first instance was a case of labeling previously used material as new material. The owner and operator of the concern in this instance drew a suspended fine of $25. In the second instance the case was failure to pay the license fee, which was settled out of court. This Department cooperated with the Federal Trade Commission in furnishing evidence which they requested.
One hundred licenses were renewed, ten new licenses issued for manufacturing and renovating plants, and eight other plants either changed hands or ceased operation. Four of the new licenses were for plants manufacturing mattresses solely of new material which does not necessitate sterilizing equipment. The remaining new licenses were for renovating plants, all of which installed and operated sterilizing equipment which complied with the requirements as specified under the Mattress Sanitary Hegulations.
An analysis of the revenue received by the Department during the three and one-half years of enforcing the Mattress Sanitary Hegulations shows that a large percentage was derived from out-of-state manufacturers selling within the state. There were 76 out-of-state concerns who purchased bedding revenue stamps to he placed on articles to he sold within the state. The following figures show the percentage of total revenue furnished by out-of-state manufacturers:

1937 1938 1939 19LJ0

ILl% 22.5% 32.0% 3LJ.l%

The following figures show the number of new licenses issued each year:

1937

54,

1938

44

1939

25

1940

10

Total --------------------------------------- 133

Division of Maternal and Child Health

J. P. Bowdoin, M.D., Dz:reclor

E R. Watson, M.D. ______________Associate Director

A. Starr Ingram, lVI.D.___ _ ______ __Obstetric Consultant

Mary Emma Barnes __

____ Nutrition Consultant

INTRODUCTION
The maternal and child health program for the year l94,Q has been characterized by healthy expansion in counties not previously served, and by improvement and extension of the work being done in organized counties. In September, 1940, a nutrition program under a full-time nutritionist was added to the division.
Expansion of the general program has been seriously impaired in certain localities by inability lo secure county medical personnel as rapidly as desired by county authorities. Several counties which wanted public health departments have been unable to obtain commissioners of health to elate. These facts have undoubtedly affected the ardor of those individuals responsible for promotion and have prevented expansion which might have taken place had such medical personnel been available. The supply of nurses as yet is unimpaired, but the rapidity with which they have been employed, together with the time element involved in training them properly, has necessitated some counties waiting several months before initiating or expanding maternal and child health work.
Lay and professional enthusiasm and cooperation has been the best ever seen, and this is particularly true of the interest shown in the newly established nutrition program. Especially encouraging is the rapid stride noted in the acceptance of clinic service by the white race, who, despite definite need, have failed in certain localities to accept the program as rapidly as the Negro race. With rare exceptions public health personnel and private medical practitioners throughout the state have accepted the maternal and child health program as an integral part of their public health program.
Public health personnel and private pract1t10ners are enthusiastically promoting the expansion and improvement of the program in their communities. The staff of the central office and the staffs of the six regional offices have throughout the year attempted to direct this cooperation and enthusiasm into channels which would result in the establishment of wellhoused and properly staffed centers. Considerable effort has been exerted toward improving both personnel and facilities of centers already in existence. Emphasis has been placed on the necessity of having the center program supported by good home visiting on the part of adequately trained public health nurses.
Accomplishments of the program during the past year have left us with an optimistic outlook for the future, except for the possibility that

68

Georgia Department of Public Health

our medical personnel, clinicians and commissioners of health, may be reduced by the National Defense Program.

FIELD ACTIVITIES OF MEDICAL STAFF

Consultations and clinical services_ __ ~------~-- _________________ _ 806
Talks, papers, addresses, total attendance_~---~ ____________ .~ __ 4,220 Physicians ____ ~----- --------------~---~-- 111 Public health personneL ___ ~-------------- 3,722 Lay groups _____________________________ 387

Motion pictures shown, attendance~--~--~--~-----~-~---------Physicians --------------------------~-~--- 544 Lay groups_____________________________ 796

1,340

Radio talks ---------------------------------------------- 3
Interviews and conferences___________________________________ 779 Physicians and health officers_______________ 382 Other public health personneL____________ 294 Officials and civic leaders__________________ 103

MCH centers supervised~-------------------------~---_

82

Special clinical examinations~~------------------------~------ 78

FIELD ACTIVITIES OF NUTRITION CONSULTANT

Papers, talks, addresses, total attendance ______________________ 2,125

Parent-teacher associations ________________ 420

WPA nursery school teachers______________ 38

WPA adult education teachers~------------ 38 Georgia Dietetics Association_______________ 1W

Federated Women's Clubs~---------------- 100

Home Economics Association______________ 270

High school students_______________________ 760

Midwife meetings _________________ ------~-

8

Nurses' institutes ----------~-------- _____ 451

MCH centers visited ___________ ~~------------------------~----

61

Interviews and conferences________________________________

293

Physicians and health officers~--~--------~--- 40

Other public health personnel______________ 74

Officials and civic leaders~---------------- 135

Conferences with mothers _____________ ~---- 40

Home visits _________ ____________________ 4

Demonstrations at MCH centers ____ ~--- __________ ______ _

20

Lunch rooms visited~-----~--~-------------~-------- _ __ _

20

Colleges visited ________ ----------------------------~-----

3

Radio talks ______________________ ~-- _______ __________ __ 1

Jlllaternal and Child Health

69

Changes in personnel
The Associate in Obstetrics, who had been on leave of absence at Johns Hopkins, returned to the Department in May. In September, he left to take a position on the faculty of the School of Hygiene and Public Health at that institution.
In September, an Obstetric Consultant was appointed to the staff. His duties are essentially those previously assigned to his predecessor as regards field activities and consultative work.
On September 1, a Nutrition Consultant was added to the staff of the division of maternal and child health. Inasmuch as this is a new addition to the program it has been necessary to formulate methods which might be utilized in attacking the basic problems underlying malnutrition.
MATERNAL AND CHILD HEALTH CENTERS
At the close of the year, there were 310 maternal and child health centers operating in the state. Of the 55 organized counties, 4,9 have MCH centers, and of the 38 unorganized counties with full-time nursing service, 34 have centers. The number of centers and type of service for the two classes of counties may be seen in the following table:

Type of center

In organized counties

Maternal ________________ 61 Infant __________________ 113 Combined _______________ 75

Total ________________ 249

In nursing counties
18 4
39
61

Total centers
79 117 114
310

Centers on State Participation
At the close of 194,0, health centers on the subsidy plan were as follows:

Type of center

In organized counties

Maternal _______________ 45 Infant _________________ 66
Combined _______________ 67

In nursing counties
16 4 39

Total centers
61 70 106

To~l _________________ 178

59

237

During the month of December, 167 private physicians received checks for their participation, and the sum expended during that month was $2,005.00. A statistical summary of activities from centers reporting in detail -follow-s.

70

Georgia Department of Public Health

MATERNAL HEALTH CENTER ACTIVITY

State-Subsidized Centers - - - - ------~-- --------------~------- - - -- - - - --------~~
%+or-

1940

over 1939

Pr~e~na~ta,--~A~dm~,~s~sions~----------~------------------

Admissions, total ----------------------

White _.

__ -------------- ------

Segro ______ _

'fr; white _
7o negro

11,12 l,G49 !1,823 14.4 8J.B

+ l(i + ~~ + l.J + t.:l + I.:-;

Period gestation, total -.-------------Cn<lcr 16 weeks ___________________ _
10-27 weeks -------------------------- __

11.233 2,96S ;),'1;)7

1-1
-1- 22
+ 2(i

28-36 weeks __ -------------------------
Over :16 weeks ______ -------------------
~k 111Hler J G weeks---------------------
r7c 16-27 weeks -------------------------'k 2R-3G week:; ________________________ ?'r over aG weeks _______________________

2.:i~X
2SO
:W.-1 HUi 22.:)
:?.:1

-1
+ l.i + -1.6
-1.~
2I

Prenatal Syphilis

Heports, total ______ _

White __

Negro
rJc of admissions, total

White _

- --- -- -----------

Xegro ________________________ --------

Xumber vositiYr, totaL--- ________ _

\Yhite ____ ---------- -------- ----Negro ___________________________ _

o/, positi\Tc, total _________________________ _ 1 White ________________________ ---- ----

S,G32 1.110 7AG2
lii.2 70.9 75.\l .'172
<o
],>102 17.1 i)_j)

+ (i + 11 +
\i. i
6.1
G.S If)
+ 11
--] 1
3.0 _;;

Negro _--------------------------------
Treatments : total ------------------------ _ Treatmentjpositive ratio ___________________ _

18.7 6,797
4.6

+ + .8

Prenatal Activities
Visits, total ------------------------------White ________ -------------------------Negro
Yisitjadmission ratio _____________________ _
White ____ ---------------------------Xegro
Transferred, total ------------------------ _ Toxemias clevelOiled, totaL ________________ _
White ___ ----------------------------Negro --------------------------------
tJc of admissions, totaL------------- ______ _
White ________ ----------------------Negro ________ _

36,93(1 4,885
32,051 3.2 2.9 3.2
18G 373
73 300
3.3 4.4 3.0

+ :22 + 19 + 2:J + .2
.l
+ .2
s:;
-- 35
10 - 84

Postnatal Activities Admissions, total --------------------------White __ ------------------ -----------Negro _____________________ ------------
Visits, total ------------------------------White -------------------------------Negro ---------------------------------
% of prenata\s, totaL _________________________
White -------------------------------Negro ___ _

1,494 325
1,169 2,476
560 1,916
13.0 19.7 11.7

+ 24 + 24 + 24 + 28 + 37 + 26 + .9
.l
+ .1

iJ!laternal and Child Health
INFANT HEALTH CENTER ACTIVITY State-Subsidized Centers

Admissions-! nfant and Preschool Admissions, total -------------------------White -------------------------------Negro -------------------------------% white -----------------------------o/o negro -----------------------------Age groups, totaL ________________________ _ Under <J months _____________________ _
4-12 months -------------------------1-5 years -----------------------------
% under 4 months___________________ _ % <l-12 months_______________________ _ o/o 1-5 years __________________________ _
Nutrition, total --------------------------Abnormal ----------------------------Normal ------------------------------% abnormal --------------------------
Visits and Activities Visits, total -----------------------------White -------------------------------1\egro -------------------------------Visitjadmission ratio ---------------------, White -------------------------------Negro -------------------------------Defects, visits -----------------------------
o/0 total cases--------------------- ____ _ Referred cases ----------------------------
Immunizations Diphtheria, total -------------------------Under 1 year ------------------------Over 1 year --------------------------
% admissions, totaL __________________ _ o/o admissions, L!-12 mo. _______________ _ % admissions, 1-5 years _______________ _
Smallpox, total --------------------------o/0 admissions, total -----------------o/0 admissions, under ! ________________ _
'l'yphoicl, total ---------------------------o/0 admissions, totaL __________________ _
r!( admissions, over 1------------------

1940
12,201 5,101 7,100 <11.8
11,9o6 3,!:>1 2.812 5,693 28.U 23.;) <17.6 7,6!Jl 1,338 6,3:i3 17.4
26,6:\9 11,1GI 18,<198
2A 2.2 2.6 3,622 12.2 1,776
6,567 3,022 3,;)45
54.9 87.6 62.3 2,939 2<1.6 <16.9 2,616 21.9 <l%.9

7l
%+orover 1939
+ 32 + 60
-1- Hl
+ i.:i
. -- j .:-1
+ 2H + 38 +8 + 37 + 1.!1
4.6
+ 2.7 + 30
7
-1-H
6.7
+:in
+ -!H
+:W
+ .1
.1
+ .3 + <17 + .9 + 20
+ 21 + 37 + 10
- 3.5
+ 2.9
-15.2
+ 97 + 8.5 + 17.6
-13 -10.3 - - ~6:?

72

Georgia Department of Public Health

MCH CENTERS
1940

COUNT IES WHERE MATERNAL 1'l CHILO HEALTH CENTERS WERE CONDUCTED

Maternal and Child Health

73

COMME T 0 1ATER AL A D CHILD HEALTH
CE TER ACTIVITIES
The Program in General The general policy of sacrificing rapidity of expansion of maternal
and child health centers in fa vor of more stringent requirements regarding facilities and personnel , which was adopted this year, has already produced results. Centers established during 1940 were, on the whole, better housed and were started on a more sati factor y footin g than previou ly established centers. As a matter of fact, little sacrifice of expansion has been noted, since most interested communities have been able to meet our standards.
Maternal Health Centers Of particular significa nce is the fact that a marked reduction ha
occurred in the number of patients reporting for care after the 28th week. There has been a 22 o increase in the number of patients r eporting before the 16th week, and a 26 % increase in the number of patient reporting between the 16th and 27th weeks which gives us definite proof that progress has been made in establishing the importance of earl y visits to maternal health centers. There was a 27 o increase in the number of white persons admitted to the clinic service.

AFETY DEMA OS PRE ATAL EXAM! ' ATIO
It is encouraging to note the 10 c decrea e in positive serological test . This reducti on it is believed was due to the increased efficiency in the treatment of syphilis, not only in the prenatal but also in the venereal

74

Georgia Department of Public Health

di ea e clinics. Thi belief is upported by the fact that the treatmentpositive ratio is hi gher than it was last year.
There was a 22 increase in prenatal i its to health enters over 1939, and in additi on the visit-admi ssion ratio has in creased sli gh t! . This bears evidence of the efficiency of the se r ice offered .
Postnatal activities have improved, although the de ired le el ha not yet been reached. There was a 24 7c in crease in po tnata l admis ions du ring 1940, and a 28 % increa e in po tnatal visit . This upward trend is a subj ect for gratificati on and for renewed efforts towa rd th e ultimate goal.
Infant Health Centers
The infant and pre chool health center acti viti e show a g reat deal of advancement during 1940. Th er e was a total in crease of 32 o in admi sion s over the precedin g year. It is gratifyin g to report an in cr ease of 60 in the admis ion of white children ; this, as in the ca e of white prenatal ca e , rep resent an ace ptance by white person of the ser ice offered by the center s. The decr ease in the number of children who were co nsidered malnouri hed may be attriluted, in part, to the parent ed ucati on that i beincr a ttempted a t both prenatal a nd infan t health ce nter s .

WELL B ABY HEA LTH CENTER
There i a decided increase in the vi it made by infa nt to health center during 19"4-0. The number of vi its by white infant is 49 more than durin g 1939, and by egroes, 29 o more. The vis it-admission rati o is approximately the sa me as durin g Ia t year.
The 1940 diphtheria immuniza ti ons showed Con id rable improvement over 1939. A total increa e of 21 /'c shows that thi s activity has been receiving more attention durin g the year. The fact that ther e was a 37 o in crease in diphtheria immunization given to children under 1 year of age indicates that thi service i being rendered to that group to which

/Vlaternal and Child Health

75

it is most vital. This in crease is ver y fa vorabl e, and the sli ght in crease in immunizations lo children over l year of age is probably due to the fact that such children have been immunized previou sly in large numbers. There was a 13 o redu ction in typhoid inununization s. The 97 %- in crease in smallpox vaccinati ons is hi ghl y gratifying.
UTRITIO
The initiation of a nutntlon program in September, 1940, under the direction of a full-tim e nutriti onist, marks the beginning of a new phase of public health in Georgia. Although orga nized work in nutrition was so recentl y begun , it is felt that an au spicious start has been made. A statistical summary of th e acti viti es of the nutriti oni st is included with those of the medical staff.

PROPER Fooo FO R EVERY CHILo
In order Lo gain familiarity with the work of the various divisions of the Georgia Depaitment of Public H ealth, the nutritioni t held individual c?nferences with staff members and studi ed activity reports of the divisiOn s.
To become familiar with the count y health departments and the administration of local health ser vice, and to learn the nutrition problems of the state, the nutriti oni st made use of the following procedures :
l. Individual conferences were held with health commissioners and nurses in conjunction with field visits.

76

Georgia Department of Public Health

2. Group discussions and demonstrations were conducted with prenatal patients, while attending maternal and well baby centers. The size of these groups ranged from 12 to 30. The time spent with any one group was about one hour. These demonstrations served two purposes: they acted as a demonstration for nurses in attendance at the centers and they offered direct contact with a large number of mothers.
3. Nutrition lectures and demonstrations were given at the Nurses' Institutes.
4. Visits were made with the nurse to the homes of individuals who attend the prenatal and well baby centers.
5. Conferences were held with prenatal patients having special nutrition problems.
The nutritionist endeavored to cooperate with all other agencies doing nutrition work and to become acquainted with their personnel. This was done by the following methods:
Conferences Attended
l. State Advisory Committee on State and Professional Projects of WPA, which is composed of the State Director of the National Youth Administration, a member of National Resources Planning Board, 3tate Supervisor of WPA lunchrooms and a mem.ber of the stafi of the Georgia Department of Public Health.
2. State Nutrition Defense Council, composed of representatives from 31 organizations interested in the welfare of the people of Georgia.
3. Committee on School Lunches and Nutrition Teaching in Schools of the State Nutrition Defense Council, of which the nutritionist is chairman. '
LJ.. Steering Committee of the State Nutrition Defense Council, of which the nutritionist is a member.
5. State Home Economics Council, which is composed of the State Home Demonstration Agent, research workers in nutrition from different colleges, the Supervisor of National Youth Administration, Supervisor of WPA lunchrooms, and the Presidents of Georgia Dietetics Association and Georgia Home Economics Association.
6. Home Economic Association, composed of home economics teachers.
Individual Conferences held with l. Nutrition instructors of Georgia Colleges, on planning a nutrition course for elementary teachers. 2. Home Demonstration Agents, on participation in health program. 3. University Extension Nutritionist, on participation in health program.

Maternal and Child Health

77

4. Director of Surplus Marketing Administration, on utilization of surplus commodities.
5. Home Economics teachers, on nutrition problems in school.
6. School lunchroom managers, on planning menus, proper equipment, gardening and sanitation.
Lectures
Lectures have been made by the nutritionist to such organizations as: Parent-Teachers Association, Home Economics Associations, Women's clubs, high schools, etc.
LVIaerial Distributed
Nutrition material prepared by the nutntwnist and obtained from the U. S. Government has been used for lay distribution.
SPECIAL EDUCATIONAL ACTIVITIES
Publications
During l9i!O, the bulletin on immunologic therapy was approved by the Pediatric Committee of the Medical Association of Georgia and was printed and distributed. A copy was sent to every physician in the state and was made available to medical students.
The Associate Director was a member 'of the committee delegated by the Citizens' Fact-Finding Committee to write a report on health in Georgia. The Fact-Finding Committee printed and distributed 14,000 copies of this report, and an additional 6,000 copies were printed and distributed by the Georgia Department of Public Health. A sufficient number of copies were sent to colleges throughout the state upon request, to he used as source material for classroom work in various subjects related to health.
The Associate Director, who was appointed Child Hygiene Chairman of the Georgia Congress of Parents and Teachers, prepared an atlas for use by the county chairmen. This atlas outlines material for the work of the child hygiene chairmen, and has been distributed for their use.
Plans were made for construction of a combination play-pen and crib. These plans were drawn by a member of the engineering sta-ff, and have been widely distributed throughout the state.
One member of the divisional staff spent considerable time during August compiling and editing the 1939 annual report of the Department.
A mimeographed outline was prepared on the treatment of prenatal and congenital syphilis. The outline incorporated the former one on treatment of congenital syphilis, and was distributed to physicians throughout the state.
The Nutrition Consultant has prepared several articles for distribution to the public. Due to popular demand her articles, which appear in the Department's monthly publication, have been reprinted for general distribution. She also started work on a nutrition syllabus which is intended for use hy public health nurses throughout the state. She has prepared

78

Georgia Department of Public Health

a pamphlet entitled, "What to Eat Befo1e the Baby Comes", which is available to the public. She has also contributed an article, "Young
Georgians' School Lunch", to the Georgia Home Economics News for December, 19LW.

Radio
The weekly broadcasting has continued, and members of the divisional staff have given 3 broadcasts during the year. A second series of programs has been added, the Dixie Farm Hour, and a staff member made one talk on this program.
Participation in Planned College Curricttla
A member of the Maternal and Child Health divisional staff, as well as members of other divisional staffs, has continued participation with the Georgia State College for Women in the presentation of subjects for students enrolled in health education classes. Quarterly visits to the college were made so that activities of this division could be portrayed to the students majoring in health education, as well as to all freshman students.
Plans were formulated for the initiation of a series of lectures to the junior medical students at EmDTy University School of Medicine. The lectures will total 32 in number, and will be presented by various inclividuals attached to the staff of the Georgia Department of Public Health, or to the staffs of local health departments. The Associate Director has been requested to give five of these lectures on the following subjects:
Midwifery Maternal Health Infant and Preschool Hygiene School Hygiene Applied Immunology.
Hearing Test Project
Through the joint efforts of the Georgia Department of Public Health and the Works Progress Administration, a project was approved which would permit the use of audiometers in the counties with full-time health departments to test school children for hearing defects. The project was initiated in October, 19LW, and is continuing in an uninterrupted manner. This has proved to be a very popular project, and in all instances school officials have welcomed the examination of children and have not in any instance objected to the interruption of classes which has been necessitated. To date, examinations have been completed in 8 counties and, as of December 31, 19LW, 32,745 childTen had been tested. Of this number, 1,237 were retested, for the reason that the first test was unsatisfactory and was indicative of some difficulty. It was found upon retesting that. about 70 per cent of those children whose initial record was questioned proved to have no hearing defect. This is pointed out as being significant for the reason that the test is sufficiently intricate for a certain number of childTen to encounter difficulty in understanding

Maternal and Child Health

79

DEFE CTIVE HEARI NG DI SCOVERED
the procedure. It is deemed wi se to r etest repea tedl y, if for an y reason the child 's reaction is not normal , becau e factor other than defective hearin g are apt to give ri se to erroneo us conclusion s.
Thi project will be ontinued until school s in the organized co unties have been co mpleted. At present a number of counti es have requ ested the ervi ce and will be accommodated at the ea rli est possible moment. It will be nece sar y to continu e the project during th e next school year in order t com plete the work. It is hoped that th e proj ect wi ll acquaint local public health per onnel with the procedure so that it will be pos ibl e for them to continu e the proj ect hereafter. Once the entire hool populati on has been tested, it will not require a gr eat deal of time to do new stud ent and retest repeaters and others durin g each school year. It is hoped that at least one audiometer can be left in each r egional office for loan to an county health department which desires to u e it. Parents of each child with a hearing defe t will be notified and will be req uested to consult a physician. In at least one co unty plan have been formulated to have a complete follow-up on all of th ose cases not having the advantages of ca re of a private ph ysician with arrangements to institute those orrective measures whi ch are indica ted.
Demonstration Equipment
The divi sion has utilized a WPA and YA project to secure chart and gra ph s which hould prove useful in illu tratin g subject to be cover ed in the lecture eries noted above. In addition. models have been mad e for the nutritionist which depict food valu es of ~ertain food s. Exhibits for loan to count y health departments and for use at various meetin gs are in the process of development in the WPA Educational Proj ect.
Analysis of Midwifery
A committee, com posed of several taff members of the Georgia Department of Public Health , has been engaged in determinin g present

80

Georgia Department of Public Health

midwife problems, and, following this study, will make their recommendations to the Director. It is hoped that it will be possible to evolve a feasible plan which will result in the elevation of midwife standards throughout the state.

BIRTH S CLASSI FIED BY ATTENDANTS AT DELI VERY

LIVE BIRTHS -ATTENDED BY PHYSICIANS CLASSIFIED AS TO PLACE
OF OCCURRENCE

)5

H

lS

- - - - - PHYS ICIAN
~M IDW IVES

~ -HOME ~HO'SP t lA L

Cooperation with Other Agencies
The Phi Mu Fraternity, which formerly aided in the operation of a trailer unit for field work in tuberculosis, agreed to contribute funds toward compensating the nutrition consultant. These plans were completed during the summer, and the nutritionist reported for duty on September l, 1940.
A member of the divisional staff was appointed by the president of the Medical Association of Georgia to the committee for the study of maternal mortality. For three years the collection and compilation of the data for this committee has been done by the Georgia Department of Public H ealth, and beginning with the present study, this division will likewise participate in the analysis and report work of the committee.

Congenital Syphilis Centers
The Associate Director on the Maternal and Child Health divisional staff has been instrumental in establishing centers where all infants and children born of syphilitic mothers are carefully studied to determine whether or not they are syphilitic.
Only by such careful studies can it be determined whether or not antisyphilitic treatment administered to the expectant mother is producing satisfactory results. There has been a tendency to treat children for congenital syphilis only when clinical signs or symptoms are present. In other in stances, children have been treated for syphilis without its being known whether or not they are syphilitic.

Maternal and Child Health

81

The necessity for early diagnosis is being stressed. The evaluation

of diagnostic methods is being emphasized and an outline of therapy

has been provided. Drugs are made available throughout the state by

the Georgia Department of Public Health for the treatment of any and

all cases.



Out of State Conferences
A member of the staff of the Division of Maternal and Child Health represented the Director of the Department at the White House Conference in Washington in January, 1940, at which time problems relative to the child health program were discussed. This same individual attended the conference on preparedness held in Washington , and since his return ha been concerned with the plannin g of this work in the State.

THE I CUBATOR FOR PRE MAT RE I FANTS
Incubator for Premature or Immature Infants
It has been recognized for some time that a large percentage of infant mortality is directly dependent upon the inability to provide condition necessar y for the survival of these cases. However, it is recognized that an incubator, regardles of its features, is only one factor .in the soluti on of this problem.
It is hoped that the providin g of such units will result in a stimulation of intere t in this problem. For some time a member of the Maternal and Child Health staff has been experimenting with an economical type

82

Georgia Department of Public Health

of incubator which has proven satisfactory when the conditions under which it will be used are considered. The incubator has been tested and found to be not only practical but satisfactory. Plans have been completed for obtaining a WPA project for the constiuction of a sufficient number of these units to provide each health department with at least one.

COMMENT ON RATES
All figures in this section are provisional, and therefore are subject to revision.
In 1940, 64,695 livebirths were reported, which gives a birth rate of 20.7 per 1,000 population. The very slight decrease over 1939 of 0.2% may be revised when the final figures are available.

a TREND OF MATERNAL INFANT DEATH RATES

- 13
12~

II

1\

MATERNAL

10

\tNEGROES

GEORGIA 1, 0

RATE PER

170
110 - 1--
100

INFANT NEGROES

9~

r--.

8~

- t-::-,

7 6

-1\ v ~ ~

""'

5

WHITES '\

4

""'

3

1000 90
v LIVE 50 1'-.
- BIRTHS 70
""' - ~ ~
- v 50 r-
---- 40

'\ / \ v

/~
WHITES -------

~ ---.__

30

?.

-

20

I

10

10 1930 31 32 -33-34-35 -36 -'>7 35 -39 4{)

0 193o . ::>I . ;z :;3 -34- )5 -36 37-7>5 39 4-0

Jl!]aternal Deaths
During 1940, 3Ll<2 maternal deaths were reported, giving a rate of 5.3. This represents a 3.6% decrease over 1939.
Stillbirths
There were 3,078 stillbirths in 19L!O, which gives a rate of 47.5. This follows the general downward trend, and is 4.. 3% lower than the 1939 rate.
Infant JVlortality
The deaths under 1 year of age during 1940 totaled 3,737, giving a rate of 57.8, or a decrease of 1.8% compared to 1939.

Jl;Jatemal and Child Health

83

ANALYSIS OF STATE-WIDE lVlCH ACTIVITIES

It is extremely gratifying to note that in almost every instance maternal and child health activities throughout the state have increased appreciably during 194.0 over the preceding year.. This is attributable largely to the fact that more public health personnel has been employed over an enlmged area, as well as to the extended clinic program which is in progress. Although the coverage is by no means at the desired level, it is encouraging to note the continued upward trend in practically every phase of the maternal and child health program.

JmmunizatioJlS

Smallpox ___ --------------------- -----------Diphtheria :
Under 1 year___________________________ _
1 thmugh <] years _______________________ _
5 years and over__________________________

1940 75,971l
11,702 17,697 14,078

% -1- or-
Over 1939
+ 9%
+ 10';/,
- 20o/c - 25o/c

Maternity Service
Admissions to prenatal medical service_______ _ Admissions to prenatal nursing service_________ Visits to lnedical conferences----------------Field and office visits ----------------------Cases given postpartum medical examination __ _ Visits to postpartum cases--------------------
Infant and Preschool Hygiene
Infants: Admissions to medical service---------------Admissions to nursing service_______________ _ Visits to medical confe1ences _----------------.Field and office nursing visits---------------P J'eschool : Admissions to medical service_______________ _ Admissions to nursing service----------------Visits to medical conferences----------------Field and office visits _______________________ _
School Hygiene
Examinations by physicians___________________
Field visits --------------------------------Office visits --------------------------------Inspections by dentists ----------------------

16,595 21,218 52,798 77,098
2,897 3<1,666
10,082 25,122 22,312 64,325
13,052 22,539 23,9<ll 5'!,356
113,186 36;!39 19,136
105 ,32<!

+ 20o/c + 20% + 25o/u + 19o/c + 39o/c + 18o/c
+ 21% + 29% + 2<1% + 4% + 31% + 33% + 33% + 23o/c
- 10o/c
+ 2o/c
- 77o/c +326Cj,-

It is noted that there is a small increase (9%) in smallpox vaccinations during 19<1.0 over the preceding year. This is in keeping with the gradual upward trend of this activity, As regards the diphtheria immunizations, there is a 10% increase in those immunizations given to children under 1 year of age. This is gratifying, as it is in this age group that the need is greatest. The decrease in immunization of older children may be attributed, at least in part, to the fact that such children have pTeviously been immunized in large numbers.
The maternity service shows a consistent increase in every activity, as does the infant and preschool service. These increases are the result

Georgia lJepctrtment of Public Health

of an expanded program based on enlarged and well-trained personnel, and bear witness of the efficiency of such a program.
In school hygiene there is a decrease in the examinations by physicians. This may be attributed to the policy of intensive, rather than extensive, coverage in this :field. The .field visits by the nurses have increased slightly over the preceding year. Inspections by dentists and dental hygienists have increased tremendously, which offers witness of the emphasis placed on the dental health program.

DEMONSTRATIONS
Han cock County Demonstration
The resignation of the Director of the Hancock County Demonstration, effective July 15, and the appointment of his successor on August 19, has resulted in considerable impairment of the work done in the Demonstration, since the new Director has of necessity required some time for orientation.
Since the appointment of the new Director, considerable time has been spent in arousing lay interest in a better balanced public health program, with more emphasis on education in the :field of nutrition and less emphasis on research. The building which housed the Health Department has been remodeled,- and considerable furnishing and materials have been made available by local lay assistance. Interest and enthusiasm have been aroused, and the outlook for a well-rounded public health program in Hancock County is optimistic, although it is quite evident that research work will be limited for some time to come.
In studying the following statistical report, it must be borne in mind that for over a month of this year the Demonstration was without a Director, and that for several weeks more it was laboring under the difficulty of administrative changes.

MATERNAL ACTIVITIES
Number prenatal medical conferences ____________________ -Average attendance per session ______________ ----------------------
Prenatal
Admissions to prenatal medical conferences: White -----------------------------------------------------Colored ----------------------------------------------------

79 6.'1
7 322

Total ------------------------------------------------------

329

Period of gestation at time of admission:

lJnder 16 >veeks_____________________________________________

69

16-27 .veeks -------------------------------------------------

149

28-36 .veeks ------------------ -------------------------------

104

Over 36 .veeks_______________________________________________

7

Positive serological reports:

White ------------------------------------------------------

0

Colored _________________________________________:____________

21

Tot~ --------------------------------------------------------

21

iVlatemal and Child l1ealth

85

Negative serological reports: White _- ---------------------------------------------------Colored ----------------------------------------------------
Total ------------------------------------------------------Total number antiluetic treatments ________________________________ _ Average number t1eatments per prenatal syphilitic _________________ _ Total visits to prenatal medical conferences ________________________ _ Ratio visits to admissions ________________________________________ _ Number of toxemias-----------------------------------------------
Postpartum Admissions for postpartum medical examinations: White _____________________________________________________ _
Colored ----------------------------------------------------
Total ------------------------------------------------------Total clinic visits for postpartum examinations:
White _________ --------------------------------------------Colored ----------------------------------------------------
Total -----------------------------------------------------Ratio admissions to visits:
Nursing Activities Number maternity classes held _____ -------------------------------Average attendance per session_____________________________________ Number of demonstrations __________________________________ --~-. Demonstrations for preparation of delivery, layette, diet, baby's toilet tray, baby's bed.
Total enrollment -------------------------------------------------
INFANT AND PRESCHOOL ACTIVITlES Number medical conferences held _____________________________ _ Average attendance per session-----------------------------------Number of admissions:
White ----------------------------------------------------- _ Colored ----------------------------------------------------
Total ------------------------------------------------------Age on admission:
Onder 4 months ____________________________________________ _ 11-12 months -----------------------------------------------1-5 years--------------------------------------------------Number children malnourished ----------------------------------Per cent of total admissions--------------------------------------Total visits to medical conferences------------------------------- __ Ratio visits to admissions _______________________________________ _ Visits by defect cases ____ -----------------------------------------
Immunizations Diphtheria: under l year _______________________________________________ _ Over l year_________________________________________________ _
Total ------------------------------------------------------
~;;~~dxi~~~~?:=~~~~s-================================~========

6 239
245 111
5
67'1 2.5 8
8 70
78
8 70
78 1
105
5
106
526
117 5.6
37 318
455
100 82
173 125 27% 687
1.5 131
}4.7
292
t139
855
2,691

86

Georgia Department of Public Health

Nursing Service

Number of admissions to nursing service____________________________

743

DEMONSTRATIONS

Demonstrations in preparation of foods for infants___________________

30

Preparation of cereal, vegetables, and fo1mula.

SCHOOL ACTIVITIES
Number children examined: White -----------------------------------------------------Colored ----------------------------------------------------
'fotal -----------------------------------------------------Dental inspections ______ ----------------------------------------Number receiving dental con-ections_______________________________ Number chilch-en examined for nutritional study____________________
HEALTH EDUCATION
Health Officer Conferences with physicians (number)----------------------------Consultations with physicians (number)--------------------------Talks to lay groups (number)------------------------------------Total attendance -----------------------------------------------Motion pictures shown (number)----------------------------------Total attendance ------------------------------------------------
SCHOOL LUNCHEON PROJECTS
Number children enrolled in schools: \Vhite -----------------------------------------------------Colored ----------------------------------------------------
Number children receiving hot luncheons: White -----------------------------------------------------Colored ----------------------------------------------------
F. S. A. GROUP
Number gardens cultivated by F. S. A. families______________________
Number qumts of food canned-----------------------------------Number cows seem-ed for these families____________________________ N ltmber demonstrations in food prepmation or preservation__________
HOME DEMONSTRATION AGENT ACTIVITIES
Quarts of food canned ------------------------------------------Number of demonstrations held___________________________________ Total attendance -----------------------------------------------Number of clubs olganized________________________________________ Total munber of meetings________________________________________ Total attendance -----------------------------------------------Number of individuals starting garden projects_____________________ Number of families who have secured milk cows--------------------
FARM AGENT
Number meetings with farmers____________________________________ Total attendance ------------------------------------------------Number demonstrations in gardening______________________________ Total attendance ------------------------------------------------N ltmber conferences with -farmers-----------------------------------

11 37
48 429
55 44
20 267
27 1,508
8 1,165
77'1 2,07'1
680
200 6,720
39 2'1
2,580 163
3,597 12
194 3,477
175 224
19 332
2 6 460

Matemal and Child Health

87

VOCATIONAL TEACHERS
Number classes held ---------------------------------------- ____ Total enrollment ------------------------------------------------
SPARTA CANNING PLANT
Total quarts food canned ----------------------------------------Number families utllizing this service------------------------------

lJ20 242
593V2 l7

Tift County Demonstration
The Tift County Maternal Demonstration has completed its third year of operation. The work done during 194-0 was the most extensive and most successful yet reported. The service of the Demonstration has been accepted by both lay and professional members of the community as a very valuable addition to the county's institutions.
No positive action has yetbeen taken by the city or county authorities toward assuming complete responsibility for the Demonstration, but the construction of a new modern 50-bed County Hospital in the community, which is prepared to administer obstetrical care to both private and charity patients, indicates that the community is aware of its responsibility. Although the hospital is assuming no responsibility for rural charity obstetrics, its willingness to admit charity patients with obstetrical abnormalities is a distinct step forward.
During the year 19LW, home nursing delivery service was given to over 94-% of the cases delivered by physicians in Tift County. The 6% which did not receive such service were either delivered in the hospital from personal choice, or the inevitable impediments to communication prevented the nurse from reaching the home in time to assist in the delivery.
Almost 100% of the midwife deliveries received nursing and medical supervision. Of course conspiracy between a midwife and an ignorant patient allowed an occasional delivery to occur without the patient's having received either medical service in the centers or visits by the nurse. Undoubtedly almost all such cases received postpartum visits by the nurse, and the midwife was visited and reprimanded, and if she was a certified midwife, her certificate was revoked. Admirable cooperation is being received from the certified midwives of the county, whose number has now been reduced to 12. Of these 12, approximately 80% of the work is being done by 5 midwives. The attendance at delivery by persons not certified is now extremely 1are.
The Commissioner of Health, who assumed responsibility for Tift County's public health program late in 1939, has by diplomacy and reliability in the management of the midwife problem worked himself into a position in which he is of great assistance to physicians as well as to midwife clientele. He has augmented the supervision of midwives by the public health nurses during deliveries_ with his medical judgment and technical skill, without assuming responsibility for the treatment of complicated midwife cases. He consults frequently and at all hours with the

88

Georgia Department of Pztblic Health

public health nurses who are supervising midwife deliveries, and when need arises visits the midwife case, determining whether or not the midwife needs medical assistance. This procedure reduces the amount of charity work being done by private practitioners to a minimum, while still allowing them to maintain entire responsibility for all abnormal deliveries.
Of the total deliveries in Tift County in 19L1Q, 154, or 30;k, were attended by midwives. Of the 310 physicians' cases, 292 received nursing delivery service. In only one case was there a delivery without an attendant, and every case received at least one postpartum visit.
It is very encouraging to note that in 1940 cases have been admitted to prenatal medical and nursing service during the early months of pregnancy in far greater numbers than in any previous year. It is also notable that the period of gestation at which physicians' cases report for nursing service hy no means indicates the amount of prenatal care that they have received, since quite often physicians delay reporting their private cases until the later months of pregnancy. This has been discouraged, hut still a number of doctors fail to report patients who have been under their care throughout pregnancy until the last trimester. It is most encour~ing to note that only 3 midwife cases reported for prenatal care during the month of delivery, and only 28 reported during the last 3 months o_f gestation. All others reported prior to this time. Of J37 deliveries, 81 were admitted for prenatal supervision before the end of the sixth month, and of this group, 48 had been admitted before the end of the fourth month.
It is fully recognized that the work in Tift County is not being done as completely as possible, and that some statistical inaccuracies still exist, hut it is encouraging to note that with a relatively small staff a fairly complete public health program has been in operation, and that definite and considerable advances have been made in the county with reference to the management of obstetrics. One of the chief obstacles at present is the amount of work which is being attempted. This undoubtedly is more than can he accomplished thoroughly hy the present staff.

Following is a statistical summary of the Demonstration's activities:

Livebirths

~l'otal -------------------------------------------------------------------

<122

White ------------------------------------------------------------------- 286

Colored

136

Deliveries

Total Deliveries ____ ----------------------------------------------- -----Admissions to Nursing Service______.;.. ____________________________________ _
Admissions to Medical Service___________________________________________ _

Deliveries by physicians-------------------------------------------- 310

Deliveries by rnldwives ---------------------------------------------- 13<1

Deliveries with no attendance _________________________________ --- ----

1

<1<15
<107
270
or 69.7 % or 30.3 %

Maternal and Child Health

89

Physicians' Cases Receiving Nursing Delivery Service

rota! -----------------------------------------------------------------White ------------------------------------------------------------------

Colored -----------------------------------------------------------------

(91.2% of all physicians' deliveries received nursing service)

Cases receiving pituitrin prior to 3rd stage_________________________ _ 83

Cases receiving pituitrin in 3rd stage and lJOStpartum only------------ 36

Lacerations, 1st and 2nd degree_____________________________________ 19

Lacerations, 3rd degree____________________________________________ _

1

Analgesia andjor Anestllesia -------------------------------------- 212

Chloroform -------------------------------- 201 Ether -------------------------------------- 11

292 275
17
Ol' 28.4 % or 12.3 % or 6.5 % or 0.34% or 72.6%

Post11artum Nursing Service Covering All Confinements 1'otal Patients receiving postpartum visits___________________________ _

Patients receiving three postpartum visits______________________ 357

Patients receiving two postpartum visits_______________________ 40

Patients receiving more than three postpartum visits____________ 35 ;I'atients receiving one postpartum visit________________________ 16

:.\Iorbidity: (lOOA degree afte1 fourth Partum) -------------

9

418 or 100.5 o/o or 79.7 % or 8.0 % 01' 7.8%
or 3.6%
or 2.0%

Rates
Maternal Deaths --------------Stillbirths --------------------Infant Deaths ----------------Deaths under one month _______ _

White 3
15 16

Colored 0
11 1

Total 3
22 27 13

Rate per M.L.B. 6.5
52.1 63.9 30.8

Delivery of Luetic Prenatals

Total -----------------------------------------------------------------

42

Treatment :

8 injections --------------------------------------------------------

20

8 to 12 injections--------------------------------------------------

11

13 or more injections ________ .---------------------------------------

11

Outcome of Luetic Prenatal Deliveries

.tlbortions -------------------------------------------------------------

3

Stillbirths -------------------------------------------------------------

4

Neonatal Deaths

2

PERIOD OF GESTATION ON ADMISSION TO PRENATAL MEDICAL ANDjOR NURSING SERVICE

Month of Gestation

Under 4 mon.

Months

6

8

9

Mon. Del.

Total

Doctors' cases

1-1-40 to 4- 1-10

11 15 23 10

13

U6

'1-1-<10 to 6-30-40

10

10

6 13 12

57

T-1-10 to 0-30-40

10

9 12 16

9

67

10-1-40 to 12-31-<!0

15

12

0 H 22

83

Total Clinic Cases

<1<1

<!0 ,!4 58 66 23

28

303

1-1-10 to 4- 1-<!0

'1-1-<10 to 6-30-40

11

7-1-10 to 9-30-10

13

10-1-<JO to 12-31-<JO

17

!

6

3

<]

5

1

3

2

2

1

!l. '2

33

1

36

o,

30

o

38

Total

48

Doctors' and Clinic Cases

'l'otal --------------- 92

25 18 18 17 65 62 76 83 31

137

31

<1'!0

ANALYSIS OF MCH AcTIVITIES IN ORGANIZED CouNTIEs FOR THE CALENDAR YEAR 194,0

'0 0

City of Atlanta Baldwin Bartow

Bibb Bleckley

Brooks Bulloch Burke Calhoun

MIDWIFE ACTIVITIES

l. Midwives registered for formal iustruc-

tion --------------------------------

39

2r

7

12

15

50

32

'l2

28

2. Midwives certified, totaL-------------

33

27

7

42

14

47

27

66

28

(j)

White ----------------------------- 1

0

3

0

1

2

4

1

0

8"'

Colored ----------------------------

32

27

4

42

13

45

23

65

28

a<i

3. Midwife meetings (number)----------

13

12

:l

12

12

11

9

121

45

"!;:',

4. Attendance Per meetings (% those reg-
istered) ----------------------------
5. Visits per midwife for Supervision __
6. Total midwife deliveries ------------
7. Average number deliveries per midwife

30 .36
100 ::I

61 1.8
189 7

:3:1 .28
72 10

66 .9
506 12

58 8.6
124 8

45

!:iti

46

11

2.6

.59

1.4

.9

298

237

Glti

211

G

9

9

8

t:::i
"''"\::)
!.;.:.,,
"

8. % of total delivered by midwives ____

1.8

60.0

12.7

32.6

56.1

9. No. midwives 60 years old or ovet __

15

14

1

12

5

PRENATAL ACTIVITIES

:-;~~.

.:;:;_~

60.0

41.4

84.4

84.7

23

8

37

16

-~"'
0

10. Cases admitted to prenatal medical ___ ..!.=;.

:'i;:::i

service ----------------------------

188

144

19

966

7l

403

150

443

126

:

11. % of midwife deliveries admitted to

~-

medical service ---------- ---------- 188

76

26

190

57

12. No. field visits per prenatal nursing

admission --------------------------

2.7

1.7

13. Average number visits by prenatal

.37

1.56

1.08

135

63

72

.68

.22

1.0

60 .Oil

i:J:::
E;",-':--

cases per session ____________________

12.7

5.8

2.1

26

4.6

12.9

5.0

ri.F:

6.11

14. Visits per admission of prenatals !o

medical conference ------ --------

3.4

2.0

1.7

4.9

2.8

15. Cases given vostpartum medical exam-

3.1

1.76

2.4

u

ination ---- ------------------------

r.

90

3

401

l

!6.% of !Jrenatal admissions receiving

10

1:!

11ostpartum examination ____________

2.7

62.5

15.8

41.5

1.4

4.0

S.7

.4:1

ANALYSIS OF MCH AcTIVITIES IN ORGANIZED CouNTIES FOR THE CALENDAR YEAR 194,0-Continued

City of Atlanta Baldwin Bartow

Bibb Bleakley

Brooks Bulloch Burke Calhoun

INFANT ACTIVITIES
17. Admissions to medical service------18. Field visits per infant adm. _________ _

700 11.5

139 2.1

11 .07

g1o 2.5

5i'i .%

147 1.67

7~
.67

2'ig 1.0

~!:!
.1:i

19. .Average number visits by infants per

session ----------------------------

7.7

""""

.47

8.3

2.3

20. Visits per admission to medical service

3.3

2.1

1.3

3.5

1.8

3.4

2.:1

3 )

.71

1.7

1.7

2.0

1.3

~

21. % of total liYe births (1940) admitted

!?.

to nursing service___________________ 105.8

.33

2.5

68.6

28.1

.40

12.2

.38

10.4

t"'

IMMUNIZATIONS (Persons Immunized)

22. Ratio diphtheria immunizations under

!;:)
:;:;

1 year to total li1e births (1940) _____ 1 :4.7

1 :3

1 :9

1 :3

l )

1 :2.7

1 :6.5

1 :3.8

1 :11

!;l.,

23. Ratio smallpox vaccinations to total

live births (1940) ------------------

1 :1.6 1 :0.22

1 :.7

1 :.9

1 :.9

1:.6

1 :.::1

1 :~.:-:

1 :1.0

C:;::J-
~

PRESCHOOL ACTIVITIES

24. Admissions to medical service________ 1:H9

l~B

110

:i20

23

154.

42

99

16

i:!::

25. Number visits per admission io medi~

cal conference ----------------------

2.ri

1.5

l.Ofi

=~.!-;;

1.04

1.6

1.0-1

1.06

1.11

"'!:;;::);-
:;::-

26. Field visits per medical admission____

IA

1.4

7''

:t.7

.65

1.1

.38

1''

27. Average number visits per session ___

9.9

4.6

1.7

;;,g

1.9

3.5

.80

!.II

SCHOOL HYGIENE ACTIVITIES 28. Number of examinations of school
children, b) physicians .---------29. % of school population examined___ _ 30. Number inspections by dentists _____ _ 31. % of school population inspected by
dentists

40962 93
38500
88

1529 53 341
12

1208 28 733
17

12950 96
11327
88

1570 76 0

353 8
1802
42

88 1.7
878
17

491 8.7

100 4.2 0

.\..0..,

\0

ANALYSIS Of MCH AcTIVITIES IN ORGANIZED CouNTIES FOR THE CALENDAR YEAR 194.0-Continued

~

Chatham Clarke Clinch

Cobb Coffee Colquitt Cris11 Oecatur Del<alb Dodge

MIDWIFE ACTIVITIES

l. :Midwives registered for formal instruc-

tion ------------------------- _______ 2:!

21

u

2. Midwives certified, totat_ ______ . ______ ~0

2~

10

White ----------------------------- 0

0

1

Colored ---------------------------- 211

22

9

3. ~1idwife meeting-s (number) __________ ~:!

lG

12

4. Attendance per meeting-s (% those reg-

isteted) --------------------------- _ 3;{

87

6:i

.i. Yisits per midwife for Supervision ____ :J.H

1.6

BA

G. 'l'otal midwife deliveries _____________ 1:19

lTG

90

7. Average number deliveries per mid\vife T

s

H

S. % of total delivered by midwives ____ 6.2

3:!.2

69.8

9. No. midwives 60 years old or over____ 6

:;

;;

PRENATAL ACTIVITIES

10. Cases admitted lo prenatal medical

service --------------------------- 1678

IRS

83

11. % of midwife deliveries admitted to

medical service ---------------------1207

lOT

92

12. Xo. field visits per prenatal nursing

admission __________________________ 4.4

Ui

2.9

13. Averag-e number visits by prenatal

cases per session____________________ 19.2

12.R

11.3

14. Yisils per admission of prenalals to

medical conference ----------------- :LR

2.3

2.2

l!j. Cases given postpartum medical exam-

inalion ---------------------------- :~2! 16.% of prenatal admissions receiving
positlartum examination _____-:....... -- 1!1.:1

2

0

1.1

0

10 11
1 10 11
47
.:w
G4 G 9.6 6

30 30
6 21
::o
11 2.9
217 7
3:1.7 H

211 31
l.!T II
1.:~
0 II

120 i3:i .:Jl 3.2 3.7 73 fil.O

33 33
2 31 10
1:i 1.5
231 7
30.1 18

3:l 28
0 28 18
67 .14
248 9
liSA Hi

36 36
1 3:-i 21
2j 3."0 249 7 ::10.2 14

196
s:;
l" 11.:; 4.1
0 0

210

2:18

S::i
.o:n

101 .18

8.7

11.2

3.1

4.:1

1

0

.0:0

0

32 32
0 :12 16
60 3.0
228 7
H.:i 9
GR
30
.69
0
1.0
29
43.0

22

20 3

<.:!
8'"

17

CT~

13

:";:",

1:::::!

39 1.1

"e't":l

22:{ 11

~

ri0.2

~'"

4 -a .

'\:j

118

c~s

.I.}

l:l::;

.06 f'": ;:::-.

3.7

2.11

16

1:1(1

ANALYSIS OF MCH AcTIVITIES IN ORGANIZED CouNTIES FOR THE CALENDAR YEAR 1940-Continued

Chatham Clarke Clinch

Cobb Coffee Colquitt Cris(l Decatur Del<alb Dodge

INFANT ACTIVITIES

17. Adlnissions to medical service ________ 635

219

01

40

205

118

90

56

73

81

18. Field visits per infant adm.__________ 16.0

7.6

6.2

.5

.87

.25

.37

.38

.32

19. Average number visits by infants per

session ---------------------------- .94

11.7

3.6

5.4

6.5

5.1

1.2

2.2

~

20. Visits 11er admission to medical senice 1.1
21. '/o of total live births (1940) admitted
to nursing ser\ice___________________ 155.8

3.6

.77

1.0

.74

83.7

5.3

3.2

2.1

1.3

2.3

1.0

1.3

.40

16.3

27.5

11.5

21.1

19.4

:'";::", "
8...,

._

IMMUNIZATIONS (Persons Immunized)

22. H.atio diphtheria immunizations under

:;::, ;:;

1 year to total live births (1940) ---- 1 :6.1 23. Ratio smallpox vaccinations to total

1 :4.5

1 :2.8

1 :9.6

1 :1.8

1:5.8

1 :3.4

1:4.8 1 :15.7

1:4.9

("'.")'

live births (1940) ------------------- 1 :.15 1 :1.1

1:3.4

1 :1.6

1 :.62

l :1.9

1:1.4

1 :.3

1 :1.3

1 :1.1

;:;-
t"S"::

PRESCHOOL ACTIVITIES

24. Admissions to medical service________ 1046

85

34

141

99

7iJ

59

41

331

124

,::.:.::

25. Number visits per admission to medi-

:;::,

cal conference --------------------- 1.06

.94

.26

1.13

2.10

1.8

1.08

3.8

.92

1.2

;::::-
;:;-

26. Field visits per medical admission____ 1.10

2.6

3.3

.09

.63

.01

.05

.17

.41

0

27. Average number visits per session____ 1.5

0

0

2.4

0

2.9

1.!1

4.9

3.2

SCHOOL HYGIENE ACTIVITIES

28. Number of examinaiions of school

children, by physicians ______________4107

!i!i6

1801

460

514

29. % of school potJulation examined____ 26

11

137

12

30. Number inspections by dentists ______ 3504

0

655

1471

0

31. % of school potmlation inspected by

dentists ---------------------------- 22

50

22

143

207

2

G

.06

5245 5:J

I:i99 34
329

\0 CJ;)

1.0

ANALYSIS OF' MCH AcTIViTIES IN ORGANIZED CoUNTIES FOR THE CALENDAR YEAR 194.0-Continued

~

Dougherty Floyd Fulton

Glynn Mcintosh Camden Grady Greene

Hall

MIDWIFE ACTIVITIES

1. ~!idwires registered for formal instruction

~- :Hidwhes certified, total --------------
\\'hite -------------------------------
Colored ----------------------------:L )lidwife meetings (number) ____________

-1. Attendance per meetings ('/o those reg-

istered) --------

-----------

:.i. Visits per midwife for Sut1ervision______

6. Total midwife deliveries ____ ----------'i. Average number deliveries ver midwife ___

S. ',{ of total delivered by midwiYes ________

9. Xo. midwives 6(1 rears old or over_

PRENATAL ACTIVITIES 10. Cases admitted (o vreuatal medi<al ~ervi('e --------- ___ ll. '/r of midwife deliveries admitted io medical service 1:!. Xo. field visits ver prenatal nursing admission -------------------------1~. AYerage number visiis by prenatal cases
per session ---------- ----------------- _ 14. Yisits per admission of prenatals to med-
ical conference ____ -------------------Iii. Cases given postpartum medical examiua-
tlon ---------------------------------16. <k of prenatal admissions receiving post-
partum examination ________ ------ -

IX

:!~

E

I7

:!:!

:!4.

:!U

IX

Li

IX

:!.J

15

13

0

3

2

I

JX

:!:!

J:J

1:!

:!4

l

:!1

1:!

1:-i

24

2:.J

l-l

13

<;')

"1:-i

I
:!~1

3 22

0 ll

:i

4

12

1:!

(i 'j J

a(I> ~
~-

XI

'j 4

j()

:IX

li.H

4.:i

:u

:!.1

TO

...

.J:,i

:1:!

:l2

t::l

X.:!

H.O

1.0

i .0

:!.J

~

I~4

l-l!l

IX4

1.11

l :!:~

liiH

J7(i

142

X(i

]] :iX.!l

"12.7

1:! :!.:i

1:! :l2.4

X

:i

7

10

7

Fi.:l

7!i.S

40.0

:i3.0

I:L.t

I;>
s."..'
(I>

~I

'j

l

I

,[

14

j'j

H

u

~

..0.._

:ISH

..

:!1:!

:!~::

j;{

:!7

IX'i

:!23

..j"

'"t;
!;:
~

:!00

r.:;

ll:J

l:J:J

l!l

:w

7H

lo7

,;()

<":>

:::.::

L:J

u

:!.1

.:i2

:tg

2.0

1.1

~

.60

2.1

I;>

~

;::,-

:!:!.i-1

0

6.:!

:LO

,10

.07

5.6

7.7

:i.R

-1.4

0

:!.H

l.li

L7

1.0

2.4

2.4

:u

(j(i

0

:!0

:!:!

0

0

g

l!:i

17.0

0

!U

!1.0

0

0

6.6

-6-'- - - - - -

ANALYSIS OF MCH ACTIVITIES IN ORGANIZED CoUNTIES FOR THE CALENDAR YEAR 1940-Continued

Dougherty Floyd Fulton Glynn Mcintosh Camden Grady Greene Hall

INFANT ACTIVITIES

17. Admissions to medical serYice___________

194

1

520

199

0

0

18. Field visits per infant adm._____________

6.2

371

4.5

~.l

253

~69

71

194

43

6.1

2.4

8.0

19. Avetage number visits by infants per

session --------------------------------

1.9

0

3.6

2.7

(I

0

9.4

4.6

3.0

20. Visits per admission to medical service__ 21. % of total live births (1940) admitted to

1.5

0

!.9

l.ri

0

(I

2.4

1.2

l.:i

~
c.:;:,

nursing service -----------------------IMMUNIZATIONS (Persons lmmuni2ed)

89.2

11.8

66.8

U!i.ll

:{:),0

73.2

59.1

102.6

~9.:1

-;:i
:;:,

22. Ratio diphtheria immunizations under 1

:;:, ;;:;

year lo total live births (1940) ----------

1 :4.1 l :l!l.l

1 :9.!i

I :1.::

1 :~.2

1 :2.[1

1 :1.95 1 :2.6

1 :2.0

:;::,...

2:1. Ratio smallpox vaccinations to total live births (1940) --------------------------
PRESCHOOL ACTIVITIES

1 :.fi

1 :.fi

1 :l.Ui l :.7

C}

I :A

I :.3

l :2.1

l :.2

1 :1.3

;;:,-.
:;::.;

~;

::::,..,

24.. Admissions to medical service__________ -

373

140

2034

:l60

0

25. Number visits per admission to medical

conference ----------------------------

2.6

1.0

1.5

l.lS

(I

67

43

178

167

:::t:

1.0

1.4

2.9

2.9

;'~";

26. Field visits per medical admission_______

3.3

.63

1.09

.43

(I

16.4

9.7

4.1

2.7

27. Average number visits per session_______

4.6

0

10.7

3.~

0

.17

3.4

10.8

18.8

SCHOOL HYGIENE ACTIVITIES

28. Number of examinations of school chi!-

dren, by physicians---------------------

lii4

3208

7932

G~

29. % of school P011Ulation examined________

3

36

41

2

30. N"nmber inspections by dentists __________

1533

0 l!iOO:l

lR~O

31. % of school ll0!1Ulation inspected by

dentists ------------------------------

34

0

7g

rt'i

1

354

1193

459

2523

(I

28

30

16

40

II

0

0

0

\0
C)1

\0

ANALYSIS OF' MCH AcTIVITIES lN ORGANIZED CouNTIES FOR THE CALENDAR YEAR 194.0-Continued

0\

Hancock .Jefferson Jenkins Jones Laurens

Lowndes Mitchell Muscogee Richmond

MIDWIFE ACTIVITIES

1. Mi.dwives registered for formal instruc-

iion --------------------------------

31

GO

13

24.

47

46

33

42

38

2. ~Hdwives certified, totaL _____________

31

GO

13

20

42

43

29

22

32

q")

White - ----------------------------

0

0

0

0

2

1

0

1

4

.0"..'.

Colored ----------------------------

31

50

13

~0

40

3. ~1idwifo meetings (number) _______.___

5

IS

12

11

10

42

29

21

28

13

12

13

9

""':";:',

4. Attendance 11er meetings (% those reg;-

istered) ----------------------------

ti3

20

83

,10

67

5. Visits 11er midwife for Supervision ____

4.7

1.5

3.4

l.l

0

6. Total midwife deliveries ------------- 254

428

141

125

386

36 2.8
388

35 .9
367

41 3.2
243

54 1.4
143

b ~
g:;:,

7. Avel'age number deliveries ver midwife

8

9

11

6

9

9

13

11

4

S. % of total delivered b) midwives ____

83.0

82.0

49.3

72.7

48.9

9. No. midwives 60 years old or over____

14

20

9

i2

19

PRENATAL ACTIVITIES 10. Cases admitted to prenatal medical

56.6

61.2

16.2

8.9

18

23

12

19

~"'
--0
~

service ---------------------------- 331

497

25J

77

21

4tl:::l

413

1007

1044

:

11. % of midwife deliveries admitted to

;s

medical service --------------------- 138

116

179

62

5.4

12. No. field visits per prenatal nursing;

admission --------------------------

.51

.12

.68

.so

1.0

13. Average number visits b~ vrenatal

127 .77

113 1.33

414 1.0

730 3.4

i::l:::
s"~'.

case~ per session ____________________

6.5

7.5

18.2

1.0

0

25.2

11.2

2.7

24.6

14. Visiis IJer admission of vrenatals io

medical conference -----------------

2.1

3.1

5.0

2.1

.3R

ltl. Cases giYen postilartum medical exam-

.'L3

2.G

4.2

3.6

inatiou --- ------------------------ 10

7!J

0

4

2

1G.% of tlrenatal admissions recei\ing

93

!J8l

3

39:1

llOSlDartum examination ------------

19.9

Hi.1

0

5.2

10.0

19.0

140.6

.03

37.6

ANALYSIS OF MCH AcTIVITIES IN ORGANIZED CouNTIES FOR THE CALENDAR YEAR 194,0--Cont:inued

Hancock Jefferson Jenkins Jones Laurens

Lowndes Mitchell Muscogee Richmond

INFANT ACTIVITIES

17. Adlnissions tCJ medical service________ 233

109

73

53

64

213

246

809

422

18. Field visits per infant adm. __________

2.75

.45

1.7

2.7

2.2

3.3

1.2

2.0

18.8

19. Average number visits by infants per

session ----------------------------

4.2

.92

1.0

6.5

0

20. Visits per admission to medical service

2.0

1.8

2.5

1.5

.06

21. % of total live births (1940) admitted

13.1

5.3

5.6

7.2

3,:1

10.8

1.9

3.1

...~
:;::,

to nursing service___________________ 132.0

20.!1

40.9

75.0

5.8

55.0

41.0

63.3

92.4

-~"'

IMMUNIZATIONS (Persons Immunized)

~

22. Ratio diphtheria immunizations under 1 year to total live births (1940) ____

1 :1.9

1:5.4

1 :4.0

1 :2.4

1 :2.8

1 :3.6

1 :2.6

1 :8.7

l :4.li

:;;::::,;

23. Ratio smallpox vaccinations to total

:;::,...

live births (1940) ------------------- 1:.36

1 :.4

1 :.7

1:.9

1 :.9

1 :1.3

1 :4.7

1 :.9

1 :1.1

(.J
:;::,-.

PRESCHOOL ACTIVITIES

I"S'::

24. Admissions io medical service ________ 237

40

0

52

87

3RO

325

976

()9:1

25. Number visits per admission to medi-

cal conference ----------------------

1.6

26. Field visits per medical admission ____

1.4

4.2

0

.27

0

1.4

.01

1.9

2.1

2.1

1.3

1.4

3.2

1.6

1.2

.61

4.

:::0
;"~;':.

27. Average number visits per session____

3.6

.87

0

l.O

0

13.1

4.4

5.03

12.2

SCHOOL HYGIENE ACTIVITIES

28. Number of examinations of school

children, by physicians--------------

75

191

29. % of school population examined____.

2.8

5

30. Number inspections by dentists ______

S9

0

31. % of school population inspected by

dentists ----------------------------

~

0

601

1454

2G

67

812

1287

:l5

59

174 2.3 0
0

4654 75 2
.03

210 4.3
146

!i83
0"

1305 11 0

10 -.l

'-0

ANALYSIS OF' MCH AcTIVITIES IN ORGANIZED CouNTIES FOR THE CALENDAR YEAR 194.0-Continued

c~

S!Jalding Sumter Telfair Wheeler Terrell Thomas

Tift

Troup Walker Catoosa

MIDWIFE ACTIVITIES

1. 1\iid\vives registered for formal instruc-

iion -------------------------------- 20 2. Midwives certified, totaL _____________ 15

White

~----------------------------

0

Colored ---------------------------- 15

3. lllidwife meetings (number)--- ______ 14

4. Attendance per meetings (% those reg-

istered) ---------------------------- 33

5. Visits per mid\vife for Sunervision - __ 1.6

6. Total n1idwife deliveries ------------ 161

7. Average number deliveries per midwife 11
8. % or total delivered by midwives ____ 31.4

9. No. midwives 60 years old or mer ____ 11

PRENATAL ACTIVITIES 10. Cases admitted (O prenatal medical
service ---------------------------- 193 11.% of midwife deliveries admitted to
medical service ---------- ---------- 120 12. :-\o. field visits per prenatal nursing
admission -------------------------- 1.33 13. Average number visits by . prenatal
case:o per session-------------------- 0 14.. Visits per admission of prenatals to
medical conference ---------------- 3.3 1G. Cases given postpartum medical exam-
ination ---------------------------- GO
1G. % of 11renatal admissions receiving llOSiparitun examinaiion ------ ----- 31.0

44 43
0 43 41
18 1.4
377 9 71.7
25
524
139
.22
10.9
2.4
11
2.1

21 25 3 22 29
20 3.2
194 8
47.8 14

ll

28

5

28

0

0

5

28

10

ll

31

42

5.8

0

78

333

15

12

45.6

77.3

3

18

32 38
1 37 12
uo
2.3 303
8 52.1 22

104 54
1.1 5.G 3.9 1
.01

96 123
.58 2.G 2.1 27 28.1

398

536

120

177

.025

.44

8.3

20.0

4.1

:~.6

1

0

.2.1

0

1~
13 0
13 10
49 4.7
l2j 10 31.7 5
268
215
2.7
5.9
4.4
S2
30.G

35 39
2 37 42
10 2.7
296 8
36.7 19
203
69
1.2
20.2.
3.7
79
~8.9

ll ll
4 7 4

:1 3
"
0 0

'0
8"'
~
"!;::">

1:::::1

55 1.3
~9
4 7.2

0
6""'
14 5 7.G

""s.",.'';.
;;J
"~ '

G

0

._0,_,

"'':;

8

(l

: c:;

21

43

i::t:

2.0

.9

"'!;::>
;~ :::-

.I d

.7::1

0

lG.G

ANALYSIS OF MCH AcTIVITIES IN ORGANIZED CouNTIES FOR THE CALENDAH YEAR 194.0-Continued

S~alding Sumter

Te~fair Wheeler Terrell Thomas

Tift

Troup Walker Catoosa

INFANT ACTIVITIES

17. Admissions to medical service-------- 139

264

44

38

112

372

138

87

24

33

18. Field visits tJer infant adm. __________ 2.9

.66

2.7

.026

0

1.53

ll.S

2.0

.12

2.8

19. Average number visits by infants ver

session ---------------------------- 8.3

6.4

2.4

20. Visits per admission to medical service 2.2

2.8

2.2

21. % of total live births (1940) admitted

.47

6.2

13.8

7.9

2.::1

.89

2.4

3.6

2,1

1.3

to nursing service------------------- 50.9

74.0

23.4

31.6

26.0

66.7

128.9

17.1

7.8

5.U

1.6

2.2

5.0

32.4

~
"".~,.'',.

IMMUNIZATIONS (Persons Immunized)

~

22. Ratio diphtheria immunizations under



1 year to total live births (1940) ---- 1 :2.2

l :6.5

1:4.2

1 :1.9

1:7.4

1 :3.1

1 :2.7

1 :8.8

l :.7

1:3.9

:;:,....

23. Ralio smallpox vaccinations to total

(.]

live births (1940) ------------------- 1:.6

1 :.4

1 :1.6

1 :1.6

1 :1.6

1:.6

1 :3.2

1 :.;}

1 :.2

l :.3

~

PRESCHOOL ACTIVITIES

~

24. Admissions to medical service ------- 272

187

7

0

0

141

159

77

us

44

::x:;

25. Number visits per admission to medi-

eal conference --------------- ------ j.l

2.1

1.0

0

0

26. Field visits per medical admission --- .69

.fi2

0

0

0

l.G

1.3

.09

1.2

1.2
].:)

1"..

2.3

.04

1.4

"~'
~

27. Armage number visits per session ____ 15.7

3.7

0

0

0

2.6

14.9

2.6

32.;'")

14.7

SCHOOL HYGIENE ACTIVITIES

28. ~umber of examinations of school

children, by physicians ------------- 457

1463

2093

760

179

239

~H. % ot' school population examined ____ n

32

6fi

40

G

12

:10. Number inspections by dentists __

0

0

533

0

0

4

31. % or school llOIHLlation inspected !Jy

denlisls ---------------------------- 0

0

16

0

0

.9

0

274

332

216

0

4

G

12

II

:17:10

!1411

0

(I

4R

11

\0 \0

I-'

ANALYSIS OF lVICH ACTIVITIES IN ORGANIZED COUNTIES FOR THE CALENDAR YEAR 194,0-Continued

0 0

--
Haber-

Walton Ware Washington Wayne Whitfield Worth Stephens Rabun sham

MIDWIFE ACTIVITIES l. Midwives registered for formal instruction 2. Midwives certified, totaL _______________
White --------------------------------Colored ------------------------------. 3. Midwife meetings (number)------------4. Attendance per meetings (% those reg-
istered) -------------------------------
5. Visits per midwife for Supervision______ 6. 'l'otal midwife deliveries_____.----------7. Average number deliveries per mid\vife ___ 8. % of total delilered by midwives ________ 9. No. midwives 60 years old or over_______
PRENATAL ACTI.VITIES 10. Cases admitted to prenatal medical
service --------------------------------11. % of midwife deliveries admitted to med-
ical service -------------------------12. No. field visits per prenatal nursing ad-
mission -------------------------------
13. Average number visits by prenatal cases per session -------------~--------------
14. Visits per admission of prenatals to med-
ical conference -----------------------15. Cases giYen postpartmn medical examina-
Uon ----------------------------------
16. % of prenatal admlssions receiving post-
partum examination -------------------

19 17
0 17 11
52 .29
150 9
35.4 8

30 28 5 23 12
39 2.9
236 8 40.6
12

58 53
0 53 123
4.7 4''
434 8 74.1
30

13 10
3 7 12
38 6.3
139 14 38.2 7

49

136

357

!IX

33

58

82

42

.32

1.2

.20

2.1

3.6

8.5

8.9

4.1

1.6

Ui

3.2

2.4

0

41

0

7

0

30.1

0

12.1

8

24

4

7

5

26

3

6

4

0

0

6

1

26

3

0

12

12

1

9

32

50

75

54

l.O

.58

6.3

3.0

66

249

59

55

13

10

20

9

11.7

48.5

19.9

32.7

4

19

1

0

46

.258

70

114

1.0

1.0

3.5

1.9

1.7

l.O

0

4

0

1.4

38

60

64

109

.9

1.0

8.3

5.0

1.3

1.8

0

s

0

13.3

10

10 6

~
~

4

.C...l

16

at,
i

33

1::::;

l.O

~

g> 9

gi;l

23.8

~

9

-~
Cl

'"1:1

33

~

36

"""'

1::!::

~

.25

i.,;..l...

;'":,"-.

1.5 12 36.4

ANALYSIS oF MCH AcTIVITIEs IN 0H.GANlZED COUNTIES FOH. THE CALENDAH. YEAH. 1940-Continued

Walton

Ware Washington Wayne

HaberWhitfield Worth Stephens Rabun sham

INFANT ACTIVITIES

11. Admissions to medical service___________

77

181

123

48

65

230

13

18

18. Field visits per infant adm. -------------

.77

1.7

2.5

1.4

.07

1.3

3.3

5.9

3.2

19. Average number visits by infants per

session --------------------------------

3.8

12.5

2.5

4.:l

3.5

1.5

2.3

1.7

1.7

20. Visits per admission io medical service __ 21. % of total live births (1940) admitted to

1.5

3.7

2.0

~.0

2.1

1.0

1.9

1.2

l.O

~

~

nursing service ------------------------

22.2

31.2

40.8

1!1.2

11.3

44.8

14.5

27 .4.

4.4

~

~

IMMUNIZATIONS (Persons Immunized) 22. Itatio diDhiheria immunizations under 1

.~,

year to total live births (1940) __________

l :4.0

1 :2.1

1 .') 9

1 :2.H

1:6.4

l :1.4

1 :6.3

1 :2.8

1 :3.0

~

23. Hatio smallpox vaccinations to total live

births (1940) --------------------------

1 :. 7

1 :.7

1 :.rl

1 :.!1

I :1.2

1 :1.1

1 :.0

1:.4

1 :.7

C)
;::,-.

PRESCHOOL ACTIVITIES

~

24.. Admissions to medical service----------

59

1'10

222

19

16S

!00

55

10

25. Number visits per admission to medical

:;

.,1::!::
ct>

conference ----------------------------
26. ltield visits per llledical admission _______

2.1

4.9

.61

1.3

1.2

1.1

.43

.10

1.6

1.2

.01

1.5

1.0

1.2

.32

3.3

1.0 l.O

;';;-.

21. AYerage number visits per session_______

4.2

13.1

3.05

2.~

6.97

.8

0

1.3

0

SCHOOL HYGIENE ACTIVIYIES

28. Number of examinations of school chi!-

dren, by physicians ____________________

331

4838

219!

295

29. % of school population examined________

9

82

48

10

440

305

17

7

10

8

.06

.04

30. Number inspections by dentists __________

0

0

19RG

II

4125

36

0

0

42::i

31. 'Ia of school population inspected by

dentists ------------------------------

0

0

43

0

H2

.9

0

0

13

-

!--'

0

!--'

Division of Dental llealth Education

]. G. Williams, D.D.S., Director

Annie Taylor .

. Associate in Dental Health

REPORT FOR YEAR ENDING DECEMBER 31, 194.0

The 1940 program of the Division of Dental Health Education has been similar to that of previous years. Our aim, to educate the public to appreciate the value of dental health, and to know and utilize the most effective preventive measures, has remained the same. In order to reach this aim, we have conducted educational programs in schools, colleges, teachers' meetings, and civic organizations of all types.
During the year, new opportunities for dental health education have been opened. The Associate has participated in the In-Service-TeacherTraining Demonstration being conducted in Colquitt County. Dental surveys have been made and educational programs have been presented in an effort to help the National Youth Administration secure dental aid for their 8,000 youths. Conferences have been held and plans made for the beginning of dental clinics for indigent children.
We wish to express our appreciation to the Georgia Dental Association, Georgia Congress of Parents and Teachers, Department of Education and local school systems, Agricultural Extension Service, National Youth Administration, and other organizations interested in health and welfare, for their active interest in the promotion of dental health and dental health education in Georgia.

PERSONNEL
The personnel of this Division consists of: a dentist who gives his services to direct the dental policies of this Division (part time) ; an Associate in Dental Health (educator), and a secretary.
EDUCATIONAL WORK
Schools The Associate in Dental Health has visited 72 schools during the
year, with an attendance of 25,888. Films were shown at 69 of these schools, with an attendance of 25,413 children.
Colleges Films were shown at five colleges: Piedmont, South Georgia Teacher
College, and Georgia State College for Women (three times). Also films were shown to 200 students of the Fort Valley Negro College. The total attendance was 1,350.
Teacher Education Talks were made and films shown at two county teachers meetings-
Tattnall and Wayne-and a teachers' conference was held at the Madison City School. The teachers of Marion County, one of the eleven counties which have not conducted dental inspections or any organized dental

Dental Health Education

103

health activities, ha ve organized a Dental Health Council. Eight teachers' meetings were attended with an attendance oi 335.
Parent-Teacher Associations, Women's Clubs, and Civic Organizations Films were shown to ll parent-teacher associations, ten c ivic organ
izations, and six women's club during the year.

Eo CATION
Women's Auxiliaries to the County iVfedical Associations The Women's Auxi liaries to the County Medica l Associations in
Chatham and Ware Counties have sponsored programs in dental health education. In Savannah about fift y members saw dental mo vie and committees attended school programs and planned for the movi es to be shown at the Coastal Fair. In Ware County, the Auxi li a ry was responsibl e for a well-planned chedule of work .
4 H Clubs Programs have been presented at three 4 H Clubs with a total a ttend
ance of 395 bo ys and girls.
ational Youth Administration Survey and Programs Th e Director of Health Work for the Na:ional Youth Ad mini trati on
of Georgia has asked the advice and supp ort of the ~ tate Departmen t o f Publi c H ealth to devise so me practical plan for assisting their 3,000 yo uths to secure dental ca re. The Public H ealth Committee of the Georgia Dental Association ha been asked to work with the Department of Health. There have been three separate surveys made: one at Chapman Sprin gs; one at Mill edgeville, and the third at Dorchester.
ix programs have been presented to National You th Administrat ion groups with an attendance of 755.
In-Service-Teacher-Train ing Demonstration in Colquitt Cottnl)' The General Education Board in cooperation with the tate Depart
ment of Education has selected Colquitt County and Moultr ie chool S ~ te ms fo r a demo nstra tio n o f " In- ervice-Teacher-Training" and

Georgia Department of Pnblic Health
dental health education is to be one of the special projects. Two very profitable days were spent in Moultrie in conference with county and city school superintendents, health officers, dentists, and five groups of teachers. The special committee on dental health agreed to accept the County Dental Health Council Plan. In the fall, three days were spent conferring with the Advisory Committee, the Dental Health Committee, the eight dentists in Moultrie, and plans for dental inspection and correc tion of defects and education were formulated. The dentists agreed to help with a plan to give dental care to indigent children. In May, the Committee on Dental Health proposed and the teachers accepted the following threepoint plan: (1) the organization of a Dental Health Council under the guidance and direction of the State Department of Health; (2) the development of a vital educational program in the schools and community to include teaching units for various grade levels and the preparation of materials to be presented to parent-teacher associations, civic organizations, the press, the radio, etc.; and (3) the conection of defective teeth among the children.
Negro Meetings Five talks have been made to Negro groups: at the Blackshear School;
the Annual Farm Program at Fort Valley Negro College; to 750 Negroes at the Woodville Negro Community Center (Chatham County), and at two Negro groups of National Youth Administration boys and girls.
Literatnre Distributed Teachers throughout the State are using educational material from
the Georgia Department of Public Health, including: "Dentistry and Public Health", "Preparing Teeth for School", "Dental Health Information", and "Good Teeth at All Ages".
Moving Pictures A new dental health education film has been purchased, "Behind the
Smile". It deals effectively with the value of nutrition, and the value of early dental care, beginning at 2 years of age. Other films used are: "Told by a Tooth", "Life of a Healthy Child", and "Care of the Teeth".
Radio Three radio talks have been made this year: "Dentistry Celebrates a
Birthday" (Dr. W. A. Garrett, member of Public Health Committee of the Georgia Dental Association, assisted the Associate) ; "Teeth, Health and Appearance" (The Dixie Farm Hour), and "Preparing Teeth for School".
DENTAL SURVEY OF SCHOOL CHILDREN IN GEORGIA, 1939-40
The accompanying tabulation of the results of the state-wide dental mspection made by the practicing dentists of Georgia during the school year, 1939-LW, is submitted by the Georgia Department of Public Health through its Division of Dental Health Education.

Dental Health Education

lOS

D ENTAL I NS PECTION
The Georgia Dental Association, the State Department of Education, the Georgia Con gress of Parents and Teachers, and the Agricultural Extension Service have been particularly active in sp onsoring the dental health education program and the Georgia Department of Public Health wishes to recognize their fin e spirit of cooperation. Appreciation is expressed to the Public Health Committee of the Georgia Dental Association and district and county dental chairmen and l ocal dentists, sch ool superintendents and teachers, and all lay groups wh o have participated individuall y and through their state and local or ganizations. Appreciation is expressed to the egro denti sts and the egr o State Dental Society for their efforts to improve dental health among Negro children.
This report includes a grand total of 153,684 dental in spections in 590 schools in 67 of Georgia's counties. Over 7,000 of these inspections were made in 36 egro schools in six counties. The tabulation includes insp ections in 454 white schools or 17.5 p er cent. of all white schools in the state.
The same typ e dental in spection blank was used this year as in the 1938-39 survey, two questions being asked: " Does child need dental treatment ? " and " Has child ever received dental treatment ?"
Analysis of data derived from the dental inspection bla nks returned reveals the following facts :
Exclusive of Atlanta, 72 % of the white children examined in the State need dental treatment.
Of the 7,163 egr o children examined in six counties, onl y 52 % need dental treatment. In the previou s year, 1938-39, it was found that 70% of the 4,523 Negro children examined in six counties needed dental treatment.
Considering the grand total of 153,684 children examined in Georgia, 63 % need dental treatment. In 1938-39, 65 % of 197,597 children needed dental treatment.

106

Georgia Department of Public Health
Sfr\TE OF GEORGIA, BOARD OF HEALTH DEPARTMENT OF f\JBLIC HEALTH Totial number white cl1.ildren inspected (exclusive of Atlanta) l53,G84
%needing dential treatment
72,3{,

LEGEND
~ 80 - 100%
am 60 - 7Yf,
40- 59%
5E 0 - 39% 0 No lnb1'ection

DEN'rAL SURVEY BY COUHTIES Showing :percentage school children needing dental treatment as reported in dental inspections, September 1939 -May 1940,
* Atlanta - 32 .a% need tree. tment

Dental Health Education

107

During the year 1938-39, a total of 98 counties conducted dental inspections in part or all of the schools. Fifty-nine of the 67 counties reporting similar inspections this year are included in surveys for both years. A reduction in percentage of children needing dental treatment is shown in 32 of the 59 counties reporting both years.
Five years ago, 1935-36, the same information was asked on inspection blanks. Records show that 37 of the 67 counties considered in this report were also included in the 1935-36 report. In 27 of these counties, the percentage of children needing treatment has been reduced from 85.8% in 1935-36, to 70.6% in 1939-4.0. These counties show what can he accomplished by an uninterrupted educational program over a period of years. In thinking of dental health education, one must consider a long range program to evaluate properly the benefits gained.
It is interesting to note that nine counties have an incidence of only 50% or below in children needing dental treatment. Further study of these counties shows that six of the nine counties have reported dental inspections for the past five consecutive years.
While fewer counties are included in this survey, we are pleased to note the addition of eight counties not reporting last year.
Among the counties deserving special commendation for the low percentage of children needing dental treatment and for returning a representative number of inspections made are (percentages): Walton, 22.9; Hancock, 25.1; lVlcDuffiie, 29.2; Jenkins, 33.6; Glynn, 48.8, and Wilkes, L19.8.

DENTAL SuRVEY oF ScHooL CHILDREN IN GEORGIA BY CouNTIEs-1939-194,0

1--'
0co

COUNTIES
Baker Baldwin

Need

Treatment Treatment

Need

Treatment

Need No

Treatment, Received in Received in

Inspected

Treatment

Received

Treatment, None None Ever Past, None Past, More

In Past

Ever Received

Received

Needed

Needed

,--

-~

~

~

~ ~ ~~

."~c'""="'
El:

""'~""''"
<".:>-c;
~~

"'" ZLlJ

" ' " C..LlJ

369 86.9

.... .":C: ."c'"-'
E~
Z"'t"-
321

~

.".,'
E

c
Q"...'.

z" c"..'

250 77.9

."...,.'.

~
~
Q

E
z::

.... c"..'

47 14.6

~

.."~ ,'.
E ::
z

z
Q....
c"..'

56 17.4

.~ ".,'

c
Q"'

=E

....

z c"..'

217 67.6

.~ .",'.
z=E

c
Q"...'.
c"..'

14 4.4

~

.~ ".,'
zE=

c
Q".... c"..'

34 10.6

IU
"'.c....
~

1,036 89.4

926

793 85.6

409 44.5

74 7.9

446 48.2

49 5.3

357 38.0 ~

Bibb Brantley Brooks
*Bulloch Calhoun Carroll

11.218 97.9 1.506 94.1 2.fi74 85.9
686 96.4 410 100.0
45 77.8

10,979 1.417 2,212
661 410
:1;;

8.812 80.3 1.06i\ 7r.i.2 1,460 66.0
49) 63.8 260 63.4
20 57.2

4.849 44.2

4

.3

247 11.2

77 18.8 20.0

1,374 12.5 351 24.8 698 31.6
111 27.1 ll 31.4

4.819 43.9 1,062 74.9 1,274 57.6
222 54.1 l7 48.6

832 7.6

1

.1

54 2A

39 9.!i 11.4

3,954 36.0

3

.2

186 8.4

b ~
:;:,

.....

"

:JS

9.3 8.6

.~,.,.

Catoosa **Chatham
Chattooga

569 92.9 9,958 92.0
1,181 90.2

:J29 9.166
1,065

4:i6 86.2 7,327 79.9
934 87.7

229 43.3 5,532 60.4
403 37.8

48 9.1 97 9.1

251 47.4 567 ri3.2

2J 4.7 48 4.:J

205 38.8 ~

353 33.1

~

Clay ... ---------------------

458 87.1

399

309 77.4

43 10.8

Clayton

390 87.2

340

278 81.8

219 64.4

55 13.8 23 6.8

305 76.4 98 28.8

37 9.3 39 11.5

.5 :
180 52.9 ~-

Clinch Cobb
Colquitt Columbia

909 95.6 1.424 91.3
558 100.0 827 92.4

869 l ,300
;')58 764

532 61.2 960 73.8
360 64.!i 391 51.2

182 20.9 488 37.5
462 82.8 215 28.1

240 27.6 130 10.0
39 6.9 248 32.5

448 51.6 580 44.6
52 9.3 304 39.8

97 11.2 121 9.3
159 28.5 121 15.8

84 9.7 469 36.1

l:l::i ~

308 55.0

~

91 11.9

Cook

228 99.6

227

1.19 70.0

00

68 29.9

159 70.0

00

0

Coweta

283 85.9

~4:)

191 78.6

93 38.3

34 13.9

113 46.5

15 6.2

81 33.3

Crawford

706 89.7

633

602 95.1

227 35.9

21 3.3

383 60.5

10 1.6

219 34.6

*Records filled out on old blanks which did not giYe enough informa lion for tabulation. **Sent incomplete reports. ****Exclusive of Atlanta. tL~~igmes and rates are not Lased on ioial number iaiJulated hut on numiJet giring information as to past dental treatment.

DENTAL SuRVEY OF SCHOOL CHILDREN IN GEORGIA BY CouNTIEs-1939-194.0-Continued

COUNTIES
DeKalb Dougherty Douglas
li"'ulton Glynn
Hancock Harris Henry _ Houston Irwin Jenkins Johnson Jones Lamar Lanier

Inspected

'

_..c..o....:,.:.

'
"C

.~.,~_
EE

" -<=E
c~.::>:-

."E~.,:_'_"lg

Z"U"J' C".."U'l

Z"t-

Need Treatment

- ~

.~ "..
E

;;; c...:.>.

z" c".

Treatment

Received

In Past

... - ~

~

c

"
E

c."..:>..

z:0 c".

Need

Need No

Treatment,

Treatment, None None Ever

Ever Received

Received

,--!'-----, ~

...~
"
E

c.""..:>.'.

z" c".

...~
"
E

'"".-..''.

z" c".'

Treatment Received in Past, None
Needed ,--J-----..

.~ ..,.
E

.....
c.""..:>.'.

z" c".

Treatment

Received in

Past, More

Needed

- ~

...~
"'

c"".:>''

E

~

z" c".'

7,298 92.1 6,718 4,898 72.9 4,408 65.6

437 6.5 1,878 27.9 1,477 21.9 2,926 43.:\

1,727 90.9 807 87.5
3,644 90.2 4,154 92.8

1,569 706
:1,284 3,8:.6

1,189 75.8
620 87 .s
2,072 63.1
2.~63 61.3

945 60.2 211 29.8 671 20.4 1)i36 39.8

105 6.7 56 7.9
1,021 31.1 950 24.6

506 32.2 440 62.4 1,594 48.:1 Ui60 40.5

281 17.9 30 4.2 1R9 !i.8 :;:n l:l.7

677 4~.1

b

180 25.!'i 480 14.G

~

819 ~1.2

~

3,154 8:1.!) 2,697 2,2Sil 84.7 15,364 92.0 14,141 10,692 7:-1.6

697 25.8 8,5ri9 60)i

356 13.2 1,181 8.4

1,646 61.0 4,349 30.8

67 2.:-l :!,2:i7 Hi.9

628 23.:1 6,354 44.9

1::!:;
~

2,594 9,i.1 t,461 1,20ii 48.8 1,291 52.3

649 26.3

509 20.6

.i~:J 24.1

714 28.9 :;;..

433 96.:1 309 88.0
388 91.:) 75 98.7
1,778 90.6

417 272
355 74
1,611

264 63.3 167 61.4
89 25.1 46 62.2 1,097 68.1

261 62.6 238 87.5
100 28.2 10 13.5 46 2.9

47 11.3 3.3
189 53.2 26 35.1
487 30.2

100 23.9 24 8.8
66 18.6 38 51.4 1,048 65.1

106 25.4. 96 35.3
17 21.7 1.4
27 1.7

164 39.:1 143 52.6

t:>:l
g!;>...

23 6.fi 9 12.2

~ .

49 3.0

645 88.7

572

418 73.1

222 38.8

91 15.9

254 44.4

63 11.0

164 28.7

526 100.0

526

525 99.8

252 47.9

.2

274 52.1

00

251 47.7

737 100.0

737

248 33.6

499 67.7

163 22.1

7l 9.6

326 44.2

177 24.0

1,139 86.6

986

645 65.4

192 19.5

256 25.9

539 54.7

84 8.5

107 10.9

658 81.8

538

332 61.7

379 70.4

n 13.2

91 16.9

Hl 26.2

235 43.7

163 80.9

132

94 71.2

55 41.7

24 18.2

51 38.6

14 10.6

43 32.(!

864 95.5

825

632 76.6

272 32.9

126 15.3

421 51.0

67 8.1

211 25.G

*Hecords filled out on old lllanks whieh did noi giYe enough information for tabulation.

**Sent incomplete reports.

****l~xclusiYe of Atlanta.

1-"

tF'igures and rates are not based on total numlJer tabulated but on numiJer ~dYing information as to nast dental treatment.

0 10

DENTAL SURVEY OF ScHOOL CinLDREN IN GEORGIA BY CouNTIEs-1939-194,0-Continued

1-1 1-1

0

COUNTIES

Need

Treatment Treatment

Need

Treatment

Need No

Treatment, Received in Received in

Inspected

....,_.._"c ~
EE

--Oc
-.c,E"_
-= ...:..;,:-:

---------,
.c"....,'."_.".e,c'

"'" Zlol

" " C..Lol

Z"'t"-'

Treatment

- ~-----..

~
"E"

c
<.":.>.'

z"' c"..'

Received

In Past

- ~-----..

."....,.
E

~."..

z"' c"..

Treatment, None None Ever

- - ,-E-v-e-r-'R-e-c--e-iv..ed

Received ~----..

;;
-"' E

Q.""...

.".,
E

c
Q"...

z"' c"..'

z"' c"..

Past, None

Needed

- ,-----''----.,

.".,
E

c
Q"....

z"' c"..

Past, More Needed
,-----''----.,

~

~

c

""E" Q."..

z"' c"..

q")
8"'

16~ 80.9 1,068 97.9

1~2
1,046

94 71.2 305 29.2

55 41.7 352 33.7

50~0-

18.2 47.8

51 38.6 193 18.6

14 10.6 243 23.2

4a 32.6 01:i
lOS 10.3 ~-

Peach Pierce

787 97.9 2,481 85.0 1,045 84.9
7,445 84.5 1,439 88.7 1,687 94.1

771 2.109
888
6,293 1,276 1,587

725 94.0 1,651 78.3
579 65.2
4,017 63.8 924 72.4
1,061 66.9

479 62.1 592 28.1 151 11.0

2,027 142 625

32.2 11.1 39.4

24 3.1 319 15.1 259 29.2
1,714 27.2 322 2J.2 302 19.0

241 31.3 1,197 56.8
482 H.3
2,44.5 38.9 802 62.9 664 41.8

24 3.1 186 8.8 51 5.7
611 9.7 30 2.4
169 10.6

482 62.5 407 19.3
96 10.8

b ~
:;:,

1,523 21.2

g.....

122 9.6 452 28.0

~

Rabun

1,398 87.1 355 100.0

1,217 355

899 73.9 153 43.1

19 !.6

321 26.4

877 72.1

3

.3

16

1.3 ~

*Spalding-

385 94.8

365

289 79.2

221 60.5

200 100.0

200

101 50.5

27 7.4

117 32.1

49 13.4

172 47.1

~
:;

Stewart

14 100.0

14

5 35.7

28.6

35.7

35.7

4 28.6

0

."...',

Taylor Telfair
Terrell 'l'homas

1,257 86.8 530 93.0
36 100.0 3,417 95.3

1,091 493
36 3,256

776 7l.l 350 70.9
34 94.4 2,332 7!.6

97 8.9 283 57.4
5.5 1,443 44.3

282 2:i.8 70 14.2
5.5 441 13.5

71:1 65.4 ljO 30.4
32 88.9 1,383 4.2.5

33 3.0 7l 14.4
482 14.8

63 G.8 1::!::

202 40.9 !Ui

"'::;;:;,:-
;;::--

950 29.2

'i'omnbs

227 78.4

178

178 100.0

.4

00

177 99.4

00

l

.4

'!'roup

4,217 89.8 3,788 3,042 80.3 1,383 36.8

381 10.1 2,026 53.5

383 10.1

998 26.3

Upson -------------

2,801 89.1 2,497 1,520 60.9

374 14.9

889 :lii.6 1,243 49.8

90 3.6

27.j 11.0

*Hecords filled out on old blanks which did not giYe enough information for tabulation. **Sent incomplete reports. ****Exclusive of Atlanta. t:H1igures and rates are not based on total number tabulated bui on number g-iving information as to }last dental ircaimeuL.

DENTAL SuRVEY oF ScHOOL CHILDREN IN GEORGIA BY CouNTIEs-1939-194;0-Contitmed

COUNTIES

Inspected
__- - - . .

" "~"
.c:
El:

-,=0_"E"
o-;
~~

z"w" o"..w"

"C
""'"~-
.c-
=E~"
Zl--

Need Treatment

- ,..--"--------.

~
."c
E

c"3
~

z"

"0..

Treatment

Received

In Past

- ~

~
."c
E
z"

c"3
'-
"0..

Need

Need No

Treatment,

Treatment, None None Ever

Ever Received

Received

,..--"-~

."c
E
"?-

c=3
'-
""-

~

- :,;
.c

0""

.""

'-
""-

Treatment

Treatment

Received in Received in

Past, None Past, More

Needed

Needed

- - ,-----"-~ ~

:,; "E"'
z"

0""
~
"0..

:,;
"E"

0""

"~ z ""-

\Yalker -------------------- _ 348 97.1

338

243 71.9

140 41.4

51 15.1

147 4:l.:i

4<1 13.0

96 28.0

Walton -------------------- - 852 100.0

852

195 22.9

728 85.4

122 14.3

2

.2

53ii 62.8

193 22.7 !;::,

3,714 87.5

2,207 90.6

5,090 81.1

*\Villws ----------------------

833 94.2

3,251 2,000 4,128
785

2,721 83.7 1,627 81.4 3,082 74.7
391 49.8

1,236 38.0 970 48.5
1,154 27.9

371 11.4 l:i3 7.7 776 18.8

1.751 53.9 877 43.9
2,107 51.0

171 5.3 215 10.8 276 6.7

958 29.;) 7:i5 37.8 969 23.5

-~"'
:;::,

:::r::

Wilkinson ------- ----------.

294 93.9

276

249 90.2

106 38.4

14 5.1

1o6 56.5

14 !l.l

"' 92 33.3 :;::, :;:;:-

****TOTAL WHITE -------- - 126,078 91.0 114,759 83,00:i 72.3 t47,17l 41.1 tl7,292 15.1 t44,616 38.9 t11.788 10.3 t29,896 26.1 ~

Atlanta -------- ---------- 32,356 96.3 31,162 10,229 32.8

t>:l

TO'l'AL STATE WHITE _____ 158,434 92.1 145,921 93,234 63.9 t47,17l 41.1 t17 ,292 15.1 t44,616 38.9 t11,788 10.3 t29 ,896 26.1

l?

Negro Schools

<':>

Brooks

- - - - -----------------~

764 99.2

758

331 4~.7

00

427 ri6.;1

331 43.7

0

(I

(I

0

~

Chatham -------------------- 6,812 82.4 5,612 2,982 53.1

782 13.9 2,400 42.8 2,428 43.:1

327 :J.S

4:)7 8.1 <S
:;:l

Floyd -----------------------

654 81.9

;j:);j

455 81.9

:H. ulton ----------------------

934 21.4

200

4 2.0

115 20.7 17 S.:i

86 1:5.:1 18 9.0

3:i3 6:1.6 148 74.0

HI :1.4

9

4.:)

97 l7.ri 2:1 12.:1

Whitfield -------- ------------

50 76.0

38

20 ti2.G

2 5.3

18 47.4

18 47.4

00

2 :-1.:1

TOTAL S'l'A'l'E !\EGlW ------ 9,214 77.7 7,163 3,792 52.9

t916 12.8 t2,949 41.2 i<1,27S 4:J.8

t3fi:i 4.9

t;>Sl 8.1

GHAND 'l'O'l'AL ------ ______ 167,648 91.7 l:i3,684 97,026 63.1 t48,087 31.3 t20,24l 18.3 t47 ,894 43.2 t12,143 10.9 t30 ,477 27.5

*Hecords filled out on old hlanks which did not p:ire enou;:d1 informt~ tion for tabulation.

**Sent incomplete reports.

****Exclusive of Anania.

tFigures and rates are not based on total number tabulated but on number giring information as to vast dental treatment.

>--'

>--'

>--'

112

Georgia Department of Public Health

FULTON COUNTY DENTAL PROGRAM
In an effort to improve the dental program for Fulton County, the Commissioner of Health and Assistant, the Director of Nurses, with the committee of dentists and school officials, agreed to change the plan of a one-day inspection so that public health nurses could assist the dentists with the active participation of the public health personnel. It is believed that a more effective follow-up program can be expected. This Division was called on to advise with the committee and .assist with the organization.
DENTAL CLINICS
Local committees and counties have been encouraged to provide dental corrections for indigent children. Without any financial aid from the State, the following counties have reported the operation of clinics giving free dental care: Worth, Thomas, Brooks, Toombs, Troup, DeKalb, Bibb, Jones, Fulton, and Atlanta. An increasing number of counties report corrections for indigent children provided in dental offices and financed in various ways.
GEORGIA DENTAL ASSOCIATION CHANGES METHOD OF SELECTION OF DISTRICT CHAIRMEN
Previously, district chairmen had been appointed by the Public Health Committee of the Georgia Dental Association. According to the new plan, the twelve District Dental Societies elect dentists to serve as district chairmen. In both plans, the district chairmen have appointed the county chairmen.
COUNTY HEALTH DEPARTMENTS, REGIONAL HEALTH DEPARTMENTS, ETC., VISITED
During the year, six regional health departments and twenty-four county health departments have been visited by the Associate.
The Associate has visited ninety-seven of the 159 counties in Georgia during the year; fifty counties having organized health departments, twenty-nine counties having public health nurses, and eighteen unorganized counties.
ASSOCIATIONS AND CONVENTIONS The associations and conventions attended this year include:
GEORGIA EDUCATION AssoCIATION-March 14., 15-in Macon. STATE PARENT-TEACHER AssociATION-April 15, 16, and 17-in
Brunswick. GEORGIA DENTAL AssociATION-May 14., 15-in Macon.
NEGRO DENTAL SociETY-May 15-in Columbus. Both Dr. Williams and Miss Taylor made talks.
GEORGIA PUBLIC HEALTH AssociATION-May 23, 24~in Atlanta.
PARENT-TEACHER AssociATION CoNFERENCE-June 19-Mercer University, Macon.

Dental Health Education

113

PARENT-TEACHER AssociATION INSTITUTE-June 26-in Athens. As Chairman of Mental Hygiene Committee, Miss Taylor was asked to participate in the round-table discussion.
NATIONAL YouTH AmviiNISTRATION CoNFERENCE-September 13at Savannah.
PARENT-TEACHER AssociATION BoARD OF MANAGERS-September 27-in Macon.
AMERICAN PuBLIC HEALTH AssociATION-October 5-ll,-in Detroit. Miss Taylor presented a paper on the subject, "Marshalling Community Forces for Dental Health," at a joint session of the Public Health Nursing Section, American School Health Association and Oral Health Group of the American Public Health Association.
GEORGIA NuRSING AssociATION-November 12-at Albany.
ANNUAL MEETING OF ScHOOL ADlVIINISTRATORs-November 22-in Atlanta.
PuBLIC HEALTH NuRSING INSTITUTE-November 25-in Atlanta. Miss Taylor led a discussion on the subject, "Factors Determining an Adequate School Health Program".
AMERICAN DENTAL AssociATION-Dr. Williams, Director of the Division of Dental Health Education, attended the meeting of the American Dental Association in Cleveland, Ohio. The Association created a new committee at its annual meeting-Public Health and Education Committee-and Dr. Williams was asked to serve as one of the seven members.

STATISTICAL REPORT OF ACTIVITIES

COUNTIES VISITED ---------------------------- 97

MILES TRAVELED ----------------------------- 20,832

PUBLIC SCHOOLS VISITED----------------------- 72

Talks -----------------------------------

3

Attendance-White --------------------- 300 Negro --------------------- 175

Films and Talks __________________________ _ 69

Attendance-White --------------------- 21,263 Negro --------------------- 4,150
Total Attendance ------------------------- 25,888

CoLLEGES VISITED ----------------------------

6

Attendance-White ____________________ _ 1,150

Negro ____________________ _ 200

Total Attendance -------------------------- 1,350

TEACHERS' MEETINGS -------------------------

9

Total Attendance -------------------------- 385

1M

Georgia Department of Public Health

TALKS AND FILMS SHOWN TO _________________ _
P. T. A.'s and Women's Clubs _______________
Attendance ---------------------------Civic Organizations ----------------------4 HAtCtelunbdsa_n_c_e__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_
Attendance ---------------------------Dental Meetings --------------------------
Attendance _________ ------------------Nurses' Meetings --------------------------
Attendance ________ -------------------Public Health Councils ____________________ _
Attendance ---------------------------National Youth Administration Groups________
Attendance ---------------------------Total Attendance --------------------------

46 17
665 10
1,139
3
395 5
72 2
10 3
85 6
755 3,121

RADIO TALKS --------------------------------

3

NEWSPAPER ARTICLES -------------------------

8

TOTAL NmviBER OF FILMS SHOWN ______________ _

215

CONFERENCES -------------------------------

537

Regional Medical Directors___________________ _ 28

Commissioners of Health___________________ _ 65

Dentists --------------------------------- 144

School Superintendents ___________________ _ 78

Physicians -------------------------------

6

Home Demonstration Agents________________ _ 12

Nurses ------------------------------------ ll5
P. T. A. Workers_________________________ _ 37

Others ---------------------------------- 52

Division of Public llealth Education

Robert V. Schultz, M.D., Director

Fannie B. Shaw

Associate Director

Status and Personnel
The Division of Public Health Education was merged with the Division of Vital Statistics July 1, 1939. For one year it functioned under the direction of Dr. David M. Wolfe and Fannie B. Shaw, Associate Director. On July 1, 1940, the Division was transferred to the Malaria and Hookworm Control Service with Dr. Justin Andrews acting as Director. Dr. Anchews and the Associate Director worked out a plan for expansion which was approved by Dr. Abercrombie and the business manager. Accordingly a director with a medical and public health education degree was sought. Dr. Andrews located Dr. Robert V. Schultz, who was employed as Director and joined the staff December l. On November 1, 1940, the Division was again established as a separate Division of Public Health Education.

Objectives of the Division
Through all these changes the objectives have remained practically the same-that is, (1) the development, accumulation, and distribution of health education materials; (2) a cooperative consultant service with the other divisions; (3) .field service of speaking and motion picture programs for school and adult health education groups; (4) consultant service to organizations and groups interested in fostering health education and for colleges and public schools initiating or enriching their health education courses.
It has been the policy of the Division to distribute motion picture and speaking engagements to the Regional Medical Directors and the County Health Officers. Appreciation is gratefully expressed for the fine cooperation they have given the Associate Director with these activities.
Distribution of Materials
During the year 194,0, 100,373 pieces of health education materials were distributed (this number includes 4.,032 pieces of May Day mate rials). There has been a definite effort to economize in numbers of bulletins distributed. Careful guidance in more effective use of materials has been given through correspondence suggesting methods of using materials.
Preparation of Materials
The Associate Director assisted Dr. Andrews and Dr. Hill in the preparation of a tentative source unit on Hookworm Control for experimental use in Coffee and Colquitt Counties. Five hundred copies were mimeographed and distributed. A small, inexpensive bulletin, "Facts About Hookworm Which Everyone Should Know," was also prepared by Dr. Andrews, Dr. Hill, and the Associate Director.
Dr. Schultz and the Associate Director prepared a bulletin showing progress made by the State Health Department in the past four years.

116

Georgia Department of Public Health

New Films
The following new films have been purchased by the Health Education Division:
3 copies-Behind the Shadows 3 copies-Let My People Live 6 copies-On Guard l copy-Clocking a Champion (was given to the Division by the
Atlanta Quota Club)
Special Activities of the Division
The Director joined the staff December l. In addition to the preparation of the bulletin depicting the progress of the Department during the last four years, he was occupied with becoming acquainted with the work of the Division.
The Associate Director participated in an intensive hookworm education program in the schools and with adults in Coffee County.
Mr. M. E. Thompson, Assistant Superintendent of Schools, appointed an advisory curriculum committee to write a new course of study in health education of the public schools in December, 1939. The new program will include Health, Physical Education, Recreation, and Safety. It will be called The Health Education Program for Georgia Schools and will be published in April, l9<'U. The Associate Director is responsible for the sections on Health Service and Health Instruction. Much time has been spent this year on this program.
The Commission on Teacher Education of the American Council of Education began an in-service teacher training program in Colquitt County early in the year. The Associate Director with Dr. Andrews helped to guide this program which developed into a health education program. Package libraries of hookworm materials were given to all teachers in the county.
The Associate Director worked one week in February with Mr. Philip Riley, Health Education Supervisor, Cleveland, Ohio, in surveying for the American Public Health Association the coordinating phases of health education at the Child Health Demonstration, Hancock County, the Bulloch County Health Education Program under Jane Franseth, and the Colquitt County Teacher Education Program. The Bulloch County Program is being used by the American Public Health Association as a rural progress report.
Constant consultation has been given Mr. W. W. McCune in the development of a Health Education Course of Study for elementary teachers in the Savannah public schools.
The Secretary of the Division of Health Education attended the Phi Mu National Convention, Glacier National Park, Montana, to ask Phi Mu to cooperate with the Division of Maternal and Child Hygiene in appropriating funds for the establishment of a Nutrition Service. She was successful in getting Phi Mu to continue to contribute the annual income from an endowment of $50,000 for a proposed Nutrition Service.

Pnblic Health Education

ll7

The Associate Director has spent much time this year in consultation with other organizations in planning their health education programs. Chiefly they are: (I) the National Youth Administration, (2) the Works Progress Administration Adult Education Group, (3) the State Home Economics Teachers who are at the present doing most of the health instruction in high schools, (Lt) the State Medical Auxiliary in their adult health education program, (5) the American Red Cross Directors, and (6) the State Department of Education.
Experimental health education programs in the Samuel Inman Elementary School, the Hoke Smith Junior High School and the Girls High School in Atlanta have been guided by the Associate Director for Dr. W. A. Sutton.
Out of State Ac,tivities
The Associate Director took her vacation the last two weeks in February and made a health education survey of N.Y. A. resident centers and C. C. C. camps for the National Youth Administration and prepared a report and chapter for a teachers' manual to be used in teaching health in both centers and camps.
Continued to act as consultant to the American Red Cross in the revision of "Home Hygiene and Care of the Sick."
Attended the meeting of the Joint Committee on Health Problems of the National Education Association and American Medical Association at St. Louis, Mo.
Acted as Chairman of Program Committee for the Health Education Program at the annual American Medical Association meeting in New York in June.
The Associate Director took three months' leave (June, July, and August) to revise her textbook, Methods and Materials of Health Educcttion. During this leave she worked part time at Florida State College for Women at Tallahassee as Director of a Health Education Workshop for six weeks and taught two health education courses at Teachers College, Columbia University, the remaining six weeks.
State JVleetings Attended
Led discussion at the Alcohol and Narcotics Educational Conference in Atlanta.
Spoke at five section meetings of the Georgia Education Association in Macon.
Spoke at the National Youth Administration Training Conference at Tybee.
Attended Georgia Public Health Association in Atlanta.
Child Health Day
The Division of Health Education again worked with the Division of Maternal and Child Hygiene. A form letter was sent to the regional medical directors, county health commissioners, county and city superintend-

118

Georgia Department of Public Health

ents of schools and presidents o the P. T. A. A total o 4,032 pieces of materials relating to the control o diphtheria were distributed.

Summary of Field Work by the Associate Director

TALKS MADE AT:

Woman's Clubs -----------------------------------

2

P. T. A. ------------------------------------------

4

Ptiblic Schools -----------------------------------

12

Colleges -----------------------------------------

18

Home Economics Meetings (section) ------------------

8

Faculty Meetings (public school) -------------------

9

County Teachers' Meetings ___________ ______________

3

Radio Broadcasts ---------------------------------

2

Georgia Public Forums -----------------------------

2

Atlanta Social Planning CounciL____________________

1

Atlanta Social Workers Club ------------------------

1

W. P. A. Adult Education Meetings ------------------

10

Miscellaneous -------------------------------------

6

N.Y. A. Programs ---------------------------------

3

Second District Medical Association ------------------

1

Home Economics Council Meetings __________________

2

District Teachers' Meetings -------------------------

4

TOTAL -------------------------------------

88

Summary of Conferences in the Field and in the Office

Group -------------------------------------------

28

Individual ----------------------------------------

56

Committee Meetings --------------------------------

18

ToTAL -------------------------------------

102

Summary of Film Showings

Total number of films shown by personnel of the
Department ----------------------------------- 812 Total estimated attendance -------------------------- 14.5,3<1<1

Summary of Materials Distributed Total number o materials distributecL ________________ 110,373

Division of Preventable Diseases

C. D. Bowdoin, M.D., Director and Epidemiologist

A. W. Brown, M.D. H. A. Nevel, M.D. R. J. Boston, Engineer

Venereal Disease Control Venereal Disease Control
Typhus Fever Control

During the calendar year 1940, the Division of Preventable Diseases was composed of four Services: Cancer Control, Epidemiology, Typhus Fever Control, and Venereal Disease Control. There is submitted herewith a narrative and statistical report of the activities of each of these services during the year :

CANCER CONTROL SERVICE

It is gratifying to report that the Cancer Control Service, during the year 1940, has been able to function for the entire year and render diagnostic and treatment service to all applicants which were approved for State aid, provided they reported to a clinic. It is with regret, however, that we are not able to make a comparison of work done with 1939, except upon an average of six months, as only the last part of that year was any State-aid work done, due to lack of funds.

Personnel

The personnel of the Service for the first five months consisted of a pathologist, two clerks, and one technician. The first of June, the pathologist resigned, the diagnostic laboratory was discontinued, and the technician was transferred to the Division of Laboratories. For the last seven months the work was done under the direction of the Director of the Division of Preventable Diseases, who had a clerical force of two stenographers.

Treatment Centers

The first of the year II treatment centers were cooperating, and during

the year one other hospital, Coker's Hospital, Canton, Georgia, met the

requirements for recognition as a cancer treatment center. At the close

of the year 12 treatment and diagnostic centers, fully equipped and

recognized, were cooperating, located in cities which make the clinics

reasonably accessible to the population, as follows: Americus, Atlanta

(2), Augusta, Canton, Columbus, Dalton, LaGrange, Macon, Savannah,

Thomasville, and Waycross.



Diagnostic Laboratory

During the first five months of 1940 (the laboratory having been discontinued the first of June), 482 specimens were examined, while during the last six months of 1939, LJ,36 specimens were examined. The average number of specimens examined per month during the first five months of 19L10 was 96. Compared with an average of 73 per month during the last six months of 1939, \ve find an increase in the number of tissue specimens examined.

120

Georgia Department of Public 11ectlth

Applications Submitted
During the year 19LJ,0, a total of 1,909 applications was received, 1,826 of which were approved and 83 rejected. These applications came from 151 counties and were given consideration upon receipt, irrespective of the number already received from any one county. According to agreement, however, no applications were submitted or approved from Fulton, Bibb, and Richmond Counties, as these counties are amply taken care of through their local facilities.
From the following table it will be seen that five counties, with a total population of 36,27LL, submitted no applications; 29 counties, with a total population of 261,056, submitted from 1-4. applications, totaling 69, at the mte of 26.4 per 100,000 population, 67 of which were approved and L!LL were diagnosed as malignant; LLl counties, with a total population of 539,LL96, submitted from 5-9 applications totaling 290 at the rate of 53.8 per 100,000 population, 280 of which were approved and 178 were diagnosed as malignant. Comparable corresponding groups follow, which reveal that some counties are sending many more applications in proportion to their population than others. A total of 156 eligible counties, with a population of 2,565,191, submitted 1,909 applications at the rate of 74..4 per 100,000 population, 1,826 of which were approved and 1,069 diagnosed as malignant. Based on the applications which were approved, rates per 100,000 population have been computed and also the rates for those which were approved that were malignant. This shows us the relationship between the number of applications approved and those cases which turned out to be malignant in the different population groups according to the number of applications which were submitted. However, we find no significant correlation between these rates.

::

"'
=..":::l

~
.:";
c.

0

<l.

36,27<1 29 261,056 <11 539,496 31 184,003 23 422,427 10 301,618
5 138,580 1 95,412 5 172,828 2 76,891

33,606

156 2,565,191

":":s"::'
"":::l
IJ)
1- 1 5-9 10-H 15-19 20-2<1 25-29 30-34 35-39 40-44 45-19 50 plus

AIIPiications

-g

>

].

c=~ -.

1-

<(

6" 290 360 380 226 137 127 181
83
56
1,909

67 280 341 364 215 128 123 172
80
56
1,826

....
c
"::
--;;~:; ;;;
<!t! 178 217 207 119
70 72 86 17
29
1,069

Rate per I00,000 Population

.....

]..
1-

"">"''
~ c.
.:t

::
"::
-~ -;;:; ;;;

26A

25.1

16.9

53.8

51.9

33.0

74,'1

70.5

11.8

90.0

86.2

19.0

1<1.2

70.6

39.1

98.9

92A

50.5

133.1

128.9

75.5

101.7

99.5

19.8

107.9

104.0

61.1

166.6

166.6

86.3

HA

71.2

11.7

Preventable Diseases

121

Applications Approved
In order to arrive at some .final and accurate figures for comparing the number of applications approved for State-aid during the life of this Service, all records have been checked by cross-indexing the names of cases that have been approved and eliminating those duplications which resulted from people making applications from year to year or whenever desiring further treatment. From this thorough verification, we found the number approved for 194.0 was 1,826, the distribution by counties being shown on Table I, and the number for the two previous years as follows:

Year

A~plications
Approved

1938 --------------------------------- 1,5,14 1939 (July 1-Dec. 31) ------------------ 715 1940 ----------------------------------- 1,826

Average per Month
129 119 152

122

Georgict Department of Public Health

CASES APPROVED FOR STATE-AID IN THS TREATMENT OF CANCSR
1940

Legend! Cancer Clinics ----------X
Cases approved for state-aid---
:
.~

Preventable Diseases

123

Applications Disapproved
During the year 19'1<0, approximately three times as many applications were rejected as in 1938 and eight times as many as in 1939. This was due to the fact that the Cancer Commission, in interpreting the Cancer Law on June 19, 1939, ruled that people over 75 years of age should not be accepted for State-aid. Of the 83 applications disapproved during the year, 79 were rejected after June 1 when a change in personnel was made. This indicates that the regulations set up by the Cancer Commission are being carried out to the letter.

Reasons Jor Disapproval

Year

APJJiications Disapproved Age

Not Incurable Cancer

Able to Pay

1D38 ---------------- 30
1D39 (6 months) ______ 5

15

15

4

1

1940 ---------------- 83

49

16

17

Cases Referred to Clinics
It will be noted from Table II that many more cases were referred to some clinics than others. This was due to the fact that some clinics had a larger area accessible, as cases were referred to those clinics that were nearest to residence of patients, unless the referring physician specified some clinic because the patient had relatives or friends who would assist in caring for him. The spot map, showing the cases approved by counties and the location of the clinics, reveals the reason for the variation in numbers referred to clinics.
Diagnosis of Cases Referred to Clinics
Of the 1,826 cases referred to Cancer Clinics, as shown in Table II, reports were received on all except 164.. Thirty-three were classified as deferred diagnoses. The malignant cases numbered 1,069 or 65.6% and the non-malignant numbered 560 or 3'1.'1% of those that were diagnosed. Table I shows the diagnoses of cases by counties. The following table, which gives the number of diagnoses made during the three years, reveals the fact that the percentage of those found to be malignant has decreased from year to year. This is an indication that people are becoming more cancer conscious and that our Service is becoming more generally recognized.

Diagnoses

Percentage

Year

Total

1D38 --------------
1939 -------------1D,JO --------------

1,419 647
1,629

Malignant Non-malignant Malignant Non malignant

1,089

330

76.7

23.3

470

li7

72.6

21A

1,069

560

65.6

g,JA

124

Georgia Department of Public Health

Cases Given Financial Aid
During the year 1,906 received some form of service, hut only 1,616 cost the state money for this work, leaving 290 served gratis by the clinics. The clinics are to he praised for their most efficient work and thoughtful consideration of finances involved. The average cost per patient for diagnosis of cases, who were non-malignent, was $17.13, and the average amount paid f0r the diagnosis and treatment of malignant cases was $4.1.94. The average cost per case served was $34..57. There is considerable variation in the cost at the various clinics. However, since the number of cases in any individual clinic is small, there is hound to he considerable variation in the type of cases which present themselves in any given year. No comparison of cost with previous years will he made, as comparable figures are not available. However, it might he pointed out that the annual report for 1938 states that the average cost per patient was $39.08. From this figure we are able to report that the average cost per patient has decreased approximately $5.00 since 1938. The total amount spent to Tender financial aid during the calendar yeaT 1940 was $65,893.76.
Record System
Much effort was put forth during the last seven months in trying to set up a new record system of accounts and cases by areas, clinics, etc. Much progress has been made, hut some plans were not instituted until the first of 1941. With the change in personnel and methods of keeping records, it has been impossible to submit a statistical Teport to date as to type of malignancy and other pertinent data desired in connection with treatments, results, etc. It is hoped that our mechanical system of tabulating records will enable us to make a report of studies made on all case records on file, so that our annual report for 1941 will incorporate these data.
Educational Measures
LITERATURE DISTRIBUTED: During 194.0, 768 pamphlets on the control of cancer were distributed by the State DepaTtment of Health, and in 1939, 7L13 leaflets were distributed, which is approximately the same number as in 1940.
CooPERATING AGENCIES: The Cancer Commission of the Medical Association of Georgia and the American Society for the Control of Cancer, through its Women's Field Army, are coopeTating with the State Department of Health in the educational campaign and are doing excellent work.
SoUND PICTURES: Seven copies of the sound motion picture, "Choose to Live", were purchased for the use of health officers, regional medical directors, and interested laymen in making lectures on the control of cancer.
ADDRESSES: During the year only six addresses were made by staff members of the Cancer Control Service, clue to the fact that for the last seven months the staff personnel was limited to one, who divided his time with the Venereal Disease Control Service, Epidemiologic Service and Cancer Control Service.

Preventable Diseases
TABLE I Applicants for Stateaid in the Treatment of Cancer Approved and
Referred to Cancer Clinics During the Calendar Year 1940

125

Reports on Diagnoses

Counties

Non

Deferred

Malignant Malignant Diagnosis

Appling --------------------------

Atl<inson --------------------------

Bacon ~-------------------------- 8

Bal<er --------------------------- 7

2

Baldwin ------------------------- 8

Banlm --------------------------- 5

Barrow --------------------------- 2

Bartow -------------------------- 5

3

Ben Hill ------------------------- 5

Beaien -------------------------- 4

3

Bibb -----------------------------

Biecl<ley -------------------------

Brantley ------------------------- li

Bmolm --------------------------Bryan ---------------------------- l

Bulloch -------------------------- 3

Bul'lm ---------------------------- 10

Butts ----------------------------

5

Calhoun --------------------------

Camden --------------------------

Candler -------------------------- 2

6

Carroll --------------------------- 15

2

Catoosa --------------------------

Charlton ------------------------- --

Chatham ------------------------- 12 Chattahoochee -------------------- __

Chattooga ------------------------ <J

Cherol<ee ------------------------- 9

2

C!arl<e --------------------------- 12

Clay ------------------------------ __

Clayton -------------------------- 4

3

Clinch ---------------------------

Cobb ----------------------------

2

Coffee ---------------------------- 13

Colquitt -------------------------- 17

13

Columbia ------------------------

7

Cook -----------------------------

Coweta --------------------------- <J

2

Crawford ------------------------- 2

Crisp ----------------------------

13

Dade ----------------------------

Da'\Vson --------------------------

Decatur --------------------------

<J

DeKalb --------------------------- 16

15

Dodge ---------------------------- 16

10

2

Dooly ---------------------------- 12

1

Dougherty ------------------------ 13

3

No Report

Total ApJJiicants

3

15

2

10

10

9

11

13

2

2

10

1

6

1

8

9 6 17

17 H
<J

2<1 2
21

2

13

13

7

2

11

23

5

38

16

<J

22

5

10

2

15

32

33

13

17

126

Georgia Department oj Public Health

CANCER CONTROL SERVICE-Continued

Reports on Diagnoses

Counties

Non

Deferred

Malignant Malignant Diagnosis

Douglas ---------------------- ____ 12

Early ----------------------------- 3 Echols ---------------------------Effingham ------------------------

Elbert ----------------------------

Emanuel ---------------------- ___ 22

11

Evans

Fannin ------------------------ __ _ Fayette ---------------------------

Floyd ---------------------------Forsyth -------------------------1!-.ranl\lin ------------------------- 3

Fulton ---------------------------

Gilmer ---------------------------

Glascocl; -------------------------

Glynn -----------------------------

2

Gordon ---------------------- _____ 8

Grady ---------------------------Greene ---------------------------Gwinnett ------------------------- 1! Habersham ----------------------- 8

Hall -------- -------------------Hancock
Haralson _____ --------- --------

Harris ----------------------------Hart ----------------------- __ _

Heard ----------------------------Hemy --------------------------- 12 Houston ______ . ------------------- 6

Irwin ---------------------------- 4

Jacl~son -------------------------- 10

Jasper --------------------------Jeff Davis -- __________ _

Jefferson _____________ _

H

Jenldns

11

Johnson

8

Jones ------------- ____________ _

Lamar --------------------------Lanier -------------------- ------Lau!'ens -------------------------- 29

Lee ------------------------------ 3

Liberty --------------------------

Lincoln -------------------------- 10

Long ____ --------------- ---------

Lowndes

11

Lumpkin

1

~lcDut'fie

8

3

~lclntosh

3

::\lacon --------------------------- 9

2

No Report

Total Applicants

22 6 :l

'1

38

10

11 8
L\ 1
22 H 1

10 6

8

14

18

2

15

11

6

21

};)

2

12

11

17

56

R 18

23 1
11 4 H

Preventable Diseases

127

CANCER CONTROL SERVICE-Continued

Reports on Diagnoses

Counties

Non-

Deferred

Malignant Malignant Diagnosis

Madison --------------------------

2

1\Iarlon -------------------------- __ 6

2

l\1eriwether -------------------- __ _ 13

'.\!iller _--------------------------- 8

i\Iitchell -------------------------- 16

11

:Monroe ---------------------------

'l

Montgomery ----------------------

:.\!organ -------------------------- 1

J..Jurray -------------------------- l

n.Iuscogee ------------------------- 13

1\ewton --------------------------

Oconee ---------------------------

Oglethorpe ------------------------ 11

Paulding -------------------------

Peach ----------------------------

Pickens --------------------------

Pierce ----------------------------

Pike ------------------------------

Polk -----------------------------

Pulasl<i

Putman -------------------- _____ _

Quitman ____ ----------------------

Rabun ---------------------------

Randolph ------------------------Richmond _______________________ _

Rockdale ------------------------Schley ___________ ________________ 5

Screven --------------------------- 11

2-l

Seminole ------------------------- {)

1

Spalding -------------------------- 12 Stephens ------------------------- 4 Stewart ________ ------------------

Sumtet ---------------------------- 18 'l'albot ------------- ______________ _

Taliaferro ------------------------

'l'attnall ---------------------------

Taylor

l

'l,elfair ________ ------------------ _

'rerrell __________________________ _

2

Thoma.::> -------------------------- 20

'l'ift ----------------- -------------- 18

12

Toombs -------------------------- 1:>

9

Towns ---------------------------

'rreutlen _________________________ _

12

'!'roup ---------------------------- 30

12

'furner _______ ---------------------

'l'wiggs --------------------------- 5

Union ----------------------------

1

Upson ---------------------------- 22

10

\Yall;;:er ---------------------------

No Report
;)

Total Applicants
10 8 23
17 28
8 19
5 19
5 2 12 7 15
20 3

11 3

3

3i 8
21

12

3

30

1

3

7

l

10

11

2fl

31

31

3 31 10

128

Georgia Department of Public Health

CANCER CONTROL SERVICE-Continued

Reports on Diagnoses

Counties

Non

Deferred

Malignant Malignant Diagnosis

Walton --------------------------- 8

3

Ware ----------------------------- 17

Warren -------------------------- !

Washington ------------------------ 8

Wayne --------------------------- 7

Webster -------------------------- __

1

Wheeler -------------------------- 5

6

White ----------------------------- 2

Whitfield ------------------------- 17

2

Wilcox --------------------------- 5

9

Wiii<es --------------------------- 1

Wilkinson ------------------------ 10

'1

Worth ---------------------------- 13

'l'otal ---------------------------1069

560

33

No Report

Total Applicants

2

13

26

6

1

13

3

11

1

11

2

20

15

1

15

27

16<1

1826

TABLE II
Applicants for State-aid in the Treatment of Cancer Approved and Referred to Cancer Clinics During the Calendar Year 1940

Clinics

Total Applicants

Malignant Non-malignant Deferred

Cases

Cases

Diagnosis

No Report Received

Americus ------------- 166

100

45

Augusta ---------------- 231

H3

'iO

Canton ---------------- 8

6

Columbus ------------- 46

28

Judd Memorial (Dalton)_ 62

47

I
i

LaGrange ------------- 105 Macon ---------------- 320

66

35

168

125

Savannah ------------- 77

37

34

Sheffield -------------- 253

159

69

1'homa.sville ----------- 252

141

89

Waycross -------------- 173

92

35

Winship --------------- 133

32

,13

21 H

8

10

3

1

18

16 16 46
8

'rOTAL -------------- 1,826

1,069

560

33

16<1

EPIDEMIOLOGIC SERVICE
The main function of this Service during the year was to serve in an advisory capacity to the commissioners of health and the regional medical directors in an effort to control communicable diseases in the State. The Epidemiologic Service reported to these health authorities all cases of communicable diseases, by counties, as they were reported to the Georgia Department of Public Health.

Preventable Diseases

129

Personnel

The personnel of this Service for the year 19Lt0 consisted of the State Epidemiologist, who is also Director of the Division of Preventable Diseases, and one stenographer.

Consultations With Physicians

A total of 398 consultations were held with physicians throughout the State. These consultations included those by the regional medical directors and the State Epidemiologist in the interest of controlling communicable diseases.

Field Visits
During the year, 73L1 field visits were made by the Director of the Division and the six regional medical directors, in counties where there are no health departments, in an attempt to control communicable diseases. In addition to these 734, medical field visits, the nursing personnel of the regions also made field. visits in following up the work of the physician members of the staff. An outline of these field visits by counties is given in the following paragraphs:

Scarlet Fever

Although only 18 epidemiologic investigations were made by the Director of the Division of Preventable Diseases and the regional medical directors, 87 trips were made by the regional nurses in unorganized counties in regard to scarlet fever. These visits by counties were as follows:

Charlton ______________ 1
Dade ----------------- 4 Fannin _______________ 7
Franklin ______________ L19 Lamar ---------------- 5 Lumpkin ______________ 1

Polk ----------------- 1 Screven _______________ 13 Union ________________ 3
Upson ---------------- 9 White _ _______________ 1 Jasper ________________ ll

Smallpox

Twenty-four field trips were made to investigate suspected cases of smallpox. Upon investigation, however, it was determined that the

large majority of these cases were chicken-pox. These trips were as follows:

Atkinson _____________ 6 Baldwin ______________ 2

Effingham _____________ 6 Harris ________________ 1

Bryan ---------------- 1 Chatham ______________ 7

Seminole _____________ 1

Measles

The following epidemiologic field trips were made in regard to measles, 14 of which were made by medical personnel:

Baker ---------------- 1 Charlton ______________ 8
Echols ______ __________ 2 Lamar ________________ 26

Macon ---------------- 3 Peach ---------------- 2 Upson ---------------- 4

130

Georgia Department of Public Health

Diphtheria

In addition to the 32 field trips made by the medical staff, 116 trips were made by the nursing personnel in connection with the control o diphtheria. Twenty-eight unorganized counties were included in these visits. These trips, by counties, were as follows:

Brantley -------------- 1 Candler --------------- 2 Cherokee ______________ 24
Coweta --------------- 1 Douglas ______________ l Effingham _____________ 6 Emanuel ---~---------- 1 Fannin --------------- 7 IGrowridnon _-_-__-_-_-_-_-_-_-_-_-_-_-_-_- 41
Jasper ---------------- 6 Lamar ---------------- 6 Lanier ---------------- 1 Lee ------------------ 1

Liberty _______________ 3 Lumpkin ______________ 6
Me1iwether ------------ 1 Murray _______________ 6 Peach _________________ 3
PPiiekrece_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_- 1135 Putnam ______________ _ 1 Screven --------------- 1 Seminole _____________ 2 Stewart _______________ 2 Toombs ______________ 17 Upson ________________ 5 Webster ______________ 12

Typhoid and Paratyphoid
Again this year, more field trips were made in the interest of controlling typhoid fever than any other disease. Seven hundred sixty-two field trips of this nature were made, L154 of which were by the physician members of the staff. The remaining 308 were made by nurses in following up the cases investigated in order that release cultures and specimens from suspected carriers might be submitted to the State Health Department Laboratory for examination. As a result of these investigations, 10 chronic carriers were located in non-health officer counties, and 5 more carriers were repmted as being found in the organized counties. The 73 unorganized counties which received this service during 194,0 were as follows:

BBaackoenr -_-_-_-_-_-_-__-_-_-_-_-_-_-_-_- 270 Banks ________________ 3

Effingham _____________ 8 EElmbaenrtue-l--_-__-_-_-_-_-_-_-_-_-_-_-_- 23

Barrow --------------- 2 Berrien --------------- 1

Evans ---------------- 2 Fannin --------------- 18

Bryan ---------------- 4 Butts ---------------- _ 6
Carroll --------------- 7

Fayette --------------- 12 Franklin -------------- 9 Gordon _______________ 11

Cherokee -------------- 3

Gwinnett -------------- 2

Clay ----------------- 5 Clayton --------------- 10

Haralson -------------- L1 Harris _________________ 1

Cook ----------------- 1

rleard ---------------- 49

Dade ----------------- 1

Henry ---------------- 1

'.

EDaorolyly _-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_- 231

Houston -------------- 1 Irwin ---------------- 2

':

Preventable Diseases

131

Jackson _______________ 13
JJoashpnesron--_-_-_-_-_-_-_-_-_-_-_-_-_-_- 1108
Lamar ---------------- 65 Lincoln _______________ 1
Lumpkin -------------- 13
Macon ________________ 24. Marion --------------- 2 Meriwether ____________ 7 Miller ---------------- 11 wionroe --------------- 2 Montgomery ___________ 1 Newton --------------- 9 Oglethorpe ____________ 5 Paulding _____________ 1 Peach ________________ 25
Pickens _______________ 11
Pifrce ---------------- 32 Pike _________________ 19

Polk ----------------- 3 Putnam --------------- 19 Quitman -------------- 4, Kandolph _____________ 17
Schley ---------------- 13
Screven --------------- 23 Seminole _____________ 2 Talbot ________________ 5
Taylor --------------- 14, Toombs --------------- 7 Turner --------------- 8 Twiggs _______________ 132 Union ________________ 5
Upson ---------------~ 5 Webster -------------- 2 White ---------------- 7 Wilcox --------------- 6 Wilkinson _____________ 3

Whooping Cough

Although no field trips were made by the medical staff in the

-.

interest of this disease, a total of 57 trips were made by the nursing

personnel of the regions to the following unorganized counties:

Brantley ______________ 5 Butts _________________ 2
Charlton ______________ 16
rlenry ---------------- 2

Irwin ________________ 15
Lan~r ---------------- 6 Meriwether ____________ 5 Upson ---------------- 6

Typhus Fever
In addition to the activities of the newly organized Typhus Control
Service, 13 medical field trips and 13 trips with the engineering personnel
were made in regard to typhus fever in the State. These trips were as follows:

Baker ________________ 1 Haralson ______________ 1 Lamar ________________ 3
Meriwether _____________ 1 Monroe _______ ________ 1

Montgomery ___________ 1
Peach ---------------- 1 Schley ----------------- Lt Taylor --------------- 9 Wilcox _______________ 4

Other Diseases
In addition to the field trips outlined in the p1eceding paragraphs, 552 trips were made in connection with other communicable diseases, exclusive of malaria and hookworm. Field visits in connection with these two diseases are omitted, since the Division particularly interested in these diseases will report such activities. Of the 552 trips made in

132

Georgia Department of Public Health

connection with the epidemiology of other diseases, 179 were made by the medical personnel. The number of trips made in connection with these miscellaneous diseases, by counties, is shown in the following tabulations:

Appling ______________ L18 Atkinson ______________ 6
Bacon ---------------- 3 Baker ---------------- 65 BBerarrnitelney --_-_-_-_-_-__-_-_-_-_-_-_-_- 13 Butts _________________ 1

Jeff Davis _____________ 1 Johnson ______________ 2 Lamar ________________ 20 Lanier ________________ 1
Lee ------------------ 12 Liberty --------------- 7 Lumpkin _____________ 3

Carroll --------------- 1 Chattooga _____________ 1
Cherokee ------------- 3 Cook ----------------- 1 Dade _________________ 4 Dooly ________________ 1 Douglas ______________ 1 Early _________________ 15 Echols _______________ Lt Effingham _____________ 23 Franklin ______________ 14
Gilmer --------------- 3 Gordon _______________ 1 Haralson _____________ 1 Harris ________________ 2 Irwin ________________ 12 Jasper ________________ 3

Niacon --------------- 5 Meriwether ____________ 1 Miller ________________ 2
Murray --------------- 1 Paulding ______________ 1 Pkrce ________________ 9 Handolph _____________ 1 Screven _______________ 1 Seminole ______________ 220 Stewart _______________ 2 Talbot ________________ 1 Taylor _______________ 12 Toombs _______________ 1 Treutlen ______________ 10 Turner _______________ 2
Upson ---------------- 19 White ________ ________ 1

Educational Activities
During the year, the Director of the Division attended 25 meetings of organized groups interested in public health activities. At these, he made 12 talks to approximately 800 individuals. Three radio broadcasts on communicable diseases were presented during the year by the personnel of this Division.
An article was written by the Director of the Division for the State Medical Journal on "Georgia's Typhus Control Program". Heprints of this article were made available for the large number of requests which were received.
A pamphlet on "Immunology" was distributed to each physician in the State and to other interested persons who requested copies. Pamphlets on typhoid fever, typhus fever, and communicable diseases were also distributed upon request.
Special Activities
After preparing statistical data concerning the number of available hospital beds, as well as the need for beds, in general hospitals in Georgia, the Director of the Division of Preventable Diseases appeared

Preventable Diseases

133

before the Senate Sub-Committee on Labor and Education at the chairman's request in connection with Senate Bill No. 3032, Washington, District of Columbia.
At the 1equest of the regional medical director of the Southeastern Health Region, the Director of the Division accompanied him to investigate an outbreak of food poisoning in an orphanage which attacked 48 people. These L18 cases included 2 of the adult workers at the institution, and the others were inmates of the orphanage.
Several trips were made to one Georgia town to investigate with the health officer an outbreak of a disease diagnosed by the local physicians as "Brushy Creek Fever." This epidemic affected some 35 people, all males, the youngest being 6 years of age and the eldest Lt2. The majority of the cases were from 12 to 28 years of age. All of the victims gave a history of having gone swimming in a creek known as "Brushy Creek". All laboratory findings were negative.
The installation of the Central Tabulating Unit, a mechanical system of keeping records, into the Venereal Disease Control Service consumed much of the State Epidemiologist's time during the year 1940. Time was spent in arranging the post-graduate courses in venereal diseases, which are being given at the University of Georgia School of Medicine in Augusta, Georgia. The National Defense Program has also p1esented a great problem in the State in regard to venereal diseases and prostitution.
The Director of the Division has also been occupied in the inauguration of the Typhus Fever Control Service within the Division of Preventable Diseases.
Much time was consumed in an effort to secure desirable and qualified personnel for the initial set-up of an Industrial Hygiene Service. With the increasing number of industrial plants in Georgia, particularly in the northern part of the State, a keen need has been felt for a service of this nature within the Department of Public Health.
During the latter part of December, the Director of the Division made a trip to the United States Public Health Service, Washington, District of Columbia, in the interest of the venereal disease and prostitution situation in Georgia which exists in connection with the extracantonment areas, and to propose a plan of control. In addition, conferences were held with Public Health Service representatives in regard to the malaria laboratory in Georgia and the typhus problem. Dr. Neal, of the Division of Industrial Hygiene, was contacted in order to discuss plans for an Industrial Hygiene Service in Georgia and the possibility of personnel. As a result of this conference, Dr. Neal <\greed to send personnel to help start the program.
The Director of the Division of Preventable Diseases served another year as Chairman of Social Hygiene for the Georgia Congress of Parents and Teachers. In connection with this, package libraries on Social Hygiene were compiled during the year and placed in the Georgia

134.

Georgia Department of Public Health

Department of Public Health library. These package libraries may be obtained on loan for a period of two weeks.
An active part was taken in the preparation of the program for the social hygiene meeting in Atlanta, Georgia, on Febwary I, 19il,O, National Social Hygiene Day. Assistance was also rendered in the preparation of two Negro conferences on social hygiene in Atlanta, one March 28 and 29, and the other, November 28 and 29. Through the social hygiene work, much has been done to inform the citizens of the State as to the nature, widespread occurrence, and destructive effects of syphilis and gonorrhea.
Analysis of Statistic,al Report
Detailed information concerning the following statistical analysis is shown in the morbidity reports on pages ILU through 143 of this report.
DIPHTHERIA: During the year l9i10, there were 5i13 cases and 59 deaths from diphtheria reported to the Department. This gives a death rate of 1.9 per 100,000 population, and is the lowest number of cases and deaths ever to be recorded by the Department. The death rate of 1.9 is a reduction from the death rate of 3.0 per 100,000 population the previous year. The fatality rate per cent of 10.9 is indicative that case reporting was not quite as good this year as during the two previous years.
DYSENTERY: The reporting of dysentery, of course, is notoriously poor. While the 582 cases reported are less than those reported in any yea1 since "'1936, the number of cases reported can hardly be interpreted as an indication of the prevalence of the disease. During l9i10, 126 deaths with the resulting death rate of i1.0 per 100,000 population is an all-time low for this disease. The fatality rate per cent of 22.2 indicates that morbidity reporting was not quite as good as for the previous year.
The venereal diseases, hookworm, and malmia will be commented on by the Services under whose jurisdiction they come. However, it is interesting to note that the smallest number of cases and the smallest number of deaths hom malaria ever to be reported were iecorded in the year 1940. The death rate of 2.8 per 100,000 population for this disease is an all-time low in the history of the Department.
MEASLES: In regmd to measles, there were 3,282 cases and 23 deaths reported for this disease during the year l9i10. This gives a death rate of 0.7 per 100,000 population. The fatality rate per cent of 0.7 indicates that reporting of measles is very greatly improved. This is the smallest number of cases reported since 1938, when l0,5li1 cases were reported, 1938 being an epidemic year. It is expected that l9i12 will be an epidemic year for this disease.
MENINGOCOCCUS MENINGITIS: During l9i1Q, there were 27 cases of meningococcus meningitis with a result that 9 deaths occurred, giving a death rate of 0.3. This is the smallest number of cases and the lowest death rate ever to be recorded for this disease. The fatality rate of 33.3

Preventable Diseases
is also the smallest fatality rate since 1933 and Is indicative of very good 1eporting.
PNEUMONIA: During 19L10, L1,480 cases of pneumonia with 2,055 consequent deaths were reported to the Department. This gives a death rate of 65.8 per 100,000 population, which is the lowest rate ever recorded in Georgia from this disease. Undoubtedly, the advent of the newer chemotherapeutic agents has had influence upon this rate.
PoLIOlVIYELlTIS: During 194-0, poliomyelitis decreased to 30 cases and 7 deaths, with a result of the death rate of 0.2. This is the smallest number of cases and deaths from this disease ever to be recorded by the Department.
SCARLET FEVER: One thousand cases of scarlet fever were reported in 19L10 with a result of 16 deaths. This gives a death rate of 0.5 per 100,000 population.
SMALLPOX: There were only 11 cases of smallpox reported to the DepaTtment dming 19L10, which is an all-time low for this disease and is surpassed only by the death rate, which was zero and has been for the past five consecutive years.
PELLAGRA: DnTing 19L10, there were L129 cases and 235 deaths from pellagra Teported to the Department. This is the smallest number of cases oT deaths ever to be reported. This low figure gives the death rate of 7.5 per 100,000 population.
TUBERCULOSIS: The year 1940 marked an all-time low in the number of reported cases of tuberculosis, which was 2,805. The number of deaths and the death rate, however, are identical with the preceding year, when 1,533 people died, giving a death rate of L19.1 per 100,000 population. The fatality rate peT cent of 5L1.7 would indicate that this disease was not as well repoTted during 1940 as in any year since 1932. As to whether the reduction in the number of reported cases is due to lack of case finding facilities or is due to an actual reduction in the incidence of the disease is debatable.
TYPHOID FEVER: The number of cases of typhoid fever reported during 1940 was 487 and the number of deaths was 68. This is the smallest number of cases and deaths ever to be reported, and the death rate of 2.2 per 100,000 population is naturally also the lowest. The fatality rate of 14.0 is a reduction from the previous year, and indicates that reporting of cases is slightly improved.
TYPHUS FEVER: Five hundred eighty-nine cases of endemic typhus fever were reported to the Department dnTing 19LW. This is the smallest number of cases to be reported since 1936, when 926 cases were reported. TheTe were 26 deaths attributed to this disease, giving a death Tate of 0.8 per 100,000 population. The fatality rate would indicate that reporting of this disease was not quite as good as the previous year, but better than the yeaTs prior to 1939. As to what the reduction in the number of repmted cases of this disease can be due, I do not have any definite answer. However, I am of the opinion that this disease is following a cycle,

136

Georgia Department of Public Health

since I do not believe that our typhus control activities have been sufficiently widespread to account for the reduction.
UNDULANT FEVER: The 123 cases of undulant fever reported to the Department during 1940 is the largest number to be reported, being two more cases than were reported in 1939. The death rate from this disease has not changed during the past three years. More attention should be paid to this disease, particularly in the way of education of the general public and in the case of workers in industries such as abattoirs, packing houses, and butcher houses.
WHOOPING CoUGH: One thousand twenty-three cases of whooping cough were reported to the department during 19LJ..O and represent the smallest number of cases reported since 1936, when 702 cases were recorded. The 108 deaths reported were likewise the smallest number since 1936, when 67 were recorded. The death rate of 3.5 per 100,000 is also the lowest since 1936, when the death rate was 2.2 per 100,000. The fatality rate per cent. of 10.6 is slightly higher than the preceding four years and is indicative that 1eporting from this disease has not been quite as good as during the preceding four years.
In conclusion, I should like to point out that the smallest number of reported cases and deaths ever to be recorded in the history of the Department were from the following diseases: malaria, meningococcus meningitis, pellagra, poliomyelitis, smallpox, and typhoid fever.
In addition, the smallest number of deaths from dysentery and pneumonia were recorded, while the deaths from tuberculosis remained the same as in the previous years.

Preventable Diseases

137

.='~

TABLE I (a)

NUMBER OF CASES AND DEATHS FROM SPECIFIED NoTIFIABLE DISEASES
REPORTED IN GEORGIA, l936-l9L!Q, WITH RATES PER 100,000
POPULATION AND PER CENT FATALITY

Diseases

Year

Cases

Case Rate Per 100,000 Population

Deaths

Death Rate Fatality Per I00,000 Rate Population (Per Cent)

Diphthel'ia:

1936

llOO

3B.O

123

1.0

11.2

1937

911'

29.8

108

3.5

ll.S

1933

1932

39.7

lOB

3A

8.6

1939

llH

35.3

95

3.0

8.5

1910

513

11'.'1

59

1.9

10.9

Dysentery:

193B 1937 1938 1939 1940

5'1<1

17.8

15B

5.1

28.7

715

23.2

130

.L2

18.2

079

21.9

192

B.2

28.3

585

18.B

127

<1.1

21.7

582

18.B

126

<J.O

21.6

Gonol'l'hea:

1936

5223

171.1

19

O.B

OA

>.:.:

1937

5519

180.'1

2<1

0.8

OA

1938

1686

151.2

21

0.7

0.'1

1939

1583

1<15.7

2<1

0.8

0.5

1910

5282

169.1

22

0.7

0.'1

Hool;;worm:

1936 1937 1938 1939 1910

10522 15891 177ll 20381 17306

31<1.6 516.6 571.'1 6<1'1.9 554.0

09

0.07

2

0.1

0.01

2

0.1

0.01

0.3

0.0<1

Influenza:

1936

15223

<198.6

18<12

B0.3

12.1

1937

11799

181.0

1<136

<16.7

9.7

1938

3782

122.0

802

25.9

21.2

1939

11592

368.5

950

30A

8.2

1940

13420

<129.6

92<1

29.6

6.9

Malaria:

1936

11931

390.7

606

19.8

5.1

1937

6813

221.'1

235

7.6

3.'1

1938

3816

123.1

H6

<1.7

3.8

1939

2996

95.2

101

3.2

3.'1

19<10

2502

80.1

89

2.8

3.6

Measles:

1936

223

7.3

0.3

3.6

1937

926

30.1

10

0.3

1.1

1938

105l<l

339.2

151

5.1

1.5

1939

3'123

108.8

51

1.6

1.5

1940

3282

105.1

23

0.7

0.7

138

Georgia Department of Pztblic Health

TABLE I (b)
NuMBER oF CAsEs AND DEATHS FROM SPECIFIED NoTIFIABLE DisEAsEs
REPORTED IN GEORGIA, 1936-19<1.0, WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY-Continued

Diseases

Year

Meningitis : (:.\Ieningococcus) 1936 1937 1938 1939 19,10

Pellagra:

1936 1937 1938 1939 1940

Pneumonia:

1936 1937 1938 1939 1940

Poliomyelitis:

1936 1937 1938 1939 19,10

Scarlet Fever:

1936 1937 1938 1939 1940

SmalllJOX:

1936 1937 1938 1939 19,10

Syphilis:

1936 1937 1938 1939 1940

Cases

Case Rate Per l 00,000 Population

Deaths

Death Rate Fatality

Per l 00,000

Rate

Population (Per Cent)

187 9,1 40 35 21
735 8<17 1209 745 ,129
6871 5637 5165 4765 'H80
165 9'1 76
101 30
1100 935 782
1055 1000
16 15 33 ,17 11
86<10 153'll 18043 20188 21259

6.1 3.1 1.3 1.1 0.9
27.5 39.0 23.7 13.7
225.0 183.2 166.6 151.5 H3..!
5A 3.1 2.5 3" 1.0
36.0 30.'1 25.2 33.5 32.0
0.5 0.5 1.1 1.5
OA
283.0 '198.6 582.1 641.7 680.6

67 35 20 15
9
391 310 365 271 235
3803 3077 2731 2299 2055
29 20 18 12
H 11 13 19 16

2.2 1.1 0.6 0.5 0.3
12.8 12.0 11.8
8.7 7.5
12,1.6 100.0
88.1 13.6 65.8
0.9 0.7 0.6 0.'1 0.2
0.5 0.'1
OA
0.6 0.5

1141

H.5

496

16.1

478

15.'1

473

15.1

587

18.8

35.8 37.2 50.0 '12.9 33.3
53.2 '13.7 30.2 36.'1 54.8
55.3 5'1.6 52.9 48.2 45.9
17.6 21.3 23.7 11.9 23.3
1.3 1.2 1.6 1.8 1.6
5.1 3.2 2.6 2.3 2.8

.:

Preventable Diseases

139

TABLE 1 (c)
NUMBER OF CASES AND DEATHS FROM SPECIFIED NoTIFIABLE DISEASES
REPORTED IN GEORGIA, 1936-19L10, WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY-Continued

Diseases

Year

Cases

Case Rate Per I00,000 Population

Deaths

Death Rate Fatality

Per I00,000

Rate

Population (Per Cent)

'l1uberculosis :

1936

3317

108.6

1713

56.1

51.6

1937

3016

98.0

15<19

50.3

51.4

1938

3011

97.1

1612

52.0

53.5

1939

2996

95.2

1533

<19.1

51.2

19<10

2809

89.8

1533

<19.1

5<1.7

':Pyphoid Fever:

1936 1937 1938 1939 19<10

926

30.3

195

6.<1

21.1

719

23.<1

139

4.5

19.3

829

26.7

121

3.9

H.6

56<1

17.9

83

2.7

1<1.7

<187

15.6

68

2.2

1<1.0

Typhus Fever:

1936

817

26.8

4<1

1.<1

5A

..:.:

1937

1092

35.5

5<1

1.8

<1.9

1938

1017

32.8

<17

1.5

4.6

1939

1131

35.9

4<1

1.<1

3.9

19<10

589

18.9

26

0.8

<!A

Undulant Fever:

1936

60

2.0

1937

58

1.9

1938

83

2.1

1939

121

3.8

19<10

123

3.9

0.03

1.7

0.1

3.6

2

0.1

1.1

3

0.1

2.<1

Whooping Cough :

1936

702

23.0

61

2.2

9.5

1937

1114

55.7

H2

<1.6

8.3

1938

2329

15.1

225

7.3

9.7

1939

161<1

51.3

134

<1.3

8.3

19<10

1020

32.7

108

3.5

10.6

- .~~-

. :.

~-;_:,:_,:,_

Age Level By Years
Under 1 Yr. 1-2 2-3 3-4 4-5 5-6 6-7 7-S 8-9 9-10

f-'

NonFtABLE DISEASES REPORTED BY CoLon, SEx, AND AcE-194.0

"0""

Cerebrospinal

I Menin9itis
wc

Di!Jhtheria
wc

M

2 ----

10

7

}<'

1 ---

9

1

M

1 ---

14

6

F

--

--

10

3

M

1

35

9

F

--- 27 10

M

'--

24

5

F

1

--

34

ll

M

---

23

9

F

2 ---- 25

5

-

M

1 ---

17

3

F

--

21

7

M

1

1

13

3

F

---

13

3

M:

1 ---

ll

3

F

1

ll

4

M

---

8

1

}<'

---

5

5

M --- ---

2

}<' --- ---

8

2

Amebic Dysentery
wc
--- ---
1
---

1

1

---

--

1 1
-----

---
---
---

Bacillary Dysentery
wc

6

1

5

7

1

2

3 ---

5

1

5

1

2

1

1

--- ----
2

1 --1

--- . ----

--- ---
-- --

1 ---
-- ----
1
---

Malaria
wc

2

5

3

2

2

3

1

3

9

10

5

10

9

7

10

s

7

s

7

l4

20

7

~

1:3

10

27

10

31

12

l7

s 32

12

26

10

1G

15

18

lti

25

Measles
wc

13

3

10

1

6

3

6

3

s

2

17

4

s

1

10

5

ll

1

15

2

9

1

13

5

15

6

15

4

23

1

30

1

22

5

16

4

13

4

16

4

Pellagra
wc

--

1

---

---
1

---

----- --- --
---
---
----- ---

Pneumonia
wc

Poliomyelitis
wc

149 lOS 102 109

40

26

13

22

1

2

c;J
(1)

0

1 '-- a~

1 1 :;::

33

30

1

1b

(1)

24

19

s'"l::l

22

10

12

8

1 2

---
1

~
(1)

~

25 14
13 9

5 ll
s
3

'--
--1

-- --0 '--
2 ::? :

c:;

24

10

17 ---

27

6

s

4

1 1

-----

::.:::
(1)

1

~
;::,-

2

ll

3

13

12

3

l4

3

.~-~.

. -:": -~-...:.~~--

Ago Level By Years
10-14 15-19 20-24 25-29 :l0-34 35-39 40--44 45-49 !"i0-:14. 55-04.

NoTIFIABLE DrmAsEs REPORTED BY CoLoR, SEx, AND AGE-1940-Continued

Cerebrospinal Meningitis
wc

Diphtheria
wc

~{I ---
F

12

2

13

2

M

5

1

1

1

F

9

1

M

F

4

1

1

7

1

~i

1

F --

M ----

F

. --

M

---

F

2

1

4

1

1 --3 . --

2 1

M:

1 . --

. --

F

1

M

1 ---

---

F

2

M

1

1

F

2

Ml . --
1"

1 2

Amebic
Dysc~!cry
wc

2

1

1 1
3 --

1

2

3

3

1

3

4

5

1

2

1

1

1 ---

2 2

2

1

1

Bacillary Dysentery
wc

2

1

1

1 1

5

1

1

2

2

3

3

1

"2

5

5

1

2

1

2

1

l

---

. --

2

3

1

4

2

3

1

Malaria
wc

65

76

47

99

48

38

4~

70

61

39

49

50

47

31

46

29

48

13

33

19

45

21

39

21

37

21

28

10

21

8

34

8

36

ll

10

12

:J!i

V:i

21

10

Measles
wc

49

9

72

7

24

7

29

5

18

5

19

-9

13

2

8

1

4

1

ll

2

1

--

1

2 --
4

---

1

1 2

PeHagra
wc

Pneumonia
wc

PoliomYe litis
wc

1

1

49

17

2

2

29

ll

--

53

33

3

1

26

30

2

37

31 . --

3

7

20

:!3

i
<::

2

1

29

48

--

12

10

26

34

--

~
:'";:",
C.,l_"'

1

2

39

36

. --

~

9

12

28

30

I;::;

~

4

39

44 ---

:~;:,

17

16

3:i

23

~ "'

"'

6

1

40

49

13

7

2G

33

5

3

49

34

14

10

20

45

10
s

"10

4!1
~4

45 37

17

4

71

!i3

2:i

22

53

49

I-'
..:..:..
I-'

Age Level By Years
65-74 75 and Above Unknown Age 'l'otal

NoTIFIABLE DISEASES REPORTED BY COLOR, SEx, AND AGE-l94D-Continued

I Cerebrospinal Meningitis Diphtheria w cw c

M ---

---

]!' --- ---- -------

M: ---

---

]!' --- ---

---

M: --- ---

6

l

F

---

1

l

M:

13

F

8

4 184

53

1 208

57

Amebic Dysentery
wc

2

l

---

l

--1 ---

7

3

9

l

32

10

28

5

Bacillary Dysentery
wc

2

2

l

3

5

2

1

8

3

ll

l

59

18

54

20

Malaria
wc

9

8

16

5

5

8

6

2

52

18

56

19

607 435 504 50S

Measles \
wc

-- ---
--

2 ---

53

3C

51

5

294

87

346

56

Pellagra
wc

Pneumonia
wc

19

5 127

38

25

9 100

34

8

6 128

13

19

3 155

29

!i

67

34

19

6

40

20

so

29 1129 684

169 114 808 613

I..-,.'
l-.:J
---
Poliomye litis
-w- - -c

<;")
c."..'
~ ;;

~

"''1:::!
:;:,

10

4

;;::;_

12

2

:::::
-"~ '
c

"""0::
0.._"' ;

\::!:::
"~'
;;,-.

NoTIFIABLE DISEASES REPORTED BY COLOR, SEx, AND AGE-194,0-Continued

,.,.!--'

Ago Level By Years
10-14 Vi-19 20-24 25-29 30-34 3!i-39 40-44 45-49 50-54 55-64.

I

Scarlet Fever

wc

~1

47

1

]!'

66 ---

M

14

1

l!'

20 ---

M

6

F

7

1

-

M

1

1

F

7

M

1 ---

F

7 ---

M

2 ---

]!'

2

M

---

F --- ---

M

---

]!'

1

M ---
F --- ---
M --F ---

Septic SJre Throat
wc

l7

1

16

3

H

1

29

2

31

5

35

6

20

1

26

2

32

1

15

1

18 ---

9

1

12 ---

9

5

12

10

1

8

1

11 ---

ll

8

2

Smallpox
wc

--- ----- ---
----- ---

1 --
---- 1

----- ---

1

1

---

----- ---

--- ----

--- ----- --

1 ----- ----

----- ---

Tuberculosis
wc

Tularemia
wc

15

ll

6

1

12

36

2

3

l7

40 ---

l

36 113

1

2

32

87

4

4

63 138

2

2

58

97

4

1

80 158

1

2

62

79

1

4

59 106

1

4

75

76

4

1

72

73

4

4

64

58 --- ---

37

57

2 ---

74

41

1

3

38 27 ---

1

61

36

3

1

20

25

4

2

84

30

1

1

53

37

2

1

Typhoid Fever
wc

16

16

12

12

17

17

ll

16

10

15

12

20

16

13

8

10

ll

8

5

9

6

4

7

6

12

2

1

3

1

1

5

2

6

2

3

1

2

l

3

1

Typhus Fever
wc

19

2

8

1

41

2

lG

2

33

3

21

4

39

13

27

6

21

8

l7

2

25

8

15

4

20

3

17

3

16

2

ll

4

25

3

12

1

17

1

9

1

Undulant Fever
wc

2

2

1 ---

5
1 ---

3

1

2 ---

10

2

4

1

6 --1 ---

5

3

3 ----

6

1

1

1

5

1

3

5 4

4

2

4

Whooping
C~ugh
wc

4 17

---
1

~
8"'

3 2

m:si

1

1 l;::j

---- ~e"'

--. --- ;.,:.;;.

---

"' 1 :::;

-----

-----
-----

-"'"
0
""1:1
:

~ ""

--- ---

-----

---

I:J::
~ "'
So

NoTIFIABLE DISEASES REPORTED BY CoLon, SEx, AND AGE-194-0-Continued

A..... Level By Years
65-74 7:1 and Above Vnlnwwn Age 1'ot!ll

I

::ca. :ct
Fever

wc

M --- --F . -- ---

M
F --- ---

M

l4

2

1

16

l

M 400

21

F 475

33

Scutic S .. rc Throat
wc

5 ----- 1
1 ---
3

22
23 ---

249

14

232

32

Smallpox
wc
---
--- ---

---

1

---

1

3

2

---

2

Tuberculosis Tularemia

w cw c

56

21 -- ---

40

9

1 ---

10

q

---

8

5 ---

27

2G

3

2

24

18

5

1

662 648

27

20

559 838

26

22

TYtl!Hl'" Fever
wc

--- --
--- ---

---
--

l4

7

6

1

133 114 100 121

TYl)iH.:S Fever
wc

9

1

1

4 2

25 ---

19

3

304

47

181

32

Undu:.,nt Fever
wc
3 2

Whoooling Cough
wc

1

3

9

1 ---

8

61

17 189

35

3 231

2~

<-.i

<:'!

~

61 54

s-;::;
Cl-'
~

t::l
;'"~ :":'", ~ "' "'

f-' ~
&l

14,6

Georgia Department of Public Health

TYPHUS FEVER CONTROL SERVICE
Typhus fever control services were rendered to 55 cities in 50 counties of Georgia during the year 194.0. Services rendered were in an advisory capacity in organizing and superv-ising local typhus control programs. Organized typhus control programs, consisting of vent-stoppage of buildings, garbage control and clean-up, and rat extermination as control measures were established in 15 cities.
The Typhus Control Service also rendered advisory assistance to the War Department in the construction of Camp Stewart, at Hinesville, and Camp Wheeler, at Macon, Georgia. Through the recommendations of the Typhus Control Service, construction plans for cantonment buildings were modified to conform with vent-stoppage specifications in order to eliminate any potential rat infestation in these buildings, thereby protecting troops from typhus fever.
Administration
The administration of the Typhus Control Service was under the direction of the Division of Public Health Engineering until July 1, 1940. After this date, the administrative responsibility was, changed to the Division of Preventable Diseases.
Personnel
The personnel of the Typhus Control Service consisted of an engineer in charge and two assistant engineers. Assistance was obtained from the U. S. Public Health Service in providing two sanitary inspectors under the direction of the State Typhus Control Service to supervise typhus control measures in counties not having health units.
Education
During the year, 4,1 addresses were made to civic organizations, meetings of city and county commissioners, and public gatherings, with a total of approximately 1,022 persons in attendance.
A total of 1,215 informal discussions and conferences were held with city and county officials, architects, contractors, and health department personnel in the promotion and supervision of typhus control programs. Information on typhus fever control was disseminated by the Typhus Control Service and by city and county health departments to the people of Georgia through the media of newspaper articles, radio talks, pamphlets, bulletins, circular letters, and handbills. Three radio broadcasts were made during the year and it is estimated that 5,000 pamphlets were distributed.
Investigations
During the year, 29 city-wide investigations and eight special investigations were made in cities requesting assistance. These investigations were directed toward the determination of the prevalence of typhus fever and existing conditions conducive to rat infestation, such as rat infestation and rat harborage in buildings and garbage conditions on premises. Reports, based on the .findings of these investigations, were submitted to the city

Preventable Diseases

147

officials. These reports included recommended control measures and cost estimates of the work to be performed.

Vent-Stoppage

Since the modification of rat proofiing of buildings to vent-stoppage in May, 1939, venl-stqpuage has proven to be a practical and inexpensive rat control measure. The average cost of materials for vent-stoppage, based on the total number of business establishments completed, is approximately $3.00 per business establishment. Vent-stoppage is effective, easily applied, and practical for municipalities to finance and enforce regulations. It is the closing or protecting of openings in exterior walls of buildings to prevent the ingress of rats. During the year, 907 business establishments were vent-slopped in 16 cities. Vent-stoppage maintenance was required of 25 business establishments. A total of 4.,554 business establishment were surveyed for vent-stoppage. Since May, 1939, 1,338 business establishments have been vent-stopped in 23 cities.

Garbage Control and Clean-Up
Garbage control and clean-up of premises were applied to 16 cities as part of the typhus control program. Many of the cities made improvements in their garbage and refuse collection system and method of final disposal. These improvements included an inestimable number of apploved garbage receptacles installed on public and private premises and additional equipment added to the collection system.

Rat Extermination

With vent-stoppage of buildings as the primary typhus control meas-

ure, no mganized city-wide rat poisoning campaigns were conducted by the

Typhus Control Service during 1940. Rat poisoning of individual prem-

ises were conducted principally by property owners, tenants or commer-

cial exterminators. In some specific instances, premises indicated as pos-

sible typhus foci were treated with poison rat bait by County and City

Health Departments.

TTapping o1 Tats has become increasingly impoTtant as a means of

eliminating rats that have become blocked within vent-slopped buildings.

TTaps were placed in approximately 800 vent-stopped buildings, with an

estimated total of 10,000 Tats caught.

Visitors Inspecting Field Activities

Representatives from Health Service in India__________________ 2

"

""

" " Turkey_________________ 1

"

" University of Hawaii, Honolulu___________ 1

"

" U. S. Public Health Service -------------- 6

"

" Harvard University, Cambridge, Mass._____ 1

"

" North Carolina State Health Dept._________ 1

Preventable Diseases

149

Scientific Publications
(1) "Advances in Murine Typhus Fever Control" American Public Health Association, Detroit, Michigan, October, 1940. In press.
(2) "Municipal Typhus Fever Control" Official News Bulletin of the Georgia Water and Sewage Association, August 5, 1940.

150

Georgia Department of Public Health

TYPHUS FEVER- 1940

Preventable Diseases

151

DISTRIBUTION TYPHUS CONTROL SERVICES
STATE OF
GEORGIA
I9 4 0

~ COUNTY HEALTH UNITS

~ t/.'~

COUNTY HEALTH UNITS RECEIVING ASSISTANCE

i --1 l~_j

CITIES IN NON-HEALTH UNIT COUNTIES RECEIVING ASSISTANCE

STATE DEPARTMENT
OF PUBLIC HEALTH

SCALE IN MILES

oo



00



STATISTICAL SuMMARY OF AcTIVITIES

1<:ll

~

.~

Business Establishments

County

Health Dept.

Non-Health Dept.

City

~ ~
>~
-".C;
;;:
zQ

Meetings

~

"C

"C
""C'
<.ce

~
~
"C "C
c(

...c,-c
~~ ~
~".'... "C
Z"'"c"(

."cte

In vcstigatio ns

c

8

... o"g'

c

~

~b

~ "' C3

"".;.;'.
(jJ

...,.,."..C,.
-e"';":'
" " ZCil

Vent-Stopped

,.,

;;;..,

.0..
C)

- ..~".>. ".0..', ":"".~ :.'.''.

!S 1"-'

.Q""'".'' ""c'
~ ~".' :'c!"'
~c
>"c:' ~:'":-'

\;"')
0"' a1

-

~-

Baldwin______________ ___________________l\lilledgeville

s

20

37

1ii1

b

------------------- __Berrien ______________ Nashville

12

Bi!Jb _____________________________________Macon

10

Broolm ___________________________________ QuHman

13

Bulloch_________________________________..statesboro

8

Burke ____________________________________Waynesboro

10

31

84

78

78

25

739

10

10

10

29

1

180 122

122

23

1

160

3

40

21

1

115

~ ~ ~
~

Catoosa_________________________________Jlinggold -------- --

20

3

~

Chatham___________________________________Savannah Beach ___ _ 2

10

3

Savannah

23

2

40

85

ww

Coffee__________________________________ _Douglas

4

2 100

12

--

'l::i
n:

C o l q u i t t _ _________________________________M o u l t r i e

15

72

141

8

_____________________Coolt _________________Adel

18

Crisp __________ ------ ________ _

Cordele

Decatur-------------- --------- ___________Bainbridge

5

8

56

1

13

50

M

--

~

-

-- --

uu

:::r::
"':;:,
;":;:-.

Dougherty---------------------- --------- _'l.lbany ------------- 28

59

u

--

u

_____________________Emanuel

_S\vainsboro

2

Fulton ______ -----------------------

_Atlanta

15

Glynn-----------------------------

n.runswick

2

0 rady -------~------- ----------------

Cairo

9

Greene _____________ _

Greensboro

6

5

45

18

8

10

21

2

75

16

1

-

-

--

--

H

u

--

u

1

1

11-

"H

2

--

2

STATISTICAL Su111MAHY oF AcTIVITIEs

County

City

Health Dept.

Non-Health Dept.

Hancoclc________________________________ .Sparta _____________________.feff Davis----------- _Hazlehurst Jenkins______________ ------------------- .Millen _____________________Lanier______________ .Lakeland Lamens __________________________________ _])ublin
_____________________Liberty-------------- !linesville Lowndes _____________ ----------- ________ _:_Valdosta ------------- ________Macon _______________M:ontezuma _____________________Meriwether___________ Manchester
Mitchell_________ --------------------------Camilla
Muscogee ___________________________________Columbus _____________________Uandol!Jll ------ ----- Cuthbert
lUchmond ---------------------------------Augusta _____________________Screven ______________Sylvania Spalding __________________________________ Griffin
_____________________Stewart_ ____________ _Lumpkin
---------------------Stewart _____________ Uichland Sumter___________________________________ Americus _____________________ri'aliaferro ___________ Sharon ---------------------'i'attnalL_____________ Ueidsville

."'

Business Establishments

-"'
>"'
~ ;;:
z0

"c::

Meetings

~ Investigations

~

c::

........
:c;::
<

'C

."c:,': - c

.. ~ .~,~.,
~ c."'

'C

'C

<'C

Q'C
Z<

"'<.)
';<
.c::
":::'
c.

.
'C
~
b
C3

.... ~ . .. "'(j)

.....,......
==E>
Z<Jl

Vent-Stopped

.....-.... .Q.,.

->;;.;.,.
,-.>,c"'.

:

C>

c. a: f"-'

..
"'

.

cc.. "c::

" -U"'?~c::

. " -c c-::
>:;;

1

3 175

4

ll

10

26

7

6

ll

27

2

30

63

3

12

1

5

8

26

ll

2

85

20

13

15

ll

16

28

41

3

10

1

2

8

35

23

13

1

7

8

1

10

6

6.

6

;";;ti

101

13

13

<:::
~

270 125

125

B' g;

co

b

&co:

56

56

56

!;>

78

7l

7l

"co'

"'

58

103 103

103

15

265

29

29

29

160 160

t-1 CJl <;J.:I

STATISTICAL SUMMARY OF AcTIVITIEs

1.c..,-n..'

~

Business Establishments

County

Health De11t.

Non-Health Dept.

City

-u";'
>
'"""'
i.:
zc

Meetings

"C
."c"e"''
::.(

~
::

"c'.., ~~
0".".~'

"".."": ZO""<"C'

:""c:'
~

I n~estigations

c

c3
"c '
~
0".'.

."..'
~
i:J
(3

...
;o
"c'.
O)

==..-c'.Q-,.>._".",.
ZCJl

Vent-Stopped

c.,.
"'

-.;.,.

".>"o-..""O.-.".,'.

3
0

0..0:

1-

""''
"'cc..

""c

-0 "c '
. -(j) "'

"' -c c-
>"'::E

~
~
<::>
~

~-

___ - ------ ___ --------'l'atlnall______________Glennville

2

C;:j

---------------------Taylor_______________ B utier 'l'erren ___________________________________ _})a wson 'l'errelL __________________________________ _Iarrott Thomas ________________________________ _:__'l'lwmasville
'l'ift _______________________________________Tifton

7

--

4 --

21

1

-- -- 10

3 --

s

21

1

2 100

39

42

39

39

132

~ !.;.:.>,

24
--

173

59

59

'
.~..

rrroup --------------- _____________________LaGrange

14

--

~

'!'roup ____ ------------------------------ West Point ________ _
_____________________Turner------------- .Ashburn : _____________________upson ________________Thomaston

75

18

142 85

85

'"t:l

:

r;

watc_____________________________________Waycross

10

68 20 ss

\Vashington _______________________________Sandersville

6 -- --

10

42

52

i:J::
~

\\'hitfield .__ ---------- ____________________.J) allon

4

1

65

12

1

232

~

_____________________Wilcox------------ __ .Rochelle

2

--

ltl

1

--

ti6

;:;:.

17 -- -- -- 26

--

62

62

25

Unclassified __ _

5

178

rl'O'l'AL ;i;'i

17

55

407

s

41 1022 1215

29

s 4.554 907 431 1338

25

Preventable Diseases

155

VENEREAL DISEASE CONTROL SERVICE
Personnel
The Venereal Disease Control Service consists of a State Venereal Disease Control Officer, Associate Venereal Disease Control Officer, United States Public Health Service consultant, three stenographers, six graduate nurses who abstract syphilis clinic record cards, :five regional reserve nurses, and members of the laboratory staff who are engaged in performing examinations for venereal diseases and with the distribution of chugs and supplies.
Case Reporting
During the year, 3,527 new cases of syphilis were reported to this Service by private physicians; 18,198 new cases of syphilis were admitted to the clinics, this making a total of 21,725 new cases of syphilis being reported to the Georgia Department of Public Health. There was a total of 23,718 new cases of syphilis reported in 1939. Private physicians reported 151 new cases of gonorrhea, and the clinics reported 831 new cases, making a total of 982 new cases of gonorrhea. There were 1,0LJ,9 new cases of gonorrhea reported in 1939. There were 36 new cases of chancroid reported by private physicians; 19 new cases reported by clinics, making a total of 55 new cases reported. There were 79 new cases of chancroid 1eported during 1939.
Distribution of Free Drugs
An estimated total of 1,64.6,L10l doses of neoarsphenamine, sulpharsphenamine, mapharsen, stovarsol, bismuth, and sulphanilamide were issued to private physicians and clinics for the treatment of syphilis and gonorrhea, as compared with 936,2L1.6 doses for the year 1939. For a detailed report of drugs distributed see Tables E and F.
Clinics
At the end of the annual period, there was a total of 167 clinics operating in 86 counties, and 135 physicians were receiving honoraria at the rate of $5.00 per clinic session for conducting free venereal disease clinics. This was an increase of Lj,2 clinics during the year.
The clinic records of the State are in the process of being transferred to the CTU, which consists of modern tabulating machines which are installed primarily for reporting morbidity, treatment-progress, and control of the venereal diseases. The clinic records are sent in to this office on schedule and are abstracted by six graduate nurses. To date, 119 clinics, representing 22,733 patients, have been transferred to the CTU.
Laboratory
During the year, 232,326 serologic examinations for syphilis were performed by the central laboratory and .the two branch_ laboratories. Of this number, there were 38,893 or 16.7% positive reactions. The number of serologic examinations for 1939 was 211,381, with 18.9%

156

Georgia Department of Public Health

g1vmg positive reactions. There was an increase of 20,945 serologic examinations over the previous year. During 1940, a total of 381
clarkfield examinations was made with 21 o/o giving a positive reaction.
There were 8,1LJ6 examinations for gonococci, with 22.3% positive.
Educational
A total of 39 lectures was made during the year to a total audience of 1,834, as compared with 123 lectures with an audience of 16,375 for 1939. Films were shown to 186 groups, comprising an audience of 22,343, as compared with 146 films shown to an audience of 26,589 for 1939. Approximately 26,331 pieces of literature on venereal diseases were distributed, as compared with 43,54.9 pieces of literature for 1939. There were 93 clinic visits made, 177 conferences, 5 follow-up visits, and 8 meetings attended (not addressed).
There have been four radio talks made during the year. For the :first time in the history of WSB, on July 30, direct use of the terms "venereal disease, syphilis, and gonorrhea" were permitted to go on the air.
Follow-Up Activities
During the year, letters were written to all patients reported as being delinquent, urging the resumption of treatment. These letters were sent to those patients referred by private physicians.
Record Farms
During the period under discussion, the Syphilis Clinic Record Card, Form RCA 1016, and the Follow-Up and Contact Investigation Card, Form RCA 1037, were combined into one form, RCA 1016-A.
RCA 103-13 (New or Readmission Card) is sent in by the clinies on those patients who have never been treated in the clinic before or on patients who were not treated in the clinic during 19itQ, but who had been treated there prior to 19i10.
RCA 103-14. (Syphilis Clinic Index) is used in the clinics as a crossindex card.
RCA 103-15 (Individual Contact History) is used in following-up contacts referred to this office.
RCA 103-16 (Patient Referral Form) is used in following-up venereal disease patients and seeing that they take treatment.
Post-Graduate Course
A course designed to bring to medical practitioners the latest available information about venereal diseases is being presented at the University of Georgia School of Medicine, Augusta, Georgia. It is sponsored by the Georgia Department of Public Health in cooperation with the United States Public Health Service and the Board of Regents of the University System. Didactic and clinical material concerning the :five venereal diseases is being presented by the medical staff at that place. Each course lasts two weeks and accommodates 10 physicians at each session. The physicians are paid an honorarium of $50.00 to cover their expenses while in Augusta.

Preventable Diseases

157

Serologic Test for Registrants
Selective Service regulations require a serologic test for syphilis on those registrants who are called for physical examination by Local Boards. Prior to call for induction, a second serologic test is required on every registrant whose first test was reported positive. All positive cases are referred back to the health officer or, where there is no health officer, to the regional medical director. The health officer and the regional medical director then see that these cases are placed under treatment.

I-' CJ1
00

TABLE "A"

SYPHILIS CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By Private Physicians

UNDER PROGRAM FOR DISTRIBUTION OF FREE ANTISYPHILITIC DRUGS January-December, 1940

NEW CASES (Never previously treated)

White

Colored

M

F

M

F TOTAL

January ---- -- -- --- 44
l:J"'ebruary -------------- 33 March ________________ 42 April ----------------- 79
May ________________ 41
.Tunc -- ------ ---- -- -- 39
July --------------- ___ 43
August ----- --------- 81

September --- -------- 41

October --------------- 34

NoYember ------ -- --- 34

Pee-ember _______

25

30

79

91

24<1

33

73

81

220

36

84

111

273

Gl

142

112

387

41

133

159

374

4l

92

107

279

37

69

98

249

6(;

133

155

434

31

93

151

316

34

98

91

257

50

96

88

268

31

so

90

226

OLD CASES (Previously treated)

White

M

F

Colored

M

F

TOTAL

45 39

45

33

24

30

37

40

40

44

(;3

G9

37

27

61

37

17

3:l

33 36

27

40

37

48

37 20

46

43

31

30

52

25

32

28

18

36

37

166

25

112

30

147

48

204

G4

179

42

129

32

128

47

172

31

134

31

135

37

146

57

139

~

(1)

TOTAL REPORTED

.0...

0:"s<

White

M

F

89

69

66

57

79

76

123

107

78

68

76

58

78

73

121

102

78

51

77

65

86

75

Colored

t;

(1)

M

s F TOTAL '"""

124

128

~ 410

103

106

332

(1)

::::1

124 201
194

141 160
213

-- 420

~

591 0

553 . ~

12ti

149

408 :

96

130

377 C""'l

181

202

606

i:l:::

139 128 128

182 122 125

450 392 414

(1)
""..,,..._
;;,-..

r:i3

49

116

147

365

TOTAL ____ ---------- 538

483 1,172 1,334 3,527

466 367

487

471 1,791 1,004

850 1,659 1,805 5,318

TABLE "B"

SUMMARY REPORT OF CLINIC ACTIVITIES SYPHILIS
January-December, 1940

January ____________ February ---------------
March ------- -------A11ril -----------------May __._________________
June ________________ July ___________________
October ----------- --Nmre1nber -------------llecember __ ------------
TOTAL ________________

NEW CASES OF SYPHILIS ADMITTED TO CLINIC

White

Colored

M

F

M

F

97

90

64

so

83

70

56

65

iJ!H

s.. s

ti24.

901

607

1,068

ti58

1,0Ui

83

82

601

975

59

62

604

878

7l

64

659

873

68

54

686

857

70

89

559

880

58

59

:!36

714

44

53

~8:!

649

31

48

369

568

784

816

6,477

l0,2:ll

OLD CASES OF SYPHILIS ADMITTED TO CLINIC

DOSES ADMINISTERED TOTAL AD

White

M

F

~su

.2!)9

102

107

102

98

84

104

119

116

72

89

98

96

93

83

Colored

MISSIONS

Arsenicals Heavy Metals

~

M

F

"<:':

1,3~1

2,1j4

5,706

19,206

18,0~5

~
~

582

1,049

3,409

23,038

21,623

,0.."..".

668

1,121

3,812

24,435

22,835

559

884

3,325

25,223

24,283

"'
tl

656

1,004

3,636

30,450

26,411

597

909

3,270

25,818

21,597

"Co'
"'>:>
Co

649

1,057

3,567

26,166

21,291

"'Co

724

1,012

3,577

26,201

20,971

103

102

493

65

54

324

- 82

90

443

79

85

tilO

891

3,187

24,974

21,368

739

2,349

19,947

15,348

131

2,475

21.727

27,311

834

2,524.

19,478

17,329

1,2s;;

1,323

7,5:16

12,385

40,8:!7

286,663

2!i8,402

1-' 1:[1 \0

,_..
0'0

TABLE "C"

GONORRHEft CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By Clinics and Private Physicians January-December, 1940

New Cases of Gonorrhea Admitted to Clinic

Acute

Chronic

M

F

M

F

January ______ 35

10

1

l"'ebruary ------ 56

7

7

2

March -------- 53

ll

9

Atlril --------- 52

5

6

May ----------- 46 June --------- 55 July ------- ___ 76
August ------- 58
September ---- 60 October ------ 65 November ---- 39 December ---- 46

20

8

1

7

7

10

7

1

17

10

4

6

5

1

2

15

1

3

7

TOTAL -- -- 611

lOS

76

6

Old Cases of Gonorrhea Admitted to Clinic

Acute

Chronic

M

F

M

F

143

3:l

23

3

131

26

36

2

138

33

32

4

124

25

42

3

150

35

16

3

193

43

40

4

177

39

34

2

92

28

127

43

112

26

6

90

20

10

9:i

16

12

1,572

367

251

21

~
0: .::: Q ~~c:-:
:e~ t0-"<C 0-
248 267 280 257
279 349 346 195
244 221 177 179
3,042

":C::
'l"n'<> cn::
~ E~
0 ..,
c<.:
702 522 622 595
587 646 562 442
467 596 427 399
6,567

Gonorrhea Cases Reported by Private Physician

White

Colored

Total

M

F

M

F

16

8

14

2

40

7

2

1

2

12

1

1

7

2

9

23

3

G

1

3:l

1

1

1

3

G

2

1

8

1

2

3

6

2

1

1

10

14

2

1

3

20

4

2

2

8

86

26

29

10

151

(')
"0 '
cr~ 5
\::j
"'"<::; ~
""' ~"'
-0-.
~
~
~
r:;
-1::!::
"~ '
;:;:.

TABLE "D"

TOTAL NEW VENEREAL DISEASE GASES REPORTED TO THE VENEREAL DISEASE CONTROL SERVICE . January-December, 1940

BY PRIVATE PHYSICIANS

BY CLINICS, HOSPITALS, OR OTHER INSTITUTIONS

TOTAL BY ALL SOURCES

White

Colored

Unknown

White

Colored Unknown

White

Colored Unknown

~

MF

M

F

M

F

M

F

M

F

MF

M

F

M

F

M

F

:'";:") "'
~

SYPHILIS

:'";":)'

Early ----- -- -- -- ----- --

406 389 816 979

---- 483 546 3938 6786

---- 889

935 4754 7765

:;:)

Late -------- -- -- ---- -- - 132 94 356 355 ---- ---- 299

Congenital*

-- --- -- --

---- - --

----

---- 2

266 2397 3393 4 32 52 ----

431 360 2753 3748

2

4 32 52 ----

;::; :;::,_

Not Stated

------------

1::!::

Cl

TOTAL --

-- --

Cl

538 483 1172 1334 ---- ---- 784

816 6367 10231 -- - ---- 1322 1299 7fi39 ll565 ---- ----

~
~

GONOCOCCUS INFEC'l'IOX Acnte _______________

;j;:)

15

22

6

---- lOS 12 265 58 268 38 163

Cl

27 287

64 268

3S

;~::;

Chronic -- ------ -- ---------- ---- ----

Not Staled

-- -------

31 l l

---- ----

13

7

4

---- ----

2 32

2 o1

---- ----

2 13 31

2 32

ll

7

2 31 4

2 VJ
;"":"j''_

TO'l'AL ___

-- -- ------

86 26 29 10

---- 121 14 297 60 299 40 207

""'' 40 326 70 299 40

OTHER VENEREAL DISEASES

Chancroid --------------------

10 10 l l

4

1 ----

7

1

3

5

3

17

ll 14

3 ---- ---- ----

2

2

6

2

2

TOTAL __________________

10 10 14

;')

1 -- -- 12

5

s

7

3

22

15 22 12

4

I--'

*Reported during period from September through December.

0\ I--'

I-' 0\ ~~
TABLE ''E" FREE ANTISYPHILITIC DRUGS DISTRIBUTED
Venereal Disease Control Service
January- December, I 940

.15
January ---February --. Marcil ______
A11ril ------
May -------.Tune ________ .Tuly --------
August -----
September --
October ---November December ___
'l'OT.-\.L
TO'AL NO. OF DOSES

.3
840 240 840 !i70
680 260 330 352
fi40 540 470 585
6,347
6,347

NEOARSPHENAMINE

.45
2,260 1,480
930 1,930
2,040 1,890 1,190 1,00:J
575 1,SS:i 1,080 1,640

.G
8,290 6,290 8,940 11,300
10,080 7,618 9,550 6,627
6,340 11,910
5,890 8,720

17 ,90:i 10l,ti5:-J

,;5
~10
:lSO
:!~0
:w
~rio
20 110
37:)
so
120
so
1,965

.9

1.5

~70

:il!l 320
540 2;)0 220 3J:i
4RO 37:1 380 430

4,090

3.0
1,:J.!O 320 740 G:iO
580 6fi
600 437
480 546 290 860
6,908

4.5
s:1o :;o
310 490
HO
360 340 210
260 760 220 580
4,750

17,905 101,555

1,965

4,090

34,540 356,250

5.4

6.0

1,4:1:-i 630
1,640 1,220

1,228

1,070

1,180

GO

1,960

735 1,05fi
650 1,265

60

14,088

10.8
280
130 140
100 270 200 160
340 130 230 200
2,180

~

"0 '

45.0

~

~

GO

t:::;

"' GO

~

~ ...,

'

GO 60

;"::':.

60 --0....

'-c

60 60 60

~
("'")

60

l::t:

!:140

"'~ :;:;:-
;:::-.

540 140,880

39,240

40,li00

Total numller of doseR of neoarsphenamine, 743,812 (}'or larger amtwules, 0.6 gms. c-onsidered average dose).

TABLE "F"

FREE ANTISYPHILITIC DRUGS DISTRIBUTED Venereal Disease Control Service January Decemter, 1940

SULPHARSPHENAMINE

0.2

0.3

0.4

G.G

MAPHARSEN

0.04

0.06

STOVARSOL

O.G

Tab~cts

BISMUTH

3JCC

60-cc

Sulpha
ni!amide
--
Tablets

January -------------- -------- 230

February ----------------------

80

March ----------------- ________ 130

April -------------------------- 290

May ____________ -- __________ 110
June -------------------------- 170
July -------------------- _______ 125
325

September _____________________ 144 Octobet ________________________ 170
November ---------------------- 70 December ------------ -------- 120

2,024

TOTAL NO. OF DOSES ____ 2,024

20 50 10 100
RO*
70
170 170

310 10
210 340
210 220
10 230
120
:-wo
180
a-to
2,540
2.:i40

60
!iO 20
70* 10 40 10
30 30 10 190 190

150 30
120 120
390 450 260 500
350 400 210 360
:1,530
3,!i30

340 90
!i70 420
630 560 320 360
410 790 530 1,050
!i,870
5,870

20 50 130 100
50 200 240
100 100 990 9,900

1,000

424

G84

16,000

~
:;:,

1,200 1,000 1,000

434 739 509

214 501 624

54,000 16,030 26,000

5...,"'
;s

:;:,

1,000

487

345

41,100 ;::;

:300

414

483

21,200

:;:t.

2,000

620

533 30,800 ::r:;

3,:125

344

ti33

27,200

0 0

:?;-<

!J!iO

<103

416

51,600 :;;

3,550 1.2:10

404 410

315 476

19,700 36,000

0
~

2,650

Gi'i7

;)82

11,000 VJ

19,02o 19,02.'\

!i,74.fi 172.:l'i0

r\,60{) 33(i,:l(i()

350,630 350,630

"c~:'; "'

*Drugs returned.

Total No. of Doses of Neoarsvhenamine __________ 743,812 (For larger ampoules, 0.6 gms. considered dose)

'l'otal No. of Doses of Sulpharspllenamine -------Total No. of Doses of Mapharscn ---------~

4,924 19,300

Total No. of Doses of S!ovarsol -------

------ 19,02:>

'rotal No. of Doses of Sulphanilamide ____________ 350,630

Total 1\To. of Doses of Bismuth ------------------ 508,710 (l-ee eonsidered dose)

,_,

TOTAL ---------------- 1,646,401

0\
CJ..)

!--' 0\
""'"

TABLE "G"

LABORATORY EXAMINATIONS FOR VENEREAL DISEASES Performed in Central Laboratory and Two Branch Laboratories
Georgia Department of Public Health January- December, 1940

SEROLOGICAL EXAMINATIONS

DARI<FIELD EXAMINATIONS

'<l

8'"

EXAMINATIONS FOR GONOCOCCI

a;tsi

Total

January ---- ---:b"'ebruary -------March ___________
April ------------

L1,28il 18,132 19,296 19,486

M:ay -------------
June ------------
Jul) -------------
August ----------

20,203 18,482 19,896 20,591

September . -----October _________ .
November ________
December ________

19,704 21,450 18,914 20,887

Number Number Positive Negative

2,628 3,283 3,712 3,904
3,778 3,391 3,491 3,511
2,824 3,088 2,423 2,860

l2,Ufi7 14,849 15,584. 15,582
16,425 15,091 16,405 17,080
16,880 18,362 16,491 18,027

Percent Positive
17.1 18.1 19.2 20.0
18.7 18.3 17.5 17.1
14.3 14.4 12.8 13.7

Number Total Positive

Number Percent Negative Positive

24

6

18

25.0

26

5

21

19.2

44

7

37

15.9

18

4

14

22.2

43

8

35

18.6

33

8

25

~4.2

39

5

34

12.8

34

8

26

23.5

32

7

25

21.9

33

9

24

27.3

2;:-)

6

19

24.0

30

7

23

23.3

Total

Number Number Positive Negative

544

140

404

654.

156

498

650

l::i2

498

722

16:-i

ri57

779

176

603

659

146

513

747

159

588

732

160

572

652

1:i6

496

670

143

527

664

131

533

673

134

539

Percent b
'.", Positive "<:; ...,

2ri.1

'

2~.8
2:l.4

~'"

22.9

-0 .

22.6

"ti

22.2

~

21.3

~-

21.9 ~

24.0 21.3

'~"
;;:,-.

19.7

19.9

TOTAL ------ 232,326

38,893 193,433

16.7

381

so

301

21.0

8,146

1,818

6,328

22.:1

TABLE "H"

Lectures

No.
January ------------ 10 February ---------- 3
March --------- ---- 8
April -------------- 4
May --------------- 3 June -------------- 1 July --------------- 2
September --------- 2 October ____________ 1 November __________ 5 December ---------- --
TOTAL - ------ :19

Au d.
595 1fi0 3!12 290
95 35 36
30 20 241 ----
1,SH

SUMMARY REPORT OF EDUCATIONAL ACTIVITIES Venereal Disease Control Service
Georgia Department of Public Health January-December, 1940

Films (V. D.)

No.

And.

2

120

8

1,M:i

;;

430

6

1,.)60

2

170

----

----

----

1

100

----

24

:J,42fi

Films (H. Ed. & Others)

No.

Au d.

14

940

10

629

15

2,275

21

3,358

24

2,823

24

2,389

8

1,040

254

5

1,287

11

1, 727

13

1,378

13

818

162

18,918

Clinic Visits
5 20 11
6
17 8 9 3
7 1 3 3
9:l

No. of

No. of

No. of Meetings Attended

~
~
~.

Follow-up

(Not Litera-

!;>

Conferences

Visits

Addressed) ture

!;;;>::

!;l_,

11

1

8

--

5,2:Jl i::l::;

3

1,663

0

3G

--

1, 7:)8

;0;.;-..

40

3

2

2,161 ~

0

39

1

2

887 ~

6 6 2

--

1
--

477 1,003 1,608

en
~ <:

c"-",

8

1,130

~

11

3,506

2

6,504

8

403

177

!i

8

26,3:ll

I-'
0\ CJ1

Division of Malaria and 1-Iookworin Service

Justin Andrews, Sc.D., Director

A. W. Hill, M.D.

Epidemiologist

The professional staff of this Division through 19t:10 consisted of a director, epidemiologist, engineer, biologist, sanitarian, and nurse. From June 16 through September 15, four assistant biologists were employed. The director and epidemiologist have headquarters in Atlanta. The biologist and engineer have their office in Macon within easy reach of most of the malarious section of Georgia. Similarly, the nurse and sanitarian are based in Waycross, as this is the approximate center of that portion of the State where hookworm disease is most important. The assistant biologists are assigned to specific counties or associated pairs of counties to render biological service in connection with Standard Plan commitments.
From July 1 through October 31, the Public Health Education Service was added to this Division for administrative purposes. Its activities are reported elsewhere.

Commencing January 1, the responsibilities of this Division included the investigation of hookworm infestation and promotion for the control of hookworm disease as well as previously scheduled activities of a similar nature in relation to malaria. The full time of the engineer and the biologists is devoted to routine and experimental investigations and promotion of control activities; of the sanitarian and nurse, to anti-hookworm activities, including mapping, hookworm and sanitary surveying, treatment, domestic sanitation and education. The epidemiologist is concerned with the medical, epidemiological, and educational phases of the anti-hookworm and the anti-malaria programs. The duties of the director have been to plan and supervise the work of both units.

ANTI-MALARIA ACTIVITIES
These have included educational and promotional support for malaria control according to "Standard Plan" principles, malariometry, entomological service, special investigations, research, and the publication of the Georgia Malaria Bulletin.
STANDARD PLAN AcTIVITIES: These have been severely restricted by two circumstances, namely, low malaria prevalence and lack of county funds.
The prevalence of malaria is so low that its importance as a health problem in many counties is dwarfed to relative insignificance in comparison with other more stable health hazards. Many factors are concerned in the current decline of malariousness. One cannot be sure whether

J1!1alaria and Hookworm Service

167

the decline is temporary or permanent. lVIaj or fluctuations in malaria prevalence with rather regular periodicity have been the rule in Georgia, in other states, and, indeed, in most malarious sections of the world. While everyone will hope that severe or epidemic malaria in Georgia is a thing of the past, more evidence than a succession of four low years will be required to justify permanent relaxation of malaria control efforts.
The other consideration is lack of county .finances to support malaria control operations. Our more malarious counties are numbered among our poorer counties. On our present basis of participation, these counties, with rare exceptions, cannot afford adequate local health organizations without which the permanent effectiveness of malaria preventive activities is fore-doomed. It is even more hopeless to look for the .financing of even a modest malaria control project which may exceed the local health budget in cost.
During the last two years, the unusual depletion of county treasuries has made the promotion of county-wide malaria control projects a futile undertaking. Therefore, promotional activities have been concentrated on projects of less than county extent but the principles of the "Standard Plan" have been otherwise upheld.
Thus, in Pulaski County, biological services were made available during the summer following the considerable investment in malaria control by the county the previous yeaT. It was hoped that this might not only lead to a more adequate formulation of the local malaria problem but assist in the promotion for full-time health services.
Similarly, in an intensely malarious section of Macon County the interests of (I) county officials, (2) Farm Security Administration (Flint River Project), (3) the Work Projects Administration, and (L1) private land-owners have been consolidated into a cooperative malaria control project for the investigational phases of which this Division has supplied .field service and planning.
ln Liberty and near-by counties is locat<'d an army antiaircraft .field, Camp Stewart, close by an area which in the past has been highly malarious. For each of the past four years, county-wide blood examinations have been made from the school children of Liberty County, at State expense, in order to provide an indication of the natural fluctuations of malaria intensity on that side of the State under circumstances which were unlikely to be modified by the control efforts of man. While the camp-site is not located in the section of greatest endemicity, it is proximal to it. Thus while the camp-site can be protected without difficulty, it seemed likely that soldiers o:ff duty would he exposed to malaria in the extra-cantonment area unless something were done to prevent it. Furthermore, the introduction of a large group of men (15,000 to 30,000), many of whom will have no acquired resistance to malaria, may conceivably change the malaria potential for the whole

168

Georgia Department of Public Health

region. Accordingly, considerable field attention has been given to this camp development.
As in the past, contacts with physicians and county medical societies have been made mainly by the epidemiologist, the engineer and biologist have worked with local health agencies where possible, and the director has made most of the connections with governmental officials and the laity. A tabulation of educational and promotional contacts by counties is shown in Table I.
NlAURIOlVlETRY: The 1939 fall malaria survey in the white and colored elementary grade schools was conducted in 13 counties by county, regional and state-wide personnel. The total number of blood examinations was 17,479, of which 2.L1o/o were positive. Spleen examinations were made on 338 individuals of whom 1.33% were found to have enlarged spleens. [The transfer of the medical epidemiologist (in July, 1939) to the Division of Local Health Organizations and the subsequent vacancy of this position until January 1, 19i1Q, precluded splenic examination on a large scale.]
The results of this survey are shown in Table II. As in previous years, the blood indices of malaria were shown to be about five times as great in the Negro as in the white race, the percentage in the latter being 0.68%, in the Negro, 3.88%. Calhoun and Laurens Counties had an increase in positive bloods of both white and colored races, Crisp and Liberty Counties only in the white, and Dougherty County only in the colored. In general, the blood indices are lower in 1939 than in 1938. This trend is comparable to the death rates from malaria of i1_7 and 3.1 per 100,000 in 1937 and 1938, respectively. The most marked increase in positive thick-blood smears was in Calhoun County and reflects a general tendency toward higher malaria rates for southwest Georgia in 1939.
Special thick-film blood collections have been conducted in a number of counties for malaria control by drugs, malaria carrier detection, and appraisals of malariousness. The counties included in this group are Jenkins, Baker, and, in a lesser extent, Glynn, Bryan, Mcintosh, Clayton, Pulaski, and Troup.
The health commissioners of Sumter and Terrell Counties made limited enlarged-spleen surveys in their respective counties. Results are shown in Table III.
During the fall of 1940, thick-film and/or enlarged-spl~en surveys were made in approximately 18,000 elementary school children in Baker, Brooks, Burke, Calhoun, Crisp, Dougherty, Jenkins, Laurens, Lee, Liberty, Sumter, and Terrell Counties. The diagnostic results are not yet available and will be shown in next year's Annual Report.

Malaria and Hookworm Service
'l'ABLE I EDUCA'l'IONAL AND PROMOTIONAL AC'l'IYI'l'IES
DUHING 'l'HE "l'EAR 1910

169

County

Meetings Addresses

Attended

Made

Consultations Exhibits Conferences
Shown Contacts, etc.

Appling __ --~------------------- ----~~-

Atldnson ---------------------------------

10

3 Bacon ----------------------------------

'1

4 Bal<er -----------------------------------

97

Baldwin ----------------- _________________

7

6 Ben Hill --------------------------------

7 Bibb ------------------------------------

229

3 Blecl<ley --------------------------------

3

Brant!ey ________________________ ----- __ _

55

10 Broolm ---------------------------------- 3

18

11 Bryan ----------------------------------

13

12 Bulloch ---------------------------------

13 Burke -----------------------------------

37

1<! Calhoun ---------------------------------

13

15 Chaiham -------------------------------- 2

70

16 Clarke ----------------------------------

17 Clay ------------------------------------

18 Cobb --------------------------------- __

1

2

19 Coffee ---------------------------------- 12

87

58

785

20 Colquitt --------------------------------- 1

H

<!2

21 Cool< ------------------------------------

22 Crawford --------------------------------

1H

23 Crisp -----------------------------------

36

2'1 Decatur ---------------------------------

25 DeKalb ---------------------------------

26 Dodge ----------------------------------27 Dougherty ------------------------------23 Douglas --------------------------------29 Early ----------------------------------30 Echols ----------------------------------

31 Effingl1am ______ ----------------------- __

32 E]lHUlnel -------------------------------- 2

33 Fulton ---------------------------------- 17

17

31 Glynn

35 Grally ______ --~ __________________________ _

36 Hall -----------------------------------37 Jefferson --------------~-----------------33 Jenkins -------------------------- ______ _
39 Johnson --------------------------------<!0 Lamar ----------------------------------

<H Lanier ----------------------------------

<!2 Laurens ---------------------------------

<13 J,ee _ -----------------------------------

14 Liberty ---------------------------------

3

1<18 2
13

H

5

2o!5

13

10
111
3

1 1<1
11
1H

170

Georgia Department of Public Health
TABLE I EDUCATIONAL AND PROMOTIONAL ACTIVI'l'IES
DURING '!'HE YEAR 19<10 (Continued)

County

Meetings Addresses

Attended

Made

Consultations Exhibits Conferences
Shown Contacts, etc.

15 Long -----------------------------------<16 Lowndes <11 Mcintosh __________ ----------------------
'18 :l\lacon ---------------------------------49 Mitchell ---------------------------------- __

50 Monroe

51 Montgomery -----------------------------

52 Muscogee

2

53 Pierce _________________________________ _

51 I.)ulasld _______ --------------------------

55 Putnam -------------------------------56 Uiclunond ------------------------------51 Rocl<dale _____________________________ .
58 Schley ----------------------- ---------59 Screven --------------------------------- __

60 Seminole -------------------------------- __ 61 Spalding -------------------------------62 Sumter ---------------------------------63 Talbot ---------------------------- _____ _ 6<1 'l'attnall _________________ ---------------

65 Telfair ---------------------------------66 Terrell ---------------------------------61 Thomas __________ ---------------------- __ 68 'l'ift
69 Toombs ---------------------------------

10 'l'wiggs ----------------------------------

11 Union -------------------------------- __ _

72 Walton ______ --------------------------

1

73 Ware ----------- ____ -------------------- 2

s

1<1 Washington

15 Wayne ______ -------------------------- _
16 Whitfield ______ ------------------------77 Worth _____ _

OU'l'-OF-STATE Auburn, Ala. Boston, Mass. ---- ---------------------Pensacola, Fla. -------------------------Hartford, Conn. -------------------- __ ---Louisville, I(y. -------------------------New Haven, Conn. ---------------------Newton, l\fass. -------------------------New Yorlr, N. Y. -------------------- _____ _ Washington ----------------------------- --

TOTAL ------------------------------- 64

156

46 2
23 13
1 8
23
10 1 3
13 61
2
10 15 3
1 9 87 1 11 1

17

3;)
1 1 11 2

12

2114

TABLE II SUMMARY BY COUNTIES OF 1939 FALL THICI<-BLOOD FILM SURVEYS OF ELEMENTARY
SCHOOL CHILDREN

White

Colored

Total

County

No. Ex'd.

'In

% of all positives

Pes. Tcrt. E-A Quartan

No. Ex' d.

%

% of all (Jositivcs

Pos. Tert. E-A Quartan

No. Ex' d.

;;

% of all 11ositivcs

Pas. Tert. E-A Quartan

.~,
.."~ ..,,.',

Brooks -- -------------------- ------ 2:-JS 0.0
Burlte -------------------------------- 7::i3 OA

-- 100.0

117 0.0 561 1.2 14.3 71.4 14.3

4l:J 1314

0.11 0.8 10.0 80.0 10.0

:::;::1,..,

Calhoun ------------------------------ 451 2.0 Crisp -------- ----------------------- 1207 0.5

--- 100.0

543 1.1

-- 100.0

569 0.7 75.0 25.0

2695 0.7 68.4 26.3 5.3

243 0.8

-- 100.0

Liberty ------------------------------- 410 Nmvton ____ -------------------------- 136 Sumter ------------------------------- 555 Terrell ___________ ---------- ----------- 240

0.2 100.0

0.0

--

0.2

-- 100.0

1.7

100.0

997 15.6 3.8 96.2

645 2.2

100.0 --

608 7.7 4.3 95.7 --

198 1.5 33.0 66.0

1568 1.5 2!'i.O 75.0

--

605 3.8 39.1 60.9

572 0
1409 720

5.3

-- 100.0

--

1.4 26.4 73.6

5.6 2.5 97 .:i

1448 11.4 1852 1.1

4.24 93.7 100.0

:::r::
C)

C)

1151 4.6 3.8 96.2

~
~

767 0.9 57.:l 42.7

C)

4263 1.1 44.3 53.4 2.3

~

848 3.0 36.0 64.0

C/l

982 3.1 3..,> 96.7

~

136 1964
960

0.0 --
1.0 2;),0 70..0 4.6 2.3 97.7

<:!
"""''

Thomas -------------------------------

0

--

--

1379 0.1

-- 100.0

1379 0.1

100.0

8060 0.7 3:!..7 (}:1,::1 1.8

9419 3.9 S.:J 91.2 0.3

17479 ~.:1 11.6 87.8 0.47

I-' --l I-'

172

Georgia Department of Public Health

TABLE Ill
ENLARGEDSPLEEN EXAMINATIONS ON ELEMENTARY SCHOOL CHILDREN

No.

County

Ex'd.

Sumter* -------------------------------------- 171

Terrell* -------------------------------------- 167

Total -------------------------------------- 338

Per Cent. Positive
20A 6.0
13.3

*Xot county-wide.

TABLE IV ENTOMOLOGICAL FIELD SERVICE

County

Ponds Investigated

Baker ----------------------------------------- ______ 33 Bibb ------------------------------------------ ______ 62 3 Brooks ---------------------------------------------- 12 1 Bryan ----------------------------------------------- S Burl<e -------------------------------------------- __ _ 50 6 Ca.llloun -------------------------------------------- 47 Cha tilam ___________________________________________ _
8 Coffee -----------------------------------------------Crisp ------------------------------------------------ 77
10 Decatur ---------------------------------------------- 54 11 Dooly ----------------------------------------------- 1 12 Dougherty ------------------------------------------- 217 13 Early ----------------------------------------------- 32 1<1 Effingham ------------------------------------------- 1 15 Glynn --------------------------------------------- __ 13 16 Jenldns ---------------------------------------------- D1 17 Lee ------------------------------------------------- 1D 18 Liberty --------------------------------------------- _ 112 10 )lacon ---------------------------------------------- 30 20 Muscogee -------------------------------------------- 8 21 Peach ------------------------------------------------- 1 22 Pulasld ---------------------------------------------- 281 23 Ric!unond -------------------------------------------- 1 24 1{ockdale -------------------------------------------25 Screven ---------------------------------------------- 23 26 Spalding -------------------------------------------- 33 27 Sumter ----------------------------------------------- 200 28 rea ell -------------------------------------- _________ 10 20 Thomas -------------------------------------- _______ 60 30 Union -------------------------------------------- __ _ 3! Whitfield --------------------------------------------- 13
To tal ________________________________________________ 15 61

Searches for Adult Anophelines
60 20
4
22
17 8
723 12
113 8
12
20 85
6 23
1 16 1276

JVlalaria and Hookworm Service

173

ENTOMOLOGICAL SERVICE: Routine entomological service was provided in most of the "Standard Plan Counties", namely, Brooks, Terrell, Thomas, Burke, Calhoun, Crisp, Dougherty, Jenkins, and Sumter, though it was intensified in the last five and Pulaski due to the special assignment of the summer-time biologists. These activities are shown by counties in Table IV.
Special Investigations and Activities
l. Field survey and planning assistance was rendered Decatur County in formulating a local malaria control program for the West Bainbridge area.
2. A special detail of N. Y. A. boys was secured to assist the Jenkins County Health Department in carrying on certain phases of its health program, especially mosquito-proofing.
3. A biological-engineering investigation was made, by private request, of an artificial water impoundment at Suches, Union County.
4. A similar exploration, plus partial malariometry, was made at the Fish Hatchery at Ways Station, Bryan County.
5. A report was rendered to interested officials in Bibb County summarizing old and new data relating to malariousness and anopheline breeding conditions in and around the Stratton area, southeast of Macon.
6. The unusual occurrence of a few cases of malaria in Whitfield County was investigated and traced to certain impoundments.
7. At the request of army authorities, brief reports Tegarcling potential malaria and recommended malaria control methods were written Tegarcling proposed military camp-sites in Baldwin, Jones, Bibb, Richmond, Ware, and Dougherty Counties.
8. A state-wide mosquito-proofing program has been promoted by the engineer in cooperation with F. S. A. and N. Y. A. objectives. Educational and demonstrational service has been rendered through local and regional personnel and agents. Due to poor physical housing conditions and the preoccupation of F. S. A. agents with non-health considerations, progress to elate has been slow. Plans have been completed and are now being effected which will permit much closer collaboration of local and regional health authorities in the planning, supervision and inspection of this work during the following year. A bulletin on mosquitoproofing is now in preparation.
RESEARCH: The engineer has carried forwaTcl his inquiry into larviciding technique in Georgia. He presented a papeT on this subject before the National Malaria Committee, in which he showed that the propulsion of a uniform mixtuTe of Paris gTeen and limestone particles from a hand- or motor-clTiven dusteT did not give a uniform distribution of these two types of particles distal to the duster due to the different specific gravities of Paris green and lime.
The biologist, with the assistance of the four temporary biologists,

Georgia Depctrtment of Public Health
was able to make a comprehensive test of the possibility of identifying the common species of anopheles larv~e macroscopically. A paper was given on this subject before the National Malaria Committee in Louisville. He has also been formulating observed plant-Anopheles quaclrimacnlatus associations which have been recorded over a period of years.
The Director has continued his interests in the annual distribution and intensity of malaria in the State and their association with environmental conditions.
The Rockefeller Foundation gave this Division $555.00 for purchasing equipment to be loaned to counties both to encourage the construction of pre-cast concrete ditch-lining materials and to make evaluative study of the cost and anti-malarial efficiency of this operation. This project was located at Quitman in Brooks County because of the excellent 1939 records of malaria prevalence, the knowledge of ditch-b1eeding of Anopheles quadrimaculatus in Quitman, and the willing cooperation of the city in participating in this undertaking. Sand, gravel, and cement have been supplied by the city and the W. P. A. Thus far, something over two miles of inverts have been made and laid. The construction of four- and six-inch concrete tile pipe is also under way and will be finished within a few months.
The Emory University Medical School requested the State Health Commissioner to permit the Director of this Division to plan and supervise the use of certain malaria research funds which recently became available. This includes the direction of a field laboratory in Baker County. This extra responsibility was undertaken as of July 1, and both engineer and biologist have been assigned special duty in connection with this laboratory. It appeared feasible to consolidate the existing program of the laboratory which was directed to a study of the quantitative relationships of malaria prevalence, adult anopheline incidence, malaria mosquito-breeding and local hydrology with another research project planned by this Division. This last consisted of an inquiry into the possible effects of malaria control drainage on ground-water levels and thence on wild life, agricultural development, and malaria prevalence.
GEORGIA MALARIA BuLLETIN: Four issues of the Georgia Malaria Bulletin have been prepared during the period covered by this report. These contain the second annual report of this Division, radio scripts on anti-malaria activities, current malariological and meteorological statistics, articles on malaria control and notes of interest to persons concerned with malaria investigation and control in Georgia. A new feature of this volume is the addition of a section entitled, "Hookworm Supplement" to each issue. The supplementary content is discussed under the next section.
MALARIA IN GEORGIA IN 194.0: The total number of malaria deaths certified in Georgia in 194-0 was 89, .a rate per 100,000 population of 2.8. This is 38.4% of the average annual death rate for the previous

JV!alaria and Hookworm Service

175

decennium. The monthly death rates for 1940 and for the preceding decade are shown in Fig. l.
Reported malaria morbidity was likewise low for the State as a whole in 1940, totaling 2,503 cases. This is an apparent attack rate of 80.F per 100,000 population, or 38% of the previous 10-year average annual reported case rate. The monthly morbidity rates for malaria in 1940 and the preceding decennium are graphed in Fig. 2.
The geographic distribution of reported malaria deaths and cases is shown by county on page 281 and 300; county-wide deaths are shown by intensity class in Fig. 3. While these records show obvious errors of omission and commission which are inherent in the reporting of malaria mortality and morbidity, it is apparent that malaria prevalence was very low in 19LJO and that the eastern side of the State suffered proportionately less than the western side.
This year is the fourth since the last (1936) of unusually high prevalence. In order to visualize these relationships more readily, Fig. 4 is presented showing state-wide case and death rates by years from 1926 through 19L!0. All points are based upon official vital statistics, but the case rates for 1937, 1938, 1939, and 1940 were recalculated from the official case loads minus the survey positives which, for these years, were included with the total cases reported.
In spite of the well-known defects in the reporting of malaria morbidity and mortality, these two graphs show a surprising degree of parallelism in trend. From them it is apparent that malaria prevalence in Georgia, as judged by these attributes, was as low in 1940 as it ever had been in the period covered. The question raised in 1940 as to whether or not the consecutive reductions recorded since 1936 are signficant is just as difficult to answer now as it was then. Malaria death rates are probably becoming less and less of a reliable indicator of malaria prevalence due to improved anti-malarial medication, yet, because malaria deaths are reported more accurately than cases, they remain the most feasible measure of malariousness.
The reasons for low malaria prevalence in 1940 are probably about the same as those offered previously in explanation of reduced incidence from 1938 to 1940. The malaria potential, i. e., the number of gametocyte carriers in which the parasite overwinters, was undoubtedly small due to the low case load in 1939. The temperature and rainfall for the year were about normal, being 97.2 and 94, per cent., respectively, of the averaged previous observations extending back to 1892. While the temperature deficiency was quite uniformly distributed over the summer months, the precipitation, excessive in July and August, was only about 30% of the normal in September and October. This must have affected malaria prevalence adversely both by restricting breeding area acreage and by reducing the longevity of adult anophelines in months which

*See seeoncl paragra])h fo11owing.

176

Georgia Department of Public Health

10.0

REPORTED JIALARIA MORTALITY IN GEORGIA FOR 1940 BY l!ONTHS

10,0

Average Jlonthlr Death Rate (1930 - 1939, inc.)

0

llonth11 Death Rate - 1940 -

A

1.38 1.37

1.73 ~ ..!.ill..

1.0

~ -- -- -- --

1.0

.-.0d:.:.

0.61

[
&.
0
8 0,38
..

- - - - ,..0.::,..5:.-3=-
~ ,-0:.:E._ 0.35
llu 1\ 0.32

0.56
-- --1-

.8.

I 0,23

I~ ~
~
~
o. 1-- - - - - - -

-- -

I~

1\- -- -- -- --

- - 0.1

0.09

o.ob

o.\

o.o

I~t:

.~"..'

.d
!:!
II ~

......c.........

~

."..

l>.
.3.,

....
.~"..

r..
G
1..c...
"U)

..
."a
..0.. 8

..
.~",0,.

r..
~"
0
.!l

o.o

-o~o

Malaria and Hookworm Service

177

~oo.o

REPORTED WALARIA MORBIDITY ~ GEORGIA FOR 1940 BY J.!ONTHS

100.0

Average Jlonthly Caoe Rate (1930- 1939, inc,)

0

20,
10,(
.5..
~
;.c[
!i.
0
8
~

JLOnt~ Case Rate - 1940 -

A

(Provisional)

25.s 26.7

~ - - 1 aJ, 20.7J ~ 17.9
12.5

20,0

"~ l , - - ~

10.0

~ IJ,

~- 4.6

4.9

_!t_,_Q_

-- -- --

~~- ;.o

...

1

.8. .
~
0
."j

~

1\

o:( 1.cr--- - - - - - - - - -- -- -- - - - - - - - - - 1,0

1..:'
..~..

1:' ~
.0
""'

..0d..
~

......-1
Q,
<

~

u
..3..

.~...

~
lit
~

...
.i"l
"Q, "0)

... ".0
..0.. 8

... ...

""

1 1()

.. z0

C1

0,1

0.1

178

Geurgia Department of Public Health

RATES

NO DUTH3 REPORTED
c:=:J

0-10

10-2~

1:;::::::::::::1 1::::::::::::::1

DEATHS PEA 100,000

2~-~0
~
FIG. 3

ivlalaria and Hookworm Service

179

were otherwise favorable for mosquito production and malaria transmissiOn. The malaria control efforts of man, both deliberate and incidental, also deserve some indeterminate amount of credit in interfering with malaria transmission. Each year sees the extension of residual drainage systems, improvement in their construction, especially from the standpoint of self-maintenance, more larviciding, better housing with emphasis on insect-proofing, better medical and health service, and last but by no means least a more competent and sympathetic understanding of health problems and their role in the social economy of rural life.
The second question raised by the two graphs in Fig. 4. is that of "cyclicity". Some malariologists, observing the regular succession of maximal malaria prevalence at intervals of from five to ten years, have committed themselves to the conviction that malaria incidence is regularly cyclical and that these years of high incidence are, therefore, predictable. As Fig. <1. indicates, Georgia experienced unusually high morbidity and mortality from malaria in 1936 and seven years previously in 1929. A similar peak occurred in 1922. Thus it might be argued that malaria in Georgia is cyclical, excesses occurring at seven-year intervals, the next one being due in 1943. If true, the trough of the current wave is considerably lower than its known predecessors, but there is nothing else in the available statistics to indicate deviation from a pattern of cyclical prevalence. On the other hand, it is just as possible that the present suggestion of cyclicity is entirely fortuitous, the complex of circumstances, whatever they may be, favoring high incidence having occurred quite by chance at seven-year intervals during the last two decades. If this interpretation is conect, a rise in malariousness is just as likely-but no more so- in 1941 as in succeeding years. It will require observation over several more years of varying meteorology to determine whether or not malaria in Georgia is intrinsically cyclical in its manifestations, and whether in 1940 we were at the low point of the wave or on a decline whose trend will remain downward as long as with continued vigilance and unremitting assiduity we continue to apply all known anti-malarial measures, direct and indirect, where indicated.
ANTI-HOOKWORM ACTIVITIES
These have included educational and promotional work, special investigations, hookworm-disease control planning and the publication of the "Hookworm Supplement" in the Georgia Malaria Bulletin. At the beginning of this new phase of our work, a short course on the biology of hookworms, and the pathology, immunology, epidemiology, and control of hookworm disease was given by the Director to th0 Staff and other interested members of the State Health Department at Waycross.
SPECIAL INVESTIGATIONS: Investigations, the objective of which was to formulate the state-wide anti-hookworm program in terms of modern principle al}d procedure, were carried on mainly in Coffee, Colquitt, and Crawford Counties during 1940. [These divisional activities are classified in Tables V, VI, and VII.]

180

Georgia Department of Public Health

ANNUAL MALARIA DEATH- AND CASE-RATES REPORTED IN GEORGIA
1926 - 1940, inc. 40

Death Rates per 100,000 Population _

Case Rates per 10,000 Popu1at ion ___ 30

I f 20

/

\

I

\

/1 ' ~
\~\ \

-~-1'

,

'

/ / '/

~ 10
~~ \T-' I

\

I

I\ I\
I\ I\

I

\

I

I

,---1

I

I

I

II

I

I

I

I

'I

I

I

\

\
1--\

I

-

I
8 1,...-.-,J ..

I

I

\., /I

\1

\
-I
~~--,\

5

1\

3

~

2 '26 127 '28 '29 '30 '31 '32 '33 '34 '35 '36 '37 '38 '39 '40

Tuberculosis Control

181

In Coffee County, a combined technical and educational program was undertaken. The technical portion consisted of (1) making a survey of hookworm incidence, using the brine flotation technique, among school children and adults; 2) an intensity survey of the flotation positives by means of the Stoll egg-counting technique, (3) a study of the distribution of hookworm larvre in the soil by means of the Baermann isolation appartus, (L.[.) correlation of the physical status of infested individuals with their average worm burden, (5) treatment of hookworminfested indigents, and (6) mapping and sanitary survey to visualize accmately the domestic sanitation problem in terms of existing and required facilities.
This survey showed that about half the population examined was carrying hookworms. About half of these positives harbored a sufficient number of worms to be of clinical importance. It was found that the signs and symptoms of hookworm disease are complicated by and complicate nutritional anemia which is commonly prevalent and frequently confused with hookworm anemia. Hookworm disease was found to be largely a family affair in Coffee County and its control, short of establishing compulsory area-wide sanitation, seems to consist of locating the more intensely infected families and seeing (1) that they are treated, (2) that they are supplied with sanitary facilities, and (3) that their dietary is improved.
The educational phase of the program involved both school-age and adult study groups. "Hookworm Package Libraries" containing literature on hookworms, hookworm-disease, sanitation, and nutrition were prepared and distributed to all teachers in the county. This included a special "Source Unit" to be used in providing teachers with specific antihookworm information which they were to adjust to the learning levels of their particular student groups. Teacher reaction to this provision was determined by means of a questionnaire circulated among them. The school program was supplemented by newspaper articles, radio programs out of a near-by station, the distribution of literature and posters, the showing of the Rockefeller Foundation hookworm film, "Unhooking the HookwDTm", and numerous talks before various organized services and professional groups.
In Colquitt County an educational anti-hookworm program was developed in collaboration with the activities in the local schools of the American Council on Education. "Hookworm Package Libraries" were distributed to some 250 teachers, most of whom registered their reaction to them by means of a questionnaire. This school program was supplemented by a radio series and by systematic contact with adult civic and professional groups. Since then a sanitary engineer has been added to the local health department and an egg-count survey is under way on a county-wide basis.
Crawford County was surveyed because it offered a good opportunity of demonstrating the relationship of soil structure to hookworm intensity.

182

Georgia Department of Public Health

This county is traversed by a broad strip of sand above and below which clay soils predominate. About 10% of the examined population were found positive. The average egg-count of both white and colored individuals was well below clinical level. Hookworm infestation was virtually restricted to the sandy section and did not occur in the clay section.
HooKWORM-DISEASE CoNTROL PROGRAM: From work in these counties it was evident that the old treatment program, largely restricted to eggpositive school children, was wasteful and ineffective and should be abandoned. Control should be directed against hookworm disease rather than hookworm incidence. It should focus upon heavily infested families rather than positive individuals of unknown worm burden. The quantitative hookworm egg-count survey of school children is one of several methods which can be used to discover these families. When they are found, the proper control measures consist of sanitation, dietary improvement, treatment, and education. This plan is now being advocated and promoted throughout the State. To obtain certain technical items of information about its results, special county-wide surveys are now In progress.
RESEARCH: The epidemiologi:;;t is making a series of observations on the relation between the average hookworm burden and the physical status of parasitized individuals. He has already made over 1,200 physical examinations and anticipates the expansion of this series considerably. He is finding that all the symptoms of intense hookworm infestation are explainable in terms of continued blood loss, and that these symptoms increase in severity with the average number of worms harbored. The vast majority of light infestations do not affect the health of the parasitized individuals nor are they benefited by anthelminthic medication.
Special studies in various parts of the State are being carried out to determine at what seasons of the year heavily infested soil may be partially sterilized by climatic conditions.
HooKWORM SUPPLEMENT: The first Hookworm Supplement contained a survey of the last decade's laboratory results of hookworm (flotation) surveys by counties and years. The second included addresses made in support of the above program before the Georgia Public Health Association. The third was devoted to an evaluation of the educational results of this program in both Coffee and Colquitt Counties. It also contained a map showing the distribution of hookworm infestation on the basis of decennial data included in the first supplement. The last supplement contains an article giving specific details about planning and carrying out a selective survey treatment and sanitation program.

Tuberculosis Cantral

183

TABLE V EPIDEMIOLOGICAL AND NURSING SERVICES

County

Physical Hookworm Spleen Blood Hemo Miscel Exams. Treatment Palpation Smears globin laneous

Dal;;:er _____________________ _ 2 Bibb ______ --------------------
Blyan _ -----------------------1 Bu!'l<e --------------------------
Calhoun --------~---------------
Coffee -------- ----------------1316 7 Crawford -------- --------------
Crisp ______ -------------------Fulton __ ---------------------10 Jenkins ______________________ _
11 Lee ______ -------------------12 Liberty ________________________ _
13 Long -------------------------1<1 Sumter ---------------- _____ _ 15 Terrell ______ ------------------
Total __________________________1318

1255 12:55

951 26
236 996 1161

1232 26
270 1289 1471

30

105

H798

2293

188

2J9

688

415

799 1096

956 1377

960

60

133

HS

113

118

6285 7902

105

18112

TABLE VI SANITARIAN SERVICE

County

Mapping (hours)

SanitarY Burveys (premises)

Sanitary Units

Brantley ---------------------------------------- -2 Coffee ------------------------------------------311 3 Liberty ________ --------------------------------15<1
Total ------------ ------------------------------'165

1532

363

1202

122

2735

<185

Georgia Department of Public Health
TABLE VII LABORATORY SERVICE

Hookworm Egg-Counts

County

Positive

Negative

Appling ------------------- ____ ------------------ 35 2 Atldnson ---------------------------------------- 33 3 Bacon ________ ----------------------------------- 100 <1 Blecldey ---------------------------------------- 15 5 Brantley ---------------------------------- ------ 1

6 Bulloch ---------------- ------------------------ 102

16

Charlton --------------- ------------------------- 3

8 Clinch ------------------------------------------ <1

9 Coffee ------------------------------------------ 1<103

10 Colquitt ----------------------------------------- 33

ll Crawford ---------------------------------------- 101

29

12 Dodge ------------------------------------------- 37

2

13 Grady ------------------------------------------- H<1

18

H Johnson ----------------------------------------- 7

15 Lanier ------------------------------------------ 10<1

16 Liberty -------------- -------------------------- SO 17 Long -------------- _____ ------------------------ 55 18 Lumpldn ---------------------------------------19 Marion ----------------------------------------- 33 20 Mitchell ------------------------------------------ 31
21 Pierce -------------- ---------------------- _____ 20 22 ~rwlggs -------------------------------------- ___ _ IG 23 Wayne __________ ---------- ---------------- ______ 35 2<1 1Vheeler ----------------------------------------- 51

'l'otal ----------------- _ ------------------------ 2<160

391

Total
41 37 107 16
us
<1 <1 1657 38
130 39
162 10
Ill
8<1 59 15 <10 35
30 20 35 55
2851

Tuberculosis Control

185

SA ITARY PIT PRIVY
UNSA ITARY PRIVIES

Division of Tuberculosis Control

H. C. Schenck, M.D., Director
Clara B. Barrett, lVI. D. J. F. Busch, M.D.

Clinician Clinician

This Division has carried on its case-finding clinic work in accordance with the established practices of the past several years. This consists of X-raying patients in clinics organized by local public health doctors and nurses, who also furnish histories and the necessary laboratory reports for those who are X-rayed. Interpretation of the X-ray films and correlation by clinicians in this .Division of the facts as presented by the local workers are made and reported to the family physician in all cases. After these reports are made, the public health nurse visits the family physician and receives his instructions for the patient. The nurse then conveys these instructions to the patient and endeavors to have them carried out in as great a degree as may be possible.
In July, 1937, the State Tuberculosis Sanatorium was placed under the administration of the State Board of Health, and this gave the Stale Health Department, through the Division of Tuberculosis Control, a splendid opportunity to develop a procedure which has been found practical and very profitable, it is believed. Previous to 1937, it had been the custom to admit patients without particular regard for the treatment needs of the patient or of the public health problem involved. At the present time, the procedure is to admit patients in turn as they are placed on the accepted list. Patients, therefore, are able to obtain special treatment when it is necessary without interminable and often fatal delay. Patients are then dismissed from the Sanatorium as soon as they have reached the period where bed care alone is required, and by this procedure a long and clogged-up waiting list is avoided.
In August, 1940, 71 beds were placed in operation at the Sanatorium for the more serious public health problem cases, and while 71 beds for such a purpose seems to be a mere drop in the bucket when considered in the light of the existing vast number of such problem cases in the State, they are of considerable value. (See separate Sanatorium Report for 194.0.)
The great gap between the number of cases there are in the State and the comparatively few beds that are available for them is partly :filled by the efforts of this Division and of the local public health doctors and nurses in organized counties to have all of the patients requiring assistance taken care of in some fashion. They do this in various waysthrough the local welfare departments, the Tuberculosis Seal Sale Committees and Associations, local civic groups, and all agencies and individuals from whom it may be possible to secure assistance for those

Tub en :uLosts Co11 I r ol

J::l7

..... , ....._ . -

RoLLI G X -RAY MACHINE

FIELD X -RAY NIT IN AcTIO

188

Georgia Department of Public Health

patients in their homes or in the communities in which they live. (See Table IX for activities of County Public Health Units.)
For years we have been encouraging physicians to learn how to administer artificial pneumothorax and manage cases of tuberculosis. In 1937, the Georgia Tuberculosis Association undertook to encourage the treatment of pneumothorax cases by local physicians by subsidizing them with small fees to pay them for at least part of the expenses in handling them. The 1939 report of this Division includes a statement of this work clone over a period of two years and seven months, which shows that there were only 26 deaths in the 327 cases treated in this period. Inasmuch as rehabilitation and job placement of patients who have healed or arrested tuberculosis is so essential to tuberculosis control, the Georgia Tuberculosis Association agreed to attempt to develop this phase, provided some arrangement was made to take care of the pneumothorax refill program. To this end, it was agreed on August 1, 1940, that transfer of this service to the State Health Department would be made and that the State Health Department would become responsible for the fees to the physicians who furnish this treatment. Treatment for 232 cases was assumed by the State Health Department on August 1, 1940. It is estimated that more than 500 patients in the State are receiving artificial pneumothorax outside of institutions. The need for institutional heels may be said, therefore, to have been lessened to the extent of 500 beds. The saving to the State, counties, and cities, had they been required to furnish hospital care to these patients, is close to $300,000.00 annually.
-.. Recently this Division installed an X-ray machine in the office of the State Health Department, which will meet the necessity of emergency X-raying of patients referred by physicians in the Atlanta area. This service, while rather small at present, is expected to reach fairly large proportions in a short time.
This Division has also agreed to interpret X-ray pictures made by the National Youth Administration projects in counties that do not have public health services, and also to X-ray, so far as possible, tuberculin reactors in similar groups in public health service counties.
Another service which is offered by this Division is the interpretation of consultation films sent in by physicians all over the State. In Table VIII it is shown that 579 such interpretations were made, resulting in 45 new cases of tuberculosis being diagnosed.
While the death rate from tuberculosis is not going down as fast as we would wish, it has shown in certain periods remarkable decreases, 3S shown below:

Tuberculosis Control

189

Period

Average Number of Deaths Per Year

1930-1932 (3 years)________________

2091

1933- 1936 (<1 years)_________________________ 11<18

1937- 1940 (<1 years)________________________ 1552

Average Decrease per Year in Number of Deaths From Previous Period
3<13 196

The first major drop occurred after larger clinics and local public health services were developed. The second drop, 1937-1940, was concurrent with the development of the pneumothorax refill program, with further development also of public health and relief programs. Below is given the number of deaths and death rates since 1930, showing trends in detail:

White

No.

%

1930 ----------- 771

36

1931 ----------- 700

32

1932 ----------- 665

35

1933 ----------- 675

38

193<1 ----------- 605

3<1

1935 ----------- 6<19

37

1936 ----------- 6<18

38

1931 ----------- 559

36

1938 ----------- 602

37

1939 ---------- 5<13

35

1910 ----------- 5<J<l

35

Colored'''

No.

%

1;101

61

1/!65

68

1,268

65

1,102

62

1,167

66

1,082

63

1,065

62

990

6<1

1,010

63

990

65

989

65

Total
2,175 2,165 1,933
1,777 1,772 1,731 1,713
1,5<19 1,612 1,533 1,533

Rate per 100,000 Population
w. & c.
White Colored Combined

12.0

130.6

11.6

37.7

135.8

73.7

35.'1

116.9

65.3

35.6

101.1

59.6

31.7

106.5

58.9

33.6

98.2

57.1

33.3

96.2

56.1

28.5

89.0

50.3

30.3

90.3

52.0

27.2

83.1

<19.1

26.7

91.2

<19.1

*l\ eg1oes compl'lse about 36 per cent of the population of Georgia.

Every possible effort is now being made to bring to the attention of the people that in the control of tuberculosis each community must recognize its own responsibility with a view toward determining what is necessary and helpful for those who have tuberculosis, providing it so far as possible in the community, and toward preventing to the greatest possible extent the spread of infection to its citizens. A full realization that the State neither has the means nor the facilities for taking care of all the needy tuberculosis patients of the State, and a determination by each community to fill the gap should result in another very marked lowering of the death rate.
It is hoped that nothing will interfere with the progression of our very widely developed and integrated or cooperative tuberculosis control program. If this broad program of case-finding, hospitalization, treat-

190

Georgia Departrnent of Public Health

ment, relief, rehabilitation, and education can be more fully and adequately developed, much more rapid control of tuberculosis will result. Prevention can be brought about only by the discovery of cases first, and by their isolation and treatment second. Everything that is to be done should be done with this in mind.
Appended are tables which give in more detail the work of this Division. Thirteen thousand six hundred fifty-six X-ray examinations were made during the year in 200 clinics, during 218 clinic days. One hundred ninety-two of the clinics were organized by the local county health units in 85 counties. Details of these clinics are shown in Tables I and II. In these clinics 582 new cases of tuberculosis were found. Add to these the L15 cases found in consultation films and a total of 627 new cases were located through this Division.
Attention must be called to the continued extraordinary work by local county health officers and nurses. Table IX shows that 3,4.L1,6 cases of tuberculosis received attention through county health service. Nearly 54,000 field visits were made to tuberculosis cases, contacts, and suspects. Over 18,000 or one-third of these visits were made to actual cases of tuberculosis, which makes an average of a little over five visits annually to each case. Nearly 17,000 tuberculin tests were made, 8,753 of which were positive, equaling 54..5% positive. Contacts were broken or partly broken in 2,133 cases. Material relief was secured for 707 patients. In addition, 20 tuberculosis cottages were built during the year. During the past four years, 1937-1940, l3L1 cottages have been built for tubercu1osis cases.
TABLE I
NUMBER OF CLINICS AND CLINIC DAYS IN 1940

Month

Number Clinics

Ja.nuary ___________________ ----------------------- __ ~1 February ________________ -------------------------- 18 :.Vfarch ---------------------------------------------- 17 April ----------------------------------------------- _ 19
:.\fay -------------------------- _______________________ 12 June ---------------------------------------------- H July ________________________ ----------------------- 18 August ____________ --------------------------------- 13
September -------------------------------------- --- 20 October --------------------------------------------- 20 November ____________________ ---------------------- _ 15 December -------------------------------------------- 13

Total for Clinics ---------------------------------- 200 X-rayed in Office ----------------------------------- --

'l'otal for Year ------------------------------------ 200

Number of Days
21 19 17 21
1:J 14 18 19
20 22 17 15
218
218

Number X- rayed
1.017 968
1,063 1,172
1,104 1.019 1,063 1,619
1,071 1,317 I ,160 1,001
13,609 17
13,656

Tuberculosis Control

191

TABLE II DISTRIBUTION OF CLINICS 1940

In <18 counties in 11<1 clinics organized by health officers ___________________________ _
In 37 counties in 71 clinics organized by county health nurses ____ -----------------Eddy High School, Baldwin County-----------------------------------------------Georgia Siate College for Women, Baldwin County_________________________________ _ South Georgia Teachers' College, Bulloch County--------------- ____________________ _
University of Georgia, Clarl<e County -------------------- -----------------------Agnes Scott College, DeKalb County ___ _
Sillcosis Survey of Granite Quarries, Elbert CountY-------------------------------Futu!'e Farmers of America Camp, ~'Iewton County________ ----------------- _____ _ Fort Valley Xormal and Industrial College, Peach County -----------------------Rabun Gap Xacoochee SchooL Rabun County____________ ---------------------Rivetside )!ill, Augusta, Uiclunond County-----------------------------Young Harris, 'l'owns County-----------------------------------------------Peerless Woolen )!ills, Wall<el' County_____________________________________________ _
Habersham College, Habersl1am County-------------------------------------------Piedmont College, Habersham County---------------------------------- -----------Dorchester Academy, Liberty County__________________________ ______ ------------
X-Iass made in Office----------------------------------------------------

7,607 3;171
167 180
82 216 75 189 70 108
76 279
50 667 161 132 76

'l'otal for Year------------------------ ________ ---------------------------------- 13,656

TABLE Ill SUMMARY OF CASES FOUND

White

Number

Cases

X-rayed

Found

%

Adult Type Original Examinations _ 4980

261

5.2

Adult Type Re-examinations _______ 2865

49

1.7

'l'otal __________________________ 784ii

310

4.0

First Infection-Infiltrative

Type-Original Examinations

1228

First Infection-Infiltrative

Type-Re-examinations ------- -- U33

32

2.6

17

l.S

Total ------------------ ________ 2161

49

2.3

Grand Total __________________ 10006

359

3.6

Number X-rayed
1832 705
2537

Colored
Cases Found
145 22
167

726

4u

360

10

1086

G6

3623

223

*27 examinations were unclassified because of poor films and lack of proper information.

.--
\0 l'-.J

~

White & Colored Combined

.ce..l.l.

Number

Cases

Gl'S<l

%

X-rayed

7.9

6812

3.1

3570

Found
406 71

% t:::J

ell

6.0

~ !;:,

~ 2.0

ell

6.6

10382

477

4.6 ~

6..o,

19G4

9.1

1293

-c .

78

4.0 '"tj

27

2.1

.c.~,,..._-_

<")

5.2

3247

lOG

6.2

13629*

582

3.2 i::!:: ell !;:,
:;:;:'
4.3 ;:,-

TABLE IV
RESULTS OF ORIGINAL EXAMINATIONS, ALL AGES, BY SEX AND COLOR, SHOWING NUMBERS AND PERCENTAGES

White

Number

Childhood ---------------------------------- 17 Minimal __________ ----- ____________ --------- 14 Mod. Adv. ---------- ---------------------- 44 Far AdY. -------------- ------------------ .- 79 Total Pos. ---------------------------------- 154
Suspicious ________________________________ 432 Negative --------------------------------- 2585
Total ------------------------------------- 3171

Male
"/c
.53 .45 1.39 2.49 4.86 13.62 81.52
100.00

Colored
Childhood ---------------------------------- 23
Minimal ------------------------------------ 5
Mod. Ad1. ---------------------------------- 17 l<'ar Adv. ----------------------------------- 44 '!'otal Pos. ---------------------------------- 89
Suspicious -------------------------------- 139 Negative __________________________________ 921
--
Total ------------------------------------- 1149

2.00 .44
1.48 3.82 7.74 12.10
80.16
---
100.00

Female

Number

%

15
~6
62 :H;
~~~ :;s~
2499

.50 .86 2.04 1.19 4.59 13.13 82.28

3037

100.00

23 9
15 55 102 154 1153
1409

1.62 .63
1.06 3.90 7.23 10.93 81.84
100.00

Male & Female

Number

%

32 40 106 115 293 831 5084
6208
46 14 32 99 191 293 2074

.51

.64

'"-':]

1.71 1.85 4.71

&-
"~ '

13.39

~

81.90 106.00

0
"""'''
C":l

..;0,:.:..s,,.

1.80 .0....

.54

1.25

3.87

7.46

11.46

81.08

2558

100.00

1-'
10
Ci-'

I-' 1.0 ~

TABLE V
CLASSIFICATION OF THE CASES FOUND BY ORIGINAL EXAMINATIONS ACCORDING TO STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES

White Age Groups

Up to 16

No.

o/o

Minimal ----------------------- 0

.0

Mod. Adv. --------------------- 5

1.9

- l!""ar Adv. ----------------------- 2

.8
-

'l.'oial ------------------------ 7

2.7

Colored

~Iinimal ----------------------- 2

1.4

~iod. Adv. --------------------- 1

.7

Far Adv. ---------------------- 5

3.4

Total ------------------------ 8

5.5

17-45

No.

o/o

33

12.6

65

24.9

71

27.2

--

169

64.7

9

6.2

23

15.9

79

54.5

111

76 6

46 Up

No.

%

7

2. 7

36

13.8

42

16.1

-

--

85

32.6

3

2.1

g

5.5

15

10.3

26

17.9

<0
8"'
~ ~-

All Cases

l;::j

No.

o/o ~"'

~

40

15.3

~

lOU 115

"' 40.6
-14.1

;:.

-- .a._

261

100.0

'"i:i
~

14

9.7 """"

32

22.1

i::;::

99

"' 68.2

~

14fi

100.0

;:::--<

TABLE VI
NUMBER AND PERCENTAGE OF CASES FOUND BY FIRST EXAMINATIONS IN RELATION TO NUMBER X-RAYED, MALE AND FEMALE COMBINED, CLASSIFIED ACCORDING TO STAGE AND AGE GROUP
CASES FOUND

White Age GroUIJS

Number X-rayed

Up to 16 ---------------------- 1235 17-45 -------------------------- 4125 46 Up -------------------------- 848
Total ------------------------ 6208

Colored
Up to 16 ----------------------- 732 17-45 -------------------------- 15 49
- - 46 Up -------------------------- 277
Total ------------------------- 2558

Minimal

No.

%

0

.00

33

.so

7

.82

40

.64

2

.27

9

.58

3

LOS

-- --

14

.54

Mod. Adv.

No.

%

5

.40

65

1.57

36

4.24

106

1.70

1

.14

23

1.48

8

2.88

32

1.25

Far Adv.

No.

'*

2

.16

7l

1.72

42

4.96

ll5

1.86

5

.68

79

5.10

15

5.42

99

3.87

All Cases

No.

Sio

'-l
&.

;C1)

7

.56 <:::

169 85

4.09 10.02

0
~-
"'

l)

261

4.20 0

-~;;

8

1.09

111

7.16

26

9.38

145

5.66

,_
10
I;..! I

1--'
10 0\

TABLE VII

NUMBER AND PERCENTAGE OF CASES FOUND BY RE-EXAMINATIONS IN RELATION TO THE NUMBER X-RAYED

MALE AND FEMALE COMBINED, CLASSIFIED ACCORDING TO STAGE AND AGE GROUP

<;")

CASES FOUND

"8
a:~;;

White Age Groups

Number X-rayed

Up to 16 ________ --------------- 933 17-45 -------------------------- 2190 46 Up ----------------- _________ 675
Total _______________________ 3798

Colored

Up to 16 ____________________

360

562

46 Up ------------ ------------ 143

Total _ -------- -------------- 1065

Minimal

No.

'/o

1

.10

17

.77

3

.44

21

.fi!'i

3

.83

6

1.06

1

.70

10

.93

Mod. Adv.

No.

o/o

0

.00

10

.46

7

1.03

17

.45

0

.00

4

.72

0

.00

4

.38

Far Adv.

No.

o/o

1

.10

s

.36

2

.30

ll

.29

4

l.ll

2

.35

2

1.39

s

.75

All Cases

b

No.

%

"'<:.:;:.::.:>.,

2

.20 "

35 12
49

1.59 1.77
1.2n

-~ "
0
::::;

~

7 12
3

1.94 2.l:l 2.09

"'
i:l::
":;:...

;;.

22

2.0G

Tuberculosis Control

197

TABLE Vlll RESULTS OF INTERPRETATION OF FILMS REFERRED BY PHYSICIANS
YEAR 1940

:.\Iinimal Cases --------------------

11

).Ioderately Advanced Cases --------

18

Far Advanced Cases

16

Total Positive ___ _

45

Suspicious ------------------------- _

136

~egative

398

Total

53<1

Total of All Films Sent in

for Interpretation --------------

579

TABLE IX
PUBLIC HEALTH TUBERCULOSIS CONTROL ACTIVIT! ES (In Organized Counties)
1940

Cases of tuberculosis admitted to setvice

____ ------------------------------ 3;1'16

Visits to tuberculosis cases, contacts and suspects ______ ----------------------------- 53,5<!8 Visits to cases of tubetculosis _________________________ --------------------------~- 18,6<19

Average number of visits to cases of tuberculosis ________ _,__________________________ _ 5.41

Office visits by cases of tuberculosis __________________ ------------------------------- <1,587

Admission to sanatoria ----------------------------------------------------

<175

:\'umbel' completed tuberculin tests_ ______ ------------------------------------------ 16,070

Numbet positive _________________________ --- ___ -------------------------------- 8,753

Contacts broken ------------------ ______ ------------------------------------------ 1,752

Contacts partly brol<en ------------------------------------------------------------ 381 Relief secmed-Numbe1 of cases______________ ------------------------------------ 707

Tuberculosis cottages built -------------------------------------------------------- 20

Public lectures and tallm ---------------------------------------------------------- 537

State Tuberculosis Sanatorium

C. lVl. Sharp, M.D., Superintendent

MEDICAL STAFF

F. C. Welchel, M.D. H. E. Crow, M.D. Fred Crenshaw, M.D.

Paul C. Burnett, M.D. Robert Cox, M.D. J. B. Ford Jr., M.D.

During 194,0 the growth and development of the Sanatorium reached a new height. More beds were in operation than ever before in the history of the institution, and during 19L10 more patients were treated than have ever been treated before at the State Sanatorium. Besides this, better therapy was rendered, as is well indicated by the fact that 67% of the patients admitted with positive sputum were discharged with their sputum negative. This compares most favorably with an analysis of the patients discharged from the State Sanatorium in 1929. In that year only 15% of the patients had their sputum converted. We can attribute this favorable result to the advent of extensive collapse therapy. Approximately 85% of all patients admitted to the Sanatorium during 1940 received some form of collapse therapy, while in 1929 only four patients received any form of collapse therapy. There has even been a striking improvement over the years of 1938 and 1939. In 1938, only 35% of the patients had their sputum converted, and in 1939 only L1,3% of the patients who had tubercle bacilli in their sputum upon admission were discharged with their sputum free of tubercle bacilli.
Many cases of infectious tuberculosis, where a severe public health problem exists, have caused the State Board of Health to modify its policy of admitting only patients who can receive some form of pulmonary collapse. During the summer of 194,0, 80 beds were added to the Sanatorium for the care of these public health problems where only domiciliary care appeared to be indicated. They were received as patients for a period of six months, instructed in proper hygienic measures to prevent the spread of the disease while provision was being made for their care at home after discharge. Many cases in this group have improved sufficiently to receive some form of collapse therapy at a later date.
In reviewing the care of patients, it is interesting to note the increase in the number of thoracoplasty operations. During 1940, 156 operations were performed on 4,7 patients, as compared to 52 operations performed on 19 patients during the preceding year. In spite of this great increase in the number of operations, there was only one operative mortality. Consequently, we feel that the risks in this rather drastic operative procedure are somewhat overrated. We definitely feel that a thoracoplasty is less hazardous than an unsatisfactory pneumothorax continued for an indefinite period of time. The good results obtained are reflected in the ease with which patients are persuaded to accept this operation.

Tuberculosis Sanatoriwn

199

There is no chead of it, as has been the case in the past. The performance of more thoracoplasties has decreased the number of pneumolysis operations performed which are so frequently accompanied by tuberculous empyema.

INCREASE IN SANATORIUM BEDS
When the State Board of Health took over the management of the State Tuberculosis Sanatorium in 1937, there were 232 beds in operation at a daily per capita cost of $2.25. By the end of l9LJO, there was a patient population of 4.13 at the Sanatorium, operating at a daily per capita cost of $1.75. Eighty beds have been added for the use of white patients and 16 beds have been added for the use of colored patients during 194,0. Hospital days for 1940 increased to 116,694 as against 100,849 during 1939.
improvements in Treatment Facilities
During the past year, many improvements have been made to facilitate the treatment of the patients at the Sanatorium.
(a) The old X-ray equipment has been modernized by the acquisition of a new 500 m. a. shock-proof rotating anode tube of the latest design. The X-ray room has been enlarged and a new General Electric photo-roentgenoscope has been installed which takes miniature X-rays at a cost of only 15 cents per film. This has resulted in a great saving on a number of X-rays, since the average cost of the ordinary X-ray as taken at the Sanatorium is approximately $1.25. So far as we know, this is the only instrument of this character in operation in the South. We were fortunate to be able to secure one of these instruments before the Federal Government purchased the entire supply in its defense program. We have also constructed a new developing tank for processing X-ray films. This service has been performed by our own maintenance department.
(b) The operating room has been enlarged and a modern operating table has been purchased along with numerous replacements of thoracic surgical instruments.
(c) The clinical laboratory has been moved to a new location on the third floor of the main building at the Sanatorium, greatly increasing the amount of space available for the anticipated increase in the amount of laboratory work.
New Construction
(a) A new 272-bed annex has been added to the main building of the Sanatorium for the treatment of tuberculous patients. This building is entirely fireproof and of the latest modern architecture. It was started in 1939 but completed in the early part of 194.0. There is every reason to believe that this valuable addition to the Sanatorium will be placed into operation in the near future. Requisitions for the equipment necessary to place it into operation have already been completed. We feel that,

200

Georgia Department oj Public Health

TATE A ATORIU f

0 E oF THE X-RAY Roo 1s
IN ALTO

I 'SPECT IO r AND I TERPRETATIO '
OF 1 -RAY PICTURES

p EUMOTHORAX TREAT fE ' T

Tuberculosis Sanatorium

201

with the opening of this annex, the treatment of tuberculosis in white people in Georgia will be well in hand.
(b) Through cooperation with WPA new dormitories for colored servants have been constructed, releasing two cottages at the colored Sanatorium now occupied by servants for the treatment of 32 additional colored patients.
(c) Much-needed pavement has been laid supplying the new annex, the new power plant, the dairy, the doctors' residences, and the Colored Sanatorium.
(d) A new five-room residence has been built for the use of the Engineer at the Sanatorium. This was built by our own maintenance forces at a cost of approximately $1500.00.
General Repairs
The plastering in the Main Sanatorium Building has been repaired and this work is being extended to the other buildings of the Sanatorium where much-neede:I plaster repair is in evidence. Two full-time painters have completely painted all of the exterior of the Main Building and the Childrens Building, and the Nurses Home and all the doctors' residences.
In the Engineering Department, there is a never-ending job of constantly keeping in good working order all electric stoves, steam, water, sewerage, and refrigeration. Many changes were made in the above-mentioned utilities and alterations and repairs must of necessity be done without interrupting the services of the Sanatorium.
Farm and Dairy
The Farm and Dairy operated at a profit to the State for the second consecutive year under the able management of our Farm Superintendent, lVIr. Carl Martin.
Among the work done by the Farm and Dairy has been terracing of new property purchased in 1939, increasing the yields from the various pastures by ~cienti:fic cultivation and cooperation of the AAA, construction of fences, raising and slaughtering 16,000 pounds of pork, installation of electric hot bed, and the production of forty thousand gallons of milk at an estimated cost of 20c per gallon. The average bacteria count for raw milk was 8,000 per c.c. and for pasteurized milk the count was only 550 per c.c. This compared with 15,900 gallons of milk produced in 1939. A detailed statement of the work done for the Farm and Dairy is included in this 1eport.
Recommendations
(a) It is recommended that a new 50-bed nurses' home be constructed to care for additional employees necessary for the operation of the new annex. When this new building is placed into operation, it will be necessary to utilize one floor as a nurses' home, thereby depriving us of the use of 56 additional beds for housing patients.

202

Georgia Department of Public Health

(b) It is further recommended that a horticulturist he employed to landscape and beautify the grounds of the new annex.
(c) It is also recommended that provision be made for the repair of the existing Colored Sanatorium and the two available cottages to be vacated by the colored servants.
Conclusions
We feel that during 1940 the Sanatorium has gained a more valued and important place in the public health of Georgia. A larger number of patients have received treatment and a greater number have been discharged as non-infectious than in any previous year.

PATIENTS ADMITTED 1940-1939

January I, 1940-December 31, 1940 White Adults ---------------------- 19<1 White Children ---------------------- 36 Colored Adults ______________________ 105 Colored Children -------------------- 7
'l'otal ____ ------------------------ 612

January I, 1939-December 31, 1939 White Adults ----------------------- 395 White Children ---------------------- 32 Colored Adults ----------------------- 151 Colored Children _------------------- 5
1'otal ______ -------------- ______ 583

PATIENTS DISCHARGED 1940-1939

January I, 1940-December 31, 1940 White Adults ------------------------ <115 White Children ---------------------- 36 Colored Adults ---------------------- 101 Colored Children -------------------- 4
Total ------------------ ___________ 556

January I, 1939-December 31, 1939 White Adults ------------------------ 381 White Children ---------------------- 37 Colored Adults ---------------------- 121 Colored Children ____________________ 5
'l1otal ---------------------------- 5c!T

Classification :

A

Far Advanced --------- 1 Mod. Advanced -------- ll Minimal --------------- 5 Primary Type --------- 29
Suspects -------------- 0 Non-tuberculous -------- 0
'l'bc. Pleurisy __________ 0 Not Considered ________ 0 Undiagnosed ---------- 0
Total ---------------- 46

Classification:

A

l!"ar Advanced --------- 0 Mod. Advanced -------- 0 Minimal --------------- 0 Primary Type --------- 5
Suspects -------------- 0 Non-tuberculous ------- 0
Tbc. Pleuris)' _________ 0
Not Considered -------- 0 Undiagnosed
Total ------ -------- 5

ADMISSION CLASSIFICATION OF WHITE PATIENTS 1940

B

c

D

SUS(l.

Non-tbc.

Tbc. Pleurisy Not. con. Undiagnosed Total

155

105

l7

0

0

0

0

0

278

137

2

0

0

0

0

0

0

150

7

0

0

0

0

0

0

0

12

0

0

0

0

0

0

0

0

29

0

0

0

23

0

0

0

0

23

0

0

0

0

29

0

0

II

29

0

0

0

0

0

4

0

0

4

0

0

0

0

0

0

1

()

1 '-3

0

0

0

0

0

0

0

4

:;::::
4 o-

";:';

299

107

l1

23

29

4

1

4

530

l;:

0

&"':

ADMISSION CLASSIFICATION OF COLORED PATIENTS 1940

\J) :;:,

;::>

B

c

D

SUS(l.

Non-tbc.

Tbc. Pleurisy Not. con. Undiagnosed Total

:s:;:,
;:.

34

28

4

0

0

0

0



0

67

15

1

0

0

0

0

0

0

16

1

0

0

0

0

0

0

0

0

0

0

14

0

0

0

l4

0

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

--

--

--

!i1

29

4

7

14

1

0

1

112

l~
0
CJ~

l'V 0 If:DISCHARGE CLASSIFICATION OF WHITE PATIENTS FROM JANUARY I. 1940 DECEMBER 31, 1940

Classification:

A Con.

B Con.

Par-advanced _____

2 Imp. 1 Ap.Ar. 1 Died 1 Not
Con.

~rod-advanced----

5 Imp. 3 Unimp.
Quies.

:uinimaL_________ 3 lmp. Ap.Ar. Quies.
Primary Type _____ 21 Ap. Ar. 2 Quies. Unimtl.
Suspects-- ________ 0
Non-tuberculosis __ 0
rrbc. l:lleurisy_____
Not Considered ___

84 Imp. 33 Unimp. 12 Quies.
2 Ap.Ar. 6 Died
77 Imp. 19 Unim]J. 33 Quies. 5 All. Ar.
4 Imp. 1 Ap. Ar. ?. Quies.
0
0
0

TOTAL ______ 4<1

278

C Con. 10 Imp. 27 Unimp. 3 Quies. l4 Died 0
0
0
0 0
54

D Con. 5 Unimp. 7 Died
1 llied
e
0 0 0
13

Susp. 0
0
0 0 19 0

Non- Tbc. 0
0
0 0 0 40

Tbc. Pleurisy Not Con. Total

0

0

20X

~
"a ' ~-
:;:,

0

0

14'1 b

"'"'::;
:::,

" "

0

0

"' 1~

~

-a -

0

0

~4

::? ::

c:;

0 0

0 0

l~
40

i::!::
"~'
;;:-.

19

40

2

1

451

DISCHARGE CLASSIFICATION OF COLORED PATIENTS FROM JANUARY I, 1940- DECEMBER 31, 1940

Classification:

A Con.

Far advanced _____ 0

)lod.-advanced____ 1 Imp. Quies.
)IinimaL_________ l Imp. P1imary Type _____ 2 Ap. Ar.
l Imp. Suspects__________ 0 Xon- tuberculosis_~ 0 'l'bc. Pleurisy_____
--'l'OTAL_______ G

B Con.
10 Imp. 12 UninllJ.
Quies. ll Died
!i Imp. c~ lJnimv.
Quies. Died
1 Quies.
0

C Con. 2 Imp. 1:1 Unhnn. 10 Died
1 llied
0 0

0

0

0

0

49

~R

D Con. 3 llied
0
0 0 0 0
3

Susp. 0
0
0 0 4 0
4

NonTbc. 0
0
0 0 0 14
14

Tbc. Pleurisy Not Con. Total

0

0

65

:::;; ;s...

0

0

1ti ";:s'

:;::

0
~"'-

(J)

0

0

>

:;,

;:;

0

0

s

:;,
.0.,

"

0

0

4

0

0

14

1

0

10;)

~
0 <:.!1

206

Georgia Department of Pztblic Health

COMPLICATIONS FROM JANUARY I, 1940, THROUGH DECEMBER 31, 1940

Tuberculous

Abscess, Lung ---------------------------------

Adenitis, Cervical ------------------------------

2

Appendicitis, Acute ----------------------------

Arthritis, Chronic ------------------------------

Asthma ---------------------------------------

Asthma, Bronchial ----------------------------Breast Amplttation -----------------------------
Bronchiectasis --------------------------------Dermatitis, Chronic ----------------------------Dementia Praecox ------------------------------

Diabetes Mellltus ------------------------------

Embolis, Pulmonary ----------------------------

Empyema _ ---~ -------------------------------

15

~~~~;.~~a-~~~~~-============================== ll

Epilepsy ______ ~------------------------~~------

Fistula, Bronchopleural -------------------------

8

Fistula in Ano --------------------------------

5

Fungus Disease in Lung -----------------------~

Glands, Axillary -------------------------------

Glands, B1onchial ------------------------------

2

Glands, Cervical -------------------------------

1

Gastroenteritis ---------------------------------

1

Heart Failure, Acute----------------------------

Hypertension, Essential -------------------------

Hookworm ____ --------------------------------

Hypertrophy of Liver --------------------------

Lmyngitis --~-----------------------------------

32

Malaria ____ ---------------------------------

Malignancy of Larynx --------------------------

Mastoiditis, Chronic -----"-----------------------

Meningitis ____ --------------------- ___________

2

Mental Subnormal ------------------------------

Mitral Insufficiency ----------------------------

Mitral Stenosis ---------------------------------

Myocarditis, Acute ----------------------------Myocarditis, Chronic --------------------------Narcotic Adiction ----------------------------Nephlitis, Chronic -----------------------------Nephtolithiasis ---------------------------------

Osteomylitis of Rib -----------------------------

1

Otitis Media, Chronic --------------------------

Paralysis, Facial -------------------------------

Peritonitis -------------------------------------

2

Pharyngitis ------------------------------------

2

Parietal, Pleural Fistula ------------------------

1

Pleurisy with Effusion -------------------------

35

Polyps, Nasal ----------------------------------

Non- Tuberculous
4
3 2 1 3 1 1 1 2 7 1
1
1
2
1 3 5 1
1 1 1
1 1 4 1 3 3 1 1
3 1
1

Tuberculosis Sanatorium

207

COMPLICATIONS FROM JANUARY I. 1940, THROUGH DECEMBER 31, 1940-(Continued)

Tuberculous

Non- Tubereu lous

Paralysis, Spastic ------------------------------

2

Pneumothorax, Spontaneous ---------------------

l

Pregnancy -------------------------------------

3

Psychosis, Depressive ---------------------------

l

Pyelitis ---------------------------------------

l

Renal Calculus --------------------------------

1

Rectal Stricture --------------------------------

1

Scoliosis ---------------------------------------

2

Silicos~ ---------------------------------------

3

Sinus, Wound ---------------------------------

l

Syphilis ---------------------------------------

21

Tapeworm, Dwarf ------------------------------

l

Tonsilitis, Sub-acute ----------------------------

1

Tonsilitis, Chnmic -----------------------------

5

Tuberculous 1-IiP--------------------------------

l

Ulcer, Gastric ---------------------------------

l

AGE ANO SEX OF PATIENTS ADMITTED FROM JANUARY I, 1940 THROUGH DECEMBER 31, 1940

Age GrourJs

Male

1-10

12

11-20

37

21-30

88

31-40

85

<11-50

53

51-60

21

61-70

11

71-80

0

'l'otal -------------------------- 313

Female
21 61 117 79 33 16
329

AGE AND SEX OF PATIENTS DISCHARGED FROM JANUARY I, 1940 THROUGH DECEMBER 31, 1940

Age Groups

Male

1-10 ------------------------- 10

11-20

25

21-30

80

31-<10 ------------------------- 74

41-50 -------------------------- 36

51-60 ------------------------- 23

61-70

9

Total ----------------------- 263

Female
18 54 1H 71 23 12
1
293

208

Georgia Department of Public Health

COUNTIES REPRESENTED (BOTH RACES) FROM JANUARY 1, 19i10- DECEMBER 31, 1940

J~tkinson ______________ 1 Bacon ________________ 1 Baker ________________ 1 Baldwin ______________ 3 Banks ________________ 2 Barrow _______________ 1
Barlow --------------- 6 Ben Hill ______________ 2 Berrien _______________ 1 Bibb _________________ 16 Bleckley ______________ 2 Bulloch _______________ 7 Burke ________________ 8 Butts _________________ 3 Calhoun ______________ 3
Camden -------------- 2 Carroll _______________ i1 Catoosa ______________ 6 Charlton ______________ 1 Chatham _____________ 12 ChaUooga _____________ 12 Cherokee _____________ 6
Clarke --------------- 8 Clay _ _______________ 1 Clinch ________________ 1 Cobb _________________ 3 Coffee ________________ 2 Colquitt ______________ l Coweta _______________ 12 Crawford _____________ 1 Crisp ________________ 5 Dade _________________ 1
Dawson -------------- l Decatur --------------- 3 DeKalb _______________ 14.
DDoodoglye _-_-_-_-__-_-_-_-_-_-_-_-_-_-_- 25
Dougherty ____________ 7 Douglas ______________ Ll, Early ________________ 1
Effingham _____________ 1
Elbert ---------------- 1 Emanucl ______________ 3 Evans ________________ 1 Fannin _______________- iJ

Floyd ________________ 31 Forsyth ________________ l Franklin ______________ 3 Fulton _______________ 52 Gilmer _______________ 6

GGllaysncnoc_k__-_-__-_-_-_-_-_-_-_-_-_-_- 7l Gordon _______________ 2
a~:~~e Gwinnel-t==_=_=_=_=_=_=_=_=_=_=_=_=__= 10j
Habersham ___________ 4,

Hancock -------------- 1 Hall _________________ 7
Haralson _____________ 4, Harris ________________ 2 fleard ________________ 1 Henry ________________ 1
Houston ______________ 1 Jackson _______________ 5 Jasper ________________ 1 Jefferson ___ ___________ 1 Jenkins _______________ 6 Johnson ______________ 1 Lamar _______________ 8

Laurens -------------- 8 Lee __________________ 1
Liberty _______________ 2 Lowndes ________ ______ 6 Lumpkin _____________ i1 Nlacon ________________ 6 Madison ____ __________ 1 McDuffie ______________ 4, Meriwether ___________ iJ

Mitchell -------------- 2
Nlonroe _______________ 2
Nionroe _______________ 2 Niorgan ______________ 1 Murray _______________ 5 Mnscogee ________ ___ 9

Newlon --Oglethorpe

--------------~---------

1 1

Peach ________________ 4,

Pickens _______________ 2

Pike _______________ _ 2

Tnbercldosis Sanatorium

209

COUNTIES REPRESENTED (BOTH RACES) FROM JANUARY I, I940 DECEMBER 3I, I9L10-Continued

Polk _________________ 9 Pulaski _______________ I Quitman ______________ I
Rabun --------------- 3 Randolph _____________ 5
Richmond _____ ------- II Rockdale ____ ________ I Schley _______________ I Screven ______________ 2 Seminole ______________ I
Spalding -------------- I2 Sumter _______________ I Taliaferro _____________ 2 Tattnall ______________ 3
Telfair ----------~---- 2 Thomas -------------- 7 Tift __________________ 4. Toombs __ ____________ 4

Towns ________________ I

Troup ---------------- 7 Turner _______________ 2

Twiggs ______ _________ I

Union ________________ I

Upson ________________ 6

Walker _______________ IO

Walton _______________ 2

Ware _________________ IO

Wanen ________________ I

Washington ___________ 5

Wayne _______________ 2

Wheeler ______________ 3

White ________________ I

Whitfield

_________ I9

Wilcox _______________ I

Wilkinson __ __ ________ 2

Worth ____ ___________ 2

OPERATING ROOM REPORT (WHITE AND COLORED) JANUARY I, 1940-DECEMBER 31, 19401939

Thoracic Surgical Procedures

1940

Initial Pneumothoraces _____ -----------------------

2<!0

Successful Pneumothoraces ____________________ ------------ 177

rnsuccessful Pneumothoraces

63

Avg. No. Pts. Receiving- Pneumothorax __________ ____________ 191

Avg. ::<Oo. Pts. Receiving Bilateral Pneumothorax______________ 8

Pneumothorax Refills

6,166

Pneumothmax Patients Discharged

134

Pneumothorax Patients Discontinued ______ ------------------ 28

Out-patients Receiving Pneumothorax, A.vg. Xo. _____________ _ 19

Extrapleu!'al Pneumothorax _____________ ------------------- 6

No. Patients Receiving Pneumoperitoneum ___________________ _ 27
Pneumoperitoneum Patients Discharged __ -----------------Pneumoperitoneum Patients Discontinued ___________________ _ Pneumovel'itoneum Refills _______________________________ _ 891
Out-patients Receiving Phrenicotomies ----------------------

Phrenicotomies ------------ _---------------------------- __ _ 85 Phrenlco-exeresis _____________ --------------------------- __ 'l'horacenteses _____________ ------------------------------- _ 98 9
Removal of Air -------------------------------------------- 72 Apicolyses _________ -------------------------------------- _ 6

1939
323 185 138 190
8,208 132 lS 17
0 165
87
391 51

210

Georgia Department of Public Health

Removal of Paraffin Pac!L---------------------------------

Avg. No. Patients Having Oleothorax ------------------------ 13

Oleothorax Treatments

142

Removal of Oleothorax ------------------------------------ 1 Lobectomy -----------------------------~------------------

Pneumonectomy -------------------------------------- __

Hemoval of Needle frmn 'Thorax ----------------+----------

Thoracoscopic Examinations

Bronchoscopic Examinations

2

Irrigation of Pleural Space

1,249

Pneumolyses: Xo. Patients -------------------------------- 27

First Stage ---------------------------------------- ______ _ 27

Second Stage -------------------------------- --------------

Third Stage ----------------------------------------------

<1

Thoracoplasties: No. Patients ----------------------------- <17 First Stage _______________________________________________ _ 47

Second Stage

<18

'l'hird Stage

31

Fourth Stage

25

Fifth Stage

6

Deaths During Surgical Procedures_______________________ _

Other Surgical Procedures:

Appendectomies

11

Blood 'l'ransfusions ---------------------------------------- 16

Cystoscopic Examinations ----------------------------------- 0

Incision of Carbuncle -------------------------------------- 0

Lumbar Punctures

10

OPERATING ROOM REPORT (WHITE AND COLORED) JANUARY I. 1940-DECEMBER 31. 1940-1939-(Continued)

Thoracic Surgical Procedures

1940

Laparotomy ---------------------------------------------- 0

Abscess Incisions ------------------------------------------ 5

Curette of Sinus------------------------------------------- <1

Tubes Inserted -------------------------------------------- 12

1,herapeutic Abortions

2

Other Operating Room Procedures: Pelvic Examinations --------------------------------------- 11 Sldn 'l'ests ------------------------------------------------ 33 Bladder Instillations --------------------------------------- 3 No. Pts. Receiving Antiluetic Treatments ____________________ _
No. Antiluetic Treatments Given ---------------------------- 288

No. Pts. Receiving 0. T------------------------------------ 30 No. 0. '1'. 'l'reatments Given--------------------------------- 55 Removal of Foreign Body from Ear_________________________ 1
Rectal Examinations ---------------------------------------
'l'otal Daily Treatments______________________________________ 9.'106

4 28
0
I 1-1 305 5ti 55 1J
19 19 19
8 2
13
2
1939
0 0 4
18 25
0 26 428 35 77

Tuberculosis Sanatorinm

211

XRAY REPORT FROM JANUARY I, 1940, THROUGH DECEMBER 31, 1940 JANUARY I, 1939, THROUGH DECEMBER 31, 1939

1940

Fluoroscopies (Colored and White) ______________ _
X-rays -----------------------------------------
Flats -----------------------------------------Buckys ----------------------------------------Stereos ---------------------------------------G. I. --------------------------------------------
Intestinal -------------------------------------Bone Plates -----------------------------------Portables -------------------------------------Fluid X-rays ----------------------------------Kidney X-rays --------------------------------Mastoid X-rays --------------------------------
Sinus X-rays ---------------------------------Lat. Chest X-rays ------------------------------Slwll X-mys -----------------------------------Obliques --------------------------------------Copies of Films--------------------------------Fetus X-rays ----------------------------------Photo Roentgenoscope ---------------------------

8,'138 <1.6<11 <],201
20 57 211
73 90 18 12 <]
5
125

White Adults: ----------------------------------
House Patients -------------------------------- 2,2<ll Consultation Patients -------------------------- 1,27<1

White Children: --------------------------------
House Patients --------------------------------- 159 Consultation Patients --------------------------- 180

Colored Adults : -------------------------------House Patients --------------------------------- 592 Consultation Patients --------------------------- 135

Colored Children: ------------------------------

House Patients ---------------------------------- 51

Consultation Patients ----------------------------

9

Lipiodol Injections: -----------------------------

House Patients ---------------------------------

6

Consultation Patients --------------------------- 10

Poor Films ------------------------------------- 13

1939 6,993 3,878 3,562
56 90 18 37 83
5
10 0 0
2,985
271
57 <J
<]8
22

In the clinic at the sanatorium, 08 new cases of puhnonary tuberculosis were found from January 1, 19<!0, through December 31, 1940.
Four hundred and sixty-nine cases were found in consultation X-rays sent ln by outside J>hyslcians, during the year of 1940.

212

Georgia Department oj Public Health
LABORATORY REPORT FROM JANUARY I, 1940- DECEMBER 31, 1940 JANUARY I, 1939 DECEMBER 31, 1939

1940

1939

1. Sputum Examinations:

(a)

Direct Smear

3,316

(b)

Concentrated

1,H2

(c)

Smear for pneumonia_~-------------------_

1

(d)

ll'ontana Stains --------- ----------------

<12

(e)

Culture for 1'. B, _______________________ _ 2<17

(f)

Examination for Fungi____________________

2

(g)

Stain for Spirochetes____________________ _

2. Blood Examinations:

(a)

Blood Counts

918

(b)

Sedimentation Tests __ ------------ ----- . 776

(c)

Blood 1'yping --------------------------- 129

(d)

Blood Matching ------------------------- 96

(e)

Blood Coagulation Time_______ _

220

(f)

Blood Chemistry ------------------------ 34

(g)

Platelet Count ---------------------------

2

(h)

Examination for Sicl<le Cel:t,Q _____________ _

~

(i)

1\etieuloc:vte Count -----------------------

0

(j)

Sttlfanilmnide in Blood -------------------

3

(I<)

)fulnria Smears

14

3. Urinalyses (a) (b)

2,815 Urine Sed. Stain ____________ -----------Sulfanilamide Det. Urine -----------------

1. Feces Examinations ______________________ _

3<19

(a)

Occult Blood (Feces) ___________________ _

(b)

Examination Exudate from Hectnm ______ _

j, Smears:
(a) (b) (c) (d) (e) (f) (g) (h)

YaginalJ Cervical, rretlual for G. C. _____ _ <16

Dntinage of Ear____ -------------------

0

Pelvic ______ ----------------------------

Tlnoat ______ ---- -----------------------

Abscess __ __

Appendectomy -------------------- ------Xasal Drainage _______ ----------------

Pl'ostatic

G. Fluid Examinations:

(a)

Fluid Culture

(b)

Pleural Fluid

H4

(c)

Spinal Fluid ---------------------------- 34

(d)

Spinal Fluid, Sulfanilamide______________ _

(e)

Spinal Fluid Cell Count_ ________________ _

7. Serological Examinations :

(a)

Kuhns ---------------------------------- 72<1

<1,763 425 0 15 H 0
776 699 H<1 182 18<1
21 0
2,169
579
<1 1 6
21 69
6 1
687

Tuberculosis Sanatorium
LABORATORY REPORT FROM JANUARY I, 1940 DECEMBER 31, 1940 JANUARY I, 1939 DECEMBER 31, 1939-(Continued)

213

1940

X. )liscellaneous Examinations:

(a)

Examination for miscellaneous exudates ___ _

(b)

Examination of gastl'ic contents___________ _

2

(c)

Examination of abdominal fluid ____ _____ _

(d)

Gram's Stain ----------------------------

0

(e)

Biopsies (S. B. IT.) ________________ ___ _

2

(f)

~\Iiscellaneous cultures ---------- _______ _

13

(g)

Bacteria. count of mille __________________ _ 13

(h)

Animal inoculations ----------------- __ _

2

1939
1
o.
4 13 13

TOTAL -- - ________ ------------- _________ 11,128

11,010

ANNUAL REPORT FOR FARM AND DAIRY, JANUARY 1, 194,0.
DECEMBER 31, 19Lt0
A. GENERAL FARM:
Produced 47:Y2 tons hay at cost of $14.25 per ton. (Fertilize1, seed, labor, mules, tractor and truck costs included.) Produced 232 tons ensilage at cost of $4..25 per ton. (Fertilizer, seed, labor, mules, tractor and truck costs included.) Terraced new property bought. Set out Lt600 kudzu plants. Set out 2300 black locusts. Hauled 238 tons compost to thin areas over crop lancl. Clover crop of every acre cultivated except lespedeza land. All land inoculated sufficiently, planted in hairy vetch and crimson clover. Thinner land sowed in winter rye. Seeded: LJO bu. apler oats; 800 lb. hairy vetch; 100 lb. clean cnmson clover; 60 bu. winter rye.
B. PASTURE:
800 lb. rye grass, 700 lb. crimson clover in burr. Sowed pasture in Kobe, Korean and Common Lespedeza, Dallis Grass and Crimson Clover. Fenced highway pasture.
C. Hoes:
Slaughtered 59 pigs, 16,576 lbs. Made vat and built chimney to cook swill. Built feeding floor for hogs and repaired hog barn.

214.

Georgia Department of Public Health

D. GARDEN:
Electric hot bed installed.
Produced for commissary:
Lima beans ------------------------------- 1359 lbs. Green Beans ------------------------------ 3298 lbs. Bee~ ------------------------------------ 3898 lb~ Cabbage --------------------------------- 3509 lbs. Carrots ---------------------------------- 1367 lbs. Collards --------------------------------- 2121 lbs. Fresh corn ------------------------------- 94.0 doz. Cucumbers -------------------------------- L1Q4. lbs. Cantaloupes ------------------------------ 12 bu. Grapes ---------------------------------- 48 lbs. Mustard greens ---------------------------- 567 lbs. Turnips and tops -------------------------- 15L13 lbs. Turnip greens ----------------------------- 5L1L1 lbs. Turnips ---------------------------------- 79 lbs. Swiss chard and spinach_____________________ 1206 lbs.
Lcttuce ---------------------------------- 858 heads Okra ------------------------------------ 1177 lbs. Onions ----------------------------------- 339 doz. Onions --------------------------- _______ 1219 lhs. English peas ------------------------------ 755 lhs. Field peas -------------------------------- 968 lbs. Green peppers ---------------------------- 265 lbs. Pumpkins -------------------------------- 91 lbs. Irish potatoes ---------------------------- 9187 lbs. Sweet potatoes ---------------------------- 397 lbs. Radishes --------------------------------- 611 doz. Squash ---------------------------------- 1960 lbs. Watermelons ----------------------------- 14 Tomatoes -------------------------------- 1228 lbs.
DAIRY:
Produced 4.0,575.5 gallons milk at estimated cost of 20.44 cents per gallon.
Additional miscellaneous repairs made: Reroofed silo and compost shed, built and painted silo door. Remodeled incinerator and built new shed over it to facilitate burning
debris.
Forty-two trips truck and man (full day) to Atlanta for commissary department.
Three trips truck and man (3 hrs.) to Clarksville for commissary department.
Bacteria count: 8,000 per c.c. for raw milk; 550 per c.c. for pasteurized milk.

Division of Laboratories

T. F. Sellers, M.D., Director

E. ]. Sunkes, D.P.H., Chief Bacteriologist

]anie Morris, M.S. Madge Reynolds, A.B. E. L. Webb, Ph.G. lVl. lVl. Harris, Ph.D. F. H. Stubbs, M.S.

Cultures Microscopy
Serology Waycross Branch
Albany Branch

During the year 19iW the Division of Laboratories showed a marked increase in all of its various activities including specimen examinations, manufacture and distribution of biologics and concomitant services such as the preparation of media, glassware and specimen outfits.
During 19i10 a total of 395,014 specimens was examined by the Division of Laboratories. This was an increase of 9,164. over 1939.

INCREASE IN LABORATORY WORK
Diagram 1 shows (1) the marked growth in laboratory work over the 20-year period from 1920 to 194.0 and (2) the gain from 1939 to 19i10. It will be noted that during this 20-year period there was an increase in the annual specimen load from 22,420 specimens to 395,014.. This was a gain of 1667 per cent.
Diagram 2 shows the gain in specimens by departments during this same 20-year period. It will be noted that while there was a continued and rather marked gain during the past year in the number of specimens handled by the serology department, the specimens handled by the culture department were approximately the same as in 1939, and there was an actual decrease in the number handled in the microscopy department.

SUMMARY OF LABORATORY EXAMINATIONS
The consolidated report of the three State Laboratories composing thr Division of Laboratories is given in Table l. The individual reports for the Central Laboratory and each of the Branches are shown in Tables 2, 3 and 4. A comparison of the number of specimens of the different types examined during ] 939 and 1940 is shown in Table 5.

216

Georgia Department of Public HeaLth

DIAGRAM l GROWTH OF LABORATORY WORK
1920 - 1940

400,000

!"""i' 300,000

U"""l'

200,000

....

0

z~""

100,000

0

1925

1930

1935

YEARS

1939

DIAG!W.! 2 GROfiTH OF L\BORJil'ORY WORK BY DEPARTMENrS

1940

Serology iii~ Culture
0 Uieroscopy

--Years--

Laboratories
TABLE I REPORT OF COMBINED LABORATORIES FOR 1940

217

Total Specimens Positive Negative Doubtful

'l'ube1c ulosis-:i\licroscopic 'l'ube!culosis-Animal Inoculation ________ _

11,339 168

Diphtheria

2,2<15

Gonorrhea

8,2'18

~lalaria __________ ---------------------------- -- 36,081

Intestinal Parasites _--------------------- _______ _ 57,512 Egg Counts ------------ ---------------------- 3,197

Rabies-!\licroscopic ____ ------------------------- 1,252 Rabies-Animal Inoculation ---------- ________ _ 171

)..fiscellaneous

3,121

Agglutinations

----------------------------

Typhoid __ ------------------------ ___ _

Brill's -------------------------------- ---- -

Undulant Tularemia ___ _

10,285

Blood Cultures _____________ ------ ______ _ ______
Typhoid ------------ ____ -----------------Paratyphoid Undulant _ ---------------------------------Other Organisms __

8,741

Negative -------------------------------- --------
Stool and Urine Cnltmes ___ ---------- ____ ----Typhoid ---- --------------------------------Paratyphoid -------------------------- _____ _ Dysentery ------------------------------------Other Organisms ---------- ------------------

7,112

Negative ---------------------------------------
Blood and Spinal Fluid for Kahn Test_________ __ 232,326 Darkfield 'fest for Syphilis---------------------- 375

Water ------------------------------------ ---- 12,359

~rissue* -----------------------------------------

482

1,006 31 384
1,818 1,137 16,299

10,312 137
1,831 6,376 3'1,94,1 41,213

<167

785

29

H2

369 429 153
97

265
22 25
8,420

360 136
5
38,893 84

6,608
189,922 282

21 30 5<1
3,511 9

1'01'AL __

395,01,1

*Figul'e t'or first five mo,nths only-this service disrontinued June l, 1940.

218

Georgia Department oj Public Health

TABLE 2 REPORT Of CENTRAL LABORATORY FOR 1940

Total Specimens Positive Negative Ooubtful

~ruberculosis-1\iicroscoplc ---------------------- 8,954 .ruberculosis-Animal Inoculation ---------------- 168

Diphtheria

1,502

Gonorrhea

6;167

Malaria ---------------------------------------- 18,35<1

Intestinal Parasites ---------------------------- 20,397 Egg Counts ------------------------------------ 357

!\abies-Microscopic ---------------------------- 1,083 !\abies-Animal Inoculation --------------------- 171

Miscellaneous

1,910

Agglutinations ---------------------------------Typhoid -------------------------------------
Brill's --------------------------------------Undulant 'fularemia

6,623

Blood Cultures --------------------------------1'yphoid ------------------------------------Paratyphoid --------------------------------Undulant ------------------------------------Other Organisms ------------------------------

5,<158

Negative ---------------------------------------
Stool and Urine Cultures________________________ 1'yphoid ------------------------------------Paratyphoid --------------------------------Dysentery Other Organisms -----------------------------

<1,667

Negative ----------------------------------------
Blood and Spinal Fluid for Kahn Test_ ___________ 158,673 Darkfield 1'est for Syphilis______________________ 322

Watet

12,359

<182

793 31 217
1,457 5<18
3,670

8,l<J5 137
1,201 <1,993 17,806 16,727

389

69<1

29

l<J2

307 238 106
60

177 6
18 18
5,239

243 2
84

25,16<1 72

<1,338
131,299 212

16 24 17
2,210 8

Total ---------------------------------------- 2<17,9<17

Laboratories
TABLE 3 REPORT OF ALBANY BRANCH l-ABORATORY FOR 1940

219

Total Specimens Positive Negative Doubtful

Tuberculosis-Microscopic ----------------------piphtheria

1A83 392

139

1,314

53

338

Gonorrhea

1,217

234

983

Malaria

15,119

540

14,579

Intestinal Parasites

17,847

5,827

12,020

Rabies-Microscopic Miscellaneous

H3

65

78

562

Agglutinations --------------------------------- 2,903

'l'yphoid -------------------------------------

<!6

Brill's _---------------------------------------

151

Undulant

41

Tularemia

23

Blood Cultures --------------------------------'l'yphoid ------------------------------------Paratyphoid ---------------------------------Undulant -----------------------------------Other Organisms -----------------------------

2,505

Negative ------------------- -------------------

Stool and Urine Cultures -----------------------
Typlwid -------------------------------------Paratyphoid --------------------------------Dysentery
Other Organisms -----------------------------

1,138

7l 1 4
2,426
86 37

Negative ---------------------------------------

1,015

Blood and Spinal Fluid for Kahn Test___________ <!0,268

7,788

31,952

528

Darl<field Test for Syphilis----------------------

<!2

33

Total

83,619

220

Georgia Department. of Public Health
TABLE 4 Report of Waycross. Branch Laboratory for 1940
Total Specimens Positive Negative Doubtful

Tu!Jerculosis-lVlicroscopic

9U2

H

823

5

Diphtheri11

351

5<1

292

5

Gonorrhea.

56<1

127

<100

37

1\faln.rin.

2,608

<19

2,559

Intestinal Parasites ____ ------------------------ 19,268 Egg Counts ----------------------------------- 2,840

6,802

12;166

Rabies-Microscopic ----------------------------

26

13

13

Miscellaneous

649

Agglutinations --------------------------------- 759

Typhoid -------------------------------------

16

Brill's ------------------- ---------------------

<10

Undulant

6

'11ularemia -----------------------------------

Blood Cultures --------------------------------- 778 'l'yphoid --------------------------------------
Paratyphoid --------------------------------- Undulant -----------------------------------Other Organisms -----------------------------

Negative ---------------------------------------

Stool and Urine Cultures -----------------------
TY!'hoid -------------------------------------Paratyphoid ---------------------------------
Dysentery -----------------------------------Other Organisms ------------------------ ____ _

1,307

17 2 4
755
31 15
5

Negative ---------------------------------------

1,255

Blood and Spinal Fluid for Kahn Test____________ 33,385

5,941

26,671

773

Darl<field 'l'est for Syphilis--------------------

11

Total ---------------------------------------- 63,448

Laboratories
TABLE 5 COMPARATIVE CLASSIFICATION OF SPECIMENS 1939-40

221

1939

'1Uberculosis ______________________________________ _ 9,'101

Diphtheria ---------- -----------------------------Gonorrhea __ __________ ----------------------------
:i\falaria __ ------------------------------------ _______ _
Intestinal Parasites -------------------------------IIabies ____ ____________ ------------------------ __

3,'182 7,599 36,691 71,283 1,153

:\liscellaneous ______ --------------------------------- 3,63'1 .J~..gglu tina tions _____________________________________ _ 11,773

Blood Cultures __ ----------------------------------- 9,558

Stool and Urlne Cultures

6,633

Blood and Spinal Fluid for Kahn 1'est ____________ 211,319

Darl<field 'l'ests for Syphilis ------------------------- 353

Water ---------------------------------------------- 12,110 'rissue __________________________ ----------------- __ _ 798

Grand 1'otal -------------------------------------- 385,Sfi0

1940
11,501 2,24;) 8,2,18 36,081 60,109 1,123 3,121 10,23!'i S,H1
7.11~ ~32,326
375 12,3fi9
,182
39n,Ol<l

Gain or Loss
2,106-f1,237-
6'19-f61310,311270-f:>131,-JS;l817--
17~+
20,917+ 22+ 2'19+
316-
9,164-f-

222

Georgia Department of Public Health

.... DIAGRAM 3 ....
SPECIMEN LOAD
BY
LABORATORIES 1940

ALBANY
83,619 21. 2 "lo

WAYCROSS
63,448 16. 6 "lo

CENTRAL
247,947 62.2"fo

MICROSCOPY
123,334 31 .4"lo
SEROLOGY
232,701 58. 8"lo

....DIAGRAM 4 ....
SPECIMEN LOAD
BY
DIVISIONS 1940

Laboratories

223

DIAGRAM 5 SPECIMEN LOAD BY DIVISIONS IN EACH LABORATORY
1940

CENTRAL LABORATORY

ALBANY LABORATORY

WAYCROSS LABORATORY

224

Georgia Department of Pnblic Health

Diagram 3 shows the percentage of the total specimen load handled by each laboratory, while Diagram L1 shows the percentage of the total specimen load handled by the several departments. Diagram 5 shows the total specimen load and percentage handled in each laboratory by its several departments. Table 6 gives the numerical data on which these diagrams are based. A compmison of these data with those of 1939 reveals that the percentage of the total specimen load handled by the Central Laboratory and by the Albany Branch increased, while that for the Waycross Branch decreased, also that specimens submitted for the l!erologic test for syphilis constitute 58.8% of the total specimen load during 1940 as compared with 54.9% in 1939. Decreased percent.ages were noted in the specimens submitted for microscopic and cultural study. This same trend was noted for each laboratory although both the Albany and Waycross Branches showed slight increases in the specimens submitted for cultural studies.

TABLE 6 COMPARISON SPECIMEN LOAD 1939-1940

Specimen Load by Laboratories:

1939

Central Laboratory ____ -------- _______ 238,458
Albany Laboratory _____ ------ ------- 77,068 Waycross Laboratory ___ . ______ .-. ______ 70,32<1

1940
247,947 83,619 63,<1<18

Per Gent. Change
3.9+ 8.4+ 10.8-

Percentage Total Load by Laboratories:

1939 Percentage

('entral Laboratory

61.8

Albany Laboratory

20.0

Waycross Laboratory -------------------- 18.2

1940 Percentage
62.2 21.2 16.6

Per Cent. Change
.4+ 1.2+ 1.6-

Percentage Total Load by Divisions:
Serology _____ --------------------------
l\Iicl'OSCOPY ------------ ----------------
Culture -------- ____ -------------------Water ----------------------------------

1939
54.9 3<1,5
7.2 3.1

1940

Per Cent. Change

5H.8

3.9+

31.4

3.1-

6.7

.5-

3.1

.0

Percentage Total Load by Divisions in Each Laboratory:

Cent1al Laboratory-
Serology -----------------------------1\Iicroseopy --------------------------Culture ------------------------------\Yater

1931J
60.3 26.3
8.0 5.1

1940
64.0 24.1
6.9 5.0

Per Cent. Change
3.7+ 2.21.1-
.1-

Laboratories

.albany .u~boratory-

Serology --------- _ ------------------- 47.8

48.2

Microscopy ------ __ ------------------- 4'1.5

'14.0

Culture -------------------------------

7.7

7.8

Waycros~ Laboratory-

Serology ------------------------------ '14.3

52.6

l\Iicroscopy ---------------------------- 51.5

'12.9

Culture ------------------------------

4.2

4.5

225
.4+
.5-
.1+
8.3+ 8.6-
.3-

It will be noted from the above table that the specimen load of thl" Central Laboratory during 1940 increased by 9,L189, or 3.9%; the Albany Branch increased 6,551 or SA%; while the Waycross Branch showed a loss o 6,876, or 10.8%. A comparison by divisions shows the ~erology division alone showing a gain-that of 3.9%. The gain in this division was noted in each laboratory while minor gains were also shown in the culture division of both Branches.

226

Georgia Department of Public Health

J.! A P 1

Laboratories

227

1.1 A P 2

228

Georgia Department of Public Health

Map 1 shows the counties from which specimens were 1eceived by the Albany Branch, while Map 2 shows the counties served by the Waycross Branch. The 83,619 specimens handled in the Albany Branch were received from L17 counties. This was an increase of 9 counties serviced during the past year by this laboratory as compared with 1939. The 63,448 specimens received in the Waycross Branch came from 51 counties. One additional county was served by this laboratory during the past year as compared with 1939.
MICROSCOPY UNIT
Tuberculosis
Table 7 shows the microscopic examinations for tubercle bacilli made during the past five years.

MICROSCOPIC EXAMINATIONS FOR TUBERCLE BACILLI FIVE-YEAR PERIOD 1936-1940

1936
Number examined --------------- '1,222 Xumber positive ---------------- 59<1 Per cent. positive ---------------- H.O

1937
5,572 693 12.4

1938
7,359 808 10.9

1939
8,985 896 9.9

1940
10,385 975 9.4

Microscopic examinations for tuberculosis showed an increase of 1,4.00 or 15.6%. This increase occurred chiefly in the Central Laboratory which showed a gain of 1,300. In line with our past policy all animal inoculations for tuberculosis and all culture studies were made in the Central Laboratory; 168 animal inoculations and 95L1 cultures. This compares with L116 and 198 cultures made in 1939. This decrease was occasioned by newly established regulations which require three negative microscopic examinations of sputa before culture study. Animal inoculations are made only when a negative culture report has been received and further laboratory studies are indicated. Exception is made when exudates other than sputa are submitted. Such specimens when found negative for tuberculosis microscopically are cultured and injected into animals ..
Diphtheria
There was a marked decrease in the total number of examinations made for diphtheria, especially among diagnostic cultures. In 1939 there were 2,11L1 diagnostic cultures, while in 19L10 there were only 1,395, a decrease of 719. The decrease in positive diagnostic cultures was also most noticeable, there having been only 161 such positive cultures in 1940 compared to 430 in 1939. See Table 8.

Laboratories
TABLE 8 CLASSIFICATION OF DIPHTHERIA EXAMINATIONS 1940

Positive
Diagnostic ---~--------------------------- 161 Release --------------------------------- 199 Carrier ---------------------------------- 18 Virulence -------------------------------- 6
Total ---------------------------------- 384

Negative
1,234 254 3<12 1
1,831

Doubtful 0 0
30

229
Total
1,395 <153 360 7
2,215 30
2,2<1!)

Gonorrhea
Table 9 shows the examinations for gonococci made during the past five years.

TABLE 9
EXAMINATIONS FOR GONOCOCCI FIVE-YEAR PERIOD 1936-1940

1936
Number specimens examined ------ <1,237 Number positive ------------------ 952 Per cent. positive ---------------- 22A

1937
;}2<15 1,081
19.2

1938
.),569 1,132
20.3

1939
7,:i99 1,662
21.8

1940
8,2<18 1,813
22.0

There was only a slight gain (M9) in the number of examinations for gonococci made during 19L10 as compared with 1939. The Albany Branch showed a gain of L!51 such specimens, the Waycross Branch an increase of 277, while the Central Laboratory showed a decrease of 79.
fllfalaria
Table 10 shows the malaria examinations made during 194,0.

230

Georgia Department of Public Health

TABLE 10 ROUTINE AND INDEX MALARIA EXAMINATIONS 1940

Central

Albany

Waycross

Total

G. Total

Routine-
Positive -----------------Negative ----------------'11otal --------------- - ---

142 J,l04 4,246

189 5,280 5,109

13

3<14

724

10,108

737

10,!52

Index-
Positive ------------------ 406 Negative ------------------ 13,702 Total -------------------- 1<1,108

351 9,299 9,650

36 1,835 1,371

793 2],836

25,629

Total --------------------------------------------------------------------------- 36,081

There was an increase of 672 routine malaria examinations during 194,0 and a decrease of 1,285 survey examinations. Practically all of the index examinations were of specimens collected in malaria surveys by the Division of Malaria and Hookworm Service. See report of that Division or details.
Table 11 gives comparative summaries o the malai'ia examinations made in 1939 and 1940, and of the positive findings for these years.

Total Number

TABLE II SUMMARY MALARIA EXAMINATIONS

1939 Positives

Per Cent. Positive

Total Number

1940 Positives

Per Cent. Positive

Routine ----- 9, 780

<1<16

1.5

10 ;152

3<1<!

3.3

Index ------- 26,914

631

2.3

25,629

793

3.1

Total ------ 36,69<1

1,080

2.9

36,081

1,137

3.2

Intestinal Parasites
Table 12 shows the routine and index intestinal parasite examma tions made in the several laboratories during 1940.

Laboratories
TABLE 12 ROUTINE AND INDEX INTESTINAL PARASITE EXAMINATIONS

231

Central

Albany

Waycross

Total

G. Total

Routine-Positive -----------------Negative ----------------1'otal --------------------

1,152 8,343 9,'195

1,118 1,019 5,737

868 1,821 2,689

3,738 1<1,183

17,921

Index-
Positive ------------------ 2,518 Negative ----------------- 8,384 Total -------------------- 10,902

4,109 8,001 12,110

5,93<1 10,616 16,579

12,561 27,030

39,591

Grand rota! -------------------------------------------------------------------- 57,512

The routine examinations increased from 1L1,563 in 1939 to 17,921 in 19Ll.O, a gain of 3,358. The index examinations decreased from 56,720 in 1939 to 39,591 in 19Ll,O, a loss of 17,129. The index examinations were made on survey specimens collected almost entirely under the supervision of the Division of Malaria and Hookworm Service, and the decrease in such examinations has, no doubt, been the result of effort to minimize unorganized and non-essential surveys. Made for the Division of Malaria and Hookworm Service were special laboratory investigations consisting chiefly of hookworm egg counts, larv[e isolations from soil, and reticulocyte counts. These special studies were carried on chiefly in the Waycross Branch, which made 2,8L10 egg counts, and in the Central Laboratory, which made 357. A comparison of the examinations m:J.de in each of the several laboratories during 1939 and 1940 is given in Table 13.
TABLE 13
CLASSIFICATION OF INTESTINAL PARASITE FINDINGS IN VARIOUS LABORATORIES
TWOYEAR PERIOD 19391940

Central

Albany

Waycross

Total

Routine1910 ---------------------1939 ---------------------Increase ------ -----------

9;195 9,112 -f-383

Index-
1940 ---------------------- 10,902
1939 --------------------- 1<1,055 Decrease ----------------- -3,153

5,737 3,630 -f-2,107
12,110 13,117 -1,607

2,689 1,821 -f-868
16,579 28,918 -12,369

17,921 1<1,563 -f-3,358
39,591 56,720
--17,1~fl

!\. classification of the positive findings is given in Table 14.

232

Georgia Department of Public Health

TABLE 14 CLASSIFICATION OF INTESTINAL PARASITE FINDINGS

Single Infestation
Worms for Identification Hookworm Dwarf Tapeworm -----------------------------------------Roundworm ______________------_________________________ _ Pinworm __________________----------------------- --------Whipworm ----------------------------------------------Rat 'l'apewo1m -------------------------------------------Others ---------------------------------------------------
Double Infestation
Hoolnvorm and Dwarf '!'apeworm -------------------------Hookworm and Roundworm ------------------------------Hoolnvorm and Pinworm ___________ ----------------------Hookworm and \'Vhipwol'lll -------------------------------Hookworm and Rat 'l1apeworm ---------------------------Hookworm and Strongyloides -----------------------------Roundworm and VVhipworm ------------------------------Roundworm and Dwarf Tapeworm ------------------------\Vhipworm and Pinworm ----------------------------------\-Vhipworm and Dwarf 'fapeworm --------------------------
Triple Infestation
Hookworm, VVhipwol'ln and Roundworm -------------------Hoolnvorm, Dwarf Tapeworm and \Vhipworn1 --------------Hoolnvorm, Dwarf 'l'apeworm and Roundworm -------------Hoolnvorm, Dv.rarf 'l,apeworm and Pinworm Hooliworm, Itoundworm and Rat Tapeworm
Total Specimens Positive for Ova of Hoolnvorm _____________ _ Dwarf Tapeworm --------------------------------------Roundworm --------------------------------------------Pin"\vorm ____ _ -----------------------------------------Whipworm --------------------- -----------------------Rat ~rapeworm

15,35<1 181 358 108 31 1 7
51 123
<14 11 3
4 2
2 2 3
15,596 241 <193 15<! 52 5

16.049 211

Table 15 gives a list of those counties submitting 100 or more specimens for intestinal parasite examinations. and the number and percentage o such specimens positive for hookworm. The 39,591 survey specimens were received from 52 counties in 194.0 as compared to 56,720 received from 5L1 counties in 1939.

Laboratories
Table 15 HOOI<WORM INDEX BY COUNTIES-1940

County

Total Specimens

Appling ______ ________ __ _ Atkinson ___ _____________ Bacon __ _____ _____ ____ Bal\er ________________ _ Baldwin
Blecl<ley Brantley J3rooks _______________ _ Bryan ________________ _ Bulloch
Calhoun Candler _________ _ Charlton _____________ _ Coffee ________________ _ Colquitt ____________ . __ _
Cool\ __________________ _
Crawforcl -------------Crisp _________________ _ Dade __ Decatur ---------------
Dodge ________________ _
Dougherty ------------Effingham ____________ _ Emanuel -------------Fannin
Floyd ------------------Fulton ----------------Grady ________________ _ Gl'eene _______________ _
Hall ___ ----------------
Irwin _________________ _ Jenldns Johnson ___________ Lanier _________________ Laurens __ ____________ _
Liberty Lumpkin ______________ :\Iarlon ________ ________ h ~Lite ell ________ __ _____ :J.Ionroe
Pierce __ Screven --------------- __ Seminole __ ____________ 'l'aylo!' ----------------

271 3B6 362 3fi0 1,886
1,55R 150 231
'1,621
2,~23
10fJ 1,292
519 301 1,277
655 399 511 213 788
333 131 2,505 522 205
223 551 130 <101 3:>5
'181 416 17t1 1,259 122
783 1,52'1
726 603

Hookworm Positive
90 1:)7 151 66 T3
JOT 7::i :ll6
(){j
271
31i:J 32 lilT
2,081 1,020
57
13:~
a:J
278
227 '18 9!J 82 18
22 22 1,112
l
T3 106
34 1!12 188
161 98
214 331
261 61'1 197 23:1

233
Per Cent Positive
33.2 12.9 1LT 18_9
:L9
21.2
;)t!.'j
:H.!I 211.'1 27.9
23_:J 2L3 16_;{ 1'i.1 :H.!I
:J2.:{ 10.3 17_!1
1.7 2LR
:H.Ii 12.0 Hl.-1 38.5
6.1
6.6 16.8 HA
.2 3.4
32.1 19.1 26.2 <17.5 53.0
3Ll 23.6 15.1 42.2
;),7
:J:l.7 -Ill.:: 27.1 3X.H

23<1

Georgia Department of Public Health

Telfair ----------------'fhomas ---------------Tift -------------------Ware ------------------
Wayne ---------------Wheeler --------------Wilcox -----------------
Worth -----------------

1.0,17 569 910 5t!7
H8 788 191 230

"167

<!<1.6

176

30.9

263

28.9

119

21.8

121

3'1.8

297

37.7

17

2'1.6

1!5

50.0

Rabies-Microscopic Examinations Table 16 gives a comparison of the microscopic examinations for
rabies made during the past five years.

TABLE 16
ANIMAL HEADS EXAMINED FOR RABIES 1936-1940

1936

1937

1938

1939

1940

Number heads examined -------- 1,135 Positive for Negri bodies-------- 590 Percentage positive ------------ :il.9

1.333 697
:12.~

1,164 538 16.2

987

1,252

H3

,196*

H.6

39.6

*Corrected to include mouse inoculation test results.
It will be noted from the above table that during the period 1937-1939 there had been a gradual decline both in the total number of examinations made for rabies and in the number found positive. During 19L10 there was a sharp increase in the total number of examinations and a small increase in the number of positives. This increase was solely due to an outbreak of rabies in predatory animals-chiefly the fox. Table 17, which gives a classification of the animal heads examined for rabies, shows that during the past year a total of 280 heads was examined and positive microscopic evidence was found in 86. Except for this epizootic among foxes, the decline both in the total and positive examinations would have continued.

Laboratories
TABLE 17 CLASSIFICATION OF ANIMAL HEADS EXAMINED FOR RABIES-1940

235

Animal

Central

Albany

Waycross

Totals

Pos. Neg. Tot. Unsat. Pos. Neg. Tot. Pos. Neg. Tot. SrJec. Pos.

Dog

261 339 600

llO

68 128

11

11

~2 7'i0 332

Fox

85 19! 279

1:1

1

0

1

0

280* 86

Cat

23

91 114

2

126

27

Cm.v

18

10

28

0

31

HJ

Bobcat ----- 0

10

10

0

tJ

0

IJ

10

0

Hog ------

10

10

0

0

0

12

0

Sqllirrel

11

11

0

11

0

Opossum --- 0

G

tJ

0

0

6

0

Raccoon --- 0

10

10

0

0

0

0

10

Chicken ---- 0

1

0

0

0

0

0

Weasel ----- 0

1

0

0

0

0

:i\:Iusl;;:!at ---

0

Mule ------

4

5

0

0

Rabbit -----

2

2

0

I)

0

Slnml\ ----- 1

2

0

0

nat -- ----- 0

0

Chipmunk --

Owl --------

Goat -------

'fatal ---- 389 694 1,083

27

65

78 143

13

1:1

26 1,252 467

*See narrative on HRabies Epizootic in Foxes".
In addition to those made in the State laboratories, examinations for rabies were also made in the Augusta and Savannah city laboratories. A classification of the findings in these laboratories is given in Table 18.
TABLE 18

Pos.

Dog -------------- 71

Fox

3

Cat

CO\V --------------
Hog - ------------

'l'otal ----------- 77

Augusta Neg.
27

Total 98 10

ll

118

Savannah

Pos.

Neg.

Total

2

The Augusta Laboratory showed a gain of 31 examinations during 19L10 as compared with 1939 and a gain of 4.8 positives. In addition to the positive findings in fox heads made by the State Central LaboratDl'y,

236

Georgia Department of Public Health

three positive .findings were made by the Augusta Laboratory. The Savannah Laboratory in 1939 had 41 rabies examinations and 10 positive, while in 194.0 no positives were reported in the 8 examinations made.

RABIES EPIZOOTIC IN FOXES
The first instance of rabies in the wild fox in Georgia was repmted in August, 1939, in Evans County. No subsequent cases were reported until March, 194.0, when increasing numbers of reports were received from Burke County of foxes being killed or driven off after bold daylight attacks on farm workers, live stock, poultry, and even dogs. Positive evidence of rabies was found in the heads of a number of domestic animals bitten by suspected rabid foxes, but it was not until June 1, 1940, that a fox head sent from Burke County was found positive. During this month two other fox heads were submitted for examination from this county, one of which was found positive and the other negative. The epizootic spread rapidly and by the end of the year 363 fox heads had been submitted for rabies examination from 17 counties. Positive findings were reported on 127 (35.0%) of these sent in from 13 counties.
Shortly after the appearance of the epizootic a control program was evolved by the county and State health authorities, the State and Federal wild life agencies, the State veterinarian, and the Rockefeller Rabies Research Laboratory, Montgomery, Alabama. This program included the hunting and trapping of foxes and other predatory animals, countywide dog quarantine, and the examination by the State Laboratory and Rockefeller Research Laboratory for evidence of rabies. With the exception of 65 foxes, 2 raccoons, and 2 opossums sent direct to the Rockefeller Foundation Laboratory, the heads of all predatory animals obtained under the control program were sent to the State Laboratory in Atlanta, where the brain and salivary glands were removed. Upon completion of the microscopic examination, the preserved glands and a portion of brain tissue were forwarded to the Rockefeller Foundation Laboratory for the mouse inoculation test.
The results of the microscopic examinations made in the State Laboratory will be found in Table 17. The tabulation in Table 19 shows the final report made on completion of the mouse test.

Laboratories

237

>tAP ~
NOTll: IJougherty County - 36 Fulton County - 5?
*Riohmond County - Auguste Lab - ?4

238

Georgia Depctrtment oj Publ~c H ealt!t

II A P 4

liAP SHOWING DISTRIBUTION 01 POSITIVE l"OX !lEADS: 1940

Map 3 shows the geographical distribution by counties of animal heads found positive for rabies. This map does not include positive findings in foxes. Noted on this map are the positive findings made by the local laboratory in Augusta. Map <1 shows the geographical distribution by counties of fox heads found positive for rabies. This includes three positive findings made by the local laboratory in Augusta.

Laboratories

239

TABLE 19 EXAMINATION OF FOXES FOR RABIES BY COUNTIES AND MONTHS-1940

County

Month Pos.

Broolrs ------------ Dec.

Bulloch ----------- Aug. Dec.

Burke _______________ June

July

<1

Aug.

29

Sept.

19

Oct.

11

Nov.

7

Dec.

5

Emanuel -----------Sept. --

Glascoell ----------Nov.

Gwinnett ---------- Sept.

Fiancoclt ____________Dec.

Jefferson ____________ July

Aug.

Sept. -- 2

Uct.

1

Nov.

7

Dec.

Jenldns _____________July

1

,.Aug.

0

Sept. --

Oct.

Lanier -------------Oct. Dec.

Lowndes ------------ Dec.

~\IcDuffie ---------- Dec. ltichmoncl --- ______ Dec.

Schley ------------ Oct. Taliaferro __________ Dec.

\Yashington -------- Sept.

3

Oct.

2

?\ov.

Dec.

2

Wilkes ------------ Nov.

Total ______________________127

Neg.

Tot.

Tot. Pos. Tot. Neg. G. Tot.

3

15

19

33

62

32

51

40

51

15

22

9

H

77

1<15

222

2

2

2

0

0

5

0

2

5

20

27

17

24

2<1

112

66

2

2

10

2

33

<10

35

<10

1

3

0

1

23:;

362

127

235

362

240

Georgia Department of Public Health

It will be noted in Table 17 that there were 13 fox heads reported as unsatisfactory for examination. The brains of four of these animals had been destroyed when the animals were killed. However, mice were injected with the salivary glands from these foxes and three positive and one negative were obtained. Only one specimen remained classified as unsatisfactory.
Besides those definitely diagnosed as rabid by laboratory tests, large numbers of foxes have been found dead in the woods and fields. Since there was no evidence of any other concurrent disease in foxes, it is believed these died of rabies also.
In connection with the investigation of this outbreak, there were 46 heads of domestic and predatory animals other than foxes submitted for examination. Five of these, including one skunk, were found positive. An undetermined but considerable loss of live stock, including mules, cows, hogs, dogs, and cats, has been established, the greatest loss occurring in Burke County. One prominent farmer reports that his loss of cattle exceeded $t100.00.
During the year, antirabic treatments were furnished for 26 humans bitten by rabid or suspected rabid foxes. These patients resided in six counties (Burke, Jefferson, Bulloch, Wilkes, Washington, and Lowndes) from which positive fox heads had been received and in four counties (Harris, Seminole, Miller, and Cook) in which the heads of the biting foxes were not available for laboratory examination. Fortunately, none of those persons bitten by the foxes developed rabies.
The most plausible explanation of the magnitude of this outbreak is that the wild fox population throughout the Southeast has greatly increased in number and density during the past few years. Fox hunters and students of wild life confirm this. If this be true, the obvious solution to the problem of control will be the reduction of the wild fox population to such extent that contact transmission of the infection from fox to fox cannot readily take place. A decline in the incidence of the disease has already been noted and it is hoped that when the fox population is reduced to certain limits, through disease or slaughter, rabies in foxes will again be of infrequent occurrence.
ivfouse lno~ulation Test for Rabies
The mouse inoculation test was employed in those cases where the microscopic examination is not in agreement with the animal history.
During the past year, 171 mouse inoculation tests were made. Twenty nine or 17.0% were positive. This was an increase of 35 tests over 1939 and a decrease of ll positives. The mouse inoculation test is made only in the Central Laboratory.
il!f iscellaneozts Table 20 shows the miscellaneous examinations made by the several
laboratories during 194.0.

Lctboratories
TABLE 20 CLASSIFICATION OF MISCELLANEOUS EXAMINATIONS

Central

J.Jueba -- -- ------ -- -------- -- 583

Pneumoeoccus typing --------------- --

32

Vincent's angina ---------------------- 212

'frichomonas vaginalis -- -------------- 292

Chancroid (B. ducrey) ------------------

31

Examinations for type of organism ----- 220

Spinal fluids for meningitis ____________

20

CuHures --------- - ----------------- --- H9

Unclassified -------------------------- 321

1'otal -- - ------ ------------------ 1,910

Albany
80 lUi
87 15
6 97 17 119 3']
562

Waycross
130 3o 31
131 15
102 2
127 75
649

Total
793
~2:-1
330 '133
52 419
39 395 430
3,121

This was a decrease of 513 such examinations. Pneumococcus typing work declined from 312 in 1939 to 225 in 19L10. The increased popularity of chemotherapy of pneumonia is largely if not entirely responsible for this decrease. One hundred forty-five positive typings were obtained in the 312 specimens submitted. Ten specimens showed two types. The distribution of these types is given in Table 21 and Diagram 6.

Georgia Department of Public Health

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SN:31NI?:3dS :3AI.LISOd .dO l:l:381NnN

Laboratories

243

TABLE 21 DISTRIBUTION OF PNEUMOCOCCUS TYPES IN 135 POSITIVE SPECIMENS

Type

No. in Central

No. in Albany

No. in Waycross

Total No.

------------ 8

18

0

0

3 -----------

----------- 2

3

29

0

19

5

----------- 11

22

----------- 2

-----------

0

10 ----------- 1

0

0

11 -----------

0

2

12 -----------

2

13 ------------ 2

3

14 ----------- 2

1

15 ----------- 1

2

1

4

16 ----------- 2

17 -----------

2

18 -----------

1

19 ----------- 2

20 ----------- 2

21 -----------

2

22 -----------

2

3

23 ----------- 2

<J

24 -----------

25 -----------

27 ------------ 0

28 ----------- 0

29 ----------- 1

31 ----------- 6

32 -----------

'!'otal __ 67

59

19

:."'o. Double Types 8

10

CULTURE UNIT
Under this heading are included blood and stool cultures, agglutination tests for typhoid, typhus, and undulant fevers and for tularemia, as well \s a miscellany of special bacteriology.
Agglutination Tests During the year, 10,285 specimens of blood were tested for agglutinins,
a decrease of 1,488 from the preceding year. The positive results obtained as compared with 1939 are given in Table 22.

244

Georgia Department of Public Health

Table 22 AGGLUTINATION TESTS

1940

1939

Typhoid ____________________________________ --------- 369

23i

Endemic 'l'yphus (Brill's) ------------------------- _ 429

832

Undulant

153

14'1

rularemia --------------------------------------------

97

130

A marked decrease in the incidence of endemic typhus as well as a noticeable decrease in tularemia is indicated in the decrease of positive Weil-Felix reactions and agglutination tests for tularemia. Since the diagnosis of these infections is based chiefly on the laboratory findings, it is felt that this marked decrease represents an actual marked decline in the incidence of these diseases. During the year, 12 cases of Rocky Mountain spotted fever were reported and the clinical diagnosis confirmed by the United States Public Health Service Typhus Research Laboratory at Albany. Three of these cases terminated fatally. A fourth case, which also terminated fatally, was clinically suggestive, but unconfirmed by laboratory test.
BLOOD CULTURES-chiefly clots cultured for typhoid-declined from 9,558 in 1939 to 8,7LU in 1940, while the positive findings for typhoid increased from 255 in 1939 to 265 in 194.0. Of especial interest in the field of enteric bacteriology was the occurrence of an epidemic of 13 cases of typhoid fever caused by the small colony variant type of Eberthella typhosa. Positive blood cultures were obtained from 9 of these cases and positive stool cultures from II. Two cases terminated fatally. A report on this outbreak, the first of its kind to be recognized in this country, is being prepared for publication.
Partly as a result of improved technical procedures, the isolations of Brucella in blood cultures increased from ILl. in 1939 to 22 in 19LW. Special culture outfits are also being provided for collection of blood from those cases whose blood shows high titres of agglutinins for Bmcellct. Included in the positive blood culture findings are isolations of Staphylococci (9), Streptococci (6), and Salmonella suipestifer (3).
STOOL AND URINE CULTURES increased from 6,633 in 1939 to 7,ll2 in 1940, while positive isolations for typhoid decreased from 4.53 to 360 during the same period. Positive stool cultures for bacillary dysentery increased from ll4. in 1939 to 136 in 194.0. During the year, a study was made of various media used in the isolation of dysentery bacilli which resulted m an improvement of methods for culture and identification.
SYPHILIS SEROLOGY Serologic tests for syphilis increased from 2ll,379 in 1939 to 232,326 in 19"10, a gain of 20,9L17 or 9.9%. A comparison of the tests made in the several laboratories is shown in Table 23.

Laboratories

TABLE 23 SYPHILIS SEROLOGY (I<AHN}

Blood

Central

1940 1939

li;8,079 H2,892
+ lri,l87

Spinal Fluids

1940 ------------

594

1939 -------------

5'18

Blood and Spinal Fluids 1940 ------------ 158,673 19:19 ------------ 1'13,<140
-l-15,233 (10.6%}

Albany
-IO,l.J.l 36,695 -j-3,449
124 128 -'1
,10,268 36,823 -I-3,<Hil (9.3o/c)

Wayoross
33,300 31,032 -j-2,268
85 84 -l-1
33,385 3!,116 -j-2,269 (7.3%}

Total
231,523 210,619 -1-20,904
803 71W
232,326 211,379 -l-20,9,17 (9.9%}

Sixteen and seven-tenths per cent. of these specimens showed positive reactions in 194-0 compared to 18.9'/o in 1939. One hundred fifty-eight thousand seventy-nine (68.3%) of these specimens were examined in the Central Laboratory; L.10,144 (17.2%) in the Albany Branch, and 33,300 (H.S%) in the Waycross Branch. In compliance with a request from the United States Public Health Service in October, arrangements were made to perform the Kahn test in the Central Laboratory on specimens of blood submitted from registrants of the various local Selective Service Boards. From this source 1,091 specimens were received in November, and L.1,850 in December.
Following the Intra-State Syphilis Serology Evaluation Study in 1939, four laboratories in the State requested and received assistance in the improvement of the performance of the serologic tests employed by them.
The Central Laboratory participated in the National Syphilis Serology Evaluation Study conducted by the United States Public Health Service in 1940, and obtained a very creditable rating with not only the Control Laboratory of the method employed, but also with the other procedures used throughout the country. An invitation to again participate in a similar study in 19L.1l has been accepted.
Darkfield Examinations
The Clarkfield examinations increased by 27 specimens over the preceding year. A consolidated report on the examinations made in the several laboratories is given in Table 24.

Georgia Department of Pztblic 11ealth
TABLE 24 DARI<FIELD EXAMINATIONS FOR TR. PALLIDA

Pos.
Consolidated Report: Specimens collected in laboratory_________ Specimens received by maiL_____________ 75
T01'AL ---------------------------- 8! Central Laboratory: Specimens collected in laboratory________ _ Specimens received by maiL~------------ 66
1'0'l'AL ---------------------------- 72
Albany Branch: Specimens collected in laboratory________ _ Specimens received by maiL ______________
1'01'AL ----------------------------Waycross Branch: Specimens collected in laboratory ________ _ Specbnens received by malL ____________ _
T01'AL --------------------------- _ Specimens examined in 1940 ________ 375 Specimens examined in 1939 ________ 338
Increase ----------------------- 37

Doubtful 8

Neg.
36 246 282
21 221 2 112
1;)
18 33

Total
16 329 375
27 295 322
17
2;)
42
11

In 1939, there were ll6 clarkfield specimens collected in the laboratories while there were only <1.6 in 19<10. Two hundred twenty-two specimens were received by mail in 1939 compared to 329 in 1940. Of the L16 specimens collected in the laboratory, 9 (19.6%) were positive. Of the 329 specimens received by mail, 75 (22.9%) were positive.

Labomtories

247

BIOLOGIC PRODUCTS
TABLE 25 BIOLOGIC PRODUCTS AND DRUGS DISTRIBUTED

Product

Central

Diphtheria Antitoxin, units------------------- <!1,849,000

Alum Precipitated Toxoid, co. ______________ _

63,470

Plain Toxoid, cc.___________________________

<1,830

Schick Material, tests----------------------Toxin Antitoxin, cc,_______________________ _

41,380 300

retanus Antitoxin, units--------------------- 2,803,000

Tetanus Toxoid, cc. ------------------------'l'yphoid Vaccine, cc._______________________ _ Tet1achlorethylene, 0.5 cc. cap,_____________ _ Oil of Chenopodium, cap,___________________ _

60 691,670 87,866
650

Carbon Tetrachloride and Oil of

Chenopodimn };fixture, oz. ______________ _

Smallpox Vaccine, points___________________ _ ':Puberculin, Diluted, cc. ____________________ _ Tuberculin, P.P.D., tests ___________________ _

103,815 17,700 2,050

Scarlet Fever Antitoxin, units______________ _

18,000

Silver Nitrate, a.m}JOules~ ------------------Antimeningococcus Serum, cc,________________

82,968 540

Brucella l\lelitensis Vaccine, cc,____________ _

Die!< Test, tests _________ -------------------

50

Antivenin, cc. __________ --------------------

30

Antipneumococcus Sennn, units _____________ _ 'j ,060,000

*.Arsenicals, ampoules ---------------------Bismuth Subsalicylate in Oil, cc, ____________ _

194,054 516,540

Stovarsol, 0.25 gm. tablets-----------------Sulfanilamide, 5 gr. tablets________________ _
**Distilled Watel', cc. ______________________ _

19,000 351,000 2,685,370

Yeast, pounds -----------------------------
***.Antirabic 'Jlrea tments --------------------

21;117 2,073

Albany
2,690,000 4,655 0 1,200 0
610,000 0
54,970 17;100
0
4,730 0 0 0
5,207 120 0 0 0
1,000,000 255 60
463,660 0
H4

Waycross
2,H5,000 3,360 0 910 0 4,500 0 28,580 5,025 0
3,815 0 0
3,111 0 0 0
510,000 270 0
136,710 0
26

*Equivalent to 169,628 doses of .6 gm. or less. **Distributed in 10 cc. and 100 cc. bottles. ***The figures given for the Branch Laboratories do not represent complete treatments. Four vials of vaccine are supplied by the Branch Laboratories from each patient for wh01n treatment is requested. The remainder of the treatment is sent from the Central Laboratory.
NO'l'E : ':J.lyphoid Yaccine, antlrablc treatment, silver nitrate and distilled water are manufactmed by the Central Laboratory. Other products are purchased from various commercial houses and distributed gratis or at cost price. All biologics clistributed by the Branch Laboratories are invoiced to them from the Central Laboratory, so that the distribution recorded f1om the Central Laboratory represents the total distribution for the year.

Georgia Department of Public Health
TABLE 26 BIOLOGICS SHOWING MARJ<ED INCREASE OR DECREASE OVER 1939 DISTRIBUTION

Product

1939

Diphtheria Antitoxin ____________________ Alum Precipitated 'foxoicL________________
Plain Toxoid --------------------------Tetanus Antitoxin ________________________ Smallpox Vaccine ________________________
1'yphoid Vaccine ------~----------------1'uberculin, Diluted ______________________ Antipneumococcus Serum ________________
Sulfanilamide ------------------------ ___ Distilled Water -------------------------

59,366,000 63,035
7,830 1,697,000
1\5,820
<!92,190 12,338
10,3<!0,000
100,000 1,315,380

1940
37,014,000 55,455 4,330
2,188,500 95,270
608,120 17,770
5,520,000 351,000
2,035,850

Increase or Decrease
22,352,000 7,5803,000-
+ 491,500 + 29,450 + 115,930 + 5,']32
4,820,000-
+ 251,000 + 770;!70

It will be noted from Table 26 that there was a marked decrease in the distribution of both diphtheria antitoxin and toxoid. This is, no doubt, accounted for by a lower incidence of diphtheria throughout the State. There was also a marked decline in the distribution of anti pneumococcus serum attributable to the increased popularity of chemo therapy for pneumonia. There was also an appreciable increase in the distribution of smallpox vaccine points, typhoid vaccine, tetanus anti toxin, the various drugs used in syphilis therapy, and distilled water.
Hwnan Antirabic Treatments A total of 1,903 completed human antirabic treatments was distrib-
uted in 194.0. This was a decrease of <1-91 (20.5%) treatments from the preceding year. This was the lowest number distributed since 1932. A comparison for the past five years is given in Table 27 and a classifica tion according to type distributed during 1939 and 1940 is given in Table 28.
TABLE 27
ANTIRABIC TREATMENTS AND RABIES MORTALITY

Year

Human Treatments

Human Deaths During or After
Treatment

Human Deaths Without Treatment

Total Deaths

10:lll ---------------1937 ---------------1038 ---------------1939 ----------------1940 ---------------

3,027 3;1<15 2,933 2,39<! 1,903

4

2

2

Laboratories

II A P 5

IIAP SHOWING DISl'RIBUl'IO!I OF liUliAll' ANI'IRABIC TllEA'l'llml'S: 1940 Total Number - 1 , 903
I!Qte: Bibb CoULity - 106 Dougherty County - 86 Fulton CoULity - 202 R1ohlllond Couaty - 180 Walkor CoULity - 81

Map 5 shows the distribution of human antirahic treatments. The total of 1,903 was distributed among 138 counties.

250

Georgia Department of Public Health

TABLE 28 CLASSIFICATION ANTlRABIC TREATMENT BY TYPE

Type Treatment

1939

Number

Per Cent

Precautionary -------------------
lVIild ----------------------------Intensive -----------------------
Drastic -------------------------
TOTAL ---------------------

9<19 1,296
135 1<!
2,391

39.64 54.13 5.63
.'iS

1940

Number

Per Cent

707 1,097
87 12 1,903

37.15 57.65
<!.57
.6~

There was one human death from rabies during 1940. The patient received no antirabic treatment. Diagnosis was based on clinical symptoms, since the case was reported too late for a laboratory study. The case history is as follows:
The case (W. C.) was that of a 25-year-old white male, a resident of Sassafras, Kentucky, employed by a traveling carnival. Information given by a companion at time of admission to the hospital, December 7 (Dr. Robert Pendergrass, Prather Clinic, Americus, Georgia), was to the effect that the patient had been bitten by a suspected mad dog which attacked other dogs, on the carnival lot some three to five weeks previously. Later (exact elapsed time unknown), he was bitten on the nose by his own dog, which was run over by a car and killed shortly after attacking him. No examination was made of the dog's head, and rabies was not suspected until the patient became ilL Patient had been confined to bed for three days before admission, but no clinical history is available. The following physical findings were recorded on admission: Temperalure 102, pulse 116, respiration 22, some tendency to flaccidity of the leg muscles, able to open and close mouth and there was no other evidence of frank paralysis, pupillary reactions normal, no convulsive signs exhibited when exposed to light or sudden noises, few moist rales in lower left lung posteriorly, intermittently irrational and unable to answer questions. The following symptoms were recorded morning of December 8: Temperature elevated, wild look in eyes, excess of saliva, head continually bobbing up and down, leg movements weaker, patient would make no effort to stand. Patient was given 2 cc. sodium luminal. Other medication consisted of sulfapyradine, caffeine benzoate, and dilaudid. Adrenalin and metTazol were given to offset sodium luminal, but patient remained comatose until death at 5:45 p. m. Temperature at 5:15 p. m. was 105 2/5 degrees. It was the doctor's opinion that fever and respiratory depression were of cerebral origin. Diagnosis of rabies based on history and clinical symptoms and not confirmed by laboratory findings. No autopsy was done.

Laboratories

251

Specimen Outfits
Table 29 shows the distribution of specimen outfits by each laboratory.
TABLE 29
DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES

Central

Keidel Tubes -------------------------Sterile Col"ired Vials___________________ _
Darl<field Outfits ---------------------Diphtheria Outfits ---------------------Slide Outfits ---------------------- ____ _ Slides _________________________________ Intestinal Parasite Outfits, Routine______ _ Intestinal Parasite Tins, Survey________ _ Sputum Outfits _ ---------------------Stool Culture Outfits __________________ _

1<12,691 87,6<11 812 3,193 11,502 37,632 7,829 69,331 17 ; I ' l l 10,562

Syringes

1 ec. Tuberculin -----------------

31

2 cc. Hypodermic ----------------

205

cc. Hypodermic

102

10 cc. Hypodennic

520

Needles 19 Gauge 22 Gauge 2<1 Gauge 26 Gauge

38 dozen 19 dozen '11 dozen 121 dozen

Albany
H,333 27,596
67 5Jl 2,118
39 1,H9
238 1,775 1,596

Waycross
1,032 8,267
56 356 793
0 0 27,935 1,089 374

Table 30 gives a comparison of the total distribution of these outfits for 1939 and 194-0.
TABLE 30
DISTRIBUTION OF SPECIMEN OUTFITS
TWO YEAR PERIOD - 1939- 1940

Increase or

1939

1940

Decrease

Keidel Tubes --------------------------Sterile Corked Vials____________________ _
Dal"i<field Outfits ------------------ _____ _
Diphtheria Outfits ---------------------Slide Outfits ---------------------------Slides ______ ---------------------------Intestinal Parasite Outfits, (Routine) ____ _ Intestinal Parasite ~rins, (Survey)--------
Sputum Outfits ------------------------Stool Cuitl!l'e Outfits---------------------

150,237 62,397 947 4,908 11;191 39,390 6,317
116,933 12,837 10,060

H2,691 87,644 812 3,193 11,502 37,632 7,829 69,33<1 17;1<11 10,562

7,596-
+ 25,2<17
1351,715-
11-t1,758-
+ 1;182
17,599-
+ <1,60<1 502 +

252

Georgia Department of Public Health

MEDIA AND VACCINE UNIT
TABLE 31

Media:
Beef Infusion Double____________________ -----------_-------------- ________ _ J?orh: Infusion -----------------------------------------------------------Beef Infusion Broth _____ --------------------------------------------------Beef Extract Broth-------------------------------------------------------Selenite ''F '' _____________________ -------------------------------------- __ _
Conradi's Bile -----------------------------------------------------------1\Iiscellaneou::; Broths ------------------------------------------------------Beef Infusion Agar___ ----------------------------------------------------Beef Extract Aga.1 ___ ----------------------------------------------------1 'ork Infusion Agar ------------------------------------------------------l<Jndo's Stocl< Agu ___ ----------------------------------------------------Wilson Blair Agar ___ -----------------------------------------------------Desoxycholate Citrate Agar________________________________________________ _ Russell's 'friple Sugar Agar________________________________________________
l\Iiscellaneous Agars ------------------------------------------------------Loefi'let's Blood Serum Medium____________________________________________ _
Petragnani's _ -------------------------------------------------- _________ _ Frye's l\Iedimu __ Sugar Fermentation 'rubes ------------------------ -------------------------Miscellaneous l\Iedia

1<15,000 cc. 70,000 cc. 58,900 cc. 7<1,000 cc. 25,000 cc. 114,000 cc.
t!,050 cc. 1'13,800 cc. 14,000 cc.
56,000 cc. 24,000 cc. 110,000 cc. 45,700 cc. 16,400 cc. 3'1,260 cc. 13,986 cc. 20,000 cc. 5,200 cc. 11,000 cc.
2,050 cc.

Soltttions and Indicators:
Indicator.::; for :\ledia------------------------------------------------------Dyes for Media Heagents for illedia -------------------------------------------------------Bismuth Sulphite "-Iixture------------------------------------------------0 lycel'ine Salt Solution__ ----------------_----- __ ---------- __ ------ ________ _ BaH Solution _________________________________ --------- ___________________ _
1\Ii:;cellaneous Solutions

1,050 cc. 750 cc.
5,100 cc. 13,000 cc. 91,000 cc. 8'15,000 cc. '15,900 cc.

Silver Nitrate:
Solution (1o/o) matte 1940-------------------------------------------------Xumber Ampoules made 1940----------------------------------------------Numbel' Ampoules filled 1940-----------------------------------------------

43,600 cc. 100,000 cc. 95,000 cc.

Sterile Distilled Water:
Watet filled 19<10 ------------------------- --------------------------------Water distributed 19<10 (approx.) --------------------------------------------

2,073,,100 cc. 1,958,800 ce.

Diluted Tuberculin (Old):
Tuberculin diluted 19'10 ------------------------------------------- ________ _ 'l'uberculin distributed 19'10------------------------------ ----------

18,613 cc. 18,263 ce.

Sterile Salt Solution: Salt solution distributed 1940-----------------------------------------------

2,,130 cc. 1,203 cc.

Typhoid Vaccine:
Lots of vaccine made- 3 Vaccine diluted and filled 19,10 -------------------------------------- ___ _ Vaccine released (apptox.) 19,10 __________ --------------------. -------------

885,000 cc. 696,590 cc.

Laboratories

253

PERSONNEL
Although there was a marked increase in laboratory activities during 19L10, the work was accomplished with very little increase in technical personnel.
There were 61 employees in the three laboratories ~excluding personnel in the water laboratory who are employed by another Division). Forty-eight are employed in the Central Laboratory and the other 13 in the Branch Laboratories. Forty-four are white and 17 colored. An increase in personnel was required in the syphilis serology unit as a 1esult of the institution of blood testing for the Selective Service Boards. One clerk has already been added, and another will be employed in January. Two very important additions were made in the laboratory organization. One of these was the employment of an experienced junior bacteriologist to di1ect the activities in the glass-washing and sterilization rooms. The other was the addition of a statistical clerk whose chief duties have to do with the analysis of laboratory statistics, the preparation of monthly anc1 annual reports, and special assignments in statistical research.
The death of Alex Sutton, colored, on August 17, was a great blow lo the laboratory. Ale~.: came to us in the capacity of janitor and porter May 1, 1912. By reason of his diligence, untiring energy and loyalty, he soon endeared himself to the entire personnel of the State Health Department. For many years prior to his death he had been in charge of the glass-washing and sterilization work for the entire laboratory. The personnel classification of each laboratory is as follows:
CENTRAL LABORATORY
Medical Director -------------------------------------- 1 Assistant Director ------------------------------------- l Sen~or Bacter~olog~sts ---------------------------------- 2 Jumor Bactenologists ------------~---------------------- 6 Technicians, Bacteriological ----------------------------- 7 Senior Serologist ___________ --------------------------- 1 Technicians, Serological --------~----------------------- L1 Office Secretaries -------------------------------------- 2 Steno-clerk ------------------------------------------- 1 Statistical Clerk ---------~-------------------------~--- 1 Report Clerks ----------------------------------------- 3 Shipping Clerks _____________ ~ __________________ ~~-- 4
Store Room Foreman ----------------------------------- 1 Porters (colored) -~-------------- ~-------------------- 2 Animal Keeper (colored)------------------------------- 1 Dieners (colored) ---------~------------------------~-- l l
48

254.

Georgia Department of Pnblic Health

ALBANY BRANCH
Director _______________ l Junior Bacteriologist ____ l Serologist ______________ l Technician, Bacteriological l Secretary ______________ l Porters ________________ 2

VVAYCROSS BRANCH
Director --------------- l Junior Bacterologist _____ l
Serologist -------------- l Technician, Bacteriological l Secretary ______________ l Porter _________________ l

7

6

RESEARCH AND INVESTIGATION

Due to the long-felt need for the services of a research bacteriologist to carefully investigate new and old laboratory technique, an effort was made to obtain someone properly qualified for this function. A number of applicants were considered, hut so far none has been found to be satisfactory. It is hoped that this very important position can be filled during the coming year. Nevertheless, a certain amount of research and investigation was done, as fallows:

l. Study of B. proteus X-19 antigens with a view of selecting a more potent and sensitive strain for use in the performance of the VVeil-Felix test for typhus.

2. Investigation of preservatives used in the preparation of typhoid vaccine. As a result of the war, certain sources of reliable brands of preservatives have been interrupted and it has been necessary to evaluate American-made substitutes. One lot of trikresol apparently made in this country was found to be greatly deficient in its preservative power.

3. Comparison of efficiency of clarkfield technique of demonstrating spirocheta pallida with the nigrosine stain as devised by Dr. E. S. Sanderson of the University of Georgia. It was found that the staining method was not in our hands as efficient as the darkfield technique.

4. Comparison of our own procedure of performing the brine flotation technique for demonstrating ova of intestinal parasites with other methods, principally that of VVillis. No definite decision has been reached, hut we are of the opinion that our own method is just as efficacious as the VVillis technique.

5. Investigation of methods of culturing Brucella from blood. The use of special media recently devised by Difco, incubated in a partial atmosphere of carbon dioxide, has greatly increased the number of isolations of Brucella.

6. Investigation of special media devised for the isolation of members of Shigella group. The advent of certain new media has greatly increased the number of isolations of this group of organ-

Laboratories

255

isms. In this study we worked conjointly with the U. S. Public Health Service Research Laboratory at Albany under the direction of Dr. James E. Watt.
7. Investigation of an outbreak of rabies among foxes in East Cen tral and South Georgia. Reference is made to this outbreak under the topic of rabies. Our laboratory worked in conjunction with the Rockefeller Rabies Research Station at Montgomery in this investigation,
8. Study of the outbreak of typhoid fever due to the small colony variant of E. typhosa. While isolated instances of the small colony strain have been encountered in Georgia during the past few years, this outbreak is apparently the first one on record in this country where the small colony variant was solely involved. One paper pertaining to the study of the small colony variant has already been submitted for publication and another is now in process of preparation.
C). Investigation of Staphylococcus food poisoning. A rather extensive outbreak involving more than 90 persons occurred at Thomaston, Georgia. It was found that this was due to buttermilk contaminated with a highly toxic strain of staphylococcus. Laboratory studies on subsequent smaller outbreaks due to contaminated pastries and meats seemed to indicate that this is a very common form of food poisoning, the importance of which has heretofore been greatly neglected.
10. Study was in progress at the close of the year which had to do with the application of mechanical methods of reporting laboratory results by means of the International Business Machine System. Not only is it hoped that the use of this system will expedite reporting and save labor and additional personnel, but also that it will permit the utilization of a large amount of valuable data furnished on the specimen information blanks which heretofore has not been utilized. Preparations are made to put this system into use by January 1, 1941.

STUDENT TRAINING
Great improvement was made during the year in our system of student trmmng. The minimum requirements for admission are two years' college wOTk in chemistry and biology and preference is given to college graduates. The accepted applicant spends one full year in training on a rotating basis, working from six weeks to three months in each unit of the laboratory. While in training the student is given instruction in the regular laboratory routine and is assigned certain duties of gradually increasing responsibility. This enables the director of each unit to guide both the instruction and manual experience of the student in such a way

256

Georgia Department of Pltblic Health

that when the time for the next rotation comes around he or she has obtained a satisfactory degree of experience and theory. Examinations are given at the time of each rotation. Students thus trained are more efficient in public health bacteriology than those coming from universities or colleges. Replacements and additions to the technical staff of the laboratories are selected largely from the student trainee group.
At the end of the year there were six students in training at the Central Laboratory and one each in the two branches. During the training period, no tuition is charged or salary paid to the trainee.

NEW LABORATORY QUARTERS
Early in the year the Central Laboratories were installed in their new quarters in the recently completed State Office Building. Not only did this meet the imperative demand for more space, but also the physical arrangement and utilities of the new quarters, such as ventilation, air conditioning and fixed equipment, provided working conditions which are hound to greatly increase the efficiency and capacity of the laboratories. Due to careful planning and installation of the best and most modem material, the Central Laboratories are now admitted by qualified critics to he second to none in the United States.
FUTURE NEEDS AND RECOMMENDATIONS
l. ONE ADDITIONAL BRANCH LABORATORY should be established in Central Georgia to serve about 25 counties situated north of the Altamaha Basin and east of Macon. The exact boundaries of the territory in question cannot be defined, except by experience. Unfortunately, there is no town or point centrally situated in this area suitable for the location of a branch laboratory. Because of the convergence of all of the principle railway lines and highways toward Savannah, it is probable that this city would provide the best location. It is estimated that the proposed additional branch will cost about $8,000 to house and equip, and $10,000 per year to maintain. The latter figure, however, is entirely dependent upon the specimen load which cannot be determined until after the operation has begun.
2. PUBLIC HEALTH FOR STATE EMPLOYEES. For many years and up to the present time no provision has been made for first-aid and emergency medical service to employees in the Capitol Building and adjoining State Office Building. There has been an increasing demand on the medical personnel of our State Health Department for such service, but unfortunately no policy has been adopted or provision made by the Health Department to take care of it. Due to the fact that the medical director of the Laboratories is more apt to he on hand than the medical personnel directors of other divisions, such demands fall largely on his shoulders and thus hamper his own duties and responsibilities as director of the

Laboratories

257

Laboratories. Furthermore, when any employee in the State Capitol or adjoining buildings becomes suddenly ill and needs emergency treatment, there is no place to receive such persons or to make them comfortable. Somewhere in or near the Capitol a suite of rooms should be provided in charge of a registered muse who can administer first-aid and see to it that proper steps are taken in each individual case. This clinic should not be a responsibility of the State Department of Public Health and certainly not a responsibility of the director of laboratories. The services of such a clinic should be definitely restricted to administering first-aid measures and under no circumstances should include medical service or practice beyond the emergency status. Many industrial plants and business concerns maintain such clinics, thus salvaging the loss of many thousands of working hours annually.

Division of Information and Statistics
D. M. Wolfe, M.D., Director
The annual report for the year 19L10 for the Division of Information and Statistics is respectfully submitted.
PuRPOSE-This division has for its purpose the recording of a certificate for each birth and death occurring in the State, the compilation of re ports of cases of reportable diseases, the preparation of morbidity and mortality reports.
ORGANIZATION-The division is made up of two parts, the vital statistics and communicable disease reporting section and the central tab ulating unit.
During 1940 there were 64.,695 births, 32,285 deaths and 3,078 stillbirths registered.
The current birth and death certificates for 194.0 were handled in the routine manner. They are received, arranged in alphabetical order by county, checked for completeness, queried for necessary additional information, credited to the local registrars, financial statements prepared for county financial agents, coded for place of residence (for reallocation tabulations) and all death certificates coded for cause of death by the Intemational List of Causes of Death and the Joint Cause Manual.
They are numbered and bound into volumes of 500 certificates each and punch cards made for each certificate of birth, death and stillbirth. These punch cards are verified against certificates and are used in making routine and special tabulations. The certificates are indexed and filed in alphabetical order.
There were 283 requests for special tabulations in regard to mortality statistics received and answered during 1940.
During 1940 the demand for certified copies increased tremendously as a result of the defense program. Congress passed laws regarding workers in defense industries which made it necessary for each worker to produce evidence of his citizenship. This would mean a birth certificate in cases of native born Americans.
As many of these persons were born prior to January l, 1919, they did not have a birth record on file. The division has done and is doing everything possible to assist these Georgians in getting their births recorded and during 194.0 we placed on file 1L1,872 delayed registration certificates. It was necessary to return thousands of these records for ad. ditional information as they failed to meet specifications for filing.
During 1940 the division issued 10,522 certified copies, whereas, only 12,286 certified copies had been issued since the work was started January, 1919. Of the 10,522 certified copies issued, 9,752 were birth and 770 death certificates, respectively. The demand for these records was greatest during the last five months of the year. In order to meet this

Information cmd Statistics

259

demand it was necessary to have some rapid method of producing certified copies. In October we started photostating certified copies and have been able to keep up with this phase of the work.
During 19L10 the Department of Public Health started cooperating with the Social Security Board in supplying Proof of Death certificates in order to speed up payment of claims to families of workers covered by this Act.
Special transcripts of birth certificates for babies born in Georgia during December 1939 and the first three months of 1940 and death certificates for babies born during this period were furnished the Bureau of the Census. These records are to serve two purposes, one being a check on birth registration, and the second, a check on the 19L10 census takers.
Routine transcripts are being sent the Bureau of the Census.
Communicable disease reports are received, tabulations made and cross indexes are made. The division issues weekly and monthly morbidity reports and the monthly mortality report.
The Central Tabulating Unit prepares Venereal Disease reports. The abstracting of the Venereal Disease Clinic records was started in August and 35 clinics were included in the September report. The December report was for 101 clinics.
Plans are being made to place other work on the machines as the procedure can be satisfactorily worked out and the work scheduled.
STATISTICS
BIRTH RATE: The birth rate for Georgia declined from 20.8 per 1,000 population in 1939 to 20.7 in 19'10, or a decrease of 0.2 per cent. The rate for Georgia is still considerably above the birth rate for the United States as a whole.
STILLBIRTHS: There was a further drop in the stillbirth rate from 49.7 per 1,000 live births in 1939 to '17.5 in 1940, or a decrease of '1.3 per cent.
MATERNAL MoRTALITY: The maternal mortality rate decreased from 5.5 per 1,000 live births in 1939 to 5.3 in 194,0, or a drop of 3.6 per cent in the maternal mortality rate.
INFANT MoRTALITY: There was a decline of 1.8 per cent in the infant mortality rate for 19'10 when the rate dropped from 58.8 in 1939 to 57.8 in 19L10. It should be emphasized that the 19L10 stillbirth, infant and maternal m01tality rates are the lowest recorded since the establishment of the Bureau of Vital Statistics.
During 19L10 the lowest death rates for the preventable diseases, or diseases amenable to public health measures, were recorded. Attention is thereby focused on the degenerative diseases which in the future should be considered public health problems. The public health attack on these problems should be educational. It must drive home the importance of periodic health examinations and proper medical care early in illnesses.

260

Georgia Department of Public Health

TYPHOID FEVER: The 19L10 typhoid death rate of 2.2 per 100,000 population is the lowest ever recorded for the State of Georgia. The rate dropped 18.1 per cent from the 2.7 in 1939 which was the previous all-time low. The number of deaths dropped from 83 in 1939 to 68 in 1940.
TYPHUS FEVER: The typhus death rate decreased 40.7 per cent from 19.39 to 1940 when the rale dropped from 1.4 to 0.8 and the deaths from 44 in 1939 to 26 in 1940.
MALARIA: The malaria death rate for 19L10 was a new low for Georgia, the death rate being 2.8 per 100,000 population or a decrease of 12.0 per cent. The number of deaths dropped from 101 in 1939 to 89 in 1940.
SMALLPOX: There were no smallpox deaths recorded in ] 940.
DISEASES OF CHILDHOOD: There was a decline in the death rate from MEASLES from 1.6 to 0.7 in 1940 or a decrease of 55.2 per cent. The number of deaths decreased from 51 in 1939 to 23 in 19L10. ScARLET FEVER: There was a decrease in the number of deaths from this disease from 19 in 1939 to 16 in 1940 when the rate dropped from 0.6 to 0.5 or 15.0 per cent. WHOOPING CoUCH: There was a 19.6 per cent decrease in the death rate hom this condition. The number of deaths declined from 134 in 1939 to 108 in 194.0.
DIPHTHERIA: There was a marked drop in the diphtheria death rate from 3.0 to 1.9, or 38.2 per cent. The number of deaths dropped from 95 in 1939 to 59 in 1940.
INFLUENZA: There was a slight decline in the death rate from influenza when 924. persons died from this disease in 194.0 as compared with 950 in 1939. The rate dropped from 30.4 to 29.6 in 194-0.
DYSENTERY: The deaths and death rates from this condition remained practically the same, as 126 persons died in 1940 as compmed with 127 in 1939.
PoLIOMYELITIS: There was a decrease in the number of deaths from 12 in 1939 to 7 in l9L10. The rate dropped from OA. in 1939 to 0.2 in l9L10 or 38.2 per cent.
MENINGOCOCCUS MENINGITIS: There was a decrease from 0.5 to 0.3 in the rate, or 4.2.1 per cent. The number dropped from 12 in 1939 to 7 in l9L10.
TUBERCULOSIS: The tuberculosis death rate remained practically the same for 1940 as in 1939 as the number of deaths from this eondition for the two years was exactly the same; 1533 persons died from this condition during each of the two years.
SYPHILIS: There was an increase in the number of deaths from this disease from 4.73 in 1939 to 587 in 194-0. The rate increased from 15.1 to 18.8, or 2L1.l per cent. I do not think this is an actual increase, nor do I believe that this is anything like the actual number of deaths caused by this disease. Many of the syphilis deaths are masked by such terms as heart disease and insanity. Also, the expanded syphilis program and the fact that this disease has had so much publicity has resulted in the condition being placed on more and more death certificates.

Information and Statistics

261

CANCER: There was a slight decrease in the number of deaths from cancer when the number of deaths dropped from 2003 in 1939 to 1959 in 1940. This is another condition which has been and can be helped by extensive educational programs advising periodic medical examinations.
DIABETES MELLITUS: The number of deaths from this condition decreased from 368 in 1939 to 349 in 19<'10. The rate declined from 11.8 to 11.2, or 5.2 per cent.
PELLAGRA: There was a slight decrease in the pellagra deaths from 271 in 1939 to 235 in 19<'10. The rate dropped from 8.7 to 7.5 or 13.3 per cent.
CEREBRAL HEMORRHAGE: There was a very slight decline in the death Tate from ceTebral hemorrhage. The rate for 19<10 was 97.15 as compared with 97.6 in 1939. The number of deaths was 3035 as compared with 304.5 in 1939.
HEART DISEASE: This is the leading cause of death in Georgia as well as the nation. The death rate from this condition increased 14.. 0 per cent when the rate jumped from 173.5 to 197.7 in 1940. The number of deaths increased from 5<'117 to 6176 in 19<'1.0.
PNEUMONIA: The number of pneumonia deaths decreased from 2299 in _939 to 2055 in 1940. The rate dropped from 73.6 to 65.8, or 10.6 per cent. The increased use of drugs and specific serum has resulted in this decrease.
DIARRHEA AND ENTERITIS UNDER 2 YEARS: The number of deaths from this condition decreased from 4.16 in 1939 to 395 in 1940. The rate declined from 13.3 to 12.6, or 5.1 per cent.
CIRRHOSIS OF LIVER: There was a decrease of 4..5 in the death rate from cirrhosis of the liver. The rate declined from 4.86 to 4.64 or 4..5 per cent.
NEPHRITIS: The deaths from this condition increased from 30<11 to 33<'18 in 19<1.0 and this condition now stands second in the list of causes of death in our State. The rate increased from 97.37 in 1939 to 107.17 in 19<'10 or an increase of 10.1 per cent.
MALFORMATION AND EARLY INFANCY DISEASES: The number of deaths from these causes decreased from 2155 in 1939 to 2034. in 19<1.0. The rate declined from 69.0 to 65.1 or 5.6 per cent.
SUICIDE: The number of deaths from suicide decreased from 316 in 1939 to 279 in 19<10 or a decrease in the rate of 11.7 peT cent.
HoMICIDE.: There was an increase in the number of deaths from homicide hom 560 to 619 in 19<W. The Tate increased from 17.9 to 19.8 oT 10.5 per cent.
AcciDENTAL DEATHS (ExcLUSIVE OF AuTo AcciDENTS): There was a marked increase in the number of accidental deaths from 1181 in 1939 to 1269 in 19<1.0. The rate incTeased from 37.8 to <10.6 or 7.4 per cent.
MoToR VEHICLE AcciDENTS: There was an increase in the number of motor vehicle deaths from 669 in 1939 to 802 in 19<10. The rate increased from 21.4. to 25.7 or an increase of 20.0 per cent.
APPENDICITIS: There was a decrease of 1.5 per cent in the death rate from appendicitis.

262

Georgia Department of Public Health

MORBIDITY
TABLE 3 (a) NUMBER OF CASES AND CASE RATES* PER I00,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY CITIES OF 5,000 POPULATION AND
ABOVE, 1940

Area

Cerebrospinal Meningitis Diphtheria
Population Cases Rate Cases Rate

Gonorrhea Cases Rate

Influenza Cases Rate

Cities 5,000 & above 899,292

Albany ----------
Americus --------
Athens ---------Atlanta
Augusta ~--------

19,055 9,281
20,650 302,288 65,919

Bainbridge Brunswiclt Canollton Cartersville -----Cedartown --------

6,352 15,035
6,21<1 6,1<11 9,025

College Park -----
Columbus -------
Cordele ----------
Dalton -----------
Decatur ---------

8,213 53,280
7,929 10;148 16,561

Dublin ----------
East Point ------
Fitzgerald -------
Gainesville ------
Griffin ----------

7 ,81<1 12;103
7,388 10,2,13 13,222

LaGrange --------
l\facon ---------Marietta --------
Milledgeville ----Moultrie

21,983 57,865
8,667 6,778 10,1<17

Newnan --------Rome ----------Savannah 'fhomaston

7,182 26,282 95,996
6,396

Thomasville 'foccoa ---------Valdosta VVaycloss --------

12,683 5,'19'1
15,595 16,763

1.0
2 0.7 1.5
16.3 2 3.8

170 18.9
2 10.5
5 2!.2 39 12.9 30 45.5
6.7 16.1 2 32.6
2 2'1.'1 16.9 12.6
'1 38.3 12.1
25.6
29.3 2 15.1
31.8 16 27.7
2 23.1 2 29.5
59.1

2,542
20 4 7
88,1 424
22
12 12 16
68

282.7
105.0 '13.1 33.9
292.4 6'13.2
3'16.3 20.0
193.1 195.'1 177.3
211A 127.6

305 2919.2 30.2

5

6'1.0

5

40.3

17 166.0 25 189.1

27.3

2'1

41.5

6

69.2

60 885.2

39 38,1.'1

13 '19.5

1.0

1<1 1<1.6

1 15.6

7.9

18.2

6A

2 12.8

6.0

11

'11.9

468 '187.5

2

31.3

15 118.3 72.8
23 1<17.5 ,18 286.3

5,409 601.5

1<19 75 4
1,333 463

781.9 808.1
19.'1 '111.0 702.'1

78.7 '16.6 <17 756.'1 65 1058.5 36 398.9

15 182.6 123 230.9
9 113.5 33 315.8 51 326.1

'12 537.5

2,1 193.5

3

'10.6

10

97.6

8

60.5

25 113.7

25

'13.2

92 1061.5

60 885.2

27 266.1

2 181 1,121

27.8 688.7 1167.8

22 173.5 109.2 32.1
338 2016.3

*Rates worked on enumerated population fl'Olll census tal\en April 1, 19'10.

In j ormation and Statistics

263

NUMBER OF CASES AND CASE RATES* PER I 00,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY CITIES OF 5,000 POPULATION AND
ABOVE, 1940

Area

Malaria

Measles

Pneumonia Poliomyelitis Scarlet Fever

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

Cities 5,000 & above _____ 267 29.7

Albany ------Americus -----Athens Atlanta

55 288.fl 7 75.4

13

<1.3

Augusta

9.1

Bainbridge

9<1.5

Brunswick -----

Cat'!'oilton -----

96.6

Cartersville ----

Cedartown -----
College Parlr --
Columbus -----
Cordele
Dalton --------

11.1

12.2

1.9

12 151.3

1

9.6

Decatur ------Dublin --------
East F'olnt ----
Fitzgerald
Gainesville ----

6.0 8 102.4
2 27.1

Griffin --------

7.6

LaGrange -----

<1.5

:Macon --------

Marietta ------

~Iilledgevllle ---

4<1.3

Moultrie ------
Newnan ------Rome ---------
Savannah
'l'homaston ----

37 346.6
3.8 19 19.8

'l1homasville ---
Toccoa --------
Valdosta
Waycross ------

6 <17.3 1 18.2 78 500.2

9<18 105.4 1,422 158.1

11 57.7 53.9
3 1<1.5 <195 163.8

<13 225.7 19 204.7 19 92.0 <136 1<1<1.2

10.6
11 73.2 16.1
182 2963.7

15<1 233.6 7 110.2 21 139.7 H 225.3 12 19:l.<!

<14.3 36.5 13 21.'1
51 A

77.fl 10 121.8 53 99.5 H 176.6 13 124.'1

<12.3 12.8 8.1
5 <18.8

16 96.6 13 166.'1 12 96.8
9<1.7 8 87.9

7.6 11 50.0 52 89.9
60 885.2

H 105.9 29 131.9 46 79.5 15 173.1
7 103.3

4 39.4 27.8
15 57.1 13 13.5 27 <122.1

12 118.3 7 97.5
<11 156.0 281 292.7 10 156.3

39.4 3 17.9

H 110.'1
s 1<15.6
11 70.5
<18 286.3

0.7

<140 <18.9

5.2

12 63.0

3 86.2

24.2

197 65.2

1.5

6.1

<16.6 16.1

11.1 60.9 H 26.3 1 12.6 15 1<13.6
19 11<1.7
6<1.5
13 126.9

<1.5 2 19.7
15.6

27.3 21 <11.5 16 18<1.6
1<1.8
88.7 13.9 13 <19.5 <18 50.0 2 31.3
2 15.8 2 36.4 2 12.8 <1 23.9

*Rates worl<ed on enumeTated Jlopulation from census taken April 1, 1940.

264.

Georgia Department of Public Health

NUMBER OF CASES AND CASE RATES* PER I00,000 POPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY CITIES OF 5,000 POPULATION AND
ABOVE, 1940

Area

Syphilis Cases Rate

Tuberculosis Cases Rate

Typhoid Cases Rate

Typhus Cases Rate

WhOOJiing Cough
Cases Rate

Cities 5,000 and above -- 12,853 H29.2

Albany -------- 81

Americus ------ 30

Athens

113

Atlanta

5,853

<140.8 323.2 571.'1 1937.9

Augusta
Bainbridge ----
Brunswick -----
Carrollton ----Cutersville ----

679 1030.1 13 201.7 6 39.9 2 32.2 33 537.'1

Cedartown ----College Parlt --
Columbus -----
Cordele
Dalton --------

17 188.'1 2 21.'1 513 962.8 1<13 1803.5 60 57<1.3

Decatur -------
Dublin --------
East Point ---Fitzgerald -----
Gainesville ----

10 60.'1 115.2 2<1.2
2 27.1 521 5086.4

Griffin -------LaGrange ----Macon --------
Marietta ------
Milledgeville ---

148 1119.3 298 1355.6 357 617.0
55 631.6 308 <15!11.1

Moultrie ------- 2<1<1

Newnan -------

Rome --------- 66

Savannah

2,877

2101.7
251.1 2997.0

1l'homaston ~J..lhomasville --'.roccoa Valdosta Waycross ------

2 31.3

1

7.9

6 109.2

2<12 1551.8

1<!6 871.0

1,31<1 H9.;;
36 188.9 5 53.9 17 82.3 158 151.5
117 177.5 10 157.'1 25 166.3 16.1 97.7
88.6 12.2 38 71.3 21 302.7 25 239.3
22 132.8 89.6
16 129.0 67.7
23 221.5
29 219.3 38 172.9 98 169.'1 12 138.5 18 265.6
l 39.4 15 208.9 43 163.6 185 192.7
19 297.1 10 78.8
3 51.6 16 102.6 16 95.'1

91 10.5
2 10.5 6 61.6

11

3.6

6.1

15.7

1

6.7

3 18.3

97.7

1 11.1

1 12.2

1

1.9

1 30.'1

57.4

2 25.6
27.1 2 19.5
22.7 13.6 15.6
73.8
9.9
3 11.4 7.3
2 31.3
2 36.'1 2 12.8 l 23.9

203 22.6
26.2 53.9

2<1

7.9

12.1 15.7 13.3

48.9
11.1 2 21.4
3.8 15.7

18.1 89.6

30.3
30 51.8 11.5 <14.3 88.7 13.9
67 69.8
7.9
32.1 13 77.6

500 55.6
21.0 2 21.5 19 92.0 131 !3.3
11 16.7
13 86.3 1 16.1 18 293.1

120 1<!61.1 9.'1

28.7 1 21.2

72.6 13.5
9.8
52.9 10.9 19 32.8 10 115.'1 29.5
3 29.6

2

7.6

15 15.6

15.6 16 126.2

1

6.'1

73 4H5.5

*I!ates worli:ed on enumerated population from census tal\en April 1, 1910.

Information and Statistics

265

DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS, DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES PER 1,000 LIVE BIRTHS
BY COLOR, IN GEORGIA: 1940

Cause of Death

Total

Number White Colored

Total

Rate White Colored

ALL CAlJSES ---------------- 32,285

Typhoid fever --------------------

68

~.P:rphus fever --------------------

26

:.\Ialaria __ ------------------------

89

Smallpox ------------------------

~Ieasles --------------------------

23

Scarlet fever ----------------------

16

Whooping cough ------------------ 108

Diphtheria ------------------------

;,9

Influenza ------------------------ 924

Drsenterr ----------------------- 126

Poliomyelitis --------------------Lethargic encephalitis ____________
::\!eningococcus meningitis ________ _
Syphilis ------------------------'l'ube1culosis (all forms)___________

1
587 1,533

Cancel' -------------------------Diabetes mellitus ----------------Pellagra ------------------------Cerebral hemorrhage,
embolism and thrombosis _______ _

1,959 319 235
3,035

Heart diseases -------------------Pneumonia ----------------------Diarrhea and enteritis (-2 yrs.) __
Appendicitis Cirrhosis of the liver_____________ _

6,176 2,055
395 276 1<15

Nephritis l\Ialformation and early
infancy diseases _______________ _
Suicide -------------------------Homicide ------------------------

3,348
2!03<1 282 616

Motor vehicle accidents ___________ _ All other accidents _______________ _
Lnln1own or ill-defined causes----All other causes ------------------

802 1,255 1,051 4,351

LIYE BIR'I'HS ------------------S'riLLBIR'l'HS -------------- ____ _ INFANT MOR'l'ALI'l'Y -----------iiiA'l'ERNAL MOR'l'ALI'l'Y ---------

64,695 3,078 3,737
342

17,313
27 18 3il
15 52 14
:)1)3
67
3 7 127 54<!
1,380 258 118
1,574
3,662 1,019
215 159 102
1,8'18
1,098 216 111
556 661 379 2,320
38,911 1,326 1,851 H6

H,972
41 8
,.d
56
1;}
421 59
2 160 989
579 91
117
1;161
2,51<1 1,036
180 117
13
1,500
936 36
505
216 594 672 2,031
23,781 1,752 1,886 196

1033.5
2.2 0.8 2.8
0.7
0.;) 3.3 1.9 29.6 1.0
0.2 0.1 0.3 18.8 49.1
62.7 11.2
7.5
97.2
197.7 65.8 12.6 8.8 4.6
107.2
65.1 9.0
19.7
25.7 40.2 33.6 139.3
20.7 47.6 57.8
5.3

1.3 0.9 1.7
0.7
0.7 2.6 2.2 24.7 3.3
0.3 0.2 0.3 6.2 26.7
67.7 12.7
5.8
77.2
179.6 50.0 10.6 7.8 5.0
90.7
53.9 12.1
5.'!
27.3 32.'1 18.6 113.8
19.1 31.1 17.6
3.8

3.8 0.7 5.0
0.8
0.1 5.2 1.'1 38.8
~A
0.2 0.1 09 <!2A 91.2
8.4 10.8
134.6
231.7
95.~
16.6 10.8
J.O
138.2
86.3 3.3
46.5
22.7 5<!.7 61.9 187.2
23.8 67.9 73.1
7.6

NO'l'E: 'l'hese figures exclude non-residents of Geo1gla and include births and deaths of Gemgia residents occurring in other states.

266

Georgia Department of Public Health

DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS, DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES PER 1,000 LIVE BIRTHS
BY COLOR, IN GEORGIA: 1939

Cause of Death

Total

Number White Colored

Total

Rate White Colored

ALL CAUSES ---------------- 31,856

Typhoid fever --------------------

33

Typhus fever ---------------------

<1<1

l\!ala.ria -------------------------

101

Smallpox ------------------------

Measles -------------------------

51

Scarlet fever ---------------- ____ _

19

Whooping cough ------------------ 13'1

Diphtheria -----------------------

95

Influenza

950

Dysentery ----------------------- _ 127

Poliomyelitis --------------------Lethargic encephalitis -----------:Meningococcus meningitis ________ _ '11uberculosls (all fo!'1ns) __________ _
Syphilis --------------------------

12 '1 15
1,533 '173

Cancer -------------------------Diabetes mellitus ________________ _
Pellagra ------------------------Cerebral hemorrhage,
embolism and thrombosis_______ _
Heart diseases -------------------

2,003 368 271
3,048 5,417

Pneumonia ---------------------Diarrhea, enteritis (-2 yrs.) _____ _ Cirrhosis of liver__________________
Nephritis -----------------------:Malformation and early
infancy diseases __ --------------

2,299 -116 152
3,041
2,15;:i

Suicide ------------------------- _ Homicide ------------------------lVIotOl' vehicle accidents ---------- _ All other accidents ---------------enl\:nown or ill-defined causes ____ _

316 360 669 1,181 921

All other causes __________________
Live Bil"ths ----------------------Stillbirths ----------------------Infant :Mortality ----------------~Iaternal Mortality ---------------

3,0,12 o'1,9IO 3,228
3,817 356

17,,186
38 39 40
16 61 65 495 65
2
J<13 61
1,'126 247 13<1
1,598 3,2,10
1,209 217 Ill
1,771
1,199
290 109 ,183 703 302
2,807 38,923
1,337 1,960
175

H,370 <15 5 61
27
73 30 ,155 62
121 137
1,450 2,177 1,090
199 41 1,270
9:i6 26 ,151 186 -173 619 2,235 25,987 1,891 1,857 181

1020.1
2.7 1.'1 3.2
1.6
0.6 '1.3 3.0 30.'1 '1.1
0.'1 0.1 0.5 49.1 15.1
6'!.1 11.8
8.7
97.6 173.5
73.6 13.3 '1.9 fl7A
69.0
10.1 17.9 21.'1 37.8 29.5
161.5 20.8 '19.7 58.8 5.5

87'1.8
1.9 2.0 2.0

1278A
'1.0 0.'1 5..!

1.2

2A

0.8

0.3

3.1

6.5

3.3

2.7

2'1.8

<10.5

3.3

5.5

0.'1

OA

0.1

0.2

0.5

0.5

27.2

88.1

3.1

36.1

71.3

f>l.3

12.'1

10.8

6.7

12.2

79.9 162.1
60.5 10.9
5.6 83.6

129.0 193.7
97.0 17.7
3.6 113.0

60.0
1<1.5 5.5
24.2 35.2 15.1
HOA 19.5 3'1.3 50.'1
'1.5

83.1
2.3 '10.1 16.5 <12.::1 JJ.l
198.3 23.1 72.8 71.5 7.0

NO'l'E : 'l'hese figures exclude non-residents of Georgia and include births and deaths of Georgia resiclents occurring in other states.

Information and Statistics

267

DEATHS UNDER ONE YEAR oF AcE, MATERNAL DEAn-Is, ILLEGITIMATE BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND STILLBIRTHS .WITH
RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1940

INFANT MORTALITY

MATERNAL MORTALITY

Year
1920 1921 1922 1923 192<1
1920) 1926 1927 1028 1929
1930 19:ll 1932 1933 193<1
1935 1936 1937 1938 1939 19<10

NUMBER

RATE

Total White Col. Total White Col.

5305 2961 23<1<1 83.3 71.1 127.1 <1905 2606 2299 73.9 58.5 105.3 <1937 2509 2<128 75.9 59.1 107 A 538<1 2938 2<1<16 8<!.5 58.'1 108.3 567<1 2989 2685 39.5 72.2 122.0
-170<1 2<!86 2218 78.9 65.0 103.9 <1<105 2299 2106 87.2 71.3 115.3 <1578 233<1 22<1<1 73.5 :\9.4 97.7 <1875 257'1 2301 80.9 67.0) 10<!.0 <1<!6<1 23<13 2121 76.8 65.5 93.1
<1713 2<!68 22<15 78.1 66.6 96.5 <123<1 2137 2097 68.5 56.9 86.5 <1097 2122 1975 6<1.3 35.5 77.:> <1079 2119 1960 67.2 59.4 78.2 5086 2628 2<!58 78.7 68.6 93.5
4316 2227 2089 68.2 59.6 80.5 <1319 211<1 2205 70.1 58.2 87.2 3968 201<1 195<1 62.0 52.7 75.6 4352 2267 2085 67.7 58.7 81.1 3817 1960 1857 58.8 50.4 71.5 3737 1851 1886 57.8 <17.6 73.1

NUMBER

RATE

Total White Col. Total White Col.

558 267 291 9.3 568 266 302 8.6 658 316 3<12 10.1 :373 288 285 9.0 708 362 3<!6 11.2
6!1 299 312 10.8 <135 222 263 9.6 !i78 291 287 9.3 622 312 310 10.3 5<19 28<1 265 9A
658 361 297 10.9 616 322 29<] 10.0 620 310 310 9.7 <1.63 227 236 7.6 50:) 262 2<!3 7.8
<]58 230 228 7.2 <]91 251 2<10 8.0 <171 2<10 231 7.4 <!21 198 223 6.5 356 175 181 5.5 3<12 1<16 196 5.3

6.4 15.8 6.0 13.8 7A 15.1 7.0 12.6 3.7 15.7
7.8 16.0 6.9 14A 7.'! 12.5 8.2 1<1.0 7.9 11.6
9.7 12.8 8.6 12.1 8.1 12.2 6A 9A 6.8 9.2
6.2 8.8 6.9 9.5 6.3 8.9 5.1 8.7 <1.5 7.0 3.8 7.6

ILLEGITIMATE BIRTHS

STILLBIRTHS

Year
1920 1921 1922 1923 1921
1925 1926 192i 1928 1929
1930 1981 1932 1933 1931
1935 1936 1937 1938 1939 1940*

NUMBER

RATE

Total White Col. Total White Col.

2695 17<1 2221 <1<1.9 llA 120.'! 3077 516 2561 <16.'1 11.6 117.'! 3606 500 3106 55.'1 11.8 137.'1 1045 513 3502 63.5 13.2 155.0 <1089 51<1 3515 6<1.5 13.9 159.7
4014 531 3<180 67.3 1<1.0 163.0 3155 461 269<1 62.5 l<J.3 1<17.5 <]089 637 3<152 65.7 16.2 150.3 3868 182 3386 6<1.2 12.6 153.0 <]061 515 35<16 69.4 l<JA 155.7
<!1<11 512 3629 68.7 13.8 156.1 <]<]29 5<17 3882 71.7 H.6 160.1 5125 600 <1525 80.5 15.7 177.6 5101 582 <]519 84.0 16.3 180.<! 5089 651 <]<]38 78.8 17.0 168.9
5031 643 4388 79.5 17.2 169.1 <1878 598 4280 79.2 16.5 169.2 <]739 526 <]213 74.0 13.8 163.1 <]724 580 <Jl<j<j 73.5 15.0 161.3 <1960 596 <]36<! 76.'1 15.3 167.9

NUMBER

RATE

Total White Col. Total White Col.

3389 1608 1781 56.'1 38.6 96.6 3820 1720 2100 57.5 38.6 96.2 3862 1716 21<l6 59.3 <lOA 9<J.g 3958 1802 2156 62.2 <!3.9 95.<! 386<1 1675 2189 61.0 40.5 99.5
3<155 1<135 2020 58.0 37.5 9<1.6 2972 12<16 1726 58.9 38.7 94.5 3836 160<1 2232 61.6 <]0.8 97.2 3<178 1335 2H3 57.7 35.0 96.6 35<]1 13 7<1 2167 60.5 38.<! 95.2
3796 H54 23<12 62.9 39.2 100.7 3678 1<12<1 2254 59.5 37.9 93.0 38<]7 l<l92 2355 60.'1 39.0 92.'1 3700 1382 2318 60.9 38.7 92.5 <!120 1673 2<]<17 63.8 43.6 93.1
3987 1532 2<155 63.0 <Jl.O 9<1.6 3666 H57 2209 59.5 <]0.1 37.3 3677 H99 2178 57.'1 39.3 8<1.3 3390 1386 200<] 52.7 35.9 78.0 3223 1337 1891 <]9.7 34.3 72.8 3078 1326 1752 47.6 34.1 67.9

*Figures not yet available.

268

Georgia Department of Public Health

DEATHS AND BIRTHS (EXCLUSIVE OF' 5TILLBIRTI-IS) AND RATES PER 1,000 POPULATION, IN GEORGIA: 1920-194.0

BIRTHS

DEATHS

NUMBER

RATE

NUMBER

RATE

Year

Total White Col. Total White Col.

Total White Col. Total White Col.

1920 1921 1922 1923 1921
1925 1926 1927 1928 1929
Hl30 1931 1932 1933 1931
1935
19:~6
1937 1938 19:'9 1940

60061 11618 18143 20.7 2!.5 15.'1 66378 11555 21823 22.9 26.0 18.'1 G5082 42475 22607 22.5 2!.6 19.3 63681 11088 22593 22.0 23.6 19.5 63386 11379 22007 21.8 23.6 19.2
59610 38251 21356 20.fi 21.6 18.8 50193 32226 18267 17.'1 18.1 16.3 62216 39281 2296:. 21.'1 21.9 20.7 60259 38135 22124 20.T 21.0 20.2 58521 35751 22770 20.1 19.6 21.1
60318 37061 23251 20.7 20.1 21.7 61TH :l7531 21213 21.0 20.'1 22.5 63690 38209 25181 21.5 20.'1 23.5 60744 35692 25052 20.'1 18.8 ~3.0 61615 38333 26282 21.5 20.1 21.0
63290 37345 25915 20.9 19.'1 23.6 61617 36320 25297 20.2 18.7 22.9 61012 38181 25831 20.8 19.'1 23.2 64307 38613 25691 20.7 19.5 23.0 61910 38923 2598T 20.8 19.5 23.1 61695 38911 2C\781 20.T 19.1 23.8

32243 17212 15031 11.1 10.1 12}i 29552 15139 1<1113 10.2 9.0 11.9 :nn4 16510 FilH 10.9 fl.B 12.9 31082 17763 16319 11.3 10.2 1<1.1 :l4797 17750 17047 12.0 10.1 H.!l
:ll278 15860 15118 10.8 9.0 13.6 29906 151<11 1<1765 10.3 8.::i 13.2 :ll869 16230 1:>639 11.0 fl.U H.l 3608:i 18642 17443 12.'1 10.3 l:i.!l 35310 1821:) 17095 12.t 10.0 l:i.S
~5188 18036 17152 12.1 9.8 lG.O 32989 11012 lo977 11.2 9.2 l<l.R 32122 16813 15309 10.8 9.0 H.!
:niSI 168<\i H337 10.~ s.o 1:1.2
35590 19157 16133 11.8 10.0 l:i.O
:l<\313 18677 15636 11.3 9.7 1 1.2 37293 20156 17137 12.2 10.<1 1:>.:; 3<1<111 18193 15918 11.2 9.<1 H.~ 33Cl7 18109 15508 10.8 9.1 l:l.!l 31856 17486 1'1370 10.2 8.7 12.8
32285 17313 11972 10.3 s.:; 13 s

DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1940

Year
1920 1921 1922 1923 1921
1925 1926 1927 1928 1929
1930 1931 1932 1933 1931
1935 1936 1937 1938 1939 1910

TYPHOID

NUMBER

RATE

Total White Col. Total White Col.

519 274 275 19.0 16.2 22.9 798 351 <1<17 27.5 20.5 37.7 71<1 326 388 21.6 18.9 33.1 601 244 357 20.7 14.0 30.8 681 292 389 23.5 16.7 33.9

675 261 <Ill 23.3 1'1.9 36.2 519 191 328 17.9 lO.T 29.3 653 285 368 22.5 lo.!l 33.2 <HI 182 262 15.3 10.0 23.9 340 HO 200 11.7 7.7 18.5

500 207 293 17.2 11.2 27.3 513 201 312 17.5 10.8 23.9 363 133 230 12.3 7.1 21.2 251 105 116 8.'1 5.5 13A 316 llO 206 10.5 5.8 18.8

261 100 161 8.6 5 ) 14.6

195

68 127 6.4 3.5 11.5

139

51

85 1.5 2.7 7.6

121

51

70 3.9 2.6 6.2

83

38

45 2.7 1.9 J.O

68

27

<11 2.2 1.3 3.8

TYPHUS FEVER

NUMBER

RATE

Total White Col. Total White Col.

2 2 2

0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.2
0.03 0.1

10

0.3 0.5 0.2

0.2 0.1 0.'1

0.03

0.1

8

0.3 0.'1 0.1

5

2 0.2 0.3 0.2

1

1 0.3 0.2 0.'1

26

1.0 1.'1 0.3

21

0.9 1.1 0.6

23

0.9 1.2 0.5

35

1.'1 1.8 0.8

13

11 1.8 2.2 1.0

33

14 1.5 1.7 1.3

39

5 lA 2.0 0.'1

18

0.8 0.9 0.7

Information and Statistics

269

DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: l920-l9L10

MALARIA

MEASLES

NUMBER

RATE

NUMBER

RATE

Year
1920 1921 1922 1923 192'1
192:) 1926 1927 1928 1929
1930 1931 1932 1933 1 93<1
1935 1936 1937 1938 1939 19,10

Total White Col. Total White Col.

242 317 19.3 H.3 26.'1 19ii 273 16.2 11.'! 23.0 256 328 20.2 1'1.8 27.9 201 288 16.9 11.6 2'1.8 181 259 15.2 10.3 22.6

285 102 183 9.8 5.8 16.1 288 107 181 9.9 6.0 16.2 296 113 183 10.2 6.3 16.5 582 253 329 20.0 H.O 30.1 677 322 355 23.3 17.6 32.8

<1<12 186 256 15.2 10.1 23.9 307 119 188 10.5 6.5 17.'1 316 136 180 10.7 7.2 16.6 36,1 193 171 12.2 10.2 15.7 '118 212 206 13.9 11.1 18.8

387 186 211 12.8 9.1 19.2

606 321 285 19.8 16.5 25.7

235 113 122 7.6 5.8 11.0

H6

63

83 1.7 3.2 7.'!

101

40

61 3.2 2.0 5A

39

35

54 2.8 l.T 5.0

Total White Col. Total White Col.

61

20 2.1 2.4 1.7

93

27 3.2 3.9 2.3

5

3 0.2 0.1 0.3

3<17 252 95 12.0 H.5 8.2

550 359 191 19.0 20.5 16.7

11

'1

OA 0.2 0.6

58 ,13 15 2.0 2A 1.3

105 79 26 3.6 4.'1 2A

1,13 106 37 '1.9 5.9 3.'1

31 26

1.1 1.'! 0.:1

128 9'1 3,1 1.4 5.1 3.2

62 37 25 2.1 2.0 2.:l

15

0.5 0.3 0.8

72 50 22 2.'1 2.6 2.0

540 ,101 139 18.0 21.0 12.7

25 15 10 0.8 0.8 0.9

5

3

0.3

0.3

o.:~

10

0.3 OA 0 >

1m 118 39 5.1 6.0 3.;)

51 24 27 1.6 1.2 2.4

23 H

9 0.7 0.7 0.8

SCARLET FEVER

WHOOPING COUGH

NUMBER

RATE

NUMBER

RATE

Year

Total White Col. Total White Col.

Total White Col. Total White Col.

1920 1921 1922 1923, 192,1
1925 1926 1927 1928 1929
1930 1931 1932 1933 193'1
1935 1936 1937 1938 1939 19,10

32

31

28

25

24

20

20

17

20

16

11

13

12

25

20

36

29

'10

33

38

33

46

38

19

17

19

19

17

16

23

21

H

11

11

10

13

11

19

16

16

15

1.1 1.8 0.1 1.0 1.5 0.3 0.8 1.2 0.3 0.7 1.0 0.3 0.7 0.9 0.1
OA 0.5 0.3
0.5 0.7 0.1 0.9 1.1 0.5 1.2 1.6 0.6 1.'1 1.8 0.6
1.3 1.8 0.5 1.6 2.0 0.7 0.6 0.9 0.2 0.6 1.0 0.6 0.8 0.1
0.3 1.1 0.2 0.5 0.6 0.3
OA 0.5 0.1 OA 0.6 0.2
0.6 0.8 0.3 0.5 0.7 0.1

373 2'10 133 12.9 H.2 11.1 183 93 90 6.3 5.1 7.6 130 51 79 1.5 3.0 6.7 25'1 116 138 8.8 6.7 11.9 43ii 203 232 15.0 11.6 20.2

313 167 146 10.8 1<11 H 67 '1.9 229 ll8 111 7.9 163 99 6'1 5.6 280 171 109 9.6

9.4 12.9 1.2 6.0 6.6 10.0 5.5 :i.9 9.'1 10.1

257 121 136 8.8 113 59 5,1 3.8 112 52 60 3.8 223 116 107 7.5 33,1 169 165 11.1

6.6 12.7 3.2 :1.0 2.8 :),:) 6.1 9.f> 8.8 I:i.l

149 77 72 4.9 1.0 6.ii 67 30 37 2.2 1.5 3.3
H2 75 67 ,1.6 3.8 6.0 225 112 113 7.3 5.7 10.1 13<1 61 73 <1.3 3.1 6.5 lOS 52 56 3.5 2.6 :>.2

270

Georgia Department of Public Health

DEATI-Is AND DEATH RATEs PER 100,000 PoPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-19t1Q

Year
1920 1921 1922 1923 192<!
1925 192B 1927 1928 1929
1930 1931 1932 1933 193<!
1935 193B 1937 1938 1939 19<!0

DIPHTHERIA

NUMBER

RATE

Total White Col. Total White Col.

<!01 283 113 13.8 16.7 9.3 415 29<] 121 1<!.3 17.2 10.2 <Ill 277 13<! 1<!.2 lB.l 11.4 21<! 199 75 9.5 11.'1 6.5 230 167 63 7.9 9.5 5.5
185 119 66 6.'1 B.7 5.8 251 199 52 8.B 11.2 <!.6 272 187 85 9.4 10.4 7.7 2<!0 171 63 8.3 9.8 5.3 183 139 <1<1 B.3 i .B <J.l
135 102 33 <l.B 5.5 3.1 158 122 36 5A 6.6 3.3 1B9 139 30 5. 7 7.'1 2.8 lSi 152 35 6.3 8.0 3.2 188 152 3B B.3 8.0 3.3
161 116 <15 5.3 B.O <].1 123 83 <]0 <l.O 4.3 3.B 108 66 <]2 3.5 3.'1 3.8 106 H 32 3.'1 3.7 2.9
95 B5 30 3.0 3.3 2.7 59 <]4 15 1.9 2.2 lA

INFLUENZA

NUMBER

RATE

Total White Col. Total White Col.

2581 273 lOH
1500 88B

1516 159 615 880 512

1065 119 399 620 37<1

1334 1<!93
971 20<11 2:)<]3

173 300 <]30 120<! l<l50

611 B93 <]91 83i 1093

96<! 532 432 1301 103 598 1170 B9<! <!76 1237 B9<! 5<!3 1009 5B3 <!4B

1357 181 576 18<!2 1058 78<! H36 739 B97
~02 393 <]09 950 <!95 455 92<! 503 <!21

89.1 9.6
35.0 51.7 30.5
<]7.7 51.'1 33.'1 70.2 87.5
33.1 <]<!.3 39.5 41.5 33.6
<111.8 60.3 <!6.7 25.9 30.'1 29.B

89.4 88.7 9.3 10.0
35.7 3<!.0 50.6 53.'1 29.2 32.B
<]3.7 53.9 <!4.9 Bl.8 26.i <]<].3 B6.5 7B.5 79.'1 101.1
28.9 <]0.3 37.8 55.'1 37.0 43.9 3B.B <!9.8 29.5 <!0.7
<!0.5 52.3 5<!.4 70.8 37.6 B2.B 19.8 36.B 2<!.8 40.5 24.7 38.8

DYSENTERY

TUBERCULOSIS (ALL FORMS)

Year
1920 1921 1922 1923 192<!
1925 192B 1927 1928 1929
1930 1931 1932 1933 193<]
1935 1936 1937 1938 1939 1940

NUMBER

RATE

Total White Col. Total White Col.

170 liB 5<] 5.9 6.8 <!.5 1<!6 88 58 5.0 5.1 <!.9 112 B9 <!3 3.9 <J.O 3.7 151 90 Bl 5.2 5.2 5.3 187 10<! 83 6.5 5.9 7.2

19<! 119 75 6.7 6.7 6.6 207 129 78 7.1 7.2 7.0 277 172 105 9.5 9.6 9.5 304 189 115 10.5 lOA 10.5 204 99 105 7.0 5A 9.7

305 158 1<!7 10.5 177 86 91 B.O 141 85 5B <!.8 153 86 67 5.1 219 123 96 7.3

8.6 13.7 <!.6 8.'1 <!.5 5.2 <!.5 6.1 6.'1 8.8

163 86 77 5.'1 1!.5 7.0 15B 78 78 5.1 <!.0 7.0 130 67 63 <1.2 3.'1 5.7 192 107 85 6.2 5A 7.6 127 65 62 4.1 3.3 5.5 126 67 59 <J.O 3.3 5.4

NUMBER

RATE

Total White Col. Total White Col..

23B2 2531 2683 26<!2 2B20
:N,18 2278 230i 2375 2190
2175 2165 1933 1777 1172
1731 lil3 15<!9 1612 1533 1533

882 l<l80 892 1639 991 1B92 9B5 1677 917 1703
872 1576 807 1<!71 798 1509 832 15<!3 7<!2 1<!48
77<! 1<!01 700 l<l65 665 1268 675 1102 605 11B7
6<!9 1082 6<!8 10B5 559 990 602 1010 5<!3 990 5<]<! 989

8l.B 87.'1 92.B 91.1 90.3
8<!.4 78.5 79.'! 81.7 75.3
7<!.6 73.7 65.3 59.6 58.9
57.1 56.1 50.3 52.0 <]9.1 49.1

52.0 123.3 52.1 '!38.1 57.'1 14<!.2 55.5 1<1<!.5 52.3 148.4
49.3 139.0 <]5.3 131.2 HA 136.2 <!5.9 1<!1.0 <]0.6 133.9
<!2.0 130.6 37.7 135.8 35.4 116.9 35.6 101.1 31.7 106.5
33.6 98.2 33.3 96.2 28.5 89.0 30.'1 90.3 27.2 88.1 26.7 91.2

information and Statistics

271

DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-194,0

SYPHILIS

CANCER

Year
1920 1921 1922 1923 192<! .
1925 1926 1927 1928 1929
1930 1931 1932 1933 193<1
1935 1936 1937 1938 1939 19<10

NUMBER

RATE

Total White Col. Total White Col.

204 34 170 7.0 296 56 240 10.2 <121 70 351 1<1.5 371 73 298 12.8 <125 81 3<14 1<!.7
45<1 72 382 15.6 <109 59 350 1<!.1 457 65 392 15.7 <194 100 394 17.0 <161 82 379 15.9
<129 77 352 1<!.7 413 5<1 359 1<!.1 <125 73 352 14.'! 391 57 33<1 13.1 4<1<! 87 357 1<!.8
<103 85 318 13.3 <1<!4 77 367 1<1.5 <196 96 <100 16.1 <178 77 <101 15.'! <173 61 <!12 15.1 587 127 <160 18.8

2.0 14.2 3.3 20.2 <!.1 29.9 <1.2 25.7 4.7 30.0
<1.1 33.7 3.3 31.2 3.6 35.4 5.5 36.0 4.5 35.0
<1.2 32.8 2.9 33.2 3.9 32.5 3.0 30.6 <1.6 32.6
<!A 28.9 4.0 33.2 <!.9 35.9 3.9 35.9 3.1 36.7 6.2 <l2A

NUMBER

RATE

Total White Col. Total White Col.

112<1 766 358 38.8 45.2 29.8 1210 803 <107 <!1.8 <16.9 34.3 1212 782 <130 .Jl.8 45.3 36.6 1263 870 393 43.6 50.0 33.9 1393 913 480 <18.0 52.1 41.8
1311 891 420 <15.2 50 A 37.0 1257 860 397 <13.3 <18.2 35.'1 1<!70 995 475 50.6 55.'! <12.9 1510 1013 <197 52.0 55.9 <15A 1<!56 988 468 50.1 5<!.1 <13.3
1552 1105 <1<17 53.3 60.0 <11.7 1580 1106 47<1 53.8 59.5 <13.9 1531 1052 <179 51.7 56.1 <1<!.2 16<17 1213 <13<1 55.2 64.0 39.8 1762 1272 <190 58.6 66.5 <1<1.7
1715 1239 476 56.6 6<1.2 <13.2 1751 1239 512 57.3 63.7 <16.3 1797 1320 <177 58.4 67.2 <12.9 1929 1343 586 62.2 67.8 52.'1 2003 1<126 577 6<!.1 71.3 51.3 1959 1380 579 62.7 67.7 53.'!

DIABETES MELLITUS

PELLAGRA

NUMBER

RATE

NUMBER

RATE

Year

Total White Col. Total White Col. Total White Col. Total White Col.

1920 1921 1922 1923 192<!
1925 1926 1927 1928 1929
1930 1931 1932 1933 193<1
1935 1936 1931 1938 1939 1940

182 139 43 6.3 8.2 3.6 202 1<!4 58 7.0 SA <1.9 255 182 73 8.8 10.6 6.2 2<19 182 67 8.6 10.5 5.8 2<17 161 86 8.5 9.2 7.5
23<1 17'1 60 8.1 9.8 5.3 223 138 85 7.7 7.7 7.6 259 177 82 8.9 9.9 1A 329 227 102 11.3 12.5 9.3 302 201 101 lOA 11.0 9.3
352 2<10 112 12.1 13.0 lOA 322 22<1 98 11.0 12.1 9.1 3<13 260 83 11.6 13.9 7.7 3<19 2<!1 108 11.1 !2.1 9.9 389 275 ll<l 12.9 l<lA lOA
388 297 91 12.8 15.<! 8.3 391 299 92 12.8 15.'! 8.3 392 281 111 12.1 1<!.3 10.0 <120 311 109 13.5 15.7 9.7 368 2<17 121 11.8 12.'! 10.8
3<19 258 91 11.2 12.7 SA

<132 210 222 1<!.9 12.'1 18.5 512 23<1 278 17.7 13.7 23.'! 527 2<19 278 18.2 l<1A 23.7 <14<1 227 217 !5.3 13.1 18.1 337 181 156 11.6 10.3 13.6

366 181 185 12.6 10.2 16.3 <125 225 200 1<1.6 12.6 17.8 611 292 325 21.2 16.3 2!J.:l 8<16 358 488 29.1 19.8 <1<1.6 871 33<1 537 30.0 18.3 ,19.1

713 255 458 211.5 13.8 563 192 371 19.2 10.3 492 205 287 16.6 10.9 421 179 2<12 1<1.1 9.5 351 163 188 11.7 8.5

365 190 175 12.0 391 18<1 207 12.8 370 175 195 12.0 365 170 195 11.8 271 13<1 137 8.7 235 118 117 7.5

9.9 I:i.!J 9.5 18.1 8.9 17 ,;; 8.6 11.4 6.7 12.2 5.8 10.8

272

Georgia Department of Public Health

DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: l920-l9L10

Year
1920 Hl21 1922 1923 1924
1923 1926 1927 1928 1929
19:iO 1931 1932 1933 193'1
1933 1936 1937 1938 1939 19<10

CEREBRAL HEMORRHAGE

NUMBER

RATE

Total White Col. Total White Col.

1336 807 529 14,19 839 610 1563 887 676 1724 1002 722 1766 963 803

1995 2006 2171 2391 2299

10'14 1078 1195 1297 1257

951 923 976 1097 1012

2523 2310 2332 2159 2310

1317 1256 1269 1195 1222

1206 1081 1113
961 1083

2!10 2633 2636 2727 3018 3035

1337 1425 14<14 1<165 1598 1574

1073 1213 1192 1262 H50 H61

46.1 50.0 53.9 59.5 60.9
68.7 69.1 7<1.7 82.'1 79.1
86.6 79.7 80.5 72.'1 76.8
79.:i 86.'1 85.7 88.0 97.6 97.2

,17 .6 '1'l.l '19.0 51.4 51.'1 57.6 57.6 62.2 5'1.9 70.0
59.0 83.9 60.5 82.8 66.5 88.1 71.6 100.2 68.8 96.3
71.5 !12.<1 67.6 100.5 67.6 102.6 63.1 88.'1 63.9 99.3
69.3 97.'1 73.2 109.6 73.5 107.1 73.9 112.8 79.9 129.0 77.2 131.6

HEART DISEASES

NUMBER

RATE

Total White Col. Total White Col.

1392 1053 839 65.3 62.1 69.9 1768 923 815 61.0 51.0 71.2 1996 1953 913 68.9 61.0 30.3 2383 1186 1202 82.3 68.2 103.6 2,121 1165 1259 33.5 66.'1 109.7

2297 2129 2929 3307 3691

1077 1198 1497 1717 1923

1220 1231 1432 1590 1768

79.1 33.7 100.9 113.8 126.9

60.9 67.2 83.3 91.8 105.3

107.6 109.8 129.3 1<15.3 163.5

1099 39,18 4102 3993 3019

2109 2101 2308 2360 2901

1990 18!7 179'1 1633 2!18

1<10.6 131.'1 138.6 133.8 166.9

11<1.5 113.0 123.0 121.6 151.8

185.'1 171.2 165.0 1<19.8 193.3

5071 3606 528'1 5246 5'!17 6176

2961 3270 3132 30:i9 3240 3662

2110 2336 2152 2187 2111 231<1

167.3 183.6 171.7 169.2 173.o 197.7

153.5 168.0 159.5 151.'1 162.1 179.6

191.6 211.0 193.'1 195.6 193.7 231.7

PNEUMONIA

DIARRHEA AND ENTERITIS (UNDER 2 YRS.)

Year

NUMBER

RATE

Total White Col. Total White Col.

NUMBER

RATE

Total White Col. Total White Col.

1920 1921 1922 1923 1921
1925 1926 1927 1928 1929
1930 1931 1932 1933 193,1
1935 1936 1937 1938 1939 1940

2766 1925 2661 3199 2922

1<170 1050 1<147 1596 1382

1296 875
1217 1603 1510

95.5 66A 91.9 110.3 100.7

86.7 108.0 61.'1 73.7 83.9 103.7 91.8 138.1 78.8 131.2

2335 1135 1200 80.3 6<1.2 105.8 2442 1180 1262 84.1 66.2 112.6 2132 1015 1117 73.'1 56.5 100.8 2776 H<ll 1335 95.5 79.5 122.0 2316 1165 1151 79.6 63.8 106.'1

2580 2165 2<144 231<1 3030

1210 1255 1204 1172 1580

1310 1210 1240 1142 1150

88.5 83.9 82.5 77.6 100.8

61A 12!.9 67.5 112.2 6'!.1 114.3 61.9 101.8 82.7 132.3

3035 3803 3077 2731 2299 2055

1572 2012 1490 1321 1209 1019

1<!63 1791 1587 1<!10 1090 1036

100.2 124.6 100.0
88.1 73.6 65.8

81.5 103.'1
75.9 66.7 60.5 50.0

132.9 161.8 1<12.6 126.1
97.0 95.5

1252 759 193 13.2 14.7 <11.1 1230 722 508 42.5 42.2 12.8 1175 686 189 10.5 39.8 41.7 1183 698 185 40.8 10.1 <11.8 1322 736 586 45.6 12.0 51.1
9<19 510 439 32.7 28.8 38.7 873 162 <Ill 30.1 25.9 36.7 810 '140 370 27.9 24.5 33.'1 730 13<1 296 25.1 24.0 27.0 526 292 231 18.1 16.0 21.6
721 <153 268 2!.7 24.6 25.0 515 291 251 18.6 15.7 23.5 390 251 136 13.2 13.5 12.5 <193 32<1 169 16.5 17.1 15.5 651 378 273 21.7 19.8 21.9
:>07 308 199 16.7 16.0 18.1 519 303 246 18.0 15.6 22.2 480 247 233 lo.6 12.6 20.9 691 385 306 22.3 19.'1 27A <Jl6 217 199 13.3 10.9 17.7 395 215 180 12.6 10.6 16.6

Information and Statistics

273

DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: l920-l9<W

Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1931 lD% 1936 Hl37 19:18 1939 Hl40

APPENDICITIS

NUMBER

RATE

Total White Col. Total White Col.

236 152 8<1 8.2 9.0 7.0 276 190 86 9.5 11.1 7.3 300 208 92 lOA 12.1 7.8 281 183 98 9.7 10.5 8.'1 318 210 108 11.0 12.0 9.'1 357 212 145 12.3 12.0 12.8 289 178 Ill 10.0 10.0 9.9 330 211 119 11A 11.7 10.7 36<1 236 128 12.5 13.0 11.7 330 228 102 11.3 12.5 9.'1 333 211 122 11.'1 11.5 11.'1 3<17 23<1 113 11.8 12.6 10.5 358 255 103 12.1 13.6 9.5 323 218 105 10.8 11.5 9.6 339 226 113 11.3 11.8 10.3 300 202 98 9.9 10.5 8.9 312 201 111 10.2 10.3 10.0 319 230 89 lOA 11.7 8.0 287 19<1 93 9.3 9.8 8.3
280 186 9<1 9.0 9.3 SA
276 159 117 8.8 7.8 10.8

CIRRHOSIS OF LIVER

NUMBER

RATE

Total White Col. Total White Col.

93 61 32 3.2 3.6 2.7

83 52 31 2.9 3.0 2.6

78 <13 35 2.7 2.5 3.0

90 51 36 3.1 3.1 3.1

98 69 29 3.'1 3.9 2.5

117 77 40 <1.0 4A 3.:1

99 62 37 3.'1 3.5 3.3

125 73 30 4.3 <1.2 <:1.5

102 61 n

3.5 3.'1 3.8

128 7<1 5tl <lA <1.1 5.0

134 80 54 <1.6 4.3 5.0

l2t1 87 37 <1.2 <1.7 3.'1

91 61 30 3.1 3.3 2.8

116 73 43 3.9 3.9 3.9

110 73 31 3.7 3.8 3.'1

142 97 <15 <1.7 5.0 <1.1

139 87 52 4.6 <1.5 4.7

151 95 56 <1.9 <1.8 5.0

1<11 100 <11 4.5 5.0 3.7

152 111 41 <1.9 5.6 3.6

1<15 102 43 <1.6 5.0 4.0

Year
1920 1921 1922 1923 192<1 1925 1926 1927 1928 1929 1930 1931 1932 1933 193<1 1935 1936 1937 1938 1939 1910

NEPHRITIS (ACUTE & CHRONIC)

NUMBER

RATE

Total White Col. Total White Col.

2200 2<1<16 2903 3139 34<19 3228 3385 3620 <1105 4003 3787 3226 3216 3118 3301 3155 3<1<16 3453 3531 3041 33<18

1258 1347 1592 168<1 1787 1715 1721 1970 2162 2187 2060 1794 1753 1769 1903 1803 1910 1919 1996 1771 18<18

9<12 1099 1311 1<155 1662 1513 166<1 1650 19<13 1816 1727 1<132 1463 13<19 1398 1352 1536 1539 1535 1270 1500

76.0 8<1.<1 100.1 108.2 118.9 111.2 116.6 12<1.6 141.3 137.7 129.9 109.3 108.6 104.3 109.8 10<1.1 112.9 112.<1 113.9 97.'1 107.2

7<1.2 78.7 92.3 96.8 101.9 97.0 96.5 109.6 119.3 119.8 111.9 96.3 93.'1 93.'1 99.6 93.3 93.1 91.1 100.7 88.6 90.7

78.5 92.6 111.7 125.'1 1<J<J.9 133.'1 1<18.'1 1<18.9 177.5 167.9 160.9 132.3 134.9 123.8 127.6 122.8 138.8 138.3 131.3 113.0 138.2

MALFORMATION, EARLY INFANCY

NUMBER

RATE

Total White Col. Total White Col.

1378 2<180 28<12 2878 299i) 2526 2239 2192 1859 17<12 1890 1827 1662 1639 1904 1736 1797 1663 2<131 2Hi5 203<1

12<15 1446 1505 1636 167<1 1<13<1 1251 12<J<l 1132 1050 1185 1111 1024
99<1 1126 1076 106<1 1028 1289 1199 1093

633 103<1 1337 12<12 1321 1092
988 948 727 692 705 716 638 6<15 778 660 733 635 1142 956 936

6<1.8 85.6 98.<1 99.2 103.2 87.0 77.1 75.5 6<1.0 59.9 64.8 62.2 56.1 5<1.9 63.3 57.3 58.8 5<1.1 78.<1 69.0 65.1

73.<1 8<1.3 87.2 9<1.0 95.<1 81.1 70.2 69.5 62.5 57.:i 6<1.3 59.7 5<1.6 52.3 58.9 55.8 5<1. 7 52.3 65.1 60.0 33.9

52.7 87.1 113.9 107.0 115.1 96.3 88.1 85.6 66.'1 6<1.0 65.1 66.'! 58.8 59.2
n.o
59.9 66.2 57.1 102.1 85.1 86.:1

Georgia Department of Pttblic Health

DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: l920-l9L10

SUICIDE

HOMICIDE

Year

NUMBER

RATE

Total White Col. Total White Col.

NUMBER

RATE

Total White Col. Total White Col.

1920 1921 1922 1923 192<1 1925 1926 1927 1928 1929 1930 19:J1 1932 1933 193<1 1935 1936 1937 1938 1939 19<10

128 110 18 <1.'! 6.5 1.5 167 142 25 5.8 3.3 2.1 181 152 29 6.2 8.8 2.5 166 150 16 5.7 8.6 1A 195 173 22 6.7 9.9 1.9 189 169 20 6.5 9.6 1.8 15'1 131 20 5.3 r.:i 1.8 198 179 19 6.8 10.0 l.'i 213 210 33 SA 11.6 3.0 287 268 19 9.9 14.7 1.8 296 273 23 10.2 H.8 2.1 313 282 31 10.7 15.2 2.9 30<! 279 25 10.3 11.9 2.3 312 276 36 10.5 14.6 3.3 297 265 32 9.9 13.9 2.9 300 270 30 9.9 14.0 2.1 311 28<1 27 10.2 14.6 2.4 315 288 27 10.2 14.7 2A 295 266 29 9.5 13.'! 2.6 316 290 26 10.1 14.5 2.3 282 216 36 9.0 12.1 3.3

<!79 100 379 10.5 5.9 31.6

;);J9 1<!3 406 19.0 SA 3<1.2

:\6'! 146 '!18 19.5 8.5 35.6

505 125 380 17.'! 7.2 32.7

562 155 ;J07 19.4 8.8 35.5

464 H1 323 16.0 8.0 23.5

395 97 298 13.6 '>A 26.6

510 1;!1 369 17.6 7.9 33.3

512 159 353 17.6 8.8 32.3

523 H9 374 18.0 8.2 34.6

569 loS <111 19.5
;;nr 179 ns 2o.8

8.6 38.3 9.6 38.8

;if>4 17G 379 18.7 9.3 35.0

670 208 462 22.5 11.0 42.'1

720 205 51::1 23.9 10.7 <!7 .0

661 n6 50<! 21.8 8.1 ;J5.8

G89 155 ,131 19.3 8.0 39.2

6<11 136 50;) 20.8 6.9 <15.'!

582 131 <!51 18.8 6.6 <!0.3

560 109 <!51 17.9 5.5 40.1

616 111 505 19.7 5A '16.5

MOTOR VEHICLE ACCIDENTS

ACCIDENTS AND OTHER VIOLENCE

NUMBER

RATE

NUMBER

RATE

Year
1920 1921 1922 1923 192'1 1925 1926 1927 1928 1029 1930 1931 1932 1933 193'1 1935 1936 1937 1938 1939 19,!0

Total White Col. Total White Col.
HO 100 '!0 <1.8 5.9 3.3 132 108 2,1 1.6 6.3 2.0 203 1<!2 61 7.0 8.2 5.2 267 189 78 9.2 10.9 6.7 313 239 H 10.8 13.6 6.5 3'!8 238 110 12.0 13.3 9.7 370 266 10'1 12.7 14.9 9.3 !33 288 1<15 14.0 16.0 13.1 473 319 15<1 16.3 17.6 14.1 531 335 196 18.3 18.3 18.1 612 425 187 21.0 23.1 17.4 655 ,128 227 22.3 23.0 21.0 585 126 159 19.7 22.7 14.7 675 '173 202 22.6 2'>.0 18.5 809 57<! 235 26.9 30.0 21.'! 942 6'16 296 31.1 33.5 26.9 991 692 299 32.'! 35.5 27.0 964 680 28<1 31.3 3'1.6 25.5 789 5<15 2<11 25A 27.5 21.8 669 483 186 21.4 2<1.2 16.5 802 556 246 25.7 27.3 22.7

Total White Col. Total White Col.

1603 1456 1508 1575 1772 1682 1585 1831 1901 1978 1992 2010 1914 1992 2251 2428 2775 2'!13 2125 1850 2057

853 788 8;16 850 945 947 928 1035 1090 1113 1164 1243 1182 1213 1389 1,153 1682 1<195 1309 1186 1217

750 668 662 725 827 735 657 796 311 865 828 767 732 779 862 975 1093 918 816 664 8,10

o5.3 50.3 32.0 5'1.3 61.1 58.0 5;J.6 63.0 65.4 68.0 68.4 68.'! 6'1.6 66.8 7<1.9 80.1 90.9 78.'! 68.6 59.2 65.9

50.3 46.1 <19.0 48.9 53.9 53.6 52.1 57.6 60.2 60.9 63.2 66.9 63.0 6<1.0 72.7 75.3 86.'! 76.1 66.1 59.'! 59.7

62.5 56.3 56.'! 62.5 72.1 6<!.8 58.6 71.9 7'1.1 80.0 77.2 71.1 67.5 7 Ui 78.7 88.5 98.7 82.5 73.0 59.0 77.'!

Tabulation for Individual Counties

POPULATION

TABLE l EsTIMATED PoPULATION AS oF }ULY l, 1939, AND THE CENsus PoPULATION
As OF APRIL l, l9tl0, IN EAcH CouNTY IN GEORGIA

Estimated Census Population Population July I, 1939 Apr. I, 1940

TO'l'AL
AJ>pling ----------
Atldnson ----------
Bacon -----------Bal\er ------------

3,122,931 1<1;115 8,060 7,869 8,75<1

3,123, 723 1<1,<197 7,093 8,096 7,3<14

Estimated Census PotJulation Population July I, 1939 Apr. I, 1940

Cl'isp ------------Dade -------------
Da\vson -----------
Decatur -----------
DeKalb ---..--------

18,638 4,895 3,793 2;),805
7<1,912

17,540 5,894 4,'179 22,234 86,9<12

Baldwin ---------Banks -----------Barrow ----------Bartow ----------Ben Hill ----------

17,127 11,276 13,881 27,82<1 13,796

17,190 8,733 13,06<1
25,283 14,523

Dodge ------------
Dooly -------------
Dougherty -------Douglas ----------
Ea!'ly -------------

2<1,300 19,<1<19 23,018 10,'188 20,021

21,022 16,886 28,565 10,053 18,679

Berrien -----------
Bibb -------------
Illecl<ley ---------Brantley ----------
BrooJ\:s -----------

17,0<11 79,308 10,095
7,783 23,00'1

15,370 83,783
9,655 6,871 20,,197

Echols -----------JGffingham -------Elbert -----------Emanuel ---------Evans ------------

2,753 11,126 19,835 26,<187
7,833

2,96<1 9,6<16 19,618 23,517 7,401

Bryan -----------Bulloch ----------Burlw -----------Butts -------------
Calhoun ----------
Camden -----------
Candle!' -----------Carroll -----------
Catoosa ----------Charlton ----------

6,562 29,922 30,815
9,530 11,427
6,726 10,008 37,509 10,<111
<1,982

6,288 26,010 26,520 9,182 10,438
5,910 9,103 34,156 12,199 5,256

Fannin ----------Fayette -----------Floyd ------------Forsyth -----------
Franl;;:lin ----------
Fulton ------------
Gilmer -----------Glascock ---------Glynn -----------Gordon -----------

15,263 9,303
52,996 12,<183 17,659
3'17,383 8,639 '1,860 20,760
19,057

1<1.752 8,170 56,1<11 11,322 15,612
392,886 9,001 4,547
21,920 18,445

Chatham ---------
Chattahoochee -----
Chattooga ---------
Cherokee --------Clarke ------------

108,428 9,736
17,127 23,083 26,1'10

117,970 15,138 18,532 20,126 28,398

Grady ------------
Greene -----------Gwinnett ---------Habershmn --------
Hall --------------

21,300 13,069 30,202 1<1,385 3'1,291

19,65,1 13,709 29,087 1<1,771 3<1,822

Clay --------------
C!rtyton ----------
Clinch ------------
Cobb -------------
Coffee ------------

7,590 11,065
7,8,17 38,220 22,616

7,06'1 11,655
6,<137 38,272 21,541

Hancock ---------Ha1alson ---------Harl'is -----------Hart -------------Heard ------------

1<1,199 1'!, 73'1 12,120 17,597 10,323

12,764 1<1,377 11;128 15,512
8,610

Colquitt ----------
Columbia --------Cook ------------Cmveta ------------
Crawford ---------

33,5<15 9,718
12,661 26,746 7,791

33,012 9,<133
11,919 26,972
7,128

Henry ------------
Houston ----------
Ilwin --------------
Jaclmon ---- -------
Jasper ------------

17,265 11,'11<! 13,fi03 23,719
9,131

15,119 11,303 12,936 20,089
8,772

276

Georgia Department of Public Health

TABLE 1-Continued
EsTIMATED PoPULATION AS oF JuLY l, 1939, AND THE CENsus PoPULATION As OF APRIL l, 1940, IN EACH CouNTY IN GEORGIA

Estimated Census Population Population July I, 1939 Apr. I, 1940

Jeff Davis
Jefferson ---------
.Jenldns -----------
Johnson ----------
Jones -------------

8,1<17 22,36,1 13,69,1 13,902
9,926

8,8<11 20,0,10 11,8,13 12,953 8,331

Estimated Census Population Population July I, 1939 Apr. I, 1940

Randolph --------Richmond
Rocl<dale --------Schley -----------Scl'eYen -----------

18,,1'11 7'!,757
7,265 5,698 23,629

16,60D 81,863
7,72'1 5,033 20,353

Lamar -----------Lanier -----------Lau1ens ---------Lee -------------Liberty -----------

10,439 5,532
35,052 8,680 8,625

10,091 5,632
33,606 7,837 8,595

Serninole ---------Spalding ----------
Stephens ----------
Stewart ----------Sumter -----------

7,990 23,902 13,<105 12,316 28,206

8,,192 28,,127 12,972 10,603 21!,502

Lincoln ----------Long -------------
Lowndes ----------
lJutUpldn ----------
~\IcDuffie

9,207 '1,<]<]8 32,510 :>;191 9,736

7,0'12 '1,086 31,860 6,223 10,878

Talbot ------------
'l'aliaferro ---------
Tattnal! ----------
'laylor -----------'l,elfair -----------

9,725 6,672 17,067 ll,<HO 16,<158

8,141 6,278 16,2,13 10,768 15,145

Mcintosh :l\Iacon -----------Madison ---------l\Iarion ----------l\Ierl\vether

5,939 11,5!10 16,706
7,6,13 21,602

3,292 15,917 13,<131
6,954 22,055

Terrell ------------
Thomas ----------Tift --------------
Toombs -----------
'11 0'\YllS ------------

19,178 3'!.92'1 17 ,21;) 19,391
:i,077

16.61.)
31.~~0 18,;)!)!) 16.H:i~
4,!l:!.j

Millet ---
:.VIitchell ----------
::\fonroe ----------~fontgomery ------Morgan -----------

10,390 26,737 12,612 11,038 13,135

9,998 23,261 10,749
9,668 12,713

T1eut1en ----------
':rroup ------------
'l1urner ----------Twiggs -----------
Union ------------

8,237 39,379 12,8'13
9,6'19 7,,131

'i,fi3:! ,13,819 10,8-16
D,lll 7,680

)..furray ----------:.VIuscogee --------Newton ----------Oconee ----------Oglethorpe --------

10,510 58,6,10 18,113 8,702 H,<163

11,137 75,494 18,576
7,576 12,430

Upson ------------

\Valker -----------

Walton -----------

\Yare

------~~------

\Yarren -----------

21,035 29,120 23,<Jl2 28,232 12,,139

25,064 31,02,1 20,777 27,929 10,236

Paulding ---------Peach -----------Pickens ----------Pierce -----------Pike --------------

H,l!2 10.610 ll,D93 13,993 11,:>8,1

12,832 10,378
9,136 11,800 10,375

\Yashington -------
\Vayne ------------
Webster ----------
Wheeler ----------
White ------------

26,,154 13,9,12
5,'1'18 10,,181
7,203

2'1,230 13.122
'1,726 8,!)35 6,417

Poll< -------------Plllasl\i ----------Putnam -----------
Quitman ----------
Rabun ------------

27,278 9,671 9.199 '1,569 7,099

28,467 9,82D 8,514 3,435 7,821

Whitfield ---------
Wilcox -----------
Wilkes ------------
Wilkinson --------Worth ------------

23,712 H,595 16,610 11,538 23,758

26,10:i 12,75:> 15,081 ll,025 21,374

Individual Counties-Natality

277

NATALITY

TABLE 2 LIVE BIRTHs AND RATEs PER 1,000 PoPULATION, STILLBIRTHs AND RATES
PER 1,000 LivE BIRTHs IN EAcH CouNTY IN GEORGIA: 1939 AND 1940

LIVE BIRTHS

Rate Per I,000

Number

Population

1940 1939 1940 1939

STILLBIRTHS

Rate Per I,000

Number

Live Births

1940 1939 1940 1939

'l'OTAL --------------- 6<1693 6<1910 20.7 20.8 3078 3228 <17 .6 <19.7

Appling -------------------

28<1

316 19.6 21.9

10

23 35.2 72.8

Atkinson ------------------

185

187 26.1 23.2

10 32.4 53.5

Bacon --------------------

187

231 23.1 29A

13

10 69.5 <13.3

Balm --------------------

162

170 22.1 19.4

6 <13.2 35.3

Baldwin ------------------

315

236 18.3 1<1.9

14

19 HA 74.2

Banlm ---------------------

195

193 22.3 17.1

6

30.8 20.7

Barrow -------------------

252

230 19.3 16.6

13 27.8 56.5

Bartow -------------------

368

546 22.5 19.6

19

23 33.5 <12.1

Ben Hill ------------------

252

293 17.4 21.2

12

ll 47.6 37.5

Berrien -------------------

291

355 18.9 20.8

27

15 92.8 <12.3

Bibb --------------------- 1553 1492 18.5 18.3

liS

10<1 76.0 69.7

Blecl<!ey ------------------

221

207 22.9 20.5

9

9

<!0.7

113.5

Brantley --------------- ___

173

182 25.2 23.'1

10

6 57.8 33.0

Broolm

<197

51<1 2t!.2 22.3

38

29 76.5 56 A

Bryan

135

125 21.;; 19.0

59.3 <18.0

Bulloch -------------------

573

638 22.0 21.3

32

34 55.8 33.3

Bur1~:e --------------------

729

689 27.5 22A

<11

53 56.2 84.2

Butts ____________________ _

197

165 21.5 17.3

7

14 35,!) 8<1.8

Calhoun

249

256 23.9 22.'1

9 2<1.1 3;).2

Camden Candler Carroll Catoosa Charlton

142

1<17 2<1.0 21.9

13

91.5 34.0

138

177 15.2 17.7

7

50.7 2H.2

61<1

782 19.7 20.8

36

35 53 A .J<l.S

185

IS! 15.2 17A

<1

21.6 16.6

108

158 20.5 31.7

ll 6'1.8 69.6

Chatharn ------------------ 2252 221<1 19.1 20A

ll2

116 ,19.7 52A

Chattahoochee -------------

1<15

171

9.6 17.6

<1

4 27.6 23.'1

Chattooga -----------------

<162

<100 2<1.9 23.4

6.5 20.0

Cherol<ee ------------------

<13<1

<152 21.6 19.6

17

15 39.2 33.2

Clal'l<;:e --------------------

530

<177 18.7 18.2

17

29 32.1 li0.8

Clay ----------------------

1<15

161 20.;) 21.2

10

ll 69.0 68.3

Clayton --------------------

200

170 17.2 l5A

6

7 30.0 'il.2

Clinch --------------------

129

142 20.0 18.1

<1

31.0 21.1

Cobb -------------------- _

665

672 17.'1 17.6

23

3<1.6 3:).7

Coffee --------------------

6<13

6<10 29.9 28.3

35

54.4 76.6

Colquitt ------------------

759

733 23.0 21.9

33

37 13.5 50.5

Columbia -----------------

203

237 21.5 2<1.4

17

11 83.7 46.4

Cook ---------------------

226

293 19.0 23.1

15

21 66.4 71.7

Coweta -------------- -----

<180

<16<1 17.8 17.3

17

23 35A 49.6

Cmwford ------------ ----

19<1

170 27.2 21.8

19

19 97.9 111.8

278

Georgia Department of Public Health

TABLE 2-Continued
LIVE BIRTHs AND RATES PER 1,000 PoPULATION, STILLBIRTHs AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1939 AND 1940

LIVE BIRTHS

Rate Per 1,000

Number

Population

1940 1939 1940 1939

STILLBIRTHS

Rate Per 1,000

Number

Live Births

1940 1939 1940 1939

Orisp ---------------------

<125

355 24.2 19.0

30

24 70.6 67.6

Dade ---------------------

119

111 20.2 22.7

2

2 16.8 18.0

Dawson

102

99 22.8 26.1

9.8 10.1

Decatur

<196

5H 22.3 19.9

36

32 72.6 62.3

DeKalb

1569 1'132 18.0 19.1

59 31.'1 <11.2

Dodge -------------------Doo!y --------------------Dougherty ---------------Douglas -----------------Early ---------------------

446 21.1 18.'1

26

22 58.6 <19.3

426 21.9 21.9

27

17 73.0 39.9

522 17.5 22.7

23

37 46.1 70.9

215 18.6 20.5

5

6 26.7 27.9

46<1 21.'1 23.2

26

17 65.0 36.6

Echols --------------------

70

52 23.6 18.9

2 71.'1 38.5

Effingham _______________ _

187

22<1 19.'1 20.1

H

15 7'1.9 67.0

Elbert ___________________ _

<120

'119 21.'1 21.1

25

16 59.5 38.2

Emanuel ----------------- _ 533

526 22.7 19.9

36

32 67.5 60.8

Evans ___________________ _

171

183 23.1 23.'1

52.6 21.9

Fannin ---------------- __ _

366

395 2<1.8 25.9

18 19.1 <15.6

Fayette -------------------

192

213 23.5 22.9

5

10 26.0 <16.9

Floyd --------------------- 1175 1141 20.9 21.5

61

<18 51.9 <12.1

Forsyth -------------------

228

2'19 20.1 19.9

<1 21.9 16.1

Franldin ------------------

299

274 19.2 15.5

12

18 <10.1 65.7

Fulton -------------------- 733<1 7213 18.7 20.8

257

272 35.0 37.7

Gilmer --------------------

259

231 28.8 26.7

Glascock _________________ _

88

118 19.'1 24.3

7.7 17.3 llA 50.8

Glynn --------------------

<166

456 21.3 22.0

20

2<1 42.9 52.6

Gordon -------------------

<119

411 22.7 21.6

10

10 23.9 24.3

Grady --------------------

440

<166 22.'1 21.9

13

22 29.5 '17.2

Greene -------------------

268

296 19.5 22.6

12

12 4'1.8 <10.5

Gwinnett ------------------

575

571 19.8 18.9

21

30 36.5 52.5

Habersham ---------------

386

3<16 26.1 2<1.1

18

11 <16.6 31.8

Hall ----------------------

641

63<1 18.'1 18.5

26

27 <10.6 <12.6

Hancocli: ------------------

306

315 2'1.0 22.2

10

15 32.7 47.6

Hamlson -----------------

277

280 19.3 19.0

<1

11 HA 39.3

Hanis --------------------

261

271 22.8 22A

10

14 38.3 51.7

Hart ------ ----------------

339

309 21.9 17.6

20

17 59.0 55.0

Hea rei

137

169 15.9 IGA

4

2 29.2 11.8

Henry

316

339 20.9 19.6

18

23 57.0 67.3

Houston ------------------

265

229 23.'1 20.0

22

2<1 83.0 104.8

Irwin ---------------------

251

287 19.'1 21.3

11

H <13.8 <18.8

Jacl.;:son -------------------

'120

<181 20.9 20.3

16

15 38.1 31.2

J-asper --------------------

182

174 20.7 19.1

15

20 82.'1 114.9

Individual Counties-Natality

279

TABLE 2-Continued
LIVE BIRTHS AND RATES PER 1,000 PoPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EAcH CouNTY IN GEORGIA: 1939 AND 1940

LIVE BIRTHS

Rate Per I,000

Number

Population

1940 1939 1940 1939

STILLBIRTHS

Rate Per I,000

Number

Live Births

1940 1939 1940 1939

Jeff Davis ----------------

197

219 22.3 25.0

11

55.8 32.0

Jefferson ------------------

522

516 26.0 23.1

25

32 '17 .9 62.0

Jenldns -------------------

286

231 21.1 16.9

IS

6 62.9 26.0

Johnson ------------------

260

262 20.1 18.8

1S

13 69.2 <19.6

Jones ---------------------

172

206 20.6 20.8

11 '10.7 53.'1

Lmnal' --------------------

203

206 20.1 19.7

11

5t!.2 <13.7

Lanier __ ------------------

76

112 13.5 20.2

14 39.5 125.0

Laurens ------------------

789

S11 23.5 23.2

<16

<13 G8.3 52.8

Lee -~----------------------

187

1S3 23.9 21.1

13

13 69.5 71.0

Liberty -------------------

179

198 20.S 23.0

20

18 111.7 90.!l

Lincoln -------------------

1<12

132 20.2 1<1.3

5 35.2 37.9

Long ---------------------

62

73 15.2 16.'1

l

1 16.1 5<1.8

Lowndes ------------------

685

699 21.5 21.5

39

35 56.9 50.1

Lumpkin ------------------

143

131 23.0 21.'1

3

21.0 22.'1

McDuffie -----------------

261

233 21.0 23.9

15

H 57.5 60.1

Mcintosh

163

160 30.8 26.9

12.9 :\6.3

:.\lacon --------------------

385

390 21.1 22.2

21

18 54.5 46.2

J1adison ------------------

285

287 21.2 17.2

13

H '15.6 48.8

:\Iarion -------------------

209

19<1 30.1 25.4

15

17 71.8 S7.6

Jieriwethe!' ----------------

176

<1<11 21.6 17.9

27

26 56.7 :i!l.O

~Iillet ---------------------

184

195 18.'1 18.8

5

s 27.2 '11.0

:\Iitcllell ------------------

600

622 25.8 24.8

35

32 58.3 48.3

Monroe -------------------

236 23.6 1S.7

19

18 74.8 76.:1

Montgomery ---------------

201 16.3 18.2

13

13 82.3 6<1.7

:\forgan

27S 28.6 21.2

20

19 55.1 68.3

:\Iurray

252

262 22.6 2'1.9

16

63.:i 30.r.

l\:Iuscogee ----------------- 1496 1316 19.S 22.'1

78

67 52.1 GO.!l

Newton -------------------

381

<119 20.5 23.1

13

23 3<1.1 5'1.9

Oconee -------------------

116

105 15.3 12.1

6

H 51.7 133.3

Oglethorpe ----------------

278

280 22.'1 19.'1

11

16 39.6 57.1

Paulding _________________ _

254

26S 19.8 19.0

16 23.6 39.7

Peach --------------------

228

216 22.0 23.2

13

16

57.0

6~.0

Pickens -------------------

213

211 23.3 19.0

3

7 H.l 3:!.2

Pierce --------------------

308

360 26.1 23.7

19

19 61.7 52.8

Pike ----------------------

245

233 23.6 20.1

11

11 4'1.9 <17.2

Polk ----------------------

622

fi65 21.8 20.7

25

20 !10.2 35.4

Pulasld ___ ---------------

1S7

176 19.0 18.2

10

10 53.5 56.3

Putnam -------------------

212

199 24.9 21.6

11

IS 51.9 90.:i

Quitman ------------------

77

80 22.'1 17.fJ

4

51.9 30.0

1\abun . ------------------~-

168

170 21.5 23.9

2

11.9 17.G

1\andolph -~--- ~- -----------

:H3

323 20.7 17.fi

19

23 55.'1 71.2

280

Georgia Department of Public Health

TABLE 2-Continued
LIVE BIRTHS AND RATEs PER 1,000 PoPuLATION, STILLBIRTHs AND RATEs PER 1,000 LIYE BIRTHS IN EAcH CouNTY IN GEORGIA: 1939 AND 19L!Q

LIVE BIRTHS

Rate Per I,000

Number

Population

1940 1939 1940 1939

STILLBIRTHS

Rate Per 1,000

Number

Live Births

1940 1939 1940 Jg39

Richmond ----------------- 1610 1525 19.7 20.'1

88

76 54.7 <19.8

Rockdale ------------------

150

157 19.'1 21.6

11 60.0 70.1

Schley --------------------

119

12<1 23.6 21.3

'1

33.6 10.3

Screven -------------------

'181

518 23.8 21.9

15

<12 93.0 31.1

Seminole ------------------

208

216 21.5 27.0

9

10 '13.3 46.3

Spalding

513

<143 18.0 18.5

39

76.0 103.8

Stephens

296

288 22.8 21.5

13

<13.9 31.3

Stewart -------------------

185

239 17.'1 19.'1

3

11 16.2 46.0

Sumter -------------------

526

528 21.5 18.7

30

26

57.0

<19.2

'l'albot --------------------

189

208 23.2 21.'1

16 42.3 76.9

'l'aliaferro _______________ _

1'i0

'l'attnall ------------------

241

'TaylOl'

220

'llelfair

312

'l'el'l'ell

<131

23.9 21.7

11 33.3 75.9

11.8 18.9

13

1U 53.9 58.8

20.'1 21.0

8

Hi 36.'1 62.5

20.6 18.5

15

1:i 18.1 19.3

25.8 22.1

19

2<1 1!.1 56.6

Thomas -------------------~

[)82

6<18 18.6 13.6

'l'ift ----------------------

39<1

<!1<1 21.2 2'1.0

'l'oombs -------------------

302

312 17.8 16.1

'l'owns --------------------

103

111 20.9 21.9

'rleutlen ------------------

H2

157 18.6 19.1

33 <!1.2 50.9

]5 60.9 36.2

16 53.0 51.3

<18.5

45.0

28.2 41.6

'l'roup 'l'urner 'l'wiggs Union
Upson

307

793 18.'1 20.1

33

53 <10.9 66.8

201

253 18.5 19.7

15

74.6 31.6

2<12

243 26.5 25.2

10

H

<ll.3 57.6

211

221 27.5 29.7

10

10 17.'1 45.2

561

518 22.5 2<1.6

16

18 28.'1 3<1.7

Walker -------------------

513

5<!1 17.5 18.6

lJ

11l 27.6 29.6

Walton -------------------

121

158 20.'1 19.6

19

13 <1<1.8 23A

Ware ---------------------

581

581 20.8 20.6

3<1

42 53.fi 72.3

'\Yu.rren ------------------ _

2<16 22.9 19.8

12

51.3 28.ii

Washington ---------------

586

519 24.2 19.6

26

26 <l,lA 50.1

\Ya.yne --------------------

36-1

337 27.7 2<1.2

12

H

33.0 <11.5

Webster ------------------

81

98 1i.1 18.0

8

10 98.8 102.0

Wheeler ------------------

171

139 20.0 18.0

<1

23A 26.5

White --------------------

175

170 27.3 23.6

31.3 35.3

Whitfield --------------- ___ 56:)

542 21.6 22.9

21

37.2 <!4.3

\Vllcox -------------------

277 21.'1 19.0

15

10

36.1

Wilkes --------------------

331 20.3 19.9

28

22

66.5

Wilkinson ----------------

206 22.1 17.9

l<l

16 57 A 77.7

wo,th --------------------

513

610 2'1.0 25.7

3<1

30 66.3 tl9.2

Births of Georgia residents

occurring in other states__

213

236

N011E: 11hese figures are allocated to county of residence and exclude non-residents of Georgia. Only tho state totals include residents of Georgia births occurring in other states.

Individual Cozmties-Mortality

281

MORTALITY

TABLE 3
DEATI-IS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHs IN EAcH CouNTY IN GEoRGIA: 1939 AND l9L10

INFANT MORTALITY

Rate Per I,000

Number

Live Births

1940 1939 1940 1939

MATERNAL MORTALITY

Rate Per 1,000

Number

Live Births

1940 1939 1940 1939

TO'fAL --------------- 3737 3817 57.8 58.8

3<12

356

5.3

Appling -------------------

11

8 38.7 25.3

1

2

3.5

6.3

Atkinson ------------------

9

10 <18.6 53.5

5A

5.3

Bacon --------------------

19

17 101.6 73.6

5.3

Baiwr --------------------

6

6.2 33.3

5.9

Baldwin ------------------

31

12 98.'1 46.9

Banl;s --------------------

13

12 66.7 62.2

2

27.3

10.3

5.2

Bar!'O"\Y -------------- ___ _

16

8 63.5 3<1.8

Bartow -------------------

53

35 93.3 6<1.1

3

4

5.3

7.3

Ben Hill ------------------

28

13 111.1 <HA

2 11.9

6.8

Ber!'ien --------- ~--------

23

H

79.0 39.'1

2

Bibb ---------------------

99

111 63.7 HA

10

Biecl<ley ------------------

18

15 81.<1 72.5

Brantley ------------------

10 23.1 54.9

Broolm

31

25 62A <18.6

6.9

6A

6.0

5.8

2

<1.0

3.9

Bryan --------------------

59.3 32.0

2

Bulloch -------------------

20

31 3<1.9 48.6

3

Burl<e --------------------

<10

36 5<1.9 52.2

5

Butts ---------------------

6

13 30.5 78.8

Callloun ------------------

2<1

12 96A <16.9

1<1.8

5.2

<1.7

6.9

7.3

18.2

12.0

3.9

Camden Candle1 Cal'!' o i l Catoosa Chal'lton

35.2 5'1.4

12

1<1 87.0 79.1

5

36.2 16.9

<19

<16 72.7 58.8

3

<1

<1.5

5.1

11 32A 60.8

2

11.0

11

10 101.9 63.3

9.3

Chatham

131

1<19 58.2 67.3

21

20

9.3

9.0

Chattahoochee -------------

7

5 <18.3 29.2

5.8

Chattooga -----------------

18

15 39.0 37.5

6.5

Cheroltee -------------------

28

12 6<1.5 26.5

2

Clarke --------------------

35

40 66.0 83.9

<1

'1.6

6.6

7.5 10.5

Clay

5

34.5 55.9

2

Clayton ------------------Clinch --------------------

1.0,

11 50.0 6<1.7 5<1.3 35.2

Cobb ---------------------

32

46 <18.1 68.5

4

Coffee ---------------------

36

39 56.0 60.9

2

13.8

6.2

5.0 ll.S

7.8

6.0

1.5

3.1

9.'1

Colquitt ------------------

<15 55.3 61A

6

8.2

Columbia ------------------

13 2<1.6 5<1.9

2

SA

Cool< ---------------------

11

17 <18.7 58.0

1

3.'1

Coweta -------------------

25

25 52.1 53.9

3 lOA

6.5

C!awford -----------------

8

9 <11.2 52.9

2

10.3

282

Georgia Department of Public Health

TABLE 3-Continued
DEATI-IS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1939 AND 194.0

INFANT MORTALITY

Rate Per 1,000

Number

Live Births

1940 1939 1940 1939

MATERNAL MORTALITY

Rate Per 1.000

Number

Live Births

1940 1939 1940 1939

Crisp ---------------------

33

28 77.6 78.9

Dade ---------------------

2

1 16.8

9.0

Dawson

2

19.6 80.8

Decntm

2<1

t!SA 66.1

DeKnlb

75

47.8

2.4 11.3 8.'1

'1.0

5.8

2.8

Dodge --------------------

18

11 '10.5 2'1.7

4

2.3

9.0

Dooly ---------------------

18

17 '18.6 39.9

16.2

Dougherty -----------------

30

32 60.1 61.3

3

1

6.0

1.9

Douglas -------------------

18

96.3 23.3

1

'1.7

Early ---------------------

35

26 87.5 56.0

10.0

6.5

Echols --------------------

28.6

14.3 19.2

Effingham ----------------

15

17 80.2 73.9

5.3

Elbert --------------------

22

12 52.'1 28.6

2

2

'1.8

4.8

Emanuel ------------------

32

37 60.0 70.3

9.'1

9.5

E\'Uns --------------------

H

8 81.9 '13.7

5.8

Fannin ------~-------------

26 65.6 65.8

Fayette --------------------

<11.7 37.6

Floyd ---------------------

71 J

69 60.'1 60.5

Forsyth -------------------

9

H 39.5 56.2

2

Franldin --------------- __ _

16

17 53.5 62.0

2.7

1.6

5.2

3.'1

3.5

8.8

10.0 10.9

Fulton --------------------

386

1122 52.6 58.5

23

2<1

3.1

3.3

Gilmer --------------------

12 30.9 51.9

1

3.9

'1.3

Glascoclt -------------------

3 79.5 25.4

11.'1

Glynn --------------------

45

26 96.6 57.0

3

'1.3

6.6

Gordon --------------------

22

29 52.5 70.6

2.'1

2.'1

Grady ----------------------

31

36 70.5 77.3

2

'l

'1.5

8.6

Gl'eene --------------------

15

21 56.0 70.9

2

2.7

6.8

Gwinnett ------------------

35

39 60.9 68.3

2

3

3.5

5.3

Habersham -----------------

19

H

'19.2 '10.5

Hall ----------------------

,13 67.1 67.8

3

2.6

8.7

9A 12.6

Hancoclr ------------------

19

62.1 28.6

19.6

3.2

Haralson -------------------

9

16 32.5 57.1

2

3.6

7.1

Harris --------------------

18

24 69.0 88.6

2

7.4

Hart ----------------------

20

15 59.0 '18.:i

2

2

5.9

6.5

Heard ----------------------

12

H 87.6 82.8

1

7.3

Henry ----------------------

10

18 60.1 53.1

3

9.5

2.9

Houston -------------------

16

60.'1 39.3

3

11.3

'1.4

Ir,vin ------------------- __

18

12

71.7

'll.~

2

4.0

7.0

Jaclmon --------------------

18

25 t12.9 52.0

9.5

11.2

Jasper --------------------

13

15 71.<1 86.2

16.5

5.7

Individual Cozmties-Jl/1ortality

283

TABLE 3-Continued DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1939 AND 19iJ,O

INFANT MORTALITY

Rate Per 1,000

Number

Live Births

1940 1939 1940 1939

MATERNAL MORTALITY

Rate Per I,000

Number

Live Births

1940 1939 1940 1939

Jeff Davis -----------------

19 <15.7 86.8

5.1

<1.6

Jefferson -------------------

17

33 32.6 6<1.0

1

<1

1.9

7.3

Jen1dns -------------------

12

3 42.0 3<1.6

1

3.5

4.3

Johnson --------------------

11

17 <12.3 6<1.9

2

7.7

3.8

Jones ---------------------

15

12 87.2 58.3

Lamar --------------------

10

13 49.3 63.1

Lanier ---------------------

3

5 39.5 '14.6

Laurens -------------------

57

33 72.2 40.5

Lee ___ --------------------

15

14 30.2 76.5

2

Liberty --------------------

20

21 111.7 106.1

2

4.9

26.8

6.3 11.1

10.7

11.2

5.1

Lincoln -------------------

3

21.1 22.7

Long

<18.'1 123.3

Lowndes ------------------

27

35 39.'1 50.1

Lumpkin -------------------

3

3 21.0 22.4

McDuffie ------------------

12

H <16.0 60.1

2

27.4

4 11.7

5.7

3

3.8 12.9

Mcintosh ------------------

10

13 61.3 81.3

Macon ---------------------

35

29 90.9 HA

Madison ------------------

12

18 <12.1 62.7

:Marion __ -----------------

15

21 71.3 108.2

lV!eriwether -----------------

19

22 39.9 <19.9

3 13.0

7.7

3.5

5.2

6.3

6.3

Miller __ -------------------

38.0 35.9

Mitchell --------------------

35

<19 58.3 7<1.0

5.0

4.5

l\'Ionroe -------------------

H

16 55.1 67.8

3.9

Montgomery ----------------

11

6 69.6 29.9

6.3

Morgan

28

12 77.1 <!3.2

3

2

8.3

1.2

Murray

19

15A 26.7

i\Iuscogee -----------------

65

8<1 <13.'1 63.8

Newton --------------------

20

33 52.5 78.8

Oconee --------------------

<1

5 3<1.5 <17.6

Oglethorpe ----------------

27

24 97.1 85.7

15.3

<1,7

5.3

2

4.8

3.6

3.6

Paulding ------------------

10

14 39.'1 52.2

3.7

Peach __ --------------------

16

23 70.2 93.5

13.2

<J.l

Piclo;:ens -------------------

19

20 89.2 9<1.8

4.'1

Pierce ___ ------------------

10

26 32.5 72.2

3

1

9.7

2.8

Pike

H

16 57.1 68.7

2 12.2

8.6

Poll<

44

25 70.7 4<1.2

f'ulasld -------------------

17 26.7 96.6

Putnam -------------------

12

11 56.6 55.3

Quitman ------------------

4

51.9 37.5

Habun ---------------------

17.9 29.'1

Randolph -------------------

18

22 52.5 68.1

2

1.6

3.5

11A

5.0

13.0 12.5

4

12.<1

284

Georgia Department of Public Health

TABLE 3-Continued DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1939 AND 1940

INFANT MORTALITY

Rate Per 1,000

Number

Live Births

1940 1939 1940 1939

MATERNAL MORTALITY

Rate Per 1,000

Number

Live Births

1940 1939 1940 1939

Richmond -----------------

73

iR <16.6 :)1.1

11

Rockclale ------------------

H

93.3 31.8

Schley --------------------

10

8<1.0 <18.'!

Screven --------------------

<13

31 88.8 59.8

Seminole

10

11 <18.1 50.9

:l

6.8

2.0

SA

'1.1

5.8

9.6

<1.6

Spalding

53

<11 103.3 92.6

Stephens

10

19 33.8 66.0

Stewart --------------------

12

16 6<1.9 66.9

Smnter --------------------

39

36 7<1.1 68.1

'l'albot ---------------------

30

15 158.7 72.1

3.9 13.5

6.8

5.4

<1.2

9::;

10.6

4.8

'lallaferro -----------------

o.:J.:l

Tattnall --------------------

:!:l

8.:J 71.2

'l'a.vlor Telfair

18.2 33.3

1:1

20 ,JS.1 o:;.x

'l'errell

37

31 85.8 73.1

<1.1 L:-i llA ll.fl

9.3
13.~
2.<1

Thomas -------------------

33

36 56.7 55.0

Tift -----------------------

27

36 68.5 87.0

'l'oombs --------------------

12 29.8 38.:i

Towns --------------------

10

97.1 <15.0

'l'reutlen ------------------

35.2 38.2

2

8.6 10.8

5.1

<1.8

12.8

9.0

14.1

6.'1

'l'roup ----------------------

55

<19 68.2 61.8

'l'urner --------------------

12

14 59.7 55.3

Twiggs ---------------------

13

13 53.7 53.5

Union ---------------------

17

17 80.6 76.9

Upson --------------------

33

39 58.ri 75.3

3.7

6.3

3.5

9.7

Wall<er -------------------

22

36 <10.5 66.:i

1.8

Walton -------------------

30

37 70.8 80.8

2

2

<1.7

Ware ---------------------

15

31 25.8 53.'!

<l

5.2

6.9

V\7arren -------------------

17

17 72.6 69.1

12.8

Washington ---------------

29

22 tl9.:1 <12.'!

6.8

1.9

Wayne --------------------

13

19 35.7 56.'!

Webster --------------------

1

<1 12.3 40.8

Wheeler -------------------

<]6.8 <12.3

White ---------------------

11

11 62.9 6<1.7

Whitfield ------------------

40

2<1 70.8 <1<1.3

2.7

8.9

20.'1

5.8

3

17.6

5.3

1.8

\Vilcox __________________ _

12

8 4<1.0 28.9

3.7

Will<es --------------------

12

17 39.2 51.'1

6

19.6

6.0

Will<inson __ ----------------

20

12 82.0 58.3

<1.1 2<1.3

Worth --------------------

tl!)

<16 87 .i 75A

1.9

!.I)

1\esidents of Georgia

dying in other states_____ _

15

12

NO'rE: 'l,hese figures are allocated to county of residence and exclude non-1eslclents of

Gteorgla. Only the state totals include residents of Georgia dying in other states.

Individual Counties-JV]ortality

285

TABLE Ll, DEATI-Is AND DEATH RATEs PER 1,000 PoPULATION IN EAcH CouNTY IN
GEORGIA: 1939 AND 19LL0

TOTAL ____ Appling ______ Atldnson ______
Baron Ba l<er _______

DEATHS

Rate Per t ,000

Number

POfJUlation

t940 1939 1940 1939

32235 31856 10.3 10.2

39

93 6.1 6.6

68

5tl 9.6 6.7

79

38 9.8 11.2

56

16 7.6 5.3

Ctisp _______ _
Dade -------Dawson ______ _ Decatur _____ DeKalb _____ _

DEATHS

Rate Per !,000

Number

Pof]Uiation

1940 !939 1940 1939

210

21B 12.0 11.1

33

1-1 ::1.6 9.0

18

21 1.0 1.1

250

2BO 11.2 10.1

716

784 8.2 10.5

Baldwin ______

238

233 13.8 13.6 Dodge _______ _

Banks _______

63

83 7.8 TA Dooly

Barrow

113

109 9.0 1.n Dougherty ___ _

Bartow ______

316

290 12.:> li)..J Doug-las ______ _

Ben Hill ____

191

H1 13.2 lOA Early __

173

7.3

171 10.7 8.8

319 13.1 13.9

84 10.1 R.O

191 9.8 9.7

Berrien ______

111

11<1 7 J 6.1 Echols

21

24 7.l 8.7

Bibb -------- 1172 1108 1<1.0 H.O Effingham

113

1H 11.7 10.2

Bleckley _____

106

96 11.0 9.5 Elbert ______ _

191

177 9.7 3.9

Brantley _____

62

59 9.0 7.6 Emanuel ____ _

:NT

2:i2 lO.:i 9.5

B1ool~:s ______

214

211 lOA 9.2 Evans ______ _

8!)

72 12.0 9.2

Bryan _______

89

TT H.2 11.7 Fannin _____ _

121

12R R.2 R.'l

Bulloch ______

192

207 TA 6.9 Fayette _____ _

73

72 R.9 7.

Burke _______

330

271 12.'1 8.8 Floyd _______ _

567

537 !0.1 10.1

Butts __

99

132 10.3 13.9 Forsyth _____ _

<l!l

;12 4.3

Calhoun _____

113

113 10.8 9.9 Franldin ____ _

135

146 8.6 8.3

Camden

77

81 13.0 12.5 Fulton ______ _ 1579 t1592 11.7 13.2

Candler

93

77 10.2 7.7 Gilmet _____ _

70

6'1 7.8 7A

Canol! _______

327

296 9.6 7.9 Glascock ____ _

32

31 7.0 7.0

Catoosa ______

65

60 5.3 5.8 Glynn

280

2'17 12.8 11.9

Charlton

52

51 9.9 10.2 Gordon _____ _

134

162 7.3 8.5

Chatham

1792 1671 15.2 15A Grady ______ _

201

199 10.2 9.3

Chattahoochee_

68

13 4.5 t!A Greene _____ _

160

13B 11.7 lOA

Cllattooga ____

116

121 6.3 7.1 Gwinnett ____ _

229

263 7.9 8.9

Cherol<ee ______

190

133 9.<1 5.3 Habersham __ _

H1

113 9.5 7.9

Clatke _______

319

352 12.3 13.5 Hall

291

332 SA 9.7

Clay __ ______

61

73 8.6 9.B Hancocl\ ____ _

148

110 1l.B 7.7

Clayton ______

90

123 7.I 11.1 Haralson ____ _

102

96 7.1 6.5

Clinrh _______

56

15 3.7 5.7 Harris

151

122 13.2 10.1

Cobb ________

352

310 9.2 3.9 Hart -

121

123 3.0 7.0

Coffee -------

190

236 8.8 lOA Heard

77

65 8.9 6.3

Colquitt ______

268

293 8.1 8.1 Henry

151

175 10.2 10.1

Columbia ____

80

76 8.5 7.8 Houston ____ _

119

112 10.5 9.R

Cook

97

108

8.1

8.5

!!'Will --------

95

86 7.3 6A

Coweta ______

250

209 9.3 7.8 Jac]<Son _____ _

1G1

188 7.5 7.9

CmwfOl'd -----

78

71 10.9 9.1 Jasper -------

122

129 13.9 H.l

286

Georgia Department of Public Health

TABLE i.lr-Continued
DEATHS AND DEATH RATES PER 1,000 PoPULATION IN EAcH CouNTY IN GEORGIA: 1939 AND 1940

Jeff Davis ___ _ Jefferson ____ _ Jenl\ins ______ Johnson _____ Jones _______ _
Lamar ______ _ Lanier _______
Laurens -----Lee --------Uberty
Lincoln Long ________
Lowndes ----Lumpkin _____ l\IcDnffie ____
Mcintosh ----1\Iaeon ______ _ l\fadison ____ _ l\farion _____ _ Meriwether __ _
Il!iller _______
Mitchell ---i\!omoe -----Montgomery __ Morgan ?thu.1ay _____ _
Muscogee ___ _ Newton ______
Oconee ------Oglethorpe --Paulc1ing ----Peach ------

DEATHS

Rate Per 1,000

Number

Population

1940 1939 1940 1939

6<1

81 1.2 9.3

174

178 8.7 8.0

115

15<1 9.1 11.2

59

102 1.6 7.3

79

95 9.:> 9.6

111

121 1!.0 11.6

37

4<1 6.6 8.0

386

361 11.5 10.4

91

86 12A 9.9

121

101 1<1.1 12.1

32

36 <1.5 3.9

3G

17 8.3 10.6

332

281 lOA 8.7

30

45 1.8 8.2

113

118 10.4 12.1

88

66 16.6 11.1

197

161 12.4 9 .,

121

116 9.0 6.0

99

97 14.2 12.7

226

227 10.2 9.2

17

55 4.7 5.3

218

243 9A 9.1

H1

138 13.1 10.9

19

60 8.2 5.4

162

141 12.7 11.0

119

86 10.7 8.2

113

732 10.2 12.5

218

182 11.7 10.0

53

65 7.0 7.5

1<1'1

123 11.6 8.5

9<1

101 7.3 1 A

117

123 11.3 11.6

Rockdale ______ Schley _______ Screven _____ _ Seminole ----Spalding Stephens _____
Stewart -----Sumter ______ _ '1'albot ______ _ 'l'aliaferro __ _ Tatfnall _____ _
Taylor ------'l,elfai! ______ _
Terrell ------~rhomas _____ _ 'fift
Toombs _____ _ Towns ______ _ 'llreutlen ____ _ rroliP 'furner ______ _
'llwiggs -----Union ______ _ Cp,on _______ \Vall<;:er Walton _____ _
Wal"e ________ Warren ______ Washington __ Wayne ______ Webster ______

DEATHS

Rate Per 1.000

Number

Population

1940 1939 1940 1939

11

10 10.0 9.1l

<17

55 9.3 9.>

246

191 12.1 3.1

51

77 6.'1 9.6

329

293 11.6 12.3

86

111 6.6 S.3

112

115 10.6 9.3

291

212 12.1 9.6

130

93 16.0 9.l)

57

57 9.1 8.:\

89

106 5.5 B .,

81

81 7.8 l.:l

H6

161 9.6 9.8

212

188 12.7 9.8

311

3H 9.9 9.0

176

205 9.5 1l.D

118

131 7.0 6.8

19

39 3.9 7.7

60

19 7.9 5.9

<196

41<1 11.3 12.0

97

96 8.9 7.5

89

65 9.8 6.7

63

70 8.2 9.4

2<12

23<1 9.7 11.1

136

203 6.0 7.1

219

239 10.5 10.2

292

312 10.5 11.!

100

95 9.8 1.6

221

236 9.2 8.9

85

89 6.5 6.4

3<1

<13 7.2 7.V

Picl{8!1S ----Pierce _______
Pike ---------Polk _________ Pulaski Putnam M------
Quitman ----Rabun ------Randolph IUchmond ___ _

84 103 125 235
90 100
32 28 204 1020

10 9.2 6.3 Wheelel" ______

42

119 8.7 8.5 White _______

10

107 12.0 9.2 Whitfield ____

2<15

238 8.3 8.7 Wilcox

8<1

119 9.2 12.3 Will<es --------

182

109 11.1 11.8

Wilkinson ____

132

36 0.3 7.9 Wol"th _______

211

52 3.6 7.3 Residents of

193 12.3 10.5

Georgia dying

1039 12.5 13.9

in other states 310

52 <1.9 3.0 5<1 6.2 r.;; 22<1 9.<1 9.4 89 6.6 6.1 178 12.1 10.7
101 12.0 S.X 230 10.2 9.7
295

NO'E: These figures are allocated to county of residence and exclude non-1esidents of Ge01gia. Only the state totals include residents of Georgia dying in other states.

Individual Counties-ill]ortality

287

TABLE 5 DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TYPHOID AND
MALARIA IN EAcH CouNTY IN GEoRGIA: 1939 AND 1940

'l'O'l'AL __________________ _
appling ------------------Atldnson ---------~~-------Bacon Bal\er ---------------------

TYPHOID

Rate Per I00,000

Number

Population

1940

1939 1940 1939

MALARIA

Rate Per 100,000

Number

Population

1940 1939 1940 1939

63

33

2.2

2.7

89

101

2.8

3.2

13.6

Ilaldwin -------------------

5.8

5.8

Ilanl<s ---------------------

Barrow --------------------

Bartow --------------------

5

19.8

Ben H\11 __________________ _

2

2 13.8 1<!.5

7.2

13.8

7.2

Berrien ------------------Bibb ---------------------Biecl<ley -------------------
Brantley ------------------Brool\8 --------------------

Bl'yan --------------------Bulloch ___________________ _
Btlrke --------------------Butts --------------------Calhoun

Camden -------------------

Candler -------------------

Canon ____________________ _

2

Catoosa-------------------- Charlton____________________ _

3.0

2

6.7

2

21.0

1

5.9

2.7

1.3

lOA

14.6 25.7

<!.9

4.3

15.9 15.2

<l

3.8 13.4

10.5 9.6 35.0

2

29.7

2.9

2.7

Chatham ------------------

1

0.8

Chattahoochee -------------

Chattooga -----------------

Chel'Ol<ee -----------------Clarke --------------------

2

3.7

3.8

2

0.8

1.3

Clay ----------------------

Clayton -------------------

2

Clinch ------------- --------

Cobb ---------------------Coffee -----------<----------

2

17.2

9.0

28.3 13.2 9.0

5.2

2.6

1

t!A

Colquit& ------------------Columbia ------------------
Cool< ---------------------Coweta --~----------------Crawford ------------------

3.0

2

3

6.1

8.9

10.3

7.9

7.5

1

3.7

3.7

38.5

1

14.0 12.8

288

Georgia Department of Pnblic Health

TABLE 5-Continued
CEATHS AND DEATH RATEs PER 100,000 PoPULATION FROM TYPHOID AND MALARIA IN EACH COUNTY IN GEORGIA: 1939 AND 194.0

TYPHOID

Rate Per I00,000

Number

Population

1940

1939 1940 1939

MALARIA

Rate Per I00,000

Number

Population

1940 1939 1940 1939

Crisp --------------------Dade ---------------------Dawson ------------------Decatur ------------------DeKalb --------------------

5.7

3.9

2

21.5

9.0

7.8

1.2

Dodge --------------------

1

!.8

1.1

11.3

4.1

Dooly ---------------------

1

5.1

5.9 15.4

Dougherty -----------------

3.5 13.0

Douglas -------------------

2

19.9

Early ---------------------

5A 10.0

3

2 16.1 10.0

Echols -------------- _____ _
Effingham ---------------Elbert -------------------Emanuel -----------------Evans

5.0

2

1.3

7.6

3

13.5

36.3 12.8

Fannin
Fayette --------------------Floyd --------------------Forsyth ------------------Franldin ------------------

6.6 12.2
8.0 5.7

Fulton --------------------

0.3

1.7

0.3

Gilmer ------~---------- __ _

Glascoe!< ------------------

22.0

Glynn ---------------------

!.8

G~ordon ___________________ _

Grady ---------------------Greene -------------------Gwinnett -----------------Habersham ----------------Hall -----------------------
Hancock ------------------Haralson -----------------Harris --------------------Hart ---------------------Heard
Henry Houston ------------------Irwin --------------------Jac1mon ------------------Jasper --------------------

1.7

7.3

1

3.3

7.0

6.6

5.8

8.7

7.7

llA

5.1 1.1

7.0

8.8

8.7

7.7

7.1

5.0

Individual :Cozmties~JVlortality

289

TABLE 5--Continued
DEATI-Is AND DEATH RATEs PER 100,000 PoPULATION FROM TYPHOID AND MALARIA IN EACH COUNTY IN GEORGIA: 1939 AND 19L10

TYPHOID Rate Per J00,000

MALARIA
Rate Per Joo,ooo

Number

Pojlulation

Number

Population

!940

!939 !940 !939 !940 !939 !940 !939

Jeff Davis ---------------Jefferson -----------------Jenldns -------------------Johnson -------------------Jones ---------------------

1

11.3

1

5.0

SA

7.3

21.6

2

15.'1

Lamar -------------------Lallier -------------------Laurens ___________________
Lee ----------------------Liberty --------------------

18.1

3.0

1

8.9

2.9

2

3 25.5 3'1.6

Lincoln -------------------Long ---------------------Lowndes ------------------Lumpldn ------------------McDuffie -----------------

2

t!5.0

'!

12.6

9.2

Mcintosh

l\Iacon --------------------

1\Iadison ------------------

1

Marion ---------------------

3

l\Iel'iwether ----------------

2

37.8

6.3

3

6.3 17.1

1.4

6.0

'!3.1

4.5

8.1

Miller ---------------------

Mitchell ------------------

2

:Monroe -------------------Montgomery ______________ _

Morgan

8.6

3.7

9.1 1.6

3

11.2

1

7.9

1

9.1

Mui'ray

1

l\Iuscogee -----------------

1

Newton --------------------

Oconee --------------------

Oglethorpe ----------------

9.0

9.5

1.3

1.7

6.9

2

3.'1

Paulding -------------- ___ _ Peach Piclwns --------------------Pierce --------------------Pil;e ------------------ ---

Polk

2

Pulaski --------------------

Hltnam -------------------

Quitman --------------------Itabun ----------------- ___ _

9.6

21.9

9.0

1.0 3
11.7 10.9

30.5 51.7 21.9

290

Georgia Department fJf Public Health

TABLE 5-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND MALARIA IN EACH COUNTY IN GEORGIA: 1939 AND 1940

TYPHOID

Rate Per I00,000

Number

Population

1940

1939 1940 1939

MALARIA

Rate Per I00,000

Number

Population

1940 1939 1940 1939

Randol11h ---------------- __ _ Richmond _______ ----------
Rocl;dale -----------------Schley -------------------Scre~en --------------------

3

18.1

1.3

13.8

19.9

H.7

Seminole Spalding Stephens Stewart Sumter

7.0

1

7.5

1

8.1

16.3

3.5

2

25.0

3.5

16.3

Talbot
'1\tllaferro ---------------Tattnall ---------- _________ 'l'aylor Telfai1

5.9 6.6

5.9

3

6.6 18.2

Teuell ~rhomas ------------------'l'ift ----------------------'Toombs
Towns __ ------------------

6.0

5.2

5

3 30.0 15.6

1

2

3.2

5.7

5.8

1

3

5.'! 17A

5.2

17.7

TJeutlen ------------------~rroup --------------------'l'urner --------------------
'l',vlggs -------------------B"nion -------- _-------- ---

12.1

1

2 13.1

2.3

2.5

7.8

9.2

7.S

11.0

Upson --------------------"\Yall\:er __ ----------------Walton ------------------\\'are ---------- ----------\Varren -------------------

'!.8
8.5 3.6
8.0

\Yashlngton ---------------

'!.1

Wayne ---------------- ___ _

Webster -------------- __ _ Wheeler ___________________ _

White -- -----------------

2

'1.1

7.6

2

7.6 H.3

21.2

Whitfiel<l ----------------- Wilcox -------------------Wilkes -------------------\Vill;inson _----------------Worlh --------------------

3.8

6.9

2 19.9 12.0

9.1

'!.7

<!.2

2

3.8

'1.2

7.8

6.9

6.6

9.1.

9A

Ilesidents of Geotgia dying in othe1 states
NO'l1E: These figu1es are allocated lo county of residence and exclude non-residents of G~eorgia. Only the state totals inelude residents of Geo1gia dying in other states.

lndividnal Cmtnties-JIIIortality

291

TABLE 6 DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TUBERCULOSIS
AND CANCER IN EACH CouNTY IN GEORGIA: 1939 AND 19LJO

TUBERCULOSIS

CANCER

Rate Per I00,000

Rate Per I00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

TO'l'AL -- --------------- 1533 1533 19.1 49.1 1959 2003 62.7 6!.1

Appling -------------------

3

20.8

5 3!.5 34.7

Atkinson -----------------

2

28.2 12A

1 28.2 12.'1

Bacon --------------------

12.7

3 2<!.i 38.1

Bal;:er --------------------

1

5<!.::i 22.8

13.6 3!.3

Baldwin --------------------

12

11 69.8 61.2

15

13 87.3 75.9

Banks --------------- ----

3

34.'1 17.7

6

68.7 53.2

Barrow ---- --------------

1 38.3 28.8

13

9 99.5 6<1.8

Bartow -------------------

23 31.6 82.7

20

18 79.1 6!.7

Ben Hill -------------------

11 62.0 79.7

8

55.1 36.2

Be!'l'ien -------------------

2

13.0 11.7

8

52.0 16.9

Bibb ----- ----------------

63

67 75.2 84.5

76

81 90.7 102.1

Blecl<ley ---- --------------

2

1 20.7 39.6

4

<JlA 89.2

Brantley ------------------

H.6 38.5

1 H.6 51 A

Bl'OOI{S -- -----------------

2

1

9.8 17.'1

1

10 3!.2 13.5

Bryan ---------------------

79.5 30.5

6

1 95A 61.0

Bulloch -------------------

19.2 16.7

19.2 30.1

Burl<e --------------------

18

11 67.9 35.7

14

23 52.8 1<1.6

Butts ---------------------

3

7 32.7 73.5

2

5 21.8 52.5

Calhoun ----------- -------

8

9.6 70.0

.J7.9 26.3

Camden -------------------

1

Ca.ndler -------------------

3

Carroll -------------------

11

Catoosa -------------------

2

Charlton ------------------

3 16.9 H.B

33.8 89.2

3 33.0 30.0

2

22.0 30.0

8 19.8 21.3

31

13 90.8 34.7

16.'1 18.0

32.8

9.6

19.0 20.1

1 38.1 80.3

Chatham ------------------

109

Chattahoochee -------------

1

Chattooga ---- ------------

15

Cherol<ee ------------------

1<l

Clarl<e --------- ----------

6

96 92A 88.:\

102

6.6 10.3

13 80.9 75.9

69.6 21.7

10

21.1 19.1

26

89 86.5 82.1 13.2 32A 35.0
12 19.7 52.0 18 91.6 68.9

Clay -- -------------------

3

42.5 65.9

42.5

Clayton -------------------

42.9 72.3

11 68.6 99.'1

Clinch --------------------

2

31.1 12.7

31.1 12.7

Cobb ----------------------

17

11 4!.4 28.8

22

21 57.5 62.8

Coffee --------------------

11 32.5 18.6

9 37.1 39.8

Colquitt -------------------

3.0 20.9

18 27.3 53.7

Columbia ------------------

2

1 21.2 10.3

10

3 106.0 30.9

Cool< ----------------------

1

9 33.6 71.1

3 33.6 23.7

Coweta --------------------

18

11 66.7 <Jl.1

16

59.3 33.6

Crawford ------------------

2 42.1 25.7

1

56.! 6l.l

292

Georgia Department of Public Health

TABLE 6-Continued
DEATHs AND DEATH RATEs PER 100,000 PoPULATION FROM TUBERCULOSIS AND CANCER IN EACH CouNTY IN GEoRGIA: 1939 AND 1940

TUBERCULOSIS

CANCER

Rate Per I00,000

Rate Per I00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

Cl'isp ---------------------

11

14 62.7 75.1

12

68.'1 31.6

Dade ---------------------

2

5 33.9 102.1

3

50.9 122.6

Dawson

2

1<1.7

26.3

Decatur

13

8 58.5 31.0

10

15 15.0 58.1

DeKalb

37

38 12.6 50.7

73

79 84.0 105.5

Dodge --------------------

4

7 19.0 28.8

10

<1 17.6 16.5

Dooly ----------------------

8

6 17.'1 30.8

9

10 53.3 51 A

Dougherty -----------------

24

11 8!.0 60.8

29

101.5 10!.3

Douglas -------------------

5

6 19.7 57.2

6

59.7 66.7

Early ---------------------

3

16.1 30.0

5 37.5 25.0

Echols --------------------Effingham ----------------
Elbert ------------------Emanuel -----------------Evans

33.7

2 33.7 72.6

5

10 51.8 89.D

5

8 51.8 71.9

7 15.9 35.3

10.8 35.3

1

1 17.0 15.1

11

10 16.8 37.8

3

38.3

5

5 67.6 63.8

Fannin ---------------------

8 27.1 52.'1

8

5!.2 32.8

Fayette -------------------

10.7

2 85.7 21.5

l!'loyd ---------------------

38

33 67.7 62.3

!3

13 76.6 81.1

Forsyth -------------------

1 17.7

8.0

3

3 26.5 24.0

Franklin -------------------

5

2 32.1 11.3

1

25.6 28.3

Fulton --------------------

3!3

337 79.7 97.0

331

319 81.2 91.8

Gilme!' --------------------

3

33.3 11.6

7

77.8 34.7

Glascock -------------------

22.0

2

1<!.0 20.6

Glynn ---------------------

12

5 54.7 2<1.1

17

1j 77.6 81.9

Go!'Clon

10

5<1.2 <!7.2

10

10 5'!.2 52.5

Grady

8 30.5 67.6

17

86.5 32.9

Gree11e --------------------

9

3 65.7 23.0

8

11 58.'1 8!.2

Gwinnett ------------------

6

20.6 23.2

12

17 11.3 56.3

llabe!sham ----------------

11

5 7<1.5 3!.8

8

6 5!.2 11.7

Hall ----------------------

13

18 37.3 52.5

23

30 66.1 87.5

Hancock ------------------

3 39.2 21.1

12

6 9!.0 12.3

Haralson ------------------

2

13.9

6.8

5

8 3!.8 5!.3

Hanis ---------------------

<13.8 !1.3

13

1 113.8 33.0

Hart ----------------------

4

7 25.8 39.8

10

64.5 15.5

Heard

23.2

9.7

1

16.5 67.8

Henry Houston -------------------
ll''iViil --------------------Jac]\8011 --------------------
Jasper --------------------

6

2 39.7 11.6

15

11 99.2 63.7

5

10

87.2

1

35.'1 61.0

2

7.7 1!.8

3

23.2 37.0

2

! 10.0 16.9

3

12 39.8 50.6

2 79.8 21.9

8

9 91.2 98.6

Individual Counties-Jl!lortality

293

TABLE 6-Continued
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TUBERCULOSIS AND CANCER IN EACH CouNTY IN GEORGIA: 1939 AND 19L1Q

TUBERCULOSIS

CANCER

Bate Per I00,000

Bate Per I00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

Jeff Davis ----------------

Jefferson ------------------

10

Jenldns -------------------

9

Johnson -------------------

Jones

--------------------~-

2

2 22.6 22.9

'19.9 <10.2

76.0 '13.8

2

HA

2<1.0 20.1

11.3 3'1.3

5

25.0 31.3

6

12 50.7 87.6

3 38.6 21.6

2 72.0 20.1

Lamar --------------------
Lanier ---------------------
Laurens ------------------
Lee -----------------------
Liberty --------------------

5

<I <19.5 38.3

79.3 <17.9

53.3

17.8 5t!.2

9

13 26.8 37.1

16

15 '17.6 12.8

1

3 89.3 3'1.6

2

25.5 57.6

'I

'I '16.5 '16.'1

3

3'1.9 81.2

Lincoln --------------------

2 12.6 21.1

Long ---------------------

2

2 '18.9 '15.0

3

73.'1 67.'1

Lowndes ------------------

11

H 31.5 '13.1

1<1

19 43.9 58.'1

JJumpldn ------------------

16.1 36.'1

1

1 16.1 127.5

~IcDuffie -----------------

<16.0 71.9

10

91.9 51.1

:\Icintosh -----------------

33.7

6

113.'1 67.'1

:\'!aeon --------------------

37.6 11.'1

<I

25.1 51.3

:Madison ------------------

2

3 14.9 18.0

13

13 96.8 77.8

)!a!'ion --------------------

HA 13.0

129A 65.'1

)!eriwethel' ----------------

15

10 68.0 '10.6

13

2<1 58.9 97.6

Miller --------------------

2

20.0

9.6

11.0

Mitchell --------------------

2 30.1

7.5

9

H 38.7 52.'1

Monroe -------------------

5

6 <16.5 '17.5

3

10 27.9 79.1

Montgomery ---------------

2 10.3 18.1

4

'I 'Jl.'l 36.2

:\!organ -------------------

'I

6 31.5 '15.7

70.8 53.3

Murray --------------------

'J<J.9 '17.6

9

10 80.8 95.1

Muscogee -----------------

'10

38 53.0 6'1.8

55

34 72.9 58.0

Newton -------------------

12

64.6 '19.7

5 <13.1 27.6

Oconee --------------------

2

2 26.'1 23.0

7 39.6 80.'1

Oglethorpe ----------------

2 <10.2 13.8

H

112.6 <18.'1

Paulding ------------- -----

5

Peach --------------------

<I

Piclmns -------------------

4

Pierce --------------------

3

Pike - ----------------------

39.0 28.3 38.5 56.6 '13.8 25.'1 'I 57.8 3'1.5

3

23.'1 63.8

67.5 66.0

6

65.7 18.0

<I

3 33.9 21A

10 57.8 86.3

Polk ----------------------

15

Pulaski --------------------

'I

Putnam -------------------

Quitman --------------------

2

Rabun --------------------

2

52.7 33.0

10

15 35.1 55.0

'10.7 31.0

5

50.9 93.1

35.2 21.7

10

6 117.5 65.2

58.2

3

3 87.3 65.7

'I 25.6 56.3

2

10 25.6 HO.O

Georgict Department of Public Health

TABLE 6--Continued
DEATHs AND DEATH RATES PER 100,000 PoPULATION FROM TuBERCULosis AND CANCER IN EAcH CouNTY IN GEORGIA: 1939 AND 19"10

TUBERCULOSIS

CANCER

Rate Per 100,000

Rate Per I 00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

Randolph ______ ----------

12

72.2 32.3

16

12 96.3 65.1

Richmond ______ ---- ----

60

68 73.3 91.0

65

72 79.'1 96.3

Rockdale -------------------

2

27.5

4

<1 51.8 55.1

Schley ____ ----------------

2

<! 39.7 70.2

5 99.3 87.8

Screven -------------------

12

11 59.0 <16.6

13 3'1.'! 55.0

Seminole Spalding Stephens Stewart Sumter ------------ ------

2

2 23.6 25.0

5

7 58.9 87.6

2<1.6 33.5

22

20 77.-! 83.7

2

2 15.'1 l<J.9

<1

8 30.8 59.7

7

66.0 ::i6.8

10

9<1.3 <18.7

5

13 20.'1 <16.1

16

17 63.3 60.3

1'albot --------------------

1

6 12.3 61.7

<1

1 '19.1 41.1

1'aliaferro _______ -----------

<1

3 63.7 <15.0

3 95.6 <15.0

~rattnall _________ .---------

2

3 12.3 17.6

3 43.1 17.6

Taylor ---------------------

1

3

9.3 26.2

<1

37.1 <13.7

Telfair __ -----------------

3

19.8 42.5

3

19.8 <12.5

Terrell

8

48.0 36.5

10

60.0 <16.9

Thomas --------------------

8

25.6 22.9

11

31 35.2 88.8

Tift __ -------------------

7 37.6 40.7

12

m !}11.5 87.1

'l1oombs --------- ---------

3

<! 17.7 20.6

9

~9.5

<16.'1

'fo\Yns --------------------

5 20.3 98.5

'l1reutlen __________ ---------

<1

<18.6

'l'roup ---------------------

31

23 70.6 58 A

32

27 72.9 68.6

'l,urner ___ --------- ------

3

3 27.7 23.'!

5

'16.1 70.1

'l'wiggs ---------------- ___ _

3

Union ____________________ _

32.9 10.'1

13.0 40.'1

5

-13.9 20.7 65.1 26.9

Cpson ------- ____ ----- __ _

16

13 63.8 61.8

12

16 -17.9 76.1

Wa!J;er __ --------- -------

19

19 61.2 6::i.2

13

12 <Jl.9 <11.2

Walton --- ----------------

6

9 28.9 38.4

11

1<l 52.9 59.. 8

Ware

11

17 39.'1 60.2

20

23 71.6 81.5

\Yanen __ ----------------

7

68.4 56.3

4

1 39.1

8.0

\Vashington ----------------

3

12.'1 30.2

8

16 33.0 60.5

Wayne ______ --------------

2

Webster __ c _______________ _

2

15.2 l<J.3

2

6 15.2 <13.0

<12.3 18A

3

55.1

Wheeler ___________ ------

2.

19.1

3

28.6

White ______ --------- ----

4 15.6 35.5

69.'1

Whitfield -------- ----------

15

16 57.3 BT.r>

20

16 76.6 67.5

Wilcox __ --------- -------

7.8 13.7

<1

5 3!A 21.1

Wi!l;es -------------- ----

10

66.3 <12.1

13

8 86.2 5<1.8

Wil1dnson ----------------

3

2 27.2 17.3

<1 <15.'1 2'1.1

Worth __ ------------------

11

51.5 25.3

10 37.'1 86.7

Uesidents of Georgia

dying in other states ___ _

33

29

NOTE: These figures are allocated to county of residence and exclude non-l'esldents of Georgia. Only the state totals include residents of Georgia dying in other states.

individual C01mties-Mortality

295

TABLE 7
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PELLAGRA AND PNEUMONIA IN EACH CouNTY IN GEORGIA: 1939 AND 1940

PELLAGRA

PNEUMONIA

Rate Per I00,000

Rate Per I00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

'l'O'l'AL -----------------

235

271

7.5

8.7 2055 2299 65.8 73.6

Appling - ------------------

10

8 69.0 55.5

Atldnson -------------------

1

56.'1 HA

Bacon --------------------

12.7

4

12 19.'1 152.5

Baker --- ------------------

8

6 108.9' 68.5

Baldwin -----------------Banl;;:s --- ------------------
Barrow -------------------
Btutow --------------------
Ben Hill -------------------

5.8

2t1

23 139.6 131.3

11.5

3

5 3<1.<1 ,1,1.3

5

7. 7 36.0

10

16.5 50 A

11.9 10.8

21

20 9'1.9 71.9

6.9

13

16 89.5 116.0

Berrien ------------------Bibb ----------------------Blecl<ley ------------------Brantley -----------------Brooks ---------------------

5.9

'1

11 26.0 61.6

11 10.7 13.9

59

48 70.'1 60.5

2

1 20.7

9.9

3

8 31.1 79.2

1 H.6 12.8

101.9

1

1 19.5 17.'1

13

11 63.<1 17 .8

Bryan --------------------

6

1 95.'1 61.0

Bulloch --------------------

2 11.5

6.7

11

12 12.3 10.1

Burke --------------------

3

1 11.3 13.0

21

18 79.2 58 A

Butts ---------------------

10.9

7

76.2 91.'1

Calhoun ------------------

8.8

<1 67.1 35.0

Camden -------------------
Candler -------------------
Carroll ------------------Catoosa ------------------Charlton ------------------

16.9

2 81.6 29.7

10.0

10

109.9 69.9

2.9

5.3

19

28 55.6 7<1.6

3

2 2<1.6 19.2

19.0 10.1

Chatham ------------------

11

21

9.3 19.'1

102

11<1 86.5 105.1

Chattahoochee -------------

1

2 26.'1 20.5

Chattooga ------------------

2

10.8

5.8

5A 10.9

Cherol<ee ------------------

5.0

H

13 69.6 56.3

Clarl<e --------------------

1

2 H.1

7.7

130

20 25.6 76.5

Clay ---------- -------------

99.1 92.2

Clayton -------------------

12 25.7 108.5

Clinch ---------------------

12.7

<1 77.7 51.0

Cobb ---------------------

3

5

7.8 13.1

20

28 52.3 73.3

Coffee --------------------

13.9

19

31 88.2 137.1

Colquitt -------------------

1

3.0 11.9

32

20 96.9 59.6

Columbia -------------------

10.6

8

3 8'1.8 30.9

Cool< ----------------------

2

16.8

5

6 <11.9 47.4

Coweta ---------------------

2

7.'1

3.7

33

18 122.3 67.3

Crawfonl -----------------

14.0

4

5 56.1 61.1

296

Georgia Department of Public Health

TABLE 7-Continued
DEATHS AND DEATH RATES PER 100,000 PoPuLATION FROlVI PELLAGRA AND PNEUMONIA IN EACH COUNTY IN GEORGIA: 1939 AND 1940

PELLAGRA

PNEUMONIA

Rate Per I00,000

Rate Per I00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

Crisp ---------------------
Dade ---------------------Dawson -------------------
Decatur -------------------
DeKalb -------------------

1

1

5.7

5.'!

7

16 39.9 85.8

20.'!

2

5 33.9 102.1

3

79.0

2

4.5

7.8

13

20 58.5 77.5

10

3.5 13.3

28

53 32.2 70.7

Dodge ---------------------

<1.1

4

19.0 37.0

Dooly ----------------------

2

2 11.8 10.3

53.3 36.0

Dougherty -----------------

5

17.5 13.0

32

25 112.0 108.6

Douglas -------------------

9.9

7

3 69.6 28.6

Early --------------- ------

2

2 10.7 10.0

18 37.5 89.9

Echols -------------------Effingham ---------------Elbert --------------------
Emanuel -----------------Evans ---------------------

101.2 36.3

2 10.'1 18.0

<11.5 62.9

5.1

17

10 86.7 50.'!

<].3 11.3

20

21 85.0 79.3

7

<1 9<1.6 51.1

Fannin --------------------
Fayette --------------------
Floyd ---------------------
Forsyth -------------------Franklin ------------------

27.1

6.6

13

9 88.1 59.0

12.2

6

9 73.'! 96.7

<1

5.3

7.5

43

53 76.6 100.0

<1

8.8 32.0

19.2

5.7

H 51.2 79.3

Fulton --------------------

23

26

5.9

7.5

2<17

298 62.9 85.3

Gilmer ---------------------

1 11.1 11.6

8

88.9 57.9

G!ascoclr ------------------

3

3 66.0 61.7

Glynn ---------------------

2

9.6

12

19 5<1.7 91.5

Gonion -------------------

<1

5A 21.0

19

17 103.0 89.2

Grady --------------------

2

9.<1

10

H 50.9 65.7

Greene ---------------------

3

21.9

7.7

10

9 72.9 68.9

Gwinnett ------------------

3.'1 16.6

16

26 55.0 86.1

Habersham ----------------

1

<1

6.8 27.8

14

11 9<1.8 76.5

Hall ----------------------

3

8.6

8.7

26

3<1 74.7 99.2

Hancocl;;: ------------------

23.5 21.1

6 5'1.8 <12.3

Haralson ------------------

6.8

11

76.5 5<1.3

Harris --------------------

1

2

8.8 16.5

9

11 73.8 90.8

Hart ---------------------

12

13 77.'! 73.9

Heard --------------------

4

<1 <16.5 38.7

Henry --------------------

12

15 79.'! 86.9

Houston ------------------

8.7

9

H 79.6 122.0

Irwin ----------------------

1

7.7

7.'1

7 46.'! 51.8

JaCll:son -------------------

1

5.0

1!,2

22 34.8 92.8

Jasper --------------------

5

57.0 '32.9

10 57.0 109.5

Individual Counties-JVJortality

297

TABLE ?-Continued
DEATHS AND DEATH HATES PER 100,000 PoPULATION FROM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEORGIA: 1939 AND 1940

PELLAGRA

PNEUMONIA

Rate Per l 00,000

Rate Per l 00,000

Number

Population

Number

Pot!Ulation

1940 1939 1940 1939 1940 1939 1940 1939

Jeff Davis ---------------Jefferson -----------------
Jenl~:ins -----------------~-
Johnson ------------ -----.Jones ----------------------

10

11<1.3

13.4

1<1

19 69.9 85.0

2 16.9 1<1.6

6

11 50.7 80.3

7.2

6

'16.3 57.5

50 A

'18.0 90.7

Lamar -------------------Lanier --------------------Laurens ------------------Lee __ --------------------Liberty -------------------

19.2

9

89.2 '17,9

3

53.3 72.3

1<1.9 17.1

23

2,1 68.'1 68.5

11.5

10

127.6 69.1

23.2 23.2

58.2 '16.'1

Lincoln Long
Lowndes -----------------Lumpldn -----------------~lcDuffie ___ --------------

28.4

10.9

24.5 '15.0

'18.9 112.'1

15.7

3.1

17

27 53.'1 83.1

1

16.1 91.1

18.'1

8

;; 73.5 51.'1

~Iclntosh ------------------
Macon -------------------:Vladlson ------------------:.\farion ------------------:VIeriwether -----------------

7

132.3 3'1.2

13

10 81.5 57.0

8 52.1 47.9

2

20.2

11 86.3 H3.9

'1

'1.5 16.3

13

23 58.9 93.5

~!iller ---------------------

2

20.0 33.5

Mitchell --------------------

16

13 63.3 18.6

Monroe -------------------

2 27.9 15.8

8 83.7 63.3

~Iontgomery ----------------

1

9.1

3 62.1 27.2

~!organ

2

1 15.7

7.6

62.9 15.7

~Iurmy

1

~Iuscogee -----------------

'1

Newton -------------------

Oconee --------------------

Oglethot'Pe -----------------

9.0

12

H 107.7 133.2

5.3

5.1

<17

'13 62.3 73.3

21.5 16.6

20

ll 107.7 60.7

1

2 13.2 23.0

6.9

9 56.3 62.2

Paulding -----------------Peach -------------------Picl<ens -------------------l'lerce -------------------Pike

23.'1

2

9.6 18.9

10.9

8.5

2

7.8 H.2

10 19.3 94.3

'13.8 36.1

:J0.8 ;)7.2

28.9 60.4

Poll< Pulasld -------------------Putnam ------------------Quitman -----------------Itabtm --------------------

3

7.0 11.0

10.2 10.3

ll 31.6 40.3 8 50.9 82.7
10 70.5 108.7 29.1 43.3
1 25.6 56.:l

298

Georgia Department of Public Health

TABLE 7-Continued
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEORGIA: 1939 AND 1940

PELLAGRA

PNEUMONIA

Rate Per I00,000

Rate Per I00,000

Number

Population

Number

Population

1940 1939 1940 1939 1940 1939 1940 1939

Handolph _____ ---------- __

18.1 10.8

10

12 60.2 65.1

Richmond -----------------

8

8

9.8 10.7

58

83 70.9 1ll.O

Itocl<dale ------------------

6

71.1 82.6

Schley ---------------------

3 59.6 52.7

Screven -------------------

2 1<1.7

8.5

20

13 98.3 55.0

Seminole

Spalding

2

Stephens

Stewart __ -----------------

Sumter

2

I

17.1 50.1

7.0 16.7

27

95.0 100.'1

7.5

9

69.'1 1<1.6

9.'1

28.3 <18.7

8.2

3.5

8

13 32.7 <16.1

'l'albot '11aliaferro -----------------
Tattnall ------------------Taylor Telfair

2-1.6 61.1

31.9

111.5 60.0

19.3 11.0

83.6 18.1

6.6

10

11 66.0 66.8

'l'errell

2

12.0 lOA

17

11 101.9 57 A

'fhomas -------------------

6.'1

5.7

25

21 79.9 60.1

'l'ift -----------------------

3

16.1

5.8

~roombs ---------------- ___ _

3

2 11.1 10.3

11 32.3 63.9 16 53.1 82.5

'.fawns --------------------

31.2 39.'1

Treutlen ------------------

1

3 13.1 36.'1

Troup ---------------------

5

!.6 12.7

37

21 8!.3 68.6

'11urner

1

9.2

7.8

I 6<1.5 31.1

Twiggs

2

21.9

3

2 32.9 20.7

"Guion

13.5

12 91.1 161.5

L:pson

3

2 12.0

9.5

19

17 75.8 80.8

\Vall<er -------------------

3.'1

1<1

21 15.1 72.1

Walton ---------------------

5

2 21.0

8.5

13

19 62.6 81.2

Ware ---------------------

2

2

7.2

7.1

17

15 60.9 53.1

Warren --------------------

8.0

11

6 101.5 18.2

Washington ---------------

2

6

8.3 22.7

19

19 78.'1 71.8

Wayne --------------------

61.0 <13.0

Webster

21.2 18.'1

6

1 127.0 73.'1

Wheeler -------------------

2

19.1

10.3

9.5

White ---------------------

69.'1

Whitfield ------------------

Wilcox --------------------

Will<es -------------------

2

Willdnson -----------------

Worth -------------------Itesidents of Georgia

dying in other states ___ _

1.1 16.9

22 91.9 92.8

6.9

31.-1 61.7

13.3

6.0

13 39.8 78.3

9.1

16

10 1<1:3.1 86.7

12

19 56.1 80.0

3

18

18

NOTE: These figures a1e allocated to county of residence and exclude non-residents of Georgia. Only the state totals include residents of Georgia dying in other states.

MORBIDITY
TABLE 8 (a) NuMBER oF CAsEs AND CAsE RATE" PER 100,000 PoPULATION oF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1940

Cerebrospinal Meningitis

Area

Population

Cases

Rate

3.123,723

27

0.9

Hural ----------------------------------- 2,049' 915

17

0.8

174,516

1

0.6

Cities 5,000 and aboYe____________________ 899,292

9

1.0

Appling -------------------------- -------
Bacon ----------------------------------Baker ______________---------------------

14,497 7,093 8,096 7,344
24,190

--

1

14.1

Banks -----------------------------------

8.733

Barro\v ---------------------------------- 13,064

Bartow ____________ -- ____ ---------------- 25,283

1

4.0

Ben Hill -------------------------------- 14,523

Berrien ---------------------------------- 15,370

--

Bibb _______ ----------------------------- 83,783

9,655

6,871

20,497

--

--

Bryan ----------------------------------

6,288

--

Bulloch --------------------------------- 26,010

--

--

B nrke ----------------------------------- 26,520

--

Butis ----------------------------------- 9,182

--

Calhoun ______________________ .__________ 10,438

--

Camden ---------------------------------

5,910

-

*Hates worked on enumerated population from census taken April l, 1940.

Diphtheria-

Cases

Rate

543

17.4

346

16.9

27

15.5

170

18.9

2

13.8

1

14.1

1

12.4

--

2

8.3

1

7.7

12

47.5

1

6.9

2

13.0

16

19.1

2

20.7

1

14.6

2

9.8

--

18

69.2

7

26.4

--

--

-

--

Gonorrhea

Cases

Rate

5282 2475
26fi 2ii42

169.1 120.7 HiLS 2S2.7

JO

69.0

10

123.5

61

252.2

--

--

4

30.6

22

87.0

6

39.0

2ri

29.8

24

248.6

2

29.1

!i

24.4

2

31.8

32

123.0

2J

94.3

2

21.8

12

llii.O

--

Influenza

Cases

Rate

13420 8221
790 4409
8 1
3 61
28 126 163
4 2
39 72 3 37 44

429.6

401.0

~

4r.2.7 601.5

~
"<:';

.:

iifi.2 14.1

~

CJ

40.8 ~ 252.2 .;,:.:,;.

320.6 964.5

l"""'''

644.7

~
0

27.5 6-

13.0

~

46.:i ~"-'

74.:1.7

43.7

ISO.!i

699.7

29

lll.:i

32

120.7

fi

fi4.!i

112

1073.0

--

[-,:)
10

10

TABLE 8 (a)-Continued NuMBER oF CAsEs AND CAsE RATE" PER 100,000 PoPULATION oF SPECIFIED
NoTIFIABLE DISEASEs REPORTED IN GEORGIA BY CouNTIEs, 194.0

Area

Population

Candler - _-- __ - --------------------------
Carroll ---------------------------------Catoosa --------------------------------Charlton -------------------------------Chatham --- _____ ------------------------

9,103 34,156 12,199 5,256 117,970

Cerebrospinal Meningitis

Cases

Rate

--

1

0.8

Diphtheria

Cases

Rate

4

43.9

1

2.9

1

8.2

--

--

19

16.1

Gonorrhea

Cases

Rate

3

33.0

12

35.1

145

1188.6

10

190.3

545

462.0

Clay ____________________________________

15,138 18,532 20,126 28,398
7,064

2

13.2

1

3.5

Clayton --- ------------------------------ 11,655

Clinch ---------- -----------------------

6,437

Cobb ____________________________________ 38,272

Coffee -------------------------------- -- 21,541

--

33,021

--

9,433

--

Cook ________ ---------------------------- 11,919

Coweta ---------------------------------- 26,972

7,128

Crisp ----------------------------------- 17,540

--

Dade ________ ---------------------------- 5,894

Dawson --------------------------------- 4,479

Decatur ____ ----------------------------- 22,234

--

DeKalb --------------------------------- 86,942

21,022

--

*Rates worked on enumerated population from census taken Anril 1, 1940.

1

6.6

13

70.1

3

14.9

10

35.2

2

28.3

1

8.6

1

15.5

4

10.5

8

37.1

7

21.2

--

1

8.4

--

1

14.0

3

17.1

4

18.0

8

9.2

7

33.3

855

5648.0

2

10.8

fi

29.8

17

59.9

4

34.3

12

186.4

14

36.6

81

376.0

45

136.3

--

38

318.8

3

11.1

7

98.2

4

22.8

170

764.6

52

59.8

40

190.3

CJ,;)
0 0

Influenza

Cases

Rate

2

22.0

187

547.5

(;J
(1)

14

114.8 0

41

894.2 ~"

ll83 1

1002.8 6.6

"'
"b"
(1)

51

275.2 "l::::

fl7 9

"" 482.0 31.1

~

2
27' 1
246 13

28.3
231.7 15.ri
642.8 60.4

(1)
-~
0
'l:l
~

46

139.3 f;

73

773.9 l:l:::

(1)

6
41

"" 50.3 .,_
152.0 So

13

182.4

21

119.7

1

17.0

596

2680.6

201

231.2

17

80.9

TABLE 8 (a)-Continued NuMBER oF CASES AND CAsE RA.TEl' PER 100,000 PoPULAT-ION oF SPECIFIED
NoTIFIABLE DisEASEs REPORTED IN GEORGIA BY COUNTIES, 1940

Cerebrospinal Meningitis

Diphtheria

Gonorrhea

Area

Population

Dooly -----------------------------------
Early ----------------------------------Echols ----------------------------------
Emanuel -------------------------------EYans ----------------------------------Fa11ni11 --------------- ________ -----------

16,886 28,565 10,053 18,679 2,964
9,646 19,618 23,517
7,401 14.,752

l,,ayette ----------------------------------
Floyd ---------------------- -------------
ll'orsyth ---------------------------------
l?ranklin -------------------- -------------
Fulton ----------------------------------

8,170 56,141 11,322 15,612 392,886

Gilmer ------------------------------ ---Glascock -------------------------------Glynn ___ --------------------------------Gordon ____ -----------------------------Grady ----------------------------------Greene _________________ -----------------
Haneock ___________ ----------------------

9,001 4,547 21,920 18,445 19,654
13,709 29,087 14,771 34,822 12,764

Gases 5
2

Rate
--
26.8
--
--
0.5
--

Gases
1 3 2 3
--
3 4 2
7
5 21 2 3 54
3 1 1 13
1
1 6 2

Rate
5.9 10.5 19.0 16.1
--
31.1 20.4
8.5
47.5
61.2 37.4 17.7 19.2 13.7
33.3 22.0 4.6 70.5
7.3
6.8
17.~
15.7

Gases
28 10'1
3 15
--
4
--
24 18 1
13
--
43 913
4 -4 35 27
4 3 1 20 12

Rate
165.8 364.1 29.8
80.3
41.5
--
102.1 243.2
6.8
--
23.2
275.4 232.4
44.4
18.2 189.8 137.4
29.2 10.3
6.8 57.4 94.0

*Hates worked on enumerated population from census taken April 1, 1940.

Influenza

Gases

Rate

7 162 291
28 2
46 36 54 2r.i 12
17 277
4 49 1599
24 1 9
68 11

41.5

567.1

2894.7

~

149.9

~

67.5 ~

476.9

~

183.:> ~

229.6 337.8
81.3

ta l
~

C""ll

208.1 493.4

"l '

35.3 313.9

~ a
'-1

407.0

0"'
~

266.6 ~"'

22.0

41.1

368.7

56.0

63

459.6

9

30.9

44

297.9

40

ll4.9

9:1

728.6

(}:)

0

I-'

TABLE 8 (a) -Continued NUMBER OF CASES AND CASE RATE'~' PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1940

Cerebrospinal Meningitis

Diphtheria

Gonorrhea

Area

Population

Cases

Rate

Haralson _____________ ----- _________ ----- 14,377

--

Harris ---------------------------------- 11,428

--

--

Hart ________ ---------------------------- 15,512

--

Heard ______ ----------------------------- 8,610

--

l{enr:,r _______ ---- ________________ ------- _ 15,119

--

-

11,30:1

--

Irwin ------------------ -------------- -- 12,936

20,089

--

8,772

--

--

8,841

--

20,040

--

Jenkins --------------------------------- 11,843

--

--

Johnson --------------------------------- 12,953

--

--

Jones ----------------------------------- 8,331

--

Lamar ---------------------------------- 10,091

--

La11ier ----------------------------------

5,632

--

--

Laure11s --------------------------------- 33,606

Lee ______________________________________

7,837

--

--

Liberty ---------------------------------- 8,59!:i

--

Lincoln --------------------------------- 7,042

Long ------------------------------------ 4,086

--

Lowndes -------------------------------- 31,860

1

3.1

Lumpkin -------------------------------- 6,223

--

Macon ---------------------------------- 15,947

---

Madison ----------------------------- ____ 13,431

--

--

Cases
1 1 1 1
2 6 7
1
3 2 1
-
--
6
1
---
3 2
--
1

Rate
8.8 6.4 46.!J 6.6
17.7 46.4 34.8
11.3
15.0 16.9
7.7
--
17.9
--
11.6
--
9.4 32.1
7.4

Cases
1
--
--
1 1
6 2 6 18 1
34 9
--
1
--
3 7 7 3 1
5 67
--
l4

Rate
7.0
---
11.6 6.6
ti3.1 15.5 29.9 205.2 11.3
169.7 76.0
--
12.0
--
53.3 20.8 89.3 34.9 14.2
122.4 210.3
--
87.8
--

*Hates worked on enumerated population from census taken April 1. 1940.

Ci~
0
l~

Influenza

Cases

Rate

39

271.3

3 4
~7

26.3 25.8 429.7

~
"0 '
~

3

19.R

~-

4 5 184 32

3;i.4 38.7 915.9 364.8

b
"<":::':)
~

2

22.6 ;"::'.

169

-. 843.3 0

70

591.1

"'1::i

2

24.0 ~

3

29.7

~ c;,

i::l::;

148

"' 440.4 :.;,:,_

15

191.4 ;:;.

6

69.8

3

42.6

6

146.8

35

109.9

5

80.3

46

288.5

5

37.2

TABLE 8 (a) -Continued NuMBER OF CAsEs AND CAsE RATE~- PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1940

Cerebrospinal Meningitis

Dillhtheria

Gonorrhea

Area

Population

Cases

Rate

llfarion -------------------------- ------- 6,954

---

--

llfcDnffie _____ -------------- _____________ 10,878

--

Mcintosh -------------------------------- 5,292

--

Meriwether ------------------------------ 22,055

--

Miller ----------------------------------- 9,998

--

Mitchell ___________ ---------------------- 23,261

---

Monroe ---------------------------------- 10,749

9,668

--

12,713

--

--

M~urray --------------------------------- 11,137

--

Mnscogee _______ -------- _______ ------- ___ 7:0.494

2

2.G

Newton --------------------------------- l8,ii76

--

--

Oconee ----- _---------------------------- 7/i7G

Oglethorpe ------------------------------ 12,4:10

--

--

Paulding __ ------- _______________________ 12,832

--

--

Ieach ------------------------------ ---- 1(),:178

--

l:lickens --------------------------------

9,136

1

10.9

Pierce ---------------------------------- 11,800

--

Pike ------------------------------------ 10,375

l~olk ------------------------------------ 28,467

--

--

Pulasld ---------------------------------

9,82!1

Putnam --------------------------------- 8,514

--

--

Quitman --------------------------------Rabun -------------------------------- --
Randolph ________________________________

3,435 7,821 16,609

--

2

12.0

Cases
2 l
---
5 l 1 l 6
11 l
2
3 4
7 4
1 2
3
--

Rate
--
18.4 18.9
21.5 9.3
10.3 7.9
53.9
14.6 5.4
16.1
--
2S.H 43.8
67.5 14.1
10.2 23.!"i
--
38.4

Cases
2 2 l 1 l
23 l 2 3
--
77 IS
--
--
60 5 4
18 30
1
5 3

Rate
28.8 18.4 18.9 4.5 10.0
98.9 9.3
20.7 23.6
102.0 96.9
--
636.0 54.7 33.9
173.5 105.4
10.~
63.9 18.1

*Hates 'vorlwd on enumerated population from census taken Avril 1. 1940.

Influenza

Cases

Rate

!j

71.9

77

707.9

5

94.5 s;-

58 l

263.0 10.0

;~ ;;

"~"

1134 15

.. 487ii.l 139.5

loS

1634.3 (")

43

338.2 a

6

g_ 53.9

142 lS

"' 188.1 "' I 96.!1

2

26.4

~

187 3
186

1504.4 23.4
17H2.3

-;a;..
;;:;~

10

109.:.

10

84.7

87

838.6

113

397.0

l

10.2

17

199.7

2

!18.2

4

51.1

213

1282.4 w

w0

TABLE 8 (a)-Continued NUMBER OF CASES AND CASE RATE'* PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 194.0

Cerebrospinal Meningitis

DitJhtheria

Gonorrhea

Area

Population

Cases

Rate

Cases

Rate

Cases

Rate

Richmond ------------------------------- 81,863

1

L2

Rockdale --------------------------------

7,724

Schley ---------------------------------- 5,033

--

Screven --------------------------------- 20,353

Seminole -------------------------------- 8,492

Spalding -------------------------------Stephens -------------------------------Ste\vart ---------------------------------
Snmter ---------------------------------Talbot ----------------------------------

28,427 12,972 10,603 24,502 8,141

--

l

7.7

1

12.3

'l'aliafetTo -------------------------------

6,278

---

'l'aitnall --------------------------------- 16,243

--

Taylor ---------------------------------- 10,768

--

Telfair ---------------------------------- 15,145

--

Terrell ----------------------------------- 16,675

1

6.0

'fhomas --------------------------------- 31,289

--

'fifL ------------------------------------- 18,599

--

Toombs --------------------------------- 16,952

--

---

TO\VUS ---------------------------------- 4,925

--

'l't;eutlen --------------------------------

7,632

--

'l'roup ---------------------------------- 43,879

---

--

Tutner ---------------------------------- 10,846

--

'1'\Yiggs ----------------------------------

9,117

U11i011 -----------------------------------

7,680

Upson ----------------------------------- 25,064

--

33

40.3

1

12.9

1

4.9

3

35.3

3

10.6

1

7. 7

2

18.9

--

--

--

--

--

--

--

--

5

33.0

6

36.0

3

9.6

2

10.8

8

47.2

2

40.6

12

27.3

1

11.0

5

65.1

5

19.9

434

530.2

14

181.3

2

39.7

19

93.4

36

423.9

36

126.6

4

30.8

5

47.2

42

171.4

--

--

--

--

5

30.8

1

9.3

32

211.3

3

18.0

39

124.6

74

397.9

18

106.2

--

7

16.0

5

46.1

2

21.9

2

26.0

2

8.0

*Rates worked on ennmerated popnlation from census taken April 1, 1940.

(.)~
0 of:-

Influenza

Cases

Rate

473

577.8

163 2
10

2110.3 39.7 49.1

<;')
~"0'

432

5087.1 ~ ""

13 6

45.7 4.:)

~
"'"<::;
;;:,

23

216.9 ;;:;.

88

359.2 ~

6

"' 73.7 .:.;.;.

2 15 83 72

31.9 92.3 770.8 475.4

--c
'i:i g~ :

99

593.7 r;

63

201.3 :::ti

24 78

"' 129.0 .;;.:.,...
s. 460.1

2

40.6

4

52.4

364

829.6

2

21.9

52

677.1

14

55.9

TABLE 8 (a) -Continued NuMBER oF CAsEs AND CAsE RATE* PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DisEASEs REPORTED IN GEoRGIA BY CouNTIEs, 194.0

Cerebros11inal Meningitis

Dillhtheria

Gonorrhea

Area

Po11ulation

Cases

Rate

Cases

Rate

Cases

Rate

\Yalker ---------------------------------- 31,024

1

3.2

Walton ---------------------------------- 20,777

Ware ------------------------------------ 27,929

1

3.6

\\'arren --------------------------------- 10,236

24,230

4

12.9

5

24.1

1

3.6

47

151.5

5

24.1

58

207.7

16

66.0

Wayne ---------------------------------- 13,122

1

7.6

Webster ---------------------------------

4,726

--

Wheeler --------------------------------White _____ ---------------- ______________

8,535 6,417

Whitfield -------------------------------- 26,105

Wilcox ---------------------------------- 12,7 55

Wilkes ---------------------------------- 15,084

1

6.6

\Vilkinson ------------------------------- ll,025

Worth ---------------------------------- 21,374

*Rates worked on enumerated population from census taken April 1, 1940.

1

7.6

2

42.3

6

70.3

3

46.8

21

80.4

2

13.3

--

3

14.0

1

7.6

3

63.5

3

35.1

1

15.6

314

1202.8

2

15.7

2

13.3

6

54.4

9

42.1

Influenza

~

:;:::..,

Cases

Rate ~-

6H 76

~

.... 222.4 ~

365.8

~

339

1213.8 l"':l

8

78.2 0

90

371.4 .,.,.

3

22.9 ~"'

86

l 1819.7

~

14

218.2 0

39

149.4

o"'j-

~

34

266.6 ~

129

855.2

8

72.6

477

2231.7

~
0
(Jl

TABLE 8 (b) NuMBER OF CASES AND CAsE RATE~ PER 100,000 PoPULATiON OF SPECIFIED
NoTIFIABLE DisEAsEs REPORTED IN GEoRGIA BY CouNTIEs, 194.0

Malaria

Area

Cases

Rate

Slate Total* ------------------
Uural -----------------------Cities 2500-5000 ------------Cities 5000 and above __________

2,503 2,046
190 267

80.1 99.8 108.9 29.7

Appling ----------------------

1

6.9

Measles

Cases

Rate

3282 2284
50 948

105.1 1ll.4
28.7 105.4

Bacon ------------------------

--

Baker ------------------------ 228

Baldwin ----~-----------------

3

--
3104.6
12.4

--

--

--

82

339.0

Banks ------------------------

1

11.5

Barrow ----------------------

1

7.7

Bartow -----------------------

2

7.9

Ben Rill ----------------------

3

20.7

Berrien ---------------------- 9

58.6

--

--

--

--

234

92::J.::i

--

--

Bibb -------------------- ----

1

24

197

Bryan ------------------------

29

Bulloch ---------------------- 43

Burke ------------------------

35

Bntls ------------------------ 1

190

2

1.2 207.1 29.1 961.1 461.2
165.3 132.0 10.9 1820.3 33.8

52

62.1

--

--

9

43.9

--

--

19

7l.G

--

3

28.7

--

*Hates worked on enumerated population from census taken April 1, 194.0.

Pneumonia

Cases

Rate

4480 2918
140 1422

143.4 142.3
80.2 158.1

12

82.8

6

84.6

4

49.4

10

136.2

24

99.2

5

57.3

20

153.1

62

245.2

12

82.6

3

19.5

59

70.4

ll

113.9

7

101.9

19

92.7

13

206.7

32

123.0

34

128.2

10

108.9

38

364.1

5

84.6

Poliomyelitis

Cases

Rate

30

1.0

20

1.0

4

2.3

6

0.7

--

--

--

--

--

--

-- '

--

--

--

1

14.6

--

2

33.8

CJ~
0 0\

Scarlet Fever

Cases

Rate

1000

32.0 (,]

479 81
440

23.4 46.4 48.9

"0 '
as~;

--

b

--

"' -- '"(:::,
-- :.;.:.,,

--

-- "

1
---
2
--

4.1
--
7.9
---

-"~'
0
-.'":1:::1
o<=;

32

38.2 :::t:

4

"' 41.4
~

2

9.8

~

1

15.9

"

]9.2

l

16.9

TABLE 8 (b)-Continued NUMBER OF CAsEs AND CAsE RATE)f PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DisEASES REPORTED IN GEORGIA BY CouNTIES, 194,0

Malaria

Measles

Area

Cases

Rate

cases

Rate

Candler ---------------------- 1

11.0

Carroll ---------------------- 6

17.6

Catoosa ----------------------

1

8.2

Charlton --------------------- 2

38.1

Chatham --------------------- 33

28.0

--

--

1

2.9

157

1287.0

16

13.6

64 3

Clarke -----------------------

Clay -------------------------

2

422.8 16.2
--
28.3

1073

7088.1

8

43.2

12

59.6

5

17.6

--

--

Clayton ----------------------

5

Clinch -----------------------

Cobb -------------------------

1

Coffee ----------------------- 14

Colquitt ----------------------

50

42.9
2.6 65.0 151.4

32

497.1

7

18.3

--

4

12.1

Columbia ---------------------

7

Cook -------------------------

22

2
Crisp ------------------------ 52

74.2 184.6
3.7 28.1 296.5

1

8.4

2

7.4

---

Dade -

------------

--

Dawson

Decatm ----------------------

90

DeKalb ----------------------

8

Dodge ------------------------

12

404.8 9.2
57.1

--

7

31.5

60

69.0

1

4.8

*Rates worked on enumerated 11opul:lt.ion from census taken Atll'il 11 1940.

Pneumonia

Cases

Rate

ll

120.8

45

131.7

10

82.0

6

114.2

307

260.2

146

964.!l

27

145.7

28

139.1

30

105.6

7

99.1

4

34.3

5

77.7

41

107.1

.!9

181.1

32

96.9

15

159.0

7

58.7

37

137.2

12

168.4

21

119.7

2

33.9

67

301.3

102

117.3

23

109.4

Poliomyelitis

Cases

Rate

--

--

--

--

--

--

--

--

--

--

--

2

9.9

--

--

--

--

--

2

31.1

1

2.6

2

9.3

3

9.1

--

--

--

--

--

--

--

--

--

--

--

--

--

--

--

Scarlet Fever

Cases

Rate

2

5.9

7

57.4
--

~
~

62 8

52.G 52.8

~"""''

16

86.3 ..

3

14.9 C)

6 1

21.1

0 ;:;

14.2 ~

3 3

25.7 46.6

"""I"'''
I

47

122.8 ~

2

9.3 0

13

39.4 ci--

~ ""'

--

-- ~-

--

3

11.1

1

14.0

2

11.4

1

4..5

45

51.8

2

9.5

~

0

-l

TABLE 8 (b)-Continued NUMBER OF CASES AND CASE RATE'' PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 194-0

Malaria

Measles

Area

Cases

Rate

Cases

Rate

Dooly ------------------------ 24

Dougherty -------------------- 137

Douglas ----------------------

1

Early ------------------------ 33

Echols -----------------------

Effingham ------------------- --

Elbert ------------------------

1

Emanuel ---------------------

21

Evans ------------------------

3

Fannin -----------------------

1

JJ. ayette ----------------------

3

Floyd ------------------------ 5

Forsyth ----------------------

Franklin ---------------------

10

Fulton -----------------------

21

Gilmer ------------------------

Glascock ---------------------

--

Glyun ------------------------

1

Gordon -----------------------

3

Grady ------------------------

84

Greene -----------------------

Gwinnett ---------------------

Habershan1 -------------------

Hall -------------------------

2

Hancock ------- ------ ------

1

142.1 479.6
9.9 176.7
--
--
5.1 89.3 40.5
6.8
36.7 8.9
--
64.1 5.3
---
4.6 16.3 427.4
---
5.7
7 .s

14

49.0

61

607.0

l4

75.0

--

--

--

--

1

13.5

--

17

30.3

1

8.8

--

--

521

132.6

31

344.4

--

11

50.2

77

417.5

--

3

21.9

1

3.4

30

203.1

7

20.1

6

47.0

*Hates worked on enumerated population from ('ensus taken April l, 1940.

Pneumonia

Cases

Rate

11

65.1

53

185.5

27

268.6

32

171.3

3

101.2

10

103.7

23

117.2

51

216.9

11

148.6

19

128.8

10

122.4

107

190.6

2

17.7

10

64.1

584

148.6

37

411.1

4

88.0

25

114.1

82

444.6

23

117.0

39

284.5

21

72.2

25

169.3

26

74.7

21

164.5

Poliomyelitis

Cases

Rate

l

3.5

1

5.4.

l

5.1

--

2

10.2

CJ;J
0 00

Scarlet Fever

Cases

Rate

16

:.o.o \0

~

8

79.6 0

3

16.1 c;rs1

1

10.4

t::J ~

...!.;.>..

~

3

20.3

~
~

2:~

41.0 -0.

""t:::

26

166.fi

~ 0"

303

77.1 ~

<":>

1

11.1 1::!::

12

s.!.~;.>...
54.7

12

65.1

s

40.7

~

14.6

6

20.6

:n

60.3

1

7.R

TABLE 8 (b) -Continued
NUMBER OF CASES AND CASE RA.TEX PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DrsEASEs REPORTED IN GEORGIA BY COUNTIES, 194.0

Malaria

Measles

Area

Cases

Rate

Cases

Rate

34.8

Harris -----------------------

Hart -------------------------

Heard -----------------------

1

11.6

Henry ------------------------

--

--

--

1

6.4

8

92.9

--

Houston ---------------------- 18

lr\Vill ------------------------

9

.Tackson ----------------------

6

Jasper -----------------------

Jeff Davis ____________________

3

159.2 69.6 29.9
33.9

2

17.7

34.

169.2

--

Jefferson --------------------- 21

Jenkins ----------------------- 31

Johnson ----------------------

2

Jones ------------------------

1

Lamar ----------------------- --

Lanier ----------------------- --

Laurens ---------------------- 41

Lee -------------------------- 46

Liberty - ------------- -~~------

53

Lincoln ---------------------- 1

Long- ------------------------

23

Lmvndes --------------------- 156

Lumpkin --------------------- --

Macon -----------------------

10

~fadison ----------------------

104.8 261.8 15.4 12.0
--
--
122.0 587.0 616.6
14.2
562.9 489.6
--
62.7
--

1

5.0

11

92.9

3

36.0

11

109.0

--

--

1

3.0

--

--

1

3.1

--

--

--

--

*Rates '\Vorlmd on enumerated nopulation from census taken April 1, 194.().

Pneumonia

Cases

Rate

21

146.1

20

175.0

l4

90.3

11

127.8

15

99.2

13

115.0

22

170.1

20

99.6

33

:J76.2

2

22.6

47

234..fl

67

565.7

6

46.3

4

48.0

11

109.0

2

35.5

53

157:7

14

178.6

5

58.2

6

146.8

20

62.8

1

16.1

30

188.1

8

59.6

Poliomyelitis

Cases

Rate

1

11.4

---

--

--

--

--

--

--

--

Scarlet Fever

Cases

Rate

1

7.0

1

8.8

4

25.8 ._

:;:;

1

6.6

~ ~-

iS.:

<::

2

15.:. ~

17

84.6

("')

1

11.4 0

~-

1
--

l 8.4 "'""'
-- ~

1

9.9 ;0;.

iS.:

3

8.9 ~""

l

12.8

4

12.6

2

14.9

<:.!-"

0

\0

TABLE 8 (b)-Continued NUMBER OF CASES AND CASE RATE::- PER 100,000 POPULATION OF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1940

Malaria

Measles

Area

Cases

Rate

Cases

Rate

Marion -----------------------

McDuffie --------------------- --

Mcintosh ---------------------

6

Meriwether ------------------- 13

Miller ------------------------

8

Mitchell ---------------------- Hi

Monroe ----------------------

--

--
113.4 5S.9 80.0
64.5

--

--

--

2

37.8

29

131.5

--

4

17.2

llforgan ----------------------

3

23.6

Murray ----------------------

1

7.9

5

44.9

llfuscogee ---------------------

6

7.9

NewLon -----------------------

Oconee ------------------------

Oglethortle -------------------

--

l'aulding ---------------------

18

23.8

5

26.9

--

--

--

--

Peach ------------------------ 19

Pickens ---------------------- --

ll-ierce ------------------------

1

l).ike ----------------- -------- 15

Polk -------------------------

3

183.1
8.5 144.6
lO.!:i

1

9.6

2

21.9

21

202.4

8

28.1

Pulaski ---------------------- 2

20.3

Puinam ---------------------- --

Quiiman ---------------------

--

Rabun -----------------------

--

Uandolph -------------------- _ 3

18.1

--

--

--

--

3

38.4

--

*H.a.ies worked on enumerated llOilttlaUon from census taken At1ril 1, 1940.

Pneumonia

Cases

Rate

6

86.3

22

202.2

9

170.1

38

172:3

5

50.0

31

133.3

11

102.3

19

196.5

17

133.7

13

116.7

65

86.1

27

145.3

1

13.2

8

64.4

1

7.8

30

289.1

7

76.6

8

67.8

25

241.0

25

87.8

4

40.7

5

58.7

1

29.1

4

tiLl

22

132.5

Poliomyelitis

Cases

Rate

--

--

--

--

--

--

1

10.0

--

--

--

--

--

--

--

--

1

5.4.

--

--

--

--

--

1

9.6

--

--

--

--

--

--

\,;~
t--'
0

Scarlet Fever

Cases

Rate

2
--

"' 18.4 '0
8

---

o-ti
15"

4 1

17.2
~.3

b
"'~:;:,

,.;.

4

3L:i ;3

-- ~"''

19 2

-. 25.2 0
10.S

: -- "'t;
--

-- 1=;

1
--

9.6 ~
";~"';

--

6

21.1

1

10.2

TABLE H ( lJ) -Lontmued NUMBER OF CASES AND CASE RATE" PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEAEs REPORTED IN GEORGIA BY COUNTIES, 1940

Malaria

Measles

Area

Cases

Rate

Cases

Rate

lUcluuond -------------------- 8 Hockdale --------------------- 2 Schley -----------------------
Screv-en ---------------------- 12
Seminole --------------------- 142

9.8 25.9
59.0 1672.2

7

8.6

::::::

12'j.:.!

8

159.0

1

4.9

234.

~991.1

Spalding ---------------------

2

Stephens ---------------------

1

Stewart ----------------------

Sumter ------------------.----- 55

Talbot -----------------------

l

1'aliaferro -------------------- --

'rattnall ---------------------.

3

Taylor ----------------------- 3

Telfair ----------------------- 19

Terrell ----------------------- 37

7.0 1.7
--
224..3 12.3
--
1s.a
27.9 117.7 221.9

8

28.1

--

5

20.-l

7

86.0

-- --

1

6.,

l:i

13!1.:)

l

6.6

7

42.0

Thomas ---------------------- 9

28.8

Tift -------------------------- 10

53.8

Toombs ----------------------

3

17.7

'l'owns -----------------------

Treutlen -------------- ------

1

13.1

7

22.4

--

1

5.9

:l

40.6

1

13.1

Troup ------------------------

9

rrurner -----------------------

l

Twiggs -------------- -------- 14

UlliOll ------------------------

--

UtlSOll -------------- ----

20.5 9.2
153.6
--

31

70.6

-1

43.9

2

26.0

.27

107.7

*Hates worked on enumerated population from census talten April l, 1940.

Pneumonia

Cases

Rate

168

20::i.2

21

271.9

3

59.6

30

147.4

70

824.3

28

98.5

9

li9.4

5

47.2

34.

138.8

~

24.6

6

9:i.6

s

49.3

ll

102.2

20

191.5

:1:1

317.8

39

121.6

ll

59.1

19

112.1

5

10Ui

.2

26.2

61

139.0

7

64.5

3

32.9

13

169.3

31

123.7

Poliomyelitis

Cases

Rate

1

1.2

--

--

2

23.6

--

-

1

9.4

--

--

--

--

--

--

-

--

--

1

3.2

1

2.3

--

1

4.0

Scarlet Fever

Cuses

Rate

4

4.9

1 l

19.9 4.9

~

--

~ ~-

:~ ;::

2

13.4 ~

C)

8

3~.7

0

~

~.

--

---

""I''
~

3

19.8 '8"""

4

24.0

~

2

6.4 .~ ~ ,... .

1

5.4. '..;:

2

ll.S

10

22.8

oo '

~!JQ}i

2

8.0

"1"-"'
1-'

(JJ t-' l~

TABLE 8 (b)-Continued NUMBER OF CASES AND CASE RATE"" PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEoRGIA BY CouNTIEs, 1940

Malaria

Measles

Area

Cases

Rate

Cases

Rate

Walker -----------------------

3

Walton -----------------------

3

\\rare

Warren ---------------------- 1
74

9.7 14.4
9.8 305.4

30

96.7

24.1

10.7

Wayne -----------------------

3

Webs(er ----------------------

l4

22.9 296.2

Wheeler ----------------------

2

23.4

15.6

2

7.7

30.6

Wilcox -----------------------

33

\Yilkes ----------------------- 1

11

258.7 6.6 27.2
51.5

34

266.6

26.fJ

23

208.6

1

4.7

*Rates worked on enumerated populaiion from census taken April 1~ 1940.

Pneumonia

Cases

Rate

37

119.3

28

134.8

61

218.4

12

117.2

37

152.7

53.3

11

232.8

82.0

2

31.2

26

99.6

20

156.8

ll

72.9

19

172.3

19

88.9

Poliomyelitis

Cases

Rate

1

7.6

co

Scarlet Fever

"c '

Cases

Rate

~
~-

59

190.2 l:;:j

16 6

77.0
"e' 21.5

~

.1,

9.8 12.4

~

"'.:,.:,:_

...c......

"i:l

6 37

93.:1 141.7

g;:;::

"'

5 4

45.4 18.7

-"':::r::
i;l
;<;:S--.

TABLE 8 (c) NuMBER oF CAsEs AND CAsE RATE"- PEn 100,000 PoPuLATION oF SPECIFIED
NoTIFIABLE DisEASEs REPORTED IN GEORGIA BY CouNTIEs, 194.0

Syphilis

Tuberculosis

TY!lhoid

TYIJhus

Area

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Rural ----------------------Cities 2500-5000 -----------Cities 5000 and above________

21,259 7,136 1,270
12,853

680.6 348.1 727.7 1429.2

2800 1257
199 1344

89.6 61.3 114.0 149.5

487

15.6

344

16.8

49

28.1

94

10.5

Appling ---------------------

1

Atkinson --------------------

1

Bacon -----------------------

1

Baker -----------------------

3

Baldwin ---------------------

312

6.9 14.1 12.4 40.8 1289.8

3

20.7

4

56.4

3

37.1

6

81.7

24

99.2

1

6.9

1

12.4

1

13.6

8

33.1

Banks ----------------------

Barro\V ---------------------

3

Barto'\V ----------------------

65

Ben Hill --------------------

2

Berrien ---------------------

7

Bibb ----------------------- 512

Bleckley -------------------- 42

Brantley --------------------

2

Brooks ----------------------

213

Bryan ---------------------- --

23.0 257.1 13.8 45.5
611.1 435.0
29.1 1039.2
--

4

45.8

4

30.6

22

87.0

6

41.3

2

13.0

111

132.5

5

51.8

3

43.7

6

29.3

9

143.1

2

22.9

1

7.7

13

51.4

3

20.7

--

9

10.7

--

--

--

1

4.9

--

Bulloch --------------------- 277

Burke -----------------------

263

Butts -----------------------

2

Calhoun -------------------- 235

Camden ---------------------

4

1065.0 991.7 21.8
2251.4 67.7

25

96.1

24

90.5

4

43.6

4

38.3

4

67.7

1

3.8

4

15.1

4

43.6

2

19.2

1

16.9

*Rates worked on enumerated population from census talten April 1, 1940.

589

18.9

313

15.3

73

41.8

203

22.6

3

20.7

2

28.2

1

12.4

1

13.6

3

12.4

4

15.8

2

13.0

31

37.0

5

51.8

3

43.7

6

29.3

1

15.9

11

42.3

6

22.6

6

57.5

Whooping Cough

Cases

Rate

1020

32.7

458

._ 22.3

62

35.5 ;::;

300

55.6

~

~-

1

6.9 "~'

2

[ 28.2

(')

2

~- 8.3

a

!i 40
1

38.3 l'i8.2
6.9

""I''
~ a

~

26 1

31.0 10.4

~ "' ~"'

Vi

73.2

10

38.4

1

3.8

38

364.1

CJ.:l 1-'
CJ~

TABLE 8 (c) -Continued NuMBER oF CAsEs AND CAsE RATEl: PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DisEAsEs REPORTED IN GEoRGIA BY CouNTIEs, 194.0

Syphilis

Tuberculosis

Typhoid

Typhus

Area

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Candler ---------------------
Carroll --------------------Catoosa --------------------Charlton --------------------
Chatham --------------------
Cherokee --------------------
Clarke ----------------------
Clay ------------------------
Clayton ---------------------
Clinch -----------------------
Cobb -----------------------Coffee ---------------------Colqnitt ---------------------
Columbia -------------------Cook -----------------------

1 6 31 1 3,537
306 3 2
482
2 107 103 15:1 312
10 34

Crisp ------------------ ---- 224.

Dade ------------------------

Dawson --------------------- --

Decatur --------------------- 109

lleKalb ---------------- ----

332

127

11.0 17.6 254.1 19.0 2998.2
2021.4 16.2 9.9
1697.3 --
17.2 1662.3
269.1 719.6 944.9
106.0 285.3
11.1 126.3 1277.1
--
--
490.2 381.9 604.1

7

76.9

18

52.7

9

73.8

6

114.2

207

175.5

24

l:iS.:i

19

102.:.

14

69.6

18

63.4

3

42.5

7

60.1

1

ltUi

24

62.7

10

46.4

4

12.1

2

21.2

5

41.9

23

92.7

10

140.3

32

182.4

12

203.6

1

22.3

20

90.0

82

94.3

15

71.4

3

33.0

6

17.6

8

6.8

1

5.4.

1

5.0

1

3.5

2

28.3

6

51.5

--

3

7.8

4

18.6

4.

12.1

2

21.2

1

8.4

1

3.7

11

62.7

1

22.3

1

4.5

2

2.3

5

23.8

7

76.9

--

--

--

--

1

19.0

74

62.7

--

1

:i.4

1

5.0

--

4

56.6

1

8.6

4

62.1

5

13.1

7

32.ti

13

39.4

--

--

G

50.3

1

3.7

--

8

45.6

5

22.5

6

6.9

23

109.4

*Hates worked on enumerated JlOl1ttlaUon from census taken Atnil l, 1940.

<:.1~ I-'
of'.

Whooping Cough

Cases

Rate

5

14.6 <;')

18

"" 147.6 8

4

76.1 a<i

19

16.1

:N ;:, ,

18 9
22

--
97.1
44.7
77.5

b
"1"ge::"1-

-- ~""

1 1

-. 8.6 0
15.5

18

47.0 ::?

61

283.2 ::

9

27.3 c:;

-- l:l:::

14 1 1

117.5 3.7

~""
;::-

14.0

28

12o.9

34

39.1

TABLE 8 (c)-Continued NuMBER OF CAsEs AND CASE RATE* PER 100,000 PoPuLATION oF SPECIFIED
NoTIFIABLE DisEASEs REPORTED IN GEoRGIA BY CouNTIEs, 194,0

Syphilis

Tubercu:osis

Typhoid

Typhus

Area

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Dooly ----------------------Dougherty ________ ----------
Douglas ---------------------
Early ----------------------Echols ----------------------
Effingham -------------------
Elbert ----------------------
Emanuel --------------------
Evans ----------------------li'anuin ----------------------
Fayette ---------------------
~'loyd ----------------------:H'orsyth --------------------Pra.nlrlin -------------------E"'ulton ----------------------
Gilmer ---------------------Glascock ------------------Glynn ---------------------Gordon ---------------------Grady --------------------.--
Greene ---------------------Gwinnett -------------------Habersham ------------------
Hall ------------------------
Hancock ---------------- ____

19 104
--
54
--
2 6 12 21
--
189
49 5,911
--
9 16 182
167 3 1
531 30

112.5 364.1
289.1
--
20.7 30.6 51.0 283.7
--
;)36.7
313.9 1504.'i
--
41.1 86.7 926.0
1218.2 10.3 6.8
1524.9 235.0

10

59.2

45

157.5

9

89.5

7

37.5

3

101.2

9

93.3

12

61.2

10

42.5

2

27.0

11

71.6

1

12.2

7::1

133.6

2

17.7

9

57.6

!'i7rl

l1r..1

6

66.7

~

66.0

:H

141.4

9

48.8

13

66.1

16

116.7

11

37.8

15

101.6

32

91.9

ll

86.2

13

77.0

2

/.0

2

19.9

1

5.4

--

--

:J

20.7

--

G

~ri.:i

6

81.1

1

6.8

7

S:J.7

3

5.3

l

8.8

1

6A

15

3.8

--

--

1

~~.0

3

13.7

3

16.3

6

30.5

l

7.oq

2

6.9

6

40.6

6

17.2

2

15.7

5

29.6

11

38.5

--

9

48.2

--

--

2

20.7

--

--

7

29.8

10

135.1

--

--

--

--

--

--

--

31

8.7

1

11.1

--

2

9.1

--

--

5

25.4

--
--

--

--

*Rates worked on enumerated population from census talren Allrll 1, 1940.

Whooping Cough
/

Cases

Rate

1

5.9

9

3l.'i

5

49.1 ._

1

5A ;:::;

--

~
.~...

~

--

~

3

12.8

(.J

1

13.5 0

-- .~...

--
14

24.9 ""I''

1

8.8

~

1 171

;:.. 6.4

0

43.ti

~

2 1

22.2 22.0

~

34

109.:.

13

70.5

1

5.1

4

29.2

2

6.9

2

13.5

1

2.9

8

62.7

I'--""'

1;)1

TABLE 8 (c) -Continued NuMBER OF CASES AND CAsE RATE'" PER 100,000 PoPULATiON OF SPECIFIED
NoTIFIABLE DisEASES REPORTED IN GEORGIA BY COUNTIES, 194-0

Syphilis

Tuberculosis

Typhoid

Typhus

Area

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Haralson --------------------

--

Harris ----------------------

2

Ha1-t ------------------------

2

Heard ------------------------

Henry ----------------------

6

14

4

.Jefferson --------------------

119

Jenkins -------------- ------

148

.rohuson ---------------------

--

Jones ------------------------

4.:-i

Ltunar ----------------------

1l

--
17.5 12.9
39.7
123.9 54.1 19.9 11.4
593.8 1249.7
--
540.2 109.0

2

13.9

9

78.8

5

32.2

3

34.8

9

59.5

6

53.1

2

15.5

8

39.8

:;

57.0

56.6

23

114.8

16

135.1

3

23.2

6

72.0

1:l

118.9

10

69.6

--

--

7

81.3

6

39.7

--

--

1

7.7

3

14.9

2

22.8

--

5

25.0

2

16.9

5

38.6

7

69.4

1

7.0

1

8.8

--

--

--

--

--

-

--

~

15.5

--

2

22.6

--

3

25.3

l

7. 7

--

1

9.9

Lanier ----------------------

1

Laurens -------------------- _ 124

Lee -----------------------

~

Liberty ----------------------

4

I..~incoln ----------------- ----

Long -----------------------

5

IJownde.s -------------------- 855

Lumpkin -------------------- --

Macon ----------------------

66

)fadison ---------------------

17.8 369.0
25.5 46.5
--
122.4 2683.6
-413.9

5

88.8

2;)

68.4

6

76.6

11

128.0

3

42.6

1

24.!J

2.)

78.ii

1".3.'

48.2 81.5

1

7.4

--

5

15.0

--

2

6.il

1

16.1

4

25.1

1

7.4

--

12

3!1.7

1

12.8

2

23.3

lll

~1.4

--

*Hates worked on enumerated population from rensus taken April 1. 1940.

(J;J
1-'
0'

Whooping Cough

Cases

Rate

4

35.0 <;')

"0 '

2

23.2 ~

1

G.6 l,S

t:

1_",

"' 100.:. ";:::

4

19.9 !..;.:.:



.":.;s.'.

---- 0 ~

:!

:!6.0

~

"""'

i::l:::

"~'

;;.

..

n.4

1

6.3

3

22.:1

TABLE 8 (c) -Continued NUMBER OF CASES AND CASE RATE~- PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 194,0

Syphilis

Tuberculosis

Typhoid

Typhus

Area

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

:liarion ______ ----------------

3

McDuffie --------------------

3

:liclniosh --------------------

Mer'iwether ------------------

51

:IIiller ----------------------

8

{3.1 27.6
231.2 80.0

7

64.4

--

27

122.4

3

30.0

3

43.1

1

9.2

1

18.9

3

13.6

2

20.0

--

--

l

4.5

3

30.0

:llitchell --------------------- 366
:lfonroe --------------------- 12
2

::\turray ---------------------

2

1573.4 111.6
20.7 55.1 18.0

13

55.9

6

55.8

3

31.0

6

4.7.~

7

6.2.9

11

47.3

--

--

l

9.0

7

30.1

1

9.3

1

10.3

--

Muscogee -------------------- 622

Newton ----------------------

6

Oconee ---------'-------------

1

Oglethorpe ------------------

Paulding --------------------

l

823.9 32.3 13.2
7.8

43

57.0

16

86.1

2

26.4

!j

40.2

5

39.0

2

2.6

9

48.4

--

4

32.2

--

2

2.6

--

--

--

--

--

--

Peach ----------------------

212

Pickens ---------------------

Pierce ----------------------

4

Pike ------------------------ 14

Polk ------------------------

2!J

2042.8
33.9 134.9 101.9

18

173.4

6

65.7

&

67.8

7

67.5

26

91.3

7

67.5

6

65.7

6

50.8

s

77 .l

5

17.6

1

9.6

--

4

33.9

l

9.6

1

3.5

Pulaski ---------------------

2

20.3

Puinam ---------------------

--

--

Quitman --------------------

1

29.1

!\abun ----------------------

2

25.6

Randolph ------------------ __

36

216.7

3

30.5

2

23.5

:1

58.2

1

12.8

11

66.2

--

3

35.2

2

25.6

4

24.1

l

10.2

3

18.1

*Hates worked on enumerated population from census taken A~lril 1, 194.0.

Whooping Cough

Cases

Rate

10

189.0

2 3

9.1 12.9

:R."~.R;..:'......

~

2

--
15.7

CJ
0

2

~ 18.0

9

11.9 ~

6

I 32.3

--

~
0

3

23.4 .c.i.-..

R.

25

273.6 ~-

l

8.5

6

57.8

,,

10.5

17

102.4

~

1--'

-.l

TABLE 3 (c) -Continued NuMBER oF CAsEs AND CAsE RATE'' PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 194.0

Syphilis

Tuberculosis

Typhoid

Typhus

Area

Cases

Rate

Cases

Rate

Cases

Rate

Cases

Rate

Richmond ------------------- 700

Rockdale --------------------

2

Schley ----------------------

4

Scrmren --------------------- 17

Seminole --------------------

81

855.1 25.9 79.5 83.5 953.8

129

157.6

--

--

4

79.5

17

83.5

5

58.9

Spalding ---------------------

232

Stephens --------------------

6

Stewart ---------------------

2

Sumter ---------------------- 279

Talbot ----------------------

816.1 46.3 18.9
1138.7
--

36

126.6

6

46.3

1

66.0

13

53.1

1

12.3

Taliaferro -------------------

5

Tatt.nall ---------------------

2

Taylor ----------------------

Telfair ---------------------- 107

Terrell ---------------------- 386

79.6 12.3
--
706.:.
2314.8

3

47.8

9

ti!'i.4

5

46.4

1

46.2

13

78.0

Thomas --------------------- 10

Tift ------------------------ 252

Toombs ---------------------

26

TOWllS ---------------------- --

Treutlen --------------------

32.0
1354.9
153.4
---

21

67.1

11

59.1

6

35.4

1

20.3

1

13.1

r!'roup ----------------------- 484

Turner ----------------------

5

Twiggs ----------------------.

--

Union ---------------------- --

U!lSOll ----------------------

2

1103.0
46.1
---
8.0

60

136.7

1

64.!i

G

65.8

--

--

33

131.7

*Rates worked on enumerated population from census taken Aptil 1, 1940.

5

6.1

--

--

6

119.2

5

24.6

1

11.8

5

17.6

2

15.4

--

15

61.2

1

12.3

--

--

--

1

9.3

4

26.4

3

18.0

2

6.4

3

16.1

4

23.6

4

9.1

2

18.4

17

l86.ii

1

13.0

2

8.0

10

12.2

--

--

3

59.6

11

u4.0

17

200.2

4

14.1

--

3

28.3

10

40.8

--

--

--

5

30.8

6

!15.7

7

46.2

12

72.0

8

25.6

21

112.9

10

5g.o

5

11.4

4

36.9

1

11.0

--

w c....o...

Whooping Cough

Cases

Rate

ll

13.4

4

:11.8 '<l

1

'" 19.9 c

~

ts

1
--

24.6 b
.,'""t;j

1

9.4 ....

2

8.2 "

--

--- ~'"
-- c -- "'tj

1

6.6 :

6
24 2

36.0
76.7 10.8
--

.-,"'"'
'l-"''N.;
'" s.

34

77.5

1

g_2

3

39.1

3

12.0

TABLE 8 (c)-Continued NuMBER OF CASES AND CAsE RATE* PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEoRGIA BY CouNTIES, 1940

Syphilis

Tuberculosis

Area

Cases

Rate

Cases

Rate

Walker ----------------------

25

Walton ----------------------

8:J

Ware ------------------------ 148

"rarren ----------------------

4

Washington ----------------- 163

'Vayne ----------------------

so

Webster ---------------------

3

Wheeler ---------------------

29

White -----------------------

9

Whitfield -------------------

63

80.6 409.1
;J~9.9
39.1 672.7
609.7 63.5
339.8 140.3
~4.1.:1

41

132.2

13

62.6

18

64.4

7

68.4

14

:J7 .8

12

91.4

~

4'' .

2

23.4

1

15.6

4J

l~il.7

Wilcox ----------------------

1

Wilkes ----------------------

4

Wilkinson -------------------

10

\Yorth ---------------------- 86

7.8 26.5 90.7 402.4

2

V'i.7

13

86.2

3

27.2

15

70.2

*Hates worked on enumerated IlOllU!atio~t from c-ensus talwu A!H il 1, l~4d.

Typhoid

Cases

Rate

1

3.2

2

9.6

4

14.3

--

--

5

20.6

6

45.7

3

63.G

3

35.1

1

15.6

N

::o.u

6

47.0

1

6.6

8

72.6

12

au.1

Typhus

Cases

Rate

4

12.9

--

--

20

71.6

--

2

8.3

--

3

63.5

3

3G.1

--

--

--

--

9

70.6

11

51.5

Whooping Cough

~

~

Cases

Rate ~:

~

26 7

83.8 33.7

.

73

261.4 C)

2

19.G :0:::

--

-- ~

it

--

--
--

"I'

~

--
4

--
15.3

0
~

~

4

31.4 ~-

ll

51.5

""t-'
\0

''.\-