Annual report for the year 1941 [Oct. 1, 1942]

S TATE OF GEORGIA
Departm~nt of
PunLil: HEALTH
ANNUAL REPORT 1941

STATE OF GEORGIA
DEPARTMENT OF
PUBLIC HEALTH
T. F. ABERCROMBIE, M.D., Director
ANNUAL REPORT FOR THE YEAR 1941
State Office Building Atlanta, Georgia October l, 1942

Contents
Page Division of Local Health Organizations____________ lO Division of Public Health Nursing_________________ 23 Division of Public Health Engineering_____________ 27 Division of Maternal and Child Health ____________ 46 Division of Dental Health Education _______________ 78 Division of Public Health Education _______________ 87 Division of Preventable Diseases:
Cancer Control Service________________________ 92 Epidemiological Service ______________________ 100 Industrial Hygiene Service___________________ 140 Typhus Fever Control Service_________________ 132 Venereal Disease Control Service_____________ 138 Division of Malaria and Hookworm Service________ 144 Division of Tuberculosis ControL_________________ 165 State Tuberculosis Sanatorium____________________ 177 Division of Laboratories___________________________ 194 Division of Information and Statistics _______________ 232

STATE OF GEORGIA
DEPARTMENT OF PUBLIC HEALTH
T. F.ASERCROMBIE,M. 0 .DIRECTOR
ATLANTA

. . '

To His J!lxcellencyHon. Eugene Talmadga 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 1941,
The death rate of Georgians reached the unprecedentedly low figure of 10,0 per 1,000 population. This is 2.9 per cent below the previous minimum,
Just how favorable the mortality was in 1941 may be illustrated by comparing the figure with that recorded 23 years agp, when the United States was engaged in a world conflict, In 1918, the mortality in the Registration Area of the United State; (figures for Georgia are not available) was 18.1 per 1,000 population, or more than 40 per cent as high as in Georgia in 1941,
Georgians are entering this war in far better health than at the beginning of the last war. The advances in medical science and public health practice have not only largely eliminated the mortality from malaria, typhoid fever, diarrhea and enteritis, and the principal communicable diseases of childhood, but have also brought under control pneumonia and tuberculosis.
Re speotfully suomi t tad
{?;~-
T. F. Abercrombie, M. D., Director State Department of Public Health

MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH OCTOBER l, l9Ltl

Ex-officio
l-IoN. EuGENE TALMADGE
Governor of Georgia

Name

RoBERT F. MADDOX, Chairman_

-_Atlanta

C. L. RIDLEY, M.D., Vice-Chairman

______ Macon

]. C. METTS, M.D.

____ Savannah

C. K. SHARP, M.D.
R. c. ELLIS- - --

_Arlington _____ Americus

]. A. CORRY, M.D.- - ---------- - --------- -
w. P. HARBIN, ]R., M.D. - ---- --

___ Barnesville __ Rome

H. W. CLEMENTS, M.D.- --- ---

_-Adel

R. L. RoGERs, M.D. _ _ _

___________ .Gainesville

D. N. THOMPSON, M.D.

___________________________ Elberton

lVI. D. HoDGEs, Ph.G. __

_______ - __

______ Marietta

]OHN W. WHITE, Ph.G.

_ ____________________Thomasville

]. G. WILLIAMS, D.D.S.--
w. K. WHITE, D.D.S.

___ Atlanta Savannah

Brief llistory of Public I-Iealth in Georgia
England set a .fine example of early public health effort by appropriating, in 1732, 13 guineas ($62.40) for the relief of sick mothers during passage to the province.
Colonial records for 1739 reveal that 40 pounds, 17 shillings, and 6 pence were paid for "physicks" to be given soldiers in General Oglethorpe's Regiment in Savannah.
As early as 1760, there was an act to oblige ships and other vessels coming from places infected with the plague, smallpox, or other contagious diseases to be quarantined. Later, in 1817, a Georgia law was passed prohibiting the sale of unwholesome meat, bread, and liquors. Offenders could be .fined for the first offense and imprisoned for the second.
In 1823, a law was passed establishing an office in each county for the purpose of recording births. In facL Georgia was the second of the States to require registration by law.
In }8:13, there was an enactment by the General Assembly requiring that a supply of smallpox vaccine matler be purchased and supplied to the people of the Stale free. Later, in 1866, the Legislature passed an act for the control o smallpox in Georgia.
In February o 1875, the Legislature passed an act creating a State Board of Health. Agitation in favor of this had been begun by the Medical A~sociation of Georgia at the close of the Civil War. Records showed that more soldiers died of preventable diseases during the war than were killed with bullets. From typhoid fever alone there was one death for every 28 soldiers enlisted.
The law creating the Board o Health authorized the Governor to appoint a physician of experience from each of the nine Congressional Districts. These together with the Comptroller General, Attorney General, and the State Geologist constituted the Board. Dr. V. H. Taliaferro was elected Secretary at a salary of $1,000 a year. The program consisted of prevention of disease, promotion of public health, and the collection of vital statistics.
Records show that Doctor Taliaferro was too busy even to attend all the meetings of the State Board of Health. A report indicates that a meeting was held in Atlanta on October 10, 1876, all members being present except the Secretary, who was delayed in Savannah on account of an epidemic of yellow fever.
Doctor Taliaferro made a complete investigation of the origin of the yellow fever epidemic and reported that sailors on the "Maria Carlina", who had moved their bedding to a boarding house, brought the fever to Savannah. At that time, sanitary conditions in Savannah, as well as in other parts o the State, were very poor and played an important part in the spread of the disease. Cases occurred in Augusta, Brunswick, and Macon.

8

Georgia Department of Public Health

On October 30, 1876, the Sa-vannah Morning News stated that 8,000 refugees had left Savannah, and that the loss to the city was over onehalf million dollars. The same article stated that Savannah had spent $120,833.00 for charity during the epidemic. That year, only $1,000 was spent for public health in the entire State!
The next outlook for public health work in Georgia was even darker, as no appropriation was made for the continuation of the work in 1877. Records for that period, furnished every ten years by the Census Bureau, show a constant increase in deaths from the more serious public health problems. Typhoid fever, malaria (then called bilious fever), and smallpox raged. Pellagra and hookworm disease were making their appearance.
Georgia was without a public health program twenty-six years. The second State Board of Health was organized September 10, 1903, under an act of the Legislature. An appropriation of $3,000 was made and Dr. H. F. Harris was elected secretary at a salary of $2,000 yearly. The remainder of the appropriation was used in the general work of the Board.
Doctor Harris, using a microscope and other apparatus of his own, began operation in one small room in the basement of the Capitol in 1904.. His first work was devoted to bacteriology and the control of smallpox and yellow fever. He also did a vast amount of research in an effort to determine the cause of pellagra.
A laboratory was opened in 1905. With assistance, Doctor Harris expanded his activities to include the manufacture of Pasteur treatment in 1908; diphtheria antitoxin in 1909; and typhoid vaccine in 1912.
The first full-time county health project was established in Glynn County in 1914. Later in the year, the Ellis Health Law was passed, thereby creating a board of health in every county in the State. This law further provides for the employment of a full-time county health officer upon two successive recommendations of the grand jury. Following the passage of this law, Glynn and Floyd Counties adopted its provisions.
At a meeting of the State Board of Health, in January of 1914., Doctor Harris expressed a desire to retire from public health work as soon as he could be relieved of his duties without prejudice to the work, in order that he might devote his entire time to research.
At a meeting of the State Board of Health, in July of 1917, Dr. T. F. Abercrombie, formerly Commissioner of Health of Glynn County, was elected Secretary.
Following is a list of the services of the State Department of Public Health, with the date of their establishment:

Pnblic Health in Georgia

9

Laboratory-------------------------- ________________ 1905 Field Sanitation (now Local Health Organizations) ______ 1910 Venereal Disease ControL ____________________________ 1918 Vital Statistics_____________________________________ 1919 Maternal and Child Health___________________________ 1920
Sanitary Engineering-------------------------------- 1920 Dental Health Education_____________________________ 1928 Tuberculosis ControL_______________________________ 1930 Preventable Disease_________________________________ 1931 Public Health Nursing_______________________________ 1936 Cancer ControL____________________________________ 1937 Typhus Control ____________________________________ 1937
Malaria Investigations_______________________________ 1937 Public Health Education _____________________________ 1938
Nutrition------------------------------------------- 194,0 Industrial Hygiene__________________________________ 194,1

Division of Local llealth Organizations

Guy G. Lunsford, M.D., Director
R. B. Griffin, M.D., JV]edical Director._____________ Northwestern Region R. B. Griffin, l\II.D., Interim Medical Director______Northeastern Region W. D. Cagle, M.D., Medical Director_____________ West Central Region A. ]. Davis, M.D., Medical Director______________ ast Central Region G. V. Rice, M.D., Medical Director ______________ Southwestern Region J. D. Stillwell, M.D., Medical Director____________Southeastern Region

One million nine hundred twenty thousand one hundred nineteen Georgia citizens were residing in fifty-six counties having full-time health departments on December 31, 19i1l. This is an increase of 26,678 since December 31, 19il,O. In addition, 693,260 persons were residing in fiftynine counties having one or more public health nurses.

The 531,866 persons living in the other forty-four counties were dependent for public health protection upon what service it was possible for the Stale Department of Public Health to give from the central office and from the six regional departments. In some of these forty-four counties requests have been made and money appropriated for health services, and such service will begin as soon as qualified personnel can be secured. This is an all-time record for the State.

During the year nine public health physicians, twenty public health engineers and sanitarians; and len public health nurses resigned to serve

in the Army, Navy or other defense work, or for personal reasons. One

physician, the Commissioner of Health of Jefferson County, died late in

December. It has been possible to replace only a few of these. However,

in nearly all cases where resignations have occurred, the remainder of the

staff has gallantly carried on, and assumed the added tasks as far as

possible.



DEFENSE ACTIVITIES

Because of the national emergency and location of numerous defense projects in the Stale, ali public health personnel has found it necessary to alter their programs somewhat. With only a very few exceptions this call for change mid increase of activities has been answered with a smile and evident eagerness by all public health workers. Personnel of county health departments and county boards of health have cooperated. Temporary leaves of absence have been granted county personnel for service in other localities.
County personnel, as well as regional public health workers, has also taken up the duty of planning for an effective civilian defense program under the State Director of Emergency Medical Defense, and they have given freely of their time and labor to get the plan in operation. Public health work, local, stale, and national, is considered by national and state leaders to be vitally important to the defense program. The Surgeon

Local Health Organizations

ll

General of the United States Public Health Service, m the "American Journal of Public Health" for January 1942, says:
The United Nations fighting for freedom face a new year begun in sorrow because it brings widespread destruction of human life rather than the continuing effort to save life and lessen suffering. Important as has been the task of public health workers in the past, it is of transcendent urgency now in the battles to defend our freedom. Not only must we hold the lines against preventable disease in the population sustaining the armed forces and producing the essentials of war; 'We must also translate scientific fact into positive action for three-thirds of our people in order to raise the level of strength, endurance and morale for the grim work ahead. Let us reappraise our own efforts, having the patriotism to discard from our plans whatever contributes little to national needs, and the courage to move ahead boldly where we can add to national strength.
Ours is the responsibility for leading the fight against the weakness from within which impedes attack upon the enemy without.
For this reason many public health workers in Georgia have remained at their stations, performing the tasks for which they are prepared, rather than follow their desires to don the uniform of one of the armed forces. For this they deserve the gratitude of the Stale and Nation.
DISTRICT HEALTH DEPARTMENTS
In several cases where physicians or public health engineers have been called to military service, or resigned, the board of health of an adjoining county has come to the rescue by sharing its personnel with the other county. The Crisp-Worth District has thus been formed, and early in 1942, Bleckley, Dodge and Pulaski Counties, and Burke and Jenkins Counties will begin operation as health districts. In these cases, additional nurses have been added to compensate in part for the loss of time by the commrsswner of health. Probably other districts will also be formed during 194-2.
PERSONNEL TRAINING
The necessity for well-trained workers in public health is just as important, or possibly more so, than ever before, and during the year three physicians, nine sanitarians, one hundred and five nurses, two laboratory technicians, and one veterinarian were given the minimum training to prepare them for their respective duties, During the emergency additional or in-service training has been discontinued,
Six young men graduated from the Georgia School of Technology in June with the Degree of Bachelor of Science in Public Health Engineering. These men were given a period of field training following their graduation, and five have been placed in positions in the State. The Director of the Division of Local Health Organizations, with other staff members of the

12

Georgia Department of Public Health

GEORGIA
f STATE BoARD I-IEALTI-I
T.F.ABERCR0/181,11.0.
Commissioner ofll!!alllt
T !

SINGLE COUNTY HEALTH DEPARTMENTS DISTRICT HEALTH DEPARTMENTS COUNTIES WITH PUBLIC HEALTH NURSES HEALTH REGIONS

Local Health Organizations

13

Department, gave a course of lectures to this class, and are listed as visiting lecturers in the Department of Biology and Public Health of the school.
Twelve medical students of the University of Georgia School of Medicine and the Emory University School of Medicine, who had completed the work in the junior class, accepted fellowships during the summer months to work with several local health departments. Five of these fellowships were given by International Health Division of the Rockefeller Foundation. These "interneships" are expected to give these future doctors a much better understanding of the public health program, and thus result in better cooperation between the physician and the health department. All of the students expressed appreciation for the opportunity to participate in this program.
GEORGIA PUBLIC HEALTH ASSOCIATION
The Georgia Public Health Association met in annual session at the Atlanta Biltmore Hotel on May 29, 30, and 31, with the largest attendance in its history. An unusually good program had been prepared for the general sessions and the sectional meetings.
RECOMMENDATIONS
The lack of available trained public health personnel, and the added responsibility caused by the national emergency make it very difficult to make recommendations for the immediate future. The decrease of medical personnel has been compensated for somewhat by increasing public health nursing service, and if more nurses become available, this increase will continue. The loyalty and patriotism of the present personnel is such that we may be sure that as emergencies arise they will be cared for.
STATISTICAL REPORT
Following is a statistical report of activities by counties for 194.1, and a summary of activities of the organized counties and for the entire State, with a comparison with 1940. A glance at this table will show an increase of activities in almost every item.

1.:;:-:..'

Year
19Li 1920 1925 1930 1935 1940 1941

Number Organized Counties
2 18 23 34 31 fl5 5G

REcORD OF CouNTY HEALTH WoRK IN GEORGIA
1915- 194,1

Number Persons Em(Jioyed
5 42 7l 205 233 498 544

Population Served
17,545 436,106 !i98,107 1,0ll,974 1,:127,018 1,893,441 1,920,ll9

Total Budget
lj; 4,637.00 7t,69!i.OO
179,812.00 451,217.00 459,292.00 1,0GG,I2G.20 1,124,72\1.00

Per Capita
.26 .21 .30 .45 .3::1 .!i6 .58

County Budget
$ 4,637.00 70,895.00
168,272.00 440,904.00 399,256.00 785,049.20 S13,06:i.:i9

~
"0 '
~ :";:,' .t:::;

Per Capita

~"'
g:;:,

"' .26 ~

.20 -0-.
.28 "1::i
~ .44
.30 c:;

.41 1:!:::

"' .4~

~

;;::--

Local llealth Organizations

15

COMPARATIVE STATISTICAL SUMMARY OF TOTAL LOCAL PUBLIC
HEALTH wORK IN GEORGIA, 19LLQ- 1941

Organized Counties

1940

1941

All Counties

1940

1941

COMMUNI CABLE DISEASE CONTROL
Admissions to medical service ______________ +__ Admissions to nursing selvice_________________
Admissions to medical andjor nursing service__ Consultations with physicians_________________

12,706 8,537
15,908 2,151

Field Visits:
Diphtheria ':ryphoid fever and paratyphoid fever_________ _
Scarlet fever -------------------------------Smallpox -----------------------------------i\Ieasles ------------------------ _____________
Whooping cough ----------------------------r.rlalaria ------------------------------------Hoolnvorrn ----------------------------------1'ypl1us -------------------------------------Other communicable diseases_________________ _

2,331 1,260 2,106
8'1 6'17 679 2,888 6,783 306 4,236

Total field visits fo1 communica.ble disease control 21,320

Persons treated for hoolnvorms________________ _ 9,121

Admissions to hOSJJitals:

Diphtheria

3<1

Typhoid fever and paratyphoid fever___________

52

Scatlet fever --------------------------------

123

Smallpox

Other communicable disease patients admitted

to hospitals -------------------------------

921

Total admissions to hospitals for communicable

disease control

1,135

Immunizations (JJersons immunized):

Smallpox -----------------------------------Diphtheria-under 1 year---------------------Diphtheria-l through 'I years_________________
Diphtheria-5 years and over__________________

59,009 9, 789
13,2,18
11,736

Total diphtheria immunizations________________ 3<1, 773
Schick tests given______________________________ 17,925 Typhoid fever -------------------------------- 178,681 Other immunizations ------------------------- 2,35<1 Public lectures and talks______________________ 310 Attendance __ --------------------------------- 20,661 Persons tested in surveys______________________ 36,690

9,9<!2 10,828 15,503
2,380
1,852 827
2,5<]<] 49
3,807 2,221
69'1 3,811
4<12 7,796
,13 32 81
802
'19, 7'12 9,273
11,952 9,126
30,351 15,335 166,751
1,19'1 27<1
13,132 13,660

15,378 11,532 19,6'!1
2,556
2,<195 2,093 2,213
93 693 7<1<1 13,770 9,333 332 '1,737
36,563
11,622
3'1 52 130
5
922
1,1<!3
76,293 11,665 17,656 13,G50
'12,871
13,831 236,755
2;568 '132
29,724 '!1,37'1

12,210 15,818 19,731
2,712
2,195 1,139 2,692
82 3,986 2,265 21,997 6,506
596 8,971
6,851
53 43 81 1
806
984
7!,530 12,732 18,835 12,027
'13,594
17,35'1 258,075
1,'161 ']<]4
20,940 21,909

16

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PUBLIC HEALTH WoRK IN GEORGIA, 1940 19iU-Continued

Organized Counties

1940

1941

All Counties

1940

1941

VENEREAL DISEASE CONTROL Admissions to medical service_________________ 10,991

Admissions to nursing service__________________ 23,961

Total adrnisslons to medical and/or nulsing

service ------------------------------------ 13,596 Cases transferred to private physicians_________ 1,105

Clinic visits (by patients)--------------------- 536,524

Field visits (to patients)----------------------- 33,773 Number of clinic treatments___________________ 478,471

Dismissed from service_________________________ 11,801

Public lectures and tall"'---------------------- 257

Attendance ---------------------------------- 19,905

TUBERCULOSIS CONTROL Individuals admitted to medical sel'Vice_______ _ 12,859

Positive cases --------------------------------
Suspicious cases ----------------------------Contacts ------------------------------------Individuals admitted to nursing service________ _

1,99'1 '1,939 5,926 17,568

Positive cases ------------------------------Suspicious cases -----------------------------
Contacts -----------------------------------Total individuals admitted to medical and/or

3,180 5,252 9,136

nursing service ---------------------------Positive cases -------------------------------Suspicious cases ----------------------------Contacts -----------------------------------Physical examinations in clinics______________ _
X-ray examinations -------------------------Clinic visits (by patients)--------------------Visits to State clinics (by patients) ___________ _ Visits to p1ivate physicians (by patients) _____ _
Visits to private physicians (health office1 or

20,775 3,<l'J6 7,382 9,9'17
12,136 15,783 24,473
8,964 1,28'1

nurse) ------------------------------------ 1,729 Visits to others (health office1 or nurse) ______ _ 1,077

Field visits ---------------------------------Visits to cases of tuberculosis ________________ _
Visits to tuberculosis suspects _________________ _ Visits to contacts ____________________________ _

53,548 18,649
8,353 26,546

Office visits --------------------------------Office visits of cases of tuberculosis ___________ _
Office visits of tuberculosis suspects___________ _ Office visits of contacts_______________________ _

19,723 '1,587 7;132 7,704

Admissions to sanatoria____ ------------------- 175 Numbel' tuberculin tests completed ____________ _ 17,506

Number positive ----------------------------- 8,269 Number negative (completed tests)------------- 9,237

Contacts broken ----------------------------Contacts partly brol<en_______________________ _ Relief secured for tuberculosis cases___________ _ Cottages, sleeping porches, etc. (number built) __

1,268 381 707 20

Public lectures and tall<s---------------------- 537

Attendance

34,038

<11,850 2'1;169
<13,262 1,106
524,180 35,760
,175,803 9,828 H9
10,060
12,5!5 1,397 4,322 6,326
19,5!3 3,253 5,343
10,912
22,054 3,522 6,663
11,869 10,958 15,866 2t!,7<!8
9,680 1,169
1,273 1,401 56,027 17,229 10;172 28,326 23;179 5,156 8,950 9,373
5'17 22,191
7.865 H,326
1,369 357 591 11 608
56,278

47,000 29,262
50,060 1,287 610,116 37,681 538,259 12,169
366 26,860
15,217 2,260 5,602 7,355
22,039 3,723 6;17'1
11,8,12
25,833 4,069 8,800 12,964 12,2<!3 19,318 28,002 12,489 1;130
2,058 1;!16 61,340 20,490 10,230 31,120 21,571 5,006 8,077 3;183
535 19,282
9,092 10,190
1,341 398 793 25 611
39,133

48,884 30,730
50,620 1,283 621,702 '13,106 561,778 10;167
192 H,68'1
16,909 2,323 5,598 8,988
27,094 '1,131 7,348
15,615
30,'150 '1,'199 8,918
17,033 11;174 21,003 30,140 H,838
1.'157
1,571 1,7<14 67,358 19;115 13,020 3'1,923 26,7<13 5,591 10,130 11,022
673 2'1,960
3,688 16,272
1,'137 368 667 13 670
77,201

Local 11ealth Organizations

l7

CoMPARATIVE STATISTICAL SmvLMARY oF ToTAL LocAL PuBLic HEALTH WoRK IN GEORGIA, 194.0- l9LH-Continued

Organized Counties

1940

1941

All Counties

1940

1941

MATERNITY SERVICE

Cases admitted to prenatal medical service _____ _ 1<1,301 Cases admitted to IH'enatal nursing service _____ _ 17,956

Cases admitted to medical andjor nursing service 19,H1 Visits by prenatal cases to medical conferences __ 17;197 Visits by prenatal cases to private physicians __ 821

Field visits to prenatal cases-----------------Office nursing visits by prenatal cases________ _ Cases attended by nurses for delivery service ___ _ Cases given postpa!'tum medical examination___ _ Cases given postpartum examination by private

28,376 39,673
3<10 2,663

physicians ____ ----------------------------Cases admitted to postpartum nu!sing service __ _
Visits to postpartum cases ____ -----------------
Permanent health centers--------------------Number of sessions ______ -------------------Itinerant health centers_______________________ _

209 13,809 32,61<1
179 6,'159
6

Sessions held -------------------------------Midwives registered for formal instruction _____ _ 1,'188

Midwife meetings ---------------------- _____ _ Attendance at meetings _______________________ _
Visits for midwife supervision ________________ _ Public lectures and talks ____________________ _

993 8,636 3,720
25<1

Attendance ----------------------------------Enrollment in 1naternity classes_______________ _
Attendance __________ ------------------------

5,982 778
1,826

INFANT AND PRESCHOOL HYGIENE

Infants: Individuals admitted to medical service ________ _ Individuals admitted to nursing service _______ _ Individuals admitted to medical andjor ntll'sing service ____________________________ ----- ____
Permanent health centers _-------------------Number of sessions__________________________ _ Itinerant health centers______________________ _
Sessions held ---------------------------- ___ _ Visits to medical conferences (by patients)----Visits to private physicians (by patients) _____ _
Field l'isits ---------------------------------Office nursing Yisits -------------------------Consultaiions with parents---------------------

9,271 22,863
2<1,222 2<17
5,605 26 92
21,206 275
<16,265 18,013 37,53<1

Preschool: Individuals admitted to medical service________ _ Individuals admitted to nursing service_______ _
Individuals admitted to medical andjor nursing
service -----------------------------------Permanent health centers_____________________ _ Number of sessions__________________________ _
Itinerant health centers ______________________ _

12,318 20,72<1
22,91<1 21<1
5,12<1 226

15,001 19,852 21.003 55,090
908 32,205 <16,299
331 2,<177
262 15,651 39,310
179 5,653
21 <16 1,371 952 8,35<1 3.207 261 <1,728 594 1,990
9,9H 23,59<1
25,268 229
7,070 58
123 22,963
<166 <18,066 22,202 <11,557
12,313 20,798
22,9<10 201
5,503 230

16,529 21,229 22,530 52,75<1
887 31,730 15,226
393 2,856
232 1<1,909 3<1,630
2<11 7,3<11
6 10 2,891 1,588 12,128 <1,821 300 6,687 791 1,839
10,1<10 25,050
26;180 291
6,167 26 92
22,870 354
<19,'121 19,913 39,722
13,06<1 22;192
2<1,789 249
5;180 228

19,250 ::N,588 25,825 62,616
1,038 37,587 54,794
389 3,081
325 17,921 <13,319
2<11 6,760
21 46 2,289 1,600 12,317 5,037 308 5,428 597 1,993
11,3<10 27,303
28,85<1 283
7,833 58
123 25,281
508 5<1,831 25,812 <16,672
13,622 23,658
25,860 240
6,019 236

18

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLic HEALTH WoRK IN GEORGIA, 19t10- 1941-Continued

Organized Counties

1940

1941

All Counties

1940

1941

Sessions held -------------------------------Visits to medical conferences (by patients) ____ _ Visits to private physicians (by patients) _____ _
Field visits ---------------------------------Office nursing visits (by patients)------------Inspections by dentists or dental hygienists ____ _ Prophylaxis by dentists or dental hygienists ___ _ Consultations with pa1ents___________________ _
Public lectures and tallm ---------------------Attendance ---------------------------------Enrollment in infant and preschool classes____ _ Attendance __ --------------------------------

392 22,688
332 29,2,17 21,495
891 183 33,036 131 1,180 693 1,882

SCHOOL HYGIENE

Inspections bY physicians or nu1ses ____________ 292,038

Examinations by physicians ______ ------------- 113,,160

Examinations by physicians "\Vith parents present 2,812

Individuals admitted to nursing service ________ _ 22.354

Field visits ---------------------------------Office visits ------ ________ ------------------Inspections by dentists or dental hygienists _____ _ Prophylaxis by dentists or dental hygienists ___ _

36,02<1 17,256 92,159
9,373

Public lectures and talks---------------------- 197
Attendance ---------------------------------- 2<1.977 Classl'oom health tallm _______________________ _ 5,585

Attendance __ -------------------------------- 193,213

ADULT HYGIENE

Medical Examinations:
1Iill<-handlers -------------------------------Other food-handlers --------------------------Midwives
Teachers -----------------------------------Other adult medical examinations ______ ---- ___ _

1,705 26,<181
603 8<10 19,711

~Po tal adult medical examiriations -------------- _ '19,340

MORBIDITY SERVICE
Admissions to medical service_________________ _
Admissions to nursing service-----------------Admission to medical andjor nursing service ___ _ Clinic visits (by patients)---------------- ____ _ Fielcl medical visits __________________________ _
Field nursing visits--------------------------Office nursing visits--------------------------Total admissions to hospitals ____ --------------~rotal patient-days of hospital service_________ _ Individuals admitted to dental service_________ _ Refractions ~Jlonsil and adenoid operations___ --------------Other defects corrected ________________________ _

1<1,37<1 8,,188
19.827 68,070
6,655 32,161
6,176 11.23<1 76,838 3,028
764 961 3,872

371 22At14
360 32,353 23,681 20,016
533 35,683
196 <1.829
639 833
313,706 95,377 3,6<16 19,87<1 33,888 18,880 77,653 3,1<17 49<1 29,75<1 <1,338
1<19,87<1
2,066 37,86<1
<17<1 1.261 H,0<13
:i'i,708
21,969 7,961
27,322 6<1,<11'1
5,6<12 26,97<1
5,217 12,606 8<1,517
5,071 726 909
2,71<1

396 23,935
<195 31,21<1 23,120
938 200 35,521 152 5,186 693 1,883
305,<112 115,121
2,897 22,785 36,<141 17,803 105,060
9,472 600
31,575 5,895
206,030
1, 705 21l,483
616 87'1 19,749
1<1,687 10,821 22,11)4 68,<198
6,807 31,993
7,791 11,36'1 77,223
3,061 780
1,068 3,891

378 24,71<1
382 35,63<1 26,206 20,093
562 10,300
221 7,090
660 1,298
330,<110 96,775 3,741 21,397 34,800 20,133 91,262 3,<151 661 '16,381 '1,8<17
165,271
2,01lll 38,001
476 1,262 14,298
56,106
22,693 10,<124 29,806 66,213
5,731 30,<123
3,394 12,767 8'1,950 5,105
7'1<1 997 2,324

Local Health 0 rganizations

19

CoMPARATIVE STATISTICAL SuMMAR7 oF ToTAL LJCAL PuBLIC HEALTH WoRK IN GEORGIA, 194-0- 19L1l-Continued

Organized Counties

1940

1941

All Counties

1940

1941

CANCER CONTROL Admissions to medical service_________________ _ Admissions to nursing service_________________ _ Admissions to medical and/or nursing service__ _ Office visits --------------------------------Field visits ---------------------------------Applications for State aid_____________________
Cases receiving diagnostic service at State-aid
cli11ics ------------------------------------Cases receiving treatment service at State-aiel
clinics -------------------------------------

597 319 696 1,,170 905 '193
,123
511

CRIPPLED CHILDREN SERVICE
Individuals reported -------------------------Individuals examined at diagnostic clinics ______ _
Inclividuals treated --------------------------Individuals admitted to nursing service _________ _ Visits to diagnostic clinics (by patients) ______ _
Nursing visits -------------------------------Public lectures ami talks---------------------Attendance __ ---------------------------------

673 927 563 328 708 1,550
3 105

OTHER ACTIVITIES

Conferences with physicians or dentists________ 19,892 Personal conferences with others_______________ 115,578

Newspaper articles --------------------------- 2,114

Bulletins distributed ------------------------- 1<11,336

Circular letters ------------------------------- 6'1,553

:Miles traveled on clutY------------------------1,968,951

Days off duty---------------------------------- 872

Conferences '\Yith official groups--------------- 655

Attendance __ --------------------------------- 10,708 Public lecttll'es and taJlrs _____________________ _ 5'19

Attendance

3'1,095

GENERAL SANITATION
Water: Approved individual water supplies installed___ _ Individual vmter supplies il11Pl'ovecL___________ _ Public water supplies improved _______________ _ Connections to public water supplies___________
Sewage: New privies installed__________________________
Wood privies installed at homes_______________ _
Concrete privies installed at homes ___________ _ Wood privies installed at schools ______________ _ Concrete Privies installed at schools__:_________ _ Wood privies installed at other public places ___ _ Concrete privies installed at other public places__ Privies repaired (or improved) _______________ _ New septic tanks installed____________________ _

1,<122 1,129
138 5,731
8,557 873
6,667 95
H6 176 300 1,688 2,753

638 <1<15 775 1,560 1,166 719
52<1
551

625 '134 815 1,5,16 1,011 561
452
535

714 6<15 976 1,739 1,339 83'1
572
608

523 653 475 379 718 2,087
4 1'19

716 9<11 571 383 728 1,636
3 105

565 781 501 527 885 2,259
'1 1<19

21,3<16 120,209
3,5'10 126,571
41,211 2,193,<171
1,080 1,628 19,890
759 38,729

25,<128 139,<187
2,339 165,88'1
69,098 2,869,501
1,703 973
1'1,985 98'1
55,'176

29,H7 152,9,17
3,39'1 149,960
'18,319 '1,115,952
2,071 2,329 27,75'1 1,9,19
71,<16'1

1,388 850 150
6,2<12
5,692 639
4,<112 53 263 129 196
1,529 3,372

1,593 1,793
239 6,118
11,408 1,<122 8,758 109 599 191 329 1,701 3,031

1,567 1,213
219 6,512
7,695857
5,906 73
486 H9 22<1 2,016 3,671

.. -------------------------------------------- ~

20

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1940- 1941-Continued

Organized Counties

1940

1941

All Counties

1940

1941

Septic tanlm installed at homes__________ ------Septic tanks installed at schools_______________ Septic tanks installed at other public places_____ Septic tanlm imp!'oved ------------------------Connections to public sewer____________________ Sewerage systems or plants improved___________

2,578 <11
13<1 213 3,942
113

Field visits:

Private premises

3<15,286

Camp sites ----------------------------------- 1,539

Swimming pools ------------------------------ 738

Barber shops and beauty parlors ______________ _ 484

Schools -------------------------------------- 3,508

Public watel' supplies (plants anil systems) ____ _ 983

Sewerage plants ------------------------------ 526

Othel' fielcl visits for general sanitation_______ _ 37,19<1

3,093 <10
239 225 3,363
so
294,007 1,327 860 161 3,<180 798 HI
60,378

2,788 57
186 240 <1,173
56
350,439 1,863 780 cJS,I <1,,187 1,360 830
37,750

3,321 52 298 299
3,<178 85
297,366 1,978 880 J6c1 <1,351 1,006 925
60,802

Total field visits for general sanitation _________ 39(),258

l nsect control: Buildings mosquito-proofed ------------------- 1,119 :\Iinor drainnge-linear feet completed __________ 582,627 Linear feet ditch cleared______________________ 4,02<1,<103 Anopheles breeding places eliminated___________ 1,2<10 Acres drained _ ---------------------- ________ 4,452 Anopl1eles breeding places controlled----------- 1<1,325

Miscellanec us: Public lectures and tall;s______________________
Attendance ----------------------------------Postel'S, charts, exhibit models completed_______ Sanitation or malaria maps completed----------

153
6,293 580 201

Rodent control: Premises surveyed for rodent controL----------
Buildings rat-proofed ------------------------Buildings improved --------------------------Premises improved __________ ----------------Pounds of poison bait distl'ibuted_______________

9,84<1
502 3<17 2,238 2,632

PROTECTION OF FOOD AND MILl<

l!,ood handling establishments registered for su-

pervision ---------------------------------- 7,166 Field visits to food-handling establishments_____ _ 81,879

Dairy farms registered for supervision _________ _ 1,505

Field visits to dairy farms -------------------- 12,<1<12

1\Iilk plants registered for supervision----------- 130

Field visits to mill;;: plants--------------------- 3,905

rows tuberculin tested

19,913

Animals slaughtered under inspection___________ 566,268

Carcasses condemned in whole or in purL______ 65,039

Public lecture& and talks______________________

45

Attendance

1,158

362,252
1,158 298,980 3,553,0<10
4,205 1.586 18,029
235 12,945
522 96
2,679 658 128 270 946
7,'195 78,342
1,280 12,828
85 3,376 11,193 5<J<I,l85 57,503
58 2,371

397,995
1,809 662,387 <1,065,783
1,278 5,1<15 l<l,329
202 16,4<19
698 241
10,01<1 530 <10<1
2,355 2,654
7,260 82,2<11
1,509 12,469
132 3,909 19,973 566,268 65,039
46 1,183

1,510 369,130 3,59<1,930
<1,215 1,62<1 18,065
272 16,022
577 113
2,470 118 1<!1 27<1 951
7,<195 78,8<17
1,280 12,883
85 3,382 11,193 5<14,185 57,503
58 2,371

Local Health Organizations

21

CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1940- 1941-Continued

ORGANIZED COUNTIES

1940

1941

Pos.

Neg.

Pos.

Neg.

LABORATORY

Specimens examined:

Water-bacteriological

I,091

\Vater-chemical ---------------------------- _ )!ilk or milk products------------------------_ Other food ----------------------------------'l'yphoid: blood cultures ----------------------Typhoid: \Vidal -----------------------------'l'yphoid: stool cultures-----------------------'l"yphoid: urine cultures ______________________ _

H I,O:iS
I 113
82 ISO

Diphtheria cultures --------------------------- 1,1<17

Syphilis-serological ______________ ----- __ ---- _ 30,;)36

Syphilis-darl<field __________________________ _

13<1

l'ndnlant fever (human)-----------------------
Bangs disease (animal)------------------------'11yphus fever --------------------------------~rularemia --------------------------------- __ :VIal aria Gonorrhea 'ruberculosis --------------- ________ -- __ ----- _ Feces for parasites ___________________________ _

66 DO 166 29 070 2.I03 1.726 I0,9<10

rrinalysis ----------------------------------- 15,112 Rabies ______________________________________ _ 309

Pneumococcus typing -------------------------

72

lJysen t ery ______ ----------------------- _____ _ I31

Other laboratory specimens exanlined__________ _ 959

'l~otal laboratory specimens examined __________ _ 67,084

6,I97 <139
16,888 I2I
1,077 1.6<19 '1,393 2,776 <1,5<!7 Hl,956
467 I.676 5,089 1,698
2H 40,073
7 ,3<]1 9,030 24,108 28.39<1
41<1 I9
325 7,I80
306,071

1,114
936
<18 G4 152 <17 598 30,258 I20 1!4 IS 256 23 503 2,843 I;185 5,894 5,I60 202 3I HI 372
50,299

6,205 398
13,00<1 H7
I,0<18 I,676 7,343 2,59<1 <1,863 167,600
<126 I,S05 1,4<1<! 1.6<18
I70 15,348 11,785
9,604 I5,84I 42,225
<170 32 I,370 6,793
3I3,S<ll

22

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLic HEALTB WoRK IN GEORGIA, 1940 1941-Continued

ALL COUNTIES 1940

Pos.

Neg.

Pos.

1941 Neg,

LABORATORY

Specimens examined: \Yater-barteriological \Yater-rhemical ____________________________ _ :\lilk or milk products ________________________ _
Other food rryphoid: blood cultures~---------------------'l'yphoid: Willa! ______________________________ TY!lhoid: stool enltures _________ _____________ 'l'yphoid: urine cultures ______________________ _
Diilhtheria cultures __ ------------------------SyJlhilis-serological _________________ --------Syphilis-darkfield ------------------ ________ _ l:ndulant fever (human) _______________________ Bangs disease (animal) _________________________
Typhus fever --------------------------------Tularemia l\Ialaria Gonorrhea ------------------------------ ____ _ Tuberculosis _____ -------------------------- __ Feces for parasites___________________________ _ "Crinalysis _________________________ ------ ___ _ Rabies ______________________________________ _
Pneumococcus typing ------------------------Dysentery ________ ---------------------------Other laboratory :::;vecimens examined __________ _

1,282 14
1,058 1
126 90
311
75 1,177 32,656
134 66 90 168 30 988 2,119 1,835 12,926 15.510 310
so
135 961

Total laboratory specimens examined _________ _ 72,142

7,500 439
16,890 121
1,090 1,656 5,08:l 2,913 4,624 151,0fi1
467 1,680 5.113 1,113
215 40,461
7,478 10,181 29,313 29,858
414 32
328 7,181
32:J ,801

1,339
936
54 54 17:3 50 653 34,236 123 44 18 261 39 536 2,914 1,640 9,026 5, 791 208 31 141 381
58,6:30

s,o:;o
399 13,004
148 1.075 1,685 7,615 2,644 5,046 182,060
434 1,818 1,453 1,666
203 18,802 12,136 11,7:J4 20,898 45,3<4
481 34
1,377 6,8:JO
345,006

Division of Public Health Nursing

Abbie R. Weaver, M.A., R.N., Director
PuBLic HEALTH NuRSING STAFF
Miss Elsie Crosby, B.A., R.N. ______________ Associate Director Miss Theodora A. Floyd, M.A., R.N. ___ Maternal Hygiene Consultant Miss Florrie L. Erb, B.S., R.N.
Instructor in Public Health Nursing Miss Mary G. Devine, R.N. ____ _Industrial Hygiene Consultant

GROWTH IN NURSING SERVICE

At the close of another year it is again possible to report uninterrupted progress in the extension of public health nursing service to new counties and additions to nursing staffs in the larger counties of the State. This growth represents the establishment of new services in the following nineteen counties:

Appling Barrow Chattahoochee Clayton Dawson Evans Forsyth

Gordon Haralson Irwin Jackson Morgan Murray Pike

Schley Tattnall Treutlen Webster Wilkinson

Nursing services were re-established in Dodge, Gwinnett, and Montgomery Counties and also by the Farm Security Administration at the Pine Mountain Valley and Irwinville Projects. Additional nurses were added to the staffs in Bibb, Cobb, Floyd, Fulton, Hall, Liberty, Sumter, and Walton Counties. A supervising nurse was appointed for th~ first time to the Bibb County Health Department and two new appointments were made to the State staff, one, that of Reserve Nurse to the East Central Health Region, and the other, that of Industrial Hygiene Consultant Nurse.
The staff was further augmented by five nurses made available to the Georgia Department of Public Health by the United St:~tes Public Health Service for assignment to areas affected by the defense program. From this group a nurse was assigned to Chattahoochee County adjacent to Fort Benning; one to Liberty County, in which Camp Stewart is located; and two to Bibb County for the added protection of the area around Camp Wheeler. The fifth nurse who had had industrial hygiene experience was appointed to the State staff.
It is gratifying to report that during the year there have been comparatively few losses in nursing personnel. Only ten nurses resigned, this figure representing but 3% of the total number of public health nurses in the State. The service of these nurses was discontinued for the following reasons:

24

Georgia Department of Public Health

Three to accept another position Three because of illness Three to enter service with Army or Navy One to be married
The total number of nurses connected with State and local health organizations has increased during the year from 258 to 307, a gain of 15%.
THE TRAINING PROGRAM
During the year lOS nurses were accepted for training. Of this group, 72 were new trainees and 33 in-service nurses. This group included seventeen colored nurses. These students were assigned to the following colleges:
Peabody College, Nashville, Tennessee__________________ 79 Medical College of Virginia, Richmond ___________________ 16 University of Pennsylvania, Philadelphia_________________ 3 Teachers College, Columbia University, New York__________ 2 Vanderbilt University, Nashville, Tennessee_______________ 2 Frontier Nursing Service, Hyden, Kentucky_______________ 1 University of Michigan, Ann Arbor______________________ l Tuskegee Institute, Tuskegee, Alabama___________________ l
In the period between April 1936 and January 1942, the Division of Public Health Nursing has given training to 261 nurses. The returns from this investment are reflected in the quality of work done, which has doubt less played a part in the reduction, year by year, in mortality rates in those services which are, in a large measure, dependent on public health nursing service for carrying out the program.
As a result of the training program Georgia has moved, between January 1940 and January 1941, from the forty-third to the twenty-eighth place among the forty-eight States in the percent of nurses who have had one full year of post-graduate study in public health nursing.
THE INFANTILE PARALYSIS EPIDEMIC
During the months of June, July and August normal public health nursing programs throughout the State were interrupted because of an infantile paralysis epidemic. The State Department of Public Welfare, which is responsible for the Crippled Children's Service, asked the State Department of Public Health to be wholly responsible for the nursing care of children suffering from this disease. In view of the fact that the public health nurses in Georgia had had no experience in the nursing of poliomyelitis, three public health nurses from outside of the State were called in to serve in an advisory capacity to the staff. Two of these nurses were loaned by the New York State Department of Health and the third by the Boston Community Health Service. They had all had experience in similar epidemics and post-graduate work in orthopedic nursing. The salaries of these nurses were paid by the State Department of Public Welfare and the

Public Health Nursing

25

National Foundation for Infantile Paralysis. In the course of the summer and early fall approximately 700 cases were cared for. As a result of the experience in this epidemic the Crippled Children's Service in the State Department of Public Welfare was reorganized and a definite working relationship entered into between that department and the Department of Public Health.
Under this agreement the public health nurses attached to local health organizations will be responsible for direct nursing care of crippled children throughout the State, and the Georgia Department of Public Welfare
will maintain a small staff of nurses with special training in orthopedics
who will serve as special consultants to the local public health nurses and will also be responsible for the organization of orthopedic clinics.
NEW DEVELOPMENTS
Among the outstanding developments in the field of public health nursing during the past year have been the establishment of an accredited teaching field in connection with the Fulton County Department of Public Health and the establishment of an industrial hygiene consultant nursing service.
After many months of planning, Fulton County was accredited as a teaching field by George Peabody College, and the first four students were assigned on January l, 1941. A teaching center was established in the Hapeville District and the Associate Director, Miss Elsie Crosby, was released temporarily from all other duties in order to devote her entire time to getting the student training program under way. As the months passed an increased number of the nurses on the Fulton County staff became fully qualified to serve as a sponsor of students so that at the end of the year the teaching field was able to take care of eight students each quarter. At the request of the College it has been agreed to accept students from outside of Georgia when the Georgia student group did not require all the facilities of the leaching field. During the last quarter of the year two students from South Carolina and two from Missouri were assigned.
The defense program brought to the Department of Public Health an increased responsibility for the protection of the health of industrial workers. Therefore, an industrial hygiene service was established and in October a consultant nurse, Miss Mary G. Devine, was assigned to that staff. An inventory of public health nurses in Georgia made early in the year showed that there were at that time about sixty industrial nurses in Georgia. Very few of these nurses had had special preparation for the field of public health and had for the most part been working alone in a single industry without the benefit of supervision and advice from any professional source. By the end of the year the Industrial Hygiene Nurse had visited many of the industries employing public health nurses and had been able to get some idea of the problems presented and to formulate a program for the coming year.

26

Georgia Department of Public Health

STAFF EDUCATION PROGRAM
During the past year, as in former y2ars, a program of staff education has been conducted. Two-day conferences of the State Consultant Nurses have been held quarterly in Atlanta, and frequent conferences of staff nurses have been held in the various regions. During the last of November and the early part of December two-day institutes on the "Care of the Premature Baby" were held in Atlanta, Augusta, Savannah, Albany, and Macon, by Miss Theodora A. Floyd, Maternal Hygiene Consultant Nurse, and Dr. E. R. Watson, Associate Director, Division of Maternal and Child Health. Miss Mary B. Willeford, Regional Consultant Nurse from the Children's Bureau, also made a very valuable contribution to these institutes which we hope will contribute definitely to the reduction of deaths among premature babies in this State.
At the request of the schools of nursing in Atlanta, Miss Floyd, with assistance from other members of the State staff, conducted a series of twelve lectures on public health nursing to student nurses. The total number of students in attendance was 120.
COMMENTS ON STATISTICAL REPORT
The statistical report of the activities of the public health nurses in Georgia appears in the report of the Division of Local Health Organizations. The increased number of public health nurses at work in Georgia during 19iU is reflected in the gTeater volume of work done in practically every service. The most significant gains were made in the tuberculosis and maternal hygiene services. The number of tuberculosis cases under nursing care increased from 3,723 to 4.,331, and the number of nursing visits made in behalf of the tuberculosis service from 6,474. to 7,3"18. The number of expectant mothers cared for in 1941 increased from 21,299, cared for in the preceding year, to 2il.,588, and the number of nursing visits to these patients from 76,956 to 92,581.

Division of Public Health Engi~eering
L. M. Clarkson, C.E., Direc.tor
W. H. Weir, B.S., Associate Director
Louva G. Lenert, B.S.C.E. ___________________ Malaria Control
N. JVI. de Jarnette, A.B.------------------ Jflater and Sewerage
G. R. Frith; B.S.Ch.E. ___________________ Jflater and Sewerage W. L. Avrett, B.S.Ch.E. ------------------ Jflater and Sewerage
A. J. Kranaskas, B.S.C.E. ____________________J1fiilk Sanitation
T. D. Adkins, B.S.Arch. ___________________________ Mapping C. N. Eldridge, Engineer_ _________________________ Mapping
H. B. Starr, Jr. __________________________ Bedding Inspector
PUBLIC HEALTH ENGINEERING SERVICES
This division of the Georgia Department of Public Health has the responsibility for the program of public health engineering, including the assignment of duties, reviewing all activities of the personnel and co. ordinating activities of the Division with all other operations of the State 'Health Department, also responsibility of maintaining cooperative relation:ship with all outside agencies, public and private, whose activities relate to sanitation and public health engineering. The Division renders a very broad and varied program of public health engineering in order to protect the health of the public. A general outline of this program is as follows:
l. Approval of engineering design and sanitary supervision of the operation of municipal, institutional, public and semipublic recreational, and industrial village water and sewage plants and systems.
2. Certification of water supplies for interstate transportation in cooperation with the United States Public Health Service.
3. Laboratory service for bacteriological examinations of public water supplies.
Ll.. Stream pollution investigations to secure basic sanitary engineering data for future planning.
5. Technical and advisory service ,in the national defense pro gram with reference to water, sewerage, drainage, malaria control, and other matters of sanitation, including cantonment and extra-cantonment areas for the protection of both military and civil populations.
6. Guidance in design and operation of swimming pools.
7. Sanitation of private water supplies for protection of the rural population by proper methods of construction and maintenance.

28

Georgia Department of Public Health

8. Annual instruction classes for public water and sewage plant operators.
9. Construction of rural and urban sanitary privies and home
sewage disposal plants. 10. Malaria surveys resulting in plans, specifications and super-
vision of drainage projects and other methods of malaria control.
ll. Control of impounded water areas for malaria prevention by impounded water regulations.
12. Typhoid and hookworm investigations preceding promotion and supervision of rural and community sanitation projects.
13. Selection, nomination, and training of engineers and sanitarians for assignment to organized county and district health departments, rendering local service in planning and advice to such personnel in matters of sanitary engineering and general sanitation.
14. Cooperation with other divisions for investigations of diseaoe prevalence and instituting measures for control.
15. Sanitation investigations, surveys, maps and reports by field engineering surveys and office mapping.
16. Improvement of water supplies, sewage disposal, and general sanitation for schools.
17. Operation of state sanitary bedding law passed in 1937 providing for inspection and licensing of manufacturers and renovators of mattresses and other articles.
18. Cooperation with State and Federal administration agencies in public works, homesteads, national resources developments, national parks, etc.
19. Participation in operation of state training center for engineers, sanitarians, and other personnel for state and county assignments.
20. Maintenance of consultative service at central administration for the benefit of plant operators, municipal officials, and public health workers in regions, counties and other local health center services.
21. Other miscellaneous sanitation and nuisance problems.
PUBLIC TfiATER SUPPLY AND SEWERAGE
The safety and adequacy of public water supply and sewerage are major responsibilities of the Department of Public Health. The rapidly changing events and conditions during 19M have added greatly to these responsibilities and focused public attention on these essential utilities as never before. Every normal activity in support of the public water supplies and sewerage has been continued with increased intensity and extended into all new population centers and situations brought about by the civilian and

Public Health Engineering

29

military preparation for victory. The public water supplies and sewerage systems of Georgia municipalities may be called upon to meet unusual emergencies in the immediate future. With all facilities in the highest state of preparation and the men in control of them alert to the role they are to play in defense of lives and property, the water supply and sewerage service of Georgia is ready for the job ahead.
Previous annual reports of the Division have described in detail the many activities involved in supervising a state-wide program of public water supply and sewerage. These descriptions of procedure and methods will be omitted in this report. Only such condensed statistical and construction project descriptions as are necessary to maintain the general pattern and historical value of these reports will be included.

WATER WORKS AND SEWERAGE CONSTRUCTION

Plans and specifications have been examined and approved for 129

military, municipal and other community projects.

Water supplies and water purification_______

69

Sewerage and sewage treatment_________ ____

60

TotaL __

129

There follows a descriptive list of projects currently planned, under construction, or completed during 19L11:

Water W arks for Municipalities and Districts Not Previously fi aving Water Works
Chattanooga Valley. \Yater distribution system served from atljacent munieipality, includes pipe system and elevated 3torag-c. ComiJieted in 19'!1 (\V.P.A.).
Cobb County. Sanitary Ojstrict No. I. "\Yater distribtttion system to he ~ervetl from atljaeent municipality and from drilled '\n~ns. ( omiJlete<l in 1941 (\Y.P.A.}.
Del<alb County. \Yater suptJly sy;:,tem to serve part of r.:ountr and all of City of Decatur. Includes ra'\v water pump station on Chattahoochee River, reservoir, coagulation, sedimentation, filtration, chlorination, clear water ~torage, and transmission main extending to the Decatur city limits. l:nder construction in 19U (W.P.A. ami contract.)
Hinesville Defense Housing Project. Deep well. chlorinator, and distribution system completed 1941. Population 800.
J(ingston. J>eep well, sterilization equipment, elerated tanl\, antl di~tribution sy~tem. Completed in U1L1l, C\Y.l>.A.). Population H;)3.
McCaysville. Spring, sterilization and carbon dioxide removal equirnnent. 1Hlll1P house, ground reservoir and dlstrihutiou system. Plans approved in 1941 nv.P.A.). PO]H!lation 1,832.

Additions and improvements to Existin,e; Pnblic Tflater Supplies
Albany. Xew drilled well sperifirations approved in 1941. Also water main extem;ions (W.P.A.). l'opulation 19,055.
Atlanta. :'lew filter units added to present gravity filter plant. Chemical and bacteriological laboratories remocleled. Completed in 1941. T\\"'O new additional sterilizing units. Extensive water main additions and improvements as \V.P.A. 11rojeet. Po1mlation :)02,288.
Austell. lmprovemPnt and audition to filtration plant. Completed in 1n41 (W.P.A.). Population 1,229.
Barnesville. Extension of main to serve adjacent mill village. (\V.P.A.). Population 3,53iJ.
Bremen. Raw water reservoir. Plans submitted in 19<!1, construction not started (W.P.A.). Population 1,708.

100
v 95
/ 1\ I ""' "' 90
/ \ v t1 85
v I .......v " v v - 80
- 1z -
w
v I v u
I 75
I 7 r---. a::
v w
I "" u. 70 v v I I 65 v I "' \ II / 60

I

I

I

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

J..-"' .

__,...
......:

v
,.....

/~

GROUND WATE.RS CHLORINATE-D~
L,/1"'----

I--"'

ALL SUPPLIE.S,f--.----...1 t---

J~
................
Lt---..

~OUND WATE.RS UNTRE.ATE.D

v 1\

~v

.......

~

~

PER CENT GEORGIA WATER SUPPLIES

cw
<;':,
(\)
0
~;s
\::::i
~s
~
(\)
~
..0....
~
~
c:;
:::r::
(\)
~
~

55 t----

"-~
50

r

""" 1926 27

v_, 1/

28

2P

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

IIIIII

31

32

33

34

35

36

37

38

39

40

YEAR

Public f1 ealth Engineering

::a

Calhoun. \Yater main extensions. (\V.P,.c'~... ). Population 2,9::>5.
Carrollton. Xew mixing and settling basin replacing inadequate facilities; new chemical feed roorn and laboratory. Completed in 19,11. \Vater main extensions. (\V.P.A.). Population 6,2H.
Chatsworth. :Xe\V water purifieation system to replace inadequate ground \Vater supply. Includes ra\v water pump station, eoagulation. sedimentation, filtration, ancl clear \Yater storage. Plans a]JproYed in 1DH. (W.P.A.). Population 1,001.
Chickamauga. Xe\v sterilizing unit. Population 1,66:-.i. Columbus. Xew concrete clear water storage basin. Com})letecl in 19,11. Chemical house an11 mixing basin }Jlans auproved in 1941. Construction not started. Population 53,280. Commerce. Reconstruction of filtralion plant including coagulation, sedimentation, filtration, sterilization, elear "\Yater storage and cht:>miral laboratory. Comtlleted in 19-11. Raw water impounding reserYoir, plans ap}lrored. (\Y.P.A.). Potmlation 3,294. Cuthbert. \Yater main extensions. PoiHtlation 3, 1147. Dalton. "'ater main extensions (\V.P.A.). Population 10,4,18. Del<alb County. Water main extensions (W.P.A.). East Point. ~e\v surface water sup})ly, including raw \Vater storage basin, modern filtration plant and conerete gronncl storage, with complete bacteriological and chemical laboratory control. To replace inadequate groun<l "\Vater sUPilly. Construction started in 19111. {\V.P.A.) Also watei' main extensions. POpulation 12,403. Fitzgerald. Water main extensions (\Y.P.A.). Population 7,388. Fort Mountain-State Parle Hypo chlorinator im::tallecl on new "\Vater supply system. Ha11eville. \Yater main extensions. POilulation :>,O:i9. Hinesville. \Yater mains Jllans approrecl 19"!1. PoiHLlation 630. Hogansville. \Yater main extensions (\V.P.A.). Population 3,886. LaFayette. \Yater main extensions (\Y.P.A.). PoJlulation 3,509. Lindale. Xew sterilizing unit. Population 3,CIOO. Lithonia. ::\ew chlorinating unit replaced ohsolete and inadequate sterilizing equipment. Population l,:"i:J-1. Macon. Plans ai)proved for water })Urifieation plant im}wovements including chemical feeders and increased clear water storage capacity. (D.P.\V.). Xew sterilizing equipment to replace inadequate equipment installed in 1941. Population 57,865. Milledgeville. Water main extensions (W.P.A.). Population 6,778. Moultrie. Xew sterilizing unit. Population 10,147. Norman Park. \Yater main extensions. (\Y.P.A.). Population 587. Pine Mountain Valley. Water main extensions. (W.P.A.). Rockmart. :'\ew sterilizing unit to provide improved water treatment. Population 3,764. Savannah. Water main extensions (W.P.A.). Population 95,996. Sterilizing unit on new well. Smyrna. Water main extensions. (W.P.A.). Population 1,,1<10. Social Circle. \Yater purification plant including coagulation, sedimentation, filtration, chlorination, clear water storage and chemical laboratory. Completed in 19111. Population 1,735. SoiJerton. Water main extensions. Population 1,339. SummerviHe. Xe\Y drilled "\Veil location avinoved. Population 1,3:>3. Sylvester. \Yater main extensions (\V.P.A.). New sterilizing unit on previously unsterilized supply. Population 2,191. Trion. ::\'e"\v sterilizing unit to replace inadequate and obsolete unit.
Vidalia. Water main extensions (W.P.A.). Population 4,109. Washington. Reconstruction of water purifieation system to replace obsolete plant. Includes raw water storage, coagulation, sedimentation, filtration, sterilization, clear water storage and chemical laboratory. Construction started in 19'11. (W.P.A.). Population 3,537.

32

Georgia Department of Public Health

West Point. :\ew sterilizing unit. PoiJulation 3.591.
Sewer Systems in Towns Not Previously Having Sewerage
Alma. Plans and specifications approved for complete sewer system and se\vage }J1ant consisting of primary trea!ment and open sludge drying beds. (W.P.A.). Population 1,840.
Hinesville Defense Housing Project. Sewer system and sewage treatment including coarse bar screen, primary settling, separate sludge digestion, triclding filter, secondary ::;ettling, chlorination, open sludge drying beds, completed 1941. Population 800.
Savannah Beach. Conllllete sewer system which clue to topography and ground water con(litions includes 8 pumping stations. Sewage treatment includes coarse screening, primary settling, sepnrate sludge digestion, and open sludge drying beds. It was necessary to provide, in the design, for unusual contributing- })OJ)nlation fluctuations as the winter population is 1,000 and the summer JJopulation is 5,000. ruder construction (\'V.P.A.).
Union Point. Se\ver system and sewage treatment plant consisting of coarse bar screens, Imhoff tank, and open sludge drying beds unde' construction (W.P.A.). Population 1,566.
New Sewage Treatment Plants on Existing Systems
Adel. Plans and specifications approved for sevmge plant providing nrimary treatment and open sludge drying beds. Population 2,13t1.
Baxley. Project provides for extending the sewer system to serve all built up sections within city limits; and constructing sewage plant consisting of pumps, coarse bar screen, primary treatment. and open sludge drying beds. Under construction (W.P.A.). Population 2,916.
Blue Ridge. Sewage treatment plant provides prhnary treatment nnd open sludge drying beds. L"nder construction (W.P.A.). Population 1,362.
Cornelia. Constructing sewage plant to consist of coarse bar screen, primary settling, separate sludge digestion, open sludge drying beds, tiiclding filter, and final 'larifier. (\V.I>.A.). Population 1,808.
Fairburn. South side se\vage plant consisting of coarse bar screen, Imhoff tank, open sludge drying beds, and trickling filter. Construction complete (W.P.A.). Population 1,502.
Marietta. Project includes combining outfalls on the southeast side of town and construction of sewage plant consisting of coarse bar screens, primary settling separate sludge digestion, tricl<ling filter, and final clarifier. Under construction (W.P.A.). Population 8,667.
Moultrie, Swift & Co. Pacl<ing house waste treatment plant consists of chemical Jlrecipitation and dewatering of sludge on vacuum filters. Sludge is recovered for tanlmge. A feature of the plant is automatic pH control of the chemical precipitation process. Construction complete.

Major Sewer Extensions in the Following Cities

Atlanta Carrollton College Park Dalton

Decatur lleKalb County East Point Fitzgeral<l

Hapeville LaFayette McDonough Millen

Moultrie Rome Savannah Sylvester

Water and Sewerage for Army, Navy, and Defense Industry Projects
Camp Toombs, near Toccoa, for the Georgia Na!ional Guard. Water is to be providecl from a surface source. 'l'he purification system includes coagulation, sedimentation, filtration, sterilization, and rl1emical control laboratory. 1~ complete distribution system for the ca1np area is provided. Se\verage to be provided includes sewers and sewage treatment plant consisting rf coarse screening, primary settling, separate sludge digestion, open sludge drying beds, trlch:ling filter and secondary clal"ifier. Under construction.
Savannah Air Base. Water is obtained from deep wells ancl is chlorinated before pumping to distribution system and elevated storage. The area is completely sewered and the sewage plant consists of conunlnutor, nrimary settling, separate sludge digestion, open sludge drying beds, activated sludge (diffused air), and secondary settling. Provision has been made for preM or post-chlorination. Control laboratory equipment is provided. Construction complete.
Camp Stewart near Hinesville is for use as an Army anti-aircraft training station. \Vater is obtained from deep wells chlorinated and pum})ed to extensive distribution system and

GEORGIA SEWERAGE SYSTEMS
DEPARTMENT Of PUBLIC HEALTH DIVISION OF SANITARY ENGINEERING
JANUAfl'f I<J4J
LEGEND

.J.Elifl___ r;~;;5vn

El l::,' I '

\1' ./ I

(

Qm~c~~7---T-------~---~t:~A/y------~~

~ CHIC~AMAUGLA::::..J ) rQRT MTN PARK

I

8LUE RIDGE

r~ .:::l

~AP6OLWU(E. RRIDGPELANT

~ \ . .:''W!I,55,

D.

TN

'

f5:J.CLAY 0

/

GEORGIA WATER SUPPLIES

' 60 r;;.. PARK6 ( 1_....... ., \

.::.:l.RTII/AS'EIm.~IA;iI~R.VfN.r,A.W,LN.,_~lI -L,_

{

/)., LS:lCROWN

' MILL

L......_ - - - - .

~.D.. ALTAOMNE~II1CANe:t:HA

fSWORTH
,/
/

...... _,
\



'~) ~ I VOC.!.L

YOU"'- HAR"S

'

COLLEGE

:

' //

,.,..~ ......-:-') (.r--~\ \ t..._.... ~ oT~/ ~g~tH

DEPARTMENT OF PUBLIC HEALTH

DIVISION

OF

SANITARY JANUARY 1941

ENGINEERING

/l;i. ~ CLAAKtSVILL~ 't ;' I II ;171 ~I

&LAFAYETTEl

THO MILL \

I
'

='UJAY

'

L::::..J

1

j-. I ) / .._,___/' El EJHA8ER~HA~ILL &LJNWOOO

......! _ _ _ _/,-::.

I

\

l-' . . . I \ 0 -LEGEND- R 0~r-: oAHLON~;:NA~~~?uMN1[g)coRNEuAQLe:\QuRNEAu -------7-;- /~TOCCOA + 11 1
i /'r- + \

jt

Qe:cHoTA

L~~I c ISUMMER\IILLE ..R . L)/bl

~CALHOUN

I
__---.n.J"L_JI\." ,

I

'

;JASPERO A\TAT!: ,,

Ot:MOAES\T

L ___ r)_../& "-

k:::J ~ /'-, __/

_ _ _/.OLAVON~~

O ~NNON ~] HO~ANO I

/

1 , BERRY scHaGrv1

0 \ /
OHo'tLINGTON

/\'1C~:J

> SCHOOL L!:!l,

>W f~\7C1THUABTIZ.EMILL ~f\7R1OMEI

-

L-.A.!:A!-);O-AI~AS-V,ILII1I-LE~_rb:!!_'J1C_A_NT_O_N _MBILAL~l'1L_GRO~UNC- DHIC.._..O.._..._.P".'.-,_-E)\-Ef:/:~il

c. N(W

I

\

~1'G\/1AINESV( ILLE CAR A ~ t$Jc'../..'F-N. ESVILLE

N'sv" 1 I
JILL

'

'~ " ' O

"

voNJA MILL

r71

\

~ \

t..!;.JHARTWELL

W o; Jv s T o N

FILTER PLANT-SURFACE STREAM WATER

OBTAINS WATER FROM ADJACENT CITY

I1L/1l FILTER r~::::F/1 ILTER

PLAN



T-LOCAL CHEMiCAL cONTROL

PLANT-LOCAL CHEMICAL AND

LABORAmRY

BACTERIOLOGICAL CONTROL LABORATORY

I :?. ) 00 ~~~~~:~R ~c. j ' v ) SC\PAVREINC~~ 6LINADc AcL~~E~oscIiIt

0ATCO

I~'VCIANTON

~ t..~ JCUMMING
1

P. / AFLOWER.Y

[Z]cARTERSVILLE

/---1

I ALPHARETTAel,

/
/f7

1

~...........L...)t.BRA/N-,\...cH

EC

CAMPlrC--?-...'.J._l,c~e~:Acr-

-

-

/



"
....__

l7J.JEffERSar

'

/-r;::i1

~

DEEP WELL SHALLOW WELL

r- - AA(g~)~-~----10-:;;;;,0:-~-l!Z,l ,,.<IC:..Jf-21:::I1 f_ r-..--\"\\_ 6.,...., " ~ '

A.

CEOAR\TOWN

'
RoCKMART PowOei

_j 1_ - - - - - - \

~Y~ SPRINGS
lZ}6.LLA

-._'"I ..

ALLEN co L::...J

1 ROSWELL./ MARI/E'T' TAQI-~..H..~.(/'(vM'">"~~,;~-N.l---o6RNc

L:..J
Ro0
c

LAw'->~virLL::::L:>:E.!.-J-~-CW-I-NO,'!Et~l~ '_AT.H...'/r.'vM~1.J''\TH'_ E\NS /

1i:..J ELBERTON\\

'

-

-

-

-

......
_:/

.

-

-

-y

-
\

~\

/

"--

.SPRING

Q\...../WELL

L .. ~
A

SPRING-IRON

REMOVAL

:d WELL 0 SPRING-CARBON DIOXIDE REMOVAL

MI~L {g) Q HtJ~.),.:~~;J,:TONE w:;~INSVILLP"</ \.,...._L] \

1 CLARK THo

MT ,..

-

lZJcRAWro;zAol

\_

SOFTENING PLANT-WELL OR SPRING

BUtCH\A-~AN 1~ 1 .../0 /\ ~I0l~~ /1--.7J A, I1rt....../' A\- 0 '-\r ' ( ,ov\/. \ HAMPT~N. u/\LOCUST/-.~ Qc~CEWOOO ~

\
\

.

l;Z_-M!VJ.EsIN-- Lo-Lf~1w-:A'::C:7~o/A- .11_RoPl.o- NI.oRC/~RAIhO'Cr-.TL:..7.LJ~.e...f.LT:LOPOoM/N1I,Au~VOs~L~~I.UMLM~EILCI~~AL~_LA.tAPLRl.AI~NEC:O!U-CD.JrS'OM.C-~ T.-'EfOP~lflAAI-CIJrLrTR;LLl-L/oLLKMfr.7S.~I~En1N~ LBoE~G)TLUfP ~AARO~''NH~ ~I~f'eAE- 0~APTQt}r1ET;0S~ VEi~o-JVTN.~L+ .fTLL,EL~~sE?B~SVofIa~""1Ef:C77~ R:c\Jsll\.~oMActL.isoor!Tu;n.;\R'Oo./AO\f(NL~HEOc~e.C/t.U..r"0~,LC'/.MN)cHoPLfYI'aL'ECA.G:'SR.-:v-IJ_ T.<SAP.1,.Er_.o.N,.oAN .R.;R_DV,oa-TeIL/Err~:~::oRL/>~":So:1~..O.LJ.O!sMA(!C~'L~/OI~Q<..A.N~.;.R..~L'R'u~'U~oICT-CA EIL.R-rr.R :C,E-:\.7L-oJ1O E~-cL'-\\.:-:L-~::..A.~\J.6..\0.R..\\ ..C.I.RS.ZO .TtJ..t.O.M K.c...P..R..HA&..Pe.~ EeR L/:ANUEEY SRNXNPKs(~IIeN'e~"1:OAo'KI_"L~LT\-ARO-..-o.N1.plM ~_.SrL-C.I:,I::L:N:RA:_::JLMTlA-w_W-AA.JKOFsJ"OWH.AA.JON.RV\.c~I.TLE.Lo\ EN~NrLT-\'..Qf\:_OH:.JUl.NT\N.Htc.)..O-(.O,.M\L.S.N'-O_-T\fN_.O.c.N'~\H,,\ACH'R-".~.S.S/. _TT'\'E.ErI...VC"RR.JfIIA"LL?IIZUZESETDDA

WITH
WITH

LIQUID CHLORINE
HYPOCHLORITE

'

s ....RCEN\0 [Z]NEWNAN\"'

, O'MPtRJAL

0 \ ,.---- I . . . . . ei"RAN~KLINOSENOII'I

\

/

\ 7 CAANTVILLE

).._/

0 ) '----.__/ 1

1

'\___'""""":;A~SON0 L)t.CROVE

\

MILLS

~

:.f~\ ~ ~(VCRlJFFIN

) l":i1t.IONTICELL00EATONTON_/

I

(',

H + PEPPC:RTON

I

)

<:.)~....... l

......__

QsPARTA \

/ ..................

~y - "

"
/

~

'-.,

'\
~I ~

r-.-------c..:- h __-J-----------.. / ~-

CALUMET MILL

JNOJAN
(1\ ---,SP.BJ.I'jfLSPARK

1

1

/

'~ ..

wRE/s

I

L'
. I
I n I \ 1 r~ ;:::, QA~?L~~A, ~GRAY LACR-foNCE

1

(ecoNcoRor.:/1

r,:::iiHOCANs'

LC.J

H

LLE

1

GREENVILLE

ZEBULON

' LC.JBARNESVILLE
I

rt...:--:1:-J-.JULI~TTE

\
I

f:i1MANcHEs



lZJroRS'I'TH \

\

I~'MVIlL-L-E~OGE\IILLE
,...........
[Z)sTAiE HOSPITAL

I \.,\

i'V1

"-~

\

c~\ LC::.IWAYNESaORO

"-..

QVEsTAL LUMBER

I 0 Q' \;0:_) I\'0 ! \, WARM SPRINCS 0 ?;"/'\_, kl?;l:w::tsLr_P_fOaU_JNNDTATl-I-O-.N..~ ..A.....

LC.J
./'.::\.,

\
Y

,_

_

_

j_

_

~

~I

f!::j,WARM SPCS IZITHQMASTON_,MILL

)

c::::l

~

~~g~~RY

THOM1A--~..J----/

,

.

.

.

/

f7'tHo
1C.J

LT

oN

\

(' \

..-" '-

).----

"\(

1~ ... eGOROON

0sANOEASVILLE

0LoubVILLE

\.:;.)

DA\'15150AO

7 0sAROIS-
_.,../-'-----/"

Te:NNitL

'

r-

f

WAOLE'Y

__;__;,_ MIDVILLE

~ I f 0 ' ~ \ 0 II I \ , AMPIINLT' oMNTlNZPJ A~ACR~H.1K1/IV)"~.P\A\LL~'ErLNYEEY~n\Q~,--r.-~AwLoaao-oL,AT"Ttj-oO:N!r>,:C.;;.J,Q..Y.~.A/I..TL~1EV"SE\~rV'R1~IOLBLEERTAI'-.'"/t..'.._~O'-..B::~I:':VI"M'RQ'1>Aosi(fC'~Ji"Oc..N.C. RP.

\
,\

y I ---- L \
Q IRWINToN 1~-_ - _.-

......,.,....--~ 1
..

, \

~ ..,.)-........_ QwRICHTSVILL
.

o.JfitFERSON\IIL'CE

.............

KITE

~
\

MILLEN

~

O

'\,

{
.. \
~1
:iYLVANIA( I

-c---~---;{ I \ / ) \ ).,/ ) 0 ~- ~ SWA;;;,BORO

ONEWINcTON

CITY/---1-J--.r-~ BUTA~~:~s 0 ~/ o~ORIAN 0 a ......._QoLI'w'~~, \ l:!}ues

\ y , / 1 I'V'IcoLUMBUS

\IC.I I ,Ae - J

1
J

,I

l ,~

'V 1~I

.

eF

ORT/VALLE'Y
/' ....,

(

-i

t )PERRY

MARSHALLVILLE\._.,.

\ OMONTROSE [?JouaLIN
1 0ouoLEY \

~ TWIN CITY /

PORTAL. .....
(~';S'\T. ATESOOR\ d

, \

/ \ QoEXTER

1

/

O

I

~cdNCHfi<LOQ/v'-." 0<0~0 I1 ORoo~~ET ,r............---- I'

i '-'1__;_/

'-.,, r 0 J -----f--...h....__.I1-0---\' "\ \ L

~ ' l - .. ~---

eautJA VISTA I

ELLAVI

OCCETHORPE ,..-.,

n " 0 0 l \ \ _.,...., / /

'

rLLE 1.. )

. I i----=--j ..--------( ? \::.; \....-:.;/ 0 \ L

) Q -;!;_, 0 RICHLANo--1

171

VMONLUJ..IA

/'

, }

~ \

ORENTZ ;

CHE\STER

OsoPERTON

o-----, UNADILLA
I

"\. oM~UNT 0HAWYNSVILLE

'

OcAOWELL ::;/)

\

/_ (

0EASTMAN GLENw60o

I

,~VIDALIA

~ L.~ PINEH\rsr QevRoMVILLE

ALAMo \

v RN/ON OLYO\S

~ "ET7R
COLLINS

oaUYTON '

QsPRLNCF'IfLO

J

""

,..-.. (

' \

QcLMTON"'., \

.....

...,OPEMBR~~~pu'_oso:;LRtI:RAL"'O

OoG :gA~~R~O~SINNTWORTH
QsAv.s~~cL~ff'co

l-- 0 Q' A \\ } I0 ' '\ /:......_..., 0 \ { 0\ .- -.........___ 0 ( J \ "-... r _. .)- ) \ I

1 QPRdToN

@AMERICUS \

' "V

""J

-

~QwEsTo~ OLUMPKIN

IIOPLAINS

QLESLie:~

- - - - - _j '\ ~------I

0vlt'NNA 1
0coR~EL--E-J1 \;:_) '
PITTSIO

o~ej BEVLLLE /

\

./

ROCHELLE

,

I

PARROTTtloSMJTHVILLE ,

I

~-=-----.....lo

I

'

OBRONWOOO

... QwARWICK

MIL~A~~EM~'ARA~Q

t

1/ ~: .ITTL! OCMULCCt
\..._

.SAVANNAH~? f QAEIOSVILLE

7------...

CITY CARDEN

Q0

PARK/

'-----7/

eQ : 'sTATEO

.... ____....

"""'~AVANNAH BEAc\1...$V

LUMBCRCOTY

)._./

~

~/ ......../

1-::\

I

\..:/-!AZLEHURST

PRISON
-.... \..

C.LENNVILLE

)

\

,

I

\

V'-.._,'1::::..'? l'HUNOERSOLTr.O\\,

", H.N(SVILLE
"-)

\<~ :;;:)"'

I

~- j f"2\I"JTlG:~---'1 ~ ~~-J 0CUTHSERTL, QoAWSON(

)

;--

l _-

I \

OsHELLMAN

1 OLEESBURC

I 0ASHBURN

l \;:.)

'ALo!



1

0BA:.<LEYr

\-..\,

\

1

\

'

...)

~OsvCA",re; ~.J--( L--r ~ \---._QLuoow~-"-- ----<;~ '\

)

OsLssER

\

1 n ,r----L <:x~m-r~T(Vro:s~~~;~;;;~O 0~~

O

J

IRWINVILLE

ocLLAO

O
BROQXsT.O~oNc.INAJ,

1
.............

"""'-....

j

0.Jt:s' u~,

\ _)

\
J...

A QL~ARY i l_""\ / ! / O Y ~~ i I ....--..._M ~O0RAGRAI.N.INOGT

ll

1
ORAoluM sPcsO QPauiAN
SYLVESTER 8TY TY

>--~

r--~ 0ooucLAs
NlC.HOLLSO

0ALMA

).,
\..1. ... -.....,_

SCRt:VEN

\

~

L---- __,J' 0 BCAKELY'---T-~-..L.----/--1 (/.;;.,~N (

O J \...._ I

.I

NCWTONt:~::.\ -/

H

I BACONTON

( Q IQoot:RUN---'--' - 0 (8 OAI~Ascus

0 ..

-....-ll j 0 1 0 oO I

----

QsAfE CITY

0 ( 0~AMILLA ~"':'\ Q.sPARK~ ~ j

I \

i

0 l \ o~~ff~~lW~ ,QJALKJN

0coLQUJTT

t"'

\:..;

,..r

[/

I .
1
0PELHAM.

I

8mroy

OMIECnrAc~'"\R ::.Mf;OURCO

L,

\... (O "

J

WILLA-C-O,OC~EE

:

~>--J

NORMAN PARK\..._\ ONASHVILLil

PEARSON

\,:_/~ouLTRIE / O

\

!.--..:J

:---~

5Wlf'T J oJ

AOCL( ORA:rl'f'(

_

OPm\RsON

1}'--.._.~

"- 0aLACKsrte:AA

!......_....._

("'......._,

SANTO ~OjO~M6JN~C~O(~PoAR0K

~rtJ~
) "-J SE:A ISLAND

Qw,.tCRO~SAH.su' NTA Q

sA_..y-~g-V:/,B'R;UtN~~S~WcLICJK'Qr-..._),

)

- "'--.. \\

ST SIMONS ISV 'IO

f-- -L "- \ lf --~--u~_l____ ~--'--1- _ j __ -~~~tl I

0 o o N A L S O N V I l.. LE



8M(1(,5-Qcooi:IDC.E-

OLAKELAND 1

OHOMERVILLE \

--

,

l

1 0 1 I , 1 b~o" ~/"'--...-~ \

O

i L.. IIWN,CITY

)

UBAINBmocf

IQ \

ocHLO~KNrt\t:;:lJ/.,o

Q~o.~o\ RvrNHAHIRA

__ \

1

\

\

(J

0<AORO~ 1 l 0' ' l
C \
\.._ rl1 -1L. .I .. I ( ., , -- -- --l I 0 'L

0wcsr (';; BAINaRioc.Y

'

\

"

"~

'

"

1

OWHICMAM

~1 1 rg rHaMAGS}VaIA~RLrWOGK

'....,-) 0vALoosrv-

QeosroN OQUITMAN ORfMCRTON(

. --\

I \
\\

oLJ:ToN Q ~NGSLANo .2>
/'-' "-...._s~~ ~ ~/

------- ___ j_ ____ '~---l.___ ' L \ _ : \ j____

---- - \' I

\/ ----J

Public H ealth Engineering

33

l'len1tcd storage. Th e ealllp are a is sewer cd a nd sewage tr ea tm ent includes coa rse strccning-, pr imar y settling, se pa ra te s ludge di ges ti o n ~ op en slud ge dry in g b eds, tri cklin g f il ters (Biofiltnl t i on ), s econd a.r y se ttlin g, aud c hl or in ation . Control l abo r;~ lo r y i s p r ov ided. Con s tr u ct ion ('o m plcte.
Ca mp Wheeler, near Ma co n. " 'a ter is nip cd from t h e l\faco n city sys tem wilh s u!)pl cmenta r y chlorin a lion. Elevated s torage is constructed at the camp site. The sewer system terminates ill a se wage pl aut (.on s is ting of coa rs e ser ee ning , primary settling, sevaratc slud ge digestion , a.ncl open sludge dry ing heels . Pre- or Jl OS t -ch l orination is possible. Control la boratory is in t'l u clcd. Con s truction co mplete.
Na vy Fu se Pl a nt, nea r Maco n. " ra ter is piped from th e l\lal'o n ci t y s uppl y. Th e a rea is f'o mpl eteh scwcr ed. Sewngc plan t eo n si~ts of co mm in ut o r . prim a ry settlin g. se pa rate s lud ge d igestio u . t rie kling- filt er , seco11d a r y settli ng, chl orinatio n, an d open s ludge dr ying l.led s . Const ruct ion colllpl etc d.
Av o nda le Air Base, nea r Maco n. 'Vnt er is s upp li ed lJ.v dee p wells . TIH:l wate r is treated to r eCilJ< e co rr o.doJl , chl o rinHt cd a nd lHlllJ]J ecl t o el evated s tora ge. Sewage pl a n t co n s is ts of com minutor, pr ima ry settlin g , sepa rate sludge di ges tio n, tricklin g f ilt e r. secondar y settlin g, chl orin at ion . a nd open s ludge dr ,r ing beds. Constru cti on l'om plet ed .
Navy Air Ba se, Oel< a lb County. \Y ate r is initially s uJlplied f r om Deca t u r [Ul d eve ntua ll y frolll til e De l\:alb Coun ty wate r s yst em . Sewe r age se rvice is prov ided hy t he A tlant a m etro polit a n s ,\:-.tem. f' on stru eU.o n comp let.c .
Lawso n General Hospi ta l, Del<alb Cou nty. \V ater is initla.l\ y supplietl from Decatu r ~lllcl Pn! ntuall~ from til e n e Kalb Count y wat e r sy:stc m. Sewe ra g-e se ni ce ls provid ed for by conn ect ion to th e Atla nta. metropolitan syst.e-111.
Georgia Nat i.J nal Guard Air Unit, De l< a lb County. \Vater initia lly w ill b e s upplied fro m Dlcat.u r :m d e \'cntu a ll y from th e DcK a. Jb Co unty w;tt er systems . Sewage dis posa l wHI b e. prov id ed by th e Al.lanta metropolitan systems. U nder constru ction.
Atl anta General Depot, n ea r Atlant a . " rater is piped from the Atlanta metropolitan system antl th e se \Yag e p1an t eon si:-; ts of coaniC bar sereen .. I111hoff ta.n\;; , OllCll slu dge di' Yillg bed, ~ l'ielding filt er and seco nd a ry s ettling with chl orination . Con s tru ction comtlle t: e.
4th Echelon Motor Repair Base, ne ar Atlanta. Wate r is SUil [lli ed by th e A tl a nta m etrop oli tan syst.e m. A co mp lete se \>ver sys tem is con strueted whi ch t erminates in a se wa ge J)lant <o ns ls lin g of coarse bar se ree n , prim ary sett ling, .separate s lu d ge diges tion , t ri c ldin g fi lte r , .seeonclary se ttling-. chl o rin a tlon , and onen s ludge drying b ed s . U nd er co nstru cti on .
Augu sta Air Bas e at Augusta. Here lves wa.tc r and se werage service fr om t h e Aug11sta systems. Construction complete.
Alb a ny Air Base, near Albany . Su p pli ed with water !'rom th e public water s uppl y o f All>nn y. Ther e is a se pa r a t e s ewer s~ stem and se wage tr eatm e nt, cons is ts of c omminutor , Jl rlrn a. r y settling, sepa. r a.te s ludge d igesti on , pu m ps, t ricld in g fil ters, secondar y settlin g, chlorinati on . a nd oven sludge d ryi ng beds . Labo rato r y control is provid ed . Con st r uc tio n complete.
Moultrie Air Base. \Vater is f u rnished b y deep wells a nd is chlorinated befor e e ntering th e e o n1pl et<~ distribution sys tem and el evat ed storage. A compl et e s ewer system is f ollowed by t.na tlll cnt consis ting of co Jnnlinut,1r, pumps, primary settling, se parate sludge diges tion, t ri clding filt e r~. secondary se ttlin g, chlorination , an d open sludge d l'y in g beds. Labora to ry co ntro l is JH'OVided . Und er con s tructi on .
Valdosta Air Base. Wate? r is furni sh ed b .r d ee p wells ttnd is chl orina ted be for e en tering t h o emnplctc di stribution syst em and el e va ted storage. A. complet e se we r S.\'S t c m is f oll owed b y t rea tm cnt. eon sisting of co tHminutor, pumps, prima ry settl in g-, sepa r ate s ludge digestion , tricklin g filte r::;, s econdar y scttlinp:, ehlorination , and open s ludgc dry ing beds. Laborator y control is provid ed. lJnder eonstruelio n.
Georgia Air Depot, nea r Maco n. Dee p w ell water is eh lo r iu atc d and tr eat ecl to redu ce co r rosion before en te ri n g th e p ipe system a.nd el eva.ted s to rage. After coll ection :-.e wa ge is tr ea ted hy a coa rse ba r screen , pl'imary settling, separate sludge digestion , trickling filter, secondary .-.;ctllin g. ehl orinati on, and ove n slud ge dr y in g b eds . J~ ab o raJor y co ntrol is proYid cd . Under con struction.
Fort Oglethorue . }:x p:l!lsion to dat e h as bee n mad e with out augm cutiu g th e ex is ting \\'at er :-:,uppl y f rom C h a tt :tn oo ~:a or the ex isti ng se wag e tre:.llment plant .

1

Georgia Department of Public Health

;

Camp Gordon near Augusta. "\Vater is obtained from the Augusta supply ami is clllol"inate<l

'

again befora pumping to the distribution system and elevated storage. 'rhe area is completely

sewered and the sewage treatment plant consists of comminutor, primary settling, trickling

filters, secondary settling, chlorination, separate sludge digestion and open sludge drying beds.

Construction complete.

Recapitulation of Pltblic Water Supplies to December 31, 194.1

Number

Percentage PerPorJUiation oentage
Using Total Population Publio State ( 1940 Census) Supplies Population

Supplies receiving both filtration and chlorination

(including softening and iton removal plants)__ 9B

3B1,SOO

62.5

21.6

Deep wells, shallow wells and springs chlorinated 90

3<13,BOO

25.3

11.1

Deep wells, shallow wells and springs not chlori-

nated --------------------------------------- 18B

163,500

12.2

5A

~l'otal public \Yater supplles _____________________ 372

1,378,900

100.0

4<1.1

\oVater from home \Vells and springs in rural areas

and villages without public water supplies ____ _

1,1H,SOO

55.9

Total for State ____ -----------------------------

3,123,100

PUBLIC HEALTH ENGINEERING LABORATORY
The purpose of the Public Health Engineering Laboratory is to perform such tests of a physical, chemical, or bacteriological nature as are needed to assist the Public Health Engineering Division in carrying out its program of improving sanitary conditions throughout the State in so far as these conditions may directly or indirectly affect the public health.
The following table lists the routine work in the laboratory and the number of samples handled during the year. The 13,210 samples examined represents an increase of about 7 per cent over the number received in 19i1Q;

Bacteriological samples from public and semi-public water supplies _____________________________________11,936

Bacteriological samples from private water supplies_____ 979 Bacteriological samples from swimming pools___________ 155

Chemical samples from various sources--------------- 109 Sewage and stream pollution samples ---------------- 26

Miscellaneous _____ ---------------------------------

5

Total ________________________________________ 13,210

As in former years, the major portion of the work performed consisted of the bacteriological examination of water samples from public and semi-public water supplies throughout the state. Samples have been submitted to the laboratory from most of the larger cities and towns at monthly intervals. Samples were received at some time durin.:; the year

Public 11ealth Engineering

35

from 333 supplies. Approximately 4.5 public and semi-public supplies failed to submit any samples during the year; however, the population groups served by these supplies were very small in most cases.
The regularity with which cities and towns submitted samples is shown as follows:
Number water supplies submitting samples 10- 12 months, 262; 6- 9 months, 39; 1 5 months, 32.
Based on the laboratory examination of the above samples it is found that for the year 286 public and semi-public water supplies met the United States Public Health Service standards of bacteriological quality. The majority of the public water supplies in the state fall into one of the following three classifications as to source and treatment: Ground watersuntreated; ground waters-sterilized; and surface waters-filtered and sterilized. The number of supplies in each classification submitting samples and the number and per cent meeting U. S. P. H. S. standards of purity are as follows:

Source and Treatment

No. Supplies

Supplies Jilleeting

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

No. Per Cent.

Ground Waters-Untreated~------- 159 Ground Waters-Sterilized _______ 91 Surf. Waters-Filtered and Sterilized 81
Total~------------------ 331*

123

77.3

84.

92.3

79

97.5

286

86.4

*Samples from two supplies not included in this tnhle.
There were no water-borne epidemics in the State during 1941.
MiLK SANITATION
Milk sanitation activities are being continuously expanded by local health departments as manifested by the increased attention devoted to such programs in organized counties. Notable improvements are being made by dairy farms and pasteurization plants in the twenty-five cities and three counties that have adopted the Public Health Service Milk Ordinance. These improvements are resulting in providing milk supplies of higher quality and degree of safety, thus instilling greater confidence in public milk supplies.
Conformi~g to the provisions of the State Department of Public Health Milk Sanitation Plan, milk surveys were made for Columbus, \:Vaycross, Thomasville, Americus, Rome, Atlanta, Toccoa, and Cndele in organized health counties. ]oint inspections of dairy farms and pas teurization plants are being made with local enforcing personnel to standmdize methods of inspection. Technic~1l interpretations and administra

36

Georgia Department oj Public fl ealth

tion of the ordinance are discussed in conferences and by correspondence. Such procedure is materially aiding in bringing about a uniform program in all organized health counties. Special assistance has been rendered in preparation and examination of plans for pasteurization plants and dairy farm structures in Marietta, Clarkesville, Columbus, Waycross, Carrollton, and LaGrange.

, . Early. this year a twenty-three-page illustrated milk bulletin, titled Drink Health Safely, was prepared by this Department to answer the need for non-technical educational material. The main factors discussed in the bulletin are food value of milk, milk-borne diseases, safeguarding milk, functions of the Standard Milk Ordinance, selecting a milk supply for the home, and home care of milk.

An amendment to the Savannah City milk ordinance was adopted in April eliminating the sale of raw milk after August l, 19<1.1.

Close cooperation is being maintained with the Army Veterinary

Corps to assist plants and dairy farms supplying army camps to comply

with grade "A" requirements. Federal specifications for army milk sup-

plies require that plants and dairy farms must comply with current

grade "A" requirements of the Public Health Service Milk Ordinance.

.,
.',

Observance of these requirements in several instances has resulted in improvements at plants operated by successful bidders.

.f,
Special attention and field investigations are being directed toward

improving milk supplies used by organized summer camps. Of the camp

supplies surveyed it was noted that many are using milk from dairies not

complying with grade "A" requirements. In many cases milk is pmchased

in hulk, necessitating dipping. Such practice nullifies the safeguards ob-

served in producing and handling milk at the dairy or pastemization

plant. Recommendations are being made for camps to purchase milk only

from approved sources, preferably pasteurized milk and in quart or

smaller bottles filled and sealed at the pasteurization plant or dairy farm.

During the year arrangements were completed providing for a technician from the U. S. Public Health Service to visit the various local health department milk laboratories for the purpose of a study of milk laboratory operations and degree of conformance with Standard Methods of Milk Analysis. This has been one of the most productive features of

the milk sanitation program.

List of cities and counties having adopted the U. S. P. H. S. Milk

Ordinance:

Public Health Engineering

37

Name
Americus Athens Atlanta Augusta Brunswick Cartersville Cordele Dalton Douglas Gainesville Griffin Hinesville Hogansville LaGrange Macon Millen Moultrie Quitman Rome Savannah
Statesboro Thomasville Tifton Waycross Waynesboro West Point Crisp County Fulton County Spalding County
Cities-26 Counties-3

Date Ordinance Adopted
April 1, 1937 1925 February 23, 1940 1930

Date Revised

November 18, 1941 November 19, 1939 January 19Ll.O March 15, 1937 November 27, 1938 January 7, 194.2 February 19, 1940 May ll, 1938 1927 January 1938 December 19, 1939 August 10, 1939 March 18, 1940 1929
June 1939 February 25, 1940 June 5, 1939 April 15, 1939 nctober L1, 1939 lVIay 1937 October 4., 1939 July 3, 1940 November 27, 1938

April 1, 194.1
July 31, 19L10, effective Aug. 1, 1941

SURVEYS AND MAPS
The absence of maps in counties and municipalities, suitable for public health purposes has prompted the Division to initiate a long-range, progressive plan for relieving this deficiency.
Because of the demand by those engaged in stale and local health work, the need for such a plan became increasingly urgent. Mapping service is especially needed when local health service is established, and the national defense program adds considerably to the demand, as such maps are indispensable in cooperative state and national defense projects.

38

Georgia Department uj Public Health

A definite plan of operations was developed, with the final objective of adoption of standards for maps suitable for all phases of public health. Within the range of this objective, basic considerations were as follows: (1) state and local maps available for development with a minimum of field surveys, (2) adaptability of such maps to revision for public health purposes, (3) types of maps necessary for various public health services, (i1) facilities for adoptio~ and continuous operation of the plan.
After a period of study and observation, together with experience gained in meeting general and specific demands, certain standards for public health maps were adopted. This resulted in the preparation of a bulletin, Public Health Mapping Standards, which is available to the pub lie. Standards adopted and shown in this bulletin are:
(a) County basic or administrative map (b) County malaria control map (c) lYlalariometric information (d) County sanitary survey map (e) Municipal basic map (f) Municipal sanitary survey map (g) Standard title sheet
The initial preparation of a map generally involves a basic map which is a basis for development of the type map required. The technical detail of instrumental field surveys confonns to usual surveying and en3ineering practice. The drafting and map production detail conforms to usual technical mapping practice. All general procedure is partially outlined in the above mentioned bulletin.
The total number of maps produced as designated above, together with special area maps, charts, and other representations amounts to approximately three hundred. The demand for maps and drafting service is greater than can be supplied. This demand is from public health workers, county and municipal officials, Federal agencies and national defense sources.
Maps and drawings completed:
4 Standard basic municipal maps (Cornelia, Demorest, Adel, Toccoa) 2 Standard basic county maps (Long, Liberty) 1 Standard malaria control map (Sumter County, revised) 1 Letterhead size county map (Richmond) 1 Special map (State of Georgia by counties) 17 Special maps and charts 10 Special drawings for water supply bulletin 6 Special drawings for National Defense mosquito control (Fort
Oglethorpe H.eservation, Conley Army Depot, Albany Air School, Richmond County Infantry School, Camp Wheeler and Vicinity, Southeast Air Corps Training Center-Bibb County) 1 Topographic map (Experimental Area, Emory University Field Station-Baker County)

Public Health Engineering

39

2 Sectional malaria control maps ILaurens County and Decatur Countv I
3 Stand~rd basic municipal sanitary survey maps (Cornelia, Demorest, Adel)
2 Standard basic municipal sanitary survey maps (Lawrenceville and Dahlonega, revised)
1 Plans for Floyd County Health Department offices 1 Plans for septic tank and filter beds (Haddock) 1 Spot map-Quitman and Brooks County malaria cases 1939
Maps and drawings in process of completion: 4, Basic county maps (Laurens, Burke, Bulloch, Decatur) 3 Municipal sanitary survey maps (Toccoa, Hiawassee, Blairsville) 2 Municipal basic maps (Hiawassee, Blairsville) 3 County malaria control maps (Laurens, Burke, Bulloch) 1 Standard plan for Producer-Distributor 10-stanchion milking barn
and milk house 1 Topographic map (Experimental Sector A, Emory University Field
Station, Baker-Early Counties)
BULLETINS AND LEAFLETS ISSUED
During the year the following bulletins, leaflets, and standard plans were prepared for distribution:
Drink Health Safely (milk) Water Supplies for Suburban and Country Homes Septic Tank System for Suburban and Country Homes Two Classrooms Converted into School Cafeteria Sink for Kitchen in School Cafeteria Built-in Cabinet and Table for School Cafeteria Essential Features of Camp Sanitation
COORDINATED COil!JMUNITY SANITATION AND MALARIA CONTROL
During the year, 7,792 privies and 3,018 septic tanks, with 577,824 feet of 4-inch drain tile for secondary treatment, were installed at homes not having public sewers available.
Much of this work was done under the cooperative program in which : relief labor was furnished by the Work Projects Administration, materials
furnished by property owners, and supervision by engineering personnel. Shortage of relief labor with which to continue this cooperative program is responsible for its reduction as a large-scale operation. A number of communities are continuing the program either by private contracting or with convict labor furnished by the counties.
Tabulation by counties is contained in files of the Division.

40

Ceorgia Department of Public Health

TOTAL PRIVIES SHOWN BY YEARS
Considering the practical suspension of the community sanitation program by the Work Projects Administration after July l, the construction of sanitary privies during the year shows continued progress.

Year

Total Privies

Per Cent Concrete

Per Cent Wood

1933 1934. 1935 1936 1937 1938 1939 l9L1Q
1941

1,370

0.0

100.0

1L1,543

6.2

93.8

10,4.61

20.7

79.3

9,868

4.0.0

60.0

10,177

60.0

40.0

13,4.71

70.5

29.5

12,079

77.1

22.9

11,115

85.7

H.3

7,792

86.5

13.5

Total 9 years 90,876

In addition to the increased attention to sanitation, indicated by the desire for replacement of old surface toilets with sanitary pit toilets, there has been continued growth of the use of more modern sanitary facilities. This is demonstrated by the increase in construction of septic tanks at homes where public sewers are not accessible.
A comparative study of septic tank construction in Georgia over the past seven years is given by the table below, showing the annual totals of septic tanks built under supervision of public health engineers.

Year
1935 1936 1937 1938 1939 1940 19M

Home
2,320 2,533 3,018

Public Property
79 53 165

Total
772 9L19 701 1,78L1 2,399 2,586 3,183

MALARIA CONTROL BY DRAINAGE
The malaria control drainage program has continued with the following accomplishments: 614,807 linear feet of ditching, 260 ponds chained, 1,333 acres drained, 854,737 linear feet of right-of-way clearing, 22,100 linear feet of logging and rafting, 198 ditch checks installed, 53,276 linear

Public Health Engineering

41

feet of ditch paved, 20,720 square yards of ditch banks sodded, 18,'140 linear feet of butt-joint tile laid, 9 sand traps installed, 513 linear feet of culvert installed, 1,363,973 linear feet of ditch and streams cleared or maintained and 197 acres of reservoir cleared. The greatest part of this work was accomplished by WPA labor operating on the State-wide Malaria Drainage Project. Maintenance work was exclusively by local convict and free labor crews working under local supervision.
One of the largest malaria drainage projects initiated in the country is under way at Hinesville for the drainage of the area in and around Camp Stewart. Six draglines are in operation on this program alone. Surveys and planning conducted by the Division staff. Other large scale operations are under way or planned for future construction in cantonment and extra-cantonment areas throughout the state. Supplementing the drainage program, the Division is cooperating with Army, Navy, and U. S. Public Health Service personnel in directing larviciding operations for mosquito control in nine defense areas for the protection of military and naval personnel, and population engaged in important industrial defense work. Since July 1, WPA labor has been used in carrying out larvicidal work under direction of this Division.
In the Georgia malaria control program, concentrated attention is being given to the preparation of accurate county maps showing, roads, houses, watered areas, and completed drainage construction. These maps are e2sential to the malaria investigation program and are used for the detail planning and administration of control operations. Five counties have made current or pending appropriations for a county-wide Paris green larvicidal program; 1i1 draglines for malaria control drainage have been used in eight counties and are contemplated in others. Area-wide Paris green programs, less than county-wide in scope, are under way in three counties.
REGULATIONS OF IMPOUNDED WATERS FOR MALARIA CONTROL
These regulations apply to small and large areas where water is impounded for hydroelectric power, recreational, and other purposes. The list of these areas are omitted for the purpose of brevity. However, the large areas, particularly for hydroelectric power, flood control and related purposes, include the following: Georgia Power Company, Crisp County Power Company, Georgia Power & Light Company, Tennessee Valley Authority, and United Stales War Department.
In general the regulations include first clearing of all areas to be impounded, followed by effective larviciding during malari:ot mosquito breeding seasons. It is quite evident that this program has been influential in prevention of serious malaria epidemics around such areas.
The National Defense program has initiated a new era of hydroelectric development and flood control which during this year has added at least four such areas in Georgia comprising approximately 51,300 acres and

1

<12

Georgia Department of Public Health

. '

cli~ided among the following projects: Nottley 11,000, Chatuge 15,000, I-hawassee 5,000, and Allatoona 20,300. These p1ojects are being cleared

conforming to regulations and it is anticipated that all will be in operation

~~g~~u19~.



SCI-IDOL SANITATION

This Division has worked in close cooperation with state and county boards o education by furnishing plans and supervision of construction of sewage disposal devices and for improvement of drinking water supplies at schools.
The Work Projects Administration and the National Youth Administration require approval of plans and specifications for sanitary facilities for all buildings, for schools and other public places, by this Division as a prerequisite for their acceptance as a construction project. It therefore requires review of complete plans and specifications for each project and often field investigation to determine adequacy of s:mitary facilities.

Privies constructed at schools and other public places_______ _ 911
Sewage plants constructed at schools and other public places__ 1L13
Plans reviewed and approved for school sewage plants ______ _ 45
Individual and school water supplies approved and constructed 1,650
Water samples collected from schools ____________________ _ 319

FEDERAL HOUSING ADMINISTRATION SANITATION

In order to secure a loan insured by the Federal Housing Administration in Georgia, those homes not connected to approved public water supplies and public sewer systems must have a private water supply and sewage disposal system constructed according to recommendations of the State Health Department.

Inspection and approval of proposed subdivisions in rural areas not

having city water and city sewers, or either, by this Division is also re-

quired by the F. H. A. before approval willbe given to such subdivisions.

This procedure has resulted in impmving the standard of construction

of all sanitary facilities in other than F. I-I. A. construction and has been

instrumental in obtaining many more connections to approved public water

supplies and sewer systems.

.

Approval certificates have been executed and forwarded to the F. I-I. A. under this program covering 1,4.07 private sewage disposal systems and 48 private water supplies in 77 counties and o the state.

FARM SECURITY ADMINISTRATION SANITATION
The Farm Security Administration has cooperated with this Division in use of standanl plans, specifications, and methods for sanitation of rural homes. This program is reaching those rural residents most in need o sanitation. The program includes sanitary disposal of sewage, improvement of water supplies, screening, and genei:al environmental corrections.

Public Health Engineering

The amounts allotted to various counties are shown bdow. Figures showing the number of homes sanitated by counties for the past year are not available.

County

Allotment

Appling -------------$3,500

Bul'l;e --------------- 3,000

Calhoun ------------- 1,500

Catoosa ------------- 2,000

Colquitt ------------- 3,00Q

Crisp ---------------- 2,500

. Douglas ---------- ___ 2,000

Emanuel ------------ 2,000

Fayette -------------- 3,500

County

Allotment

Greene --------------$2,500
Gwinnett ------------ 1,500
Habersham ---------- 2,000 Heard _______________ 7,500

Jackson ------------- 2,000 Jones --------------- 1,:>00 McDuffie ------------ 2,000 :uontgomery --------- 2,000 Oglethorpe ----------- 3,500

County

Allotment

Randolph ------------$2,500

'l'albot -------------- 1,500

Terrell -------------- 3,500

'l'homas ------------- 3,500

Washington ---------- 2,000

White --------------- 2,500

Whitfield ------------ 2,500

Willdnson ----------- 3,000

RURAL ELECTHIFICATION ADMINISTRATION SANITATION
The Rural Electrification Administration in cooperation with the Division is promoting sanitary features at such homes as receive rural electricity. This is generally because immediately following the installation of electricity in a rural home development of a water pressure system is in order. This involves (1) an improved well (2) plumbing facHities (3) proper disposal of sewage. The amount of such sanitation is measured by the number of approximately 1,500 homes in one year receiving approved ....! water supplies, plumbing and satisfactory sewage disposal.
NATIONAL YOUTH ADMINISTRATION
In addition to the review of all plans and specifications proposed for construction by the N. Y. A. for approval by this Division, as mentioned in the section on school sanitation, active assistance is rendered in the inspection of sanitary facilities at N.Y. A. resident projects. This inspection, which is followed by detailed recommendations, covers water supply, sewerage, milk supply, housing, bathing, ventilation, lighting, food hancUing and storage, garbage collection and disposal, etc.
The N. Y. A. is building new resident centers where as many aJ 200 to 500 boys and girls are provided for and all plans and specifications covering sanitary facilities are reviewed and approved by the Division before construction.

CAMP SANITATION
A concerted effort has been made to protect the health of summer campers. With this in view a bulletin has been prepared, entitled Essential Features of Camp Sanitation, together with inspection blanks. This program has involved finding and listing all summer camps, such as Boy Scouts, Girl 3couts, Y. lVl. C. A., Y. W. C. A., Camp Fire Girls, 4-H Club, and general recreational summer camps. Attempt is made by inspections of all camps, preferably during camping season, to record all necessary sanitary improvements. Conferences and correspondence are conducted with organizataion officials and camp directors in order to effect such im-

Georgia Department of Public Health

provements as may assure protection of the health of campers. The Division maintains a file showing records of all camp inspections, showing improvements necessary and improvements effected.

MATTRESS SANITATION
In March, 1937, the General Assembly of Georgia passed the "Mattress Sanitary Regulations, Act No. 4.72 Georgia Laws, 1937" which was approved by the Governor on 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 fee and sale of revenue stamps for the operation of this law, which makes the service self-sustaining.
During 194.1, a total of 1,761 inspections were made with 177 rechecks on machinery not in use. The inspections included mattress manufactming and renovating plants, furniture stores, and other establishments where mattresses were stored or sold.
Three hundred forty-one mattresses were inspected, during and after manufacture, for use in State Tuberculosis Sanatorium. The total number of samples tested was forty-five, with six samples forwarded to the National Institute of Health Laboratory, Division of Industrial Hygiene, Washington, D. C. In addition to these samples, twenty-seven samples were collected in assisting Dr. C. D. Bowdoin, Director of Division of Preventable Diseases, in an attempt to determine the cause of numerous cases of fever contracted by parties working in and around A. A. A. Mattress Projects. A total of 18 conferences were held concerning the policy of A. A. A. Mattress Projects and bedding at Alto.
During 194.1, 102 licenses were renewed, six new licenses were issued, and nine other plants either changed hands or ceased operations. The new licenses were for renovating plants all of which installed and operated sterilizing equipment that complied with the requirements as specified under the Mattress Sanitary Regulations.
Numerous complaints of bedding law violations were thoroughly investigated; however, it was necessary in only one instance to resort to legal action. This violation was by an out-of-stale renovator.
An analysis of the revenue received by the Department during the four mid one-half years of enforcing the Mattress Sanitary Regulations shows that a large percentage was derived from out-of-state manufacturers selling within the state. During 19L11, there were seventy-five out-of-state concerns who purchased bedding revenue stamps to be placed on articles to be sold within the state. The following figures show the percentage of total revenue furnished by out-of-state manufacturers:

1937- --------------- -1938_________ _________
1939-------------------1940______________ -1941_________ ------ -

11.1% 22.5o/o
32.0% 34.1% 40.0%

Public Health Engineering The following figures show the number of licenses issued each year:
1937___________ ------ 54 11993398__-_--_-_-_-_-_-_-_-_-_-_.._-_-_-_-_-_- 2454 1940___________________ 10 194.1___________________ 6
Total_________________ 139
. }

l
Division of Maternal and Child Health
]. P. Bowdoin, lVI.D., Director
E. R. Watson, lVI.D. ______________________ Associate Director A. Starr Ingram, lVl.D, __________________Obstetric Consultant Mary Emma Barnes ____________________ Nntrition Consnltant
The general activities of the division dming 1941 embraced those fields previously incorporated in the program. These consisted of the registration and supervision of midwives, the promotion and improvement of maternity care, infant care, care of the preschool child, and school health programs, in local areas, plus direct field activities of the divis!onal staff in the nature of case consultation, advisory services, and education, both professional and lay. There was also a continued increase and acceleration in activities which had been selected for special emphasis during the year 194.0, namely, an intensive, widespread educational and promotional program of nutrition, special provisions for the care of premature infants, and the hearing test project conducted in cooperation with the W. P. A. In addition to the foregoing ten major points, the division directed special attention toward selective increase of immunization, and increased distribution of information relative to the health and nutritional problems of mothers and children.
Statewide maternal and child health activities expanded during the year, principally as a result of the addition of new local health units or newly instituted nursing service in areas previously or recently unserviced. Industrial and mobilization programs in the interest of national defense have not materially interfered with maternal and child health activities to date, although various readjustments have been necessary in certain localities. It was anticipated that numerous maternal and child health centers might be discontinued because of the shortage of physicians incident to mobilization. During the year, however, relatively few of the part-time physicians left for military service, and in most instances of this sort it was possible to substitute other local practitioners. In only a few places was it necessary to close the centers or to convert them into nursing conferences. It is expected that health centers will fare less well during the ensuing year.
The continuing decline in the number of physicians in private practice indicates an increasing necessity for centralization of medical and health services. The existing structure of strategically located health centers should provide a medium through which these problems may be met, in areas wherever the service can be maintained.
Health Center Standards
A major change affecting maternal and child health centers has been the adoption of new standards concerning the provision and maintenance of appropriate quarters, fixtures, and equipment. It has been realized for some time that definite requirements should be established and enforced wherever State participation is extended. Formal application of a uniform

Maternal and Child Health

schedule, however, has been delayed until the value and practical accomplishments of these health centers were thoroughly demonstrated in many communities throughout the State. The standards adopted are concerned with physical requirements rather than professional procedure. New centers must meet these standards before financial participEttion is e.\tended. Centers previously approved for participation are now required to meet the minimum standards after a reasonable interval.
A maternity and child health manual, relating to methods of organizing and conducting centers, standards of procedure and records and reports, is now in process of preparation, but had not been completed at the close of the year. As soon as completed this manual will replace the present incomplete bulletin on the subject.
Standard Notification Cards
During the course of the year three types of cards were prepared for distribution to various local departments to assist in case-finding procedures. The first card is an ordinary postcard, to be mailed to parents as each child reaches the age of six months, as shown by birth certificate files. Information is given as to the need for diphtheria immunization and a request for the child to be brought to the health center at a definite elate and hour for this service. A number of local departments are using similar cards originated by themselve3. The new card may relieve the departments of this expense and stimulate the adoption of the procedure in other areas.
The second card is for formal clinic appointments, giving a defmite date, hour, and place for return visit to prenatal or child health centers.
The third card is for the purpose of early birth notification, to enable neonatal home nursing visits to be started within the first two or three days. This card is completed by the nurse, addressed to herself, and includes directions which will enable her to locate the home. It is given to the expectant mother with instructions to have it mailed as soon as her baby is born. Several local departments are already using a card of this type. It is hoped that its provision by the State Department will stimulate its use in other areas. The lapse of time in initiating neonatal services has long been a handicap in the infant hygiene program.
Changes in Staff
The obstetric consultant resigned in October, having been called to service in the medical department of the Army. A suitable replacement has not been secured.

FIELD ACTIVITIES OF MEDICAL STAFF
Consultations and clinical services ____________ _ Papers, talks, addresses, tot"al attendance _______ _
Public health personneL_______________ _ 826 ProfessionaL ___________________________ _ 101 Lay groups ____________________________ _ 2,962

30~1.
3,889

48

Georgia Department of Public Health

Motion pictures _____________________________

155

Physicians __ _______ _____________________ H1

Lay groups ____________________________ 14

Conference and interviews ___________________ _

662

Physicians and health officers______________ 305

Nurses and other public health workers______ 261

Civic leaders and officials_________________ 96

MCH centers conducted or supervised_________ _

112

Special field visits___________________________

4

Conferences re: civil defense_________________ _

64

Addresses re: civil defense __________________ -

125

Direct service in clinical consultation decreased greatly from the number performed during the preceding year. Increased administrative duties, including new responsibilities in civilian defense, made it impossible to devote as much time to the prolonged stays in the field from which the majority of consultations originated. Likewise, the divi'lion operated with only one field physician during the entire last quarter. A number of consultations were occasioned by the epidemic of poliomyelitis in the area of the State proximate to Atlanta.
Other field activities are moderately decreased from those of the preceding year for the reasons given above. With the limited staff now available, further decrease in consultation and other field activities is anticipated for the ensuing year.

FIELD ACTIVITIES OF NUTRITION CONSULTANT
Papers, talks, addresses, total attendance_______ _ Public health personneL _________________ _ 208 Medical students _______________________ _ 50 Lay groups_____________________________ 4,696
MCH centers visited _________ ~--------------Interviews and conferences____________________
Physicians and health officers_____________ _ 96 Other public health personneL___________ _ 168
Officials and civic leaders _______________ _ 155 Conferences with mothers------------ ____ _ 268
Food demonstrations at MCH centers __________ _ Lunchrooms visited ________________________ -Colleges visited ____________________________ _ Radio talk_________________________________ _
Association meetings attended__________________ _
Total attendance, association meetings _____ _ Home visits ________________________________ _

4,954
67 687
20 36
6 1 21 2,608 4.2

The considerable increase of activities over those of the preceding year is due largely to longer tenure of. the nutritionist during the current report period. The numerous visits to health departments, health centers, and families served the twofold purpose of supplying the nutritionist with

JViaternal and Child Health
~'. first-.hand information concerning the varying local problems, and keeping
.:' up-to-date the technique and content of nutrition education on the part of the local staffs.
Through talks, papers, and attendance at meetings, a total of 7,562 individuals was reached.
MATERNAL AND CHILD HEALTH CENTERS
At the close of the year there were 316 maternal and child health centers operating throughout the State. The accompanying map shows the geographic distribution of the areas served. The increase of six centers over the number functioning at the close of 1940 is not representative o.f the exact number of new establishments, inasmuch as several previously operating centers were closed during the year.
The t.otal number of centers operating at the close of 1941, by type of center and by type of department, is as follows:

Type of Center

In Organized in Nursing Counties Counties

MaternaL____________ __ ____ 8L1

16

Infant_____________________ 85

7

Combined___________ ._______ 79

45

To~} __________________ 248

68

Total Centers
100 92
124
316

Centers on State Participation
The number of centers operating on the State subsidy plan was the same at the end of 194.1 as at the close of the preceding year. The centers in nursing counties increased, while an equivalent decline occurred in organized counties. This shift applies almost entirely to the combined centers, where expectant mothers, infants, and preschool children are all served at the same session.
There were two principal reasons for the discontinuation of some centers. First, in some isolated portions of organized counties the case load proved insufficient to justify an independent center, and the activities were transferred to one nearby. Secondly, in some isolated areas it was impossible to bring the quarters up to a minimal standard of acceptability.
The number of State-supported centers regularly reporting their activities at the close of 1941 is shown in the following table:

50

Georgia Department of Public Health

DISTRIBUTION OF Jt~TEENAL AND CHILD HEALTH CENTERS BY COU!lTIES

Nursing Counties Organized Countio$
Nunoral 1nd!ce.te.J number of MCH centers reporting as of December 31~ 1941

Maternal and Child Health

51

Type of Center

In Organized In Nursing Counties Counties

MaternaL ___ ---------------- 54

16

Infant_______________ ______ 64

7

Combined___________ _ ____ 51

45

TotaL __________________ 169

68

Total Centers
70
7l 96
237

Activities of State Subsidized Centers
The accompanying tables show, for mothers and children, respectively, the activities reported from State subsidized centers for the year 1941, with the percentage increase or decrease of the various items over the preceding year. A surprising increase in volume is noted with respect to practically every activity. Principal emphasis during the year having been placed upon improvement in quality, the increase in volume is largely a result of momentum rather than designed promotion.
Total prenatal admissions increased 21 j{, and those among white women increased 53',7o, which furnishes additional proof of the fact that medical supervision during the prenatal period is widely appreciat~d 11nd accepted. The distribution as to the period of gestation on admission is about the same as formerly. Approximately three-fourths of all admissions occurred prior to the twenty-eighth week, and over one-fourth of all admissions occurred within the first sixteen weeks of pregnancy. In only 73'io of all admissions was the result of prenatal serology reported by the centers. This continues the steady downward trend, from a proportion in excess of 90'/( for the last quarter of 1938, when these reports were first compiled. Repeated investigations have indicated that this declining proportion is a reporting lapse rather than one of performance. The proportion of serologic reports found positive is 6'/( for whites and 20% for Negroes, not significantly different from the report of the preceding year. The ratio of treatments to positive reports remains the same as formerly, 4.6. Prenatal visits have increased, both in number and in proportion to cases admitted. This is particularly marked in the case of white patients.

52

Georgia Department of Public Health

MATERNAL HEALTH CENTER ACTIVITY State-Subsidized Centers

1941

Prenatal Admissions
Admissions, total ---------------------------White ----------------------------------Negro ----------------------------------
% white -------------------------------% negro --------------------------------
Pel'iod gestation, totaL_______________________ Under 16 weel;s_________________________ _
16-27 weeks ---------------------------28-36 weel<s ---------------------------Over 36 weeks __________________________ _
% under 16 weeks-----------------------% 16-27 weeks__________________________ % 28-36 weeks------------------------% over 36 weel;s_________________________

13,891 2,528
11,363 18.2 81.8
13,676 3,728 6,<157 3,111 330 27.3 <17.2
22.7 2.8

Prenatal Syphilis
Reports, total White ______ ------- ____________________ _
Negro ----------------------------------
o/0 of admissions, totaL ____________________ _
White ---------------------------------Negl'o ---------------------------------Number positive, totaL _______________________
White ---------------------------------Negl'O ----------------------------------
% positive, totaL ____________________________
White ---------------------------------Negro ---------------------------------'l1reatments : total --------------------------Treatmentjpositive mtio ---------------------
Prenatal Activities
Visits, total -------------------------------White ___ ---------- ____________________ _
Negro ---------------------------------Visit/admission ratio -----------------------
White ---------------------------------Negro -~-------------------------------'l'mnsferred, total --------------------------Toxemias developed, total. ____________________ White ______ ----- ______________________ _ Negro ---------- __________ --------------
% oWf haidtemis_s_io_n__s,__t_o_t_a_L__________c__________________________________
Negro ----------------------------------
Postnatal Activities
Admissions, total ---------------------------White _______________ ------- ____________
Negro ----------------------------------

10,11<1 1,692 8,422 72.8 66.9 74.1 1,63<1 102 1,532 16.2 6.0 20.5 7,560 <1.6
<17,<140 9,306
38,13<1 3.'1 3.7 3.4
497 <130 117 313
3.1 4.6
2.8
2,095 386
1,709

%+orover 1940

+ 22 + 26 + 18 + 23 + 36

+ +

17 <15

+ 13

++11 <16
+9

+11
+ 28 + 91 + 19

+167
+ 15 + 60 +4

+ <10

+ +

19 <16

Maternal and Child Health
INFANT HEALTH CENTER ACTIVITY State-Subsidized Centers

1941

Visits, total --------------------------------

White ---------------------------------.

Negro

o/o of prenatals, totaL ________________________ _

I

White __________________ ----------------

I

Negro

'6.dmissions-lnfant and Preschool

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

White ------------------------------- __ _

Negro ---------------------------------% white ------------------------------ _
o/o negro ------------------- ----------- _
Age groups, totaL __________________________ _

Under ! months _________________________ _

4-12 months ----------------------------

1-5 years ------------------------------ _

<j
0

under

<.I:

months______________________ _

% <l-12 months __________________________ _

% 1-5 years____________________________ _

Ntttrition, total ----------------------------Abnormal ------------------------- _____ _
Nannal ---------------------------------
o/o abnormal

Visits and Activities

Visits, total ---------------------------------

White ---------------------------------Negro

Visit/admission ratio ------------------------

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

Negro

Defe%cts,

visits ------------------------------total cases___________________________ _

Ii Referred cases ------------------------------

Immunizations

Diphtheria, total ----------------------------

Undet 1 year___________________________ _

!

Over 1 year----------------------------_

% admissions, totaL ____________________ -

o/o admissions, 1-12 lno. _________________ _ % admissions, 1-5 years________________ _

Smallpox, total ----------------------------- _ o/o admissions, totaL ____________________ _
o/o admissions, under ! __________________ _

Typhoid, total --------------------- -------% admissions, totaL_____________________
o/o admissions, over !_____________________

2,812 551
2,258 15.1 15.3 15.0
1'>.010 6,456 8,55<] 43.0 57.0
1<!,859 4,88ii 3,274 6,700 32.9 22.0 45.1
10,172 1,738 8;!3<] 17.1
38,141 1G,633 22,508
2.5 2.'! 2.6 <],390 11.5 2,204
7,251 3,<153 3,798
<]8.3 105.5
56.7 3,692
2<1.6 <15.3 3,321 22.1 19.6

5> 0
')',+orover 1940

+ 23 + 27 + 20 + 2<] + 42 + 16 + 18

++

29 <]0

+ 22

+ 21 + 2<1
+ 10
-l-14
+7

+ 26 + 27

Georgia Department of Public Health

There was a 40% increase in post-partum examinations. Nevertheless only about one out of six prenatal admissions secures postpartum servic~ in a center.
The increase in infant and preschool activities is greater than could be explained on the basis of the few new centers. Not only was there a greater number of admissions, but there was a shift in the direction of an increased proportion of children admitted prior to the age of four months. There were 42% more admissions of these younger infants than reported in the preceding year. The number of immunizations is not in keeping with the increased volume of admissions, although considerably more im-
munizations of all types were performed as compared with 1940. There
is reason to believe that automatic and timely performance of this service should receive additional attention. In the case of diphtheria toxoid there is evidence that the age selection is improving. Total visits by infants and
children increased by 29%. Particularly gratifying is the increase of 40%
in the visits made by white children. Visit admission ratios indicate that continuity of attendance is satisfactory.

MIDWIFE CERTIFICATION
Over the past ten years the number of midwives has declined annually,
with the exception of but two periods. The total registrations for 1941 were 2,594, representing approximately three-fourths the number certified
ten years previously. 'fhe number of occasional practitioners not regisistered is uncertain, but the number of all cases handled by them is relatively very small. The following table shows the number of certificates issued each year for the past decade:

1932 ________ 3,358 1933 ________ 3,562 1934________ 3,434 1935 ________ 3,510 1936________ 3,297

1937________ 3,171 1938 ________ 3,049 1939 ________ 2,951 1940 ________ 3,865 1941 ________ 2,594

The number of individuals certified for the first time for each of the past four years is as follows:
1938 ________ 134 1939________ 59 1940________ 75 1941________ 68

This again reflects the decrease in available attendants of this type. A "new midwife" is one whose name has never been reported to the division, even though she may have practiced prior to her registration.
With steadily decreasing numbers, the age distribution of midwives has naturally centered in the advanced ages. The following table shows
the age distribution of all midwives certified during the year 1940.

Maternal and Child Health

55

-~
Total
2,865
-

AGES
I

White Colored Midwives Midwives Midwives Midwives Midwives

Under I 50 - 60 161 - 70 171 - 80 Over ' Ag~ not

50 Yrs. Yrs.

Yrs.

Yrs. 80 Yrs. Given

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

273

2,592

394

857

922

:39:-i

66

:u

~I-:;- - - - - - - - - - -~ - - -

10%

90%

21%

30%

32%

--1%

It may be seen that 48';{ of these women were aged 60 and over, whereas only 21% were under the age of 50. The sixty-eight midwives newly certified during the year 1941 included thirty-seven, or only 54'/c, under the age of fifty, which of course affects the existing age dictribution to an extent more than offset by the aging of those carried on the roster.
CARE OF THE PREMATURE INFANT
During the year 1940, first steps were taken to initiate a statewide program of care for the premature infant. Definite activities and some tangible evidence of results became manifest during 1941. Early in the year production was started on an experimental incubator developed during the preceding year.
Distribution of Incubators
Through the cooperation of the WPA and NYA, 189 incubators were built, at a cost of only about eight dollars per unit. By the end of the year, 124 of these units had been distributed to various local health departments, regional health departments, and local hospitals over a total of some eighty-one counties. The accompanying map shows, by county, the number of incubators placed.
Survey of Hospital Nurseries
There was undertaken, and largely completed, a survey of the hospitals of the State with respect to their facilities for the care of premature infants. Members of the G~orgia Pediatric Society. participated in this study. Few of the institutions had any facilities for the care of premature infants, and many of them were eager to take advantage of the provision of an acceptable incubator. This, plus the efforts of the Georgia Pediatric Society, stimulated interest in the care of the newborn infant. The working relationships established between hospitals and local health departments are expected to assure a coordination through which hospital care may be secured for numerous premature infants who otherwise would be poorly served. It is hoped that continued efforts will result in definite improvement in the care of other infants in the same institutions.

56

Georgia Department of Public Health

Georgia Department of Public Health Atlanta, Gaorgia
DISTRIBUTION OF INCUBATORS FOR

Maternal and Child Health

57

Technical Instruction
Institutes were conducted throughout the State for purposes of training and demonstration in the care of premature infants, to which all public health and institutional nurses were invited. The entire program of the regular public health nursing institute was devoted to this subject. These meetings were held ~n five cities durinf!; the months of November and December. Each sesswn lasted for two days and covered every phase of premature infant care. In addition to the divisional staff members, appearing on the programs were the Dire:tor of t~e Division of Pu~lic Health Nursing, the State Maternal and Child Hygiene Consultant Nurse, and the Regional Consultant Nurse of the Children's Bureau. Specially purchased and prepared literature was supplied, and intensive demonstrations of equipment and procedure were conducted. Practically all of the public health nurses of the State attended, as did a large number of nurses attached to hospital staffs.
NUTRITION
The nutrition program at the State level is essentially one of indirect application. Major points of emphasis are: Promotional and advisory efforts to develop nutritional phases of local health programs, to supply expert consultation and advisory service in the techniques of application to local health departments and workers in dietetics, editorial service to provide source and reference material for use and distribution by local organizations, in-service education to workers in public health and in dietetics, plus statewide educational efforts, both direct and through the media of various regional and statewide organizations.
The field services have been classified and enumerated in the report of the activities of the nutritionist.
Staff Education
Efforts to increase the interest and implement the effectiveness of public health nurses in the nutritional phase of their daily activities, met with continuing success. Participation in nursing institutes, health center demonstrations, and individual conferences with nurses in the field, occupied a large proportion of the nutritionist's time. Material for distribution and other data for personal use and reference, plus posters and exhibits on the subject of nutrition, were supplied to many local staffs.
Lessons on food preparation given during the sessions of sixty-seven different maternal and child health centers served to stimulate a continuance of this activity by many of the centers themselves. Home economists from the Farm Security Administration, local high schools, the Red Cross, and the Georgia Power Company, also participated in this activity. In connection with work at the centers, joint conferences by the nurse and nutritionist were held with mothers and expectant mothers.
There is considerable evidence that nutritional services have expanded in many local areas, and that their effectiveness has been materially increased. This, of course, is not measurable in terms of final results.

58

Georgia Department of Public Health

Publications Distributed
During the year seventeen bulletins on nutrition were prepared and distributed as follows:

Title

No. of Copies

I. Buying _Food for tile Family ____ ------------------ _____________ _ ') Facts You Should Know AlJout Yitamin..o;;: _______________________________________ _ 3. Hot Jar Lunches for School Children __________________________________________ _
4. Practical Information on Xutrition (:For use by physieians, dentists, nurses, home economists and nutritionists)------------------------------------------------
5. Buy Your Yitamins in Food ______________________________ - - - - - - - - - - - - - - - - - - - - - 6. What to Feed Your Baby (revision of feeding cards already ir. use) ______________
7. How to Select and Prepare Yegetables _---------------------------------------8. Food Budget (For Family of Six with Total Income of $19.00 per week)__________ 9. Food Budget (}'or Family of i'\ine with Total Income of $36.1!0 per month)_______ IO. Guide for Buying Food________________________________________________________ II. Enriched Flour and Bread______________________________________________________ I) Hyg"iene and Sanitation Htandards for School Lunchrooms_______________________ I3. How to Fight Pellagra (revision) ___ -----------------------------------------14. What Is Your I. Q. in Xutrition ~ ----------------------------------------------I5. Are Your Pet Food Theories False! ______ -------------------------------------I6. Does Your Child Have Good Food Habits? ______________________ ---------------17. Count Your Calories _________ ------------------------------------------------

I:l,7oo 24.800 5.700
1,900 49,000 39,500
3,000 2,500 2,550 3,000 3.300 3,000 17,000 I2,850 2,400 2,200 2,000

Total ___________________________ ---------------------------------------- 188,600

A total of 43,816 copies of previous publications, added to the above new material, gives an annual total of 232,416 bulletins supplied to the public.
Most of the educational material was distributed through various local departments of health. However, a considerable number of reprints of articles from Georgia's Health were sent to individuals and clubs on request. Cther major media of distribution were:
( l) Private physicians. The Sixth District Medical Society requested reprints of an article from Georgia's Health, "Buy Your Vitamins in Food." These reprints were sent to 2,500 private practitioners throughout the State. Additional copies requested by many of them for use among their patients, brought the total distribution of this bulletin to 49,000 copies.
(2) Home Economics departments in schools. Over 5,000 pamphlets were distributed through these agencies.
(3) State Nutrition Committee for Defense. Six thousand bulletins relating to school lunchrooms were dispensed through these auspices.
(4) The Women's Auxiliary of the Medical Association of Georgia was responsible for the distribution of 11,000 copies of nutrition material.
(5) The WPA Adult Education Program, employing 308 teachers and reaching approximately 21,500 individuals, used 3,700 bulletins on nutrition.

Maternal and Child Health

59

(6) Red Cross. Approximate!y 3,000 bulletins were used by the Atlanta Chapter in their courses in nutrition.
School Lunch Programs
Efforts to inaugurate lunchroom projects in schools throu6hout the State not previous!y so served, have been of rnaj or concern to the division for over two years. Momentum gathered previously plus the promotional activities of the present report period, have resulted in great extension of hot lunch services to school children. Accompanying the organization of new lu~chrooms has been the equally emphasized objective of improving the sanitary and nutritional standards of those already operating.
From all directions come reports of improved school attendance, accelerated weight gains, and reduction of scholastic failures in the schools where hot lunches are furnished to the children. It is felt that the time of the nutritionist has been well spent in her conferences with lunchroom supervisors, home demonstration agents and teachers. In addition to the technical advice and assistance rendered, a major point of emphasis has been to coordinate the work of these people with the aims and functions of the medical, nursing, and sanitary staffs of their respective health de partments.
The Surplus Marketing Administration played a most important role in expanding the lunchroom program. There are 5,554 public schools in Georgia. During 1941 surplus commodities were distributed to lunch rooms as follows:

Lunches served Hot lunches ______________ _ Cold lunches -------------Total ---------------------

Number of schools
1,742 1,331
3,073

Number of children served
2::17,668 261,441
G19,109

The WPA cooperated extensively in the successful operation of school lunchrooms. The activities reported by them during the year are as follows:

Number of lunchrooms operated_________

951

Number of workers employed ___________ _

3,000

Number of lunches served _______________ _ 19,218,437

In addition, this agency carried out a summer feeding program m sixty-eight locations, during which 199,502 meals were served.

60

Georgia Department of Public Health

JOINT UNDERTAKINGS AND COOPERATION WITH
OTHER AGENCIES
Medical and nutritional staff members of the division were associated in joint committees with many voluntary agencies directly and indirectly related to the furtherance of public health aims. Such organizations in. eluded: the Medical Association of Georgia, the Auxiliary of the Medical Association, the State Nutrition Committee for Defense, the Georgia De. partment of Education, the Georgia Congress of Parents and Teachers, the Georgia Pedriatric Society, the Works Progress Administration, the Crippled Children's Service of the Georgia Department of Public Welfare, the Georgia Dietetic Association, the Georgia Home Economics Associa. tion, the American Red Cross, Farm Security Administration, and numerous civic clubs.
Hearing Test Project
Inaugurated as a cooperative undertaking with the WPA in 1940, this program continued as previously. Six audiometers, purchased by the State Departments of Education and Health, were utilized by individuals trained and employed by the WPA, in cooperation with various local health and school officials. Nearly all of the schools in health unit counties had been surveyed by the end of 1941. Compilations identifying defect cases were returned to the local health departments in each area.
Maternal Mortality Survey
As in the past, this annual study is a joint undertaking of the Medical Association of Georgia and the Georgia Department of Health. The Divi sion of Information and Statistics transmits relevant death certificates, which are copied by clerks in this division onto the standard questionnaires provided by the Children's Bureau. These questionnaires are mailed to the physi:::ians who submitted the original death certificates. Where a physician was not in attendance, the questionnaire is mailed to the county or regional health director. The individuals investigating and completing the questionnaire forward them directly to the chairman of the Maternal Mortality Committee of the Medical Association of Georgia. Delays and delinquencies are followed up by regional and local health departments, according to procedure established by the Committee.
On the completion of a year's compilations, the Maternal Mortality Committee analyzes these records and submits a report to the spring meet ing of the Medical Association of Georgia, which is subsequently published
in the f ournal of that organization.
Hospital Survey
The division cooperated with a Committee of the Medical Association of Georgia in securing a moderately detailed survey of hospitals through out the State. The information gathered is useful not only to the Depart ment of Health and the Hospital Committee of the Medical Association, but likewise has been made available to the Emergency Medical Service of

iV!aternal and Child Health

61

the State Office of Civilian Defense. A large exhibit was prepared by the Committee and displayed at the annual meeting of the Medical Association of Georgia. Subsequently the exhibit has been presented and discussed at various district medical society meetings.
SPECIAL EDUCATIONAL ACTIVITIES
Members of the maternal and child health staff continued active par ticipation in numerous statewide and local educational efforts. Field trips were made in response to invitations to appear on forums in the series on Public Affairs, and to speak to a varied assortment of civic clubs and other public assemblages. Presentation or loan of motion pictures played a considerable part in these activities.
Participation in Planned College Curricula
Divisional staff members continued their regular assignments in the health education courses at the University of Georgia, the Georgia State College for Women, and the Martha Berry Schools. Single lectures were delivered at other colleges.
Lectures on maternal and child health and on the public health aspects of nutrition were given as part of the course in public health in the medical schools of Emory University and University of Georgia. In both schools these courses are given to the third-year classes.
Professional Education
Participation in public health courses in schools of medicine has been referred to, as have the activities of the nutritionist in courses for teachers and home economists in various schools and institutes. Cooperative work with the Medical Association ot Georgia and the Georgia Pediatric Society as regards hospital surveys, mortality surveys, and special emphasis on the care of premature infants, resulted in the presentation of numerous discussions and exhibits to State, district, and local medical societies. In addition to this, the motion picture loan service to medical societies was continued. Most of the subjects were obstetrical.
In-service education embraced the annual nursing institutes and the quarterly regional conferences held in each of the six subdivisions of the State. As previously mentioned, the entire program of the nursing institutes, held in five cities, was devoted to demonstrations and discussions on the care of the premature infant. Many nurses from nearby hospitals attended these institutes.
At a number of the quarterly regional conferences, sessions were devoted to a discussion of maternal and child health subjects. An excellent opportunity was provided to discuss mutual problems and all phases of the program, with exchange of ideas among all categories of personnel.
Publications
The widespread dissemination of literature for both professional and lay use has continued. The current accumulation of material was augmented by new items prepared by the division, or adapted from other

62

Georgia Department of Public Health

sources. Bulletins, pamphlets, posters and exhibits were distributed direct. ly through local departments, and through numerous voluntary agencies, to a numerical extent in excess of any preceding year. Further reference is made only to new or revised publications.
The Georgia Baby Book was completely revised and brought up to date. Several new chapters were added. Sufficient booklets were printed to provide an estimated two years' supply. Similarly, the publication, Maternal Care was revised and a two years' supply printed.
Previous mention has been made of a bulletin outlining standards for quarters and equipment of maternal and child health centers, which was issued during the year. Preparation of a Maternal and Child Health Cen. ter Manual relating to organization and procedures, progressed but not to the point of completion.
A new booklet outlining recommended home delivery supplies was published for the use of physicians and local health departments who wish to develop a delivery pack service.
In connection with the program of care for premature infants, pamphlets on the subject were purchased and supplied to physicians, hos. pitals, nurses, and public health staffs. The two compends on obstetrics and one on the newborn infant, previously distributed by the division, were again supplied to medical schools and to private physicians requesting them.
The publications on nutrition were augmented by the addition of seventeen new bulletins, referred to in connection with that program.
"Georgia's Health"
This monthly bulletin of the department completed its twenty-first year of continuous publication. The Director of the Division of Maternal and Child Health has been the editor of this bulletin since its inauguration. More than 1,500 new names were added to the mailing list during the year, bringing the circulation to approximately 26,000 copies per month. Copies of the bulletin go into every county and nearly every town in the State. From the repeated requests for additions to the mailing list, and the very large number of requests for reprints or additional copies, it is evident that the bulletin is widely read.
Scientific Meetings and Publications
Staff members attended the State Medical Association meeting, numerous district and county medical society meetings, and over twenty meetings of various associations devoted to subjects relating to child hygiene, nutri tion and dietetics, within the State. One or more staff members participated, either formally or informally, in the program at nearly all of these meetings.
Out of State meetings included the National Conference of the Children's Bureau and the National Conference on Nutrition, both held in
Washington, D. C. Numerous meetings devoted to the subject of civilian
defense were attended by the Associate Director, who serves as Assistant

Maternal and Child Health

63

to the Director of Emergency Medical Services of the Georgia 0. C. D., a position occupied by the Director of the Department of Public Health.
An article was contributed to each of the following: The Child, monthly publication of the Children's Bureau, and The Mother, monthly bulletin of the American Committee on Maternal Welfare. These articles, prepared by the Associate Director, deal with the nutrition program in Georgia, and the Georgia midwife, respectively.
NATALITY AND RELATED MORTALITY
The following table shows, for the State at large and by color, both the number and rate of live births, stillbirths, maternal deaths, total infant deaths, and deaths within the first month of life, covering the calendar year 1941.

Item

Total

LIVE BIRTHS -Number_ ______________ 67,785 Rate per 1000 population___________ 21.6
STILLBIRTHS - Number_ _____________ 2,903 Rate per 1000 live births____________ 42.8
MATERNAL DEATHS- Number_ _______ 315 Rate per 1000 live births____________ 4.6
INFANT DEATHS- Number_ __________ 3,955 Rate per 1000 live births____________ 58.3
NEONATAL DEATHS- Number_ _______ 2,298 Rate per 1000 live births____________ 33.9

White Colored

41,277 20.1
1,276 30.9
133 3.2
1,988 48.2
1,228 29.8

26,508 24.4
1,627 61.4
182 6.9
1,967 74.2
1,070 40.4

Live Births
The year's total of 67,785 live births represents an increase of about 5% over the number of births reported the preceding year. The birth rate, 21.6 per thousand population, is approximately 4.5';{ greater than for the year 1940. This indicates a slight trend upward in natality over the almost stationary situation of the preceding three years.
Stillbirths
The reduction in number, and particularly in the rate, of stillbirths is gratifying indeed. This marks the fourth consecutive year of consistent decline in the stillbirth rate and establishes another new low for the State.
The 1941 rate of 42.8 is about 10 per cent lower than the precedin~ year, and represents a reduction of more than 25 per cent from the 1937 rate (57.4). There are 774 fewer stillbirths reported for the current year than for 1937, despite the fact that total births had increased by three thousand. It is reasonable to consider this a reflection of the accelerated public health activities dating back to 1936.

64

Georgia Department of Public Health

Maternal Deaths
Progress is again reflected in the establishment of a new all-time low rate for the fourth consecutive year. For the first time in the history of Georgia, fewer than five mothers died for each one thousand live births reported. The current rate of 4.6 is lower than that for the preceding year by more than 13 per cent, and represents a reduction of about 38% from the 1937 rate (7.4).
During 1941, 156 fewer maternal deaths were reported than for 1937, despite the fact that total births had increased by three thousand. The consistent four-year reduction in maternal mortality is part of an established trend of more than a decade.
Infant Deaths
The infant mortality rate of 53.3 is approximately the same as for 1940, showing an increase of less than 1%. There has been no appreciable change in this rate since 1939. The current rate is about 14% lower than that experienced in 1933.
Deaths of infants within the first month of life continue to embrace a large proportion of all infant deaths (53%). There has been no significant change in neonatal death rates in the past two years. The present rate of 33.9 represents a decrease of about 3% from the rate for 1938.
The high numbers and rates of neonatal and total infant deaths among Negroes are apparent in the table. Despite continual increases of infant health activities, the reflection in mortality statistics leaves much to be desired.
Ten-year Rates by Counties
In the accompanying table are shown, for each county, and for the State at large, the maternal mortality and infant mortality rates per thousand live births, over the ten-year period 1931-1940. Also shown is the percentage of births attended by midwives covering the same period. The counties are listed in the order of magnitude of rates for each of the three items.

J~laternal and Child Health

65

MATERNAL MoRTALITY, INFANT MoRTALITY, AND PERCENT MIDWIFE
DELIVERIES BY COUNTIES FOR TEN YEAR PERIO:Q 1931- 194.0
(Counties Are Listed According to Magnitude of Rates)

MATERNAL MORTALITY

(Per 1,000 Live Births)

State -------------- 7.<17

County:

Rate:

Schey --------------- 21.3<1 Lanier ______________ 17.43

Long ---------------- 16.25
Spalding ------------ H. 66 Ben Hill ------------- 13.'18
Brantley ------------- 13.29 Ware ---------------- 12.72
Thomas ------------- 12.36 McDuffie ____________ 12.18

Lowndes

11.85

Chatham

11.75

Candler ------------- 11.27

Grady --------------- 11.23

Richmond ------------ 10.87

'l'lft ---------------- 10.41 Seminole ------------ 10.09 '.} Muscogee ------------ 10.07 :..'! Liberty ------------- 9.86 . Decatur ------------- 9.83
J>vans --------------- 9.83 Stewart ------------- 9.77 Randolph ----------- 9.60 relfair ...... ----------- 9.57

Laurens ------------- 9.'18

1 Pulasld ------------- 9A2

Toombs --------------- 9.31
1
Hall ----------------- 9.21

'freutlen ------------- 9.21 Dougherty __________ _ 9.19

Lee ----------------- 9.15

Echols

9.11

Lamar -------------- 9.10

Clay __ -------------- 9.09

Clinch

9.01

Glynn

8.96

Macon

8.95

Wilkes

8.91

Morgan

8.88

~rroup --------------- 8.87 Webste ------------- 8.85

Clarke

8.82

Jenkins -------------- 8.79

Jasper

8.78

liouston ------------- 8.61

Peach --------------- 8.56

Polk ---------------- 8.55

~.,j Bryan

8.48

.. Talbot

8.'17

INFANT MORTALITY

(Pe1 1,000 Live Births)

State ---------------- 66.29

County:

Rate:

Liberty ______________ 115.07 Lee _________________ 102.26

Peach --------------- 97.17 'l'ift ----------------- 96.58 Spalding ------------- 91.36 Mcintosh ------------ 92.30 Effingham ----------- 90.82 Bartow -------------- 90.15 Blecl<ley ------------- 89.78 Crisp --------------- 87.37 'l'albot -------------- 81.75 Heard --------------- 84.62 Candle1 ----------~-- 84.02 Worth --------------- 83.06 Barrow -------------- 82A~!
Lanier --------------- 82.'11 Jones ---------------- 82.28 Terrell __.. ___________ 81.99
Grady _______________ sun
'l'homas _____________ 80.51

Bacon __ ------------- 80.17 Richmond ___________ 79.96

Pike ---------------- 79.91 Schley -------------- 79.81 Clarl<e -------------- 79.54 'l'rOUjl --------------- 79.35 Calhoun ------------- 79.33 Will<inson ----------- 78.58
Bibb ---------------- 78.18 Macon ----------- ..... 77.39 Chatham ------------ 75.37 li'loyd --------------- 75.30 whitfield ------------- 74.28 Greene -------------- 74.12 Mitchell -~---------..- 73.'15 Taliafel'l'o ----------- 73.26 Upson --------------- 73.21 Screven ....___________ 73.00

Union J,amar

... ------------______________

1722.8.sa1

Bryan -------------- 72.79 McDuffie ------------ 72.1l0 Oconee -------------- 72.29 Decatur ------------- 71.82 Oglethorpe ----------- 71.48 Fannin ------------- 71.45 Pierce --------------- 71.17 Putnam ------------- 70.48

MIDWIFE DELIVERIES (Pe1 1,000 Live Births)
State ---------------- 38.6<1 County:

Twiggs -------------- 87.43

Stewart ------------- 86.()1

Lee ----------------- 85.95

Hancocl< ------------- 85.17

Bal<er --------------- 8<1.08

Calhoun ------------- 84.06

Camden ------------- 83.81

Burl<e --------------- 83.01

Clay ---------------- 83.01

Quitman ------------- 81.71

Terrell -------------- 8!.65

'l'albot --------------- 81.26

Mclnt0sh ------------ 80.63

Harris ---------- ____ 79.8<1

Jefferson ------------ 79.12

Taliaferro ------------ 78.58

Crawford ------------ 78.55

Early

78.5<1

l\I:tcon

78.23

)!iller

78.20

.Jones

76.29

Putnam _____________ 75.'13

Handolph ------------ 7fi.OS Sumter -------------- 73.70 Webster ------------- 72.83 Schley -------------- 72.<11 Pnlasl;i ------------- 70.53 i\!Olll'Oe ------------- 69.71 Wanen ------------- 69.60 Washington ---------- 69.56 Houston ------------- 69.29 Columbia ------------ 69.25 Morgan __ ----------- 68.62 Libel'ty -------------- 68.55 Will<es ______________ 67.54

Charlton ------------ 66.67 1Iitchell ----------- ..... 66.25 McDuffie ------------ 66.18
Dooly --------------- 66.H Marion -------------- 65.50 Baldwin ------------- 63.51 Brool<s -------------- 63.50 Will<inson __ --------- 63.49 1Iontgomery --------- 63.<13 Blecl<ley __ ----------- 63.02
Henry --------------- 62.92 'l'aylor -------------- 62.72 Jenkins ______________ 62.65

66

Georgia Department of Public Health

MATERNAL MoRTALITY, INFANT MoRTALITY, AND PERCENT M'DWIFE DELIVERIES BY CouNTIES FOR TEN YEAR PERIOD 1931-1940-Continued
(Counties Are Listed According to Magnitude of Rates)

MATERNAL MORTALITY

(Per 1,000 Live Births)

County:

Rate:

INFANT MORTALITY

(Per 1,000 Live Births)

County:

Rate:

MIDWIFE DELIVERIES

(Per 1,000 Live Births)

County:

Rate:

Wayne --------------- HAO Glynn --------------- 70.37 Irwin --------------- 61.88

Mcintosh ------------ 8.39 Clayton ------------- 70.30 Bryan --------------- 61.'/0

CGlquitt ------------- 8.32 Jasper --------------- 69.79 Oglethorpe ----------- 60.89

Brooks -------------- 8.32 Rocl<dale ------------ 69.72 Pil\e ---------------- 60.86

Burke ---------------- 8.31 Stewart ------------- 69.70 Greene -------------- 60.36

Tenell -------------- 8.30 Fulton -------------- 69.62 Crisp --------------- 60.30

Emanuel ------------ 8.27 Long ---------------- 69.'12 Dodge ----------------60.12

Quitman ------------- 8.21 Polk ---------------- 69.09 Jasper -------------- 59.69

Dodge --------------- 8.13 Early --------------- 68.81 Johnson ------------- 59.40

Hancock ------------- 8.09 Sumter -------------- 68.41 Lo\vndes ------------- 58.'15

'l'attnall ------------- 8.08 l\lonroe -------------- 68.'10 Peach --------------- 58.00

Camden ------------- 8.03 Muscogee ------------ 68.12 Meriwether ---------- 57.83

Bibb ---------------- 7.99 Hall ---------------- 67.79 Decatur ------------- 57.83

Mitchell ------------- 7.91 Emanuel ------------ 67.6'1 Seminole ------------ 57.81

\Vai'l'en ------------- 7.88 Crawford ------------ 67.07 Lamar -------------- 56.12

Franldin ------------ 7.87 l\Iarion -------------- 66.10 Wilcox -------------- 55.25

Jefferson ------------ 7.87 Walton -------------- 65.99 ~:rhomas ------------- 54.92

Sumter -------------- 7.84 Dougherty ----------- 65.30 Glascock ------------ 5'1.80

..

Banlm -------------- 7.80 Gwinnett ------------ 65.30 Elbert --------------- 5'!.66

Bulloch -------------- 7.79 Douglas ------------- 65.2'1 Lanier -------------- 5'1.36

Dooly --------------- 7.55 Gordon -------------- 65.03 Bacon --------------- 54.16

Habersham ---------- 7.55 Chattooga ----------- 64.9'1 Telfair -------------- 53.69

'faliaferro ----------- 7.51 Cobb ---------------- 6'1.91 Emanuel ------------ 53.66

Irwin --------------- 7.50 Seminole ------------ 6'1.87 Butts ---------------- 53.35

Coweta -------------- 7.'17 Carroll -------------- 6<1.79 IlJffingham ----------- 53.18

Baldwin ------------- 7.'15 White --------------- 6'1.73 Clinch ------------ -- 52.39

Johnson ------------- 7.'14 Evans --------------- 6'1.61 Heard --------------- 51.69

Montgomery --------- 7.'13 Turner -------------- 6'1.10 Fayette ------------- 51.00

Bacon --------------- 1.'11 Jeff Davis ----------- 6'1.0'1 Treutlen ------------- 50.09

Bartow -------------- 7.39 Montgomery --------- 63.97 Laurens ------------- ,19.9'1

'Walton ------------- 7.38 'fwlg-gs -------------- 63.9'1 Brantley ------------ '19.'19

Wheeler ------------- 7.36 Pulasld ------------- 63.71 Gilmer -------------- 49.29

Haralson ------------ 7.26 \'Vayne -------------- 63.29 Echols --------------- '18.63

Crawford ------------ 7.21 Toombs -------------- 63.21 Lincoln ------------- 48.09

Charlton ------------ 7.09 Lowndes ------------ 62.97 Oconee -------------- 48.05

\Vol'th --------------- 7.04 I-Ianis -------------- 62.79 Worth ---------------- 47.31

Calhoun ------------- 6.97 Newton -------------- 62.31 White --------------- '17.27

Screven ------------ 6.93 Webster ------------- 61.95 Ben Hill ------------- '17.20

Jeff Cris

pDa_v_is___-_-,-_-_-__-_-_-_-_-_-

6.82 6.82

Treutlen ------------- 61.81 Warren ------------- 61.80

Union --------------- '16.90 Appling ------------- <16.27

Berrien ------------- 6.78 Broolm -------------- 61.71 Rabun -------------- '15.15

Upson --------------- 6.74 Hart ---------------- 60.99 Wheeler ------------- <15.12

Henry --------------- 6.63 Pickens ------------- 60.82 Coweta -------------- 44.88

Pletce --------------- 6.63 Randolph ------------ 60.73 Pierce 4<1.81 -~-----------

Coffee --------------- 6.62 Ben Hill ------------- 60.33 Bulloch ------------- <1<!.59

Effingham -~--------

6.55

Camden ------------- 60.20

Dougherty ----------- 44.53

Carroll --------------- 6.53 Meriwether ---------- 59.95 Gmdy ---------------- 4'1.30

l\farion ------------- 6.51 i\forgan -------------- 59.59 Wayne -------------- '14.03

Monro" -------------- 6.50 Madison ------------- 59.44 Clayton ------------- 43.23

Maternal and Child Health

67

MATERNAL MoRTALITY, INFANT MoRTALITY, AND PERCENT MIDwiFE DELIVERIES BY CoUNTIES FOR TEN YEAR PERIOD 1931-1940-Continued
(Counties Are Listed According to Magnitude of Rates)

MATERNAL MORTALITY

(Per 1,000 Live Births)

County:

Rate:

INFANT MORTALITY

(Per 1,000 Live Births)

County:

Rate:

MIDWIFE DELIVERIES

(Per 1,000 Live Births)

County:

Rate:

Floyd --------------- 6.50 Chattooga ___________ 6.'19
Butts ---------------- 6AJ Clayton ------------- 6A<! ' Early --------------- 6.38 Oconee -------------- 6.33 \Yashington ---------- 6.35 : Rocl<dale ---------- 6.34 Glascoe!< ------------ 6.3'1 Pil<e ---------------- 6.21 Harris --------------- 6.20 ~feriwethet ---------- 6.20 Greene -------------- 6.18 Catoosa ____ --------- 6.01 Whitfield ____________ 6.07
Columbia ------------ 6.02 Barrow ------------- 6.01 Wilcox -------------- 6.01 Elbert --------------- 5.97 White --------------- 5.94 Cook ---------------- 5.92 Fulton -------------- 5.85 Will<inson ___________ 5.8'1
Douglas ------------- 5.11 Cherol<ee ____________ 5.63
Munay -------------- 5.60 Bleck!ey ____________ 5.53
Paulding ------------ 5.54 ~Paylor -------------- 5.33 Appling ------------- 5.30 Fannin -------------- 5.22
Xewton -------------- 5.07 Hart ---------------- 4.84 Gordon -------------- 4.70 Picl<ens ------------- 4.64 Heard --------------- 4.62 Cobb ---------------- 4.'18 Gilmer -------------- 4.42 Oglethorpe ----------- 4.34 Turner -------------- 4.33 Chattahoochee _______ 4.32
Jacl;son ------------- 4.30 DeKalb _____________ '1.21
~rowns --------------- 4.23 Fayette -------------- '1.21 Bal<er --------------- '1.18 l\Iadisoh ------------- 4.16 Atl<inson ------------ '1.13 Rabun ___ ----------- 3.51

Dooly --------------- 59.'12

Telfair -------------- 59.37 Wallm -------------- 59.26

Murray -------------- 59.22 Wilcox ______________ 59.07

Gilmer

58.80

Laurens

58.76

Berrien ------------- 58.75
Jad;:son ----------.--- 58.52 Jenkins ______________ 58.29

Baldwin ------------- 57.86

Franklin

57.69

Irwin --------------- 57.39

Stephens ------------ 56.'17

Colquitt ------------- 56.21

Banl;s --------------- 56.10 Charlton ____________ 55.95

Johnson ------------- 55.78 Catoosa _____________ 55.11

Elbett --------------- 55.60
Clinch -------------- 55.4'1 'l'aylor ______________ 55.31

Glascoe!< ------------ 55.25 Fayette _____________ 55.21

DeKalb -------------- 5'1.76 washington __________ 5'1.31
5'1.15
Houston ------------- 53.83 Habersham __________ 53.13 Brantley ____________ 53.69 Atldnson ____________ 53.64

Haralson ------------ 53.38 Wheeler _____________ 53.02

\Yare __ ------------- 52.98 Coweta ______________ 51.91

Hemy --------------- 51.86 \lay ________________ 51.75

Cherol<ee ------------ 51.26
Baker --------------- 51.15 Bulloch _____________ 51.07

Burke --------------- 51.00 '!'attnall ------------- 50.67 Quitman ------------ 49.24
Jefferson ------------ '19.19 \Vil!;es ______________ '19.01

Paulding ------------ '18.30 Butts _______________ 48.24

Lumpldn ------------ 18.24 ~!iller _______________ '18.19

Evans --------------- 13.19 ~Purner -------------- !2.63
Newton ------------- <11.69 Candler _____________ 41.65

Rocl<dale ------------ '11 .27 'l'oombs _____________ 41.17

Atldnson ------------ '10.74 Coffee _______________ 39.70

Murray -------------- 38.26
Ware ---------------- 38.25 Jeff Davis ___________ 37.38

Tift ----------------- 36.62 '!'roup _______________ 36.37

Long ---------------- 35.60
Madison ------------- 3'1.86 Cook ---------------- 3'1.21 Fannin -------------- 33.85 \Yalton -------------- 33.11 Dawson ------------- 32.96
Lumpldn ------------ 32.85 Spalding ------------ 31.39 Muscogee ____________ 31.18

Banl;s --------------- 31.17 Screven _____________ 30.73

Habersham ---------- 30.40 Colquitt _____________ 29.0'1

Clarlw -------------- 28.78 Bibb _--------------- 28.49 Chattahoochee ________ 28.39 Haralson _____________ 26.80

Upson --------------- 26.42
Franklin ------------ 26.28 Stephens ____________ 26.15

Fo1syth -------------- 2!.1<! 'l'attnall _____________ 22.29
Douglas ________ ----- 22.05 Glynn _______________ 21.61

'l,owns --------------- 21.24 Carroll ______________ 19.91

Jac!;son ------------- 18.98
Hart ---------------- 18.30 Gwinnett ____________ 18.16

Polk ---------------- 17.18

Barrow

16.96

Pickens

16.16

Berrien

16.57

DeKalb

16.31

Hall ---------------- 14.45 Cobb ________________ 14.40

68

Georgia Department of Public Health

MATERNAL MoRTALITY, INFANT MoRTALITY, AND PERCENT MIDWIFE DELIVERIES BY CouNTIES FOR TEN YEAR PERIOD 1931-194.0-Continuecl
(Counties Are Listed According to Magnitude of Rates)

MATERNAL MORTALITY

(l'er 1,000 Live Births)

County:

Rate:

Gwlnnett ___________ _ 3.'!6

Forsyth ------------- 3.38 l'nlon _______________ 3.29

Lumpldn

3.06

Stephens ------------ 2. 93

Putnam ------------- 2.86 Dade ________________ 2.7G

\Ya11<er ______________ 2.71

'Twiggs ______________ 2.56

Jones --------------- 2.43
l.Jincoln ------------- 2.28 Dawson ______________ 2.2<1 Miller _______________ 1.81

INFANT MORTALITY

(Per 1,000 Live Births)

County:

Rate:

Cofl'ee _______________ <17 .32 Appling _____________ 46.80 Dodge _______________ 45.13 Hancock _______________ ,1,1.80
Chattahoochee _______ <14.25 Dade __________________ 1'1.12
l:ehols ------ ________ <11.89 Hahun ______________ 40.73 Dawson _____________ <10.36
C'ook ---------------- 38.83 Lincoln _____________ ~:l.90 Columbia ___________ 34.71 Forsyth _____________ 32.71

MIDWIFE DELIVERIES

(Per 1,000 Lire Births)

County:

Rate:

Floyd _______________ 1<1.01

Bartow -------------- 13.74 Whitfield ____________ 13.20
Dade ________________ 13.14

Paulding ____________ 12.59

Gordon -------------- 11.87 Chattooga ___________ 10.39

~Nall-i:er -------------- 9.90

Cherokee

9.77

Chatham ___________ _ 9.24

Richmond __________ _ 8.9<1

Catoosa

8.'!<1

Fulton ______ ________ 3.08

ANALYSIS OF LOCAL MATERNAL AND CHILD HEALTH ACTIVITIES
Tne accompanying table shows a statistical summary of local activities related to the maternal and child health program. This compilation includes the performances of State subsidized maternal and child health centers, with the addition of activities in nonsubsidized centers and of local personnel outside of health centers. The percentage of decrease or increase in volume as compared with the preceding year, is shown for each item. With but few exceptions, all activities show considerable increment. This is due principally to the extension of health unit or nursing service to areas recently unserved.

Immunizations

Smallpox ________________ . ---------- _____ . _ ___ __
Diphtheria : Under 1 year__________________________________ 1 through '1 years______________________________ 5 years and over_______________________________

1941 7<1,530
12,732 18,835 12,027

Maternity Service Admissions to prenatal medieal service_____________ _ Admissions to prenatal nursing se!'vice _____________ _
Yisits to medical conferences ---------------------I~ield and office visits _________________ ------------Cases given postpartum medical examination________ _
Yislts to postpartum cases-------------------------Cases attended by nurses for delivery service_______ _ Cases admitted to postpartum nursing service_______ _ Yisits for midwife SU!lervision _____________________ _ Attendance ______________________________________ _

19,250 2<1,588 62,616 92,501
3,081 43,319
398 17,921
5,037 1,993

%+orover 1940
2%
+ 9%
+ 6% -15%
+ 16%
+ 16%
+ 19% + 20%
+ 6% + 25%
+ 1% + 20% + <lo/o
+ 8%

JV]aternal and Child Health

69

Infant and Preschool Hygiene Infants: Admissions to medical service_______________________ Admissions to nursing sel'vice________________________ Visits to medical conferences ______________ --------Field and office nursing risits______________________
Preschool: Admissions to meclieal serrice ___ ____________________
Admissions to nulsin~; service______________________
Visits to medical conferences----------------------Field and office visits______________________________

11,340 27,303 25,281 80,6<13
13,622 23.658 21, 711 61,8,!0

School Hygiene Examinations l.Jy physicians________________________ Examinations by l)hysiciaus-parents present________ Field nursing visits________________________________ Offiee nur..-;ing visits __________ -----------------~--Inspeetlons L.r dentists or dental hygienists__________

96,775 3,74<1 31,800 20,133 91,202

+ 12% + 9% + 11%
-1- 2fio/c
+ 4'lc
-1- 5lfc -1- 3'/c
+ H7
- H% -1- 29% - '!%
+ 5/o
- l3'1c

Immunizations
lVlore than 74,500 immunizations for smallpox were reported. Were there reasonable assm:ance that extensive protection against this disease had accumulated over the past twenty years, this number of vaccinations would represent an appropriate annual maintenance accomplishment. Unfortunately, that assumption is unwarranted. While the decline of 2% from the number o immunizations of the preceding year is negligible, it is nevertheless true that protection against smallpox accumulates at less than a safe pace.
Increases of 9% and 6%, respectively, in the number of immuniza-
tions against diphtheria for individuals under one year of age, and from one to four years, accompanying a 15% decrease in such immunizations o older children, represents a distinctly advantageous shift in age emphasiE. The 12,732 infants receiving toxoid corresponds to 20% of the estimated number of infants surviving the first year of life. Considering the portion of the population as yet unserved by local health facilities, this seems a fair degree of accomplishment. Nearly 19,000 immunizations of children from one to four years of age constitute an additional margin of protection.
lvlaternal Health Services
There was a remarkable increase in these activities, particularly when the large volume of work reported during 1940 is borne in mind. Admissions to prenatal medical and nursing services increased by 16/'o, and prenatal visits to clinics increased 19%. Antepartum nursing visits increased 20%, and postpartum visits by 25%. An increase of 20% in admissions to postpartum nursing service is an excellent accomplishment.
Postpartum medical examination remains one of the weakest points in the maternal health program. Despite the fact that postpartum examinations increased by 6% in the current year, this still represents a proportion less than 16% of those admitted to prenatal medical service, and only 17% of those receiving nursing care postpartum.

70

Georgia Department of Public Health

Infant and Preschool Services
All of these activities showed a distinct increase over the preceding year, admissions of infants to medical service increasing by 12%, those to
nursing service by 9%. Visits to medical conferences showed an ll%
increase, while nursing visits were 25% more numerous. Similar items of preschool activities showed smaller increases, varying from 3% to 14%.
School Health
Examinations by physicians and inspections by dentists declined 1LJ/7o and 13%, respectively. In view of the vacancies in health officer positions, and the effect of mobilization on the number of physicians and dentists, these decreases are expected. An encouraging aspect of school health activities is the increase of 29% in the number of examinations with parents present.

TIFT COUNTY MATERNAL HEALTH DEMONSTRATION
The demonstration in nursing delivery service was continued on the basis of plans previously outlined. The adoption of new policies which permitted the Health Department to discontinue supplying linens and supplies for home deliveries has proved most satisfactory. The physicians readily agreed to supply those items which they use in the home, with the exception of such materials as are secured by the patient. During the year the physicians continued to use the intrapartum nursing service for practically all of their patients, and there is evidence of an increase in their referral of private patients to the Health Department for prenatal nursing service.
It has been decided that the demonstration has been in operation a sufficient length of time to provide information for its evaluation. In view of the fact that such a service is not considered feasible in other areas, and because the preparedness program d~mands the efforts of all public health nurses that can be mobilized, it was decided to discontinue the demonstration as of December 3], 19L1l. The local board of health has agreed to retain three public health nurses for a generalized program. The local Health Department has agreed to retain as many phases of the maternal health program as possible, with the exception of the home delivery service itself. The midwives will continue to report their cases ancl will be super. vised. The physicians will continue to Teport their private cases to the Departmenf for nursing service, and sterile packs for home deliveries will continue to be sterilized in the Depm'tment for use by physicians in home deliveries.
A complete report of activities for the four years during which the demonstration has been in operation, is now being prepared for publication. An attempt will be made to evaluate the service in all of its phases, and to summarize the activities in such a way as to reveal the shortcomings as well as the accomplishments of the project.

Maternal and Child Health

7l

Statistical Summary
For the current year, activities of the Tift County Health Department are included in the general compilation for the State. Data relative to the demonstration phase of the 1941 program follow.

Live births ------------------------------------------Stillbirths -------------------------------------------Maternal deaths ----------------- ____________________ _
Infant deaths ____ ------------------------------- _____ _ Deaths under I month----------------------------------

Total 439
23 3
2<1 15

White 280 18 2 H 7

Colored 159 5
10 8

l\Iaternity Admissions:

462

'!'otal births in county ______ ----------------------------------------------------- 462 Admissions to nursing service____________________________________________________ 416

Admissions to medical service---------------------------------------------------- 3<16

PERIOD DF GESTATION DN ADMISSION TO PRENATAL MEDICAL AND/OR NURSING SERVICE

Cases

Month of Gestation

Under

5th

5th

6th

7th

8th

9th

lOth

Doctor's ---------- 36

25

38

56

53

31

28

Clinic ----------- 33

31

24

21

16

6

Total -------- 69

56

62

77

69

39

31

Total 267 139
406

Physicians' Cases Receiving Nursing Delivery Service: \Vl1ite --------------------------------------------------------------------- 250 Coloreel __________________________________________________________ ----- __ __ _ 20
Total ____________________________________ ------------------------------ 27 0 Cases receiving pituitrin to 3rd stage__________________________________________________ 95 Cases recei ring pituitl'in in 3rd stage and postpartum only----------------------------- 18 Lacerations, .first and second degree__________________________________________________ 29 Lacerations, third degree------------------------------------------------------------- 0 Analgesia andjor anesthesia -------------------------------------------------------- 191
Chloroform __ ___ _____ ____ ______ ____ __ ________ ____ ____ __ ________ __ ____ ___ ____ 18 '1
Ether ---------------------------------------------------------------------- 12 Postpartum Nursing Service Covering All Confinements:
Total patients receiving postpartum visits----------------------------------------- 411 Patients receiving mo1e than 3 postpartum visits----------------------------------- -'17 Patients receiving 3 postpartum visits--------------------------------------------- 353 Patients receiving 2 postpartum visits onlY---------------------------------------- 21 Patients receiving one postpartum visit onlY--------------------------------------Prenatal Syphilis Cases with 1\nown posltire serology----------------------------------------------- 42
Treatment: 0- 7 injections___________________________________________ 18 8-12 injections------------------------------------------- 16
13 or more injections------------------------------------------- 8
42

72 .

Georgia Department of Public Health

Outcome of above pregnancies: Abortions ------------.---------- ________ ________________ _ _________ _

Stl!lbirths ------------------------- ---------------------------------- 2
Neonatal deaths ----------------------- _-----------------------------Live births and 1 month surri;-aL____________________________________ 37

42

HANCOCK COUNTY NUTRITION AND CHILD HEALTH DEMONSTRATION
Much time was devoted to program planning and reallocation of effort, resulting in the preparation of a detailed written description of future plans and schedules for this demonstration unit.
The health center building was completely remodeled and redecorated during the fall of 1940 and the spring of 194.1. The changes provide more space, more attractive rooms and better equipment. This remodeling was made possible through the expenditure of local funds, and the cooperation of theN. Y. A.
A small laboratory was installed in the health department building for the purpose of determining the content of blood as it relates to meas urements of nutrition for those families who are participating in the gardening program.
A full-time garden supervisor was added to the staff. His work was chiefly concerned with those families who are participating in the garden ing project. Arrangements were made whereby seeds, fertilizer and insecti-
cides will be made available during the coming year. A compulsory rabies immunization program was adopted, as a result
of the rabies epizootic among foxes.
A conference, attended by national, state and local nutrition leaders, was held in the demonstration office in February. As an outgrowth of this conference, personnel was supplied from the Bureau of Home Economics, United States Department of Agriculture, for anthropometric measurements on 700 white school children.
School Lunchrooms
All white school lunchrooms were brought up to WPA standards as regards sanitation and equipment. The funds for this improvement came from the County Board of Education. Every white school child in the county may now secure a hot lunch for five cents, or the equivalent in produce. Younger children unable to render service for their lunches are served free of charge. At present an attempt is being made to provide one half of the children's daily food needs at the noon hour when school lunches are served. Labor for the lunchrooms is supplied in part by P. T. A. members. In addition, they donate $10.00 each month for operating costs.

iVlatemal and Child Health

73

Special emphasis was placed on the lunch programs in colored schools. At the close of the year, twenty-nine of the forty-three colored schools had constructed buildings for lunchroom purposes, or had remodeled other rooms for the purpose. A Jeans worker played a large part in this transition in the Negro schools. TheN. Y. A. has furnished cooks for the two-teacher schools, while the one-teacher schools have to depend largely upon the teacher assisted by her pupils. Twelve school gardens have been planted, and the vocational agriculture teacher and county agent are superintending these projects.
Nutrition Snrvey
A nutrition survey of colored school children was made by the questionnaire method, using the minimum standard allowances recommended by the National Nutrition Conference as a basis. This surve-, showed the following findings:

Item
:\!ilk ---------------------------------------Yegetables ~------------------- _ -----------~~ruit _ --------------- ----------------- __ - _______ _ Pot a toes ____ ___ ________________ ------- ______________ _

Perfect Score
:W
..: I~
Iii

Eggs _______ "---------- --------- ---- "-------- "------ 10

:\lent ______ ------------------------------------------- 10

Butter -------------- ----------- -- ----- --------------

a

Whole gmin ________________ -------------------------- 10

\Yater ____ ---------- ---------------------- --------

Avg. Score on I 000 Question nairas 8.3 10.9 6.6 tf.2
2.0 tUJ 2.6 6.9 5.0

This gives composite average score of 56.2 for the 1,000 students reporting for seven days' food intake (a total of 7,000 child-days).
While this can not be taken as an accurate index of the food intake of this group, it certainly indicates a serious shortage of protective foods in its diet.
Further analysis of these surveys shows that:
16.2% of the 1,000 students drank no milk i12.L1% had less than one pint daily average 31.0% had one pint to one quart for a daily average 10.4% had an average of one quart or more per clay

100.0%
2.9% of these 1,000 students scored nothing in vegetables 40.0% scored less than 10 in vegetables L13.5% scored from 10 to less than 20 in vegetables 13.6% scored "required" amount daily in vegetable diet

100.0%

Georgia Department of Public Health
These records further show that 6.L1% of 'these children had no eggs at all during the week surveyed,
. Further statistical analysis of these figures has not been done because of lack of clerical help. It would be of interest to separate the data into the school lunch group and non-school lunch group.
Public Cooperation
The lay committee has devoted its efforts largely to volunteer service in maternal and child health centers and to promoting activities concerned with Child Health Day. The committee was awarded the health cup by the State Parent-Teacher Association for their outstanding school health program.
Two portable tuberculosis cottages were constructed by the N. Y. A. Materials were supplied by the county commissioners.
The Sixth District Medical Association meeting was held in the Health Department offices, and review of activities of the Demonstration was a part of the program.
Statistical Report
An analysis of activities reported for this demonstration area reveals that considerable progress has been made. There are, however, weaknesses in the program that should be strengthened, provided additional personnel can be made available in this area.
Admissions of communicable disease cases to medical service do not compare favorably with their admissions to nmsing service. Although the number of persons immunized exceeds that for the preceding year, there is need for further emphasis on diphtheria immunization to infants.
Admissions to prenatal medical service are equivalent in number to those individuals served by midwives. The number o.f visits by prenatal cases to medical conferences averages about two per admission. Field visits to prenatal cases average only about two visits for each three admissions to medical service. The postpartum medical service is inadequate; midwife meetings are infrequent and attendance does not exceed the average for other aieas.
Admission of infants and preschool children to medical service is fairly satisfactory. However, visits by these individuals are inadequate when compared with admissions. Visits average about two per year for each admission. Field visits to infants and preschool children exceeded field visits to expectant mothers. The school hygiene program receives more attention in the demonstration area than in most other counties. Examinations of school children by physicians with parents present, reveal that there is definite parental interest in the program.
Complete reports of departmental activities are included in the compilation for the State at large. Special phases of the Demonstration efforts include the following:

Maternal and Child Health

75

SUMMARY OF STATISTICAL ACTIVITIES

Prenatal Clinic Services
Admissions to prenatal medical service: White ---------------------------------------------------------------------- 16 Colored _____ --------------------------------------------------------------- 348

Total ---------------------------------------------------------------------- 364 Pel'iod of gestation at time of admission:

Under 16 weel'"------------------------------------------------------------- 88

16-27 weelm

175

28-36 weel<s ---------------------------------------------------------------- ~6

36+ weel<s ----------------------------------------------------------------Serologic re]Jorts:

Positive 1'\egative

White 0
11

Colored 9
3<10

Total 9
351

'l'otal ----------------------------------------- 11

3<19

'Total number antiluetic treatments__________________________________________

Avel'age number of treatments per prenatal syphilitic______ --------------------

':l'otal nmnber of visits to prenatal medical conferences________________________

Number of toxemias---------------------------------------------------------

360 67 7.44 739
25

Postpartum Clinic Services Postpartum examinations --------------------------Visits to postpartum clinics ________________________ _

White 3 3

Colored 63 70

Total 7l 73

Prenatal Group Instruction Number of maternity classes held________________________________________________ 106 Average attendance per session___________________________________________________ 22
Number of mothers enrolled------------------------------------------------------ 382 Demonstration of preparation for delivery, layette, diet, baby's toilet tray, and
baby's bed

Infant and Preschool Hygiene:

Number visits to Inedical conferences--------------------------------------------- 955 Average attendance per session--------------------------------------------------- 19 Number of admissions to medical service:

White --------------------------------------------------------------------- 69

Colored

4<17

'l'otal ---------------------------------------------------------------------- 516 Age on admission :
Under <1 months------------------------------------------------------------- 1<12 <1-12 months --------------------------------------------------------------- 102 1-5 years ------------------------------------------------------------------ 272 Immunizations: Diphtheria, under 1 year----------------'------------------------------------ 19<1 Diphtheria, over 1 year_____________________________________________________ 177
Diphtheria, total ----------------------------------------------------------- 371 Smallpox inununizations ---------------------------------------------------- 90S ~ryphoid Immunizations ----------------------------------------------------- 1,15H Nursing service: Number of admissions to nursing selvice________________________________ ------ 787
Demonstrations: Preparation of cereals, vegetables and formula

76

Georgia Department of Public Health

.Preparation of food for infants---------------------------------------_

1:!

X umber held --------------------------------~~--~ ~--~----~--~~----~ --~-~~~~ 42

'1~otul attendance -------------------------------------------------- -------- 3-1~

Average attendance per session____________ ----------------------------------- 31

School Activities

Xumber children examined:

White ~ ~ ~ ~~ ~ ~ ~ ~ ~~ ~ ~ __ ------ ~- -- __ ---------- ~ ~ ~

427

Colored

98t

Total ~ ~~ -~~~~~----------------------------~-- _________________ ~ ~~~ ~-- ______ 1,409

?\umber children examined with parents 11resent:

White -~--~-----~- -~------------------------~-~~~ -----~-~~~~~- ___ ~~~~~ -~~~~ 1 oo

Colored

137

Total ________ ------------------------------- ~ ~-~~-------~~ ~-~~-- _~~ ~ ~ ~~-- -- 237

Dental inspections -----------~------------------- __________ -~~----~-~~- -~-- ~~---

0

Per cent with defects--~----~------~~--~~~~-------~ ____ -~~ _____ ~--------~-_~~~~ __ _

~~umber receiving dental corrections ______________ ----------------------- _______ _

~umber children examined for nutritional study _____________ ______-:.._______________

0

Xumber tallm to school children ____________________ ~~--~~~~~~~~~~~~~~~~~~~~~~~~~~ 48

Total attendance -~~~~----~~ ---~--~-----------~------- ______ ------------------~~ 1, !86 Comments: 'l~hese tn1l\s were made in the schools by the nurses just prio1 to school

examinations

Health Education Health Officer: 1. Conferences with physicians~~~~~~~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 3-15 2. Consultations with physicians__________________ ------------------ _________ 130

3. Talks to lay groups ____________________ ---------------------------------- 25 Total attendance ~~~~~~~-~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~-~~~ ~~~~~~~~~~ 1,364
11. Motion pictures shown _______________ ------------------------------------ 6

Total attendance ----------------------- _____ --------------- _____ ______ 750 j_ Conferences with individuals____________________ ------------------ ______ 6:30

~urses:
1. Conferences \Vith lay groups______________________________________________ ~I

2. Home hygiene classes~~~~~~~~~~-~~~~~-~~~~-~~~~~~~~~~~~~~~~~~~-~~-~~~~--~~

Total attendance -~--~~--~~--~~~~~~-~~~~--~~~~~~~~~~~~~~~~~~~~~-~--~~~~-~ 90

3. Tallm to lay groups~~-~~~~~~~~~~~~~~~-~~~~~~~-~~~~-~~~~~~~~~--~~~~~~~~~~-~ 19

Total attendance

923

School Luncheon Projects:

X umber children en!'Olled in schools:

White ~~~~~ ~~ ~~~~~~~-~~ _~~~~~~~~-~ ~~- ~~~ ~ ~~ ~ ~~ ~ ~ ~~~~~~-~ ~~~ ~~~~~~ ~~~~~~~ ~~ 2,3 00

Colored ~~~~~~ ~~~~~~~ --~~~--~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ -~ -~~~~~~~~~~ 5,515

::\umber children rerei dng hot lunches:

White ~--~~~--~~~~---~--~~-----~----~-~---------~~--~~~~--~-~~--~~~~~~~~~~ 15,638

Colored --~--~-----~~~~~~~-~--~~~-~~--~~-~~~~-~~~~~~ ~ ~~~~~-~~~ ~~ ~~~~~ ~~~~~

58 7

Xumber school gardens cultivated for luncheon purposes__________________________

lT

F. S. A. Group: Number pl'ivies installed for F.S.A. families __ ~~~~~~~-~~~~~~~~~~~~~~~~--~~~~~~~~ Sumber gardens cultivated by F.S.A. families~~~~~~~~~~-~~~~-~~~~~-~---~---~-~~ Number quarts food canned~~---~~~~~~~---~---~~~~~~~~~~~~-~~~~~~~~~~~--~~~~~~ Sumber cows secured for these families________________________________________
So. demonstration in food preparation or preserYation _____ ---------------------

13 655 21,088 41
:?fl

Home Demonstraticn Agent: S umber demonstrations held~---~~~~~~~~~~-~~~~~---~--~~~~~~~~~-~~~~--~~~~~~~~~~~ 162 Total attendance -~~~~~~~--~~~~~~~~~~~~-~~~~~ -~~~~-~~~~~~~~~~~~~~~-~~~~~~~~~ 2,308

Maternal and Child Health

77

Xumber of clubs ________________________ ------ __ -------------------------------- 47 ~rota! number of meetings___________ __ ------------------------------------------- 158
'otal attendance ----------------------------------------------------------,- 2,315 ~umber of individuals starting garden projects ______ ------------------------------ 800 Nmnber families who have milk cows_____________________________________________ 825
Farm Agent: Number meetings with farmers___________________________________________________ 33 Total attendance ---------------------------- ___ _______ _____________________ 87<1 Number demonstrations in gardening_____________________________________________ 12 ~umber conferences with farmers------------------------------------------------ 791
Vocational Teachers: Number classes 11eld___ _____ __ __ ___ ____ ___ ____ ___ __ ____ __ __ __ _____ ____ ____ ____ __ _ 1,425
Total attendance ----------------------------------------------------------- 86<1 Subjects taught: Home Economics and Vocational Agriculture.

Division of Dental Health Education

J. G. Williams, D.D.S., Part-time Director

Annie Taylor

Educational Director

During the year l9i1l the Division of Dental Health Education has worked toward the following objectives:
l. Dental Health Education for children and adults.
2. Correction of dental defects for those able to afford dental care.
3. A plan to provide dental care for children whose families are unable to pay.
iJ,. Participation of community organizations through County Dental Health Councils.
The following narrative and statistical reports summarize activities to carry out this program and to make it effective in the various counties.
In general there is an increased interest in dental health as evidenced by a willingness on the part of local people to face dental problems and to work for programs of education and service, even to the extent of raising funds to equip and maintain dental clinics for needy children. The enlistment of State agencies- official and voluntary- to promote dental health is an important function of this division. Appreciation is expressed to lhe Georgia Dental Association, State Department of Education, Agricultural Extension Service, Georgia Congress of Parents and Teachers, Farm Security Administration, National Youth Administration and other clubs and agencies for valuable assistance.
EDUCATION
Believing that the most practical and lasting solution to the problem of dental health lies in education, the major portion of activities of this division are directed toward dental health education for children and adults. Correction of dental defects for self-supporting families is an outcome of dental health education.
Schools
One hundred and ninety-three schools have been visited for educational work. Talks were made and pictures shown to approximately 84-,000 students and teachers at these schools. Teachers and superintendents accept the films as valuable aid in teaching dental health, and as motivation for correction of dental defects. Visits to these schools also give opportunity for analysis of local dental problems with superintendents and teachers. In many instances Parent-Teacher representatives are included. County and regional public health personnel are always encouraged to attend school visits with the educational workers from this division.

Dental Health Edztcation

79

Colleges
Colleges in regular and summer sessions afford excellent opportunity for teacher training instruction. Thirteen colleges have been visited; fifteen talks were given, and eleven films were shown to 1,155 students during the year. College students respond splendidly to films.
Teacher Education
Programs of eight teachers' meetings were devoted to the discussion of dental health and local dental problems. Talks have been given and films shown at these meetings by representatives from this division.
Parent-Teacher Associations, Women's Clubs and Civic Organizations
Films were shown and talks given to: thirteen parent-teacher associations, one home demonstration council; one woman's club; and seven civic clubs.
Such meetings not only have educational value, but in many instances have led to organization and financial support of dental clinics.
New Dental Health Film Produced
About Faces, a dental health education film, was shown for the first time at the American Dental Association in Houston, Texas. At the opening general session the picture was dedicated "To the Children of America." At a joint luncheon session of American Association of Public Health Dentists and American Association of Dentistry for Children the picture was featured and enthusiastically received. The Public Health and Education Committee of the American Dental Association officially approved the picture, and voted that the distribution be handled by the Bureau of Public Relations of American Dental Association. There can be no doubt that the Division of Dental Health Education of the Georgia Department of Public Health has made a valuable contribution to dental health education through its. efforts to produce this picture.
The Fifth District Dental Society sponsored a very elaborate premiere of About Faces on November 14., at the Woman's Club Auditorium. The Division of Dental Health Education cooperated with the Dental Society to plan the program, and to send out 1,500 invitations to all dentists in the State and to officials of Public Health, Agricultural Extension Service, Parent-Teacher Association and to other interested people. About five hundred were present.
By December 31, approximately sixteen thousand Georgia people had seen the picture.
Radio
Through the cooperation of the Public Health Committee of the Georgia Dental Association a series of six radio talks have been presented over WSB. The talks were of the discussion type. The subjects were:
1 The Care of Permanent Teeth.
2. Orthodontia.

~-- --~-----------------.

80

Georgia Department of Public Health

3. Pyorrhea and Diet and Dental Decay. Lt, Your Teeth andYour Health.
5. Your Teeth andYour Health.
6. Your Teeth and Your Health.
At the request of the Office of Government Reports a broadcast entitled Dental Health and 1ts 1rnportance to National Welfare, prepared by the Office of Government Reports, was given.
All seven of these radio programs have been mimeographed and are available upon request. One other radio talk was given by the Educational Director while working in Colquitt County.
Literature
The bulletin, Your Child's Teeth, was added to the list of educational literature in February, and is being distributed to teachers and county health departments, and is proving very valuable in dental health education.
DENTAL SURVEY OF SCI-IOOL CHILDREN IN GEORGIA 19L10- 4.1
For the seventh consecutive year a tabulation of the results of the Statewide dental inspections made by local practicing dentists of Georgia was submitted.
This report includes a grand total of 143,353 dental inspections in 51L1 schools in fifty-five of Georgia's counties. Over 12,000 of these inspections were made in fifty-three Negro schools in seven counties. The tabulation includes inspections in L161 white schools, or 20.4.% of all white schools in the State.
The same type dental inspection blank was used this year as in the 1939 40 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 blanks returned reveals the following facts:
Exclusive of Atlanta City Schools, 73.6% of 101,"188 white children examined in the State need dental treatment. Of 29,331 children in the Atlanta City Schools, only 29.5% need dental treatment. Of the 12,534. Negro children examined in seven counties, 65.7% need dental treatment. Considering the grand total of 143,353 children examined in Georgia, 63.9% need dental treatment. Exclusive of Atlanta City Schools (where all children have dental corrections), 48A% of the white children examined have had dental treatment in the past; 16.5% of the Negro children have had dental treatment.
Seventeen of the fifty-five counties were not included in last year's survey, and three counties, Dade, Marion, and Talbot, are reporting for the first time.
It is realized that many counties not included in this report have conducted programs of dental inspection and conection.

Dental Health Education

81

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: McDuffie, 17.4%; Columbia, 19.2%; Atlanta City Schools, 29.5%; Montgomery, L10.4%; Glynn, 45.3%, and Jenkins, 49.4/'o.
DENTAL CLINICS
Experimental Dental Clinics
The Georgia Department of Public Health, in cooperation with the Public Health Committee of the Georgia Dental Association, selected five . counties in which to experiment with dental clinics for indigent children. The counties selected were: Brooks, Colquitt, Floyd, Glynn, and Thomas. A report of services rendered in these five clinics for the months February through June follows:

:,.. .__.

.. ., : -~

~

DENTAL GLINIG TOTALS FOR FIVE COUNTIES*

Total admissions -------------------------------Total visits -----------------------------------Total patients completed_________________________ No. Prophylaxis gi\en___________________________ No. Decid. teeth extracted_______________________
No. 1st perm. molars extracted------------------No. Other perm. teeth extracted-----------------No. Decid. teeth filled--------------------------No. 1st perm. molars filled_______________________ No. Other perm. teeth filled______________________ No. Teeth treated silver nitrate___________________
No. Fillings-totaL-----------------------------No. 2-Hr. clinic sessions------------------------No. Clinic hours-totaL------------------------No. Dentists worldng____________________________
Honoraria paid dentists--------------------------

FebruarY

March

April

May

White Negro White Negro White Negro White Negro

108 129
47 41 86
6
46 38
3 47 96 26 52 6 $130

6

275

6

352

24

328

19

8

385

24

427

37

382

24

3

251

8

275

11

247

19

2

73

--

75

--

47

--

12

220

33

302

22

259

22

--

10

4

33

22

8

2

-

2

--

9

--

10

1

160

10

185

12

64

6

-- 332

11

403

13

346

13

37

--

20

--

21

1

6

285

6

627

31

326

1

-- 576

21

686

25

464

13

1

78

4

91

7

70

5

2

156

8

182

14

140

10

1

15

1

16

1

14

1

$5 $390

$20 $455

$35 $350

$25

June White Negro

109

--

124

--

47

--

9

--

54

--

11

--

1 --

24

134

--

33

--

174

191

--

34

--

68

--

5

--

$170

--

Totals

":!

"' White Negro c ~

1172

55 ~""

1447 867

93 41

.gb

245 921

g 2 ~
89

68 22 479 1251 114 1459 2013 299 598 21 $1495

-28 1

.";:.:.';.

28 c

37

1

"i:j
l;:

44 0..."..'

[)9 ~ ""
17

34 1::!::
"' 1 ~
$85 ~

*Brooks County (Quitman).; Colquitt County (Moultrie) ; Floyd County (Rome) ; Glynn County (Brunswick), and Thomas County (Thomas\'ille).

Dent(tl f1 ealth Education

83

"Permanent Dental Clinic Plan Adopted
From information gathered in the experimental clinics, Regulations for Paying Honomria to Clinicians Conducting Dental Clinics was adopted in August. Under this plan all organized counties that qualify, and one 'nursing county in each of the six regions are offered dental clinics. The nursing county is to be chosen for experimental purposes.
The standards that are required by counties emphasize the educational program for children and adults, the examination of school children by local dentist and organization of county dental health councils. By so doing, the dental clinic will serve as part of a well-rounded dental program.
By December 31, there were thirteen counties operating dental clinics, seven counties approved to begin in January and six counties with pending applications. The counties operating dental clinics on December 31, were: Appling, Brooks, Colquitt, Decatur, DeKalb, Floyd, Glynn, Mitchell, Thomas, Toombs, Upson, Ware, and Wayne.
Two Tegions have organized experimental clinics in nursing counties. They are, Toombs County in the Southeastern Region, and Upon County 1 in the West Central Region.
1
;Report of Services in Dental Clinics
REPORT OF DENTAL CLINICS BY MONTHS

September October November December Totals

No. Counties Operating Clinics__________

3

'No. of Clinics______ -------------------

3

No. 2-Hr. Clinic Sessions_______________

24

No. Clinic Hours-totaL_______________

48

No. Dentists Worl<ing -----------------

6

Honoraria Paid Dentists _______________ $120.00

'l'otal Admissions ---------------------- 111

Total Visits ---------------------- ---- 118

Total Patients Completed_______________

70

No. Prophylaxis Given _________________

31

No. Decid. reeth Extracted_____________

59

No. 1st Perm. Molars Extracted_________

<1

No. Other Perm. Teeth Extracted_______

No. Decid. 'l'eeth Filled________________

21

No. 1st Penn. l\:Iolars Filled____________

66

No. Other Perm. 'l'eeth Filled___________

26

No. l!'illings-totals ------------------- 113

7 78 156 17 $390.00 300 3<15 20<1 106 203 15 H 160 239 20 419

10 11 108 216 22 $5<10.00 452 557 367 127 323 25
1 2<19 392
90 731

13 1<1 lH 228 29 $570.00 <106 511 310 H7 24<1 21
2 250 356 114 724

13 H 324 6<18 3<1 $1,620.00 1,269 1,531 951 411 829 65 17 680 1,053 250 1,987

_,

84

Georgia Department of Public Health

TOTAL DENTAL CLINIC REPORT FOR 1941

Experimental

Clinics

White

Negro

Permanent Clinics White

Totals

White

Neuro

:\o. Counties Operating Clinics _____ :\o. of Clini('s ____________________ Xo. 2-Hr. Clinie Hessions ___________ Xo. Clinic Hours- -totaL __________ Xo. Dentists \Yorking ______________ Honoraria Paid Hentists ___________
Total .A.dmi:;:,~ions ----------------Total Yhdts --------------------Total Patients Completed _________ Xo. Provhylaxis GiYen ____________ Xo. Decid. Teeth Extracted __________ :\o. 1st Perm. )lolars Ertraeted ____
:\o. Other Perm. Teeth Extracted __ Xo. Vecid. Teeth ~'illed ____________
Xn. 1st Perm l\Iolars Filled------- :\o. Other Perm. Teeth Filled ______
*Xo. Teeth 'freated Ril\(r Xitrate __
Xn. Fillings- total

299 598
21 $1.49.1.00
1,172 1.447
867 24;) 921
!i8 22 479 1,251 114 1,4;)9
~.013

1j 3-1
$8:i.OO :J.) 93 H
8\J 28
1 28 37
1 H .)9

]:; 14 324 !i4X :!4 $1.1i20.1111 1,2!:!1 l,.l:ll H01 411 X29 H:J 17 680 1,033
~30
1,!187

IS lH
li~:)
1.:!46
:).)
$::.11.).011 2,421
~.tl7R
1.818 ti:Jfi
1.7:,o l :~:-j
:~!I
1,1'l9
~.:)0-!
36-1 1,-l:J\l 1.000

17 34
1 $X.\oo
35 93 41
89 28
28 Si
H
~9

*Xot included in tn)C of serYiec in "Regulations for Paying Honoraria to Clinicians Conducting Dental Clinles.

STATISTICAL REPORT OF ACTIVITIES

COUNTIES VISITED___ ------------------------ ------

86

Counties with full-time Health Departments_________ 35

Counties with Nursing Service__________________ _ 43

Unorganized Counties________________________ _

8

MILES TRAVELED
Educational Director_________________________ _ 19,096 Associate Educational Director___________________ _ 7,467

PUBLIC SCHOOLS VISITED ___ --- - ----------------

193

Talks _______________________________________ _ 129

Attendance-White_______________________ _ 59,096

Negro _____ ----------------- 1,000

Films and Talks ______________________ _

186

Attendance-White_______________________ _ 80,326

Negro ___ _

1,100

Total Attendance ____________________________ 83,201

Dental Health Education

85

COLLEGES VISITED_________________________________

13

Talks --------------------------------------

4

Attendance-White________________________ 205

Films and Talks______________________________ 11

Attendance-White_________________________ 765

Negro________________________ 185

Total Attendance_____________________________ 1,155

TEACHERS' MEETINGS______________________________

8

Talks________________________________________

8

Attendance-White________________________ 635

Negro________________________ 100

Films----------------------------------------

6

Attendance-Wbite_________________________ 525

Negro________________________ 10

PARENT-TEACHER Assoc. ATTENDED
Talks________________________________________ 13 Attendance________________________________ 75tl,
Films________________________________________ 14
Attendance____ ------------------- ----- ___ 754,

WoMTEaNl'kss_C_L_u_B_s__________________________________ _

2

Attendance_______________________. --------- 165

FilmAstt-e-n-d-a-n-c-e-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_

1 35

CIVICTaOlRkGs_A_N_IZ_A_T_I_O_N_S______________________________ _

8

Attendance________________________________ 357

Films----------------------------------~----

7

Attendance_______________________________ 307

4-H CLUBS

Talks_______________________________________ _

1

Attendance______________________________ _ 360

Films ____ -----------------------------------

1

Attendance______________________________ _ 360

PUBLTICalkMsE_E_T_I_N_G_S_________________________________ _ Attendance______________________________ _
Films---------------------------------------Attendance_______________________________ _

10 5,625
10 5,625

NATIOTNaAlkLs_Y_o_u_T__H__A_D_M_I_N_I_S_T_R_A_T_IO__N_P_R__oG__R_A_M__s ________ _

1

Attendance-White_______________________ _ 75

:;

86

Georgia Department of Public Health

DENTAL CLINICS VISITED___________________________

ll

REGIONAL OFFICES VISITED_________________________

6

CONFERENCES

l. Regional Medical Directors__________________ 22

2. County Health Commissioners________________ 96 3. Dentists___________________________________ 295

4. School Superintendents_____________________ 86

5. Physicians __ __ ------------------------

<1,

6. Home Demonstration Agents________________

3

7. Nurses___________________________________ 212

8. Parent-Teacher Workers ___________ _:_________ 35

9. Others____________________________________ 184.

RADIO TALKS_____________________________________

8

ARTICLES______________________ ------------------

8

AssociATIONs, CoNVENTIONs ATTENDED_______________

8

Division of Public Health Education

Robert V. Schultz, M.D., Director

Justin Andrews, Sc.D.

Interim Director

This Division was last established as an independent administrative unit on November 1, 1940. It continued to function as such until Septem her 15, 1941, when the director was called to active duty in the United States Navy. The professional personnel consists of a full-time photographer and an artist, radio announcer and journalist on part time.
The Division of Public Health Education acts as a consulting bureau in educational methods and technics for the various divisions of the State Health Department, and its local and regional health oHices, assists in initiating and in cooperating in public health educational programs of the Georgia Department of Education and creates visual educational materials for the Georgia Department of Public Health, the regional health offices and other public and private organized health and educational agencies.
ROUTINE ACTIVITIES
Some 158 conferences with health officials and 141 contacts with educational authorities were made by the director during his 1941 tenure. He also wrote and/or delivered six radio broadcasts, four articles, and two addresses. He attended fifteen conventions and association meetings all within the State.
During the summer-school sessions, the director taught public-health viewpoints three days at the Georgia State Teachers' College in Statesboro, two at the University of Georgia in Athens, and one at the Georgia State Women's College in Milledgeville. This was undertaken in the interest of promoting closer co-operation between the State Health and Education Department.
LITERATURE DISTRIBUTED
The Georgia Department of Public Health offers for distribution through this Division over 135 different items of health literature in addition to several others of a more highly specialized or professionalized nature sent out by other Divisions. Of these, about thirty were produced or basically revised during the year; members of the Division of Public Health Education advised editorially or assisted with the illustration of many of these. Special mention should be made of two pamphlets-Appendicitis Strikes Youth and Get Rid of Rats- Get Rid of Typhus- which have commanded attention as much for their pictorial content as for their textual matter. In all, 293,563 pieces of health literature were distributed in 1941.
HEALTH FILM ACTIVITIES
As in the past, films for health education were made available to the laity through projection facilities in each regional health headquarters.

88

Georgia Department of Public Health

The number of showings per month is indicated in Table I. During the year, each regional office was supplied with a copy of the United States Public Health Service cancer control film, Choose to Live.
At the annual meeting of the Medical Association of Georgia held in Macon this year, the Association voted $5,000 for a lay health education program, the primary objective of which is to increase lay appreciation of the health problems in Georgia and to stimulate cooperative results in solving them. With this fund, ten moving-picture projectors were pur. chased and distributed to the District Managers of the Woman's Auxiliary to the Medical Association of Georgia, the Auxiliary contributing $125 for this same purpose. Twenty-one films belonging to the Medical Association were turned over to the State Health Department. In consideration of these contributions, the Georgia Department of Public Health agreed to purchase $1,000 worth of films and to assist in organizing their distribution, scheduling, checking, cleaning, etc. Film showings by the Women's Auxiliaries are also listed in Table I.
During 1941, twenty copies of the following fifteen films were acquired: Tuberculosis, Moving X-Rays, Told by a Tooth, Behind the Smile, The House Fly, For Health and Happiness, The Story of Appendicitis Pasteur the Benefactor, How We Get Our Milk, Milk the Master Builder: More Life in Living, Behind the Shadows, A bout Fa~es (color), Pneumonia, and Modern Magic. These films are selected and approved by a joint committee of the Medical Association and the State Health Department.
TABLE I
HEALTH FILM SHOWINGS IN GEORGIA BY MONTHS

Month

1941 Health Staff Number of Films Shown

Woman's Auxiliary Number of
Attendance Films Shown Attendanca

.January

lti

lll,6H~

J<'ehruary --------------~ __ ~~~---

~-~

~larch __________________ ___

2!-l

April ___ . _____________________ _ :!H

~lay ___________________________ .

~~~

.Tu11e __ ---------~------~~-~-- --~--

J::

,July _________________________ -- _ 1:1

14,61~
31.UilR ::;:),0!-lti 21,16<
2,871 2,02!-l

August ------------------ _______ _

693

September _______________________ _ Li

ri,4 71

Odober _____________________ _

:n

:~:~.644

1:)

LJ,15j

Xovemher ________________________ _ :!0

33,3:_ti

19

6,761

neeember _______________________ _

26

21.73!1

l:J

6,123

TotaL ______ ---------------- 233

211.44i

4<

28,039

Public Health Education

89

REVISION OF RADIO ACTIVITIES
The weekly broadcasts over Station WSB have in the past been undertaken by the directors of the various divisions of the Georgia Department of public Health. As of August, however, a new series was inaugurated by one of the program specialists of Station WSB appearing as the Voice of the Health Department. These presentations, which are much more popular in their appeal, appear to have attracted a larger and more keenly interested audience. The change has also relieved high-salaried division directors from the onnerous and time-consuming responsibility of preparing and presenting radio scripts.
Once a month, the guest feature of the early morning Dixie Farm Hour of Station WSB is supplied by staff members of the Georgia Department of Public Health. Instead of the IS-minute interviews previously offered, brisk, compact six-minute monologues are now presented. This change has also resulted in augmented audience interest as attested by the increase in "fan mail" response.
EXHIBITS
The Health Education Division tries to assist local health agencies by supplying exhibit material to be used at county fairs, in show windows, etc. During 1941, such exhibits were prepared on the following subjects: Appendicitis (Macon, Americus, Valdosta), Prematurity (Macon, Atlanta, Sparta), Well Babies (Lavonia, LaFayette), Sanitation (Blairsville), and Nutrition (Dougherty County). The nutrition exhibit was installed in a trailer to be used by the Home Economics Supervisor of Dougherty County.
The National Youth Administration project in Atlanta facilitated the preparation of exhibit material by supplying numerous series of cut-out letters of various types~ upper and lower case~ and several exhibition boxes of mahogany plywood to be carried to clinics, fairs, health centers, etc., for temporary or permanent use.
In addition to the above exhibits, three maternity and baby posters and three more posters on infant mortality in Georgia were prepared.
DRAWINGS, GRAPHS, AND LETTERING
The following is a list of graphic-arts materials produced in this Division at the request of other agencies.
l. Front cover and eight drawings for appendicitis bulletin.
2. Cover for hookworm source unit.
3. Fronts and back covers, thirty drawings and one graph for typhus bulletin.
4. Four plans (mimeograph stencils) of houses in which premature infants were born and cared for.
;:>. One stencil of uniform designs for nurses.
6. Front and back covers of departmental annual report for 1940.
7. Design for exhibit on the transmission of upper respiratory diseases.

90

Georgia Department of Public Health

8. Eighteen graphs for maliara and hookworm lantern slides.
9. Seven graphs of maternal and child health statistics on chart cloth. 10. Graph of rabies in Georgia. 11. Lettering for personal identification card.
PHOTOGRAPHY
The employfiolent of a full-time professional p~otographer is supplying a need long felt In the Health Department. Dunng 1941, the following photographic materials were produced:
A-Still Black-and-White Photographs
1-Copy and lantern slide of hookworm infestation map of Georgia. 20----Lantern slides and prints of malaria and hookworm subjects. 38-Photographs of rats and rat-infestation sites for typhus bulletin. 12-Photographs of rural water supplies in Fulton County. 12-Photographs of dairy activities in Fulton County.
9-Photographs of Sanitarium at Alto. 48-Photographs of milk and food sanitationn in Muscogee County. 34-Lantern slides of above. 14-Lantern slides of malaria control projects.
6------8" x 10" prints of above. ~Photographs of premature babies at Grady. 6-8" x 10" prints of above. 1-Photo-copy of Quitman aerial-photo map. 3-8" x 10" prints of above. 3-8" x 10" prints of enlarged hookworm heart series. ~Lantern slides of rabies data. 22-Miniature lantern slides of chest X-Ray plates. 22-Lantern slides of che~t X-Ray plates. 22-5" x 7" prints of chest X-Ray plates. 8-Photographs of health center in Lavonia. 2~8" x 10" prints of above. 12-Photographs of laboratory activities in Albany. 24-8" x 10" prints of above.
B--Still Color Photographs
1-Copy of chart for nutrition exhibits. 12-Transparencies for Dougherty County trailer. 2-Transparencies for premature exhibit. 2-Copies of appendicitis drawings.
C~Color Movies
Construction and installation of concrete malaria-control ditch-lining. Construction and installation of sanitary pit privies. Appendicitis operation at Grady. Construction and finishing of Peacock River drainage project.

Public Health Education

91

PROJECTS UNDER WAY
Because considerable time during 1941 was spent on work projects that have been delayed in their development or that require more than twelve months for their completion, the following brief descriptions are given of work items planned and commenced but not finished.
l. Early in the year, interested members of the Medical Association of Georgia sought the aid of this Division in determining the major causes of deaths from appendicitis in Georgia. A survey was proposed which would include the examination of hospital records of all approved hospitals in the State. As originally planned, the investigational phases of this survey were to be made by WPA, with the interpretation of the findings made by the two sponsoring agencies. Accordingly a non-manual project for this purpose was drawn up, but before it could be submitted to Washington, the present nationwide emergency was proclaimed. This resulted in the project being held in abeyance temporarily or indefinitely by WPA. When it became apparent that WPA assistance would not be forthcoming, aid was sought from the NYA. Due to federal regulations, this group could not undertake the work. Since that time, the vocational division of the N. Y. A. has been approached with partial assurance of its cooperation being given. The proposed survey awaits the results of further correspondence but, due to the drastic curtailment of federal svpport of the above mentioned agencies, it seems improbable that immediate progress can be made.
2. In cooperation with the Division of Malaria and Hookworm Service, a revision of the teacher's source unit on Hookworms and Hookworm Disease is in progress. A new cover has been desi~ned and numerou; illustrations and drawings added. This booklet should be ready for release some time during 1942.
3. A major barrier to health-education efforts is the lack of knowledge concerning self-expressed health desires and interests of lay individuals. If lay health interests could be ascertained, health-education programs would be much more effective.
Accordingly, such a questionnaire has been drawn up, the answers to which may give us some light on the subject. Some 10,000 copies haYe been printed, and these have been distributed in Gainesville, Savannah, and in Walton County. Roughly one-half of these questionnaires have been returned to this office, but thus far no analysis of the forms has been made.
4. Late in the year, a non-manual WPA writers' project for the producticn of a "health almanac ' w~'; CC'=p0n core1 by tn"' '~~~:-"i" Department of Public Health. This is to be a booklet of simple information about health presented in typical almanac style with the intention of introducing its contents into rural homes accustomed to almanac literature. The research and composition will be done by WPA writers; technical guidance and publication costs will be supplied by the State Health Department.

Division of Preventable Diseases

C. D. Bowdoin, M.D., Director and Epidemiologist

John M. Walton, M.D.
William J. Murphy, M.D.
Lester M. Petrie, M.D.
Roy J. Boston, Engineer

Venereal Disease Control Cancer Control
Industrial Hygiene Typhus Fever Control

CANCER CONTROL SERVICE

The Georgia Cancer Control Program functioned without interruption throughout the year. Though the number of applications for State-aid showed an increase over previous years, it was possible to provide diagnos. tic and treatment service for all applicants who were eligible for such aid.
At the beginning of the year twelve diagnostic and treatment centers were participating in the program and all of them functioned continuously throughout the year. As outlined in previous reports, these treatment centers are conveniently situated with respect to accessibility. No additional clinics met the requirements for recognition during the year.

Eligibility for State-Aid

Eligibility requirements for State-aid were changed on July 22, so as to permit treatment of patients who are seventy-five years of age or older. Prior to that date, applications from such patients had been disapproved because of the Yery limited life expectancy of the group as a whole. In rescinding this regulation, the Executive Committee of the State Cancer Commission considered the following factors: 1) Some patients of seventyfiye years and over are in comparatively good physical condition; 2) The number of applications from patients of such advanced age constitute but a small proportion of the total number received; 3) Most of the applicants of this age group have skin cancer which can be treated at comparatively low cost; 4) Public reaction to the regulation was unfavorable. At present, applications for State-aid are approved if the following requirements are met: 1) The referring physician knows or suspects that the patient has cancer; 2) The cancer is not so far advanced as to offer little or no hope of arrest; 3) The patient is unable to pay for treatment.

Applications for State-Aid

Applications for State-aid during 1941 totaled 2,229 as compared with 1,909 in 1940. Thus, the number of applicants for this service is con tinuing to increase. In order to show this increase for a three-year period, however, it is necessary to consider only the last six months of each year since State-aid was not available during the first half of 1939. Applications received during the last six months of the past three years are as follows:

1939 ---- ----- 787 1940__________ 956

194L_

_ 1,179

Preventable Diseases

9u')

These figures indicate an increasing interest in the Cancer Program. That such interest is widespread is indicated by the fact that during 1941, applications were received from 151 counties.
Of the 2,229 applications received during the year, 2,162 were approved and sixty-seven were disapproved. Of those not approved during the year, the reasons for disapproval were as follows:

Due to age__ _____ . 54 Not cancer_________ 8

Incurable__________ 4

Able to pay

l

These sixty-seven cases represent only those for whom formal application was made to the Cancer Control Service. They do not take into consideration cases for whom preliminary inquiries were made but, because of ineligibility for State-aid, formal applications were not forwarded.
Of the fifty-four cases who were disapproved because of age, forty were reconsidered after Jt::y 22, 1941, when the regulation prohibiting their acceptance was rescinded.
Though applications were received during the year from all parts of the State, there was considerable variation in the number of applicants per unit of population in different areas. Such variations may be observed not only as between different areas but, also, as between different counties in the same area. Since the twelve State-aid cancer clinics are located in various parts of the State and, since applicants are referred to the nearest clinic, it is possible to estimate the population served by each clinic, as well as the number of applicants from each section, and compute the rates at which applications have been received from the different areas.
In Table II is shown the estimated population served by each clinic, the average number of applications received from each area during the period 1940- 41 and the number received per 10,000 population. These figures deal with the total number of applications received and include those which were disapproved. Though the areas served by the different clinics are not sharply defined and, consequently the figures employed are merely estimates, the results obtained are believed to approximate the actual rates. The variations noted in the rates at which applications are being received from different areas probably reflect differences on the part of the laity and physicians with respect to interest in the Cancer Control Program.
Clinic Activities
A total of 2,229 applicants was referred to the various clinics during the year. This total includes 2,162 cases whose applications were immediately approved, forty old-age cases whose applications had been disapproved prior to July 2.?. ::;41, and an additional twenty-seven old-age cases whose applications had been disapproved during 1940. Many of these cases did not report to the clinics after having been approved. This was especiallv true of the old-age cases. On the other hand, a few cases

94

Georgia Department of Public Health

which had been approved late in 1940 reported to the clinics for the first time after January l. Altogether, 2,010 patients reported to the twelve State-aid clinics during 1941.
Of the 2,010 patients who reported to the clinics, 1,272 were diag. nosed as having malignant disease, 703 were diagnosed as having non. malignant disease and in thirty-five cases the diagnosis was deferred. Appropriate treatment was given to all cases of malignant disease with the exception of those who were so far advanced as to offer little or no hope of arrest and a few others who refused treatment. All non-malignant cases were referred back to the family physician as soon as a diagnosis was established.
Financial Aid
In addition to cases referred to the Clinics during 1941, financial aid was also given on behalf of many cancer patients upon whom treatment was begun prior to January L A total of 1,551 cases classed as malignant received financial aid during the year. Of the 703 non-malignant cases and the thirty-five cases with a deferred diagnosis, bills were paid on behalf of 506 patients for expenses incurred in establishing a diagnosis while in the remaining cases no charge was made. Thus, bills were paid during 1941 on a total of 2,057 cases. The sum of $78,826.14 was expended for diagnosis and treatment of these cases at an average cost of $38.32.
In Table I is shown a summary of the activities of the Cancer Control Service in 1941 as compared with similar data for 1940. It will be noted that the amount of financial aid given in 1941 was materially greater than that spent in 1940. This was due entirely to an increase in the number of patients for whom State-aid was granted. The average cost per case, including only those for whom a charge was made, showed a decline in 1941. The averages for both years would be somewhat lower if the cases upon whom no charge was made were included.
In Table III is shown a summary of the cases treated by the various clinics together with the amounts paid to each. In comparing the costs per case as shown for the various clinics it must be remembered that such costs vary greatly with the type of case, and true comparisons can be made only when similar cases are considered. Furthermore, a few difficult cases may materially raise the average cost per case. This was true, for example, with respect to the Winship Clinic.
Tabulation of Data
The Cancer Control Service is preparing to transfer to punch cards pertinent data with respect to State-aid patients. In addition to identifying data as age, sex, color, etc., reports from the Cancer Clinics supply complete information with respect to site of lesion, duration of symptoms, description of the lesion, biopsy reports, X-ray and laboratory findings and treatment. The code sheet to be used in the transfer of this data to punch cards is now nearing completion. Follow-up data with respect to each cancer case seen in the clinics will also be entered on the punch cards. When this work is completed, it will be possible to prepare detailed sum-

Preventable Diseases

95

maries of all the work done in the various clinics since the State-aid Program was begun.
Organization of Clinic Directors
The Directors of the State-aid clinics organized during the year for the purpose of discussing problems encountered in the conduct of such clinics. The first meeting was held in Milledgeville on December 29, and consisted of a round-table discussion of pertinent problems encountered in the conduct of such clinics. The date for the next meeting was tentatively set for June, l9L12.
Educational Jl!leasztres
Because of limited personnel during most of the year, the Cancer Control Service was unable to take a very active part with respect to educational measures. Only three addresses were made. More than seven thousand pieces of literature dealing with cancer were distributed, however, and seven copies of the sound motion picture, Choose to Live, were employed by health officers, regional medical directors and interested laymen in giving lectures on Cancer Control.
The Cancer Commission of the Medical Association of Georgia and the American Society for the Control of Cancer, through its Women's Field Army, continued giving excellent cooperation throughout the year with respect to educational measures. Through the efforts of these two organizations, information dealing with various aspects of cancer reached a large proportion of the citizens of the State including both physicians and laity.
TABLE I

SuMMARY oF AcTIVITIES

1940

1941

Applications ':rota! received ______________________________________________ _
Number approved ------------------------------------------Number disapproveel ________________________________________ _
Sumber of' counties submitting applications ___________________ _

1909 1826
83 15<1

Case ReilOrts from Clinics Cases classed as malignant____________________________________ Cases classed as non-malignanL______________________________ Cases with deferred diagnosis_________________________________

1069 560 33

Cases Given Financial Aid 'fotal cases receiving aid______________________________________
Cases classed as malignant----------------------------------Cases classed as non-malignant_______________________________

1616
1256 360

! Amount of Financial Aid Given
Total amount given__________ --------------------------------Average amount per malignant case (Including only those cases
for which a charge was made)-----------------------------Average amount per non-malignant case (Including only those for
which a charge was made)--------------------------------Number of cases for which no charge was made (Malignant and non-malignant)

$65,893.76 4<!.75 26.93 290

2229 2162
67 151
1272 703 35
2057 1551
506
$78,826.1<1
<12.83
280*

*Non-malignant cases for which no charge was made totaled 232. 'the total for 111alignant cases (48) is a preliminary figure and may vary somewhat when checlred.

96

Georgia Department of Public Health

TABLE II
APPLICATIONs REcEIVED FRoM CLINic AREAS IN RELATION To PoPULATIONs SERVED

Clinic

Population Served

~\!aeon ______ -----------Augusta -------------- __ _
Tlwmasville ---- --------Wayctoss
Americus ---------------LaGrang-e ---------------Sheffield an<! Yl'insl!ip ____ _
Dalton -----------------Canton ________ ---------
Columbus Savannah ______________ _

338,000 238,500 275,000 200,000 217,500 H7,500 500,500 166,500
08,000 122,000 210,000

State

2,618,07<1

Applications Received Number Applications 2 Year Average 1940-41 Per 10,000 Population

127.0

11.0

271.0

11.5

268.0

0.7

182.0

8.7

180.5

3.3

109.5

7.'!

137.0

7.4

01.5

5.5

<16.5

1.7

56.0

<1.6

02.0

<!.2

2161

3.2

Fulton and Riclunon<l Counties not included. Average for llibb County determined on basis of applications teceired during last 5 months of 1911.

., :.:".r.:

TABLE Ill

SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS WITH COST FOR CALENDAR YEAR-1941

Malignant

Non-Malignant

Malignant and Non-Malignant

Clinics
Americus ____________
Augusta------------Canton. _____________
Columbus -----------llalton.-------------LaGrange-----------Macon _______________ Savannah ____________
Sheffield------------ 'l'homasville __________ \Vaycross ____________
WinshiP-------------

No. Cases
98 2lti
30 69 69 76 323 47 200 178 112 134

Amount
$ 4,326.61 8,716.27 913.73 2,882.35 2,258.49 2,699.15
10,518.89 1,626.48
10,042.88 8,551.58 5,710.34 8,187.85

Average Cost
$44.15 40.54 30.46 41.77 32.73 35.52 32.57 34.61 50.21 48.04 50.99" 61.10

No. Cases
59 84
G G 7 18 78 25 71 59 40 53

Amount
$ 903.98 2,184.05 65.00 67.92 60.50 510.50 1,915.14 428.12 2,624.56 1,617.65 557.25 1,456.85

Average Cost
$15.a2 26.00 10.83 11.32 8.64 28.36 24.55 17.12 36.97 27.4.2 13.93 27.49

No.

Average

Cases

Amount

Cost

~

157 299
36

$ 5,230.59 10,900.32
978.73

$33.32 36.46 27.19

""~"'''

75

2,950.27

39.34

"~"

76 94 401

2,318.99 3,209.65 12,434.03

30.51 34..15 31.01

"'
1&:::;:'!

72 271 237

2,054.60 12,667.44 10,169.23

28.54 46.74 42.91

""""""''''

152

6,267.59

4.1.23

187

9,644.70

51.58

Tolal --------------- 1,551

$66,434.~2

$42.83

506

$12,391.52

$24.49

2,057

$78,826.14

$38.32

The abme summarr ~ncludes only patients on whom bills were vaid. :s-ot included are 280 additional cases \Vho receiYed service wHhout charge.

10 -.l

98

Georgia Department of Public Health

TABLE IV
SUMMARY Of PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS, WITH COST FOR CALENDAR YEAR, 1941

Counties

~

"c '

~ c
c"' :- ""O-''~ "o"~'

"'<;; . ., :;:~
=~
zOol

"'"-~
~~
Ol 1-0

"~Jlpling

13

Atkinson

Bacon ---------

12

Baker ---------

6

Balcl\vin ------- ][)

13

Banl\s ---------

11

Barrow --------

BartmY --------

Ben rrm -------

Berrien --------

Bibb ---------- 3!)

,1:1

Bleckler ------- 10

11

Brantley -------

8

Brool\s -------- 10

13

Bryan ---------

Bulloch

11

Burl<e

21

26

Butts ----------

10

Calhoun -------

Camden

Candler Carroll Catoosa Charlton Chatham

16 10 26
T 29 10 39

Chattahoochee --

Chattooga ------ 12

13

Cherol.;:ee

10

12

Clarl<e ---------

10

Clay ----------

Clayton

10

Clinch ---------

1

Cobb ---------- 16

21

Coffee --------- 16

~3

Colquitt ------- 3'1 10 'H

Columbia ------ 10

16

Cool;;: ----------

Coweta -------- H

19

Crawford ------

6

Crisp ----------

H

~ ~
0
0
457.50 510.83 220.50 38,1.20 66;i.51
535.'!6 698.<t'i
~;)1!,;)0
90.30 :12fL:>O
1,29,1.67 227.99 286.86 69,1.37
459.25 1.221.88
:i82.17 H6.7<l 320.96
1<16.75 805.65
150.70 1,'l16.22
52.30 630.2<1 285.38 387.00 202.6,1
810.82 <14.00
930.];; 39<1.70 831.79
<131.65 221.68 1,048.13 261.50 213.75

Counties

c

"c '

~
c
="' :- ""O-''~ "o"~'

.<";;'
., :;:~
=~
zoo. ,

-~ "'"~~
ol 1-0

~
0
0

Dade ----------

Dawson

Deeatur

16

IJeKalb

29

1>odgc

~~

11.50

19

901.20

38 2;183.62

2i

773.39

llooly ---------- H

Dongherty ----- 15

IJouglas

lH

Early

21

Echols

1

:!1

537 .8~

2[)

942.63

26 1,080.09

29 1,593.27

10.00

Effingham -----

I~! bert ---------

Emanuel

26

Evans ---------
Fannin

8 1 ].J ,10
10

221.88 367.00 1,095.98
84.50 297.15

Ji~ayette

1;)

18

236.15

Floyd

10

570.71

Forsyth

;{

73.00

Fntnlrlin

'1

315.75

Fulton

Gilmer
Glaseoclr ------Glynn Gordon -------- 12
Grady --------- 7

1

5

9

13

9

2'18.00 53.10 265.50 33,1.25 608.23

Greene

11

1'1

,177. 96

Gwlnnett

13 11 !N

988.30

Habersham

ll

6 17 1,076.75

Hall ----------- 6

,181.00

Haneoclr

10

507,50

Haralson

10

Harris --------- 7

Hart ---------Heard

Hen1y --------- 13

Houston -------

Irwin ---------

.Jacl\son

18

JaSiler ---------

.Jeff navis

10

515.75

'183.31

183.:\0

136.75

21

377.55

13

686.62

<l<l3.7S

23 l, 781.33

ll

369.9;)

209.76

Preventable Diseases

99

TABLE tV-Continued

SUMMARY OF PEOPLE ON WHOM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINICS, WITH COST FOR CALENDAR YEAR, 1941

Counties

c
..c
"~~ --~ " ": E o

Counties
~ ~
0"

...

c

"c

.':!

..."'";:;;~
=~
"" """" zo

-~
-~ l-0

~ ~
0"

.Jefferson ______ 22
Jenldns -------- 27 Johnson ------- 14 Jones --------- 3 JJamar --------- 10

30 32 3 17 <1 12 13

687.80 869.68 690.'!6 <184.38 15<1.25

Richmond _____ _

Rockdale _____ _

Schley _______ _

2

297.'!1

Screven -------- 18 20 38 1,<103.33

Seminole

6

158.70

Lanier --------- 2 Laurens ____:___ 53
Lee ----------- 2 Hberty
J.Jincoln -------- lt!

Long ---------- __ Lowndes _______ 13

Lumpldn

2

...- McDuffie

10

Mcintosh

GO 1 12
17

139.80 2,015.07
89.'!<1 38.00 756.75

19 1,000.H

5

88.70

11

553.'!8

Spalding

H

19

Stephens ------ H Stewart ________ 2

21

<1

6

Sumter -------- 18 H 32 1'albot _________ 1 1

'11aliat'erl'O ____ _

'l'attnall -------

Taylor ------- __ 5

Telfair

10

1'errell

8

38 5
2 12 3 11

833.37 578.00 1!6.00 8<12.18
90.50
125.00 286.'10 868.2<! 382.80

Macon --------- 8 :VIadison ______ _
:Marion -------- 10 :IIeriwether ____ 16 :\!iller _________ 12
Mitchell _______ 15
Monroe -------Montgomery ____ 25 :Morgan l\furray --------
1\Iuscogee ______ 37 Newton -------- 1 Oconee ________ 4 Oglethorpe _____ 8 Paulding ------ 18

11

10 18 16

3 18

7 12

3 28

2

2

2 39

2 20

38<!.89 275.85 295.00 586.00 457.85
1,357.35 536.69 778.0<1 <12.20 1<13.25
1,898.8<1 15.00 179.50
404.07 755.15

'flhomas

12

Tift ----------- 16 'l,oombs ________ 22

'l,owns --------- 2 'l1reutlen -------

'l'roup --------- 37

Turner

Twiggs

11

Union

Upson --------- 22

Wallmr -------- 20 Walton -------- <1
Ware ---------- 17
Warren -------- 7 Washington ____ 11

19

912.35

22 1,18<!.82

28

1<!5.72

3

63.50

13

206.06

<15 1,33<!.62

7

253.55

<1 15

152.33

1

3.00

27

810.61

21

836.95

9

317.25

26 1,369.39

9

187.50

5 16

592.35

Peach --------- 12 Picl<ens -------Pierce --------- II Pil<e __________ 8
I_,olk ----------

Pulasld ________ Putnam _______

Quitman -------

Rabun

<1

Randolph ______ 8

5 17 1 3H
9 11

<1

8

2 11

2 10

<182.52 11<!.50 6<15.25 290.57 586.01
<128.75 195.65
306.50 <121.3<1

Wayne --------Webster ------Wheeler _______ 8 White _________ 3
Whitfield ------ 23
Wilcox ________ <1
Will<es --------- <1 Wilkinson __ c___ 13 Worth _________ 11

3

<1

1

9

3

3 26

6 10 4
2 15 20

222.38 81.19
331.13 211.25 976.37
290.68 251.13 <162.68 687.73

'l'otal ______ 1,551 506 2,057 $78,826.1<1

100

Georgia Department oj Public Health

EPIDEMIOLOGIC SERVICE
During. the yea1 19M there has been no change in the functions of this Service as compared with 1940. The office of the State Epidemiologist has been a clearing center for the assembling and distribution of information concerning the incidence of preventable diseases. Regional Medical Directors have been notified in regard to cases reported to this office from various sources and were delegated to make such investigations as seem pertinent. Weekly morbidity reports were mailed to all staff personnel and health officers. Monthly morbidity reports were mailed to the same group and all physicians engaged in active practice. The State Epidemiologist, who is also the Director of the Division of Preventable Diseases, acts in . an advisory capacity to all public health workers in the State, concerning I the control of preventable diseases, and is subject to call by them for consultation and assistance in this connection. Since the work of the State Epidemiologist is so closely linked with the activities of the Director of I Preventable Diseases and both positions are served by the same individual, ' all of the activities of the Director in regard to the various Services which make up the Divisiqn of Preventable Diseases, are incOl'porated in this report.
Field Visits
The following table gives a summary of consultations with physicians, field visits, and admissions to medical service by the State Epidemiologist, Regional Medical Directors, and public health nurses in unorganized and organized nursing counties:
TABLE I
SuMMARY oF AcTIVITIEs IN THE CoNTROL oF PREVENTABLE DisEAsEs, 194.1

Type of Activity

Regional Medical Directors and State
Epidemiologist

Consultations with physicians_______________ 468

Admissions to meclical, andjor nursing service

Field visits:

Diphtheria ----------------------------

i\feasles -------------------------------

5

Poliomyelitis -------------------------- 21<1

Scarlet fever --------------------------

12

Smallpox ------------------------------

9

'l'yphoid and paratyphoid fever__________

95

Typhus fever --------------------------

63

Whooping cough -----------------------

2

Others -------------------------------- 119

Total --------------------------------- 527

Public Health Nurse
327 178 669 106
28 289
56 <11 253
1,9,17

Total
'168 1,377
335 183 883 118
37 38'1
11~
'13 372
2;174

Preventable Diseases

101

Consnltations With Physicians
From Table I it is found that t168 consultations were made by Regional Medical Directors and the State Epidemiologist. These consist of those made throughout the State, but not those made in the office of the Epidemiologist. Comparing this number with the number consulted during the previous year, 398, we find that seventy more consultations were held in 194.1 than in 19t10.

Admissions to Medical, and/or Nursing Service

From this table it will be noted that 1,377 people were admitted to medical service by the Regional Medical Directors, State Epidemiologist, and public health nurses. By far the majority of these were infantile paralysis cases, due to the epidemic of this disease during the year. The next largest numbers in this connection were typhoid fever and typhus fever cases.

The number of field visits made in the control of specified and other

preventable diseases by the State Epidemiologist, Regional Medical Direc

tors, and public health nurses in all unorganized and organized nursing

counties during the year 194.1 is as follows:



NuMBER OF FIELD VISITS MADE IN THE CoNTROL oF SPECIFIED AND 0THEn PREVENTABLE DISEASES BY STATE EPIDEMIOLOGIST, REGIONAL MEDICAL
DIRECTORS, AND PUBLIC HEALTH NURSES-Con tinned

Diphtheria:

Bacon

3

Barrow

5

Brantley

1

Butts

3

Clayton

15

Coweta

1

Crawford

2

Dade

LJ,

Dodge

6

Evans

7

Fannin

8

Forsyth

3

Gordon

83

Haralson

1

Harris

95

Irwin

9

Jackson

12

Lanier

15

Lee

5

Lumpkin

5

Macon

2

Montgomery 18

Pierce

1

Pike

6

Screven

2

Taylor

1

Toombs

15

Upson

2

Webster

5

il;leasles:

Baker

14.

Butts

4

Charlton

2

Evans

1

Franklin

4.

Harris

40

Irwin

5

Jackson

1

Jasper

3

Lumpkin

35

Macon

15

Toombs

15

Treutlen

3

Upson

38

White

3

102

Georgia Department of Pztblic Health

NUMBER OF FIELD VISITS MADE IN THE CONTROL OF SPECIFIED AND OTHER PREVENTABLE DISEASES BY STATE EPIDEl\IIIOLOGIST, REGIONAL MEDICAL
DIRECTORS, AND PUBLIC HEALTH NURSES-Continued

Poliomyelitis:

Atkinson

21

Bacon

39

Barrow

17

Ben Hill

6

Butts

10

Carroll

7

Chattooga

5

Cherokee 22

Clay

3

Clayton

66

Cook

2

Coweta

31

Crawford

6

Dade

9

Dawson

6

Dooly

1

Douglas

24.

Elbert

ll

Fannin

7

Fayette

5

Forsyth

23

Franklin

6

Gordon

59

Gwinnett 145

Haralson 28

Harris

10

Heard

6

Henry

1

Houston

1

Irwin

13

Jackson

23

Jasper

13

Lamar

2

Lee

8

Lincoln

3

Long

2

Lumpkin

7

Macon

1

Meriwether 25

Monroe

17

Morgan

8

Murray

1

Newton

6

Oconee

11

Oglethorpe 13

Paulding

15

Peach

16

Pickens

3

Polk

30

Randolph

4.

Seminole

2

Stewart

6

Talbot

9

Tattnall

3

Toombs

7

Towns

1

Union

4

Upson

41

Webster

6

Wilkes

1

Health Officer

Counties by

Epidemiologist 5

Smallpox:

Ben Hill

1

Candler

2

Carroll

4

Evans Harris Lee

5

Peach

4

4.

Screven

12

5

Scarlet Fever:

Atkinson

8

Baker

7

Butts

6

Clayton

3

Crawford

1

Fannin

3

Franklin

3

Gordon

26

Harris

1

Irwin

1

Jackson

3

Jasper

]6

Lumpkin

8

Macon

9

Montgomery 1

Polk

l

Screven

1

Stewart

l

Toombs

6

Twiggs

10

Upson

2

White

l

Typhoid and Paratyphoid Fever:

Atkinson

3

Bacon

1

Berrien

2

Butts

3

Candler

2

Clayton

2

Cook

2

Coweta

ll

Crawford

1

Early

1

Echols

2

Effingham

5

Elbert

2

Emanuel

3

Evans

26

Fannin

4

Fayette

6

Forsyth

36

Preventable Diseases

103

NuMBER oF FIELD VISITS MADE IN THE CoNTROL OF SPECIFIED AND OTHER PREVENTABLE DISEASES BY STATE EPIDEMIOLOGIST, REGIONAL MEDICAL
DIRECTORS, AND PUBLIC HEALTH NuRSEs-Continued

Franklin

21

Gordon

10

Gwinnett

2

Harris

l

Heard

26

Irwin

21

Jackson

26

Lamar

12

McDuffie

13

Macon

14

Madison

1

Meriwether 32

Monroe

13

Morgan

5

Murray

9

Newton

3

Oglethorpe 3

Paulding

l

Peach

12

Pike

12

Polk

l

Schley

l

Screven

2

Taylor

2

Twiggs

5

Upson

17

Warren

6

White

l

Typhus Fever:

Charlton

4.

Crawford

l

Early

4

Evans

4.

Irwin

3

Jasper Lamar Macon Marion Peach

l

Pike

2

2

Seminole

86

u')

Tattnall

l

1

Taylor

LJ,

2

Toombs

l

Whooping Cough:

Baker

l

Brantley

1

Butts

7

Clay

1

Forsyth

5

Glascock

8

Jasper

4

Lanier

l

Macon

8

Peach

3

Pierce

l

Upson

2

Wilkinson

1

Other Preventable Diseases:

Bacon

2

Forsyth

5

Baker

9 d

Franklin

6

Barrow

5

Glascock

5

Ben Hill

I

Haralson

3

Brantley

1

Butts

4

Candler

2

Carroll

2

Charlton

30

Columbia

4

Dade

8

Dodge

30

Harris

14.

Henry

31

Irwin

8

Jackson

12

Jasper

1

Johnson

12

Lee

6

Liberty

1

Effingham

l

Emanuel

l

Evans

14

Long

l

Lumpkin

6

Macon

]

Meriwether 5

Monroe

l

Morgan

l

Newton

l

Pierce

2

Pike

51

Screven

l

Seminole

35

Tattnall

3

Taylor

20

Toombs

2

Twiggs

8

Union

2

Upson

8

Wilkinson 12

Geor.gia Department oj P~tblic Health
Edztcational Activities
During the year the Director attended twenty meetings of organized groups interested in public health, thirteen of which he addressed with an approximate attendance of M2. In addition to the eighteen meetings at tended in the State, he was present at the American Public Health Asso ciation in October and the Southern Medical Association in November.
It is gratifying to report that 32,884 pamphlets and bulletins on pre ventable diseases were distributed during the year. The dissemination of data into public schools and to conscientious inquisitors contributes a great deal toward the control of communicable diseases in our State.
An article entitled The Incidence of Spotted Fever in Georgia was written by the Director for the August issue of the State Medical Journal.
Special Activities
As a result of typhoid epidemiologic investigations and studies, eleven typhoid carriers were added to the known 151 typhoid carriers in our State. Finding typhoid carriers and placing them under control measures has contributed a great deal to the reduction of typhoid in our State for the past ten years.
The chief accomplishment during the year has been the setting up of the Industrial Hygiene Service, a medical director and engineer having been secured and given special training at Harvard for this work. Further information concerning this Service will be found in the report submitted for this Service from September 1 to December 31, the length of time it functioned in 1941.
The Director of the Division of Preventable Diseases served another year as chairman of the Social Hygiene Committee for the Georgia Con gress of Parents and Teachers and as secretary-treasurer for the Georgia Social Hygiene Council. He assisted in arranging and carrying out a Social Hygiene Day, February 5th.
At the request of the Savannah-Chatham County Commissioner of Health, a system of keeping records in connection with communicable dis eases was set up in that county. Reports to date indicate that this system is working effectively.
Mention should be made of the special amount of time consumed in the office of the Director of Preventable Diseases Telative to the epidemic outbreak of poliomyelitis, which will be discussed again under analysis of statistical reports. Due to the excitement caused by this very unusual epi demic, it was almost impossible to handle the telephone calls, inquiries from other states, and office consultations in this respect. Other states interested, special organized groups, and all county public health personnel were notified daily of all cases reported to the Department. A very close working relationship was immediately established between the Georgia Chapter of the National Foundation for Infantile Paralysis and the Crippled Children's Division of the Georgia Department of Public Welfare. Physiotherapists and orthopedic nurses were made available through the cooperating agencies. The Georgia Chapter of the National Foundation for

Preventable Diseases

105

Infantile Paralysis also financed an orthopedic consultation service, using the services of recognized orthopedists throughout the State. Iron lungs were made available through this agency, and insofar as we know everything possible was done for every child suffering from this disease. By far the majority of the cases occurred in Atlanta, Fulton County and counties adjacent to Fulton.

In addition to trips made for the purpose of epidemiologic investigations, counted in field visits tabulated in Table I, the Director of this Division made thirty-three special trips in the promotion of the Services under his jurisdiction and in contacting prospective personnel. These efforts resulted in securing a director for the Cancer Control Service and personnel for the Industrial Hygiene Service.

Analysis of Statistical Report

Detailed information concerning the following statistical analysis is shown in the morbidity reports, Tables II and III.

Diphtheria: During the year 1941, 758 cases of diphtheria were reported, giving a case rate of 24.1 per 100,000 population with sixty-three

deaths and a death rate of 2.0 per 100,000 population. While 215 more cases were reported in 1941 than in 19L10, only four more deaths were l'e-

ported. The death rate during 19LU of 2.0 is only slightly more than the

.....

death rate of 19L10, which was 1.9. The fatality rate of 8.3 per cent is the

lowest recorded during the five-year period 1937- 19LU and points to better

reporting of this disease. The year 1938 was an epidemic year, there being

1,232 cases and 106 deaths reported. Diphtheria is a needless disease, and more emphasis must be placed on the immunization of young children

in order to further reduce the number of cases and deaths.

Dysentery: In 19Ltl there were 516 cases of dysentery with 109 deaths

reported to the Department. The case rate of 16.4. and the death rate of 3.5 per 100,000 population show considerable reduction during the five-

year period 1937 - 1941, and the fatality rate per cent of 21.1 is the lowest

in this period. In the future more stress must be laid upon carriers in both bacillary and amebic dysentery.

Gonorrhea: A detailed analysis of this disease will be found in the report of the Venereal Disease Control Service. However, it should be

pointed out that 7,229 cases were reported during 1941, which is the largest number during the five-year period 1937 - 194.1. The twenty-four deaths

reported is about the same number as in previous years, while the fatality

rate of 0.3% is the lowest during this five-year period. This signifies better reporting of this disease, which is at least encouraging.

Influenza: The year 19Ltl experienced the largest influenza outbreak which we have had in many years. A total of 36,021 cases was reported,

giving a case rate of 1l4<5.3 per 100,000 population. This disease was extremely mild and the death rate did not increase appreciably, there being

only 994. deaths reported, which is only slightly in excess of the previous

three years, and 442 less deaths than were reported in 1937. The death rate per 100,000 population was 31.6 in contrast to the death rate of L16.7 dur-

106

Georgia Department of Pztblic Health

ing the year 1937. The fatality rate of 2.8% is the lowest to ever be recorded by the Department and points to a wonderful increase in the reporting of this disease.
Malaria: One is directed to the annual report of the Division of Hookworm and Malaria Control for a detailed analysis of this disease. However, attention should be called to the fact that 1,122 cases reported is the smallest number of cases ever to be reported to the Division. The seventy-five deaths which were reported is also the smallest number to ever be reported, and gives a death rate per 100,000 population of 2.4., which is slightly less than the preceding year. The fatality rate of 6.7% is an increase over the previous five years.
Measles: The year 1941 was a measles year as 11,009 cases were reported. 'lh1s is a slight increase over ~908 when 10,5H cases were reported. One hundred and fifty-seven deaths were reported in 19ctl, the same number as in 1938. However, the death rate of 5.0 in 19~11 is slightly less than 5.1 in 1938. The fatality rate per cent of 1.4 is also slightly less than the fatality rate of 1.5 in 1938.
Meningococcus J1!feningitis: During 194.1, 35 cases of this disease were reported. Seventeen deaths were also reported, giving a fatality rate per cent of 4.8.6. The fatality rate per cent would lead one to believe that additional cases must have occurred which were either unrecognized or unreported. The seventeen deaths in 19Ltl are contrasted with nine deaths in 1940 and with thirty-five deaths reported in 1937. The death rate of 0.5 is not greatly different from the death rate in the three previous years.
Pellagra: During 1941, 334 cases of pellagra were reported, giving a case rate of 10.6 per 100,000 population. Only 204. deaths with a death rate of 6.5 per 100,000 population were recorded. This is the lowest number of cases and deaths ever reported to the Department and possibly the reduction is accounted for by the new drug nicotinic acid as well as improved financial condition of the general population.
Pneumonia: Three thousand six hundred and twenty-three cases of pneumonia were reported in 194.1, giving a case rate of 115.2 per 100,000 population. This is the smallest number of cases and deaths as well as the lowest case rate and death rate ever recorded by the Department. The fatality rate o.f 47.3 is slightly higher than the fatality rate of 45.9 during 19Lt0, but with that exception it is lower than has ever been recorded by this Department. No doubt the advent of the sulfonamide drugs has played an important part in the reduction of deaths, which was 341 le;:s than were reported in 19LJ0.
Poliomyelitis: During 1941 Georgia experienced the worst epidemic from poliomyelitis ever known in the history of the State. Seven hundred and ninety cases of this disease were reported to the Department. However, for the most part the disease was extremely mild, only thirty-three deaths occurring. This same number of deaths was reported to the Department in 1931, and twenty-nine deaths were reported in 1936. In the 1936 epidemic only 165 cases were reported. The death rate of 1.1 per 100,000 popula-

Preventable Diseases

107

tion is the same as recorded in 1930 and 1931 and is slightly higher tharl

the Tates rec01ded for any of the intervening years. The epidemic began in Atlanta during the latter part of June and reached a peak of 283 cases

reported in August, after which there was a rapid decline, only 115 cases

being reported in September and forty-five in October.

Scarlet Fever: During the year 19M, 1,079 cases of this disease were

reported. This number is not significantly different from the number of

cases reported during the two previous years. The number. of deaths was nine, the smallest number ever rep01~ted to the Department. Likewise the

death rate of 0.3 is also the lowest.

Smallpox: Eleven cases of this disease were reported during 194.1,

giving a case rate of 0.3 per 100,000 population. This is the sixth year

that no deaths have been reported from this disease.

Tuberculosis: During 19L1l, 2,635 cases of tuberculosis were reported,

giving a case rate of 83.8 per 100,000 population. A total of 1,385 deaths with a death rate of 44.0 per 100,000 population was recorded. The fatality

iate of 52.6%, while less than the previous year, is slightly greater than

51.2 fatality rate per cent recorded in 1939. This is the smallest number

of cases and deaths ever to be reported to this. Department.

Typhoid Fever: During 19M, 397 cases of typhoid fever with a case

rate of 12.6 per 100,000 population were recorded. Fifty-five deaths with

a rate of 1.8 per 100,000 population were also recorded. The fatality rate

of 13.9% is the lowest to have been Tecorded as is the number of cases and

...~

deaths in the history of the Department.

Typhus Fever: Nine hundred and forty-six cases of endemic typhus

fever were repoTted eluTing 194.1. This is 357 more cases than were re ported in 19L10. However, the 9L16 cases are in contrast to 1,131 cases

reported in 1939. It would appear that this disease has a definite cycle and that the year 19L10 was the low ebb. During 19L11, thirty-six deaths

were reported from this disease with a death rate of 1.1 per 100,000 popu

lation. The fatality rate of 3.8o/o is the lowest since 1932. While consid-

erable work has been done in various communities throughout the State

in an attempt to control this disease, these efforts have been more than off-

set by spread into sections not previously reporting this disease.

Undulant Fever: One hundred and seventeen cases of this disease were

reported in 19M, which number is six less than the number reported in

1940. Two deaths were reported, giving a death rate of 0.1 per 100,000

population.

Whooping Cough: The reported cases of this disease for 19L11 totaled 1,4.06. This is the largest number of cases to be reported since 1938,

when 2,329 were reported. Likewise, the HO deaths reported with a death

rate of 4..5 per 100,000 population is the largest since 1938. Summary: In conclusion attention is called to the fact that this year

marks an all-time l?w in the reported cases of malaria, pellagra, pneu-

monia, smallpox, tuberculosis, and typhoid. Likewise, the lowest death rates ever iecorded for dysentery, malaria, pellagra, pneumonia~ scarlet

fever, tuberculosis, and typhoid fever are found.

-._,,

.-,-.

~-- :.:

TABLE II

...... c0 o

NOTIFIABLE DISEASES REPORTED IN GEORGIA BY MONTHS, 1941

Diseases

Total

Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec.

Actinmnycosis -------------------------- ---- ---- ---- ---- ---

Acute Inf. Conjunctivitis-----------------

30

l

4

8 ----

l

1 __, __ ----

7

7

A.uthrax ------------------------------- ---- ---- ----

Cete. Meningitis ------------------------

35

3

4

Chicken-pox ------------------ _________ 1219

254.

156

Dengue -------------------------------- ----

----

Diphtheria ----------------------------- 758

40

19

7 294
28

----
5
231
----
19

----
1
79
----
13

---1
26
----
18

----
-Q
11
----
18

----
l
8
----
67

---3
4
----
128

----
4 20
183

l
25
----
150

"' 3 ~
111

---75

cr1
~

Dysentery, Amebic ----------------------

71

2

6

13

3

3

7

17

4

5

4

3

4b

Dysentery, Bacillary --------------------

373

Dysentery, Unspecified -------------------

72

4 2

"l

3 2

21 l

H 4

85

111

9

16

63 17

29 4

10 5

11 7

17 ~ 4 !.;.:.>,

Gonorrhea ----------------------------- 7229

381

444

548

518

765

638

663

776

684

668

597

g 547

Hookworm ---------------- ------------Influenza ----------------------.--------
Leprosy ------------------------------- _ .Lethargic Encephaliiis ------------------

7143 36021
---8

778 28307
----
- --

778 4694 ----
2

713
1393
-------

495
678
----
1

760 165 -------

518 55
---2

431
44
----
l

541
65
-------

455
65
-------

540
111
----
l

730
238
----
l

404 206



-------

""
-0 .

Malaria ------------------------------ - 1122

~0

23

26

44

109

129

134

201

1:j9

132

Measles ---------------------------- ____ 11009

224

986 2047 3347 2429 1044

303

190

96

37

Mumps -------------------------------- 1156

13a

104

211

305

14::i

72

59

15

22

8

Paratyphoid Fever ----------------------

12 ---- ---- ----

1

1 ----

'2

3

2

1

77 83 13
2

38 223
67

-~
0::
""'"<"')

----

Pellagra ------------------------------- 334

24

18

18

26

36

41

37

27

27

30

32

18 ~

Pneumonia ----------------------------- 3623

746

496

560

358

281

119

104

100

112

148

257

"' 342 ~

Poliomyelitis ---------------------------
Puerperal Sepsis ------------------------

790

7

3 ----

3

2 ----

2

42

270

288

j 15

45

12

l ---- ---- ---- ---- ---- ---- ----

1

l

4 S""o'"'

nabies (In man)---------------------- __

3

Uheumatic Fever ------------------------

63

<!

.j

9

4

1

4

3

5 ----

2

2

2ri

Uoclty Mr. Spotted Fever__________ ------

Scarlet Fever --------------------------- 1079

97

9~

lOS

64

73

32

2::J

46

75

133

20:-t

129

Screw Worm Inf. (In man)

Septic Sore Throat______________________

553

35

41

82

94

69

15

28

30

23

36

34

66

Smallpox ---------------------------- -- 11

1

---- ----

5

1 ----

1 ----

3

SY!Jhilis ------------------------------- 19540 1300 160:) 1889 1764 2359 r;;oo 1512 1640 1550 1669 1610 1112

1_eranus
Tuberculosis Tularemia TYI>hoid Fever Typhus Fever
Total_-----------------------------

38 4
,,
26:H; 67
397 946 llf 1406
97876

1~8
11
36 5 92
32747

241
42 2 Ill 9898

2
2fl7 10 14 26 8
167
8458

247 8
ll 19 11 170
8448

2
240 3 22 30 9
190
7813

226 6
50 50 24 81
4802

~37
i 7:1 78 8 158
4391

2:1o
:J
105 131 12 127
4706

179
49 133
8 64
4002

200 1
28 148
12 104
4295

210 3 22
119 3
94
4545

160 8
134 l!:i 48
3771

..,
"'"~""
~
:::1
B'
:::::
~
t:::l
I;
;~::,
"~ '
"'

.....
0 \0

llO

Georgia Department of Public Health

TABLE Ill
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA, 1937-1941 WITH RATES PER I 00,000 POPULATION AND PER CENT FATALITY

Year

Cases

Case Rate Per I 00,000 Population

Deaths

Death Rate Per I 00,000 Population

Fatality Rate
(Per Cent)

Diphtheria:

1937

917

29.8

103

3.5

11.8

1938

1232

39.7

106

3.4

8.6

1939

1112

35.3

95

3.0

8.5

19<10

5<13

17.4

59

1.9

10.9

19<11

758

24.1

63

2.0

8.3

Dysente!'y:

l93i 1938 1939 1940 19<11

715

23.2

130

4.2

18.2

679

21.9

192

6.2

28.3

585

18.6

127

<!.1

21.7

582

18.6

126

<l.O

21.6

516

16A

109

3.5

21.1

Gonorrhea:

1937

5.)<19

180.'1

24

0.8

OA

1933

4686

151.2

21

0.7

0.'1

1939

<1583

H5.7

21

0.8

0.5

19<10

5282

169.1

22

0.7

OA

19<!1

7229

229.8

21

0.8

0.3

Hoolnvorm:

1937 1938 1939 19<10 19<11

1589<1 17711 20384 17306
7143

516.6 571.'! 6<17.9 554.0 227.1

0.1

0.01

2

0.1

0.01

0.3

0,0<1

0.03

0.01

Influenza:

1937

1<1799

<181.0

H36

<16.7

9.7

1938

3782

122.0

802

25.9

21.2

1939

11592

368.5

950

30.'1

8.2

1940

13420

<129.6

92<1

29.6

6.9

19<11

36021

11<15.3

99<1

31.6

2.8

~lalaria:

1937

6813

221.'!

235

7.6

3.4

1938

3816

H3.1

1<16

<!.7

3.8

1939

2996

95.2

101

3.2

3.'!

19<10

2502

80.1

89

2.8

3.6

19<11

1122

35.7

75

2A

6.7

:Measles:

1937

926

30.1

10

0.3

1.1

1938

1051<1

339.2

157

5.1

l.::i

1939

3<123

108.8

51

1.6

1.5

19<10

3282

105.1

23

0.7

0.7

19<11

11009

350.0

157

5.0

1.'1

Preventable Diseases

Ill

TABLE Ill
NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA, 1937-1941 WITH RATES PER I 00,000 POPULATION AND PER CENT FATALITY-Continued

Year

llfeningitis: (Meningococcus)
1937 1938 1939 1940 19<11

Pellagra: Pneumonia:
.-t
Poliomyelitis: Scarlet Fever Bmallpox: Syphilis:

1937 1938 1939 19<10 19<11
1937 1938 1939 19<10 1941
1937 1938 1939 1940 19'11
1937 1938 1939 1910 1941
1937 1938 1939 1910 19<11
1937 1938 1939 1910 19'11

Cases

Case Rate Per 100,000 Population

Deaths

Death Rate Per I 00,000 Population

Fatality Rate
(Per Cent)

9<1 40 35 27 35
847 1209
7!5 429 33<1
5637 5165 <!765 <1480 3623
9'1 76 101 30 790
935 782 1055 1000 1079
15 33 17 11 11
153<11 18043 20188 21259 195,10

3.1 1.3 1.1 0.9 1.1
27.5 39.0 23.7 13.7 10.6
183.2 166.6 151.5 1<13.'1 ll5.2
3.1 2.5 3.2 9.0 25.1
30.'1 25.2 33.5 32.0 31.3
0.5 1.1 1.5
OA
0.3
198.6 582.1 6<11. 7 680.6 621.3

35 20 15
9 17
370 365 271 235 20<1
3077 2731 2299 2055 171<1
20 18 12
7 33
11 13 19 16
9

1.1 0.6 0.5 0.3 0.5
12.0 ll.S
8.7 7.5 6.5
100.0 88.1 73.6 65.8 51.5
0.7 0.6 0.4 0.2 1.1
0.4 0.4 0.6 0.5 0.3

496

16.1

478

15.'1

473

15.1

587

18.8

503

16.0

37.2 50.0 <12.9 33.3 <18.6
<13.7 30.2 36.'1 5<1.8 61.1
5l.ll 52.0 <18.2 t!5.9 17.3
21.:! 23.7 11.9 23.:!
<1.2
1.2 1.6 1.8 1.6 0.8
3? 2.6 2.3 2.8 2.6

112

Georgia Department of Public Health

TABLE Ill

NUMBER OF CASES AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA, 1937-1941 WITH RATES PER I 00,000 POPULATION AND PER CENT FATALITY-Continued

Year

Cases

Case Rate Per I 00,000 PO!JUiation

Deaths

Death Rate Per 100,000 Population

Fatality Rate
(Per Cent)

'Jlubereulosis;

1937

3016

98.0

15,19

50.3

51.'1

1938

3011

97.1

1612

52.0

53.5

1939

2996

95.2

1533

'19.1

51.2

19,10

2805

89.8

1533

'19.1

54.7

1941

2635

83.3

1385

<14.0

52.6

Typhoid Fever:

1937 1938 1939 19,10 19<11

719

23A

139

!.5

19.3

829

26.7

121

3.9

1'1.6

56,1

17.9

83

2.7

1'1.7

,187

15.6

68

2.2

H.O

397

12.6

55

1.8

13.9

'l1yJ)hus Fever:

1937

1092

35.5

5,1

1.8

4.9

1938

1017

32.8

'17

1.5

'1.6

1939

1131

35.9

<14

1.'1

3.9

19,10

589

18.9

26

0.8

!A

19<11

946

30.1

36

1.1

3.8

Undulant Fever:

1937

58

1.9

1938

83

2.7

1939

121

3.8

1940

12:f

3.9

1941

117

3.5

0.03

1.7

0.1

3.6

2

0.1

1.7

3

0.1

2.4

2

0.1

1.7

Whooping Cough :

1937

1714

55.T

lt12

'1.6

8.3

1938

2329

75.1

225

7.3

9.7

1939

161<1

51.3

134

'1.3

8.3

19,10

1020

32.7

lOS

3.5

10.6

19<11

1406

<14.7

1,10

t1.5

10.0

.. : :~. .;

NoTIFIABLE DISEASES REPORTED BY CoLOR, SEX, AND AGE-194<1

Age LeYel by Years

j Meningitis
Cerebrospinal
wc

Diphtheria
wc

Amebic Dysentery
wc

Bacillary Dysentery
wc

Malaria
wc

Measles
wc

Pellagra
wc

Pneumonia
wc

Poliomyelitis
wc

M

4

1

l:i

8

4

l7

12

1

22

l7

--

-- 160 176

18

Under 1 Year F

1

--

4

2

2 -- ll

8

3

2

27

l7

--

--

so 124

ll

]\{

1-2 Years

F

--

18

3

1

1

ll

4

2

5

35

l4

--

15

3

1

ll

2

1

--

26

15

--

4

38

44

12

--

38

43

34

2-3 " 3-4 " 4-5 " 5-6 " 6-7 " 7-8 "

M

3

35

l4

1 -- 20

1

3

2

47

22

--

--

40

22

56

24

F

1

38

7 -- -- 19

3

5

--

48

18

--

--

18

15

44

15

'1:;

]\{

1

1

33

10

}' -- -- 38

6

2 --

9

10

]\{ -- -- --

9 -- --

3

4 1

2

--

46

12

--

11

12

45

14

2

--

43

13

--

--

12

7

31

19

6

6

56

15 --

--

10

2

26

10

~
...(:I;>;
:;:,

F

40

7 -- --

5 --

2

2

37

14

--

--

9

8

25

4

~

(I>

M -- -- 31

4

1 --

9

s

4

56

7 -- -- 12

3

19

2

b

F --

31

6 -- --

2 --

2

3

46

l7

--

3

4

13

5

~-

11

-- 30

7

1 --

2 --

6

9 153

29

F

1

33

8

1 --

1 --

5

7 169

41

-- 14
12

3 20 --

5

16

1

":;:', "'(I> "'

l\1

1

--

17

F --

23

1

1

5 --

7 --

7

2 126

33

--

--

12

9

ll

3 -- 12

7 155

42

--

--

14

3

14

3

111

8-9 "

l!'

-- 21

-- --

2 --

7

2 ll6

27

-- 18

2 -- --

1 --

6

8 197

26

9

6

19

--

4

5

10

4

]\{

9-10 "

l!'

8

2 --

1

2 -- --

3 356

24

--

12

6

15

--

6

2 -- --

1

5 19 -- 12 -- --

2

1

ll

10-14 " 15-19 "

M

2

2

19

7

1 --

4

F

1

2

28

ll

--

1

8

40

12

66

23 -- 317 77 --

26

15

36

5

19

14

35

3

M

1

--

4

l!'

1

16

1 -- --

3

2 --

6 4

1

26

11

83

56

5

29

37 117

67

1

--

34

18

25

2

--

ll

31

0

8


f-' f-'
CJ~

.. ~ . . .'" : . ..

NoTIFIABLE DISEASES REPORTED BY CoLoR, SEX, AND AGE-1941

Age Level

I Meningitis

Amebic

(Continued)
BacillarY

I-' I-'
of'-
Polio

by Years

Cerebrospinal Di11htheria

Dysentery

Dysentery

Malaria

Measles

Pel laura

Pneumonia

myelitis

Jw

c

w
2

c --

w
5

c

20-24. Years F

1

--

9

2

1

1

wcw c wc wcw c wc

6

2

20

25

48

15

--

23

39

8

1

9

1

24.

--

46

48

1

12

15

31

7

4

25-29 "

M 2 --

F

1

2 9

--

5

5

1 1

6 6

2

16

18

2

30

20

40

9 8

1 8

1

23

4.2.

2

s

17

36

6

1 1

~
.0~.,

M -- --

2 -- -- -- 10

1

14

7

12

4.

-

l

2

34

35

(fo_

4 --

~""

30-34 " 3ii-39 " 40-44 "

F --

M

1

F -- --

M

2

F -- --

1

--

2 --

6

1

3

1

1

1

1

1

1

6

1

33

8

24

1

1 -- 12

8

7

6

3

21

8

12

1

1

1

21

7

7

1 -- -- 15 11 14

7

5

9

20

20

3

3

2

23

42

2

G 11

12

21

1

4

28

45

7

ll

14

14

23

1 --

b

2 --

2

1

~.~....,.

1 --

~
~

.;;.::.!.

- M ......1. --

--

1

1

5"

3

11

7- 2- --

3

2

26

40

I

..0...,

45-49 "

F -- --

2 --

1

1

2

1

9

4

2

1

11

11

11

26

--

'"tJ

M --

1 --

1 --

2

--

12

19

3

1

3

3

30

46

1 --

~

50-54 "

F

-- --

1

1

4

--

9

5

5

1

ll

7

18

24

--

"'""'

55-64. "

M -- -- --

F -- -- -- --

M

-- --

1 --

4

1

3 --

3 -1

13 12

2

2

4

3 2

3

11

G 66

62

--

3

--

2C

ll

45

63

--

--

1

--

19

s

69

49

:::t:;
~
~ ~

65-74 Years

F --

--

1 --

4

1

3

1

9

s

3

--

31

14

86

M --

--

--

--

75 and Abo1e F --

-- --

1 --

-

M -- -- 4 -- --

Unknown Age F

-- --

1 --

4 --

3

4

1

2

3

-

28

3

1

35

5

4

7

13

2

89

24

2

--

16

ll 114

17

1

63

2 100

9

--

-

22

10

1

21

4

Total

l\{

18

F

6

4 281

68

26

5 135

30 263 137 1264 364

55

29 777 744 354

93

3 314

73

27

10 123

34 293 154 1433 440 127 109 595 !125 269

7l

NOTIFIABLE DISEASES REPORTED BY.\~oLcm, 5Ex;----.AND AGE-I9Zl;l-- (Continued)

Age Level by Years

I Scariet Fever

Septic Sore Throat

Smallpox

- -- -Typhoid

Tuberculosis Tularemia

Fever

-Typhus Fever

Undulant Fever

Whooping Cough

wcw c wc

-

M

7

1

1 -- -- --

Under 1 Year

F

3

1 -- --

--

wcw c wc

2

4 -- --

--

2

5 -- -- --

1

wcw c wc

1 -- -- -- 48 23

--

44

34

~I

10

--

1-2 Years

}<'

12

1

-

l

--

1 -- --

2

8 --

4

2 --

-- -- -- --

--

2;:)

10

1 -- -- -- -- -- 26 15

M 30

3

4

1

--

1

4

4

2

-- -- -- 33 10

2-3 " 3-4 "

F

~2

~

5

l -- --

3

3 --

3

2 -- -- -- -- 31 21

~

M 33

2

5

2 --

--

7

l --

3

5

2

2

-- 44

6

~ <::

F 39

5

6 -- -- --

1

2 --

2

3

1 -- -- -- 29 14

"'.;,:.:,1_

4.-5 " 5-6 " 6-7 "

1if 35
F 60
M 41 F 44

4 2
2 9

3

--

2 -- --

5 -- -- --

6

3 -- --

3 4
3 1

2 -- -3 -- --

1 --

1

--

2 6
4 2

1 5
3 2

3 -- -- -- --

6

-)

--

1

34

8

2

--

2 --

--

24

10

1 -- 25

3

1;:,
0.,'"_'
b"'
~
"'I:)

M 53 F 62

2 5

4

1 --

1

" 1 -- --

2

3 --

" 2 -- --

4 6

6 --

1 -- -- 37

6

1 -- -- -- 38

8 3

"""'''

M 30

4

4

1 --

1

3 --

1

3

4

4 --

-- 34

7-8 "

F 1i4

3

4

--

1

1

4

1

1

5 --

2 -- -- -- 26

8-9 "

M 34

,)

5 -- -- --

4

2 --

1

3

5

3

1 -- -- --

F 36

3

4 -- --

--

3 --

4

2 -- --

-- 10

9-10 "

;II 16

3

5

2 -- --

1

4 --

3

3

2 --

1 -- 13

1

F 42

3

2

--

1

2 -- -- --

2

1

3

2

1 -- 12

1

10-14 " 1:l-19 "

l\1 58

1

9

2 --

1

8

13

1

1

18

12

33

1

2

17

]i,, 101

2

21

2 -- -- 21 16

1

2

9

10

21

3

3

2

12

1-'

M 15

.2

9

l --

1

18

43

l --

8

15

51

2 --

2

1 --

1-' <:/1

}<'

15

1

21

4 -- -- 41 89

4

4

9

19

30

6

2

1

5

2

Age Level by Years

I Scarlet Fever

Septic Sore Throat

Smallpox

Tuberculosis Tularemia

TyphoidFever

Typhus Fever

-Undulant Fever

Whooping

f-' f-'

Cough

0\

wc w c wc wc w c wc wc w c wc

-

M

9

1

20

4 -- -- 48 90

2

3

13

14

52

9

11

20-24 Years

If

9

l

24

4 -- -- 66 155 --

2

7

13

34

14

1

-----

M

5

l

39

6

1

1

58 103

1

--

14

13

30

12

23-29 " 30-34 "

If

5

2

26

-

M 4 -- --

-- 7 --

80 138

2 --

1

58

81

6

10

2 -- 11

4

26

2

44

6 8

il
8

-- --
1 -- --

~
."C..'.l

If

1

1

23

2 -- -- 54 97

4

3

5

4

35

4

3

3 -- --

ere, N,

~

35-39 "

M -- -- 11

l

--

1

64

59

1

2

8

5

55

9

8 -- -- --

b

If 4 -- --

6

--

1

61

72

2 --

4

3

26

6

1

1 -- -- ~

40-44 "

M --

15 -- -- -- 70 52

If

-

--

15

--

--

--

50

53

2

2

2

3 --

1

27

2

19

7 4

5 --
1 --

1
1 --

~ .....
"~ "

45--49 "

M -- -- 11

2 --

62

44

--

1

4

3

42

8

5

1 -- --

1"?' .

If -- --
-

7

3 -- -- 37 31 --

1

2

3

23

4

3 -- -- -- ..C...l...

M -- --

7 -- -- -- 56 36

2 --

4 -- 24

3

3

2 -- --

"'e

50-54 "

If

--

M

55-64 "

If

---------

M: -- --

5

2 -- -- 31 20 --

-

3

2

27

6

-- -- lOS 34 -- --

6 -- 34

5

--

--

3j

18

1

6

1

27

3 -- -- -- 46 19 -- -- --

30

1

3 --

--

7

13

2 -- --

2 6 -- -- --

4

2 --

1 --

~
g:
N,
"'
.,\::!::
.",.'_

65-74 Years

F

-

--

5

1 -- -- 32

9

1

5 -- 10 -- -- -- -- --

";:"::-.

M

1

-- -- 12

4 -- -- -- --

4

75 and Abo\'e If --

-- -- -- --

9

5

--

--

2

M 3 --

2 -- -- --

8

12

3

2

1

33

2

1 -- 11

Unknown Age If

3

1

4

--

--

l;'j

6 --

1

2

1

19

3

2 --

6

2

---

M 383

29 179

25

1

6 635 628

16

11 116

95 475

78

65

11 289

80

Total

If 524

42 188

40

--

3 555 734

13

24

93

84 311

53

31

9 300 110

Preventable Diseases

117

NuMBER oF CAsEs AND CAsE RATEs PER 100,000 PoPuLATION oF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1941

counties

Cerebrospinal

Estimated Meningitis

Diphtheria

Population Cases Rate Cases

Rate

State Total ---- 3,145,245 35 1.1 758

24.1

Rural - ------- 2,071,447 18 0.9 49:!

2:1.9

Cities 2,0>00-5,000 147,828

1.4

55

:17.2

Cities 5,000

and Above --- 925,970 15 1.6 208

22.G

Appling -------- 14,497

34.5

Atkinson -------

7,093

14.1

Bacon ---------

8,096

12.4

Baker ---------

7,344

Baldwin ------Banks --------Barrow -------Bartow -------Ben Hill -------

24,190 8,733
13,064 25,283 14,523

12

49.11

4

4"i 8

23.0

11.9

Berrien -------Bibb ---------Bleckley ------Brantley ------Brooks --------

15,370 83,783
9,655 6,871 20,497

2'i.O

2.4

13

V:i.J

31.1

14.6

Bryan --------Bulloch -------Burke --------Butts ---------Calhoun

6,288 26,010 26,520
9,182 10,438

1:0.9

lB.~

4

15.1

Camden Candler Carroll Catoosa Charlton

5,!!.10 9,103 34,156 12,199 5,256

3.9

4

11.7

Chatham Chattahoochee -Chattooga ----Cherokee -----Clarke ---------

117,970 15,138 18,532 20,126 28,398

6.6

12

6

3.5

15

4 J
64.8 29.8
:1~.8

Clay ---------Clayton -------Cllnch --------Cobb ---------Coffee ---------

7,064 11,655
6,437 38,272 21,541

14.2

4

34.~

17

H. I

Colquitt -------
Columbia -----Cook ---------Coweta -------Crawford ------

33,012 9,433
11,919 26,972
7,128

3.0

6

1~.2

2

21.2

i.4 42.1

Gonorrhea Cases Rate

7,229 3,890
226

229.8 187.8 152.9

Influenza

Cases

Rate

36,021 22,649 1,913

1,145.3 1,093.4 1,294.1

3,113 Hi

336.2
103.5 28.2 24.7

47 1\!4.3
15.3 31.6

3

19.5

87 l03.8

30 310.7

3

43.7

4:!.9

47.7

:!7 103.8

46 173.5

6

65.3

57.a

18 197.7

14

41.0

48

393}.1

20 380.5

:>43 460.3

380 2,510.2

4

21.6

10

49.7

1,",

15.8

8.6 11 170.9
23.:J 102 4i3.5

j3 221.1

10.6

10

83.9

14.0

11,459
8 6
280 103 273 1,520
58
33 28
2
163 28
136 21 32
129 215
52
2,200 2,323
6 324
6
113 784 236
85 214
8 100

1,237.5
55.2 84.6 24.7 13.6
1,1:!7.5 1.179.4 2,089.7 6,011.9
399.4
45.5 39.4 290.0 29.1 43.9
2,592.2 107.7 512.8 228.7 306.6
33.8 54.9 377.7 1,762.4 989.3
1,864.9 13,358.7
32.4 1,609.9
24.6
84.9 25.7 1, 755.5 1,917.9 1,095.6
257.5 2,268.6
67.1 370.8
70.1

118

Georgia Department of Public Health

NuMBER oF CAsEs AND CAsE RATEs PER 100,000 PoPULATION OF' SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY CouNTIEs, 1941-Continued

Counties

Cerebrospinal

Estimated Meningitis

Diphtheria

Population Cases Rate Cases

Rate

Crisp ---------- 17,540

4

22.8

Dade ----------

5,894

17.0

17.0

Dawson

4,479

Decatur

22,234

3

13.5

JleKalb

86,942

3 3.:)

15

17.3

Dodge --------- 21,022

14.3

Dooly --------- 16,886

2!).0

Dougherty ----- 28,565

7.0

3.:i

Douglas ------- 1o,o;;3

Early ---------- 18,679

5.4

Echols -------Effingham ----Elbert --------Emanuel ------Evans ---------

2,964 9,646 19,618 23,517 7,401

93.3

18

!Jl.8

3

40.:i

Fannin -------Fayette -------Floyd --------Forsyth -------},ranklin -------

14,752 8,170
56,141 11,322 15,612

6.8

33.9

49.0

70 U4.7

1

8.8

32.0

Fulton (;Umer
Gla~cock ------Glynn --------Gordon --------

392,886 9,001 4,547
21,920 18,443

1.3

41

10.4

11.1

22

119.3

Grady ---------

G-reene

-~-------

Gwinnett ------

Habersham ----

Hall -----------

19,654 13,709 29,087 14,771 34,822

10.2

21.9

13.8

17

llti.l

17

48.8

Hanctck ---- Haralson -Harris --------Hart -Heard - -------
Henry --------Houston Irwm -- ------ -Jackson .Jasper --------Jeff Davis -----
Jefferson -----.Jenkins -------Johnson ------.Tones ----------

12,764 14,377 11,428 15.512
8,610
15,119 11,303 12,931) 20,089
8,772 8,841
20,040 11,843 12,95:1
8,331

::1.0 11..1

1:-i j
13 113.8
11.6
L:~.2
15.5 44.8 11.4

7 .i

Gonorrhea Cases Rate
36 205.2 17.0

29 130.4

32

36.8

l4

66.6

11.8

142 497.1

11 109.4

16.1

6 13 41 1,178 16 1 33 67
8
211
~()
62 4
16

82.9
8.5 81.1
40.7 61.2 26.7
262.(;
299.8 177.8
22.0 41.1 178.9
340.9 :i8.4 17.2 13.5 :i7.4
203.7 13.9 8.8
:14.8
19.8 26.5 l::i.5
:J.O 706.8
15.2
79.8 67.6
7.7 36.0

Influenza

Cases

Rate

21

ll9.T

182 1,040
44 216
69 216
6
55 228
17 55
14 4 4,308 567
~~25
4,453
24 231
235 611
14 294 29
167 64 86 41 42
10 4 27
167 214
1
108 28 46 3

818.6 1,196.2
209.3 1,279.2
241.6 2,148.6
32.[
168.7 370.2 1,162.2
72.3 743.1
94.9 49.0 7 ,673,j :>,007.9 2,081.7
1,133.4
22.0 109.5 1,252.4
1,195.7 4,456.9
48.1 1,990.4
83.3
1,308.4 445.2 752.5 264.3 487.8
66.1 35.4 208.1 831.3 2,439.6 11.3
338.9 236.4 355.1 36.0

Preventable Diseases

119

NuMBER oF CAsEs AND CAsE RATES PER 100,000 PoPULATION oF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CouNTIEs, 1941-Continued

counties

Cerebrospinal

Estimated Meningitis

Diphtheria

Population Cases Rate Case:;

Rate

Lamar -------Lanier -------Laurens ------Lee ----------LibertY Lincoln

10,091 5,632 33,606 7,837 8,595 7,042

6

17.9

11.6 42.6

Long ---------Lowndes Lumpkin -----)lacon ---- ----)!adisou -------

4,086 31,860
6,223 10,878
5,292

18.8

3

48.2

9.2

3

:!7.6

18.9

37.8

lfariou ------ -- 15,947

llcDuffie ------ 13,431

14.9

~lclntosh -------

6,954

)feriwether ---- 22,055

22.7

Miller ---------

9,998

)!Itchell ------:Monroe -------Montgomery ---)forgan llurray --------

23,261 10,749
9,668 12,713 11,137

8.6

1

9."0

3 :n.o

15.7

62.9

Mustogee -----Newton -------Oconee -------Oglethorpe ----Paulding ------

75,494 18,576
7,576 12,430 12,832

2.6

17

22.5

:l7.7

24.1

Peach --------Pickens
Pierce --------Pike ---------Polk ----------

10,378 9,136
11,800 10,375 28,467

17 186.1

3

25.4

3

28.9

3.5

31.6

Pulaski -------Putnam ------Quitman -----Rabun ---------Randolph

9,829 8,514 3,435 7,821 16,609

4

47.0

12.8 6.0

Richmond Rockdale Schley --------Screven
Seminole

81,863 7,724 5,033 20,353 8,492

36

44.0

iil.S

3

14.7

1U

Spalding Stephens Stewart Sumter

28,427 12,972 10,603 24,502

3

10.6

39 200.6

9.4

2

18.9

16.3

Gonorrhea Cases Rate

9.9

:.13.5

;;

8.9

10 127.6

22 2G6.0

195.8

49 1:>3.8

1

16.1

26 239.0

6.3 14.9

10.0

14

60.2

10.3 21 165.2

:W

34.4

43 231.:-i

7.8

68 65:J.2

3

32.8

2~

186.4

77.1

12

42.2

63.9

4

24.1

i77 949.1 18 233.0
39.7 22 108.1 9 106.0

32 112.6

8

61.7

2:-i 235.8

W' 375.5

Influenza

Cases

Rate

ll!i 1,139.1)

17.8

259

770.7

63.8

2:)

2U0.9

115 1,1l33.1

171.3

7:!

226 I)

14 21
159 3
215
41 27
110
587 131
20G
295 219
4 473 717
3 12
75 157
1,004 325 7 25 627
10 107
49 81

128.7 396.8
18.8 1.188.8
4:-Ll 974.8
10.0
176.3 251.:!
:J1.7 865.:1
26.H
777.:. 70rl.2 118.8 1,649.2
54.G
2,842.6 2,397.1
33.9 4,359.0 2,.)18. 7
30.:i 140.9
29.1 959.0 94f>.3
1,226.4 4,207.7
139.1 122.8 7,383.4
35.2 824.9 462.1 330.6

120

Georgia Department of Public Health

NuMBER OF CAsEs AND CAsE RATES PER 100,000 PoPULATION oF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CouNTIEs, 1941-Continued

Counties

Cerebrospinal

Estimated Meningitis

Diphtheria

Population Cases Rate Cases Rate

Talbot -----Taliaferro ----Tattnall ------Taylor --------Tflfair

8,141 6,278 16,243 10,768 15,145

12.:1

12.3

18.6

6

39.6

Terrell 'fhomas Tift ----------Toombs -------Towns ---------

16,675 31,289 18,599 16,952
4,92;)

10

60.0

6.4

4

21.5

5

29.Z'i

60.9

Treutlen ------Troup ---------
Turner -------Twiggs -------Union ---------

7,632 43,879 10,846
9,117 7,680

2.3

20,;)

2

:n.9

19

:!4 7.4

Upson --------Walker -------Walton -------Ware ---------\Varren --------

25,064 31,024 20,777 27,929 10,236

8.0

13

4Ul

4.8

2

9.6

9.8

Washington ---Wayne -------Webster ------Wheeler ------White ---------

24,230 13,122
4,726 8,535 6,417

24.8

1

7.6

3

63.5

23.4

10\!.1

Whitfield -----. Wilcox -----Wilkes Wilkinson -----Worth ---------

26,10:i 12,7;i:) 15,084 11,025 21,374

2:-i

H:i.8

6.6

2

13.:1

~.1

1

\!.1

23.4

Gonorrhea Cases Rate
12.3
36.9
53 350.0

58 185.4 62 333.4 28 165.2

39.3

:l.j

79.8

46.1

98.7

4.0 ,1:-i 145.0
33.7 100 358.1

3

12.4

34 259.1

2

42.3

1;).6

~10

804.4

8

62.7

36.3 110 ;)14.6

Influenza

Cases

Rate

83

405.1

19

302.6

12.3 299 2,776.7 214 1,413.0

200 1,199.4

168

536.9

14

75.3

112

660.7

1

20.3

3

39.3

643 1,465.4

2

18.4

14

153,6

259 3,372.4

79 315 143 1,698
12

315.2 1,015.3
688.3 6,079.7
117.2

189

780.0

48 1,015.7

11

128.9

16

249.3

11

42.1

75

588.0

962 6,377.6

72.6

6

28.1

Camp Wheeler Ft. Oglethorpe Ft. Screven Savannah Air Base . Ft. Benning La\Yson General Hospital .... 2 Turner Field. Darr Aero Tech Camp Stewart Camp Gordon Ga. Aero Tech Camp Hancock Daniel Field

326

88

H4

117

1

1178

176

23

2

4.3 120

Preventable Diseases

121

NuMBER oF CAsEs AND CAsE RATEs PER 100,000 PoPuLATION OF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
By CouNTIES, 1941-Continued

counties

Malaria

Measles

Cases Rate Cases Rate

state Total ------ 1,122 Rural ----------- 814 Cities 2,500-5,000 -- 81 Cities 5,000
and Above ----- 227

35.7 11,009 39.3 6,803 54.8 586

350.0 328.4 396.4

24.5 3,620 390.9

Appling ----------

13.8

Atkinson ---------

Bacon -----------

Baker ----------- 12 163.4

Baldwin ---------

41.4
13.6 41 169.5

Banks -----------

39 446.6

Barrow ----------

23.0

19 145.0.

Bartow ---------- 2

7.9 118 466.7

Ben Hill --------

13.8

3 20.7

Berrien ---------- 6 39.0

6.::.

Bibb ------------

6.0 1,345 1,605.3

Bleckley ---------

93.2 28 290.0

Brantley ---------

Brooks ---------- 58 283.0

4.9

Bryan -----------

31.8

41 652.0

Bu!lorh

14 r.3.8

Burke . ---------- 23

86.7

Butts ___________ _

J4.5

Calhoun

26 249.1

Camden

10 169.2

26.!1 146 550.;)
4 38.3 3 50.8

Candler Carroll Catoosa Charlton Chatham

22.0

5.9

62 18Ui

41.0

61 500.0

1 19.0

38.1

39 33.1 44G 377.2

Chattahoochee __ . 12 79.3 892 5,892.G

Chattooga ______ _ 2 10.8

3 16.2

Cherokee _______ _

173 859.6

Clarke _____ .. ___ _

238 838.1

Clay ___________ _

Clayton _________ _

Clinch __________ _

Cobb ___________ _

2.6

Coffee ___________ ;, 23.2

Colquitt _________ 18 54.5

Columbia ________ Cook ___________ _ Coweta __________ Crawford ________ Crisp ____________ 43

53.0
3. 7 42.1 245.2

. 13 111.5 109.7
39 101.9 38 176.4 27 81.8
2:1 265.0
20 74.2 4 56.1 13 74.1

Pneumonia Poliomyelitis Scarlet Fever Cases Rate Cases Rate Cases Rate

3,623 115.2 790 25.1 1,079 34.3

2.419 116.8 474 22.9 494 23.8

161 108.9

46 31.1

56 37.9

1.043 112.6
11 7:0.9 12 169.2
9 111.2 68.1
14 :i7.9
91.6 18 137.8 29 114.7 18 123.9
6 39.0
;:-,3 ll'i.3 1:J 134.6
72.8 11 53.7 11 174.9
207.6
13:~.!1
10 108 !I 7 67.1
50.8
:13.0 2li 10:i.4
:n 2:14.1
38.1 39) 273.0
13.2
3~.4
21 104.3 13 4:0.8
[I 127.4
j].;)
31.1 :ill 146.3
:n Hi3.2
27 81.8
18 190.8 10 83.9 22 R1.6
112.2 21 119.7

270 29.2
6.9 28.2 24.7
8.3
11.5 6 45.9 10 39.6
13.8 6.5
18 21.;. 2 20.7
14.6
34.6 3.8
32.7
16.9
11.7 49.2
17 14.4
13.2 14 13 64.6
8 28.2 2 28.3
12 103.0
17 44.4 23.2 9.1
21.2 25.2 22.2 14.0 51.3

529 ri7.1
14.1
10 41.3 11.5 30.6
12 47.5 6.5
27 32.2 41.4
3.8 3.8
23.4 41.0 100 84.8 67 442.6 6 32.4 34.8 18 63.4
:34.3 3 46.6 33 86.2
21.2
8.4 3. 7 3 17.1

122

Georgia Department of Public Health

NuMBER OF CAsEs AND CAsE RATES PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASEs REPORTED IN GEORGIA
BY CouNTIEs, 1941-Continued

Counties

Malaria

Measles

Cases Rate Cases Rate

Dade ____________

Dawson ________ _

Decatur ________ _ 4 DeKalb _________ _

Dodge

10

4 89.3

18.0 150 674.6

5.8 200 230.0

47.6

17 80.9

Dooly

23.7

Dougherty ______ _ 29 10Ui

Douglas ________ _ 3 29.8

Early ___________ 8 42.8

Echols _________ _

2::14 819.2 9.9

Effingham ______ _

10.4

Elbert ___________

Bmanuel _________

17.0

Evans ___________ 10 135.1

Fannin

l!,a:rette _________ _

73.4

]'loyd ___________

12.5

Forsyth

Franklin ________ _ 4 25.6

2i!

6.4

Gilmer __________ _

11.1

Glascock ________ _

22.0

Glynn __________ _

Gordon _________ _

21.7

Grady __________ _ 2 10.2

Greene __________ _

7.3

Gwinnett -------Habersham ______ _

Hali ____________

5.7

Hancock ---------

Haralson _______ _

Harris __________ _

17.5

Hart ____________

HeBrd ----------- 23 267.1

Henry ___ ________

6.6

Houston ________ _

26.:1

Irwin ___________ _ 1 54.1

Jackson ________ _ 1

5.0

Jasper __________ _

k f f llavis __ _

22.6

.Jefferson ____ _

44.9

Jenkins

8.4

Johmmn

7.7

Jones _

l . amar

2 20.7 51 260.0
21.3
12 81.3
~13 486.3 58 512.3
226 1,447.6 852 216.9
282 1,286.5 162 878.3
5.1
36 262.6 13.8
48 325.0 26 74.5 38 297.7
23 160.0 31 271.3 10 64.5 20 232.3 21 138.9
70.8 38.7 145 721.8 6 68.4 ll.3
3 15.0 51 430.6 11 84.9 18 216.1

Pneumonia Poliomyelitis Scarlet Fever Cases Rate Cases Rate Cases Rate

1 17.0 2 44.7 42 188.!J 94 108.1 13 61.8
41.5 48 168.0 14 139.3 13 69.6 1 33.7

6 101.8 22.3
4 18.0 47 i!4.1
23.8

3 17.8

2

7.0

49.7

22.5 61 70.2
4.8
23.7 11 38.5
19.9

4 41.';

51.8

24 122.3

6 30.6

5.1

18 76.5

7 94.6

13.5

61.0

20.3

27.1

24.:J

36.7

12.2

88 156.7

12.5 36 64.1

79.5

10.7

8.8

19 121.7

32.0

25.6

144 36.7 172 43.8 276 70.2

100.0

52 237.2 53 287.3 23 117.0
17 124.0 14 48.1 13 88.0 19 54.5
6 47.0
13 90.4 6 52.5
10 64.5 81.3
10 66.1
61.9 18 139.1 16 79.6
79.8 4 45.2
26 129.7 35 29:i.5
1;).4 36.0 18 178.4

4.6 38.0

2 14.6 24 82.5
2 13.5 ll 31.5
54.8

10 69.6

2 17.5

1

6.4

3 34.8

46.3

3 23.2 9 44.8 3 34.2 4 45.2

4 20.0

1

8.4

7.7

12.0

9.9

4.6 17 92.2
2 10.2
30.9 33.9 31 88.9 54.8
7.0 8.8 19.3
3 14.9 2 22.8
12.0

Preventable Diseases

123

NuMBER oF CAsEs AND CAsE RATEs PER 100,000 PoPuLATION OF SPECIFIED
NoTIFIABLE DisEASEs REPORTED IN GEoRGIA
BY COUNTIES, 1941-Continued

counties

Malaria

Measles

Cases Rate Cases Rate

Lanier ---------Laurens --------- 18 Lee -------------- 10
Liberty -
Lincoln ---------

Long ------------ 10

Lowndes

176

Lumpkin ---------

Macon ----------

Madison ----------

53.6 127.6
69.8
244.7 552.4
64.4

12 35.7 4 51.0
23.3
11 34.5 4 36.8
20 377.9

Marion ----------

McDuffie -------- 2 14.9

Mcintosh -------- 1 14.4

Meriwether ------

22.7

Miller ----------- 4 40.0

7.4
11 185.9 10.0

Mitchell --------- 4 17.2 704 3,026.5

Monroe ----------

45 418.6

Montgomery -----

10.3

Morgan ----------

68 534.9

Murray ----------

Muscogee -------Newton ---------Oconee ---------Oglethorpe ------Panlrling ---------

2.6 178 235.8 4 21.5
48 386.2

Peach ----------- 6 57.8

24 231.3

Pickens ----------

82 897.5

Pierce -----------

8 . .5

Pike ------------ 6 57.8

38 366.3

Polk ----- ------- 1

3.5 154 541.0

Pulaski ----------

Putnam ----------

11.7

Quitman ---------

Rabun -----------

173 2,212.0

Randol PI'

6 36.1 14 84.3

Richmond

12 14.7

Rockdale

12.9

Schley -----------

19.9

Screven

9 44.2

Seminole

11 48~.8

435 531.4 120 1,553.6
3 14.7 16 188.4

Spalding

3.5

Stephens

2 15.4

Stewart --------- 6 :i6.6

Sumter ---------- 22 89.8

Talbot -----------

12.3

6 21.1 64 493.4 13 122.6 23 93.9
3 36.9

Pneumonia Poliomyelitis Scarlet Fever Cases Rate Cases Rate Cases Rate

53.3

34 101.2

4 11.9

89.3

2

~5.!J

12.8

11.6

42.6

56.8

18 9

24.5

17 53.4

6.3

13.7

1 16.1

48.2

11 101.1

6 113.4

2;).1

1g 96.8

14.9

2 28.8

26 117.9

27.2

6 60.0

19 81.7 10 93.0 11 113.8
ri5.1 26.9

18.6
2:~.6

2

8.6

7.9 9.0

101 133.8 19 102.3 6 79.2 40.2 10 77.9

18 23.8 26.9 92.4
4 32.2 5 39.0

46 60.9 10.8

30 289.1 76.6 76.3
27 260.2 19 66.7

19.3 10.9
8.5 6 57.8 17 59.7

9.6 8 28.1

9 91.6 8 94.0
58.2 13 166.2 15 90.3

10.2 4 24.1

10.2
3 38.4 5 30.1

J9

96.::;

77.7

19.9

22 108.1

18 212.0

9.8

8.6

38.8

19.9

3 14.7

1 11.8

29 10~.0 7 54.0
14 132.0 1R 195.9 8 98.3

10 35.2 7.7
37.7 16.3 24.0

17.6 61.7 8 75.5
8.2

124

Georgia Department of Public Health

NuMBER OF CAsEs AND CASE RATES PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DisEASEs REPORTED IN GEoRGIA
BY CoUNTIES, 1941-Coatinued

Counties

Malaria

Measles

Cases Rate Cases Rate

Taliaferro

Tattnall ---------

12.3

Taylor ----------- 4 37.1

Telfair ---------- 15 99.0

Terrell ---------- 13 78.0

88 817.2 61) 39tl.2 13 78.0

Thomas ----------

23.6

Tift -------------

48.4

Toombs ---------- 26 153.4

To,vns -----------

Treutlen ---------

Troup ------------ 12 Turner - --------Twiggs ---------Union ----------Upson ------------

27.3 9.2

136 434.7
374 2,206.2 J6 1,137.1

so 182.3

32.9

76 989.6

1

4.0

\Yalker - --------

29.0

Walton -----------

4.8

Ware ------------

""arren ----------

87.9

""'ashington ------ 33 136.2

267 860.6 79 380.2 3-l 121.7 4 39.1 29 119.7

'Vayne "\Yehstcr --------Wht'eler -----White ---------Whitfield --------

2 15.2 6 127.0
93.7

2

7.7

Wilcox ---- --- --- 26 203.8

""'ilkes ----------

:13.1

Wilkinson -------- 6 :i4.-l

Worth -----------

3 22.9

14 296.2

23.4

:t.~

2

1.1

16 125.4 3:; 2:~2.0
;14.4 2~ 117.0

Pneumonia Cases Rate

Poliomyelitis Scarlet Fever Cases Rate Cases Rate

111.5 :l4.6 46.4
2:1 16G.1 :12 191.9

12.3 ~ 19.8

2 18.6 6.6 6.0

17 54.3 43.0
11 64.9 182.7 13.1

3.2 4 21.5
11.8

6.4 3 16.1

26 :19.3 1 :16.9 8 87.7
11 143.2
:n 123.7

6.8 2 18,4
11.0 13.0 11 43.9

16 36.5 4 16.0

34 109.6 18 86.6 70 250'.6
48.8 42 173.3

20 64.5 12 57.8
14.3 9.8 4.1

53 170.8 7 33.7 7.2 9.8 12.4

38.1 17 359.7
23.4 77.9 20 76.6

22.9

21.2

11.7

1'i.6

15.3

28 107.3

70.6

:;3.0

6.6

13.3

17 154.2

27.2

:l2.8

9.4

32.8

Camll VvTheeler Ft. QglethOI'D

239

:'j(J

2:3

20

Ft. Screven

Savannah Ai1 Base...

Ft. Benning

41

vn

-16~

Lawson Gen'l Hosv. 2

Tuiner Field

Dan Aero Tech

Camp Ste\vart

Camp Gnrdon

Ga. Aero Tech

CamiJ Hancock

Daniel Field

]:; 124

Preventable Diseases

125

NuMBER OF CAsEs AND CAsE RATES PER 100,000 PoPULATION oF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CoUNTIES, 1941-Continued

Counties

Syphilis Tuberculosis Cases Rate Cases Rate

State Total

19,540 621.3

Rural ----------- 6,662 :121.6

Cities 2,500-5,000 1,096 741.4

Cities 5,000

and Above _____ 11,782 1,272.4

2,63;) 1,180
179
1,276

83.8 57.0 121.1
137.8

Appling ---------- 148 1,020.9

27.6

Atkinson ---------

14.1

28.2

Bacon ----------- 2 24.7

86.5

Baker ------------

Baldwin

111:1

Banl\s

1

Barrow Bartow - _________ _ 4

Ben Hill ________ _

425.8 1U) 2:1.0 15.8 6.9

Berrien _________ _

Bibb --------- ___ 643 Blecldey _________ 45
Brantley ________ _

Brooks

18:1

4J.5 767.5 466.1
892.8

95.1 6 68.7 1:J 99.5 16 63.3 4 27.5
2 13.0 106 126.5
1 10.4 29.1
15 73.2

Ur:n111 ----------Bulloch _________ _ 218
Burke __________ _ 161

111.3 838.1 607.1

Butts ------------

10.9

Calhoun

113 1,082.6

11 174.9 11 42.3 36 135.7
9 98.0 11 105.4

Camden

152.3

Candler

6 65.9

Carroll ____________

Catoosa __________ 26 213.1

Charlton

19.0

67.7 33.0 11 32.2 17 139.4 57.1

Chatham _________ 3,695 3,132.2

Chattahoochee Chattooga _______ _ Cherokee ________ _
Clarke ___ ________

135 891.8

1

ri.4

2

9.9

449 1,581.1

Clay ____________ _ Clayton __________ _ Clinch ___________ 37 Cobb _____________ 219 Coffee ______ _____ 168

17.2 574.8 572.2 779.9

Colquitt _______ ___ 249 Columbia ________ 3 Cook _ _____________ 4 Coweta ___________ 2
Crawford

754.3 31.8 33.6 7.4
14.0

203 172.1 12 79.2 12 64.8
8 39.7 17 59.9
42.5 42.9 6 93.2 42 109.7 14 65.0
21.2 10.6 50.3 24 89.0 4 56.1

Typhoid Cases Rate
397 12.6 261 12.6
47 31.8

Whooping

Typhus

Cough

Cases Rate Cases Rate

946 30.1 1,406 44.7

477 23.0 816 39.4

155 104.9

53 35.9

89

9.6 314 33.9 537 58.0

6.9

15 103.5

55.2

14.1

70.5

24.7

68.1

4.1
4.0 3 20.7

8.3

24.8

ll.fi

7.7

61.2

15.8

19.5

6 39.0

4.8

49 58.5 212 253.0

7 72.5

14.6

4.9

12 58.5

63.6

7.7

19 73.0

11.3

1:) 49.0

19.2

21 201.2

15.9 3.8
9 33.9 3 32.7
19.2

16.9

152.3

33.0

20.5

2.9

33 96.1i

8.2

18 147.6

19.0

9:>.1

3 57.1

13 11.0

86 72.9

63 53.4

4 21.6 R 3tl.7

ri.O

1

5.0

24 84.5

28.3

31.1
1G.1 8.4
11.1

31.1 13.1 6 27.9
22 66.6
11 92.3 3.7

18.3 23 106.8
6.1 74.2 10 83.9 16 59.3

126

Georgia Department of Public Health

NuMBER oF CAsEs AND CASE RATES PER 100,000 PoPULATION OF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CoUNTIES, 1941-Continued

Counties

SYilhilis Tuberculosis Cases Rate Gases Rate

Crisp _____

2211 1,277.1

Dade ___________ _

Dawson Decatur DeKalb

15 67.:. 375 131.3

1:J H.1 101.8 67.0
16 72.0 65 74.8

Dodge

92 437.6

Dooly

3 17.8

Dougherty _______ _ 33 115.5

Douglas __ --------

29.8

Early ____________ _ 15 80.3

Echols __________ _

Effingham ______ _ 1 41.5

Elbert ----------- '1 20.4

Emanuel

8 3'1.0

Evans

13.5

19.0 35.5 32 112.0 14 139.3 3 16.1
101.2 8 82.9 6 30.6 12 51.0 3 40.5

.Fannin

3

Fayette Floyd ___________ _ 230 ll10rsyth _________ _

Franldin _________ 30

20.3 36.7 '109.7
192.2

10 67.8 61.2
78 138.9 61.8 ,1,1.8

Fulton ___________ 5,461 1,390.0 Gilmer __________ _

Glascoe!; ----- ___ _ Glynn ___________ _ 6 27.4

Gonion

lfi 81.3

,198 126.8 11.1
110.0 16 73.0 13 70.5

Grady

151

f:reene ___________ _ s;;

Uwinnett ________ _ 3 Habersham _______ _ 1~

Hall _ ----------- 122

768.3 620.0
10.3 81.2 349.8

40.7 10 72.9 12 <11.3
47.4 26 74.5

Hancock

34 266.'1

Haralson 1Iatris ___________ _ '1 35.0 Ha1't ____________ _ 2 12.9

Heard

2 23.2

Henry Houston Irwin _____________ _ Jackson _________ _
Jasper -----------

13.2 53.1 2 15.5 'l 19.9 102 1,162.8

.Jeff Davis ________ _ .Jefferson _________ .Jenlrins ___ ___ __ _ .!ohnson ___________ .Jones ______________

100 499.0 181 1,::i28.3
1 7.7 40 588.2

6 17.0 11 76.5
52.5 4 25.8
3'1.8
52.0 17.7 3 23.2 10.0 79.8
39.9 19 160.4
5 38.6 10 120.0

Typhoid Cases Rate
34.2

Whooping

Typhus

Cough

Cases Rate Gases Rate

:>9.9

25 112.4

82 368.8

2.3

11 12.7

17 10.6

4.8

26 123.7

23.7

11.8

7.0

28 98.0

61 213.5

11 109A

5A

30 160.6

10.4 20.4 12.x 108.1
6.8

3

ri.3

61.8

57.6

6.1 22.2

10
25.4
7.~
6.9
5.7
2:i.5 34.8
8.8
10<1.5 26.il
46.'1 19.9
11.3 2 10.0
RA
23.2

2 20.7 5.1 21.3 27.0

11 G6.1 S.5
20.3 12.2 12.r>
8.8

13.7 12 23 117.0
2.9

;);) 1<1.0 11.1 22.0
36 16,1.2 10.8
5.1 1<1.6
6.9 9'1.8 14.3

17.5
8.8 61.8
3'1.2 22.6
5.0 8.4 7.7

26.:~
6.4 46.5
6.6
30.9 12 59.7

H 69.9

3

2ri.3

7.7

72.0.

Preventable Diseases

127

NuMBER OF CAsEs AND CAsE RATEs PER 100,000 PoPULATION oF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CouNTIES, 1941-Continued

Counties

SYJJhilis Tuberculosis Cases Rate Cases Rate

Lamar --- ---------

9.9

Lanier -----------

53.3

Laurens ---------- 93 276.7

Lee --------------

12.8

Liberty -----. ___ _ !3 151.3

6 59.5 17.3
18 53.6 9 114.8 8 93.1

Lincoln ---------Long _----------IJowndes _________
Lumpldn --------Macon -----------

1<!.2 10 24<1.7 627 1,968.0
1 16.1 58 533.2

:Madison ---------

lllarion ----------- 1 6.3

McDuffie _______ _ 1

7A

Mc!ntosll --------- 3 13.1 Meriwetller ______ _ l 18.1

11 156.2 2 18.9
18 56.5 8 128.6 13.5
4 75.6 3 13.3 2 l<J.9 1 57.5 13 58.9

1111ler -----------~v!itchell --------Monroe ---------l'llontgomery _____ _
:Morgan ----------

5 50.0 395 1,698.1
6 56.8
55.1

J.\hu'!'ay ---------:Vluscogee -------- 4<10 Newton ---------- 11 Oconee -----------Oglethorpe ------- 2

:J82.8 59.2 13.2 16.1

10.0 6 25.8 6 55.8 2 20.7
62.9
10 89.8 50 66.2
9 !SA l 52.8 4 32.2

Paulding
Peach -----------Pickens ---------""Pierce -----------Pike --------------

137 1,320.1 3 32.8 76.3 18.2

Polk

17 59.7

Pulasl<i ---------- 2 20.3

Putnam ---------- 3 25.2

Quitman ---------

Itabun ___ -------

2 15.6 1<1 134.9
l 13.8 10 84.7 11 106.0
23 80.8 3 30.5 58.7 1 29.1 3 38.'1

Randolph -------- ~1 l!ichmond -------- 725 Itock<lale --------- 6 Schley ----------- 2 Screven ---------- 13

186.6 885.6
77.7 39.7 63.9

<!2.1 103 131.9
1 12.9 59.6
12 59.0

Seminole Spalding Stephens Stewart
Sumte1 ----------

30 253.3 320 1,125.7
21 185.0 10 94.3 525 2,1<12. 7

7 82A

45 158.3

13 100.2

1

9.'1

23 93.9

Typhoid Cases Rate
9.9

Whooping

Typhus

Cough

Cases Rate Cases Rate

17 168.5

H.9 2 25.5
11.6

16 47.6 51.0 3<1.9

6 H6.S

22.0

28.2

3.0 12.8
127.8 9A

5 46.0

32.7

9.2

3 56.7

12.5

16 119.1

7.'1

13.6
3<1.'1 27.9 10.3 2 15.7
35.9 2.6
~6.9
16.1
7.8 9.6 10.9
(; 57.8
21.1

l 10.0 27 116.1

7.9

2

2.6

2 26A

10 96A
18 152.5 9.6
3.5 2 20.3

10.0

50 215.0

1

9.3

21 165.2

9.0

18 63.6

1

5A

2 15.6

28.9

1

6.0

9 11.0

<1.9
3.5 1.1 9A 6 2'!.5

2 53.2 12.1

19.9 13 63.9

32 376.3

1

3.5

23.3 13 53.1

70 395.0
6.0 31 37.9 10 129.5
26 306.2 3 10.6 5 38.5 17.2
17 69.4

128

Georgia Department of Pnblic Health

NuMBER oF CAsEs AND CAsE RATEs PER 100,000 PoPULATION oF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA
BY CoUNTIES, 194.1-Continued

Counties

SYJJhilis

Tuberculosis

Cases Rate Cases Rate

'l'albot -----------

36.9

Taliaferro ---------

47.8

'l'attnall ---- ------- 1 21.6

'faylur ----------- 2 18.6

elt'nir -- -------- 87 57!.4

'l'el'l'ell ----------Thomas - -----.----
'l'ift -------------
'l'oombs ---------'!'owns -----------

281 1, 685.2 10 32.0
219 1,177.5 33 191.7

Treutlen ---------
'J'roup ------------ 323
Turner ----------- 1
'Xwiggs ---------- 1
Union -------------

736.1 9.2
18.9 13.0

73.7 1 63.7 2<1 1<17.8 1 37.1
39.6
17 101.9 22 70.3 18 96.8 12 70.8
10.6
13.1 16 104.8
9 83.0 8 87.7
13.0

Upson ----------- 1
\\'all<er ------------- 11 Walton ---------- 50
'.\"'aJ'e ------------- 113 \Ynrren --------- -- v

16.0 132.2 210.7 101.6
29.3

\Yashington ----- . 135
\\~ayne ----------- 57
Webster ------ v--- 6
Wheeler ---------- 25 White ------------ 5

557.2 134.'1 127.0 292.9
77.9

Whitfield

77

Wilcox ------ ---- 9 Wilkes -----------
"\Vil1nnson v- ------
\Yorth ----------- 82

Camp Wheeler

51

Ft. Oglethorpe 18

Ft. Screven

Savannah Air Base...

Ft. Benning .................290

Law:soon Gen'l Hosp. 1<1

Turner Field

Dan Aero Tech

Camp Stewart

Camp Gordon

Ga. Aero Tech

Can1p Hancock

Daniel Field

Ft. McPherson

295.0 70.6 13.3
383.6

l<l 55.9 19 157.9
7 33.7 23 82.'1 5 18.8
25 103.2 H 106.7
1 21.2 70.3
5 77.9
37 Hl.7 1 31.4 8 53.0 7 63.5 12 56.1
,10

Typhoid Cases Rate

Typhus Cases Rate

Whooping Cough
Cases Rate

<1 2-1.6
2~.4

12.3
11 67.7 8 7'1.3
15 99.0

2 31.9 2 12.3 31 313.6 2 13.2

18.0

,",

9.6

18.4

16 96.0 20 63.9 33 177.'1 10 59.0

1 24.0
5.'1 11 61.9
81.2

3

6.8

2 18.4

13.0

3 39.3 18.'1

18 <!1.0 9?
1 11.0 3 39.1

12.0
13 62.6 3.6
3 20.3

1

l.O

8 25.8

12 13.0

10 :12.2 20 96.3 H 265.0
78.2

l2A

12 <19.5

11 45.4

r.o

5 38.1

2 42.3

82.0

105.'1

lG 17:i.7

16.8

12 16.0 7.8
2 13.3 9.1 !.7

10 73.'1 18 8<!.2

7.8 ll 73.0
1 18.!

3

128

Preventable Diseases

129

NuMBER oF CAsEs AND CASE RATES PER 100,000 PoPULATION IJF SPECIFIED
NOTIFIABLE DISEASES REPORTED IN GEORGIA CITIES,
5,000 POPULATION AND ABOVE, 194.1

Cerebrospinal Cities 5,000 Estimated Meningitis
and Above PotJU lation Cases Rate

Albany ------ 19,055

10.5

Amel'i<'t!s -- - 9,281

Athens ---- -- 20,650

<1.8

Al!anta ----- 302,288

2.3

Augusta ----- 65,919

Bainbridge --
Brunswiek ---
Carrollton ---
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,<l<l8 16,561

1 16.1
3.8 6.0

Douglas
Dublin -----East Point -Elberton ---_ Fitzgerald ---
Gainesville _.

5,175 7 ,81<1 12,<103 6,188 7,388 10,2<13

Griffin ------ 13,222

Hapeville --- 5,059

IJaGrange --- 21,983

l\Iacon ------ 57,865

1.7

~\fal'ietta ---- 8,667

;l<!illedgevllle - 6,778

1foultrie ----
Newnan ----
Rome ------Savannah
Statesboro ---

10,1<17 7,182
26,282 95,996
5,028

Thomaston --
Thomasville --
~l'ifton ------
Toccoa -----Valdosta
\Ya.ycross ----

6,396 12,683
5,228 5,49<1 15,595 16,763

Diphtheria Cases Rate

5.2

3

32.3

31

10.3

31

<17.0

<1

6<1.'!

4

<11.3

15

28.2

1

12.6

12

1H.9

2

12.1

2

25.6

2

16.1

12

193.9

68.3

2

15.1

22.7

12

20.7

3

34.6

<1

59.0

2

19.7

22

33.7

5.2

7.9

38.3

22

400.4

6.4

Gonorrhea Cases Rate

13
1 1,136
7<19

68.2 53.9 <1.8 375.8 1,136.2

15.7

46.6

1;1

225.3

48.9

33.2

2

2<1.4

25

<16.9

75.7

203 1,9<13.0

3

18.1

55 1,062.8

12.8

10

80.6

17

166.0

25

189.1

19.8

25

113.7

50

86.'!

6

69.2

<13

63<1.'!

65

640.6

19.0

491

511.5

5

99.<1

15.6

28

220.8

23

<139.9

8

1<15.6

<1<1.9

76

!53 A

Influenza Cases Rate

<13 63
3,<190 1,000

225.7 678.8
29.1 1,15<1.5 1,5!7.0

6

94.5

10

66.5

58

933.4

76<1 12,<1<ll.O

177 1,961.2

2<1

292.2

128

2t!0.2

20

252.2

1

38.3

18.1

13<1 2,589.'!

188 2,<105.9

27

217.7

57

921.1

8

108.3

48.8

1

30.3

132 2,609.2

209

950.7

2<1

t!l.5

7

80.8

56

826.2

55

5t12.0

82<1 2,075
7
75 19
6 21 3<1 1,696

3,135.2 2,161.5
139.2
1,172.6 l<l9.8 114.8 382.2 218.0
10,117.5

130

Georgia Department of Pztblic Health

NuMBER oF CAsEs AND CASE RATES PER 100,000 PoPULATION oF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA CITIES,
5,000 POPULATION AND ABOVE, 1941
(Continued)

Cities 5,000 and Above

Malaria Cases Rate

Albany --------- 19 99.7

Americus -------

53.9

Athens ---------

Atlanta --------- H

<1.6

Augusta -------- 8 12.1

Bainbridge

Brunswicli:

Carrollton

16.1

Cartersville -----
Cedartown ------

College Pari< ----

Columbus

1

Cordele --------- 11

Dalton ----------

Decatur ---------

1.9 138.8
19.1 6.0

Douglas ---------

Dublin ----------

89.6

East Point ------ 2 16.1

Elberton --------

Fitzgerald -------

27.1

Gainesville ------

9.8

Griffin ----------

7.6

Hapeville -------

LaGrange -------

l\Iacon ---------- 2

3.5

Marietta --------

Milledgeville ----

Moultrie --------

69.0

Newnan ---------

Rome -----------

3.8

Savannah ------- 26
Statesboro ------
'11homaston ------
'11homasville -----
'fifton ----------

27.1 39.8
23.7 133.9

'11occoa ---------Valdosta -------- 103 "\Vaycross -------

18.2 660.5

Measles

Pneumonia

Cases Rate Cases Rate

159 834.4 'll 215.7 20 215.5 21 226.3
230 1,113.8 11 53.3 719 237.9 102 33.7 387 587.1 72 109.2

62 <112.4 <1 6<1.4 90 1,<165.6
27 299.2

31.5 36 239A 13 209.2
3 <18.9 22.2

21 255.7 57 107.0
50 A 2 19.1

5 60.9 92 172.7 10 126.1 10 95.7
5<!.3

23 H<1A 10 128.0 32 258.0
2 32.3 <10.6

11 212.6 12 153.6 11 88.7
1!5A 11 1<!8.9

15 H6A <1 30.3 15 296.5 26 118.3 979 1,691.9

9.8 20 151.3
19.8 21 95.5 39 67.'1

11 196.1 15 221.3 20 197.1
96 365.3

16 18<1.6 11 162.3 1<1 138.0
3 <11.8 <16 175.0

363 378.1 2g5 296.9

19.9

139.2

15.6 16 250.2

111 875.2

:~9A

95.6

62 1,128.5

9

57.7

34 202.8

2 36.'1 8 51.3 60 357.9

Poliomyelitis Cases Rate

21.5

29.1

115 38.0

6

9.1

31.5

16.1 16.3 12 133.0

2 21A

16 30.0

6 75.7

9.6

H

8<1.5

19.3 2 25.6 3 2-=1.2
<18.5 27.1

68.3 60.5 2 39.5
<1.5 16 27.7

5 57.5 H.8

13.9 11.1
15 15.6

9 1<10.7

1

7.9

4 76.5

2 11.9

Scarlet Fever Cases Rate
36.7 21.5 1<f 67.8 202 66.8 10.6
6.7 16.1 32.6 3 33.2
109.6 <14 82.6
2 25.2 16 153.1 . 22 132.8
<1 32.3
11 107.'1
98.8 8 36.4 2:} <13.2
15 173.1 132.8 9.9
17 6-1.7
83 86.5 19.9
4 62.5
19.1
127A 25.6
2 11.9

Preventable Diseases

131

NuMBER oF CAsEs AND CAsE RATES PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA CITIES,
5,000 POPULATION AND ABOVE, 19M
(Continued)

Cities 5,000 and Above

Syphilis Cases Rate

Albany ~--------

27

Americus ------- 9

Athens --------- 75

Atlanta -------- OJ,'156

Augusta -------- 697

141.7 97.0
363.2 1,80<1.9 1,057.'1

Bainbridge -----

Brunswick

Carrollton ------

Cartersville

2

Cedarto\YU

12

31.5 33.3
32.6 133.0

College Park ____

12.2

Columbus ------ 42<1 795.8

Cordele -------- 137 1,727.9

Dalton --------- 72 689.1

Deeatur

11 66.4

Douglas

111 2,H5.0

Dublin ---------

89.6

East Point ----- 2

16.1

Jl.!lberton -------

32.3

Fitzgerald ------

13.5

Gainesville ----- 110

Griffin

21<1

Hapeville ------- 1

LaGrange ------ 229

!\lacon --------- 251

1,074.0 1,618.5
19.8 1,0<J1.7
'133.8

Marietta ------- 105 1,211.5

~lilledgerille ---- 93 1,372.1

:.Ioultrie

230 2,266.7

Newnan --------- 1 13.9

Rome ---------- H

53.3

:::;avannah ------3,028 Statesboro ------ 91 Thomaston ----- l Thomasville ---Tifton ---------- 168

3,15t!.3 1,809. 9
62.5 63.1 3,213.0

Toe('oa --------- 22

Yaldosta

53

\Yaycross ------- 107

<100.4 339.9 U38.3

Tuberculosis

Typhoid

Cases Rate Cases Rate

32 167.9

5.2

16 172.4

21.~

15 72.6

392 129.7 H

<1.6

95 144.1

2

3.0

110.2

11 73.2

<1 6<1A

<18.3

81.4

77.6

33.2

109.6

12.2

<16 86.3

3.8

8 100.9

12.6

25 239.3

8U.1

12 75.5

173.9

13 166.4

51.2

15 120.9

18.5

16.2

4 54.1

13.5

17 166.0

9.8

38 287.4

7.6

3 ;)9.3

19.8

29 131.9

!1.5

96 165.9

6.9

1;j 173.1

H 206.6

14.8

3 29.6

15 208.9

1:U

51 194.0

3.8

177 184.4 99.4
1<10.7 15 118.3 H 26U

12 12.5 1 19.9
46.9 7.9
1:i3.0

12 218.4

18.2

14 89.8

4'1.9

21 125.3

6.0

Typhus Cases Rate
22 115.5 11 118.5
52 17.2
11 173.2 11 73.2

11.1

12.2

2

3.8

<1 50.4

6.0
58.0 10 128.0

16.2

9.8 7.6

,13 1<1.3 3<1.6
12 118.3

81 8<1.<1 99.4 15.6 17.3
22 '120.8
25.6 29.8

Whooping Cough
Cases Rate 31 162.7 10 107.7 23 111.4 50 16.5 30 '15.5
27 179.6 3 <18.3 16.3
32 60.1
30.2 4 77.3
12.8 16.1 6'1.6
'1 39.1
19.8 22.7 167 288.6 3 3<1.6 6 88.5 2 19.7 13.9 6 22.8 38 39.6
91.0 12.8 1<1 4<11.4

132

Georgia Department of Public Health

TYPHUR FEVER CONTROL SERVICE
For 19Ll.l, 927 cases of typhus fever were reported as compared with 57L1 cases for the year 19L10, an increase of 353 cases or 61.5% in 19L11 over 194,0. This increase during 19L11 has been due apparently to an extension of the disease in areas heretofore unaffected and an up-swing in the apparent cycle of this disease.
Three hundred and fifty-six field visits were made in rendering services to fifty-eight cities in fifty-two counties in the year 19LU, as compared with 4,07 field visits to fifty-five cities in fifty counties during the year 19L10. Although there is a slight decrease in the number of field visits made in l9L11 compared with 19LJ0, this figure cannot be interpreted as meaning more services rendered due to the fact that each field visit may range from one-half day to one week. However, it is sho-wn from the above figures that about an equal number of cities and counties received services for the year 19LU as compared with 19LJO.
In addition to the services rendered to cities and counties, an increase in services was rendered to the War Department during 19LU over 194,0 in the rat-proofing of buildings under construction in Army mobilization camps and air bases in Georgia. Also in 19LH, a Typhus Fever Investigative Project was placed into operation within the City of Savannah, Georgia. This project was started during the month of February, 19LU, and continued throughout the year. It is expected that this project will be terminated about the first of March, 194,2, and results published for information to all health agencies throughout the nation. The purpose of the Savannah Investigative Project is to evaluate the effectiveness of typhus control measures, originated and currently employed by the Typhus Control Service in controlling typhus fever in counties throughout the State. Agencies cooperating in this investigation are the Georgia Department of Public Health, United States Public Health Service, City Council and Health Department of the City of Savannah, and the Works Projects Administration.
Education
Information on typhus fever control was disseminated by the Typhus Fever 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.
During the year, twenty-five addresses were made to civic organizations, meetings of city and county commissioners and public gatherings with a total of approximately 34-5 persons in attendance. A total of 1,332 informal discussions and conferences were held with city and county officials, architects, contractors, merchants, and health department personnel in the promotion and supervision of typhus control programs.
Lectures were given in the public health class at Emory University, and public health engineering classes at the Georgia School of Technology.

Preventable Diseases

133

Three radio broadcasts were made during the year, resulting in many requests for additional information.
A new bulletin on the control of typhus fever, Murine Typhus Fever, was published during the latter part of 19M to meet the demand for complete information on this subject by the people of Georgia. In addition to the hundreds of requests that have been 1eceived throughout the State, a large number of requests are being received from people in other states. Among the out-of-state requests, many have been from federal, state, and city health agencies. The first printing of 5,000 of these bulletins was exhausted before the end of the year.
Investigations
Thirteen city-wide and three special investigations were made in cities requesting assistance. These investigations were directed toward the determination of the prevalence of typhus fever and the existing conditions affecting the prevalence of typhus fever, such as rat infestation, rat harborage in buildings, and refuse and garbage disposal on premises. The reports, based on findings from the investigations and including control meastues and cost estimates of work to he performed, were submitted to the city officials.
Vent-Stoppage
Vent-stoppage, a modification of rat-proofing buildings, has proved to be a practical and inexpensive rat-control measure, and consequently a typhus-control measure. Vent-stoppage is closing or protecting openings in exterior walls of buildings to prevent the ingress of rats. During the year, 1,227 business establishments were surveyed for vent-stoppage, and 589 were vent-stopped. The total number of vent-stopped buildings to date ' since lVlay, 1939, when vent-stoppage was fi1st applied, is 1,842. A total of 2,8<1.0 inspections were made of business establishments that had previously been vent-stopped, and 28<1. vent-stopped business establishments received maintenance during the year.
Garbage Control cmd Clean-Up of Premises
During l9L1l, all cities conducting typhus control programs also carried on measures for garbage control and clean-up of premises. Progress in improvement of garbage collection systems and methods of final disposal was reported in many cities. Numerous garbage receptacles of the approved type were placed on public and pTivate premises and many cities added equipment to their collection systems.
Rat Extermination
Rat exterminations under the direction of the Typhus Control Service were confined principally to the trapping of .rats after the completion of vent-stoppage in business establishments in the cities conducting typhus control programs. Rat poisoning on individual p1emises was conducted principally by property owners, tenants and commercial exterminators. In

Georgia Department of Public Health
some specific instances, premises indicated as a typhus focus were treated with poisoned rat bait by county and city health depa1tments.
Publications I. "Rat Proofing and Vent-Stoppage of Buildings in Rat Control"National Pests Publication, July, 1941, page 12. 2. "Murine Typhus Fever"-bulletin, Georgia Department of Public Health.

TYPHUS FEVER CoNTROL PROGRAM
STATISTICAL SUMMARY OF ACTIVITIES
194.1

County

Health Dept.

No. Health Dept.

City

-~

>~
;'C;
~

~ 'C
:~""":-<":'::.""".::

--"'" ""'C
~ ~~ ~
" 'C
:":0:'<C.

~
0~"""'.~""-'
c--~ Z<.

~
-0"~ """~' ."-0"""""~"'

~
."."..
t-
:cc
0":'

---

Baldwin ___________ -------------- ____ ~Hlledgeville ______ _

4

_____ ------ _______ .Ben Hill. _________.Fitzgerald_______ _

ll

7

------------------.BerrietL ___________ Nashville _________ _

4

Bibb _________________________________ Macon _________ ---

l::i

Bleckley----------- ___ --------------- Cochran __________ _

1:1 ll

Brooks _______________________________ Quiiman ______ ____ 3 ------------------Bryan_____________ Pembroke_________ . 6 B ulloc!L ______ ---- __________________ .Statesbora_________ 1
Chathan'---------------------------- Sa\annalL _________ 73 -------------- ____Cltattahoochee _____ Fort Benning ____ _

1 10 33
4 632

~fariet(a __________ . Coffee_______________________________ Douglas_________ -- ColquitL ________ -- ___________________)[oultrie __________ _
------------------Cook------------- Adel------------- _ Decatur----------- ___________________Bainbridge_________ 2

Dougherty--------- __________________.Albany___________ _ Fulton______ ----- ____________________ .ALlanta__ __ ________ 12
---------------Hapeville__________ 1 Glynn------------- __________________.Brunswick_________ 10
Grady------------- ______ ------------ Cairo-------------

Vent Stoppage-Business Establishments

Invest!gations

'"C'

~ ....

i;
(3

'<;
"c.
(/)

Completed

~,
"i:: "(/)
zQ

,

:;;:
"-"

- --;;;.,

""' "~ " 0">~. 0"c:'.

3
c t-

~
:""g' ;" ; "
Q

~,
">
;~ ;;
"0:
Q

-"""""""~

z z ::<:

""tt

~

!9:i

~g

18 lOu

:10

S3

:!;)

HI

3G

riO

120

-- -- -- --

12:! ltt

<::
"':::>
~ ~
~"'
&;

37 198

--

;J

198 ll4u 4

so """""'''''

67 riO iiO 18 18

8:1 85

1

215 17 2:12 18

--

29

7

'

;),i

>-'

:(:.)n~

TYPHUS FEVER CONTROL PROGRAM

w1-'

STATISTICAL SUMMARY OF ACTIVITIES-Continued

0\

194<1

County City

Health Dept.

No Health Dept.

Greene ____________ ------ ____ --------.Greensboro

w

>.w..
o; ;;:

.w.,
"'

.....,..

:~":.'<-~

...
w ., .., w
:."":,:' ,w~..

w c
...E.Q, .":'
c.. c .S

~

" ., - "c
c~

Q .,

w
~

.c..

:l::<

Q-
Z<C

C" ..QQ

w
-.:;.;:
1-
:Qc
"" '

Alto Hancock_______________________________ Sparta ---------- 4
------------------.Harris ____________ Pine ML Yalley..

------------------.Houston----------Wellston

1

----- __ -- ____ ---- _.Jasper ---------- Monticello -------------------.Jeff Davis .. _______ Hazlehmst _______ _

L~~l~~~~--~~~~~-~~~~-Lanier

_______ Lakeland

--------- Dublin

ll

------------------.Libel'ty------------Hinesville

Lowndes __________ _

---.Valdosta

___________________!\lacon------------ :\1ontezuma --------

-------------------~ieriwether ________ Manchester_ ___ _

MitchelL________________ ..

13

----------------- ..Polk _____________ .Cedartown _____ . ------------------.Randolph ------ ___ Cuthbert __________ _ ------------------.Schley __ ---------- JOllaville

12
2
-
2
1

2

34
---
2.) 12

13 13

1

4

22
-s

l:i

2:1

3

4

6

Vent Stoppage-Business Establishments

lnvesti gations

."..

~

}; i:3

"c"~'".
"'

Completed

~

i"":''

"'-;;;.,.

~
Q
z

..,. "'

-" "' Q
>

-Q~

" c"~..'

c.
a:

...
-:;;
1-

-39
1

w ...

c
Q
~
c.
"c '
Q
z

.i"",:'
~
"'
Q
z

- "' "~"'
c

"0 '

.c"..

~
~-

=::

b

~

:.;.:.,,

g

126

14

;.".:.';.

--0
'""ti

6 13 13 12j 125 147

~ "'""''

2ri

-- -- 13

1

367

-- --

so

--

--

1::!::
s~ "'-

::i6 56 H

71 7l 291 78 100

--

144

-- -- -- -- --

103 103 r:1

4:-1

-.' .~ .

TYPHUS FEVER CONTROL PROGRAM
STATISTICAL SUMMARY OF AcTIVITIEs-Continued
194,1

Vent Stoppage-Business Establishments

County Hea:th Dept. No. Health Dept.

City

~

~
> ,e~n .,

C'C

.,_ 'Q
o;

~-::c

u:: ==<

~

" 'C ., ~
- . ., " en ~
c~

8 en
~ C..'Cc

=e ~ ~ 0::

< == < z

.~,

-
c

"""~'

.~ c~, -cc"'

'!-""

."~ .".
1-
:cc
"" '

___________________seminole __________ Donalsonville

2

Spalding ___________ ----------- _____ Griffin _____________ s

--

1 15 5 --
-- 16

--------- _______.Stewart ___________ Lumpkin _______

l

- 2 --

Sumler------------ ----------------Americus------ ___ 2 -- --

2

_------- ___________~l'a.ylo r ------ ____ -- Hoi:rard ___________ . 1 --

-- 1

-----------------Butler---------- 6 --

- 11 --

Telfair----------------------------- McRae ____________ 1 -- --

Terrell_____________ .------- ___________Dawson ___________ . ;; --

1 10

-- ________________Graves -------- 1

-- --

'l'homas______________________________ 'l'honutsYille ________

3 7
2 --

lnvestigations

'"C'

~
b
C3

"';;
"c'.
(fJ

1 ----
-- ---
-- ---
---

Completed

,.,

""1::' "(fJ

-"c;' ;;t.:,,

Q
z

:;
-C>

~-

c
;fr

C..CI:

3
c 1-

~
"

,., .,

.,

=."c,. ~

.:1;,:;:

-c "'

."".
.~c"..

Q

Q

z z ==

73 -- -- --

-- --

-- --

-- -- --

-- 29 29

9

-- 160 160

--

--

-- --

--

39 39 5S 4~

--

-- --

6 2 -- 2 5 -- --

--

2

::?
ni <::
";::';
iS
~
b"'
~
"'::::, """'''

Tift_ ________________________________ 'l'iflon_____________ 19

--

ril --

1 --

15 114 59 173 812 173 fi9

Troup _____________ .------------------LaGrange--------. 6

-----------------West Point ________ 3 --

16

___________________1'u rner ____________Ashburn ______ ----- 1

Ware--------------

_____________\Yaycross __________ 1

--
--

--

--
--

1
1 -- -- --

88 88

Washington ________

_____________Sandelsville _______ . 2

____________.Davisboro ____ ----- l

Worlh-------~----- - ... _____________Sylvester__________. 10

--

Unclassified_______. - ------------------------- ------- 61 7

4
-- 4 1 5 15 --
8 167 171

1 -1 --

--

52 52

43

-- 62 62 90 47

l'otal

31

21

58 356

8 25 345 1332

3 13

3 1227 589 1253 1842 2840 574 284

......
CJ~

-l

138

Ge01gin Department oj Public Health

VENEREAL DISEASE CONTROL SERVICE
It has been obvious for some time that there has been an urgent need for the venereal disease program to be balanced, both within itself and in relation to the other activities of the general health problem.
With 199 clinics in operation, it has been shown that slightly over fifty (50) per cent. of our case load is located in only eight (8) urban clinics. Obviously, efforts should be intensified in these urban areas.
Conversely, in many smaller communities, an unduly large proportion of time has been spent in operation of venereal disease clinics, usually in quarters which are entirely inadequate to be consistent with efficient service.
Furthermore, public health nurses, in operating clinics, spend a disproportionate amount. of time setting up for and cleaning up after clinics, filling and sterilizing syringes, and doing other purely clinical work which precludes proper interviewing of patients and other activities more essentially of a public health nature.
In view of the above considerations, two steps were takne:
l) Revised minimum standards for venereal disease, maternal and child health centers were set up.
2) Plans were made for use of local graduate nurses in venereal disease clinics, for purely clinical work, on an honorarium basis.
Case Reporting
A total of 21,657 new cases of syphilis were reported in 19M as against 21,725 new cases in 194.0. This small difference is apparently not significant. However, inasmuch as the number of new cases occurring yearly constitutes the only accurate index of the efficiency of control measures, any decrease in this number, case-finding procedures being as good as or better than previously, suggests a measure of success.
Over three times as many cases of gonorrhea and chancroid were reported in l9L11 as in l9L10. This is apparently due mainly to the increased interest in these diseases by clinics and to the fact that many new clinics have been set up. Private physicians, however, showed an appreciable increase in number of gonorrhea cases reported (375 cases in 194,1-151 cases in l9LJ0.)
Clinics
At the end of the year 194.1 there were 199 clinics operating in 102 counties with 222 physicians receiving honoraria, as against 167 clinics in eightY:six counties with 135 physicians at the end of the year 1940. All clinics are now serviced by the Central Tabulating Unit System.
It has been urged that diagnosis of syphilis not be made on the stl'ength of a single positive blood test.
Treatment schedules as outlined by The Cooperative Clinical Groups are usually followed in clinics. The routine treatment of late syphilis by beginning with arsenic instead of bismuth has been discouraged.

Preventable Diseases

139

Epidemiology continues to be the weakest point in the program. This is due more to lack of sufficient personnel than to lack of ability on the part of field workers.
Cooperation With Armed Forces
Local deparhnents, notably Augusta, Macon, Columbus, and Albany, have been reasonably successful in securing the closing of open houses of prostitution.
Epidemiological work in these areas has been very inadequate, due partly to poor contact reports submitted by the Army, but mainly to lack of full-time venereal disease control officers and adequate nursing personnel.
Cooperation With Selective Service
All positive reports on selectees clear through this division and are referred to local departments. Naturally, in "no service" counties such referrals cannot be followed up effectively by the limited number of personnel in the regional offices.
Obviously, many selectees receive treatment without our knowledge. This affects ,adversely our repor,ts as to per cent put under treatment.
Syphilis Control in Industry
It is hoped that, with the setting up of the new Division of Industrial Hygiene, a worthwhile program of venereal disease control measures can be carried on by collaboration of the Divisions of Industrial Hygiene, Public Health Education and Venereal Disease Control.
The new sound film, Know for Sure, is well adapted for industrial male audiences. Six copies have been ordered, a copy to be given each region. A widespread educational program among industdal workers is much needed.
Distribution of Drugs
The reduction in total doses of dntgs distributed for 19M as compared to 1940 is accounted for in the decrease in the amount of antisyphilitic drugs issued. This, in turn, is probably due to the fact that many larger clinics, in view of crowded facilities, have dismissed large numbers of noninfectious syphilitic patients.
Educational Jlileasnres
A marked decrease in lectures by State staff is shown for 194..1 as compared with 19~.10. This is due mainly to the fact that the Sbate Veneral Disease Control Officer, since assuming his new duties on May 1, 19M, has spent most of his time visiting clinics in 'the field and attending to administrative work in the office.
Almost twice as many pieces of literature were distributed in 194.1 as in 194-0.

HO

Georgia Department of Public Health

INDUSTRIAL HYGIENE SERVICE
The Georgia Department of Public Health has been considering the establishment of an Industrial Hygiene Service for many years. In recent years, requests for such services have been received from Georgia industries with increasing frequency. The National Defense production effort served to stimulate the birth of the Service in August, l9L1l, in the Division of Preventable Diseases.
The medical director and chemical engineer spent May, June, and July at Harvard School of Public Health taking the special intensive course in industrial hygiene preparatory to the inauguration of the new Service. Fortunately, by October, the United States Public Health Service was able to make available the services of a nurse who has had some industrial experience, and she is being employed as the acting consultant nurse in industrial hygiene.
The function and objective of the Service is "to keep as many workers at as many machines as many days as possible" and to keep the productive capacity of each individual worker at his maximum level. Two fields of preventive effort are involved, namely personal hygiene and environmental hygiene. The worker must be protected from communicable diseases, filth borne diseases, insect and rodent borne diseases, nutritional deficiencies, and all the other preventable illnesses ordinarily combated by the Health Department. He must also he protected from noxious dusts, gases, fumes, vapors, mists, smokes, etc., and from other unhealthy influences in the industrial environment which may result in mechanical injuries, burns of all kinds, electric shock, or any other injury or illness.
Adequate protection of the industrial worker from all these harmful influences hinges upon broad experience and knowledge. Such knowledge embraces all the usual fields of public health, and in addition, highly specialized technical knowledge of the medical, engineering, and chemical problems peculiar to each industrial environment.
An industrial hygiene laboratory is being equipped to make the necessary physical and chemical determinations. The completion of this has been delayed because of difficulties in obtaining the necessary furnishings and equipment, resulting from National Defense effort. It appears at the present time that the laboratory will be functioning by January or February, l9L12. Field equipment is also being provided for the collection of samples and for certain field determinations.
The work of the Service is resolving itself into two categories--the first is promotional and the second is technical and professional assistance. Some of the measures which are being promoted, as they have been shown to be most effective in the prevention of disease and accidents among industrial workers, include:
l. Pre-employment examinations of all applicants and assignment of each applicant to an occupation in a;:cordance with his physical and mental capabilities. This examination shoulci include chest x-ray and blood test.

Preventable Diseases

Hl

2. Periodic examinations of all employees, including any special medical and laboratory studies indicated as a result of exposure to specific hazards. If signs of toxicity are found, the worker should be assigned to work which is not dangerous to him.
3. Lunchroom facilities 'on a cooperative basis to teach and provide the fundamentals o.f a balanced diet.
4. Mid-morning and mid-afternoon recess periods for all workers to provide opportunity for relaxation and refreshment.
5. Control measures for cancer, tuberculosis, venereal diseases, and other communicable diseases in cooperation with the established policies of the health department.
6. All known or suspected hazards should be thoroughly investigated and suitable control measures devised and applied.
7. Provision for a system of recording and following through each case of absenteeism resulting from illness or injury. This entails home visiting by the nurse.
8. A practical system of case records and reports is necessary, similar to the records used in other public health activities. These should be so designed as to yield statistical information when desirable.
9. Health education through talks, movies, educational pamphlets, posters, etc. The United States Public Health Service has available a series of pamphlets on health in industry. Subjects include flu, appendicitis, carbon monoxide, and benzol. These are suitable for distribution in pay envelopes or in other ways, and are very helpful.
10. Rehabilitation service. Suitably trained cripples make reliable wmkers and become more stable employees than the so-called "physically perfect group."
The technical and professional services made available to industry by the Industrial Hygiene Service include:
l. Surveys: (a) To estimate the cost of illness to both the employer and the employee.
(b) To gain information as to absenteeism resulting from illness, whether it be of occupational or non-occupational migin.
(c) To gain information relative to the medical, sanitary, safety, and welfare facilities available to plant employees.
(d) To evaluate the potential health hazards and the e:,dsting con trol of preventive measures in the plant.
2. Qztantitative Studies:
(a) Studies of toxic dusts, fumes, vapors, gases, mists, or other air contaminants.
(b) Ilh1mination studies.
(c) Humidity and temperature studies.

Georgia Department of Public Health
(d) Studies of any other environmental conditions which may affect the health of workers.
(e) Clinical laboratory studies of workers affected by hazards. 3. Control Measures:
(a) Recommendations for corrective measures. (b) Reviewing plans and specifications for new installations. (c) Checking the effectiveness of corrective devices through quan-
titative field determinations after they have been put into operation. 4.. Records: (a) Assistance in developing and maintaining physical examination and absenteeism records, and assistance in s,tatistical analyses of such records. 5. Consultation Service: (a) Medical, nursing, engineering, and chemical problems which relate to the health and productive ability of workers.
For the maximum benefit to be obtained from this Service, it is necessary that diseases of occupational origin be repor,ted in a manner similar to the reporting of communicable diseases. The regulations concerning the reporting of occupational diseases and investigations covering them which were adopted by the State Board of Health on October 16, 19M, are appended to this report.
All plant studies, surveys, investigations, etc., are conducted in an advisory and consulting manner. All data, including reports, recommendations, opinions, etc., are confidential records of the Board of Health and shall not be open for public inspection. All studies are in cooperation with local health departments and with the industrial physicians. A representativ~ of the health department and all the physicians concerned are urged to accompany the industrial hygiene personnel in all plant surveys.
In setting up the program, State and Federal official agencies and private organizations were contacted.
The 8,500 industrial employers in this State are being tabulated by industries, and records are being made of all occupational diseases reported and all investigations being made. Special attention is being given to industries with defense contracts.
REGULATIONS CONCERNING THE REPORTING OF OCCUPATIONAL DISEASES AND INVESTIGATIONS COVERING THEM
It shall be the duty of each physician having knowledge of any person whom he believes to be suffering from any occupational disease to report the same to the Board of Health in the same manner as he reports other notifiable diseases to the Board of Health.
Occupational diseases may be defined for the purpose of this regula-

Preventable Diseases
tion as any disease contracted as a result of the nature of employment. Bulletin No. M of the United States Department of Labor, entitled Occupation Hazards and Diagnostic Signs, is adopted as a guide to impairments to be looked for in hazardous occupations. A copy of this bulletin shall be made available to all physicians to serve as a guide in reporting.
All reports made pursuant to the provisions of this regulation shall be confidential records of the Board of Health and shall not be open for public inspection. The State Department of Public Health is authorized to investigate and to make recommendations for the elimination or prevention of occupational diseases which have been reported to it or which shall be reported to it in accordance with the provisions of this regulation. Said Department is also authorized to study and make recommendations in regard to conditions that may be suspected of causing occupational diseases. Information obtained and opinions based upon these investigations shall be confidential records of the Board of Health and shall not be open for public inspection.
(Regulation adopted by the State Board of Health-October 16, l9L1l.)

Division of Malaria ancl Hookworm Service

Justin Andrews, Sc.D., Director

A. W. Hill, M.D.

Epidemiologist

During the .first half of 19L11, the professional staff of this Division consisted of a director (Atlanta), medical epidemiologist (Atlanta), engineer (Macon), biologist (Macon), sanitarian (Waycross), and nurse (Waycross). Commencing June 16th, one more biologist (Statesboro) and four assistant biologists (Americus, Albany, Dublin and Millen) were added. On September 15th, the four assistant biologists were dismissed.
The full time of the biologists and the engineer is devoted to malaria investigations; of the sanitarian and nurse, to anti-hookworm activities. The epidemiologist's time is divided about equally between the anti-malaria and anti-hookworm programs. The duties of the director -: have been to plan and supervise the work of both units.
ANTI-MALARIA ACTIVITIES
As in the past, these have included standard-plan promotion and support, malariometry, entomological service, special investigations, research and the publication of the Georgia Malaria Bulletin.
The developing defense program-military, naval and industrial-has brought a diversity of new problems to and is exacting new services from the anti-malaria unit. It is asked to assay the malariogenic potentiality of proposed camp, depot and industrial sites. Within the reservations, its personnel is invited to assist sanitary officers in malaTiological investigations and in the foTmulation of mosquito-control plans. Immediately outside defense areas wheTe civilian populations clusleT and off-duty soldieTs congregate, the problem of planning the best means of protection against health and comfort hazards from mosquitoes-sometime with severe limitations of personnel, equipment, material and authority-have been ours jointly with the malaria-control service of the Division of Public Health Engineering.
In addition to the special investigations made at camp-sites listed below, this unit was assigned the training and checking of the activities of larvicidal inspectors employed by the State in connection with the United States Public Health Service-sponsored, extra-cantonment, oil-larvicide, mosquito-control prog-ram. Early in July this program was taken over from the United States Public Health Service by the WoTk Projects Administration under the sponsorship of the Georgia Department of Public
*As of September 16th, the director was asl;ed to assume the interim-direction of the Division of Public Health Education for the duration of the emergency, Dr. Robert V. Schultz having been called to active duty in the Navy on that date. The activities of this Division are reported separately.

ivlalaria and Hookworm Service
Health. During the second and third quarters of the year, these service demands consumed most of the time and effort uf the anti-malaria field personnel.
Standard Plan Activities:
Educational and promotional support for malaria control accordiPg to "Standard Plan" principles have been at a low level during 19L1l. One reason is that the continuous recession of malaria mortality and morbidity during the last four years has brought us to the situation where it can be said that serious malaria exists only in those parts of the Stale that cannot afford to undertake malaria control. The other reason is that demands for mosquito-control services in and around defense areas have preoccupied our time and efforts. Nevertheless, apparent progress has been made in Laurens County, which has operated in the past as a quasi-Standard Plan County, and in Bulloch County, which has definitely adopted the Plan. The Bulloch County Commissioners have agreed to supply materials and labor for a ditch-lining project in one of their towns and to keep a six-man convict crew available for malaria-control and sanitation activities under the supervision of the local health department.
As in the past, medical contacts have been made principally by the epidemiologist and the director, health-official contacts by all members of the units and governmental and lay contacts by the director. A tabulation of educational and promotional anti-malaria and anti-hookworm activities by counties is shown in Table I.
JVlalariometry: The 1940 fall malaria reconnaissance in the white and colored elementary schools was conducted in thirteen counties by county personnel assisted by the medical epidemiologist of this Division (see Table VI). Thick-film examinations were made on 18,131 children of which 1.8 per cent were parasite-positive. Spleen palpations on 7,177 individuals indicated an incidence of splenic enlargement of 11 per cent.
The results are shown by race and county in Tables II and III. As in previous years, the percentage parasite-positive is uniformly greater in the colored children, while the white children show a disproportionately higher incidence of splenic enlargement. This observation, verified by annual experience, has led us to the conviction that nearly as much useful information about the distribution of malaria in a county may be obtained with a smaller expenditure of time and materials by palpating the spleens only of the white school children and of taking blood specimens only from Negro children. This was done in the 194-1 fall reconnasisance, the results of which will be available in the 1942 annual report.
The figures do not differ markedly from those of the previous year; if anything, they are a little lower. However, caution must be exercised in comparing the State or even the county rates of one year with those of another unless it is known that the scope of investigations was the same in both instances. Of recent years, it has been the practice of health officers in Standard Plan counties, having determined the general distribution of malaria in their areas, to restrict subsequent examinations to rural sections

146

Georgia Department of Public Health

where malaria is ordinarily endemic. Where this is done, the unit of comparison year by year becomes the school rather than the county population.
Entomological Service: As is customary, the biological staff was expanded in June to supply biological service to our operating and prospective Standard Plan counties. These included in 19M, Burke, Jenkins, Laurens, Crisp, Sumter, Dougherty, Pulaski, and Bulloch Counties. These activities are shown by counties in Table IV. Due to the exigencies of the defense program, it was necessary to divert some of this biological assistance to making mosquito investigations in and around military camp sites.
Special investigations: In response to requests from proper officials, this unit appraised the potential malariousness and made recommendations for the nullification of the more serious intra- and/or extra-cantonment malaria hazards in relation to Cochran Field and Camp Wheeler (Bibb County), Moody Field (Lowndes County), Spence Field (.Colquitt County), Turner Field (Dougherty County), Camp Gordon (Richmond County), and Camp Stewart (Liberty County).
The medical epidemiologist investigated and made reports upon spring malariousness and the anti-malarial consumption in Liberty County, determined the malaria incidence in the Stanley Creek area of Pulaski County following major hut incomplete drainage of this section in 19<10, and .made a thick-film survey in the environs of the Griggs fish pond in Heard County.
Other special investigations made by either the engineer or biologist or both concerned 1) the potential malariousness of the Ways Mill Pond area in Liberty County, 2) the sewage-disposal facilities requir.ed at the N.Y.A. Training School at Blythe Island, Glynn County, 3) the construction and operation of the proposed King Creek impoundment on St. Simon Island, Glynn County, 4.) mosquito breeding at Camp John Hope (NYA and FSA) in Macon County, 5) the potential malariousness of the Ball Mill Pond impoundment in Fulton County, 6) the malariacontrol management of the Spring Creek impoundment in Decatur County, 7) the potential malariousness near the Griggs fish pond in Hea1d County and 8) the potential malariousness of two localities in Fulton County.
Research: A considerable portion of the time of the director, engineer and biologist was spent in Baker County at the Emory University Field Station where a study of the relationships of rainfall, hydrology, anophelism and malaria incidence is being carried on under the supervision of the divisional director. During the study leave of the station biologistin-charge, the more important administrative and engineering duties were assumed by the division engineer while routine biological observations were made by the division biologist. Since the retum of the station's biologist in September, these divisional services have been discontinued though some research projects are still carried on jointly by both agencies.
The research study in Brooks County, made possible by a grant of money from The Rockefeller Foundation, in which a comparison of cost, efficiency and durability of various types of malaria-control ditch-lining

Jlllalaria and Hookworm Service

147

structure was attempted, has been completed. A reportorial account of this project was presented before the National Malaria Committee in St. Louis. The equipment made available to Brooks County by the Foundation has been loaned to the Bullock County Health Department.
Together with a member of the Division of Public Health Engineering, a concrete precast, automatic siphon to be used in fluctuating the poollevel of impoundments or in down-stream flushing action for malariamosquito control was designed and described by the engineer. A paper on the subject was presented before the National Malaria Committee.
Georgia Malaria Bulletin: Four issues have been prepared and distributed during the period covered by this report. These contain the third annual report of this division, specifications for Paris green to be used in anopheles control, articles on 1) the place of larvicides in mosquito control, 2) catching stations in mosquito control, 3) the losses from malaria in an Arkansas county, 4.) the F.S.A. home environmental sanitation program in Terrell County, 5) recommendations for routine mosquito collecting, 6) malaria-control experiments in Jenkins County and 7) 1940 malariometry, a review of an issue of the "Triple S", a Memphis high school paper, one issue of which is annually devoted to malaria and other insect-borne diseases, current malariological and meteorological statistics and notes of interest to persons concerned with malaria investigations and control in Georgia. The contents of the "Hookworm Supplements" are discussed in the next section.
Malaria in Georgia in 1941: According to the provisional figures at present available, there were 75 deaths and 1065 cases reported in 194.1 as being clue to malaria. These are rates of 2.4 and 35/1 per 100,000 population respectively. They are the lowest on record thus far. They are shown graphically in relation to previous annual rates in Figure I.
The 1941 monthly rates as projected against the mean monthly rates for the previous decennium are shown in Figures 2 and 3. The geographic distribution by counties is indicated in Figure 4 and Table V.
The significance of the downward trend in malaria mortality and morbidity since 1936 is hard to evaluate. There is little to add to the discussion of this subject in 1940 report. The temperature for 1941 was not far from normal (102 per cent of the averaged observations since 1892), excesses during the mosquito-breeding season being noted during 1 August, September and October. Rainfall for the year was deficient being 4.9.9 inches or 85 per cent of the averaged observations since 1892; it
1
was notably deficient during the winter and spring months, the period in which, according to hydrological engineers, the ground-water resorvoirs are replenished. It was also below average during the principle mosquitobreeding months in the summer and fall. Thus we may suppose that surface water acreage and, therefore, potential breeding area was markedly reduced and that atmospheric humidity was low during the mosquito season resulting in reduced longevity of adult mosquitoes. These deterrent effects added to what must have been a remarkably low number of gametocyte

148

Georgia Department of Public Health

FIGURE II

10.0

10.

REPORTED MALARIA MORTALITY IN GEORGIA FCR 1941

-- --- ------------------B-YJ-lO-N-THSn--------- ----.-----------

5.0

5.0

AVERAGE MONTHLY DEATH RATE PER

100,000 POPULATION, 1931-1940

..L____,_

(Calculated on basis of 1940 census)

MONTHLY DEATH RATE

Malaria and Hooku:onn Service

149

FIGURE III

1,0

J T-+-- ----l--+ I 1

--T-- I
i o.s ,
0,7

II
'1

I
III
.


I
I

--- --- --- --- __!_,0

II Ii !

II

I

I!

Ool

..r:l r":' ..., ., .o:;:::I

~
,J:J

1'.

.c
u 1-.
~

I....-..1.
1-.



<0.

~

.,
...,


...,..-1
:::1

1-.

....,,
:::1

~.".,'

<IS" <""I')'

...
Q)
,.J.0:.J,
0 0

1-.
i"l'
Q)
:>
~

1-.
Q)
il
Q)
0
"<=>

0,1

150

Georgia Department of Public Health

carriers in the Stale are presumably the natural factors involved in the observed reduction.
How much credit is due to the malaria-control efforts of man is still debatable. Some screening and mosquito-proofing were carried on under the sponsorship of the Farm Security Administration and private initiative. Large-scale, malaria-control drainage operations by W.P.A. with few exceptions were discontinued by July and it is probable that less ditch maintenance was done in 19i1l than in 19iW. Larvicidal operations were carried on as usual and, in addition, were instituted on and around military and certain other defense situations.
A disturbing feature from the standpoint of slate-wide malaria potentiality is the introgression of camp-construction crews, military populations and defense workers from other states. Those coming from nonmalarious areas are more susceptible to malaria than are our own people; those from other malarious stales may bring with them strains of malaria parasites to which our local populations are susceptible. Aside from some ineptness in the selection of camp-sites, most reasonable anti-malaria precautions-such as mosquito-proof construction of barracks, hospitals, mess-halls, and defense housing units, intra- and extra-cantonment larviciding and some drainage operations- have been applied extensively though imperfectly due to lack of coordination, knowledge of the problem and trained personnel. Happily, there is no material evidence thus far that an increase in the malaria morbidity of the State has resulted though it must be emphasized that these developments have occurred during a peculiarly auspicious year. Our relative freedom from malaria in 194-1 should not occasion any relaxation in anti-malaria efforts in subsequent years.
ANTI-HOOKWORM ACTIVITIES
These have consisted of special county-wide hookworm surveys, routine quantitative hookworm investigations, research, and the publication of Hookworm Szbpplernents in the Georgia J1!larlaria Bulletins.
Special Hookworm Surveys: The policy of making hookworm surveys in counties at State expense 1) as a basis for planning improvements in anti-hookworm programs and 2) as a health service to these counties has been continued. Such surveys have been completed in Liberty, Long and Brantley Counties. This has necessitated the making of basic maps (by the division sanitarian) and sanitary surveys for these counties. The findings in these counties have not yet been completely analyzed but in all of them families with severe hookworm disease have been found. Cases and their families were treated and, where possible, sanitary facilities were supplied. Extensive programs of health education concerning hookworms and hookworm disease were carried on in conjunction with these other activities.
Hookworm-disease Control Program: The change in emphasis from the egg-positive individual to the hookworm-diseased family, proposed as a result of previous observation, has had a gratifying reception by local

Malctria and Hookworm Service

151

health agencies in hookworm-infested sections of the State as shown by
Table V111. Many changes have been made in the technique originally
suggested for detecting these families. 1n an effort to preserve the principles of emphasis on highly-infected families, while trying to minimize the time, effort and transportation required by the previous system of discovery, it was found 1) that the majority of the "hookworm families" could be located without making school surveys by inquiring from county agents, welfare agents, home demonstration agents, physicians and others whose business takes them into rural homes, concerning the whereabouts of large, white, low-income, anemic families living in unsanitated sections and 2) that egg-counts made on anemic school children were sufficiently representative of the general egg-count level - and, therefore, of the average worm burden- o.f the family to constitute a reliable indicator of the degree of family hookworm infection so that further investigation of the family was unnecessary. At present, families of anemic individuals under 20 years of age who have egg-counts of 5,000 eggs per cc or more of stool, are considered to he of hookworm-disease importance. Attempts are made to provide sanitation if possible. If, not immediate anti-anemic and anthelminthic treatment of hookworm-diseased individuals and hookworm-removal treatment of their entire families during the winter months is provided. In either instance, efforts are made to improve the irondeficient dietary which is almost inevitably associated with hookworm disease.
Resectrch: Supplementary to the investigations which have led to the above developments, the epidemiologist has made careful physical examinations on a series of individuals representing various levels of hookworm infection with the view of correlating their physical status with various egg-count classes. l-Ie has found that symptoms of hookworm disease are rarely seen in Georgia in individuals with less than 5,000 eggs per cc of stool and that the severity of the symptoms increases directly with the egg-count. These observations were reported before the American Society of Tropical Medicine. He has also tested two proposed drugs for hookworm removal, namely; vioform and sulphaguanidine. In a series of carefully controlled observations, neither of these drugs a}Jpeared to have any anthelminthic value.
The study of the effect of environmental factors commenced last year has been continued by the biologist and sanitarian. While results are not yet complete, it seems fairly certain that the chance of natural infection during the winter months in Georgia is much less than in the summer months. This is in agreement with the .findings of investigators in other states and is the basis of our recommendation of complete family treatment during the winter months as the likelihood of prompt reinfection, so considerable in the summer, is almost entirely lacking during the cold season.
The progressive withdrawal of W.P.A. from community sanitation projects, the difficulty, even under the most propitious circumstances, of p'urchasing sanitary privies by those whose need is greatest and the varia-

152

Georgia Department of Pztblic Health

tion in construction of the domestic sanitary unit have led us to examme the question of home excreta-disposal facilities more closely. Our object is to evaluate current accomplishments in this line and to see whether or not it is possible 'to substitute a cheaper device .to serve the purpose as well or better than present models.
Approximately a thousand pit-privy units from one to .five years old have been carefully examined by the sanitarian to note structural and functional defects. The data obtained have not yet been completely analyzed but enough has been clone to justify the following conclusions. The majority of these structures are hookworm-proocf and probably do not endanger drinking-water supplies hut few of them are fly-proof. Those built on clay soil are functionally more durable than those on sandy soil. Systematic maintenance of these units greatly prolongs their period of usefulness.
Accordingly, we have been experimenting with a greatly simplified excreta-disposal unit especially adapted to sandy soil. It is a modification of the well-known bored-hole latrine commonly used in the Orient. Our observations are not yet sufficiently numerous or controlled to permit any conclusions.
Hookworm Sztpplemeuts: These were .first published in 1940 as addenda to the Georgia Malaria Bulletin. During the current year, they have carried the radioscripts of .five hookworm broadcasts, a tabulation by counties of hookworm egg-counts, reports on the use of vioform and sulfaguanidine as hookworm anthelminthics, new developments in our routine anti-hookworm program and notes of interest to those concerned in the investigation and control of hookworm disease in Georgia.
EDUCATIONAL ACTIVITIES
So much of the work of this Division is educational in nature, it seems proper to direct attention to the fact by devoting a special section of this report to it.
A series of eleven .fifteen-minute radio programs dealing with hookworms and hookworm disease originally presented over the Waycross and Moultrie stations have been transcribed twice. These records have been broadcast over outlets in Macon, ::avannah, Valdosta, Cordele and Brunswick.
Special malaria and hookworm moving pictures are being made with the assistance of the Division of Public Health Education. These are in color and, it is hoped, will have their effectiveness heightened by the addition of a sound track. They deal with particular phases of malaria control such as ditch-lining, sub-grade tilage, dynamite ditching and tree-felling, etc., and with hookworm control by privy sanitation, treatment and dietary improvement.
This Division is cooperating with the Division of Public Health Education in the revision and amplification of the teachers source unit on

JV!alaria and Hookworm Service

153

Hookworms and 11ookworm Disease.
Didactic lectures on the epidemiology and control of malaria and/or hookworm disease have been delivered by the director at Harvard University, Emory University Medical School, University of Georgia Medical School, Georgia School of Technology, St. Joseph's Hospital, the Fourth Corps Area Laboratory Technicians' School, the Public Health Nurse Trainee Classes, and the mosquito-control clas.ses given to the trainees of the U. S. Public Health Service at Norfolk, Virginia, and Washington, D. C. The engineer discussed malaria-control engineering with the public health students at Georgia Tech and the same group received instructions from the biologist in the collection and identification of the anopheline mosquitoes. This topic was presented three times by the biologist to the technician trainees at the Fourth Corps Area Laboratory.
Research reports have been read by the director or sta:ff members at Emory University, the Association of Southeastern Biologists, the Florida Anti-Mosquito Association, the Southeast and Southwest Public Health Associations of Georgia, the Georgia Academy of Science, the Georgia Entomological Society, the American Public Health Association, the National Malaria Committee, The American Society of Tropical Medicine, the Section on Gastro-enterology at the Southern Medical Association, and the American Society of Parasitologists.

Georgia Department of Publ'ic Health

TABLE I
EDUCATIONAL AND PROMOTIONAL ACTIVITIES DURING THE YEAR 1941

County

Meetings Attended

Appling

2 Atkinson ----------------------------

3 Bacon ------------------------------ _ 4 Baker -------------------------------
Bibb ---------------------------- ___ _

Bleckley ----------------------------

7 Brantley ---------------------------Brool;;:s ------------------------------

B,yan -----------------------------10 Bulloch -----------------------------

11 Bml<e -------------------------------

12 Calhoun ----------------------------

13 Camden ----------------------------14 Charlton ----------------------------15 Chatham ----------------------------

16 Chattahoochee ----------------------17 Clark ------------------------------18 Coffee ______ -------.------------- __ _

19 Colquitt ----------------------------20 Cook -------------------------------21 Crisp -------------------------------

22 Decatur ----------------------------23 DeKalb ----------------------------2<1 Dodge -----------------------------25 Dooly ------------------------------26 Dougherty --------------------------27 Early _ -----------------------------28 Echols ------------------------------29 Emanuel ----------------------------

30 Evans ------------------------------31 Fulton ------------------------------ 16
32 Glascock ----------------------------

33 Glynn ------------------------------31 Grady ------------------------------

35 Greene -----------------------------36 Hall --------------------------------

37 Harris ------------------------------
38 Heard -----------------------------39 Houston

10 Jenldns -----------------------------

41 Lamar ------------------------ ------

42 La.urens ----------------------------

13 Lee ---------------------------------

4<! Liberty -----------------------------

1

15 Long ------------------------------46 Lowndes ----------------------------

41 Mcintosh ---------------------------48 Macon
49 Marlon

Addresses Made
3 8 3 5
2 28
2
1 2

Consultations Exhibits Conferences Shown Contacts, etc.

7!

231

5

9

181

1

39

4

21

<!2

17

12

23

38

18

1

10

63

12

1

13
n

4

115

2

6

15

11

2

18

2

165

1

32

3

10

2

53

10

l

3<13

5

191

20

3

1

Malaria and Hookworm Service

155

TABLE I
EDUCATIONAL AND PROMOTIONAL ACTIVITIES DURING THE YEAR 1941-Continued

County

Meetings Attended

50 :Meriwether --------------------------

5! Mitchell ----------------------------

2

52 Montgomery -------------------------

58 llluscogee --------------------------54 Peach _________ ----------------------

55 Pierce -----------------------------58 Pulasl;i ------------------------------

57 Richmond ---------------------------

58 Schley ------------------------------

59 Seminole ----------------------------

60 Spalding ----------------------------

61 Sumter -----------------------------62 Tattnal! -----------------------------

63 Taylor ------------------------------

64 Telfair ------------------------------

65 Terrell ------------------------------

66 Thomas -----------------------------

67 'rift ---------------------------------

68 Toombs -----------------------------

69 Towns -------------------------------

70 '!'roup ------------------------------71 ~I'U!'llel' ----------------------------- _

72 'rwiggs ------------------------------

73 Union ---------------------------------

1<1 Ware -------------------------------

4

75 Wayne ----------------- ------------

2

76 Worth ------------------------------

Out-of state 1 Atlantic City, N. J.___________________

2 Auburn, Ala. ------------------------

3 Baltimore, llld. ----------------------

,1 Bethesda, Md. -----------------------

5 Boston. l\fass. -----------------------

Chapel Hill, N. C-------------------Dallas, ~rexas -----------------------

8 Jacksonville, Fla. --------------------

9 New York City ----------------------

10 11

Norfolk, Mmphy,

Va. N.

c-.

-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_

12 Philadelphia, Pa. --------------------

3

13 St. Louis, Mo------------------------ 25

1! 'l'allahassee, Fla. --------------------

15 Washington, D. C--------------------

'l'O'l'AL ______________ .. _____________ _ 98

Addresses Made
1 3 1
2
1 5 113

Exhibits Shown

Consultations Conferences Contacts, etc.

3

28

8 '1 6 19
'Jij

6 3 67 19

1
1~

3

2

209

3

59

'1

3

61

2,163

......,
CJl 0\

County
Baker--------------Brool~:s -------------- Bryan _______________
llud.;:e -------------Calhoun----- ________ Crisp ________________ Dougherty ___________ J e n k i n s _______________ Laurens _____________
Lee.---------------- Liberty-------------Sumter______________ ' J ' e r r e l L ______________
'l'OTAL ____________

TABLE II

SUMMARY BY COUNTIES OF 1940 FALL THICI<BLOOD-FILM EXAMINATIONS OF

<;"')

ELEMENTARY SCHOOL CHILDREN

~

0

White

No.

%

%of all Pos.

Colored

No.

%

%of all positives

Total

~

No.

%

%of all Pos.

:N ;, ,

Ex' d.
610 1640 ll8 982 494 1010

Pos. Tert. EA

0.3

50

50

0.06

--

100

o.o

0.2

100

2.1

100

0.3

G7

33

Ex' d. Pos. Tert. EA

Ex' d.

Pos. Tert. EA

b

~

789

1.8

100

71~

0.0

1399

1.1

(J

94

2352

0.04

100

~
-- !.,2.;.

119

3.4

100

237

1.7

100

;3

298

3.7

9

91

--

1280

1.l

8

92

--

~
.;,:.I,.

989

11.7

722

3.5

1

99

8

88

1483

S.!'i

1

99

4

1732

1.6

l4

82

4 ..0._

563

0.0

707

0.14

--

--

100

172

1.1

--
100

563

0.0

879

0.3

100

-- :";:t:i

2137

0.2

60

40

1324

1.1

7

93

3461

0.5

21

79

-- C.,.l."..'

333

0.3

100

722

3.5

8

92

1055

2.4

8

92

-- N, {")

593

0.5

100

986

4.9

2

98

439

0.0

--

535

1.1

100

339

0.8

-- 100

798

4.1

6

94

1579

3.3

974

0.6

1137

3.2

8

92

100

6

94

-- l::l::

---

~ :.,;.,...
;:;..

9965

0.3

29

71

8166

3.7

3

96.4

0.3 18131

1.8

5.7

94

0.3

iVlalaria and Hookworm Service

157

TABLE Ill ENLARGED-SPLEEN EXAMINATIONS OF ELEMENTARY
SCHOOL CHILDREN

County

White

No.

Per Cent

E'xd.

Enlarged

Colored

No.

Per Cent

Ex' d.

Enlarged

Total

No.

Per Cent

Ex'd.

Enlarged

Baker

'190

12

421

911

Bryan

116

10

10<!

220

10

BurJre

773

11

235

'1

1008

Calhoun -------- <140

17

717

1157

12

Crisp ---------- 188

19

188

19

, Jenldns -------- 539

20

1'18

iLee ------------ 199

16

569

l

687

16

768

10

:Liberty

393

12

5'10

933

[Sumter --------- 105

22

63

168

17

Terrell

339

22

798

12

1137

15

'l'O'l'AL ------ 3582

15

3595

8

7177

11

TABLE IV ENTOMOLOGICAL FIELD SERVICE

County

Ponds Investigated

Baker -------------------------------------------- 34 2 . Bibb --------------------------------------------- 69
B!oolrs ------------------------------------------- 10
Bryan -------------------------------------------

5 Bulloch ------------------------------------.------ 66

Burke --------------------------------------------

3

7 Chatham ----------------------------------------- 30

8 Colquitt -------------------------------------<'---. 60

Crisp -------------------------------------------- 89

10 Decatur ------------------------------------------

3

11 DeKalb -------------------------------------------

12 Dooly -------------------------------------------13 Dougherty ---------------------------------------- 68

:14 Early --------------------------------------------

Fulton -------------------------------------------

8

Glynn -------------------------------------------- 20 Heard

Houston

Jenldns

115

20 Laurens

179

21 Liberty

165

22 Lowndes

51

23 Meriwether --------------------------------------- 17

i21 l\fuscogee -----------------------------------------

25 Peach -------------------------------------------

'1

26 Pulasl<i ------------------------------------------ 105

27 Uichmond ---------------------------------------- 82

28 Sumter ------------------------------------------- 121

:29 Thomas ------------------------------------------

'l

,30 Twiggs -------------------------------------------

TOTAL ------------------------------------------ 1332

Searches for Adult AnoiJhelines
H3 18 30
1 63 2
162 1G
.15 393
'J 15
2 85 5G 33
'1 1
12 17 160
2
1261

158

Georgia Department of Public Health

TABLE V
REPORTED MALARIA DEATHS AND CASES AND APPARENT RATES PER 100,000 POPULATION IN GEORGIA FOR 1941

County

Mortality

Deaths

Rates

Appling ---------------------- 75

2.4

2 Bal\er -------~ ---------------

3 Barrow ------- ---------------

<1 Bartow -------------------- --

Ben Hill --------------------- 2

13.6

Bel'l'ien ----------------------

Bibb ------------------------

(Camp Wheeler) -----------

8 Blecl<ley -------- -------------

10.3

Broolm -------------- -------- 2

9.8

10 Bryan -----------------------

ll Bulloch ----------------------

3.8

12 Burke -- ---------------------

11.3

13 Butts ------------------------

H Calhoun --------------------- 3

28.7

15 Camden ----------------------

16 Candler ----------------------

17 Carroll ----------------------

2.9

18 Catoosa ----------------------

(Fort Oglethorpe) ----------

19 Charlton ---------------------

20 Chatham ---------------------

0.8

21 Chattahoochee ----------------
- (Fort Benning) ------------
22 Chattooga --------------------
23 Cobb ------------------------
2t! Coffee -----------------------
25 Colquitt ---------------------

26 Columbia --------------------

27 Coweta ----------------------

28 Crawford --------------------

29 Crisp ------------------------

llA

30 Decatur ----------------------

1

4.5

31 DeKalb ---------------------(Lawson Gen. Hospital) _____

32 Dodge -----------------------

4.8

33 Dooly ------------------------

2

11.8

34 Dougherty -------------------

'l

13.7

35 Douglas ----------------------

36 Early ------------------------

5.3

37 Effingham -------------------

38 Emanuel --------------------.1..

39 Evans -----------------------

40 Fayette ----------------------

19 i)

Morbidity

Cases

Rates

2

13.7

12

163.4

3

22.8

7.0

6.8

38.9

5

5.9

(l)

9

92.7

57

278.1

31.6

H

53.8

23

86.7

5

54.5

26

2<19.1

10

169.2

2

21.9

5.9

40.1

(5)

1

18.7

39

32.7

12

76.1

(<17)

2

10.6

2.6

23.0

18

54.1

52.6

3.7

42.0

<13

2t14.9

18.0

5.6

(2)

10

<17.6

<1

23.7

29

99.3

3

29.7

<12.7

1

10.'1

4

17.0

10

134.6

73.4

jJ!Jalaria and Hookworm Service

159

TABLE V-Continued REPORTED MALARIA DEATHS AND CASES AND APPARENT RATES
PER 100,000 POPULATION IN GEORGIA FOR 1941

County

Mortality

Deaths

Rates

Morbidity

Cases

Rates

<Jl Floyd -----------------------!2 Franklin ---------------------
43 Fulton ----------------------,1<1 Gilmer ----------------------<15 Glascock ---------------------

l.S

1

12.3

<1

25.6

25

6.3

10.9

1

10.9

1

21.9

46 Gordon
17 Grady ----------------------48 Greene ---------------------<19 Hall ------------------------50 Harris

<1

21.5

2

10.2

1

7.2

2

5.7

2

17.5

51 Heard 52 Henry 53 Houston 5,1 Irwin __ ---------------------ri5 .Jacl;;:son

23

267.1

6.6

1

6.6

26.5

53.8

5.0

o6 Jeff Davis ------------------51 Jefferson --------------------58 Jenldns 59 Johnson 60 Latuens

11.2

22.4

15.0

<)<1.9

SA

1.1

1.1

11.9

18

53.4

61 Lee --------------- __________ _
62 Liberty ---------------------(Camp Stewart) ___________ _
63 Long -----------------------6<1 Lowndes 65 McDuffie

10

127.6

11.6

6

69.8

(1)

10

2t1<1.1

3.1

176

549.2

9.0

2

18.1

66 Mcintosh
61 Macon ----- ----------------68 Meriwether ------------------69 Miller ----------------------70 Mitchell

18.9 6.3
9.9 <1.3

1

<)3.9

5

22.7

39.6

12.9

71 1\lontgomery -------~----------

72 Muscogee ------------- ______ _

2

2.6

73 Pearl! -----------------------

1<1 Pierce -----------------------

75 Pike -------------------------

9.6

' 16 Polk

77 Putnam ---------------------

78 Randolph --------------------

2

12.0

79 Richmond -------------------

2

2A

. 30 Ilocl<dale ---------------------

10.3 2.6
27.8 8.5
48.2

1

3.5

11.7

5

30.1

12

1<!.5

1

12.9

81 Schley _ ----------------------

32 Screven ----------------------

3

1<!.7

. 83 Seminole

2

23.3

. 3<1 Spalding

. 85 Stephens

19.9

8

39.3

<11

<17H.6

1

3.4

2

15.3

160

Georgia Department of Public Health

TABLE V-Continued
REPORTED MALARIA DEATHS AND CASES AND APPARENT RATES PER 100,000 POPULATION IN GEORGIA FOR 1941

County

Mortality

Deaths

Rates

Morbidity

Cases

Rates

86 Stewart ----------------------
87 Sumter ----------------------
88 1'albot ----------------------89 Tattnall ---------------------
90 Taylor -----------------------

91 Telfair ----------------------- 2

13.2

92 Terrell -----------------------

6.0

93 Thomas ---------------------- 1

3.2

91 1'ift --------.-------------- --- 1

5.3

95 'l,oombs ----------------------

1

23.6

96 ~Pro up -----------------------

97 Turner ----------------------- 1

9.2

98 Wallwr -----------------------

99 Walton ----------------------

100 'Yanen ----------------------

101 Wasbington ------------------

1.1

102 Wayne ---------------------- 2

15.2

103 Webster ---------------------

104 Wheeler --------------------- 1

11.7

105 Whitfield ---------------------

106 Wilcox -----------------------

23.5

107 Will<es ------- -----------------

108 Willdnson --------------------

5

117.2

22

89.8

1

12.3

2

12.3

4

37.1

16

105.5

13

78.0

25.6

13

69.0

22

129.8

12

26.9

1

9.2

28.6

1

4.8

9

87.9

33

136.2

2

15.2

6

127.0

8

93.7

2

7.5

25

196.0

5

a3.1

6

54.3

TABLE VI EPIDEMIOLOGICAL AND NURSING SERVICES

County
Baker ___________________ -- _- ______ - ------- -
2 Brantley ----------------------------------Brooks ____________________________ -- ---- ___
4 Bryan ------------------------------------Bulloch ------------------------------------
Burke ------------------------------------- -Callwun ----------------------------------Cmnden -----------------------------------Coffee ------------------------------------10 Crisp --------------------------------------
11 :Fulton ------------------------------------12 Heard --------------------------------------
13 Jenldus ------------------------------------
14 Laurens -----------------------------------15 Lee --------------------------------------- _
16 Liberiy -----------------------------------17 Long ------------------------------------ -18 MeIntosh __________ --------------- __________ 19 Mitchell ---------------------------- ----- 20 Montgomery -------------------- -- ------ --
21 Pulaski _____________________________________.
22 Tallnall ____________ -- __ -------------------23 Terrell ____________ --~ ______________________
TOTAL ------------------------------------

Physical Exams.
94
---
111 1
--
11
153 234 194
--
6 804

Hookworm Treatment
129
102 12 1
228 214
69
755

Malaria Treatment
--
--
2
--
3
---
5

Spleen Palpation
424
---
103
704 389 381
3 ] 5:-~
--
l;j
5:i9 93.i 23:l
174
266 6
13
296
46~4

Hemoglobin 132
28 5
24 38 218
<14S

Blood Smears
284 66
268
19
585 725 619
28
34 207 31n
~7
723 7
641 ri7
457
43 5109

Blood Counts

Miscellaneous

1

1876

--

--
334

~

--

-- ~""

N.

--

---

;:"";::"";:,..

10

175 ::r::

--

,0
0
-- "'"' 0

-- ~

-- en

;";;'

33

1331 c;-

9

"' 1229

4

--

385

57

5330

I-' 0\ I-'

162

Georgia Department of Public Health

TABLE VII SANITARIAN SERVICE

County

Mapping Sanitary Surveys Sanitary

(hours)

(premises)

Units

Appling -------------

18

2 Bibb ----------------

2t!

3 Brantley ------------ 126

12<17

<1 Brool<s --------------

<10

5 Bryan --------------

128

Bulloch -------------

15

7 Camden ------------- 25

8 Charlton ------------ 126

773

Coffee -------------- 5

126

10 Dougherty -----------

22

11 Glynn ---------------

26

12 Hall ----------------

29

13 Liberty -------------- 17

125

96

H Long --------------- 127

1075

15 Montgomery ---------

22

16 l\Iuscogee ------------

12

11 Pierce --------------

36

18 Tattnall -------------

<15

19 Telfair --------------

21

20 Thomas -------------

3<1

21 'l'oombs -------------

96

22 Ware ---------------

19

roTAL ------------- <131

3963

97

Soil Samples
21
21

Miscel laneous
68 11
79

TABLE VIII LABORATORY SERVICE A. Haokworm Flotatians

County

Tatal No. Cases

Appling 2 AtJ<;:lnson 3 nacon ---------------------------------------------
<1 Balter ---------------------------------------c____ _
5 Baldwin
Ben Hill ---------------------- ---------------------1 Brantley ------.---------------------------- -------8 Brool<s
Bryan --------------------------------------------10 Bulloch --------------------------------- __________ _
11 Calhoun 12 Candler 13 Carrall
14 Charlton ------------------------------------------15 Clay -----------------------------------------------

908 573 1,603 <14<1 200
207 1;131
939 685 <119
19<1 355 194 2211 221

Per Gent
Positiv~
35.6 39.6 20.6 25.5 17.0
12.1 55.5 5<1.9 30.1 31.0
31.5 22.3 llA 19.6 18.1

Malaria and Hookworm Service

16 Clinch -------------- ------------------------------17 Coffee ---------------------------------------------18 Colquitt -------------------------------------------19 Cook 20 Dodge
21 Dooly 22 Dougherty 23 Echols --------------------------------------------24 Emanuel ------------------------------------------25 EVU11S ----------------------------------------------
26 Floyd -------------------------- -------------------27 li'ulton ________ ------------------------------ _____ _ 28 Glynn --------------------------------------------29 Habersham ----------------------------------------30 Hall -----------------------------------------------
31 Irwin ---------------------------------------------32 Jeff Davis ----------------------------------------33 Lanier --------------------------------------------31 Liberty -------------------------------------- _____ _ 35 Long ~---------- ____ -------------------------------
36 Macon ------------------------------------- _______ _ 37 Mitchell ------------------------------ ____ --------38 :lfonroe -------------------------------------------39 :IIontgomery ---------------------------------- _____ _ <10 :\forgan --------------------------------------------
41 l\Iuscogee -----------------------------------------42 Peach ---------------------------------------------43 Pierce --------------------------------------------44 Richmond ------------------------------------------<15 Seminole -------------------------------------------
<16 Taylor --------------------------------------------17 'l'elfair ---------------------------- ----------------48 ~rooJnbs -------------------------------------------49 Troup 50 'l,urner

176 322 501 220 259
173 764 341 150 282
211 1,232 1,211<!
371 221
279 301 193 771 398
165 1,305
219 251 143
267 217 338 370 301
567 392 212 116 230

51 Walton ---------------------------------------------

136

52 Ware -------------------------------.--------------

553

53 Wayne

816

511 \Yheeler

236

55 White ---------------------------------------------- __

106

'fOTAL --------------------------- _______ ---------- 23,949

163
38.1 43.5 46.7 50.3 43.2
17.9 13.4 37.5 25.3 26.2
8.1 8.5 23.8 13.2 7.2
27.2 35.2 57.0 36.6
6.8
13.3 30.6
3.7 38.2 10.0
20.2 3.7
43.8 6.2
48.2
4<1.3 !0.3 48.1
2.5 82.6
8.8 l<J.5 3<1.2 31.8 16.0
31.1

lM

Georgia Department of Public Health

TABLE VIII-Continued LABORATORY SERVICE B. HOOI<WORM EGG-COUNTS

County

Total No. Cases

Appling

123

Atkinson

1<13

3 Bacon --------------------------------------------- 211

1 Baker ---------------------------------------------

20

5 Blecl;!ey -------------------------------------------

6

Brantley

363

Brool\S

335

Bryan --------------------------------------------- 150

Bulloch -------------------------------------------- 100

10 Calhoun

53

11 Camden

52

12 Candler --------------------------------------------

8

13 Clinch ---------------------------------- _----------

25

l<l Coffee ______ -------------------------------------- _

90

15 Colquitt -------------------------------------------- 196

16 Dodge ---------------------------------------------

17 Dougherty

37

18 Da\vson --------------------------------------------

3

19 Echols ---------------------------------------------

<19

20 Glascock

20

21 Johnson

22 Laniel' ______ ---------------------------------------

77

23 Liberty -------------------------------------------- 188

2<1 Long ---------------------------------------------- 297 25 Mitchell ------------------------------------------- 334

26 Montgomery ---------------------------------------- llO

27 Pierce ---------------------------------------------

61

28 Tattnall -------------------------------------------

17

29 Taylor

75

30 1'elfair

<19

31 1'honuts --------------------------------------------

32 Toon1bs --------------------------------------------

33 Wayne --------------------------------------------- 167

34 Wheeler

39

TOTAL

3,<123

Per Gent Positive

80 77 67 100 100

52 100 100 100 100

100 100 100 100 100

100 100 100
69 100

100

6

<I

98

100

100

100 98
100 100 100

100 100
5<1 100

86

Division of Tuberculosis Control

H. C. Schenck, M.D., Director Clara B. Barrett, M.D. John F. Busch, M.D. .

Clinician Clinician

The year 1941 was marked by another spectacular drop in number of deaths from tuberculosis and in death rate. 1,385 deaths were reported and the new rate is 44.0 per 100,000 population. This is a drop in the rate of 10.4%. A comparison of l9LW and 19M figures are shown below:

White

No.

%

1940

:iH

:~;;

19'11 ---- --. 301

;j;)

Colored

No.

%

HX!>

6.)

R84

{;:)

Total W. &C.
1,ii33
us:;

Rate per 100,000 Population W.&C.
White Colored Combined

26.7

91.2

49.1

2J,:l

81.3

44.0

This is an exceedingly gratifying showing. In the 1940 annual report it was shown that in three years, 1930-1932, the average number of deaths was 2,091 per year. This was a period when case finding was being developed. Again, in 1933-1936, a four year period, the average number of deaths per year was 1,748 and during this period artificial pneumothorax was largely developed in sanatoriums, and refill service through practicing physicians throughout the State. Then, in 1937-1940, another four year period, the average deaths numbered 1,552 per year. During this period surgical service at Alto was greatly increased, extra-sanatorium artificial pneumothorax refill service was greatly increased, as were case-finding, relief and rehabilitation measures. It is hoped that the present large drop in number of deaths marks the beginning of another period of decline in death rate and that the advantage can be held during the trying times to come.
A much larger service was performed by the Division of Tuberculosis Control in 19<11 than in any preceding year. 2LW field clinics were held in which 16,266 X-ray examinations were made, resulting in the discovery of 624 new cases of tuberculosis, 381 white and 243 colored. 208 X-rays were made in the central office in which 14 cases of tuberculosis were found. 534, consultation films were sent in by physicians from all over the state and 54, cases were diagnosed through this means. Altogether, this Division participated in the diagnosis of 692 cases of tuberculosis.
As formerly, we have continued the distribution of literature to tuberculous patients. In an effort to acquaint laymen and physicians with all information possible concerning tuberculosis, we have continued to write articles and radio talks.
The State Pneumothorax Refill Program, which was begun in 1940, was continued throughout the year and an average of 396 patients per month were treated. During the year, 7,174- artificial pneumothorax refills

166

Georgia Department of Pnblic Health

were given, 264. aspirations, 24.9 special fluoroscopic examinations and 211 X-rays, all performed by the 66 participating physicians. The cost per person on a yearly basis was less than forty dollars. The total number of cases treated during the year was <193, and at the end of the year 409 were on the list. Only 13 patients of the 4.93 died during the year, which is considered a rather remarkable record.
212 additional beds were placed in operation at the State Tuberculosis Sanatorium and they proved of real value in permitting admission without delay of the more urgent surgical cases and many of the more serious public health problem cases. There are 620 beds in operation at this time --49<1, for white patients and 126 for Negroes. Unfortunately, there still remains a very great shortage of beds for Negroes, and this shortage hinders us most severely in our efforts in the control of tuberculosis. Every possible energy should be bent toward overcoming this deficiency. There is a pressing need of institutional beds for long time care of chronic tuberculosis and even for long time bed care treatment of curable cases, both of which are impossible for many patients with our present sanatorium facilities. No particular plan of providing these is presented except it is suggested that a program of PARTICIPATION BY THE STATE IN THE MAINTENANCE OF INSTITUTIONS, OR HOSPITALS, OR SANATORIA which may be constructed by local governments be seriously considered. Such a measure could go far in relieving Alto of the need for providing domiciliary beds, which it now does to an inadequate extent, and permit it to use part of its beds for the surgical care of Negro patients. At present it is often impossible to admit Negroes soon enough after application is made to benefit them.
It is believed that the responsibility for the control of tuberculosis is being recognized more and more as a community problem, which of course it is, to be supplemented by whatever governmental assistances that can be provided. These additional aids are particularly required in the maintenance of whatever tuberculosis hospital or sanatorium facilities communities may provide.
The Georgia Tuberculosis Association is making a very determined effort to assist in the rehabilitation of patients and their families in every possible way. It is not possible to include at this time a report of the accomplishments of this Association, but it may be said that it is growing and has answered appeals in every case brought to its attention.
Below is given the number of cases of tuberculosis reported in the state, together with the rate per 100,000 population, for the years 1934. through 19<11:

Tuberculosis Control

167

Year
1934 1935 1936 1937 1938 1939 1910 1941

Number of Cases Reported
3617 3588 3317 3016 3011 2996 2800 2635

Rate per I00,000 Population
121.3 118.4 108.6
98.0 97.1 95.9 89.6 83.8

Cases of tuberculosis reported in the state show a decline, and nearly come up to the minimum standard requirement of two new cases per each annual death. The decline in the number of cases reported indicates that there is with the decrease in deaths a comparable drop in the development of new cases. As case finding is still far from being fully developed, the number of cases TepoTted can be expected to increase as case finding is improved. Our own case-finding effort shows little change in the number of cases found in persons examined. It is a service limited to selected material.
The appended 'J1ables give in greater detail .the services Tendered by this Division. Table V shows that a larger percentage of minimal cases were found in both white and colored patients than in former years, and that fewer far-advanced cases were found in .the white race, although less change has occurred in this particular in the colored race. On the whole, this shows a better selection of material for the tuberculosis clinics. Table IX with the comparison of public health activities for 194.0 and 19M shows that they were increased to a considerable extent, except in "Contacts Broken", from which may be inferred that there a1e not so many to break as formerly, and in the number of cases for whom relief was secured, possibly because there are not as many needing relief as formerly. The same reason may apply also to the number of tuberculosis cottages that were built.
SUGGESTIONS FOR COUNTERACTING ULTERIOR INFLUENCES OF WAR
GeneTally speaking the decrease in tuberculosis death rates in Georgia is nearly that of the United States as a whole, although a little higher. The rate for the United States in l9iW was 4.5.8; Georgia's rate was 49.1. It is still a devastating disease and according to available reports kills more people annually than any other reportable infectious disease, with the exception of pneumonia. More than 5,000 deaths from tuberculosis are reported each month.
There are many reasons for never letting up on the fight against tuberculosis which is far from having been conquered.
War itself is a major reason, for it has been shown that the tuberculosis death rate has increased in England in l9iU nearly 10%, and 15%

168

Georgia Department of Public Health

in young women and adolescent giTls. The same phenomena occuned in the first WoTld WaT.
It has been stated that eighteen wo1;keTs at home aTe TequiTed to keep one soldieT in the fighting aTea, and this is ceTtainly a most impoTtant Teason foT maintaining the health of the entire nation to the highest degTee possible. Heplacement of wDTker loss and fighteT loss must come eventually fTom the youngeT Tanks. That they may come most efficiently equipped to take the!T places as woTkeTs and fighters they must have had, all of their lives, abundant and proper food, protection from disease, and education and tTaining designed to make them self-suppoTting. The pTomotion of propeT nutrition and hygiene and protection from infection by the state and local health departments plays an impoTtant paTt in tubeTculosis contTol. Much more can be done by intensifying case-finding programs in the more populous cities wheTe tuberculosis death rates are higheT and tuberculosis patients are more concentrated. In order to reach an immensely greateT pmt of the geneTal population much more cheaply than has heTetofore been possible, it is urged that by some means 35 mm. fluorophotographic appaTatus should be installed in the larger population centers for continuous use.
The function of this Division may well be:
l. Assistance to local agencies in organizing the service.
2. Teaching rapid technic to local health or otheT peTsonnel.
3. Assisting and teaching otherwise qualified physicians in miniature X-ray film interpTetation as Telated to screening foT determining need of an individual foT regular study.
4. Making interpretation of miniature and regular X-ray films as the capacity of the Division may permit.
The Director of this Division has made a personal extended study of 35 mm. film technic and agrees with those who have made similar studies that for mass survey work or case finding it is a very cheap and satisfactory process. The intelligent use of this method and the moTe universal employment of sputum examinations in people who cough would help greatly in what still remains a fundamental in tubeTculosis control, that is, discovery of early cases and the souTces of infection.

Tubercnlosis Cantral

TABLE I NUMBER OF CLINICS AND CLINIC DAYS IN 1941

Month

Number Clinics

January --------------------------- 22

Febmary -------------------------- 19

lVIarch ---------------------------- 21

April

19

May

20

June

20

July

22

August ---------------------------- 15

September ------------------------- 21

October --------------------------- 27

Noveu1ber

20

December

H

Total for clinics____________________ 240 X-rayed in office __________________ _

Total fOl' year_____________________ 210

Number of Days
22 20 21 22 20 21 22 16 20 22 19 H
~39
239

169
Number X- rayed
1221 1313 1356 1350 1231 1125 1538 1090 ll07 1976 lfH5
770
1G053 208
16266

TABLE II

DISTRIBUTION OF CLINICS

In 13 counties in 123 clinics organized by health officers______________________________ In 61 counties in 109 clinics organized by county hea!tl1 nurses_______________________
Georgia State Industrial College, Chatham County__________ --------------------------West Geo1gia College, Carroll County---------------------------~-------------------Toccoa Falls Institute, Stephens County---------------------------------------------Georgia State College, .Peach County-----------------------------------------------Cook County Clinic----------------------------------------------------------------Aldora Mills, Lamar County--------------------------------------------------------University of Georgia, Clal'l;e County-----------------------.------------------------Gainesville Mills, Hall CountY----------~-------------------------------------------Rauscl1enberg Mills, Whitfield CountY-----------------------------------------------Agnes Scott College, DeKalb CountY-------------------------------------------------Georgia State College for Women, Baldwin CountY-----------------------------------Georgia State College, l'each County------------------------------------------------

8615 57H
153 23 98
278 116
50 428 111 157
93 147
65

Total for year---------------------------------------------------------------------- 16058

1--' -.J
0

TABLE Ill SUMMARY OF CASES FOUND

Adult Type Original Exam ________________
Adult Type Re-exams --------------------
Total ---------------------------------
li"irst Infection-Infiltrative Type-
Original Exams ---------------------- ~'irst Infection-fufiltraU\'c T)pe-
Reexaminations ----------------------Total ---------------------------------
Grand Total ---------------------------

Number X-rayed
4799 3681 8480
1584
1231 2815 11295

White Cases Found
281 64 345
21
15 36 381

Number % X-rayed

5.9

2367

l.7

985

4.1

:1352

l.;)

nt3

l.2

4!,1

1.3

1364

3.4

4716

*47 examinations were unclassified because of poor films and lack of proper information.

Colored Cases Found
169 30 199
:J9
44 243

~
..,Cl)
0 Cl'l
N. ~

White and Colored Combined t:;:,

Number

Cases

Cl)
"<::;

% X-rayed

8.2

7166

Found 450

g % !q
6.3

3.0

4666

94

!3.9

11832

544

aCl)
2.0 4.6

..0_

4.3

2497

60

1.1

1682

20

3.2

4179

80

5.2

160ll

624

2.4
1.2 l.9

-'"'1;:1
:;::: o-
N. C')

3.9 :::t:: Cl) ;~:;..

White Childhood )linimal __ ~fod. Adv.
Total Colored
'l'olal

TABLE IV
RESULTS OF ORIGINAL EXAMINATIONS, ALL AGES BY SEX AND COLOR SHOWING NUMBERS AND PERCENTAGES

Number
7 28 54 57 146 496 2288
2930

Male

%
.24
.~G
1.84 l.9ti 4.99
Hi.~:!
78.08
100.00

Female

Number

%

14 :l9 fi7 46 l!'JG 467 2830

.41 1.13 l.6G 1.33 4.52 13.!:12 81.96

3453

100.00

19
10 56 92 240 984
1316

1.44 .53 .76
4.26 6.99 18.24 74.77
100.00

20 20 21 55 116 262 1586
1964

1.02 1.02 1.07 2.80 5.91 13.34 80.75
100.00

Male and Female

Number

%

21 67 111 103 302 963 :Jll8
6383
39 27 31 111 208 502 2570

.23

1.05 1.74

'.-: l

1.61 4.73 15.09 80.18
100.00

0""'
;";'
.: 0
"""'''
(.J

Cl

:;:::l;

.C,l_
1.19

.82

.95

3.38

6.34

15.30

78.36

3280

100.00

I-' -..j
I-'

I-'
-.] ~~

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 Minimal ------------------------ --------------Mod. Adv. --------------------------------------
Total ------------------------------------------

Up to 16

No.

%

3

1.1

3

1.1

'

7

2.fl

17. 45

No.

%

:1:1

18.9

73

26.7

66

23.1"1

194

69.1

46 U"

No.

%

11

3.9

3:l

11.7

36

12.8

so

28.4

Colored

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

9

.G

2:1

.0

27

4.1

so

5.3

130

1:!.!1

:~

l.X

16.0

4

2.4

47.:1

:l3

13.6

76.9

30

17.8

C<l
"0 ' ~:s

.",' All Cases

b

No.

% '<::>

67

23.9 """'

lll 103

"' 39.5
36.6

.;:,;.

..0_

281

100.0

"ti

~

27

"' 16.0 ""

:-n

18.4 :::c:

111 16H

"' 65.6
100.0

;~;..

TABLE VI

NUMBER AND PERCENTAGE OF CASES FOUND BY FIRST EXAMINATIONS IN RELATION TO NUMBER XRAYED, MALE AND FEMALE COMBINED, CLASSIFIED ACCORDING TO STAGE AND AGE GROUP CASES FOUND

White Age Groups

Number X-rayed

Up to 16 ------------------------------17 45 --------------------------------46 Up ---------------------------------

1588 3870
925

Total ---------------------------------c 6383

Colored Up to 16-------------------------------17 45 -------------'-------------------46 Up ---------------------------------

921 1942 417

'l'otal ---------------------------------- 3280

Minimal

No.

%

3

.19

53

1.37

ll

1.19

6~

1.05

1

.11

23

1.18

3

.72

27

.82

Mod. Adv.

No.

%

3

.19

75

1.94

33

3.57

lll

1.74

0

.00

27

1.39

4

.96

31

.95

Far Adv.

No.

%

1

.06

66

1.71

36

3.89

103

1.61

~

.87

so

4.12

23

5.51

111

3.38

~

All Cases

&. No.

%

"'~

7

.H :;::

194

5.02 0

so

8.65 &"';

2S1

4.40

(.J 0

;~:;

"-

9

.9S

130

6.69

30

7.19

169

5.15

!-"
-w.1

1-1
.-:;-:.l.

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

0
~....

White

Number

CASES FOUND Minimal

Mod. Adv.

Far Adv.

1"";::;

~

All Cases

~

Age Groups

X-rayed

Up to 16.----------------------------17 - 45 ------------------------------46 Utl --------------------------------

1231 2834 S47

No.

%

1

.OS

28

.99

5

.59

No.

%

No.

%

1

.OS

1

.OS

ll

.39

9

.32

6

.70

2

.24

No.

% ".g."..

3 48

"' .24
1.70 .;,;.:,l.

13

1.53 -.0..,..

'l'otal -------------------------------- 4912

Colored

451

l7 - 45 ------------------------------

785

4G Up _________ -- --------------------

200

'rotal -------------------------------- 1436

34

.69

18

.37

12

.24

64

~ 1.30

4

.S9

ll

1.40

1

.50

1

.22

3

.67

s

l.7S ~ ....

2 1

.25 .50

7
(j

.89 .00

20 2

'"' 2.54

1.00

i::l::
~

16

l.ll

4

.2S

10

.70

30

2.09 ;".:.".;.....

Tnberculosis Control
TABLE VIII RESULTS OF INTERPRETATION OF FILMS REFERRED BY PHYSICIANS
January I thNJ ugh December 31, 1941
l\Iinimal Cases ---------------------------------------- - --- ----- -l\foderately Advanced Cases_______________________________________ 22 Far Advanced Cases---------------------------------------------- 23
~rota! Positive Suspicious ------------------------------------------------------- 116 Negative ____ ---------------------------------------------------- 36<1
Total -----------------------------------------------------------
TOTAL OF ALL FILMS SENT IN FOR INTERPRETATION_________

175
54 480 531

TABLE IX PUBLIC HEALTH TUBERCULOSIS CONTROL ACTIVITIES
1940 and 1941

Cases of tubereulosi~ admitted to service---------- __________ _
Visits to tuberculosis ca:ies, contacts and suspects-----------Visits to cases of tuberculosis ________________________ -----Ave!'age number of visits to cases of tuberculosis ____________ _ Office visits by cases of tuberculosis_______________________ _ Admission to Sanatoria___________________________ ---------
Number completed tuberculin tests __ -----------------------Sumber positive --------------------------------------
Contacts broken ----------- -----------------------------Contacts partly broken---------------------------------- Relief secured-Number of cases------------------------Tuberculosis cottages builL _______________________ ---------Public lectures and tallm on tuberculosis ___________________ _

Year 1940
3,<1<16 53,5<18 18,649
5.'11 4,'>87
<175 16,070
8,753 1,752
381 707
20 537

Year 1941
'1,<199 67,358 19;115
4.32 5,591
613 2<1,960
8,688 1;137
368 667
13 670

176

Georgia Department of Public Health

TABLE X

RESULTS OF INTERPRETATION OF X-RAY FILMS MADE IN CENTRAL OFFICE

January I through December 31, 1941

Original Examinations

Childhood eases _____ -------------------- -------------------------------------------

l\'Ilnimal cases __ ____________ __________

.. --------------------------------------

Moderately advanced cases ________________________________________________________ _

4

Far advanced caSl'E

6

Total positive

11

Suspicious ______________ - __________________________ - __ ------ ___ ------ _- -----------

r6

1'\egative

98

Total

Re-examinations

'fotal :\umber re-examined

83

New Cases Found Childhood _________ _
~Iinimal
Far Advanced _________ --------------------------------- ________ ------------------

Total Number of Positive Cases Found by Original and Re-examinations

Childhood cases ___ --------------------------- --------------------------------- __ _

1\finimal cases ------------------------------------------------ --------------------

1

l\loderately Advanced cases_________________________ --------------------------______

4

Far advanced eases-------------------------------- _________ -----------------------

~rotal positive ----------------------------------------------- ____________ _________

11

'l'O'l'AL OF ALL X-RAYS );JADE IX OFFICE ____ --------------------------------- 20'

State Tuberculosis Sanatorium

ALTO, GEORGIA

ANNUAL REPORT FOR YEAR 194-1
C. NI. Sharp, M.D., Superintendent

MEDICAL STAFF

F. C. Whelchel, M.D.

J. B. Ford, Jr., M.D.

Fred Crenshaw, M.D.

P. C. Burnett, M.D.

H. E. Crow, M.D.

Robert H. Cox, M.D.

Norman L. Anderson, M.D.

C. D. Whelchel, M.D., Thoracic Surgeon-Non Resident John G. Scott, D.D.S., Dentist-Non Resident

Medical Report
It is always a pleasure to report progress in any endeavor. There has been constant progress at this institution since it was placed under the direction of the State Board of Health in 1937. In a hospital progress is expressed in terms of expanded service and service in terms of facilities for treatment.
In 1937, 250 beds were available, at the end of the year. In 1938, 296 beds were available, at the end of the year. In 1939, 309 beds were available, at the end of the year. In 194.0, l'1ll beds were available, at the end of the year. In 1941, 621 beds were available, at the end of the year.
In 19,;10 there were ll6,69l'1 patient days, while in 194.1 there were 168,171 patient days. This is an increase of 51,L177 patient days over the previous year. The average daily census in 19l'U was 461 against 319 in 194.0. This is an increase of H2. The total number of admissions was 820 patients against 642 in the preceding year, an increase of 178.
These figures show rather graphically the growth of the Sanatorium. It has occurred largely by the opening of the new Infirmary Annex and by placing into operation two cottages for colored patients, housing thirty-two additional NegToes.
Various activities at the Sanatorium have shown proportionate increases:
Operations and operating room procedures increased by 82% over the preceding year.
Laboratory procedures increased by 28% over the preceding year.
Activities of the X-ray Department were increased in approximately the same proportion.
Due to the increased demands for surgery, an additional day each week for thoracic surgery was added this year.

178

Georgia Department of Public Health

The medical staff has been augmented by the addition of three staff physicians, 9 graduate nurses, and 26 nurses aides.
A registered dietitian has been placed in charge of the Culinary Department. This complies with the recommendation made by the American College of Surgeons, and has resulted in a definite saving in food cost.
The process of cross-indexing ail hospital records was started, using up-patients for :the wo1:k, thereby assisting in their rehabilitation, and we are also rehabilitating .additional patients in the office and laboratory.
A much needed basal metabolism machine and an electrocardiograph have been purchased which assist greatly in some of our diagnostic problems.
The increased importance of the bronchoscope is demonstrated by the increase in the number of examinations. In 1940 only two bronchoscopic examinations were performed, while in 1941 twenty-eight were done at the Sanatorium. These resulted in the demonstration of tracheobronchial tuberculous lesions in twenty-seven of these patients. This is one of the outstanding advances in modern diagnostic procedures.
The increase in the number of patient beds available for white adults has made it possible to take more of the advanced public health problems for bed rest and isolation, thereby removing many of these severe public problems from contact with people where they reside. This makes possible the retaining of patients longer at the Sanatorium on bed rest alone and the collapse therapy group receives longer hospitalization.
The superintendent of nurses is conducting classes for training nursing aides, and is able to provide the nursing service at the ,Senatorium with additional practical nurses. This has rendered a great service to the Sanatorium in supplying additional nurses, a problem which has become serious with all hospitals.
Additional Activities
A circulating library has been established, giving the patients a wellrounded selection of good reading material.
A motion picture projector has been installed by the generous donation of one of the friends of the Sanatorium, whose name must remain anonymous. This allows the patients to have the recreation of motion pictures once a week. The films seen by the patients have been donated by various film organizations in Atlanta, including Paramount, Columbia, Republic, and Monogram.
Replacements and New Construction
Four new trucks were purchased during the past year, three of which were replacements and one an additional truck made necessary by the increased work at the Sanatorium.
The Colored Sanatorium has been plastered and painted and the roofs repaired on some of the old cottages that have been in use about twenty-five

State Tuberculosis Sanatorium

179

years. Two other old cottages have been reconditioned and completely equipped to care for thirty-two additional patients.
Two cottages have been furnished and placed into use. One is occupied by three single physicians and the other by a married physician.
With the scarcity of commodities due to the war, construction of a large warehouse will enable the ordering and storing of an entire quarter's supply of material while it is available in quantity lots. This will result in a definite saving in the cost of supplies, since there has been an 18% increase in the price of all hospital commodities.
An addition has been constructed to the laundry which is to be used as a sorting room and a storage room for the excess laundry necessitated by the increased patient load. An additional large washing machine and a much-needed mattress sterilizer was purchased.
The daily per capita cost for operation in 194.1 was only $1.90 per patient in spite of an 18% increase in the price of hospital commodities.
Recommendations
The Sanatorium is severely handicapped by the absense of adequate housing facilities. Extra nurses are occupying the .first floor of the new Infirmary Annex which should be available to patients. It is not suited for nurses who should have more privacy after their work at the Sanatorium. Many nursing aides are living in large wards with very little privacy. The enlargement, by at least .fifty beds of our present nurses' home would not only help to solve the problem of our personnel but would enable 62 more patients to receive treatment at the Sanatorium.
The problem of housing of staff personnel is also a factor that needs rectification.
The problem now at the Sanatorium is the provision of more beds for Negroes. At the present, there is a long waiting list and it takes a Negro about three months to be admitted to the Sanatorium. After this time, the disease has usually spread so rapidly that most of the patients at the Colored Sanatorium are in a practically hopeless condition. This is a problem that requires every consideration, because until this situation is remedied it will remain a serious obstacle in making headway in the control of tuberculosis in Georgia.

180

Georgia Department of Public Health

AGE AND SEX OF PATIENTS DISCHARGED FROM JANUARY I, 1941, THROUGH DECEMBER 31, 1941

Age Groups
1- 10 11- 20 21 - 30 31 - <]0 41 - 50 51- 60 61 - 70
71- so
Total

Male
13 36 86 79 51 38 11
315

Female
21 50 lOS 73 40 15
0
308

PATIENTS ADMITTED January I, 1941- December 31, 1941

Admitted

Total

White men

332

White women ----------------------- 312 White boys ------------------------- 20 White girls ------------------------- 21 Colored men ------------------ ______ <19

Colored women -------------- ------ 79
Colored boys ----------------------- 5 Colored girls ----------------------- 2

Total

820

PATIENTS DISCHARGED January I, 1941- December 31, 1941

Discharged

Total

Wl1ite men ------------------------- 251 White women ----------------------- 218 White boys ------------------------- 19 White girls ------------------------- 23 Colored Men ------------------------ 45 Colored women --------------------- 65 Colored boys ----------------------- 1 Colored girls -----------------------

'l'otal

623

ADMISSION CLASSIFICATION OF WHITE PATIENTS-JANUARY I, 1941 DECEMBER 31, 1941

Classification

A

B

c

D

Susp.

Non-tbc. Tbc. Pleurisy Undiagnosed Total

li'ar advanced ----------------------- 3

1~7

151

19

0

0

0

0

313

Mod.-advanced -------------------- 3

192

15

2

0

0

0

0

212

Minimal -------------------------- 3

37

1

0

0

0

0

0

41

Primary Type --------------------- 38

0

0

0

0

0

0

0

38 VJ

Suspicious ------------------------ 0 Non-tuberculous ------------------- 0

0 0

0 0

0 0

4

0

0

30

0 0

0 0

4 30

cB;"

Tbc. Pleurisy ---------------------- 0

0

0

0

Undiagnosed ---------------------- 0

0

0

0

Total --------------------------- 47

366

170

21

0

0

10

0

10 '-'l

0

0

0

37

& 37

4

30

10

37

"' 68ri :::;

:,;.::_

0
;":";;

Classification

ADMISSION CLASSIFICATION OF COLORED PATIENTS-JANUARY I, 1941 DECEMBER 31, 1941

A

B

c

0

Susp.

Nan-tbc. Tbc. Pleurisy Undiagnosed

Total

V:;:,J
~

:F-aradvanced --------------------Mod.-advanced --------------------

0..

~l
27

42

ll

1

0

l\iinimal -------------------------- 1

2

0

0

0 0 0

0 0 0

0 0 0

0 0 0

H 33
3

0
~-


Primary 'l'yDe ------------------- __ 7

0

0

0

0

0

0

0

7

Suspicious ------------------------ 0

0

0

0

0

0

Non-tuberculous ------------------- ()

0

Tbc. Pleurisy ---------------------- 0

0

0

0

0

0

0

0

0

8

Total ---------------------- ----- 10

50

46

ll

0

5

5

8

135

1--'
0~
1--'

DISCHARGE CLASSIFICATION OF WHITE PATIENTS FROM JANUARY I, 1941. THROUGH DECEMBER 31, 1941

Classification:

A Con.

B Con.

:Far-advanced_____ l Imp. Unilll!l. Qnies. Ap. Ar.
1\fod.-advanced____ 1 Imp. Quies.
MininutL--------- 0
Primary Type _____ 7 Imp. 1 Healed 5 Unimp. 2 Ap. Healed
21 Ap. Arr. 3 Arrested Suspicious-------- 0 Non- tuberculous __. 0 Tbc. Pleurisy_____. 0 Undiagnosed______ 0

76 Imp. 40 Unimp.
1 Quies. 7 Died
Ap. Ar. Arr. 67 lmp. 24. Ui1imp. l:l Quies. Died Atl]l.Ar. 1:1 Imp: UnimiJ. Quies. 2 Ap. Al'. 0
0 0 0 0

Total ___________t8

2 :3

C Con. 13 Imp. 46 Unillltl.
l Quies. 31 Died
3 Gnimp.
0
0
0 0 0 0 94

D Con.
6 Unimp. 17 Died
0
;
0
0
0 tl 0 0 23

Susp. 0

Non- Tbc. 0

Tbc. Pleurisy 0

0

0

0

0

0

0

0

0

0

12

0

0

0

52

0

0

0

8

0

0

0

12

52

8

*The majority of these patients left the Sanatorium against medical advice before diagnosis could be made.

Undiag. 0
0
0
0
0 0 0 ll* 11

I-'
o:>
l-..:l

Total
24fi

'<l
~
0
.,~ ~.
119

t::;

.,~
'"1;:j

;;:;.

2ri

;3
~

-~ Cl

39 ~

.0,_..
~ ~-

12 :s..~:,,:._t.:
52

8

ll

511

DISCHARGE CLASSIFICATION OF COLORED PATIENTS FROM JANUARY I, 1941, THROUGH DECEMBER 31, 1941

Classification:

A Con.

B Con.

Far-advanced_____ 1 Imp.

10 Imp.

3 Unimp.

2 Quies.

Died

Mod.-ad\anced ____ 2 Imp.

16 Imp.

4 Unimp.

2 Quies.

1 Ap. Ar.

MinimaL _________ l Imtl.

2 Imp.

Primary 'rype_____ 2 Imp.

0

2 Ap. Ar.

1 Died Suspicious________ 0

.0

Non-tuberculous__ 0

0

Tbc. Pleurisy_____ 0

0

Undiagnosed______ 0

0

TotaL__________ 9

41

C Con. 6 Imp. 8 Unimp. 2 Quies. 13 Died 0
(I
0
0 0 0 0 29

D Con. 7 Unimp. 10 Died
0
0 0
0 0 0
17

Susp. 0

Non-Tbc. 0

Tbc. Pleurisy 0

Undiag. 0

0

0

0

0

0

0

0

0

0

0

0

0

5

0

0

0

0

11

0

0

0

0

0

0

5

11

0

0

Total

63

VJ
~

"""'"l

"' 25

o~c;

"0,_'

3 z":':

5 VJ !;:> ~
5
"' 11 ..:.
0 ;3

112

f-1
00
~

l84.

Georgia Department of Public Health

LABORATORY REPORT FROM JANUARY I, 1941, THROUGH DECEMBER 31, 1941

Sputum:

Direct Sn1ear ---------------------------------------------------------------Concentration ---------------------------------------------------------------Culture ---------------------------------------------------------------------Animal Inoc. (S.B.H.) ---------------------------------------------------------
Fontana ------------------ --------------------------------------------------Fungus

Blood: Culture

Count ----------------------------------------------------------------------Coagulation -----------------------------------------------------------------.ryping ---------------------------------------------------------------------Crossmatching --------------------------------------------------------------Kahn ----------------------------- _------------------ __________ ______________
1\'Ialaria

Blood Chemistry:

Sedimentation ----------------------------------------------------------------
Blood Sugar ------------ ----------------------------------------------------Sulfanilamide _____________ -------------------- _____________ -------- _---------

K. P. N----------------------------------------------------------------------

Urine:
P. S. P. noutine Culture

'l'esL-----------------------~----------------------------------------

Feces: I\outine Culture

Pleural Fluid:

Smear ----------------------------------------------------------------------Culture ------------------------------- __ ------------- ----~------------------Spinal Fluid:
Routine

Culture -----------------------------------------------------------------------Smears:

lvlixed Organisms ------------------------------------------------------------Gonococci
Pneun1ococci _______________ ---------------------------------------------------

Staphylococci ---------------------------------------------------------------Streptococci ---------------------------------------------------'---------------
Vincents -------------------------------------------------------------------Colon Bacilli ----------------------------------------------------------------Bacteria Count:

Milk -----------------------------------------------------------------------Gastric:

Direct Sn1ear -----------------------------------------------------.----------RotLtille ------------------- ________________________ ---------------------- ___ _

Culture ---------------------------------------------------------------------ll.ninlal Inoc. ---------------------------------------------------------------ll.nalysis --------------------------------------------------------------------Miscellaneous :

Gran1 Sn1ear ----------------------------------------------------------------Gonococci Cultme --------------------------------------------~--------------~P. B. Snlear------------------------------------------------------------------
Mastic .rest (S.B.H:) -------- .------------------------------------------------Bleeding Time ---------------------------------------------------------------

4,784 505 <123 12 59 11
1,3,15 208 220 116 885 20
1,012 37
., '1,101
107 37
13 ~
'1 7 23
2
6 7
11
6 8 21 1
2 3 6 4 3

State Tuberculosis Sanatorium

185

.Febrile Antigens -------------------------------------------------------------

3

Secondary Organisms ---------------------------------------------------------

Knee Fluid Culture-----------------------------------------------------------

1

Choles toral _______________________ ------------ ___ ----------- ________________ _

Total __ --------------------------------------------------------------------- 1<1,263

OPERATING ROOM REPORT (WHITE AND COLORED) JANUARY I, 1941- DECEMBER 31, 1941

Thoracic Surgical Procedures:
.tl.picolyses -------------------------.---------------------------------------------Bronchoscopic Examinations -----------------------------------~----------------- Incision and Drainage of Abscess in Chest-----------------------------------------Irrigation of Pleural Space_______________________________________________________ _
Lobectomy ----------------------------------------------------------------------1\Ionaldi Tube Inserted------------------------------------------------------------Oleothorax, Average Number of Patients-------------------------------------------Oleothorax Refills ---------------------------------------------------------------0 leothorax, Out-pa tien ts Receiving ________________ --------- ____________ -------------
Oleothorax, Out-patient Refills----------------------------------------------------0 leo thorax, Removal of _________________ ------------ ________ ----------------------Phrenicotomies ------ ______________ -------------- __ ------------------------------Pneumolyses-No. of Patients_______________ --------------------------------------Pneumolyses :
First Stage -----------------------------------------------------------------Second Stage ---------------------------------------------------------------Third Stage -----------------------------------------------------------------Pneumoperitoneum, Initial -------------------------------------------------------Pneumoperitoneum, Average Number Receiving______________________________________
Pneumoperitoneum Hefills --------------------------------------------------------Pneumoperitoneum Patients Discharged____________________________________________ _
Pneumopel'itonemn Patients Discontinued ------------------------------------------Pnemnoperitoneum, Average Number Out-patients Receiving _____________________ ~----
Pneumoperitoneum, Out-patient Refills---------------------------------------------Pneumotholaces. Initial ----------------------------------------------------------Pnmunothorax, Average Number Patients Receiving __________________________________
Pneumothoraces, Successful ------------------------------------------------------Pnetnnothoraces, Unsuccessful ---------------------------------------------------Pneumothorrrx, Refills ------------------------------------------------------------Pneumothorax Patients Discharged------------------------------------------------Pneumothorax Patients Discontinued_______________________________________________ Pneumothorax, Average Number Out-patients Heceiving_____________________________ _ Pneumothorax, Out-patient Refills_________________________________________________ _
Renloval of .il.ir------------------------------------------------------------------Removal of Part of Scapula_______________________________________________________ _ Rib Resection and 'ube Insertion__________________________________________________
Spontaneous Pneumothorax, Needle in ChesL--------------------------------------Thoracenteses -------------------------------------------------------------------Thoracenteses, Out-patient -------------------------------------------------------'l,horacoscopic Examinations -----------------------------------------------------'l'horacoplasties-No. of Patients______________________________________________ -----
'l,horacoplasties:
First Stage -----------------------------------------------------------------Second Stage ---------------------------------------------------------------'l'hird Stage -----------------------------------------------------------------Fourth Stage ---------------------------------------------------------------Fifth Stage ------------------------------------------------------------------

28 1
1,227 1 3 4
79 3
~
1 116
23
~3
'l
22 41 1,927 12 17
16 382 19<1 271 110 9,195 100
50 18 381 145
2 9 2,003
48
<18 48 46 30

186

Georgia Department of Public Health

OPERATING ROOM REPORT (WHITE AND COLORED) JANUARY I, 1941 DECEMBER 31, 1941-Continued

Secondary Closure of Thoracoplasty Wound_________________________________________

2

Transpleural Decon1pression -------------------------------------------------------

5

1'ube Inserted in Pleural CavitY----------------------------------------------------

13

Deaths During Surgical Procedures-------------------------------------------------

1

Other Surgical Procedures:

Appendectomies ------------------------------------------------------------------

2

Blood ~Pransfusions ---------------------------------------------------------------

30

Curette of Sinuses ----------------------------------------------------------------

1

Debridement of Hand--------------------------------------------------------------

2

Enucleation of Eye----------------------------------------------------------------

Incision and Drainage of Abscess--------------------------------------------------

21

Incision and Drainage of Rectal Abscess____________________________________________

1

Incision of Rectal Abscess---------------------------------------------------------

Lumbar Punctures ---------------------------------------------------------------

Mastoidectomy -------------------------------------------------------------------

1

Removal of Cyst ------------------------------------------------------------------

1

Removal of Lymph Node ----------------------------------------------------------

Surgical Drainage ----------------------------------------------------------------

Suturing of Lacerated Upper LiP--------------------------------------------------

'l'herapeutic Abortions ------------------------------------------------------------

2

1'ubes Inserted ------------~------------------------------------------------------

10

Other Operating Room Procedures:

.Antiluetic T1eatments, Average No. Patients Receiving_______________________________

12

Antiluetic 'l'reatments, Nuntber Given----------------------------------------------

700

Application of Plaste1 Splint to WrisL---------------------------------------------

2

Application of Radium--------------------------~----------------------------------

Autopsy -------------------------------------------------------------------------

Gland Biopsy, Axilla______________________________________________________________

1

Biopsy of Gland on Neclc_________________________________________________________

1

Biopsy of H:nee-------------------------------------------------------------------

1

Bladder Instillations __ ------------------------------------------------------------

1

Injections, I. V.

Gastric Lavages ------------------------------------------------------------------

15

Oxygen Lavages -----------------------------------------------------------------

3

0. 2"'.} .Average Number Patients Receiving__________________________________________

2

0. 1"'., Number Treat1nents Given___________________________________________________ 121

Rectal Examinations _____ --------------------------------------------------------

1

Pelvic Examinations --------------------------------------------------------------

38

Sldn Tests -----------------------------------------------------------------------

40

Suturing of Lacerated Finger-----------------------------------------------------Suturing of Lacerated Wound on Forehead _________________________________________ _

0 tl1er ~frea tntents ------------ ______________ ------------------------- -------------

1'otal Daily Treatments_ ___ --------------------------------------------------- 17,112

State Tuberculosis Sanatorium

187

XRAY REPORT FROM JANUARY I, 1941, THROUGH DECEMBER 31, 1941

Fhtoroscopics (Colored and White)------------------------------------------ ______
X-rays -------------------------------------------------------------------...:._____ _ Flats ___________ ------------ ________ -------- ___________ ----------------- ___ _____ Buckys ----------------~----------------------------------------------------- --Stereos -------------------------------------------------------------------------G. I. --- ------------------------------------------------------------------ _____ _ Bone Plates ---------------------------------------------------------------- ..---Portables ---------------------------------------------------------------------- ... Fluid X-rays -------------------------------------------------------------------Kidney X-rays -------------------------------------------------------------- ---Mastoid X-rays -----------------------------------------------------------------SinllS X-rays -------------------------------------------------------------------0 bliques --------------------------------- ------------------------------ __ ------. Copies of films--------------------------------------------------------------------
Fetus X-rays -------------------------------------------------------------------Photo Roentgenoscope ---------------------------------------------------------B. 111. It. -----------------------------------------------------------------------E. IC G. -----------------------------------------------------------------White Adults:
House Patients --------------------~-----------------------------------------Consultation Patients White Children :
House Patients --------------------------------------------------------------Consultation Patients Colored Adults:
House Patients ------------------------------------------------------- ________ Consultation Patients Colored Children :
House Patients -------------------------------------------------------------Consultation Patients Lipiodol Injections : House Patients ______________________c______________________________________ _
Consultation Patients -----------------------~---------------------------------

12,352 5,732 '1,976 30 58 <18 113 99 16 25 9 12 2
343 13 21
3,009 1,502
200 183
650 1<14
4<1 0
11

In the clinic at the Sanatorium 77 new cases of pulmonary tuberculosis were found f1on1 January 1, 1941, through December 31, 1941,
Four hundred and seventy-one cases were found in consultation X-rays sent in by outside physicians, during the year of 19<11.

188

Georgia Department of Public Health

CouNTIEs REPRESENTED (BoTI-I RAcEs) FRoM JANUARY 1, 1941, THROUGH DECEMBER 31, 1941

Bacon -------------- 2 Baldwin _____________ 6
Banks -------------- 3 Barrow _____________ 8 Bartow _____________ 9 Bibb _______________ 23 Bleckley ____________ 2 Brooks _____________ 1
Bulloch ------------- 7 Burke ______________ 5 Butts _______________ 3 Camden ____________ 2 Carroll _____________ 1
Catoosa ------------- LJ, Chatham ____________ 22 Chattahoochee _______ 1 Chattooga ___________ 9 Cherokee ____________ 3 Clarke ______________ 12 Clayton _____________ 6 Cobb _______________ 8 Coffee ______________ 5
Colquitt ------------ 2 Columbia ___________ 1 Cook _______________ 2 Coweta _____________ 3 Crawford ___________ 2 Crisp _______________ 6 Dade _______________ 3
Dawson ------------- 2 Decatur _____________ 7 DeKalb ______________ 17 Dodge ______________ 2 Dooly ___ ___________ 3 Dougherty __________ 7 Douglas ____________ 8 Early _______________ 1
Effingham __________-_ 1 Elbert ______________ 2 Emanuel ____________ 3 Evans ______________ 1
Fannin _____________ 8 Fayette _____________ 2

Floyd -----~--------- 36 Forsyth _____________ 2

Franklin ____________ l

Fulton ______________ 67

Gilmer _____________ 2

Glascock ____________ 3 Glynn ______________ Lt Gordon _____________ 8

Grady ____________ ___ 3

Greene _____________ _ 3

Gwinnett ____________ 10

Habersham _________ _ tj. Hall _________________ 23

Haralson ____________ Lt Hart _______________ 2

Heard _____________ ,_ 2

Houston ____________ 2 Irwin _______________ 2

Jackson __________ _ _ 6

Jeff Davis ___________ 1 Jefferson ____________ 1

Jenkins _____________ 2

Johnson_____________ 3 Lamar _____________ __ 2

Laurens ____________ _ 10
Liberty ________ ------ 1 Lincoln ____________ _ 1

Long --------------- 1 Lowndes ___________ _ 6
Nlacon __________ --- 2 Madison ____________ _ 3
Meriwether ____ _ _ _ 1 Mitchell ____________ _ 1 Monroe _____________ 2

lVlorgan ____________ __ 3
Murray ____________ _ 1 Muscogee ___________ 14 Newton _____________ 5

Oconee _____________ 1

Oglethorpe _ _____

2

Paulding __________ __ 2

Peach ___________ __ 2

Pickens _____________ 3

State Tuberculosis Sanatoriwn

189

CouNTIEs REPRESENTED (BoTI-I RAcEs) FRoM JANUARY 1, 1941, THROUGH DECEMBER 31, 194.1-Continued

Pierce ______________ 2 Pike ________________ 1 Pclk ________________ 13 Putnam _____________ 3 Quitman ____________ 1 Rabun ______________ 2
Randolph ___________ 3 Richmond ___________ 8 Rockdale ____________ 1 Screven _____________ 1 Spalding ____________ 10 Sumter _____________ 1 Tatnall _____________ 3
Taylor -------------- 2 Telfair _____________ 1 Terrell ______________ 1
Thomas ------------- 6 Tift ________________ 4,

Toombs ____________ _ 2 Towns ______________ 1 Troup ______________ 5
Turner ______________ 1 Twiggs _____________ 2 Union ______________ 1 Upson ______________ 2 Walker ______________ 9 Walton _____________ 3
Ware ---------------- 11 Warren ____________ _ 1 Washington ________ _ 9 Wayne _____________ _ 6 Wheeler ------------ 1 White ______________ 2 Whitfield ____________ lit Wilkinson ____:._ _____ _ 5 Worth -------------- 3

SPECIAL MEDICAL REPORT
Each year we try to supplement our regular medical report with a detailed statistical study of some phase of the modern treatment of tuberculosis.
This year we have elected to study the results obtained from the use of thoracoplasty. Our analysis includes the year performed, age of patient, stages performed, sex of patient, and type of operation.
. The number of thoracoplasties has steadily increased. The mortality rate when first studied in 1936 was high and this makes the mortality rate of the total group high. The mortality rate for the last year, during which forty-eight complete operations were performed, has been considerably reduced and is now on a par with nationally published statistics.
The following supplement is a summary of our results in all thoracoplasties done at the Sanatorium from 1936 through 194.1.

t-' \C
C

Year
1936
1937 1938
1939 1940 1941 Total group __

TOTAL THORACOPLASTY GROUP, WHITE AND COLORED

-----------
Neg. sputum

or no expect.

Total Ea. Year

No. %

Positive sputum No. %

Converted No. %

Tbc. empyema

4

1 or 25%

3 or 7:5%

1 01' 33.3%

'fbc. empyema

4

1 or 25%

3 or 75o/o

2 or 66.7%

11

2 or 18.2%

9 or 81.8%

5 01' 55.6%

(1 Tbc.-1 non-

10

Tbc. elllp)ema)

10 or 100%

9 or 90%

36

36 or 100%

2S or 77.8%

44

44 or 100%

34 or 77.3%

109

4 or 3.7%

105 or 96.3%

79 or 75.2%

Unconverted
No. %
2 or 66.3% 1 or 33.3% 4 or 44.4%
1 or 10% S or 22.2S:'o 10 or 22.7% 26 or 24.8%

~
".0..'.
0'<! ~

Died

t:1

No. %

~

~

1 or 2Gcf0

"

1 or 25%

.;",:.':,.

2 or 18.2%

-0 .

1 or 10% 5 or 13.9%

"tl
.&,._.

3 or 6.8%

~

13 or 11.9%

1::!::
".~,.',.

;;r.

State Tuberculosis Sanatoriztm

191

SUMMARY OF STATISTICAL STUDIES OF THORACOPLASTIES DONE AT THE SANATORIUM THROUGH 1941
TABLE No. I Total Thoracoplasty Group, White and Colored-109 Patients Negative sputum
No expectoration: 4 or 3.7%; 1 Non tuberculous empyema; 3 ~ruberculous empyema (Sputum concentrated prior to thoraco.) Positive sputum: 105 or 96.3% Converted sputum: 79 or 75.2% Unconverted sputum: 26 or 21.8% :Mortality rate for total group of 109-13 or 11.9%.
TABLE No.2
Total Female Thoracoplasty Group, White and Colored-60 Patients Negative sputum
No expectoration: 3 or 5%; (1 non tuberculous empyema, 2 tuberculous empye1na.) Positive sputum: 57 or 95%
Converted sputum: 12 or 73.7% Unconverted sputum: 15 or 26.3% Mortality rate for total group of 60-9 or 15%
TABLE No. 3
Total Malo Thoracoplasty Group, White and Colored-49 Patients Negative sputum
No expectoration: 1 or 2.1% (1 tuberculous empyema.) Positivo sputum: 18 or 97.0%
Converted sputum: 37 or 77.1% Unconverted sputum: 11 o1 22.9% Mortality rate for total group of 49-1 or 8.2o/o
TABLE No. 4
Total Thoracoplasty Group Classified as Far Advanced-92 Negative sputum
No expectoration: 3 Ol' 3.2% (3 tuberculous empyema) Positive sputum: 89 or 96.7%
Converted sputum: 63 or 70.8% Unconverted sputum: 26 or 29.2% !\Iortality rate for total group of 92-11 o1 12%
TABLE No. 5
Female Thoracoplasty Patients Classified as Far Advanced-53 Negative sputum
No expectoration: 2 or 3.8% (Tuberculous empyema) Positive sputum: 51 or 96.2%
Converted sputum: 36 or 10.6o/'0 Unconverted sputum: 15 Ol' 29.4% Mortality rate for total group of 53-9 or 17%
TABLE No. 6
Male Thoracoplasty Patients Classified as Far Advanced-39 Negative sputum
No expectoration: 1 o1' 2.6% ('fuberculous empyema) Positive sputum: 38 or 97.4%
Converted sputum : 29 or 76.3% Unconvertecl sputum: 9 or 23.7% Mortality rate for total group of 39-2 or 5.1%

192

Georgia Department of Public Health

TABLE No. 7
Total Thoracoplasties in Moderately Advanced GrouJJ-16 Negative sputum
No expectoration: Positive sputum: 16 or 100%
Converted sputum: H or 87.5% Unconverted sputum: 2 or 12.5% Mortality rate for total group of 16-2 or 12.5%
TABLE No. 8
Female Thoracoplasty Patients Classified as Moderately Advanced-6 Positive sputum: 6 or 100%
Converted sputum: 6 o1 100% Mortality rate-0
TABLE No. 9 Male Thoracoplasty Patients Classified as Moderately Advanced- I0 Positive sputum: 10 or 100%
Converted sputum: 8 or 80% Unconverted sputum: 2 or 20% Mortality rate for total group of 10: 2 or 20o/0
TABLE No. 10
AGE GROUP Total Patients in I0-20 Age Group-5 or 4.6% Negative sputum: 1 or 20% (empyema) Positive sputum: 1 or 80o/0
Converted sputum: <1 or lOOt,~ Unconverted sputum: C.Imtality rate : 0
TABLE No. II Total Patients in 20-30 Age GroUIJ-44 o1 40.3% Negative sputum: 2 or '!.5% Positive sputum: !2 or 95.5%
Converted sputum: 36 or 35.7% Unconverted sputum: 6 or 11.3% Mortality rate for total group of <14: 3 or 6.8%
TABLE No. 12 Total Patients in 3040 Age Group-38 o1 34.9% Negative sputum: 1 or 2.6% (Non tuberculous empyema.)
Positive sputum: 37 or 97 Ao/o
Converted sputum: 2<1 or 6'!.9% Unconverted sputum: 13 or 35.1% )fortality rate fm total group of 38: 6 or 13.2%
TABLE No. 13 Total Patients in 40-50 Age GroUJI-IB or 16.5% Positive sputum: 18 or 100%
Converted sputum: 11 or 61.1% Unconverted sputum: 7 or 38.9% )lortality rate for total group of 18: 4 or 22.2%
TABLE No. 14 Total Patients in 50-60 Age Group-3 or 2.8% Positive sputum: 3 or 100%
Converted sputum: 3 or 100%

State Tubercnlosis Sanntorinm

193

TABLE No. 15
Total Patients in 60-70 Age Group-! or .9o/o Posltivo sputum: 1 or 100%
Converted sputum: I or 100~"7o
TABLE No. 16
TYPES OF OPERATIONS Rib Resections Alone-Total Patients in Group-11 )legative sputum: 3 or 27.3% Positivo sputum: 8 or 72.7%
Converted sputum: <! or 50% Unconverted sputum: 4 or 50% )!ortality rate for total group of ll-3 or 27.3%
TABLE No. 17 Rib Resections and Transverse Processes-Total Patients in Group-70 Positive sputum: 70 or 100%
Converted sputum: 52 o1 74.3% Unconverted sputum: 18 or 25.7% ~Iortality rate for total group of 70: 9 or 12.9%
TABLE No. 18
Tip of Scapula. Rib Resections and Transverse Processes-Total Patients in Group-7 Positive sputum: 7 or 100%
Converted sputum: 6 or 85.7% Cnconverted sputum: 1 or 1<1.3% :uortality rate for total group of 7: 1 or 14.3%
TABLE No. 19
Bony Plate. Rib Resections and Transverse Processes-Total Patients in Group-5 Positive sputum: 5 or 100%
Converted sputum : '1 or 80% Unconverted sputum: 1 or 20% I\Iortality rate for group of 5 patients-0
TABLE No. 20 Posterior and Anterior Rib Resections and Transverse Processes-Total Patients in GrOUJJ-14 Negative sputum: 0
Positive sputum: H or 100% Converted sputum: 12 or 85.7% Unconverted sputum: 2 or 11.3% ~Iortality rata for total group of H-0
TABLE No. 21
Other Types of 0JJeraticns-Total Patients in Group-5 Negative sputum: 0 Positive sputum: 5 or 100%
Converted sputum: 3 or 60% Unconve1ted sputum: 2 or <!Oo/o :\Iortality rate: 2 or <!0%
TABLE No. 22
Total Thoracoplasty Group of 109 -:rota! primary thoracoplasties: 1! or 12.8% ~l'otal secondary thoracoplasties: 95 or 87.2%
Total thoracoplasties performed du!'ing first admission to Sanatorimn: 55 or ;}0.5% Total 'lllwracoplasties ]Jerformerl on readmission to Sanatorium: 54 or 119.5%

Division of Laboratories

T. F. Sellers, M.D., Director

E. J. Sunkes, D.P.H., Chief Bacteriologist

Janie Morris, M.S. . Madge Reynolds, A.B. E. L. Webb, A.B. M. M. Harris, Ph.D. F. H. Stubbs, M.S.

Cultures Microscopy
Serology Waycross Branch
Albany Branch

For the calendar year ending December 31, 19<11, the Division of Laboratories examined 507,323 specimens. This was an increase of 112,309, or 22.1 per cent over the previous year.

INCREASE IN LABORATORY WORK
Diagram l shows (l) the marked growth in laboratory work over the 21-year period from 1920 through 1941 and (2) the gain from 1940 to 19M.
Diagram 2 shows the gain in specimens by departments during this same 21-year period.
A comparison of the numbers of specimens of the different types examined during 1940 and 19<11 is given in Table l and shows that the greatest increase occurred in the Kahn test for syphilis. See discussion on page 21. Significant declines were noted in the tests for malaria and intestinal parasites, these losses occurring as a result of the restrictions in index or survey projects. See Tables, l, 16 and 19.

Laboratories

195

DIAGRAM I
GROWTH OF LABORATORY WORK
1920-1942

642,916

507,323 395,004

187,727

-22,420 1920

45,990 1925

89,949 1930

1935

1940

1941

1942

196

Georgia Department of Pnblic Health

540,000 480,000

DIAGRAM 2
GROWTH OF LABORATORY WORK BY DEPARTMENTS 1920-1942

0 MICROSCOPY
I CULTURE
0 SEROLOGY

180,000 120,000

1920

1925

1930

1935

/940

1941

1942

Laboratories

197

81,203 16 0"/,
CENTRAL
3~3,658
69 7.1.
507,323

DIAGRAM 3
SPECIMEN LOAD
BY
LABORATORIES
1941

198

Georgia Department of Public Health

DIAGRAM 4
SPECIMEN LOAD
BY
DIVISIONS 1941

SEROLOGY
347,270 664;.

Laboratories

199

DIAGRAM 5

SPECIMEN LOAD BY DIVISIONS

IN EACH LABORATORY

1941

CENTRAL LABORATORY

ALBANY LABORATORY

WAYCROSS LABORATORY

200

Georgia Department of Pnblic Health

DIAGRAM 6
SPECIMEN LOAD BY DIVISIONS 1942
PERCENTAGE TOTAL LOAD HANDLED IN EACH LABORATORY

CENTRAL LABORATORY

SEROLOGY

CENTRAL LABORATORY

CENTRAL LABORATORY 15,993 - 52.2%

ALBANY LABORATORY 9,646- 31.4'Ao

MICROSCOPY

CULTURE

Laboratories

201

TABLE COMPARATIVE CLASSIFICATION OF SPECIMENS 1940 1941

'l1ttbmculosis --------------------------Diplltlleria ----------------------------
Gonorrhea -----------------------------
i\Ialaria ------------------------------IntestinaJ Parasites -------------------Rabies -------------------------------Miscellaneous -------------------------Agglutinations ------------------------Blood Cultures -------------------------
Stool and Urine Cultures________________ Blood and Spinal Fluid for Kahn Test_ ___
Darl<field ~Pests for syplli!is ------------
Tissue ---------------------------------
\Vater ---------------------------------

1940
11,507 2,215 8,2<18 36,081 60,709 1;123 3,121 10,285 8,741 7,112 232,326
375 '182 12,359

Grand ~'otal ----------------------- 395,01<1

1941 13,969
2,693 9,880 33,157 53,206 1,26'1 3,121 10,9,13 9,322 8,112 3<11,270
309
13,205
507,323

Gain or Loss + 2;162 + ,149 + 1,63'1
2,921 7,501
159
+ 658 + 581 + 1,811 +1H,9<H
66
+ 8'16
+112,309

Table l also shows that marked gains were noted in the various test5 for venereal disease (with the exception of the clarkfield test for syphilis). The examinations for venereal diseases have in recent years continued to increase until they now constitute the greater percentage of our laboratory examinations. See also Table 2.

TABLE 2
RELATIONSHIP OF EXAMINATIONS FOR VENEREAL DISEASE TO TOTAL SPECIMEN LOAD

1937

v. 'l'otal Specimens
Spechnens for

-D--. -__-_-_-_-_-_-_-_-_-_-

251,153 133,751

Per Cent for v. D. ____________

52.6

1938
355,51'1 185,033
52.0

1939
385,850 219,331
56.9

1940
395,014 240,9,19
61.0

1941
507,323 357,461
70.6

Diagram 3 shows the percentage of the total specimen load handled by each laboratory while Diagram 4 shows the percentage of the total specimen load handled by the several departments. Diagram 5 shows the total specimen load and percentage handled in the several departments of each laboratory. Table 3 gives the numerical data on which these diagrams
are based.

202

Georgia Department of Public Health

TABLE 3
COMPARISON SPECIMEN LOAD 1940 1941 Specimen Load by Laboratories:

Increase or Decrease in 1941

1940
Central Laboratory ---------------------- 258,380 Albany Laboratory ---------------------- 83,619 Waycross Laboratory ___________________ _ 63;148
Grand 'l'otal ------------------------ 105;147 Percentage Total Load by Laboratories:

1941
353,658 81,203 72,462
507,323

Spec.
+ 95.278
- 2,416
+ 9,01<1
-1-101,876

Per Cent
+ 26.9
- 3.0
+ 12.4 + 20.1

1940 Percentage

Central Laboratory ------------------

62.2

Albany Laboratory ------------------ __ 21.2

Waycross Laboratory ----------------- _ 16.6

Percentage Total Load by Divisions:

1941 Percentage
69.7 16.0 1<1.3

Per Cent Change
+ 7.5
-5.2 -2.3

1940

Per Cent

1941

Serology ---------------------- 232,326

58.8

3<17.270

Microscopy ----------------- 123,709

31.4

117,600

Culture ----------------------- 26,138

6.7

29,248

Water ------------------------- 12,359

3.1

13,205

Percentage Total Load by Divisions in Each Laboratory:

Per Cent
68.'1 23.2
5.8 2.6

Per Cent Change
+ 9.7
- 8.2
.9 - .5

1940

1941

Per Cent Change

Central Laboratory

Serology ------------ ____________ _ 61.0

73.'1

+ 9.'1

Microscopy ----------------------- 21.1

17.9

6.2

Culture ---------------------------

6.9

5.0

1.9

Water ----------------------------

5.0

3.7

- 1.3

Albany Laboratory Serology

48.2

51.6

+ 6.'1

Microscopy ---------------------- _ !L!.O

35.5

8.5

Culture ------------------------

7.8

9.9

+ 2.1

Waycross Laboratory

Serology

52.6

G9.7

+ 7.6

Microscopy ______________________ _ 12.9

35.3

- 7.6

Culture

4.5

'.l.U

-r ''

Laboratories

203

BRANCH LABORATORIES
The branch laboratories at Albany and Waycross handled a total of 153,665 specimens during the past year as compared with 147,067 during 19LLQ, an increase of 6,598 specimens. This constituted 30.2 per cent of the total specimen load for the laboratories. There was an mcrease of 9,014. (12A, per cent) in the number of specimens handled by the Waycross Laboratory. The concentration of intestinal parasite examinations in this laboratory, and a marked increase in the number of public health nurses assigned to the area served by this laboratory account chiefly for the increase. The Waycross Laboratory served 5L1 counties. A decrease of 2,LH6 specimens (3.0 per cent) was noted in the Albany Laboratory. This decrease resulted chiefly from a marked decline in intestinal parasite examinations. 17,84.7 such examinations were made in the Albany Laboratory during 19L10 while only 8,509 were made during the past year. There was an increase in practically every other type of examination made in this laboratory. This laboratory served 48 counties.
Map 1 shows the counties from which specimens were received by the Albany branch, while Map 2 shows the counties served by the Waycross branch.

SUMMARY OF LABORATORY EXAMINATIONS
The consolidated report of the three State Laboratories, composing the Division of Laboratories, is given in Table 4. The individual reports for the Central Laboratory and each branch laboratory are shown in Tables 5, 6 and 7.

204

Georgia Department of Pnblic Health

TABLE 4 REPORT OF COMBINED LABORATORIES FOR 1941

Total

Tuberculosis-Microscopic ----------------------------------Tuberculosis-Cultures -------------------------------------~l'uberculosis-Animal Inoculations --------------------------Diphtheria ------------------------------------------------Gonorrllea. -------------------------------------------------Darkfield Test for Syphilis__________________________________ _
Malaria ---------------------------------------------------Intestinal Parasites ----------------------------------------Egg Counts -----------------------------------------------Rabies-1\1icroscopic ---------------------------------------Rabies-Animal Inoculations -------------------------------1\IIiscellaneotlS ----------------------------------------------
'l'O'l'AL FOR MICROSCOPY------------------------------
Agglutinations ---------------------------------------------'l'yphoid Fever -----------------------------------------'yphus (Brill's) Fever__________________________________ _
Brucellosis --------------------------------------------Ttllarenlia ---------------------------------------------Blood Cultures --------------------------------------------E. typhosa --------------------------------------------Salmonella --------------------------------------------Brucella ----------------------------------------------Others ------------------------------------------------Stool and Urine Cultures_____________________________________
E. typhosa --------------------------------------------Salmonella --------------------------------------------Shigella -----------------------------------------------Othel's ------------------------------------------------TO'l'AL FOR CULTURE----------------------------------
Blood and SJJiual Fluid for Kahn Test________________________
Water -----------------------------------------------------

13,008 708 251
2,693 9,880
311 33,157 49,352 3,85'1
1,090 1H
3,121 117,599
10,9<13
9,322
8,984
29,2,19 347,270
13,205

GRAND TO'l'AL ---------------------------------------- 507,323

Positive
1,063 61 52
513 1,929
78 555 12,772
491 36
116 651 115
63
182 7 12 25
266 3
206 0
50,695

Laboratories

TABLE 5 REPORT OF CENTRAL LABORATORY FOR 1941

Total

Tubere ulosis-Microscopic __ --------- _______________________ _ '.fuberculosis-Culture 'lluberculosis-Animal Inoculation ---------------------------Diphtheria ___ ------- _--------------------------------------Gonorrhea ------------------------------------------------Darl;field 'l'est for Syphilis----------------------------------Malaria ---------------------------------------------------Intestinal Parasites ----------------------------------------Egg Counts -----------------------------------------------Rabies-Microscopic ---------------------------------------Rabies-Animal Inoculations -------------------------------lVliscellaneous ----------------------------------------------
'l'OTAL l!'OR MICROSCOPY------------------------------
Agglutinations ---------------------------------------------Typhoid Fever -----------------------------------------'l'yphus (Brill's) Fever----------------------------------Brucellosis --------------------------------------------'flllalenlia ----------------------------------------------
Blood Cultures --------------------------------------------E. typhosa --------------------------------------------Salmonella --------------------------------------------Bru.cella ----------------------------------------------Others -------------------------------------------------
Stool and Urine Cultures_____________________________________
E. typhosa --------------------------------------------Salmonella --------------------------------------------Shigella -----------------------------------------------Others ------------------------------------------------'l'OTAL FOR CUL'l'URE_________________________________ _
Blood and Spinal Fluid for Kahn Test_ _______________________ Water .. __

9,669 7<17 23<1
2,119 6,826
26,1 14,312 2'1,656
1,<177 960 17<1
1,176 63,163
6,639
5,869
5,119
17,627 259,663
13.205

GRAND 'l'O'l'AL

353,658

205
Positive
835 37 '19 4,19
1,373 66
315 '1,579
430 36
83 251
59 3,1
131 6
37 11
188 3
158
36,89,1

206

Georgia Department of Public Health

TABLE 6 REPORT OF ALBANY LABORATORY FOR 1941

Total

~rubelculosis-l\llicroscopic ----------------------------------Diphtherin, -------------------------------------------------Gononhea -------------------------------------------------Darkfield Test for Syphilis-----------------------------------~ Malaria ------------------------------------------------ ____ _ Intestinal Parasites Rabies-l\l!icroscopic -----------------------------------------Miscellaneous ------------------------------------------------
'l'OTAL FOR MICROSCOPY-------------------------------
Agglutinations ----------------------------------------------'l,yphoid Fever ------------------------------------------'l'yphus (Brill's) Fever____________________________________
Brucellosis ---------------------------------------------'l1ulare]nia ----------------------------------------------Blood Cultures ---------------------------------------------E. typhosa ---------------------------------------------Salmonella ---------------------------------------------Brucella -----------------------------------------------Others -------------------------------------------------Stool and Ul'ine Cultures______________________________________
E. typhosa ---------------------------------------------Salmonella ---------------------------------------------Shigella -----------------------------------------------Others -------------------------------------------------'l'O'l'AL FOR CUL'l'URE---------------------------~-------
Blood and Spinal Fluid for I{alm 'l'esL________________________

1,677 2'17
2,204 35
6,623 8,510
92 <175 28,823 3;111
2,650
1,990
8,051 4<1,329

GRAND TO'l'AL ----------------------------------------- 81,203

Positive 137 22 311 8 77
2,585 42
18 299
41 26 33
11 50
7,102

Laboratories

TABLE 7

REPORT OF WAYCROSS LABORATORY FOR 1941 Total

'l'uberculosis-:Microscopic ----------------------------------Tuberculosis-Culture _________ ----- ________________ ----- ___ _
Diphthel'ia __ ------ ____________ ------------------------------
Go11orrl1ea. --------------------------------------------------Darl;field Test for Syphilis____________________________________
Malaria _____ ------------- ________ --------------------------Intestinal Parasites ----------------------------------------Egg Counts ------------------------------------------------Rabies-l\licroscopic ----------- _______ -------------- ________ _ Miscellaneous ----------------- _____________ -----------------
TOTAL FOR MICROSCOPY-------------------------------

1,662 29
327 850 12 3,262 16,186 2,377
38 870 25,613

Agglutinations
Typhoid Fever -----------------------------------------'l'yphus (Brill's) -Fever________________ -------------------
Brucellosis Tularemia Blood Cultures E. typhosa
Sal1nonella ------------------------------------ ---------Brucella ------------------------------------------------Others ------------------------------------------------Stool and Urine Cultures-------------------------------------
E. typhosa ---------------------------------------------Salmonella ---------------------------------------------Shigella -----------------------------------------------Others -------------------------------------------------TOTAL FOR CULTURE----------------------------------

893 803 1,875 3,571

Blood and Spinal Fluid for Kahn 'fest_________________________ <13,278 GRAND TO'l'AL ---------------------------------------- 72,'162

207
Positive 91 2 <12 2<15 4 42
5,608 19
15 98 15
3 18 2 3 28
0
6,69U

MICROSCOPY UNIT
A study of various examinations made in the Microscopy Unit will be found in the tables that follow.

TABLE 8
MICROSCOPIC EXAMINATIONS FOR TUBERCLE BACILLI FIVE YEAR PERIOD 1937- 1941

1937

1938

1939

1940

Number examined -------------- 5,572

Number positive ---------------- 693

-- Per cent positive

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

12.4

7,359 808 10.9

8,395 896 9.9

10,385,
975
SA

1941
13,008 1,063 8.2

208

Georgia Department of Public Health

MAP 1

Laboratories

209

In line with our past policy, all animal inoculations for tuberculosis, and all culture studies (except 29 made in the Waycross Laboratory) were made in the Central Laboratory. This policy also requires that three negative microscopic reports on sputum must be obtained before requesting further laboratory studies. A fourth specimen can be submitted for culture only. When negative culture results are reported, a fifth specimen may be submitted for animal inoculation. Other fluids and tissues submitted for tuberculosis are routinely subjected to microscopic, cultural, and animal inoculation studies.
During 194.1 a total of 74.? cultures and 234. animal inoculations for lVL tuberctllosis were completed. 526 specimens were cultured only. 221 were both cultured and inoculated into guinea pigs. The results of the culture studies are given in Table 9. The results on cultures and animal inoculations are given in Table 10.

TABLE 9 TUBERCULOSIS CULTURES

Type Specimen

Tctal

Positive

Sputum -------------- -------------- ___ _ 170

33

Pleural Fluid ----------------------------

2

Urine __________________ -------------- __ _ 18

Stool ------------------------------------ 5

0

Pus ------------------------------------ 5

1

11hroat Swab ---------------------------- 1

Blood ------------- _____ ---- ____________ _

Synovial Fluid --------------------------

Total _------------------------------ 507

37

No. of cultures not reported

(Check specimens) -------------- ____ _ 19

'l'O'l'AL CULTURES-19<11 ---------- 526"*

Negative
127 1
17 5
4

Atypical''
10 0

160

10

*Atypical organisms morphologically, tinctorially and culturally typical of 'iii. tuberculosis but non-pathogenic for guinea pig. All submitted from one patient.
*Does not include specimens submitted to both culture and animal inoculation..

210

Georgia Department of Public Health

MAP 2

WAYCROSS BRANGH LABORATORY
Source of specimens recei~ed durinq the yeor 1942
69,832 Specimens

Laboratories

211

TABLE 10 TUBERCULOSIS ANIMAL INOCULATIONS

Tyne Snecimen

Total

Micro. Findings

Culture

Neg. Pos. Neg. Pos.

Animal Inoculations Neg. Pos. Uns.

Sputum ------------------- 59

56

3

50

9

47

12

0

Pleural Fluid ------------- 82

80

2

74

8

66

15

1

Urine -------------------- 26 25

26

2'1

Pus ------- -------------- 18

17

H

<1

13

Synovial Fluid ------------ 17

17

17

17

Ascitic Fluid --------------

2

Stomach Contents --------- 8

Spinal Fluid --------------

0.

Cystocele Fluid ------------ 1

l\fernbrane (throat) -------.- 1

0

Monkey 'Tissue ------------

1

Mill< ---------- ------------

0

Cultmes (Check) ---------- 15

15

2

13

0

1'0'l'AL --------------- 236 212

24

198

23

185

<19

2

TABLE II CLASSIFICATION OF DIPHTHERIA EXAMINATIONS 1941

Total

Positive

Negative

Diagnostic ------------------------ 1,832
Release and Carrier________________ 8<19
Virulence ------------------------- 13

278

1,535

229

619

7

6

'l'O'l'AL ----------------------- 2,69<1

51<1

2,160

Doubtful 19 1
20

TABLE 12

EXAMINATIONS FOR GONOCOCCI FIVE YEAR PERIOD 1937 1941

1937

1938

1939

Number specimens examined_____________ 5,2,15
Number positive ----------------------- 1,081 Per cent positive________________________ 20.6

5,569 1,132
20.3

7,599 1,662
21.8

1940
8,2<18 1,818
22.0

1941
9,882 1,929
19.5

212

Georgia Department of Public Health

TABLE 13
ROUTINE AND INDEX MALARIA EXAMINATIONS 1941 (Routine specimens are those submitted from individual patients. Index specimens a1e those collected in organized surveys to determine malaria indices.)

Central

Albany

Waycross

Total

Routine PositiYe -------------------------Negative ------------------------Total -----------------------------

116 3,510 3,626

77 6,546 6,623

2<1

211

716

10,772

7<10

Grand 'l'otal _____ ---------- ____ --------------- ____ __ _______ _____ ___ ___ ____ 10,989

Index

Positive -------------------------- 199 Negative -------------------------- 10,<187 Total ---------------------------- 10,686

121 8,839 8,960

18 2,504 2,522

338 21,830

Grand 1'otal -------------------------------------------------------------- 22,168 TO'l'AL ROU'riNE AND INDEX MALARIA EXAMINATIONS ---------------- _______ 32,819

TABLE 14 SUMMARY MALARIA EXAMINATIONS

Routine __ . Index ___

Total
10,989 22,168

1'0'fAL ____ 33,157

1941
Positives 217 338
555

Per Cent Positive
2.0 1.5
1.7

Total 10;152 25,629
36,081

1940
Positives 34<1 793
1,137

Per Cent Positive
3.3 3.1
3.2

TABLE 15 CLASSIFICATION OF MALARIA POSITIVES

Tertian
Routine -------------------- -- 116
Index ------------------------ -- 50
'fOTAL -------------------- 166

EA 96 276
372

Quartan

Unci ass. <1 10
14

Total 217 338
555

The effort in recent years to minimize unorganized and non-essential malaria surveys has resulted in a marked decline in the number of specimens submitted for malaria examinations. This is shown in Table 16 which also shows that there has been a continued increase in the routine specimens submitted.

Laboratories

TABLE 16
EXAMINATIONS FOR rriALARIA FIVE YEAR PERIOD 1937 1941

Routine

1937

Total -------------------------- 7,5<10

Gain or Loss over preceding yem

Index
Total ----.---------------------- 2<1,761
Gain or Loss over preceding year

1938 0,537 +1,997
,19,185 +2<1,<124

1939 0,780 + 2<13
26,914 -22,271

1940 10,452 + 672
25,629 -1,285

213
1941 10,989 + 537 22,168 -3,']61

TABLE 17
ROUTINE AND INDEX INTESTINAL PARASITE EXAMINATIONS (Routine Sl)ecimens are those submitted from individual cases. Index specimens a1e tho3e collected ln mganized surveys to determine intestinal pa!'asite (chiefly Hoolnvorm) indices.)

Central

Routine Positive Negative 'rota! -----------

1,457 11,531 12,988

Index
Positive ---------
~egative
~rota! -----------

3,122 8,5<16 11,668

Albany
1,916 3,955 5,871
670 1,969 2,639

Waycrcss
1,0<13 2,t150 3,493
4,565 8,128 12,693

Total
4;ll6 17,936
8,357 18,643

Grand Total 22,352 27,000

GRAND TOTAL --------------------------------------------------------------. _ 49,352

214.

Georgia Department of Public Health

TABLE 18

CLASSIFICATION OF INTESTINAL PARASITE FINOINGS-1941

Single Infestation Worm for Identification ______________________________________
Hoolnvorm ------------------------------------------------Dwnl'f 'fapeworm ------------------------------------------Round Worm ----------------------------------------------Whip Worm -----------------------------------------------Pin Worm ________ ------------ ___ -------------------------Others _________________ -- _____ -----------------------------

9 12,261l
113 333
67 137
11

Double Infestation

Hookworm and Pin \Vorm____________________________________

20

Dwarf 'fapeworm and Round \Yorm___________________________

1

Hool;;:worm and Dwarf 'l,apeworm_____________________________

27

Hoolmorm and Round Worm_________________________________

<11

Rat Tapeworm and Hoolnvmm________________________________

1

I-Ioo!nvorln and \Vhip 'Worm__________________________________

10

Triple Infestation Hookworm, Round \Vorm, whip \Vorm _______________________ _ Hoolnvorm, Dwarf 'l,apevwrm, Pin VVorm _____________________ _

'fotal Specimens Positive fo1 Ova of HoolnvornL--------------Dwarf 'fapeworm -------------------------------------- _ Hound Worm _______________ ----------------------------
Whip Worm -------------------------------------------Pin Worm --------------------------------------------Others --------------------------------------------------

12,363 202 376 79 158 20

12,983
100 2

The decline in the number of specimens examined for intestinal parasites continues and, as is shown in Trable 19, is due entirely to a loss of survey specimens. Practically all sruch index specimens are now submitted in conjunction with studies made under the direat supervision of the Division of Malaria and Hookworm Investigations. In addition to the examinations for ova, other important laboratory examinations have been made in connection with the Hookworm Control program. In the Central and Wiaycross laboratories, 3,854 hookworm egg counts were made. In these laboratories 14-6 soil samples were examined for the presence of hookworm larvae.

Laboratories

TABLE 19
EXAMINATIONS FOR INTESTINAL PARASITES FIVE YEAR PERIOD 1937- 1941

Routine

1937

.rota! ------------------ -------- 7,835

Gain 01' Loss over preceding year

Index
Total -------------------------- 41,511
Gain 01' L03S over preceding year

1938 11,959 +4,12,1
48,6<JI -f-7,130

1939 14,563 +2,604
56,720 +8,079

1940 17,921 +3,358
3~,591
-17,129

215
1941 22,352 +4,431 27,000 -12,591

Rabies-Jl!Iicroscopic Examinations
A total of 1,090 animal heads was examined microscopically for evidence of rabies during 19L1l. An analysis of these .findings is given in Table 20. It will be noted that 28 fox heads were found .positive for rabies. The epizootic of rabies in wild foxes reported during 19L10 declined rapidly during the early months of 19LU. 25 of the 28 positive findings were obtained during the .first four months of the year.
In addition to ~hese examinations made in the State laboratories, microscopic examinations for rabies were also made in the various city and county board of health laboratories. A classification of these .findings is given in Table 22. Map 3 shows the source of all heads found positive for rabies by the several laboratories throughout the State.

Animal

TABLE 20
CLASSIFICATION OF ANIMAL HEADS EXAMINED FOR RABIES 1941
No. Specimens

Dog

78'1

Fox

71

Cat

H5

Cow

48

Hog

13

Mule ---------------------------------

Goat ---------------------------------

Squirrel ------------------------------

13

Rat ----------------------------------

3

Skunl' --------------------------------

2

O'possum ~----------------------------

1

Raccoo11 -----------------------------Chicken __ ----------------------------

'l'OTAL -------------------------- 1,090

Positive
406 28 29 25
2
0 0 0 0 0
,192

216

Georgia Department of Public Health

M}. P 3
MAP SHOWil~G ANI!'& HEADS POSITIVE lOR RAlliES
14

NO'nl: .!'u.l.ton County - 102

Richmond County - J.u<:uata Lab - 22

Muscogoo County - Collllllbua Lab - 5

llibb County

- Macon Lab - 15

Chatham County - Savallilah Lab - 6

Total - Cit;r Laboratorioo - 45

Total - State Laboratori-492

Grand-Total

-54o

Laboratories

TABLE 21

ANIMAL HEADS EXAMINED FOR RABIES 1937 1941

1937

1938

1939

1940

Number heads examined __ __ __ 1,333 Positive for Negri bodies______ 697 Percentage positive ----------'-- 52.2

1,164 538 46.2

987

1,252

<143

<196

44.6

39.6

217
1941 1,090
528* <18.4

*Correcte(l to include positive mouse inoculation tests.
In addition to these examinations made in the State hrboratories, microscopic e~aminations for rabies were also made in the various city and county board of health laboratories. A dassification of these findings is given in Table 22. Map 3 sho,ws the source of all heads found positive for rabies by the several laboratories throughout the State.

Rabies-Animal Inoculation
The mouse inoculation test f m- rabies is employed: (l) in th.ose cases where the microscopic examination is not in agreement with the animal history or dinical diagnosis; (2) when confirmatory evidence of micro scopic findings is desired; (3) routinely w~th rat and squirrel specimens because of bhe frequency with which humans are bitten by ~hese rodents.
173 mouse inoculation tests for rabies were made during 19M. An analysis of these studies is given in Taible 23.

TABLE 23 ANIMAL INOCULATIONS FOR RABIES

Type SJJeeimen

Micro.Mouse-

Dog -------------------- 78
Cat --------------------- 25
Fox --------------------
Cow -------------------- 4 Hog -------------------Squirrel -- -------------- 8
Rat -------------------- 1 Goat ------------------- 1 Mule ------------------- 2 Chic!<en --------- ------

TO'l'AL ------------- 128

Micro.-
+ Mouse
20 2
0 0
27

+ Micro. 1 Micro.- Micro.
Mouse- Mouse Uns. Cheeks
2
0 0

1

0

0

0

0

0

0

0

3

9

Total
107 3<1 1 9 8 8
2 1
173

218

Georgia Department of Public Health

Miscellaneous Examinations
Table 24 shows the miscellaneous examinations made during 1941. Pneumococcus typing again showed a decline, from 225 in 1940 to 170 during 1941. Positive typing was obtained in 101 specimens, compared to 145 in 194.0. Two specimens showed double infections and two triple. It was necessary to resort to the mouse test with 28 specimens, presumably because chemotherapy had been instituted prior to the collection of the specimen. Of the 51 specimens examined for meningitis, positive findings were obtained in 1LJ, as foUows: H. influenzae-6; N. intracellularis-6;
D. pneumoniae-1; Staphylococcus (hemolytic) -1.
The examinations for Glandular Fever consisted of studies of the blood picture -and the performance of the heterophile antibody test on liquid specimens of blood. These studies were made at the Waycross Branch Lwboratory.

TABLE 24 CLASSIFICATION OF MISCELLANEOUS EXAMINATIONS
Ameba ----------------------------------------------------------- 581 Pneumococcus typing----------------------------------------------- 170 Vincent,s organisms ----------------------------------------------- 298 Trichomonas vaginalis ---------------------------------------------- 338 Chancroid (B. ducrey) --------------------------------------------- 57 Spinal fluids for meningitis.--------------------------------------- 51 Examinations for type of organism__________________________________ 437
Cultures ---------------------------------------------------------- 521 Unclassified ------------------------------------------------------ 598 Glandular Fever (Heterophile antibody test)------------------------- 63

TO'l'AL

3,115

CULTURE UNIT
Under this heading are included blood and stool cultures, agglutination tests for typhoid, typhus, undulant fever and tulaTemia as well as a miscellany of special bacteriology.
Increase in each of the several examinations for enteric and other fevers occuned during 19M .as compared to 1940. Agglutination tests increased from 10,285 to 10,943; blood cultures from 8,741 to 9,322 and stool and urine cultures from 7,112 to 8,98LJ,. The positive results obtained in 19Ll.l as compared with previous years are shown in the tables that follo-w.

TABLE 25

POSITIVE AGGLUTINATION TESTS

1937

1938

1939

1940

1941

'l'yphoid --------------- 35,1

396

237

369

116

Endemic 'l'yphus (Brills) 909

8,11

832

429

651

Undulant -------------- 66

83

1'1,1

153

115

'l1ularemia. -------------- '18

59

130

97

63

Laboratories

219

In Table 26, it will he noted bhat 182 positive isolations of E. typhosa were obtained from blood clots, as compared to 265 in 19L1l.

During the past year the Culture Unit of the Central Laboratory undertook the typing of E. typhosa strains by the application of bacterio-

phage. A total of 391 cultures, isolated during 1941 and previous years from 280 cases and carriers, were studied. Cultures from 216 persons

(77.1 per cent) were typed as follows: Type A-M; Type G-45; Type

E-91; Type F-6; Type J-10. This work will be continued during the

coming year since the information obtained is of epidemiologic signifi-

cance. Included in the positive blood culture findings are isolations of

S. paratyphi A (1); S. paratyphi B (4); S. suipestifer (2); S. sendai

(1); S. panama (1); C. welchii (1); Streptococci, gamma type (5);

Streptococci, beta type (1) .



During the past year, the policy was continued of furnishing special

blood culture outfits containing try:ptose broth for all cases showing positive or doubtful agglutination reactions for undulant fever. 43 isolations of Brucella were obtained and classified as follows: Br. ahortus-8; Br.

suis-35.

TABLE 26

POSITIVE BLOOD CULTURES

1937

1938

1939

1940

1941

E. typhosa ------------- 260

403

255

265

182

Salmonella ------------- 11

12

11

9

9

Brucella --------------- 8

5

14

22

43

Other Organisms -------- 14

15

32

25

25

Included in the positive stool and urine cultures were isolations of: S. paratyphi B (1); S. oranienburg (1); S. hareilly (1); S. montevideo (1).
Typing of all salmonella cultures was made or confirmed by the New York Salmonella typing center at Beth Israel Hospital.
Isolations of Shigella from stool and urine cultures increased from 136 in 194.0 to 206 in 194.1. This increase can be attdbuted, in part, to the refinement of cultural technic resulting from previous studies of newly developed culture media. Through the use of agglutination and bacteriophage tests, 160 cultures were typed as follows:
Flexner __________ 120 Newcastle ________ 13 Sonne ___________ 27

TABLE 27

POSITIVE STOOL AND URINE CULTURES

1937

1938

1939

1940

1941

E. typhosa ------------- 281

612

453

360

266

Salmonella ------------ 6

3

5

Shigella ---------------- 34

85

114

136

206

Other Organisms ________ 3

7

1

5

0

220

Georgia Department of Public Health

SYPHILIS SEROLOGY
All specimens submitted for the serologic test for syphilis are :first subjected to the Presumptive Kahn test, and if found negative are so reported. Those showing any degree of reaction with the presumptive test are then subjected to the Standard Kahn test, and the reactions obtained with this test are reported.
Syphilis Serology constituted 68.5 per cent of the total specimen load in 194.1, as compared to 58.2 per cent in 194.0. A total of 3L17,270 S'pecimens were tested, compared to 232,326 in 19L10, a gain of 1}4.,954.. 1L1.6 per cent gave a positive reaction as compared to 16.7 per cent in 1940. A comparison of the Kahn tests made in the several laboratories is shown in Table 28. This marked increase was due, not only to a progressive increase in routine specimens, hut to an increased number submitted by selective smvice boards. All selective service specimens are examined in the Central Laboratory. 71,957 specimens of blood weie submitted from the 188 selective service hoards and represent approximately 21 per cent of the receipts in this unit of the laboratory. 13,3M of these specimens or 18.6 per cent gave positive reactions. This percentage of positive results cannot he taken as incidence of infection, however, since registrants giving positive reactions .are required to have a repeated test. In order to handle this volume, the capacity of this unit of the laboratory was increased from 800 specimens daily to 1,120 specimens.
During .the year, the chief seroiogist made personal contact with the clerks of LJ8 of the local hoards in addition to telephone contact with the 20 hoards in Fulton and DeKalb counties. It is gratifying to learn that the service of the laboratory to the selective service hoards is being rendered in a prompt and efficient manner.

TABLE 28 SYPHILIS SEROLOGY (I<AHN)

Blood 19<11 1940

Central
258,985 158,079

Albany
~11,201
'10,14'1

Waycross
,13,199 33,300

Total
3,16,385 231,523

Spinal Fluids 1941 -----------------------1940 ------------------------

+100,906
678 59,1

Blood and Spinal Fluids 1941 -----------------------19,10 ------------------------

+ 84
259,663* 158,673**

+100,990

128 12<1
+4
'1'1,329 40,268
t '1.061

+ 9,899
79 85
-6
,13,278 33,385
+ 9,893

+114,862
885 803
+ 82
317,270 232,326
+11<1,9,14

*Includes 71,957 selective service specimens. **Includes 5,941 selective service specimens. 'rhe examination of selective service specimens began in November, 19'10.

Laboratories

221

The Central Laboratory participated in the National Syphilis Serology Evaluation Study in 19t1l 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. The results obtained by our laboratory as compared with the Control Laboratory are given below.

TABLE 29 NATIONAL SEROLOGY EVALUATION STUDY-1941

Laboratory

Presumptive l<ahn Test

Sensitivity

Specificity

Control

87.8

9D.G

Ge01gia ---- ___________ _ 85.5

98.8

Standard l<ahn Test

Sensitivity

Specificity

79.2

100.0

78.'1

100.0

Following this, an evaluation study was made of the branch laboratories with the Central Laboratory acting as the control. The results given below indicate that a high standard of performance has been attained in all three laboratories.

TABLE 30 INTRA-STATE SEROLOGY EVALUATION STUDY-1941

Labcratory

PrestlllliJtive J<ahn Test

Sensitivity

SiJecificity

Central ------------------- 91.'1 Albany ------------------- 92.9 'Waycross -------------- __ _ 90.0

100.0 98.0 97.0

Standard l<ahn Test

Sensitivity

S(Jecificity

85.9

100.0

81.6

100.0

83.0

100.0

Darkfield Examinations
Darkfield examinations for Treponema pallidum showed a decTease. 375 were examined in 19t10, compared to 311 in 19M. 78 specimens or 25.2 per cent were positive.

TABLE 31

DARI<FIELD EXAMINATIONS FOR TR. PALLIDA

Consolidated Re110rted:

Pos.

Neg.

Dbt.

Specimens collected in laboratory-------- __ 13

37

0

Specimens received by maiL________________ 65

liD

l:i

'rota! --------------------------------- 78

216

15

Specimens examined in 19<11 _________________ 311

S11ecimens examined in 19<JO________________ 375

Decrease ------------------------- ____ 6<1

Total 50 261
311

222

Georgia Department of Public Health

BIOLOGIC PRODUCTS

Product

TABLE 32

BIOLOGIC PRODUCTS AND DRUGS DISTRIBUTED

Central

Albany

Diphtheria Antitoxin, Units_______________ _ Diphtheria ~roxoid, cc. ___________________ _ Diphtheria Shick Material, tests____________ Tetanus Antitoxin, units _________________ _ 'fyphoid Vaccine, cc, _____________________ _
Tetrachlorethylene, cap. -----------------Oil of Chenopodium, cap.__________________ Smallpox Vaccine, ampules_______________ _ Silver Nitrate, ampules___________________ _
Tuberculin, tests ------------------------Yeast, lb. -------------------------------Antipneumococci Serum, units ____________ _
Sulfanilamide, tablets -------------------Stovarsol, tablets -----------------------Arsenicals, ampules* --------------------Bismuth in Oil, cc. ---------------------Distilled Water, cc.**--------------------Sulfathiazole, tablets*** -----------------Diphtheria Toxin Antitoxin, units__________
Antivenin, cc. --------------------------Antistreptococci Serum, cc.________________ l\feningococcus Antitoxin, units ___________ _ Antimeningococci Serum, cc, ______________ _
Antirabic (~l'otal persons treated)**** ______ _

48,768,000 71,765 4<1,620
2,753,500 544,520 53,180 222
11<1,'140 73,202
188,120 20,'150
'1,,180,000 61,500 25,375
195,415 421,980 2,539,110 388,500
900
30 30 10,000 360 2,262

3,824,000 '1,530 880
15,1,500 '10,160 7,900 4,560 2,713
200,000
535 180 481,080
90 362

Waycross 2,260,000
5,560 2,510 10,500 41,990 12,100 7 ,0,10 4,016
200 120 273,840
277

*Equivalent to 450,505 doses of 0.6 gm. or less. **Distributed in 10 cc. and 100 cr. bottles. ***Added during 1941 to list of drugs available for venereal disease clinics. ****'l1he figufes given for the Branch Laboratories do not represent complete treatments.
Four vials of 1'arrine are supplied by the Branch Laboratories for each patient for whom treatment is requested. 'fhe remainder of the treatment is sent from the Central Laboratory.
NO'l1E: Typhoid vaccine, antirabic treatment, silver nitrate and distilled water are manufactured by the Central Laboratory, Other product~ are purchased from various commercial houses and distributed gratis or at a cost price. All biologics distributed by the branch laboratories are invoiced to them from the Central Laboratory, so that the distribution recorded from the Central Laboratory represents the total distribution for the year.

Laboratories

223

TABLE 33 BIOLOGICS SHOWING MARI<ED INCREASE OR DECREASE OVER 1940 DISTRIBUTION

Product

1940

Diphtheria, Antitoxin
Diphtheria, Toxoid ----------------------'l'etanus Antitoxin ----------------------'l'yphoicl Vaccine ------------------------'l'etrachlorethylene ----------------------Smallpox Vaccine ------------------------Tuberculin, tests ------------------------Antipneumococci Serum -------------- __ _
Sulfanilamide ---------------------------Distillecl Water --------------------------

37,014,000 60,285
2,188,500 608,120 65,461 95,270 10,750
5,520,000 351,000
2,085,000

1941
'18, 768,000 71,765
2,753,500 5<H,520 53,180 11<1,4,10 188,120
'1,'180,000 61,500
2,539,110

Increase or Decrease
+11,751,000 + 11;180 + 565,000
63,600 12,281
+ 18,170 + 168,370
- 1,0,10,000
289,500
+ '15,1,110

Human Antirabic Treatments
There was a rather sharp increase in the number o human .antirabic treatments distributed during the past year, 2,262 having been distributed in 194.1, an increase o 359 over the preceding year. A comparison for the past .five years is given in Table 3<1 and a classification according to type during 1940 and 194.1 is given in Ta:ble 35. Map <1 shows the distribution of human antirabic treatments.

TABLE 34 ANTIRABIC TREATMENTS AND RABIES MORTALITY

1937

Human 'l,!'eatments _____________..:._______ Human Deaths During or After 'freatment Human Deaths Without 'l'reatment_____ _ 'l'otal Deaths --------------------------

3,t145 3
'1

1938
2,938 0 2 2

1939 2,394
1
2

1940
1,903 0 1 1

*Diagnosis doubtful in one case.

1941
2,262 2 2* 4

TABLE 35 CLASSIFICATION ANTIRABIC TREATMENT BY TYPE

Type Treatment

1940

Number

Per Cent

PrecautionarY --------------- 707

37.2

Milcl ----------------------- 1,097

57.6

Intensive ------------------- 87

'1.6

Drastic ---------------------- 12

.6

1941

Number

Per Cent

901

39.8

1,255

55.5

95

4.2

11

.5

'l'OTAL ----------------- 1,903

2,262

224

Georgia Department of Public Health

MAP 4 .
MAP SHOWING DISTRIBUTION OF HUMAN ANTIRABIG TREATMENTS
1942 Toto! Number - 2130 Note: Bibb County 221
Fulton County 321 Lowndes County I 01

Laboratories

225

During 19<'11, there were four human cases of rabies reported. Three were cHagnosed clinically. Two cases, including the one brought to autopsy, were seen and diagnosed by the director of laboratories. Two received antirahic treatment, hut onset of symptoms occurred prior to completion of treatment. Two received no antirahic treatment. The case histories are as follows:
Case 1
D. B., white, male, age 14. years, Munnerlyn, Georgia (Burke County). Bitten on nose, February 7, 19<1.1, by dog which disappeared. Drastic antirabic treatment was started 2<.1, hours later. Fourteen days after exposure, the patient developed a symptom complex very comparable to rabies, and died on February 24th, or three days after onset. Details available in laboratory files. No autopsy obtained. Diagnosis rabies-not confirmed.
Case 2 W. R. B., white, female, age 4 years, Smyrna, Georgia. Possibly
exposed indirectly to family dog which disappeared February II, 19<1.1. No antirabic treatment administered. Fifteen days after last exposure, the child developed a syndrome not at all suggestive of rabies except for nervous manifestations. Death occurred March I, or three days after onset. Details avaibble in laboratory files. No autopsy obtained. Diagnosis questionable rabies-unconfirmed.
Case 3
C. L., white, male, age II years, Lawrenceville, Georgia (Gwinnett County). Bitten on hand, June 7, 19M, by rabid dog (diagnosis confirmed). No antirabic treatment administered. Fifty days later, the child developed typical symptoms of rabies, and died, July 30, 1941. Diagnosis confirmed by autopsy and animal inoculation. Details of case available in laboratory files.
Case 4 L. W., white, male, age 10 years, Jackson, Georgia (Butts County).
Bitten on bridge of nose slightly, December 10, by neighborhood dog which showed definite symptoms of rabies and was killed. No laboratory (fiagnosis. The intensive schedule of antirabic treatment was administered. Eighteen days after last exposure, patient developed typical symptoms of rabies .and died three days later, December 31, 1941. No autopsy obtained. Details available in laboratory files.

226

Georgia Department of Public Health

TABLE 36 DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES

Central

Albany

Waycross

Keidel Tubes ---------------------Sterile Corked Vials---------------Darl<fielcl Outfits -----------------Diphtheria Outfits ----------------Slicle Outfits ----------------------
Slicles ----------------------------I. P. Outfits, Routine ___________ ----
I. P. 'Tins, Survey-----------------Sputum Outfits -------------------Stool Culture Outfits----------------

253,276* 98,86'1 665 3,790 9,974 21,672 8,907 86,155 17,701 10,841

14,968 29,326
'10 373 2,0'18 2,304 3,100 7,226 2,337 2,178

2,,128 14,320
59 792 1,373 1,521 986 16,920 1,923 38'1

Needles 19 Gauge 22 Gauge 24 Gauge 26 Gauge

45 dozen 74'\i! dozen 93 clozen 124 dozen

Syringes

1 cc. 'ruberculin ________________ ------------------------------- ___________ _ 78

cc. Hypodermic ______ ---------------------------------------------------- 2'13

cc. Hypodermic

100

10 cc. Hypoclermic

555

*Includes 89,13,1 Keidel tubes suppliecl to local Selec~ive Service Boards ancl Army In<luction Centel's.

TABLE 37 DISTRIBUTION OF SPECIMEN OUTFITS TWO YEAR PERIOD 1940- 1941

1940

Keidel ~rubes -------------------Sterile Corked Vials ______________
Dal'l~:fleld Outfits ---------------Diphtheria Outfits --------------Slide Outfits -------------------Slides --------------------------I. P. Outfits, Routine _____________
I. P. ~rins, Survey---------------Sputum Outfits -----------------Stool Culture Outfits-------------

142,691 87,6,14 812 3,193 1!,502 37,632 7,829 69,33'1 17,'111 10,562

1941
253,276 98,86'1 665 3,790 9,974 21,672 8,907 8u,t55 17,701 10,841

Increase or Decrease
+ 1!0,585 + 11,224
H7
+ f)97 l,:i2S 1:i,960
+ 1,018 + 16,321 + 260 + 279

Laboratories

227

Media:

MEDIA AND VACCINE UNIT
TABLE 38

Beef Infusion Double________________________________________________________ _
Pork Infusion --------------------------------------------------------------Beef Infusion Broth ___________________________ _:_____________________________ _
Beef Extract Broth----------------------------------------------------------Selenite f'F'' __ -----------~ -------------------------------------------------Conradi's Bile . -------------------------------------------------------------l\!iscellaneous Broths -------------------------------------------------------Beef Infusion Agar----------------------------------------------------------Beef Extract Agar-----------------------------------------------------------Por1-i: Infusion Agar---------------------------------------------------------Endo's Stock .ll..gar___________________________________________________________ _
Wilson Blair Agar----------------------------------------------------------Desoxycholate Citrate Agar--------------------------------------------------Krumwiede's 'Triple Sugar .A.gar______________________________________________ _
lLlfoiesfcfellelra'nseoBulsooAdgaSresrm-n--_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_--_
P et.ra gnani's ~ ____ -----------------------------------------------------------Fryes ~Ieditllll -------------------------------------------~-----------------Sugar Ferrnentation Tubes---------------------~----------------------------- ::\Iiscellaneous ~Iedia ---------------------------------------------------------

190,000 cc. 56,000 cc. 66,<100 cc. <18,000 cc. 20,000 cc.
122,000 cc. 13,550 cc.
228,650 cc. 13,000 ec. 50,500 cc. H,OOO cc. 12<1,000 cc. <1<1,000 cc. 16,500 cc. <10,340 cc. 11,322 cc. 1<1,000 cc. 1,500 cc. 13,350 cc. 3,650 cc.

Tho following media were prepared in the Engineering Laboratory:
Lactose Broth -------------------------------------------------------------Endo Agar ----------------------------------------------------------------Nutrient .tl.gar --------------------------------------------------------------BI'illiant Green Lactose Bile Broth ____________________________________________

2,200 Liters 32 Liters 20 Liters 15 Liters

Solutions and Indicators: Indicators for I>Iedia_________________________________________________________ _
Dyes for llfedia-------------------------------------------------------------Reagents for :Media----------------------------------------------------------Bismuth Sulfite :Mixture_____________________________________________________ Glycerine Salt Solution _______________________________________________________
Salt Solution ::.\Iiscellaneous Solutions

500 cc. 600 cc. 7,550 cc. 21,000 cc. 7<1,000 cc. 710,500 cc. :J8,900 cc.

Silver Nitrate: Solution (1 %} made 19<ll ___________________________________________________ _
:\umber Ampules made 19<11--------------------------------------------------Xumber Ampules filled 19<11--------------------------------------------------

59,600 cc. 140,000 cc.
92,'100 cc.

Sterile Distilled Water: Water filled 1941_----------------------------------------------------------- 2,772,000 cc. Water distributed 19<11----------~-------------------------------------------- 2,832,000 cc.

Diluted Tuberculin (Old}: 'fuberculin, diluted 19<11------------- ______________________ ---------- ________ _
ruberculin, distl'ibuted 19<11 ---------------------------------------------------

22,182 cc. 21,589 cc.

Sterile Salt Solution: Salt Solution filled 1941 _____________ ----------------------------------------Salt Solution distributed 19<11-------------------------------------------- _____ _

2,000 cc. 2,999 cc.

Typhoid Vaccine: Lots of vaccine made-7 Vaccine diluted and filled 19<ll_______________________________________________ _
Yaccine released 1941____________________ ______ -------------------------------

600,000 cc. 627,000 cc.

228

Georgia Department of Public Health

PERSONNEL
There were 77 employees in the three laboratories (excluding personnel in the water la:boratory who are employed by another division). Fifty-nine were employed in the Centr.al Laboratory and the other 18 in the branch laboratories. Fifty-eight are white and nineteen colored.

CENTRAL LABORATORY
Medical Director ------------------------Assistant Director ----------------------Senior Bacteriologists -------------------Junior Bacteriologists -------------------Technicians, Bacteriological ______________ 14 Senior Serologist ________ ---------------- J Junior Serologist -----------------------Technicians, Serological -----------------Office Secretal'ieo -----------------------Stenographers _______ ----------- __ -----Statistical Clerk ------------------------Heport Cleri<S --------------------------- 3 Shipping Clerks ------------------------Store Uoom Foreman--------------------Mail Clerk -----------------------------Porters (Colored) ----------------------Animal Keeper (Colored)-----------------Dieners (Colored) ----------------------- 12
'foUtL ________ ------------------------ 59

ALBANY BRANCH
Director Junior Bacteriologist ----------------11echnicians ------------------------Stenographer ----------------- ______ _ Cieri.;: -------------------------- _____ Porter _____________________________ _
Maid -------------------------------

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

10

WAYCROSS BRANCH Director Technicians ------------------------Steno-clerh: ------------------------ __ Porter _____________________________ _ Maid _____________________________ _
Total -------------------~--- _____ _

Personnel Problems
What with better salaries being paid by newly established military laboratories, selective draft, increase in marriage, the laboratories have lost a number of technicians and clerical workers. There were ten resignations and twelve appointments. Fortunately, a class of eight trainees was available to supply most of the replacements.

Student Tmining
Six, carefully selected candidates, were appointed as student trainees, beginning July l. For the first time, arrangements were made for paying the student a stipend of $35 per month, which amount compensates her for limited service rendered during training.

Laboratories

229

During the past year, it became necessary to offer partly trained students positions on the regular staff due to the scarcity of qualified applicants from elsewhere. Three accepted staff positions on condition that the training status could he re-established at any convenient time agreed upon in each case.
One trainee was selected for each of the branch laboratories. These, after a few months general training, were transferred to the Central Laboratory for special rotation.

Seminars
Weekly seminars were instituted this year in the serology department. \Vhile chiefly intended to encourage the staff in parallel reading and practice in presentation of abstracts and reviews, outside speakers are imported from time to time. It is hoped that the plan can be extended to :include all departments of the laboratory.

Cooperation With Fourth Corps Area U.S. Army
Every effort has been made to aid the director of the Fourth Corps Area and his staff in physical organization and in manning a new laboratory system. 11wo of our best technicians, attr.acted by higher salaries and promotions left us to join the Fourth Corps Laboratory staff.
Profiting by our recent experience in planning and building, the director of the Fourth Corps Laboratory received from us numbers of architectural items and ideas of equipment and arrangement.

Selective Service
The Central Laboratory ex,amined 71,957 blood specimens for Selective Service Boards of the U. S. Army. These specimens were given preferential handling and many expressions of appreciation for expeditious service were received from numerous local board officials as well as from the several induction centers. Because of the special type of repmt form and a large amount of filing and correspondence, it was necessary to employ two additional steno-clerks for this purpose. A complete alphabetical file of all selective service blood tests is available.

RESEARCH AND INVESTIGATIONS
Hookworm Outfits With Preservative A study made to determine if the L1% phenol solution contained in
individual hookworm outfit interferes with the accuracy of the examination. It was found that, while the phenol slightly altered the appearance of helminth ov-a, it did not otherwise affect the accuracy of the findings.

230

Georgia Department of Public Health

Diphtheria Ozttfits Should Contain Media A study of 2,200 throat cultures completed in 1941 clearly indicates:
(1) That outfits distributed by the laboratory for making throat cultures for diphtheria should contain both swabs and media.
(2) That after inoculating the :media at the bedside, the throat swab should be returned along with the media to the laboratory.
(3) That the returned swab should be re-inoculated onto another tube of media on arrival at the laboratory.
(4) That the field culture is more apt to be positive than the labma tory culture, but that the use of both reduces the chances of error.

Bacteriophage Typing of E. typhosa
The discovery of Craigie and Yen of Connaught Laboratories, Toronto, Canada, that Eberthella typhosa strains may be rather sharply divided into ten or more groups in acc01dance with the specific reaction of each group with its homologous bacteriophage, excited our interest late in 19t10. The potential utility of this phenomenon so aroused our attention that in August, 1941, a senior bacteriologist of the staff (Miss Janie Morris) was sent to Dr. Craigie's laboratory for special training. Over three hundred strains of E. typhosa isolated from cases and carriers during the year have been phage-typed, and plotted on maps. The results are reported under "Culture Unit". If the claim of Craigie, that all cases of typhoid fever in any given outbreak are of like type and the same as the carrier str.ain, then it is quite possible that phage typing will serve as a most vahmble tool in tracing sources of infection.

Flttorescent Microscope
A study was made on the identification of lYL tuberculosis by means of a fluorescent microscope. Over a hundred (106) specimens, including sputa and other body exudates, were examined. While the series studied was small and does not warrant .any definite conclusion, the new method does not appear to be superior to the old standard Ziehl-Neelson, and at present is not feasible for a laboratory carrying a large and varied volume of microscopic work.

Atypical Strains of M. Tuberculosis
In the cultural diagnosis of tuberculosis several strains of acid-fast organisms have been isolated, which morphologically resemble M. tuberculosis, but which appear to be non-pathogenic to guinea pigs. These cultures are being studied and investigated in cooperation with Dr. Byron
J. Olson, National Institute of Health, to determine peculiarities of viru-
lence.

Laboratories

231

Laboratory Reporting by Tabulating Machinery Beginning January l, l9Ltl, the experiment of transcribing routine
serology reports by means of the newly installed International Business Tabulating machine was begun. After one year's trial the plan was abandoned as impracticable for the foil owing reasons:
(l) The extra clinical labor and machine time required for this project in the Central Tabulating Unit mol'e than counter balanced the clerical time and labor apparently saved in the Laboratory Report Office.
(2) The statistical data available from serologic specimen forms is inaccurate and incomplete, hence not worth machine utility.
(3) The multiple test report o the I. B. lVL was not popular among the physicians and health officers.
(<:1) The laboratory can render more reliable service with its clerical force than in conjunction with other agencies.
Therefore, at the beginning o the year 194.2, the reporting of serological tests at the Central Laboratory will be done by manual transcription of individual Teports, and the original filing system by physicians and counties will be resumerl.

Division of Information and Statistics

David lVI. Wolfe, M.D., C.P.H. Frank M. Woodruff James lVI. Sitton

Director Field Agent Central Tab. Unit

The Division of Information and Statistics has f.or its purpose the filing of records for each birth and death occurring in the state, the filing of a delayed birth certificate for all persons born in Georgia who were not registered at the time of birth, the issuing of certified copies of these certificates upon request and payment of the statutory fee, the recording of each case of reportable communicable disease occurring in the state, the recording of each treatment given in the Venereal Disease clinics operating under the Central Tabulating Unit System, the preparation of monthly mortality reports, the weekly and monthly morbidity reports, the monthly venereal ,disease reports, and reports of fifteen day lapses in venereal disease clinics, the preparation of daily serological reports to physicians, and is cooperating with the Accounting Di'Vision in preparing ce1tain of the routine .accounting 1Jrocedures on the Central Tabulating Unit.

The Division of Information and Statistics is composed of two parts, the Vital Statistics Section and the Central Tabulating Unit.

At the close of 19tl.l the personnel of the Division of Information and Statistics was composed of the director, field agent, secretary, steno-clerk, two transcribers, eight certified copy clerks, three routine cle1;ks, one photostat opel'ator, one Central Ta,bulating Unit Supervisor, chief machine operator, uwo machine operators, five key punch operators, four code and check clerks.

The year 19L1l brought radical changes in the Vital Statistics Section as a result of the new procedtne for filing delayed birth certificates. At a meeting in Washington in March, 19M, the federal agencies, through the Bureau of the Census, submitted a delayed certificate form to be used in recording births not recorded at the time of birth, for proving citizenship for enlisting in armed forces and for working in various phases of the defense program. Unless delayed birth records meet the standards as set forth, they are not acceptable for the purposes for which they are to be used.

The State Board of Health adopted this New Standard Delayed Birth Certificate Form with instruction for filing at the April 17th, 1941, meeting. This new certificate made it much more difficult for one to file his or her certificate and greatly increased the time required in our office -for filing such records.

During 19L1l the demand for delayed birth certificates swamped our office. After the Pearl Harbor attack and the lowering of educational requirements for entering the Air 'Corps, our office was deluged with requests for certified copies of birth certificates. It was necessary for

Information and Statistics

233

additional personnel to be added in order to try to keep up with the work. The war program offering better salaries caused a considerable turnover in personnel, all of which greatly reduced our capacity to meet the demands made upon our office.
During 194.1 the division issued 19,64.3 certified cupies as compared with 10,522 for 1940, or, an increase of 53.6 per cent. Of the l9,M3 certified copies issued 19,106 were for births and 537 deaths.
In addition to this, hundreds of requests were received and answered, verifying ages for the Navy, Army, Labor and Welfare Departments.
There were LJ03 requests for special tabulations received and complied with during 19M as compared with 283 such requests in 1940 or an increase of 70.2 per cent.
The current birth and death certificates for 194.1 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 International 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.
During 1941 there were 67,785 birth and 31,579 death certificates placed on file. These certificates are handled in the routine manner.
The change in the procedure for recording delayed birth certificates made it necessary that the applicant for such a record present supporting data as to parents names, the date and place of his or her birth. This information must be reviewed and abstracted on the birth certificate by the clerks in our office, then the record must be signed, numbered, dated, the certified copy prepared and mailed. This procedure plus the mailing of blanks and the instructions to persons calling at the office consumes considerable clerk time. It is estimated that one-half hour per certified copy is a low estimate on the time necessary to prepare a delayed certificate and issue a certified copy.
The division received 86,396 pieces of letter mail during 1941.
At the close of 194.1 there were 202 venereal disease clinics reporting to the Central Tabulating Unit as compared with 101 for the same period in 194.0. The 1941 case load was 26,384. patients. In addition to venereal disease reporting on the tabulating machinery, the laboratory reporting, communicable disease reporting, vital statistics records and some of the routine accounting procedures are being handled on the Central Tabulating Unit.

234.

Georgia Department of Public Health

STATISTICS
BIRTH RATE. There was an increase of t1.1 per cent in the birth rate for Georgia in 19M. The number of births reported was 67,785 as compared with 64.,695 in 1940. The rate was 21.6 for 19M and 20.7 for 19t10. This increase is probably due to increased registration and to the fact that there have been a large number of young persons transferred to Georgia as a result of the war.
STILLBIRTHS. There was a decrease of 10.0 per cent in the stillbirth rate during 194.1 when the rate declined from tlo7.6 in 19t10 to 42.8 in 1941. The number of stillbirths decreased from 3,078 to 2,903 in 194.1.
INFANT MoRTALITY. There was a slight increase in the infant mortality rate from 57.8 to 58.3 in 19tlol. This is explained by the decrease in the stillbirth rate in that many of the children formerly born dead are now being born .alive but die shortly after birth.
MATERNAL MoRTALITY. The maternal mortality rate dropped to a new all time low when the rate was 4..6 for 19M as compared with 5.3 for 1940, or a decrease of 12.1 per cent in the rate. The number of maternal deaths for 19M was 315 compared with 342 in 1940.
TYPHOID FEVER. There w.as a decrease of 19.7 per cent in the death rate from typhoid fever when the rate decreased from 2.2 in 19tW to 1.8. The number of deaths from this condition dropped from 68 in 1940 to 55 in 19M. The 19t10 rate was the lowest ever previously recorded in Georgia.
TYPHUS FEVER. There was an increase in the typhus death rate from 0.8 in 1940 to 1.1 in 19M. The number of deaths increased from 26 in 1940 to 36 in 1941.
MALARIA. The death rate from malaria reached a new all time low in 1941 when the rate declined from 2.8 in 194.0 to 2.4. in 1941. The number of deaths dropped from 89 in 19tW to 75 in 1939.
SMALLPOX. There were no deaths from smallpox recorded in Georgia during 19tH.
CI-IILDHOOD DISEASES. Of the childhood diseases whooping cough and measles were on the increase in 1941. The whooping cough death rate increased from 3.5 in 1940 to 4..5 in 1941. The number of deaths increased from 108 in 19t10 to 140 in 19t11. The death rate from measles increased from 0.7 to 5.0 in 194.1, the number of deaths from 23 to 157 in 1941. The death rate from scarlet fever decreased from 0.5 to 0.3 in 19tlol, the number of deaths from 16 to 9 in 194.1.
DIPHTHERIA. There was an increase in the diphtheria death rate from 1.9 in 1940 to to 2.0 in 19tH or an increase in the rate of 5.8 per cent. The knowledge of the value of diphtheria toxoid still has not reached all of the parents of new babies born in Georgia.
INFLUENZA. There was an increase in the influenza death rate from

information and Statistics

235

29.6 to 31.6 in 19<11. The number of deaths increased from 92<1 to 994. in 1941.
DYsENTERY. The number of deaths from this condition decreased from 126 to 109. The rate dropped from 4.0 to 3.5 or 13.9 per cent.
PoLIOMYELITIS. There was a marked increase in the number of deaths from poliomyelitis during 194.1 as Georgia had the greatest number of cases of this disease ever recorded in the state. The deaths increased from 7 in 1940 to 33 in 1941. The rate increased from 0.2 to 1.1 or 377.3 per cent.
MENINGOCOCCUS MENINGITIS. There was an increase in the number of deaths from 9 in 19LJ0 to 17 in 1941. The rate increased from 0.3 to 0.5.
TUBERCULOSIS. There w.as a marked decrease in the number of deaths from tuberculosis in 19<1<1, 1,385 as compared with 1,533 in 1940. The rate decreased from <19.1 to L1<1.0 or 10.3 per cent.
SYPHILIS. There was a decrease in the number of reported deaths from syphilis in 1941, 503 as compared with 587 in 1940. The rate dropped from 18.8 to 16.0 in 194.0. I am of the opinion that many of the deaths recorded as apoplexy, heart disease and nephritis are due to this condition and are masked under the above causes. This is due in a large part to the fact that the cause of death is shown on certified copies issued and the true condition would be somewhat embarrassing to families and would hold up payment of insurance claims in others.
CANCER. There was an increase in the cancer death rate from 62.7 in 19L10 to 68.0 in 1941. The number increased from 1,959 to 2,139 in 19<11.
DIABETES MELLITUS. There was an increase of 7.0 per cent in the death rate from this condition from 11.2 to 12.0, the number from 3L19 to 376.
PELLAGRA. The number of deaths from pellagra decreased from 235 to 204 in 1941. The rate decreased from 7.5 to 6.5 or 13.7 per cent.
'CEREBRAL HEMORRHAGE, EMBOLISM AND THROMBOSIS. The deaths from these conditions were practically the same when 3,035 occurred in 19L10 and 3,033 in 1941. The death rate was 96.<1 as compared with 97.2 in 19<10.
HEART DISEASE. The leader in the causes of death in Georgia, as well "'" the nation took 5,780 lives in 194.1 as compared with 6,176 in 194.0. The death rate was 183.8 as compared with 197.7 in 1940.
PNEUMONIA. There were 1,714 deaths from these conditions in 19Ltl as compared with 2,055 in 19<W. The rate dropped from 65.8 to 54-.5 in 1941 or 17.2 per cent.
DIARRHEA AND ENTERITIS-2 YEARS. There was .an increase in the number of deaths from these conditions from 395 to 4,35 in 1941. The rate increased from 12.6 to 13.8.
APPENDICITIS. The number oi appendicitis deaths decreased from 276
to 230. The rate dropped from 8.8 to 7.3 in 19<11 or 17.3 per cent.

236

Georgia Department of Public Health

MoTOR VEHICLE AcciDENTS. There was an increase from 802 to 946 in the number of deaths from motor vehicle accidents. The rate increased from 25.7 to 30.1 or 17.2 per cent.
The crude death rate, or deaths from all causes, decreased 2.9 per cent when the rate dropped from 1,033.5 to 1,004..0 as 31,579 persons died m Georgia in l9L.H as compared with 32,285 in 19L.10.

TABLE I 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 AND THE PER
CENT INCREASE OR DECREASE IN THE RATES, IN GEORGIA: 1940 AND 1941

Cause of Death

Number

1941

1940

Rate

1941

1940

Per Cent Increase or Decrease

ALL CAUSES Typhoid fever ----------------------
Typhus fevel' ----------------------~lalaria. ---------------------------Smallpox ______ ---------------------
l\IIeasles ---------------------------Scarlet fevel' -------------------- __ Whooping cough --------------------
Diphtheria ---------- --------------Influenz>L --------------------- -----Dysentel'Y -------------------------Poliomyelitis ----------------------Lethargic encephalitis ______________
1\feningococcus meningitis ----------'J'uberculosis (all forms)-------------
Syphilis --------------------------Cancer ---------------------------Diabetes mellitus -------------------
Pellagra --------------------------Cerebral hemorrhage, embolism and
thrombosis --------------------Heart diseases ---------------------Pneumonia ----------------------- __ Diarrhea and enteritis (under 2 years)
Cirrhosis of livel'-------------------Appendicitis -----------------------Nephritis - ------------------------:J.Ialformation & early infancy diseases
Suicide ---------------------------Homicide ------------------- ------Motor vehicle accidents______________ _ All other accidents _________________ _
Unl\nown and ill-defined cau~es ____ .

31,579 55 36 75
157
1<10 63
99<1 109
33
17 1,385
503 2,139
376 204
3,033 5,780 1,7H
<135 15<1 230 3,381 2,163 236 649 946 1,262 1,026

32,285 68 26 89
23 16 108 59 92<1 126
7 <1
1,533 587
1,959 3<19 235
3,035 6,116 2,055
395 l<l5 276 3,348 2,03<1 282 616 802 1,255 1,051

100<1.0 1.8 1.1 2A
5.0 0.3 <1.5 2.0 31.6 3.5 1.1 0.2 0.5 4<1.0 16.0 68.0 12.0 6.5
96.4 183.8
5tl.;) 13.8
<1.9 7.3 107.5 68.8 7.5 20.6 30.1 <10.1 32.6

1033.5 2.2 0.8 2.8
0.7 0.5 3.5 1.9 29.6 <1.0 0.2 0.1 0.3 <19.1 18.8 62.7 11.2 7.5
97.2 197.7
65.8 12.6
<1.6 8.8 107.2 65.1 9.0 19.7 25.7 40.2 33.6

- 2.9 - 19.1
+ 37.3
- 16.2
+57<1.3 - 43.1
+ 28.6 + 5.8 + 6.8
- 13.9 +377.3 + 23.1
+ 86.2
- 10.3 - 1<1.9
+ 8.5 + 7.0
- 13.7
- 0.8 - 7.1 - 17.2
+ 9.'1 + 5.6
- 17.3
+ 0.3 + 5.6
- !6.U
+ 4.6 + 17.2
0.1 3.0

All other causes---- ______________ _ Live bil'ths --- __________ ---------Stillbirths ___ ____ _____________ _
Infant Mortality -------------------Maternal mortality ------------------

<1,270 67,785 2;903
3,955 315

<1,693 64,695 3,078
3,737 342

135.8 21.6 <12.8 58.3 4.6

150.2 20.1 <17.6 57.8 5.3

9.6 + <1.1 - 10.0
+ 1.0
- 12.1

NOTE: Figures exclude non-iesidents of Georgia and include births and deaths of Georgia residents occurring in other states.

lnfonnation and Statistics

237

TABLE 2 DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS AND STILLBIRTHS WITH
RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 19201941

Year

Infant Mortality

Number Maternal Mortality

Stillbirths

Infant Mortality

Rate Maternal Mortality

Stillbirths

1920 1921 1922 1023 102<1 1025 1926 1927 1928 1029 1930 1931 1932 1933 1034 1935 1036 1037 1938 1939 19<10 19<11

5,305

558

3,389

88.3

0.3

56.4

4,905

568

3,820

73.9

8.6

57.5

4,937

658

3,862

75.0

10.1

59.3

5,38<1

573

3,958

8<1.5

9.0

62.2

5,67<1

708

3,864

80.5

11.2

61.0

<1,704

6<11

3,<155

78.0

10.8

58.0

<1,<105

<185

2,972

87.2

9.6

58.9

<1,578

578

3,836

73.5

9.3

61.6

<1,875

622

3;178

30.9

10.3

57.7

<1,464

5<10

3,5<11

76.3

OA

60.5

<1,713

658

3,796

73.1

10.9

62.9

4,23<1

616

3,678

68.5

10.0

59.5

4,097

620

3,847

6<1.3

9.7

60.'1

4,079

463

3,700

67.2

7.6

60.9

5,086

505

4,120

78.7

7.8

63.8

<1,316

<158

3,987

63.2

7.2

63.0

4,319

491

3,666

70.1

8.0

59.5

3,968

471

3,671

62.0

7.4

57 A

4,352

421

3,390

67.7

6.5

52.7

3,817

356

3,228

58.8

5.5

<19. 7

3,737

342

3,078

57.8

5.3

47.6

3,955

315

2,903

53.3

'1.6

<12.8

TABLE 3 BIRTHS AND DEATHS (EXCLUSIVE OF STILLBIRTHS) WITH RATES PER 1,000
POPULATION AND BIRTHS PER 100 DEATHS, IN GEORGIA: 19201941

Year

Births

1020 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 193<1 1935 1936 1937 1933 1939 19<10 19<11

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

60,061 66,378 65,082 63,681 63,386 59,610 50,<193 62,246 60,259 58,521 60,318 61,774 63,690 60,7'!4 64,615 63,290 61,617 64,012 64,307 6<1,910 64,695 67,785

Number Deaths
32,243 29,552 31,714 3<1,082 3<1, 797 31,273 29,906 31,869 36,085 35,340 35,188 32,989 32,122 31,18<1 35,590 3<1,313 37,293 3<1,'111 33,617 31,856 32,285 31,579

Births
20.7 22.9 22.5 22.0 21.8 20.5 17A 21.4 20.7 20.1 20.7 21.0 21.5 2DA 21.5 20.0 20.2 20.8 20.7 20.8 20.7 21.6

Rate

Deaths
11.1 10.2 10.9 11.8 12.0 10.8 10.3 11.0 12.'! 12.2 12.1 11.2 10.8 10.5 11.8 11.3 12.2 11.2 10.8 10.2 10.3 10.0

Births Per I 00 Deaths
186 225 205 187 182 191 169 195 167 166 171 137 198 195 182 18<1 165 186 191 20<1 200 215

238

Georgia Department of Public Health

TABLE 4

DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS, ILLEGITIMATE
BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND STILLBIRTHS WITH
RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1941

Year
1920 1921 1922 1923 1921 1925 1926 1927 1928 1929 1930 1931 1932 1933 193<1 1935 1936 1937 1938 1939 1910 19<11

INFANT MORTALITY

NUMBER

RATE

Total White Col. Total White Col.

5305 1905 <1937 5381 5674 1704 1405 <1578 <1875 <J<l61 <1713 <1234 <1097 4079 30H6 4316 1319 3968 <1352 3817 3737 3955

2961 2606 2509 2938 2939 2486 2299 233<1 257'1 2313 2168 2137 2122 2119 2628 2227 21l<l 20l<l 2267 1960 1851 1988

23H 2299 2128 2J<l6 2635 2218 2106 22<14 2301 2121 2245 2097 1975 1960 2158 2089 2205 1951 2085 1857 1886 1967

88.3 73.9 75.9 81.5 89.5 78.9 87.2 73.5 R0.9 76.3 73.1 68.ii 61.3 67.2 78.7 68.2 70.1 62.0 67.7 58.8 57.3 58.3

71.1 58 . .'5 59.1 :)3.4 72.2 65.0 71.3 59A 67.5 65.5 66.6 :36.9 55.5 59A 68.6 59,6 58.2 52.7 58.7 50.'1 47.6 <18.2

127.1 105.3 107.4 108.3 122.0 103.9 115.3
97.7 101.0
93.1 96.5 86.5 77.5 78.2 93.5 80.5 87.2 75.6 81.1 71.5 73.1 7'!.2

MATERNAL MORTALITY

NUMBER

RATE

Total White Col. Total White Col.

558 267 291 9.3 6A 15.8 568 266 302 8.6 6.0 13.8 658 316 342 10.1 7.'1 15.1 573 288 285 9.0 7.0 12.6 708 362 316 11.2 8.7 15.7 6<11 299 3<12 10.3 7.8 16.0 185 222 263 9.6 6.9 HA ri78 291 287 9.3 TA 12.5 622 312 310 10.3 8.2 1<1.0 519 281 265 9A 7.U 11.6 658 361 297 10.9 9.7 12.8
616 322 291 10.0 s.B e.1
620 310 310 9.7 8.1 12.2 463 227 236 7.6 6A 9.'1 505 262 2<13 7.8 6.8 9 ) 458 230 223 7? 6.2 3.3 491 251 2<10 3.0 6.9 9.5 471 210 231 7A 6.3 8.9 121 198 223 6.5 <3.1 8.7 356 175 181 5.5 1.5 7.0 3<12 l<l6 196 5.3 3.8 7.6 315 133 182 1.6 3.2 6.9

Year
1920 1921 1922 1923 192<1 1925 1926 1927 1928 1929 1930 1931 1932 1933 193<1 1935 1936 1937
J~:~R
l 030 1940 19<11

ILLEGITIMATE BIRTHS

NUMBER

RATE

Total White Col. Total White Col.

2695 3077 3606 <10<15 1039 <101<1 315fi 4089 3868 1061 11<11 4129 5125 5101 5089 5031 4878 <1739
47~<!
'1960 50<16 513<1

174 2221 11.9 11A 120.'1 516 2561 <16.'1 11.6 117.'1 500 3106 55 A 11.8 137A 513 3502 63.5 13.2 155.0 57'1 3515 6<1.3 13.9 159.7 531 3180 67.3 H.O 163.0 461 269<1 62.5 1<1.3 1<17.5 637 3<152 65.7 16.2 150.3 182 3386 61.2 12.6 153.0 515 3516 69A HA 15:3.7 fi12 3629 68.7 13.8 156.1 5<17 3882 71.7 H.6 160.1
r,oo <15-25 80.3 l:i.7 177.6
582 <1519 8<!.0 16.3 180A 651 4438 78.8 17.0 168.9 643 1388 79.5 11.2 169.1 598 <1280 79.2 16.5 169.2 526 <1213 7<1.0 13.8 163.1 580 <11<14 73.5 15.0 161.3 596 <13h<! 71).-1 1:5.3 167.9 565 1481 78.2 1<1.5 173.8 607 4527 75.7 14.7 170.8

STILLBIRTHS

NUMBER

RATE

Total White Col. Total White Col.

3339 3820 3862 3958 3864
3Mi~
2972 383 3178 3541 3796 3678 38<17 3700 <1120 3987 3666 3677 3390 3228 3078 2903

1608 1720 1716 1802 1675 J<l35 1211l 11l01 1335 1374 1<154 1<12<1 1492 1382 1673 1532 1<157 1<199 1386 1337 1326 1276

1781 2100 21<16 2156 2189 2020 1726 2232 21<13 2167 23,12 225<1 2355 2318 2<1<17 2155 2209 2178 2004 1891 1752 1627

56.'1 57.5 59.3 62.2 61.0 58.0 58.9 61.6 :>7.7
60.5 62.9 59.5 BOA 60.9 63.8 63.0 59.5 57 A 52.7 <19.7 17.6 42.8

38.6 38.6 lOA 43.0 <10.5 37.:i 38.7 10.8 3i}.IJ
33..1 39.2 37.9 39.0 38.7 <13.6 <Jl.O 40.1 39.3 35.9 31.3 31.1 30.9

96.6 96.2 9<1. 0 D5A 99.3 U4.6 9'1.5 97.2 9il.6
95.2 100.7
93.0 92A 92.5 93.1 91.6 87.3 8<1.3 78.0 72.8 67.9 61.'1

information and Statistics

239

DEATHS AND BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND RATES PER 1,000 PoPULATION, IN GEORGIA: 1920-1941

Year
1920 1921 1n2 Hl23 1924 l!l:!;) 1926 1927 1928 l!l2D 1930 1931 1!132 1938 1e31 103;; 1!!36 1937 1938 1989 1!l<JO 1941

BIRTHS

NUMBER

RATE

Total White Col. Total White Col.

600(ll 66378 (;)082 ti3681 63386 59610 ii019:1 62246 60259 ii8521 HOB18 61774 636!10 607!.1 61615 63290 (<1617 640J 2 64307 6'ln10 64605 67785

<11613 <J<J5.')ii 4217'i
<1108~
'11379 382ii4 :12226 39281 38135 337ii1 37064 37531
3820~
35692 38333 37345 36320 381S1 38613 38923 3S911 <ll277

18<143 21823 22607 22o93 22007 21356 18267 22965 2212<1 22770 23254 212,13 2.i481
250~2
26282 25915 25297 2:>831 25691 25987 25784 26508

20.7 22.9 22.5 22.0 21.3 20.ii 17.'1 21.'1 20.7 20.1 20.7 21.0 21.5 20.4 21.5 20.9 20.2 20.8 20.7 20.8 20.7 21.6

21.5 26.0 24.6 23.6 2:1.6 21.6 18.1 2l.!l 21.0 19.6 20.1 20.'1 20.'1 18.8 20.1 19.'1 18.7 19.'1 19.5 1!l.:i 19.1 20.1

15.'1 18.'1 19.3 19.;, 19.2 18.8 16.3 20.7 20.2 21.1 21.7 22.:> 23.5 2:1.0 24.0 23.6
2~.9
23.2 23.0 2:1.1 2:LS 24.<1

Year
1~20
1921 1922 1923 1921 1925 1926 1927 1928 1929 1930 1931
1~32
lfJ:l:> 1934 1933 l!l36 1937
1~38
1P39 19<10 1 !lll

TYPHOID

NUMBER

RATE

Total White Col. Total White Col.

549 27<1 275 19.0 16.2 22.!)

798 351 4<17 27.:i 20.5 37.7

714 326 388 21.6 18.9 33.1

601 2<14 357 20.7 l<l.O 30.8

681 292 389 23.5 16.7 33.9

675 261 <Jl1 23.3 14.9 36.2

519 191 328 17.9 10.7 29.3

653 285 368 22.5 15.9 33.2

441 182 262 15.3 10.0 23.9

340 140 200 11.7 7.7 18.5

500 207 293 17.2 11.2 27.3

:i1:l 201 312 17.5 10.8 28.9

:>6:1 133 230 12.3 7.1 21.2

2:51 10!1 1'16 8.'1 5.5 13.<1

316 110 206 10.5 5.8 18.8

j()l 100 161 8.6 :..2 14.G

1!):)

!>B

127

GA

3.;> 11.:-)

139

G4

Sj 4.5 2.7 7.li

121

;)1

70 3.9 2.6 ll.2

S:l

:;s

lj;)

2.7

1.9

1.0

liS

'll 2.2 1.3 3.8

22

:13 1.7 1.1 3.0

DEATHS

NUMBER

RATE

Total White Col. Total White Col.

32213 295;;2 31714 31082 34797 31278 29906 31869 36085 35340 33188 32989 32122 31184 :33590 31313 37293 :Hl11 33617 318ii6 3228i"i 3Hi79

17212 15439 16510 17763 17750 15860 15l<l1 16230 18642 1824i"i 18036 17012 16813 16817 19157 18677 201i"i6 18193 18109 17486 17313 16717

15031 H113 1517<1 16319 17017 15118 1<!765 15639 17<143 17093 17152 1:i977 1ii309 14337 16438 15636 17137 15918 15508 11370 l<l972 l<l862

11.1 10.2 10.9 11.8 12.0 10.8 10.3 11.0 12.<1 12.2 12.1 11.2 10.8 10.5 11.8 11.3 12.2 11.2 10.8 10.2 10.:1 10.0

10.1 9.0 9.6
10.2 10.1
9.0 S.:i 9.0 10.3 10.0 9.8 9.2 9.0 8.9 10.0 9.7 10.<1 9.<1 9.1 8.7 8.:> 8.1

12.:> 11.9 12.9 1<1.1 1Ul 13.6 13.2 1<1.1 1:>.9 1:>.8 16.0 l<l.S 1<1.1 18.2 15.0 14.2 15.:> 14.3 13.9 12.8 13.3 13.7

TYPHUS FEVER

NUMBER

RATE

Total White Col. Total White Col.

0.1 0.1 0.1

0.1 0.1

0.1 0.1

3

0.1 0.2

1

0.03 0.1

10

s

0.3 O.i"i 0.2

2

0.2 0.1 0.'1

1 0.03

0.1

s

1 0.3 0.'1 0.1

5

2 0.2 0.3 0.2

'1

0.3 0.2 0.4

26

1.0 1.'1 0.3

21

0.9 1.1 0.6

23

0.9 1.2 0.5

3ri

1.'1 u

0.8

13

11 1.8 2.2 1.0

33

1<l 1.5 1.7 1.3

39

1.'1 2.0 O.'l

18

0.8 0.9 0.7

27

1.1 1.3 0.8

Georgia Department of Public Health

DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEoRGIA: 1920-19<11

Year
1920 1921 1922 1923 1921 1925 1926 1927 1928 1929 1930 1931 1932 1933 193<1 1935 1936 1937 1938 1939 1940 19<11
Year
1920 1921 1922 1923 1921 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1910 19<11

MALARIA

NUMBER

RATE

Total White Col. Total White Col.

550 242 317 19.3 1<1.3 26.'1

168 195 273 16.2 11.<1 23.0

581 256 328 20.2 1<1.8 27.9

489 201 288 16.9 11.6 21.8

1<10 181 259 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 1<1.0 30.1

677 322 355 23.3 17.6 32.8

<142 186 256 15.2 10.1 23.9

307 119 188 10.5 6.5 17.'1

316 136 180 10.7 7.2 16.6

364 193 171 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.;, 25.7

235 113 122 7.6 5.8 11.0

1<16

63

83 1.7 3.2 7.'1

101

10

61 3.2 2.0 5.'1

89

35

54 2.8 1. 7 5.0

75

29

46 2.'1 1.'1 <1.2

SCARLET FEVER

NUMBER

RATE

Total White Col. Total White Col.

32

31

28

25

2<1

20

20

17

20

16

11

8

13

12

25

20

36

29

40

33

38

33

46

38

19

17

19

19

17

16

23

21

l<l

11

11

10

l3

11

19

16

16

15

9

8

1.1 1.8 0.1 1.0 1.5 0.3 l 0.8 1 9 0.3 0.7 1.0 0.3 0.7 0.9 OA 0.'1 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 2 0.6 0.9 0.2 0.6 1.0 0.6 0.8 0.1 2 0.8 1.1 0.2 0.5 0.6 0.3
OA 0.5 0.1
2 0.4 0.6 0.2 3 o.6 0.8 0.3
o.5 0.7 0.1
0.3 0.<1 0.1

MEASLES

NUMBER

RATE

Total White Col. Total White Col.

61

H

20 2.1 2.<1 1.7

93

66

27 3.2 3.9 2.3

5

3 0.2 0.1 0.3

317 252

95 12.0 1<1.5 8.2

550 359 191 19.0 20.5 16.7

11

1

0.'1 0.2 0.6

58

13

15 2.0 2.'1 1.3

105

79

26 3.6 1.'1 2.'1

1<13 106

37 4.9 5.9 3.'1

31

26

1.1 1.'1 0.5

128

94

31 1.4 5.1 3.2

62

37

25 2.1 2.0 2.3

15

6

0.5 0.3 0.8

72

50

22 2A 2.6 2.0

5t!O <101 139 18.0 21.0 12.7

25

15

10 0.8 0.8 0.9

8

5

0.3 0.3 0.3

10

2 0.3 0.'1 0.2

157 113

:n

2t!

~9 5.1 6.0 3.5 27 1.6 1.2 2.'1

23

1<1

9 0.7 0.7 0.8

157

94

63 5.0 4.6 5.8

WHOOPING COUGH

NUMBER

RATE

Tctal White Col. Total White Col.

373 210 133 12.9 1<1.2 11.1

183

93

90 6.3 5.<1 7.6

130

51

79 1.5 3.0 6.7

251 116 138 8.8 6.7 11.9

435 203 232 15.0 11.6 20.2

313 167 1<16 10.8 9.4 12.9

1<11

7<1

67 1.9 1.2 6.0

229 118 Ill 7.9 6.6 10.0

163

99

61 5.6 5.5 5. 9

280 171 109 9. 6 9A 10.1

257 121 136 8.8 6.6 12.7

113

59

51 3.8 3.2 5.0

112

52

60 3.8 2.8 5.5

223 116 107 7.5 6.1 9.8

33'1 lti9 165 11.1 3.8 15.1

1<19

77

72 1.9 1.0 6.5

67

30

37 2.2 1.5 3.3

1<12

75

67 4.6 3.8 6.0

225 112 113 7.3 5.7 10.1

134

61

73 1.3 3.1 6.5

108

52

56 3.5 2.6 5.2

110

69

71 1.5 3.'1 6.5

Information and Statistics

241

DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEoRGIA: 1920-1941

Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929
:o:~o
1o:n 1932 1933 )93'1 1935 1931j 1937 1938 1939 19-10 19,11
Year
1920 1921 1922 10:23 1921
19~;)
1926 1927
l!):!~
1929 HJ:::J 1931 Hl:12 1933 193'1 1935 19:lu 1937 1938 1939 lP40 19.Jl

DIPHTHERIA

NUMBER

RATE

Total White Col. Total White Col.

101

118 13.8 16.7 9.8

11;)

121 H.3 17.2 10.2

Ill 277 134 H.2 16.1 11.'1

274 199

73 9.5 llA 6.5

230 167

63 7.9 9.3 5.5

185 119

66 6.'1 o.7 5.8

251 199

52 8.6 11.2 1.6

272 lSi

85 9.'1 lOA 1.1

210 177

63 8.3 9.8 5.8

183 139

H 6.3 7.6 'l.l

13:\ 102

:13 1.6 5.5 3.1

15S 122

:J6 5.'1 6.6 3.3

lBO 139

30 5.7 7.'1 2.8

187 I:i2

35 6.3 8.0 3.2

lSR 152

36 6.3 8.0 3.3

161 116

15 5.3 6.0 4.1

123

33

40 '1.0 '1.3 3.6

108

66

,12 3.5 3.4 3.8

106

H

32 3.'1 3.7 2.9

95

65

30 3.0 3.3 2.7

59

H

15 1.9 2.2 1.'1

63

36

27 2.0 1.7 2.5

DYSENTERY

NUMBER

RATE

Total White Col. Total White Col.

170 116

5'1 5.9 6.3 <!.5

H6

88

58 5.0 5.1 '1.9

112

il9

43 3.9 1.0 3.7

1G1

90

61 5 ) :J.2 5.3

187 10,1

83 6.5 5.9 7.2

19'1 119

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

:J01 189 115 10.5 10.'1 10.5

20'1

99 10'i 7.0 5.4 9.7

:JO:i 133 1'17 10.5 8.6 13.7

177

86

91 6.0 '1.6 8.'1

1.Jl

!Hl ,l.S 4.:i 5.2

153

86

67 5.1 <1.5 6.1

21H 123

96 7.3 6.'1 8.8

163

86

11 5.'1 4.5 7.0

156

78

78 5.1 '1.0 7.0

130

67

63

<1.2

;;A

ti.7

192 107

83 6.2

7.6

127

65

62 1.1 3.3 5.5

126

61

59 4.0 3.3 5.'1

109

;)2

:i7 3.5 2.5 5.2

INFLUENZA

NUMBER

RATE

Tctal White Col. Total White Col.

2581
27~
1014 l:iOO 886 1381 H93
971 20<11 25,13
96'1 1301 1170 1237 1009 13fi"/ 1842 H36
302 050 924 991

1516 159 615 880 512 173 800 ,180
120'1 1<150
532 703 691 694 563 781 1058 73il 303 195 503 483

1065 119 399 620 374 611 693 '191 837
1093 ,132 598 ,176 !i43 4,16 576 78'1 697 '109 155 421 511

89.1 9.6
35.0 51.7 30.5 47.7 51.'1 33.'1 70.2 87.5 33.1 44.3 39.5 '11.5 33.6 14.R 60.3 '16.7 25.9 30.'1 29.6 31.6

89.4 9.3
33.7 o0.6 29.2 '13.7 <14.9 26.7 fi6.5 79.'1 28.9 37.8 37.0 36.6 29.:\ 40.5 5'1.4 37.6 19.8 24.8 2'1.7 23.5

88.7 10.0 31.0 53.'1 32.6 53.9 61.8 4'1.3 76.5 101.1 40.3 ;;5A 13.9 4H.S 40.7 :>:!.3 70.8 62.6 36.6 40.5 38.8 ,17 .0

TUBERCULOSIS (ALL FORMS)

NUMBER

RATE

Trtal White Col. Total White Col.

2362 2331 2683 2642 2620 2143 2278 2307 2375 2190 2175 2165 1933 1777 1772 1131 1713 15,19 1612 15S3 1533 1383

882 892 991 965 91i 872 307 798 832 742 7H 700 665 675 605 649 618 559 602 513. 54,1 fiOl

H80 1639 1692 1617 1703 1576 14 71 1509 1543 H'l8 H01 H65 1268 1102 1167 1082 1063
990 1010
990 989 88<!

81.6 87.4 92.6 91.1 90.3 8<1.<1 78.5 79.'! 81.7 75.3 74.6 73.7 65.3 59.6 58.9 57.1 56.1 30.3 32.0 49.1 '19.1 4<1.0

52.0 :i2.1 57 A 5;-i.!)
52.3 '19.3 '15.3 '14.'1 ,15.9 '10.6 '12.0 37.7 35.'1 35.6 31.7 33.6 33.3 28.'i 30.'1 27.2 26.7 21.3

123.3 138.1 114.2 14<1.5
1<18.'1 139.0 131.2 136.2 Hl.O 133.9 130.6 135.8 116.9 101.1 106.5
98.2 96.2 89.0 90.3 88.1 91.2 81.3

242

Georgia Department of Public Health

DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: 1920-1941

Year
1920 1921 1922 1923 1921 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1036 1937 1938 1939 1910 1941
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1931 1935 1936 1937 1938 1939 1940 1941

SYPHILIS

NUMBER

RATE

Total White Got. Total White Got.

201

31 170 7.0 2.0 1!.2

296

56 210 10.2 3.3 20.2

121

70 351 1<!.5 l.l 29.9

371

73 298 12.8 4.2 25.7

1125

31 3<]<] 1<!.7 !.7 30.0

0!5<1

72 382 15.6 1.1 33.7

109

59 350 H.l 3.3 31.2

<!57

65 392 15.7 3.6 35.'!

191 100 391 17.0 5.5 36.0

161

82 379 15.9 4.5 35.0

429

77 352 1<!.7 !.2 32.8

113

51 359 14.1 2.9 33.2

425

73 352 1<!.4 3.9 32.5

391

57 334 13.1 3.0 30.6

<!<!<!

87 357 H.S !.6 32.6

103

85 318 13.3 1.4 28.9

144

77 367 1<!.5 4.0 33.2

496

96 400 16.1 4.9 35.9

178

77 101 15.4 3.9 35.9

173

61 412 15.1 3.1 36.7

587 127 160 18.8 6.2 12.'!

503 110 393 16.0 5.3 36.2

DIABETES MELLITUS

NUMBER

RATE

Total White Col. Total White Col.

182 139

13 6.3 8.2 3.6

202 1<]<]

58 7.0 8.'! 4.9

255 182

73 8.8 10.6 6.2

219 182

67 8.6 10.5 5.8

247 161

86 8.5 9.2 7.5

231 174

60 8.1 9.8 5.3

223 133

85 7.7 7.7 7.6

259 177

82 8.9 9.9 7.4

329 227 102 11.3 12.5 9.3

302 201 101 lOA 11.0 9.3

352 210 112 12.1 13.0 10.'1

322 224

98 11.0 12.1 9.1

313 260

83 11.6 13.9 7.7

349 241 108 11.7 12.7 9.9

389 275 114 12. D HA 10.'!

388 297

91 12.8 15.'! 8.3

391 299

92 12.8 15A 8.3

392 281 111 12.7 14.3 10.0

120 311 109 13.5 15.7 9.7

368 2<17 121 11.8 l 2A 10.8

349 258

91 11.2 12.7 8.4

376 278

98 12.0 13.5 9.0

GANGER

NUMBER

RATE

Total White Got. Total White Col.

1121 1210 1212 1263
13~3
1311 1207 1170 1510 1<156 Hi52 1:580 1531 1647 1762 1715 1751 1797 1929 2003 1959 2139

766 803 782 870 913 891 860 995 1013 983 1105 1106 1052 1213 1272 1239 1239 1320 1343 1<!26 1380 1<!73

358 38.8 15.2 29.8 407 !1.8 16.9 34.3 130 41.8 15.3 36.6 393 13.6 50.0 33.9 180 18.0 52.1 U.S 120 15.2 50A 37.0 397 13.3 48.2 35.4 475 50.6 55.4 42.9 197 G2.0 55.9 !:JA 168 50.1 5!.1 13.3 417 53.3 60.0 <11. 7 17<1 53.8 59.5 13.9 179 51.7 56.1 1!.2 131 55.2 6!.0 39.8 190 58.6 66.5 H.7 176 56.6 6'!.2 13.2 512 57.3 63.7 16.3 177 58.'! 67.2 12.9 586 62.2 67.8 52.'1 577 6<1.1 71.3 51.3 579 62.7 67.7 53.4 666 68.0 71.6 61.:~

PELLAGRA

NUMBER

RATE

Total White Got. Total White Gal.

432 210 222 H.9 12.4 18.5

512 231 278 17.7 13.7 23.4

527 219 278 18.2 14.'! 2U

<141 227 217 15.3 13.1 18.7

337 181 156 11.6 10.3 13.6

36H 181 185 12.6 10.2 16.~

125 225 200 1<1.6 12.6 17.8

617 292 325 21.2 16.3 29.3

816 358 ,188 29.1 19.8 1!.6

871 331 537 30.0 18.3 19.7

713 255 <1:)3 2t!.5 13.8 <12.7

5()3 192 371 19.2 10.3 34.4

192 205 237 16.6 10.9 26.5

'121 179 242 H.l o.:, 22.2

351 163 188 11.7 8.5 17.2

36G 190 175 12.0 9.9 l:i.O

391 181 207 12.8 9.5 13.7

370 175 195 12.0 8.9 17.5

365 170 195 11.8 8.6 17.'1

271 131 137 8.7 6.7 12.2

235 118 117 7.5 5.8 10.3

204 106

98 6.5 5.1 9.0

Information and Statistics

243

DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: 1920-1941

Year
1920 1921 1922 192i! 192<! 1925 1926 192'? 1928 1929 1930 1981 1932 1933 1931 1935 1936 1937 1938 1939 1910 1941

CEREBRAL HEMORRHAGE

NUMBER

RATE

Total White Col. Total White Col.

13o6 H19 1563 172<1 1766 1995 2006 2111 2891 2299 2523 2.:NO 2382 2159 2310 2410 2638 2636 2727 3043 3035 3033

SO'i 839 887 1002 963 10'14 1073 1195 1297 1257 1317 1256 1269 1195 1222 1337 H25 H11 H65 1598 151<1 1513

529 610 676 722 803 951 923 976 1097 1042 1206 1081 1113 961 1088 1073 1213 1192 1262 H50 1161 1520

16.1 50.0 53.9 59.5 60.9 63.7 69.1 7'1.7 82A 79.1 86.6 79.7 80.5 72A 76.8 79.5 86.'1 85.7 88.0 97.6 97.2 96.'1

17.6 49.0 51.4 57.6 51.9 59.0 60.5 66.5 71.6 68.8 71.5 67.6 67.6 63.1 63.9 69.3 73.2 73.5 73.9 79.9 77.2 73.5

41.1 5V1 57.6 62.2 70.0 33.9 32.8 88.1 100.2 96.3 112A 100.5 102.6 88A 99.3 97.4 109.6 107.1 112.8 129.0 131.6 139.9

HEART DISEASES

NUMBER

RATE

Total White Col. Total White Col.

1892 1768 1996 2388 2'12'1 2297 2<129 2929 3307 3691 '1099 3918 4102 3993 5019 5071 5606 528'1 52,16 5417 6176 57RO

1053 923
1953 1186 1165 1077 1198 H97 1117 1923 2109 2101 2303 2360 2901 2961 3270 3132 3059 3240 3662 3316

839 8'15 9'13 1202 1259 1220 1231 H32 1590 1768 1990 1847 179'1 1633 2118 2110 2336 2152 2187 2177 25H 2464

65.3 61.0 63.9 82.3 83.5 79.1 83.7 100.9 113.8 126.9 H0.6 13<JA 138.6 133.8 166.9 167.3 183.6 171.7 169.2 173.5 197.7 183.8

62.1 54.0 61.0 68.2 66A 60.9 67.2 83.3 9'1.8 105.3 11<1.5 113.0 123.0 12,1.6 151.8 153.5 163.0 159.5 15,1.'1 162.1 179.6 161.1

69.9 71.2 80.3 103.6 109.7 107.6 109.8 129.3 H5.3 163.5 1S5A 171.2 165.5 1<19.8 103.3 191.6 211.0 193.'1 195.6 193.7 231.7 226.7

PNEUMONIA

Year
1920 1921 1922 1923 192'1 1!>25 1926 1927 1928 1929 1930 1931 1932 1933 1931 1935 1936 1937 1938 1939 1940 19,11

NUMBER

RATE

Total White Col. Total White Col.

27~6
1925 266'1 3199 2922 2n5 2442 2132 2776 2316 2580 2165 2414 231'1 3030 3035 3803 3077 2731 2299 2055 1714

1470 1050 1<147 1596 1382 1135 1180 1015 1H1 1165 12<10 1255 120<1 1172 1580 1572 2012 1<190 1321 1209 1019
800

1296 875
1217 1603 15,10 1200 1262 1117 1335 1151 13'10 1210 12,10 1142 1450 1463 1791 1587 1410 1090 1036
91<1

95.5 66.'1 91.9 110.3 100.7 80.5 84.1 73.'1 95.5 79.6 88.5 83.9 82.5 77.6 100.8 100.2 12,1.6 100.0 88.1 73.6 65.8 5'1.5

86.7 61.4 83.9 91.8 78.8 6<1.2 66.2 56.5 79.5 63.8 67.4 67.5 6'1.1 61.9 82.7 81.5 103.4 75.9 66.7 60.5 50.0 38.9

108.0 73.7
103.7 138.1 134.2 105.8 112.6 100.8 122.0 106.'1 124.9 112.2 1H.3 104.8 132.3 132.9 161.8 142.6 126.1
97.0 95.5. 8'1.1

DIARRHEA AND ENTERITIS (UNDER 2 YRS.)

NUMBER

RATE

rotal White Col. Total White Col.

1252 759 493 43.2 <14.7 41.1 1230 722 508 42.5 42.2 <12.8 1175 686 489 40.5 39.8 <11.7 1183 698 485 40.8 '10.1 <11.8 1322 736 586 45.6 42.0 51.1
9'19 510 439 32.7 28.8 38.7 873 462 411 30.1 25.9 36.7 810 '140 370 27.9 21.5 33.4 730 13'1 296 25.1 2'1.0 27.0 526 292 23<1 18.1 16.0 21.6 721 <153 268 24.7 24.6 25.0 5,15 291 25'1 18.6 15.7 23.5 390 25'1 136 13.2 13.5 12.5 193 324 169 16.5 17.1 15.5 651 378 273 21.7 19.8 2'1.9 507 308 199 16.7 16.0 18.1 549 303 2'16 18.0 15.6 22.2 480 2<11 233 15.6 12.6 20.9 691 385 306 22.3 19.'1 27.4 416 217 199 13.3 10.9 17.7 395 215 180 12.6 10.6 16.6 435 218 217 13.8 10.6 20.0

244

Georgia Department of Public Health

DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: 1920-1941

Year
lU~O
1921 1922 1923 1924 192:> 1026 192'i 1928 1929 1930 1931 1932 1933 193'1 1935 1936 1937 1938 1939 1940 19<!1
Year
1920 1921 1922 1923 192<1 1925 1926 1927 1928 1929 1930 1931 1932 1933 193<1 1935 1936 1937 1938 1939 1940 19<11

APPENDICITIS

NUMBER

RATE

Total White Col. Total White Col.

236 152

84 g_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

318 210 103 11.0 12.0 9.'1

3ri7 212 Ho 12.3 12.0 12.s

289 178 111 10.0 10.0 9.9

330 211 119 11.'1 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 11.4

3'17 234 113 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 11.8 11.8 10.3

300 202

98 9.9 10.5 8.9

312 201 Ill 10.2 10.3 10.0

319 230

89 10.'1 11.7 8.0

287 19'1

93 9.3 9.8 8.3

280 186

9'1 9.0 9.3 8.'1

276 159 117 8.8 7.8 10.8

230 135

95 7.3 6.6 8.7

NEPHRITIS (ACUTE & CHRONIC)

NUMBER

RATE

Total White Col. Total White Col.

2200 2<146 2903 3139 3449 3228 3385 3620 <1105 4003 3787 3226 3216 3118 3301 3155 3446 3<158 3531 30<!1 3348 3381

1258 1347 1592 168'1 1787 1715 1721 1970 2162 2187 2060 179<1 1753 1769 1903 1803 1910 1919 1996 1771 18<18 1816

942 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 1565

76.0 84.'1 100.1 108.2 118.9 111.2 116.6 12<1.6 1<11.3 137.7 129.9 109.8 108.6 104.5 109.8 10<1.1 112.9 112.4 113.9 97.'1 107.2 107.5

7<1.2 78.7 92.3 96.8 101.9 97.0 96.5 109.6 119.3 119.8 111.9 96.5 93.'1 93.4 99.6 93.5 98.1 97.7 100.7 88.6 90.7 88.2

78.5 92.6 111.7 125.'1 1'14.9 133.'1 1<18.'1 1<18.9 177.5 167.9 160.9 132.8 134.9 123.8 127.6 122.8 138.8 138.3 137.3 113.0 138.2 1<1<1.0

CIRRHOSIS OF LIVER

NUMBER

RATE

Total White Col. Total White Col.

93

61

83

52

78

<13

90

5<1

98

69

117

77

99

62

125

75

102

61

128

7'1

13'1

80

12<1

87

91

61

116

73

110

73

1<12

97

139

87

151

95

1<11 100

152 111

1<15 102

154 110

32 3.2 3.6 2.7 31 2.9 3.0 2.6 35 2.7 2.5 3.0 36 3.1 3.1 3.1 29 3.'1 3.9 2.5 <10 1.0 !A 3.5 37 3.'1 3.5 3.3 50 <1.3 <1.2 4.5 <!1 3.5 3.'1 3.8 54 4.'1 '1.1 5.0 5<! <1.6 <1.3 5.0 37 <1.2 !.7 3.4 30 3.1 3.3 2.8 43 3.9 3.9 3.9 37 3.7 3.8 3.'1 <15 <1.7 5.0 <1.1 52 <1.6 4.5 <1.7 56 <1.9 '1.8 5.0 41 <1.5 5.0 3.7 <!1 4.9 5.6 3.6 '13 4.6 5.0 4.0 44 <1.9 5.3 4.0

MALFORMATION, EARLY INFANCY

NUMBER

Total White Col. Total White Col.

1878 2480 28,12 2878 2995 2526 2239 2192 1859 1742 1890 1827 1662 1639 190'1 1736 1797 1663 2431 2155 203<1 2163

12<15 1446 1505 1636 167<1 1'13<1 1251 12<111 1132 1050 1185 1111 102<1
99<1 1126 1076 1064 1028 1289 1199 1098 1206

633 1034 1337 1242 1321 1092
988 9<18 727 692 705 716 638 645 778 660 733 635 1142 956 936 957

64.8 85.6 98.'1 99.2 103.2 87.0 77.1 75.5 6'1.0 59.9 6<1.8 62.2 56.1 54.9 63.3 57.3 58.8 5<1.1 78.'1 69.0 65.1 68.8

73.'1 52.7 8<1.5 87.1 87.2 113.9 94.0 107.0 95.'1 115.1 81.1 96.3 70.2 88.1 69.5 85.6 62.5 66.4 57.5 6<1.0 6<1.3 65.7 59.7 66.'1 54.6 58.8 52.5 59.2 58.9 71.0 55.8 59.9 5<1.7 66.2 52.3 57.1 65.1 102.1 60.0 85.1 53.9 86.3 58.6 88.1

Information and Statistics

245

DEATHS AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: l920-l9LH

Year
1920 1921 1922 1923 192<1 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 19<10 19<11
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 19,10 1941

SUICIDE

NUMBER

RATE

Total White Col. Total White Col.

128 110 167 142 181 152 166 150 195 173 189 169 15<1 13<1 198 179 243 210 287 2fi8 296 273 313 282 304 279 312 276 297 265 300 270 311 28<1 315 288 295 266 316 290 282 246 236 212

18 4.'1 6.5 1.5 25 5.8 8.3 2.1 29 6.2 8.8 2.5 16 5.7 8.6 1.4 22 6.7 9.9 1.9 20 6.5 9.6 1.8 20 5.3 7.5 1.8 19 6.8 10.0 1.7 B3 8.4 11.6 3.0 19 9.9 1<1.7 1.8 23 10.2 1<1.8 2.1 31 10.7 15.2 2.9 25 10.3 14.9 2.3 36 10.5 1<1.6 3.3 32 9.9 13.9 2.9 30 9.9 H.O 2.7 27 10.2 H.6 2A 27 10.2 1<1.7 2A 29 9.5 13.'1 2.6 26 10.1 1<1.5 2.3 36 9.0 12.1 3.3 24 7.5 10.3 2.2

MOTOR VEHICLE ACCIDENTS

NUMBER

RATE

Total White Col. Total White Col.

HO 100

<10 <1.8 5.9 3.3

132 108

2<1 4.6 6.3 2.0

203 1<12

61 7.0 8.2 5.2

267 189

78 9.2 10.9 6.7

313 239

7<1 10.8 13.6 6.5

348 238 llO 12.0 13.5 9.7

370 266 104 12.7 14.9 9.3

<133 288 145 14.9 16.0 13.1

<173 319 15'1 16.3 17.6 14.1

531 335 196 18.3 18.3 18.1

612 <125 187 21.0 23.1 17.'1

655 1128 227 22.3 23.0 21.0

585 <126 159 19.7 22.7 1<1.7

675 <173 202 22.6 25.0 18.5

809 57<1 235 26.9 30.0 21.'1

942 646 296 31.1 33.5 26.9

991 692 299 32.4 35.5 27.0

964 680 28'1 31.3 3<1.6 25.5

789 5<15 244 25.4 27.5 21.8

669 <183 186 21.'1 24.2 16.5

802 556 2<16 25.7 27.3 22.7

946 657 289 30.1 31.9 26.6

HOMICIDE

NUMBER

RATE

Total White Col. Total White Col.

479 100 379 16.5 5.9 31.6

5<19 14~ <106 19.0 3.4 3<1.2

56t! H6 <118 19.5 8.5 35.6

505 125 380 11.4 7.2 32.7

562 155 <107 19.4 8.8 35.5

46<1 141 323 16.0 8.0 28.5

395

97 298 13.6 5.4 26.6

510 141 369 17.6 7.9 33.3

512 159 353 17.6 8.8 32.3

523 H9 37<1 18.0 8.2 3<1.6

569 158 <111 19.5 8.6 38.3

597 179 <118 20.3 9.6 38.8

554 175 379 18.7 9.3 35.0

670 208 !62 22.5 11.0 <12.'1

720 205 515 23.9 10.7 '17.0

661 156 504 21.8 8.1 <15.8

589 155 <13<1 19.3 8.0 39.2

6<11 136 505 20.8 6.9 <15.4

582 131 <151 18.8 6.6 <10.3

560 109 '151 17.9 5.5 40.1

616 111 505 19.7 5.4 '16.5

6<19 120 529 20.6 5.8 <18.7

ACCIDENTS AND OTHER VIOLENCE

NUMBER

RATE

Total White Col. Total White Col.

1603 853 750 55.3 50.3 62.5 1456 788 668 50.3 <16.1 56.3 1508 846 662 52.0 49.0 56.4 1575 850 725 5<1.3 <18.9 62.5 1772 9<15 827 61.1 53.9 72.1 1682 9<17 735 58.0 53.6 6<1,8 1585 928 657 54.6 52.1 58.6 1831 1035 796 63.0 57.6 71.9 1901 1090 811 65.'1 60.2 7<1.1 1978 1113 865 68.0 60.9 80.0 1992 116<1 828 68.'1 63.2 77.2 2010 12<13 767 68.'1 66.9 71.1 191<1 1182 732 6<1.6 63.0 67.5 1992 1213 779 66.8: 6<1.0 71.5 2251 1389 862 7<1.9 72.7 78.7 2,128 1<!53 975 80.1 75.3 88.5 2775 1682 1093 90.9 86.'1 98.7 2413 1<!95 918 78.4 76.1 82.5 2125 1309 816 68.6 66.1 73.0 1850 1186 661 59.2 59.4 59.0 2057 1217 8<10 65.9 59.7 77.4 2208 1412 796 70.2 68.6 73.2

24.6

Georgia Department of Public I-1ealth

TABLE 5
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: 1941

Number

Gause of Death

Total White

ALL CAUSES

31,579

'l'yphoid fever --------------------

55

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

36

Malaria

75

Smallpox ------------------------

Measles

157

Scarlet fever --------------------Whooping cough ----------------Diphthelia -----------------------
Influenza -----------------------Dysentery ----------------------Poliomyelitis --------------------- __ Lethargic encephalitis -----------lVIeningococcus meningitis --------Tuberculosis -------------------- _ Syphilis -------------------------
Gonorrhea ----------------------Cancer -------------------------Diabetes mellitus -----------------
Pellagra - ----------------------Cerebral hemorrhage, embolism

HO
63 99,1 109
33
17 1,R85
503 2!
2,139 376 204

and thrombosis ----------------- 3,033 Heart diseases ------------------- 5,780

Pnemnonia ---------------------- 1,71<1 Diarrhea and enteritis (-2 yrs.) __ '135

Appendicitis ---------------------Cinhosis of liver ---------------Nephritis -----------------------l\Ialfor1nation and early

230 15'1 3,381

infancY diseases ----------------
Suicide -------------------------Homicide -----------------------Motor vehicle acciclents___________ _ All other accidents________________
Unl<mown and ill-defined causes ___ _ All other causes__________________

2,163 236 .649 9'16
1,262 1,026 4,246

16,717 22 27 29
9'1 8
69 36 ,183 52 25
3 H :i01 110
1.'173 278 106
1,513 3,316
800 218 135 llO 1,816
1,206 212 120 657 755 356
2,172

Colored
H,862 33
'16
63
Tl 27 511 57
8 2
884 393
23 666
98 98
1,520 2,46'1
9H 217
95 <1<1 1,565
957 2<1
529 289 507 670 2,07'1

Total
1004.0 1.7 1.1 2.'1
5.0 0.3 4.5 2.0 31.6 3.5 1.0 0.2 0.5 <1<1.0 16.0 0.8 68.0 12.0 6.5
96.'1 183.8
51.5 13.8
7.3 <1.9 107.5
68.8 7.5
20.6 30.1 '10.1 32.6 135.0

Rate
White
812.1 1.1 1.3 1.'1

Colored
1367.5 3.0
0.~

4.6 0.'1 3.'1 1.7 23.5 2.5 1.2 0.1 0.7 2'1.3 5.3 O.M 71.6 13.5 5.1

5.8 0.1 6.5 2.5 '17.0 5.2 0.7 0.2 0.3 81.3 36.2 2.1 61.3 9.0 9.0

73.5 161.1
38.9 10.6
6.6 5.3 88.2

139.9 226.7
8'1.1 20.0
8.7 '1.0 14,1.0

58.6 10.3
5.8 31.9 36.7 17.3 105.5

88.1 2.2
48.7 26.6 '16.6 61.6 190.8

Live Bil'ths ---------------------- 67,785 <11,277 26,508

21.6

20.1

21.<1

Stillbirths ----------------------- 2,903

1,276

1,627

'12.8

30.9

61.'1

Infant Mortality ----------------- 3,955

1,988

1,967

58.3

'18.2

74.2

Maternal Mortality --------------- 315

133

182

4.6

3.2

6.9

N01'E: 'l'hese figures exclude non-residents of Georgia and include births and deaths of Georgia resid~nts occurring in other states.

Information and Statistics

24.7

TABLE 6
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

Number

Cause of Death

Total White

ALL CAUSES

32,285

Typhoid fever --------------------

68

11yphus fever ---------------------

26

1\falaria -------------------------

89

Smallpox ------------------------

l\'Ieasles --------------------------

23

Scarlet fever ---------------------

16

Whooping cough ------------------ 108

Diphtheria -----------------------

59

Influenza ------------------------ 92'1

Dysentery ----------------------- 126

Poliomyelitis

Lethargic encephalitis ------------

'1

1\Ieningococcus miningitis ---------

9

Tuberculosis --------------------Syphilis ------------------------Gonorrhea -----------------------
Cancer -------------------------Diabetes mellitus ----------------Pellagra ------------------------Cerebral hemorrhage, embolism

1,533 587 22
1,959 3,19
235

and thrombosis ---------------Heart diseases -------------------.
Pnemnonia ----------------------Diarrhea and enteritis (-2 yrs.) __

3,035 6,176 2,055
395

Appendicitis --------------------- 276 Cirrhosis of liver_________________ _ 145

Nephritis ------------------------ 3,3,18 Malformation and early

infancy diseases ---------------- 2,03'1

Suicide -------------------------Homicide -----------------------Motor vehicle accidents____________ All other accidents________________

282 616 802 1,255

Unlmown and ill-defined causes____ 1,051 All other causes _________________ _ '1,671

17,313 27 18 35
14 15 52 ,14 503 67
5 3
5'1<1 127
4 1,380
258 118
1,57'1 3,662 1,019
215 159 102 1,8,13
1,098 2,16 11_1 556 661 379
2,<102

Colored
14,972 <ll 8 54
I 56 15 421 59
2 989 460 18 579
91 117
1,'161 2,51<! 1,036
180 117
43 1,500
936 36
505 246 594 672 2,209

Total
1033.5 2.2 0.8 2.8
0.7 0.5 3.5 1.9 29.6 '1.0 0.2 0,1 0.3 49.1 18.8 0.7 62.7 11.2 7.5
97.2 197.7
65.8 12.6
8.8 '1.6 107.2
65.1 9.0
19.7 25.7 '10.2 33.6 H9.6

Rate
White
8'19.2 1.3 0.9 1.7

Colored
1379,8 3.8 0.7 5.0

0.7

0.8

0.7

0.1

2.6

5.2

2.2

!A

24.7

38.8

3.3

5.4

0.3

0.2

0.2

0.1

0,3

0.2

26.7

01.2

6.2

'12.4

0.2

1.7

67.7

53.4

12.7

8.'1

5.8

10.8

77.2 179.6
50.0 10.6
7.8 5.0 90.7

13<1.6 231.7
95.5 16.6 10.8
4.0 138.2

53.9" 12.1
5.4 27.3 32.4 18.6 120.8

86.3 3.3
'16.5 22.7 54.7 61.9 203.6

Live Births ---------------------- 6'1,695 38,911 25 '78'1

20.7

10.1

23.8

Stillbirths

3,078

1,326

1,752

47.6

34.1

67.9

Infant Mor'tality ----------------- 3,737

1,351

1,886

57.8

47.6

73.1

Maternal Mortality ______________ _ 3,12

146

196

5.3

3.8

7.6

NO'l'E : 'l'llese figures exclude non-residents of Gegrgia and include Nrths and deaths of Georgia residents occurring in other states.

248

Georgia Department of Public Health

TABLE 7
CENSUS ENUMERATED POPULATION AS OF APRIL I, 1940, BY COLOR, IN EACH COUNTY IN GEORGIA.

rounty

Census Enumerated Po pulation as of Ai!ril I, 1940
Total White Colored

TOTAL ____ 3,123,723 2,038,278 1,085~415

Appling ------ 14,497
1-l.tldnson ----- 7,093

Bacon

8,096

Baker -------- 7,3<1<1
*Baldwin ----- 16;111
Banlrs -------- 3,733

Barrow

13,60<1

Bartow ------- 25,283 Ben Hill ----- 1<1,523

Berrien ------ 15,370

Bibb --------- 83,783

B!ecl<ley

9,655

Brantley ----- 6,871
Broolm ------- 20,'197

Bryan

6,288

Bulloch ------ 26,010

Burke

26,520

Butts -------- 9,182

Calhoun

10;138

Camden ------ 5,910
Candler ------ 9,103
Carroll ------- 34,156

Catoosa ------ 12,199
Charlton ----- 5,256
Chatham ----- 117,970
Chattahoochee__ 15,138

Chattooga ---- 13,532
Cherokee ----- 20,126

Clal'l<e ------- 28,398
Clay --------- 7,06<1

Clayton ------ 11,655

Clinch ------- 6;137
Cobb --------- 38,272

Coffee

21,5<11

Colquitt ------ 33,012

Columbia

9,'133

Cook --------- 11,919

Coweta ------- 26,972

Crawford ----- 7,128

Crisp -------- 17,5<10

Dade

5,89<1

Dawson

<1,479

DeCatur ------ 22,23<1

DeKalb

86,912

Dodge --------
Dooly -------Dougherty ----
Douglas ------

21,022 16,386 28,565 10,053

Early -------- 18,679

11,856 5,<122 7,0<12 3,0<19 7,713 3,072
10,605 21,073
9,61<1 13,033 <18,239
6,331 5,727 9,990 3,735 16,168 6,654 <1,891 3,309 2,486 5,996 26,903 11,876 3,760 65,027 12,110 16,720 19,229 18,335 2,077 3,611 3,938 31,990 16,165 2<1,955 3,769 3,728 16,149 3,105 9,'126 5,597 <1,415 11;113 72,973 14,045 7,555 13,028 7,880 9,065

2,6<11 1,611 1,054 4,295 3,693
661 2;159 4,210 1,8<19 2,337 35,51<1 3,324 1,1<J<J 10,507 2,553 9,842 19,866 4,291 7,129 3,42<1 3,107 7,253
323 1,496 52,943 3,023 1,812
897 10,063
<1,987 2,98<1 2;199 6,282 5,376 8,057 5,664 3,191 10,823 <1,023 8,114
297 6<1
10,761 .13,969
6,977 9,331 15,537 2,113 9,614

County

Census Enumerated Po pulation as of April I, 1940
Total White Colored

Echols

2,96<1

Effingham

9,616

Elbert

19,618

Emanuel ----- 23,517

Evans

7,401

Fannin

1<1,752

l!,ayette

8,170

Floyd -------- 56,141

}110l'SYth ------ 11,322

Franldin ----- 15,612

Fulton ------- 392,886

Gilmer ------- 9,001

Glascock ----- 4,5,17

Glynn

21,920

Go1don

18,'145

Grady -------- 19,65<1
Greene ------- 13,709
Gwinnett ----- 29,087

Habersham --- 1<1,771 Hall --------- 34,822
Hancock ----- 12,764

Haralson ----- 1<1,377 Harris ------- 11,428
Hart --------- 15,512

Heard -------Henry -------Houston ------
Irwin --------

8,610 15,119 11,303 12,936

Jaclmo.n -----Jasper ------Jeff Davis ---Jefferson -----
.Jenkins ------

20,089 8,112 8,8<11
20,0<10 11,8<13

Johnson ------ 12,953 Jones -------- 8,331
Lamar ------- 10,091

Lanier ------- 5,632 Latuens ------ 33,606
Lee ---------- 7,837

Liberty ------- 8,595

Lincoln ------ 7,0<12

Long

<1,086

Lowndes

31,860

Lumpkin

6,223

McDuffie

10,878

Mcintosh

5,292

Macon ------- 15,9<17

Madison ------ 13;131
Marion ------- 6,95<1

1,899 5,611 11,887 15,206 '1,903 1<1,675 5,503 <17,500 11,281 13,342 269,1<13 8,952 3,326 13,356 17,2<12 12,930 6,554 25,751 14,10<1 31;183 3,581 12,853 4,626 11,551 6,023 7,955 3,981 8,178 16,5<18 3,777 7,231 8,583 5,306 8,029 3,250 5,668 <1,017 19,861 1,895 3,077 3;123 2,625 17,186 6,003 5,565 2,135 5,053 10,326 3,129

1,065 <1,002 7,731 8,311 2,'193
11 2,667 3,6<11
41 2,270 123,1<13
<19 1,221 8,56<1 1,203 6,72<1 7,155 3,336
661 3,339 9,183 1,524 6,802 3,961 2,587 7,164 7,319 <1,758 3,541 4,995 1,610 11,457 6,537 4,924 5,081 tl,Ll23 1,615 13, 7<15 5,9<12 5,518 3,619 1;161 1<1,61<1
220 5,313 3,157 10,894 2,605 3,825

Information and Statistics

249

TABLE 7-Continued
CENSUS ENUMERATED POPULATION AS OF APRIL I, 1940, BY COLOR, IN EACH COUNTY IN GEORGIA.

County

Census Enumerated Pouulation as of A11ril I, I 940

Total

White Colored

~Ieriwether
~Liller _______ _ ~Iitehell _____ _
>Ionroe ~Iontgomery __ ?-.forgan _____ _ :.\Iurray _____ _
:.\Iuscogee )i"ewton Oconee ______ _
Oglethorpe Paulding ____ _ Peach _______ .
ricl;;:ens -----Piel'ce Pike ______ --Poll< ________ _
Pulasld Putnam _____ _
Quitman Rabun ______ _ Randolph ____ _ Richmond ___ _ Hocltdale ____ . Schley _____ _
Screven _____ _
Seminole
8paldin~
8tephens Stewart Htmter

22,055 9,998
23,261 10,7'19
9,668 12,713 11,137 75,49<1 18,576 7,576 12;130 12,832 10,378
9,136 11,800 10,375 28,167
9,829 8,511 3;135 7,821 16,609 81,863 7,724 5,033 20,353 8,492 28,427 12,972 10,603 24,;102

10,331 6,753
10,996 1,596 5,788 5,936
10,756 19,<!78 12,154 5,317
6,931 11,53<1
1,012 8,656 9,316 5,310 23,698 4;170 3;117 1,057 7,686 5,205 <18,<!94 ;:),27<1 1,999 8,7<16 5,035 19,48> 11,111) 2,882 9,504

11,721 3,245
12,265 6,153 3,880 6,777 381
26,016 6,<122 2,259 5;196 1,298 6,366 180 2/154 5,065 <],769 5,359 5,097 2,378 135.
11,40<1 33,369
2,448 3,034 11,607 3;157 8,912 1,856 7,721 1<1,998

Census Enumerated Population as of April I, I 940

County

Total

White Colored

Talbot ______ _ Taliaferro ___ _
Tattnall -----'J.,aylor Telfair --- ___ _
Terrell ------'l'homas _____ _ Tift __ Toombs _____ _
'110'iVllS - - - - - - -
Treutlen Troup -------Turner ______ _
Twiggs -- ----Union _______ _
lf1)S0l1
\Vall\er ______ _ Walton ______ _
\Yare VYarren \Vashington \Vayne ------Webster _____ _ \Vheeler __ ~- White -------Whitfield ____ _ Wilcox ______ _
Willtes ------Willtinson ___ _
Worth --------

8,1<!1 6,273 16,213 10,768 15,1<!5 16,675 31,289 18,599 16,952 4,925 7,632 13,879 10,816 9,117 7,680 25,064 31,021 20,777 27,929 10,236 2<!,230 13,122 ],726 8,535 6,<!17 26,105 12,755 15,084 11,025 21,374

2;160 1,997 12,076 5,586 10,358 <],71'1 17,309 13,106 12;131 4,925 5,333 27,527 7,036 3,253 7,669 17,377 28,789 14,168 20,389 3,571 10,357 10,328 1,834 5,855 6,050 24,610 7,879 6,0<!1 5,618 11,397

5,681 1,281 1,167 iJ,lS:! 1,787 11,961 13,980 5,493 1,518
2,299 16,352
3,810 5,864
11 7,687 2,235 6,609 7,540 6,66:1 13,873 2,791 2,892 2,680
367 1;165 4,876 9,043 ri,407 9,977

*Baldwin County population exeludes the State Milledgeville Hospital.

250

Georgia Department of Public Health

TABLE 8
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

LIVE BIRTHS

Rate per 1,000

Number

Population

1941 1940 1941 1940

STILLBIRTHS

Rate per 1,000

Number

Live Births

1941 1940 1941 1940

'l'O'l'AL

67,785 61,695

Appling -------------------- 329 284

Atkinson -------------------

179

185

Bacon --------------------- _ 207 187

Bal<er --------------------- _

156

162

Baldwin

336 315

Banks ----------------------

180

195

Bar!ow ---------------------

277

252

Bartow -------------- ______ _

525

568

Ben Hill -------------------

279

252

Berrien --------------------

330

291

Bibb ----------------------- 1,861 1,553

Biecldey --------------------

233

221

Brantley ------------------- 17<1 173

Brool\3 ---------------------

503

197

Bryan ----------------------

145

135

Bulloch ________ c ___________

558

573

Burlw ----------------------

729

729

Butts ----------------------

211

197

Calhoun

230

249

Camden

155

H2

Candler

131

138

Carroll

721

~H

Catoosa --------------------

173

185

Charlton -------------------

123

108

Chatham ------------------- 2,513 2,252

Chattahoochee --------------

71

145

Chattooga ------------------

447

462

Cherol\ee -------------------

437

43<1

Clarl\e ---------------------

499

330

Clay -----------------------

165

145

Clayton __ ------------------

191

200

Clinch __ -------------------

107

129

Cobb -----------------------

759

665

Coffee ----------------------

597

643

Colquitt --------------------

719

759

Columbia -------------------

213

203

Cook -----------------------

248

226

Coweta ---------------------

482

480

Crawford -------------------

159

191

Crisp ----------------------Darle ----------------------Da"Wson -------------------Decatur -------------------DeKalb __ -----------------Dodge ---------------------Dooly ---------------------Dougherty ------------------

<108 118
9'1 506 1,702 413 123 585

425 119 102 496 1,569 <!4<1 370 499

Douglas --------------------

204

187

21.6 22.7 25.2 25.6 21.2 20.5 20.6 21.2 20.8 19.2 21.5 22.2 24.1 25.3 24.5 23.1 21.5 27.5 23.0 23.0 26.2 1<1.4 21.1 15.9 23.4 21.3 13.8 24.1 21.7 17.6 23.4 16.4 16.6 19.3 27.7 21.8 22.6 20.3 17.9 22.3 23.3 20.0 21.0 22.8 19.6 21.1 25.1 20.5 20.3

20.7 19.6 26.1 23.1 22.1 19.2 22.3 19.3 22.5 17.'1 18.9 18.5 22.9 25.2 24.2 21.5 22.0 27.5 21.5 23.9 21.0 15.2 19.7 15.2 20.5 19.1
9.6 24.9 21.6 18.7 20.5 17.2 20.0 17.'1 29.9 23.0 21.5 19.0 17.8 27.2 24.2 20.2 22.8 22.3 18.0 21.1 21.9 17.5 18.6

2,903 14 11 13 8 11 3 11 2<1 17 14 105 7 10 35 10 H <15 4 11 11
25
1 102
3
10 21
9 16
2 25 13 37 11 18
7 10 2<1
2 2 17 51 22 13 32 7

3,078 10
13
14
19 12 27 118
10 38
32 41
7 6 13
36 4
112 1 3 17
17 10
1 23 35 33 17 15 17 19 30
2
36 51 26 27 23
5

42.8 42.6 61.5 62.8 51.3 32.7 16.7 39.7 15.7 60.9 12A 56.'1 30.0 57.5 69.6 69.0 25.1 61.7 19.0 47.8 71.0 38.2 31. 7 23.1 32.5 40.6 12.3
8.9 22.9 <12.1 5<1.5 83.8
1~.7
32.9 72.0 51.5 G1.6 72.6 }t1.5 62.9 58.8 16.9 21.3 33.6 30.0 19.7 30.7 54.7 31.3

47.6 35.2 32A 69.5 43.2 <14.4 30.8 27.8 33.5 <17.6 92.8 76.0 40.7 57.8 76.5 59.3 55.8 56.2 35.5 24.1 91.5 50.7 53.4 21.6 61.8 49.7 27.6
6.5 39.2 32.1 69.0 30.0 31.0 34.6 ;)4.4 43.TJ 33.7 66A 35.4 97.9 70.6 16.8
9.8 72.6 34.4 58.6 73.0 16.1 26.7

Information and Statistics

251

TABLE 8-Continued
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

LIVE BIRTHS

Rate per 1,000

Number

Population

1941 1940 1941 1940

STILLBIRTHS

Rate per 1,000

Number

Live Births

1941 1940 1941 1940

Early ----------------------

'!<17

400 23.9 21.'1

13

26 29.1 65.0

Echols ____ -----------------

68

70 22.9 23.6

3

5 ,1,1.1 71.'1

Effingham -----------------

241

187 25.3 19.'1

10

14 <!1.0 7<1.9

Elbert ---------------------- 370 '120 18.9 21.'1

23

25 62.2 59.5

Emanuel -------------------

502

533 21.3 22.7

29

36 57.8 67.5

l~vans ----------------------

185

171 25.0 23.1

13

70.3 52.6

Fannin ------------------ __ _

329

366 22.3 2'1.8

9

7 27.'1 19.1

Fayette ---------------------

202

192 21.7 23.5

5 39.6 26.0

Floyd ---------------------- 1,27<1 1,175 22.7 20.9

'13

61 33.8 51.9

Forsyth --------------------

237

228 20.9 20.1

5

8.'1 21.9

Franldin ------------------- 315 299 20.2 19.2

13

12 <!1.3 '10.1

Fulton ---------------- ____ _ 8,026 7,33'1 20.'1 18.7

270

257 33.6 35.0

Gilmer ---------------------

232

259 25.8 28.8

8

2 34.5

7.7

Glascock -------------------

110

88 2<1.2 19.'1

1 45.5 11.'1

Glynn ----------------------

'197

,166 22.7 21.3

30

20 60.'1 '12.9

Gordon ---------------------

!50

'll9 24.'1 22.7

13

10 28.9 23.9

Grady ----------------------

4<13

'!<10 22.5 22A

19

13 42.9 29.5

Greene ---------------------

320

268 23.3 19.5

16

12 50.0 4'1.8

Gwinnett ------------------- 509 575 17.5 19.8

18

21 35.'1 36.5

Habersham -----------------

318

386 21.5 26.1

13

18 40.9 '16.6

Hall -----------------------

706

6<!1 20.3 18.'1

19

26 26.9 10.6

Hancock --------------------

3H

306 2'1.6 2'1.0

10

10 31.8 32.7

Haralson -------------------

223

277 15.5 19.3

'1 40.'1 1<1.<1

Harris ---------------------

253

261 22.1 22.8

10

10 39.5 38.3

Hart -----------------------

326

339 21.0 21.9

11

20 33.7 59.0

Heard ---------------------

119

137 13.8 15.9

5

'1 42.0 29.2

Henry ----------------------

317

316 21.0 20.9

13

18 41.0 57.0

Houston --------------------

270

265 23.9 23.'1

H

22 51.9 83.0

Invin

28'1

251 22.0 19.'1

H

11 '19.3 43.8

Jacl;:son --------------------

'133

,120 21.6 20.9

16

16 37.0 38.1

Jasper ---------------------

183

182 20.9 20.7

8

15 43.7 82.'1

Jeff Davis ------------------

211

197 23.9 22.3

10

11 47.'1 55.8

Jefferson ---------------- __ _ '180 522 2'1.0 26.0

25

25 52.1 47.9

Jenkins -------------------- 336 286 28.'1 2<1.1

18

18 53.6 62.9

Johnson -~ ------------------

200

260 15.'1 20.1

H

18 70.0 69.2

Jones ----------------------

187

172 22A 20.6

9

'18.1 '10. 7

Lamar ---------------------

207

203 20.5 20.1

12

11 58.0 54.2

Lanier ---------------------

35

76 15.1 13.5

5

3 58.8 39.5

Laurens --------------------

723

789 21.5 23.5

'18

46 66.4 58.3

Lee __ ----------------------

150

187 19.1 23.9

13

13 86.7 69.5

Liberty ---------------------

182

179 21.2 20.8

10

20 5'1.9 111.7

Lincoln --------------------

159

H2 22.6 20.2

1

5

6.3 35.2

Long -----------------------

71

62 17.'1 15.2

1 H.1 16.1

Lowndes --------------------

633

685 19.9 21.5

26

39 41.1 56.9

Lumpl<in -------------------

117

143 18.8 23.0

2

17.1 21.0

McDuffie -------------------

2<17

261 22.7 2'1.0

12

15 '18.6 57.5

~lclntosh -------------------

135

163 25.5 30.8

6

7 <!!A 42.9

Macon

,17<1

385 29.7 24.1

12

21 25.3 5'1.5

l'tiadison -------------------

288

285 21.4 21.2

11

13 38.2 <!fi.B

252

Georgi(b Department of Pnblic, Health

TABLE 8-Continued
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

LIVE BIRTHS

Rate per I ,000

Number

Population

1941 1940 1941 1940

STILLBIRTHS

Rate per I ,000

Number

Live Bi~ths

1941 1940 1941 1940

J\.larion ---------------------

181

209 26.0 30.1

15 38.7 71.8

:.\feriwether ----------------- 182 476 21.9 21.6

19

27 39.4 56.7

:VIiller ---------------------- 207 181 20.7 18.<1

10

5 48'.3 27.2

)Iitchell -------------------- 580 600 2<1.9 25.8

31

35 53.4 58.3

:\Ionroe ---------------------

233

25<1 21.7 23.6

12

19 51.5 74.8

Montgomery ---------------- 175 158 18.1 16.3

6

13 34.3 82.3

J.\Iorgan --------------------

289

363 22.7 28.6

17

20 58.8 55.1

Murray -------------------- 255 252 22.9 22.6

11

16 43.1 63.5

l\Ittscogee ------------------- 2,106 1,496 27.9 19.8

85

78 40.'1 52.1

Newton -------------------- 375 381 20.2 20.5

22

13 58.7 34.1

Oconee ---------------------

111

116 1<1.7 15.3

5

15.0 51.7

Oglethorpe ----------------- 303 278 24.'1 22.4

27

11 89.1 39.6

Paulding -------------------

274

251 21.'1 19.8

8

6 29.2 23.6

Peach ---------------------- 23<1 228 22.5 22.0

17

13 72.6 57.0

Pickens -------------------- 228 213 25.0 23.3

5

3 21.9 1<1.1

Pierce ----------------------

284

308 2<1.1 26.1

15

19 52.8 61.7

Pike -----------------------

213

245 20.5 23.6

Polk -----------------------

601

622 21.1 21.8

8 24

11 37.6 i' 44,9 25 39.9 ~- <i0'.2'' -

Pulasl<i

210

187 21.'1 19.0

1<1

10 66.7 53.5

Putnam --------------------

201

212 23.6 2<1.9

8

11 39.8 51.9

Quitman -------------------

93

77 27.1 22A

1 21.5 51.9

Habun ---------------------

183

168 23.4 21.5

2 16.4 11.9

Uandolph -------------------

352

3<13 21.2 20.7

30

19 85.2 55.<1

Richmond ------------------ 1,824 1,610 22.3 19.7

59

88 32.3 54.7

Uockdale ------------------- 118 150 15.3 19.4

3

25.<1 60.0

Schley --------------------- 136 119 27.0 23.6

<1 44.1 33.6

Screven

458

48<1 22.5 23.8

33

<15 72.1 93.0

Seminole

230 208 27.1 24.5

8

9 3<1.8 13.3

Spalding

511 513 18.0 18.0

39

39 76.3 76.0

Stephens

293 296 22.6 22.8

13

3.<1 <13.9

Stewart

203 185 19.1 17.'1

<1

3 19.7 16.2

Sumter ---------------------

558

526 22.8 21.5

31

30 60.9 57.0

'l'albot ----------------------

179

189 22.0 23.2

10

55.9 42.3

Taliaferro ----------------- 114 150 18.2 23.9

<1

35.1 33.3

Tattnall --------------------

2<17

2<ll 15.2 1<1.8

19

13 76.9 53.9

Taylor

177 220 16.'1 20.'1

9

50.8 36.'1

~Pelf a i r

351

312 23.2 20.6

12

15 3<1.2 <18.1

'iel'l'ell

419 <131 26.9 25.8

22

19 <19.0 <14.1

Thomas

675

582 21.6 18.6

29

2! 43.0 <ll.2

~rift ------------------------

<133

394 23.3 21.2

2<1

21 55.4 60.9

1,oombs --------------------

370

302 21.8 17.8

16

16 <13.2 53.0

Towns ----------------------

114

103 23.1 20.9

5

8.8 <18.5

rreutlen --------------------

172

l<l2 22.5 18.6

10

'1 58.1 28.2

,l,roup ----------------------

919

807 20.9 18.'1

<12

33 <15.7 40.9

'11urner ---------------------

235

201 21.7 18.5

15 21.3 7<1.6

'fwiggs ---------------------

271

2<12 29.7 20.5

15

10 55A <ll,3

Union ----------------------

208

211 27.1 27.5

10 33.7 47.4

Upson ----- ----------------

559

564 22.3 22.5

26

16 46.5 28.4

Walker ---------------------

653

5<13 21.0 17.5

18

15 27.6 27.6

Information and Statistics

253

TABLE 8-Continued
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County
Walton --------------------Ware ---------------------Warren -------------------Washington ----------------Wayne ---------------------
Webster -------------------Wheeler --------------------
White ---------------------Whitfield ------------------Wilcox --------------------Will<es --------------------Wilkinson ------------------
Worth ----------------------
Camp Wheeler ---------------l!-,ort Oglethorpe -------------Fort Screven ---------------~avannah Air Base__________ li10rt Benning --------------Naval Reserve Air :Base______
'lurner Field ---------------Fort McPherson -----------Camp Stewart -------------Residents of Geo1gia, births
occurring in other states -

LIVE BIRTHS

Rate per 1,000

Number

Population

1941 1940 1941 1940

STILLBIRTHS

Rate per I,000

Number

Live Births

1941 1940 1941 1940

452 12<1 21.8 20.'1

21

19 46.5 <1<1.3

6H 581 24.1 20.8

36

34 53.4 58.;-J

208

234 20.3 22.9

7

12 33.7 51.3

53<1

586 22.0 21!.2

<10

26 7<1.9 <HA

35<1

36<1 27.0 27.7

16

12 <15.2 33.0

109

81 23.1 17.1

7

8 6<1.2 98.8

182

171 21.3 20.0

<1 27.5 23.4

135

175 21.0 27.3

59.3 34.3

585

565 22.4 21.6

19

21 32.5 37.2

22<1

273 17.6 21.'1

8

15 35.7 5<1.9

328

306 21.7 20.3

25

28 76.2 91.5

23;)

2<!1! 21.3 22.1

15

14 63.8 57 A

,178

513 22A 24.0

28

34 58.6 66.3

3

5 <1 G9 1

2

3.Jl

218

NO'!'E: 'l'hese figures are allocated to county of residence and exclude non-residents of Georgia. Only the state totals include residents of Georgia, birth occurring in other states.
19<11 County totals exclude births occurring in a government fort or camp located in that county.

254

Georgia Department of Public. Health

TABLE 9
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

Number 1941 1940

Rate per I ,000 Live Births 1941 1940

TOTAL
Appling ----------------------Atkinson --------------------Bacon -----------------------Baker -----------------------Baldwin ---------------------Banks -----------------------Barrow ------------------- __ _ Bartow ----------------------Ben Hill ---------------------Berrien ----------------------Bibb ------------------------Bleckley ------~-------------- Brantley ---------------------Brooks -----------------------B1yan -----------------------Bulloch ---------------------Burke -----------------------Butts --~--------------------- Calhoun ---------------------Camden Candler Carroll
Catoosa ----------------------Charlton --------------------Chatham ---------------------Chattahoochee ---------------Chattooga -------------------Cherokee ---------------------Clarl<e -----------------------Clay ------------------------Clayton ----------------------Clinch -----------------------Cobb ------------------------Coffee -----------------------Colquitt ---------------------Columbia --------------------Cook ------------------------Coweta ----------------------Crawford --------------------Crisp ------------------------Dade ------------------------Da,vson ----------------------Decatur ----------------------DeKalb __ --------------------Dodge -----------------------Dooly -----------------------Dougherty __ -----------------Douglas ---------------------- _ Early ------------------------

3,955
11 9 13 6
22 41 20 15 139 8
5 38 13 H 31 15 21 8
50 11
8 155
4 12 32 29 11 21
7 39 35 ,!9 17
6 25 19 25
'! 2 39 68 26 27 37 15 28

3,737
11
19 1
31 13 lB 53 28 23 99 18 4 31 8 20 '10 6 2,!
12 49
6 11 131
7 18 28 35
5 10
7 32 36 42
5 11 25
8 33
2,! 75 18 18 30 18 35

58.3
33.4 50.3 62.8 38.5 71A 33.9 79.'1 78.1 71.7 45.5 74.7 3'!.3 28.7 75.5 89.7 25.1 42.5 71.1 91.3 51.6 45.8 69.3 63.6 65.0 61.7 56.3 26.8 73.2 58.1 66.7 109.9 65.'1 51.'1 58.6 68.2 79.8 24.2 51.9 119.5 61.3 33.9 21.3 77.1 '!0.0 58.7 63.8 63.2 73.5 62.6

57.8
38.7 48.6 101.6
6.2 93A 66.7 63.5 93.3 111.1 79.0 63.7 81.'1 23.1 62A 59.3 34.9 54.9 30.5 96A 35.2 87.0 72.7 32.'1 101.9 58.2 48.3 39.0 64.5 66.0 3'1.5 50.0 54.3 '!8.1 56.0 55.3 24.6 48.7 52.1 <11.2 77.6 16.8 19.6 <!SA <!7.8 '!0.5 48.6 60.1 96.3 87.5

Rate per 1.000

Number

Live Births

1941 1940 1941 1940

315 342

4.6

5.8

3.0

3.5

2

1 11.2

5A

1

<1.8

5.3

4

11.9

2

10.3

1

3.6

6

3 11.<1

5.3

3

3.6 11.9

2

6.9

9

10

<1.8

6A

1

5.8

2

2

4.0

'1.0

2

2 13.8 14.8

2

3

3.6

5.2

3

5

<1.1

6.9

3

12.0

6.5

5 15.3 36.2

3

3

4.2

4.5

3

17.3

1

9.3

15

21

9.3

2.2

6.5

2

2

4.6

4.6

2

<1

4.0

7.5

13.8

5.2

5.0

9.3

7.8

3

<!

<J.O

6.0

2

2

3.4

3.1

12.5

<1.7

12.1

3

5

6.2 10.4

2

2 12.6 10.3

1

2.5

2A

8.4

3

2

5.9

4.0

0.6

2

1

<1.5

2.3

6

16.2

2

3

3.4

6.0

4

2.2 10.0

Information mvd Statistics

255

TABLE 9-Continued
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

Number 1941 1940

Rate per 1,00.0 Live Births
1941 1940

Rate per 1,000

Number

Live Births

1941 1940 1941 1940

Echols -----------------------

2

2 29.'1 28.6

1

H.3

Effingham --------------------

12

15 49.2 30.2

1

4.1

5.3

Elbert ----------------------.--

32

22 86.5 52A

2

2.7

<1.8

Emanuel ----------------------

42

32 83.7 60.0

2

<1.0

9.4

Evans ------------------------

17

H 91.9 31.9

5.8

Fanllin -----------------------

31

2<! 94.2 65.6

2.7

Fayette -----------------------

12

59 A <11.7

2

9.9

5.2

Floyd -------------------------

86

71 67.5 BOA

3

<1

2.4

3A

Forsyth -----------------------

5

9 21.1 39.5

2

1.2

8.8

Franldin ----------------------

15

16 <17.6 53.5

1

3

3.2 10.0

Fulton ------------------------ 41<1 386 51.6 52.6

19

23

2A

3.1

Gilmer ------------------------

17

73.3 30.9

1

<1.3

3.9

Glascoe!< ----------------------

6

7 5<1.5 79.5

18.2 11.'1

Glynn ------------------------

38

<!5 76.5 96.6

2

2.0

<1.3

Gordon -----------------------

19

22 112.2 52.5

3

6.7

2.'1

Grady ------------------------

21

31 <17.4 70.5

3

2

6.8

<1.5

01eene ------------------------

20

15 62.5 56.0

1

3.1

3.7

Gwinnett ----------------------

39

35 76.6 60.9

2

3.9

3.5

Habersham -------------------

19

19 59.7 49.2

2.6

Hall -------------------------

t!t!

<13 62.3 67.1

2

2.8

9.'1

Hancock ----------------------

10

19 31.8 62.1

1

3.2 19.6

Haralson ---------------------

10

9 4<1.8 32.5

4

17.9

3.6

Harris ------------------------

10

18 39.5 69.0

Had -------------------------

22

20 67.5 59.0

2

2

6.1

5.9

Heard ------------------------

12 50.'! 87.6

7.3

Hemy ------------------------

18

19 56.8 60.1

3

3.2

9.5

Houston ----------------------

13

16 <18.1 60.4

<1

14.8 11.3

Irwin -------------------------

20

18 70.4 71.7

3.5

4.0

Jackson ----------------------

29

18 67.0 42.9

<1

2.3

9.5

Jasper ------------------------

11

13 60.1 71.4

3

16.5

Jeff Davis --------------------

13

9 61.6 <15.7

1

9.5

5.1

Jefferson ----------------- ____

17

17 35.'1 32.6

3

1

6.3

1.9

Jenkins -----------------------

H

12 <Jl. 7 <12.0

2

1

6.0

3.5

Johnson ----------------------

11 25.0 <12.3

2

5.0

7.7

Jones

15 37.4 87.2

Lamar -----------------------

24

10 115.9 <19.3

1

4.9

Lanier -----------------------

6

70.6 39.5

2

23.5

Laurens ----------------------

37

57 51.2 72.2

5

<1.1

6.3

Lee --------------------------

H

15 93.3 80.2

2

2 13.3 10.7

Liberty -----------------------

13

20 71.4 111.7

2 5.5 11.2

Lincoln -----------------------

8

3 50.3 21.1

Long -------------------------

3

3 <12.3 48A

Lowndes

2'1

27 37.9 39A

2

8

3.2 11.7

Lumpl<in

3

3 25.6 21.0

8.5

McDuffie

12

12 <18.6 46.0

1

3.8

Mcintosh

6

10 <14.4 61.3

1

7.4

Macon ------------------------

38

35 80.2 90.9

3

5

6.3 13.0

Madison ----------------------

19

12 66.0 42.1

1\'larion -----------------------

16

15 88.4 71.8

1

5.5

lVIeriwether --------------------

24

19 49.8 39.9

5

3 lOA

6.3

256

Georgia Department of Pnblic. Health

TABLE 9-Continued DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES PER 1,000
LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

Number 1941 1940

Rate per 1,000 Live Births 1941 1940

llliller -----------------------

'1

Mitchell ----------------------

39

Monroe -----------------------

22

:Montgomery ------------------

13

)forgan -----------------------

14

1\funay -----------------------

18

Muscogee --------------------- 123

Newton -----------------------

18

Oconee -----------------------

9

Oglethorpe --------------------

25

Paulding ----------------------

18

Peach ------------------------

17

Pickens -----------------------

14

Pierce -----------------------

10

Pilre -------------------------

13

Pollr -------------------------

3<1

Pulasld -----------------------

15

Putnam ----------------------

16

Quitman ----------------------

4

Rablln ------------------------

10

Randolph ---------------------

17

Itichmond -------------------- 105

Roclrdale -------------~ -------

ll

Schley -----------------------

9

Screven

37

Seminole

16

Spalding

52

Stephens

7

Stewart -----------------------

ll

Sumter -----------------------

,11

Talbot ------------------------

13

1'aliaferro --------------------

4

~rattnall

13

'l'aylor

7

~relfair

12

~rerrell

23

Thon1as -----------------------

37

'l'ift --------------------------

31

'l100Ulbs -----------------------

18

To,vns ------------------------

3

1'reutlen ----------------------

9

'l'roup

M

'rurner

12

'rwiggs

18

Union

10

Upson

32

Wallrer -----------------------

27

Walton -----------------------

28

Ware -------------------------

31

VVarren -----------------------

13

19.3 38.0

35 67.2 58.3

H 9<1.'! 55.1

ll 74.3 69.6

23 '13.4 77.1

19 70.6 75.'1

65 58.4 '13.'1

20 '13.0 52.5

<1 81.1 3'1.5

27 82.5 97.1

10 65.7 39.'1

16 72.6 70.2

19 61.4 89.2

10 35.2 32.5

H

61.0 57.1

,g 56.6 70.7

5 71.4 26.7

12 79.6 56.6

'1 43.0 51.9

54.6 17.9

13 48.3 52.5

75 57.6 '16.6

14 93.2 93.3

10 66.2 8'1.0

'13 80.8 88.8

10 69.6 '18.1

53 101.8 103.3

10 23.9 33.8

12 5L1.2 6'1.9

39 73.5 74.1

30 72.6 158.7

8 35.1 53.3

2 52.6

8.3

'1 39.5 18.2

15 3<1.2 48.1

37 51.2 85.8

33 54.8 56.7

27 71.6 68.5

9 48.6 29.8

10 26.3 97.1

5 52.3 35.2

55 69.6 63.2

12 51.1 59.7

13 66.'! 53.7

17 48.1 80.6

33 57.2 58.5

22 4.1.3 40.5

30 61.9 70.8

15 46.0 25.8

17 62.5 72.6

Rate per 1,000

Number

Live Births

1941 1940 1941 1940

2

3

3.4

5.0

1

3.9

1

6.3

3

3 10.4

8.3

3.8

4.7

2

5.3

2

18.0

8.6

3.3

3.6

2

3

8.5 13.2

4.'1

3 10.6

9.7

2

3

9.4 12.2

2

1

3.3

1.6

1

5.0

1

13.0

11.4

11

3.3

6.8

3

1 22.1

3.4

3

2

6.6

4.1

2

2

8.7

9.6

7

2 13.7

3.9

2

2

6.8

6.8

2

1

9.9

5.4

5

5

9.0

9.5

2

10.6

2

1

8.1

4.1

3

1 16.9

4.5

2

2

5.7

6.4

2

5

4.5 11.6

5

1.5

8.6

2

9.2

5.1

2.7

2

2 11.6 14.1

13

3 14.1

3.7

2

8.5

2

1

1A

4.1

2

3.6

3.5

2

3.1

1.8

2

6.6

'1.7

3

7.'1

5.2

2

3

9.6 12.8

Information and Statistics

257

TABLE 9-Continued
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1940 AND 1941

Count~

Number 1941 1940

Rate per 1,000 Live Births
1941 1940

Washington ------------------- 25 29 <16.8 <19.5

Wayne ----------------------- 1<1 13 39.5 35.7

Webster ---------------------- 7

64.2 12.3

Wheeler ----------------------

7

8 38.5 46.8

White - - - - - - - - ---------------~

8 11 59.3 62.9

Whitfield --------------- ------ t!<! <10 75.2 70.8

Wilcox ----------------------- 12 12 53.6 <14.0

Wilkes ------------------------ 1<1 12 42.7 39.2

Willdnson --------------------- 18 20 76.6 82.0

Worth ------------------------ 26 <15 54.4 87.7

Residents of Georgia,

death occurring in other states

23

15

Rate uer I,000

Number

Live Births

1941 1940 1941 1940

2

4

3.7

6.8

1

2.7

1

9.2

5.5

5.8

5.1

5.3

2

1

8.9

3.7

6 3.0 19.6

<1.3

4.1

1

2.1

1.9

5

NO'l'E: '.rhese figures are allocated to county of residence and exclude non-residents of Georgia. Only the state totals include residents of Georgia dying in other states.

258

Georgia Department of Public, Health

TABLE 10
DEATHS AND DEATH RATES PER 1,000 POPULATION IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County
'l'OTAL Appling -----Atldnson ____ _ Bacon ______ _
Balmr ------Baldwin _____
Banks -------
Bal'l'OW ______
Bartow _____ _ Ben Hill

DEATHS Rate per 1,000
Number Population

1941 1940 1941 1940

31579 32285 10.0 10.3

78

89 5.4 6.1

<18

68 6.8 9.6

78

79 9.6 9.3

40

56 5A 7.6

211 238 12.9 13.8

66

63 1.6 7.8

133 118 10.6 9.0

280 316 11.1 12.5

H5 191 10.0 13.2

Berrien

98 Ill 6.4 1.2

Bibb -------- 1204 1172 HA 14.0

Biecl<ley ____ _

87 106 9.0 11.0

Brantley

59

62 8.6 9.0

Brool<S _____ _ 131 2H 3.8 10.4

Btyan ______ _

81

89 12.9 1<1.2

Bulloch _____ _ 159 192 6.1 7.'1

Burl<e ------- 315 330 11.9 12.'1

Butts -------- 125

99 13.6 10.8

Calhoun

115 113 11.0 10.8

Camden

89

11 15.1 13.0

Candler

16

93 8.3 10.2

Cart oil

292 327 8.5 9.6

Catoosa

65

65 6.0 5.3

Charlton -----

36

52 6.8 9.9

Chatham

1110 1792 15.0 15.2

Chattahoochee

26

68 5.1 4.5

Chattooga ___ _

75 116 4.0 6.3

Cherol<ee ____ _ 190 190 9.4 9.'1

Clatl<e ------- 344 349 12.1 12.3

Clay

16

61 10.8 8.6

Clayton _____ _ 12<1

90 10.6 7.7

Clinch -------

<12

56 6.5 8.7

Cobb _______ _ 385 352 10.1 9.2

Coffee ------- 196 190 9.1 8.8

Colquitt

287 268 8.7 8.1

Columbia ____

92

80 9.8 8.5

Cook --------

95

91 8.0 8.1

Coweta _____ _ 238 250 8.8 9.3

Crawfonl ___ _ 104

78 H.6 10.9

Crisp -------- 191 210 10.9 12.0

Dade __ ------

23

33 4.8 5.6

Dawson

23

18 5.1 <J.O

Decatur

252 250 11.3 11.2

De!{ a l b

769 116 8.8 8.2

Dodge ______ 182 158 8.7 7.5

County
Dooly Dougherty ---Douglas Early _______ _
Echols ------Effingham __ _ Elbert ------Emanuel ----Evans ______ _
Fannin -----Fayette -----Floyd _______ _
Forsyth -----Franldin ----Fulton ______ _
Gilmer ------Glaseoclr ____ _ Glynn Gordon
Grally Greene Gwinnett ----Habersham __ _ Hall ________ _
Hancoclr _____ Haralson -----Harris . ------Hart Heard -------
Henry ------Houston ----Irwin Jaclmon Jasper
Jeff Davis __ _ Jefferson ----J enl<ins -----Johnson ----Jones -------Lamar _______
Lanier ------Laurens ----Lee ________ _ Liberty
Lincoln -----Long --------

DEATHS Rate per 1,000
Number PoJ)ulation
1941 1940 1941 1940
166 181 9.8 10.7 383 311 13.4 13.1
35 102 8.5 10.1 H8 183 1.9 9.8

17

21 5.7 7.1

10<1 113 10.8 11.7

203 191 10.3 9.7

2<13 247 10.3 10.5

83

89 11.2 12.0

127 121 8.6 8.2

75

73 9.2 8.9

5<19 567 9.8 10.1

52

49 <1.6 <1.3

1H 135 7.3 8.6

<1<172 <1579 11.4 11.7

80

10 8.9 7.8

26

32 5.7 1.0

293 28.0 13.4 12.8

113 134 6.1 7.3

150 201 1.6 10.2 132 160 9.6 11.7 228 229 7.8 1.9 121 141 8.2 9.5 300 291 8.6 SA

82 148 6.4 11.6

83 102 5.8 7.1

110 151 9.6 13.2

121 124 7.8 8.0

43

77 5.0 8.9

178 154 11.8 10.2

109 119 9.6 10.5

68

95 5.3 7.3

157 151 7.8 7.5

98 122 11.2 13.9

79

64 8.9 7.2

111 174 8.8 8.7

112 115 9.5 9.7

46

59 3.6 4.6

75

19 9.0 9.5

121 111 12.0 11.0

40

37 7.1 6.6

327 386 9.7 11.5

91

91 11.6 12.4

100 121 11.6 14.1

<16

32 6.5 <1.5

23

36 5.6 8.8

Information and Statistics

259

TABLE I0-Continued DEATHS AND DEATH RATES PER 1,000 POPULATION IN EACH COUNTY IN GEORGIA:
1940 AND 1941

County
Lowndes
l.;lllUP]dn
McDuffie Mcintosh Macon ------Madison ____ _
Marion -----l\leriwether __ Miller _______
:VIitc:hell -----
Monroe -----1\Iontgomery __ l\'Iorgan _____ _
Murray -----l\Iuscogee ___ _
Newton __ ---Oconee -----Oglethorpe ___ Paulding ____ _
1'each ------Pid;:ens _____ _
Pierce ------Pi!;e _________
Polk -------Pulasl<i ______
Putnam _______ Quitman _____
Rabun ------Randolph Richmond ____
Rockdttle ____ _ Schley Screven -----Seminole Spahling
Stephens Stewart -----Sumter -----Talbot ------Taliaferro ____
'1'attnall '1'aylor Telfair

DEATHS Rate per 1,000
Number Population 1941 1940 1941 1940

273 332 8.6 10.4

37

30 5.9 4.8

100 113 9.2 lOA

8<1

88 15.9 16.6

188 197 11.8 12A

117 121 8.7 9.0

73

99 10.5 1<1.2

246 226 11.2 10.2

61

<17 6.1 4.7

228 218 9.8 9A

1<15 141 13.5 13.1

77

79 8.0 8.2

126 162 9.9 12.7

66 119 5.9 10.7

938 773 12A 10.2

198 218 10.7 11.7

72

53 9.5 7.0

132 14<1 10.6 11.6

102

94 7.9 7.3

120 117 11.6 11.3

79

84 8.6 9.2

104 103 8.8 8. 7

109 125 10.5 12.0

228 235 8.0 8.3

93

90 9.5 9.2

120 100 1<1.1 11.7

37

32 10.8 9.3

35

28 4.5 3.6

165 204 9.9 12.3

1081 1020 13.2 12.5

88

77 11.4 10.0

66

47 13.1 9.3

197 246 9.7 12.1

67

54 7.9 6.'1

341 329 12.0 11.6

56

86 4.3 6.6

89 112 8.4 10.6

283 297 11.6 12.1

80 130 9.8 16.0

61

57 9.7 9.1

99

89 6.1 5.5

71

84 6.6 7.8

136 146 9.0 9.6

County Ten ell 'l'homas ______
Tift --------Toombs ______ '!'owns -------

DEATHS Rate per I,000
Number Population 1941 1940 1941 1940

183 212 11.0 12.7

307 311 9.8 9.9

188 176 10.1 9.5

137 118 8.1 7.0

28

19 5.7 3.9

'l'1entlen -----

69

60 9.0 7.9

Troup

<192 496 11.2 11.3

'l'urner

80

97 1A 8.9

Twiggs

107

89 11.7 9.8

Pnion

<19

63 6.4 8.2

Upson

203 2<12 8.1 9. 7

Wall<er _____ _ 184 186 5.9 6.0

Walton ------ 223 219 11.0 10.5

Ware -------- 287 292 10.3 10.5

Warren ______

98 100 9.6 9.8

Washington __ 230 22<1 9.5 9.2

Wayne -------

7<1

85 5.6 6.5

Webster ____ _

24

34 5.1 7.2

Wheeler -----

'19

<12 5.7 <1.9

White ______ _

59

<10 9.2 6.2

Whitfield ___ _ 222 2<15 8.5 9.4

Wilcox ______

82

84 6.4 6.6

Wilkes

151 182 10.2 12.1

Willdnson ___ _ 115 132 lOA 12.0 Worth _______ 187 217 8.7 10.2

Camp Wheeler

9

Cochran Field

!

Fort Oglethorpe 10

Fort Screven

1

Savannah Air :Base 8

Fort Benning

36

Lawson General

Hospital

Turner Field

5

Darr Aero 'l'ech

3

Fort McPherson

5

Camp Stewart

Georgia Aero ~Pech 1

Augusta Air Base 4

Residents of GeOl"gia death occurring in other states <175 310

NOTE: These figures are allocated to county of residence and exclude non-1esidents of Georgia. Only the state totals include residents of Georgia dying in other states.
1941 county totals exclude deaths of men in the armed fOl"ces stationed in a government fort or camp located in that county.

260

Georgia Department of Public, Health

TABLE II
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND MALARIA IN EACH COUNTY IN GEORGIA: 1940 AND 1941

Ccllnty
TOTAL
Appling ----------------------At.ldnson Bacon -----------------------Baker ------------------------
Baldwin ---------------------Banks -----------------------Barro'\v ----------------------Bartow ----------------------Ben Hill ----------------------
Berrien ----------------------Bibb ------------------------Biecl<ley ---------------------Brantley ---------------------Broo1;;:s
Bryan -----------------------Bulloch ----------------------Burl;;:e -----------------------Butts ------------------------Calhoun
Camden Candler Carroll Catoosa Charlton
Chatham Chattahoochee ----------------Chattooga -------------------Cherokee --------------------Cla!'l<e ------------------------
Clay -------------------------Clayton ---------------- ______ _ Clinch -----------------------Cobb ------------------------Coffee ------------------------
Colquitt Columbia --------------------Cool< ------------------------Coweta ----------------------Crawford ---------------------
CrisP ------------------------Dade -------"----------------Dawson -----------------------

Information and Statistics

261

TABLI;: 11-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND MALARIA IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County
Decatur DeKalb Dodge -----------------------Doo!y Dougherty
Douglas Early Echols -----------------------Effingham -------------------Elbert _______________________ _
Emanuel ---------------------Evans -----------------------Fannin ----------------------Fayette ----------------------Floyd ------------------------
Forsyth ----------------------Franldin ---------------------Fulton -----------------------Gilmer -----------------------Glascoe!< ----------------------
Glynn -----------------------Gordon ----------------------Grady -----------------------Greene Gwinnett
Habersham -------------------Hall -------------------------Hancock ---------------------Haralson ---------------------Harris ------------------------
Hart Heard -----------------------Henry -----------------------Houston ---------------------Irwin -------------------------
Jacll:son ----------------------Jasper -----------------------Jeff Davis ___________________ _ Jefferson Jenldns
Johnson ---------------------Jones ------------------------Lamar ________ ----------------

TYPHOID

Number 1941 1940

Rate per I 00,000 Population 1941 1940

<1.8

<1.8

5.9

2

19.9

5A

10.2

<!.3

<1.3

13.5 13.5

12.2

17.7

3

0.8

0.3

22.0

7.3

7.0

1

11.6

1

6.6

1

7.7

7.7

1

llA

11.3

1

8.4

7.7

MALARIA

Number 1941 1940

Rate per I 00,000 Population 1941 1940

2

4.5

9.0

1

1.2

3

<1.8 H.3

2

1 ll.8

5.9

4

14.0

3.5

5A 16.1

12.8

1

12.2

1

1.8

0.3 ll.1

5.1

7.0

6.6 8.8 7.7
5.0

11.3 11.3

15.0

5.0

2

7.7 15.'!

262

Georgia Department of Publi~ Health

TABLE 11-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND MALARIA IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County
Lanier -----------------------Laurens ------------------- __ _ Lee -------------------------Liberty Lincoln -----------------------
Long ------------------------Lowndes Lumpldn McDuffie Mcintosh
l\Iacon -----------------------Madison ---------------------Marion ----------------------Meriwether ------------------Miller ------------------------
Mitchell --------------------- _ Momoe ----------------------Montgomel'Y -----------------Morgan ----------------------Murray -----------------------
l\'Iuscogee --------------------Newton ----------------------Oconee --------~------------: Oglethorpe -------------------Paulding ---------------------
Peach -----------------------Picl<ens ----------------------Pierce -----------------------Pil<e _______ -----------------Poll< -------------------------
Pulasld Putnam Quitman Rabtln -----------------------Randolph ---------------------
Richmond Rocl<dale Schley _ Screven Seminole
Spalding Stephens Stewart -----------------------

TYPHOID

Rate per

I 00,000

Number

Population

1941 1940 1941 1940

MALARIA

Rate 11er

I 00,000

Number

Population

1941 1940 1941 1940

3.0

4

11.9

8.9

2

25.5

2

25.5

11.6

11.6

'1

3.1 12.6

4

36.8

9.2

9.2 2 18.9 37.8

6.3

6.3

TA 7A

3

'13.1

4.5

1

1

6.3

6.3

4.5 10.0

I

2

4.3

8.6

1

4.3

1

9.3

10.3

9.0

9.0

1

1.3

1.3

2

2.6

2

10.3

8.0

1

9.6

2

21.9

1

9.6

2

7.0

1

11.7

3

30.5

2

12.0 18.1

2

2.4

19.9 3 2

1<1.7 14.7 23.6

2

7.0

3.5

Information and Statistics

263

TABLE 11-Continued DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID A~D MALARIA
IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

Sumter ----------------------Talbot _______________________ _
~raliaferro
Tattnall Taylor Telfair

Terrell Thomas Tift -------------------------'l'oombs ----------- ___ --------To,vns ------------------------

'l,reutlen '11roup Turner Twiggs Union

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

Upson Walker Walton Ware ------------------------Warren -----------------------
Washington _______ -----------Wayne Webster ----------------------Wheeler ---------------------White ------------------------
Whitfield -----------------Wilcox Wilkes Will<inson --------------------Worth -----------------------Residents of Georgia, death
occurring in other states____ _

TYPHOID

Rate per

I 00,000

Number

Population

1941 1940 1941 1940

'1

16.3

6.2

6.6

6.6

6.0 3.2 10.8

1

2.3

11.0

4.3 3.6
'1.1

1

3.8

19.9 9.1 t!.7

MALARIA

Rate per

I 00,000

Number

Population

1941 1940 1941 1940

'1

16.3

13.2

6.6

5

6.0 30.0

3.2

3.2

1

5.'1

5A

'1

3 23.6 17.7

13.1

9.2

9.2

'1.1

4.1

2

15.2

7.6

21.2

1

11.7

3.8

3

1 23.5

7.8

1

6.6

1

9.1

2

9.4

NOTE: These figures are allorated to eounty of residence and exclude non-residents of Georgia. Only the state totals include residents of Georgia dying in other states.

2M

Georgia Department of Public. Health

TABLE 12
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TUBERCULOSIS AND CANCER IN EACH COUNTY IN GEORGIA: 1940 AND 194f

County

TUBERCULOSIS

Rate per I00,000

Number

Population

1941 1940 1941 1940

CANCER

Rate per I00,000

Number

Population

IMI IMO IMI IMO

'l'OTAL

1385 1533 4<1.0 '19.1 2139 1959 68.0 62.7

Appling -----------------------

'1

5 27.6 3'1.5

Atkinson

1

1<1.1 28.2

2

2 28.2 28.2

Bacon

1

12A

2 12.'1

Balcer ------------------------

4

1 '10.8 13.6

Baldwin ----------------------

12 5'1.8 73.1

18

15 109.7 87.3

Bani\:8 ------------------------

3 11.5 3<1.<1

3'1.'1 68.7

Barro"\V -----------------------

2

15.3 38.3

13 '15.9 99.5

Bartow -----------------------

12

8 47.5 31.6

17

20 67.2 79.1

Ben Hill ----------------------

4

9 27.5 62.0

3'1.'1 55.1

Berrien -----------------------

2

13.0

11

8 71.6 52.0

Bibb -------------------------

58

63 69.2 75.2

82

76 97.9 90.7

BleckleY ----------------------

2 lOA 20.7

6

'1 62.1 <11.4

Brantley ----------------------

2

29.1 H.6

'1

58.2 1<1.6

Brooks

4.9

9.8

11

53.7 34.2

Bryan Bulloch Burke ---------- ------------Butts ------------------------Calhoun
Camden Candler Carroll Catoosa ----------------------Charlton ----------------------
Chatham ---------------------Chattahoochee Chattooga --------------------Cherokee --------------------Clarl<e ------------------------
Clay -------------------------Clayton ----------------------Clinch -----------------------Cobb ------------------------Coffee ------------------------
Colquitt ---------------------Columbia --------------------Coole ------------------------Coweta __ ------------------Crawford ----------------- ___ _ Crisp _ c_____________________ _
Dade ------------------------Dawson Decatur DeKalb

3

47.7 79.5

15.9 95.4

4

15.'1 19.2

11

5 '12.3 19.2

20

18 75.4 67.9

20

1<1 75.4 52.8

4

3 '13.6 32.7

7

2 76.2 21.8

28.7

9.6

57.5 47.9

50.8 16.9

2 8'1.6 33.8

11.0 33.0

2 11.0 22.0

8

17 23.'1 '19.8

17

31 49.8 90.8

5

2 45.9 16.'1

3

'1 27.5 32.8

1 19.0 19.0

2

2 38.1 38.1

83 109 70.4 92.<1 112 102 9'1.9 86.5

3

58.'1

6.6

2

2 38.9 13.2

3

15 16.2 80.9

'1

6 21.6 32.4

7

1<1 34.8 69.6

18

10 89.'1 49.7

11

6 38.7 21.1

26

26 91.6 91.6

2

28.3 42.5

3

3 '12.5 42.5

4

3'1.3 '12.9

9

8 77.2 68.6

2

31.1

2

31.1

12

17 31.'1 tlt1.4

26

22 67.9 57.5

4

7 18.6 32.5

9

'11.8 37.1

1

3.0

3.0

17

51.5 27.3

2 10.6 21.2

'1

10 42.4 106.0

'1

4 33.6 33.6

'1 75.5 33.6

10

18 37.1 66.7

18

16 66.7 59.3

3

'12.1 '12.1

2

'1 28.1 56.1

'1

11 22.8 62.7

11

12 62.7 68.4

2

2 33.9 33.9

3

3 50.9 50.9

2 22.3 '1<1.7

8

13 36.0 58.5

13

10 58.5 '15.0

40

37 46.0 42.6

71

73 81.7 84.0

Information and Statistics

265

TABLE 12-Continued DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TUBERCULOSIS AND
CANCER IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County
Dodge -----------------------Dooly -----------------------Dougherty -------------------Douglas ---------------------Early ------------------------

TUBERCULOSIS

Rate per I00,000

Number

Population

1941 1940 1941 1940

CANCER

Rate 11er I00,000

Number

Population

1941 1940 1941 1940

4 19.0 19.0

11

10 52.3 17.6

8 35.5 17.'1

53.3 53.3

15

2t1 52.5 84.0

30

29 105.0 101.5

3

29.8 49.7

5

6 19.7 59.7

2

10.7 16.1

7 18.2 37.5

Echols ------------------------

1 lOU! 33.7

1

33.7

Effingham --------------------

5 <11.5 51.8

1

<!1.5 51.8

Elbert ------------------------

30.6 15.9

16

81.6 : 40.8

Enlanuel ----------------------

2

1

8.5 17.0

17

11 72.3 16.8

Eval1S ------------------------

3

10.5

10.5 67.6

Fannin --------- --------------

il 33.9 27.1

61.0 51.2

Fayette -----------------------

4

19.0.

6

13A 85.7

Floyd ------------------------

33

38 58.8 67.7

56

13 99.7 76.6

Forsyth ------------------------

2

2 17.7 17.7

3 61.8 26.5

Franldin ----------------------

2

12.8 32.1

57.6 25.6

Fulton ------------------------ 305 313 77.6 79.7 390 331 99.3 81.2

Gilmer -----------------------

1

3 11.1 33.3

6

7 66.7 77.8

Glascoe!;;: --------------------- _

1

22.0 22.0

2

44.0

Glynn -------------------------

15

12 68.4 54.7

13

17 59.3 77.6

Gordon ------------------- __ _

3

10 16.3 5t1.2

7

10 38.0 51.2

Grady -------------------------

3

6 15.3 30.5

11

17 56.0 86.5

Greene -----------------------

6

9 13.8 65.7

8 13.8 58.'1

Gwinnett ---------------------

1

6 13.8 20.6

21

12 72.2 41.3

Habersham --------------------

5

11 33.9 7<1.5

8

8 51.2 54.2

Hall --------------------------

12

13 31.5 37.3

18

23 51.7 66.1

Hancoclt _______________;______ _

4

31.3 39.2

8

12 62.7 91.0

Haralson ---------------------

2

13.9

5

31.8 31.8

liarris ------------------------
Hart -------------------------Heard

5 35.0 43.8

10

13 87.5 113.8

4 25.8 25.8

3

10 19.3 61.5

2 11.6 23.2

4

16.5

Henry Houston ----------------------Irwin -----------------------J aclison ----------------------Jasper ------------------------
Jeff Davis ------------~------ Jefferson --------------------J enl<ins ----------------------Johnson ---------------------Jones -------------------------
J..~an1ar ------------ __ .:. ________ _ Lanier -----------------------Laurens ----------------------Lee --------------------------Liberty -----------------------

3

6 19.8 39.7

16

15 105.8 99.2

5 26.5 44.2

1

4 35.'1 35.4

1

7.7

2

3 15.5 23.2

2

2 10.0 10.0

11

54.8 39.8

7 34.2 79.8

1

11.'1 91.2

2

2 22.6 22.6

1

1 15.2 11.3

7

10 34.9 19.9

7

31.9 25.0

8

67.6 76.0

8

67.6 50.7

2

15.4

1

7.7 38.6

5

2 60.0

7

84.0 72.0

2

5 19.8 19.5

5

8 19',5 79.3

3

53.3

4

71.0 17.8

8

23.8 26.8

24

16 71.'1 17.6

1

7 12.8 89.3

7

2 89.3 25.5

7

1 81.4 46.5

1

3 16.5 31.9

266

Georgia Department of Public. Health

TABLE 12-Continued

DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TUBERCULOSIS AND

-------====C=AN=C=ER==IN=E=AC=H=C=O=UN=T=Y =IN==GE=O=RG=IA=: =1=94=0 =AN=D=1=94=1 =======

TUBERCULOSIS

CANCER

Rate per I 00,000

Rate ner I 00,000

Number

Population

Number

Ponulation

County

1941 1940 1941 1940 1941 1940 1941 1940

Lincoln ----------------------Long ------------------------Lowndes Lumpkin McDuffie

1<1.2

71.0 <12.6

2

<18.9

24.5 73.'1

9

11 28.2 3<1.5

19

1<1 59.6 43.9

5

80.3 16.1

2

I 32.1 16.1

2

!SA 46.0

10

10 91.9 91.9

Mcintosh

2

37.8

6 18.9 113.4

Macon ------------------ _____ _

31.4 37.6

9

4 56.'1 2G.I

1\fadison ----------------------

2 37.2 14.9

5

13 37.2 96.8

Marion -----------------------

2

28.8 HA

3

9 <13.1 129.4

Meriwether -------------------

11

15 49.9 68.0

18

13 81.6 58.9

Miller -----------------------Mitchell ---------------------1\Ionroe ----------------------1\Iontgomery ------------------1\Iorgan _____ ------- -----------

2 10.0 20.0

7

8.6 30.1

15

5 55.8 <16.5

6

I

10.3

4 <17.2 31.5

60.0 64.5 38.7 55.8 27.9 !lA <1IA 70.8 70.8

l\Iurray ----------------------1\'Iuscogee --------- ------- ____ -~-
Newton ---------------------Oconee ----------------------Oglethorpe --------------------

5 53.9 <14.9

2

18.0 80.8

40 58.3 :):;;.o

H5

55 86.1 72.9

12 37.7 6<1.6

18

96.9 <13.1

2 26A 26A

<1

3 52.8 39.6

5 32.2 40.2

1<1 <18.3 112.6

Paulding ----------------------

2

5 15.6 39.0

3 5<1.6 23.'1

Peach ------------------------

6

4 57.8 38.5

4

38.5 67.5

Piclwns -----------------------

4 5<1.7 <13.8

6

65.7 65.7

Pierce ------------------------

59.3 25.'1

50.8 33.9

Pike

6 67.5 57.8

28.9 57.8

Polk

17

15 59.7 52.7

20

10 70.3 35.1

Pulaski -----------------------

I

4 10.2 <10.7

5

5 50.9 50.9

Putnam -----------------------

<1

3 <17.0 35.2

<1

10 47.0 117.5

Quitman ----------------------

2 29.1 58.2

3

87.3 87.3

Rabun ------------------------

2

25.6

2 12.8 25.6

Randolph

<1

12 2<1.1 72.2

1<1

16 8<1.3 96.3

Richmond

83

60 101.4 73.3

70

65 85.5 79.4

Rockdale ---------------------

12.9

4 51.8 51.8

Schley -----------------------Screven

3

2 59.6 39.7

7

12 34.4 59.0

39.7 99.3 29.5 34.4

Seminole

Spalding

13

Stephens

Stewart

Sumter -----------------------

11

Talbot -----------------------Taliaferro -------------------Tattnall ---------------------'l'aylor
Telfair ------------------------

2

23.6

2

23.6 58.9

<15.7 2<1.6

20

22 70.<1 77.4

7.7 15A

7

4 5<1.0 30.8

7

66.0

10 28.3 94.3

5 4<1.9 20A

18

16 73.5 65.3

1 <19.1 12.3

24.6 49.1

4 63.7 63.7

79.6 95.6

2 55A 12.3

30.8 <13.1

27.9

9.3

3

4 27.9 37.1

19.8 19.8

4

26.4 19.8

Information and Statistics

267

TABLE 12-Continued
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TUBERCULOSIS AND CANCER IN EACH COUNTY IN GEORGIA: 1940 AND 1941

County

TUBERCULOSIS

Rate per I 00,000

Number

Population

1941 1940 1941 1940

CANCER

Rate per I 00,000

Number

Population

1941 1940 1941 1940

Terrell

'11homas ----------------------

17

Tift ------------------------- _

~roombs -----------------------

3

'l'o\VllS ------------------------

30.0 <18.0

10 <18.0 60.0

8 54.3 25.6

22

11 70.3 35.2

26.9 37.6

H

12 75.3 6<1.5

3 17.7 17.7

7

<11.3 29.5

20.3

5

101.5 20.3

TreuL!en ----------------------

39.3

'!'roup

26

31 59.3 70.6

38

32 86.6 72.9

Turner

2

3 18.4 27.7

8

5 73.8 46.1

rwiggs

2

3 21.9 32.9

<1 76.8 43.9

Union

13.0 13.0

5 52.1 65.1

Upson

5

16 19.9 63.8

10

12 39.9 47.9

Wall<er

12

19 38.7 61.2

17

13 54.8 <11.9

Walton

3

6 14.4 28.9

19

11 <13.3 52.9

Ware ------------------------Warren -----------------------

8

11 28.6 39.4

21

20 75.2 71.6

4

7 39.1 68.4

7

<1 68.4 39.1

Washington -------------------

11

Wayne -----------------------

4

Webster

Wheeler ----------------------

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

5

3 <15.4 12.4

13

8 53.7 33.0

2 30.5 15.2

4'

2 30.5 15.2

2

42.3

21.2

11.7

<1

<16.9

77.9 15.6

3

<16.8

Whitfield ---------------------

16

15 61.3 57.5

16

20 61.3 76.6

Wilcox

1 23.5

7.8

<1

7.8 31.4

Will<es

4

10 26.5 66.3

13

13 86.2 86.2

Will<inson ---------------------

4

36.3 27.2

8

5 72.6 45.4

\Yorth ------------------------

11 37.4 51.5

8 42.1 37.4

:H'ort Benning ----------------Lawson General HospitaL_____ _

Residents of Georgia, death

occurring in other states_____ _

57

2 1

37

33

NOTE: These figures are allocated to county of residence and exclude non-residents of Georgia. Only the state totals include residents of Georgia dying in other states.
1941 county totals exclude deaths of men in the armed forces stationed in a government fort or camp located in that county.

268

Georgia. Department of Public, Health

TABLE 13 DEATHS AND DEATH RATES PER I 00,000 POPULATION FROM PELLAGRA AND
PNEUMONIA IN EACH COUNTY, IN GEORGIA: 1940 AND 1941

County

PELLAGRA

PNEUMONIA

Rate per I 00,000

Rata per I00,000

Number

Population

Number

Population

1941 1940 1941 1940 -1941 1940 1941 1940

'fO'l'AL ------------------- 204 235 6.5 7.5 1714 2055 54.5 65.8

Appling -----------------------

10 3!.5 69.0

Atkinson ----------------------

5

! 70.5 56 A

Bacon ------------------------

! 111.2 19.'1

Bal;:er ------------------------

5

68.1 108.9

Baldwin ----------------------

5.8

13

2<! 79.2 139.6

Banlrs ------------------------

11.5

!

3 !5.8 3!A

Barrow ------------------------

1

1

7.7

7.7

10

10 76.5 76.5

Bal'tow -----------------------

1

3

<!,0 11.9

17

2<1 67.2 94.9

Ben Hill ----------------------

2

1 13,8

6.0

15

13 103.3 80.5

Berrien ----------------------Bibb ------------------------- 16
Bleckley ---------------------Brantley --------------------Broolrs ----------------------- !

6.5

5

! 32.5 26.0

19.1 10.7

52

59 62.1 70.4

2

20.7

5

3 51.8 31.1

1

14.6

5

7 72.8 101.9

! 19.5 19.5

11

13 53.7 63A

~~{@~~======================= /

2 3

Butts ------------------------ 2

Calhoun ----------------------

31.8

2

31.8 95.4

11.5

11 30.8 !2.3

11.3 11.3

16

21 60.3 79.2

1 21.8 10.9

9

7 98.0 76.2

5

47.9 67.1

Camden ---------------------Candler ----------------------Carroll ----------------------Catoosa ---------------------Charlton ----------------------

16.9

3

50.8 8!.6

10 33.0 100.9

2.9

16

19 <!6.8 55.6

5

3 15.9 24.6

19.0

Chatham --------------------- 16 11 13.6 0.3 90 102 83.9 86.5

Chattahoochee ----------------

2

4 38.9 26.4

Chattooga ---------------------

2

10.8

!

1 21.6

5A

Cherol<ee ---------------------

5.0

5.0

19

14 04.'! 69.6

Clarke ----------------------- 2

7.0 1<!.1

12

30 42.3 105.6

Clay ------------------------- 1 Clayton ---------------------()linch ----------------- -----Cobb -------------------------Coffee ------------------------

14.2

127.'! 99.1

3 51.5 25.7

2

5 31.1 77.7

2.6

7.8

18

20 <!7.0 52.3

0.3 13.9

19

19 88.2 88.2

Colquitt ----------------------

3

9.1

3.0

19

32 57.6 96.9

Columbia ---------------------

10.6

5

8 53.0 84.8

Cool< --------- ----------------

2

16.8

5 50.3 41.9

Coweta -----------------------

2

3.7

1A

15

33 55.6 122.3

Cl'awford ---------------------

H.O

7

4 98.2 56.1

Crisp -------------------------

5.7

8

7 !5.6 39.9

Dade -------------------------

1

2 17.0 33.9

Dawson -----------------------

Decatur ----------------------

1

4.5

7

13 31.5 58.5

DeKalb -----------------------

7

3

8.1

3.5

35

28 40.3 32.2

Information and Statistics

269

TABLE IS-Continued DEATHS AND DEATH RATES PER I00,000 POPULATION FROM PELLAGRA 'AND
PNEUMONIA IN EACH COUNTY, IN GEORGIA: 1940 AND 1941

County

PELLAGRA

Rate per I00,000

Number

Population

1941 1940 1941 1940

PNEUMONIA

Rate per I00,000

Number

Population

1941 1940 1941 1940

Dodge ------------------------ 4

19.0

11

<1 j2,3 19.0

Dooly -----------------------

11.8

4

23.7 53.3

Dougherty --------------------

5 17.5 17.5

25

32 87.5 112.0

Douglas ----------------------

9.9

3

7 29.8 69.6

Early ------------------------

10.7

8

t12.8 37.5

Echols ------------------------

1

33.7 101.2

Effingham --------------------

1

1 10.4 10.4

2

<1 20.7 <11.5

Elbert ------------------------

2

1 10.2. 5.1

11

17 56.1 86.7

Emanuel ----------------------

<1,3

17

20 72.3 85.0

Evans ------------------------ 1

13.5

3

7 <10.5 94.6

Fannin ----------------------

4

2'7.1

13 <17.5 83.1

Fayette -----------------------

1

1 12.2 12.2

2

6 2<1.5 73.4

Floyd ------------------------

4

3

7.1

5.3

33

<13 58.8 76.6

Forsyth -----------------------

3

1 26.5

8.8

Franldin ----------------------

3

19.2

9

8 57.6 51.2

Fulton ------------------------

26

23

6.6

5.9 191 247 18.6 ..'(~~ 62.9

Gilmer -----------------------

1

1 11.1 11.1

8

8 88.9 -'" -88:6'!'--

Glascocit --------------------- 1

22.0

't.fifi:o

Glynn ------------------------ 1

4.6

20

12 91.2 5<1.7

Gordon -----------------------

1

1

5.'1

5.4

9

19 <18.8 103.0

Grady ------------------------ 1

Greene ----------------------- 1

Gwinnett ---------------------- 5

Habersham ------------------- 3

Hall ----------------------------

2

5.1

6

10 30.5 50.9

7.3 21.9

7

10 51.1 72.9

17.2

3.'1

17

16 58.'1 55.0

20.3

6.8

6

1<1 <10.6 9<1.8

5.7

8.6

19

26 54.6 7<!.7

Hancock ---------------------- 2 Haralson --------------------Harris -----------------------Hart ------------------------Heard ------------------------

15.7 23.5

<1

31.3 5<1.8

7.0

10

11 69.6 76.5

8.8

3

26.3 78.8

10

12 64.5 77.'1

3

<1 3<1.8 <16.5

Henry ------------------------

10

12 66.1 79.4

Houston ----------------------

<1

9 35.'1 79.6

Irwin -------------------------

1

7.7

3

6 23.2 46.4

Jaclrson ----------------------

1

1

5.0

5.0

8

7 39.8 3<1.8

Jasper ------------------------ 1

11.4 57.0

4

45.6 57.0

Jeff Davis --------------------

<1

45.2

Jeffetson --------------------- 1

5.0

8

14 39.9 69.9

Jenltins -------------- ---------

2

2 16.9 16.9

76.0 50.7

Johnson ----------------------

2

15.'1 <16.3

Jones ------------------------

1

12.0

<1 36.0 48.0

Lamar ------------------------
Lanier -----------------------
Laurens ---------------------Lee -------------------------Liberty -----------------------

15

1<18.6 89.2

53.3 53.3

5

14.9

23

23 68.'1 68.4

3

10 38.3 127.6

2

23.3

1

5 11.6 58.2

270

Georgia Department of Public. Health

TABLE IS-Continued DEATHS AND DEATH RATES PER I00,000 POPULATION FROM PELLAGRA AND
PNEUMONIA IN EACH COUNTY, IN GEORGIA: 1940 AND 1941

County
Lincoln ----------------------Long ------------------------Lowndes ---------------------Lumpldn ---------------------McDuffie ---------------------

PELLAGRA

Rate per I00,000

Number

Population

1941 1940 1941 1940

PNEUMONIA

Rate per I00,000

Number

Population

1941 1940 1941 1940

2

28.'!

2

28.'!

24.5

2 2'1.5 48.9

5

3.1 15.7

12

17 37.7 53.4

1

16.1 16.1

2

9.2 18.'!

6

55.2 73.5

Mcintosh --------------------Macon ------------------------ '1 :Madison ---------------------IV!arion ----------------------Meriwether --------------------

25.1

14.4

'1.5

'1.5

2

7 37.8 132.3

6

13 37.6 81.5

3

7 22.3 52.1

4

6 57.5 86.3

13 27.2 58.9

Miller ------------------------

5

2 50.0 20.0

Mitchell ----------------------

7

16 30.1 68.8

.i\lonroe -----------------------

27.9

10

9 93.0 83.7

Montgomery ------------------

10.3

6 93.1 62.1

lVI01:gan -----------------------

2

2 15.7 15.7

3

8 23.6 62.9

il1urray -----------------------

1

9.0

3

12 26.9 107.7

Muscogee ---------------------

6

4

7.9

5.3

74

47 98.0 62.3

Newton -----------------------

1

4

5.'1 21.5

11

20 59.2 107.7

Oconee -----------------------

6

1 79.2 13.2

Oglethorpe --------------------

3

7 2'1.1 56.3

Paulding ---------------------

3

7.8 23A

10

77.9

7.8

Peach ------------------------

1

9.6

9.6

4

2 38.5 19.3

Picl<ens -----------------------

10.9 10.9

'1 5'1.7 '13.8

Pierce ------------------------

8.5

6

6 50.8 50.8

Pi!;e ------------------------- 1

9.6

8

3 77.1 28.9

Polk -------------------------

2

2

7.0

7.0

9 2'1.6 31.6

Pulasld -----------------------

1

10.2

9

5 91.6 50.9

Putnam -----------------------

8

94.0 70.:J

Quitman ----------------------

29.1

2

58.2 29:1

Rabun ------------------------

2

2 25.6 25.6

Randolph --------------------- 2

12.0 18.1

10 36.1 60.2

Richmond --------------------

8

3.7

9.8

68

58 83.1 70.9

Rockclale ----------------------

12.9

5

6'1.7 11.1

Schley ------------------------ 3

59.6

3 19.9 59.6

Screven ------ ----------------

2

3

9.8 1'1.7

12

20 59.0 98.3

Seminole ---------------------- 2

23.6

7

'1 82.'1 '17.1

Spalcling ----------------------

2

7.0

29

27 102.0 95.0

Stephens ---------------------

3

9 23.1 69.'1

Stewart ----------------------

9.4

6

3 56.6 28.3

Sumter -----------------------

2

8.2

20

81.6 32.7

Talbot ----------------------- 1

12.3

6

73.7 24.6

Taliaferro --------------------

2

2 31.9 31.9

31.9 111.5

Tattnall ----------------------

3

18.5 <19.3

Taylor ------------------------ 1

9.3

4

!17.1 33.6

'l'elfair -----------------------

1

6.6

10 39.6 66.0

Information and Statistics

271

TABLE 13-Continued
DEATHS AND DEATH RATES PER I00,000 POPULATION FROM PELLAGRA AND PNEUMONIA IN EACH COUNTY, IN GEORGIA: 1940 AND 1941

County

PELLAGRA

Rate per I00,000

Number

Population

1941 1940 1941 1940

PNEUMONIA

Rate per 100,000

Number

Population

1941 1940 1941 1940

Terrell -----------------------

2

2 12.0 12.0

17 54.0 101.9

Tho~nas ----------------------

2

6.4

6.'1

13

25 <11.5 79.9

11ift --------------------------

<1

3 21.5 16.1

4

21.5 32.3

Toombs -----------------------

2

3 11.8 17.7

10

59.0 53.1

Towns ------------------------

1

<1 20.3 81.2

T1eutlen ----------------------

13.1 13.1

Troup ------------------------

2

2

<!.6

<!.6

22

37 50.1 8<1.3

'Turner -----------------------

1

9.2

7 27.7 64.5

':fwiggs -----------------------

2

21.9

3 5<!.8 32.9

Union ------------------------

13.0

13.0 91.1

Upson ------------------------

12.0

15

19 59.3 75.8

'Nall\el' -----------------------

1

3.2

12

H 38.7 45.1

Walton -----------------------

2

5 9.6 24.0 11 13 52.9 62.6

Ware

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

2

7.2

13

17 <!6.5 60.9

Wa!Ten -----------------------

9.3

<1

11 39.1 107.5

Washington -------------------

1

2

4.1

3.3

13

19 53.7 78.4

Wayne -----------------------

5

8 38.1 61.0

Webster ----------------------

21.2

6

127.0

Wheeler ----------------------

11.7 70.3

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

15.6

5

77.9

Whitfield --------------------Wilcox ----------------------Will<es -----------------------\Villdnson --------------------Worth ------------------------

2

7.7

7.7

18

2<1 69.0 91.9

7

5<1.9 31.4

2 6.6 13.3

<l

26.5 39.8

9.1

13

16 117.9 145.1

4.1

5

12 23A 56.1

Camp Wheeler ----------------

Fort Oglethorpe ---------------

Fort Benning -----------------

Residents of Georgia, death

occuring in other states _______

4

1

2 2

28

18

NO'l'E: 'fhese figures are allocated to county of residence and exclude non-residents of Georgia. Only the state totals inclucle residents of Georgia dying in other states.
1941 county total exclui!e deaths of men in the aimed forces stationed in a government fort or camp located in that county.

272

Georgia Department of Public, Health

DEATHS AND DEATH RATES PER J00,000 POPULATION FROM SPECIFIED CAl,lSES IN GEORGIA FOR THE YEARS 1850-1940

Cause of Doath

Number of Deaths

1850 1860 1870 1880 1890 1900 1920 1930 1940

ALL CAUSES ------
Typhoid fever --------
Malaria ------------Smallpox -----------l\ileasles --------------
Scarlet fever --------Whooping cough -----Diphtheria ----------Dysentery, diarrhea
and enteritis -------
Tuberculosis --------Cancer -------------Pneumonia ---------Heiu~t diseases ------All other causes______

9,925 557 185
H 202 385 3<1<1
65<1 379
60 60 603 5,331

12,813 887 56R 8 <17 217 334 <140
1,061 550 31 31 723
6,629

13,606 772 705 IS 270 12 92 417
1,<11<1 996 131 131 27<1
7,112

21,5<19 987
1,060 2
<196 31 650
1,309
2,011 1,882
2<10 2<10 1;151 9, 7<15

21,174 1,000 937
440 8
89 553
2,353 2,32<1
293 293 1,405 10,034

26,941 1,766 1,226 46 201 44 222 319
2,235 2,830
382 382 2,127 12,<1<15

32,2t!3 5<19 559 3 61 32 373 <101
1,725 2,362 1,124 1,12<1 1,392 20,396

35,188 500 4<12
128 38
257 135
1,347 2,175 1,552 1,552 4,0:19 21,935

32,285 68 89
23 16 108 59
693 1,533 1.959 1,959 6,176 19,506

Rates per I00,000 Population

1850 1860 1870 1880 1890 1900 1920 1930 1940

ALL CAUSES ------ 1095.3
'ryphold fever -------- 61.5
Malaria ------------- 20.4 Smallpox -----------Measles ------------- 3.2
Scal'let fever --------- 22.3 Whooping cough ----- 42.5 Diphtheria ----------- 38.0 Dysentery, diarrhea
and enteritis ------- 72.2 Tuberculosis --------- <11.8 Cancer --------------- 6.6 Pneumonia ----------- 71.8 Heart diseases ------- 66.5 All other causes ______ 643.5

1211.9 83.9 53.7 0.8 <1.5 20.5 31.6 <11.6
100.'1 52.0 7.7
119.9 68.'1 627.0

11<19.0 65.2 59.7 1.5 22.8 1.0 7.8 35.2
119.'1 84.1 11.1
115.1 23.1 603.2

1397.3 6<1.0 68.7 0.1 32.2 2.0 '12.1 3<1.9
130.'1 122.0
15.6 109.3
94.1 631.9

1152.4 5<1.'1 51,0
24.0
OA
<1.8 30.1
128.1 126.5
16.0 9<1.6 76.5 546.1

1219.1 79.9 55.5 2.1 9.1 2.0 10.0 37.1
101.1 128.1
17.3 117.6
96.2 563.1

1113.2 19.0 19.3 0.1 2.1 1.1 12.9 13.8
59,6 81.6 38,8 95.5 65.3 70<1.2

12~7 .4 17.2 15.2
<1.4 1.3 8.8 4.6
<16.2 74.6 53.3 88.5 1<10.6 752.7

1033.5 2.2 2.8
0.7 0.5 3.5 1.9
22.2 <19.1 62.7 65.8 197.7 62!.4

:."/OTE: Figures for the year 1910 not available.