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= "i =~ 6 42 802 463 3125 404 3935 270 3795 85 153 186 391 148 20S 434 681 123 232 272 808 .=...a.=.. II: "........ 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 =a= =" 3 2 58 49 82 392 6811 417 6298 51 44 51 53 -------- a= ..c".. = -------- --- --- ------ -1c:--< (") l;l ::t:: ....;l:;;l:- ---- 0... l:1tl 1;:) "' 7 .;:.:.1.. ------ 7 !.c.a... 1;; ----- ~ 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' < ] " .... ~ .=.;. -; . ...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 0 =.! ~ ~ c ~s tl ~ ::::l ~ a~ ~ ;p o1?= ~ ~ 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 .... ..';l = = .>"I'I 0 =.0 =...=... =""0' = .".>II =" E =" ".."=0.'. '-l ..."e=... '-l 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 .. :;; :i '-l 43 1 43 594 ct-< (') 167 ~ 1392 :::t:: (I> 159 ~ 2160 87 ;;:.- a.... 1918 ~ ..;~.;l.. 72 95 72 239 .~... c &; 72 111 190 273 33 87 46 145 ~ """' 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 . u .e0: u..!! 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 ""' -.=.. :uE 2 ~ 6 "c" 3 7 ~s -------- ~ ""'"c::l .., 2902 !;l 37 " 40 50 -i"?" . c '1:l -------- !;: ~ ('"">' 34 45 28 ::X:: !;..":..;":..l...-. 872 CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouN'l'Its-1943--Continued .... ~ ...."".... .. ~ ~ :.s= i ....lol ..... ."~ ........~..., ..c.. ......, .IS. ~ 0 0 0 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 ...."".... u0 ~ uC""i' :c .aEi u0 ..., 0 u0 ... "II= u0 .... ."...0.. u -.~ u .,.".. Q "r:: ...0 Q 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 ~ ""' 174 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=.. I> 101 40 104 t'-< 373 0 147 2..... 1888 ::t: C1) 202 3311 ~.,... 664 0.... 2938 Cl1) 0 ~ ~ 0 ~ ..t' ..= "0 ' ~ ~".' 0 ~ ~ .-=a "1';1 "1';1 e ...".= 1>1) =;.:: 1';1 ......,. f;i ."il ="Ei 1';1 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 ="' ;.. "1';1 ~ 6 c~ ---- ~ 30 ~ t:l ~ ..,~ 109 l;l -------- ~ 9 13 -...~ ;::1 c ~ c::r- ~ 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.: r.. 0: ::0:: r"..' 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 .. ~ " 2 318 20 152 16 140 1 1 1 ......Ill .0 , G 1 1 6 5 26 1510 67 948 17 800 40 46 42 117 48 120 74 165 0: 0: b " 1529 86 738 1720 1513 4284 2416 27283 896 21895 222 359 272 595 248 248 632 369 83 128 195 867 ..s... ""' ------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 1:1:: ~ 685 6948 !;:> : 127 6227 0.... ~ 87 162 87 a~c:;: 534 ::.&; 126 124 360 356 57 125 92 301 ~ \0 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 .~.., r0.. 13 98 18 128 779 3 38 45 -------- 4 113 -------- 12 348 :..==; r.. -3=; r.. .. E 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, 0 " 109 272 651 -------- -------27 ~------- 2 18 346 0""' .....,. " 53 \;') 105 <1> 0 s 79 ~ 169 i::l <1> 140 1263 ..."<::l ~ ..... ;:l 2 <1> 35 .::.:.1.. 5 ..0...... ~ 327 :g::::: o 37 6 ::t:: <1> s: .,_______ ~ 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 :.:. ..s: J " 49 62 677 127 3411 184 5256 42 4871 100 235 183 855 50 67 149 271 69 90 151 327 .c. ...r:: "' ~ = 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 ..""".: = 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 ... =" 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.: ="""' 8 5 11 ------- ct--o <":> -------- .~..... ::r: ------- ~ ~ -------------- : c -------- ~ -------- ;::s 9 ~ 9 .~....... 7c 9 i:; ....,_. -------- 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 . 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- :=...:..,; Eo< 1 -------- ------------- ct'-< ~ !..;.:l... ::X:: 188 ~ 3883 ~ 29 3593 ;::.- c ~ ~ 1 ;:I c: 1 ~ .~... ------- 1 1:; ---- .t..i.l. CoNDENSED REPORT OP AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs--1943-Continued .... ..e.==.. ...;. ~ sa 0 ~ :"a' "rJl ..."= "rJl 'C" ..e5 rJl loll ~ ;; "'rJl ..""==' :"' t.:. :it rJl rJl . .. .:e1 =rJl :0; Eo< 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 ~ ;...".;..... Eo< -------- ~ (b -------- 0 -------- ~ -------- ~ -------- !::::l (b -------- l.....,. ------- ~ -------- ------------ (b ;::I ...0 -";::':t: t ....<:l"' (') --------------- ~ ~ : -------- 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___________ :; Ill Eo< 26 -------- 31 1178 121 2131 99 2819 148 2783 9 29 9 62 26 48 61 134 20 35 60 76 . ~.". Eo< 17 4 9 49 1426 185 4694 87 4363 21 28 22 51 -------32 -------88 -------8 -------31 .....;.. 4l Eo< 10 2 547 197 1462 177 2769 230 2620 43 85 43 293 109 109 437 506 84 85 411 469 :..; "Eo< -------1 225 126 1202 467 8167 2 7971 1 14 -------25 441 441 1737 1737 144 144 460 460 e~ .:": Eo< 20 -------- 42 564 203 4362 349 4172 143 4133 90 104 99 306 452 510 1705 1999 250 441 507 1330 ;::: E:: 4 -------- 20 339 179 3369 830 5960 669 5868 144 372 158 671 227 363 1041 1192 121 244 183 482 ., .ea E""o< 90 2 222 1508 633 2576 261 3351 10 3230 65 169 57 328 130 141 210 320 159 167 218 309 ., 1: I: "Eo< ---------------------1058 47 593 ---------------------- ----------------------------- --------------- --------------- ----------------------------- ;1: "." Eo< .co. "" Eo< 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 . .=" "Eo< 2 49 348 126 ct--< 613 ;C:".).. ::t:: .... 107 940 <1> ..!..;..l... 27 918 0 ~ !;l -------- ;.:.:.!.. "' 32 -------- .c.!..;..l... 67 ;::! "' 57 91 108 226 94 108 226 U1 1:1:> CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued :; ~.. 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 ..;.. .".i.l 49 49 64 64 1 87 203 ------ -------- 714 ~... f-4 29 29 127 -------- -------- 1443 .... ..Ec=i f-4 32 32 60 77 65 250 26 12 184 33 -------6 -------- 77 ------495 2407 :;:; f-4 25 122 31 237 -------- 196 --------------- ----- -------6 -------- --------------- -------- 2373 ...., Ecci f-4 232 241 320 451 15 15 15 15 336 -------- 13 5 1189 . 1'1 IcI: f-4 -------- 1 4 2 ~". ... ".c f-4 f-4 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 ~ ...1'1 "f-4 ~ 7 .(c.b.. s~ 11 -------- l;::j (b "l;:j 99 ..0..:..:... ---- ;l 5 (b 5 -------- -;.:.:.! . c "'c::: .... -------- !;:! 0"' (:) 34 l:l:: (b ------ 0::. : 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 '8 p 9 1 11 1201 130 585 ---------------------- ------- ---- ~ p"" 24 3 95 129 472 1194 452 8214 113 7289 170 122 182 787 79 so. 189 188 46 54 84 110 .. ~ lit: 47 11 243 1346 957 9766 90 1667 373 1618 159 175 240 897 13 19 66 106 84 263 s1'1 'iii 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 .1..'.1 lit: 2 208 4152 12 3850 3 ---- 10 . 1'1 -;i.g... lit: .5 25 46 31 466 299 4566 301 6211 81 6108 135 169 130 571 377 394 1556 1813 103 282 103 1396 . .1.'1. li"t: 75 -------- 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 6 G4 ..'il ...= lit: -------- 29 ~ 189 173 .2.... 1284 ::t: ...<1> ~ 36 ;:- 707 161 0.... 707 ~ .;.;.:.. ...N ..... -------- !;:> 36 C) 20 62 ;;: "" 73 85 216 300 39 42 45 45 c(.Jnl CoNDENSED REPORT OF AcTIVITIES OF LocAL HEALTH DEPARTMENTS, BY CouNTIEs-1943-Continued ."" c: .!! ..~.. ;.:!c;!:, .c...,: ;:;, . ::"!!! ~" c: ~ ~ ~"". ..c: ~" ..c' .c.: :it ~ .!! ."c.: ~" . .~ .".,, ~" 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\ ;...; ..c ~ --------------- ~ .c~., -------- s()q -------- t:l ~ .....,~ 5 !;:l 176 ;! 114 ~ 125 149 -i:l. c "'t:: ;:;::!;:! -------- ~ 30 l:i:: ~ !;:l : 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 ----------------------------------- .. ::!!! 0= ;g~ ;5 ~ ~ ~ 0 ~ 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 :$= ~ "CC s"il := ~ c H .."::' ::""!!'! "c"'' ~ -.5.. ~ ~ ~ ~"' 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 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 Maternal and Child Health 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 . ... .=. ....= .... :;~ ::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 ~ :z::> 400 300 200 100 ~ 0 62!> *:.::.:: 489 =: 1J414 t~-~.::.-: lii!i rt) v U'l ID rt) rt) rt) rt) en en en en .....................109..2................ 1017 t~ .... (0 rt) rt) en en 1131 en rt) en I589 ...==....==.... 944 1154 w.........~~~~:~ .......~~~~:~ tt~~~~--~::.............~::.............:................: ~...........................................................' 0v v v(\1 ~ If. en en en a 51 53 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----:-- .. ~ 1- . . . 21 :; f]l '"""""CC; .......... .~.~.., :~.:: -~ ~I -1 -1 -1 :~';j ~- :. ;3~ ~ :l ., CIS Q.l bG G.l =.~.~ t=j f~ "CC ..:.:,< Z< .:.J< Q,l 0 Q,) .... ll0 .."...,~:,;. ~ ~ ~ =~ 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 ..:.) 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 ~ .0.., 9 r:.ro.... ~ 0 47 702 0 104 0 0 0 0 0 0 0 853 ~ "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. 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.