Annual report for the year 1943 [1944]

STATE OF GEORGIA
EPARTMEN
DDD
ANNUAL REPORT

STATE OF GEORGIA
DEPARTMENT OF
PUBLIC HEALTH
T. F. ABERCROMBIE, M.D., Director
ANNUAL REPORT FOR THE YEAR 1943
State Office Building Atlanta, Georgia

Table of Contents
Page Division of Local Health Organizations________________________________ 13 Division of Public Health Nursing ------------------------------------ 61 Division of Public Health Engineering ------------------------------ 67 Division of Dental Health Education ---------------------------------- 95 Division of Maternal and Child Health________________________________ 105 Division of Public Health Education____________________________________ 133 Division of Preventable Diseases ------------------------------------------ 139
Cancer Control Service____________________________________________________ 141 Epidemiological Service ------------------------------------------------ 151 Industrial Hygiene Service______________________________________________ 187 Typhus Control Service__________________________________________________ 200 Venereal Disease Control Service____________________________________ 208 Division of Malaria and Hookworm Service__________________________ 221 Division of Tuberculosis Control ------------------------------------------ 231 State Tuberculosis Sanatorium. _______________________________________________ 251 Division of Laboratories ------------------------------------------------------ 265 Division of Information and Statistics_____ ------------------------------ 307

~tatt of 0torgf.a
~rpartmtnt of ;&3ub lie !WiltII
T. F. ABBBCBOIIBIII. H. D DIDCTOR .&TL&NT.&
To His Zxcellency ~on. Ellis Arnall Go~~rnor of Georgia
Dear Sir:
I hhve the honor to present to you the ~~nual report of the work of the De-oartment of Public Health for the year 1913. Considering the im!)act of ':ar conditions, the health of Georgians re.,ained exceptionally go~d. The birth rate was the highest on record, 25,1 per 1,000 population. The death rate from all causes was 9.4 per 1,000 population.
Eight important conditions recorded new minimum rates for 1943. Typhoid fever decreased 3.9 per cent; malaria, 51.4 per cent; diphtheria, 14.8 p~r cent; dysentery, 8.4 per cent; and pellagra, 3.3 per cent.
jn encouraging trend is indicated by the 6.8 per cent decline in maternal :nortality, 5.2 per cent in infant mortality, and. 11.9 per cent in stillbirths. These decreases have been accomplished under exceedingly difficult circumstancee. There were 78,327 births in 1943, in comparison with the average normal of 6o,OOO, Considerably fewer physicians were ~vailable to offer obstetrical service, aa well as much less personnel to offer public health assistance,
Since 1937 the infant mortality rate h&s decreased from 62.0 to 46.7 per 1,000 live birthe, the maternal rate from 7.4 to 3.9, and the stillbirth rate from 57.4 to 34.0, This record speaks well for the services rendered by Georgia J)hysiciana and the protection afoorded by public health I'Orkers,
Syphilis deaths indicate a downward trend since 194o when the rate was 18.8 per 100,000 population. In 1931, it had dropped to 16.0; in 1942, to 14,8; an~. in 1943, to 13.9.
The health record for the year 1943 was indeed fortunate a!'.~. one of which we 1na;r be just l;r proud,
~~
T, F. Abercrombie, M,D,, Director State Department of Public Health

GEORGIA DEPARTMENT OF PUBLIC HEALTH

MEMBERS OF THE GEORGIA STATE BOARD OF HEALTH
RoBERT F. MADDOX, Chairman___________________________________________________________Atlanta .C. L. RIDLEY, M. D., Vice-Chairman ___________________________________________________Macon .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 foHN 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, and 6 pence were paid for "physicks" to be given soldiers in General Oglethorpe's Regiment in Savannah.
As early as 1760, there was an act to oblige ships and other vessels coming from places infected with the plague, smallpox, or other contagious diseases to be quarantined. Later, in 1817, a Georgia law was passefd 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 act 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 soldiers 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 indicated that a meeting was held in Atlanta on October 10, 1876, all members being pcesent except the Secretary, who was delayed in Savannah on account of an epidemic of yellow fever.
Doctor Ta:liaferro made a complete investigation of the origin of the yellow f~ver epidemic ,and reported that sailors. on the '.'Maria Carlina", who bad moved their bedding to a boarding house, brought the 'fever to

10

Georgia Department of Public Health

Savannah. At that time, sanitary conditions in Savannah, as well as in other parts of the State, were very poor and played an important part in the spread of the disease. Cases occurred in Augusta, Brunswick, and Macon.

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 one-half 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 Legislature. An appropriation of $3,000 was made and Dr. H. F. Harris was elected secretary at a salary of $2,000 yearly. The remainder of the appropriation was used in the general work of the Board.

Doctor Harris, using a microscope and other apparatus of his own, began operation in one small room in the basement of the Capitol in 1904. His first work was devoted to bacteriology and the control of smallpox and yellow fever. He also did a vast amount of research in an effort to determine the cause of pellagra.

A laboratory was opened in 1905. With assistance, Doctor Harris expanded his activities to include the manufacture of Pasteur treatment in 1908; diptheria 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 ~oon 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 Glyliil. Couiily; was

elected Secretary.

'1 , ::

. -

A Brief History

II

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 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

LOCAL HEALTH SERVICE
STATE OF
GEORGIA DECEMBER 31,1943

IIIII
3
~
~

COUNTY HEALTH DISTRICTS NURSING COUNTIES HEALTH REGIONS

KAI.l Ill Mti.U

1

I

!

I

I

r

Division of Local Health Organizations
Twenty-nine years after the passage of the Ellis Health Law, which created a board of health in each county in Georgia and enabled each county to organize and operate a health department, sixty-two counties, with a population of almost two million, had departments of health, and other counties were ready to make appropriations for public health. At first, much time and effort were spent in convincing the people of the need for and value of public health service. Often it was more difficult to get local authorities to make the necessary appropriations than it was to -;~~~'ince the people of the need. During the last few years, because of the unavailability of qualified public health workers, little effort has been put forth in promoting local health departments. The health education program of the earlier years is bearing fruit, and we are looking forward to the time when every county in Georgia will have full-time public health service.
Effect of the War
Although all public health work is of prime importance to the national welfare and contributes to the winning of the war, demands for special stress on certain activities have been made upon health departments. One evidence of this is that all activities, except venereal disease control and sanitation of food-handling establishments, showed either a decrease or very little increase in 1943 over the previous year. The two exceptions showed increases of from nine to thirty-seven per cent.
Loss of personnel continued to handicap the expansion of the programs of local health organizations, and threatened even the maintenance of the standard of services established in previous years. During 1943, there were, in local health departments, thirty-one doctors, nurses, engineers, and clerical employees who resigned to enter the armed forces or to accept positions connected with the war effort. Sixty such persons had previously resigned for the same reason. Replacement of a large part of this personnel has been impossible. Where replacement is possible, frequently the person is not so well qualified, due either to lack of training or to inexperience. However, an effort is being made to select only persons qualified for formal training after the war emergency.
In spite of the loss of experienced personnel, the changed emphasis in the program, and inefficiency of new and untrained workers, the responsibilities consequent to the war have been assumed with cheerfulness and zeal. The fact that there has been no serious epidemic proves the effectiveness of the work.
Formation of Health Districts arul Change of Status of Counties
To partly compensate for the loss of personnel, remaining workers have patriotically taken over as much of the work as possible. Counties having full-time health officers have graciously agreed to the health officers' sharing their time with neighboring counties in several cases. Since the

16

Georgia Department of Public Health

beginning of the war emergency, five such districts have been formed. These are: Burke-Jenkins, Crisp-Worth, Greene-Hancock-Wilkes, LibertyLong and Muscogee-Chattahoochee. Thus, six counties, which otherwise would not, have the services of a health officer. Late in 1943, arrangements, effective January 1, 1944, were made for Screven County to join with Burke and Jenkins in a tri-county unit. Other such districts will be formed during 1944. However, the number of vacancies in position of commissioner of health increased from ten to seventeen in one year. The present vacancies are :

Appling-Wayne District

Grady County Health Department

Baldwin County Health Department Hall County Health Department

Bleckley-Dodge-Pulaski District

Habersham-Rabun-Stephens District

Brooks County Health Department Harris-Meriwether District

Bulloch County Health Department Jefferson County Health Department

Calhoun County Health Department Mitchell County Health Department

Coffee County Health Department Telfair-Wheeler District

Dougherty County Health Depart- Terrell County Health Department

ment

Tift County Health Department

Continuation of Itinerant V. D. Nursing Servipe

Since April of 1942, a service providing treatment for men rejected by local Selective Service Boards because of venereal disease infection has been conducted in counties not having full-time nursing service. One nurse serves from two to four counties, and physicians conducting the clinics are paid on an honorarium basis. As of December 31, 1943, there were six nurses, serving nineteen counties, employed in this phase of the public health program.

Regional Work

The service rendered by the staff of the six regional offices to nurses in unorganized counties has had to be expanded to include supervision of the activities in those counties where there are vacancies in local health department staffs. At all times the entire staff of the regional offices is available for advisory service.

New Buildings

One evidence of the increased recognition of the importance of public health work is the fact that, instead of allotting quarters to the health department in the basement or attic of the courthouse or over some store, buildings designed to meet the needs of the public health program are being erected. Where the shortage of critical materials makes this impossible, larger and more suitable quarters are being provided from existing facilities. Although it is the smallest county iri the State from the point of population, Echols, in 1939, built for its nurse Georgia's first health center. This forward step has been encouraged by the Federal Works Agency in some instances, where funds are provided under the

Local Health Organizations

17

Lanham Act for new buildings or renovation of existing buildings in those counties where military or industrial projects are located.
New Laws
The basic laws regarding local health departments in Georgia had not been changed since 1914. The 1943 Legislature amended some of these laws and passed new ones. The amendments were as follows:
(1) To facilitate the establishing of countr departments by eliminating the necessity of two successive grand jury recommendations.
(2) To establish a single board of health for the county, including the towns and cities therein, permitting or requiring members of the board appointed by the towns or cities, and providing for financial participation by the towns and cities, and by the State.
(3) To permit the formation of health districts of two or more counties without regard to population.
(4) To enlarge and liberalize the duties of the commissioner of health.
The new laws were as follows:
(1) Placing the county health departments under a state-wide merit system.
(2) Requiring blood examination for syphilis of all expectant mothers.
(3) For the control of prostitution.
Unfortunately, some of the benefits of these laws were vitiated by adding of amendments to them on the last day of the session.
Statistics
Although there was a marked decrease in the number of communicable disease cases admitted to service in 1943 over 1942, more service was rendered these cases. V. D. control services showed a marked increase, while some decrease was seen in most of the other services. 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.
On December 31, 1943, 63.87% of the population had health department service, and 24.12% had full-time nursing service, a total of 88% of the population of Georgia. All remaining counties except fifteen were being covered by itinerant nursing service. As of the same date, 578 persons were employed in local health departments for full-time service as compared with 550 on December 31, 1942. This increase in personnel is 1 explained by the expansion in clinic service in the metropolitan areas. In addition, there were twenty-eight persons employed in the regional offices, fifty public health nurses in unorganized counties (vacancies existing in fourteen counties on the last day of the year), and six nurses and six clerks in the itinerant nursing districts.

18

Georgia Department of Public Health

PEMBROKE HEALTH CENTER BRYAN CouNTY

BLACKSHEAR HEALTH CENTER PIERCE COUNTY

Local Health Organizations

19

TABULATION oF SPECIFIED AcTIVITIES IN 1943 SHOWING PER CENT oF

INCREASE OR DECREASE OVER 1942

Per Cent

Increase

Total for Decrease

COMMUNICABLE DISEASE CONTROL

Year 1943

1942

Admissions to Pervice ______________________________ _

5,508

-48.3%

Consultations with physicians ..............

1,298

-37.3%

Field visits - ....................

"21,824

_-36.5%

Smallpox immunizations --------------------

77,599

-15.9%

Diphtheria immunizations Typhoid fever immunizations __

46,304 295,098

8.4%
- 0.9%

VENEREAL DISEASE CONTROL

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

71,644

Clinic visits - .....................................

............................ 1,136,792

Field visits ............................................ ....................

70,846

TUBERCULOSIS CONTROL

Individuals admitted to medical service .............................

Individuals admitted to nursing service_____ --------------------------

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

_____ ---------------------- _

Nursing visits --------------------------------- __________________ -----------------------------

15,493 22,245 30,845 86,731

MATERNITY SERVICE

Cases admitted to medical service _______ -----------------------------

Cases admitted to nursing service_ _

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

Visits by antepartum cases to medical conferences--~--

Nursing visits ~ ------~-----------------------~--~-------- -----------------------------------------~~---

23,965 47,568 64,781 139,464

INFANT HYGIENE Individuals admitted to medical service....................................... Individuals admitted to nursing service............................................... Visits to medical conferences ..~---~-Nursing visits ------~-------------~--~-~--~--------------------
PRESCHOOL HYGIENE Individuals admitted to medical service ........................... Individuals admitted to medical service................................................... Visits to medical conferences .... _______________________
Nursing visits -~------------Inspections by dentists or dental hygienists

12,488 33,829 29,137 78,054
12,100 25,746 23,689 63,875
815

10.9% 36.8% 17.9%
3.2% 0.4% 4.5% 1.3%
4.0<;{! 0.6% 4.1% 5.6o/o
10.6% 6.8%
10.2% -11.0%
7.4% 1.8% 1.4% 3.3% -11.7%

SCHOOL HYGIENE Inspections by physicians or nurses -------------------------------~-----Examinations by physicians _____________~----------~-------- ______ ------------~----------------~
Individuals admitted to nursing service----------------------Nursing visits -------------------------------------~~~------~----- Inspections by dentists or dental hygienists ...

314,744 73,358 22,174 53,757 44,367

3.3o/o 7.8%
5.8~~
-25.1% -29.3%

ADULT HYGIENE Medical examinations

56,173

2.0o/o

MORBIDITY SERVICE Medical visits Nursing visits -----~---Admissions to hospitals._________ -----------------------------------------------------
GENERAL SANITATION Approved individual water supplies installed ................... Approved excreta disposal systems installed ................. Field visits

32,490 27,857
7,934
1,371 3,197 206,571

-35.0% -13.3% -25.7%
-14.6% -42.9% -39.9%

20

Georgia Department of Public Health

PROTECTION OF FOOD AND MILK Food-handling establishments registered for supervision__________________ Field visits to food-handling establishments ________________________________________

Dairy farms registered for supervision_ ~--~~--------------------------------------------

Field visits to dairy farms -------------------------------------------------- __ ------------------

Milk plants registered for supervision

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

Field visits to milk plants ---------------------------------------------------

7,415 80,320
1,251 9,518
78 2,795

LABORATORY Specimens examined ________ _

456,141

0.6% 9.2% 3.8% 9.5% -17.0% -11.1%
5.2%

RECORD OF COUNTY HEALTH WORK IN GEORGIA 1915- 1943

Year 1915 1920 1925 1930 1935 1940 1941 1942 1943

Number Organized Counties
2 18 23 34 31 55 56 59 62

Number Persons Employed
5 42 71 205 233 498 544 550 578

Population Served 17,545 436,106 598,107
1,011,974 1,327,018 1,893,441 1,920,119 1,960,851 1,995,159

Total Budget $ 4,637.00
72,695.00 179,812.00 451,217.00 459,292.00 1,066,126.20 1,124,729.00 1,370,304.90 1,456,824.58

Per Capita
.26 .17 .30 .45 .35 .56 .59 .70 .73

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 1,023,983. 78

Per Capita
.26 .16 .28 .44 .30 .41 .42 .49 .51

Local Health Organizations

21

CoMPARATIVE STATISTICAL SUMMARY OF ToTAL LocAL Pusuc HEALTH
WoRK IN GEoRGIA, 1942-1943

Organized Counties

1942

1943

COMMUNICABLE DISEASE CONTROL Admissions to medical serviee_______________________ _ Admissions to nursing service___________________ Admissions to medical and/or nursing service ---------------------------------------Consultations with physicians ___________________
Field Visits: Diphtheria__________________________________________________
Typhoid fever and paratyphoid fever ____ _ Scarlet f!lver_____________________________________________
Smallpox:~--------------------------------------------------Measles _________________________________________________ Whooping cough___________________________________________
Malaria.___________________________ -----------------------------H o o k w o r m ___________________________________________________ _
Typhus ______________________________ -------------------------Other communicable diseases __

8,589 8,700
12,151 1,495
2,386 2,822 2,548
30 2,703 1,604
503 2,633
472 4,055

4,163 5,895
8,678 1,149
1,793 475
2,104 22
1,603 1,569
174 1,515
434 3,896

Total field visits for communicable disease controL_________________________________________
Persons treated for hookworms ______________
Admissions to hospitals: Diphtheria__________________________________________________ Typhoid fever and paratyphoid fever____ Scarlet fever----------------------------------------------- S m a l l p o x __________________________________ _ Other communicable disease patients admitted to hospitals______________________________

19,755 2,951
47 28 90
2
442

13,485 1,114
45 14 51
158

Total admissions to hospitals for communicable disease control _________
Immunizations (persons immunized) : S m a l l p o x _________________________________________________________ _ Diphtheria-under 1 year_________________________ Diphtheria-l through 4 years._____________ _ Diphtheria-5 years and over_________________

609
63,062 10,292 14,414 12,434

268
52,699 11,320 14,032 10,273

Total diphtheria immunizations ____________ Schick tests given_______________________________________ Typhoid fever_______________________________________________
Other immunizations___________ ---------------------Public lectures and talks _________________________
Attendance------------------------------------------------Persons tested in surveys___________________________

37,140 11,731 194,427 1,103
173 11,195 15,366

35,625 8,289
196,258 5,029 134 5,613
15,050

All Counties

1942

1943

10,654 12,062
15,674 2,072

5,608 8,418
11,284 1,298

2,633 3,265 2,728
42 2,803 1,656 11,125 5,281
490 4,377

2,U~~
748 2,287
46 1,546 1,665 4,381 4,661
466 4,027

34,390 4,979

21,824 2,039

50

46

30

15

90

53

6

443

172

619

286

92,368 14,028 21,022 15,537
50,587 12,866 297,818 1,173
242 13,860 20,229

77,599 14,670 19,098 12,536
46,304 8,968
295,098 7,031 180 7,442
16,980

22

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL Pusuc HEALTH WoRK IN GEORGIA, 1942-1943-Continued

Organized Counties

1942

1943

VENEREAL DISEASE CONTROL Admissions to medical service---------------Admissions to nursing service__________________ Total admissions to medical and/or
nursing serviee -------------------------------------- Cases transferred to private physicians. Clinic visits (by patients) ________________________ Field visits (to patients) __________________________
Number of clinic treatments ------------------Dismissed from service_____________________________
Office visits--------------------------------------------Public lectures and talks --------------------A t t e n d a n c e ........ -----------------------------------

52,298 36,174
56,467 1,657
658,405 50,766 507,946 14,370
207 101 9,470

57,102 45,660
60,439 2,483 867,266 59,756 797,788 21,492
325 90
5,353

TUBERCULOSIS CONTROL
Individuals admitted to medical service. Positive cases .........------------------------------ Suspicious cases______________________________________ C o n t a c t s _______________________________________ _
Individuals admitted to nursing service. Positive cases _________________________________________
Suspicious cases.....---------------------------------Contacts___________________________________
Total individuals admitted to medical and/or nursing service________________________
Positive cases__________________________________________
Suspicious cases---------------------------------C o n t a c t s _______________________________________
Physical examinations in clinics___________ X-ray examinations--~---------------------------- Clinic visits (by patients)----------------- Visits to State clinics (by patients) ___________ Visits to private physicians (by patients) Visits to private physicians (health
officer or nurse---------------------------Visits to others (health officer or nurse) Field visits____________________________________________
Visits to cases of tuberculosis_________________ _ Visits to tuberculosis suspects _____________________
Visits to contacts---------------------------------Office visits --------------------------------------------,, O{fice visits to cases of tuberculosis--------Office visits to tuberculosis suspects________ Office visits of contacts______________________ Admissions to sanatoria___________________________, Number tuberculin tests completed___________ Number positive_________________________________
Number negative( completed tests) _________
Conta..ts broken------------------------------Contacts partly broken_______________________
Relief secured for tuberculosis cases_______

12,386 2,075 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 52,357 15,945 9,338 27,074 21,292 5,290 6,492 9,510
588 21,602
6,664 14,938
1,208
:x

12,123 2,035 4,187 5,901
16,750 2,754 5,156 8,840
18,973 3,036 6,162 9,775 13,584 15,854 26,851 6,595 749
1,009 1,388 53,492 15,138 9,425 28,929 19,944 5,281 6,850 7,813
440 20,884
5,406 15,478
1,153 374 525

All Counties

1942

1943

64,585 48,710
69,315 1,758 830,700 60,072 667,250 15,518
335 125 11,645

71,644 60,551
75,432 2,737
1,136,792 70,846
1,050,265 24,457 860 106 6,330

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 7,567 10,980
746 25,278
7,655 17,&23
1,406 396 651

15,493 2,461 4,979 8,053
22,245 3,5g7 6,592
12,056
26,079 4,077 7,912
14,090 14,088 19,876 30,845 10,558
836
1,182 1,632 63,273 17,639 11,445 34,189 23,458 5,919 7,947 9,592
556 24,192
6,614 17,578
1,343 399 609

Local Health Organizations

23

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1942-1943-Continued

Cottages, sleeping porches, etc. (number
built)------------------------------------------------------------ Public lectures and talks___________________________
Attendance.________________________ ----------------------------
MATERNITY SERVICE
Cases admitted to prenatal medical service -------------------------------
Cases admitted to prenatal nursing service------------------------------------------------
Cases admitted to medical and/or nursing service_______________________________
Visits by prenatal cases to medical c o n f e r e n c e s . _________________________________________ _
Visits by prenatal cases to private physicians --------------------------------------------------
Field visits to prenatal cases -----------------Office nursing visits by prenatal cases Cases attended by nurses for delivery
service ------------------------~------~ Cases given postpartum medical
examination.______________________________________________ Cases given postpartum examination by
private physicians -----------------------------------Cases admitted to postpartum nursing
service ------------------------------------------Visits to postpartum cases __________ Permanent health centers.________________________
Number of sessions -----------------------------------Itinerant health centers---------------------------Sessions held -----------------------------------------------Midwives registered for formal
instruction -------------------------------Midwife meetings---------------------------------------Attendance at meetings---------------------------- Visits for midwife supervision Public lectures and talks._________________________ A t t e n d a n c e .___________________________________________________ _
Enrollment in maternity classes_ Attendance._____________________________________________________
INFANT AND PRESCHOOL HYGIENE
Infants: Individuals admitted to medical service Individuals admitted to nursing service Individuals admitted to medical and/or nursing service_________________________________________ Permanent health centers.________________________ Number of sessions_____________________________________ Itinerant health centers.____________________________
S"essions held--------------------------------------------

Organized Counties

1942

1943

10 348 23,431

16 301 29,724

17,126
20,870
22,014
57,781
936 34,128 51,220
155
2,940
427
17,632 39,994
189 6,145
12 40
1,334 1,028 8,347 4,085
362 4,849
217 2,333

16,053
20,570
21,148
53,505
1,357 29,663 48,207
52
3,090
951
18,349 39,307
170 5,718
11 23
1,232 874
6,283 3,568
311 3,209
801 2,270

9,825 27,113
27,976 236
6,596 36 80

10,710 28,920
29,784 216
6,512 20 37

All Counties

1942

1943

11 376 25,501

16 324 32,742

21,497
26,659
27,960
67,578
1,021 40,558 61,877
218
3,487
456
20,369 45,309
242 7,469
12 40
2,481 1,617 11,794 5,795
390 5,099
217 2,333

20,155
26,523
27,222
64,781
1,417 34,320 61,374
82
3,810
971
20,963 43,770
239 7,274
11 26
2,256 1,349 9,164 5,015
341 3,479
801 2,270

11,290 31,647
32,593 . 282
7,503 36 80

12,488 33,829
34,809 279
7,718 20 37

24

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY OF TOTAL LocAL Puauc HEALTH WoRK IN GEORGIA, 1942-1943-Continued

Visits to medical conferences
(by patients)------------------------Visits to private physicians
(by patients)----------------------------Field visits --------------------------------Office nursing visits ______________ Consultation with parents ________
Preschool: Individuals admitted to medical service Individuals admitted to nursing service Individuals admitted to medical and/or nursing service ---------~------------------------Permanent health centen ________________________ Number of sessions_____________________________ Itinerant health centers ____________________________

Sessions held----------------------------------------------- Visits to medical conferences (by
patients) ----------------- ----------------------------Visits to private physicians (by patients)
Field visits ------------------------------------------------Office nursing visits (by patients) _______ .
Inspections by dentists or dental hygienists ________________________________________
Prophylaxis by dentists or dental
hygienists---------------Consultations with parents _______
Public lectures and talks------------------------Attendance----------------------------------------------Enrollment in infant and preschool
classes ------------ -------------------------------------------Attendance________________ ------------------------

SCHOOL HYGIENE Inspections by physicians or nurses ______ Examinations by physicians ______________________

Examinations by physicians with par...

ents present -------------------------------------------

Individuals admitted to nursing service

Field visits _____________

-------------------------- _

Office visits ________________________________________

Inspections by dentists or dental

hygienists ------------------------------------------Prophylaxis by dentists or dental

hygienists -------------------------------------------------Public lectures and talk! ________

Attendance-------- -----------------------------------------Classroom health talks _______________________________
Attendance _______________ _

ADULT HYGIENE Medieal Examinations:
Milk-handlers------------Other food-handler _______

Organized Counties

1942

1943

23,604
291 51,308 24,703 46,133
11.861 22,379
23,987 205
5,861 192 256
21,897 406
32,249 23,678
12,644
460 39,732
223 3,051
330 586
311,590 78,372
2,342 19,887 32,121 19,216
52,970
3,883 613
37,231 3,528
131,964

25,515
897 55,680 27,590 41,257
11,008 23,246
24,518 203
5,763 126 151
21,965 326
36,718 22,177
779
76 33,163
423 6,121
69 129
298,790 71,376
2,546 22,253 27,923 24,183
41,573
2,227 581
19,978 3,546
122,133

1,940 37,134

1,430 36,223

All Counties

1942

19(3

26,420
343 59,602 28,187 49,004
13,073 25,268
26,931 243
6,470 202 265
24,049 430
36,891 25,922
12,674
564 41,502
218 4,067
330 586
325,532 79,650
2,663 20,945 33,022 38,795
62,789
4,372 739
42,911 4,027
146,023

29,137
928 62,606 32,510 45,644
12,100 25,746
27,240 255
6,5117 132 107
23,681) 453
39,230 24,646
816
77 35,467
428 6,606
70 143
314,744 73,368
2,639 22,174 28,794 24,963
44,367
2,973 710
26,289 3,960
134,114

1,940 37,184

1,438 36,263

Local Health Organizations

25

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK INGEORGIA, 1942-1943-Continued

Organized Counties

1942

1943

All Counties

1942

1943

Midwives _____

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

Teachers ~~~~~ ~~~~-~~~~~~~ ~~-~---~-~~~~~~~-~---~------~-

Other adult medical examinations _________

374 850 13,282

339 856 16,134

374 850 14,767

339 856 17,295

Total adult medical examinations __

MORBIDITY SERVICE
Admissions to medical service Admissions to nursing ~ervice ----------------- Atlmissions 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 --------------Otber defects corrected--~-~---~~--~-~---~

CANCER CONTROL
Admissions to medical service _____ Admissions to nursing service _______________ _ Admissions to medical and/or nursing
oervice ------------------------------------------------------Office visits ~~ ~-~~ ---~~~~ ~ -~ -~~~~~--~--- ~~--- --~-~--~~~ __ Field visits -~-----~-~~~-~--~-------~--~ ~~~~~------~--~--~--~ Applications for State aid . ---~~--~----~---~~~-~~- Cases receiving diagnostiC service at
State-aid clinics------~--~------~--~~--~~-------~--~- Cases receiving treatment service at
State-aid clinics____~--~~---~~~~-~~----~------~~---~--

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

OTHER ACTIVITIES

Conferences with physicians or dentists

Personal conferences with others ~-~---~~~

Newspaper articles --------------

Bulletins distributed

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

53,580
19,148 5,914
22,865 46,555
2,829 19,709
6,356 10,617 84,561 10,491
699 745 3,714
659 385
826 1,562
937 632
833
616
927
1,026 549 438
1,111 2,008
10 821
19,828 131,062
1,373 101,441

54,982
17,977 4.099
21,430 30,154
2,190 17,960
4,846 7,836 46,055 21,158
628 725 2,445
471 318
644 1,152
701 481
731
598
329
439 302 514 626 1,766
150
17,287 107,686
1,396 103,522

55,055
19,545 7,835
24,789 47,083
2,916 22,985
9,163 10,690 84,833 10,493
721 781 3,786
719 557
999 1,713 1,130
747
892
660
981
1.069 589 650
1.205 2,431
10 821
28,127 162,711
1,673 136.221

56,173
18,105 6,527
22,864 30,239
2,251 20,609
7,248 7,934 47,093 21,909
632 794 3,700
547 488
814 1,340
867 597
7R6
648
403
505 827 777 626 2.214
1 150
23,848 141,975
1,660 127.26U

26

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLic HEALTH
WoRK IN GEORGIA, 1942-1943-Continued

Organized Counties

1942

1943

All Counties

1942

1943

Circular letters___________________________________________ Miles travelled on duty_______________________________
Days off dutY------------------------------------------ Conferences with official groups_____________
Attendance------------------------------------Public lectures and talk---------------------
Attendance------------------------------------------------ Red Cross classes (sessions)------------------Attendance_____________________________________________________

86,874 1,527,506
1,069 1,294 17,724
944 49,182
1,129 24,210

63,904 2,004,194
2,813% 1,269 16,190
490 14,899
267 5,642

93,766 2,941,201
2,236 1,957 22,786 1,603 76,063 1,637 29,677

75,545 2,901,639
3,551 1,652 17,724
892 27,366
390 7,474

GENERAL SANITATION
Water: Approved individual water supplies Installed._____________________________________________________
Individual water supplies improved _____ Public water supplies improved_____________ Connections to public water supplies.____

1,489 603 64
4,059

1,346 647 168
10,076

1,606 939 102
6,346

1,3'n 918 198
10,193

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 pub-
lie places ----------------------------------
Privies repaired (or improved)--------------New septic tanks installed --------------------Septic tanks installed at homes ______________ Septic tanka installed at schools__________
Septic tanks installed at other public
places -----------------------------------------------Septic tanks improved____________________________
Connections to public sewer-------------------Sewerage systems or plants improved __

2,073 376
1,447 38 72
100
41 1,800 2,261 2,177
21
63 211 4,213 58

1,176 314 733 21 30
44
33 1,606 1,378 1,213
13
162 603 9,618 149

3,077 640
2,183 59
114
122
59 1,854 2,623 2,415
34
74 252 4,280 71

1,739 365
1,244 26 36
46
83 1,598 1,468 1,276
26
157 668 9,523 150

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...

284,472 1,170 429 203 2,633
966 588 49,680

171,735 885 491 219
1,869
524 328 28,716

287,399 1,200 433 204 2,972
1,196 680
49,682

172,809 904 495 219
2,230
784 396 28;'734

Total field visits for general sanitation __ 340,140

204,766

343,766

20((571

Local Health Organizations

27

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL PuBLIC HEALTH WoRK IN GEORGIA, 1942-1943-Continued

Organized Counties

1942

1943

lllSI!et Control:

Buildings mosquito-proofed ------------------------ 2,655

Minor drainage-linear feet completed____ 158,726

Linear feet ditch cleared ______________________________ 2,069,7S8

Anopheles breeding places eliminated _____

86

Acres drained __________________________________________________

270'h

Anopheles breeding places controlled _______ 12,380

4,919 49,133 2,283,987
147 2,406 8,658

Miscellaneous Public lectures and talks_____________________________
Attendance-------------------------------------------------------Posters, charts, exhibits models
completed ___ ------------------------- ------------------------Sanitation or malaria maps completed_

196 5,828
242 143

112 5,657
2,260 192

Rodent Control: Premises surveyed for rodent control ______
Buildings rat-proofed-----------------------------------Buildings improved ____ ---------------------------------Premises improved._____________________________________ Pounds of poison bait distributed _____________

2,481 521 374
1,162 2,621

4,662 193 416
2,211 13,027

PROTECTION OF FOOD AND MILK

Food-handling establishments registered for supervision_____________________________

7,359

Field visits to food-handling establishments_____________________________________________ 73,478

Dairy farms registered for supervision ____
Field visits to dairy farms __ ---------------------Milk plants registered for supervision_____ Field visits to milk plants____________________________

1,195 10,507
94 3,144

Cows tuberculin tested __________________

12,795

Animals slaughtered under inspection _____ 258,799

Carcasses condemned in whole or in part 51,955

Public lectures and talks _______________________________

82

Attendance ________________________________________________________ 3,343

7,415
80,300 1,251 9,507 78 2,793 2,045
233,973 34,973 34 1,125

AU Counties

1942

1943

3,030 185,126 2,093,788
86 2,289'h 12,381

5,152 49,133 2,283,987
147 2,406 8,678

209 6,446
269 156

113 5,680
2,267 192

2,544 521 374
1,162 2,621

4,662 193 416
2,211 13,027

7,364
73,531 1,205
10,522 94
3,144 12,795 258,799 51,955
82 3,343

7,415
80,320 1,251 9,518 78 2,795 2,045
233,973 34,973 34 1,125

ORGANIZED COUNTIES

Year 1942

Year 1943

Positive Negative Positive Negative

LABORATORY Specimens examined: W a t e r - b a c t e r i o l o g i c a L _________________________________ _
Water----ehemicaL-----------------------------------Milk or milk products___________________________________ Other food _______________________________________________________ Typhoid: blood cultures_____________________________
Typhoid: WidaL------------------------------------------Typhoid: stool cultures_________________________ Typhoid: urine cultures____________________________c
Diphtheria cultures -------------------------------------

1,014 10
977 2 60
45 396
32 733

5,628 445
10,740 61
757 1,395 9,891 2,637 8;195

885
1,663
44 28 96 31 425

5,064 378
12,298 112 626
1,725 7,964 2,577 6,862

28

Georgia Department of Public Health

CoMPARATIVE STATISTICAL SuMMARY OF ToTAL LocAL Pusuc HEALTH WoRK IN GEORGIA, 1942-1943-Continued

Syphilis-i!eriological _____ -----------------------Syphilis-darkfield ___________ -------------------
Undulant fever (human)----------------------Bangs disease (animal) __ ------------------------Typhus fever ...... _ Tularemia Malaria _________
Gonorrhea _________________ ---------------------------------Tuberculosis _____
Feces for parasites ___ --------------------------------Urinalysis ___ __________________ ------------------Rabies ...... _____________________ --------------------------------Pneumococcus typing ____ ------------------------Dysentery___________________________________________________
Other laboratory specimens examined_.

ORGANIZED COUNTIES

Year 1942

Year 1943

Positive Negative Positive Negative

39,386 95 40 3
257 23
375 4,549 1,608 3,946 3,674
124 13 135 416

188,674 310
1,388 656
1,218 198
8,276 16,518 10,334
9,510 41,742
137 28
1,124 5,495

54,770 72 45 12
427 15
101 7,182 1,744 2,225 4,326
262
90 993

180,584 240
1,737 724
1,442 239
6,028 26,042 12,568
6,206 40,976
145 6
638 10,198

Total laboratory specimens examined_

57,953

325,357

75,438

325,379

ALL COUNTIES

Year 1942

Year 1943

Positive Negative Positive Negative

LABORATORY Specimens examined: W a t e r - b a c t e r i o l o g i c a l ._______ _ Water-chemical._____________ Milk or milk products___________________________
Other food -------------------------- _------------------Typhoid: blood cultures -----------------Typhoid: Widal _________________________________________
Typhoid: stool cultures----------------------Typhoid: urine cultures ___________________________
Diphtheria cultures -----------------------Syphilis-i!eriological __________ -----------------------
Syphilis-darkfield -----------------------------------Undulant fever (human) _________________________ Bangs disease (animal) _________________ Typhus fever ____________________ -----------------Tularemia _________________ Malaria .......____________________________________________________ _
(]onorrhea -----------.-----------------------------------------Tuberculosis_________________ ------------------------------- Feces for parasites __ ---------------------------------Urinalysis______________________________ -----------------------
Rabies-------------------------------------------------------Pneumococcus typing -----------------------------Dysentery......................-----------------------------Other laboratory specimens examined __

1,269 10 979 2 70 47 448 40
825 45,141
97 42
3 276 129 393 4,675 1,921 5,850 5,455 125
13 135 563

7,406 445
10,742 61
799 1,409 10,218 2,666 8,437 207,262
315 1,413
656 1,263
256 13,527 17,341 14,059 12,288 47,292
139 28
1,143 5,584

1,147
1,666
57 31 133 42 490 62,321 74 46 12 438 15 112 7,370 2,053 4,508 5,563 265
91 1,195

6,644 378
12,208 112 677
1,787 8,306 2,658 7,156 204,217
244 1,754
724 1,459
252 6,794 27,366 15,413 8,421 50,689
148 6
687 10,372

Total laboratory specimens examined __

68,503

364,749

87,631

368,510

CoNDENSED REPORT OF AcTIVITIEs oF LocAL HEALTH DEPARTMENTS, HY CouNTIEs-1943

to
-.5;,
~"'

COMMUNICABLE DISEASE CONTROL

Admissions to medical service --------------------Consultations with physicians ---------------------

Field visit--------------------------------------------------Smallpox immunizations _________ ------------------Diphtheria immunizations __________ --------------- __

Typhoid immunizations --------------------- ______________ VENEREAL DISEASE CONTROL
Admissions to medical service ______________________

Clinic visits ---------- ___________ ----------------- --------------

Field visits -------------------------------------- ------------Number of clinic treatments _______ -----------TUBERCULOSIS CONTROL
Admissions to medical service ..... _______________
Admissions to nursing service _______ _____________

Clinic visits _ --------------------------------------------Field and office visits ----------------------- ______ MATERNiTY SERVICE

Admissions to medical service ---------Admissions to nursing service _____ ----------------

Visits by antepartum cases to medical

conferences ----------------

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

Field and office visits ___________ -----------------------

INI<'ANT HYGIENE

Admissions to medical service ____ ----------------Admissions to nursing service ___ Visits to medical conferences ______ Field and office visits _______________________________

45 9
113 464 320 3052
175 1962
86 1913
88 198 103 347
92 92
283 309
64 73 108 147

-.. ..a=
"a=
~ <

;..:...."....
<1:i

10
-------
12 188 105 1807

383 8
760 5590 4090 2497

79 1363
166 1288

8446 145282
12382 138837

36

1947

54

2422

36

5547

129 19217

54

264

69

585

86

634

171

2801

20

797

41

6681

35

2395

108

11274

..".a.=.
Ill
72 --------
255 348 193 1894
74 1139
178 1088
74 109
85 199
51 57
120 201
41 71 109 229

...
.=.."...
14
4204 28
189 1853
129 2640
42 2570
8 31 22 196
94 137
425 605
6 85
8 366

a=
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=~
6 42 802 463 3125
404 3935
270 3795
85 153 186 391
148 20S
434 681
123 232 272 808

.=...a.=..

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Ill

------
16 37 :!00
26 to:J
4
.250
1 1 1

------36
211 142 1485
276
6~28
69 4901
143 189 143 523
44 90
104 267
44 146
81 403

=...Is.I..:
18 104
43 441
65 1431
47 1300
36 65 36 73
6 5

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3 2 58 49 82 392 6811 417 6298 51 44 51 53
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CoNDENSED REPORT OF AcTIVITIEs OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

~e=o <"'
PRESCHOOL HYGIENE

Admissions to medical service__

21

Admissions to nursing service

24

Visits to medical conferences .

45

Field and office visits_

57

Dental inspections

SCHOOL HYGIENE

Inspections by physicians or nurses

694

Examinations by physicians _______

Admissions to nursing service __________________

73

Field and office visits

------------ 74

Dental inspections

21

ADULT HYGIENE

Medical examinations

________________ _

27

MORBIDITY SERVICE

Medical visits _______ ___________

___________

Nursing visits----------------- _________ ______ ___________ 103

Admissions to hospitals ___________ _______ _

3

SANITATION

Water supplies approved ______ --------------------------Privies and septic tanks installed _________________

Food-handling establishments registered Dairy farms registered ____________________________ _
Milk plants registered ____________________

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

LABORATORY SPECIMENS

Specimens examined

961

.....

;"=g'
<

]<i:;i

3

1694

7

5728

4458

10

11546

176 92601

27310

7

2510

14

9130

29722

23083

19026

_11

1161

1637

6 3403 571 27 34956

473

41756

..=C>
"

....
~

.=.;.
-;

. ...Ill
=

..~...

l:Q

l:Q

l:Q

l:Q

l:Q

6

75

63

18

140

145

17

144

122

38

366

374

603

148

1

36

64

2

6

3

24

805

4

13

7

464

15

15

10

26 19
134

692

893

1810

40

1216

~...

i
~

l:Q

l:Q

436

13

171

2360

w
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tl ~
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~

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

....,,
iii

COMMUNICABLE DISEASE CONTROL

Admissions to medical service ___ ------------ 48

Consultations with physicians ______

243

Field visits ~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ ~~~~

636

Smallpox immunizations ________________________ 1377

Diphtheria immunizations ------------- _

1127

Typhoid immunizatons --------------------- __________ 1117 VENEREAL DISEASE CONTROL

Admissions to medical service __ Clinic visits ________________________________________
Field visits ~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~ ~ ~~~~~~~~~~~ Number of clinic treatments ________

3304 79712
6629 76093

TUBERCULOSIS CONTROL

Admissions to medical service_ ---------------------- 381

Admissions to nursing service __

-------

Clinic visits __________ -----------------------------

Field and office visits ~~~~~~~~~~~~ ~~~~~~~~~ ~~~~~~~~~~~

MATERNITY SERVICE

Admissions to medical service _______________________

350 1772
795
1360

Admissions to nursing service_--------------------- 1927

Visits by antepartum cases to medical

conferences ------------------------------------------------
Field and office visits ------------------- ------INFANT HYGIENE

5764 2873

Admissions to medical service ________

------- 998

Admissions to nursing service ________________

1773

Visits to medical conferences--------------------- 2603 Field and office visits ~~~~~~~~~~~~~~~~~~~~~~-~~~~~~~~~~~ 2858

...
.!
.>II
.="!
11 12 20 205 168 1369
130 2294
344 2276
40 79 48 229
98 116
335 378
35 44 94 105

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77

5

7

40

8

79

3

-------

--------

105

208

108

29

--------

--------

1

76

57

4

90

398

8

1312

966

232

38

18

70

282

192

450

544

201

32

21

485

2930

3153

3848

3743

2090

2007

104

24

262

189

657

938

283

286

103

295

4768

3931

6911

16213

4993

3997

1470

20

103

141

474

737

408

53

98

293

4620

3931

6911

16203

4720

3935

1238

12

100

1

148

72

126

59

3

14

127

60

154

183

117

80

7

12

101

76

151

180

132

59

5

14

361

195

553

875

295

105

13

24

296

33

279

749

153

189

37

34

469

34

315

749

193

204

37

54

924

158

749

2335

362

436

37

85

1585

69

1375

2484

634

440

76

7

18

16

241

499

74

36

7

47

439

23

431

499

184

36

8

7

27

93

549

1018

108

62

7

108

678

67

1031

1170

410

62

10

..
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43

1

43 594

ct-<

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167 ~

1392 :::t::

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159 ~

2160 87

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1918 ~

..;~.;l..
72

95 72 239

.~...
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72 111

190 273

33

87

46

145

~

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CoNDENSED REPORT OF AcTIVITIEs OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs--1943-Continued

......
iii

PRESCHOOL HYGIENE

Admissions to medical service

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

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

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

Field and office visits ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~

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

577 1532 1781 2321
--------

SCHOOL HYGIENE

lnspections by physicians or nurses _____________ 42574

Examinations by physicians _________

1201fi

Admissions to nursing service-----------------------
Field and office visits ----------------------------Dental inspections ________ --------------------------

1304 1891
u-

ADULT HYGIENE

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

--------

MORBIDITY SERVICE

Medical visits ~~~~~~ ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~ Nursing visits _______________
-----------
Admissions to hospitals -------------------------

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

SANITATION

Water supplies approved

-----------

16

Privies and septic tanks installed _______

92

Food-handling establishments registered~~ 298

Dairy farms registered------------------------------------ 114

Milk plants registered~~~~~~~~~~~~~~~~~ -------------1

5

Field visits~~~~~~~~~~~~~~--~~~~~~~~~~~~~~~~~~ ----------------- 26128

LABORATORY SPECIMENS

Specimens examined _ ~~ ~~~ ~ ~~~~~~~~ ~~~~~~~~~~~~~~~~ 42656

~
.!:
"~"'
lil
-------
3 3 -------
3 3
--------
60
------- ------- -------
10
30 745

~
~
.c
"Q:l
8 79 10 108 --------
28 37
--------
1 86
2
4 339

."00""''
Q:l
5 236
10 655
6 3716
6 185 530 411
--------
15
3018

.c
"~
Q:l
3 3 5 7
1478 16 26
118 4
-----
766

.c
~" "'Q:l
136 142 244 365 ------300 42 81
20 6 14 79 4 1003
197:l

..
"Q"":l''
43 15 55 20
1755 8 4
16
278
55 3 8
38 42
7
1RJ5
<l764

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104 136 133 198
325 3 2 5
20 171
16
18
86 2491

c
."0c'
";
u
-------508
U61

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E
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8 8 8 9
35 4 42
29 23 22
53
49~

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u

19 ~

28 24

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1:1'<

32 5"

0

(1)
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1

(1)

4

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c '""l::l

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~

6

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(1)

!;...:.:.:.).:..-.

17

1369

CoNDENSED REPORT OF AcTIVITIES OF LocAL 1-lEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

~..
u"

3.0".'
u

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u.:::

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u

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3
u""

COMMUNICABLE DISEASE CONTROL Admissions to medical service ___ Consultations with physicians FieId visits~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Smallpox immunizations ------------------------Diphtheria immunizations --------------------Typhoid immunizations --------------------------------
VENEREAL DISEASE CONTROL Admissions to medical service _______
Clinic visits _------------------------------------Field visits ____ ----------------------------------------Number of clinic treatments __ TUBERCULOSIS CONTROL Admissions to medical service _
Admissions to nursing service----------------------Clinic visits _____________________ --------------------------------Field and office visits~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MATERNITY SERVICE Admissions to medical service --------------------- Admissions to nursing service_ Visits by antepartum cases to medical
conferences -------------------------,-----------------------Field and office visits ----------------------INFANT HYGIENE Admissions to medical service_ Admissions to nursing service Visits to medical conferences
Field and office visits--------------------

-------~
-------4
8 686 160 4523
256 5317
150 5203
53 69 53 135
------- -------
-------
------- 6
----- 9

9 3 34 147 956 5036
11 36 28 37
98 45 82 460
5 18
--------
59
36 41 45 278

61
132 18 35
920
94 1291
79 1291
31 54 31 115
89 102
350 487
87 86 198 325

823 435 2490 4275 1840 7943
6996 97358 23292 72781
469 391 1813 4959
1383 1303
3996 9358
439 3140
537 15697

4

2

93

4

34

54

10

22

--------

5

353

629

1357

2014

12

38

60

275

101

349

1543

6583

71

8

80

555

342

1486

6089

-----2

2

2

67

10

225

93

11

765

7

185

11

227

14

527

23

1162

5

233

8

443

7

1099

27

1981

2
11 367 111 1876
182 3766
227 3548
50 90 63 173
52 59
136 193
15 26 22 38

..:::
u.5

69

579
180 !c:"-<
110 ~
1151
::z::
~
... 128 .!.;.)..
1728 ;::-

160 .a.,

1276 t1'l

32 68

.~...
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32 c;

72 &;

51 63

101 146

6

21

19

47

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CoNDENSED REPORT OF AcTIVITIES OF -LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

..~ ~
u"

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u

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PRESCHOOL HYGIENE

Admissions to medical service __________________ Admissions to nursing service._____________________ Visits to medical conferences-------------------Field and office visits ---------------------------------Dental inspections ---------------------------------------

--------
8
------- 8
--------

34 19 57 35
--------

22

671

176

898

35

691

236

3617

500

1

5

1

18

------

2

84

2

--------

4

674

4

SCHOOL HYGIENE

Inspections by physicians or nurses

123

624

869 39105

116

Examinations by physicians ___

-------

220

14

2002

88

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

13

8

5594

31

Field and office visits ___________________________________

19

22

7952

81

6178

785

7

56

9

113

9

Dental inspections -------------------------------------- ----4

242

1756

ADULT HYGIENE

Medical examinations _____________________________________ -------4

9

--------

7038

6

1779

MORBIDITY SERVICE

Medical visits____________________ ----------------------------- ------4

7

8

7216

23

--------

Nursing visits _________________

1

7

27

19878

193

108

Admissions to hospitals

------------------ -------4

-------4

3699

19

SANITATION

Water supplies approved

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

1

-------

-----

855

1

Privies and septic tanks installed _________________

8

3

--------

313

8

73

25

Food-handling establishments registered____ -------

-------4

-------4

950

128

Dairy farms registered ____________ ---------4------------- ------

--------

--------

28

32

Milk plants registered ...__________________________

------

------

7

--------

1

2

Field visits _____ ----------------------------- ----------------------- 18

38

91878

17

5

15750

106

LABORATORY SPECIMENS

Specimens examined--------------------------------------- 517

80

428 73814

31

218

7889

1

758

C/..l
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2

~

6 "c"

3 7

~s

--------

~

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.., 2902

!;l

37 "

40 50

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c '1:l

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!;:
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34

45 28

::X::
!;..":..;":..l...-.

872

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouN'l'Its-1943--Continued

....
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..

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i

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0

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0

0

0

0

0

Q

Q

COMMUNICABLE DISEASE CONTROL Admissions to medical service_________________________ Consultations with physicians________________________
Field visits----------------------------------------------------------Smallpox immunizations -----------------------------Diphtheria immunizations -------------------------Typhoid immunizations -------------------------------VENEREAL DISEASE CONTROL Admissions to medical service _______________
Clinic visits-------------------------------------------------------Field visits ______________________________________
Number of clinic treatnlents ________ -----------TUBERCULOSIS CONTROL
Admissions to medical service ___ Admissions to nursing service____ Clinic visits _____ ----------------Field and office visits ____________________ ---------------
MATERNITY SERVICE Admissions to medical service _______ Admissions to nursing service _____ Visits by antepartum cases to medical conferences -------------------------------------------------Field and office visits_______________________________
INFANT HYGIENE Admissions to medical service ____ _i.ldmissions to nursing service __ Visits to medical conferences ----Field and office visits________________

156 10
399 707 599 4453
403 7092 1247 6853
231 593 242 1923
9 92
6 237
8 173
3 439

24 2
378 339 1229 1929
389 7106
667 4738
68 109 169 879
275 298
854 949
287 320 725 816

34 25 64 989 436 2683
494 8102 239 7929
138 143 161 255
196 220
790 943
114 207 233 456

---179
3507 31
3244 4 4
-----

1 1 1
115 1408
76 1251
7 7
--------
------

2 1 5 213 159 857
487 10754
349 10056
90 92 74 513
1 90
1 255
3 32
3 73

1 47 49 595
132 2369
18 1999
27 49 18 105
39 62
90 116
11 46 15 114

34 2
62 742 389 2419
573 9649 335 8603
103 151 108 470
290 297
872 1048
129 204 295 504

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

2 77 144 1136
-------47 60 51 71
135 --------
264
141 404

3...
Q""

24 524

ct"-t

i 183

- 1703 ::t:

1487 6038

~
:

c 261

~ 4594

;:l

86 ~
.... 100 ~
221 c 419 ~

254 255

1059 1051

65

68

154

328

C;.l

l;ll

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CoUNTIEs--1943-Continued

......
u0

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PRESCHOOL HYGIENE Admissions to medical service _______ Admissions to nursing service____________ Visits to medical conferences _________

Field and office visits ---------------------------Dental inspections --------------------------- ______________

SCHOOL HYGIENE Inspections by physicians or nurses Examinations by physicians .. _______________________

Admissions to nursing service___________ Field and office visits._________________________

Dental inspections -----------------------------------ADULT HYGIENE
Medical examinations ________________________

MORBIDITY SERVICE Medical visits ____________________ ----------------------

Nursing visits ___________________ ------------------------Admissions to hospitals ____ ---------------------- ________

SANITATION

Water supplies approved

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

Privies and septic tanks installed _

Food-handling establishments registered

Dairy farms registered.________________

Milk plants registered _______________________

Field visits__________________________________

LABORATORY SPECIMENS Specimens examined ________

171 436 171 741
78
1211 297 71 357
-------
605
25 258
5
11 68 74 41 2 1013
2986

155 166 358 351
--------

78 83 135 159
--------

9270 --------
5 13 ------

1248 259 12 111 1128

--------
--------
96 --------

526
----------------------

------- ---------------
--------' --------
2

--------
11
18 8 2
99

1604

2229

--------
--------
----------------------
----------------------------
--------
----------------------
4
379

------
---------------------
---------------------
381

43 79
326 --------
2 21
---------------
31 2
64 ------------135
949

14 42 21 51
157 156 165 185
25
--------
-------8
--------
-----14
---------------
30
424

22 31 63 191 --------
1 60 25 222 1186
101
14 16
9
12 --------
5
117
2789

-----------------------------
--------------------------
----------------------
---------------
10
7

20
-----
21
---------------
---------------
114 --------
-----------------------------
323

w
0\

..."...
u
Q"

22 28

~
c~

101 ~

139 ~

-------- \:::::1 ~ ~
2341 ~

--------

-------33
1156

~
-i;
c
~

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I;::
.....

~

4 40

~

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

;;:-

30 93 60 4

3546

3529

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

.~
i:d
~

. ..Ill
"CC ~

..>.
'C
~

b.
.c
..Ill
"~

~~.".

b..
101

..
.'C.c..
101

.E.
.c
Ill
:as=
101

...
~

"il
;"
E 101

COMMUNICABLE DISEASE CONTROL

Admissions to medical service_________________________ 106

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

51

Field visits___________________________________________________________ 251

Smallpox immunizations -----------------------------Diphtheria immunizations -------------------------Typhoid immunizations --------------------------------

1879 796 7305

VENEREAL DISEASE CONTROL

Admissions to medical service____________________

701

Clinic visits ___ -------------------------------------------

11321

Field and office visits___________________________~ ______ 161

Number of clinic treatments~~----------------~-~~---~- 11321

TUBERCULOSIS CONTROL

Admissions to medical service ________________________ 304

Admissions to nursing service.______________

357

Clinic visits ____________________________________ -------------------- 501

Field and office visit----------~-~~---~-------------~---- 1345

MATERNITY SERVICE

Admissions to medical service _________

287

Admissions to nursing service __________

437

Visits by antepartum cases to medical

conferences ---------------------------------------------------- 835 Field and office visits~------------------- -~---~--------- 1075

INFANT HYGIENE

Admissions to medical service----~

215

Admissions to nursing service _____________

402

Visits to medical conference~-------

477

Field and office visits___________________________________ 842

20 --------
13 253 243 1066
257 3706
129 3497
112 205 112 280
125 165
384 526
83 110 177 175

--------
17 ---------------
185 237 5593 291 5254
1 4
--------
----------------------

70 10 150 650 408 4291
81 1373
189 1337
133 173 169 1053
373 464
1828 2353
149 550 190 1240

2 2 5 138 78 1634
41 1179
82 1148
57 108 57 255
30 71
83 231
17 69 26 211

--------
----------------------------
-------------
---------------
---------------
2 --------
-------
---------------
-----------------------------

179
227 41 68 54
123 1662
177 1660
10 13 8 21
39 59
75 160
22 57 38 148

2
20 356 149 1601
140 2506
74 2263
28 94 58 166
36 72
96 174
21 75 39 178

253 4288
36 4288
--------
--------

--------
-------345 210
3311
294 3377
99 3033
44 88 93 185
76 88
204 260
17 18 50 50

..a=..
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101

40

104 t'-<

373 0

147 2.....

1888 ::t:

C1)

202 3311

~.,...

664 0....

2938 Cl<l

20 131

ar:;;::sl
.....

17 0

320 i;;

57 109

81 396

26

142

38

380

~

....:1

J

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

:;
.~
~

....1>1)
0 ~

~
0 ~

..t'
..=
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~

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e

...".=
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PRESCIJ:OOL HYGIENE

Admissions to medical service ---------------- 316

2

--------

571

2

--------

10

20

Admissions to nursing service _______________

469

2

964

15

27

25

Visits to medical conferences____

332

2

1026

12

--------

26

21

Field and office visits

----- 1059

2

3359

16

--------

52

34

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

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

-------~

--------

107

--------

--------

SCHOOL HYGIENE

Inspections by physicians or nurses _____________ 2562

103

6796

440

22

213

Examinations by physicians _____ ________________

4325

--------

49

1

--------

--------

Admissions to nursing service ___ Field and office visits ---------------------Dental inspections ______________ -------------------------

355 359 -------

103

--------

135

--------

------

--------

4

103

221

--------

--------

11

------

--------

--------

400

----

286

--------

ADULT HYGIENE

Medical examinations_____________________________________ 736

42

185

--------

--------

--------

967

MORBIDITY SERVICE

Medical visits____________________________________________________ 905

Nursing visits ___________________________________________________. 396

Admissions to hospitals _______

---------- 94

-------29

--------

---1
------

-------15
--------

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

61

61

2

-----

--------

1

SANITATION

Water supplies approved __________________________________

Privies and septic tanks installed _________________

Food-handling establishments registered_

Dairy farms registered_____________ -------------

Milk plants registered _______________

Field visits ___________________________________

------

LABORATORY SPECIMENS Specimens examined _______________________

109 ------- -------
-------
929
3729

------------ -------
-------
1233

--------
------- -------
------
1225

26 90 19 10 2 416
4596

3

2

--------

--------

24

---

3

337

9

935

843

6

3

42

2

843

~
00

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;..
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~

6

c~

----

~

30 ~

t:l

~

..,~

109

l;l

--------

~

9 13

-...~
;::1
c
~

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~

3 S12
3

-::t:
~
l;l
s.

843

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

.a0.:
r..

COMMUNICABLE DISEASE CONTROL AdmisSions to medical service_______________________

Consultations with physician~~

FieId visits~~-~~~~~~~~~-~-~~~~~~~~~~-~~~~~~~~~~~~~~~~~~~~~~~~ ~~~-~~ ~ ~ Smallpox immunizations ---------------------~------Diphtheria immunizations -------------------------Typhoid immunizations ---------------------------VENEREAL DISEASE CONTROL Admissions to medical service____________ ----------Clinic visits ____________________________________________

Field visits~~~~ ~~ ~ -------- ------- -----Number of clinic treatments TUBERCULOSIS CONTROL

Admissions to medical service..

-----

Admissions to nursing service

Clinic visits-----------------------------Field and office visits~~~~~~~~~~~~~~~~~~~~~~~-~~~~-~~~~-MATERNITY SERVICE Admissions to medical service________ --------------Admissions to nursing service_______

Visits by antepartum cases to medical

conferences -------------------------------------------------Field and office visits~~~-~~~~~~~~~~--~~~-~~~~~~~~~~ INFANT HYGIENE Admissions to medical service_______________

Admissions to nursing service__________

Visits to medical conferences ____ Field and office visits~~~-~----~~~~~~~~~~~~~~~~~~~~~~~~~-

4 -------
30 1205
260 1673
12 114 36 105
79 304 100 319
105 201
303 558
65 173 105 399

.....!l
...r..

....
.rls>..o

5 4 9
27 845
135 2711
136 2421
15 22 17 22
--------
------
--------
------

41 23 116 1526 865 7389
806 13453 1178 13089
215 654 171 2135
53 177
63 576
6 247
809

o...f.
r"..'
---------------
19 76 165 485
1 --------
1 --------
36 28 36 162
23 116
46 315
30 211 50 525

~..0.:
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1
21 266 138 2961
98 1840
93 1731
59 75 59 183
19 46
29 100
20 99 25 201

18 5
597 1936 1265 8903
4145 46127 2882 46500

1627 1307 2571 4600
483 794
1295 3368
629 1438 1435 6269

..
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2 318
20 152 16 140
1 1 1

......Ill
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1 1 6 5 26 1510
67 948
17 800
40 46 42 117
48
120
74
165

0: 0:
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1529 86
738 1720 1513 4284
2416 27283
896 21895
222 359 272 595
248 248
632 369
83 128 195 867

..s...
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------103 749 259 3287
53 1280 147 1259
143 243 156 722
33
66
"' 1
51 1 148

.....l>..o "

44

6

62 501

tc"-<

"' 233

~

2727

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685 6948

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127 6227

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87 162 87

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534 ::.&;

126 124

360 356

57

125

92

301

~

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CoNDENSED REPORT OF AcTIVITIES OF LocAL HtALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

r=.==..

PRESCHOOL HYGIENE Admissions to medical service______ Admissions to nursing service-----~------------------' Visits to medical conferences_________________________. Field and office visits____________________________________
Dental inspections ----------------------------------------
SCHOOL HYGIENE Inspections by physicians or nurses ______________ Examinations by physicians___________________________ Admissions to nursing service_______ ________________ Field and office visits____________________________________
Dental inspections -----------------------------------------ADULT HYGIENE
Medical examinations___________________________________

57 182 81 319 -------
344
69 69

M;ORBIDITY SERVICE Medical visits________________________________ --------------------Nursing visits _____________________________________________________
Admissions to hospitalS---------------------------
SANITATION Water supplies approved.____________________ ----------- Privies and septic tanks installed._______________ Food-handling establishments registered____ Dairy farms registered.____________________________________ Milk plants registered______________________________________. Field visits__________________________________________________________

3 178
2
--------
-----
20

LABORATORY SPECIMENS

Specimens examined____________________________________

610

r=.~..
--------
--------
--------
-------12
--------
------
45 774

...,
~
165 428 159 877 --------
3645 2052
26 62
1047
29 146 25
2 15 157 42
3 1878
2827

.~..,
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13 98 18 128
779 3 38 45
--------
4 113
--------
12 348

:..==;
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-3=;
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23

1339

64

3018

44

2246

182

7973

--------

7 17 --------

9198 5042"
862 1821
--------

542

1

--------

6

515

2

93

6
-------
21

207 361 157
-----------2572

472 13384

---------------
2 --------
7 32

...

...""0!,!
"

s.==

35

19

167

117

31

237

521 2 2
194
403 --------

1327 1
789 5648 1685
1696
421 105
19

-------337

466 135
9 1 56385
16506

...=0,
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109 272 651 --------
-------27
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2
18 346

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53 \;')

105

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s 79 ~
169

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140 1263

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37 6

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17

7020 2973

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

COMMUNICABLE DISEASE CONTROL Admissions to medical service_______ Consultations with physicians _________ Field visits__________________________________________________________
Smallpox immunizations ---------------------------Diphtheria immunizations ____________
Typhoid immunizatons -----------------VENEREAL DISEASE CONTROL
Admissions to medical service __ -------------------Clinic visits_________________________________________ Field visits________________________________________________________,
Number of clinic treatments------------------TUBERCULOSIS CONTROL
Admissions to medical service ________________ Admissions to nursing service Clinic visits __________________________ ----------------------------Field and office visits __________ ----------------------MATERNITY SERVICE Admissions to medical service________________________
Admissions to nursing service----------------------Visits by antepartum cases to medical
conferences --------------------------------------------------Field and office visits__________________________________
INFANT HYGIENE Admissions to medical service________________________ Admissions to nursing service___________________ Visits to medical conferences________________ Field and office visits ------------------------ _________

.....:
"
16 2 32 418 113 3063
352 7482
39 7458
70 227
99 735
209 216
376 411
81 255 139 513

:.:.
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49
62 677 127 3411
184 5256
42 4871
100 235 183 855
50 67
149 271
69 90 151 327

.c.
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19 10 243 1223 221 3510.
63 1064
86 1021
64 62 76 164
42 59
85 189
41 73 65 141

=:;;
1 1 135 1054 686 3932
516 7951 228 7606
222 180 236 775
110 231
227 692
103 444 175 1594

.Of
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2 --------
10 427 303 2223
94 1162
6 1162
19 52 47 71
298 326
566 703
229 444 448 833

.:
.."; ="
-------------
3 487 152 2464
99 1898
60 1875
65 129
68 250
3 37
3 92
-----65
-------169

...;13 ="
9 10 45 625 296 1724
262 4846
49 4337
29 55 37 165
152 155
474 498
17 31 17 48

...
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2 1
81 1759
18 1746
5 5
--------

........ =
3 3 7 ---------------
-------13 13 12 13
------

=..t:-
2 2 7 101 4 445
186 2701
1 3366
73 46 72 127
1 8
16
31
137

s.:
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8

5

11 -------

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9 .~.......
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

PRESCHOOL HYGIENE Admissions to medical service Admissions to nursing service Visits to medical conferences Field and office visits _____ -----------------------,----Dental inspections ____________ ---------------------------

SCHOOL HYGIENE lnspections by physicians or nurses ______________
Exami_nations by physicians-------------------~---
Admissions to nursing service ____________

Field and office visits Dental inspections ______
ADULT HYGIENE

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

Medical examinations .. -------------------------------MORBIDITY SERVICE

Medical visits ----------------------------------Nursing visits-----------------------Admissions to hospitals ----------------------------------

SANITATION

Water supplies approved

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

Privies and septic tanks installed _

Food-handling establishments registered_

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

Milk plants registered ___

Field visits _

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

LABORATORY SPECIMENS Specimens examined

..="...
"
118 464 368 1313 --------
1340 138
--------
1122
283
------4
------2
-------------
231
1929

::::
"==~
"
122 155 156 247 --------
941 1010
326 332
57 88 4
4 19
6 --------
381
773

.e.

"=....."c"...:'

::;
=

49

108

100

362

87

263

271

1191

302

426

260

2

25

77

43

164

673

62

T--

4

4

6

105

2

30

12

13

8

34

3

6

282

1670

767

2347

"...c="..... =

=c
'..".i..' =

..;".:.:'. =

.....
=

.......... =

......
=="

220

12

447

70

355

12

657

121

--------

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

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

263

46

2

43

--------

243

3

78

1

25

3

85

2

118

4

--------

8

--------

45

14

6

1

1

--------

401

--------

1

--------

6

38

39

12

28

35

53

121

855

280

1184

20

41

322

of-
~

.=c.
=""c'

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

~
c<1>
~s

~

<1>

..,~

--------

~

--------

~

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

...<1>
~
c
-;p
0"
-~

--------

::X::
<1>

--------

~
:

15

134 65

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTs; BY CouNTIEs-1943-Continued

=;
,!:;

....."."=..,.

..,. .~...,

..:,
...~....".,,..

.......".=..,,,..

.:;.=.'=.",,;

..,.=.c""=:,:

..,
."=.,

. ".e.
..;l

.a.,
"..;l

COMMUNICABLE DISEASE CONTROL

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

2

225

24

65

3S

10

C~nsultations with physicians

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

--------

1

-------

--------

38

3

Field visits ______ ----------------------

--------

22

13

448

39

93

33

62

3

11

3

8

33

Smallpox immunizations _________ -------------------- 182

567

1484

710

304

444

284

247

82

125

Diphtheria immunizations ________

86

682

872

387

507

246

73

239

133

111

Typhoid immunizations ____________________________ 1545

4692

3708

997

2536

2790

1819

2988

1923

501

VENEREAL DISEASE CONTROL

Admissions to medical service _______

141

217

261

119

363

269

193

189

213

91

Clinic visits._______________

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

2695

3630

3371

1996

4055

4667

2804

3809

4226

598

Field visits

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

58

160

340

238

1052

53

53

82

284

58

Number of clinic treatments _

2506

3617

3236

1972

4049

4667

2545

3803

3898

454

TUBERCULOSIS CONTROL

Admissions to medical service

50

134

26

49

53

102

62

56

74

1

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

71

160

27

84

95

147

89

99

96

4

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

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

50

143

26

45

139

150

87

84

96

Field and office visits _______________

178

273

144

135

666

619

594

429

258

7

MATERNITY SERVICE

Admissions to medical service __

119

39

76

27

443

274

100

111

146

36

Admissions to nursing service __________________

129

56

185

95

451

274

119

150

188

45

Visits by antepartum cases to medical

conferences ________________________________________________ 326

108

131

60

1485

920

250

297

314

54

Field and office visits ___ ------------------ ___________ 377

150

682

324

1790

1148

345

430

555

78

INFANT HYGIENE

Admissions to medical service _____________________

78

33

30

19

228

112

12

69

4

20

Admissions to nursing service _________________

110

47

136

140

228

246

12

199

229

35

Visits to medical conferences____________ ____________ 119

121

85

42

848

301

16

159

8

20

Field and office visits ------------------------------ 194

192

303

293

909

467

16

470

606

80

..='",
""..;l

90

10

201
213 tc-<

353 41!l9

(")
.l;.:.l..

::t:

~

.... 606 ~
16135

227 16125

a...,
~

l;:l

73 r;::I

c 227

~

227

427 ~

44 62

12 125

93
56 18
133 ..... ~

CONDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

.=;
.....

PRESCHOOL HYGIENE Admissions to medical service __________________
Admissions to nursing service._______ Visits to medical conferences~~--------~-~~---Field and office visits~----------~--------------------~-Dental inspections ----------------------------------------
SCHOOL HYGIENE Inspections by physicians or nurses ______ Examinations by physicians_____________ Admissions to nursing service ____________ Field and office visits__________________________________

Dental inspections -----------------------------------------ADULT HYGIENE
Medical examinations____________________________

MORBIDITY SERVICE

Medical visits~----------------------- ---------------------Nursing visits________________________

Admissions to hospitals~-

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

SANITATION

Water supplies approved~---------------- ---------------~ Privies and septic tanks installed~-----Food-handling establishments registered ___

Dairy farms registered____________ ------------------

Milk plants registered~---------Field visits___________________________________ ---------------- -----

2 2 2 4
-----4
112 1183
48 68 --------
--------
1 10 2
----------------------
--------

LABORATORY SPECIMENS Specimens examined __________ __________

1175

,..=.,
.."".,
18 24 50 59 --------
--------
----------------------
--------
-------4
--------
1 6 ---------------
32
1301

.
...~..,
13 47 24 66 -------45 1
1
38 --------
14
--------
1573

..;":' ....Q........,
40 198 62 391 ------
60 60 223 447
--------
31
----------------------
--------
1226

...........=...,..,
37 39 20 128 --------
2457 17 13 30 70
653
25 13 1
-----------------------------
34
1833

~..=.".,'
47 23 52 24 --------
385 4
-------2
22
81
35 1 1
1 12 33
3
941
1148

.=. ....:.=":.:,'
-----
308 1
-------13
866

..=.."..,'
57 279 115 630 --------
1490 1054
39 312 408
279
36 90 36
1 6 ---------------
79
751

.
."e.
...;l
184 284
-------26
-------5
---------------
28 1074

..a.
...;l
10 40 10 50
1402 48 2 14
-------
14 25 --------
-----------
-------4
218

Jl:>. Jl:>.

.."='
.."...;l

116

~:;')

60

c~

s 4 ~
169

-------- t;:::,

~

~

... 1509 .;.:.:.,
314 ;:l

31 492
--
1544

...;~::s
c
-~ ~ 0"'
-~

12 33

~
~

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

;::-

15 70
8 13

470

403

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

..""..

COMMUNICABLE DISEASE CONTROL Admissions to medical service ___ Consultations with physicians _______ Field visits_____________________________________________
Shallpox immunizations -------------------------------Diphtheria. immunizations -------------------------Typhoid immunizations --------- _________ -----------VENEREAL DISEASE CONTROL Admissions to medical service ________________________ Clinic visits _________________ Field visits_____________________________________________
Number of clinic treatments _____________________ TUBERCULOSIS CONTROL
Admissions to medical service ___________________ Admissions to nursing service __________________ Clinic visits _____________________~-----------------------Field and office visits --------------------- _____________ MATERNITY SERVICE Admissions to medical service________ Admissions to nursing service________________________
Visits by antepartum cases to medical
conferences ---------------------------------------------------Field and office visits ____________________________________
INFANT HYGIENE Admissions to medical service________________________ Admissions to nursing service ______________ Visits to medical conferences__________ Field and office visits ____

---------------
116 77
684
301 3130
70 2847
-------19 25 99
215 225
565 665
134 172 253 424

t.>
~"
52 2
209 641 460 1413
632 12795
402 12188
45 58 84 167
189 217
626 733
155 195 446 632

~
"a=
::3
-----56
208 113 7610
10 7610
--------
--------
--------

.,

"'a=
..0..

.."a.=.
~
..0..

157

305

58

680

741

253

12

818

925

648

71

956

861 16759

96

252

830 14342

34

156

51

156

36

171

87

1858

16

504

27

589

59

1831

91

2685

3

381

33

569

3

1549

52

2365

:a;=

;.".:.

"E"

~"

.."..

::";:

37

341

373

40

14

574

1017

16

413

135

9480

6

202

115

8834

50

78

79

124

50

80

111

240

9

50

14

13

91

41

12

108

10

17

189

27

...s;
..a.=. ::";:
99
42 116
84 1607
90 1671 517 1153
6 61 13 94
42 44
42 260
28 52 28 187

..a=
0
::";:
12 10 27 164 63 806
209 4028
502 3723
54 31 60 235
209 235
421 738
14 54 65 255

a=
0
......~.
::;:
85 1718
37 1719 -----------
--------

a=
..;0::
::;:

1 542
39 198
120 2483 120

tc-<
2
-::t:
~ ~
-s.
a....

2303 ~

....

1 1

.."~..'...

-------1

c ~

.;>. :.;.

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

.,
."..

PRESCHOOL HYGIENE

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

Admissions to nursing service----------------------Visits to medical conferences ____

Field and office visits __ Dental inspections ____

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

SCHOOL HYGIENE

Inspections by physicians or nurses

Examinations by physicians ___________________

Admissions to nursing service Field and office visits ___________________________________

Dental inspections _____________

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

MORBIDITY SERVICE

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

Nursing visits_

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

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

SANITATION

Water supplies approved -----------------------------Privies and septic tanks installed------------Food-handling establishments registered ___

Dairy farms registered_____ _---------------------------Milk plants registered ___

Field visits-------------------------------LABORATORY SPECIMENS
Specimens examined ------------------- ___________________

80 139 134 282 -------
173 15 4 30
~-------
3
-------324 1
--------------
--------------
--------
740

t..o
~
33 42 88 109 --------
490 300
11 26 30
14
6 60 --------
---5 1 1
1256
2414

i
~"
------------
--------
--------
-------
--------
--------------------
3 2

..
.c.~.:
3 6 9 11 -------50 --------
-~----~
--------
39
1 -------
76 448

..(..j
c:
.i.~t.
618 698 1679 2252
-------
1020 1174
657 2354
2074
3398 4238
2
---------------------
85
6810

;c;:
.""a.".
18 41 32 85 ------------
39
18 285

:..":.
Q"
::";:
---------------
40 --------
~-------
--------
400
1 31
-------26
17 1130

...<:
:..:.~ .s;...:
9 33
9 89 -------
109
--------
61 124 --------
65
36 38
------
34 5
4
677

..c:
~
::";:
20 37 110 337 -------180 -------17 110 --------
614 8
4
10 478

:.c.~a.:
::;:
----------------
--------
---
-------
-------
------------
--------
--------
-------
--------
2 1
26
10

"0""\

c:
..;~:
::;:

-------- ~
...c<1)
---- aq ------ IS

-------- t::l

<1)

-- ......"1:::1 l;:l

-------- ;:!

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

<1)
~
c
-;p
o-
-I=)

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

::t::
<1)
...l.;.:.l..

;::.-

3

13 160

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

..." ~ .s::
. ." ...
);l ~

COMMUNICABLE DISEASE CONTROL Admissions to medical service Consultations with physicians----------------------Field visits---------------------------------------------------Smallpox immunizations________________________________
Diphtheria immunizations ---------------------Typhoid immunizations -----------VENEREAL DISEASE CONTROL Admissions to medical service___ -----------------
Clinic visits-------------------------------------------------------Field visits ------- ----------------------- ---------------------Number of clinic treatments_________________________ TUBERCULOSIS CONTROL Admissions to medical service----------------Admissions to nursing service_______
Clinic visits ----------------- -------------- ------------Field and office visits-------------------------------MATERNITY SERVICE Admissions to medical service ________________________ Admissions to nursing service _________________ Visits by antepartum cases to medical
conferences Field and office visits ______________________________
INFANT HYGIENE Admissions to medical service-------------------Admissions to nursing service_________ Visits to medical conferences._____________ ---------- Field and office visits_______________________________

6 11 16 560 335 2073
389 5733
174 5067
81 147
96 526
187 258
446 776
81 244 100 632

i=."

...: ~
i

8
c"
0
);l

. ....
~c

et"o.
~

:
~"

:;
"""
);l

.::.
0
~"

;
zi

;::
0"

81

3

19

41

2

144

11

74

440

1056

675

181

431

172

199

2263

2576

2

19

1

3

33

16

799

345

121

900

141

197

1369

526

2090

4218

621 9331 1000 7227

270 6613
182 3085

42 1160
30 1140

188 2929
50 2676

2805

558

40

2

54827

12578

942

3

1236

336

22

1

57144

11855

902

208

113

52

82

82

459

60

2

208

157

62

71

131

929

161

154

130

49

92

106

845

64

2

808

573

176

160

207

2373

254

323

43

323

123

38

131

86

139

39

627

87

1245

1009

322

81

285

71

3063

1265

427

137

219

206

6452

263

48

9

67

9

803

253

110

71

114

81

1992

3

449

79

12

117

16

1760

640

263

141

133

160

7206

11

e.
0
~=
0

2

ct-o
~

::t:

150 3453
111

~ So
c

~ 3323

r:

c~

~

..,.
-l

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

. .c ;":

.
~

~ ::iJ

i

<I
]
i

".a0
::.1

.. .....
~<= "E~

.=.
~ ::s

..~
::=.1

i
::""=.1'

a
~

t
j

PRESCHOOL HYGIENE

Admissions to medical service __________

138

Admissions to nursing service.__________

384

Visits to medical conferences__

173

Field and office visits ____________________________________ 525

Dental inspections

91

3

51

5

1124

91

5

57

29

2405

115

5

1

84

8

1951

246

5

35

35

6302

SCHOOL HYGIENE

Inspections by physicians or nurses __________

20

Examinations by physicians_________

341

Admissions to nursing service ______________________

2

Field and office visits _____________________________

2

Dental inspections_________ ________________

1259 79 23
211

19

20380

13

1359

2

4605

2

9107

699

200

ADULT HYGIENE

Medical examinations __________________

118

60

13

MORBIDITY SERVICE Medical visits__________________ Nursing visits____________________
Admissions to hospitals _

________________ _ _______________ 199

1

7

2

133

4

10

1211

7

SANITATION

Water supplies approved

4

Privies and septic tanks installed

24

43

6

Food-handling establishments registered

Dairy farms registered __

Milk plants registered _________

Field

19

42

21

3

5

2

168

8

7

256

47

3

19

12

5257

34

12

LABORATORY SPECIMENS Specimens examined

1379

1719

700

488

218 24825

160

.c..o.
~"
;i
-&
0
~
cC1)
~s;
t:::l
C1)
~....
'
...C1)
;:)
~
-~
""'~=;
~ ~
;;:--
66
21

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

~~ =..
~

.."...
~"

,.="",.'
~

~""."

~"
~

~
~

1
-;
~

s..
E
If

=..
. ; a

.".=0.
~

COMMUNICABLE DISEASE CONTROL Admissions to medical service ______________ Consultations with physicians ________ Field visits __________________________________________________________
Smallpox immunizations ________________ Diphtheria immunizations ___________________________
Typhoid immunizations ------------------

2 2 6 191
-------166

7 1 23 207 131 1392

36

3

2

5

2

2

58

30

3

2

378

326

488

57

170

-----

315

2124

1708

989

5

------

13

71

138

90

820

VENEREAL DISEASE CONTROL

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

47

358

12

118

195

338

426

197

19

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

1108

4853

123

2025

4261

6134

5435

5501

431

Field visits _____ -----------------------------------

72

156

1

146

203

345

--------

306

55

Number of clinic treatments ____

1042

4657

119

1980

3813

6023

5435

4162

427

TUBERCULOSIS CONTROL

Admissions to medical service

3

101

Admissions to nursing service

3

82

Field and office visits ________________________

3

103

Clinic visits __________ -------------------

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

295

2

44

97

91

2

66

106

1

114

2

44

118

-------

99

118

241

1

161

59

1

39

91

1

264

MATERNITY SERVICE

Admissions to medical service

219

95

91

-------

29

31

Admissions to nursing service

223

112

158

224

36

62

Visits by antepartum cases to medical

conferences

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

486

277

212

90

126

Field and office visits _

------

535

383

376

--------

725

90

271

INFANT HYGIENE

Admissions to medical service ________________

57

72

11

23

20

Admissions to nursing service _____ _

103

107

97

172

23

135

Visits to medical conferences

69

119

12

79

39

Field and office visits _

--------

142

218

165

--------

399

79

492

...
c"."="."
~

10

1491 to-<
i 422
3389

-::t:

326 8294

.".~.,.'...

a 282
7875 ...,

~

~

72

;:l
!:j

.... 181 ..:.0..
151 c

609 i;;

284 301

1031 1184

76
153 .... 10

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs---1943-Continued

..-:1=a;10
0..

PRESCHOOL HYGIENE

Admissions to medical service

Admissions to nursing service Visits to medical conferences _______ _________

Field and office visits______ Dental inspections ________

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

SCHOOL HYGIENE

Inspections by physicians or nurses .

Examinations by physicians._

Admissions to nursing service Field and office visits ___________

Dental inspections ________

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

ADULT HYGIENE

Medical examinations ______

----------

MORBIDITY SERVICE

Medical visits

----------

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

Nursing visits ____________________ --------------

Admissions to hospitals _______

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

SANITATION

Water supplies approved ____

Privies and septic tanks installed __________

Food-handling establishments registered_

Dairy fai-ms registered Milk plants registered _____________________

Field visits ___________ -------------------

LABORATORY SPECIMENS

Specimens examined _________

----------

-------
18
191

.....c..:
"0..
52 127
63 154
968 --------
10 19 --------
25 3
8
-----17
458

.=.."..'
'
------
-------7
27

..<.>.

43 60 63 135
366 29 49 51 16
2 8 1
--------
1189

~"
1 2 1 2 --------
48 1 1 1
4 9 4
11 -----
28
720

~

..;;;
-"; '

0..

0..

109

--------

218

-------

--------

34

50

------

39

--------

401

--------

-------4
--------

23 --------

43

676

1024

.E
-=;;
0..
----------------------
--------
---------------------
--------
-------7
4 870

=..
..E;.. a
-------------

."..=,
il::
13 23 19 35
346 133 20
55 177
11
-------252
--------
6 1 6
2 265
576

:.n
0

..c:
=.~.=....

~-------

~

---------------
1

~
.C..).
s(1q

------ 1::::1 ~

293 203
16 21 --------
-------

'"..~."...'.
.";~:.":.,
...C)
-;":1::::1

g:

)!

~

19 ::X::

... 1

~
~ ......

;;:.-

1 1805

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

.=..,,
-~s"=

COMMUNICABLE DISEASE CONTROL

Admissions to medical service________________________

Consultations with physicians ___

Field visits--------------------------- ____________________________

Smallpox immunizations ____________ -----------------

Diphtheria immunizations ______

-----------

Typhoid immunizations _________ ----------------------

91 4
1331 2047 1570 8115

VENEREAL DISEASE CONTROL

Admissions to medical service._______________________ 7488

Clinic visits _________ --------------------------------------- 74196

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

6403

Number of clinic treatments ___

65899

TUBERCULOSIS CONTROL Admissions to medical service ________________________
Admissions to nursing service-----------------------
Clinic visits-------------------------------------------------------Field and office visits ____________________________________

1407 1678 6017 7378

MATERNITY SERVICE Admissions to medical service _____
Admissions to nursing service----------------------Visits by antepartum cases to medical
conferences -------------------------------------------------Field and office visits ____________________________________

1220 1599
4283 6072

INFANT HYGIENE Admissions to medical service _____
Admissions to nursing service __ Visits to medical conferences __________________________ Field and office visits___________________

806 1933 2407 8207

...;,
.,.Ill ~"
123 3143
111 3021
--------
-------------

1>.
.-r"=n!
11 7
15 5
23 81 1803 379 1692
7 7 7 7
------
--------

.r="""In>
"3 2 8
458 96
2255
487 7682
1 7182
141 183 147 248
129 129
482 488
46 68 101 124

'-=ai

10
~..

r"n

r"n '

.-r."="=:nl'

t.:.
~
r.:nl

..s"..
r"n

.........,.
Eo<

2

184

8

3

12

2

26

14

--------

3

1

6

245

43

5

16

2

10

1473

593

418

209

1

16

1059

245

307

76

6

84

4800

3766

1548

3046

189

7

894

235 20722

6

682

228 17746

149 2436
167 2295

221 2932
26 2908

474 9225
97 9157

155 2697
241 2405

355

73

202

6

20

344

156

5

275

10

616

183

32

126

10

33

1556

328

29

913

10

8

278

14

359

37

198

484

74

190

571

39

969

98

739

1858

56

1210

267

699

2278

13

188

27

64

203

13

611

60

89

226

16

449

14

107

617

20

1407

210

146

707

P-

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1

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

ct'-<
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::X::

188

~

3883 ~

29 3593

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-------

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CoNDENSED REPORT OP AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs--1943-Continued

....
..e.==..

...;.
~

sa

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PRESCHOOL HYGIENE Admissions to medical service ______________________ Admissions to nursing service__________ Visits to medical conferences __________________----~------~~ Field and office visits__________________________________
Dental inspections ------------------------------- __________ SCHOOL HYGIENE

708 912 2444 5603
--------

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

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

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

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

235

19

404

69

--------

397

8

723

122

--------

28

28

130

--------

139

--------

--------

Inspections by physicians or nurses _____________ 19136

--------

7

Examinations by physicians--------------------------- 649

--------

Admissions to nursing service _______________________ 2482
~~~~;ni~s~~:;i:n:isits -------:::::_:::::::::-::::=: 5175

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

--------

ADULT HYGIENE

8

--------

1526

1440

--------

13

563

13

7

146

181

59

74

655

--------

--------

1

--------

1

2

--------

-------

--------

MOMRedBiIcDalITexYamSiEnRatVioInCsE________ --------- ------------ 199

--------

1898

54

487

--------

Medical visits______________

Nursing visits________________ _____-~~~~~~~~~~~~-

--------

Admissions to hospitals ________________________________

SANITATION

-------1521

Water supplies approved ___________ ---------------- 83

Privies and septic tanks installed

70

Food-handling establishments registered __ 1000

Dairy farms registered ________

121

Milk plants registered _____________________________________

5

Field visits_____________________________

24639

LABORATORY SPECIMENS

Specimens examined

64084

---------------
-------26
------------
27
299

--------
10 --------
--------
19
98

3 --------
4 2777

1 1
-------18
----------------------
111

22 19 16
-------18 54 99 2
729
4655

13 3
3 7 5
360
1729

--------
1 --------
1 1236

2 --------
18 26
2281 3623

1 --------
21
43 241

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240

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

COMMUNICABLE DISEASE CONTROL Admissions to medical service________________________ Consultations with physicians________________________
Field visits--------------------------Smallpox immunizations --------------------------Diphtheria immunizations -------------------------Typhoid immunizatons -----------VENEREAL DISEASE CONTROL Admissions to medical service___________________
Clinic visits-------------------------------------------Field visits----------------------------------------------------------Number of clinic treatments__________________________
TUBERCULOSIS CONTROL Admissions to medical service_______________________ Admissions to nursing service________________________ Clinic visits_________________________________________________________
Field and office visits---------------------MATERNITY SERVICE
Admissions to medical service________________ Admissions to nursing service_________________ ______ Visits by antepartum cases to medical
conferences ------------------------------------Field and office visits___________________________
INFANT HYGIENE Admissions to medical service________________________ Admissions to nursing service________________________ Visits to medical conferences_________________________ Field and office visits___________

:;

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26 --------
31 1178
121 2131
99 2819
148 2783
9 29
9 62
26 48
61 134
20 35 60 76

. ~.".
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17 4 9
49 1426
185 4694
87 4363
21 28 22 51
-------32
-------88
-------8
-------31

.....;..
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10
2 547 197 1462
177 2769
230 2620
43 85 43 293
109 109
437 506
84 85 411 469

:..;
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225 126 1202
467 8167
2 7971
1 14 -------25
441 441
1737 1737
144 144 460 460

e~ .:":
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20 --------
42 564 203 4362
349 4172
143 4133
90 104
99 306
452 510
1705 1999
250 441 507 1330

;:::
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4 --------
20 339 179 3369
830 5960
669 5868
144 372 158 671
227 363
1041 1192
121 244 183 482

.,
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90 2
222 1508 633 2576
261 3351
10 3230
65 169
57 328
130 141
210 320
159 167 218 309

.,
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---------------------1058
47 593
----------------------
-----------------------------
---------------
---------------
-----------------------------

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3 --------
7 19 78 458
59 829
94 766
30 26 38 239
70 93
250 398
18 75 31 230

32 7
328 971 872 6166
833 17365
220 15691
113 335 318 1246
284 355
879 1332
128 358 172 661

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348 126

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67

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91

108 226

94 108 226 U1
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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

:;
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f-4

PRESCHOOL HYGIENE Admissions to medical service _________________ Admissions to nursing service_______ Visits to medical conferences _______________________
Field and office visits.----------------------------------Dental inspections ________________ ------------------------
SCHOOL HYGIENE Inspections by physicians or nurses Examinations by physicians_________________
Admissions to nursing service----------------------, Field and office visits ________________ Dental inspections ___________________ -------------ADULT HYGIENE Medical examinations _______________________

2 2 2 4 --------
----------------------

MORBIDITY SERVICE

Medical visits.________ ------------------------------------

Nursing visits ___________ --------------------------

Admissions to hospitals

--------

SANITATION Water supplies approved. ____________________

Privies and septic tanks installed _______

Food-handling establishments registered_ Dairy farms registered ____________________ Milk plants registered _________________ -----------------

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

LABORATORY SPECIMENS

Specimens examined --------------------

---------------
-----
-------1
327

. ~..
f-4
----3
12 -----560
2 14
---------------
5
29
62 222

..;..
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49 49 64 64
1 87 203
------
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714

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127
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--------
1443

....
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32 32 60 77 65
250 26
12 184
33
-------6
--------
77
------495
2407

:;:;
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25 122
31 237 --------
196 ---------------
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2373

....,
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f-4 232 241 320 451
15 15 15 15 336
--------
13
5 1189

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8

2

10

146

10

2

27

248

3

5366

35

12

244

25

424

300

47

25

284

36

9 53 176 75 4 1735

519

3104

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372

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

....";....'..

COMMUNICABLE DISEASE CONTROL Admissions to medical service________________________ Consultations with physician~~Field visits--------------------------------------~------------------Smallpox immunizations -----------------------------Diphtheria immunizations ---------------------------Typhoid immunizations -------------------------------
VENEREAL DISEASE CONTROL Admissions to medical service___________________ Clinic visits _________________________________________________________ Field visits______________________________________________________~
Number of clinic treatments ________________________
TUBERCULOSIS CONTROL Admissions to medical service_____________
Admissions to nursing service ----------------------Clinic visits---------------------------------- _________________ Field and office visits~-------------------------
MATERNITY SERVICE
Admissions to medical service---------------------Admissions to nursing service Visits by antepartum cases to medical
conferences -----------------------Field and office visits_______________________________
INFANT HYGIENE Admissions to medical service.________________ Admissions to nursing service._____________ Visits to medical conferences ___________ Field and office visits------------------~------------~

3
4 173 244 1994
205 3986
111 3725
81 48 181
182 189
665 801
130 173 560 455

..1'1
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9 1 11 1201 130 585
----------------------
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24 3
95 129 472 1194
452 8214
113 7289
170 122 182 787
79
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189 188
46 54 84 110

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47 11 243 1346 957 9766
90 1667
373 1618
159 175 240 897
13
19
66 106
84 263

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lit:
12 13 189 2246 808 4942
206 6346
184 6325
17 240 196 734
114 288
241 779
64 417
92 1208

...
lit:
98 60 21 682 421 3390
371 5760 -------5141
130 130 117 475
174 174
321 369
122 122 351 333

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lit:
2
208 4152
12 3850
3 ----
10

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25 46 31 466 299 4566
301 6211
81 6108
135 169 130 571
377 394
1556 1813
103 282 103 1396

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224 899 251 1117
233 3245
223 1780
74 156 122 740
57 58
137 296
30 31 67 165

.........
lit:
2 3 15 212 24 771
78 1074
14 1044
11 25 20
19 46
63 134
6 32
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189 173

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216 300

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42

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CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued

.""

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PRESCHOOL HYGIENE

Admissions to medical service________________________ 57

35

174

37

174

159

21

4

Admissions to nursing service________________________ 57

--------

40

209

193

174

122

23

6

Visits to medical conferences________________________. 69

76

241

34

314

--------

84

47

5

Field and office visits___________________________________ 71

--------

92

36

287

354

205

121

6

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

--------

--------

--------

-----

SCHOOL HYGIENE Inspections by physicians or nurses _____________ 388 Examinations by physicians____________________________

336

1320

2332

29

125

330

861

2934

2500

18

2739

Admi~sions to nursing service________________________

97

30

1775

88

Field and office visits_________________________________ -------

376

100

196

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

--------

243

144

20

7

104

8

--------

ADULT HYGIENE Medical examinations________________________________

169

1091

672

138

MORBIDITY SERVICE Medical visits_____________________________________________________
Nursing visits..--------------------------------------------------Admissions to hospitals____________________________________

-------244

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

4

15

241

22

11

--------

13

580

91

13

2363

171

7

--------

347

6

--------

2

SANITATION

Water supplies approved__________________________________

--------

--------

18

1

Privies and septic tanks installed__________________ --------

16

6

43

28

5

18

3

Food-handling establishments registered.___ -------

--------

--------

1

--------

225

--------

33

Dairy farms registered_____________________________________ --------

--------

--------

12

4

Milk plants registered.._____________________________________

--------

--------

--------

2

Field visits_________________________________________________________ --------

3

97

349

464

7640

7

1283

LABORATORY SPECIMENS Specimens examined.________________________________________ 999

1668

973

2010 10517

573

2199

641

268

(,[1
0\

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

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176 ;!

114

~

125 149

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30

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~

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:

330

Local Health Organizations

57

CoNDENSED REPORT OF AcTIVITIEs OF LocAL HEALTH DEPARTMENTs, BY CouNTIEs-1943-Continued

COMMUNICABLE DISEASE CONTROL

Admissions to medical service______

Consultations with physicians ________________________

Field visits __________________ ---------------------------

Smallpox immunizations -------------------------

15

Diphtheria immunizations ---------------------------- 15

Typhoid immunizations ------------------------

272

VENEREAL DISEASE CONTROL Admissions to medical service________________________ 32

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

685

Field visits __________________________________________________________

Number of clinic treatments ______________

646

TUBERCULOSIS CONTROL Admissions to medical service_____________ _ Admissions to nursing service____ Clinic visits ________________
Field and office visits -----------------------------------

MATERNITY SERVICE Admissions to medical service Admissions to nursing service ______________________
Visits by antepartum cases to medical conferences --------------------------------
Field and office visits ___

INFANT HYGIENE Admissions to medical service.________________ Admissions to nursing service________________________ Visits to medical conferences_________________________.
Field and office visits -----------------------------------

..
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~

~

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57 72 379 842 1037 3359
356 4884
226 4183
316 430 506 1272
16 78
34 202
82 235 176 499

273 62
988
253 5405
238 5122
24 28
2 34
2 115
18 41

3

2
2 80

28

41

1204

16
258 1275
458 2946

393 6806
320 6801

181 2956
34 2753

670 10819
1549 9408

136

12

16

235

36

209

10

99

1414

28

47

204.

33

62

386

26

136

793

59

167

1561

13

41

131

29

58

388

13

82

332

30

114

1088

58

Georgia Department of Public Health

CoNDENSED REPORT OF AcTIVITIEs OF LocAL HEALTH DEPARTMENTS, BY CoUNTIEs-1943-Continued

:$=
~

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:=
~

c

H
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~

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~

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PRESCHOOL HYGIENE

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

207

Admissions to nursing service_____________________

225

Visits to medical conferences_________

313

Field and office visits ____________________________________

401

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

SCHOOL HYGIENE Inspections by physicians or nurses __ Examinations by physicians__________________________ Admissions to nursing service_______ Field and office visits --------------------Dental inspections -------

3230

50

979

1

1

ADULT HYGIENE Medical examinations __

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

1428

MORBIDITY SERVICE

Medical visits....___________ ------------------------------------

36

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

14

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

10

SANITATION

Water supplies approved ___ ----------------------

2

3

Privies and septic tanks installed _

8

Food-handling establishments registered ___

36

DairY farms registered_________________________

24

Milk plants registered._________________________________

2

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

7

615

LABORATORY' SPECIMENS Specimens examined ___ _---------------------------

18

3738

877

30

24

37

82

46

35

62

159

43

1520 191 229 448

105
4 67
9

1

5

12

5

451

2898

Local Health Organizations

59

CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, RY CouNTIEs-1943-Continued

NOTES:

The following counties have full time health unit-

Atlanta, City of Appling-Wayne* Baldwin Bibb-Jones* Bleckley-Dodge-
Pulaski* Brooks Bulloch Burke-Jenkins* Calhoun Chatham Clarke Cobb Coffee Colquitt Crisp-Worth* Decatur DeKalb Dougherty Floyd Fulton Glynn-Camden-
Mcintosh* Grady Greene-Hancock
Wilkes*

Gwinnett Habersham-Rabun-
Stephens* Hall Barris-Meriwether* Jefferson Laurens Liberty-Long* Lowndes Mitchell Muscogee-
Chattahoochee* Richmond Spalding Sumter Telfair-Wheeler* Terrell Thomas Tift Troup Walker-Catoosa* Walton Ware Washington Whitfield

*Health district composed of two or more counties.

The following counties have nursing service only-

Atkinson Bacon Baker Barrow Bartow Brantley Bryan Ben Hill Butts Candler Carroll Charlton Clayton Clinch

Coweta Crawford Dade Dawson Douglas Echols Effingham Emanuel Evans Fannin Forsyth Franklin Glascock Gordon

60

Georgia Department of Public Health

Haralson
H~nry
Irwin Jackson Jasper Jeff Davis Johnson Lamar Lanier Lee Lumpkin McDuffie Macon Monroe Montgomery Morgan Murray Newton

Peach Pierce Pike Putnam Randolph Screven Seminole Stewart Tattnall Taylor Toombs Treutlen Turner Twiggs Upson Webster Wilkinson

Work in the remaining counties was done by regional personnel an1 special venereal disease control itinerant nurses.

Division of Public Health Nursing
MRs. ABBIE R. WEAVER, M.A., R.N ----------------------------------------------------Director Miss ELSIE CROSBY, B.A., R.N. __________________________________________ Associate Director MRs. BEsSIE F. SwAN, M.A., R.N.______Maternal and Child Health Consultant Miss FLORRIE L. ERB, B.S., R.N.____________fnstructor in Public Health Nursing Miss MARY G. DEVINE, R.N._________________________ _fndustrial Hygiene Consultant Miss ELOISE MILLER, B.S., R.N.________________Tuberculosis Nursing Consultant

Division of Public Health Nursing

It was not until early in 1943 that the nursing service of the Georgia Department of Public Health began to feel the full impact of the war. Shifting of population with serious overcrowding in areas where military camps and war industries are located, the increase in birth rate, overcrowded hospitals with early di~missal of patients to make room for new admissions, the withdrawal of doctors to military service, the imperative need to control venereal diseases, the importance of reducing absenteeis~n in industry due to illness, have all made many new demands for public health nursing service. Yet, with each succeeding month it has become increasingly difficult to maintain a stable, efficient nursing staff.

On January 1st there were 358 public health nurses on the staffs of official health agencies; before the year closed, 76 of this number had resigned, a loss of 21% as compared with a loss of between 5% and 10% in normal years. It has been difficult and, in many instr!llces, impossiL1e, to fill vacancies on the staff with qualified public health nurses. Recognizing this fact, the Merit System Council authorized a departure from minimum qualifications when circumstances seemed to justify such action. Many nurses who failed to meet Merit System requirements have been given emergency appointments with the understanding that they will be replaced by qualified personnel as soon as possible. At the close of the year there was a total of 329 public health nurses on the staffs of official health agencies.

The following table represents a census of all public health nurses in Georgia as of January 1, 1944.

Type of Agency State Department of Health ___ Other State Agencies _______________ Local Health Departments _____ Non -official Health Agencies_ Industrial Companies --------------------

Supervisors 15 1 15 2 1

Staff 6 5
287 30 184

Total 21 6
302 32
185

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

34

512

546

From the above figures it would appear that the actual loss of nursing staff in numbers has been slight. The greater loss is represented by the replacement of well prepared, experienced nurses by those unacquainted with public health nursing and by the inability of thf.' present staff to meet the greater demands for services of all types.

A number of changes have occurred on the state public health nursing staff. Miss Theodora A. Floyd, Associate Director, resigned to become Ccmsultant Nurse for the Children's Bureau in the Southeastern Region, and one Regional Reserve Nurse, Miss Madelyn Harris, resigned to join

64

Georgia Department of Public Health

the armed forces. Mrs. Bessie F. Swan was appointed Maternal and Child Health Consultant and Miss Eloise Miller, Consultant in Tuberculosis Nursing.
The State Department of Public Health has continued to maintain an itinerant nursing service to organize and assist in conducting venereal disease clinics in some 20 counties where local nursing service is not provided. This service was established in order to make treatment available to draftees rejected because of venereal diseases. Immunizations for diphtheria, typhoid fever, and smallpox are offered in these counties in connection with the venereal disease clinics whenever time permits.
One of the most acute nursing problems during the past year was in connection with the venereal disease control programs in the large cities of the state. In order to strengthen this service, Miss Elsie Crosby, Associate Director, was loaned to the Atlanta Department of Public Health for 4% months and to the Savannah Department of Public Health for Ilj2 months to as8ist in reorganizing the nursing service in these clinics and to give instruction to the staff in the technique of case finding and case holding.

Immediately after war was declared, the State Department of Public Health adopted a general policy that educational leave would not be given to members of the staff. Early in I943 this policy was slightly modified. During the spring, summer and fall quarters a few in-service nurses have been granted leave for further training. The following table shows the total number of nurses for whom training has been provided and gives the educational institutions these nurses attended.

College

New In-Service Trainees Trainees Total

Peabody College --------------------------------- I7

2

Columbia University ____________________________

2

Medical College of Virginia _ __________ 5

I

I9 2 6 (colored)

Nurse Midwife Training School ___________

I

I (colored)

Keen interest in providing better nursing care for premature babies has continued throughout the year and advantage has been taken of every opportunity offered to send Georgia nurses to Michael Reese Hospital in Chicago for experience in this service. Two public health nurses and two supervisors of nurseries in two large hospitals of the state have been given this two weeks period of training.
The Maternity Home in Clayton, Rabun County, which opened in November I942, to give better obstetrical care to mothers in this mountain community, has prospered and plans which will double the capacity of this small but unique institution are now being carried out. The public health nurse midwife on the staff of the County Health Department has

Public Health Nursing

65

continued to give nursing supervision and actual nursing assistance, when necessary, to the Maternity Home.
Because physicians of the county were finding it increasingly difficult to attend deliveries, the Walton County Hospital and the Walton County Health Department sought the advice of the State Health Department in regard to some plan to provide increased obstetrical service for the hospital. As a result of joint conferences, an arrangement was made whereby the State Department of Public Health, through the Walton County Health Department, agreed to participate financially in a program which would make available to the hospital the service of a resident nurse midwife, and on October 5, 1943, Miss Gene Stout, trained in midwifery at the Frontier Nursing Service, was appointed to that position. Miss Stout is one of a very few nurse midwives in the entire United States to occupy the position of resident nurse midwife in a hospital.
The State Department of Public Health has continued throu~hout the year its agreement with the Department of Public Welfare under which county public health nurses render a visiting nurse service to crippled children in Georgia. During the year, nurses attached to health department staffs made 777 visits to crippled children.
At the beginning of the year there were in Georgia about 100 industrial nurses. At the close of the year there were 185 industrial nurses employed by 75 industries. Miss Mary G. Devine, the Consultant on Industrial Nursir.tg. has visited practically all of these industries and her service is increasingly in demand by industrial nurses.
An analysis of the statistical report, which is given in full in the report of the Division of Local Health Organizations, shows that during the year there was a marked increase in the public health nursing service rendered in the field of venereal disease control both as to the number of patients carried and the number of office and field visits made. This increase was accompanied by a decrease in nursing activities in communicable disease control, including immunizations, and in field and office visits made to premature infants and school children. There was little change in the nursing service rendered in the infant, preschool and tuberculosis service. The total number of patients cared for in all services by public health nurses of the state decreased from 219,849 in 1942 to 208,247 in 1943, a loss of over 11,000 patients.
The usual program for staff education for public health nurses has been carried throughout the year. Quarterly educational conferences have been held in each of the six regions of the state with a good attendance.
During the month of November, a two day institute on venereal disease control nursing was held in Atlanta, Savannah, Albany, Macon and Augusta, with a total attendance of 392.

66

Georgia Department of Public Health

This report would be incomplete without mentioning one of the most momentous developments in the history of nursing in this country and one which will, it is hoped, effect public health nursing favorably. Reference is made to the passage of the Bolton Act by Congress in June. This Act made available to schools of nursing throughout the United States $52,500,000.00 for nursing education. This sum is being administered by the U. S. Public Health Service under whose direction a U. S. Cadet Nurse Corps was established, through which enrollment in schools of nursing has been greatly increased. According to this plan the basic course of study will be reduced from 36 to 30 months and senior Cadets will spend the last six months of the three years course in supervised practice in approved hospitals and public health departments. It is anticipated that through the Cadet Nurse Corps many young nurses will elect to spend their practice periods with county health departments and will desire, upon becoming registered nurses, to enter the field of public health nursing. It would appear therefore that the one great obstacle to the development of public health nursing in Georgia, the inability to secure qualified public health nurses, will be, to some extent, overcome in 1944.
The nurses of Georgia have responded eagerly to the call for service with the Army and Navy, with the result that the quota allotted the state has been more than met. Since indications are that during the year to come the state of Georgia will be asked to provide fewer nurses to the armed forces, a greater stability in the nursing staff can be anticipated.
A review of public health nursing in Georgia during the past year seems to indicate that, in spite of insufficient staff, limited travel, and inability to meet many recognized needs, the over-all picture is not too discouraging. Most of the gains made during recent years have been held and the ground lost can readily be regained when public health nurses are again to be had in sufficient numbers.

Division of Public Health Engineering
L. M. CLARKSON, C.E. ___________________________________________________________________J)irector N. M. DE }ARNETTE ________________________________________________Acting Associate Director

Division of Public Health Engineering
Although a large portion of the normal personnel is in military service, the operations of the Division of Public Health Engineering proceeded during 1943 with little or no curtailment of service.
Following is an enumeration of the services rendered by the Division:
Studies of needs for satisfactory development of water and sewerage facilities. Approval of engineering design and sanitary supervision of the operation of municipal, institutional, public and semi-public, recreational, and industrial water and sewage plants and systems.
Well and spring protection for homes, schools, local institutions and buildings, camps, parks and recreation centers. Collection of water samples for bacteriological analysis, physical improvements and sterilization of private and semi-public water supplies.
Sanitary excreta disposal at homes, schools, state and local institutions and buildings, camps (recreational, migratory, labor, and prison), parks and recreational centers.
Industrial waste collection, treatment and disposal, including canning, slaughtering, and other waste materials. Garbage and waste collections and disposal by incineration or other means.
Promotion of construction of sanitary swimming pools, studies of sources and quality of water, approval of plans and specifications for construction, supervision and advice on safe operations and bacteriological analysis.
Malaria surveys and plans for control through the mosquito vector, including drainage, semi-permanent and permanent ditch lining, fluctuation of pond and lake water levels and larviciding breeding areas.
Malaria cotrol operations conducted in extra-cantonment areas at all military, naval and war industrial plants through facilities made available by the U. S. Public Health Service in cooperation with military, naval, and maritime authorities.
Investigation of proposed impounded water projects, issuance of permits under state regulations for construction, maintenance and supervision of mosquito control methods.
Approval of subdivision sites for residential construction and provision for water and sewerage. Certification of such for approval for loans to the Federal Housing Administration, Farm Security Administration, and other federal agencies.
Field surveys, sanitary investigations and preparation of maps with reports and recommendations for malaria control and sanitary improvements for communities, small cities, and counties.
Food and restaurant sanitation problems in collaboration with the local city and county health departments and in cooperation with army, navy, and maritime authorities.
Certification of public water and milk supplies to the U. S. Public Health Service for use by public carriers in interstate passage traffic.

70

Georgia Department of Public Health

Milk sanitation for municipalities and counties operating under standard approved milk ordinance. Regular field sanitary inspections of milksheds, dairies, pasteurization and other milk plants, rendering advisory service to the milk industry and to local health departments in problems of milk sanitation.
Shellfish sanitation, surveys, investigations and maps determining sanitary and insanitary areas for shellfish production, collection of samples of water and shellfish from producing areas, supervision of design, construction and operation of oyster shucking plants, retail and wholesale plants and certification of sanitary quality to the U. S. Public Health Service for interstate shipments.
Mattress sanitation, including field inspections of mattress manufacturing and renovating plants, sterilization of used materials, enforcement of state law requirements for manufacturing and renovating, labeling, and marketing.
Preparation of bulletins, and other literature for informing the public relative to all public health protection involving safe water, milk, food, protection against insects and general sanitary problems.
Maintaining membership with local and national committees, associations and societies, and serving on committees for sanitary research and investigations for exchange of modern scientific information.

WATER SUPPLY AND SEWERAGE
One of the chief functions of the Division of Public Health Engineering is that of exercising the general supervisory powers of the Georgia Depart ment of Public Health over all matters pertaining to water supplies and sewerage. In general, the aim of the division is to see-
(1) An ample and dependable supply of safe water furnished to the citizens of each community, and
(2) An adequate system of sewerage collection and disposal to care for the needs of each community.
The execution of this program entails such matters as administration, education, promotion, engineering studies of field conditions, examination of plans and spcifications, laboratory examinations and plant inspections. In so far as was possible with the limited personnel available, all of these activities have been carried on during 1943.
Due to the restrictions on materials, limited construction has been undertaken except on military posts or in those communities where increased populations, brought about by direct war connected activities, have overtaxed existing water or sewerage facilities. Under the Lanham Act, federal funds were made available for assisting local political subdivision in such cases, these funds being administered by the Federal Works Agency. Throughout the year, the Engineering Division has worked closely with various federal agencies in studying the water supply and sewerage needs of all areas in the state where war activities have occasioned

Public Health Engineering

7l

major increases in population. This has resulted in plant additions and service extensions in a number of cases. (See tables< showing water supply and sewerage improvements.)

WATER WORKS AND SEWERAGE SCHOOL
The Division participated in the Twelfth Annual School for water works and sewage operators held at the Atlanta Water Works in October. This school was attended by approximately 325 persons including operators from many of the military posts in this area. Maintenance of equipment, operation under war conditions and post-war planning were the subjects emphasized.

CERTIFICATION OF WATER FOR USE ON INTERSTATE CARRIERS
The Division made field inspections, investigations, recommendations regarding improvements and laboratory examinations on samples from all water supplies in the state where water is used for drinking or culinary purposes on railway coaches, vessels or airplanes engaged in interstate traffic. Favorable certification to the U. S. Public Health Service was made in 35 cases, provisional certification in 1 case, and 1 supply was prohibited, as shown in the following list.

Favorable
Albany Americus Ashburn Athens Atlanta Augusta Bh.~e Ridge Brunswick Camilla Cedartown Columbus Cordele Cornelia

Dublin Fitzgerald Fitzgerald A.B.&C. R.R. Fort Valley Griffin Jesup Macon Manchester Monroe Moultrie Rome Savannah

Savannah Sugar Ref. Corp.
Smithville C. of Ga. R.R.
Sylvania Tennille Thomasville Valdosta Vidalia S.A.L. R.R. Wadley Waycross

Provisional Gainesville
Prohibited Midville

PLANS AND SPECIFICATIONS FOR WATER AND SEWERAGE
CONSTRUCTION
During 1943, plans and specifications have been examined and approved for 23 water supply or sewerage projects, of which 9 were for water supplies and water purification and 14 for sewerage and sewage treatment.

72

Georgia Department of Public Health

STATUS OF WATER SUPPLY IMPROVEMENTS AND ADDITIONS
Augusta. Major improvements at raw water pump station completed and new raw water line from river to filtration plant under construction (FWA).
Bainbridge. Water main extensions to serve war housing project completed 1943.
Brunswick. New deep well (3 MGD), storage reservoir, pump station, and major distribution system extensions completed 1943.
Brunswick. Goodyear Housing Project. New well, pump, chlorinator, and distribution system to serve war housing project completed in 1943 (FPHA).
Brunswick. Naval Lighter Than Air Base. New water supply system consisting of deep well, pumps, chlorinator and distribution system completed 1943 (Navy).
Columbus. New raw water Jine from river to filtration plant, new chemical feed house, chlorinators, chemical feeders and mixing basin completed 1943 (FWA).
Dalton. Crown Cotton Mills. New chlorinator to replace obsolete machine. InstaUed 1943.
East Point. New surface supply including raw water pump station, raw water line, storage reservoir, filtration plant and high service pump station started as WPA project-again under construction in 1943 as FWA project.
Forest Park. Major water main extensions and connection to city of Atlanta supply completed 1943 (FWA).
LaGrange. Callaway Mills. Pump station on Chattahoochee River, raw water line, one MGD filtration plant and high lift pump station completed 1943.
Marietta. Connection to city of Atlanta supply, booster pump station and major water main extensions to war housing projects completed 1943 (FWA).
McCaysville. New water works system consisting of springs, pumps, calcite filter, hypo chlorinator, storage reservoir and distribution system under construction 1943 (FWA).
Moultrie. New deep well and water main extensions to war housing projects completed in 1943.
Rome. Water main extensions to army hospital and war housing projects completed 1943.
Summerville. Water main extensions to serve area housing industrial workers completed 1943.
Thomaston Cotton Mills. Additions to water filtration plant completed 1943. Thomasville. Water main extensions to serve army hospital completed 1943.
Warner Robins. New well~ water main extensions, and elevated tank to serve war housing projects completed 1943 (Army and FPHA).
Warrenton. Hypo chlorinators installed on two city wells in 1943.
Washington. Reconstruction of water filtration plant completed 1943 (WPA).

STATUS OF SEWERAGE SYSTEM IMPROVEMENTS AND ADDITIONS
Atlanta. Army Motor Repair Base. Additions to separate sludge digestion-trickling filter plant doubling its capacity completed 1943 (Army).
Brunswick. Sewer extensions to war housing projects and additional outfall completed 1943 (FWA).

Public Health Engineering

73

Brunswick. Naval Lighter Than Air Base. Sewerage system and treatment plant <activated sludge) completed 1943 (Navy).
Camp Stewart. Addition& to sewage treatment plant completed 1943 (Army).
Columbus. Muscogee County. Interceptor and lateral sewers in Bealwood area and m area south of Columbus under construction in 1943 (FWA).
DeKalb County. Interceptor and lateral sewers to serve additions to naval air base and housing projects near Chamblee completed 1943.
Macon. Interceptor to serve area south of Macon under construction 1943 (FWA).
Marietta. Laterals, pump station, force main outfall sewer and 1 MGD treatment plant consisting of bar screens, primary clarifiers, standard rate trickling filters, secondary clarifiers, sludge digestor, sludge drying beds and chlorinator completed 1943 (FWA).
Marietta. Marietta Aircraft Assembly Plant. Sewerage system and 2.3 MGD treatment plant consisting of mechanically cleaned bar screens, primary clarifier, standard rate trickling filter, secondary clarifier, sludge digestor, sludge drying beds, pumps, chlorinator and force main discharging into Sweetwater Creek completed 1943 (Army).
Milledgeville. Naval Ordnance Plant. Primary treatment plant consisting of bar screen, primary clarifier, sludge digestor and sludge drying beds completed 1943.
Moultrie. Sewer extensions to war housing projects completed 1943.
Perry. Major sewer extensions to serve portions of town not previously covered completed 1943 (FWA).
Port Wentworth. Major sewer extensions and new outfall sewer serving war housing projects completed 1943 (FWA).
Robins Field. New primary sewage treatment plant and sewers to serve additions to Robins Field and war housing projects in Warner Robins completed 1943 (Army).
Rome. Sewer extensions to army hospital completed 1943.
Savannah. Sewer extensions to serve war housing projects on east side of town under construction 1943 (FWA).
Savannah Beach and Fort Screven. Completed sewerage system consisting of collecting system, pump stations, force mains and primary treatment plant started as WPA project-under construction in 1943 as FWA project.
Savannah Air Base. Additions to activated sludge plant completed 1943 (Army).
Savannah. Chatham Field. Sewerage system and primary treatment plant (Imhoff tank), completed 1943 (Army).
Thomasville. Finney General Hospital. Sewerage system and treatment plant consisting of bar screens, Imhoff tank, standard rate trickling filter, secondary clarifier and sludge drying beds completed 1943 (Army).
Union Point. Sewerage collecting system completed 1943 (WPA).

ENGINEERING LABORATORY
The engineering laboratory serves to supplement the work of the Division of Public Health Engineering by performing such tests, analyses, or examinations of a physical, chemical or bacteriological nature as may be required in the general statewide sanitation program.
The work consists primarily of the bacteriological examinations of

74

Georgia Department of Public Health

samples of water from public and semi-public supplies, public school supplies, improved private supplies and approved swimming pools, and from shellfish growing areas. Chemical laboratory service for the purpose of aiding the municipalities in more efficient operation of water and sewage plants, as well as stream pollution studies, has been rendered.
During 1943, the shellfish sanitation program was inaugurated by the Division of Public Health Engineering and, with such a program, the laboratory made the bacteriological analyses of shellfish and shellfish growing waters pertaining thereto.
The laboratory also made a comparative study on the use of "EC" medium proposed for the bacteriological examinations of drinking waters, shellfish and shellfish growing waters.
The following table shows the distribution of work in the engineering laboratory.
Bacteriological samples:
Public and semi-public _______ -------------------------------------12,249 Private ---------------------------------------------------------------------- 742 Swimming pool _____________________ ----------------------------------- 87 Shellfish ------------------------------------------------------------------- 1,204 Comparative media ---------------------------------------------------- 223 Chemical samples -------------------------------------------------------- 51 Stream pollution samples --------------------------------------------- 66 Miscellaneous ---------------------------------------------------------------- 2
Total ________________________________________________________________14,624

No epidemics were attributed to public water supplies during the year.

The public and semi-public water supplies in the state may be divided, according to source and treatment, into the following classifications:
l. Ground waters-No treatment 2. Ground waters-Carbon dioxide removal 3. Ground waters-Iron removal
4. Ground waters-Chlorination 5. Ground waters-Chlorination and carbon dioxide removal 6. Ground waters--Chlorination and iron removal 7. Ground waters-Chlorination and softening 8. Surface supplies-Filtration and chlorination 9. Surface supplies-Filtration, chlorination and softening

Public Health Engineering

75

The number of months each of these supplies submitted samples is shown in table below:

Supplies Submitting Samples

10-12

Ground waters-No treatment -------------- 99 Ground waters-C02 removal __________________ 4

Ground waters-Fe. removal ------------------ 2

Ground waters-Chlorination ------------------ 75

Ground waters-Chlorination & COz

removal -------------------------------------------------- 4

Ground waters-Chlorination & Fe.

removal -------------------------------------------------- 2

Ground waters-Chlorination & softening 3

Surface supplies-Filtration &

chlorination ------------------------------------------ 76

Surface supplies-Filtration, chlorination

& softening --------------------------------

1

T o t a l ____________________________

266

Number of Months

6-9

1-5

0

22 52 22

130

0

1

0

12 5 2

Total
195 8 3
94

3

0

0

7

0002 0003

1 2 1 80.

0001

39 63 25 393

Cumulative bacteriological averages were kept on all samples received from public and semi-public supplies, as shown in table below.

No. Neg. for
Coliform

Ground waters-No treatment __ 40

Ground waters-C0 2 removaL__ 3 Ground water-Fe. removal._____ 0

Ground waters-Chlorination 36

Ground waters-Chlorination

and C0 removaL_______________ 2

5

Ground waters-Chl.orination

and Fe. removaL_________________ 2

Ground waters-Chlorination

and softening ______________________

1

Surface supplies-

Filtration and chlorination ____ 51

Surface supplies-

Filtration, chlorination and softening __________________________ 1

No. showing No. showing

0.1-10.0% more than

of 10 MI. 10% of 10 MI.

portions

portions

positive for positive for

Coliform Coliform

Supplies Meet-

ingUSPHS

Standards

No.

%

83

50 123 71.1

4

1

7 87.5

3

0

3 100.0

44

11

80* 87.9

1

1

6 85.7

0

0

2 100.0

2

0

3 100.0

28

0

79 100.0

0

0

1 100.0

TotaL______________________________ 139

165

63

304*

*Bacteriological averages not compiled on samples received from one supply.

82.8

76

Georgia Department of Public Health

A study of the above table reveals the fact that 304* or 82.8% of the 368 supplies from which we received bacteriological samples met the U. S. Public Health Service standards of quality. Briefly, these standards state, in part, that, in a given series of samples, not more than 10 per cent of all 10 milliliter portions examined shall show the presence of the coliform group of bacteria. A further study would indicate that the quality of water, as a whole, produced by supplies employing filtration and chlorination is superior to water from either the untreated or the chlorinated ground water supplies.

SANITATION FOR WAR CANTONMENTS, EXTRA CANTONMENT AREAS AND INDUSTRIAL AREAS CONNECTED WITH WAR ACTIVITIES

Previous to the beginning of the war, the Division had established, by long and careful planning, a state and local sanitation program covering the entire state and rendering all possible services. This normal program demanded all of the resources at the command of the Division. Thrust upon us suddenly was the necessity of adding to the normal services a national defense program of enormous proportions.
The general plan of preparedness involved the acquisition of land areas by the federal government for cantonment and war industrial purposes. New and unusual sanitation problems were presented. Additional problems of water, sewerage, environmental sanitation, malaria control, milk and food sanitation, garbage disposal, sub-division development, housing, and other sanitation problems were presented. Although there has been a definite lessening in momentum in establishment and construction, some new projects continue to develop and the maintenance and operations of water and sewage plants, the problems of malaria control, milk and food sanitation, housing and general sanitation place a heavy demand upon the Division.
The following is a list of war activity areas, involving 38 counties and approximately 103 individual projects, in which the Division of Public Health Engineering is engaged in development and operations of plants for water and sewage, malaria control, housing areas, milk and food sanitation and miscellaneous sanitation problems.

Area Albany

County Dougherty

War Activity and Location_
Turner Field - Army Advanced Flying School No.6, 2.5 mi. N.E. of Albany
Darr-Aero Technical School under Army supervision, 1.5 mi. S. of Albany
USO Headquarters

Public Health Engineering

77

Area

War Activity and Location

Americus Sumter

Athens

Clarke

Atlanta

Fulton

DeKalb

Clayton

Augusta

Cobb Richmond

Avondale Bainbridge

Decatur

Souther Field (Graham Aviation Co.) 4 mi. N. of Americus
City of Americus Access Road
Pre-flight Training Center (Univ. of Ga.) Navy
Signal Corps Training School (Univ. of Ga.) Army
Ft. McPherson (Army) 4 mi. S. of Atlanta Candler Field (Army Base) , 6 mi. S. of
Atlanta near Hapeville (Mun. Airport) Hdq. 4th Service Command-In Atlanta
Lawson General Hospital-2,000 beds, both l and 2 at Chamblee lO mi. N.E. of Atlanta
Naval Air Station (Chamblee)
Army General Q.M. Depot at Conley 4th Echelon Motor Repair Base, 12 mi. S. of
Atlanta at Conley
Marietta Bell Bomber Plant, 3% mi. S. of Marietta (Plant not yet complete)
Daniel Field (Army Air Base) at Municipal Airport
Camp Gordon-8 mi. S.W. of Augusta U. S. Arsenal-in Augusta Q.M. Depot Ga. Aero-Technical Flying School, lO m1.
S.E. of Augusta-Bush Field Oliver General Hospital (Army) l mi. W.
of Augusta Army Housing Area Gasoline Storage Base-under construction
See Macon
Basic Training School-Army Airfield 8 mi. N. of Bainbridge
West Bainbridge City of Bainbridge Access Road

78

Georgia Department of Public Health

Area

County

War Activity and Location

Brunswick Glynn

McKinnon Field (Navy Air Station) Brunswick Marine Const. Corp., S.W. edge
of Brunswick (2 plants) Army Recreational Area on St. Simons
Island (W) Army Detachment Camp Naval Blimp Base---6 mi. N. of Brunswick
(Glynco Field) Coast Guard Depot on St. Simons Island Army Recreational Area on St. Simons
Island (C) Maritime Housing Area

Mcintosh

Harris Neck Air Field-At Riceboro, 45 mi. of Brunswick

Camden

Navy Flying Field at St. Marys, 35 mi. S. of Brunswick

Chamblee

See Atlanta

Columbus Muscogee

Ft. Benning, 9 mi. S. of Columbus (Also, 10 mi. S. of Phenix City, Ala.)
Lawson Airfield (Army), S. of Columbus Armored Division Camp Newton D. Baker Village (Housing) Access Road (Fort Benning to Columbus)

Chattahoochee l24th Infantry Camp City of Cusseta

Chickamauga Walker

Ft. Oglethorpe, 2 mi. N. of Chickamauga and 9 mi. S. of Chattanooga, Tenn.
Army Housing Area

Conley

See Atlanta

Cusseta

See Columbus

Douglas

Coffee

Raymond.Brincherhoff Aviation Co.-A fly. ing school 2 mi. E. of Douglas
City of Douglas

Dublin

Laurens

Dublin Airfield (Army) Naval Base Hospital

Hampton Hinesville

Henry Liberty

Ordnance Plant (Booster Mfg.)
Camp Stewart-2 mi. N.W. of Hinesville Army Air Base City of Hinesville Army Housing Area Access Road (Allenhurst to Midway)

Public Health Engineering

79

Area

War Activity and Location

Macon

Bibb

Baldwin Houston
Marietta Milledgeville McCaysville

Moultrie Colquitt

Riceboro Liberty

Rome Rossville Savannah

Floyd Chatham

Camp Wheeler-S mi. S.E. of Macon Cochran Field-at Avondale about 10 mi. S.
of Macon Ammunition Plant (Navy) S mi. S. of
Macon Herbert Smart Field-32 mi. E. of Macon Access Road (to Macon) Navy Housing Unit Army Housing Unit

Reynolds Ammunition Plant at Milledgeville 33 mi. N.E. of Macon

Wellston Air Corps Depot at Wellston about 18 mi. S. of Macon
Robins Field Army Housing Units (2)

See Atlanta

See Macon

Tennessee Copper Company E. Tenn. Ordnance Works
Tenn.) TVA Ocoee No. 3 TVA Apalachee Dams

(Copperhill,

Spence Field-S mi. E. of Moultrie (an Army Advanced Single Engine Flying School)
City of Moultrie Access Road (Spence Field to Moultrie)

Harris Neck Bomber Base, 36 mi. S. of Savannah

Army Base Hospital, 2 mi. N.W. of Rome

See Chickamauga

Hunter Field (Army Air Base), S mi. S. of Savannah
Fort Screven-at Tybee Island, 16 mi. E. of Savannah
Southeastern Shipbuilding Corp., in Sa vannah
MacEvoy Shipbuilding Co., at Port Wentworth, 7 mi. N.W. of Savannah

80

Georgia Department of Public Health

Area

War Activity and Location

St. Simons Island

Statesboro Bulloch

Sylvania

Screven

Thomasville Thomas

Tifton Toccoa

Tift Stephens

Valdosta

Lowndes

Vidalia Waycross Wellston West Point

Toombs Ware
Troup

Chatham Airfield No. 2, 8 mi. N.W. of Savannah (Army)
Q.M. and Medical Depot (Army), 5 mi. N. of Savannah
Savannah Mach. & Foundry Co. (shipbuilding)
Marine Corps Base Coast Guard Base Inshore Patrol Naval Station Army Recreation Area (Daffin Park) Army Housing Unit War Housing (2 for each of above 3 ship-
yards)
See Brunswick
Army Air Base-S mi. N.E. of Statesboro
Army Air Base (No night population)
Finney General Hospital (Army Hospital) 1900 beds
Thomasville Airfield (Dive Bombing Station)
Army Air Base--l mi. S.E. of Tifton
Camp Toccoa (Parachute Regiment) 5 mi. S.W. of Toccoa
Munitions Plant (LeTourneau Co.), 3 m1. E. of Toccoa
Moody Field-10 mi. N. of Valdosta City of Valdosta Access Road (Valdosta to Moody Field)
Army Air Base (No night population)
Army Airfield-2 mi. N. of Waycross
See Macon
Ordnance Works

ENVIRONMENTAL SANITATION
During the year, 1,844 privies and 1,506 septic tanks, with 266,000 feet of 4-inch drain tile for secondary treatment, were installed at homes not having public sewers available. 1,605 privies were repaired during this period.
The distribution of these facilities by counties is shown in the following tabulations.

Public Health Engineering

81

PRIVIES CoNSTRUCTED BY CoUNTIES

County

Home Wood Concrete

Atkinson _______________________

6

Baldwin _____

4

Banks

Barrow____________ --------------------------------------

Bibb ______________________________

13

36

Bulloch ___ B u r k e ______________________________ _

46 19

Butts ---------------------------Candler_________________ _ Carroll ___________________________ _
Catoosa _____________ -------------------------Chatham______________________ ------------------------Chattahoochee _-----------------C h a t t o o g a ____ _

17 17 6

100

10

4

8

C l a r k e ______________ _

55

Clayton_______________ ------------------------ ____________________

13

Cobb______________________ ----------------------

4

Colquitt _____

C o w e t a _______________ _

51

C r a w f o r d __________ _

13

C r i s p ________________ _

6

Decatur-------------------------------- ---------------------------

96

DeKalb-------------------------------------------------------------

40

DoughertY-------------------------------------------------------

60

Douglas___________________________________________________

3

Early-------------

7

Elbert _______________

EmanueL

F a n n i n _____________ _

F a y e t t e___________ _

11

Floyd___________________ ----------------------------F o r s y t h ___________________________________________________________

Franklin-----------------------------------------------------------

3

F u l t o n ____________________________________________

103

Gilmer------------------------------------------------------------- 2

Gordon -----------------------------------------------------------

Grady________________ ----------------------------------------------- 13

Greene ____________________________________ ------------------

Gwinnett_____________________________________________________ ____ 2

1

Habersham___________________________________________________

9

Hal'------------------------------------------------------------ 2

Harris-------------------------------------------------------------

38

Hart _________________

4

H e a r d _________________________________ _

38

Henry ------------- ------------------------------------------------ 5

22

Houston___________________________________________________________ 7

7

J a c k s o n ________________________________ _

3

2

Jeff Davis ------------------------------Jenkins _____________________________

2 6

School Wood Concrete Total

6

3

7

49

11

57

3

6

28

17

17

10

16

110 4

55 13 22

51 13 12

5

101

2

42

60

3

7

2

2

11

4

4 103
2

2

4

17

4

2 38
5 38 27 14 2
2 3

Repair
2 51 27 62
5
171 2
624 2
4 26
2 75
13 14
29
i
48 4 6 9
51

82

Georgia Department of Public Health

PRIVIES CoNSTRUCTED BY CoUNTIES (Continued)

County

Home Wood Concrete

Lamar_

Johnson Jones ______________

Laurens _________ _

22

Lowndes---------------------- -----------------------------------Lumpkin___________________ ---------------------------------------

McDuffie ______ -----------------------------------------------

Macon _____ ----------------------------- ------------------- _
Marion _________________ -------------------------------------------
Meriwether__________________________ --------------------------- 2 Miller_________________________________________________________________

MitchelL

12

Monroe -------------------------------- --------------------------- 2

Morgan -----------------------

Muscogee -------

Newton ____

2

Oconee ________________ ---------------------------------------------

Oglethorpe

Peach _______ --------------------------- ------------------------

Pike ___________ --------------------------------------------------P o l k . _________________________________________________________ _

Putnam ________ ----------------------- ---------------------------

Rabun---------------------------------------------------------

Richmond_________________________________________

10

Rockdale.----------------------------------------------------S c h l e y_________________________________________________________ _ S e m i n o l e ________________________________________________ _ S p a l d i n g_______________________________________________________ _

3
10
24 4
17 24 24
3
139
5 66
7 10 18
25 10 18

Stephens ______
Stewart ------Sumter Talbot ----Taylor -----Telfair Thomas
Troup Twiggs Upson Walker Walton Ware Warren _____
Washington Wayne Whitfield Wilkes Worth _

19 22 25 65
43

16

40

8

5

2

3

6

School Wood Concrete Total
3

Repair 9

1

6

20

4

56

78

12 24

4

2

3

19

2

24

36

5

145

4

6

5

66

10 18
6

19

46

26

10

18

8

11

6

3

4

3

7

11

19

6

22

25

7U

60

10

57

29

16

40

24

10

4

8

55 3 7

5

Total

340 1.360

62

82 1,844 1,605

Public Health Engineering

SEPTIC TANKs CoNsTRUCTED BY CouNTIES

County

Baldwin----------------------------------------------------------Bibb_____________________________________________________________

Bu!loch--------------------------------------------------------------------Burke-----------------------------------------------------------Butts-----------------------------------------------------------C a r r o l l ________________________________________________________________________

Catoosa-------------------------------------------------------------------

Chatham-----------------------------------------------------------------------Chattahoochee-----------------------------------------------------C h a t t o o g a ___________________________________________________________ _
Clarke---------------------------------------------------------------------Ciayton________ --------------------------------------------------Cobb.___________________________________________________________________
Colquitt _____

Coweta ________ ---------------------------------------------------------- Crawford-----------------------------------------------------------------Decatur----------------------------------------------------------------DeKalb ____________________________________________________________________________
Dodge ----------------------------------------------------------------------- D o u g h e r t y______________ _
Fayette -------------------------------------------------------------------------
Floyd ---------------------------------------------------------------------- F r a n k l i n _____________________________________________________________________ _
Fulton ----------------------------------------------------------------------Flynn ______________________________________________________________________________
Greene ----------- ---------------------------------------------------------------G w i n n e t t ___ _
Habersham ___ -------------------------------
Hall------------------------------------------------------------------------------Haralson .. Hart-----------------------------------------------------------------------------Henry _________________________________________________________________________
Houston ___-------------------------------------------------------------J enkins ______________________________________________________________________ Jones ________________

Lamar _____ Laurens_________________________ ------------------------------------------------Liberty___________________________________ ----------------------------Long_____________________~--------------------------------------------------------McDuffie ______________
Madison------------------------------------------------------------------------MitcheJI ________________ ------------------------------------------

Monroe-----------------------------------------------------Morgan ------------------------------------------------------------------------Muscogee ---------------------------------------------------------------------N e w t o n ______________________________________________________________ _

Oconee------------------

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

Pike _______________________________________________________________________________

Putnam-------------------------------------------------------------------------

Home 37 39 22 10
1 2 200
16 11 46
9 10
6 63
24 1 3
142 465
2 11
1 9
12
10 2 7 6
11
7
23 3

Public Property
1 6 1 2 1 1 3 1 2 2
1 121
1 1 1 2
2
3 1

83
Total
37 43 22 10 1
2 !
206 1 1 18 12 46 9
13 1 6 64 2 26 1
3 2 263 466 2 12 2
11 1 1 12
3 10
2 10
6 1 11 1
23 3 1 1

84

Georgia Department of Public Health

SEPTIC TANKS CoNSTRUCTED BY CouNTIES (Continued)

County
Rabun _______________ -------------------------------------------Richmond-------------------------------------Spalding ____ -----------------------------------------------------------------Stephens-------------------------------------------------------Sumter.___________________________________________________________________________ Talbot ________ -----------------------------------------------------------------Taylor __________________ -------------------------------------------------------
Thomas -------------------------------------------------------------------------T o w n s . ______________________________________________________________ _ Troup _____________________________________________________________
Walker--------------------------------------------------------------------------Walton --------------------------------------------------------------------------Ware-----------------------------------------------------------------------------W a r r e n _____________________________________________________ _
W a s h i n g t o n _____________________________________________________ _ Whitfield ----------------------------------------------------------Wilkinson ..-----------------------------------------------------------
Total ____________________________________________

Home
1 28
3 2 13 2 2
7 4 11 5 2 14
11 1 1
1,328

Public Property
2 5 5
4
178

Total
1 30
8 3
1~
2 7
7 4 12 5 3 18
11 1 1
1,506

Shortage of materials and labor has reduced very greatly the number of privy and septic tank installations. The termination of th~ Work Projects Administration and the National Youth Administration has eliminated the reservoir of labor which has been used during the past ten vears for privy construction. Some progress has been made in securing local contractors who can obtain small amounts of materials and make installations. Some counties are using county convict labor for putting in sanitary privies where such are vitally needed. Septic tank construction, due to building restrictions, has been limited to housing needs in military and war industrial areas.
SCHOOL SANITATION
The purpose of the school sanitation program is to provide for the preservation of the health of approximately three-fourths of a million school population in more than six thousand schools in the state. The greatest need for this is in the rural schools. It is proposed that every school shall have a safe water supply, a satisfactory system of sewage disposal, drinking fountains, sanitary school lunch service, and a safe and wholesome milk supply.
With regard to water supplies, plumbing, and sewerage, such problems are handled by agreement between the state departments of health and education with the school architect collaborating. Assistance is rendered by the Division on the school lunch and penny milk program which are sponsored jointly by the State Department of Education and the War

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85

Food Administration, U. S. Department of Agriculture. The safety of milk supplies is investigated by this Division and reported to the Department of Education. This service is rapidly expanding and it includes many of the schools of the state. Safe milk for schools will be the objective.
Provision is made that plans and specifications for school water and sewerage shall be submitted to this Division for examination and approval before a contract is let or before a new building is constructed or remodeled.
The Division has maintained close contact with state and county boards of education and furnished plans and specifications and supervised construction of sewage disposal systems and improvement of water supplies and drinking fountains at schools.
Privies constructed at schools and other public places________________ 144
Septic tanks constructed at schools and other public places...... 178 Water samples collected at schools______________________________________________ 275

FEDERAL HOUSING ADMINISTRATION SANITATION
This administration continues to require approval of the Division on all water supply and sewage disposal systems at homes on which the loan is insured by FHA.
Inspection and approval by the Division is also required on all subdivisions and additions which are not connected to approved municipal water or sewer systems.
This procedure has continued to improve the private water supply and sewage disposal standards and has resulted in many new connections to municipal systems.
Approval certificates have been executed on 677 private sewage disposal systems (septic tanks and drain fields) .

FARM SECURITY ADMINISTRATION SANITATION
The environmental sanitation program of the Farm Security Administration, under which many of their clients have been provided with sanitary pit privies, improved water supplies and screened houses, has resulted in improved conditions at homes which are very difficult to reach through ordinary educational programs. The requirement of health department approval prior to payment of the contractor for improvements made has resulted in a higher standard of construction and greater health protection.
During the five fiscal years, 1937-1942, through June 30, 1943, the Farm Security Administration expended a total of $449,777.95 in this

86

Georgia Department of Public Health

state and secured 11,616 sanitary pit privies, 3,033 improved water supplies, and 4,193 houses screened. All of this construction during the past five years has been in accordance with health department standards.

MALARIA CONTROL
The responsibilities of the Division in malaria control have increased tremendously during the year, divided principally between control measures directed against the malaria vector, A. quadrimaculatus, in extracantonment zones near military, naval and war industrial establishments, and the supervision of farm stock-watering and fish ponds.
The malaria control operations in extra-cantonment zones, known generally as the Malaria Control in War Areas (MCWA) program, have progressed through their second mosquito breeding season, and during this period not a single case of malaria has been contracted in the controlled zone, or on the military, naval or war industrial reservation for which protection was designed.
There are now 19 areas in which the program operates, 15 of these having full-time personnel assigned for inspection, drainage and larvicidal measures. Approximately 100 war establishments are involved in Georgia.
The MCWA program is a cooperative enterprise in which the local and state health departments and the U. S. Public Health Service join in the extra-cantonment control work, coordinating the work as closely as possible with the work being done on the reservations by the army or naval personnel. Operations are conducted under the technical direction of this Division, integrated with the county health departments' program. Materials, equipment and personnel are furnished from Federal funiP.s through the U. S. Public Health Service, the latter also furnishing advisory technical service when requested.
In all areas where previous data have indicated a potential malaria hazard, regular weekly inspections are made for mosquito larvae in every collection of water found in the zone of operations. Adult catching stations are established in strategic locations so that the presence or absence of mosquitoes would indicate the density and type of mosquito population throughout the area. When the collections of a;dults andjor larvae of A. quadrimaculatus indicate their presence, larvicidal measures are immediately instituted and, if necessary, are maintained on a weekly schedule throughout the mosquito breeding season. Whenever it is possible, such breeding areas are eliminated completely by drainage or filling.
As the program is designed for malaria control and not as a pest mosquito measure, the larvicide in use in this state is made up of a mixture of Paris green and hydrated lime in the proportion of one to ten by weight. It is applied to the surface of the breeding areas at the rate of one-half to one pound of Paris green to each acre of water surface, using a rotary

Public Health Engineering

87

hand duster for such areas as can be reached by wading, or with power dusters from boats where the breeding areas are more extensive and more economically dusted in this manner.
All personnel, including engineers, entomologists, engineering aides, inspectors, foremen, laborers and administrative aides have been traineld in the areas where they work. A field headquarters for the state is maintained in Macon where all of the administrative detail necessary to Federal controlled purchases and personnel are handled. Tthirty-two outomotive vehicles, twelve boats, fifteen outboard motors, five powered dusters, much small equipment and tools, an'd approximately 150 persons are used on the program.
A brief summary of larvicide used and work accomplished is as follows:
16,178 pounds Paris green 155,620 pounds hydrated lime 661 gallons of oil 3,180,190 linear feet ditches, 4' or less, and 17,864 acres water surface treated 228,259 linear feet ditching 994,329 linear feet ditch cleaning 24,707,115 square feet ditch clearing 6,867,810 square feet water surface eliminated 6,935 logs pulled from reservoir

Regulations of the State Board of Health governing the impounding of water apply to all projects where the surface of the impoundment covers more than one-tenth of an acre. All of the major hyidro-electric developments are under constant surveillance. Some of these are licensed by the Federal Power Commission and a stipulation of the license requires approval of malaria control operations by the department. Almost without exception, excellent cooperation of the developers is obtained.
Probably most of the malaria mosquito breeding responsible for malaria in the state originates in artificial ponds constructed for fishing, stock-watering, grist mill or recreational purposes, which have not been constructed and are not maintained in accordance with the provisions of the regulations. While these ponds constitute a definite liability on the owner for the health of the community, there is very little evidence of recognition of this responsibility.
The Agricultural Adjustment Administration has adopted a production allowance for the construction of fish and stock ponds of moderate size. The program allows reimbursement of construction cost of the dam to the extent of fifteen cents per cubic yard up to a certain size. This has stim-

88

Georgia Department of Public Health

ulated tremendously the construction of ponds and for the coming year will probably be one of the major activities of public health engineers. The AAA, and its subsidiary, the Soil Conservation Service, and the Extension Service are all cooperating with the health department in securing approved construction on all ponds built under this program. The elimination of health hazards, improvcll appearance, better fish production, etc., in the new ponds may lead to improvement of existing impoundments, and thus to better malaria control operations.
During the year, 63 preliminary permits were issued for new impoundments and 9 maintenance permits were issued on old ponds. 229 acres of impounded water were involved.

SURVEYS AND MAPS
Due to the shortage of reliable maps in Georgia, the Engineering Division has been forced to supply its own needs, especially in cases where drainage, roads, houses, etc., must be shown correctly in order for working plans to be properly examined and expedited.

Surveys and maps of practically all extra cantonment zones and major industrial developments for war have been completed. These surveys extend two miles in all directions from the actual property line and are complete planimetric maps prepared from aerial photographs in accordance with the best standard mapping procedure.
These maps and information obtained from three dimensional aerial photographs have been of considerable value to the Engineering Division, and representatives of the Army and Navy while conferring on extensions and improvements to water and sewage treatment plants.

The following tabulations show work accomplished.

Square miles surveyed and mapped:

Extra cantonment areas Basic county mapping_____ Hydro-electric area __________
lncompleted surveys

____________________________I,700 sq. mi.
--------------------------------------- 805 ------------------------------------- I40 _______________________________________ I , 3 0 0

Total________________________ 3,945

Completed surveys and maps:
Standard basic county maps _______ ----------------------------------- I Extr~ .canton~ent _maps_________________________________________________ 28 Mumc1pal samtary survey maps____________________________________ I Special malaria control maps__________________________________________ 2 Special survey and map of state property______________________ I Miscellaneous drawings and charts_______________________________ I6

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89

Incomplete surveys and maps: Standard basic county maps____________________________________________ 1 Extra cantonment maps---------------------------------------------------- 4 Municipal sanitary survey maps______________________________________ 1

MILK AND FOOD SANITATION

Milk and food sanitation is a service rendered by the Division for the purpose of assistance to local health departments and cities for a program of milk and food sanitation. No service is attempted except in cities and counties operating under public health law specifically giving authority to the local health department and to those providing trained and qualified public health personnel for conducting the program. Operation of the program is based upon local official adoption of a standard milk ordinance and code and an ordinance and code regulating eating and drinking establishments.

These two ordinances have been prepared by a board of consultants selected from health departments, federal agencies and industries and have been recommended by the U. S. Public Health Service for local adoption. A sanitarian with the Division is the technical advisor to the local health department and consultant on matters of inspections, grading, and administrative and technical interpretations.

The health officer is the designated official for operating the ordinance. The local municipal administration has the authority for legal enforcement.

There are approximately 30 cities and counties operating under the standard milk ordinance and approximately 50 cities and counties operating under the standard eating and drinking establishment ordinance. Technical assistance has been rendered to these during the year.

Information collected over a period of several years showing the number of pasteurization plants and the number of retail raw dairies in the state is shown in the following tabulation. It represents more nearly a prewar condition and, because of the confusion in the milk situation during the present emergency, it cannot be established with accuracy at this time.

Total number pasteurization plants

___________________________ 100

Total number retail raw dairies________________________________________________ 408

Total daily distribution by pasteurization plants in gallons____31,359 Total daily distribution by retail raw dairies in gallons________18,008 Total daily milk distribution in state in gallons ___________________--49,367

During the year, assistance was rendered to 71 pasteurization plants and to 245 raw milk dairies. This was in addition to assistance rendered the local health departments and municipal inspection service.

A major accomplishment during the year was a complete renovation

90

Georgia Department of Public Health

and installation of pasteurizing, cooling and bottling equipment, and serving of milk at the Tuberculosis Sanatorium at Alto. More modern equipment, improved sanitary handling and serving patients with milk from individual bottles was accomplished.

Milk sanitation conferences have been held and provision made for food handlers classes to he held at various places in the state.

Counties and municipalities which have adopted the U. S. Public Health Service Milk Ordinance and Code:

Americus Athens Atlanta (Downward
revision) Augusta Bainbridge Brunswick Cartersville Cordele Dalton (Revised
downward)

Douglas Gainesville Griffin Hinesville Hogansville LaGrange Macon Millen Moultrie Quitman Rome

Savannah Statesboro Thomasville Tifton Waycross Waynesboro West Point Crisp County Fulton County Spalding County Thomas County

Cities-27; Counties-4.

Counties and municipalities adopting U. S. Public Health Service Food Or,dinance:

Counties

Bibb Clark Cohh-N Decatur DeKalh Glynn

Jenkins Laurens Liberty Lowndes Muscogee Rabun

Richmond Spalding Stephens-I Troup (1940) G Walker Walton-!

Americus Athens Bainbridge Cairo-2 Chamblee Chickamauga Clayton Columhus-G Cordele--G Cornelia Dalton-2

Municipalities
Dublin-I Gainesville--G Greensboro-I Griffin-I Hinesville-G Hogansville--G Jesup LaFayette LaGrange--G Lawrenceville-2 Louisville

Macon Marietta-N Millen-I Moultrie Rome--2 Savannah Smyrna-N Tifton Toccoa West Point-G

Figures in parentheses indicate the edition used.

G = grading type.

N = non-grading type.

I = 1938 ed.

2 = Prior to 1938 ed.

Public Health Engineering

91

SHELLFISH SANITATION
Previous to March 1943, shellfish sanitation was delegated by law to the State Department of Agriculture. This was transferred to the State Health Department by the 1943 session of the Georgia General Assembly in Senate Bill No. 75, House Bill No. 339.
In 1924, because of serious oyster-borne typhoid epidemics, the United States Public Health Service and various state health departments collaborated in establishing operations to control sanitation in the shellfish industry. In a number of states such operations were seriously restricted because of lack of legislative authority afforded the state health depart ment. Georgia was one of these until 1943.
The recent laws passed by the Georgia General Assembly are definitely adequate to effect the purpose of shellfish sanitation. One of the major objectives was to enable the U. S. Public Health Service to permit interstate shipment and sale of Georgia oysters, an action which had not been possible under previous operations. It also provides for effective collaboration between the State Health Department operating under these laws and local municipalities operating under ordinances for sanitary regulations of shellfish distributed and sold within the municipalities.
Pursuant to this law, the State Board of Health has promulgated and adopted rules and regulations authorizing the Georgia Department of Public Health to effect the purpose of the law and to enforce such pro visions necessary to protect the public from oysters grown, produced or marketed from polluted areas.
The laws passed by the General Assembly also establish compulsion of collaboration between the State Health Department and the Department of Game and Fish for both sanitation and propagation of shellfish. These two phases of shellfish operations will undoubtedly effect the dual purpose of industrial rehabilitation and health protection.
In initiating this service many obstacles were presented. First, it was necessary that the law be publicized and the industry informed that it would be enforced effectively and impartially. Plans in agreement with the State Department of Game and Fish and the U. S. Public Health Service were established. It was necessary to survey all water areas producing oysters and to collect samples for laboratory analysis. This was followed by preparation of maps showing areas approved and unapproved. A search was made to find all shucking houses and sanitary inspections were made so that they would be required to meet sanitary requirements under the regulations. Both land and water transportation had to be provided. It was not until about July 1 that the routine became fairly well established. There follows a brief tabulation of the work accomplished during approximately one-half year of operations.

92

Georgia Department of Public Health

Acres of water investigated for safe sources of oysters____________26,863

Samples of water and oysters examined in Engineering

Laboratory _________ ----------------------------------------------------------------- 1,204

Samples of water and oysters examined by U. S. Public

Health Service _

--------------------------- --------------------------- 542

Shucking houses permitted to operate______________________________________ 14

MATTRESS SANITATION
The mattress sanitation regulations under the law passed by the 1937 General Assembly are still in operation. However, because of restrictions on critical materials, manufacturing of mattresses other than for army purposes has been greatly reduced. Many small mattress renovators and manufacturers have, for this reason, gone out of business at least temporarily. Since the larger ones are still operating, collection of licenses and sale of stamps is continued by the Department. Field inspections, although considerably curtailed, are still in progress.

FEDERAL AND OTHER AGENCIES COOPERATING WITH DIVISION OF PUBLIC HEALTH ENGINEERING
In the operations of the Division of Public Health Engineering It IS necessary that the objectives of the Division be coordinated, as far as possible, with all federal and other agencies which recognize sanitation as a necessary component in the objectives of the total program. The extent to which such agencies have projected sanitation into their programs is quite conspicuous, and it reflects the public conscience in the great need for sanitation in all public endeavor.
There follows an outline of brief descriptions of collaborations by the Division with some of these agencies.
U. S. Public Health Service. The many phases of collaboration with this service are too numerous to describe. However, some of the most prominent are certification of public water supplies for use on common carriers, similar certifications of milk and milk products, certification of shellfish for interstate sale and distribution, malaria control in war areas, and joint operation with this Service in collaboration with other federal agencies.
Federal Housing Administration. Adoption of common sanitary standards for water, sewerage and other construction, together with inspections. If public water and sewerage facilities are not available, sanitary construction approved by the health department is required, studies and approval of sites for suburban and other housing developments, and final approval of FHA for loan eligibility.
Farm Security Administration. Rural sanitation is required in the

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93

rehabilitation program so that farm owners, tenants and sharecroppers may derive public health benefits and at the same time be established with less financial risk to the government. Sanitary standar.ds for water, sewerage, screens, and other construction are furnished by the health department and required by the Farm Security Administration.
Soil Conservation Service. Soil conservation districts are established throughout the state for the purpose of conserving the soil. In conjunction with this objective are drainage for development of more productive areas for crops and establishment of farm fish ponds for home fish consumption. These objectives, without proper engineering planning, might seriously jeopardize the rural health by introduction or spread of malaria. Therefore, state health department regulations for impoundment of water are required and engineering consultation on drainage and pond construction is afforded the Soil Conservation Service by the Division.
Federal Power Commission. This commission has federal control over licensing all companies and corporations for operating hydro-electric developments. Until a few decades ago such developments in malarious states invariably created malaria epidemics in serious proportions. In 1925 the State Board of Health adopted regulations over such impoundments. The Federal Power Commission recognizes these regulations in the routine of licensing such companies or corporations for hydro-electric development.
Tennessee Valley Authority. This authority acquires and develops hydro-electric projects in the Tennessee Valley. A portion of Georgia is in the Tennessee Valley and certain projects have been acquired and developed in this section. State Board of Health regulations over such impoundments have been recognized by the T.V.A. and all requirements under the regulations have been followed in minute detail so as to prevent the prevalence of malaria.
Committee on Water and Sewerage Post War Projects. This committee sponsors a major post-war objective of a safe and satisfactory water supply, together with sewage and trade waste treatment and disposal for every city and town possible in the United States. This Division is interested in this endeavor particularly for Georgia and is cooperating with the committee in its objective.
Federal W arks Agency. This agency operates in connection with war housing projects which are federally financed and supervised and concerned with spending funds under the Lanham Act. This Division has worked closely with the Federal Works Agency in studying the needs for many projects in all areas of the state where war activities have been established.
Miscellaneous Agencies. There are a number of other agencies operat-

94

Georgia Department of Public Health

ing in collaboration with this Division for establishment of standards of sanitation and promotion of projects contributing to the war effort and to better standards of operations. Some of these are as follows: Office of Civilian Defense, U. S. Coast and Geodetic and U. S. Geological Survey, Agricultural Adjustment Administration, U. S. Fish and Wild Life Serv ice, Sanitary Engineering Committee of the War Manpower Commission, and agencies and committees.

Division of Dental Health Education
J. G. WILLIAMS, D.D.S._________________________ __________________________Part-time Director ANNIE TAYLOR________________________________________________________________Educational Director

Division of Dental Health Education
PERSONNEL
The Personnel of the Division of Dental Health Education consists of: A dentist who gives part-time services without compensation; an educational director; an associate educational director, and a secretary- Changes in personnel during the year were as follows:
Associate Educational Director-Miss Eugenia Whitehead resigned August 1 to accept a scholarship for further study_ The position has not been filled to date_
Secretary-Miss Virginia Cason was employed January 4_
COOPERATION WITH STATE AGENCIES
It has been the purpose of this division to work with and through State agencies, official and voluntary, that are concerned with health and education_ Some of these are the Georgia Dental Association, the State Department of Education, the Agricultural Extension Service, the ParentTeacher Association, Women's Clubs and Civic Clubs_ These and other agencies in Georgia have contributed much to the success of dental health efforts.
Appreciation is expressed to the Georgia Dental Association and to its Public Health Committee for their continued support of all phases of the dental health program. In spite of increased working hours, individual practicing dentists throughout the State are to be commended for their attitude toward and contribution to the dental health program. The Public Health Committee, with Dr. Homer Davis as chairman and Doctors Frank Lamons, Roy Shaw, William A. Garrett, and Joe Stegall as members, has cooperated with the Division of Dental Health Education in every possible way.
EDUCATION
Education is the primary objective of the Division of Dental Health Education and all media in the State are used to disseminate information as to dental health needs and recommended dental practices.
Educational activities of the personnel of this division can be summarized as follows: 172 talks to schools, colleges, and lay groups with an approximate attendance of 13,000; moving pictures shown to seventy-three groups with approximately 7,000 in attendance, and conferences with 598 school officials, dentists, public health personnel, Parent-Teacher Association workers, and others concerned with the promotion of and organization for dental health programs.

98

Georgia Department of Public Health

FIRST GRADERS LE ARN ABOUT D ENTAL HEALTH
Pre-Service and In-Service Teacher Training
Cooperating with the special In-Service Teach er Training Program of the State Department of Education, this division has had splendid opportunity for teacher training through workshops and county teachers' planning conferences. There is much evidence that school curriculums in Georgia are being revamped to meet health needs and that teachers are more interested irr the school and community health problems than ever before. By working with and through th e colleges, a number of pre-service teachers have been reached.
High School Victory Corps Dental Fitness Program
To speed the war effort, a special dental fitness program for high school seniors has been spon sored by the Georgia Department of Public Health, the Georgia Dental Association, and the Georgia Department of Education. The physical fitn ess program of the High School Victory Corps has stimulated much interest in dental h ealth and its problems.
Dr. 0 . C. Aderhold, State Director of the High School Victory Corps Program, has taken an active interest in promoting the dental fitn ess program. The educational director has served as a member of the Physical Fitness Committee and h as had opportunity to work with the 62 educators who serve as the Victory Corps staff. Appropriate dental health education materials have been supplied to approximately 500 Victory Corps schools. Through this program , special emphasis has been placed on securing dental corrections for high school seniors. Unofficial r eports to date are e nco u r ag in g .
Parent-Teacher Associations, Women's Clubs , and Civic Organizations
The educational director has again served on the Board of Managers of the Georgia Congress of Parents and Teachers. This has afforded

Dental Health Education

99

D ENTAL HEALTH EDUCATION FOR MoTHERS oF To M ORRo w
opportunity to work effectively with and through local Parent-Teacher Association s. Curtailed travel has limited the number of lay organizations reached in the State, but such clubs continue to give sponsorship and financial aid to local dental programs.
Educational Aids The division has used and distributed widely, free of cost, the following
aids:
Bulletinsyour Child's Teeth Dental Health Guide About Faces Dental Health Education What to Teach and How to Teach It The Truth About Teeth Hold On to Your Teeth Teaching Dental Fitness in High School Classes Fighters-Workers Keep Fit! (High School Victory Corps)
FilmsAbout Faces Our Teeth Told by a Tooth
DENTAL CLINICS
Dental Clinic activities may be summarized as follow s : Thirty clinics in twenty-nine counties, with sixty-eight white dentists and two Negro dentists working 4,525 hours, have admitted 5,697 white children and seventy-eight Negro children. There were 21 ,959 operations or approxi-

100

Georgia Department of Public Health

mately four operations per child, including fillings, extractions, and prophylaxis. There were sixtynine prenatal cases treated. Local dentists were paid $11,3 12.50 in honoraria for these ser vices.
Expansion of dental clinic services has been curtailed by the serious shortage of dentists caused by the war. Many additional counties would have provid ed dental clinic services if dentists had been available. Th e counties conducting clinics and th e local dentists participating are to be commended. It is realized that these clinics have been operated at a sacrifice on the part of denti sts and with difficult y on the part of local public health personnel.

DENTAL CLINIC F OR I NDIGENT CHILDREN, FLOYD CouNTY HEALTH DEPARTMENT

Following Regulations for Paying Honoraria to Clinicians Conducting Dental Clinics, the counties which con ducted dental clinics during 1943 are as follows :

County

Months 0 perating in 1943

Type of Clinic

l. Appling 2. Brooks 3. Charlton 4. Chatham 5. Clark 6. Colquitt 7. Crawford 8. Crisp 9. Decatur 10. DeKalb 11. Floyd 12. Grady

5

White Children

8

"

"

9

"

"

12

White and Negro Children

7

White Children

5

"

"

4

"

"

7

"

lO

"

"

12

"

"

12

"

"

2

"

"

;- ..
County
13. Hall 14. Jenkins 15. Mitchell 16. Morgan 17. Rabun
18. Spalding 19. Stephens 20. Telfair 21. Thomas
22. Toombs
23. Upson 24. Walker 25.. Ware 26. Wayne 27. Wheeler 28. Whitfield 29. Worth

Dental Health Education

101

Months 0 perating in 1943
6 10
8 9 12
12 2 8 9
7
12 6 9 5 9 9 ll

Type of Clinic

"

"

"

"

"

"

White Children and

White Prenatal Cases

White Children

"

"

"

"

White Children and

Negro Prenatal Cases

Two Clinics for White

Children

White Children

"

"

"

"

"

"

"

"

"

"

Clinic Supervision

During the year, the director visited the following dental clinics to supervise and evaluate clinic activities:

Brooks Charlton Chatham Crawford Crisp Floyd Grady

Hall Jenkins Mitchell Morgan Telfair Thomas

Upson Walker Ware Wayne Wheeler Whitfield

INDUSTRIAL DENTISTRY
Cooperating with the Division of Industrial Hygiene, efforts have been made to promote industrial dentistry. The director took part in the Industrial Hygiene Institute and has conferred with educational leaders when requested. Dr. Lyman D. Heacock, Dental Consultant of the Division of Industrial Hygiene, U. S. Public Health Service, spent a week in Georgia assisting with the formulataion of an Industrial Dentistry Program for the State.

102

Georgia Department of Public Health

MEETTNGS AND ASSOCIATIONS ATTENDED

Meetings

Attended by

High School Victory Corps Conferences, State and RegionaL___________Taylor, Whitehead Supervisors of Education Annual Meeting __________________________________________Taylor, Whitehead Social Hygiene Institute _______________________________________________________________________Taylor, Whitehead Agricultural Extension Service Annual Meeting____________________________________________________Taylor American Dental Association Mid-Winter Meeting________________________________________Williams Industrial Hygiene lnstitute______________________________________________________________________Williams, Taylor
Georgia Dental Association Mid-Winter Clinic ______________________________________Williams, Taylor Parent-Teacher Association Board of Managers______________________________________________________Taylor Parent-Teacaher Association Convention______________________________________________Taylor, Whitehead Georgia Dental Association___________________________________________________Williams, Taylor, Whitehead Parent-Teacher Association Convention ________________________________________________Taylor, Whitehead
Southeastern Regional Dental Health Personnel Conference________________Williams, Taylor High School Victory Corps Staff Workshop_________________________________________________________Taylor American Public Health Association_______________________________________________________________________Taylor American Dental Association____________________________________________________________________________________Williams Tennessee State Dental Society________________________________________________________________Williams, Taylor

STATISTICAL REPORT OF ACTIVITIES
COUNTIES VISITED ---------------------------------------------------------------------------------------------- 59 Counties with full time health departments______________________________________________________ 26 Counties with nursing service________________________________________________________________________________ 27 Unorganized Counties --------------------------------------------------------------------------------------------- 6
MILES TRAVELED -------------------------------------------------------------------------------------------------16,958 Educational Director ------------------------------------------------------------------------------------------ 9,458 Associate Educational Director------------------------------------------------------------------------- 7,500
PUBLIC SCHOOLS VISITED________________________________________________________________________________ 24
Talks -------------------------------------------------------------------------------------------------------------------------- 24 Attendance-White ------------------------------------------------------------------------------------ 7,275
Films and Talks---------------------------------------------------------------------------------------------------------- 11 Attendance-White -------------------------------------------------------------------------------------- 4,685-
TEACHERS' MEETINGS --------------------------------------------------------------------------------------- 82 Talks ------------------------------------------------------------------------------------------------------------------------- 82 Attendance-White ------------------------------------------------------------------------------------ 3,143 Negro -------------------------------------------------------------------------------- 384 Films ----------------------------------------------------------------------------------------------------------------- 40 Attendance-White______________________________________________________________________________________________ 924 Negro ---------------------------------------------------------------------------------- 270
COLLEGES VISITED --------------------------------------------------------------------------------------------- 14 Talks ----------------------------------------------------------------------------------------------------------------- 14 Attendance-White --------------------------------------------------------------------------- 783. Negro ----------------------------------------------------------------------------- 395 Films and Talks--------------------------------------------------------------------------------------------------- 5 Attendance-White ------------------------------------------------------------------ 525
pARENT-TEACHER ASSOCIATIONS ATTENDED__________________________________ 8 Talks -------------------------------------------------------------------------------------------- 8 Attendance ------------------------------------------------------------------------------------- 500
s. Films ------------------------------------------------------------------------
Attendance ------------------------------------------------------------------- 285.

Dental Health Education

103

WOMEN'S CLUBS ____ -------------------------------------------------------------------------------------------- 2
Talks ----------------------------------------------------------------------------------------------------------------------------- 2 Attendance --------------------------------------------------------------------------------------------------- 30
Films --------------------------------------------------------------------------------------------------------------------------- 2 Attendance --------------------------------------------------------------------------------------------------- 30

CIVIC ORGANIZATIONS --------------------------------------------------------------------------------------- 5
Talks ------------------------------------------------------------------------------------------------------------------------ 5 Attendance -------------------------------------------------------------------------------------------------- 202
Films -------------------------------------------------------------------------------------------------------------------------- 5 Attendance -------------------------------------------------------------------------------------------------- 202

DENTISTS ---------------------------------------------------------------------------------------------------------------- 1 Talks ------------------------------------------------------------------------------------------------------------------------- 1 Attendance -------------------------------------------------------------------------------------------- 35
PUBLIC HEALTH PERSONNEL_____________________________________________________________________________ 4
Talks --------------------------------------------------------------------------------------------------------------- 2 Attendance ------------------------------------------------------------------------------------------------------- 55
Films ---------------------------------------------------------------------------------------------------------------- 2 Attendance ------------------------------------------------------------------------------------------------ 55
PUBLIC HEALTH MEETINGS______________________________________________________________________________ 1

PUBLIC OR DENTAL HEALTH COUNCILS_____________________________________________________ 2
Talks --------------------------------------------------------------------------------------------------------------- 2 Attendance ------------------------------------------------------------------------------------ 26
Films ---------------------------------------------------------------------------------------------------------------- 2 Attendance ------------------------------------------------------------------------------------------------- 26

OTHER MEETINGS --------------------------------------------------------------------------------------------- 31

Talks-------------------------------------------------------------------------------------------------------------------- 31

Attendance ------------------------------------------------------------------------------------- 354

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

1

Attendance ---------------------------------------------------------------------------------------- 20

DENTAL CLINICS VISITED_______________________________________________________________________________ 30

VISITS TO REGIONAL OFFICES------------------------------------------------------------------------------- 10
VISITS TO COUNTY HEALTH DEPARTMENTS___________________________________________ 96
ASSOCIATIONS AND CONVENTIONS_________________________________________________________ 17
State ------------------------------------------------------------------------------------------------------------------- 11 National or RegionaL---------------------------------------------------------------------------------- 6
CONFERENCES -------------------------------------------------------------------------------------------------------- 598 I. Regional Medical Directors--------------------------------------------------------- 10 2. County Health Commissioners________________________________________________________________ 61 3. Dentists ------------------------------------------------------------------------------------------ 78 4. School Superintendents ----------------------------------------------------- 95 5. Physicians ------------------------------------------------------------------------------------- 7 6. Home Demonstration Agents--------------------------------------------- I 7. Nurses -------------------------------------------------------------------- 132 8. Parent-Teacher Workers --------------------------------------------- 11 9. Others ---------------------------------------------------------------------------------- 203

104

Georgia Department of Public Health

DENTAL CLINIC REPORT FOR THE YEAR 1943

NUMBER COUNTIES OPERATING CLINICS NUMBER CLINICS ____________ NUMBER CLINIC SESSIONS NUMBER CLINIC HOURS (TOTAL) NUMBER DENTISTS WORKING

White
29 30':' 21632 4327 68

HONORARIA PAID DENTISTS ____

$10,817.50

TOTAL ADMISSIONS _____ ______ _

TOTAL ADMISSIONS BY AGES 6-8 yrs. 9-11 yrs. __________________________________ --------------------------

12-14 yrs. --------------------------------------------

'7o 6-8 yrs. ----------------------------------- ----------------------

% 9 11 yrs. _------------------------ -------------- --------------

% 12-14 yrs. ________

_______________

TOTAL VISITS __ ______

_______ _

TOTAL PATIENTS DISMISSED Completed _______________________
Others % Completed ____________________

PROPHYLAXIS _________________ %of Admissions ________ ------------------------------
NUMBER TEETH EXTRACTED______ ____ __ Decid. ___________ 1st Perm. Molars_________________________________ -------------Other Perm. Teeth ___________________________________________
NUMBER TEETH FILLED _________________ Decid. 1st Perm. Molars _____________________________________________
Other Perm. Teeth
NUMBER FILLINGS ___ ____ _ __________
Cement Alloy_ Silicate

*Toombs county operates clinics at Lyons and Vidalia.

5697
2427 2117 1153 43% 37% 20% 8085
4900 4614
286 81 o/o
2534 44%
6324 5544
664 116
10710 3293 5838 1579
12615 1116
10939 560

Negro
2 2 99 198
2
$495.00
78
47 23
8 60% 30% 10%
220
73 69
4 88%
56 72%
137 122
14 1
252 122 109 21 293
94 136 63

Division of Maternal and Child Health

EDWIN R. WATSON, M.D.

_______________________________ _____________________ Director

PAUL R. ENSIGN, M.D. ____________________________________________________Pediatric Consultant

HUGH J. BICKERSTAFF, M.D. lPart-time)

_______Obstetric Consultant

MARY EMMA BARNEs ______________________________________________________Nutrition Consultant

Division of Maternal and Child Health
INTRODUCTION
During the calendar year 1943, the Division of Maternal and Child Health has been primarily concerned with continuing previously established programs. Lack of professional personnel on the staff of the Division has materially interfered with field activities. The staff of the Division has been seriously reduced for quite some time but reached the irreducible minimum in August 1942 when the medical phase was handled as a parttime assignment by the present director. No staff additions were possible until June 1943 at which time a pediatric consultant, and a consultant nurse, were added to the Division. Their activities have been largely utilized in the inspection of hospitals and other field activities necessitated by the Emergency Maternity and Infant Care program. It is hoped that they will be able to devote much time toward evaluating and improving activities in maternity and child health centers. At no time since the health center program was initiated has the Division been more out of touch with local situations and activities. It has been necessary to depend largely upon correspondence for field contact.
The Division has been confronted with numerous requests for services which can be provided only by highly trained professional workers. It is to be regretted that activities of importance have arisen at a time when the Division is not in position to meet the demands. It would appear that many activities must be postponed until sufficient personnel can be procured. Every effort should be made to curtail activities which are considered least essential so that the more essential duties can be better performed. Every effort will be made to discourage the initiation of services or plans which would serve to further reduce previously established services.
Discontinuation and reduction of activities have occurred to a greater extent than previously. In spite of these difficulties, a surprisingly small degree of decline in accomplishments has resulted. The fact that many services have increased can be accounted for only by the untiring efforts of our loyal workers at State, regional and local levels. Such accomplishments bear out the feeling that duties at home have received the devotion and sacrifice of those attempting to safeguard the health of Georgia citizens.

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Georgia Department of Public Health

GENERAL ACTIVITIES
The divisional staff has continued to lecture to nurse-trainees in the attempt to acquaint them with the more important phases of maternal and child health with which they will be concerned when assigned, and has continued to attend regional conferences to discuss subjects of interest to county and regional public health personneL These conferences have proved helpful in conveying new plans and policies hdopted from time to time. All miscellaneous requests for lectures to lay groups have been refused due to the devotion of time to other phases of work which appear more essentiaL
A report on maternal and child health activities was made to the Georgia members of the American Academy of Pediatrics at its meeting in December, and a complete statement of the Emergency Maternity and Infant Care program was presented to the Georgia Pediatric Society at its meeting in May. The Division has continued to inform the above pediatric groups with respect to any and all activities pertaining to medical services for children. It is indeed fortunate that the Division is provided, semi-annually, with the opportunity to discuss present and future progress and activities with this group.
Invitations from local medical societies for a discussion of the Emergency Maternity and Infant Care program were received and a representative of the Division met .with these societies. In all instances the program was adopted. There still remains, however, some misunderstanding in the medical profession, principally due to misinterpretation of the program. In such instances every effort is made to prov~de the individual physician with complete information.
During the year, the problem of illegitimacy was presented from a health standpoint at the annual meeting of the Georgia Social Welfare Conference. Though this problem is principally in the welfare and social field, there are certain public health aspects that must not be neglected. It is hoped that in the future the Negro illegitimate problem will receive its share of attention. In the past, the white illegitimate problem has received the majority of welfare services, and yet, on the average, there is only one white illegitimate child for each ll Negro illegitimate children. A review of the incidence of illegitimate births by counties reveals that the problem is to be found in every locality, and that almost without exception the greater problem is among the Negro group. For the past twentythree years the white illegitimate rate has increased from ll to 14 per 1,000 live biths, whereas the Negro rate has increased from 120 to 171 per 1,000 live births.
Assistance has been given the State Department of Public Welfare in preparing health standards for day-nurseries.

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109

Georgia's Health, a departmental publication, continues to be edited in this Division. The popularity of this publication is attested by the increase in the number of additions to the mailing list, which now con tains over 28,000 names.
During the year, the director cooperated with the Atlanta Junior Chamber of Commerce in providing radio programs designed to promote the control of venereal disease. A program was presented on the subject of congenital syphilis.
Junior students of medicine at Emory University School of Medicine and the University of Georgia School of Medicine were provided with lee tures by the staff of the Division in an attempt to acquaint them with the medical aspects of the maternal and child health program. Experience during the past few years has demonstrated that this is an excellent means of acquainting future practitioners with programs with which they will be concerned following graduation. It should be evident that this contact paves the way for a working relationship when these physicians begin to provide medical services in maternal and well baby conferences.

MEDICAL ACTIVITIES

Statistical Summary of Activities:

Number Attendance

Consultations and clinical services ___

24

Paper, talks, addresses:

Public health personnel ______________________________________ 8

162

Professional _________________________

10

501

Lay groups _______________________________________________________

5

141

Conferences and interviews:



Physicians and health officers

168

385

Nurses and other public health workers _______________ 38

141

Civic leaders and officials_____________________________

35

173

MCH centers conducted or supervised_____________________ 17

Projects or health centers reviewed_

38

Group conferences ___________________________________________ Radio talk ______________________________________________

21

620

1

Hospitals inspected ___________________________________________________ 96

Meetings attended ____________________________________________________ 2

162

llO

Georgia Department of Public Health

Selected Activities:
A state-wide whooping cough immunization program was initiated in March following approval of the plan by the Georgia Pediatric Society. The program has been well received by the medical profession throughout the State. The response from the public is gratifying. The department is absorbing 80 per cent of the cost of the antigen so that local health departments and physicians may secure it for a nominal charge. Studies made of the antigen distributed by the State Department of Health indicate that this product is producing results comparable to that produced by more expensive products.
The divisional staff has continued to focus attention on premature infant care. All incubators have now been distributed to counties and hospitals. Hospitals interested in planning for better premature infant care have been consulted. Recommendations, with regard to arrangement of nurseries and selection of equipment, have been made to hospitals when requested.
Considerable time has been devoted to the evaluation of plans for maternity shelters and hospitals. Numerous conferences have been held with hospital authorities, hospital superintendents and architects for the purpose of evaluating proposed hospital plans and recommending changes therein. Contributions to hospital planning have been limited solely to planning maternity and newborn service because of lack of knowledge in providing consultative service for good general hospital planning. It is encouraging to note that our effort in this field of endeavor is heartily received. In no instance has our recommendation failed to receive consideration. Hospital standards have improved in hospitals as a result of stimulating interest in this phase of care. It is to be regretted that the Department does not afford hospital consultative service. However, the creation of such a service is now anticipated. A loss will continue to be sustained until provision is made for review of hospital plans prior to their adoption. This phase of hospital planning, together with many others, can be provided satisfactorily only through an organized hospital service directed by an adequately trained staff.
The proposed legislative enactments, approved by the Medical Association of Georgia, were introduced during the last session of the legislature. One proposed bill was concerned with the licensing of facilities providing maternity and newborn care, and the other was concerned with conferring authority to the State Board of Health to regulate the practice of midwifery. It is hoped that these bills will be re-introduced at the next session of the legislature and that they will be more favorably received in the future than they have been in the past.
The Division has appointed part-time obstetric and pediatric clinicians who will provide local health department staffs with clinical services in

Maternal and Child Health

lll

health centers and hospitals. Their duties will include delivery service, maternity health center activities, child health center activities and case consultations. To date, seven such appointments have been made.
During the year, policies concerned with participation of private physicians in maternal and child health centers were revised. Heretofore, all physicians desiring to participate were allowed to do so on a rotation basis. Since July l, 1943, clinicians have been chosen by the Georgia Department of Public Health following recommendations by the local commissioners of health or regional medical officers. In this way, the physician best prepared to conduct these conferences can be made available. Definite requirements were established as to qualifications which clinicians must possess in order to be eligible for appointment. This change is in line with a previously adopted policy whereby a physician is maintained on a part-time salary basis, rather than on an honoraria basis for clinical activities in maternal and child health centers.
Several articles have been prepared for publication in the Journal of the Medical Association of Georgia. Four were published during the year, one on Whooping Cough Immunization, and the others on Nutrition, Survey of Premature Care in Hospitals, and the Emergency Maternity and Infant Care program. Several divisional publications have been rewritten in order to bring the information up-to-date, and one new publication is now in the process of being prepared for distribution.
The Division has continued to make postgraduate training and experience in premature and newborn infant care available to selected hospital and public health staff nurses. During the year, three hospital and two public health nurses were provided with experience at the Michael Reese Hospital, Chicago. This training has been of material help in focusing attention on the need for adequate hospital facilities for premature and full-term newborn infants.
The Division made scholarships available to physicians serving in maternal and child health centers in order that they might attend the Southern Pediatric Seminar. These refresher courses serve to acquaint the physician with current developments in the field of obstetrics and pediatrics.
One Georgia hospital is now employing a nurse-midwife, whose salary is paid from State and local funds, in order that a greater number of charity cases may be served. The nurse-midwife is a member of the local health department staff, but devotes her time to the hospital except for attendance at the prenatal health center from which her delivery cases are selected and assigned.
As a result of requests from local health departments, provision was made to furnish material to be utilized in performing urine sugar tests.
The Division has prepared a plan whereby the Summer Round-Up

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Georgia Department of Public He?lth

activities of the Georgia Congress of Parents and Teachers will be coordinated with infant and preschool center activities, rather than conducted as a separate endeavor. This will enable local health departments to benefit from the information obtained from the Summer Round-Up.
During the year, all maternal and child health centers in the City of Atlanta were personally evaluated by the staff of the members of the Division of Maternal and Child Health and the Division of Public Health Nursing. A complete written report, with recommendations, will be filed with the City of Atlanta Health Department. Already numerous improvements have been made as the result of this study. It is hoped that a similar survey can be made in other urban areas during the coming year. In this way, the Division can be most helpful to those who are responsible for providing the most acceptable service that can be made available.

NUTRITION ACTIVITIES
Nutrition Service
Securing the support and active cooperation of all public health workers is essential if an effective fight against malnutrition is to be waged. Realizing this fact, the nutritionist, during 1943, directed principal activities toward providing local health departments with information on nutrition and suggestions regarding the best methods of utilizing such information in every day activities.
Activities of the Nutritionist
Much of the nutritionist's time was devoted to working with nursetrainees, who represent one of the most important mediums through which nutrition information may be disseminated. A quiz on nutrition was prepared and given to each of the 25 trainees and they were furnished lists of source material on the subject. They were assisted in planning low cost food budgets and meals for families under their supervision and were informed concerning the newer findings regarding nutrition. Personal conferences and home visits were utilized.
One hundred counties were aided in improving, developing or expanding their respective nutrition programs. This was accomplished by participation in staff conferences, consultations, home visits with nurses, assistance in choice and use of educational material, and interviews with parents attending the child health centers in regard to diet. Suggestions were made regarding the enlargement of local nutrition programs and evaluation reports were prepared on each county visit. This close contact with individual health departments both stimulated interest of public health personnel in promoting better nutrition and gave the nutritionist better insight into local nutrition problems.

Maternal and Child Health

113

The nutritionist participated in five nurses' institutes and discussed the newer findings in nutrition.
Food demonstrations in maternal and child health centers were extended. For example, Fulton County Red Cross canteen workers gave 102 demonstrations in 5 health centers to a total of 996 mothers. Proof of the demonstrations' value is shown by the fact that nurses and physicians noted an increase in consumption of whole grain cereals, dry milk, green vegetables and peanuts by center patients.
In cooperation with the Industrial Hygiene Division of the Health Department, visits were made to eight industrial plants to observe cafeteria and kitchen equipment storage facilities, menus offered, preparation and care of food, sanitation and the type of nutrition educational program being given workers. Reports and recommendations were submitted to the Industrial Hygiene Division and officials of plants surveyed. As a result, food selection and preparation were improved, more sanitary methods of food handling were inaugurated and, in some instances, skilled dietitians were employed to supervise plant cafeterias .
Special nutrition services rendered by the nutritionist included:
l. Preparing an outline on food purchasing, menu planning and food preparation for the maternity home located in Clayton, Georgia.
2. Assisting the medical department of Warner Robins Air Base in planning a simplified nutrition course for wives and employees of the depot.
3. Assisting the State Department of Welfare in compiling standards for nursery schools and planning low cost adequate diets for children at the Convalescent Home for Children and the Industrial Home for Girls.
Bulletins prepared by the nutritionist during the year included "Food Selection and Preparation," "Nutrition in the Lunch Box," and "What You Need to Keep Strong and Well." Each month the nutritionist wrote an article on some phase of nutrition for "Georgia's Health," the official publication of the Georgia Department of Public Health. A total of 52,559 copies of material prepared by the nutritionist was distributed to the public during 1943.
The nutritionist made every effort to correlate her work with all other groups and agencies promoting better nutrition. She served as a member of the Sub-Committee on Nutrition in Industry of the State Nutrition Committee, which promoted better nutrition in industrial plants. She continued to serve on the Health Committee of the Wartime Commission of Education and participated in three teachers' workshops during the year. Conferences were held with officials and teachers on food problems in

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Georgia Department of Public Health

schools, teaching materials, dietary standards for school lunches, and educational possibilities of school lunch. She served as a member of the Children's Wartime Service Committee of the Office of Civilian Defense, which promotes better care for children in war congested areas. In this connection, four talks on good food habits for preschool children were given to volunteers assisting in day care centers. As a member of the Advisory Committee and chairman of the School Lunch Sub-Committee of the State Nutrition Committee, she aided in planning the quarterly programs of the committees and participated in these programs. She worked closely with the State Nutrition Committee in its efforts to promote nutrition education and elevate the nutritional standards of Georgians.
School Lunch Program As chairman of the School Lunch Sub-Committee, State School Advis-
ory Committee of the State Department of Education, the nutritionist helped revise bulletins on "Minimum Standards of School Lunchrooms" and "Hygiene and Sanitation for School Lunchrooms."
Part of the nation-wide wartime food program of the Food Distribution Administration was to provide food for community school lunches. Schools in need of assistance were provided approximately 60 per cent of the cost of food required to serve one nutritious meal each day. In Georgia, the State Department of Education was the sponsoring agency and administered the school lunch program. One of the most progressive steps made in the revised wartime school lunch program was the employment of a state lunch supervisor and two assistants as members of the general staff of the State Department of Education.
There were 158 schools operating lunchrooms in Georgia in February, 1933. At the present time, there are 1,129 schools with lunchrooms approved for participation in the school lunch program operated jointly by the State Department of Education and Food Distribution Administration. The number of schools serving hot lunches increased 615 per cent in the last ten years and great improvements in facilities and type of lunch served have been made. Reduction of failures, improvement in attendance and weight gains were noted by officials of schools serving hot lunches.

Maternal and Child Health

Statistical Summary of Activities:

Number

Papers, talks, addresses:

Public health personnel

5

Lay groups ___________

11

Professional ______ _

5

MCH centers visited

9

Interviews and conferences:

Physicians and health officers_____________ 49

Nurses and other public health workers 136

Officials and civic leaders __________________ 161

Mothers ____

23

Nurse-trainees

25

Food demonstrations ____

5

Lunchrooms visited

12

Associated meetings

3

Home visits ______

2

Industrial plants visited ___

8

Attendance
120 637 395
97
49 136 161 23
25 73
350

115 Total
1152 97
394
2 8

Nutrition Work of Related Agencies
During last year, 198 standard American Red Cross nutrition courses were taught in Georgia and 3,064 certificates issued. Nineteen standard canteen courses were completed and 409 persons awarded certificates. Material prepared by the nutritionist was used in these classes.
Vocational home economics teachers taught 43 standard Red Cross nutrition classes and 11 canteen courses. In addition to the Red Cross course, 109 nutrition classes were taught.
Three hundred and thirty-six vocational home economics teachers taught nutrition classes to boys and girls who were members of the Victory Corps Program.
Two power companies extended the "Health for Victory Clubs" for benefit of wives and mothers of industrial workers. Seven industrial plants now have the club as part of their educational program.
There are 550 community canning plants in Georgia. The home demonstration agents promoted food production and food preservation among urban and rural families. They gave 4,300 method demonstrations on food production and food preservation to audiences totaling 173,000 persons.

ll6

Georgia Department of Public Health

MATERNAL AND CHILD HEALTH CENTERS
Maternal and child health centers increased from 321 in 1942 to 340 in I943. These centers are conducted by clinicians who are paid from
State funds on an honoraria or part-time basis. The following table reveals the number of centers operating, the type of center conducted, and whether the counties, where centers are located, have full-time health units or are limited to full-time public health nursing service. Practically all of the non-participating centers are established by health departments in urban areas and are served medically by part-time clinicians who are paid from local funds.

MATERNAL AND CHILD HEALTH CENTERS IN OPERATION

Participating
Organized Nursing Counties Counties

Maternal ------------

81

7

no Infant ----------------------

IO

Combined _____________ 74

58

Total
88 I20 I32

Non-Participating
Organized Nursing Counties Counties

32

I

45

I

0

0

TotaL____________ 265

75 340

77

2

Total
33 46
0
79

Maternal arul Child Health

117

lJl..BBR OF IIATI!RNAL AND CHilD HEAL'n! CENTJ!RB BY CamTIES AS OF DECl!31B:m :u, 1!H3

lherner a 41g1t appears in a c01111ty, it denotes the au.ber or IICH centera roporUq u or Deoelllber 31, 1943

118

Georgia Department of Public Health

MATERNAL AND CHILD HEALTH CENTER ACTIVITIES
It is evident from a review of the statistical report that maternal health center activities failed to continue their previous trend, because, for the first time, these activities failed to exceed, to an appreciable extent, comparable activities listed for the previous year. In addition, it should be noted that in some respects the report does not compare favorably with activities reported in 1942. A serious decline in admission of white cases to prenatal centers is evident. There was no significant progress in securing admission of prenatal cases to medical centers early in pregnancy. The number of prenatal cases receiving anti-syphilitic treatment showed a remarkable increase, but this is due to a more accurate account, resulting from change in the method of securing reports. The treatment positive ratio did not reveal an increase in the average number of treatments per syphilitic expectant mother. In fact, the treatment per syphilitic case was 6.7 in 1943 as compared to 7.6 in 1942. One phase of the maternal health center activities did show definite improvement, namely, postnatal activities. An increase in both admissions and visits for both white and Negro cases is evidence of an increasing acceptance of this phase of maternity care. Altogether 3,435 mothers returned for postpartum examination. This represents approximately 25 per cent of those mothers who were in need of this service and who had been admitted to the center for supervision during pregnancy.
Infant and preschool health center activities showed some increase in admissions, but this was entirely limited to Negroes. Some improvement is revealed in the admission of infants under four months of age when admitted. One of the chief difficulties in securing continuous medical and nursing supervision for infant and preschool children is the limitation impos.ed by inadequately staffed local health departments. Case finding is time consuming, but is essential in the fulfillment of our objective to provide supervision for infants and preschool children in the most desirable manner. Visits to infant and preschool health centers, likewise, reveal an increase, but again this trend is due to increase in visits made by Negro infants and preschool children. The visit admission ratio remains rather low.

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119

MATERNAL HEALTH CENTER ACTIVITY State-Subsidized Centers

1943

%+orover 1942

Prenatal Admissions Admissions, totaL_ White ____________________
Negro _______ ---------------------- ____________________
% white ____________________________ '7o Negro _____
Period gestation, total ____________________
Under 16 weeks ________ ----------------------------------16-27 weeks ___________________ 28-36 weeks _________________________
Over 36 weeks ___________________

15,306 1,508
13,798 9.85
90.15 15,303
4,263 7,267 3,383
390

+1
-29
+5
+1
-6
+5 +1
-17

% under 16 weeks o/o 16-27 weeks ________
% 28-36 weeks _______ _

27.86 47.49 22.10

1/o over 36 weeks ________ ------ -------------------- -----------2.5-5------------------

Prenatal Syphilis

Total cases registered for treatment _______ White ____________________________
Negro ______
o/o of total syphilitics-white________ o/o of total syphilitics-Negro__________

2,122 71
2,051 3.35
96.65

Total treatments administered____ W h i t e __________________________________________________________________ _
Negro__________________________________________________ ------------------
c/0 of total admissions treated_______
White ________________________________
N e g r o ... __

14,213 573
13,640 13.86 4.7 14.86

Average treatment per prenatal case_________________

6.7

White ______________________________________________________________________

8.1

Negro........ ------------------------------------------------------------

6.7

Prenatal Activities Visits, totaL. White _____________ Negro_____________________________________________________________________
Visit/admission ratio ________________________________________________

White........ N e g r o _____________ _

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

Transferred, totaL

52,626 5,128
47,498 3.4 3.4 3.4
636

+3
-22
+7

Postnatal Activities Admissions, total -----------------------------------------------------W h i t e ___________________________________________________________________ _ N e g r o ____________________________________________________________________ _
Visits, total.---------------------------------------------------------------- White.......-------------------------------------------------------------Negro____________________________________________________________________
% of prenatals, totaL....._________________________________________
White........------------------------------------------------------------Negro________________________________________________________________

3,435 412
3,023 4,290
525 3,765
22.44 27.32 21.91

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Georgia Department of Public Health

INFANT HEALTH CENTER ACTIVITY State-Subsidized Centers

1943

Admissions-Infant and Preschool Admissions, total_ White ______________________________ _
Negro
7o white
~,;.- Negro ______
Age groups, total-------------Under 4 months _ 4-12 months _________
1-5 years_ '0 under 4 months_ r 0 4-12 months ----------~7o 1-5 years ____________________ ------------------------------------

16,572 5,644
10,928 34.06 65.94
16,572 5,908 4,211 6,453 35.65 25.41 38.94

Visits and Activities
Visits, total------------------------White
Negro -------------------Visit/admission ratio ____________________ -------------------------
White __
Negro __ -------------------------Referred cases_________________

42,531 14,696 27,835
2.6 2.6 2.5 2,032

+ o r - !;-,_,.o
over 1942
+11 -5 +21
+11 +21 +18 -1
+15
+2
+23
+1

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121

COMMENTS ON STATEWIDE MATERNAL AND CHILD HEALTH
ACTIVITIES
Immunizations: Records of persons immunized in 1943, as compared with 1942, reveal a serious decline in the number of persons immunized against smallpox, a slight increase in number of infants under one year immunized against diphtheria, and a decrease in number of children over one year immunized against diphtheria. Whooping cough immunization was initiated during 1943 and a total of 7,031 children were immunized against this disease.
Maternity Service: The outstanding feature of maternity service is the fact that no single activity showed an appreciable increase other than cases given postpartum medical examination. A serious decline occurred in the number of visits for midwife supervision, as well as in the number of field and office visits to prenatal cases. The decline in cases attended by nurse for delivery service is understandable since this phase of the program was curtailed during the latter part of 1942.
Infant Hygiene: In spite of the reduction in personnel, admissions to medical and nursing service, when compared with 1942, increased in 1943. Visits to medical conferences, as well as field and office nursing visits, likewise showed improvement. The limited increase in activities in this phase of public health is due to reduced staffs of local health departments.
Presclwol Hygiene: Preschool activities showed very little change however, and it is significant that admissions to medical services and visits to medical conferences declined in 1943 as compared with 1942. The serious decline in attendance at infant and preschool classes is due to reduction in educational phases of public health in favor of other services. This statement should not be construed to mean that this is a favorable trend.
Sclwol Hygiene: A decline in all phases of school hygiene activities was reported in 1943 as compared with services rendered in 1942. Examinations by physicians showed a moderate decline which is, in part, due to reduction in medical staffs of local health departments. The serious decline in field and office nursing visits is, no doubt, due to increased services rendered in other phases of public health. Likewise, the number of school children inspected by dentists was reduced because dentists were not in position to provide the usual school inspection services.

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Georgia Department of Public Health

1942

Immunizations
Smallpox ----------Diphtheria:
Under 1 year --------------------1 yr. through 4 yrs. ___ 5 yrs. and over _________
Pertussis: Under 1 year _____ -----------------Over 1 year

92,368
14,028 21,022 15,537

Maternity Service
Admissions to prenatal medical service_ Admissions to prenatal nursing service------------Visits to medical conferences _ ___ ---------------Field and office visits ________ -------------------------Cases given postpartum medical examinations _ Visits to postpartum cases ____ ------------------------Cases attended by nurses for delivery service_ Cases admitted to postpartum nursing service_ Visits for midwife supervision _______ --------------------Attendance at maternity classes --------------------- _

24,984 47,246 67,578 147,744
3,487 45,309
218 20,369
5,795 2,340

Infant and Preschool Hygiene
Infants: Admissions to medical service -------------Admissions to nursing service----- ----------------------Visits to medical conference____ --------------------Field and office nursing visits
Preschool: Admissions to medical service_ Admissions to nursing service Visits to medical conference ____________
Field and office visits -------------------- _---------------------Attendance at infant and preschool classes ____

11,290 31,647 26,420 87,789
13,073 25,268 24,049 61,813
586

School Hygiene Examinations by physicians____ ---------------------Examinations by physicians-parents present_ Field and office nursing visits ____________________________
Inspections by dentists or dental hygienists....

79,650 2,663 71,817
62,789

1943

%+orover 1942

77,599
14,670 19,098 12,536
4,550 2,481

-16
+5
-9 -19

23,960 47,563 64,762 139,436 3,810 43,770 82 20,963 5,013 2,270

-4
+1 -4
-6
+9
-3
-62
+3
-13
-3

12,484 33,825 29,129 95,094
12,100 25,746 23,689 63,875
143
73,358 2,639
53,743 44,367

+11
+7
+10
+8
-7 +2 -1
+3
-76
-8 -1 -60 -29

Maternal and Child Health

123

INFANT DEATHS
DEATHS UNDER ONE YEAR OF AGE
GEORGIA

1924

:>TAL
.,675

1943

---------------------------------- I

EACH AGURE REPRESENTS

OTAL

500 DEATHS

~.661

MATERNAL DEATHS
IEATHS FROM CAUSES PERTAINING TO CHILDBIRTH
GEORGIA
1924

' ' ,_, ' t ' TOTAL 708

1943

' t t TOTAL 303

EACH FIGURE REPRESENTS 100 DEATHS

124

Georgia Department of Public Health

EMERGENCY MATERNITY AND INFANT CARE PROGRAM
Following numerous conferences with representatives of the Children's Bureau and the Advisory Committee of the Medical Association of Georgia, the Emergency Maternity and Infant Care Program (a Children's Bureau program providing medical and hospital care to wives and infants of men in military service who are in pay grades four, five, six and seven) was initiated in Georgia on September 15, 1943. Although unanimous approval by representatives of the Medical Association of Georgia was not obtained, the majority voted to approve the program for the duration of the war and six months thereafter. It was maintained by members of the Advisory Committee that the fees allowed were not commensurate with existing fees, and that it would be difficult to secure participation by the necessary number of hospitals. Approval was given with the understanding that this service would be rendered by the medical profession for patriotic purposes only.
Due to the fact that the Emergency Maternity and Infant Care Program is largely concerned with maternity care, and inasmuch as the .Advisory Committee to the Division is composed altogether of pediatricians, it has been suggested to the president of the Medical Association of Georgia that a combined maternal and child health advisory committee be appointed. The director considers it desirable to have this committee fully acquainted with the details of the Emergency Maternity and Infant Care program in order that a complete report, including recommendations, may be made at the next annual meeting of the Medical Association of Georgia. Numerous activities concerned with the Emergency Maternity and Infant Care program should be formulated in collaboration with this advisory committee. Numerous modifications of the program will be necessary from time to time due to the fact that the program was not outlined in sufficient detail to permit its administration without change. The program, as it relates to the medical profession, will be thoroughly reviewed by the committee.
Prior to the initiation of the program, all general hospitals in Georgia admitting obstetric and/or pediatric cases, were inspected to determine whether or not they met minimum requirements outlined by the Children's Bureau. Because of their desire to participate, numerous hospitals were re-inspected, and it was found necessary for many to alter present services. These inspections proved helpful by virtue of the fact that attention was called to many undesirable situations in the hospitals and led to the correction of these situations in many instances.
Some of the difficulties encountered in securing hospital participation revolved around the hospital's inability to provide a calculated per diem rate, inability, due to limited bed capacity, to provide adequate facilities, inability to meet minimum requirements outlined by the Children's Bureau, and inability, due to increased cost during the first few days following

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125

admission, to provide sufficient days of care to secure cost of services rendered.
Those physicians practicing in rural areas have expressed themselves as favoring the program to a greater degree than have those in urban areas. This is largely due to the differential in fees and the varying degree of time and effort expended in providing more complete obstetric care.
As of December 31, 1943, 53 hospitals arranged to participate in this program. Of these, 13 were operated by Army or Navy personnel. At the close of the year, a number of areas in the State were without hospital facilities for cases eligible under this program. Judging from the response during December, it is doubtful that many additional hospitals will participate.
The following statistics will give detailed information in regard to the Emergency Maternity and Infant Care activities from September 15 to December 31, 1943:

Maternity Care:

No. Women Receiving Care

Deliveries among cases completed _____

192

a. Person in attendance:

(1) Doctor of medicine___________

192

b. Place of delivery: (1) In hospitals _____________________ _ ____ _______________ _____________ 104

(2) At horne _____________________________ ---------------------------------- 88

Cases completed ____________

77

Total cases completed ________________________________________________________

199

Both services of attending physicians and hospital care paid for,

but paid separately ______ ___________________ ________________ _________________

46

a. Physicians' services

b. Hospital care (Days of hospital care-380)

Attending physicians paid but not hospital care

90

Hospital care paid but not attending physicians _______________

59

(Days of hospital care-660)

Consultation service ____________________ --------------------------- __________________________ 3

I26

Georgia Department of Public Health

Infant Care:

No. Cases Receiving
Care

Total ______

20

Both services of attending physicians and hospital care for sick

infants paid for but paid separately

_________________ 2

a. Physicians' services

b. Hospital care (Days of hospital care-I2)

Attending physicians paid for care of sick infants, but not hospital

care ----------------------------------------------- ________________

I7

Hospital care paid for care of sick infants, but not attending

Physicians _________________

I

(Days of hospital care-4)

Consultation service __

I

RABUN COUNTY MATERNITY HOME
The first maternity home in Georgia, operating on a community basis as a local health department activity and meeting minimum requirements for the protection of many of its patients, was opened November I942 in Rabun County. The home continued to function throughout I943 with remarkable success. This maternity facility furnishes a splendid example of the value of stimulating a community to take care of its health needs, rather than the establishing and operating of such facility from the federal or State level. It would be difficult to find citizens of Rabun County who are not acquainted with the activities and services provided by this maternity home. The pride of all is evident from the interest expressed by citizens throughout the county.
Although inadequate housing was provided during I943, the maternity home is now assured of being housed in a suitable structure provided with adequate equipment for its purposes. Through the financial assistance of a foundation, the community has been able to secure the necessary funds with which to renovate an existing structure in such a manner as to provide the necessary space and equipment. Though the county is relatively small in area and has a population of less than 8,000, its citizens were able to raise local funds with which to match, in part, a grant made by the foundation. During I943, architectural plans were completed, and arrangements to convert the existing structure into satisfactory quarters, Were being made.

Maternal and Child Health

127

It should be thoroughly understood that such a facility is not suitable for all localities. Since a minimum case load is necessary for the economical operation of such a facility, and because of the fact that this type of facility should, under no circumstances, be operated in areas where hospital facilities are provided, it is necessary to be very careful in selecting the areas for this type of facilitv.
The advantages of the centralized facility for intrapartum care is immediately evident to those who have observed the program now in operation at Rabun County. It would be impossible to assure the attendance of a physician at all home deliveries, just as it would be impractical to provide constant nursing care to mothers and infants on an individual home basis. A review of the statistical activities is convincing proof of the magnitude of services which a single trained nurse-midwife or obstetric nurse can render in such a facility. The reduction in physicians' time for confinement cases in the maternity home as compared with confinement in the patient's home is such as to make it possible for physicians to attend a much larger number of cases with the expenditure of less time and effort, but nevertheless securing better results and providing better care.
The Rabun County maternity home has been financed entirely from local funds, except for services of a nurse-midwife who has been loaned by the Georgia Department of Public Health for a period of time during which she is to develop the nursing standards of care and routine pro cedures. It is anticipated that an adequately trained obstetric nurse will replace the nurse-midwife in view of the fact that physicians willingly accept all cases for delivery whether they be service cases referred from the prenatal health center or private cases.
One of the advantages of the maternity home is that it provides intrapartum care for all expectant mothers in the county regardless of race, social or economic status. The provision for payment on the basis of financial status makes it possible to serve all cases and yet preserves for the individual the feeling of having paid for her care rather than having been an object of charity.
It is evident that there are many dangers inherent in the operation of such a facility, unless adequate precautions are exercised to insure transfer to hospitals of such abnormal cases as require care not available in the maternity home, to insure adequate nursing care, to provide for necessary safeguards for patients who might otherwise be unnecessarily exposed to infection, to insure necessary medical services, to provide for employment of proper medical and nursing procedures in the care of mothers and infants, to provide housing, to insure segregation of cases and to provide for routine inspections by qualified personnel.
Financial data is not available at the present time as regards cost per case for services rendered in the Rabun County Maternity Home. It is hoped that an analysis of expenditures for operation of the maternity home

128

Georgia Department of Public Health

will enable us to arrive at a definite cost figure per case so that other communities may have information on this point. At the present time, the cost per case will average about $40.00. Provided adequate intrapartum care is rendered, it is doubtful that such service can be offered for less than this amount of money under any plan that has been attempted. The followin~ statistical report will provide definite information as to services rendered during the year 1943. It is most encouraging to note that 118 expectant mothers were admitted out of a total of 160 estimated births in the county. Since this is the first full year of this program's operation, its acceptance by the citizens of the county is viewed as heartening. The fact that no Negro births occurred in the home is due not to lack of provisions therefor, but to the very small number of Negro families residing in the county.

ACTIVITIES OF RABUN COUNTY MATERNITY HOME January 1- December 31, 1943

White

Antepartum admissions ___

---------------- -------------------- 118

(a) Private physician's cases _________

91

(b) Health center cases ______________ ---------------------------------- 27

(c) Others ------------------------------------------------------------------------ 0 Deliveries by physicians----------------------------------- __________________ 0

Deliveries by physicians, assisted by nurse or

nurse-midwife -----------------------------------------

107

Deliveries by nurse-midwife__________________________________________

6

Deliveries by others______________________________________ _ _________________ 2

Stillbirths occurring in maternity home________________________________ 3

Labor cases with complications__________________________________________ 3

Operative obstetric cases ______________________ ------------------------------- 3 Postpartum admissions (delivered in maternity home)____ 114 Postpartum admissions (delivered elsewh~re) __________________

Cases transferred to hospitaL___ ------------------------------------------ 1
(a) Antepartum cases _____________ ---------------------------------- 1 (b) Postpartum cases.____________________ -------------------------------- 0 (c) Newborn ____________________ -------------------------------------------- 0 (d) Premature infants --------------------------------------------- 0 Public health nursing visits in maternity home_______________4008 (a) Antepartum ____ .----------------------------------------------------- 127 (b) Intrapartum ------------------------------------------------------------ 70 (c) Postpartum --------------------------------------------------------------1720 (d) Newborn ------------------- -----------------------------------------.1670 (e) Premature infant -------------------------------------------- 421

Colored
0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

Total
118 91 27
0 0
107 6 2 3 3 3
114
1
0 0 0 4008 127 70 1720 1670 421

Maternal and Child Health

129

ACTIVITIES OF RABUN COUNTY MATERNITY HOME (Continued)

White

Days of care_

----------------------------- _____2093

(a) Antepartum -------------------------------------------------------------- 101 (b) Postpartum -------------------------------------------------------------- 891%

(c) Newborn __ -------------------------------------------------------- ------ 896% (d) Premature ---------------------------------------------------------------- 178 (e) Infant (over 4 wks.) __________________ --------------------------- 26

Newborn admissions (born in maternity home)________________ 108

(a) Premature infants ---------------------------------------------------- 9

Newborn admissions (born elsewhere)----------------------------- 1 (a) Premature infants ---------------------------------------------------- 1 (b) Infant (over 4 wks.) ---------------------------------------------- 1

Morbidity cases ------------------------------------------------------------------- 2

(a) Antepartum

------------------------------------------------------ 1

(b) Intrapartum ----'--------------------------- ---------------------------- 1

(c) Postpartum -------------------------------------------------------------- 1

(d) Newborn ----------------- ------------------------------------------------ 1

(e) Premature ------------------------------- ----------------------------- 1

Births and deaths:

(a) Maternal deaths ------------------------------------------------------ 0 (b) Infant deaths ---------------------------------------------------------- 1 (c) Live births ---------------------------------------------------------------- 111

(d) Stillbirths ---------------------------------------------------------------- 3

(e) Abortions ----------------------------------------------------------------- 3

Instruction and demonstrations to practical nurses__________ 639

Instruction and demonstrations to cases ______________________________ 368

Colored
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0

Total
2093 101 891% 896% 178 26 108 9 1 1 1 2 1 1 1 1 1
0 1 111 3 3 639 368

130

Georgia Department of Public Health

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 MATERN~L DEATHS, AND RATES PER 1,000
LIVE BIRTHS IN GEORGIA, 1943

White

LIVE BmTHs: Number ___ ------------------------------------- ________________ 50,149 Rate -------------------------------------- ________________________ 24.6

STILLBIRTHS:

Number --------------------------------------------

1,238

Rate -------------------------------------------------------------- 24.7

MATERNAL DEATHS:
Number ---------------------------------------------------------- 150 Rate ---------------------------------------------------------------- 3.0

INFANT MoRTALITY:
Number --------------------------------------------------------Rate ----------------------------------------------------------------

1,911 38.1

Negro
28,178 26.0
1,426 50.6
153 5.4
1,750 62.1

Total
78,327 25.1
2,664 34.0
303 3.()
3,661 46.1

NUMBER AND PER CENT OF LIVE BIRTHS BY ATTENDANT, BY COLOR, IN GEORGIA, 1943

White

Physician ------------------------ 47,795

Midwife ---------------------------- 2,277

Other --------------------------------

77

Number
Negro
9,397 18,741
40

Total
57,192 21,018
117

Per Cent White Negro Total

95.3

33.3

73.0

4.5

66.5

26.8

0.2

0.2

0.2

NUMBER OF STILLBIRTHS AND RATE PER 1,000 LIVE BIRTHS BY ATTENDANT, BY COLOR, IN GEORGIA, 1943

White

Physician ------------------------
Midwife ---------------------------Other -----------------------------

1,168 64 6

Number
Negro
636 780 10

Total
1,804 844 16

White
24.4 28.1 77.9

Rate
Negro
67.7 41.6 250.0

Total
31.5 40.2 136.8

Maternal and Child Health

131

MIDWIFE PROGRAM
The following table presents the number of midwives certified during the years 1932-1943. It is apparent that the decline in number of midwives certified during 1943 foreshadows the disappearance of midwives from many communities. At the present time, several communities are without any midwives, and this situation will necessarily make it imperative that some other type of intrapartum care be developed.
The decline in both white and Negro midwives has occurred each year for the period reported, but the decline in 1943 is the result of certification of the minimum number of midwives needed for the present case load served by them.
Though many counties have an excessive number of midwives, numerous others do not have a sufficient number to meet current demands. The refusal to certify unsatisfactory midwives is partly responsible for the decline, but deaths among the aging group continue to be an important factor. Likewise, the policy of certifying only those new applicants who are needed for existing case load and the more rigid requirements for certification have contributed to the decline in certifications. Perhaps the inability to secure a midwife will enhance the development of a better type of confinement care. The need for care will continue, and the providing of such care will require the interest of all concerned. In this way, facilities can be made available.

MIDWIFE APPLICATIONS, DEATHS, AND CERTIFICATIONS BY AGE GROUP

1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

Initial Certifications by Age Groups

w. c. Certifications
Total

Age

Applications.\'Iidwife

Under 50 50-65 Over 65 Tnknown Total Refused Deaths Retired

3358



3562



3434

3510 316 3194






3297

326 2971

3171



3049

298 2751

2951

2861

267 2594

2594 253 2341

37

22

4

2412 233 2179

25

13

3

2203 200 2003

24

16

6

2949

3463

125

3402

99



3510

223

135 3509

165



134

518

134

59

749

85



75

653

86

5

68

638

71



2

43

447

64

37

52

394

46

45

*Figures not available.

132

Georgia Department of Public Health

According to incomplete statistical data, maternal and infant mortality showed the lowest rate ever recorded in Georgia while number of births reported exceeded those reported in previous years. The birth rate showed a 8. 7 per cent increase over rate reported for 1942.
The total number of stillbirths was the lowest ever recorded. The stillbirth rate declined 13.5 per cent as compared with rate reported for 1942.
The maternal death rate showed a significant decline in both white and Negro cases, and the rate of 3.9 maternal deaths per 1,000 live births is the lowest figure yet recorded in Georgia. This represents a 5 per cent decline in the maternal death rate for 1943 as compared with the 1942 rate.
Infant mortality showed a most satisfactory decline, the most significant decline occurring among Negro infants. The 1943 death rate of 47.1 infants (under one year of age) per I ,000 live births, represents a decline in rate of more than 5 per cent as compared with the rate reported for 1942.
Physicians attended 95.3 per cent of all white cases in comparison with 93.1 per cent for 1942. Likewise, physicians attended an increased percentage of Negro cases, making a total of 73.1 per cent of all maternal cases attended by physicians. The number of maternal cases attended by midwives declined among both white and Negro, and established the lowest percentage of cases attended by midwives ever reported, namely, 26.8 per cent of total live births as compared with 30.4 per cent for 1942. Surprisingly enough, deliveries by others (principally cases attended by neighbors) decreased in spite of the decline in number of physicians and midwives available for confinement cases.

Division of PubHc Health Education
C. D. BoWDOIN, M.D._____________________________________________________________Acting Director

Division of Public Health Education

The activities of the Division of Public Health Education are still restricted due to the Director's being in the Armed Forces, the higher wages to be secured in other fields by the personnel and to the restriction of travel not only to our staff, but to the lay public for getting to such meetings.

The chief function of the Division at the present time is the maintenance of an up-to-date film library and a supply of worthwhile health literature. The motion picture films are sent to Regional, Citv, County or District Public Health Personnel or to others when requested through the above officers. The literature on health subiects is mailed out upon request, to interested parties either for personal use or for use in the teaching of courses in health by teachers and other workers.

In addition to the above, a summary of the activities of the motion

picure showings by the Woman's Auxiliary of the Medical Association

of Georgia was kept for attendance by districts.



Motion picture films from our film library were shown 762 times to an audience of 139,014 persons. Several new films were added to the collection during the year. After a preview of those new films available, the best and most useful films are purchased for use in our program. The outstanding films added during the year were on the subjects of malaria, nutrition and syphilis.

During the year, 415,435 pieces of public health literature were distributed by the Division. In addition, the requests for information not available in published form were answered by personal letters.

LITERATURE DISTRIBUTED-1943
DIVISION OF PUBLIC HEALTH EDUCATION

January

----------------------------------------------------- _________________ _____________ 46,116

February ---------------------------------------------------------------------------------------------- 46,509

March ---------------------------------------------------- _________________ ----------------------------- 22,664

ApriL ... ---------------------------------------------------------------------~------------------118,929

May ________________________________ ------------------------------------------------ ____________ 19,817

.Tune ----------------------------------- ______________________________________________:_________________ 28,263

July __________________ __________________ __________ _______ __ ___________

19,948

August .... _______________

------------------------------------------------------------ 23,713

September ----------------------------------------- _______________________________________________ 21,654

October ___________________ -------------------------------------------------------- ________________ 25,117

November --------------------------------------------------------------------------------------- 31,339 December _________________________ -------------------------------------------------------------------- 11,375

T o t a l ... ---------------------------------------------------------------------------415,435

136

Georgia Department of Public Health

FILM REPORT-1943
DIVISION OF PuBLic HEALTH EoucATION

No. times films

January ___________________ ______________________ ________________

were shown
50

February ____

_______________ ___________________ 51

March ___________________________________________ ----------------------------- 134 April _______________ _______________ _ ____________ _____________________ 141

May ------------------------------------------------------------------------------ 59 June ---------------- --------------------------------------- _____________________ 24

July ------------------------------------------------------------------------------ 41

August ------------------------

__________

37

September ______ _________________ __________

32

October _____________________ ___________ ______________ _______________

68

November ___________________________ ________________ _______________________ 61

December ________ --------------------------------------- ___________________ 64

TotaL

762

Attendance
9,999 6,625 23,818 34,666 7,605 12,775 2,740 6,603 2,993 9,668 10,636 11,426
139,014

MEDICAL LIBRARY
The library of the State Department of Public Health, set up in the new State Office Building in 1940, passed in July 1941 from the supervision of the Work Projects Administration of Georgia to that of the Department. A Staff Library Committee was appointed by the Director, consist ing of Dr. C. D. Bowdoin, Dr. T. F. Sellers, Dr. Justin Andrews, Mr. W. H. Weir, and Dr. R. V. Schultz. It was decided to retain as librarian Miss Pearl Motley under whose direction the work of organizing and cataloging the collection had been started, and the WPA continued to furnish help.
According to the plan adopted, the Department Library is intended, primarily, to serve the needs of the official health workers in the State of Georgia, but it is open to the general public for reference use during the regular working day of the Department. In addition to the central collection, the Department has small collections in the regional offices an,d branch laboratories. The catalog including all these is furnished in duplicate in each regionaloffice. A loan service, including the collections in the divisional and_ regional offices, has been set up, making it possible for public health officials throughout the state to write in and get material as they need it. Outsiders have this privilege also, provided they comply with certain regulations.
Our collection may be roughly divided into books, pamphlets (including reprints) , journals, official reports, and health department bulletins. All these have been classified and cataloged according to the Dewey Decimal system, the pamphlets being placed in classified order in labeled pamphlet boxes. The bulletins-state, city, county, and foreign-have been filed in labeled loose-leaf covers. The reference shelves show works

Public Health Education

137

such as the Quarterly Cumulative Index Medicus (1938-1944), the American Medical Directory (1923-1942), six titles of the Practical Medicine Series of year books, Tobey's Public Health Law, Georgia Code of 1933, Georgia Laws, et cetera. A substantial start has been made, moreover, in the fields of preventive medicine, public health engineering, laboratory and research, communicable diseases, maternal and child health, industrial hygiene, malaria control, nursing, and nutrition.
The War Emergency, with its increase in the work load of the Department and accompanying decrease in the force at work, has naturally affected the Library. The lack of adequate help, especially the first half of the year, held back the work and prevented the accomplishment of some of the things that had been planned. The addition of a regular clerical assistant in June, however, has been a great help and has made possible the addition of several activities hitherto impossible.
During 1943, the Library undertook two new activities. The first was the compilation, with the cooperation of staff members, of a reading list for the lay reader entitled Reading in the Field of ~ublic Health. A copy of this was sent to each health office in Georgia-both state and local-and to the official head of each public library in the hope that it might help to promote reading in this field. The second of the activities added was the compilation of monthly indexes of current periodicals for the use of the divisional offices.
It is of interest to note here that the Department this year added to the portrait collecion begun in he Library a portrait of Mr. R. F. Maddox, Chairman of the State Board of Health, and one of Mr. R. C. Ellis, member of the Board and, also, author of the Ellis Health Law. Others thus honored previously are: Dr. T. F. Abercrombie, Director of the Department since 1917; Dr. H. F. Harris, Director of the Department from 1903 to 1917; and Dr. J. P. Bowdoin, Deputy Commissioner from 1918 until his death in 1942.
Users of the Library outside the Department have included, during 1943, health officers from various parts of the state, members of the welfare departments of the state and of the City of Atlanta, the National Resources Planning Board, the Atlanta Tuberculosis Association, officers of the United States armed forces stationed in and around Atlanta, the Library of the U. S. Department of Agriculture (Atlanta Branch) and teachers and students of a good many Georgia schools and colleges.

Division of Preventable Diseases

C. D. BowDOIN, M.D. _______ ----------------------Director and Epidemiologist

JoHN M. WALTON, M.D------------------------------.Venereal Disease Control

WILLIAM J. MURPHY, M.D ------------------------------------------Cancer Control

LESTER M. PETRIE, M.D.............................----.lndustrial Hygiene DAVID M. WoLFE, M.D...________________ ______________________ Assistant Epidemiologist

RoY J. BosTON, Engineer_

______________________________Typhus Fever Control



Division of Preventable Diseases
CANCER CONTROL SERVICE
The state-aid cancer program functioned without interruption throughout the year. Diagnostic and treatment service was provided for all eligible patients who were approved for state-aid. No major changes in policy were made during the year.
One of the twelve treatment centers (Dalton) discontinued its services to state-aid patients. Dr. D. L. Wood, radiologist, entered the armed services in October and the Dalton Clinic has not accepted any patients since that time. All of the other clinics gave uninterrupted service throughout the year.
Applications. During 1943 applications for state-aid totaled 1915 as compared with 2,249 in 1942. This represents a decrease of almost 15 per cent and marks the first time since the program was inaugurated that the number of applicants fell below that of the previous year. The decline in the number of applications was first observed during the latter half of 1942 and probably reflects changing economic conditions and transportation difficulties.
Clinic Activities. During 1943 a total of 1,723 patients reported to the state-aid clinics for the first time. Of this number, 974 were diagnosed as having cancer, 723 were diagnosed as having non-malignant disease and in 26 cases the diagnosis was deferred. The proportion of malignant cases (56.5 per cent) continued to decline, being appreciably lower than the corresponding figure (59.8 per cent) for 1942.
In addition to the cases which reported for the first time, 661 patients of previous years received diagnostic and treatment service during 1943.
In Table I is shown the total number of patients reporting to the clinics for the first time and the number of malignancies observed according to the site of the lesion. A comparison is also made with the average annual number of malignancies of similar type which reported during previous years. The figures for 1943 are quite similar to the previous averages. In a few types, such as cancer of the skin and lower lip, some decrease occurred in 1943 while in others, such as cancer of the mouth and lungs, an increase was noted. Nevertheless, the two groups of figures are quite similar. When color is taken into consideration, however, it is noted that white cases of both sexes decreased while colored cases increased. Not shown in the table, but worthy of mention, is the proportionate increase shown on the part of colored females over white females with respect to cancers of the breast and cervix. During the year, 52 colored females reported with cancer of the breast as compared with 42 white females while the corresponding figures for cancers of the cervix were 98 and 86 respec-

142

Georgia Department of Public Health

tively. During previous years white cases of each type had predominated in about the ratio of 5 to 4.
In Table II is shown the frequency with which biopsies were employed to confirm the dia~nosis of malignancy. Biopsies were performed least often in cancers of the skin and lower lip where 21.8 per cent and 21.2 per cent, respectively, of the diagnoses were confirmed by microscopic examination of tissue. For all other sites combined biopsy was employed in 65 per cent of the cases.
Financial Aid. A total of 2.047 patients received financial aid during the year. Of this number, 1,504 had cancer while 543 had non-malignant lesions. An additional 260 patients with benign lesions and 77 patients with cancer received diagnostic service without charge to the state. The sum of $84,694.91 was expended for diagnosis and treatment.
Of the total amount spent for the care of indigent cases, the sum of $61,263.95 was expended in behalf of the 1,723 patients who reported to the clinics for the first time during 1943. Of this amount. ~27,471.50 or 44.8 per cent of the totRl was snent fnr hospital board. This represents the largest single item of expenditure in the state-aid program.
Of the patients reporting for the first time during the year, 755 or 43.8 per cent were hospitalized. These patients spent 7,849 days in the hospital or an average of 10.3 days per case. The average cost per case of all patients reporting for the first time during 1943 amounted to $35.55. In the case of hospital patients. the average cost amounted to $67.91 while for all others it amounted to $10.32. This latter group includes 337 patients for whom no charge was made. Table III shows for each clinic the number of patients reporting, the amount of hospitalization provided and the cost per case.
In addition to the patients who reported for the first time during 1943, bills were paid in behalf of 661 patients of previous years. In Table IV is shown the total expenditures for the year for malignant and nonmalignant cases upon whom bills were paid.
A summary of activities for the year is shown in Table V in comparison with similar activities for 1942. Total expenditures for 1943 declined considerably although the average cost per case increased slightly.
Tabulation of Data. The task of transferring to punch cards data from the clinic records was completed during the year. At the present time, cards have been punched for all patients who were approved for state-aid from the beginning of the program through December 31, 1943.
Educational. Educational activities by the Women's Field Army, the State Cancer Commission and the Cancer Control Service continued as in previous years. An additional feature was the preparation of material on

Preventable Diseases

143

cancer to be used in the biology classes of the high schools of the state. This method of approach should in time have a decided influence on the attitude of the layman with respect to cancer.

Educational activities of the Cancer Control Service are listed below:

Addresses made -------------------------------------------------------------- 20 Meetings attended other than those addressed _______________ 4
Consultations and miscellaneous visits__________________________ 15

Articles written ________________________ -------------------------------------- 6

Exhibits shown ----------------------------------------------------

1

Literature distributed ------------------------------------------------------1,517

144

Georgia Department of Public Health

TABLE I.
PATIENTS REPORTING TO CLINICS FOR THE FIRST TIME
1943

Site of Lesion

No. Patients Reporting 1st Time

Skin ------------------------------ 544 Lower Lip____________________ 51 Mouth____________________________ 83
Breast---------------------------- 171 Larnyx. _________________________ 12 Lungs and Bronchi_______ 15 Esophagus ____________________ 4 Stomach_________________________ 53
Colon ---------------------------- 24 Rectum -------------------------- 27 Cervix __________________________ 338 Body Uterus_________________ 143
Ovary---------------------------- 9 Other female genitaL__ 31 Prostate_________________________ 18 Penis ______________________________ 7
Testicle______-------------------- 6
Kidney-------------------------- 5 Bladder________________________ 6
Bones ---------------------------- 25 Soft tissues ___________________ 53
Brain -------------------------- 1 All others_____________________ 97

Number Malignant
444 33 46 97 9 8 1 11 12 10
184 13 6 15 10 3 1 1 4 4 4 1 57

Per Cent Malignant

Average Annual No. Malignancies
1937-1942

81.6

495

64.7

53

55.4

31

56.7

109

75.0

6

53.3

3

25.0

2

20.7

10

50.0

7

37.0

11

54.4

182

9.0

14

66.6

4

48.3

10

55.5

8

42.8

7

16.6

2

20.0

4

66.6

6

16.0

7

7.5

17

100.0

2

58.7

46

TotaL __ -------------- 1,723

974

56.5

1,036

STATE-AID CASES FOR 1943 By Sex and Color

Number Reporting

White male ___________

453

White female _______________ 767

Colored male __

107

Colored female ____________ 396

TotaL___________________ 1,723

Number Malignant
335 384
so
205
974

Per Cent Malignant
73.9 50.0 46.7 51.5
56.5

Annual Malignancies
1937-1942
406 423
38 169
1,036

Preventable Diseases

145

TABLE II.
MALIGNANT CASES REPORTING FOR THE FIRST TIME MicRoscoPIC CoNFIRMATION oF DIAGNOSIS
1943

Site of Lesion

Number Malignancies

Skin_________________________________________________ 444 Lower lip________________________________________ 33 Mouth_______________________________________________ 46 Breast._______________________________________________ 97

Larnyx --------------------------------------------- 9 Lungs and Bronchi_________________________ 8 Esophagus________________________________________ 1 Stomach____________________________________________ 11
Colon______________ ----------------------------------- 12 Rectum___________----------------------------------- 10 Cervix______________________________________________ 184 Body Uterus___________________________________ 13 Ovary______________________________________________ 6 Other female genitaL___ _________________ 15
Prostate ------------------------- _____ 10 Penis_------------------------------------------------ 3 Testicle ------------------------------------------- 1 Kidney--------------------------------- ___________ 1
Bladder--------------------------------------------- 4 Bones---------------------------------- 4 Soft tissues__ ______________ _____________________ 4 Brain.._______________________________________________ l
All others__________________________________________ 57

TotaL___________________ _________________ 974

Number Biopsies
97 7
25 51
7 3 l 4 9 9 141 12 5 8 5 3 l
3 3 1
32
427

Per Cent of Diagnoses
Confirmed
21.8 21.2 54.3 52.5 77.7 37.5 100.0 36.3 75.0 90.0 76.6 92.3 83.3 53.3 50.0 100.0 100.0
75.0 75.0 25.0
56.1
43.8

I46

Georgia Department of Public Health

TABLE III.

HosPITALIZATION AND CosTs PATIENTS REPORTING FOR THE FIRST TIME
I943

... "'
"' .c.~.:.

Clinic

..Q ~
"' g.
z~

Americus

I35

Augusta___

269

Canton _____

42

Columbus____________ 39

Dalton_________________ 32

LaGrange_____________ 65

Macon__________________ 397
no Savannah_____________

Sheffield_______________ 22I

Thomasville_________ I83

Waycross------------- Ill Winship____________ ll9

....

.!":'l

. . .. .. J~
z"a="'

]
c...;. ""&' rl.l E-<=Q

62 825 I35 I,480 IS I49 I3 3I3
7 I09 4I 32I I76 I,347 35 334 I34 I,506 63 645 26 II6 48 704

-...."I..I'O!."~.l' ...
<=Q
13.3 I0.9 9.9 24.0 IS.S 7.8 7.6 9.5 Il.2 I0.2 4.4 I4.6

--_<.;.....
. .. .. ..C.I.S ."w' .......
""'"~ 6,897.82 10,260.97 I,3Il.50 2,I24.00 I,2I5.50 3,395.58 .II,4IS.I3 2,944.92 I0,460.59 4,648.I8 2,036.47 4,553.29

TotaL____________ I,723 755 7,849 I0.3 6I,263.95

. .~".o'~<-- ..c.:.
. .. .. ~~:!
<'-'~
51.09 38.I4 31.22 54.46 37.98 52.23 28.75 26.77 47.33 25.39 I8.34 38.26
35.55

TABLE IV.
SuMMARY OF PEOPLE oN WHoM BILLS WERE PAID FOR DIAGNOSIS AND TREATMENT IN CANCER CLINics WITH CosT FOR
CALENDAR YEAR - 1943

Americus____________________ Augusta______________________ C a n t o n ________________________ Columbus _________________ D a l t o n ________________________ LaGrange____________________ Macon _________________________ Savannah____________________ Sheffield ______________________ Thomasville ________________ Waycross__________________ W i n s h i p _______________
TotaL__________

No.
Cases
122 222 50 47 39 85 333 69 183 168 68 118
--
1504

MALIGNANT

Amount

Average Cost

8,353.60 9,246.02 1,673.50 2,971.13 1,523.93 4,508.69 12,194.11 3,825.19 9,845.06 6,356.63 2,308.62 4,953.72
67,760.20

68.47 41.65 33.47 63.22 39.08 53.04 36.62 55.44 53.80 37.84 33.95 41.98
--
45.05

NON-MALIGNANT

No. Cases

Amount

Average Cost

MALIGNANT and NON-MALIGNANT

No. Cases

Amount

Average Cost

48 1,616.19 33.67

115 3,760.25 32.70

14 472.50 33.75

11 439.86 39.91

4

44.00 11.00

14 470.82 33.63

126 3,170.86 25.17

33

638.30 19.34

85 3,633.75 42.75

36 1,360.86 37.80

21

270.50 12.88

36 1,056.82 29.36

170 9,969.79 58.65

337 13,006.27 38.59

.~...

Cb

64 2,146.00 33.53

~ Cb

58 3,410.99 58.81

~

43 1,567.93 36.46

0"

99 4,979.51 50.30

1b

459 15,364.97 33.47

t)
&:

102 4,463.49 43.76

Cb
~

268 13,478.81 50.29 204 7,717.49 37.83

Cb
"'

89 2,579.12 28.98

154 6,010.54 39.03

543 16,934.71 31.19

2047 84,694.91 41.38

The above summary includes only patients on whom bills were paid. In addition, 260 patients with benign lesions and 77 patients with malignant lesions received diagnostic service without charge to the state.

~

148

Georgia Department of Public Health

TABLE V.

SUMMARY OF ACTIVITIES

APPLICATIONS
Total received -----------------------------------------------Number approved ----------------------- __________________ Number disapproved -------------------------------------Counties represented ________________________________

1942
2249 224S
4 ISS

1943
I9IS I9I4
I
1S2

CASE REPORTS FROM CLINICS

Classed as malignant__________________________

1199

974

Classed as non-malignant_________________

789

723

Deferred diagnosis _______________________________________

14

26

CASES GIVEN FINANCIAL AID
Total cases -----------------------------------------------------Malignant ________ ----------------------------------------------Nonmalignant ___ -----------------------------_______________

2226 I64I S8S

2047 1S04 S43

AMOUNT OF FINANCIAL AID GIVEN

Total amount given______________________________________ $9I,18l.37

Average amount per malignant case

(Including only those cases for which a

charge was made)--------------------------------------Average amount per non-malignant case

44.64

(Including only those cases for which a

charge was made)---------------------------------------

30.6S

$84,694.9I 4S.OS 31.19

Number of cases for which no charge was made:

Nonmalignant --------------------------------------------

2I8

260

Malignant ----------------------------------------------------

71

77

Preventable Diseases

149

TABLE VI.

SuMMARY oF PEOPLE ON WHoM BILLS WERE PAID FOR DIAGNOsis AND

TREATMENT IN CANCER CLINics WITH CosT FOR CALENDAR YEAR-1943

Counties

. ... .=.
....= .... :;~
::<lu

=.=.

;;
~

..

Z"= u.~.

_.,
..":-oU"'

..

;.=..

c-~;"~'

Counties

::<lu

_.,
""'~:-I=U

Appling ______

7

Atkinson ____ 2

Bacon ~---------

6

Baker __________

8

Baldwin ______ 11

Banks __________ 8

Barrow --------

5

7

2

4

3

9

2 10

4 15

1

9

4

9

196.00 66.50 78.80
886.94 791.54 498.05 305.20

Dade ___________

2

2

22.00

Dawson ________ 2

3

5

162.00

Decatur ________ 12

2 14

449.15

DeKalb _______ 34 11 45 1,533.65

Dodge _________ 12

6 18

663.97

Dooly ------------ 24

7 31 2,189.93

Dougherty __

9

2 11

979.42

Bartow --------

7

8

Ben Hill ____ 4

2

6

412.25 42.50

Berrien ________

5

5

307.50

Bibb ------------ 75 20 95 4,051.55

Bleckley ______ 9

2 11

165.45

Brantley ____ 5

5

45.00

Brooks ________ 10

2 12

370.59

Douglas ______ 10

7 17

554.06

Early _________ 22

5 27

836.40

Echols ________

2

74.00

Effingham __

4

1

5

355.60

Elbert _________

4

4

8

224.50

Emanuel ______ 40 22 62 2,013.37

Evans __________

3

3

101.00

Bryan ---------

3

Bulloch _______

8

Burke

20

Butts ------------

8

Calhoun _____

9

Camden _____

4

Candler ________ 2

2

5

235.25

2 10

236.55

6 26 1,429.00

4 12

518.54

2 11

701.57

5

38.00

2

211.00

Carroll ________ 17 11 28 1,147.85

Catoosa ________

1

1

2.00

Charlton ____ 1

2

111.50

Chatham ---- 33 18 51 2,243.09

Chattahoochee 1

1

79.50

Chattooga __

6

7

106.50

Cherokee ___ 17

2 19

718.75

Fannin ________ 12

Fayette

5

Floyd ____________ 2

Forsyth ________ 5

Franklin ____ 7 Fulton ________

5 17

6

2

2

7

495.85 126.90
65.00 319.00 358.10

Gilmer

4

2

6

404.00

Glascock ____ 2

2

4

70.50

Glynn

4

4

201.05

Gordon ________

9

2 11

290.00

Grady __________

6

7

461.00

Greene ________ 15 12 27 1,204.35

Gwinnett ____ 17

9 26

699.85

Habersham

4

5

9

487.25

Clarke __________ 13

Clay--------------

1

Clayton ______ 4

Clinch __________ 2

Cobb ------------ 17

Coffee ---------- 12 Colquitt _____ 42

Columbia ____ 8

Cook ____________

4

Coweta ________ 22

Crawford ____ 4

Crisp __________ 16

14

980.05

1

2.00

2

6

174.63

2

78.50

17

941.93

4 16

528.92

9 51 1,286.54

4 12

289.00

4

303.08

4 26 1,225.03

2

6

189.95

4 20

691.99

Hall

11

Hancock

9

Haralson

Harris __________

6

Hart ____________ 2

Heard _________

5

Henry __________ 10

Houston ______ 8

Irwin __________

8

Jackson ________ 10

Jasper ________

3

Jeff Davis____ 3

11

3 12

2 10

2

8

2

1

6

4 14

3 11

8

7 17

4

7

6

399.50 198.05 823.70 468.00 240.75 328.14 722.05
509.82 297.95 778.92 417.68 154.50

150

Georgia Department of Public Health

Counties

..;..

.... . -.. . ......
0:

0:
~

:;; ... 0:
~u

~:1
0:"'
Zu 0 ..

...,....
... u

Jefferson __ Jenkins Johnson_ Jones _ Lamar __ _ Lanier Laurens
Lee Liberty Lincoln Long Lowndes Lumpkin McDuffie
Mcintosh Macon Madison Marion Meriwether Miller Mitchell

21

2 23

13

9 22

6

3

2

5

8

2 10

4

4

37 12 49

5

13

3

4

16 13 29

2

2

13

3 16

4

15

4 19

3

4

15

5 20

5

5

17

18

10

3 13

11

14

Monroe

13

Montgomery

8

Morgan

2

Murray ___

6

Muscogee

28

Newton

5

Oconee

3

Oglethorpe

7

Paulding

10

Peach

2

Pickens

5

Pierce

Pike

3

Polk ___ _

7

Pulaski

5

Putnam

10

Quitman

Rabun __________

8

Randolph ____

5 18

14

3

5

4 32

3

8

4

4 11 2 12 7
5 10
3 6 13

2

7

4 14

4 12 11

~
u0
726.55 1,459.25
140.55 118.58 353.50
74.00 985.00
750.97 227.50 1,316.73
27.00 682.69 494.95 475.00
87.50 134.85 604.50 288.50 955.95 212.50 580.90
901.59 284.75 154.25 304.20 2,305.56 562.10 165.50
336.10 299.88 342.00 253.75 282.05
35.00 877.56
493.49 392.56
294.07 595.65

Counties

..........
0: 0:
:;~
~u

.......
0:
0:
..:;
:.;
0: ..
zo~"'

_. ...
..,u..0.. .".'

Richmond Rockdale Schley Screven Seminole Spalding Stephens

11

21 21 42

2

11

5 16

5

3

8

Stewart _ Sumter Talbot Taliaferro Tattnall ___ _
Taylor Telfair

2

18 13 31

6

5

7

6

2

8

6

18

27

Terrell

8

Thomas

15

Tift

6

Toombs

26

Towns _

Treutlen

12

Troup __________ 31

2 10 4 19 1 6 32
1 17 6 37

Turner Twiggs Union Upson Walker Walton Ware
Warren _____ _ Washington Wayne Webster Wheeler White Whitfield

6

4 10

7

9 16

4

4

19 12 31

10

10

15

20

2 10

16

4 12

4

5

6

12

13

2

2

10

11

Wilcox __ _ Wilkes Wilkinson Worth

9

11

13

12

4 16

9

2 11

....
[! u
660.45 1,788.36
449.86 910.85 286.50
79.50 1,954.62
89.70 254.40 319.50 349.60 742.72
622.89 973.58 267.90 705.78 114.75 218.90 1,876.53
323.01 315.20
96.50 844.32 542.50 1,347.30 558.90
573.30 551.71 114.50 288.65 344.72
13.00 734.25
493.20 391.30 797.12 752.46

Total __ 1,504 543 2,047 $84,694.91

Preventable Diseases

151

EPIDEMIOLOGIC SERVICE
Personnel
General supervlSlon of the activities of the Epidemiologic Service is conducted by the Director of the Division of Preventable Diseases. In addition to the regional staff members, who have the direct responsibility of making epidemiologic investigations, one other staff member was delegated to assist in epidemiologic investigations upon request. Office procedures were handled by the Director and one stenographer. Statistical data were compiled and tabulated by the Central Tabulating Unit.
Functions
The Epidemiologic Service functioned during the year in collecting and disseminating data pertaining to the incidence of preventable diseases. Weekly and monthly reports were mailed to health officers, U. S. Public Health Service and others interested, giving the reported incidence of diseases by counties. Daily reports of cases of major diseases were sent to regional medical directors in order to expedite epidemiologic investigations, and all requests for special investigation of disease outbreaks were studied and recommendations made. A classified medical directory of physicians in the state by counties and type of work was kept up to date and notices of all known changes were transmitted to other public health workers.
Field Visits
Exclusive of field VISits made in connection with malaria and hookworm control, activities of which were delegated to that particular division, a total of 1,023 field visits was made in the control of preventable diseases during 1943. A total of 1,462 visits, 439 more than the 1943 figure, was made during 1942. This shows that 30.0 per cent less visits were made in 1943 than in 1942. This reduction is justified in that there was a reduction in the incidence of those diseases in which investigations and studies are indicated. Comparing the number of field visits made by staff members an,d public health nurses, we find that, of the 1,023 trips made, 80.0 per cent were made by public health nurses. This, in all probability, was due to the fact that release cultures for typhoid and diphtheria were taken by nurses, which procedure requires more than one visit to a case. The following table shows the distribution of field visits by diseases, nurses and staff members made in non-health officer counties:

152

Georgia Department of Public Health

SuMMARY OF AcTIVITIES IN THE CoNTROL OF PREVENTABLE DISEAsEs, 1943 AND 1942

Type of Activity

Regional Medical Directors and State Epidemiologists

1943

1942

Public Health Nurses

1943

1942

Total

1943

1942

Consultations with physicians 128 Admissions to medical servict 1482
Admissions to nursing service
Admissions to medical and/01 nursing service___________________

304 2246

2534

3375

128 1482 2534 2781

304 2246 3375 3635

Field Visits:

Diphtheria________________________ 9 12 297 240 306 252

Measles _______________________________

4 43 95 43 99

Poliomyelitis----------------------- 7 23

3 31 10 54

Scarlet fever----------------------- 11 Smallpox_____________________________ 15

6 72 174 83 180

7

9

5 24 12

Typhoid and paratyphoid 100 125 179 338 279 463

Typhus ____________________________

28

lO

4 10 32 20

Whooping cough__________ Others ____________________________

2

2 94 49 96 51

33 103 117 228 150 331

Total field visits _____

205 292 818 1170 1023 1462

Note-Admissions to medical and nursing service include those admitted to malaria and hookworm service.

Field Visits by Counties
The following tabulations will show the number of field visits made in the control of specified and other preventable diseases in non-health officer counties for 1943 as reported by regional medical directors, public health nurses, and staff members of this Division:

DIPHTHERIA:
Barrow ______ ----------------------- 20 Bartow ______ _______________________ l 7 Ben Hill ____ ----------------------- 2 Brantley ---------------------------- 3 Carroll ------------------------------ 8 Clinch ______ _________________________ 5 Effingham ------------------------- 1

Fannin _____ ______ _______ __ 3 Fayette ____ _____ _____ _________ 3

Forsyth ----------------------------- 3

Gordon ________________

82

Haralson ____________________________ 3

Jackson ____________________________ 19

Jasper -------------------------------- l

Preventable Diseases

153

Jeff Davis ----------------------- 12 Lanier ------------------------------ 17 Monroe ------------------------------ 1 Murray ------------------------------ 8 Newton ------------------------------ 1 Pierce -------------------------------- 1

Pike _______________ __________________ 5
Randolph -------------------------- 3 Toombs ------------------------------ 11 Upson -------------------------------- 75 Webster ---------------------------- 2

MEASLES:

Bryan -------------------------------- 1 Butts ______________________________ 12

Douglas ---------------------------- 1

Fannin ------------------------------ 7

Forsyth __________________

4

Peach _____ -------------------------- 7 Pike ------------------------------------ 7 Turner ------------------------------ 2 Twiggs ----------------------------- 1 Upson -------------------------------- 1

ScARLET FEVER:
Butts ________________________________ 25 Echols ________________ ______________ 5 Fannin _______________ ______________ 4 Forsyth ______________ ______________ 3 Glascock ---------------------------- 2 Gordon _____________________________ 10
SMALLPOX:
Screven ------------------------------ 8 Union ------------------------------- 11

Jackson ------------------------------ 1 Jeff Davis ------------------------- 5 Lumpkin ---------------------------- 2 Macon -------------------------------- 4 Montgomery ______________________ 19 Stewart ------------------------------ 3
Walton ---------------------------- 1 Webster ---------------------------- 4

TYPHOID:
Butts __________ _______________________ 5
Catoosa ------------------------------ 1 Chattooga -------------------------- 3 Cherokee ---------------------------- 4 Clayton ------------------------------ 10 Coweta ------------------------------ 5 Dooly -------------------------------- 17 Douglas ------------------------------ 1 Effingham -------------------------- 5 Evans -------------------------------- 2 Fayette ------------------------------ 5 Fannin ------------------------------ 14 Franklin ---------------------------- 21 Forsyth __________ ___________________ 2
Gilmer ------------------------------ 2 Gordon ---------------------- _______ 11

Hart ---------------------------------- 2 Heard -------------------------------- 7 Henry -------------------------------- 4 Houston --------------------------- 7 Jackson ------------------------------ 2 Jasper -------------------------------- 4 Jeff Davis -------------------------- 1 Lamar -------------------------------- 7 Lumpkin ---------------------------- 13 Macon ------------------------------ 11 Marion ------------------------------ 1 Monroe ------------------------------ 9 Morgan ____________________________ 33
Murray ------------------------------ 6 Oglethorpe ------------------------ 2 Paulding --------------------------- 6

I 54

Georgia Department of Public Health

Pike --------------------------------- I8

Pickens ____________________

I

Polk----------------------------------- 3 Randolph -------------------------- 6
Schley ------------------------------ 6 Talbot _ _____ _____________________ I

Taliaferro -------------------------- 2 Upson ___ ____________________________ 7 Warren _____ ________________________ 2 Webster _____________________________ 4 Wilkes __ _____________________ _ 4 Wilkinson __________________________ 2

TYPHUS FEVER:

Baker ---------------------------------- I

Butts _--------------------------------- I

Glascock ---------------------------- I Houston ____________________________ 3

Macon_

6

Peach ___ _____ ___

I

Schley ___________________ ___________ 8

Talbot ----------------------------- I

Tattnall ------------------------------ 3 Taylor ________________________ 5

Upson _______

_____ I

Webster ______________________________ I

WHOOPING CouGH:
Barrow ____________ Brantley Butts ______________ Charlton ________________ Dawson -----------------Effingham ___________ Evans ______________

I3 6 I2 I2 2 I --- I2

OTHERS:

Baker ________________________

I

Barrow ____________________ ___

2

Bartow -----------------------

I

Brantley __________________

4

Bryan -------------------------

6

Butts ---------------------------------- 2

Chattooga ________________

I

Cherokee ________________ __

I

Clayton ------------------------------ I Clinch _____________________________ I4

Cook --------------------------------- I Douglas ---------------------------- 3 Effingham ------------------------- 4 Evans -------------------------------- 29 Fannin -------------------------------- 2 Fayette ------------------------------ I

Henry _______________________________ 2

Jasper _________________ _____________ 7

Lumpkin __________ __________ 7 Macon _______________ _____________ 4 Peach ________________ ____________ I

Pierce

I3

Treutlen __

4

Forsyth _________ _________________ 7

Glascock

____________________ 3

Henry

_____________ 2

Houston

____________________ I

Lamar __________ _____________________ I

Lanier ___________________ __________ 9

Lumpkin ____________ _____________ 36

Macon -------------------------------- 2 Monroe ______________________________ I

Murray ------------------------------ 2
Peach -------------------------------- 2 Polk -------------------- _____________ 2 Tattnall ______________ _______________ 2
Upson ________________ _______________ 4

Webster ---------------------------- 3

Preventable Diseases

155

S peciallnvestigations
Gastro-Intestinal Outbreaks. On March 17, upon request from the chief medical officer of the U. S. Naval Pre-Flight School, Athens, Georgia, the assistant state epidemiologist made an investigation of a series of gastro-intestinal outbreaks occurring at the Pre-Flight School since December, 1942. It was related that the original set-up was for about 1,800 cadets, but at the time of investigation there were approxi- . mately 2,400 cadets, a number which overtaxed the existing facilities. Accompanied by the captain and chief petty officer, the epidemiologist visited the John Paul Jones Mess Hall in the Baldwin Administration Building and the dairy barn and creamery. It was recommended: (1) that immediate reporting of cases of gastro-enteritis to local county health officer be done, (2) that the seating capacity of present mess halls be enlarged to accommodate the expected capacity, (3) that certain indicated sanitary measures be instituted, and (4) that re-examinations of food handlers, sick with any condition thought to be communicable, be carried out before being allowed to return to work.
On May 2, 1943, an investigation was made of an outbreak of gastroenteritis, involvin~ 211 cases, at the U. S. Naval Wave Training Station, Milledgeville, Georgia. Thorough studies, made by the assistant state epidemiologist and a sanitary engineer from the Division of Sanitary Engineering, indicated that this food infection, in all probability, was caused by unsanitary milk.
In addition to the above two outbreaks, two known gastro-enteritis outbreaks occurred in health officer counties, one in Thomas County during the first week in June and the other in Glynn County the fi.rst of February. The one in Thomas County involved some four or five hundred people and, according to the health officer's report, this outbreak appeared to be fly-borne. The one which occurred in Brunswick was reported to be caused by food. Upon the examination of sandwiches connected with those who ate them and became ill, it was found that the meat filling showed heavy contamination with staphylococci.
Tuberculosis. This investigation was made during the month of August in response to a request from the Cherokee County Superintendent of Schools, who stated that several cases of tuberculosis had been reported among children attending the Toonigh School and that the teachers were afraid to teach there. Accompanied by the medical director of the Northwestern Health Region, one of the staff members met with the county school superintendent and the county commissioners and later called on one of the teachers who had been teaching there for several years. It was found that the cause of the alarm was a series of cases of tuberculosis among those families where cases had occurred over a period of years and had involved only adult members of the families. One of the cases had died with tuberculosis during the current summer and a 19 year old

156

Georgia Department of Public Health

boy in one of the other families had active tuberculosis at the time of investigation. Nine children in the three families attended school, ages ranging from 6 to 13 years. There was no outward manifestation of tuberculosis in any of the children. The real problem was that parents with children of school age were seriously considering keeping their children out of school. Moreover, another problem was encountered in regard to getting teachers to teach there. Anxiety was allayed by a frank discussion with respect to the improbability of the children being infectious for others. It was decided that the best solution to the problem would be the examination of all members of the three families to determine whether or not they were infectious. A side effect of the effort was the creation of sentiment in favor of a county health department.
Typhus Fever. During the month of March, two special investigations were made in connection with typhus fever incidence in Jenkins and Coffee Counties. In both instances all reported cases that could be located were interviewed, 12 in Coffee County and ll in Jenkins County. History cards were obtained on all in Coffee County except one who claimed to have had the disease in Appling County. There was a wide distribution of the cases within the city and they were spread generally over the county. From the number of cases of typhus that have occurred in both Coffee and Jenkins County, as well as the information obtained through case investigation, one must necessarily conclude that the rat population of both counties is a problem of serious proportions, and can look forward only to conditions being worse in time to come, unless a program is worked out with widespread publicity to get the cooperation of the entire population of each county in a systematic effort to rid the areas of rats.
Trachoma. Following up information furnished by the regional medical director of the East Central Health Region, three children in the Chester School, Dodge County, were examined for trachoma in February. The little girl showed signs of the disease, but the two boys appeared to have chronic conjunctivitis and no typical signs of the disease. Visits were made in several homes in rural areas where a number of patients were found with chronic conjunctivitis and some three or four showed typical signs of trachoma. One white man, age 68, gave a history of having had trouble with his eyes for ten years. He had lost the sight of one eye and was practically blind in the other eye. In all probability, this man was the source of cases found, as most of the patients were his nieces and nephews or close contacts of the three persons. The formation of a clinic for these people to receive treatment un(ler the care of local physicians was urgently recommended to the regional medical director.
Analysis of Statistical Reports
Comments on the morbidity and mortality rates in connection with reportable diseases are based on per 100,000 population and the fatality rates are the percentages of cases that were reported as deaths.

Preventable Diseases

157

Diphtheria. The number of reported cases of diphtheria continued to decrease, 520 cases being reported in 1943 and 660 in 1942, a reduction of 140 cases, or 21.2 per cent. The case rates for each year respectively were 16.6 and 21.1. In 1943, 47 deaths were reported and the previous year 55, a reduction of 14.5 per cent. The fatality rate increased from 8.3 per cent in 1942 to 9.0 per cent in 1943.
Dysentery. From 1942 to 1943 the number of cases and deaths from dysentery, amebic and bacillary decreased from 584 cases and 86 deaths to 459 cases all)d 79 deaths. The case rate dropped from 18.7 to 14.7 and the mortality rate from 2.8 to 2.5. The fatality rate increased from 14.7 to 17.2.
Hookworm. There was a reduction of 26.2 per cent of cases of hookworm reported in 1943 compared with 1942, 4,617 cases having been reported in 1942 and 3,409 in 1943. This is of no particular significance, due to the fact that the hookworm program was curtailed in personnel and case finding was consequently diminished. Deaths reported from hookworm decreased from 2 to l.
Influenza. Influenza reached approximately epidemic proportions in 1943 when 13,238 cases were reported, while only 2,900 were reported in 1942. Likewise the deaths increased from 482 to 624, but the fatality rate decreased from 16.6 per cent to 4.7 per cent, indicating a less virulent form of this disease. Sulfa drugs probably played an important role in reducing deaths due to secondary invaders.
Malaria. The percentage reduction in cases of malaria reported for 1943 compared with 1942 was 46.5, and the decrease in deaths for corresponding years was 51.3 per cent, in 1942 the number of cases being 981 and deaths 76 and in 1943 the cases being 525 and deaths 37. The case rates for the two years, 1942 and 1943, were 31.4 and 16.8 and the death rates were 2.4 and 1.2 respectively. Fatality percentage declined from 7.7 to 7.0.
Measles. The reported incidence of measles has continued on the downward swing since 1941 when we had an epidemic year. In 1942, 5,921 cases were reported with a case rate of 189.5 and in 1943, 4,413 were reported with a case rate of 141.3. The deaths numbered 60 in 1942 and 27 in 1943 with mortality rates of 1.9 and 0.9. True to form, the fatality rate decreased from l.O per cent to 0.6.
Meningococcus Meningitis. More cases of this disease were reported in 1943 than have ever been recorded since the Epidemiologic Service was set up. During this year, 211 cases with a case rate of 6.8 were reported, while the previous year only 53 cases with a case rate of 1.7 were reported. The percentage increase in cases was 74.9. The increase in deaths over the previous year was 41.9 per cent, 31 deaths being reported for 1943 and 18 the previous year. The reduction from 34.0 per cent fatality rate

158

Georgia Department of Public Health

to 14.7 is approximately 50 per cent less than all previous years on record, indicating the value of sulfa drugs in the treatment of this disease.
Pellagra. Fewer cases of pellagra, as well as deaths, were recorded in 1943 than any previous year. 208 cases and 175 deaths, and during 1942, 257 cases and 181 deaths were reported. The case rates for 1942 and 1943 were 8.2 and 6.7 and the death rates were 5.8 and 5.6 respectively. The fatality rate made a rise from 70.4 to 84.1 over the previous year.
Pneumonia. Comparing the pneumonia morbidity and mortality figures for 1942 and 1943, we have a 9.0 per cent reduction in the number of cases, but a 7.0 per cent increase in the number of deaths, 4,172 cases being reported in 1942 and 3,797 in 1943; 1,612 deaths in 1942 and 1,734 in 1943. The case rate decreased from 133.6 to 121.6 and the death rate increased from 51.6 to 55.5. The fatality rate increased from 38.6 to 45. 7.
Poliomyelitis. The 28 cases of polio reported in 1943 was the smallest number ever recorded in Georgia. Likewise, the three deaths from this disease was the smallest number ever reported in one year. The case rate was reduced from 1.6 to 0.9 and the death rate from 0.3 to 0.1. The fatality rate was cut practically 50.0 per cent, the rates being 20.4 in 1942 and 10.7 in 1943.
Scarlet Fever. There was a reduction from 1,148 cases of scarlet fever in 1942 to 964 in 1943, but an increase from 2 deaths to 6 deaths. The case rate dropped from 36.8 to 30.9, the death rate increased from 0.1 to 0.2, and the fatality rate increased from 0.2 to 0.6.
Smallpox. Twelve cases of smallpox were reported in 1943 and 7 in 1942, an increase of 5 cases, or 71.4 per cent. The case rates for the comparable years were 0.2 and 0.4 respectively. No deaths from smallpox were reported either year.
Tuberculosis. Here we also find a decrease in the number of cases, but an increase in the number of deaths as well in the fatality rate. In 1942, 3,067 cases and 1,265 deaths were reported and in 1943, 2,981 cases and 1,304 deaths. The rates for 1942 and 1943 were 98.2 and 95.4 for cases and 40.5 and 41.7 for deaths respectively, while the fatality rates were 41.2 and 43.7.
Typhoid Fever.. From 1,252 reported cases of typhoid in 1934, we had a remarkable decline to 208 in 1943, and the 23 deaths, also, was the smallest number ever recorded, decreasing from 316 in 1934 to 23 in 1943. In 1942, 384 cases and 24 deaths were reported from this disease. The case rates for 1942 and 1943 were 12.3 and 6.7 and the death rates for the same years were 0.8 and 0.7. The fatality rate increased from 6.3 in 1942 to 11.1.

Preventable Diseases

159

Typhus Fever. The past two years gave an increase in the number of cases of typhus fever over the previous two years, and the year 1943 increased over 1942 8.2 per cent in cases reported and 8.8 per cent in deaths reported, 1,153 cases in 1942 and 1,256 in 1943 having been reported. In 1942, 52 deaths were recorded and in 1943, 57 deaths were recorded, giving mortality rates of l.7 and 1.8. The fatality rate decreased from 4.6 to 4.5.
Urululant Fever. With the exception of two years, when no deaths were reported, from 1 to 3 deaths have been reported each for undulant fever, and while no deaths were reported in 1942, 3 were reported in 1943. However, the number of cases reported decreased from 129 to 98. The case and death rates for 1942 and 1943 were 4.1 and 3.1 for cases allld 0.0 and 0.1 for deaths respectively. The fatality rate was 3.1.
Venereal Diseases. Twelve deaths were reported from gonorrhea in 1943 and 6 in 1942, which gives exactly a 50.0 per cent increase in deaths. The number of cases of gonorrhea reported in 1942 was 16,786 and in 1943, 10,028. The case rates for the two years were 537.4 in 1942 and 321.0 in 1943. The fatality rate for gonorrhea increased from 0.03 to 0.1. The number of syphilis cases for both years was practically the same, 21,544 in 1942 and 21,548 in 1943. Deaths decreased from 462 in 1942 to 435 in 1943 and death rate from 14.8 to 13.9. The fatality rate for syphilis decreased from 2.1 to 2.0.
Whooping Cough. The largest number of cases of whooping cough was reported since the year 1938 when 2,329 were reported, and likewise, the largest number of deaths since the same year, when there were 225, was recorded. During the year 1943, 1,749 cases and 170 deaths were reported from this disease and in 1942, 1,369 cases and 101 deaths were recorded. From 1942 to 1943 the case rate increased from 43.8 to 56.0, the death rate from 3.2 to 5.4 and the fatality rate from 7.4 to 9.7.
Summary. Diphtheria, dysentery, gonorrhea, hookworm, malaria, measles, pellagra, pneumonia, poliomyelitis, scarlet fever, tuberculosis, typhoid fever, and undulant fever decreased in the number of cases reported and influenza, meningococcus meningitis, smallpox, syphilis, typhus fever and whooping cough increased. The number of deaths from diphtheria, dysentery, hookworm, malaria, measles, pellagra, poliomyelitis, syphilis, and typhoid decreased and the number of deaths for gonorrhea, influenza, meningococcus meningitis, pneumonia, scarlet fever, and tuberculosis increased over the previous year.

Typhoid Carriers
During 1943, a list of all typhoid carriers in the State of Georgia was prepared, giving name, color, sex, and age as well as address, date reported, and attending physician. This list was prepared in alphabetical

160

Georgia Department of Public Health

orlder for the entire State and then broken down by county of resident. These lists were sent to all public health personnel in the State asking that they check on those persons in their area, at their leisure, to determine whether or not they were still carriers. The response to this request has been good, but the migration of carriers from one place to another has necessitated considerable correspondence and follow-up to complete the investigation of many of these individuals. Because this work is being done as the workers are on business in the region in which the carrier resides and because of the shortage of public health personnel, it will take some time to complete the study. A complete report of the study will be made at a later date. According to our records, we now have on file 194 typhoid carriers in the State, 15 of which were found during 1943.

Educatiorwl Activities
Twelve meetings promoting public health activities were attended by the Director during the year, and 9 other similar meetings with an estimated attendance of 825 were addressed by him. A total of 22,368 bulletins relating to the control of preventable diseases was distributed.
The Director attended 36 special conferences other than regular office interviews and conferences. These conferences were held for the promotion of activities connected with all the services under his supervision.

Preventable Diseases

161

NUMBER OF CASES AND DEATHS FROM SPECIFIED NoTIFIABLE DISEASES
REPORTED IN GEORGIA, 1939-1943 WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY

Disease Diphtheria: Dysentery: Gonorrhea: Hookworm: Influenza: Malaria: Measles:

Year
1939 1940 1941 1942 1943
1939 1940 1941 1942 1943
1939 1940 '1941 1942 1943
1939 1940 1941 1942 1943
1939 1940 1941 1942 1943
1939 1940 1941 1942 1943
1939 1940 1941 1942 1943

Cases

Case Rate Per 100,000 Population

1112 543 758 660 520
585 582 516 584 459

35.3 17.4 24.1 21.1 16.6
18.6 18.6 16.4 18.7 14.7

4583 5282 7229 16786 10028

145.7 169.1 229.8 537.4 321.0

20384 17306
7143 4617 3409

647.9 554.0 227.1 147.8 109.1

11592 13420 36021
2900 13238

368.5 429.6 1145.3
92.8 423.8

2996 2502 1122
981 525

95.2 80.1 35.7 31.4 16.8

3423 3282 11009 5921 4413

108.8 105.1 350.0 189.5 141.3

Deaths

Death Rate Fatality Per 100,000 Rate Population (Per Cent)

95

3.0

8.5

59

1.9

10.9

63

2.0

8.3

55

1.8

8.3

47

1.5

9.0

127

4.1

21.7

126

4.0

21.6

109

3.5

21.1

86

2.8

14.7

79

2.5

17.2

24

0.8

0.5

22

0.7

0.4

24

0.8

0.3

6

0.2

0.03

12

0.4

0.1

8

0.3

0.04

1

0.03

0.01

2

0.1

0.04

0.03

0.02

950

30.4

8.2

924

29.6

6.9

994

31.6

2.8

482

15.4

16.6

624

20.0

4.7

101

3.2

3.4

89

2.8

3.6

75

2.4

6.7

76

2.4

7.7

37

1.2

7.0

51

1.6

1.5

23

0.7

0.7

157

5.0

1.4

60

1.9

1.0

27

0.9

0.6

162

Georgia Department of Public Health

NUMBER OF CASES AND DEATHS FROM' SPECIFIED NoTIFIABLE DISEASES
REPORTED IN GEORGIA, 1939-1943 WITH RATES'PER 100,000
POPULATION AND PER CENT FATALITY

Disease

Year

Meningitis: (Meningococcus) 1939 1940 1941 1942 1943

Pellagra:

1939 1940 1941 1942 1943

Pneumonia:

1939 1940 1941 1942 1943

Poliomyelitis:

1939 1940 1941 1942 1943

Scarlet Fever:

1939 1940 1941 1942 1943

Smallpox:

1939 1940 1941 1942 1943

Syphilis:

1939 1940 1941 1942 1943

Cases

Case Rate Per 100,000 Population

Deaths

Death Rate Fatality Per 100,000 Rate Population (Per Cent}

35 27 35 53 211
745 429 334 257 208
4765 4480 3623 4172 3797
101 30 790 49 28
1055 1000 1079 1148 '964
47 11 11
7 12
20183 21259 19540 21544 21548

1.1 0.9 1.1 1.7 6.8
23.7 13.7 10.6
8.2 6.7
151.5 143.4 115.2 133.6 121.6
3.2 1.0 25.1 1.6 0.9
33.5 32.0 34.3 36.8 30.9
1.5 0.4 0.3 0.2 0.4
1'41.7 680.6 621.3 689.7 689.8

15 9 17 18 31
271 235 204 181 175
2299 2055 1714 1612 1734
12 7 33 10
19 16
9 2 6
473 587 503 462 435

0.5 0.3 0.5 0.6 1.0
8.7 7.5 6.5 5.8 5.6
73.6 65.8 54.5 61.6 55.5
0.4 0.2 1.1 0.3 0.1
0.6 0.5 0.3 0.1 0.2
15.1 18.8 16.0 14.8 13.9

42.9 33.3 48.6 34.0 14.7
36.4 64.8 61.1 70.4 84.1
48.2 45.9 47.3 38.6 45.7
11.9 23.3
4.2 20.4 10.7
1.8 1.6 0.8 0.2 0.6
2.3 2.8 2.6 2.1 2.0

Preventable Diseases

163

NuMBER OF CAsEs AND DEATHS FROM SPECIFIED NOTIFIABLE DISEASES
REPORTED IN GEORGIA, 1939-1943 WITH RATES PER 100,000
PoPULATION AND PER CENT FATALITY

Disease

Year

Tuberculosis:

1939 1940 1941 1942 1943

Typhoid Fever :

1939 1940 1941 1942 1943

Typhus Fever :

1939 1940 1941 1942 1943

Undulant Fever:

1939 1940 1941 1942 1943

Whooping Cough : 1939 1940 1941 1942 1943

Cases

Case Rate Per 100,000 Population

2996 2805 2635 3067 2891
564 487 397 384 208
1131 589 944
1153 1256
121 123 117 129
98
1614 1020 1406 1369 1749

95.2 89.8 83.8 98.2 92.5
17.9 15.6 12.6 12.3
6.7
35.9 18.9 30.2 36.9 40.2
3.8 3.9 3.5 4.1 3.1
51.3 32.7 44.7 43.8 56.0

Deaths

Death Rate Fatality Per 100,000 Rate Population (Per Cent)

1533 1533 1385 1265 1304
83 68 55 24 23
44 26 36 52 57
2 3 2
3
134 108 140 101 170

49.1 49.1 44.0 40.5 41.7
2.7 2.2 1.7 0.8 0.7
1.4 0.8 1.1 1.7 1.8
0.1 0.1 0.1
0.1
4.3 3.5 4.5 3.2 5.4

51.2 54.7 52.6 41.2 43.7
14.7 14.0 13.9
6.3 11.1
3.9 4.4 3.8 4.6 4.5
1.7 2.4 1.7
3.1
8.3 10.6 10.0
7.4 9.7

164

Georgia Department of Public Health

NoTIFIABLE DISEASES REPORTED BY CoLOR, SEx AND AGE IN GEORGIA, 1943

Diphtheria
Age Level by Years w c

Amebic Bacillary* Dysentery Dysentery
wcwc

Malaria
wc

Measles
w

Meningoccus Meningitis
wc

Under 1 year

M

16

2

F'

7

5

1- 2 years

M 27

5

2- 3 years

F 11

6

M 33

8

F 19

6

3- 4 years

M 23

9

F 25

4 - 5 years

M 17 7

F 25

5 - 6 years

M

23

2

F 29

5

6- 7 years

M 19

4

F 17

3

7 .. 8 years

l\1 11

F

7

7

S- 9 years

l\1

7

3

F

8

9-10 years

M

4

F

8

10-14 years

M

14

2

F 15 5

15- 19 years

M

9

2

F

8

2

20-24 years

l\1

4

F

3

25-29 years

l\1

2

3

F

33

30-34 years

M

6

F

35-39 years

M

F

2

2

40-44 years

M

F

45-49 years

M

F

50-54 years

M

F

55-64 years

M

F

65- 74 years

M

F

75 and above

M

F

Unknown Age M

F

Total

M 215 46 10

F 191 54 12

22

9

2 22

6

4

14 10

22

2

3

15

6

26

5

2

15

4

27

4

12

4

31

12

1

38

7

5

34

5

5

4

30

4

5

2

37

3

2

46

8

2

3

36

3

5

3

38

3

4

80

5

3

3

2 89

2

72

4

103

5

2

67

5

1

70

I

2

I

2

1 51

1

1

1 46

3

6

12

1 103 10 12

6

5 95

7

6

1

2

12

32

6 15

2

6

9

3 29

7

5

1

6

14

86

4 11

2

8

18

8 21

5

6

4

12

9 27

2

2

11

15

9 22

3

3

4

15

5 14

4

5

21

4 10

I

.j

2

4

5

9

2

5

4

14

8

8

1

5

13

5

5

6

16

4

5

4

9

2

3

2

1

14 2

2

6

12

5

2

6

4

2

7

I

4

4

2

6

5

2

8

g

5

2

3

1

6

2

2

1

4

1

2

1

8

22

474

23

4

8

3 233

2

5 126 36 171 53 1211 72 113 14

3 128 34 164 65 934 63 52

* This also includes unspecified dysentery.

Preventable Diseases

165

NoTIFIABLE DisEASEs REPORTED BY CoLoR, SEx AND AcE IN GEoRGIA, 1943

Age Level by Years

Pellagra
wc

Pneumonia
wc

Poliomyelitis
wc

Scarlet Fever
wc

Sc:>ptic Sore Throat
wc

Smallpox
wc

Under 1 year

M

129 191

5

4

~'

115 153

4

5

1- 2 years

M

28 46

5

17

2

F

26 45

1 18

4

2- 3 years

M

17 19

1 31

F

19 20

27

3- 4 years

M

16 14

2

2 44

2

F

18

8

42

6

4

4- 5 years

M

6

8

42

5

F

11

48

2

5- 6 years

M

9

6

32

4

3

F

11

5

31

3

6- 7 years

M

6

6

39

4

F

8

3

59

2

7- 8 years

M

11

6

30

F

5

51

4

S- 9 years

M

8

2

33

2

F

8

39

2

9- 10 years

M

4

24

F

4

35

10- 14 years

M

34 10

1 37

2

F

18

6

1

101

11

15- 19 years

M

33 22

1

11

8

3

F

2 17 19

19

13

20-24 years

M

22 22

4

12

F

4 17 29

15

13

25- 29 years

M

20 25

6

12

F

1 24 22

11

15

4

30-34 years

M

1 28 34

1

12

3

F

2

6 15 23

12

18

2

35 - 39 years

M

2 33 24

11

li'

8 20 20

11

2

40-44 years

M

29 43

10

2

F

5

13 25

8

45- 49 years

M

30 43

3

F

15 32

2

50- 54 years

M

3

27 45

4

F

3

4 24 30

3

55-64 years

M

5 69 63

3

F 17

8 46 48

4

65 -74 years

M

9

3 80 42

2

F 23

9 86 36

75 and above

M

23

9 86 36

F 15

8 117 23

Unknown Age M

289 15

24

F

116 9

4

Total

M 31 22 l 011 707 lti

380 13 116 24

F 70 71 75a 561

4

3 fil2 27 135 24

166

Georgia Department of Public Health

NoTIFIABLE DisEASEs REPORTED BY CoLoR, SEx AND AGE IN GEORGIA, 1943

Tuberculosis Tularemia
Age Level by Years w c w c

Typhoid Fever
wc

Typhus Fever
wc

Undulant Fever
wc

Whooping Cough
wc

Under 1 year

M '2

5

F

2

1- 2 years

M

2

F

2

6

2- 3 years

M

3

2

2

2

F

4

3- 4 years

M

3

2

1

2

F

2

3

3

3

1

4- 5 years

M

1

3

2

2

F

4

2

4

4

1

5- 6 years

M

5

2

F

2

2

7

6- 7 years

M

2

5

F

4

2

4

7- 8 years

M

4

4

435

F

5

7

8 9 years

M

2

6

F

3

6

9-10 years

M

3

5

9

F

6

10 -14 years

M 13 12

2 10

8 51

F 11 26

2

1 12 37

4

1

15 19 years

M 22 54

2

3 10 74 10

4

F 28 93

5 28

9

20-24 years

M 43 77

2

4

6 42

8

F 53 137

3

1

5 33

8

25-29 years

M 55 76

6

4 50 10

9

F 74 90

4

6

5 37

6

3

30-34 years

M 70 92

7

5 45 17

8

F 57 72

3

2 43 11

2

35- 39 years

M 82 71

4

2 3 60 13 12

F 50 57

3

1

5 60

6

2

40-44 years

M 67 59

3

4

1 44 13 10

F 35 45

4

2

1 33

6

3

45-49 years

M 69 44

1

30

4

6

F 37 32

2

39

2

50-54 years

M 68 33

46

5

5

F 30 22

1

1 32

8

2

55 64 years

M

93 31

4

4

3 44

3

5

F 46 33

2

2

3

2 34

4

2

65- 74 years

M 46 19

1

:10

F 36

8

2 3 14 2

75 and above

M 12 10

3

F 17 1

21

Unknown Age M 77 322

2

43

6

3

F 29 10

1

39

3

Total

M 740 936 21 18 52 56 595 101 67

F 526 653 16 21 40 55 463 71 19

71 68

60 59

36 24

37 21

35 25

35 33

34 15

43 lG

35 17

42 19

24 12

24 13

38 10

43 10

25 15

25

5

17

8

24

5

11 4

9

7

16

9

17 11

6

11 1

2

3 1
8

7 356 208 3 370 204

Preventable Diseases

167

NuMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1943

Area

Censu Population

Diphtheria Cases Rate

Gonorrhea Cases Rate

Influenza Cases Rate

Malaria Cases Rate

State TotaL_____ ______ 3,123,723 R u r a L____________________... 2,062,070
Cities 2500-5000__________ 135,683
Cities 5000 and above.. 925,970
Military Reservta'ns___ Appling___________________ 14,497 Atkinson____________________ 7,093

Bacon_____________ 8,096

Baker----------- 7,344 Baldwin________ 16,411

USN Training Sch._____________

B a n k s ____________

8,733

Barrow______________________ 13,064

Bartow_________________________ 25,283

Ben HilL____________________
Berrien ______________ Bibb _________________

14,523 15,370 83,783

H. Smart Airport----------------Cochran Field___________________
Camp Wheeler______________________

Bleckley_____________________ 9,655

Brantley______________________ B r o o k s ____________________________ B r y a n ___________________________ B u l l o c h __________________________ Burke____________________________ Butts_________________________ Calhoun_________________________

6,871 20,497
6,288 26,010 26,520
9,182 10,438

Jamden ___________ Candler________________

5.910 9.103

CarrolL____________________ 34,156

Catoosa________________________.:. 10,899

Fort Oglethorpe____________________

Charlton__________________ 6,256

Chatham_______________________ 117,970

USN Section Base___________________

Fort Screven____________________

Savannah Air Base_____

Chattahoochee ___

5,138

Fort Benning_________________

Chattooga ---------------------- 18,532 Cherokee______________ 20,126

Clarke______________________ 28,398

USN Preflight Sch._________________

Clay______________________________ 7,064

Clayton _____________________

11,665

520 16.6 10028 321.0 13238 423.8

347 16.8 1379 66.9 4447 215.7

34 25.1

269 198.3

280 206.4

139 15.0 5135 554.6 8077 872.3

3245

434

1 6.9

12 82.8

183 1262.3

3 42.3

1 14.1

12.4

13.6

2 27.2

6.1

27 164.5

181 1102.9

4 45.8 5 38.3 6 19.8
6.9
9 10.7

4 30.6 4 15.8
20.7 2 13.0 96 114.6 4

55 629.8

62 474.6

2

7.9

3 19.5 13 15.6

4 63.6 4 15.4 6 18.9 2 19.2
5 14.6 2 18.4
2.5

306 38 393.6

16 78.1 1 15.9
35 134.6 35 132.0
10.9 12 115.0

11.0

2

5.9

2 18.4

646

4 76.1

254 216.3

18 186.4

4 58.2

2

9.8

128 2035.6

56 215.3

170 641.0

8 87.1

9.6

2 2 49 1 239 44 1965

33.8 22.0 143.6
9.2
837.1 1665.7

1010

14 75.5

:! 10.8

8 39.7

6 29.8

11 38.7

76 267.6

13

32 17~.7

2

9.fl

9 31.7

2 28.3 8.6

525 16.8 368 17.8
68 50.1 67 7.2 22 2 13.8
5 68.1 6.1
7.7
6.9 6.5
3 5 51.8
61 248.8 8 127.2
34 130.7 4 15.1 2 19.2 2 33.8 2.9
7 1 19.0 18 16.3
2 1 6.& 1 6.0

168

Georgia Department of Public Health

NUMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED 1943 NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs,

Area

Census Population Diphtheria
Cases Rate

Gonorrhea Cases Rate

Influenza Cases .::Rate

Malaria Cases Rate

Conley Sup. Depot __ Clinch_ Cobb Coffee
A . A . F . F . T . D ______________ Colquitt ____________
Spence Field

6,437 38,272 21,541
33,012

Columbia_ -----------------Cook ______

Coweta

Crawford Crisp_ Dade .. Dawson_

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

9,433 11,919 26,972
7,128 17,540
5,894 4,479

Decatur __

22,234

A.A.F.B. Fly. Sch._
DeKalb __ -------------------- 86,942 Lawson Gen. Hosp. __________

USN Air Base Dodge __ Dooly ____

21,022 16,886

Dougherty __
Turner Field Darr Aero Tech .... Douglas.
Early
Echols ___ --------------------
E f f i n g h a m..- - - - - - - -

Elbert __ Emanuel Evans_

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

Fannin --------------------------
Fayette. ----------------Floyd ____

Forsyth_ --------------------

28,565
10,053 18,679
2,964 9,646
19,618 23,517
7,401 14,752
8,170 56,141 11,322

F r a n k l i n ..

15,612

Fulton ..

----------- 392,886

Fort McPherson _

N AS-Ga. Tech _________ - -

Gilmer_

9,001

Glascock ------------------------ 4,547

Ghmn_

21,920

NAS-St. Simons _______ NAS- Glynco Gordon .. Grady __

18,445 19,654

15 5 4 10.5
B'/.1
10 30.3

25 65.3 28 1:!0.0
41 124.2

15.5 23 60.1 15 69.6
21.2

10.6 16.8
3.7
4 22.8

24 201.4

2

7.4

1 14.0

51 290.8

17.0

31.8 22 184.6
5 18.5
16 n.2 1 17.0

27.0

5

5.8

33.3

2 19.9 3 1.1

72.6
2 10.2 4.3

2 13.6

<2.2

16 28.5

1

8.8

1

6.4

44 11.2

16 72.0 42 19 21.9 125
16 76.1 4 23.7
91 :l18.6 43
10.7

5.1 21.3

22 13 150
2
12 1226

149.1 159.1 267.2
17.7
76.9 312.0

36.0 9 146 167.9 7
25 118.9 22 130.3
17 59.5 29
7 69.6 7 !37.5
33.7 22 228.1
4 20.4 13 55.3
5 67.6 2 13.6 1 12.2 590 1050.9 12 106.0
103 659.7 2276 579.3

22.8 19 103.0

12 9 15 81.3 56 284.9

11.1 22.0 15 68.4
75 406.6 3 15.3

5.2

2

6.1

12 100.7 3.7
14.0 5.7

10.5

1

1.2

4

14.3

31.5

2 10.7 20.7 12.8
12.2 11 19.6

9

2.3

13.7 10.8

Preventable Diseases

169

NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIES, 1943

Area

Census Population

Diphtheria Cases Rate

Gonorrhea Cases Rate

Influenza Cases Rate

Malaria Cases Rate

Greene_ Gwinnett __________
Habersham Hall Hancock _________________
Haralson Harris

13,709 29,087 14,771 34,822 12,764 14,377 11,428

Hart

15,512

Heard __

8,610

Henry ___

------------------ 15,119

Houston ___

11,303

Robins Field -------------------------

Irwin - ---------------------------- 12,936

Jackson_

20,089

Jasper_ Jeff Davis_ Jefferson __ Jenkins_ Johnson_ Jones Lamar

8,772 8,841 20,040 11,843 12,953 8,331 10.091

Lanier -------.------------

5,632

Laurens_

33,606

Lee

7,837

Liberty

------------------- 8,595

Camp Stewart-----------------------

Lincoln Long ___________________

7,042 4,086

Lowndes -----------------------Moody Field ___
Lumpkin Macon Madison _________ Marion McDuffie ___
Mcintosh ______ Meriwether_____________________ Miller Mitchell -------------------Monroe Montgomery .. Morgan _____
Murray_ Muscogee __ NewY,n Oconee Oglethorpe __

31,860
6,223 15,947 13,431
6,954 10,878
5,292 22,055
9,998 23,261 10,749
9.668 12,713
11,137 75,494 18,576
7,576 12,430

2 13.5 8 23.0
7.8
4 35.0 10 64.5
5 58.1
2 17.7
13 64.7 2 22.8 5 56.6 3 15.0
4 30.9 36.0
8 23.8
6 69.8

33 240.7

4 13.8

11 74.5

67 192.4

1

7.8

7.0

69.7

1

6.6

8 70.8

29

11 85.0

5.0

11.4 11.3 23 114.8 17 143.5
7.7

44 130.9 10 127.6
4 46.5

85 620.0 9 30.9 22 148.9
177 508.3 75 587.6
3 26.3
5 32.2 19 220.7
2 13.2 6 53.1
4 19.9
14 159.6 11.3
77 384.2 38 320.9
4 30.9 12.0
3 29.7
17.8 18 53.6 10 127.6 12 139.6

7.4

2

8.6

2 15.7 2 18.0 32 42.4

8 25.1 19 50 313.5
3 27.6
11 49.9 92 395.5
37.2 2 15.7
107 141.7 14 75.4 8.0

24.5
669 2099.8 55 152 2442.6

7.4 14.4
9.2
75.6 91 412.6
20.0 21.5 10 93.0

16 125.9

1

9.0

55 72.9

18 96.9

3 39.6

191 1536.6

7.3
8.8
6.6 4 35.4
38.7 4 19.9
2 10.0 8 67.6 10 77.2
11 32.7 21 2U8.0
11.6
48.9 28.2

18.9 4.5
4.3 9.3 10.3

4

5.3

170

Georgia Department of Public Health

NUMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED
1943 NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES,

Area

Census Population

Diphtheria Gonorrhea Cases Rate Cases Rate

Influenza Cases Rate

Malaria Cases Rate

Paulding ______ Peach. _____________________________
P i c k e n s _______________
Pierce _____ Pike _________________________________
Polk_________ ----------------------Pulaski __________________

12,832 10,378
9,136 11,800 10,375 28,467
9,829

P u t n a m ______________ Q u i t m a n ___________ R a b u n ________ R a n d o l p h _____________________ Richmond ___________

8,514 3,435 7,821 16,609 81,863

Oliver Gen. Hosp. ____ ---------------Camp Gordon.__________________________

Ga. Aero Tech_________________________
Camp Hancock _________________________
Daniel Field_________ --------------------Rockdale________________________ 7,724 Schley_____________________________ 5,033 Screven__________________________ 20,353 Seminole________________________ 8,492

Souther Field ___

28,427

Sumter----------------------- 12,972
Camp Toccoa ___ -------------------Stewart________________________ 10,603 Stephens______________________ 24,502 S p a l d i n g _______________________________________

Talbot _____________

8,141

Taliaferro_______________________ 6,278

Tattnall____ -------------------- 16,243 Taylor_____________________________ 10,768

Telfair ------------------

15,145

TerrelL. -------------------

16,675

Thomas_________________________ 31,289

Finney Gen. Hosp. ___________________

Tift________________________ 18,599 Toombs____________________________ 16,952
Camp Toombs___________________________

Towns ____________ Treutlen __________________________ Troup __________________________ Turner____________________________

4,925 7,632 43,879 10,846

T w i g g s ____________________________ Union ______________________________ Upson _____________________________ Walker_______________________

9,117 7,680 25,064 31,024

5 54.7 2 16.9
9.6 7 24.6
10.2

39 375.8 10.9 8.5 9.6
23 80.8
2 23.5

6 76.7

2 12.0

6 30.1

11 13.4 3002 3667.1

61

802

8 62.3 61 587.8 126 1379.2
8 67.8 28 269.9 262 920.4
6 70.5 2 68.2 8 102.3 289 1740.0 662 808.7

7.7 9.4

5 33.0

2 12.0

1

3.2

5.4 4 23.6
5 101.5 1 13.1 9 20.5

1 11.0 28 364.6
5 19.9 9 29.0

105 6 77.7
15 73.7
72 253.3 8 61.7
10 9.4
73 297.9

6 36.9

29 191.5 11 66.0 24 76.7 20

18 96.8

1

5.9

1 13.1 34 77.5 2 18.4
1 13.0
a 12.0
39 125.7

12 155.4 30 596.1
6 29.5 64 753.7
8 28.1 38 292.9 21 52 490.4 253 1032.6
2 24.6
5 79.6 4 24.6 81 752.2 2 13.2 4 24.0 17 54.3 1
16.1 206 1215.2
6 65.5 18 41.0
5 54.8 34 442.'1 24 95.8
5 16.1

4 38.5
9.6 6 21.1 2 20.3
9 54.2 2 2.4

2
7 34.4 42 494.6

9.4 3 12.2 1

1

9.3

3

9.6

4 21.5

1

5.9

4

9.1

11.0

4 12.9

Preventable Diseases

171

NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DisEASES REPORTED IN GEoRGIA BY CouNTIEs, 1943

Area

Census Population

Diphtheria Cases Rae

Gonorrheo Cases Rate

Influenza Cases Rate

Malaria Cases Rate

Walton.....-------------- 20,777 Ware________________ 27,929
Army Air Base_________________

Warren_______________________ 10,236

Washington__________________ 24,230

Wayne -------------------------- 13,122

Webster............

4,726

Wheeler ____ ------------------White ________________________
Whitfield ......__________________ Wilcox ___________________________
W i l k e s ...........________________
W i l k i n s o n ___________ _ Worth ______________________________

8,535 6,417 26,105 12,755 15,084 11,025 21,374

4 19.3

2

8.3

10 76.2

1 21.2

7 82.0

16 249.3

15 57.5

9.1

22 105.9 53 189.8
18 74.3 41 312.5
11.7 15.6 179 685.7 3 23.5 2 13.3
51 238.6

2 1129
59 6
67 5
17 7

9.6 4042.4
58.6 276.5
38.1 359.7 11.7

569 2179.7 56 439.0 348 2307.1
5 45.4 7 32.8

3.6
23 94.9 64 487.7
3 63.5
13 101.9
2 9

Rates are based on enumerated population of 1940 census.
NOTE: All Military Reservations are exclusive of county totals (included in State Total), are indented, and follow the county in which located.

172

Georgia Department of Public Health

NuMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DisEASES REPORTED IN GEoRGIA BY CouNTIEs, 1943

Area

Measles

Meningococcus Meningitis Pneumonia Poliomyelitis

Scarlet Fever

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

State TotaL__
Rural ---------------------------Cities 2500-5000 ----Cities 5000 and Above_ Military Reservat"ns __

4413 1405
102 1486 1420

141.3 68.1 75.2
160.5

Appling __._ -------------------Atkinson. __ Bacon
Baker ------------------Baldwin ________
USN Training Sch. _

20.7 12 73.1

Banks ______ ----------------Barrow __ -----------------Bartow -----------Ben Hill -----Berrien Bibb_

68.7 66 505.2
29 188.7 315 376 0

H. Smart Airport -- Cochran Field._________ Camp Wheeler ____
Bleckley___.---------------B r a n t l e y ____ ..
Brooks-----

792 20.7
21 102.5

Bryan ___

Bulloch ---------

Burke -------- ------------------

Butts.

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

Calhoun_

Camden

3 11.5

Candler Carroll -------------------Catoosa
Fort Oglethorpe -----
CharIton------------------- Chatham _______

22 64.4 42 385.4 289
36 30.5

USN Section Base.___.

Fort Screven

7

Savannah Air Base_ 61 Chattahoochee _________

Fort Benning_

34

Chattooga ----------------------

5.4

Cherokee --------------------- _ Clarke --------------
USN Preflight Sch ... Clay_ -----------------------------

14 69.6 38 133.8
7

211 6.8 3797 121.6

46 2.2 1513 73.4

4 2.9 155 114.2

97 lO.fi 1145 123.7

64

984

13.8

28 193.1

4 49.4

18 109.7

11 13.1

11.5 53.6 11 43.5 20 137.7 45.5 68 81.2

37 15.9
2 18.4 3 32 27.1

228 62.1
3 43.7 16 78.1
16 254.5 31 119.2 28 105.6
32.7 9.6
12 203.0
22.0 20 58.6
27.5 238
5 95.1 291 246.7

4

2

2 38.9

s

393

9 48.6

7 34.8 22 77.5

7 99.1

28 0.9 964 30.9

12 0.6 354 17.2

2 1.5

62 45.7

13 1.4 516 55.7

32

6.9

41l.:l

54.8
22.9 30.6
6.!) 48 57 .:l

11

10.4

4 41.4

6:l.6

3.8

2 7.7

10.9

3 8.8 5 45.9

2.5

51 42.3

4

2 9.9 5 17.6

Preventable Diseases

173

NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1943

Area

Measles

Meningoccus Meningitis

Cases Rate Cases Rate

Pneumonia Cases Rate

Poliomyelitis Cases Rate

Scarlet Fever
Cases Rate

Clayton ____________
Conley Sup. Depot ... Clinch._________________. Cobb _______________________ Coffee ____________________________
A.A.F.F.T.D. _____________ Colquitt________.________________

219 572.2 7 32.5

Spence Field______________ Columbia __________ Cook ....______________________ Coweta ___________
Crawford........................ C r i s p ________________________ Dade ___________________________
Dawson ___________________ Decatur______________
A.A.F.B. Fly'g Sch.
DeKalb....-----------------Lawson Gen Hosp... USN Air Base...........
Dodge-------------------Dooly__________________ Dougherty_____________________
Turner Field______________ Darr Aero Tech __ Douglas________________________
EarlY----------------------------Echols. ______________________
Effingham____________ Elbert. ___________
EmanueL.. -----------------Evans _______________ Fannin _______ -------------------Fayette_ ------------------------Floyd _____ -----------------------
Forsyth Franklin ---------Fulton ---------------------------
Fort McPherson_______ NAS-Ga. Tech......... Gilmer_ ----------------------Glascock. ---------------------
Glynn----------------NAS-St. Simons____ NAS-Glynco_________
Gordon ---------

2 7.4 4 56.1
17.0
1 4.5 20 87 100.1 95
3 14.3 5.9
4 14.0 17
5 17 169.1
2 10.2
1 6.8 8 97.9 32 57.0
6.4 479 121.9
2 22.2
146 666.1
14 75.9

10 85.8

46.6

2.6

27 70.5

4.6

15 69.6

29 87.8

5.7 17.0
5 5.8 4
4.8 1 5.9 3 10.5

2 8.5 13.5

5

8.~

10 106.0 5 41.9 8 29.7 4 56.1
11 62.7 50.9
2 44.7 13 58.5 10 117 134.6 101
18 85.6
18 106.6 29 101.5
1
49.7 11 58.9
67.5
19 197.0 6 30.6
17 72.3 4 54.0 5 33.9 4 49.0 76 135.4

16 102.5 20 5.1 385 98.0

8 36.5

55.5 22.0
51 232.7

19 103.0

8.6

2.6 4.6
3 9.1

30 78.4 5 15.1

2 7.4 5.7

2 2.3

4.5
60 69.0 9
4.8 1 5.9 2 7.0

9.9

29.8

10.4

10.4

45.9

11 74.6 13 23.2

5 1.3 233 59.3

4.6

9 41.1

1 6 32.5

174

Georgia Department of Public Health

NuMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NOTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1943

Area

Meningococcus

Measles

Meningitis Pneumonia Poliomyelitis

Searlet Fever

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

Grady,._ -----------------Greene-----------Gwinnett________________ Habersham________________
HalL---------------Hancock _________________ H a r a l s o n . ____________________
Harris __________________
HHeaarrtd-_-_-_-_-_-_-__-_-_-_-_-_-_-__Henry________________
Houston.------------------ Robins Field________
Irwin ______________________
Jackson __________________ Jasper ______ --------------Jeff Davis____________ Jefferson...____________________ Jenkins __________________________ Johnson _______________________
Jones -----------------------------
Lamar ---------------------------Lanier --------------------------Laurens _________________________
Lee--------------------Liberty_________
Camp Stewart_______ Lincoln ____________________
L o n g ________________________ Lowndes ______________________
Moody Field______ Lumpkin ---------------------Macon ___________________________ Madison _____________________
Marion -------------------------McDuffie_________________ Mcintosh ______________________ Meriwether _________________
Miller------------------------Mitchell -----------------------Monroe_______________________ M o n t g o m e r y _________________
Morgan ----------------------Murray Muscogee ________
Newton------------

10 72.9 33 113.5 51 146.5
26.3 92 1068.5 16 141.6
2 10.0 57.0 5.0
2 16.9 4 48.0
46 136.9
2 6.3 8
6.3
32 145.1
34 267.4 247 327.2
22 118.4

1 5.1 6.8 7.0 8.8
9.9 11.6

6 30.5 28 204.2 23 79.1 3 20.3 20 57.4
5 39.2 21 146.1
7 61.3 8 51.6 7 81.3 8 52.9 38 336.2 3 2 15.5
11 54.8 6 68.4 5 56.6
35 175.0 31 261.8
5 38.6 7 84.0
6 59.5 2 35.5 17 50.6 7 89.3
11.6
14.2

14 18.5 5.4

19 28.2
4 64.3 10 62.7
5 37.2 4 57.5
10 91.9 2 37.8
20 90.7 1 10.0
10 43.0 9 83.7 4 41.4
5 39.3 4 35.9 143 189.4 9 48.4

5.1

1 5.1

7 24.1 10 67.7 29 83.3
2 15.7

8.8 2 12.9

6 53.1 1
2 10.0 2 22.8 1 11.3 4 20.0 4 33.8

4 11.9 12.8

5 15.7 16.1
2 12.5
18 165.5 2 9.1 1 4.8

57 75.5 8 43.1

Preventable Diseases

175

NuMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED 1943 NOTIFIABLE DISEASES REPORTED IN GEORGIA BY COUNTIES,

Area

Meningococcus

Measles

Meningitis Pneumonia Poliomyelitis

Scarlet Fever

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

Oconee _________________
Oglethorpe--------------- Paulding --------------------- Peach ____ ------------------------Pickens _________________________
Pierce --------------------------Pike _______________________
Polk _______________________________ Pulaski___ ____________________ Putnam___________________________ Quitman ___ ----------------Rabun--------------------------Randolph _________ Richmond _______
Oliver Gen. Hosp. _____ Camp Gordon ____________ Ga. Aero Tech ____________ Camp Hancock ____ Daniel Field_______________ Rockdale ________________ Schley__ ---------------------------
Screven_ ------------------------Seminole ___
Spalding-----------------------Stephens _______
Camp Toccoa Stewart -------------------------Sumter -------------------------
Souther Field __ Talbot ---------------------------- Taliaferro---------------------Tattnall -------------------------Taylor _________________________
Telfair ---------------------------
Terrell ----------------------------
'Thomas ------------------------Finney Gen. Hosp. __
Tift ------------------------------Toombs _____ ------------------
Camp Toombs _ Towns -------------------Treutlen
Troup ----------------------------Turner----------------------------Twiggs _________________________ Union _______________________

3 24.1 16 154.2 64 700.5
1 8.5 32 308.4 12 42.2
9 54.2 54 66.0
2
38 25.9 4.9
24 282.6 81 284.9 42
3 12.2
15.9 7 65.0
33.0
196 446.7
2 26.0

2 16.9 3.5
38.4 6.1

39.6 9 72.4 5 39.0 23 221.6 6 65.7 29 245.8 24 231.3
10 35.1 7 71.2 11.7 1 29.1 3 38.4
24 144.5 83 101.4

12.9 3.5
1 5.4

13 168.3 2 39.7
9 44.2 6 70.6 21 73.9 2 15.4
2 18.9 17 69.4
7 86.0 4 63.7 9 55.4 10 92.9 6 39.6 12 72.0
23 73.5 4 5 26.9 29.5
6 121.8 3 39.3
48 109.4 4 36.9 3 32.9
20 260.4

10.9

6 57.8

3.5

10.5

12.8

6.0

1.2

67 81.8

1 12.9
22 77.4
9.4 4.1

6 19.2

2.3

21 47.9

3 39.1

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, 1943

Area

Meningococcus Measles Meningitis Pneumonia Poliomyelitis

Scarlet Fever

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

Upson
Walker~~
Walton Ware_
Army Air Base __ Warren ----- _ Washington ___ Wayne ____________
Webster~~ ---------------------
Wheeler~~~~~~~~~~~~~-~
White ------------------Whitfield .......... Wilcox ------------------Wilkes
Wilkinson~.-
Worth

18 71.8 197 635.0
5 24.1 2 7.2
4.1
11.5 47.0 4 26.5

4 12.9 1 4.8
10.7 4
22.9
11.5

10 39.9 12 38.7 12 57.8 31 111.0
8 78.2 38 156.8
3 22.9 14 296.2
2 23.4 15.6
10 38.3 6 47.0
15 99.4 7 63.5
14 65.5

33 106.4 6 28.9 3 10.7 3

4.1

9 37.1

7.6

1 7.6

124.7 31 118.8

Rates are based on enumerated population of 1940 census.
NOTE: All Military Reservations are exclusive of county totals (included in State Total), arc indented~ and follow the county in which located.

Preventable Diseases

177

NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DisEASES REPORTED IN GEORGIA BY CouNTIES, 1943

Area

Syphilis

Tuberculosis

Typhoid Fever

Typhus Fever

Whooping Cough

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

State Total ... ------- 21548 689.8

Rural

6912 335.2

Cities 2500-5000 ___________ 811 597.7

Cities 5000 and Above 11938 1289.2

Military Reservatns Appling __________

1887 64 441.5

Atkinson........

Bacon _______________
Baker ---------------------------Baldwin __________ -------
USN Training Sch. Banks ______________ Barrow __________ Bartow ___________

3 37.1 2 27.2 106 645.9
11.5 7.7 4.0

Ben Hill Berrien __________ _ Bibb __________
H. Smart Airport __ Cochran Field . Camp Wheeler B l e c k ley---------------------.
Brantley _______ Brooks Bryan _______ Bulloch _______
Burke ...------------------ Butts---------------------------- Calhoun-------------------------

3 20.7 7 45.5 981 1170.9
94 63 652.5
14.6 85 414.7 19 302.2 187 719.0 281 1059.6
21.8 101 967.6

Camden --------Candler ------------------------ Carroll ---------------------Catoosa --------------------- ..
Fort Oglethorpe ....... Charlton________________________
Chatham----------------------

22.0 2.9
1263 5 95.1
4188 3550.1

USN Section Base . Fort Screven ____________

Savannah Air Base

Chattahoochee Fort Benning _____
Chattooga _______
Cherokee

19.5 162
2 10.8 5.0

Clarke. USN Preflight Sch..
Clay-----------------Clayton .._____________________

492 1732.5

2891 1268 189 1358
76

92.5 61.5 139.3 146.7
48.3 84.6

37.1 2 27.2 27 164.5

34.4 18 137.8 12 47.5
9 62.0 4 26.0 111 132.5

4 41.4
29.1 6 29.3 3 47.7 20 76.9 28 105.6 14 152.5 6 57.5
3 50.8 3 33.0 9 26.3 7 64.2 45
164 139.0

1 19.5 2 15 80.9 11 54.7
16 56.3
4 56.6 9 77.2

208 6.7 1256 40.2 1749 56.0

158 7.7 617 29.9 999 48.4

16 11.8 211 155.5

90 66.3

34 3.7 414 44.7 657 71.0

14

3

6.9

72 496.7

10 69.0

7 98.7

2 27.2 4 24.4

2 24.7 10 136.2
6.1

1, 12.4 18 109.7

11.5 5 6.0

15.3 4.0
10 68.9 6.5
57 68.0

6 68.7 5 38.3 1 4.0
48.2
267 318.7

2 9.8
3 8.8 1 9.2

11 113.9
4 58.2 13 63.4
1 15.9 23 88.4 10 37.7
10.9 67.1
2 33.8 8 87.9 2 5.9
27.5

2 38.1 5 4.2 119 100.9

2
12 58.5 37 588.4 32 123.0 20 75.4 11 105.4
2 5.9 25 229.4 14 266.4 57 48.3

7 37.8 3 14.9
8.6

2 9.9 3.5
4 15R.~

? 21.1 14.2

178

Georgia Department of Public Health

NuMnER oF CAsEs AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DisEASES REPORTED IN GEoRGIA BY CouNTIES, 1943

Area

Tubercu-

Typhoid

Syphilis

los is

Fever

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

C3:ses Rate Cases Rate Cases Rate

Typhus Fever
Cases Rate

Whooping Cough
Cases Rate

Conley Sup. Depot Clinch.
Cobb~
Coffee A.A.F.F.T.D.
Colquitt ~~--- Spence Field
Columbia--Cook -------------------Coweta ___ Crawford .. Crisp _____ Dade_ Dawson
Decatur................. A.A.F.B. Fly'g Sch.
DeKalb.............. Lawson Gen. Hosp. USN Air Base
Dodge_____....... Dooly.
Dougherty-Turner Field ~--Darr Aero Tech ~
Douglas_ Early _____ Echols
Effingham~
Elbert ...... Emanuel Evans __ Fannin Fayette. Floyd Forsyth
Franklin .... Fulton --
Fort McPherson NAS-Ga. Tech Gilmer._ Glascock Glynn ... -------------------
NAS-St. Simons NAS-Glynco . Gordon .... Grady--

15.5 287 749.9 140 649.9
168 508.9
1 84 2 7.4 1 14.0 163 929.3
22.5
394 453.2 27
68 323.5 29.6
23 80~5 21
2 19.9 5 26.8
23 238.4
2 8.5 3 40.5 8 54.2 1 12.2 472 840.7
20 128.1 5536 1409.1
11.1 44.0 16 73.0
32.5 164 834.4

46.6 27 70.5
37.1
18 54.5
4 R 67.1 20 74.2
84.2 11 62.7
67.0 14 63.0
75 86.8 17
4 19.0 4 2!3.7 44 154.0
49.7 8 42.8
8 82.9 18 91.8 12 51.0 2 27.0 19 128.8 1 12.2 60 1C5 H
8.8 6 88.4 584 148.6
5 55.5 66.0
22 100.4
26 14!.~ 11 56.0

2.6 4.6 3.0
39.9 44.7
9.0 1.2
2 9.5 47.4 7.0
9.9
10.4 4.3
1 13.5 3 20.3
12.2 2 17.7
19.2 11 2.8
13.7
2 10.8

9 139.8 2.6
21 97.5 16 48.5
50.3 3.7
41 233.8
19 85.5 17 20.0

4 10.5 28 130.0
12.1
29 307.4 12 100.7
1 3.7 1 14.0 12 68.4
17.0
25 112.4
38 43.7

24 114.2 35.5
20 70.0 2

28.5 36 126.0

19 101.7
51.8 1 5.1 10 42.5 7 94.6

5.4 33.7 20.7
10.2

8.8 55 14.0

11 19.6
22 140.9 122 31.1

35 159.7

11.1 18 82.1

34 173.0

4 21.7 5.1

Pteventable Diseases

179

NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1943

Area

Syphilis

Tuberculosis

Typhoid Fever

Typhus Fever

Whooping Cough

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

Greene---------------~------
G w i n n e t t__________ _ H a b e r s h a m ________________ _ Hall ________________________ Hancock _____________ Haralson ___________
Harris------------------
Hart ______________ Heard _________
H e n r y _________________ _ Houston _________
Robins Field _____ Irwin ___________________________ Jackson ________________
Jasper__________________________ _ Jeff Davis___________ _ Jefferson _____________ J e n k i n s . __________ _
Johnson---------------Jones ---------------------Lamar __

78 569.8 3.4
3 20.3 149 427.9
2 15.7
66 57.7.5
11.6 3 19.8 2 17.7 6 3 23.2
5.0
2 22.8 11.3
157 783.4 103 86B.7
2 15.4 41 492.1
1 9.9

L a n i e r _________________ _
Laurens________________
Lee--------------------------------- Liberty___________________________
Camp Stewart _ L i n c o l n _____________________ _ L o n g_________________ _

17.8 251 746.9
2 25.0 20 232.7
14.2 146.8

Lowndes___________
Moody Field___ _ Lumpkin ________________ M a c o n ___________________ _ Madison __________________________ Marion.____________________________ McDuffie _____________

12 37.7 8 16.1
23 144.2 1 7.4 2 28.8 4 36.8

Mcintosh ________________________
Meriwether-------------------Miller____ ----------------------Mitchell------------------Monroe --------------------------M o n t g o m e r y________________ _

7 132.3 97 439.8
2 20.0 218 937.2
9.3

Morgan -------------------------

2 15.7

Murray__________________________

Muscogee __________________ 1488 1971.0 Newton_______________________ 52 279.9

Oconee --------------------------

12 87.5 17 58.4 12 81.2 28 80.4
7 54.8 7 48.7 6 52.5
19.3 6 69.7 16 105.8 6 53.1
6 46.4 9 44.8
5 57.0 3 33.9 15 74.9 14 118.2 2 15.4 6 72.0 5 49.5
17.8 26 77.4
3 38.3 6 69.8
171.3
21 65.9
6 96.4 15 94.1 4 29.8
4 57.5 13 119.5
5 94.6 8 36.3 5 50.0 9 38.7 20 186.1 7 72.4 12 94.4
12 107.7 170 225.2
35 188.4 4 52.8

6 43.8 4 13.8 2 13.5
2.9

10 72.9 26 89.4
17.2

2 12.9 2 23.2
19.8 17.7
22.8 10.0 25.3
9 26.8 11.6

53.1
2 15.5
8 90.5 4 20.0 3~ 320.9 2 15.4 1 12.0
17.8 31 92.2
3 38.3 3 34.9

6.4 41 476.2
2 13.2 8.8
4 30.9 20 99.6
11.3 4 20.0 5 42.2 1 7.7 30 360.1
9.9
17.8 6.0

3.1 2 32.1 1 6.3 2 28.8
3 12.9 3 27.9 4 41.4 2 15.7
9.0

24.5 11 34.5
7 43.9
9.2 2 37.8 1 10.0 25 107.5 5 51.7
5 6.6

10 62.7 1 7.4 14.4
37.8
4.3
1 10.3 9 70.8
9.0 63 83.5 26 140.0

180

Georgia Department of Public Health

NUMBER OF CASES AND CASE RATE PER 100,000 POPULATION OF SPECIFIED NoTIFIABLE DISEASES REPORTED IN GEORGIA BY CouNTIEs, 1943

Area

Syphilis

Tuberculosis

Typhoid Fever

Typhus Fever

Whooping Cough

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

O g l e t h o r p e ____ P a u l d i n g _________ _ P e a c h ____ _ Pickens _________ P i e r c e ____________ _ Pike ______________________ _ Polk ___________________
Pulaski __________ Putnam ___________ Q u i t m a n ___ _
Rabun --------------------Randolph ___ _________ _________
Richmond---------------------Oliver Gen. Heap.

116 1117.7 32.8 8.5 19.3
31 108.9
1 10.2 2 23.5
29.1
9 54.2 849 1037.1
27

Camp Gordon__

252

Ga. Aero Tech ______

Camp Hancock_

Daniel Field _________

11

Rockdale _________________________

S c h l e y ___________________________ _

Screven___________________________ 17

59.6 83.5

Seminole_______________ _ S p a l d i n g________________________ _ Stephens _________________________
Camp Toccoa _____________
Stewart __ ----------------------Sumter _______
Souther Field______

215 756.3 8 61.7
3 28.3 183 746.9

Talbot -------------------------T a l i a f e r r o ______________________ _

2 24.6

T a t t n a l l _________________________ _

6 36.9

Taylor.--------------------------Telfair _________ ------------
TerrelL T h o m a s __________________________ _

41 270.7 126 755.6
19.2

Finney Gen. Hosp. ____ Tift __________________________________ Toombs __________________________
Camp Toombs____________ Towns _____________________________ T r e u t l e n _________________________ _ Troup _______________________________
Turner __________ _
Twiggs -------------------------Union _____________________________ U p s o n __________________________ _

7 217 1166.7
2 11.8
1 13.1 268 610.8
1 13.0 2 8.0

6 48.3 3 23.4 17 163.8 3 32.8 2 16.9 12 115.7 33 115.9 14 142.4 2 23.5 1 29.1 2 25.6 18 108.4 75 91.6
2 7 90.6
19.9 22 108.1
2 23.6 49 172.4 14 107.9
7 66.0 28 114.3
3 36.9 3 47.8 13 80.0 2 18.6 12 79.2 8 48.0 21 67.1
16 86.0 6 35.4
4 52.4 44 100.3
5 46.1 4 43.9 2 26.0 29 115.7

8.0
10.9 3 25.4 3 28.9
3.5 10.2
1 6.0 2 2.4

2 19.3 14 118.6
8 81.4
10 60.2 17 20.8

16 128.7 7.8
13 125.3 23 251.8 15 127.1
4 38.6 18 63.2
11.7
4 51.1 21 126.4 51 62.3

2 39.7 2 9.8
7.7
12.3
9.3 2 12.0 3 9.6 4 21.5 3 17.7

7 139.1 25 122.8 12 141.3
3.5 7.7
9.4 33 134.7
16 98.5 7 65.0 32 211.3 14 84.0 22 70.3
20 107.5 11 64.9

10 129.5 5 24.6 11.8 10.6
12.3 4 63.7 1 6.2
7 42.0 50 159.8
5.4

2 26.0 4.0

39.3
3 27.7 2 21.9
4.0

27 61.5 3 12.0

Preventable Diseases

181

NUMBER OF CASES AND CASE RATE PER 100,000 PoPULATION OF SPECIFIED
1943 NoTIFIABLE DISEASEs REPORTED IN GEORGIA BY CouNTIES,

Area

Syphilis

Tuberculosis

Typhoid Fever

Typhus Fever

Whooping Cough

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

Walker.... ----------------------Walton ------------------
Ware______ --------------------
Army Air Base..... Warren _________________________ W a s h i n g t o n ...... Wayne............................. Webster .... Wheeler..........................
White __________________________ Whitfield ______________________ Wilcox ____________________________ Wilkes _____________________________ W i l k i n s o n _______________________
Worth ... ----------------------

18 58.0 57 274.3
93 333.0
116 478.7 79 602.0 2 42.3
15.6 76 291.1
5 39.2 9 59.7 2 18.1 161 753.3

26 83.8 13 62.6
29 103.8
5 48.8 19 78.4
6 45.7
4 46.9
1 15.6 49 187.7
1 7.8 6 39.8 8 72.6 13 60.8

3 9.7 2 9.6
3.6
6 58.6
2 15.2 21.2 11.7
3.8 7.8 3 19.9 1 9.1 2 9.4

16.1 28.9 13 46.5
11 45.4 14 106.7
4 84.6 11 128.9
39.2 13.3
28 131.0

13 41.9 75 361.0 66 236.3
18 74.3 6 45.7
24 281.2 2 31.2 7 26.8 19 149.0 40 265.2 5 45.4 6 28.1

Rates are based on enumerated population of 1940 census.
NOTE : All Military Reservations are exclusive of county totals (included in State Total), are indented, and follow the county in which located.

182

Georgia Department of Public Health

f\uMBER oF CAsEs AND CAsE RATE PER 100,000 PoPULATION oF SPECIFIED NoTIFIABLE DISEASES REPORTED IN CITIES OF 5,080 PoPULATION AND ABOVE IN GEORGIA, 1943

Area

Census

Di;:>htheria

-----

Po;JUlation Cases Rate

Gonorrhea Case8 Rate

Influenza Cases Rate

JVIalaria Cases Rate

TOTAL-------- AlbanY------Americus _______
Athens Atlanta (DeKalb) _ Atlanta (Fulton) Augusta __

925,970 19,055 9,281 20,650 28,044
273,294 65,919

Bainbridge Brunswick Carrollton Cartersville . Cedartown .... College Park --- Columbus ....____________________
Cordele________ -----------------D a l t o n _________________________
Decatur------------------------Douglas _______________________
Dublin .............-East Point __ Elberton --------------------

6,352 15,035
6,214 6,141 9,025 8,213 53,280
7,929 10,448 16,561
5,175 7,814 12,403 6,188

Fitzgerald _ Gainesville Griffin -- Hapeville LaGrange _ Macon M a r i e t t a .....

7,388 10,243 13,222
5,059 21,983 57,865
8,667

Milledgeville.... Moultrie ..._________________ Newnan __________________________ Rome __________ Savannah _________
Statesboro .--Thomaston_

6,778 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

139 15.0

10 48.4

1

3.4

27

9.9

9 13.7

15.7 26.6

16.3 44.3

27 50.7

12.6

11 105.3

1

6.0

5 96.6

12.8

48.8

7 31.8 12.1

14.8

19.7

13.9

6 22.8

3

3.1

31.3
7.9 19.1

5135 21

554.6 110.2
10.8

5 17.2 1201 439.5 3002 4554.1
2 31.5

16.1 4 65.1 9 99.7 2 24.4 95 178.3
19 239.6 173 1655.8
18.1 23 444.4 14 179.2
6 48.4 16.2
40.6 60 585.8 44 332.8

26 118.3 24 41.5 10 115.4
25 368.8 34 335.1
l 13.9 6 22.8 231 240.6 8 159.1 3 46.9
71.0 4 76.5
109.2 38.5
53 316.2

8077 14
1957 659

872.3 73.5 32.3 38.7 10.3
716.1 999.7

15.7 8 53.2
32.2 16.3 26 288.1 156 1899.4 25 46.9

8 100.9 565 5407.7

58.0 89.6 20 161.3 16.2

122 1191.1 4 30.3
85 1680.2 11 50.0 10 17.3
3 34.6

180 2 2
453 1898
17 22

2655.7 19.7 27.8
1723.6 1977.2
338.0 344.0

9 2 1 662 1127

71.0 38.3 18.2 4245.0 6723.1

67

7.2

4 21.0

2 21.5

2.2
1 15.7 3 20.0

55.4 5.6
12.6 6.0
4 51.2

13.5

4 18.2
11.5 14.8
9.9
7 26.6 11 11.5
19.9
23.7 2 38.3
4 25.6 6.0

This includes also that part of College Park in Clayton County.

Preventable Diseases

183

NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPULATION OF SPECIFIED NoTIFIABLE DisEAsEs REPORTED IN CITIEs OF 5,000 PoPULATION AND ABOVE IN GEORGIA, 1943

Area

Measles

Meningococcus Meningitis Pneumonia Poliomyelitis

Scarlet Fever

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

TOTAL Albany Americus Athens .. Atlanta (DeKalb) _ Atlanta (Fulton) _____ Augusta _______
Bainbridge __________ Brunswick ______ Carrollton _____________ Cartersville_________ Cedartown ____________________ *College Park _________ Columbus

1486
26
434 53
126 11
6 8 149

160.5 10.5 32.3
125.9
158.8 80.4
838.0 177.0
66.5 97.4 279.7

Cordele ______
Dalton Decatur Douglas ____ Dublin_ East Point_ Elberton ______
Fit,gerald ___ Gainesville ____ Griffin _____ ------------------Hapeville _ LaGrange Macon Marietta _____

3 28.7 5 30.2 2 38.6 27 345.5 4 32.3
16.2
45 439.3 13 98.3
1 19.8 117 532.2 278 480.4 101 1165.3

Milledgeville Mo"...lltrie _______
Newnan ------------------------Rome ----------------------------Savannah --------------------Statesboro __ Thomaston ___

12 177.0
5 19.0 30 31.3
3 59.7 17 265.8

Thomasville __

Tifton ---------------- ----------- --..---

Toccoa -------------------------

Valdosta-----------------------

2 12.8

Waycross --------------------

2 11.9

-97 10.5 10.5
2 6.9 17 6.2
4 6.1 46.6
11.1 13 24.4
28.7 12.1 19.3
8.1
7.6
11 19.0
11.4 28 29.2

1145 22
16 31 296 70

123.7 115.5
64.6 77.5 106.9 108.3 106.2

94.5 40 266.0 6 96.6
4 65.1 33.2 73.1
103 193.3

6 75.7 4 38.3 12 72.5 4 77.3 9 115.2 7 56.4
32.3

11 148.9 11 107.4 17 128.6 4 79.1 15 68.2 56 96.8 7 80.8

9 132.8 14 138.0
4 55.7 36 137.0 247 257.3
6 119.4 125.1

10 78.8

1 18.2

12 76.9

6.0

24 143.2

13 1.4
4 1.5 6.7
12.2
6.0 19.3

516 55.7 5.2
10.8 5 24.2 19 65.5 173 63.3 61 92.5
15.7 39.11 16.1
11.1 2 24.4 40 75.1
12.6 13 124.4 21 126.8
3 38.4 4 32.3 5 80.8

4.5 11.5
9.9
2 2.1

12 117.2 13 98.3
3 59.3 36.4
45 77.3 80.8
9 132.8 9.9
13.9 10 38.0 38 39.6

5 39.4

4 25.&

2

11.~

This includes also that part of College Park in Clayton County.

184

Georgia Department of Public Health

NuMBER OF CAsEs AND CAsE RATE PER 100,000 PoPuLATION OF SPECIFIED NoTIFIABLE DisEASEs REPORTED IN CITIES OF 5,000 PoPULATION AND ABOVE IN GEORGIA, 1943

Area

Syphilis

Tuberculosis

Typhoid Fever

Typhus Fever

Whooping Cough

Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate

TOTAL ________________ Albany________________________
Americus ____________________
Athens-----------------------Atlanta (DeKalb) __ Atlanta (Fulton) ______ Augusta ______________________

11938 1289.2 17 89.2
7 33.9 4 13.8 5498 2011.8 846 1283.4

Bainbridge _________________ B r u n s w i c k ________________ _ C a r r o l l t o n __________________ _ C a r t e r s v i l l e _________________ Cedartown_________________
*College Park ____________ C o l u m b u s ________ _

15 99.8 1 16.1
19 210.5
1225 2299.2

Cordele___ -------------------Dalton ________________________
Decatur_--------------------Douglas______________________ _ Dublin _________________________
East Point___________________ Elberton ____________________

100 1261.2 9.6
3 18.1 96 1855.1
3 38.4 3 24.2

Fitzgerald_________________ G a i n e s v i i l e ________________ _ Griffin ______________
Hapeville -------------------LaGrange _______________
Macon _----------------------Marietta __________

3 40.6 121 1181.3
58 438.7 2 39.5
55 250.2 111 191.8 209 2411.4

Milledgevil]e_______________ Moultrie ________ Newnan _______________________ Rome ___________________________ Savannah ____________________ S t a t e s b o r o _________________ _ Thomaston _____________ ..

103 1519.6 162 1596.5
1 13.9 4 15.2 3099 3228.3 70 1392.2

Thomasville --------------Tifton __________________________
Toccoa __ --------------------Valdosta --------------------W a y c r o s s____________________ _

9 57.7 93 554.8

1358 33 13 11 16
475 64

146.7 173.2 140.1 53.3 55.2 173.8
97.1

6 94.5 18 119.7
2 32.2 4 65.1 19 210.5 7 85.2 126 236.5

7 88.3 30 287.1 15 90.6
2 38.6 12 153.6 10 80.6 10 161.6

7 94.7 14 136.7 37 279.8

28 127.4 86 148.6 12 138.5
22 324.6 13 128.1 13 181.0 30 114.1 125 103.2
6 119.3 19 297.1
10 78.8 8 153.0
12 218.4 13 83.4 23 137.2

34 3.7 414 44.7 657 71.0

13 68.2

19 99.7

15 161.6

1 4.8

4 19.4

1 3.4

5 17.2

1 3.4

5 1.8

50 18.3 105 38.4

2 3.0

16 24.3

50 75.9

8 125.9 30 199.5

15 99.8

16.3

11.1

6 66.5

12.6 19.3 8 102.4 2 16.1
2 3.5 4 59.0

5 9.4 29 365.7
7 42.3 7 135.3 20 256.0
7 94.7 7.6
51 88.1 11.5
1 14.8 4 39.4

48 90.1
7 88.3 5 47.9 5 30.2 18 347.8 2 25.6
2 32.3
4 54.] 6 58.6
22.7 3 59.3 7 31.8 202 349.1 3 34.6
12 177.0

3 3.1
2 38.3 1 18.2
6.0

109 113.5 7 139.2 15.6
6 47.3 6 114.8 1 18.2 5 32.1 7 41.8

3 11.4 34 35.4
2 39.8 3 46.9 21 165.e
19.1
66 393.7

This includes also that part of College Park in Clayton County.

PREVENTABLE DisEAsEs REPORTED IN GEORGIA BY MoNTHs, 1943

Diseases

- - -- - - - - - - - - - - - - --- - Total Jan Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec.

Actinomycosis-~---------------------------------------

Acute Inf. Conjunctivitis_______________________________ 17

3

1

2 --------

2

4

1

-------

------

4

Anthrax

Chickenpox _----------------------------------------------------- 1332

262

126

237

166

150

59

12

4

9

41

57

209

Dengue -------------------------------------------------------------------

4

Diphtheria ------------------------------------------------------------ 520

Dysentery, Amebic ---------------------------------------------- 37 Dysentery, Bacillary___________________________________________ 342

Dysentery, Unspecified-------------------------------------- 80

Gonorrhea --

------------------------------------------------ 10028

Hookworm ---------------------------Influenza ______________________________

------------------------ 3409 -------------------------- 13238

Leprosy ------------------------------------------ ----------------------- --------

Lethargic Encephalitis ______________ ------------------------ 10

1 32
6 6 7 1678 220 692
1

19

20

17

17

10

2

4

3

4

4

3

2

51

89

4

3

1

9

25

792

805

795 1008

853

326

209

253

275

278

697

677

322

111

44

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

2

1 --------

2

20

1

--------

52

101

124

2

--------

"..,tj

76

32

~

5

2

4

4

2

1

~ ~

;:::!

87

42

14

17

19

10

11

5

1

3

8 1

oiS-
1b

988 319 54

714 291 66

516 277 82

747 371 79

603 331

.... 629 t:l
"' 259 ~

139 10276 ~

-------

--------

--------

-------

--------

--

"~ ' "'

Malaria ------------------------------------------- ----------------------- 525

12

14

27

26

60

62

100

65

51

56

38

14

Measles ________________ ------------------------------------------------ 4413

73

294

767 1330

939

339

72

38

23

38

94

406

Meningococcus Meningitis ------------------------------- 211

12

16

42

33

17

19

18

6

2

13

7

26

Mumps ---------------- ------------------------------------------------ 2267

324

313

402

368

274

90

91

60

48

49

97

151

Paratyphoid

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

50

1

3 --------

3

6

8

4

14

4

1

3

Pellagra _______________

---------------------------------------- 208

19

14

19

22

22

15

22

13

15

21

12

14

Pneumonia ___________________ ------------------------------------ 3797

846

410

476

386

225

150

167

146

134

187

224

446

Poliomyelitis _____________ -------------------------------------- 28

1

1

1

1

1 --------

5

1

7

5

f-'
00 Vl

,.....
00 0'-
PREVENTABLE DisEAsEs REPORTED IN GEORGIA BY MoNTHS, 1943

Diseases Puerperal Sepsis

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

Jan.

Feb.

Mar.

Apr.

May

June

- - July Aug.

-Sept.

Oct.

Nov. Dee.

Rabies (In man) __ -----------------------------------

1

Rheumatic Fever ________________________________________

110

Rocky Mt. Spotted Fever ___________

4

Sc3.rlet Fever _________________________________________

964

Screw Worm Inf. (In man) ----------------

2

Septic Sore Throat Smallpox Syphilis

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

377

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

12

21548

Tetanus

----------------- 72

Trachoma ------------

20

Trichinosis

-----------

6

Tuberculosis

2891

Tularemia

80

Typhoid Fever _ -------------Typhus Fever ______________________

208 1256

Undulant Fever_

98

9
142 1
48 2
2035 2 I
226 8 7
73 4

1 8 ------94
78 -------194&
4 6 I 247 10 10 24 3

-------7
48
42 8
1924 2
11
197 16 6 53 6

17

5

51

38

35 1
1959 2

16
28E6 2

5

24:l

260

16

4

3

13

33

46

8

14

11 1 30 -------23
1948 9 1
220 4
:)2 E2 11

13 1 36 -------20
2202 8
265 7
49 152 15

1
52
15
1525 7
285 5
43 l6:l 14

4 2 86
24
1267 14 1
222 4
17 216
5

----12
174
32
1617 14
256 I
16 181
7

10
107 1
23
1228 4
256 4 g
138 5

--------

~

13 .C"..')

----

s<:Jo.

106

1:::::1

"' -----"1::l

... 21

!;:)

1 '

1009 4
----

-"'.;:.::.!.
0
'"0
;::
o-

2H "(:';"

1 ::J:,

4 ~"'
95 :;:::.::::
6

Vincent's Infection

----------

235

22

20

21

26

26

14

28

26

14

16

8

14

Whooping Cough Total

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

1749 ---

------------ --------------- ---------- 70148

143
--
6916

132
--
5624

164
--
6197

338 6463

195
--
6675

283 4715

192 4965

74 3740

65 3233

46 4127

44 3548

73
--------13940

Industrial Hygiene Service
Introduction
The Industrial Hygiene Service has been working directly with the various war industries of the State in an attempt to assist them in matters pertaining to employee health, thereby keeping the workers on the job. The Industrial Hygiene Service also serves in a liaison capacity with re lated agencies. It correlates all health services available in the State for the benefit of industry. Special acknowledgement should be made for the assistance of the United States Public Health Service, Division of Industrial Hygiene.
The volume of work handled by the Industrial Hygiene Service has expanded rapidly, and is limited only by the restricted number of personnel and cramped quarters in the laboratory.
Personnel
To accomplish the above comprehensive industrial health program, the knowledge and skills of the medical, engineering, chemical, and nursing professions must be closely integrated. With this objective in view, the following personnel are attached to this Service: one medical director; one industrial hygiene physician (assignee from the U. S. Public Health Service) ; one chemical engineer; one consultant nurse; two chemists, and three stenographers. The employment of an additional engineer is desired, and would have been effected if a qualifin:l individual could have been found. In fact, additional personnel in each profession represented could be used to great advantage in answering the ever increasing requests for ~ervice being received from industry.
Federal Authorization
The War Department, Navy, Maritime Commission, and the United States Public Health Service have requested that specific health services be made available through the Georgia Department of Public Health to the employees of war production plants. By this arrangement, the Industrial Hygiene Service has been specifically charged with the responsibility of assisting war production plants in the State in matters pertaining to the health of their employees. This is a matter worthy of serious considera tion, since absenteeism and productive ability of the individual are direct functions of the employee's health. Furthermore, compliance with the State health regulations is required by the Walsh-Healy Public Contracts Act.
Restricted Reports
All personnel of the Industrial Hygiene Service are under oath to the War Department with regard to the handling of information, reports, and the like, in connection with plant studies. Copies of reports covering plant

188

Georgia Department of Public Health

studies are submitted to plant managers and file copies are kept under lock and key at all times in accordance with the meaning of the Espionage Act 50, 6.S.C. 31 and 32.

J!fedical and Nursing Program
The Service, therefore, investigates war contract industries operating under the Walsh-Healy Contracts Act. The medical personnel investigates occupational diseases; assists management in setting up proper medical programs and facilities; assists in planning adequate nursing service with the industry; assists in the establishment of adequate record keeping, including sickness absenteeism records; and promotes all public health measures in industrial concerns, such as preplacement examinations, tuberculosis control, venereal disease control, immunization programs, nutrition programs, dental programs, public health education, and the like.

Engineering and Chemical Program
The engineering unit conducts plant surveys for the purpose of evaluating exposures of toxic substances. This is done by detailed plant surveys followed by accurate chemical determinations where indicated. Results are assembled and carefully interpreted before the report is prepared for the industrial management. Engineering consultation is given to industry regarding the correction of hazards observed or discovered in the course of the survey. Furthermore, assistance is given industry in the development of proper sanitary facilities, and in training individuals concerned with the plant industrial hygiene and safety program.
Each divisio~ of the Health Department lends valuable assistance to the Industrial Hygiene Service in accomplishing the above purposes.

Industrial Hygiene Service Laboratory
A well equipped industrial hygiene laboratory provides facilities for the quantitative and qualitative investigation of air contaminants such as dusts, fumes, gases, vapors, mists, smokes, etc., as well as other toxic materials which may be present in the industrial environment. Facilities are also available for the study of blood, urine, and other biological samples taken in connection with the plant studies. Laboratory findings are correlated with the engineering and medical investigations so that a more intelligent and comprehensive report may be submitted to the industry concerned. During the year, 1,443 physical and chemical analyses were made; 7 biological specimens were examined, and 30 special stu.idies were made. The Service has the full use of a station wagon for transportation of bulky equipment directly to the various industrial plants. With the expansion in volume of work and more numerous requests for service from many sources, the laboratory space available is becoming somewhat cramped. It is anticipated that the need for more laboratory space will become increasingly more pressing.

Preventable Diseases

189

Public Relations
During the period covered by this report, 113 plants in 31 counties were visited. In 48 of these plants, the initial visit was made in 1943. Also 872 conferences were held, with an average of 3 people at each conference. 121 meetings were attended. Talks by Industrial Hygiene Service personnel were made at 79 of these meetings with an average attendance of 52. There were 39 showings of industrial hygiene and other public health films. 14,194 pieces of literature were distributed. 27 articles were submitted for publication. The policy of submitting an industrial hygiene article in each monthly issue of "Georgia's Health" was continued. Many of the pamphlets distributed were copies of papers and talks prepared by members of the Industrial Hygiene staff. Several of the addresses enumerated above were lectures delivered to students of the Emory University Medical School, Georsia University School of Medicine, and Georgia School of Technology.
Reciprocal benefits have been derived from close working relationship between the Industrial Hygiene Service and some twenty chambers of commerce, seven industrial insurance carriers, and two manufacturers associations. Valuable assistance has been secured from many state and federal agencies, including the U. S. Public Health Service, U. S. Navy, U. S. Army, U. S. Maritime Commission, American Medical Association, National Nutrition Committee, Food Distribution Administration, U. S. Department of Labor, Georgia State Department of Education, and the Medical and Dental Associations of Georgia. The Industrial Hygiene Director has been appointed as Medical Consultant to the State Advisory Committee of the National Committee for Conservation of Manpower in War Industries. With the engineering members of his staff, he has arranged and conducted lectures on industrial hygiene at special schools for training safety directors and foremen. The contacts established at these meetings have resulted in several requests from industrial management for an industrial hygiene survey of their plant.
Industrial Health Institutes
Of outstanding interest was a series of industrial health institutes during March in Augusta, Savannah, Atlanta, and Columbus which were organized and conducted by members of the Industrial Hygiene Service staff. Well qualified local and national speakers were procured to discuss various problems pertaining to industrial health from the standpoint of management, labor, medical profession, governmental agencies, and the local and state departments. The institutes were advertised as a program for the conservation of manpower, and jointly sponsored by the Medical Association of Georgia, the Georgia Department of Public Health, and the Associated Industries of Georgia.

190

Georgia Department of Public Health

Out of State Meetings
The director and the engineer attended the National Conference of Governmental Industrial Hygienists joint meeting with the American Industrial Hygiene Association and the American Association of Industrial Physicians and Surgeons. The director of the Service presented a paper during the Conference on "Administrative and Working Relationships of the Georgia Department of Public Health With The Maritime Commission." At this meeting, the director of the Service received public acknowledgement of his part in the promotion of "Minimum Requirements For Safety and Health In Contract Shipyards," which has been adopted by the Maritime Commission and the Navy on a nation-wide basis. The director also attended the Fifth Annual Congress of Industrial Health of the American Medical Association, and the Regional Meeting of the Committee for the Conservation of Manpower in War Industries. The engineer visited Vanderbilt University as guest lecturer on industrial hygiene. The consultant nurse delivered two lectures at the Industrial Nurses' Institute in Alabama. She also attended and participated in the Conference of State Industrial Consultant Nurses held in Washington, D. C.

Field Activities
Direct assistance is being rendered to war plants manufacturing critical materials such as ships, artillery shells, bombers, airplane parts, ordnance materials, chemicals, munitions, etc. Of the approximately 2,400 industrial plants in the State of Georgia, only those concerned with the national war effort are being served for the duration of the war.
During the period covered by this report, 257 promotional visits were made; 47 plant surveys were made, and 185 miscellaneous serv.ices were rendered. These services were rendered to a total of 113 plants. More specific information regarding these activities will be presented under the sections on engineering activities and medical and nursing activities; also see Table I.

Medical and Nursing Activities
During the year, 163 field visits were made by the medical personnel and 147 field visits by the nurse. 166 cases of occupational disease were investigated. In connection with these investigations, 164 consultations with physicians were held; 424 conferences with industrial nurses served the purpose of promoting better nursing service in industry and, in some instances, the actual education of the industrial nurse in industrial nursing.
The most notable achievements during this period include the following:
l. Promotion and establishment of improved medical facilities and program in the various shipyards located along Georgia's

Preventable Diseases

191

coast. This activity was carried out in conjunction with the Maritime Commission_
2. The promotion of an improved industrial health program at Warner Robins Army Air Depot. Such civilian activities as a tuberculosis x-ray survey, a venereal disease control program, public health education program, nutrition program, improved industrial nursing, and other similar activities were accomplished in cooperation with the Army Air Service. Because of the location of the project, strenuous efforts of the State Department of Public Health and the Depot Surgeon to have the area declared a remote area by the War Department were rewarded by the Depot's being declared as such.
3. A cutting oil dermatitis study at the LeTourneau Company of Georgia. This has resulted in the institution of control procedures and plans for the reorganization of the entire medical program to render a more satisfactory industrial health service.
4. The organization and inauguration of an industrial health clinic for the combined industries of Winder, Georgia, where no previous plans for the 1,500 employees had existed. This is a cooperative group clinic supported by some eight or nine small industrial organizations.
5. Successful promotion of chest x-ray surveys in industry has been continued in cooperation with the Division of Tuberculosis Control. Using a 35 mm. photofluorographic unit transported by truck and set up in the industrial establishments, 49,308 35 mm. x-ray pictures of employees were taken in 58 industries. Follow-up work by industrial physicians and nurses, health departments, and tuberculosis associations, has resulted in many cases of tuberculosis being hospitalized in time to arrest the disease. Many contacts have been broken. 985 cases of non-tuberculosis chest pathology were also discovered and reported to industrial medical departments. The Industrial Hygiene Service has made a follow-up study of 32,644 individuals x-rayed in 37 industries. The findings are tabulated as follows:

192

Georgia Department of Public Health

ANALYSIS OF PULMONARY TUBERCULOSIS FINDINGS IN 32,644 INDIVIDUALS X-RAYED IN 37 INDUSTRIES IN GEORGIA IN 1943

Negative for The. Cases per
1000

Suspicious for The. Cases per 1000

Positive for The. Cases per
1000

Unclassified Cases per 1000

Total

961.1

9.6

3.9

25.4

1000

I

6. The medical program at the Bell Aircraft Corporation was surveyed and promotional efforts to improve it appear to be bearing fruit. The medical department has been reorganized, more adequate dispensary facilities provided, sickness absenteeism records have been instituted, company owned and operated cafeteria service is provided, an x-ray machine has been secured for routine pre-placement and periodical chest x-rays, venereal disease control program and dental control program are being planned.
7. The cooperative study of dental health requirements at Bell Aircraft Corporation with Dr. Heacock of the National Institute of Health and members of the Georgia Dental Association has resulted in a 7-point program recommended by the Georgia Dental Association.
8. An outbreak of dermatitis in textile industries manufacturing mosquito netting for the War Department was investigated with the assistance of Dr. Peck from the Division of Industrial Hygiene, National Institute of Health. Control measures are being instituted.
9. With the assistance of Dr. Hoecker from the National Institute of Health, x-ray and radium exposures at various plants were studied and control procedures recommended.
10. The director is serving as the Co-Chairman of the State Nutrition In Industry Sub-Committee. Better facilities for nutrition in industry are being promoted in all plants by active cooperation with the Food Distribution Administration, the State Department of Health Nutritionist, and local health departments and nutrition committees. Arrangements have been made for active cooperation with the Industrial Feeding Consultant of the Food Distribution Administration. The Industrial Hygiene Service calls her frequently for assistance to industrial plants in Georgia. Detailed studies of eight plants have been completed. All her reports to

Preventable Diseases

193

such plants are channeled through the Industrial Hygiene Service. Many plants have expressed their appreciation of her most helpful surveys, recommendations, and reports.
The activities of the nursing consultant continued along the previous high level of efficiency. Outstanding accomplishments include a reor!!;anization of the nursing program in several of the larger industries of the State. In several localities, industrial nurse associations have been promoted and initiated by the consultant nurse.

Engineering Activities
The engineering activities for this period include 159 field V1s1ts and 1,480 laboratory determinations. These cover work on sanitation, ventilation, dust studies, organic solvents, and detailed plant surveys. In addition, certain field visits have included presentation and discussion of reports, presentation of group talks, conferences, promotional visits, special services, etc.

l. Training of U.S. Public Health Personnel
Two industrial hygiene engineers from the Public Health Service were detailed to this Department for an in-service training in the field of industrial hygiene engineering. These individuals spent three months and two months respectively in observing field and laboratory methods used in the evaluation and control of occupational diseases. In arranging schedules for these engineers an attempt was made to have them work in plants which presented a broad picture of current industrial hygiene engineering problems. Some time was spent in work with Maritime and Navy shipyards as it was felt that such experience would be highly valuable on any future work to which these men might be assigned. In addition, problems involving studies of toxic dusts, organic solvents, ventilation, sanitation, and the like were investigated. Current approaches used in the investigation, evaluation, and control of occupational exposures were followed with these men in an effort to bring to their attention the latest techniques employed in this type work. In addition to detailed field studies, laboratory procedures were reviewed and each man spent considerable time in making actual chemical analyses on samples which he had collected from previous field visits. Also instruction was given in the preparation of engineering reports covering plant studies. Terminating their work with the Industrial Hygiene Service of this Department, these men were detailed to other states.

2. Participation in the War Production Conferences
In April, engineering personnel of the Industrial Hygiene Service participated in a war production conference held in Atlanta. Technical discussions were presented covering hazards associated with welding, heat

194

Georgia Department of Public Health

;;

treating, woodworking, and machine shop work. Reprints of these discussions appear in the official transactions of this meeting under the Georgia Engineering Society. About five hundred individuals attended the various panel discussions. In addition to the formal presentation of this material, active cooperation is carried out with other official agencies whose purpose is to assist various plants with their problems pertaining to war production. The interest of the personnel of the Industrial Hygiene Service in these group meetings is to assist in matters pertaining to the health and productive ability of the employees.

3. Cooperation With U. S. Army Air Force
Of major importance has been the detailed study covering repair facilities of the U. S. Army Air Force located at Warner Robins Army Air Depot, Warner Robins, Georgia. A complete engineering survey of these facilities has been made and a report covering the evaluation of hazards, along with recommendations for their control, has been presented to the officials who are responsible for this activity. Excellent cooperation has been obtained from these individuals and specific recommendations set forth in the report are being carried out at the Depot in an effort to alleviate observed exposures. In view of the nature and extent of occupational exposures present at Warner Robins, it was recommended that a full time industrial hygiene engineer be assigned to this Depot. In accordance with this recommendation, an industrial hygiene engineer has been assigned to the Field on a full time basis and is currently cooperating with the Industrial Hygiene Service of this Department.

4. Bell Aircraft Corporation
At the request of the Bell Aircraft Corporation, a complete industrial hygiene survey has been made of their bomber plant located at Marietta, Georgia. Complete manufacturing operations are carried out at this plant, and it appears that industrial hygiene problems will increase rather than decrease as plant production gets under way. Therefore, one of the principal recommendations included in the report covering this study was the employment of a full time industrial hygiene engineer. This particular recommendation was received favorably and at the present time, this Company is making every effort to obtain, on a full time basis, a well trained, industrial hygiene engineer. From the standpoint of employee population and nature of product manufactured, this is one of the most important plants in the State.
5. Cooperation With Maritime and Navy Shipyards
Detailed engineering surveys of the shipyards in this State have been made with the cooperation of the Health Consultants of the Navy and Maritime Commissions. From an engineering standpoint, this work has

Preventable Diseases

195

been concerned principally with the control of hazards associated with welding. This is especially true of the Navy yar!d which is producing war ships which require a high percentage of galvanized metal in construction. Although the control of metal fume fever presents an acute problem in the one Navy yard, probably the greatest single exposure observed in these yards results from the common practice of welding and burning on surfaces which have been coated with red lead paint. Reports covering these studies and recommendations for observed hazards have been presented to and discussed with the management of these yards and a fair degree of compliance with recommendations has been obtained. It has been found, however, that consultant and follow up visits with these yards is highly important in obtaining the continued interest which is highly ~ecessary for the proposed control of these exposures.

6. Survey of Chemical Plants
Surveys of some of the more important plants producing chemicals for war use have been made. These include the production of such products as war gas intermediates, cellulose for cordite, rayon, and the like. These plants presented certain exposures to highly toxic materials and it is felt that the control of these acute exposures is a problem which deserves especial consideration. Following the presentation of reports covering studies of these plants, excellent cooperation has been obtained.
7. Foundries
Some time has been spent in surveying certain foundries of this State. These include both ferrous and nonferrous metals. A general lack of adequate dust control has been observed in these plants, however, a fair degree of compliance with recommendations has been obtained. Plants are experiencing some difficulty in obtaining necessary ventilating equipment. This is due primarily to restrictions on materials and low priority ratings. Certain of these foundries which have high priority ratings are carrying out recommendations and installing what should be adequate dust control equipment.
8. Promotion of Safety Programs
In working with industrial plants, an attempt is being made to carry safety along as a part of any industrial hygiene prol'!:ram. In this connection, assistance is being rendered to plant safety engineers from the standpoint of both obtaining reference material on safety and of training on safety techniques. A general plan is being followed by which safety engineers with little or no past experience are taken into plants which have well established safety programs. By such a procedure it is possible for these men to review the functioning and organization of well established safety programs. Much has been accomplished in developing more adequate safety facilities in many of these plants.

196

Georgia Department of Public Health

9. Promotional Work With Engineering Groups
Since the installation of ventilating equipment in industrial plants is normally done by either plant or consulting engineers, some effort has been made to contact these groups and to promote industrial hygiene with them by contacting consultant engineers 'and their representatives. Ar rangements have been worked out whereby certain plans for constructio11 of proposed ventilating systems are submitted to the Industrial Hygiene Service of this Department for review before construction is actually started. By following this approach, a satisfactory working relationship with these groups has been developed and, as a result, a number of plants in which these individuals are working have been referred to this Department for assistance on problems relative to the control of occupational hazards.

Development of the Engineering Program for the Year
During this period, the demands upon the engineering personnel of the Industrial Hygiene Service have been tremendously increased due to the all out production by industries of this State in the national war effort. Engineering field visits showed an increase of 57.5 per cent over the pre vious year, and laboratory analyses showed an increase of 240 per cent. Measured in terms of recommendations carried out, it appears that real progress was made from an engineering standpoint cluing the past year.

Preventable Diseases

197

TABLE I.
NuMBER oF PLANTS SERVED BY THE INDUSTRIAL HYGIENE SERVICE AND TYPES OF SERVICE RENDERED

1941

Total Number of Plants Visited____

20

Number of New Plants (initial service during

current year) ________________ _________ ____

20

l'\umber of Old Plants (service initiated m

previous years)

______ _______ 0

l'\umber of Plants which received medical

service

17

Number of Plants which received nursing

service _

ll

Number of Plants which received engineering

service

17

Number of Plants which received laboratory

service ____

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

4

Number of Plants which received feeding serv-

Ice

0

Number of Plant Days Plants were visited

48

Reason for Visit to New Plants:

Occupational Disease Report____

0

Self Initiated ________________

9

Management Request _

7

Local Health Department Request____

0

Physician Request __

___________ _

0

Army Request

0

Other Request ___

4

Total Employee Population of Plants

Number of Counties m which Plants were

Located __

------------------------------------------ 14

1942 1943 96 113

87

48

9

65

60

76

43

64

30

33

12

19

0

8

309 396

0

0

70

24

19

24

3

1

0

0

0

2

2

6

163,798

31

31

198

Georgia Department of Public Health

TABLE II.
SuMMARY OF MoNTHLY AcTIVITIES REPORTS OF INDUSTRIAL HYGIENE SERVICE PERSONNEL

I. PuBLic RELATIONS:

Totals

A. Conferences
1. Number _____ ------------------------------------------------------------------------ 872 2. Average Attendance (not including IHS personnel)________ 3

B. Meetings

l. Number Attended -------------------------------------- _______________________ 121

2. Number Addressed ------------------------------------------------------------ 79

3. Average Attendance Addressed_____ --------------------------------- 52

4. Number of Films Shown______________________________________

39

C. Literature Distributed _________________________ D. Radio Talks ________________________

--------------- ---- ____14,194 0

E. Published Articles

27

II. FIELD VISITS:

A. Promotional Visits ______________________ ____________________ ___________________ _ 257

B. Special Services ------------------------------------------------------------------

185

C. Formal Survey Reports Presented__________________________________________ 25

Ill. ENGINEERING AcTIVITIES:

A. Sanitation Studies

15

B. Ventilation Studies _____________ _

50

C. Dust Studies ------------------------

19

D. Organic Solvent Studies

16

IV. LABORATORY STUDIES:

A. Samples Collected _____________________ ______________________________________ 198

B. Physical and Chemical Analyses Made________________________

1,414

C. Special Studies ---------------------------------------------------------------

38

V. MEDICAL AND NuRSING AcTIVITIES:
A. Conferences with Physicians____________ _________________ _____________________ 164 B. Conferences with Nurses__________________________________________________________ 424 C. Occupational Disease Cases Reported____________________________________ 12 D. Occupational Diseases Cases Investigated_____________________________ 166

Preventable Diseases

199

TABLE III.
TYPES oF SAMPLES CoLLECTED BY INDUSTRIAL HYGIENE SERVICE
IN GEORGIA IN 1943

1. Acid mists ____________ --------------------------------- --------------------------------------- I

2-. Acrolein -------------------------------------------------- --------------------------------------- I

3. Arsenic Trioxide ______ _______________ ----------------------------------------------------- 1

4. Asbestos dusts ___________ ____ ___ _____ ___

7

5. Biological specimens

7

6. Calcium arsenate

6

7. Chlorides ------------------------------------------------------------------------------------------ 4 8. Chlorines ------------------------------------------------------- ____________________________ _ 5

9. Chromic acid _________ ------------------------------------------------------------------------ 2 10. Fluorides ---------------------------- ________________________________________________________ 5

11. Iron oxides ---------------------------- ----------------------------------- --------------------- 6

12. Lead dusts ____________________________ --------------------------------------------

21

13. Lead fumes -------------------------------------------- ----------------------------------------- 16

14. Organic solvents _________________ ____ ____ ___________________

15

I5. Silica dusts ________ __________________ ----------------------------------------------------- 27

16. Sulphates ________________ _________________

------------------------------------------- 4

I7. Sulphur dioxide ---------------------------------------------------------------------------- 4

18. Zinc oxide ---------------------------------------------------------------------------------------- 2 19. Miscellaneous ___________________________________ -------------------------------------------- 64

198

200

Georgia Department of Public Health

TYPH S FEVER CONTROL SERVICE

For th e year 1943, the professional staff of the Typhus Fever Control Service rendered services to 51 citi es and towns in 49 counties as compared with ser vices rendered to 40 cities and towns in 35 counties for the previous year. A total of 427 field visits was made during 1943 as compared with 298 field visits for 1942.
Administrative
The activities of the T yphu s Fever Control Service are directed from the central.office in Atlanta by th e Medical Director and the Engin eer of th e Division of Preventable Diseases. F ield activitjes are co ndu cted fr om th e Macon office which is located in the P ersons Building.
The professional staff of the Typhus Fever Control Service consists of sanitary engin eering personnel. Medical assistance is provided by the medical staff of the Division of Preventable Diseases, regional medical directors. and county health officers. In order that all available method of con trolling typhus fever may be utilized to the maximum ex tent, complete professional advisory assistance is rendered to the citizens of the
tate, principall y through their municipal and county governments.
Personnel
Personnel of the central office consists of one sanitary engin eering director of the service, and one secretar y. Personnel of the Macon fi eld office during th e first half of the year consisted of two sanitary engineers, one engin eering aide, and one secretary. For th e greater part of the secon d half of the year, the personnel of the Macon office con isted of one sa nitary ensi neer, one engin eering aide, and one secretary.

Preventable Diseases

201

Educational and Promotional
The educational program is conducted principally through the medium of visual education, using stereopticon slides, and a descriptive booklet entitled "Murine Typhus Fever." The Typhus Fever Control Service maintains a collection of approximately four hundred 2" x 2" stereopticon slides on various phases of the control program as conducted in Georgia during the past six years. Stereopticion slides and the descriptive booklet are used extensively to illustrate lectures before public groups, civic organizations, and meetings of county and municipal officials.
The efforts of the Typhus Fever Control Service to conduct an intensified educational and promotional program during 1943 are supported by the following accomplishments:
During the year, L575 personal conferences were held; 5 meetings attended; 23 meetings addressed with approximately 570 persons in attendance; and approximately 4,000 pieces of literature distributed. Of the 28 meetings addressed, 9 were city council meetings and 19 civic organization meetings.
Investigations
EPIDEMIOLOGY
Special epidemiologic investigations were made in Jenkins and Coffee Counties by the Epidemiologic Service. Routine investigations were made by regional medical directors and county health officers.~
ENGINEERING
As a part of the standard plan for typhus control, engineering investigations are made in predetermined typhus foci areas prior to the inauguration of control measures. Engineering investigations are directed toward the determination of the prevalance of typhus fever and the environmental conditions conductive to the animal reservoir (rat) and the transmitting agent (rat flea) of the disease. Investigations and recommendations are supported by detailed reports that are submitted to the local sponsoring agency, such as the municipal government, local health department, or civic organization.
Seven city-wide and 9 special investigations were made during 1943. The city-wide investigations are made on the basis for the establishment of a complete typhus fever control program. Special investigations are made of environmental conditions involving some phase of the typhus control program, such as refuse collection and disposal practices.
Investigative Studies
Although no comprehensive investigative study project was conducted during 1943, the Typhus Fever Control Service constantly conducts studies of control measures as they are applied. As a result of routine studies

202

Georgia Department of Public Health

during 1943, improvements were made in the design of curtain walls as used in "vent-stoppage" of buildings. The new type of curtain wall consists of concrete construction, 2 inches thick, and constructed in the shape
of an inverted L. The horizontal arm of the L is constructed l8 inches long
and the vertical arm extends in the ground to a minimum of 30 inches. The curtain wall is sealed to the existing foundation wall at a point 2 inches above the bottom of the foundation wall. This type of curtain wall appears to be a more effective barrier than a straight vertical type of curtain wall in preventing rats from burrowing under existing building walls.

Control Measures
Control measures currently applied in the standard plan of typhus control consist of "vent-stoppage" of buildings, rat extermination, and refuse collection and disposal practice.
Accomplishments, as indicated by figures in the following paragraphs, are based only on the activities of the personnel of the Typhus Fever Control Service and do not include a complete record of the accomplishments made by local health departments that are currently applying typhus control measures.

Vent-Stop page
"Vent-stoppage," a modified form of "rat-proofing" buildings, consists of closing or protecting exterior walls of buildings to prevent the ingress of rats. "Vent-stoppage" is applied as a permanent rat control measure. During and immediately following the application of "ventstoppage," rat extermination is applied in order that rats may be completely eliminated from the "vent-stopped" buildings.
The average cost of applying "vent-stoppage" is about $30.00 per business establishment. This figure is based on the war time prices of materials and wage scale of labor.
During the year, 1,575 business establishments and 18 residences were surveyed for "vent-stoppage" and 3,000 business establishments and 84 residences were inspected. Incomplete records show that 221 business establishments and 4 residences were "vent-stopped" and 284 previously "vent-stopped" business establishments and 2 residences were repaired.

Rat Extermination
Rat extermination campaigns, employing the use of poison bait, were conducted in the business district of 8 cities and towns. A total of 2, 776 business establishments were treated. In addition, one county-wide rat extermination campaign in Hall County was conducted under the direction of the local health department.

Preventable Diseases

203

Rat trapping campaigns were conducted in the business district of 6 cities and towns, involving a total of 791 business establishments.
Rat extermination campaigns were conducted, for the most part, under the direction of the Typhus Fever Control Service.
Refuse Collection arul Disposal Practices
Advisory assistance, pertaining to this phase of the typhus control program, was rendered to all municipalities engaged in typhus control activities during the year. Special reports covering investigations and recommendations were submitted to 4 cities and towns. In addition, results of investigations accompanied by recommendations were included in the 7 city-wide reports as previously discussed, under the paragraph "Investigations," in this report.
In view of the shortage of Jabor, material and equipment, together with the financial burden placed on many of our cities and towns in war areas due to the war effort, expansion or improvement of existing municipal refuse collection and disposal facilities has been greatly limited during 1943. However, through the assistance of the Federal Works Agency in rendering financial aid to communities in war areas, the City of Hinesville purchased the necessary equipment for the operation of a sanitary land-fill for refuse disposal. In addition, other cities and towns in war areas throughout the State have applied to the Federal Works Agency for financial aid to purchase equipment for the improvement of collection services and the establishment of sanitary land-fills in place of open dumps for the final disposal of refuse.
Publications
"Facts About Typhus Fever"-published in the Journal of the Medical Association of Georgia, September 1943, pages 314-315.
Typhus Fever in Georgia
On the basis of provisional figures, 1,236 cases and 57 deaths were reported for 1943 as compared with 1,153 cases and 52 deaths reported for 1942. This is an increase of 7.2% in the number of cases and 9.6% in the number of deaths reported for 1943 over 1942.
Approximately 90% of the cases and deaths reported for 1943, as well as for previous years, was from the southern part of the State or south of Augusta, Macon and Columbus. In certain war areas of this section of the State, a definite increase in the number of reported cases over previous years has been recorded. This increase has, no doubt, been influenced to some extent by the migration of the population from non-war areas of Georgia and adjoining states into war areas of Southern Georgia, thereby resulting in a larger population becoming exposed to the disease. For this reason and because of the importance to the war effort, activities of the Typhus Control Service are concentrated in war areas of the State.

204

Georgia Department of Public Health

MURINE TYPHUS FEVER GASES AND DEATHS REPORTED IN GEORGIA

1300

12

1200

1100

1000

(/)

w 900
(/)

817

< o(w0 800

- oLwm0:oLo:w:I:~:-:

700 600 500

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:z::>

400 300

200

100 ~

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Preventable Diseases

205

Statistical Summary of Activities
The following Statistical Summary of Activities gives a tabulation of accomplishments by counties and cities for the year 1943. In addition, a separate statistical summary of activities for the City Health Departments of Atlanta and Savannah are tabulated. These two cities have a permanent Typhus Control Service as a part of the activities of the local health department. Personnel are engaged full time in rendering typhus control services. The City of Camilla also established, during 1943, a Typhus Control Service as part of the activities of the local health department. This was made possible, as in the case of Atlanta and Savannah, by funds appropriated by the city council.

COUNTY

Health Officer

Non-Health Officer

CITY

Appling Baldwin
Bibb Bleckley Burke Chatham Coffee Colquitt
Crisp Decatur Dodge Dougherty
Fulton
Glynn Grady
Jefferson Jefferson

Barrow Ben Hill Berrien
Cook
Emanuel Franklin Gilmer Houston Houston

Baxley Milledgeville Winder Fitzgerald Nashville Macon
Cochran Waynesboro Savannah Douglas Moultrie A del Cordele Bainbridge Eastman Albany Swainsboro Rural Atlanta Ellijay Brunswick
Cairo Perry Warner Robbins Louisville Wadley

STATISTICAL SUMMARY OF ACTIVITIES

t-.:l
~

Educational

Control Measures

Investigations

Vent-Stoppage Number of Establishments

I Rat Extermi- Ordinance

nation

Enacted

~

--

I

1----:--

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1- . . . 21 :; f]l '"""""CC;
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pa1red

rn
= z .... '-' Ill

~~

~ o

:~:J

~.._a

.;.1>0
.."...,~:,;.

~
~

~

=~ t G.l!::~.t.~ i:j

~ =. ..... g: ze ..f.. >; ~o

~.s &
'~if ~'tA.~

~

l I I I I I I I I I I --~-- ! I I I

I

I 131 721 I 21 471 I 231 11 I 1181

I

I

I I 180

I

'

I I I I 11 10211 II II

101I II II

I 11 61 I 11 321 I 391 I I

I II II II

I

II I

Cb
~

I 11 I I I I I I I I

311 I I I

I

~

I I I 151 671
I I I I I 1011 2221j

III I II II

20 I 11 31 3

I

II

41 I I I 151

I

I I 161I

26 I II

~
0"'

I I I I 29 1521
I I I - 151 601

I 1 101

11 74 18 1311 41 5461 181 2251 2 261 I 2841

I 11 1196

I

301 I

II

I

~

I I 371 1771 1 51 1111

201 1 289

I

221

I

I

I I I 61 141
I 3 31

I II

I II

I I 391

I

I

I

IIIII II

I

I I t 51 301 I

I

201

I 175

I I 761 I I I I I I

I 391 1601 11 31 651

221

I

1111 1111

II

II II II II \

I 11 61 I I I I I I I

11 21 I I I

I I 1110

161 II I

1451 561 71 II I II
I I 51 I

I I
I

I II

II 161 II I

611 I 7501 I 41 123851

791

21 61

6
1

23411

11 11

121 561

11 11

I11 11 20 I II II

III

I 31 211

I

I

40 I II II II
II I I

II 11I II II I I 11

II
I I I

I 30 I 51
I II 91I
II I 421 III

II
I I I

1261 II I
I II

II I

I II I I I

11 11 I I I

I I I1

IIIII

I

J nkins

L urens

L >erty

L wndes

M tchel!

erce

Iaski

.bun

Randolph

chmond

aiding

Screven

s mter

Stewart

Taylor

T !fair

T Et

T omas

Truetlen

T oup

T oup

ww

alton are

Upson

w, > r t h

Wilcox

Unclass ified

TOTAL

Millen Dublin Hinesville Valdosta Camilla Blackshear Hawkinsville Clayton Cuthbert Augusta
Sylvania Griffin Lumpkin
Americus Butler McRae Tifton
Thomasville Soperton LaGrange
West Point Thomaston Monroe Waycross Abbeville Sylvester

16[ 51[

3[ 51[

~I

2[ 3[

II II

1[ 21

II

50[ 201[

21 19[

1[ 2[

II

4[ 12[

1[ 23[

1[ 3[

II

1[ 1[ 2[ 71 1[ 3[

II II II

2[ 151 1[ 2[
3[ 2[

II II II

21 4[

II

2[ 41 71 20[

II II

51 10[ 1[ 1[

II II

141 241

II

17[ 90[

1[ 9[

1[ 9[

1[ 55[

11 4[ 8[ 23[

II II

1[ 1[

II

22[ 45[

1[ 6[

57[ 167[ 2 3[ 101[

II

II

427[1575[ 5 28[ 570[

i 50[ 1[

III

I I

I

I

I

III

I 10[ I

I 20[ I

III

III

III

III

I II

III

III

III

III

I I 1[

III

III

III

I 3[ 1[

I 31[ I

III

III

I

I

I I

I II

[3642[ I

III

[3950[ 7[

I 1511

I

I

I

I

I

I

I

I 47

13[

I

I

II

I

1[ I

I

I

I

1[
! I,
I

I I I

II

I

I II
I I
217\

I I I I I

II
I 100

I I I

I

I

I

I

21 12

i

I

I

I I

82\

I I

II

I

9[1575[ 18 2212[

I 50[

3[

I2 1

I I

I

14051

29[

II

I I

I 191 39[

I I I

II

I

I 231 I 16[

I

I

I

231

I

I 361

I I I

I 11

I

II I 283\

I
17[
I

I 10

I

i

I

ilI
I4

I I I

413oool 84 2851

I 3[ II II II II

I

I
I

II II II
II I I II
II I II
II

I 151 II
I I
I II

II

II

2[2776[

II II
l I
I 186[ I
II II II
I I
I II II II
l I
1,
I II
I I
I II 1161 I II II
I I
I
I 110[ I I I
791[

I IIIIIIIII

IIIIIIIIII

I Repor ts of City Health Departments Having Established a Permanent Typhus Fever Control Service:- I

I III II i I II

III

IIIIII

F !ton
c atham

Atlanta Personnel: 1- Director 1- Supervisor 5- Laborers
Savann ah Personnel: 1- Director 4- Laborers

Atlanta Savannah

1 2561 14\ 101 4341

II

II

II I II
I /160!
II

II
I9

II II II
41 2001
II II

II

II

1 1751
II II II II
1 241
II II II

I I I II I II I

I 1101 II
I I I
II I 74 18 Ii I

611 I 7501

41

IIIII

IIIII

II II II II II

321 41 1061 181 711

I I II II I II II

I

II

/23851
II II II
I21 231 II II

I 791 II II II II
II 441 II II

I
I I
I
I

I I I I I I _I__ I I

I I I I I II I I

"'i:l ~
<:!
~
s;::1
C"' ~
1c 1:; ~ ~
2 "'
~
0 -1

208

Georgia Department of Public Health

VENEREAL DISEASE CONTROL SERVICE
Personnel
The personnel of the Venereal Disease Control Service includes:
State Venereal Disease Control Officer Associate State Venereal Disease Control Officer P. A. Sanitarian, U.S.P.H.S. -Transportation Officer A. A. Sanitarian, U.S.P.H.S. -In charge of Central Registry Social Hygiene Consultant Six (6) Stenographers
A large number of the staff of the Division of Laboratories are engaged in performing laboratory tests and distribution of drugs.
The department has, as yet, been unable to secure the services of a full-time State V. D. Consultant Nurse. Such a person is very badly needed.
Case Reporting
There is evidence to believe that the program has finally begun to catch up with the huge "back log" of neglected cases with which it was saddled in its beginning a few years ago. In beginning a new program for control of a chronic disease, such a handicap is to be expected.
Since the start of the program a few years ago, there has been, month by month, a steady increase in number of syphilis cases reported by physicians and clinics. However, for the first time, during the last half of 1943, there has been a steady decline in these figures. Since case-holding and case-finding are, if anything, better than they have ever been, it would seem that a definite reduction in incidence and prevalence has been accomplished. (See Table I.)

TABLE I NEW CASES OF VENEREAL DLSEASE REPORTED DURING 1942 AND 1943

Clinics

Disease
Syphilis ~----------------------
Gonorrhea -----------------------------Chancroid -------------------------------Gran. inguinale ---------------------Lympho. ven. -----------------------

1942
21,517 7,453 557 78 34

1943
18,376 9,049
454 185 89

Pri. Phy.

1942
3,525 2,125
83 26 17

1943
3,023 1,917
59 9 6

TOTAL

1942
25,042 9,578 640 104 51

1943
21,399 10,966
513 194
95

Preventable Diseases

209

0 importance is the fact that 71.7% o syphilis cases reported by clinics during 1943 were early cases of public health significance.
For cases "other than syphilis" reported, increases for 1943 over 1942 are shown except for chancroid. This shows that more attention is being paid to these other important diseases than heretofore.

Clinic Activities
As of December 31, 1943, there were 267 clinics operating in 147 counties, as compared with 251 clinics operating in 144 counties at the end of 1942. Case loads are shown in Graph I.
In line with the steady decline, during the last half of 1943, in number of syphilis cases reported, there has been, over the same period of time, a steady drop in clinic case loads. There had been, previous to this period, a steady increase in clinic case loads since the beginning of the program. (Graph I shows rise and fall of case loads for 1942 and 1943).

Epidemiology
This activity was greatly handicapped for a long time by the simplt fact that workers in the field knew very little about the venereal diseases themselves, let alone the fundamentals of their epidemiology.
Repeated clinic visits, talks at quarterly staff meetings, and finally a well planned series of V. D. institutes held in November, 1943, have improved this situation to a remarkable extent.
The new epidemiologic report form, which is now in use, will undoubtedly improve the quality of contact tracing extensively.
All in all, good epidemiology is now being done in most localities. Needless to say, no V. D. control program is any better than its epidemiology.

Central Registry
Eo.tablishment of the unit constitutes an outstanding step forward. The new epidemiologic report form provides for accurate contact history taking and record keeping in local departments and provides means for accurate evaluation of epidemiology done by means of punch card study in the central office.
The registry also will prevent duplication of follow-up efforts, detect duplicate admissions to the CTU, show location of problem areas, and point out weaknesses in epidemiologic methods.
The Central Registry is under the supervision of J. W. Rion, A. A. Sanitarian, U. S. Public Health Service.

210

Georgia Department of Public Health

GRAPH I
a ACTIVE SYPHILIS CASE LOADS FOR 1942 1943
ALL CLINICS
50,000

1942

MONTHS

1943

Distribution of Free Drugs
While the first half of 1943 showed a 36 per cent increase in doses of drugs distributed over a similar period in 1942, the decrease in clinic case loads during the last half of 1943 has resulted in a total distribution of drugs for 1943 which was not noticeably greater than 1942. (2,450,868 doses distributed in 1942 against 2,605,987 doses for 1943.)
Laboratory
The laboratory continues to show an increase in serologic tests for syphilis performed, as well as an increase in smears examined for gonorrhea.
It is noted with regret that very few clarkfield examinations for syphilis were submitted, the number for 1943 being even less than the number for 1942. This is one of the most important tests in differential diagnosis and should be routinely used where lesions are present.

Preventable Diseases

211

TYPE OF TEST

1942
No. tests No. Pos. o/o Pos.

Syphilis (Serologic)

515,566

Syphilis

(Darkfield)

226

Gonorrhea (Smears) ------------------

9,813

77,459 84
1,593

15% 37.2% 16.2%

1943
No. tests No. Pos. o/o Pos.

552,187 72,839 13.2%

168

53 31.5%

11,784 1,642 13.9%

Education (Professional)
The informative program among field personnel has been mentioned
under epidemiolo!!:Y By and large, our nurses are now ahead of our cli-
nicians in knowledge of management of the venereal diseases.
An informative program for physicians is badly needed and should be carried out as soon as conditions permit.
Education (Lay)
This program is progressing nicely. Arrangements are almost com-
pleted for teaching of sex hygiene in schools throughout the State fol-
lowing ground work done mainly by Mrs. Charles D. Center, our social hy!!:iene consultant, and Dr. W. A. Mason, A. A. Surgeon, U. S. P. H. S., on loan. In this connection, all summer schools and workshops were visited by Mrs. Center or Dr. Mason, or both. Sex hygiene will be incorporated into school curricula.

SUMMARY OF EDUCATIONAL ACTIVITIES

Activity

No.

Meetings addressed ________________________________________

69

Meetings attended ___

62

Films shown

184

Clinic visits _____________

113

No. of conferences _________________________________

129

Exhibits shown ---------------------------------------------------------------- 36

Literature distributed ______________ ----------------------------------- 230,952

New members Go. Social Hygiene Council_________________ 56

Audience
9,202
35,882

212

Georgia Department of Public Health

Cooperation with Selective Service
During 1943, 86,514 selectees reported by Selective Service and military authorities as being venereal disease subjects were followed up and 27,771 placed or found under treatment.

Legislation
H. B. 136, reqmrmg blood test for syphilis on all pregnant women, was enacted in March, 1943, becoming effective July 1, 1943.
H. B. 137, expanding legal coverage of prostitution activities, was enacted March, 1943.
H. B. 138, requiring premarital blood test for syphilis, failed to pass the legislature.

Prostitution Control
Open prostitution has apparently been suppressed throughout the State.

Detention and Quarantme
The U. S. P. H. S. facilities in Savannah are now operating to near capacity. A substantial increase in number of patients admitted has resulted from broadening of eligibility regulations and establishment of bus routes to facilitate transportation. Mr. Warren T. Davis, P. A. Sanitarian, U. S. P. H. S., is in charge of arrangement of transportation for patients. His work has materially improved the status of patient admission, especially as regards increased number of patients secured.

Summary
It is felt that the program, which for sollle time was almost entirely one of treatment, has taken shape and may be said to consist of reasonably complete and well balanced activities including:
1. Diagnosis and treatment. 2. Case-finding and case-holding. 3. Education (not propaganda). 4. Records and reports. 5. Cooperation with law enforcement and military agencies. 6. Detention and quarantine.

TABLE "A"

SYPHILIS CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By Private Physicians
UNDER PROGRAM FOR DISTRIBUTION OF FREE ANTISYPHILITIC DRUGS
January December, 1943

NEW CASES (Never previously treated)

White

Colored

M

F

M

F TOTAL

January ------------------------- 35

20

77

81

213

February ------------------------ 27

18

62

64

171

March ----------------------------- 37

40

95

87

259

April -------------------- 45

40 115

143

343

May ------------------- 31

35 124

140

330

June ---------------------- 37

43

79

96

255

July ---------------------------- 32 38 82 164 316

August ---------------------- 56

53 100

168

377

September ------------- 35

28

53

98

214

October ------------------------- 33

31

64

87

215

November ---------------- 24

28

46

102

200

December __ -------------------- 27

19

35

49

130

TOTAL ------------------- 419 393 932 1,279 3,023

OLD CASES (Previously treated)

White

Colored

M

F

M

F TOTAL

35

25

25

27

112

25

18

22

28

93

21

17

20

22

80

40

20

47

53

160

30

29

43

68

170

24

21

42

35

122

21

22

46

48

137

27

23

51

77

187

28

24

37

64

153

29

24

31

31

115

10

16

19

28

73

13

22

10

25

70

303 261 393 506 1,463

TOTAL REPORTED

White

M

F

70

45

52

36

58

57

85

60

61

64

61

64

53

60

83

76

63

52

62

55

34

44

40

41

Colored

'..".,tl

M

F TOTAL

<b
<::

<b

102

108

325 .;:,:.1..

!;l

84

92

264

0...."..'.

115

109

339

<b

162

196

603

0
!:;

167 121

208 131

600 377

<b
~
<b

128

212

453 "'

151

245

555

90

162

367

95

118

330

65

130

273

45

74

200

722 654 1,325 1,785 4,486

tv
w"""'

,"~ .".".

TABLE "B"

SUMMARY REPORT OF CLINIC ACTIVITIES

SYPHILIS

January- December, 1943

NEW CASES OF SYPHILIS ADMITTED TO CLINIC

White

Colored

M

F

M

F

January ____ --------------------- 66

41 1,123

685

February .... ------------ 67

52 1,068

853

March ...........

------- 86

50 1,108

942

April ...........

64

42

911

953

May-------------------------------- 48

28

859

785

June ______________________________ 49

37

800

799

July ................................. 38

46

695

732

August ........................... 37

48

730

706

September ----------------- 31

49

472

539

October ...... ------------- 37

41

420

477

November

-------------- 60

46

450

461

December ------------------------ 45

37

336

327

TOTAL ------------------------- 628 517 8,972 8,259

OLD CASES OF SYPHILIS ADMITTED TO CLINIC

White

Colored

M

F

M

F

187 141 173 179 180 156 148 121 123 151 140 99
1,798

116 98
119 123 137 114 106 83 87 299 82 71
1,235

1,721 1,337 1,634 1,556 1,430 1,472 1,382 1,822 1,243 1,278 1,382 1,072
17,329

1,683 1,370 1,358 1,653 1,357 1,530 1,217 1,186 1,214 l,l87 1,170
834
15,759

DOSES

~

Total Under

ADMINISTERED

c~

Total Ad- Treatment

Heavy

~s

missions During Month Arsenicals Metals

t:::1

~

5,622

30,512

45,437

39,608

~
...!..:.l.

4,986

32,257

47,029

40,767

~

5.470 5,481 4,824 4,957 4,364

33,467 35,183 34,367 34,503 33,089

50,039 53,262 50,823 50,080 46,938

43,910 48,907 49,206

-...;~:s
c ""c'

~

48,040

.c0.:.";..'

47,488

4,733 3,758

31,527 30,328

::X::

44,717 45,499

43,424 41,464

~
.!..,:..l....

3,690

29,899

39,975

39,605

3,791

28,589

38,324

40,138

2,821

25,997

34,076

34,360

54,497

546,199

516,917

-:-:.-!

Y~;?;~~:
'

TABLE "C"

GONORRHEA CASES REPORTED TO VENEREAL DISEASE CONTROL SERVICE By Clinics
January- December, 1943

NEW CASES ADMITTED (Not previously treated)

White

Colored

M

F

M

F

January _______ ------------------ 36 147 205 270

February _____ -------------------- 38 114 208 334

March ---------------------------- 46

81 153 338

April ------------------------------ 38

73 161 293

May -------------------------------- 53

141

202

397

June ------------------------------- 56

182

258

530

July _____ ---------------------------- 79

133

265

280

August --------------------------- 46

99 178 584

September --------------------- 92

144

224

425

October ------------------------- 79

183

244

446

November ----------------------- 76

159

173

351

December ----------------------- 34

150

118

133

TOTAL ---------------------------- 673 1,606 2,389 4,381

OLD CASES ADMITTED (Previously Treated)

White

Colored

M FM

F

10 16 109 25

10 12 94 18

5

3 79 21

12 13 62 30

30 32 104 54

12 14 72 37

22 29 102 46

8

7 33 12

27 16 77 37

34 22 63 55

11 15 63 38

8 53 33 160

189 232 891 533

CASES ADMITTED No information as
to previous treatment

White

Colored

MFM F

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

2 ------ 16

6

1 16

6

2

1 13

3

6

6

1

6

6

9

6 16 12

1 23 14

6

12 19 13 12

22

2 24

1 13

4 10

1 45

5 32

20 136 111 126

Total

Total

Under

Treatments

Total

Treatment

During

Admitted During Month Month

~

818

1,170

~

1,582

<::
~

852

1,086

1,548

s;::!

o-

749

1,028

1,515

~

701 1,025 1,183
990

972 1,292 1,322 1,411

1,391

t:::l

);;

1,698

;~,

1,531

"~ ' "'

1,956

1,011

1,364

1,345

1,098

1,380

1,301

1,174

1,605

1,463

914

1,380

1,130

772

979

974

11,287

17,434
1,.:.>..:.)
C/1

TABLE "D'

TOTAL NEW VENEREAL DISEASE CASES REPORTED TO THE VENEREAL DISEASE CONTROL SERVICE January - December, 1943

BY PRIVATE PHYSICIANS

White

Colored

M

F

M

F

SYPHILIS

Pri. & Sec..._______ -------------------------------------- 313 296

571

744

Early latent _______ ------------------------------------ 8

15

38

59

Late & Iate Iatent_______ --------------------------- 84

63

302

450

Congenital ---------------------- --------------------------- 14

17

21

20

Prenatal _________________________ ---------------------------- -----

2

------

6

BY CLINICS, HOSPITALS OR OTHER INSTITUTIONS

White

Colored

M

F

M

F

72

114

696

730

218

252 4,257 4,795

311

134 3,808 2,478

27

17

211

256

----

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

TOTAL ----------------------------------------------------

419 393

932 1,279

GONOCOCCUS INFECTION

Genito-urinary ______________ ----------------------------- ----- ------

--------

------

Opthalmia Neo -------------------------- ----------------- ------ ------

--------

------

Not stated ----------------- _______ ------------------------- 314 140 1,019

444

628

517 8,972 8,259

10

70

75

198

----- ------ -------- ------
663 1,536 2,314 4,183

TOTAL ------------------------------------------------------ 314 140

OTHER VENEREAL DISEASES

Chancroid -----------------------------------------------------

7

Granuloma ing. ------------------------ -------------------- 1

Lymphogranuloma -----------------------------------
--

TOTAL ________ ---------------------------------------------

8

3
--
3

1,019
27 8 3
--
38

444
22 ---3
--
25

673 1,606 2,389 4,381

27 6
--
33

11 1 1
--
13

296
77
68
--
431

120
101
30
--
251

1>.:)
>-' 0\

TOTAL BY ALL SOURCES

White

Colored

M

F

M

F

~
"c '

385

sa1
410 1,267 1,474

226

267 4,295 4,854

0

395

197

4,110

2,928

"''1::! !;l

41

34

232

276 ;;:!.

-------1,047

;:!

2 910

-------9,904

6 9,538

-.";.:.='..
c
~

10

70

75

.... 198 0-.,=.."..

977

------1,676

-------3,333

------4,627

:":"t::
s:"'!;l

987 1,746 3,408 4,825

34

14

323

142

7

1

85

101

----

1

61

33

-- -- -- --

41

16

469

276

--- , .-; ~

TABLE "E"

FREE ANTISYPHILITIC DRUGS DISTRIBUTED Venereal Disease Control Service
January December, 1943

.3

.45

N E 0 A R S PH EN A M.I N E

.6

.75

.9

3.0

4.5

6.0

10.8

45.0

January ---- ---------------------- 390 1,590 6.800 50 200

933

440

February .... ------------------- 675 1,825 8,150

130

970

270

3,060

270

200

2,540

370

March ,.___ --------------------- 260 1,370 9,435

470 1,020

230

April -------- ---------------------- 725 1,175 10,105 10 420 1,140

540

May ....................._............- 300 1,680 9,140

220 1,010

600

June --------------------- 160 1,110 7,950

170

860

590

J u )y .........................________ 380

890 9,190 130 160

870

430

2,415

475

3,560

250

2,062

700

2,060

350

2,340

190

August ------------------------------ 330 1,270 5,370

80

September ---------------------- 200

720 6,560

130

October ------------------------------ 90

650 4,770 100 160

November .........._____________ 150 1,185 6,365

170

502

100

600 1,120

570

235

335

20

1,500

350

375

1,680

750

1,295

100

1,555

500

350

December ------------------- 170 1,320 6,320 300

110

280

100

1,550

60

TOTAL ----------------------- 3,830 14,785 90,155 590 2,420 9,090 4,575

25,617 4,355

925

TOTAL NO. OF DOSES -------------------- 3,830 14,785 90,155 590 2,420 45,450 34,212.5 256,170 78,390 69,375

CLORARSEN

.045 .067

.45

.67

200 280 680 250 210 730 630 1,580 875 120 70 620

2,100 1,770 1,430
890 580 1,050 860 2,030 880 880 745 720

20 170

150 80

...._, ,

<'tl

34

180

~
<'tl

260

s;:l
c-

324

290 ib

510

496

t::l &:

120

480

<'tl
~

270

410

<'tl
"'

70 1,025

50

420

260

310

370

6,245 13,935 1,760 4,471

6,245 13,935 17,600 44,710
,t.-.....J.
-1

TABLE "F"

FREE ANTISYPHILITIC DRUGS DISTRIBUTED Venereal Disease Control Service January- December, 1943

January --~---------------------February ----------------------March ---------------------------April ----------------------------May -----------------------------June -------------------------------July ----------------------------August --------------------------September ---------------------October --------------------November ------------------December ------------------------
TOTAL-----------------------
TOTAL NO. OF DOSES._____________

Sulpharsphenamine

0.2

0.4 0.6

280 140 70

120 190 60

40

35 10

115 205

5

345 940 170

400

80 230

90

30 70

95 170 20

85 200

295 110

5

80 1,010 70

20

30 60

1,965 3,140 760

1,965 3,140 760

Total No. doses of neoarsphanemine __________
Total No. doses of clorarsen -----Total No. doses of sulpharsphenamine __________
Total No. doses of mapharsen ---------------------------Total No. doses of stovarsol -----------------Total No. doses of tryparsamide -------Total No. doses of sulfathiazole ------------------------Total No. doses of bismuth --------------------------

TOTAL _____________ ----------- _____

0.04
1,260 1,840 1,530 1,210 1,470
790 1,150 1,240 1,480
590 780 650
13,990

Mapharsen

0.06

0.4

1,320

470

1,860

1,910

2,060 110

1,880

1,780

2,600

40

1,800

10

1,860

50

2,270 100

1,830

50

21,640 420

0.6
no
560 380 820 950 950 800 430 1,010 680 840 1,038
9,168

Stovarsol Tablets
3,950 4,050 1,875 1,535 2,250 3,525 1,900 2,300
600 2,600 2,150 1,100
27,835

Bismuth

30-cc

60-cc

709 437 598 1,008 1,914 942 439 432 557 465 283 229

573 508 788 606 132 952 686 1,878 971 624 759 468

8,013

8,945

13,990 21,640 4,200 91,680

27,835

240,390

595,377.5 (For larger ampoules, 0.6 considered dose) 82,490 5,865
131,510 27,835
20
985,800 }"''"' . 777,090 (l-ee considered dose)

5:16,700

2,605,987.5

t-:i >-'
00

Sulfathiazole

--
Tryparsa-

Bottles of mide

Tablets 40 tablets 3.0

~

55,000 464

83,000

55'3

88,000 492

~s"c"

72,000 237

63,000 411

91,000 342

19,000 450

90,000 215

20

72,000 247

61,000 207

70,000 174

55,000 378

t::1
..~""
.<.=..l
;:;
.."";:I
c
-"1:1

819,000 4,170

20

!g;: :

"C'')

985,800

20

::t:
"":;<:.=:.:l.-.

TABLE "G"

LABORATORY EXAMINATIONS FOR VENEREAL DISEASES Performed in Central Laboratory and Two Branch Laboratories
Georgia Department of Public Health
January- December, 1943

SEROLOGIC EXAMINATIONS

Number TOTAL Positive

Number Negative

Percent Positive

January ------------------ 54,738

7,349

47,389

13.4

February .................. 51,833

7,343

44,490

14.2

March --------------------- 53,698

7,873

45,825

14.7

April ----------------------- 47,936

7,420

40,516

15.5

May ....-------------------- 45,738

6,656

39,082

14.5

June ------------- 44,915

5,911

39,004

13.2

July ............______________ 48,314

6,117

42,197

12.7

August ----------- 42,163

5,341

36,822

12.7

September --------- 39,514

4,287

35,227

10.8

October ------- 44,066

4,944

39,122

11.2

November ---------- 40,169

4,764

35,405

11.8

December ------- 39,103

4,834

34,269

12.4

TOTAL ------------- 552,187

72,839

479,348

13.2

DARKFIELD EXAMINATIONS
Number Number Percent TOTAL Positive Negative Positive

18

7

17

9

24

6

14

4

11

4

8

3

14

3

26

5

9

2

4

2

13

4

10

4

11

38.9

8

53.0

18

25.0

10

28.6

7

36.4

5

37.5

11

21.4

21

19.2

7

22.2

2

50.0

9

30.8

6

40.0

168

53

115

31.5

EXAMINATIONS FOR GONOCOCCI

Number Number Percent

TOTAL Positive Negative Positive

.~ ...

~

862

121

741

14.0

<::!

~

961

141

820

14.7

,;:.:!.

1,146

170

976

14.8

lc;lCb

1,065

134

931

12.6

~

1,171

129

1,042

11.0

~-
~

1,195

170

1,025

14.2

~
~

1,015

149

866

14.7

"'

944

131

813

13.9

903

101

802

11.2

856

135

721

15.8

895

127

768

14.2

771

134

637

17.4

11,784

1,642

10,142

13.9

t-:l I-'
\0

TABI.E "H"

SUMMARY REPORT OF EDUCATIONAL ACTIVITIES Venereal Disease Control Service
January- December, 1943

Meetings

Addressed

No.

Au d.

January _________ ------------ 1

February ----------------- 13 March ______ --------------------- 3

April

-------------------- 5

May --------------------------- 4

June ------------------------ 7

July ------------------------------ 6

August -----------

4

September _______ ------------ 3

October _______________________ 3

November -------------------- 19 December ----------------- 1

TOTAL

69

150 1,677
313 1,150 1,062
438 453 199 249 570 2,869
72 9,202

Meetings Attended (Not addressed)

Films No. Aud.

2

14

4,943

5

6

855

3

19

3,035

5

27

4,592

2

17

2,745

7

8

5,311

14

14

1,274

8

23

3,871

4

10

1,095

1

14

2,777

8

12

2,102

3

20

3,282

62

184

35,882

No. of Clinic Visits
5 11 14 11 12 10 9 13 11 8
1 8
113

No. of Conferences
4 2 18 18 6 7 21 12 8 7 12 14 129

t-.:) t-.:)
0

Exhibits Displayed
1 3 2
13 7 3 1
5 1 36

Literature Distributed
31,549 5,292 8,869
102,032 6,966
18,083 12,081 13,200 10,400
9,451 10,752
2,277
230,951

Member-

ships

I;)

Obtained for Ga.

"'.0...,
0'

Social

15'

Hygiene

~

"' Council "!::l

...l..:..l,

;:l

53
1 2

.";.:'.
0
-"'tl ~ 0""
-~

-::r::
."l.:'.l
;::,-.

56

Division of Malaria and Hookworm Service
D. M. WOLFE, M.D.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~Acting Director
J. ALLEN ScoTT, Sc.D. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~Associate Director

Division of Malaria and
Hookworm Service
The personnel of the Division at the beginning of the year consisted of the Acting Director, the Associate Director, three Field Biologists, one Field Nurse, a secretary and one clerk. The clerk resigned in May and was not replaced. The Associate Director resigned effective the end of May to accept a position with the Federal Government, and one of the Field Biologists was moved up to take his place. The Associate Director was placed in charge of the Hookworm Program with headquarters at Waycross in the office of the Southeastern Health Region, so as to be located in the hookworm region of the State. A secretary was hired to handle routine office work there. The Field Biologist working on the Crisp County Reservoir entered the Armed Forces and the Field Biologist in Jenkins County was transferred to take his place. The work in Jenkins County was to be done by a temporary Biologist hired only for malaria season. At the close of the year, the personnel of the Division consisted of the Acting Director, Associate Director, one Biologist, one Field Nurse and two secretaries.
ANTI-MALARIA ACTIVITIES
A reported outbreak of malaria in the Doctortown Area of Wayne County was reported and an investigation showed considerable "Quad" breeding in the area. However, a thick blood smear survey on all the population in the small community revealed but two cases of malaria. A further study of the sickness occurring in this area revealed several cases of undulent fever. Regular checking of the area for mosquito breeding showed that although no control work was done, the "Quads" just stopped breeding in the area about this time for some unexplainable reason.
An increase in the incidence of malaria in the Barwick region of Brooks County was investigated and there was considerable "Quad" breeding in the City of Barwick and in the area of a one mile radius around the town. A large pond, part of which is within the city, showed heavy breeding on repeated checks. This pond is one that was to have been drained some years ago, but the project never materialized. It has remained a source of danger to the people of Barwick and to those who visit that city.
At the request of the authorities of the Warm Springs Foundation, an investigation was made of two cases of malaria occurring in the personnel of that Institution. It was determined that both persons had just returned from vacations which took them into malaria areas of Florida. A study of the grounds and surrounding area showed that, although there was heavy mosquito breeding within the grounds, not any of these were identified as "Quads." There was considerable "Quad" breeding in the ponds of the Government Fish Hatchery which is within flight range of the U. S. Foundation.

224

Georgia Department of Public Health

The Staff of the Division cooperated with the Malaria Control in War Areas of the U. S. Public Health Service in putting on a program of Health Education in Malaria Control. This work was carried out in ten counties by local school teachers trained at Memphis, Tennessee, by the Public Health Service for the work they were to do in Georgia. The program consisted of meetings and talks at which motion pictures and sound film strips were used to illustrate the value and methods of malaria control. This program was carried out in those counties having War Areas. These workers worked as members of County Health Department personnel and the comment on this program by the health officers was that it was beneficial and that they would like to see it carried on again next year.
The incidence of reported malaria was at such a low level that, with the shortage of personnel and so many more pressing duties, the local health departments declined to do fall surveys as the health commissioners felt that the time of their personnel could be spent to better advantage in other fields.

MALARIA MORBIDITY AND MORTALITY
If malaria morbidity and mortality had run true to form in the seven year cycle as it has done in the past in Georgia, we should have had a peak year in 1943. Instead it showed a further reduction to establish a new all-time low when we had only 491 cases reported with 35 deaths as compared to 76 deaths in 1942 when 981 cases were reported.
The incidence of malaria in our worst areas where no control measures have been instituted is noteworthy. Lee County in southeast Georgia is a good example of this in that only 21 cases and no deaths were reported for the year 1943. This county is one that usually has a high incidence of malaria if we are having it in any section of the State. A thick-film blood survey taken on the colored children under 12 years of age in the Fall of 1942 showed only 8 positive in 343 slides. No survey was made in 1943.
A number of the cases of malaria reported during 1943 were from areas where we do not usually have the disease and proved to be relapsed cases in soldiers home on furlough from the South Pacific. This may be a factor in future Malaria epidemics that may occur in our State because we are having abundant "Quad" breeding- even in the northern sections of our .State. However, we do not have the carriers necessary to spark an epidemic of this disease in many sections of the State of Georgia.

ANTI-HOOKWORM ACTIVITIES
The hookworm program during 1943 followed somewhat the plan described in reports for 1941 and 1942. The lost momentum brought about by major changes in personnel and the shortage of anthelminthic

Malaria and Hookworm Service

225

drugs was only partially regained. After limited supplies of tetrachlorethylene were again made available, an attempt was made to limit its use to those counties and individuals whose needs were most pressing. Greater emphasis was placed on selective surveys and quantative laboratory diagnois (egg-count), and it was recommended that only individuals with moderate to heavy infestations and hookworm-positive members of their families receive treatment. Towards the end of the year, however, it was recommended that in cases of pronounced anemia, treatment be given to individuals having somewhat less than 5,000 eggs per cc. of stool, the level heretofore regarding as indicating the threshold of pathologically significant hookworm burdens. From an epidemiological point of view, it is recognized that even the lightest hookworm infections have significance, but under present circumstances of limited personnel and drugs, any serious attempt to completely erradicate hookworm, even from a small locality, would seem overambitious.
HooKWORM CoNTROL PROGRAMS IN 1943. In the State as a whole, anti-hookworm activities consisted of selective surveys of significant cases in the public schools and other special groups followed by family follow-up and treatment; clinic and laboratory services to voluntary patients; education, and a limited amount of school and home sanitation improvement. Services of the divisional staff, for the most part, consisted of consultations and direct assistance to local health organizations and educational activities. Certain researches on methods of hookworm control were continued from previous years, and new investigations on control methods and epidemiology were undertaken. A cooperative research project was continued from last year. No general hookworm surveys were made in 1943.

SELECTIVE SuRVEYS AND FAMILY FoLLOW-UP. It has not been possible to establish a standard plan of anti-hookworm activity suitable to all counties. In general, some variation of the plan recommended in previous years has been followed. School surveys, in which apparently anemic children were selected by inspection or segregated on the basis of actual hemoglobin determinations, were carried out in about twenty counties of the hookworm region. Specimens for egg-count were obtained from these individuals and the cases with significant worm burdens were followed up with visits to their families whenever possible. In a few counties, time and transportation difficulties made it necessary to either dispense drugs at the schools or send notices to the home requesting a visit to the clinic by a responsible member of the family. The latter method proved more successful than was anticipated. Even in cases where home visits were made, it was found generally possible to shift from the nurses to the patients, or to a fairly mature child, much of the responsibility of obtaining laboratory tests, treatments, and check-ups. Instead of making three or four visits, i.e., a separate visit for each of the steps necessary for freeing a family of its infestation, an effort was made to accomplish specifically one end; namely, the education of the family to such a level a,: would make

226

Georgia Department ofPublic Health

the necessary steps clear and provoke active interest in taking these steps. It is expected that these families will appreciate the experience of prevention.
CLINIC AND LABORATORY SERVICES. The above type of program does not obviate all home visiting for the hookworm services. It may, however, aid in creating such a favorable attitude toward these services that in the future a large proportion of the cases will voluntarily seek aid from county health departments and, thereby, relieve the burden of case finding by surveys and home visits. Figures are not available to show the exact number of cases thus found at present, but it is apparent that, in counties where public health services have been uninterrupted for a number of years and some emphasis has been placed on clinic hookworm services, a large proportion of the cases have already been served when fall and winter surveys are made.
SANITATION. Although there was less hookworm control by sanitation improvement in 1943 than in recent previous years, evidence of interest in and appreciation of this important means of prevention was not lacking. In spite of the high cost of materials and their scarcity, lack of qualified consultants, carpenters, and plumbers, and the withdrawal of all assistance from public funds, requests for various types of assistance continued to be received and a number of satisfactory new sanitary units were constructed at rural homes and schools where hookworm control was the primary consideration. In many cases, the standards of the approved type of sanitary pit privy were not met, but the most essential features of this type of structure were generally included. Experimentally, a new type of low-cost bored-hole latrine was installed to serve 26 rural families, mostly in Brantley County.
RESEARCH. Studies on the relative prevalence of hookworm and nonhookworm anemias; mass treatment with iron compounds; normal hemoglobin levels in South Georgia school children; the efficacy of anthelmaintic treatment at different seasons of the year, and selective survey methods were in progress at the end of 1943. It is expected that some of these studies will terminate in 1944 and will then be reported.
During 1942 and 1943, inexpensive latrines consisting of a narrow, deep unlined pit covered by a wooden platform were installed to serve 26 hookworm families in Brantley, Wayne, and Long Counties. Observations on these experimental devices were terminated with the following conclusions: about half of the families were satisfied with the arrangement and made daily use of it; almost all families that evidenced interest in this means of sanitation were easily encouraged to make improvements in it, and some few voluntarily provided themselves with satisfactory variations of the standard pit privy. Thus, it is suggested that information regarding sanitation is, in itself, adequate stimulus for some types of rural families. It was further observed that house flies would breed only in

Malaria and Hookworm Service

227

latrines that were nearly filled; only 2 of the 26 latrines were offensive because of odors; and even in fairly sandy regions, relatively few of the pits caved before they were full enough to require moving.
A cooperative program for the study of immunity in hookworm disease started in 1942 was continued in 1943 and J:s expected to be concluded in 1944. The program is supported by the International Health Division of the Rockefeller Foundation. Dr. Gilbert F. Otto of the School of Hygiene, Johns Hopkins University, is directing the project. In addition to staff members of the Division of Malaria and Hookworm Service and the Waycross Branch Laboratory, he was assisted by Dr. Arne Hunninen of Oklahoma City University and a technician during a ten weeks period of last summer.

PUBLICATIONS
l. The Georgia Malaria Bulletin-Vol. VII, No. 1-March, 1943. 2. Malaria in The War and Its Relation to Georgia-David M. Wolfe, M.D.-Journal
of the Medical Association of Georgia, 32:212-June, 1943. 3. A tray for Collecting Anopheline Mosquito Larvae-Paul C. Beaver, Journal of
Parasitology, Vol. 29, No. 3-PP:229--June, 1943. 4. "Malaria 'Chills & Fever' "-a four page illustrated leaflet prepared for general dis-
tribution-David M. Wolfe, M.D.

DIVISIONAL AcTIVITIES

1943

Meetings Attended ________ --------------------------------------------- ________________________ 11 Addresses Made ----------------------------------------------------------- ________________________ 11

Exhibits Displayed ------------------------------------------------------------------------------

3

Conferences, Consultations, etc..__________________________________________________

860

ENTOMOLOGICAL SERVICES
Ponds Investigated ------------------------------------------------------------------------------Adult Searches ------------------------------------ ____________ --------------------------Days spent in office by staff members ___________________________________

771 1,208
409

EPIDEMIOLOGICAL AND NURSING SERVICE

Physical Inspections ---------------------------------------------------------------------------- 1,221

Hemoglobin ------------------------------------------------------------ ----------------------------- 1,161

Hookworm Treatment - Anthelmintic ---------------------------------------------- 426

Hookworm Treatment - Iron _______________________________________________

87

Home Visits --------------------------- ____________________ ----------------------------------- 551

Containers Distributed _________ -------------------------------------------------------------- 3,395

Containers Collected ______

____________________ -----------------------------

964

Soil Samples ______________________________________________________________________

73

Bloods Collected (malaria smears and others) _________________________________ 436

SANITARIAN SERVICES
Sanitary Surveys - Premises ------------------------------------------------------------ 482 Sanitary Units- Installed ------------------------------------------------------------------ 25 Mapping Hours ____-------------------------------------------------------------------------------- 24

COUNTY

Educational and Pcomotional Mtgs. Addrs. Attd. Made Exhibits Confs.

Appling ---------------

Atkinson _______

37

Bacon -------------------- ----

------

-----

7

Baldwin _______________

------

------

1

Ben Hill ________________ ------

------

------

6

Brantley

------

------

53

Brooks

------

------

------

5

Bryan ____ ------

------

------

4

Bulloch ------------------ 2

2

20

Burke ------------------- ------

------

------

15

Candler ---------------- ------

------

------

1

Charlton --------------

------

------

21

Clarke -------------------- ------

------

------

5

Clinch-------------------- 1

1

------

~3

Coffee --------------------

------

69

Crisp ----------

------

------

------

48

Decatur ---------- _____ 2

2

------

12

DeKalb ------------

------

----

2

Dougherty ____________ 1

1

4

Echols ______________

------

------

12

Emanuel

1

1

------

7

~vans

Fulton ---------------

2

2

1

44

Glynn

Grady

Irwin ------------

------

------

------

2

Jeff Davis

------

------

------

10

Jefferson -------- ------

------

------

2

~

~

EPIDEMIOLOGICAL SERVICES

00

Hookworm Treat.

Phy.

Anthe!- Persons

Exams. Hgb. mintic Treated Home Malaria Spleen

Containers

Soil

Iron Visits Smears Palp. Dist. Coli. Samp.

54

435

~-----

------

-----

-----

------

-----

-----

------

20

------

672

186

----

-----------

-----------

-----------

-----------

---- ~
..,(1)
----- 0

------

------

-----

241

99

37

---215

------

-----------

----476

-----281

s ----- C/'! 8

------

----

1

------

------

------

------

----- 1::::!

(1)

------
---------------------
153

37
------
-----
---------------------

-
----
--
-----
71
--------

-----2

---------------
7
------

-----------

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

--------------------121
-----255

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

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

~..~,..,.
s

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

(1)
-.;,:.I.
0
~

------

------

4

16

88

------

170

------

---- .-=..:.

221

------

-----

------

------

6

------

----

(")

------

------

------

------

------

------

------

------

60

90

186

------

------

------

----- ::t:

------

------

------

------

---- (1) ~

------

------

-----

------

------

---- ~ ;::-

102

------

320

72

COUNTY

~Educational and Promotional Mtgs. Addrs. Attd. Made Exhibits Confs.

Jenkins ---------------- ------

------

6

Lanier. -~-------------- ------

------

------

2

Laurens --------------

------

-----

7

Lee

Liberty ---------------- ------

------

13

Long ---------~------------

-----

------

9

Lowndes -------------- ------

------

1

Meriwether __________ ------

------

----

4

Mitchell -------------- ------

------

------

1

Montgomery --~-----

------

5

Pierce ----------------- ------

------

------

2

Richmond ----------- ------

-----

3

Seminole -------------- -----

-----

2

Stewart -------~--------

-----

------

2

Sumter ---------------

------

------

4

Tatt11all --------------- ------

------

------

5

Telfair -----------------

------

2

Terrell ------------------ ------

------

------

2

Thomas ----------------- ------

------

------

5

Tift ______________,_________ ------

------

------

1

Toombs -----------~

4

Turner ______:___ ~------

Ware ----------------------

1

----

12

1

100

Washington -------Wayne ---------------- 1

-----

1

1

_,_ ____

62

Wheeler ----~~---- -----

------

4

Wilcox -----------~-----

------

8

Wilkinson --------~--- ------

------

------

1

Worth ------------- _____,_

---

-----

2

Phy. Exams.
----

Hgb.
--

EPIDEMIOLOGICAL SERVICES Hookworm Treat. Anthel- Persons mintic Treated Home Malaria Spleen
Iron Visits Smears Palp.

---

------

-----

9

Containers Dist. Coli.

Soil Samp.

-- ----- ---

-----

---- -- -

----

2

------

-----

------

------

53

------

-----

148

82

------

~
!:l

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

-----

------

------

------

------

-----

-----

-----

--

------

------

-----

------

-----

------

-----

l...S......'
!:l

--

------

--

-----

-----

------

------

-----

------

6

----

-----

-----

-----

-----

------

------

---

;:,
5..

----- -- -

-----

---

--

------

------

------

------

------

------

-----

::t:
0

------ -- -

-----

------

-----

------

------

------

0;.:..

-----

---

-

---- ---- -

------

-----

--

----

------

------

------

21

-----

------

------

------

"0 ~ '

------

52

------

--- -- -

------

-----

------

----

------

------

------

(F)
.(.b..
~

------

----

----

-----

-----

------

------

------

ii:

(b

35
----- ---- -

------

-----

------

------

------

21

-----

18

41

9

60

297

349

71

3

290

------

------

------

------

------

-----

-----

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

~ ~
10

~ ~
0 ENTOMOLOGICAL SERVICES

C.O.UNTY

No. Ponds Ponds Anoph. nves. Dipped Found Aq.

Adult

Species Found

Search- None

A e.

Ap. Others es Found Q.

Species Found

c.

F.

Sani- Sani tary tary Surveys Units Map. Others Premises Instal'd Hours

Appling -------------- ----
Bacon --------- ------

-----
------

-----
------

--------

-----
-----

--------

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

-----
------

------

------

------

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

1
1 ----- --

(0

Ben Hill ----------- 1

------

------

------

------

Brantley ----------- 19

19

17

------

6

------

------

Brooks ---------------- 13

3

2

2

1 ------ -----

6 1 5

6

------

------

------

------

------

------

------

1 3

------
2

-----1

-----
------

----------

262
-----

16
----

----
--

~
-0.,
CsJ'l-

Bulloch ----------------- 85 Burke ------------------- 39
Camden -------------- 8

71 36
4

65 20
2

22 20
1

62

1 --

6

3

3

3

1 ------ ---- ----- ---

23

7 ----- ----- ------ ----- ----- ------ ------ -- ----- ----

2 ---- ----

6

4

2 ----- ------ ----- ---- ---- --

t;
~
'"o !-;.:>,

-- Charlton ------------ ----- ----- ---- ---- ---- ------ ------

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

5 ------ --

'

Clinch ------------------ -----
Coffee ,.,__________________ 5

---
4

-----
3

-----
-----

-----
1

--------

---------

----34

-----32

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

1

3 ------ -----

Crisp -------------------- 287

119

51

33

34

13

2

337

60

183

32

23 ------

Dooly --------------- 7

4

1

1 ------ ---- ----

68

10

51

24

16 -----

Echols -------------- 3

3

1 -----

1

-----

---

2

2

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

5 ----- -----

44

7 -----

1

----

------ -10 ----- -

-.;~:.:.,.
0
"1::1
!;::

Jeff Davis------------ -- ----- ------ ---- ------ ----- ------ ------ ------ ------ ----- ------ ------

4

------

16

.0..'-..'
(':;

Jenkins. ---------- 19

19

13

10 --- -

------ 111

92

4

4

4 15 ---- ----

Liberty---------------- 1 ------ --- ----- ---- --- ----- ----- ------ ---- ----- ----- ------ ----- ----- ----

::.:
~

Long -------------------- ------

------

------

Meriwethe~ --------- 18

13

9

------

------

9

9

1

17

2

8

1 6

9 2

3

3

-----

36 ------ -----

2

-----

2 ----- ---- -----

.,..!;:>
i:;:'

Sumter -------------------- 59

16

7

4

1 ----- --- 285

65

183

17

20

Telfair ---------------------- ----- ------ ---- ----- ------ ----- ---

3

3

Thomas ------------------ 6

3

1

1

1 ------ -----

4

4

Turner -------------------- ------

------

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

------ -----

8

W. care ----------------- 1

Wayne -------------------- 65

58

31

4

14

1

------

151

74

56

15

9

1

104

7

Worth --------------- 58

28

20

3

19 ----- ------

29

17

9

5

-._,_'

,;t~S,-?~(J

Division of Tuberculosis Control
H. C. SCHENCK, M.Dh--------------------------------------------------------------- _______Director CLARA B. BARRETT, M.D. ____________________________________________________________________Glinician J. F. BuscH, M.D---- ----------------------------------------------------------------Clinician

Division of Tuberculosis Control
As has been predicted, there was a rise in the number of deaths from tuberculosis in Georgia and an increase in the rate per 100,000 population from 40.5 in 1942 to 41.1 in 1943. The 1943 figures are provisional and delayed reports will no doubt show a further increase in the death rate for 1943. Strange to say, the increase shown has been among white persons instead of colored. The number of new cases of tuberculosis for J943, however, has shown a decided drop from 3,607 in 1942 to 2,409 in 1943. These figures again are provisional and delayed reports will show an increased number. The following tables show deaths and death rates frcm tuberculosis and case incidence:

1930 ------------------1931 1932 1933 -------------------1934 -------------------1935 -------------------1936 -----------------1937 1938 -------------------1939 -------------------1940 -------------------1941 -------------------1942 -------------------1943 -------------------

DEATHS AND DEATH RATES

White

Colored

Total

No.

%

No.

% W.&C.

Rate per 100,000 Population White Colored W.&C.

774

36

140]1

64

2175

42.0

130.6

U.6

700

32

1465

68

2165

37.7

135.8

'73.'7

665

36

1268

65

1933

35.4

116.!1

65.3

675

38

1102

62

1777

35.6

101.1

59.6

605

34

1167

66

1772

31.7

106.5

58.9

649

37

1082

63

1731

33.6

98.2

57.1

648

38

1065

62

1713

33.3

96.2

56.1

559

36

990

64

1549

28.5

89.0

50.3

602

37

1010

63

1612

30.3

90.3

52.0

543

35

990

65

1533

27.2

88.1

49.1

544

35

989

65

1533

26.7

91.2

49.1

501

35

884

65

1385

24.3

81.3

44.0

465

35

800

65

1265

22.8

73.7

40.5

486

35

799

65

1285

23.8

73.6

41.1

Year
1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

CASES OF TUBERCULOSIS REPORTED IN THE STATE

Number of Cases Rate Per 100,000

Reported

Population

3647 3588 3317 3016 3011 2996 2800 2635 3067 2049

121.3 118.4 108.6
98.0 97.1 95.9 89.6 83.8 98.2 77.1

234

Georgia Department of Public Health

Following is a brief summary of clinics and results:

Kind of Clinic

No. of Clinic Clinics Days

Regular ------------------------------ 212 205

College 14 x 17__________________ 13

14

(35 mm. survey)

College 14 x 17__________________ 5

9

(Tuberculin Reactors)

Industrial 35 mm. ______________ 19

35

Follow-up 14 x 17

14 x 17 X-rays made in Central Office______________

Number of Number of X-rays Cases Found o/o
10,147 558 5.50 1,056 18

853

lO l.l7

2,450 160 0.41"

355 23 6.47

Total 14 x 17 films made__ 249 263 14,861 769 5.17

X-rays sent in by doctors for interpretation ____________

1,093 264 24.15

X-rays sent in by doctors

on cases with previous

diagnosis and no change

shown ------------------------------

730

Total 14 x 17 films interpreted and Cases Found______ 249 263 16,948 1,033 6.09

*College 35 mm. survey X-rays made ------------------------ 22

46 14,018

**Industrial plant 35 mm. survey X-rays _________________ 34 124 39,255

A grand total of 70,221 X-rays were interpreted and 1,033-cases were found as a result.
*Number recommended for 14 x 17 X-ray - 1,526. Numbe_r recommended for 14 x 17 X-ray- 3,624.
(1 )-o/o cases found as applied against total 14,018 surveyed. (2)-o/o Calles found as applied against total 39,255 surveyed.

CLINICS
REGULAR CLINICS
SCHOOLS AND COLLEGES 35 MM. SURVEY
COLLEGE 14 X 17 X-RAY FOLLOW-UP OF 35 MM. SURVEY

Number of Clinics
Number of Days
Number X-rayed
Number of Clinics
Number of Days
Number X-rayed
Number of Clinics
Number of Days
Number X-rayed

TABLE OF CLINIC NUMBERS, DAYS AND X-RAYS-1943
MONTH Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec.

Total

20

18

15

12

19

12

20

20

23

19

19

15

212

Hi

18

10

12

19

12

20

20

22

19

19

15

205

'"-3

1310 1351

538

670

690

480

893

937

973

895

868

542 10,147

~c-

.~ ..,

6

3

0

0

0

0

1

0

0

4

7

1

22 "~'

"(;';

15

6

0

0

0

0

1

0

0

9

12

3

46

C"')

0

.~..,

4540 1290

0

0

0

0

511

0

0 3169 3424 1084

14,018

;2...

0

3

2

0

0

0

0

1

0

2

3

2

13

0

4

2

0

0

0

0

1

0

2

3

2

14

0

652

143

0

0

0

0

34

0

82

27

118

1,056

t--:1
<:,;~ (Jl

CLINICS COLLEGE 14 X 17 X-RAYS POSITIVE TUBERCULIN REACTORS
INDUSTRIAL 35 MM. SURVEYS
INDUSTRIAL 14 X 17 FOLLOW-UP
OFFICE X-RAYS

Number of Clinics
Number of Days
Number X-rayed
Number of Clinics
Number of Days
Number X-rayed
Number of Clinics
Number of Days
Number X-rayed
Number of X-rays

1-.:l CJ,o 0\
TABLE OF CLINIC NUMBERS, DAYS AND X-RAYS-1943 (Continued)

Jan.

Feb.

Mar.

Apr.

May

MONTH June July Aug.

Sept.

Oct.

Nov.

Dec.

Total

0

1

3

0

1

0

0

0

0

0

0

0

0

1

7

0

1

0

0

0

0

0

0

0

5 ~
<I>
.0..,
9 r:.ro.... ~

0

47

702

0

104

0

0

0

0

0

0

0

853

~
<I>

"c:l

;~:;.

0

4

7

2

1

1

2

2

12

2

1

1

34

;3

0

5

31

12

16

19

10

9

18

3

1

2

124

-.;<:.I:>.:.
0
'"c:l

0 1792 11508 3449 5271 4287 1903 2327 7481

570

203

464

39,255

~
?:::

~=;

5

2

1

2

2

1

1

0

1

3

0

1

5

4

2

7

5

2

3

0

3

3

0

1

19 l::t: .,~.._.
35 """

508

386

191

506

370

107

71

0

121

159

0

31

2,450

26

62

32

30

25

30

40

37

16

22

24

11

355

Tuberculosis Control

237

DISTRIBUTION OF CLINICS-1943

In 56 counties in 119 clinics organized by health officers _____6,193 In 62 counties in 91 clinics organized by county health
nurses __________________ ______________________________________________________3,954

In 13 counties in 19 clinics 35 mm. follow-up industrial

plants ________________________

_______________________________ 2,450

In 9 counties in 13 clinics 35 mm. follow-up in colleges _______1,056 In 4 counties in 5 clinics positive tuberculin reactors in
colieges __ __________________________ __ ______________________ ___________________ _________ 853

Regular x-rays in office of patients referred by physicians 355

Total number 14 x 17 x-rays made in State Clinics

35 mm. fluoro-photographic surveys in 34 industrial plants

promoted by the Division of Industrial Hygiene, represent-

ing 124 additional clinic days_____ __ _________

_________________

35 mm. fluoro-photographic surveys in 22 colleges, representing 46 additional clinic days__ _ ___ _

14,861 39,255 14,018

GRAND TOTAL OF X-RAY PICTURES MADE IN 1943__________

68,134

Consultation film interpretations____________________________________________ 2,087

ToTAL INTERPRETATIONs MADE IN 1943

70,221

As shown in the above tables, a total of 70,221 x-rays were interpreted by this Division in 1943. Of these, 2,087 were consultation x-rays made by physicians in the State and sent in for interpretation. 39,255 of these x-rays were 35 mm. fluoro-photographic pictures made in 34 industrial plants. As a result, 1,033 new cases of tuberculosis were discovered. The summary of clinics shows the relative value of case-finding work in the regular clinics, the 35 mm. surveys in colleges and industrial plants, as well as in the 14 x 17 surveys. The lowest percentage of cases found was .13 in colleges, while in the industrial plants the percentage was .41 and in the regular clinics it was 5.5. The greatest percentage, 24.15, was in the group of x-rays sent in by physicians for interpretation.
The relatively low rate in industrial plants shows that these surveys were well worth the effort because they represent 160 new cases which probably would not have been revealed otherwise. It is urged that this field of case-finding be expanded as rapidly as possible.
The number of cases being treated by the 58 physicians participating in the artificial pneumothorax refill program has increased from 559 on January 1, 1943 to 672. During this period, only seven of these patients have died. A total of $20,538.50 was spent for this service during 1943.

238

Georgia Department of Public Health

PuBLIC HEALTH TuBERCULOSIS CoNTROL AcTIVITIES
1942 AND 1943

Year 1942

Cases of Tuberculosis Admitted to service _____________ 4,203

Visits to tuberculosis cases, contacts and suspects _ 63,575

Visits to cases of tuberculosis________________________

16,707

Average number of visits to cases of tuberculosis ___ 3.98

Office visits by cases of tuberculosis ______________________ 5,773

Admission to sanatoria___________

746

Number completed tuberculin tests _________________________ 25,278

Number positive _________________________

7,655

Contacts broken _________________________________

1,406

Contacts partly broken_____________________________________ _

396

Relief secured-Number of cases____

651

Tuberculosis cottages builL____________ _

11

Public lectures and talks on tuberculosis

376

Year 1943 4,077
63,273 17,639
4.32 5,919
555 24,190
6,614 1,343
393 609
16 324

The table above gives a comparison of the services rendered by local public health officers and nurses for the year 1942 and 1943 shows little difference in the two years. Actually, the visits to cases of tuberculosis were increased from 16,707 in 1942 to 17,639 in 1943. The average number of visits to cases of tuberculosis in 1943 was 4.32 as against 3.98 in 1942. All of these services are extremely valuable in tuberculosis control and it is hoped that ways and means can be found to still further increase them.
The Georgia Tuberculosis Association has continued its response to requests for rehabilitation service in problem cases, especially those in which there is particular difficulty in obtaining the necessary assistance. 202 persons were given assistance in their rehabilitation program during the year 1943.

GENERAL CONSIDERATION OF TUBERCULOSIS AND
RECOMMENDATIONS FOR MORE EFFECTIVE CONTROL
The control of tuberculosis, simply expressed, requires the discovery and isolation of every communicable case of tuberculosis, and the discovery and supervision of all the persons who have had contact with source or communicable cases. It is known that the most danger is to the immediate or household contacts. Nevertheless, the tuberculin test has shown that more than fifty per cent of our general population has

Tuberculosis Control

239

been infected with tubercle bacilli, and from these infected cases, from time to time, new cases will develop.
In 1943, 1,285 deaths occurred from tuberculosis, and 2,409 new cases were reported. Judging by the records of the past twelve years, we may expect not less than 2,700 new cases to develop each year. Nor can we reasonably expect fewer deaths to occur unless we intensify our efforts at case-finding, treatment of cases found, closer supe:r;.vision of contacts, and the enactment of laws making it possible to satisfactorily control people with communicable tuberculosis.
The following measures are proposed:
(1) A minimum of 2,500 sanatorium beds in the State are needed. Actually, we have approximately 900 beds. In order to encourage the building of institutions by local governments, it is suggested that subsidy of thirty dollars per month for the operation of such institutions be paid by the State. The balance, which would probably be about thirty dollars per month, would be provided by the county or city operating the institution. Funds for the construction of such institutions would be borne by the local governments.
It is recommended that a colored sanatorium of two hundred fifty beds at an approximate cost of $500,000 be built by the State, operated by the State, located in Atlanta, and that the ramshackle buildings at Alto be scrapped.
It is further suggested that the State require thiry dollars per month for every patient treated in the State Tuberculosis Sanatorium, this amount to be paid either by the patient or by the county from which the patient comes.
The total cost to the State, then, for the subsidy and maintenance of 2,500 beds would amount to $912,500.
(2) In order that tuberculosis control measures may be more effectively put into use, it is suggested that every county in the State be required to have a full-time public health nurse, at least, if it is not possible to set up a complete public health unit.
(3) It is suggested that twelve field tuberculosis clinicians be employed in regions developed on a population basis to cover the entire State, each to have an office in the respective regions. If the clinicians could be secured at $3,600.00 per year, the salary cost would be $43,200, to which travel expenses of approximately $14,400.00 would have to be added. These clinicians could hold fifteen clinics each per month, and have the rest of the time for case follow-up, special consultations and supervision of artificial pneumothorax clinics, consultation work in local sanatoria, and work with problem cases.
Instead of having mobile units for each of these field clinicians, a

240

Georgia Department of Public Health

more economical and certainly a much more satisfactory program in the long run, could be carried on if a fluoroscopic-radiographic unit were established in each county in the State. Thirty of these units have already been established, leaving 129 counties not yet provided with such apparatus. At an average cost of about $1,000.00, such equipment could be installed at a total of about $129,000. Development of films could be done locally, pictures could be made when emergencies required them between clinics; records of films could be kept in the regional offices instead of the central office in Atlanta, and the reports to the physicians of clinic results could emanate from the local offices.
Additional money would probably have to be provided for secretarial work in the offices of the regional tuberculosis clinicians. However, such an office might be established with the local county health office in which the clinician might make his headquarters. If so, perhaps 25% of the salary of the local secretary, which expenditure might be about $3,600.00 per year, could be borne by the State Health Department.
An extremely useful adjunct to tuberculosis control activities would be the installation, in each local health department, of a suitable visible tuberculosis register. Such a register properly set up and employed would provide an easy method of checking up at any time on the tuberculosis problem or situation in the health area covered. It would show what service was being rendered and where and when services should be performed. It would afford an instantly available record of each case and each contact, showing classification status, supervision, kind of treatment and any other pertinent information desired. Comparatively little time would be required to keep it up and the outlay for equipment and supplies would not be prohibitive.
It is suggested that the establishment of proper tuberculosis control measures in all State institutions under the supervision of the State Health Department, assisted wherever possible by the local health departments, be provided by law; that a tuberculosis hospital for tuberculous prisoners be established in connection with the State Prison at Tattnall, and, if it seems necessary, another at Gracewood.
It should be provided by law that transients be hospitalized at State expense until their legal residence can be established and removal to their place of residence accomplished.
It is believed that the laws should be amended to provide for immediate apprehension by complaint of local health officers or official health agencies of communicable tuberculosis cases who show evidence of mental incompetency and to further provide for incarceration at the State Sanatorium at Milledgeville, pending final disposition of the case in court.
Prevention of the spread of tuberculosis and other communicable diseases in jails should be made possible. It ~hould be required that each jail have quarters to effectively isolate inmates with tuberculosis or other

Tuberculosis Control

241

communicable disease, or that it be made possible to transfer such persons to the State Prison hospital.

SuMMARY OF CosT EsTIMATE
Negro Sanatorium-250 beds____________________________$500,000.00 Fluoroscopes for counties____________________________________ 129,000.00
$ 629,000.00 12 clinicians @ $3,600.00 per year____________________ 43,200.00
Travel @ $1,200 per year____________________________. 14,400.00 Secretaries ------------------------------------------------------ 3,600.00 X-ray films, 240 per year per county Total-57,240 @ 65c per film______________________ 37,206.00

Operation of Sanatorium when 2,500 beds are finally put into use at $30.00 per month would require per annum _
1 Extra field unit-35 millimeter___________________________________________ _ Films for 2 units, 35 millimeter, about 100,000 for use in
schools and industry @ $7.50 per 100 foot roll, approximately ______________________ ---------------------------------------
Follow-up films-10,000 @ 65c each__________________________

98,406.00 912,500.00
3,000.00
1,000.00 6,500.00

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

$1,650,406.00 *60,000.00

$1,710,406.00

*In addition to these costs, should be added the cost of the Division of Tuberculosis Control as now operated, and cost of installing and operating central tuberculosis registers in counties where it may be practical to do so.

.t...,:.l
t..:l

NUMBER AND PERCENTAGES OF CASES FOUND BY ORIGINAL EXAMINATIONS IN RELATION TO NUMBER X-RAYED, MALE AND FEMALE COMBINED, ACCORDING TO STAGE AND AGE GROUP YEAR 1943

White

Number X-rayed

Up to 16 -------------

---------- 1063

17-45 ----------------------------------- --------------- 1756

46 Up

------------------------------------------ 551

Total __

------------------------------------- 3370

Colored

Up to 16 17-45 46 Up

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

--------- 738

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

-- ------- ------ --- 1413

--------------------------------------- 347

REGULAR CLINICS

Minimal

No.

%

Mod. Adv.

No.

%

0

.00

0

.00

32

1.82

66

3.76

13

2.36

37

6.71

45

1.34

103

3.05

1

.14

3

.41

12

.85

32

2.26

0

.00

7

2.02

Far Adv.

No.

%

0

.00

38

2.16

19

3.45

57

1.69

8

1.08

74

5.24

14

4.03

All Cases

No.

%

0

.00

136

7.74

69

12.52

205

6.08

12

1.63

118

8.35

31

6.05

G"J
."c.",
Cll:l
15' t:l
~.!"..:.",l.
;3
-.";:.":,.
c
;?
C...o..o.
~
~
s.!.".:".l...

Total --------------- --------------------- ______________ 2498

13

.52

42

1.68

96

3.84

151

6.04

CLASSIFICATION OF THE CASES FOUND BY ORIGINAL EXAMINATIONS ACCORDING TO STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES

White Age Groups
Minimal .......................................................... Mod. Advanced ............................................... Far Advanced .................................................

YEAR 1943
---

OFFICE X-RAYS

Up to 16

No.

%

17-45

No.

%

0

.00

0

.00

0

.00

4

28.57

5

35.71

3

21.43

Total .............................................................

0

.00

12

85.71

Colored Minimal _____________ --------------------------------------------Mod. Advanced ................................................ Far Advanced .................................................
Total

0
0
0
--
0

.00
.00
.00
--
.00

0
1
2
--
3

.00
25.00
50.00
--
75.00

46 Up

No.

%

0

.00

2

14.29

0

.00

2

14.29

0

.00

1

26.00

0

.00

1

25.00

All Cases

No.

%

""-3

4

28.57

o~ .<.l.>.

7

60.00

("')
~.c....

3

"' 21.43

!;;

14

100.00

...c~
;:l
..c........

0

.00

2

50.00

2

50.00

4

100.00

~

t

CLASSIFICATION OF THE CASES FOUND BY ORIGINAL EXAMINATIONS ACCORDING TO STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES

YEAR 1943

White Age Group
Minimal ---------------------------------------------------------Mod. Advanced ----------------------- ______________________ Far Advanced __ --------------------------- ------------------
Total -------------------------------------------------------------

COLLEGE 35 MM. FOLLOW-UP CLINICS

Up to 16

No.

%

17-45

No.

%

2

20.00

3

30.00

0

.00

3

30.00

0
~-
2

.00 20.00

0
~-
6

.00
--
60.00

Colored Minimal . __________ -----------------------------------------Mod. Advanced ---------------------------- -Far Advanced __________ -------------------------------------
Total --------------------- -----------------------------------

1 2 0
~-
3

7.69 15.38
.00
~-
23.07

7 2 1
~-
10

53.85 15.38 7.69
~-
76.92

46 Up

No.

%

0 2 0
~-
2

.00 20.00
.00
~-
20.00

0 0 0
~-
0

.00 .00 .00
~-
.00

~
~

All Cases

No.

o/o

~s

~

('~)

5

50.00

...~
l;l

5

50.00 '

('~)

0

.00 ;.,:..

-.0.....

10

100.00 ";:j

!g'= :

~-

H 4

61.54 30.77

s~ :

7.69

13

100.00

RESULTS OF ORIGINAL EXAMINATIONS, ALL AGES, SEX AND COLOR SHOWING NUMBERS AND PERCENTAGE8-1943

White

Number

Childhood -----------------------------------------------------------Minimal---------------------------------------------------------------Moderately Advanced --------------------------------------Far Advanced ----------------------- ----------------------------Total Positive --------------------------- --------------------------
Suspicious ----------------------- -~----------------------------Negative ---------------------------------------------------------

7 20 50 34 111 363 1058

Total ------------------------------------------- -------------------- 1532

Colored Childhood ---------------------------------------------------------Minimal -------------------------------------- ----------------------Moderately Advanced -------------- -----------------------Far Advanced ---------------------------------------------------Total Positive .::__: ________________________________________________
Suspicious --------------------------------------------------
Negative -----------------------------------------------------
Total -----------------------------------------------------------------

12 9
22 46 89 285 774
--
1148

Male

REGULAR CLINICS

%
.46 1.31 3.26 2.22 7.25 23.69 69.06

Number
17 25 53 23 118 325 1395

Female %
.93 1.36 2.88 1.25 6.42 17.68 75.90

100.00

1838

100.00

1.05 .78
1.92 4.00 7.75 24.83 67.42
---
100.00

10 4
20 50 84 187 1079
--
1350

.74 .30 1.48 3.70 6.22 13.85 79.93
--
100.00

Male and Female

Number

%

24 45 103 57 229 688 2453
3370
22 13 42 96 173 472 1853

.71

1.34

3.06

1.69

'""!

I;:

6.80 20.42 72.78

...o-
<1>
0.I;.:..
c

"&':

100.00

C":)

c

.88

-..~.....
c

.52

1.68

3.84

6.92

18.90

74.18

2498

100.00
t-:)
~

~

CLASSIFICATION OF THE CASES FOUND BY ORIGINAL EXAMINATIONS ACCORDING TO STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES

YEAR 1943

White Age Group
Minimal ----------------------------------Mod. Advanced --------------------Far Advanced ------------------------------

REGULAR CLINICS

Up to 16

No.

%

17-45

No.

%

0

.00

32

16.61

0

.00

66

32.20

0

.00

38

18.53

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

0

Colored

Minimal --------------------------------Mod. Advanced ------------------------Far Advanced -------------------------------
Total ---------------------------

1
3
8
--
12

.00
.66 1.99 5.30
--
7.96

136
12 32 74
--
118

66.34
7.95 21.19 49.01
--
78.15

46 Up

No.

%

13

6.34

37

18.05

19

9.27

69

33.66

0
7
14
--
21

.00
4.64
9.27
--
13.91

~

All Cases

No.

%

sa.c<q.1.>.

l::;j

46 103

21.95 60.25

<1>
~.......
;:!

57

... 27.80

;<:1s>

..c......

205

100.00

...;'":1::::1
0"'

~

13

8.61 ::t::

<1>

42

27.81

~

~

96

63.58

-- --

161

100.00

CLASSIFICATION OF THE CASES FOUND BY ORIGINAL EXAMINATIONS ACCORDING TO STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES

A~l '
--.. ~
White Age Group
Minimal ----------------- --------------------------------------Mod. Advanced ---------------------------------------------Far Advanced ____________________ --------------------------

YEAR 1943

INDUSTRIAL PLANT 35 MM. FOLLOW-UP CLINICS

Up to 16

No.

%

17-45

No.

%

46 Up

No.

%

0

.00

42

29.57

11

7.75

0

.00

37

26.06

42

29.58

0

.00

7

4.93

3

2.11

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

0

.00

86

60.56

56

39.44

Colored

Minimal ________________ -------------------------------------------

0

Mod. Advanced ____

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

Far Advanced _______ --------------- --------------------------

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

0
0
--
0

.00
.00
.00
--
.00

2

16.66

4

33.34

3

25.00

9

75.00

1

8.34

0

.00

2

16.66

3

25.00

All Cases

No.

%

;'"":"'3

0"'

53

37.32

~
~

79

55.64 ;..:....

0

10

7.04

"'(;;

C"':i

142

100.00

..;0.:..s...

~

3

25.00

4

33.34

5

41.66

12

100.00

~

t-.:l
~

CLASSIFICATION OF THE CASES FOUND BY ORIGINAL EXAMINATIONS ACCORDING TO STAGE IN AGE GROUPS, MALE AND FEMALE COMBINED, SHOWING NUMBERS AND PERCENTAGES

White A&'e Group
Minimal ----------------------------------------------------------Mod. Advanced -----------------------------------------------Far Advanced ---------- ---------------------------------------

Up to 16

No.

%

2

.54

0

.00

0

.oo

YEAR 1943

17-45

No.

%

81

21.83

111

29.92

48

12.94

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

2

Colored Minimal -----------------------------------------------------------Mod. Advanced ----------------------------------------------Far Advanced --------------------------------------------------
Total --------------------------------------------------------------

2
5
8
--
15

.54
1.11 2.78 4.44
--
8.33

240
21 39 80
--
140

64.69
11.67 21.67 44.44
--
77.78

46 Up

No.

%

24

6.47

83

22.37

22

5.93

129

34.77

1

.56

8

4.44

16

8.89

25

13.89

~

All Cases

No.

%

c~
~s

107

28.84 t;

~

~

194

52.29 !....:..).

70

18.87

;l

.;~.:.:.

..0......

371

100.00

-.o~..-
(')

24

13.33

i:l::

52

28.89

~ !:)

:

104

57.78

180

100.00

Tuberculosis Control

249

STATE PNEUMOTHORAX REFILL PROGRAM
January 1 through December 31, 1943
Number patients under treatment, January 1, 1943~~------------------ 559 New cases admitted to service, January 1 through December
31' 1943 ----------------~~-------------------------------------------------------------- 139

Total cases under treatment during period January 1 through December 31, 1943------------------~----------------------~ --------------~--------~------- 698
Patients dropped from service, January 1 through December 31, 1943: Admitted to Sanatorium-----~-----------------~~-------------------------------~- 8
Pneumothorax discontinued: Pneumothorax unsuccessful ~----------------------------~~~--~----- 6
Obliterature pleuritis -~--~~--------~-~~----------------~ ~~--~~---------- 1 7

7

Discharged to private physician ~~-~~----------~--~-~~~-----~~----------~~ 3

Moved --------------~-~~~-~--- ~~---~---~---------~ _____________ ----~-----~~~~~~~-~~~--------- 1

Deaths --------------~~~---~~---~~~----~-----~----~--~---~~-------------------~------~-~----- 7

26

Total number patients under treatment December 31, 1944----~~-~~~~-~- 672

RESULTS OF INTERPRETATION OF FILMS REFERRED BY PHYSICIANS

January 1 through December 31, 1943 Childhood ----------~~-----~~~--~----------------------~--~-----~--------------~-----------~---- 19 Minimal --------~-------------------------------------~ _------------~~--- --------~-----------~~~- 36 Moderately advanced ----------------------------------------------------~-~------------- 125 Far advanced ------------------------------~-~------------------- -------------------------~~~ 84

Total Positive __ ----------------~~--------------------------------~-------~-----------

264

Suspicious --------~----------~~--------------- ___________________.______ ....______...____..,..... 431

Negative ______ ------------------------------------------------------------~-~-----~------------- 662

1093
CAsEs ON WHICH PREVIOus DIAGNOSIS HAD BEEN MAnE:
Films sent in for review on cases that had been previously diagnosed and no change shown----------------------------------------------------~-----~~ 730

ToTAL oF ALL FILMs SENT IN FOR INTERPRETATION__________~~~- 2087

State Tuberculosis Sanatorium

H. C. ScHENCK, M.D. ________________________________________________________________ Superintendent

MEDICAL STAFF:
F. C. Welchel, M.D. H. E. Crow, M.D. Fred Crenshaw, M.D.

Paul C. Burnett, M.D. Robert Cox, M.D. J. B. Ford, Jr., M. D.

State Tuberculosis Sanatorium

A brief summary of services rendered during 1943 follows showinf!; comparison with a similar period in 1942:

1943 Patients treated ___ ________________ __________ ______ 1,122

Patient days ____

______________ 182,345

1942 1,332 216,325

X-ray pictures made_

4,486

Fluoroscopic examinations made __

12,517

Total operating room procedures _________ 20,098

Total laboratory examinations ____ _

14,870

6,525 20,608 26,694 13,595

As may be seen, nearly all activities have been reduced. This reduction has come about for several reasons, but chiefly because of altered economic conditions due to the war.
The patient capacity of the sanatorium has been purposely reduced to overcome the attempt to meet a situation that no amount of overcrowding can possibly meet. That is, it is impossible to offer either treatment or domiciliary care to more than 6,000 known cases in the State with the few hundred beds there are at Alto. That situation can be met only by providing, in some way, other beds elsewhere. The Sanatorium has been so overcrowded that no space was provided for patient sitting or recreation rooms. These have now been provided and the rated capacity of the Main Building and the Annex is now 374. With 144 beds for colored patients, our present capacity totals 518. After the Children's Building can be made into a Nurses Home, the first floor of the Annex could be opened and an additional 60 beds could be opened for patients, provided personnel to operate them could be secured.
Even with the reduced patient load, many administrative and operational difficulties are still encountered. They concern the nursing and dietary departments particularly. Both are absolutely essential to the good care of patients, and the latter to the welfare and contentment of employees.
Another most serious defect is the lack of proper housing facilities for employees of all descriptions. This need is felt probably to greater degree than ever before because native help is less prevalent than formerly due to their attraction to the armed forces and to better paying jobs in industry.
Too little was spent in pre-war days--too little to keep the plant and equipment up properly. Now we have many costly emergency repairs and replacements to make as a consequence of the policy of operating on just barely enough to get by.

254

Georgia Department of Public Health

However, in spite of the many troubles we have in maintaining the Sanatorium to its capacity and in keeping up a good medical service, plans have been laid which should bring good results in the coming years. It is not supposed that 1944 can he exceptionally good.
These plans, some of which are under way, provide for better storage facilities, a more convenient arrangement of business and medical record offices, pharmacy and Post Office, remodeling of the Childrens Building for a Nurses Home, and conversion of the school house into apartments.
Two important additions to the Sanatorium personnel were made in 1943, and both are expected to contribute much to the smoother and more satisfactory operation of the Sanatorium. Col. Richard Job, formerly Director of the State Planning Board, rich in hospital management experi ence, has been appointed General Manager, and will relieve the Superintendent of a large volume of business administration. Miss Ethel Johnson, formerly an instructor in nutrition and dietetics at Vanderbilt University, has been appointed as Nutritionist in the dietary department, and is to teach nutrition and practical dietetics to patients, their families, and to employees. It is expected that her efforts will result in not only a better understanding on the part of patients and others of what goo,d nutrition means and how it may he attained, hut in a generally better food service.

Recommendations
(1) The chief need is a housing program. In addition to urging the completion of the present planned and under-way projects, it is recommended that three or four houses be built annually until the need is satisfied.
(2) It is further recommended that a survey be made to ascertain the need and cqst of repairing deteriorated machinery and buildings and in new equipment needs.
(3) For recommendations for an enlarged tuberculosis sanatorium program, see the 1943 Annual Report of the Division of Tuberculosis Control.
In conclusion, mention should be made of the very great material help which has been given to the Sanatorium by the State Health Department. It has taken care of the greater part of the accounting for the Sanatorium and has donated the services of the Director of the Division of Tuberculosis Control as Superintendent. The Division of Accounting of the State Health Department has been of inestimable assistance in looking after purchases, securing large supplies of surplus commodities, and in arranging for vegetable and fruit canning and preserving so that a considerable stock of them has been and is being provided against the needs of the coming seasons.

Tuberculosis Sanatorium

255

ADMISSIONS AND DISCHARGES JANUARY 1, 1943- DECEMBER 31, 1943

Patients Remaining
12-31-42

White Men~~

212

White Women ~~~~ 207

White Boys ~~~~~~~ 12

White Girls ~~~

7

Colored Men ~~~ 51

Colored Women ~ 65

Colored Boys~~-~ ~ 6

Colored Girls

2

Patients Admitted Jan.-Dec. '43
214 203
2 7 65 65 3 1

Total Treated in 1943
426 410
14 14 116 130 9 3

Patients Discharged Jan.-Dec. '43
288 229
12 12 61 66 1 0

Patients Remaining
12-31-43
138 181
2 2 55 64 8 3

Total ~- ~~~~~

562

560

1,122

669

453

AGE AND SEX OF PATIENTS DISCHARGED FROM JANUARY 1, 1943DECEMBER 31, 1943

Age Groups

1-10 ~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~ ~-~~~~~~~~~~ ~~~~~~~ ~~~~~~~ ~ ~~~~~~~~~ ~~~~~~

11-20 ~~~~ ~~~~ -~~ ~~~~~ ~~~~~~~~~ ~- ~~~~~~~~~ ~~~ ~~~~ ~- ~ ~

~ ~ ~~~~ ~~~~~~~~~

21-30

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

31 ~40 ~~~- ~ ~ ~~~ ~~~ ~~~ ~~~~~~~ ~~ ~~~~~~~~~~~ ~~~~~~~ ~~~~~~~~~~~ ~ ~~~~~~~- ~~~~~~~

41-50 ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ ~~~-- ~- ~~- ~- ~- ~--- ~~- ~~~~~~~~~~~~~~

51-60 .~~~~~~~~~~~- ~ ~~~~~~~ -~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~--

61-70 --~~~ ~~ ~~~~~ ~~ ~~~ ~~~~~~~~- ~~-~~--~-- ~ -~~--~ ~ ~~ ~ ~ ~ ~ -~-~ ~-- ~ ~ ~ ~ ~ ~- ~ ~ ~ ~. ~

71-80 ~~~~~~~~~~

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

Male
11 38 106 97 60 37 ll
2

Female
8 50 113 77 38 18
3 0

Total ~~~~

362

307

CoMPARISON OF NuMBER OF PATIENTS ADMITTED IN YEARS OF
1942 AND 1943

1942

1943

White Men ------~~~--~~~~ --~~----~~--~~----~--------------~--~~~~~~~-~~ 296

214

White Women ~~~-~----~~~-~--- --~--~------~-~----~--~-~-~-~--~~~~~ ~~ 262

203

White Boys ~~~~--~~~-----~~--~-~~~~-~~~~~~-~-----------~--~-~---~-----~--

25

2

White Girls ---~~~---~---------~~--~~---------~---~~----------~---~~~~~-

19

7

Colored Men ~~~~~~~~~~~~~~~~~~~~~~-~~~~-~~~~--~~--------~-----~~~~~~~~~~

75

65

Colored Women -~~~~~~~~~~~~~~~-~~~~~~~~~~~~-~~~---~~~~~~~~~~~~~~~~~~

69

65

Colored Boys ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~

8

3

Colored Girls -~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~ ~~~~~~~~~~~~~~

5

1

Total ~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~-~~~~~~~~~-~~-~~~~~~~~~~

7 59

560

256

Georgia Department of Public Health

CoMPARISON oF NuMBER OF PATIENTs DiscHARGED IN YEARs oF
1942 AND 1943

1942

1943

White Men _______________________________________________

286

288

White Women _____________________________________________

285

229

White Boys ___________________________ _____________ ___________________ 25

12

White Girls _____________________________________________________ 22

12

Colored Men ________ ------------------------------------

61

61

Colored Women ___________________________________________________ 70

66

Colored Boys ___________________________________________

ll

1

Colored Girls __________________________________

10

0

TotaL__ ________ ___ _____ __ ____________

770

669

ADMISSION CLASSIFICATION OF WHITE PATIENTS
January 1, 1943- December 31, 1943

Jan.-June

Jul.- Dec.

Total

Far-advanced ------------------------------------

79

76

155

Moderately-advanced _________________

77

7l

148

Minimal ----------------------- ------------- --

22

13

35

Primary Type ------------------------------------

5

1

6

Miliary ________________________________________

1

0

1

Suspicious ----------------------------------------

8

1

9

Non-tuberculous _______________________________ ll

6

17

Tuberculous Pleurisy _____ ________________

1

0

l

Undiagnosed ____________________________________ 43

l1

54

Total ___________________________________ 247

179

426

ADMISSION CLASSIFICATION OF COLORED PATIENTS
January 1, 1943- December 31, 1943

Jan.-June

Jul.- Dec.

Far-advanced ------------------------------------

30

33

Moderately advanced ________________________ 16

21

Minimal --------------------------------------------

1

4

Miliary Type ------------------------------------

0

0

Suspicious ------------------------------------------

0

0

Non-tuberculous ----------------------- _________

1

0

Tuberculous Pleurisy ------------------------

1

0

Undiagnosed --------------------------------------

18

5

Total________________________________________ 67

67

Total
63 37 5 0 0
1 1 23
134

Tuberculosis Sanatorium

257

DISCHARGE CLASSIFICATION OF WHITE PATIENTS JANUARY 1, 1943- DECEMBER 31, 1943

App. Heal. Arrest. App. Arr. Quies

Far-advanced

1

2

4

26

Moderately-ad-

vanced

0

2

9

72

Minimal -------------- 0

0

6

12

Miliary ---------------- 0

0

0

0

Primary Type ______ 0

1

6

1

Suspicious ______________ 0

0

0

0

Non-tuberculous -- 0

0

0

0

Undiagnosed -------- 0

0

0

0

The. Empyema ____ 0

0

1

0

The. Pleurisy ________ 0

0

0

0

Total ______________

5

26

111

Imp. Unimp. Died

79

53 41

76

47

5

8

8

0

0

0

1

8

0

0

12

2

0

31

3

16

0

0

0

0

6

0

0

236 114 48

Total
206
211 34
16 14 35 17 1 6 541

DISCHARGE CLASSIFICATION OF COLORED PATIENTS JANUARY 1, 1943- DECEMBER 31, 1943

App. Heal. Arrest. App. Arr. Quies

Far-advanced

0

0

0

0

Moderately-ad-

vanced -------------- 0

0

8

0

Minimal -------------- 0

0

3

0

Primary Type ------ 0

0

0

0

Miliary ------------------ 0

0

0

0

Suspicious ------------ 0

0

0

0

Non-tuberculous ____ 0

0

0

0

Undiagnosed

0

0

0

0

The. Empyema ______ 0

0

0

0

The. Pleurisy ________ 0

0

0

0

TotaL____

0

0

ll

0

Imp. Unimp. Died Total

26

l7 20

63

21

7

2

33

1

1

0

!)

0

0

0

0

0

0

3

3

4

0

0

4

7

0

0

7

7

0

0

7

0

0

0

0

1

0

0

1

67

25 25 128

-

--------~

258

Georgia Department of Public Health

COMPARATIVE X-RAY REPORT OF THE YEARS 1942 AND 1943

Fluoroscopies (Colored and White) -----------------------------------X-rays ------------------------------------------------------------------------- ----Flats ----------------------------------------------------------------------------------------Buckys --------------------------------------------------------------------------Stereos ------------------------------------------------------------------------Colon X-rays ---------------------------------------------------------------------G.I. ---------------------------------------------------------------------------Bone Plates -----------------------------------------------------------------Sinus X-rays ----------------------------------------------------------------------------Fluid X-rays -----------------------------------------------------------------------Portables ----------------------------------------------------------------------------Kidney X-rays -----------------------------------------------------------------Mastoid X-rays -------------------------------------------------------------------Lateral Chest X-rays--------------------------~-----------------------------Skull X-rays__________________________________________________________________________
Photo Roentgenoscope ----------------------------------------------------Oblique X-rays ------------------------------------------------------------------B.M.R. -----------------------------------------------------------------------------E.K.G. -------------------------------------------------------------------------------
White Adults: House Patients ----------------------------------------------------------------Consultation Patients ------------------------------------------------------
White Children: House Patients --------------------------------------------------------------Consultation Patients ________ ---------------------------------------------
Colored Adults: House Patients -----------------------------------------------------------Consultation Patients ------------.---------------------------------------
Colored Children : House Patients ______________________ ---------------------------------------Consultation Patients _______ ---------------------------------------------
Lipiodol Injections: House Patients --------------------------------------------------------------Consultation Patients ----------------------------------------------------

1942
20,608 6,525 5,468
1 57
2 57 115 19 0 31 27 1 0 0 747 0 8 36
3,679 I,474
167 163
755 256
30 I
26 4

1943
12,517 4,486 4,304
32 6 0 45 68 3 0 8 20 0 0 0 0 0 2 6
2,220 I,247
63
140
651 I34
30 1
I4 2

In the clinic at the Sanatorium, 55 new cases of pulmonary tuberculosis were found from January 1, I943, through December 31, I943.
Five hundred and seventy-two of the consultation x-rays sent in by outside physicians from January I, I943, through December 31, I943, were positive.

Tuberculosis Sanatorium

259

CLINICAL LABORATORY PROCEDURES OF YEARS 1942 AND 1943

Smears: Acid Fast Sputum Direct --------------------------------------------Acid Fast Sputum Conc'td. ----------------------------------------Acid Fast Pleural Fluid ----------------------------------------------Acid Fast Miscellaneous --------------------------------------------Gram Stain ---------------------------------------------------------------Fontana -----------------'----------------------------------------------------------
Cultures: Acid Fast --------------------------------------------------------------------Nutrient ------------------------------------------------------------------------Sabouraud --------------------------------------------------------------------Loffier's ----------------------------------------------------------------------------
Blood: Count --------------------------------------------------------------------------Sedimentation --------------------------------------------------------------------Kahn -------------------------------------------------------------------------Coagulation ---------------------------------------------------------------------Typing -------------------------------------------------------------------Crossmatching ---------------------------------------------------------------Blood Chemistry -------------------------------------------------------------
Miscellaneous: Urinalysis ---------------------------------------------------------------------Feces ---------------------------------------------- -------------------------------Animal Inoculation to S.B.H.___________________________________________ Spinal Fluid Examination______________________________________________
Gastric Analysis -------------------------------------------------------------Milk Bacteria Connt -----------------------------------------------------Blood Agar Throat Culture______________________________________________
Malaria Smear -------------------------------------------------------------Miscellaneous Smears ----------------------------------------------------Agglutination (S.B.H.) ----------------------------------------------Diptheria --------------------------------------------------------------------------G.C. Cultures -----------------------------------------------------------------Silicosis-Saranac Lake --------------------------------------------
TOTAL ______________________________ ------------------------------

1942
3,430 3% 183 0 13 23
442 0 17 0
1,239 1,230
917 188 77 65 104
5,035 35 105 16 0 8 0 16 46 4 4 1 1
13,595

194.3
3,043 198 29
7
22 13
225 30 114 10
843 875 573 100 52
33 80
8,531 25 97 5 8 30 24 3 0 0 0 0 0
14,970

COMPARATIVE OPERATING ROOM REPORT OF YEARS 1942 AND 1943

1942

1943

THORACIC SURGICAL PROCEDURES:
Apicolyses-Attempt ------------------------------------------------Apicolyses ----------------------------------------------------------------------------Bronchoscopic Examinations ----------------------------------------Incision 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 --------------------------------------------------------------------

0 1 45 2 3 2 1 1 2,568 1

1
0 24
2 0 0 0 0 1,800 0

260

Georgia Department of Public Health

COMPARATIVE OPERATING ROOM REPORT OF YEARS 1942 AND 1943

Oleothorax, Avg. No. Pts. Rec.____________________________________________

Oleothorax, Refills -------------------------------------------------------------Oleothorax, No. Avg. Out-Patients Rec.____________________________

Oleothorax, Out-Patient Refills -----------------------------------Phrenicotomies _______ ------------------------------------------------------------
Phrenicotomies, Out-Patients -------------------------------------------Pneumolyses: Patients ------------------------------------------------ _____
Pneumolyses =---------------------------------------------------------------------First Stage: ________ ------------------------------------- ______________________

Second Stage ---------------------------------- ----------------------------------Third Stage ______________________________________ -------------------------------------

Pneumoperitoneum, Initial -----------------------------------------------Pneumoperitoneum, Avg. No. Pts. Rec.__________________________

Pneumoperitoneum, Refills ---------------------------------------------Pneumoperitoneum, Pts. Adm. with__________________________________ Pneumoperitoneum, Patients Discharged ________________________ Pneumoperitoneum, Patients Discontinued ___________________ Pneumoperitoneum, Avg. No. Out-Pts. Rec.__________________ Pneumoperitoneum, Out-Pts. Refills__________________________________

Pneumothoraces, Initial ---------------------------------------------------Pneumothoraces, Sussessful ---------------------------------------------Pneumothoraces, Unsuccessful ---------------------------------------Pneumothorax, Avg. No. Pts. Rec. ___________________________________

Pneumothorax, Refills

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

Pneumothorax, Patients Admitted with ----------------------------

Pneumothorax, Patients Discharged --------------------------------

Pneumothorax, Patients Discontinued ---------------------------l~neumothorax, Avg. No. Out-Pts. Rec.......----------------------

Pneumothorax, Out-Patient Refills ------------------------------------

Removal of Air ----------------------------------------------------------------

Removal of Oil --------------------------------------------------------------------

Removal of Transverse Process ----------------------------------------

Rib Resections ------------------------------------------------------------------

Secondary Closure of Thoracoplasty Wound----"-----------------

Thoracenteses ----------------------------------------------------------------------

Thoracenteses, Out-Patients ----------------------------------------------

Thoracoplasties: Patients ---------------------------------------------------Thoracoplasties:
First Stage ---------------- -------------------------------------------------------Second Stage ---------------------------------------------------------------------Third Stage ---------------------------------------------------------------------------Third Stage-Anterior ---------------------------------------------------------Fourth Stage -------------------------------------------------------------------------Fourth Stage-Anterior ------------------------------------------------------Fifth Stage --------------------------------------------------------------------- -----Sixth Stage ---------------------------------------------------------------------------Sixth Stage-Anterior ----------------------------------------------------------Seventh Stage ---------------------------------------------------------------------Thoracotomies -----------------------------------------------------------------------Tube Inserted in Pleural Cavity_________________________________________ _

1942
2 41 0 0 257
1 27 27 0 4
1 129 62 5,475
0 30 7 1 24 218 155 54 132 11,732 8 130 81 29 174 111
0 0 1 1 2,851 1
38
38 36
48
1 14 5 4 1 1 1 3 8

1943

3 128
0 0 243 1 7 7 0 0
0 224 170 8,4%
1 111 41
2 24 84 56 ll 140 5,590 13 78
40 5
67 45 1 1 0
1 1,301
0
31

31

19

15

2

9

0

6

2

0

1

1

'-

0'

Tuberculosis Sanatorium

261

COMPARATIVE OPERATING ROOM REPORT OF YEARS 1942 AND 1943

DEATHS DURING SURGICAL PROCEDURES ___________
OTHER SURGICAL PROCEDURES: Appendectomies ------------------------------------------Blood Transfusions ___________________________________
Coccygtomies ------------------------------ ------------------------------------Dilation and Curettage ____________________________ ---------------Lumbar Punctures -----------------------------------------------Mastoidectomies ________ ------------------------------- --------------------Myringotomies -------------------------------------------------------------'-----Removal of Cysts ------------------------------------------------------Removal of Growth from Breast ____________________________________ Removal of Growth from Forehead _________________ Removal of Growth from Mouth ___________________________________
Removal of Lymph Gland -----------------------------------------------Removal of Lymph Node -----------------------------------------Removal of Wart from Hand ______________________________________________
Therapeutic Abortions --------------------------------------------
OTHER OPERATING ROOM PROCEDURES:
Antiluetic Treatments, Avg. No. Patients Rec. Antiluetic Treatments, No. Given --------------------------------Application of Radium______________________________________________________ Autopsies _________ ------------------------------------------------------- ______________ Debridement of Wounds_____________________________________________________ Excision of Furnucle.________________________________________________________ Gastric Lavages __________ _______________________ _____________ ________ Gluteal Aspirations ------------------------------------- ______________________ Incision and Drainage of Abscesses _________________ Injections, I.V. ___________ ---------------------------- -----------------------Laceration of Ankle Repaired __________________________________________
Oxygen Lavages ------------------------------------------------------Paracenteses ------------------------------------------ -------------------------Pelvic Examinations -------------------------------- --------------------------Rectal Examinations ----------------------------------------- ______________ Removal of Foreign Body from Finger -------------------------Removal of Forl'ign Body from Hand _______________ Removal of Lipoma from Forearm ________ -----------------------Skin Tests --------------------------------------------------------- ___________________ Tetanus Antitoxin ____________ ------------------------------------------------Vaginal Dilations ------------------------------------------- ------ _______________
TOTAL OPERATING ROOM PROCEDURES ____________

1942
0
7 33
1 1 19 2 0 1 2 1 1 0 0 1 2
19 1,165
1 4 3 0 35 6 33 431 0 27 5 23 0 1 1 1 279 0 1
26,694

1943
0
4 20 0 2
7 0 1 0 1 0 0 1 1 0 1
22 781
0 0 0 1 53 0 13 121 0 9 15 18 1 0 0 0 189 1 0
20,098

262

Georgw Department of Public Health

COUNTIES REPRESENTED BY DISCHARGES (BOTH RACES) FROM JANUARY I, I943- DECEMBER 3I, I943

Appling __________________ __________ 2 Bacon ________________________ ______ 3
Baldwin ------------------------- ___ 8 Banks -------------------------------- 2 Barrow ------------------------------ 6 Bartow ----------------------------- 5 Ben Hill --------------------------- I Berrien ------------------------------ 2 Bibb ---------------------------------- I9 Bleckley --------------------------- I Brantley --------------------------- I Brooks ------------------------------ 3 Bulloch ------------------------------ 2 Burke -------------------------------- 4 Butts ---------------------------------- I Candler ------------------------------ I Carroll ------------------------------ 4 Catoosa ------------------------------ 4 Chatham ------------------------- I8 Chattooga -------------------------- I 0 Cherokee --------------------------- 7
Clarke ------------------------------ I6 Clayton ------------------------------ 3 Cobb ------------------------------- 9 Coffee ----------------------------- 3 Colquitt ---------------------------- 4 Coweta ------------------------------ 7. Crisp ---------------------------------- 4 Dawson ------------------------------ I
Decatur ------------------------------ 6 DeKalb ------------------------------ I8
Dodge ------------------------------- 2 Dooly -------------------------------- 4 Dougherty ------------------------ 9 Douglas ------------------------------ I
Early ---------------------------------- 2 Effingham ------------------------- 2 Elbert -------------------------------- I 0 Emanuel ---------------------------- 6 Evans ------------------------------- I
Fannin -------------------------- I 0 Fayette ------------------------- 2 Floyd -------------------------------- 32

Forsyth ------------------------------ 2 Franklin ---------------------------- 3 Fulton ------------------------------ 7l
Gilmer ------------------------------ 2 Glynn ------------------------------- 5 Gordon ----------------------------- ll Grady ------------------------------- 3 Greene -------------------------------- I Gwinnett ---------------------------- I5 Habersham ------------------------ 5 Hall ---------------------------------- I6 Hancock ---------------------------- 5 Haralson ---------------------------- 2
Hart ---------------------------------- 2 Heard ------------------------------- 4
Henry ------------------------------- 5 Irwin ---------------------------------- 2 Jackson ------------------------------ 3 Jasper ------------------------------ I Jeff Davis ----------------------- __ I Jefferson ---------------------------- 5 Jenkins ------------------------------ 5 Jones ---------------------------------- 4 Lamar -------------------------------- I Laurens ------------------------------ 4 Liberty ---------------------------- _ I Lincoln ------------------------------ l Long ------------------------ __________ 2

Lowndes ---------------------------- 6 Lumpkin ___________________________ 6

McDuffie ---------------------------- 1 Maeon ------------------------------- 3 Madison ---------------------------- l Meriwether ------------------------ 3 Mitchell ____________________________ 4

Monroe ____

3

Montgomery ______________________ l

Morgan ------------------------------ 7 Murray ______________________________ ll

Muscogee -------------------------- 8 Newton ------------------------------ 6 Paulding --------------------------- l Peach -------------------------------- 4

Tuberculosis Sanatorium

263

COUNTIES REPRESENTED BY DISCHARGES (BOTH RACES) FROM JANUARY I, I943 - DECEMBER 3I, I943-Continued

Pickens ------------------------------ 2

Pierce -------------------------------- 2

Pike --------------------------------- 3

Polk --------------------------------- 10 Pulaski ----------------------------- 2

Quitman --------------------------- I

Rabun ----------------------------- 2 Randolph ------------------------- 2

Richmond ------------------------- 8 Rockdale ____ ----------------------- I

Schley ----------------------------- 2

Screven ----------------------------- 2 Spalding --------------------------- I8

Stephens -------------------------- 4

Stewart --------------------------- 2

Sumter

4

Talbot ------------------------------ 2 Tattnall ---------------------------- 3

Telfair ------------------------------ 3

Terrell -------------------------------- 3

Thomas ------------------------------ 2 Tift ------------------------------------ 2 Toombs ------------------------------ I
Towns -------------------------------- 2 Truetlen ---------------------------- 2 Troup -------------------------------- 5 Turner ------------------------------ I
Twiggs ------------------------------ 2 Upson -------------------------------- 7 Walker ______ __________________ __ 8
Walton ----------------------------- S Ware ----------------.----------------- I 0 Washington ---------------------- 5 Wayne ------------------------------ I Wheeler ---------------------------- 2 White -------------------------------- 2 Whitfield -------------------------- 25 Wilkes ----------------------------- I
Wilkinson -------------------------- 2 Worth -------------------------------- 5

Division of Laboratories

T. F. SELLERS, M.D. ____ -------------------
E. J. SuNKES, DR. P.H.______

_________________________________________ Director ___________________________Assistant Director

JANIE MoRRIS, M.S., Chief Bacteriologist ________________________Culture Unit

MADGE REYNOLDS, A.B., Chief Bacteriologist __________________Microscopy Unit

E. L. WEBB, A.B., Chief Serologist

___ ______ ____________Serology Unit

M. M. HARRIS, PH.D., Director___________________ __ Waycross Branch Laboratory

ELIZABETH BUTT, A.B., Acting Director________ _Albany Branch Laboratory

r,...:

Division of Laboratories
During the year 1943, the Division of Laboratories examined 670,349 specimens. This was an increase of 27,433 or 4.3 per cent, as compared with 1942. During the war period {1940-1943) there has been an increase of approximately 275,345 specimens handled annually-approximately 69.7 per cent. See Diagram I.

DIAGRAM I

GROWTH OF LABORATORY WORK 1920-1943
642,916

670,349

395,004

187,727

89,949

-22,420 1920

45,990
1925

1930

1940

One of the chief effects of the war on the laboratory work has been the marked increase in the number of specimens submitted for syphilis serology. Also, there has been a definite decrease in blood smears from malaria surveys and fecal specimens from intestinal parasite surveys. See Diagram II.

268

Georgia Department of Public Health

DIAGRAM II
GROWTH OF LABORATORY WORK BY UNITS 1920-1943
600.000
~40,000
480,000 4.20,000

360,000

300,000 240,000 180,000

D MICROSCOPY II CULTURE
SEROLOGY

120,000 60,000
0 ..

~~ o,~[ll

1920

1925

1930

1935

Table l, giving an analysis of the work by types of specimens and a comparison with the preceding year, follows:

Laboratories

269

TABLE 1 COMPARATIVE CLASSIFICATION OF SPECIMENS-1943-1942

1943

Tuberculosis -----Diphtheria _____

19,413 2,785

Gonorrhea

------------- 11,784

Malaria ------ --------------- ------- 11,951

Intestinal Parasites ---------- 23,779

Rabies ---------- --------------------- 1,238

Miscellaneous

2,807

Agglutination Series ------- 10,943 Blood Cultures __________________ 9,514

Stool and Urine Cultures_ 9,420

Syphilis Serology ___________ .552,187

Water ------------------------ --------- 14,624

GRAND TOTALS --- 670,349

MICROSCOPY ---------- 73,757
CULTURE - ------------ 29,877 SYPHILIS SEROLOGY 552,187 WATER ____________________ 14,624

1942
15,969 2,939 9,813 19,189
30,884 1,216 2,763 10,829 9,244 10,586 515,566 13,918
642,916
82,773 30,659 515,566 13,918

Increase or Decrease

+ 3,444 154
+ 1,971
- 7,238
- 7,105
+ 22 + 44 + 114 + 270 - 1,166
+36,621 + 706

+2L6% -5.2%
+20.1%
-37.7%
-23.0%
+ L8% + L6% + L1% + 2.9% -1LO%
+ 7.1% + 4.4%

+27,433 + 4.3%

- 9,016 782
+36,621 + 706

-10.9%
-2.6%
+ 7.1%
+ 5.1%

270

Georgia Department of Public Health

. '
Table 2 shows the division of the specimen load among the three laboratories with the comparative gain or loss in each. The Southwestern Branch at Albany declined 4.8 per cent in specimen load in 1943 due largely to a loss in public health personnel such as health officers, public health nurses and practicing physicians in the territory serviced by this laboratory. The work in the Southeastern Branch at Waycross increased 37.1 per cent, chiefly as a result of the demands for syphilis serology for the ship building and war industrial plants at Brunswick and along the Georgia coast. The work in the Central Laboratory at Atlanta remained rather stable.

TABLE 2 SPECIMEN LOAD BY LABORATORIES

1943 Central Laboratory,
Atlanta ----------------------__506,199
Southwestern Branch, Albany ------------ -------- 68,440
Southeastern Branch, Waycross -------------------- 95,710
GRAND ToTALS ____________670,349

1942 501,229
71,856 69,831 642,916

I ncrease or Decrease

Spec.

PerCent

+ 4,970

+ 1.0

- 3,416 - 4.8

+25,879 +27,433

+37.1 + 4.3

A further analysis of the work is shown in the diagrams that follow.

Laboratories 271

DIAGRAM_III
SPECIMEN LOAD
BY
LABORATORIES 1943

CENTRAL 506,199
75.6~

WAYCROSS 95,710
14.3~
ALBANY 68,440 10,1,

SEROLOGY
552,187
82.3~

DIAGRAM IV
SPECIMEN LOAO
BY
UNITS 1943

272

Georgia Department of Public Health

DIAGRAM V

SPECIMEN LOAD BY UNITS IN EACH LABORATORY 1943

CENTRAL LABORATORY

SEROLOGY 41,422 67.8%

ALBANY LABORATORY

WAYCROSS LABORATORY

Laboratories

213

DIAGRAM VI

SPECIMEN LOAD BY TYPES 1943
SPECIMEN LOAD HANDLED IN EACH LABORATORY

SEROLOGY

C.ENTRAL. 41,833 56.7%

CENTRAL. 16,623 55.6%

MICROSCOPY

CULTURE

274

Georgia Department of Public Health

The consolidated reports of the three laboratories composing the Division of Laboratories is given in Table 3.
TABLE 3 CoNSOLIDATED REPORT FOR 1943
Total Positive

Tuberculosis-Microscopic ______________ -------------

Tuberculosis-Culture ___________________

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

Tuberculosis-Animal Inoculation

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

Diphtheria _____________________________

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

Gonorrhea _________ --------------------------- --------.---------------
Malaria ____________ -------------------------------------------------Intestinal Parasites ______________________ ----------------------Egg Counts_________________________________________________________________ _

Rabies-Microscopic _______ ----------------- _-------------------

Rabies-Animal Inoculation _________

_____________

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

_____________ _

TOTAL FOR MICROSCOPY________ ----------------------------------

Agglutination Series _______

____________________ _

Typhoid Fever______________________________________________________ _

Typhus (Brill's) Fever ___________ Brucellosis .______________________________________________

Tularemia ___________ --------------------------- ___________ -------------

Blood Cultures ____ ---------------------------

___________ _

Elberthella typhosa __________________________

Salmonella __________________________________________________________

Brucella ____ ____________________________

Others ___________________________________________________________________ _

Stool and Urine Cultures

__________________ _

Eberthella typhosa _____________

Salmonella ____________________________________________ ---------------

Shigella_ Others ____

ToTAL FOR CuLTURE ____________ _
Syphilis Serology _______________ Water __________________________________

17,795 1,349 269 2,785
11,784 11,951 20,772
3,007 1,085
153 2,807 73,757 10,943
9,514
9,420
29,877 552,187 14,624

1,590 150 50 450
1,642 77
6,654
529 51
106 839 96
84
115 19 30 16
162 52 208
2
72,839

GRAND TOTAL------------------------------------

670,349

DISCUSSION OF WORK BY LABORATORIES
CENTRAL LABORATORY
The Central Laboratory handled 75.5 per cent of the total specimen load handled by the Division of Laboratories. The Water Laboratory handled a total of 14,624 specimens, an increase of 5.1 per cent over the

Laboratories

275

previous year. The activities of the Water Unit of the Central Laboratory are covered in the report of the Division of Public Health Engineering. For the activities of the Industrial Hygiene Laboratory, see the report of the Division of Industrial Hygiene.
The load in the Microscopy Unit decreased by 2,949 specimens, due chiefly to a drop of 2,069 in malaria examinations and 5,185 in intestinal parasite tests. Chief gains were in tests for tuberculosis (+3,523) and for gonorrhea (+975). The load in the culture unit remained rather stabilized, with an increase of only 630 specimens as compared with the preceding year. The gains were noted in each of the several types of examinations. In addition to the routine work, this unit did considerable research into the typing of isolated organisms. The Serology Unit exam ined 443,215 specimens-an increase of 6,669 over the preceding year. Specimens from Selective Service totaled 184,681 or 42.6 per cent of the Central Laboratory serology load. See Tables 4 and 5.

276

Georgia Department of Public Health

TABLE 4 REPORT OF CENTRAL LABORATORY FOR 1943

Total

Tuberculosis-MicroscopiC----------------------------------------Tuberculosis-Culture_________________________________________________ Tuberculosis-Animal Inoculation_____________________________ Diphtheria______________________________ --------------------------------------MGoanlaorrirah__e__a_____~_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-__-_-_-_-_-_-_-_-_-_-_________________
Intestinal Parasites_______________________________________________________
Egg Counts..------------------------------------------Rabies-Microscopic____________________________________________________ Rabies-Animal Inoculation_______________________________________ Miscellaneous________________________ ----------------------------------------
ToTAL FOR MicRoscopy____________________________________________ _
Agglutination Series____________________________________________________
Typhoid Fever--------------------------------------------------- _____ Typhus (Brill's) Fever-------------------------------------------Brucellosis________________________________________________________________ Tularemia ________________________________________________________________ _ Blood Cultures______________________________________________________________ Elberthella typhosa__________________________________________________ Salmonella________________________________________________________________ Brucella_____________________________________________________________________ Others_______________________________________________________________________ _

14,308 1,208 269 2,136 7,114 5,271 8,522 275 926 153 1,651 41,833 5,828
5,155

Stool and Urine Cultures__ -----------------------------------------Eberthella typhosa___________________________________________________
Salmonella_____________________________-------------------------__ ..._... Shigella_____________________________________________________________________ _

5,640

Others------------------------------------------
TOTAL FOR CULTURE__________________________________ .................
Syphilis Serology__________________________ ------------------------------Water--------------------------------------------------..............._...... _.._

16,623 433,215 14,624

GRAND TOTAL______________________________________ -------------- 506,199

Positive
1,337 148 50 362 939 44
1,356
442 51
76 342
52 47
82 16 25 10
128 31
161 0
57,349

Laboratories

277

TABLE 5
COMPARATIVE CLASSIFICATION OF SPECIMENS-1943-1942 CENTRAL LABORATORY

1943

Tuberculosis ______________________ Diphtheria _________________________ Gonorrhea __________________________ Malaria______________________________ Intestinal Parasites ___________ Rabies_------------------------------Miscellaneous ___________________ Agglutination Series____ Blood Cultures __________________ Stool and Urine Cultures Syphilis Serology______________
Water---------------------------------

15,785 2,136 7,114 5,271 8,797 1,079 1,651 5,828 5,155 5,640 433,215 14,624

GRAND ToTALs_______________ 506,199

1942
12,262 2,552 6,139 7,330 13,982 1,048 1,459 5,817 5,129 5,047 426,546 13,918
501,229

Increase or Decrease
+ 3,523
416
+ 975
- 2,059
-- 5,185
+ 31 + 192 + ll + 26 + 593 + 6,669 + 706
+ 4,970

MICROSCOPY---------CULTURE----------------SYPHILIS SEROLOGY __ WATER ________________________

41,833 16,623 433,215 14,624

44,772 15,993 426,546 13,918

- 2,939
+ 630 + 6,669 + 706

-6.6%
+ 3.9% + 1.6% + 5.1%

The Branch Laboratories at Albany and Waycross handled a total of 164,150 specimens during 1943, as compared with 141,687 in 1942, an increase of 22,463. This constituted 24.4 per cent of the total specimen load as compared to 22.0 per cent in 1942. The decrease in the Albany Laboratory specimen load of 3,416 was occasioned chiefly by a decline in malaria examinations (--4,447) and in stool and urine cultures (-1,452). There was an increase of 2,942 specimens submitted for syphilis serology.

278

Georgia Department of Public Health

WATER UNIT IN CENTRAL LABORATORY
SECTION MICROSCOPY UNIT CENTRAL LABORATORY

Laboratories

279

The Waycross Laboratory showed a gain of 25,879 (37.1 per cent) over the previous year. The increase occurred in practically all types of examinations, but chiefly in the serology load-which showed a gain of 27,010 specimens. The greatest decrease occurred in the malaria examinations (-857!. The tables that follow give statistical reports and comparatiYe classifications of the examinations made in the Branch Laboratories.

TABLE 6 REPORT OF ALBANY BRANCH LABORATORY FOR 19'13

Tuberculosis-Microscopic Diphtheria Gonorrhea Malaria_ Intestinal Parasites _ Rabies-Microscopic Miscellaneous _
ToTAL FOR MrcRoscoPY_
Agglutination Series Typhoid Fever Typhus (Brill's) Fever Brucellosis _ Tularemia_
Blood Cultures__ Elberthella typhosa Salmonella Brucella Others
Stool and Vrine Cultures
Eberthella typhosa _ Salmonella Shigella
ToTAL FOR CuLTURE _________________ _
Syphilis Serology

Total 1,4l)9
148 2,3.54 .=J,182 1,538
115 445 14,281 3,320
2,643
1,774
7,737 -l6,422

Positive 132 5 233 2]
1.283 62
18 277
28 33
26
:Z 4 3
l9
22 31

GRAND ToTAL

68,440

280

Georgia Department of Public Health

TABLE 7
COMPARATIVE CLASSIFICATION OF SPECIMENS-1943-1942 ALBANY BRANCH LABORATORY

1943

Tuberculosis____ ------- ----------

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

Gonorrhea

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

Malaria ___ ------------------------

Intestinal Parasites ___________

Rabies _______________ ----------------

Miscellaneous . ------------------Agglutination Series ___

Blood Cultures ____

Stool and Urine Cultures

Syphilis Serology -------------

GRAND ToTALs --------------

1,499 148
2,354 5,182 4,538
115 445 3,320 2,643 1,774 46,422
68,440

MICROSCOPY ------------- CuLTURE _______ SYPHILIS SEROLOGY -

14,281 7,737
46,422

1942

Increase or Decrease

1,692 159
1,938 9,504 4,834
127 474 3,636 2,786 3,226 43,480
71,856

193 11
+ 416
- 4,322 296 12 29 316 143
- 1,452
+ 2,942
- 3,416

18,729 9,648
43,480

- 4,447 - 1,911
+ 2,942

-23.7% -19.8%
+ 6.8%

Laboratories

281

TABLE 8 REPORT OF WAYCROSS BRANCH LABORATORY FOR 1943

T u b e r c u l o s i s - M i c r o s c o p i c _____________________________________ _

Tuberculosis-Culture_________________________

_____________ _

Diphtheria________________________ ___ ____ __________________________

Gonorrhea ---------------------------------- _________________________________ _ Malaria_________________________________________________________________________ _

Intestinal Parasites_____________________ --------------------------------Egg Counts__________________________________________________________________ _
Rabies-Microscopic__________________________________________________ Miscellaneous_______________________________________________________________

TOTAL FOR MICROSCOPY____________ -- -----------------------------
Agglutination Series_____________________________________________________
Typhoid Fever----------------------- __________________________ Typhus (Brill's) Fever_________________ ___________________ _ Brucellosis_______________________________________________________________ _ Tularemia______________________________________________________ _
Blood Cultures______________________ ~--------------- ___ __ __ ---------
Elberthella typhosa__________________________________________ Salmonella_________________,____________________________________________ Brucella ______ -------------------------------- ___________________________ Others_______________________________________________________________________ _
Stool and Urine Cultures___________________________________________
Eberthella typhosa________________________________________________ Salmonella--------------------------------------------------- ____________ _ Shigella __________________________________________________ _

Total 1,988
141 501 2,316 1,498 7,712 2,732 44 711 17,643 1,795
1,716
2,006

TOTAL FOR CULTURE ___________________________________________________ _
Syphilis Serology-------------------------------- ___________________ ____
GRAND TOTAL ___________________________________________________ _

5,517 72,550 95,710

Positive
121 2 83
470 12 4,016
25
ll 220
16 4
7 1 1 3
14 1 16

282

Georgia Department of Public Health

TABLE 9

COMPARATIVE CLASSIFICATION OF SPECIJ\fEl\S-1943-1942

WAYCROSS BRANCH LABORATORY

1943

1942

- - - - - - - - - - -
Increase or Decrease

T u b e r c u l o s i s __ Diphtheria Gonorrhea_ M a l a r i a __ Intestinal Parasites _ Rabies __ Miscellaneous _ Agglutination Series _ Blood Cultures__ Stool and Lrine Cultures Syphilis Serology
GRAND ToTALS

2,129 SOl
2,316 1,498 10,444
M 711 1,795 1,716 2,006 72,550
9.5,710

2,015 228
1,736 2,355 12,068
41 830 1,376 1,329 2,313 45,540
69,831

+ 114 + 273 + ;)80
857

1.624

+

3

119

+ 419
+ 387
307

+27,010

-~-25,879

MICROSCOPY_ CuLTURE_ SYPHILIS SEROLOGY

14,281 5,517
72,5.50

18,728 5,018
45,540

- 4,447 + 499 +27,010

-23,/r;
+ 9.9;,;
--+--59.3';:~

Laboratories

283

STAINING SLIDES ALBANY BRANCH LABORATORY
UNIT IN WAYCROSS LABORATORY

284

Georgia Department of Public Health

DISCUSSION OF WORK BY UNITS
MICROSCOPY UNIT
Tuberculosis
Included in the examinations for M. tuberculosis were microscopic examinations, cultures and animal inoculations made on selected microcopically negative or doubtful sp~cimens. Cultures were made in both the Central and Waycross Laboratories, while the Central Laboratory alone handled all animal inoculations. Microscopic examinations showed an increase of 3,128 or 21.3 per cent. See Table 10.

TABLE lO
MicROSCOPIC ExAMINATIONS FOR TUBERCLE BACILLI
FIVE YEAR PERIOD 1939-1943

1939

1940

1941

1942

1943

Number examined ------------ 8,985 Number positive ~~~-~~--~~~~~~~--~ 896

Per cent positive --~-~-

9.9

10,385 975 8.4

13,008 1,063 8.2

14,667 1,256 8.6

17,795 1,590 8.9

A total of 1,348 specimens was subjected to culture--an increase of 608 or 80.9 per cent. In addition, 264 specimens for animal inoculation were also cultured, making a total of 1,613 cultured for M. tuberculosis. Three tubes of Petragnani media are routinely inoculated with each specimen. Animal inoculations showed a decrease of 45 or 16.3 per cent. The increased cost and difficulty of securing guinea pigs have necessitated careful selection of those specimens to be subjected to animal inoculation. Table ll gives an analysis of the culture and animal inoculation studies.

TABLE 11
ANALYSis AuxiLIARY TUBERCULOSis EXAMINATIONs

CULTURES

ANIMAL INOCULATIONS CENTRAL LABORATORY

TYPE SPECIMEN

Central

Waycross

Total Pos. Total Pos.

Total Total Pos. Total

Micro.

Culture

Neg. Pos. NeJI'. Pos.

Animal Neg. Pos.

Sputum ~~~~~--~~-~-~~~~~~~~--- ~~~ 919 ---- -~- 106 136 2 1,055 108 37 37 ---- 33

4 33

4

Pleural Fluid -~~~~~-~~~~~~ ~~~--~-~

103 18

1

~~-

104 18 69 69 ---- 58 12 50 19

Gastric Washing ~~-~~~~~ ~~~~ .... ~~~--- 111 14 ----

111 14 106 106 ---- 97 9 88 18

Urine ~~~-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~-~~ ~- 37

4

1

Peritoneal Fluid ~~ --~~~-~~

1

----

~~~

Spinal Fluid ~~~~~~~~~~--------- ~-~ ____

lO

----

1 ~~~

Pus ~~~~~~~~~~~~~~~~~~~~~~~~- -- ~~~~~~~~~~~~ ~~-- ~~~~~

7

4

----

Synovial Fluid ~~~~~~~~~~~~~~~~~~~~~~~~~--~~

5

----

1

38 4 28 28 ---- 25

1 ----

3

3

----

2

3 25 12

3 1

t--
c.ol.:.l-

ll

----

9

9

----

9 ----

9 ----

..c.l...:....l....

7433

2* 2

1

2

~
"'

6 ---- 5 5

5

----

5

Stool _~~~~~~~~~~~~~~~~~ --~ ~ ~~~~~ ~~ -~~~~ ~ ~- ~

5

----

1 ~~~

6

Miscellaneous~~~~~~~~~~~~~~~~~~~~~~~~~-~~~-~~

8

1

8

1

2

2

----

2

----

2

Cultures for Pathogenicity~~~~~ ~~ ~

2

1

2

1

7

2

5

----

----

4

3

TOTALS ~~~~~~~~~~~~~~~~~~~-~~~~~~~~ ~~~~~~~~~ 1,208 148 141

2 1,349 150 269 264

5 233 31 219 50

NOTE : Culture report includes specimens cultured only and those cultured in conjunction with animal Inoculations. An analysis of the latter

findings is given under "Animal Inoculations."

Report on one specimen based on culture findings only, as animal inoculation test was unsatisfactory.

t:-.:1
~

286

Georgia Department of Public Health

Diphtheria
Diphtheria examinations decreased from 2,939 in 1942 to 2,781 in 1943, with positive cultures declining from 515 to 446 during the same years. See Table 12.

TABLE 12 CLASSIFICATION OF DIPHTHERIA EXAMINATIONS 1943

Diagnostic ___________ Release and Carrier ______________ _ Virulence ________________________
TOTALS -------------------

Total
2,124 651 6
2,781

Positive
231 211
4
446

Negative
1,859 438 2
2,299

Doubtful
34 2
36

Gonorrhea
An increase of 1,971 specimens or 20.1 per cent occurred in the examinations for N. gonorrheae. See Table 13. During the year, 211 specimens received from the Atlanta Health Center Clinic were examined microscopically and culturally for N. gonorrhoeae in a study of cultural methods. No attempt has been made to institute gonococcus culturing on a statewide basis, since a satisfactory method of transporting such cultures by mail has not been found.

TABLE 13
MicRoscoPIC ExAMINATIONS FOR GoNococci
FIVE YEAR PERIOD 1939-1943

1939

1940

1941

1942

1943

Number specimens examined ___ 7,599

Number positive ____

1,662

Per cent positive

21.8

8,248 1,818
22.0

9,882 1,929
19.5

9,813 11,784 1,593 1,642
16.2 13.9

Malaria
Malaria examinations showed a definite decline of 37.7 per cent in 1943. Routine specimens decreased 3,312 or 34.6 per cent and index specimens 3,926 or 40.8 per cent. This decline was due not only to a shortage of physicians and public health personnel, but also to a continued low incidence of malaria. See Tables 14 and 15. Of the 77 positive specimens, 29 were P. vivax (tertian) and 48 P. falciparum (aestivoautumnal).

Laboratories

287

TABLE I4 ExAMINATIONS FOR MALARIA FIVE YEAR PERIOD 1939-1943

Routine

1939

1940

1941

1942

1943

Totals ______

9,780

Increase or decrease over preceding year
Index Totals ________

- +243 _26,914

Increase or decrease over preceding year____-22,271

10,452 +672 25,629 -1,285

10,989 9,576 +537 -1,413 22,168 9,613 -3,461 -12,555

6,264 -3,312
5,687 -3,926

TABLE 15
RouTINE AND INDEX MALARIA ExAMINATIONs-1943
(Routine specimens are those submitted from individual patients. Index specimens are those collected in organized surveys to determine rnalara indices.)

Specimens Examined

Central

Albany

Waycross

Total

Routine Index Routine Index Routine Index Routine Index

Total Positive

__ 2,896 2,375 2,427 2,755 941 557 6,264 5,687

40

4 L3

8

5

7 58 19

Intestinal Parasites
Examinations for intestinal helminths decreased from the preceding year by 7,643 or 26.9 per cent. Hookworm egg counts increased by 538 or 21.8 per cent. Practically all specimens for egg counts were collected in studies made by the Division of Hookworm and Malaria Investigations. See Tables 16, 17 and 18 for an analysis of the intestinal parasite studies.

TABLE 16 ExAMINATIONS FOR INTESTINAL PARASITES
FIVE YEAR PERIOD 1939-1943

1939
Total ____ ----------------- 71,283 Increase or decrease+10,683 Egg Counts _________ lficrease or decrease

1940
57,512 -13,771
3,197

1941

1942

49,352 -8,160
3,854 +657

28,415 -20,937
2,469 -1,385

1943
'20,772 -7,643
3,007 +538

288

Georgia Department of Public Health

TABLE 17 INTESTINAL PARASITE EXAMINATIONS -194.'3

Central Albany Waycross Total Grand Total

Positive ------------------------
Negative -----------------------Total -----------------------------Egg Counts ------------------

1,356 7,166 8,522
275

1,283 3,255 4,538

4,015 3,697 7,712 2,732

6,654 14,118

GRAND ToTAL _________________________________________________________________________ _

20,772 3.007
23,779

TABLE18
CLASSIFICATION OF INTESTINAL PARASITE FINDINGS-1943
SINGLE INFECTION
Worms for Identification--------------------------------------------------------------------- 9 Hookworm ----------------------------------------------------------------------------------------------6,272 Dwarf Tapeworm --------------------------------------------------------------------------------- 47 Round Worm -------------------------------------------------------------------------------------------- 102 Whip Worm ----------------------------------------------------------------------------------------- 28 Pin Worm --------------------------------------------------------------------- ------------------------------- 73 Others ---------------------------------------------------------------------------------------------- 4
DouBLE INFECTION
Hookworm and Pin Worm_____________________________________________________________________ 31 Hookworm and Dwarf TapewornL--------------------------------------------------- 8 Hookworm and Round Worm______________________________________________________________ 69 Hookworm and Whip Worm_________________________________________________________________ 9 Hookworm and Rat Tapeworm___________________________________ ------------------------- l
TRIPLE INFECTION
Hookworm, Round Worm, Whip Worm_________________________________________ 4 Hookworm, Pinworm, Round Worm____________________________________________ l
Total Specimens Positive for Ova of Hookworm___________________________________6,395
Round Worm ------------------------------------------------------------------------------------- 176 Pin Worm ------------------------------------------------------------------------------- 105 Whipworm ------------------------------------------------------------------------------------- 41 Dwarf Tapeworm ---------------------------------------------------------------------------------- 55 Others -------------------------------------------------------------------------------------------------- 4

6,537
ll8 5

Rabies-Microscopic Examinations

Microscopic examinations for rabies showed increases during 1943 in

the total number of animal heads examined and the number and per cent

found positive. A comparison of the results obtained during the past five

'~

years is given in Table 19. A classification of the animal heads examined

during 1943 is shown in Table 20.

Laboratories

289

TABLE 19 ANIMAL HEADS EXAMINED MICROSCOPICALLY FOR RABIES-1939-1943

1939

Number heads examined _

987

Positive for Negri bodies____________ 443

Percentage positive -------------------- 44.6

1940
1,252 496 39.6

1941
1,090 492 45.1

1942
1,050 488 46.5

1943
1,035 529 48.8

TABLE 20
CLASSIFICATION OF ANIMAL HEADS-1943 EXAMINED MICROSCOPICALLY FOR RABIEs-STATE LABORATORIES

Animal

Central

Albany

Waycross

Totals

Specimens Posa Specimens Pos. Specimens Pos:. Specimens Pos.

Dog ---------------

711 381

90

53

32

19 833 453

Cat --------------------- 129

27

l7

5

6

3 152

35

Cattle

40

22

4

2

4

3

48

27

Mule and Horse ____ 8

2

1

9

2

Hog ----------

7

7

Fox --------------------

12

7

2

2

14

9

Goat -- --------------------

3

3

3

-3

Squirrel ------------------ 12

1

13

Rat -----

1

1

Opossum ----------------

2

2

Chicken ------------------

1

1

Raccoon ---------------

1

1

Rabbit --------------------

1

1

Totals ________ 926

442

llS

62

44

25 1,085 529

The outbreak of rabies in foxes which began in September, 1942., continued throughout the past year. Dade, Chattooga, and Walker Counties were involved as well as counties in Alabama and Tennessee. While few fox heads were submitted for laboratory examination, wild life rangers operating in the Georgia counties involved, reported having obtained histoies of approximately 250 rabid foxes during the present outbreak. In addition, approximately 90 cases of rabies in domestic animals were reported from this area. Skunks and squirrels were also suspected of being involved, but verification by laboratory examinations was not obtained. Rabid foxes were also reported in the following counties: Richmond, Worth, Dooly, Seminole, and Houston. Two rabid foxes were submitted by the Fourth Service Command Labortory from out of state.
In addition to the examinations for rabies made in the state laboratories, examinations were also made in four municipal laboratories. Their results are shown in Table 21.

290

Georgia Department of Public Health

TABLE 21 CLASSIFICATION OF ANIMAL HEADs-1943 EXAMINED MICROSCOPICALLY FOR RABIES-MUNICIPAL LABORATORIES

Columbus Pos. Total

Dog --------------- 1

17

Cat ------------------

5

Fox ---------------------

Squirrel ----------------

2

Raccoon --------------

Pig ------------------------

ToTALs____________ 1

24

Macon Pos. Total

3

27

5

1 3 33

Savannah Pos. Total
15 10
2
l
28

Augusta Pos. Total

24

35

5

11

1

1

30

47

Map 1 shows the source of all heads found positive for rabies by the several state and municipal laboratories. The map does not show the actual incidence of rabies, since the number of heads submitted to the laboratory for examination will vary roughly with the availability of laboratory service.
Rabies-Animal Inoculation
There were 153 mouse inoculation tests for rabies completed during the year, compared to 166 during the preceding year. An analysis of these studies is given in Table 22. This table shows that 44 specimens reported after microscopic examination as negative or unsatisfactory were positive by animal inoculation. Since 529 were positive after microscopic examination only, a total of 573 heads examined by the state laboratories, and 607 examined by state and municipal laboratories were positive for rabies. In addition to the routine testing done in the Animal Laboratory, 31 special tests were made, consisting chiefly of inoculations of salivary glands removed from rabid animals, to determine the presence or absence of rabies virus. Due to the loss of personnel, this work was discontinued early in the year.

Laboratories

291

TABLE 22 ANIMAL INOCULATIONS FOR RABIEs-1943

Type Specimen

Micro.Mouse-

CDaot_g_-_-__-_-_-_-__-_-_-__-_-_-_-__-_-_ Cow________________

63 8 1

Fox________________ 8

SquirreL__________ 6

Chicken____________ 1

Hog____________________ 2

Rat. ________________

Mule __________________ 2 GoaL _________________

Opossum_________ 2 Raccoon ____________ 1

TOTALS _________ 94

Micro.. -
+ Mouse
33 2 l
1 2
39

Micro 7 Mouse--
5 1

Micro. Uns.
+ Mouse
3

+ Micro.
Mouse& Cheeks
3 3

1

1

1

l

1

7

5

8

Total
107 14 1 9 6 1 4 1 6 1 2 1
153

292

Georgia Department of Public Health

MAP I.

MAP SHOWING ANIMAL HEADS

POSITIVE FOR RABIES 1943

RICHMOND COUNTY - AUGUSTA LAB 30

MUSCOGEE COUNTY- COLUMBUS LAB I

BIBB COUNTY

-MACON LAB 3

TOTAL- CITY LABORATORIES 34

TOTAL-STATE LABORATORIES !529

GRAND TOTAL

563

Laboratories

293

Miscellaneous
Table 23 shows the miscellaneous examinations made during 1943. Of the 79 specimens examined for meningitis, positive findings were obtained as follows: N. intracellularis, 20; H. influenzae, 3; D. pneumoniae, 5; anaerobic streptococcus, 1; and hemolytic streptococcus, l. During the year, 81 specimens were examined for Donovan's bodies. Twenty-four were found positive. In the Waycross Laboratory, 165 heterophile antibody tests for glandular fever were made, as compared to 75 made in 1942. Of these, 7l were found positive, compared to 25 reported positive in 1942. Twelve specimens were found positive for E. histolytica. Three of these were received in the Waycross Laboratory, the remainder in the Central Laboratory.

TABLE 23

CLASSIFICATION OF MISCELLANEOUS EXAMINATIONS

Ameba------------------------------------------------------------------------------ 429

Vincent's ------------------------------------------------------------------------ 298

Trichomonads ---------------------------------------------- 253

Chancroid (B. ducrey) ---------------------------- ____

70

Darkfield (Tr. pallidum) __________________________ ________________ __ 168

Spinal fluids for meningitis................ ------------------- __ 79

Examinations for type of organism....----------------------- 149

Cultures --------------------------------------------------------------

513

Glandular fever (heterophile antibody test)____

165

Unclassified __________ ----------------------------------------------

683

T O T A L ___________________________________________________________________ . . 2,807

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.
Small increases occurred in both agglutination tests and blood culture studies, while stool and urine cultures decreased by ll.O per cent. The relative low incidence of enteric infections and the absence of any extensive outbreaks during the year account for this decrease. During 1943 this unit made 29,877 examinations, as compared to 30,659 in 1942. A comparison of the positive findings during the past 5 years is shown in the tables that follow.

294

Georgia Department of Public Health

TABLE 24 PosiTIVE AGGLUTINATION TEsTs

1939

1940

1941

1942

1943

Typhoid 237 ---------------- -----------------

369

ll6

Ill

106

Endemic Typhus (Brill's) _____ 834

429

651

796

839

Brucellosis ------------------------------ 144

153

ll5

153

96

Tularemia -------------------------------- 130

97

63

78

84

TABLE 25 PosiTIVE BLooD CuLTURES

1939

1940

1941

1942

1943

E. typhosa

255

265

182

184

ll5

Salmonella

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

ll

9

9

15

19

Brucella -----------------------

14

22

43

38

30

Other Organisms ____________________ 32

25

25

21

16

TABLE 26 PosiTIVE STooL AND URINE CuLTURES

1939

1940

1941

1942

1943

Eberthella typhosa __

453

360

266

500

162

Salmonella - -----------------

9

3

5

28

52

Shigella ------------------- -------------- ll4

136

206

240

208

Other Organisms --------------------

l

5

2

During the year, 30 positive isolations of Brucella were made from blood cultures. A classification of these is given in Table 27.

TABLE 27 BRUCELLA CLASSIFICATION-1943

Central

Albany

Waycross

Total

Brucella abortus __________

10

l

ll

Brucella suis _________________________ 15

3

l

19

Experimental work in bacteriophage typing of the Eberthellas and Shigellas and in the antigenic classification of the Salmonellas was expanded considerably during the year. Of especial interest in the Shigella studies was the isolation from 6 patients of Shigella Boyd P 274--a strain previously unreported in this state. Of these cases, 5 occurred in a family of negroes at Chattahoochee, while the sixth case, apparently having no epidemiological relationship to the others, occurred in Norcross. A classification of the Shigella positives is given in Table 28.

Laboratories

TABLE 28 SHIGELLA CLASSIFICATION~-1943

Central

Albany

Waycross

Flexner --------- -----------------------

84

19

12

Sonne ---------- -----------------

62

lO

3

Newcastle

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

8

2

1

s. p Boyd 274_ -------------------------
paradysenteriae SP-----

6 1

ToTALs ___________________________ 161

31

16

295
Total 115
75 ll 6
1
208

During 1943, there were 19 Salmonella isolations from blood and 52 from stool and urine. An increasing number of these isolations has been made in recent years. During the period 1938-1940 only 47 isolations of Salmonella organisms were made. During the succeeding three years, 1941-1943, there were 130 isolations. This increase is probably due to the development of more efficient methods of isolation and identification rather than an actual increase in incidence. Classification of the Salmonella strains isolated during the past three years is given in Table 29. A new type isolated during the year from the stool of a normal food handler has been designated S. georgia.
Most of the strains isolated were, after identification and typing in our laboratories, sent to the New York Salmonella Center at Beth Israel Hospital, either for confirmation or identification of type.

TABLE 29 SALMONELLA TYPEs IsoLATED IN GEORGIA 1941- 1943

Group Salmonella

1941 1942 1943

A

paratyphi A

B

paratyphi B

typhi murium

derby

bredeney

c

cholerae suis

oranienburg

bareilly

montevideo

tennessee

georgia

newport

muenchen

litchfield

D

sendai

panama

E

give

anatum

meleagridis

Others poona

114

5 8 20

14 10

21

1

265

136

1

132

2

1

11

3

1

1

1

9

1

25

11

3

TOTALS

14 44 72

One isolation was from pus from knee

Total No. Isolations
6 33 24
3 1 13 10 1 6 2 1 2 3 1 1 10 1 7 2 3
130

From
Blood Stool
6 17 16
1 23 3
1 9* 4 55
1 15 11
1 2 3 1 1 28 1 7 2
44 86

Total No. Individuals
4 22 18
3 1 13 7 1 6 1 1 2 1 1 1 3 1 7 2 2
97

296

Georgia Department of Public Health

During 1943 typing by the application of bacteriophage was done on 280 isolations of E. typhosa from 138 persons. This work was instituted in the culture unit of the Central Laboratory in 1941. Since then, a total of 1,310 cultures have been studied. Included in this study were 1,238 cultures from 691 persons, isolated from 1941 to 1943 inclusive. An analysis of this work is given in Table 30.

TABLE 30
BACTERIOPHAGE TYPING OF E. TYPHOSA 1941- 1943
(Figures given opposite type represent number of cultures typed. Figures in parentheses represent number of persons from whom types were isolated.)

Type
A
c
E F H
J
Beta, Gamma and Wforms
TOTALS

1941
95 (57) 70 (39) 68 (54) 5 (4)
ll (lO)
73 (44) 322 (208)

1942
381 (145) 78 (39) 65 (47) 10 (9) 5 (2) 8 (6)
89 (58) 636 (303)

1943
42 (31) 61 (43) 75 (42) 9 (5) 4 (l) 6 (5)
83 (50) 280 (177)

Totals
518 (233) 209 (121) 203 (143) 24 (18)
9 (3) 25 (21)

Per Cent
33.7 17.5 20.7 2.6 0.4 3.0

245 (152) 1,238 (691)

22.0 100.0

SUMMARY

*Prior to 1941
1941-1943 TOTALS

Beta, Gamma, &

A

c

E

F

H

J

W Forms

9

6 37 2

18

236 122 146 18 4 21

153

245 128 183 20 4 21

171

*Isolations prior to 1941- typed in 1941

Total
72 700 772

Syphilis Serology
Syphilis serology tests increased from 515,566 specimens in 1942 to 552,187, a gain of 36,621 or 7.1 per cent. This small percentage increase, compared to the much larger increase for the two previous years, suggests that we have approached the peak for the annual volume. A tabulated report of this work is given in Table 31. The serology specimens represent 82.4 per cent of the entire laboratory specimen load, compared with 80.2 per cent in the previous year. Of the specimens examined, 13.2 per cent were reported positive, as compared to 1Ji.Op~_t_ cent in 1942.

Laboratories

297

TABLE 31 SYPHILIS SEROLOGY-1942-1943

BLOOD
1943 -------------------- -------------1942 ----------------------------------

CENTRAL
432,413 425,919

ALBANY WAYCROSS

46,281 43,337

72,491 45,474

TOTAL
551,185 514,730

+

SPINAL FLUIDS
1943 1942

----------------------------"-

6,494 + 2,944 +27,017 + 36,455

802

141

627

143

59

1,002

66

836

BLOOD AND SPINAL FLUIDS

1943

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

1942 ---- -------------------------

+175 - 2

-7 + 166

433,215* 46,422 426,546** 43,480

72,550 45,540

552,187 515,566

+6,669
*Includes 184,681 Selective Service specimens. **Includes 199,544 Selective Service specimens.

+2,942 +27,010

+36,621

The Central Laboratory achieved a creditable rating in the 1943 syphilis serology evaluation study conducted by the U. S. Public Health Service. The results obtained by our laboratory as compared with the control laboratory are given in Table 32.

Laboratory
Control Georgia

TABLE 32 NATIONAL SEROLOGY EvALUATION STUDY 1943

PRESUMPTIVE KAHN TEST

Sensitivity

Specificity

80.1

100.0

81.3

100.0

STANDARD KAHN TEST

Sensitivity

Specificity

71.8

100.0

67.3

100.0

During the year, an intra-state evaluation study was conducted with 24 private and municipal laboratories and the two state branch laboratories. In this study, serial dilutions of pooled positive sera and pooled negative sera were utilized, according to the method of Damon and Brougher, instead of whole blood as was used in previous studies. Eighteen of the 24 private and municipal laboratories, together with our branch laboratories, were approved for the performance of the serologic tests for syphilis in accordance with the provisions of the state prenatal law.

298

Georgia Department of Public Health

During the year, a syphilis serology research laboratory was organized to render a complete serology service on specimens which may warrant special consideration over and above the routine examination.

Biologics and Drugs
Table 33 gives the distribution of drugs and biologics during the past year, while Table 34 lists those showing the most marked increase or decrease as compared with the preceding year. Pertussis vaccine was added in March to the list of biologics distributed. Because of war time restrictions an'd a lessened demand, the distribution of several items, including scarlet fever antitoxin and antipneumococcic serum, has been discontinued.
TABLE 33
BIOLOGIC PRODUCTS AND DRUGS DISTRIBUTED
(Figures for Central Laboratory represent total distribution. Biologics distributed by Branch Laboratories are invoiced to them from the Central Laboratory.)

CENTRAL

ALBANY

WAYCROSS

SERA AND VACCINES
Diphtheria Antitoxin, units ~~~ ~~~ Diphtheria Toxoid, cc. ~~~~~~~~ ~~~~ Diphtheria Schick Tests, tests ~~
Tetanus Antitoxin, units Smallpox Vaccine, points ~~~- ~~~~ Typhoid Vaccine, cc. -~~~~~~~~~ ~~-- ~ Tuberculin, PPD, tests ~~~~~~~~~~~ Tuberculin, Diluted, cc..~~-~~~~~~~~~~ Pertussis Vaccine, cc. vials ~~~~~~~
(I) Antirabic Treatments (Persons treated) -~~~~~-~~~~~~~~-~~-~-~
DRUGS
Silver Nitrate, ampules ~~~~--~~~-~~~ Tetrachlorethylene, 0.5 cc.
capsules ----------------~-~---~~------~ Blaud's Pills, 5 pills~-~--~--~~~~~~~~~~~ Brewers Yeast, pound ______:___~-~~-~~Sulfathiazole, tablets, 0.5 gm-~--- Stovarsol, tablets, 0.25 gm---------~ (2) Bismuth Subsalicylate in
Oil, cc. --------------------------------
(3) Arsenicals, ampules ----~--~--- (4) Distilled Water, cc..-~-----------

46,845,000 81,840 38,630
2,546,500 ll3,170 527,300 1,900 18,545 67,100
2,296
74,891
14,827 54,800 22,323 1,051,760 27,835
787,020 258,451 4,682,600

2,761,000 4,470 570
327,000 6,040
41,910
21 785 4,212
540 1,050 640,050

3,997,000 6,790 1,950
167,000 7,430 38,600
460 280 4,760 3,600 6,900
IIO
395,980

(1) The figures given for the Branch Laboratories do not represent complete treatmente.

Laboratories

299

Four vials of vaccines are supplied by the Branch Laboratories for each patient for whom treatment is requested. The remainder of the treatment is sent from the Central Laboratory. (2) Distributed in 30 cc. and 60 cc. bottles. (3) Equivalent to 685,613 doses of 0.6 gms. or less. (4) Distributed in 10 cc. and 100 cc. bottles.

TABLE 34 BIO!-OGics SHOWING MARKED INCREASE OR DECREASE OvER
1942 DISTRIBUTION

SERA AND VACCINES Diphtheria Antitoxin, units ______ Diphtheria Schick Tests, tests.___ Tetanus Antitoxin, units ___________
Typhoid Vaccine, cc. ----------------

1943
46,845,000 38,630
2,546,500 527,300

1942
40,569,000 43,530
3,373,000 555,240

Increase or Decrease
+6,276,000 4,900
826,500 27,940

DRUGS

Tetrachlorethylene, 0.5 cc.

capsules ------------------------------

14,827

Hexyresorcinol Crystoids, tr.._____

30

Blauds Pills, pills.._____________________

54,800

Distilled Water, cc.__________________ 4,682,600

20,444 115
39,720 3,646,330

5,617 85
+ 15,~80 +1,036,270

Human Antirabic Treatments
Human antirabic treatments distributed showed an increase of 166 during 1943, as compared with 1942. These were sent to 138 counties as compared to 148 counties in the previous year. A comparison of treatment distributions and human mortality during the past 5 years is given in Table 35, while Table 36 gives a classification according to type during the past 2 years. Map 2 shows the geographical distribution.

300

Georgia Department of Public Health

MAP 2.

MAP SHOWING DISTRIBUTION
OF
HUMAN ANTIRABIC TREATMENT 1943
TOTAL NUMBER- 2,296

NOTE: BIBB COUNTY

14B

FULTON COUNTY 3B7

COBB COUNTY

104

RICHMOND COUNTY B3

Laboratories

301

TABLE 35

ANTIRABic TREATMENTs AND RABIES MoRTALITY



Human Treatment ------------------
Human Deaths During or After Treatment ----------------------------------
Human Deaths Without Treatment____

1939
2,394
1 1

1940
1,903
1

1941
2,262

1942
2,130

1943
2,296

2

2**

1

2*

2

Total Deaths -----------------------------

2

1

4

4

1

*Diagnosis doubtful in one case. **One patient bitten in Georgia, treated and died in South Carolina.

TABLE 36 CLASSIFICATION ANTIRABIC TREATMENT BY TYPE

Type Treatment
Pr~cautionary __________________________ _ Mild -------------------------------------------Intensive Drastic
TOTAL

1943 Number Per Cent

995

43.3

1,174

51.1

109

4.8

18

.8

2,296

19 4 2 Number Per Cent

780

36.7

1,243

58.3

91

4.3

16

.7

2,130

Human Case of Rabies
One human case of rabies was reported during the year, this occurring in December. Antirabic treatment was completed prior to onset of symptoms. The case history is given below:
CASE 1-W. D., alias W. H. R., Atlanta, Fulton County, Georgia, colored, female, age 50. Bitten by pet dog on November 20, 1943. Diagnosis of rabies in animal confirmed by laboratory examination. Patient received one puncture wound near base of little finger of left hand. Mild type antirabic treatment was begun two days later. November 22, and continued through to completion on December 13. Six days later, December 19, (29 days following bite) she began to show characteristic symptoms of rabies. She died on December 22. The clinical diagnosis was rabies. No autopsy was performed.

302

Georgia Department of Public Health

TABLE 37
DISTRIBUTION OF SPECIMEN OUTFITS BY LABORATORIES

Keidel Tubes For Selective Service____________ 203,262
Other ------------------------------------ 221,781 Sterile Corked Vials_______________________________
Darkfield Outfits -------------------------------------Throat Culture Outfits__________________________ Intestinal Parasite Outfits, Routine__________ Intestinal Parasite Tins, Survey_____________ Slide Outfits -----------------------------------------Slides -----------------------------------------------------Sputum Outfits ---------------------------------Stool Culture Outfits______________________________
NEEDLES, DOZ
19 Gauge, 2 inch -------------------------------
22 Gauge, 11h inch ----------------------------
24 Gauge, %, inch --------------------------
26 Gauge, % inch & 1h inch ------------
SYRINGES
1 cc. Tuberculin --------------------------2 cc. Hypodermic 5 cc. Hypodermic 10 cc. Hypodermic

Central Albany

425,043 139,471
334 3,122 7,373 4,128 9,899 5,856 19,912 6,996

13,390 29,105
99 209 2,153 2,578 1,460 2,132 2,087 1,514

120 187 5/6 134 124

69only 744only 108 only 845 only

Waycross Totals

3,937 15,373
70 748 1,099 5,040 1,289 100 2,325 2,843

442,370 183,949
503 4,079 10,625 11,746 12,648 8,088 24,324 11,353

Laboratories

303

TABLE38

MEDIA AND VACCINE UNIT

MEDIA

Meat Infusion Double______________________
Pork Infusion -------------------------------Meat Infusion Broth_______________________ Beef Extract Broth____________________________
Conradi's Bile --------------------------Miscellaneous Broths ----------------------Meat Infusion Agar__________________________ Beef Extract Agar__________________________ Pork Infusion AgaL_________________________ Endo's Stock Agar__________________________ Wilson Blair Agar___________________________ Desoxycholate Citrate Agar____________ Kligler's Triple Sugar Iron Agar____ Miscellaneous Agars ----------------------Loeffler's Blood Serum _____________________
Petragnani's -------------------------------------Fryes Medium ---------------------------------Sugar Fermentation Tubes________________
Miscellaneous Media ---------------------

1943
109,000 cc. 42,000 cc. 45,850 cc. 37,000 cc. 86,000 cc. 35,450 cc.
156,000 cc. 9,000 cc. 21,000 cc. 12,000 cc.
132,700 cc. 15,000 cc. 18,350 cc. 86,140 cc. 11,056 cc. 22,000 cc. 3,000 cc. 5,450 cc. 8,200 cc.

1942
100,000 cc. 14,000 cc. 64,500 cc. 49,000 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.
38,890 cc. 11,322 cc. 17,000 cc. 3,000 cc.
5,750 cc. 3,405 cc.

Increase or
Decrease
+ 9,000 + 28,000 - 18,650 - 12,000 - 9,000
+- 5,550 46,000 + 8,000 + 7,000 - 4,000 -122,370
3,000 3,000 2,750
266 + 5,000
300 + 4,795

SOLUTIONS AND INDICATORS

Indicators for Media__________________________

150 cc.

Dyes for Media__________________________ Reagents for Media___________________________

700 cc. 9,000 cc.

700 cc. 14,659 cc.

Bismuth Sulfite Mixture__________________ 13,000 cc.

24,500 cc.

Glycerine Salt Solution_____________________ 49,300 cc.

59,000 cc.

Salt Solution -------------------------------------- 871,000 cc. Silver Nitrate Solution_____________________ 67,000 cc.

845,700 cc. 40,300 cc.

Miscellaneous Solutions -------------------- 49,000 cc.

47,650 cc.

- 5,659 - U,500 - 9,700
+ 25,300 + 26,700 + 1,350

(The following media were prepared in the Engineering Laboratory)

Lactose Broth --------------------------------Endo Agar-------------------------------------Nutrient Agar -----------------------------------Brilliant Green Lactose Bile Broth__
Miscellaneous ----------------------------------

1,800 Liters 56 Liters 14 Liters 101 Liters
56 Liters

1,440 Liters 48 Liters 24 Liters 90 Liters
1 Liter

++ 360 8

10

+

11

+

55

1% SILVER NITRATE

Number ampules made ___ -----------------------Number ampules made__________________________________ Number ampules distributed__________________________

1943
80,000 92,500 96,250

1942
100,000 68,000 78,750

Increase .,r Decrease
20,0:10 + 24,500 + 17,500

STERILE DISTILLED WATER

Water filled, CC-------------------------------------------- 5,426,900 Water distributed, cc.____________________________________ 5,507,800

3,873,900 3,855,900

DILUTED TUBERCULIN (OLD)
Tuberculin diluted, cc.____________________________________ 19,000 Tuberculin distributed, cc.__________________________ 18,870

20,500 21,085

+ 53,000 +5,507,300
1,500 2,215

304

Georgia Department of Public Health

UNRECORDED WoRK
The foregoing report deals chiefly with routine activities. Reference is made here and there to special studies and research activities which cannot be measured and credited quantitatively. However, these extra procedures involved many thousands of specimens and items which consumed much time and labor.
For example, in bacteriology (Culture Unit) hundreds of specimens were retested an'd checked in the interest of greater accuracy. Scores of animal inoculations were made in the preparation of special diagnostic antisera, and large numbers of trial tests were made in measuring the efficiency of current and new methods. All pathogenic organisms isolated at the Branch Laboratories are confirmed at the Central Laboratory. Also, in the Serology Unit, the testing of new antigens involved hundreds of additional tests. The evaluation of other laboratories in the state in serology performance required the c~eful preparation and preliminary testing of thousands of specimens. Other thousands of demonstration tests were made in the training of students and visiting technicians from other laboratories.
In the Microscopy Unit, a goodly percentage of specimens require multiple repeat tests in the interest of accuracy of results, and so on in all units of the laboratory. These extra procedures are so varied and difficult of description that to record them in detail would render this report too bulky and complex. Nevertheless, protocols and records of all special activities are on file for reference as needed.

UNSATISFACTORY SPECIMENS
More than 90 per cent of the 19,518 unsatisfactory specimens rejected by the laboratories during the year were blood samples which had spoiled in transit. Spoilage was greatest during the summer months. Delay in parcel post transportation was the chief factor. Other causes for rejection were leakage, breakage in transit 'due to faulty packing, insufficient quantity and improper collection. While the number of rejected specimens seems large, it constitutes only about 3 per cent of the total specimen load.

BRANCH LABORATORIES
The Southwestern Branch at Albany has, as shown in Table I, declined 4.8 per cent in specimen load. In view of the loss of health officers, public health nurses and practicing physicians to Military Service, this is not surprising. The same factors apply to the Southeastern Branch at Waycross; but, in spite of this, the specimen load in this Branch increased 37 per cent due to the heavy demands for laboratory service from the ship building and war industrial plants concentrated along the Georgia coast.

Labo rata rie s

305

RESEARCH LABORATORY IN SYPHILIS SEROLOGY
A well qualified, experienced serologist was sent for a study period of 3 months to the laboratories of several of the best known author serologists; namely, Kahn, Kline, Kolmer, Hinton, Eagle and Mazzinni. The expense of this project was met by a travel grant from the Rockefeller Foundation. Upon completion of the study, this serologist was assigned to the investigation of special problems in serology, including the preparation and testing of antigens and other reagents, verification tests, and evaluation specimens. A separate laboratory was assigned and equipped for this purpose.
CERTIFICATION OF LABORATORIES IN SYPHILIS SEROLOGY
The prenatal law requiring tests for syphilis on all pregnant women stipulates that these tests be performed only in laboratories approved by the Georgia Department of Public Health. Twenty-six laboratories of various types in the state participated in an evaluation study. Of this number, 20, including the Branch Laboratories, demonstrated satisfactory performance of one or more of the recognized tests for syphilis. Six failed to qualify. These will be given every opportunity to correct their difficulties, and probably all will finally be approved. In addition, 17 Army and Navy laboratories located in the state were automatically given approval on the basis of certification by the Fourth Service Command Laboratory at Fort McPherson, Georgia.

FURTHER LABORATORY EVALUATION PLANNED
Plans are being made to evaluate essential types of laboratory performance other than syphilis serology in all laboratories engaged in communicable disease laboratory diagnosis. Special emphasis will be stressed on tests for malaria, tuberculosis, enteric infections, intestinal parasites, gonorrhea, rabies and diphtheria.

STUDIES OF STAPHYLOCOCCUS BACTERIOPHAGE
The role of the staphylococcus in food poisoning is becoming better understood and recognized. Various devices have been employed toward the objective of differentiating the toxic and nontoxic stains. Some of these have promise, but are complex and, as yet, unreliable.
Just as in the case of E. typhosa and many other organisms, many strains of staphylococci are susceptible to the action of bacteriophage. This susceptibility varies widely, but there is such remarkable stability in the activity of certain groups of staphylococci that it may be possible to divide them into types having definite toxigenic values.
During 1943, large numbers of strains of staphylococci isolated from foods, diseased tissues and saprophytic sources have been studied for their general biologic character as well as for their behavior toward bacterio-

306

Georgia Department of Public Health

phage. A number of specific phages have been isolated. This study is still in progress.

INSTRUCTION CouRsE IN MALARIA TEcHNIQUE
For the fourth successive year, Miss Aimee Wilcox, of the United States Public Health Service, gave a two weeks course of instruction to a class of 10 of our student trainees and new technicians in the technique of staining and examining thick blood films for malaria parasites.

PERSONNEL
Difficulty in maintaining an adequate staff of qualified technical workers continued as in 1942. The high standards of qualification, particularly for the technical group, set up under the State Merit System have further complicated the problem. As the year closed, there appeared to be some evidence of improvement. However, unskilled male personnel, such as porters and clerks, are becoming exceedingly hard to get. There were 34 resignations and 28 replacement appointments.

VISITORS

In the laboratory guest book of 1943 are the names or records of 371 visitors. These were classified as follows:
I. Students and teachers from schools and colleges, including student nurses ________________________________________ 209

2. United States Public Health Service PeFsonnel __

9

3. Military Personnel _____________

94

4. Miscellaneous _____________ _____ ___________ __________________________ _ 32

5. From foreign countries, including Chile, Mexico,
Brazil, Paraguay, Colombia. Ecuador, Peru, Bolivia,
Dominican Republic, the Island of Dominica and Trinidad ___________ __ __ _________ _____________ ___________________ ____ 21

A number of the foreign visitors were assigned to the Georgia Department of Public Health by such ar-;encies as the Rockefeller Foundation, the Commonwealth Foundation and the United States Institute of InterAmerican Affairs.

THE DIRECTOR's TRIP TO CoLoMBIA, SouTH AMERICA
In November, the Director of the Division of Laboratories accepted an invitation from the Colombian Government, through the auspices of the Institute of Inter-American Affairs, to study the organization of the National Institute of Hygiene at Bogota. He returned to his post p ... cember 13.

Division of Information and Statistics

RICHARD BREWER ------------

___________________________ _______Director

LEALON M. LACY_______________________________________________________________Dffice Supervisor

FRANK M. WooDRUFF..__ _____

____________________________________________ Field Agent

J/

Division of Information and Statistics
The Division of Information and Statistics is responsible for the filing of a certificate for each birth and death occurring in the State of Georgia and the training and supervision of the large field force of local registrars required to collect vital records in the counties.
CuRRENT BIRTH CERTIFICATES: The procedure for filing a certificate for a current birth is as follows: The physician or midwife fills out a birth certificate, signs it, and files it with the local registrar. The local registrar enters the information in his record book, makes a copy for the County Ordinary or the County Health Officer, and forwards the original certificate to the Division of Information and Statistics where it is checked, indexed, and permanently filed. Each month the Division certifies to the fiscal officer of the County the number of certificates filed by each registrar. Payment is made to the local registrar by the county on the basis of the report rendered.
DEATH CERTIFICATES: Death certificates are filed with the local registrar by the undertakers. Personal information is placed on the certificate by the undertaker who then presents the certificate to the physician for the medical certification of the cause of death. The certificate is then sent to the local registrar who handles the certificate in the same manner as a birth certificate.
STILLBIRTHS: At the present time, Georgia has no special stillbirth certificate. The procedure is to file a birth and death certificate for each stilibirth.
DELAYED BIRTH CERTIFICATES: There are two methods by which a delayed birth certificate may be filed in Georgia. The first method, the so-called "State" procedure, is where the certificate is filed by the Division upon the presentment of certain required forms of evidence. There is no charge made for filing a birth certificate in this manner, although the statutory fee of fifty cents for a certified copy is required in the event such a copy is desired. In 1943, over 44,000 delayed birth certificates were filed by this procedure. The second method of filing a delayed birth certificate is the so-called "County" procedure authorized by an act of the General Assembly in March, 1943. By this procedure the applicant may apply to the Ordinary or Superior Court of the county of birth or residence, and, upon the presentment of the evidence required by the Court and compliance with certain other regulations as set forth in the law, the applicant is granted a Certificate of Birth. Two original records are made of the order, one of which is filed with the Court and the other with the Division of Information and Statistics. Certified copies may be obtained from either the Court or the Division of Information and Statistics. During the months of 1943, in which this procedure was operative, 22,699 Court Order certificates were filed with the state. Approximately 67,000 delayed birth certificates were filed in 1943 by the two procedures. In 1942, less than 60,000 delayed birth certificates were placed on file.

310

Georgia Department of Public Health

CERTIFIED CoPIES: The demand for certified copies continues to dominate the work of the Division. In 1943 the Division issued 65,497 certified copies. In order to complete the picture, however, it is necessary to add to this total the more than 22,000 certified copies of delayed certificates issued by the Ordinaries and the estimated 40,000 certified copies issued by local Health Departments and Ordinaries of births and deaths currently filed. In addition to the certified copies, the Division has issued an estimated 11,000 certificates for Army Allotments and thousands of verifications for governmental agencies.

STATISTICS
BIRTH RATE: In 1941 a marked increase was noted in the birth rate in Georgia. The already high rate continued its upward climb until all previous records were exceeded. This increase is probably due to an increase in registration efficiency as well as to natural increase in births always noted in war times. The number of births registered in 1943 was 78,327, an 8.5 per cent increase over the 72,189 births registered in 1942. The rate in 1943 was 25.1 as compared with 23.1 in 1942.
STILLBIRTHS: Despite the increased birth rate, the decrease in stillbirths continues. The rate declined from 38.6 in 1942 to 34.0 in 1943, a decrease of 11.9 per cent. The number of stillbirths reported in 1943 was 2,664 as compared with 2,786 in 1942.
INFANT MoRTALITY: There was a further drop in the infant mortality rate in 1943 to 46.7 per 1,000 as compared with 49.3 in 1942. A decrease of 5.2 per cent.
MATERNAL MORTALITY: A decrease of 6.8 per cent was shown in maternal mortality when the rate dropped from 4.1 in 1942 to 3.9 in 1943.

CAUSE OF DEATH
TYPHOID FEVER: The deaths from typhoid fever continued to decline reaching an all time low of 23 in 1943. The rate of 0.7 compared with 0.8 in 1942, a decrease of 3.9 per cent.
TYPHUS FEVER: Typhus fever is still on the increase as 57 deaths were reported in 1943 against 52 in 1942. This is an increase in the rate of 1.7 in 1942 compared with 1.8 in 1943 or 9.6 per cent.

Information and Statistics

311

TABLE 1
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM SPECIFIED CAUSES, LIVE BIRTHS AND RATES PER 1,000 POPUULATION, STILLBIRTHS, INFANT AND MATERNAL MORTALITY WITH RATES PER 1,000 LIVE BIRTHS AND THE PER CENT
INCREASE OR DECREASE IN THE RATES, IN GEORGIA: 1942 AND 1943

Cause of Death

Number

1943

ALL CAUSES_______________

______ 29,488

Typhoid fever ____ ---------------------------------------------------

23

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

57

Malaria ----------------------------------------------------------------

37

Smallpox ----------------------------------------- _____________________

Measles --------------------------------------------------------------------

27

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

6

Whooping cough --------------------------------------------------

170

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

47

Influenza ----------------------------------------------------------------

624

Dysentery ----------------------------------------------------------------

79

Poliomyelitis --------------------------------------------------------

3

Lethargic encephalitis ----------------------------------------

5

Meningococcus meningitis ---------------- _______________

31

Tuberculosis (all forms)------------------------------------ 1,304

Syphilis -------------------------------------------------------------------- 435

Cancer ------------------------------------------------ --------------------- 2.097

Diabetes mellitus ---------------------------------------------------- 430

Pellagra ------------------------------------------------------------------ 175

Cerebral hemorrhage, embolism and

thrombosis ------------------------------------------------------- 2,945

Heart diseases --------------------------------------------------- 5,775

Pneumonia -------------------------------------------------------------- 1,734

Diarrhea and enteritis (2 yrs.) ------------------------ 292

Cirrhosis of liver-------------------------------------------------

152

Appendicitis ---------------------------------------------------------- 188

Nephritis ---------------------------------------------------------------- 3,139

Malformation and early infancy diseases ________ 2,048

Suicide ------------------------------------------------------------------ 165

Homicide ---------------------------------------------------------------- 438

Motor-vehicle accidents -------------------------------------- 606 All other accidents ______________________________________________ 1,319

Unknown and ill-defined causes._______________________ 1,065 All other causes______________________________________________________ 4,072

1942
28,807 24 52 76
60 2 101 55 482 86 10 5 18 1,265 462 2,120 370 181
2,873 5,251 1,612
284 157 174 3,187 2,020 219 519 673 1,383 1,071 4,015

LIVE BIRTHS ----------------------------------------------------STILLBIRTHS ----------------------------------------------------INFANT MORTALITY ------------------------------------MATERNAL MORTALITY-----------------------------

78,327 2,664 3,661 303

72,189 2,786 3,559 299

Rate

1943
944.0 0.7 1.8 1.2

1942
922.2 0.8 1.7 2.4

Per Cent Increase
or Decrease
+ 2.4 3.9
+ 9.6 - 51.4

0.9

1.9 - 55.2

0.2

0.1 +216.7

5.4

3.2 + 68.4

1.5

1.8 - 14.8

20.0

15.4 + 29.4

2.5

2.8 - 8.4

0.1

0.3 -71.9

0.2

0.2

1.0

0.6 + 73.7

41.7

40.5 + 3.1

13.9

14.8 -- 5.9

67.1

67.9 - 1.1

13.8

11.8 + 16.2

5.6

5.8

3.3

94.3 184.9
55.5 9.3 4.9 6.0 100.5 65.6 5.3 14.0 19.4 42.2 34.1 130.4

92.0 168.1
51.6 9.1 5.0 5.6
102.0 64.7 7.0 16.6 21.5 44.3 34.3
128.5

+ 2.5 + 10.0 + 7.6
+ 2.8 3.2 + 7.9
1.5
+ 1.4 -24.7
-- 15.6 - 10.0
4.6 0.6
+ 1.4

25.1

23.1 + 8.5

34.0

38.6 - 11.9

46.7

49.3

5.2

3.9

4.1 - 6.8

NOTE: Figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states.
Rates based on the 1940 Census Enumerated Population.

312

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: 1920-1943

Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 -1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

Infant Mortality
5,305 4,905 4,937 5,384 5,674 4,704 4,405 4,578 4,875 4,464 4,713 4,234 4,097 4,079 5,086 4,316 4,319 3,968 4,352 3,817 3,737 3,955 3,559 3,661

Number Maternal Mortality
558 568 G58 573 708 641 485 578 622 549 658 616 620 463 505 458 491 471 421 356 342 315 299 303

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 3,677 3,390 3.228 3,078 2,903 2,786 2,664

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 61.2 78.7 68.2 70.1 62.0 67.7 58.8 57.8 58.3 49.3 46.7

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 9.7 7.6 7.8 7.2 8.0 7.4 6.5 5.5 5.3 4.6 4.1 3.9

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 69.5 67.4 62.7 49.7 47.6 42.8 38.6 34.0

TABLE 3

BIRTHs AND DEATHS (ExcLUSIVE OF STILLBIRTHS) WITH RATES PER 1,000 .POPULATION AND BIRTHS PER 100 DEATHS, IN GEORGIA: 1920-1943

Year

Number

Births

Deaths

Rate

Births

Deaths

Births Per 100 Deaths

1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

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

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 78,327

32,243 29,552 31,714 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 37,293 34,411 33,617 31,856 32,285 31,579 28,807 29,488

20.7 22.9 22.5 22.0 21.8 20.5 17.4 21.4 20.7 20.1 20.7 21.0 21.5 20.4 21.5 20.9 20.2 20.8 20.7 20.8 20.7 21.6 23.1 25.1

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 9.4

186 225 205 187 182 191 169 195 167 166 171 187 198 195 182 .
184 165 I 186 191 204 200 215 251 266

Information and Statistics

313

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: 1920-1943

INFANT MORTALITY

NUMBER

RATE

Year Total White Col. Total White Col.

1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

5305 4905 4937 5384 567 4 4704 4405 4578 4;875 4464 4 713 4234 4097 4079 5086 4316 4319 3968 4352 3817 3737 3955 3559 3661

2961 2606 2509 2938 2989 2486 2299 2334 257 4 2343 2468 2137 2122 2119 2628 2227 2114 2014 2267 1960 1851 1988 1756 1911

2344 2299 2428 2446 2685 2218 2106 2244 2301 2121 2245 2097 1975 1960 2458 2089 2205 1954 2085 1857 1886 1967 1803 1750

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.g 58.3 49.3 46.7

71.1 58.5 59.1 58.4 72.2 65.0 71.3 59.4 67.5 65.5 66.6 56.9 55.5 59.4 68.6 59.6 58.2 52.7 58.7 50.4 47.6 48.2 38.9 38.1

127.1 105.3 107.4 108.3 122.0 103.9 115.3
97.7 104.0
93.1 96.5 86.5 77.5 78.2 93.5 80.5 87.2 75.6 81.1 71.5 73.1 7 4.2 66.8 62.1

MATERNAL MORTALITY

NUMBER

RATE

Total White
558 267 568 266 658 316 573 288 708 362 641 299 485 222 578 291 622 312 549 284 658 361 616 322 620 310 463 227 505 262 458 230 491 251 471 240 421 198 356 175 342 146 315 133 299 146 303 150

Col. Total White Col.

291 9.3 302 8.6 342 10.1 285 9.0 346 11.2 342 10.8 263 9.6 287 9.3 310 10.3 265 9.4 297 10.9 294 10.0 310 9.7 236 7.6 243 7.8 228 7.2 240 8.0 231 7.4 223 6.5 181 5.5 196 5.3 182 4.6 153 4.1 153 3.9

6.4 15.8 6.0 13.8 7.4 15.1
7.o 12.6
8.7 15.7 7.8 16.0 6.9 14.4 7.4 12.5 8.2 14.0 7.9 11.6 9.7 12.8 8.6 12.1 8.1 12.2 6.4 9.4 6.8 9.2 6.2 8.8 6.9 9.5 6.3 8.9 5.1 8.7 4.5 7.0 3.8 7.6 3.2 6.9 3.2 5.7 3.0 5.4

ILLEGITIMATE BIRTHS

STILLBIRTHS

Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

NUMBER

RATE. -'-----~.

NUMBER

Total White Col. Total White Col.

Total White Col.

2695

474

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

- - --~

-~-

2221 44.9 11.4 120.4

3389

1608

1781

3077 516 2561 46.4 11.6 117.4

3820 1720 2100

3606 500 3106 55.4 11.8 137.4

3862 1716 2146

4045 543 3502 63.5 13.2 155.0

3958 1802 2156

4089 574 3515 64.5 13.9 159.7

3864 1675 2i89

4014 534 3480 67.3 14.0 163.0

3455 1435 2020

3155 461 2694 62.5 14.3 147.5

2972 1246 1726

4089 637 3452 65.7 16.2 150.3

3836 1604 2232

3868 482 3386 64.2 12.6 153.0

3478 1335 2143

4061 515 3546 69.4 14.4 155.7

3541 1374 2167

4141 512 3629 68.7 13.8 156.1

3796 1454 2342

4429 547 3882 71.7 14.6 160.1

3678 1424 2254

5125 600 4525 80.5 15.7 177.6

3847 1492 2355

5101 582 4519 84.0 16.3 180.4

3700 1382 2318

5089 651 4438 78.8 17.0 168.9

4120 1673 2447

5031 4878 4739 4724 4960 5046 5134
50~8
4911

643 4388 79.5 17.2 169.1 598 4280 79.2 16.5 169.2 526 4213 74.0 13.8 163.1 580 4144 73.5 15.0 161.3 596 4364 76.4 15.3 167.9 565 4481 78.0 14.5 173.8 607 4527 75.7 14.7 170.8 578 4460 69.8 12.8 165.2 537 4374 62.7 10.7 155.2

3987
~666
3677 3390 3228 3078 2903 2786 2664

1532 1457 1499 1386 1337 1326 1276 1268 1238

2455 2209 2178 2004 1891 1752 1627 1518 1426

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

RATE

Total White Col.

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 34.0

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 24.7

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 50.6

314

Georgia Department of Public Health

DEATHS AND BIRTHs (ExcLUSIVE OF STILLBIRTHs) AND RATEs PER 1,000 PoPULATION, IN GEORGIA: 1920-1943

BIRTHS

NUMBER

RATE

Year Total White Col. 1920 60061 41618 18443 1921 66378 44555 21823 1922 65082 42475 22607 1923 63681 41088 22593 1924 63386 41379 22007 1925 59610 38254 21356 1926 50493 32226 18267 1927 62246 39281 22965 1928 60259 38135 22124 1929 58521 35751 22770 1930 60318 37064 23254 1931 61774 37531 24243 1932 63690 38209 25481 1933 60744 35692 25052 1934 64615 38333 26282 1935 63290 37345 25945 1936 61617 36320 25297 1937 64012 38181 25831 1938 64307 38613 25694 1939 64910 38923 25987 1940 64695 38911 25784 1941 67785 41277 26508 1942 72189 45192 26997 1943 78327 50149 28178

Total 20.7 22.9 22.5 22.0 21.8 20.5 17.4 21.4 20.7 20.1 20.7 21.0 21.5 20.4 21.5 20.9 20.2 20.8 20.7 20.8 20.7 21.6 23.1 25.1

White 24.5 26.0 24.6 23.6 23.6 21.6 18.1 21.9 21.0 19.6 20.1 20.4 20.4 18.8 20.1 19.4 18.7 19.4 19.5 19.5 19.1 20.1 22.2 24.6

Col. 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 26.0

DEATHS

NUMBER

RATE

Total White Col. 32243 17212 15031 29552 15439 14113 31714 16540 15174 34082 17763 16319 34797 17750 17047 31278 15860 15418 29906 15141 14765 31869 16230 15639 36085 18642 17443 35340 18245 17095 35188 18036 17152 32989 17012 15977 32122 16813 15309 31184 16847 14337 35590 19157 16433 34313 18677 15636 37293 20156 17137 34411 18493 15918 33617 18109 15508 31856 17486 14370 32285 17313 14972 31579 16717 14862 28807 15820 12987 29488 16414 13074

Total 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 9.4

White 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 8.1

Col. 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 12.0

TYPHOID

NUMBER

RATE

Year Total White Col. Total White Col.

1920 549 274 275 19.0 16.2 22.9

1921 798 351 447 27.5 20.5 37.7

1922 714 326 388 24.6 18.9 33.1

1923 601 244 357 20.7 14.0 30.8

1924 681 292 389 23.5 16.7 33.9

1925 675 264 411 23.3 14.9 36.2

1926 519 181 328 17.9 10.7 29.3

1927 653 285 368 22.5 15.9 33.2

1928 444 182 262 15.3 10.0 23.9

1929 340 140 200 11.7 7.7 18.5

1930 500 207 293 17.2 11.2 27.3

1931 513 201 312 17.5 10.8 28.9

1932 363 133 230 12.3 7.1 21.2

1933 251 105 146 8.4 5.5 13.4

1934 316 110 206 10.5 5.8 18.8

1935 261 100 161 8.6 5.2 14.6

1936 195

68 127 6.4 3.5 11.5

1937 139

54

85 4.5 2.7 7.6

1938 121

51

70 3.9 2.6 6.2

1939

83

38

45 2.7 1.9 4.0

1940

68

27

41 2.2 1.3 3.8

1941

55

22

33 1.7 1.1 3.0

1942

24

6

18 0.8 0.3 1.7

1943

23

8

15 0.7 0.4 1.4

TYPHUS FEVER

NUMBER

RATE

Total White Col. Total White Col.

2

1

2

2

2

2

3

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 0.3 0.5 0.2

6

2

4 0.2 0.1 0.4

1

1 0.03

0.1

9

8

1 0.3 0.4 0.1

7

5

2 0.2 0.3 0.2

8

4

4 0.3 0.2 0.4

29

26

3 1.0 1.4 0.3

28

21

7 0.9 1.1 0.6

28

23

5 0.9 1.2 0.5

44

35

9 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

8 0.8 0.9 0.7

36

27

9 1.1 1.3 0.8

52

40

12 1.7 2.0 1.1

57

44

13 1.8 2.2 1.2

Information and Statistics

315

DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: 1920-1943

MALARIA

NUMBER

RATE

Year Total White Col. Total White Col.

1920 559 242 317 19.3 14.3 26.4

1921 468 195 273 16.2 11.4 23.0

1922 584 256 328 20.2 14.8 27.9

1923 489 201 288 16.9 11.6 24.8

1924 440 181 259 15.2 10.3 22.6

1925 285 102 183 9.8 5.8 16.1

1926 288 107 181 9.9 6.0 16.2

1927 296 113 183 10.2 6.3 16.5

1928 582 253 329 20.0 14.0 30.1

1929 677 322 355 23.3 17.6 32.8

1930 442 186 256 15.2 10.1 23.9

1931 307 119 188 10.5 6.5 17.4

1932 316 136 180 10.7 7.2 16.6

1933 364 193 171 12.2 10.2 15.7

1934 418 212 206 13.9 11.1 18.8

1935 387 186 211 12.8 9.1 19.2

1936 606 321 285 19.8 16.5 25.7

1937 235 113 122 7.6 5.8 11.0

1938 146

63

83 4.7 3.2 7.4

1939 101

40

61 3.2 2.0 5.4

1940

89

35

54 2.8 1.7 5.0

1941

75

29

46 2.4 1.4 4.2

1942

76

24

52 2.4 1.2 4.8

1943

37

15

22 1.2 0.7 2.0

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

5

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

7 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

5 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

27

20

7 0.9 1.0 0.6

Year
1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

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

2

6

5

1 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

4 0.7 0.9 0.4

3 0.4 0.5 0.3

1 0.5 0.7 0.1

5 0.9 1.1 0.5

7 1.2 1.6 0.6

7 1.4 1.8 0.6

5 1.3 1.8 0.5

8 1.6 2.0 0.7

2 0.6 0.9 0.2

0.6 1.0

1 0.6 0.8 0.1

2

~8

1.1

~2

3 0.5 0.6 0.3

1 0.4 0.5 0.1

2 0.4 0.6 0.2

3 0.6 0.8 0.3

1 0.5 0.7 0.1

1 0.3 0.4 0.1

0.1 0.1

1 0.2 0.2 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

813 167 146 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

118

59

54 3.8 8.2 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

67

30

37 2.2 1.5 3.3

142

75

67 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

170

76

94 5.4 3.7 8.7

316

Georgia Department of Public Health

DEATHS AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLOR, IN GEORGIA: 1920-1943

DIPHTHERIA

NUMBER

RATE

Year Total White Col. Total White Col.

1920 401 283 118 13.8 16.7 9.8

1921 415 294 121 14.3 17.2 10.2

1922 411 277 134 14.2 16.1 11.4

1923 274 199

75 9.5 11.4 6.5

1924 230 167

63 7.9 9.5 5.5

1925 185 119 66 6.4 6.7 5.8

1926 251 199

52 8.6 11.2 4.6

1927 272 187

85 9.4 10.4 7.7

1928 240 177

63 8.3 9.8 5.8

1929 183 139 44 6.3 7.6 4.1

1930 135 102

33 4.6 5.5 3.1

1931 158 122 36 5.4 6.6 3.3

1932 169 139

30 5.7 7.4 2.8

1933 187 152

35 6.3 8.0 3.2

1934 188 152

36 6.3 8.0 3.3

1935 161 116

45 5.3 6.0 4.1

1936 123

83

40 4.0 4.3 3.6

1937 108

66

42 3.5 3.4 3.8

1938 106

74

32 3.4 3.7 2.9

1939

95

65

30 3.0 3.3 2.7

1940

59

44

15 1.9 2.2 1.4

1941

63

36

27 2.0 1.7 2.5

1942

55

42

13 1.8 2.1 1.2

1943

47

32

15 1.5 1.6 1.4

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
802 950 924 994 482 624

1516 159 615 880 512 773 800 480 1204
1450 532 703 694 694 563 781 1058 739 393 495 503 483 200 319

1065 119 399 620 374 611 693 491 837
1093 432 598 476 543 446 576 784 697 409 455 421 511 282 305

89.1 9.6
35.0 51.7 30.5 47.7 51.4 33.4 70.2 87.5 33.1 44.3 39.5 41.5 33.6 44.8 60.3 46.7 25.9 30.4 29.6 31.6 15.4 20.0

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 15.7

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 28.1

DYSENTERY

NUMBER

RATE

Year Total White Col. Total White Col.

1920 170 116

54 5.9 6.8 4.5

1921 146

88

58 5.0 5.1 4.9

1922 112

69

43 3.9 4.0 3.7

1923 151

90

61 5.2 5.2 5.3

1924 187 104

83 6.5 5.9 7.2

1925 194 119

75 6.7 6.7 6.6

1926 207 129

78 7.1 7.2 7.0

1927 277 172 105 9.5 9.6 9.5

1928 304 189 115 10.5 10.4 10.5

1929 204

99 105 7.0 5.4 9.7

1930 305 158 147 10.5 8.6 13.7

1931 177

86

91 6.0 4.6 8.4

1932 141

85

56 4.8 4.5 5.2

1933 153

86

67 5.1 4.5 6.1

1934 219 123

96 7.3 6.4 8.8

1935 163

86

77 5.4 4.5 7.0

1936 156

78

78 5.1 4.0 7.0

1937 130

67

63 4.2 3.4 5.7

1938 192 107

85 6.2 5.4 7.6

1939 127

65

62 4.1 3.3 5.5

1940 126

67

59 4.0 3.3 5.4

1941 109

52

57 3.5 2.5 5.2

1942

86

43

43 2.8 2.1 4.0

1943

79

42

37 2.5 2.1 3.4

TUBERCULOSIS (ALL FORMS)

NUMBER

RATE

Total White Col. Total White Col.

2362 2531 2683 2642 2620 2448 2278 2307 2375 2190 2175 2165 1933 1777 1772 1731 1713 1549 1612 1533 1533 1385 1265 1304

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 55.5 144.5 917 1703 90.3 52.3 148.4 872 1576 84.4 49.3 139.0 807 1471 78.5 45.3 131.2 798 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 65.3 35.4 116.9 675 1102 59.6 35.6 101.1 605 1167 58.9 31.7 106.5 649 1082 67.1 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 81.3 465 800 40.5 22.8 73.7 499 805 41.7 24.5 74.2

Information and Statistics

317

DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR,.IN GEORGIA: 1920-1943

SYPHILIS NUMBER

RATE

CANCER NUMBER

RATE

Year Total White Col. Total White Col.

Total White Col. Total White CoL

1920 204

34 170 7.0 2.0 14.2

1921 296

56 240 10.2 3.3 20.2

1922 421

70 351 14.5 4.1 29.9

1923 371

73 298 12.8 4.2 25.7

1924 425

81 344 14.7 4.7 30.0

1925 454

72 382 16.6 4.1 33.7

1926 409

59 350 14.1 3.3 31.2

1927 457

65 392 15.7 3.6 35.4

1928 494 100 394 17.0 5.5 36.0

1929 461

82 379 15.9 4.5 35.0

1930 429

77 352 14.7 4.2 32.8

1931 413

54 359 14.1 2.9 33.2

1932 425

73 352 14.4 3.9 32.5

1933 391

57 334 13.1 3.0 30.6

1934 444

87 357 14.8 4.6 32.6

1935 403

85 318 13.3 4.4 28.9

1936 444

77 367 14.5 4.0 33.2

1937 496

96 400 16.1 4.9 35.9

1938 478

77 401 15.4 3.9 35.9

1939 473

61 412 15.1 3.1 36.7

1940 587 127 460 18.8 6.2 42.4

1941 503 110 393 16.0 5.3 36.2

1942 462

97 365 14.8 4.8 33.6

1943 435 102 333 13.9 5.0 30.7

1124 1210 1212 1263 1393 1311 1257 1470 1510 1456 1552 1580 1531 1647 1762 1715 1751 1797 1929 2003 1959 2139 2120 2097

766 803 782 870 913 891 860 995 1013 988 1105 1106 1052 1213 1272 1239 1239 1320 1343 1426 1380 1473 1509 1547

358 38.8 45.2 29.8 407 41.8 46.9 34.3 430 41.8 45.3 36.6 393 43.6 50.0 33.9 480 48.0 52.1 41.8 420 45.2 50.4 37.0 397 43.3 48.2 35.4 475 50.6 55.4 42.9 497 52.0 55.9 45.4 468 50.1 54.1 43.3 447 53.3 60.0 41.7 474 53.8 59.5 43.9 479 51.7 56.1 44.2 434 55.2 64.0 39.8 490 58.6 66.5 44.7 476 56.6 64.2 43.2 512 57.3 63.7 46.3 477 58.4 67.2 42.9 586 62.2 67.8 52.4 577 64.1 71.3 51.3 579 62.7 67.7 53.4 666 68.0 71.6 61.3 611 67.9 74.0 56.3 550 67.1 75.9 50.7

DIABETES MELLITUS

PELLAGRA

NUMBER

RATE

NUMBER

RATE

Year Total White Col. Total White Col.

Total White CoL Total White Col.

1920 182 139

43 6.3 8.2 3.6

1921 202 144

58 7.0 8.4 4.9

1922 255 182

73 8.8 10.6 6.2

1923 249 182

67 8.6 10.5 5.8

1924 247 161

86 8.5 9.2 7.5

1925 234 174

60 8.1 9.8 5.3

1926 223 138

85 7.7 7.7 7.6

1927 259 177

82 8.9 9.9 7.4

1928 329 227 102 11.3 12.5 9.3

1929 302 201 101 10.4 11.0 9.3

1930 352 240 112 12.1 13.0 10.4

1931 322 224

98 11.0 12.1 9.1

1932 343 260

83 11.6 13.9 7.7

1933 349 241 108 11.7 12.7 9.9

1934 389 275 114 12.9 14.4 10.4

1935 388 297

91 12.8 15.4 8.3

1936 391 299

92 12.8 15.4 8.3

1937 392 281 111 12.7 14.3 10.0

1938 420 311 109 13.5 15.7 9.7

1939 368 247 121 11.8 12.4 10.8

1940 349 258

91 11.2 12.7 8.4

1941 376 278

98 12.0 13.5 9.0

1942 370 275

95 11.8 13.5 8.8

1943 430 325 105 13.8 15.9 9.7

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

337 181 156 11.6 10.3 13.6

366 181 185 12.6 10.2 16.3

425 225 200 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

713 255 458 24.5 13.8 42.7

563 192 371 19.2 10.3 34.4

492 205 287 16.6 10.9 26.5

421 179 242 14.1 9.5 22.2

351 163 188 11.7 8.5 17.2

365 190 175 12.0 9.9 15.9

891 184 207 12.8 9.5 18.7

370 175 195 12.0 8.9 17.5

365 170 195 11.8 8.6 17.4

271 134 137 8.7 6.7 12.2

235 118 117 7.5 5.8 10.8

204 106

98 6.5 5.1 9.0

181 104

77 5.8 5.1 7.1

175

89

86 5.6 4.4 7.9

318

Georgia Department of Public Health

DEATHS AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: 1920-1943

CEREBRAL HEMORRHAGE

NUMBER

RATE

Year Total White Col. Total White Col.

1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

1336 1449 1563 1724 1766 1995 2006 2171 2394 2299 2523 2340 2382 2159 2310 2410 2638 2636 2727 3048 3035 3033 2873 2945

807 839 887 1002 963 1044 1078 1195 1297 1257 1317 1256 1269 1195 1222 1337 1425 1444 1465 1598 1574 1513 1538 1469

529 610 676 722 803 951 928 976 1097 1042 1206 1084 1113 964 1088 1073 1213 1192 1262 1450 1461 1520 1335 1476

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 94.3

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 72.1

44.1 51.4 57.6 62.2 70.0 83.9 82.8 88.1 100.2 96.3 112.4 100.5 102.6 88.4 99.3 97.4 109.6 107.1 112.8 129.0 134.6 139.9 123.0 136.0

HEART DISEASE

NUMBER

RATE

Total White Col. Total White Col.

1892 1768 1996 2388 2424 2297 2429 2929 3307 3691 4099 3948 4102 3993 5019 5071 5606 5284 5246 5417 6176 5780 5251 5775

1053 923
1953 1186 1165 1077 1198 1497 1717 1923 2109 2101 2308 2360 2901 2961 3270 3132 3059 3240 3662 3316 3165 3662

839 845 943 1202 1259 1220 1231 1432 1590 1768 1990 1847 1794 1633 2118 2110 2336 2152 2187 2177 2514 2464 2086 2113

65.3 61.0 68.9 82.3 83.5 79.1 83.7 100.9 113.8 126.9 140.6 134.4 138.6 133.8 166.9 167.3 183.6 171.7 169.2 173.5 197.7 183.8 168.1 184.9

62.1 54.0 61.0 68.2 66.4 60.9 67.2 83.3 94.8 105.3 114.5 113.0 123.0 124.6 151.8 153.5 168.0 159.5 154.4 162.1 179.6 161.1 155.3 179.7

69.9 71.2 80.3 103.6 109.7 107.6 109.8 129.3 145.3 163.5 185.4 171.2 165.5 149.8 193.3 191.6 211.0 193.4 195.6 193.7 231.7 226.7 192.2 194.7

PNEUMONIA

NUMBER

RATE

Yea1' Total White Col. Total White Col.

1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

2766 1925 2664 3199 2922 2335 2442 2132 2776 2316 2580 2465 2444 2314 3030 3035 3803 3077 2731 2299 2055 1714 1612 1734

1470 1050 1447 1596 1382 1135 1180 1015 1441 1165 1240 1255 1204 1172 1580 1572 2012 1490 1321 1209 1019
800 737 796

1296 875
1217 1603 1540 1200 1262 1117 1335 1151 1340 1210 1240 1142 1450 1463 1791 1587 1410 1090 1036
914 875 938

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 51.6 55.5

86.7 108.0 61.4 73.7 83.9 103.7 91.8 138.1 78.8 134.2 64.2 105.8 66.2 112.6 56.!) 100.8 79.5 122.0 63.8 106.4 67.4 124.9 67.5 112.2 64.1 114.3 61.9 104.8 82.7 132.3 81.5 132.9 103.4 161.8 75.9 142.6 66.7 126.1 60.5 97.0 50.0 95.5 38.9 84.1 36.2 80.6 39.1 86.4

DIARRHEA AND ENTERITIS (UNDTR 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 42.8

1175 686 489 40.5 39.8 41.7

1183 698 485 40.8 40.1 41.8

1322 736 586 45.6 42.0 51.1

949 510 439 32.7 28.8 38.7

873 462 411 30.1 25.9 36.7

810 440 370 27.9 24.5 33.4

730 434 296 25.1 24.0 27.0

526 292 234 18.1 16.0 21.6

721 453 268 24.7 24.6 25.0

545 291 254 18.6 15.7 23.5

390 254 136 13.2 13.5 12.5

493 324 169 16.5 17.1 15.5

651 378 273 21.7 19.8 24.9

507 308 199 16.7 16.0 18.1

549 303 246 18.0 15.6 22.2

480 247 233 15.6 12.6 20.9

691 385 306 22.3 19.4 27.4

416 217 199 13.3 10.9 17.7

395 215 180 12.6 10.6 16.6

435 218 217 13.8 10.6 20.0

284 138 146 9.1 6.8 13.5

292

1~2

lfiO

Q~

fi!; 14.7

Information and Statistics

319

DEATHS AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAUSES, BY CoLoR, IN GEORGIA: 1920-1943

APPENDICITIS NUMBER

RATE

Year Total White Col. Total White Col.

1920 236 152

84 8.2 9.0 7.0

1921 276 190

86 9.5 11.1 7.3

1922 300 208

92 10.4 12.1 7.8

1923 281 183

98 9.7 10.5 8.4

1924 318 210 108 11.0 12.0 9.4

1925 357 212 145 12.3 12.0 12.8

1926 289 178 111 10.0 10.0 9.9

1927 330 211 119 11.4 11.7 10.7

1928 364 236 128 12.5 13.0 11.7

1929 330 228 102 11.3 12.5 9.4

1930 333 211 122 11.4 11.5 11.4

1931 347 234 113 11.8 12.6 10.5

1932 358 255 103 12.1 13.6 9.5

1933 323 218 105 10.8 11.5 9.6

1934 339 226 113 11.3 11.8 10.3

1935 300 202

98 9.9 10.5 8.9

1936 312 201 111 10.2 10.3 10.0

1937 319 230

89 10.4 11.7 8.0

1938 287 194

93 9.3 9.8 8.3

1939 280 186

94 9.0 9.3 8.4

1940 276 159 117 8.8 7.8 10.8

1941 230 135

95 7.3 6.6 8.7

1942 174 102

72 5.6 5.0 6.6

1943 188 118

70 6.0 5.8 6.4

CIRRHOSIS OF LIVER

NUMBER

RATE

Total White Col. Total White Col.

93

61

83

52

78

43

90

54

98

69

117

77

99

62

125

75

102

61

128

74

134

80

124

87

91

61

116

73

110

73

142

97

139

87

151

95

141 100

152 111

145 102

154 110

157 123

152 104

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 2.5 40 4.0 4.4 3.5 37 3.4 3.5 3.3 50 4.3 4.2 4.5 41 3.5 3.4 3.8 54 4.4 4.1 5.0 54 4.6 4.3 5.0 37 4.2 4.7 3.4 30 3.1 3.3 2.8 43 3.9 3.9 3.9 37 3.7 3.8 3.4 45 4.7 5.0 4.1 52 4.6 4.5 4.7 56 4.9 4.8 5.0 41 4.5 5.0 3.7 41 4.9 5.6 3.6 43 4.6 5.0 4.0 44 4.9 5.3 4.0 34 5.0 6.0 3.1 48 4.9 5.1 4.4

NEPHRITIS (ACUTE AND CHRONIC)

NUMBER

RATE

Year Total White Col. Total White Col.

MALFORMATION, EARLY INFANCY

NUMBER

RATE

Total White Col. Total White Col.

1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

2200 2446 2903 3139 3449 3228 3385 3620 4105 4003 3787 3226 3216 3118 3301 3155 3446 3458 3531 3041 3348 3381 3187 3139

1258 1347 1592 1684 1787 1715 1721 1970 2162 2187 2060 1794 1753 1769 1903 1803 1910 1919 1996 1771 1848 1816 1766 1749

942 1099 1311 1455 1662 1513 1664 1650 1943 1816 1727 1432 1463 1349 1398 1352 1536 1539 1535 1270 1500 1565 1421 1390

76.0 84.4 100.1 108.2 118.9 111.2 116.6 124.6 141.3 137.7 129.9 109.8 108.6 104.5 109.8 104.1 112.9 112.4 113.9 97.4 107.2 107.5 102.0 100.5

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 90.7 88.2 86.6 85.8

78.5 92.6 111.7 125.4 144.9 133.4 148.4 148.9 177.5 167.9 160.9 132.8 134.9 123.8 127.6 122.8 138.8 138.3 137.3 113.0 138.2 144.0 130.9 128.1

1878 2480 2842 2878 2995 2526 2239 2192 1859 1742 1890 1827 1662 1639 1904 1736 1797 1663 2431 2155 2034 2163 2020 2048

1245 1446 1505 1636 1674 1434 1251 1244 1132 1050 1185 1111 1024
994 1126 1076 1064 1028 1289 1199 1098 1206 1137 1234

633 1034 1337 1242 1321 1092
988 948 727 692 705 716 638 645 778 660 733 635 1142 956 936 957 883 814

64.8 85.6 98.4 99.2 103.2 87.0 77.1 75.5 64.0 59.9 64.8 62.2 56.1 54.9 63.3 57.3 58.8 54.1 78.4 69.0 65.1 68.8 64.7 65.6

73.4 84.5 87.2 94.0 95.4 81.1 70.2 69.5 62.5 57.5 64.3 59.7 54.6 52.5 58.9 55.8 54.7 52.3 65.1 60.0 53.9 58.6 55.8 60.5

52.7 87.1 113.9 107.0 115.1 96.3 88.1 85.6 66.4 64.0 65.7 66.4 58.8 59.2 71.0 59.9 66.2 57.1 102.1 85.1 86.3 88.1 81.3 75.0

320

Georgia Department of Public Health

DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, BY CoLoR, IN GEORGIA: 1920-1943

SUICIDE NUMBER

RATE

Yeal' Total White Col. Total White Col.

1920 128 110 1921 167 142 1922 181 152 1923 166 150 1924 195 173 1925 189 169 1926 154 134 1927 198 179 1928 243 210 1929 287 268 1930 296 273 1931 313 282 1932 304 279 1933 312 276 1934 297 265 1935 300 270 1936 311 284 1937 315 288 1938 295 266 1939 316 290 1940 282 246 1941 236 212 1942 219 203 1943 165 152

18 4.4 6.5 1.5 25 5.8 8.3 2.1 29 6.2 8.8 2.5 16 5.7 8.6 1.4 22 6.7 9.9 1.9 20 6.5 9.6 1.8 20 5.3 7.5 1.8 19 6.8 10.0 1.7 33 8.4 11.6 3.0 19 9.9 14.7 1.8 23 10.2 14.8 2.1 31 10.7 15.2 2.9 25 10.3 14.9 2.3 36 10.5 14.6 3.3 32 9.9 13.9 2.9 30 9.9 14.0 2.7 27 10.2 14.6 2.4 27 10.2 14.7 2.4 29 9.5 13.4 2.6 26 10.1 14.5 2.3 36 9.0 12.1 3.3 24 7.5 10.3 2.2 16 7.0 10.0 1.5 13 5.3 7.5 1.2

HOMICIDE NUMBER

RATE

Total White Col. Total White Col.

479 100 379 16.5 5.9 31.6

549 143 406 19.0 8.4 34.2

564 146 418 19.5 8.5 35.6

505 125 380 17.4 7.2 32.7

562 155 407 19.4 8.8 35.5

464 141 323 16.0 8.0 28.5

395

97 298 13.6 5.4 26.6

510 141 369 17.6 7.9 33.3

512 159 353 17.6 8.8 32.3

523 149 374 18.0 8.2 34.6

569 158 411 19.5 8.6 38.3

597 179 418 20.3 9.6 38.8

554 175 379 18.7 9.3 35.0

670 208 462 22.5 11.0 42.4

720 205 515 23.9 10.7 47.0

661 156 504 21.8 8.1 45.8

589 155 434 19.3 8.0 39.2

641 136 505 20.8 6.9 45.4

582 131 451 18.8 6.6 40.3

560 109 451 17.9 5.5 40.1

616 111 505 19.7 5.4 46.5

649 120 529 20.6 5.8 48.7

519 102 417 16.6 5.0 38.4

438 102 336 14.0 5.0 31.0

MOTOR-VEHICLE ACCIDENTS

NUMBER

RATE

Year Total White Col. Total White Col.

1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943

140 100 132 108 203 142 267 189 313 239 348 238 370 266 433 288 473 319 531 335 612 425 655 428 585 426 675 473 809 574 942 646 991 692 964 680 789 545 669 483 802 556 946 657 673 474 606 421

40 24 61 78 74 110 104 145 154 196 187 227 159 202 235 296 299 284 244 186 246 289 199 185

4.8 4.6 7.0 9.2 10.8 12.0 12.7 14.9 16.3 18.3 21.0 22.3 19.7 22.6 26.9 31.1 32.4 31.3 25.4 21.4 25.7 30.1 21.5 19.4

5.9 6.3 8.2 10.9 13.6 13.5 14.9 16.0 17.6 18.3 23.1 23.0 22.7 25.0 30.0 33.5 35.5 34.6 27.5 24.2 27.3 31.9 23.3 20.7

3.3 2.0 5.2 6.7 6.5 9.7 9.3 13.1 14.1 18.1 17.4 21.0 14.7 18.5 21.4 26.9 27.0 25.5 21.8 16.5 22.7 26.6 18.3 17.0

ACCIDENTS AND OTHER VIOLENCE

NUMBER

RATE

Total White Col. Total White Col.

1603 1456 1508 1575 1772 1682 1585 1831 1901 1978 1992 2010 1914 1992 2251 2428 2775 2413 2125 1850 2057 2208 2056 1925

853 788 846 850 945 947 928 1035 1090 1113 1164 1243 1182 1213 1389 1453 1682 1495 1309 1186 1217 1412 1328 1192

750 668 662 725 827 735 657 796 811 865 828 767 732 779 862 975 1093 918 816 664 840 796 728 733

55.3 50.3 52.0 54.3 61.1 58.0 54.6 63.0 65.4 68.0 68.4 68.4 64.6 66.8 74.9 80.1 90.9 78.4 68.6 59.2 65.9 70.2 65.8 61.6

50.3 46.1 49.0 48.9 53.9 53.6 52.1 57.6 60.2 60.9 63.2 66.9 63.0 64.0 72.7 75.3 86.4 76.1 66.1 59.4 59.7 68.6 65.2 58.5

62.5 56.3 56.4 62.5 72.1 64.8 58.6 71.9 74.1 80.0 77.2 71.1 67.5 71.5 78.7 88.5 98.7 82.5 73.0 59.0 77.4 73.2 67.1 67.5

Information and Statistics

321

TABLE 5
DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM SPECIFIED CAusEs, LIVE BIRTHs AND RATES PER 1,000 PoPULATION, STILLBIRTHS,
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHs, BY Cor.oR, IN GEORGIA: 1942

Cause of Death

Total

ALL CAUSES------------------- 28,807

Typhoid fever ----------

24

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

52

Malaria

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

76

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

Measles -------------------

60

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

2

Whooping cough --------

101

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

55

Influenza ---------------------------------- 482

Dysentery

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

86

Poliomyelitis ---------------------------

10

Lethargic encephalitis ----------

5

Meningococcus meningitis ---

18

Tuberculosis -------------------------- 1,265 Syphilis ------------------------------------- 462

Gonorrhea ----------------------------------

6

Cancer ---------- ------------------

2,120

Diabetes mellitus ------------------

370

Pellagra

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

181

Cerebral hemorrhage, embo-

lism and thrombosis _________ 2.873

Heart diseases -------------------------- 5,251

Pneumonia -------------------------- 1,612

Diarrhea and enteritis (-2

years) ---------------------------------- 284

Appendicitis ---------------------------

174

Cirrhosis of liver____________________

157

Nephritis ---------------------------------- 3,187

Malformation and early in-

fancy diseases ------------------- 2,020

Suicide ------------------------

219

Homicide ------------------------------------ 519

Motor-vehicle accidents ---------- 673 All other accidents ____________________ 1,383

Unknown and ill-defined

causes ----------------------------------- 1,071

All other causes ----------

4,009

Number White
15,820
6 40 24
23
35 42 200 43
5 3 12 465 97
1,509 275 104
1,538 3,165
727
138 102 123 1,766
1,137 203 102 474 854
403 2,193

Colored
12,987
18 12 52
37
66 13 282 43
5 2 6 800 365 6 611 95 77
1,335 2,086
873
146 72 34
1,421
883 16
417 199 529
668 1,816

Total
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

Rate White
776.1
0.3 2.0 1.2

Colored
1196.5
1.7 1.1 4.8

1.1

3.4

0.1

1.7

6.1

2.1

1.2

9.8

26.0

2.1

4.0

0.2

0.5

0.1

0.2

0.6

0.6

22.8

73.7

4.8

33.6

0.6

74.0

56.3

13.5

8.8

5.1

7.1

75.5 155.3
36.2

123.0 192.2
80.6

6.8

13.5

5.0

6.6

6.0

3.1

86.6

130.9

55.8

81.3

10.0

1.5

5.0

38.4

23.3

18.3

41.9

48.7

19.8 107.6

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

Maternal mortality

299

146

153

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.

322

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: 1943

Cause of Death

Total

Number White

Colored

Total

Rate White Colored

ALL CAUSES.

29,488

Typhoid fever

23

Typhus fever ----

57

Malaria

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

37

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

Measles ------------------------

27

Scarlet fever --------

6

Whooping cough -------------

170

Diphtheria ----------

47

Influenza -----------------

624

Dysentery --------- -----------------------

79

Poliomyelitis ---------------------

Lethargic encephalitis

5

Meningococcus meningitis

31

Tuberculosis (all forms) ________ 1,304

Syphilis -------- ------------------

435

Gonorrhea

12

Cancer ------------------ ------------------- 2,097

Diabetes mellitus -------------------- 430

Pellagra ----------------------------------

175

Cerebral hemorrhage, embolism and thrombosis __________ 2,945

Heart diseases --------------

5,775

Pneumonia --------------~4

1,734

Diarrhea and enteritis (-2

yrs.)

44---4--4~------------------------

Appendicitis ------------------------------

Cirrhosis of liver_____________________

292 188 152

Nephritis

------------------------- 3,139

Malformation and early in-

fancy diseases --------------------

Suicide

---~----------4----------------------

Homicide ------------------------------------

2,048 165 438

Motor-vehicle accidents

606

All other accidents __________________ 1,319

Unknown and ill-defined

causes

---------------------- 1,065

All other causes

4,060

Live births

------------------ 78,327

Stillbirths

----------------------- 2,664

Infant Mortality

3,661

Maternal mortality

303

16,414
8 44 15
20 5
76 32 319 42
27 499 102
2 1,547
325 89
1,469 3,662
796
132 118 104 1,749
1,234 152 102 421 771
387 2,160 50,149 1,238 1,911
150

13,074
15 13 22
7
94 15 305 37
2 4 805 333 10 550 105 86
1,476 2,113
938
160 70 48
1,390
814 13
336 185 548
678 1,900 28,178 1,426 1,750
153

944.0
0.7 1.8 1.2
0.9 0.2 5.4 1.5 20.0 2.5 0.1 0.2 1.0 41.7 13.9 0.4 67.1 13.8 5.6
94.3 184.9
55.5
9.3 6.0 4.9 100.5
65.6 5.3
14.0 19.4 42.2
34.1 130.0 25.1
34.0 46.7
3.9

805.3
0.4 2.2 0.7
1.0 0.2 3.7 1.6 15.7 2.1 0.1 0.1 1.3 24.5 5.0 0.1 75.9 15.9 4.4
72.1 179.7
39.1
6.5 5.8 5.1 85.8
60.5 7.5 5.0
20.7 37.8
19.0 106.0 24.6 24.7
38.1 3.0

1204.5
1.4 1.2 2.0
0.6 0.1 8.7 1.4 28.1 3.4 0.1 0.2 0.4 74.2 30.7 0.9 50.7 9.7 7.9
136.0 194.7 86.4
14.7 6.4 4.4
128.1
75.0 1.2
31.0 17.0 50.5
62.5 175.0 26.0 50.6
62.1 5.4

NOTE: These figures exclude nonresidents of Georgia and include births and deaths of Georgia residents occurring in other states.
Rates based on the 1940 Census Enumerated Population.

Information and Statistics

323

TABLE 7
CENsus ENUMERATED PoPULATION As OF APRIL 1, 1940,
BY CoLoR AND CouNTY, IN GEORGIA

County

Total White Colored

County

Total

TOTAL -- 3,123,723

Appling -------- 14,497 Atkinson ------ 7,093

Bacon ----------
Baker ----------*Baldwin ______

8,096 7,344 16,411

Banks -----------Barrow __________
Bartow __________
Ben Hill ________

8,733 13,064 25,283 14,523

Berrien ---------- 15,370

Bibb -------------- 83,783 Bleckley ________ 9,655

Brantley ------ 6,871

Brooks

20,497

Bryan ------------ 6,288

Bulloch --------Burke ----------Butts -----------Calhoun

26,010 26,520
9,182 10,438

Camden -------- 5,910

Candler

9,103

Carroll

34,156

Catoosa

10,899

Charlton

5,256

Chatham

117,970

Chatt'chee ____ 5,138

Chattooga --- 18,532 Cherokee ------ 20,126

Clar'll#!

28,398

Clay

7,064

Clayton

11,655

Clinch ____________ 6,437

Cobb -------------- 38,272

Coffee

21,541

Colquitt -------- 33,012

Columbia

9,433

Cook -------------Coweta Crawford ______

11,919 26,972
7,128

Crisp

17,540

Dade -------------- 5,894

Dawson

4,479

Decatur -------- 22,234

DeKalb -------- 86,942 Dodge ____________ 21,022

Dooly ------------ 16,886

Dougherty

28,565

Douglas ------- 10,053 Early ------------ 18,679

2,038,278 11,856 5,422 7,042 3,049 7,713 8,072 10,605 21,073 9,674 13,033 48,239 6,331 5,727 9,990 3,735 16,168 6,654 4,891 3,309 2,486 5,996 26,903 10,576 3,760 65,027 3,110 16,720 19,229 18,335 2,077 8,671 3,938 31,990 16,165 24,955 3,769 8,728 16,149 3,105 9,426 5,597 4,415 11,473 72,973 14,045 7,555 13,028 7,880 9,065

1,085,445 2,641 1,671 1,054 4,295 8,698 661 2,459 4,210 4,849 2,337
35,544 3,324 1,144
10,507 2,553 9,842
19,866 4,291 7,129 3,424 3,107 7,253 323 1,496 52,943 2,028 1,812 897
10,063 4,987 2,984 2,499 6,282 5,376 8,057 5,664 3,191
10,823 4,023 8,114 297 64
10,761 13,969
6,977 9,331 15,537 2,173 9,614

Echols

2,964

Effingham

9,646

Elbert

19,618

Emanuel ------ 23,517

Evans ------------ 7,401

Fannin ---------- 14,752 Fayette ______ 8,170

Floyd ---------- 56,141
Forsyth __________ 11,322

Franklin ------ 15,612

Fulton ---------- 392,886

Gilmer ---------- 9,001

Glascock ------ 4,547 Glynn ------------ 21,920

Gordon

18,445

Grady ------------ 19,654

Greene ---------- 13,709 Gwinnett _____ 29,087

Habersham -- 14,771
Hall -------------- 34,822

Hancock ------ 12,764

Haralson

14,377

Harris ____________ 11,428

Hart

15,512

Heard -----------Henry ____________ Houston ________

8,610 15,119 11,303

Irwin

12,936

Jackson -------Jasper ---------Jeff Davis ____

20,089 8,772 8,841

Jefferson ______ 20,040

Jenkins -------- 11,843

Johnson -------- 12,953

Jones ----------- 8,331

Lamar --------- 10,091

Lanier

5,632

Laurens -------- 33,606

Lee ---------------- 7,837 Liberty __________ 8,595

Lincoln --
Long -------------

7,042 4,086

Lowndes

31,860

Lumpkin

6,223

McDuffie

10,878

Mcintosh

5,292

Macon ------------ 15,947

Madison

13,431

Marion __________ 6,954

Meriwether

22,055

Baldwin County population excludes the State Milledgeville Hospital.

White
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

Colored
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

324

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

Miller ~~~~~~~~~~~~ Mitchell -------Monroe __________
Montgomery __
Morgan -------Murray ~~~~~~~~~~ Muscogee ______
Newton ------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 10,375 28,467
9,829 8,514 3,435 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

County

Total

Talbot ~~~~~~~~~~~~
Taliaferro ----
Tattnall --------
Taylor
Telfair Terrell Thomas -------Tift ~~~~ Toombs -~~~~~~~~ Towns_
Treutlen ~~~~~~~~ Troup
Turner Twiggs Union ___________
Upson ~~~~~~----~ Walker .......... Walton ~~-Ware ....
Warren -------Washington .. Wayne ----------
Webster --------
Wheeler -------White -----------Whitfield ---Wilcox ----------
Wilkes ----------
Wilkinson ---Worth ............

8,141 6,278 16,243 10,768 15,145 16,675 31,289 18,599 16,952 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 12,755 15,084 11,025 21,374

White Colored

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 3,571 10,357 10,328 1,834 5,855 6,050 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

325

TABLE 8
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHs IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

LIVE BIRTHS

Rate Per 1,000

Number

Population

1943 1942 1943 1942

STILLBIRTHS

Rate Per 1,000

Number

Live Births

1943 1942 1943 1942

TOTAL-----------

________ 78,327

Appling ---------------------------~--

403

Atkinson ---~----------~-------------~------ 196

Bacon ------------------------------------------ 228

Baker -----------------------~--------------~--- 159 Baldwin -------------~------------------------- 397 Banks ----------~------------------------------ 196 Barrow ~-------~----------------------------- 289 Bartow ------~----------------~------------~-- 587

Ben Hill ~-------------------------

321

Berrien -------------~--------------------------- 340 Bibb -----------------~--------------------------- 2728

Bieckley ---------------------------------------- 258 Brantley --------------------~---------------- 188

Brooks -----~---------------------------------- 529

Bryan ------------------------------------------- 141

Bulloch ------------------------------------------ 582

Burke -------------------- ----------------------- 638

Butts ----------~-------------------------------- 226

Calhoun

253

Camden ~-------------------------------------- 177

Candler ---------------------------------------- 190 Carroll ----~----------------------------------- 722

Catoosa ---------------------------------------- 307 Charlton ___________ ------------------ 112

Chatham ------~---- ------------------------- 3625

Chattahoochee _______ ------------------- 45

Chattooga ------~----------------~--------- 480

Cherokee -------------------------------------- 453 Clarke ~-------------------~------------------- 615

Clay ------------~--------------------~---------- 176

Clayton -------------------- --------~--------- 268

Clinch --------~------------------------------- 134

Cobb -----~-------------------------~------------ 952

Coffee ------------------------------------------ 700

Colquitt ------------------ --------------------- 996

Columbia --------------------

226

Cook -------------------------------------------- 283

Coweta ------------------------------------------ 571

Crawford -------------------------------------- 182

Crisp -------------------------------------------- 433

Dade ----------~--------------------------------- 173

Dawson --------------------------------------- 93

Decatur ---------------------------------------- 697 DeKalb ________________ ------------------------- 2074

Dodge ------------------------ ------------------- 450

Dooly --------------

364

Dougherty ---------------------------------- 859

72,189
364 187 228 199 324 161 262 599 278 265 2336 249 169 550 143 519 713 215 287 186 134 653 190
97 3137
66 413 409 542 157 207 138 880 652 910 207 248 524 167 423 122
72 608 1929 444 378 692

25.1 27.8 27.6 28.2 21.7 24.2 22.4 22.1 23.2 22.1 22.1 32.6 26.7 27.4 25.8 22.4 22.4 24.1 24.6 24.2 29.9 20.9 21.1 28.2 21.3 30.7
8.8 25.9 22.5 21.7 24.9 23.0 20.8 24.9 32.5 30.2 24.0 23.7 21.2 25.5 24.7 29.4 20.8 31.3 23.9 21.4 21.6 30.1

23.1 25.1 26.4 28.2 27.1 19.7 18.4 20.1 23.7 19.1 17.2 27.9 25.8 24.6 26.8 22.7 20.0 26.9 23.4 27.5 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 21.1 22.4 24.2

2,664 18 6 7 7 10 6 8 19 16 11 103 12 4 23 9 26 26 8 15 12 4 26 6 2 158 3 4 12 25 6 7 4 27 24 34 5 10 12 10 17
3 35 50 22
9 35

2,786 14 6 12 8 15 10 7 26 12 6 111 8 9 24 9 22 27 8 11 11 5 29 5 10 160
3 17 21
2 11
34 34 40
5 4 23 10 22 3 2 30 65 10 20 28.

34.0 44.7 30.6 30.7 44.0 25.2 30.6 27.7 32.4 49.8 32.4 37.8 46.5 21.3 43.5 63.8 44.7 40.8 35.4 59.3 67.8 21.1 36.0 19.5 17.9 43.6 66.7
8.3 26.5 40.7 34.1 26.1 29.9 28.4 34.3 34.1 22.1 35.3 21.0 54.9 39.3
5.8 32.3 50.2 24.1 48.9 24.7 40.7

38.6 38.5 32.1 52.6 40.2 46.3 62.1 26.7 43.4 43.2 22.6 47.5 32.1 53.3 43.6 62.9 42.4 37.9 37.2 38.3 59.1 37.3 44.4 26.3 103.1 51.0 15.2
7.3 .U.6 38.7 12.7 53.1
7.2 38.6 52.1 44.0 24.2 16.1 43.9 59.9 52.0 24.6 27.8 49.3 33.7 22.5 52.9 40.5

326

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: 1942 AND 1943

LIVE BIRTHS

Rate Per 1,000

Number

Population

1943 1942 1943 1942

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 -------------------------------Heard --------------------------------------Irwin................................................

Jackson ----------------------------Jasper ---------------------------------------

Jeff Davis -----------------------------------

Jefferson -----------------------------

Jenkins --------------------------------Johnson ---------------------------------Jones ---------------- _______________

Lamar ------------------------

Lanier ----------------------------Laurens -----------------------

Lee -----------------------------------------Liberty -----------------------------Lincoln ----------------------

Long ------------------Lowndes
Lumpkin

McDuffie

Mcintosh

202 483
42
252 450 482
165 442
190 1268
266 360 8716 270 102 919 458 483 336 541 355 821 316 325 275 276 122 368 418 122 355
493 198 236 514 302 253 197
242 85
762
222 244 187
83 906 162 266 164

196 489 61 188 429 479 187 320 160 1326 257 294 8534 244 106 585 388 473 318 571 313 751 365 259 239 303 118 327 303 118 338 458 174 177 486 310 226 208 198 83 746 142 195 171 68 811 144 289 153

20.1 25.9 14.2 26.1 22.9 20.5 22.3 30.0 23.3 22.6 23.5 23.1 22.2 30.0 22.4 41.9 24.8 24.6 24.5 18.6 24.0 23.6 24.8 22.6 24.1 17.8 14.2 24.3 37.0 14.2 27.4 24.5 22.6 26.7 25.6 25.5 19.5 23.6 24.0 15.1 22.7 28.3 28.4 26.6 20.3 28.4 26.0 24.4 31.0

19.5 26.2 17.2 19.5 21.9 20.4 25.3 21.7 19.6 23.6 22.7 18.8 21.7 27.1 23.3 26.7 21.0 24.1 23.2 19.6 21.2 21.6 27.9 18.0 20.9 19.5 13.7 21.6 26.8 13.7 26.1 22.8 19.8 20.0 24.3 26.2 17.4 25.0 19.6 14.7 22.2 18.1 22.7 24.3 16.6 25.6 23.1 26.6 28.9

STILLBIRTHS

Rate Per 1,000

Number

Live Births

1943 1942 1943 1942

7

5 34.7 25.5

17

12 35.2 24.5

4

78.4

9

10 35.7 53.2

10

19 22.2 44.3

15

14 31.1 29.2

8

4 48.5 21.4

9

20.4 18.8

5

5.3 31.3

29

54 22.8 40.7

5

10 18.8 38.9

16

7 44.4 23.8

294

269 33.7 31.5

7

15 25.9 61.5

4

6 39.2 56.6

44

30 47.9 51.3

10

9 21.8 23.2

15

27 31.1 57.1

15

17 44.6 53.5

11

20 20.3 35.0

10

9 28.2 28.8

14

16 17.1 21.3

13

8 41.1 22.5

9

3 27.7 11.6

7

9 25.5 37.7

5

11 18.1 36.3

6

3 49.2 25.4

12

15 32.6 45.9

13

13 31.1 75.9

6

49.2 25.4

10

5 28.2 14.8

10

7 20.3 15.3

10

50.5 51.7

5

9 21.2 50.8

17

24 33.1 49.4

5

10 16.6 32.3

7

19 27.7 84.1

9

8 45.7 38.5

7

8 28.9 40.4

3

4 35.3 48.2

31

37 40.7 49.6

12

54.1 63.4

8

10 32.8 51.3

3

3 16.0 17.6

2

1 24.1 14.7

29

30 32.0 37.0

5

30.9

20

15 75.5 61.9

6

5 30.5 32.7

Information and Statistics

327

TABLE 8 (Continued)
LIVE BIRTHS AND RATES PER 1,000 POPULATION, STILLBIRTHS AND RATES PER 1,000 LIVE BIRTHS IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

LIVE BIRTHS

Number

Rate Per 1,000 Population

1943 1942 1943 1843

Jllacon ------------------------------------------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 ----------------------------------Rockdale -----------------------------------Schley -----------------------------------------Screven --------------------------------------Seminole ---------------------------------Spalding ------------------------------------Stephens -----------------------------------Stewart ---------------------------------Sumter ------------------------------Talbot -------------------------------Taliaferro ----------------- Tattnall -------------------------Taylor
Telfair -------------------------------Terrell ---------------------------------------Thomas -------------------------------------Tift ----------------------------------Toombs ----------------------------Towns ----------------------------Treutlen -------------------------------Troup -------------------------------------

460 291 199 532 219 605 271 166 308 296 3043 496 130 266 287 280 208 310 244 705 236 212
71 180 380 2250 153 128 420 177 712 457 284 579 213 129 347 265 296 495 738 617 367 131 128 1133

397 274 206 542 180 615 257 201 325 204 2672 443 113 285 246 278 167 283 212 618 196 181
81 182
38o
2078 142 104' 422 216 493 400 225 568 184 120 263 187 302 438 663 474 365
10~
133 968

28.8 21.7 28.6 24.1 21.9 26.0 25.2 17.2 24.2 26.6 40.3 26.7 17.2 21.4 22.4 27.0 22.8 26.3 23.5 24.8 24.0 24.9 20.7 23.0 22.9 27.5 19.8 25.4 20.6 20.8 25.0 36.2 26.8 23.6 26.2 20.5 21.4 24.6 19.5 29.7 23.6 27.8 21.6 26.6 16.8 25.8

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 21.3 23.6 23.3 22.9 25.4 18.4 20.7 20.7 25.4 17.3 30.8 21.2 23.2 22.6 19.1 16.2 17.4 19.9 26.3 21.2 25.6 21.5 20.7 17.4 21.8

STILLBIRTHS

Number

Rate Per 1,000 Live Births

1943 1943 1943 1942

15

16 32.6 40.3

8

4 27.5 14.6

12

12 60.3 58.3

19

19 35.7 35.1

6

6 27.4 33.3

21

24 34.7 39.0

11

13 40.6 50.6

4

24.1 44.8

14

6 45.5 18.5

2

8

6.8 39.2

80

84 26.3 31.4

25

23 50.4 51.9

2

2 15.4 17.7

16

17 60.2 59.6

8

7 27.9 28.5

10

14 35.7 50.4

6

5 28.8 29.9

15

17 48.4 60.1

10

12 41.0 56.6

25

28 35.5 45.3

14

8 69.3 40.8

9

11 42.5 60.8

4

4 56.3 49.4

2

ILl

18

13 47.4 34.2

68

72 30.2 34.6

6 45.8 42.3

4

2 31.3 c 19.2

17

14 40.6 33.2

6

9 33.9 41.7

23

41 32.3 83.2

7

8 15.3 20.0

7

10 24.6 44.4

32

16 55.3 28.2

5

9 23.5 48.9

8

5 62.0 41.7

12

4 34.6 15.2

9

11 34.0 58.8

12

11 40.7 36.4

23

16 46.5 36.5

32

46 43.4 69.4

23

15 44.6 31.6

9

12 24.6 32.9

4

1 30.5

9.8

3

2 23.4 15.0

41

44 36.2 46.9

328

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: 1942 AND 1943

LIVE BIRTHS

Number

Rate Per 1,000 Population

1943 1942 1943 1942

Turner ------------------------------------------ 206

Twiggs --------------------------------------- 255

Union -------------------------------------------- 211 Upson ------------------------------------------ 609

Walker ------------------------------------------ 877

Walton ------------------ ---------------------- 456

Ware -------------------------------------------- 776

Warren ---------------------------------------- 240

Washington ------------------------------- 629

Wayne ----------------------------------------- 399

Webster

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

133

Wheeler -------------------- ----------------- 176

White ------------------------------------------- 172

Whitfield ------------------------------------- 747

Wilcox ----------------------------------------- 251

Wilkes -------- ------------------------------- 357
Wilkinson ----------------------------------- 256

Worth ------------------------------------------- 577 Residents of Georgia, birth

occurring in other states ....

*Military Reservationa ----------- 98

213 19.0 19.6 268 28.0 29.4 191 27.5 24.9 593 24.3 23.7 631 28.3 20.3 454 21.9 21.9 687 27.8 24.6 251 23.4 24.5 561 26.0 23.2 342 30.4 26.1 117 28.1 24.8 204 20.6 23.9 167 26.8 26.0 724 28.6 27.7 228 19.7 17.9 321 23.7 21.3 250 23.2 22.7 514 27.0 24.0
429 95

STILLBIRTHS

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

17

8 82.5 37.6

9

17 35.3 63.4

10

8 47.4 41.9

13

22 21.3 37.1

9

16 10.3 25.4

14

24 30.7 52.9

36

37 46.4 53.9

8

8 29.2 31.9

27

31 42.9 55.3

11

9 27.6 26.3

2

5 15.0 42.7

6

2 34.1

9.8

5

3 29.1 18.0

19

17 25.4 23.5

6

5 23.9 21.9

14

15 39.2 46.7

11

12 43.0 48.0

27

23 46.8 44.7

2

4

NOTE: The number of births of Georgia residents with birth occurring in other states for the year 1943 were reallocated to county of residence while in 1942 they were not and only the total number was added to the state total.
Births listed in this report are only births giving a fort or camp as place of residence ani not the number of births occurring in the Station Hospitals.
Rates based on the 1940 Census Enumerated Population.

Information and Statistics

329

TABLE 9
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LivE BIRTHs IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

INFANT MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

TOTAL------------------------------Appling -----------------------Atkinson ------------- ----------------------Bacon -------------------------------------------

3661 11 5 13

Baker ------------------------------------------

4

Baldwin ------------------------------------- 14

Banks -------------------------------------- ____

9

Barrow --------------------------------------

23

Bartow ------------------------------------------ 37

Ben Hill -------------------------------------- 23

Berrien _______ ---------------------------------

8

Bibb ------------------------------------------ 148 Bleckley --------------------------------------- 10

Brantley ---------------------------------------- 15

Brooks ------------------------------------------ 20

Bryan -------------------------------------------

6

Bulloch --------------------------------------- 25

Burke ------------------------------------- 30

Butts --------------------------------

9

Calhoun

19

Camden

14

Candler

6

Carroll

25

Catoosa ------------------------------ 16 Charlton --------------------------------- 12

Chatham ------------------------------ 242

Chattahoochee ------------

5

Chattooga ---------------------- 12 Cherokee ---------------------------------- 14

Clarke ------------------------------ 42

Clay ----------------------------------- 10

Clayton -----------------------------------

9

Clinch --------------------- ----------------------

6

Cobb ------------------------------------------- 37 Coffee ----------------------------------- 40

Colquitt -------------------------- 53

Columbia --------------------------- 12

Cook -----------------------

6

Coweta ---------------------------------------- 19

Crawford -----------------------------

9

Crisp --------------------------------- 21

Dade ------------------------------------

5

Dawson +--------------------------------------

Decatur ------------------------------------- 28

DeKalb _____ ---------------------------------- 68

Dodge _____

18

3559 11 2 13 10 10 3 17 39 21 8 100 17 9 23 7 25 24 11 20 8
28 11
206 3
11 30 28
7 15
32 35 37 9 14 21 11 29
3 3 47 75 14

46.7 27.3 25.5 57.0 25.2 35.3 45.9 79.6 63.0 71.7 23.5 54.3 38.8 79.8 37.8 42.6 43.0 47.0 39.8 75.1 79.1 31.6 34.6 52.1 107.1 66.8 111.1 25.0 30.9 68.3 56.8 33.6 44.8 38.9 57.1 53.2 53.1 21.2 33.3 49.5 48.5 28.9
40.2 32.8 40.0

49.3 30.2 10.7 57.0 50.3 30.9 18.6 64.9 65.1 75.5 30.2 42.8 68.3 53.3 41.8 49.0 48.2 33.7 51.2 69.7 43.0 52.2 42.9 57.9 10.3 65.7 45.5 26.6 73.3 51.7 44.6 72.5 65.2 36.4 53.7 40.7 43.5 56.5 40.1 65.9 68.6 24.6 41.7 77.3 38.9 31.5

MATERNAL MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

303

299

3.9

4.1

3

2

7.4

5.5

1

5.1

5.3

1

1

4.4

4.4

1

1

6.3

5.0

4

2 10.1

6.2

2

12.4

2

6.9

3

1 6.1 1.7

2

4

6.2 14.4

2

1

5.9

3.8

6

11

2.2

4.7

2

7.8

4.0

2

2 10.6 11.8

2

1

3.8

1.8

2

2

3.4

3.9

5

2

7.8

2.8

1

4.7

3.5

1

5.6

2

14.9

6

2

8.3

3.1

1

5.3

13

12

3.6

3.8

3

6.3

3

7.3

6

3

9.8

5.5

1

3.7

4

2

4.2

2.3

6

9.2

7

5

7.0

6.5

2

1

8.8

4.8

4

1 14.1

4.0

2

4

3.5

7.6

5.5

3

6.9

2.4

7

5 10.0

8.2

3

4

1.4

2.1

3

2.2

6.8

330

Georgia Department of Public Health

TABLE 9 (Continued)
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS Wrm RATEs PER 1,000 LivE BIRTHS IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

INFANT MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

Dooly ----------------------------------------- 11

Dougherty ---------------------------------- 29

Douglas ------------------------------------

Early---------------------------------------------- 27

Echols -----------------------------------------

4

Effingham _________________ ------------------ 12

Elbert ---------------------------------------- 14 Emanuel ____________ ---------------------- 25

Evans --~~--------------------------------

15

Fannin --------------------------------------- 17

Fayette ----------------------------------- 11

Floyd ------------------------------------- 40

Forsyth -----------------------------------

2

Franklin -------------------------------- 21

Fulton ----------------------------------------- 420

Gilmer --------------------------------------- 18

Glascock -------------------------------

2

Glynn ------------------------------------------ 86

Gordon ----------------------------------- 20

Grady ----------------------------------------- 22

Greene ------------------------------------- 25

Gwinnett ------------------------------- 25

Habersham --------------------------------- 10

Hall ------------------------------------------ 32

Hancock -----------------------------------

9

Haralson ------------------------------- 20

Harris ---------------------------------- 13

Hart ------------------------------------------ 15

Heard -------------------------------------

6

Henry ---------------------------------------- 18

Houston -------------------------------------- 18

Irwin ------------------------------------ 9

Jackson ------------------------------------- 20

Jasper --------------------------------------- 13

Jeff Davis --------------------------- __

6

Jefferson ---------------------------------- 16

Jenkins --------------------------------------- 16

Johnson -------------------------------------

9

Jones ------------------------------------------

8

Lamar ------------------------------------------

9

Lanier ------------------------------------------

4

Laurens -------------------------------------- 36

Lee ---------------------------------------------- 11

Liberty ----------------------------------- 13

Lincoln -------------------------------------

3

Long ---------------------------------------------

6

18 30.2 47.6

42 33.8 60.7

6 24.8 30.6

24 55.9 49.1

2 95.2 39.2

20 47.6 106.4

16 31.1 37.3

sa

51.9

6~.9

11 90.9 58.8

32 38.5 100.0

10 57.9 62.5

61 31.5 46.0

11

7.5 42.8

15 58.4 51.0

406 48.2 47.6

10 66.7 41.0

2 19.6 18.9

30 93.6 51.3

23 43.7 59.3

30 45.5 63.4

19 74.4 59.7

21 46.2 36.8

15 28.2 47.9

28 39.0 37.3

10 28.5 28.1

14 61.5 54.1

5 47.3 20.9

11 54.3 36.3

11 49.2 93.2

13 48.9 39.8

12 43.1 39.6

5 25.4 14.8

21 40.6 45.9

15 65.7 86.2

13 25.4 73.4

19 31.1 39.1

13 53.0 41.9

10 35.6 44.2

10 40.6 48.1

9 37.2 45.5

4 47.1 48.2

34 47.2 45.6

7 49.5 49.3

14 53.3 71.8

2 16.0 11.7

4 72.3 58.8

MATERNAL MORTALITY
Rate Per 1,000 Number Live Births 1943 1942 1943 1942

5

2 13.7

5.3

2

4

2.3

5.8

4.1

7.0

lll 4

4.~

2

L0.7

1

3.1

2

10.5

6.3

3

2

2.4

1.5

1

1

2.8

3.4

23

15

2.6

1.8

3.7

4.1

9.4

4

4

4.4

6.8

2

2.2

5.2

4

5

8.3 10.6

2

3.5

3

8.5

3

3.7

4.0

2.8

2

7.3

4.2

2

7.2

3.3

8.2

2

5.4

3.1

1

2.4

2

5.9

2

4.4

5.1

5.7

2

2

3.9

4.1

2

6.6

3.2

4.0

4.4

4.8

3

12.4

4

7

5.2

9.4

13.5

3

12.3

5.1

6.3

Information and Statistics

331

TABLE 9 (Continued)
DEATHS UNDER ONE YEAR OF AGE AND MATERNAL DEATHS WITH RATES
PER 1,000 LIVE BIRTHs IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

INFANT MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

MATERNAL MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

Lowndes

30

Lumpkin

5

McDuffie

11

Mcintosh

7

Macon --------------------------------------- 28

Madison -------------------------------------- 14 Marion ----------------------------------------- 14

Meriwether --------------------------------- 16

Miller --------------------------------------------

8

Mitchell --------------------------------------- 22

Monroe ------------------------------------------

9

Montgomery -------------------------------

7

Morgan ------------------------------------------ 14

Murray ---------------------------------------

3

Museogee ------------------------------------- 105

Newton ---------------------------------------- 15

Oconee ---------------------------------------- 12

Oglethorpe --------------------------------- 11

Paulding --------------------------------- 16

Peach -------------------------..------------- 27

Pickens --------------------------------------

9

Pierce ------------------------------------------ 19

Pike --------------------------------------------- 10

Polk --------------------------------------------- 38

Pulaski ---------------------------------------- 10

Putnam ------------------------------------- 10

Quitman ------------------------------------

Rabun ----------------------------------

Randolph ---------------------------------- 23

Richmond ----------------------------------- 110

Rockdale ------------------------------ 10

Schley ------------------------------------

9

Screven ---------------------------------- 29

Seminole -----------------------------------

4

Spalding ---------------------------------- 45

Stephens ----------------------------------

6

Stewart ------------------------------ 10

Sumter ----------------------------- 36

Talbot --------------------- 21

Taliaferro ------------

8

Tattnall ------------- 14

Taylor

8

Telfair ---------------

4

Terrell ---------------- 26

Thomas ----------- 39

Tift ------------------- 32

29 33.1 35.8

4 30.9 27.8

13 41.5 45.0

12 42.7 78.4

39 60.9 98.2

48.1 25.5

10 70.4 48.5

18 30.1 33.2

10 36.5 55.6

26 36.4 42.3

19 33.2 73.9

11 42.2 54.7

15 45.4 46.2

11 10.1 53.9

109 34.5 40.8

15 30.2 33.9

12 92.3 106.2

22 41.4 77.2

19 55.7 77.2

14 96.4 50.4

10 43.3 59.9

10 61.3 35.3

16 41.0 75.5

27 53.9 43.7

8 42.4 40.8

18 47.2 99.4

3 70.4 37.0

2 27.8 11.0

22 60.5 57.9

99 48.9 47.6

7 65.4 49.3

3 70.3 28.8

38 69.0 90.0

9 22.6 41.7

45 63.2 91.3

3 13.1

7.5

9 35.2 40.0

32 62.2 56.3

20 98.6 108.7

7 62.0 58.3

6 40.3 22.8

7 11.3 37.4

11 13.6 36.4

29 50.5 66.2

40 52.8 60.3

22 61.9 46.4

4

4

4.4

4.9

1

2.2

3.5

2

13.1

4

3.4 10.1

1

2 15.1

7.3

3

3.8

2

1

3.8

1.8

1

4.6

5.6

3

4

5.0

6.5

3.7

3.9

5.0

1

3.4

6

12

2.0

4.5

5

18.3

3.5

4.1

3.6

6.0

4

3.2 14.1

3

4 12.3 18.9

4

5.7

3.2

5.1

9.4

5.5

14.1

2

5.3

2.6

5

11

2.2

5.3

7.1

2.4

2

2 11.3

9.3

6

4.2 12.2

2

5.0

1

3.5

4.4

3

5.2

1.8

4.7

2

5.8

3.8

1

5.3

2

6.6

4

8.1

4

8

5.4 12.1

3

1.9

6.3

332

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: 1942 AND 1943

INFANT MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

Toombs ---------------------------------

14

Towns ----------- --------------------------------

5

Treutlen --------- ------------------------------

6

Troup -------

68

Turner ------------------------------------------ 16

Twiggs ------------------------------------------ 10

Union -------------

10

Upson

22

Walker -------------------------------------- 33

Walton ----------------------------------------- 30

Ware ----------------------------------

37

Warren ---------------------------------------- 15

Washington -------------------------------- 26

Wayne

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

15

Webster ----------------------------------------

4

Wheeler ---------------------------------------

4

White ------------------------------------------- 10

Whitfield -------------------------------------- 29

Wilcox ---------------------------------------- 7

Wilkes ------------------------------------------ 13

Wilkinson ------------------------------------

8

Worth ------------------------------------------ 26

Residents of Georgia, death

occurring in other states_._ 16

15 38.1 41.1 3 38.2 29.4 5 46.9 37.6
62 60.0 64.7 10 77.7 46.9 16 39.2 59.7
7 47.4 36.6 20 36.1 33.7 27 37.6 42.8 32 65.8 70.5 31 47.7 45.1 16 62.5 63.7 25 41.3 44.6 10 37.6 29.2
3 30.1 25.6 11 22.7 53.9 10 58.1 59.9 34 38.8 47.0 5 27.9 21.9 18 36.4 56.1 16 31.3 64.0 41 45.1 79.8
18

MATERNAL MORTALITY

Number

Rate Per 1,000 Live Births

1943 1942 1943 1942

4

1 10.9

2.7

1

7.8

5

6

4.4

6.3

1

4.9

4.7

2

7.8

2

10.5

3

3

4.9

5.1

1.1

1.6

4

2.2

8.8

5

4

6.4

5.8

1

4.0

4

7.1

2.5

8.5

2

11.4

2

12.0

4

5.4

1.4

1

1

4.0

4.4

3

2

8.4

6.2

3

1 11.7

4.0

5

3

8.7

5.8

2

6

Information and Statistics
TABLE 10
DEATHs AND DEATH RATEs PER 1,000 PoPULATION IN EACH CouNTY IN GEORGIA: 1942 AND 1943

DEATHS
Rate Per 1,000 Number Population 1943 1942 1943 1942

TOTAL ___ 29,488

Appling

75

Atkinson

40

Bacon

73

Baker

40

Baldwin

147

Banks ____

52

Barrow

124

Bartow

201

Ben Hill _

170

Berrien

84

Bibb

1164

Bleckley

85

Brantley

68

Brooks _

180

Bryan

69

Bulloch

187

Burke

225

Butts

100

Calhoun

97

Camden

86

Candler

57

Carroll ____

266

Catoosa _____

76

Charlton

33

Chatham ______ 1946

Chattahoochee

20

Chattooga

96

Cherokee _

133

Clarke

334

Clay

68

Clayton

96

Clinch

36

Cobb

384

Coffee

188

Colquitt ____

290

Columbia

82

Cook

84

Coweta

168

Crawford

70

Crisp

191

Dade

49

Dawson

15

Decatur ________ 241

DeKalb

765

Dodge

130

Dooly _

155

28,807 91 40 59 68
141 44
109 226 169
79 1066
91 60 162 53 149 253 120 95 76 61 209 61 28 1789 21 84 161 307 46 88 46 349 183 252 75 98 169 62 175 33 13 256 725 137 158

9.4 5.2 5.6 9.0 5.4 9.0 6.0 9.5 8.0 11.7 5.5 13.9 8.8 9.9 8.8 11.0 7.2 8.5 10.9 9.3 14.6 6.3 7.8 7.0 6.3 16.5 3.9 5.2 6.6 11.8 9.6 8.2 5.6 10.0 8.7 8.8 8.7 7.0 6.2 9.8 10.9 8.3 3.3 10.8 8.8 6.2 9.2

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.S
13.1 9.1
12.9 6.7 6.1 5.6 5.3
15.2 4.1 4.5 8.0
10.8 6.5 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 9.4

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 Irwin Jackson Jasper ___ _
Jeff Davis Jefferson Jenkins Johnson Jones _______
Lamar Lanier __ Laurens Lee Liberty Lincoln Long Lowndes Lumpkin

DEATHS
Rate Per 1,000 Number Population 1943 1942 1943 19(2

357 51 146 12 89 146 173 65 106 67 406 25 124 4550 73 24 355 134 126 153 227 101 236 95 96 113 87 55 146 109 66 129 102 55 151 105 81 73 100 25 309 73 112 24 34 340 40

319 79 161 16 107 171 200 78 112 67 465 48 114 4216 64 34 248 126 178 120 202 100 247 89 90 108 92 60 140 118 60 112 92 62 149 117 72 93 95 38 347 66 104 33 33 284 38

12.5 5.1 7.8 4.0 9.2 7.4 7.4 8.8 7.2 8.2 7.2 2.2 7.9
11.6 8.1 5.3
16.2 7.3 6.4
11.2 7.8 6.8 6.8 7.4 6.7 9.9 5.6 6.4 9.7 9.6 5.1 6.4
11.6 6.2 7.5 8.7 6.3 8.8 9.9 4.4 9.2 9.3 13.0 3.4 8.3 10.7 6.4

11.2 7.9 8.6 5.4
11.1 8.7 8.5
10.5 7.6 8.2 8.3 4.2 7.3
10.7 7.1 7.5
11.3 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
10.5 7.0 7.4 9.9 5.6 11.2 9.4 6.7 10.3 8.4 12.1 4.7 8.1 8.9 6.1

334

Georgia Department of Public Health

TABLE 10 (Continued)
DEATHs AND DEATH RATES PER 1,000 PoPULATION IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

DEATHS Rate Per 1,000
Number Population 1943 1942 1943 1942

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 -------0-----Randolph ________
Richmond Rockdale Schley ______________ Screven ____________ Seminole ________ Spalding __________
Stephens Stewart Sumter

88 67
166 84 67
199 68
193 107
58 136
59 821
155 63 88 83
133
67 91 111 228 88 95 21
25 179
1064 72 44
149 59 297
51 88 304

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 1043 79 41 149 80 284 59 81 255

8.1 12.7 10.4
6.3 9.6 9.0 6.8 8.3 10.0 6.0 10.7 5.3 10.9 8.3 8.3 7.1 6.5 12.8 7.3 7.7 10.7 8.0 9.0 11.2 6.1 3.2 10.8 13.0 9.3 8.7 7.3 6.9 10.4 3.9 8.3 12.4

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 8.3 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 4.5 7.6 10.4

DEATHS RatePer1,000
Number Population
1943 1942 1943 1942

Talbot

106

Taliaferro ______ 42

Tattnall __________ 93

Taylor

45

Telfair

98

Terrell

183

Thomas ____________ 336

Tift _________________ 176

Toombs

128

Towns ____________ 26

Treutlen ________ 49

Troup ______________ 421

Turner ------------ 66

Twiggs ----------- 73

Union ------------ 49

Upson

188

Walker ------------ 218 Walton ------------ 207
Ware ---------------- 305 Warren __________ 82

Washington __ 209 Wayne __________ 107
Webster ________ 39 Wheeler _________ 44

White ------------- 45 Whitfield ________ 211

Wilcox ------------ 75
Wilkes --------- 150 Wilkinson _____ 74

Worth ------------ 182

Residents of Georgia death occurring in other states ___ 287

Military Reservations ______

96 13.0 11.8 61 6.7 9.7 86 5.7 5.3 55 4.2 5.1 122 6.5 8.1 204 11.0 12.2 324 10.7 10.4 168 9.5 9.0 115 7.6 6.8 25 5.3 5.1 45 6.4 5.9 430 9.6 9.8 69 6.1 6.4 76 8.0 8.3 45 6.4 5.9 182 7.5 7.3 178 7.0 5.7 204 10.0 9.8 264 10.9 9.5 72 8.0 7.0 205 8.6 8.5 76 8.2 5.8 23 8.3 4.9 51 5.2 6.0 46 7.0 7.2 180 8.1 6.9 65 5.9 5.1 156 9.9 10.3 90 6.7 8.2 214 8.5 10.0
325
260

*Deaths occurring in Georgia for the year 1942 were reallocated to post or camp where Atationed. In 1943 they were reallocated to place of residence.
Rates based on the 1940 Census Enumerated Population.

Information and Statistics

335

TABLE 11
DEATHS AND DEATH RATEs PER 100,000 PoPULATION FROM TYPHOID AND MALARIA IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

TYPHOID

Number

Rate Per 100,000 Population

MALARIA

Rate Per 100,000

Number

Population

1943

TOTAL_________________________________ 23 Appling -------------------------------------Atkinson -------------------------------Bacon ~----------------------------------------- Baker ------------------------------- Baldwin -----------------------------------Banks -----------------------------------------Barrow -----------------------------------------Bartow ----------------------------------Ben HilL..____________________________________

Berrien -----------------------------------------

Bibb------------------------------------------------

Bleckley --------------------------------

Brantley -----------------------------------

Brooks --------------------------------------------

Bryan --------------------------------------------

Bulloch -----------------------------------------

Burke ----------------------------------------------

Butts ----------------------------------'---------

Calhoun -----------------------------------------

Camden ------------------------------------------

Candler ------------------------------------------

Carroll -------------------------------------------

?.

Catoosa ________ ---------------------------------

Charlton ---------------------------------------

Chatham ________ ------------------------------

Chattahoochee ___ -------------------------

Chattooga --------------------------------------

Cherokee -------------------------------------

Clarke ------------------------------------------

Clay----------------------------------------------

Clayton ------------------------------------

Clinch --------------------------------------------

Cobb ----------------------------------------------Coffee ------------------------- __________________

Colquitt ------------------------------------------

Columbia ________

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

Cook--------------------------------

Coweta -------------------------------------------

Crawford ---------------------------------------

Crisp ---------------------------------------------

Dade----------------------------------------------Dawson --------------------- -------------------

Decatur ------------------------------------------

DeKalb ------------------------------------------Dodge _____

1942 24

1943 0.7

13.6

5.9 9.2
0.8
5.4

1942 0.8
16.9 0.8

1943 37
2

1942 1943

76

1.2

6.9

10.4

2

9.8

1

3.8

4

3.8

1942 2.4
14.1 40.8
6.9
9.8 15.9
3.8 15.1 10.9
14.2

336

Georgia Department of Public Health

TABLE 11 (Continued)
DEATHs AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHOID AND MALARIA IN EACH CouNTY IN GEORGIA: 1942 AND 194,3

TYPHOID

MALARIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

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 ----------------------------------------Irwin _________ Jackson __
Jasper ____ -------------------------------------Jeff Davis ------------------------------------
Jefferson ------------------------------Jenkins ______ Johnson __________________
Jones Lamar ______
Lanier_ Laurens ______
Lee-----------------------Liberty __________ Lincoln _______ Long ______________

5.9

3.5

3.5

2

6.8

1.8

8.8

6.4

0.3

0.5

3.5

3.5

10.7 10.7 :;3.7
10.4

4.3

4.3

1.8 0.8

5.1 7.3
15.7

8.8

5.0

5.0

8.4

7.7

9.9

2

6

6.0 17.9

Information and Statistics

337

TABLE 11 (Continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHOID AND MALARIA IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

TYPHOID

MALARIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Lowndes

1

3.1

3.1

3.1

Lumpkin- McDuffie ............................. .

Mcintosh --

Macon ~-------------------------------------

6.3

6.3

Madison - Marion --------------------------------Meriwether ........................ Miller ...................................... Mitchell ........................................
Monroe ---------------------------------------Montgomery ............................
Morgan- Murray .........................................
Muscogee ------------------------------------Newton ..........................................

14.4

4.3

10.3

7.9

7.9

1.3

2

9.3

9.3

10.3

2.6

Oconee - Oglethorpe ....................................

Paulding -

Peach-

9.6

Pickens ...................

Pierce --------------------------Pike ................................... Polk ................................... Pulaski ...- ...................... Putnam .......................................... Quitman ........................................ Rabun .......................................

1

3.5

10.2

2

8.6
20.3 10.2 1.2

Randolph -

Richmond '

Rockdale ........................................

Schley .....

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

Screven ________ ---------------------------------

Seminole

Spalding .......................................

1.2

3

4.9 14.7

2 11.8 23.6

Stephens

Stewart ..

Sumter ...

Talbot

12.3

Taliaferro

Tattnall .................

Taylor ......

Telfair

Terrell .

Thomas

Tift .............................. .

2

10.8

9.4

9.4

4.1

9.3

1

6.6

2

12.0

3.2

3.2

1

5.4

5.4

338

Georgia Department of Public Health

TABLE 11 (Continued)
DEA.THS AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHOID Al\1) MALARIA IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

TYPHOID

MALARIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 19,2

Toombs ----------------------------------------Towns -------------------------------------Treutlen ------------------------------------Troup ------------------------------------------Turner ------------------------------------------Twiggs ---------------------------------------Union--------------------------------------------Upson ---------------------------------------Walker -------------------------------------Walton -----------------------------------Ware ----------------------- ---------------------Warren -------------------------Washington ________ ------------------------Wayne ------------------------------Webster -------------------------------------Wheeler -------------------------------------White-------------------------------------------Whitfield --------------------------------------Wilcox ------------- ----------------------------Wilkes-----------------------------------------Wilkinson --------------------------------Worth ----------------------------------------Residents of Georgia, deaths
occurring in other states ___

2.3
13.0 3.2

3

5.9 17.7

11.0 3.2

4

16.5

21.2

11.7

15.6

3.8

7.8

7.8

4.7

1

4.7

NOTE: Rates based on the 1940 Census Enumerated Population.

Information and Statistics

339

TABLE 12
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TYPHUS FEVER AND DIPHTHERIA IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

TYPHUS FEVER

DIPHTHERIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

TOTAL ..................................... 67

62

1.8

1.7

47

55

1.5

1.8

Appling ..........................................

2

6.9 13.8

Atkinson --

Bacon -------

Baker ..............................................

2

Baldwin ..........................................

Banks ..............................................

Barrow ...........................................

Bartow ...........................................

Ben Hiii.................................-----

Berrien --------------~---------------------------

Bibb-

27.2 13.6

6.9

1.2

1.2

1

13.6

1

6.1

11.5

4.0

1.2

1.2

Bleckley Brantley --- Brooks ----------- Bryan---- Bulloch ---- Burke ..............................................

14.6 14.6 4.9

3.8

3.8

Butts ----------
Calhoun-- Camden ..........................................
Candler - Carroll - Catoosa ..........................................

9.6 11.0
9.2

16.9
~:;:
l.2

Charlton ........................................

Chatham .........................................

3

4

2.5

3.4

0.8

Chattahoochee ...............................

Chattooga - Cherokee ........................................

1

'" 5.4

2

5.0

9.9

Clarke .............................................

3.5

Clay ..............................................

0.9 14.2

Clayton ..........................................

Clinch .............................................

Cobb-- Coffee .............................................
Colquitt ..........................................

2 13.9

9.3

3

3

3.0

9.1

2.6

13.9

4.6

3.0

Columbia ........................................

10.6

Cook ...............---

4

33.6

8.4

Coweta ............................................

Crawford .......................................

Crisp --

3

17.1

Dade ................................................

Dawson -----------------------------------------Decatur .......................................... DeKalb ........................................... Dodge ..............................................

2

9.0

1.2

4.8

4:8

340

Georgia Department of Public Health

TABLE 12 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHUS FEVER AND DIPHTHERIA IN EACH COUNTY IN GEORGIA: 1942 AND 1943

TYPHUS FEVER

DIPHTHERIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Dooly ---------------------- Dougherty ---------------------------------Douglas ---------------- -------------------------
Early--------------------------------Echols ----- ----------------------------Effingham _____________ - -------------------

5.9

2

2

7.0

5.4

Elbert ------------------ ------- ---- - Emanuel ------------------------------Evans -------------------------------Fannin -------------------------------- --------Fayette ------------------------------------------Floyd------------- ------------------------ Forsyth ----------------------------------------Franklin __ - --------- --- - ---- --Fulton ---------------- ---------------------------

8.5 13.5

2

1.3

0.5

4

Gilmer ----------------- --------------------------

Glascock -----------------------------------------

Glynn --------------------------------------------

Gordon ______

Grady _______

5.1

Greene --------------------------------------------

Gwinnett ---------------------------------------

Habersham _

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

Hall-------------------- ---------------------

Hancock

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

Haralson ____

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

Harris -------Hart ____________

Heard ___

Henry --------------Houston

Irwin Jackson

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

Jasper --------- -- - -------------------- Jeff Davis -------- ----------------------------Jefferson ____________ -----------------

6.6

7.7

7.7

11.3 11.3

Jenkins -------Johnson Jones ------------Lamar -----Lanier -------Laurens ------ -----------------

2

6.0

6.0

Lee--------Liberty --------------------------------Lincoln ----------------------------

Long ----------------------------------------------

11.8

2 10.7 10.7

5.1

6.8 13.6

2

1.8

3.6

5

1.0

1.3

11.1

2.9 7.0
11.6
7.7 2 10.0 10.0
11.4 11.4 11.3

2

6.0

11.6

Information and Statistics

341

TABLE 12 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHUS FEVER AND DIPHTHERIA IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

TYPHUS FEVER

DIPHTHERIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

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 ------------------------------ Rockdale ------------------------------ Schley ------------------------------------ Screven -----------------------------Seminole ---------------------Spalding --------------------Stephens -------------------- Stewart --------------------------Sumter ----------------------------- Talbot -----------------------------------Taliaferro --------------------------------Tattnall ------------------------Taylor ..... ----------------- ----------------- Telfair -----------------------Terrell ----------------------- ----- Thomas ------------- --------------- Tift ------------------------Toombs -----------

3.1

10.0 10.0

4.3

4.3

9.6
8.5 9.6

6.0 3.7

19.9

4.9

4.9

11.8

12.2

12.3

6.2

2

13.2

2

12.0

6.4

3.2

9.2

4.3 9.3

7.9

9.0

1.3

1.3

2

26.4

1

8.0

10.9

10.5

2.4

3.7

9.4

9.4

6.6 5.4

342

Georgia Department of Public Health

TABLE 12 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TYPHUS FEVER AND DIPHTHERIA IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

Towns ~---- Treutlen Troup _____ _ Turner_ Twiggs_ Union __ _ Upson _____ _
Walker Walton Ware ___ _ Warren Washington Wayne_ Webster Wheeler White Whitfield _
Wilcox--------------------------Wilkes ___ _ Wilkinson ---------------- __________________ _ Worth Residents of Georgia, deaths
occurring in other states
NOTE: Rates based on the 1940 Census Enumerated Population.

Information and Statistics

343

TABLE 13
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TuBERCULOSis AND CANCER IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

TUBERCULOSIS

CANCER

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

TOTAL________________________________ 1304

Appling ------------------- _

Atkinson ______________________________

2

Bacon ---------------

Baker -------------------- _ Baldwin ________________________________

Banks --------------- __ ----------------

Barrow

5

Bartow

Ben Hill

4

Berrien ------------------------

2

Bibb ---------------------

56

Bleckley --------------------

4

Brantley ----------------------------

Brooks ---------------------------

Bryan -------------------------------

2

Bulloch -------------- -------------------

6

Burke -------------------------------------------- 11

Butts ------------------ -------------------------

4

Calhoun

Camden --------------

2

Candler --------------- -----------------------

Carroll --------- --------------------------------

Catoosa

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

Charlton ---------------- --------------------

Chatham ---------------------- _

99

Chattahoochee __ -----------------------

Chattooga ----------------- __________________ 6

Cherokee _____________

12

Clarke -----------------------------------------

8

Clay -------------------------------------------

Clayton ----------------------------------------

3

Clinch ------------------- ----------------------

2

Cobb ----------------------------

12

Coffee --------------------

3

Colquitt ----------------------------------------

6

Columbia --------------------------------------

4

Cook ----------------------------------------------

5

Coweta ---------------- -------------------------

6

Crawford -------------------------------------

4

Crisp --------------------------------------------

5

Dade ---------------------------------------------

Dawson ---------------------------------------

Decatur ------------

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

6

DeKalb

--------------------------- 34

Dodge

2

1265
1 4 11
10 4
65
2 2 9 14 3 3 3
5 3
105
5 4
5 1 15 6 7 2 2 8
7 3 1 9 26

41.7 6.9
28.2 12.4
30.5 34.4 38.3 23.7 27.5 13.0 66.8 41.4 14.6 29.3 31.8 23.1 41.5 43.6 28.7 33.8
8.8 27.5
83.9
32.4 59.6 28.2 42.5 25.7 31.1 31.4 13.9 18.2 42.4 41.9 22.2 56.1 28.5 17.0
27.0 39.1
9.5

40.5
12.4 54.5 67.0
7.7 39.6 27.5
77.6 10.4
9.8 31.8 34.6 52.8 32.7 28.7 50.8 22.0 14.6 27.5
89.0
27.0 19.9 24.6
42.9 15.5 39.2 27.9 21.2 21.2 16.8 29.7 14.0 39.9 50.9 22.3 40.5 29.9
4.8

2097 2
3 12
5 11 14
8
76 4
8 2 10 18 6 6 3 3 22 5
114
9 13 25
3 6 4 34 12 11 5 6 17 4 11 7
12 85
8

2120 4
4
3 14 17 15
7 55
7 4 6 4 7 15 4 6 6 2 19 5 3 122
3 18 23
2 7 5 31 17 15 10 7 13 6 6 3 1 10 81 7

67.1 13.8 42.3 86.5 40.8 73.1 57.3 84.2 55.4 55.1 45.5 90.7 41.4 14.6 39.0 31.8 38.4 67.9 65.3 57.5 50.8 33.0 64.4 45.9 19.0 96.6

67.9 27.6 14.1
54.5 42.7 34.4 107.2 67.2 103.3 45.5 65.6 72.6 58.2 29.3 63.6 26.9 56.6 43.6 57.5 101.5 22.0 56.6 45.9 57.1 103.4

48.6 64.6 88.0 42.5 51.5 62.1 88.8 55.7 33.3 53.0 60.3 63.0 56.1 62.7 118.8 22.3 54.0 97.8 38.1

16.2 89.4 81.0 28.3 60.1 77.7 81.0 78.9 46.4 106.0 68.7 48.2 84.2 34.2 50.9 22.3 46.0 93.2 33.3

344

Georgia Department of Public Health

TABLE 13 (Continued)
DEATHs AND DEATH RATEs PER 100,000 PoPULATION FRoM TuBERCULOsis AND CANCER IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

TUBERCULOSIS

CANCER

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Dooly --

6

3 35.5 17.8

8

7 47.4 41.5

Dougherty

24

16 84.0 56.0

23

27 80.5 94.5

Douglas -------

3

29.8

5

8 49.7 79.6

Early ......... ---------

5 32.1 26.8

6

9 32.1 48.2

Echols ------

Effingham ----

3

Elbert .........................

7

1 31.1 10.4

5

4 51.8 41.5

5 35.7 25.5

15

15 76.5 76.5

Emanuel - ------

4

Evans

3 17.0 12.8

3

40.5

9

14 38.3 59.5

6

4 81.1 54.0

Fannin ------------------------------------,Fayette ......

8

8 54.2 54.2

9

9 61.0 61.0

1

12.2

6

4 73.4 49.0

Floyd ---- 20

30 35.6 53.4

43

43 76.6 76.6

Forsyth ____ -------

4

2 35.3 17.7

Franklin ---------

2

12.8

8

10 51.2 64.1

Fulton ---

261

292 66.4 74.3

373

355 S4.9 90.4

Gilmer ---

2

22.2 11.1

3

2 33.3 22.2

Glascock -------

1 22.0 22.0

5

2. 110.0 44.0

Glynn ------Gordon -- -----

11

4 50.2 18.2

10

14 45.6 63.9

8

8 43.4 43.4

15

8 81.3 43.4

Grady ---

3

Greene ------------------------

5

Gwinnett -------------

9

Habersham - -------

5

3 15.3 15.3

9

12 45.8 61.1

2 36.5 14.6

13

8 94.8 58.4

8 30.9 27.5

18

21 61.9 72.2

5 33.9 33.9

13

4 88.0 27.1

Hall -----Hancock ..............

10

6 28.7 17.2

21

20 60.3 57.4

8

2 62.7 15.7

5 39.2 39.2

Haralson ____ -----

3

3 20.9 20.9

8

7 55.6 48.7

Harris --

3

4 26.3 35.0

5

10 43.8 87.5

Hart -----

2

2 12.9 12.9

9

4 58.0 25.8

Heard ---------

2 34.8 23.2

6

69.7 58.1

Henry

6

11 39.7 72.8

10

12 66.1 79.4

Houston ----------------------------------------

1

3

8.8 26.5

2

8 17.7 70.8

Irwin ------------------------------------------- 2

Jackson -----

Jasper - ----------

2

3 15.5 23.2

2

3

5.0 14.9

5

4 22.8 45.6

12

7 15.5 54.1 8 24.9 39.8 4 136.8 45.6

Jeff Davis --------

1

4 11.3 45.2

Jefferson . ---------------.

7

7 34.9 34.9

6

11 29.9 54.9

Jenkins -------

8

8 67.6 67.6

7 50.7 59.1

Johnson - -----------

2

Jones ________

3

Lamar ____________________________

5

15.4

3 36.0 36.0

49.5

9.9

5

7 38.6 54.0

7 60.0 84.0

3

14 29.7 138.7

Lanier ------------------------

17.8

2 17.8 35.5

Laurens ----------------------

17

7 50.6 20.8

10

18 29.8 53.6

Lee ------------

3

1 38.3 12.8

6

7 76.6 89.3

Liberty ......... -----Lincoln _____ ------

2 11.6 23.3

7

3 81.4 34.9

5

4 71.0 56.8

Long -----------

2

48.9

3

2 73.4 48.9

Information and Statistics

345

TABLE 13 (Continued)
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM TUBERCULOSIS' AND CANCER IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

TUBERCULOSIS

CANCER

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Lowndes

8

6 25.1 18.8

26

19 81.6 59.6

Lumpkin

1

2 16.1 32.1

6

4 96.4 64.3

McDuffie

6

55.2

9.2

3

10 27.6 91.9

Mcintosh

2

2 37.8 37.8

3

7 56.7 132.3

Macon ---------------------------------------- 10

6 62.7 37.6

10

15 62.7 94.1

Madison --------------------------------------

4

2 29.8 14.9

8

11 59.6 81.9

Marion ---------------------------------------

3

2 43.1 28.8

3

1 43.1 14.4

Meriwether ------------------------------

2

10

9.1 45.3

19

11 86.1 49.9

Miller ------------------------------------------

5

3 50.0 30.0

2

6 20.0 60.0

Mitchell ---------------------------------------

8

6 34.4 25.8

8

12 34.4 51.6

Monroe ---------------------------------------

5

46.5

12

10 111.6 93.0

Montgomery -----------------------------

3

3 31.0 31.0

4

4 41.4 41.4

Morgan ----------------------------------------

5

7 39.3 55.1

7

9 55.1 70.8

Murray ------------------------------------------

4

35.9

9.0

10

5 89.8 44.9

~uscogee ---------------- -------------------- 33

35 43.7 46.4

48

52 63.6 68.9

Newton ----------------------------------------

8

43.1

5.4

12

8 64.6 43.1

Oconee -----------------------

4

1 52.8 13.2

7

92.4 13.2

Oglethorpe ------------------------------------

4

5 32.2 40.2

9 48.3 72.4

,Paulding -------------------------------------

1

6

7.8 46.8

4

3 31.2 23.4

Peach -----------------------------------------

5

8 48.2 77.1

7

6 67.5 57.8

Pickens ----------------------------------------

2 10.9 21.9

7

76.6 65.7

Pierce -----------------------------------------

1

3

8.5 25.4

5

4 42.4 33.9

Pike --------------------------------------------

2

2 19.3 19.3

7

12 67.5 115.7

Polk ---------------------------------------------- 14

11 48.2 38.6

29

17 101.~

59.7

Pulaski ---------------------------------------

3

30.5 10.2

11

8 111.9 81.4

Putnam ----------------------------------------

2

23.5

7

4 82.2 47.0

Quitman ---------------------------------------

2

58.2

3

87.3 29.1

Rabun -------------------------------------------

7

12.8

2

25.6

Randolph -------------------------------------- 11

4 66.2 24.1

12

17 72.2 102.4

Richmond ------------------

60

70 73.3 85.5

77

88 94.1 107.5

Rockdale --------------------------------------

4

4 51.8 51.8

5

2 64.7 25.9

Schley ------------------------------------------

2

39.7

7

2 139.1 39.7

Screven --------------------------------------

8

5 39.3 24.6

6

9 29.5 44.2

Seminole --------------------------------------

11.8 11.8

3

4 35.3 47.1

Spalding ----------------------------------------

8

8 28.1 28.1

17

25 59.8 87.9

Stephens --------------------------------------

3

1 23.1

7.7

2

7 15.4 54.0

Stewart ---------------------------------------

4

5 37.7 47.2

2

4 18.9 37.7

Sumter -------------------- --------------------- 15

10 61.2 40.8

12

22 49.0 89.8

Talbot ------------------------------------------

3

Taliaferro _________________

3 36.9 36.9

2

31.9

5

11 61.4 135.1

2

4 31.9 63.7

Tattnall ---------------------------------------

4

8 24.6 49.3

4

4 24.6 24.6

Taylor

1

2

9.3 18.6

1

4

9.3 37.1

Telfair --------------------- --------------------

4

26.4

8

11 52.8 72.6

Terrell -----------------------------------------

7

42.0 42.0

14

16 84.0 96.0

Thomas ------------------- --------------------

4

12 12.8 38.4

24

21 76.7 67.1

Tift -----------------------------------------------

9

6 48.4 32.3

17

17 91.4 91.4

346

Georgia Department of Public Health

TABLE 13 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM TuBERCULOSis AND CANCER IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

TUBERCULOSIS

CANCER

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Toombs ------------------------------7--------

3

3 17.7 17.7

11

9 64.9 63.1

Towns ----------------------------------------

20.3

2 20.3 40.6

Treutlen -------------------------------------

13.1

3

2 39.3 26.2

Troup ------------------------------------------- 22

17 60.1 38.7

36

26 82.0 57.0

Turner ------------------------------------------

3

2 27.7 18.4

3

6 27.7 46.1

Twiggs --------------------------------------

4

4 43.9 43.9

6

4 65.8 43.9

Union ---------- --------------------------------

2

4 26.0 52.1

2

4 26.0 52.1

Upson -------------------------------------- 16

7 63.8 27.9

17

16 67.8 63.8

Walker --------------------------------------- 20

14 64.5 45.1

16

18 51.6 58.0

Walton ---------------------------------------

3

3 14.4 14.4

18

18 86.6 86.6

Ware -------------------------------------------- 20

8 71.6 28.6

21

10 75.2 35.8

Warren ------------------------------------ 4

2 39.1 19.5

2

3 19.5 29.3

Washington -------------------------------

8

9 33.0 37.1

10

13 41.3 53.7

Wayne --------------------------------------

10

6 76.2 38.1

Webster ------------------------------------Wheeler ------------------ 1

21.2

4

1 84.6 21.2

11.7

s

3 35.1 35.1

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

1 15.6 16.6

6

3 77.9 46.8

Whitfield ----------------------------------- 16

18 61.3 69.0

11

22 42.1 84.3

Wilcox -----------------------------------------

1

7.8

7.8

2

2 16.7 16.7

Wilkes --------------------------------------- 2

6 13.3 33.1

12

13 79.6 86.2

Wilkinson -----------------------------------

3

3 27.2 27.2

2

6 18.1 64.4

Wortb --------------------------------------------

9

7 42.1 32.8

10

9 46.8 42.1

Residents of Georgia, death

occurring in other states__ 61

37

26

34

Military Reservations -------------

5

10

NOTE: Rates based on the 1940 Census Enumerated Population.

Information and Statistics

347

TABLE 14
DEATHS AND DEATH RATES PER 100,000 POPULATION FROM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEoRGIA: 1942 AND 1943

PELLAGRA

PNEUMONIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

TOTAL-------------------------------- 175

Appling ----------------------------------------

Atkinson -------------------------------------

Bacon -------------------------------------------

2

Baker --------------------------------------------

Baldwin --------------------------------------

Banks -------------------------------------------

Barrow ----------------------------------------

Bartow ----------------------------------------

Ben Hill ------------------------------------- 2

Berrien ------------------------------------------

3

Bibb ----------------------------------------------

4

Bleckley --------------------------------------

Brantley -----------------------------------

Brooks -----------------------------------------

2

Bryan --------------------------------------------

Bulloch ----------------------------------------

1

Burke --------------------------------------------

2

Butts -------------------------.------------------

Calhoun ----------------------------------------

Camden -------------------------------------

Candler ----------------------------------------

Carroll ----------------------------------------

Catoosa ----------------------------------------

Charlton --------------------------------------

Chatham -------------------------------------- 23

Chattahoochee ----------------------------

Chattooga ------------------------------------

Cherokee ------------------------------------

Clarke ---------------------------------------

Clay ---------------------------------------------

Clayton ---------------------------------------

Clinch -----------------------------------------

Cobb ------------------------------------------ --

3

Coffee ------------------------------------------

1

Colquitt -------------------------------------

4

Columbia --------------------------------------

Cook ----------------------------------------------

Coweta -----------------------------------------

Crawford --------------------------------------

Crisp -----------------------------------------

Dade ----------------------------------------------

Dawson ----------------------------------------

Decatur ---------------------------------------

2

DeKalb -----------------------------------------

Dodge -------------------------------------------

181

5.6

5.8 1734 1612 55.5 51.6

4

8 27.6 55.2

14.1

3

42.3

24.7 12.4

4

49.4 37.1

13.6

2

27.2

17

21 103.6 128.0

11.5

1

1 11.5 11.5

6

4 45.9 30.6

2

7.9

11

11 43.6 43.5

13.8

20

13 137.7 89.5

19.5

2

5 13.0 32.5

4

4.8

4.8

61

43 72.8 61.3

4

2 41.4 20.7

3

6 43.7 87.3

2

9.8

9.8

16

6 78.1 29.3

3

47.7

3.8

10 26.9 38.4

2

7.5

7.5

12

10 45.2 37.7

10.9 10.9

3

8 32.7 87.1

9.6

1

9.6 38.3

11

186.1 50.8

11.0 11.0

11.0 33.0

2.9

2.9

18

13 52.7 38.1

9.2

3

27.5 64.2

1

19.0

2

3 38.1 57.1

9 19.5

7.6

119

105 100.9 89.0

2

2 38.9 38.9

6

7 32.4 37.8

5.0

4

12 19.9 59.6

3.5

3.5

22

23 77.5 81.0

14.2

7

1 99.1 14.2

9

9 77.2 77.2

15.5

3

3 46.6 46.6

4

7.8 10.5

19

11 49.6 28.7

4.6

15

18 69.6 83.6

12.1

3.0

29

18 87.8 54.5

2 10.6 21.2

7

5 74.2 53.0

3

8.4 25.2

4

5 33.6 41.9

3.7

8

6 29.7 22.2

4

7 56.1 98.2

6

3 34.2 17.1

4

2 67.9 33.9

2

44.7

1

9.0

4.5

12

16 54.0 72.0

2

2.3

46

36 52.9 41.4

2

9.5

6

6 19.0 28.5

348

Georgia Department of Public Health

TABLE 14 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM PELLAGRA AND PNEUMONIA IN EACH COUNTY IN GEORGIA: 1942 AND 1943

PELLAGRA

PNEUMONIA

- Rate Per 100,000

Number

Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Dooly -------------------------------------

3

Dougherty ----------------------------------

2

Douglas --------------------------------------

Early -------------------------------------------

2

Echols -------------------------------------

Effingham -------------------------------

Elbert --------------------------------------

Emanuel ---------------------------------

2

Evans ----------------------------------------

2

Fannin ---------------------------------------

1

Fayette --------------------------------------

Floyd --------------------------------------------

3

Forsyth ---------------------------------------

Franklin ----------------------------------

1

Fulton ------------------------------------- 13

Gilmer -----------------------------------

Glascock ------------------------------------

Glynn -----------------------------------------

Gordon -----------------------------------------

Grady -----------------------------------------Greene --------------------------------------Gwinnett ----------------------------------Habersham ----------------------------Hall -----------------------------------------Hancock ---------------------------------------Haralson -------------------Harris ------------------ ----------------------Hart _________ ----------------------------------Heard

Henry ----------------------------
Houston ----------------------------------------
Irwin ----------------------------------------Jackson _____

Jasper ------------------------------------------

Jeff Davis ------------------------------------

Jefferson --------------------------------------

3

Jenkins ______

Johnson

Jones

Lamar

Lanier

Laurens ----------------------------------------

3

Lee ------------------------------------------------

Liberty ------------------------------------------

2

Lincoln

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

Long---------------------------------------------

3 17.8 17.8

4

7.0 14.0

9.9

10.7

10.4

1

5.1

8.5

27.0

6.8

6.8

12.2

3

5.3

5.3

1

6.4

6.4

24

3.3

6.1

5.4

2

5.1 10.2

1

7.3

7.3

3 20.6 10.3

2

6.8 13.5

2

5.7

2

7.8 15.7

7.0

2

17.5

6.4

6.6

6.6

8.8

7.7

2

5.0 10.0

11.4 34.2

15.0 10.0 8.4

3

36.0

9.9

5

8.9 14.9

23.3

24.5 24.5

12 20
5 11
2 6 13
4 3 24
242 4
46 7 6 18 19 3 12 6
6 8
8 9
4
5 12 11
5 6 5 2 13 4

9 71.1 53.3

13 70.0 45.5

5 49.7 49.7

12 58.9 64.2

67.5

5 20.7 51.8

4 30.6 20.4

55.3 38.3

7 40.5 94.6

8 27.1 54.2

36.7 73.4

38 42.7 67.7

4

35.3

8 38.4 51.2

204 61.6 51.9

4 44.4 44.4

1 22.0 22.0

11 209.9 50.2

6 38.0 32.5

8 30.5 40.7

3 131.3 21.9

15 65.3 51.6

6 20.3 40.6

17 34.5 48.8

2 47.0 15.7

5 48.7 34.8

3 52.5 26.3

9 51.6 58.0

4 81.3 46.5

13 52.9 86.0

11 79.6 97.3

3

7.7

10 19.9 49.8

5 34.2 57.0

6 56.6 67.9

6 59.9 29.9

5 92.9 42.2

2 38.6 15.4

72.0 96.0

12 49.5 118.9

2 35.5 35.5

11 38.7 32.7

6 51.0 76.6

11.6

14.2 81.4

24.5

Information arul Statistics

349

TABLE 14 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

PELLAGRA

PNEUMONIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

------------------ -1943---19-4-2 --1-9-43---1-94-2---19-4-3 ---19-42---1-94-3---1-94-2

Lowndes

3

2

9.4

6.3

17

17 53.4 53.4

Lumpkin

3

3 48.2 48.2

McDuffie

9.2

5

6 46.0 55.2

Mclntoeh

2

1 37.8 18.9

2

2 37.8 37.8

Macon ---------------------------------------

3

3 18.8 18.8

6

9 37.6 56.4

Madison -----------------------------------

2

14.9

4

1 29.8

7.4

Marion -------------------------------------Meriwether ----------------------------------

4.5

4.5

4

9 57.5 129.4

8

11 36.3 49.9

Miller ------------------------------------------

1

2 10.0 20.0

Mitchell --------------------------------------

2

8.6

4.3

8

6 34.4 25.8

Monroe ---------------------------------------

9

24 83.7 223.3

Montgomery ---------------------------

3

1 31.0 10.3

Morgan --------------------------------

3

23.6

4

6 31.5 47.2

Murray -------------------------

1

9.0

3

7 26.9 62.9

Muscogee --------------------------------

6

6.6

1.3

55

48 72.9 63.6

Newton -----------------------------------

2

2 10.8 10.8

9

9 48.4 48.4

Oconee ----------------------------------

3

6 39.6 79.2

Oglethorpe -----------------

7

7 56.3 56.3

Paulding ------------------------------

2

7.8 15.6

5

7 39.0 54.6

Peach -----------------------------------

9.6

9.6

8

6 77.1 57.8

Pickens ----------------------------------

10.9

3 54.7 21.9

Pierce ------------------------------------------

2

16.9

6

6 50.8 50.8

Pike ----------------------------------

2

2 19.3 19.3

13

16 125.3 154.2

Polk ------------------------------

2

7.0

3.5

7

9 24.6 31.6

Pulaski ------------------------------------

10.2

7

8 71.2 81.4

Putnam ---------------------------------

3

35.2

11.7 23.5

Quitman -----------------------------------

29.1 29.1

Rabun --------------------------

12.8

Randolph ---------------------------

6.0

7

7 42.1 42.1

Richmond -----------------------------

4

5

4.9

6.1

81

65 98.9 79.4

Rockdale -------------------------

12.9

9

6 116.5 77.7

Schley -----------------------------

2

39.7 19.9

Screven -------------------------------------

1

3

4.9 14.7

7

14 34.4 68.8

Seminole ----------------------------

2

23.6

6

10 70.7 117.8

Spalding ---------------------------

2

7.0

3.5

19

27 66.8 95.0

Stephens -----------------------------------

2

15.4

7.7

Stewart -------------------------------

2

18.9

2

18.9

Sumter -----------------------------------

17

17 69.4 69.4

Talbot -----------------------------------

7

10 86.0 122.8

Taliaferro ---------------------------------

15.9

4

3 63.7 47.8

Tattnall -------------------------------------

6.2

9

3 55.4 18.5

Taylor

3

3 27.9 27.9

Telfair -----------------------

2

13.2

Terrell -------------------------

1

6.0

4

7 26.4 46.2

10

10 60.0 60.0

Thomas --------------------------------

2

6.4

22

7 70.3 22.4

Tift ------------------------------------------------

2

5.4 10.8

6

6 32.3 26.9

350

Georgia Department of Public Health

TABLE 14 (Continued)
DEATHS AND DEATH RATEs PER 100,000 PoPULATION FRoM PELLAGRA AND PNEUMONIA IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

PELLAGRA

PNEUI\IONIA

Number

Rate Per 100,000 Population

Rate Per 100,000

Number

Population

1943 1942 1943 1942 1943 1942 1943 1942

Toombs ---------------------------------------

Towns --------------------------------------------

Treutlen ------------------------------

Troup ---------------------------------------

Turner ------------------------------------------

Twiggs ---------------------------------------

Union ------------------------------------

2

Upson ---------------------------------------

Walker ------------------------------------

Walton -----------------------------

2

Ware ---------------------------

Warren -------------------------------------

Washington -----------------------------

Wayne ----------------------------------------

Webster ----------------------------------------

Wheeler --------------------------------------

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

Whitfield ----------------------------------

2

Wilcox -------------------------------------Wilkes ------------------------------------------

Wilkinson -----------------------------------

Worth ------------------------------------------

Residents of Georgia, death occurring in other states____

Military Reservations -------------

4

5.9 23.6

5

9 29.5 53.1

20.3

2

1 40.6 20.3

3

2 39.3 26.2

3

2.3

6.8

28

24 63.8 54.7

9.2

9.2

4

1 36.9,

9.2

3

4 32.9 43.9

26.0

4

52.1 13.0

1

4.0

11

7 43.9 27.9

2

3.2

6.4

12

10 38.7 32.2

2

9.6

9.6

11

9 52.9 43.3

2

7.2

26

14 93.1 50.1

9.8

8

3 78.2 29.3

2

8.3

8

9 33.0 37.1

7.6

2

2 15.2 15.2

2

42.3 21.2

1 11.7 11.7

2

1 23.4 11.7

2

31.2

1

3 15.6 46.8

7.7

9

10 34.5 38.3

7.8

5

3 39.2 23.5

6

3 39.8 19.9

7

13 63.5 117.9

4.7

7

13 32.8 60.8

9

15

8

NOTE: Rates based on the 1940 Census Enumerated Population.

Information and Statistics

351

TABLE 15
DEATHS AND DEATH RATES PER 100,000 PoPULATION FRoM MoToRVEHICLE AcciDENTS IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

MOTOR-VEHICLE ACCIDENTS
Rate Per 100,000 Number Population
1943 1942 1943 1942

TOTAL. 606 673 19.4 21.5

Appling -----

6

41.4

6.9

Atkinson ....

5

4 70.5 56.4

Bacon __________

Baker ..........

Baldwin ______

4

Banks ----------

2

Barrow ________

3

Bartow ........

4

Ben Hill ......

6

Berrien ________

1

Bibb ..............

14

Bleckley ......

Brantley

Brooks ........ Bryan ...______

Bulloch ........

8

Burke --------

5

Butts

4

Calhoun ......

Camden

2

Candler -------

2

Carroll ........

Catoosa Charlton ..__

Chatham ......

33

Chattah'chee

2

Chattooga __

Cherokee ....

5

Clarke ..........

8

Clay-------

Clayton

2

Clinch --------

Cobb ____________

20

Coffee ----------

6

Colquitt -----

3

Columbia ___

3

Cook ___________

Coweta _______

4

Crawford ----

3

Crisp --------

3

Dade ------------

Dawson -------

Decatur ------

5

DeKalb _______

8

Dodge --------

7

2

27.2

4 24.4 24.4

1 22.9 11.5

2 23.0 15.3

6 15.8 23.7

7 41.3 48.2

3

6.5 19.5

26 16.7 31.0

10.4 10.4

2

29.1

6 14.6 29.3

3

47.7

2 30.8

7.7

3 18.9 11.3

3 43.6 32.7

1

9.6

9.6

2 33.8 33.8

22.0 11.0

9 17.6 26.3

9.2

19.0

51 28.0 43.2

2 38.9 13.2

5.4

3 24.8 14.9

12 28.2 42.3

2

28.3

3 17.2 25.7

15.5 15.5

11 52.3 28.7

27.9

8

9.1 24.2

4 31.8 42.4

4

8.4 33.6

3 14.8 11.1

7 42.1 98.2

2 17.1 11.4

17.0 17.0

5 22.5 22.5

20

9.2 23.0

4 33.8 19.0

MOTOR-VEHICLE ACCIDENTS

Rate Per 100,000 Number Population

1943 1942 1943 1942

Dooly __________

7

Dougherty __

7

7 41.5 41.5 7 24.5 24.5

Douglas --------

3

Early ___________

3

Echols ________

Effingham __ Elbert __________

Emanuel ___ 10

Evans __________

2

Fannin

Fayette ________

Floyd ............

5

Forsyth .......-

Franklin ______

Fulton __________ 60 Gilmer _____.._

Glascock ______

1

Glynn

11

Gordon

4

Grady

Greene

2

Gwinnett ____

Habersham __

Hall ____________

6

Hancock ______

1

Haralson ....

2

Harris ________

1

4 29.8 39.8

7 16.1 37.5

33.7

4 31.1 41.5

3

5.1 15.3

8 42.5 34.0

2 27.0 27.0

4 20.3 27.1

2 12.2 24.5

5

8.9

8.9

8.8 26.5

6.4

39 15.3

9.9

1 11.1 11.1

22.0 22.0

15 50.2 68.4

2 21.7 10.8

9

45.8

2 14.6 14.6

9 24.1 30.9

5 20.3 33.9

4 17.2 11.5

2

7.8 15.7

7 13.9 48.7

3

8.8 26.3

Hart ----------

2

Heard ....______

2

2 12.9 12.9 1 23.2 11.6

Henry ----------

6

Houston ______

3

6 39.7 39.7 2 26.5 17.7

Irwin -------

Jackson ________

3

Jasper __________

6

Jeff Davis __

Jefferson ____

2

Jenkins ________

2

Johnson ______

14.9 68.4 11.4

2 10.0 10.0

2 16.9 16.9

7.7

7.7

Jones -----------Lamar ________ Lanier ________ Laurens ____

2

3 24.0 36.0

3

9.9 29.7

17.8

5

13 14.9 38.7

Lee -----------

1

Liberty _______

12

3 12.8 38.3 5 139.6 58.2

Lincoln -----

Long ----------

3

78.4

352

Georgia Department of Public Health

TABLE 15 (Continued)
DEATHS AND DEATH RATES PER 100,000 PoPULATION FROM MoTORVEHICLE AcciDENTS IN EAcH CouNTY IN GEORGIA: 1942 AND 1943

MOTOR-VEHICLE ACCIDENTS

Rate Per 100,000 Number Population

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 ---Rockdale ---Schley -------Screven ________
Seminole ---Spalding ______
Stephens ______
Stewart -------Sumter --------

1943 7
5 3
5
1 2 3
25 3
3
2 3 1 2 2
2
22 1
4 2 4 7 2 7

1942 9
6 1 3
4 3 7 5 2
4 26
4
2 2
4 2 3 4
2 21
2
3 5 4 1 3

1943
22.0
46.0 56.7 18.8
14.4 22.7 10.0
4.3 9.3 20.7 23.6
33.1 16.1
24.1 7.8 19.3
32.8 8.5
19.3 7.0 10.2 23.5 29.1
6.0 26.9 12.9 19.9 19.7 23.6 14.1 54.0 18.9 28.6

1942
28.2
55.2 18.9 18.8 22.3
18.1 30.0 30.1 46.5 20.7
35.9 34.4 21.5 13.2 16.1 15.6
9.6 43.8 16.9 28.9 14.1
12.0 25.7 25.9 19.9
4.9 35.3 17.6 30.8
9.4 12.2

MOTOR-VEHICLE ACCIDENTS

Rate Per 100,000 Number Population

1943 1942 1943 1942

Talbot ----------
Taliaferro --
Tattnall -----Taylor
Telfair -------Terrell -------Thomas ________
Tift -------------Toombs ________
Towns ---------Treutlen -----Troup ---------Turner. Twiggs
Union
Upson ---------Walker -------Walton -------Ware ----------~-
Warren ------
Washington __ Wayne __________
Webster -----Wheeler -----White ---------Whitfield ---Wilcox -------Wilkes __________
Wilkinson -Worth ----------

1

12-3 12.3

2

12.3

6.2

3

2 27.9 18.6

5

1 33.0

6.6

4

2 24.0 12.0

7

4 22.4 12.8

3

2 16.1 10.8

2

3 11.8 17.7

2

40.6

9

10 20.5 22.8

9.2

9 11.0 98.7

3 13.0 39.1

2

6

8.0 23.9

4

12.9

6

28.9

4.8

8

15 28.6 53.7

2

2 19.5 19.5

6

3 24.8 12.4

4

2 30.5 15.2

11.7

1

1 15.6 15.6

4

5 15.3 19.2

2

15.7

7.8

2

4 13.3 26.5

2

18.1

4

6 18.7 28.1

Residents of Georgia, deaths
occurring in other states

Military

Reservations

10

NOTE: Rates based on the 1940 Census Enumerated Population.
Deaths from motor-vehicle accidents are reallocated to county of accident instead of county of residence. These figures exclude deaths of military personnel killed from motor-vehicle aceidents while on maneuver or on a military reservation.

Information and Statistics

353

TABLE 16
NuMBER AND PERCENT OF BIRTHS (EXCLUSIVE OF STILLBIRTHS) BY
PERSON IN AtTENDANCE AND CoLoR, IN GEORGIA: 1929-1943

Total
Total 1929 ---- --- 58,521 1930 ------. 60,318 1931 -------- 61,774 1932 -------- 63,690 1933 -------- 60,744 1934 -------- 64,615 1935 -------- 63,290 1936 -------- 61,617 1937 -------- 64,012 1938 ---- --- 64,307 1939 -------- 64,910 1940 -------- 64,695 1941 - ------ 67.785 1942 -------- 72,189 1943 -------- 78,327
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 1943 -------- 50,149
Colored 1929 -------- 22,770 1930 -------- 23,254 1931 -------- 24,243 1932 -------- 25,481 1933 -------- 25,052 1934 -------- 26,282 1935 -------- 25,945 1936 -------- 25,297 1937 -------- 25,831 1938 -------- 25,694 1939 -------- 25,987 1940 -------- 25,784 1941 -------- 26,508 1942 -------- 26,997 1943 -------- 28,178

Number Physician Midwife Other

38,448

19,956

117

39,416

20,728

174

38,322

23,315

137

37,981

25,578

131

35,112

25,396

236

39,498

25,043

74

37.312

25,737

241

36,659

24,661

297

39,510

24,262

240

40,111

23,970

226

40,856

23,769

285

41,637

22,807

251

44,872

22,715

198

50,099

21,968

122

57,192

21,018

117

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 47,795

3,429

93

3,695

129

4,761

107

5,944

96

5,919

176

5,226

55

5,373

174

4,998

211

4,615

154

4,473

126

4,275

200

3,830

174

3,544

121

3,035

80

2,277

77

6,219

16,527

24

6,176

17,033

45

5,659

18,554

30

5,812

19,634

35

5,515

19,477

60

6,446

19,817

19

5,514

20,364

67

5,548

19,663

86

6,098

19,647

86

6,097

19,497

100

6,408

19,494

85

6,730

18,977

77

7,260

19,171

77

8,022

18,933

42

9,397

18,741

40

Percent Total Physician Midwife Other

100.0

65.7

34.1

0.2

100.0

65.3

34.4

0.3

100.0

62.0

37.7

0.3

100.0

59.6

40.2

0.2

100.0

57.8

41.8

0.4

100.0

61.1

38.8

0.1

100.0

59.0

40.7

0.3

100.0

59.5

40.0

0.5

100.0

61.7

37.9

0.4

100.0

62.4

37.3

0.3

100.0

62.9

36.6

0.5

100.0

64.4

35.3

0.3

100.0

66.2

33.5

0.3

100.0

69.4

30.4

0.2

100.0

73.0

26.8

0.1

100.0

90.1

9.6

0.3

100.0

89.7

10.0

0.3

100.0

87.0

12.7

0.3

100.0

84.2

15.6

0.2

100.0

82.9

16.6

0.5

100.0

86.2

13.6

0.2

100.0

85.1

14.4

0.5

100.0

85.7

13.8

0.5

100.0

87.5

12.1

0.4

100.0

88.1

11.6

0.3

100.0

88.5

11.0

0.5

100.0

89.7

9.8

0.5

100.0

91.1

8.6

0.3

100.0

93.1

6.7

0.2

100.0

95.3

4.5

0.2

100.0

27.3

72.6

0.1

100.0

26.5

73.2

0.3

1(}0.0

23.3

76.5

0.2

100.0

22.8

77.1

0.1

100.0

22.1

77.7

0.2

100.0

24.5

75.4

0.1

100.0

21.3

78.5

0.2

100.0

21.9

77.7

0.4

100.0

23.6

76.1

0.3

100.0

23.7

75.9

0.4

100.0

24.7

75.0

0.3

100.0

26.1

73.6

0.3

100.0

27.4

72.3

0.3

100.0

29.7

70.1

0.2

100.0

33.3

66.5

0.1

354

Georgia Department of Public Health

TABLE 17
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

Typhoid fever ~~~~~~~~~~~-~~~~~ 557

tMalaria

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

All other cause~~~~~~~~~~~~~~ 5,831

12,813 887 568 8 47 217 334 440
1,061 550 81
1,268 723
6,629

13,606 772 705 18 270 12 92 417
1,414 996 131
1,363 274
7,142

21,549 987
1,060 2
496 31
650 1,309
2,011 1,882
240 1,685 1,451 9,745

21,174 1,000
937
440 8
89 553
2,353 2,324
293 1,738 1,405 10,034

26,941 1,766 1,226 46 201 44 222 819
2,235 2,830
382 2,598 2,127 12,445

32,243 549 559 3 61 32 373 401
1,725 2,362 1,124 2,766 1,892 20,396

35,188 500 442
128 38
257 135
1,347 2,175 1,552 2,580 4,099 21,935

32,285 68 89
23 16 108 59
693 1,533 1,959 2,055 6,176 19,506

Rates Per 100,000 Population 1850 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

All 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 25.2
119.4 84.1 11.1
115.1 23.1
603.2

1397.3 64.0 68.7 0.1
~2.2
2.0 42.1 84.9
130.4 122.0 15.6 109.3
94.1 631.9

1152.4 54.4 51.0
24.0 0.4 4.8
30.1
128.1 126.5 16.0
94.6 76.5 546.1

1219.11 1113.2

79.9 19.0

55.5 19.3

2.1

0.1

9.1

2.1

2.0

1.1

10.0 12.9

37.1 13.8

101.1 128.1 17.3 117.6
96.2 563.1

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 2.8
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

355

MALARIA: A marked decrease in deaths from malaria is shown in 1943 with only 37 deaths as compared with 76 deaths in 1942. The rate in 1943 declined from 2.4 to 1.2 in 1942 or 51.4 per cent.
SMALLPOX: The greatest number of deaths from smallpox ever recorded in Georgia was in 1924 when 25 deaths were reported. From that epidemic year the rate steadily decreased until an all time low of 1 death was reached in 1935. Since that year no deaths have been reported. 1943 maintained the "all clear."
DISEASES OF CHILDHOOD: Of childhood diseases deaths from measles continued to decrease in 1943 to 27 deaths as compared with 60 in 1942. The rate of 0.9 in 1943 declined from 1.9 in 1942 or a decrease of 55.2 per cent. Scarlet fever and whooping cough are on the upward trend. In 1943 the rate of 0.2 increased from 0.1 in 1942 or 216.7 per cent. The number of deaths climbed from 2 in 1942 to 6 in 1943. Deaths from whooping cough increased from 101 in 1942 to 170 in 1943. The rate of 5.4 in 1943 compares with 3.2 in 1942 or an increase of 68.4 per cent.
DIPHTHERIA: The number of deaths from this disease dropped from 55 in 1942 to 47 in 1943. The rate decreased from 1.8 in 1942 to 1.5 in 1943 or 14.8 per cent.
INFLUENZA: The death rate on influenza increased. The number of deaths from this cause in 1943 was 624, an increase of 29.4 per cent over the 482 deaths reported in 1942.
DYSENTERY: The deaths and death rates from this condition show a decrease of 8.4 per cent, a rate of 2.5 in 1943 compares with 2.8 in 1942. The number of deaths dropped from 86 in 1942 to 79 in 1943.
POLIOMYELITIS: From the all high record of 33 deaths in 1941, the decrease in the death rate from this disease has been steady and marked. Only 3 deaths were reported in 1943, a 71.9 per cent decrease from the 10 deaths reported in 1942. The rate dropped from 0.3 in 1942 to 0.1 in 1943.
LETHARGIC ENCEPHALITIS: The deaths and death rates from this disease remain the same as 5 persons died in 1943, 5 in 1943 and 1941. The death rate has been the same for the past three years, consequently no per cent in increase or decrease.
MENINGOcoccus MENINGiTIS: In 1943 a marked increase of 73.7 per cent was shown in the death rate from this cause. The rate in 1942 climbed from 0.6 to l.O in 1943. In 1943 the number of deaths increased to 31 over the 18 in 1942.
TUBERCULOSIS, ALL CAUSES: There was a slight increase in the number of deaths from tuberculosis reported in 1943 of 1,304 as compared with 1,265 deaths in 1942. The rate increased from 40.5 in 1942 to 41.7 in 1943 or 3.1 per cent.

356

Georgia Department of Public Health

SYPHILIS: A slight decrease in the reported death rate from syphilis continued through 1943. There was a 5.9 per cent decrease or a rate of 13.9 in 1943 compared with 14.8 in 1942. The number of deaths reported in 1943 was 428 against 262 in 1942. These figures are provisional.
CANCER: There was a 1.1 per cent decrease in the cancer death rate from 67.9 in 1942 to 67.1 in 1943. The number of deaths decreased from 2,120 in 1942 to 2,097 in 1943.
DIABETES MELLITUS: The death rate from this disease is sli~.!;htly on the upward trend again. The death rate showed an increase of 13.8 in 1943 over ll.8 in 1942 or 16.2 per cent increase. The number of deaths reported in 1943 was 430 as compared with 370 in 1942.
PELLAGRA: The number of deaths from pellagra decreased from 181 in 1942 to 175 in 1943. The rate of 5.6 in 1943 compared with 5.8 in 1942 or a decline of 3.3 per cent.
CEREBRAL HEMORRHAGE, EMBOLISM AND THROMBOSIS: The deaths from this condition increased 2.5 per cent when 2,945 deaths were reported in 1943 as compared with 2,873 in 1942. The rate in 1943 being 94.3 against 92.0 in 1942.
HEART DISEASES: The leader in the cause of death in Georgia, as well as the Nation, took 5,775 lives in 1943, an increase of 10.0 per cent over the 5,251 deaths in 1942. The death rate in 1943 was 184.9 compared with 168.1 in 1942.
PNEUMONIA: Very recent years have shown a steady, slight decrease in deaths from pneumonia, however 1943 finds it on the increase. The rate climhetd from 51.6 in 1942 to 55.5 in 1943, a per cent of 7.6. The number of deaths in 1943 was 1,734 as compared with 1,612 in 1942.
DIARRHEA AND ENTERITIS (2 Yrs.): The number of deaths from this condition increased from 284 in 1942 to 292 in 1943. The rate of 9.3 in 1943 compared with 9.1 in 1942 or 2.8 per cent increase.
CIRRHOSIS OF LIVER: There was a slight decrease in the deaths due to this cause. The number of deaths dropped from 157 in 1942 to 152 in 1943. The rate decreased from 5.0 in 1942 to 4.9 in 1943 or 3.2 per cent.
APPENDICITIS: Deaths from appendicitis are slightly on the increase accordin~ to reports in 1943. The rate in 1942 was 5.6 as compared with 6.0 in 1943 or an increase of 7.9 per cent. The number of deaths in 1942 was 174 against 188 in 1943.
NEPHRITIS: Although deaths from this cause is next to the leading cause of deaths, it is slightly on the decrease. The rate decreased from 102.0 in 1942 to 100.5 in 1943 or 1.5 per cent. The number of deaths reported in 1943 was 3,139 as compared with 3,187 in 1942.

Information and Statistics

357

MALFORMATION AND EARLY INFANCY DISEASES: The deaths and death rates remained practically the same as 2,048 died from these causes in 1943 as compared with 2,020 in 1942. The rate 65.6 in 1943 and 64.7 in 1942 or a slight decrease of 1.4 per cent.
SUICIDE: The number of suicidal deaths dropped from 219 in 1942 to 165 in 1943. The rate decreased from 7.0 in 1942 to 5.3 in 1943 or 24.7 per cent.
HoMICIDE: The death rate from this cause dropped from 16.6 in 1942 to 14.0 in 1943 or 15.6 per cent. The number of deaths was 438 in 1943 against 519 in 1942.
MoTOR VEHICLE AcciDENTS: There was a slight decrease in the death date from 21.5 in 1942 to 19.4 in 1943 or a 10.0 per cent decrease. The number of deaths reported in 1942 was 673 as compared with 606 in 1943.
ALL OTHER AcciDENTS: A decrease is shown in the number of deaths from other accidents in the rate of 42.2 in 1943 against 44.3 in 1942 or a per cent of 6.6. The number of deaths reported in 1943 was 1,319 as compared with 1,383 in 1942.
UNKNOWN AND ILL-DEFINED CAUSES: The death rate from ill-defined causes dropped 0.6 per cent or from 34.3 in 1942 to 31.1 in 1943. The number of deaths reported in 1943 was 1,065 against 1,071 in 1942.
ALL OTHER CAUSES: The crude death rate or deaths from all causes remained practically the same, as 4,072 died in 1943 as compared with 4,015 in 1942. The rate slightly increased from 128.5 in 1942 to 130.4 in 1943 or 1.4 per cent.