- Collection:
- Georgia Government Publications
- Title:
- Annual report for the year 1942 [Oct. 1, 1943]
- Creator:
- Georgia. Department of Public Health
- Contributor to Resource:
- Georgia. Department of Public Health
- Publisher:
- Atlanta, Ga. : Georgia. Department of Public Health
- Date of Original:
- 1943-10-01
- Subject:
- Georgia
- Location:
- United States, Georgia, 32.75042, -83.50018
- Medium:
- publications (documents)
- Type:
- Text
- Format:
- application/pdf
- External Identifiers:
- Call Number GA H700 .A1 1942
- Metadata URL:
- https://dlg.galileo.usg.edu/id:dlg_ggpd_y-ga-bh700-b-pa1-b1942
- Digital Object URL:
- https://dlg.galileo.usg.edu/do:dlg_ggpd_y-ga-bh700-b-pa1-b1942
- Language:
- eng
- Holding Institution:
- University of Georgia. Map and Government Information Library
- Rights:
-
STATE OF GEORGIA DEPARTMENT OF PUBLIC HEALTH
ANNUAL REPORT
1942
STATE OF GEORGIA
DEPARTMENT OF
PUBLIC HEALTH
T. F. ABERCROMBIE, M.D., Director
ANNUAL REPORT FOR THE YEAR 1942
State Office Building Atlanta, Georgia October I, 1943
Contents
Page Division of Local Health Organizations____________ lO Division of Public Health Nursing_________________ 71 Division of Public Health Engineering____________ 76 Division of Dental Health Education______________ 95 Division of Maternal and Child Health ____________ 107 Division of Public Health Education ______________ 142 Division of Preventable Diseases:
Cancer Control Service ______________________ 145 Epidemiological Service ____________________ 154 Industrial Hygiene Service ___________________ 191 Typhus Fever Control Service ________________ 202 Venereal Disease Control Service _____________ 209 Division of Malaria and Hookworm Service________ 220 Division of Tuberculosis ControL _________________ 242 State Tuberculosis Sanatorium ___________________ 255 Division of Laboratories _________________________ 270 Division of Information and Statistics _____________ 311
STATE OF GEORGIA
DEPARTMENT OF PUBLIC HEALTH
T.F.ABERCROMBlE,M D .OIRE.CTOR ATLANTA
!o Hie Excellenc7 Bon. Ellie Arnall Cove!'llor of Georgia
Dear Sir:
I haTe the honor to preeent to JOU the annual report of the
work of the Department of Public Health for the 78ar 1942. !he death rate from all cauaee was 9.2 per 1,000 population, the lowest on record. !he birth rate shows an incn-eaee from 21.6 to 23.1 per 1,000 population
.Aaong the important C811aea of death, eleTen show minilllum rates
for 1942. !vo of these are the communicable diseaeea of childhooddiphtheria with a reduction of 12 per cent, and scarlet feTer with a reduction of 78.6 per cent. Another two are the important reapiratoey conditione- tuberculosis, declining 8 per cent: and pneumonia. 5.3 per cent. ~id feTer with a reduction of 56.3 per cent; appendicitis, 23.8 per cent; pellagra. 10.6 per cent: and diarrhea and enteritis (under tvo 7eara) with a 34.3 per cent reduction complete the list of specific
disease a with new low rates.
In addition, minilllum rates with significant reductions of 9.9 par cent for atillbirtha, 15.5 per cent for infant mortalit7, and 10.8
par cent for aate!'ll&l mortalit7 are recorded.
Another factor which baa contributed to the excellent health
record of 1942 1a the decline, eTen though alight, in the" rate for the
cerdio-Taacular renal diseases, where inoreaaea haTe been accustomed.
a Of the four dheasea which make 1lP this grQ1JP, three- cerebral hemorrha&e
with 4.6 per cent reduction: nephrith, 5.1 per cent: and heart disease, 8.5 per cent haTe recorded lower rates in 1942 than the preTious 7ear. Cirrhosh of linr indicates a 2.7 per cent higher rate than formerl7.
!vo other important diseaaee of middle 1111d later life- cancer with a 0.2 per cent reduction and diabetes with a reduction of 0.9 per cent alec registered low for 1942.
71~
T. J. Abercrombie, M.D., Director
State Department of Public B'eal th
MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH
RoBERT F. MADDOX, Chairman_______________________________ Atlanta C. L. RIDLEY, M.D., Vice.Chairman _______~ ____________________ Macon J. C. METTS, M.D._______________________________________ Savannah C. K. SHARP, M.D. _______________________________________ Arlington R. C. ELLIS_____________________________________________Americus J. A. CoRRY, M.D._____________________________________ Barnesville W. P. HARBIN, JR., M.D. ____________________________________Rome H. W. CLEMENTS, M.D. _______________________________________ Adel R. L. RoGERS, M.D. ______________________________________Gainesville D. N. THOMPSON, M.D.___________________________________ Elberton M. D. HoDGES, Ph.G-----------------------------~~--------Marietta JoHN W. WHITE, Ph.G---------------~-----------------Thomasville J. G. WILLIAMs, D.D.S. ____________________________________Atlanta W. K. WHITE, D.D.S. ____________________________________Savannah
Brief History of Public Health 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, anJ 6 pence were paid for "physicks" to be given soldiers in General Oglethorpe's Regiment in Savannah.
As early as 1760, there was an ad to oblige ships and other vessels coming from places infected with the plague, smallpox, or other contagious diseases to be quarantined. Larter, 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 fact, Georgia was the second of the States to require registration by law.
In 1843, there was an enactment by the General Assembly requiring that a supply of smallpox vaccine matter be purchased and supplied to the people of the State free. Later, in 1866, the Legislature passed an acrt for the control of smallpox in Georgia.
In February of 1875, the Legislature passed an act creating a State Board of Health. Agitation in favor of this had been begun by the Medical Association 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 soidiers enlisted.
The law creating the Board of 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 Tali.aferro 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 par,ts of 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 Savannah 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 O'peration 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 peUagra.
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:
Laboratory________________________________________ 1905
Field Sanitation (now Local Health Organizations) _______ 1910 Venereal Disease ControL___________________________ 1918 Vital Statistics_____________________________________ 1919 Maternal and Child Health__________________________ 1920
History of Public Health in Georgia
9
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__________________________________________ 1940 Industrial Hygiene __________________________________ 1941
Division of Local Health Organizations
Guy G. Lunsford, M.D., Director
R. B. Griffin, M.D., Medical Director______________ Northwestern Region W. B. Harrison, M.D., Medical Director____________Northeastern Region W. D. Cagle, M.D., Medical Director_______________West Central Region A. J. Davis, M.D., Medical Director________________ East Central Region 0. F. Whitman, M.D., Medical Director____________ Southwestern Region J. D. Stillwell, M.D., Medical Director_____________ Southeastern Region
Only a few years ago the principal objective of the Division of Local Health Organizations was the promotion of county health departments. Much of the time and effort of the director was spent trying to convince the people of the need for and value of public health service. Often it was harder to get local authorities to appropriate the necessary funds than it was to convince the people of the need for such service.
PROGRESS IN TWENTY-EIGHT YEARS
On December 31, 1934, twenty years after the passage of the Ellis Health Law which created a board of health in each county and enabled each county to organize and operate a health department, only thirty-one counties, with a population of 1,314,663, had departments of health. Eight years later, on December 31, 1942, fifty-nine counties, with a population of 1,960,851, had such departments, and four others were ready to make appropriations for public health. During these last eight years little effort was put forth in promoting local health departments for the reason that qualified commissioners of health and other personnel were not available. Truly the health education program in the earlier years has horne fruit, and the harvest has been bountiful.
EFFECT OF THE WAR
Added services and responsibilities consequent to 'the large number of Army, Navy, and other war projects located in Georgia since 1940 have been taken over hy the affected departments with cheerfulness and zeal. The fact that no epidemic has occurred as a result of the concentrations of population bears witness to the effectiveness of the labors of the public health workers in spite of the long-existing shortage of personnel, made more acute by the call of many of the staff to military duty or other work in connection with the war effort--and this handicap is increasing more and more as the nation goes forward in the war effort. During 1942, twenty-nine local public health workers resigned to enter military service or an activity directly connected with the war effort, bringing the number of such resignations from local and regional departments to fifty-four.
During the year there was a number of changes in the commissioners of health due to resignations and transfers. To partly off-set this, eight
Local Health Organizations
11
physicians entered public health work for the first time. These were employed after a course of in-service orientation with the State Health Department and one or more of the local health departments, with the understanding that formal training in public health would be offered when the war emergency had passed. In other instances, districts composed of two or three counties were formed, where the commissioner of health of one county assumed the direction of the public health activities in a second or even a third county where a vacancy existed. However, at the close of the year there were vacancies in the position of commissioner of health in the following health departments:
Appling-Wayne District Bleckley-Dodge-Pulaski District Brooks County Health Department Bulloch County Health Department Calhoun County Health Department Coffee County Health Department Hall County Health Department Telfair-Wheeler District Terrell County Health Department Tift County Health Department
Full-time health services were instituted in Dodge, Gwinnett, Harris, Meriwether, and Pulaski Counties, but discontinued in Bartow and Clinch Counties. The commissioners of health resigned in these two counties during 1941, and due to the dearth of public health doctors, their places were not filled. However, these counties continued the public health nursing program. Other counties employing a public health nurse during the year were:
Heard Jeff Davis
Monroe Randolph
Stewart Turner
Dodge, Gwinnett, Harris, and Meriwether Counties had public health nursing service before the complete health department was organized. Schley County had had a public health nurse for part of 1941 and in 1942 until the V. D. itinerant nursing service program was started.
ITINERANT V. D. NURSING SERVICE
This program, beginning in April of 1942, provided a nurse to conduct V. D. clinics in two to four counties not being served otherwise, and if time permitted, also to carry on an immunization program. The chief purpose of this service was, and is, to provide treatment for men who have been rejected by the loeal Selective Service Boards because of venereal disease infection. The physicians conducting these clinics are paid on an honorarium basis. As of December 31, 1942, there were nine such nurses employed, serving twenty-nine counties.
12
Georgia Department of Public Health
REGIONAL WORK
In addition to supervising the work of the nurses in the unorganized counties and that of the V. D. itinerant nurses, where there are vacancies in the position of the commissioner of health in organized counties, supervision of this work is done by the regional medical directors. Likewise, where there is a vacancy in the sanitation staff, the regional engineer renders such assistance as is possible. At all times the entire staff of the regional offices is available for advisory service.
PERSONNEL PROBLEMS
As mentioned previously in this report, there is a shortage of qualified personnel, but at the same time there has been an increase in the total number of persons at work. This is accounted for by the fact that in the emergency created by the war less qualified personnel has been employed in many instances. The nurses and clerks employed to carry on the V. D. clinic service providing for treatment of draftees rejected because of venereal disease infecti,on, and the addition of registered nurses to assist in the V. D. clinics, thereby relieving public health nurses for more important duties, account for this increase.
As of December 31, 1942, there were five hundred and fifty full-time and forty-six 'part-time public health workers employed in county health departments, sixty-four public health nurses in unorganized counties, nine nurses in the V. D. itinerant program, nine clerks to assist these nurses, and twenty-nine workers in the regional health offices, making a total of seven hundred and seven persons as compared with six hundred and fifty last year. There were 1,960,851 persons served by full-time health departments (in fifty-nine counties), 698,819 by public health nurses (in sixtytwo counties), or 85.14% of the population of Georgia, as compared with 83.08% in 1941. In addition, 368,148 persons, or 11.78% of the population of Georgia, lived in counties served by the V. D. itinerant nurses.
STATISTICAL COMPARISON
Following is a complete statistical report of activities in local health departments for 1941 and 1942, and a condensed report by counties for 1942. In addition, there is a table showing a summary of activities for 1942 and the per cent of increase or decrease in these activities over 1937 and 1941. It is encouraging to note the very large per cent increase in services rendered in a five-year period. The decreases are also worthy of notice, especially the number of admissions to service for communicable disease control, 56%, which shows the effect of public health work. The decreases in 1942 as compared with 1941 are in preventable disease control, tuberculosis control, infant, 'preschool and school hygiene, morbidity service, and sanitation. The reduced number of sanitation personnel, and the fact that malaria control in war areas was assumed by another division, account for the reduction in sanitation activities in this report. The largest per cent increase over 1941 is shown in venereal disease control, followed by immunizations and maternal hygiene.
Year
1915 1920 192'1 1930 193:; 1MO 1941 1942
Number Organized Counties
2 18 23 34 31 .):i :16 59
REcORD OF CouNTY HEALTH WoRK IN GEORGIA
1915-1942
Number Persons Employed
;.
4~
71 205 233 498 544 550
Population Served
li,54;) 4:l6,106 [;98,107 1,011,974 1,327,018 1,893,441 1,920,119 1,960,851
Total Budget
$ 4,637.00 72,695.00 119,812.00
451,217.00 4:i9,292.00 1,066,126.20 1,124,729.00 1,370,304.90
Per Capita
.26 .11 .30 .4:-i
,;{;)
.56 .;)9 .70
County Budget
$ 4,637.00 70,895.00 168,272.00
440,904.00 399,256.00 785,049.20 813,065.59 956,863.05
Per
-tc"-<
(") !;l
::X::
Capita
~
;~;.
.26 .16
0....
.28 .44 .30 .41
.~.;:.:..
&a
.42 i;;
.49
~ ~
14
Georgia Department of Public Health
CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC
HEALTH WORK IN GEORGIA, 1941-1942
Organized Counties
1941
1942
COMMUNICABLE DISEASE CONTROL Admissions to medical service__________ _ Admissions to nursing service___________ _ Admissions to medical and/or nursing service _____________________________ _
Consultations with physicians ___________
Field Visits:
Diphtheria Typhoid fever and paratyphoid fever_ __ _ Scarlet fever --------------------------Smallpox -----------------------------Meru;les Whooping cough ----------------------Malaria _______ -----------------------Hookworm ----------------------------Typhus __ -----------------------------Other communicable diseases_____________
9,942 10,828
15,503 2,380
1,852 827
2,544 49
3,807 2,221
694 3,811
442 7,796
8,589 8,700
12,151 1,49:i
2,38;) 2,822 2,548
30 2,703 1,604
503 2,633
472 4,055
All Counties
1941
1942
12,210 15,818
19,731 2,742
10,654 12,062
1a,674 2,072
2,195 1,189 2,692
82 3,986 2,265 21,997 6,506
596 8,971
2,633 3,255 2,728
42 2,803 1,6a6 11,12G 5,281
490 4,377
Total field visits for communicable disease control ------------------------- ____ _
Persons treated for hookworms__________ _
Admissions to hospitals:
Diphtheria ----------------------------Typhoid fever and paratyphoid fever ____ _ Scarlet fever -------------------------Smallpox -----------------------------Other communicable disease patients ad-
mitted to hospitals ___________________ _
24,043 4,884
48 32 81
802
19,7:>5 2,951
47 28 90
2
442
50,479 6,851
53 43 81
806
34,390 4,979
50 30 90
443
Total admissions to hospitals for communicable disease controL____________
Immunizations (persons immunized):
Smallpox __ ---------------------------Diphtheria-under 1 year ______________ _ Diphtheria-l through 4 years _________ _ Diphtheria-5 years and over____________
964
49,742 9,273
11,952 9,126
Total diphtheria immunizations__________
Schick tests given _____________________ _ Typhoid fever ________________________ _ Other immunizations_____________________ Public lectures and tall<S _____________ _ Attendance _--------------------------Persons tested in surveys______________ _
30,351
15,335 i66,751
1,194 274
13,132 18,660
609
63,062 10,292 14,414 12,434
37,140
11,731 194,427
1,103 173
11,195 1:!,366
984
74,530 12,732 18,83:. 12,027
43,594
17,354 258,07G
1,461 444
20,940 21,909
619
92,368 14,028 21 ,o22 15,537
50,587
12,866 297,818
1,17:1 212
13,860 20,22!!
Local Health Organizations
15
CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
1941
1942
VENEREAL OISEASE CONTROL
Admissions to medical service___________ _ Admissions to nursing service___________ _ Total admissions to medical and/or nursing
service _____ -----------------------Cases transferred to private physicians ___ _ Clinic visits (by Jlatients) ______________ _ Field visits (to patients) _______________ _ Xumber of clinic treatments _____________ _ Dismissed from serYiC'e _________________ _ Public lectures and tall\:s _______________ _ Atte'Ildance __________ --- _--------------
41,850 24,469
43,262 1,106 524,180 35,760 47:i,803 9,828
149 10,060
TUBERCULOSIS CONTROL
Individuals admitted to medical service__ _ Positive cases -------------------------Suspicious cases -----------------------Contacts ______________________________ _
Individuals admitted to nursing service ___ _ Positive cases ------------------------Suspicious cases -----------------------Con! acts --------~--------------------- __ Total individuals admitted to medical
and/or nursing service_______________ _
Positive cases ------------------------Suspicious cases ----------------------Contacts _____________________________ _
Physical examinations in clinics_______ _ X -ra.Y examinations _____________________ _ Clinic visits (by patients) ______________ _ Yisits to State clinics (by patients) _______ Visits to private physicians (by patients) Visits to private physicians (health officer
or nurse) ---------------------------Yisits to others (health officer or nurse) __ Field visits ---------------------------Yisits to ea~es of tuberculosis __________ _ Yi~its to tuberculosis suspects __________ _ Visits to contacts_____________________ _
Office visits ---------------------------Offiee visits of rases of tuberculosis _____ _ Offi<'e visits of tuher~ulosis susileets ____ _ Office visits of contacts_________________ _ ..Admissions to sanatoria _________________ _ XumUcr tubereulin tests ('olllplett.>d _____ _
XumlJer positive -------------------------
12,545 1,897 4,:122 6,326
19,513 3,258 :>,343
10,912
22,034 3,522 6,663 11,869
10,958 15,866 24,7 48
9,680 1,169
1,273 1,401 56,027 17,229 10,472 28,326 23,479 :-i,156 S,!l:;O 9,373
547 22,191
7,86:\
52,298 36,1i4
56,467 1,657 6:i8,405 30,766 507,946 14,370
101 9,470
12,386 2,07:> 3,478 6,833
16,180 2,942 5,071 8,167
19,049 3,234 5,801 10,014 8,682
18,259 25,441 9,048
942
1,095 1,799 52,337 15,945 9,338 27,074 21,292 5,290
n,-tH~
9,510 G88
21,602 H,664
All Counties
1941
1942
48,884 30,730
50,620 1,283
621,702 43,106
561,778 10,467 192 14,684
64,585 48,710
69,315 1,758 830,700 60,072 667,250 15,518
125 11,645
16,909 2,323 3,598 8,988
27,094 4,131 7,348
15,615
30,4:i0 4,499 8,918 17,033
11,474 21,003 30,140 14,838
1,457
1,571 1,744 67,358 19,415 13,020 34,923 26,743 5,591
1 o,J:Jo
11,022 673
24,960 8,688
16,013 2,477 4,378 9,158
22,147 3,720 6,728
11,699
26,327 4,203 7,712 14,412
13,352 22,187 29,515 13,032
1,040
1,313 2,141 63,575 18,707 11,639 33,229 24,320 5,773 7 ,:i67 10,980
746 2:i,278
7,655
16
Georgia Department of Public Health
CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
1941
1942
TUBERCULOSIS CONTROL-Continued
Number negative (completed tests) ____ _ Contacts broken ------------------------ _ Contacts partly broken _________________ _ Helief secured for tuberculosis cases ____ _ Cottages, sleeping porches, etc. (number
built) ______________________________ _
Public lectures and talks_______________ _ Attendance ____________________________ _
14,326
1,36~
357 :;91
11 608 56,278
MATERNITY SERVICE
Cases admitted to prenatal medical service Cases admitted. to prenatal nursing service Cases admitted to medical andjor nursing
service Yisits b.r prenatal cases to medical confer-
ence's ________________________________ _
Visit..~ by prenatal cases to private physicians _______________________________ _
Field visits to vrenatal cases __________ _ Office nursing visits by prenatal eases __ _ Cases attended by nurses for delivery
service _____________________________ _
Cases given vostpartum medical examination
Cases given postpartum examination by 'private physicians ____________________ _
.eases admitted to vostpartum nursing service _______________________________
' 1.tisits. to postpartum cases _______________ _
Permanent health centers ______________ _ ?\umber of sessions __________________ _ Itinerant health centers ___________ _ Sessiuns held _________________ _ Midwives registered for formal instruetion l\Iidwife meetings ---------------------Attendance at meetings _______ ---------Yisits for midwife supervision __________ _ Public leetures and talks ________________ _ Attendance }~nrollment in maternity classes Attendan<'e
13,001 19,852
21,003
35,090
B08 32,20ii 46,299
331
2,477
262
15,631 39,310
179 3,653
21 46 1,371 9:52 8,354 3,207 261 4,728 594 1,990
14,938 1,208 378 :i86
10 348 23,431
li,126 20,870
22,014
57,781
936 :l4,128 51,220
155
2,940
427
17,632 39,994
189 6,143
12 40 1,3H 1,028 8,347 4,08.) 362 4,849 217 2,333
All Counties
1941
1942
16,272 1,437 368 667
13 670 77,201
11,623 1,406 396 6;)1
11 376 2:;,:;01
19,250 24,588
2:J,82J
62,616
1,038 37,387 54,794
389
3,081
17,921 43,319
241 6,760
21 46 2,289 1,600 12,317 5,037 308 5,428 597 1,993
21,497 26,659
27,B60
67,o78
1,021 40,3:;8 61,877
218
3,487
4'i6
20,369 40,309
242 7,469
12 40 2,481 1,617 11,794 :1,793 :l90 5,099 217 2,333
Local Health Organizations
17
CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL Pusuc HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
1941
1942
INFANT AND PRESCHOOL HYGIENE
Infants:
Individuals admitted to medical service __
Individuals admitted to nursing service __
Individuals admitted to medical and/or nursing service _____________________ _
Permanent he.alth centers _____________ _
~umber of sessions
______________ _
Itinerant health centers _______________ _
Sessions held _ Yisits to medical conferences (by patients) Visits to prhate physicians (by patients)
Field visits ---------------------------Offiee nursing visits ___________________ _
Consultations with parents _____________ _
9,944 23)39-l
25,268 229
7,070 :iS
123 22,963
466 48,066 22,202 41,557
Preschool:
Individuals admitted to medical service__ Individuals admitted to nursing service__ Individuals admitted to medical and/or
nursing service ______________________ Permanent health centers ______________ _ Kumber of se.ssions _____________________ _ Itinerant health centers________________ _
Sessions held -------------------------Yisits to medical conferences (by patients) Yisits to private physicians (by patients) }""ield visits ---------------------------Office nursing visits (by patients) ______ _ Inspections by dentists or dental hygienists Prophylaxis by dentists or dental hygienists Consultations with parents ____________ _ Public lectures and talks _______________ _
Attendance Enrollment in infant and })reschool classes Attendance ___________________________ _
12,313 20,798
22,940 201
5,503 230 371
22,444 360
32,353 23,684 20,016
533 35,683
196 4,829
639 833
SCHOOL HYGIENE
Insve.ctions by physicians or nurses______ Examinations by physicians______________ Bxaminations Uy physicians with parents
present --------------------------- __ _ Iudi\iduals admitted to nursing service__ l""ield visits ----------------------------
313,706 95,377
3,646 19,87 4 33,888
9,825 27,113
27,976 236
6,596 36 80
23,504 291
5!,308 24,703 46,133
11,861 22,379
23,987 205
5,861 192 235
21,897 406
32,249 23,678 12,644
460 39,732
223 3,051
330 :>86
311,590 78,372
2,342 19,887 32,121
All Counties
1941
1942
11,340 27,303
28,854 283
7,833 58
123 25,281
508 54,831 2'3,812 46,672
11,290 31.64 7
32,593 282
7,503 36 80
26,420 343
59,602 28,187 49,004
13,622 23,658
25,860 240
6,019 236 378
24,714 382
35,634 26,206 20,093
562 40,300
221 7,090
660 1,298
13,073 25,268
26,931 243
6,470 202 265
24,049 430
35,891 25,922 12,674
564 41,502
218 4,067
330 586
330,410 96,775
3,744 21,397 34,800
325,532 79,650
2,663 20,94'i 33,022
18
Georgia Department of Public Health
CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
1941
1942
SCHOOL HYGIENE-Continued
Office Yisits --------------------------Inspections by dentists or dental hygienists Prophylaxis by dentists or dental hygienists Public lectures and talks________________
Attendance Classroom health talks __________________ _ Attendance ___________________________ _
18,880 77,653
3,147 494
~9,754
4,338 I49,874
ADULT HYGIENE
Medical Examinations:
:llilk-handlers -------------------------Other food-handlers -------------------liidwives ______________ ---- ______ -----Teachers _______________ - __ --- ____ ---- __ Other adult medical examinations________
2,066 37,864
474 1,261 I4,043
Total adult medical examinations _________ 55,708
MORBIDITY SERVICE
Admissions to medical service ___________ Admissions to nursing service ___________ _
Admissions to medical and/or nursing service _________ ----------------------Clinic visits (by patients) ______________ _ Field medical visits _____________________ _ Field nursing visits_____________________ Office nursing visits___________________ _
Total admissions to hospitals __________ _ Total patient-days of hospital service___ _ Individuals admitted to dental service___ _ Refractions ____________ - --- _____ ------Tonsil and adenoid operations___________ Other defects corrected__________________
21,969 7,96I
27,322 64,414
5,642 26,974 5,217 12,606 84,517 5,071
726 909 2,714
CANCER CONTROL
Admissions to medical service Admissions to nursing se.rvice___________ _
Admissions to medical and/or nursing service ------------------------------
Office visits ---------------------------Field visits ---------------------------Applications for State aid ------------Cases receiving diagnostic service at State-
aid clinics _________________________ _
Cases receiving treatment service at Stateaid clinics ---------------------------
638 445
775 I,G60 I,166
719
524
551
19,216 52,970
3,88:1 613
37 ,23I 3,528
131,964
1,940 37,I34
374 850 13,282
53,580
19,I48 5,914
22,865 46,555
2,829 19,709 6,356 10,617 84,561 I0,491
699 745 3,714
639 385
826 I ,562
937 632
833
616
All Counties
1941
1942
20,138 91,262
3,451 664
46,381 4,847
165,271
38,7!)5 62,789
4,372 739
42,911 4,027
146,023
2,066 38,004
476 1,262 14,298
36,106
1,940 37,I34
374 850 14,757
;:i5,0G5
22,695 10,424
29,806 66,218
5,731 30,428 8,394 12,767 84,950
5,105 744 997
2,824
19,545 7,835
24,789 47,083
2,916 22,985 9,153 10,690 84,83:1 10,493
721 78I 3,786
714 645
976 1,739 1,389
834
608
999 1,713 I,130
747
892
660
Local Health Organizations
19
CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL Pusuc HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
All Counties
1941
1942
1941
1942
CRIPPLED CHILDREN SERVICE
Individuals reported Individuals examined at diagnostic clinics Individuals treated --------------------Individuals admitted to nursing service __ Visits to diagnostic clinics (by patients) Xursing visits ------------------------Public lectures and talks________________
Attendance
523 653 475 379 718 2,087
149
OTHER ACTIVITIES
Conferences with physicians or dentists __ 21,346
Personal conferences with others ________ 120,209
:Xewspaper articles --------------------- 3,540
Bulletins distributed -------------------- 126,511
Circular letters ------------------------ 41,211 1\Iiles travelled on duty________________ _ 2,193,471
Days off duty-------------------------Conferences with official groups________
1,080 1,628
Attendance __________ ------------------Public lectures and talks ______________ _
19,890 759
Attendance
38,729
Red Cross classes (sessions) _____________
Attendance ___________ ------------------
GENERAL SANITATION
Water:
Approved individual water supplies installed Individual water supplies improved_______ Public water supplioo improved__________ Corrnections to public water supplies____ _
1,388 850 150
6,242
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 rei)aired (or improved) __________ New septic tanks installed_______________ Septic tanks installed at homes ________ _ Septic tanks installed at schools Septic tanks installed at other public places Septic tanks improved __________________ _
Connections to public sewer~-~~---~-----Sewerage systems or plants improved______
5,692 639
4,412 53 263
129
196 1,529 3,372 3,093
40 239 225 3,363
80
927 1,026
549 438 1,111 2,008
10 821
19,828 131,062
1,373 101,441
86,874 1,527,506
1,069 1,294 17,724
944 49,182 1,129 24,210
1,489 603 64
4,059
2,073 375
1,447 38 72
100
41 1,800 2,261 2,177
21 63 211 4,213 58
565 781 501 527 885 2,259
4 149
29,447 152,947
3,894 149,960
48,319 4,115,952
2,071 2,329 27,754 1,949 71,464
1,567 1,213
219 6,512
7,695 857
5,906 73
486
149
224 2,016 3,671 3,321
52 298 299 3,478
85
981 1,069
589 650 1,205 2,431
10 821
28,127 162,111
1,673 136,221
93,756 2,941,201
2,236 1,957 22,785 1,603 75,0f\3 1,637 29,677
1,605 939 102
5,346
3,077 540
2,183 59
114
122
59 1,8:.4 2,523 2,415
34 74 252 4,280 71
20
Georgia Department of Public Health
CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL Pusuc
HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
1941
1942
All Counties
--------
1941
1942
GENERAL SANITATION-Continued
Field visits:
Private premises ---------------------
Camp sites --------------------------
Swimming pools ----------------------
Barber shops and beauty parlors------
Schools ------------------------------
Public water supplies (plants and
systems)
-----~--------------------
Sewerage plants ----------------------
Other field visits for general sanitation __
294,007 1,827 860 161 3,480
798 741 60,378
284,4 72 1,170 429 203 2,633
965 588 49,680
297,366 1,978 880 164 4,351
1,066 925
60,802
287,399 1,200 433 204 2,972
1,196 680
49,682
Total field visits for general sanitation __ 362,252
In sect contNll:
Buildings mosquito-proofed ------------
1,158
Minor drainage-linear feet completed__ 298,980 Linear feet ditch cleared_______________ 3,553,040
Anopheles breeding places eliminated___ 4,205
Acres drained -----------------------
1,586
Anopheles breeding places controlled ____ 18,029
Miscellaneous: Public lectures and talks ______________ Attendance --------------------------Posters, charts, exhibit models completed Sanitation or malaria maps completed __
235 12,945
522 96
Rodent control:
Premises surveyed for rodent controL_ Buildings rat-proofed ----------------Buildings improved ------------------Premises improved -------------------Pounds of pi)!son bait distributed------
2,679 658 128 270 946
PROTECTION OF FOOD ANO MILK
Food-handling establishments registered
for supervision --------------------Field visits to food-handling establish-
ments ----------------------------Dairy farms registered for supervision__ Field visits to dairy farms ___________ Milk plants registered for supervision __ Field visits to milk plants_____________ Cows tuberculin tested________________ Animals slaughtered under Inspection __
Carcasses condemned In whole or In part Public lecturoo and talks ______________
Attendance ---------------------------
7,495
78,342 1,280 12,828
85 3.376 11,19:l 544,185 57,503
58 2,371
340,140
367,472
2,655 158,726 2,069,788
86 27011, 12,380
1,510 369,730 3,594,930
4,215 1,624 18,065
196 5,828
242 143
272 16,022
577 113
2,481 521 374
1,162 2,621
2,470 718 141 274 951
7,359
73,478 1,195 10,507
94 3,144 12,795 2:\8,799 51,953
82 3,:l4:l
7,495
78,847 1,280 12,883
85 3,382 11,193 544,185 57,o03
58 2,371
343,766
3,030 185,126 2,093,788
86 2,28911, 12,381
209 6,446
269
1~6
2,544 521 374
1,162 2,621
7,364
73,531 1,205 10,522 94 3,144
12,795 2:i8,799
51,95:-i 82
3,:143
CoMPARATIVE STATISTICAL SuMMARY oF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1941-1942-Continued
Organized Counties
1941
1942
LABORATORY Specimens examined: Water-bacteriological ------------------------Water-chemical -----------------------------1\I!lk or milk products __________________________
Other food -----------------------------------Typhoid: blood cultures ________________________ Typhoid: Widal ------------------------------Typhoid: stool culture__________________________ Typhoid: urine cultures _________________________ Diphtheria cultures ---------------------------Syphilis-serologicaL __________________________ Syphilis-darkfield ---------- -----------------Undulant fever (human)------------------------
(animal)-------------------------
Tularemia -----------------------------------~I alaria _______________________________________ Gonorrhea ------------ -----------------------Tuberculosis ------------------------- --------~eces for parasites _____________________________ lrrinalysis ---------------------------- --------Rabies ________________________________________
Other laboratory specimens examined ___________
Pos.
1,114
936
48 54 152 47 598 30,258 120 44 18 256 23 503 2,843 1,485 5,894 5,160 202 31 141 372
Total laboratory specimens examined-~---_ ---~~~ 50,299
Neg.
6,205 398
13,004 147
1,048 1,676 7,343 2,594 4,863 167,600
426 1,805 1,444 1,648
170 15,348 11,785
9,604 15,841 42,225
470 32 1,370 6,795
313.841
Pos.
Neg.
1,014 10
977 2
60 45 396 32 773 39,386 95 40
3 2:i7 23 375 4,549 1,608 3,946 3,674 124 13 135 416
57,953
5,628 445
10,740 61
757 1,395 9,891 2,637 8,195 188,674
310 1,388
656 1,218
198 8,276 16,518 10,334 9,510 41.742
137 28
1,124 5,49ti
--~~~
325,357
All Counties 1941
1942
Pos.
Neg.
Pos.
Neg.
1,339
936
54 54 175 50 653 34,236 123 44 18 261 39 536 2,914 1,640 9,026 5,791 208 31 141 381
58,650
8,050 399
13,004 148
1,075 1,685 1,615 2,644 5,046 182,060
434 1,818 1,453 1,666
203 18,802 12,136 11,754 20,898 45,374
481 34
1,377 6,850
345,006
1,269
7,406
10
445
979 2
70 47 443 40 825 45,141 97 42
3 276 129 393 4,675
10,742
~
61 799 1,409 10,218 2,666 8,437
0
;":",
-::r::
;":',
-;;..
207,262
c
315 ~
1,413
656 1,263
256
a.c;.;.;..
13,527 t:
17,341
1,921 5,850 5,455
125
14,059 12,288 4 7,292
139
13
28
135
1,143
563
5,584
--
68,503
364,749
1:..:1 I-"'
22
Georgia Department of Public Health
TABULATION OF SPECIFIED AcTIVITIES IN 1942, SHOWING PER CENT oF INCREASE OR DECREASE OVER 1937 AND 1941
Total for Year 1942
Per Cent Increase Decrease
1937
Per Cent Increase Decrease
1941
COMMUNICABLE DISEASE CONTROL
Admissions to service_____ -------- __________ _ 10,654 Consultations with physicians___________________ 2,072
Field visits ------------------------------------ 34,390 Smallpox immunizations ------------------------ 92,368 Dh)htheria immunizaHons ---------------------- 50,587 Typhoid fever immunizations ____________________ 297,818
Venereal Disease Control:
Individuals admitted to medieal service___________ 64,585
Clinic visits ----------------------------------- 830,700 Field visits _____________________ ______________ 60,072
Tuberculosis Control: Individuals admitted to medical service___________ 16,013 Individuals admitted to nursing service.___________ 22,147 Clinic visits ----------------------------------- 29,515 Nursing visits --------------------------------- 87,895
Maternity Service:
Individuals admitted to medical service
24,984
Individuals admitted tn nursing service__________ 47,246
Visits by ante-partum cases to medical conferences 67,578
Nursing visits -------------------------------- 147,744
Infant Hygiene:
Individuals admitted to medical service___________ Individuals admitted to nursing service__________ Visits to medical conferences____________________ Nursing visits ---------------------------------
11,290 31,64 7 26,420 87,789
Preschool Hygiene:
Individuals admitted to medical service __________ Individuals admitted to nursing ser1ice ___________ Visits to medical conferences-------------------Nursing visits ---------------------------------Inspections by dentists or dental hygienists______
13,073 25,268
24,049 61,813 12,674
School Hygiene:
Inspections by physicians or nurses ______________ 325,532 ~~xaminations by physicians--------------------- 79,650 Individuals admitted to nursing service__________ 20,945 Nursing visits --------------------------------- 71,817 Inspections by dentists or dental hygienists_______ 62,78U
Adult Hygiene: :Medical examinations -------------------------- C.:i,O:-i:i
-56% -13% + 22% +227% + 81% +208%
+235% +400% +419%
+161% +123% +249% +109%
+183% +336% +216% +219%
+135% +319% +252% +146%
+109% +198% +221% +164% + 604%
+ 72% - 16o/o + 42%
37% 10%
+282lj~
-13% -24% -32% + 24% + 16% + 15%
+ 32% + 34% + 39%
- 5o/o -18%
2% - 7%
+ 12% + 10% + 8% + 9%
+ 16% + 5% + 9%
4% + 7%
3%
-37%
1%
18% 2% + 31%
--- :~1 o/o
- 2o/o
Local Health Organizations
23
TABULATION OF SPECIFIED AcTIVITIES IN 1942, SHOWING PER CENT oF INCREASE OR DECREASE OvER 1937 AND 1941-Continued
Total for Year 1942
Per Cent Increase Decrease
1937
Per Cent Increase Decrease
1941
Morbidity Service:
~Iedical visits --------------------------------i\ursing visits ---------------------------------Admissions to hospitals_________________________
49,999
32,138 10,690
General Sanitation: Approved individual water supplies installed______ 1,605 Approved excreta disposal systems installed_______ a,600 Field visits ------------------------------------ 343,766
Protection of Food and Milk:
Food-handling establishments registered for supervision ________________________________ _
Field visits to food-handling establishments______ Dairy f.arms registered for supervision__________ ~'ield visits to dairy farms _____________________ _ Milk plants registered for supervision____________ Field visits to milk plants_______________________ _
7,364 73,531
1,205 10,522
94 3,144
Laboratory: Specimens examined --------------------------- 433,252
-26% 41%
+ 36%
+240% 19%
+54%
+ 26% + 38% + 36% + 37%
1% - 8%
+ 78%
-31%
-17%
- 16%
+ 2% 51%
- 6%
2%
7% 6% -18% + 11% - 7%
+ 7%
24
Georgia Department of Public Health
LOCAL HEALTH SERVICE
STATE OF
GEORGIA
DECEMBER 31, 1942
-~
~:;:;:;:;:;d
COUNTY HEALTH DISTRICTS NURSING COUNTIES
,.,...- HEALTH REGIONS
CoNDENSED REPORT OF AcTiviTIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942
i""i'
c. oc(
COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________ ConsuHatlons with physicians __________ Field visits -------------------------Smallpox immunizations ______________
Diphtheria immunizations ------------Typhoid immunizations _______________
186 3
272 1,719
481 3,038
VENEREAL DISEASE CONTROL
Admissions to medical service __________ Clinic visits -----------------------Field visits ----------------------- Number of clinic treatments
148 1,934
2 1,836
TUBERCULOSIS CONTROL
.Admissions to medical service __________
84
Admissions to nursing service__________ 242
Clinic visits -------------------------- 100 Field and office visits________________ 524
MATERNITY SERVICE
.Admissions to medical service_________
76
Admissions to nursing service __________
79
Visits by ante-partum cases to medical
conferences _________________________
166
Field and office visits ___ ----- ________
200
"0w :";;
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18 3
26 224 303 1,983
394 15
:>86 7,292 :J,687 3,&28
73 1
90 ;)06 li5 2,413
31
10,663 101 67
1,727
17 6
:)8 1,052
253 4,901
118 1,631
273 1,604
9,848 104,119
7,373 95,998
94 1,194
226 1,067
97 1,029
4:i 1,007
318 4,432
500 4,080
;j5
1,818
63
24
102
111
2,287
120
711
196
59
f>,340
69
3:1
280
201 li>,962
231
131
;;14
60
187
86
740
;)4
13ri
133
'\7
174
149
126
735
1113
292
478
326
:1,618
1711
4:-i2
582
.w
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Ill
:t
t "Ill
.::c
"
Ill
1
16
8
188
333
176
189
463
1,432
"7
211 5,592
174
5
3,035
12:1 1,333
!Iii 1,149
114
220
11
114
4:i3
11
64 88
118 149
.."".. ......
Ill
iii
250
649
t""< 0
2,402 1,242
("'>
.!;.:.>...
1,634 ::z:: ~
~
3,336 34,042
0
.....
3,99;)
.... i>4,410
;a;
... 497
;0:s
4
497
1,829
4
1,062
1,563 2,242
6,314 3,2rHi
!>.:) <:11
t-:1
CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
0'-
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c.
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INFANT HYGIENE
Admissions to 1nedical service
92
27
740
23
18
103
56
Admissions to nursing service____ _
92
91
6,369
78
70
162
118
Visits to medical conferences _________ _ 173
39
2,273
48
18
310
173
Field and office
194
186 10,553
19~
176
539
261
PRESCHOOL HYGIENE
Admissions to medical service _________ _ 130
37
1,585
144
89
Admissions to nursing service _________ _ 130
71
'i,537
36
163
128
Visits to medical conferences_________ _ 197
65
3,897
241
229
Field and office visits _______________ _ 209
90
9,946
49
321
159
Dental inspections
40
SCHOOL HYGIENE
Inspections by Ilhysicians or nurses ___ _
99
309 90,994
40
Examinations by physicians __________ _
73
662 31.677
366
Admissions to nursing service_________ _ 33
309
3,471
_Field and office visits _______________ _
5:i
314
8,765
15
67
Dental inspections
268
29,832
ADULT HYGIENE
Medical examinations
13
24,524
5:\3
~
1,007
~ c
1,820 ~
2,601 ~
3,120
1::::1
~
772 ~ ...,
1,898 '
1,895 3,405
~
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c
~
g:o-
47,321
12,676
1,386 2,928
-i:l:::
~ ~
s..
1,179
CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIEs-1942-Continued
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MORBIDITY SERVICE
Medical visits ------------------------ 23
~\using visits --------------------- ___
33
Admissions to hospitals _______________
SANITATION
\Vater supplies approved_______________
--
Privies and septic tanks installed ______ --
Food-handling establishments registered --
Dairy farms registered ________________
Milk plants registered _________________
Field visits --------------------------
5
LABORATORY SPECIMENS Specimens examined __________________ 1,340
1 24,665
79
822
3
723
1
58
28
2
3,403
646
37
143 47,710
403 39,09:i
3
49
10
28
224
15
1
5
1
26
8
10
25
1
18
86
il16
2,641
1,812
30
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2
--
2
12
7
2;)
1,117
136
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402 376 119
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6 0...,
25,278 42,672
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CoNDENSED REPORT oF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
.,..,
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COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________ Consultations with physicians________ Field visits -------------------------Smallpox immunizations_______________ Diphtheria immunizations______________ Typhoid immunizations________________
32 12 31 115 130 1,268
VENEREAL DISEASE CONTROL
Admissions to medical service__________ Clinie visits ________________
Field visits ------------------------ __ ~umber of clinic treatments ____________
109 l,:l06
294 1,213
TUBERCULOSIS CONTROL
Admissions to medical service_________ 60
Admissions to nursing service__________
91
95
329
MATERNITY SERVICE
Admissions to medical service __________
61
Admissions to nursing service~--------- 104
Visits by ante-11artum cases to medieal conferences ________ ----~ ____________ 238
Field and office visitL _______________ 308
,.,
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11 1 139 217 192 1,387
40
344 874 300 4,117
12
19 267 104 1,152
34 26 44 696 289 2,911
;;4 15 93 2,653 922 4,242
30
243
127
362
913
:162
3,227
2,124
4,089 13,10:)
36
397
251
136
614
353
2,920
2,000
4,078 13,049
17
4
46
152
144
20
63
77
173
218
17
61
59
146
190
:J4
464
161
813
1,01G
;,o
244
66
360
47
1;)7
689
62
163
689
90
936
134
382
1,967
104
1,6f>4
82
415
2,036
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5 3 6 96 182 1,787
9
63 572 330 1,378
205 21 61
433 454 1,708
32 1
34 491 170 1,222
197 3,13!)
139 2,8f>3
305 3,918
94 3,918
106 2,494
167 1,718
213 3,048
94 2,785
48
43
23
117
ri7
86
70
135
49
43
43
120
193
87
184
338
99
206
158
84
124
216
217
118
281
381
167
207
445
403
325
276
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65 140
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CoNDENSED REPORT oF AcTIVITIES oF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
.,., .:;;
i"ii
INFANT HYGIENE
Admissions to medical service__________ 22
Admissions to nursing service__________
51
Visits to medical conferences _____
81)
l'ield and office visitL_______________ 150
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13
91
27
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100
353
60
111
354
18
156
38
251
724
319
799
115
299
871
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14
23
165
45
105
27
165
78
14
28
138
76
146
34
286
140
PRESCHOOL HYGIENE
Admissions to medical service __________
11
46
58
2
55
120
12
Admissions to nursing service__________ Visits to medical conferences _____ ___
1.2,
148
351
46
137
6
;;;_;
93
51
2
68
138
12
Field and office visits_________________ 21
188 1.17'>
13
78
74
64
Dental Inspections_____________________
7
43
26
249
39
43
58
460
68
SCHOOL HYGIENE
Inspections by physicians or nurses ____ 578
4,377
148
:;s3
1,119
470
}~xamina tions by phys,icians __ ________
66
1
54
2
5
197
Admissions to nursing service__________
(;4
492
2
22
11
12
Field and office visits_________________
112
1,302
3
77
26
16
Dental inspections_____________________
135
34
3
109
6
200
643
ADULT HYGIENE
)ledical examinations -----------------
38
196
306
MORBIDITY SERVICE
Medical visits ------------------------ --
~
2
8
81
81
20
Nursing visits _______________________
25
146
122
44
86
4
45
Admissions to hospitals _______________
3
4
3
3
3
25
77
6
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Water supplies approved _______________
Privies and septic tanks installed _____
Food-handling establishments registered --
Dairy farms registered_________________ Milk plants registered_________________
Field visits --------------------------
4
LABORATORY SPECIMENS Specimens examined _________________ 656
1
46
12
3
3
775
581
3,990
18
15
2
67
67
24
5
44
4
3
17
32
724
1,037
2,135
552
1,675
4,074
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9 53
213
35
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2,408
2,561
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Admissions to medical service_________ Consultations with phrsicians________ Field visits __________________________
Smallpox immunizations_______________ Diphtheria immunizations ______________ Typhoid immunizations ________________
17 3
69 346 813 3,910
294
1,237
71
H6
:!26
4,226
42
32
3,419
239
73
963
136
698
2,082
34
1
15:1
1
101
1
1,0Il
434
947
3,lii4
VENEREAL DISEASE CONTROL
Admissions to medical service__________ 10
129
6,218
33
29
5;)
350
Clinic visits ------------------------ 107
1,379 76,149
482
319
697
8,044
Field visits __________________________
21
352
8,831
44
26
20
692
Xumber of clinic treatments___________ 106
1,379 62,625
473
376
68o
6,713
TUBERCULOSIS CONTROL
Admissions to medical service __________
98
42
616
5
3
7
40
Admissions to nursing service__________ 74
96
571
14
160
Clinic visits -------------------------
79
42
1,621
3
7
148
Field and office visits _________________ 265
223
6,325
61
716
MATERNITY SERVICE
Admissions to medical service__________
10
70
2,080
6
Admissions to nursing service__________
21
78
1,738
37
Visits by ante-partum cases to medical
1:!
206
6,466
6
46
383 16,109
70
207
--
258
52!-f 1,6fJ2
. ...ce
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6
5
1
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5;:)5
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2,005
120
1,359
3
20
1,125
1
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128
1
110
276
41 90
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Admissions to medical service__________
19
Admissions to nursing service________ 52
Visits to medical conferences ___________
54
Field and office visits _________________ 119
PRESCHOOL HYGIENE
Admissions to medical service________ 58
Admissions to nursing service__________
53
Visits to medical conferences_________ 81
Field and office visits ________________ 60
Dental inspections____________________
SCHOOL HYGIENE
Inspections by physicians or nurses ____ 9o6
Examinations by physicians ____________ 291
Admissions to nursing service__________
Field and office visits ________________ 98
Dental inspections_____________ _______
75
68
535
1
96
3,27:l
58
151
578
1
296 12,864
149
566
8
243
969
11
570
275
2,888
4
668
850 36,:\30
2;")7
15
2,031
1
9
5,692
8
13 12,912
20
110
2,892
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Medical examinations __________________
36
ti,707
1,174
--
264
MOBIDITY SERVICE
Medical visits -----------------------
2
Xursing visits ______ ------------------ 29
Admissions to hospitals________________ --
8 16,283
4
13
9,846
62
6,184
1
190
--
31
--
16
94
313
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SANITATION
Water supplies approved _ ~-----------
1
Privies and septic tanks installed ----
9
Food-handling establishments registered
--
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Milk plants registe-red_________________
Field visits _________________________
79
LABORATORY SPECIMENS
Specimens examined -- ----- ----------
22
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1
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950
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559 61,768
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Admissions to medical service__________ Cansultations with physicians -------Field visits -------------------------Smallpox immunizations_______________ Diphtheria immunizations______________ Typhoid immunizations ________________
158 28
366 1,405
618 2,557
VENEREAL DISEASE CONTROL
Admissions to medical service__________
Clinic visits -------------------------Field visits ------------------------Number of clinic treatments__________
256 4,983
274 4,434
TUBERCULOSIS CONTROL
Admissions to medical service__________ 116 Admissions to nursing service__________ 172 Clinic visits -------------------------- 132 Field ,and office visits_________________ 954
MATERNITY SERVICE
Admissions to medical service_________ 129 Admissions to nursing service__________ 231 Visits by ante-partum cases to medical
conferences ------------------------ 791 Field and Qffice visits----------------- 926
143
1
50
1
71
1
561
427
1,924
476 7,446
152 7,321
108 1,313
4 1,172
106
156
1
135
220
1
256 260
1,003 1,020
5 1 25 300 319 1,320
1
11 219 201 1,200
3
529
143
7,339
2,274
3
276
83
6,539
2,100
93
62
134
85
111
89
729
263
--
4
61
60
91
3
139
170
~21
18 3 46 543 224 1,()79
409 6,843
246 6,087
155 212 142 477
304 337
1,046 1,274
12 65 12!"J 1,369
4
84 91 93 163
5 333 292 1,074
--
6 6
310 22 86 671 326 2,6G2
1,232 4,729
337 3,566
116 116
59 681
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s 66 ~
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2,998 901
2,317
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274
312
54
128
274
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820
117
284
1,303
1,312
CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
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Admissions to medical service__________ 92
127
Admissions to nursing service__________ 200
164
Visits to medical conferences__________ 465
274
Fi.,ld and office visits _________________ 591
344
PRESCHOOL HYGIENE
Admissions to medical service__________ 48
171
Admissions to nursing service ________
91
169
Visits to medical conferences __________ 239
229
Field and office visits _________________ 274
227
-- Dental inspections_____________________
SCHOOL HYGIENE
lnspect1ons by physicians or nurses __ 2,868
1,414
Examinations by physicians ____________ 1,187
290
--
Admissions to nursing service__________
9
4
Field and office visits _________________ 22
96
Dental inspections_____________________
2,011
ADULT HYGIENE
1\'Iedical examinations ________________ 222
644
MORBIDITY SERVICE
Medical visits ------------------------ 187
3
Nursing visits ------------------------ 164
2
Admissions to hospitals________________
--
3
12
127
4
58
230
35
47
233
87
113
65
424
3
17
72
151
231 518
166
5 355
132 189
362 735
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84
66
38 51 47
98
4 13
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51 54 117
.... 515
488 514
";~.;..':.-
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129
4
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67
130
3
2
1,282
52
52
103
2
61
29
20
63
224
31
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185 808
605 728
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33
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185
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253
534
11
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43
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNT.Es-1942-Continued
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\\'ater supplies approved_______________
13
Privies and septic tanks installed _____
65
Food-handling establishments registered 11
18
Dairy farms registered _______________
8
:\lilk plants registered----------------
2
Field visits ____ ----------------------
58
565
14
LABORATORY SPECIMENS Specimens examined _________
1,242
2,783
309
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------
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COMMUNICABLE DISEASE CONTROL Admissions to medical service __________ 39
Smallpox immunizations_______________ Diphtheria immunizations______________ Typhoid immunizations________________
39 307 341 1,867
VENEREAL DISEASE CONTROL
Admissions to medical service __________ Clinic visits _________________________
Field visits -------------------------Number of clinic treatments ____________
234 2,886
87 2,663
TUBERCULOSIS CONTROL
Admissions to medical service__________
63
Admissions to nursing service __________ 116
Clinic visits __________________________
78
Field and office visits ________________ 263
MATERNITY SERVICE
Admissions to medical service________ 143 Admissions to nursing service __________ 139 Visits by ante-partum cases to medical
conferences ________________________ 419 Field and office visits _______________ 287
5
392
2
21
2
9
2,617
6
--
858
170
36
392
94
256
4,701
1,186
l:ll 1, 776
96 1,5ri7
72 1,013
97 981
67 1,193
179 1,195
88
33
2
212
80
1
113
57
5
747
228
425
30
--
498
54
--
1,939
67
--
2,582
168
2
87
2
5
94
1
5
1
2
181
2
2
6
148
178
2:l7
258
208
125
116
199
256
656
1,481
133
2,701
871
99
814
1
119
810
84
58
271
120
917
917
3,179
1,464
194
2
91
275
808
917
2,904
1,387
30
18
63
30
47
127
91
73
87
l!H
12:{
86
176
463
38
51
92
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63
1:!7
239
180
52
94
62
117
160
131
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407
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157 329
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Admissions to medical service____ ------ 79 Admissions to nursing service__________ 104 Visits to medical conferences ___________ 225 Field and office vis!ts _______________ 212
PRESCHOOL HYGIENE
Admissions to medical service__________ 30
Admissions to nursing service__________
9
Visits to medical conferences_________
31
Field and office visits _________________
11
Dental Inspections_____________________
--
SCHOOL HYGIENE
Inspections by physicians or nurses ____ 120
Ex,aminations by physicians___________
Admissions to nursing service __________
4
Field and office visits_________________
4
Dental Inspection---------------------
--
ADULT HYGIENE Medical examinations _________________ 38
MORBIDITY SERVICE
Medical visits ------------------------
6
Nursing visits ------------------------ 23
Admissions to hospitals_______________
--
120
14
457
53
169
20
1,017
132
--
21
21
76
45
34
25
213
106
7
62
11
149
26
99
32
332
370
8
819
16
837
10
3,659
21
5,963 58
139 233
1,271 205
430
42
42
10
14
29
21
61
--
--
199
--
--
--
83
--
13
4
15
30
13
4
24
40
--
--
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1
163
255
5
1
2
24
3
2
42
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1,229
4
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1
422
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
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Water supplies approved_______________
21
21
Privies and septic tanks Installed_______
--
209
21
17
Food-handling establishments registered --
--
20
--
Dairy farms registered________________
--
--
11
Milk plants registered_________________
--
1
--
--
--
Field visits -------------------------
--
1
930
23
5
1
4
LABORATORY SPECIMENS Specimens examined __________________ 1,497
700
5.H7
184
9
1,025
439
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775
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COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________ Consultations with physicians __________ Field visit' ____ ------------------Smallpox immunizations _______________ Diphtheria immunizations_____________ Typhoid immunizations ________________
I 1 3 70 28 1,493
VENEREAL DISEASE CONTROL
Admissions to medical service__________ Clinic visits __________________________
Field visits -- ----- -----------------Number of clinic treatments __________
77 1,740
36 1,348
TUBERCULOSIS CONTROL
Admissions to medical service --------
22
\.dmissions to nursing service__________
22
Clinic visits ______________________
23
Field and office visits ________________
24
MATERNITY SERVICE
Admissions to medical service __________
--
Admissions to nursing service__________
--
Visits by ante-partum cases to medical
conferences __ ----------------Field and office visits _______________
c
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126 1,743
619 6,j74
164 63() 415 2,461
10 216 197 2,914
44 23 448 2,264 1,338 7,500
529 7,620
575 7,247
93
3,850
1,850 3:1,331
--
134
2,266
1,728 32,781
272
82
88
2,::105
579
99
1,o61
293
98
3,5:13
1,800
250
191
5,414
14
138
116
33
577
54
868
21
;.4
1.782
332
3:)4
102
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140
36
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128
1,721
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483
331
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36
70
1,100
195
264
296
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1,3i3
2,624
3,652
2,719
2,28:i ..~.....
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20
29
1,637
85
421
374
~ ;::,
177 11
174
619 20,G84
:;o
2,447
444 L\,898
900 79
886
6,118 257
5,154
8,811 75
8,436
--""
0 ~
0:::
5;)
96
1:)2
fi2
28:)
278
:
~ '"'
30
126
69
26:1
:::z::
~
54
1,684
168
1,370
159 599
23 210
134 807
..~..,............
2,)9
61
29S
617
17G
760
151
240
14
173
2:i8
451
50
2:)
596
6Ki
_j
CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
-..."..,..'
., "'C>
ii:
c
=.C".~.>'
.:;;;
c
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c
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c c
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~
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INFANT HYGIENE
Admissions to medical service__________
--
Admissions to nursing service__________
Visits to medical eonferences
Field and office visits _____
PRESCHOOL HYGIENE
Admissions to medical service __________ Admissions to nursing service__________
Yisi.s to medical conferences
}~ield and office visits _______
Dental inspections_______
--.-------
--
SCHOOL HYGIENE
Ins!Jections by physicians or nurses ___ J<:xaminations by physicians ___________
Admissions to nursing service__________ Field and office visits_ ___
Dental inspections________ -------------
--
30
2:11
Ei:J
38
Gil
677
116
~II
398
!!6
229
36
914
211
:i,669 4,6:1!
34 166
~.278
1 2.) 36
42
725
88
1,476
67
1,579
2:J7
ri,671)
28
1,948
47
2,949
8:;
2,693
129
7 ,lOG
3
;,,426
2,:)88
1,129
11
2,511
25
82
60
83
84
:J311
28
184
307
137
141
141
I:"-< Ci
2f:7
1,324
120
487
649 ."Q."...
374
31
:i17
430
39
946
::t:
45
17
8!)
176 604
;;".:.:;'.,...
20 89
42 170
435 1,618
a...,
'{
::l
t;;
2
1,860 3
1,09:J
121 1,2:18
1,334 419
;.,:.:,,. "0"
;:I
24
44:J
0
"'
36
3,894
1,33G
ADULT HYGIENE
Mediral examinations ----------------
924
1,293
2111
1,781
--
869
66
MORBIOITY SERVICE Medical visits _______________________
Xursing vh:its _______ --------- ----Admissions to hospitals _____________
3
2
91
IO:J
7
13
5
7;)8
87
--
2,262
423
188
140
142
18
13
1 13
.o.f..>...
I
J
CoNDENSED REPORT OF ACTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
.~.......
......
0
ii:
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...c:
c: II.
c:
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::1
..
E ~
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.c.0...:
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........
Cll
Cll
SANITATION
Water supplies approved______________
--
2
3
--
206
--
Privies and septic tanks Installed ______
38
22
20
3
397
--
Food-handling establishments registered
--
176
157
--
Dairy farms registered_________________
--
Milk plants registered_________________
--
42 18
--
--
1
--
----
Field visits __________________________ 126
1,268
22
11
7,100
3
LABORATORY SPECIMENS
Spcimens examined __________________
1
2,007
430
408 13,584
209
--
2
114
125
15
1
18 156,230
2
2
41
104
--
--
22
9,402
414 18,024
1,148
2,649
t
....
~
~
61
~
<:>
72
--
~s
---
458
t:::! ~
.~..
~
2,206
~
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~
g:0"'
t:t:
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;~;.
CoNDENSED REPORT oF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY COUNTIES-1942-Continued
=.
1:
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Ill
.....E...
.a
:z:
..
:z:
....10....:
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0
~.
:z:
:z:
.......
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:z:
.~
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..~
1:
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-"0:;'
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COMMUNICABLE DISEASE CONTROL
.Admissions to medical service__________ Consutatlons with physicians __________
Field visits -------------------------Smallpox Immunizations_______________ Diphtheria immunizations______________ Typhoid Immunizations________________
50
94 785 418 3,811
22 18 132 390 263 2,243
13 1 226 486 660 3,703
11 25 60 645 497 2,565
1 3 18 1,115 222 1,661
9 5 30 1,251 123 2,169
1
3
4
11
2
1
3
11
2
13
11
21
4
601
1
2
442
634
VENEREAL DISEASE CONTROL
.Admissions to medical service__________ 190
49
603
68
21
211
51
148
--
Clinic visits ------------------------- 3,901
515
5,312
1,135
128
3,100
969
2,296
--
Field visits -------------------------- 82
116
306
58
40
10
--
3
Number of clinic treatments____________ 3,502
512
5,071
1,135
92
3,056
836
--
2,081
--
TUBERCULOSIS CONTROL
.Admissions to medical service__________ 118
136
112
2
71
90
10
6
46
6
.Admissions to nursing service__________ 214
82
184
55
161
96
6
91
6
Clinic visits ------------------------- 79
137
110
54
16
92
10
3
57
6
Field and office visits ________
685
454
663
110
295
210
8
159
6
MATERNITY SERVICE
Admissions to medical service__________ 42 Admissions to nursing service__________ 73 Visits by ante-partum cases to medical
conferences ~-----------------------
86
Field and office visits ________________ 145
37
13
340
55
219
435
71
186
911
203
123
992
--
140
31
146
391
60
413
--
--
5
4
--
--
--
--
--
6
5
.
~
3
25 118
ct--o
165 1,312
.2....
::X::
38 ~ "s'.
419 1
c...
391
-~
35 c
128 ;::
36 "'
218
95 119
300 510
~
CONDEN~~D REPORT oF AcTIVITIES OF LOCAL HEALTH DEPARTMENTS, BY CouNTIEs-l942~Con~inued
"cc
'i
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...
~
."0
"c
c
0
~
f.
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~
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:c
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X
INFANT HYGIENE
Admissions to medical service~--------
48
Admissions to nursing service__________ 104
30
103
215
--
10
77
430
459
47
25
Visits to medical conferences
112
81
214
336
27
Field and office visits _________________ 268
228
1,875
1,065
112
46
-.~
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c
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~
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1
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--
1
126
PRESCHOOL HYGIENE
Admissions to medical service
112
Admissions to nursing service__________ 143
Visits to 1nedical conferences __________ 161
Field and office visits ________________ 254
Dental inspections _____________ -------
--
SCHOOL HYGIENE
lnspertions by vhysicians and nurses _
Examinations by physici-ans ____________
Admissions to nursing service __________
Field and office visits ________
Dental inspections ______
-------
5r:i7 1,033
814 870
36
141
246
63
48
403
fi89
68
29
98
331
432
68
193
1,189
951
167
44
123
3,217
648
9
322
290
686
5
66
35
s
42
90
103
17
147
1
103
1
1
1
--
1
1 4 8 22
ADULT HYGIENE
)fediral examinations ________________
30
1
416
1
17
MORBIDITY SERVICE
l\fedical visits
-------------
48
Xursing visits ------- ________________ 187
Admissions to hospitals _______________
14
3
26
32
2!'!
'\7
sn
28
4
7
7"
3
23
4:16
3
........
c
~
~
54 92
".c..'.
101
r:Je. ~-
104
i:::l
1 "."~,"...",,'.
5 ;::!
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c
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138 8
:
:"":t''::
14 \":.'..
;;.
230 3:i0
5
CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-l942----ontcinued
-""""i
.E
.~
."c
-;
~
8".
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X
X
X
SANITATION
'Vater supplies aPilroved ____________ __
2
Privies and septic tanks installed _____ _ 19
Food-handling establishments registered
Dairy farms registered________________
Milk plants registered_________________
14
20
65
13
26
Field visits
733
203
2.385
.~"""'
."~ '
~
X
X
10 13
4
75
."t:
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X
X
;:_.
t":
X""
:::J
X"
--
7
22
73
35
19
62
161
183
LABORATORY SPECIMENS Specimens examined
761
458
2.163
1.022
151
868
12
33
197
43
"~
19
t"-<
0
."!;.:>'..
5 ::t::
....~
!;:>
387 ;:;:.
a....
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"g~'
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CoNDENSED REPORT oF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY COUNTIES-l942-----ontinued
...."0....,
........,.
.
;;;
1:
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0
I!
...,
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COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________ Consultations with physicians____ . _____
Field visits --------------------- ---Smallpox immunizations_______________ Diphtheria immunizations ______________ Typhoid immunizations________________
2 4 33 43fi 826 4,345
VENEREAL DISEASE CONTROL
Admissions to medical service__________
Clinic visits ------------------------Field visits -------------------------Number of clinic treatments __________
144 1,838
230 1,820
TUBERCULOSIS CONTROL
Admissions to medical service _________ f5 Admissions to nursing service__________ 121
Clinic visits -------------------------- 75 Field and office visits ________________ 314
MATERNITY SERVICE
Admissions to medical service __________ 31 Admissions to nursing service_________ 50 Visits by ante-partum cases to medical
conferences ------------------------ 95 Field and office visits _________________ 156
1 2 19 568 569 1,781
146 1,976
193 1,826
17 29 17 137
76 100
209 383
1
14
61
8
1
1
6
18
1
2
49
121
1
61
1
288
242
262
7'3
168
248
632
318
318
62
300
117
964
2,627
2,541
1,715
3,049
1,734
92
244
347
132
826
3,084
4,405
1,253
142
929
54
31
803
3,052
4,397
1,089
163 3,029
109 3,022
220 3,593
223 3,206
72
34
117
37
59
104
130
98
118
38
103
132
72
28
151
39
62
128
168
264
42:i
114
381
461
14
493
271
37
86
142
26
493
271
55
138
183
24
1,471
1,150
135
90
1,826
1,225
252
192
350
332
691
48
254
2
117
64
106
165
2.913
188
750
778
5,155
133
466
987
4.389
445
54
784
4,372
38
105
66
105
38
205
144
333
91
12
116
20
242
8
373
40
~
.
....
~
1 1
."c.,'
10 ~ ;;
472
203 1,056
t:l
"'"!.l.:..::.1,.l.
;3
"'.... 295
~
2,864
119 ~
2,293
~
!o;: -
33 f-
48 ::t:
36 128
;a";'...
202 218
500 620
J
CoNDENSED REPORT oF AcTIVITIES oF LocAL HEALTH DEPARTMENTS, BY CoUNTIEs-1942-Cont>inued
.."...
~"
..........
....;.:
Cl ~
.:%...".:..!
.,
.~.""..
..s""0....
.".......
.....E....
..
..."..
.. ."f
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....
INFANT HYGIENE
Admissions to medical service__________ 22
27
7
163
125
4
44
62
40
Admissions to nursing service__________ 47
62
25
163
163
ll7
172
198
87
11
Visits to medical conferences__________ 67
65
13
334
280
4
77
110
40
Field and office visits________________ 185
149
70
426
222
63
405
599
210
14
PRESCHOOL HYGIENE
Admissions to medical service__________ 21
Admissions to nursing service__________ 16
Visits to medical conferences___________ 46
Field and office visits_______________
69
Dental Inspections_____________________
--
SCHOOL HYGIENE
Inspections by physicians or nurses ____ --
Examinations by physicians____________
--
Admissions to nursing service__________ --
Field and office visits .--------------- --
Dental Inspections_____________________ 41
3
44
32
22
14
32
28
65
27
7
58
35
15
14
163
148
71
1
6
61
84
25
14
48
45
88
19
24
91
104
15
14
333
313
136
13
--
-- --
5
29
--
--
to
-- 1,753
31
233
1,274
20
1,454
789
--
42
--
--
946
109
8
49
--
54
--
55
16
14
81
4
--
310
--
84
150
--
--
582
--
621
ADULT HYGIENE
Medical examinations ________________
--
MORBIDITY SERVICE
Medical visits _______________________
--
Nursing visits ------------------------ 13
Admissions to hospitals---------------- --
426
9
--
388
1,107
--
--
44
50
--
33
--
214
2
7
6
78
4
--
89
85
493
2
--
1
--
31
..
....
78
151
154 tc--
372 .'!".:>.'..
::t::
106 138 156 285
s"~'.
a....
-- I{
;::s
405 9
~.!o:.>.
;::s
6 49
"'
2 121
~
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIES-1942-Continued
c
.,~
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~
SANITATION
Water supplies approved_______________
1
Privies and septic tanks installed _____
22
Food-handling establishments registered
Dairy fanns registered ________________
--
Milk plants registered _________________
Field visits __________________________
11
LABORATORY SPECIMENS Specimens examined ------------------ 782
... ~"""''
:";:'
-Q "
~
=."0.'.
~
:;"c;;'
c
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c
.c~.,
~
2
--
12
--
1
4
43
3
8
--
18
--
--
3
1
112
39
825
36
640
65~,
uh.
1,321
320
...
...
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"c"'
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14..
14
2
30
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CJq
~
4
6
52
36
1:i
322
1::::::1
~
7
"T;,
.i...;....l.
;3
s:;s
961
609
3,043
1,487
~
-.~....
a
~
g:!o::-
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~
i;l
s""."'
CoNDENSED REPORT oF AcTIVITIES oF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
~
.::c:;
COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________
Consultations with 11hysicians ------
]'!eld visits -------------------------Smallpox immunzations _______________ Diphtheria immunizations ______________ Typhoid immunizations ________________
157 :;
603 750 339 1,453
VENEREAL DISEASE CONTROL
Admissions to medical service _________ Clinic visits _______________________ Field visits __________________________ Numbc.r of rlinic treatments __________
442 7,289
556 6,545
TUBERCULOSIS CONTROL
Admissions to medical service
20
Admissions to nursing service _________
61
Clinie visits ________________________
14
Field and office. visits _______________ 210
MATERNITY SERVICE
Admissions to n1edical service__________ 148 Admissions to nursing service __________ 175 Yi.sits by ante- parturn cases to medical
conferences ____ ------------------- 452 Field and offiee visits ________________ 607
~
c
0 ~
:::;
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0
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""c"
"0
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i73
338
3
70
1,131
679
279
1,343
9
92
621
1,023
388
104 1,178
13 1,162
113 3,126
373 3,o42
1,048 16,78;)
322 11,513
41
160
G3
166
44
167
ISO
1,4 iO
40
478
60
566
l!'il
I ,851
209
2,835
.c
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"~
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.c
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c"
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u
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1
130
12
1
14
5
38
66
52
160 131
.96
9,"
458 13
728
1,2:15
1,600
25
328
505
5,178
10
12
499
4,710
109 2,164
774 1,6.>:!
392 6,054 1,028 5,471
82
10
71
113
22
87
93
102
107
141
:!43
352
33
79
151
59
86
206
71
78
367
1:39
n:l
1,387
c
.~
:;; ::;;
c
~
":;;
2
2
2
106
49
20
8
137
52
72
849
1,288
2
564
994
=;~s
:;;
10
6
61 1,234
312
-ta"-
(') 1:)
3,769 ::X::
"(:'..
;:;.
269 3,621
a...,
72 C/0.
1:)
3,144
N;:: .
90
c~;
;::
199 "'
90
491
119 163
256 333
.j:. 10
CoNDENSED REPORT OF AcTIVITIES oF LOCAL HEALTH DEPARTMENTS, BY CouNTIEs-1942--Continued
....
.'1.:.:
:::;
..c:
0
c:
:::;
.....
.."0.'.
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E
g
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c:
c;
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:E
:E
c:
..:i;i;i
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~
:E
:E
INFANT HYGIENE
Admissions to medical service_________ 147
Admissions to nursing service_________ 214
Visits to medical conferences__________ 371 Field and <Jffice visits _______________ 641
PRESCHOOL HYGIENE
Admissions to medical service__________ 107
Admissions to nursing service__________ 115
Visits to medical conferences________ 184
Field and office visits _________________ 246
Dental insp!X'tions_____________________
--
SCHOOL HYGIENE
Inspections by physicians or nurses ____ Examinations by physicians____________ Admissions to nursing service __________ Field and office visits________________ Dental insp!X'tions_____________________
1,120 569 109 453
--
ADULT HYGIENE Medical examinations ----------------- 29
MORBIDITY SERVICE
Medical visits ------------------------ 87
Nursing visits ------------------------ 123
Admissions to hospitals________________
3
15
339
26
--
31
45
86
501
93
--
69
147
--
22
1,584
54
--
31
251
--
149
2,352
198
--
363
928
--
10
522
56
--
67
17
641
148
--
34
82
12
1,758
114
275
24
2,864
284
--
215
1,213
--
--
1,042
1,488
40
--
580
--
9
452
48
199
8
60
17
13
2,639
271
236
--
737
3,699
45
212
1
2,273
31
--
52
5,478
37
--
145
1,379
--
20
--
%2
(./1
0
;...:.,
.~
:E
~
... 33
Ccb
147 CT'l
39 ~
192 1::::1
Cb
126 260 136 325
--
~!.;.:..::...
-...C;:b:,
c
~
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30
6 ::t::
---
;.!.C:.,r:..b...-..
39
24 146
CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs, BY CoUNTIES-1942-Gontinued
~.
:"::'i
0"., :"::i
.
."0..
.."..'
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.,:I
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:;;
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::E
::E
::E
SANITATION
Water supplies approved______________ Privies and septic tanks installed ______ Food-handling establishments registered Dairy farms registered ________________ Milk plants registered _________________ Field visits __________________________
3 17 31
1 1 1,486
LABORATORY SPECIMENS Specimens examined ----------------- 3,360
--
6
--
5
9
17
3
--
--
--
--
2
39
342
4
94
9
47
--
34
--
5
--
--
--
64
115
26
--
1
1,199 10,079
217
988
1,033
655
1
48
;... .~
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26
t--
--
--
-0
(')
1!:1
92 ::X::
;~:..
s. 1,011 c...,
~
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o
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1:/1
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-l942~Con~inued
~
"
:;:
COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________
Consultations with physicians ________ Jl'ield visits __________________________
Smallpox immunizations_______________
--
Diphtheria immunizations_____________
Typhoid immunizations________________
VENEREAL DISEASE CONTROL
Admissions to medical service__________
1
Clinic visits _____________________
Field visits -------------------------
1
TUBERCULOSIS CONTROL
Admissions to medical service_________
Admissions to nursing service __________
4
Clinic visits ______________ - - - - ~------
Field and office visits _______ ~-----
4
MATERNITY SERVICE
Admissions to medical service Admissions to nursing service __________ Yisits by ante-partum eases to mediral
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so
272 iiS:l 491 4,84H
609 8,702
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89 8:1 55 636
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SANITATION
Water supplies approved
8
28
18
Privies and se>Ptlc tanks Installed ____ _
19
111
44
10
17
211
34
Food-handling establishments registered
189
Dairy farms registered ________________
65
~Iilk plants
3
Field visits
18
94
53
19
13
17
8,342
31
6
21
--
5
56
LABORATORY SPECIMENS Specimens examined
1,919
604
355
202 10,728
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COMMUNICABLE DISEASE CONTROL
Admissions to medical service__________ Consultations with physicians__________
Field visits -------------------------Smallpox immunizations _______________ Diphtheria immunizations_____________ Typhoid Immunizations________________
15 5
52 564 438 1,754
VENEREAL DISEASE CONTROL Admissions to medical service__________ Clinic visits -------------------------Field visits ---------------------------
306 5,693
281 5,080
TUBERCULOSIS CONTROL
Admissions to medical service _________ 110
Admissions to nursing service__________ 165
Clinic visits ------------------------- 137 Field and office visits_________________ 386
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280
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1,355
19
164
224
205
1,862
3,773
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215
202
1, 778
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240
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Admissions to medical service__________ 236 Admissions to nursing service________ 307 Visits by ante-partum cases to medical
conferences ------------------------ 543 Field and office visits ______________.___ 609
113
61
72
66
130
131
--
150
66
290
159
320
256
377
357
--
151
292
53
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63
107
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194
354
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Admissions to medical service __________
99
Admissions to nursing service__________ 150
VL;Its to medical conferences ________ 1;)3
Field and office visits _______
214
PRESCHOOL HYGIENE
Admissions to medical service __________
20
Admissions to nursing service __________
14
Visits to medical conferences _________
9:J
Field and office visits _______________ 109
Dental inspections____________________
--
SCHOOL HYGIENE
Inspections by physicians or nurses Examinations by physicians __________ Admissions to nursing service __________ Field and office visits _________________
Dental inspections ___ ~'i-"--"c-~---------
24
5 5 1,250
ADULT HYGIENE
:Medical e<xaminations -----------------
--
MORBIDITY SERVICE
~-!edical visits -----------------------
Nursing visits -- ----- ---------- -----
1
Admissions to hospitals ______ .,:. ________
57
2
100
83
116
2
231
160
92 123 131 242
12
60
49
1
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52
5
54
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29
140
29
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172
221
184
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101 163 2:!1 709
--
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40 138
81 5;)0
9 37
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1,239 318 11 212
1,927
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469 1,603
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21
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
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\Vater supplies aimroved ______________ _
Privies and septic tanl{s installed ____ _
23
Foodhandling establishments registered
Dairy farms registered________________
:\Iilk plants registered_________________ _
Field visits
55
LABORATORY SPECIMENS
StH>rimens examined _________ _
601
22
18
9
39
55
29
1,015
737
70
2
28
2,048
30
12
11
4:17
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Admissions to medical service _________
1
11
9
51
18
10
3
38
1
Consultations with physicians __________
1
2
3
28
8
13
Field visits ---------------------------
1
73
16
43
63
67
21
85
2
1
Smallpox immunizations_______________ 74
159
229
81
591
1,212
1,187
116
112
--
Diphtheria immunizations______________ 102
95
194
189
474
311
606
302
11
--
Typhoid immunizations________________ 967
l'i3
2,388
558
5,125
2,738
1,912
4,365
198
VENEREAL DISEASE CONTROL
.Admissions to medical service__________ 87
164
554
121
915
66
Clinic visits -------------------------- 2,259
2,928
8,485
809 19,427
773
Field visits -------------------------- 40
499
6
235
452
150
~umber of clinic treatments_ _________ 1,412
2,308
7,919
747 16,928
765
58
611
611 12,867
:13
107
586 11,544
102 1,808
28 1,380
162 2,725
5 2,496
TUBERCULOSIS CONTROL
Admissions to medical service__________ -Admissions to nursing service__________ -Clinic visits -------------------------- -Field and office visits _________________ --
84
52
91
213
26
81
128
667
138
124
48
392
212
34
149
447
1,fl96
174
43
106
49
127
46
99
113
;}26
3
14
3
2
14
3
MATERNITY SERVICE
Admissions to medical service__________ --
25
105
120
274
43
65
452
--
Admissions to nursing service__________
--
53
107
133
348
78
111
577
--
Visits by ante-partum cases to medical
42
296
350
1,029
83
127
1,583
118
302
438
1,326
~32
217
2,134
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290 6
291 1,327
158 2,748
81 1,368
167 1,361
3 83
3 150
4 48
7 113
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Admissions to medical service__________
--
9
6
39
153
22
15
217
--
--
Admissions to nursing service_________ --
42
25
91
369
68
60
347
Visits to medical conferences__________
11
7
62
301
50
23
531
Field and office visits ________________
109
34
194
1,084
197
100
1,163
PRESCHOOL HYGIENE
Admissions to medical service__________
4
6
159
107
Admissions to nursing service__________
--
28
Visits to medical conference.. _________
4
10
394
130
6
292
117
Field and office visits ________________
46
17
818
184
Dental inspections____________________
--
--
--
SCHOOL HYGIENE
Inspections by physicians or nurses ____
Examinations by physicians ____________
--
Admissions to nursing service__________
Field and office visits~---------------
Dental Inspections ____________________
--
393
1
4
2,754
1,199
253
172
2
1
28
12
4
18
165
114
57
5,438
ADULT HYGIENE ].!edical examinations ----------------
1,292
207
98
1
169
297
3
560
--
7
J32
552
--
13
8
31
161
--
-- --
----
MORBIDITY SERVICE
Medical visits ________________________
Nursing visits --------------- -------
2
Admissions to hospitals ________________
15
9
35
3
13
8
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SANITATION
Water supplies approved ______________ _
Privies and septic tanks installed __ __
Food-handling establishments registered Dairy farms legistered _____ _ :V!ilk plants registered __________ _
Field visits
11
LABORATORY SPECIMENS Specimens examined
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1,381
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Admissions to medical service __________ Consultal.ions with physidans ------ ___ Field visits ___ -- -----------------Smallpox immunizations ______________ Diphtheria immunizations ______________ Typhoid immunizations ________________
T4 3
63 I
39 1,023
VENEREAL DISEASE CONTROL
Admissions to medical service__________
Clinic visits ------------------------ __ Fie!d visits __ ----------------------:Number of clinic treatments _________
215 4,738
102 3,311
TUBERCULOSIS CONTROL
Admissions to medical service _________
50
Admissions to nursing senice________ __ 53
Clinic visits
---- -------
GO
Field and office visits ________________ 120
MATERNITY SERVICE
Admissions to medical service________
53
Admissions to nursing service__________
79
Visits by ante-partum cases to medical
conferences ------------------------ 166 Field and office visits _________________ 260
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1 188 2:i2 1,387
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1 8,790
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308
38
118
482
123
482
475
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549
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479 4,724
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55;) 606
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138
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171
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612 4,688
317 4,423
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98 2,784
170
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96
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433
147
306
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399
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1942-Continued
>....
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1-
INFANT HYGIENE
Admissions to medical service----------
2
86
Admissions to nursing service---------- 15
105
Visits to medical conferences---- _____
3
:J77
}~ield and office visits ___________
36
496
PRESCHOOL HYGIENE
Admissions to medical service__________ --
1
Admissions to nursing service__________
1
1
Visits to medical conferences ________
3
1
Field and office visits --------------
4
7
Dental inspections____________________
--
SCHOOL HYGIENE
Inspections by physicians or nurses
156
10
Examinations by physicians
Admissions to nursing service __________
4
!8
Field and office visits ----------
30
53
Dental inspections____________________
579
306
ADULT HYGIENE
Medical e.xaminations ----------------
--
MORBIDITY SERVICE
~Iedical visits ------------------------
Nursing visits ------------------------
2
1
Adn1issions to hospitals ________________
~. ..E.....
1-
1-
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1-
146
316
142
43
146
571
360
98
427
891
374
90
435
1,877
753
209
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175
29
103
215
56
2ll
155
49
237
327
131
--
--
--
182
104
1,064
82
18
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6
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127
1
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187
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205
439
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310
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220
139
824
116
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22
188
9
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32
326
15
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41
9,029
135
4
390
13
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445
181
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SANITATION
'Vater supplies approved _______________
1
Privies and septic tanks installed ______
9
Food-handling establishments registered
--
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--
:\filk plants registered_________________
Field visits --------------------------
35
1
1
2
1
18
12
19
3
--
--
--
8
129
15
259
73
LABORATORY SPECIMENS Sveeimens examined -------
218
678
1,855
2,477
2,168
698
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4
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2,295
344
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COMMUNICABLE DISEASE CONTROL
Admissions to medical service--------
1
Consultatio:-ts with physicians - -- --
Field visits ---- ---- ---------- --
2
Smallpox immunizations ____________ 2:i1
ll"iphtheria immunizations ____________ 223
Typhoid immunizations _______
926
VENEREAL DISEASE CONTROL
Admissions to medical service_________
--
Clinic visits -- ---- ---- ---- ------
Field visits ------------------------
TUBERCULOSIS CONTROL
Admissions to medical service __________ Admissions to nursing service __________ Clinic visits ____________________
Field and office visits -- ---- --
MATERNITY SERVICE
Admissions to medieal service _________
Admissions to nursing service __________
--
ViRits hy ante-partum casrs to medieal
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30
132
1
16
21
81
13
251
1:30
19
219
1,535
404
842
107
592
476
462
--
1,035
r.,201
4,188
4,006
324 8,456
ri6 7,795
106 2,096
226 2,039
207 3,41:1
145 3,409
:168 5,983
5,342
16o 1,935
1,681
136
226
66
94
268
316
221
94
162
222
144
102
760
846
627
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\Vater supnlies approved______________
Ptivie~ and septi<"' tanks ins~alled ______
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220
47
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74
363
808 1:i.008
49
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Specimens examined ------------------
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COMMUNICABLE DISEASE CONTROL Admissions to Commttations Field visits __ Smallpox Diphtheria Typhoid
VENEREAL DISEASE CONTROL
Clinic visits Field visits Xumbcr of clinic treatments ____________ _
TUBERCULOSIS CONTROL Admissions to medical
MATERNITY SERVICE Admissions to medical sernce________ Admissions to nursing Visits by ante-nartum Fie~ct and office vL<;its
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PRESCHOOL HYGIENE Admissions to medical
Dental inspections___________________________________________________________________ _
SCHOOL HYGIENE Inspections by physicians
Admissions to nursing Field and office '\'isiLs Dental inspections ADULT HYGIENE :Medical examinations - MORBIDITY SERVICE Medical visits Nursing visits Admissions to
98 117 1:;9 20\J
265 264 333 363
3,367 799 6 26
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Dairy t'arms regis~erell _____________________ ------------------------------------------ _____________
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Milk plants registered------------------------------------------------------------ ________________
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Field visits _____________ ________ ______ __ ____________________ --------------------------- _______ :>86
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LABORATORY SPECIMENS
Specimens examined _____________________________________ . -------------------------- ___________ 2,461
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70
Georgia Department of Public Health
NOTES:
The following counties have full time health unit:
Atlanta, City of
Avvling-\Ya:vne *
Baldwin Bibb-Jones
* Blecldey-Dodge-Pulaski
Brooks Bulloch
Burl{e-.Tenkins *
Calhoun Chatham Clarke Cobb Coffee Colquitt Crisp-Worth* Decatur DeKalb Houghert:r Floyd Fulton Glynn-Camden-)Iclntosh * Grady Greene G\vinnett
Habersham-Rabun-Stephens *
Hall Hanrork
Harris-.:\Ieriwether *
Jefferson Laurens Liberty Lowndes )!ltchell .:\Iusrogee Richmond Spalding Sumter Telfair- Wheeler* Terrell Thomas Tift Troup
"'alh:er-C'atoosa *
Walton Ware Washington Whitfield
*Health district composed of two or more counties.
The following counties have nursing serv1ce only:
Atkinson Baron Baker Barrow Brantley Bryan Butts Candler Charlton Chattahoochee Clayton Clinch f'oweta Crawford Dade Da\vson Douglas Echols Effingham Emanuel Evans Fannin Forsyth
Franklin Glascoek Gordon Haralson Heard Henry Irwin Jackson .Tasver .Jeff naris Johnson Lamar Lanier Lee Long Lum}lkin ::\I a e o n ~Ion roe ::\lontgomery )I organ llurray Peach Pierce
Pike Putnam Randolph Serer en Seminole Stewart Tattnall Taylor Toombs Treutlen Turner Twiggs rnson Webster \Yikinson
Work in the remarmng counties was done by regional personnel and special venereal disease control itinerant nurse1i.
Division of Public Health Nursing
January 1, 1942, found the country at wa.r. It was impossible to forecast what changes would be necessary in the nursing program to meet this overwhelming national catastrophe. Certain changes could be anticipated, among them~the shifting of population, with the concentration of people around war industries and army camps, causing an increased hazard in relation to communicable disease; the withdrawal of women from their homes to industries and other types of war work creating the problem of child care; the scarcity of foods with the problem of maintaining good nutrition; the withdrawal of private physicians to military service resulting in the lack of adequate medical care, especially in rural areas; but, the problem which gave greatest concern was the anticipated withdrawal of public health personnel-physicians, nurses and engineers-to service with the armed forces. All of these changes have occurred, creating the need for greater health protection than has existed in recent years, a need which has had to be met with a depleted staff.
GROWTH IN NURSING SERVICE
The annual census of public health nurses which is taken on January 1st of each year, shows a total of 507 nurses employed on January 1, 1943. This figure represents an increase of 84 nurses as of January 1, 1942, a growth during the year of 19 per cent in the total number of nurses employed. Of this group 358 nurses were employed by official health agencies, 32 by non-official health agencies, and 117 by industries. Though definite gains have been made in the extension of public health nursing in Georgia during the past year there still remained at the end of ~he year 37 counties without full-time nursing service. During the year nursing services were es.tablished in seven new counties, namely: Dawson, Heard, Monroe, Jeff Davis, Randolph, Stewart, and Turner. One county, Schley, discontinued service. Walker and Spalding counties employed a fourth nurse, one of the group being given status as senior nurse. Two assistant supervisors were appointed in Fulton County and one in Muscogee County. Four counties added a second nurse, Stephens, Decatur, Meriwether, and Colquitt. The nursing unit connected with the venereal disease service in the City of Atlanta was reorganized. A supervising nurse was appointed and three colored nurses were added to the staff.
In order to bring at least part time service to those counties which had no nursing service whatever the State Department of Public Health established an itinerant nursing service through which treatment for venereal diseases and immunizations against communicable diseases are being provided. This service now covers 32 counties.
At the close of the year 35 public health nursing positions were waiting to be filled.
On December 31, 1942, State and local official health organizations employed the following nursing staff:
72
Georgia Department of Public Health
Director ------------------------------------------- 1 Associate Directors_________________________ ________ 2 Industrial Hygiene Consultant_________________________ 1 Instructor, Public Health Nursing______________________ 1 Regional Consultant Nurses___________________________ 6 Regional Reserve Nurses______________________________ 4 Local Health Organizations-Supervisors_______________ 19 Local Health Organizations-Staff Nurses_______________ 324
Total_______________________________________ 358
Additional nurses employed byNon-official agencies_______________________________ 32
Industries --------------------------------------- 117 Total _______________________________________ 507
During the year 42 nurses resigned, 12 to enter military service; 10 to marry; 5 for maternity leave; 4 because of illness; 4 to accept other positions; and 7 for other reasons. The number of resignations in 1942 was nearly twice the number that occurred during the entire two prect>ding years.
The service of the public health nurse has been augmented by the use of clinic nurses who have been recruited for the most part from among inactive marrried nurses. In cities these nurses have usually served in a full time capacity .and in rural areas on a part time basis. At the close of the year there were 15 full time and 77 part time clinic nurses being used. Their service has included the setting up and dismantling of clinics; administration of vaccines, the sterilization of equipment, syringes and needles for the venereal disease clinics; the mixing of drugs and assisting physicians in these clinics; assistance in record keeping and clinic management.
V:olunteer lay help is also being increasingly used especially in connection with maternal child health conferences.
TRAINING PROGRAM
One of the most serious effects of the war on the development and extension of public health nursing in Georgia has been the decrease in the number of new nurses being trained for service. That number has decreased from 65 in 1941 to 46 in 1942, a loss of 29 per cent, and this reduction in trainees occurs at a time when additional service of hi '!h quality is increasingly and urgently needed. It is doubtful if the number of trainees can he increased in the coming year. It is the young graduate nurse who is most needed for military service and a very high per cent of
all the younger nurses will continue to join the Army or Navy Nurse Corps.
The 46 nurses selected for training during the past year attended the institutions listed below:
Public Health Nursing
73
Peabody College __________________________ Frontier Nursing Service____________________
Columbia University ----------------------Medical College of Virginia__________________
34 2 1 9 (colored)
HEALTH CENTERS AND NURSING EQUIPMENT
Thl'oughout the year steady gains have been made in securing better housing for health services. This has been especially true in nursing counties where in many instances the provision of offices was very inade quate. Several new health buildings have been completed and plans for the erection of others are being made with the hope that they can be carried out as soon as the war is over. Additions have also been made to nursing and clinic equipment. These materials include standard nursing bags, scales, examining tables, sterilizers, a more adequate supply of syringes and needles. Many of the health centers have been made more attractive by the provision of paint and new floor covering, and suitable furniture to replace improvised articles.
MATERNAL AND CHILD HEALTH SERVICE
Early last spring five nurse mdwives were assigned to carefully selected counties to carry on a program of intensive supervision of the lay midwives. These nurses had all had special training in midwifery. A detailed account of this program and an evaluation of results obtained is given in the report of the Division of Maternal and Child Health. Throughout the year emphasis has been placed on more adequate nursing care for pre mature babies. Miss Theodora A. Floyd, Assodate Director, spent three weeks at the Michael Reese Hospital observing the care of premature infants. Miss Floyd has shared this knowledge with the public health nurses throughout the State through demonstrations at staff conferences in each region and in several of the large cities.
INDUSTRIAL NURSING
At the close of 1941, the industrial nurses in Georgia numbered appmximately 58. At the end of 1942 they numbered well over 100 and this number is steadily increasing.
During the year these nurses have been visited by the Nursing Consultant, Miss Mary G. Devine, and their programs reviewed. An effort has been made to assist them in the development of well-rounded public health nursing pmgrams properly integrated with the indus.trial hygiene service in the plant and public health aotivities in the community.
New industries, machines and materials have created new problems for management, worker, and medical, nursing and engineerin2; personnel, not the least of which are health hazards. One special function has been to acouaint the nurse in industrv of the hazards in her respective indu-,try and controls needed. The new industries in Georgia are shipbuilding, airplane assembly, shell plants.
74
Georgia Department of Public Health
An outstanding problem is procurement of qualified nursing service in small industries; lack of personnel has particularly handicapped this development of the service.
IN-SERVICE EDUCATION
Because of the war emergency no in-service nurses have been released for formal education. As the year closes some modification of that policy is under consideration.
Quarterly staff conferences have been held in each of the six regions of the State with a good attendance. The programs have included demonstrations on the nursing care of the premature baby and on the Kenny method of nursing care during the acute stage of poliomyelitis.
In the summer the Warm Springs Foundation offered an institute covering a period of one week in the nursing care of infantile paraly;<is. One nurse from each of the regions, either the Consultant or Reserve Nurse, attended this institute.
Three meetings were held during the year of the Consultant Nurses. These meetings were held in Atlanta and lasted two days.
A goodly number of new books of especial interest to public health nurses have been added to the State Library. The first number of a Nursing Bulletin appeared in October and will he published quarterly.
OUT OF STATE VISITORS
During the past year a number of public health nurses from out of the State have visited the Health Department. This number included: Miss Helen Bean and Mrs. Mildred Eslick of the regional office of the U. S. Public Health Service; Miss Naomi Deutsch and Miss Ruth Doran of the U. S. Children's Bureau; Mrs. Matilda Wade, consultant nurse, Farm Security Administration; Miss Idalia Padgett, maternal child hygiene consultant, South Carolina Department of Public Health; Mrs. Nan Cox Hare, Tennessee Valley Administration; Miss Mildred Mouw, Director of the nursing service, Hamilton County, Tennessee.
Miss Janet Corwin, a fellow from the Rockefeller Foundation, spent one week in the state office and an additional five weeks with the Thomas County Health Department.
STATISTICAL REPORT
An analysis of the statistical report, which appears in the report of the Division of Local Health Organizations, shows an increase in nursing activity in the prenatal, venereal disease and immunization services in 1942 as compared w1th 1941. The number of patients admitted to the venereal disease service increasd from 30,730 to 48,710, and the nvmber of field visits to patients fr.om 43,106 to 60,072; the number of prenatal cases cared for increased from 24,588 to 26,659 and the nursing visits from 92,381 to 102,435; immunizations against diphtheria ncreased from 43,594 to
Public Health Nursing
75
50,582; typhoid fever from 258,075 to 297,818; smallpox vaccinations from 74,530 to 92,368.
The number of cases admitted to nursing service and the visits made remained about the same for all other services except tuberculosis control in which there was a decrease in admissions from 27,094 to 22,147 and in visits from 94,101 to 87,859.
As we enter a second war year we are keenly aware of the inadequacy of .the nursing service to meet the full demands that will be made upon it. The great need is, of course, for more nurses and there is little hope that this need will be supplied. Our task is to conserve public health nursing strength and time to the fullest, using it where it will count for the most and to supplement the work of the public health nurse with that of clinic nurses and lay helpers to the fullest extent possible.
Division of Public Health Engineering
L. M. Clarkson, C.E., Director N. M. de Jarnette, A.B., Acting Associate Director
Louva G. Lenert, B.S.C.E. ___________________________Malaria Control M. H. Goodwin, B.S. ________________________________ Malaria. Control T. D. Adkins, B.S.Arch.___________________________________ Mapping C. N. Eldridge, Engineer_ _________________________________ Mapping J. R. Culp, B.S.____________________________________ Milk Sanitation H. B. Starr, Jr. __________________________________ Shellfish Sanitation
PUBLIC HEALTH ENGINEERING SERVICES
The Division of Public Health Engineering of the Georgia Department of Public Health has the responsibility of employment of personnel, of planning and administration of the program of public health engineering, including reviewing and approving all plans and specifications in designing and construction of public and private utilities involving sanitary structures for health protection, planning all engineering and sanitation projects, coordinating all activities of the Division with those of other divisions of the Department and assisting local health organizations in all technical matters relating to the program of the division. It has the responsibility of collaborating with the engineering profession and consulting engineers, all agencies, public, private and governmental, whose activities relate to sanitation and engineering. The services rendered under the program are numerous and varied. The chief services rendered are described under the s.everal major subjects in the following report.
In submitting this report attention is called to the loss by the Division during the year of six engineers from a total of fifteen, a loss of 40 per cent. This loss is as follows: three on water and sewerage, one on milk sanitation, one on general sanitation, and one on engineering and mapping. This has necessarily reduced the amount of service previously rendered. However, no service has been discontinued. It has necessitated some reorganizing to the extent that the maximum service will continue commensurate with the personnel available.
PUBLIC WATER SUPPLIES AND SEWERAGE
The adequacy and safety of public water supplies and sewerage systems is one of chief concern of the Division of Public Health Engineering.
The Department conducts studies of local conditions as to necessity and adequacy of treatment, inspects proposed sources of water supply, reviews engineering plans and specifications, assists in training operating personnel, inspects plant opemtion, and conducts special investigations of unusual conditions. These activities have been continued during 1942 in so far as was possible with limited personnel and restricted travel.
The scarcity of materials due to the war has curtailed new construction
Public Health Engineering
77
in all places eX'cept those where military or war industrial requirements have necessitated increased capacities. A few projects which were under construction before the scarcity of materials became so acute have been completed during the year; others in various stages of construction may not be completed until after the war.
Local governmental officials and opemtors, impressed with the necessity of careful maintenance of equipment, have responded to the emergency. As a whole, operators have realized that the country is at war and they are exercising diligence in the protection of equipment and in the production of a safe ,product.
Some municipalities have experienced difficulty or delay in securing repair parts and supplies. Chlorine or chlorine compounds, where used only for such purposes as sterilizing new wells, reservoirs or mains, have been difficult to obtain on short notice.
WATER WORKS AND SEWERAGE SCHOOL
The Eleventh Annual Water Works and Sewerage School was conducted by the Division in cooperation with the Biology Department, Georgia School of Technology, and the Georgia Water and Sewage Association. Slightly more than 250 persons attended the school, and of this number more than 200 were directly connected with municipal or industrial water supplies or sewage treatment plants in Georgia. The subjects covered at the 1942 school dealt chiefly with operation and maintenance of service under war conditions. Inspection trips to the recently completed DeKalb County water purification 1plant, to the Adanta water purification plant, and to the Atlanta sewage treatment plants were conducted on the last day of the school.
CERTIFICATION OF WATER SUPPLIES FOR USE ON INTERSTATE CARRIERS
The Division was called upon by the United States Public Health Service to investigate 39 water supplies furnishing water for drinking and culinary use on interstate carriers. This information was assembled and transmitted to the United States Public Health Service.
PARTICIPATION IN CIVILIAN DEFENSE PROGRAM
The Civilian Defense Program as adopted in Georgia placed the associate director of the Divis,ion in charge of water supply and sewerage problems in the State. Early in the program a mutual aid plan was adopted. This plan called for the pooling of all water works knowledge, repair material, emergency service and other assistance within the State so that these would be available to any community where local resources could not cope with the situation in the event of an emergency.
The State has been divided into ten defense districts, district chairmen appointed, and inventories of supplies, materials and trained personnel compiled and tabulated.
78
Georgia Department of Public Health
Throughout the year, the Division has continued to distribute information on civilian defense matters and on other items of war connection to the water works profession in the State.
PLANS AND SPECIFICATIONS FOR WATER WORKS AND SEWERAGE CONSTRUCTION
During 1942, plans and specifications have been examined and approved for 39 military, municipal or other community projects.
Water supplies and water purification___________________ 16 Sewerage and sewage treatment________________________ 23
Total_______________________________________ 39
There follows a descriptive list of the pwjects contemplated, under construction or completed in 1942. The populations listed are those given in the 1940 census.
Water Supply Improvements and Additions for Municipalities and Districts
Albany. Xew deep well. Completed 1942. Population 19,05'i. Ashburn. Xew sterilizing equipment to replace obsolete unit installed 1942. Population 2,266. Atlanta. \Vater main extensions and reconditioning original filters at gravity Illant completed 1942 (W.P.A.) Population 302,288. Baxley. \Yater works improvements consisting of ground water storage and elevated tank completed 1942. Water main extensions under construction 1942 (W.P.A.). Population 2,916. Bealwood-Highlands. (Muscogee County.) Water works system, consisting of mains, booster station and standpipe, to secure water from Columbus. Completed in 1942 (F.W.A.). Bremen. Raw water storage reservoir. Under construction 1942. Population 1,708. Broxton. Xew hypo chlorinator on water supply not previously chlorinated. Installed 1942. Population 908. Brunswick. \Vater main extensions to housing projects completed 1942. Povulation 1S,035. Calloway Mills (LaGrange). Pumping station on Chattahoochee River, raw water pipe line and one M.G.D. capacity filter plant. t:nder construction 1942. Chamblee. Deep we.Jl supply abandoned and w~~,ter obtained from DeKalb County system during 1942. Population 1,081. Chatsworth. Xew chlorinating equipment installed 1942. Population 1,001. Columbus. \Yater main extensions and additions to purification plant consisting of chemical house, feeders and mixing chambers. Vnder construction 1942 (F.\Y.A.). Population 53,280. Commerce. Raw water storage reservoir. Plans apptoved in 1942. Povulation 3,294. Cumming. Extension to water distribution system. Plans approved 1942. Population 938. Dalton, American Thead Company. Xew chlorinating equipment installed to replace former unit. DeKalb County. \Yater supply to serve vart of county and cities of Decatur and Chamblee. Includes raw water JHmlp station on Chattahoochee River, reservoir, coagulation, sedimentation, filtration, chlorination, clear water storage, transmission main to Decatur and elevated tank. Completed in 1942 (W.P.A. and contract). Douglasville. :!'\ew 'vater purification })lant and vump station. Plans a}lproved 1942. Populati-on 2,5Jti. East Point. ~ew surface su})ply inducting raw water pump station, mains, raw water
Public Health Engineering
79
storage, reservoir, coagulation and sedimentation basins, filters, clear water storage, ehlorination and high senice pump station. Under construction 1942 (W.P.A.). Population 12.408.
Hampton. Xew deep well to supplement existing supply. Completed 1942. Population 619. Jackson. Georgia Power Company, Lloyd Shoals. Xew sterilizing unit on water supply not previously chlorinated. Installed 1942. Macon. Xew 3,000,000 gallon clear water reservoir and new feeder main to town comilleted 1942 (F.\Y.A.). Plans approved for 4 :.\I.G.D. additional filter capacity (F.\Y.A.). Population 57,865. Port Wentworth. Xew deep well completed 1942 (F.W.A.). Ringgold. :Xew chlorinating equipment installed to replace obsolete unit. Population 882. Savannah. "~ater main extensions to shii>:rards and housing projects. Completed in 1942. Population 95,996. Summerville._ Xew deep well COIUilleted and plans for water treatment plant avprO\ed 1942. Population 1,358. Thomaston Cotton Mills. Plans for additions and alterations at water vurification plant approved 1942. Valdosta. Plans and specifications for new deep well approved 1942. Population 13,39:>. Washington. Reconstruction of raw water reservoir, coagulation and sedimentation basins, filters and clear water resenoir. Under construction 1942 (\Y.P.A.). Population 3,537. Waycross. Xew 750,000 gallon storage reservoir completed 1\l42 (WPA). Population 16,673. Zebulon. Xew hypo ehlorinator on water supply not previously chlorinated. Installed 1942. Population 543.
Sewers and Sewage Treatment for Municipalities and Districts
Blue Ridge. Imhoff tank and sludge drying beds completed 1\142 (W.P.A.). Population 1,362.
Brunswick. Sewer extensions to housing projects completed 1942. Population 15,0~Ei. Cornelia. Sewage treatment vlant consisting of coan;;e sereens, 11rimary clarifier, trickling filter, secondary clarifier, sludge digester, sludge drying beds and control house eomvleted in 1942 (W.P.A.). Population 1,808. Dalton. Sewer extensions completed 1942. P,opulation 10,44S. Decatur. Sewer extensions completed 1942. Population 16/)61. Del<alb County. Trunk sewer from Lawson Hosilital and Xaval Air Base comple,ted 1942 (W.P.A.). Hinesville. Sewer extensions and intereeptor eompleted 1942. (F,,Y.A.). Povulation 6:i0. Macon. Interceptor and outfall sewers for southwest side of city under eonstruction 1942 (F.W.A.). Population :17,865. Madison. Sewer extensions completed 1942. Population 2,04:-i. Marietta. Sewer extensions to housing Ilrojeets c,ompleted 1942. Population R,667. Muscogee County. Trunk sewer for area south of Columbus. Under construction 1942 (F.\Y.A.). Plans and sveeifirations for interceptor and la.teral se\\'ers for Bealwood area approved 1942 (F.W.A.). Perry. Se\ver extensions to new housing project cotnllleted 1942. Povulation 1,542. Port Wentworth. lnterreptor and outfall sewers from housing projects under construction 1942 (F.W.A.). Rome. Sewer extensions completed 1942 (W.P.A.). Population 26,2S2. Rossville. Sewer extensions completed 1942. Povulation 3,538. Savannah. Trunk sewer and laterals for shivyard housing 11rojeets under construction 194!1 (F.W.A.). Population 95,996. Savannah Beach and Fort Screven. Se\veragc system to serve Savannah Be.ach and Fort Screven consists .of collection system, lift stations, force main and primary clarifiers, slud~e digester and sludge drying bedg. Under cmBtruction 1942 (W.P.A.). Population !)44.
80
Georgia Department of Public Health
Thomson. Sewer extensions and lift station. Plans ap(Jroved 1942. Population 3,088.
Union Point. Sewerage system consisting of collecting sygtem, Imhoff tank and sludge dying beds. Collecting system under construction and treatment plant completed 1942 (W.P.A.), Population 1,566.
Water and Sewerage for Military and Defense Industry Projects
Atlanta General Depot. Additions to sewage treatment plant completed in 1942.
Atlanta Motor Repair Base. Xew water main from city of Atlanta completed in 1942. Additions to sewage treatment plant under construction In 1942.
Bainbridge Air Base. near Bainbridge. Deep well water sU(lply, Including chlorination, and sewerage system completed, 1942.
Milledgeville Naval Ordnance Plant. Primary sewage treatment plant under construction, 1942.
Brunswick Naval Lighter Than Air Base. Deep well water supply and activated sludge sewage treatment plant under construction, 1942.
Camp Stewart, Hinesville. Additions to water SUPilly and sewage treatment plant under construction, 1942.
Spence Field, near Moultrie. Deep well water supply consisting of storage, distribution system and chlorinat,or. Sewerage system and treatment plant consisting of pump station, primary settling, separate sludge digestion, triekling filters, secondary settling, chlorination and sludge drying beds. Completed 1942.
Moody Field, near Valdrsta. Deep welJ water supply with distribution system, elevated storage and chlorinator. Sewerage system consisting of comminutor, pumps, primary settling, separate sludge digesti-on, trickling filters, secondary settling, chlorination and sludge drying beds. Completed 1942.
Robins Field and Georgia Air Depot, Wellston. Deep well water supply and distribution system with storage and chlorination. Sewerage system and treatment plant consisting of screens, primary settling, separate sludge digestion, trickling filters, secondary settling, chlorination and sludge drying beds. Com(>leted in 1942.
Waycross Air B.ase. Water supply from deep well and distribution system with storage and chlorination. Sewerage system and treatment plant consisting of Imhoff tank and sludge drying beds. Under construction 1942.
St. Simons Island Naval Air Base. Water supply from deep well with storage, chlorination, and distribution system. Sewerage sys.tem and treatment plant consisting of pump station, Imhoff tank, sludge drying beds and tile drain field. Completed in 1942.
Camp Toccoa, near Toccoa. Water suiJply system containing water from surface stream. Purification plant includes coagulation, sedimentation, filtration, sterilization and laboratory control. Distribution and elevated storage is provided. Sewerage system and treatment plant consisting of coarse screens, primary settling, separate sludge digestion, open sludge drying beds, trickling filter and secondary clarifier. Completed in 1942.
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81
Recapitulation of Public Water Supplies to December 31, 1942
Number
Supplies receiving both fillration and chlorination (including softening and iron removal plants)_ 96
Deei> wells, shallow wells and springs chlorinated------------- 92
Deep wells, shallow we.Jls and springs not chlorinated __________ 183
Total public water supplies ______ :171 \Vater from home wells and springs
in rural areas and villages without public water supplies _____ _
Total for State _____________ _
Population ( 1940 Census)
Percentage Population
Using Public Supplies
862,900 330,100 165,900 1,378,900
1,744,800 3.1~3. iOO
62.6
25.4
12.0 100.00
Percentage Total State
Population
27.6 11.1
G.4 44.1
55.9
PUBLIC HEALTH ENGINEERING LABORATORY
This laboratory serves to supplement the work of the Public Health Engineering Division by performing such tests, analyses, or examinations of a physical, chemioal or bacteriological nature as may be required in the general state-wide sanitation program.
For the most part, the work has consisted primarily of the bacteriological examinations of samples of water from public and semi-public supplies, public school supplies, improved private supplies, and approved swimming pools. However, a certain amount of chemical work for the purpose of removal of iron and carbon dioxide and the prevention of corrosion at various public and private supplies, as well as steam pollution work, in an effort to assist municipalities in efficient operation of sewage treatment plants has been clone.
Du11ing the year, the laboratory handled a total of 13,918 samples, :m increase -of 708 samples or 5.3 per cent over the number examined in any previous year. The following table shows the distribution of these samples,
Bacteriologiral samples : Public and semi-public _____________________________ 12.525 Private __ ____________ ____________ __________ _______ 1,027
Swimming I>ool _________ ____ _____ _____ _____________ 244
Chemical samples _ ------------------------------------------- _____ _____ __
46
Stream pollution samples ________________________________________ --------____
76
An attempt has been made to secure monthly samples for bacteriological examination from all the .public and semi-public water supplies in the State, but due to the scarcity of county engineers and the limited amount of travel from the central office on account of the rationing of tires and gas we have had to depend more and more on local representatives to see
82
Georgia Department of Public Health
that samples are submitted. This has resulted in samples being received at irregular intervals from quite a few supplies and 34 supplies failed to submit any samples during the year. On the other hand, samples were received from eight supplies for the first time.
The public and semi-public water supplies in the State may be divided into three major classifications as to source and treatment: namely, ground waters, untreated; ground waters, sterilized; and surface waters, filtered and sterilized. The number of months each of these submitted samples is shown in the table below.
Supplies submitting samples:
10-12 Ground waters-untreated ______________ 107 Ground waters-sterilized ____________ __ R:) Rurfacc supplies-filtered and sterilized__ 77
Total _ __ ___ ___ __ __ 267
Number Months
6-9
1-5
:1.)
2!J
:~o
13
0
4R
3;)
:1-t
Total 201 104
7V
3R4
Cumulative bacteriological records were kept on all samples received in the laLoratory, as shown in the table below.
No. Showing
0.1 to I O.O<(c,
No. Neg. of 10 MI. Portions
for
Prsitive
Co:iform for Coliform
No. Showing More Than
10'/f. of 10 MI. Portions Positive
for Coliform
Supplies Meeting
USPHS Standards
No.
'!c
Ground \Vaters-untreated __ 35
84
52
ll9
69.6
Ground water-sterilized ___ 33
j(l
17
83
83.0
Surface Sllllr>lies-
filtered and sterilized____ 42
33
'j::J
!l6.2
Total __________________ ll(l
167
'i2
277
79.4
A study of the above table reveals the fact that 277 or 79.4 per cent of the 350 sup-plies from which we received bacteriological samples met the United States Public Health Service Standards. Brieflv, these standards state, in part, that in .a given series -of samples not more. than 10 per cent of all lO ml. portions examined shall show the presence of the coliform group of bacteria. A further study would indicate that the quality of the water, as a whole, produced by supplies employing filtration and sterilization is superior to water from either the untreated or the sterilized ground water supplies.
*Bacteriological a\erages not compiled on samples received from one supply.
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83
THE WATER BORNE TYPHOID FEVER OUTBREAK AT
FLINT RIVER COTTON MILL, DOUGHERTY, COUNTY, GEORGIA
The Flint River Cotton Mill and village are located just north of the city of Albany in Dougherty County, Georgia.
On January 22, 1942, rthe attention of public health officials was called to the fact that an outbreak of diarrhea had occurred among the employees of the mill and residents of the village. An investigation of this outbreak was started on January 23 and the first ease of typhoid was repo11ted the following day. More cases followed in rapid succession until late in February a total of eighty-one cases had been discovered, and two deaths occurred. In addition to the typhoid cases, a total of seventy-nine cases of bacillary dysenrtery were confirmed by stool cul,tures in the State Health Department laboratory.
The epidemiological investigation indicated that this outbreak was water borne. There was no common milk supply, food supply, nor had there been any ,public gathering; flies were not prevalent at this season. On the other hand, both the mill and village were served by the independent water supply owned and operated by the mill.
Prior to the latter part of 1941, water for this supply had been obtained from a drilled well located immediately behind the mill. This well, designated as well No. 1, was reported to be approximately 700 feet deep and for the major portion of its depth :penertrated the limestone formations which underlie all of this part of Geo.rgia. It is reported that for many years this was a flowing well, but gradually the static pressure of the underground water in this area was reduced as other wells were drilled in the cicinity. When the well ceased to flow it was equipped with a pump and continued to serve as the sole source of water until the summer of 1941 when it became apparent that additional water would be required. A new well, designated as well No. 2, was then drilled in dose proximity to well No. l. According to the drillers' log, well No. 2 is 215 feet deep, and, like well No. 1, penertrates limestone for most of its depth. A steel casing extends from the ground surface to a depth of 95 feet, the remainder of the well being an open hole. The drillers' records show that water bearing strata were encountered almost continuously below a depth of 150 feet. The static level of 1the water was 42 feet below the ground surface. The well was equipped with a turbine type deep well pump discharging directly into the distribution system.
Sewage from the village was collected by a gravity system and conveyed to a small septic tank, :the effluent from which discharged into a vertical drainage well in the bottom of a nearby limesink. Sewage from the mill proper discharged into the sewer system of the city of Albany. A sewer line from one portion of the village passed approximately 200 feet from the site of the two water wells and the sewage drainage well was approximately 675 feet from the site of the water wells. The bottom of the limesink is approximately 40 feet lower than the ground surface at the water wells and the casing of the sewage drainage well is reported to end 36
84
Georgia Department of Public Health
feet below the lowest point in the limesink. Thus the elevation of the lower end of the drainage well casing seated in a limestone fissure !is a few feet higher rthan the lower end of the casing in well No. 2.
Very little definite information could be obtained as to the exact time well No. 2 was put into service. This well was released for use by the driller in July, 1941, but representatives of the mill and the County Health Department asserted that the well was not put into service until some time in October and not Ullltil samples of water collected by the County Health Department had shown no ev,idence of contamination. The state water laboratory, however, had no record of such samples nor could laboratory reports be produced by local authorities. Water samples collected during the epidemiological investigation showed that water from well No. 2 was grossly contaminated in January and February, 1942.
The following recommendations were made by the Public Health Engineering Division.
l. Warter from the mill and village be obtained fr.om the ciil:y of Albany water supply and the two wells at the mill be abandoned and sealed.
2. The practice of discharging sewage into the limesink be discontinued and a pump station installed .to pump sewage from the village inio the Albany sewerage system.
A temporary water line from the city of Albany was installed immediately following these recommendations and permanent improvements will be carried out as soon ~as the necessary ma~terials can be secured.
MILK SANITAT/ON
On July 1 our milk sanitarian entered military service. This seriously interrupted milk sanitation service which had been rendered to local hoolth depa11tments and cities which have adopted the standard milk ordinance. However, at the time of writing this report it can be stated that the United States Public Health Service has assigned to us a milk sanitarian and an effort is being made to resume the service to the extent that it was formerly rendered.
A demand for more and better milk is rapidly increasing in Georgia. Looal heal,th department milk sanitation aci:Jivities like other sanitation programs of county and city health departments are being handicapped by loss of personnel for miJ.itary service. In spite of this difficulty, together with priority requirements for materials and supplies, improvements are being made by dairy farms and pasteurization plants in the twenty-six cities and three counties that have adopted the Public Health Service Milk Ordinance. Many of the improvements are influenced by increased demands fm milk and milk products, particularly in defense areas. As rapidly as possible under war-time conditions, existing facilities are being expanded to keep abreast with the increased demand. These improvements are resulting in providing milk supplies of higher quality and degree of safey, 'thus instilling greater confidence in public milk supplies.
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85
List of cities ,and counties having adopted the United States Public Health Service Milk Ordinance (Standard Milk Ordinance) :
Cities
Americus Athens Atlanta Augusta Brunswick Cartersville Cordele
Cities
Dalton Douglas Gainesville Griffin Hinesville Hogansville LaGrange
Cities
~fa ron :II i l l e n :l!oultrie Quitman Rome Savannah
Cities
Statesboro Thomasv!lle Tifton Waycross Waynesboro West Point
Counties
Crisp Fulton Spalding
SURVEYS, MAPS, AND PLANS
In connection with the war effort it has been necessary to prepare maps of each of the extra-cantonment zones around army and navy establishments, war industrial plants, and emergency housing areas. These maps are generally developed from aerial photographs, by field surveys, stereoscopic examination, and projection on a light table, with final field checking. A very highly satisfactory map has been produced by this method, especially suitable for malaria control and sanitation studies.
Surveys and maps for portions of the following counties have been made:
Baker Bibb Burke
Coffee Colquitt DeKalb
Dougherty Early Echols
Fannin Laurens Liberty
Lowndes Richmond Stephens
Towns rnion
Standard municipal sanitary survey maps have been prepared of Hiawassee, Blairsville, Toccoa, and McCaysVIille. A standard sectional sanitary survey map was also prepared by McCaysville vicinity. Six suggested plans for health centers were drawn, and plans made for milk house alterations at the State Tuberculosis Sanatorium at Alto. Letterhead size ma:ps of Echols and Coffee Counties were prepared for the Regional Health Office at Waycross. Seventeen speoial ,drawings were completed for an automatic siphon, precast ditch lining inverts, screening details for special bulletin, miscellaneous profiles, e>tc. Twenty-four special maps were prepared for the Malaria Control in War Areas program, as well as a chart showing the organization of that program.
Maps and drawings in process of completion include (1) standard basic county maps of Laurens, Burke, Brantley, Charlton, Bulloch, and Decatur (2) standard county malaria maps of Laurens, Burke, and Bulloch (3) standard county sanitary survey maps of Brantley and Charlton, and (4) special malaria control maps of portions of Mcintosh, Tift, Thomas, Bulloch, and Glynn Counties.
86
Georgia Department of Public Health
COORDINATED COMMUNITY SANITAT/ON
During the year 3,255privies and 2,493 septic tanks, with 496,124 feet of 4" drain tile for secondary treatment, were installed at homes not having public sewers aV'ailable.
Because of the reduced quota of relief labor on WPA rolls, and a reluctance to give pviority to this type of project even when cerbified to by army and navy officials, the cooperative program, in which relief labor was furnished by the WPA, materials by property owners, and supervision by personnel of the various health departments, has dropped to the point where it is now being carried on 'in only two counties. Wherever possible the program is being carried on either by private contracting or with convict labor furnished by 'the counties. The shortage of certain critical materials, rising costs and necessity for priorities on lumber have also curtailed the program.
The following tabulation shows the number of privies built during the year, listed by counties. It also shows the comparison in those built with concrete floor and riser and the more tempor,ary wooden fl.oor and riser type. The increase in wooden floors is accounted for by the reduction of central plant operations and the difficulty of concrete construction for in dividuals who do their own work.
TABLE SHOWING PRIVIES BUILT IN 1942
Home
County
Wood
Concrete
Appling ~-----
Atkinson ----- 40
Bacon ------- 3
40
Baldwin ----- 8
Banks -- ----
Bibb --------
30
Brantley -----
Brooks --- --
26
Bryan --- ---- 3
Bulloch ------ --
36
Burke -------
32
Butts -------- 4
9
Calhoun ------ 10
Camden ------
2
Carroll -------
Catoosa -----
Chatham ---- 103
28
Chattahoochee_ 2
1
Chattooga ----
Clarke ------- 76
8
Clay --------
8
Clayton --- ---
14
Cohb ----- -- 1!
61
Colquitt ------ 11
(l
School
Wood
Concrete
11 7
2
41
2
26 10
20
20 1
Total
:J;)
50 15
2 9:-i
32
~
fi:2
;)j
13 10
1'i1 3
86 8
20 107
23
Repair
l!l 14 36 14
123
~18
10
Public Health Engineering
TABLE SHOWING PRIVIES BUILT IN 1942-Continued
Home
School
County
Wood
Coweta ------Crawford ---Cris}J -
Dt>eatur
21
DeKalb
Dodge --------
Dougherty ----
Douglas ------
Early --------Elbert -------
Fannin
104
Fayette -----Floyd -------Forsyth ------
Fulton -------
Glascock ----(;ordon ------
Grady --------
Ureene
17
Gwinnett
Habersham
Hall --------Harris ------Hart --------Heard -------- Henry -------Houston ------ 41
Jackson -----Jasper ________
.Jeff DaYis ---.lenldns
Johnson
.Jone.;; --------
Lamar -------
Lanier -------
Laurens
1:1
Liberty -----J.ong -------Lowndes
~lrDuffie ----::\Ia eon ------:\Iadison -----::\Ieriwether
~Iiller - - - - - -
}litl'hell ------ ()2 Monroe -----::\lontgomeT.Y -)!organ -----)luseogee ----
Xewton ------
Concrete
74 :J
102 289
1:-.i 31 20
:1s
27
33
18 144
1
28
;)2
10 38 12
17 :.!0
21 1
15
Wood
Concrete
IC
16
4 15
4 66 28 19 40 38
10 16 1 ?')
34
Total
,,,
144 289
1:1 37 20 :18 27 120
;-:;;,
20 148
33 71 16 17 42 17
23 2:-i J2 21
1
38
11
17 6
4
66 41 19 102 44 HI 16 12()
a4
87
Repair
107
311 50
27 30
2 10
Hi
88
Georgia Department of Public Health
TABLE SHOWING PRIVIES BUILT IN 1942-Continued
Home
County
Wood
Oconee _______ Oglethorpe __ _
Paulding ____ _ Peach _______ _ Pierce ______ _ Pike _________ Polk _________
Quitman ____ _
Rabun ______ _ Randolph ___ _
Schley Seminole Spalding ____ _ Stephens ____ _ Stewart _____ _
Talbot _____ _ Taliaferro ___ _ Tattnall _____ 3 Taylor _______ __ Telfair ______ Terrell ______ _ Thomas ____ _ Tift ________ _ Toombs ______ Troup _______ Turner ______ _
rnion ------- --rpson -------Walker _____ _ Walton _____ _ Ware _______ _
Washington __ 11 Wayne Webster ______ Wheeler _____ _ Whitfield __ _ Wilcox Worth _____ _
Concrete
20 :J6 14 21 16
12
24 20 12
18 9
14 54 21 19 39
10
67
Schcol
Wood
Concrete
Total
22 36 14
21 16
3 3
1~
6 8 24 23 12
8
18
14
54 21
8 21
59 16 20 1:>
2 8
67
Repair
24
14:> 286
1
649
2,263
181
162
3,255
1.816
The total construction of private sewage disposal systems at homes where public sewers are not available has continued at almost the same level as for the preceding year notwithstanding restrictions on general building, The majority of these improvements have been made m war areas where housing conditions continue to be acute. The following table
Public Health Engineering
89
shows the number of septic tanks built during the past year at homes, schools, or other public places, by counties, which have been approved by the health department.
SEPTIC TANKS FOR 1942 BY CouNTIES
County
Home
Appling Atkinson
Baldwin -------- 15
Bibb ----------- 275
Brool.::s ----------
6
Bulloch ---------
Burke -----------
9
Butts -----------
8
Camden ---------
Catoosa ---------
C'hwrlton --------
Chatham -------- 211
Clarke ---------- 25
Clayton --------- 68
Cobb ------------ 104
Colquitt --------- 42
Coweta ---------- 11
Crawford --------
3
Crisp -----------
Dawson
Decatur
10
DeKalb
127
Dodge ----------Dougherty ------- 168 Douglas ---------
Evans -----------
Fayette ---------
Floyd
13
Franklin --------
Fulton ---------- 209
Glascock --------
Glynn ----------- 114
Grady -----------
6
Greene ----------
Gwinnett --------
Habersham -----Hall ------------ 12 Hancock --------Harris ---------Henry ---------- 46 Houston -------- 31
Jackson
1
Jenkins
Johnson
Public Place
6 8
16
4
3 5 2 3
Total
Vi 281
14
215 2:i 69
120 42 11 5
12 131
172 1 1
13 3
214
114 7 1 3 3
15 1 7
47 33
1 7 1
County
Home
Jones -- ---
Lan1ar ---------Laurens ~~ - - - - - -
Liberty --------Long -----------Lowndes
McDuffie -------- 1:i
)lacon ----------
1
)leriwether ------
Mitchell --------
Morgan ---------
::\Iuscogee -------- 84
Newton ---------
Oglethorpe ------
Paulding --------
Peach -----------
9
Pierce ----------
Pike ------------
1
Polk -----------
2
Rabun ---------Richmond ------- 437
Schley ----------
1
Screven ---------
Spalding -------- 12
Stephens -------- 44
Sumter ---------- 42
Talbot ----------
6
Taylor ----------
7
Thomas ---------
Tift -------------
Toombs ---------
Troup ----------- 13
l:pson ----------
3
Walker ---------- 11
Walton
8
----~-----
Ware ----------- 39
Washington ----- 10
Wayne --- -------
2
Wheeler ---------
2
Whitfield -------- 15
\Vilcox ----------
1
Public Place
Total
10 10
15 1 9
85
9 2
2 7 437
13 46 42
7
;)
13 3 12 10 41 11 2 2 15 1
TOTAL ---------- 2,394
99
2,493
90
Georgia Department of Public Health
MALARIA CONROL
The malaria control drainage program using WPA relief labor on the statewide malaria drainage project continued on a l'imited scale during the first half of the year. The major portion of this work wes done in the war areas in Chatham and Liberty Counties. Smaller projects were carried on in Troup and Washington Counties, principally for completion of drainage already under way when curtailment of labor was found necessary.
All WPA drainage projects were closed out during the early fall. Maintenance of existing or newly constructed drainage systems has been conducted exclusively with local convict or free labor crews working under local superv.ision.
Accomplishments of record under the drainage program consist of 406,672 linear feet of ditching, 85 ponds drained, 3,014 acres drained, 1,788,551 linear feet of right-of-way clearing, 11,000 linear feet of ditch paved, 32,100 square yards of ditch banks sodded, 455 linear feet of culvert placed, 1,038,727 linear feet of ditch and stre&ms cleared or maintained.
Major drainage operations in the Camp Stewart-Hinesville area were largely completed under the WPA drainage program with a limited amount of lateral construction. Eight or ten miles of ditches on the Camp Stewart army reservation have been 1ined with precast concrete slabs, the banks being sodded with grass, and this work will be continued until all lateral drainage in this flat area is carried in lined ditches. Most of the ditch 1ining installed is of the new type of precast slab developed by personnel of this Division.
The Division personnel is also cooperating in a similar program being carried on in the Fort Benning Reservation.
Progress has been recorded in the development of a precast concrete automatic siphon for use in fluctuating reservoir water levels and for flushing ditches for the prevention of Anopheles mosquito breeding. Considerable success has been achieved in the use of the siphon for ditch flushing.
In the Georgia malaria control program, concentrated attention is being given to the preparation of accurate maps showing roads, houses, watered areas and completed drainage construction. These maps are essential to malaria 'investigations and are used for the detailed planning and administration of control operations. Five counties have made current or pending appropriations for a county-wide Paris green larvicide program; 14 dragl.ines have been used in eight counties. Area-wide Paris green larvicidal programs, less than county-wide in scope are under way in three counties.
MALARIA CONTROL IN WAR AREAS
Early in the year the Division, upon request from the United States Public Health Service to the Director of the State Department of Public
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91
Health, undertook the organization of a malaria control program through control of th evector, the A. quadrimaculatus mosquito, in all war areas in the State where malaria might possibly be of sanitary significance.
Field headquarters were stationed at Macon and during the season operations were carried on in 12 areas protecting 57 war establishments. The United States Public Health Service provides personnel consisting of engineers, entomologists, engineering a-ides, inspectors, foremen and laborers, and the major portion of material and equipment costs, the work being planned and conducted under direct supervision of state personnel. As much as possible the work is coordinated with that of the local health department operating in each individual area, operating head quarters usually being set up in the local health department offices.
Mosquito control measures are conducted only in the areas where regular inspection indicates a definite need for control, thus in some areas routine inspections of all possible mosquito breeding places is the only activity undertaken. Control measures for the 1942 season are enumerated as follows: 237 gallons of oil and 3,813 pounds of Paris green used in larviciding 2,491,150 linear feet of ditch, and 204,138,994 square feet of pond surfaces; 436,554 linear feet of ditching and cleaning was done, and 80,005 linear feet of ditch and 7,045,887 square feet of pond surface was cleared; 64.,341 man hours of work were required .in these operations.
During the coming year, these operations will be extended to a num-
ber cf new areas where war establishments have been set up during the
loatter months of the year 1942. Very close cooperation is maintained with army and navy personnel carrying on similar measures within the reservations in order that the most effective control can be maintained.
REGULATIONS OF IMPOUNDED WATERS FOR MALARIA CONTROL
These regulations apply to large and small areas where water is impounded for hydroelectric power, recreational and other purposes. The lis,ting of smaller areas is omitted to save space. Larger areas, used particularly for hydroelectric power, flood control and related purposes include impoundments owned by the Georgia Power Company, Crisp County Power Commission, Georgia Power & Light Company, Tennessee Valley Authority, and the United States War Department. A number of these are licensed by the Federal Power Commission, one of the stipula tions of the license being that malaria control operations are maintained to the satisfaction of the Georgia Department of Public Health.
In general the regulations include, first, clearing of all areas to be im pounded, followed by effective larvici.ding during the malaria mosquito breeding seasons. It is quite evident that this program has been influen tial in prevention of serious malaria epidemics around such areas.
The War Program has initiated a new era of hydroelectric develop ment and flood control which has added at least four such areas in Georgia comprising 51,300 acres and divided among the following projects:
92
Georgia Department of Public Health
Nottley, 11,000; Chatuge, 15,000; Hiawassee, 5,000; and Allatoona, 20,300. These 1proj ects .are practically all cleared, conforming to the regulations of the State Board of Health.
Added to the above, new preliminary permits for 16 impoundments to cover some 213 acres, and one maintenance permit for an impoundment of 2% acres, have been issued during the past year. The majority of these impoundments are for fishing and stock watering purposes.
SCHOOL SANITAT/ON
The Division has worked in close cooperation with state and county boards of education by furnishing plans and supervising construction of sewage disposal devices and for improvement of drinking water supplies at schools.
While still in opemtion the Work Projects Administration and the National Youth Administration require approval by the Division of all plans and specifications for sanitary facilities for all buildings, for schools and other public places, as a prerequisite for their acceptance as a construction project. Review of complete plans and specifications for each project was required and often field investigations were necessary to determine adequacy of sanitary facilities.
Privies constructed at schools and other public places ____ 343 Water samples collected at schools____________________ 307
FEDERAL HOUSING ADMINISTRATION SANITAT/ON
In order to secure 'a loan insured by the Federal Housing Administration in Georgia, those homes not conneoted 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 required by the F.H.A. befme 31pproval will be given to such subdivisions.
This procedure has resulted in improving the standard of construction of all sanitary facilities in other .than F.H.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.H.A. under this program covering 626 private sewage disposal systems and 13 private water supplies in 30 counties of the State.
FARM SECURITY ADMINISTRATION SANITATION
The Farm Security Administration has received aid from the Division in the form of standard plans, specifications, and methods of sanitation of rural homes. Many clients of the F.S.A. have received grants for sanitation needs and cooperation has been given by assistance .in preparing plans and estimates and final approval by a health department representative to
Public Health Engineering
93
insure satisfactory completion of the work. This program is reaching those rural residents most in need of sanitary facilities, ~and includes sanitary G.isposal of sewage, improvement of water supplies, screening and general environmenta.I sanitation corrections.
This program operated in the following counties during the past year:
ApJlling Burke Calhoun Catoosa Colquitt f'risiJ
Douglas Emanuel Fayette Greene Gwinnett
Habersham Heard Jackson Jones :llcDuffle
Montgomery Oglethorpe Randolph Talbot Terrell
Thomas Washington White Whitfield Wilkinson
RURAL ELECTRIFICATION ADMINISTRATION SANITAT/ON
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 (l) an improved well (2) plumbing f>acilities (3) proper disposal of sewage. The amount of such sanitation is measured by the number of approxima.tely 1,500 homes in one year receiving approved water supplies, plumbing and satisfactory sewage disposal.
NATIONAL YOUTH ADMINISTRATION
In raddition 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 in. spection of sanitary facilities at N.Y.A. resident projects. This inspection which is followed by detailed recommendations, covers water supply, sew. emge, milk supply, housing, bathing, ventil,ation, lighting, food handling and storage, garbage collection and disposal, etc.
CAMP SANITAT/ON
A concerted effort has been made to protect the health of summer campers. With this in view a bulletin has been prepared, "Essential Features of Camp Sanitation", together with inspection blranks. This program has inV'olved finding and listing all summer camps, such as Boy Scouts, Girl Scouts, Y.M.C.A., Y.W.C.A., Camp Fire Girls, 4H Club, and general recreational summer camps. Attempt is made by inspections of all camps, preferably during oamping season, to record all necessary sanitary improvements. Conferences and correspondence are conducted with organization officials and camp directors in order to effect such improve ments as may assure protection of the health of campers. The Division maintains a file showing records of all camp inspections, listing improve ments necessary and improvements effected.
MATTRESS SANITAT/ON
This service conforms with an act of the State Legislature which re
94
Georgia Department of Public Health
quires the inspection and licensing of aU mattress manufacturers, renovators and establishments where mattresses, as defined in the law, are sold. Provision is also made for the labeling and purchase of revenue stamps to be 'attached to each label, said labels being required on all articles coming within jurisdiction of this law.
During the year, 753 inspections and 460 rechecks on machinery not
in use were made. The rechecks were m::tde in order that all machinery not in use could be located in event of complaint or possible violation. The inspections made included manufacturing and renovating establishments, furniture stores, and other establishments where mattresses were stored with intent to sell or trade.
The following assistance was given to the State Tuberculosis Sanatorium: All mattresses bought new or renovated were inspected; located and purchased supplies for maintenance of building, equipment and grounds; also assisted in the installation of equipment where necessary.
During the year, 66 licenses were renewed, three new licenses issued,
eight plants consolidated to form four plants consisting of two each of the original eight. Seven other plants 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. All complaints of bedding law violations were investigated; however, in no ins.tance was it necessary to resort to legal action.
An 'analysis of the revenue received by the Department during the five and one-half years of enforcing the mattress sanitary rel!ulations shows that a large percenbage was derived from out of state manufacturers selling
within the state. During 1942, there were 68 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 1942
New Licenses Issued
1937
54
1938
44
1939
25
1940
10
1941
6
1942
3
11.17. 22.5'/r 32.0'/r
34.1 'I<
40.07< 45.17r
Licenses Renewed
1937 1938 1939 1940 1941 1942
Firo't year of operation
52 82 100 102 66
Division of Dental Health Education
J. G. Williams, D.D.S., Part-time Director Annie Taylor __________________________________Educational Director
During the year 1942, the Division of Dental Health Education has continued a program which has as its objectives:
l. Dental health education. 2. Correction of dental defects. 3. A plan to provide dental care for indigent children and pre-
natal cases. 4. Community participation in dental health programs through
County Dental Health Councils.
The following narrative and statistical reports summarize activities.
The enlistment of and cooperation with State agencies-official and voluntary-are important functions of this division. Appreciation is expressed to the Georgia Dental Association and to its Public He,alth Committee who have so willingly and c;.bly advised and assisted whenever called on by the Georgia Department of Public Health. During the year the Public Health Committee, wi,th Dr. Homer Davis, chairman; Dr. W. A. Garrett and Dr. Frank Lamons, have met with the Director and Educ01tiona.l Director for approximately twenty conferences. Appreciation is also expressed to the Sta.te Department of Education, Agricultural Extension Service, Farm Security Administration, Georgia Congress of Parents and Teachers and to each organization, club and agency that has contributed to dental health either by educational efforts or by financial a-ssis.tance.
The plan of work during this year has of necessity been altered to meet the unusual conditions brought about by war. While there have been many obstacles as: Limited travel, disorga:nized schools, decreased number of dentists, it is encouraging to note an increased 'awareness on the part of the public as to dental needs and a large increase in <the number of corrections which can be partly attributed to improved economic conditions.
With the advent of the High School Victory Corps with physical fitness 1as the basic objective, we expect many high school students to secure dental corrections. This division is making plans to work very closely with the directors of the High School Victory Corps.
PERSONNEL
The personnel of this division consists of: A dentist who gives parttime service without compensation; an educational director; an associate educational director; and a secretary. Changes in pers'onnel during the year follow:
Associate Educational Director-Miss S.ara lvey resigned July l. Miss Eugenia Whitehead employed September 14.
Secretary-Mrs. Bettie Owen resigned November 30. The position was not filled by December 31.
96
Georgia Department of Public Health
EDUCATION
Education of the public as ,to dental health needs and as to methods of control and prevention of dental diseases continues to be fundamental to the improvement of dental health conditions. This division has worked with and through State and local agencies illlterested in health.
Schools
Two hundred schools with approximately 62,000 attendance wert visited for educational wmk. Talks were made and 'pictures shown. C<m sultation with superintendents 1and teachers g,ave opportunity for analysis of local problems and for suggestions as to the solution of these problems. Local public health personnel and dentists are always encouraged to attend school visits and ,also representatives from ParentTeacher Associations whenever possible.
Colleges
Twelve visits to colleges were made where classes were taught and conferences held. Extension courses in health education which are being offered by the University of Georgia afford opportunity for inservice teacher training. This division has cooperated with the instructors of such courses by providing dental health education materi.als to the teachers who have been required to give reports.
Teacher Education
Eighteen teachers' meetings have been attended where talks were made, films shown and discussions led.
ParentTeacher Associations, Women's Clubs and Civic Organizations
Films were shown and talks were made to: twentythree parent-d:eacher associations; two women's clubs; five dental meetings; eleven public meetings; and twentytwo civic clubs. Many 'invitations had to be refused because of curtailed travel.
Educational Aids
The division has used and distributed widely, free of cost, the following aids:
Bulletins Your Child's Teeth Dental Health Guide About Faces Dental Health Education What to Teach and How to Teach It The Tmth About Teeth What About the School Dental Program?
Films About Faces Told By a Tooth
Dental Health Education
97
DENTAL SURVEY OF SCHOOL CHILDREN IN GEORGIA
1941-42
The following tabulation of the results of the statewide dental inspection made hy ~he practicing dentists of Georgia during the school year, 1941-42, is submitted by the Georgia Department of Public Heal,th through its Div,ision of Dental Health Education.
The Georgia Dental Association, the State Department of Education, the Georgia Congress of Parents and Teachers, and the Agricultural Extension Service have been active in sponsoring the dental health education program and the Georgia Department of Public HeaLth wishes to recognize their fine spirit of cooperation. Appreciation is ex;pressed to the Public Hea1~h Committee of the Georgia Dental Association and district and county dental chairmen and local dentists, school superintendents and teachers, and all lay groups who have participated individually and through their State 'and local organizations. Appredation is expressed to the Negro dentists for their efforts to improve dental health among Negro children.
This report 'includes a grand total of 100,468 dental inspections in 341 schools in 41 of Georgia's counties. Of these inspections 4,946 were made ,in 17 Negro schools in four counties. The tabulation includes inspections in 324 whi.te schools, or 10.3 per cent of 'all white schools in the State.
The same type dental inspection blank was used this year as in the 1940-41 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 49,473 white children examined in the State need dental trea.tment. Of 36,159 children in the Atlanta City Schools, 43.8% need dental treatment. Of the 4,946 Negro children examined in four counties, 63.3% need dental treatment. Considering the grand total of 100,468 children examined in Georgia, 64.7% need dental treatment. Exclusive of Atlanta. City Schools, 59.1% of the white children examined have had dental treatment in the past; 10.7% of the Negro children have had dental treatment.
Sixteen of the 41 counties were not included in last year's survey.
We realize that many counties not included in this report have conducted progmms of dental inspection and correction.
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: Columbia, 20.1%; McDuffie, 21.7%; Wilkes, 32.9%; Carroll, 43.8%; Glynn, 48.8%; and Atlanta City Schools, 43.8%.
Cou ntles
...._,._~ ..,
Ef
" " Zlll
Appling Calhoun
Camden --------Carroll --------Chatham ______ _
Clarke Clay Olayton Clinch Colquitt ________ Columbia ______ _ Coweta ________ _
Dade Decatur --------DeKalb _________
Douglas Franklin Fulton Glynn Habersham Harris Henry _________ _
429 285 579 375 10,876 724 448 1,882 884 3,054 289 134 525 688 3,410 415 505 17,294 3,010 382 103 1,528
Inspected
.. -0 " -.c: E
.. -Q a.... I-."0l..l
......._,_;_:
E,S
Z"'l"-
99.8 97.9 97.8 90.1 88.1 88.5 96.0 86.0 86.4 85.3 100.0 95.5 99.6 95.2 92.7 91.3 59.8 91.8 81.6 97.1 100.0 90.6
428 279 566 338 9,568 641 430 1,618 764 2,606 289 128 523 655 3,163 379 302 15,877 2,456 371 103 1,385
Need
Treatment
.......
E
z"
-.
.Q...
a.
344 191 298 148 6,884 514 288 1,260 444 2,140
58 106 448 470 2,351 283 265 12,154 1,198 290
78 1,053
80.4 68.4 52.6 43.8 71.9 80.2 67.0 77.9 58.1 82.1 20.1 82.8 85.6 71.7 74.3 69.9 87.7 76.5 48.8 72.8 75.7 76.0
Treatment Received in Past
........
E
z"
-." .
Q.....
a.
186 66.7 238 42.0 2()9 61.8 5,341 55.8 377 58.8 297 69.1 938 58.0 160 21.0 1,674 64.2 135 46.7
50 39.1 166 31.7
77 11.7 2,123 67.1
207 54.6 196 64.9 10,711 67.5 1,719 70.0
53 14.3 35 34.0
Need No
Treatment,
None Ever
Received
.."....
E
z"
-." .
Q... a".
llO 16 143 72 1,132 37 27 12:> 249 203 126
;")
48 156 199
45 10 939 389 77 10 332
25.7 5. 7 25.3
21.3 11.8
5.8 6.3 7.7 32.6 7.9 43.6 3.9 9.2 23.8 6.3 11.9 3.3 5.9 15.8 20.7 9.7 24.0
Need
\0
00
Treatment
Treatment
Treatment,
Received in
Received in
None Ever
Past, None
Past, More
Received
Needed
Needed
.."..,.
E
z"
317 80
187 69
2,841 216 87 556 341
1,146 30 62
313 423 839 126 96
-c
Q"... IE
74.1 28.7 33.0 20.4 29.7 33.7 20.2 34.4 44.6 44.0 10.4 48.4 ii9.8 64.6 26.5 33.2 31.8
.:.;.;
E
z"
-.c .
.Q...
a.
77 12;i .118 1,462 83
115 232 86 2'16 102 15 30 30 616 50 27
27.6 22.1 :H.9 1ii.3 12.9 26.7 14.3 11.2 9.8 35.3 11.7 !i. 7 4.6 19.5 13.2 8.9
.."....
E
z"
106 111
79 4,033
305 201 705
88 1,001
67 46 132 46 1,509 158 169
Q""
... a" .
~
"'C)
.2 ~
38.0 (S
19.6 tl
"' 23.4
42.1 ~
47.6 46.7
~
43.6 11.5 38.4 23.2
-.~,.., C) ~
3fi.9 !2::
25.2
~-
7.0 19.5 41.1 56.0
::t:
~
4,334 27.3 2,769 17.4
7,835
49.3
340 13.8
867 35.3
860
3ii.O
250 67.4 58 56.3
4 1.1 15 14.6
40
10.8
20
19.4
1,053 76.0
Counties
Irwin Jenkins Macon McDuffie
______ _
**Meriwether --Mitchell Morgan Peach Rabun Schley Stephens Taylor Toombs Twiggs Upson
Washington ----\Yayne ______ _
Wheeler
Wilkes
-..E=....="......
::lc ZLIJ
2,078 710 807 719 111 837
1,242 890
1,331 294
2,248 1,114
634 648 3,085 2,109 475 286 430
.-.. -Inspected
" " c
~.
o
...
-"...
Q"..LIcJ
. ....
... !l
.Eel-:
Z""t-'
70.1 99.8 92.1 99.3 92.8 87.6 82.2 96.1 87.9 78.9 86.1 88.1 93.7 94.1 92.7 90.0 100.0 98.2 78.4
1,456 709 743 714 103 733
1,021 855
1,170 232
1,935 982 594 610
2,861 1,898
475 281 337
Need
Treatment
- ... c
."c
E
.0 "
z"
"0..
1,377 364 676 155 98 578 717 604
1,081 226
1,571 701 480 565
2,102 1,638
392 260 111
H.6 51.3 91.0 21.7
9~1 ~.8
70.2
rn.6
9L4
9~4
81.2 71.4 M.8 9L6 73.5
8~3
8L5 9L5 3L9
Treatment
Received
In Past
... ."c
E
z"
-0...c...
0..
319 21.9 125 17.6 527 70.9 420 58.8
369 50.3 190 18.6 163 19.1
156 921 307 378 137 1,769 1,044 73 57 2oH
67.2 47.6 36.4 63.6 22.5 61.8 :l5.0 15.4 20.3 75.1
Incomplete Report.
Need No
Treatment,
None Ever
Received
- ..
."c
E
c
~..
z" ;,
41
2.8
284 40.0
l:l
1.7
338 47.3
81 11.0
225 22.0
200 23.4
89
7.6
3
1.3
172
8.9
146 14.9
28
4.7
27
4.4
308 10.8
108
5. 7
50 10.5
15
5.3
28
8.3
Need
Treatment,
None Ever
Received
- .. c
."c
E
0"...
z"
"0..
1,176
8.1
300 42.3
202 27.2
19
2.7
282 605 438 1,081
73 857 481 191 446 855 753 353 201 60
38.5 59.2 51.2 92.4 31.1) 44.3 49.0 32.1 73.1 29.8 39.7 74.3 71.5 17.8
Treatment
Received in
Past, None
Needed
-.. c
. ."c
E
0."..
z" a.
Treatment
Received in
Past, More
Needed
- .. c
.. ."c
~
E
z"
"0..
38 2.6 61 8.6 50 6.7 220 30.8
74 10.1 79 7. 7 50 5.8
1.3 193 10.0 141 14.3
86 14.5 18 3.0 456 16.0 152 8.0 32 6.7 6 2.1 198 58.7
201 64
478 137
296 112 167
153 713 214 289 119 1,245 885 40 59 51
13.8
9.0
64.3 19.2
1:::::1
~
~
40.4 ::t::
11.0
ct.
19.0,
~
66.0
~
37.0
R.::..
21.8 48.6 19.5
.fc.l.;.
;:l
43.5
46.6
8.4
20.9
15.1
~
Need No
......
0
Need
Treatment Treatment
0
Treatment
Treatment,
Treatment,
Received in Received in
Need
Received
None Ever
None Ever
Past, None Past, More
Counties
-..=...~.-.
=E=f
ZlU
TOTAL WHITE __ 70,31:;
Atlanta _________ 36,1ii9
TOTAL STATE
WHITE
106,474
Inspected
-...0
-,c
_.Ec,
.. ..oc;
.. c
...,.._.,,
-=-
E=~"
Q.lU
Zl-
93.6
67,218
78.3
28,304
89.7
95,522
Negro Schools: Fulton --------~Peach ____ ~----Schley __________
Chatham _______
25 161 223 6,108
100.00 65.8 72.2 76.2
25 106 161 4,654
TOTAL STATE
Treatment
- ..
-E=
..c ,
0
z"
D.
49,473 73.6 12,410 43.8
61,883 64.8
19 76.0 33 31.1 138 85.7 2,941 63.2
in Past
- . .c
-E=
z"
0..,.
D.
39,753 59.1
39,753 41.6
1
4.0
--
2
1.2
528 11.3
Received
. - . .c,
. -E=
0
z"
"D.
8,468 12.6
--
8,468
8.9
5 20.0 73 68.9 23 14.3 1,621 34.8
Received
- .., .c.
-E=
z"
0..,.
D.
25,663 38.2 --
25,663 26.9
19 33 136 2,614
76.0 31.'1' 84.5 56.2
Needed
Needed
..,
-E=
z"
-.c ,
0
..,
D.
..,
-E=
z"
9,276 14.0 --
23,702
--
-.c ,
0 ..
c;":)
D.
c(1>
35.3 ~
-- ~-
9,276 9. 7 23,702
t:::::l
~
... 24.8 ~..., ;:;
1 4.0
-- --
166 :;.6
-2 353
--
--
1.2 7.6
-...(1> ;::!
c
~
g~:;
o
NEGRO
6,517 75.9
4,946
3,131 63.3
531 10.7
1,722 34.8
2,802 56.6
167 3.4
355
GRA~D TOTAL __ 112,991 88.9 100,468 6ii,014 64.7 40,284 40.1 10,190 10.1 28,465 28.3 9,443 9.4 24,057
7.2 23.9
-::X::
(1>
~
;;..
***Exclusive of Atlanta.
J
Dental Health Education
101
5TATE OF GEORGIA, BOARD OF HEALTH DEPAJUM ENT OF PUBLIC HEAl1H
LEGEIID
1Ifi 80 - 100% Showing percentage school children needing dental
I I tiJ - 79% treatment as reported in dental inspections,
~ 40 - 59% September 1941 - !lay 1942.
fJ 0 - 39%
o Uo inspection
" Atlanta - 43.8%
102
Georgia Department of Public Health
CORRECTION OF DEFECTS
The primary objective of the dental health education program is to stimulate dental corrections; to encourage people of self-supporting families to secure dental corrections regularly and to prevent the accumulation of dental defects by beginning a regular program of dental care for the young child. We have many evidences that an increasing number of children and ~adults are receiving dental care. It is also encouraging to note the increased interest on the part of the dental profession to provide a high standard of dentistry for children.
Dental Clinics
The dental clinic 1plan, which was first begun in February, 1940, and adopted in August, 1941, as a permanent plan, has continued to meet with approval of all participating. Regulations for Paying Honoraria to Clinicians Conducting Dental Clinics was amended June, 1942, allowing:
(1) All counties with full-time public health personnel and who meet qualifications to conduct dinics.
(2) Lowering the admission 1age of children from 6 to 5 years. (3) Allowing limited dental service for indigent prenatal cases.
Lack of available equipment, lack of dentists and transportation difficulties have prevented many counties from organizing dental clinics.
During the year 27 counties have conducted dental clinics as follows:
County
AJlpling Brooks Camden Chatham
Clarke Colquitl CrisP DeKalb Decatur
Floyd Glynn
Jenkins :Vlitchell 1\!organ Rabun
Spalding Stephens Telfair Thomas
Toombs
Months Qperatinf in 1942
6 12 3 12
8 8 12 11
12 8 1 9
9 3
Type of Clinic
WJlite Children White Children White Children White Children Negro Children White Children White Children White Children White Children White Children Negro Children White Children WJ!He Children Negro Children White Children White Children White Children White Children White Prenatal Cases White Children White Children White Children White Children Negro Prenatal Two Clinics fot White Children
Upson Walker Ware \Vayne Wheeler Whitfield Worth
Dental Health Education
12 4 7
12 6 4 12
103
White Children White Children White Children White Children White Children White Children White Children
DENTAL CLINIC REPORT FOR THE YEAR 1942
White
NUMBER COUXTIES OPERATIXG CLIXICS_____________________
NUMBER CLINICS -------------------- ----------------------XUMBER CLIXIC SESSIONS ________________________________ _
1'-Tl\!BER CI,INIC HOURS (TOTAl,) ___________________________ _ 1\U)!BER DEXTISTS WORKIXG __________________________ _
27 28 2,079 4,158 77
HOXORARIA PAID DENTISTS __ _
$10,395.00
TOTAL AD~USSIONS ----------------------------------------TOTAL ADMISSIONS BY AGES
6-8 years ------------------------------------------------9-11 years -----------------------------------------------12-14 years ----------------------------------------------Percentage 6-8 years----------------------- _______________ _ Percentage 9-11 years-------------------------------------Percentage 12-14 years _____________________________________
TOTAL VISITS --------------------------------------- ________
TOTAL PATIENTS DISMISSED _______________________________ _
Completed ------------------------------------------------Others Percentage Completed______________________________________
5,737
2,533 2,152 1,052
44% 38% 18% 7,916
5,236 4,867
369 84%
PROPHYLAXIS Percentage of Admissions ___________________________________
NUMBER OF TEETH EXTRACTED _____________________________
Decid. ---------------------------------------------------1st Perm. Molars__________________________________________ _ Other Perm. Teeth_________________________________________
NUMBER TEETH FILLED_____________________________________
Decid. ---------------------------------------------------1st Perm. Molars------------------------------------------Other Perm. Teeth-----------------------------------------
NUMBER FILLINGS -----------------------------------------Cement --------------------------------------------------Al!oy ----------------------------------------------------Silicate
2,258 39%
6,626 5,601
484 141
12.474 3,765 6,895 1,814
13,685 1,306 11,772
607
Negro
4 122 244
4
$610.00
177
120 44 13 68% 25% 7%
418
154 151
3 85%
135 76% 129 115 13
322 180 184
8 365 111 243
11
Toombs County operates clinics at Lyons and Vidalia.
104
Georgia Depurtment of Public Heulth
Clinic Supervision
During the year the director has visited twenty-four of the twenty-eight clinics. Conferences were planned in advance with public health personnel-den~is,ts, County Dental Heahh Councils and sponsoring groups to evaluate and discuss the following:
(1) Equipment and quarters. (2) Service reported. (3) Records. (4) Cooperation of School. (5) County Denta~ Health Council. (6) Plan of selecting children. (7) Recommendations bv:
a. Local dentists. b. County Health Department. c. State Health Department.
FARM SECURITY ADMINISTRATION DENTAL PROGRAM
A cooperative dental program of the Farm Security Administration should he cited as a means by which dental corrections are being obtained among farm families in Georgia.
The following report was made to this division by Mr. E. C. Young, State Director, on August 3, 1942:
"According to repor,ts recently received from various counties in Georgia, we have 68 dental programs covering 78 counties in the State, including 8,350 families, 45,495 individuals, with an average of $3,530.01 available monthly to pay for necessary dental services consisting of extradions, simple fillings, cleanings, and soft tissue treatment."
Dental Health Education materials are made 'available to the workers of Farm Security Administration and this division cooperates whenever possible with this agency.
ASSOCIATIONS AND CONVENTIONS ATTENDED
Listed below are the State and National meetings attended by one or more of the personnel of this division:
ADA Committee Meetings, Chicago-Williams. Dent,al Meeting, Adanta-Williams, ~aylor. State Parent-Teacher, Gainesville-Williams, Taylor, lvey. Georgia Educational Association, Savannah-Ivey. Georgia Dental Association, Savannah-Williams, Taylor. Parent-Teacher Institute, Athens-Taylor, lvey. American Dental Association, St. Louis-Williams. Parent-Teacher Association Board Meeting, Atlanta-Taylor. American Public Health Association, St. Louis-Taylor. State School Administrators, Atlanta-Taylor, Whitehead.
Dental Health Education
105
High School Victory Corps Institute, Atlanta-~aylor, Whitehead.
PAPERS AND ARTICLES PUBLISHED
Dr. Williams presented a. pHper Is Dental Health Education the Answer? before the First District Dental Society of New York. It was published in the Journal of that society. Dr. Williams also presented a paper before the Fulton County MedicHl Society.
Articles written by Miss Taylor were published in January issue of The Bulletin of the American Association of Public Health Dentists, and the May issue of Dental Health.
STATISTICAL REPORT OF ACTIVITIES
COUXTIES VISITED ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~ ~ ~~~~~~~~~~~- ~~~~~~
78
Counties with full time Health Departments~~~~~~~~_~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
44
Counties with Xursing Service_________________________________ ------------------ 26
Unorganized Counties ----------------------------------------------------------
8
MILES TRAYELED Educational Director _ ~~~~~~~~~~~~~~~~~~- ~~~~ -~~ _~ ~~~~~~~~~~~~~~~-~~~~~~~~~~~~ 7,317 Associate Educational Director_~~~~~~-~-~-~~~~~~~~~~--~~~~~~~~~~~~~~~~~-~-~~~~~~ 11,654
PUBLIC SCHOOLS YISITED~~~~~~~~~~-~~- ~~~~~~~-~~~~~~- ~~~~~~~-~~~~~~~~~ ~~~~~~~~
200
Talks ~~~~~~~~~~~~~~~~~~~~~-~~~~~~- ~~~~~~~~~- ~- ~~~~~- ~~~~~~~~~~~~-~~~~~~- ~~~~~~
200
Attendance-White ~~~~~~~~~~~~~~~ ~~-- ~~~- ~~-~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~ 55,835
X egro ___________________ -------------------------------- _______ 5,875
Films and Talks ~~ ~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
200
Attendance-White ~~~~~~~~--~~ ~~~~ _~~~~ _~~~~~~~~~~~~ ~ ~~ ~~~~~~~~~~~~~ -~~~ ~~~ 55,835
Negro ________ --------------------- _----------------------- ___ 5,87 5
COLLEGES VISITED ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Talks ~~~~~~~~~~ ~~~~ -~~~~ -~~~~ -~~~~-~~~~~~~~~~~~~~~~~~~~~~~- ~~~~~~~~~~~~~~~~~~ Attendance-White ~~~~~ _~~~~~ ~~~~~~~~~~- ~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~ Films and Talks-~~~~~~~_~~~~~~~~~~~~~~~~~~~~~_~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~_~~ Attendance-White ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~~ ~ ~~ ~ ~~~~ ~ ~ ~ ~~~ ~ ~~ ~ ~~ ~ ~ ~ ~~ ~~~ --~ ~ ~ ~ ~ ~ Total Attendance ~~~~~~~~~~~ -~~~~~~~~~~~~~~~~~~~~~~~- ~~~~~~~~~~~~~~~~~~~~~-~~~~
12 12 1,03 7
8 970 2,007
TEACHERS' MEETINGS ~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~ ~ Talks ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~ ~~~~- ~~~~~~ Attendance-White ~~~~~~- ~~ -~~~~~~~~~~~- ~~~~~~~~- _~~~~~~~~~~~~~~~~~~~~~~~~ X egro __________________ ____________ ____________ _________ _____
Films ~ ~~~~~~~~ -~~~~~~~~~-~~~~~~~ ~- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Attendance-White ~~~~~~~~~~~~~~~ ~~~~~-~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Negro -- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~-~~~~~~~~~~
18 18 798 7j
6 193
75
PAREXT-TEACHER ASSOC. ATTEXDED Talks ~ ~ ~~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~~ ~~ ~ ~~ ~~~~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~~ ~ ~~ ~ ~~ ~ ~ ~~ ~ ~ ~ A tte.nda nee _ _ __ ___ __ ___ ___ __ __ __ ___ _ __ _ __ __ __ _ _ __ ___ _ __ __ __ ___ _ __ __ ___ _ ___ _
Films ~ ~ ~ - ~ ~~ ~ ~ ~ ~ ~~ ~~ ~~~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~~ ~ ~~ ~ ~ ~ ~ ~ ~ ~~~~~ ~~ ~ ~ ~ ~ ~~~ ~~ ~ ~ ~ ~~ ~ ~ ~~ ~~ ~ ~ ~ Attenda nee ~ ~ ~ ~~ ~~ ~ ~ ~ ~ ~ ~~~ ~ ~ ~ ~ ~~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~~ ~~ ~ ~ __ ~ ~~ ~~ ~ ~ ~ ~ ~ ~ ~ ~
23 1, 55 5
21 1,3 6 5
WOMEN'S CLUBS
Talks ~~ ~~~ ~~~~ ~~ ~ ~ ~ ~~ ~ ~ ~ ~ ~~~ ~~ ~ ~ ~ ~~ ~~ ~ ~ ~~~~ ~ ~ ~ ~~ ~~ ~~ ~ ~ ~ ~ ~ ~ ~~ ~ ~~~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~
Attendance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
69
Films ~~~~~~~~~~~~~~- ~-~~~~~~~~~~~~~~~~~~~--~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2
Attendance ~~~~~~~~~~~--~~~~~~--~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
69
106
Georgia Department of Public Health
CIVIC ORGANIZATIONS
Talks ------------------------------------------------------------------------- 22 Attendance _____ -------- ________ -- ______ __ ____ ___ __ ____ ___ __ __ ___ __ __ __ ____ 757
Films ------------------------------------------------------------------------- 22
Attendance
757
4-H CLUBS
Talks
Attendance ---------------------------------------------------------------- 550
Films
1
Attendance
550
DEXTISTS
Talks
5
Attendance ___ ___ _______ ____ __ __ __ ___ _____ __ ____ ______ ____ ________ ____ ____ _ 90
Films
3
Attendance ---------------------------------------------------------------- 90
PUBLIC HEALTH PERSONNEL
Talks
4
Attendance -----------------------------------------------------------------
79
Films ---------------------------------------------------------------------
3
Attendance ---------------------------------------------------------------- 61
PUBLIC :\IEETIXGS
Talks ________________________________________________________________________ _
10
Attendance ---------------------------------------------------------------- 757
Films
11
Attendance ________________ -- ___ --- _---- _____________ ---------------------- 757
PUBLIC OR DEXTAL HEALTH COUNCILS
Talks
Attendance ----------------------------------------------------------------
69
Films
2
Attendance ___ - ------- ___ -- ---- _ --- __ --- ___ --------------------------------
23
OTHER MEETINGS
Talks ____ ___ __ __ ______ __ __ _____ ____ __ ___ ___ ___ __ _____ ____ ____ __ ____ __ _____ ____
3
Attendance ---------------------------------------------------------------- 155
Films -------------------------------------------------------------------------
.Mtendance
155
DENTAL CLIXICS VISITED_______________________________________________________ 27
REGIO"'AL OFFICES VISITED_____________________________________________________
6
CONFEREXCES
1. Regional Medical Direct.ars___________________________________________________
8
2. County Health Commissioners_______________ ----------------------------------
71
3. Dentists -------------------------------------------------------------------- 177
4. School Superintendents ------------------------------------------------------ 101
5. Physicians ----------------------------------------------------------------- 12
6. Home Demonstration Agents__________________________________________________
3
7. Nurses --------------------------------------------------------------------- 158
8. Parent-Teacher Workers -----------------------------------------------------
27
9. Others --------------------------------------------------------------------- 178
RADIO TALKS -------------------------------------------------------------------ARTICLES ----------------- -------------------------------------------------------
ASSOCIATIONS. CONVENTIONS ATTENDED
In the State_____________________ -------------------------______________________
3
Out of the S.ate________________________________________________________________
3
Division of Maternal and Child Health
Joe P. Bowdoin, M.D., Director
Edwin R. Watson, M.D. ___________________________Associate Director Mary Emma Barnes____________________________Nutrition Consultant
The Division suffered the loss of its Director, Dr. Joe P. Bowdoin, on August 7, 1942. Doctor Bowdoin had been at the helm since 1923, and continued to devote his time and effort to this phase of public health until and including the day of his death. It was his nurture that paved the way for the development of the clinical iphase of the program. The Division will continue to benefit from his guidance, counsel and insight as a result of his tutorship. His humanitarian qualities were unsurpassed. His interest in mothers and babies never declined. His outlook was a.Iways optimistic. Public health is in dire need of more workers with the qualities which he so beautifully exemplified.
Many personnel changes occurred in the Division during the year. In May the Associate Director was called to active duty by the United States Public Health Service and assigned to the Director of the Georgia Department of Public Health as Deputy State Chief of Emergency Medical Service fur civilian defense. The activities thus imposed left scant time for his former duties in the Division. The Divison had just previously lost its obstetric consultant, who was called to active duty hy the Army. Thus, the Director and Nutrition Consultant were the only full-time staff members remaining. The Associate Professor of Public Healrth Administration of the Johns Hopkins School of Public Heal~h was a Division staff member during some of the spring and summer months on a discontinuous basis. A pediatrician was employed temporarily during the summer months when she was not required to serve as college physician. Upon the death of the Director, the Associate Director wa,s instructed to assume directorship of the Division and in addition continue his previous assignment as Deputy State Chief, Emergency Medical Service.
Due to continuing personnel changes in State and local staffs, and numerous impediments resulting from t:he sate of war and conditions of population shifts, the Division has advisedly operated in an aHempt to hold the quantitative status of service as nearly as possible and to improve i:ts quality whenever possible. A part of the considered policy has been to refrain from wholesale promotion of new activities, except where the staff was convinced of considerable likelihood that such extensions can be maintained despite probable readjustments. With this in mind, it is somewhat surprising to find rthat quantitative increases of service have occurred in sl' r-ht to moderate degrees.
GENERAL EDUCATIONAL ACTIVITIES
The divisional staff has continued to lecture to nursing trainees while engaged in securing field experience. This opportunity is utilized to convey to prospective public health nurses the more important phase of maternal
108
Georgia Department of Public Health
and child health services with which they should be concerned. It also provides an opportunity to emphasize those particular aspects whioh are not included in their general experience.
Regional conferences have continued to be held each quarter and members of the staff have participated in those meetings upon request. Although regional conferences permit an excellent opportunity for discus sion of current problems with local staffs, it has not been possible to devote sufficient time and effort to prog.ram planning to utilize the conferences as frequently.
Members of the divisional staff have continued ~o cooperate with the two schools of medicine, in that lectures were given to junior students of medicine. This activity permits the divisional staff to become acquainted with future practitioners of medicine, and provides for a very brief presentation of objectives, plans and policies of the Division.
Participation in public forums has been sharply curtailed. Although this provides an excellent opportunity to discuss health problems with representative citizens, other duties have not permitted our participation to the extent desired. It has been deemed wise to curtail travel for this purpose.
The staff confers frequent! y with members of the State Department of Public Welfare regJarding health standards and health problems pertaining to Day Care Nurseries. In this connection it might be said that some time has been devoted to problems concerned with evacuation, .though plans for evacuation and registration are as yet incomplete.
In May, the Division received from the Medical 'and Surgical Relief Committee, a national organization wirth headquarters in New York City, an inquiry as to whether there were areas in the State where donations of foods and drugs might be put to good use. It was arranged that vitamin concentrates, pr.incipally cod liver oil and iron preparations, would be contributed by that agency in small to moderate amounts from time to time, with no assured regularity. Three shipments were received. Unfortunately the products, received as yet, do noil: nearly meet the probable need. Nevertheless, this is a desirable supplement to locally procured products.
Georgia's Health, the departmental monthly publication, has continued to be edi1ted in this Division. This publication is continuing to reach a great number of subscribers. As au added feature, an effort is being made to include at least one cut along with a feature article in each issue.
The customary distribution of promotional literature for the observance of May Day was carried out. In addition, two special bulletins on smallpox and diphtheria were prepared, which were included in thP May Day material.
Althou~h the maternal demonstration in Tift County was discontinued on December 31, 1941, a complete statement of the results has not been prepared in final form due to other pressing commitments. It is hoped that this report can be made ready for publication in the very ncar future.
Maternal and Child Health
109
Out-of-state meetings attended by staff members of the Division included: the regional meeting of the Children's Bureau and the National Conference of Social Workers held in New Orleans; the American Congress on Maternal Welfare and the American Public Health Association held at St. Louis. The Associate Director, while attending the American Public Health Association meeting, was an official representative of the Director of 1;he Department at a meeting of the Association of State Health Officers.
MEDICAL AcTIVITIES
Statistical Summary of Activities:
Number Attendance Total
Papers, talks, addresses, total attendance__
734
Public health personneL____________ 14
162
Professional __________________ ____ 2
7
Lay groups ______________________ 4
565
Consultations and clinical services________ 23
Interviews and conferences, total attendance
865
Physicians and health officers________ 171
280
Nurses and other public health workers 136
368
Officials and civic leaders___________ 29
172
Civilian defense activities___________ 11
43
MCH centers conducted or inspected_____ 56
340
Visits to nurseries, schools, lunchro-oms, hospitals, etc. ______________________ 13
Selected Activities:
Case consultation service has been discontinued except insdar as it can be rendered in connection with other services. Assistance has been provided local health departments in securing hospitalization of needy cases.
The premature infant care program has progressed very satisfactorily. The premature infant death rate for 1942 was 15.2 per 1,000 live births, which is rthe lowest mte ever recorded. Incubators for premature infants furnished by the Department have been used extensively in homes and hospitals. lnformation pertaining -to medical and nursing care provided through institutes has been utilized by public health personnel throughout the State to a gratifying extent. One county has had from four to six incubators in constant use. Hospitals and health departments have become interested in constructing additional incubators, and the Division is lending guidance in this movement. All incubators have now been completed and have been placed in the counties for their use.
In view of the fact that many new hospitals have ignored sound planning for maternity and newborn services, the Associate Director has devoted considerable time to the study of recommended hospital standards for maternity and newborn services. Several requests have been received for professional advice on this subject, and in each instance construction
no
Georgia Department of Public Health
plans were altered to permit the recommendation of the Division to be put into effect. Additional time should be devoted to this activity in the future, both in regard to new structures and rearrangement of old structures. This type of activity will coincide with the proposed licensing and standardization of services rendered maternal and child health cases by hospitals and m&ternity homes.
In anticipation of financial participation with hospitals, and in view of the establishment of maternity homes, proposed legislation was drawn up which would empower the State Board of Health to adopt such rules a.nd regulations as it deemed necessary to protect mothers and newborn infants, cared for during the antepartum, intrapartum, postpartum and newborn period, in institutions offering such service or care within the State of Georgia. Ali institutions rendering such service would be licensed. In addition, a part of the bill would empower the State Board of Health to make rules and regulations necessary to protect individuals served by midwives. At present, midwife certification is regulated by the State Board of Health, but is not supported by a specific law, which makes it difficult to prosecute midwives successfully.
In anticipation of increased federal grants-in-aid for maternal and child hea.lth ipurposes, it was deemed wise to submit to the Advisory Committee of the Medical Association of Georgia a projected medical care plan. This plan was approved by the committee authorizing the Georgia Department of Public Health to participate in intrapartum care programs in any one or more of the following ways: (1) By subsidizing hospitals rendering acceptable standards of service for delivery of cases now served by midwives. (2) By aiding financially in the construction, maintenance and opE>>ation of maternity homes in rural areas without hospital facilities (deliveries to be done by local physicians or nurse-midwife; the latter must be acceptable to the Department and must he agents of local physicians). (3) By the employment of nurse-midwives (acceptable to the Department) for home deliveries in areas where hospitals or maternity homes are not feasible. (4) By compensating private physicians for home deliveries or deliveries in quarters related to their office for cases now cared for by midwives. It is thought that one or more of the above combinations would prove to he a satisfactory appr'Oach to the problem.
Survey of hospitals in the State, with respect to facilities for the care of premature infants was made during the year. The survey form used was supplied by the Children's Bureau of the United States Department of Labor. Approximately one-third of the hospitals completed and returned the form. The results have been tabulated, and an article has been prepared for .publication in the Journal of the Medical Association of Georgia. The survey provided sufficient evidence to warrant the statement that premature infant care in Georgia hospitals is far from desirable. There waG no indication that ho&pitals in Georgia provide a good premature infant care program.
The maternity mortality study was discontinued during the spring be-
Maternal and Child Health
Ill
cause many physicians were leaving for the armed services, thus is was difficult to get the questionnaires completed. Results of this study over a period of years have provided us with information as to causes of death, and it now remains for us in cooperation with the medical profession to formulate programs which will help to solve the causes previously determined. It s doubtful that the continuation of this study would do more than provide us with essentially the same data as that collected for some years.
The Associate Director has continued to serve as a member of the Scientific Advisory Committee to the State Nutrition Committee. During the year considerable time and effort was devoted to the study of enriched flour and bread. The State Committee adopted proposed legislation to prohibit the sale of other than enriched Hour and bread. In addition, he has served as Child Hygiene Chairman of the Georgia Congress of Parents and Teachers for a number of years. Although time has permitted him to devote adequate attention to this phase of Parent-Teacher activities, he has attempted to promote those child health services in which this organization is interested. As a result of their interest, more local associations are contributing toward the securing of quarters and equipment for health centers, and an increasing number of members are serving as volunteers in centers.
The Associate Director has continued to serve as a member of the Policy Committee, Publications Committee and the Record Committee of the Department. All printed publications and reports are submitted to these committees for approval prior to adoption or distribution.
Articles, per'taining to maternal and child health subjects, have continued to be submitted to the editor of the Journal of the Medical Association of Georgia for publication. Every effort is made to write on a timely subject and to choose subjects that are of interest to private practitioners of medicine.
At the request of the Director of the Division of Local Health Organization, a maternal and child health section of a proposed health officer's manual was prepared. It is hoped that this manual will aid in familiarizing health officer trainees and others in the interpretation of divisional objectives, policies and plans.
At the request of physicians serving in maternal and child health centers, a brochure on the professional aspects of infant feeding has been prepared and is to be published at an early date.
Plans offering postgraduate instruction and experience to hospital supervisors of maternity and newborn services were formulated during the latter part of the year. There is every reason to believe that this project will materialize. Interest in this phase of infant care must be stimulated. Accptable experience should do much to encourage elevation of standards of care. Though supervision from this office will aid materially, it can best be utilized in hospitals that have staffs trained in this phase of infant :;are.
Early in the spring physicians participa<ting in maternal and child
112
Georgia Department of Public Health
health centers were offered an opportunity to attend postgraduate courses in obstetrics and pediatrics. As a result twenty-four white and nine Negro physicians attended the Southern Pediatric Seminar and Meharry Medical College, respectively. White and Negro physicians were provided with a stipend which was sufficient to cover, in part, travel, tuition and subsistence incurred. The response from both groups was excellent, and the Division was happy to have letters of appreciation for this opportunity. The improvement of services rendered by physicians taking these courses :is indicative of the value of this type of activity. The Division hopes to continue this activity whenever the opportunity permits.
Audiometers are loaned by the Division to local health departments interested in detecting school .children with hearing defects. Though many counties have not been able to eontinue their previous school program, some are utilizing the audiometers.
Plans were ,initiated early in the year to add pertussis immunization to the immunization procedures already adopted. Following 'approval of this policy by the general and pediatric advisory commit,tee of the Medical Association of Georgia to the Georgia Department of Public Health, plans were made to measure the antigenioty ,of available antigens before selecting one for distribution. Though measurement of immunity response has not been concluded, it is ,anticipated that the antigen can be decided upon early next year. It is appreciated that antigens may have to be changed from time to time as more is known of their effectiveness. Our objective is not the elimination of pertussis, but rather a diminution in mortality in young children from this disease by the use of one of the ava,ilable antigens.
NuTRITION AcTIVITIES
Statistical Summary of Activities:
Number Attendance Total
Papers, talks, addresses, total attendance__ Public health personneL___________ 5 Professional ____________ __ _______ 7 Lay groups ________ _______________ 36
MCH centers visited____________________ 53
Interviews a.nd conferences______________ Physicians and health officers________ 55
Nurses and other public health officers 133 Officials and civic leaders___________ 80 Mothers _________________________ 108
42 492 2,177
55 133 126 108
2,711 422
Food demonstrations at MCH centers_____ 41
459
Lunchrooms visited -------------------- 47
Assoeiat.i~n meetings attended____________ 5
525
Home visits __________________________
8
Radio talks __________________________
1
Maternal and Child Health
113
Selected Activities:
During 1942 the advancement of the nutrition program has been most gratifying. Special emphasis has been placed on in-service training of public health workers. This has been accomplished through the training center and field visits.
In working with nursing trainees, the practical application of nutrition was stressed because for a nutritional program to be effective it must meet the needs of the people.
County health departments were visited and individual .conferences held with health officers and public health nurses concerning existing local nutrition problems. Suggestions were offered for clarifying these problems as well as enlarging the scope of the nutrition program. These visits and consultations have increased the interest of public health personnel in promoting better nutrition. Nutrition material w.as supplied nurses for their own information and for distribution to the public.
The nutritionist personally attended 53 maternal and child health centers and conducted 40 food demonstrations.
While visiting various counties, the nutritionist assisted the public hea1th nurse in securing the aid of home economists from Federal F.arm Security, Agriculture Extension Service, American Red Cross, Georgia Power Company, and local high schools in conducting food demonstrations in health centers. The home economists who assisted were supplied with outlines of procedure that conformed to the program established by the State Health Department.
As a result of these demonstrations, during the year eight additional county health departments have inaugurated food demonstrations as an integral part of their health cenrter activities. In Ful.ton County alone 231 food demonstrations were given by American Red Cross Canteen workers in eight centers with 1,846 mothers attending.
Maternal and ehild health centers prove1d invaluable in the practical application, by demonstmtion method, of good nutr.ition principles. The nurses have observed an increase in the consumption of whole grain cereals, fruits, and vegetables by the families of the mothers who attended food demonstrations in health centers.
At the request of the Industrial Hygiene Division of the State Health Department, a visit was made to the Southeastern Shipbuilding Company to discuss with officials ways and means of improving the nutritional status of employees. The nutritionist served as a member of the Committee on Nutrition in Industry of the State Nutrition Committee to aid in promoting better nutrition in industry.
The Georgia Power Company and the Wesrtinghouse Company sponsored three "Health for Victory Clubs" in Georgia during 1942. These clubs were formed at the Sibley Enterprise Mills in Augusrta, Swift Manufacturing Company at Columbus and Brighton Mills at Rome. Through these clubs, wives and mothers of the indus.trial workers are given infor-
114
Georgia Department of Public Health
mation that will aid them in the selection and preparation of the protective foods necessary for optimum health. Workers benefit from the club through better health, and the mills and plants benefit as a result of reduction in absenteeism due to illness. Thus the plan is mutually beneficial to employer and employee alike. Efforts to secure the interest and cooperation of industrial officials have been successful because many managers now recognize the importance of proper nutrition for workers.
The nutritionist ,taught a nutrition course to fifty members of Doctors' Aide Corps of the Fulton County Medical Society.
Assistance was rendered the personnel at the "Convalescent Home for Children" on planning low-cost, adequate diet for children.
Groups reached by talks and papers were: Georgia Home Economics Association, Georgia Congress of Parents and Teachers, Georgia Home Economics Council, County Nutrition Committees, Women's Division of the Office of Civilian Defense, nutrition groups, school officials and numerous other organizations.
The following new publications were prepared:
"Count Your Calories." "What You Should Know About Eggs." "How to Select and Prepare Vegetables." "School Gardens for School Health." "Does Your Child Have Good Food Habits?" "Does Your Child Measure Up?" "Food After Fifty." "Streamline for Health."
Material was furnished to the Fulton County Chapter of the American Red Cross for their twenty-hour course in nutrition. One hundred and fifty classes were completed and 2,904 nutrition certificates were awarded during the year.
Home economists of the Georgia Power Company taught a total of
1,170 standard nutrition classes and 190 canteen classes. Vocational home economics teachers taught approximately 352 standard nutrition classes. Nutrition material used in these classes was furnished largely by the State Health Depavtment.
Mwterial was likewise contributed to the program of the Medical Association of Georgia. This organization has sponsored the distribution of several thousand nutrition pamphlets.
The State Department of Education was given permission to reproduce the bulletin, "Practical Information on Nutrition", prepared by the nutritionist. It will be incorporated in the reference material for vocational home economics teachers.
A total of 90,658 pamphlets on nutriton were distributed to the public by the Division during 1942.
The nutritionist, as Chairman of the School Lunch Committee of the State Nutrition Committee, devoted much time to promoting the school
Maternal and Child Health
115
lunch program. Talks were made to professional and civic organizations emphasizing the value of hot school lunches for children.
The bulletins on "Minimum Standards for School Lunchrooms", "Hygiene and Sanitation Standards for School Lunchrooms", and "Train. ing of the Lunchroom Personnel" were prepared by the Lunchroom Committee of the State Nutrition Committee and have been widely distributed to school officials.
The Work Projects Administration cooperated extensively in the successful operations of school lunchrooms. At the close of the school year, May, 1942, 3,341 WPA workers were employed in the school lunchrooms, but due to the curtailment of the Work Projects Administration program, only two-thirds of the workers formerly employed in the lunchrooms were available in September. Therefore, a plan was adopted by which the sponsors furnished one-third and the Work Projects Administration furnished two-thirds of the p<1id workers. With approximately 2,700 workers, 821 school projects were operating in September, 1942. This plan was largely responsible for communities accepting increased responsibility for the operation of their lunchrooms. Workers in approximately 150 lunchrooms canned food for consumption by the children.
The Food Distribution Administration of the United States Department of Agriculture by furnishing foods to lunchrooms has played one of the vital roles in expanding the program.
Of the 5,221 public schools in Georgia 4,823 were eligible to receive surplus foods. During 1942, 1,793 schools, receiving food from the Food Distribution Administration, provided 237,981 school children with at least one hot dish daily, while 3,030 schools furnished 240,610 school children with raw or uncooked lunches.
Fifty-seven home demonstration agents assisted in developing interest in 786 school lunchrooms and the number of children benefited was 98,586. Home demonstration club members in 94 counties have aided in canning for the school lunch progmm. Containers numbering 419,120 were utilized for preserving food for school lunchrooms.
Home economics teachers planned menus and supervised the preparation and serving of lunches in approximately 330 schools.
Parent-Teacher Associations and County Boards of Education have been largely responsible for equipping lunchrooms and supplying food necessary for well-balanced school lunches.
Despite the withdrawal of Work Projects Administration workers from the lunchrooms, there was an increase of 3% during 1942 in the number of schools serving at least one hot dish daily.
MATERNAL AND CHILD HEALTH CENTERS
Relatively few new maternal and child health centers were established during the year, principally bec<luse most counties with local health departments had already established the number of centers they could staff. It will be noted that centers on State subsidy totaled 321 as of December
116
Georgia Department of Public Health
31, 1942. This is an increase of five centers over the number reported for 1941. Actually more new centers were established, but this was offset by the discontinuation of centers that had previously been in existence. In ability to secure qualified public health personnel to the same extent as in previous years was the principal factor in curtailing the number of newly established centers. For the duration of the emergency the number of health centers will most probably remain more or less stationary. It is gratifying to note that vary.ing arrangements have made it possible to continue to operate the large number of centers previously developed. This is due to the unselfish devotion of private physicians to this phase of pubi'tc heal.th, and the medical profession is to be congratulated for its interest in this work, even though faced with increased activities in their private practice.
The number of centers, and type of activities for the two classes of counties, is presented in the following table:
MATERNAL AND CHILD HEALTH CENTERS IN OPERATION
Type of Center
Organized Nursing Total
Maternal ---------------------------- 73
Infant ------------------------------- 92 Combined --------------------------- 89
9
82
3
95
55
144
TotaL__________________________ 254
67
321
In most ins~ances the new centers have complied with minimum standards. Exceptions have been permitted because of inability to secure necessary materials. Numerous centers, previously approved, have obtained excellent quarters. However, there remain some with inadequate quarters and additional aHention should be devoted by regional personnel to this problem. Personnel should not be assigned to areas not now employing public health workers, until adequate facilities for a satisfactory program are made available.
In May, a form was mailed to all counties wi,th local health departments, with the request that a report be made on each maternal and child health activity not covered by the regular statistical report. The completed forms served as a basis for the annual Progress Report to the Children's Bureau, and as confirmation in the central office concerning the current status of activities.
The Division has felt constrained to make certain advance purchases of equipment, anticipating 1price rises and shortages. All equipment purchased is carried on State inventory, showing the counties to which the various items are allocated. Shortage facilities being limited, the reserve equipment accumulated is being carried on divisional inventory or regional inventory. Each regional office is carrying a reserve of three complete health center sets of equipment, plus several additional hot plates. The principal items carried in the divisional office consist of hot plates, blood
Maternal and Child Health or or lllliBIII IIA.'I!l!RIIAL AliD CHILD !IEALTH CEim!IIB Br CamTY AB Ill!CIIIIBl!R 31, 1942
117
118
Georgia Department of Public Health
pressure instruments, and a few minor items. New items of equipment are also kept in this office. They include:
l. Laboratory coats for use in clinicians. These have been distributed on request to practically all centers.
2. Otoscopes. Although previously a few such instruments have been supplied on special request, only recently has the Division purchased a stock of these instruments. The item has no't been made a part of the routine equipment, but is furnished only to centers where we have reasonable assurance that it will be used.
3. Sahli Hemometers. So little has been done to combat hypochromic anemia in pregnant women, and in children, that the Division hopes to stimulate interest in this very prevalent condition by supplying this item to centers and to health departments where we have assurance th&t it will be used. It was formerly recommended that hemoglobin determinations be made by the blotter paper method, but little interest in the subject was evinced. It is hoped that the application of a more relia.ble test will convince local workers of tthe importance of this determintaion.
Other desimble items have of necessity been omitted as a result of difficulty in securing the necessary priority. It is hoped that these items can be made available at the earliest possible date, particularly platform scales.
MATERNAL AND CHILD HEALTH CENTER ACTIVITIES
Maternal health center activities increased to a gratifying extent during the year. An increase of 10% in admissions over the previous year reveals a continuing acceptance of this service. The period of gestation on admission did not vary significantly from that reported for 1941. The total admissions to prenatal medical service provided in health centers were equivalent to about 60% of annual midwife deliveries. Of course, this coverage would be improved if health centers were in operation in each county in the State. The number of prenatal syphilitics reported is essentially the same as that for previous years; however, the number of antileutic treatments showed a remarkable increase which .is accounted for by 'the adoption of the Central Tabulating Unit method of reporting, rather than the type of report previously employed. This increase in total antiluetic treatments resulted in 7.6 treatments per syphilitic prenatal for 1942 as compared with 4.6 for 1941. The Central Tabulating Unit reports reveal number of treatments given to prenatal syphilitics regardless of whether treatment in !prenatal or venereal disease centers. The per cent of prenatal syphilitics with positive serology showed no significant change, however, the distribution was altered in that only 16.66% of the Negro prenatals had positive serology as compared with 20.5% for 194,1. Prenatal and admission visits increased, but in both instances the increase was entirely limited to Negroes. The visit admission ratio showed a decline which is probably a result of restrictions affecting travel. Admissions to post-
Maternal and Child Health
119
partum medical service showed an increase for the Negro and a slight decline for white patients.
Infant and preschool health center activities did not show increases 1parallelling that noted above for maternal health centers. Admissions
declined 1% because white admissions declined 8% and Negro admissions increased only 5%. Distribution by age group on admission showed
no signifiicant change. Visits to child health centers declined 3%, and
this decline is a result of a decline of 8% in white admissions. The visit
admission mtio showed no significant change. The number of cases referred for treatment declined 9%. Immunizations against diphtheria increased 3'/c, and this increase is accounted for by an increase of 9% in diphtheria immunizations in children under one year of age. This is encouraging in that it reveals continued acceptance by parents of early immunizations. Immunization, of infants attending child health centers, against diphtheria equaled total admission of infants from four months to one year of age admitted to centers. This is proof that public health personnel is devoting adequate a.ttention to this phase of child health center activity in the case of those infants admitted to service.
It is encouraging to note that child health center aotivities retained the degree of activity developed during previous years. However, the continued increase in maternal health center activities could only give rise to the conclusion .that the maternal phase has received more emphasis and that more facilities are utilized for prenatal care exclusively. Perhaps the fact that midwife cases are in most counties required to attend maternal health centers in order to secure permit for midwife service accounts for the differential which exists between maternal and child health center activities.
MATERNAL HEALTH CENTER AcTIVITY
State-Subsidized Centers
1942
Prenatal Admissions
Admissions, lola! ---------------------------------
White ----------------------------------------
Xegro ----------------------------------------
% white ------------------------------------% negro ------------------------------------
Period of gestation, totaL_________________________ T:nder 16 weeks________________________________
15,283 2,096
13,187 13.7 86.2
15,244 4,312
16-27 weeks ---------------------------------28-36 weeks ---------------------------------Over 36 weeks_________________________________ % under 16 weeks_____________________________
% 16-27 weeks------------------------------% 28-36 weeks--------------------------------% over 86 weeks------------------------------
6,917 3,346
469 29.6
45.3 21.9 3.0
%+orover 1941
+ 10
-17
+ 16
+ +
11 21
+7
++ 23
120
Georgia Department of Public Health
Prenatal Syphilis Reports, total ___________________________________ _
White ------------------- ------- ------------Xegro -------------------- ------------------% of admissions, totaL ____________________________ _
White __________ ------------------------------N egr.o -----------------------------------------:\umber positive, totaL _____________________________ _
White _____________________ ------------------:\egro __________________ ------------------ ___ _
% positive, totaL ______ ----------------------------
White _______________________ ________________
10,864 1,202 9,662 71.0 57.3 73.2 1,673 63 1,610 15.4 5.2
Xegro ----------------------------------------
16.6
Treatments: total ___________________ ______________ 12,713
Treatment/positive ratio _________ __________________
7.6
Prenatal Activities
Visits, total __________________ ---------------------
White __ -------------------------------------:\egro --------------------------- -----------Yisit/admiss,ion ratio ------------------------------White ____ -----------------------------------Negro ---------------------------------------Transferred, total
50,938 6,570
44,468 3.3 3.1 3.4
387
Postnatal Activities
Admissions, total -------------- -------------------White _____ ----------------------------------Negro -------- ___ -- _____ ----------------------
Visits, total --------------------------------------White ________________________________________
Negro ------------------------------------ ___ _
% of prenatals, totaL _____________________________ _
White ___________ ------ ----------------------Negro ________________ ------------------------
2,560 361
2,199 3,348
477 2,871
16.7 17.2 16.6
INFANT HEALTH CENTER AcTIVITY
State-Subsidized Centers
1942
Admissions-Infant and Preschool Admissions, total ________________________ _
White _____________ --------------------------
Xegro -------------- -------------------------
% white ____________________________________ _ % negro ____________________________________
Age groups, totaL _________________________________ _ l:nder 4 months ________________________________
4-12 months ---------------------------------1-5 years ------------------------------------% under 4 months_____________________________
% 4-12 months _______________________________ _ % 1-5 years ___________________________________
14,961 5,952 9,009 39.7 60.2
14,973 4,869 3,557 6,547 32.5 23.7 43.7
+
-29
+ 15
+
-38
+
+ 66
+
-30
+ 17
-22
+ 22
-6
+ 29 + 19
14
+ 27
%+ or -
over 1941
1 8
+ + +
Maternal and Child Health
Visits and Activities
Visits, total -------------------------------- -----White ________________ -------------- -------Negro _________ -------------------------------
Visit/admission ratio _____ -------------------- ___ _ White __________________ --------------- ______ _ Negro ______________________________ ----------
Referred cases
37,095 14,386 22,709
2.5 2.4 2.5 2,003
Immunizations
Diphtheria, total _______ -------------------------Lnder 1 year_________ ________________ _ ___ ___
Over 1 year --------------------------- ______
% admissions, totaL _______________ ----------% admissions, 4-12 mo._________________________ % admissions, 1-5 years________________________
Smallpox, total ------------------------------------
% admissions, totaL____________________________ % admissions, under !______________ ___ ________
Typhoid, total ___________________ _ ___ _______ ____
% admissions, totaL__________ ________________ % admissions, over !___________________________
7,606 3,755
3,851 50.8
105.5 58.82
3,830 25.6 45.4
3,078 20.5 47.0
121
-8
+1
-9
+3 +9 +4
-6
COMMENTS ON STATEWIDE MATERNAL
AND CHILD HEALTH ACTIVITIES
The following table reveals a gmtifying increase in the number of immunizations performed during the year. Compared with 1941, smallpox vaccinations increased 24%. An increase of 10% in diphtheria immunizations in children under one year of age is worthy of note. However, an increase of 12% and 29% in the preschool and school age group, respectively, reveals that sufficient interest is not yet focused on the optimum time for this immunization procedure. Total diphtheria immunizations numbered 50,587, which compares rather favorably with the annual number of births.
A remarkable increase in maternal services rendered, when compared with 1941, is evident from the fact that admissions to prenatal medical and nursing service increased 30% and 92%, respectively. There was not a corresponding increase in visits to medical conferences. However, field and office visits showed a remarkable increase. There is evidence that postpartum medical examinations are increasing, ,though the total number served does not compare favorably with the total number of prenatal admissions to medical service. Field visits to postpartum cases did not change appreciably. The decline in cases attended by nurses for delivery service is accounted for by the discontinuation of the demonstration unit where this service was offered county-wide. An increase of 14% in the number of cases admitted to postpartum nursing service is encouraging.
Infant hygiene activities showed no significant changes during 1942 when compared with activities reported for 1941. This can only be explained by s.tating that maternal and child health centers are placing more
122
Georgia Department of Public Health
emphasis on the maternal phase than on the infant phase of the program. Until all centers offering prenatal medical and nursing service include infant medical and nursing service, a favorable result cannot be expected.
Preschool hygiene activities showed no significant changes. This phase of maternal and child health care is not receiving as much attention from public health personnel as is devoted to maternal hygiene activities. Both infant and preschool admissions and visits should exceed prenatal admissions and visits, for the reason that infants and preschool children are on the whole more eligible for service, inasmuch as prenatal cases are largely limited to those engaging midwives. Physicians as a rule do not object to the admission .of infants and preschool children to medical service provided they are medically indigent, or whose parents are no>t financially able to secure medical or nursing supervision.
School hygiene activities show a distinct decline in the number of school children examined by physicians with and without parents present. This was antic~pated in view of the additional duties incurred by public health medical personnel and private physicians as a result of the war emergency. The remarkable increase in field nursing visits, as well as office nursing visi,ts, is not readily explainable. Nursing personnel has not been increased to this extent during the year. This increased activity is probably a result of focusing attention on additional nursing service in an effort to overcome the diminution of medical service to school children and also probably as a result of better reporting.
Inspections hy dentists show a significant decline. This probably has resulted from the increase in private practice due to a decrease in the number of dentists available as a result of the war emergency, and perhaips because many inspections are now being done in the dental clinics, rather than in schools. It is thought that transportation has been a factor in reducing this activity.
%+or-
1942
over 1941
Immunizations
Smallpox ---------------------------------------------
Diphth<>ria, under 1 year-------------------------------1 through 4 years _____________________________
5 years and over_____________________________ _
92,368 14,028 21,022 15,53 7
Maternity Service
Admissions to prenatal medical serv,lce_________________ 24,984
Admissions to prenatal nursing service__________________ 47,246
Visits to medical conferences____________________________ 67,578 Field and office visits _________________________________ 14 7, 744
Cases given postpartum medical exam._______________ 3,487
Visits to postparum cases______________________________ 45,309
Cases attended by nurses for delivery service____________ 218
Casoo admitted to postpartum nursing service____________ 20,369
Visits for midwife supervision_________________________ 5,795 Attendance __ ____ _____ __ _____ __ ____ __ _________ __ ____ __ 2,3 40
+ 24 + 10 + 12 + 29
+ 30 + 92
++ 60 + 13 +5
-45
+ +
14 15
+ 17
Maternal and Child Health
123
Infant and Preschool Hygiene
Infants: Admissions to medical service______________________ Admissions to nursing service______________________ Visits to medical conferences_______________________ Field and office nursing visits______________________ Preschool: Admissions to medical service_______________________ Admissions to nursing service~---~----------------Visits to medical conferences_______________________
Field and office visits-----------------------------Attendance
11,290 31,647 26,420 87,789
13,073 25,268 24,049 61,813
586
- 45
+ 16 +5 +9
4
+7
-55
School Hygiene
Examinations by physicians-----------------------Examinations by Ilhysicians~parents present_ _____ _ Field nursing visits________________________________
Inspections by dentists or dental hygiene __________ _
79,650 2,663 71,817 62,789
- 18
- 29
+ 31
-- 31
MATERNITY HOMES
During 'the latter part of the year two maternity homes were opened. One of these maternity homes had been incorporated and was operating when ~he details became known to this Division. This maternity home closed before the end of the year and probably will not reopen soon. The other matern~ty home was established in Rabun County in November. This Division has been stimulating interest in this project in this particular county for several years. Although a.U obstacles have not been overcome, the Rabun County home is functioning satisfaotorily. This county is a part of a tri-counrty unit 'and had one public heahh nurse on the staff until recently when a nurse-midwife was placed there by the Georgia Department ,of Public Health to instruct and supervise midwives and work toward improvement and integration of maternal and child health services. The nurse-midwife continued her more specialized public health activities, devoting particular attention to private physicians' cases in that she included these in her routine antepartum, postpartum, and newborn services. At the time that the maternity home was opened she began rto devote her full time to organizing this service. She is being assisted by a midwife with many years of training, though the latter's activi,ties are limited to practical nursing duties. The expenses ,of the home are borne by the county-wide Community Chest, general funds of the county, contributions, and by funds collected from cases that are able to pay.
The ma,ternity home is a modern frame structure, containing eight rooms, four rooms of which are used for living quarters of the staff and the other four rooms are used for cases. Although full-time nursing service on a twenty-four-hour basis is not now ,available, plans are under way to employ a qualified nurse for this purpose. Deliveries are attended by physicians, except in a few instances when the nurse-midwife assumes this responsibility as an agent of a local physician. Cases are admitted regardless of ability to pay, but are charged on the basis of their ability
l I
124
Georgia Department of Public Health
to pay. The maternity home serves all cases in the county, regardless of economic or social status, and physicians are limiting their services to those cases confined in ~the maternity home, except in a few instances in which they previously had committed themselves to home delivery. The private physicians requested that they be permitted to deliver all cases and were willing to attend charity cases without charge. Private cases make their own financial arrangements with priv,ate physicians, hut pay the maternity home for services rendered. The home has not operated a sufficient length of time to make any definite statement concerning cost of patients per day. Deliveries are 'avemging about ten per month at present. The maternity home is affiliated with a hospital so that all complicated cases can be transferred to the latter. This probably is the best solution to the midwife problem in counties where hospital facilities are not feasible.
The maternity home is closely coordinated with the Health Department and one local physician is thoroughly familiar with health center cases that are admitted for delivery service since he is the dinieian at the maternal health center. T!he facility has provided us with the means of caring for premature infants in rural areas without hospi,tals. Though it will require much effort and time to standardize the maternity home service and adapt it to the best advantage, it is fe1t that a good start has been made in this direction. Forms have been prepared which the maternity homes will use to report their activi,ties to the Department. In this way we hope to gain 'an insig'ht into the cost of operation, and the types and extent of services rendered.
MIDWIFE PROGRAM
Certified Lay-Midwives
As a resul't of the war emergency, it has been impossible to purchase, for resale 1to certified midwives, the type of midwife bag previously used. As a result it has been necessary to purchase bags that are not as suitable hut more expensive. Since the cost of these bags ex;ceeds the midwife's ability to pay, a paPt of the cost has been absorbed by the Department. Plans are under way to make midwife bags of a waterproof canvas material patterned along approved lines which will be cheaper and more durable.
Policies were ado,pted by the Division which do not permit the certification of midwives not previously certified, unless there is a demonstrated need for their services individually. This policy was adopted in an attempt to discourage wholesale recru~tment. All public healbh personnel has been encouraged to retire all midwives in excess of the number needed.
To encourage retirement, badges have been purchased and are awarded to the midwives who make a promise under oath not to engage in practice. It is thought that this badge will be helpful in securing such .a pledge from those with religious zeal who do not qualify.
The following table presents all available statistical information pertaining to certification of midwives in Georgia for the eleven-year period elapsing between 1932 and 1942 inclusive:
Year
Total
1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
3,358 3,562 3,434 3,510 3,297 3,171 3,049 2,951 2,861 2,594 2,412
Not available.
MIDWIFE APPLICATIONS, DEATHS, AND CERTIFICATIONS BY AGE
Certifications
w.
.
316
326
298
267
253
233
c.
.
3,194
2,971
2,751
*
2,594
2,341
2,179
Initial Certification by Age Groups
Age
Under 50
5065
Over 65 Unknown
Total
. ..
..
*
135
*
*
*
*
134
59
75
37
22
4
5
68
25
13
3
2
43
Applications Midwife
Refused
Deaths
2,949 3,463 3,402 3,510 3,509
*
518 749 653 638 447
125
...~
l:l
<..b,
99
:::s
223
.l.:.l..
165
l:l
[
*
134 85
C.;.:..":.....:-.i.
l:l...
86
::t::
71
<b
l:l
64
~ ;::.-
,......
t-.:1 I:Jl
J
126
Georgia Department of Public Health
Nurse-Midwife Program
A specialized nurse-midwife supervision program was inaugurated in five counties during the year. The project was initiated on a different date in each county, the darte being determined by the return of the nurse-midwife from schools of midwifery. The counties in which the projeots were conducted are as follows: Sumter, Thomas, Rabun, Crisp, and Spalding. Thomas was the first county in which the program was initiated, it being in January. The services in Crisp County were initiated in March. The other rthree counties started their programs in April.
The five nurse-midwives were placed in the counties as regional personnel, loaned to the individual counties on a full-time basis. They were to proceed according to objeotives outlined by the Division and approved by each local health department. Prior rto the initiartion of this program, each of the five counties was committed to provide medical service in the individual's home for eomplicated cases, and hospitalization for patients whose condition necessirtated this rtype of care. This agreement was ar ranged wit:h local medical societies and hospital authorities.
One of the princ~pal objectives of the nurse-midwife program was to elevate the standards of public health nursing care rendered prenatal and postnatal cases. The nurse-midwife was requested rto make her visits with the staff nurses in order that she might convey to the regular nursing staff any suggestions regarding nursing activities concerned with prenatal or :postpartum care. In addi.tion, the nurse-midwife was expected to coordinate in the best manner possible the nursing activities in the maternal health centers, and to integrate the maternal and child health program of the local healrth departments with other services rendered in the community.
Fact finding, with respect to the actual caliber of the lay midwives, was the first objective in each area. An appraisal form for evaluating each midwife was developed and distributed to the nurse-midwives. Each of these nurse-midwives became a part of the local health department Staff and was subject to the direction of the commissioner of health, with supervision from the Division of Public Health Nursing and the Division of Maternal and Child Health. In her own area, each nurse-midwife took over the organized lay midwife group, arranging special group and individual instruction sessions, using talks and demonstrations in an attempt to apply the most intensive teaching possible to t:he lay midwives.
Each nurse-midwife encouraged lay midwives to call her when attending cases in labor, and she attended the case with the lay midwife whenever the call did not interfere wirth her other activities. Nurse-midwife's attendance at labor cases was for the punpose of inspection and supervision of the lay midwife, and to demonstrate proper procedures. The nurse-midwife likewise attended prenatal and infant health centers and made antepartum and pos.tparrtum home visits.
To date the projects have been discontinued in all counties, save one, for various reasons. Rabun County has established a maternity home which should obviate midwifery. The nurse-midwife assigned to Spalding
Maternal and Child Health
127
County became ill and was granted a leave of absence. The Crisp County project was discor.tinued because it 'proved impractical for many reasons. The Sumter County project was discontinued because there was evidence that its continued operation would not be productive. The Thomas County project is being continued for a brief period of time.
The results can be briefly summarized by stating that no concrete evidence exists to warrant the conclusion that lay midwives have in any way improved sufficiently to justify the cost of the service. Detail analyses are not yet available and for that reason the specific results obtained in each phase -of midwifery cannot be stated. Though it was possible to convey to lay midwives many acceptable procedures, ii was impossible to persuade them to employ them. In order to convey the types of nurse-midwife activity, and to state quanti,tatively their activities, the following statistical report is given:
NURSE-MIDWIFE ACTIVITIES
D. MATERNITY SERVICE
Total
r.i. Home visits to antepartum cases--------------------------------------------- 318 a. With midwife present________________________________________________ 60 b. With staff nurse presenL______________________________________________ 68
7. Xumber of confinements observed (whole or part) ___________________________ 180
a. Number intrapartum visits to midwife cases___________________________ 173 b. Number of above (a) with staff nurse__________________________________ 18 c. Cases in labor reported by midwife____________________________________ 62 11. Home visits to postpartum cases___________________________________________ 780
a. With midwife present----------------------------------------------- 107 b. With staff nurse present______________________________________________ 82
12 (b). Maternal centers attended (sessions)----------------------------------------- 181 13. Midwives registered for formal instruction__________________________________ 62 a. Current roster of certified midwives___________________________________ 67 b. Current roster of student or trainee midwives __________________________ _
c. Midwives resigning or dying since last certification date________________ 2 d. Probable number of midwives practicing without certification____________ 10
14. Midwife meetings ---------------------------------------------------------- 88 a. Attendance at meetings_______________________________________________ 625
16. Individual midwives receiving didactic instruction_____________________________ 799 a. In midwife homes____________________________________________________ 654 b. In office or center___________________________________________________ 233
18. Interviews, lectures, and conferences with lay individuals______________________ 233
a. Attendance ---------------------------------------------------------- 894 22. Midwife and clinic cases receiving medical consultation in homes_____________ 38
a. Antepartum cases --------------------------------------------------- 90 b. Intrapa,rtum cases --------------------------------------------------- 18 c. Postpartum cases ---------------------------------------------------- 6 23. Deliveries by physician with nurse-midwife assistance_______________________ 4
24. Midwife and clinic cases hospitalized--------------------------------------- 48 a. Antepartum cases --------------------------------------------------- 18 b. Intrapartum cases____________________________________________________ 6
c. Postpartum cases ---------------------------------------------------- 0 d. Inf,ant cases -------------------------------------------------------- 17
128
Georgia Department of Public Health
E. INFANT AND PRESCHOOL HYGIENE
(c). Child health centers attended _________ _
54
5. Home visits to neonatal cases _______ ------~-- ____________ ----~ ________ _ 649
a. With midwife present_ _____________ _
56
b. With staff nurse present_ __________ _
28
RABUN COUNTY:
Conferences with doctors _________________ _
113
Deliveries alone in ).laternity Center________ _
1
Home visits to infant cases_____________________ ------------------------ 30
NATALITY AND RELATED MORTALITY Natality and related mortality is revealed by the following tables:
LIVE BIRTHS AND BIRTH RATE PER 1,000 POPULATION, BY COLOR; TOTAL STILLBIRTHS, INFANT AND MATERNAL DEATHS; AND RATES PER 1,000 LIVE BIRTHS IN GEORGIA: 1942
White
Negro
Total
Live Births:
Number ____ ----------------------------
45,192
Rate ___________________________________________ _ 22.2
Stillbirths:
Number _______________ _____ ____________ _________ 1,268
Rate ______________ __ ________ ____________________
28.1
Maternal Deaths:
Number -------------------~~--- _______ ___________ Rate _______________ ___________________ _________
146 3.2
Infant Mortality : Number __________________ ----~-------------- ~-- 1,756
Rate ____________ ------------------------------- 38.9
26,997 24.9
1,518 56.2
I'J3 5.7
1,803 66.8
72,189 23.1
2,786 38.6
299 4.1
3,559 49.3
NUMBER AND PER CENT OF LIVE BIRTHS BY ATTENDANT, BY COLOR, IN GEORGIA: 1942
Number
Per Cent
White
Physician ----- 42,077
Midwife ------ 3,035
Other ---------
80
Negro 8,022 18,933
42
Total 50,099 21,968
122
White 93.1
6.7 0.2
Negro 29.7 70.1
0.2
Total 69.4 30.4
0.2
NUMBER AND PER CENT OF STILLBIRTHS BY ATTENDANT, BY COLOR, IN GEORGIA: 1942
Number
Per Cent
White
Physician _____ 1,188
Midwife ______ _ 76
Other ---------
4
Negro 654 855
Total 1,842
931 13
White 93.7
6.0 0.3
Negro 43.1 56.3
0.6
Total 66.1 33.4
0.5
=======~-~==============================================================
Maternal and Child Health
129
Live Births
The year's total of 72,189 live births represents an increase of about 61;2% over the number of births reported during the preceding year. The birth rate (23.1 per 1,000 population) was approximately 6.9% greater than for the year 1941. This is the second consecutive year in which an increase in the number of births occurred.
The increased birth rate is principally a result of an increase in the number of whi,te births from 41,277 in 1941 to 45,192 in 1942. The white birth rate was 22.2 for 1942 as compared with 20.1 for 1941. The total Negro birth increased very little, but 'the rate increased from 24.4 for 1941 to 24.9 in 1942. The increase in white births was more than 9%, and the increase in Negro births was 1.8% in 1942 as compared with 1941.
Stillbirths
The reduction in number, as well as in the rate of s'tillhirths is gratifying. This marks the fifth consecutive year of consistent decline in the stillbirth rate, and establishes a new low for Georgia. The 1942 rate of 38.6 is about 10% lower than for 1941 and represents a reduction of more than 32% from the 1937 rate which was 57.4.
There were 117 fewer stillbirths reported for the current year than in 1941, although the total births increased by 4-,404. The decline in the number of stillbirths in 1942 as compared with 1941 was limited almost entirely to Negroes. However, the white stillbirth rate declined from 30.9 in 1941 to 28.1 in 1942 as a result of an increase in totallive births.
Maternal Deaths
Progress has again been refleoted by the establishment of a new all-time low maternal death r.ate for the fourth consecutive year. For the second time in the history of the State fewer than five mothers died for each 1,000 live births reported. The current rate of 4.1 is lower tharn that for 1941 by more 'than 10% and represents a reduction of about 45% from the 1937 rate which was 7.4.
The number of white maternal deaths increased slightly in 1942 as compared with 1941, but the rate was maintained by virtue of an increase in the number of white live births. The decline in the maternal death rate was the result of a decline in Negro maternal deaths from 182 in 1941 to 153 in 1942, giving a corresponding decline in rate from 6.9 to 5.7.
Infant Deaths
The infant mortality rate of 49.3 represents a marked decline from the rate of 58.3 for 1941, which is a decrease of more than 15%. White and Negro infant deaths declined, thus producing a decline in the white infant mortality rate from 48.2 to 38.9, and in the Negro rate from 74.2 in 1941 to 66.8.
130
Georgia Department of Public Health
CHILD HEALTH DEMONSTRATION
The Child Health Demonstration continued along essentially the same lines previously outlined, except for the employment of a nutritionist, the addition of a second clerk, and the installation of a laboratory for study of cases with suspected dietary deficiencies.
The activities of the nutritionist will be found following the statistical report of all activities in the demonstration area. The following s~tatistical summary presents the different 'types of activities, and a numerical statement of each activity rendered by all workers concerned with nutrition and child health in the area.
CHILD HEALTH DEMONSTRATION
Hancock County
Total Number prenatal medical sessions _________ ------------------------------------------ 123 Average attendance per session------------------------------------------------------- 6
Prenatal Admissions to }lrenatal medical service:
White
5
Colored ___________ 406
Total ____________
411
Period of gestation at time of admission:
Under 16 weeks ______________________ ---------------------------------- 98 16-27 weeks -------------------------------------------------- ________ 206 28-36 weeks ----------------------------------------- ----------------- 9:; Over 36 weeks__________________________________________________________ 12
Positive serological reports:
White ___________ _
Colored ___________ 22
'Total _____________
22
Negative serological reports:
White ____________ 5
Colored ___________ 384
Total _____________
389
Total number antiluetic treatments__________________________________________________ 121
Average number treatments per prenatal syphilitic___________________________________
3
Total visits to prenatal medical conferences_________________________________________ 781
Numbe'r of toxemias _____________ ------------------------------------_______________ 17
Postpartum
Admissions for postpartum medical examination :
White ____________ 4 Colored ___________ 103
Total _____________
109
Total clinic visits fo,r postpartum examination:
White ___________ _ 4
Colored __________ 111
Total ____________
115
Nursing Activities
Number maternity classes held______________ 49 Total enrollment __ _
425
Average attendance per session ________________________________________________ _
8
Number of demonstrations ____ ----------------------~~-----~________________________ __
59
Maternal and Child Health
131
INFANT AND PRESCHOOL ACTIVITIES
Number of medical sessions held~---------------------------------------------------A\erage attendance per session_____________________________________________________ _
!\umber of admissions:
White ____________ 63 Colored __________ 419 Total _____________
Total 130 6
482
Age on admission:
Under 4 months __ _
119
4-12 months ______
102
1-5 years _________
261
Xumber of malnourished children___________________________________________________ 54 Total visits to medical conferences--------------------------------------------------- 805 Visits by defect cases--------------------------------------------------------------- 141
Immunizations
Diphtheria, under 1 year____________________________________________________ 88 over 1 year_____________________________________________________ 130 Total _____ __ __ ___ __ _____ ___ ___ ____ ____ ___ ____ ____ ___ __ _____ ____ 218
SmaHllOX immunizations __ ------------------------------------------------- 214 Typhoid __ --------------------------------------------------------------- __ 191
Demonstrations
Demonstrations in preparation of foods for infants:
1. Xumber of demonstrations held___________________________________________
41
2. Total attendance _______________ ----------------------------------------- 249
3. Average attendance per session~------------------------------------------
:!\umber children examined:
School Activities
White ____________ 499
Colored ___________ 186
Total _____________
685
Number children examined with parents present:
White ____________ 12
Colored __________ 19
Total _____________
31
Dental inspections ----------------------------------------------------------------Per cent with defects ___________________________________ -------------------------
Number receiving dental corrections_______________________________________________
X umber children examined for nutritional study------------------------------------
27
!\umber talks to school children________________ 68 (1) Health Officer_________________________ 13
(2) !\urse -------------------------------- 15 (3) Nutritionist __ ------------------------ 40
Total attendance __ Total attendance 'fntal attendance Total attendance __
3,488 378 610
2,500
HEALTH EDUCATION
Health Officer (1) Confercnees with physicians________ (2) Consultations with physicians ______
(3) 'l'alks to lay groups---------------- 19 (4) Motion pictures shown _____________ (:i) Conferences with individuals _______
Total Attendance __
Total
168 76
1,876 0
512
~l urse
(1) Conferences with lay groups ________
15
(2) Home Hygiene Classes------------ 8 Total Attendance.-
162
(3) Talks to lay groups ________________ 16 Total Attendance __
100
132
Geo,rgia Department of Public Health
SCHOOL LUNCHEON Number ch!ldren enrolled in schools:
Number ch!ldren receiving hot lunches:
PROJECTS
White __________ 2,978
'Colored _________ 10,749
T<>taL __________ _
White _________ _ 2,770
/Colored
2,525
iTotal
12,727 3,900
Number school gardens cultivated for lunch purposes_________________________________ 48 Number quarts food canned in school for lunch purposes_____________________________ 5,000
FARM SECURITY ADMINISTRATION
Number privies installed for F. S. A. families _______________________________________ _
Number gardens cultivated by F. S. A. families______________________________________ 146 Number quarts of food canned_______________________________________________________ 46,500
Number demonstrations in food preparation or food preservation_______________________ 59
Number cows
260
HOME DEMONSTRATION AGENT
Quarts of food canned_______________________________________________________________ 10,900
Number demonstrations held__________________ 115 Total attendance_
932
Number of clubs_____________________________
9 Total attendance_
609
Total numher of meetings_____________________ 108 Total attendance_
321
Number individuals starting garden projects__________________________________________ 937
Number families who have milk cows_______________________________________________ 650
FARM AGENT
Number meetings with farmers ______________ _
8 Total attendance_
Number demonstrations in gardening__________ 16 Total attendance_
Number c,onferences with farmers_____________ 5,028 Total attendance_
Number farmers cooperating in fertilizing practices___________________________________
1,615 320
5,028 675
VOCATIONAL TEACHERS
Number classes held_________________________ 1 daily Total enrollment_
31'>
Maternal and Child Health
133
SUMMARY OF ACTIVITIES OF NUTRITIONIST IN HANCOCK COUNTY
(AUGUST-DECEMBER 31, 1942)
I.
Total
D-17A-Diet Questionnaire and Mothers' Diet History Taken__ 33
D-17B-Nutritionist Field Visits__________________________ 11
D-17C-Nutritionist Office Visits_________________________ 15
D-17D-Attendance at Maternal Conferences on Special Food
Problems ------------------------------------- 36
D-20 -Enrollment in Maternity Food Classes_______________ 65
D-21 -Attendance at Maternity Food Classes_______________ 479
E-7A -Nutritionist Field Visits (Infant)__________________ 9
E-7B -Nutritionist Office Visits (lnf'ant) _________________ 21
E-19 -Enrollment in Infant and Pre-School Food Classes____ 3
E-20 -A,ttendance at Infant and Pre-School Food Classes____ 30
E-21A-Nutritionist Field Visits (Pre-School)______________ 2
E-21B-Nutritionist Office Visits (Pre-School)_____________ 2
F-9A -Visits to Lunchroom by Nutritionist_ _______________ 100
F-9B -Office Conferences on Lunchroom Program by Nu-
tritionist -------------------------------------- 18 F-lO -Public Lectures and Talks------------------------ 2 F-11 -Attendance ____________________________________ 60
II. Demonstrations: Total Number Held_____________________________________ 47 Attendance ________________________________________ 623 Average Attendance_________________________________ 12+ Number Who Refused Food Served_____________________ 24 Number Who Ate Only Part of Food___________________ 10 Number Who Ate All of Food Served___________________ 495 Number Who Said They Liked the Food Served__________ 247 Visits Made to the 16 Families Taking Part in Garden Project__ 20
,....
Cl.:l of>.
MATERNAL MORTALITY PER 1000 LIVE BIRTHS
IN GEORGIA AND U.S. REGISTRATION AREA ( 1920 -1941)
12
II
10 1"',/-\_/V"--...
10
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9 1/)
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~5
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...,..,o-
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...... 0
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o
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"'GA.
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2
DEATH RATE UNDER ONE MONTH OF AGE IN GEORGIA AND U.S. REGISTRATION AREA
(1920-1941)
100
90
80
~
Ill
~ ...,
X:i: 70
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m
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0 50
0
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0
R..
a: 40 w
Q.
.,o---o---o---o--o---o-....o.,../-o-o_--o-o_-O-o_-oo..-..._oo-_--oo/-o--o...-...-...-..oo_-o-.-..o....-._~-o-....o..o---o-o---ooU~.GS.A.
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136
Georgia Department of Public Health
0
2
0en
0
CXI
0
,.._
000 10 10 <t
0 ..,
0 "'
0
SH.LI:IIB 31111 0001 1:13d 3.L1tl:l
ILLEGITIMATE BIRTHS IN GEORGIA BY COLOR AND BY YEAR
( 1920 -1941) 1'-T-T--...
.-"'_,...,.
/---
~~-T/ T
/II -------./ T
-........._._____
,--
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T TOTAL
o==
WHITE COL .
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......
~
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,.....
CJJ 00
STILLBIRTH RATE IN GEORGIA BY YEAR
COMPARED WITH U.S. REGISTRATION AREA
(1920 -1941)
100
~
90
"'.c....
CBJ'l
___ ...Cl) 80
:z:
~70
Ill
___ __.......-..........
~60
..............,.-...___ ..----"'--..........._
..J
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'
"'.;,:.:.l,.
g 50
!2
::; 40
Q.
~--.........
~
-----------.-------------------------------------------u.s'.GA.
"ti ,!o::_:-
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1~1130 a:
20
::z::
"' :
10
Maternal and Child Health
139
PER CENT OF BIRTHS (STILLBIRTHS EXCLUDED) ATTENDED BY MIDWIFE IN GEORGIA AND U.S. REGISTRATION AREA (1929-1941)
100
90
80
Ill
.:.1..: 70
a:
iii
1&.1 60
~ ..J
LL 50
0
~ 40
1&.1
U
-
a: 30
1a&..1
20
10
o ~-...._ __.,...-....~ _ o-.,_ 0-o...._oGA. .,_ __ .,_ --------o---o U.S.
140
Georgia Departnu11t of Public Health
PER CENT OF BIRTHS(STILLBIRTHS EXCLUDED) OCCURRING IN HOSPITALS AND HOMES BY COLOR IN GEORGIA (1929-1941)
100
80
.n
~ a:
70
iii
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:::i 50
1&.
0
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~ 40 w
(.)
a: 30 wa..
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, .0 , , . - o -
------ 10 ---o---o---o--o---o---o''
______....---
--~---------------~---------
-=HOME --=HOSP.
o=WHITE =COL.
Maternal and Child Health
141
PER CENT OF BIRTHS IN GEORGIA(STILLBIRTHS EXCLUDED) OCCURRING IN HOSPITALS AND HOMES
( 1929-1941)
100
90
80
(I)
~70 a: iii 60
1.1.1
> .J 50
II..
0
.z.. 40
1.1.1
()
a: 30
1.1.1 CL
20
10
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Division of Public Health Education
During the first five months .of the year the Division functioned about as usual, except meetings attended by staff personnel were curtailed due to restricted travel.
On May 15th the Director entered 'the armed forces and the Division was placed under the supervison of the Director of the Division of Preventable Diseases. Up to this time the staff had consisted of the Director, an illustrator, a photographer and two stenographers. Then on August 31st the illustrator resigned and one of the stenographers was transferred to another division, and on October 2nd the photographer resigned. Replacements for these technically trained persons could not be found and it was necessary to greatly curtail the work in the field of public health education.
During the fint six months of the year this Division distributed 207,379 pieces of health education material. There were 94 films which were shown 1,093 times to a total audience of 204,014 people. During this same period this Division had exhibits at the following meetings:
Medical Association of Georgia meeting-Augusta, Georgia.
Georgia Conference of Social Welfare-Savannah, Georgia.
Six hundred seven photographic prints, 601 negatives and 188 slides were made by the staff photographer. Our staff artist made a total of 61 illustrations and posters.
This Division has cooperated whole-heartedly with the Woman's Auxiliary and the Medical Association of Georgia and has continued in the capacity of being advisory and acting as secretary to this organization in the capacity of keeping a strict acoount of the films shown and attendance at meetings promoted hy them.
We are indeed appreciative of the cooperation which this organization has given us and we take this opportunity to eongratulate them upon the fine and extensive health educa.tion program which they have promoted. Arrangements have been made whereby this program will be continued during the next twelve months.
We are also grateful for the fine eooperation of the Georgia Congress of Parents and Teachers who have for years been foremost in the field of health educati.on. Emphasis on Nutrition has been greatly increased due to the efforts of both of the above organizations and to the splendid work of our Nutritionist.
During the last six months of the year the work of this Division consisted chiefly of the mailing out of pamphlets on public health subjects, answering by letter requests for information we do not have published for distribution.
For the entire year the Division distributed 335,145 pieces of literature and sent out 456 films, which were shown a total of 1,339 times to an audience of 248,662. The Division will have to carry on its work through
Public Health Education
143
the mailing of literature and the booking of films for groups who have their own projectors until more personnel is available and traveling conditions are better_
BULLETINS, PAMPHLETS AND OTHER LITERATURE
DISTRIBUTED
January ------~--------------------------------- 22,711 February --------------------------------------- 29,670 March ------------------------------------------ 53,258 April ------------------------------------------- 46,825 May -------------------------------------------- 27,277 June ------------------------------------------- 27,638 July -------------------------------------------- 21,441 August _____ __ ________ __________ ________________ 12,447
September -------------------------------------- 23,456 October ----------------------------------------- 24,754 November --------------------------------------- 18,247 December --------------------------------------- 27,391
VISUAL EDUCATION
Number Different Total Number
Month
Films Shown
January __________________ _
48
February ______________________ _ 49
March ------------------------- 50
April -------------------------- 57 May __________________________ _ 47
June --------------------------- 32 July __________________________ _ 22 Augu~ ________________________ _ 14
September _____________________ _ 26 October _______________________ _ 40 November _____________________ _ 43 December _____________________ _ 28
Times Shown Attendance
190
39,923
317
62,823
217
45,122
213
39,913
111
12,565
45
3,668
31
1,761
15
525
31
5,734
60
20,374
72
12,631
37
3,623
Total _________________ 456
1,339
248,662
LIBRARY
The Library of the Georgia Department of Public Health, set up in the State Office Building in 1940, functioned with a fair degree of success during 1942. The Staff Library Committee, reduced to two members by losses to the war effort, made several important rulings with regard to the requisitioning of books and journals, and to the administering of the divisional and regional collections. The Work Projects Administration of
144
Georgia Department of Public Health
Georgia continued to furnish help-one assistant all the year, and one for 'about six months.
The general collection was increased by about 147 new hooks and 878 pamphlets, the accession number rising from 5,200 to 6,225. In addition to these, the library has had the use of 53 books loaned for the duration of the war or longer by Dr. A. W. Hill when he left to enter the service. At his request, these are being used just as if they were regular library books. A new branch collection was catalogued and prepared for the Training Center of the Division of Public Health Nursing, beginning with 33 h1 ooks. Also, a number of books and pamphlets were added to the previously organized branch collections, many of !!hem going to the industrial Hygiene Service. To 'the 73 journals on the 1941 list have been added 25 new tides, among them the bi-weekly Proceedings of the Staff Meetings of the Mayo Clinic and the weekly Current List of Medical Literature from the Library of the Surgeon General of the United States Army. The latter carries with it the privilege of procuring microfilm reprints from the Medicofilm Service connected with this library. Books and journals for the year, including binding, have cost about $1,143.00, and library supplies, furnishings, et cetera, have cost about $272.00. The cataloging is considerably behind, but the duplicate cards for the regional offices have 1heen typed up to the point decided upon. As soon as the references and eross references, and the checking are completed, these duplicate catalogs can he set up.
Loans for the year add up to 2,648 or more, and reference calls numbering 1,988 have been recorded-an average of about 220 per month for the former, and 165 for the latter. This does not include all the use of material in branch collections, and some of the most frequent users of the library went into the service during the year. In addition to official public health workers, 'there have been a number of other users of the collectionpublic welfare workers, doctors, students, teachers, officials in the United States armed forces, and others. The Fernhank Forest Association, upon request, was loaned a considerable number of books and pamphlets, and was furnished with several bibliographies, for use in an exhibit put on by the Association during National Book Week in November.
Division of Preventable Diseases
C. D. Bowdoin, M.D., Director and Epidemiologist
John M. Walton, M.D. ____ ~ _________________ Venereal Disease Control
William J. Mu11phy, M.D. ____________________________ Cancer Control
Lester M. Petrie, M.D. ________________________ ____ Industrial Hygiene David M. Wolfe, M.D. ______________________ Assistant Epidemiologist
Roy J. Boston, Engineer_ _______________________ Typhus Fever Control
CANCER CONTROL SERVICE
The Georgia Cancer Control Program functioned without interruption throughout the year. Problems were encountered as the result of war activities, but the Program was not seriously affected and it was possible to provide diagnostic and treatment service for all eligible patients who applied for state-aid. No major changes in policy were made during the year.
PERSONNEL~CANCER CONTROL SERVICE
At the beginning of the year the personnel of the Cancer Control Service consisted of a director and two clerks. These three individuals served continuously throughout the year. On October 1, 1942, a new clerk was added to the staff for the purpose of assisting with the tabulation of data provided by the clinic records.
TREATMENT CENTERS
The twelve treatment centers which are cooperating in the Program gave uninterrupted service throughout the year. No additional clinics met the requirements for recognition.
A considerahle number of the physicians on the staffs of the clinics entered the armed services during the year. For the most part, however, it has been possible for the Clinic Directors to secure adequate replacements.
One clinic director, Dr. R. C. Pendergrass, of Americus, entered the armed services. He was succeeded by Dr. A. C. Primrose, who has been associated with the Americus Clinic since it was organized.
ACTIVITIES
Applications. Alpplications for state-aid totaled 2,249 in 194.2 as compared with 2,229 in 1941. Though the number of applicants in 1942 increased slightly over the preceding year~ the net increase was the smallest noted in any year since the Program was begun. Moreover, during the last six months of 1942 the number of applications received showed a decrease over the corresponding period for 1941. This was most pronounced during the last three months of the year when only 474 applications were received as compared with 544 for the final quarter of 1941.
The causes associated with the reduction in the number of applicants for state-aid during the la,st half of the year are not wholly clear, but two
146
Georgia Department of Public Health
factors are undoubtedly responsible in part: (1) Increase m the annual income of many families; (2) Transportation difficulties.
Comparison of the number of applications received in 1942 from each of the twelve clinic areas with the number received from the same area in 1941, shows considerable variation in the findings in different parts of the State. In some areas the number of applicants in 1942 increased markedly over the previous year while in other areas decreases occurred. This is shown in Table I. In the same table is shown the number of applications received per 10,000 population from each clinic area. These rates vary greatly in different parts of the State.
Of the 2,249 applica.tions received during the year all but four were approved. The number of applications disa'pproved has been negligible since July, 1941, when the regulation dealing with patients over 75 years of age was rescinded.
Clinic Activities. During 1942 a total of 2,002 patients reported to the clinics for the first time. Of this number, 1,199 were diagnosed as having malignant disease, 789 were diagnosed as having non-malignant disease and in 14 cases the diagnosis was deferred.
The number of patients reporting to the clinics for the first time in 1942 was slightly less than the number (2,010) reporting in 1941. The total number of cases receiving diagnostic and treatment service in 1942, however, showed a substantial increase over the number receiving such service during the previous year.
Each year since the Control Program was inaugurated there has occurred a gradual but steady increase in the number of cases classed as non-malignant. The increase is noted not only with respect to the number of patients reporting but also in the proportion of non-malignant to malignant cases. The significance of this trend is not wholly clear, but it is consistent with the assumption that physicians are trying to refer cases earlier in the course of the disease.
In Table II is shown a summary of the activities in 1942 as compared with those <Of the two previous years.
Financial Aid. A total of 2,226 patients received financial aid during the year. Of this number, 1,641 had malignant disease, while 585 had benign lesions. In addition, 218 patients with benign lesions received diagnostic service during the year without charge to the State. The sum of $91,181.37 was expended for diagnosis and treatment.
A comparison of costs in relation to the number of patients served shows that the average cost per case increased in 1942 over the preceding year. This was true for both malignant and benign cases.
With respect to malignant cases, the acverage cost per case showed a very moderate increase. Such slight fluctuation might reasonably be ex pected to occur from year to year and may represent only a chance variation. On the other hand, certain factors might well have had a bearing on the increased cost. In many areas the problem <Of obtaining
Preventable Diseases
147
lodging outside the hospital for ambulatory cases became increasingly difficult. As a result, it was necessary to hospitalize some ambulatory patients who otherwise would have been placed in boarding houses. Fu:rthermore, transportation difficulties made it necessary to keep an occasional patient in the hospital a. day or two after the original date of discharge. That such factors may have contributed to the increased cost is indicated by the fact that the increase occurred during the last half of the year.
With respect to non-malignant cases, the increased cost is quite substantial and is probably related to fa.ctors other than those mentioned in connection with the malignant group. Expenditures on behalf of patients with benign lesions are related wholly to costs incurred in es,tablishing a diagnosis and, since no change has been made either with respect to charges allowed for diagnostic procedures or with respect to policy. it does not appear likely that the rise in cost is attributable to increased charges on the part of the clinics for similar types of patients. On the contrary, it seems more probable that a change has occurred with respect to the type of patient reporting for diagnosis.
Examination of expenditures on a semi-annual basis shows that average diagnostic costs have been rising for some time:
Number Patients First 6 months 1940 ___________________ 129 Last 6 months 1940 ___________________ 231
First 6 months 1941___________________ 246 Last 6 months 1941 ____________________ 260
First 6 months 1942___________________ 317 Last 6 months 1942 ___________________ 268
Average Cost 31.47 24.39
21.49 27.32
28.85 32.77
Since the cost of establishing a diagnosis is much greater when dealing with certain groups of patients (e. g., patients with symptoms referable to the gastro-intestinal tract) than when dealing with others (e. g., patients with superficial lesions) any relative increase in the former group or decrease in the latter would result in a rise in the average cost for the group as a whole. Such change might be brought about on the one hand through an increasing number of referrals by physicians of patients with obscure symptons and, on the other, through some factor (e. g., transportation difficulties) tending to prevent many of those with more trivia.! lesions from reaching the clinics.
In Table III is shown a tabulation of expenditures in relation to each clinic. As pointed out in previous reports, any fair comparison of costs must take into consideration the type of case treated. A few difficult cases in any one clinic may materially raise the average cost for the group as a whole. One most unusual case at the Sheffield Clinic, for example, was responsible for a material increase in the average cost for the total group of malignant cases.
148
Georgia Department of Public Health
TABULATION OF DATA
The task of transferring to punch cards information contained on the clinic records got under way during the year. Beginning with the records of patients reporting at the start of the Control Program, the data is being summarized and placed on punoh cards. Up to the present time slightly more than 4,000 records have been completed.
In the following table is grouped the first 4,000 patients to be a'pproved for state-aid:
Malignant eases ----------------------------------- 2,392 Borderline and Precancerous cases___________________ _ 62 Non-malignant cases _______________________________ _ 1,206 Diagnosis not completed___________________________ _ 32 Failed to report_ _________________________________ _ 308
In Table IV is shown a breakdown of the 2,454 malignant and borderline cases according to site. In Table V is shown a similar breakdown with reference to the non-malignant cases.
EDUCATIONAL MEASURES
In the Georgia Cancer Control Program, educational activities are carried on by a large number of agencies and individuals. Included in this group are the State Cancer Commission, Women's Field Army, Cancer Control Service and the Department of Education of the Georgia Department of Public Health, Regional Medical Directors, Healbh Officers, nurses and interested laymen.
Listed below are the activities of the Cancer Control Service of the Department of Public Health.
Addresses made ----------------------------------- 13 Films shown -------------------------------------- 2 Meetings attended other than those addressed__________ _ 10 Articles written ----------------------------------- 4 Literature distributed ____ -------------------------- 3,469
Preventable Diseases
149
TABLE I
APPLICATIONS RECEIVED FROM CLINIC AREAS IN RELATION TO PoPULATION SERVED
Clinic
Population Served
Macon ____________________ _
Augusta -------------------LaGrange -----------------Thomasville Savannah Waycross Americus __________________ _
Sheffield and Winship_______ _
Canton --------------------Dalton __ ------------------Columbus -------------------
355,000 230,000 150,000 275,000 220,000 205,000 210,000 585,000 100,000 165,000 145,000
Applications 1941
Applications Applications Per 10,000
1942 Population, 1942
414
443
12.5
280
274
11.9
115
168
11.0
270
297
10.8
110
196
8.9
219
183
8.9
177
146
6.9
427
363
6.2
48
47
4.7
99
75
4.5
70
57
3.9
State ----------------------- 2,640,000
2,229
2,249
8.5
Fulton and Richmond Counties not included.
TABLE II SuMMARY oF AcTIVITIEs
Applications
Total received Number approved ________________________ Number disapproved _____________________ Counties represented ____________________ _
1940
1909 1826
83 154
Case Reports From Clinics
Classed as malignant--------------------Classed as non-malignant_ _______________ Deferred diagnosis _______________________
1069 560
33
Cases Given Financial Aid
Total cases ----------------------------Malignant ______ ------------------------Non-malignant --------------------------
1616 1256
360
Amount of Financial Aid Given
Total amount given ______________________ $65,893.76
Average amount per malignant case (in-
cluding only those cases for which a charge was made) ______________________
Average amount per non-malignant case (in-
44.75
. eluding only 'those for which a charge was
made) -------------------------------Number of cases for which no charge was
26.93
made:
Non-malignant --------------------------
206
Malignant _______________________________ _
84
Not available as yet.
1941 2229 2162
67 151
1272 703 35
2057 1551 506
$78,826.14
42.83
24.49
232 48
1942 2249 2245
4 155
1199 789 14
2226 1641 585
$91,181.37
44.64
30.65
218
.......
<:.J1
TABLE III
0
SuMMARY OF PEOPLE oN WHoM BILLs WERE PAm FOR DIAGNOSIS AND TREATMENT IN CANCER CLINics WITH CosT FOR CALENDAR YEAR-1942
Clinics
Americus ____________
Augusta-----------Canton ______________ Columbus ____________ Dalton ______________ LaGrange ___________ Macon _______________ Savannah ____________
Sheffield ----------- Thomasville __________ Waycross ____________ Winship _____________
Total ________________
Malignant
No. Cases
106 215 51 55
54 103 333
75 209 213 104 123
1.641
Amount
$ 6,538.4 7 10,156.10 1,724.29 2,1401.94 1,791.87 4,466.39 14,030.20 2,7011.00 11,968.07 9,005.75 3,360.76 5,314.15
$73,2012.99
Average Cost
$61.68 47.24 33.81 39.02 33.18 43.36 42.13 36.68 57.26 42.28 32.31 43.20
$44.64
Non-Malignant
No.
Cases
Amount
:15
1,779.68
10;)
4,361.00
7
156.75
4
54.50
u
78.00
48
1,360.45
128
3,704.11
45
1,203.00
65
2,578. 76
60
1,674.63
28
346.00
31
631.GO
585
$17,928.38
Averag1 Cost
32.36 41.:J:l 22.39 13.62 8.67 28.34 28.94 26.73 39.67 27.91 12.36 20.37
$30.65
Malignant and Non-Malignant
No.
Average
Cases
Amount
Cost
161 320
58 59 63 151 461 120 274 273 132 154
2,226
$ 8,318.15 14,:)17.10
1,881.04 2,200.44 1,869.87 5,826.84 17,734.31 3,954.00 14,546.83 10,680.38 3,706. 76 5,945.65
$91,181.37
$51.66 45.36 32.43 37.29 29.68 38.59 38.47 32.95 53.09 39.12 28.08 38.61
$40.96
The above summary includes only patients on whom bills were paid. In addition, 218 non-malignant cases received diagnostic service without charge. The corresvonding figure for malignant cases is not available.
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Preventable Diseases
151
TABLE IV
SITE OF LESION IN 2,454 MALIGNANT AND BORDERLINE CASES
AccoRDING TO SEx AND CoLOR
White Males
Buccal Cavity ~- ------------------------ 173 Digestive Tract ------------------------- 27 Respiratory Tract ---------------------- 8 Uterus -------------------------------Other Female Genitals________ ----------Breast --------------------------------- 2 Male Genitals -------------------------- 24 Urinary Organs ------------------------Skin ----------------------------------- 670 Brain --------------------------------Bones --------------------------------All Other ------------------- ----------- 55
Total _______________________ 980
White Females
35 21
7 261
19 156
461 I 6
23
995
Colored Colored Males Females
11
19
13
8
2
193
14
0
109
14
8
10
14
1
4
15
22
91
388
Total
228 80 25 454 33 267 38 29 1,155
8 22 115
2,454
TABLE V
SITE oF LEsiON IN 1,206 NoN-MALIGNANT CAsEs
AccoRDING TO SEx AND CoLOR
White Males
Buccal Cavity _____________ ____________ 30 Digestive Tract___________________________ 58 Respiratory Tract ----------------------Genital Organs ------------------------- 13 Breast --------------------------------- 4 Urinary Organs ------------------------ 6 Skin ----------------------------------- 61 Bones --------------------------------- 12 All Other ------------------------------ 31
TotaL ______________________ 223
White Females
23 52
362 125
14 73 5 28
689
Colored Males
Colored Females
7
12
10
22
2
17
116
2
30
3
0
13
8
10
15
20
69
225
Total
72 142
19 508 161
23 152 35 94
1,206
152
Geo,rgia Department of Public Health
TABLE VI
SuMMARY oF PEoPLE ON WHoM BILLS WERE PAID FOR DIAGNOSis AND TREATMENT IN CANCER CLINics WITH CosT FOR CALENDAR YEAR-1942
Counties
c
c"'
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Appling
10
11
Atkinson
7
1
8
Bacon -----
9
Baker
2 11 10
Baldwin --- 11
Banks ----- 10
Barrow
7
8 19
3 13
2
9
Bartow ----
7
9
Ben Hill ---
5
6
Berrien ----
8
2 10
Bibb ------- 71 21
92
Bleckley --- 13
15
Brantley ---
8
11
Brooks _____ 11
12
Bryan -----
Bulloch ---Burke ----- 21 Butts ------
Calhoun --Camden ____
28 2 10 2
2
Candler ____
3
5
Ca~roll _____
19
28
Catoosa ---Charlton ___
Chatham --- 46 27 73
Chatt'chee Chattooga -- 12 Cherokee ___ 17
2 14 1 18
Clarke -----
8
1
9
Clay ------- 3
3
Clayton ----
4
6
Clinch -----
4
Cobb ------ 25
Coffee ----- 12 Colquitt ____ 41
2 27 15
8 49
Columbia -- 11
20
Cook -------
Cowet'a ---- 21
21
Crawford --
5
2
7
Crisp ------
13
t:
0 (,)
330.00 178.50 162.35 718.34 926.26 555.50 622.80 610.67 444.70 262.31 4,714.90 484.30 152.62 356.28 143.55
15.00 1,532.86
326.05 527.00
25.50 168.85 1,735.22
2,138.26
593.25 774.25 548.90 40.00 458.60 184.20 1,373.61 516.14 1,495.40 1,190.50 271.63 1,094.70 223.35 421.27
Counties
~ c
"c '
~ c
"c ' -"-.'"",' :"!i'i(",')
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Dade ------
4
Dawson
Decatur --- 12
12
DeKalb ---- 41
8 49
Dodge ----- 16
4
20
Dooly ------
9
3
12
Dougherty __ 12
18
Douglas ____
7
16
Early ------ 21 11
32
Echols -----
4
1
Effingham -
5
3
8
Elbert -----
6
2
8
Emanuel
25 26 51
Evans -----
3
2
5
Fannin ---- 15
3 18
Fayette ---- 12
6
18
Floyd ----- 10
10
Forsyth ----
4
4
Franklin ---
6
Fulton _____
Gilmer _____
4
6
Glascock ---
3
3
Glynn ----- 10
13
Gordon _____
6
Grady -----
2 10
Greene ---- 15 10
25
Gwinnett --- 23
6 29
Habersham Hall ------- 13 Hancock --- 12
5 13 13 13
Haralson ---
Harris -----
8
Hart _______
7
2 10
Heard -----
8 11
19
Henry ______ 12
4 16
Houston --- 11
17
Irwin ------
2
Jackson ----
2
4
10
Jasper -----
3
6
9
Jeff Davis __
t:
0 ':J
131.75 3.50
569.67 1,746.25
689.42 617.57 1,131.55 817.56 1,096.26 53.00 184.20 400.05 1,943.80 170.00 656.74 535.52 496.50 215.19 103.50
82.00 72.30 671.82 153.25 548.27 2,149.18 1,080.00 377.50 577.22 706.25 187.75 292.28 521.85 382.83 777.75 934.35 113.60 319.50 269.55 336.67
Preventable Diseases
153
Counties
c.
.~
c:
c:
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~~
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zo
C> .. 1-0
Jefferson -- 22
8
30
Jenkins ---- 18
24
Johnson ---
7
2
9
Jones ------
3
8
Lamar -- -- 10
6
16
Lanier -----
6
6
Laurens --- 41 11
52
Lee --------
3
5
8
Liberty ----
4
Lincoln ---- 16 10
26
Long ------
1
Lowndes
28
35
Lumpkin ---
1
McDuffie -- 17
4 21
lllclnt-osh --
l\lacon -----
6
l\Iadison --- 10
2
8
2 12
:Marion -- ~-
6
7
Meriwether - 23 16
39
Miller ----- 14
3
17
Mitchell
13
18
Monroe ---- 10
15
Montgomery_ 19
6 25
Morgan ----
3
6
9
1\lurray ----
Muscogee ___ 32
33
Newton ----
6
8
Oconee -- ---
3
4
Oglethorpe -
2
Paulding --
6
1
Peach -----
8 10
18
Pickens ----
3
Pierce -----
10
3 13
Pike -------
7
5 12
Polk ------- 16
6
22
Pulaski ----
6
3
9
Putnam ----
6 11
Quitman ---
Rabun
5
2
Randolph
Richmond -
-:;;
C> 0
1,122.25 1,262.50
359.29 37 4.20 586.33 165.;)5 1,190.75 354.13 330.50 1,025.25
10.00 1,678.75
45.50 548.38
391.15 480.70 221.50 1,881.81 506.00 1,059.09 575.80 662.64 247.7o 106.50 1,431.52 432.00 221.50 268.07 132.62 423.18
73.50 280.00 325.77 1,253.25 286.62 476.68
6.50 295.00 516.32
c.
Counties
.~
c:
. .c:
-"-"'""''
:lEO
c: .':!!
. .Oi
:z".;,;'o:"..,',
-.."..'
~C>"'. . 1-0
-:;;
C>
0
Rockdale --
2
Schley
6
Screven ---- 13 14
Seminole
5
1
Spalding --- 11
Stephens
10
Stewart ----
1
Sumter __ -- 17 17
Talbot
4
Taliaferro --
6
Tattnall ----
9
2
Taylor
5
Telfair
11
Terrell
6
4
Thomas
19
8
Tift -- ----- 14
Toombs ----
26
Towns -----
1
1
Treutlen --- 12
2
Tvoup
33 12
Turner
11
2
Twiggs
Union
2
Upson
15
Walker _____ 15
4
Walton ----
3
Ware ------ 12
6
'Varren ----
7
Washington _
\Vayne --. -- 11
Webster ----
Wheeler ---
White ------
3
Whitfield -- 16
3
Wilcox --
8
2
Wilkes -- --
8
Wilkinson -- 12
Worth
19 11
2
36.50
186.11
27 1,236.40
6
167.08
16
689.70
12
4:17.75
1
10.00
34 1,707.94
4
200.27
6
278.18
11
586.64
6
405.91
16
694.87
10
44 7.65
27
744.26
21
660.78
31 1,097.32
2
111.25
14
364.27
45 1,906.20
13
721.60
10
167.00
2
128.00
18
420.52
19
270.15
208.00
18
668.71
12
453.90
14 1,105.45
11
402.00
411.02
7
243.55
3
80.00
19
835.80
10
404.65
8
466.00
15
584.96
30 1,598.56
-----
Total --- 1,641 585 2,226 $91,181.37
154
Georgia Department of Public Health
PERSONNEL
EPIDEMIOLOGIC SERVICE
The personnel of this Service consists of the Director of the Division of Preventable Diseases, who is also State Epidemiologist, and one stenographer. Valuable assistance has been rendered by staff members of the Division of Preventable Diseases in making special investigations connected with unusual outbreaks of disease. Regional medical directors and nurses as well as county public health nurses in non-health officer counties have also assisted in making epidemiologic field visits and investigations.
OFFICE PROCEDURES
Regular routine office procedures have been carried out in which this Service collaborated with the Regional Medical Directors and Health Officers by accumulating and disseminating morbidity reports to these officials weekly and monthly as well as daily whenever necessary to expedite investigation and control of communicable diseases. Information pertaining to the names of physicians and their locations in the State has been given to public health workers regularly in order to effect a more accurate accounting of reports, correspondence, and finances. Inasmuch as the State Epidemiologist is a:lso Director of the Division of Preventable Diseases, much of his time has been spent in directing not only the activities for this Service but for the following Services: Industrial Hygiene, Venereal Disease Control, Typhus Contml and Cancer Control. In addition to this he was appointed acting director for the Divisions of Health Education and Malaria and Hookworm during the absence of their directors who are in armed forces.
SPECIAL INVESTIGATIONS
Typhoid and Dysentery-On January 22 this Service was notified of an outbreak of typhoid fever and bacillary dysentery at the Flint River Cotton Mill Village, Albany, Georgia. The following day a preliminary investigation was conducted in this mill village and vicinity by a member of our medical staff and one engineer, in cooperation with the Dougherty County Health Department as well as officials of the mill. At this time the seriousness of the outbreak was not fully demomtrated, but on February 4 a call meeting of the Dougherty County Board of Health with State Health Department representatives was held, at which time it was agreed that the most probable route of the infection wa.s polluted water from the Flint River Cotton Mill wells. Arrangements were made for closing this water supply and substituting safe water from the City of Albany and for a more complete investigation by the State Health Department.
By February 9 the outbreak had reached such proportions that it seemed advisable that the State Heaith Department take complete charge of the work connected with clearing up the epidemic as well as the nursing program connected with it. This proposal submitted to the Dougherty County Boar.d of Health on February 10 received their unanimous approval.
The assistance rendered in personnel by the State Health Department
Preventable Diseases
I 55
consisted of 4 physicians, 7 nurses, 2 engineers, I bacteriologist, and I technician. The mill furnished 2 graduate nurses and 5 practical nurses. Expenses of hospitalization, medical and nursing care, field headquarters, telephone, supplies, and equipment were horne by the mill. The services of the local WPA Housekeeping Project were secured. They supplied 7 housekeepers and a supervisor.
Epidemiological investigations were made and specimens for culture were obtained from every known case of typhoid fever or dysentery and from every known suspect. The final report of the investigations and studies revealed that a total of 8I cases of tyrphoid fever occurred, 2 having died. Twelve of these cases were without symptoms of typhoid. In addition to the typhoid fever, there were 79 cases of bacillary dysentery, 4 of these cases having a double infection with both typhoid and bacillary dysentery. Two individuals died from diarrhea of undetermined etiology. All epi demiological evidence indicated that this was a water-borne outbreak. Drinking water from the Flint River Cotton Mill wells was common to all but one of the victims whose source of water was a nearby private well, drawing water from the same underground source. A more detailed report of this investigation is being prepared for publication.
Typhus Fever-A request was made to the Division of Preventable Diseases for an investigation of the I7 cases of typhus fever which had been reported for the City of Brunswick and Glynn County for the period of January I through November I4. Two of these cases were reported in February, I in May, II in August, 3 in September, and none in October and November. Of the I7 cases reported, I3 were investigated and complete epidemiological cards made. Of the 4 not contacted, 2 had moved from Brunswick, l could not be located in the county and the fourth case was appa-rently out of town, as repeated visits to his home failed to get any response. All of the I7 cases reported were white and 10 were male and 7 female.
The I3 cases investigated were widely scattered over the town, only 2 of them living in the same neighborhood, l of which occurred in February and the other in October. Therefore, it was concluded that the place of infection was at the place of employment, since all cases pointed back to the business district of the town, especially the food stores and restaurants which gave a definite history of rat infestation, and the employees stated they had had insect bites but could not state definitely whether they were from fleas or mosquitoes.
The staff member making the investigation reported that he found a serious situation with all of the eating establishments over-taxed by the unusually large influx of population brought on as a result of a ship-building project and other governmental construction going- on in and around Brunswick and that it was possible for a serious outbreak of typhus to develop in this locality. He recommended that the business district of Brunswick be rat-proofed and that after this was done a campaign for destruction of existing rats be carried out.
156
Georgia Department of Public Health
Gastro-Intestinal Episodes-
!) A food poisoning outbreak occurred in the FFA Camp near Covington during the latter part of January and early part of February, involving 20 cases, 10 or 12 of which were hospitalized. The principal symptoms were nausea and vomiting which lasted about 24 hours. An investigation was made by a member of our staff and one of our sanitary engineers, who reported that circumstantial evidence suggested that this was a milk-borne outbreak connected with the same dairy which was reported to be the source of a simila-r outbreak in Covington during 1941.
2) An epidemiologic report of a milk-borne outbreak, diagnosed as gastroenteritis, was received from the medical director of the Northwestern Health Region, which occurred in March at the Haralson County jail where each of 15 prisoners became sick. The same day the wife of the sheriff and the negro cook suffered similar attacks. The following day two visitors who had lunch at the jail were also subject to similar vomiting and diarrhea. All illnesses terminated within a few hours. E'pidemiological investigation showed that the only common article of food ingested by the prisoners and others was milk, produced in the home. The Assistant Engineer on Milk Sanitation made a study of the two cows owned by the sheriff and reported that labomtory results indicated that 1the food 1poisoning cases were probably caused by toxin resulting in the milk caused by the presence of staphylococcus aureus organisms in one of the cow's udders.
3) On June 2 a citizen of Blue Ridge, Georgia, reported to the publi::: health nurse of Fannin County that her family, consisting of 6 members, two other families, consisting of 8 members, and one other from the hotel had all taken sick about ll :00 P. M., June l, with vomiting, diarrhea and cramps. When the nurse made an investigation the following evening she found them all up, feeling better, vomiting had ceased about 4:00 A. M., but all were still nauseated. Diarrhea had been checked but they were not entirely comfor.table. None had temperature above normal, but all showed signs of shock.
'Ilhe only common article of food used by all in their respective homes was buttermilk and cornbread, which was taken about 6:00 or 7:00 o'clock P. M. on June l. All had obtained milk from the same source that day, but the cornbread had been prep;ued in each individual home.
On June 15, the Regional Medical Director noted the report of this outbreak and in company with the public health engineer made further investigation. The producer of the buttermilk reported that he and his family of 4 as well as another family of 4 drank some of the same milk with no bad results. It was reported that each of the families who became sick and another family who drank milk from the same source but did not become ill used water from the same unprotected spring. The producer of the milk also used water from his spring also unprotected.
After approximately 15 days after the outbreak it was impossible to point out the definite source of the outbreak, but the character of the sickness was of the type produced by toxins such as are commonly formed in
Preventable Diseases
157
milk infected wi.th staphylococcus aureus, under favorable conditions for culture.
4) On July 7 an investigation was made by one of the staff members of the Division .of Preventable Diseases of a G. I. upset among the students at North Georgia College, Dahlonega, Georgia. Most of the cases who had been sick during the so-called epidemic were contacted as well as the college physician, and the history obtained from him was that of a typical case of food poisoning. The physician was called during the early morning hours about 2:00 A. M. and found some 20 boys acutely ill-nausea, vomiting and diarrhea. Some few of the boys had violent cramp-like pains in abdomen. They were all 'considerably better the next day and the following day all were back in class except one boy. None of the girls reported ill at "sick call" but one gave a history of having been slightly upset during the night.
The dietician reported that they had cold supper Sunday night, consisting of cold sliced ham, pineapple and potato salad. The boys and girls both ate the same food, but the boys ate considerably more than the girls. No new help had been recently employed in the kitchen and n.o history could be gotten of any of the kitchen help having suffered with this trouble. The boys who had been ill had eaten ice cream both from canteen and local Soda Company, but nearly everyone had had different kinds from different places and some had not eaten any. The public health physician who made the investigation reported that his impression of the outbreak was one of food poisoning.
5) An outbreak of an intes,tinal trouble developed in the Darlington School, Rome, from December 8-12 with a case rate of 85 of the 144 (41.3% of total) boarding students and 13 of the 62 (6.3% of total) day students. From detailed history records of cases, previously obtained by the president of the school and information obtained from the dietician and nurse, it was concluded that it was difficult to determine just what was the cause of this trouble. The fact that an investigation was not made until the trouble cleared up afld that stool cultures on all food handlers from ki,tchen and dairy were not obtained made it more difficult to give a definite opinion as to the source of outbreak. However, from the laboratory and engineer reports and from the 1past experience of this .office with staphylococci in milk, it was the opinion of the epidemiologis,t that milk was the etiological factor in this outbreak.
6) Two gastro-intestinal outbreaks occurred following dinners served on November 20 and December 20, 1942, at the same hotel in Dalton, Georgia. The last outbreak was investigated by a staff member of this Division, accompanied by the county health officer and public health engineer. Ninety-eight of the personnel of the American Thread Mill attended the last dinner and practically everyone had some upset, varying from slight pains in the abdomen to severe griping pains with profuse diarrhea at the end of 3 days. Menus for both dinners were obtained. However, from checking the menu with each patient, it was impossible to point out any one food as a causative agent, as nearly everyone ate the foods you
158
Georgia Department of Public Health
would most likely suspect. The milk and cream served came from a dairy that has constantly run a very high bacteria count. On both occasions an extra cook and 4 extra waiters were employed, none of which had been examined for fnod handler's cer.tificates, but regular employees had. Arrangements were made to have stool specimens sent in on all kitchen help as well as extra help employed, but one extra cook was not located at the time of investigation. It was concluded that this was a food poisoning outbreak with no definite known origin.
Paratyphoid Fever-On December 20th a trip was made to Elberton, Georgia, by a member of our staff to investigate 2 proven cases of paratyphoid fever and 2 suspected cases that had occurred during the last two months. After getting a history of these cases, it was decided that the one common factor seemed to be milk. It was, therefore, concluded that this was milk-borne paratyphoid.
Septic Sore Throat-In response to a telephone call on May 4 from the Superintendent of the State Tuberculosis Sanatorium at Alto, an investigation was made of a very decided increase in the prevalence of sore throat noted among patients and employees of the institution. Studies of the outbreak were begun on May 5. Participating in the investigation were one medical s'taff member, director of laboratories, and assistant engineer, milk sanitation, Sta.te Department of Public Health, and the veterinarian from the City of Atlanta.
For several weeks prior to the date of investigation, sporadic cases of sore throat had been noted among nurses and employees of the institution. During the period of March 27 to April 26, a total of 14 cases of sore throat were known to have occurred. During the four-day period of April 27-30, there occurred a small outbreak of respiratory diseases among the white patients on the third floor annex. Seventeen cases occurred on this floor among a total of 101 patients. During this same four-day period five sporadic cases, apparently unrelated to the outbreak on the third floor, occurred in various parts of the institution among patients and employees. From Sunday evening, May 3, to Monday evening, May 4, a total of 101 cases of sore throat developed. During the entire period covered by the survey, a total of 157 cases of sore throat developed in persons associated with the institution. After May 4, the outbreak rapidly subsided and there were no new cases after May 7.
Epidemiologic investigation revealed that the distribution of oases was associated with the source of the food supply rather than type of employment. Considering the evidence at hand, it was found that the most likely food responsible for the outbreak appeared to be milk. The main arguments in favor of this conclusion are: 1) Large-scale outbreaks of septic sore throat are practically always associated with milk supplies; 2) In connection with this outbreak, opportunities for contamination of the milk supply were 'present; 3) Evidence tending to incriminate the milk supply lacked some of the details needed for a clear explanation of how contamination and subsequent distribution were brought about, the findings in general are consistent with respect to this assumption.
Preventable Diseases
159
FIELD VISITS
The following table gives a summary -of consultations with physicians, admissions to medical service and field visits by public health nurses, regional medical directors and staff members of the Division of Preventable Diseases in non-health officer counties for !!he years 1941 and 1942. This table is self-explanatory and will show the comparison of these activities for the two years. However, the number of admissions ~to medical service for each year is not comparable with the number of field visits, in that these numbers include persons admitted for medical service in connection with malaria and hookworm, which is res1ponsible in all probability for the large number for each year. Inasmuch as the number of admissions on reports from regional medical directors and nurses were not broken down according to diseases, but included all cc:-ses admitted in connection with preventable diseases, it is impossible to state the actual number of persons admitted for medical service for the diseases tabulated below.
TABLE I
SuMMARY OF AcTIVITIEs IN THE CoNTROL oF PREVENTABLE DisEASEs IN NoN-HEALTH OFFICER CouNTIES, 1941 and 1942
Type of Activity
Regional Medical Directors and Staff
1941
Consultations with physicians __ 468 Admissions to mediral service -- 2,268 Admissions to nursing service ___ Admisssions to medical and/or
nursing service -------
Field Visits:
Diphtheria ----------------
Me.asles ------------------
Poliomyelitis ------------- 214
Searlet fever ------------- 12
Smallpox -----------------
9
Typhoid and paratyphoid __ 95
Typhus fever ------------- 63
"'hooping cough ---------Others _____________________ 119
1942 304 2,246
12 4 23 6
125 10
2 103
Total field visits ____ 327
292
Public Health Nurses
1941
1942
4,990
3,375
327 178 669 106
28 289 56 41 2:\3
1,947
240 95 31
174 5
338 10 49 228
1,170
Total
1941
468 2,268 4,990
1942
304 2,246 3,375
4,228
3,o3a
335 183 883 118
37 384 119
43 372
2,474
252 99 54 180 12 463 20 51 331
1,462
Other Field Visits: In addition to the above field VISits, numerous other trips were made in health officer counties and for other purposes. The foregoing narrative of special outbreaks incorporates some of the o.ther field visits by staff members of this Division made in connection with same. The State Epidemiologist responded to 4 requests for assist-
160
Georgia Department of Public Health
ance from health officers in addition to those reported above: an outbreak of diarrhea and nausea in Savannah during February; a typhoid case in the State Hospital, Milledgeville, in April; an outbreak of several cases of typhoid in Columbus in June; and an outbreak of food poisoning at the Ship Building Yards in Savannah also during June. He also made 19 field trips for the purpose of investigating locations for detention homes for prostitutes in the following towns: Macon, 3; Milledgeville, 1; Chatsworth, 1; Eton, 1; Chipley, 1; Marietta, 1; Rutledge, 1; Waynesboro, 1; Augusta, 2; Rydal, 1; Greensboro, 1; and Atlanta, 5.
Field Visits by Counties-The following table will show the number of field visits made in the control of specified and other preventable diseases in non-health officer counties for 1942 as reported by regional medica-l directors, public health nurses, and staff members of this Division:
Diphtheria:
Barrow -------- 13 Brantley ------- 5
Butts ---------- 3
Candler -------- 2 Clayton -------- 4 Clinch --------- 4 Coweta 6 - - - - - - - - - -
Dade ---------- 4 Dawson -------- 2 Douglas -------- 1
Measles:
Atkinson -------- 1
Bryan --------- 4 Charlton ------- 15
Dade ---------- 1 Evans -- ---- --- 10
Poliomyelitis:
Bryan ---------- 1 Carroll --------- 1 Cherokee --------- 1
Fannin ----------- 31
Forsyth --------- 4
Scarlet Fever:
Atkinson ---
2
Baker ----------- 1
Bryan --------- 2
Clayton -------- 1
Coweta -------- 4
Dade ----------- 5
Emanuel ------- l
Evans ----------- 6 Forsyth -------- 44 Gordon ------- 48 Haralson ------ 15 Jackson -------- 12 Jasper ---------- 16 Jeff Davis ----- 2 Lanier -------- 4 Macon --------- 1 Monroe ------- 13
Murray ------- 16 Peach -------- 2 Pike ----------- 15 Rockdale ------- 2 Screven ------- 2 Stewart ------- 3 Taylor -------- 3 Turner 2 - - - - - - - Union -------- 2
Fannin ------- 8 Macon -------- 17 Forsyth -------- 1 Pike ----------- 11 Glascock ------ 8 Upson -------- ] Irwin --------- 16 Toombs ------- 1 Long --------- 5"'
Gilmer -------- 2 Jackson ------- 1 Lumpkin ------ 3 Macon -------- 1 Pickens -------- 1
Pierce -------- 4 Polk --------- 1 Towns ------- -- 1 Turner 1 --------Webster ------ 1
Fannin -------- ll Forsyth ------- 42 Glascock ------ l l Gordon ------- 73 Jackson ------- 5 Jasper -------- 4 Lumpkin ------ 6
Murray ------- 1 Rockdale ------ 1 Toombs ------- 2 Turner -------- 2 Twiggs ------- 1 Upson -------- 5
Preventable Diseases
161
Smallpox:
Atkinson _______ 2
Carroll ________ 1
Columbia _
1
Haralson ~-----
3
Lee ----------- 2
Monroe ------- 1
Screven 1 ~-----Webster -------- l
Typhus Fever:
Evans __________ 2 Henry _________ 1 Irwin __________ 4
Marion ------- 2 Peach -------- 3 Schley --------- 2
Taylor -------- 4 Twiggs ------- 2
Typhoid Fever:
Ben Hill ________ 8 Brantley ________ 4 Butts __________ 4 Carroll ____ ____ 2 Clay ___________ 1
Clayton ________ 37 Coweta ________ ll Crawford _______ 4 Dooly _________ 9 Douglas ________ 5 Early __________ 1 Effingham ______ 2 Elbert _________ 6 Emanuel _______ 1 Evans _________ 6
Fannin --------- 41
Fayette ------- 3
Forsyth - ------ 9
Franklin ------ 8
Gordon ---- -- 15
Haralson -------- a"
Hart ---------- 2
Heard -------- 7
Henry -- ----- ll
Houston ------- 23
Irwin ----------- l
Jackson ------- 15
Jasper --------- l
Lamar -------- 1
Macon
------ 20
Munay ------- 15 Paulding ------- 1 Peach ------- -- 24 Pierce -------- 1 Pike --- ------- ll Randolph ----- 9 Stewart ------- 20 Talbot -------- 2 Taliaferro ----- 1 Toombs ------- 2 Turner ------- 31 Twiggs ------- 7 White -------- 1 Wilcox ------- 4 Wilkinson ----- 73
Whooping Cough:
Brantley _______ 1 Evans _________ 18 Fannin _________ 2
Forsyth _______ 2 Lumpkin ______ 16 Glascock ______ 1 Macon ________ 9 Gordon _______ 2
Other Preventable Diseases:
Atkinson _______ 7 Brantley _______ 62 Butts __________ 6 Candler ________ 1 Dade __________ 2 Clinch _________ 4 Cook ___ _______ 2 Cowet:a ________ 4 Dawson ________ 3 Early __________ 1
Emanuel _______ 5 Evans __________ 17
Fannin ________ 25
Forsyth _______ 58 Glascock _____ __ 8 Gordon _______ 6
Habersham ____ 50 Henry ________ 1 Houston ___ ___ 4 Johnson ______ 1 Irwin _________ 3
Lumpkin ______ 17 Macon ________ 2 Murray _______ 3
Newton _______ 2 Peach ________ 4 Pierce ________ 5
Pike __:________ 4 Polk __ ___ ___ 2
Randolph _____ 1 Screven _______ 7 Stewart _______ 3 Tattnall _______ 2 Tiaylor ________ 3 Turner _______ 4 Upson ________ 2
162
Georgia Department of Public Health
REGULATION:
On April 16, 1942, the Director of this Division submitted to the State Board of Health a regulation prohibiting the importation, purchase, breeding, giving away, sale or offer of sale of birds of the psittacine family, which was adopted effec:tive not less than three months after the date of its adoption.
EDUCATIONAL ACTIVITIES
Meetings Attended and Addressed: During the year 1942 the Director of this Division attended 14 public meetings, 6 of which were addressed, with an approximate attendance of 768. At the Southern Medical Association, Richmond, Virginia, he discussed a paper on "Pretibial Fever-An Obscure Disease," read by Worth B. Daniels, Lt. Col., Medical Corps, Fort Bragg, North Carolina.
Articles Contributed: The Director of this Division contributed an article entitled "A New Disease Entity?" to the Journal of the Medical Association of Georgia, which was published in the December issue, 1942.
Literature Distributed: During the year 46,327 bulletins on the control of preventable diseases were distributed to schools, organizations, and individuals. This number exceeded the number of bulletins distributed in 1941 by 13,443, when 32, 884 pamphlets were sent out.
ANALYSIS OF STATISTICAL REPORT
Tabulated information concerning morbidity and mortality reports in connection with preventable diseases are attached, and the comments on certain of these diseases which follow are based on these tables.
Diphthera: During 1942 there were 660 cases and 55 deaths from diphtheria reported to the Department 1as compared with 758 cases and 63 deaths in 1941. The case rate 'per 100,000 population dropped from 24.1 to 21.1 and the death rate dropped from 2.0 to 1.8 to set a new all-time low rate for the State. The case fatality rate was 8.3, the same as for the previous year.
Dysentery: There was an increase in the number of cases of dysentery reported in 1942, when the number increased from 516 in 1941 to 584. The case rate per 100,000 population increased from 16.4 to 18.7, although there was a decline in the death rate from 3.5 in 1941 to 2.8 in 1942, when the number of deaths decreased from 109 to 86.
Gonorrhea: There was a considerable increase in the number of cases of gonorrhea reported in 1942, when the number jumped to 16,786 from 7,229 in 1941. The case rate per 100,000 population jumped from 229.8 in 1941 to 537.4 in 1942. This was due chiefly to Selective Service as a case-finding 'agency and to the distribution of free drugs to physicians for treatment of this disease.
Hookworm: In 1942 there were 4,617 cases of hookworm reported as compared wi~th 7,143 cases in 1942, and the c<::se rate decreased from 227.1
Preventable Diseases
163
to 147.8 in 1942. This does not mean an actual drop in the rate hut rather is the result of curtailing the hookworm program. See report of Division of Malaria and Hookworm.
Influenza: There were 2,900 cases of influenza reported in 1942 as compared with 36,021 cases in 1941. The case rate dropped from 1,145.3 to 92.8 in 1942. The probable reason for the great drop is that influenza was epidemic in 1941 and to the fact that many of the milder cases were not seen by a, physician in 1942, due to the shortage of doctors. There were 994 deaths in 1941as compared with 482 in 1942, and the death rate dropped from 31.6 to 15.4.
Malaria: The number of reported cases of malaria drorpped from 1,122 in 1941 to 981 in 1942. The case rate dropped from 35.7 to 31.4, but the number of deaths remained practically the same, when there were 75 deaths in 1941 and 76 deaths in 1942. The death rate remained the same, 2.4 for the two years.
Measles: There was a drop in the number of cases of measles from ll,009 in 1941 to 5,921 in 1942. The case rate dropped from 350.0 to 189.5 in 1942, the death rate from 5.0 to 1.9, and the number of deaths from 157 in 1941, when measles was epidemic, to 60 in 1942, which was a post epidemic year.
Meningitis: There was an increase in the number of cases of meningitis from 35 in 1941 to 53 in 1942. The rate increased from 1.1 to 1.7, the death rate increased from 0.5 to 0.6 in 1942, but the case fatality rate dropped from 48.6 in 194,1 to 34.0 in 1942.
Pellagra: There was a continued decline in pellagra repmted in 1942, .the number of cases dropping from 334 in 1941 to 257 in 1942. The case rate dropped from 10.6 to 8.2 and the death from 6.5 to 5.8 in 1942. The case fatality rate increased from 61.1 to 70.4 in 1942.
Pneumonia: The number of cases reported in 1942 increased from 3,623 to 4,172, and the rate increased from ll5.2 to 133.6. However, the deaths from this disease decreased from 1,7 A to 1,612, .the death rate from 54.5 to 51.6, and the case fatality rate dropped from 47.3 to 38.6. Some of the increase in the number of cases is probably accounted for by including the "virus" or atypical pneumonia in this classification, which were probably called influenza in former years. The reduotion in the number of deaths is in all probability due to the greater use of the "sulfa drugs."
Poliomyelitis: There were 49 cases of poliomyelitis reported in 1942, as compared with 790 cases in 1941, Georgia's great epidemic year. The case rate was 1.6 as compared with 25.1 per 100,000 population in 1941, and there were lO deaths as compared with 33 in 1941, when the death rate decreased from 1.1 to 0.3 in 1942.
Scarlet Fever: There was an increase in the number of cases of scarlet fever from 1,079 in 1941 .to 1,148 in 1942, and the erase rate increased from 34.3 to 36.8. However, the deaths decreased from 9 in 1941 to 2 in 1942, and the case fatality rate dropped from 0.8 to 0.2 in 1942.
164
Georgia Department of Public Health
Smallpox: There were 7 cases of smallpox reported in 1942 as compared with ll cases in 1941. The case rate decreased from 0.3 to 0.2 and there were no deaths recorded.
Syphilis: There were 19,540 cases of syphilis repor,ted in 1941 and 21,544 cases in 1942, a case rate increase from 621.3 to 689.7. The number of deaths, however, decreased from 503 to 462, when the death rate dropped from 16.0 to 14.8 and the case fatality rate declined from 2.6 to 2.1 in 1942.
Tuberculosis: The number of cases of tuberculosis increased from 2,635 to 3,067 in 1942, and the case rate from 83.8 to 98.2, but the deaths decreased from 1,385 to 1,265 and the death rate dropped from 44.0 to 40.5 in 1942. The ca-se fatality rate dropped from 52.6 to 41.2 in 1942.
Typhoid Fever: There were 384 cases of typhoid fever reported in 1942 as compared with 397 cases for 1941, and the case rate declined from 12.6 to 12.3. The deaths from typhoid fever dropped from 55 in 1941 to 24 in 1942, and the death rate from 1.7 to 0.8, a new all-time low death rate for the State from this disease. The case fatality rate dropped from 13.9 to 6.3 in 1942.
Typhus Fever: There was ,an increase in the number of cases of typhus fever in 1942, from 946 in 1941 'to 1,153, and a case rate increase from 30.1 to 36.9. The number of deaths from ,this disease increased from 36 in 1941 to 52 in 1942, and the death rate increased from 1.1 to 1.7, when 'the case fatality rate increased from 3.8 to 4.6.
Undulant Fever: There was a slight increase in the number of cases of undulant fever in 1942 from 117 ,to 129, and the case rate increased slightly from 3.5 to 4.1. However, there were no deaths in 1942 as com pared with 2 from this disease in 1941.
Whooping Cough: There was a slight decrease in the case rate from whooping cough from 44.7 to 43.8 in 194.2, and the number of cases dropped from 1,406 to 1,369. The deaths dropped from 140 in 1941 to 101 in 1942, the death rate declined from 4.5 to 3.2, and the case fatality rate dropped from 10.0 to 7.1 in 1942.
It is encouraging to note that the numbers of cases o influenza, malaria, pellagra, smallpox, and t)'lphoid fever are the lowest to ever be reported to the Department. The numbers of deaths caused from diphtheria, dysentery, gonorrhea, influenza, pellagra, pneumonia, scarlet fever, tuberculosis, and typhoid fever are also less than ever previously reported. Deaths from undulant fever again reached the zero mark as it did in 1936, and no deaths froiiL smallpox have occurred for the past seven years.
Preventable Diseases
165
NuMBER OF CAsEs AND DEATHS FRoM SPECIFIED NoTIFIABLE DISEAsEs
REPORTED IN GEORGIA, 1938. 1942 WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY
Diseases Diphtheria : Dysentery: Gonorrhea: Hookworm: Influenza Malaria: Measles:
Year
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
Cases
Case Rate Per 100,000 Population
Deaths
Death Rate Per 100,000 Population
Fatility Rate
(Per Cent)
1232 1112
543 7;)8 660
39.7
106
3;).3
95
17.4
59
24.1
63
21.1
55
679
21.9
192
58;)
18.6
127
582
18.6
126
516
16.4
109
584
18.7
86
4686
lfil.2
21
1;)83
14;).7
24
5282
169.1
22
7229
229.8
24
16786
537.4
6
17711 20384 17306
7143 4617
571.4 647.9 554.0 227.1 147.8
3782
122.0
802
11592
368.5
950
13420
429.6
924
36021
1145.3
994
2900
92.8
482
3816
123.1
146
2996
95.2
101
2502
80.1
89
1122
35.7
75
981
31.4
76
10514
339.2
Vi7
3423
108.8
51
3282
105.1
23
11009
350.0
157
5921
189.5
60
3.4 3.0 1.9 2.0 1.8
6.2 4.1 4.0 3.5 2.8
0.7 0.8 0.7 0.8 0.0
0.1
0.3 0.03 0.1
25.9 30.4 29.6 31.6 15.4
4.7 3.2 2.8 2.4 2.4
5.1 1.6 0.7 5.0 1.9
8.6 8.;; 10.9 8.3 8.3
28.3 21.7 21.6 21.1 14.7
0.4 O.:i 0.4 0.3 0.03
0.01
0.04 0.01 0.04
21.2 8.2 6.9 2.8
16.6
3.8 3.4 3.6 6.7 7.7
1.~
l.:i 0.7 1.4 1.0
166
Georgia Department of Public Health
NuMBER oF CAsEs AND DEATHs FRoM SPECIFIED NoTIFIABLE DISEASES
REPORTED IN GEORGIA, 1938. 1942 WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY-Continued
Diseases
Year
~Ieningitis:
Pellagra: Pneumonia: Poliomy<llitis : Scarlet Fever: Smallpox: Syphilis:
1938 1!!39 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
1938 1939 1940 1941 1942
Cases
Case Rate Per 100,000 Population
Deaths
Death Rate Per 100,000 Population
Fatility Rate
(Per Cent)
40 35 27 35 53
1209 745 429 334 257
5165 4765 4480 3623 4172
76 101
30 790 49
782 1055 1000 1079 1148
33 47 11 11
7
18043 20188 21259 19540 21544
1.3 1.1 0.9 1.1 1.7
39.0 23.7 13.7 10.6
8.2
166.e 151.5 143.4 115.2 133.6
2.5 3.2 1.0 25.1 1.6
25.2 33.5 32.0 34.3 36.8
1.1 1.5 0.4 0.3 0.2
582.1 641.7 680.6 621.3 689.7
20 1:\
9 17 18
365 271 235 204 181
2731 2299 2055 1714 1612
18 12
7 33 10
13 19 16
9 2
478 473 587 503 462
0.6 0.5 0.3 0.5 0.6
11.8 8.7 7.5 6.5 5.8
88.1 73.6 65.8 54.5 51.6
0.6 0.4 0.2 1.1 0.3
0.4 0.6 0.5 0.3 0.1
15.4 15.1 18.8 16.0 14.8
50.0 42.9 33.3 48.6 34.0
30.2 36.4 54.8 61.1 70.4
52.9 48.2 45.9 47.3 38.6
23.7 11.9 23.3
4.2 20.4
1.6 1.8 1.6 0.8 0.2
2.6 2.3 2.8 2.6 2.1
Preventable Diseases
167
NuMBER oF CAsEs AND DEATHS FRoM SPECIFIED NoTIFIABLE DISEASES
REPORTED IN GEORGIA, 1938- 1942 WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY-Continued
Diseases
Year
Tuberculosis :
1938 1939 1940 1941 1942
Typhoid Fever :
1938 1939 1940 1941 1942
Typhus Fever:
1938 1939 1940 1941 1942
Undulant Fever: 1938 1939 1940 1941 1942
Whooping Cough: 1938 1939 1940 1941 1942
Cases
Case Rate Per 100,000 Population
Deaths
Death Rate Per 100,000 Population
Fatility Rate
(Per Cent)
3011 2996 2805 2635 3067
829 564 487 397 384
1017 1131
589 946 1153
83 121 123 117 129
2329 1614 1020 1406 1369
97.1 95.2 89.8 83.8 98.2
26.7 17.9 15.6 12.6 12.3
32.8 35.9 18.9 30.1 36.9
2.7 3.8 3.9 3.5 4.1
75.1 51.3 32.7 44.7 43.8
1612 1533 1533 1385 1265
121 83 68 55 24
47 44 26 36 52
3
3 2
225 134 108 140 101
52.0 59.1 49.1 44.0 40.5
3.9 2.7 2.2 1.7 0.8
1.5 1.4 0.8 1.1 1.7
0.1 0.1 0.1 0.1
7.3 4.3 3.5 4.5 3.2
53.5 51.2 54.7 52.6 41.2
14.6 14.7 14.0 13.9
6.3
4.6 3.9 4.4 3.8 4.6
3.6 1.7 2.4 1.7
9.7 8.3 10.6 10.0 7.4
>-
PREVENTABLE DisEASES REPORTED IN GEORGIA BY MoNTHs, 1942
0\ 00
Disease
Total
Actinomycosis
Acute In f. Conjunctivitis----------------- 65
Anthrax __________________________________
3
1426
Dengue ------------------------- ---------
Diphtheria ------------------------------- 660 Dysentery. Amebic ------ ---------------- 67 Dysentery, Bacillary -------------------- 373
Dysentery, Unspecified -------------------- 144
16786
4617
Influenza ---------- ---------------------- 2900
Leprosy ----------------------------------
Lethargic Encephalitis --------------------
7
981
5921
53
1659
32
257
Pneumonia ----------------------------- 4172
P-oliomyelitis _______ --------------------- 49
3
4
88
6
1148
357
Smallpox _________________________________
7
Syphilis __________________________________ 21544
Tetanus __________________________________ 39
Jan.
2
173
50 5 17 3 87i 570 607
1 13 1036
1 136
2 21 462
4
10 1 132 47 2 1520 1
Feb.
2 1 234
34 1
45 5
893 698 627
28 1530
3 212
23 459
2 1
7
100 54
1313 2
Mar.
1
211
23 8 51 10 839 538 517
1 9 1370 8 163 1 26 468 1 1
5
74 27
1612 1
Apr.
6
309
19 2
10 8
848 511 245
1 36 857
6 345
4 20 302
3
1 4
55 20 1 1484 3
May
237
14 4
21 8
1702 484 126
70 804
4 262
1 22 279
5 1 1 11
45 44 3 2093 10
June
1
67
--
10 9
100 19
1369 356
43
--
93 176
4 115
5 22 159
1
--
6
22 25
1745 4
July Aug. Sept. Oct. Nov. Dec.
24
26
3
1
1
6 17
5
4
24
57
--
45
125
180
103
99
~
40 .c<.b.
6
6
8
6
6
35
34
14
20
17
6 9
Cl'l ~-
49
5
5
17
6
9 t:::l
1031
1584
2079
1701
1938
1925
<b ~
330
267
248
206
229
180 ~...
32
51
70
134
129
319 ';":"!"
174 58 5 69 5 31
--
175 17 2 49 1 16
2 171
9 2 33 7 19
149 20 7 59 4 23
1 46 14 4 108
1 16
1 17 30 7 108 1 18
;<::b:
c'"""
-~
1:::
-.".."..'
'~"'
152
204
213
392
469
613
<b
~
12
5
7
5
2
2
~ ;;::-
2
2
6
16
8
5
8
26 31
1 1776
2
51 14
2101 7
90 28
1872 3
238 32
2566 3
180 21
1820 2
13:i 14
1642 1
PREVENTABLE DISEASES REPORTED IN GEORGIA BY MoNTHs, 1942- Continued
Disea~o
Total
Jan. Feb. Mar. Apr. May June
July
AUt). :-.ent. IJd. Nov
leC.
'frachoma ------------------- _____ --------
6
Trichinosis
Tuberculosis _________ --------------------- 3067
201
189
214
216
266
258
257
243
280
296
323
324
Tularemia __ ------------------------------ 79
17
6
17
8
7
7
5
2
3
3
4
384
27
75
14
13
24
48
72
ao
19
2:i
1153
84
48
35
24
40
70
91
205
191
152
115
98
Undulant fever ___________________________ 129 Whooping Cough -------------------------- 1369
10
6
5
13
24
1!1
13
84
125
137
104
222
1GG
I:iO
12 8:;
9 90
7 76
7 7:i
4 Gri
~ ....
~
<::!
Total ___ ----------- --- 695:16
6116 6725 6:l90 5478 6835 4921
4439 fi244 :i644 6379 5705 5680
.";:.:'.
!;:>
<..::.!.".".'
".~.'..
"""""!;:>'''''
...... ~
170
Georgia Department of Public Health
NoTIFIABLE DisEAsEs REPORTED BY CoLoR, SEx, AND AcE-1942
Age Level by Years
Diphtheria
wc
Amebic Dysentery
wc
Bacillary Dysentery
wc
Malaria
wc
Menincococcus Measles Meningitis
w cwc
Under 1 Year M 10
F
8
14
2
14
3
13 12
15
1-2 Years
111 25 18 F 12
13
4
13
3
3 19 13
1 30
8
2-3 Years
M 38 F 31
10
2 31 19
9
29 11
2
3-4 Years
111 29 F 39
8
2 44 10
11
3 30 14
4-5 Years
M 29
4
6 44 12
F 31
6
1
44
5-6 Years
M
23
6
3 33
3
F 21
6
47
9
6-7 Years
M 20 F 26
94 14 89 21
7-8 Years
M 18
2
1
3 80 12
F 17
3
4
2 82 16
8-9 Years
M 17 F 14
6
2
62 16
2
2
5 57 15
9-10 Years Ill 13
3
3
2 34
9
F 10
2
4
39 13
1()--14 Years M 28
3
1
F 33
6
1
13
34 16 75 41 24 15 98 36
15-19 Years M
7
F 11
3
21
20 43
1
13
9 16 12
2
20-24 Years M
4
F
6
18 11 14 12
6
11
25 16 13
4
2,5-29 Years M F
2
6
20 12 14
2
3
22 16
6
6
30-34 Years M F
2
6
29
8
3
2
7
26 12
35-39 Years
)\[
F
17
5
3
2
6
20
11
40-44 Years M F
16
6
2
5
16 12
45-49 Years M F
12
6
3
22
50-54 Years M F
3
6
2
13
55-64 Years M F
21 16
18
9
65-74 Yem'S M F
2
2
3
2
75 and Above ~~
~'
10
3
3
2
Unknown
111
F
10
1 22
13
3 27
39 38 11
Total
M 265 52 18 10 131 31 262 133 622 229 21
F 276 47 24
146 3:J 2;j6 141 659 201 10
This also includes unspecified dysentery,
Preventable Diseases
171
NOTIFIABLE DisEAsEs REPORTED BY CoLoR, SEx, AND AcE-1942 (Continued)
Age Level by Years
Under 1 Year M F
1-2 Years
l\1
F
2-3 Years
M
F
3-4 Years
M
F
4-5 Years
M
F
5-6 Years
M
F
6-7 Years
l\1
F
7-8 Years
l\1
F
8-9 Years M F
9-10 Years l\1 F
10-14 Years M
]'
13-19 Years M F
20-24 Years l\1 F
25-29 Years M F
30-34 Years M F
35-39 Years M F
40--44 Years M F
45-49 Years M F
50-54 Years M F
55-64 Years M F
6:\-74 Years M F
75 and Above M F
Unknown
M
F
Total
M
F
Pellagra
wc
Pneumonia Poliomyelitis
w cwc
Scarlet Fever
wc
Septic Sere Throat
wc
129 133 93 164
28 35 25 23
22 19 12 18
17
7
15
;;
19
6
17
14
2
9
8
16
6
7
4
13 8
17
1
2
14
2
40 21 26 10
23 35 10 20
18 29
4
I 16 28
2 16 41 20 30
17 44 23 15
2 18 45 7 13 32
1 32 26
10
8 24 34
23 50 19 34
4
6 36 40
10
31 23
6
45 46
18 12 37 38
14
75 35
39 10 84 22
11
2 78 32
15
8 88 24
16 13 19 13
43 26 726 674 23 108 71 612 560 1:>
6
1
7
2
11
22
4
26
3
37
4
45 56
50
51
6
39
74
5
55
3
76
3
3
46
63
3
40
54
5
29
2
40
4
1
73
8
9
85
9
10
16
14
10
15
1
17
3
18
8
3 9
6 7
6 4
439 28 102 30 611 31 136 23
Smallpox
wc
172
Georgia Department of Public Health
NoTIFIABLE DisEASEs REPORTED BY CoLoR, SEx, AND AcE-1942
(Continued)
Age Lev11l by Years
Under 1 Year M F
1-2 Years M F
2-3 Years
M
F
3-4 Years
M
F
4-5 Years M F
5-6 Years
M
F
6-7 Years
M
F
7-8 Years
M
F
8-9 Years
M
F
9-10 Years M F
10-14 Years M F
15-19 Years M F
20-24 Years M F
25-29 Years M F
30-34 Years M F
35-39 Years M F
40-44 Years M F
45-49 Years M F
50-54 Years ;\I F
55-64 Years M F
65-74 Years M F
75 and Above M
F
Unknown
M
F
Total
M
F
Tuberculosis Tularemia
wcw c
2
8
3
2
6 3
3
3
1
2
3
2
3
3
2
2 3
1
2
3
2
3 2
3
3
4
3
1
2
2
12 20 7 18
15 53
4
24 83
46 101
1
66 136
3
I
57 108
2
66 128
73 94
I
2
53 85
2
4
61 60
I
45 53
4
56 50
3
38 51
5
47 38
40 35
2
54 39
33 17
3
89 37
3
45 16
2
36 14
2
27
11 12
24 21
3
3
I'
6
4
604 672 21 17 494 658 17 21
Typhoid
Undulant
Fever Typhus Fever Fever
w c wcw c
1
2
2
2
3
2
2
4
8
4
2
5
3
3
7
3
2
2
7
6
3
4
5
5
4
5
4
9
2
4
3
3
4
6 10 45
1
2
14 10 22
5
19
9 55 12
2
2
6
41
5 41 14
3
10
9 58
8
11
8 49 10 10
5
8 35
6
1
9 56 10
6 31
4
9
2 48
7 12
2
7
4 26
2
2
1
3
8 48
5 12
4
3:>
4
2
2
6
:l9
6 10
3
24
3
3
3
46
3
6
3
3 25
1
2
:\6 10
6
39
6
2
14 13
2
Whooping Cough
wc
36 41 42 43
20 20
21
9
28 16 27 22
20 22 13
32 13
22
7
15 30 16
22 11
34
8
11
6
24
16
8
9 3
11 16
11
8 46
1
3 38
4
112 82 577 88 79 14 218 l:l4
113 62 415 46 20
7 264 147
Preventable Diseases
173
NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION oF SPECIF'IED
NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1942
Area
Census* Diphtheria Population Cases Rate
Gonorrhea
Cases
Rate
Influenza
Malaria
Cases Rate Cases Rate
State Total ----- 3,123,723
Rural --- ----- 2,049,915
Cities 2,5{}0-5,000. 118,844
Cities 5,000
And Above
954,964
Military Res.
Appling -------- 14,497
Atkinson -------
7,(}93
Baoon
--------~
Baker ---------
BaldwLn -------
Banks ---------
Barrow --------
Bartow --------
Ben Hill -------
Berrien --------
Bibb ----------
Cochran Field.
Camp Wheeler_
Bleckley -------
Brantley -------
Brooks --------Bryant ---------
Bulloch -------Burke
Butts ---------
8,096 7.344 16,411 8,733 13,064 25,283 14,523 15,370 83,783
9,655 6,871 20,497 6,288 26,010 26,520 9,182
Calhoun Camden
Candler
Carroll Catoosa
Ft. Oglethorpe Charlton ------Chatham -------
Navy Sec. Base Fort Screven__
Savannah Air
Base ------Chattahoochee --
Fort Benning__ Chattooga -----Cherokee ------Clarke ---------
10,438 5,910 9,103
34,156 10,899
5,256 117,970
5,138
18,532 20,126 28,398
660 21.1 16,786 537.4
416 20.3
1,924
93.9
47 39.5
329 276.8
198 20.7 2
6.9
1 13.6
1
6.1
11 126.0
1
7.7
6.9
6
7.2
3,364 11,176
7 2
54
2 3
2 97
352.3
48.3 28.2
61.8 40.8 329.0
15.3 11.9
13.0 115.8
10.4 14.6 4.9
26.9 4 15.1
3 28.7
16.9
1 11.0
3
8.8
6 55.1
9
1.6
403 29 300.4
3
14.6
111.3
43 165.3
106 399.7
10.9
25 239.5
14 153.8
6
17.6
12 110.1
543
8 152.2
265 224.6
1
6 32.4 8 39.7 47 165.5
9,390 10 6 29
54.0 29.8 102.1
2,900 1,403
197
92.8 68.4 165.8
1,125 175
14 3
117.8
96.6 42.3
4 24.4
2 22.9
7 53.6
3 11.9
1
6.9
1
6.5
12 14.3
30 17 176.1
14.6 4.9
42 667.9 6 23.1 8 30.2 15 163.4
12 115.0
1 16.9
1 11.0
3
8.8
1 64.2
11
5 95.1
434 367.9
19.5
50
4 21.6
2 n.9
7 24.6
981 31.4 641 31.3
80 67.3
139 14.6 123
17 117.3 14.1
11 149.8 3 18.3
7.7
2
7.9
13.8
10.7
21 2 20.7
64 312.2 13 206.7 16 61.5 47 177.2
10.9
1 67.1
54.9 2.9
10 8 152.2 14 11.9
83
174
Georgia Department of Public Health
NUMBER OF CASES AND CASE RATE PEi 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY CouNTIES, 1942-Continued
Area
Census* Diphtheria Population Cases Rate
u.s. Nav. Pref.
School ----Clay ----------Clayton --------
Conley Supply
Depot -----Clinch --------Cobb ---------Coffee ---------
A.A.F.F.T. D. __ Colquitt -------
Spence Field __
Columbia ------
Look ---------Coweta -------Crawford --~----
Crisp ----------
7,064 ll,65:i
6,437 38,272 21,541
33,012
9,433 ll,919 26,972
7,128 17,540
Dade ---------Dawson -------Decatur --------
A.A. F. B. Fly.
School -----
DeKalb -------Lawson General Hasp. -----U.S.N. Air Base
Dodge ---------Dooly ---------Dougherty ------
Turner Field __
Darr Aero Tech
Douglas --------
5,894 4,479 22,234
86,942
21,022 16,886 28,565
10,053
Early ----------
Echols --------Effingham ----Elbert ---------
Emanuel -------
Evans ---------
18,679 2,964 9,646
19,618 23,517
7,401
Fannin
Fayette
Floyd ---------Forsyth -------Franklin ------Fulton ---------
Ft. McPherson
14,752 8,170
56,141 11,322 15,612 392,886
15.5 lj 39.2
23.2
10.6 :i8.7 18.:;
11.4
2 44.7 7 3l.:J
10 11.5
9 42.8 11.8 3.5
19.9 4 21.4
2 20.7 9 45.9 3 12.8
13.5 2 13.6
23 41.0 4 35.3
6.4 51 13.0
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
6 84.9
11.2
8.6
8.6
31.1
33
86.2
82 380.7
50 151.5
27 226.5
4
14.8
14.0
53 302.2
22.3 22.5
11 28.7 10 46.4
10 30.3
28 296.8 34 285.3
3 11.1
12 68.4
13 34.0 9 41.8
10 30.3
3 31.8 13 109.1
3. 7 1 14.0 6 34.2
5 22.5
13 58.5
36
41.4
125
1
18
85.6
u.s
104 364.1
4
2
59.7
3
16.1
67.5
10 103.7
2
10.2
3
12.8
4
54.0
12
81.3
10 122.4
42
74.8
10 1,013
64.1 257.8
130 149.5
15
28 133.2 14 82.9
6 21.0
14 139.3
4 21.0
6 62.2 7 35.7 3 12.8 3 40.5
6.8 12.2 137 244.0 9 79.5 23 147.3 469 119.4
8.5
16
9 42.S ll.S
30 10;).0 1
6 32.1 33.7 51.8
6 25.5 2 27.0
6.8
12.2
2
3.6
2 17.7
46 11.7
Preventable Diseases
175
NuMBER OF CAsEs AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1942-Continued
Area
Census Diphtheria Population Cases Rate
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
Gilmer
Glascock ------Glynn
Gordon Grady
Greene ---------
Gwinnett -------
Habersham -----
Hall
-----~-----
Hancock -------
Haralson ------
Harris ---------
Hart -----------
Heard ---------
Henry ---------
Houston --------
Robins Field -
Irwin ----------
Jackson -------Jasper --------Jeff Davis ------
Jefferson -------
Jenkins -------Johnson -------J.ones ----------
Lamar Lanier --------Laurens -------Lee -----------Liberty
Camp Stewart.
Llnwln -------Long ---------Lowndes
-- Moody Field
Lumpkin
Macon --------Madison ------Marion -------McDuffie ------Mcintosh ------Meriwether ----!\Iiller --------Mitchell
.Monroe --------
9,001 4,547 21,920 18,445 19,654 13,709 29,087
14,771 34,822 12,764 14,377 11.428 15,512
8,610 15,119 11,303
12,936
20,089 8,772 8,841
20,040 11,843 12,953
8,331
10,091 5,632
33,606 7,837 8,595
7,042 4,086 31,860
6,223
15,947 13,431
6,954 10,878
5,292 22,055 9,998 23,261 10,749
11.1
2
9.1
16 86.7
2 14.6 3.4
18 121.9 12 34.5
:; 2il.5 4 27.8 2 17.5
1
6.6
6 53.1
15.5
18 89.6 24 273.6
1 11.3 20.0 25.3
12.0
18 53.6
3.1
6.3 7.4 9.2
1
4.3
4 37.2
4
44.4
22.0
31 168.1
59 300.2
42 306.4
7
24.1
75 215.4
~ 10
2
13.9
2
17 ,::,
32.2
2
23.2
2
13.2
3
23.2
9
44.8
19 216.6
9 101.8
58 289.4
10
84.4
1
7.7
12.0
1
9.9
2
35.5
]~
36.5
114.8
134 1559.0
2
48.9
82 257.4
48 301.0
1
7.4
43.1
56.7 23 104.3
114 490.1 14 130.2
2 44.0
13.7
13 70.5
4 20.4
3 21.9
2
6.9
4 27.1 11 31.6 13 101.8
27.8 8.8
6 38.7 6 69.7
46.3 2 17.7
22.0 4 21.7
5.1 2 14.6 3 10.3
2 15.7
4 46.5 3.'i.4
3 23.2
62 308.6 11 125.4
1 11.3 21 104.8
2 16.9 3 23.2
12.0
39.6 1 17.8 36 107.1
25.5 11.6
12 59.7
14 69.9 28 236.4
15.4
18 53.6 21 268.0
2 23.3
24.5 13 40.8
2 32.1
5 31.4
14.4
75.6 36 163.2
10.0 4 17.2 6 55.8
2 48.9 54 169.5
4 25.1
9.2 22.7
4.3 9.3
I
176
Georgia Department of Public Health
NuMBER OF CAsEs AND CASE RATE PER 100,000 PoPULATION oF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1942-Continued
Area
Census* Diphtheria Population Cases Rate
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
Montgomery Morgan -------Murray -------Muscogee ------
Newton
9,668 12,713 11,137 75,494
18,576
Oconee Oglethorpe -----
Paulding ------Peach --------Pickens -------Pierce __________
Pike ----------Polk ----------Pulaski Putnam
7,576 12,430
12,832 10,378
9,136 11,800 10,375 28,467
9,829 8,514
Quitman
3,435
Rabun ---------
Ran!folph -----Richmond ------
Oliver General
Hospital ---
Camp H<>rdon _
Ga. Aero Tech_ Camp Hanc<>ck Augusta Air
Base Rockdale -------
7,821 16,609 81,863
1,124
Schley --------Screven -------Seminole
Spalding -------
st.,J>hens ------Camp Toccoa _
Stewart -------Sumter ------- -
Souther Field_
5,033 20.3:i3
8,492 28,427 12,912
10,603 24,502
Talb<>t ---------
Taliaferro ------
Tattnall -------Taylor
Telfair ---------
Terrell --------Thomas --------
Finney General
HOBPital ----
8,141 6,278 16 !43 10,768 15,145 16,675 31,289
4 31.5 4 35.9 21 35.8 3 16.1 2 26.4
16.1
98.5 8.5
5 48.2 20 70.3 1 10.2
11.7
6.0 20 24.4
1
90.6
4.9 7.0 1 54.0 3 28.3
8.2
12.3
9.3
6 39.6
1
6.0
3
9.6
2
15.7
22
29.1
24 129.2
8.0
60 578.1
3
32.8
11
93.2
19.3
24
84.3
10 101.7
3 2 1,243
38.4 12.0 1518.4
661
35
1
90.6
3
59.6
11
54.0
6
70.7
41 165.3
8
6U
9.4 66 269.4
2
24.6
9
55.4
62 409.4 60 359.8 41 131.0
10.3 10 18.1 4 35.9 23 30.5
31.1
5 66.0 10 80.5
5 39.0 14 134.9
42.4 29 279.5 90 316.2 30 305.2
4 47.0
3 87.3
3
4.0
4 38.5
8.5
1
9.6
1 24.6
9 91.6
59 355.2 65 19.4
4 24.1 10 12.2
3
116.5
6 29.5
53 624.1
5 17.6
1
1.1
9.4 16.3
22 108.1 84 989.2
2 15.4
66.ij 11 44.9
12.3
3 47.8
3 1s.a
55 510.8 6.6
52 311.8 18 57.5
12.:;
3 19.8 3 18.0 9 28.8
Preventable Diseases
177
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1942
(Continued)
Area
Census* Diphtheria Population Cases Rate
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
Tift ------------
Toombs -------Camp Toombs _
Towns ---------
Treutlen ________
Troup ---------Turner Twiggs ---------
Union Upson
Walker Walton --------Ware ----------
Waycross Air Base ------
\Varren -------Washington ---Wayne --------Webster --------
Wheeler --------
White ----------
Whitfield -----Wilcox ---------
Wilkes Wilkinson -----Worth ---------
18,599 16,952
4,925 7,632 43,879 10,846 9,117
7,680 25,064
31,024 20,111 27,929
10,236 24,230 13,122
4,126 8,535 6,417 26,105 12,755 15,084 11,025 21,374
5.4
20.3 1 13.1 16 36.5
9.2 11.0
11 143.2 12.0
8 25.8
10 48.1
2
1.2
1
9.8
4 16.5
1
1.6
2 42.3
62.3 17 65.1
6.6 9.1 4.1
69 371.0
9
53.1
55 125.3
1
9.2
11.0
3
39.1
4.0
46 148.3
11
52.9
158 565.7
68.4
4.1
51
3~~.7
1
21.2
8
93.7
7i.9
253 969.2
22 172.5
46.4
89 416.4
2 10.8 34 200.6
4 81.2 13.1
11 25.1
3 32.9
21 3:il.6 12.0
6 19.3 6 28.9 31 111.0
3 16.1 41.3
11.4 3 32.9
4.0 6.4 1.2
5 48.8
34 140.3
1.6
5 105.8
11.7
15.6
3.8
19 149.0
59 391.1
1~.1
2
9.4
4 39.1 11 43.4
1.6 11 232.8
23.4
22 1i2.5
.;,ii
4.7
Rates are based on enumerated census population of 1940.
NOTE: All U. S. Army and Navy Air Fields, Forts, and Camps are exclusivE> of county totals and follow the county In whiDh located.
178
Georgia Department of Public Health
NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION oF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1942-Continued
Area
Meningococcus
Measles
Meningitis
Cases Rate Cases Rate
Pneumonia Poliomyelitis Cases Rate Cases Rate
Scarlet Fever Cases Rate
State Total ----- 5,921 Rural ---------- 3,040 Cities 2,500-5,000 517 Cities 5,00(} and
Above 1,835 ~-----Military Res. ____ 529
Appling -------- 77
Atkinson -------
Bacon ----------
Baker ----------
Baldwin --------
Banks ----------
Barrow -------- 17
Bartow --------
Ben Hill -------
6
Berrien --------
Bibb ----------- 205
Cochran Field
Camp Wheeler_ 276
Bleckle.y ------- 33
Brantley -------
Brooks --------- 19
Bryan
70
Bulloch -------- 34
Burke
30
Butts ----------
Calhoun
Camden
9
Candler
2
Carroll ---------
Catoosa ---- . -- 33
Ft. Oglethorpe_ 36
Charlton ------- 30
Chatham ------- 854
Xavy Sec. Base
Fort Screven Savannah Air
Base -------
Chattahoochee -Fort Benning - 206
Chattooga ------ 51
Cherokee -------
Clarke --------- 70
189.5 148.3 435.0 192.2
531.1
13.6 12.2 11.5 130.1 41.3
6.5 244.7
341.8 92.7
1113.2 130.7 113.1
98.0 9.6
152.3 22.0
302.8 570.8 723.9
275.2 246.5
53 1.7 20 1.0 6 5.0 16 1.7 11
14.1
7.7 4.0 1.2 5
1 9.6 1 16.9
11.0 9.2
3 2.5
4 5.0
4,172 1,615
190
1,070 1,297
20
3 3 31 1
16 13
48
99
6
15 34 22 8
17
78 6 297
1,080 8
26 23
133.6 78.8
159.9
112.0
138.0 56.4
37.1 40.8 J >8.9 11.5 30.6 63.3 89.3 32.5 57.3
72.5 87.3 34.2 238.5 130.7 83.0 87.1
86.2 50.8 33.0 50.0 82.6
114.2 251.8
38.9
43.2 129.2
81.0
49 1.6 1,148 36.8
32 1.6
517 25.2
3 2.5
42 35.3
13 1.4
555 58.1 34
4 24.4
3 34.4
3 23.0
4.0
3 11.9
6.9
6.5
37 44.2
13 31.1
4.9
7. 7
3 2.5
2 19.2
2.9 10 91.8
27 22.9
16
9.9
24.8
14 49.3
Preventable Diseases
179
NUMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1942-Continued
Area
Meningococcus
Measles
Meningitis
Cases Rate Cases Rate
u. s. Naval
Pref. Sch. --
Clay -----------
Clayton -------Conley Supply
Depot ------
Clinch ---------
1
Cobb -----------
4
Coffee --------- 114
A.A.F.F.T.D. --
Colquitt --------
6
Spence Field __
Columbia ------ 71
Cook ----------- 11
Coweta --------- 26
Crawford -------
1
Crisp ----------
9
Dade ----------Dawson --------
Decatur -------- 193
A.A.F.B. F.S._
DeKalb -------- 15
Lawson General
Hospital --- 4
U.S.N. Air Base
Dodge ----------
8
Dooly ----------
3
Dougherty ------ 120
Turner Field -
Darr Aero Tech 4
Douglas --------
Early ----------
3
Echols ---------
Effingham ----- 20
Elbert ---------- 12
Emanuel -------
Evans ---------- 6
Fannin ---------
Fayette --------
Floyd ---------- 40 Forsyth --------
Franklin ------- 4
Fulton --------- 9()
Ft. MePherson_
14.2 8.6
15.5 10.5 529.2 18.2 752.7 92.3 96.4 14.0 51.3
868.0 17.3
38.1 17.8 420.1
16.1 207.3 61.2
81.1
71.2 25.6 22.9
6.1 3.7
4.8 3 16.1
3.6 1.3
Pneumonia Poliomyelitis Scarlet Fever Cases Rate Cases Rate Cases Rate
14.2
77.0
8.6
3
46.6
22
57.5
30 139.3
21
63.6
;":_j
12 127.2
13 109.1
9
3"3.4
14 196.4
6
34.2
33.9
30 134.9
79
90.9
40
6
28.5
20 118.4
30 105.0
2.6
55 143.7
4.6
13 39.4
8.4
8.4
11.4
5.7
17.0 22.3 3 13.5
2.3
101 116.2
9.5 5 29.6 24.5
49.7
17
91.0
14 145.1
40.8
11
46.8
19 256.7
12
81.3
6
73.4
54
96.2
6
53.0
11
70.;)
395 100.3
5.4
4.3 6 40.7
8.8 4 1.0
4 39.8 5.4
3 15.3
6.8
64 114.0
5 44.2
1
6.4
283 72.0
180
Georgia Department of Public Health
~UMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA
BY COUNTIES, 1942---Continued
Area
Meningococcus
Measles
Meningitis
Cues Rate Cases Rate
Pneumonia Poliomyelitis Cases Rate Cases Rate
Scarlet Fever Cases Rate
Gilmer
Glascock -------
2
44.0
Glynn ---------- 375 Gordon --------- 58
Grady ----------
Greene --------- 42
1710.8 314.4
306.4
Gwinnett ------- 1
3.4
Habersham -----
Hall -----------
Hancock -------- 25 195.9
Haralson -------
Harris --------- 1
8.8
Hart -----------
Heard ----------
Henry ----------
Houston ------- 2 17.7
Robins Field __
Irwin ---------- 2 15.5
Jackson -------- 11
Jasper ---------
Jeff Davis ----- 3
Jefferson ------ 56 Jenkins -------- 4 Johnson -------Jones ---------- 25
54.8
33.9 279.4
33.8
300.1
Lamar --------Lanier ---------
Laurens -------- 15
Lee ------------
Liberty
Camp Stewart_
Lincoln -------Long ----------- 5
Lowndes
61
MoodY Field_
Lumpkin
44.6
122.4 210.3
Macon --------- 14
Madison --------
Marion --------
McDuffie
38
\l:clntosh -------
87.8 349.3
4
44.4
1
22.0
17
11.6
33 178.9
5.1
21 106.8
9
65.7
15
51.6
9
60.9
21
60.3
5
39.2
12
83.5
3
26.3
12
77.4
81.3
6.6
15
99.2
13 115.0
11.1
4 18.2 25 135.5
7.3 20 68.8
3 20.3 45 129.2
54.8
2 17.5 4 25.8
6
46.4
14
69.7
7
79.8
6
67.9
1 11.3
19
94.8
30 253.3
7.7
2
15.4
8
96.0
13 128.8
2
35.5
17
50.6
9 114.8
1
81.4
14.2
1 14.2
1
24.5
18
56.5
3.1
3
48.2
24 150.5
6.3
7.4
9 129.4
25 229.8
2
37.8
6 29.9 2 22.8
3 36.0
4 11.9 2 25.5 5 71.0
3.1
7.4
Preventable Diseases
181
NuMBER oF CAsEs AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1942-Continued
Area
Meningococcus
Measles
Meningitis
Cases Rate Cases Rate
Meriwether
38
Miller ----------
Mitchell -------- 476
MQnroe -------Montgomery ---Morgan --------
112.3 2046.3
Murray ---------
Muscoge ------- 43
57.0
4.0
Newton --------
2
10.8
Oconee ---------
Oglethorpe ------
Paulding -------
Peach ---------- 10 96.4
Pickens --------
Pierce ----------
59.3
Pike -----------
4
38.6
Polk -----------
4
14.1
3.5
Pulaski
54 549.4
Putnam
Quitman
Rabun --------
Rand<>lph ------- 451 2715.4
6.0
Richmond ------ 212 259.0
6.1
Oliver General
Hospital ----
Camp Gordon -
Ga. Aero Tech
Camp Hancock
Augusta Air
Base -------
Rockdale -------
12.9
Schley --------- 18 357.6
Screven --------
Seminole
14 164.9
Spalding ------- 4 14.1
Stephens -------
Camp Toccoa -
Stewart -------- 10
94.3
Sumter --------- 33 134.7 Souther Field __
Talbot ------ --
12.3
Taliaferro ------ 11 175.2
Tattnall ----- --
6.2
Pneumonia Poliomyelitis Scarlet Fever Cases Rate Cases Rate Cases Rate
33 149.6
2
20.0
12
51.6
24 223.3
2
20.7
8
62.9
1 10.0 1 4.3
6. 27.2 17.2
7.9
7
62.9
88 116.6
12
64.6
6
79.2
7
56.3
7
54.6
65 86.1 2 10.8
16.1
34 327.6
23 251.8
15 127.1
55 530.1
16
56.2
8
81.4
10.9
8.5
9.6
3 28.9
3.5
24.6
23.5
29.1
4
51.1
24 144.5
70
85.5
3 38.4
1.2
10 12.2
16 207.1
12.9
20.0
25 122.8
13 153.1
30 105.5
3.5
7.7
23.1
28.3
17
69.4
28.6
10 122.8
3
47.8
30.8
182
Georgia Department of Public Health
NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1942-Continued
Area
Meningococcus
Measles
Meningitis
Cases Rate Cases Rate
Taylor
9.3
Tel.falr
13.2
Terrell
293 1757.1
1homas
81 258.9
Finney General
Hospital ----
Tift ------------
5.4
Toombs -------- 44 259.6
5.9
Camp Toombs _
Towns ---------
Treutlen --------
Troup ----------
4
9.1
Turner ---------
3
27.7
Twiggs ---------
Union ----------
Upson ----------
9
35.9
Walker --------- 72 232.1
3.2
Walton ---------
8
38.5
Ware ---------- 160 572.9
Pneumonia Poliomyelitis Cases Rate Cases Rate
65.0
22 145.3
42 251.9
8
25.6
6
32.3
5.4
11
64.9
12 243.7
2
26.2
35
79.8
18.4
9.2
4
43.9
6
78.1
12
47.9
10
32.2
11
52.9
4.8
32 114.6
Scarlet Fever Cases Rate
6.0 16.0
14 31.9 11.0
16 208.3 69 222.4
6 28.9
\V.aycross Air
Base ---------
\Varren --------
5
Washington ----- 15
Wayne --------- 27
Webster
33
Wheeler -------- 16
White ----------
Whitfield ------- 14
Wilcox ---------
8
Wilkes --------- 107
Wilkinson ------
Worth ---------- 35
48.8 61.9 205.8 698.3 187.5
53.6 62.1 709.4
163.8
4
39.1
16
66.0
2
15.2
4
84.6
2
23.4
62.3
10
38.3
35 274.4
21 139.2
14 127.0
21
98.3
4.1 2 13.3
37.1
70.3
67 256.7
7.8
6.6
1
9.1
2
9.4
NOTE: Ail U. S. Anny and Xavy Air Fields, Forts and Camps are exclusive of county totals and follow the county in which located.
Rates are based on enumerated census population at 1940.
Preventable Diseases
183
NuMBER OF CAsEs AND CASE RATE PER 100,000 PoPULATION oF SPECIF'IED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES, 1942
(Continued)
Area
Syphilis
Cases
Rate
State Total. 21,544 Rural ----- 6,528 Cities 2,500-
5,000 ---- 967 Cities 5,000
and Above 12,295 1\lilitary Res-
ervations_ 1,754
Appling ---
59
Atkinson -- 11
Bacon -----
Baker -----
2
Baldwin --- 165
Banks -----
1
Barrow --Bartow ---Ben Hill -Berrien ____
Bibb Cochran Field -
4 3 1 1 1,094
Camp
Wheeler 130
Bleckley --
40
Brantley --
Brooks ---- 118
Bryan
25
Bulloch --- 174
Burke ---- 487
Butts -----
Calhoun
97
Camden ---
6
Candler ---
Carroll ----
4
Catoosa ---
3
Ft. Ogle-
thorpe -
73
Charlton --
Chatham -- 3,119
~avy Section
Base --
Fort
Screven
Savannah Air
Base -Chatta-
hoochee Fort Ben-
ning -Chattooga Cherokee
Clarke ----
1,318 1 1
379
689.7 318.5 813.7 1287.5
407.0 155.1 27.2 1005.4
11.5 30.6 11.9
6.9 6.5 1305.8
414.3 14.6
575.7 397.6 669.0 1836.3 929.3 101.5
11.0 11.7 27.5
57.1 2643.9
5.4 5.0 1334.6
Tuberculosis Cases Rate
3,067 98.2 1,312 64.0
Typhoid Fever
Cases Rate
384 12.3 236 11.5
Typhus Fever
Cases Rate
1,153 36.9 565 27.6
158 132.9
24 20.2
188 158.2
1,466 153.5 123 12.9
393 41.2
131
48.3 14.1 61.8 81.7 32 195.0 6 68.7
8 61.2 12 47.5
34.4 2 13.1 130 155.2
1 2 13.8
1 13.6 4 24.4
2 13.8 6.5
10 11.9
16 110.4 11 155.1
9 111.2 6 81.7
10 68.9 32.5
73 87.1
15 31.1 29.1
5 24.4 3 47.7 19 73.0
33 124.4 6 65.3 47.9 67.7 9 98.9
12 35.1
3 27.5
15 3 57.1
221 187.3
14.6 3 14.6 1 15.9
7.5 10.9
9.6 33.8 11.7
2.5
10 103.6 3 43.7 23 112.2 47.7 28 107.7 11 41.5
16 153.3
4 43.9
6 114.2 82 69.5
64
37.8
4 21.6
34.8
1
5.0
5.0
19 66.9
3 10.6
Whooping Cough
Cases Rate 1,369 43.8
793 38.7
88 74.0
479 50.2
14 96.6
12 73.1 3 34.4
1
4.0
18 123.9
73 87.1
31.1 39.0 12 46.1 11 41.5
118.4
73.4
14 266.4 215 182.2
61 303.1 19 66.9
184
Georgia Department of Public Health
NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASEs REPORTED IN GEoRGIA BY CouNTIEs, 1942
(Continued)
Area
Syphilis
Cases
Rate
Tuberculosi~
Cases Rate
Typhoid Fever
Cases Rate
Typhus Fever Cases Rate
Whooping Cough
Cases Rate
C.S.N.P.S. Clay -----Clayton ____
Conley Sup. Depot __
Clinch ---Cobb ------ 214
Coffee ---- 156 A.A. F. F.T.D. -
Colquitt --- 199 Spence Field --
Columbia Cook ------
Coweta
Crawford --
Crisp
167
Dade
Dawson
Decatur
14.2 17.2
15.5 559.2 724.2
602.8
10.6 75.5 18.5 952.1 22.3 18.0
1 14.2 6 51.5
2 28.3 3 25.7
3 46.6 30 78.4
17 78.9
5 13.1
22 66.6
2
6.1
5 53.0 4 33.6
14 51.9 70.1
19 108.3 84.8 22.3
14 63.0
18.5 39.9
3 13.5
5 70.8 8.6
5 77.7 2.6
32 148.6
45 136.3
16 134.2
13 74.1
29 130.4
8.6 3 46.6 7 18.3 30 139.3 4 12.1
26 218.1 4 56.1
17 76.5
A.A. F.
B.F.S. -
DeKalb
484
Lawson
General
Hosp.
39
U.S.N. Air
Base --
Dodge
119
Dooly -----
3
Dougherty -
28
Turner
Field --
3
Darr Aero
Tech ___
Douglas ---
Early ----- 16
l!:chols -----
1
Effingham -
14
Elbert -----
6
Emanuel --
Eva>ns -----
Fannin
Fayette ----
2
Floyd ----- 363 Forsyth ---Franklin -Fulton ---- 5,634
Ft. 1\lcPher-
son ---
556.7
566.1 17.8 98.0
85.7 33.7 145.1 30.6 12.8 40.5 27.1 24.5 646.6
1434.0
59 67.9
4
4.6
37
10 47.6 5 29.6
56 196.0
2
9.5
47.4
87 304.6
9 89.5 6 32.1
2 19.9 5.4
3 31.1 10 51.0
9 38.3 6 81.1 15 101.7 4 49.0
76 135.4 3 26.5 6 38.4 711 181.0
3 15.3
5 33.9
4
7.1
8.8
6.4
20
5.1
14 16.1
6
6.9
21 99.9 41.5
26 91.0
2
2
9.5
14 49.0
9.9 25 133.8
20.7
34.1 3 40.5
2
3.6
55 14.0
33.7
6 62.2 2 10.2
4.3 3 40.5 5 33.9
24 42.7
16 141.3
1
6.4
113 28.8
Preventable Diseases
185
NuMBER OF CAsEs AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED
NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1942-Continued
Area
Syphilis
Cases
Rate
Gilmer
11.1
Glascock ___
Glynn ~----
22.8
Gordon
10
54.2
Grady
135 686.9
Greene
89 649.2
Gwinnett --
Habersham _ 14
Hall ------ 148
Hancock -- 16
Haralson --
Harris ----
58
Hart ------
Heard -----
Henry
5
Houston ---
Robins
Field --
Irwin ------
24.1 94.8 425.0 125.4 507.5
33.1
15.5
Jackson --Jasper ---Jeff Davis _
Jefferson -Jenkins
Johnson ---
24.9
5
57.0
11.3
152 758.5
200 1688.8
7.7
Jones -----
79
Lamar ----
4
Lanier ----
Laurens --- 228
Lee -------
2
Liberty ---- 31
Camp Stew-
art ----
Lincoln ---
Long ------
4
Lowndes
295
Moody
Field
Lumpkin
948.3 39.6 17.8
678.5 25.5
360.7
97.9 925.9
Macon ---- 37 232.0
Madison ---
Marlon ----
McDuffie
18.4
Mcintosh --
37.8
Tuberculosis Cases Rate
22.2 22.0 16 73.0 31 168.1 9 45.8 6 43.8
29 99.7 18 121.9 29 83.3
54.8 12 83.5
3 26.3
2 12.9 23.2
16 105.8 3 26.5
Typhoid Fever
Cases Rate
11.1
9.1
4 21.7
1
5.1
3.4 5 33.9 8 23.0
7.8 7.0
23.2 3 19.8 5 44.2
Typhus Fever Cases Rate
22.0 17 77.6
23 117.0
1
6.8
2
5.7
1
7.8
13.2
54.1
8 39.8 57.0
34.9 16 135.1
3 23.2
6 72.0 49.5
18 53.6 6 76.6 58.2
7.7
10.0 11.4
20.0 16.9
9.9
3
8.9
11.6
38.7
6 68.4 6 67.9 16 135.1
17.8 14 41.7
2 25 5 2 23.3
14.2
73.4
22 69.1
3.1
48.2
13 81.5 3 22.3 2 28.8 3 27.6 3 56.7
9 56.4 9.2
24.5 11 34.5
4 25.1 3 43.1
W~ooping
Cough Cases Rate
22.2
1 22.0
6 27 4
1
5.4
5 25.4
20 145.9
2
6.9
6.8
23 160.0
92.9 33.1
8.8
26 129.q
15 74.9 8.4
96.0
6 47.6 12.8 58.2
3 18.8 7.4
186
Georgia Department of Public Health
NuMBER OF CAsEs AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1942
(Continued)
Area
Syphilis
Cases
Rate
Tuberculosis Cases Rate
Typhoid Fever
Cases Rate
Typhus Fever Cases Rate
Whooping Cough
Cases Rate
Meriwether _ 40
Miller -----
Mitchell --- 360
Monroe ----
1
Montgomery_
:\Iorgan ---
Murray --1\Iuscogee -Kewton ---Oronee ----
Oglethorpe Paulding --
1,222 14 3 3 1
Peach
160
Pickens ---
6
Pierce ----
10
Pike ------
3
Polk ------
17
Pulaski ----
Putnam ---
Quitman --
Rabun ----
Randolph
37
Richmond
882
Oliver
Gen.
Hosp
Camp Gor-
don --- 186
Ga. Aero
Tech --
Camp Han-
cock --
Augusta
Air
Base --
3
Rockdale --
4
Schley ----
Screven ---
Seminole --
Spalding --- 342
Stephens ___
29
Camp
Toccoa_
Stewart ---
Sumter ---- 258
Souther
Field --
Talbot ----
Taliaferro -
1
Tattnall ---
22
181.4 1547.7
9.3 31.5 18.0 1618.7 75.4 39.6 24.1
7.8 1541.7
65.7 84.7 28.7 59.7 20.3
222.8 1077.4
51.8
34.4 23.6 1203.1 223.6
37.7 1053.0
15.9 135.4
18 81.6 20.0
16 6R.X 12 111.6
5 51.7 17 133.7
12 107.7 85 112.6
8 43.1 39.6 64.4
4 31.2
17 163.8 4 43.8 50.8 86.7
33 115.9 3 30.5
3 35.2 58.2 51.1
10 60.2 120 146.6
9.1 8.6
15.7
9.0
23 33.1
1
5.4
8.0
48.2
21.9
1
8.5
2 19.3
3 10.5
25.6 18.1
103.6 79.5
17 83.5 94.2
33 116.1 61.7
2 25 9 9.8 7.0
16 150.9
28.3
24 98.0
12.2
49.1 47.8 16 98.5
2
9.1
3 30.0
38 163.4
10.3
3
4.0
4 32.2
3 28.9
18 152.5
1
9.6
1
3.5
22 223.8
36.1 17 20.8
4 79.5 16 78.6 12 141.3
10.6
18.9 15 61.2
21 129.3
46 208.6
20.7 31.5
11 14.6
1
5.4
4 38.5
32 350.3
76.3
1
9.6
6 21.1
12.8 2 12.0 9 11.0
25.9
14.7 11.8 21.1 20 154.2
5 20.4
Preventable Diseases
187
NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DisEASEs REPORTED IN GEoRGIA BY CouNTIEs, 1942
(Continued)
Area
Syphilis
Cases
Rate
Tuberculosis Cases Rate
Typhoid Fever
Cases Rate
Typhus Fever Cases Rate
Whooping Cough
Cases Rate
Taylor
Telfair
53 350.0
Terrell
142 851.6
Thomas ---
4
12.8
Finney Gen.
Hosp. Tift
~------
217 1166.7
27.9
46.2
54.0
18.0
26 83.1
3.2
18 96.8 10 53.8
8 743 26 171.7 14 84.0 28 89.5
20 107.5
2 18.6 4 26.4
54.0 26 83.1
5.4
Toombs --Camp
27 159.3
Toombs_
Towns ----
Treutlen ---
Troup ----- 207 471.8
Turner
6
55.3
13 76.7
2 11.8
2 40.6 3 39.3 57 129.9 8 73.8
23 4 36.9
16 94.4
56 330.3
4 52.4 2.3
64.5
20.3
136 309.9 9.2
Twiggs
Union -----
Upson
8.0
Walker ---- 50 161.2
Walton ---- 84 404.3
Ware ------ 123 440.4
65.8 4 52.1 26 103.7 34 109.6 10 48.1 19 68.0
3 32.9
3.2 24.1
2
6.4
1
4.8
19 68.0
4 52.1
1
4.0
4 12.9
19.3
7.2
Waycross Air Base --
Warren ____ Washington_ Wayne _____
Webster Wheeler ---
3
29.3
88 363.2
155 1181.2
21.2
18 210.9
68.4 24 99.1
15.2 3 63.5 2 23.4
4.1 7.6 2 42.3 11.7
9.8 10 41.3
5 38.1 3 63.5 8 93.7
6 58.6
30.5 84.6 58.6
White ----Whitfield --
Wilcox ----
Wilkes ----
Wilkinson -
W-orth ----
69 264.3
22 172.5
3
19.9
3
27.2
298 1394.2
2 31.2 33 126.4
4 31.4 12 79.6
81.6 17 79.5
62.3
2
7.7
15.7
45.4
12 94 1
2 13.3
1
9.1
20 93.6
3.8 39.2 9 59.7 3 27.2
4.7
NOTE: All U. S. Army and Navy Air Fields, Forts and Camps are exclusive of county totals and follow the county In which located.
Rates are based on enumerated census population of 1940.
188
Georgia Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEAsEs REPORTED IN GEoRGIA BY CouNTIES, 1942
(Continued)
Diphtheria Population Cases Rate
Gonorrhea Cases Rate
Influenza
Malaria
Cases Rate Cases Rate
Total ------------- 954,964
Albany Americus Athens Atlanta (DeKalb)
19,055 9,281 20,650 28,994
Atlanta (Fulton) Augusta Bainbridge Brunswick CarroJH.on Cartersrille
273,294 65,919 6,352 15,035 6,214 6,141
Cedartown College Park Columbus Cordele Dalton Decatur
9,025 8,213 53,280 7,929 10,448 16,.>G1
Douglas Dublin East Point Elberton Fitzgerald Gainesville
5,175 7,814 12,403 6,188 7,388 10,243
Griffin Hapeville LaGrange Macon Marietta Milledgeville
13,222 5,059
21,983 57,865
8,667 6,778
Moultrie Newnan Rome Savannah Statesboro Thomaston
10,147 7,182
26,282 95,996
5,028 6,396
Thomasville Tifton Toccoa Valdosta Waycross
12,683 5,228 5,494
15,595 16,763
198 20.7
10.8 36 174.3
36 13.2 17 25.8
15.7 2 13.3 2 32.2
11 121.9 1 12.2
21 39.4 1 12.6 9 86.1
b.u
19..'! 64.0
8 129.3
3,364 16 6
10 993 1,202
1
16 2 22 22 248
46 4 5
352.3
84.0 64.6 14.5 34.5
363.3 1823.4
15.7
80.5 16.3
177.3 24.4 41.3 277.5
2373.7 6.0
888.9 51.2 40.3 16.2
48.8
15.1
19.8
8 36.4
4
6.9
57.7
14.8
13.9
6 22.8
3
3.1
3 46.9 15.8
54.6
6.0
57 556.5
40 302.5
2
39.5
33 150.1
56
96.8
9 103.8
46 678.7
44 433.6
3
11.4
236 245.8
16 318.2
15.6
16 226.2
28 535.6
127.4
13
83.4
153 912.7
1,125 4
3 413
61 2 3 2
18 2 17
4 24
3 32 11
3 4 6 1 22 423
8
6 30
117.8
21.0
9.1 10.3
151.1 92.5 31.5 20.0 32.2 16.3
199.4 24.4 31.9 75.7
6.0
77.3 307.1
8.1 16.2
9.8
22.7 632.5
22.7 19.0 34.6 59.0
59.1 13.9 83.7 440.6 19.9 46.9
63.1
18.2 38.5 179.0
139 14.6
9 47.2 3 32.3
2
6.9
12
4.4
10 15.2
4 63.0
6 66.5
3.8 50.4
2 12.1 3 58.0
89.6 8.1
27.1
1
4.5
5
8.6
3 29.6
13 13.5 2 39.8 15.6
19.1 2 36.4 42 269.3 2 11.9
Preventable Diseases
189
NuMBER OF CAsEs AND CASE RATE PER 100,000 PoPULATION oF SPECIFIED NoTIFIABLE DISEASEs REPORTED IN GEORGIA BY CouNTIEs, 1942
(Continued)
Area
Meningococcus
Measles
Meningitis
Cases Rate Cases Rate
Scarlet
Pneumonia Poliomyelitis
Fever
Cases Rate Cases Rate Cases Rate
Total -------------
Albany Americus Athens Atianta (DeKalbJ
Atlanta (Fulton) Augusta Bainbridge Brunswick Carrollton Cartersville
Cedartown College Park Columbus Cordele Dalton Decatur
Douglas Dublin East Point Elberton Fitzgerald Gainesville
Griffin Hapeville LaGrange Macon Marietta Milledgeville
Moultrie Newnan Rome Savannah Statesboro Thomaston
Thomasville Tifton Toccoa Valdosta Waycross
1,835 84 28 38
80 210 195
41 9 2
43 2
4
146
5 13 648 21
8 40
42 160
192.2
440.8 301.7 184.1
29.3 318.6
1297.0
11.1 12.2 77.0 113.5 19.1
830.9 25.6 8.1 16.2 61.1
30.3
4.5 252.3 34.6
29.5
49.3
49.5 675.0 417.7 125.1
315.4 19.1
269.3 954.5
16 1.7 1,070 21
18 21
4 1.5 305
4 6.1
61
9
15
7
11.1
3.8
76
12
5
8.1
9
3
9
11
3
16
1.7
37
10
13
11
2
3.8
22
2.1 262
12
3 1
12 25
112.0
141.7 97.0 87.2 72.4
111.6 92.5
141.7 99.8 112.6 130.3
33.2 60.9 142.6 12.6 19.1 30.2
231.9 64.0 72.6 48.5
121.8 68.3
128.6 59.3 72.8 63.9
115.4 191.8
108.4 27.8 83.7
272.9 238.7 109.4
23.7 19.1
76.9 149.1
13 1.4 2 6.9 3 1.1 1.5 11.1 12.6
11.5 3.1
6.4
55G 58.1
6 31.5 53.9
14 67.2 26 89.7
216 79.0 8 12.1 15.7 13.3
2 22.2 4 48.7 51 95.7 1 12.6 35 335.0 24 144.9
25.6 16.1 48.5
19 185.G
9 177.9 9 40.9 33 57.0 8 92.3
29.5
12 118.3
30 114.1 23 24.0
19.9
5 39.4
18.2 6.4
190
Georgia Department of Public Health
NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASEs REPORTED IN GEORGIA BY CouNTIEs, 1942
(Continued)
Syphilis Cases Rate
Tuberculosis Cases Rate
Typhoid Fever
Cases Rate
Typhus
Whooping
Fever
Cough
Cases Rate Cases Rate
Total
Albany Americus Athens Atlanta (DeKalb)
Atlanta (Fulton) Augusta Bainbridge Brunswick Carrollton Cartersrille
Cedartown Colleke Park Columbus Cordele Dalton Oeratur
Douglas Dublin East Point Elberton Fitzgerald Gainesville
Griffin Hapeville LaGrange Macon Marietta Milledgeville
Moultrie Newnan Rome Savannah Statesboro Thomaston
Thomasville Tifton Toccoa Valdosta \Vaycross
12,295 1287.5 1,466 153.5
20 105.0 61 657.3 48 232.4
4 13.8
44 230.9 15 161.6 16 77.5 16 55.2
5,609 2052.4 871 1321.3
20.0 32.2
526 192.5 99 150.2
2 31.5 9 59.9 3 48.3
81.4
99.7
1,168 107 68
2192.2 1349.5
650.8 12.1
12 133.0 7 85.2
60 112.6 12 151.3 19 181.9 11 66.4
98 1893.7 6 76.8
8.1 64.6 13.5 133 1298.4
9 173.9 7 89.6 20 161.3
64.6 27.1 26 253.8
221 1671.5
134 609.6 483 834.7 154 1776.9 149 2198.3
29 219.3 11 217.4 38 172.9 113 19"5.3 11 126.9 18 265.6
180
2,331 63
1773.9 27.8 11.4
2428.2 1253.0
31.3
15 147.8 8 111.8
47 178.8 173 180.2
8 159.0 13 203.3
15.8 184 3519.5
21 382.2 28 179.5 123 733.8
11 86.7 12 229.5
7 127.4 11 70.5 17 101.4
123 12.9 393 41.2 479
32 167.9 18 94.5
8 86.2
2
9.7
16
3.4
10.3
16
::i.9 47 17.2 100
17 25.8
16 251.9
2
2 13.3 15 99.8
6
4 64.4
50.2
36.7 10.8 77.5
36.6 12.1 :H.5 39.9
12.2 21 39.4 3 37.8
9.6
2 25.6
2 27.1 19.5
7.6
4.5 8 13.8 2 23.1
14.8
19.7 41.8 15.2
3.1
1
7.9
7 133.9
6.4
11.1
3
5.6
12 151.3
2 12.1
16 309.2 4 51.2 8.1
8 108.3 9.8
22.7
67 115.8 1 11.5
23 226.7
11.1 24.4 11 20.6
9.6 12.1
173.9 12.8
16.2
37.8 19.8 71 323.0 43 74.3 11.5 14.8
19.7
7.6
19.0
73 76.0 144 150.0
10 198.9
1 19.9
15.6"
55.2 17 325.2
32.1 13 77.6
14 110.4 1 19.1
20 364.0
6.0
Preventable Diseases
191
INDUSTRIAL HYGIENE SERVICE
During the year 1942, the demands upon the Industrial Hvgiene Service were tremendously increased due to the all-out production by the industries of the State in the National war effort. The Industrial Hygiene Service for the year 1942 has been working directly with the various plants in an effort to assist them in matters of industrial health, with the objective in view ,of keeping the industrial worker on the job.
PERSONNEL
In approaching the comprehensive program of industrial health, the professions of medicine, engineering, chemistry, and nursing become intimately involved. In order to render the required service of these professions, the following personnel are attached to this Service:
1 Medical Director.
1 Assistant Physician who was assigned to the Service from the National Institute of Health in July of 1942.
1 Chemical Engineer.
1 Chemist, employed September 1, 1942.
1 Consultant Nurse who has been assigned to the Service from the Nati,onal Institute of Health and who was transferred to the Service in July.
3 Secretaries--2 of the secretaries were assigned to Industrial Hygiene in September and October, 1942.
The consultant nurse spent one month taking a post-graduate course at St. Louis University.
PROBLEMS AND SCOPE OF WORK
During a portion of the year 1941, in which the activities of the Industrial Hygiene Service were inaugurated, obviously little definite information was at hand as to the exact extent of the problem in the State, and the approaches which should be taken through the various field activities. During the :period covered in this report, it has been possible to evaluate the nature and extent of the work to be accomplished, and also to develop policies and methods of handling the work. Due to the limited personnel, it appears necessary to devote all efforts to those plants which are producing war materials. This policy will be followed for the duration.
The importance of maintaining the health of workers in industry has long ,been recognized. The Army has established an Industrial Hygiene Service, the purpose of which is to work with ordnance plants owned and operated by the Government. The Navy has developed an Industrial Hygiene Division which functions in the various shipyards and other shore establishments owned and operated by the Navy. Since a greater portion of the war materi,al is produced by private industry, under war contract, it became necessary to establish some official agency
192
Georgia Department of Public Health
to render Industrial Hygiene Service to plants in this group. The responsibility for this service to privately owned 1plants under war contracts was delegated to the Georgia Department of Public Health.
The most important problems presented during this period are associated with war plants. From a medical standpoint, these include developing first aid and medical facilities, physical examinations including chest x-ray services, study and control of dermatitis, observing and treating individuals ex:posed to poisonous or toxic materials. Engineering activities include complete studies of industrial plants, engineering recommendations and consultations on control of observed hazards, collection and examination of atmospheric 'and other samples, presentation of industrial hygiene material through talks and group meetings.
There are certain industries in the State which have potential and actual problems for which Industrial Hygiene Services are greatly in need. This applies especially to the granite industries, most of which are located in the area of Elberton. Although the importance of silicosis is definitely realized and particularly its potentialities in the granite industries, it has been deemed advisable to postpone work with the granite industries for the duration. This decision has been based on the fact that these pl-ants are not engaged in the production of war material and also because of priorities they are unable to secure protective equipment.
LABORATORY
A complete chemical laboratory provides facilities for the quantitative and qualitative investigations of air contaminants such as dusts, fumes, gases, vapors, mists, smokes, etc., and for other toxic materials in the industrial environment. This laboratory is also used for study of blood, urine, and other biological samples which are taken in connection with plant studies. From January l, through December 31, 428 samples have been analyzed in .this laboratory. The findings obtained in laboratory studies are correlated with the general engineering investigation of the plant, and the results incorporated in the report presented to the industry concerned. Certain pieces of field equipment have been obtained which permit .the analysis of samples in the plant at the time the study is being made.
PUBLIC RELATIONS
During the period covered by this report, a total of 47l conferences were recorded with 1,006 individuals. These conferences were concerned with the various Industrial Hygiene problems. The members of the staff of this Service attended 34 meetings; addressed 30 meetings attended bv 700 persons. These included ll lectures to the students at Emory University, Georgia School of Technology, University of Georgia, Georgia Baptist Nurses' Training School, and .a paper read before the Medical Association of Georgia ail its annual meeting. There were four showings of the industrial hygiene film "Save a Day." Approximately 7,300 pieces of literature were distributed, including copies of papers and talks 'prepared by
Preventable Diseases
193
the members of the Industrial Hygiene Service Staff. The U.S. Department of Labor Bulletin No. 41, "Occupational Hazards and D~agnostic Signs-A Guide to Impairments to be Looked for in Hazardous Occupations", together with a copy of rthe regulations for reporting occupational diseases was distributed to each physician in the State. Two mdio talks were made and two newspaper articles were submitted for 'publicwtion. The policy of inserting an industri,al hygiene article in each monthly issue of "Georgi,a's Health" was initiated. At the meeting of the Medical Association of Georgia, an Industrial Hygiene exhibit was on display.
Organizations already existent, whose active cooperation has been secured, include twenty chambers of commerce, seven industrial insurance carrie11s, two manufacturers' associations, the Army engineers, Army laboratory, and the Army Industrial Hygiene Service. Valuable assistance has been secured from many related agencies, including the U. S. Public Health Service, State Health Department, the U. S. Navy, U. S. Maritime Commission, American Medical Assodation, National Nutrition Committee, educational insti,tutes, and many others-the U. S. ,and State Labor Departments, State Department of Education, and the Medical Association of Georgia.
Formal instruction in industrial hygiene courses have been developed at the Georgia School of Technology, and at the University of Georgia Medical School in Augusta. A course which is to include industrial hygiene material is being considered for the School of Medicine at Emory University. This 'proposed course is to go into effect at Emory next year. In connection with these courses at Georgia Tech and the University of Georgia, :personnel of the Industrial Hygiene Service have been assisting in presenting lectures. These lectures cover the medical, engineering, and chemical approach to the investi@ation and control of hazards involving toxic smokes, dusts, fumes, mists, vapors, and the like. In addition to the lectures which have been presented at Georgia Tech, students taking this course have visited the Industrial Hygiene Laboratory and observed equipment and methods used in plant studies.
NUTRITION PROGRAM
The Industrial Hygiene Director participated in the Region VII meeting of National Nutrition Committee of Office of Defense Health and Welfare in Birmingham, Alabama, July ll, 1942. He has also been appointed co-chairman of the State Nutrition in Industry Sub-Committee. Better facilities for nutrition in industry are being promoted in all plants, the work being correlated with the State and local Nutrition Committee programs in the homes of individual workers.
NATIONAL COMMITTEE FOR CONSERVATION OF MANPOWER IN WAR INDUSTRIES
The Industrial Hygiene Director has been appointed as Medical Consultant to the State Committee of this organization. With the engineering members of his staff he has arranged and conducted lectures on industrial
194
Georgia Department of Public Health
hygiene at the special schools for training safety directors and foremen under this program.
FIELD ACTIVITIES
Direct assistance is being rendered to the critical war plants of the Sta,te which include shipyards, plants manufacturing artillery shells, plants manufactuTing bombers, and airplane assembly parts, naval ordnance materials, chemical munitions, and other various plants which are producing essential war materials. There are ap,proximately 2,400 industrial plants in the State of Georgia which are concerned with manufacturing and transpO'ltation. Of these a portion are producing materials which are concerned with the National War effort. In addition, these plants which are engaged in the manuhcture of war materials are required to meet the health and safety regulations in the State in which work is being performed as set forth in the Walsh-Healey Public Contracts Act.
During the period covered by this report, 148 promotional visits were made. Sixty-four plant investigations and 30 completed plant surveys. A statistical analysis of these field visits indicates a well-rounded program covering the various engineering activities.
MEDICAL AND NURSING ACTIVITIES
The medical and nursing personnel of the Industrial Hygiene Service investigated 237 cases of diseases in industrial areas. In connection with these investigations 132 conferences were held with physicians. Conferences were held with 177 nurses. Certain of these conferences were concerned with the procurement of industrial nurses for the various industries of the S~ate which are in need of qualified nurses for their industrial health programs.
Of outstanding importance was the investigation and prompt control of the explosive water-borne outbreak of typhoid fever and bacillary dysentery in a cotton mill village in southwe~t Georgia. This outbreak involved 81 cases of typhoid and 79 cases of dysentery, with four deaths. There were no secondary cases discovered, although several hundred might have been anticipated if no trained personnel had been available. The medical director and 'the consultant nurse devoted pTactically the entire month of February and all !the month of March to this outbreak. The consultant nurse also spent the month of April doing follow-up work in connection with this outbreak.
In April, the medical director, chemical engineer, and consultant nurse lll1:tended the Conference of Governmental Industrial Hygienists which was held in Washington, D. C. This meeting afforded an opportunity to discuss with industrial hygiene personnel of other states their programs and approach to various problems.
In May a visit was made to the construction project of the Tennessee Valley Authority located near Farner, Tennessee. This visit was made by the medical director and the chemical engineer. The purpose of the visit
Preventable Diseases
195
was to observe in detail general methods used in controlling occupational hazards incident to tunnelling operations.
Considerable time was spent in the preparation of the proposed industrial health program for the Southeastern Shipbuilding Corporation in Savannah. Additional time was also spent in assisting the other shipyards of the State in developing adequate medical services. It was found necessary to promote the proposed program with the Maritime Commission on a national scale to secure approval for its adoption in the Georgia Maritime Commission Yards. In this connection, a trip was made by the medical ciirector to the Hartford Accident & Indemnity Company, New York City, where a .conference was held with Mr. George T. Merrick, Associate Manager. This meeting was at the request of Mr. C. L. Daughtry, Hartford Accident & Indemnity Claims Manager, Atlanta. Mr. Daughtry had expressed his conviction that this type plan is important to the national war effort in increasing the productive capacity of the shipyards, and that it should be promoted on a national scale and not confined essentially to the Southeastern Shipbuilding Corporation. A conference was also held with Mr. Robert T. Hooker, Jr., of the Maritime Commission, Washington, D. C. Mr. Hooker expressed interest in the proposed program as a general plan to be applied to all shipyards owned and operated by the Maritime Commission. Indorsement of this program was secured from the National Institute .of Health, General Motors Medical Department, and Harvard University School of Public Health. This proposed pwgram was later broadened so as to include any large war industry. As a direct result of this promotional effort, a health program for all maritime commission yards in the country has been developed to be administered by the U. S. Navy with the 'assistance of Professor Philip Drinker as special consultant.
A considerable amount of time has been spent with the various industries in promoting x-ray services. To date, thirty plants are being surveyed and 12,861 chest x-rays have been taken. This 'activity appears to be of definite value in an industrial health program. In addition to surveying individuals previously employed, chest x-rays are being promoted as a :part of the routine pre-placement physical examination. Its application should result in reducing the possible exposure to individuals infected with tuberculosis, and in terms of a long range program should show definite results.
A report was prepared by the medical director and submitted to the Physicians' Procurement and Assignment Service. Facts were given about the principle industries and industrial areas of the State and certain health services available to workers and their families, such as the number of physicians and hospital beds per unit population.
ENGINEERING ACTIVITIES
A total of 101 engineering visits to plants were made during this period. A total of thirty plants have been surveyed and studies completed. Four hundred and twenty-nine samples were collected and 'analyzed, 192 determinations were made in the field and 237 in the laboratory. Considerable time was spent with the shipyards of the State in developing an en-
196
Ceorgia Department of Public Health
gineering approach to the control of metal fume fever. This occupational disease has caused considerable Ioss of time on the part of skilled welders in the shipbuilding industry, and obviously has resulted in considerable loss of productive ability. Studies for the control of this situation involved detailed measurement of exhaust systems used by the various shipyards, including a great number of individual measurements covering velocities, air flows, and other pertinent data on ventilation. These observed data have been carefully analyzed and a detailed report prepared rand presented to the shipyards. These studies also involved chemical analysis of the air which contained varous contaminants produced by welding operations. These findings, along with recommendations for control procedures were submitted to the yards.
Some time has been spent with the industrial plants in assisting with the design of ventilating equipment for the control of toxic dusts such as asbestos. This has involved the correlation of existing dust concentrations with current engineering practice employed for the control of these dusts. These studies have been further augmented by design of new ventilating equipment which has proved considerably more efficient than that formerly used. Much time has been spent with plants manufacturing artillery shells. This requires oomplete study of various plant operations and atmospheric samples when indicated. The exposures to dusts, organic solvents, gases and cutting oils appear to be the principal problems observed in these plants. Important examples of these are the control of dust in foundry operations, and control of acrolein in heat treating operations. A great number of samples have been taken in these plants and the results correlated with the engineering findings and used in the basic design of exhaust systems.
In wmking with these plants, detailed studies 'are made which include indicated atmospheric samples, air flow measurements, study of operations, machinery .and the like. When all of the data have been obtained, samples and information are analyzed and studied and a complete en gineering report is prepared. These reports which include recommendations for control of observed hazards are presented and discussed with the plant management. In .addition, enl!ineering services are rendered in assisting with the design and installation or construction of recommended control equipment.
Some time has heen spent with the welding schools of this State in an effort to demonstrate safe welding practices. This included actual investigations of these schools and recommendations for the control of toxic materials 1and rays which are produced by welding.
SUMMARY
The various activities of the Industrial Hygiene Service are carried out with the active cooperation of the related divisions of the Georgia Department of Public Health. By such a cooperation, all the facilities of the State Department of Health are made available to industry. In these instances where follow-up of individual patients or their contacts is indicated, ar-
Preventable Diseases
197
rangements are made with the local health departments and members of the medical profession. The medical director has been appointed also as secretary of the lndustri,al Health Committee of the Medical Association of Georgia and 1as co-chairman of the State Nutrition in Industry Committee. By these and other similar relationships an effective program for discovery, prevention, and control of all known preventable health hazards to our industrial workers is !'apidly expanding.
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Cancer Control
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Epidemology
DIVISION OF PREVENTABLE DISEASES DIRECTOR
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Typhus Control
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Industrial Hygiene
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V.D. Control
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Public Health Education
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1. Administration 2. Professional Consultations 3. Promote and assist plant
Medical Departments 4. Promote routine Physical
Examinations 5. Diagnostic assistance
1. Consultations with Industrial Nurses
2. Promote Medical, Nursing and Industrial Hygiene Services
3. Standing orders for Industrial Nurses
I. Conducting plant studies
I. Collection of Samples
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2. Consultation on Control Procedures
2. Chemical Analyses 3. Special Investigations
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4. Assist in Plant studies
4. Preparation of Reports
5. Instruction in Instruments
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6. Supervision of Chemical
6. Assistance in Reports
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6. Industrial Epidemiology
4. Interpret Industrial hazards
Laboratory
7. Examination of Biological
7. Sickness Absenteeism
to Industrial Nurses
7. Promotion in Plants
Samples
8. Industrial Nutrition
5. Industrial Nutrition
8. Group Talks
9. Promote Industrial
6. Education Industrial
9. Analysis of hazardous
Dentistry
Nurses and Public
Operations and Exposuses
10. Education
Health Nurses
10. Checking Plans and
7. Coordinate Program Public
Specifications on Exhaust
Health Nursing ana
Systems
Industrial Nursing
COOPERATION WITH OTHER ESTABLISHED AGENCIES
FEDERAL AGENCIES U. S. Public Health Service U. S. Department of Labor U.S. War Department U.S. Navy U. S. Maritime Commission U. S. Bureau of Mines Office of Defense Health and Welfare Services N.Y. A.
STATE AXD LOCAL GOVERNMENTS Labor Department Industrial Board Department Education Local Health Departments Other Divisions Georgia Department Public Health Welfare Department
PRIVATE AGENCIES
Schools and Universities
American Medical Association
American Public Health Association
American Dental Association
Insurance Companies
Chambe.rs of Commerce
Tuberculosis Association
Civic Organizations
::\ianufacturers Associations
Labor Organizations
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Georgia DeJXIrtment of Public Health
INDUSTRIAL HYGIENE SERVICE
I. Public, Relations:
Activities Reported for Year 1942
I. Conferences:
a. Number ------------------------b. Attendance ______________________ _
2. Meetings: a. Attended ________________________ _ b. Addressed ______________________ _
c. Number of persons addressed ______ _ d. Films shown_____________________ _ 3. Literature distributed ________________ _ 4. Radio talks_________________________ _
5. Newspaper articles submitted__________ _
491 1,005
34 31 751 4 7,474 2 2
II. Field Visits:
I. Promotional VISits ___________________ _ 148
2. Plant investi~ations__________________ _
M
3. Follow-up _________________________ _
1
4. Plant survey _______________________ _ 20
5. X-ray survey-individuals____________ _ 12,861
III. Medical Nursing Activities:
I. Cases investigated ___________________ 241
2. Consultations with physicians__________ 132
3. Conferences with nurses_______________ 177
4. Special investigations _________________
1
5. Nursing consuLtations_________________ 13
IV. Engineering Activities:
I. Sanitation -------------------------- 22
2. Ventilation ------------------------- 66 3. Dust studies_________________________ 34
4. Organic solvents_____________________
4
5. Illumination ________________________ 13
6. Temperature humidity_________________
0
7. Special investigations_________________ 13
V. Chemical Studies:
l. Samples collected____________________ 422
2. Samples analyzed____________________ 428
3. Field determinations__________________ 209
4. Laboratory determinations_____________ 226
5. Special studies_______________________
0
Preventable Diseases
201
STATISTICAL SUMMARY INDUSTRIES IN GEORGIA SERVED BY INDUSTRIAL HYGIENE PERSONNEL OF
THE GEoRGIA DEPARTMENT oF PuBLic HEALTH
1941
Number of Plants Visited______ ------------------- 20 Number of New Piants Visited______________________ 20
Reason for Visit to New Plants: Occupational Disease Report___________________ 0 Self-initiated -------------------------------- 9 Employer Request --------------------------- 7 Local Health Department______________________ 0 Physician Request --------------------------- 0 Army Reque~ ------------------------------- 0 Other Request ------------------------------- 4
Type of Studies Done: Medical ------------------------------------ 17 Engineering -------------------------------- 17 Nursing ------------------------------------ 9 Laburatory --------------------------------- 5
1942
96 88
1 65 17
3 0 0 2
60 31 42 13
202
Georgia Department of Public Health
TYPHUS .FEVER CONTROL SERVICE
The Typhus Control Service of the Division of Preventable Diseases is directed by the Engineer of the Division, who duties are also divided with other services of the Division.
The Director and Engineer of the Division are located in Atlanta. A field office is located in Macon, Georgia, which is within the proximity of the most important typhus area of the State. An assistant engineer, en gineering aide, and stenographer are located in this office.
For the most part of 194.2, the pwfessional staff of the Typhus Control Service consisted of one engineer in charge and one assistant engineer, as compared with one engineer in charge and two assistant engineers for previous years. However, the professional staff was increased in Octoher, 1942, by the addition of an engineering aide.
Medical activities of the Typhus Control Service are provided by the medical staff of the Division of Preventable Diseases, Regional Medical Directors, and County Health Officers.
At the close of 1942, the first full year of the present World War II, the Typhus Control Service, like all other public health activities throughout the State and Nation, was placed on a war.time basis of pro viding the most efficient service possible for the protection of the health of soldiers and civilian war industrial workers. Activities of the Typhus Control Service for the year were therefore concentrated primarily in war .areas of Georgia in which typhus tever was prevalent. In addition to services rendered cities, towns, and rural communities in war areas, ad. visory services were rendered the U. S. Army in construction and main tenance of military cantonments, and Federal Agencies in the construction of war housing projects, for the prevention of typhus fever.
Due to the critical shortage of materials for civilian use, as caused by the war effort, essential materials used in the control o.f typhus fever became difficult to obtain during 1942 without preference ratings from the War Production Board. This shortage of materials has practically eliminated the individual citizen from purchasing materials, mainly metals, for vent stopping (rat proofing) his own building or residence. However, typhus control programs that are given financial sponsorship by local govern mental agencies in war areas, preference ratings may be ohtained as indicated by the fact that several of the cities in Georgia have received high preference ratings to procure all the materials necessary for conducting typhus control programs.
During the year, the City of Savannah established a permanent typhus control division within the City Health Department. This is the second large city of Georgia to establish a permanent typhus oontrol division; the other city being Atlanta, which established their typhus control division in 1940. Undoubtedly other Georgia cities will soon follow the action of Atlanta and Savannah.
Preventable Diseases
203
TYPHUS CONTROL ACTIVITIES
The activities of the professional staff of the Typhus Control Service consisted in general of educational and promotional activities, epidemiologic and engineering investig.ations, special investigative studies, and advisory assistance to cities, towns, and rural communities in establishing control measures; such as, vent-stoppage .of buildings (a modified f.orm of rat-proofing), rat extermination, and municipal refuse collection and disposal. During the year, 298 field visits were made rendering these services to 40 cities, towns, and rural communities in thirty-five counties of Georgia.
EDUCATIONAL AND PROMOTIONAL ACTIVITIES
The educational and :promotional activities continued in 1942, as in previous years, through the principal media of radio talks, pamphlets and booklets, public meetings, and personal conferences.
During the year, two meetings were attended in the interest of typhus fever control in which no participation in the program was made and seventeen additional meetings were 'attended and addresses made. About 379 persons were in attendance at the meetings addressed. There were 1,201 personal conferences conducted 'and one radio talk made. Approximately 6,598 pieces of typhus literature were distributed. The literature distributed was principally the booklet entitled, "Murine Typhus Fever." In addition to the many requests received for this booklet by citizens of Georgia, an inestimable number of requests have been received from governmental agencies throughout the nation. From the records of requests received, this booklet has undoubtedly reached every state in the nation 'and many foreign countries. An inestimable number of reprints of published scientific papers of the typhus fever eontrol program in Georgia, and other available scientifie information on this subject as kept on file by the Typhus Control Service, have been requested by public health agencies and individuals in many states.
Two lectures were given to students in the public health engineering class at the Georgia School of Technology, and one lecture to students in the public health class of the University of Georgia Medical School.
INVESTIGATIONS
Epidemio[o,gic
Two special epidemiologic investigations of rep.orted typhus fever cases were made during the year. One investigation was made in Brunswick, Glynn County, and the other one in Savannah, Chatham County. The Brunswick investig.ation was made by a member of the medical staff, Division of Preventable Diseases; whereas, the Savannah investigation was made by the medical staff of the Ty.phus Control Division, U. S. Public Health Service, and the Assistant County Health Officer of Chatham County. These investigations precede the engineering investigations and indicate the possible foci of the disease on spot maps.
204
Georgia Department of Public Health
Engineering
Six city-wide and seven special engineering investigations were made during the year. These investigations were directed towards the determination of the prevalence by species of rats encountered, types of buildings and amount of harborage, and refuse conditions and harborage on premises. The investigations also included the type of business establishments, and the amount of material required for applying control measures.
SPECIAL INVESTIGATIVE STUDIES
The Savannah typhus fever investigative study as started in February, 1941, continued throughout 1942. However, with the withdrawal of the Work Projects Administration participation in this study on December 31, this investigative study was 'officially terminated on this date. The agencies involved in this study were the Georgia Department of Public Health, U. S. Public Health Service, Savannah City Health Department, and the Work Projects Administration.
The purpose of the Savannah investigative study was to evaluate the effeotiveness of typhus fever control measures originated and currently employed by the Trphus Control Service in controlling typhus fever in cities, towns, and rural ,communities throughout the State. Epidemioiogic, entomologic, and engineering control studies were made. Data obtained from this study is now being assembled and correlated for publication.
During the year many visitors engaged in public health activities in other states inspected the work of this project, and numerous requests for information were received.
CONTROL MEASURES
Vent-Stoppage
Vent-stoppage is the primary typhus fever control measure which is applied to business establishments to prevent the entry of rats, thereby preventing the close 'association .between man and rat that is necessary for .the transmission of the disease. At the close of the year, 727 business establishments were surveyed for vent-stopp,age and 437 were vent-stopped. Since May, 1939, when vent-stoppage was first applied, a ,total of 2,279 business establishments have been vent-stopped. Of this number of business establishments vent-stopped, 481 received maintenance during 1942. Inspections were made of 4,720 business establishments.
Rat Extermination
Organized rat extermination progmms employing the use of poisons were conducted in three cities and towns. Organized trapping campaigns were carried on in twelve cities and towns during the year. These rat extermination programs were under the direction of the Typhus Control Service, and were conducted principally during the instaUation and after completion of vent-stoppage to business establishments. This has been found to be the most effective method of obtaining the best results from rat eJCtermination.
Preventable Diseases
205
Refuse Collection and Disposal
Advisory assistance in matters of refuse collection and disposal was rendered many municipalities requesting assistance ~n controlling .typhus fever during the year. A special investigation was made of the refuse collection and disposal practices in the City of West Point.
In view of the shortage of materials and equipment for civilian use, expansion or improvement of refuse collection and disposal facilities, involving new construction or equipment, has been greatly curtailed. Impairment of sanitary refuse disposal on public and private premises has been specifically experienced by municipalities, due to the shortage of metal garbage receptacles. These receptacles are made of galvanized metal, consequently, come within the classification of critical materials by the War Production Board. It is therefore anticipated, that for the duration of the war, municipalities can 'Only hope to maintain minimum facilities :or refuse collection and disposal.
VISITORS INSPECTING FIELD ACTIVITIES
During .the year, many visitors were received to inspect the field activities of the Typhus Control Service. Among the list of visitors received were representatives from Public Health Agencies in China; British West Indies; Columbia, South America; and the States of Tennessee, North Carolina, Louisiana, and Florida.
TYPHUS FEVER IN GEORGIA DURING 1942
The geographical distribution of typhus fever continues to he prevalent, as in previous years, throughout the coastal plain counties of the State, with the greatest incidence in the Southwest portion. The disease also con tinues to be a problem in the cities, towns, and rural communities, more so than in the sparsely settled areas of the counties. During the year 1942, there were 1,154 cases of typhus fever reported as compared with 944 oases for :the year 1941. This is an increase of 210 cases or 22.2 per cent in 1942 over 1941. The number of deaths occurred during 1942 were 53 as compared with 36 deaths in 1941, an increase of about 47 per cent in the number of deaths reported for 1942 over 1941.
It is interesting to note, from the graph, the apparent cycle of the disease over the tenyear period 1933 through 1942. This :apparent cycle is indicated more effectively by the number of deaths repmted, as these re :ports are more reliable than the reports of the numbers of cases. However, inasmuch as .typhus fever in Georgia is comparatively a new disease, in so far as recognition is concerned, it is too early to attempt to dr.aw any definite conclusions on the basis of existing data, as to .the cycle occurrence of the disease; or any factor or condition that may be responsible for the increase in the disease during 1942 over previous years.
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STATISTICAL SuMMARY oF AcTIVITIEs
1942
Educational
lnvestigations
Control Measures
County
Non Health Officer Health Officer
Cities Towns and Rural Communities
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Lowndes ----------------------Valdosta :.\Iusrogee ------------------- __ Columbus
TYPHus FEVER CoNTROL SERVICE
STATISTICAL SuMMARY OF ACTIVITIES
1942
Educational
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Vent Stoppage of Rat Exter- Ordin's
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County
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2
1
65
Unclassified ----------------- ----------------- 66 147
3 75
1 :>924
Total ------ 30
5
Total ------ 31
21
40
298 1,201
2 17 379
1 6.)98
6
r 1369 437 4078 481 3 12
~
Statistical Summary of 1941
0
-.1
58
356 1,332
8 25 345
3 5000 13
3 1227 589 3414 284
208
Georgia Department of Public Health
U) 60 :~c 0 50
~~ 40
~~ 30
Q..
~~ 20
~ 10
::I
z
0
MURINE TYPHUS fEVER CASES AND DEATHS REPORTED IN GEORGIA
Preventable Diseases
209
VENEREAL DISEASE CONTROL SERVICE
PERSONNEL
The Venereal Disease Control Service consists of a State Venereal Disease Control Officer, Associate Venereal Disease Control Officer, four stenographers, and members of the laboratory staff who are engaged in performing examinations for venereal diseases and with the distribution of drugs and supplies.
CASE REPORTING
During the period under discussion, 3,525 new cases of syphilis were reported to this Service by private physicians; 21,517 new oases of syphilis were admitted to the clinics, making a total of 25,042 new cases of syphilis being reported to the Georgia Department of Puhlic Health. There was a total of 21,657 new cases of syphilis reported in 1941. Private physicians reported 2,125 new cases of gonorrhea, and the clinics reported 7,453 new cases, making a total of 9,578 new cases of gonorrhea. There were 3,36L cases of gonorrhea reported in 1941. There were 640 cases of chancroid, 104 cases of granuloma inguinale and 51 cases of lymphogranuloma inguinale reported in 1942.
Case reports are received by the Venereal Disease Control Service from: l) private physicians on individual case report cards (which are also used for ordering free drugs), and 2) venereal disease clinics. Each patient admitted to a syphilis clinic is reported individually to the CTU on a new ,admission card approved for this purpose. Each service rendered each patient is reported to the CTU on treatment progress cards. At the end of the month, the CTU furnishes the Venereal Disease Control Service with administrative reports, showing the number of patients treated and the amount of treatment given. Venereal diseases other than syphilis are reported by private 'physicians on individual case report cards and by clinics on the Clinic Monthly Report.
DISTRIBUTION OF FREE DRUGS An estimated total of 2,450,868 doses of neoarsphenamine, sul-
pharsphenamine, mapharsen, stovarsol, bismuth, and sulfathiazole were issued to private physicians and clinics for the treatment of syphilis and gonorrhea, as compared with 1,340,826 doses for 1941.
For ,a detailed report of drugs distributed see Tables E and F.
CLINICS At the end of the year, there was a total of 251 clinics operating in 144
counties; 376 physicians were receiving honoraria at the rate of $5.00 .per clinic session for conducting free venereal disease clinics, and 201 nurses were receiving honoraria at the rate of $2.50 per clinic session for assisting in these clinics.
210
Georgia Department of Public Health
LABORATORY
During the year, 515,566 serologic examina'tions for syphilis were performed by the central laboratory and the two branch l'aboratories. Of this number, there were 77,459 (15.0%) positive reactions. The number of serologic examinations for 1941 was 347,270, with 50,695 positive reactions. During the period under discussion, a total ,of 226 clarkfield examinations were made, with 84 (37.2%) giving ,a positive reaction. The number of clarkfield ex'aminations for 1941 was 309, with 77 giving a positive reaction. During 1942, there were 9,813 examinations made for g-onococci, with 1,593 (16.2%) giving a positive reaction. During 1941, there were 9,882 examinations made for gonococci, with 1,929 giving a positive reaction.
EDUCATIONAL
A total of eight lectures was made during the year to a total audience uf 189, as compared with eight lectures with an audience of 310 for 194.1. Films were shown to 87 groups, comprising an audience of 13,217, as com pared with 155 films shown to an audience of 19,792 for 1941. Approximately 85,266 pieces ,of li,terature on venereal diseases were distributed, as compared with 46,168 pieces of literature distributed during 1941. There were 138 clinic visits made, 54 conferences, and 3 meetings attended (not addressed) .
FOLLOW-UP
Letters were written to health 'authorities concerning all patients reported as being a delinquent or contact of venereal disease.
ITINERANT NURSING SERVICE
As a result cf additional federal funds, an itinerant nursing service has been provided for some 38 counties in Georgi,a, which were without public health organizations, with each public health nurse covering ,three or four counties and holding clinics weekly or oftener in each county. Clinics are open to all indigent patients as well as draftees. Treatment is given by local practicing physicians and no charges are made.
The itinerant nursing service has been available only since May, 1942. Nine nurses have been assigned to cover 31 counties.
COOPERATION WITH SELECTIVE SERVICE
All positive reports on selectees clear through this Service and are referred to the health officer, or where there is no health officer, to the regional medical director. The result of the investigations for eleven months, not including December, which is not avaiiable at this time, is as follows:
Total investigated-5,652. Put under treatment-4,837. Already under treatment-191. Investigated but not put under treatment-299.
Preventable Diseases
211
Unable to locate-196. Moved out of State-87. Moved into State-42.
It should be noted that this report consists only of the investigations, and does not include the total number referred.
RECORD FORMS
RCA 103-20-Syphilis Patient Transfer Form. This form has been adopted :to facilitate transfer of patients from one treatment source to another. The form is used in duplicate, one copy being given the patient and one copy being sent to the CTU. The patient can receive immediate treatment upon appearing at the new clinic upon presenting his copy.
OTHER ACTIVITIES
Doctor R. A. Vonderlehr of the U. S. Public Health Service visited this Service February 20.
The State Venereal Disease Control Officer attended the meeting of the Georgia Medical Association in Augusta April 29.
Mr. Earl Lippincott of the Division of Social Protection, Federal Security Agency, visited this Service frequently relative to the controlling of prostitution in Georgia.
During the month of November, the State Venereal Disease Control Officer accompanied Dr. P. S. Pelouze, Assistant Professor of Urology at the University of Pennsylvania and an eminent author and authority on gonorrhea, on a lecture tour throughout the State. Dr. Pelouze made 17 lectures to an audience of approximately 1,077.
TABLE "A"
SYPHILIS CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE BY PRIVATE PHYSICIANS
UNDER PROGRAM FOR DISTRIBUTION OF fREE ANTISYPHILITIC DRUGS
January-December, 1942
New Cases (Never Previously Treated)
White
January -----------February ____________ March ______________
April --------------May ________________
June ---------------July ________________
M
F
----
58
34
55
34
48
41
18
10
41
40
57
49
47
28
42
41
60
39
46
36
21
28
43
33
Colored
M
F
101
76
144
113
93
94
72
90
132
117
135
143
107
118
107
116
128
125
106
118
107
83
79
72
Total
269 346 276 190 330 384 300 306 352 306 239 227
TGtal --------------- 536
413
1311
1265
3525
Old Cases (Previously Treated)
White
M
F
Colored
M
F
24
19
68
34
23
15
46
33
39
31
30
28
17
15
30
31
17
22
33
32
44
28
70
62
27
:n
38
48
16
18
31
16
31
21
37
32
25
24
41
38
27
23
44
48
29
19
18
23
319
266
486
425
Total
145 117 128 93 104 204 144
81 121 128 142 89
1496
Total Reported
White
M
F
Colored
M
F
82
53
169
110
78
49
190
146
87
72
123
122
35
25
102
121
58
62
165
149
101
77
205
205
74
59
145
166
58
59
138
132
91
60
165
157
71
60
147
!56
48
51
151
131
72
52
97
95
855
679
1797
1690
1..-.:.1..
1-:1
~
...<1>
<;) ~
15"
t:l
Total 414
<1>
~.;....:...
463 404 283 434 588 444 387
.;<.:1.:.>,.
0
-~
-.Io.:.: -.
<"l
473 434
::t::
<1>
381
l;::;l:-
316 ;::.-
5021
TABLE "B"
SUMMARY REPORT OF CLINIC ACTIVITIES SYPHILIS
January-December, 1942
New Cases of Syphilis Admitted to Clinic
White
M
F
48
45
29
41
March ____________________________________ 59
54
April ------------------------------------- 68
67
May ______ -------------------------------- 72
54
June ------------------------------------- 48
62
July ------------------------------------- 76
47
83
50
87
51
October ---------------------------------- 90
61
67
40
December _________________________________ 80
40
Total ______________ - - -- --- ----- 807
612
Colored
M
F
518 436 639 769 743 769 1087 1112 1136 1193 1066 1001
489 474 697 824 757 934 1018 1019 1021 1067 768 561
10469
9629
Old Cases of Syphilis Admitted to Clinic
Total Admissions Doses Administered
White
M
F
91
68
117
100
106
89
140
113
126
91
106
89
144
110
166
140
209
168
206
238
170
137
134
99
Colored
M
F
634 810 948 1038 981 889 979 1442 1498 1472 1345 1085
809 1235 1084 1284 1111 1029 1124 1408 1541 1562 1320 856
Heavy
Arsenicals Metal
'...t. j
2702 3242 3676
23487 25534 30210
21037 21222 22736
<:!
""'';:::
gIS':
4303 3935 3926
32413 34681 33594
26230 26075
"t:'::l
26698
~
4585 5420 5ill
36452 39322 43331
30007 29746 32268
""""l=''''l
5889
48418
37445
4913
42690
35873
3856
37792
31854
17Vi
1442
13121
14363
52158
427924
341191
!>:)
.......
'"'"
TABLE "C"
!,>..:.).
of:.
GONNORRHEA CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE
BY CLINICS
January-December, 1942
New Cases of Gonorrhea Admitted to Clinic
Genitourinary
White
Colored
M
F
M
F
Opthalmia
Neonatorum
Wh.
Col.
M F MF
Other
Wh.
Col. Unknown
M FM FM F
Old Cases of Gonorrhea Admitted to Clinic
Genitourinary
Wh.
Col.
MF M F
Opthalmia
Neonatorum
Wh.
Col.
M F MF
Wh. MF
Other
Col. MF
Unknown
MF
Jan. ____ 70 57 242 54
1
Feb. ____ 42 38 172 68
1
March __ 57 53 154 46
1
April ___ 70 48 217 67
1
M,ay
56 51 232 59
22 5 7
-- -- -- --
June --- 60
68 257 103
July ____ 62 323 524 329
11 1
-- 10 10 52 24
August - 65 148 469 244
1
6
6 27 60 61
Sept. --- 4:l 97 429 224 1
8
9 19 47 33
October _ 54 158 582 322
6 2:i 47 102
Nov.
59 85 311 278 1
7 5 24 3
Dec. ____ 11 14 138 37
9 6 52 15
57 4 1
--
---
1
-- --
5 1 17 7
Total
649 1140 3727 1831 2 1 1 1 10 7 67 17
45 95 239 233
5 1 17 8
Total Admissions
No. of Treat-
men! Visits
424 321 327 403 398 586 1239 1087 913 1296 772 329
1234 756 873 1303 1344 1414 2591 2381 1861 3319 1908 886
8095 19870
~
~
Si
r:.r.o....
I;>
t::;
~
~ ..........
;::;
~
.;:.:.,.. c
-~ ~ -.o...-. ('>
::r::
;~ ";'.
TABLE "D"
ToTAL NEW VENEREAL DISEASE CASES REPORTED TO THE VENEREAL DISEASE CoNTROL SERVICE
January-December, 1942
By Private Physicians
White MF
Colored
M
F
Unknown
M
F
Syphilis
Primary and secondary__ 393 :ng 893 82.1
Early and latent ______ 1
2
2
4
J..ate and late latent ____ 12:1 91 397 :198
Congenital _____________ 17
19
16
Prenatal _______________
1
22
Total ------- - -------- 536 413 1311 1265
Gonococcus Infection
'denHo-urinary ---------
'Opihalmia neo __________
--
Other __________________ 340 144 1218 423
Total ------------------ 340 144 1218 423
Other Venereal Disease
Chancroid ------------- 9
2
59
13
Granuloma inguinale __
20
6
Lymphogranuloma
1
10
6
Other
Total __________________ 9
3
89
25
By Clinics, Hospitals or Other Institutions
White MF
Colored
M
F
Unknown
M
F
96 10') 824 620 312 309 ril47 5947 363 162 4250 2800
36 36 248 262 --
807 612 10469 9629
649 1140
2
1
10
7
661 1148
3727 1
67
3795
1831 1
17
1849
Total By All Sources
White
M
F
Colored
M
F
Unknown
M
F
491 424 1717 1445
31:~ 311 o149 'l951
486 2:-i3 4647 3198
53 36 267 278
1
22
1343 1025 11780 10894
649 1140
2
1
330 151
1001 1292
3727 1
1285
5013
1831 1
440
2272
."..'t, ;j
~
~
...~
--
;::!
I':>
0..."..'
~
t:::; &;
~
~
~
"'
32
8 438
79
6
6
43
23
3
14
17
41 14 495 119
41 10 497
92
6
6
63
29
3
1
24
23
50 17 584 144
.t.-...:1..
VI
TABLE "E"
.15
ranu&ry ----- -- --
February ------- -March ____________ April ___________ 10 May ----------- 10 June ----------- -July ____________ 10 A.ugust --------- -September ------ -October ___________ November _________ December _________
rota! ___________ 30
Total Number of Doses________ 30
.3
2~0
750 260 280 1000 560 380 1140 360 1240 300 400
6890
6890
.45
1290 2040 1760
920 1230 1150 1520 2570 800 2220 1840
875
18215
18215
FREE ANTISYPHILITIC DRUGS DISTRIBUTED
VENEREAL DISEASE CONTROL SERVICE
1anuary-December, 1943
NEOARSPHENAMINE
.6
.75
.9
1.5
3.0
4.5
6010
200
160
9450
40
220
7800
450
780
6370
200
82fi0
130
240
7570
60
210
9060
440
10530
10
170
8490
100
220
1700
120
610
8010
400
190
7230
180
730
620
350
310
630
280
620
20
920
310
930
90
970
460
960
300
1140
220
920
540
1300
290
715
460
96470
1510
3620
10185
3900
96470
1510
3620
50925
29250
5.4
6.0
1710 1317 1820 1640 2530 1930 2740 2490 1970 2640 3270 1790
25907
259070
Total number of doses of neoarsJ>henamine. 563,708 (for larger ampoules, 0.6 gms. considered average dose.)
.t.-...:..l
0\
10.8
240 380 370 150 206
90 110 120 110 550 270 500
3096
45.0
~
60
~ c
--
60
~
~-
t::::l
~
60 100
'g.....,.
;3
~
100 ISO
-.;.::.l.
c
~
!c.'.:.!.-..
560
~.
(")
:::t:
~
55728 42000
:l;:::l:.--
TABLE "F"
fREE ANTISYPHILITIC DRUGS DISTRIBUTED
(Continued)
VENEREAL DISEASE CONTROL SERVICE
January-December, 1942
Sulpharspehenamine
0.2
0.3
0.4
0.6
60
--
10
10
50
290
10
March --------------- 60 April ----------------- 200
170
--
60
20
May ----------------- 180
50
40
June ----------------- 70
280
10
July ------------------ 110
50
50
210
--
120
90
40
50
200
460
10
130 December ____________ 10.5
90
50
315
75
Total _________________ 1495
1915
315
Total Doses __________ 1490.
1915
315
Mapharsen
0.04
1100 920 870 880
1060 1220 1110 1310 1090 1840 1600 1030
14030
14030
0.06
1660 1430 1960 1600 1640 1970 1600 3280 1880 3070 3030 1420
24540
24540
0.6
100 130 480 120 540 620 730 570 340 760 380 950
5720
57200
Stovarsol
Bismuth
Su lgath iazole
T-abl-ets2250 3430 75 1120 1500 5635 3285 1300 4400 5425 2600 1125
30-cc
408 531 397 366 564 735 561 438 452 676 506 336
:l2145
5970
Bottles of
60-cc 566
Tablets
---
36000
40 Tablets
344
41000
.~..
530
61500
300
46000
474
53000
2499
704
55000
307
"~ ' "';:::
IS g:
697
91000
344
9;)5
99500
610
467
105000
732
805
101000
901
968
78000
521
1~63
76000
312
."i.:.':..l ;""""":''',''
8073
843000
6226
32145 179100 484380
1092040
T.otal number of doses of neoarsphenamine -------- ------------
11otal number of doses of sulpharsphenamine ---------------------------- --Total number of doses of manharsen _____________________________________
;i63,708 3,725
9ri,770
Total number of doses of stovarsol _________________ ---------------------- 32,145
Total number of doses of sulfathiazole __________ ------------------------- 1,092,040
Total number of doses of bismuth ----------------------- __________________ 663,480
--
Total -------------------------------------------------------------- 2'4 50,8 68
(For large.r ampoules, 0.6 gmR. considered dose)
(l-ee considered dose) t-.J
1-' -.)
~
TABLE "G''
~
00
LABORATORY ExAMINATIONS FOR VENEREAL DISEASES
PERFORMED IN CENTRAL LABORATORY AND Two BRANCH LABORATORIES
GEORGIA DEPARTMENT oF PuBLIC HEALTH
January-December, 1942
Serologic Examinations
Number
Number
Percent
Darkfield Examinations Number Number Percent
Examinations for Gonococci
~
Number Number Percent
.c~..,
Total
Positive
Negative Positive Total Positive Negative Positive Total
Positive Negative Positive
(Jo.
~
January -------------- 31,202
4,073
27,129
13.1
17
5
12
29.4
813
150
663
18.5
t:::;
February ------------- 28,477
4,689
23,788
16.5
30
8
22
26.6
660
102
558
15.5
~
March --------------- 35,588
5,712
29,876
16.1
18
5
13
27.7
747
April ----------------- 31,841
4,889
26,952
15.4
16
10
6
62.5
821
102 124
645
13.7
697
15.1
"<:;
;..:....,,.
May ----------------- 32,969
4,778
28,191
14.5
22
19
3
86.4
786
120
666
15.2
;3
June ------------------ 43,741
6,636
37,105
15.2
23
11
12
47.8
862
136
726
15.8
.:~ :.=.
July ----------------- 51,109
7,917
43,192
15.5
22
4
18
18.2
871
August --------------- 47,314
7,509
39,805
15.9
13
3
10
23.1
1,010
162 174
709
18.6
836
17.2
...c.....
September ------------ 52,544
7,962
44,582
15.2
21
3
18
14.3
862
171
691
19.8
October --------------- 59,857
9,025
50,832
15.1
9
2
7
22.2
909
140
769
15.4
;"t:1 0,_"
November ------------ 50,876
8,160
42,716
16.0
23
10
13
43.0>
806
111
695
13.8
~.
December _____________ 50,048
6,109
43,939
12.2
12
4
8
33.3
666
101
565
15.2
"::'t:
Total ----------------- 515,566
77,459
438,107
15.0
226
84
142
37.2
9,813
1,593
8,220
16.2
~
;:,
~
~
J
TABLE "H"
Lectures
No.
January __ February _ 2 March April ____ 1 May _____ 1 June ---- 1 July _____
August --
Sept. ---October __ November. 1 December. 2
'rota! ____ 8
Au d.
80
45 8 6
--
--
10 40 189
SuMMARY REPORT OF EDuCATIONAL AcTiviTIES VENEREAL DISEASE CONTROL SERVICE
January-December, 1942
Films (V. D.)
No.
Aud.
--
--
2
240
--
1
45
--
--
--
--
--
--
--
--
--
--
3
285
Films
No.
Au d.
7
996
16
985
8
972
18
4,538
8
508
4
817
9
453
4
1,504
5
1,840
1
20
4
299
84
12,932
No. of Clinic Visits
No. of No. of Follow-Up Conferences Visits
No. of Meetings
Attended
(Not Ad-
Litera-
dressed)
ture
12
4
--
2
--
--
2
1
6
4
9
2
21
11
15
8
24
13
--
24
4
10
2
1
15
3
138
54
1
2,664
.'"..i.:l
1
4,012 5,942 12,328
.,"'~
"';::::
""
8,775
0...."..
6,700
"'
2
8,551 6,077
536 5,987 3,410
.,.....1::::::1
""""'"''''
20,284
3
85,266
1..'-.:.1.
\0
Division of Malaria and Hookworm
Service
Justin Andrews, Sc. D., Director* D. M. Wolfe, M.D. _________________________________Acting Director
J. Allen Scott, Sc.D. ______________________________Associate Director
Arthur W. Hill, M.D. _______________________ Medical Epidemiologist*
I
During 1942 there was a considerable turnover in the personnel of this Division brought about by various staff members entering the armed forces or other types of work. For rthe first four months the staff consisted of the Director, Medical Epidemiologist, Engineer, two Field Biologists, Field Nurse, Sanitarian, two secretaries and a part-time steno-clerk. During May, the entire staff, with the exception of the Field Biologist, Field Nurse and the secretaries, departed to enter the armed forces or for other work related to the war.
The Biologist was shifted .to the central office and made Associate Director, and the Division was placed under the supervision of the Director of the Division of Preventable Diseases. The Associate Director was placed in charge of the office work and new field personnel were employed as qualified persons could be found. One Field Biologist was assigned to the Division of Public Health Engineering 'to assist with a program in cooperation with the U. S. Pubrlic Health Service, Office of Malaria Control in War Areas. On July 15th, the Assistant Epidemiologist, Division of Preventable Diseases, was made Acting Director of the Division Qf Malaria and Hookworm Service. Then On October lst, further changes were made in the field personnel so that the staff from then until the end of the year consisted .of the Acting Director, Associate Director, three Biologists, Field Nurse and One secretary. Two Assistant Biologists were also employed for the summer season.
With certain modifications due to the unusual conditions, the antimalaria activities of the Division have been of the same type as those of previous years, including standard plan activities, malariometry, entomological service, special investigations, research, and publication of the Georgia Mal,aria Bulletin.
Early in the year, the U. S. Public Health Service created an office of Malaria Control in War Areas, and the supervision of this program in Georgia was assigned to the Division of Public Health Engineering. The Division of Malafi.a and Hookworm Service assisted in the organization of this program by selecting, training and supervising the inspectors who were to collect mosquitoes in the areas to be brought under control. These duties in addition to certain special investigations in new war areas occur-ied most of the time of the staff during the first four months of the year. At the end of that time, the Director of the Division and several staff
Left for military duty during May,
Malaria and Hookworm Service
221
members left to enter the armed forces. One biologist was assigned to work exclusively with the malaria control program in war areas, and a report of his activities will be included in the report of the Division of Public Health Engineering.
Standard Plan Activities
Early in the year it was decided that with the loss of engineering personnel from the county health department staffs it would be impossible for most counties to fulfill their commitments under the standard plan. It was, therefore, announced that the standard plan would be discontinued for the duration. Several counties did, however, continue their control activities and whenever assistance was requested from the Division of Malaria and Hookworm Service, the usual type of aid wa-s given. During the summer period, biologists were assigned to Bulloch, Crisp and Jenkins Counties to assist in the supervision and evaluation of their control programs. They, and the Associate Director, also .spent part of their time assisting other counties in their control programs. Only a minimum of educational and promotional work under the standard plan was continued, because of the abnormal conditions. A tabulation of the educational and promotional anti.malaria and antihookworm activities in the various counties is shown in Table I.
Malariometry
The 1941 Fall Malaria Survey in white and colored elementary schools was conducted in thirteen counties by county health department personnel, assisted in some cases by the Medical Epidemiologist of the Division (See Table VII). As noted in the previous annual repor.t, hlood film diagnosis is not as satisfactory as spleen palpation for the purpose of making surveys of malaria prevalence in white children. Spleen palpations were made of a total of 4,715 children, the results of which are shown in Table II. In
all, approximately ll% showed some degree of splenic enlargement,
which is a~most exactly the same proportion encountered in the survey of the previous year. In Table III, the results of examination of thick blood films are shown. In the case of white children, these films were taken only from those showing splenic enlargement, except in cases noted. The films from colored children, however, represent a random sampling. A total of 9,223 films were examined.
The prevalence of malaria in white children as indicated by the spleen palpation and blood film diagnosis was approximately the same in 1941 as in the previous year. That is to say, approximately 11% showed some degree of splenic enlargement, while less ,than 1% showed parasites in their blood. Perhaps if .all the films had been taken at random as they were previously, the proportion of positives would have dropped stiU lJwer. The prevalence of malaria in colored children as indicated by blood film diagnosis dropped from approximately 4% in 1940 to less than 1% in 1941. This difference is borne out by a comparison of the figures for those counties in which a reasonably large number were exemined both years. In brief, these figures added to those of previous
222
Georgia Department of Public Health
reports, indicate that malaria prevalence in white children may have reached a minimum in 1939, while that in colored chirldren did not drop to the same minimum until 1941.
The Fall Survey of 1942 was made on a limited basis, on account of the shortage of personnel in this Division and in the laboratory, and since in county health departments there had been an increase in other activities due to the warr. In some counties surveys were omitted, while in others blood-films were :taken only in regions known to be malarious in the past.
In addition to counties usually surveyed, plans were made to take approximately 300 thick blood-films from counties having control programs supervised by the Division of Public Health Engineering in cooperation with the U. S. Public Health Service, Office of Malaria Control in War Areas. The films were collected from rural regions in which the control program was operating, namely, regions surrounding cantonments and other war activities, and also from persons residing in a zone of five miles outside of the controlled areas. Negro children were eJQamined principally as they seemed to provide the best index, but where possible some white children were included. The data from .the survey are shown in Table IV.
Spleen surveys were omitted eX:cept in one county, Burke, where officers from the U. S. Public Health Service were taken to obtain eJCperience with spleen palpation. All spleens of 141 children were negative, however, as
TABLE IV
PROVISIONAL SUMMARY BY COUNTIES OF 1942 FALL THICK BLOOD-FILM EXAMINATIONS OF ELEMENTARY SCHOOL CHILDREN
County
Blood-films Number Examined
Made
To Date
Baker x ____________________ 1669
Bibb * ____________________ _ 345
Brooks ____________________ _ 316
CBuhraktheam---*--_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_--_
59 300
59 300
Coffee * ___________________ _ 306
306
Colquitt * _________________ _ 331
Dougherty * _______________ _ 169
169
Glvnn * ___________________ _ 300
300
LLeibeer-t-y-*---_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_--_
343 296
343 296
Lowndes * _________________ _ 289
289
Peach ______________________ 296
296
Richmond * ________________ _ 245
Sumter * ------------------- 85 Ware * ____________________ _ 250
Total ______________________ 5599
2358
x Emory University Project. Counties included In control prog.ram for War Areas.
Number Positives
1 2 8
11
Malaria and Hookworm Service
223
were blood-films taken from every fourth child in the group.
Entomological Service
In spite of the changes In the biological staff which occurred during the year, and the necessity for training new persons, some of whom did not remain with the Division even during the balance of the year, the entomological services rendered during the year, 'as summarized in Table V, were three-quarters of the number rendered during l94L In fact, the reduction in the amount of service rendered was due more to the lack of requests for this service on the part of the counties, than to our inability to meet the demands.
Special Investigation
In response to requests from the proper officials, investigations were made by the division biologists of mosquito breeding in the defense areas in the vicinity of Columbus, and at the Lynn Station area in Decatur County. The engineer made a special investigation of mosquito control and filter fly breeding at Cochran Field. In response to requests from officials in county health departments, investigations and reports were made of pest mosquito breeding in Washington, Georgia; of anopheline breeding and the efficiency of larviciding measures 1at the Crisp County Impounded Reservoir; of anopheline breeding in the fish ponds of Bulloch County; of anopheline breeding in the ponds of Worth County; of malaria mosquito breeding and the efficiency of hrviciding measures in Crisp and Sumter Counties; as well as observations on malaria control in Jenkins County, and a report on .a screening project in Liberty County.
Research
During the first part of the year, the Director continued in his capacity as advisor to the Emory University Field Station in Baker County, but when he left the Division, this work was turned over to other agencies. During the summer, in connection with mosquito investigations associated with control operations in various counties, data were collected to supplement those collected in previous years on several long-time studies of mosquito breeding in certain key areas of the State.
A new device for collecting mosquito larvre from certain types of vegetation was originated by one of the division biologists and will be described in a forthcoming publication.
Studies of epidemiological, entomological and climatological data were undertaken and tentative conclusions reached. The results will not be reported until additional data have been collected.
224
Georgia Department of Public Health
v TABLE
ENTOMOLOGICAL FIELD SERVICE
County
Ponds Investigated
1 Baker ------------------------------- 6
2 Bibb ------------------------------- 36 3 Brooks ----------------------------- 1 4 Bulloch ---------------------------- 117 5 Calhoun ____________________________ 2
6 Chatham --------------------------- 21
7 Coffee ----------------------------8 Colqu~t ---------------------------- 10 9 Crisp ------------------------------ 420 10 Decatur ____________________________ 16
11 Dooly ----------------------------12 Dougherty __________________________ 15 13 Glynn ----------------------------- 6 14 Grady ------------------------------ 1 15 Houston ---------------------------- 3
16 Jenkins ----------------------------- 242
17 Lee -------------------------------- 5
18 Liberty _________ ___________________ 48
19 Muscogee --------------------------- 10 20 Pulaski ---------------------------- 5
21 Richmond __________________________ 6 22 Sumter ----------------------------- 51 23 Terrell ----------------------------- 3 24 Thomas ---------------------------- 8 25 VVorth ______________________________ 43
Total ------------------------------ 1075
Searches for Adult
Anophelines 2 24
27 l
2 16 250
28 12 3
178 5
317
4 16 885
Georgia Malarial Bulletin
Three issues of the Georgia Malarial Bulletin have been prepared and distributed during the year. These contained the fourth annual report of the Division; an article on malaria control in Jenkins County during 1941; a brief key ~to the identification of anopheles mosquitoes of Georgia; excerpts from an article on the macroscopic species-identification of larval 'anopheles, and the usual ~tables on malariometry. The contents of the hookworm supplements are discussed below.
Malaria and Hookworm Service
225
Malaria in Georgia. in 1942
There were 76 deaths and 981 cases reported in 1942 as being due to malaria. The deaths were slightly more and the cases slightly less than those reported in 1941, but the differences are probably not significant in either case. The deaths and cases and their respective rates are listed by counties in Taible VI and their distribution shown in Figure l.
The 1942 monthly rates for the State as a whole are projected against the mean monthly rates for ,the previous decennium in Figures 2 and 3. The current rates are not far .different from those of the previous year.
In the previous annual report, mention was made of the significance of the downward ,trend of malaria mortality and morbidity since 1936. The data of Figure 4 indicates .that this trend has not yet been reversed. It was noted in the previous report that rainfall had been deficient for several years and, therefore, surface water acreage was probably markedly reduced and atmospheric humidity low during ,the mosquito season. During the present year, rainfall has been slightly above average for every month in the year with the exception of February, the total for the year being approximately 50 inches or 107% of the average rainfall since 1892. It is especially significant that rainfall was a.bove normal during the winter season when the ground water reservoirs are replenished, and that it remained above normal throughout the mosquito breeding season. It can not yet be said whether this excessive rainfall will have a delayed effect upon mosquito breeding in the coming year. The mean monthly tempem ture during t:he year was approximately equal to the average observations since 1892.
In summary then, the results of mortality and morbidity reports and the data from the Fall Survey indicate that malaria was not significantly higher during 1942 than during the previous year, in spite of the fact that rainfall during the year was above normal. It seems very doubtful if malaria control activities in the State have been sufficiently widespread to account for this low level, and there should be no relaxation of the effort to maintain a control of ,this disease. The potential effect of large numbers of military personnel either non-immune or carrying strains of parasites new to the State has not yet ~been determined. Since malaria epidemics have occurred in Georgia three times at intervals of seven years, a cyclic hypothesis has often been suggested, on the basis of which there would have been postulated a rise in the rates for 1942 and a peak in 1943. The data so far availa!ble show no rise in the rates during 1942.
ANTI-HOOKWORM ACTIVITIES
Two circumstances have tended ,to reduce the amount of anti-hookworm activities that could be carried on during this year. Early in May the Medical Epidemiologist was called to active duty in the Army, and under the present conditions his place could not be filled. Soon thereafter, we were informed that it was impossible to purchase tetrachlorethylene for the treatment of hookworm and the distribution of this drug was therefore stopped during the summer months. By the time the drug again became
226
Georgia Department of Public Health
'available in the fall and plans had been made for its distribution on a limited scale, many county health departments had dropped hookworm work from their county programs.
In spite of these difficulties, however, the figures reported here show that those anti-hookworm activities which can ~be reduced to a numerical form were about three-quarters of the number achieved in 1941. Moreover, hookworm treatments and certain other items far outnumbered those of the previous year. These 'accomplishments were made possible by the Field Nurse continuing her work throughout the year, and by an increase in the number of biologists to three, all of whom were engaged primarily in anti-hookworm aotivi,ties after the opening of the elementary schools in ,the fall. After an intensive educational and promotional campaign, most of the counties formerly doing hookworm work have reinstated it in their programs, and several new counties have started anti-hookworm programs.
Hookworm Control Programs Under War-Time Conditions
Previous reports of .this Division have mentioned a change in emphasis from a broad hookworm survey and trea,tment program to a program consisting of the selection of probable clinical cases with subsequent treatment of these cases and their families. Because of the need for conserving tires and travel time under war conditions, ,the medical epidemiologist devised a system of hookworm clinics. Entire families who have been found to be heavily infected with hookworms are brought to the county seat in school buses, and there given a physical examination and treatment for hookworm disease. Thus the need for a return ~trip on the part of the doctor to ~distribute this treatment was obviated. Later in the year, regulations regarding the use of ~tires again changed, and this program had to be abandoned. At the end of .the year, an attempt was being made in cooperation with the staffs of the regional headquarters to more thoroughly integrate hookworm control work into the bal,ance of the health program of the county departments.
Members of the divisional staff assisted in the organization of selected school surveys in a number of counties, especially where inexperienced nurses have been stationed in newly organized health departments. The school children were examined for the signs of anemia in order to pick suspected hookworm cases, specimens were collected from these children, and if .the resulting egg count proved high, the county nurse was advised to visit the family for the purpose of examining other members. The divisional staff assisted in making some of these visits and frequently made visits with the nurse for purposes of consultation. Subsequent treatment of the families needing such attention was arranged through the cooperation of local physicians. Partially as a result of an eXJperimental approach to the problem of anemia on the part of the divisional staff, a number of counties began the distribution of iron compounds for the improvement of the health of the school children.
A number of the families having a high degree of hookworm infection
Malaria and Hookworm Service
227
were supplied with sanitation as a part of a research program to be described below.
The anti-hookworm aotivi.ties of the staff .of the Division are recorded according to counties in Tables VII and VIII.
On account of the loss of clerical staff, it has not been possible to bring the figures on hookworm egg count up to date, hut they will be published in an early number of the Georg~a Malaria Bulletin. The laboratory reports show that 2,469 egg counts were made, i.e., 72% of the number done in 1941, which is considered a very satisfactory accomplishment in view of the difficulties already mentioned. Calculations based on the usual rate of infection indicate that of the 11,142 index S'pecimens submitted, about 7,000 were submi,tted .for egg count. It is clear that the promotional work of the last two years is beginning to show fruit in a reduction in the number of specimens submitted solely for flotation examination, with a corresponding increase in the proportion of examinations submi,tted for egg count.
Research
Throughout the work of the year, there has been a constant attempt to evaluate scientifically the program described above, namely, the location of suspected hookworm cases and treatment on a family basis. Data are also being collected for eventual analysis to determine more exactly the correlation between symptoms and hookworm egg counts. In a number of .::ounties programs to determine the effects of treatment with preparations containing iron have been started. Egg counts and hemoglobin determinations were made before the treatment began, and will be repea.ted at intervals of three or four months during the 'period of treatment. In most oases an initial anthelmintic treatment was given as well, but in one county the scarcity of physicians has made the use o anthelmintic drugs impossible, and :an attempt is therefore being made to determine how effective treatment wi,th iron compounds alone will ibe.
The experiments which have been carried out during previous years to determine the effect of cold weather on the hookworm infestation of the soil were continued in the winter of 1941 and 1942, and are being continued in the present year. The results indicate the soundness of the previous conclusions, namely that little or no hookworm infection occurs during three or four months of the winter season, even in the most southern part of Georgia. Based on these studies, we are continuing to recommend to health departments that they do all of the treatment possible during this season, so that entire families can be brought to a low level of infection at a time when they will not be liable to immediate reinfection.
The attempt to devise a means of sanitation for hookworm infected families, who usually live at the lowest economic level and cannot afford a standard privy, has been continued. Early in the summer, the sanitarian was transferred to another 'public health agency where his work would be n:ore closely connected to the .defense program, but at ~the end of the mosquito breeding season it was possiJble to assign a biologist to this
228
Georgia Department of Public Health
program for ,the winter season. Observations will have to continue over a period of years before conclusions can be drawn, but the preliminary results are very encouraging from all points of view.
Observations have been continued during the year on various phases of the epidemiology of hookworm diseases. As a result, we feel very confident in saying that our information at the present time indicates that most hookworm infection is acquired in the close proximity of the houses. It is possible that some infection arises in the neighborhood of schools where sanitation is often poor. But since hookworm infection generally occurs in its severest form in specific families where sanitary conditions are poor, the home environment seems to be 'the primary factor at fault. It is still impossible to determine exactly when and where the person acquires his infection, facts which it is desimble to know if a rational program of control is to be instituted. Our information on these points is increasing.
One of the biologists recently attached ,to our staff has already originated a new device for isolating hookworm larvre from the soil. Although this will not replace the well known Baermann isolation apparatus for routine work, it has made possible a solution of certain specific problems of epidemiology.
A cooperative program for a study of immunity in hookworm diseases has been carried out during the year. The program was supported by the International Health Division of the Rockefeller Foundation, and sponsored by the Division of Malaria and Hookworm Service of the Georgia Department of Public Health. The work was under ,the direction of Dr. Gilbert F. Otto, of the School of Hygiene and Public Health, John Hopkins University. He was assisted by Dr. Sterling Brackett, of the School of Public Health, University of North Carolina, and a technician. A laboratory was established in the offices of the Regional Director at Waycross. Assisted by staff members of ,the Division of Malaria and Hookworm Service and by the director and staff of the Branch Laboratory at Waycross, extensive studies were made in the southeastern part of the State. Dr. Otto also made a preliminary visit in January, and will need to make additional return visit of short duration before conclusions can be drawn from the data which he collected.
Hookworm Supplements to the Georgta Malara Bulletin
Each issue of the Georgia Malaria Bulletin during the year carried a hookworm supplement. The script of two radio broadcas,ts on hookworm disease were published in these supplements, while the third issue carried notices with regard to the changes in the recommended hookworm control program and an article on a war-time anti-hookworm program.
EDUCATIONAL ACTIVITIES
The educational activities of the Division have been reduced during the year covered by this report. Several causes contri!buted to this reduction. The loss of engineering personnel on the part of the county health depart-
Malaria and Hookworm Service
229
ments, the reducton of WPA assistance, and the scarcity of materials and labor have made it impossible to organize effective progvams to follow the educational effor,ts. Moreover, the interest of the public has been centered on projects related to civilian defense. There has also been an effort to reduce ~the use of transportation facilities which has contributed to this reduction of educational activities.
In addition to 'addresses given to various district medical and public health groups in ,the State, a number of formal lectures were delivered. The Director twice gave a lecture on malaria investigation and control to the U. S. Public Health Service trainees. He lectured to a conference of the 'public health workers of Alabama on hookworm disease control in Georgia. As Acting Director of the Division of Public Health Education, he addressed the Medical Association of Georgia on Public Health Education for laymen. The Acting Director of this Division addressed the public health classes of nurses at Grady Hospi~al on malaria and hookworm control. The Associate Director also addressed these classes, as well as several classes of trainee nurses in rthe Georgia Department of Public Health on our malaria and hookworm control progvams. He also addressed various groups under the agencies of the American Association of University Women, the P. T. A., District Medical Associations and their various auxiliaries, and the Georgia Teachers College, and lectured to the Alabama Association of Medical Technicians on hookworm egg counting.
The following ten articles were published in scientific journals during the year by members of the divisional staff:
l. Studies on the Concentration and Distribution of Paris-Green-Lime Mixtures Applied as Anopheline Larvicides.-R. S. Howard and Justin Andrews. Amer. Jour. Trop. Med. 22:283-293.
2. Observations on the Macroscopic Species-Identification of Larval Anopheles in Georgia.-R. E. Bellamy. Jour. Parasit., 28:299-310.
3. New Methods of Hookworm Disease Investigation and Control.Justin Andrews. Amer. Jour. Pub. Health, 32:282-288.
4. The Design and Application of a New Type Automatic Siphon.W. A. Legwen, and R. S. Howard, Jr. Jour. Nat. Malaria Soc. 1:83-92.
5. Relation of Hookworm Burden to Physical Status in Georgia.Ar,thur W. Hill and Justin Andrews. Amer. Jour. Trop. Med., 22 :499-506.
6. The Transmission of Endamoeba Histolytica and Amebic Disease.Justin Andrews. Sou. Med. Jour. 35:693-699.
7. The Natural Pattern of Dilution Counts of Helminth Eggs.-J. Allen Scott. Amer. Jour. Trop. Med. 22:647-654.
8. Malaria Control, Ditch-Lining Experience in a South Georgia County.-Justin Andrews, R. S. Howard, Jr., and E. Archer Turner. Jour. Nat. Malaria Soc. 1:57-67.
9. Hookworm Disease Control Methods in Georgia.-Justin Andrews. Jour. Med. Assoc. Ala., April, 1942.
10. Modern Views on the Treatment and Prevention of Hookworm Disease.-Justin Andrews. Annals Int. Med., 17:891-901.
230
Georgia Department of Public Health
TABLE VI
REPORTED MALARIA DEATHS AND CASES AND APPARENT RATES
PER 100,000 PoPULATION IN GEORGIA FOR 1942
County
Mortality
Deaths
Rates
1 Appling ____________________________
2 .Atkinson ---------------------------
14.1
Baker ------------------------------ 3
40.8
4 Baldwin ----------------------------
5 Barrow
Bartow ----------------------------Ben Hill ___________________________
Bibb ------------------------------(Camp Wheeler) -------------------Bleckley ___________ ----------------10 Brooks ----------------------------- 2
11 Bryan -----------------------------12 Bulloch ----------------------------- 1 13 Burke ------------------------------ 4 14 Butts -----------------------------15 Calhoun ----------------------------
16 Candler 17 Carroll -----------------------------
(Fort Oglethorpe) __________________ _
18 Charlton --------------------------19 Chatham ---------------------------
(Hunter Field) --------------------20 Chattahoochee _____________________ _
(Fort Benning) ---------------------
21 Clay ------------------------------22 Cobb ------------------------------23 Coffee -----------------------------24 Colquitt ---------------------------- 3 25 Columbia ---------------------------
6.9
9.8 15.9
3.8 15.1 10.9
14.2 9.1
26 Cook ------------------------------27 Coweta ----------------------------28 Crawford --------------------------29 Crisp -------------------------------- 4 30 Decatur ---------------------------- 3
31 DeKalb ----------------------------(Lawson General Hospital) __________ _
32 Dodge -----------------------------33 Dooly -----------------------------34 Dougherty --------------------------
(Turner Field) ---------------------35 Early ------------------------------ 2
36 Echols ----------------------------37 Effingham -------------------------38 Emanuel --------------------------39 Evans -----------------------------40 Fannin -----------------------------
14.0 22.8 13.5
3.5 10.7 33.7
4.3
Morbidity
Cases
Rates
17
117.3
1
14.1
11
149.8
3
18.3
7.7
7.9
2
13.8
9
10.7
21
2
20.7
64
312.2
13
206.7
16
61.5
47
177.2
1
10.9
7
67.1
54.9
2.9
10
8
152.2
14
11.9
83
14.2
13
34.0
9
41.8
10
30.3
3
31.8
13
109.1
3.7
14.0
6
34.2
13
58.5
8.1
42.8
11.8
30
105.0
1
6
32.1
33.7
51.8
25.5
2
27.0
6.8
Malaria and Hookworm Service
231
TABLE VI (Continued)
REPORTED MALARIA DEATHS AND CASES AND APPARENT RATES
PER 100,000 POPULATION IN GEORGIA FOR 1942
County
Mortality
Deaths
Rates
41 Fayette -----------------------------
42 Floyd ------------------------------
1.8
43 Forsyth ----------------------------
44 Fulton ------------------------------ 3
0.8
45 Glascock ----------------------------
46 Gordon -----------------------------
47 Grady ------------------------------
5.1
18 Greene -----------------------------
49 Gwinnett ---------------------------
50 Hancock ----------------------------
15.7
51 Heard ------------------------------
52 H'Juston ----------------------------
53 Jackson -----------------------------
54 Jefferson ---------------------------
5.0
55 Jenkins -----------------------------
8.4
56 Johnson ----------------------------
7. 7
51 Laurens ---------------------------- 6
17.9
58 Lee --------------------------------
59 Liberty -----------------------------
60 Long -------------------------------
61 Lowndes ----------------------------
3.1
62 Macon -----------------------------
6.3
63 McDuffie ---------------------------
64 Meriwether ------------------------65 Mitchell ___________________________ _
66 Monroe -----------------------------
9.3
67 Muscoge.e --------------------------
6S Peach -----------------------------
9.6
59 Pierce ----------------------------- 1
8.5
70 Pike -------------------------------
71 Polk
72 Pulaski -----------------------------
10.2
73 Randolph ---------------------------
74 Richmond -------------------------- 1
1.2
(Camp Gordon) ---------------------
75 Screven ----------------------------- 3
14.7
76 Seminole --------------------------- 2
23.6
77 Stephens ---------------------------
78 Stewart ----------------------------
9.4
79 Sumter -----------------------------
SO Tattnall ----------------------------
Morbidity
Cases
Rates
12.2
2
3.6
2
17.7
46
11.7
22.0
4
21.7
5.1
2
14.6
3
10.3
2
15.7
4
46.5
4
35.4
12
59.7
14
69.9
28
236.4
2
15.4
18
53.6
21
268.0
2
23.3
2
48.9
54
169.5
4
23.1
1
9.2
5
22.7
1
4.3
1
9.3
3
4.0
4
38.5
8.5
9.6
24.6
9
91.6
4
24.1
10
12.2
1
22
108.1
84
989.2
2
15.4
66.0
11
44.9
2
12.3
232
Georgia Department of Public Health
TABLE VI (Continued)
REPORTED MALARIA DEATHS AND CASES AND APPARENT RATES
PER 100,000 POPULATION IN GEORGIA FOR 1942
County
Mortality
Deaths
Rates
Morbidity
Cases
Rates
81 Telfair
6.6
19.8
82 Terrell
12.0
18.0
83 Thomas ----------------------------
3.2
9
28.8
84 Tift -------------------------------- 1
5.4
3
16.1
85 Toombs __,___________________________ 3
17.7
41.3
i16 Troup -----------------------------81' Twiggs ----------------------------88 Upson -----------------------------89 Walker ----------------------------90 Ware ------------------------------
11.4
11.0
3
32.9
1
4.0
2
6.4
7.2
91 Warren ----------------------------92 Washington ------------------------- 4 93 Wayne ----------------------------94 Webster ---------------------------95 Wheeler ----------------------------
4
39.1
16.5
11
45.4
1
7.6
21.2
11
232.8
23.4
96 Wilcox ----------------------------97 Wilkes _---------------------------98 Worth ------------------------------
7.8
22
172.5
1
6.6
4.1
NOTE: Army camps and Army Forts are exclusive of county totals and follow the counties in which located.
Malaria and Hookworm Service
233
.--------
JIMI 2
1
REPO!irl!:D V.ALA.'IUA MORTALITY IN G!Dl!GU lOR 1942 :BY 140NTI!S
AVl!:RAGE MO~lTHLY DEATH :UTE PER 100,000 PoPULATION, 1932-1941 ( CalCillated on basis of 194o census)
il
i
2. 0 ,... -------------------------------............................................................. ................................... 2. 0 1.56
. 1.14~'1 1.0 ......................_ .............- .......................- ................T~:..~~ ..t--------~---------.................. ~ ............... 1.0
0.5 ...................-
~I
o.61
................................................... ~-------~~--------
.-1?41 1
- ,0.21 i
I
I
.-2.&!-~
11
I
I
I
I 0.15
1!
'"O.i3"
...................-J-6;~-- o.5
0.1
0.05.
;t' ~
o.o1!_, ...:~:_~ ___] ~"-'-~=-\-fiP-\.~~
t
... k
1 i -i ~
~
: r i _
_:~.:_
_
_~G)
_
_.';~1,_
_
~" _<_
_._,
_
_o~~ _ _: _~_
~"
_R
_
0.01
234
Georgia Department of Public Health
FIGURE 3
-19-
UPORTJlli MALARIA MORBIDITY Ill GEORGIA FOR 1942 l!Y MONTHS
50.0 i~~~~~~~~r:~~-~~:::i;1.......................H................ _.......... 50.0 (Calculated on basis of 194o census)
MONT!iLY CASE RATE- 1942
2~.6 24.8
~--l
I ~16 0
to.o --------------- -------;---1-1-.F5 ----------------------------- ------- 10.0 8,2
. . . . . . . ~.:=~ :.:.~~ 6..!l_j
----f.......... __.......... 5 0 .........................................
5. 47
6,
ws- 4 2
4.1
1.0
......... ~
0.29
I
O.lllI
t"
~
~
""
-.5.. :.1
....
"."..
~
::~.:-
~"
...
.....
~
...,.
j
.~..".p,,,. "'
...
Q)
~...,
0"
... ...
.gQ)
Q)
.g
.".. uQ)
~
Q)
101
0,1
Malaria and Hookworm Service
235
~EATH-A.'tlD IJj AliNUAL MALARIA
CASE-BATES REPORTED IN GEORGIA!
1926 - 194;:!, inc.
4oo
Deat!,l Rates per 100,000 - - : ~ ; '
pop1~ation.
11
' '
1
Case Rates per 100,000
'I
30 ~ation.
!, I
,_ ; : ... 300
'
I! I .
I i \'
I
20
--+ ......~.. ! ... 200
j
.
---+I .
j
+-
t-- ...l............
-J. ~-M0-~000-00o!
!
I
I .{............ti......... .........~.
~
5
I
~
,.i . I ~+
...L.... .J. ..
p.,
S 100
,JL::::il
.
.
.
. ..L
1
i-~--
80
8...
~
;\j---+ 60 ~
30
Jl'igure '4
236
Georgia Department of Public Health
-17-
STATE OF' GEORGIA, BOARD OF HEALTH DEPARTMENT OF PJBLIC HEAIJH
Reported
MALARIA DEATH l!ATES l!Y COUNTI:CS
GEORGIA
1942
10.25
25-50
FIGURE I
County
Physical Exams.
1 Brantley ------------------
72
2 Burke ------- ------------------
3 Charlton ----------------------- 484
6 Coffee ----- ------------------- 11 7 Colquitt -----------------------8 Echols _________________________ 9 Jeff Davis ---------------------10 Liberty ---- ---------- -------11 Long ___________________________ 41 12 Lowndes ------------------ ---13 Pierce -- ----------------------14 Tattnall ------------------------ 73 15 Telfair ----------- ------------- 6 16 Turner ------------------------17 \Vare ----- -------------------18 Wayne ------------------------- 23
Total ---------- ------ -- - ---- 720
TABLE VII
EPIDEMIOLOGICAL AND NuRsiNG SERVICE
Hemoglobin 155
Hookworm Treatment
389
Home Vi sots
399
Epid. Misc.
878
303
511
39
72
!".150
350
20
20
20
16
--
70
104
6
37
152
32
54
43
52
151
5
724
101
6o
6
19
41
270
2')
1035
3
1
1
6
27
10
103
1:ll
428
665
2204
8:i1
:1709
Malaria Smears
30 59
353 231
289 --
1 232
1195
Spleen Palp.
--
141 3
--
144
Blood Count
;. ----
----
--
--
--
1 ---
6
Soil Samp.
39
--
~
!.;.:>...
!.;.:.>,
~
!;:>
;::
!;:>,.
::t::
0 0
;"::": '
.0.., ;:;
\J)
.(.I.>,
~
~
120
(I>
l:i9
1:-,j <:.J.')
""-I
238
Georgia Department of Public Health
TABLE VIII
County
SANITATION SERVICE
Sanitary Surveys
Atkinson -------------------------------------- 12 Brantley -------------------------------------- 44 8 Bryan ---------------------------------------- 30 4 Camden --------------------------------------5 Charlton -------------------------------------6 Coffee ----------------------------------------7 Echols ---------------------------------------- 3 8 Glynn ----------------------------------------- 5 9 Laurens --------------------------------------- 78 10 Liberty --------------------------------------- 35 11 Pierce ---------------------------------------- 31 12 Tift ------------------------------------------- 32 13 Turner ---------------------------------------- 6 14 Ware ----------------------------------------- 63 15 Wayne ----------------------------------------
Total ----------------------------------------- 346
Sanitary Units 9 2
1 9
22
Mapping Activities
19 5
2 3 36
Malaria arul Hookworm Service
TABLE EDUCATIONAL AND PROMOTIONAL ACTIVITIES
DuRING THE YEAR 1942
County
Meetings Attended
1 Appling_____________________________ 2 A tklnson___________________________ _
Bacon~-----------------------------
4 Baker-----------------------------Baldwin ___________________________ _
Bibb _______________________________, Bleckley___________________________ _
Brantley---------------------------Rrooks _______ ~---------- ----------- 10 Bryan _____________________________ _
11 Bulloch _____________________________ 12 Burke ___ --------------------------13 Calhoun ___________________________ _ 14 Camden ____________________________ _ 15 Candler---------------------- ______ _
16 Charlton___________________________ _ 17 Chatham ___________________________ _ 18 Chattahoochee ______________________ _ 19 Clarks _____________________________ _ 20 Clay--~-----------------------------
21 Clinch _____________________________ _ 22 Coffee_____________________________ _ 23 Colqu!tt_ ___________________________ _
24 Crisp ------------------------------25 Decatur_ __________________________ -
26 DeKalb ____________________________ _
27 Dooly------------------------------28 Dougherty--------------------------29 Echols _____________________________ _
30 EmanueL ___ ------------------------
31 Evans-----------------------------32 Fulton _____________________________ _
3:3 Glynn ___ --------------------------- 34 Grady-----------------------------35 Houston____________________________ _
36 Irwin ______________________________ _ 37 Jeff Davis_ ________________________ _ 38 Jefferson_____________________________ 39 Jenkins ____________________________ _
40 Lanier-----------------------------
Addresses Made 1 3
2 2 2
20
Exhibits Shown
3
2
239
Consultations, Conferences, Contacts, Etc.
10 12 l7
142 152
4
38
66 41
7 4
40 10 57
8
42 30
3 104
21 1 3 3 3 1 28 1
240
Georgia Department of Pubiic Health
TABLE I (Continued)
EDUCATIONAL AND PROMOTIONAL AcTIVITIEs
DURING THE YEAR 1942
County
Meetings Attended
Addreoses Made
41 Laurens---------------------------- 42 Lee ________________________________ _
43 Liberty __ ----------------------------
44 Long_______________________________
3
45 Lowndes____________________________
46 MitchelL ______ ------~--------------
47 Montgomery------------------------48 Muscogee --------------------------49 Peach ___________ ------------------50 Pierce_____________________________ _
51 PulaskL ___________ -----------------
52 Richmond____ ---------------------- 4 53 Schley__________ ------------------- 54 Seminole____________________________ 55 Sp aiding ____________________________ _
56 Stewart_ ___________________________ _
57 Sumter_-----------------------------
f>8 TattnalL___________________________ _
11
59 Taylor________ --------------------
60 Telfair------------------------------
61 TerrelL _________ -------------------62 Thomas ____________________________ _
63 Tift_ _____ -------------------------- 64 Toombs ____________________________ _
65 TurnHr _______ -----------------------
66 Twiggg _____________________________ _
67 Walker_----------------------------
68 Ware ______ -------------------------
69 Wayne _____ ------------------------
3
70 Wheeler_ _________ ------------------
71 Wilkes ______________________________ 72 Wilkinson ___________________________ 13 Worth______________________________
Out of State____________________________ 8 TotaL__________________________________ 31
Exhibits Shown
2
5
4 25
Consultations, Conferences, Contacts, Etc.
21 1 136 43 21 3
18
1,..,
29 41
4 4 8
302 104
1
Malaria and Hookworm Service
241
TABLE II
SuMMARY BY CouNTIEs oF THE 1941 FALL SPLEEN SuRvEY
OF WHITE ELEMENTARY ScHOOL CHILDREN
No. Ex'd
Baker-------- _____________________ 404
Bulloch -------------------------- 168
Burke____________ -------- _________ 703 Camden__________________________ - 370 Calhoun___________________________ 401
Crisp ---------------------------- 154
Jenkins ___ --------- ________________ 559
Laurens ------ -------------------- 942
Lee______________ ------ ___________ 233 Liberty---------------------------_ 221 Mcln tosh __________________________ 264
Terrell --------------------------- 296
TotaL_____________________________ 47Ei
No.
%
Enlarged Enlarged
% of All Enlarged
P.O. I.
I.
2.
97
24
93
0
18
11
89
11
56
8
80
18
2
20
100
0
0
62
15
79
21
30
20
60
33
7
45
8
87
13
0
93
10
77
22
21
9
100
0
21
10
57
43
0
3
75
12
12
35
12
83
14
3
506
11
83
16
Division of Tuberculosis Control
Nineteen-forty-two has proved to be another banner year in reduction of tuberculosis mortality for the State. There were 1,265 deaths against 1,385 in the year 1941, and the new death rate per 100,000 population is down to 40.5, which is a decrease of nearly 8% for the year and of 45.1% since 1930, and of 16.1% in the past two years. Increased interest by the many public health offices, practicing physicians, and the public in case finding and treatment is no doubt a contributing factor. The doubled bed capacity of the State Tuberculosis Sanatorium and the increased load carried by the participating physicians in the State Health Department's artificial pneumothorax refill program surely have much to do with it.
Three thousand sixty-seven new cases were reported in the year 1942. This is an increase of 432 over the previous year. It may be due to an increase in incidence of tuberculosis, but is rather believed to be due to increased case finding efforts such as that in Fulton and other counties. The discovery of more cases and prompt treatment and effort to prevent spread of infection should result in lowered death rate and infection incidence. The following tables show death and case incidence:
DEATHS AND DEATH RATES
White
Colored
Total Rate per I00,000 Population
No.
1930 ----------------- 774
1931 ----------------- 700
1932 ----------------- 665
1933 1934 1935 1936
----------------- 675 ----------------- 605 ----------------- 649 ----------------- 648
1937 ----------------- 559
1938 ----------------- 602
1939 ----------------- 543
1940 ----------------- 544 1941 ----------------- 501
1942 ----------------- 465
%
No.
36
1401
32
1465
35
1268
38
1102
34
1167
37
1082
38 1065
36
990
37 1010
35
990
35
989
35
884
35
800
%
W&C White Colored W &C
64
2175
42.0
130.6
74.6
68
2165
37.7
135.8
73.7
65
1933
35.4
116.9
65.3
62
1777
35.6
101.1
59.6
66
1772
31.7
106.5
58.9
63
1731
33.6
98.2
57.1
62
1713
33.3
96.2
56.1
64
1549
28.5
89.0
50.3
63
1612
30.3
90.3
52.0
65
1533
27.2
88.1
49.1
65
1a33
26.7
91.2
49.1
65
1385
24.3
81.3
44.0
65
1265
22.8
73.7
40.5
CASES OF TUBERCULOSIS REPORTED IN THE STATE
Number of Cases
Year
Reported
1934 ------------------------ 3647
1935 ------------------------ 3588
1936 ------------------------ 3317
1937 ------------------------ 3016
1938
3011
1939 ------------------------ 2996
1940 ------------------ ----- 2800
1941 ------------------------ 2635
1942 ------------------------ 3067
Rate Per 100,000 Population
121.3 118.4 108.6 98.0
97.1 95.9 89.6 83.8 98.2
Tuberculosis Control
243
An unprecedented amount of x-ray clinic work was done in 1942, as is shown by the following table:
TABLE I
NuMBER OF REGULAR CLINICS AND CLINIC DAYS IN 1942
Month
Number Clinics
Number of Days
Number X-rayed
January -------------------------------------- 23
20
1,211
February ------------------------------------- 26
20
1,521
March ---------------------------------------- 22
22
999
April ----------------------------------------- 19
22
1,447
May ------------------------------------------ 21
21
1,008
June ----------------------------------------- 23
22
1,178
July ------------------------------------------ 18
18
681
August --------------------------------------- 15
16
1,092
September ------------------------------------ 21
22
1,254
October --------------------------------------- 12
12
548
December ------------------------------------- 16
16
678
216
211
11,617
NOTE: No regular clinics were held in November. Special surve,ys were made with the
35 mm. x-ray machine.
TABLE II
DISTRIBUTION OF CLINICS
In 56 counties in 109 clinics organized by health officers___________________ In 59 counties in 99 clinics organized by county health nurses______________ Jackson Lake School-Newton County________________________________________
Emory University-DeKalb County ------------------------------------------Toccoa Falls Institute-Stephens County------------------------------------Georgia State College-Chatham County_______________________________________
Habersham and Piedmont College-Habersham County--------------------------
6848 4111
65
393 72 68
60
Total regular x-rays made in regular clinics__________________________________ Regular x-rays in office of patients referred by physicians_____________________ Regular x-rays in incomplete follow-up study of 35 mm. fluoro-photographlc
surveys -----------------------------------------------------------------
11617 520
263
35 mm. fluoro-photographic surveys in 28 industrial plants promoted by the Division of Industrial Hygiene, representing 48 additional clinic days______
12400 12861
Grand T,otal of X-ray Pictures Made in 1942---------------------------
25261
This work resulted in the finding ,of 553 new cases. Or, including the
54 cases located through the consultation films, in the finding of a total of
607 cases, shown as follows: Number of x-rays in regular clinics___________ ll617~Cases found 443
Number of x-rays in 35 mm. survey follow-up (not completed) _____________________ _ 263-Cases found 17
Number of x-rays made in office_____________ _ 520--Cases found 93
Total _______________________________ 12400
553
Number of consultation x-rays interpreted for physicians requesting it_________________ 652-Cases found 54
244
Gem gia Department of Public Health
Miniature Fluoro-photographic X-ray
In September, 1942, survey work in industrial plants was begun as a part of the program promoted by the Division of Industrial Hygiene and, as shown in Table II, above, 12,861 35mm. chest x-ray films were made. Unfortunately, we have been delayed for many reasons in completing the follow-up by conventional x-ray of 1,873 persons with suspicious and unsatisfactory pictures. It is being completed, however, and the figures will be available at any early date.
The purpose of this phase of case finding is to carry a comparatively cheap x-ray service to large groups such as industrial plants, colleges, and high schools. The film cost is only about 1/20 of that of regular x-ray films. It is also very rapid and an average of 400 to 500 pictures per day is possible.
Shortage and disturbance of personnel, professional and clerical, a natural and unavoidable result of our participation in the present World War, is responsible for our difficulties. It is hoped that the work can be kept up, as it should prove very valuable, espec~ally in the indus.trial field.
Artificial Pneumothorax Program
Five hundred fifty-nine patients, an increase of 170 over the previous year, were under treatment at the end of the year, a total of 646 having been treated in 1942. Of these, 14 or a little over 2% have died, which is considered remarkable because a large number were not conceded to have much chance of being benefited when the pneumothorax was commenced. Only 59 physicians were participating in this program at the end of the year. Thirteen entered military service and five retired from service for various reasons. The average cost per month per patient was only $2.89, which was much helow the anticipated figures of $5.00 per month. Details o.f this service are shown in Tables XI and XII.
Placement of Fluoroscopic-Radiographic. Machines in County Health Offices
During the latter part of the year, 30 fluoroscopic x-ray machines with which chest and other x-ray pictures may be made were purchased by the State Health Department and placed in as many county health offices. These are being used to further tuberculosis case finding and are eXJpected to be used for many other purposes, such as in prenatal and venereal disease clinics, and bone work in nutritional deficiency investigations. Lack of medical personnel in the Division occasioned by the need at the State Tuberculosis Sanatorium for practically full-time service of one of our physicians and part time of another one has unfortunate!y prevented the development of this x-ray service as was planned. However, it is believed possible to make better headway with this program in the coming year.
Tuberculosis Control
245
Follow-up of Rejected Selectees
Reports of selectees rejected because of tuberculosis are received by this Division and the opportunity is offered each rejectee (indeed it is urged) for x-ray and other necessary follow-up diagnostic study and treatment.
County Public Health Services
A study of Table IX reveals some falling off of many services. This is to he expected because of restricted automobile travel. Office visits by patients, admission to sanatoria, relief secured, contacts broken and tuberculin testing have increased or closely approached the 1941 level. The service performed by local public heal,th workers in close cooperation with the medical profession has certainly played an exceedingly important part in case-finding, treatment and disease prevention, and in securing the relief so necessary in most cases. Much, if not most, of the credit for the lowered death rate is due to their intelligent and untiring effort.
Appended are other tables showing det,ail and results of tuberculosis services of this Division and by local public health physicians and nurses.
Georgia Tuberculosis Association
As usual, the Georgia Tuberculosis Association has been most cooperative in securing x-ray examination of persons who cannot secure this service without finandal assistance. This service is especially useful in counties not having local public health services and are not visited by State x-ray clinics, and in other counties between state clinics when the need for x-ray is pressing.
Another of its services is in arranging for assistances to needy cases and their families and for the rehabilitation and vocational training and
job placement of patients needing such services. Mr. J. P. Faulkner, the
Executive Secretary of the Association, has always responded to our many requests for such service and his cheerful response is deeply appreciated, not only by the State Health Department, but by the many recipients of his favors. He may be assured there will be an ever increasing need for these services and it is hoped he may always be able to meet the demand.
In spite of the decreased mortality rate, attention must be called to the still very great need for many more ins,titutional beds; actually more than a thousand additional beds should be provided, either in branch state sanatoria, or by ,the larger cities. It is absolutely impossible with the present facilities to isolate the many, many hundreds of communicable cases who should be domiciled.
246
Geor.gia Department of Public Health
This report would not be complete without a word of thanks to our very efficient Division co-workers:
Dr. John F. Busch, Associate Clinician Dr. Clara B. Barrett, Associate Clinician Mr. T. S. Tinsley, X-ray Technician Mr. D. B. Lewellen, Xray Technician Mr. Wm. Bailey Harrison, X.ray Technician Miss Marie Price, Secretary Mrs. Eleanor A. Almand, Secretary Mrs. Inez Riley, Darkroom Technician arul Typist Miss D. C. Livsey, X-ray Technician arul Clerk Mrs. Cebe Smith, Typist and File Clerk
These have made possible the immense and varied service of this Division.
TABLE Ill
Sul\tMARY OF CAsEs FouND 1942
White
Colored
White and Colored Combined
Number Cases
Number
Cases
Number
Cases
Xrayed Found
%
Xrayed
Found o/o
Xrayed
Found
o/o
Adult Type Original Exams ___________________________ 3185
175
5.5
1915
138
7.2
5100
313
6.1
Adult Type Re-exams ----------------------- ------- 2383
41
1.7
799
28
3.5
3182
69
2.2
""'3
>:::
0""'
Total ----------------------------------------------- 5568
216
3.9
2714
166
6.1
8282
382
4.6
".0..'.
First Infection-Infiltrative Type-Original Exams______ 1202
18
1.5
765
22
2.9
1967
40
2.0
>..:.:.:...
0
First Infection-Infiltrative Type--Re-examinations--- 867
15
1.7
420
6
1.4
1287
21
1.6
~"'-
C')
Total ____ ------------------------------------------- 2069
33
Grand TotaL_________________________________________ 7637
249
1.6 3.3
1185 3899
28
2.4
194
5.0
3254 11536
61 443
1.9 3.8
-.0.;..:..:.!.
0
81 examinations were unclassified because of poor films and lack of proper information.
~
248
Georgia Department of Public Health
TABLE IV
RESULTS OF ORIGINAL ExAMINATIONs, ALL AGES BY SEx AND COLOR SHOWING NUMBERS AND PERCENTAGES
Male
White
Number
o/o
Childhood
Minimal
15
:lfod. Adv. ----- 33 Far. Adv. ______ 32
Total Pos. ---- 88
Suspicious ----- 345
Negative ------- 1774
.36 .68 1.50 1.45 3.99 5.63 80.38
Total ---------- 2207
100.00
Colored
Childhood
14
1\linlmal ------- 4
1\lod. Adv.
21
Far Adv.
54
Total Pos.
93
Suspicious
157
Negative ------- 861
1.26 .36
1.98 4.87 8.37 14.13 77.50
Total --------- 1111
100.00
Female
Number
o/o
10 18 49 28 105 326 1749
.46 .83 2.25 1.28 4.82 14.95 80.23
2180
100.00
Male and Female Combined
Number
o/o
18 33 82 60 193 671 3523
.41 .75 1.87 1.37 4.40 15.30 80.30
4387
100.00
9 12 38 67 210 1292
1569
.51 .57 .77 2.42 4.27 13.38 82.35
100.00
22 13 33 92 160 367 2153
2680
.82 .49 1.23 3.43 5.97 13.70 80.33
100.00
TABLE V
CLASSIFICATION oF THE CAsEs FoUND BY ORIGINAL ExAMINATIONS AccoRDING To
STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES
White Age Groups
Up to 17
No.
%
17-45
No.
%
46 Up
No.
'.it-
Minimal ------------------------------------ 2 Mod. Adv. ----------------------------------- 1 l'ar Adv. ----------------------------------- 1 Total ______________ -- _______________ ------ -- 4
1.14
25
.57
56
.57
46
2.28
127
14.29
6
32.00
25
26.28
13
72.57
44
3.43 14.29
7.43 2G.l5
Colored
Minimal ------------------------ _____ ------- 1 Mod. Adv. __________________________________ 1 Far Adv. ____________ ----------------------- 7 Total -------- ------------------------------- 9
.72
10
.72
23
5.08
67
6.52
100
7.25
2
16.67
9
48.5;)
18
72.47
29
1.45 6.52 13.04 21.01
All Cases
No.
(Yo
33
18.8~
'""'l
~
82 60
46.86
0"
34.28
~ ....
~
175
100.00 .c~.....
;";';
("')
13 33
9.42 23.91
c ..~....... ;2...
92
66.67
138
100.00
1:-.J
~
~
0
TABLE VI
NuMBER AND PERCENTAGE oF CAsEs FoUND BY FIRsT ExAMINATIONs IN RELATION To NuMBER X-RAYED, MALE AND FEMALE CoMBINED, CLAssiFIED AccoRDING To STAGE AND AGE GROUP
White Age Groups
Number X-rayed
Up to 17-------------------------------- 1205 17-45 ------------------------------------ 2515 46 Up ----------------------------------- 667 Total ------------------------------------ 4387
Colored Up to 17--------------------------------- 774 17-45 ------------------------------------ 1565 46 Up ------------------------------------ 341 Total ------------------------------------ 2680
Minimal
No.
%
2
.17
25
.99
6
.90
33
.75
1
.13
10
.64
2
.59
13
.49
Cases Found
Mod. Adv.
No.
%
1
.08
56
2.23
25
3.75
82
1.86
1
.13
23
1.47
9
2.64
33
1.23
Far Adv.
No.
%
1
.08
46
1.83
13
1.95
60
1.38
7
.90
67
4.28
18
5.27
92
3.43
~
All Cases
<11
0
No.
% ~.....
4
.33 ~
127
5.05
1::::1
<11
44 175
... 6.60 ~....
3.99 ~
...;<::1s1
9
1.16 ~
100 29
6.39 8.50
~
o!.;..:-..
138
5.15 ~
::X::
<11
s~ :
TABLE VII
1942
NuMBER AND PERCENTAGE oF CAsEs FouND BY RE-EXAMINATIONS IN RELATION TO THE NuMBER X-RAYED,
MALE AND FEMALE CoMBINED, CLASSIFIED AccoRDING TO STAGE AND AGE GROUP
---
Cases Found
White Age Group
Number X-rayed
Up to 17------------------------------------- 867 17-45 --------------------------------------- 1809 46 Up --------------------------------------- 574 Total --------------------------------------- 3250
Colored
Up to 17------------------------------------- 420 17-45 --------------------------------------- 624 46 Up -------------------------------------- 175 Total --------------------------------------- 1219
Minimal
No.
%
4
.46
16
.88
3
.52
23
.71
2
.48
4
.64
2
1.14
8
.66
Mod. Adv.
No.
%
1
.12
9
.50
3
.52
13
.40
2
.48
5
.80
1
.57
8
.66
Far Adv.
No.
%
0
.00
4
.22
1
.17
5
.15
3
.71
9
1.44
0
.00
12
.98
All Cases
No.
%
5
.58
;'":"::"'3
o-
29
1.60 .<..b.
7 41
1.21 1.26
~.c.....
~"'-
~
7
1.67 ...c;...:...s.....
18
2.88
3
1.71
28
2.30
1>;1
I..J...l.
- -----------,
252
Georgia Department of Public Health
TABLE VIII
RESULTS OF INTERPRETATION OF FILMS REFERRED BY PHYSICIANS
January 1 Through December 31, 1942
New Cases:
Childhood
2
Minimal
3
Moderately Advanced ------------------------------------------------------ 22
Far Advanced -------------------------------------------------------------- 27
Total Positive -------------------------------------------------------------
54
Suspicious ----------------------------------------------------------------- 97 Negative ------------------------------------------------------------------- 226 323
Cases on Which Previous Diagnosis Had Been Made:
Films sent in for review on cases that had been previously diagnosed and
no change shown -------------------------------------------------------
275
TOTAL OF ALL FILMS SEXT I~ FOR INTERPRETATIOX IN 1942_____________
652
TABLE IX
PuBLic HEALTH TuBERCULOSIS CoNTROL AcTIVITIES
1941 and 1942
Year 1941
Cases of tuberculosis admitted to service________ ----------------- 4,499
Visits to tuberculosis cases, contacts and suspects----------------- 67,358 Visits to cases of tuberculosis ____________________________________ 19,415
Average number of visits to cases of tuberculosis __ _________ __ __
4.32
Office visits by cases of tuberculosis____________________________ 5,591
Admission to sanatoria___________________________________________ 673
Number completed tuberculin tests________________________________ 24,960
Number positive ---------------------------------------------
Contacts broken ------------------------------------------------Contacts partly broken __________________ -----------------------__ Relief secured-number of cases___________________________________
8,688
1,437 368 667
Tuberculosis cottages built______ -------------------------------- 13 Public lectures and talks on tuberculosis____________________________ 670
Year 1942 ~ 63,!)75 16,707
3.98 5,773
746 25,278
7,655 1,406
396 651
11 376
TABLE X
RESULTS OF INTERPRETATION OF X-RAY FILMS MADE IN GENERAL OFFICE
January 1 Through December 31, 1942
Original Examinations Childhood cases Minimal cases ----------------------------------------------------------------------- 4 Moderate advanced cases-------------------------------------------------------------- 16 Far advanced caseS------------------------------------------------------------------- 16
Total positive ------------------------------------------------------------------------ 43 Suspicious --------------------------------------------------------------------------- 57 ~egative _____________________________________________________ ------------------------ 233
Total ------------------------------------------------------------------------------- 353
Tuberculosis Sanatorium
253
Re-examinations
Childhood cases --------------------------------------------------------------------- 4 Minimal cases ----------------------------------------------------------------------- 11 Moderately advanced cases ____________________________________________________________ 1j Far advanced cases___________________________________________________________________ _ 18
Total positive ----------------------------------------------------------------------- 50
Suspicious
15
Negative
102
Total __
167
Total of All X-rays Made in Office_____________________________________________________ 520
TABLE XI
STATE PNEUMOTHORAX REFILL PROGRAM
Year 1942
Number of patients unde.r treatment January 1, 1942__________________________ 389 New cases admitted to service during 1942 ___________________________________ 237
Total cases under treatment during 1942 ________________ -----------------------
646
Patients dropped from Service during 1942: Admitted to sanatorium____________________________________________________ 44
Pneumothorax discontinued ____ ------------------------------------------- 17
Pneumothorax unsuccessful ------------------------------------- 14
Disease arrested ----------------------------------------------- 3 Discharged to private physician--------------------------------------------
Moved -------------------------------------------------------------------Deaths _________ __ __ __ ____ _____ ____________ __ ____ ____ _____ ____ __ _______ ___ 14
Total patients dropped from Service during 1942----------------------------Total Number of Patients Under Treatment Jlecember 31, 1942 __ __________ ____
-8 7 559
TABLE XII
STATE PNEUMOTHORAX REFILL PROGRAM CosTs
Year 1942
Number Patients
1942
On List at End of
Month
Month
January __________ -------------------------------------- 402
February ____ ------------------------------------------- 408
March -------------------- ----------------------------- 404
April -------------------------------------------------- 415 May __________________ --------------------------------- 431
June
448
July
482
August
_ ------------------------------------------- 494
September ___ ___ ______ ____ ____ __ __ ____ ____ ___________ ___ 50 4
October _____ ------------------------------------------- 528
November
546
December
559
Total _______ ----------------- _------------------------Total average per month ________________________________ 468
Average cost per patient________________________________ 2.89
Total Cost Per Month
$ 1,164.00 1,119.'JO 1,190.00 1,264.00 1,169.00 1,529.00 1,378.50 1,416.00 1,444.50 1,666.00 1,484.00 1,442.00
$16,266.50 $ 1,355.54
ExAMINATIONs MADE AT TuBERCULOSIS CLINICS
Original Examinations _________________ 7148
- - Re-examinations ----------------------- 4469 Total ------------- _______________ 11617
Counties, 205
Year 1942
White
* 20
To 16
Age Male
* 10
17-45
46 up
Childhood T.B. ------------------------------ 7
1
0
Minimal ------------------------------------- 1
11
3
Mod. Adv. ---------------------------------- 1
22
10
26
5
10
60
18
Suspicious ------------------------------- 109
145
91
515
1032
227
Total --------------------------------- 634
1237
336
Colored
3
* 10
*I
Childhood T.B. ------------------------------ 14
0
0
Minimal ------------------------------------ 0
4
0
Mod. Adv. ----------------------------------- 1
13
7
Far Adv. ----------------------------------- 5
36
13
Total Positive ------------------------------- 20
53
20
52
90
15
282
457
122
Total ----------------------------------- 354
600
157
Date, 1942
Total Male
8 15 33 32 88 345 1774
2207
14 4
21 54 93 157 861
1111
*9 To 16
10 1 0 0
11 74 486
571
9
8 1 0 2 11 66 343
420
Number Clinics, 216
Age Female *6 17-45
46 Up
Total Female
0 14 34 20 68
164
1046
0
10
3
18
15
49
8
28
26
105
88
326
217
1749
1278
331
2180
* 10
0 6 10 31 47
120
798
*I
0
8
2
9
2
12
5
38
9
67
24
210
151
1292
965
184
1569
Unclassified~81
Re-examinations: White~3250
Black~1219
Total~4469
t-.:l <:.11
~
((;)
Cb
Total
~
<1'l
18 iS"
33 82 60 193
~
~
...!.;.:>.,
671
;3
Cb
3523
1::.
4387 --c....
."::t:::
<..:.:.!.".
22
0~-
13 ::r::
33 92
Cb
~
160
;::-
367
2153
2680
STATE TUBERCULOSIS SANATORIUM
John W. Oden, M.D. _________________ -c _______________Superintendent
MEDICAL STAFF
F. C. Whelchel, M.D. Fred Crenshaw, M.D.
H. E. Crow, M.D. Robert H. Cox, M.D. Norman L. Anderson, M.D. Glenn P. Dewberry, M.D.
C. D. Whelchel, M.D. __________________ Thoracic:; Surgeon, Non.resident
John G. Scott, D.D.S. ____________________________ Dentist, Non-resident
Patient days in 1942 increased from 168,171 in the previous year to 216,323, and the average daily census from 461 in 1941 to 593. The daily per capita net cost was 1.897 against 1.888 in 1941.
Number of patients admitted, treated and discharged during the year is shown as follows: Patients remaining December 31, 194L_______________________ 573 Patients admitted in 1942___________________________________ 759 Total number of patients treated in 1942______________________ 1,332 Number of patients discharged in 1942________________________ 770 Patients remaining December 31, 1942________________________ 562
Greater detail concerning patients by color, sex, age and disease classification is given in the appended tables, numbers 1 to 12. Some of these tables compare figures for 1941 and 1942.
A study of the .table.;; of x-ray, 1uboratory and operating procedures, which are comparative for the years 1941 and 1942, will afford some idea of ,~he enormous amount of work done at the Sanatorium as well as of its nature.
Especial attention is called to the increase of x-roy service, 20,608 examinations in 1942 against 12,352 in 1941, and in operative procedures which amounted to 25,919 in 1942 and 17,103 in 1941. This work has been done and has been kept up to a high level in spite of war conditions and the resultant effect of reducing personnel and making personnel replacements difficult. Inadequate employee housing is a fu;ther contributing factor toward the latter difficulty.
Function of the Sanatorium
For several years (since 1937) the Sanatorium has bet>a an integral part of the tuberculosis control program of the State Health Department and this integration has been of distinct value in the control of tuberculosis and the reduced death rate. (See 1942 report of the Division of Tuberculosis Control.) The policy of admitting patients chiefly for lung collapse measures when indicated and depending on community resources for the
256
Georgia Department of Public Health
bed care of those requiring only such measures has worked out as affording the greatest good to the greatest number.
The State has more than 5,000 known cases of tuberculosis. One thousand three hundred thirty-two received treatment in the Sanatorium in 1942. More than 600 received artificial pneumothorax and pneumoperitoneum refills after discharge from the Sanatorium through the State Health Department and the 70 or more practicing physicians who par ticipate in this program. The rest of the 5,000 tuberculosis patients are being supervised by the county and city public health physicians and nurses, and the latter secure additional aid through local physicians, the local welfare departments, state and local tuberculosis associations, civic clubs, the relatives of patients and of interested individuals.
Although the Sanatorium beds are being used primarily for lung collapse cases, some few patients constituting particularly difficult public health menace problems are admitted when, after investigation and effort by the proper authorities, no other solution of the problem can be found. In order to prevent the Sanatorium from becoming filled with what may be termed "boarder" patients there should be no let up in effort to provide a way for them to be cared for in their own communities so that they may be discharged as early as possible. It is obvious that the State Tuberculosis Sanatorium with its approximate bed capacity of 600 can house a.t one time only 12% of known patients. The above policy of admission is fair and efficient under the circumstances and every effort should be made to keep it in force.
A word should be added in reference to the colored patient situation. An attempt is being made to put the same policy of admission in effect for Negroes, but because the proportion of beds is much smaller than that of the whites, the need being greater, less institutional care can be given and more by local communities is necessary.
Recommendations
CHILDREN'S BUILDING.
It is recommended that the Children's Building should be closed to P'atients. Usually only three or four of the seventeen or eighteen patients cared for in this building require treatment, and those who do can be cared for properly in the Main Building or in the Annex. It would have the effect of releasing four nurses badly needed for other service and to close the kitchen and dietary service now in operation in this building.
J,t would temporarily, at least, relieve some of the acute employee housing situation if some of the moms and other space could be utilized for ,the purpose. It would be a measure of real economy, so sorely needed in these times, and would serve a much better purpose than it does now.
Future Planning
The need for adequate housing of all personnel for whom it may be required should be gone into thoroughly so that needs, plans and costs can be presented at the first suitable time.
Tuberculosis Sanatorium
257
Repairs
A great amount of repairing has become necessary and it is expected that a list of these will soon be availaible showing in what order they are necessary and estimated costs.
Need for Additional Funds
It is believed to be absolutely impossible to operate the Sanatorium to its full capacity in the future within the limits imposed by the present appropriation. The per capita cost for the fiscal year July I, 1941, to June 30, 1942, was 1.888. Since then supplies of all kinds have increased in cost and are still increasing. So have wages and salaries. The funds previously made av,ailable have not been enough to operate on and to properly keep up the buildings and plant. In addition to the increasing demands for repairs, stocks of supplies purchased when their cost was lower are rapidly diminishing. Help of all kinds is being lost. We are always short-handed, and inexperienced help, even difficult to secure, must fill,the vacancies. The only remedy for the latter is increased pay, which would no doubt be cheaper in the end. It is firmly believed, no matter how we economize, that we will very soon be faced with the alternative of greatly reducing our patient load and our personnel if sufficient money is not provided to meet the increasing costs of supplies and service. An additional report setting forth in more detail what will be needed is being made up and will be presented at a later date.
Conclusion
The year 1942 was marked by many administration changes:
Dr. Sharp resigned the superintendency September 8, 1942, and was succeeded by Dr. John F. Busch, who carried on as Acting Superintendent until the appointment of Dr. John W. Oden, September 20, 1942. Dr. Oden was forced to resign by sudden illness from which he did not recover sufficiently to resume his duties, and again Dr. Busch functioned as Acting Superintendent.
The resignation of Dr. Busch made it necessary for the Director, Division of Tuberculosis Control, to act as superintendent beginning January ll, 1943. Dr. Sharp resigned to enter the United States Public Health Service, and Dr. Busch to enter the service of the American Red Cross. This is an illustration of one of the many personnel difficulties encountered and explains the unavoidably delayed report which had to be prepared.
258
Georgia Department of Public Health
Patients Remaining
12-31-41
White Men ---------------- 202 White Women ------------- 230 White Boys --------------- 12 White Girls --------------- 10 Colored Men --------------- 37 Colored \Vomen ----------- 66 Colored Boys --------------Colored Girls --------------
Total -------------- ------- 573
TABLE
Patients Admitted In 1942
296 262
25 19 75 69
5
759
Total Treated In 1942
498 492
37 29 112 135 17 12
1,332
Patients Discharged
In 1942
286 285
25 22 61 70 11 10
770
Patients Remaining
12-31-42
212 207
12
51 65
6
562
TABLE II
AGE AND SEX OF PATIENTS DISCHARGED
From January 1, 1942, Through December 31, 1942
Age Grc ups
Male
1-10 -------------------------------------------------------- 27
11-20 ------------------------------------------------------- 38
21-30
110
31-40
99
41-50 ------------------------------------------------------- 49
51-60 ------------------------------------------------------- 45
61-70
11
71-80
Total
384
Female
27 61 132 84 48 25
9 0
386
TABLE Ill
CoMPARISON oF NuMBER oF PATIENTS ADMITTED IN YEARS oF
1941 AND 1942
1941
1942
White Men -------------------------------------------- ______ 332
296
White Women ------------------------------------------------ 312
262
White Boys --------------------------------------------------- 20
25
White Girls -------------------------------------------------- 21
19
Colored Men ----------------------------------------- _________ 49
75
Colored Women ----------------------------------------------- 79
69
Colored Boys ------------------------------------------------- 5
8
Colored Girls -------------------------------------------------
Total -------------------------------------------------------- 829
759
Tuberculosis Sanatorium
259
TABLE IV COMPARISON OF NUMBER OF PATIENTS DISCHARGED IN YEARS
1941 AND 1942
1941
White Men --------------------------------~~----------------- 251 White Women ------------------------------------------------ 218 White Boys --------------------------------------------------- 19 White Girls --------------------------------------------------- 23 Colored Men ------------------------------------------------- 45 Colored Women --------------------------------~ ________ ______ 65 Colored Boys --------------------------------------------- ____ 1 Colored Girls ------------------------~ ------------------------
Total --------------------------------------------------------- 623
1942
286 285
2~
22 61 iO 11 10
770
TABLE V
ADMISSION CLASSIFICATION OF WHITE PATIENTS
January 1, 1942-December 31, 1942
Far advanced ------------------------------------------------------------------------ 232 Moderately advanced __ ___ _______ __ _______ ___ _____ ___ ____ ___ __ __ ______ __ __ ______ ____ __ 191 Minimal ----------------------------------------------------------------------------- 27 Primary Type ------------------------------------------------------------------------ 37 Miliary __________________ ------------- ______________________________________________ _ Suspicious _________________________________________________________________________ _
Non-tuberculous --------------------------------------------------------------------- 20 Tuberculous Pleurisy ----------------------------------------------------------------Undiagnosed ------------------------------------------------------------------------- 84
Total ------------------------------------------------------------------------------- 603
TABLE VI
ADMISSION CLASSIFICATION OF COLORED PATIENTS
January 1, 1942-December 31, 1942
Far advanced _______________________________ --------------------------~------------- 85
:lloderately advanced --------------------- -------------------------------------------- 30 :Minimal _____ ____ _______________________________ ~-- _____ __ __ __ __ _______ ___ __ _______ __ 13
Primary Type _______ ----------------- ____ ------------------------------------------- 9 )liliary ________________________ ----- ____________________________________ --------- __ _
Suspicious
1
Non-tuberculous ________ -- __________________________________ ------------------------- 0
Tuberculous Pleurisy -----------------------------------------------------------------
Undiagnosed ------------------------------------------------------------------------- 17
Total ____________ ---------------------- _____________ __________________ ___ __________ __ 17
260
Georgia Department of Public Health
TABLE VII
DISCHARGE CLASSIFICATION OF WHITE PATIENTS January 1, 1942-December 31, 1942
Heal. App.Heal. Arrest.App. Arr. Qules. Imp. Unimp. Died
Far advanced
0
0
1
Moderately advanced _
6
Minimal _____________ 0
0
Primary Type -------
2
0
M!Jiary ______________ 0
0
0
Suspicious ---------- 0
Non-tuberculous ----- 0
0
Tbc. Adenitis ________
Tbc. Pleurisy ------- 0
Undiagnosed _________ 0
0
0
Total ---------------
1
8
80
70
63
9
36
131
36
4
3
9
14
4
36
0
0
0
0
0
0
19
0
0
42
1
2
0
1
0
0
0
7
0
29
13
53
359
112
69
Total
223 225
30 39
19 45
1
29 619
TABLE VIII
DISCHARGE CLASSIFICATION OF CoLORED PATIENTS January 1, 1942-December 31, 1942
Heal. App.Heal. Arrest.App. Arr. Quies. Imp. Unimp. Died
Far advanced ________ 0
0
0
1
16
20
35
Moderately advanced~- 0
0
6
17
5
3
Minimal ------------
0
2
6
2
0
Primary Type -------
6
Mil!ary ______________ 0
0
0
0
11
0
0
0
0
Suspicious ___________ 0
0
0
Non-tuberculous ----- 0
0
0
Tbc. Pleurisy ________ 0
0
0
0
6
0
0
Undiagnosed --------
0
0
Total ----------------
0
15
10
59
27
39
Total 73 33 15 20
1 6
151
Tuberculosis Sanatorium
261
TABLE IX
COMPARATIVE X-RAY REPORT OF THE YEARS 1941 AND 1942
1941
1942
F!uoroscopics (Colored and White) --------------------------------- 12,352 X- rays ------------------------------------------------------------ 5,732 Flats __ -------------------------- __________________ ------------- __ 4,976 Buckys __________________________ --------------------------------- 30
Stereos
58
Colon X-rays ________________ ------------------- __________________ _
G. I. -- -----------------------------------------------------------
48
Bone Plates ____________ ------------------------------------------- 113
Portables ----------------------------- .. ----------------------------
99
Fluid X- rays -------------------------------------------.. -- -------
16
Kidney X-rays
25
Mastoid X-rays
Sinus X-rays ------------------------------------------------------
12
Lateral Chest X-rays______________________________________________ _
0
Skull X-rays -------------------------------------------------------
Obliques ---------------------------- ------------------ ___________ _
Fetus X-rays ------------------------------------------------------
Photo Roentgenoscope --------------------------------------------- 343
B. M. R. ----------------------------------------------------------- 13
E. K. G-----------------------------------------------------------
21
White Adults: House Patil'nts Consultation Patients
3,009 1,502
White Children :
House Patients --~---------------------- --------------------------- 200
Consultation Patients
183
Colored Adults:
House Patients
650
Consultation Patients
144
Colored Children :
House Patients ---------------------------------------------------- 44
Consultation Patients
0
Lipiodol Injections :
House Patients ----------------------------------------------------
11
Consultation Patients ----------------------------------------------
20,608 6,525 5,468 1 57 2 57 115 31 0 27 1 19 0
0
747
36
3,679 1,474
167 163
755 256
30
26 4
In the clinic at the Sanatorium 75 new cases of pulmonary tuberculosis were found from January 1, 1942, through December 31, 1942.
Four hundred and eighty-two of the consultation x-rays sent in by outside physicians, during the year 1942, were positive. How many were previously diagnosed is not shown.
262
Georgia Department of Public Health
TABLE X
CoMPARATIVE LABORATORY REPORT oF YEARS 1941 AND 1942
1941
Sputum: Direct Smear -------------------------------------------------Concentration ___ ___ ___ ______ ____ ____ _____ _______ ________ __ __ ___ Culture ____ __ ____ ______ ________ ___ __ ___ __ ___ _____ _____ __ _______
4,784 5 65
4 23
Animal Inoculation (S.B.H.) ------------------------------------ 12
Fontana ------------------------------------------------------- 59
Fungus -------------------------------------------------------- 11
Fungus Culture -----------------------------------------------
0
Blood: Culture
Count --------------------------------------------------------CoagulaJ!lon --------------------------------------------------Typing -------------------------------------------------------Crossmatchlng _______________ ----------------------------------
Kahn (S.B.H.) ------------------------------------------------Malaria -------------------------------------------------------
1,345 208 220 116
885 29
Blood Chemistry : Sedimentation
Blood Sugar Urea- Nitrogen
________________________________________________ _
Sulfanilamide -------------------------------------------------N. P. N -------------------------------------------------------
1,012 37
5 6
Urine:
p. s. p ----------- --------------------------------------------
Routine ______ ---------------------- ----------------------------
Culture
4,101
Feees:
Routine
104
Culture
6
Pleural Fluid:
Smear ~ ______________________________________________________ _ 107
Cuiture ______________________________________________________ _
37
Secondary Organisms __________________________________________
Spinal Fluid :
Routine
13
Culture
2
Smears:
Mixed Organisms ______________________________________________
47
Gonococci _______ ----- _______________________________ ------- __ _ 23
Pneumococci ________________________________ ------------ _____ _
2
Staphylococci _________________________________________________ _
Streptococci -------------------------------------------------------
6
Vincents _________________________________ ---------------------
Colon Bac!Ill --------------------------------------------------
Bacteria Count :
Milk ___________ ~--- ___________________________________________ _
11
1942
3,430 396 302 49 23 15 2
1,239 188 77 65 917 15
1,230 73 3
15
5,038 5
34
183 140
0
13 2
11
1~
2 6 2
0
Tuberculosis Sanatorium
263
TABLE X (Continued)
CoMPARATIVE LABORATORY REPORT oF YEARS 1941 AND 1942
1941
Gastric:
Direct Smear ___________ ------------ ______ ---------------------
2
Routine ______________________________________________________ _
6
Cuiture _______________________________________________________
Animal Inoculation (S.B.H.) ------------------------------------ 21 Analysis ______________________________________________________
Miscellaneous :
Abdominal Fluid ----------------------------------------------
0
Agglutination Test ________________ -----------------------------
0
Bleeding Time __ -------------------------------- ______________ _ Cholestoral ___________________________________________________ _
Creatinine __________________________ ----------'----------------
0
Diphtheria Culture _____ ----------------------------------------
0
Diphtheria Smear __ -------------------- _-----------------------
Direct Smear-Buttocks Abscess_________________________________
0
Drainage from Abscess -----------------------------------------
0
Ear Smear for Tuberculosis -------------------------------------
0
Febrile Antigens -----------------------------------------------
G. C. Culture --------------------------------------------------
3
Glucose Tolerance _____________________________________________ _
0
Gram Stain-Drainage from Abscess ----------------------------
0
Gram Smear _____ ------------------------------ ______________ _
2
Knee Fluid Culture --------------------------------------------
1
Mastic Test ____________________________________________________
4
Sickle Test ___________________________________________________ _
Silicosis (Saranac Lake) ---------------------------------------
Sulfathiazole Test ___________ ----------------------------------
0
T.B. Smear _______ ---------------------------------------------
6
Total _____________ ----------------------------- __ ____________ _____ ___ 14.263
1942
28 21
2 4
1 2 1 0
8 0 13.595
264
Georgia Department of Public Health
TABLE XI
CoMPARATIVE OPERATING RooM REPORT OF YEARS 1941 AND 1942
1941
Thoracic Surgical Procedures:
ApioolYses Bronchoscopic Examinations --------------------------------------Inci&ion and Drainage of Abscesses ------------------------------ __ Incision and Drainage of Lung Abscesses _____ ----------------------Incision and Drainage of Pleural Cavity ---------------------------Injection of Intercostal Nerve --------------------------- _________ _ Instillation of Continuous Irrigation ----------------------------- __ _ Irrigation of Pleural Space ----------------------------------------Lobectomies ______________________________________________________ _
Monaldi Tube Inserted ------------------------------------------- __ Oleothorax, Avg. No. P.atients Receiving ____________________________ _
28 1 0
1,227 1 3
Oleothorax, Refills -------------------------------- _______________ _ 79
Oleothorax, Out-Patients Receiving ______________________________ _
3
Oleothorax, Out-Pat10nts Refills ______________________________ _
8
Oleothorax, Removal of ---------------------------------------------
Phrenicotomies --------------------------- __ ___ ____ ______________ _ 116
Phrenicotomies, Out-Patients ---------------------- _________ _
0
Pneumolyses: Patients ______________________ --------------- _____ _ 23
Pneumolyses :
First Stage ________ ------ ____________ -- ------------------------ 23 Second Stage _________________________________________________ _
Third Stage ___________ ----------------------------------------
1
Pneumoperitoneum, Inlttal ------------------------------------------ 22 Pneumoperitoneum, Avg. No. Patients Receiving _____________________ _ 41
Pneumoperitoneum, Refills ----------------------------------------- 1,927
Pneumoperitoneum Patients Discharged ---------------------------- 12
Pneumoperitoneum Patients Discontinued ---------------------------- 17
Pneumoperitoneum, Avg. No. Out-Patients Receiving-----------------Pneumoperitoneum, Out-Patient Refills______________________________ _ 16
Pneumothovaces, Initial __ ----------------------------------------- 382
Pneumothoraces, Successful ---------------------------------------- 194
Pneumothoraces, Unsuccessful -------------------------------------- 271 Pneumothorax, Avg. No. Patients Receiving_________________________ _ 110
P-neumothorax, Refills -------------------------------------------- 9,195
Pneumothorax, Patients Admitted with______________________________ _
0
Pneumothorax Patients Discharged -------------------------------- 100
Pneumothorax Patients Discontinued ------------------------------- 59
Pneumothorax, Avg. No. Out-Patients Receiving__ ------------------- 18
Pneumothorax, Out-Patient Refills ________________ ------------------ 381
Removal of Air ---------------------------------------------------- 145
Removal of Part of Scapula ----------------------------------------
1
Rib Resections ----------------------------------------------------
0
Rib Resection and Tube Insertion ----------------------------------
Secondary Closure of Thoracoplasty Wound -------------------------
2
Thoracenteses ____________________________________________________ _ 2,093
Thoracenteses, Out-Patients ----------------------------------------
2
Thoracoplasties: Patients ----------------------------- _------------ 48
Thoracoplasties :
First Stage
48
1942
45 2 3 2
2,568 1 0
41 0 0
257 1
27
27 4
129 62
5,475 30 7
24 218 155
54 132 11,732
8 130
81 29 174 111
0 1 0
2,851 1
38
38
Tuberculosis Sanatorium
265
TABLE XI (Continued)
CoMPARATIVE OPERATING RooM REPORT oF YEARs 1941 AND 1942
Second Stage ------------------------------------------------Third Stage --------------------------------------------------Third Stage~Anter!.or -----------------------------------------Fourth Stage -------------------------------------------------Fourth Stage~Anterior ---------------------------------------Fifth Stage --------------------------------------------------Sixth Stage --------------------------------------------------Sixth S!age--Anter!or _________________________________________ _
Seventh Stage ------------------------------------------------Thoracotomies _____________________________________________________
Transpleural Decompression ---------------------------------------Tube Inserted In Pleural Cavity ------------------------------------
Deaths During Surgical Procedures:
1941 48 46 30 0
13
Other Surgical Procedures:
Appendectomies ___________________________________________________ _
Blood Tran.sfusions ____________________ ---------------------------- 30
Coccygotoml es ____________________________________________________ _
0
Curette ,of Sinuses -------------------------------------------------
DHation and Curettage ---------------------------------------------
Enucleation of Eye ------------------------------------------------
Lumbar Punctures ___ ---------------------------------------------l\Iastoidectomies __________________________ ------------ ____________ _
Removal of Cysts ___ ----------------------------------------------Removal of Growth from Breast -----------------------------------Removal of Growth from Forehead -------------------------------Removal ,o.f Growth from Mouth _____________ -----------------------
Removal ,of Lymph Xode -------------------- __ --------------------
Removal of Wart from Hand ---------------------------------------
Therapeutic Abortions ----------------------------------------------
Tubes Inserted ----------------------------------------------------
10
Other Operating Room Procedures:
Antiluetic Treatments, Avg. No. Patients Receiving______________
12
Antiluetic Treatments, No. Given ----------------------------------- 709
App!ica.tion of Radium ---------------------------------------------
Application of Plaster Spllnt to Wrist_______ .------------------ ____ _
2
Autopsie.s ________________________________________________________ _
Biopsy of Gland on C\1eck ------------------------------------------
Biopsy of Knee _______ --------------------------------------------Bladder Instillations ________________ _
Debridement of Wounds Gastric Lavages ____ --------------------------------------------- 15
Gland Biopsy, Axilla -----------------------------------------------
Gluteal Aspira!ions ------------------------------------------------
Incision and Drainage of Abscesses________________________________
23
Injections, I. V. -------------------------------------------------- 224
Oxygen Lavages --------------------------------------------------0. T., Avg. No. Patients Receiving________________________________ _
0. T., No. Treatments Given --------------------------------------- 127
Paracenteses _____________________________________________________ _
0
1942 36 48 14 4
3
0
33 1
19
19 1,165
1 0 0
35 0 6
33 431
27 0 0 5
266
Georgia Department of Public Health
TABLE XI (Continued)
CoMPARATIVE OPERATING RooM REPORT OF YEARS 1941 AND 1942
1941
Pelvic Examinations ----------------------------------------------- 38
Rectal Examinations -----------------------------------------------
1
Removal of F<>reign Body from Finger----------------------------
0
Removal of Foreign Body from Hand________________________________
0
Removal of Lipoma from Forearm__________________________________
0
Skin Tests _________________ -------------- ------------------------- 40
Surgical Drainage --------------------------------------------------
1
Suturing <>f Lacerated Finger --------------------------------------Suturing of Lacerated Wound on For.,head ___________________________
Suturing of Lacerated Upper Lip___________________________________
1
Vagina! Dilations __________________________________________________
0
Other Treatments --------------------------------------------------
5
Total Operating Room Procedures: --------------------------------- 17,103
1942
23 0
279 0 0 0 0 1 0
25,919
TABLE Ill
SuMMARY BY CouNTIES OF 1941 FALL THICK BLoOD-FILM ExAMINATIONS
OF ELEMENTARY ScHOOL CHILDREN
No. Ex'd
Ral\er * ---- ----------- [)46
Bulloeh ------------ -- 18 Burke ---------- ------ 60 Camden _______________ 370 Calhoun<! .-- _____________ 62
Crisp ---------------- -- 30 Dooly x ---------------- 460
49 Laurens --------------- 82 Lee ------------------- 21 Liberty -------- ---- 267 Mcintosh _______________ 8 'rerrell -- ---- ---------- 35
Total ___
2008
No. Pos.
3 0 0 0 1 2 1 0 1 0 4 0 0
12
White o/o Pos. 0.5
1.6 6.7 0.2 1.0 1.5
o/o of All Pos.
Tert.
E-A.
67
33
--
0
100
100
0
100
0
100
0
0
100
0.6
GO
50
No. Ex'd
728 0
555 G01 ll:ll
0 0 719 693 669 622 632 959
7215
Colored
No.
o/o of All Pcsitives
Pos.
% Pos.
Tort.
E-A
Un'd
0
--
--
--
3
0.5
0
100
0
19
3.7
5
95
0
14
1.2
14
43
43
--
--
1
0.1
0
100
0
6
0.9
100
0
0
5
0.7
20
20
0
15
2.4
0
100
0
1
0.2
0
0
100
0
64
0.9
16
13
ll
Total Ex'd
1274
18
;~:
61:> 0"'
877
(II
.....
ll93 ;'":'
30 0
"' 460
~::
768
115 690 889 640
CJJ ;!;::>:
...!c;...:.>.......
994
;: ;3
922a
1941 Survey represents--random blood films on colored school children and blood films of white school children with enlarged spleens, except counties marked as follows:
* Random survey on both white and colored.
x Random survey on white children.
t--.:1 0\ --J
I.
268
Georgia Department of Public Health
TABLE XII
COUNTIES REPRESENTED (BOTH RACES)
JANUARY I, I942-DECEMBER 3I, I942
Atkinson _______________ _ I Bacon __________________ _ I Baker __________________ _ I Baldwin ________________ _ 7 Banks __________________ _ 3 Barrow __________________ 5
Bartow __________________ 9
Berrien __________________ 2
Bihb ____________________ I8
Brantley _________________ 2
Brooks __________________ 3
Bulloch __________________ 6
Burke ___________________ 3
Butts ____________________ 4
Calhoun
____________ 3
Camden _________________ 2
Candler _________________ I
Carroll __________________ 2
Catoosa _________________ 4
Charlton _________________ I
Chatham _________________ 21
Chattooga _______________ 19
Cherokee ________________ 5
Clarke ___________________ 4
Clayton ____ _____________ 5
Clinch __________________ I
Cobb ___________________ I3
Coffee ___________________ IO
Colquitt _________________ 9
Columbia ________________ I
Cook ____________________ 3
Coweta __________________ 5
Crisp ___________________ 4
Dade ____________________ 4
Dawson ________________ _ 3 Decatur ________________ _ 7 DeKalb _________________ _ 20 Dodge _________________ _ 2
Dougherty ______________ _ 9 Doug~s ________________ _ 5 Early __________________ _ 3 Echols _________________ _ 1 Effingham ______________ _ I
Elbert ___________________ 6 Emanuel _________________ 6 Fannin __________________ 8 Fayette __________________ 5 Floyd ___________________ 47
Franklin _________________ 3 Fulton __________________ 94 Gilmer __________________ 2 Glascock _________________ 1 Glynn ___________________ 8 Gordon __________________ I8 Grady ___________________ 2 Greene __________________ 4 Gwinnett ________________ I2 Habersham ______________ 12 Hall ____________________ 11
Hancock ----------------- l Haralson _______________ _ 4 Hart ___________________ _ 6 Heard __________________ _ l Henry __________________ _ 3 Irwin __________________ _ 2 Jackson ________________ _ 2 Jasper _________________ _ I Jefferson _______________ _ 2 Jenkins _________________ _ 7 Johnson ________________ _ I Jones ------------------- 2 Lamar __________________ _ 3 Laurens ----------------- 8 Liberty _________________ _ I Lincoln ----------------- l Long ___________________ _ 2 Lowndes ----------------- 3 Lumpkin _______________ _ 3 Mcintosh --------------- I Macon _________________ _ 4 Madison ----------------- 4 Marion _________________ _ 1 Meriwether ______________ _ 2 Mitchell ---------------- _ 4 Monroe ----------------- 4 Montgomery ____________ _ 2
Laboratories
269
TABLE XII (Continued)
COUNTIES REPRESENTED (BOTH RACES)
JANUARY 1, 1942-DECEMBER 31, 1942
Morgan _______ ________ 1 Murray __________________ 8
Muscogee ________________ 10
Newton ------------------ 1 Oconee __________________ 1
Oglethorpe _______________ 3 Paulding ________________ 4
Peach ___________________ 4
Pickens __________________ 3 Pierce __________________ _ 2 Pike ____________________ 1
Polk -------------------- 8 Pulaski _________________ _ 1 Putnam __________________ 1 Rabun ___________________ 4 Randolph _______________ _ 3 Richmond ______________ _ 12 Rockdale _______________ _ 1 Screven ________________ _ 1 Schley _________________ _ 1 Seminole _______________ _ 2 Spalding _______________ _ 17 Stephens ________________ _ 2 Stewart _________________ _ 1 Sumter __________________ 1
Talbot __________________ 1 Tattnall _________________ 4 Telfair __________________ 4 Terrell __________________ 10 Thomas _________________ 5 Tift _____________________ 7 Toombs _________________ 3 Towns ___________________ 1 Troup ___________________ 8 Turner __________________ 1 Twiggs __________________ 2
Union ------------------- 6 Upson ------------------- 11 Walker __________________ 6 Walton __________________ 1 Ware ___________________ 13 Warren _________________ _ 1 Washington _____________ _ 4 Wayne ------------------ 7 Wheeler ________________ _ 1 Whitfield _______________ _ 23 Wilkes ------------------- 1 Wilkinson ______________ _ 8 Worth __________________ _ 3
----,
Division of Laboratories
T. F. Sellers, M.D., Director
E. J. Sunkes, Dr.P.H., Chief Bacteriologist
Janie Morris, M.S. ________________________________________Cultures Madge Reynolds, A.B.__________________________________Microscopy E. L. ~'ebb, A.B. ________________________________________Serology M. M. Harris, Ph.D. _______________________________ Waycross Branch Elizabeth Butt, A.B.* ________________________________Albany Branch
* Acting Director.
The work of the Division of Laboratories reached a new high level during 1942. There was a marked increase not only in the number of specimens examined, but in all other >activities, including the manufacture and distribution of biologics and auxiliary services such as the preparation of media, glassware and specimen outfits. During the year 642,916 specimens were examined. This was an increase of 135,593, or 26.7 per cent, over the number examined in 1941. It was the Iargest increase for a comparable period in the history of the Division of Laboratories.
INCREASE IN LABORATORY WORK Diagram 1 shows (l) the marked growth in the specimen loads over the
20-year period from 1920 to 1940, and (2) the gain annually from 1940 to 1942.
Diagram 2 gives a comparison of the specimen load in the several departments during the 20-year period from 1920 to 1940, and annually from 1940 to 1942.
Laboratories
DIAGRAM I
GROWTH OF LABORATORY WORK 1920-1942
271
642,916
507,323 395,004
272
Georgia Department of Public Health
40 000 '
DIAGIIAM 2
GROWTH OF LABORATORY WORK BY DEPARTMENTS 1920-1942
0 MICROSCOPY
m CULTURE
SEROLOGY
120,000
Cbll
1925
19:JO
1"5
1940
1941
1942
Laboratories
273
A comparison of the number of specimens of different types examined during 1941 and 1942 is given in Table l.
TABLE I
COMPARATIVE CLASSIFICATION OF SPECIMENS 1941-1942
1941
Tuberculosis ------------------------------------ 13,969 Diphtheria ------------------------------------- 2,694 Gonorrhea -------------------------------------- 9,882 Malaria __ --------------------------------------- 33,157 Intestinal Parasites ------------------------------ 53,205 Rabies ------------------------------------------ 1,264 Agglutinations ------------------- _______________ 10,943 Blood Cultures --------------------------------- 9,322 Stool and Urine Cultures ------------------------ 8,983 Darkfield --------------------------------------- 309 Water ------------------------------------------ 13,205 Miscellanoous ----------------------------------- 3,120 Syphilis Serology ------------------------------- 347,270
Grand Total ------------------------------------ 507,323
1942
15,969 2,939 9,813 19,189 30,884 1,216 10,829 9,244
10,586 226
13,918 2,537
515,566
642,916
Gain or Loss
+ 2,000 + 245
69 - 13,968 - 22,321
48 114
78 + 1,603
83 + 713
583 + 168,296
+135,593
Examination of Table 1 reveals the fact that the greatest increase occurred in specimens submitted for syphilis serology, which showed a gain of 168,296. Much of this gain resulted from the increase in specimens submitted by Selective Service boards. There were 199,544 such specimens submiUed in 1942, compared to 71,957 submitted in 1941, a gain of 127,587. Lesser increases were noted in those submitted for examination for enteric organisms, tuberculosis, diphtheria, and water analyses. Losses occurred in the number of specimens submitted for all other examinations, the greatest decrease occurring in those submitted for malaria and intestinal parasite examination. There were 36,289 fewer of these. Malaria specimens decreased 13,968; intestinal parasite specimens 22,321, and hookworm egg counts 1,385. The marked decline in malaria work was due in part to diversion of field personnel to War activities, and in part to the low incidence of this disease. The interruption of the field hookworm program likewise explains the decline in examinations for intestinal parasites.
Table 2 shows the division of the specimen load among the three laboratories with the increase or decrease in each.
274
Georgia Department of Public Health
TABLE 2 SPECIMEN LOAD BY LABORATORIES
1941 Central Laboratory, Atlanta __________________ 353,658 Southwestern Branch, Albany________________ 81,203 Southeastern Branch, Waycross______________ 72,462
Grand Total ------------------------------- 507,323
1942
501,229 71,856 69,831
642,916
Increase or Decrease In 1942
+147,511 - 9,347 - 2,631
+ 135,593
Diagrams 3, 4, 5 and 6 show in graphic form the number and the percentage of the total specimen load carried by each laboratory during 1942, the specimen loads handled hy the several divisions, the specimen load by divisions in each laboratory, and the percentage of the specimen load classified according to the type handled in each laboratory.
Laboratories
275
DIAGIIAII :S
SPECIMEN LOAD
BY
LABORATORIES 1942
CENTRAL
!101,229
78.0'1.
SEROLOGY
5e1!o1,n56.6
DIAGRAM 4
SPECIMEN LOAD
BY
DIVISIONS 1942
276
Georgia Department of Public Health
DIAIRAM 5
SPECIMEN LOAD BY DIVISIONS IN EACH LABORATORY
1942
CENTRAL LABORATORY
ALBANY LABORATORY
WAYCROSS LABORATORY
Laboratories
277
DIA8RAII I
SPECIMEN LOAD BY DIVISIONS 1942
PERCENTAGE TOTAL LOAO HANDLED IN EACH LABORATORY
SEROLOGY
MICROSCOPY
CULTURE
278
C'Jorgia Department of Public Health
The consolidated repor,ts of the three State Laboratories, composing the Division of Laboratories, is given in Table 3.
TABLE 3
REPORT OF COMBINED LABORATORIES FOR 1942
Total
Tuberculosis-Microscopic ________________________________________ _ Tuberculosis-Cuiture _____________________________________________
Tuberculosis-Animal Inoculations --------------------------------Diphtheria ____ ------------------------------- -------------------Genorrhea __ ------- _______ ----- __ --------------------------------Darkfield Test for Syphilis ---------------------------------------Malaria ------- _-------------------------------------------------Intestinal Parasites ----------------------------------------------Egg Counts _____________________ --------- ___________ - _- ______ - ---
Rabies-Microscopic Rabies-Animal Inoculations -------------------------------------Miscellaneous __ __ ___ ___ __ ___ _____ __ _____ ___________ ___ ___ ___ __ __ __
14,667 946 356
2,939 9,813
226 19,189 28,41;)
2,469 1,050
166 2,531
Total for Microscopy --------------------------------------------- 82,113
Agglutinations ____ -------------------- ----------------------------
Typhoid Fever -----------------------------------------------Typhus (Brill's) Fever --------------------------------------Brucellosis ______ ------------------------------ ______________ _ Tularemia __ ____ ____ ____ _________ __ ____ ______ _____ __ ____ ____ __
10,829
Pcsitive
1,256 89 58
515 1,593
64 290 1,771
488 56
111 196 153
18
Blood Cultures ---------------------------------- __________________ 9,244
E. typhosa ------------------------------ ______________________
184
Salmonella ___________ -------------------------- ---------------
15
Brucella ____ -------------------------------------------------
38
Others __ ___ __ ___ ______ ______ ___ _______ __ _____ ____ __ ___ ____ ___
21
Stool and Urine Cultures__________________________________________ 10,586
E. typhosa _--------------------------------------------------
500
Salmonella ______________________ ----------- ------------------
28
Shigella _________________________________________________ - ----
240
Others ____ - ---------------- ----------------- ------------------
T,otal for Culture
30,659
Syphilis Serology
515,566
Water
13,918
Grand Total __ ----------------------------------- _________________ 642,916
76,996
Laboratories
279
DISCUSSION OF WORK BY LABORATORIES CENTRAL LABORATORY
The statistical report for the Central Laboratory is shown in Table 4, while Table 5 gives a comparative classification of the examinations made in this laboratory. Examination of Table 5 reveals that the gain of 147,571 specimens handled in the Central Laboratory was due chiefly to the increase in the syphilis serology load, and to a lesser extent to the gains in examinations for tuberculosis, diphtheria and water analyses. The greatest decrease occurred in those specimens submitted for malaria and intestinal parasite examination, which showed a loss of 19,133. Lesser losses, totaling 2,988 specimens, occurred in all other types of examinations.
TABLE 4
REPORT OF CENTRAL LABORATORY FOR 1942
Total
Tuberculosis-Microscopic ----------------- -----------------------Tuberculosis-Culture --------------------------------------------Tube-rculosis-Animal Inoculation --------------------------------Diphtheria ______ ------------------------------------------------Gononhea ------------------------------------------------------Darkfield Test for Syphilis --------------------------------------~Ialaria _______ -------------------------------------------------Intestinal Parasites ___ ------------------------------------------Egg Counts __ ---------------------------------------------------Rabies-Microscopic --------------------- _____________ ____________
Rabies-Animal Inoculation --------------------------------------~Iiscellaneous _________ ------------------ _____________ ____________
Total for Microscopy ----------------------------------------------
11,064 842 356
2,552 6,139
168 7,330 13,450
532 882
166 1,291
44,772
Agglutinations __ ____ ____ ____ ________ _____ _____ __ __ __ __ ____ ___ _____
Typhoid Fever _ ---------------------------------------------Typhus (Brill's) Fever ---------------------------------------Brucellosis __________________________________________________ _ Tularemia ___________________________ ------ ____________ --------
5,817
Blood Cultures --------------------------------------------------E. typhosa ________________ ----------------------------------Salmonella ___________________________________________________ Brucella ____________________________________________________ _
Others ____________ --- ------ _------------------------ ----------
5,129
Stool and lJrine Cultures -----------------------------------------E. typhosa __________________________ ------- _________________ _ Salmonella ___________________________________________________
Shigella ________________________________ - __ - ----------- __ -------
Others ______ --------------------------------------- _________ _
5,047
Total for Culture
15,993
Syphilis Serology __________________ ------------------------------ 426,546
\Vater ---------------------- __ ____ __ __ __ ________ ____ ____ _________ 13,918
(>rand Total ________ __ __ __ _____ ____ _ ___ __ ________________ 501,229
Pcsitive 932 80 58 484 80 2 48 186
2,253
408 56
58 315
85 30
103 11 27 9
174 24
107
63,997
280
Georgia Department of Public Health
TABLE 5
CoMPARATIVE CLASSIFICATION oF SPECIMENs 1941-1942
CENTRAL LABORATORY
1941
Tuberculosis --------------------------- ____________ 10,599 Diphtheria ----------------------------------------- 2,119 Gonorrhea ____ ------------------------------------ 6,826 Darkfield Test tor Syphilis ------------------------- 264 Malaria ------------------------------------------- 14,312 Intestinal Parasites -------------------------------- 26,133 Rabies -------------------------------------------- 1,134 Miscellaneous ------------------------------------- 1,776 Agglutinations ------------------------------------ 6,639 Blood Cultures ------------------------------------ 5,869 Stool and TJrine Cultures -------------------------- 5,119 Syphilis Serology ---------------------------------- 259,663 Water -------------------------------------------- 13,205
1942
12,262 2,552 6,139 168 7,330
13,982 1,048 1,291 5,817 5,129 5,047
426,546 13,918
Gain or Loss
+ 1,663 + 433
687 96 6,982 - 12,151 86 485 822 740 72
+ 166,883
+ 713
Grand Totals -------------------------------------- 353,658
501,229
+147,571
Microscopy ------------------------------------ 63,163 Culture --------------------------------------- 17,627 Syphilis Serology ------------------------------ 259,663 Water _________ -------------------------------- 13,205
44,772 15,993 426,546 13,918
- 18,391
- 1,634
+166,883
+
713
BRANCH LABORATORIES
The branch laboratories at Albany and Waycross handled a total of 141,687 specimens during 1942, as compared with 153,665 during 1941, a decrease of 11,978 specimens. This constituted 22.0 per cent of the total specimen load as compared to 30.2 per cent in 1941.
The Albany Labora,tory handled 71,856 specimens in 1942, a decrease of 9,347, or 11.5 per cent, compared with 1941. Decreases occurred in those specimens submitted for microscopic examination and for syphilis serology. A material increase was noted in the number of specimens submitted for agglutination tests and cultures. This was the result of a typhoid-dysentery outbreak in Dougherty County, which is discussed on page 26. Table 6 gives the statistical report for the Albany Laboratory, while Table 7 gives a comparative classification of the specimens examined in 1941 and 1942. Map 1 shows the counties from which specimens were received by the Albany Laboratory.
Laboratories
TABLE 6
REPORT OF ALBANY LABORATORY FOR 1942
Total
Tuberculosis-Microocopic ______________________________________ _
Diphtheria ------- ____________________ --------- -- ----------------G<>norrhea ______ ---------------------- --------------------------Darkfleld Test for Syphllls ----------------------------------------Malaria _______________________ ----------------------------------Intestinal Parasites Rables-Microscopic _________________________________________ ------
Miscellaneous -------------------------------------- ___ ___________ Total for Microscopy _______________________ -----------------------
1,692 159
1,938 42
9,504 4,834
127 432 18,728
Agglutinations ____________________________ -----------------------Typhoid Fever _____________________ ---------------------------Typhus (Brlll's) Fever ____________ ---------------------------Brucellosis ____________ _______________________ ________________ Tularemia ______ ______________ _______ _________________________
3,636
Blood Cultures E. typh<Jsa Salm<Jnella Brucella _______________________ -----------------------------Others ------ _____ -- -------- _---------------------------------
2,786
Stool and Urine Cultures ----------------------------------------E. typhosa Salmonella _____________________ ----------------------- ______ _ Shigella Others ______________ -----------------------------------------
3,226
Total for Culture
9,648
Syphilis Serology
43,480
Grand Total __________ ------------------- _________________________ 71,856
281
Positive 209 6 284 13 88
1,574 64
44 309
40 38
70 11
6
317 4
126
7,113
282
Georgia Department of Public Health
TABLE 7
COMPARATIVE CLASSIFICATION OF SPECIMENS 1941-1942
ALBANY LABORATORY
1941
Tuberculosis -------------------------------------Diphtheria ---------------------------------------Gonorrhea ---------------------------------------Darkfield Test for Syphilis -----------------------Malaria ---------------------- ------------------Intestinal Parasites -------------------------------Rabies -------------------------------------------Miscellaneous ------------------------------------Agglutinations ------------------------------------Blood Cultures ----------------------------------Stool and Urine Cultures --------------------------Syphilic Semlogy ----------------------------------
1,677 247
2,204 35
15,583 8,510
92 475 3,411 2,650 1,990 44,329
Grand Total ___ _
81,203
Microscopy _
28,823
Culture --------------------------------------- 8,051
Serology
44,329
1942
1,692 159
1,938 42
9,504 4,834
127 432 3,636 2,786 3,226 43,480
71,8'i6
18,728
9,648
43,480
Gain or Loss
+ 13 88 266
+ 6,079 3,676
+ 35 43
+ 22') + 136 + 1,236
849
9,34>
- 10,093
+ 1,597
849
Laboratories
283
MAP I
ALBANY BRANCH LABORATORY
Specim1111
284
Georgia Department of Public Health
A total of 69,832 specimens were examined by the Waycross Laboratory during the year, a decrease of 2,632, or 3.6 per cent, compared with 1941. The loss occurred solely in the microscopic load and was due to a loss of 6,055 in the number -of specimens examined for intestinal parasites. Nearly every other type of examination showed increases. The considerable gain in the number of specimens submitted to the Waycross Laboratory for syphilis serology was due to the faot that a considerable number of specimens was received from war industry 'plants located in the area serviced by this laboratory. Table 8 gives a statistical report for the Waycross Laboratory, while Table 9 gives a comparative classification of the specimens examined in 1941 and 1942. Map 2 shows the counties from which specimens were received by the Waycross Laboratory.
TABLE 8
REPORT OF WAYCROSS LABORATORY FOR 1942
Total
Tuberculosis-llficroscopic ~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ Tuberculosis-Culture ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Diphtheria ~~~~~~- ~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ -~~~~~~~ Gonorrhea ~~~-- -~~ ~~~~~~~~~~~~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~ Darkfield Test for Syphilis ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Malaria ~- ~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Intestinal Parasites ~~~~~~~~~~~~~~ -~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Egg Counts ~~ ~~~~~~~~~~~~~~~~~~~~-~~~~--~~~~~--~~~~~~~~~~~~~~~~~~~~ Rabies-Microscopic ~- ~~~~~~~~~~~~-~~~~~~~~~~~--~~~~~~~~~ -~~~~~~~~~~ Miscellaneous ~~ ~~ ~ ~~ ~~~ ~~~ ~~ ~~~ ~ ~~~ ~ ~~~ ~~~~~~~~~~~~ ~ ~ ~~ ~~~ ~ ~ ~~~~~ Total for Microscopy ~~- ~~~~~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1,911 104 228
1,736 16
2,355 10,131
1,937 41
814 19,273
Agglutinations ~ _~~ ~~ ~ ~~~ ~~~ ~ ~ ~~ ~~ ~ ~~~~ ~~ ~~~~ ~~~ ~~~~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~~ ~~ Typhoid Fever ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~-~~~~-~~~-~~~ Typhus (Brill's) Fever ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Brucellosis ________________ -- _____________________ - -- __ -------
Tularemia ~ ~ ~ ~ ~~ ~ ~~~~ ~~~~ ~~ ~ ~ ~ ~~~~~ ~ ~ ~~ ~ ~~~~ ~~~~~ ~~ ~~~~ ~~~~~~ _
1,3 76
Blood Cultures E. typhosa ~~~~~ ~ ~~ ~~ ~ ~ ~~ ~ ~~~~~~~ ~~ ~~~~~~~ ~~~ ~~~~~~ ~~~~~ ~~~~ ~ ~ Salmon ell a ~~ ~~ ~ ~~~ ~~ ~~ ~~ ~~ ~ ~~ ~~ ~~~ ~~~~~~~~~- ~~~ ~~~ ~~ ~ ~~~ ~ ~~~ ~ B rue ella ~~ ~ ~ ~ ~ ~~ ~~~~~~~~ ~ ~ ~ ~~ ~~ ~ ~~ ~~~~ ~~~ ~~ ~~~ ~~~~~ ~~~~ ~ ~~~ ~ ~ Others ~~~~ ~ ~~ ~ ~~~~ ~~~ ~~~~ ~~~ ~ ~~~~~ ~~~ ~~ ~~ ~ ~ ~ ~ ~~ ~~ _~ ~ ~ ~ ~~ ~ ~~~~
1,329
Stool and Urine Culture ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~~~~~ E. typhosa ~~~~~~~~~~~~~~~~~~~~~~~-~~~~~~-~----~~-----~~~~---Salmonella ~~ ~~ ~~~ ~~~ ~~ ~~ ~ ~~ ~~ ~~ ~ ~~ ~ ~~~~ ~-~~~~~~ ~~ ~~~ ~~ ~~ ~ ~~~~ Shigella ~~~ ~~~~~~~~ ~~~~~~ ~ ~~~~ ~~~ ~~ ~~~-- ~~----~ ~~~~ ~~~~~~ ~~~~~ Others ~~ _~ ~ ~~ ~ ~~ ~~ ~ ~~~ ~~ ~~~ ~ ~~~ ~ ~~ ~~~~~~ ~~ ~ ~ ~~~~ ~~~~ ~ ~~ ~~ ~~ ~~
2,313
Total for Culture
5,018
Syphilis Serology
45,540
Grand T-otal ~~~~~~~~~~~~~~-~~~-~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~~ 69,831
Positive 115 9 25 507 16
3,944 16
172 28 10
11 2 0 6
9 7
6,349
Laboratories
285
TABLE 9
CoMPARATIVE CLASSIFICATION OF SPECIMENs 1941-1942
WAYCROSS LABORATORY
1941
Tuberculosis --------------------------------------Diphtheria ---------------------------------------Gonorrhea --------------------- ______ ------------Darkfield Test for Syphilis ________________________
1,691 327 850 12
Malaria -----------------------------------------Intestinal Parasites -------------------------------Rabies -------------------------------------------Miscel!anoous ------------------------------------Agglutin.,tions -----------------------------------Blood Cultures -----------------------------------Stool and Urine Cultures -------------------------Syphilis Serology ----------------------------------
3,262 18,563
38 870 893 803 1,875 43,278
1942
2,015 228
1,736 16
2,355 12,068
41 814 1,376 1,329 2,313 45,540
Gain or Loss
+ 324 99
+ 886 +
907 -6,495 +3
56 + 483 + 526 + 438 +2.262
Grand Total --------------------------------------- 72,462
69,831
-2,631
Microscopy ------------------------------------ 25,613 Culture --------------------------------------- 3,511 Serology -------------------------------------- 43,278
19,273 5,018
45,540
-7,557 +1.447 +2,262
286
Georgia Department of Public Health
MAP 2
WAYOROSS BRANCH LABORATORY
Source of specimens received durinQ the year 1942
69,832 Specimens
-
Laboratories
287
DISCUSSION OF WORK BY UNITS
MICROSCOPY UNIT
TUBERCULOSIS
Included in the studies made for M. tuberculosis were microscopic examinations, cultures and animal inoculations. Compared with 1941 the following gains were noted during the past year in the several types of examinations: Microscopic, 1,659; cultures, 199; animal inocul,ations, 140; total increase, 1,998. Most of the specimens for culture and/or animal inoculations were received from the State Sanatorium at Alto and from county health nurses.
TABLE 10 MicRoscoPIC ExAMINATIONS FOR TuBERCLE BAciLLI
Five Year Period 1938-1942
1938
Number examined ----------- 7,359 Xumber positive ------------ 808 Per cent positive ------------ 10.9
1939
8,985 896 9.9
1940
10,385 975 8.4
1941
13,008 1,063 8.2
1942
14,667 1,256 8.6
A total of 1,042 cultures for M. tuberculosis was made during the year. The Central laboratory made 938 of these, and the Waycross branch 104. Of these 741 specimens were cultured only, while 301 were made in conjunction with animal inoculations. The results of the culture studies only are given in Table ll, while results on cultures and animal inoculations are given in Table 12.
Type StJeclm&n Stool Total
TABLE II
TuBERCULOSIS CuLTUREs
Central
Pos.
Neg.
Total
52
576
628
1
1
2
Waycross
Pos.
Neg.
8
87
6
Total
95 6
53
584
637
95
104
Type Specimen
Total
Stomach Washings ------------------- 101
Pleural Fluid ------------------------ 61
Sputum ----------------------------- 53 Urine ------------------------------- 42 Cultures ---------------------------- 16 Pus --------------------------------- 13 Synovial Fluid _______________________ 1 Abdominal Fluid _____________________ 6
Miscellaneous and Unclassified Fluids__ 15
rota! -------------------------------- 314
TABLE 12
TuBERCULosis ANIMAL INocuLATIONs
Micro. Findings
Neg.
Pos.
101
--
61
52
1
42
--
16
13
--
7
6
14
1
296
18
Culture
Neg.
Pos.
92
8
55
9
45
42
7
1
6
J.
16
4
210
31
1-.:l
85
Totals
Pos.
Neg.
Total
60
663
723
7
8
~
6
7
.~ c..
0<:!
~-
62
679
741
t:;
~
...'"1::l
l;:l
.....
~
-...~ ;::! c ~
Animal Inoculations
(:::
o....-..
Neg.
Pos.
~.
<"l
81
20
::X::
~
47
14
;l;;::l -
44
9
~
42
7
9
11
2
1
4
13
-
256
58
Laboratories
289
Diphtheria
Diphtheria cultures increased from 2,693 in 1941, to 2,939 in 1942. The greatest gain was made in diagnostic cultures, which increased from 1,832 to 2,203. However, there was an increase of only 13 positive diagnostic culture findings during this period. Twenty-eight virulence tests were made in 1942, compared to 13 in 1941. See Table 13.
TABLE 13
CLASSIFICATION OF DIPHTHERIA EXAMINATIONS 1942
Total
Diagnostic ~~~~~~- _~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2,203
Release and Carrier ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 708
Virulence ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
28
Total ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 2,939
Positive
291 205
19
515
Negative
1,902 496 9
Doubtful 10
2,407
17
TABLE 14
ExAMINATIONS FOR GoNococci
Five Year Period 1938-1942
1938
:'\umber specimens examined~~~~~~ 5,569 Number positive ~~~~~~~~~~~~~~~~ 1,132 Per cent positive ~~~~~~~~~~~~~~- 20.3
1939
7,599 1,662
21.8
1940
8,248 1,818
22.0
1941
9,882 1,929
19.5
1942
9,813 1,593
16.2
Malaria
During :the past year 19,189 malaria examinations were made compared to 33,157 in 1941, a decrease of 13,968. There were 1,413 fewer routine specimens, and 9,613 fewer index specimens. See Table 17. Positive findings decreased from 551 in 1941, to 290 in 1942. During the fall 2,703 blood films were received from extra-cantonment areas in five counties. Examination of 1,158 of these was completed. with only two positive findings. Examination of 698 index films hom three other counties not having cantonment .areas gave eight positive findings. Table 15 shows the malaria examinations made and the results obtained in the seve11al laboratories during 1942. Table 16 gives classification of the positive findings.
290
Georgia Department of Public Health
TABLE 15
RouTINE AND INDEX MALARIA ExAMINATIONs 1942
(Routine specimens are those submitted from individual patients. Index specimens are those collected in organized surveys t<> determine malaria indices.)
Central
Albany
Waycross
Total
Routine Positive Negative
147 2,835
Total ----------------------------------- 2,982
018 5,241
5,299
10 1,285
1,295
Grand Total -----------------------------------------------------------
Index Positive Negative
39 4,309
30 4,175
6 1,054
Total ----------------------------------- 4,348
4,205
1,060
Grand Total -----------------------------------------------------------T,otal Routine and Index Malaria Examinations______________________________ _
215 9,361
9,5 76 75
9,538
9,613 19,189
TABLE 16
CLASSIFICATION oF MALARIA PosiTivEs
Tertian
E-A
Quartan Unclass.
Routine ------------------------------------ 54
158
3
Index -------------------------------------- 16
58
Total --------------------------------------- 70
216
Total
215 75 290
TABLE 17
EXAMINATIONS FOR MALARIA
Five Year Period 1938-1942
Routine
1938
Totals --------------- 9,537
Gain 'Or Loss over pre-
+ ceding year ------- 1,997
Index
Totals ---------------- 49,185 Gain or Loss over pre-
+ ceding year _______ 24,424
1939 9,780
+ 243
1940 10,452
+ 672
26,914 -22,271
25,629
- 1,285
1941 10,989
+ 537
22,168 - 3,461
1942 9,576 - 1,413
9,613 -12,555
Laboratories
291
Intestinal Parasites
The past year showed a material decrease in the number of specimens submitted for intestinal parasite examination. For the first time in many years there was a decline in the routine specimens as well as in the index. This is shown in Table 18. This decrease, noted during the past three years, has been due not only to the discouragement of surveys other than those related to definitely planned programs of control, but also, especially during the past year, to a loss of personnel engaged in hookworm control. A considerable por.tion of the index work as well as hookworm egg counts was made in the Waycross Laboratory. See Table 19.
TABLE 18
EXAMINATIONS F'OR INTESTINAL pARASITES
Five Year Period 1938-1942
Rcutine
1938
Total -------- -------- 11,9:;!1
Gain or Loss over pre-
ceding year
+ 4,124
Index
Total ------------------ 48,641
Gain or Loss over pre-
ceding year --------+ 7,130
1939 14,563
+ 2,604
1940 17,921
+ 3,358
1941 22,352
+ 4,431
56,720
+ 8,079
39,591 -17,129
27,000 -12,591
1942 17,273 - 5,079
11,142 -15,858
TABLE 19
RouTINE AND INDEX INTESTINAL PARASITE ExAMINATIONs (Routine specimens are those submitted by private physicians. Index specimens are those collected in organized surveys by Public Health agencies to determine intestinal parasite (chiefly hookworm) indices.)
Central
Routine Positive ____________________ 1,115 Negative -------------------- 8,184
Total ---------------------- 9,299
Albany
Waycross
Total Grand Total
1,310 3,000
4,310
1,213 2,451
3,664
3,638 13,635
17,273
Index Positive ____________________ 1,138 Negative ___________________ 3,013 T"tal ______________________ 4,151
Egg Counts 532
264
2,731
4,133
260
3,736
7,009
524
6,467
11,142
1,937
2,469
Grand Total
30,884
292
Georgia Department of Public Health
TABLE 20
CLASSIFICATION OF INTESTINAL PARASITE FINDINGs-1942
Single Infestation
Wmms for Identification ------------------------------------------------- 14 Hookworm ____ ____ __ __ _____ ___ ______ ___ __ ______ ______ __ __ _____ ______ ____ 1,430
Dwarf Tapeworm -------------------------------------------------------- 10 Round Worm ------------------------------------------------------------ 191 Whip Worm ------------------------------------------------------------ 43 Pin Worm --------------------------------------------------------------- 111
Others ------------------------------------------------------------------ 6-7,865
Double Infestation Hookworm and Pin Worm________________________________________________ _ Round Worm and Whip Worm ___________________________________________ _ Hookwonn and Dwarf Tapeworm _________________________________________ _ Hookworm and Round Worm_______________________________________________ Hookworm and Whip Worm _______________________________________________ _ Round Worm and Pin Worm______________________________________________ Whip Worm and Pin Worm ________________________________________________ _
43 1
20 68 11
2 1- 152
Triple Infestation Hookworm, Round Worm, Pin Worm---------------------------------------
Total Specimens Positive for Ova of Hookworm ________________________________ 1,519
Dwarf Tapeworm -------------------------------------------------------- 90 Round Worm _______________ --------------------------------------------- 263 Whip Worm _________________________ _______________________ _____________ 62
Pin Wonn _________________ ---------------------------------------- __ ____ 158
Others __________ ----------------------------------------------------- ---
Rabies-Micros~o pic Examinations
Compared with 1941 there was very Httle change during the past year either in the total of examinations made for rabies, or in the number of positive findings. A comparison of the results obtained during the past five years is given in Table 21. A classification of the animal heads examined during 1942 is shown in Table 22. During the year an extensive outbreak of rabies among foxes occurred in Dade, ChaUooga and Walker Counties. First reports of the presence of suspected rabid foxes were received from Dade County early in September. Beyond the definite identification of the -disease as rabies through the examination of a few specimens, no attempt was made to secure all fox heads for laboratory examination. However, during the remainder of the year Ill positive fox histories were reported by wild life rangers. Fortunately very few persons were attacked and only one human antirabic treatment was administered. The findings in various city and county boards of health laboratories throughout the State is given in Table 23.
TABLE 21
ANIMAL HEADS EXAMINED FOR RABIES 1938-1942
1938
Number heads examined __________ 1,164 Positive for Negri bodies _________ 538 Percentage positive _______________ 46.2
1939
981 443 44.6
1940
1,252 496 39.6
1941
1,090 492 45.1
1942
1,050 488 46.5
t-:1
1w 0
Columbus
Pos.
Total
Dog -------------------------------------- 3
11
Cat -------------------------------------- --
5
Pig
Raccoon
Total ------------------------------------- 3
16
TABLE 23
Macon
Pos.
Total
5
31
2
7
39
Savannah
Pos.
Total
4
16
5
4
21
t-.:1
:12
Augusta
Pos.
Total
11
19
~
1
5
~
.<.:.;>,
~ :s
12
24
I;,
~
.!.:..>..,.
~
~
.;:.:.!.
-c .
'"'t:1
I;:
o\..:.).".
:::r::
~
!:>
:
Laboratories
295
Map 3 shows the source of ,aU heads found positive for rabies by the several State and municipal laboratories. This map does not necessarily show the actual incidence of rabies since the number of heads submitted to the laboratory for examination will vary roughly with the avaihtbility of the laboratory service.
MAP!
MAP SHOWING ANIMAL HEADS
POSITIVE FOR RABIES
1942
Richmond County-- Augusta Lab 12
Muac:og" County - - Columbus Lab 3
Bibb County
- - Macon Lab 1
Chatham County - - Savannah
4
Tolol - City Laboratories 26
Total- State Laboratories 488
Grand Totol
51 4
296
Georgia Department of Public Health
Rabies-Animal Inoculation
There were 166 mouse inoculation tests for rabies completed during 1942, compared to 173 in 1941. Thirteen tests were unsatisfactory. An analysis of these studies is given in Table 24.
TABLE 24
ANIMAL INOCULATIONS FOR RABIES
Type Specimen
Micro.Mouse-
+ Micro.- Micro. ? Micro. Uns. Micro.
+ + Mouse Mouse- Mouse
Checks
Dog ---------------------- 62
25
Cat ----------------------- 27
4
Cow ---------------------- 2
Mule ----------------------
Hog ----------------------Goat ______________________
Squirrel ------------------- 10
Rat ----------------------Fox _______ ---------------Glands-dog ______________ _
Miscellaneous _____________ _
Total --------------------- 106
36
4
2
18
Total 100 36
10 1
166
Table 24 shows .that 38 specimens reported after microscopic examination only as either negative or unsatisfactory were positive by animal inoculation. Since 488 were reported as positive after microscopic examination only, a total of 526 examined by the Division of Laboratories was positive for rabies during 1942.
Miscellaneous
Table 25 shows .the miscellaneous examinations made during 1942. There was a decrease of 578 such examinations compared with 1941. Ameba examinations increased from 581 to 679. Pneumococcus typing, which decreased from 170 in 1941 to 76 in 1942, was discontinued in November because of the difficulty of securing both typing and therapeutic serum. During the year 27 specimens were examined for Donovan's bodies, pathonogmonic of granuloma inguinale. Of these 14 were found positive. Of the 17 specimens examined for meningitis positive findings were obtained in nine specimens as follows: N. intracellularis 3; H. inftuenzre 4; D. pneumonire 2. During the year 75 heterophile antibody tests for glandular fever were made compared with 63 in 1941. Twenty-five were positive. These tests were made in the Waycross Branch Laboratory.
Laboratories
297
TABLE 25
CLASSIFICATIONS OF MISCELLANEOUS EXAMINATIONS
Ameba __
679
Pneumococcus typing __ ------------------------------------------------------------- 76
Vincent's -organisms _______ ----------------------------- ___ __ ________________________ 355
Trichomonas vaginalis ______________________________________ ------------------------ 219
Chancroid (B. ducrey) ------------------------------------------------------------- 56
Spinal fluids for meningitis --------------------------- ------------------------------ 17 Exam.inations for type of organism__________________________________________________ 250
Cultures --------------------------------------------------------------------------- 368 Glandular fever (heterophile antibody test)------------------------------------------- 75 Unclassified ----------------------------------------------------------------------- 442
Total _______________________ ----------------------------------- ________________ _____ 2,537
CULTURE UNIT
Under this heading are included blood and stool cultures, agglutination tests for typhoid, typhus, undulant fever, and tularemia, as well as a miscellany of special bacteriology.
The work in the culture unit remained fairly stable during 1942, as compared to the previous year. Agglutination tests decreased from 10,943 to 10,829; blood cultures from 9,322 to 9,244, while stool and urine cultures increased from 8,984 to 10,586. The total number of specimens handled by this unit in 1942 was 30,659 compared to 29,248 in 1941, an increase of 1,411.
The positive results obtained in 1942, as compared with previous years are shown in the tables that follow.
TABLE 26
PosiTIVE AGGLUTINATION TEsTs
1938
Typhoid --------------------------------- 396 Endemic Typhus (Brill's) ----------------- 841 Undulant ------------------------------- 83 Tularemia ------------------------------- 59
1939
237 832 144 130
1940
369 429 153
97
1941
116 651 115
63
1942
111 796 153
78
TABLE 27
PosiTIVE BLOOD CuLTURES
1938
E. tyvhosa ------------------------------ 403 Salmonella ____ -------------------------- 12 Bruce-lla -------------------------------- 5 Other Organisms ------------------------- 15
1939
255 11 14 32
1940
265 9 22 25
1941
182 9 43 25
1942
184 15 38 21
298
Georgia Department of Public Health
TABLE 28
PosiTIVE STooL AND URINE CuLTURES
1938
E. typhosa ------------------------------ 612 Salmonella -----------------------------Shigella --------------------------------- 85 Other Organisms ------------------------ 7
1939
453 9
114 1
1940
360 3
136 5
1941 266 206
1942
500 28 240
During the year an outbreak of typhoid fever combined with bacillary dysentery occurred in Dougherty County. From 78 individuals E. typhosa was isola.ted 33 times from the blood, and 270 times from feces and urine. S. dysenterire was isolated 116 times from 80 individuals. Typing studies by application of bacteriophage showed all the cases of typhoid to be Type A. There were 7l cases of Flexner type dysentery, eight of New Castle, and one from which both Flexner and New Castle was isolated. During the outbreak a study was made of the relative efficiency of various media for the isolation of enteric pathogens.
During the year Brucella was isolated by blood culture in 38 of 153 blood specimens showing some degree of positive agglutination. Twentyseven of these were made at the Central laboratory and ll at the Albany branch. They were classified as follows: Br. abortus 8, Br. Suis 30.
The typing of E. typhosa strains by the application of bacteriophage, instituted in 1941, was continued during the past year. Six hundred thi1.1tysix cultures from 309 individuals were typed. The results are shown in Table 29.
TABLE 29
BACTERIOPHAGE TYPES E. TYPHOSA-1942
A
c
E
F
H
-:;"umber persons _______ 147 39 47
2
6
Xumber cultures ________ 381 78 65 10
5
Beta Gamma W
59 89
Total
309 636
The preponderance of Type A strains is due to 291 isolations typed during the outbreak in Dougherty County, all of which were Type A.
There were 44 isoiations of members of the Salmonella group during 1942. Fifteen were from blood and 29 from stool cultures. The types isolated by each of the several laboratories is given in Table 30. Typing of all Salmonella cultures were made or confirmed by the New York Salmonella Typing Center at Beth Israel Hospital.
Laboratories
TABLE 30
SALMONELLA CLASSIFICATION-1942
Central
S. para A S. para B S. bredeney -----------------------------8. anatum -------------------------------8. cholerae suis -------------------------- 3 S. derby ---------------------------------- 2 S give ----------------------------------8. montevideo ____________________________ S. lichtfield __________________ -----------S. newport __ ----------------------------8. oranienburg --------------------------S. typhi murium ------------------------- 14 S. meleagridis --------------------------- _
Total ------------------------------------ 36
Albany
Waycross
299
Total
2 6 2
1 3 14 44
Isolations of Shigella from stool and urine cultures increased from 206 in 1941, to 240 in 1942. The types isolated by the several laboratories during 1942 is given in Table 31.
TABLE 31
SHIGELLA CLASSIFICATION-1942
Central
Flexner ---------------------------------- 76 Newcastle _------------------------------Sonne ------------------------------------ 24
Total
107
Albany
109 13 4
126
Waycross
Total
191 20 29
240
TABLE 32
MiscELLANEous BLOOD CuLTURE IsoLATIONs
Central
Strevtococcus gamma type _______________ _ Stre-ptococcus hemolyticus ----------------Streptococcus Yiridans ---------------------Streptococcus (anaerobic) ________________ _ Staphylococcus albus _____________________ Staphylococcus aureus _ __ ______________ 4 Staphylococcus (hemolytic) ________________
Albany 4
Waycross
Total
4 6 20
300
Georgia Department of Public Health
SEROLOGY UNIT
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.
Serologic tests for syphilis increased from 347,270 specimens in 1941, to 515,566, a gain of 168,296, or 48.7%. Syphilis serology in 1942 represented 80.2 per cent of the specimen load as compared to 68.5 per cent in 1941, and 57.3 per cent in 1940. Fifteen per cent of the specimens examined in 1942 gave positive reactions as compared to 14.6 per cent in 1941. During the year 199,544 specimens submitted by Selective Service boards were examined in the Central Laboratory, an increase of 127,587 specimens, or 177.3 per cent as compared with 1941. These specimens represented 46.8. per cent of the syphilis serology load in the Central Laboratory as compared to 27.7 per cent in 1941; 15.9 per cent were positive. This percentage cannot be taken as incidence of infection since registrants giving :posi,tive reactions are required to have a repeated test.
During 1942, routine specimens (those submitted from sources other than Seleotive Service) increased by 40,609.
A comparison of the tests made in the several laboratories is shown in Table 33.
TABLE 33
Blood
Central
1942 ------------------1941 -------------------
425,919 258,985
+ 166,934
Spinal Fluids
1942 -------------------
627
1941 -------------------
678
- 51
Blood and Spinal Fluids
1942 ------------------1941 ------------------
426,546. 259,663
+ 166,883
Albany 43,337 44,201 864
143 128
+ 15
43,480 44,329
849
Waycross 45,474 43,199
+ 2,275
66 79 -13
45,540 43,278
+ 2,262
Total 514,730 346,385
+ 168,345
836 885 - 49
51G,;J66 347,270
+ 168,296
Includes 199,541 Selective Service specimens.
Includes 71,957 Selective Service specimens. The examination of Selective Service specimens began in November, 1940.
Labomtories
301
The Central Laboratory again achieved a very satisfactory rating in the 1942 syphilis serology study conducted by the U. S. Public Health Service. The results obtained by our laboratory as compared with the control laboratory is given in Table 34.
TABLE 34
NATIONAL SEROLOGY EvALUATION STUDY-1942
Laboratory
Presumptive Kahn Test Sensitivity Specificity
Contvol
87.9
Georgia ----------------------------- 87.8
100.0 99.6
Standard Kahil Test Sensitivity Specificity
80.7
100.0
80.0
99.6
The Central Laboratory serving as the control conducted an intrastate evaluation study participated in by the two branch laboratories and eight other public health laboratories. Specimens from 100 syphilitics and 50 normal individuals were submitted. The ratings of sensitivity and specificity in all except four of these laboratories came within the limits for acceptable performance of diagnostic procedures. The following laboratories participated: Central-Control, Albany Branch, Waycross Branch, Muscogee County, Richmond County, Savannah-City, AtlantaCity, Clarke County, Grady Hospital-Atlanta, Lowndes County, Macon Hospital.
A new type form with interleaved carbon, which serves both for the identification of the specimen and for the report of the examination, was constructed and placed in use during the year for both the routine and Selective Service syphilis serology specimens.
BIOLOGICS AND DRUGS
Several changes occurred during the past year in the list of biologies and drugs distributed. Sulfathiazole tablets were substituted for Sulfanilamide. These were distributed free of charge, along with the arsenicals, bismuth and Stovarsol .through the Division of Venereal Disease Control. The distribution of Oil of Chenopodium was discontinued and Hexylresorcinol Crystoids distributed instead. Difficulty was encountered during the year in securing sufficient Tetrachlorethylene capsules to supply our usual demands. The policy was therefore instituted of supplying these capsules only to those cases showing clinical evidence of hookworm disease confirmed by laboratory findings. Tetrachlorethylene C'apsules, Hexylresorcinol Crystoids and Blaud's pills are distributed through the Division of Malaria and Hookworm Service. Because of increasing difficulty in securing antipneumococcic serum this item is no longer carried in stock.
Table 35 shows the distribution of biologics and drugs by the various laboratories during 1942.
302
Georgia Department of Public Health
TABLE 35
BIOLOGIC PRODUCTS AND DRUGS DISTRIBUTED
Product
Central
Albany
Sera and Vaccines
Diphtheria Antitoxin, units
40,569,000
Diphtheria Toxoid, cc. -----------------------Diphtheria Toxin-antitoxin, cc. ________________ _
80,155 240
Diphtheria Schick Tests, tests ------------------
43,530
Tetanus Antitoxin, units ------------------------ 3,373,000
Scarlet Fever Antitoxin, units -----------------Gas Gangrene Antitoxin, package _______________
18,000 1
Antitularemic Serum, cc. ----------------------
45
Antipneumococcic Serum, units ________________ 260,000
A.ntivenin, cc. ---------------------------------
60
Smallpox Vaccine, points ----------------------- 115,490
Typhoid Vaccine, cc. --------------------------- 555,240
Tuberculin, P.P.D., tests -----------------------
830
Tuberculin, Diluted, cc. ----------------------- 18,395
(1) Antirabic Treatments (persons treated) ___ _
2,130
Drugs
Silver Nitrate, ampules ----------------------Tetrachlorethylene, 8 minim capsules _________ Oil of Chenopodium, ti minim capsules ________ _ Hexylresorcinol Crystoids, treatments __________ _
B!aud's Pills, 5 gr. --------------------------Brewer's Yeast, pound ------------------------(2) Distilled Water, cc. ----------------------Sulfathiazole, tablets, 0.5 gm. _________________
Stovarsol, tablets, 0.25 gm. --------------------(3) Bismuth Subsalicylate in Oil, cc. ___________
(4) Arsenicals, ampules ----------------------
76,063 20,444
9 115 39,720 21,721 3,646,330 1,101,120 32,145 671,250 236,079
2,630,000 5,040 860
373,000
7,260 60,440
599
3,532 1,900
554,650
300 835
Waycross
1,252,000 4,740 1.610
60,000
6,340 38,900
162 4,700 8,100
269,090
1 259
(1) The figures given for the Branch Laboratories do not represent complete treatments. Four vials of vaccine are supplied by the Branch Laboratories for each patient for whom treatment is requested. The re mainder of the treatment is sent from ,the Central Laboratory.
(2) Distributed in 10 cc. and 100 cc. bottles. (3) Distributed in 30 cc. and 60 cc. bottles. (4) Equivalent to 685,613 doses of 0.6 gms. or less.
Laboratories
303
TABLE 36
BIOLOGICS SHOWING MARKED INCREASE OR DECREASE
OVER 1941 DISTRIBUTION
Product
1941
1942 Increase or Decrease
Sera and Vaccines
Diphtheria Autotoxin, units ___________ 48,768,000 Diphtheria Toxoid, cc. _______________ 71,765 Tetanus Antitoxin, units ______________ 2,753,500 Antipneumococcic Serum, units _____ __ 4,480,000
Drugs
Tetrachlorethylene, :s minim capsules __
Distilled Water, cc. -----------------Stovarsol, tablets, 0. 2:; gm. ___________ _ Biemuth Subsa!icylate in Oil, cc. ____ _ Arsenicals, ampules
53,180 2,539,110
25,375 421,980 195,415
40,569,000 80,155
3,373,000 260,000
20,444 3,646,330
32,145 671,250 236,079
-8,199,000
+ 8,390 + 619,500
-4,220,000
32,736
+ 1,107,220 + 6,770 + 249,270 + 40,664
Human Antirabic Treatments
There was a slight decrease in the number of antirabic treatments distributed during the past year. In 1941 there were 2,262 treatments sent to 148 counties, whereas last year 2,130 were distributed to 139 counties. A comparison for the past five years is given in Table 37, while Table 38 gives a classification according to type for 1941 and 1942. Map 4 shows the geographical distribution of treatments.
304
Georgia Department of Public Health
MAP 4
MAP SHOWING DISTRIBUTION OF HUMAN ANTIRABIC TREATMENTS
1942
Totol Number - 2130
Note: Bibb County 221 FuHon County 321 Lowndes County I Of
Laboratories
TABLE 37
ANTIRABIC TREATMENT AND RABIES MORTALITY
1938 Human Treatments ____________ 2,938 Human Deaths During or After
Treatment ---------------Human Deaths Without Treat-
Treatment ---------------- 2
Total Deaths ------------------
Diagnosis doubtful In one case. See case history number 3.
1939 2,394
2
1940 1,903
1941 2,262
2
305
1942 2,130
2 2 4
TABLE 38
CLASSIFICATION ANTIRABIC TREATMENT BY TYPE
Type Treatment
1941
Number
Per Cent
Precautionary ______________ __________ 901
39.8
Mild ------------------ _____________ 1,255
55.5
Intensive _____________ ________________ 95
4.2
Drastic ------------------------------ 11
0.5
Total -------------------------------- 2,262
1942 Number Per Cent
780
36.7
1,243
58.3
91
4.3
16
0. 7
2,130
Human Cases of Rabies
During 1942 four human cases of rabies were reported. Two were
diagnosed clinically and two brought to autopsy. Two received antirabic
treatment, but onset of symptoms occurred prior to completion of treat-
ment. Two received no antirabic treatment. One of the two receiving
treatment was bitten in Georgia, treated in South Carolina, and died in
Georgia. (See Case 3.)
.
CASE I-A.T.N., Route 2, Decatur, DeKalb County, Georgia. White, male, age 9. Bitten on let thumb by stray rabid cat March 20, 1942. Diagnosis of animal confirmed by laboratory examination. Mild antirabic treatment begun three days later. On April 7 (19 days after date of bite) the child began to show characteristic symptoms of rabies, was admiUed to Grady Hospital, Atlanta, and died April 10. The clinical diagnosis of rabies was confirmed by the mouse inoculation test of brain tissue obtained at autopsy.
CASE II-V.S., Route l, Clayton, Rabun County, Georgia. White, female, age 5. Bitten on upper lip, left wrist and ankle April 9, 1942, by a neighbor's dog. This dog was considered normally vicious and rabies was not suspected, but it was killed the following day. No laboratory examination was made of its brain. Antirabic treatment was not administered. On May 1 (22 days after she was bitten) the child began
306
Georgia Department of Public Health
to show symptoms which rapidly became typical of rabies. Death occurred May 6. No autopsy was performed. The clinical diagnosis was rabies.
CASE 111-C.E.P., Greenville, South Carolina. White, male, age 5. While visiting relatives in Oglethorpe County, Georgia, this child was bitten on the nose October 18, 1942, by a dog which was killed at once. No laboratory examination was made of the dog's brain. The child was returned to his home in Greenville, where intensive antirabic treatment furnished by the South Carolina Health Department was administered beginning October 23. No November 6 (19 days after he was bitten) the child began to show symptoms which rapidly became typical of mbies. The child died November 8. No autopsy was performed. The clinical diagnosis was rabies.
CAsE IV-D.B., Route 7, Gainesville, Hall County, Georgia. White, male, age 22. No history of this man's exposure to rabies could be elicited from the family or any other source except that about 21 months previously he played with a pet dog, which after biting two children in this family, suddenly disappeared. The two children received antirabic treatment. If this man was bitten he failed to reveal the fact, and he received no treatment. An incubation period as long as 21 months has never been recorded, the longest in our experience being seven months, hence this possible exposure was discounted. lt is assumed that a much more recent but unrevealed exposure must have occurred. On November 10, 1942, this man began to show symptoms, which three days later, became typical of rabies. Death occurred November 14 (four days after onset). Autopsy was performed and the diagnosis of rabies was confirmed by the finding of Negri bodies in the brain, and also by the mouse inoculation test.
More or less detailed clinical notes of all four cases are on file in the Laboratory office.
Laboratories
307
TABLE 39
DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES
Central
Albany
Waycross
Keidel Tubes
For Selective Service-------------- 227,103 Other ------------------------------ 190,959
Sterile Corked Vials ------------------Darkfield Outfits ---------------------Throat Culture Outfits__________________ Intestinal Parasite Outfits, Routine ___ _ Intestinal Parasite Tins, Survey ________ Slide Outfits ------------------------Slides --------------------------------Sputum Outfits -----------------------Stool Culture Outfits ------------------
418,062
121,808 749
3,659 5,860 23,983 9.153 16,704 16,576 8,138
14,505
28,348 73
341 2,935 2,208 1,404 4,752 2,297 3,692
2,974
13,665 101 561
1,404 5,579
965 1,769 1,62f> 1,599
Needles
19 Gauge, 2 inch -------------------
22 Gauge 1'h inch ----------------24 Gauge % inch _________________ _ 26 Gauge % inch and 'h inch _____ _
97 2-3 dozen 173 1-3 dozen 188 dozen 138 dozen
Syringes
1 cc. Tuberculin ___________________ _ 2 cc. Hypodermic __________________ _ 5 cc.Hypodermic___________________ _ 10 cc. Hypodermic ___________________ _
59 only 833 only 201 only 1,182 only
Includes Keidel tubes sent to the Albany ~nd Waycross Branch Laboratories and distributed by them.
TABLE 40
DISTRIBUTION OF SPECIMEN OuTFITS
Two Year Period 1941-1942
1941
Keidel Tubes --------------------------------- 253,276 Sterile Corked Vials __________________ _________ 98,864 Darkfield Outfits _____________________________ _ 665 Diphtheria Outfits ___________________________ _ 3,790
Slide Outfits ---------------------------------- 9,974 Slides _______________ ------------------------- 21,672 Intestinal Parasite Outfits, Routine______________ 8,90i Intestinal Parasite Tins, Survey _______________ _ 86,155
Sputum Outfits ------------------------------- 17,701 Stool Culture Outfits -------------------------- 10,841
1942 Increase or Decrease
418,062 121,808
+ 164,786 + 22,944
749
+ 84
3,659
131
5,860 23,983 9,155
4,114
+ 2,311 + 248
16,704
69,451
16,576
1,125
8,138
2,703
308
Georgia Department of Public Health
Media and Vaccine
TABLE 41 MEDIA AND VACCINE UNIT
Media
Beef Infusion Donble____________________ ---------------------------- _ Pork Infusion ------------------------------------------------------Beef Infusion Broth____________ ------------------------------------Beef Extract Broth ________________ -----------------------------------
Selenite ''F'' ------------------------------------------------------Conrad's Bile ------------------------------------------------------Miscellaneous Broths _______________________________________________
Beef Infusion Agar -------------------------------------------------Beef Extract Agar --------------------------------------------------Pork Infusion Agar________ -----------------------------------------Endo's Stock Agar__________________________________________________
Wilson Blair Agar______________ ------------------------------------Desoxycholate Citrate Agar ---------------------------------------Krumwiede's Triple Sugar Agar_____________________________________
MacConkey's Agar --------------------------------------------------S. S. Agar -------------------------------------------------------1\l:iscellaneous Agars ------------------------------------------------Loeffler's Blood Serum --------------------------------------------Petragnani's -------------------------------------------------------Frye's Mediurn _____________________________________________________ -
Sugar Fermentation Tubes ----------------------------------------- _ Miscellaneous Media -------------------------------------------------
100,000 cc. 14,000 cc. 64,500 cc. 49,000 cc. 4,000 cc. 95,000 cc. 36,000 cc.
110,000 cc. 1,000 cc.
14,000 cc. 16,000 cc. 255,070 cc. 18,000 cc.
9,800 cc. 9,500 cc. 11,500 cc. 17,890 cc. 11,322 cc. 17,000 cc. 3,000 cc. 5,750 cc. 3,405 cc.
(The following media were prepared in the Engineering Laboratory.)
Lactose Broth ------------------------------------------------------Endo Agar --------------------------------------------------------Nutrient Agar ______________________________________________________ _ Brilliant Green Lactose Bile Broth___________________________________ Miscellaneous -------------------------------------------------------
1,440 Liters 48 Liters 24 Liters 90 Liters 1 Liter
Solutions and Indicators
Dyes for Media -----------------------------------------------------Reagents for Media ------------------------------------------------Bismuth Sulfite Mixture __________ ---------------------------------Glycerine Salt Solution ---------------------------------------------Salt Solution ------------------------------------------------------Silver Nitrate Solution ---------- __ -------------------------------Miscellaneous Solutions
700 cc. 14,659 cc. 24,500 cc.
59,000 cc. 845,700 cc. 40,300 cc.
47,650 cc.
1% Silver Nitrate
Number Ampules made 1942-----------------------------------------Number Ampules filled 1942-----------------------------------------Number Ampules distributed 1942------------------------------------
100,000 Ampules 68,000 Ampules 78,750 Ampules
Water filled 1942 Water distributed 1942
Sterile Distilled Water
3,873,900 cc. 3,855,900 cc.
Diluted Tuberculin (Old)
Tuberculin diluted 1942 ---------------------------------------------Tuberculin distributed 1942 ------------------------------------------
20,500 cc. 21,085 cc.
-
Laboratories
309
PERSONNEL
There were ninety-two employees in the three laboratories. Seventyseven were employed in the Central Laboratory, seven in the Waycross Branch, and eight in the Albany Branch. Seventy were white and twentytwo colored.
CENTRAL LABORATORY
Medical Director, Bacteriologist VI_________________________ 1 Assistant Director, Bacteriologist V______________________ 1
Bacteriologist IV --------------------------------------- l Serologist IV _____________________ _____________________ 1
Bacteriologist III ----------------------------------------- 1 Bacteriologist II ----------------------------------------- 1 Bacteriologist I ---------------------------------------- _ 6 Technicians A ------------------------------------------ 9 Technicians B ------------------------------------------ 7 Technicians C ------------------------------------------ 3 Office Secretaries --------------------------------------- _ 2 Stenographers ------------------------------------------ 2 Typists _---------------------------------------------- _ 1 Statistioal Clerk ---------------------------------------- 1 Report Clerks ________________________ __________________ 7
Shipping Clerks ---------------------------------------- 4 Mail Clerk --------------------------------------------- 1 Laboratory Clerks --------------------------------------- 5 Stockroom Foreman _______________ ________________________ 1
Stockroom Clerk ----------------------------------------- 1 Porters __________________________ ______ _______________ 3
Maids ------------------------------------------------- 15
74
Students ----------------------------------------------- 3--77
ALBANY LABORATORY
Acting Director, Bacteriologist II _______________ 1
Technician A _____________ 1 Technician B _____________ 2 Stenographer _____________ 1 Clerk ___________________ 1 Porter ___________________ 1 Maid ____________________ 1
WAYCROSS LABORATORY
Director, Bacteriologist IV__ 1 Technicians A ____________ 2 Technician B _____________ 1 Stenographer _____________ 1 Maids ___________________ 2
7
310
Georgia Department of Public Health
PERSONNEL PROBLEMS
One of the outstanding problems confronting the laboratory management during the past year had to do with personnel turnover_ Six of the personnel entered the military service. A number of well trained women technicians left the service either because of marriage or to obtain positions in military hospital laboratories. A partial solution of the technical personnel problem was obtained through the training of students. During 1942, nine persons were admitted as trainees and eight completed training. The chief turnover, however, has been in the clerical help who have been able to obtain higher salaries in other positions.
In spite of personnel problems and increasing difficulty in obtaining supplies, we are maintaining a laboratory service of rapidly increasing size and we believe of excellent quality.
MERIT SYSTEM
Under the Merit System established July lst, and approved by Federal agencies, the entire laboratory personnel was classified and qualified either by assembled or unassembled examination. In addition a formal program of didactic and technical instruction was given to both students and staff workers.
MALARIA SCHOOL
During the year a malaria school was conducted by Miss Aimee Wilcox, Assistant Technologist, Malaria Investigations, National Institute of Health. The school was attended by eleven members of our personnel and by four from other laborat:ories.
Division of Information and Statistics
Richard C. Brewer, Acting Director
The year 1942 saw the Division of Information and Statistics almost deluged under a tremendous number of requests for certified copies of birth certificates. This increase, first noted in 1940, climbed upward month by month until it had passed all previous records many times. From time to time it has been necessary to expand both the personnel and quarters to take care of the increase.
The department issued 74,996 certified copies in 1942. These were composed of 74,379 births and 617 deaths, respectively. This was an in crease of 55,353 certified copies or 282 per cent over 1941.
It is interesting to note that the demand for ce11tified copies in 1942 was almost 32 .times greater than in the typical year 1938.
At the same time, the department was placing on file 59,416 delayed certificates of birth. This was an increase of 40,416 or 212 per cent over the 19,000 delayed birth certificates filed in 1941.
Incoming mail to this department, which had reached the total of 86,396 pieces of letter mail in 1941, reached a total of near 200,000 pieces in 1942.
A special certificate was used in the latter part of 1942 to give infor mation required by the Servicemen's Dependent's Allowance Act of 1942 (Public Law 625) . Several thousand of these certificates have been issued.
Special requests for verifications of births were received in great numbers from the Army, Navy, and other official agencies. The usual de mand for notifications of Birth Registrations was felt upon the opening of schools in the fall of the year.
During 1942 there were 103,782 current eertificates piaced on record consisting of 72,189 births, 28,807 deaths and 2,786 stillbirths. The current birth and death certificates were handled in the !'outine manner. They are received, arranged in alphabetical order by county, checked for com pleteness, 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, and punch cards are made for each certificate. These punch cards are vertified and are used for making routine and special tabulations. The certificates are indexed and filed in alphabetical order.
STATISTICS
BIRTH RATE: The birth rate for Georgia increased from 21.6 per 1,000 population in 1941 to 23.1 in 1942, or an increase of 7.2 per cent. The rate for Georgia is considerably above the birth rate for the United States as a whole. This is the highest birth rate ever recorded for Georgia.
312
Georgia Department of Public Health
STILLBIRTHS: There was a further drop in the stillbirth rate from 42.8 per 1,000 live births in 1941 to 38.6 in 1942, or a decrease of 9.9 per cent. This is the lowest rate ever recorded for stillbirths in Georgia.
MATERNAL MoRTALITY: The maternal mortality rate decreased from 4.6 per 1,000 live births in 1941 to 4.1 in 1942, or a drop of 10.8 per cent in the maternal mortality rate. This is also the lowest rate ever recorded for Georgia.
DEATH RATE: During 1942 the death rate decreased from 1,004 per 100,000 population in 1941 to 922.2 per 100,000 population in 1942 or a decrease of 8.1 per cent. This is the lowest death rate ever recorded in Georgia.
TYPHOID FEVER: The 1942 typhoid death rate of 0.8 per 100,000 population is the lowest ever recorded for the State of Georgia. The rate dropped 56.3 per cent from the 1.7 in 1941 which was the previous all-time low. The number of deaths dropped from 55 in 1941 to 24 in 1942.
TYPHUS FEVER: The typhus fever death rate increased 45.6 per cent from 1941 to 1942 when the rate increased from 1.1 to 1.7 and the deaths from 36 in 1941 to 52 in 1942.
MALARIA: The malaria death rate for 1942 shows a very slight increase, the death rate being 2.4 per 100,000 population or an increase of 1.3 per cent. The number of deaths increased from 75 in 1941 to 76 in 1942.
SMALLPOX: There were no smallpox deaths recorded in 1942.
DISEASES OF CHILDHOOD: There was a decline in the death rate from MEASLES from 5.0 to 1.9 in 1942 or a decrease of 61.5 per cent. The number of deaths decreased from 157 in 1941 to 60 in 1942. ScARLET FEVER: There was a decrease in the number of deaths from this disease from 9 in 1941 to 2 in 1942 when the death rate dropped from 0.3 to 0.1 or 78.6 per cent. WHOOPING CouGH: There was a 27.4 per cent decrease in the death rate from this condition. The number of deaths declined from 140 in 1941 to 101 in 1942.
DIPHTHERIA: There was also a drop in the diphtheria death rate from 2.0 to 1.8, or 12.0 per cent. The number of deaths dropped from 63 in ] 941 to 55 in 1942.
INFLUENZA: There was a marked drop in the influenza death mte when 482 persons died from this disease in 1942 as compared with 994 in 1941. The rate dropped from 31.6 to 15.4 in 1942 or a rate decrease of 51.2 per cent.
DYSENTERY: The deaths and death rates from this condition also show a decrease as 109 persons died in 1941 as compared with 86 in 1942. The rate dropped from 3.5 in 1941 to 2.8 in 1942 or 20.3 per cent.
PoLIOMYELITIS: There was a marked decrease in .the number of deaths from 33 in 1941 to 10 in 1942. The rate dropped from 1.1 in 1941 to 0.3 in 1942 or 69.2 per cent.
LETHARGIC ENCEPHALITIS: The deaths and death rates from this disease remained the same as five persons died in 1941 and also five in 1942. The
Information and Statistics
313
death rate was ,the same for both years, 0.2, consequently no percent of increase or decrease.
MENINGococcus MENINGITIS: The deaths and death rates remained practically the same, 'as 17 persons died in 1941 as compared with 18 in 1842, thus showing a slight increase of 5.6 per cent, the rate being 0.5 in 1941 against 0.6 in 1942.
TuBERCULOSIS: The tuberculosis death xate shows a decrease with 1,385 deaths in 1941 against 1,265 in 1942. The death rate for 1941 was 44.0, decreasing to 40.5 in 1942, the mte being 8.0 per cent.
SYPHILIS: There was a decrease in the death rate from syphilis from 503 in 1941 to 462 in 1942. The rate being 16.0 in 1941 against 14.8 in 1942 or 7.5 per cent.
CANCER: The death rate for this disease remained practically the same with 2,139 deaths in 1941 compared with 2,120 in 1942. The rate 68.0 in 1941 and 67.9 in 1942 the rate of decrease being 0.2 per cent.
DIABETES MELLITUS: There was a very slight decline in this disease from 376 deaths in 1941 to 370 in 1942 at the rate of 12.0 in 1941 to 11.8 in 1942 or 0.9 per cent.
PELLAGRA: Shows a decrease of 10.6 per cent. The deaths in 1941 were 204 compared with 181 in 1942, the rate being 6.5 in 1941 to 5.8 in 1942.
CEREBRAL HEMORRHAGE: There was a decline in the rate of deaths from cerebral hemorrhags. The rate for 1942 was 92.0 ,as compared to 96.4 in 1941. The number of deatns was 2,~73 as compared with 3,033 in 1941 or 4.6 per cent.
HEART DISEASE: This is the lea :ling cause of death in Georgia as well as the nation. However, the death rate from this condition shows a decrease of 8.5 per cent, 'the mte for 1941 being 183.8 as compared with 168.1 in 1942. The number of deaths in 1941 was 5,780 and in 1942 it was 5,251.
PNEUMONIA: Deaths due to pneumonia show a very slight decrease, the rate 'being 54.5 in 1941 against 51.6 in 1942. The number of deaths was 1,714 in 1941 and 1,612 in 1942.
DIARRHEA AND ENTERIS UNDER 2 YEARS: The number of deaths from this condition decreased from 435 in 1941 to 284 in 1942. The rate de-
in clined from 13.8 to 9.1 or 34.3 per cent. CIRRHOSIS OF LIVER: There was ,a very slight increase deaths due to this cause. The rate increased from 4.9 to 5.0 o.r 2.7 per cent. The number of deaths from 154 in 1941 to 157 in 1942.
APPENDICITIS: There was a decrease in deaths due to appendicitis, the number being 230 in 1941 as compared with 174 in 1942. The rate was 7.3 in 1941 and 5.6 in 1942 or 23.8 per cent.
NEPHRITIS: The deaths from this condition show a slight decrease, but it still stands second in the list of oouses of death in our State. The rate decreased from 107.5 in 1941 to 102.0 in 1942 or a decrease of 5.1 per
314
Georgia Department of Public Health
cent. The number of deaths in 1941 was 3,381 in 1941 compared with 3,187 in 1942.
MALFORMATION AND EARLY INFANCY DISEASES: The number of deaths from these causes decreased from 2,163 in 1941 to 2,020 in 1942. The rate declined from 68.8 to 64.7 or 6.0 per cent.
SuiCIDE: The number of deaths from suicide decreased from 236 in 1941 to 219 in 1942 or a decrease in the rate of 6.5 per cent.
HoMICIDE: There was a decrease in the number of deaths from homicide from 649 in 1941 to 519 in 1942. The rate decreased from 20.6 to 16.6 or 19.5 per cent.
MoTOR VEHICLE AcciDENTS: There was a decrease in the number of motor vehicle deaths from 946 in 1941 to 673 in 1942. The rate decreased from 30.1 to 21.5 or a decline of 28.4 per cent.
AcciDENTAL DEATHs (ExcLUSIVE OF AuTo AcciDENTS) : There was an increase in the number of accidental deaths from 1,262 in 1941 to 1,383 in 1942. The rate increased from 40.1 to 44.3 or 10.3 per cent.
Information and Statistics
315
TABLE
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 PERCENT INCREASE OR DECREASE IN THE RATES, IN GEORGIA: 1941 AND 1942
Cause of Death
Number
1942
1941
ALL CAUSES
28,807
Typhoid fever --------------------- 24
Typhus fever --------------------- 52
Malaria --------------------------- 76
Smallpox --------------------------
Measles --------------------------
60
Scarlet fever ----------------------
Whooping cough ------------------- 101
Diphtheria ------------------------ 55
Influenza ------------------------- 482
Dysentery ------------------------- 86
Poliomyelitis
10
Lethargic encephalitis _____________
5
Meningococcus meningitis ___________
18
Tuberculosis (aH fonns) ___________ 1,265
Syphilis
462
Canc0r ---------------------------- 2,120
Diabetes mellitus ----------------- 370
Pellagra -------------------------- 181
Cerebral hemorrhage, embolism and
thrombosis --------------------- 2,873
Heart diseases --------------------- 5,251
Pneumonia ------------------------ 1,612
Diarrhea and enteritis (under 2 years) 284
Cirrhosis of liver ------------------- 157
Appendicitis ----------------------- 174
Nephritis -------------------------- 3,187
Malformation and early infancy
diseases ----------------------- 2,020
Suicide --------------------------- 219
Homicide
519
Motor vehicle accidents __________ _ 673
All other accidents ________________ 1,383
Unknown and !!!-defined causes ____ _ 1,071 All other means ___________________ 4,015
31,579 55 36 75
157
140 63
994 109
33
17 1,385
503 2,139
376 204
3,033 5,780 1,714
435 154 230 3,381
2,163 236 649 946
1,262 1,026 4,270
Live births ------------------------ 72,189 St!llbirths ------------------------- 2,786 Infant mortality ------------------- 3,559 Maternal mortality ________________ _ 299
67' 785 2,903 3,955 315
Rate
1942
1941
922.2 0.8 1.7 2.4
1004.0 1.7 1.1 2.4
Per Cent Increase or Decrease
- 8.1 - 56.3
+ 45.6 + 1.3
1.9
5.0
61.5
0.1
0.3
- 78.6
3.2
4.5
- 27.4
1.8
2.0
- 12.0
15.4
31.6
- 51.2
2.8
3.5
- 20.3
0.3
1.1
- 69.2
0.2
0.2
0.6
0.5
+ 5.6
40.5
44.0
8.0
14.8
16.0
7.5
67.9
68.0
0.2
11.8
12.0
0.9
5.8
6.5
10.6
92.0 168.1
51.6 9.1 5.0 5.6
102.0
96.4 183.8
54.5 13.8 4.9
7.3 107.5
4.6 8.5 5.3 - 34.3
+ 2.7
- 23.8 5.1
64.7 7.0
16.6 21.5 44.3 34.3 128.5
23.1 38.6 49.3
4.1
68.8 7.5
20.6 30.1 40.1 32.6 135.8
21.6 42.8 58.3
4.6
6.0 6.5 - 19.5 28.4
+ 10.3 + 5.1
5.4
+ 7.2
9.9 - 15.5 - 10.8
NOTE: Figures exclude non-residents of Georgia and include births and deaths of Georgia residents occurring in other states.
316
Georgia Department of Public Health
TABLE 2
DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS AND STILLBIRTHS
WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1942
Year
1920 1921 1922 1923 1924 192:> 1926 19:::7
~-
1928
19~9
1930 19:H 1932 1933 1934 198:! 1936 1937 1938 1939 1940 1941 1942
Infant Mortality
5,305 4,905 4,937 5,384 5,674 4,704 4,405 4,578 4,875 4,464 4,113 4,234 4,097 4,079 5,086 4,316 4,319 3,968 4,352 3,817 3,737 3,955 3,559
Number Maternal Mortality
558 568 658 573 708 641 485 578 622 549 658 616 620 463 505 458 491 411 421 356 342 315 299
Stillbirths
3,389 3,820 3,862 3,958 3,864 3,455 2,972 3,836 3,478 3,541 3,796 3,678 3,847 3,700 4,120 3,987 3,666 3,671 3,390 3,228 3,078 2,903 2,785
Infant Mortality
88.3 73.9 75.9 84.5 89.5 78.9 87.2 73.5 80.9 76.3 78.1 68.5 64.3 67.2 18.1 68.2 70.1 62.0 61.1 58.8 57.8 58.3 49.3
Rate Maternal Mortality
9.3 8.6 10.1 9.0 11.2 10.8 9.6 9.3 10.3 9.4 10.9 10.0 9.1 1.6 7.8 7.2 8.0 1.4 6.5 5.5 5.3 4.6 4.1
Stillbirths
56.4 57.5 59.3 62.2 61.0 58.0 58.9 61.6 57.7 60.5 62.9 59.5 60.4 60.9 63.8 63.0 59.5 57.4 52.7 49.7 47.6 42.8 38.6
TABLE 3
BIRTHS AND DEATHS (EXCLUSIVE OF STILLBIRTHS) WITH RATES PER 1,000 POPULATION AND BIRTHS PER 100 DEATHS, IN GEORGIA: 1920--1942
Year
Number
Births
Deaths
Rate
Births
Deaths
Births Per 100 Deaths
1920 1921 1922 1923 1924 1925 19:36 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1v:;s 1939 1940 1941 1942
~ --------
-------------------------------------------------------------- ----------------~ -----------------
----------
----------------------------- -----------------
----------
-------------------------- --
60,061 66,378 65,082 63,681 63,386 59,610 50,493 62,246 60,259 58,521 60,318 61,774 63,690 60,744 64,615 63,290 61,617 64,012 64,307 64,910 64,695 67,785 72,189
32,243 29,552 31,114 34,082 34,797 31,278 29,906 31,869 36,085 35,340 35,188 32,989 32,122 31,184 35,590 34,313 31,293 34,411 33,617 31,856 32,285 31,579 28,807
20.7
11.1
186
22.9
10.2
225
22.5
10.9
20:i
22.0
11.8
187
21.8
12.0
182
20.5
10.8
191
17.4
10.3
169
21.4
11.0
195
20.7
12.4
167
20.1
12.2
166
20.7
12.1
111
21.0
11.2
137
21.5
10.8
198
20.4
10.5
195
21.5
11.8
182
20.9
11.3
184
20.2
12.2
165
20.8
11.2
186
20.7
10.8
191
20.8
10.2
204
20.7
10.3
200
21.6
10.0
215
23.1
9.2
251
Information and Statistics
317
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: 1920-1942
Year
1920 1921 1922 1923 1924 192;, 1926 1927 1028 1929 1930 1931 1932 1933 1034 1935 1936 1937 1938 1939 1940 1941 1942
INFANT MORTALITY
NUMBER
RATE
Total White Col. Total While Col.
5305 2961 2344 88.3 71.1 127.1 4905 2606 2299 73.9 58.5 105.3 4937 2509 2428 75.9 59.1 107.4 5384 2938 2446 84.5 58.4 108.3 5674 2989 2685 89.5 72.2 122.0 4704 2486 2218 78.9 65.0 103.9 4405 2299 2106 87.2 71.3 115.3 4:178 2334 2244 73.5 59.4 97.7 4875 2574 2301 80.9 67.5 104.0 4464 2343 2121 76.3 65.5 93.1 4713 2468 2245 78.1 66.6 96.5 4234 2137 2097 68.5 56.9 86.5 4097 2122 1975 64.3 55.5 17.5 4079 2119 1960 67.2 59.4 78 ..2 5086 2628 2458 78.7 68.6 93.5 4316 2227 2089 68.2 59.6 80.5 4319 2114 2205 70.1 58.2 87.2 3968 2014 1954 62.0 52.7 75.6 4352 2267 2085 67.7 58.7 81.1 3817 1960 1857 58.8 50.4 71.5 3737 1851 1886 57.8 47.6 73.1 3955 1988 1967 58.3 48.2 74.2 3559 1756 1803 49.3 38.9 66.8
MATERNAL MORTALITY
NUMBER
RATE
Total White Col. Total White Col.
558 267 291 9.3 6.4 15.8 568 266 302 8.6 6.0 13.8 658 316 342 10.1 7.4 15.1 573 288 285 9.0 7.0 12.6 708 362 346 11.2 8.7 15.7 641 299 342 10.8 7.8 16.0 485 222 263 9.6 6.9 14.4 578 291 287 9.3 7.4 12.5 622 312 310 10.3 8.2 14.0 549 284 265 9.4 7.9 11.6 658 361 297 10.9 9.7 12.8 616 322 294 10.0 8.6 12.1 620 310 310 9.7 8.1 12.2 463 227 236 7.6 6.4 9.4 505 262 243 7.8 6.8 9.2 458 230 228 7.2 6.2 8.8 491 251 240 8.0 6.9 9.5 471 240 231 7.4 6.3 8.9 421 198 223 6.5 5.1 8.7 356 175 181 5.5 4.5 7.0 342 146 196 5.3 3.8 7.6 315 133 182 4.6 3.2 6.9 299 146 153 4.1 3.2 5.7
Year
1920 1921 1922 1923 u924 1925 "1926 l927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
ILLEGITIMATE BIRTHS
NUMBER
RATE
Total White Col. Total White Col.
2695 474 2221 44.9 11.4 120.4 3077 516 2561 46.4 11.6 117.4 3606 500 3106 55.4 11.8 137.4 4045 543 3502 63.5 13.2 155.0 4089 574 3515 64.5 13.9 159.7 4014 534 3480 67.3 14.0 163.0 3155 461 2694 62.5 14.3 147.5 4089 637 3452 65.7 16.2 150.3 3868 482 3386 64.2 12.6 153.0 4061 515 3546 69.4 14.4 155.7 4141 512 3629 68.7 13.8 156.1 4429 547 3882 71.7 14.6 160.1 5125 600 4525 80.5 15.7 177.6 5101 582 4519 84.0 16.3 180.4 5089 651 4438 78.8 17.0 168.9 5031 643 4388 79.:\ 17.2 169.1 4878 598 4280 79.2 16.5 169.2 4739 526 4213 74.0 13.8 163.1 4724 580 4144 73.5 15.0 161.3 4960 596 4364 76.4 15.3 167.9 5046 565 4481 78.0 14.5 173.8 5134 607 4527 75.7 14.7 170.8 5038 578 4460 69.8 12.8 165.2
STILLBIRTHS
NUMBER
RATE
Total White Col. Total White Col.
3389 3820 3862 3958 3864 3455 2972 3836 3478 3541 3796 3678 3847 3700 4120 3987 3666 3677 3390 3228 3078 2903 2786
1608 1720 1716 1802 1675 1435 1246 1604 1335 1374 1454 1424 1492 1382 1673 1532 1457 1499 1386 1337 1326 1276 1268
1781 2100 2146 2156 2189 2020 1726 2232 2143 2167 2342 2254 2355 2318 2447 2455 2209 2178 2004 1891 1752 1627 1518
56.4 57.5 59.3 62.2 61.0 58.0 58.9 61.6 57.7 60.5 62.9 59.5 60.4 60.9 63.8 63.0 59.5 57.4 52.7 49.7 4 7.6 42.8 38.6
38.6 38.6 40.4 43.9 40.5 37.5 38.7 40.8 35.0 38.4 39.2 37.9 39.0 38.7 43.6 41.0 40.1 39.3 35.9 34.3 34.1 30.9 28.1
96.6 96.2 94.9 95.4 99.5 94.6 94.5 97.2 96.6 95.2 100.7 93.0 92.4 92.5 93.1 94.6 87.3 84.3 78.0 72.8 67.9 61.4 56.2
318
Georgia Department of Public Health
DEATHS AND BIRTHS (EXCLUSIVE OF STILLBIRTHS) AND RATES PER 1,000 PoPULATION, IN GEORGIA: 1920-1942
BIRTHS
NUMBER
RATE
Year Total White Col. Total White Col.
1920 60061 41618 18443 20.7 24.5 1921 66378 44555 21823 22.9 26.0 1922 65082 42475 22607 22.5 24.6 1923 63681 41088 22593 22.0 23.6 1924 63386 41379 22007 21.8 23.6 1925 59610 38254 21356 20.5 21.6 1926 50493 32226 18267 17.4 18.1 1927 62246 39281 22965 21.4 21.9 1928 60259 38135 22124 20.7 21.0 1929 58521 35751 22770 20.1 19.6 1930 60318 37064 23254 20.7 20.1 1931 61774 37531 24243 21.0 20.4 1932 63690 38209 25481 21.5 20.4 1933 60744 35692 25052 20.4 18.8 1934 64615 38333 26282 21.5 20.1 1935 63290 37345 25945 20.9 19.4 1936 61617 36320 25297 20.2 18.7 1937 64012 38181 25831 20.8 19.4 1938 64307 38613 25694 20.7 19.5 1939 64910 38923 25987 20.8 19.5 1940 64695 38911 25784 20.7 19.1 1941 67785 41277 26508 21.6 20.1 1942 72189 45192 26997 23.1 22.2
15.4 18.4 19.3 19.5 19.2 18.8 16.3 20.7 20.2 21.1 21.7 22.5 23.5 23.0 24.0 23.6 22.9 23.2 23.0 23.1 23.8 24.4 24.9
DEATHS
NUMBER
RATE
Total White Col. Total White Col.
32243 29552 31714 34082 34797 31278 29906 31869 36085 35340 35188 32989 32122 31184 35590 34313 37293 34411 33617 31856 32285 31579 28807
17212 15439 16540 17763 17750 15860 15141 16230 18642 18245 18036 17012 16813 16847 19157 18677 20156 18493 18109 17486 17313 16717 15820
15031 14113 15174 16319 17047 15418 14765 15639 17 443 17095 17152 15977 15309 14337 16433 15636 17137 15918 15508 14370 14972 14862 12987
11.1 10.2 10.9 11.8 12.0 10.8 10.3 11.0 12.4 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
9.2
10.1 9.0 9.6
10.2 10.1
9.0 8.5 9.0 10.3 10.0 9.8 9.2 9.0 8.9 10.0 9. 7 10.4 9.4 9.1 8.7 8.5 8.1 7.8
12.5 11.9 12.9 14.1 14.9 13.6 13.2 14.1 15.9 15.8 16.0 14.8 14.1 13.2 15.0 14.2 15.5 14.3 13.9 12.8 13.8 13.7 12.0
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
TYPHOID
NUMBER
RATE
Total White Col. Total White Col.
549 274 275 19.0 16.2 22.9
798 351 447 27.5 20.5 37.7
714 326 388 24.6 18.9 33.1
601 244 357 20.7 14.0 30.8
681 292 389 23.5 16.7 33.9
675 264 411 23.3 14.9 36.2
519 191 328 17.9 10.7 29.3
653 285 368 22.5 15.9 33.2
444 182 262 15.3 10.0 23.9
340 140 200 11.7 7. 7 18.5
500 207 293 17.2 11.2 27.3
513 201 312 17.5 10.8 28.9
363 133 230 12.3 7.1 21.2
251 105 146 8.4 5.5 13.4
316 110 206 10.5 5.8 18.8
261 100 161 8.6 5.2 14.6
195
68 127 6.4 3.5 11.5
139
54
85 4.5 2.7
7.6
121
51
70 3.9 2.6
6.2
83
38
45 2. 7 1.9
4.0
68
27
41 2.2 1.3
3.8
55
22
33 1.7 1.1
3.0
24
6
18 0.8 0.3
1.7
TYPHUS FEVER
NUMBER
RATE
Tctal White Col. Total White Col.
2
2
2
2
2
3
1
0.1 0.1 0.1 0.1 0.1 0.1 0.1. 0.1 0.2 0.03 0.1
10
8
2 o.3 o.5 q_2
6
2
4 0.2 0.1 0.4
1
1 0.03
0.1
9
0.3 0.4 0.1
7
0.2 0.3 0.2
4
4 0.3 0.2 0.4
29
26
3 1.0 1.4 0.3
28
21
0.9 1.1 0.6
28
23
5 0.9 1.2 0.5
44
35
1.4 1.8 0.8
54
43
11 1.8 2.2 1.0
47
33
14 1.5 1. 7 1.3
44
39
5 1.4 2.0 0.4
26
18
0.8 0.9 0. 7
36
27
9 1.1 1.3 0.8
52
40
12 1.7 2.0 1.1
Information and Statistics
319
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1942
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
MALARIA
NUMBER
RATE
Total White Col. Total White Col.
559 242 317 19.3 14.3 26.4
468 195 273 16.2 11.4 23.0
584 256 328 20.2 14.8 27.9
489 201 288 16.9 11.6 24.8
440 181 259 15.2 10.3 22.6
28G 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 14.0 30.1
677 322 355 23.3 17.6 32.8
442 186 256 15.2 10.1 23.9
307 119 188 10.5 6.5 17.4
316 136 180 10.7 7.2 16.6
364 193 171 12.2 10.2 15.7
418 212 206 13.9 11.1 18.8
387 186 211 12.8 9.1 19.2
606 321 285 19.8 16.5 25.7
235 113 122 7.6 5.8 11.0
146
63
83 4.7 3.2
7.4
101
40
61 3.2 2.0
5.4
89
35
54 2.8 1.1
5.0
75
29
46 2.4 1.4
4.2
16
24
52 2.4 1.2
4.8
MEASLES
NUMBER
RATE
Total White Col. Total White Col.
61
41
20 2.1 2.4 1.7
93
66
27 3.2 3.9 2.3
2
3 0.2 0.1 0.3
347 252
95 12.0 14.5 8.2
550 359 191 19.0 20.5 16.7
11
4
1 0.4 0.2 0.6
58
43
15 2.0 2.4 1.3
105
79
26 3.6 4.4 2.4
143 106
37 4.9 5.9 3.4
31
26
1.1 1.4 0.5
128
94
34 4.4 5.1 3.2
62
37
25 2.1 2.0 2.3
15
6
9 0.5 0.3 0.8
72
50
22 2.4 2.6 2.0
540 401 139 18.0 21.0 12.7
25
15
10 0.8 0.8 0.9
8
5
3 0.3 0.3 0.3
10
8
2 0.3 0.4 0.2
157 118
39 5.1 6.0 3.5
51
24
27 1.6 1.2 2.4
23
14
9 0.7 0.7 0.8
157
94
63 5.0 4.6 5.8
60
23
37 1.9 1.1 3.4
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
SCARLET FEVER
NUMBER
RATE
Total White Col. Total White Col.
32
31
28
25
24
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
14
11
11
10
13
11
19
16
16
15
9
8
2
1.1 1.8
0.1
3 1.0 1.5
0.3
4 0.8 1.2
0.3
3 0.7 1.0
0.3
0.1 0.9
0.4
0.4 0.5
0.3
0.5 0.1
0.1
0.9 1.1
0.5
1.2 1.6
0.6
1.4 1.8
0.6
5 1.3 1.8
0.5
8 1.6 2.0
0.7
0.6 0.9
0.2
0.6 1.0
1 0.6 0.8
0.1
2 0.8 1.1
0.2
0.5 0.6
0.3
0.4 0.5
0.1
2 0.4 0.6
0.2
3 0.6 0.8
0.3
0.5 0.1
0.1
0.3 0.4
0.1
0.1 0.1
WHOOPING COUGH
NUMBER
RATE
Total White Col. Total White Col.
373 240 133 12.9 14.2 11.1
183
93
90 6.3 5.4 7.6
130
51
79 4.5 3.0 6.7
254 116 138 8.8 6.7 11.9
435 203 232 15.0 11.6 20.2
313 167 146 10.8 9.4 12.9
141
74
67 4.9 4.2 6.0
229 118 111 7.9 6.6 10.0
163
99
64 5.6 5.5 5.9
280 171 109 9.6 9.4 10.1
257 121 136 8.8 6.6 12.7
113
59
54 3.8 3.2 5.0
112
52
60 3.8 2.8 5.5
223 116 107 7.5 6.1 9.8
334 169 165 11.1 8.8 15.1
149
77
72 4.9 4.0 6.5
61
30
37 2.2 1.5 3.3
142
75
61 4.6 3.8 6.0
225 112 113 7.3 5.7 10.1
134
61
73 4.3 3.1 6.5
108
52
56 3.5 2.6 5.2
140
69
71 4.5 3.4 6.5
101
35
66 3.2 1.7 6.1
320
Georgia Department of Public Health
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: 1920-1942
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
DIPHTHERIA
NUMBER
RATE
Total White Col. Total White Col.
401 283 118 13.8 16.7
9.8
415 294 121 14.3 17.2 10.2
411 277 134 14.2 16.1 11.4
274 199
75 9.5 11.4
6.5
230 167
63 7.9 9.5
5.5
185 119
66 6.4 6. 7
5.8
251 199
52 8.6 11.2
4.6
272 187
85 9.4 10.4
7.7
240 117
63 8.3 9.8
5.8
183 139
44 6.3 7.6
4.1
135 102
33 4.6 5.5
3.1
158 122
36 5.4 6.6
3.3
169 139
30 5.7 7.4
2.8
187 152
35 6.3 8.0
3.2
188 152
36 6.3 8.0
3.3
161 116
45 5.3 6.0
4.1
123
83
40 4.0 4.3
3.6
108
66
42 3.5 3.4
3.8
106
74
32 3.4 3.7
2.9
95
65
30 3.0 3.3
2.7
59
44
15 1.9 2. 2
1.4
63
36
27 2.0 1.7
2.5
55
42
13 1.8 2.1
1.2
INFLUENZA
NUMBER
RATE
Total White Col. Total White Col.
2581 278 1014 1500 886 1384 1493 971 2041 2543 964 1301 1170 1237 1009 1357 1842 1436 802 950 924 994 482
1516 159 615 880 512 773 800 480 1204 1450 532 703 694 694 563 781 1058 739 393 495 503 483 200
1065 119 399 620 374 611 693 491 837 1093 432 598 476 543 446 576 784 697 409 455 421 511 282
89.1 9.6 35.0 51.7 30.5 47.7 51.4 33.4 70.2 87.5 33.1 44.3 39,::; 41.5 33.6 44.8 60.3 46.7 25.9 30.4 29.6 31.6 15.4
89.4 9.3 35.7 50.6 29.2 43.7 44.9 26.7 66.5 79.4 28.9 37.8 37.0 36.6 29.5 40.5 54.4 37.6 19.8 24.8 24.7 23.5 9.8
88.7 10.0 34.0 53.4 32.6 53.9 61.8 44.3 76.5 101.1 40.3 55.4 43.9 49.8 40.7 52.3 70.8 62.6 36.6 40.5 38.8 47.0 26.0
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
DYSENTERY
NUMBER
RATE
Total White Col. Total White Col.
110 116
54 5.9 6.8
4.5
146
88
58 5.0 5.1
4.9
112
69
43 3.9 4.0
3.7
151
90
61 5.2 5.2
5.3
187 104
83 6.5 5.9
7.2
194 119
75 6.7 6.7
6.6
207 129
78 7.1 7.2
7.0
277 172 105 9.5 9.6
9.5
304 189 115 10.5 10.4 10.5
204
99 105 7.0 5.4
9.7
305 158 147 10.5 8.6 13.7
177
86
91 6.0 4.6
8.4
141
85
56 4.8 4.5
5.2
153
86
67 5.1 4.5
6.1
219 123
96 7.3 6.4
8.8
163
86
77 5.4 4.5
7.0
156
78
78 5.1 4.0
7.0
130
61
63 4.2 3.4
5.7
192 107
85 6.2 5.4
7.6
127
65
62 4.1 3.3
5.5
126
67
59 4.0 3.3
5.4
109
52
57 3.5 2.5
5.2
86
43
43 2.8 2.1
4.0
TUBERCULOSIS (ALL FORMS)
NUMBER
RATE
Total White Col. Total White Col.
2362 2531 2683 2642 2620 2448 2278 2307 2375 2190 2115 2165 1933 1111 1172 ,1131 1713 1549 1612 1533 1533 1385 1265
882 1480 81.6 52.0 123.3 892 1639 87.4 52.1 138.1 991 1692 92.6 57.4 144.2 965 1677 91.1 55.5 144.5 911 1703 90.3 52.3 148.4 872 1576 84.4 49.3 1:39.0 807 1471 rs.::; 4o.3 131.2 798 1509 79.4 44.4 136.2 832 1543 81.7 45.9 141.0 742 1448 75.3 40.6 133.9 774 1401 74.6 42.0 130.6 700 1465 73.7 37.7 135.8 665 1268 63.3 35.4 116.9 675 1102 59.6 33.6 101.1 605 1167 58.9 31.7 106.5 649 1082 57.1 33.6 98.2 648 1065 56.1 33.3 96.2 559 990 50.3 28.5 89.0 602 1010 52.0 30.4 90.3 543 990 49.1 27.2 88.1 544 989 49.1 26.7 91.2 501 884 44.0 24.3 81.3 465 8()0 40.5 22.8 73.7
Information and Statistics
321
.CEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY COLOR, IN GEORGIA: 1920-1942
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
SYPHILIS
NUMBER
RATE
Total White Col. Total White Col.
2114
34 170 7.0 2.0 14.2
296
56 240 10.2 3.3 20.2
421
70 351 14.5 4.1 29.9
371
73 298 12.8 4.2 25.7
425
81 344 14.7 4.7 30.0
454
72 382 15.6 4.1 33.7
409
59 350 14.1 3.3 31.2
4:i7
65 392 15.7 3.6 35.4
494 100 394 17.0 5.5 36.0
461
82 379 15.9 4.5 35.0
429
77 352 14.7 4.2 32.8
413
54 359 14.1 2.9 33.2
425
73 352 14.4 3.9 32.5
391
57 334 13.1 3.0 30.6
444
87 357 14.8 4.6 32.6
403
85 318 13.3 4.4 28.9
444
77 367 14.5 4.0 33.2
496
96 400 16.1 4.9 35.9
478
77 401 15.4 3.9 35.9
473
61 412 15.1 3.1 36.7
587 127 460 18.8 6.2 42.4
503 110 393 16.0 5.3 36.2
462
97 365 14.8 4.8 33.6
Year
1920 1921 1922 1923 1924 1923 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
DIABETES MELLITUS
NUMBER
RATE
Total White Col. Total White
182 139
43 6.3 8.2
202 144
58 7.0 8.4
255 182
73 8.8 10.6
249 182
67 8.6 10.5
247 161
86 8.5 9.2
234 174
60 8.1 9.8
223 138
8:; 1.1 1.1
259 177
82 8.9 9.9
329 227 102 11.3 12.5
302 201 101 10.4 11.0
352 240 112 12.1 13.0
322 224
98 11.0 12.1
343 260
83 11.6 13.9
349 241 108 11.7 12.7
389 275 114 12.9 14.4
388 297
91 12.8 15.4
391 299
92 12.8 1:).4
392 281 111 12.7 14.3
420 311 109 13.'i 1:>. 7
368 247 121 11.8 12.4
349 2'>8
91 11.2 12.7
376 278
98 12.0 13.5
370 27;)
93 11.8 13.:>
Col.
3.6 4.9 6.2 5.8 7.5 5.3 7.6 7.4 9.3 9.3 10.4 9.1 7. 7 9.9 10.4 8.:; 8.3 10.0 9. 7 10.8 8.4 9.0 8.8
CANCER
NUMBER
RATE
Total White Col. Total White Col.
1124 1210 1212 1263 1393 1311 1257 1470 1510 14:)6 1332 1580 l'i31 1647 1762 1715 1751 1797 1929 2003 19'\9 2139 2120
766 803 782 870 913 891 860 995 1013 988 1105 1106 1052 1213 1272 12:l9 1239 1320 1343 1426 1380 1473 1509
358 38.8 4:>.2 407 41.8 46.9 430 41.8 45.3 393 43.6 50.0 480 48.0 52.1 420 45.2 50.4 397 43.3 48.2 475 50.6 35.4 497 52.0 55.9 468 50.1 :i4.1 447 53.3 60.0 474 53.8 59.5 479 51.7 56.1 434 55.2 64.0 490 58.6 66.5 476 56.6 64.2 512 :)7.3 63.7 477 58.4 67.2 586 62.2 67.8 577 64.1 71.3 579 62.7 67.7 666 68.0 71.6 611 67.9 74.0
29.8 34.3 36.6 33.9 41.8 37.0 35.4 42.9 45.4 43.3 41.7 43.9 44.2 39.8 44.7 43.2 46.3 42.9 52.4 51.3 53.4 61.3 56.3
PELLAGRA
NUMBER
RATE
Total White Col. Total White Col.
432 210 222 14.9 12.4 18.5
512 234 278 17.7 13.7 23.4
527 249 278 18.2 14.4 23.7
444 227 217 15.3 13.1 18.7
337 181 1:i6 11.6 10.3 13.6
366 181 185 12.6 10.2 16.3
42:; 22J 200 14.6 12.6 17.8
617 292 325 21.2 16.3 29.3
846 358 488 29.1 19.8 44.6
871 334 537 30.0 18.3 49.7
71:l 23::i 458 24.5 13.8 42.7
563 192 371 19.2 10.3 34.4
492 20j 287 16.6 10.9 26.'i
421 179 242 14.1 9.5 22.2
3;;1 163 188 11.7 8.5 17.2
365 190 175 12.0 9.9 15.9
391 184 207 12.8 9.5 18.7
370 17'\ 19') 12.0 8.9 17.3
36;; 170 195 11.8 8.6 17.4
271 134 137 8.7 6.7 12.2
23:1 118 117 7.'J 5.8 10.8
204 106
98 6.5 :u 9.11
181 10!
77 ;1,8 :i.l 7.1
322
Georgia Department of Public Health
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEoRGIA: 1920-1942
Year
1B20 1!!21 1922 1923 1924 1&25 1926 1927 1928 1929 1930 19:11 1932 1933 1934 19a5 1936 1937 1938 1939 1940 1941 1942
CEREBRAL HEMORRHAGE
NUMBER
RATE
Total White Col. Total White Col.
1336 1449 1563 1724 1766 1995 2006 21il 2394 2299 2:\23 2340 2382 2159 2310 2410 2638 2636 2727 3048 3035 3033 2873
807 839 887 1002 963 1044 1078 1195 1297 1257 1317 1256 1269 1195 1222 1337 1425 1444 1465 1598 1574 1513 1538
529 610 676 722 803 951 928 976 1097 1042 1206 1084 1113 964 1088 1073 1213 1192 1262 1450 1461 1520 1335
46.1 50.0 53.9 59.5 60.9 68.7 69.1 74.7 82.4 79.1 86.6 79.7 80.5 72.4 76.8 79.5 86.4 85.7 88.0 97.6 97.2 96.4 92.0
47.6 49.0 51.4 57.6 54.9 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 75.5
44.1 51.4 37.6 62.2 70.0 83.9 82.8 88.1 100.2 96.3 112.4 100.5 102.6 88.4 99.3 97.4 109.6 107.1 112.8 129.0 134.6 139.9 123.0
HEART DISEASE
NUMBER
RATE
Total White Col. Total White Col.
1892 1768 1996 2388 2424 2297 2429 2929 :1307 3691 4099 3948 4102 3993 5019 5071 5606 5284 5246 5417 6176 5780 5251
1053 923
1953 1186 1165 1077 1198 1497 1717 1923 21119 2101 2308 2360 2!!111 2961 3270 3132 3059 3240 3662 3316 3165
839 65.3 62.1 845 61.0 54.0 943 68.9 61.0 1202 82.3 68.2 1259 83.5 !Hi A 1220 79.1 (i().!J 1231 83.7 (i7 .2 1432 100.!! s:1.:1 1590 113.8 !14.8 1768 126.9 10:1.:1 1990 140.6 114.:J
1847 134.4 u:;.o
1794 138.6 12:!.11 1633 133.8 12Ui 2118 166.9 1;-)J .X 2110 167.3 J:i:l.:J 2336 183.6 168.0 2152 111.7 lti!),j 2187 169.2 134.4 2177 173.5 162.1 2514 197.7 17!1.6 2464 183.8 161.1 2086 168.1 1:-i:J.:;
6!1.!1 '1.2 811.3 1113.6 I 11!1.7 1117.1i 111!1. 8
1~:1.:1
l4:J.:I Hi:l.:i 18:1.1 J7U J!i;i ..i li!I.S 1 u:L:; l!ll.li 211.0 JU3.4 I!IG.Ii I !1:1.7 2:ll.7
2~(i.7
JH2.2
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
PNEUMONIA
NUMBER
RATE
Total White Col. Total White Col.
2766 1925 2664 3199 2922 2335 2442 2132 2776 2316 2580 2465 2444 2314 3030 3035 3803 3077 2731 22(!9 2055 1714 1612
1470 1050 1447 1596 1382 1135 1180 1015 1441 1165 1240 1255 1204 1172 1580 1572 2012 1490 1321 1209 1019
800 737
1296 875
1217 1603 1540 1200 1262 1117 1335 1151 1340 1210 1240 1142 1450 1463 1791 1587 1410 1090 1036
914 87f)
95.5 66.4 91.9 110.3 100.7 80.5 84.1 73.4 95.5 79.6 88.5 83.9 82.5 77.6 100.8 100.2 124.6 100.0 88.1 73.6 65.8 54.5 :il.6
86.7 61.4 83.9 91.8 78.8 64.2 66.2 56.5 79.5 63.8 67.4 67.5 64.1 61.9 82.7 81.5 103.4 75.9 66.< 60.5 50.0 38.9 36.2
108.0 73.7
103.7 138.1 134.2 105.8 112.6 100.8 122.0 106.4 124.9 112.2 114.3 104.8 132.3 132.9 161.8 142.6 126.1
97.0 9:>.:i 84.1 80.6
DIARRHEA AND ENTERITIS (UNDER 2 YEARS)
NUMBER
RATE
Total White Col. Total White Col.
1252 759 493 43.2 44.7 41.1 1230 722 508 42.5 42.2 42.H 1175 686 489 40.5 39.8 41.7 1183 698 485 40.8 40.1 41.8 1:122 736 586 4o.6 12.11 :; 1.1
!149 510 439 32.7 28.8 3H.7 873 462 411 30.1 25.!1 ::li.7
810 440 370 27.!1 2cl.:) :::1.1
730 434 296 2:\.1 24.11 2<'.11 :i26 292 234 18.1 16.0 2Ui 721 453 268 24.7 24.6 2:i.O 54:i 291 2;,4 18.6 1:i.7 2:1.:; 3!10 254 136 13.2 1:J.:J 12.5 493 324 169 16.:i 17.1 l:J.:> 651 378 273 21.7 1!1.8 24.9 ;)07 :lOS 199 16.7 16.0 18.1 :149 3G:J 246 18.0 1:i.(i 22.2 480 247 233 1:1.6 12.6 20.9 fiHl 38:) :J06 22.3 19.4 27.1 416 217 1!19 13.3 10.9 17.7 395 21J 180 12.6 10.6 16.6 43:> 218 217 1:3.8 10.6 20.0 284 138 146 9.1 6.8 13.:i
1nformation and Statistics
323
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: 1920-1942
Year
1920 1921 1922 1923 1924 1920> 1926 1927 1928 1929 1930 1931 1932 1!133 1934 1935 1936 19:l7 1938 1939 1940 1941 1942
APPENDICITIS
NUMBER
RATE
Total White Col. Total White
236 152
84 8.2 9.0
276 190
86 9.5 11.1
300 208
92 10.4 12.1
281 183
98 9.7 10.5
318 210 108 11.0 12.0
357 212 145 12.3 12.0
289 178 Ill 10.0 10.0
330 211 119 11.4 11.7
364 236 128 12.5 13.0
3:;o 228 102 11.3 12.5
333 211 122 11.4 11.5
H7 234 113 11.8 12.6
358 2tiil 103 12.1 13.6
:J23 218 105 10.8 1 Ui
339 226 113 11.3 11.8
300 202
98 9.9 10.5
312 201 111 10.2 10.3
319 2:l0
89 10.4 11.7
287 194
93 9.3 9.8
280 186
94 9.0 9.3
276 159 117 8.8 7.8
230 135
95 7.3 6.6
174 102
72 5.6 'i.O
Col.
7.0
';',3
7.8 8.4 9.4 12.8 9.9 10.7 11.7 9.4 11.4 I O.:i 9.5 9.6 10.3 8.9 10.0 8.0 8.3 8.4 10.8 8.7 6.6
NEPHRITIS (ACUTE AND CHRONIC)
NUMBER
RATE
Year Tctal White Col. Total White Col.
1920 1921 1922 1923 1924 1923 1926 1927 1928 1929 1930 19:11 1932 1933 19:14 1935 1936 1937 1938 1939 1940 1941 1942
2200 2446 2903 3139 3449 3228 3385 3620 4105 4003 3787 :1226 3216 3118 3:J01 315;; 3446 3458 :J:i31 3041 3:l48 :1381 3187
1258 1:147 1592 1684 1787 1715 1721 1970 2162 2187 2060 1794 1753 1769 1903 1803 1910 1919 1996 1771 1848 1816 1766
942 1099 1311 1455 1662 1513 1664 1650 1943 1816 1727 1432 1463 1349 1398 1352 1536 1539 153'\ 1270 1o00 1'i6:i 1421
76.0 84.4 100.1 108.2 118.9 111.2 116.6 124.6 14U 137.7 129.9 109.8 108.6 104.'\ 109.8 104.1 112.9 112.4 113.9 97.4 107.2 107.'\ 102.0
74.2 78.7 92.3 96.8 101.9 97.0 96.5 109.6 119.3 119.8 111.9 96.5 93.4 93.4 99.6 93.5 98.1 97.7 100.7 88.6 !10.7 88.2 86.6
78.5 92.6 111.7 12:i.4 144.9 133.4 148.4 148.9 17Ui 167.9 160.9 132.8 134.9 !23.8 127.6 122.8 138.8 138.3 1:l7.3 113.0 138.2 144.0 130.9
CIRRHOSIS OF LIVER
NUMBER
RATE
Tctal White Col. Total White Col.
93
61
83
52
78
43
90
54
98
69
117
77
99
62
12!)
75
102
61
128
74
134
80
124
87
91
61
116
73
110
73
142
97
139
87
151
95
141 100
Ia2 111
14:i 102
154 110
157 123
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 3.4 3.9 2.:;. 40 4.0 4.4 3Ji 37 :l.4 3.3 3.3 50 4.3 4.2 4.a
41 3.5 3.4 3.8
:i4 4.4 4.1 ;;.o
54 4.6 4.3 :>.0 37 4.2 4.7 3.4 30 3.1 3.3 2.8 43 3.9 3.9 :1.9
:n 3. 7 3.8 3.4
45 4. 7 5.0 4.1 52 4.6 4.;) 4. 7 56 4.9 4.8 5.0 41 4.'\ 5.0 3. 7 41 4.9 5.6 3.6
43 4.6 ;;.o 4.0
44 4.9 a.3 4.0
34 5.0 6.0 3.1
MALFORMATION, EARLY INFANCY
NUMBER
RATE
Total White Col. Total White Col.
1878 2480 2842 2878 2995 20>26 2239 2192 180>9 17 42 1890 1827 1662 1639 1904 1736 1797 1663 2431 2150> 2034 216:l 2020
1245 1446 1505 1636 1674 1434 1251 1244 1132 1050 118a 1111 1024
994 1126 1076 1064 1028 1289 1199 1098 1206
n:;;
633 64.8 1034 85.6 1337 98.4 1242 99.2 1321 103.2 1092 87.0
988 77.1 948 7'\.r; 727 64.0 692 :\9.9 70:i 64.8 716 62.2 638 56.1 645 :i4.9 778 63.3 660 !l'i".:J 73:J ii8.8 6:1:J :>4.1 1142 78.4 956 69.0 936 65.1 957 68.8 883 64.7
73.4 84.5 87.2 94.0 95.4 81.1 70.2 69.:i 62.'\ Oi7.5 64.3 59.7 54.6 52.:i 58.9 5:J.S 54.7 52.3 65.1 60.0 53.9 58.6 5ii.S
:i2. 7 87.1 113.!1 107.0 .I,I!i.1 96.:1 88.1 8'\.6 66.4 64.0 65.7 66.4 ;;s.x :i!l.2 71.0 ri9.H 66.2 57.1 102.1 8'\.1
86.~
88.1 81.3
324
Georgia Department of Public Health
DEATHs AND DEATH RATES PER 100,000 PoPuLATION FROM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: 1920-1942
Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930
19~1
1932 1933 1934 1!13:0 19H6 1!1:H u1:1s 1939 1940 1941 1942
Year
1921) 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 193:) 1936 1937 1938 1939 19411 1941 1942
SUICIDE
NUMBER
RATE
Total White Co!. Total White Col.
128 110
18 4.4 6.a
1.;)
167 142
25 5.8 8.3
2.1
181 152
29 6.2 8.8
2.5
166 150
16 5.7 8.6
1.4
19;j 173
22 6.7 9.9
1.9
189 169
20 6.:0 9.6
1.8
1:04 134
20 5.3 7.5
1.8
198 179
19 6.8 10.0
1.7
24:1 210
33 8.4 11.6
:l.O
287 268
19 9.9 14.7
1.8
296 27:!
2:1 10.2 14.8
2.1
31:; 282
31 10.7 15.2
2.9
304 279
25 10.3 14.9
2.3
:n2 276
36 10.5 14.6
3.3
2H7 26:1
32 9.9 13.9
2.9
300 270
30 9.9 14.0
2.7
311 284
27 10.2 14.6
2.4
315 288
27 10.2 14.7
2.4
29;; 266
29 9.5 13.4
2.6
316 290
26 10.1 14.5
2.:l
282 246
36 9.0 12.1
3.3
2:16 212
24 7.'i 10.3
2.2
219 20:1
16 7.0 10.0
1.;)
MOTOR VEHICLE ACCIDENTS
NUMBER
RATE
Total White Col. Total White Col.
140 100
40 4.8 5.9
3.3
132 108
24 4.6 6.3
2.0
203 142
61 7.0 8.2
5.2
267 189
78 9.2 10.9
6.7
31:1 239
74 10.8 13.6
6.5
348 238 110 12.0 13.5
9.7
370 266 104 12.7 14.9
9.3
483 288 14'i 14.9 16.0 13.1
473 319 Li4 16.3 17.6 14.1
G:H 33;, 196 18.3 18.3 18.1
612 425 187 21.0 23.1 17.4
655 428 227 22.3 23.0 21.0
:-18:-i 426 159 19.7 22.7 14.7
6Fi 47:1 202 22.6 25.0 18.'i
809 574 23'i 26.9 30.0 21.4
942 646 296 31.1 33.:i 26.9
991 692 299 32.4 35.'i 27.0
964 680 284 31.3 34.6 2:-i ..)
789 !)45 244 2fi.4 27.S 21.8
669 483 186 21.4 24.2 16.5
802
;);)6
246 25.7 27.3
22.7
946 6:)i 289 311.1 31.!1 2.6
67:1 47-1 1!19 21.5 23.3 18.3
HOMICIDE
NUMBER
RATE
Total White Col. Total White Col.
479 100 379 16.5 5.9 31.6
a49 143 406 19.0 8.4 34.2
564 146 418 19.G 8.:i 3G.6
505 12:1 380 17.4 7.2 32.7
:>62 15;:) 407 19.4 8.8 3a.5
464 141 323 16.0 8.0 28.3
395
97 298 13.6 5.4 26.1i
;)10 141 369 17.6 7.9 '!13.3
:)12 159 3:i3 17.6 8.8 32.3
:J2:l 14H 374 18.0 8.2 34.6
569 us 411 19,:, 8.6 31!.3
597 179 418 20.3 9.6 38.8
:354 175 379 18.7 9.:; 35.0
670 208 462 22.5 11.0 42.4
720 205 :il5 23.9 10.7 4/.0
661 1:i6 504 21.8 8.1 4:0.8
:J89 1;)5 434 19.3 8.0 39.2
liH 136 50:i 20.8 6.9 45.4
582 131 451 18.8 6.6 40.:l
i)6(l 109 451 17.9 5.5 40.1
616 111 50;:) 19.7 5.4 46.5
649 120 529 20.6 5.8 48.7
:-i19 102 417 16.6 5.0 38.4
ACCIDENTS AND OTHER VIOLENCE
NUMBER
RATE
Total White Col. Total White Col.
1603 853 750 55.3 50.:~ 62.5
1436 788 668 50.3 46.1 56.:l
1508 846 662 52.0 49.0 fi(i.4
1575 8:10 725 54.3 48.9 62.:i
1772 945 827 61.1 53.9 72.1
1682 947 735 58.0 fi3.6 64.8
Li85 928 657 54.6 ;)2,1 58.0
1831 1035 796 63.0 a7.6 7U1
1901 1090 811 6a.4 60.2 74.1
1978 1113 865 68.0 60.9 80.0
1992 1164 828 68.4 6:1.2 77.2
2010 1243 767 68.4 66.9 71.1
1914 1182 732 64.6 63.0 Gl.:i
1992 1213 779 66.8 64.0 71.:i
22:;1 1389 2428 1453
862 74.9 72.7 78.7
97:; 80.1 7G.3 ss.:;
277.i 1682 1093 90.9 86.4 98.7
2413 149:i 918 78.4 76.1 82.:i
212;) 1309 816 68.6 66.1 7:!.11
1850 1186 664 59.2 59.4 59.0
20:i7 1217 840 6o.9 59.7 77.4
2208 1412 7!!6 70.2 68.6 7:!.2
2056 1328 728 6o.s 65.2 67.1
Information and Statistics
325
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 RATE-S
PER 1,000 LIVE BIRTHS, BY CoLoR, IN GEORGIA: 1942
Cause of Death
Total
Number White
Colored
Total
Rate White
Colored
ALL CAUSES
28,807
Typhoid fever ____________ _ Typhus fever ____________ _
:llalaria Smallpox _________________ Measles ___________________ Scarlet fever _____________ Whooping cough __________ _ Diphtheria ________________
Influenza Dysenlery ________________ _ Poliomyelitis ______________
Lethargic encephalitis ____ _ l\Ieningoeoccus meningitis _ Tuberculosis ______________ Syphilis _________________ _ Gonorrhea ________________
Cancer ------------------Diabetes mellitus _________ _
Pellagra -----------------Cerebral hemorrhage, em-
bolism and thrombosis __ Heart diseases ___________ _ Pneumonia _______________ _
[}iarrhea and enteritis (-2 rears) _______________ _
Appendicitis Cirrhosis o.f liver _________ _ Xephritis ________________ _
:\lalfonnation and early infancy diseases _________
Suicide ___________________ Homicide __ ________________
24 52 76
60 2
101 55
482 86 10
18 1,265
462 6
2,120 370 181
2,873 5,251 1,612
284 174 157 3,187
2,020 219 519
Motor vehicle accidents ___ All other accidents ________
l:nlmown and ill-defined causes ________________
All other causes ____ _______
673 1,383
1,071 4,009
15,820
40 24
23
35 42 200 43
12 465
97
1,509 275 104
1,538 3,165
737
138 102 123 1,766
1,137 203 102 474 854
403 2,193
12,987 18 12 52
37
66 13 282 43
800 365
611 95 77
1,335 2,086
875
146 72 34
1,421
883 16
417 199 529
668 1,816
922.2
0.8 1.7 2.4
1.9 0.1 3.2 1.8 15.4 2.8 0.3 0.2 0.6 40.5 14.8 0.2 67.9 11.8 5.8
92.0 168.1
51.6
9.1 5.6 5.0 102.0
64.7 7.0
16.6 21.5 44.3
34.3 128.3
776.1
0.3 2.0 1.2
1.1 0.1 1.7 2.1 9.8 2.1 0.2 0.1 0.6 22.8 4.8
74.0 13.5
5.1
75.5 155.3
36.2
6.8 5.0 6.0 86.6
5J.8 10.0
5.0 23.3 41.9
19.8 107.6
1196.5
1.7 1.1 4.8
3.4
6.1 1.2 26.0 4.0 0.5 0.2 0.6 73.7 33.6 0.6 56.3 8.8 7.1
123.0 192.2
80.6
13.5 6.6 3.1
130.9
81.3 1.5
:J8.4 18.3 48.7
61.5 167.3
Live births _______________ 72,189
45,192
26,997
23.1
22.2
24.9
Stillbirths _________________ 2,786
1,268
1,518
38.6
28.1
56.2
Infant mortality
3,559
1,756
1,803
49.3
38.9
66.8
:\laternal mortality
299
146
10,3
4.1
3.2
5.7
NOTE: These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring In other states.
326
Georgia Department of Public Health
TABLE 6
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED
CAUSES, LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS,
INFANT AND MATERNAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS,
BY CoLoR, IN GEORGIA: 1941
Cause of o.,atn
Total
Number White
Colored
Total
Rate White
Colored
ALL CAUSES --------- 31,579
1'yphold fever ------------
5;.
Typhus fever --------------
36
Malaria ------------------
75
Smallpox _________________
Measles -------------------Scarlet fever -------------Whooping cough ____ ------Diphtheria __________________
Influenza ---------------Dysentery ___________________
Poliomyelitis ___ -----------Lethargic encephalitis -----Meningococcus meningitis -Tuberculosis --------------Syphilis ------------Gonorrhea ---------------Cancer ------------------Diabetes mellitus ---------Pellagra -----------------Cerebral hemorrhage, em-
bolism and thrombosis Heart diseases -----------Pneumonia ---------------Diarrhea and enteritis (-2
years) ---------------Appendicitis -------------Cirrhosis of liver --------Nephritis ----------------Malformation and early In-
fancy diseases -------Suicide ------------------Homicile -----------------Motor vehicle accidents ---AU other accidents ------Unknown and Ill-defined
causes ----------------
157 9
140 63
994 109 33
5 17 1,385 503 24 2,139 376 204
3,033 5,780 1,714
435 230 154 3,381
2,163 236 649 946
1,262
1,026
16,717
22 27 29
94 8 69 36 483 52 25
14 501 110
1,473 278 106
1,513 3,316
800
218 135 110 1,816
1,206 212 120 657 755
356
14,862
33 9 46
63
71 27 511 57
2 3 884 393 23 666 98 98
1,520 2,464
914
217 95 44
1,565
957 24
529 289 507
670
1004.0
1.7 1.1 2.4
5.0 0.3 4.5 2.0 31.6 3.5 1.0 0.2 0.5 44.0 16.0 0.8 68.0 12.0 6.5
96.4 183.8
54.5
13.8 7.3 4.9
107.5
68.8 7.5
20.6 30.1 40.1
32.6
812.1
1.1 1.3 1.4
4.6 0.4 3.4 1.7 23.5 2.5 1.2 0.1 0.7 24.3 5.3 0.04 71.6 13.5 5.1
73.5 161.1
38.9
10.6 6.6 5.3
88.2
58.6 10.3
5.8 31.9 36.7
17.3
1367 .a
3.0 0.8 4.2
5.8 0.1 6.!) 2.5 47.0 5.2 0.7 0.2 0.3 81.3 36.2 2.1 61.3 9.0 9.0
139.9 226.7
84.1
20.0 8.7 4.0
144.0
88.1 2.2
48.7 26.6 46.6
61.6
All other causes ----------- 4,246 Live births --------------- 67,785 Stillbirths ---------------- 2,903 Infant mortality ----------- 3,955 Maternal mortality -------- 315
2,172 41,277
1,276 1,988
133
2,074 26,508
1,627 1,967
182
135.0 21.6 42.8 58.3 4.6
105.5 20.1 30.9 48.2 3.2
190.8 24.4 61.4 74.2 6.9
NOTE: These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states.
Information and Statistics
327
TABLE 7
CENSUS ENUMERATED PoPuLATION As OF APRIL 1, 1940,
BY COLOR AND CouNTY, IN GEORGIA
County
Total
White Colored
County
Total
White Colored
TOTAL 3,123,723 2,038,278 1,085,445
Appling ---- 11,497
11,856
2,641
Atkinson --
7,093
5,422
1,671
Bacon -----
8,096
7,042
1,054
Baker -----
7,344
3,049
4,295
Baldwin --
Banks -----
16,411 8,733
7,713 8,072
8,698 661
Barrow ---- 13,064
10,605
2,459
Bartow ---Ben Hill ___
25,283 14,523
21,073 9,674
4,210 4,849
Berrien ---- 15,370
13,033
2,337
Bibb ------ 83,783
48,239
35,544
B!eckley
9,655
6,331
3,324
Brantley ---
6,871
5,727
1,144
krooks
20,497
9,9no
10,507
Bryan
6,288
3,735
2,553
Bulloch
26,010 16,168
9,842
Burke ----- 26,520
6,654
19,866
Buas ------
9,182
4,891
4,291
Calhoun --- 10,438
3,309
7,129
Camden
5,910
2,486
3,424
Candler
9,103
5,996
3,107
Carroll
34,156 26,903
7,253
Catoosa
10,899 10,576
323
Charlton
5,256
3,760
1,496
Chatham
117,970
65,027
52,943
Chatt'chee -
5,138
3,110
2,028
Chattooga -Cherokee ___
18,532 20,126
16,720 19,229
1,812 897
Clarke
28,398
18,335
10,063
Clay ------
7,064
2,077
4,987
('layton --- 11,655
8,671
2,984
Clinch -----
6,437
3,938
2,499
Cobb ------ 38,272
31,990
6,282
Coffee ----- 21,541
16,165
5,376
Colquitt --- 33,012
24,955
8,057
Columbia --
9,433
3,769
5,664
Cook ------ 11,919
8,728
3,191
Coweta ---- 26,972
16,149
10,823
Crawford --
7,128
3,105
4,023
f'risp ------ 17,540
9,426
8,114
Dade ------
5,894
5,597
297
nawson
4,479
4,415
64
Decatur ____ 22,234
11,473
10,761
DeKalb
86,942
72,973
13,969
Dodge ----- 21,022
14,045
6,977
Dooly ----- 16,886
7,555
9,331
Dougherty Douglas ____
28,565 10,053
13,028 7,880
15,537 2,173
Early ----- 18,679
9,065
9,614
Echols ~----
Effingham Elbert
Emanuel --Evans Fannin ---Fayette Floyd ----Forsyth
Franklin
Fulton ----Gilmer _____
Glascock Glynn ----Gordon ---Grady ----Greene _____
Gwinnett -Habersham _
Hall
Hancock --Haralson ___
Harris ----Hart -----Heard ----Henry ----Houston --Irwin -----Jackson --Jasper ----Jeff Davis -
Jefferson --
Jenkins
Johnson --Jones -----Lamar ---Lanier ----Laurens --Lee ________
Liberty
Lincoln ---Long -----Lowndes --Lumpkin McDu~fie -Mcintosh --
Macon ----Madison --Marion Meriwether _
2,964 9,646 19,618 23,517 7,401 14,752 8,170 56,141 11,322 15,612 392,886 9,001 4,547 21,920 18,445 19,654 13,709 29,087 14,771 34,822 12,764 14,377 11,428 15,512 8,610 15,119 11,303 12,936 20,089 8,772 8,841 20,040 11,843 12,953 8,331 10,091 5,632 33,606 7,837 8,595 7,042 4,086 31,860
6,223 10,878
5,292 15,947 13,431
6,954 22,055
"'Baldwin County population excludes the State Milledgeville Hospital.
1,899 5,644 11,887 15,206 4,908 14,675 5,503 47,500 11,281 13,342 269,743 8,952 3,326 13,356 17,242 12,930 6,554 25,751 14,104 31,483 3,581 12,853 4,626 11,551 6,023 7,955 3,984 8,178 16,548 3,777 7,231 8,583 5,306 8,029 3,250 5,668 4,017 19,861 1,895 3,077 3,423
2,625 17,186
6,003 5,565 2,135 5,053 10,826 3,129 10,334
1,065 4,002 7,731 8,311 2,493
77 2,667 8,641
41 2,270 123,143
49 1,221 8,564 1,203 6,724 7,155 3,336
667 3,339 9,183 1,524 6,802 3,961 2,587 7,164 7,319 4,758 3,541 4,995 1,610 11,457 6,537 4,924 5,081 4,423 1,615 13,745 5,942 5,518 3,619 1,461 14,674
220 5,313 3,157 10,894 2,605 3,825 11,721
328
Georgia Department of Public Health
TABLE 7 (Continued)
CENSUS ENUMERATED PoPuLATION As OF' APRIL l, 1940,
BY COLOR AND CouNTY, IN GEORGIA
County
Total
White Colored
County
Total
White Co:ored
Miller ----lllitchell --1\Ioiiroe ---Montgomery_
Morgan ---Murray ---l\luscogee --
:"'ewton ---Oconee ---Oglethorpe Paulding -Peach ----Pickens ---Pierce
Pike ------Polk _______
Pulaski --Putnam ---Quitman
Rabun
Randolph -Richmond -Rockdale ___
Schley ----Screven
Seminole --
Spalding
Stephens --Stewart Sumter ----
9,998 23,261 10,749
9,668 12,713 11,137 75,494 18,576
7,576 12,430 12,832 10,378 9,136 11,800 10,373 28,467
9,829 8,514 3,43;) 7,821 16,609 81,863 7,724 5,033 20,353 8,492 28,427 12,972 10,603 24,502
6,753 10,996
4,596 5,788 5,936 10,756 49,478 12,154 5,317 6,934 11,534 4,012 8,656 9,346 5,310 23,698 4,470 3,417 1,057 7,686 5,205 48,494 5,274 1,999 8,746 5,035 19,485 11,116 2,882 9,504
3,245 12,265
6,153 3,880 6,777
381 26,016 6,422
2,259 5,496 1,298 6,366
480 2,454 5,065 4,769 5,359 5,097 2,378
135 11,404 33,369
2,448 3,034 11,607 3,457 8,942 1,856 7,721 14,998
Talbot Taliaferro Tattnall Taylor ----Telfair Terrell Thomas Tift -- Toombs Towns Treutlen --Troup ----Turner ---Twiggs ---Union ----Upson ----Walker Walton ---Ware -----\Varren ---Washington_
Wayne ---Webster --Wheeler --White Whitfield -Wilcox ---Wilkes ----Wilkinson -Worth -----
8,141 6,278 16,243 10,768 15,143 16,673 31,289 18,599 16,932 4,925 7,632 43,879 10,846 9,117 7,680 25,064 31,024 20,777 27,929 10,236 24,230 13,122 4,726 8,535 6,417 26,105 12,7;);) 15,084 11,025 21,374
2,460 1,997 12,076 5,586 10,358 4,714 17,309 13,106 12,434 4,925 5,333 27,527 7,036 3,253 7,669 17,377 28,789 14,168 20,389 3,G71 10,357 10,328 1,834 5,855 6,o;,o 24,640 7,879 6,041 5,618 11,397
5,681 4,281 4,167 5,182 4,787 11,961 13,980 5,493 4,518
2,299 16,352
3,810 5,864
11 7,687 2,235 6,609 7,540 6,665 13,873 2,794 2,892 2,680
367 1,465 4,876 9,043 5,407 9,977
Information and Statistics
TABLE 8
LIVE BIRTHs AND RATES PER 1,000 PoPULATioN, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHs IN EAcH CouNTY IN GEoRGIA: 1941 AND 1942
County
LIVE BIRTHS
Rate Per 1,000
Number
Population
1942 1941
1942 1941
TOTAL
72,189 67,78:> 2:l.l 21.6
Appling
364
329 25.1 22.7
Atkinson _________________ _ 187
179 26.4 25.2
Bacon
228
207 28.2 25.6
Baker
199
1:i6 27 .I 21.2
Baldwin
324
Banks __
161
Barrow ___________________ _ 262
Bartow __________________ _ 599
Ben Hill ____ ----~ _______ _ 278
336 19.7 20.5
180 18.4 20.6
277 20.1 21.2
;)2;)
23.7
20.8
279 19.1 19.2
Berrien Bibb Bleckley Brantley Brool<s
26;)
:130 17.2 2U
2,336 1,861 27.9 22.2
249
233 25.8 24.1
169
174 24.6 25.3
5:Hl
503 26.8 24.;
Bryan
14:1
Bulloch
519
Burke ___________________ _ 713
Butts _
215
Calhoun
287
145 22.7 23.1 538 20.0 21.5 729 26.9 27.5 211 23.4 23.0 230 27.5 22.0
Camden
186
Candler
134
Carroll
653
Catoosa __________________ _ 190
Charlton __ ~---------------
97
Chatham _________________ _
Chattahoochee Chattooga _______ ---------Cherokee ________________ _ Clarke ___________________ _
3,137 66
413 409 542
Clay ---------------------- 157 Clayton __________________ _ 207
Clinch -----------~~-------- 138 Cobb ____________________ _ 880
Coffee -------------------- 652
Colquitt __________________ _ 910 Columbia ________________ _ 207 Cook ____________________ _ 248
Cowe<ta ------------------- 524 Crawford _________________ _ 167
Oris]l -------------------Dade --------------------Da\vson Decatur DeKalb
423 122
72 608 1,929
155 131 721 173 123
2,513 71
447 437 499
165 191 107 759 597
719 213 248 482 159
408 118
94 506 1,702
31.5 14.7 19.1 17.4 18.5
26.6 12.8 22.3 20.3 19.1
22.2 17.8 21.4 23.0 30.3
27.6 21.9 20.8 19.4 23.4
24.1 20.7 16.1 27.3 22.2
26.2 14.4 21.1 15.9 23.4
21.3 13.8 24.1 21.7 17.6
23.4 16.4 16.6 19.8 27.7
21.8 22.6 20.8 17.9 22.3
23.3 20.0 21.0 22.8 19.6
STILLBIRTHS
Rate Per 1,000
Number
Live Births
1942 1941 1942 1941
2,786 2,903 38.6 42.8
14
14 38.5 42.6
6
11 32.1 61.5
12 13 52.6 62.8
s
8 40.2 51.3
1:\
11 46.3 32.7
10
3 62.1 16.7
7
11 26.7 39.7
26
24 43.4 41.7
12
17 43.2 60.9
6 14 22.6 42.4
111 105 47.5 56.4
8
32.1 30.0
10 53.3 !l7.S
24 35 43.6 69.6
9 10 62.9 69.0
22
14 42.4 25.1
27
45 37.9 61.7
8
4 37.2 19.0
11
11 38.3 47.8
11
11 59.1 71.0
37.3 38.2
29
25 44.4 34.7
5
4 26.3 23.1
10
103.1 32.5
160 102 51.0 40.6
1
3 15.2 42.3
3
4
7.3
8.9
17
10 41.6 22.9
21
21 38.7 42.1
12.7 54.5
11
16 53.1 83.8
7.2 18.7
34
2;) 38.6 32.9
34 43 52.1 72.0
40
37 44.0 51.5
11 24.2 51.6
18 16.1 72.6
23
7 43.9 14.5
10 10 59.9 62.9
22
24 52.0 58.8
24.6 16.9
2 27.8 21.3
30
17 49.3 33.6
65
51 33.7 30.0
330
Georgia Department of Public 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: 1941 AND 1942
County
LIVE BIRTHS
Rate Per I,000
Number
Population
1942 1941
1942 1941
STILLBIRTHS
Rate Per I,000
Number
Live Births
1942 1941 1942 1941
Dodge
444
Dooly --------------------- 378
Dougherty
692
Douglas ------------------- 196 Early ____________________ _ 489
443 21.1 21.1 423 22.4 25.1 585 24.2 20.5 204 19.5 20.3 447 26.2 23.9
Echols __________________ _
51
Effingham _______________ _ 188
Elbert -------------------- 429 Emanuel _________________ _ 479 Evans ___________________ _ 187
68 17.2 22.9 244 19.5 25.3 370 21.9 18.9 502 20.4 21.3 185 25.3 25.0
Fannin ___________________ 320
329
21.7
22.3
Fayette __________________ 160
202 19.6 24.7
Floyd --------------------- 1,326 1,274 23.6 22.7
Forsyth ------------------- 257 Franklin __________________ 294
237 22.7 20.9 315 18.8 20.2
10
22 22.5 49.7
20
13 52.9 1l0.7
28 32 40.5 54.7
25.5 34.3
12 13 24.5 29.1
4
3 78.4 44.1
10
10 53.2 41.0
19 23 41.3 62.2
14
29 29.2 57.8
4
13 21.4 70.3
6
18.8 27.4
31.3 39.6
54
43 40.7 33.8
10
38.9
8.4
13 23.8 41.3
Fulton -------------------Gilmer __ -----------------Glascock __________________ Glynn ___________________ _
Gordon
8,534 244 106 585 388
8,026 232 110 497 450
Grady
473
443
Greene -------------------- 318 320
Gwinnett ------------------ 571 509
Habersham _______________ 313
318
Hall ---------------------- 751
706
Hancock ------------------ 356 314
Haralson ------------------ 259
223
Harris -------------------- 239 253
Hart ---------------------- 303
326
Heard
118
119
Henry
327 317
Houston ------------------ 303
270
Irwin --------------------- 338 284
Jackson ------------------- 458
433
Jasper ____________________ 174
183
Jeff Davis ---------------- 177
211
Jefferson _________________ _ 486
480
Jenkins ------------------- 310
336
Johnson ------------------- 226
200
Jones --------------------- 208 187
Lamar -------------------- 198 207
Lanier ___________________ _ 83
85
21.7 27.1 23.3 26.7 21.0
24.1 23.2 19.6 21.2 21.6
27.9 18.0 20.1! 19.5 13.7
21.6 26.8 26.1 22.8 19.8 20.0
24.3 26.2 17.4 25.0 19.6 14.7
20.4 25.8 24.2 22.7 24.4
22.5 23.3 17.5 21.5 20.3
24.6 15.5 22.1 21.0 13.8
21.0 23.9 22.0 21.6 20.9 23.9
24.0 28.4 15.4 22.4 20.5 15.1
269 270 15 6 30 30 9 13
27
19
17
16
20
18
13
16 19
10
10
11
11
3
15 13
23
14
14
16
9
8
10
24
25
10
18
19
14
8
8 12
31.5 61.5 56.6 51.3 23.2
57.1 53.J 35.0 28.8 21.3
22.:i 11.6 37.7 36.3 25.4
45.9 75.9 14.8 15.3 51.7 50.8
49.4
32.~
84.1 38.5 40.4 48.2
33.6 34.5 45.5 60.4 28.9
42.f, 50.0 35.4 40.9 26.9
31.8 40.4 39.5 33.7 42.0
41.0 51.9 49.3 37.0 43.7 47.4
52.1 53.6 70.0 48.1 58.0 58.8
Information and Statistics
331
TABLE 8 (Continued)
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1941 AND 1942
CountY
LIVE BIRTHS
Rate Per 1,000
Number
Population
1942 1941 1942 1941
STILLBIRTHS
Rate Per 1,000
Number
Live Births
1942 1941 1942 1941
Laurens ------------------ 746
Lee ---------------------- 142
Liberty ------------------- 195
Lincoln ------------------- 171
Long ---------------------
68
Lowndes
811
Lumpkin
144
McDuffie
289
Mcintosh
153
Macon -------------------- 397
Madison ------------------ 274
Marion ------------------- 206 Meriwether _______________ 542
Miller ------------------- 180
Mitchell
615
Monroe ------------------Montgomery _____________ _
Morgan
Murray ------------------Muscogee _________________
257 201 325 204 2,672
Newton __________________ _ 443 Oconee ___________________ _ 113 Oglethorpe _______________ _ 285
Paulding
246
Peach -------------------- 278
Pickens ------------------- 167 Pierce ___________________ _ 283 Pike _____________________ 212
Polk ---------------------- 618
Pulaski
196
723 150 182 159
71
633 117 247 135 474
288 181 482 207 580
233 175 289 255 2,106
375 111 303 274 234
228 284 213 601 210
22.2 18.1 22.7 24.3 16.6
25.5 23.1 26.6 28.9 24.9
20.4 29.6 24.6 18.0 26.4
23.9 20.8 25.6 18.3 35.4
23.8 14.9 22.9 19.2 26.8
18.3 24.0 20.4 21.7 19.9
21.5 19.1 21.2 22.6 17.4
19.9 18.8 22.7 25.5 29.7
21.4 26.0 21.9 20.7 24.9
21.7 18.1 22.7 22.9 27.9
20.2 14.7 24.4 21.4 22.5
25.0 24.1 20.5 21.1 21.4
37 48 49.6 66.4
13 63.4 86.7
10 10 51.3 54.9
3
17.5
6.3
14.7 14.1
30
26 37.0 41.1
17.1
15
12 51.9 48.6
5
32.7 44.4
16 12 40.3 25.3
4
11 14.6 38.2
12
7 58.3 38.7
19 19 35.1 39.4
6 10 33.3 48.3
24 31 39.0 53.4
13 12 50.6 :n.5
9
6 44.8 34.3
6 17 18.5 58.8
8 11 39.2 43.1
84 85 31.4 40.4
23
22 51.9 58.7
5 17.7 45.0
17 27 59.6 89.1
7
8 28.5 271.2
14 17 50.4 72.6
5 29.9 21.9
17 15 60.1 52.8
12
8 56.6 37.6
28
24 45.3 39.9
8 14 40.8 66.7
Putnam Quitman -----------------Rabun ___________________
Randolph Richmond _________________
181 81
182 380 2,078
Rockdale _________________ _ 142 Schley ___________________ _ 104 Screven __________________ _ 422
Seminole
216
Spalding
493
201 93
183 352 1,824
118 136 458 230 511
Stephens
400
293
Stewart ------------------- 225
203
Sumter ------------------- 568 558
Talbot -------------------- 184 179
Taliaferro ----------------- 120
114
21.3 23.6 23.3 22.9 25.4
18.4 20.7 20.7 2o.4 17.3
30.8 21.2 23.2 22.6 19.1
23.6 27.1 23.4 21.2 22.3
15.3 27.0 22.5 27.1 18.0
22.6 19.1 22.8 22.0 18.2
11
60.8 39.8
4
2 49.4 21.5
3
16.4
13 30 34.2 85.2
72 59 34.6 32.3
6
42.3 25.4
2
6 19.2 44.1
14 33 33.2 72.1
8 41.7 34.8
41
39 83.2 76.3
8
20.0
3.4
10
4 44.4 19.7
16 34 28.2 60.9
9 10 48.9 55.9
5
4 41.7 35.1
332
Georgia Department nf Public 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: 1941 AND 1942
LIVE BIRTHS
County
Number 1942 1941
Rate Per 1,000 Population 1942 1941
Tattnall Taylor Telfair Terrell Thomas
263
247 16.2 15.2
187
177 17.4 16.4
302 351 19.9 23.2
438
449 26.3 26.9
663 675 21.2 21.6
Tift ----------------------- 474 Toombs __________________ _ 365
Towns -------------------- 102
Treutlen ------------------ 133
Troup
958
433 25.5 23.3 370 21.5 21.8 114 20.7 2:l.l 172 17.4 22.5 919 21.8 20.9
Turner
213
Twiggs
268
Union -------------------- 191
Upson --------------------- 593
Walker
631
235 19.6 21.7 271 29.4 29.7 208 24.9 27.1 559 23.7 22.3 653 20.3 21.0
Walton
454
\Vare --------------------- 687 \Varren __________________ _ 251 Washington ______________ _ 561
\Vayne
342
452 21.9 21.8 674 24.6 24.1 208 24.5 20.3 534 23.2 22.0 354 26.1 27.0
Webster
117
Wheeler __________________ 204
White ___________________ _ 167
Whitfield ________________ _ 724
\Vilcox
228
109 24.8 23.1 182 23.9 21.3 135 26.0 21.0 585 27.7 22.4 224 17.9 17.6
Wilkes
321
\\~ilkinson ________________ _
250
Worth ____ ---------------- 514
Military Reservations
95
Residents of Georgia, birth
occurring in othe,r states 429
328 21.3 21.7 235 22.7 21.3 478 24.0 22.4
90
344
STILLBIRTHS
Rate Per 1,000
Number
Live Births
1942 1941
1942 1941
4 19 15.2 76.9
11
9 58.8 50.8
11
12 36.4 34.2
16
22 36.:i 49.0
46
29 69.4 4:l.O
15
24 31.6 5;).4
12 16 32.9 43.2
1
9.8
8.8
10 13.0 !J8.1
44
42 4:i.9 45.7
8
;, 37.6 21.3
17
15 63.4 ri5.4
8
7 41.9 33.7
22
26 37.1 46.5
16
18 2:i.4 27.6
24
21 52.9 46.5
37 36 53.9 53.4
8
31.9 33.7
31
40 55.3 74.9
9
16 26.3
45.2
42.7 64.2
5
9.8 27.:l
3
8 18.0 59.3
17 19 23.5 32.5
5
8 21.9 3:>.7
15
25 46.7 76.2
12
15 48.0 63.8
23
28 44.7 ;)8,6
NOTE: These figures are allocated to county of residence and exclude non-residents of Georgia. Only the state totals include residents of Georgia with births occurring in other states.
Live birth rates based on the 1940 Cen."ts Enumerated Population.
Information and Statistics
333
TABLE 9
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHS IN EAcH CouNTY IN GEORGIA: 1941 AND 1942
County
INFANT MORTALITY
Rate Per I ,000
Number
Live Births
1942 1941
1942 1941
TOTAL AJlllling Atkinson __________________ _
Baeon Raker _
3,559 11 2 13 10
3,955 11 9 13 6
49.3 30.2 10.7 57.0 50.3
58.3 33.4 50.3 62.8 38.5
Baldwin
10
Banks --------------------
3
Barrow ------------------- 17
Bartow -------------------
39
Ben Hill ------------------
21
24 30.9 71.4 7 18.6 38.9 22 64.9 79.4 41 65.1 78.1 20 75.5 71.7
Berrien -------------------
Bibb
100
Bleckle'Y ------------------ 17
Brantley ------------------
9
Brooks
23
15 30.2 45.5 139 42.8 74.7
8 68.3 34.3 53.3 28.7
38 41.8 75.5
Bryan --------------------
Bulloch -------------------
25
Burke --------------------
24
Butts __ -------------------
11
Calhoun
20
13 49.0 89.7 14 48.2 25.1 31 33.7 42.5 15 51.2 71.1 21 69.7 91.3
MATERNAL MORTALITY
Rate Per I ,000
Number
Live Births
1942 1941
1942 1941
299 313
2
1
4.1
4.6
5.5
3.0
5.3 11.2
4.4
4.8
5.0
4
6.2 11.9
12.4
1
3.6
6
1.7 11.4
14.4
3.6
3.S
11
9
4.7
4.8
1
4.0
2
11.8
1
2
1.8
4.0
2
13.8
2
3.9
3.6
2.8
4.1
1
4.7
1
3.5
Camden
Candler
Carroll
28
Catoosa
11
Charlton
1
Chatham
206
Chattahoochee -------------
3
Chattooga -----------------
11
Cherokee ------------------ 30
Clarke --------------------
28
Clay ___ -------------------
Clayton ___________________
15
Clinch __ ------------------
Cobb ____________________ _
32
Coffee
35
Colquitt ___________________
37
Columbia _________________ _
9
Cook ____________________ _
14
Coweta --------------------
21
Crawford ________________ _
11
Cristl ____________________ _ 29
Dade _____________________
3
Dawson
D'el'atur
47
DeKalb
7:i
8 43.0 51.6 52.2 45.8
50 42.9 69:3 11 57.9 63.6 8 10.3 65.0
155 65.7 61.7 4 45.5 56.3
12 26.6 26.8 32 73.3 73.2 29 51.7 58.1
11 44.6 66.7 21 72.5 109.9
65.2 65.4 39 36.4 51.4 35 53.7 58.6
49 40.7 68.2 17 43.5 79.8
6 56.5 24.2 25 40.1 51.9 19 65.9 119.5
25 68.6 61.3 4 24.6 33.9 2 41.7 21.3
39 77.3 77.1 68 38.9 40.0
1
6.5
2 14.9 Hi.3
3.1
4.2
3
5.3 17.3
12 15
3.8
6.0
2.2
2
7.3
4.6
2
5.5
4.0
5.2
1
9.3
3
2.3
4.0
6
2
9.2
3.4
9
5.5 12.5
4.8
4.7
3
4.0 12.1
3
7.6
6.2
12.6
2.4
3
8.2
il.9
4
2.1
0.6
334
Georgia Department of Public Health
TABLE 9 (Continued)
DEATHS UNDER ONE YEAR OF AcE AND MATERNAL DEATHS WITH RATES PER 1,000 LIVE BIRTHS IN EACH COUNTY IN GEORGIA: 1941 AND 1942
County
INFANT MORTALITY
Rate Per I ,000
Number
Live Births
1942 1941 1942 1941
Dodge ---------------------
14
Dooly ---------------------
18
Dougherty
42
Douglas
6
Early
24
26 31.5 5S.7 27 47.6 63.8 37 60.7 63.2 15 30.6 73.5 28 49.1 62.6
Echols
Effingham ________________
20
Elbert --------------------
16
Emanuel _________________ _ 33
Evans ---------------------
11
Fannin __________________ _ 32
Fayette ___________________
10
Floyd _____________________
61
Forsyth __________________ _
11
Franklin ------------------
15
39.2 12 106.4 32 37.3 42 68.9 17 58.8
31 100.0 12 62.5 86 46.0
42.8 15 51.0
29.4 49.2 86.5 83.7 91.9
94 2 59.4 67.5 21.1 47.6
Fulton -------------------- 407
Gilmer --------------------
10
Glascock __________________
2
Glynn _____________________
30
Gordon
23
414 47.7 51.6 17 41.0 73.3
6 18.9 54.5 38 51.3 76.5 19 59.3 42.2
Grady
30
Greene
19
Gwinnett ________________ _
21
Habersham ________________
15
Hall ______________________
28
Hancock __________________
10
Haralson _________________ _ 14
Harris --------------------
Hart ----------------------
11
Heard
11
Henry ____________________
13
Houston ------------------
12
Irwin --~------------------
Jarks.on __________________ _
21
Jasper ___________________ _
15
,Jeff Davis ________________ _
13
Jefferson _________________ _
19
Jenkins ______ -------------
13
Johnson __________________ _
10
Jones ---------------------
10
Lamar ____________________
Lanier -------------------Laurens __________________ _ 34
Lee -----------------------
7
Liberty _________________ --
14
21 63.4 47.4 20 59.7 62.5 39 36.8 76.6 19 47.9 59.7 44 37.3 62.3
10 28.1 31.8 10 54.1 44.8 10 20.9 39.5 22 36.3 67.5
93.2 50.4
18 39.8 G6.8 13 39.6 48.1 20 14.8 70.4 29 45.9 67.0 11 86.2 60.1
13 73.4 61.6 17 39.1 35.4 14 41.9 41.7
44.2 2ri.O 48.1 37.4
24 45.5 1!:1.9 6 48.2 70.6
37 45.6 51.2 14 49.:1 93.3 13 71.8 71.4
MATERNAL MORTALITY
Rate Per I ,000
Number
Live Births
1942 1941
1942 1941
2
6.8
4.5
5.3
4
5.8
3.4
4.1
2.2
4.1
7.0
2.7
4.2
4.0
2
10.7
3.1
1
2
6.3
9.9
2
3
1.5
2.4
4.2
3.4
3.2
15
!9
1.8
2.4
4.1
4.3
2
9.4 18.2
1
6.8
2.0
3
5.2
6. 7
10.6
6.8
1
3.1
2
3.5
3.9
4.0
2.8
1
2.8
3.2
4
17.9
4.2
2
3.3
6.1
3.1
3.2
4
14.8
5.9
3.:l
4.4
2.3
5.7
~-:;
2
3
4.1
6.3
2
3.2
6.0
4.4
:).0
4.8
2:~.5
9.4
4.1
1:1.3
5.1
5.::J
information and Statistics
335
TABLE 9 (Continued)
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LivE BIRTHS IN EACH CoUNTY IN GEORGIA: 1941 AND 1942
County
Lincoln ______________
Long ---------------Lowndes Lumpkin
~!cDuffie
INFANT MORTALITY
Number 1942 1941
Rate Per 1,000 Live Births
1942 1941
11.7 50.3
58.8 42.3
29
24 35.8 37.9
4
3 27.8 25.6
13
12 45.0 48.6
:lie Intosh
12
!\lacon --------------------
39
Madison ------------------
1\Iarion -------------------
10
Meriwether ________________
18
l\liller ____________________
10
Mitchell
26
Monroe ___________________
19
Montgomery ______________ _
11
).!organ
15
78.4 44.4 38 98.2 80.2 19 25.5 66.0 16 48.5 88.4 24 33.2 49.8
4 55.6 19.3 39 42.3 67.2 22 73.9 94.4 13 54.7 74.3 14 46.2 48.4
MATERNAL MORTALITY
Number 1942 1941
Rate Per 1,000 Live Births
1942 1941
4
2
4.9
3.2
1
8.5
3.5
13.1
7.4
10.1
6.3
7.3
5.5
1.8 10.4
5.6
2
6.5
3.4
3.9
5.0
3
10.4
.:\lurray
11
~J uscogee- ________________ _ 109
"X ewton ------------------- 15
Oconee -------------------
12
Oglethorpe ____________ _
22
Paulding
19
Peach ---------------------
14
Pickens
10
Pierce --------------------
10
Pike ----------------------
16
Polk
27
Pulasl<i __________________ _
8
Putnam __________________ _
18
<luitman _________________ _
Rabun ________________ ----
Randolph
22
Richmond
99
Rockdale
Schley -------------------Screven _______ ------------ 38
Seminole
Spalding
45
Stephens
3
Stewart -------------------
9
Sumter
32
Talbot
20
Taliaferro ________________ _
Tattnall ___________________ _
Taylor
Telfair _ ---------------- --
11
18 53.9 70.6 123 40.8 58.4
18 33.9 48.0 106.2 81.1
25 77.2 8:!.5
18 77.2 6:i.7
17 50.4 n6
14 59.9 61.4 10 35.3 35.2 13 75.5 61.0
34 43.7 56.6 15 40.8 71.4 16 99.4 79.6
37.0 43.0 10 11.0 54.6
17 .)7.9 48.3 105 47.6 57.6
11 49.3 93.2 9 28.8 66.2
37 90.0 80.8
16 41.7 69.6 91.3 101.8 7.5 23.9
11 40.0 54.2 41 56.3 73.5
13 108.7 4 58.3
13 22.8 7 37.4
12 36.4
72.6 3:i.1 52.6 39.5 34.2
12
4.5
3.8
5.3
18.0
3.:i
3.:1
4.1
:1.6 R.:i
1
6.0
4.1
3 14.1 10.1>
4
2 18.9
9.4
3.2
3.3
5.1
5.5
5.0
4
2.6 11.4
11
6
5.:l
:~.3
3
22.1
3
2.4
6.6
9.:l
8.7
12.2 13.7
5.0
6.8
4.4
9.9
1.8
9.0
3.8
8.1
5.3 16.9
6.6
5. 7
336
Georgia Department of Public 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: 1941 AND 1942
County
INFANT MORTALITY
Number 1942 1941
Rate Per I ,000 Live Births
1942 1941
Terrell
29
Thomas ______ ------------
40
Tift ----------------------
22
Toombs -------------------
15
Towns --------------------
3
Treutlen _________________ _
Troup _____ ------- -------- 62
Turner ___________________ _
10
Twiggs --------------------
16
Union
7
23 66.2 51.2
:H
li0.:1
. -! ~
31 46.4 71.6
18 41.1 48.6
3 29.4 26.3
9 37.6 52.3 64 64.7 69.6 12 46.9 51.1 18 59.7 66.4 10 36.6 48.1
Upson
20
Walker
27
Walton
32
Ware ---------------------
31
Warren
16
Washington ______________ _
25
Wayne --------------------
10
Webster -------------------
3
Wheeler _______ ----- _____ _ 11
White __________________ --
10
Whitfield _________________
31
Wilcox --------------------
Wilkes --------------------
18
Wilkinson ________________
16
Worth --------------------
41
Residents of Georgia, births
or deaths occurring in
other states -----------
18
32 33.7 57.2 27 42.8 41.3 28 70.5 61.9 31 45.1 46.0 13 63.7 62.5
25 44.6 46.8 14 29.2 39.5
7 25.6 64.2 53.9 38.5 59.9 59.3
44 47.0 7G.2 12 21.9 53.6 14 56.1 42.7 18 64.0 76.6 26 79.8 54.4
23
MATERNAL MORTALITY
Number 1942 1941
Rate Per I ,000 Live Births
1942 1941
4.:.
8
I
U.l
l.:J
3
4
6.3
9.:!
2. 7
2. 7
ll.G
6 13
6.3 14.1
4.7
8 ..)
'j .4
10.5
3
5.1
:u
1.6
3.1
4
8.8
6.6
4
5.8
'j.4
1
4.0
!l.6
4
7.1
3. i
8.5
9.2
2
12.0
3 1.4 :u
4.4
8.9
2
6.2
3.0
1
4.0
4.3
3
5.8
2.1
6
6
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.
Information and Statistics
337
TABLE 10
DEATHS AND DEATH RATES PER 1,000 POPULATION IN EACH COUNTY IN GEORGIA: 1941 AND 1942
DEATHS
Number 1942 1941
Rate Per 1,000 Population 1942 1941
TOTAL __ 28,807 31,579
Appling ______
91
78
Atkinson _____
40
48
Bacon
59
78
Baker _______ 68
40
Baldwin _____ 141
211
Banks
44
66
Barrow ______ 109
138
Bartow ______ 226
280
Ben Hill _____ 169
145
Berrien
79
98
Bibb ________ 1,066 1,204
Bleckley
91
87
Brantley
60
39
Brooks
162 181
Bryan
53
81
Bulloch
149
159
Burke ______ _ 253
315
Butts
120 125
Calhoun ____ _
95
115
Camden
76
89
Candler
61
76
Carroll
209
292
Catoosa
61
65
Charlton ____ _ 28
36
Chatham ____ _ 1,789 1,770
Chattahoochee_
21
26
Chattooga
84
75
Cherokee ____ _ 161
190
Clarke
307 344
Clay ________ _
46
76
Clayton
88 124
Clinch ______ _
46
42
Cobb ________ 349
385
Coffee
183
196
Colquitt ____ _ 252
287
Columbia ___ _ 75
92
Cook _______ _ 98
95
Cowe~a
169
238
Crawford ___ _
62
104
Crisp
175
191
Dade _______ _ 33
28
Dawson
13
23
Decatur
256 252
DeKalb
725
769
Dodge ______ _ 137
182
9.2 6.3 5.6 7.3 9.3 8.6 5.0 8.3 8.9 11.6 5.1 12.7 9.4 8. 7 7.9 8.4 5.7 9.5 13.1 9.1 12.9 6.7 6.1 5.6 5.3 15.2 4.1 4.3 8.0 10.8 6.'i 7.6 7.1 9.1 8.5 7.6 8.0 8.2 6.3 8.7 10.0 5.6 2.9 11.5 8.3 6.5
10.(1 5.4 6.8 9.6 5.4 12.9 7.6 10.6 11.1 10.0 6.4 14.4 9.0 8.6 8.8 12.9 6.1 11.9 13.6 11.0 15.1 8.3 8.5 6.0 6.8 15.0 fi.l 4.0 9.4 12.1 10.8 10.6 6.5 10.1 9.1 8. 7 9.8 8.0 8.8 14.6 10.9 4.8 5.1 11.3 8.8 8.7
DEATHS
Number 1942 1941
Rate Per I ,000 Population 1942 1941
Dooly ------- 158
Dougherty __ _ 319
Douglas ____ _
79
Early
161
Echols ______ _
16
Effingham
107
Elbert
171
Emanuel ____ _ 200
Evans ______ _
78
Fannin ______ 112
Fayette
67
Floyd _______ _ 465
Forsyth _____ _
48
Franklin ____ _ 114
Fulton _______ 4,216
Gilmer ______ _
64
Glascock ____ _ 34
<aynn _____ _ 248
Gordon ______ 126 Grady _______ 178
Greene ------- 120 Gwinnett ____ _ 202
Habersham __ _ 100
Hall --------- 247
Hancock _____
89
Haralson ____ _ 90
Harris ______ _ 108
Hart ________ _
92
Heard _______
60
Henry _______ 140
Houston _____ 118
Irwin ________
60
Jackson
112
Jasper ______ _
92
Jeff Davis ___ _
62
Jefferson ___ _ 149
Jenkins _____ _ 117
Johnson _____ _
72
Jones
93
Lamar _______
95
Lanier ______ _ 38
Laurens _____ _ 347 Lee ________ _ 66
Liberty _____ _ 104
Lincoln
33
Long
33
166 383
85 148
17 104 203 243
83 127
75 549 52 114 4,472
so
26 293 113 150 132 228 121 300
82 83 110 121 43 178 109 68 157 98 79 177 112 46 75 121 40 327 91 100 46 23
9.4 11.2
7.9 8.6 5.4 11.1 8.7 8.iJ 10.5 7.6 8.2 8.3 4.2 7.3 10.7 7.1 7.5 11.:1 6.8 9.1 8.8 6.9 6.8 7.1 7.0 6.3 9.5 5.9 7.0 9.3 10.4 4.6 5.6 IO.:i 7.0 7.4 9.9 5.6 1tl.2 9.4 6.7 10.3 8.4 12.1 4.7 8.1
9.8 13.4
8.5 7.9 5.7 10.8 10.3 10.3 11.2 8.6 9.2 9.8 4.6 7.3 11.4 8.9 5.7 l:l.4 6.1 7.6 9.6 7.8 8.2 8.6 6.4 5.8 9.6 7.8 5.0 11.8 9.6 5.3 7.8 11.2 8.9 8.8 9.5 3.6 9.0 12.0 7.1 9.7 11.6 11.6 6.5 5.6
338
Georgia Department of Public Health
TABLE 10 (Continued)
DEATHS AND DEATH RATES PER 1,000 PoPULATION IN EAcH CouNTY IN GEORGIA: 1941 AND 1942
DEATHS Number
Rate Per 1,000 Population
1942 1941
1942 1941
Lowndes _____ Lumpkin _____ McDuffie ____ Mcintosh ____ Macon _______ Madison _____ Marion ______
Meriwether __ Miller _______ Mitchell ______ Monroe ______ Montgomery __ Morgan ______ Murray ______ Muscogee ____ Newton ______ Oconee ______ Oglethorpe ___ Paulding Peach _______ Pickens ______ Pierce _______ Pike _________
Polk Pulaski ______
Putnam Quitman _____ Rabun _______ Randolph ____ Richmond ____ Uockdale _____ Schley _______ Screven ______
Seminole Spalding Stephens Stewart Sumter ______
284 38 97 82 164 104 72
195 59 209
128 53
138 63 774 152 63 126 91 121 61 107 122
179 81
70 28 20 164 1,043 79 41 149
80 284 ;.9 81 255
273 37 100 84 188 117 73 246 61 228 145 77 126 66 938 198 72 132 102 120 79 104 109 228 93 120 37 35 165 1,081 88 66 197 67 341 ri6 89 283
8.9 6.1 8.9 15.5 10.3 7.7 10.4 8.8 5.9 9.0 11.9 5.5 10.9 5. 7 10.3 8.2 8.:1 10.1 7.1 11.7 6.7 9.1 11.8 6.3 8.2 8.2 8.2 2.6 9.9 12.7 10.2 8.1 7.3 9.4 10.0 4.:\ 7.6 10.4
8.6 5.9 9.2 15.9 11.8 8.7 10.5 11.2 6.1 9.8 13.5 8.0 9.9 5.9 12.4 10.7 9.!) 10.6 7.9 11.6 8.6 8.8 10.5 8.0 9.5 14.1 10.8 4.5 9.9 13.2 11.4 1:1.1 9. 7 7.9 12.0 4.3 8.4 11.6
DEATHS Number
Rate Per I ,000 Population
1942 1941
1942 1941
Talbot ______ _ 96
Taliaferro ___ _ 61
Tattnall ____ _ 86 Taylor ______ _ 55
Telfair
122
Terrell _____ _ 204
Thomas ______ 324
Tift ________ _ 168
Toombs _____ _ 115
Towns
25
Treutlen ____ _
45
Troup
430
Turner
69
Twiggs
76
t:"nion
45
Upson
182
'\Vallwr _____ _ 178
Walton _____ _ 204
Ware -------- 264
Warren ______
72
Washington __ 20G
Wayne ______ _
76
\Yebste1r ____ _
23
Wheeler ____ _ Gl
White ______ _
46
Whitfield ___ _ 180
Wilcox ______ _ 65
Wilkes
156
Wilkinson ___ _ 90 Worth ______ _ 214
R e s i d ents of
Georgia, death
occurr i n g in
other states __
Military Reser-
\'ations __
260
80 11.8 9.8 61 9.7 9.7 99 5.3 6.1 71 5.1 6.6 136 8.1 9.11 183 12.2 11.0 307 10.4 9.8 188 9.0 10.1 137 6.8 8.1 28 5.1 5. j 69 5.9 9.0 492 9.8 11.2 80 6.4 7.4 107 8.3 11.7 49 5.9 6.4 203 7.3 8.1 184 5.7 5.9 228 9.8 11.0 287 9.5 10.3 98 7.0 9.6 230 8.5 9.:i 74 5.8 5.6 24 4.9 5.1 49 6.0 5. 7 59 7.2 9.2 222 6.9 8.5 82 5.1 6.4 154 10.3 10.2 115 8.2 10.4 187 10.0 R.7
475
95
~OTE: 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.
Rates based on the 1940 Census Enumerated Population.
--------------------------------
Information and Statistics
339
TABLE II
DEATHS AND DEA'I!H RATES PER 100,000 PoPULATION FRoM TYPHOID AND MALARIA IN EAcH CouNTY IN GEORGIA: 1941 AND 1942
County
TYPHOID
Rate Per I 00,000
Number
Population
1942 1941
1942 1941
MALARIA
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
TOTAL
24
Appling ___________ . _______
Atkinson -----------------Bacon -------------------Baker --------------------Baldwin -------------------
0.8
1.7
14.1
76 75
2.4
2.4
14.1
3
40.8
Banks -------------------Barrow ------------------Bartow _------------------Ben Hill _________________ _
Berrien -------------------
2
13.8
6.5
6.9 13.8
Bibb ---------------------Bleckley
Brantley -----------. -----Brooks ------------------Bryan ---------------------
.10.4
9.8
9.8
15.9
Bulloch ------------------Burke ------------------- __ Butts --------------------Calhoun -----------------Camden
2
7.i
1
3.8
16.9
1
3.8
3.8
3 1:>.1 11.3
1
10.!1 28.i
'
Candler Carroll Catoosa Charlton Chatham ------------------
Chattahoochee _____________ Chattooga ________________ _
Cherokee --------------- __ Clarke -------------------Clay ----------------------
Clayton __________________ _
Clinch -------------------Cobb --------------------Coffee ___________________ _ Colquitt ___________________
Columbia _________________ Cook ______________________ _
Coweta ------------------Crawford _________________ Crisp Dade
2.9
19.0
2
0.8
1.7
4
19.!)
4.6
3.7
ri.7
:1.7
2.9 0.8
14.2
3
9.1
14.0 2 22.8 11.4
340
Georgia Department of Public Health
TABLE II (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TYPHOID AND MALARIA IN EAcH CouNTY IN GEoRGIA: 1941 AND 1942
County
Dawson Decatur DeKalb Dodge -------------------Dooly
Doughe.rty ---------------Douglas ------------------Early -------------------Echols -------------------Effingham _________________
TYPHOID
Rate Per I00,000
Number
Population
1942
1941
1942 1941
1.2
1
4.8
4.8
1
5.9
5.9
3.5
Elbert Emanuel -----------------Evans _____________________
Fannin ------------------Fayette -------------------
Floyd _____________________
Forsyth
Franklin ------------------
Fulton --------------------
2
Gilmer --------------------
Glascock -----------------Glynn -------------------Gordon ------------------Grady -------------------Greene --------------------
Gwinnett ________________ Habersham _______________ _
Hall ---------------------Hancock Haralson ------------------
Harris ------------------Hart ---------------------Heard --------------------Henry --------------------Houston ------------------
Irwin --------------------Jackson ------------------Jasper -------------------Jeff Davis ---------------Jefferson ------------------
.Tenldns ------------------Johnson _________________ _ Jones _______________ _
Lamar
2
10.2
4.3
13.5
1.8
8.8 17.7
6.4
3
0.5
0.8
11.6
1.1 11.3
1.1 9.9
MALARIA
Rate Per I00,000
Number
Population
1942 1941 1942 1941
5.1
15.7
6.6
11.3 5.0 15.0
8.4
1. 7
1. 7
Information and Statistics
341
TABLE II (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TYPHOID AND MALARIA IN EAcH CouNTY IN GEoRGIA: 1941 AND 1942
County
Lanier -------------------Laurens __________________ _
Lee ----------------------Liberty ------------------Lincoln -------------------
Long ---------------------Lowndes -----------------Lumpkin -----------------1\IcDuffie ----------------Mcintosh
Macon Madison Marion -------------------Meriwether ---------------1\Iiller --------------------
Mitchell Monroe Montgomery ~lor~ an Murray -------------------
1\Iuscogee ----------------Newton ------------------Oconee ------------------Oglethorpe ________________ Paulding ------------------
Peach -------------------Pickens ------------------Pierce -------------------Pike ______________________
Polk ----------------------
Pulaski ------------------Putnam ------------------Quitman -----------------Rabun -------------------Randolph Richmond -----------------
Rockdale __________________ Schley Srreven ___________________ Seminole Spalding
Stephens Stewart ___________________
TYPHOID
Rate Per I00,000
Number
Population
1942
1941
1942 1941
25.5 11.6
36.8
6.3
6.3
7.4
4.3
4.3
1
9.3
1
10.3
7.9
9.0
1.3
1.3
10.8
8.0
3.5
MALARIA
Rate Per I00,000
Number
Population
1942 1941 1942 1941
6
17.9 11.9
11.6
3.1
3.1
1
9.2
1
18.9
6.3
6.3
4.5 10.0
4.3 9.3
2.6
9.6 8.5
9.6
10.2
12.0
1.2
2.4
14.7 14.7
2
23.6 23.6
9.4
342
Georgia Department oj Public Health
TABLE II (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHOID AND MALARIA IN EAcH CouNTY IN GEORGIA: 1941 AND 1942
County
Sumter ___________________ Talbot ___________________ _ Taliaferro _________________
Tattnall ------------------Taylor
Telfair Terrell Thomas ------------------Tift ---------------------Toombs -------------------
Towns ____________________
Treutlen Troup Turner Twiggs
------------------
Union Upson Walker Walton ---------------- __ _ \Vare ---------------------
Warren __________________ _ Washington ______________ _
"rayne -------------------Webster -----------------Whee.Jer -------------------
White -------------------Whitfield ________________ _
Wilcox -------------------Wilkes -------------------Wilkinson -----------------
Worth -------------------Residents of Georgia, death
occurring in other states
TYPHOID
Rate Per I 00,000
Number
Population
1942 1941
1942 1941
6.2
6.6 3.2 10.8
2.3
4.8
11.7
13.6 3.8 i.8
MALARIA
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
2
6.6 13.2
12.0
6.0
3.2
3.2
5.4
5.4
17.7 23.6
9.2 11.0
4
16.5
4.1
2
15.2
21.2
11.7
3
7.8 23.5
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.
Information and Statistics
343
TABLE 12
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM TuBERCULOSis AND CANCER IN EACH COUNTY IN GEORGIA: 1941 AND 1942
County
TUBERCULOSIS
Rate Per 100,000
Number
Population
1942 1941 1942 1941
CANCER
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
TOTAL
1,265 1,385 40.5 44.0
Appling
Atkinson _________________ _
14.1
Bacon ___________________ _
1
12.4 12.4
Baker --------------------
4
Baldwin __________________
11
54.5 67.0 54.8
2,120 2,139
4
4
1
2
18
67.9 68.0 27.6 27.6 14.1 28.2
12.4 54.5 40.8 42.7 109.7
Banks ___________________ _
Barrow -------------------
Bartow __________________ _
10
Ben Hill __________________
Berrien -------------------
11.5 7.7 15.3 12 39.6 47.5 4 27.5 27.5
3
34.4 34.4
14
6 107.2 45.9
17
17 67.2 67 .:!
15
103.3 34.4
7 11 45.5 71.6
Bibb ---------------------- 65
Bleckley __________________ _
1
Brantley __________________
Brooks Bryan
58 77.6 69.2
1 10.4 10.4
29.1
1
9.8
4.9
3 31.8 47.7
55
82 65.6 97.9
6 72.5 62.1
4
58.2 58.2
6
11 29.3 53.7
63.6 15.9
Bulloch
Burke --------------------
14
Butts ____________________ _
Calhoun
3
Camden
34.6 15.4 20 52.8 75.4
4 32.7 43.6 28.7 28.7 50.8 50.8
11 26.9 42.3
15
20 56.6 75.4
4
43.6 76.2
6
6
57.5
57.~
101.5 84.6
Candler
Carroll Catoosa __________ _
Charlton ___________ _
Chatham _________________ _ 105 Chattahoochee ____________ _
1 22.0 11.0
8 14.6 23.4
27.5 43.9
19.0
83 89.0 70.4
3
Ci8.4
22.0
19
17 5:J.6
3 45.9
3
57.1
122 112 103.4
11.0 49.H 27.5 38.1 94.9 38.9
f'hattooga ________________ _ Cherol{ee _________________ _ Clarke _____________ _ Clay ______________________ Clayton
27.0 16.2
19.9 34.8
11 24.6 38.7
2
28.3
42.9 34.3
16.2 21.6
18
18 89.4 89.4
23
26 81.0 91.6
2
3 28.3 42.!'.1
9 60.1 77.2
Clinch _____________ _
Cobb ____________________ _
15
Coffee ___________________ _
6
Colquitt _________________ _
Columbia
15.5
12 39.2 31.4,
4 27.9 18.6
21.2
3.0
21.2 10.6
77.7
:n
26
81.0
H7 .H 1
17
78.9 41.8
Fi
17 4!i.4 5l.;i
10
4 106.0 42.4
Cook ____________________ _
2
16.8 33.6
r-18. 7 7G.fi
rm\'eta -------------------
8
10 29.7 37.1
Cra\\ford _________ _
1
3 14.0 42.1
13
18 48.2 66.7
6
84.2 28.1
Crisp
7
39.9 22.8
6
11 34.2 62.7
Dade
50.9 33.9
GO.!l 'ill.9
---------------------------------------------
344
Georgia Department of Public Health
TABLE 12 (Continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TUBERCULOSIS AND CANCER IN EAcH CouNTY IN GEORGIA: 1941 AND 1942
County
Dawson Decatur DeKalb Dodge -------------------Dooly ---------------------
Dougherty _________________ Douglas ------------------Early -------------------Echols Effingham _______________ _
Elbert ___________________ _ Emanuel __ __ _ ____ _ Evans ____________________ _
Fannin ------------------Fayette __________________ _
Floyd Forsyth ------------------Franklin _________________ _ Fulton Gilmer --------------------
Glascock _________________ _ Glynn ___________________ _ Gordon ___________________ Grady -------------------Greene --------------------
Gwinnett __________________ Habersham ________________ Hall ---------------------Hancock Haralson ------------------
Harris -------------------Hart ______________________
Heard --------------------Henry ____________________ Houston __________________
lr'\vin ____________________ _ Jackson _________________ _ Jasper ___________________ _ .Jeff Davis _________________ Jefferson _________________ _
TUBERCULOSIS
Rate Per I 00,000
Number
Population
1942
1941
1942 1941
1
22.3 22.3
9
40.5 36.0
26
40 29.9 46.0
1
4
4.8 19.0
3
6 17.8 35.5
16
15 56.0 52.5
3
3 29.8 29.8
2 26.8 10.7
3
101.2
4 10.4 41.5
6 25.5 30.6
12.8
8.fi
3
40.5 40.5
54.2 33.9
12.2 49.0
30
33 53.4 58.8
17.7
12.8 12.8
292
305 74.3 77.6
1
11.1 11.1
22.0 22.0
4
15 18.2 68.4
8
3 43.4 16.3
3
3 15.3 15.3
6 14.6 43.8
4 27.5 13.8
33.9 33.9
6
12 17.2 34.5
2
4 15.7 31.3
3
20.9
4 35.0 35.0
4 12.9 25.8
1 23.2 ll.6
11
3 72.8 19.8
3
26.5 26.5
23.2
2 14.9 10.0
3 45.6 34.2
2
22.6
7 34.9 34.9
CANCER
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
22.3
10
13 43.0 58.5
81
71 9:l.2 81.7
11 33.3 :J2.3
41.5 53.3
27 30 94.G 105.0
8
5 79.6 49.7
48.2 48.2
4
4 41.5 41.3
15 16 76.5 81.6
14 l7 59.5 72.3
4
3 54.0 40.5
9 61.0 61.0
4
6 49.0 73.'!
43 56 76.6 99.7
2
17.7 61.8
10
64.1 57.G
355 390 90.4 99.:1
2
6 22.2 66.7
44.0
14 13 63.9 'i9.3
8
43.4 38.0
12
11 61.1 56.0
8
58.4 43.8
21
21 72.2 72.2
4
8 27.1 54.2
20
18 57.4 51.7
5
8 39.2 62.7
48.7 34.8
10
10 87.5 87.5
4
25.8 19.3
58.1
12 16 79.4 1oo.s
8
4 70.8 35.4
54.1 1::1.::1
8 11 39.8 54.8
I 45.6 11.4
43.2 43.2
11
c4.9 34.9
Information and Statistics
34.S
TABLE 12 (Continued)
DEATHS AND DEATH RATEs PER 100,000 PoPULATION FROM TuBERCULOSIS AND CANCER IN EACH COUNTY IN GEORGIA: 1941 AND 1942
County
Jenkins Johnson Jones --------------------Lamar -------------------Lanier -------------------Laurens ------------------
Lee ----------------------Liberty ____________________
Lincoln ------------------Long --------------------Lowndes
Lumpkin McDuffie Mcintosh -----------------:\lacon -------------------Madison
Marion ------------------Meriwether ________________ Mille-r ------- ------------l\Iitchell :\Ionroe -------------------
Montgomery _______________ Morgan ------------------Murray ------------------1\Iuscogee ----------------Newton -------------------
Oconee -------------------Oglethorpe ________________ Paulding -----------------Peach ___________________ _ Pickens ___________________
Pierce -------------------Pike --------------------Polk ______________________ Pulaski Putnam -------------------
Quitman -----------------Rabun -------------------Randolph ________________ _
Richmond ----------------Rockdale __________________
TUBERCULOSIS
Rate Per I 00,000
Number
Population
1942
1941
1942 1941
8 67.6 67.6
2
15.4
36.0 60.0
2
9.9 19.8
20.8 23.8
1
12.8 12.8
2
23.3 81.4
14.2
6
18.8 28.2
32.1 80.3
1
9.2 18.4
2
37.8 37.8
37.6 31.4
14.9 37.2
28.8 28.8
10
ll 45.3 49.9
3
1 30.0 10.0
2 25.8
8.6
55.8
3
31.0
55.1 47.2
6
9.0 53.9
35
44 46.4 58.3
5.4 37.7
2 13.2 26.4
4 40.2 32.2
6
46.8 15.6
8
77.1 57.8
2
21.9 54.7
3
25.4 59.3
19.3 67.5
ll
l7 38.6 59.7
10.2 10.2
4
47.0
58.2 29.1
1
12.8
4
4 24.1 24.1
70
83 85.5 101.4
4
51.8 12.9
CANCER
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
7
59.1 67.(i
54.0
7.7
84.0 84.0
14
138.7 49.:>
35.5 71.0
18
24 53.6 71.4
89.3 89.3
34.9 46.5
4
G6.8 il.O
48.9 2<:1.5
19
19 59.6 59.6
4
64.3 32.1
10
10 ()1.9 91.9
7
1 132.3 18.9
15
9 94.1 56.4
ll
81.9 37.2
14.4 43.1
ll
18 49.9 81.6
6
6 60.0 60.0
12
1:i ;:)1.6 64.::;
10
6 93.0 53.8
41.4 41.!
9 70.8 70.8
2 44.[) 18.0
52
65 68.9 8fi.l
18 43.1 96.9
4 1:1.2 ri2.8
6 72.4 48.3
3
23.4 54.6
4 57.8 38.5
6 65.7 6J.7
4
6 33.9 50.8
12
3 ll:\.7 28.9
l7
20 59.7 70.:l
8
81.4 50.9
4
4 47.0 47.0
3 29.1 87.3
12.8
17
14 102.4 84.3
88
70 107.:> 83.5
4 2:1.9 ;)1.8
346
Georgia Department of Public Health
TABLE 12 (Continued)
DEATHs AND DEATH RATES PER 100,000 PoPULATION FROM TuBERCULOSIS AND CANCER IN EACH COUNTY IN GEORGIA: 1941 AND 1942
County
TUBERCULOSIS
Rate Per I 00,000
Number
Population
1942 1941
1942 1941
CANCER
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
Schley
Screven -------------------
Seminole _-----------------
1
Spalding __________________
8
Stephens
Stewart ___________________
Sumter ____________________
10
Talbot --------------------
3
Taliaferro _________________
2
Tattnall -------------------
3 39.7 59.6
24.6 34.4
11.8
13 28.1 45.7
7.7
7.7
47.2 11 40.8 44.9
36.9 49.1 4 31.9 63.7 9 49.3 55.4
39.7 39.7
9
44.2 29.5
4
47.1 23.6
25
20 87.9 70.4
7 54.0 54.0
37.7 28.3
22
18 89.8 73.5
11
133.1 24.6
4
63.7 19.6
24.6 30.8
Taylor
Telfair
Terrell
Thomas ___________________
12
Tift ----------------------
6
3 18.6 21.9
3
19.8
42.0 30.0
17 38.4 54.3
32.3 26.9
4
31.1 27.9
11
72.6 26.4
16
96.0 48.0
21
22 67.1 711.:)
17
14 91.4 75.3
Toombs -------------------
3
Towns --------------------
1
Treutlen ------------------
Troup
17
Turner
2
17.7 17.7 20.3 20.8
26 38.7 59.3 18.4 18.4
9
53.1 41.3
40.6 111l.o
26.2 3!!.3
38 57.0 86.6
8 46.1 7:l.8
Twiggs
4
Union
Upson
Walker
14
Walton ------------------
3
Ware ____________________ _
\Varren ------------------\Yashington ______________ _
Wayne -------------------Webster
43.9 2!.9 52.1 13.0 27.9 19.9 12 45.1 38.7 14.4 14.4
28.6 28.6
19.5 39.1
11 37.1 45.4
4
30.5
21.2
4
43.9 7G.H
4
G2.1 52.1
16
10 63.8 39.9
18
17 58.0 :i4.8
18
19 86.6 43.3
10
21 33.8 7;).2
2\J.:l 68.4
13
J3.7
i13.7
38.1 30.;)
21.2 21.2
Wheeler White ___________________ _
Whitfield -----------------
1H
Wilcox ----------- _________
1
Wilkes -------------------
"rilkinson ________________ _ Worth ___________________
Residents of Georgia, death
occurring in other states
37
Military Reservations _____ _
11.7
15.6 17.9
16 69.0 61.:3
3
7.8 :!:).J
33.1
26,;)
27.2 36.3 32.8 37.4
57
:J:-;,1 46.9
3
46.8 46.S
22
16 84.3 61.8
1 15.7
7.8
13
l:J 86.2 8fi.2
6
8 :>4.4 72.6
9
42.1 42.1
34 37 10
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. Rates based on the 1940 Census Enumerated Population.
Information and Statistics
347
TABLE 13
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEoRGIA: 1941 AND 1942
County
PELLAGRA
Rate Per 100,000
Number
Population
1942 1941 1942 1941
TOTAL ---------------
Appling ------------------Atkinson -----------------Bacon -------------------Baker --------------------Baldwin ---- -------------
Banks -------------------Barrow ------------------Bartow -------------------Ben Hill ----------------Berrien -------------------
Bibb --------------------B!eckley -----------------Brantley ----------------Brooks -------------------Bryan --------------------
Bulloch -------------------
Burke --------------------
Butts ---------------------
Calhoun -------------------
Camden
- - - - - ----~------~-
(and1er --------------------
Carroll
---------~---~---~-
Catoosa
----------~---~---
Charlton - - - - - - - --------~--
Chatham
-----~------------
Chattahoochee
--------~---
Chattooga ----------------
Cherokee -----------------~
Clarke --------------------
Clay --------------- ----~--
Clayton -- -----------------
Clinch --------------------
Cobb --- ------------------
Coffee
- - - - - --------------~
Colquitt -------------------
Columbia -------------- ---
Cook -------- -----~- ------
Coweta
- - - - ------~---~----
Crawford ------------------
Crisp -------------- ~-~----
181
2 2 1
1 4 2
204
1 2 16 4 2 2
16
5.8
12.4
11.5 7.9
4.8
9.8
7.5 10.9
11.0 2.9 9.2
19.0 7.6
3.5 14.2
15.5 10.5 3.0 21.2 25.2
3.7
6.5
7.7 4.0 13.H 6.5 19.1 19.5 31.8 11.3 21.8
13.6
5.0 7.0 14.2
2.6
~.3
9.1
3.7
PNEUMONIA
Rate Per 100,000
Number
Population
1942 1941 1942 1941
1,612 1,714 51.6 54.5
55.2 34.5
3
5 42.3 70.5
3
9 37.1 111.2
2
27.2 68.1
21 13 128.0 79.2
1
11.5 4:i.8
4 10 30.6 76.5
11 17 43.5 67.2
13
15 89.5 103.3
5
5 32.5 32.5
43 52 51.3 62.1
20.7 51.8
6
5 87.3 72.8
6
11 29.3 53.7
2
31.8
10
38.4 30.8
10
16 37.7 60.3
8
9 87.1 98.0
38.3 47.9
50.8 50.8
3
3 33.0 33.0
13 16 38.1 46.8
7
5 64.2 45.9
3
57.1
105 99 89.0 83.9
2 38.9 38.9
37.8 21.6
12 19 59.6 94.4
23
12 81.0 42.:1
1
14.2 127.4
9
6 77.2 51.;)
46.6 31.1
11 18 28.7 47.0
IX
19 83.6 88.2
18
19 54.5 57.6
53.0 53.0
6 41.9 50.3
6
15 22.2 55.6
98.2 98.2
3
17.1 45.6
348
Georgia Department of Public Health
TABLE 13 (Continued)
DEATHs AND DEATH RATES PER 100,000 PoPULATION FROM PELLAGRA AND PNEUMONIA IN EACH COUNTY IN GEORGIA: 1941 AND 1942
County
PELLAGRA
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
Dade --------------------Dawson
Decatur -------------------
1
DeKalb ------------------
2
Dodge
2
4.5
2.3
8.1
4
9.5 19.0
Dooly
3
Dougherty ---------- ______ _
4
Douglas -------------------
Early ---------------------
Echols --------------------
Effingham ----------------Elbert -------------------Emanuel -----------------Evans -------------------Fannin -------------------
Fayette ------------------
Floyd ---------------------
3
Forsyth
Franklin ------------------
Fulton -------------------- 24
Gilmer
Glascock ------------------
Glynn --------------------
Gordon --------------------
Grady ----------------- ---
2
Greene --------------------
Gwinnett ------------------
3
Habersham ----------------
2
Hall ----------------------
2
Hancock
2
11.8 14.0 11.5 9.9
10.4 5.1 10.2
13.5 6.8
1
12.2
4
5.3
7.1
6.4
26
6.1
6.6
11.1
1
22.0
4.6
1
5.4
1 10.2
5.1
7.3
7.3
5 10.3 11.2
3 13.5 20.3
2
5.1
5.7
2 15.7 15.7
Haralson
Harris --------------------
Hart ---------------------
1
Heard --------------------Henry ___________________ _
7.0 11.5
6.4
6.6
Houston ------------------
1
Irwin ---------------------
Jackson __________________ _
2
Jasper --------------------
3
Jeff Davis _______________ _
8.8
10.0
5.0
34.2 11.4
PNEUMONIA
Rate Per I00,000
Number
Population
1942 1941 1942 1941
33.9 17.0
16
72.0 31.5
36 35 41.4 40.3
6 11 28.5 52.3
4 53.3 23.7
13
25 45.5 87.5
3 49.7 29.8
12
8 64.2 42.8
33.7
2 51.8 20.7
4 11 20.4 56.1
9
17 38.3 72.3
3 94.6 40.5
8
1 54.2 47.5
6
2 73.4 24.5
38 33 61.1 58.8
4
3 35.3 26.5
8
9 51.2 57.6
204 191 51.9 48.6
4
44.4 88.9
1
22.0
11
20 50.2 91.2
6
9 32.5 48.8
6 40.7 30.5
3
21.9 51.1
15 11 51.6 58.4
6 40.6 40.6
11 19 48.8 54.6
2
4 15.7 31.3
10 34.8 69.6
3
3 26.3 26.3
10 58.0 64.5
4
3 46.5 34.8
13
10 86.0 66.1
11
4 97.3 35.4
3
3 23.2 23.2
10
8 49.8 39.8
4 57.0 45.6
4 67.9 45.2
Information and Statistics
349
TABLE 13 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEORGIA: 1941 AND 1942
County
PELLAGRA
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
Jefferson
Jenkins -------------------
Johnson ------------------
Jones ---------------------
3
10.0
5.0
8.4 16.9
36.0 12.0
Lamar --------------------
Lanier -------------------
Laurens ------------------
5
14.9
Lee -----------------------
Liberty -------------------
Lincoln
Long ---------------------
1
Lowndes
2
Lumpkin
McDuffie
24.5
6.3
3.1
9.2
9.2
Mcintosh ------------------
1
Macon
3
Madison -----------------:\larion ______ _________ _
Meriwether ----------------
18.9 4 18.8 25.1
1
14.4
1
4.5
4.5
Miller --------------------Mitchell -----------------:llonroe ------------------Montgomery --------------Morgan -------------------
Murray
Muscogee -----------------
Newton
2
Oconee -------------------Oglethorpe _______________ _
4.3
10.3 15.7
9.0
6
1.3
7.9
10.8
5.4
Paulding Peach --------------------Pickens __________________ _
Pierce --------------------
2
Pike ----------------------
2
Polk Pulaski ------------------Putnam ------------------Quitman -----------------Rabun --------------------
Randolph ----------------Richmond ----------------Rockdale -----------------Schley -------------------F;creven __________________ _
15.6
7.8
9.6
9.6
10.9 10.9
16.9
19.3
9.6
2
3.5
7.0
10.2
29.1
2
6.0 12.0
3
6.1
3.7
12.9 12.9
3
59.6
14.7
9.8
PNEUMONIA
Rate Per I 00,000
Number
Population
1942 1941 1942 1941
6
29.9 39.9
5
42.2 76.0
2 15.4 15.4
8
96.0 36.0
12
15 118.9 148.6
2
3 35.5 53.3
11
2:1 32.7 6S.4
6
3 76.6 38.3
7
81.4 11.6
28.4
24.5 24.5
17
12 53.4 37.7
3
1 48.2 16.1
6
6 55.2 55.2
2 37.8 37.8
9
6 56.4 37.6
3
7.4 22.3
9
129.4 57.5
11
6 49.9 27.2
20.0 50.0
6
25.8 30.1
24
10 223.3 93.0
10.3 93.1
3 47.2 23.6
7
62.9 26.9
48 74 63.6 98.0
9
11 48.4 ri9.2
6
79.2 79.2
7
3 56.3 24.1
10 54.6 77.9
6
4 57.8 38.5
3
21.9 54.7
6
6 50.8 50.8
16
154.2 77.1
9
31.6 24.6
8
81.4 91.6
2
8 23.5 94.0
1
2 29.1 58.2
2
23.6
7
6 42.1 36.1
65
68 79.4 83.1
6
77.7 64.7
19.9 19.9
14 12 68.8 59.0
350
Georgia Department of Public Health
TABLE 13 (Continued)
DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM PELLAGRA AND PNEUMONIA IN EACH COUNTY IN GEORGIA: 1941 AND 1942
County
PELLAGRA
Rate Per I00,000
Number
Population
1942 1941 1942 1941
Seminole ------------------
Spalding ------------------
Stephens ------------------
Stewart -------------------
2
Sumter --------------------
23.6 3.5
18.9
Talbot -------------------Taliaferro ----------------Tattnall -------------------
Taylor -------------------Telfair -------------------
1
12.3
2 15.9 31.9
6.2
9.3
Terrell --------------------
Thomas ------------------
2
Tift ----------------------
2
Toombs -------------------
4
Towns -------------------
12.0
6.4
6.4
10.8 21.5
23.6 11.8
20.3
Treutlen ------------------
Troup --------------------
3
Turner --------------------
Twiggs -------------------
Union --------------------
6.8
4.6
9.2
13.0
Upson --------------------
1
Walker -------------------
2
Walton -------------------
2
Ware ---------------------
2
Warren -------------------
4.0
1
6.4
3.2
2
9.6
9.6
7.2
9.8
Washington ---------------
2
Wayne --------------------
Webster -------------------
Wheeler ------------------
White ---------------------
8.3
4.1
11.7 31.2 15.6
Whitfield ----------------Wilcox -------------------Wilkes ------------------Wilkinson ----------------Worth --------------------
7.7
6.6
4.7
4. 7
Residents of Georgia, death
occurring In other states
4
Military Reservations ------
PNEUMONIA
Rate Per 100,000
Number
Population
1942 1941 1942 1941
10
117.8 82.4
27
29 95.0 102.0
1
3
7. i 23.1
6
56.6
17 20 69.4 81.6
10
6 122.8 73.7
3
47.8 31.9
3 18.5 18.5
3
4 27.9 37.1
7
6 46.2 39.6
10
9 60.0 54.0
7 13 22.4 41.5
4 26.9 21.5
9 10 53.1 59.0
20.3 20.3
26.2 13.1
24
22 54.7 50.1
3
9.2 27.7
43.9 54.8
13.0 13.0
15 27.9 59.8
10 12 32.2 38.7
9 11 43.3 52.9
14 13 50.1 46.5
3
4 29.3 39.1
13 37.1 53.7
5 15.2 38.1
21.2
11.7 11.7
3
46.8 i7.9
10 18 38.3 69.0
3
7 23.5 54.9
4 19.9 26.5
13 13 117.9 117.9
13
5 60.8 23.4
15 28
8
5
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.
Rates based on the 1940 Census Enumerated Population.
-----
Information and Statistics
351
TABLE 14
NuMBER AND PERCENT OF BIRTHs (ExcLUSIVE OF STILLBIRTHS) BY
PERSON IN ATTENDANCE AND COLOR, IN GEORGIA: 1929-1942
Total
Total
1929 ----- 58,521 1930 ----- 60,318 19:Jl ---- 61,774 1932 ----- 63,690 1933 ----- 60,744 1934 ----- 64,615 19R5 ____ 6R,290
1936 1937 1938 1939 1940 1941 1942
----- 61,617 ----- 64,012 ----- 64,307 ----- 64,910 ----- 64,695 ----- 67,785 ----- 72,189
White
1929 ----- 35,751 1930 ----- 37,064 1931 ----- 37,531 1932 ----- 38,209 1933 ----- 35,692 1934 ----- 38,333 1935 ----- 37,345 1936 ----- 36,320 1937 ----- 38,181 1938 ----- 38,613 1939 ----- 38,923 1940 ----- 38,911 1941 ----- 41,277 1942 ----- 45,192
Colored
1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942
----- 22,770 ----- 23,254 ----- 24,243 ----- 25,481 ----- 25,052 ----- 26,282 ----- 25,945 ----- 2!i,297 ---- 2:>,831 ----. 25,694 ----- 25,987 ----- 25,784
26,508 ----- 26,997
Number Physician
38,448 39,416 38,322 37,981 35,112 39,498 37,312 36,659 39,510 40,111 40,856 41,637 44,872 50,099
32,229 33,240 32,663 32,169 29,597 33,052 31,798 31,111 33,412 34,014 34,448 34,907 37,612 42,077
6,219 6,176 5,659 5,812 5,515 6,446 5,514 5,548 6,098 6,097 6,408 6,730 7,260 8,022
Midwife
19,956 20,728 23,315 25,578 25,396 25,043 25,737 24,661 24,262 23,970 23,769 22,807 22,715 21,968
3,429 3,695 4,761 5,944 5,919 5,226 5,373 4,998 4,615 4,473 4,275 3,830 3,544 3,035
16,527 17,033 18,554 19,634 19,477 19,817 20,364 19,663 19,647 19,497 19,494 18,977 19,171 18,933
Other Total
Percent Physician Midwife Other
117 100.0
65.7
34.1
0.2
174 100.0
65.3
34.4
0.3
137 100.0
62.0
37.7
0.3
131 100.0
59.6
40.2
0.2
236
100.0
57.8
41.8
0.4
74 100.0
61.1
38.8
0.1
241
100.0
59.0
40.7
0.3
297 100.0
59.5
40.0
0.5
240 100.0
61.7
37.9
0.4
226 100.0
62.4
37.3
0.3
28;) 100.0
62.9
36.6
0.5
251 100.0
64.4
3'i.3
0.3
198 100.0
66.2
33.5
0.3
122 100.0
69.4
30.4
0.2
93 100.0
90.1
9.6
0.3
129 100.0
89.7
10.0
0.3
107 100.0
87.0
12.7
0.3
96 100.0
84.2
15.6
0.~
176 100.0
82.9
16.6
0.5
55 100.0
86.2
13.6
0.2
174 100.0
85.1
14.4
0.5
211 100.0
85.7
13.8
0.5
l!l4 100.0
87.5
12.1
0.4
126 100.0
88.1
11.6
0.3
200 100.0
88.5.
11.0
0.5
174 100.0
89.7
9.8
0.5
121
100.0
91.1
8.6
0.3
80 100.0
93.1
6.7
0.2
24 100.0
27.3
72.6
0.1
45 100.0
26.5
73.2
0.3
30 100.0
23.3
76.5
0 )
35 100.0
22.8
77.1
0.1
60 100.0
22.1
77.7
0.2
19 100.0
24.5
75.4
0.1
67 100.0
21.3
78.5
0.2
86 100.0
21.9
77.7
0.4
86 100.0
23.6
76.1
0.3
100 100.0
23.7
75.9
0.4
85 100.0
24.7
75.0
0.3
77 100.0
26.1
73.6
0.3
77 100.0
27.4
72.3
0.3
42 100.0
29.7
70.1
0.2
352
Georgia Department of Public Health
TABLE 15
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES IN GEORGIA FOR THE YEARS 1850-1940
Cause of Death
1850
Number of Deaths 1860 1870 1880 1890
1900
1920
1930
1940
ALL CAUSES ---- 9,925 12,813 13,606 21,549 21,174 26,941 32,243 35,188 32,285
Typhoid fever --------- 557
Malaria --------------- 185
Smallpox -------------
Measles --------------- 74
Scarlet fever ---------- 202
Whooping cough ------- 385
Diphtheria ------------ 344
Dysentery, diarrhea and
enteritis ---------- 654
Tuberculosis ----------- 379
Cancer --------------- 60
Pneumonia ----------- 651
Heart diseases --------- 603
A!I other causes
5,831
887 568
8 47 217 334 440
1,061 550 81
1,268 723
6,629
772 705
18 270 12 92 417
1,414 996 131
1,363 274
7 ,14~
987 1,000 1,766
549
500
68
1,060
937 1,226
559
442
89
2
46
496 440 201
61 128
23
31
8
44
32
38
16
650
89
222
373
257
108
1,309
553
819
401
135
59
2,011 1,882
240 1,685 1,451 9,745
2,353 2,324
293 1,738 1,405 10,034
2,235 2,830
382 2,598 2,127 12,44:i
1,725 2,362 1,124 2,766 1,892 20,396
1,347 2,175 1,552 2,580 4,099 21,93;)
693 1,533 1,959 2,0ti5 6,176 19)06
Rates Per 100,000 Population
[850 1860 1870 1880 1890 1900 1920 1930 1940
ALL CAUSES ---- 1095.3
Typhoid fever ------- 61.5
Malaria -------------- 20.4
Smallpox -------------
Measles -------------- 8.2
Scarlet fever --------- 22.3 Whooping Cough _______ 42.5
Diphtheria ----------- 38.0
Dysentery, diarrhea and
enteritis
72.2
Tuberculosis ---------- 41.8
Cancer --------------- 6.6
Pneumonia ----------- 71.8
Heart diseases -------- 66.5
AI! other causes ----- 643.5
1211.9 83.9 53.7 0.8 4.5 20.5 31.6 41.6
100.4 52.0 7.7
119.9 68.4 627.0
1149.0 65.2 59.5 1.5 22.8 1.0 7.8 35.2
119.4 84.1 11.1
115.1 23.1 603.2
1397.3 64.0 68.7 0.1 32.2 2.0 42.1 84.9
130.4 122.0
15.6 109.3 94.1 631.9
1152.4 1219.11
54.4 79.9
51.0 55.5
2.1
24.0
9.1
0.4
2.0
4.8 10.0
30.1 37.1
128.1 126.5
16.0 94.6 76.5 546.1
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 65.3 704.2
1207.4 17.2 15.2
4.4 1.3 8.8 4.6
46.2 74.6 53.3 88.5 140.6 752.7
1033.5 2.2 2.S
0.7 0.5 3.5 1.9
22.2 49.1 62.7 65.8 197.7 624.4
NOTE: Figures for the year 1910 not available.
Information and Statistics
353
TABLE 16 DEATHS UNDER ONE YEAR OF AGE, MATERNAL DEATHS AND STILLBIRTHS
WITH RATES PER 1,000 LIVE BIRTHS, IN GEORGIA: 1920-1942
Year
Infant Mortality
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935
1W~&
1937 1938 1939 1940 1941 1942
------------------- 5305
---------------------- 4905
--------------------- 4U37 --------------------- 5384 --------------------- 5674 ---------------------- 4704 - -------------------- 4405 --------------------- 4578 --------------------- 4875 --------------------- 4464 --------------------- 4713 ---------------------- 4234 --------------------- 4097 --------------------- 4079 - ------------------- 5086 --------------------- 4316 --------------------- 4319 --------------------- 3968 --------------------- 4352 --------------------- 3817 --- ------------------ 3737 --------------------- 3955 --------------------- 3559
Number
Mortality
558 568 658 573 708 641 485 578 622 549 658 616 620 463 505 458 491 471 421 356 342 315 299
Stillbirths
3389 3820 3862 3958 3864 3455 2972 3836 3478 3541 3796 3678 3847 3700 4120 3987 3666 3677 3390 3228 3078 2903 2786
Infant Mortality
Rate
Maternal Mortality
88.3 73.9 75.9 84.5 89.5 78.9 87.2 73.5 80.9 76.3 78.1 68.5 64.3 67.2 78.7 68.2 70.1 62.0 67.7 58.8 57.8 58.3 49.3
9.3 8.6 10.1 9.0 11.2 10.8 9.6 9.3 10.3 9.4 10.9 10.0 9.7 7.6 7.8 7.2 8.0 7.4 6.5 5.5 5.3 4.6 4.1
Stillbirths
56.4 57.:1 59.3 62.2 61.0 58.0 58.9 61.6 57.7 60.5 62.9 59.5 60.4 60.9 63.8 63.0 59.5 57.4 52.7 49.7 47.6 42.8 38.6
TABLE i7
BIRTHS AND DEATHS (ExcLusivE oF STILLBIRTHS) WITH RATES PER 1,000
PoPULATION AND BIRTHs PER 100 DEATHs, IN GEORGIA: 1920-1942
Year
Number
Births
Deaths
Rate
Births
Deaths
Births Per 100 Deaths
1920 -------------------- 60,061
32,243
20.7
11.1
186
1921 -------------------- 66,378
29,552
22.9
10.2
225
1922 -------------------- 65,082
31,714
22.5
10.9
205
1923 -------------------- 63,681
34,082
22.0
ll.8
187
1924 -------------------- 63,386
34,797
21.8
12.0
182
1925 -------------------- 59,610
31,278
20.5
10.8
191
1926 -------------------- 50,493
29,906
17.4
10.3
169
1927 -------------------- 62,246
31,869
21.4
11.0
195
1928 -------------------- 60,259
36,085
20.7
12.4
167
1929 -------------------- 58,521
35,340
20.1
12.2
166
1930 -------------------- 60,318
35,188
20.7
12.1
171
1931 -------------------- 61,774
32,989
21.0
11.2
187
1932 -------------------- 63,690
32,122
21.5
10.8
198
1933 -------------------- 60,744
31.184
20.4
10.5
195
1934 -------------------- 64,615
35,590
21.5
ll.8
182
1935 -------------------- 63,290
34,313
20.9
11.3
184
1936 -------------------- 61,617
37,293
20.2
12.2
165
1937 -------------------- 64,012
34,411
20.8
ll.2
186
193S -------------------- 64,307
33,617
20.7
10.8
191
1939 -------------------- 64,910
31,856
20.8
10.2
204
1940 ---- ---------------- 64,695
32,285
20.7
10.3
200
JR41 -------------------- 67,785
31,579
21.6
10.0
215
1R42 -------------------- 72,189
28,807
23.1
9.2
251